Whether you’re a student or professional changing into a surgical specialty, there is no manual that tells you how to properly prepare to maximize your surgical experience.
It’s no secret that surgery people tend to be the opposite of forthcoming with information, not because we mean to, but because we’re probably in our heads overthinking about something.
Our job requires us to have high levels of anticipatory skills. This is why we have the propensity to think 10 steps ahead in 4 dimensions at all times. That is what we’re trained to do.
So let me apologize in advance for every surgical person out there and say that we have every intention of helping you get the most out of your surgical experience, but our mind fails us at times.
That’s why I want to tell you everything that someone meant to tell you about preparing, learning, and enjoying your surgical or procedural experience, so that you can have more direction, be more relaxed, have less unexpected surprises and rockstar the sh** out of your surgical experience.
Let's dive right in.
1. THINK LIKE A SURGEON
Get the most out of your surgical experiences by doing this one thing: Pretend that every surgery you participate in, you will have to perform the exact surgery by yourself later on that day.
Doing this completely shifts your perspective from passive observer to active participant, and also helps you to get a taste of the huge responsibility that comes with performing any procedure or operation.
Think about it.
If today someone told you, you were going to have to perform a surgery tomorrow night, and you would have the chance to observe it being done in the morning, it would completely change the way you would observe and participate in the case, right?
It totally would.
You would likely thoroughly read up on the pertinent anatomy, critical structures to avoid, not to kill/ permanently disable your very real, fake patient. You would probably read the surgical technique in painstaking detail beforehand, like if it was gospel.
You would get your ass in gear and probably try and polish up your suturing and tying to the best you can in 24 hrs. A person's life depends on it!
I bet that when it came time to observe or scrub in, You would observe that surgery like someone’s life really depended on it, and it would- in the parallel universe where you became in Instant Surgeon.
If you had to perform the procedure yourself later, you would likely ask about every step, every maneuver and, you would be highly compelled to know why these things are being done because if you had to actually do it next, you would need to know all these things!
Think like a surgeon. Whenever you’re learning there is a natural tendency to over-focus on the order of the steps of the operation, and this is a low yield approach.
You see, when you do this you run the risk for forgetting the order.
As they say, to “err is human”, and human error doesn’t happen if- its just a matter of when.
So if a patient’s life is in your hands, you cannot afford to depend solely on memory.
However, when you truly understand why each step needs to be taken at what moment in the operation, you are far less likely to forget it.
If you have aspirations to work in surgery, whether as a PA, Nurse, anesthesiologist, or surgeon, or any other capacity, you must learn to think like a surgeon.
The more you know about exactly what is happening and why in the sterile field, the better the patient care you will provide, the better it is for the patients in your care, and the more useful you will be to the team.
2. STUDY LIKE A SURGEON
So now that you have a clearer picture of the kind of things a surgeon must know, let me give you some tips on how surgeons prepare for procedures. This is also the technique I use to be well prepared to first assist in any operation.
There are many great books about surgery, but I find that they’re expensive, and with constantly emerging new technology and the evolution of surgical approaches and techniques they go obsolete after a couple of years.
Typing into a search bar is a lot and easier, portable, and less time consuming than searching the index on the back of a massive surgery book.
So I’ll give you the method I use to prepare for operations that’s thorough and also free, and accessible from anywhere your smartphone is, thanks to our best friend Google.
Here is a simple outline of my technique.
Gather as much information as possible about the patient’s pre-op.
✔If possible try to get an operative report from your surgeon from the same operation to know the exact technique the surgeon uses. This will save you lots of time because you’ll only have to study it the way the surgeon does it.
✔If possible, read the patient’s chart, history, diagnoses, and medication.
✔If you can have a look at any diagnostic images used to diagnose the surgical problem & read the radiology reports. Often times even if you can’t read them, by reading the report you’ll be able to appreciate important relevant structures.
✔Try and discuss the patient with the surgeon or staff.
2. Read up on basic information about the procedure
✔Google is your best friend here. Just type what is *name of procedure* into google and see what it spits out. One of the first things that usually pop up is a simple explanation of the surgery in laymen's terms, typically meant for patients to read. These are great to start and get a general idea. Read that plus any other search results that you find pertinent. Make sure you find out these things in our search:
✔Overview of the procedure
✔Why it’s done
✔What approach? laparoscopic, open, or both? Davinci robotic, hybrid, etc?
✔Get familiar with all approaches and types of surgical techniques as often there are multiple ways of doing something- and surgeons choose the patients based on which will be the least risk and most beneficial.
