Haleigh Brooks

Surgical Observation Journal

NURS 3741L: Professional Nursing 2 Clinical
Mrs. Mucci
22 September 2022

Surgical Experience Journal

This week for my clinical experience, I got the opportunity to go to surgery and observe a
coronary artery bypass graft. I was also able to observe the end of an orthopedic surgery as they
were suturing the surgical incision. During this experience, I was able to observe the things that I
have been learning about in class.
Upon entering the operating room, the room had already been cleaned and all of the
equipment needed for the procedure was set up on the sterile fields. These sterile areas were
marked with blue sterile drapes. Throughout the procedure, aseptic technique was observed by
the plastic coverings for equipment handles used on the monitor screens and lights, maintaining
integrity of all sterile fields, and the surgical team wearing sterile gloves and PPE. The patient
was cleansed using multiple solutions, including betadine through the swab dispensers and
alcohol on cloths.
After the patient arrived in the OR, the team took a surgical time out before beginning
anything else. The team identified the patient, operation, patient allergies, and verified that the
informed consent was on the chart. This surgical pause ensured safety for the patient and
protected the surgical team from making a safety error. After the time out was performed, the
anesthesia team inserted an arterial and central line that were used in the procedure. The arterial
line allowed the surgical team to closely monitor the patient’s blood pressure throughout the
procedure to watch for any critical drops in pressure. The central line was used to administer
bolus amounts of fluids, medications, and blood.
Inside the OR there was about 15 people present for the surgery. Among the staff were
the surgeon, nurses, anesthesiologist, perfusion specialists, nurse anesthetists, surgical techs,
myself, and one other student. Throughout the procedure, all of the surgical team communicated
very well to help the process go smoothly. The team communicated effectively by using clear,
audible language and repeating back information to ensure they had heard correctly. The surgeon
led the communication amongst the team and provided orders to the other staff members for
what he wanted done and when to do things. This precise and clear communication allowed for
minimal confusion during the procedure. Clear and effective communication is essential in the
operating room because without this, patient safety is at risk and mistakes can be made.
During the procedure, I observed the surgical team remove a segment of the saphenous
vein from the patient’s right leg, expose the internal mammary artery, and use the harvested
vessels to form three grafts to complete a triple bypass. The team started the procedure by
obtaining the saphenous vein and exposing the internal mammary artery from the chest wall. The
patient was then put on bypass and functioning of the heart was stopped. The doctor then sewed
the vessels to the heart to restore blood flow to the heart. The patient was taken off of bypass and
blood flow through the heart was returned using the newly attached grafts. This procedure was
very exciting to observe and I greatly enjoyed the experience of spending a day in the OR and
being able to see things I have learned in class in action during a surgical procedure.