just another day in the OR...

Johns Hopkins Hospital is known to many as "the best hospital in the world."  For a while now, I've wondered what part of the hospital these people were referring to... but my questions were finally answered at clinical last Friday.  I've come to learn that the pediatric population we serve is far from normal -- we see the rarest of all diseases and syndromes on our floor, simply because no other hospital knows what to do with these children.  Hopkins boasts some of the best specialists in the world, those who are able to diagnose and treat this vast array of "unknown" illnesses.  I have to constantly remind myself that the patient population we see and care for on a daily basis are not typical of most hospitals... but it has definitely prepared me well for how to handle the unexpected.  So when I learned that my young patient on Friday had been flown in from Saudi Arabia a few days earlier for skull reconstruction surgery after a car accident left many of her facial bones crushed (car vs camel... did not bode well for either), I was eager and ready to take care of her prior to her scheduled procedure.  She was easily my most complicated patient to date, and there was a lot that I had to be aware of and monitor.  I know she couldn't understand what I was saying (either because of her mental status or the language barrier) but I offered her words of comfort as I did her pre-op assessment.  Her brother arrived shortly thereafter (he is the only family she has here), and I left them alone so that he could read through prayers for her.  The time finally came, and we transported her down to the general pediatric OR.  Her brother never left her side, reciting prayers and words of comfort in their Arabic language before she was wheeled into the sterile operating room.  As I walked into the OR with my patient, I looked back to the brother, and realized that this was his sister that was now in our hands.  It's easy sometimes to forget the immensity of our responsibilities as health care providers, and that moment made it very clear to me.  Without going into graphic details of the 7-hour surgery, the doctors were able to re-assemble the shattered pieces of her temporal bone and reconstruct the crushed frontal sinus -- and I was able to witness the entire procedure from just a few feet away.  It was incredible.  Although I kept reminding myself that it was my patient underneath the sterile drapes, I was captivated by the pure "magic" that is surgery.  It brought me back to my days in Advanced Anatomy... I had forgotten how truly incredible the human body is, and how fascinating the complex inner-workings and processes are that keep us alive and running.  Aside from a brief 30-minute break to rest my legs, I observed the entire surgery, and it was quite an amazing experience.  And what's even better - it was a success!  She was transferred to the PICU after the operation, so I wasn't able to follow her, but the doctors were hopeful that she would recover.  To what level, we aren't quite sure.  I believe she has a few more surgeries scheduled before she eventually returns to her native Saudi Arabia, but I do hope that she pulls through. 

Even though I feel such a strong connection and fascination with the realm of surgery, I realized that I could NEVER be an OR nurse.  Standing next to the surgeon, handing him tools for multiple hours... the atmosphere was "relaxed" (everyone chats during the surgery, listening to music as they work) but the nurses don't ever meet the patient or the family, and they have no connection to the case they are working.  It's just another chart and another surgery before the end of shift.  I need patient interaction -- even if I don't see the end-result of my efforts caring for my patients, it's the relationships nurses can develop and the comfort we have the opportunity to bring while we work with these individuals.  It truly is a calling, and I am so grateful for this opportunity I have been given.  And I'm getting closer... 10 months down, 3 to go!  Third semester will be complete by the end of the week (exams today and tomorrow, final peds clinical day on Friday) and then I begin my FINAL SEMESTER next Monday!  We take our "Transitions to Clinical Practice" course, Public Health, and Special Topics -- which I found out will be "Fetal Surveillance" on Fridays!  So perfect.  I can't wait!  But first... I have to make it through this week.  Meaning I need to get back to studying.... until next time, take care all!