All Alone

Today is the last day of my 8-day straight duty and what is the best way to cap it off is to be the solo circulating nurse in the CABG. Kamusta naman unfair kung unfair ang nangyari supposedly dapat yung mga from off or double off yung ilalagay diyan pero dahil ni-request ni Sir J na ako ang circulating e d ako na nga ang napunta. But I guess ok na rin yun dahil at least ako tahimik ang buhay ko sa suite room 8 doing circulating job in the heart surgery, while other staff were being toxic to their cases. Aside from that one case lang yung napunta sa akin dahil heavy case nga yung open heart surgery while some have three or more dahil toxic nga rin nung araw na yun.

Anyways, last time second circu lang ako pero isang linggo ako namroblema so this time around, sabi ko aayusin ko ang trabaho ko lalo na sa pagccharge ng mga supplies na nagamit para hindi ako ma-question and yun nga okay naman lahat, everything went smoothly until nung bago kami mag-trans-out to PACU. Kasi naman mali rin ako, in the middle of the surgery, siyempre swabe na ako ulet unfortunately nakalimutan kong ireview yung chart nung patient so nung patapos na sila doon ko lang narealize na hindi ko pa pla nagagawa yun, buti na nga lang at mabait yung PACU nurse na naka-assign sa akin. Hindi niya ako tinoxic :) Buti rin at mabait yung anesthesiologist ko at hindi yung mga toxic na anesthesiologist kung hindi lagot talaga ako.

No Rest For Three Days

If you're a nurse, you work in shifts and most of the time the shifting in hospital goes by the following shift: 6am-2pm, 2pm-10pm and 10pm-6am. "Every 8" is a term used when you have only 8 hours of rest before going to work, for example you are in the night shift then the following day you have to work in the 2p-10p shift, it means you're in every 8 shift.

Anyways, since Saturday I have working in every 8 shift. I'm on the night shift last Saturday, then 2-10 shift on Sunday then 6-2 shift on Monday. In short, I have so little time to have a rest, considering that my travel time going home is almost 2 hours so that means 4 hours were wasted just going to work then going back home.

Here's the breakdown of what happened to me for the last three days:

SATURDAY

I'm on the night shift once again and this time around Jops mentioned that we will have a German Food night. I really don't have any idea what kind of food does Germans eat or what kind of food they're famous for. What I only know is that there is a food known as German sausage, and they're really heavy drinkers and they like beers. That's all, so I decided not to bring any food. But to my surprise, Jops brings food this time around, birthday kasi ng kapatid niya. Pero dahil isa lang ang nagdala ng food sa amin, we had another emergency case: emergency cysto-RPG.

SUNDAY

I'm on the 2p-10p shift andbecause I attended the mass first before going home, I was only able to get a 2 hours of sleep, so I decided that I'll just take a nap at work. Hoping that we don't have any emergency case in the afternoon.Unfortunately, when I decided to take a nap already, the nursing office called our area and asked for a pull-out in the CS case of the DR-CD, and seeing that I'm the junior in the staff, I'm the lucky one. Pero kahit papaano, I think it's a blessing in disguise dahil pagkabalik ko, meron namang emergency case sa amin which is kinda toxic buti hindi na ako doon. :)

MONDAY

I'm on the 6-2 shift this time at dahil every 8 nga ako, doon na ako sa OR natulog nung Sunday night. And dahil mukhang kawawang -kawawa ako, I requested to be placed in one of the heaviest case para stable lang ako at hindi kung san-san napupunta. At dahil heavy case siya, ni-request ko na rin na maging circulating si Sir Ge para hindi ko na siya hihintayin pauwi. Good thing they granted my request.

Yung case ko is pyelolithotomy possible anatrophic nephrolithotomy. At dahil ang swerte-swerte ko, ayun nga at naging anatrophic nephrolith ang ginawa sa patient. Good thing at si Sir Ge yung circulating ko at madaling pakiusapan kapag may kelangan ako.

