A DAY IN A LIFE

There are many schedules that you can assume as a traveling medical professional, the work schedule that I have consistently kept throughout my career is one that is around 10 hours a day working typically four days a week, with the option from the clinical environments to do additional time if requested. 

My alarm usually goes off around 5am, I get up and get ready for the day. Most surgical cases start at 7:00-7:30am depending on which setting you are working at either the hospital or same day surgery center.  I make sure to eat breakfast before because some days you might not get a morning break.  When I get to the hospital, I change into my surgical attire.  Don’t forget the scrub hat, mask, and shoe covers! 

I like to get on the floor 15 minutes early before the morning huddle. This early coordination provides plenty of time to do my morning scrub, check the surgical board, go through my case cart using my preference card for that particular surgical procedure's setup, then proceed  to my OR suite and organize my room and set everything up for surgery...this can take approximately 30 minutes depending on the complexity of the procedure being done. This early prep allows for built in time to ensure I have covered all possible medical supplies are present and I have considered physician preferences as they may differ depending on who the attending physician is and their personal approach to the operation. Additionally, be helpful and assist your team and nurses locate equipment if you can as every surgery is a team effort.

A note on preference cards: A preference card is only as good as your make it and document what is needed, they are not meant to be perfect, but by being attentive to the needs of individual physicians, you will have as many bases covered as possible and be able to adapt on the fly. 

The average cases you will do in a day depends on the scheduled cases and which specialty are available. For example, if you’re doing total joints, it could vary between 4-5 cases. You can be in a total joint replacement procedure for a couple hours or more.  When you’re in a total joint replacement procedure you will not get breaks because there should be no traffic in and out of the OR. There may be a surgical sale product representative in the surgery with you to assist the physician in the use of a new device being implanted in a patient, they can be highly helpful in assisting you during your prep phase and can help get you ready for the case! Although, some places you might be on your own, don't let that scare you! Most surgeons have a set routine, and you’ll learn those quickly. 

I prefer to go on my lunch break between my cases, in the meantime your room gets turned over and cleaned before you can set up for the next case. You will be responsible for all instruments, counts, local medication (always label), and make sure you have everything beforehand. 

When the patient arrives and is transferred onto the OR table, ALWAYS put the safety strap on first! If you are scrubbed in, don’t worry about it. Next, anesthesia will put the patient to sleep and the nurse will help position them properly for the procedure. Before the procedure, skin prep is done before draping the patient. Prior to performing the surgery, everyone does a timeout to make sure everyone is on the same page prior surgery start time and first incision is made. During the case, pay close attention, listen, be attentive and anticipate. Surgeons typically love eagerness to learn and if you know the next step and always have what they need next in your hand ready for them.  

In time, you’ll pick up new skills and techniques! Remember to do counts with the nurse in charge of the surgery of all disposable items (sponges, blade, needles, hypos, cauterizing tips) three counts are completed for verification before closing the incision site (trust, but verify). After dressings are placed, drapes are taken down and the patient is prepped to exit the OR. As a preventative measure, I always keep additional surgical invention instruments available on the back table separate from instruments that are designated as dedicated to the procedure being done. This is in case they are needed for critical procedure revision or life saving measures, this will ensure that you do not run out of instruments. When the procedure is completed the back table and mayo stand can be torn down, lastly your gown can be taken off and thrown away. After removing your gown, you will assist in the complete tear-down of the surgery room, this will include putting used instruments (those contaminated with biological material) into a designated bin or tray, then spray instruments and dispose sharp instruments separately. This sums up a normal day, but we all know it can change quickly with critical procedures coming up last minute. 

I did not go into small detail, but if you have any questions please don’t hesitate to ask.