Working in the operating room (OR) is an environment unlike any other. It is unpredictable, intense, and very cold! However, I cannot imagine working in any other setting or doing anything else. As a surgical neurophysiologist, you are a crucial part of the surgical team. Over time, this team becomes your work family, and you are all there to take the best care of a patient.
As surgical neurophysiologists, every case requires some preparation because every day is different. Each surgeon works differently, and every patient you see is unique with their history. Intraoperative neuromonitoring can be useful for a variety of case types, including brain, spine, otolaryngology, vascular, orthopedic, and peripheral nerve procedures. Each of these procedures varies widely on what is at risk, what you will be monitoring, what hospital you will be at, and who you are working with. Therefore, each day will be completely different than the next! Working in the OR has very little consistency, which most people in the field find keeps their job so exciting day-to-day.
Your typical day starts with the dreaded sound of your alarm blaring, usually before the sun is even out. A first start case is usually at 7:30 A.M., and you show up to work and ready to go as early as an hour before. Each case monitored requires an extensive set up including: electrodes and tape preparation, setting up the surgical bed with your hardware, setting up your software, as well as speaking with anesthesia, the surgeon, and the patient. All of this is done before your day truly even begins.
Next thing you know, it is game time as the patient is brought into the room. You go through your standard patient set up depending on the case type, obtain baselines, and get ready for incision. Most routine cases are predictable and smooth sailing. However, there are factors that can throw a curve ball to make your day interesting. Is the surgeon going to do what is planned? Is the surgery going to go longer than expected? And the most anticipated question of all: Will I have an alert today?
The days you face an alert are the most stressful and challenging of all. However, this is the reason you are part of the surgical team in the first place! I firmly believe that one of the best feelings in the world is detecting an alert and successfully communicating the data changes to your surgeon, surgical team, and working together to solve the problem so the patient does not wake up with a post-operative deficit. Days like this are definitely the closest I have ever felt to being a superhero!
So, what is the average day like in the operating room? You never know what challenges and surprises the day has in store for you when you walk through those hospital doors in the morning. It can be fast, easy, and uneventful (fingers crossed); or it can throw several challenges your way. Whatever it has in store, just know you are trained for it and ready to conquer to provide your patient with the best post-operative outcome possible.
Written by: Anna Morusiewicz, Au.D., CCC-A, CNIM