Dizzy during circumcision

[RavensNation]

So today in my WBN clinical rotation I was lucky enough to be able to witness a circumcision....well I got dizzy and had to walk out. I had breakfast but it was at 6am before clinical and the procedure took place at 11am. I tried to convince myself that I was ok and just started moving around a bit to get the blood flowing but eventually I said "self you better stop trying to be mrs tough girl and leave before the doc has to stop what he's doing to pick you up off the floor". So I walk out and one of the nurses saw me and insisted I sit and have some water. she knew right away why I looked the way I did, apparently I was white as a ghost according to her. So my question is, is there anything I can do to help this situation other than eating closer to the time? We aren't really allowed to have food on the floor my only Time to eat is on lunch break and before I go in. When I was in a&p we went to cadaver labs where we saw full bodies, skinned bodies, and body parts and I was ok, got a little dizzy the first time but as I got moving around I was ok from that point on. Idk why that got to me so hard, and of course 2 of my partners in clinical are surgical techs and I felt SO stupid!

[HouTx, BSN, MSN, EdD]

I had a wonderful nursing instructor who told me (after one such episode) that this was an indication of my genuine empathy for my patients. If I didn't feel a connection, it wouldn't bother me. I have passed on her wisdom over the years. It is not a weakness or an undesirable trait. It is part of being humane.

BTW, it doesn't have anything to do with eating.... puredee ol' vasovagal. In fact, a full stomach may even make it worse because it could trigger nausea along with a faint. But rest assured that you will become desensitized as time goes on. The intensity of feeling will subside along with the novelty. That's not to say that you still won't feel the gut 'squinch' when something unpleasant is happening to your patients... but you will be better able to deal with it and the vasovagal reaction will probably go away.

[casi, ASN, RN]

The circumcision I saw in nursing school got to me too. I didn't do the dizzy pass out thing, but it took a lot for me to keep the professional face on. For some people it's a hard procedure to watch, especially if you have reservations against circumcision. This doesn't mean your not cut out for this area of nursing or that you'll have the same reaction in similar situations. I can be bone deep in a bed sore, but the circumcision freaked me out.

[hiddencatRN, BSN, RN]

Well, they do at least anesthetize them now.

Sometimes :-/ The one I saw was not.

[klone, MSN, RN]

Sometimes :-/ The one I saw was not.

Well, that's just barbaric, and that doc should be reported to AAP (assuming the doc was a FAAP).

[hiddencatRN, BSN, RN]

Well, that's just barbaric, and that doc should be reported to AAP (assuming the doc was a FAAP).

It was in a huge teaching hospital known for being a baby factory. No one batted an eye so I didn't get the impression that it was an uncommon practice there. But it's not my specialty and I only saw the one so I have no clue.

[RavensNation]

Thanks guys for all of the comments, def makes me feel better about it. And I think maybe some of you are right in that it's close to my heart. I have a son who is circumcised, and needless to say if I were to have another one he would not be lol! But the same thing happened when I watched my dad get stitches in his finger lol! But I've seen other things that never bothered me...So maybe it is just an empathy thing? The baby that I watched was not given anything except sugar water! He let out a few cries initially but not during the actual cutting part, just initially when the doc clamped the skin.

I really hope I can get over this because I want to work somewhere in the OB field when I'm finished school. I always thought I wanted to do L&D but after experiencing L&D, postpartum, and WBN I think I actually like WBN and postpartum more than L&D. It's something about being there for a new mom that makes my heart feel good. I just sent in for my CNA and I'm in the process of applying for a tech position in that same hospital. My instructor gave me direct contact info for the clinical manager there. Believe it or not I got to have my clinical rotation at that hospital that originally inspired me to want to be a nurse in the first place, which is where I had both of my kids. I've loved my experience there as a student nurse and hope I get the job

[Here.I.Stand, BSN, RN]

I've only seen one so I can't say if it gets better or not...but that one is the main reason why my boys are not circumcised. I work in the SICU of a level 1 trauma center so have seen open fractures, open bellies, open stumps, a couple GSWs to the face... doesn't bother me a bit. But that circumcision, I couldn't watch. (I honestly don't think the local the ped gave him worked.) Hugs!!

[Here.I.Stand, BSN, RN]

I was a very seasoned nurse doing a thorasic angio on a trached trauma with a de-gloving injury of the face (his face was peeled back from the skeletal structure) when the Neuro trauma surgeon came in eating a apple to "explore" this patients gaping skull injury with his other gloved hand at 3 AM. Crunch on the apple as he probed the gaping forehead would.......

Ummm...that might bother me a bit. I have seen a degloving of the face, but this is painting a very disturbing picture.

[nurseprnRN, BSN, RN]

Breathe. Really- it's easy to find yourself holding your breath. In addition to allowing your CO2 to rise, when you Valsalva you decrease your venous return, which then decreases your cardiac output. What happens when your brain senses a lower cardiac output? Right, it says, "Time to lie down now." Perhaps abruptly.

Also, remember not to lock your knees. This is why new guards at Buckingham Palace occasionally keel over, because they are rigidly at attention and haven't learned to flex inconspicuously inside those baggy trousers. Venous return is also dependent on muscle action, since it is passive, rather than active like arterial flow being pushed by a sturdy ventricle. Bounce up and down on your toes, flex your ankles and knees, move around.

Stress consumes your energy reserves. Eat some protein and fats at breakfast, not a lot of simple carbs (sugars, white flour, etc). Some nice whole-wheat toast or bagel with peanut butter or cream cheese, and maybe a hard-boiled egg, is the way to go if you're eating on the run. That way your energy will last longer because your blood sugar won't be tanking after a rush of insulin produced to deal with a simple-carb load.

Last, remember the Fat Man's Laws from the immortal House of God. #4: The patient is the one with the disease. :)

[duskyjewel]

I'm just gonna leave this here:

http://childrightsnurses.org

If/When I become a nurse, I'm joining immediately.

[Blue Roses]

That exact same thing happened to me in nursing school. It was the most embarrassing thing that has happened to me because the doctor doing the circumcisions was my old pediatrician!! My episode was so bad they had to wheel me out... And they made me lay down in the c-section recovery area and eat crackers and drink orange juice. It was awful. I was so embarrassed... More than embarrassed, I was ashamed. I will never work in labor and delivery!! God bless all the wonderful lucky nurses who do. I once entertained the fantasy of working with children and babies but I know now I'm not cut out for it, and I adore my job in adult rehab.

[monkeyhq]

I just don't want it to become a pattern. My instructors have informed us if we ever get a mom for a patient that is going to have a c section we will witness that as well and I would never want to end up passing out in the OR!

I nearly passed out when I held a placenta for the first time. The hospital kept them refrigerated for a few days after birth, and it was dumped on the table in front of me so we could touch it and feel it. I am not easily grossed out, but it truly was the first time I had seen anyone else's 'parts'.

You will get used to the human body, surgical procedures, etc., and blacking out is unlikely to become a pattern.

It gets better, I promise! :-)

Best of luck to you!