I was at the end of my internship for Surgical Technology school. I walked into the hospital and signed in like any other day. My Preceptor* walked up to me and smiled, “Are you ready?” she asked. Wide eyed and curious, I replied, “Sure! What are we doing today?”. She looked at me and said, “Today your going to the heart room.” We walked down the operating room hallway. Everyone was rushing around, getting ready for their morning cases. Carts and equipment were being moved around in every which way. The strong smell of disinfectant was in the air. Surgeons and residents were walking by discussing cases and patients. For a girl who loved the show “E.R.” for years, I was grinning ear to ear. I made it! I was here in the operating room! I was so excited! I was going to see open heart today! We turned a corner, stopped at the scrub sink and grabbed a mask. I tied my mask on, feeling my cheeks touching the sides of the mask from my huge, excited smile. Then we walked in.
The nurse was running around getting meds. Anesthesia was prepping their drugs. Then I saw the scrub tech, or in this case the “CVOR tech”* because it was open heart. She was organizing and displaying instruments and objects in the most meticulous manor. I was fascinated by all the suture* being laid out that would be used in one single case. I was soaking all of it in when I got this sinking feeling that everyone was looking at me. Well, they were. My wide eyed look of unfamiliarity and inexperience must have given me away. The fear was oozing off of me like a bad stench that they could all smell. My heart started beating faster. I started to sweat. My stomach had now jumped into my throat. I was frozen. I started screaming at myself, in my head. What are you doing! Say something! Pull yourself together girl! Introduce yourself! You trained to be here. The time is now. Don’t wuss out! Show them you have got this! What is wrong with you!!! Say something!!!!
I licked my now very dry lips, and opened my mouth and squeaked, “Hi, I am Tashina. I am learning today.” They all looked at me, looked at my preceptor, nodded without a word, and went about their business. Whew! Ok, survived that one! “Don’t touch anything blue.” The scrub tech barked at me a bit. “Okay.” I said and nodded. “Grab your gown and gloves and put them on the table. I am going to have you stay over here until we get started.” The nurse tells me. I go and get a gown and my gloves from the cabinet. I walk over to the scrub’s table. She looks at me with suspicion and judgement. “Put them over here.” she says, while pointing at a spot on the table. “Okay.” I reply. I open the gown and gloves the way I was trained in class, popping them onto the table with success and keeping them sterile. I let out a big breath. Well I didn’t screw that up thank God. “Go ahead and scrub in, I will explain some things to you on the table and about my set up.” The scrub tech says to me, this time a bit nicer. Hmmm not scary alien invader status anymore? Maybe I am now just stranger danger status since I didn’t screw up opening my gown?
I went out and started to scrub, in the scrub sink, counting all the scrub strokes as I did it. I was still so new that it wasn’t second nature yet. So, I counted 10 strokes here, 10 strokes there, swipe around the elbow… check. check. and check.
I walk into the room, arms dripping. The scrub tech throws a towel onto my hand. I begin to dry my hands and arms like I was taught. She watched me like a hawk. Examining and testing me with every move I made. I donned my gown, put on my gloves, then held my hands between nipple line and hip level, like I was taught. She nods in approval. She begins pointing to every clamp, instrument, and bit of supplies on her table, She starts explaining to me what they are called, what they are for, and why she had them where she had them. My head was spinning. How was I ever going to learn all of this!!?? I felt so overwhelmed, but held my ground. They smell fear, don’t let them smell you, you scared little rabbit! Fake it to make it! Fake it to make it! You got this! Then the patient came into the room.
Everyone hustled to get to their position of each of their jobs. Anesthesia and the anesthesia tech began placing on wires and monitoring devices and checking I.V. sites. The operating room nurse was talking to the patient, making sure they were comfortable. She works with the PCT* to position the patient securely on the bed, and waits to assist anesthesia with anything they need during intubation*. The seasoned scrub tech with me was standing by her table waiting to start the case. The nurse and the tech had already counted all the items that needed to be counted*. The patient is prepped. The room does a time out* and the case begins. All of these things and so many more, that I am sure I didn’t even notice at the time, were being played out like a well rehearsed play. I was back in awe struck mode and felt that smile creeping up again.
The surgeon walks in. The scrub gowns and gloves him. The scrub introduces me. He grunts and basically ignores me, then walks to the, now being draped patient. I gulp. Okay, back to scary alien invader status again I guess? “Scalpel.” The surgeon says to the scrub. He takes the scalpel. It begins. If getting ready for the case was a well rehearsed play, the surgery itself was like a perfected ballet or dance. Their hands were all so fast! The scrub tech was putting things into his hands faster than I could even catch at times. She was suctioning and preparing things needed for the next step of the procedure. All the while, watching me, the surgeon, the people walking around her table or anything sterile. Bam! Insert stomach in throat again. Sweet baby Jesus! How am I ever going to do this!? I will never be as fluid as they are! The loud noise of the saw broke me from my rant of fear and self doubt in my head.
Holy shit! They are sawing that person’s chest in half! This is really happening!? Don’t pass out. Don’t faint. You got this. Big girl panties. Suck it up.
