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I’ve only caught bits and clips of this guy’s show, but I tripped over a link to this video and have a lot of respect for the guy now. If it’s a marketing ploy, he’s got me fooled. I’ve been around my share of alcoholics, and can appreciate much of what he touches on.

Lego Operating Room

I’m only a nursing student. I don’t have years of nursing experience to draw on. I have two days of OR observation behind me.

I’m curious though, why nurses are in the operating room. I understand why maybe they should be there, but I didn’t actually see anything that couldn’t be done by another person in my two days of observation.

As I understand and believe, an RN is there for patient care, and as a patient advocate. Seems like an unconscious person should have someone thinking about their care and what’s being done to them. In practice, I saw the only RN in the room running errands and doing administrative stuff that could likely be done by an LVN/LPN without a difference to the patient experience.

Even if something were to go wrong during the procedure, there’s a surgeon (or 3), an anesthesiologist (or 2), as well as an OR/Med Tech available for handling the situation. What might the nurse contribute that isn’t readily available in those other people’s repertoires?

I must be missing something, and would love to hear feedback on what it is. I have nothing against nurses being there, I just didn’t see evidence of why it would be necessary.

Help?

Change of Shift banner

Airway Control at Protect the Airway is my bestest friend ever. My submission made Change of Shift!

The nursing program I’m in includes two days of OR rotation. It’s not a ton of time, but I had my first day today. Lots of standing and trying not to lean on anything or get in the way or trip or knock anything over….

With all that time to be quiet, I was able to compile a list for the other students to put them on the fast track in the OR rotation.

1. Keep hydrated. Drink lots. Probably some of it shouldn’t be alcoholic in nature.

2. Wear a diaper. This will keep you from having to leave the OR from all the liquid you drank. Alternately, you could wear a Foley catheter, but that brings up questions about where to hang the bag, and people might ask why your purse is sloshing.

3. The area is a literal maze, so you should plan to use string or something that you tie-off from the lounge area and unroll as you walk, so you can find your way back. Probably this will cause some consternation from the other people, but point out that you’re a student, and it’s really for everyone’s safety.

4. Bring a pad of paper and something to write with. There may be questions that you think of, or perhaps you need to leave a note for your family if someone cuts the string and you end up huddled in a corner unable to find food or the way out.

5. Try to wear stilts under your scrubs, and don’t forget to walk nonchalantly. Nod and smile if people look at you funny. This will greatly enhance your ability to see over everyone in the OR.

6. Practice the phrase “I’m not sterile” to help in avoiding any type of work whatsoever. If you’re asked to move a light, pass an instrument, whatever. You can even use it before your OR time. It works for getting out of doing the dishes, as well as changing a flat tire.

7. There will be lots of medical jargon thrown around. Don’t let it get to you. If something is said and you’re unclear, never admit it. Start speaking another language, if at all possible. Make one up on the spot if you need to. You can even resort to a distractor like “Does anyone else smell smoke?”

8. To fit in with the rest of the people working there, you should take every opportunity to judge or make disparaging comments about the patients. Make a point to mention weight or bodily defects (real or imagined).

Crying baby

John over at DisappearingJohn brings up an interesting point regarding getting “attached” to patients. It’s something I’ve thought of periodically, as I know it’s going to be something I have to wrestle with.

I typically “click” with at least one patient per shift, and have gotten a lot of feedback from patients and their families that I help them feel better cared for.

Given that I used to watch Schwarzenegger, Kung-Fu, and Western movies like most teenagers in my youth, it was an odd switch that seemed to coincide with having kids. Suddenly diaper commercials had deeper meaning, and images of starving children that Sally Struthers was personally tasting food for had me on the verge of tears. Most chick flicks will cause the dust in the room to suddenly swarm near my face, causing my eyes to start swelling up and leak.

I had an experience earlier in the week with a patient that made a rapid turn for the worst, but didn’t actually die. I had only been around the patient for about 10 minutes, so hadn’t developed much of a bond. I expect by the time I finish school I’ll have to deal with a patient closer to me dying, though.

“Laser Vasectomy”

That little drawing by Dave Farley seems to sum up what every guy is afraid of when the “V” word comes up.

We’re living in the information age. Yet for most men, vasectomy = castration. Why is this? I’ve tried explaining to friends and anyone who asks about the procedure. How could this possibly come up in casual conversation, you might ask. It does. And I answer truthfully, much to the horror of most people not really wanting an answer. I even posted about my vasectomy back when it was done:

My vasectomy

It started out well. I was ushered into a small room with a padded table to get “undressed below the waist” and put the smock on “with the opening in the back”.

I did those things, and remained standing since I didn’t know protocol for sitting on furniture while wearing a smock with the opening in the back.

The nurse returned to have me sit on the table so she could ground me. This consisted of a large sticky pad applied to my hip (through the back of the smock since there was a handy opening there). When I asked why this was necessary, she told me it was required to allow the cauterization, which was done with electricity, so I needed to be grounded. Whatever — I write software.

After her departure I was alone only long enough to start worrying about having to pee soon. I had just gone, but my bladder was sending warning signals that it was filling up.

The Doctor arrived and got right to business. He had me lay back and started opening containers and tried to scare me by banging instruments on a rolling tray.

On looking back, it probably wasn’t the wisest thing I ever did, but I asked him about his schedule and if he was felling rushed. I tried to phrase it in very general terms since I had no reason to try to hurry things along. My day was pretty open.

I’m not sure I properly communicated my curiosity about a lifestyle constantly plagued by tardiness as opposed to upset at being slightly delayed for a non-critical procedure. He seemed a bit defensive of his lateness, explaining the need to perform an unforeseen procedure on an emergency basis.

During this discussion the Dr had lifted my smock, and continued to prep me. This consisted of grabbing my scrotum in one hand, massaging like a caffeine filled day-trader with a stress toy. He explained this was to “arrange things better” and then used both hands to manipulate and scoot testicles to some ideal arrangement that god and managed to miss in his infinite wisdom.

This surreal conversation continued with his interjected “this will be cold” (while slathering iodine from thighs to waist). At one point he even interrupted himself to say “little prick here”. I opened my mouth to defend the now red-colored cold and frightened turtle nestled in my crotch when I realized he was going to use a syringe.

I haven’t had a ton of experience with Novocaine, but I should have recalled dentists having difficulty achieving the proper numbness in my jaw.

Imagine my surprise to find my resistance to this anesthetic extends to all parts of my anatomy.

The Dr was very quick to apply liberal amounts once it became clear the initial injection wasn’t working. He completed the procedure with no loss of life or limb.

Overall, the time spent on my back was under 10 minutes. I could even watch to an extent, thanks to a reflection in the overhead surgical light.

Swelling and bruising are at a minimum, and everything seems to be progressing nicely.

That was several years back, and I’ve never regretted it. Explaining the difference between a few minutes of relatively minor discomfort to the alternative needed for a woman to be similarly “fixed” seems an exercise in futility though. Most men shrug off the prospect of major abdominal surgery for their significant other (SO) as part and parcel of being the one able to produce offspring.

For all you males out there, consider that a woman can need hormone therapy to correct the imbalance after the surgery, along with healing the not trivial incisions into her abdomen. And for us, it’s a long weekend lounging on the couch with a bag of frozen peas keeping our boys chilled.

Your SO will thank you for taking one for the team. Heck, you might even be able to wrangle a “therapeutic massage” into the deal because of your incredible altruism.

So, if faced with the “what now” question and you’re done with having or trying to have kids via your own plumbing, do the easy thing and rent some westerns and spend a couple days on the couch.