– For several years, you worked at St. Jacob’s Hospital, and since 1998 you work at the Republic of Vilnius University Hospital. Tell us more about how you got to your current position?
– I always dreamed of working in the fields of cardiac surgery or neurosurgery. While studying in the second year, I started working as a nurse at St. In the Department of Neurosurgery of Jacob’s Hospital. I became an operating room nurse due to the circumstances: the nurses who worked in the department’s operating room decided to change jobs, so I had to urgently take their place – I and another colleague went through an intensive several-day “course” in the art of surgery, we were taught by both outgoing employees and surgeons.
I can’t say it was difficult – it was just different from working in the inpatient unit. There was a territorial limitation – work only in the operating room, the circle of communication narrowed – only with the team working in the operating room, satisfaction with the result of the work performed changed – the operating room does not see all the changes in the patient’s health from his arrival to recovery. Only occurred “here and now” while the patient is in the operating room.
Three years later St. Jacob’s Hospital, 1998. I started working at RVUL, I started as a neurosurgery operating room nurse, and for the past eight years I have been the head nurse of the Operative Anesthesiology Department of this hospital.
– You worked with patients in the wards, even assisted neurosurgeons in the operating room for 21 years, and now you lead the nursing staff of one of the largest departments. Are you realizing yourself?
– I would never change the surgical nurse specialization to any other and I would not want to return to the inpatient department. We operating room nurses are a bit of a mystery, separated from others by stop lines. We have many strict rules and high hygiene standards.
We only allow personnel related to the operation into the operating room. All this is necessary to ensure safe conditions for operations. I really like this closed nature of work.
In addition, as an operating room nurse, I assisted both scheduled and emergency operations. I would never change my choice to work with emergency patients either. I am very fascinated by speed and surprise. This is a job that requires independence, you need a very quick reaction, coordination, you need to be able to maintain attention for a very long time. I’m not saying that it’s not necessary during elective surgery, but when assisting an emergency surgery, everything needs to be done much faster.
Meanwhile, the position of head nurse requires a wide spectrum of knowledge and skills: legal, accounting, related to equipment, medical tools. You also need the ability to plan, analyze, organize, adjust, shape the department’s needs, and have psychological, communication, cooperation, and mentoring skills. Improving is always fun.
– Perhaps because of the above-mentioned closedness, not only colleagues at the hospital, but also patients know little about the specifics of your work?
– Although our work is very interesting, it is invisible to the public. Few people know that the operating room nurse begins to prepare for the operation much earlier than the patient arrives in the operating room: he adds supplies, prepares sets of instruments and dressings, additional instruments, bandages, devices, checks the readiness of the operating room, discusses with the nursing assistant what tools may be needed and from where they should be brought, prepares the documents.
We enter the operating room when the patient’s attention is distracted from the instrument tables by the anesthesiology team. We have an unwritten rule to prepare instruments and other tools without the patient’s sight so as not to cause additional stress. Of course, there are also curious patients who ask what one or another instrument will be used for. After the operation, the operating room nurse collects and transports the instruments for sterilization, so when the patient wakes up, he no longer sees them.
– What knowledge and personal, psychological qualities does an operating room nurse need?
– Knowledge of human anatomy and physiology is necessary. We must know the stages and course of the operation, instruments and special equipment. During one operation, we prepare from 50 to 300 or even more instruments of different purposes. Sometimes the preparation for the operation takes even longer than the operation itself.
Regarding personal qualities, I think that an operating room nurse must be ambitious and resilient both physically and psychologically, able to maintain attention for a long time and concentrate on different tasks at the same time, able to anticipate various situations and quickly adapt to changes, have determination, and be able to make decisions independently , very communicative and cooperative. For example, if an endoscopic operation is to be continued in an open manner, the operating room nurse must quickly, in accordance with the requirements of aseptic and antiseptic, collect unnecessary instruments and replace them with others. Such a change must not affect the quality of the team’s work.
By the way, if you were to observe the work of the staff in the operating room from the outside, at first it would seem that there is no teamwork, and team members perform individual tasks. However, after the preparatory work is completed, the staff gathers at the operating table – then you can see joint activities, coordinated actions, active eye and gesture language. Eyes can convey all emotions, ask and receive, understand the answer. By the way, when I started working in the operating room, I had to learn to smile with my eyes, because the smile was hidden by a mask.
– Some operations may not last an hour or two. How do you stay focused?
– Only when I started working as an operating room nurse did I have to get used to standing in one place. The longest surgery I assisted in lasted over 10 hours with only one very short break.
