I work in the Operating Theatre AMA

[StealingYourWiFi]

I work across anaesthetic, scrub and recovery. Currently in the private sector.

Ask away

Where has OP gone? I was looking forward to this!

Can anyone else answer:

1. Does anyone comment when the gown is opened/removed on the operating table?

1. What happens if the surgeon makes a mistake? Do you all keep shtum?

1. Ever seen anyone’s teeth break when being intubated?

1. Why do I take so long to come round after a general compared to other people?

yes, the patient, but what about theater staff?

LOL, if it's a long procedure you get a break.

I'm another former theatre nurse too.

I now scrub for non -sterile procedures where the patients are awake and generally prefer awake patients as I like chatting to them. Swings and roundabouts really - during cases where the patients are asleep, I'm still chatting but to my colleagues.

During routine procedures, we chat about anything & everything. What we had for tea, what's on TV, holidays etc. Our team have commented on people's appearances - I love body art so admire tattoos and have also admired people's hair colours etc. I've never ever heard someone be negative about a patient's appearance & can't quite imagine how poorly it would be judged. We're always respectful of the people we're looking after

Never annoyed by people holding up the list for whatever reason (enjoyed the few minutes respite) but I know that the anaesthetic team appreciate being warned in advance so that they can shift the list around ie anxious kids first, adults at the end so they can have a sedative before/don't disrupt the running of the list. But it can be very scary so they are understanding.

I've only once been in theatre when a patient died on the table. We knew going in that there was a very high chance of the patient not making it, and that they would certainly die without intervention so while it was sad I was just glad that we'd done all we could to try & save a life.

I've never seen someone wake up. Sometimes people twitch a bit but the anaesthetic is altered then.

Our team had a policy of swapping around to avoid being there while someone we knew was in. If it was a colleague then they were operated on with the minimum necessary in the room, generally sister and another nurse from a different team.

1. Does anyone comment when the gown is opened/removed on the operating table? No one ever comments on the patient, other than in professional terms.

1. What happens if the surgeon makes a mistake? Do you all keep shtum? I've never seen a surgeon make a mistake.

1. Ever seen anyone’s teeth break when being intubated? Never

1. Why do I take so long to come round after a general compared to other people? Everyone reacts differently to anaesthetics.

OP - sorry if this brings tour thread down but my Mum died whilst under anaesthetic, she was having heart valve replacement surgery.

What I want to know is, when they turned the machines off, would har body still have taken time to shit down or would it have been instant? Either way would someone of been with her while it happened and then would then have closed her up up inside like someone who was alive or just tidied the outside up and been down with it?

I've come to terms with her death but it kills me wondering if she had someone to look after her as and after she was gone.

I'm so sorry for your loss. I've never been in theatre when someone died but on the wards the patients who died were looked after, so I'm sure your mum was cared for. As a student nurse we were taught to respect and care for dying and dead patients.

The only comments I’ve ever heard when gowns are being removed is people talking to the practitioner who is the other side of the patient to ensure that we don’t cause skin damage when removing the gown from underneath someone or that it isn’t wrinkled up or wet. Our concern is for the patient.
People do chat in theatre but the scrub nurse and the surgeons don’t tend to participate in the chat because we are concentrating on the procedure.
No chatting happens during the important checks or when specimens are being handed out.
The anaesthetist monitors your heart rate and blood pressure constantly and if they need us to stop, they tell us and then tell us when we can start again.
I’ve not had to go to the loo during a procedure I’ve been scrubbed for but my longest I’ve scrubbed for was 4.5hrs and I hadn’t had lunch or a drink so I didn’t need the loo.
Infrequently I have seen staff pass out. We always try to catch them in a chair or guide them to the floor safely without desterilising the surgical field.

Ds had some kind reaction when they put the tube down his throat. He needed adrenaline and chest compressions.
They said it was just one of those things. Is this likely to happen again? For ages after I was worried about him being in an accident and having to have emergency surgery and having a worse reaction.

I had a spinal anaesthetic and afterwards my back really hurt and did for days afterwards. The anaesthetist said it would have been a coincidence as spinals don’t cause back problems, but I don’t see how it was fine before and not after th injection. Can you give your view?

@Titsalina - I can only answer for the one case I saw, but when our patient's machines were turned off, his body stopped, because it was no longer working for him.
He was finished in the same way as any other patient, internally and externally, with just as much care to ensure that his sutures were neat & tidy.
Afterwards he was given a wash and was dressed (his clothes had been cut off so he was given a gown) and he was brought into a side room where his family could spend as much time as they needed with him. A nurse stayed with him until his family arrived and then went back in after they'd left to make sure he wasn't on his own until he was collected by the porters.

I hope this answers some of your questions.

