Large Slice of Humble Pie

Ok I am sorry, I have yet to update you on my first observation day and life in general in between. So it goes like this. We all met up at the VA here and head up to the OR. There we all changed into hospital scrubs in the dressing room. You can't wear street clothes in the OR area, because of sterility. We came out and donned shoe covers and beautiful bouffant caps. Then we took a tour around the OR block. We observed what surgeries were going on, which are placed on a huge board behind the main desk and saw where the clean and dirty supplies go in and out.

There was a big belly case going on in OR 1. And I thought to myself that would be a great one to go in on. So we toured around and see all the OR's there was a total hip replacement, carpal tunnal repair, a huge EENT for a neck cancer patient and bunion removal. So we saw the sights and then decided what we wanted to sit in on and watch. I cancelled out all thoughts of the ortho (hip replacement), all the sawing and hammering makes my knees weak. I have seen a total knee replacement when I was in nursing school and that was enough for me. I thought about the EENT but two of my other classmates jumped on that. Only 2 students observing could be in a room. I really wanted to go in for the big belly, but alas they had already finished and taken the patient out. Then there was an open hernia and I wanted to do that but they were finishing suturing when we came back there. My only stipulation was to see something big and gory. The other two classmates who were left were hesitant and said they were not ready for that but wanted something more simple and not gory. So we waited for the lap chole. that would follow the hernia. (Sorry that is removal of the gallbladder by using endoscopes, which means only 4 tiny incisions and you watch the surgery on a monitor) It was good to watch the Surgical tech set up and we caught all the breaks in technique, sadly there were a lot of them. Then I stood outside the window and let the other two go in for it. I was still hoping we could find something exciting to watch. I ended up just staying out there and watching.

Here comes the humility.

I had been out there for about 2 hours watching, and we were about 10 minutes from leaving when it hit me. I started feeling a little weak and then seeing spots and my peripheral vision started closing in. I made it to the chair before I fell completely out on the floor. I hoped it would pass before my classmates all came out but it did not. I have no idea what set me off. I was not grossed out, but I was about ready to pass out. My classmates were so bothered by how white I was. Even when it had passed they said I still looked as white. My instructor was asking me when my color would return. It had never happened before so I had no idea. My instructor said she was sure it was not from what I saw, essentially I was just watching a computer monitor and I have watched some serious gory surgeries on my computer. I don't know if I was standing still too long and locking my knees or what. But it just can't happen again. I felt completely humbled after ranting about how I wanted to see a gory surgery.

Tomorrow is a new day and we will be here at UAMS observing. I will just take what I can get, as far as the surgeries go.

Yesterday was my final check-off. All of the other check-offs I didn't even bat an eye at, since I practiced them and they were simple skills, like the 6 min. surgical scrub, and gowning and gloving. Yesterday was the check-off of all check-offs. The check off was two-fold: one part being the surgical tech for the surgery and the other for being the circulator. Because my initial check-off partner decided to leave the program I was put in with another check off, so there were three of us checking off. I circulated, Sandra was the surg tech first. Then Sandra circulated and Nicole was the surg tech. Then I was last to be the surg tech and Nicole circulated for me.

As the circulator checking off we pulled a position out of a cup and had to place the patient on the OR bed into that position. Then I was to assist the person who was checking off as surgical tech, helping them do counts, get medications and other things as a non-sterile team member. Then I had to prep the patient's skin for surgery, then be the assistant during the mock surgery. That was the EASY part.

To check off for the surgical tech we had to clean all horizontal surfaces in the room and gather and place all of our supplies in the room. Once our packs were in place we had to open our packs using sterile technique, those become our sterile fields. Then we had to perform a surgical hand scrub and don sterile gown and gloves. Then we had 20 minutes to set up our sterile field. When we were finished setting up we gown and glove our circulator and start draping the patient. After that we pull up our sterile fields that we have set up and start the mock surgery. Our instructor is the surgeon and she would call for instruments and we would have to know what they were and how to pass them. She was hilarious, actually playing around like she was doing the surgery and taught us a few skills we would need to know during surgery that would be expected of us. Then we were done and we had to break down our field and perform counts.

I am so excited that I am now ready to practice what we have learned in clinicals starting the Monday after Thanksgiving. I however am not looking forward to being on my feet in an OR from 6:30-3 Monday through Friday. But my feet will get used to it. Oh I guess you would like to know that not only did I pass my check-off I aced it. The only thing she saw me do wrong was when I prepped the patient I donned my gloves before I opened the prep pack but I caught myself and stated that I would have had to get another pair of gloves and put them on after I opened the package, so she did not take away a point. I was over-joyed when she told me I aced it. Going in I knew I would pass it because I had been diligent to practice it, but I really wanted to do well on it. All the prayers helped and God answered above and beyond. God is so GOOD!