LFD (Learning feedback Diary)
General Objectives:
• To apply our nursing skills and knowledge in the clinical practice.
• To enhance our experience and exposure on the specific area assigned to our group.
Specific Objectives:
• To be familiarize to the operating room set-up and general procedure done in the area.
• To get cases of clients that will be passed in the PRC.
• To adapt to the area and to get our self trained to see actual operations done in the operating room.
• To assist the client throughout the operation
Learning Insights
Day 1 (08/05/10)
We ARRIVED EARLY. At 10pm kuya oliver and I had our first experience in the OR, the actual; role of being a scrub nurse and a circulating nurse. I was instructed to be the scrub nurse that night ang kuya oliver as the circulating nurse. Sir Habac taught me once again on how to maintain sterility, how to prepare a mayo table and the instruments and how to handle instruments. At first, I’m totally rattling but Sir habac helped me out so i got calm afterwards. The surgeon conducted a “e” LTCS on the client with an arrested cervical dilatation. I think that it was almost 2 hours of standing beside the surgeon and inside the OR major. Our clinical instructor is really good. He’s really good. He’s calm and strict in the same tempo and tune so it was then fine for us and for me.
After the procedure, I was so relieved. Sigh. We’re the first pair who took 1st on handling patients on the operating room on our group.
We had put first pre-test and the result were fine. There are some questions that are out of this world at first since it wasn’t yet discussed in the lectures and it was first heard in the practice. Our clinical instructor discussed the requirements for this rotation.
Day 2(08/06/10)
We arrived early again. This time lovely and Hannah was the pair. They assisted on removing the appendix of the client which was characteristically foul-smelling and looked like smoked longganisa with the size of lizard. This client was typically indigent so he was persistent on talking about his relative that was also in the medical field. He continuously talked even he is sedated and for some time he stopped.
The next pair who took part of the role was Kuya Oliver and Angelique (Angel I think).They participated on the many surprises of this procedure. At first, this should only be an “e” LTCS but then as I Said before there were extreme surprises that shocked us. After the incision of the skin to peritoneum, the first surprise is the “thought to be” Fluid that had accumulated because of the client’s ascites. Next one is the “assumed” ruptured gallbladder since the fluid is really foul-smelling and it somewhat smells like a urine combined with some fecal matter. The procedure was collaborated with other surgeons. The complications found on this client almost killed the baby luckily the baby was alive but it was only for 2 hours. The surgeon had to repair the bladder since it was ruptured and it was the cause of this fluid accumulation on the peritoneum of the client. The baby was also a post term so as expected another foul-smelling odour surrounded our nose. The baby was filled with meconium and a combination of the urine from his mother. It was almost 3 hours of foul-smelling procedure filled with surprises similar to a Pandora’s Box. It was quite an experience, an out of the routine LTCS was seen by our group. The surgeon “cleansed” the mess of this operation. Since the client was an indigent, She 1st took the “Hilot” that killed her third child... Oh! Before I forgot it’s gravida 3 with a parity of 3. 3 babies were born including this one and no one was alive how unfortunate really it’s quite a scene. I was sad knowing that really but sometimes we should cling to change for the better. She should have not gone to a ”hilot”. The “hilot” was thought to be the cause of the perforated bladder and since it was post term it increased the risk of infection of the child.

Day 3(08/07/10)
We always arrived early and for the record it’s 3 in a row. =) . The third was the post-orientation...
We have no cases for this night and our clinical instructor discussed the instrumentation, the operating room set-up, the equipment and the general procedure on the area which was Rizal Provincial Hospital. After the discussion, he gave us our specific drugs to study and it should be passed on the last day. After this, we slept since there’s no case. It was quite a night since it’s so quiet.
Day 4(08/12/10)
We arrived early again for the fourth time. It was our trademark (LOL=). This day was for waiting a case. We waited for the case (I think until 2:30 am) and it was thought to be a D&C. When the case arrived (the client I guess) it was for “e” LTCS. It was 5:30 am and we were ought to be preparing for our dismissal. It’s better late than nothing right? So Hannah and Lovelyn took the case. After the operation, we went home for another rest.
Day 5(08/13/10)
WE arrived early. Oh yeah! Sir Habac conducted our post-test and the results were fine. Luckily, I got a fair score and thanks to the Lord. It was really good to pray first before any battles LOL. After the quiz, We were instructed to go back to the students room. Sfter waiting for some time for the case to arrive, we decide to go to the “lugawan” and eat. We went there with the permission of our C.I. and then we ate. We bought some burger, a hotdog burger (???) and lugaw. Kuya oliver got a lugaw with a foil and that thing threw us out. We lost our appetite though I finished eating my own lugaw. Sigh. I was totally out. After eating we headed back to our quarters and get a nap. It was 5:30 am when the case arrived and unluckily it’s a private client so we had to ask the permission of the surgeon. We didn’t wait for it since we thought we will just be rejected and it was out of our time. The surgeon was from taytay at 5:30 am, Sir Habac told us that he was just on the way (kaka-alis lng). So Sir Habac dismissed us and we went home for a rest instead.

Facilitating Factors
Our group’s cooperation and our Clinical instructor’s Skills and knowledge greatly helped me. The staffs in the operating room and Sir Habac were nice to us so there’s a calm environment, I guess.
Underlying Factors
The location was very remote. It was really a ride on a cliff. It’s dangerous since the road has its streetlights but isn’t working. The time of our duty was graveyard though it was really fun, I think that would contribute. The availability of the cases since OR cases was always a Weather-weather thing.
Awesome!1

Sana maging Or nurse din someday hehe... tulad ni ma'am teruel at Sir habac.. at pati ng ibang... awesome OR nurses.. ...

Sana lng kayanin haha... konti na lng.. oh yeah!!!