Reanna Bell

Mrs. Higham

Professional 2 Clinical

10 Nov 2020

Surgery Observation

This week of clinical I got to go to surgery. I observed a few different cases throughout

the day and learned a lot from the nurses. The one procedure that was the most interesting to me

was the wound debridement. A forty-eight year old paraplegic man had two sacral pressure

wounds. The one wound was infected and not healing like the other. The infected wound was

very red, had lots of drainage, and had a horrible odor. The patient had a colostomy and a

suprapubic catheter, so it was not incontinence causing the infection. The patient does not have a

lot of reliable help with the care he needs at home as well. The wound was being debrided to

remove the infection to promote healing and further complications the infection could possibly

cause.

To prepare the patient for surgery, the patient had an IV placed and was talked to by the

surgeon and the CRNA in the pre op area. Then, the nurse met the patient in pre op and asked

him one more time if he had any questions and double checked that the patient followed the pre

op orders, being NPO the day before and such, before he was taken to the OR. Once the patient’s

vitals were taken, the CRNA put him to sleep. Next, the patient was intubated and needed to be

in a prone position for this procedure. The patient was moved to the edge of his bed, then rolled

over onto the operating table. Once he was rolled over, the CRNA made sure his airway was

good and the other nurses made sure he was not laying directly on his colostomy or his
suprapubic catheter. The wound area was then cleansed with iodine and covered appropriately

for the surgeon to work on.

The procedure was interesting to observe. There was a CRNA, surgeon, physician’s

assistant, scrub tech, and two circulating nurses in the OR. The CRNA was maintaining the

patient’s airway and vitals, the surgeon and physician’s assistant were performing the procedure,

the scrub tech was handling instruments and collecting removed tissue, and the two circulating

nurses were charting, gathering needed supplies, and handling all outside communication as well

as responsible for the timeout. The patient’s wound was cauterized from the sacral area to

halfway down the back of his thigh. It was cut in a triangle form. The surgeon removed lots of

infected tissue from the patient. I did not realize how much of the skin needed to be cauterized

compared to the size of the wound. I enjoyed watching the skin be stitched and stapled back

together. The surgical site was dressed by the physician’s assistant and the patient was rolled

back to supine position by the OR team. The communication during the procedure was great as

everyone knew exactly what their role was and there was a mutual manner of respect between all

of the staff, no matter their position.

The nurse acted as a patient advocate in many ways. The nurse always made sure that the

patient was comfortable and listened if they were to voice any concerns. She also made sure the

patient had dignity and privacy while in the OR room. The patient also had requested that they

put a brief on him after the procedure since he does not have help when he gets home. The nurse

also made sure the patient was lying on the correct positioning aids during the procedure to keep

him comfortable as possible. The nurse cared for all of her patients to the best that she could and

made sure they were in good hands. I enjoyed my time in OR and learned a lot!