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nurse leaders shared their so-called "recipe cards" for their surgeries. These recipe cards listed all the supplies, the medications, the equip- ment, and the list of stitches that these nurses and surgeons had used when separating twins. Because of the Covid pandemic, assembling necessary quantities of the supplies and personal protective equipment needed for the marathon surgery was a concern, and the nurses started requesting allocations as early as April. Some training ses- sions and meetings were also held over Zoom, or booked in much larger conference rooms to allow for social distancing. It then fell to the scrub nurses, such as Lisa Peterson, RN to determine how best to place so many machines, so many people, so many instruments, and so many supplies in easy reach of anyone who might need them, but out of the way of those trying to carry out the most delicate of operations in a limited space. "Prior to nursing school, I worked at an outpatient surgery center, so I am pretty good at organizing a room," said Peterson, but she said get- ting the feng shui right was tough in this case. "We had to figure out how to organize machines to minimize space. How can we position monitors so everyone can see all these monitors at all times? We were definitely putting together a puzzle and each piece had a very specific spot." Benitez chose five junior nurses as scrub nurses for the surgery, Peterson, Frances Villote, Tatyana Kolpakchi, Sandina Bega, and Olga Yakoubovsky. Benitez supplied the nurses with as much infor- mation as she could, compiling articles, schedules, lists, and cheering the apprehensive nurses on like a coach. "They are nervous nellies," said Benitez, "but in action they are amaz- ing to watch. On training days, they would have all these questions, but I would tell them, 'You guys, you know what you are doing! You have to convince yourself that you are ready,' and they were. They had it." With the room prepped, the schedules posted, and custom trays prepared, the nurses began a series of mock surgeries. Six for the nurses alone, three more with the full surgical team. Using mannequins joined at the head, the team carried out the dry runs, working to anticipate different scenarios. The nurses and team members who took care of Micaela wore purple caps, and those caring for Abigail wore orange. Team leads wore black caps. Scrub nurse Frances Villote said Benitez made it very clear what each nurse had to do throughout the operation. "You knew where you stood and where your role was," said Villote. The night before the surgery, the team carried out their last run- through, this time enacting how they would handle the worst-case scenario. "We actually practiced if baby orange codes, what are we going to do? And we ran through the actual motions. And the same thing if baby purple codes—we walked through the motions, so it was in our brain," said Evans. when villote walked into the operating room the morning of the surgery, Oct. 24, she carried with her the memories of her aunt whose cancer diagnosis had led her to nursing and colleague Jessica Geissler, a fearless nurse who had died from cancer in November of last year. "I actually had a dream about Jess that morning," said Villote. In the dream, Geissler had scrubbed in with Villote but then she had stabbed her. When Villote asked why, "She said 'I am stitched with you and I am always going to be with you.'" Villote said that through- out the twins' surgery, she felt like she was drawing from Geissler's strength and tenacity. O C T O B E R | N O V E M B E R | D E C E M B E R 2 0 2 0 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 21 nurses who helped separate twins conjoined at the head.