Liverpool Cardiothoracic Centre, part 2.

In March, 1997 I left ICU and started in theatres. This was a change that had a positive impact upon me. Learning the skills of a scrub nurse as well as the processes of various different surgical procedures was brilliant. I’d go home and practice each phase of the operation, different passes and instrument swaps and how to mount sutures in my head. My mentor wanted me to emulate her ways for setting up but I soon developed my own way, you needed a mental image of where each suture holder and forcep was so that when you turned your back on your instruments to stand along side the surgeon you could turn and pick up the instrument without needing to look.

It took me a couple of months before I could scrub solo. I had great people around me to learn from but the pressure to get it correct first time was immense. It was a high pressure environment and it was not unheard of for a number 11 blade and holder to be launched across the theatre table if the wrong suture was passed! Getting everything right first time was key. My time in intensive care was very useful. Watching cardiac rhythms and trends in blood pressure through the operation allowed me to be ready to respond to emergencies such intra operation bleeding or post op ischaemiac events. We operated ten times a day, often six days a week. It was not unheard of to have to have to re open someone’s chest as they suddenly deteriorated during the closing stages of the operation. With all your instruments lined up and counted ready to go for cleaning and sterilisation it was a brave scrub nurse who allowed there trays to go away before the patient had left the theatre!

Some operations took 5 hours, these were like long studies in cardiac anatomy with each stitch and cut taken time over to ensure they were precise. I learnt to admire classical music through working with that surgeon. Other surgeons were like a rollercoaster, over and done with in 90 minutes. The same operation, the same outcome, the same recovery time just done differently. Every time I hear pop master on Radio 2 I’m taken back to that theatre.

I learnt how to scrub for coronary artery bypass surgery, cardiac valve replacement as well as some advanced lung surgery such as lung reduction. Towards the end of my time at the CTC I also learnt how to scrub in for oesophagogastrectomy’s. This surgery required 2 scrub nurses, with a general surgeon operating on the stomach and a cardiothoracic surgeon leading on the thoracic sections. It was a complex procedure with several trays of instruments and not a lot of room to manoeuvre in the theatre.

There is a theme in my career. I get to a point when I’m confident and happy in what I’m doing and then I start looking for the next future challenge or the next great person to follow. For some reason I thought I could become a theatre assistant, someone who supported the lead surgeon in the operation. My housemate, Al, performed works of art in my mind. He could remove the saphenous vein from a patients leg, stitch, clean up and by the end you had to look really close to see which leg had been operated on. I’d stood opposite him and listened to his teachings on why each suture or additional cut was needed. I new how to do it but the physical process of putting knife to skin was beyond me. I’d given numerous injections, inserted no end of tubes into every human orrifice possible, but cutting someone? Not a chance, it just felt wrong.

In the end I learnt how to be a good scrub nurse and how to run an endoscopy room. I really liked the job I had. Next step was going to be an E grade. I’d already started working some weekends and on call work and was helping new scrub nurses learn the ropes.

Fate was creating a different path for me though. My sister had qualified and was moving away from the north west and Kate was really struggling to live in the city. The pull of wide open spaces and a sea to swim in were too much for her to stay any longer in Liverpool. Despite all my efforts with trips to North Wales, Delamere forest and the beaches of my childhood knew I had to either find a new job and move away from my friends or find another Kate. Knowing that there was no one else like her, I had to move.

After many interviews and trips up and down the M5 we both moved to Bournemouth. By October 1998 I had started my first post at Royal Bournemouth in the general theatre team and Kate was working as an OT in the rehabilitation hospital at St. Leonard’s.