What a way to spend the last day of N7 clinical,
Shoulder to shoulder between 2 doctors performing a triple bipass (CABG).
After the chest was opened and the pericardial sac opened, I was allowed to reach inside, sliding my hand between the pericardial sac and the pericardium, until I was underneath, and then I lifted this warm and heavy heart up from the cavity while it continued to beat, and I held it in my hand!!!!
WAY COOL!!
I am still in awe of the whole experience.
This is how Jane G. and I spent our last clinical day!
It took over an hour to get the patient prepped and the room ready. The doctors came in at 0800 and the heart was in my hand at 0845.
The surgery was completed at 1200.
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Jane and I were in the OR from beginning to end. We saw the patient while he was awake presurgery until they put him back together and woke him up at 1200. After they had put him to sleep, foleyed and intubated him, they put in a Swan ganz catheter (Jane and I were standing right next to him). When we asked "Is he supposed to be able to feel this and move around?" They said, No, he is completely paralyzed and sedated" We asked," then why is he moving his arm and jerking everytime you push the catheter?", and they said, oh..... you're right! and they had to explain to him what they were doing and give him more sed meds. They said that he is a fast metabolizer.
His heart reminded me a HUGE chicken thigh, you know, with the fat all over it. The heart was yellow (covered in fat) exceprt for where the right atrium is. It was kind of purpley/red. The right side of the heart was on top and the left side was in the back. It weighed about the same as a 1000 ml NS bag (this man is obese), but was shorter/ fatter than that. If you held it too tight, you could see it throw a PVC on the EKG monitor. (Whoa, that is a lot of responsibility!) The Dr. showed me all of the arteries that were blocked and showed me where they were going to attach the great saphenous vein and left internal mammary vein to bipass the blockages. They had a TEE (trans-esophageal-echo) down his throat and we could see all of the valves working. He had some calcification on the aortic valve (will probably give him grief later). We were allowed to walk around in the OR throughout the whole proceedure (don't ever turn your back on the sterile field though) and look at all the doins and goins on. We checked out how they were collecting his blood, washing it and keeping only the RBCs mixed in with NS to give back to him.We hung out with the anethesiologist and checked out all of her equip and meds and stuff. I asked a TON of questions! You can learn a lot when you are together in a room for 5 hours. One of the circulating nurses remembered me from Chemistry class(that was in 2002 for crying out loud) She had just passed the boards and this was her first surgey with an RN behind her name.
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