The good, the bad, and the OR

Had an interesting 1st med/surg clinical week--a VERY long week, for sure.


Because of my grades in theory, I was selected to have observation 1st in my clinical group, so I was sent to OR right off the bat--and took with me the evil eye from my classmates, but oh well.

I watched a prostatectomy done with a laser and a laproscopic hysterectomy gone bad that was converted to a total abdominal hysterectomy with bladder repair and bilateral ureter stent placement. All really cool and I actually feel like I made an impact on one of my patients care when in post op!

The prostate guy was fairly nervous in pre-op, so I chatted a bit with him and his wife and told him about how I used to live in West Texas. A few moments after he woke from surgery, he said, "Where's Prisca from West Texas?" Later his wife told me I have a "wonderful bedside manner." I think she was contrasting me with the rather hardened OR nurses. I thought they were great but they were kind of brusque--gotta love that OR humor (half of which I didn't "get" because there were lots of inside jokes). If I ever burn out on floor nursing, maybe I'll end up there?

During the hysterectomy, the whole OR ganged up on me and tried to convince me to go into anesthesiology--too funny. I was shown ALL the equipment IN DEPTH by a doctor with a cool name--something right out of a famous book. He also let me visualize some vocal cords while intubating and explained all the meds he was using, the monitors...he was just really great!

The laser guy was pretty funny too--he said he doesn't know a thing about surgery--he just drives the laser from place to place. I asked him what he does when the laser screws up, and he looked at me blankly and said he doesn't even know how to fix the thing--so I told him he could always give the machine a kick and see if that works, or call the 800 number on the side of the machine. He looked truly thankful for my advice. Oh boy.

Then, at the end of the surgery, the laser head fell off into the patients pelvic cavity--the doc lost it, basically.

The doc looked at the laser guy and said, "This ever happen before?"

"Uh, no..." the laser guy replied, stunned.

"Um, ok, gotta find it..." the doc mumbled. Into the OR walked two other urologists to see what was happening. Doc said, "You guys ever have this happen?" and points to the tip of the laser catheter that is missing its head.

"Uh, no..." they both responded simultaneously. Doc looked a little freaked at that moment. But, after about a half hour of exploring, he found the tiny head of the laser in the patient and somehow managed to grasp it with some weird tool and get it out. You could tell he was just a tad bit worried!

The converted hysterectomy was exciting. After nicking the patients bladder while trying to do things laproscopically, they called in a GU surgeon and had to open the lady up. In the end the nurses showed off the woman's removed cervix (which looked turkey-neckish) and fibroid filled uterus.

So yesterday I had the hysterectomy as my patient--and it was pretty horrid. Ya know that first day on a unit where you are completely discombobulated and don't know where anything is, etc? Well, I felt totally disoriented and add to that the HUGE learning curve and I was a bit of a mess. I know my clinical instructor thought I was truly "slow" in more ways than one. I was oriented to the pyxis, a new computer charting system, plus doing total patient care with meds and everything. It was NUTS!

By the end of the day, truck driving school was looking REALLY fantastic.

Got home and had two calls on the machine--one from the hospital I interviewed with in Dec asking me if I wanted a job (again--I said no once already) and the second from the OB Dream Nurse Tech Job people wanting an interview. Gonna turn down the first--but how nice that they remember me and still want me--and go interview for the 2nd. Apparently the OR people from my observation called the OB Dream Nurse Tech Job hospital and gave me a recommendation. Groovy!

Off to write two papers and study for an exam. Blech.