Day 5: Surgical Services

Today I thought I would observe the pharmacist of the Surgical Services pharmacy satellite. I arrived and watched the pharmacist and technicians catch up on the morning orders. Surgeons stopped by the window asking for bags of normal saline, ephedrine, heparin, etc., to prepare for their morning cases.

Then, I was given scrubs and was informed that I would be watching surgeries!

I saw a total of 3 in a 4-hour span. The first was a skin graft after removing melanoma. I'm glad that was first because this was my first surgical experience. While I don't normally get squeamish and I'm not afraid of needles, I wasn't sure how I would handle this much. But I was fine, and you actually get used to it once you think of the patient as a body you are trying to fix instead of the pain they will probably feel post-anesthesia.

The second was a transurethral resection of the prostate (TURP). I won't go into the gory details, but the surgery lasted about 2 hours. During this case, I mostly stayed with the Certified Registered Nurse Anesthesist (CRNA) and spoke to him about how he sedates patients, maintains sedation, and then wakes them up. There are a combination of infusions used to sedate the patient, relax the muscles, and control blood pressure (which tends to drop). It was interesting to be around so much medicine administration and not have any sort of pharmacist intervention any step of the way. Maybe it's a future niche to be filled?

As the second case finished, it was 11:30AM, and a discussion was scheduled at noon for all of the students. I walked out of the room and there was a Da Vinci surgical robot being used in the hallway. The big screen TV on the wall showed what was happening in a whole separate room. This case was removing a large fibroid from the uterus, and I watched for about 20 minutes. I couldn't believe I got to see such amazing technology being used first hand!

Scheduled for tomorrow: Round with a pharmacy resident - Bone Marrow Transplant