After our case, sabay rin kaming nakauwi pero before going home, sinamahan ko muna siya to get yung deposit nila sa dati nilang inuupahang bahay. Dapat idedeposit na rin namin yun sa bank pero he said wag na lang muna dahil icocompute pa niya and everything kung bakit mababa lang yung nakuha nila. After that naglaro muna kami bago tuluyang umuwi sa kanya-kanyang bahay.

Closer Look: Laparoscopic Appendectomy

Today was my first time to assist in Laparoscopic Appendectomy and I'm glad that finally I was able to assist in such procedure. This kind of surgery is rarely done in our institution due to different reasons but because primarily the cost of the procedure is not that affordable compared to the open approach and secondly the incision of laparoscopic and open approach are nearly the same.

Anyways, here's the closer look of the surgery:

Laparoscopic Appendectomy

Definition:  A laparoscopic appendectomy is a surgical procedure that removes the appendix from the body through a small incision. During this procedure, small incisions are made in the abdomen so a surgeon can insert a small camera and surgical instrument. With the camera in the right place, the surgeon can watch what he is doing on a video screen, while he is removing the appendix.

Position: The patient is in supine position, arms tucked at the side. The surgeon stands on the left side of the patient with the camera holder-assistant. For maintaining co-axial alignment surgeon should stand near left shoulder and monitor should be placed near right hip facing towards surgeon.

Procedure:

A small incision will be made for insertion of the laparoscope. Additional incisions may be made so that other instruments can be used during the procedure. Carbon dioxide gas will be introduced into the abdomen to inflate the abdominal cavity so that the appendix and other structures can be easily visualized. The laparoscope will be inserted and the appendix will be located. The appendix will be tied off with sutures and removed. When the procedure is completed, the laparoscope will be removed.  A small tube may be placed in the incision to drain out fluids.

Instruments and Supplies: Lap Chole Set (consists of: allis #6, towel clips #6 , kelly #6 , tissue #2, thumb #1, needle holder #3) Trochars: 5mm #2, 11mm/10mm #1 Hand Instruments: grasper, dissector, needle holder, mixter/ hook, scissors, extractor, suction tip Silk 2-0 Prolene 2-0 Prolene 4-0 betadine (for betadine wash) asepto Sources: Lap AP,  World Laparoscopy Hospital

Tagong Galit

Dahil sa sunod-sunod na atraso ni Sir J.A sa akin tuwing siya ang HNOD, lalong lumalalim ang pagkaasar ko sa kanya. Kahit wala namang alitan sa aming dalawa nagmumukha tuloy na meron pero palihim lang ang lahat. 

Kasi naman hindi ko alam kung may galit din siya sa akin o sadyang favorite lang niya ako na apihin. Patong-patong na talaga yung mga kasalanan niya tuwing nagHHNOD siya, parati na lang ako, napapansin ko lang naman.

Anyways, itong latest na pagHHNOD niya, ako nanaman ang nasagasaan. Asar na talaga ako sa kanya. Imagine andami niyang staff sa umaga at konti lang ang kaso pero hindi siya nagpa-adjust para sana walang ma-OT na 6-2. Tapos dahil andami ngang staff na available, yung ibang staff naka-double scrub or circulating sa mga kaso. Eto naman ako, obviously nung nakita ko ung kaso ko alam ko na na maOOT ako dahil yung last case ko ay CD case ng ortho at matagal silang gumawa. Pero dahil yung kasama ko e maguundertime, minamadali namin yung case namin. First case namin e yung 2nd knee arthroscopy ni Dr. M. Nakakagulat dahil within 10 minutes natapos kami agad so nung patapos na kami pinapasundo na namin yung sa CD para matapos na rin before 1pm pero imbes na ipahatid na niya, binigay niya sa amin yung emergency Lap Appendectomy. Sa isip ko bakit hindi ung mga naka-double scrub at circu yung i-utilize niyang staff, bakit kami pa?

Anyways, after nung Lap AP namin pinasundo naman niya yung CD case pero sobrang bilis ng pangyayari so hindi na ako nakapag-lunch pa. Buti na nga lang at mabilis rin yung mga Anesthesiologist Resident sa pagaanesthesize sa patient at pati ung mga resident ng Ortho mabilis din gumawa so sandali lang yung na-OT ko.

