FlyOR

You know you're an OR nurse when you hand people stuff that they murmur under their breath unintelligibly that they want. You know you're an OR nurse when you figure out you've created a "sterile field" around whatever vegetables you're chopping/ washing on a cutting board. You know you're an OR nurse when you require "read back" for every damn question someone asks. You know you're an OR nurse when someone says "Eww Pus" and you want to see from where and how much. You know you're an OR nurse when your kid comes to you with a good size cut and is bleeding and you say, "aw that's not much, put pressure on it". You know you're an OR nurse when you finish your dinner before anyone else has made a dent in theirs.

I thank you all very much. I feel a bit better about my struggles with this mess. I guess my "keep your mouth shut" policy is really the best one, amazing how that one always works. I will explore the Al-anon meetings, I think it would help my spouse and the rest of us. Many thanks! Happy Thanksgiving!

Ahh. In this case, I am going to have to admit to not doing my homework. Jeepers, I know better! I guess I just thought that no one would come here and admit that they loathe a mentally fragile individual who happened to be in their sphere. And, as a nurse, I guess I thought I should have a better grip on this. Please forgive the any assertion that nurses aren't human too. Not what I meant to do. How do you handle this though? So far, I am trying to keep my mouth shut, because nothing I have to say is helpful. There's no way to cut this person off, the only thing I can think of is to try to facilitate an escape pod for their immediate family. I think this person has had wayyyyyyyy too many chances, and sometimes if people do not get to rock bottom can they finally heal?

I haven't done any psych nursing since nursing school. At the time, I actually did very well at it, and it was a definite option, however, I decided it was too much like my previous job and I wanted something different. Here's what I would be grateful for- some tough love advice. I hope this is useful for other nurses, and I really do not know who else to ask. I recognize that mental illness is indeed an illness, and has all kinds of pain, suffering and maladaptation. I was always able to retain the "unconditional positive regard" with my patients. I saw their suffering, their distance from their families, and how it decimated their life and I tried to help. I know it's often the result of biochemical imbalances, genetic disorders passed on, and maladaptive responses to life. I know all this. However. I find that a person close to my spouse, whom he cares for a great deal is apparently mentally ill- bipolar and an alcoholic. I have never liked this person, I have always found them infantile, selfish and with that ever present "poor me" mien that is inevitably irritating- and that was before it was discovered that they were an alcoholic. This person has done a lot of destructive things, and currently is causing a ton of pain in my spouse's world. This person has a family and is currently destroying its fabric. I am finding it really hard to do anything but despise this person, and I realize that, that fact is indeed a character flaw on my part. Please help me re-acquire the nursing regard, the constructive way to see this person. Slam me for not seeing what I should see, I really want to be constructive and help, not be judgmental and a silent source of negativity. If this person had not really hurt those that I love, I guess it would be easier, but as a nurse, I find my loathing unacceptable. I would be grateful for an experienced psych nurse's view on this. Thanks.

Pick up the newest edition of Periop standards and read it cover to cover, almost everything about being an OR nurse is in there, and it will give you the knowledge as a base while you pick up the rest. With already having training in how to move/ handle a sterile field, you do have experience. A lot of being an OR nurse is hearing and seeing; hearing what the scrub/ surgeon need and seeing every single thing that is happening to the patient. I think that if you show them that you're willing to learn, willing to help and can take criticism you'll do fine, but you really need the basic knowledge behind what we do, so that you can ask good questions and think critically about every patient. Examples: Positioning Anesthesia meds and allergies Diabetics and their needs in the OR Obese patients and normothermia ETC. Good luck!

Bravo! What a generous post Esme! I wish I had seen that when I was in anatomy! Just a suggestion, if you google "cardiac animations" or really any animations, you can get some good stuff. Sometimes the visual is the trick for certain learners, it helped me during my NCLEX studying. Hope this helps and I LOVE the backed up toilet analogy!

