The Winds of Change?

I noticed some signs today suggesting, perhaps, that I am starting to settle into things here. There are routines to my days in the hospital that are beginning to feel familiar and almost comfortable. My senses are no longer so overwhelmed by the novelty of my environment, and I feel myself relaxing into things a little more. Whilst outwardly I think I have probably conducted myself pretty reasonably so far, it is only now that inwardly things are feeling somewhat easier.

With this sense of comfort comes the ability to notice a little more. And, as I notice gentle changes in myself, I am also starting to notice very pleasing gentle changes to my surroundings. Gentle shifts in culture that, I hope, suggest my presence here is positive and the developments sustainable. Much needed personal evidence perhaps to vindicate the effort that it has taken to get to this point. A handful of examples:

The diathermy machine. I realised today that the diathermy machine has now been set up routinely without any prompting from myself for every case that I have been involved in. Furthermore, the plate has been placed under the patient properly and the correct settings dialled into the machine. Considering that it hadn’t been used since my last visit in July, the staff have clearly become more confident and familiar with its use over the last few weeks. Its routine use for the future would be a massive step forward for the surgery performed here. Now all we need to do is to find a sustainable solution to the instruments we require and procure a second machine for the other theatre!

The Board: A work in progress.

You have to start somewhere!

Swab Counts. The counting of swabs in the UK is a theatre tradition set in stone, iron plated and universally accepted. Quite rightly, as a surgeon you are not allowed to get anywhere near the instruments (or swabs) until the counts have been done. No matter how dire the emergency, this practice is sacred. Yet here, where swabs are all small, easily lost and not visible by x-ray (prepacked swabs have a radio-opaque indictor strip), there was no such tradition. 

The 'Special' Bowl

Having identified this as an area to address, I have been delighted with the response. Some early teething issues have been quickly overcome, and a ‘special’ bowl has even produced to improve the process. This means that there is no mixing with other swabs (for example used by the anaesthetist) nor are they binned mid case. A small thing perhaps, but great initiative and speaks volumes of the desire to evolve.

The Autoclave. An absolute result today was that when I entered theatre this morning, the new autoclave was already on and up and running. The successful introduction of using mesh here is dependent on so many different factors – the process of sterilisation crucial. Whilst we are still at the start of this journey, I feel today shows big steps in the right direction.

So perhaps the winds are blowing in the right direction.

However, to ensure I don’t get too comfortable too soon, there are always family issues to keep me on my toes. Poor R&L have been dreadfully sick with what we hope is ‘just’ a tummy bug. It has been a miserable 24hrs for them and not much fun for the rest of us either!