OR Experience, Research Paper Example

On the morning of the 29^th, I stood in the lobby of Salem Hospital at 7am.  Today was a big day:  I was going to participate in student observation on a number of surgeries in the operating room!  I met three ladies at the nurse’s desk, all dressed in scrubs.  As I introduced myself as a student from Salem University, I recognized one of them as Donna.  She had someone lead me to a place where I changed from my normal uniform to OR scrubs.

When I returned to the nurse’s station I met three other students.  There were two from different colleges, and Nick and I knew each other from the same clinical group. There weren’t enough procedures scheduled that day for four individual students, so we divided ourselves into two teams. I was paired with Tony, one of the students from the other school.  We were assigned to work with Cathy, one of the veteran OR nurses.  As she introduced herself, Cathy promised us that we would be going home that day with a ton of new experiences.  We had already missed the morning conference, and the station was already busy with nurses buzzing around everywhere.  After studying the board with the names of all the day’s procedures, times, and surgeons, I stood by eagerly tightening my cap and checking my badge to make sure that Cathy could easily call on me to jump into action!  I chose to observe an arthroscopic acromioplasty at 8am, arthroscopy of the left knee at 9:30am, and a bunionectomy at noon.

Among the three procedures, the 45-minute acromioplasty of the right shoulder was the most extensive – and exciting. In the holding room, I introduced myself to the patient, a 62-year-old male.  After he approved my observation of his procedure, he was wheeled to the operating room on a rolling bed and then transferred onto the operating bench.  Once inside the room it was critical that I identified the roles each person in the room had to play.  I easily recognized Dr. Steve, the surgeon, as he sat by the corner wearing his cap, mask, scrubs and ID badge.  I wanted to ask Cathy for some help in figuring things out, but she looked too busy:  Cathy was the circulating (non-sterile) nurse, and her duties included everything from reviewing anatomy, physiology, and the surgical procedure to reporting the information relevant to the care of the patient to the recovery room.  I stood away from the sterile field and started to soak everything in.

The scrubbed (sterile) nurse prepared the instruments, organized the equipment for functional use and reported the amount of anesthesia used.  The Anesthesia Care Provider (ACP) and anesthesia nurse monitored the patient’s airways, pulmonary status, and ordered appropriate pain relief therapy.  After gowning the surgeon, the surgical assistant helped to hold the retractors exposing the surgical areas and assisted with homeostasis and suturing. While Cathy confirmed that they had the right patient for the right procedure, he was being incubated and put to sleep, with all the sterile fields in place. The purpose of this procedure was to widen the space between the upper arm and the shoulder blade so that the rotator cuff tendons do not get stuck between them. The plan was to remove a small overgrown bone that was causing pain to the patient’s shoulder whenever he hyper-extended his arm.

Dr Steve kept glancing at me as he explained in detail every move, cut, and squeeze of the muscle he made. The mood in the OR was oddly light; nurses were making jokes with each other, one playfully referring to Dr. Steve as “big daddy.” The doctor smiled and looked at me, stopped the procedure for 2-3 seconds and told me, “Joe, keep your eyes open when with all these girls!”  Instead of joining in the banter, I tried to focus and concentrate on the patient.  Eventually, the surgeon located the bone in question, took it out and closed the incision.  The two nurses counted the sponges to make sure that Dr. Steve hadn’t forgotten to remove any from the patient’s shoulder. After a few minutes, I accompanied the patient to the recovery room while I was waiting for the next procedure to commence.

The next procedure started at 9:30am in the same operating room.  The patient was a 54-year-old male who was undergoing an arthroscopic of the left knee.  Although this procedure did not involve intubation, the patient was put to sleep. In this procedure, a surgery camera with a fiber optic light source was inserted into the joint through a small incision (about a centimeter wide) and displayed an internal picture on a monitor. I noticed two bags of 2,000ml of normal saline hanging next to the patient, and hoped that Cathy would look at me so that I could ask what they were for. But the surgeon had already started explaining to me that the saline would clear debris and enhance the visibility of the joint.  Once the camera was inserted, the surgeon used another shaving instrument to trim the knee cartilage. I knew those two “holes” on the knee did not require sutures – the only part of the procedure that I could attempt to foretell – so the surgeon covered the tiny wounds with a Band-Aid as if nothing major had happened.  With all the hi-tech equipment and monitors around, the end of the procedure left me feeling like I had just watched a “Rated Knee” movie!

The last patient on my list was a middle-aged male undergoing a bunionectomy.  The procedure was to take place in Theater #4, an observational OR.  I had never heard of this procedure before and I was eager to see a chisel at work on human bone. The patient’s toe was slightly swollen with a protruding raised area on the distal end. The podiatry surgeons noted that this necrotic ulcer was the bunion. The goal of this procedure was to cut a piece of bone, which would shorten the toe and thus eliminate the underlying cause of the bunion.  Like any other surgery, this was slow, systematic, careful, and well facilitated. The surgeon used a tiny saw instrument to cut the bone, pulled it out and stitched the skin back together. The patient was only given a local anesthetic, so he was awake and pretty cheerful through the procedure.  He talked about his wife and children, and told me that he was pleased that a student from Salem University was observing him today. “I have a nephew at Salem University,” he said with a wide smile, “and those kids are very smart!” After the surgeons finished up, the patient was escorted out of the recovery room, where he would rest for about 3-4 hours before being discharged to go home.

At the end of the day, Cathy’s prediction that I would leave with new experiences had certainly come to pass.  Not only did I witness some fascinating procedures, but I also learned that many hands other than the surgeon’s play a vital role in an operation. I know now that if I need to go “under the knife,” there will be a team of people dedicated to seeing me through from start to finish.