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Queasy and uncomfortable - Help!


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I'm starting PA school in the fall, and (aside from all of the hardcore studying) I am worried about surgery. I have always been kind of queasy when I see someone's skin being punctured or cut. When I watched an open-heart surgery (from a viewing room above the OR), I wasn't going to vomit or faint, but I just felt queasy and uncomfortable. Even watching surgeries on TV or in movies makes me squirm. Yes, I know the movie scenes aren't real, but I can't help the squirming!

 

So I'm thinking: if I can't even watch someone else do it in a movie, then how am I supposed to learn to draw blood, start IVs, and eventually survive a surgery rotation? I once spoke to a med student who said it's just something you'll "get over," but I'm worried.

 

As a CNA, I'm okay with feces, vomit, blood, cadavers, etc... but there's just something that makes me really uncomfortable about cutting into or puncturing the flesh of a living person. Has anyone else had a similar problem? Does anyone have any tips for how to overcome this?

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When I first spent time in the OR during paramedic clinicals or shadowing it used to make me a little nauseated... sometimes. I could never predict when, exactly. It took a while to figure out my triggers: watching the initial incision too closely, identifying with the patient overly, or anytime they messed with faces during surgery.

 

So I took time, when no one was watching me, to watch those procedures over, and over, and over again until it didn't nauseate me most of the time.

 

 

And then I applied to law school, making the time I spent watching people get cut up a total waste.

 

 

Anyway, either you will get over it, or you won't. But be grateful you have to wear a surgical mask to cover your face so no one can see your reaction, and fake it until it becomes second nature would be my advice. It works for almost everything. Hell, people even think I have always been calm under pressure... so I must be a pretty good actor, because stuff used to freak me out in the back of the ambulance.

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Also, the advice I gave the person standing there pale and diaphoretic holding the IV cath with shaking hands and pointing it at my arm... "Honey, just step back for a minute and take a good deep breath. You can do this, now relax and go OK?" (She got through it and is now very good at it...)

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"Necessity is the Mother of Invention" -Plato

 

Just depends on how bad you want to excel. Never hurts you to give someone a shot. A surgery can expedite a person's healing dramatically, or even completely save their life. If a person requires immediate pain relief, an IV is one of the best routes to administer it...

 

My point is that maybe if you concentrate on the fact that the procedure you are doing is going to benefit the patient, then maybe it might help you get through it.

 

That being said, don't pass out INTO the sterile field. If you are close to the field, and feel things going sideways...step away and sit down before you fall down. The sound of a face crashing into a Mayo stand loaded with instruments is rather distracting.

 

As for the vomit feeling...I have found that forcing myself to cough has proven a strong immediate emergency stop button to keep from barfing. Some instances you would swear I had TB

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Nothing like the smell of a freshly lanced infected abscess in the morning! Hahaha, I remember on my surgery rotation ... I was standing in the back, just observing, not even scrubbed in ... a huge pus-filled cyst on a patient popped and spewed a stream of pus-tinged liquid across the room, straight onto my forehead lol

 

Suturing is fun :D

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Nothing like the smell of a freshly lanced infected abscess in the morning! Hahaha, I remember on my surgery rotation ... I was standing in the back, just observing, not even scrubbed in ... a huge pus-filled cyst on a patient popped and spewed a stream of pus-tinged liquid across the room, straight onto my forehead lol

 

Suturing is fun :D

 

Haha. I work in rural primary care. I don't Offically start my day till I finish my coffee. Throw on some Vicks vapor rub under the nostrils, throw on a mask and I and D my first patient. Good times ;)

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I signed up for a phlebotomy class exactly for this reason....has nothing to do with my OT license or my job. It was 8 weeks, Tues and Thurs nights and I got over that fear within that time frame. For me, I wasn't confident going in, because I was afraid that the patient would faint or panic, which made me very nervous. Then, I did it a few times, and it got easier, and then I had a patient faint on me, and I realized the world didn't end.

 

I'm fine with watching surgery anywhere except the face. For me, the smell of surgery is unpleasant...but it is something you can get over, to get the job done. Whether you want to make a career out of it or not is another story...

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Long ago on my first RT clinical day I watched as my instructor suctioned a gallon of thick, yellow secretion out of a pt's lungs and I remember my stomach flopping over... I didn't vomit but damn, it was a close one... Never happened again though and I've certainly been closer to the action not to mention seeing and smelling things that were much worse... A co-worker and I were intubating a pt on the post-op ward and were both sprayed with vomit: it didn't phase either one of us... The pulmonologist on call recommended buring our scrubs after that one...

 

I think it's just something you eventually get used to...

