Second-year Operating Department Practice student Jackie guides us through a night shift on anaesthetics placement.
It’s 7pm on a Friday in October and the beginning of a 45 minute drive to start my first night shift. It feels really weird going out to work when I’m usually meeting up with friends or sharing a bottle of wine in front of the TV.
On arrival, the car park looks so empty. No problem parking tonight, it’s definitely not like this during the day.
The first stop is the changing room where I change into scrubs and then the rest room to pop my snacks in the fridge and find out what’s planned for the shift and catch up with the day staff.
At night the hospital only has a few theatres open so the corridors are fairly quiet. Tonight I’m covering emergency theatre and maternity theatre which is in another part of the hospital. Good job I’m fit!
As an anaesthetics practitioner, the first job is to check and set up the anaesthetic machines. This involves visiting the store to collect new breathing circuits, filters and catheters.
There are two different machines to set up and check, one in the anaesthetic room and one in the theatre. As it is the emergency theatre, all breathing circuits are changed after every patient in case they are Covid positive.
The anaesthetist relies on the ODP to ensure the equipment is safe. As well as carrying out physical checks on oxygen cylinders, gas pipelines and suction, you have to run diagnostic checks on the machine to check for leaks and correct pressures.
Next I check the airway trolley to ensure I have a range of masks, airways, laryngoscopes and tracheal tubes. An ODP needs to be able to anticipate what type of airway is needed and react quickly to assist the anaesthetist. It is quite a responsibility and it does feel scary at times.
Once that’s done I’m ready for whatever might come through the door. And it doesn’t take long before the Maternity bleep goes off and I have to race down to the maternity unit. I really hope to see a baby born tonight – fingers crossed.
Maternity theatres are slightly different to main theatres as they have special equipment for the babies and we work alongside the midwives as well as anaesthetists and surgeons.
The first call of the night involves the removal of a retained placenta. Although this is being done under epidural anaesthetic, I get everything ready to do a general anaesthetic using RSI (Rapid Sequence Induction) and prepare an emergency airway, should the patient get into difficulties. I prepare the ET tubes and cannulas, and check the laryngoscopes are working.
I spend a lot of my time reassuring the patient and monitoring their pain whilst the procedure is taking place. I really love this part of the job as most people are very anxious and so grateful for your support.
While I’m there some other ladies require epidurals. So I prepare the equipment and drugs and assist the anaesthetist and midwives. It’s a very delicate procedure so everyone is super concentrating. Positioning is so important but it can be very difficult for patients to sit still during contractions. I help the patients with their breathing and ensure their spine is in the best position.
It’s now about 1.30am and I take the opportunity to have a break and top up on coffee and snacks whilst doing some revision for my drugs exam. Never one to miss an opportunity!
Then it’s back to main surgery as a patient is rushed in with a large abscess which has burst. So it’s into the anaesthetic room for a GA, then into theatre for the surgery. All I can say is that I’m glad I’d already eaten my snacks, as you need a strong stomach to deal with the smell.
Once the surgery has finished, I assist with the extubation and hand over the patient to the recovery nurses in PACU.
All quiet until 7.00am and it’s a call back to maternity for another epidural and a very distressed patient. Felt really good afterwards as the anaesthetist praised my skills and said that my calm manner made a very difficult situation much better. What a way to end the shift: tired, exhausted but great to know I’d made a difference.
It’s 8.00am and time to go home.
I get changed, hand over to the day shift and locate my car in the car park.
Well, no babies delivered tonight but I survived my first night shift – HOORAY!
I really hope the motorway isn’t busy as I’m so looking forward to my bed!