Cleaning OR between patients

GigLs2u · Jul 24, 2005

I guess I am confused about the staffing in your OR and the patient status at end of case.

The majority of the cases I had the patient was breathing on his/her own at the time of placement on the stretcher for transport. Once on the stretcher, anesthesia was almost always (95%) ready to take immediately to recovery/PACU. While the circulator was taking the patient to recovery, non-licensed staff cleaned the room.

For 8 major ORs, 2 urology rooms and 1 lithotripsy room there were 3 non-licensed staff. In addition, there were two anesthesia non-licensed personal. One was designated for CVS.

What was important to the hospital was having the operating rooms occupied the majority of the day because this increased revenue. The goal was 15-20 minutes turnover time. Depending on the case it ranged from 11 -23. Big neurosurgery cases usually took the longest.

Our ORs, non-teaching hospital except LVNs and Scrub Tech schools, had scheduled cases from 7:30 a.m. to 6:00 p.m. There were frequent add ons so in addition to 7-3 staff for the 10+ rooms there were 2 teams scheduled to 11 p.m. and 1-2 teams scheduled 7a - 7p. The CVS team, 7-3, scheduling was independent of general surgery.

During the turnover time, the scrub nurse/tech would take instruments to decontamination, get instruments for the next case, use the rest room if needed, and set up for the next case. Each case's supplies was in the room in seperate containers at the beginning of the day to expedite turnover.

The circulating nurse would give report to PACU on post-op patient, interview and do consents for new patient, return to OR to confirm have supplies/instruments needed, help finish opening supplies/instruments, get missing supplies/instruments, confirm or do anesthesia turnover, do count with scrub nurse/tech, return to Pre-op to confirm patient has been seen by surgeon and anesthesia, and take to OR when surgeon/anesthesia ready.

Keep in mind the above is based on good staffing days. There were times I mopped floors, took trash out, scrubbed in, counted with floaters while a scrub tech/nurse took a break. In addition, this turnover time between major surgeries was very stressful for a newbie. I dreamed of roller skates but even if I had them I knew I was proficient on them.

A good scrub tech/nurse is GOLD! If you work together and help them you can be a great team. If they know their stuff then no instruments or supplies will be missing even in an emergency. If they don't or they want to make you miserable you will be running for stuff.

Especially, in the beginning I had scrub techs (male) and a surgeon send me for things repeatedly. One was an OTIS. This was their OR joke. There is an elevator manufacturer called OTIS. Late, I think it was an orthopedic sales rep who told me the scrub tech and surgeon were wrong because there is an instrument called an OTIS.

If you are not as busy as we were then I can see how you may not have non-licensed personal to help with turnovers.

Good Luck to you!

Hi there, I am a OR nurse, (one year on the job, fresh out of school). Working in elective ortho surgery in UK. When the procedure is finished and the patient is being moved back on to their bed to be transfered to recovery, the circulating staff are to take out the rubbish, clean the OR and bring all that is required for the next case.
The problem I have, is that when it is time to clean up the mess, the senior staff vanish leaving the new ones to do the housekeeping. Is this normal practice? I know I have to earn my seniority, but surely if I can scrub for cases just like them, there should be a team effort all round. Sometimes I feel that studing at Uni for 3 years makes a very expensive rubbish remover, and I hate it! What can I do?

carcha · Jul 24, 2005

I can see where the original poster is coming from, in London we dont have techs or LVN's to clean up the OR's or get the packs. I work in an RN only dept , no unlicensed personnel care for patients, however we do have cleaners who move into the OR between each case to clean it and empty bags, mop floors ect. I think the original poster is being made a fool of and if I were her would either speak to one of the senior staff about how she feels or I would wait until the senior staff are about to leave her to go for a break and make a move to join them. If anything is said she is totally within her right to point out that being a junior does not mean doing all the housework.

Marie_LPN, RN, LPN, RN · Jul 25, 2005

If anything is said she is totally within her right to point out that being a junior does not mean doing all the housework.

Neither does being a tech or an LVN, as your post is implying.

Marie_LPN, RN, LPN, RN · Jul 25, 2005

The problem I have, is that when it is time to clean up the mess, the senior staff vanish leaving the new ones to do the housekeeping.

Is management aware that this is happening?

nubes · Jul 26, 2005

In the hospital where I work, we have 15 theatres all staffed by registered nurses. No medical tecn, nor LVN nor healthcare assistants.

Nor do we have housekeeping staff during the day. So the work of cleaning out theatre and making it ready for the next patient is up to the circulating staff which is normally 2 nurses.

Unfortunately the manager left 2 months ago, and until now there is no new manager so it feels like a free for all!! :chuckle

I will survive as I love this speciality, I only hope to not become heartless in the process!

Marie_LPN, RN, LPN, RN · Jul 26, 2005

It's should be up to whoever is assigned to that room for the day to get a room ready, not just a few.

So if you don't have a manager, then who is acting as a manager for that dept.?