I've needed to be relieved to go to the loo - I just ask one of my colleagues to scrub up and step in. You need to give yourself enough time though as the new scrub will need to do a set check to make sure all instruments are accounted for - no good if you've let yourself get to the stage of practically bursting!

I haven't done much, if any, work with patients under a spinal, but I had one for labour after which I had back pain. I asked an anaesthetic consultant about and the answer I was told was that it wasn't the spinal that caused the problem, but how I was lying on my back when I couldn't feel it (didn't move much, no natural shifting when things got uncomfortable because I didn't feel any discomfort etc). Made sense to me

What happens if the surgeon makes a mistake? Do you all keep shtum?

I've been involved in a case where I thought the surgeon hadn't made their correct decision. I brought it up twice directly with the surgeon, and again with his reg. I also told recovery staff looking after the patient that I was concerned about this issue, so could they keep the patient a bit longer so that they could keep a close eye on the situation.

In addition, I told my sister about my concerns and she recommended I w

Sorry!
Sister recommended I wrote a statement about what has happened so that there was a records in case I was asked for my recollection further down the line.

Am just about to start an ODP degree myself so hope OP comes back!

Do trainee surgeons always work on the right hand side of the body when working with another surgeon? I always seem to have great results on the left and shit results on the right. Would we be told if a trainee was working on us? I’m talking about being stitched up in particular. All the stirches on the right hand side of my body & face look like theyve been done by a child.

Thanks for the job you do OP, and to the others on the thread doing similar.

I had an operation last year and apparently it was very difficult to put the tube in; I now have a card that I’m meant to give in if I ever need surgery again! Is this common? Is it normally difficult anaesthetising people?

What made you pursue this line of work? How long did you train for?

Can MNHQ enforce OPs to respond? I was looking forward to reading the responses

I think the point of 'Ask me Anything' is that you actually respond to questions..

What does 'scrub' mean? Does that mean actually in the theatre during the surgery?

Does anyone ever poo or wee themselves whilst under? I had surgery recently and kind of needed a poo before I went in, but couldn't quite go, and then I was really scared I would shit myself whilst I was under! Obviously if you are just asleep in bed and you need a wee/poo you will wake up, but if you are under anaesthetic you won't wake up?

@TitsalinaBumSquash

Sorry to hear about your mum. I am part of the cardiac theatre team, so have sadly seen this happen on quite a number of occasions.

It's not really possible to tell how long it took after the machines were switched off for your mum's body to completely shut down. It depends a bit on what stage they were at in the operation and also it just varies a bit between different people. If she was still on the heart/lung machine when the decision was made to withdraw treatment, then it's likely that she died extremely quickly, because she would have gone from complete support to nothing in a short space of time.

If she was in the later stages of the operation, so her heart had been supporting her circulation to an extent, then it can take a bit longer, maybe a few minutes for the heart to stop completely. Please be reassured that she would have known absolutely nothing about it.

As I say, I've been involved in quite a large number of cases where the patient didn't survive surgery and I always made sure that I or another team member was holding their hand as they slipped away. I hope all cardiac theatre teams would do the same. After a patient passes away a surgeon closes the wound and puts a dressing on. If we know that the patient will be having a post mortem then sometimes just the outside will be stitched, rather than wiring the breast bone together, so that the pathologist can see more easily what had happened during the operation. As far as I know then after the PM the wound is closed as normal.

When a patient dies during an operation the whole team is very affected by it. None of us just carries on as usual, we really do feel very sad for the patient and their family. The patient is treated with the utmost care and respect afterwards. I sometimes shed a few tears, to be perfectly honest with you.

I hope this is some comfort/help to you. Please ask if you have any other questions.

There are always a number of people who scrub for an operation. These people stand at a sink and wash their hands, nails and arms for 10 minutes. They are then helped into sterile gowns and they put on sterile gloves. These people are the only ones who can touch the instruments and they will clean the area to be operated on and put the drapes on. All this has to be done very carefully without touching anything that isn’t sterile.

Other nurses, ODPs and nursing assistants support the scrub staff. The anaesthetist doesn’t scrub.

Is it really unusual to be "wired" after a GA? I ping awake, starving and thirsty and once I've eaten and drink I'm then wide awake. ALL night 😭 usually for around 48hrs after I can't sleep
The ward staff seemed a bit bemused by it and said it wasn't common! Although I think they liked the company and gossip at 3am

@cuppateaandajammydodger ODP is great, 12 years in I still really like the job.

newestbridearound
I’m not theatre staff but I am a critical care sister. Did the anaesthesist come and speak to you about your difficult intubation? Did they tell you what grade you were? It might be worth trying to get some more information and possibly wearing a medic alert bracelet for the very unlikely event you needed to be intimated in an emergency. That said: there are checklists and very clear protocols to follow in this event and all airway staff know these. HTH.