Surgical Anticipation and Instrument Passing

[@wholeNwon]

I can recall a great professor of surgery who had his own instrument tech. They hardly ever spoke in the OR ....or had to.

[@AngelTFC]

Easiest way to anticipate is to write down the steps, precise steps. Different surgeons could have different steps even if its the same type of surgery, don't be lazy, just write it down. Then review them Only right before surgery, for 5 mins. Helped me alot.

[@pb4ugo19]

You can remember all of that in 5mins?

[@AngelTFC]

@@pb4ugo19 No it took me a very long to remember. But looking through the steps put my mind into the right state and prep me for that particular surgery.

[@empressnehnehneh]

So true. I pay attention as with Vascular the patients veins and artery differs greatly and sometimes due to the size of the patient the veins can be so deep it requires so much more. But the process is the same.

[@Ashley-og9ti]

​@@empressnehnehnehare you a ST ..how long and would you say you found your niche with vascular or you don't limit yourself to just one specialty?

[@empressnehnehneh]

@@Ashley-og9ti Hi Ashley, I found niche with vascular a little over a year now. I would like to broaden my skills more as with Vascular you have to consider the radiation exposure during 98% of the cases, though you wear your led and my surgeon is very protective over his team. I honestly enjoy what I do and the team that I work with. It makes it all worthwhile.

[@anamarijamilos1290]

EXACTLY... it takes time to memorize the procedure just like in school when we did a lap chole. I can’t tell you how many times I was yelled at because I didn’t know the procedure my first day. Here in CA they yell at you about everything. They sure know how to lower your confidence.

[@paigetiffany5817]

Boy do I know that!! Let it go in one ear and out the other because it takes time and experience with any type of jobs work 😔 you got this ❤️🤗

[@ThatGirl-tg7wd]

I can attest it is the same in NJ and doesnt matter what type of surgical suite you're in when you're a new tech.... yelled at and getting kicked OUT for absolutely no offense at all was part of what we were trained to "expect" and both happened with certain known professionals. (some are just not in the mood for clinical students and they will just kick you all out when they feel like it)

[@TheLibra926]

Learning as I speak!!

[@karinabandera1337]

@@ThatGirl-tg7wd man this really scares me lol. It’s discouraging lol

[@pb4ugo19]

@@karinabandera1337same. I start my program soon. :/

[@xavierdisante2071]

Man I recently started scrubbing ortho and it’s so insane and fast, I’m still in school but I wanted to scrub in with the “guy” this dude is an ortho tech all he does is ortho which explains why he is so good at it. I tell ya, watching this guy work is fascinating, I’ve never been impressed by anyone however watching him at the speed and anticipation In which he moved was very humbling experience for me. The best I can do is observe him and try to mimic as much as I can, one day I will be at his level.

[@Nooorrriii]

I’m in the same situation and it’s a lot! Especially totals.

[@watchingyou7945]

When I did my internship at a major hospital many years ago, I was told “see one, do one, teach one” and they weren’t kidding. I scrubbed in surgery for 20 years.🤗

[@Ashley-og9ti]

I'm currently in my surg tech program, and one of the instructors said the exact same thing! "See one; do one; teach one" 🤗

[@mattjasper9419]

These vids keep me positive about going into this. A lot of negative out there that I try and not have overwhelm it.

[@traciprovins3221]

Just wanted to say I’m a med student on my OB rotation, first time in the OR and terrified, and your videos have helped me so much in trying to figure out what’s going on in the OR and maintaining sterile field! Thank you!

[@njomokenn4719]

Stupid comment

[@judjudersawn2596]

@@njomokenn4719 Ratio

[@frankstrong81]

Love this video. Im in my final months of clinicals and this makes so much sense thank you. Ive been watching your videos since i started my pre requisites and you have helped so much through my 2 year associate degree program in the field of CST. Now i just need to pass my national exam in July 2019

[@vanessagonzalez8266]

Woohoo!! I am barely starting my journey. I can't wait to feel accomplished .. CONGRATULATIONS

[@lumelumelu]

did you pass ?! 🤩

[@LadyAmanita]

I started watching these videos because I'm doing research for a story I'm writing (Urban Fantasy meets medical drama, the protagonist ends up undergoing surgery after she's injured), and I'm honestly finding all these videos about OR procedures fascinating in their own right. I might also be needing surgery in the near future myself, so in a way, these are kind of reassuring too, seeing just how many people are involved in making sure that even a routine surgery goes smoothly.