You know, I have thought a lot about prayer when I am at work, mostly because I am doing the praying. Sometimes, I have been in cases that have been so dicey, that I have thought that one of the the reasons I drew it, WAS to pray. I think that at any institution, framed properly, prayer can be there, just like at any institution, the absence of anything religious can be there. Like the old adage, it isn't what you say, but how you say it. This is an OR board, we are with people the moment before they or their loved ones are cut open. Choices, to pray or not to pray should be given gently, but not done away with.

LOVE Ortho! Great big femur fractures, drills, plates, screws, Jackson table and the satisfaction of "fixing"! Like General, but only at certain times. General surgeons can be mean )&*()*&(&& s. Cases are great, just who you're working with. Urology, can't say I love the cases, but our urology team is made up of very very nice people. Pleasure to work with them. Eyes? Snooze. Especially after lunch. Except for ocular plastics, I do like that. That's the great thing about the OR! So much you can do!

Using the argument "you knew it when you took the job" applies only so far, and likening pregnancy to various diseases doesn't hold water. Pregnancy is a life event, not a disease. There are two lives affected and protective policies benefit not just the pregnant woman but the employer. From a purely economic point of view, it is in neither the employee or employer's best interests for the pregnant person to experience complications from the environment of the OR. Exhausted pregnant workers are more likely to take disability, use sick time, and terminate emploment. None of which is free for the employer. There are also valid and real liabilities for the employing institution. Imagine a day in court where a lawyer can prove fetal harm due to Xray and bone cement? You do not want me on that jury. Add to that is the inconvenient reality, oft discounted by employers but certainly germane to their bottom line, the expense of training and growing a productive OR nurse. It takes a year to bring an OR nurse to function. Optimal productivity is estimated at 3-5 years and rises from there. Losing an otherwise productive employee because of a nine month window of decreased (arguable) productivity is stupid. Finally, NURSES ought to know better and take better care of one another.

Yup, these responses are pretty typical of what I have seen in nursing. I come from outside the healthcare industry and I have been pretty appalled by how it deals with pregnant workers, especially considering the previous and continuing prevalence of females as nurses. The OR is a physical and high stress environment, with quite a few dangers to a growing baby. The data shows that more needle sticks and exposure happens to OR workers than other healthcare workers. Radiation exposure is not monitored nearly well enough, with wrap around lead rare in some facilities because "it's expensive". Bone cement is a known danger and I am glad my facility doesn't require pregnant workers to be exposed to it. AORN standards are primarily for standing surgeries, sitting is basically frowned upon unless absolutely necessary, such as eyes. Standing all day is tough on anybody much less a pregnant body. Even the maternity leave is appalling. I was able to take up to six months post partum, as that is industry standard in my other industry. The last three month are unpaid, but at least they're available if you want them. It allows for the best case breast feeding advocated by "health experts". Unless you're a nurse, of course and need to pump every two hours. Good luck getting that from your unit. I remember a nurse that returned to work after having a baby and the breaker came in to do breaks for us. The breaker asked me to go first because, gesturing at the other nurse, "she takes too long". I asked why and she made a face and said "she's pumping". I fixed my eyes on her and said, "let her go first, she can have my time". Nurses need to start taking care of eachother. The brutal atmosphere so often prevalent in healthcare needs to change. As it stands nurses are still predominantly female. Females get pregnant. Recognizing this and adapting for it is just common sense. Finally, be advised that depending on your job, if you are physically unable to do YOUR job, you probably qualify for unemployment, unless your facilty makes another position for you.

When I was in nursing school, I just kept repeating to myself "shut up and learn". I think that helped me in orientation. Nurses who teach tend to like to teach, but it can be pretty thankless when you have someone who doesn't want to be taught, or is more about their ego, than taking care of the patient. Here's what I decided: 1. criticism is your friend. If someone cares enough to give you criticism, say thank you. It may hurt, you may think you don't need it, but say thank you and try to figure out how to use it. 2. If some one rechecks or confirms your work in the OR, which I WILL do if I am relieving you, don't take it as an affront, be happy that I am confirming your good work. I want you to do the same to me, because if I miss something, I damn well want to know about it. 3. Lose any and all attitude when it comes to counting. Yes, I know there is no way that you will lose a lap pad in that incision. My chart requires two counts. If anything goes wrong in the case, I don't want any aberrations in my charting. If you ditch your drapes after just counting the sharps, I have to dig through the trash to confirm the second lap count and guess what? Now I KNOW I don't want to work with you again, and you're not a team player. Good for you asking the question.

