OR Experience

This quarter I only have two classes, Medical/Surgical nursing and Psychiatric and Mental Health Nursing.  Now I probably shouldn't say "only" because I know they're going to be very intense courses and have a lot of clinical hours attached to them.  My schedule is as follows:  

Monday:  Med/Surg Class  9-3

Tuesday:  Med/Surg Clinical 6:45-4

Wednesday:  Med/Surg Clinical 6:45- 4

Thursday:  Psych Clinical at Haymarket Center:  8-4

Friday:  Psych Class 9-12   

Not to mention all the studying I'll need to do.  

Talk about a full time job right?!

For one day out of all our med/surg clinicals we get to go observe a non-bedside nurse.  I was placed in the OR.  There were four of us that day.  First we got a tour of the new operating rooms in the tower which are equip with all the latest technology.  On the tour we'd peak in through the windows to see what procedures were going on.  

Some doctors would wave, some carry on with their business and one even invited us into the room as he did a bronchoscopy procedure to get a lung tissue biopsy on a cancer patient.  He talked us through the procedure, took time to point out the cancer tissue from the healthy tissue and let us ask questions all because he saw students peeking through the window.  This is what I love about learning in a teaching hospital, you never seem like a burden.  Fun Fact:  To prevent excessive bleeding he would flush the lungs with old fashioned ice cold water which would constrict the capillaries.  He said that worked better than any of the drugs they have out there. 

looking down the trachea where
the two bronchi branch off to the lobes

After the tour we got to pick which surgery we wanted to see.  One picked a brain tumor removal where she said she could actually see the brain pulsating during the procedure.  One picked to see the Davinci Robot do a hysterectomy.  The surgeon was on the opposite side of the room as the patient and controlled this robot like it was a video game.  One picked to see a cardiac bypass done, which was one of the longest procedures and I picked an orthopedic OR to see a total hip replacement.  Since my grandma is going in to get one done next week, I wanted to see what she would have to go through.  Below is just some of the tools used in a hip replacement.  The metal balls you see at the top or the picture is what attaches to the drill and cleans out the socket 

Are we building a house or replacing a joint?!

The team worked like a well oiled machine and could successfully complete a total joint replacement in about an hour.  There was no need for the attending to say “drill” or “mallet” because the surg tech already had the utensil in hand ready to hand off like two runners handing off a baton in a 4x100 sprint relay.  The residents would help with suctioning and minor assistance while the fellow and attending did most of the pounding and sawing.  Meanwhile, the nurse would be completing paper work at the computer in the corner of the room.  There would be small chatter from the attending giving genuine words of wisdom for life to a couple of comments that had the team in laughter, ie. suggesting that one of the members of the team open a brothel (yes, your surgeon may talk about whore houses while your under the knife).  There was an iPod playing a plethora of music due to the fact that the attending let each member of the team pick songs for the playlist.  the residents made a point to say that that was a rarity.  Usually you listen to whatever the attending wants to hear, but this particular doctor was very democratic.  It was quite obvious that this team had a good rapport and consistently worked together.  Hands down this was a exceptional experience and may have unexpectedly driven me to take my nursing career in the OR direction.

Above you can see what a knee replacement looks like.  The doctors motto was minimally invasive surgery with quick recovery.  His incision was maybe half of what the picture above shows.  One of the patients was coming back to get his second knee replacement only after having the first one done just 6 weeks ago!  They saw off part of the bones, size you for the artificial joint and cement it in place and then sew you up!  Now that's a very, very, very, very watered down version of a knee replacement, but I could spend days talking about it.  As they cut off certain parts they would hand them to me so I could feel what human bone and a meniscus felt like.  I also was able to help them open up some of the supplies pre-op.  We had to open the sterile packages and toss them onto the sterile field without touching the gloves or sutures because that would contaminate it.  I also helped part of the team gown for the procedure.     

Below you can see what a hip replacement looks like.  I felt like this procedure was much more gruesome and patients would have a longer recovery time, but actually it's the opposite.  Knees are more difficult to recover from than hips. To insert the metal shaft the doctor needs to clear out the canal of the bone.  To do that he pounds in a smaller version of the implant that has a cheese grater like texture on it so when he pulls it out some of the marrow comes out too.  Then he does it again with the next size up and again with the size up from that until he gets it open to the right size.  It was an amazing day.  In the words of one of my instructors, "an educational experience that's exciting is truly a gift."        

Breaks are never long enough!

I'm a week into Q3 and was reminiscing about my break and how short it felt.  This break I didn't really plan anything but always had something going on.  Here are some of the highlights....

Joey's All Star Lacrosse Game, which was conveniently played at WEGO high school.  There was a great family turn out and a lot of them came over to my mom's house after for some post game cocktails.  Congrats Joe on making the first goal for your team which set the pace for a 15-14 victory!

Love this little nugget, can't wait for the third!

Making a goal!

Joey is #2

If you uncork it, they will come!