[@Ashley-og9ti]

I would love to read it once it's finished!! Happy writing 😊🖊

[@isiahsteele7418]

Anatomy, procedure, type of tissue and structure of the tissue gives you some idea on anticipation. Delicate tissue requires non crushing and non penetrating instruments. Vessels for examples. You would use non crushing vascular clamps. Debakey forceps for handling. Peritoneum .You use non crushing clamps and forceps. Facia kocher clamps with teeth heavy forceps like bonnie or ferris smith forceps. Orthopedics use heavy forceps heavy clamps like kochers and mayo clamps. Bone cutting use saw or ronguers curettes. Muscle heavy non penetration clamps. Metzembalm scissors for delicate tissues like fellopian tubes bowel subcuticular tissue. Mayo for heavy tissue dissection. If your dealing with procedures like carpal tunnel, use weitlaner, small metz scissors, fine hemostat, sometimes a freer elevator and senn miller hand held retractors. Yes experience is a large part of anticipation however anatomy, know the procedure, type of tissue involved. Oh yes! You must know your instruments!!! That's critical. When you know your instruments you know how to anticipate the Surgeons' needs!! You would not use stevens tenotomy scissors to cut facia? You would not close skin using a debakey forcepts? Epidermis is tough so you would use an adson with teeth. This is universal, and cut with heavy straight mayo scissors and not metz? If your doing vascular such as A V fistula, you'll need vessel loops along with right angle or mixter clamps. Castr vijao needle drivers. Real mosquito clamps with rubber shods for controlling the fine sutures. Tenotomy scissors, halstead clamps for dissection and debakey bulldog clamps.

[@Rapunzel1212]

This comment is spot on, well done Sir! I only add the Trocar process.

[@MegaHydrocarbon]

Thank u mate. U cant imagine how helpful these videos are for me to decrease my anxiety and plan ahead to work in OR.

[@ameliaadams1327]

WOW!!! I am so amazed at these videos. I’m not in medicine but have kicked my butt every day for not going into it upon high school graduation. Instead I was a finance major. I retain medical info very easily and have been asked what field of medicine I was in. Most people are shocked when I tell them I’m a finance person. Keep up the excellent videos. I love them!!!

[@hahardridge]

Never too late to pursue your dreams.

[@scarred10]

This is surgery,not medicine and its also just assisting.I worked for a whule as an orthopaedic PA and found many of the surgeons very arrogant, abusive and openly hostile at times.I left after 6 months.

[@annadawn921]

I start my first placment in a week as an ODP.. These are really helping me as had so little clinical time due to covid x

[@conniee79]

I want to thank you for doing these videos I'm a CNA and am thinking about going into this field. There was a lot more involved than I realized thank you.

[@heathcockrell7831]

Fantastic video! I'm a surg tech student! These videos help allot! Keep it up!

[@RandomXbxPlayer]

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[@8cccp8]

Great video and great pointers. Learning to how to scrub as an RN. This is a lot of help, thanks

[@heathtich3]

I'm learning to be a scrub nurse thank you!

[@meithink642]

helpful videos for students.....let's do a slight alteration> 0. Overhead light for visual, 1. Marking pen (maybe), 2. knife/skin forceps, 3. sponge (raytec or lap) 4. bovie/suction, 5. small retractor, etc....and good luck

[@sharpcitizens9936]

Can you make a video on showing each instrument closely and how they use(or hold) it. May be on a fake dummy so we can have an idea . Also if you can show for some common surgeries. Or can try to mock surgery by you pretending to be surgeon and bring a friend to be surgical tech.

[@stephaniesanchez2057]

This is a great idea

[@Pionike]

This comment need more thumbs up

[@vanessagonzalez8266]

Agreed! . Please & Thanks.

[@shafique943]

Im manufacturers of eye and surgical instruments anything want so contact me at this number [phone]

[@sharpcitizens9936]

@@Pionike thanks dear.❤️ I just checked your comment after a year ago. I was curious to know it in more detail.

[@mutated__donkey5840]

“Instrument passing doesn’t need a whole video” *SurgeTech Academy would like a word*

[@piggykhan]

He seems annoyed that everything he tried to explain ended up as "its really about experience you have to do the work to know" 🤣🤣🤣🤣good effort cutie I'm refreshing myself watching your channel. Thank you!!

