Back to the floor - Well I didn't faint

I did an early shift in main theatres at Royal Preston Hospital.  I arrived at 8am and was met by Sister Sarah Currie who formally inducted me to the theatre area - I was totally bewildered by the end of it. Everywhere looks the same! I was then handed over to Sam, a wonderful Health Care Assistant who knows everything there is to know about our theatres, the look on his face when he realised he was responsible for me for the whole shift was a joy to behold! Actually he was utterly fantastic and looked after me extremely well. Every theatre we went into he observed what was going on and within a few seconds his brain had computed just what was needed and whilst still chatting away had quietly and deftly put things in place – no fuss, bother or noise. A real skill to have - I wish I had it!

Theatres to the uninitiated is a bewildering place, dozens of people dressed in exactly the same way doing things that initially seem disconnected but just at the right time they come together to provide superb and seamless care. I was so impressed with the commitment of staff at all levels to make sure they followed the WHO (World Health Organisation) checklist and I was lucky enough to personally witness the start of sessions when it was used. And it goes a bit like this …someone takes charge of the session by asking everyone present in the theatre to say who they are and what they do. Everyone agrees what the operation is going to be and on which side surgery will take place. They talk about really important things like whether they are expecting any complications so that if they aren’t expecting a problem and someone in theatre thinks that something isn’t quite right they can say so. It gives permission to everyone and anyone - senior surgeon, trainee, staff nurse or Health Care Assistant - to make sure the whole theatre team is focused on the safety of our patients. At the end of surgery a similar process takes place to review how the session has progressed. It’s such a simple idea and yet so effective. It makes you feel safe.

When I was a student nurse many years ago I remember watching many different major operations and even scrubbing for a few, but for some odd reason there was one that knocked me out every time – and that was seeing a little toe being amputated! It didn’t bother me AT ALL seeing an amputation of a big toe but watching that little beggar being removed made the room spin and go all black ……! It has been a very long time since I’ve been in a general theatre so when it came to working in our theatres I desperately didn’t want to disgrace myself! There was one tiny moment when I was in the anaesthetic room with a consultant anaesthetist and for about 5 minutes I had to focus on his eyebrows (sorry Craig!) to take my mind off what was happening just to my right!

Everywhere I went in theatres, recovery, anaesthetics and stores I met many incredibly dedicated, passionate, professional people. I got such a strong sense of team, camaraderie and in some areas real friendship. This is a highly pressured environment at times and I know that the staff must deal with distressing cases. I got a real sense of people helping, supporting and generally being kind to one another. There are so many teams within teams in theatre so friendships and relationships will be stronger in some areas than others – but between teams there was respect and friendliness. There was also some very irreverent humour which is exactly as it should be!

One of our nurses mentioned that since we became the Major Trauma Centre our theatre staff are more involved in the rapid response team dealing with traumatic accidents – she felt that some of our theatre team would welcome access to counselling services. It’s a good idea and essential that we do everything we can to help our staff deal with some of the traumatic scenes they encounter. I later had my coffee break with the staff from plastic theatres and dressing clinics – they were brimming with ideas about how to take their services forward and how they could improve patient care. They also invited me back to spend some time in the dressing clinics – and I’m definitely going to take them up on that! Especially if they have cakes again!

Some of our nursing and HCA staff talked to me about the training they had done over the years and how they want to use their new skills in different ways. We agreed two things; that they would speak to the theatre sister to discuss how they could do this and I would raise it with the theatre management team. It would be good to come back in a few months and see if there’s a difference.

When I did shifts in Emergency Department and on the wards my feet were throbbing by the end of it because I had done so much walking; at the end of my shift in theatres my legs were killing me because I had done so much standing! I have enormous respect for all those in theatres who stand for hours on end and yet keep focused and vigilant – it’s no mean feat! Our theatre complex is such a hive of industry and no part of it can function well without the whole system working. It’s a tribute to all concerned that despite all the pressures we have as a hospital there’s a fabulous multi-disciplinary team working in concert to provide such excellent care to our patients and fabulous training for our staff.

What are the things I'm going to do?

Speak to Karen Swindley Director of Workforce and Education to see how we can provide more counselling services.
Speak to the theatre management team to see if there’s anything we can do to support our staff in further using the skills they’ve gained on courses and programmes.
Spend some time with the plastics team to hear their ideas for future care

To everyone on duty that morning - a sincere thank you for being so kind and welcoming to me.

Karen Partington