Yiasmene Chirgott

Open Heart Observation Journal

NURSE 4840L Complex Care Clinical

Dr. Cynthia Shields

October 13, 2022

 Today during my clinical I got to go to the OR and observe a coronary artery bypass graft

(CABG) surgery. This surgery is done to treat coronary artery disease by bypassing the blockage

using a blood vessel from somewhere else in the body and attaching it above and below where

the blockage is to bypass it and get blood to the heart. For the surgery that I observed, the

surgeon used the greater saphenous vein in the right leg to bypass the blockage. Prior to the

surgeon beginning, he gave the physician assistant and nurse practitioner time to go in

laparoscopically and graft the greater saphenous vein so that by the time he needed it, the vein

would be ready for him. For the surgeon to be able to perform this surgery, the heart needed to

be still. To get the heart to stop moving, a cardiopulmonary bypass machine is used by the

perfusionists. This machine takes over the job of the heart by adding oxygen to the patient's

blood, taking carbon dioxide out of the blood, and pumping the blood back into their body.

Having a major surgery comes with its concerns and issues. A potential ethical concern

related to open heart surgery or post-operative care could be if a patient was a Jehovah's Witness

and needed a blood transfusion. This would be an ethical concern because these individuals

believe that it goes against God’s will to receive blood- so in most cases, they will refuse blood

transfusions. Nursing management priorities for patients requiring coronary artery bypass

surgery would be preoperative teaching, and monitoring the patient postoperatively for any

complications, such as infection, hemodynamic instability, bleeding, and pain.

I had a really great experience today in the OR. I’ve gotten to observe a few surgeries in

my past clinicals, but I never got to see an open heart surgery, so today was a really amazing

opportunity for me. Everyone in the operating room was so kind- the nurses, the perfusionists,

the anesthesiologist, and the nurse anesthetists. The one perfusionist took time before the surgery

began to explain the procedure to me and the nurse anesthetist came and got me and had me
watch the surgery with him so I could see better- he also took the time to explain certain steps of

the procedure to me. Everyone in there really wanted me to have a good learning experience and

I could not recommend this experience enough for other students!