[@luckyme1784]

It depends to the preferences of different surgeons, good anticipation and observed properly that was being a good scrub nurse/tech inside operating theater.

[@prolilgamer9233]

Pay attention pass it like their going to use it 💡

[@MinnieLitty-b7x]

you should make a surgical tips book :o Clincals start next week for me and I'm so nervous. I hope they don't expect for me to know the whole procedure man

[@Alleykat727]

Can you possibly do videos for csection? L&D is csection and d&c etc simple but the anticipation is the question again bc every MD is different in how they go in and come back out once baby is out! Anyway you can do a csection video? Even a set up?

[@andyvan5692]

interesting comments about instrument passing, I am a mechanics son, and have "assisted" like you do the surgeons, between 5 years old and now 41years!!(I also have Autism)and I do the same, passing sockets, spanners, diagonal cutters, same way, the way DAD uses them, and you forgot ONE thing, above all others- NEVER get between them and their TOOLBOX!!, and they have their tools their way, so replace exactly as you removed them :-) as a saying goes" happy wife.... Happy life". they also appreciate tidying up, tool maintanence, and those small things.

[@empressnehnehneh]

For my surgeon the first thing is the “local” - B/Caine to numb the area then the following steps mentioned. It truly does depend on the surgery. Vascular is similar just smaller instruments etc. Thank you for this.

[@asiyaterkenova7601]

Rewatching your videos, make much more sence since I started intership.

[@showcasecity]

I’m not in the medical field nor am I planning on going into it but these videos are pretty interesting to watch.

[@dorothytaylor7369]

I love this videos, I’m retired, never worked in the medical field , However I just fine these videos extremely fascinating , & quite interesting , keep up the good work young man, your viewers will definitely appreciate, particularly those in the medical field, God bless!!!!

[@RobMBG]

Loved the hulk clip!! My wife and I LOL'd and watched it 2x. My wife said "yep that's you." I do tend to lean towards the hulk example with life in general. I'll have to keep that in mind when passing instruments to surgeons!

[@kathleenoelberg3770]

The towel wrap for your stringer: best roll method to keep instruments upright, organized and not getting all tangled up with each other?

[@Harlem55]

It depends upon the facility and protocols- as a smaller veterinary practice- we don't use stringers at all (because it's considered less aseptic) - the entire instrument set comes in autoclave peel packs.

[@tonyton6169]

Thank man! Looking forward to more of your videos. They are very informative and helpful!

[@cindyavila8007]

Thank you so much for taking your time

[@virginiapacer5164]

Iam eager to follow all your explanation Im studying surgical technologist Its very interesting

[@hazimdaham975]

short practise of surgery ..very nice.thanks

[@playfulpanthress]

Ties are getting phased out. If it's a younger doc, they're using more cautery, harmonic and ligasure over ties. I can't even tell you the last time I handed a reel. I don't know when I got so old.

[@latashalowman8356]

What advice do you have for a struggling surgical tech student, that knows this is what they really want to do.

[@JirenT]

what do you struggle with?

[@mikemalcom7449]

Great advice Sir. That helps a lot. However, if we wanted to watch surgical procedures that are basic and every tech will encounter more times than they want which ones would you recommend? Thanks in advance.

[@beasworld88]

I love your videos they are so helpful ❤

[@TrueBeauty786]

Thanks so much!!!!!!!!

[@ajvazquez6298]

Love your videos man! 3 months into my clinical rotation at a level 1 trauma hospital and this video has worked great for me. Will you release a draping video soon?

[@SurgicalTechTips]

Yes, I will have to get in touch with a school to do this however, I don't have all the drapes I would need.

[@rogerdawg977]

Can you do a step by step form or like a website where we can get those docs for different surgeries I would pay you

[@j.mayhem5211]

Love and appreciate all the videos, my one question would be wouldn't it be local, knife blade, then bovie. or not every doctor uses local?

[@mannydahitman313]

Local isnt always done on the sterile field

[@alexb9319]

LOL @ how you added hulk into this🤣🤣🤣love your videos, thank you!

[@brendavera3920]

Awesome Video 👏🏼👏🏼👏🏼

[@ambitiousbeauty1013]

Do you get a lists of tools needed for cases? How do you know the order of tools to give them?

