Sunday, March 18, 2012

Surgery

One of our assignments is to do a "full admission" assignment. This is where we follow a patient throughout the entire surgery process: from beginning to end.

I got to do mine on February 29th.
It was a patient getting a port placement. For those of you that don't know what that is:
a port is basically a semi permanent IV access site. It is a small round disc that is connected to a small tube or catheter. The tube goes directly to the heart and the disc is placed under the skin in the chest, usually right below the collar bone. The port can be felt under the skin. When the port is "accessed" that means it has a needle into it and medicine can be given and blood can be drawn. Ports are usually placed for patients that go through a lot of treatments. Cancer patients almost always get a port. It is common with other diagnoses as well, but most commonly, cancer. Anyway, they go into surgery to get this placed. It can last for years and years. But eventually, it can be removed when it is no longer needed.

The benefits of having a port vs an IV or a PICC line or whatever is you can bathe, swim, do pretty much anything and you don't have to do dressing changes or get it replaced. With other lines, you can't get them wet or anything, so showering is difficult, you can't swim and forget sports.

Anyway, that is what a port is.

This kid had to get one and I got to watch.
I started out meeting them the night before and the family was so so sweet. I showed up at the hospital at 6:30am and donned my ugly green surgical scrubs and pocketed my surgical mask, shoe covers and head covering thing.
It turns out that surgical people don't wait on anyone because while I was waiting for the family to wake up and get around (I was 10 feet away from the door, around the corner) they left me. They came and got the patient and I totally missed it. I started getting worried because it was almost time for their scheduled surgery. I finally bucked up and walked in the room. They were gone. DANGIT!!!

I ran down to surgery just in time. They were 1 minute away from taking him back into the OR. I was pissed! The nurses knew where I was and that I was there to observe the surgery. Whatever.

We got back there, I stood in the corner like a dweeb trying to stay out of the way. At one point the nurse asked me to go help the doctors tie their gowns!! I had no idea what I was doing. Those gowns are confusing and everything is sterile. I kept replaying what my supervisor had told me: "Don't touch ANYTHING that is blue." (because that means it is sterile and you are not sterile.) Wellllll the gown was blue... I was terrified that I was going to contaminate something. It turns out the nurses had to walk me through the procedure. Well when it came to the second doctor, I was feeling a little more confident. She handed me some string with a piece of paper and told me to hold onto the piece of paper. When I did, she spun around and all the nurses started clapping and saying, "yay! you did it." and I got excited, so I let go. That wasn't the correct thing to do. I was supposed to keep a hold of the paper until it fell of, then tie the gown. I felt like an idiot. Everyone was laughing at me. Haha, needless to say, I went back to my corner.
During the surgery, I couldn't see a whole lot, but I kept reminding myself that I wasn't there to see the actual surgery, but to observe the surgical experience, ie. the surroundings, the environment, the sounds, the smell, etc.
After the surgery, I went into recovery with the patient. He did really well. One of his biggest fears was crying when he woke up. He didn't. He woke up and started talking, not a tear.
It was a really cool experience seeing that from the inside.

When I was in recovery, before my patient woke up, I was looking around at the other kids who were waking up. There was one patient, probably 18 months old or so. She was having a hard time coming out of the anesthesia and did not want to lay flat on her bed. she was fighting it, and crying. One of the care techs came over and pulled up a chair and held her for over 45 minutes. I thought he was a volunteer because the places was SLAMMED!! Every bed was full and nurses and doctors were all over the place. I just couldn't believe that he took time out of his day to hold that baby. That baby just snuggled up to this burly man and fell right to sleep. As a mother, that would be the most comforting thing, knowing that when I can't be with my baby, someone else is making it their priority to make that baby feel comforted. Gawww!

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