Shocked at Surgery

  1. I'm a freshman nursing student in an ADN program and yesterday I had the opportunity to observe in OR for the whole day. It was very cool, but I came home with my eyes wide open, I tell ya. It is really 'just a job' - not in a bad sense, but more like, "yes, I'm going to work now and there I may have to change some people's lives forever, but if I think about it, I probably will not do it, so I'm going to work now."

    I'm left with a few items that need clarification, I'm hoping some of the more experienced nurses out there can help out. I want to emphasize, I am NOT making judgments, but in my naive state of never having observed surgery before, I just need to know these things:

    #1: Are surgeons never gentle? I observed 5 different surgeries, everything from a T/A on a 5yo to a urethrotomy on a 60yo, with 4 different surgeons; none of the surgeons were what I would call gentle. Pulling, tearing, slashing, forcing through resistance - that's what I observed.

    #2: Is it common for a surgeon to staple a drape onto a patient? I mean, stapling.the.cloth.into.a.patient. (On an 18yo's butt, to be exact)

    #3: how bad does something have to be before the pt is told? In one surgery, the surgeon cut into a vein by mistake; will the doc tell the pt this? Will there be note made of things like this? In the urethrotomy, the doc forced the instruments hard enough that when he finally put the camera in, he found he had created a "false passage" - I do not know if this will be a LT problem, he didn't seem to be too upset, but will the pt know this? I just know that I would want to know that kind of thing.

    Ok, again, I am NOT making judgments, maybe this is a common reaction to observing surgery for the first time, but it definitely makes me re-think any and all surgery I (or my loved ones) may ever opt for in the future!

    Thanks everyone ---
    Karen
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  2. 30 Comments

  3. by   MarySunshine
    Karen,
    I've only observed a couple of surgeries as well so I can't answer your question, but I wanted to say that I had a similar reaction to you when I went to the OR. Also, the staff was very loud and vulgar and making fun of one of the patient's weight. I'm sure a lot of OR nurses would never do that but I was really upset that day. I think that surgery, in and of itself, probably couldn't appear "gentle" to us anyway but I bet they're not helping with the post-op pain control issues when they are being unneccessarily rough.
  4. by   TazziRN
    Surgery is NOT a gentle thing......one reason why pts are put to sleep for it. It can be brutal, but sometimes brutality is the only way to fix the problem. As for the mistakes made, if the doc has any scruples he will say something.
  5. by   marilynmom
    I observed surgery for the first time last semester and it was an eye opener for me as well.

    One of the patients was like 5'7' and weighed 130 pounds, the surgeon commented that she needed to lose about 30 pounds! I was like from where?! It was very vulgar and the nurses were talking on their cell phones the whole time, giggling, etc.
  6. by   2008nurse2b
    I can say for myself that I woke up during surgery, just a little appendectomy and they were talking about my breast, which are not small by any means, but I heard what they were saying.
  7. by   LogCabinMom
    Yup - we've been told in class to watch what you say when pt are under anasthesia - but from my observation yesterday it seemed that once the person was under, it was a piece of meat they were handling. Very impersonal.
    Which may be the way they can actually do the work, I guess.
  8. by   bigdogu
    Unfortunately it sounds like you had a very disenchanting experience. Which is really to bad, because surgery can be very enlightening and rewarding. I have to say while most of us do try and have fun while we work, anyone can go overboard. Surgery is not a delicate thing, it takes muscle and strength to go through muscle and bone. From the viewers perspective it can be very rough looking. Just remember that the outcome is the most important. As far as the behaviours it is unfortunate that you ended up viewing some very unprofessional sounding people. The Or is a different enviroment and can be very stressfull, this can result in people acting out sometimes inappropriately. What I can tell you is try it again, maybe at a different facility and see what happens. Just like every other nursing venue it may not be your cup of tea. good luck

    bigdogu
    MSN ACNP BC RNFA
  9. by   LogCabinMom
    No, I wouldn't say it was "disenchanting" - just eye-opening. It would not make me say no to a surgical job, but it would make me be an RN who kept my eyes open and mouth shut (about anything inappropriate) when a pt was put under...
  10. by   SuesquatchRN
    Heh. I remember seeing my first surgery - a shoulder replacement. The surgeon was trying to disarticulate that joint like me shaking a chicken I was deboning.

    All I could think was, "Wow. We're meat."

    I think you have to depersonalize the patient or you can't cut them up, y'know?