[@melissasullivan5899]

Super!! Thank you!

[@ingridgarrett9023]

I will remember to pass it like they are going to use it.

[@sarahpowell9391]

Thank you for your insight starting my new role shortly ,your videos are amazing !!

[@dewan2518]

Great video!!👏👏🖒🖒

[@colebrewer5950]

Thanks again the videos are very informative

[@stephanielake7439]

Perfect! Just what I needed!

[@ambitiousbeauty1013]

Best type of facility for new surgical techs to start off in?

[@guillermoguzman1621]

Can you show me the set up for brain surgery and kind of instruments, the basic instruments like for simple brain surgery. Also laparoscopy instruments . The set up or if possible the actual surgery. I will start working as O.R. Tech. Soon and I'm terrified.

[@BiscuitFever]

“Simple brain surgery” wat.

[@ginanugent2598]

Thank you for the insight Sir. Happy Surg Tech Week!

[@SurgicalTechTips]

+Gina Nugent thanks, you too!

[@bayanrabbo3632]

Surgical Tech Tips I have a question! Does surgical techs work with X-rays a lot ? And if they would it be a risk ? Thanks

[@ccoop3774]

Bayan Rabbo, it depends. You may work in ortho a lot, for instance. You wear your xray apron. You also have a doximeter badge and it's checked monthly. In 16 years, I've never seen an employee benched due to exposure. Think about it, the rad techs work more hours in radiology than OR staff, right?

[@pauladeoliveira5529]

You didn’t include the local?! Hi, I love your videos. So helpful :)

[@mannydahitman313]

Local isnt always done on the sterile field

[@Zelda2094]

Love your videos man extremely helpful. Keep it up.

[@SurgicalTechTips]

+Azami Kurosaki ty 🤗

[@tashaanderson1885]

Thank u!

[@redgyal2681]

Do you know anything about preppy school online?

[@fioredigirasole9075]

With the gloves you don't lose too much sensitivity during surgery you work well?

[@زهرهسخایی-ر1ق]

very good.thx❤❤❤

[@dishantjangid5085]

Amazing sir

[@valentinadelasaguas8244]

Very good

[@lindathrall5133]

OPERATING ROOM AND HIS MEN ARE MY FAMILY

[@shortbossbg4475]

😂😂😂 Hulk smash had me

[@phuongvu527]

this helped. a lot

[@oliviapetrowski4553]

To be honest, I’ve had so many surgeries, the OR doesn’t even bother me anymore.

[@Chrisp_E]

Olivia Petrowski same here

[@anitaelghandor5489]

Awesome love it!

[@teyiahhazard5764]

Okay.... I can breathe now. The hulk thing.... I am have been dying for like 15 mins lmao

[@melissavonderhofen2190]

great video. Im a new OR nurse , I mostly will be a circulator but part of the training at the hospital im working at wants us to be able to scrub. and understand the scrub role. we only have a very short time (1 month ) of learning to scrub . Ill be working in ortho. would you suggest watching you tube videos of the procedure to understand what tools to anticipate/ sequences of the surgery. Ive been trying my best to take notes after procedures at work with doc preferences, looking at pick list.. if you can give any tips or suggestions let me know. its been a challenge and your videos have been very helpful. thanks

[@ccoop3774]

Melissa Von Der Hofen, just relax. We all have to learn sometime. I'm an RN, too. We had to scrub where I worked, too. I actually enjoyed scrubbing. When I first started in the OR, I had to scrub. Personally, I feel that's the way to learn the job. As a circulator, you can't run go get the table large deavers if you don't know what they are. You'll get it. Good luck!

[@rayraybernard]

Melissa Von Der Hofen

[@ccoop3774]

Melissa Von Der Hofen, I just read over your question again. 1 month is not that much time. Hopefully you have been back there long enough to learn some basic concepts of the OR before you started in ortho. The reps were always a good source, too. They should have some handouts for you about their systems. They were a help to the scrub running the table. You have to watch some of them, though. Some will get too close to your table. Some will try to reach across your table, too. We had to start limiting how many could be in the room, too. A few will try to get you to open too much too soon. I hope things are clicking for you!

[@dalton412]

Ortho has a lot of instruments. Takes time to memorize them.

