by Orthopaedic & Spine Center’s Tonia Yocum, PA-C
(Physicians Assistant – Certified)
On a typical surgical day, I am up and out of bed at 5:15 AM. I leave the house at 6:00 AM and normally arrive at the hospital around 6:30 AM. I usually change into surgical scrubs when I arrive, although I wear a lab coat when rounding on our post-operative patients.
My days in the hospital are divided into two distinct parts: (1) rounding (visiting and evaluating) patients who have already had surgery and; (2) assisting Dr. Jeffrey Carlson with his orthopaedic surgical cases in the operating room.
Upon arrival at the hospital, I usually complete rounds (evaluations) on post-operative patients. When I am in a patient room, my activities include:
• Asking the patient how they are feeling while checking the surgical area for any abnormalities (if I find anything of concern, I report it to Dr. Carlson immediately)
• Answering any questions they may have about their surgery and recovery
• Outlining expectations of what will happen during the day at the hospital & helping them feel comfortable with the planned therapies (mainly ambulating with physical therapy),
• Reviewing their lab results, vitals and writing SOAP (Subjective, Objective, Assessment Plan – medical format) notes in their chart.
Around 7:30 AM, I report to operating room for first surgical case of the day. Part of the surgical P.A.’s job involves pre-operative preparation. I spend time with each of our surgical patients before surgery and these are some of the responsibilities I have:
• Speaking with the patient before surgery to answer any last minute questions and to reassure the patient if they are anxious about their surgery
• Discussing post-operative instructions
• Listening to patient’s heart and lungs
• Assessing vital signs
• Asking the patient pre-operative questions (Example: Did you have anything to eat or drink after Midnight?)
If everything checks out okay with the patient, I then pull together all of the information necessary for Dr. Carlson to proceed with the surgery. This includes patient demographical information, their history & physical and MRI images. Dr. Carlson will review this information before the surgery and may refer to it during the surgery.
At this point, the patient has been prepared for surgery and has been seen by the anesthesiologist, who has started an IV and sedated the patient to help them become less anxious. The patient is wheeled into the OR and I then begin to assist with the surgery. Some of the duties I perform are:
• Helping the surgical team transfer patient to O.R bed
• Standing-by during patient intubation
• Positioning the patient properly on O.R table
• Scrubbing- in for the surgical case
• Opening surgical instruments
• Making sure all necessary equipment is available and ready
• Draping the surgical patient
• Performing suction, retraction, tying, suturing during the operation
• Applying dressing to surgical area
At 10:10 AM, we finish our first surgical case. The patient is extubated and transferred back to a hospital bed. I write post-operative notes & orders specific to our patient that will be used by the nursing staff while the patient remains in the hospital. I then assist with transferring the patient to recovery room.
At 10:25 AM, I start the process over again with our second surgical patient of the day. My evaluation lasts until 10:40 AM. I then start writing some orders and grab a quick snack before returning to the OR.
Dr. Carlson and I have successfully completed 5 surgical cases today. I did get to grab a bite of lunch after our second surgical case and another quick snack around 5:00 PM. Today, my day at the hospital ends at 7:15 PM. I now leave for my second job, being a wife and mother!