It’s not exactly breaking news that doctors and nurses have historically struggled to find professional camaraderie. Much has been written about the nurse-doctor relationship, about the patriarchy of the medical establishment, and about the well-documented workplace abuse that can occur.
But there is another side. And on that side are all of the doctors all over the country who care tremendously about their patients and who value and respect the nurses they work with. Doctors that are regular people. I’ve seen it. And I know you have, too.
The Code Brown
In the pediatric cardiac ICU where I worked, we had an adolescent patient, *Brian, who’d been successfully resuscitated after a sudden ventricular fibrillation arrest. He had mild mental retardation at baseline, making it a little challenging to keep him in bed as he began to recover. Although he was making great strides, he still had a central line with multiple inotropic drips running.
One night, in the split second his nurse was away from his bedside, Brian managed to have a loose bowel movement in his bed. He then proceeded to get out of bed and with his drip lines in a complete tangle, wound up behind his IV pumps at the head of the bed.
This was a Code Brown of epic proportions. One of our senior fellows was on the unit that night. He was an excellent doctor and co-worker. When he came upon our situation, he jumped into action, helping us clean up the patient, change his bed, and detangle his lines. We worked as a team, laughing good-naturedly at the “crisis.” We never needed to explain to him the complexity of our work, what it was like to titrate dopamine and epinephrine while preventing a patient from trying to escape the walls of his own patient bed. He already knew.
One night, an older adolescent with cardiomyopathy went into cardiac arrest. Our team quickly fell into our usual roles. Resuscitation continued for quite some time, but unfortunately efforts were unsuccessful. The patient died.
The attending in charge that night was newer to that role, though experienced in the unit and exceptionally smart and compassionate. He seemed defeated at the end, disappointed that we were unable to save this boy’s life.
I had been the documenter during the code, a role I took often and felt comfortable in. I kept diligent time and notes throughout the hour or so. That morning, I left the record with the attending to review and sign. When I came back in the following night, he found me to thank me for detailed account I had taken. It made a difference to him because the record protected him should there have been any questioning. But it also seemed to bolster him. He had an opportunity to see exactly how the scenario played out. He had an opportunity to see that he, and the whole team, had truly done everything we possibly could have. His acknowledgement and thanks, from one colleague to another, made a great impact on me and I’ve never forgotten it.
Surgeons have earned a … shall we say … reputation for having … shall we say … strong personalities. But lest we forget, there are those out there who are not only skilled, but have a sense of humor, too.
I took care of an infant girl who’d been in the ICU for several weeks following an initial repair of a cardiac defect. She’d experienced a slew of complications after surgery, including persistent fluid in the thoracic cavity. She had bilateral chest tubes in place for an extensive period. One of the tubes became clogged. The cardio-thoracic surgical resident on-call that night came to the bedside to clean the tube out with a Fogarty catheter. He inserted the catheter, then pulled it out, creating a popping sound. It sounded like the opening of a bottle of champagne.
“Congratulations, *Bella,” he said, with a Mediterranean accent, “your chest tube is patent.”
We laughed together. It was well-timed and well-delivered. And even though it was a brief interaction, it freed me from my own judgmental prison. I had erroneously labeled all surgeons as angry, rude and condescending. He proved me wrong. I was thankful for the education.
What’s your great doctor story? I know you have at least one. Tell us about a doctor you love to work with and why.