[@StevenssonnySamuel]

Is really challenge for us in

[@sanmiguel5866]

My daughter wants to become a surgical assistant I'm not sure what tip of schooling she's gonna need... please give me some advice on what shes gonna need to do thank's

[@willneverdead7524]

Every program is a little different. They are also doing away with the certification programs and requiring students to complete an AAS. Google 'Surgical Technology programs near me' and read up on their prerequisites. Get your daughter enrolled in those classes, and go from there. Best of luck.

[@herreraanniet7021]

I want to learn more I thinking go to the school and study surgical technologist

[@ResPetergaming]

How long will it take me to become a Surgical Tech

[@focusglory]

Which Would you recommend going to school to become an RN or surgical tech if your intent is to eventually become a First assist? Why?

[@SurgicalTechTips]

If I had the time to do it all over again, I would go for PA, or NP. They are more marketable positions that can request more money for the work you do, and they are nationally recognized. RNFA AND CSFA are not nationally recognized yet so you will have to move to a state that will work with you.

[@focusglory]

Surgical Tech Tips thank you. Great channel!

[@frankstrong81]

Are you in it for the money or excitment and intensity? Money is nursing the felling you get in the OR with the surgeons is priceless

[@racheldemain1940]

Explanation of the instruments eg Bovie!

[@norheamariecando9341]

hi i am a new nurse. and i want to learn the step by step in doing cesarean section. what instruments they use. thanks11 =)

[@notneuro]

the steps are pretty much the same, except once they get down to the muscle they usually rip it with thier hands, ones the baby is out they might need penningtons to stop the uterus from bleeding, 2 peans and scissors to cut the cord, sponge sticks to remove placenta, bucket to hold it, then you close.

[@ccoop3774]

Norhea Cando, can you scrub some? I found that was the best for me to learn . These are quick cases. Many times I have had to chart after the patient has been rolled to PACU.

[@k2world85]

What's the difference between circular nurses and surgical tech in the OR?

[@tiffanyhood8002]

The circulator is in charge of everything that’s not sterile, and opening sterile packages and setting up sterile drapes for scopes, and setting up equipment, helping prep the patient, sending specimens, and doing things for the people who are sterile. The scrub tech or scrub nurse is at the sterile field and assists with the surgery. They can’t break sterile field everything they need something so the circulator assists with those things.

[@lashaykyles8809]

When applying for the job do you pick what speciality you want to go in or they just place you wherever?

[@SurgicalTechTips]

You get placed wherever they need you. You end up specializing over time when certain doctors can't stand to do surgery without you lol.

[@stephanielake7439]

Do you have any tips on differentiating instruments? Certain things are obvious, I know. For example, I know what scissors are, but there are different types of scissors. The same with clamps and retractors, etc. Some instruments have only subtle differences. I've already picked up the instrument textbook I need for next semester as well as a set of flashcards. Is it just a matter of memorization?

[@SurgicalTechTips]

+Stephanie Lake sadly, mostly all instrumentation just comes down do memorization.

[@stephanielake7439]

That’s what I figured. Surgical instrumentation is a little overwhelming, but I’ll get there 😊

[@michaelconant921]

Stephanie Lake yes a dissecting scissor would be a pair of metz, tenotomy, joseph I've even seen some use a stat

[@rashidamehnaz151]

I'm scrub nurse thanks

[@yoceeowe]

In your opinion, which is the best study guide (text) for passing the cst exam. Thank you much.....

[@stephanielake7439]

Just thought I'd add my two cents worth. I can't say what the absolute best study guide is but I really like what I'm currently using. The NBSTSA CST study app and the Mometrix Flashcard Study System. Mometrix also has a study guide in book format. I've used a Mometrix study guide previously and love their format and content. It really helped me make a top score on the entrance test my school uses as the deciding factor for all of their competitive medical programs. With the NBSTSA app, there is a subscription available but the app itself is free as are some practice questions including a Question Of The Day every day. Hope this helps a little

[@SurgicalTechTips]

+Release_da_beast back when I had taken it I used the NBSTSA study guide and all of the notes/ books from class. I did A LOT of group study sessions as well.

[@Sabrina-Angella]

@8:50 : this sums up everything for you...

