This Week I Learnt...

So what did I learn this week? 

I once again was able to go into theatre, although this was my longest surgery yet! I was in there for 4 hours. Yes, four! 

The surgery was unbelievable though. It was a surgery that the surgeons had never done before as it was something they had never come across before.  This was a very special patient indeed! The surgery was amazing though.  They had it on a screen so I was able to watch so I didn't interfere too much with the surgeons. There were five scrubbed in surgeons plus one theatre nurse.  So at some points it was a little hard to get close enough to see as there were many hands and heads in the way! So the screen came in useful at some points.  Once again, the surgeons were great in answering questions and explaining what was happening.  The patients scans and x-rays were also up on a computer screen for reference.  This enabled me to see what the surgeons had noted and why the decision had been made for the route the surgery was going in.  It was an orthopaedic surgery, of which I hadn't yet seen. So I was able to see the various layers of tissue, the skin, subcutaneous layers, the adipose tissue, muscle, tendons, ligaments and bone.  Utterly fascinating.  As it was such a delicate surgery, the surgeons were orthopaedic and plastic surgeons. So the different levels of knowledge in the room was vast.  The anaesthetists was also helpful in explaining the fluids they were giving the patient due to length of the surgery and potential for blood loss.  They also explained what they look for on the monitors and how important it is for them to know all about the different drugs that are available, their contra-indications and how to calculate doses in paediatric patients.  Constant monitoring is vital in any surgery, so it is important for them to be vigilant and know their stuff! 

Unfortunately I cannot say too much about the surgery due to how rare the surgery actually was.  I have researched on the internet and there is very little about this patients condition.  So due to the rarity and the chance for identification I will be withholding those details. The patient and their family consented to me viewing the surgery and asked how I had found it afterwards.  They were very helpful in explaining and only to happy for people to learn more.  It definitely helps when you come across people like that as it does make your journey for learning a little easier.  

I was also able to get a little mathematics practice in this week too.  I had my mentor assisting me with drug calculations on the ward and then making up some questions for me to enable to work out medication doses in the children.  As a learning disability nurse, we can work with adults or children.  I have yet to decide what path I want to go down.  So it is even more important that I understand childrens and adults calculations! Fluid intake and output is measured, and in babies their nappies are weighed. This, along with blood tests, allows us to know how well that child may be and have an understanding of their fluid and nutritional intake.  

I have managed to get copies of fluid balance charts, growth charts and PEWS charts. So I am hoping to use these to not only assist in my own knowledge, but to also use them in my essay writing and use them for reference.  I have also learnt that if you don't always ask, then you may not always take advantage of that learning situation available to you. You are responsible for your own learning and that means you need to take advantage of what is available to you on placement while you can. As you may not have those available to you again. Placements go so quick and it may be the only time you are supernumerary and are able to take advantage of all available to you.