Thursday, January 27, 2011

Inside the Operating Room

Today I will write about what happens in the Operating Room.

The Operating Room is actually a team of 'inside the OR' people interacting with 'take care of the OR' people and 'take care of the patient' people.

The patient starts in Pre-Op. The nurses there started YESTERDAY preparing for the patients. All the charts were checked to make sure everything was ready for today. There were many phone calls, electronic chart checks, and FAXes. Pre-Op's function is to get everything ready for the patient to undergo surgery. They start the i.v., enter data into the system, and sometimes call into the O.R. during one patient to ask questions about my plan of care for the next patient.

The O.R. team has a surgeon, surgical assistants (another surgeon, RN first assist, physician assistant), a scrub nurse or scrub tech who is in charge of all the instruments, anesthesia, and anesthesia technician, and a circulating nurse. Between all of these people the actual surgery gets done. There is a 'time out' at the beginning of surgery like a flight check on a plane, to make sure everyone in the room knows what is to be done.

After the surgery, the Recovery Room (or PACU, post-anesthesia care unit) watches over the patient until they are safe to transfer to the floor or go home, depending on the surgery involved.

For the patient, depending on what is given to them in Pre Op, they might or might not know what the O.R. actually looks like. The patient is moved, either on their own or by themselves, to the operating table. Tables are not all the same. Some bend in certain ways, some slide out so the x-ray movies can be taken, some are for fixing certain kind of fractures. There is a 'bean bag' that can be put on top of the table, that when suction is applied, holds the patient in the lateral position (on their side).

Once I put a patient to sleep, I help them breathe, and administer the anesthesia to meet their needs for the surgery. It changes. Depending on the part of the procedure, they may need more or less. I watch all the monitors, chart everything on the anesthesia record, and write orders for recovery room to meet their pain and nausea needs. If everything is going well, I sometimes may prepare my syringes for the next case. I am sure to keep it clean and separate from the other patient. My system is 'the anesthesia machine is for this patient' and the 'anesthesia cart is for all following ones'. There is a list printed every day with all the cases, patients, surgeons, anesthesia personnel, and rooms listed. I refer to it a lot. There are also the billing slips I have to fill out, so the pharmacy gets paid, and so I can charge for my services. I wake the patient up and make sure the PACU nurse knows what to expect in taking care of our patient's needs.

How much of this time is spent doing Reiki? Not a whole lot. On a long slow case, about five minutes. Today, there were interruptions due to tasks that arose. Anesthesia ALWAYS takes priority over Reiki. Reiki can wait. I get back to where I was, when possible. Sometimes the Reiki is unfinished...but really isn't.

Let me explain. Energetically speaking, Reiki is a partnership between Reiki practitioner and Spirit. Spirit helps to smooth out the gaps, no matter where and under what circumstances Reiki is given.
It all has to do with the intent.

So in a Reiki-based viewpoint, Reiki can start BEFORE surgery. It can be sent in advance to a place and time. I did that for a hostile operating room I worked with, where they did hearts and the surgeons were cranky and I had no time to do Reiki in the O.R. As a medical intuitive, I often know what size equipment to pick out first. My intuition is quite helpful in this regard, before I look at the chart or examine the patient.

With the patient, my tone and manner helps them stay calm when we meet in Pre Op. I do not do actual Reiki until they are asleep and the surgery is underway.

My Perioperative Reiki is 1) starting it  2) opening the aura and scanning for problem spots 3)grounding the patient 4)doing an actual treatment. Sometimes adding advanced techniques, but not always. 5) closing the aura and 6) turning Reiki off. I do not touch the patient. I use my mind and when it's not too visible, my hands. For example, I may 'check the bair hugger' over the arms if I am actually doing Reiki there.

Five minutes. It isn't much, and yet it is. I learn much about disease. My Reiki skills are sharp from practice. The energy flows like in a traditional healing. And the patients *smile* very much when they wake up.

Furthermore, according to studies in the metaphysical arts, there are times when the aura is weakened. Great stress is one of them. Having anesthesia is another. What I do counteracts this process by strengthening the aura at a time when it is weakened. (This subject, if you are interested, is well addressed by Margaret Mc Cormick, if you want to look it up.

Having things go well for our patients is most important. Perioperative Reiki is given much like I give routine anti-nausea prophylaxis--it is given at the time of surgery to decrease the chance of common side effects, and give the patient a wonderful healing experience at an important time for them.

* Photo is taken during 'deep hypothermic circulatory arrest'. The patient is technically 'dead', but once cardiopulmonary bypass is restarted and patient is rewarmed, will be having normal heart rate, blood pressure, and oxygen saturation and will emerge with no ill-effects.