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pointing out "mistakes" in OR?



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Apr 14, 2006 03:26 PM

pointing out "mistakes" in OR?


Of the several times I've been in the OR this semester (I'm in a fully front-loaded program), I have noticed that some of the CRNA's that I am with will do things completely opposite of the way I was taught in class.....mainly related to things such as patient positioning, maintaining adequate MAP's, etc....

My question is: should I, as a student, point out these "mistakes" or should I keep my mouth shut? Is there ever a good time to speak up about "that's not how we were taught in class", or will CRNA's see this as me trying to be a little bi-otch? (which is obviously not my intent). It's just disheartening to learn all these things in class and the reasoning behind them only to get to clinicals and see that people don't really maintain this standard in the "real world." Any inputs or suggestions??

Tracie


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8 Comments
No. 1
from heartICU
Old Apr 14, 2006, 03:45 PM

Default Re: pointing out "mistakes" in OR?
Originally Posted by WVUturtle514
My question is: should I, as a student, point out these "mistakes" or should I keep my mouth shut?
Tracie
I wouldn't point out the "mistake." As a student, it is important to remember that our preceptors have been doing this longer than us, and they probably have a reason for doing the things they do. That's not to say that you shouldn't ask why - there may be a reason that you don't even know about, and that you could learn from. However, there are always good and bad preceptors, so you may be right - they could be totally wrong. I would bet, though, that they simply have different priorities. Anesthesia is allll about priorities...A is more important than B is more important than C.

I had a preceptor once who would show me a different way to tape the IV EVERY time I started one. I mean, every time. First stick of the day, she wants Chevron strips. Then she wants a tegaderm flat over the site, no chevrons. Then she wants two inch tape flat on the IV. Then a heplock first. I think some preceptors are just bipolar.

But no...don't point it out as a mistake. If it is a positioning thing or whatever, just as what his/her rationale is for choosing A over B. But don't utter the dreaded words "that's not what we were taught in class." They hate that.
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No. 2
from Nitecap
Old Apr 14, 2006, 03:47 PM

Default Re: pointing out "mistakes" in OR?
I would just ask nicely , what is your rationale for doing this that way?

Then take their answer and ask another or look it up. There are many ways to skin a cat.
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No. 3
from vloho
Old Apr 14, 2006, 06:50 PM

Default Re: pointing out "mistakes" in OR?
when someone has been taught a different way of doing something ,why is then called a "mistake" ?
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No. 4
from suzanne4
Old Apr 14, 2006, 08:01 PM

Default Re: pointing out "mistakes" in OR?
Remember back to the days that you were in nursing school...........you had different instructors, and they had different ways of doing things, same as with your preceptors. You learned and took what worked best for you.

Same thing with anesthesia. There is more than one way to do something, same as more than one way to position a patient. Just absorb everything as a sponge................and if questioning something, just ask why that person uses that practice. Not saying anything about it being different from what you learned in class is the best way to go.
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No. 5
from yoga crna
Old Apr 14, 2006, 10:57 PM

Default Re: pointing out "mistakes" in OR?
I would only point out what you think are mistakes if you would like to find another career.

I change my techniques all of the time for various reasons, including because I just feel like trying something different today.

Keep an open mind and you and your patients will be better for it.

Yoga
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No. 6
Old Apr 15, 2006, 12:13 AM

Default Re: pointing out "mistakes" in OR?
Thanks to all the replies.....when I said "mistakes" I didn't necessarily mean it in the context of someone doing something wrong, which is why I put it in quotations. What I meant was when I saw someone do something that goes against what we were taught in class, should I ask about it or just keep my mouth shut and go with the flow. I know that there are a million and one ways to skin a cat and I know that everyone has their particular way of doing things. I think my main goal is to not pick up "bad habits" from things I've seen.....I've already had a couple of CRNAs say to me, "don't pay attention to any of the bad things I do, just pay attention to the good things." I guess I'll just keep my mouth zipped from now on......l
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No. 7
from TopherSRN
Old Apr 15, 2006, 03:44 PM

Default Re: pointing out "mistakes" in OR?
I would imagine CRNA school is somewhat similar to nursing school. I know the way I am taught things are not the way most people do them. When I see a difference I will just politely ask the rationale and sometimes I will adopt their style. I have picked up some good tips/short cuts, and I ignore the poor ones. I really respect someone who has been a nurse for an extended lentgh showing me better ways to do something.


I definately wouldn't say "well my instructor said to do it this way, you're doing it wrong." Not that you would, but I'd imagine you would spend the rest of the case in the corner or outside the OR.
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No. 8
Old Apr 17, 2006, 04:26 PM

Default Re: pointing out "mistakes" in OR?
You'll find out that there are two ways to learn in the clinical setting: "I like the way that worked...I'm going to do it that way all the time," and, "That is a terrible way to do it; I'll never do it that way." Through your student period, you will have the opportunity to pick and choose techniques that you will synthesize and turn into your unique style. As Yoga said, that style will continue to evolve throughout your career. Ask why, but try not to condemn.
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