On Wednesday, the lay surgical team got gloved and gowned and ready to practice scrubbing and scouting.
Getting ready for such an operation involves many steps: firstly preparing the theatre for the patient, then preparing the patient for theatre and of course preparing ourselves, getting correctly dressed and completing all the necessary documentation and items on our detailed checklists as well as being ready to carry out the procedure itself. I run regular training in the surgery to keep the team up to speed up with skills and knowledge.
The equipment bay had just been thoroughly re-organised for surgical set up and the first thing we did was “go shopping”. This involved the largest trolley in the suite and collecting items on our wish list for a possible abdominal operation. I made Dave, my lay scout nurse, work quite hard and with hardly any prompting, he and the team filled the trolley with over 30 items needed in the set up.
We then did a refresher on gloving and gowning, where I reminded everyone which hand was which and where your thumbs go, making them dance with each other to tie their gowns without desterilising and having to start again like a game of snakes and ladders. Draping can be equally tricky as packs must be opened a certain way, all the time observing the highest standards of sterile technique. Luckily no one was sent back to the scrub sink like an embarrassed medical student.
We had set everything up in the operating theatre as we would a real case, checking and testing the equipment just like an actual scenario. Once I was happy that all the whizz bang bits of kit were connected correctly and behaving, like any worthwhile surgeon, I loudly complained about the lights and had them adjusted several times throughout. Exploiting the situation still further, I also required someone to mop my brow. Luckily Craig and Rob were available as spare assistants and happy to step up to this great task.
Once we were set up and ready to start, I practiced being an impatient surgeon calling for different instruments off the set. This sent my lay scout nurse Dave backwards and forward into the set up bays trying to locate “the long handled thing” or the “shorter blade”. We decided to keep a laminated copy of instruments on the set so I could simply point to things, like a lazy surgeon. I also kept Craig and Rob on their toes with various comments such as “the suction’s blocked” and “I’m not getting any diathermy” and they problem-solved like professionals.
My lay surgical assistant Bri did an excellent job of passing instruments, assisting and counting packs off at the end without taking her eye off the sterile field. Once I called for closure and dressings there was a sigh of relief all round as the operation finished and we packed up and debriefed.
In spite of this only being a practice, it was fairly realistic as I deliberately put everyone under some pressure. I must say I was very pleased with my little team at the end of the case.
The lay anaesthetic team are next up to undergo a refresher workshop and I will be putting them to the test with various drugs, equipment and maybe even a rubber doll…
Sheri Newman, Station Doctor and Surgical Registrar
