Operating Room

        Surgery week was filled with many long days for us, but the opportunity to help before, during, and after the operations was well worth it. A group from the United States comes down here to Chinandega every year to do as many orthopedic surgeries as they can. Meg has been working with them for years, and we spent a whole day in our clinic when the doctors first arrived doing consults of the people in our villages to see if any where good candidates for surgery. In the end we had around six of our locals go for surgery.

            The surgeries weren’t done in the hospital, but rather a clinic in Chinandega that is only used by Americans who come down here to volunteer and the rest of the time it’s closed. There’s one room for preop, another for postop, and two tiny operating rooms. All the equipment is ancient, and I’m still amazed they continue to work. Preop is one big room filled with about ten beds where patients shower, get an IV placed, answer a set of questions, and then wait for their surgery. Each day there is a general order in which the surgeries will take place and about how long each one takes, but with walk-ins, no-shows, and surgeries taking longer than expected I’m not surprised that they don’t even try to make a schedule. Most of the patients arrived in the morning and then waited around the entire day for their surgery. A medical translator came along with the orthopedic group but she was crazy busy, so I helped whenever I could.

            Postop is similar to preop, with a room full of beds all together. I was so surprised that there was only one monitor and one oxygen tank for the entire room, so they were only used on the person most recently out of surgery. Luckily we never had two patients coming out at the same time or I don’t know what they would have done with only one monitor. After getting a few sets of vitals, the nurses would keep and eye on their patients, keep them comfortable with pain medications, and then eventually do discharge teaching.

            There is one scrub room for the two operating rooms, which are both behind glass doors. Unfortunately these doors don’t close all the way and we occasionally had a fly in the OR that we’d have to keep an eye on. Supplies were low so the surgeons and nurses had to make do with what they had. When we ran out of light covers, they began using sterile gloves instead, and then when the lights went out the surgeons and scrub techs used headlamps.

      In the beginning we had some problems getting the doctors and nurses to trust us, which is understandable because surgery can be life-threatening especially in a place with limited resources. Eventually they allowed us to do more and more when they realized that we knew what we were doing. Most nursing schools don’t get the opportunity to be in the operating room at all, but Case students spend 6 weeks there, so all of us were quite comfortable and knowledgeable in that situation. Cat and I both circulated a few cases and Gaby even scrubbed in to give the tech a break on some especially long cases.