[USA987]

Hi all,

I haven't posted in a long time. After 4 years in L&D I switched gears this past June and started circulating in the OR. Starting in December I am taking call alone for everything but hearts.

I am still learning a ton every day. My boss asked me if I was ready to start call and I am feeling kind of ambivalent about it. I just feel like I will never actually "feel ready" and I think I just need to do it. I have been taking buddy call since the beginning of September and have seen everything from a simple ureteral stent, closed reduction, etc. to a lap chole that went open which ended up being a perforated duodendal ulcer and most recently a GSW to the liver and the kid ended up dying.

I am feeling weak in some of the ortho stuff, haven't dealt with any neuro (we only have one surgeon who will do crani's), and the only triple AAA's I've done are scheduled and stable.

The way that call works is that we have one circulating RN, two scrubs, an ortho scrub if needed, and anesthesia tech if needed. We also have a Life and Limb team consisting of one circulator and two scrubs....kind of our "back up" or if we need to run two cases at the same time.

I still sometimes have no idea what my scrub needs when she asks for it...so I will make a rough guess of what storage room it's in and look for something that sounds similar. Is this normal for 5 months in?

Any little tips you can offer up for me would be helpful. I am not on my own for four more weeks so I want to make good use of my learning opportunities.

Thanks!!!

[ebear]

It would be good if the "Life and Limb" RN could back you up for any cases where you feel uncomfortable. Just start looking around and write in a little book where supplies are located (and keep it with you when on call). Try to get into more ortho rooms in the next few weeks. You will likely do a lot of ortho. when on call. Sometimes, the only way to learn is just jump in and I think everybody felt the same as you do when we first started call! You'll be fine! Just make sure you have somebody to call if you get stuck! GOOD LUCK!!
ebear

[akor]

I hear ya! I am three years now in a busy Level 1 trauma center and was scared to take call. It is very nerve racking but with perseverance and time, you get better. I worked in a busy OR from 88 to 93, then took off 12 years. I entered back into nursing in Italy and because I had OR experience, they put me there. I wanted to go to L&D! I do love the OR. It is SO interesting and I am thankful that most of my colleagues help me out when I need them. However, when I am on- call which is 6 time or more a month, I feel less nervous as time goes by. Good luck......
AKOR

[brewerpaul]

If you have any choice in the matter, try to get assigned to call with a good solid tech who you get along with. A good tech is your best friend!

[ebear]

AMEN, brewerpaul!

[judy931]

This is my first posting here. I have worked in the OR since 1982 as an LPN/ORT.
I'm in school for my RN now. I have a great deal of respect for the RN 's I work with, especially when all of us are asking for something at the same time! As suggested by another post, a strong scrub will be a tremendous help, and steer you in the right direction when your not sure what is needed. It will help if you realize that any job as complicated as nursing takes about 12 months to feel really comfortable. It sounds like your right on track!
Good luck!

[USA987]

Thanks all!!!

I agree with you 100% brewerpaul regarding the techs. They can really make or break it...and so far I think I have a good relationship with most of them.

I will keep you posted! Thanks again for all the encouragement.

[aguirre]

Hi there,
I have been a Surg Tech going on 10 years now. I have just passed my NCLEX-PN and am currently working in the OR.

It would be nice if you were able to take call with a strong tech, but there are times when that won't happen. Try to be as prepared as you possibly can. As stated before in another text, keep a small notepad of notes as to where things are at. Keep notes on what the Doc prefers, such as suture, prep, dressings, meds if any, and if they like certain specialty trays.

Write down what trays you would need for certain specialties.

Example:
General surgery, lap tray, retractor tray, long accessory and intestinal intrument trays.

Vascular, depending on what they are working on, mini vascular, large vascular tray say for AAA, (my facility has a carotid tray, everything you need for that specific case.

Ortho, we have a major bone tray, minor bone tray depending what you are working on. if large bones, large drill set, smaller bones, mini driver set.

I still keep a small notebook that I had made up at Staples.

Dr. __________ Case________________

Prep
Dressing
Specialty Instruments
Suture
Meds
Mayo Stand Instruments
Back Table

These are a few things you can try to keep track of.

Try to help the tech as much as you possibly can, If they see you are helping them, they will go above and beyond the call of duty to help out the RN.

:bal loons:

[shodobe]

Having a strong Tech is a good idea, but when getting comfortable in the OR on call that strong RN is even better. There are many, many tasks that a tech just can't help you with and they are pretty much one dimensional so their help is one aspect. Their outlook on call situations can be invaluable but remember they are the scrub but you take care pretty much everything else when it comes to the patient. You are the ultimate responsible person for what happens to that patient. I would rather find a strong RN that can circ and scrub to learn from, their skills are can make taking call less stressful. See if that backup RN can be available on those nights where you get that oddball case that you feel uncomfortable with and they can come in to help. I your post it states you have 2 scrubs on call, are these RNs or techs? Makes a big difference in my book. Why so many people? Large hospital or what? I work in a 350 bed facility and there are only two of us on call, both RNs, plus anesthesia. Good luck and take the advice of the above posters, carry a small book with you write down those little comments so you can get them imprinted in your mind years down the road.

[USA987]

Our hospital is about equivalent in size to yours Shodobe. Our techs are not RN's but almost all of them did go through a 2 year tech program where they received Associate's Degrees. Some of them are First Assists. A lot of times both of them scrub in, but in some cases one doesn't and they can run for me. Very few RN's in my hospital scrub (unless they were previously a scrub and went back to school for their RN).