The OR clinical day has been one of my favorite experiences thus far. I thoroughly enjoyed each phase from the “Preoperative Phase” to the “PACU Phase”. At first, I was very nervous about everything but, when I got used to how things worked, I really got into it. I learned a lot of useful information throughout the day and in this paper, I will discuss each portion.
During the “Preoperative Phase” I learned that our patient “TL” was scheduled to have a “right wrist scope & lunate chondroplasty”. A right wrist scope has 5-7 small incisions for insertion tools and the lunate chondroplasty is used for debridement (Wagner, Ipaktchi, Livermore, & Banegas, 2014). My first interaction with this patient was very positive. He was completely fine with
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The scrub tech and nurse retrieved the surgical tools and prepared the room for the surgery. The patient was given medication to relax him on the way back by the anesthesiologist. Everyone in the room greeted “TL” in a very friendly way and transferred him to the operating table. His legs were strapped down so that he didn’t fall at any point. The nurse checked the ID bracelet and the site marked for surgery. He asked the patient what type of surgery he was having, his name, DOB, and that the site was marked to validate that it was the correct patient. He documented this, the medications given, and supplies used throughout the procedure while it was being used or after. The “Universal Protocol/Time-Out process” was done immediately after the surgeon arrived and was ready for the patient to be sedated. This process helps prevent mistakes like the wrong site, person, or procedure (Pellegrini, 2017). Right before everything begins, the check this information with their records, the surgeon, and the patient. The OR team worked together to prepare the surgery, ensure everything was correct, assist during the procedure, immediately after the surgery, and maintain patient safety. The patient was then given the anesthesia and his site was prepped. I thought that the patient was treated very well during the surgery and I could only hope that all teams work this well
The patient will be asked to remove clothing and will be given a gown to
Pre-Op begins momentarily, where the patient meets with nurses, surgical technicians, Dr. Todd, and the anesthesiologist to discuss the operation and go over any new concerns or questions the patient may have. They will be hooked up to an IV where the anesthesiologist with administer the local anesthesia before Dr. Todd begins to operate.
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
A patient, waiting to undergo his cardiac surgery, is lying on a surgical platform. An
Over the last few years, I shadowed a Primary Care Adult Nurse Practitioner whose office is located in the underserved urban area of Irvington, NJ. She also takes care of patients from the surrounding areas of Irvington, Newark, and East Orange, all of which have very large underserved populations including African Americans, Latinos, and patients from the Middle East. During my clinical shadowing, I gained a appreciation for the complexity of treating long term chronic conditions such as asthma, diabetes, HIV, and hypertension. In many cases these conditions were exacerbated due to poor nutrition, non-compliance, and lack of education about healthy lifestyle choices. I gained a keen understanding of the importance of patient education and the ability to connect patients with community services to help them with their economic and social challenges.
AHC Media LLC. (2008, August). Joint commission revises universal protocol, clarifies who marks site. Same-Day Surgery, 32(8), 81-85.
I noticed that Mr. X was still on normal saline 0.9% on flow, and his report from this morning showed sodium at the higher end. Since increased sodium post operative would have an impact on his blood pressure and urine output. So, I stopped the flow and informed his doctor about the fluid and discussed if we could switch it with any other fluid. He then, said to keep it in hold, and he would decide when he comes for the round by checking at his total intake output chart and his lab values if to continue or to stop. I followed his order and explained to the patient. Since, it was day 3 (usually in the day, three patients would be mobilized on a chair) so I explained to him that he would be ambulated out of bed today to make him aware of the plan and to give him time to prepare him for the upcoming plan. As first-time mobilization could be stressful for the patient and some needs more time to get themselves ready for it. I explained him that it would be done with the doctor around. As i left the patient, I made sure to keep the nurses call bell near and told him that I would be back to check on
Everyday life in a hospital is complete and absolute chaos. There are doctors and nurses running everywhere to treat patients, ambulances coming through every so often, children and patients crying, and surgeons telling a family that their loved one did not make it. However, outside of all that craziness is an operating room (OR). A place filled with pressure, intensity, high hopes, and stress. There to help control the environment is a surgical technologist. While preparing patients for surgery, surgical technologists manage the equipment and operating room, follow the instructions of the surgeon, and ensure the safety of the patient.
