October 19, 2020

The Missing Piece

From the July 2008 Issue

Linda Farmer, RNFA, CNOR, CWS, works in the private practice of a General/Peripheral Vascular Surgeon in Meridian, MS.

Have you ever had the feeling you’ve forgotten something? Although you couldn’t put your finger on it, something just wasn’t quite right? Or that, after months or even years of rehearsing and preparing, something was missing or somehow out of place? That was my life before I became a first assistant.

I’d been an RN for over 20 years, happily working as a clinic nurse in a busy surgical practice…or so I thought. Clinic nursing has its own rewards and challenges, and for the first few years I was content. No doubt about it, this was the perfect nursing job for combining family and career.

I had wonderful daytime hours, no call, holiday, or weekend work, and overall a predictable job. When we did minor procedures in the office, I was even able to “assist” from time to time on a small scale. Although I was doing new patient interviews, pre-op teaching and post op checks, there was a blank space when a patient’s questions pertained to intra-operative matters. I was frustrated that when my patient looked to me for answers, I couldn’t deliver them. My nursing experience was definitely missing something, and the longer I worked in the same position, the larger the hole in my career seemed to grow. My employer sensed my restlessness.

“How would you like to come to surgery?” he asked me one day. “There’s a huge shortage of OR nurses, and with the practice getting busier each week, I could use a consistent pair of hands.”

“But I know so little about assisting. Are you sure I’ll be any help to you?”

“Sure you will,” he said. “We’ve worked together for years. I’ll bet you catch on really quickly. You know me already, and if you’re willing to study the procedures, learning the instrumentation will come in time. And I’m certain a familiar, consistent pair of hands will be of help!” he smiled encouragingly.

So at age 43, off to surgery I went, proving that you really can teach “an old dog new tricks!” There was an unexpected twist, however, and I was soon to realize my new role on a larger scale than I’d ever expected.

There was so much to learn! From the first day, though, I knew that assisting in surgery was the missing piece in the puzzle for me. Although learning the routine was difficult at first, I loved studying the procedures, anticipating the surgeon’s moves, and seeing the procedure carried out. After a year, the surgeon suggested I enter a formal RNFA program just as soon as I had two years of intra-operative experience. He helped me research programs, and we ultimately chose NIFA. There were many features that stood out about this program, and I never dreamed it would be so challenging. Yet without question, NIFA delivered what was promised.

The twist? I couldn’t have known that one of the surgeons in the group would develop Multiple Myeloma and be forced to retire, making my expertise even more in demand.

Today, my life has changed so much! I feel more like a professional member of the team and a better advocate for my patients. I’m carrying my education to the next level by pursuing an advanced practice nursing degree, and every day look for opportunities to promote the value of collaborative practice within surgical specialties. Though my hours are now more flexible, I still work primarily with the same surgeon and get to do more pre-operative teaching and assessments as well as some post-op rounds. I still love studying for the cases, helping anticipate the surgeon’s needs, and the satisfaction of a successful outcome. But the best reward is in being able to truly live the role of perioperative nurse.

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