I’m not sorry I’m human

What could possibly go wrong?

It’s just a quick ______ repair.

We’ll be done soon.

Don’t worry, it’s a light schedule today.

Such words are taboo in the operating room. Yet I’ve spoken them all.

I once asked a general surgeon about his infection rate with mesh for hernia repairs – as he sewed mesh into a patient’s peritoneum – and he jokingly told me to “Get out.”

I once started to walk into a surgery without a mask on and immediately froze in shock as the scrub yelled at me.

Another time I forgot to clamp some tubing as I spiked a 3 liter bag of saline and I gave my self and the surrounding area a salty shower.

I once applied EKG leads on the wrong side of a patient’s body.

I was scheduled to be on call one day, but didn’t know it. I arrived at the hospital in a panic because I didn’t have by badge or know what kind of trauma I was walking into. I ended up being there for almost 9 hours without a break or food.

I make mistakes. I’m imperfect. I’m human. And I’m not sorry.

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I’m not sorry I’m human because the best parts of me are the most human parts. Someone once told me, “Once you’re perfect, you’re dead.” In other words, once you’ve achieved perfection, you no longer have a purpose for being here. This was a great reminder; perfection as an end goal is a dead end.

In AA, there’s a part in the main book that says,

“Our next function is to grow in understanding and effectiveness. This is not an overnight matter. It should continue for our lifetime.” (p84)

My daily challenge is to see how I can stretch and grow, while staying stimulated and occupied. This is why operating room nursing is a great fit; because it forces me to multitask and to use clinical judgement, all while utilizing all the people skills I never thought I’d have.

I also know that nursing brings out the best of my human side. In the brief moments that I have to connect with a patient before surgery, I use every fiber of my imperfect self to connect with my patient and his/her family, all while trying to inspire their confidence in my clinical skills.

No matter how much a surgeon or anesthesiologist criticizes or praises me, the golden moment of the day is when an post-anesthetized patient remembers my name. I can’t promise you’ll be cured or the surgeon will fix the problem perfectly or you’ll emerge from anesthesia without pain or nausea, but I can promise that I’ll look out for you and care for you in your most vulnerable moments. I’ll play Michael Jackson during surgery if that’s what you want. I’ll tell the staff to call you by your favorite nickname. I’ll text your mom/sister/daughter in the waiting room. I will care for you and about you – things a robot couldn’t do. And for that, I’m not sorry I’m human.

 

 

 

B Positive

A few weekends back, I got called in to do an emergency spine surgery on a 40-something year old guy who flipped over his handlebars while riding his bicycle in the countryside. I came in and set up for the surgery: I coordinated with the anesthesiologist, the surgeons, the vendors whose surgical technology we used for the procedure, the surgical tech, the radiology tech (who took x-rays throughout the procedure), and the ICU nurses taking care of the patient.

I met the sweet man who was about to have his fractured back repaired. He was extremely healthy and had a surprisingly positive attitude (and he even chuckled when I told him his blood type was B Positive).

The surgery went well and the surgeons were satisfied with their work. The anesthesiologist was satisfied with the status of the patient as he emerged from general anesthesia. We headed from the operating room suite over to the recovery room. We were greeted by the recovery room nurses and while they applied monitors to the patient, the anesthesiologist and I began to give the nurses a report.

Vital signs stable.

Then, in the midst of reporting to the recovery room nurses, the oxygen monitor began to alarm, the patient’s oxygen levels fell steadily from 98% down to 92%, then 89, 84, 80, 85, 70, 68…

I panicked.  I have never seen a number drop that quickly and I’m pretty sure my heart was about to pop out of my chest. I felt so responsible and yet so useless. I wasn’t sure what to do next. Luckily I wasn’t alone.

The seasoned nurses, techs and MDs around me were swift to take the next crucial steps. The ensuing 30 minutes taught me so much. As the ICU nurses, respiratory therapists, and radiology techs joined us as the patient’s bedside, it became clear that this man had experienced negative pressure pulmonary edema. All the classic signs were there, it was actually quite a textbook scenario: assisted ventilating attempts were unsuccessful, he remained unresponsive, re-intubation was performed and pink, frothy sputum was suctioned from the endotracheal tube, a flat plate x-ray was taken and displayed “whited out” areas of infiltrates. An array of medications were pushed through his IV, yet his status didn’t change too much. He was finally transferred back to the ICU on a ventilator with his oxygen saturations still around 86%.

At that point, I had to get the ball rolling for another surgery. No time to reflect on what just happened. No time to debrief. No time to check in with the family members of the patient. No time to check in with the person who felt personally responsible for this drastic change in status: my dear anesthesiologist (who also, by the way, is one of the sweetest gentlemen I know and I get all school-girl-giddy when I get assigned to work with him).

Get yourself together and be positive. We moved forward. Our team completed the next surgery and went home after the next shift came in.