Because I provide the surgeon with medications, hemostatic agents and irrigation solutions it is crucial to know the proper usage of each, along with the side effects, patient's allergies, and contradictions of certain medications and their reactive
Dr. Tagge, the lead surgeon, finally updated the family over two and a half hours later stating that Lewis did well even though he had to reposition the metal bar four times for correct placement (Kumar, 2008; Monk, 2002). Helen reported wondering if Dr. Tagge had realized how much Lewis’ chest depression had deepened since he last saw him a year ago in the office, especially considering he did not lay eyes on Lewis until he was under anesthesia the day of surgery (Kumar, 2008). In the recovery room, Lewis was conscious and alert with good vital signs, listing his pain as a three out of ten (Monk, 2002). Nurses and doctors in the recovery area charted that he had not produced any urine in his catheter despite intravenous hydration (Kumar, 2008; Monk, 2002). Epidural opioid analgesia was administered post-operatively for pain control, but was supplemented every six hours by intravenous Toradol (Ketorolac) (Kumar, 2008; Solidline Media,
On my hospital bed, I sit and stretch out my arms to relieve some nervous tension. My room is nothing but dull grey walls and the smell of disinfectant. My ears perk up as I listen to doctors and nurses conversing outside. Their voices grow louder and louder as I hear their feet coming closer to my door. I crane my neck towards sounds, only to spot the brass knob of my door turning. My heart begins to race and my breathing becomes shallower. I quickly pull out a pocketknife from under my pillow and slip it into my pants pocket. Stealthily, I roll out of bed, forgetting about the various tubes attached to my body. I wince in pain and tears well up in my eyes as they get yanked ou...
It was an exciting opportunity to watch them set up the vac, and have an opportunity to interact with the doctors. I felt good during this situation, the doctors made me feel comfortable while in the room with them, that I was able to even move in and get a better look at the wound, as well as confident to ask questions. Throughout the situation I kind of felt bad for the patient, he was definitely in some pain during the dressing change, and the doctors didn’t really address it. However they did include the patient and did not treat the patient like he wasn’t even there. Overall I felt good about this learning experience, it was a great opportunity I was glad to be a part of especially to be able to watch the doctors work. I also enjoy watching dressing changes like these to compare them to what I have been taught in my clinical lab. While I had little knowledge about the vac dressing, I did watch to see if the doctors follow all of the sterile field and sterility rules I had been
When the patient arrived in the room, the nurse identified the patient, and made sure she knew what procedure was ready to take place. He then helped the CRNA place the patient on the bed.
Time out was done by the anesthesiologist, the circulating nurse, the surgeon, and the scrub tech all pausing before the surgery and verifying the patient’s name and date of birth, the procedure being done, the site and location on the body in which the procedure was being done, and documented the count of all the equipment the scrub nurse had before surgery to compare to after surgery. 5. The patient’s privacy was protected and respected throughout the whole surgical procedure. The staff was very professional and I felt I learned a lot from them during my OR experience. 6. A sponge count is when the scrub nurse counts the sponges that are unused before the surgery she relays this to the circulating nurse and it is documented. After the surgery the count is redone to make sure that there are no sponges left in the patient. 7. The circulating nurse documents the information and signs the chart in the operating room. From pre-op to the operating room the nurses in pre-op gave off report to the circulating nurse by SBAR. From the operating room to PACU the anesthesiologist went with the patient and handed off the patient’s condition and information to the nurse in there. 8. There were no ethical or legal issues that were raised during my observation in the whole surgical process. 9. I learned how the whole operating procedure works from start to finish, all the legal paperwork involved, and how the team interacts and helps each other out to give the patient a safe and
For so many years I’ve asked myself the question, “what are you going to do with your life?” For a period of time I struggled with this question. Today, I sit staring at my computer, confronting myself, asking my subconscious “what do I want to do for the rest of my life?” Have I finally found the answer I 've been looking for, or am I under the false assumption that this is the right path for me. This semester has been the ultimate opportunity to explore my questions, doubt, issues, and concerns. I feel that by the end of this paper I will have answered all these questions, and will have made the best decision for my future.