Once Upon A Time ....................Part 10

Image via WikipediaFollowing on from Part 9.....Did the Theatre Sgt listen to my plea to get out of theatre? Did he help me to leave? Did he hell!!!!!

Basically it was along the lines of "you've made your bed, now lie on it." In other words-you are stuck, now get on with it. Once you signed up to become an Operating Theatre Technician, you found out that it was what was known as a Restricted Trade. There WAS no get out of jail free card, this was no monopoly game. So what was a poor boy to do? Correct! GET STUCK IN.

My apprenticeship in the Sluice Room was actually far more instructional than I at first thought it might be. It was an excellent place to start learning the identities of the myriad of instruments available to surgeons of different surgical persuasions. In Tidworth, back in the sixties, those "persuasions" or Specialties, were E.N.T (Otorhinolaryngology), General Surgery, Orthopaedics, Gynae, Dental and Trauma. If I have misssed any from the list, I apologise to any surgeon reading this-please don't be offended, it's nothing personal.

Before proceeding, I must pay my respects to some of the Surgeons who passed through the theatres while I was there. Those that stand out in my mind are,  Patrick "Paddy" Dignan, (please see the note at the end of this re: Paddy Dignan) Adrian Boyd, Major Owen-Smith and "Pop" Reid. Each was outstanding and a pathfinder in a way, within their specialties, without whom surgery and research in general, may not have benefitted.

I should not forget the Anaesthetists. I remember Col. Cardew, Anthony Booth and Jeremiah Leahy amongst others. They worked very hard, not just in their efforts to stabilise patients and have them ready for surgery at exactly the right moment, allowing surgery to continues non-stop until lists were finished, but to ensure that trainee Technicians benefitted during their formative days in theatre. Col Cardew and Anthony Booth were especially helpful with training.

Now I've mentioned the above, I really must mention the Theatre Sisters. I mentioned three of them in an earlier part of this Blog. The outstanding Sister, in my humble opinion, was Mary Challis. I found her to be strict in her approach to performance and behaviour as well as turn out in theatre. Most of all however, she made sure that training was delivered as required, but even more than that, she ensured that it was received by the individuals learning the trade, by questioning us trainees and ensuring we were on the ball. I sometimes despair that this ensuring that training has been received and validated does not always occur these days.

I'll move forward now, leaving the housework period behind us. Just before I do, I would admit that, just as in the nursing training, if you don't get that background work right, the treatment delivered to each patient might not succeed without infection. Cleanliness IS the key.

After three months the level of Operating Theatre Technician, Class 3 had been achieved. Looking back it doesn't seem to have been much of an achievement, but at that time-I felt good about myself, knowing that I had indeed stuck to the task despite my early misgivings.

 One of the advantages of having trained as an Army Nurse, was that a very good knowledge of anatomy and physiology had been gained during that former training. This helped dramatically when surgeons "talked" a trainee through a procedure. It certainly helped knowing the relationship of one internal organ to another when an appendicectomy or other abdominal procedure was being described. Part of the training for Part Two of the three level full qualification, included scrubbing up and just standing at the operating table. (This, apart from, at first anyway, making one feel like a spare appendage at the wedding of a lady of the night, was exceptionally helpful in getting used to scrubbing up and learning to respect the "sterile field") I spent many a time just standing behind the surgeon listening carefully to what was being talked about. Surprisingly enough, not all of what was being discussed was concerning the case in hand!!! Having signed the Official Secrets Act upon joining the Army, I knew not to discuss the details of the latest bit of "gossip" picked up at the table.
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Next time-more of life at the table, and the dangers of not paying attention!!!

Re: Patrick "Paddy" Dignan. He has written a book, "A Doctors Experiences Of Life." by Patrick Dignan.I would reccomend this to anyone who knew him, as well as to those who would like to know of his life as an Army surgeon. It is published by The Pentland Press Limited. ISBN 1 85821 136 0
I got my copy via Amazon, but can be obtained via other reputable booksellers.

Once Upon A Time........Part 9

I WANT OUT! is how I finished Part 8. I had just gone to start training in Theatre as an OTT. Time now for DAY 2.


