Nervous about 1st day in OR

gaspassah · Dec 23, 2004

hehe

dont touch anything blue.

preoxygenate

get a set of vitals before induction

project confidence not only to your instructor but to your pt also.

make sure you know your drug dosages, for the drug you plan to use and one the preceptor may ask you to use.

check your suction before bringing the pt into the room

make sure your light works on the laryngoscope.

when you mask vent, keep your fingers on the mandible not the soft tissue.

learn everyones name in the OR.

introduce yourself to the surgeons.

slow down and take your time during the induction dont rush.

dont shove the tube to the hub, watch the cuff pass the cords.

VENTILATE the pt after putting in the tube (you would be amazed how many ppl forget this part, ive done it myself) make sure to put the vent on.

oh, relax, smile, have fun.

d

SproutRN · Dec 23, 2004

RELAX!

Ask questions, if you don't know the answer DO NOT make one up, just tell them you don't know but you will find out and let them know---look up the answer and get back with the person.

Sprout :nurse:

Oh yea, remembering to turn the ventilator on is always good! :-)

sproutsfriend · Dec 23, 2004

Oh yea, remembering to turn the ventilator on is always good! :-)

Yes, at least turn the vent on before the bag blows up to the size of a basketball.

susswood · Dec 23, 2004

be quiet and listen carefully

(some people might say "put up and shut up")

also, learn the phrase "that's a good idea..." and repeat frequently...

kmchugh · Dec 23, 2004

I was in Newman's first class, and I can remember my anxiety before my first day in the OR. It was made a bit more difficult by the fact that we also had TWU students in the Wichita area, and at that time, the CRNA's figured we should know as much as the TWU students knew. Of course, TWU was front loaded, and Newman is not, so we weren't up to the standards the CRNA's had planned on. I think that's a lot better now.

The CRNA's have done this for several years now, and are used to Newman students. You will be fine. Relax, take in as much as you can. Remember, the patient can stand not breathing for more than 5 seconds, so don't try to rush the intubation, and you don't need to give them 30 breaths a minute while bagging them.

Where are you doing your first clinical rotation?

Kevin McHugh, CRNA

deepz · Dec 23, 2004

My first day in the OR is Jan 2nd ......

You've already received good advice here, Maria. It's GOOD to be nervous about your first clinical; nervous is good: you're moving into a new phase, assuming new functions, taking a patient's life in your hands. (Not that that would put you under PRESSURE or anything....!) All I could add would be to always remember where we come from: as NURSES first, CRNAs bring special skills and insights to the bedside. Connect with your patients; you'll do fine.

deepz

Passin' Gas · Dec 23, 2004

hehe
...watch the cuff pass the cords.
VENTILATE the pt after putting in the tube (you would be amazed how many ppl forget this part, ive done it myself) make sure to put the vent on.
oh, relax, smile, have fun.
d

I remember hearing voices sing "Hallelujah" choruses with the first few intubations! I was so excited to see the 'pearly gates' and have the tube go into the light....I was gently brought back to earth by the CRNA whispering 'you're not finished, inflate the cuff, connect the circuit, make sure it's in the CORRECT hole!'

I have to admit I still hear the Hallelujah choruses after difficult intubations.

Have a great time on your first day and all that follow,

PG

Ava's mom · Dec 23, 2004

Thank you, Thank you, Thank you for the great advice!!!!

I will take it all to the OR with me. You guys are the best (and quite comical too!!)

Where are you doing your first clinical rotation?

I will be doing my first rotation at Wesley Medical Center. I am oscillating between pure excitement and the urge to vomit!!!

:rotfl:

Again, thanks everyone!!! Keep the advice and funny stories coming!!!

Maria

jewelcutt · Dec 24, 2004

My senior buddy taught me the 1234 rule for induction drugs and that's how I remembered them. Of course this isn't always the exact dose, but in the range anyhow.

1mg/kg- Ketamine

2mg/kg- Propofol

.3mg/kg- Etomidate

4mg/kg- Pentothal

I know different hospitals have different drugs in the drawer but it always helps to know the induction dose, maintenance, onset, and duration of these NMB's:

Succinylcholine

Vercuronium(norcuron)

Rocuronium(zemuron)

Pancuronium(pavulon)

Cisatracurium(nimbex)

One other point, some students will get their first intubations and those afterwards easily. Some students won't. Don't let it bother you if you have a hard time intubating, it's a skill and will come with time. It really is the best feeling in the world though when you do get that first intubation :rotfl:.

kmchugh · Dec 28, 2004

I will be doing my first rotation at Wesley Medical Center. I am oscillating between pure excitement and the urge to vomit!!!

Well, Maria, enjoy yourself. The folks in the OR at Wesley are great, and will help where ever they can. I assume, then, that your first clinical rotation is with WAC? They have some great CRNA's and docs that love to teach students. I think you are going to have fun.

Do me a favor, please. Tell the OR staff at WMC I said hi. There is a male RN there, a black guy named Ricky. Let him know I'm in Arkansas now, and that I send my best. Thanks.

Kevin McHugh

Ava's mom · Dec 29, 2004

Well, Maria, enjoy yourself. The folks in the OR at Wesley are great, and will help where ever they can. I assume, then, that your first clinical rotation is with WAC? They have some great CRNA's and docs that love to teach students. I think you are going to have fun.
Do me a favor, please. Tell the OR staff at WMC I said hi. There is a male RN there, a black guy named Ricky. Let him know I'm in Arkansas now, and that I send my best. Thanks.
Kevin McHugh

I will be starting with WAC Jan 3rd. I will tell them that you said "Hello". I am glad to hear they are student friendly!! Thanks to everyone for the excellent and comical advice!!! I will take it all to the OR with me!!

Maria