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Saturday, July 23, 2016

Ate Resident's Tips to Junior Interns: Proper OR Attitude

I always start with a disclaimer.  These are all my personal opinions and tips for you junior interns as a surgery resident.  They're not in any way endorsed or rules implemented by the Surgery Department.  These tips are most applicable to the UST Hospital Setting, since I had my junior internship, senior internship, and residency in the UST Hospital. Different rules may apply to other institutions.

Greetings my fellow junior interns =D.  Welcome to Surgery Department, here you'll experience lots of fun things and sad events, and these are important in your process of becoming a physician.  They say, that this department is one of the coolest department (nagbubuhat lang actually ako ng sarili kong bangko/lamesa) hehe. Anyways, let's get to the tips and enough lame intros.

Every year, there'll be an incident when a junior intern will be asked to scrub out of the OR.  This is a common thing, ever since I was a junior intern, may napapascrub out na.  As  a junior intern, you don't know why pinascrub out ka??? Then you come in to conclusion, residents are power tripping.  This is the stupid "hierarchy" in UST.

Now that I'm a resident, let me tell you "MY" side of the story as a Resident.

Being inside the operating room is a privilege, you know why? Because of all the 400-500+ junior interns in your batch, you're the one chosen by God to be involve in a surgical case, whether it's appendectomy, knee replacement, nephrectomy, thyroidectomy etc.  Not all are given the chance to go inside the operating room and be involve in a case to save the life of a patient.  So do you get my point? Treasure every case you have.  Because not all junior intern can see a person opened up to cut out his kidney, thyroid, breast, etc. Who knows, this may be your last chance to witness this case, you may never be able to go inside the OR again if you will not choose the surgical field.  So treasure this chance!

Now that you see that every case is a privilege, you should also accept that this comes with a responsibility.  With every privilege comes with responsibilities (Parang iba ata to sa Spiderman quote, great power comes with great responsibility ata sabi dun).  As being the JIIC (Junior Intern in Charge) of the patient, you have the privilege to go inside the operating room and be part of the surgical team.  You're PART of the surgical team. The patient has entrusted his/her life to the 'surgical team'.  So it's your responsibility as part of the team to study about your case.  

Let me stress this out more:
If you'll imagine, you're the patient, "Kanino ka magpapaopera?" 
  • To someone who is a summa cum laude who did not study about your surgery? or 
  • To a normal surgeon who studied every detail of your surgery/case?
Every time I ask this, to my junior interns, I always get the same answer.  And yes, your answer is their answer.

So it's just fair and just to the patient that you go inside the operating room, and cut open a part of his body but YOU SHOULD Have at least an Idea of what you are doing! Because I personally would never let another doctor who knows nothing about the surgery to do any surgery on me.

So now do you get my point? Study every case before going inside the operating room.
What do I have to study as a junior intern you'll ask....
  1. First of all, know your patient, meaning, you should have talked to the patient, interview him, why is he here admitted in the first place?
  2. Study the anatomy involve in the case.  If you'll do a nephrectomy, study the kidney anatomy, if you'll do breast surgery, study the breast anatomy. - You spent 1 whole year studying human anatomy, you spent a lot to buy Netter, might as well use it now.
Those are the 2 basic things that EVERY JIIC SHOULD KNOW.  Knowing the process of the surgery, why the surgery is being done are plus things you should know.  If you know the first 2, I guarantee you that you will not be asked to scrub out of the case.

Another responsibility is being the JIIC, you should know the schedule of your surgery: Meaning, you should be the first one inside the operating room, you should be the one accompanying the patient from the ward to the operating room.  As a patient, isn't it nice to see that one of your doctors is with you all the way from the ward to the operating room??? This is what the UST Compassion is about.  You are how old already? 20+ right? You're an adult, you're freaking going to do surgery already, so you should be disciplined enough to be there on your own.  It's not the nurse's, not the resident's, not the consultant's responsibility to call you why you're not in the operating room yet.  It's YOUR OWN responsibility to be there on time.  For me, this is responsibility and discipline, this is NOT hierarchy. Besides the surgery can start without you, and it's not the residents nor the nurses loss that you lose that opportunity to see a surgery.

Oh yeah... another thing, please eat before you go inside the OR.  You falling down and contaminating the surgical field is the last thing the residents/consultants need to worry about.  Not eating your breakfast or your lunch prior to OR and going hypoglycemic will only endanger the patient and predispose the patient to infection if you fall down the operating field.  There's nothing martyr in not taking your food prior to the OR.

Lastly, bring your proper gear.  Be responsible enough to bring your own scrub suits, your own hair net, your own mask, and don't forget your smart phone.  Who knows you might need to call your runner to get some things needed.

These are some tips I could think of as of now.... I'll add more if I thought of more. Enjoy surgery rotation =D Remember, we've been there... Nagawa na namin yun kalokohang ginagawa ninyo ngayon. =D Naging junior interns din  kami dati =D.
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