During my lunch break the next day, I went to the ICU to visit my patient. A wave of relief flooded through me as I saw the resilience of the human body exemplified. He had the tube out of his throat and was breathing on his own. His oxygen saturation was at 97% with 2 liters of supplemental oxygen. He was talking with his parents who were at his bedside. I visited with them for a short while and then returned to my shift.

I also followed up with that anesthesiologist. Surprisingly, I learned that this was his first case of negative pressure pulmonary edema and that it would have been difficult to prevent. I asked him if he ever ‘got over’ those kinds of situations. “No,” he candidly expressed with a concerned, yet warm smile. He gave me a reassuring pat on the shoulder. It felt good to know that doctors don’t always have the perfect outcomes and sometimes they feel powerless too.

I connected with his humility. Although we can’t always fix the right things the right way at the right time, we can – at the very least – aim to do right by our patients. And when the results are still discouraging, we strive to be positive, not just because it’s part of our job performance evaluation, but because there’s always another surgery to do, another patient to help, and another lesson – and maybe even a miracle – to be revealed.

An Abscess Answered my Prayers

“You have to be at the hospital at 7am tomorrow for a washout of a wound. Then after that, you’ll repair a hip fracture,” the nurse supervisor told me at 10pm Friday night.

“Ok.” No biggie, I thought to myself. I was familiar with the doctors I’d be working with and I knew I’d have a stellar scrub tech.

So I went to bed, consciously aware that I needed to be getting quality sleep. Do you ever do that – think to yourself in your sleep, “I need to be sleeping well right now”? I do that every morning at 3am when my body wakes up for no reason.

So, this past weekend I was on call for the surgery department at the hospital, which meant that from 7am to 3pm on Saturday and Sunday, I was to be available to work. I usually get called in and end up working a regular shift, except there are only two or three other people in the department and I usually don’t get to take a break. On the other hand, If I don’t get a call the night before telling me to be ready for surgery the next morning, I usually hang out in bed and watch Netflix, crossing my fingers that my phone doesn’t ring.

But this past Saturday I had to go into work to take care of a leg abscess and a hip fracture, and later we would also do a urologic procedure to take care of a guy’s bladder tumor that was causing bleeding. I arrived at the hospital having done my morning spiritual routine at home. Lately, as I drive my 7 minute commute to work, I’ve been having a conversation out loud with my Higher Power, simply asking for strength, guidance and inspiration to do the right thing for my patients, coworkers, and doctors.

I got to the Surgery Main Office to start the process of getting ready for these procedures. As I start to book the wound washout, I look down and do a double take. My first patient is my ex-boyfriend.

***

Now to back up, I have been single for four years since I broke up with this guy. We had been together for four years, during which we both did a lot of growing up. We met in recovery meetings and spent our early sobriety together, weaving idiosyncrasies in and out of each others’ personalities, families and lives. I was 18 years old when I met him, young, impressionable, and without a sense of self. So, I became him. Whatever he liked, I liked. Whatever he thought was stupid, I thought was stupid. I learned to love baseball and horror movies. I also learned that I had a terribly sarcastic and bigoted line of thinking, if I allowed myself to be that way. You could say we were enmeshed.

Since our painful parting of ways four years ago (more on the break-up another time), I haven’t had a relationship since, but I know he’s involved himself in a couple. We are both very active in our recovery community, so I see him from time to time. We usually hang out after our recovery meetings and chat for a bit. Sometimes, if I’m not in a rush to get somewhere, we can end up talking for over an hour.

I’ve struggled with our occasional encounters because we still get along so well. We have a dynamic where we could talk about everything or nothing for hours. Plus, it’s hard to unlearn all the details and familiarities of someone with whom I shared my life.

So, I’ve started to became aware of this little gut feeling I have when we talk. It feels like a little a kid is standing by my side, tugging at my sleeve, trying to get me to leave. I’ve felt like this lingering and chatting is no longer appropriate for us. He has a girlfriend (and I want a boyfriend which sounds desperate, but we won’t go there right now). I’ve been looking to my Higher Power for guidance – to show me a new way to be around my ex, to spiritually direct me in the way that leads to harmony, and to help me have an appropriate relationship with him.

***

Back to my first patient – the reason I had to wake up at 5:30am on rainy Saturday… I worked with my scrub tech and anesthesiologist to get ready for the procedure, then I walked out to the main hallway where we check in patients for surgery.

And there he was, sitting pathetically in a hospital bed, sticky with sweat (not because he was septic, but because he’s just always warm). He was accompanied by his girlfriend who was visibly upset. I wasn’t sure if it was because was going to be his nurse or because the last time he was in the hospital for the same issue, he almost lost his leg.

I approached them like I would any other patient. I asked him to confirm his name and date of birth – even though I knew it by heart. I went through the whole pre-operative interview and reviewed his chart. I gave his girlfriend a hug and told her to go get some coffee. It didn’t feel strange – it almost felt normal.

