Gisborne Hospital Report - Health and Disability Commissioner

Gisborne Hospital 1999 – 2000
Operating Theatre Protocols
2.5 Dr Lucas was very concerned at the frequency with which theatre sessions
were cancelled. He described the theatre as “horribly inefficient”.
“Often the first 8.30 patient would not be in the theatre and available for
my care until 8.50. I am used to an 8.30 booking to mean that the cut is
made at 8.30. Another cause for delay was that the nurses preferred to
prepare their instruments in an anteroom and would not come into the
theatre until the patient was asleep. Sometimes they seemed to require
coaxing even at that point. They preferred to attach the brackets for the
various table attachments only after the patient was asleep. They
preferred to check the function of the fluoroscopy machine only after the
patient was asleep and when it did not work immediately, anaesthesia
was needlessly prolonged. In all of these examples the rationale of their
approach was that they didn’t want the patient to be frightened; they
didn’t want the patients to see the instruments. To me this seems a very
condescending attitude to patients. What did the patients think they
were in theatre for?”
2.6 Dr Lucas’ drive for efficient use of the theatre upset the routine of others; he
got off-side with them. He also used techniques that were not commonly
employed in Gisborne (for example, his use of ice, and the demand for clip-on
straps for theatre tables), and this led to misunderstandings.
Staff perceptions
2.7 Staff perceptions of Dr Lucas are important to an understanding of the
incidents that are alleged to have occurred in theatre and the allegations made.
A range of comments were made about Dr Lucas from the very negative to the
very positive. The following comment from a senior doctor may explain much
about staff perceptions:
“[Dr Lucas had] difficulty in reading social cues. He would not have
wanted to have hurt anyone. He was naïve, oriented to doing a good job
and not attuned to social banter. He was honest to the point of being
blunt.”
What to one person is bluntness is to another humiliation. This was the
response of the anaesthetic technician who said she was called incompetent
and useless by Dr Lucas in front of others and felt “like a piece of dirt”. Dr
Lucas denied calling anyone incompetent or useless, either alone or in front of
others.
2.8 A surgeon stated of Dr Lucas:
“He is an interesting and quite sophisticated person. Some of what he
said could be perceived in a negative way especially by those who have
no sense of humour, limited intelligence or perhaps a bad will. He is
somewhat extraordinary but in a good way. No doubt he is a serious,
intelligent, sensible, very well qualified and trained medical
professional. If he demanded something he would be persistent about it.
69