L.E.A.R.N.

L.E.A.R.N. Note 2

Brooke Gagnon

NUR420

Maria Isorena

March 19, 2019

L.E.A.R.N. 2

L.E.A.R.N. Note 2

Look Back

On March 12, 2019 in clinical at The Scarborough Hospital, I spent the day observing

surgeries in the operating room and wish I had known more about total knee arthroplasties than I

did going in to observe that surgery.

Elaborate and Describe

Last week in clinical I had the opportunity to observe two surgeries. The second surgery,

in the afternoon, was a total knee arthroplasty. Before going in to the surgery, I knew only that this

would be the replacement of the patient’s entire knee with an artificial knee. Because of the timing

of the surgeries, I entered OR8 with another student. Present in the operating room was one RN,

one RPN, two surgeons, one anesthesiologist, and one brand representative for the parts. I felt

slightly overwhelmed and, after trial and error, the RN and brand rep found a good place for me

and the other student to stand and watch the surgery. As the surgery went on, I felt very confused

and increasingly overwhelmed. I did not have any idea of what was happening and felt as though

I didn’t know what I was seeing. I also felt shy and was not sure if I should ask these questions or

who to ask them to. When the surgery was ending and the RN instructed us to leave, I did not feel

like I learned very much from watching the surgery as I was confused the entire time.

Analyze

I did not know what was going on in the surgery, and as a result felt as though I did not

learn anything, because I had not done any research on the procedure before watching it. Therefore,

I did not know what I was seeing or what to watch for. After doing research, I now know that knee

replacements are typically indicated in patients who are diagnosed with osteoarthritis, have severe

knee pain, have had no response to alternate therapies, are medically fit, and who are of capacity

to give informed consent (Carr et al., 2012). There are four basic steps to the procedure. These
L.E.A.R.N. 3

include preparing the bone by removing the damages cartilage at the end of the femur and bit of

the underlying bone. This must have been what was being sawed off. Next, metal parts are placed

to recreate the surface of the joint. In this surgery, the parts were cemented into the bone. The

following step in the resurface the patella. This step is optional and I am not sure if it was done in

the surgery I observed. Lastly a plastic spacer is inserted for smooth gliding (4. New Hire Surgical

Package PDF copy). A bone graft was also done in the surgery. This may have been done to

augment defects or the fix any bone deficiencies (Lewis et al., 2019). From the situation I learned

to always prepare before going in to surgeries in order to know what I am watching and why it is

being done. The literature taught me the basics of what this surgery was for and what it entailed.

If I had of done this research before going in to the surgery I would have understood more of what

was happening and would have felt less confused and overwhelmed.

Revise Approach

Feeling as overwhelmed and confused as I did in this situation was important because it

gave me the motivation to never feel that way again. I did watch the surgery attentively and went

it with an open mind. I also made mental notes of what I needed to research. I am glad that I did

these things while watching the surgery and would do them again in a similar situation. I should,

however, research surgeries and procedures before going in to observe them. I should also have

asked someone in the OR some of my questions in the moment.

New Trial
I recommend to future nursing students in similar situations to go into observing in the OR

with an open mind, read-up on why the surgery in question might be being done and what, in

general, will be done, and to ask questions to the nurses, surgeons, and anesthesiologists present if

possible
L.E.A.R.N. 4

References

Carr, Robertsson, Graves, Price, Arden, Judge, & Beard. (2012). Knee replacement. The Lancet,

379(9823), 1331-1340.

Lewis, S., Bucher, L., Heitkemper, M., Harding, M., Barry, M., Lok, J., Tyerman, J., &

Goldsworthy, S. (2019). Medical-surgical nursing in Canada: Assessment and management

of clinical problems (4th ed.). Toronto: Mosby Elsevier ISBN 9781771720489

4. New Hire Surgical Package PDF copy. Emailed from: Maria Isorena.