Anyways, maliban sa mga asar ko kay Sir J.A, may isang tao rin ang naasar sa kanya nung araw na yun, si Sir Ge. Ang masaklap nga lang sa akin niya binuhos yung galit niya. Kasi naman pinasundo na nila yung patient for the 3rd case ng knee arthroscopy, e matagal pa siya, so imbes na ibalik sa kwarto yung patient, itinambay lang siya sa isang suite room habang naghihintay ng kanayang turn. E may antibiotics na dapat ibigay sa kanya, e si Sir Ge strict pagdating sa gamot kaya nung inendorse na sa kanya hala naasar siya at kung anu-ano ang tinanong sa akin regarding sa gamot. Kung hindi pa ba expire yung gamot, bakit hindi pa binibigay, sino yung intern na nagbasa nung skin test and many more. E natotoxic na nga rin ako kasi ipapasok na ung emergency lap AP namin so sabi ko na lang sa kanya na 24 hours bago ma-expire yung gamot. Buti na nga lang at nakasulat din yun sa bote nung antibiotics.

Hay basta ang gulo nung araw na yun. Pero buti rin at nagsorry after si Sir Ge sa akin at nakuha ko naman yung point niya. Gusto ko sanang sabihin na sana next time wag niya sa akin ibuhos galit niya dahil hindi ko rin naman kasalanan kung bakit sinundo na yung patient niya. Inutusan lang ako. Pero I just kept quiet baka saan pa mahantong ang usapan e.

After that, akala ko naman mahihintay ako ni Sir Ge dahil by 3pm tapos na siya, e ako naman patapos na rin, closing na nga kami pero hindi pa rin niya ako hinintay. Sa isip ko grabe naman siya kung ako nga dalawang oras ang inuubos para lang hintayin sioya tapos siya 30minutes lang hindi pa niya magawa.

In the end si Rain na lang ang hinintay ko. Parehas rin kasi ang way namin pauwi at nagsabi siyang hintayin na ako. So hinintay ko na siya at habang naghihintay sa kanya, ayun nakifree wi-fi muna ako sa PACU. Ang swerte nila dahil may free wi-fi sa kanila. Hehe :)

Colon Surgery and Tap of War

Dahil si Sir J.A ang HNOD ng 2-10, nagrequest ulet ako na magpa5-1 kahit na colon surgery pa ni Dr. O yung case kesa naman maging staff ako ni J.A at abusuhin pa nya kabaitan ko. Okay naman yung surgeon pero na-trauma na ata ako sa kanya at mas pipiliin ko pang mag-scrub kay Monster Surgeon A kesa sa kanya.

Anyways, to follow yung case ko today. Dalawang colon surgery at okay lang sa akin yun. Okay rin yung circulating nurse ko, sa una ay si Sir J yung pangalawa si Sir Ge na. Pero in the middle of the first operation, biglang humirit itong si Sir J na kami na rin dun sa pangalawa. Sabi ko ayoko dahil everytime na sya ang circulating nasstress ako at hindi maka-focus. Pumasok rin si Sir Ge at nagsabing kung pwede sya na lang dahil anong oras na wala pa rin syang first case pero ayaw magpatinag nitong si Sir J. In the end, nasunod pa rin si Sir J, iba talaga nagagawa kapag senior ka.

Anyways, okay naman yung colon surgery namin pero sa dulo naramdaman kong wala pa rin akong kwenta sa pag-sscrub. Sabi nga ni Sir J parang sa una trial and error ako, nagprapractice, sa pangalawa ganun pa rin daw. Nakakasakit ng pride pero feeling ko tama naman siya.

Si Sir Ge naman dahil sa hindi na sya nag kasama ko sa second colon surgery, kung san san napunta, in the end may 1pm case pa sya na MRM. At dahil sabi ko hihintayin ko sya, so hinintay ko sya kahit ang tagal ng operation nila.

