Now we have started our last placement in Mater Dei hospital. The last but not the worst. In the beginning we thought that we would never like to work in the operative side. But after these couple of weeks our mind is starting to change… 🙂
There’s 20 different kind of operating theatres with their own areas. Now we have been already in general, urology, gynaechology, cardiacs, vascular, paediatrics, orthopaedics and ENT (ear-nose-throat) theater. It has been so amazing! Both of us is very excited and the motivation to learn is very high! The greatest thing in operative side has been the staff. Because there work so many surgeons and anaesthetics who have moved from abroad to Malta, they are speaking basically English all the time. Not so much Maltese, like in other wards. The other positive thing is that everybody has been interested of our background and our country, and really want to explain and teach us – even the surgeons! They have explained us either during the operation or after it what is happening and why, what they are doing and why. We are very lucky to be here right now. One of the nurses said that the vascular and cardiac side are one of the most wanted places to go to do the internship in Europe because the staff is so helpful and ready to teach and explain You whatever You want to know.
Now we have followed and observed basically the anaesthesia (doctor and nurse). They are lucky here: In each theatre there’s an own anaestecia doctor who takes care of the patient during the operation. There’s also a nurse who helps the doctor and takes care of the anaesthesia when the doctor is not in theatre. It’s a good thing but we think in Finland one anaesthetic takes care of a couple of theatres at the same time and gives the orders to nurses how to act during the operation. The responsibility is again bigger in Finland than here in Malta, we think.
There’s two kind of operations: elective and emergency. The most of the operations are elective. During one operation there’s a big group of professionals working. Operative side is really a place where You can see how the team work should be done. Even though there might be ten different professionals working at the same time or even more, everybody knows their place and responsibilities.
First, the patient comes to the theatres, he/she goes to holding bay where the nurses do the first check up before the operation. The nurses follow the check up list which includes the basic questions: name, ID, operation to be done, allergies, last time of eating/drinking etc. When the thearte is ready, the patient comes to the anaestesia room to wait his/her turn to get in.
There happens the second check up, which follows the same protocol than the first one. The anaesthetic prepares the medicines for the operation, inserts the cannulas and intravenous cathaeters and arteria channels if needed. The anaesthesia nurse assists the doctor, prepares the sterile tables if needed and connects the patient to the monitor.
Basic things to measure during the operation are ECG, oxygen saturation, pulse and blood pressure. The bigger the operation is, the more they have to monitor and take into account while they’re doing the anaesthesia (temperature, arterial pressure, etc.)
Before starting the anaesthesia (general one) the anaesthetic inserts the tracheal tube to the trachea so that they can connect the patient to the anaesthesia machine. The main job of the machine is to breath for the patient. The machine mix the inhalating gases to air and takes them to patient’s lungs by making the inhales and exhales with a ventilator. That’s because the given muscle relaxants makes the patient not to breath spontaneously.
During the operation, the anaesthetic and nurse take care of the maintaining the anaesthesia. They make sure that the patient doesn’t feel the pain and is sleeping deeply enough. After the operation they wake up the patient and make sure that he/she is okay after the anaesthesia. The anaesthetic gives the orders about the treatment and medication for the recovery where the patient goes right after the operation.
These days at the operating theatres have been very interesting. We have learnt a lot about the procedures, team working, medicines, anaesthesia, the responsibilities and main issues concerning the operative department in the hospital. There’s still a lot of things to learn and operations to see. Luckily we have a few weeks of time and tens of hours to do before leaving Malta. We can’t wait to get to follow the scrub nurse and the circulating nurses in the theatres.
With excited regards,
Katariina & Tiia
PS: We couldn’t have even thought what all we get to see here: One day we were following the hysterectomy (removing of the uterus and the ovaries). After they removed them, we got to take it in to our hands and have a look. Yes, the tissue which makes woman as a woman! In that moment we think that we can’t get any closer to human bodies and tissues than here. After all, we have something to tell for our grandchildren in the future. 😉