I should just say, if anyone reading this is an OTT, I apologise for some of the details, with which you will all be familiar. There are however, a lot of readers trained in other areas of responsibility in the RAMC, for whom the details are included. ....................


My first day in Theatre had passed by in a blur. In truth I was very excited and could hardly wait for the next day to come along. So, bright eyed, bushey tailed and well-breakfasted I headed for work on day two. It being a Tuesday, it was General Surgery, all day.

I was assigned to one of the Corprals. His job for the day was to make sure the Theatre was in good order and ready for all cases that appeared on the Operating List, as well as to keep an eye on me and ensure that I listened to his every instruction, and to learn how to do things as quickly as possible. (I have to say that the only way to learn in those days was quickly-failure to grasp detail at the first time of telling,and, depending on the teaching technique employed by the trainor, could lead to extra sluice and floor scrubbing duties as well as extra on-call duties,as if there weren't enough anyway.) From memory, duties included making sure the scrub-up area was stocked with sufficient Operating Gown Packs, a complete range of surgical gloves from size 6 through to 8, with 6 being the smallest and 8 the biggest. (The range would be different from theatre to theatre depending on the staff membership.) I don't know if any other OTT reading this remembers this, but invarioubly it was the Gynaecologists who wore the largest size!!!. There was also the need to make sure the Post Op dressings tray was topped up and that all any extra Operating Table parts were ready, such as arm tables, hand tables and stirrups.

One of the more critical pieces of equipment to ensure being available was a stool upon which the surgeon would sit for some of the procedures on the list. These might typically include hand and foot surgery, gynae procedures, rectal surgery, or, sometimes just to sit on while waiting for the patient to emerge from the anaesthetic room, hopefully suitably stunned and ready for knife to penetrate skin without the patient jumping off the table!!!. During my first few weeks, I found that the second biggest sin that could be commited as the gopher for the day, was to have to be told to put the stool under the rapidly lowering undercarriage of the surgeon. He always "knew" it would be there so didn't even look round for it. It was always expected that the surgeons' every move was being anticipated by the hopefully fully alert gopher. The FIRST and BIGGEST sin was to whip the stool away before the surgeon was finished with it. Sometimes the surgeon would stand up and have a little rummage around whichever part of the lower end of the body he was servicing, and a quick witted but sadly mistaken gopher would whip the stool away-complete with smile on face, firmly believing he was being efficient. Sadly, on more than one occasion he would be wrong. Only once though, in my career in theatre, did I see a surgeon end up on the floor, letting fly with deletives that could not be deleted. I will not name the surgeon involved, but, I developed an instant respect for him and his knowledge of the English, and possibly several other languages, when it came to cussing.

Having ensured the Theatre was ship-shape, it was off to the sluice to check out such things as stocks of linen bags, rubbish bags, and copious quantities of detergents and soaps with which to clean the floors at the end of the operating list. At this point, my new found friend and tutor made it quite clear that I was to familiarise myself with all the practices of the sluice, as it was to be my new home until it was thought that I had mastered the art of cleaning all things, movable or immovable. Now, where had I heard that before? Oh yes!-when I started my Nurse training.

Before the day was out, I had made up my mind that I was not as happy with my new career as I had hoped. To be perfectly honest, I never did get to like the cleaning aspect of working in theatres, throughout the years between 1968 and 1986. Don't get me wrong, life wasn't all about cleaning, but it did play a massive part in the overall role of the OTT. With training, demonstration to the bosses of competence and subsequent seniority came progression within the organisation, and more opportunity to practice such other skills as teaching and management in the different aspects of managing day-to-day life in the Theatre and ensuring patient safety at all times.

At the end of Day 2 however, I knew nothing of the future and what it would hold for me. I was not going to waste my time cleaning again. I wanted OUT, and damn it, I was going to tell the theatre sergeant this, as soon as he got back from the bookies shop. I was sure he would understand!!

NEXT TIME........ did he understand? did he listen to me?

Once Upon A Time..........Part Eight

It's my own fault I suppose! I started  a series of reminiscenses about the five years I spent in Tidworth at the Military Hospital. I got to the point where I was, at last, starting a new career, this time as an Operating Theatre Technician, and then it all went quiet. I have received quite a number of messages, nay, enquiries, asking when I am going to get on with the series of articles. Oddly enough, most of them come from outside the UK and mainly from Eastern European readers. As a mark of respect to all of you, thanks for your messages and now-Part Eight.
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As with any change, whether it be a change of job, location, role or in the case of a military career, a promotion, life is immediately a challenge. The first few days can even be a maker or breaker period. My first few days in Theatre were close to being a breaker!