Habang naghihintay, itong si Sir A naman e hinamon ako sa isang laro, Tap of War. Minsan hindi ko alam kung san nanggagaling ang yabang ng taong ito at dahil gusto ko syang matalo tinanggap ko yung hamon niya. Pero sadya ata syang magaling kaya kahit ilang beses kaming maglaro talo ako. Pero nung hinamon ko syang kaliwang kamay lang ang gagamitin hala natalo ko ang mokong.

Tap of War

Anyways, dahil malapit na ang alis ng misis ni Sir Ge papuntang US, parati syang nagmamadaling umuwi pero parati naman syang na-OOT. Kanina nga dapat magmemeet pa sila para sabay silang umuwi pero dahil overtime nga sya hindi na sila nagsabay.

Closer Look: Cochlear Implant Surgery

To avoid being asked to do an overtime and to reserve my energy as well considering I still have 7 days left to work, I asked the HNOD if I could have a 5-1 shift instead and fortunately she granted it to me.

Anyways, my case for today is Cochlear Implant Surgery. It is not a frequent surgery done in our hospital so I'm really lucky to assist in this kind of surgery. Anyways, here's a closer look in this surgery.

COCHLEAR IMPLANT SURGERY

Definition: A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. The implant consists of an external portion that sits behind the ear and a second portion that is surgically placed under the skin.

Procedure:

The actual surgical procedure, which takes 2 to 4 hours and uses general anesthesia, involves securing the implant package under the skin and inside the skull, and then threading the wires containing the electrodes into the spirals of the cochlea.

To secure the implant, the surgeon first drills a 3- to 4-millimeter bed in the temporal bone (the skull bone that contains part of the ear canal, the middle ear, and the inner ear). Next the surgeon opens up the mastoid bone behind the ear to allow access to the middle ear. Then, a small hole is drilled in the cochlea and the wires containing the electrodes are inserted. The implant package is then secured and the incision is closed.

Instruments and Supplies:

• Plastic Set
• freer/dissector
• wetlainer
• periosteal elevator
• gentian violet
• cotton applicator
• cotton balls
• PNSS 500ml (for irrigating)
• suction tube
• NST
• Leica machine
• Leica cover
• rubber band
• extra bowl
• iris scissor

Sources:  Cochlear Implants, Cochlear Implant Surgery - Intraoperative Details, http://kidshealth.org

It's The Start

Today is the start of my 8-day straight duty and I'm preparing for it big time. I just hope that this week will not be a toxic one. I really need to save my energy to survive the week. Anyways, I know all of the sacrifices I made will be worth it. :)

My duty from March 22-31

I'll be starting my 8-days straight duty as a 12-8 staff. Then I'll be having a three consecutive every 8 duty starting March 26. Ako na ang walang kapaguran, I just really hope I can do this for the sake of a two day vacation. :)

Table Dead!

Buti na lang at hindi ako duty ng Sunday night....nakakatakot yung nangyari sa kanila kagabi e..a gunshot wound patient arrived in OR and they weren't able to save him so ayun table dead sya!

Kaninang umaga ko lang nakuha yung details regarding the incident. The patient was rushed in the Emergency Room in the private division. He was already dead but the residents gave him epinephrine so ayun nagkaroon ng heart beat. Syempre hindi sila nawalan ng pag-asa and the surgical residents decided to open him up. Okay lang sana but they did it without giving any anesthesia. They open his chest, gave him a heart massage...the weird thing is they didn't observe any aseptic technique. Nakagloves nga yung doctor kaso ung kamay nya hanggang braso ang nakapasok sa puso.

Anyways, they immediately rushed the patient in OR, even though it is a CD case, sa pay na nila diniretso dahil yun ang malapit. Walang pakialaman kung pumasok sila sa OR in their street clothes basta maka-opera sila. Ang weird lang hindi man lang sila tumawag ng Consultant (surgeona nd Anesthesiologist) to help them.

Ayun in the end, namatay din ang patient, pinahirapan lang nila yung relatives. Syempre andami nilang charges dun lalo na't sa panahon ngayon wala ng libre...tsk tsk!

