The week beginning 13th February, I did work experience in the orthopaedics department, in which I shadowed different consultant orthopaedic surgeons on ward rounds, in clinic and in theatre.
The most exciting part of the week was going in theatre; it was interesting to see the roles of each professional during the surgery, including the scrub nurses, theatre assistants, anaesthetists, and of course the surgeons. I was able to observe many operations including arthroscopies of the knee and shoulder, a trapeziectomy, and knee replacements. Other than orthopaedics, I was also able to watch surgery in the field of otorhinolarynology (ear nose and throat).
The procedures involved in orthopaedics are very aggressive, with the use of mallets, drills and saws. In contrast, ENT surgery is more delicate as I saw in a thyroidectomy, with more use of forceps and scissors. In all types of surgery, sanitation is controlled in many ways such as wearing scrubs, using hibitane/iodine on the patient’s skin as an antiseptic, and thoroughly washing up to the elbow. Despite this I noticed there is greater emphasis on infection control in orthopaedic theatres compared to other specialties. During orthopaedic surgery, I had to wear a face mask, and there was a ventilator in the ceiling, whereas in the ENT surgery this wasn’t needed, and I was allowed to stand right next to the patient. This is because in orthopaedics the bones are exposed to the air, and can easily get infected (osteomyelitis). Infections in the bone are very problematic and difficult to treat.
Before the operations began, I observed the anaesthetists, who not only had a job of anaesthetising the patient, but also had to calm them down, which can be very difficult with anxious patients. They either gave general anaesthetic, or local in the epidural (back). An epidural anaesthetic was given if the patient is unfit for general: if the patient was overweight or a heavy smoker, respiratory problems could occur during surgery if general was used. Another advantage of epidural anaesthetic is that the patient will experience less sickness and drowsiness after the surgery, which can help in recovery. The anaesthetists also taped the eyelids shut, to prevent the patient blinking, which could dry out and damage the cornea. A endotracheal tube was also fed down the trachea, and breathing was monitored throughout the procedure.
whilst in clinic, I learned about many different conditions, how to spot them on different forms of body imaging, and how to treat them. As I was able to observe more than one doctor, It was interesting to compare how they interacted with the patients when examining them, but both in an empathetic, thorough way.