LIMA PERU 2012 BLOG #3

LIMA PERU 2012 BLOG #3
After several days experience, I now know what a “sterilizer” does. It goes something like this. Surgeons use trays of instruments that are fitted out with the specific instruments needed for a particular procedure. Each tray is exactly like all others designed to support the named procedure. The instruments used in the operating room are sterile as is all else, as much as possible, that comes in contact with the patient. My job as sterilizer is to insure that the instruments delivered to the operating room are clean, sterile and that the tray has all of the instruments expected.
As each surgery is completed, the tray of instruments used in the surgery is delivered to the area where I work. A Peruvian lady specifically trained for the purpose washes the returned instruments and delivers them to me. I examine the instruments to determine that all of the instruments that need to be on the tray are present. Some of the instruments need to be reassembled; a task for which I have been trained. I count and recount the instruments and note the number on a card that is placed on the tray. The tray is then placed in a machine, an autoclave, that is designed to create steam and maintain a temperature of 270 degrees Fahrenheit for a minimum of three minutes. The process takes about thirty minutes per tray except when the washed instruments brought to me doesn’t include all of the instruments that are supposed to be on a specific tray. This leads to a search that may include a return to the operating room where the tray was last used, an examination of other trays that may have been used at the same time as the incomplete tray and an occasional search of waste cans in the area where the missing item may have been inadvertently tossed. If the missing item cannot be found, a replacement must be taken from a supply of “extras” so that the tray will be complete for the next surgery. When a surgeon calls for a specific instrument during a procedure, he or she needs to know that the needed item will be available.
Since most of our days so far have been 10 or more hours long, I have had the opportunity, when no trays need my attention, to walk freely among the operating rooms to watch the surgeons at work. My presence in the OR area requires that I wear scrubs at all times, a hat and covers on my shoes. Whenever I enter an operating room while a patient is present I must wear a face mask. A number of times the operating surgeon has invited me to put my head next to his or her head so that I could look directly into the mouth of the patient’s mouth. This was a totally new experience for me and one that I found fascinating. Often there were Peruvian doctors and/or doctors and nurses in training gathered around the operating table observing the procedure. The surgeons often kept up a continual dialogue explaining everything that was happening. In some instances, two of our team’s surgeons worked together on a single patient. Most often, the “scrub nurses” supporting the surgeon were Peruvian nurses who normally assisted Peruvian doctors in the operating room. Our surgeons each took the time to train the Peruvian nurses in the techniques that were expected by the American doctors. I found our surgeons to be very patient with the training process that they found necessary.
This was my first experience working closely with a group of medical professionals. Many in our group had served on pervious Rotaplast missions. I was impressed with several qualities that were present among the medical professionals. Although we worked long hours each day, starting early and ending late, none of the professionals ever seemed to tire. Each moved rapidly from one task to another never slowing down. Everyone smiled and joked even after a fourteen hour day. Most of all, each demonstrated an intensity of purpose that I imagined was the product of knowing that what was being done would be a significant benefit to the patient being served. My first few days as a part of the Rotaplast team gave me a new understanding and appreciation for those who choose to serve as medical professionals.
Love to each and everyone,
Bill, Grandpa Bill and Dad