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I have been a nurse for fifteen years, with the last twelve years spent as an Adult Nurse Practitioner. My bedside nursing was on a medical/surgical and kidney transplant unit. After graduating as a NP, I spent eleven years working at a busy urban Level 1 trauma hospital with the Trauma and Acute Care Surgery team. I managed surgical patients on the floor, ICU, and in clinic. During that time, I greatly expanded my knowledge base and skill set, but the fact that I was never in Operating Room always made me feel like I was missing out on the bigger picture of each patient’s care. I would take care of very sick patients in the ICU that would go back and forth to surgery multiple times, but if a resident didn’t give me a good sign out or the operative report was vague, there would be times when I couldn’t answer specific patient or family questions and I disliked feeling underinformed.
One day I was in clinic and palpated an incisional hernia at one of the trocar sites on a young child who had undergone a recent appendectomy. I ordered an ultrasound and touched base with the attending surgeon. “What?” she exclaimed. “No way, we don’t even close those trocar sites–they are just 5-millimeter ports.” The child did turn out to have a hernia (it took a MRI to find it) and needed to have it repaired. However, that experience really sparked me into action–I realized that unless I actually got into the OR, my practice would plateau and I’d never be able to know such subtleties.
The next week I researched First Assist programs and ultimately enrolled with NIFA. The training was wonderful. The six-day suture star workshop was incredibly well run, and I left feeling confident and prepared. Once I got into the Operating Room, multiple surgeons commented that they wished they had been given such extensive preparation when they were in medical school. One surgeon commented: “We got a four-hour suture lesson and that was it–we were on our own to figure the rest out ourselves.” Another surgeon invited me to start coming to the monthly medical student suture lesson to assist with teaching suture techniques and knot tying.
Getting into the operating room was scary–it was hard going from feeling like an expert in the ICU to fumbling with self-gowning and praying I didn’t forget to take my rings off before I scrub, or forget to put on a bonnet cap before I cross the red line, or inadvertently contaminate a sterile field. However, this has been one of the best things I’ve done for my career. We recently moved to a new state and now I work full time with a spine surgeon. I assist all of his cases, round on the inpatients every morning, and see the post-operative follow ups. The continuity of care is incredibly fulfilling for both myself and our patients. And now, I can finally answer questions about all the little details of what happened in the operating room that didn’t make it to the final operative report. Thank you NIFA!!!
Recent Graduate Danielle Berthold RN, ANP-C, RNFA