Adaptability: Part 4


Adaptability

I would say more often than not, surgery does not go the way it’s intended. Especially with a sicker clientele base, there are more moving parts that can get cogged.

You must be able to adapt and move with the flow, all while maintaining your integrity and holding the space for the room. This is your room. It will only get as chaotic as you let it.

Sometimes you get into an abdomen and there is an upset not caught by imaging. Isn’t it cool that we work with surgeons who are capable of recognizing all issues, not just the ones the monkey computer spit out at them?

I think it’s rad anyways.

It’s even cooler that our society has specialized, and we have the capability of calling in other experts. My Emergency General Surgeons are good, we recognize that a patient’s ovary does not look normal while searching for her appendix.

But they’re not the experts. They know that. So we adapt, we call in the experts, the GYN staff, and ask for their opinion.

Sometimes it’s a look – oh, nothing terrible, GYN will consult with her through clinic once she’s recovered from the appendectomy.

Sometimes it’s a scrub in – oh, nothing that bad, maybe we’ll take some fluid and figure out what’s happening here.

Sometimes it becomes much bigger – this does not look good. We need to take the cyst out for fear of it rupturing and becoming a much bigger problem if we wait.

So then your scrub will ask for more supplies, you’ll need a cystology sheet, maybe even a different floor bed. GYN might close the skin so EGS can move onto the next patient.

You must be flexible, you must adapt to the environment, and you must remain calm.

This might be a challenge, this may be a new situation, but it’s nothing you cannot handle. You’ve done worse before.

Comments

  1. AnonymousOctober 27, 2019 at 8:32 PM

    Adaptability is a huge attribute for success as an OR Nurse. Imaging and scans can only tell the surgeon so much. Only once the team is in the patient or can see via a laparoscopic camera can they really assess the anatomy. One thing we are really stressing and practicing is the need to convert from MIS to open, which we are seeing more-and-more, especially as MIS is being used more. Our nurses are learning how to quickly get ahead of the team when a conversion becomes necessary, which includes re-gowning and gloving, skin prep, and setting up key instrumentation like self-retaining retractors (bookwalter, etc).

    We are also doing a lot more simulations on critical situations that can happen to ANY patient in the O.R., including intraoperative cardiac arrest and malignant hyperthermia. Being adaptive to the needs of the team in order to address these life-threatening situations is critical because time is so critical. When the heart stops, every second that goes by means increased potential for lasting and irreversible neurological damage, and being prepared eliminates wasted time.

    ReplyDelete

Post a Comment

Popular posts from this blog

Perioperative Nurse Residencies

Great! You got the call back and they want you. Whether or not you start before you take your NCLEX, there are a few guidelines for nursing residencies, especially in the OR. First, this is a real-life nursing job. Whether you’ve had a real job before, had a nursing job before, or never worked a day in your life besides school, this is completely different. Now that you’ve finished with school, you’re back in for more! This time there’s more at stake and there are a whole lot of relationships, connections, and bridges you need to harness. This is where life gets tricky. How many times did you procrastinate and do that assignment late because you knew you could? Now every day you have something due, and it is mostly mental and physical muscle memory, not a tangible paper essay. How many times did you sleep in a little, roll into class late, maybe talk to your professor once a month? Now every day you must be on time according to the clock, every day you
Read more

Critical Observation: Part 6

Critical Observation Critical observation is problem the biggest part of your job that is very difficult to teach. When I precept and my student is pretty confident in their skills, I’ll sit and think out loud. The issue with OR precepting, is that we are always thinking about the entire room, and it gets exhausting talking through all of it. And we don’t know where the student is, in terms of how much information is too much. When my student asks more questions or looks at their phone, it indicates to me that they’re ready for scaffolding to the next phase. So challenge them. What do you notice? What can we do to make the next step easier? What do we need for the second case? Is there anything we need for the second patient? Streamline the process, be grateful for the time to reflect on what you’ve done – could you have done anything differently or better? How is the room looking right now? How much blood is in the bucket? Are the surgeons joking? Is
Read more

Open Communication in the OR

Open communication is mandatory in today’s world. Employees will not follow leaders who work behind closed doors with no shared vision. But neither will patients. Strive to be ahead of the curve. You are getting paid to treat one patient at a time. Act like it. You may not like the idea that the hospital is a hotel, however in the OR, you should make your patient the king or queen of that room. When you open, get everything ready like you’re expecting the biggest celebrity of all time. Each time. Each patient. They deserve the best. When you go speak to your patient, look them in the eyes. Give them a handshake. Rest your hand on their side rail if you’re not sure touching is appropriate in their culture. Ask them how they are. You already know that they’re scared, anxious, tired, exhausted, worried, in pain. And that’s all because of their condition and plan of care. Honestly, they have no idea what’s in store for them on the other side. Even if t
Read more