License risk in the OR

Specialties Operating Room

Published

I am interested in hearing answers from fellow OR nurses....

You know how in other areas of nursing how sometimes your license can be at risk for doing or not doing one thing or the other?

Well in your opinion, what kinds of risks do the perioperative nurses take? What would be the biggest thing that comes to your mind? Meaning, what mistakes that could happen on any given day in the OR could possibly cost you your license?

Thanks!!! ;)

( I am an OR nurse, and do know these things, just curious to see what everybody elses assessment is!!!!!)

Most facilities have a loophole in their coverage of malpractice. They simply state that you are covered if you operate within facility policy. Case and point is that if it is true malpractice you were outside of the facility policy, meaning they can leave you high and dry.

For $100 to $150 per year you are willing to risk everything you have? I am a CST in school for nursing and carry my own malpractice for the above reasons. When someone is named in a suit, everyone who in the room gets listed and they sort it out from there.

I am always concious that I have a license and that I work with a surgical technician who is not licensed. When I was a tech before becoming an rn with a license I was told that I was working on the nurse's license. Don't know if that is literal but I sure felt a huge responsibility and respect for that license. Note: isin't it intersting that we are called "registered" when we are really "licensed"?

re: . I have worked long enough that I have seen nurses be protected by the institution during a litigation in which they were named and then action taken against that nurse once the litigation ended. I always carry my own insurance. It is inexpensive and lets me put my head to my pillow just a little easier at night!

I am always concious that I have a license and that I work with a surgical technician who is not licensed. When I was a tech before becoming an rn with a license I was told that I was working on the nurse's license. Don't know if that is literal but I sure felt a huge responsibility and respect for that license. Note: isin't it intersting that we are called "registered" when we are really "licensed"?

The surg tech does not operate under the license of the RN any more than the RN operates under the license of the surgeon. It is not literal as many would suggest. It would seem like it is because it's really a delegation of tasks issue. The RN’s license can be jeopardized by what is delegated to the tech (verbal or non-verbal). In fact the First Circulator is in charge of the room (except physicians) which means that their license is on the line for anyone else in the room (sales reps, LPNs, STs, CSTs, Second Circulator, other RNs etc…). So in a nutshell the primary circulator is responsible for the room.

An RN is both licensed and registered where a LPN/LVN is licensed only.

I agree with that wholeheartedly. thanks for that input.

Specializes in NICU, ER, OR.
The surg tech does not operate under the license of the RN any more than the RN operates under the license of the surgeon. It is not literal as many would suggest. It would seem like it is because it's really a delegation of tasks issue. The RN's license can be jeopardized by what is delegated to the tech (verbal or non-verbal). In fact the First Circulator is in charge of the room (except physicians) which means that their license is on the line for anyone else in the room (sales reps, LPNs, STs, CSTs, Second Circulator, other RNs etc...). So in a nutshell the primary circulator is responsible for the room.

An RN is both licensed and registered where a LPN/LVN is licensed only.

First, I have never had the pleasure to have more than 1 circ on any case, no matter how big... but what exactly is the RN "responsible" for... can I have a black and white example?

In my state only Rns circulate so that in itself narrows the scope. I too have never had more than one circulator. The RN circulator can deliver a mediction to the sterile field, an ST cannot. That is my experience.

Specializes in Vascular,Heart team, Urology,Gen...

You need to go to your State Board of Nursing web site and get a copy of your Nurses Scope of Practice. This is the best way to know what you are and not allowed to do. As a nurse who became a registered nurse fist assistant, I found out a whole lot more about what is allowed to occur in the OR and what happens if I allow it to occur. Examples: allowing a surgical tech. to close a wound, allowing or asking an aide to prep or step out of their scope of practice. I was told that if I was in the room and allowed these things to happen then I could lose my license because as a professional I should know better. I am the one with a license....... in other words, the tech may get a hand slap, but they do not have a license to take away. I am a professional and as such am responsible for protecting that patient from harm.

Specializes in Vascular,Heart team, Urology,Gen...

personal is inexpensive and well worth it. Remember that a surgeon or anesthesiologist is NOT the caption of any ship. YOU are a PROFESSIONAL and as such you need to be aware that you will go down just as easily as anyone else. That is why you should know AORN standards of care because if God forbid you ever end up in court, that is the resource the attorneys are going to quote. Documentation and a great memory are what you have on your side, as well as an attorney who will be there for YOU not the hospital or anyone else.

HI,at the hospital that I work in we have had several sentinel events related to the drug: Lovenox. One particular patient was an inpatient and the floor nurse wasn't supposed to give the drug. She didn't sign off on this. It was given again in the OR. Bad end result. So a good practice would to call the floor nurse and check and double check if the patient had their dose or not. If the paitent receives it twice this could be fatal. It has also occured when nursing and ANES don't check the patient's Pt/INR. I have one surgeon that requests lovenox on a regular basis. If it is an inpatient he has no idea that the patient already takes it. So, just beware of this. You are always being rushed rushed rushed in the OR. If you are on call in the middle of the night don't let the team rush you before you check all of your paperwork and labs. The patient could go to ICU and bleed out and die.

when we have enough staff for a second circulator; they are under the direction (delegated duties) of the primary circulator. perhaps this gives a better understanding. i copied the link from the aorn site. http://www.aorn.org/practiceresources/aornpositionstatements/position_healthcareprovidersandsupportpersonnel/

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