The case and the perfected ballet went on and on. I was just trying to soak it all in, then I abruptly came back to the real world, when the scrub tech looked at me and said, ” He is talking to you.” I looked at her confused. She says to me, ” He asked if you want to hold the heart? ” I froze. Big girl panties. Big girl panties. Freaking big girl panties aaaah!!! I managed to squeak out, “Yes.” They led me to the top of the table and began instructing me exactly what to do. Obviously, they wouldn’t let me do anything that could hurt the patient or that I could screw up. Remember, I was still scary alien invader status. I was just still in shock that the surgeon was even talking to me! Apparently, not all, but most surgeons love what they do and love to teach.
He explains to me that he needs to place sutures on the back of the heart. He needed me to hold the heart for him in a specific position to do that. I nod my head. He takes my hand and feels that I am shaking like a leaf. He looks at me and says calmly, “Now, I am going to need you to stay very, very still or I will have the other scrub hold the heart for me.” I took a deep breath. You got this, you can do this. My hand started to calm. He placed my hand into the patients chest and around the heart. He said, “Okay, I need you to hold it just like this for me. If you think you might move, you must tell me before you do.” I nodded.
The heart had been put on bypass* and the chest cavity was filled with ice to cool the heart. My hand was so cold! You got this. You got this. The surgeon began to sew. He continued to put throw after throw of the tiny blue prolene suture into the heart. I watched him with awe and amazement. I felt I was watching an artist create some masterpiece. My hand was frozen, but I didn’t care. This was so cool! Was I really here? Was I really holding a human heart?!
The surgeon looked at me and said, “Okay, all done. We are going to take the patient off of bypass now and start to warm the heart.” He nodded to the perfusionist*. Seconds went by and I could feel the heart warming. They were all watching around the table. Then what happened became one of the moments in my life that I will never forget. The heart started to beat in my hand. My hand and arm were bloody. My fingers were frozen, but slowly warming. The heart was warm now and the weight seemed to increase a bit. The strong muscles pulsing against my fingers. It was so strong it practically jumped out of my hand. Lub-dub, Lub-dub, Lub-dub. It made me realize how strong and resilient our life forces are, yet how vulnerable and soft they can be as well. It was incredible. I could write another thousand words of how I felt at that exact moment and it still couldn’t possibly explain how I felt. All I knew, while holding a warm, beating heart in a human’s chest, was that I was right where I was supposed to be. I knew that I was in love with my job. I knew that I would do whatever I needed to do to learn to be the best scrub tech that I could be. I would put on the big girl panties and chuck the finger at fear. I fell in love with my job and haven’t lost it since.
- This excerpt was a preview of what ” The secret life of techs” will be like. If you are interested, fascinated, or just curious about the behind the scenes action in the operating room, than you will like these excerpts. I will be writing about surgical procedures and day to day happenings in the O.R. I will have to keep some details vague and non- descriptive. I may not be able to answer questions you may message and ask me. This is due to H.I.P.P.A. and the fact that I still work in this field and must remain private and professional about certain matters.
- What inspired me to write these excerpts, other than being passionate about my job, was honestly, always being referred to or asked if I was a nurse. I have the utmost and absolute respect and admiration for nurses. Many of my friends are nurses. They are truly angels for all that they do for patients. The issue is that there are a lot of other positions in the medical field that do incredible things and care for patients on a daily basis, that are ghosts. They are the unsung heroes. Many people have no idea that 95% of the time the person assisting the surgeon in a surgery is not an RN, it is a tech, a surgical technician. There are also first assistants as well. There are CT’s, PCT’s, PCA’s, anesthesia techs, radiology techs. There are so many that I can’t even mention them all. They are invisible to an average patient. If you didn’t work in the medical field you wouldn’t know we all existed. So, the last time I told someone that I assisted in surgery and traveled for my job, they automatically said, “Oh!, You are a nurse?” Direct hand to forehead, “No, I am not a nurse.” I then decided I needed to write about techs and shine a bit of light on what they all do.
- I will also try to interview other techs and get some stories and insight on their jobs because I obviously can only truly speak with experience about mine. Are you a tech? What do you think? Do you have any cool stories that made you fall in love with what you do? Feel free to write me or comment!
So, until my next entry,
I hope you enjoyed “The secret life of techs”,
and as always,
sending you all love and light,
Tashina- Wild Antevasin
*Preceptor* : A person that trains a new person in the O.R.
*CVOR tech* : A surgical tech, specially trained in cardiac surgeries
*Suture*: The name for what is used to do stitches on a person
*PCT*: Patient care technician
*Intubation*: Placing an endo tracheal tube down a patient’s throat to keep them breathing
*Counted*: The nurse and tech must always count a certain amount of items before every case and sometimes throughout and at the end to ensure that nothing is left in the patient.
*Time out*: A brief pause with everyone involved in the surgery to talk about the details of the patient and the surgery for safety purposes.
*Perfusionist*: A person specially trained to run a perfusion machine. (what is used to place a person on bypass)
*Bypass*: creating new routes for the blood to flow around the heart so the heart can be repaired.
***Credit for the pictures go to Google and pintrest**