Sunday, February 28, 2021

The Survey

 



Many years ago, I was a teacher for residents who were in the anesthesia residency program at my work. Slowly, gradually, I too, had learned the art and also the science, of keeping patients safely asleep under their anesthesia care, or their legs asleep in the case of epidurals and spinals, or their limbs asleep with blocks. 

Over time I learned what was important to share, and what was not, so my approach was more practical than theoretical.

Many unanticipated things happen to the patient during surgery. I.V. pumps can beep--they need to be plugged in because their battery has drained, or there's air in the tubing and the pump won't go, or their drip needs to be refilled. The little plug on the bottom of the operating table can become disconnected and you need to crawl under the table to reconnect it. Otherwise the surgeon will say 'table up' and the button you push to make it go won't work!

Sometimes the arm can fall off the armboard, sometimes equipment can rest on the patient's face (tubing and cameras usually, sometimes a resident might lean on the patient), sometimes the head can roll to the side a little when the table is adjusted in a tilt, putting tension on the breathing tube. Breathing tubes themselves can become disconnected, kinked, or blocked by a mucous plus.

You tank of anesthesia gas can empty during a long case. 

And of course there's the patient's vital signs to manage--blood pressure, pulse, oxygenation, carbon dioxide levels, as well as depth of anesthesia. 

What I was taught, years ago, by a nurse anesthetist, was one of the most valuable insights and I have passed it along to my residents ever since.

You never assume anything.

You survey.

Every five minutes or so, you scan your work area from left to right, and make sure everything is okay. Is the i.v flowing? Is the patient's body okay? How is the circuit? Do you have enough anesthesia in the vaporizer (tank)? How are the vital signs?

I would add to this, 'where are we in the surgery, and what things will be needed to be given?', things like heparin, protamine, nausea medicine, muscle relaxant, reversal. You need an oxygen mask after extubation, should you take it out and get it ready? 

We call this 'surgical awareness'.   Good workers in the O.R. have a 'sense' for everything that is going on. They are proactive.


Ross asked me today to share this, and to guide you to apply it to your attention flow, and your life situation.

From time to time, ask yourself, and survey your immediate surroundings. Am I being loving? Am I in tune with Spirit? How do I feel inside? Do I feel nurturing, warmth, love and compassion? What is ahead, and how do I need to prepare for it? What can I fix to make things better?

You can even survey the difference between your perception of reality, and reality itself (the Spiritual one).

In our lives we are often programmed and encouraged to 'do! do! do!' and that 'more is better!'

Remember in the realm of Spirit, rest is important. Family is important. Helping others who are in need is important. Self care in balance with your surroundings and helping where you can is the goal. 


Ross asks me to give examples.

After work he wanted me to visit one of my two sisters on the way home. My brother in law's birthday is coming up soon. Ross let me know what store to go to, and to buy beer and 'bubbly' asti spumante.  Fun beer, local beers, things that are hard to get. To make it special. 

But there, which was where I had grown up, was a Sears that is going out of business. 

I had been so sad over Sears closing. I've been going since I was a kid, and they gave kids free popcorn and dad would take us through the hardware aisles. I'll never forget the first tent I asked dad if we could get, and we did, he said YES! I was so happy. It was blue, light blue, with a yellow roof and slept six people. In time, it was the only place I could find clothing for my mother and my grandmother--house dresses and dresses that were good for petite women. 

So I went in. I found all kinds of deals. I bought shorts for the summer, at five dollars a pair. I found a fuzzy pink sweater. A beautiful wrap dress for under twenty dollars. Beautiful moccasin slippers for my niece. Matching heart 'toi et moi' pajama bottoms for myself and my other niece. Even Twin XL sheets for Anthony's bed. They are very hard to find. 

At the checkout, there was a shirt, a St. Patricks day shirt, with a message that seared itself into my consciousness. It said something like, 'It's not luck. I am BLESSED.' with a rainbow and a huge pot of gold. It had green raglan sleeves like a baseball practice shirt. I knew it was from Ross, he had planned this, and I was so grateful to be at that store one last time. I asked if it was available, and the cashier said yes, so I bought it. 

I visited my sister, and they were glad for the visit. We did a quick mask visit but we ended up talking at the bistro table in her front yard. 

People need support. Your time. Your energy. Even if it's your earnings from your work--you choose to spend it as Spirit guides you. 

The next day, I visited my other sister with the newborn. We brought empanadas. Both cooked and frozen. Empanadas are not cheap--even though I'm sure my sister didn't know it. We brought a whole dinner and extras. Quick meals in the microwave help when there's a two year old and a newborn in the house. 

Sure enough, this sister needed us too. The family needed us. They were going on their first walk outside to help cheer her up. It's not easy with a newborn, especially one who is more awake at night than in the day. 

I learned there's a flavor of ice cream she really likes. Ben and Jerry Oats of this Swirled. So I went to the store to buy some while everyone was watching the Disney movie UP.  They didn't have it. The checkout guy even closed the station to go look for some in the back. But I found other flavors, Netflix and Chill. And even tiny containers--I got one for my niece. She has a sweet tooth. My mom told me, 'I want you to get to know that girl' and I honor mom. Spirit told me to always bring her one flower and a little chocolate. The first time I brought a daffodil from the yard, and this time I brought pink daisy-like flower from a bouquet Ross had me buy. Just one flower from it. But all wrapped in the paper like a real bouquet.  I gave her the moccasins and had hidden a chocolate leprechaun in one shoe. 

My brother in law was tired from work. But he was very touched by the kindness. And in return (we expected nothing), he gave us two venison sausages. One spicy, one garlic. 

Both times from visiting family, I went home with a full heart. 



Today is a day for chores and tasks I need to complete. I'm also going to add some fun to it. And a little sunshine and rest. 

I told my family with the newborn, what mom had told me:  if it doesn't cry, it can wait. 

My housekeeping reflects this. So does my son. He's a wonderful young man. Kind. Caring. Helpful. Because sometimes as a single parent, or a working parent, you have to choose what you put your attention to. And thanks to mom's advice, I did. 



Ross is glowing and happy. I can feel it in my heart, through my soul connection to him. I'm glad I was able to help the effort by writing this for us, writing with him, for you.




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Aloha and Mahalos,

Namaste,

Peace,

Ross and Carla

the Twins