As our team brought him to the operating room and started the procedure, I spoke to him informally, but then the realization hit me: this was how I ought to interact with him – like a patient. This was exactly what I had been praying for! It felt like my Higher Power said to me, “You want a new way to interact with your boyfriend, here’s a new way to treat him.” I chuckled. Sometimes Divine inspiration is gradual and subtle, but this was not one of those times. This felt a lot more prominent – much like the abscess that we washed out that morning.

Humbly be the Drifter

A few days ago, my assignment at work was to be the “float person”. It meant that instead of being designated a single operating room to attend to with all its surgeries, I was to be an extra pair of hands for all the other OR nurses. I floated from room to room, helping anesthesiologists, surgeons, the other nurses, and scrub techs with whatever they needed: I pulled medications, fetched instruments, brought in special equipment, and brought extra supplies. When I finished my task or was no longer needed, I would leave and drift on to the next duty.

Yes, its reaffirming to get a “thanks” from the other staff members, but the recognition is not what motivates me. The joy of this role is that I have the chance to support my peers and set them up for success. If I feel like slacking or glossing over the details, I remember what its like to be the nurse in the operating room suite, receiving the help from this float person. I aim to be the nurse I’d want to work with.

In my recovery life, this role reminds me of a certain part of literature that tells us we must aim to be one among many, to be a peer among peers – not to be the best nor the worst. This means finding the middle ground, being right-sized, which for me means humility. My mind often automatically thinks self-centered thoughts and seeks validation, so what I need is less thoughts about myself and more thoughts about others – how can I be of service to others?

This saying works anywhere! Not only does the search and practice of humility help me at work, but it helps me get along with my family, friends, roommates, fellow gym-goers, or strangers at the grocery store. If I am thinking of others more, I am thinking of myself less, and that is the kind of person I’d want to know.

Bless These Hands

Sitting in the hospital cafeteria at lunch this past Wednesday, I breached the subject of spirituality in the operating room. My company: two surgical assistants (like nursing assistants) and a chaplain. The conversation started with one of the surgical assistants recalling a “Hand Blessing” the chaplains used to do in different hospital departments. The blessing was, in essence, focusing on the hands that do the healing, compassionate, God-given service of patient care. He wanted the chaplains to come back to our department and bless everyone’s hands. This was a tender moment that unlatched a door that was evidently ready to be kicked wide open.

Though I’m relatively a newcomer to the operating room environment, it didn’t take long for me to see how quickly one can become desensitized to other human experiences. Everyday, I see patients at their most vulnerable moments – literally and figuratively. Whether it’s a middle aged man getting major spine surgery or a young lady getting her gallbladder removed, the patient is told by the doctors what to expect from the surgery and is placed in a thin hospital gown on an uncomfortable operating table and strapped into placed and covered in a few layers of blankets.

Though I haven’t been a surgical patient (and I don’t intend to be one anytime soon), I know these patients are overcome by fear and uncertainty, seeking reassurance, and depending on someone else who has more insight to tell them, “It’s okay to be scared. I’m here for you.”

And while we’re so busy hustling to ensure we take the best care of our patients, I notice we often forget how to take care of our coworkers. I hear coworkers snap at each other, voices ring across the overhead loud speaker to complete tasks and get ready for the next surgery, “get me the microscope” or “bring me the cast cart” without a “please” or “thank you.” Yes, it is our job to do the things that move the surgeries along, but it is also our job to do these things with kindness, otherwise we might as well be robots.

Over the past year, I have found it difficult to maintain a sense of serenity amidst the sometimes harshness and pressure of the operating room environment. So when tasks or personalities become seemingly intolerable, I must return to the fact that I am grateful to even have a job (and a meaningful one at that), I enjoy most of the people I work with (yes, even the doctors), and most of all, I get the chance every day to interact with patients and work toward becoming the nurse I would want if I were in their shoes.

I have no idea what I’m doing

“Did you fart?” my sister asks me in a half sleeping stupor. “No,” I reply. We are tucked into our queen bed together at my parent’s house and I honestly did not fart. If I did in fact Dutch-oven her, I would have promptly admitted it. Its 1:30am and time to put away my laptop, but I am compelled to start typing. This is my graceless attempt to start a blog as a New Year’s resolution.

What shall I write about? I am full of ideas. My brain is tremendously gifted at inspiring me and wrecking me simultaneously.

I wear many hats throughout the day (daughter, sister, friend, mentor, co-worker, nurse, patient, consumer, provider), so I am not just one thing, nor am I particularly skilled at just one thing. I am not a master of anything, other than being myself.

I yearn for the satisfaction of completing a challenge, just like running a 10k or cleaning out my bedroom closet. I intend for this blog to be a challenge, inspiration, and perhaps even a catalyst for self-discovery. Moreover, I want the experience of sharing my human escapades (wearing every hat): this will be the chronicles of my very unglamorous, extra ordinary life.