Developing sterile consciousness

[SAS2016]

I need advice on how to gain sterile consciousness. I am a new RN in my 4th month of my orientation program in the OR and last week I didn't notice I contaminated different things on a few occassions. Some of the times I noticed & others I didn't. What bothers me is the ones I didn't notice. If someone else didn't notice I would have put the patient at risk. I guess since I am new and absorbing everything there is so much going thru my head at one time. I have gotten better but I am struggling with becoming more aware. Any advice? One was when I was smoothing out the drape from the foley kit...I guess I had touched the blanket on the patients legs. Another time was holding my hands up with my sterile gloves, the back end touched my shirt. Then I have had trouble opening sterile supplies onto the back table. Otherwise, it is just hard being aware all around you at all times (behind you, etc). I am having a hard time getting into the habit since it is so unnatural. In 9 weeks I will be on my own and want to be better at this. I haven't made a huge contamination mistake but I'd really hate to be the one that makes us take down the entire back table & order all new instruments in the middle of a case.

[oceanblue52]

I'm not an OR nurse, so this suggestion might be a little odd. But have you considered signing up for a class teaches you to focus on somatic (body) movement, like dance or a sport of some sort? It sounds like you are aware of the theory behind sterile technique...so perhaps you just need to develop better proprioception, which is the sense of knowing where your body parts are. This sense is why some people have better hand eye coordination and can catch things or hit a tennis ball more frequently with a racket. It's a bit of an odd suggestion, but better body awareness can definitely be developed with conscientious practice.

[SAS2016]

Thank you. I didn't think of it that way. I exercise & grew up doing dance but have never been good at sports. I have good feet coordination but not hand-eye coordination. I do not like sports so I will certainly have to think of something I can do. Perhaps some kind of kickboxing or self-defense/martial arts type work. I love staying active.

[bunnehfeet, BSN]

You're still pretty new, and I went through these same issues too my first weeks in the OR. Stop comparing yourself to people who have done this for 10 years or more, you're still a novice (was the best advice I keep getting from all my mentor CNORs). You will open things onto a field that will fall on the floor, everyone does from time to time. It's a thing that requires repetition and muscle memory to get better at. For me, I noticed I made more mistakes in the beginning because I was so hyper aware. It's like overcorrecting when you're a new driver because you're too worried about staying in your lane. After awhile you learn that if you keep your gaze down the road, you automatically stay in the lane. It just takes a little time.

How many hours in the OR have you done at this point? Just take a deep breath and remember, there is nothing you do can do that can't be fixed - other than not speaking up. Having surgical conscience means you speak up, no matter what, when you know you or someone else has contaminated - there's no judgement, that's how it works. Enjoy your new career.

[SAS2016]

Thank you. This week was better. 9 weeks at 4 days per week, 8 hours per day. So I am at 288 hours roughly. We are in class on Mondays and in OR Tues-Fri.