c1: (Star of Life)
[personal profile] c1
I was in surgery for about 8 hours yesterday; my last case was supposed to have been at 13.30, but didn't even get wheeled into the OR until 14.00. Fortunately, my boss was understanding.

I went to the OR rotation with a certain amount of trepidation. There is a culture of surgeons and OR nurses being of a mindset, and indeed, some had prepped us by saying OR rotations typically suck, because before long you're being barked at by the surgeon or someone. The inverse proved to be my case. (Since this has been happening a lot lately, I'm wondering when my luck will run out.) 

The hospital uses a combination of (MD) anesthesiologists and (RN) nurse anesthetists. They were all a pleasure to work with; the doctor was particularly interested in working with me on my posture, and repeatedly complimented me on effectively ventilating the patient. (On the posture thing, if good mechanics are followed, ventilations become pretty effortless.) 

It was frustrating that I got scheduled during the week of Thanksgiving: no-one wants to go to t-day dinner while recovering from surgery. As a result, I got all of four of my required ten check-offs. I'm scheduled for next Friday as well, as a result. On the other hand, there was a bit of downtime to chat with the doctors and nurses about how I'm doing, what I can do better, and the like. They were all happy to share their accumulated wisdom.

Started the day by changing into scrubs, including booties and the funny hat. Face masks required in all operating theatres. From my end, nothing was sterile. I'd walk in with the patient and at least a nurse (sometimes the anesthesiologist) and they'd do some prep work -- getting the patient to shuffle onto the operating table, and so on -- and then Mrs. Sandman would sprinkle some of her magic pixie dust. Usually Propofol, which would suppress the patient's respiratory drive, though there were a couple others used at times.

At this point, I'd go to work, but it was funny. We'd have given the patient 100% oxygen, and by and large the patients were in good health, so time got stretched out a lot. We had time for the doctor to point out airway issues in the patient or whatever, for what seemed an eternity, and the patient's O2 saturation would still be pegged at about 100%. But then I'd insert an airway, and start ventilating the patient, and the magic of watching the chest rise, the patient keeping nice and pink, and so on, before the doctor would jump in and insert a breathing tube of some sort for more definitive airway management. In contrast to performing CPR when seconds aren't squandered, this seemed almost like a walk in the park. Lots of time to take in feedback and make adjustments to form and technique. (Also a big focus on keeping my eyes away from the waveform capnography, because while it's an amazing tool for assessing the effectiveness of ventilations, one might not always have it in the field, so it's important to know what good chest rise looks like.) 

(Meanwhile, the surgeon was standing to one side, maybe reviewing her notes or something, maybe watching approvingly. The weird thing was that our end was decidedly "dirty", and the surgeon's area was sterile, but walking into the room, it was almost like any other room at the hospital, excepting that we were all wearing masks, hoods, and booties. Computer over in the corner (complete with printer -- which seems like a serious mess waiting to happen) other odd stuff here and there, and then this over-riding sense that you shouldn't touch anything. And yet more dissonance from the fact that we were just in exam gloves, not sterile gloves... odd.)

It's intoxicating stuff, doing that. Watching the chest rise and fall due solely to my interventions was nothing short of magic.
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