Rather than PRN can you switch to part-time? At least that way you might have it easier dealing with the mandatory OT. Also, try going out of the box, can you work a weekend day? One night and a day? Sometimes you just have to start asking the right questions. Finally, if you can tough it out for another six months, you will probably have more options. The cold hard facts: -You don't have floor experience, so that will be a tough transition, which isn't something that sounds good for you right now. -OR nurses are expensive to train. Get to your two full years, get your CNOR, and you'll be able to get a PRN gig somewhere. Look at the back of the AORN journal, there are a lot of openings for OR nurses, hospitals just do not want to pay to train them. Often, there are jobs that are not advertised, but a unit will jump on an experienced OR nurse. I know mine would! -You'll have more leverage if you tough it out. 1.5 years isn't a lot in OR nurse years. Two years is better. Your hospital is short sighted, they'd be better off keeping you in some capacity. You're trained, you know where everything is, you know your surgeons, and frankly, they haven't gotten their money's worth yet. Usually it takes three years to recoup training costs. Not to mention, if you're a good employee (which I am sure you are) whydo they want to gamble on someone new? Look for another gig, then if you find one, go to your manager and state your case. If they're smart, they'll realize better to keep you in some capacity than lose you to a hospital that did not pay to train you. Best of luck!

I once pulled my sterile mayo over an undraped patient. Everyone has dumb moments. The fact that you realized it and immediately reported it says that you are where you should be. Sterile conscience is just that, a conscience, and the people who would scare me are the ones that won't say anything or worse just let it go. Hopefully your OR has a good "there but for the grace of God go I" vibe. Every OR should have a zero negatives policy toward a mistake and just focus on rectifying it. If you're like me, your head is thrumming with self recrimination, but if you're like me, you probably don't remember other staff's mistakes, so they probably don't remember yours either. Be kind to yourself.

I don't know if this will help, but I treat a day in the OR like an athletic event. I make sure I go to bed early, prepare everything I need the night before and kind of block out life for those eight hours. I eat protein at about 0630 and then a second protein breakfast during my break. (I joke that I have become a hobbit-what no second breakfast today?) I wear Danskos, compression knee highs and if you can elevate one foot on a stool or the bed, it helps your back in a long standing case. (FYI, never touch the bed if there's a microscope involved, you'll get hissed at by everyone, for good reason.) I also have found after three years that if I keep myself physically fit, I weather work days better. Finally, if you're going to see something that might gross you out, look at it purposefully. I remember one case that if I was going to lose it, it would probably be that one, so I made myself stare at it, and then I shrugged. Okay, gross, let's fix it. Hope this helps.

You've been given a lot of good answers, but as someone who is still relatively new to healthcare I see the circulating nurse in the OR as the minimum. Surgery is the cutting open of the human body. The patient has no defenses except those that the team provides. That requires knowledge and expertise. Being a patient advocate is not just caring, it's knowing your stuff so you can see danger coming. I know plenty of nurses that I don't exactly like, or think are kind people, but I would have my family member with them in the OR, because they are hell on wheels for their patient. Expertise = safety. The OR is a team, there's a surgeon, anesthesiologist, a scrub tech and the circulating nurse, at minimum. The surgeon and the anesthesiologist have their responsibilites and often they are very much in their own head. Knowingly or not, they rely on me to catch what may be outside their present view. That's why I am there. Effective safety protocols have layers and I am the last layer. Without my education, how would I know what often simple dips and rises mean? Everyday I tell myself that my goal is to be THE nurse that I would want my family member with. I want someone who will assess, observe and check all throughout the case and sorry, but I want them licensed and responisible. At the end of the day healthcare is very elitist at heart, especially amongst doctors. Whether or not you are listened to and respected rests on your expertise and that requires education and experience and THOSE allow you to call STOP and be effective.