Path to SFA 6 Ortho rules!

five here
Training in the "real O.R." was much more stressful, but the cool factor was significantly elevated. In the beginning, you do a lot of work on opening supplies for the case, setting up the back table and mayo stand, and then observe as the primary scrub passes instruments. It is sort of like grunt work with no glory but a valuable lesson none the less. You may be surprised at how easy it can be to contaminate the field if you aren't careful. Do it once or twice and have to explain to the surgeon why you have delayed the case, and explain to the OR manager why you have wasted supplies and you become more vigilant.
Scrubbed in as the observer during those early cases, I would use an empty glove wrapper and a sterile marking pen and take notes of the procedure in sequence. After the case, I would transfer my notes to a sheet of paper and use it for reference the next time the same procedure came along.
After observing as second scrub for about a week, you begin to first scrub and your preceptor gets to sit back and observe. With the pressure of knowing that I would have to take call in about four months I became anxious to scrub everything. The crew was more than happy to oblige me. If there was only one line that day, I scrubbed it all. If anything got added on during a slow day, I scrubbed it.
The influx of information was often overwhelming and I thought that I would never be able to retain it all. Ortho cases, particularly total joints, have a high volume of instruments. You may have as many as six instrument trays in addition to your basic setup. In fact, you need to use two back tables to accommodate them all. Being slightly (yes, just slightly) obsessive compulsive, the clutter from total joints was frustrating for me. It was also hard to retain the sequence of surgical steps and instruments during the case. I would take whatever notes I had been able to gather and tape them to the wall behind my back table so I could "cheat" during the case. It was too difficult to turn away from the procedure long enough to squint at my notes trying to find my place again in the sequence. I longed for a better way since I didn't have a better memory.
Then my hero came along. The girl from central sterile processing, that I had spent a week with back in the beginning, had discovered that if you use a permanent marking pen on a 4x6 index card, put it in a peel pack and run it through the autoclave, it comes out sterile and still readable. Hallelujah! I soon had a collection big enough to require it's own space in the supply cabinet. Total knees went from my most frustrating case (I am a perfectionist), to the most satisfying and fun. And, bonus! The orthopaedic surgeon was the most fun to scrub for.
The general surgeon was very high strung, and the Gyn doc was a bit of an ass, but in a clever sort of way. More on that later.
prelude here
one here
two here
three
SFA four here