Claustrophobia and Sterile Fields

Do you ever remember doing something you’d never done before, and you had that sickened feeling where the presence of butterflies was bordering the unkind verge of vomitus maximus? Well, I would like to say that this is quite the normal sensation as a nervous ninny in nursing school.

The fine day I want to walk you through was like most others: I woke up and immediately began force feeding myself mantras to get out of bed in a timely fashion and furthermore attempting a hand at an 0530 breakfast. Now, these weren’t exactly breakfasts. I mean, I DID break my fast, but this was different. These occurrences were major meals that I couldn’t process or rather feel at this early of a start. BUT! I knew deep down that I wouldn’t get my hands on food for a hot minute once my shift started. Therefore, reason enough to have a scrambled egg, toast and coffee feast. The flavors always eluded me, as they always would at the butt-crack of dawn. (Welcome friends, yet again to digression).

This morning, as similar as it was to many others, was also incredibly and wonderfully different. My very hard-core persona of the nurse-in-training was dead set on rocking an awesome day in the operating room. Yes, I would be on the outskirts, yes my hands would touch absolutely NOTHING, but the excitement of being present while someone’s insides were exposed to the World always sounded heavenly. 

I know this is troubling to many, but I have a stomach of gold when it comes to the Nursing World. I can handle gaping wounds, blood, gore and basically any Quentin Tarantino movie being acted out within the walls of a hospital establishment (some of these characteristics have changed mind you, but that’s besides the point and totally another story). In all honesty, this was the holy grail of days to go to clinicals. I had been praying for a triple bypass, mitral valve repair or even some form of transplant, but really, I was ready to take what I could get!

I showed up like a deer in the headlights, blinking uncontrollably into the harsh fluorescent lights radiating off of the freshly polished linoleum floors. Of course, not knowing my head from my tail, I had to ask some extremely well-seasoned nurse as to where in the heck I was to put myself. What an odd situation clinicals are. You show up at the designated time and usually there’s an awkward scramble to figure out what to do with you until someone claims you (like a bad game of dodge-ball). 

Soon enough, a woman donned in her OR gear grabbed me by the elbow and showed me where I was to change. Here was the second dilemma. I am a peanut of sorts. All 5’3’’ and 120 pounds of me was staring at a rack of OR scrubs that I needed to somehow find the right size. APPARENTLY, these things are color-coded. I had to ask yet another nurse for assistance, then put on the LARGEST extra-small set of scrubs I’ve ever seen. They made WalMart scrubs look like apple-bottom jeans, just sayin’.

People, people, people. 

There is so much more to getting dressed, and I’ve not even gotten to the best part! Apparently you grab a sterile mask, hair net thing, and booties. Goggles are an option too (mind the back spray)! There is also the unfortunate circumstance of the temperature gracing, oh I dunno, minus 10 I think? Maybe I exaggerate, but some lovely soul gave me some other unkown soul’s OR jacket to wear so I didn’t turn blue. Whoever you are, and you’ll never know me, thank you SO MUCH for sharing..Even though you had no idea.

I waited in the sterile area for my preceptor. Ah, the preceptor. For those of you who DON’T know, the preceptor is the person responsible for you during the shift. This role is reserved for guiding frightened nursing students and nurses entering a new job position on the floor. This is the person whose license you are operating under. Whatever shenanigans you cause can lead to sticky situations for these people. God. Bless. Their. Souls. Round of applause please.

She showed up smiling at me, and then very quickly furrowed her brow. “Jacquie, mask!” Right, right! Because in the designated sterile areas of the hospital, it is literally sterile. Even from your halitosis. So put your flipping mask on! Please understand that I was so excited and nervous, this sentence happened well over a dozen more times. When I sensed it was coming and I wasn’t prepared, it was that deer in the headlights look again as I slowly pulled my mask over my face. Let’s talk about the surgical mask for a minute here...

The surgical mask comes in many forms. The one of which I realized I despise with ultimate hatred and deem to be the spawn of everything unholy, is the mask that comes in one piece. This is the mask and face shield combination of which I am speaking. Recall that this was my first choice. All will unveil shortly, I promise. The other option is the mask you tie around your face, and then you can put on goggles separately. This is the better choice for me as I learned so beautifully only an hour or so from this moment we are speaking.

Now that my mask was on, it was safe to head into the operating room suite. This was a smaller hospital, so there were only 6 or 7 suites. If you know me, and you might, I started tooshie kissing as soon as I had the chance. I realized I was in for hernia repairs, gall bladder removals and it’s not that I wasn’t excited, but it’s no open heart surgery. The nurses at this point were laughing at me, but one surgical technologist overheard me and slipped into the adjoining suite to sweet talk my way into this totally brilliant open heart surgery that was to happen only two hours from that very moment. I struggled to control my excitement.

The cases I was assigned to began. The first patient was wheeled in and I was given a trusty stool to stand on so I could see all of the action first-hand. So, thoughtful those nurses. I was standing next to a HUGE machine that was behind me, the sterile field/operating table/patient were all in front of me. The surrounding areas were lights, the anesthesiologist’s corner (at the head of the patient), and the surgeon to my front left-ish. This surgeon was hilariously short, like me, but his head filled the room. He strutted in, swinging his arms and looked at me as if I were standing there next to my new bike with streamers and pigtails in my hair. Fair enough, I’m in the beginning of this career choice, but give me some credit man!

