Essay On Nursing Observation

Description: For my last journal entry, even though I want to summarize my entire clinical experience over the two semesters, I want to focus on my observation experience which I completed in the OR two Mondays ago. For my observation, I went down to the day surgery window and was brought out back to change into different scrubs. Then I was introduced to the charge nurse for the day, who was more than excited to have me observing in the OR that day. I was given the choice of seeing two surgeries that are interesting or seeing one surgery that the nurse seemed extremely interested in. Instead of seeing a knee arthroplasty and a hip replacement, I chose to go with the surgery the nurse was very interested in. The surgery I saw was a robotic prostatectomy with bilateral lymph node tissue dissection and it was very interesting. I met the patient before they were brought to surgery and then followed the anesthesiologist while they did their speech on what to expect before and after the surgery. Then the anesthesiologist helped a nurse wheel the patient down to surgery and I followed behind. Once in the OR, I met the

circulating nurse, her trainee, and noticed the surgical tech was already there setting up all the sterile equipment which would be used during the surgery. The anesthesiologist and circulating nurse then helped the patient move onto the operating table and had them move to the correct position while awake to make it easier on the nurses. The anesthesiologist then sedated the patient and an endotracheal tube was placed as well as a catheter to regulate the patient’s breathing and allow for the patient’s urine to “flow free” from their body. The surgeon and first assist came into the OR and the surgical tech helped them gown up while the anesthesiologist took care of the patient and the circulating nurse went on to set up the rest of the equipment which did not need to be kept sterile. After everything was prepped and the surgeon had finished the skin prep, the circulating nurse and her trainee called the time out, in which everyone stopped what they were doing to confirm the patient, time, and surgery being performed. After the time out was completed, the surgeon then went on to make incisions into the patient’s abdomen to insert the robotic arms and tools into the abdomen. After the robotic arms were set up the surgeon then de-gowned and moved to a machine which would control the robotic arms and started the surgery inside of the patient’s body. The surgeon had lots of adhesions to cut through before getting to the patient’s bladder and prostate, since the patient had recently had an appendectomy and the adhesions had grown from that surgery. It took the surgeon about an hour or an hour and a half to get through all the adhesions, and after that it was smooth sailing removing the prostate and taking lymph node tissue out for testing. Once the surgery was completed, the patient was woken up and moved to PACU, and I went back to the pre-operative area. There were no more surgeries for me to see that would end before 1 pm when I returned, so the charge nurse had me return to Fuller unit around 12:15 pm.
Feelings: My observation in the OR was awesome.

I have had both good and bad observation experiences throughout clinical, so I was not as nervous about observing the OR as I was about observing the IV team. The surgeon I observed perform the surgery was excited to have me there and made sure I knew what was going on and answered any questions I had. The circulating nurse and her trainee, along with the anesthesiologist, were excited to have me there as well and encouraged me to get closer to see the surgery or ask questions. I felt very welcome in the OR room and was even warmly welcomed when I met the patient who would be receiving the surgery. Being in a new space and working with new people always makes me nervous, however once I met everyone on the pre-operative unit and on the OR staff, I felt right at home and all my nervous jitters

disappeared.
Evaluation: I still believe spending the day observing a different unit, team, or specialty is extremely beneficial to me as a nursing student. I personally have had somewhat of an interest in being a surgical nurse or a circulating nurse, so it was important for me to get to see what nurses do in those positions. Throughout the surgery, I asked the circulating nurse questions about her job and what it was like to be a circulating nurse during different surgeries, which I was glad happened because after I talked to her, she was more than willing to tell me about her job and the other jobs in the OR. After this observation, I secured an interest in circulating or scrub nursing, however I do not know if this is a job I would like to do for my career. I still missed the patient-centered bedside care and getting to make that connection with your patient, however seeing the surgeries was exciting and interesting.
Critical Analysis: As a junior nursing student, we have gone over in med-surg the basics of pre-operative, intra-operative, and post-operative expectations and care. From this observation in the OR, I observed how a nurse can utilize different techniques in planning and documenting while also maintaining sterile field and overseeing the OR. Not only this, but I know now different tips and tricks to utilize when taking care of patients while on the unit. I realized while in the OR that I do have a general idea of what is happening, however I only know the basics and should educate myself more on perioperative nursing. I have plans over the next couple of weeks to refresh my knowledge on everything we have learned in med-surg, so I will be going over the information I do and do not know relating to perioperative nursing.
Conclusion/Action Plan: From my experience in the OR, I plan on taking this new experience and the organizational skills I learned and utilizing them in my practice not only as a nursing student, but for my future as a registered nurse as well. I would also like to learn more about the circulating and surgical nurse roles. I got to talk to the circulating nurse a little bit, however I would like another chance to talk to a circulating or surgical nurse to see their perspective on their job, what they like and dislike about it and what is important for me as a nursing student to know. I wish we had more than one day in the OR observing because I only saw one surgery and surgical team, so I think it would be interesting to see more surgeries and compare them to one another. Comparing the surgeries would be beneficial in learning how to work with different surgeons, which would be like working with different doctors on the unit, as well as seeing the different processes for set up and timing with different surgeries. I thoroughly enjoyed my experience in the OR and would not hesitate to go back again if the opportunity presented itself.