Using same syringes all day

Actually propofol (Diprivan) is good for 12 hours. After that, the bottle and the tubing must be replaced.

As for reusing syringes, just the thought of it makes my skin crawl!!! Surely noone still does that today!!!

Yes, but--in every operating room in which I have worked or taught, the anesthesia department is a separate entity which makes its own rules, and is not interested, for the most part, in the input of the operating room nurses on subjects such as this. Not to say they don't respect us as professionals or value our input on other things; not to say they are not perfectly pleasant and sociable individuals--it's just on this subjects such as this, they make their own policies and procedures.

I found this to be particularly true when teaching safety IV catheters, both for B Braun and for BD (Becton Dickinson--) even though I would teach how the safety IV catheters could be used as an art line (some anesthesia providers are skeptical, but it can be done) many anesthesia departments DID NOT want to use safety IV catheters. They were more comfortable with the old style non-safety catheters (i.e., InSyte vs. InSyte AutoGuard, the BD product which has the push button to release the stylet.) Heck, so were we--so was I--but the learning curve involves, perhaps, 3 sticks--after that, you don't even think about it any more.

Also, even though the safer IV products were mandated by a bill signed into effect by then President Clinton, and hospitals could be fined for not using the safer products, for some reason the anesthesia department was always exempted. This included the last facility where I worked per diem. Our supervisor didn't like it, but she said that as long as the products were IN STOCK-- that is, AVAILABLE--they were in compliance, so who knows. However, she would have preferred that they switch, but was powerless in requiring that they do so---it was not her call.

I do understand why other safety needles--i.e,. TB and insulin syringes with self-capping and pre-attached needles, or individual self-capping needles--are impractical and useless in an operating room, where most of our injections are IV through needleless ports, so that's never been an issue to argue about, in my opinion.

We still need to keep the old, non-safety injection needles in the OR, not replace those with safety needles. When we draw up meds, we need non-safety 18 g needles to do it with. (Although, with multi-access vials, you can insert a spike adapter and draw through an empty syringe--but, then if you want to prepare a piggyback or just add medication to a bag of IV fluid for decanting onto the sterile filed, you STILL need an 18 G needle--so we need to keep the non-safety ones for tasks like this.

I agree it is a matter of preference--that's why I am defending it. As an OR nurse, I would find it a real pain to come to work one day and find out that all our individual non-safety needles had been replaced with safety needles--they really are not practical in an operating room, and, since we (either OR nurses or anesthesia providers) rarely give IM injections--rather, we are simply using needles to draw up meds, etiher while circulating, or for local on the field, while scrubbed--we have little chance of being stuck with a contaminated needle.

I am simply concerned with the threat of being fined or shut down by OSHA for non-compliance--but, guess it's not really my concern--it's the facility's. As for me, I can start an IV with whatever is available, regardless of brand, safety or non-safety---I am no prima donna.

I understand what is and is not standard of care, and that isn't why I brought the issue up here. Again, I brought it up because I was curious as to what people were seeing in other areas of the country, and to promote honest discussion. I've worked with both CRNAs and anesthesiologists all over the country; I have to say the CRNAs are more receptive to change than some of the
anesthesiologists who trained in the '70s and '80s are. However, the younger anesthesiologists are pretty much by the book where safety in patient care is concerned, as are the younger CRNAs--however, that is not universal.

Honestly, InterestedRN, I find your replies to me just a tad condescending. I can't understand why--these are interesting discussions, and I have been around a long time as an OR nurse and paid my dues. If you do a search of my posts over time, you might just find I am pretty knowledgeable! I am not sure if you are an anesthesia provider or not, but I have been practicing as an OR nurse since '81; before that I was a corpsman who trained during the Vietnam era. I have no reason to exaggerate or make up stories, as you seem to insinuate. Simply because you have not seen something doesn't mean it doesn't occur. Hopefully, as discussions like this take place more and more, some of the unsafe practices I have described (and, remember, it was not so long ago that no one considered them unsafe; some still don't) occur less and less until they no longer occur at all. But, change cannot occur unless issues are brought up and DISCUSSED.

Remember this, as well--OR nurses go from room to room and work with a variety of anesthesia providers, sometimes for hours at a time. Unless you give extended breaks (other than for coffee and lunches) to your fellow anesthesia providers and are intimately familiar with their carts and their routines, you may not know WHAT your fellow anesthesia provider in your facility are doing--you can only speak with absolute certainty about your own practices.

"Conspiracy--" where the heck did THAT come from? LOL!!

..... the unsafe practices I have described (and, remember, it was not so long ago that no one considered them unsafe......

I have noticed several nurses on the floor who reuse those pre-filled saline syringes to flush IVs. For example, if they don't use all of the solution in the syringe, they recap it and put it in their pocket to use for another patient. Or they leave it in the patient's room to use again on the same patient.