Introductions ensued and then the business began. The surgeon would tease/teach/ask questions over his shoulder as I stood on tiptoes to see the laparoscopic surgeries happening in front of me. Please note, laparoscopic = nothing to see. Literally two to three small incisions in a localized area, and then everything else happens internal. But, I can make a "dull" moment exciting. This is where things get very, very interesting..

It is maybe the third or fourth hernia repair with mesh placement and I’m trying to get a better view, when some terrible awful stench reaches my nose. I realize with absolute disgust that this scent is that of burning flesh. Not because there’s a fire everyone, but because you use a cauterizing machine in operating rooms, especially to prevent bleeding during procedures. Therefore, I realized that the giant machine behind me was actually the cauterizing machine. What a lofty piece that thing is. Positive and negative cables run out of the machine itself that you place onto the patient, and then a third cable is the actual tool. Not that any of you really care what this thing looks like, but if you’re visual like me you need it for “setting the scene”..

Well this stink hits my nose like a grizzly bear chasing you from it’s cubs in the wilderness. If you didn’t get that, it hit me with a vengeance. A terrible awful vengeance. At that point in time I realized that the air turnover in my surgical mask wasn’t as great as I originally had realized. It at least felt that way. Trying to maintain sterile procedure, especially considering I was standing above the patient’s body, I would pull the mask off of my face about a millimeter, and try to take a deep breath. Well, when you’re freaking-out-ish, breathing comes rapidly and heavily. So the heavy breathing just led to me fogging up my own eye shield that was so fantastically engineered to the whole STUPID apparatus. Whoever thought that up, I understand the ease that you take care of two VERY important situations, but is it really that necessary?!

For lack of a better description, little to no air turnover, fogged up mask all lead to the feeling that the room is MUCH smaller than it actually is.

Dizziness hit me and I suddenly became aware of the fact that I was holding my breath. WHOOPS! Oh yes, locked the knees too. Not breathing and locking knees. Not good people, not good at all. 

My first thought was, if I fall, I either land on the patient by falling forward, or on the cauterizing machine in falling backwards. So I chose to step off my platform after trying to regroup and failing miserably. I walked very unsteadily to my preceptor who was seated in the safer outskirts of the operating room, you know, away from the sterile field. She looked up at me and noted oh so sweetly, “Jacquie, you are white as a sheet!” I asked if I could sit, not even able to further formulate words to suggest that I totally agreed. So I sat, hard, on a stool. As soon as my bum hit this lovely chair, the stars began to collect in my peripheral vision. Seconds later, the tunnel vision hustled in rapidly. Oh no no no no noooooo!

All I could think of was totally embarrassing myself by passing out on this amazingly sterile floor in the middle of surgery being performed. Talk about making a name for yourself!

I turned to my preceptor, feeling very green, covered in sweat, and sensing that I may possibly die in this very moment. Not dramatic, I know.

“Hey, uhm, I think I’m going to pass out…” Talk about eloquent word choices. My preceptor squealed, “WHAT!?” And literally, simultaneously pushed my head between my knees. “BREATHE!” She shouted. So I kept on breathing, with this feeling of impending doom—face hitting floor doom. 

Her next statements came in a really quite fast accusatory tone, “Did you eat this morning? Does blood freak you out? Are you sure that you ate?” If I could sigh, I would have, but all I could muster were puny responses, “I did eat. It was at 5:30 AM. Blood doesn’t scare me. Do you realize I made it to four surgeries and now this is happening? Of course I ate, I TRY to eat every three hours.” A little snarky mind you, she was only trying to help, but being out of your element something fierce with your head between your own knees doesn’t make sweet-talk a priority.

At that point she grabbed the back of my scrub top, brought my head up really fast and looked me dead in the eye… “Are you claustrophobic?!” At which I paused, as if the light-bulb just came on, and nodded.

Like Superman, she ripped the eye shield cover from my mask, exposing my eyes to the lack of back-spray (thank you laparoscopic surgeries!) and began fanning my face in a hurried fashion. “How does that feel?” My preceptor asked in a worried voice. “Better actually.” With that, she shoved my head back between my knees.

The surgeon continued to do his fancy handy work with that patient’s insides as I sweated out a fierce almost-passing-out situation. He giggled and made comments, of course. But at that point, I was gracious to have not broken sterile field by passing out ON the PATIENT or breaking a VERY important surgical machine.

Toward the end of the surgery I was led out of the room by the surgical tech that I had spoken to earlier that morning. He got me snacks, ginger ale, and commented on how sweaty and white I was. Thanks for that. He was kind, and even apologized for my circumstances, which only made me laugh. I explained that I have a knack for really strange adventures at the most inopportune times.

How much times passed, I will never remember, but somehow I collected myself and was summoned back to the operating room. The doctor was RELENTLESS with jokes. Holy smokes was he terrible. Determined to not feel small I interjected my own replies and then began asking questions about the surgery.

To my astonishment, he paused, and asked me to come and stand at his shoulder for the rest of the surgery and through the next few.

I guess if you are me, and you find yourself in interesting situations, and then furthermore live up to it and not cave when someone comes swinging, you reap the reward (whatever it may be).

Now, I would have MUCH rather gone about it TOTALLY differently.

But.

Well..

Beggars can’t be choosers friends.