I am the team leader for the Fetal Surgery Team in the Children's Surgery Center (CSC). I had the honor of caring for M, a 27-year-old patient pregnant with twins, diagnosed with twin-to-twin transfusion syndrome. On this particular day, I was precepting Olga Yakoubovsky, Ryan Esguerra (new RN graduates) and Beverly Navarrete (new scrub technician).
M was scheduled in the CSC for laser ablation of common vessels that her twins shared, which left untreated can lead to the demise of both twins. I quickly explained the procedure to my surgical team and took Olga with me to meet M and her husband in Labor & Delivery. M had many questions. Although many of the questions were more appropriate for the surgeons, I was able to answer some of her questions and promised to be in the room with her during the procedure.
Note: this surgery is done under spinal anesthesia with limited sedation because of the risk to the fetuses. M was very nervous about remaining awake for the surgery but appeared calmer once she learned I would be in the room with her. Upon returning to the operating room, I explained to the entire team that M was very nervous and that we would need to provide a very calm and soothing environment for her. Everyone quickly agreed.
When M entered the room, each member of the team introduced themselves and returned quietly to their tasks. We positioned M for her spinal block (sitting on the side of the OR bed, leaning on me) and talked her through the procedure. With some distraction therapy, we were able to successfully place the block and position her for the rest of the procedure. When the lights were turned off (the procedure is done video-assisted in the dark), Beverly told me that M was calling out my name.
I quickly made my way to the head of the bed and climbed under the drapes to see what she needed. She just needed somebody to hold her hand. Dr. James Jones (attending anesthesiologist) and Dr. Jeff Tully (resident anesthesiologist) got me a sitting stool and I sat under the drapes for 15 minutes until change-of-shift relief arrived. At the change of shift, Allison Horsely and David Dietrich took over. I explained to M that it was time for me to go home but that David had held many hands and would take good care of her for me. She said thank you with tears in her eyes.
David didn't ask any questions, he just leaned in, introduced himself and took over for me under the drapes. Because of the cohesive teamwork done by all members of the team that day, we were able to provide very individualized and special care for M that day. On behalf of M, "Thank you!" to Olga, Ryan, Beverly, Allison, David, Dr. Jones, and Dr. Tully for their exceptional teamwork and care. Of note, both twins were delivered successfully.