Schmutz

Cooler, raining, window open, cat hiding.

Dreaming work dreams. Scrubbed in, trying to find out from the surgeon what plate he wanted, resident already getting gowned and gloved before me, so that she was just standing around waiting for me to set up the table. I roll my eyes and get ready, only to find schmutz in a clamp, so the whole sterile field is compromised, and I have to get my circulator's attention and break down everything, get new supplies and autoclave the special plate chosen, and try to get the resident's attention, because she isn't sterile anymore either and needs to break scrub. By this point the room is full of people chatting, no patient, and I can't get anyone's attention or assistance, but I notice my blue Xmission mug, figure that just has to be clean, not sterile, so I salvage that and the dream drifts off.

I have to get up, I'm hungry, stiff and sore. It's still pretty dark when I open the blinds slightly. But until D gets up, I don't realize it's raining lightly. He opens the blinds wide and the window to let in the cool Pacific fog come all the way from the coast to finally end our sere summer.




*On a sterile field, any evidence of contamination is cause to discard everything and start again. Tissue from a previous patient still in or on an instrument is proof that it was not properly cleaned, and if it ain't clean, it ain't sterile. Referred to as bioburden, not common, but it does happen. In the dream, it was pretty obviously gross oversight. A resident who gowns and gloves before the scrub is akin to a guest at a formal dinner sitting down at the table and getting their napkin under their chin before the servants have finished setting the table. Breaking scrub is removing gown and gloves - intentionally removing oneself from the sterile field. Although in a trauma it does get that crowded in the OR, there is still strict observance of sterile field - enforced by scrub, circulator, surgeon even, but first line is the scrub. In the dream, there was never a patient, and the atmosphere was more of a gathering before a meeting, or a work party.