Operating Theatre – not my nursing specialty

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surgical nurseThere’s been a lot of chit-chat on NU about choosing a specialty and I’ve written  a post previously about my specialty and how I knew Maternal, Child & Family Health nursing was for me. However, a conversation I had with some of my fellow bloggers encouraged me to write about why I didn’t choose a certain nursing specialty.

Way back in 1977, when I did my hospital-based registered nurse training only 3rd year student nurses could have an Operating Theatre (OT) rotation.  Naturally, this rotation was highly coveted by everyone and so when my rotation came up, I was very excited. I thought that this was what nursing was really all about. I imagined that working in the OT was the pinnacle of technical nursing achievment and had dreams of participating in some life-saving surgery.

For 3 years, I had delivered kids to the OT doors and been deeply impressed by the “senior” student nurses and RNs dressed in their green scrubs or theatre pinafores with theatre gowns hanging negligently open over the top of them, special shuffly booties and hair swept back under special blue scarfs. I would stand respectfully silent, covertly examing every aspect of this attire, while these elite nurses diligently checked name bands and notes. They barely ever acknowledged my inconsequential junior nurse existence. When, finally at the end of the performance the flappy, plastic OT doors would swing open and the child, theatre nurse and wardsman would disappear into that enticing, mysterious world, I knew I was so ready to join this theatre performance.

Finally, when my turn arrived and I began my rotation, I found that like so many longed for things, the anticipation of the event was far more exciting than the actual experience.

Operating Theatres were a peculiar and smelly place: all at once exciting and terrifying. Everyone shuffled about in the same green scrubs, but there was no difficulty in recognising who were the surgeons, registered nurses and the 3rd year grunt student nurses at the bottom of the pile. The same rigid pecking order existed in the theatres as it did in the rest of the hospital.

Now, I have never enjoyed the cleaning aspect of nursing or the highly adrenaline charged clinical areas. OT involved both! It turned out that most of the time spent in OT either involved vast amounts of cleaning an assortment of areas and objects – or being a “scout”, which involved running from room to room finding obscure unknown items and getting yelled at for being too slow or bringing the wrong obscure thing back to the theatre.

The 3rd year student nurse was eternally wiping down trolleys, picking up gore soaked drapes and swabs, emptying suction bottles and rinsing bloody instuments under the eagle eye of the instrument nurse. It was mostly fetch, carry and clean. It was all very disappointing really.

So that was Theatres – every morning, we student nurses would arrive at work and look at the theatre board to see whether we were to be the scout or the cleaner for our shift. And, all the time each of us nervously waiting for the moment when the Charge Sister decided that we were ready to scrub-up. We never knew when the scrub moment was to happen. The Charge Sister always made sure it was unexpected.

So, after weeks of cleaning and gingerly picking up bloody swabs, enhaling copious amounts of mysterious fumes, and getting yelled at for being too slow at finding some thingumyjig or other, my turn to scrub-up came.

I was to scrub with the Orthopaedic Scrub Sister and was martialled to a sink and shown how to scrub, gown and glove with thorough accuracy. Then, I was ushered into the theatre and into position around the table. My first setback – I was too short and a foot-stool had to be found for me to stand on so I could see properly and hand the instruments as the Scrub Sister directed me. Once I was settled, the next thing I knew, I was up close and personal with an anaethetist and his helper, two surgeons and the scub nurse. It all seem to happen so  slowly and dream-like; it was one of those moments in life where you feel as if you’re not really a part of what’s going on. Just a disconnected observer with very high levels of cortisol or something!

So, in some alternate reality, I anxiously watched with my gloved hands held firmly against my gowned chest, as a small child was prepped and draped for surgery. As far as my memory allows me, I think the proceedure was surgery to a leg.

While all this was happening, I could feel my breath hot under my mask as the surgeon joked his way through the first incision and the scrub sister whispered instructions into my ear. I believed I was managing splendidly until I realised that the surgeon’s instruments included a saw, drill and hammer. This was a memorable moment.

