OR days

I'm pretty far along through my 16 week orientation but I was still surprised to discover it already time for me to train in the operating room. Though I'd been through my share of C-sections before this, I'd only learned enough to know to be terrified when heading back to the OR. 

As a Labor & Delivery nurse, I am supposed to be able to shift immediately from the bedside to the operating table, from holding my patient's hand to staying at least 12 inches from her abdomen in order to preserve the sterile field. Though I think that this is common to most obstetrical units, every time I go to the OR I have the sense that I'm working in a small rural hospital where a few nurses work all "units" rather than developing skills in a single specialty area. Elsewhere in my hospital, cardiac nurses administer all the heart drugs and read EKG rhythms but don't follow their patients to the OR for a triple bypass. I think that one day I will count myself lucky for L&D's unique variety, but for the most part these days I find myself just trying to stay calm and breath through my surgical mask. 

Training specifically in the OR has helped a lot already. I'm more emotionally prepared when I know that I'm going to be in there than when I'm racing back with my patient crying and the fetal heart rate plummeting. As the circulating nurse I am responsible for the setup, the counts, charting, the patient's safety, and ensuring the baby's well-being while he waits for his mother to be closed. The setup includes applying sequential pressure devices to the patients feet that mimic walking so she doesn't develop blood clots, inserting a Foley catheter in her urethra to empty her bladder, positioning her on the OR table leaning to the left to perfuse her uterus, applying a Bovie grounding pad so she doesn't get electrocuted by the cauterizing of her blood vessels, starting suction, taking a fetal heart rate every five minutes, shaving her belly, covering her in Betadine, and keeping the unexposed parts of her warm in the cold OR. Once this is done I'm mostly charting and counting. The instrument counts are exhaustive and difficult. Everything has an odd name and everything looks like scissors. Thankfully the nurse who is training me and the scrub tech have endless mnemonics and dirty jokes to remind me what's what. On my first day of OR training I laughed so hard that I forgot my terror.