Shocked at Surgery

Nani1234 · Jan 10, 2007

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.

Marie_LPN, RN, LPN, RN · Jan 11, 2007

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."

Wow, this couldn't be any further from the truth for me.:trout:

#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.

If you think that's ungentle, watch a total knee replacement lol (hip replacement would be harder to see if you're observing). Saws, drills, hammers, staypins.

#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)

This is common for the docs that use betadine paint or scrub for a prep (the adhesive paper towels don't stick to that prep well) or the ones that drape with blue cloth towels.

#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.

Cutting into veins happens all the time. Everyone doesn't have the exact same anatomy, so to avoid doing so all the time would be impossible.

Marie_LPN, RN, LPN, RN · Jan 11, 2007

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

I could agree with this, if my purpose was to inflict harm on a pt. I don't see it as "cutting them up," i see it as improving quality of life.

Marie_LPN, RN, LPN, RN · Jan 11, 2007

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!

If it's done with a saline inflation, sometimes those saline pump bags have had a few mls of epi added to them, for the hemostatic purpose.

lorster · Jan 11, 2007

#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.
i realize this may be common, but is it absolutely necessary?

jimthorp · Jan 11, 2007

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.

LOL.

I've seen a myringotomy with tubes (surgeon let me watch through the binocular microscope during the procedure), adenoidectomy, lap chole, meniscectomy, C-section, and WIPPLE procedure (got to stand right next to the anesthetist and peer over the drape).

If I'd have had anything to say about it, I would have been standing right next to the surgeon!

I had a meniscectomy a year before seeing one and kept thinking, damn I'm glad they knocked me out. I had asked the surgeon to let me watch but he declined. Might be different watching them contort your own body parts.

HeatherB,CST · Apr 9, 2007

#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.
i realize this may be common, but is it absolutely necessary?

i may be showing my inexperience, but it doesn't seem all that awful or absurd to me. central iv lines, for example, get sutured to the pt.'s chest/neck so they do not move around if the tape comes off. it seems to me that if the adhesive didn't stick and the sterile drape slid around during the surgery, wouldn't that be a contamination risk? if i was pt., i'd rather have a few holes in my bum than an infection.

Crux1024 · Apr 9, 2007

I may be showing my inexperience, but it doesn't seem all that awful or absurd to me. Central IV lines, for example, get sutured to the pt.'s chest/neck so they do not move around if the tape comes off. It seems to me that if the adhesive didn't stick and the sterile drape slid around during the surgery, wouldn't that be a contamination risk? If I was pt., I'd rather have a few holes in my bum than an infection.[/quote]
:yeahthat: Words out of my mouth...

Marie_LPN, RN, LPN, RN · Apr 10, 2007

I'd rather have a few holes in my bum than an infection.

I want a bumpersticker that says that lol.

Atl_John · May 18, 2007

You think staples are bad, try towel clamps, while in school I saw 2-CABG, 1-C-section, 1-lap. Hysterectomy. And they used towel clamps think of a set of small meat hooks going through your skin to hold down these towels. OUCH !!!!!! And yeah they are brutal, the CABG surgerys after the surgeon opened up the chest he pulled up the left side of the chest a good 7 or so inches higher, it was like watching a horror movie or something along those lines. Just crazy, and as someone said, THANK GOD they knock you out, and for narcotic pain meds. I think the more you see the more "desensitized" you get to it. I worked Vet. surgery before vetschool so seeing these things weren't that big of a deal.

ChristyMNOP · May 18, 2007

I have only seen 7 surgeries-2 c-sections, one eye surgery, and 4 adenoidectomies. All of the surguries I saw were professional with not too much talking about the patient, etc. However, during a surgery that I had in which I was just under sedation and epidural, I heard the nurse commenting on my weight. I had just been through an extremely traumatic experience, was splayed out on the table and exhausted but awake, and that was the very last thing I needed to hear. I can remember it to this day, and its been 3 years. I doubt I'll ever forget it. I don't know if they realized or looked at me as awake, but I was. That nurse had been a total wench to me beforehand too, not sure why I expected different.

Anyway, I write this to say that while you may have seen some inappropriate behavior, it is just that. Inappropriate behavior most likely born of a stressful situation. Take it for what it is, and if possible, avoid doing it yourself. It is just bad form and can be hurtful to your patient.

blueheaven · May 18, 2007

When I did my surgery rotations in nursing school, the staff in the OR were ALWAYS professional. The nurse manager did not tolerate unprofessionalism in her staff or from the doctors. Sometimes the doc played music. This should give you a good eye opening to why your fresh post op patient needs pain management!!!

I had a extensive abdominal surgery when I was 16. When I woke up, my shoulders (among other places) were killing me. Little did I know at the time, they had me in trendelenburg and used brackets to keep me from sliding off the bed! My mom told me why later (she's an old OR, OB, med-surg nurse).