Tuesday, August 08, 2006

More EP

It hasn't been even 24 hours and here I am posting again on the week after the BME immersion term technically ended. Somebody stop me! No, but seriously, since I started later than everyone else I owe it to the program and everyone involved to continue this week in the same way as I have been the previous 5 weeks. While everyone is posting their final post wrapping up the immersion, I'm here to make it last that-much-longer. This time I want to share a few thoughts that I have after being in an several operating rooms.

I hadn't been inside on operating ever before this immersion program. But there were a few things that I noticed almost immediately about how one is run most effectively. The first thing that was readily apparent was the chain of command in the operating room. Well, maybe not so much chain of command as knowledge of ones position and duty. That is to say that everyone in the operating room not only knew exactly what he/she was expected to do, but that he/she also knew what everyone else in the room was expected to do. The top man (or woman) is obviously the attending clinician. This is the person with all the years of school, all the years of training, and all the years of practical experience. From what I saw, whatever this person says is final. That is not to say that they may not ask others in the room for an opinion or suggestion. It is true that most times the attending will ask questions as a way to quiz the other fellows or residents in the room. But there were sometimes that I witnessed when a fellow's or resident's thoughts were actually acknowledged and considered in a operating room scenario. But for all intents and purposes, the attending was always right, and everyone there acted as his/her assistance. Which brings me to the fellow/resident. I've heard the both terminologies for what I consider as the same position, so let me elaborate. This is the person who is only a few years away from being an attending themselves. To make life easier I will call this the 3rd or 4th year fellow. Their main goal is to learn as much as possible by both closely observing all and actually performing some the procedures. Comparing the 3rd and 4th year fellow, you have another interesting dynamic. Because the 4th year fellow has had one more year of experience, they are often required to act as teacher to the 3rd year fellow while at the same time being student to the attending. This is important to the 4th year because it further solidifies his/her knowledge of the subject matter and it is important to the 3rd year because every chance to learn is beneficial. The nurses in the room play an invaluable role in making sure everything runs smoothly in perfect harmony. Previous records, patient comfort, operating room sterility and medical tool retrieval are just a few of their many tasks. The attending and/or fellow constantly rely on these people to keep the operation moving forward. The technician is responsible for all the computers/software/hardware in the room. As technology becomes more and more advanced, more sensors and digital recorders and high powered imaging devices are finding their way into the operating room. A malfunction of any could create major problems and its their job to make sure all of the technology cooperates. The anesthesiologist is in every operating room as well and their job is extremely important to everyone as well because no one wants a patent waking up in the middle of open heart surgery! All in all a smooth operating room is quite a marvel to witness as each piece of the puzzle fits in perfectly to create a masterpiece. (that is the cheeziest line in the whole blog I promise) Another thing to highlight specifically is everyones ability to mutli-task. Just because the jobs are relatively well defined in an OR room, that doesn't mean that everyone has one or two things they are expected to do.

On another note, I want to express my desire to see operating rooms go completely digital. Maybe its because I'm an engineer, but I really think that in an operating room there not need be one piece of paper. What I mean by this is that everything should be digitized and on some sort of computer. This would make the creating, retrieval, and transfer of data along with all other forms of documentations much more easy to manage. This would save time and everyone knows that time is money. I'm sure it would take boat-loads of money to revamp all operating rooms in the U.S., but I fee like the 6th best hospital in the nation should be a little more 'wired' than it is now.


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