[@knzay]

7:56 lmao nice

[@JD-ez8fg]

At shoes u recommend to wear

[@SurgicalTechTips]

Hoka, or dansko

[@nickpanvlogz3353]

You forgot to show us the incinerator from a previous video

[@SurgicalTechTips]

+DJ Nick Black true that. My phone camera is currently broken though. So once I get that fixed I'll upload the pictures to the Facebook group. You follow the FB group?

[@Klyce]

How'd you fold your roll towel like that?

[@SurgicalTechTips]

+The Morning Sage 😉

[@guardian6652]

He doubled folded a paper towel in the middle of his roll to heighten and give it more rigidity.

[@meharjavidmeharjavid1401]

Instrument Surgical Instruments I also have available

[@Tfichtenbaum]

I know that now some hospitals depending on the situation use a surgical robot? ...with the robot is it a simpler surgury? I always wondered how would a surgeon need training for that and how it may change a job like yours ...in terms of preparation ect

[@shamicutx9090]

Hi

[@vashti2389]

Who hands the doctor the tools, the operating room nurse or the surgical Tech?

[@SurgicalTechTips]

+olive surgical tech.

[@vashti2389]

Surgical Tech Tips then what does the operating room nurse do?

[@SurgicalTechTips]

They pick up the patient from pre-op, set them up on the OR bed and assist the anesthesiologist with intubation. Insert foley catheter's, possibly insert an IV. Most important;y and what takes up most of there time is charting everything we do in the OR, and putting down times in the system as to when everything happens in the room. Also like Jackson said, they can grab supplies for the tech if needed.

[@ccoop3774]

Surgical Tech Tips, before rolling the patient back, we have to quickly review that chart. Are the appropriate labs ordered? What are the results? Many times the preoperative nurse misses this. Certain procedures require certain labs. You have to review the H&P. Does it match the procedure? Same for the permit. Then interview the patient. Again just make sure everything matches. Make sure the surgeon has marked the site if appropriate. Then after the patient is anesthetized, there may be positioning and padding required. If so, you have to position correctly. I have seen nerve damage (not by me) from a slack RN that did not position, pad and secure safely and correctly.

[@helengregor8589]

What is a bovie ? After all my nursing life as a registered nurse never heard of a bovie...either scissors or diathermy lol 😆😆😆

[@helengregor8589]

Micindo or mayo scissors? Come on,it's American tell me what a bovie is ? 30 years as a theatre scrub nurse 😆😆

[@chrisgibbons2049]

Honest question that none of my teachers can answer. Is it scissor or scissors?

[@ianburau7521]

Chris Gibbons scissors

[@benperry490]

so in Nevada, Surgical techs (scrub techs) are allowed to suture in the OR and pass instruments to the surgeon? I thought that was only the job of a surgical assistant or scrub nurse? what am I not understanding? Edit: I just learned by watching an older video from 2017 that you are a surgical assistant no longer a tech I think the layperson like me may assume by your title "surgical tech tips" that you were still a tech it makes the person like me a little nervous assuming that you are a tech with no surgical training and performing suturing and other invasive procedures as a tech...not criticizing just pointing out that it is not just Tech school students that watch your videos, I am soon to be a patient and was researching for an upcoming spinal surgery I have to have and came across your page I was freaking out a little about techs cutting, closing and dissecting patients...maybe update the name or put in a disclaimer that you are not a tech but an assistant??? or not just a thought keep up the great videos

[@Rapunzel1212]

From what I know about back surgery is that you will have the chance to meet the O.R. team that will be in the room with you minus the Surgeon you already know and should have seen before being brought to the O.R. you can ask questions and feel as comfortable as possible before being transferred to the Operating Table and buckled in for Safety. You will know everyone in the room and feel confident that the team in there has your back, man I had to😂. Good luck with your surgery, hope you solve your discomfort. I'm a CRST certified registered surgical technologist

[@empressnehnehneh]

Pass the instrument the way the surgeon uses the instrument but the sharp points away from you and the surgeon.

[@lp1043]

Write em out! Jk Not really

[@kylecountryman4794]

genral anttpictions awaitng furtes haded tools of chooses sight view ready haned to fouces throghes pain time remeroys day in day out inlearn exampling uses for time time now learn two three ways of same pages numbers rtyhmatcies in to lost spaces forgoteing spaces mind land

[@mheaabarracoso9630]

your face, you look sad with your job

[@jenniferboyer9506]

lol if you know anything about the super hero's that work in the OR, he's not sad he's exhausted.