Posted by: iamlillian | January 20, 2010

‘Time out’ week

according to my nurse manager, ‘Time out’ is a week when graduate nurses working in day surgery unit get to go to 5 different units within the operating room services in hospital. And i’m priviledged to be one of the nurses.

And this week happens to be The week. Time-out from day surgery unit, i suppose. i get to go into theatres for 2 days, one day in general recovery, one day in pre-anaesthetic clinics & one day with the Acute Pain Services team.

Day 1: It was a lovely morning as i walked to work early in the morning when the air was still crisp.

I wore casual clothing as i knew i would change into scrubs. i like the blue scrubs with pockets. A scrub jacket is needed too as it gets cold in theatre. It’s not a complete attire until you put a blue shower cap on. It seemed like all theatre staff has their personal colourful patterned caps or just-ordinary-hospital-disposable-blue-cap on. And it has to cover all your hair. including your ears if earrings are worn.  Have to abide by the rules/policies/best practices, so to speak. For example, you are not allowed to roam around outside operating room services (like going to the cafeteria/other wards) in your scrubs. You either have to change into your uniform or wear another white-hospital gown over the scrubs. If not, you’ll be told off…if you get caught.

i think people always tend to think that it’s all strict and stressful in theatres…well, it turned out otherwise for me. Yes, you can feel quite intimidated and lost especially if you’re new and unfamiliar with the settings etc. Yes, it can be stressful too…especially for the patients. However, most of the staff are experienced and generally work together to achieve good team work.

but, i was greeted with smiles and when i looked lost, someone was there to offer help.

I was buddied up with an anaesthetic nurse yesterday under orthopedics theatre list. 4 surgeries. 8am-4+pm.

Both the anaesthetist and anaesthetic nurse were very approachable and willing to explain things to me. Slowly, by observing i gathered the bits and pieces and pieced them together in my head…with lots of ‘a-ha’ moments. The anaesthetic machine with monitors, lots of cores of machines, equipment attached to the powerpoints…it’s quite a hazardous environment if not careful. That is why safety measures are put into place, with zipped-up sleeves to cover the bundles of wires, overhead hanger to hang the cores/wires etc. But the staff seemed to know what they are doing, very efficient…The surgeons, anaesthetist and nurses all working together as a team to shift the patient across from the table to the bed post-operation.

Yesterday, i saw a total knee replacement and a total hip replacement. It just amazes me how surgeries are conducted. Definitely an eye-opening experience. From preparing the theatre, the machines, the patient, the surgeons and instrument nurse to the end when the patient is half-awake to transfer to General Recovery Unit. (or Post-Anaesthetic Recovery Unit (PARU)), it’s amazing the time just flies by so quickly and before i knew it, the day was over.

For orthopedics surgeries, usually all staff who goes into the theatre room is required to wear a balaclava over the normal cap and a mask. This is to protect the patient, preventing any foreign objects falling into joints/bones. Last thing we all want is an osteomyelitis. Interestingly, the surgeon and his 2 assisting surgeons were wearing these gigantic balaclava over a helmet, they looked just like astronauts!! A window to see their faces behind the glass window, covered from head to toes. They double-gloving and generally all surgeons wear white gum boots with their surname written with texter at the back of the boots. So, you can use your imagination to picture 3 of them hovering over the patient who was entirely covered in green drapes, exposing only the surgical site. Well and truly protected.

Generally the nurses working in theatres move around fast-paced. No time to be wasted, especially in between cases. to clean up and prepare for the next case. Everything went smoothly. They are in control.

i followed the nurse into the store room to collect stuff needed for surgeries. She carried a basket and grabbing stuff of the shelves, just like in the supermarket shopping for groceries, except there isnt much room in the store room and there were a few nurses in there looking for stuff. Stuff like ampules of medications, syringes, IV fluids, giving sets, gauzes, breathing masks, all sorts of things needed in the theatre. And we also need to stock up for the following day too.  All in all, it was an interesting day and to witness the process the patients went through, now i can truly understand and felt for them when they woke up in great pain/ nausea/vomiting.

day2: buddied up with a scout nurse. Observed how the theatre packs are being set-up and opened. Helping surgeons to tie knots at the back of their sterile gowns. Being extra careful not to touch the sterile fields. ‘Dont touch anything that’s green.’ said a nurse. green = sterile. understood.

saw a scalp being cut open and peeled back towards the face of the patient, in order for the surgeons to remove the small…extra small screws and metal bits from a patient’s frontal part, just abover the nose in between the eyebrows, as the x-ray showed.

as i am still not used to see parts of body being cut open + blood, tissues, bones etc…i thought i was going to feel sick/ faint. but i didnt. Phew!  Although the burning smell of tissues can be revolting at times too.

so, it’s been very very interesting experience to be in the theatres of a major public metropolitan hospital. And i am grateful for this opportunity, for it doesnt come by easily.

the question people often ask me lately since i am in my final stage of graduate program: “So, which area do you want to work in? What is your interest?’

i would say, “I would choose the areas which i’ve worked in which were ENT, Orthopedics surgical ward – pre-post surgery. So not like intraoperative nursing.”

 But now i’m thinking, why not give theatre nursing a go too. The more i am exposed to, the more it intrigues me. If i were to be given a chance to be employed to work in theatre either as instrument or scout or anaesthetic nurse, i would definitely be interested. bit on second thought, it could be daunting too!!

oh well, if it’s God’s will for me to end up in theatre nursing…why not 😛

trying to illustrate some of the interesting things i saw in theatre….like me in scrubs and shower cap 😛

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Responses

  1. Wow it looks brilliant! I wish I had those chances…


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