Sunday, February 17, 2013

Operating Room Clinicals

Dear readers,
I am almost 100% sure I have found my calling in life. (a very large emphasis on almost) That calling, you may ask? It's the operating room. Oh baby, is it the operating room! Which comes as a slight surprise to me, because I was almost 100% sure I was going to pass out, or get sick to my stomach, or actually vomit during this clinical rotation. None of that happened! 
In fact, I was moving all around the room, both days, to get better looks! On Wednesday I got to see a wide variety of surgeries. I saw 3 ear tube placements, which wasn't new to me, but I got to hang out with the nurse anesthetist (CRNA) while he kept the little kids under, and ask him questions about his schooling, and the medications he used. Then I saw 2 nerve block procedures, which were less thrilling, but involved a machine that looked a lot like an MRI, which was cool to watch. Last I watched a colonoscopy with multiple biopsies. That was the first day, which was cool, but not screaming to me "This is where you're meant to be!"  Though the nice cozy blue scrubs were definitely a big plus.

Day two: a whole different experience. Oh man, I got to see a hysterectomy, and an attempt at laser prostate resection. Both were cool, but the hysterectomy wins for most awesome thing I've ever seen. WARNING: this blog post is gonna get graphic, if you are squeamish, stop reading. 
The hysterectomy was done vaginally, so this poor female's legs were suspended way up in the air. She was covered up, so the only thing showing was the vaginal area. The doctor was so wonderful to let me see what was happening, and he told me what he was doing the entire surgery. It was fun to listen to him chat with his nurses, and it was so impressive to see the camaraderie between them. It made me look forward to the time when I will have work friends to chat with, too. He showed me the Fallopian tubes and ovaries while he was doing the surgery, and after the uterus was removed, he sewed shut the opening. Then he told me to put some gloves on, which was unexpected and weird, so I do, and he proceeds to turn around and HAND ME THE UTERUS. Which was awesome, by the way, freaking awesome. Then he hands me scissors and tells me to cut the uterus open. 
I've done dissections in anatomy lab, and in high school, but to have a fresh human organ in my hands... it was incredible. Seriously ya'll, I'm meant to be in the medical field. So I cut it open, felt the tissues and whatnot, then sent it off to patho for testing.

The next surgery was a laser prostate resection on an elderly guy who's prostate was so enlarged that he had to use an indwelling catheter to urinate. The plan was to thread a laser tipped catheter up into the prostate area, then turn the laser on and pretty much disintegrate the tissue. we all had these green goggles on to protetc our eyes (which I found slightly odd because the entire procedure was completely internal), and there was the laser technician in the room, who had brought the machine from Salt Lake.
It took the surgeon almost 10 minutes to get the laser catheter up to the prostate, because the skin was completely shredded all the way up the urethra, which the surgeon assumed was from months of catheter use. The tissues were spouting blood everywhere you looked; I felt so bad for the poor guy. The catheter finally reached the prostate, and the surgeon tells the tech guy to start up the laser. He does, we all fasten our goggles on securely, and... nothing.
Yeah, after 10 minutes of work threading that laser up there... the thing doesn't work. Turns out the wire to the foot pedal had a cut in it, and during the 10 minutes of catheter threading, urine and blood had been dripping down on to the foot pedal wire... ruining the entire system and bringing the surgery to a halt. You should have seen that tech guy. He didn't bring a replacement foot pedal, and he hadn't thought to check wiring before the surgery started. He was stammering and apologizing to the surgeon, when really, he should have stuck around and apologized to the patient. The surgeon put in a new catheter so it would be easier for him to get to the prostate on the second try in a few weeks. After the laser catheter was removed, the tech guy left pretty much immediately, and left the circulating nurse to explain to the patient what had happened, and that he would have to wait another few weeks for the surgery.
While it was disappointing to not get to watch a laser disintegrate tissue, it was a great lesson for me on the importance of double checking your equipment before surgeries, and for Heaven's sake  have a replacement or two waiting in the wings!

So those were the surgeries I got to watch, and really, all of them were pretty dang cool. So we will see if operating room nursing is what ends up being my calling in life.

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