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."