Rezidentura 2,419 Views
Joined: Nov 25, '05;
Posts: 44 (18% Liked)
; Likes: 20
Talk to your strkyer instrument rep about the Neptune Bronze system. It's unpowered except for offload and is okay to use. It's lighter easier to transport and quieter.
If I know them it's first name. If I don't it's Dr. So and So. I almost never address Attendings by the first name, even some I've worked with many years (Exception, is a few that are my age and that trained while I was working).
Work in an advanced practice ASC. We run lean so I clean my own or suite after cases. We use the beach chair position for most of our shoulder arthroscopy cases. Our current shoulder drapes do a **** poor job at capturing fluid which makes cleanup slower. What drapes do you use (model number and company) and what strategies have you guys used to keep fluid at bay?
Btw we use a lateral drApe made from cardinal.
In my little surgical center I am the Radiology tech. Apparently the Doc's all had some learning annex coarse or something So we operate the machine under them. Our C-Arms are All digital and work much like a mini carm. The nurses do all the movement of the carm. We can put down the footpedal and during some of my cases I have to. It's no big deal really. We have a good radiation safety protocol. Also we never take but a few shots so it's not a huge dose issue.
One of the true heroes of the Nursing profession. Hospice nurses most go straight to heaven. Anyways thank all of you for your heartbreaking work, hopefully I don't need you guys too soon but when I do I know my loved ones will be in good hands.
I start at area of incision and scrub circum.up the leg, toss sponge; scrub with new sponge starting at incision area and circum. down the leg, (twice each); blot dry; then paint the same way. I'm a little anal about the prep :icon_roll. I shudder to see someone "wipe" rather than blot and peel away.
A nurse who scrubs is doing the exact same things that a Scrub Technician does. Nurses don't generally take on expanded duties when they scrub compared to a tech.
So I'm guessing the real issue isn't Fogging it's overheating. So here's some things that may or may not help. The obvious: If you normally wear an undershirt maybe go without and use an overcoat for when you get too cold. For the fogging try a mask with the integrated tape it does help. For the eye shield postion it away from you face a bit to give the heat from you breath somewhere to go.
If your nomally cold, perhaps it's anxiety thats causing this overheating. If thats the case maybe overtime with comfort this will decrease.
One of my Ortho docs sweats profusely especially during hard cases. I always heckle him (Doctor_____ I can't bring the temp down any more because our thermometer stops at-20 degrees)
BTW I Love heckling the Surgeons I know.
I have some advice which you probably already know but. Whatever you do, Don't look at your assignment if thats the kinda thing that will stress you outside of work.
Look at whats right with your job rather than worrying about whats wrong. You can keep searching and searching moving from one floor to another finding problem after problem. In the end you'll miss out on whats happening around you. Good people taking care of people in need. I know positive thoughts only get you so far. However, how you present yourself to the world directly influences how the world sees you. So if you dread working with a specific person (Scrub tech, surgeon Anethetist) things you do maybe in without knowing it probably reinforce this.
In the end its only you. Do whats best for yourself.
Understand the sterile field how to approach and work around it.
Understand safe patient positioning in the following positions: Supine, Prone, Lateral Decubitus, High Fowler(Beach chair) and Jack Knife.
(If used)Understand computerized charting and how to use technology to provide accurate safe patient care.
Recognize frequently used Medication and their likely usage.
Well for me if It's a typical vaginal prep say for a Hysteroscope I do it this way. We use just betadine prep sticks. With the first stick I prep the thighs then suprapubic area than vaginal vault followed down to the buttocks. With the second stick I usually do a final thorough vaginal prep, leave the stick the vagina to straight cath and than done.
For Laparascope/hysteroscope cases. We prep lower first with paint sticks (see above) than change gloves and do an alcohol wipe followed by Duraprep. The idea here being not to splash betadine from the vaginal prep onto the abdomen (As was stated above).
Okay so You have 70 instruments in tray 1 and 30 instruments in tray 2, but your break person put 8 things in tray 2 that should be in tray 1 plus an additional set of stats were opened that throws your count off more.
Now if these trays are broke down into Allis, mosquito etc... it's an easy fix, if it's some inventory deal game over.
Efficiency often over rules safety even inadvertently. We as Nurses hold the trump card which is advocating patient safety and I can guarantee if your need to slow down is that, You'll never be chastised.
There is a limit though, Some nurses stick to there guns and count every item no matter the case. Your not going to loose an allis doing a knee scope.
Ever run over a cable as you were moving a bed, CARM, Monitor tower? It's for ease of replacement. Before you had to have Biomed take the equipment or send it out to be repaired because of a cord problem.
Truth is thats another common problem the cord simply pulls out, actually I think Valley Lab has a nice bracket that keeps the power plug in place. Though honestly, I wouldn't want everyone to go this route I can't tell you how many times I've had to steal a cable from a piece of equipment we weren't using to prevent having to delay and hunt another down.
So what kind of troubleshooting algorithim do you guys go through? Do you rely on someone else (Biomedical technician)?
What tips do you have?
Here's some of mine.
Make sure it's plugged in both at the outlet and into the machine.
Try turning it on and off (Most issues respond well to simply going through their boot restart I guess the engineers call power cycling).
Bad picture on the monitor? Make sure if you have Digital imaging that your monitor is using this input (all these monitors have VGA, SV, DVI Being the digital one that provides the best picture) Another thing is wipe the end of lens with an alcohol wipe this usually clears up any residual detergent thats caked on (Foggin is a whole other issue hot water or fog out is the answer).
Bipolar cable not working? Try bending the little tabs out a bit so they make better contact on the inside of the generator.
I realize there are systems in place for dealing with these issues but I think you get a lot of Credit for problem shooting on the spot.
BTW ever had an instrument stick? Open a chromic gut suture and pour the preservative liquid thats in it around the stuck part. It works almost every time.
I think it's ultimately why Nurses don't go into this field. Insecure Surgeons who think that if they're chosen few aren't in the room the have the right to behave badly. Wanna know why? Because certain peers and mentors teach them if they want to get what they want they have to Yell and Scream (I know because one of our graduating fellows told me exactly that.
Here's another one. They don't want to take any responsibilty to learn the equipment they use. "Get me someone in here who knows what they're doing". I say Get me a surgeon who knows what they're doing.
Verbal abuse is a crime. If your facility doesn't treat it this way Leave!
No matter how close I am to a Surgeon or how much I like them I write up verbal abuse every single time and send them to our Clinical Practice people. For me this produces results.
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