Limit to the Number of People in the OR??

brewerpaul · Feb 23, 2008

We don't have a limit, but ours is a small/medium community hospital so numbers are not usually a problem. One ortho surgeon is very strict about limiting people in his total joint cases for infection purposes and nobody leaves or enters unless it's absolutely necessary-- lunch and breaks are out until the case is over. Luckily, he's also a fast worker

;-)

GadgetRN71, ASN, RN · Feb 23, 2008

We don't have a set number either but often, the physician will not want students in there or sometimes, I will even turn down a student in my room if it's a tough case or things aren't going well. Had to do this just the other day. I didn't know what background the student had. When you have a student in there , you have to watch them closely so they don't contaminate anything or pass out(it's happened!).

I find the numbers work themselves out. If it's a cranky surgeon, not many people are going to be clamoring to go in there. :lol2: Our docs don't really mind if the techs and nurses get a break or lunch during a total joint, but we have a dedicated group of staff for Ortho, so they know whoever is going in there has done totals before. We also have a very, very, low infection rate, so they can't argue the too many people going in and out factor.

Scrubby · Feb 23, 2008

We don't have a set limit, though i think we should. One nursing student and one med student should be enough. I don't believe it's fair on the nursing staff because we don't have time to educate them, they should be taught before they come to theatre how to maintain sterility and that the operation is not an entertainment show put on for their benefit. I had four med student and two nursing students in the room, i had to ask them to leave because they were in the way and compromising the sterile field (one med student actually reached across my field and started pointing at instruments).

[One ortho surgeon is very strict about limiting people in his total joint cases for infection purposes and nobody leaves or enters unless it's absolutely necessary-- lunch and breaks are out until the case is over. Luckily, he's also a fast worker

;-)]

I'd like to see him try that at my work :icon_roll

mcmike55 · Mar 7, 2008

We don't have a set number either, like your brewerp.,,,,,we're a small hospital, but get a lot of students.

Nursing students (RN&LPN), scrub tech students, paramedic students, physical therapy students, medical students, and occasionally, a high school student (job shadowing).

We sometimes tease, saying that we need to pull out the bleachers in the OR!!

In a way, a lot of students requesting clinical time, I think is a bit of a compliment.

We do try to keep the numbers down, especially in totals.

In totals, we may take one student in with us, but limit in and out traffic.

I try to keep in mind, that I was a student once, and try to give 'em a nice expericence.

Remember, these students are going to be taking care of us as we get older you know!!!

Mike

gnom · Mar 8, 2008

Hi there,

We are a huge teaching hospital. Our ORs are really big and we don't limit number of student. We have 18 OR and we're opening 12 more so we just put 1 or 2 student in every room. I think our problem is residents though-)) not students..sometime we have 5 of them that want to scrub a case...waste of gowns and gloves since the most active one usually grabs the spot and does all the work-)))

Our joint guys does not practice "closed door" police since it's imposible..everybody gets a lunch relief..

Mourkoth · Mar 15, 2008

Hi there,

We are a huge teaching hospital. Our ORs are really big and we don't limit number of student. We have 22 OR rooms and are building 4 more. I feel that regardless of the teaching aspect, the patient always comes first. As the Circulator, it is my responsibility to be the manager of the room. If I can't do my job effectively or I feel that we are not giving the best possible care, I can become an ass. There is a sane limit to numbers... especially large trauma surgeries. I will point to individuals who are not an active part of my team and tell them to leave the room. If it is a particularly chaotic I will thin the herd more. For example, we recently had a trauma with general doing an ex-lap on a pregnant woman with OB assisting, ortho working on an open tibia. Opthomology, comes in with his three assistants to take a look at the "cornea problem". I told him to take a quick look, lube it, patch it and come back when one of the other teams has finished. Anyone else, especially if they are not really needed, I send out. So many residents, other nurses, techs and even managers seem to just want to come in to "see whats happening".

Anxious Patient · Mar 16, 2008

We don't have a set number either, like your brewerp.,,,,,we're a small hospital, but get a lot of students.
Nursing students (RN&LPN), scrub tech students, paramedic students, physical therapy students, medical students, and occasionally, a high school student (job shadowing).
We sometimes tease, saying that we need to pull out the bleachers in the OR!!
Mike

As I'm on the patient end, I'd like to know if the patient is informed that a high school student (job shadowing) will be observing the operation. Personally, as my 2 operations have been gyn related, I would be appalled if teenagers or any non-medical person would be allowed in the room when my feet are in lithotomy stirrups, and the surgeon is operating between my legs. Please tell me it isn't true.

BridgetJones · Mar 16, 2008

I highly doubt that any hospital would let a high school student in the OR to job shadow. It's crowded enough as it is with medical and nursing students. You can request before surgery not to have any students in the room, I'm sure. I just did my senior leadership rotation in outpatient surgery and one lady requested all female staff in the room for her GYN surgery since she worked as a tech and didn't want her male coworkers getting a show. Of course, I, as a good patient advocate, would kick out anyone my patient didn't want in there. :nurse:

ORNLxxx · Mar 19, 2008

I highly doubt that any hospital would let a high school student in the OR to job shadow. It's crowded enough as it is with medical and nursing students. You can request before surgery not to have any students in the room, I'm sure. I just did my senior leadership rotation in outpatient surgery and one lady requested all female staff in the room for her GYN surgery since she worked as a tech and didn't want her male coworkers getting a show. Of course, I, as a good patient advocate, would kick out anyone my patient didn't want in there.

Although what you say is true, it assumes that the Patient is informed about the student BEFORE the procedure and is given the opportunity to accept or decline their participation. As I have said on this forum before - AMA Ethics dictate that any potential student involvement is DISCUSSED with the patient. This doe NOT always happen.

Having a patient sign a consent document without discussing the Student involvement, sometimes only minutes before a procedure, sometimes after being administered Versed, and sometimes when everyone is aware that there is no way the PT could have read the entire document does NOT constitute informed consent and does not meet the ethical requirement.

Please, please, please - it is such a small thing but can everyone who reads this take time to think about this. To some patients, and especially for something like a gyn procedure, it is a big deal that could be averted so easily...

GadgetRN71, ASN, RN · Mar 20, 2008

Every OR I've worked in, patients were always informed about students/observers etc, and given the oppourtunity to decline. The place I am now is a teaching hospital and patients are made aware of this also.

I was also taught in nursing school(and tech school too) to introduce myself to the patient before a procedure, and to ask them if it was OK if I was in the room.

Personally, it doesn't bother me. I've had several surgeries and I figure, people have to learn somewhere..as long as the students were respectful, I'm not going to worry about it. Often, the med students and nursing students were very nice and spent a lot of time talking to you, making sure you had warm blankets etc.

GadgetRN71, ASN, RN · Mar 20, 2008

As I'm on the patient end, I'd like to know if the patient is informed that a high school student (job shadowing) will be observing the operation. Personally, as my 2 operations have been gyn related, I would be appalled if teenagers or any non-medical person would be allowed in the room when my feet are in lithotomy stirrups, and the surgeon is operating between my legs. Please tell me it isn't true.

They wouldn't put a high school shadowing student in a GYN case. Actually, I don't ever think I've seen a high school student shadowing in the OR. Med and nursing students , yes.

Usually, they'll put(nursing) students in very basic cases. Lap chole's seem to be the popular choice, along with knee arthroscopies, and simple Ortho.

In nursing school, they put some of us in to observe C-sections and vag deliveries, but we always asked the patient's permission first.