A story of some mistake they made from which they learned something that they will never forget…..let’s face it, things happen. We are all human and bound for error at one point or another. To err as an OR nurse is NEVER intentional and the lessons learned are meant to be shared and never forgotten. I long for the confidance that only experience will give me, and slowly I am gaining little bits of confidance every day.
The experiences I have had in the 10 months that I have been in training have been nothing short of amazing. Every day is a new adventure and it will be that way for me for a very long time. Slowly, pieces are coming together and I am having “A ha” moments more often now as I see more and do more on a daily basis.
The tried and true Girl Scout adage “Be prepared” could not be more appropriate as an OR nurse. But sometimes, it doesn’t matter how prepared you think you are, or how much you know, there will always be a challenge…. The OR is obviously a whole new world for me, and every day I am learning something new. Even if I have seen or done a case before, every rerun teaches me something else, or I remember something else, or better yet – I actually anticipate the need before it arises !!!! That is the most satisfying “A Ha” moment…. knowing what the surgeon needs before he has to ask. Which leads me to one of my biggest challenges…. (names have been changed to protect the not so innocent)
Let me start by saying that I have been teaching young interns and residents for many years…. it’s pay back time !! I get the frustration of working with some one who is inexperienced. I get the irritation of having to wait for something. I completely understand the gravity of a situation, and believe me, I am experienced enough to know when I should step back and let my expert preceptor step in. But give me a break…I can do this, just let me show you.
Stage left, Dr “Let’s make this as complicated as possible.” Dr LMTACAP is a good physician and a skilled surgeon. He is very passionate about his patients and does wind up with some of the most compromised patients imaginable. But he can turn a simple toe amp in to what looks like open heart surgery by virtue of the instrumentation and/or equipment that he requests…. And he frequently changes his mind and is sometimes inconsistent in his approach. This is all very frustrating for a scrub nurse in training. Throw in sarcasm and at times, obvious impatience, well, it is not a recipe for success. May I also add that he has his own names for instruments and things which, in a world where one instrument can go by 3 or 4 different names, just serves to be that much more confusing. In addition, I can truthfully say that, after one case in particular with him, I questioned my decision to become an OR nurse and wondered just what had I gotten myself into for the long haul. Not to say that he is the most difficult personality, there are MUCH worse – but I was thinking, if I cannot handle him, what am I doing in the OR ??? I spent a whole weekend agonizing after that bad day with him and was reduced to tears… But then the rational me showed up and I thought through the case and realized that this is part of my learning curve and I needed to figure out how to deal with the Dr LMTACAP’s that I will encounter in the rest of my journey.
I actually like Dr LMTACAP and can truly appreciate his sarcasm. He does come off a little rough though and is at times misinterpreted. That being said… if he could just be a little more consistent, his life might be easier too. After that particularly bad day with him, I actually wanted to avoid scrubbing with him but realized that is not the answer to the situation. I have been fortunate enough to work with some truly wonderful preceptors, and with their support have gained a lot of confidance in my ability to scrub, even with Dr LMTACAP.
So yesterday, I scrubbed with Dr LMTACAP but the difference was, I was prepared. I tossed and turned the night before, I agonized over the speed at which I knew I needed to perform. But the day before my assignment to scrub in two cases with Dr LMTACAP I received wonderful tips from the two experts on the vascular service and I wrote everything down and practically memorized it in order to prepare myself for all the possibilities. I launched in to my day with every ounce of determination to succeed. The first case went down really very well and much smoother than any one of us in the room could have anticipated. It was technically fairly simple, but could have easily taken a turn – or Dr LMTACAP could have careened off in to a wild detour and turned it in to an all day event. That did not happen. I think he even surprised himself. Dr LMTACAP was also in a good mood and not too annoyed by things that usually would cause a running sarcastic commentary.
The second case of the day was big – a carotid endarderectomy – somewhat complicated and very delicate ! ( simply put – cleaning out the carotid artery ) YOU DON’T WANT TO MAKE ANY MISTAKES IN THIS CASE – stroke, hemorrhage to name just a couple of things that could go wrong. Me nervous ?????? Yes, I was but not a panic nervous – a healthy kind of nervous because I knew I needed to be at the top of my game. I was prepared. I had plenty of time to set up my back table and get everything organized. I had everything I needed and a few more things that I probably didn’t, but they were all within an arm’s reach in the event Dr LMTACAP made a request (demand). I owned this case and I was going to prove that I could not only keep up, but stay ahead. AND I DID !!!! My preceptor stood gowned and gloved behind my table, ready to step in if I needed help – but I managed. I panicked only slightly when some one came in to relieve us for lunch… I didn’t want to step out for lunch. I needed to be in this case from start to finish. I did not know the nurse who relieved my preceptor, but my preceptor told her that I was doing fine and the relief nurse said she had worked with Dr LMTACAP before – my panic subsided. So not only did I keep up, but I anticipated the needs before the requests. I knew what I needed to have ready, and I was able to switch gears when there was a little trouble. I faltered but once trying to load a tiny little prolene suture on a castro needle holder – it may have been because Dr LMTACAP asked for it no less than 3 times breathing down my neck – and I have practiced with these types of needle holders at home with tons of expired prolene – every castro feels different and some are more cooperative than others. I did ask my preceptor once to load the needle but I managed every other time thereafter….. I DID IT !!!! At the end of the case Dr LMTACAP actually told me that I did a good job…. I nearly dropped all the instruments. My preceptor and I high fived and fist bumped.
I felt tremendous relief and I can tell you that I was so completely exhausted at the end of my day…. it was a victory for me.