Celeste Cavanaugh

Professional Nursing 2

Clinical OR

October 7, 2016

My First Experience in the Operating Room

The only experience I have ever had with surgery in my life has been reading about it from my

textbook. I have never been able to witness a surgery being performed, whether it was pre-op, intra-op,

or post-op. I was able to observe five different intraoperations from start to finish. However, I was not

able to observe any pre-op or post-op nursing care. During my day in surgery, I imagined I'd spend

most of the time with the circulating nurse. That was not the case. I actually spent most of the day

with the anesthesiologist. He was very nice, allowed me to stand up at the head of the bed so I could

see each operation being performed, and he explained to me everything that was happening and why it

was happening.

The first operation I witnessed was a PEG, percutaneous endoscopic gastrostomy, tube and

tracheotomy insertion. The patient undergoing this procedure was at the end of his life and his family

wanted measures taken to keep him alive. The staff wasn't happy to be doing this procedure because

they said this patient had no quality of life left and the patient's family wasn't ready to admit it yet. The

procedure was very interesting. When the surgical resident placed the PEG tube, he fed a wire with a

camera and light down the patient’s esophagus into the stomach. Then he could see the light shining

through the abdomen, so he knew where to make the incision to place the PEG tube. The tracheotomy

was more difficult for me to be able to see, but I saw the surgeon cut into the anterior part of the

patient's neck into the trachea. I thought it was interesting how the anesthesiologist had to slowly pull

out the tube that was in place for surgery while the surgeon simultaneously placed the tracheotomy. It

was a very tense procedure because the airway is the number one concern in a situation like this one.
 The next two procedures I witnessed were not as in depth or tense as the procedure I just discussed.

One of them was a mass being removed from the left forearm and another was a bronchoscopy. During

the mass removal I was only able to see a very small amount of the procedure due to a surgeon, two

surgical residents, and a medical student being crowded around the arm. The anesthesiologist did pull

me up to the head of the bed so that I could peek around and see a bit more. I saw them making the

incision into the arm and I saw one of the residents putting in the sutures to close the arm. The whole

time in between, the anesthesiologist was explaining to me what his job is and explaining how to read

his monitors and tell if something is going wrong. It was very interesting to listen to him and see what

his side of the surgery is like. During the bronchoscopy, I also was not able to see much because I went

in half way through the procedure. The most I saw was on the screens that they use during an

endoscopic procedure. I saw the inside of the trachea and the bronchi; it was very fascinating to see

what they actually look like and not just a picture out of my textbook.

The next procedure I witnessed was a Metaport insertion. I was pretty confused during this

procedure because I didn't really understand what a Metaport was or the procedure of inserting it, but I

read about it later to try and put two and two together. From what I read, they thread a catheter into the

jugular vein and placed the port in the patient's chest. When they placed the port in the patient's chest,

the surgeon made an incision where he wanted the port to go and then used his finger to open up a

space under the incision big enough to stick the port in. They will use this port with the patient's

oncology treatment, so they have quick and easy access to give the patient medications.

The final procedure I was given the opportunity to watch was a laparoscopic cholecystectomy. This

was, by far, the most time consuming and in-depth procedure of the day. The patient who was

undergoing the surgery had two large gall stones so the surgeon decided the whole gall bladder should

be removed. During the procedure, the surgeon and his residents made four small incisions to put the

laproscopic tools into the abdominal cavity. They had a camera with a light, a cauterizing tool, and two

grasping tools. The procedure went well, except for one of the surgical residents made a slip up and hit
the gall bladder with the cauterizing tool which caused bile to spill out into the abdominal cavity. The

surgeon fixed it by spraying a solution onto where the resident had cut into the gall bladder. The

surgeon also said he would have to prescribe the patient an antibiotic to make sure she did not get an

infection. After they had the gall bladder unattached from everything, they used this bag to pull it up

through one of the incisions that they had made. Since the gall stones were rather large, they had to

break them up while they were still inside of the patient’s abdomen before they could fit them through

the incision.

Overall, I had a great experience my first time in the operating room. I thought going into my

surgery day that I might like to become a surgical nurse, but after seeing what a circulating nurse's role

in the OR is, I don't think it will be the right fit for me. I enjoy talking and interacting with my patients

too much to be a surgical nurse with all their patient’s unconscious for most of the time they are with

them. I enjoyed my day in the OR and I enjoyed even more getting one step closer to figuring out what

kind of nurse I want to be.