Heart Surgery in America: Wednesday 1.2

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Editor’s Note:

This piece was written by Ms. Weng Puno-Baldeo, a perfusionist in the Philippines.

Going to a battle unarmed, clueless and unprepared-

Yes that’s me.

I entered the world of perfusion by chance. Last 2011, I was offered a training in perfusion at the Philippine Heart Center while working as a CV Recovery Room Nurse at the Mindanao Heart Center. I said “yes” to the offer because at that time I was pretty much intrigue and amaze how the heart lung machine works and that’s all! Little did I know that it is just of the many machines the perfusionists operates and not to mention that basically the life of every patient on bypass is in the hands of the pump perfusionist.

For six months, i found myself in great effort in learning the circuitry, theories, protocols and the possible variations you can make in order to tailor-fit the circuit with the patients surgical needs. After the first 2 weeks of my training, I said to myself, I wasn’t ready for this? This is totally a man’s job! I could not be improvising circuits, carrying and putting on the heavy water hose of the water heater/cooling machine or running around operating one machine to another or going down on your knees troubleshooting the circuit you thought was perfectly set up! I vented this to my preceptor and all he said was  “ in perfusion, you have to think like a plumber and the circuit tubings, your pipes, map out the circuit, master it and you’re good to go…it’s basic and it’s simple as that” Well, I think He said it well enough for me to change my perception towards perfusion. Maybe perfusion isn’t that difficult to understand and learn. All it takes is constant practice and upgrading. I just have to make an extra effort in everything that I do since we all know that a perfusionist job is not only mental but it is also a very physical one. We have to be quick and strong to push and assemble the machine the shortest time possible.

At first it was very difficult and not to mention that I felt there were biases in my immediate environment at that time. In the Philippine settings surgeons are not used to working with female perfusionists. At that time, almost everybody thought we went to train as operating room nurses, even the resident perfusionists of the hospital have some doubts that we, my co-trainee, would make it through because they know how physical this job is. If I am not mistaken the Philippines has only about 9 female perfusionists up to date, three are working overseas already.

Obviously, it is basically a male dominated field here in the Philippines. The fact that I’m young in the field and a “female” for that matter, it has been and will always be a challenge for me to be able to pump cases with a full trust coming from the surgeons and anesthesiologists. Half-way point in my training as a perfusionist, I was gradually gaining confidence and earning the trusts of my preceptors. They begin to allow me to execute commands and wean stable patients from bypass. And yes, I learned the reverse way… weaning the patient from bypass first before attempting to put patients on bypass. My first wean was a very life changing experience for me, the sense of fulfillment was so overwhelming and very reassuring that I was doing a good job. All the biases and apprehensions I had in mind were all gone. The cardiac surgeons and my preceptor were all in fact very supportive and affirmative.

Six months almost over, and I learned different techniques from different preceptors and surgeons both on adult and pediatric cases. I gained applied knowledge that I thought I could never learn from the four corners of the classroom. I also learned that no amount of biases can bring a determined person down. I said to myself, there will always be criticisms, people who discriminate and bring you down and treat you less than you deserve, and you know what? Just do your thing! Put extra effort and strive for excellence and they will look at you in a different way.

At present, I’m back in the hospital where I used to work and it has been a year since my training. So far, our surgeons here are “confidence booster”, they push us to practice pumping alone without the supervision from our seniors from the hospital where we were trained. Sometimes I think it’s too soon for us to be dispense from the supervision of our seniors but with the financial status of most of the patients here in my place -they cannot cover the expenses to flew in our senior perfusionist from manila- I just have to take a leap of faith and put on a little confidence to pump the case.

Doing the case on my own, deciding for the good of the patient while on pump is indeed nerve-wracking at first, I just have to trust myself that I can do this and that I am equipped with knowledge and skills to do this and let go all of the negativities.

Now I can proudly say that I am slowly getting the hang of being a young Filipina perfusionist, trying in any way I can to broaden my knowledge and strengthen my skills. Together with some of my seniors, I’m currently taking part in realizing the dream of our society to have our own curriculum here in the Philippines so that everybody will have an equal chance to learn perfusion technology.