Ducking, weaving, shivering and not looking like an idiot… The OR.

I spent the entire day in the OR today.

This makes two days this week.  And tomorrow is an OR day too.

Often, as a junior off-service resident, OR days equal me running around and taking care of patients on the floors.  When the running around is slowed down, you peer at stuff from the back of the room.

However, on this service, the floor work is much less, so I actually get to go and peer at a lot of surgeries.  This can be a good thing.  But, it can get a bit dull.

What?  Dull?  How can surgery be dull, might you ask.

Take these people, and then try to hover around to see what is happening without touching most of anything. Challenge accepted! Image via mediawiki.com.

Well, the thing is, you help get the patient positioned and then while you wait for the team to scrub, drape and start cutting into the patient, you write the orders and some of the operative note.  Then, you wander around the room hovering, standing on your toes, dodging heads and shoulders to try to get a good look at the action.  While the stretch your body into a way that enables you to see stuff is happening, you are being reminded repeatedly by the scrub nurse and the circulating nurse to not touch a million things and be careful of thing blank (these are very important warnings because contaminating a field is a very bad thing).  If you are lucky, it is a laprascopic procedure  for which you can see one of the tv screens.  Then, it is kind of like watching TV or a video game.  If you are unlucky, it is a procedure in a deep hole with a ton of arms and bodies in the way of any hope you had of seeing very much.

Eventually, the ducking, weaving and straining gets tiring.  By that time, they are finally doing something kind of interesting.  You start to space out, daydream.  That is always when the staff asks a question that you are supposed to answer.  You fumble through it.  You stare  at what is happening.  You try to not concentrate on the fact you are freezing and can no longer feel your toes.  You fidget a little.  You try to pay attention.  You try not to fall asleep standing up.

After what will feel like hours (and it often is), you realize that you enjoyed about 20 minutes of unobstructed viewing (most of which was the more senior residents closing) and maybe an hour or less of something that was cool to see… At least from that far away.  The rest consisted of chunks of view, watching people curse, watching people dig around at something you can’t see and some pimping.

You finish writing the notes.  You help move the patient to the bed and take them down to recovery.  You just start to think you might warm up and then you repeat the cycle.

Sometimes, you do get to see more.  And don’t get me wrong, the OR offers some wonderful learning experiences, even if you aren’t right in there in the action.  I have seen some really cool stuff (smelly liver abscesses, giant tumors) from the side of the room.  But, watching people do stuff you don’t fully understand for hours in dreadful. Especially when you are cold and afraid to break something.

We don’t have comfy looking viewing theatres like on Grey’s Anatomy.  I wish we did.  Maybe I could sit there instead.  And see more.  And keep warm.

It looks like much better and warmer viewing up there. Image via greysanatomy.wikia.com.

But, today, I got to mix it up.  Thanks to teaching for the other program, I got to assist in a few surgeries.  Assisting at my level is similar to assisting as a med student.  I retract.  I move the uterus around on a stick.  I suction a bit.  I cut sutures.  I clean up the patient when we are done.

Scrubbing in frightens me.  I lack hand eye coordination that is required to avoid contaminating myself or something else, so although I am fine now, I have been known to walk into undraped limbs or touch things I shouldn’t.  When I scrub, I remember those times.  Also, I am slow at suturing and such, so I am always nervous about looking stunned (even though some might argue I am supposed to be stunned because I am a first year resident).

I swear this has pretty much happened to me. Image via ddxcomics.com.

The awesome part is that you actually get to see stuff and feel stuff and although you get grilled more because you can see and feel (and they remember you are there), you also get to do something and keep a bit warmer.  It is a fabulous place to learn anatomy and about how diseases work.  A tiny piece of me likes it.

I nearly stroked out today though when I was told to assist kind of first assist style with opening the patient today.  Really, the staff was two feet away and helped me, but I did actually use the cautery (first time ever) and cut through the abdominal wall.  And helped with the procedure more than I normally would when I scrub in with an attending and a senior resident.  I was relieved when someone better at that stuff took over, but for a bit, I was kind of being surgical.  Kind of.

Being able to do that stuff is cool.  I can see the appeal.  I still don’t want to do that for the rest of my life.  Or do it very often.  But, it was cool.

Tomorrow, I am back to the freezing and hovering.  But, the first case will at least be on the screens again.  Thank goodness.  Apparently, I will be assisting more next week.  I have mixed feelings about that.  But, I am glad to be learning.  And while I am scrubbed in, I am glad we don’t have viewing theatres like on Grey’s Anatomy to see me look “special.”

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2 thoughts on “Ducking, weaving, shivering and not looking like an idiot… The OR.

  1. I have to go to OR for some dialysis procedures, and the first time I was shocked over how casual it was. I mean, the radio was on and people were joking around! It shook my notions of serious OR. Of course, when things aren’t so happy, I have seen the you know what hit the fan. I am fascinated at how the OR staff can have viscious fights with their eyes only. I have seen foes vanquished, and have hung back in embarrassment. Who knew eyes could say so much?

    • It is true. It can be a remarkably casual and fun place… Or terrifying. It is totally dependent on the people you are in with and what is happening.
      I found it surprising the first time I went in too.

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