Addressing the Elephant in the Room: Surgical Delays

I need your help with how to approach surgeons who are upset with surgical delays. Every surgeon’s nightmare is being late and, as the circulator, I am often put in situations where I am the first person to interact with the surgeon. I would love some advice on the best approach to handling their unhappiness while also putting the patient first.  

I recently had a situation where a surgical delay was caused by a previous case. In the case, we unexpectedly had to convert from laparoscopic to open due to a surgical complication and significant bleeding. I ran what felt like a 5K gathering instruments, supplies, equipment and blood. I felt confident I did the best I could, given the situation at hand. The patient did well, thankfully, which is the most important outcome.  

When I went to preop to interview my next patient, I was worn out—emotionally and physically exhausted from the previous case. I passed by the surgeon sitting visibly upset in the nurse’s station and felt the disappointment and annoyance she had for me and the entire room staff. I wanted to address her with professionalism and kindness while also being transparent about the previous case. How should I handle this? 

You were in a tough spot and faced what will be inevitable in our line of work. When you cross paths with an upset surgeon, it's smart to have a well-prepared statement ready for service recovery. Open with, "I apologize for the delay; I understand how upsetting this has to be." Then, provide context to help them understand the situation: "I want to reassure you that we are fully prepared to provide the best possible care to your patient. Unfortunately, our last case encountered an unexpected complication." 

Honesty and transparency are the best policy in these situations. As a new nurse, demonstrating the confidence to address their concerns directly can go a long way in defusing the situation while also building rapport. 

Surgical delays are an ongoing challenge for perioperative nurses. Finding the delicate balance between keeping surgeons on schedule and satisfied (when possible) and accommodating the needs of the anesthesia team is the goal. Nurses navigate this fine line daily to ensure the best possible outcomes for patients.