Return To ME

For eight months, I have been silent. It’s not that I don’t want to write… When I am just about to pull out my laptop, something gets in my way. It’s my To Do List, the telephone, the need to tidy my surroundings before I do something that requires sitting. More accurately, I get in my way. The excuses are really my tendency to procrastinate. I know that this will be good for me – to write and get everything off my chest.

I am so much better than before. Truly. Seriously. I promise I am.

What has helped me over the last several months, is that I finally put myself first. I leveled up my meditating game and have been making breakthroughs thanks to Dan Harris and crew at Ten Percent Happier. I have been doing MORE – more yoga, more listening to music, more cooking, more sitting down and doing NOTHING. It was a struggle not to feel like I should be doing more and being more “productive.” Thankfully, I came to the realization that, even if I was doing “nothing,” that that was actually SOMETHING for me and my mental health.

Meanwhile, things at work are interesting. COVID brought on different challenges, but then we all got used to the way we had to live our lives (N95 masks, all the PPE, negative pressure rooms, etc.). In the last six months, came another change – the loss of staff to lucrative agency contracts. My former co-workers have not been traveling out of state, just staying local. In fact, it feels like all the big hospitals in the city have just exchanged staff. We have been lucky to get some talented nurses who are very nice and fun to work with. Agency work isn’t for everyone, so we have added new staff as well. As a result, I have been teaching – A LOT. I actually enjoy it, but it doesn’t hurt that we get extra pay for precepting.

Watching my friends leave to pursue agency contracts has been hard. I completely understand why they are doing it, but still… It feels a little like breaking up.

Inevitably, I think that I will be going the agency route too. My boyfriend and I have been talking about moving to another state, so for now, I am putting agency opportunities on hold. Thoughts about leaving my current job make me sad, but things have changed so much that one way or another, it will never been what it once was.

Yes, change is inevitable. I have to accept this and be willing to let go of my comfort zone. The way I choose to look at the state of nursing and the uptick in agency staff is that I am increasing my network of nurse friends. Operating Room Nursing is such a small world. There aren’t many of us out there, so it stands to reason that I will eventually work with my friends again! And I’m good with that.

With all the changes in my personal life, professional life, and the world in general, it feels like I found my center and ready to ride whatever wave comes next.

A Not-So-Routine Routine

During the Monday through Friday work week, I work four ten-hour shifts.  On those work days, my alarm goes off at 5:00 AM.  And the routine starts…

5:00 AM – Jump out of bed and get ready for work.  Brush my teeth, blah, blah, blah.

5:30 AM – Feed the Doggie and take her out.

6:00 AM – Drive like a bat out of hell to the hospital.  [CUE:  Upbeat dance music.]

6:25 AM – Arrive at work, throw lunch box in one of the overstuffed refrigerators, get scrubs from the scrub machine, change into scrubs and OR-use-only Sanita clogs, put my hair up and put on one of my cute scrub caps.

6:40 AM – Grab a quick coffee in the lounge with my co-workers.

6:53 AM – Clock in and head down to the OR.

7:00 AM – Check for my assignment at the Command Center/Charge Desk.

And this is where the routine ends.

Operating Room Nurses are typically assigned to one room where there are several cases scheduled.  These are usually procedures that fall under their primary specialty (e.g., Orthopedics, General Surgery, Urology, etc.).  However, most operating room nurses are cross-trained in the other specialties, therefore, the assignment may not be in the primary specialty.  Or maybe it’s a room with a variety of procedures that fall under a variety of specialties.

Not only does the assignment vary in specialty, but it varies in role.  There are two staff members needed to set up for a procedure:  A Circulating Nurse and a Scrub Nurse/Surgical Technician (a.k.a. “Scrub Tech).  Operating Room Nurses can either be a Circulator or a Scrub.  A Surgical Technician can only perform in the scrub role due to their training and licensure.

Scrub Nurses/Scrub Techs are responsible for preparing the sterile field.  She or He performs a surgical scrub on both hands and arms at a scrub sink (just like on TV), then puts on a gown and gloves with proper aseptic technique.  The sterile field consists of a sterile drape covering a large table with a setup of items that are needed to perform the procedure (supplies and instrument). The Scrub sets it up so that instruments and supplies can be passed to the surgeons when they need it.  Knowing how to set up for a variety of procedures is a skill learned on the job – starting with an intense orientation.

In the role of Circulator, the nurse performs a patient assessment in the pre-op holding area.  It involves a checklist of questions that have also been asked by other providers.  It is our version of Checks and Balances.  Patients get an overview of what they can expect when they are brought to the OR.  Family and friends of the patient can also ask questions.  I call this, for my readers of a certain age, my “Julie McCoy, your Cruise Director” moment. In the OR, the Circulating Nurse’s work continues with helping the Scrub, sometimes the Anesthesiologist/CRNA, and works around the sterile field (circulator = circulate = circle = around) supporting the surgical team throughout the case.   Eyes and ears are always alert.  Circulating means helping coordinate and facilitate case progress, documentation, and whatever else is needed to provide safe patient care.

Anyway, back to getting my assignment…

Wait, what am I doing?

Every day, my assignment is a surprise to me. The Charge Nurse/Manager/Team Leaders put together the initial draft of the assignment sheet the day before, but it always seems to change the morning of, based on call-offs and schedule changes.  I have learned my lesson to avoid checking the day before because I don’t want to get myself unnecessarily upset or excited about the next day.  Pointless, really.

On the days I am in my specialty, I am in my comfort zone:  Orthopedic Surgery.    In the Main OR of my hospital, the procedures we perform the most are total hip or knee replacements, repairing broken bones, fixing someone’s spine, and even taking out cancerous bone and tissue.  I work with the surgeons and residents that I know well and my partner is usually someone from my specialty team (nurse or scrub tech).  When you have the “regular team” together, there is a flow that is like….a symphony.  I love that feeling.

Outside of my specialty, I am fine, but I am on extra alert for any nuances that are unfamiliar.  While this sounds scary to some people, the beautiful thing about working in surgery is the amazing teamwork we have with our staff.  My co-workers are excellent resources when I am in a bind or when I just want just-in-case information.  It is reassuring to know that someone has my back!

Today is my day off which means I return to work tomorrow.  What will I be doing?

I have absolutely no idea.

All I know is that there definitely will be coffee in the morning.