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Discussion

Almost done my final focus in the OR. I think I might suck.

Ok so here is my situation. I am a nursing student in the fourth year of my program doing my final focus at the OR. I am almost always in ortho, doing cases such as total hips and knees. I also spend a some days in ophthamology and 2 days in plastics. I have been there for two months, and have been getting the sense that I am not catching on fast enough. So far I have only scrubbed by myself once which was for a bilateral breast reduction. The other two students who are in the OR have both spent all their time in gyne, plastics, and general. They are both able to regularly scrub by themselves at this point. I had thought that the reason I was not scrubbing by myself is because I am in ortho and ophthamology and those are more complicated in general. My preceptor today told me I'm not doing as well as the others. Then she told me to scrub in for an eye operation and I was extremely nervous the whole case. The problem is I am almost done, only five shifts left. I had thought I was doing fine until now and was planning on trying to go into the OR, but now am not sure. I'm just wondering if there is anyone else who struggled a bit at first, but then got the hang of it later? When days are good I really like the OR, but if I don't have a penchant for it maybe I should move on. Can anyone relate to this? Some guidance would be much appreciated!

C

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    Don't be so hard on yourself! In my facility, the last service we orient new staff in is ortho because of the complexity of it!! New staff starts in general and gyn to learn their basics and then move through the services. Sounds like they set you up to struggle by giving you the more complex cases first. If you still like the OR, stick with it and you will be fine!!! Hang in there. :) And who cares if you are not doing as well as the others--how well are they doing with the types of cases you've been doing??? Doesn't sound like they've been expected to do those kinds of cases yet. So they aren't really comparing apples to apples. Keep your chin up!!

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    I'd been told by many people when I started my orientation that it would take at least a year to feel comfortable in the OR. And that makes sense, because our orientation lasted for six months with a one to one preceptor (not the same one every day, unfortunately) followed by another 3 months with one preceptor for two orientees. And the fact that you are scrubbing by yourself is also amazing- we don't even allow nursing students to scrub or really do anything solo. It's more of an observational role. They can put in foleys, prep, and that's about it- no giving meds, no counting, no documentation (although that may be because of our computer system).

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    OMG! Your instructor totally set you up for failure! OF COURSE you can't scrub ortho by yourself! It is a very complicated service. You have a gazillion trays of instruments, you have to work in space suits, you have a million more meds on your back table and you have to handle heavy and slippery instruments! Eyes are also highly specialized. YIKES! Your fellow students are doing better because their cases are probably easier. I can scrub an ex-lap with my eyes closed, but I still get confused doing a total joint procedure, and I have been doing it for years! The docs use different systems in ortho and you will sometimes have a rep to help you out, and sometimes you have to fly on your own.

    You say that you have 5 more shifts left. Ask your instructor if you can do general or gyne. I think that after setting up and scrubbing in ortho, gen will be relatively easy for you. How are you doing in the classroom setting? Are you or have you been doing better than your classmates in the classroom setting? Your instructor may have put you in a more difficult service because she may have felt that you were advanced enough to handle it. Although this is totally unfair to you, this may have been her rationale. I think it stinks that you were given a much harder rotation than your classmates. It would only be fair to judge your performance in the OR if you were given the opportunity to scrub the general cases. THEN she would have a balanced playing field in which to compare your performance to the others. Bring this up to her, because you surely don't want this rotation in the OR to leave a sour taste in your mouth.

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