Help for new O R NURSE

[mondragon]

I need input from other nurses.I am a new grad.,working in the OR. This hospital has no count policy,when I asked for it,I was told they are working on it,.... since April. I had a few scrubs/surgical tech's who refused to count,or said "we can count later ",however they draped the patient then handed the surgeon the knife,and we still had not counted.The scrubs tell the nurses what to do,when I questioned this I was told ,"Well,we try to be good to our scrubs because we have not had good luck with hiring good scrubs and we would like to keep the ones we have". Some scrubs will take the safety belt off the patient,before the patient is extubated,then walk away from the bedside.Most scrubs also scrub in,then have the RN run to get supplies that they did not pull for the case,in other words they do not gather supplies or suture,they just open a pack for the back table,then have you run for everything needed for the case. I also had a scrub who was going to draw up Narcan,she had the vial & syringe and was inserting the needle in the bottle when I caught it,I told her no,then took the med. out of her hand.The scrubs are also quick to stand at the head of the OR table with the intent to assist in starting an IV or intubation. I say excuse me,and they still will not move.I have taken these issues to management,but really get no support,management said "What's wrong with them helping"? My understanding is they are not qualified.I am also new to South Carolina.Is this allowed in South Carolina? I get the impression the scrubs do not actually know what their range of practice is.I am also trying to find out what is the scope of practice for surgical tech's in South Carolina.I love my job,working with the surgeon's & CRNA's,but I am also uncomfortable with the practices of scrubs. I would really appreciate feedback and advice.

[Rose_Queen, BSN, MSN, RN]

You may want to move this to the OR forum or crosspost it there. If I were in your shoes, I'd be running and not looking back. Management sees nothing wrong with the surgeon starting before counts are done? Yeah, then they'll be throwing you to the wolves when they get a lawsuit for a retained item. Seriously, how can there not be a policy for counting? Mind boggling.

I'm in PA, not SC, but I know that only a licensed medical profession can give drugs. There have been times in dire emergencies where our anesthesia techs are drawing up meds under direct supervision, but they still aren't allowed to push them. Never would that be allowed in routine circumstances though.

[P_RN, ADN, RN]

Moved to OR forum

[Tiffany, RN, BSN]

One question, OP. Do you value that brand new shiny nursing license that you just got? If you do, you better hit the highway and don't ever look back. That environment is a disaster waiting to happen. I work in SC as well and none of the stuff you have described is allowed or safe. I wouldn't bother trying to fight this in your current position. I would just leave. Find a new job ASAP, work your notice, and call JCAHO on the first business day after you leave.

[NurseLumpia]

Scrub in NJ are not allowed to do anything of that sort that u described.

I, like every one, would start looking for a new job ASAP and report them to the Joint Commision...

[canesdukegirl, BSN, RN]

Oh my goodness. I had to read your post a few times in order to digest what I was actually reading. NO COUNTS?!?! In what universe is this acceptable? I agree with everyone else; this is a lawsuit waiting to happen, and you will be slaughtered for it. This is not worth your license, dear one. One of my pet peeves is scrub techs thinking that they are nurses...in no way shape or form are they allowed to PUSH MEDS!!! It is highly unusual for anyone other than the anesthesia care provider to push meds in the first place, but a ST is clearly not allowed. Also, why are the techs standing at the head of the bed to assist in intubation? They should be standing at the ready waiting to prep and drape. Why are they not sterile? This is disturbing to say the least. I would look for another job PRONTO. I am just sorry that your first introduction to OR nursing was so completely awful...this is not the way OR nursing is supposed to be. It sounds like the techs are working way outside of their scope of practice, and JCAHO will have a field day with this if they knew. I would write a letter to legal stating some of the things that you have witnessed.

[BethCNOR, BSN, RN]

I have to agree with the advice you have already been given. Get the heck out of Dodge. I hope there are other hospitals in your area. How has this OR passed JCAHO certification? I work in NC and I have come to accept that things are about 10 yrs behind the times of other states I have worked. Your situation is just downright dangerous. The only time not doing a count is acceptable is for a "crash through the door" trauma. Then x-rays are taken. OMG, I thought it was bad here.

Good luck and DO GET OUT OF THERE!!

[mondragon]

I have moved on from this hospital.I did not give a notice,I was too scared to work another day,I handed in my badge to HR,and felt relieved.I did an exit interview with the top dog in HR,the nurse manager must have given her point of view before I got there,he listened but felt it was the responsibility of other staff RN's to show me where the count policy & EGD policy,and should have been the ones to make arrangements to orient me to the EGD's. My comeback was how can the other RN's be held accountable ? They are assigned to rooms all day,they don't have the authority to change assignments made by the nurse manager,how can they show me a policy when the nurse manager doesn't even know where it is ? How low for the nurse manager to control every aspect of the day to day decisions/assignments,and then place blame on the staff RN's .The HR and the Chief Nursing Officer put the responsibility back on me and the RN staff,well,I ended with "Yeah,I took responsibility,I left".Well I have moved on,have another job,and happy I don't have to work with a nurse manager who disregards AORN,BON and the hospital policy.And lord how mercy,the first thing I get on the new job....Policies & Procedures, happy happy joy joy.

[jessrene, LPN]

sounds like you did the right thing by leaving, did you ever talk to anyone about your old facility's practices, policies, and procedures? (or lack of)

[mondragon]

I did talk to the director of HR and the Chief Nursing Officer,but not to any organization outside of the hospital.Before leaving this facility I did go to HR requesting to transfer to another department or to their other facility,but was told I had to be in the current position for 6 months before I could,well I'm not going to risk my license for 6 months.The CNO said I should have gone above the Administrator.Well,I did go to the Administrator,and my Nurse Manager told me in front of the Admin. that I should not have gone to the Administrator,by the way the Admin. never rebuked this.I told the CNO instead of that advice she should be holding the Nurse Manager & Administrator accountable,not me,the Nurse Manager was already trying to intimidate me for going above her,and of course no response from the CNO.This is a Christian hospital upholding the wrong doings of Admin. & the Nurse Manager,the facility took a stand that it was the responsibility of my peers,RN staff,to precept me in EGD's and to show me policy & procedures.I said how can that be possible when the Nurse Manager has assigned them to rooms that are booked with cases from the time they clock in to staying late to finish,the Nurse Manager makes the assignments not the staff,and I have never known any facility to put that responsibility on the staff RN's.I don't get it,I was shocked by the stand that the facility took.Basically the Nurse Manager & Administrator threw the staff RN's under the bus.

[Libitina]

Have you officially reported the previous hospital to the authorities? You must not let them continue to work like this, for the safety of the patients.

Congrats on the new job btw

[mondragon]

No, I have only spoken with the Chief Nursing Officer,the Nuns, and HR. Should I report it to BON and JACHO,or just one of the two organizations ? I have been looking for another position,which I have been hired,not an OR position though. The end result from HR is that the staff RN's at this facility were responsible. Can you believe that they threw the staff nurses's under the bus ? Such bs !