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Need advise regarding uncomfortable, disrespectful situation

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by Maria Crocker Maria Crocker (New) New

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TriciaJ has 39 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

14 Followers; 3,701 Posts; 38,465 Profile Views

On 3/3/2020 at 6:51 AM, NICU Guy said:

I have a theory for the ciculator's clothing. He could be lazy. He may be in the habit of wearing the scrubs from the previous day home. He puts the same scrubs back on to go back to work. Since the OP's case was the first case of the day, he came to work, clocked in, and reviewed the case. Once he was done, went the locker room, put his coat in the locker and put on a fresh pair of scrubs. Since the pre-op area is not a sterile area, he didn't feel the need to change before meeting the patient. I understand that it is still unprofessional and gross, but it explains him walking into the pre-op area with his dirty scrubs and outside coat on.

Yes maybe someone should speak to him about that because the optics just aren't good.

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Undercat has 41 years experience as a BSN, MSN, CRNA and specializes in Retired.

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On 3/8/2020 at 3:00 PM, Nurse_Mike said:

In a clinical once, while shadowing a floor nurse, one of the clients was due for a vaginal exam. I had been shadowing the floor nurse for all of her clients, and she had said she would ask the client if it was OK if a student observes her perform the exam. The client, looked at me long enough to see that I was of the male variety, and said something like "Uh, no." I told the nurse OK and that I would sit this one out. When the nurse came out, she seemed concerned as to whether or not I was either upset, or was OK with the refusal or lack of a learning opportunity (although there was to reason to feel this way other than to make sure we were on the same page). I had to reassure her two or three times that I had not given it a second thought. The client had the right to make the decision, it caused no problem for us as we were well staffed, and with female nurses. There may have many angles to look at this, but for me the short version is, it was probably a more comfortable experience for the client without me/a second nurse/a male nurse in there during the exam. The job got done and all was well. I have not been in the clients shoes, nor would I need to be, and my training can come later. There will always be a certain percentage of refusals by clients for any and all medical procedures when the regular staff tries to integrate a student, male or otherwise. I have read all of the previous dialogue and it was a good discussion. Just putting my two cents in.

Shades if the 70's!:)  Ate we back to "clients" almost 50 years later?

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jena5111 has 5 years experience as a ADN, ASN, RN and specializes in Tele, Interventional Pain Management, OR.

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On 3/1/2020 at 3:36 PM, skydancer7 said:

YES circulators absolutely are supposed to do their own pre-op interview and intake. It is abbreviated compared to the admission intake, but should involve introductions, name and date of birth, allergies, metal in the body, hearing aids/contact lenses, mobility limitations pertinent to surgical positioning etc. 

Everywhere I have worked, which has been  a LOT of places over the 10 years, circulators are expected to do a pre-op interview (abbreviated yes, though it sounds like the RN in this situation didn't even do that) and  sometimes clearly it gets missed because people are in a big-*** hurry to keep the conveyer belt cranking along because $$$.  Anyway, yes, it is redundant for a reason; if the pre-op nurse or someone forgets to ask about allergies, someone else can catch it.  That's why the patient gets asked the same questions several times before surgery.  It's so we can all catch each other's misses and mistakes before it causes a safety problem.  I can't tell you how many times EVERYONE missed something, and it's in the OR that the circulator finds out the patient still has their contact lenses in, or is allergic to latex, or is still wearing shorts under their gown and we need access.  System of checks and balances, and things still get through the cracks.

That said, yeah a lot of circulators just show up and wheel the patient back without so much as double checking the wrist band.  Doesn't make it good practice.

THIS. In my brief time as an RN circulator, I took my (abbreviated) pre-op interview seriously. That was most definitely time to catch details that had fallen through the cracks--which didn't happen often, but happened often enough to make me realize the value of my interview with the patient.

Moreover, that short time was my opportunity to establish a rapport with the patient BEFORE fentanyl. Introductions and role explanations from all peri/intra-operative team members are important. The patient needs to understand that an entire care team exists during surgery to keep him/her safe. The circulator should reinforce and establish the patient's trust.

I had an OR charge nurse yelling the 2 or 3 minutes late I would be wheeling the patient back WHILE wheeling the (luckily fentanyl-ed) patient back. "Jena5111, do you know it's 0733??!!" Super unprofessional and dramatic. Please note that this was not a consistent occurrence on my part. I understand the rationale for on-time case starts. However, the hair-on-fire mentality around case start TIME (among other things) made me realize that I prefer awake patients.

I found my way to a hospital-based surgery clinic and I love my job. Well, the nurse part of it. The admin part that happens in so many outpatient settings...not so much.

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Mywords1 specializes in nursing ethics.

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I understand this feeling in a way. I had no choice about the medical staff who assisted with my surgeries and procedures. The doctor, who was new to me did not introduce himself or even say hello, very unfriendly. Not much you can do except next time tell them your preferences ahead of time. Having a HMO or not is not so relevant. It is one thing for a male MD to operate and another issue when the personnel are male. 

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