To be fair, I was welcomed warmly into the new "family." Each and every person from Stan Jones-Theatre Sgt., through to Jim Goreman, civilian Porter, made my first day one to remember. I had better add here that I remember the first day for all the RIGHT reasons. Stan was an easy going kind of guy, not a bad bone in his body I would suggest. He did have a tendency though to study racing form, rather than what cases were on the operating list! The rest of the team, or as many as I can now remember included: Ken Hudson, Barry Gaukroger, "Chimp" Roberts, Bud Holder, Phil Reeves, a guy called Gartside (first name escapes me,) Phil Olive, John Thomas, Ron Days and others. Not all were senior Techs, some were new but just a little less new than I was. Over the years many more techs came and went, I would need a new Blog to mention all names.

During my first day, I was introduced to the Theatre Sisters, of whom there were two. Please don't ask me who they were. I see faces in my minds eye, but names totally escape me. In all the years I was there, some names remain in my mind for varying reasons. I can think of Mary Challis, Phyllis Broad and Maggie Watson. Of these, I remember two with great fondness. They were good at their own jobs, and able to gain the respect of just about everyone they worked with.  The other? Well, lets just say that she made much out of nothing, appeared to dislike all technicians, trusted no-one other than herself, and rather annoyingly, insisted upon scribbling her initials on just about everything, whether it belonged to her or not and whether it was nailed down or not! Those of you reading this and who knew the above three ladies will know to whom I refer.

My first day consisted of "the tour" of the estate, which included a remote Central Sterile Supply Department building, (CSSD) on the other side of the Hospital "square." The theatre suite consisted of an entrance corridor, Foyer, Anaesthetic Room, Laying Up Room, one Operating Theatre, a Sluice room, a Store room and the Sisters office. The CSSD consisted of two conjoined "packing areas" within which were two dependable steam sterilisers and a store area and a tea room. I say the sterilisers were dependable, which they were, until Phil, the electrician/maintenance man came in to do his weekly maintenance, following which they played up for the rest of the day!!! Oh, why can't people just leave things alone I used to think.

 There were two more operating theatres besides the main one. The Casualty Department directly beneath main theatre, had a theatre that was used for minor operations and emergency surgery and for MUA's and EUA's. These were Manipulation Under Anaesthetic and Examination Under Anaesthetic. There was also a Maternity Theatre within the Maternity Unit, used for Caesarian Sections and various other pre and post natal procedures.

Before I knew what was what, my first day was over. The highlight of my day? It had to be the dressing up. The change from my Nursing "whites" to theatre "greens" was kind of exciting to a young lad, such as I was then. I felt rather strange in them at first, but that soon went. My only complaint would be that the trousers were supposed to have waist and fly buttons, but many didn't. This meant using a one inch cotton bandage to tie around the waist to keep them up. Safety pins were the order of the day to keep the fly area in good order and under control.

Day two took on a totally new complexion. As with my introduction to life on the wards as a trainee Nurse, cleaning was to play a major part in daily life in the Operating Theatre. Clearly I hadn't done my homework before forsaking my hard earned level of status at nursing level before jumping ship for this new career. If I had I would possibly not have opted for starting at the bottom all over again. Day two started in reasonable style. Tuesday was General Surgery all day. I was "given" to one of the senior techs for the day. He, quite clearly, was not over impressed with the gift bestowed upon him by Stan Jones. I won't mention his name out of fairness to him. After the first case, which I believe was an Inguinal Hernia repair, I was taken out of the theatre itself and into the sluice. No more surgery for me THAT day!!

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Next time-I WANT OUT!!!!!

A little early perhaps, but Happy Christmas To All

Not the usual Christmas carols or video, but something that brings a tear to my eye every time I hear it. I hope you enjoy it too. Happy Christmas and a very Special 2012 to all.

http://www.youtube.com/watch?v=4pWDp-cbKX4&feature=youtube_gdata_player