Saturday Night Series: Birthday, Emergency and a Mystery

It's a Saturday again and as usual I'm on a night duty. It's also Benj's birthday and I promised her that I would be dropping by in their place before going on duty.

Anyways, as I promised her I made some food for the Saturday Night Food Tripping. I made two type of muffins and a lasagna. Sabi kasi nya dadaan sya and dahil birthday nya I told her na it will be my birthday gift to her na lang.

Strawberry- Banana-Orange Cupcake

ChocoBanana Cupcake

Cheesy, Creamy Lasagna

Anyways, I was really proud of the way the two muffins turn out. Maganda ang itsura and masarap naman daw. But what I really love is my lasagna. Still not perfect but it has improved a lot already compared to the first ever lasagna that I made.

Anyways, akala ko ok na kami dahil yung emergency case na supposedly sa 2-10 e pinaschedule na ng surgeon ng 6am on the following day but unfortunately nagbago rin isip nila and pinagawa rin nya ng 11:30pm. And so what we thought a paceful night turns out not to be one, buti na nga lang at emergency ex-lap lang. The weird thing is all of us including the anesthesiologist all thought that is was a simple case: an eppendectomy case only tapos yun pala colon surgery na ang gagawin.

All in all it was ok naman. Swabe lang unfortunately hindi namin nakain ung dinala ko. The worst part is bigla syang nagdisappear kaya hndi na namin nakain. Seriously when Emjay, Carla and Yeye dropped by sabi ko kuha sila ng food meron sa nurses' room pero they keep on insisting na wala daw. When I check it, wala nga!

That's really a big mystery...or not. Tatlo lang naman kaming nasa OR nun, yung isa naka-scrub, yung isa yung aide namin na nawawala sa room dahil natutulog pala sa student's room at ako, so sino kaya ang mapagbibintangang kumain ng mga food? Si Mickey Mouse kaya?

HNOD Again

I'm the 2-10 HNOD today and guess what I made my closest friend angry to me again. Tsk!

I'll post another entry regarding this matter....but for now I'm gonna sleep because I'm still the 6-2 HNOD tomorrow and I'm not in the mood because of what happened earlier.

Surgery in Nursery?

Just assisted in a surgery of a newly born child in the nursery. Well it's a different setting and somehow the sterility of the procedure is questionable but still I tried my best to observe aseptic technique.

Saturday Night Duty...Second Time Around

Mam B is craving for an oatmeal chocolate chip cookies while I'm craving for cassava cake and so we decided that we'll bring each others' cravings for our Saturday Night Duty Food Tripping.

Oatmeal Chocolate Chip Cookies courtesy of Me :)

A slice of cassava cake courtesy of Mam B :)

Good thing I still have left over chocolate chips so it was an easy job to bake an oatmeal chocolate chip cookies. Mam B's cannot make a cassava cake and so she decided to buy one instead.

It was an almost peaceful night until I was asked to be pulled-out in OB-DR because they have a CS. But aside from that all is well. :)

And I Waited Once Again

Waited for Sir Ge, at dahil 5-1 ako mas una akong nakauwi sa kanya but because I promised him na I'll wait for him, so pinanindigan ko na, naghintay ako ng mga 2 hours.

Anyways, medyo naawa rin ako sa kanya kahit papaano dahil yung mga case nya e to follow cases ni Dr. N (ex-lap then colon surgery after) The weird thing is, after ng almost 4 hours of ex-lap ipinasok na nila yung for colon surgery so si Sir Ge hindi na nakakain ng lunch.

While waiting for a ride going home, he mentioned na naging concerned daw sa kanya si Dr. N, bakit daw hindi muna sya nag-lunch, they'll wait for him naman daw. Sa loob niya paano sya maglulunch e nung pagkabalik daw nya after iligpit yung mga gamit nya in their previous surgery naka-scrub na ung buong surgical team, sya na lang ang kulang.

Hay ang hirap talagang maging in-demand na OR nurse, sobrang galing kasi ni Sir Ge e. Gusto ko rin maging kasing galing nya but am I willing to pay the price? I really don't know.

