Saturday, January 16, 2010

Thoughts on Surgery

I've completed 2 weeks of my surgery rotation which means I'm 1/4 of the way through and I'm still loving it! Most of the past week has been spent doing ortho cases with a few general cases sprinkled in between. Thus far I've scrubbed in on total knee replacements, total hip replacements, a partial knee replacement, an ACL repair, a rotator cuff repair, a open reduction and fixation (ORIF) of a tibia fracture, just to name the ortho cases! I have also scrubbed in on a few hernia repairs, a mastectomy with lymph node biopsy and excision, a breast implant exchange, a laparascopic cholecystectomy and a nephrectomy. I've done more on some cases than others - like doing some drilling or hammering on the ortho cases, stapling or suturing some cases and others just holding retractors or sucking smoke out of the operative field (the smoke is caused by a tool that cuts and cauterizes tissue). I was even put on a case this past week as a first assist (no other PA with me, just the plastic surgeon and I) and was complemented by the surgeon. He even let me do some sutures on the breast implant exchange and told me I did a "respectable job." I'll take it!

Things I've determined in my time in the OR:
1. Plastic surgeons are by far the nicest and most charismatic surgeons I've come across thus far (with the ortho guys coming in second)
2. I haven't gotten used to the smell of burning flesh
3. Total joint replacements are cool to see the first few times around, but can get a little old after that
4. I need more upper body strength to be an ortho PA (Lots of lifting, holding, manipulating legs when the patients are practically dead weight)
5. Scrub techs/nurses don't trust students and won't ever trust students - but I don't blame them, I'm sure they've had many a student contaminate themselves or the field!
6. There are a lot of egos that must be stroked while working in the OR including, but not limited to, the surgeons, the scrub techs/nurses, the anesthesiologists and the reps from various biomedical supply companies
7. Bone bleeds a lot when cut/sawed
8. Ortho and plastics guys are fanatics about preventing infection (kudos to them!)
9. Some people love working with students and others would prefer to never see them in their workplace. How to handle those who don't like me? Smile and kill them with kindness :)
10. I find surgery fun and interesting because its something new everyday - will I still like it in 6 weeks? We'll see!

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