Jewelry in the OR

Fun2, BSN, RN · Jun 22, 2008

I would think it would be both.

I think any metals on your body could act like a conductor of electricity, etc and burn the pt....or surgical team, for that matter!

Also, any jewelry could be lost "in" the incision, or fall off and be lost in the OR suite.

So....to those in the know....what do you do about a pt who has a metal caps on their teeth? (Of any substance....)

GadgetRN71, ASN, RN · Jun 22, 2008

Jewelry is not allowed in the OR for the following reasons(this was what I was taught)

There is a burn risk with cautery-I don't think it's a huge one, but why take chances?

Some patients swell after and during surgery, if the patient is wearing a ring for example, the ring can cause a "tourniquet" effect on the finger. We've had to cut people's rings off of them for this reason.

The loss factor is valid. Actually, this is a pet peeve of mine. It seems that we get so many patients from the floors/ER that come to the OR with jewelry. They've been told by the nurses that their jewelry can stay on. When they get to us, now we have to be the bad guy, and tell them that the jewelry has to come off. Most places have a perioperative checklist or protocol that the unit nurse has to follow as part of getting the patient ready for the OR and removing jewelry, glasses, dentures is part of this.

Sometimes, the patients aren't very stable or they start to do badly once they get to us-I'm running for what the tech needs, the doctor needs, setting up blood runs, sending specimens, but now, I also have to worry about the patient's ring or other valubles. There is a policy but I have to fill out lots of paperwork, send an orderly to security with the ring to put in in the safe etc.

Sheesh, I guess you can tell that it's a pet peeve, huh? Excellent question by the way. Good luck in school!!

Fun2, BSN, RN · Jun 22, 2008

I've had tape put over my ring before.

What's the reasoning behind that, except for diamonds not to fall off?

GadgetRN71, ASN, RN · Jun 23, 2008

I've had tape put over my ring before.
What's the reasoning behind that, except for diamonds not to fall off?

Yeah, I've seen some people do this-I think it's kind of silly. In my OR, the docs and anesthesia want all jewelry removed so it comes off. I try to do this in holding and if there is family present, I have them take it. We had to cut a womans ring off once because she was getting lots of fluids, and most people's hands will swell, and it could cut off circulation to the finger. We do tell people that this may be a possibility.

Some places have an actual document outlining the dangers and the fact that your jewelry may be lost if you wear it into the OR. It absolves the hospital of any responsibilty.

ewattsjt · Jun 23, 2008

Both reasons are great ones.

The idea behind the taping of jewelry is to break the electric current should the metal touch a better ground than what the pad is. When you really look at this reasoning, you would have to say the better is to remove it entirely before coming to the OR. As Witchy said, “Why take chances?”

freezebabyRN · Jun 25, 2008

? for all of you OR nurses! I have a friend that wears the insulin pump and she has an interview for a surgery position which is a rural hopsital so they do it all from assisting to circulating, pacu etc. Anyway, would there be a problem with her wearing her pump during surgeries? I know she said she was always able to wear her pump when she actually had surgery herself, and they never made her disconnect. But, wasn't sure if the technology would interfer with anything? I'm sure with it being attached to her and she could even put in on her backside that wouldn't interfer with burns etc.

Just thought may be some of you surgery/OR nurse might know of nurses that were in this situation or may be even some have diabetes and wear a pump!

Thanks! :yeah:

cdsga · Jun 26, 2008

Glad you are enjoying the OR experience. It is great.

The answer is concerning the burn risk. It has to do with conductivity and grounding and the small risk attached to wearing metal.

If patients refuse to remove jewelry, they assume the risk, and that must be notated that they were made aware of those risks and that we may have to remove the jewelry if necessary.

Also there are situations where there is the element off swelling and subsequent restrictive circulation, where say a ring would have to be cut off to keep the finger from being compromised.

With piercings commonplace in very hidden areas, you must ask the patient about everything. Sometimes we are very surprised.

KayceeCA · Jun 27, 2008

OK, for all you experienced OR nurses...what's the worst jewelry/piercing you've had to remove?

I always thought tongue piercings were the worst to get out - until we had a trauma patient with a Prince Edward piercing that I had to remove. For those of you who don't know what that is, it is a piercing that runs through a man's member. Talk about hard to remove! We definitely didn't want to take any chances on this guy getting a cautery burn though. Ouch.

GadgetRN71, ASN, RN · Jun 27, 2008

OK, for all you experienced OR nurses...what's the worst jewelry/piercing you've had to remove?
I always thought tongue piercings were the worst to get out - until we had a trauma patient with a Prince Edward piercing that I had to remove. For those of you who don't know what that is, it is a piercing that runs through a man's member. Talk about hard to remove! We definitely didn't want to take any chances on this guy getting a cautery burn though. Ouch.

I had to remove multiple body piercings on a patient who didn't have the best hygiene(nipples, belly button and hoo-hoo). They were all crusted over.:stone

Fun2, BSN, RN · Jun 27, 2008

I had to remove multiple body piercings on a patient who didn't have the best hygiene(nipples, belly button and hoo-hoo). They were all crusted over.:stone

Kind of defeats the purpose of getting the 'sexy piercings' in the first place, doesn't it?

Ewe......keep youself clean, people!

shaomai · Jul 1, 2008

Eight labia rings! :eek: