Archive April 2019 XX, No. 4

Behind Closed Doors: The Way We Were

Longing for the golden olden days of the Main OR.

Paula Watkins

Paula Watkins, RN, CNOR

BIO

Way We Were

More and more, I wonder if I'm still outpatient surgery material. I don't mean writing for Outpatient Surgery Magazine, but rather keeping up with all those pretty, perky nurses and all those dashing, dexterous surgeons cranking out all those short, same-day cases.

Have I stayed too long at the party? Have I officially become the cranky, crotchety old nurse I swore I'd never be? You know, the one who has to have things done a certain way because it's always been done a certain way. Or maybe a part of me yearns for the golden olden days of the Main OR.

I'll admit, I prefer the longer cases with the slower surgeons. The youngsters bang their heads against the wall when assigned to Dr. Molasses. Me? I clap my hands and jump up and down with my good knee when I get to spend the day — and sometimes the night — with him. Not to wax nostalgic, but I love working with the surgeon who has been doing surgery as long as I have, or longer. There is real music on in the room (and not at a decibel that makes dogs howl). We can talk about the good ole bad days.

Making a list, checking it twice

As many of you have the battle scars to prove, nursing is different in the Main OR. Not just longer cases and sicker patients, but little things like instant odor recognition. All you need is a whiff to know it's a GI bleed or gangrene — and to know you'll need Xeroform or at least oil of peppermint all over your mask.

And the Main OR teaches you to be prepared. I still make 2 checklists. List No. 1 is to ensure I have everything in the room that I'll need before I go to get the patient.

  • Do I have the safety strap, arm boards and hardware to attach the equipment to the bed?
  • Are the settings on the cautery correct?
  • Is there a suction apparatus in the room? Preferably an empty one. If not empty, then at least zeroed out on the intake volume.
  • Is there a 3000-ml or 1000-ml bag of whichever fluid we'll need? Note to self: Make sure the tubing is clamped off before spiking an irrigation bag. Last thing I need is a shower because the scrub left the tubings un-clamped.

List No. 2? After I've brought the patient in the room, I doublecheck List No. 1 to ensure some well-meaning team member didn't deliberately move an item or change a setting.

I guess you can say I've always felt at home in the Main OR. I've never had trouble telling a family member not to snap pre-op photos of my patient in a flimsy gown or telling a resident not to slingshot his dirty gloves across the room to the trash receptacle.

Scared strait

I probably should retire. I'm tired. But dammit, I love what I do. When you have the "OR disease" in your blood, it's difficult to leave. It's probably going to take a crippling malady to get me out of the OR. Or worse, my family putting a straitjacket on me and dragging me out, kicking and screaming for Dr. Molasses to take me back to the way it used to be. OSM

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