I'm embarking on the tail end of my surgery rotation. This past week was the first week I was starting to feel comfortable with all the craziness of the OR. I knew how to be helpful in prepping the patient and bringing them into the room, what instruments to ask for during surgery and how to best assist the surgeon at any given moment, and how to clean up the OR after a case. I've been doing more suturing, making my skills a step above atrocious (actually more and more of my stitches are now acceptable which is encouraging). The anesthesiologists have been excellent at teaching me intubation and I nailed my first flexible LMA the other day. The one thing I haven't got the hang of that annoys me is the sterile preparation of the field once I have scrubbed in! It's my job as the first assist to adjust the lights to a good position, help lay out the drapes, and organize the tubing of the suction and bovie (electrocautery) and any laparoscopic equipment on the field. Well, I haven't figured out the best way to unfold the drapes, I usually bang the lights together because I haven't figured out how they move yet (which is a no-no because theoretically dust could fall from the lights onto the sterile field), and I haven't figured out how to organize the tubing...the surgeon almost always has to fix what I've done because I either have too much or too little tubing, or it's not organized well. In fact, earlier this week I had a string of events that just made my roll my eyes and be extremely thankful that I am with the staff that I am at. While trying to hang the drapes in a sterile fashion, I accidentally touched the circulating nurse's glove with my sterile glove, meaning she had to get me a new one. I then proceeded to try and grab the tubing of the OR tech's stand, which is usually a big faux-pas, as they don't like people messing with their equipment, but he was busy assisting the surgeon with something and I felt stupid waiting for him to get done when I could easily grab it myself. In the process of doing so, I unorganized his equipment set up (they keep things super super neat and organized), and then magically touched the end of the suction tip to the light above, making the tip unsterile. While then trying to take the now unsterile tip off the suction, I accidentally touched the tip to my sleeve, making my sleeve unsterile. This all happened in about 60 seconds. Thankfully no one was mad, but it could have been very bad if I had been in any other environment where people were not exceptionally patient. Plus, I found out that they have sterile sleeve covers that they can just whip out if you contaminate your sleeve! You don't have to degown and glove and rescrub. Perfect for me!

The end of the week was pretty busy. I worked something like 31 hours in two days, and only got nine hours of sleep between the two nights. I also lived off of cheese sticks and PB crackers bc I would only have two minutes or so between each case before I would have to run and start helping with another patient. We also had a sad OD case come in, which was interesting for me to see but horrible because it was almost a given that she wouldn't make it. She had OD'd on amphetamines (most likely bath salts based on their half life and the fact that we found out she had been comatose for two days before being brought in), and featured some pretty major brain damage. We ended up lifeflighting her two a bigger hospital that could address her needs more, although I don't think they would have been able to do much more than what we did.

I still can't believe how lucky I am to be here. The staff all love me and take care of me. They challenge me as well. There are some days where I'm more exhausted mentally and emotionally than physically, because of how often I'm pimped (in the good way), and how often I have to deal with failure and being wrong or messing something up. The patients are so different from the ones I encounter in the Philly area, and I love it. They are down to earth, hardworking, usually poor laborers who tend to have such interesting stories. I am so thankful for this experience.