Kaufmann, J., & Kung, E. (2019). Factors Affecting Cardiovascular Physiology in Cardiothoracic Surgery: Implications for Lumped-Parameter Modeling. Frontiers in surgery, 6, 62. https://doi.org/10.3389/fsurg.2019.00062
I wanted to blog about my future career choice as a perfusionist. A perfusionist is someone who operates machines, specifically the cardiopulmonary bypass machine, that keep a patient alive during serious procedures, such as open-heart or open-lung surgery. Another machine that is frequently used by perfusionists is an extracorporeal membrane oxygenation machine (ECMO) that allows for individuals whose hearts and lungs cannot work properly (such as COVID patients or individuals waiting for a heart transplant) in a Cardiothoracic Intensive Care Unit (CTICU). These machines allow an individual’s blood to be circulating and oxygen flowing to vital organs. From a physiological standpoint, perfusionists need to manipulate the body’s normal physiological processes in order to ensure the intended result in surgery. For example, a drug that does this that is administered in almost every open-heart surgery is Heparin, which reduces clot formation in the blood. Like we learned in class, this acts as a “blood thinner” which greatly thins the blood allowing for it to move smoothly throughout the body as well as the bypass machine. Another drug administered is cardioplegia, which reduces the oxygen demand and metabolic rate in the heart muscle, eventually stopping the heart. This allows the surgeon to operate on a motionless heart with no blood in it. For patients on ECMO, a lot of the time a perfusionist has to monitor the oxygenation of the blood. For example, a patient I was showing one time was waiting for a lung transplant and needed to walk around the ICU floor. The nurses have their patients walk on ECMO to reduce other complications related to immobility, as well as preventing pneumonia. When this patient was walking, their SPO2 (Saturation of Hemoglobin with oxygen) went from 80 to 65. Here, the patient had to sit down and rest, and the perfusionist explained to me that as the patient was resting their SPO2 increased and they were reaching normal levels of oxygen-saturated hemoglobin. This relates to the beneficence ethic in physiology because perfusionists help keep individuals alive during invasive open-heart and lung surgeries. I am excited to go into a field of such high demand and I cannot wait to see how the field and technology will expand.
Hi Hannah! This post was super helpful because I have probably asked you seven times (at least) what a perfusionist does and I could never quite remember. As I was reading through your post, I could not help but think that the job you want to do is probably the most stressful out of all the jobs in the surgery room. It will be your job to make sure the person’s heart is in the perfect condition for the surgeon to operate (stopped) while ensuring that the person is getting enough oxygen and blood circulation to the other parts of the body. I did a quick search and there were a few papers that touched on the extreme stress that perfusionists face.
ReplyDeleteOne was from 1998 and focused on the personality traits of perfusionists and how that could affect their stress. The paper stated that at the beginning of the study, perfusionist had a tendency to move towards people (sweetness) and move away from people (detachment) in a balanced way. After six years, those same people were reevaluated again and it was found that they now had an increase in moving against people (aggression), their level of moving away from people was the same, and there was a decrease in their tendency to move towards people. (Friday & Mookt, 1998). I found this really interesting as it suggested that in order for perfusionists to cope with the stressful nature of their job, they had to become less personable. I do not think this is a bad thing, but I do think it is something that is important to know because jobs do change you and if you know, going into it, that it might challenge your ability to move towards people, then you can find ways to combat that if you so wish.
The other paper I found, stated that the job demand of a perfusionist is the cause for the high burnout rate (Bui, Hodge, Shackelford, & Acsell, 2011). The fact that you are quite literally keeping the person alive is super stressful and it is because of the nature of the job that some people in that profession burnout. This was encouraging in a way because the high burnout rate did not have to do with the people they worked with, working conditions, pay, or time commitment, it mostly had to do with the actual work you were doing. As I typed that, I realize that seems really depressing, but I also think it means that what we are doing in Physiology Lab is super pertinent to you.
Having the ability to deal with the stress you will be under is a valuable skill. Knowing that, for example, exercise and gratitude help you manage stress, you might go for a run every morning before work and then journal about what you are grateful for. This will help you start the day with less stress before heading to work. After work, you might find yourself super stressed and because you know kindness also helps reduce your stress, you could volunteer to help tutor kids in chemistry. By adding actions that you know, because of lab, help reduce your stress, you will be able to adapt to the stressful nature of your job much more effectively than someone who did not have the opportunity to learn how to manage stress. This will also help you maintain your amazing ability to move towards people and not lose it due to the stress.
Of all the people I know, you are the best suited for this line of work because of your ability to try new things with intent. I hope this comment did not make you stressed or anxious about your dream career because my intent was that you know how much I admire what it is you want to do because of the stressful nature of the job. Not everyone has the desire to learn how to stop a heart while keeping the person alive, and I think you are going to be amazing at it!
Bui, J., Hodge, A., Shackelford, A., & Ascell, J. (2011). Factors contributing to burnout among perfusionists in the United States. Sage Journals, 26(6), 461-466. https://doi.org/10.1177/0267659111411521.
Friday, P.J. & Mookt, W.J. (1998) The managed care revolution: How medical technologists have tolerated change. Occupational Medicine, 48(7), 451-453. https://doi-org.dml.regis.edu/10.1093/occmed/48.7.451
Smalls!!
DeleteThank you for your response. I really appreciate the time you took to read my post. I find those articles very interesting, thanks for sharing. I agree a perfusionist is a very stressful job, and I find it interesting that in the first article you shared the perfusionists six years later were more detached from the patients. I think that this occurs within a lot of medical professions in order to cope with stressful situations such as the death of a patient. My parents and older sister are in the medical field and throughout my life they told me that unfortunately as you lose more and more patients the losses eventually become easier to cope with.
Also, thanks for sharing different methods to maintain relationships with people at a personal level. I think that there is definitely a difference between your work life and personal life, and I want to utilize my time helping others and volunteering outside of my profession, as well as other methods to help manage my stress! Exercise has always helped me manage my stress levels, however I also love giving back to the community (volunteering or fostering puppies); this makes me feel better about myself and lowers my stress.
Thanks again for responding! Your articles were interesting reads!
Hi Hannah,
ReplyDeleteThis was a great post. I knew you wanted to be a perfusionist but I wasn’t completely sure what they did. I really liked that you explained the role in general and then gave examples of the different types of medications they need to use. It was great to learn more about a career I didn’t know much about. It is was amazing how a perfusionist is able to learn everything about the heart and aid in heart surgeries. There are so many types of careers in the healthcare field that are essential for the treatment of patients. What does the process look like become a perfusionist?
Hi Wendy,
ReplyDeleteIn order to become a perfusionist you need to go to graduate school. The program length ranges from 2-3 years depending on where you apply. Most programs do a year of schooling and then the second/third year is clinical rotations. You spend 3 months in a tertiary hospital setting and then rotate to a new hospital. Then, based off of where you get a job you have 6 months to "prove yourself" basically and if you do well then you are able to stay at that hospital. The prereqs for gradschool are physics, anatomy and physiology, 6 credits of math, english, history, and psychology classes. The most important thing is shadowing/observation hours. Perfusion is a small niche field and it you want to make sure that the school you are applying to knows you know what you're getting yourself into!