MN jury opinion please (work related issue)

[HicDraconis]

I'm an anaesthetist. This is probably totally trivial but I wondered I was BU with something at work yesterday.

I was on call and a young girl (early 20s) came in with abdominal pain, she was booked for a diagnostic laparoscopy. Had to be done later in the evening for various reasons (7ish). It's keyhole surgery where you can see what the internal organs etc look like on screens. Mostly the patient is covered but there are parts (beginning and end - before and after drapes) when they are more exposed.

A member of staff who works within the theatre area but not in a patient care role (washes used instruments and puts them in packs through the steriliser) asked if she could come in to watch.

I felt uncomfortable with this as I didn't think being in the room for her would improve patient care in any way and I wasn't happy with the thought of a stranger's surgery being used as entertainment for a bored staff member. I also felt it would be inappropriate to ask a scared, possibly vulnerable young girl, in pain, for permission to have an extra person in theatre essentially as she arrived as it makes it difficult to say no. Medical information regarding the patient would be discussed in theatre (and was) and again I was uncomfortable with someone else being privy to that information who really had no need to know it.

However the theatre nurse who asked me if I minded this person being present was clearly surprised and annoyed when I said yes and outlined my reasons. So - was I being overly precious? Should I arrange for this theatre person to watch someone's surgery next week?

[lovingmatleave]

Sounds like you did the right thing - I would certaintly like to have you in my operation room standing up to other staff in my interset! However from the other persons point of view, maybe at some point they wonder how the instruments they wash etc are actually used and thought that as it had been quiet (and presumably other staff not not rushed, stressed etc) that it was a good moment to ask if they could watch? If it is bothering you I would first find out why they wanted to watch instead of assuming its boredom. If for valid reasons then pre-arrange for planned procedure etc.

[lookatmybutt]

I think it's very nice of you, as it CAN be hard to refuse as a patient.

I had to turn down multiple abdominal 'feelings' from medical students because honestly they could have formed a queue as there were so many of them. After about the first 5 me poor guts were feeling even more battered. I had to put up with student sad faces when I said no.

I also agreed to a very invasive/minor surgical procedure to be performed by a student doc and the doctor made me feel very guilty when I said no initially. The poor student did balls it up and I ended up in a lot of pain as well as the procedure taking far longer because of it.

A bit different to your particular situation, but I wish somebody sane had advocated for me at the time.

[HicDraconis]

PicaK / lovingmatleave / anyone else who pointed out - you're probably more right than I'd like to admit in terms of dismissing a non clinical staff member who I felt had no business there. I'll think about that part of my attitude (even reflect on it).

I did think there was an element of boredom / almost morbid curiosity? Poor description probably - anyway, not a desire for her own learning. She's been in her role years, if she'd wanted to watch surgery she could have arranged it through our theatre manager was my train of thought. However on thinking, she may not have time in the normal week (all theatres running, lots of instruments to be washed) and during the Christmas shutdown when there's less going on there is more opportunity. However I still think this was the wrong patient so I still think I wasn't being unreasonable.

That said, I'll have a chat with our theatre manager after things are back to normal, explain the request etc and see if she can organise (with appropriate consents) for non clinical staff to observe elective surgery if they would like.