A day in the life of a perioperative nurse

Most of us take what we do for granted, and sometimes we need to step back and recognise that we make a difference to the lives of the patients we serve.

As I reflected on the day while driving home recently in the wee hours of the morning, I was able to smile and say our team did a great job. Each of us, wherever we practise, has these days and collectively we should be proud of the difference we make to patient care.

12:30pm

As my shift starts, I check the allocations on the emergency board. The first case is the removal of an infected port-a-cath. At first glance it appears to be simple. Surgically it might be simple but is it by no means a straightforward case. We find within the first five minutes that the patient is in palliative care for bone cancer. Chemotherapy has run its course and he and his family are preparing for their last days together. Our patient is both positive and realistic about what lies ahead. We quickly discover his wife has just been diagnosed with melanoma and it doesn’t look good. The whole team is in awe of how this patient is dealing with his situation. The team is truly in the moment with him and our interaction is focused on his needs. As we say goodbye, I reflect on how well we cared for him but also on what he gave us - hope and an important life lesson.

2:30pm

I review the emergency board with the duty anaesthetist and contact doctors regarding availability. I notify radiography of cases and check availability.

3:00pm

We have to fit in two surgical procedures to screw and plate a fractured ankle.

7:00pm

The emergency team is called about a caesarian for a 26-week-old baby. Surgery is required within 30 minutes. The parents are well supported and prepared for the fact that the baby may not survive. The paediatrician assesses the baby girl after delivery. She is then wrapped and given to her parents for her few brief hours. We are still attending to her surgical needs but also acutely aware of the extra support this family need. You cannot be totally detached from the emotions of this situation, no matter how experienced you are. To fully support the parents, the team has to put their needs ahead of the “normal” mechanics of a caesarean delivery.

11:30pm

Before I sign off, we operate on a five-year-old girl to drain an abscess. Her mother is distraught and the team brings her into the operating room to be with her child before she goes to sleep. We use a story book to engage the girl. This settles her and her mother enough to allow us to briefly explain what is happening. A team member escorts the mother from the operating room. Once the operation is over, we reunite the mother with her daughter in the recovery room.

1:00am

I sign off. On my way home and before I finally fall asleep I have no control over my mind, reviewing all of the patient interactions of the day.

2:15am

We are called back to operate on a 16-year-old with testicular torsion. We cannot save his testes. We leave work again at 5am.

By Stephen Born, registered nurse and executive officer of the Australian College of Operating Room Nurses

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