    I loved it, BTW. My classmate, during a hysterectomy, was turning green and getting faint whereas I was trying to get the good spot to see.
  11. by   Antikigirl
    I saw two in RN school, a shoulder reconstruction and a c-section...both had my eyes open wide! The shoulder of course dealt with bone...can't be gentle with that...ohhhh I cringed at the sounds a few times, but it was done mainly via a scope so it was pretty cool, and not a lot of blood loss either which was a shock to me!

    The C-section was cut and dry so to speak..but the thing that got me is how far the doc went into the pt to get the baby out...it was like his whole upper half was in her...and volia...baby (like the magicians hat trick!). I found it to be kinda fun!

    Both surgeries I didn't hear too many people speak at all...mostly just about the surgery and what people needed and other sugical communication needed. They did play music though, which was cool.

    Now that I am in med surge ortho again, I have asked to see a spinal surgery and a hip or knee so I can become familiar again with the 'before the floor' happenings to my patients. Be kinda nice to know what happened under all those dressings and staples...
  12. by   CIRQL8
    i'm going to state my opinions one question at a time: i'm doing the cut and paste thing, not the quote thing! and, excuse my spelling and typing, please.

    #1: are surgeons never gentle? i observed 5 different surgeries, everything from a t/a on a 5yo to a urethrotomy on a 60yo, with 4 different surgeons; none of the surgeons were what i would call gentle. pulling, tearing, slashing, forcing through resistance - that's what i observed.
    as other shave mentione, surgery is hardly every gentle. it is all about exposure and the end-result. thank goodness for anesthesia and narcotic pain control. much tissue is not easy to get throught. just wait until you see laparoscopic surgery. placing the trocars are barbarick. and laparoscopic surgery has a faster healing time!

    #2: is it common for a surgeon to staple a drape onto a patient? i mean, stapling.the.cloth.into.a.patient.

    i see it all the time. i do not know where the process of squaring off the area (with towels before draping) started, but they are many times staples, and the drapes, too. especially if it is high risk that the drapes may drop.

    #3: how bad does something have to be before the pt is told? in one surgery, the surgeon cut into a vein by mistake; will the doc tell the pt this? will there be note made of things like this? in the urethrotomy, the doc forced the instruments hard enough that when he finally put the camera in, he found he had created a "false passage" - i do not know if this will be a lt problem, he didn't seem to be too upset, but will the pt know this? i just know that i would want to know that kind of thing.
    i would hope that the surgeon would tell the patient/family most everything. but, if a vein is cut, and there is minimal blood loss and little risk for post op bleed, why worry the family? as long as it is documented appropriately in the dicatation, and the surgeon does not mislead the family... veins are cut all the time - mostly because there are veins everywhere and you cannot avoid them all. if it is a major breack (like the vena cava - yea, they should be told!!
    as far as the false passage - it may have been there before... i don;t know. but the patient should be told about that one, i would think.

    well - i gotta go - maybe i'll have time later to type more...


  13. by   CIRQL8
    Quote from MarySunshine
    Karen,
    I've only observed a couple of surgeries as well so I can't answer your question, but I wanted to say that I had a similar reaction to you when I went to the OR. Also, the staff was very loud and vulgar and making fun of one of the patient's weight. I'm sure a lot of OR nurses would never do that but I was really upset that day. I think that surgery, in and of itself, probably couldn't appear "gentle" to us anyway but I bet they're not helping with the post-op pain control issues when they are being unneccessarily rough.
    I'm not going to say that it's right - but the OR can (and does) get loud and vulgar. Perhaps not a very good excuse, but the OR is a high stress situation, and when we can we try to vent, and deal with different situations as best as we can. A dirty joke. An off-colored comment (hopefully not about the patient). Discussing personal life. Talk about clinic. Whatever it takes. Keep in mind - every surgeon, every nurse, every procedure (even w/ same staff) is different. When the time comes, full attention is placed on the patient and the task at hand. Most (80-90%) of what I see, is discussion about the procedure. Options, outcomes, etc.

    However, I and everyone (nurses, techs, surgeons) that I have worked with always treat the patient with respect and dignity.
  14. by   Nani1234
    It sounds as if you needed to see or care for one of the patients before and after their operation. Students and new grads need to see what is involved in the entire surgical process to help understand and improve the post-operative skills they use in the future. Medical personnel can seem crass and uncaring with a bizarre sense of humor. You will develop similar coping skills and hopefully they will be "seen" by your first orientee as appropriate and acceptable.

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