ARU skills labs: Making placement less scary

The skills labs at ARU are a great facility to get some hands on experience of the equipment and the procedures that you encounter on placement.

This can be anything from setting up the anaesthetic machines, selecting and preparing the airway devices and invasive monitoring, positioning patients, handling and preparing the surgical instruments and even practicing how to scrub and gown up.

Believe me, there is nothing more terrifying than doing your first surgical scrub in hospital under the glare of the in-charge practitioner, usually a senior nurse or ODP, who watches students like a hawk in case they contaminate the sterile field and put the patient at risk. Even the surgeons are wary of the ‘in-charge’ and I’ve seen many surgeons and anaesthetists reprimanded and told to de-gown and re-scrub as they hadn’t done it properly.

Thank goodness for our skills session on scrubbing, gowning and draping. It sounds so easy, doesn’t it? I mean, all you have to do is wash your hands, pop on a gown and gloves and help the surgeon spread sterile drapes on the patients. How difficult can that be? Oh how very wrong I was!

As we embarked on our first surgical module, thankfully our lecturer took us through the whole procedure using the skills lab’s scrub sinks, operating table, patient manikins and stocks of PPE. After washing my hands for what seemed like hours, it took me seven attempts to get my gloves on using the closed glove technique. I managed to rip several pairs of gloves and desterilise myself at least twice, amid much laughter from the rest of the group (until they tried to do it themselves of course).

Closed gloving means that you have to put on your blue under gloves whilst wearing a surgical gown AND without your fingers actually touching the outside of the gloves, before then putting on your white outer gloves! This in itself is quite a skill and it’s not until you try it that you realise how difficult it is.

Then I attempted to drape the patient whilst keeping the drapes sterile, not desterilising myself and making sure the surgical site is still exposed. Again, it was not easy but it was nice to be able to have several attempts and not made to feel stupid. Our lecturer was great and told humorous stories of her experiences as a student which helped us students gel as a group.

The afternoon was spent looking at and handling some generic surgical instruments and practicing mounting extremely sharp blades on scalpels and tiny sutures on scissor-like needle holders. Again, it sounds quite straightforward, but trying to do it whilst wearing two pairs of surgical gloves is quite difficult and you become very clumsy.

Making sure you can identify the right instrument and hand it correctly to the surgeon without inadvertently stabbing them, yourself, or worse, the poor patient, is yet another skill, in the seemingly hundreds that we need to learn. Not only that, but you need to know the names of the instruments and the purpose of each; for example a Ramsey toothed forceps is often to used when suturing the skin, whereas a Ramsey non-toothed is a soft tissue forceps used when dissecting or suturing muscle layers in the abdomen.

In practice surgeons might simply ask for ‘forceps’ and you, as the ODP, need to know what forceps they actually want by understanding the steps in the surgical procedure and looking at the type of tissue they will be using it on. However, so many of them look alike! It was so useful to be able to handle each instrument in the safety of the lab and look at what tiny details make them different and ask questions about their use.

I’m not going to deny that I wasn’t scared to scrub for procedures initially, I was. And yes, I got things wrong and still do, but doing the sessions in the skills labs were an invaluable and gave me the basic knowledge and confidence needed to be effective in placement.

---

Jackie is studying Operating Department Practice at ARU in Chelmsford. To find out more about our degree courses and student life at ARU, book your place at an Open Day.