Beating Heart

During clinical’s today, I was floated to Morgan Heart at Morton Plant Hospital. Today I got to observe an aortic valve replacement. Unfortunately, I was not in the OR at the time when the chest was cut open, and even though it sounds morbid, I wish I hadn’t missed that part. When I walked into the OR, the Rolling Stones was playing on a radio in the background, and the surgeon and PA chatted together before they looked up to see me and the nurse I was shadowing. The Nurse Anesthetist, who stood at the head of the operating table, flagged me down and asked me to bring a stool along with me. I placed the stool at the head of the operating table. She demonstrated how to safely peek over the paper drape that covered the patient’s head, so that I could watch the surgery from the prime spot in the house. Next to the surgeon and his two assistant’s, you can’t get a better view in the OR. I hopped onto the stool with the face mask, hair covering and eye shield and peered over the drape to watch the surgeon perform his magic. It was so fascinating. He replaced a calcified inadequate heart valve, with a porcine (pig) valve.

Right behind the surgeon, stood the perfusionist. Until today, I had never heard such a title. The job of the perfusionist is to operate the heart lung machine. Prior to open heart surgery, the patient is given an overdose of potassium, which forces the heart into cardiac arrest. A potassium injection is what’s given to prisoner’s who are executed. But, back to my story here, the potassium overdose stops the heart, because how can a surgeon operate on a heart, let alone replace a heart valve, if it’s beating at 80-100 beats per minute? It’s impossible. This is where the heart lung machine comes into play. It’s job, in a very basic sense, is to provide blood flow and respirations to the patient while the heart is stopped. It adds oxygen to the blood from your heart and pumps it back to the body.

As I stood watching the surgeon  sew the new valve into the heart, I couldn’t take my eyes off the the fluidity of his movements and sewing skills. It was magnificent. All the while, he’s talking to us about his two kids, and how one loves football and the other likes to make hair bows from decorated duck tape. To this surgeon, not one detail is missed, but it’s his art and something he’s comfortable with, so it’s also effortless. It makes me want to become a surgeon. I have so much respect for the dedication that a surgeon possesses. Nursing school is not easy; we have to know nearly as much as a doc knows these days. But I can’t began to imagine Med School. I can’t imagine cutting into a chest for the first time, and then watching the heart stop, and then restarting it. It’s a heart! It’s a life. And it’s up to the surgeon to keep it going or not. That deserves so many cheers.

Once the valve was in place, and a few other major things accomplished, the surgeon grabbed the sterile internal cardiac paddles and placed them on either side of the heart. Then the heart began pumping again. And this is when I went into a trance, watching the heart pump and the lungs expand and relax. Although no one in the OR could see my facial expressions behind my mask, I think perhaps they could see the warm  aww-inspired and proud smile through my eyes. It was mesmerizing and also overwhelming, because my mind went to the thought this heart, the size of the patients fist, beats 80-100 beats per minute for anywhere from 70-100 years. How does it not get too tired? How does it just keep going and going and going?? It’s amazing and fabulous.

I watched the surgeon and PA sew up the layers of tissue and muscle over the heart, and then wire the chest bone back together.

I’m once again amazed at the fact that I get to be apart of this process. I get to be apart of saving lives too. I get to witness peoples lives being saved. I get to work with the most complex and detailed creation in the world; the body. But, it’s much more then just a body, I get to work with the soul too, and that’s so rewarding and exciting!

Nursing 3 has been great so far! I’m understanding so much more about the complexity of the body and the different disease processes. We’re studying pediatrics and psychiatric nursing as well. We’ve already done our pediatric rotations at All Children’s Hospital and Psych rotations will  start in a few weeks. I love it…all of it, especially today after seeing a real beating heart.

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