Two weekend trips to Bass Lake.  One nice and relaxing, where I was able to sit with me, myself and I for a few hours before Aunt Neici and Uncle Bob arrived.  I consider myself a very sociable person, but sometimes its nice to just be alone.  The following weekend was a little more crazy with all the Marcuccilli sisters together.  Nani and Papa closed on the cottage and I feel it was left in good hands with people who will love making memories there as much as we did.  Lots of laughs and good times.

An afternoon with the grandparents.  I love going out and catching up.  I can always count on a good conversation.  Grandma and I will usually go get a mani/pedi or go shopping and then meet my grandpa for lunch afterwards.  This time we went shopping and I got some great stuff for my psych clinicals... as well as a friendly reminder that the gym needs to be added to my daily routines.

A lovely sail on lake Michigan.  My nursing friend Nadine and her boyfriend have a sail boat in Montrose Harbor.  While not being on a schedule, they were gracious enough to take me out for a ride and then drop me off at Monroe Harbor so I could make it to Bear Necessities bowling event at 10 Pin.  I'm not going to lie, it was kinda cool getting dropped off via sailboat.

I Surrender!

After a lot of though and consideration I have decided to quit at the sausage factory.  My hours were ridiculous and while I've been able to manage working til 5 or 6 am and still be on time for class at 9, I refuse to work those hours and then take care of a patient in the hospital with no sleep.  The past few weeks I've been training my replacement and my last week was suppose to be before school started, however he was not quite ready to be left alone and the other cook was going to be on vacation in Vegas so I was somehow gypsied into staying another week.  But now I am officially done.  I will still babysit and have been asked to write a manual for the smokehouse so there will still be some income, but I guess I am officially living off student loans.  A though I choose not to think about until graduation.  However, I am looking forward to seeing what a week in school is like without working.  I already have a test Thursday and hope to do stellar on it.  

Bye bye sausage, maybe I'll see you again next quarter!

  

And now I can breath...

Q2 is over and man was it intense! Test after test and then a final assessment skills validation.  Pre-finals I had to strategize my studying.  I locked in an A in both synthesis and health promotion, but was borderline B/C in Pharmacology and a pretty solid B in Assessment.  The likelyness of me getting near 100% on an Assessment final to bump up to an A was near impossible so I decided to hit the books hard for Pharmacology since that grade can go either way.  In the end it paif off and I've managed to raise my overall GPA above a 3.0.  To some that might sound like a great average, but by Rush's standards it's the bare minimum.

My final skills validation went really well aside from the fact that I missed an entire section.  We all
paired up with a different student and had to pretend to be the patient once and then act like the nurse for another area.  The body was divided up into three sections:  head and neck, thorasic and lungs, and abdominal and peripheral vascular.  You had to pick one area to assess, but didn't know which one you had until 5 minutes before your demo.  Because my partner was so nervous, I told her I'd go first.  Personally I knew it was going to be a breeze, not because it was easy but because they were things that we've been talking about and practicing all quarter.  Plus you get to look at the sheet to see what you forgot and go back for half points.  In the history of this program only one student ever failed.  I went through, did my assessment and answered my instructors questions confidently.  I had a hunch I was forgetting something but wasn't going to dwell on it.  I looked at the sheet and realized I forgot 2 things... range of motion and jugular vein distention.  So I got back into role (although the moment was kinda over) and did the tests I had forgotten.  It was definately more awkward to get into character for 30 seconds.   My instructor told me I only checked one side for the jugular vein to which I responded, "It's pass/fail.  I can deal with that."  Aside from those little mistakes she said I seemed to make the patient very comfortable and did a really awesome job finding teachable moments for my patient.  After our validation, which was officially the last test of the quarter, we undoubtedly went to a bar down the street for lunch and a couple of cocktails.  We were done and noone was getting held back in the program. 

Almost looks like a pro photo shoot!

The next day was a planned barcrawl.  Not as many people as Q1, but still a decent showing.  Mary I-bake-like-a-professional-pastry-chef Johnson invited a few girls over for mimosas and monkey bread since we were foregoing the all you can drink special at the first bar.  She has yet to disappoint with her baking abilities!  I was not on team drink-a-lot because I had to work that evening and opted for good company and a glass of water at the second bar.  I was sad to hear that I missed out on the fun because a couple of the guys in our program had everyone over to grill out later in the night :o( It was a great relaxing end to a hectic, pull-your-hair-out quarter. Now I must brace myself for med-surg...

(clearly I was way too busy to post during break.  Those are on their way soon)

Vino Vangogh

A while back Carla and I stumbled upon a living social deal for Vino Vangogh, a company where you go to a restaurant and learn to paint a picture step by step.  I knew my mom would love this so I bought one for her too and kept it a surprise until we were in the car and on our way there.  It was a great time.  We ordered a bottle of wine and some appetizers and let our creativity flow through our paintbrushes.  My mom got really into it (as anticipated) and even knocked over her cup of water.  Thank goodness it wasn't the wine glass is all Im saying!  As we painted I thought, wow this looks like crap.  When all was said and done though, I think mine looked the best.  It was neat to see how all of us got the same instructions, but each came out completely unique.  I highly recommend Vino Vangogh for a ladies night out if you're looking for something fun and different.  (more pictures may be on their way if Carla can get them off her phone....)