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I signed up for a phlebotomy class exactly for this reason....has nothing to do with my OT license or my job. It was 8 weeks, Tues and Thurs nights and I got over that fear within that time frame. For me, I wasn't confident going in, because I was afraid that the patient would faint or panic, which made me very nervous. Then, I did it a few times, and it got easier, and then I had a patient faint on me, and I realized the world didn't end.

 

I'm fine with watching surgery anywhere except the face. For me, the smell of surgery is unpleasant...but it is something you can get over, to get the job done. Whether you want to make a career out of it or not is another story...

 

The face...I was observing an open heart one day...standing at the head, looking over the anestheia screen watching them play in the patient's chest. Didn't bother me a bit. Then I looked down at the patient, looked at his face. What was once just a big puzzle with lots of cool parts suddenly became the inside of a patient. Put a spin on things that caught me off guard.

 

Steve

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Guest guthriesm

I support the vick's vapo-rub on the upper lip. Also, definitely try to figure out what is making you queasy- is it the blood? the skin? the smell? the movement of the tools?

 

I usually focus on the steps rather than the patient. I also have always been in favor of the surgery, agreeing it was the right step for the patient.

 

Take a mint in before surgery, make sure you don't have anything too volatile in the stomach.

 

Worst case scenario, if you do believe you are going to throw up, excuse yourself from the sterile field and throw up. Fact is- most of the staff has seen it before. Just don't contaminate and it can all be cleaned up. Sh*t happens.

 

You can do it and there is no point in worry in in May for something that is at least a year out.

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I really think the more you see these things, the more comfortable you'll become. Just do your best to be aware of your own body and if you must faint/vomit (like others have said), try to aim somewhere except the sterile field and you will be forgiven. Don't try to tough it out or pretend you aren't feeling that way; most likely you'll end up creating a major interruption for the rest of the team to deal with and they might not be so forgiving.

 

I know for a fact that I have a strong vasovagal response when it comes to watching another person suffer. I was allowed to observe a very short, simple procedure on our unit as a CNA- a PA came into the patient room to remove a port that had been used for dialysis. Unfortunately, the anesthetic either wasn't the correct dose or didn't have enough time to act, because the patient let out a bloodcurdling scream at the first incision. Now watching any surgery can be hard if you allow yourself to imagine yourself in the patient's place... but imagining yourself being in the bed and feeling that first cut made it much worse. My palms got sweaty, my vision began to get dark, and my ears started ringing. I just had to excuse myself from the room quickly before I dropped on the floor. :P

 

You just have to analyze each situation and figure out what "triggers" you, so that you can anticipate those factors in the future and overcome them. I was tired, I hadn't eaten lunch yet, it was an isolation room so I was hot under my extra gown and mask, and the patient reacted strongly to an incision they shouldn't have felt. That particular set of factors hopefully won't come into play ever again, but I know now to always stay extra hydrated and to pick a neutral point that I can glance to every now and then if I start to feel overwhelmed. I know it will get better and better with time.

 

Another idea from a student I once spoke with: just think of the cells. All that scalpel is doing is separating two cells from each other; all the needle is doing is poking in between a bunch of cells and gently pushing them apart. No big deal, on that level it's similar to poking through the surface of water.

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I think it's about being able to separate yourself from what your doing.

 

Before shadowing a surgeon in OR I was really nervous as to how my body and mind is going to react. Seeing bloody surgery on t.v is ok for me I like it and really interested in it, but being in a hot OR, with sweating surgical gown on and the smell of cauter with an empty stomach can make you feel queasy.

 

So a rule of thump my surgeon told me is, to always eat when you can, and don't think as if your hurting the patient. Focus on what your doing and separate yourself from that mind set and you should be fine.

 

good luck and congrats on PA school!!

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I know that I don't yet have the experience of being a pa student, but I am pretty sure that most pa schools have a cadaver course that you have to take. I just finished a cadaver course (although it was undergrad). Probably my favorite course that I have ever taken. I envision the smells and sights from that class are beyond the smells and sights in an OR. So.... maybe that will help?

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Well, at least unless the patient on the OR table let's go of their bowels and defecates all over the place. That was quite a mess.

 

One of the "benefits" of CNA work- one becomes numb to all of those sorts of smells, at least. I haven't yet smelled cauterized flesh so who knows how I will feel about that on my first time...

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One of the "benefits" of CNA work- one becomes numb to all of those sorts of smells, at least. I haven't yet smelled cauterized flesh so who knows how I will feel about that on my first time...

 

Cauterized flesh? Sit outside at night with one of those bug zapper lamps right next to your face. That's the closest thing I can come up with. We had one when I was a kid and that's exactly what popped into my head on that first whiff, which is usually the worst. Then you get used to it.

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