My tour in 1-day surgery

So… my surgery “rotation” (if you can call it that).

I was the first person in our clinical group to go down there, so I had no idea what to expect. The first thing they had me do when I got down there was to change into scrubs. I’ve got to admit that was kind of fun. Wearing “Property of X Hospital” emblazoned, incredibly ill-fitting scrubs… it felt very official or something. And they had some surprisingly snazzy warm-up jackets. I also got the lovely bonnet (which is slightly less embarassing when everyone is wearing one). The people I met were all incredibly kind. People kept checking to see if I’d eaten and a woman I met in the locker room showed me where to get toast. The whole environment felt a bit more collegial and welcoming than the med-surg floor I’m usually on… probably because things are a bit more ordered in the OR. It’s more… assembly line medicine. Which I don’t mean in a negative way, it’s just the nature of the department. The person is wheeled in, they get their surgery, they get transferred to the PACU, then they get transferred to phase II, then they go home (if all goes according to plan). Everyone has his or her own role in the process.

The first surgery I saw I came in on partway through. The surgeon was doing a carpal tunnel repair (basically cutting the tendon that runs across the wrist to relieve pressure on the nerve). The patient was awake for most of it and did quite well. While I was going into the second surgery I saw a little kid get wheeled by… in a little red wagon. How cute is that! The next surgery was performed by the same doctor and was to remove a ganglion cyst. That one I saw from the beginning and it was pretty cool to see the cysts under the skin.

After that they had me switch rooms so that I could see some more interesting surgeries and I saw two hysteroscopies. The CRNA let me stand next to her when she intubated the patient which was pretty cool. Then I hung out behind the gynecologist while she did the procedure… which was done with the scope so you saw everything on the video screen. It was like watching a documentary on TV except, you know, it was live. This is when it gets embarrassing. At this point I had seen open incisions on two people, heard flesh being cauterized, seen the blood, seen the sutures being done… no problem. The surgery where there is no visible incision, it’s all on the TV screen, and I’ve stood through the whole thing just fine… that’s the one where I began to feel nauseated and decided it was time to chill out on the floor. Never fear, I realized that I should probably sit down on one of the stools and the nurse suggested I might be happier on the floor with my back against the wall. Then they shipped me to the lounge where someone offered me an orange (and someone else offered me a Girl Scout cookie). Ugh. How embarassing. I have no idea what prompted it. The procedure was pretty much over by the time I began to feel it. It must happen pretty often, though, judging from everyone’s reaction. The nurse in the room said that when she started working in the OR it happened to her a few times and she thinks that sometimes just wearing the mask can do it. But I got my legs back under me and went back for the 2nd hysteroscopy. I kinda felt nauseous again and decided to start asking questions about different things and that seemed to help reorganize my brain. This was a bloodier procedure and I managed to survive it unscathed. Unfortunately the next procedure I was going to see the patient didn’t feel comfortable about having a student in there observing and at that point it was getting towards the end of my day, so I went back up to the floor.

All in all, it was a cool experience. There are a lot of things I like about the OR… the teamwork among all the different people, the organization, the fact that it’s got a pretty regular schedule (they’re on-call for nights and weekends, but the majority of surgeries go on between Monday and Friday). I really liked that the physicians invited me to stand/sit near them and explained what they were doing. But I’m not sure I’d want to be an OR nurse. It seems like the assisting is generally done by surgical techs at this point. The circulating nurse mostly seems to chart and occasionally runs around to get something. It seems kind of boring… though PACU (post-anesthesia care unit) might be okay. People have pretty short stops in there, too, only about half an hour or so before they’re wheeled back to phase II where they complete their recovery, but there’s a bit more patient care.

So, that was the OR. Back to the floor next week…

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