Latest Comments by sandiegojames

sandiegojames 2,415 Views

Joined: Mar 30, '07; Posts: 42 (21% Liked) ; Likes: 23

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    Getting more efficiency out of your operating room assistants would without question be the primary area I would focus on to start with. In our OR, the periOP assistants are responsible for checking in with the room staff and having the equipment for the next case ready. If we are switching from a regular OR bed to a Jackson table they have it made and ready to be put in the room as soon as it is cleaned after the case. There are a number of tasks they can accomplish and be accountable for. I'd recommend "Introduction of the Operating Room Assistant to the Surgical Environment", the book is a training guide for the operating room assistant covering things like OR set up, equipment identification, patient transport and lots of other stuff. Operating room assistants are the least expensive employees for the hospital but can have a significant impact on cost effectiveness.

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    It isn't actually required to have a CNA cert to be an operating room assistant, of course it helps, but for those who move to a new state or have had their cert expire its a good option to paying for a new certification course. is a good resource for information on it as well. Considering there currently are about 50 million surgeries performed each year in the US, I think the job market looks pretty good...

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    @juniperpearl - If you are interested in OR nursing after nursing school you should definitely explore it. OR nurse internships can be difficult to get, but if you are already in the department, it really opens up opportunities.

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    tikiphil likes this.

    Wow, nice job on the career path with the army... You definitely made the most of your time! I was a Korean Linguist 98c, then nursing school and have worked in the OR for 12 years.

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    I'm an RN in the Operating Room, but while in school, like lots of students, worked as a CNA. At the time I didn't realize there were CNA jobs in the Operating Room. We actually call them Operating Room Assistants. The operating room assistant or operating room attendant shouldn't be confused with a surgical technologist. Think of the surgical technologist like an LVN and the operating room assistant like the CNA.

    This can be a great option for people considering working as an MA or CNA and want to work somewhere other than the floor. The job down in the OR is definitely different than on the floor or in the office.

    So what do our operating room assistants do?
    They transport patients from the floor down to the operating room.
    They assist the RNs and Surgeons with positioning and prepping the patient for surgery.
    They assist in emergencies by getting blood from the blood bank for the anesthesiologist to give.
    They take specimens from the operating room to the pathology department for help with cancer diagnosis.
    They help turn over the room between surgeries. This mean they help clean the room but more importantly they help configure the equipment needed for surgery. Depending on what kind of surgery we are doing, special equipment needs to be set up in the OR, and the operating room assistant helps with this.
    Some hospitals have the operating room assistant scrub into surgery to hold retractors during surgery.

    The operating room is fast paced, the operating room assistants work very hard, but there is also much more of a team in the OR. I think it's pretty common for CNAs to get back injuries from heavy patients, but in the OR generally you are moving these patients with the assistance of the RN, surgeon and anesthesiologist.

    Base pay is about the same for an operating room assistant as it is for a CNA, but often times take call in the OR. So in our OR, the operating room assistants work an 8 or 12 hr shift, but then at night or on the weekends will get $6.50/hr standby in case of added surgeries. So while you're on call you can be doing what ever you want but just need to be at the hospital within 30 minutes if you get called. And if you do get called you get paid time and half for the hours you work. So at the end of the day, the operating room assistants make a fair bit more than the CNAs on the floor do.

    You don't actually have to have your CNA certification for the job, but CPR is necessary. Then the training can either be on the job, or the ISIP operating room assistant course.

    And... You get to see a lot of cool surgeries....

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    CeceStar5 likes this.

    Nothing in medicine is worth it simply for the money. OR nurses or specialty nurses usually have the same base rate, but plenty of opportunity to make extra for call pay. Heart team and Transplant team in our OR are on call 50% of the time so pick up about $17,000 a year just for carrying the pager. Then make more if they are called for a case. But make no mistake, you work for it...

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    Yes it is a challenge to get into the OR with no experience. Our hospital system offers a training program for nurses about once a year. I would say simply applying for a position out of the blue is a matter of being in the right place at the right time. If you really want to be in the OR the proactive things you can do are... 1) Get to know someone from the OR who will keep their ears open for an up coming training program, it's always easier when you have an advocate on the inside. 2) Ask your educator or email the OR educator and ask if you can have an observation day in the OR even offer to do this on your day off. This shouldn't be a problem if you are an RN working at the hospital. When you are observing, pay attention to what the OR nurse is doing... Meaning pay special attention to what the RN's job is as opposed to the surgeon's. Asking appropriate questions to the OR nurse will make you stand out as someone who is motivated. 3) See if there is a job under the OR management, I moved from the floor to a pre-op nurse position. While working in this position I made it known I was very happy to be working as a preop nurse, but was also very interested in the OR training program when available. In 4 months a training program came available and I was selected for it because I was right in front of them. I have seen this work for other preop and PACU nurses.


