Forced to Assist in C-Sections

Is there a reason that you can not function as the circulating nurse for C-Sections?

I have not received adequate training nor is it a department I am familiar with. I`m not going to put my license on the line when I get called in for a C-section and it goes sideways. Everyone in the room will be expected to be proficient in their role and I would not be able to. For example, I don't even know where the departments Omnicell is or supplies. 

Promacta said:

I have not received adequate training nor is it a department I am familiar with. I`m not going to put my license on the line when I get called in for a C-section and it goes sideways. Everyone in the room will be expected to be proficient in their role and I would not be able to. For example, I don't even know where the departments Omnicell is or supplies. 

Is there some reason that you can't familiarize yourself with where the supplies or omnicell are located?  

toomuchbaloney said:

Is there some reason that you can't familiarize yourself with where the supplies or omnicell are located?  

Its one of many examples. At the end of the day, I have not received adequate training to fulfill the role which places mother and baby safety at risk

Promacta said:

Its one of many examples. At the end of the day, I have not received adequate training to fulfill the role which places mother and baby safety at risk

It sounds like you are making excuses to me. 

toomuchbaloney said:

It sounds like you are making excuses to me. 

Not receiving proper training in a specialty that I have never worked and placing patients safety at risk is making excuses?

Promacta said:

Not receiving proper training in a specialty that I have never worked and placing patients safety at risk is making excuses?

Yes. You are using that as an excuse to not circulate on a specific specialty of surgery rather than getting the training so that you can circulate in all of the specialty surgeries that your hospital offers.  Why can't you get the training? Why are these cases so scary for you?  Does your hospital have a high M & M in obstetrics cases? 

toomuchbaloney said:

Yes. You are using that as an excuse to not circulate on a specific specialty of surgery rather than getting the training so that you can circulate in all of the specialty surgeries that your hospital offers.  Why can't you get the training? Why are these cases so scary for you?  Does your hospital have a high M & M in obstetrics cases? 

I never said these cases are "so scary"? I am not able to receive adequate training for C-Sections because we do not do them in the OR department. They are done on a different floor. This provides the OR staff with no exposure to them. We do not see a large case load of C-sections to begin with. We may have a couple to a few a week at best. This provides very limited opportunity to see a C-section at all. Even, when an opportunity presents itself it is further limited by us being tied up in an OR room. 

Promacta said:

I never said these cases are "so scary"? I am not able to receive adequate training for C-Sections because we do not do them in the OR department. They are done on a different floor. This provides the OR staff with no exposure to them. We do not see a large case load of C-sections to begin with. We may have a couple to a few a week at best. This provides very limited opportunity to see a C-section at all. Even, when an opportunity presents itself it is further limited by us being tied up in an OR room. 

Correct. Those surgeries are done in surgical suites on another unit.  The surgical standards, routines, and procedures are not unusual. There is a nurse there for the care of the infant.  You are just doing the typical circulator duties.  

You mentioned putting your license at risk so I used the term scary.  

I dunno.  I don't think this is an unreasonable request for an on-call OR circulating nurse to be called in to circulate in a pinch.  I think that you could request a training in circulating in one of those suites.  Ask for a walk through of the OB suites so you know where stuff is.  Lots of times the action tech opened the suite for the procedure.  The circulator checked it's readiness.  In our hospital the OR education department taught all surgical suite skills to the OB staff.  I bet you could get a "level up" in your orientation. 

Learning new skills makes you a more confident and valuable professional.  

There aren't many C-section cases at your hospital so this should be an unusual request.  The OB staff likely prefer to cover their own surgical cases and only request on-call circulating assistance when they are too busy to safely take an RN out of the labor suites for that surgery.  

Good luck.  

Do you scrub in the OR? Sounds like orientation to that unit would solve the problem. Not knowing where their supplies are kept is a pretty low-level excuse.

Who circulates when you're not on call? I suspect dual role L and D nurses that have less training and experience in OR nursing than you do in C-Sections. If they do it, you can certainly do it. This is the reality of small, critical access hospitals. In the end, it's abdominal/pelvic surgery with all of the attendant risks for complications therein, and that's really all you need to know. If you had to take care of the baby, that would be a different story, but you don't. 

offlabel said:

Who circulates when you're not on call? I suspect dual role L and D nurses that have less training and experience in OR nursing than you do in C-Sections. If they do it, you can certainly do it. This is the reality of small, critical access hospitals. In the end, it's abdominal/pelvic surgery with all of the attendant risks for complications therein, and that's really all you need to know. If you had to take care of the baby, that would be a different story, but you don't. 

So you're saying L&D nurses can also come down to the OR and circulate any case? OB has their own call team and we have been told time and time again that they are adequately staffed. However, they still call us. I even heard recently that their call person was able to refuse the call and then we got called in. Of course L&D nurses have less OR experience but they have substantially more experience with C-sections as it is the only case they have to do. In the end, I am not trained or competent to be apart of a C-section.