[devilbunny]

When I had a stat section late at night and the nurse who was circulating the case (for the non-medical, a “circulator” is a nurse whose job is to get whatever is needed to make the surgery happen smoothly) didn’t know how to hook up the Glidescope (um, the best airway-securing device ever) while I’m trying to mask-ventilate a full-term patient and save the baby (you don’t want to mask-ventilate highly pregnant patients; their stomachs empty slowly and they are at high risk for vomiting and then inhaling it; you want a tube straight past their vocal cords so that the lungs are protected), I went to the nurse manager on the next regular day and said that not knowing what a Glidescope is and how to set it up was an unforgivable lack of knowledge. I don’t directly blame the nurse; she was thrown into a situation she had not been trained for. I blame those who didn’t teach her before putting her on night shifts with very few other nurses around.

“This is a chance to do this case electively, in a controlled manner, in a situation in which Bad Things are monumentally more likely to occur. At noon, I can have all the help in the world. At two AM, it’s me, and I only have two hands and one brain.”

As I have said in codes before, I’m eventually out of ideas, so if you have one that we haven’t tried yet, talk. I will not judge you as dumb. I may not do it, but I will listen and consider it seriously before making that call.