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    I was circulating a case the other day and the surgeon asked for an instrument we didn't have on the field or in the room, so of course the search was on... The surgical tech said he thought it lived in one of the sets but wasn't sure which one. So we ended up opening about three different instrument sets before finding the instrument needed, total pain.

    1. Does anyone else ever have this problem? and 2. Anyone have a good method/procedure in their OR so it's easy to find anything you need?

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    Our hospital just got fined $75,000 for self reporting that an Ortho instrument was found to have some bone fragments down in one of the small lumens that didn't get completely cleaned out prior to going through the autoclave. Does anyone else have SPD problems? Seem's like the instrumentation is becoming more and more complex. We have scores of loaner trays coming in from outside reps everyday. How do other facilities deal with it?

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    Just my thoughts on your questions...

    There are many many advanced opportunities that come from the OR. Management, educator, medical device sales, surgical first assist. OR nurses tend to be on the higher side of the salary scale simply because of the amount of call and extra pay for clinical lead positions and such.

    I would never recomend a master's degree for a nurse if money is the primary reason or even if it is very important. With only a couple of exceptions, getting your masters will mean you make less money ultimately simply because the increased ammount you will make will most likely not make up for the loss of income from not working as much while in your master program and the cost of the program itself. Hour for hour I make more as a staff nurse than the Master's prepared Nurse Practitioners and the Physician Assistants in the operating room, and get a lot more vacations time.

    One should only get a master's in nursing if they want to persue a goal for personal reasons. If you've always dreamed of being a Nurse Practitioner, by all means go for it, just don't expect to make a significantly higher salary.

    Working on the floor is never a bad thing. Floor nursing is the back bone of nursing and you will take those skills any where you go. There are lots of great OR nurse's with no floor experience, but the more you understand the other side of the fence the better.

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    delphine22 and ncube like this.

    If your goal is to become a cardiac NP, you need to go to the CCU/ICU. The role of a cardiac OR nurse, while highly specialized, is a very different skill set than what is required of an NP. As far as just being trained as a heart nurse in the OR with out any other responsibilities, I'm not aware of any reason or programs for training OR staff this way. It may exist, but I don't see the point. The work done in the heart room as an OR nurse is built upon the experience of being a good gereral/vascular OR nurse.

    If you want to be a cardiac NP involved in the OR scrubbed in for procedures there may be some benifit of having OR RN experience, but not mandatory. The CCU/ICU experience will however be mandatory without exception.

    The OR is a great place to work, but if you want to be an NP, you need the critical care exp.

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    I'm sure regulation varies from state to state. Here in california we are absolutely not allowed to activate the c arm or move it after it has been used on the patient ie reposition the c arm. The only thing we can do is move the arm prior to it's use on a patient. The notion of acting under the doctors license at our facility is not allowed.

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    My mother is also an OR nurse and I just got this email from her today. Something to think about when you prep with duraprep or probably chloraprep.

    "Hi----Hey just want to let you in a a bit of advice----today I was prepping the pt for a discectomy--we do the iodine scrub and paint first then follow with dura prep. Well I hit the top of the duraprep with my hand to release the paint and somehow it shattered in a funny way sticking a knifeblade like piece up thru the top of the plastic which went into my hand--of course it was sterile but went in probably 1/4-3/8 inch and if it had hit the right spot may have caused some damage. We have done thousands of preps and have not had that happen before but it was not good---spent about 3 hours in the ER having it x-rayed and probed to detect if any fragments were in the hand----I will live and be quite fine but just want you to be aware---I think I will hit the end on something else other than my hand after this tho that will cause the end to be unsterile---Chat with you later---Love, Mom"

    It's always good to have mom looking out for you.


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    midlife_nurse and ChrisRN08 like this.


    It has a bunch of quizes on a lot of the surgical instruments with really good close up pictures.

    You can also check out amazon, there are a few books which are nice resources, but the site above is probably the best one on the web.

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    As mentioned in the first post, jewelry should be removed before coming to the OR. There doesn't seem to be any arguement agaist this.

    However, to say "Cultural considerations comes second to safety" is not always true. An example of this is honoring patients right to refuse blood or other tissue on religous grounds dispite it being the best treatment.