what I did on my tuesday
Yesterday was one for the ages. We did 6 operations but only 5 were successful.
Had a Code Blue/All Hands on Deck/Cardiac Arrest arrive a lunchtime.
It's a weird time to be in an operating theatre, because this is one of the few times you will ever see a theatre at top 100% speed outside of a warzone or after a natural disaster. Cases like this are rare even for where I work and our operating department covers major 24/7 trauma surgery as well as elective cases.
Imagine if you can the alarm going off, and in the staff room - where I was having lunch - i didn't even hear it at first because of my ipod and then people were sitting talking and muttering "what's that alarm for?" it happens so rare that many of the new staff aren't familiar with the sound. And there's no flashing light system to tell anyone which theatre the emergency's happening. We just have to follow the people.
When I rushed back into theatre with half a bagel in my mouth we had the ITU nurse pounding on the patient's chest, the anesthetist and her crew checking bloods and SATS, the surgeons cutting into the patient's abdomen, the scrubber frantically trying to hand equipment to the surgeons and toss out lines to her running crew and the running crew (incl me) doing figures of eight around each other connecting lines, flinging out power pedals and going over and over in our own heads anything we might need and if we had it to hand.
Then we stopped.
And things got very quiet.
And slow. Like we were all sleep-walking in our jobs. Equipment got cleaned down, soiled linen got taken away, rubbish bags emptied, the ITU guys returned whence they came, and in the end it was two scrub nurses and the anesthetic nurse just tidying up around the place.
After we transferred the patient to the trolley so the family could come and see them, and then after that we had to go and dress and call the porters to take them to the morgue.
And you know that it's rare we do such things as there is a whole step-by-step list of things to do before you call the porters.
It's very weird, many of my colleagues are religious, majority catholic from the Philippines or India and they each had their own opinion on the subject of the afterlife. But also some of the English atheist nurses agree with proper respect when performing Last Offices (as it's known officially in the NHS) and we all had chance to talk about such events during and after the task in hand.
Then we ordered the next patient and the world continued as normal. In the "olden days" we used to close the theatre for the day on account of bad luck for forthcoming operations but now we have to carry on.
But it did make me think that many of the people in the NHS myself included forget that we are involved in a profession where people can DIE. And with the exception of a warzone it's almost the sole exception of that situation in 21st Century (Great) Britain. We personally forget it. We have to; you can't pull someone's guts out and fix them if you're thinking that the person you're doing it too might die. That is why surgeons and crew drape everything within an inch of its life; it's not a patient, it's a leg or an arm or a stomach. We have to disconnect the personal otherwise the mental strain can be tremendous. This is also why you are never allowed to operate on family or close friends (like my friend a few weeks ago), it causes too much distress.
How in the US people can actually WATCH surgery from a viewing gallery is amazing. I don't know I could do that if given the option.
But anyway, that was my day.
Had a Code Blue/All Hands on Deck/Cardiac Arrest arrive a lunchtime.
It's a weird time to be in an operating theatre, because this is one of the few times you will ever see a theatre at top 100% speed outside of a warzone or after a natural disaster. Cases like this are rare even for where I work and our operating department covers major 24/7 trauma surgery as well as elective cases.
Imagine if you can the alarm going off, and in the staff room - where I was having lunch - i didn't even hear it at first because of my ipod and then people were sitting talking and muttering "what's that alarm for?" it happens so rare that many of the new staff aren't familiar with the sound. And there's no flashing light system to tell anyone which theatre the emergency's happening. We just have to follow the people.
When I rushed back into theatre with half a bagel in my mouth we had the ITU nurse pounding on the patient's chest, the anesthetist and her crew checking bloods and SATS, the surgeons cutting into the patient's abdomen, the scrubber frantically trying to hand equipment to the surgeons and toss out lines to her running crew and the running crew (incl me) doing figures of eight around each other connecting lines, flinging out power pedals and going over and over in our own heads anything we might need and if we had it to hand.
Then we stopped.
And things got very quiet.
And slow. Like we were all sleep-walking in our jobs. Equipment got cleaned down, soiled linen got taken away, rubbish bags emptied, the ITU guys returned whence they came, and in the end it was two scrub nurses and the anesthetic nurse just tidying up around the place.
After we transferred the patient to the trolley so the family could come and see them, and then after that we had to go and dress and call the porters to take them to the morgue.
And you know that it's rare we do such things as there is a whole step-by-step list of things to do before you call the porters.
It's very weird, many of my colleagues are religious, majority catholic from the Philippines or India and they each had their own opinion on the subject of the afterlife. But also some of the English atheist nurses agree with proper respect when performing Last Offices (as it's known officially in the NHS) and we all had chance to talk about such events during and after the task in hand.
Then we ordered the next patient and the world continued as normal. In the "olden days" we used to close the theatre for the day on account of bad luck for forthcoming operations but now we have to carry on.
But it did make me think that many of the people in the NHS myself included forget that we are involved in a profession where people can DIE. And with the exception of a warzone it's almost the sole exception of that situation in 21st Century (Great) Britain. We personally forget it. We have to; you can't pull someone's guts out and fix them if you're thinking that the person you're doing it too might die. That is why surgeons and crew drape everything within an inch of its life; it's not a patient, it's a leg or an arm or a stomach. We have to disconnect the personal otherwise the mental strain can be tremendous. This is also why you are never allowed to operate on family or close friends (like my friend a few weeks ago), it causes too much distress.
How in the US people can actually WATCH surgery from a viewing gallery is amazing. I don't know I could do that if given the option.
But anyway, that was my day.