HELP!!! Ob OR Standards - page 2

Hi there, I am a scrub tech in L & D and we are having some trouble finding out what the standards are for the OR. We recently had a supervisor decide that we were going to have the OR... Read More

  1. by   Chrissy24RN
    Quote from deehaverrn
    One thing we do here.. and we supposedly had the state board and jcaho approval, but i disagree with it..our hospital "trains" nurse's aides to scrub for cesarian sections. They even refer to themselves as scrub techs but they are not. They have brief classes on instruments and sterile technique and a followup test. They then do about five cesarians with a preceptor before they are "signed off". I protested this whole idea, since I would be the RN in the room who would be circulating and so "in charge". We were told that they were able to do this without a whole course because they were only doing select procedures..like cesarians. The problem is, not only do they not do well on cesarians, but when you run into a problem they have nooo idea..It is actually bad enough that I feel that these cases should all be done in the main OR anyway. I cant understand how they pushed it through at all.
    I am a 'scrub tech' in L&D. That is my title. I am not a surgical technologist like you are thinking we are calling ourselves. Alot of hospitals have nurses aides trained to scrub in a c/s. I dont think that there is anything wrong with that. Its not like its hard to do.....
  2. by   Jolie
    Quote from deehaverrn
    There are standards (check PACU anesthesia online) that state that these auxilary rooms must be held to same standards as any regular OR and PACU.

    I am not familiar with AORN standards of care, but this issue is definitely addressed by JCAHO, and is the reason one of my former employers decided to re-assign certain functions back to the main OR staff rather than OB.
  3. by   lannisz
    As an RN who is currently orienting to OB (my background and experience is med/surg) I have to tell you that I feel completely incompetent in the OR for our C-sections! I was told that our unit use to send the C/S to OR, but then they "trained the LD nurses to do them in our own OR". Well the new LD nurses ARE NOT even given the benefit of that training...we watch our preceptor and read some handouts from AORN. I have told several people that I am unfortable with the way things are done and that I don't think I can learn this. I mean, OR nursing takes intensive training right? Scary.
  4. by   deehaverrn
    actually our RNs weren't all given much training either, I had only gone to the OR for 2 weeks and did hysterectomies there, after this I was on my own to circulate or scrub for cesarians. our present RNs at least get a few days of class time with the educator then orient in the OR until their precepor feels they are ready to fly solo.,

    as far as Nurse's aides scrubbing...they do get better with experience, which is true for all of us. and note that not all of them even WANTED to take this step, they were just informed that it had become part of their job. i have seen way too many mistakes caused by improper technique and training, and i really don't think you can blame it all on them, they don't have the theory to go with the practice. As far as it "not being that hard", what about when the mom goes into DIC, is cold blue and mottled, is bleeding everywhere, and the RN is new and barely trained, the RN circulator is trying to help anesthesia since L&D does not have any anesthesia aides-she needs to get more fluids, get albumin, get blood, get the TAH boat, and the nurse's aide NEVER was in a case that turned in to a hysterectomy before so she needs direction, and the husband is screaming and carrying on because he's scared to death, and the baby is still in the room because the baby nurse had to leave for another delivery....HOW EASY IS IT THEN? and remember, you're (nurse's aide) NOT the one who is going to get sued as being responsible for the room
  5. by   Mrs.S
    Quote from lannisz
    As an RN who is currently orienting to OB (my background and experience is med/surg) I have to tell you that I feel completely incompetent in the OR for our C-sections! I was told that our unit use to send the C/S to OR, but then they "trained the LD nurses to do them in our own OR". Well the new LD nurses ARE NOT even given the benefit of that training...we watch our preceptor and read some handouts from AORN. I have told several people that I am unfortable with the way things are done and that I don't think I can learn this. I mean, OR nursing takes intensive training right? Scary.
    our orientation to circulating for c/sections went like this too. I also told our educator I didn't think this was adequate training, but apparently I am the only one...
  6. by   enfermeraSG
    Wow, nurse's aides trained to scrub c-sections. Well, a previous poster mentioned that this is no big deal as a C-section is "not hard", at this I had to post-up. You are correct, a textbook, every goes smooth section is not hard. Unfortunately for us and the pts they do not always go well. I had a previous instructor (I was a cert. scrub in my other life!) tell us that you could train a monkey to pass instruments, but to have the theory behind what you are doing and why, how to anticipate and handle a bad situation where someone could potentially die - takes a decent amount of training. I would not want to be on that table with someone who had a few weeks of nurse aide training along with some on-the-job scrub training, if something went wrong in my surgery. There is so much more to it than passing an instrument and not touching what is not blue! I mean really, who couldn't do that? I also can't believe that JCAHO is alright with this considering they make us pull our employees files to prove that they are not only school trained scrubs, but also certified. I wonder why some L&D units consistently lower their standards compared to what is acceptable in the main OR? Surgery is surgery. SG
  7. by   deehaverrn
    thats my point exactly! why aren't we (ob) held to the same standards as reg OR? by doing things like having barely trained nurse's aides scrubbing we are giving our pts a lower level of care. When our nurse manager and her supervisor proposed this idea we thought that "no way it would be approved", don't know how it was at all. I think we should have either OR techs and nurses come to our OR to do the cases or our pts should go there. There is no way that all our people can trully maintain their competency, especially on off shifts. Then they expect you to remember how to do different stuff that you do once in a blue moon..like all the bladder equipment. Its even worse once we get to PACU, where there's only one (BCLS only not ACLS) RN in the room, and in 20 years those of us who have been here that long have received no further cardiac telemetry than what we originally had when we opened. They even have put nurses who are on light duty in the PACU..when they have a cast shoe on one foot or a cervical collar! So much for responding in a code!

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