Archive February 2019 XX, No. 2

Behind Closed Doors: 25 Murphy's Laws of the OR

If something can go wrong, it will (blame anesthesia when it does).

Paula Watkins

Paula Watkins, RN, CNOR


Pamela Bevelhymer, RN, BSN, CNOR
MURPHY'S LAW There goes Murphy taking a header in the OR.

We're all subject to Murphy's Laws of the operating room, like the not-so-funny one that matches the slowest circulator with the fastest surgeon. Here are 25 laws I wish they'd abolish.

1. There will be plenty of "oops." For surgery's unexpected adventures, always have some "oh-bleep" suture in the room.

2. You always get the C-arm cases because the other 2 nurses are pregnant.

3. You always get the meanest surgeon because he's kicked everybody else out.

4. The tallest surgeons always get the shortest techs and nurses, who always get the heaviest patients.

5. Your buddies who were gabbing at the nurses station just a minute ago vanish into thin air when you need their help.

6. There is only 1 inflatable transfer mattress and 2 rooms will need it at the same time.

7. The procedure with the most documentation is in the room with the computer that's most likely to freeze.

8. The patient sent from the urgent care center in need of an appendectomy will stop for a Big Mac.

9. There will be a patient who's related to an OR nurse or a lawyer (yes, the relative will be with the patient in pre-op).

10. Your patient in pre-op will wait until the last minute to pee.

11. The surgeon will want a Foley on the patient who's dry with an empty bladder.

12. The largest patient will be the hardest stick. Best you can hope for: a 22 gauge in Bluto's thumb.

13. The patients who can't afford diabetes meds and antibiotics can afford Dilaudid, codeine, cigarettes and marijuana.

14. Joint Commission or State will choose your case to audit.

15. On laparoscopic abdominal cases, have an absorbable hemostat in the room. You can always credit it back to the patient.

16. Never assume the relationship of the person with the patient. Better to ask, "And you are this patient's _____ ?" than to mistake the elderly patient's daughter for her sister.

17. The patient scheduled for an incision and drainage has had the wound for more than a week, but tells you he just woke up and there it was.

18. The drug-user patient will blame the cellulitis on an extremity on a bug or spider bite.

19. Your nose will itch the very moment your gloved hands get contaminated with bodily fluids.

20. You get the hardest cases with the least experienced tech, the neediest anesthetist and the crappiest preferences sheets.

21. Your reward for doing great work and turning over rooms quickly? Another case in your room. Congrats!

22. No matter what time it is or how long you've been in this case, if you are given a chance to take a break, take it. It may not come your way again until tomorrow. Of course, the moment you sit down, the supervisor walks around the corner and sees you doing nothing.

23. When you reach under the surgeon's gown to grab his cell phone, the draw string on his scrub pants will be untied.

24. You always forget what it was you needed when you get to the supply room. You only remember when you get back to the OR.

25. The last patient of the day will be late. As will Dr. Dark Thirty, who moves slower and takes longer than any other physician. OSM

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