Specialized Care and Community
St Joe's Surgical 6th Unit specializes in a wide range of complex surgeries, from orthopedic procedures to intricate abdominal surgeries. Beyond its medical expertise, our unit fosters a supportive environment where experience, dedication, and passion converge to deliver exceptional patient care. It's quite uncommon in today's job market to find a unit where the majority of staff have such long tenures. Many have either started their careers here and never left, returned after gaining experience elsewhere, or discovered this unit and decided it was where they belonged for the long haul.
Navigating High-Stress Situations at St Joe's Surgical 6th Unit
During one particularly challenging shift, all of my patients showed unstable vitals, with one presenting sudden high fever, low oxygen saturation levels, and elevated heart rates—a concerning combination that turned out to be post-operative complications resulting in pulmonary thrombosis (blood clots in the lungs). This condition significantly impedes oxygenation, forcing the heart to work harder to compensate.
Understanding MRSA in Healthcare Settings
Another patient, already receiving a variety of antibiotics for post-operative complications, also developed sudden high fever. Further investigation through blood cultures revealed a positive result for MRSA (Methicillin-resistant Staphylococcus aureus). MRSA is a type of bacteria that is resistant to many antibiotics commonly used for infections, making it more challenging to treat.
MRSA spreads easily in healthcare settings due to several factors:
Close Proximity: Patients in hospitals often share rooms or wards, increasing the likelihood of direct contact between individuals and surfaces contaminated with MRSA.
High Antibiotic Use: Antibiotics, while crucial for treating infections, also contribute to antibiotic resistance. Prolonged or inappropriate use can lead to the development of resistant bacteria like MRSA.
Invasive Procedures: Patients undergoing surgeries or invasive procedures are at higher risk of MRSA infection due to the introduction of bacteria into the body through incisions or catheters.
Healthcare Workers: Healthcare personnel can inadvertently spread MRSA from patient to patient if proper hand hygiene and infection control measures are not strictly followed.
Environmental Contamination: MRSA can survive on surfaces and medical equipment for extended periods, posing a risk of transmission to patients and healthcare workers alike.
Understanding MRSA and its transmission dynamics is crucial for implementing effective infection control measures, such as isolation protocols, rigorous hand hygiene practices, and antibiotic stewardship programs. These measures help prevent the spread of MRSA within healthcare facilities and protect vulnerable patients from infection. Coming from an emergency department background back home, where stabilizing patients swiftly for transfer to intensive care units is the norm, transitioning to surgical care at St Joe's has been a revealing experience.
Collaborative Patient Care
Here at St Joe's, the approach to patient care is distinctly collaborative. While the emergency department remains a vital resource, stabilizing patients here demands a different kind of care. Each patient is intricately tied to one of three specialized surgical teams, each with its focus and expertise. This setup requires close coordination with surgeons and other specialists to ensure immediate intervention and ongoing monitoring tailored to each patient's surgical needs.
Since nurses are the backbone of this floor, their critical eye is of utmost importance. They oversee everything from medication administration and interventions to bridging communication between various units—whether it's the general surgery team, cardiovascular department, thrombosis unit, interventional radiology, and beyond. This role not only ensures seamless patient care but also fosters a holistic approach that integrates expertise from diverse medical disciplines.
Specialized GI Surgeries
The majority of patients at our unit are treated for gastrointestinal (GI) related conditions. Common procedures include:
Appendectomy: Surgical removal of the appendix due to appendicitis, an inflammation of the appendix often caused by obstruction.
Colectomy: Partial or total removal of the colon (large intestine), usually due to conditions such as diverticulitis, colorectal cancer, or inflammatory bowel disease (IBD).
Gastric Bypass Surgery: A surgical procedure to help with weight loss by making the stomach smaller and bypassing a part of the small intestine.
Cholecystectomy: Removal of the gallbladder, often due to gallstones or gallbladder inflammation.
Obstructed Bowel Surgery: Surgical intervention to relieve bowel obstruction, which can occur due to adhesions, tumors, hernias, or other causes.
Hernia Repair: Surgical correction of hernias, including inguinal (groin), umbilical, and hiatal hernias.
Each patient receives meticulous care, often including intravenous fluids such as Ringer's solution or saline to maintain hydration and electrolyte balance. There are strict dietary and mobilization regimens both before and after surgeries to ensure optimal recovery. The unit's focus on GI surgeries underscores its commitment to specialized care and patient well-being.
Mastering IV Lines and Patient Care Challenges
What I find most challenging, besides learning all the medical terms in English, is ensuring accurate IV placements. Nearly every patient requires some form of intravenous therapy, involving a variety of medications—from antibiotics to potassium to pain relief. Throughout my time here, I've drawn medications into syringes, administered numerous medications, and managed various IV lines through the drop unit, where we change primary and secondary lines regularly throughout the day. I've had to learn how to prime different lines correctly, sometimes learning the hard way with air bubbles, spills of saline or medication, tangled lines, and alarming machines.
Learning through Practice
I have also had the opportunity to assist in priming a PCA (Patient-Controlled Analgesia) pump, a device that allows patients who require higher and more frequent narcotic-class pain medications to self-administer in a controlled and safe manner. This system empowers patients by giving them control over their pain management within preset limits, enhancing their comfort while ensuring their safety under nursing supervision.
Despite the challenges, there's a sense of accomplishment when I can confidently manage IV lines and administer medications effectively. The occasional spills and the awkwardness of my inexperienced hands often lead to laughter and bonding moments with patients. I usually start my shift by joking, "It's your lucky day today because you get to teach this Swedish nursing student about the Canadian health system." Just recently, I successfully primed a new secondary line and started potassium infusion, knowing exactly what steps to take. It's moments like these that highlight the hands-on learning experience and the fulfillment of contributing to patient care at St Joe's Surgical 6th Unit.
Tip of the Day
Thinking of taking your nursing skills abroad? Embrace the adventure! International experience is an invaluable opportunity to learn, grow, and broaden your horizons. Don't let fear hold you back. Every challenge is a chance to gain new perspectives and skills. Take the leap and turn every moment into a learning opportunity!
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