10 Reasons Why I Hate Neurosurgery

Photo courtesy of Michelle Au (http://theunderweardrawer.blogspot.com)

If I were to rank the different services in the Operating Room, my ranking would be as follows: General Surgery, Cardiothoracic, OB, Pedia, ENT, Plastic, Orthopedics, Neurosurgery and lastly would be Urology. But I really don't hate Uro, it's just that I just hate the cases where only a circulating nurse is needed like TURP, RPG- Cystoscopy and others like that if you get what I mean. But if the case of urology is like the cases of GS which means they're gonna cut and expose the abdominal cavity, then I would rather scrubbed in this surgery rather than be a part in the neurosurgery service team cutting up the brain and everything. With that consideration in mind,  it is easy to conclude that neurosurgery is my least favorite among the services and this entry would least down 10 reasons why I hate neurosurgery.

1. Attitude of the Neurosurgeons. I don't know if this is true all among neurosurgeons and their residents or it only applies to those who I've only encountered. The problem I had with the neurosurgeons is that they have this kind of air in their attitude. I never felt comfortable with their presence unlike those with the other surgeons in other services. I don't know but they always have this tendency to look down on you if you don't know what you're doing unlike those with other services that they are willing to help you. In short, my perception to them is an egotistic and arrogant being.

2. Appreciation to the surgery per se. Unlike those surgeries that involved opening up the abdominal cavity, operation of the brain doesn't help me to understand the operation that they're doing. The operative area is viewable only to the surgeons and the residents unless they opted to have a video set-up for the surgery team to see, unfortunately this happens only once in a blue moon in our hospital. :(

3. High risk of losing sponges (cottonoids, cottonballs and the like). Due to the limited space of the operative field and the size of the sponges, there are higher risk of losing the sponges being used compared to those used in the surgeries dealing with abdominal cavity. Adding to the problem is the fact that resident surgeons don't know how to return those little cottonoids back to us, so every now and then it is our duty and responsibility to check if our cottonoids are complete or they already fell in the floor. It is just too difficult when the surgery already used almost 200 cottonoids, it's just too hard to track all of them so you're only option is to pray hard that when you start counting the sponges, it is complete!

4. Difficulty of prepping the table. You cannot open the sterile dram immediately in neurosurgeries to avoid contamination of the field and because of that, it was always a tedious task in preparing the sterile table. And with all the countless supplies and load of instruments to be open for the surgery, you'll just get surprised that the whole team is already ready and you're still not.

5. Difficulty of controlling bleeders. Same reason, the limited space of the operative area makes it difficult for surgeon to control bleeders and with the complexity of the brain area, the surgeon is always at their edge and as the scrub nurse, you are always the one who gets the blaming.

6. Too many equipments in the room. It's okay if the OR suite/room is big but in our case, our big room is always not enough for the BIGGER equipments that are needed in the surgeries like the Leica Microscope and the C-arm. And with all these big equipments packed in a small room, there is not enough space for us to move around comfortably.

7. Different instruments from the usual/familiar instruments. Ok I admit it, neurosurgery is one of the specialized field like those of orthopedics and others and that means aside from the usual instruments commonly found in OR, neurosurgeons used other instruments that are quite exotic in my brain to register  immediately after using it. It takes time to memorize all those unfamiliar names of the weird instruments but those excellent surgeons (note the sarcasm in my voice please) always expect it that you are bound to know those names right away. I just hate it when they are asking for an instruments and you being new and unfamiliar have that weird look in the face (plus the weird question mark in your head) then suddenly those surgeons would comment something like "you should know the names of your instruments before assisting us in this surgery..blah blah blah." My fault for being new and having a senior circulating nurse who doesn't even care for my welfare.

8. Almost all cases were long standing. With all the surgeries of neuro services only a handful can be done in minimum of 1-2 hours, the rest you can bet can last til God knows when. I have experienced one surgery that lasted almost 16 hours and in the end they have one cottonoid missing out of 300+. That is just too scary.

9. Different cases but no definite sequence. Ok maybe there is a definite sequence to their surgeries like those in GS and OB but I still cannot see it.

10. I just hate it.  No explanations needed. I just hate the service that's all.