Late and Lacking

I'm late at work today. Supposedly I'm in the 9a-5p shift but because I'm not used to this kind of shift, I wasn't able to anticipate when is the best time to leave the house. And so there are few obstacles I have to face before getting to work like difficulty of getting a ride (office workers are already out in the street waiting for a ride too, so there are more competitions compared to an early hour) and being stuck in traffic (yes! it's always the reason why I hate being adjusted)

Anyways, good thing the morning HNOD is nice to allow me to get the 10a-6p shift instead for me not to have any late in my record.

We have a benign shift and fortunately the one case where I was assigned was not a long standing case as we thought first. It is really lucky one because we all thought that our OR which is parotidectomy will last God knows when but good thing is the operation lasted for 2 hours only.

Anyways, it is not the case that make my day stressful but rather the fact that my student nurse (who washed my instruments) forgot to mention to me that she accidentally dropped one skin hook in the sink. I was really rattled when I learned that I'm missing one skin hook so the best way to solve is to dismantle the sink and see if it is there or not. Good thing the GS staffs are there to help me to find the missing instrument. :)

Skin hook retractor, sa sobrang liit posibleng mahulog sa sink :(

Pasta and Pastry Party

Night duty shouldn't be a frightening experience but rather a joyful one, expecting a surprise not by the emergency cases that one may experience but rather being surprised to what food your co-worker may bring, hence I decided that every Saturday night (instead of having a Saturday Night Parties in different clubs in the metro), we will have our own OR Saturday party with different themes every week.

Last night is our first party night duty, and because Mam B and I were the one who is on duty we decided to have a Pasta and Pastry Party. I'm the one responsible for the pastries while she'll do the pasta, specifically she'll do a Seafood Marinara.

I can't decide what to bake, in the end I decided to make three different kinds of cookies. I kinda felt pressured kasi ang mamahal ng ingredients nung seafood pasta ni Mam B, so para ma-compensate naman sya I’ll make three different kinds of cookies: Oatmeal Raisin Cookies, Chocolate Chocolate Chip Cookies and Peanut Butter Cookies.

Anyways, we always believed that when we brought foods in OR during the night shift, will be having less emergency cases but last night muntikan ng hindi umepek ang dala namin buti na lang marami yung dala naming foods so when we arrived the ongoing emergency craniotomy is already closing (skin suturing) and hindi na dumating yung isa pang emergency cranio from Laguna.

The first theme party we had was a success. Jops, Benj and Sir Aldrin also dropped by around 11pm so nakiparty na rin sila sa amin and as expected the food we brought is highly appreciated. The Sunday morning staffs were able to eat our treat too and they loved it.

Next Saturday is another event although this time around, I’ll be the one responsible for the main dish while Mam B’s responsible for the dessert.

10 Reasons Why I Hate Neurosurgery

Photo courtesy of Michelle Au (http://theunderweardrawer.blogspot.com)

If I were to rank the different services in the Operating Room, my ranking would be as follows: General Surgery, Cardiothoracic, OB, Pedia, ENT, Plastic, Orthopedics, Neurosurgery and lastly would be Urology. But I really don't hate Uro, it's just that I just hate the cases where only a circulating nurse is needed like TURP, RPG- Cystoscopy and others like that if you get what I mean. But if the case of urology is like the cases of GS which means they're gonna cut and expose the abdominal cavity, then I would rather scrubbed in this surgery rather than be a part in the neurosurgery service team cutting up the brain and everything. With that consideration in mind,  it is easy to conclude that neurosurgery is my least favorite among the services and this entry would least down 10 reasons why I hate neurosurgery.

1. Attitude of the Neurosurgeons. I don't know if this is true all among neurosurgeons and their residents or it only applies to those who I've only encountered. The problem I had with the neurosurgeons is that they have this kind of air in their attitude. I never felt comfortable with their presence unlike those with the other surgeons in other services. I don't know but they always have this tendency to look down on you if you don't know what you're doing unlike those with other services that they are willing to help you. In short, my perception to them is an egotistic and arrogant being.

