Infection Dejection
If you’re like me, you got into surgical technology to help people. (If you aren’t in it to help people then I’m not sure I want to know why you’re here.) Unfortunately, sometimes things happen that are out of our control and patients leave the OR in worse shape than they entered. Luckily for me, this is an incredibly rare occurrence. In fact, up until recently my track record for patient success was exceedingly awesome which is why it was devastating when one of them came back with an infection.
When you see as many patients per week as I do, unless there’s something crazy about the anatomy or patient’s personality, one total knee arthroplasty starts to look exactly like another. In this case, there was no doubt the infected patient was mine. The procedure was something relatively obscure (apparently the last one the hospital had done was several YEARS ago) so everyone was aware that it was my patient. Annoyingly, they had no problem pointing this out to me. “Didn’t you do that weird case with Dr. Reeves last week? I see the patient is back with an infection.” “Did you see you’re patient got an infection? It’s on the schedule for today.” “What happened in that Reeves case? Did you contaminate something?” “Yes, I did the case.” “Yes, I saw it on the schedule.” “Nothing happened and I’d appreciate it if you didn’t make assumptions that my sterile technique is anything less than impeccable.” (I may have been losing my sense of serenity by the time this last person brought it up.)
I spent the day worried about my infected patient. I wanted to know if they’d be okay. Since the case was scheduled for evening, I wouldn’t be the one scrubbing it and it drove me crazy. Growing up, I was taught that if you made a mistake you should take responsibility and fix it. Due to scheduling, I wouldn’t be putting that plan into action, so I went home upset and worried. I replayed the case over and over in my head, looking for any contamination or breaks in technique that I might have missed. I came up empty-handed. Nightmares about patients dying in my OR plagued me. Needless to say, it wasn’t a restful night.
After a several sleepless nights I returned to work, tired and stressed, where I talked to some techs about my feelings of guilt and failure. They all had similar stories and assured me that as long as I’d done my due diligence with patient safety and sterile technique then I’d done a fine job. They reminded me that any number of things could have caused the infection: nurses changing dressings, patients not following post-op care instructions… It hadn’t occurred to me how many things could go wrong once a patient left my hands. It took some time, but eventually I was able to accept the fact that I’d taken responsibility for my involvement in this patient’s care by reviewing my surgical technique and done everything in my power to prevent a surgical infection.
If you’re new or haven’t experienced one of your patients coming back with an infection, just know that it isn’t necessarily a reflection on your skill as a tech. I will encourage you to review the case to be sure, but if you don’t identify any breaks in technique, don’t beat yourself up over it. As Type-A as some of us (okay, most of us) are, we have to recognize that it takes small army of people to care for a patient and we don’t have 100% control over every aspect of sterility once the patient leaves our care. All we can do is monitor our own performance and encourage the same high-level of conscientiousness from our coworkers.
Until next time, stay ster