✔What the patient can expect before, during and after the procedure
✔Follow up is this a short-term or longterm issue like cancer than needs lifelong monitoring?
Read up on the Surgical Technique
✔Review pertinent anatomy and critical structures
✔Pertinent bones, fascia + surrounding musculature
✔All pertinent blood supply: major veins and arteries
✔Pertinent ducts and secretions: bile, lymphatics, sperm, pancreatic, etc
✔Innervation: critical surrounding nerves
✔Watch at least 3 youtube videos on the procedure from start to finish, skin to skin, opening to closing. I like the ones that identify anatomy and that is a faster speed to save time.
3. PREPARE YOUR BODY FOR BATTLE
It’s likely that you will be standing, unable to eat/drink or go to the bathroom for long periods of time. Here are some practices that have helped me stay healthy and thrive in the OR
✔Hydrating well right after waking up. I'm typically hydrating all the way into work. I like electrolyte powders a lot. The tendency to run yourself dry so the urge to pee doesn't hit you inter operatively is counterproductive. Doing this can not only make you feel like total shit from symptoms of dehydration like headache, lightheadedness &syncope, but it can even put you in kidney failure if you are chronically severely dehydrated.
✔A quick 20-minute workout does wonders for my mood, energy levels, and physical conditioning- especially for orthopedic surgeries where I’m dislocating hips and wielding heavy mallets and other instruments. Even though I despise waking up early- it’s so worth peeling myself out of bed for.
✔ Coffee- its a must for me. I love bulletproof coffee and I make mine with ghee + MCT oil for brain clarity and natural energy.
✔Eating a solid & healthy breakfast of good protein and fats like scrambled eggs+ spinach + avocado, Plant-based protein shake with coconut oil + turkey bacon, or if you're vegan, almond butter + blueberries or avocado toast are great. These will hold you over for a long time and keep your blood sugar steady and not at any extreme. A glucose crash intra-operatively is the worst. I try to avoid it at all costs.
✔ Make sure your nails are clean and short. ORs have different policies regarding nail polish, so be safe and arrive polish free just in case. Powder and gel polish is prohibited more often than not for anyone touching patients because they harbor more germs.
✔ Emptying your bowels at home. If you're a home bowl enthusiast like me, figure out a natural way of getting it done. 🤣 Sorry if this is TMI lol but this is something you will have to deal with so might as well plan for it now cuz there won't be any time and who likes pooping in a hurry in loud public restrooms?
✔ Emptying your bladder fully right before starting the case. JUST TRUST ME.
4. COMFORT IS KING IN THE OR
✔Wear comfortable clothing.
✔Keep in mind that the OR is very cold and I recommend layering your clothes if you're prone to being cold like me. My go-to combo is Figs Scrubs under disposable paper scrubs. They're seriously comfy- you won't regret getting yourself a pair and I can get you 15% off if you use my code FIGS x Karen.
✔If you’re going to an operating room you will likely be asked to wear their OR scrubs or paper scrubs. If you’re scrubbing in, whatever under the scrubs clothing you wear has to have short sleeves. if you’re not you can wear long sleeves under your scrubs and/or ask if you can bring your own clean hoodie.
✔Compression Socks are a must for your legs
✔Wear really comfortable + cushioned shoes
✔Pack healthy snacks, lunch + a big hydro water bottle with ice for all-day sustenance, so that you’re not left with having to eat the garbage they usually have in the surgeon’s lounges.
✔ Make sure you tinker with your personal protective equipment and set it up for maximum comfort. ✔Prevent eye protection fogging by making sure you're pinching the nose strip on the surgical mask to prevent your exhales from blowing up into your eyes and making your glasses fog up.
✔Make sure your shoe protection is not too big so that your trip. Been there, not fun.
I've put my favorite stuff from this list on amazon list for you here.
If you use any of the links I have provided to purchase a product I do make a small commission.
5. SHOW UP EARLY
There is a lot of prep that happens before the case actually starts.
If you’re hanging out with the clinical team, you can go see the patient with them before and observe those important interactions and also the clinical prep prior to the operation.
If you’re hanging out with the surgical team they will always appreciate anyone’s desire to help the cause so ask and see how you can get involved. Make sure you are also familiar with The Unspoken Rules of the OR.
By doing these things, whether you’re a student or a medical professional changing specialties, you will arrive at your surgical experience calm, very well prepared, and poised to be a dream student/ new team member and people will likely warm up to you sooner.
Hopefully having less stress about the do’s and don’ts of the surgery world will allow you to learn more, create opportunities for hands-on experiences for yourself, and really, really enjoy your time there.
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