Guide to Medical Etiquette: the operating theatre

Not many jobs entail putting on a pair of pyjamas, a paper hat, and a mask. The benevolent connotations of this silly costume, a clown, magician, or some other such children's entertainer, belie the harsh reality. In truth, the operating theatre abounds with delicate egos and complicated power structures. To survive in this arena the wise student develops an intimate knowledge of his antagonist, and his own role. Until you develop this awareness these notes may be useful. Simply cut them out, stick them to card, and laminate for your wipe clean quick reference guide.

Consultant surgeon - She is the one holding the knife. The wise student keeps this fact in mind at all times. As a student, you will encounter the surgeon mainly while scrubbing up. To make a good impression you should scrub for longer than her. Unfortunately, surgeons are well aware of this student dictum and may amuse themselves by keeping you scrubbing for hours on end. Similarly, it is possible for you to overdo it. Generally, your pants and socks should remain on at all times.

Anaesthetist - He is the one doing the crossword. When an alarm goes off he may look up and tut. Occasionally he can be seen putting a towel or pillow over the patient's head. Do not be alarmed by this, he is merely attempting to avert hypothermia. On the other hand, if you notice similar behaviour in the outpatient clinic you should intervene or alert the police immediately, or both. Generally, the anaesthetist is pleasant to talk to, or have a relaxed game of chess with, but on no account wake him up if he is having nap.

Theatre sister - If you defecated in your sister's bed (while she was still in it), she would continue to hold you in higher regard than the sisters in theatre do. To remain safe from harm, do not sneeze, spit, or exhale in her presence. Do not address her unless spoken to, and always try to keep an item of furniture or member of staff between you and her.

Dirty nurse - The dirty nurse opens packages and such like. It would be wise to get any double entendres out of your system now, thus leaving you free to appear mature when confronted with the title in theatre.

With your new found insights, no doubt you'll be invited round the golf course in no time. Of course, golfing etiquette is another matter entirely.

David McAllister, third year medical student, Glasgow University


studentBMJ 1999;07:394-436 November ISSN 0966-6494