To this very day, I can remember the sound of that saw and the smell of burning bone as the surgical team sawed, drilled and hammered away, all the time discussing the scones that were to be for morning tea. In the meantime, all my senses swirled in a confused haze of scones, burning bone, my own heated sweat, the rising nausea and the disbelief that these skilled professionals were hammering and sawing away at a bone just as my father hammered and sawed wood in his workshop.

I didn’t know what to do, but I must have done something that alerted the scub sister to my rapidly deteriorating physiological state because in some misty far away place I heard her say – “push her away from the table -she’s down!” and I was.

The surgical team had no time to deal with another student nurse who couldn’t take the heat. Rightly so – the sterile area had to be kept intact. And, as I went down, I was pushed backwards and behind the surgical team. I was stepped over as the team closed in and continued with their proceedure. Meanwhile, someone caught me and dragged me back and out of the theatre. I can remember sitting in the outer scrubbing-up room with my head swimming and feeling so incredibly stupid, yet absolutley relieved to be out of the OT. It was at this moment I knew that OT wasn’t for me.

Of course I was not alone – it was not an uncommon occurrence for students to faint and no one thought the worse of me. The surgical teams were very adept at sweeping swooning students aside and maintaining their sterile field.

The scrub sister came and found me later and was kind and encouraging. She told me how to manage the whole messy process. She also told me never to come to work in theatres without having a good breakfast and plenty of fluids. The surgeon found me later and thought it a very good joke and encouraged me to have another go – which I did.

The rest of my rotation passed uneventfully. I learned to manage scrubbing up and watching a surgery without too much difficulty. I learned to pass instruments, hold retractors, and participate in jokes and humdrum conversations and eat the lovely morning teas that came to the OT. But, I never learned to like it.

I was glad when my rotation was over, but a bit sad that another nursing illusion was gone. In the 32 years since then, I have never had a desire to work in the OT or specialise in OT nursing. One 8-week rotation was enough to let me know that this skilled nursing specialty was definitely not for me.

What about you? Do you have a tale to tell about the moment when you realised a nursing specialty was NOT for you?

3 COMMENTS

  1. MrNetNurse – says:
    Added on – 09 Nov 2009 01:58PM

    I only lasted 10 minutes! Yes Fran I can remember all the fanfare as a student nurse when taking patients to theatre and how I felt like I was dropping patients into militarized zone and the admission into theatre was like getting a patient past a boarder checkpoint.

    As student nurses (in 1987) our intro into the OT was to go in and observe an operation as a group. As a thin tall student nurse who got interested in nursing after watching the BBC TV series “Your Life in Their Hands” I was very disappointed after being the only one in the group to leave the OT that first day as I felt faint. It was also an orthopedic operation…something unnatural about hammering and sawing bones but I was also encouraged to move past this minor setback and went onto enjoy my rotation in the OT as part of my training.

    I did go back many years latter (1991) and trained for three months as a scrub nurse in a women’s’ hospital in Qld but bailed out to return to NSW to be closer with my then girlfriend (now wife).
    Rich

  2. I am with you. It is impressive to know how important it is to choose right area of nursing. I am nursing student graduating in next 2 months. I am wirting a selection criteria about : why would you chose to work in this area? I had to select 4 specialties in my job application and I selected – perioperative, critical care, surgical and emergency. I need help with answering this question :”why would you chose these specialties for your graduate program?”

    • Hi, I worked in critical care (ICU) for 6 years and LOVED it!! All the stuff you learn at uni about wholistic nursing can be applied in ICU because with only 1-2 patients right in front of you, you know everything that is going on with them by the minute (and as you get experienced, you can often predict what is about to happen in the near future and be ready for it or prevent it). You can care for ALL of the patient’s needs and that of their families because you have time to be thorough. It does not feel like production line nursing, again because of the low patient/ nurse ratio. Finally, you work so closely with all the other health professionals that professional respect is mutural (in my experience anyway). I found the doctors trusted and valued our opinions more than I ever experienced on the ward and this made me proud to be part of the team. You need to put in a lot of effort and study to stay current in this area, but if you have the time it is so rewarding. I only left the area due to becoming a mum which significantly reduced my availability to both work or study, otherwise, would still be there.

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