I have thought for a long time about publishing this account.
If you read my blog, you will probably get the impression, that I don't suffer fools gladly, and that I occasionally and often unintentionally stir up shit.
Now in case I go into politics, I would like to state that anybody who uses their authority including their sexual gender to bully or disadvantage somebody is a complete slime bucket. I am sure most people share this revulsion. It is however this revulsion that makes accusations of sexual harassment so potent.
I am male and a doctor. Most nurses are female ( a significant number of ICU nurses are male though). Doctors who are mostly male are higher on the hospital food chain than nurses (although as a student and resident I fequently questioned this). In the hospital the relationship between doctors and nurses is often one of tension. Part of this is a good thing. If either side automatically deferred to the other, it would be to the detriment of the patient.
Now, when I first started working at the Centre of Excellence, it was pretty obvious that there was some real bad blood between anaesthesia and the ICU nurses. Everywhere I worked there has been some sort of tension; I think ICU nurses resent anaesthetists who aren't intimidated by all the machines and lines in the ICU. The first time I dropped a patient off in the ICU, one of the nurses asked, "Who is the idiot who sutured in this central line?". I told her I was the idiot and waited for the apology which never came. Anyway it seemed for the first few years all we talked about at staff meetings was the steady stream of complaints: ETT not taped in correctly, line tangled, O2 cylinder empty, patient brought into ICU at inconvenient time for them, and, incredibly, an accusation of billing fraud by anaesthesia. After a while it seemed like things got better but I suspect it was just that things that used to piss me off didn't matter any more and I just learned to do things that wouldn't piss them off. Sort of like a bad marriage.
Sorry that this is taking so long to get to the point but I have to give the background.
About a month before the event in question I took a patient back to the ICU after a major head and neck case. We called these face-offs and they usually last at least 16 hours. This one however had been done once before and only took 8 hours so we took the patient back to the ICU around 1600 hours. When you take a freshed trached, ventillated patient back to the ICU, it is a lot more complicated for anaesthesia than just taking a patient back to the RR. While the CofE does at least 3 of these cases a week, it seems like every time I take a patient back to the ICU it is like they have never done it before. I have to ask for a transport monitor, ambu bag and oxygen cylinder. I'm not sure whether my colleagues just take their patients back to the ICU apneic and unmonitorred. I have to usually connect the monitors, zero the art line, make sure the lines aren't tangled or pulled out during the move. I also have to make sure the patient doesn't wake up on the way to the ICU. In short phoning the ICU to tell them we are on the way, is low on my priority list and something I figure someone else can do. Besides at the CofE when a patient goes to the ICU, an orderly actually goes over there to get the bed so that the patient doesn't have to transferred twice. Sort of a warning that we're coming pretty soon.
Now I don't know whether somebody from the OR phoned the ICU that day. It was apparent when we arrived that they weren't ready for us. For example there wasn't a ventillator.
The second clue that they weren't expecting us was the arrival of the charge nurse into the room where I was ventillating the patient by hand while waiting for the RT and ventillator to arrive. She unleashed a string of invective at me which lasted at least 5 minutes. The jist was that I alone of all the people involved in the case should have phoned the unit.
Now I am married and went to medical school, internship and residency in the 1980s so I have had my share of public tongue lashings and maybe I should have just said sorry and slunk out but on this particular day, I felt that a line had been crossed.
After the ventillator arrived. I walked out in the corridor approached the charge nurse, took her to an out of the way part of the ward and told her that her behaviour was entirely innappropriate and that I expected an apology. She refused.
So, I wrote a letter.
About a week later, the unit supervisor phoned me to tell me that she had a investigated the incident, that what I said happened had actually happened, that it was not appropriate, and that the nurse in question would be writing me a letter of apology which I received in due course.
To be continued......