2. Appreciation to the surgery per se. Unlike those surgeries that involved opening up the abdominal cavity, operation of the brain doesn't help me to understand the operation that they're doing. The operative area is viewable only to the surgeons and the residents unless they opted to have a video set-up for the surgery team to see, unfortunately this happens only once in a blue moon in our hospital. :(

3. High risk of losing sponges (cottonoids, cottonballs and the like). Due to the limited space of the operative field and the size of the sponges, there are higher risk of losing the sponges being used compared to those used in the surgeries dealing with abdominal cavity. Adding to the problem is the fact that resident surgeons don't know how to return those little cottonoids back to us, so every now and then it is our duty and responsibility to check if our cottonoids are complete or they already fell in the floor. It is just too difficult when the surgery already used almost 200 cottonoids, it's just too hard to track all of them so you're only option is to pray hard that when you start counting the sponges, it is complete!

4. Difficulty of prepping the table. You cannot open the sterile dram immediately in neurosurgeries to avoid contamination of the field and because of that, it was always a tedious task in preparing the sterile table. And with all the countless supplies and load of instruments to be open for the surgery, you'll just get surprised that the whole team is already ready and you're still not.

5. Difficulty of controlling bleeders. Same reason, the limited space of the operative area makes it difficult for surgeon to control bleeders and with the complexity of the brain area, the surgeon is always at their edge and as the scrub nurse, you are always the one who gets the blaming.

6. Too many equipments in the room. It's okay if the OR suite/room is big but in our case, our big room is always not enough for the BIGGER equipments that are needed in the surgeries like the Leica Microscope and the C-arm. And with all these big equipments packed in a small room, there is not enough space for us to move around comfortably.

7. Different instruments from the usual/familiar instruments. Ok I admit it, neurosurgery is one of the specialized field like those of orthopedics and others and that means aside from the usual instruments commonly found in OR, neurosurgeons used other instruments that are quite exotic in my brain to register  immediately after using it. It takes time to memorize all those unfamiliar names of the weird instruments but those excellent surgeons (note the sarcasm in my voice please) always expect it that you are bound to know those names right away. I just hate it when they are asking for an instruments and you being new and unfamiliar have that weird look in the face (plus the weird question mark in your head) then suddenly those surgeons would comment something like "you should know the names of your instruments before assisting us in this surgery..blah blah blah." My fault for being new and having a senior circulating nurse who doesn't even care for my welfare.

8. Almost all cases were long standing. With all the surgeries of neuro services only a handful can be done in minimum of 1-2 hours, the rest you can bet can last til God knows when. I have experienced one surgery that lasted almost 16 hours and in the end they have one cottonoid missing out of 300+. That is just too scary.

9. Different cases but no definite sequence. Ok maybe there is a definite sequence to their surgeries like those in GS and OB but I still cannot see it.

10. I just hate it.  No explanations needed. I just hate the service that's all.

Disturbing Dream Again

I had another disturbing dream last night, or rather another so-vivid-that-it-looks-like-it's-really-happening kind of dream.

I'm afraid having these kind of dreams lately because the last two dreams that I had, had made its way into reality, and I don't know if I want this dream to happen too. Like the last two dreams, my dream last night has no fictional feel to it, it was so realistic that it is possible that it can happen in real life.

Anyways, my dream starts with me working as usual and as usual we're working overtime. I received a text message from Sir Ghe's wife asking me if he is still working in OR or not. Then I went to him and told him that his wife already texted me which is so unusual. Anyways, the HNOD for the day asked me to circulate in a heart surgery, the problem is the anesthesiologist is one of the strictest. Everything seems fine until the operation starts, I really don't know what I'm doing so in the end the anesthesiologist gets angry and walked out. And because their is still an ongoing heart surgery, she went over there to help. I, on the other hand, prayed that I will be relieved already. And then I woke up.

I'm really glad that it ended without the anesthesiologist demoralizing me further. It's already enough being demoralized in real life but being demoralized even in dreams, it's worst.