We have to be constantly focused, because if we talk to someone or just daydream, we can harm the patient and colleagues. I think that such a quality can be cultivated, but at the same time you also need to love your work very much. It’s true that we sometimes need a break from the noise of medical equipment (sweaters, caustics, coagulators, anesthesia machines, etc.), so we turn on music.
– What does your job as a head nurse look like?
– This work is very interesting and is also low-profile – it may appear that I am just sitting at the computer and planning. Scheduling and daily adjustments, planning vacations, preparing reports, analyzing operating room availability and finding new opportunities, working with the operation planning program really takes up the majority of the work. The work in the operating rooms takes place every day, the number of personnel is large, so there are a lot of unexpected changes. I see the department’s work as a whole and when an unforeseen event occurs – whether it’s an employee illness or a patient emergency – I look at all options and quickly find a solution. Often the calls and messages start as early as 6:30 in the morning, so when I go to work I know that the daily plan has collapsed like dominoes, but in a few minutes I put everything back together.
Of course, working with people is always difficult, each team member is different, his needs, sometimes, capabilities, and mood are different, so I have to choose the right way to talk to a person, delegate tasks to him. A sense of humor is very often useful at work. I never raise my voice, and when problems arise I always talk to the employee face to face. It is not necessary to speak a lot and loudly to be heard.
I came to my current position from the operating room nursing circle, so there had to be a certain boundary between us so that the staff could hear me and do what needed to be done for the smooth running of the department. As a head nurse, I have to constantly monitor, control, organize and coordinate, but I don’t do it ostentatiously and it works. I can only be happy that the team is professional, harmonious, team-oriented and aware of the importance of their work, if necessary they always agree to stay longer to finish the day’s work.
– 15-20 emergency patients are admitted to the Department of Anesthesiology every day. How do you prepare for their reception?
– Each day of operations is planned the night before. We know which planned patient, in which operating room and by which surgeon will be operated on, we allocate teams of operating personnel. We are also prepared for emergencies that we cannot foresee. Of course, there are times when there are more of them and all operating theaters are occupied. We usually have a maximum of 10 minutes to prepare, often even several teams have to come together to help. In such cases, I have to coordinate all our actions very quickly to accept such a patient. And when the patient enters the operating room, the operating room nurse is like a “conductor”: he directs the actions of the staff, prepares the instruments, equipment, tools on time, gives instructions and keeps a watchful eye on the team and the patient.
– You have been working at the hospital since 1998. How has RVUL changed during that time – what hospital did you come to and what is it like now?
– Coming here from St. Jacob’s Hospital already seemed like a big change in those days. And comparing RVUL, for example, ten years ago and now, the changes in both infrastructure and information technology, as well as social guarantees are evident. We are very happy that our nurses can raise their qualifications, have lunch for 1 euro, exercise in the staff gym, wear new, beautiful clothes, take advantage of two paid wellness days a year, and a day off on their birthday.
We are happy with the latest work tool – the operations planning program. Seven years ago, we could only dream of such a thing. Back then, we tried to plan operations manually on a whiteboard, and I received dozens of calls from surgeons a day. Now we can use the innovative tool and see the situation in the operating rooms in real time, planning has become much more efficient.
Also, four years ago, we transferred the preparation of surgical instruments to the staff of the Sterilization Sub-Department and standardized the instrument sets. We have catalogs with sample kits and tool lists. These catalogs are also useful for new employees and students who come to work with us.
Many positive changes have taken place in equipping operating rooms with the necessary tools and organizing work. Stocks of general, specialty and power instruments are updated based on the needs of surgeons. Operating tables and lamps have been changed in all operating rooms, X-ray equipment is in operation in all operating rooms of traumatologists and neurosurgeons, there is no need to transport this equipment from one operating room to another. Couriers deliver instrument containers to the Sterilization Sub-section and medical devices to the storage area. Soon we will have vacuum mail to send the tests to the laboratory.
– These changes contribute to a smoother work for you and the whole team. Do they help attract new employees as well?
– Operative nursing as a profession is not a very popular field at the moment – I think because of the specifics of the work – so it is very gratifying that employees who worked here 10-15 years ago and tried work in other institutions are returning. They are drawn back by ongoing changes, pay and social guarantees. Nurses who come to work with us from other institutions are happy with the friendlier and more open staff.
We have excellent opportunities for students to get to know the hospital before starting work. As a department we are becoming a little more open, we are seeing our colleagues from other departments take an interest in us, we are even getting requests for a tour of the department. We do not take them to operating rooms, but we always show the general picture and are happy with the attention. I also hope that the public will be more and more interested and learn about the work we, operating room nurses, do.
Tags: bit mysterious aloof stop lines
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