Mine was:

Asked for one? Bring in two.

That simple rule changed how I prepared for cases. I started anticipating instead of reacting.

What's yours?

When I arrived at work this morning my room was scheduled for two lap choles (general), a skin grafting (plastics), followed by and ORIF distal radius (ortho). We started the first chole and they move the plastics case to a different room. About an hour later they moved the ortho case to a different room. Then moved a colorectal case in to follow the choles. . Soon after they moved the colorectal case back out and put the ortho case that was originally in my room back in. Lastly, they put a lap appy add on in. All of these changes were made in an 8 hour period. And keep in mind that we usually run 16 rooms and only had 8 running today because the case load was low due to the holidays. Add on's were minimal and we had plenty of staff standing around. Is it normal for cases to be moved around like this at other hospitals? There are times when the cases in my room change 4 - 6 times in 8 hours. And all the rooms are like this so it's not just mine.  And it's also not uncommon for a room to go from a lithotomy OB/Gyn case, to prone neuro case on a Jackson table, to a supine vascular case on a stille. It's almost impossible to prepare in advance with all the changes they make through the day and it feels so inefficient to constantly move beds and equipment in and out of the same room. We have two robot rooms but none of the other rooms are assigned to a specialty. Any feedback is appreciated.

More specifically, what is your policy on procedures such as a radical orchiectomy inguinal approach? Inguinal hernia? Procedures where there may be a conflict of thought process. 

I'm interested in possibly transitioning from cardiac stepdown to the OR. I was wondering if there's any classes I could take, credits, or certifications I could earn to boost my resume? Most OR residencies offered near me are for new grads only. Any help or advice is appreciated.

I have been an outpatient operating room circulator for 4 years now, mostly in orthopedics. I enjoy the outpatient life, however, the higher pay and benefits of working at a hospital are very appealing to me. The only thing that I am hesitant about switching from outpatient to the hospital is dealing with sick patients in critical care situations. I worked in the ER during Covid and that basically scarred me forever LOL. I went from the ER to outpatient life after a year of working in the ER in 2020. I feel like I have my circulator skills down, at least in the orthopedic setting. However, because I am outpatient, our patients tend to be healthy, and there are very minimal emergency situations. Anyways, I'm wondering what the environment is like working in the hospital OR as a circulator. The hospital I'm interested in is not a trauma center and does very minimal pediatric procedures. How is the hospital OR stress when it comes to emergencies? Is anesthesia always there to help? I am worried about being alone and ill-equipped in those situations. I do have experience in code situations etc and tend to handle those well, but I get VERY anxious if that is a constant in the environment I am working in. 
signed, 

an anxious nurse. 

I was wondering if it's just my specific department/coworkers/managers or if it's like this everywhere. I feel belittled and unimportant as a nurse, by the scrub techs. Even some with maybe only 3 more months working experience than me. I am basically a task-rabbit there to assist their needs. They order me around to move things like trash cans, have me run for supplies like crazy, and basically throw their trash at me. Today one misused a pulse lavage and splashed me in the eye with irrigation containing blood and tissue- no apology. 
 

I already struggle with the transition from being on the floor using my skills during school to being a circulator. I know there's a different skill set not taught in school, but I'm wondering if I belong in the OR.

Is it just my specific unit or is it like this everywhere? Rude surgeons, anesthesia, and patients I can handle- I'm just over techs who are under my license, bossing me around as I'm their subordinate.

The problem with charting during a case is you are taking your eyes and attention off the field.

If you chart during a procedure does the computer face the field?

Do you wait until after the case to chart?

What is your practice?

I have been trying to find an answer to this question but have not come across it so far. I am currently working as a CSFA and I am in nursing school. I was wondering what I need to do to become an RNFA once I get finished with nursing school? I am hoping I don't have to take another assistant course because I have been working in the operating room for 10 years. Seven years of being a CST and 3 as a first assistant. If anyone has any information it would be great.

Thanks

Can you put a Bair Hugger over a blanket ? Does this make it useless?

There are those who swear you should only put them directly against the skin, others who put a warm blanket on the pt then the Bair Hugger over it.

Is there any evidence for/against either?

I tried looking up manufacturers directions and stuff, nada

Would appreciate any feedback! Thank you

We are interpreting RNs restocking a med machine as dispensing drugs, which, as I understand it, is against nurse practice acts plus we do not want to restock narcotics. 
 

Does anyone have any info about this?  Upon reviewing the health system policy, no where within that policy does it say nurses are responsible for restocking a medication machine; pharmacy staff are the only staff stated in the policy to have the task of restocking the machine.

1. I understand that research backs this up, that this should reduce the rate of infection, but the vagina isn't in our surgical field. It will have a nonsterile blanket over it after it's prepped which would totally contaminate the area. If we are doing a vaginal prep, we should do a real prep with stirrups and sterile sleeves over the stirrups. However, placing the patient in stirrups would prevent us from placing a safety strap to keep her safely secured on the bed.

2. They are recommending that we prep with chlorahexadine, which is contraindicated on mucous membranes. It says right on the manufactures IFUs "do not use in vagina." We're told it's "an off label use" and they have been doing it for years at our bigger sister facility.

As a surgical nurse, I'm a stickler for following the standards of care. In this case, I'm just finding the logic contradictory and it's causing me angst. Can anyone help me understand or give me an alternative I can propose to management?

In April 2017, about 8 months now, I made the switch to the main OR in a trauma hospital. At first I felt very happy about my decision and was so excited to get to work and learn something new. It took some time for me to get used to it. I felt stressed out every day and would sometimes come home crying. Right now I feel somewhat comfortable and definitely a lot less stressed. I mostly do orthopedic, spine, general, and plastic cases.

Recently I have been feeling more and more regret for changing specialties. I feel like I am not using a lot of the nursing skills that I used to in L&D and I don't have a lot of patient interaction like I used to. When people ask me about what I do for a living, I used to be so proud to say I work in L&D and now when I talk about my job in the OR, I don't feel the same sense of pride. I feel like my heart is still in L&D.

When I worked on L&D I had a 12 hour night shift position. The one thing that I really like about the OR is that I work during the Day 7am-3:30pm. My fiance loves the fact that I am home every night for dinner. But I feel miserable waking up every day for work and really miss having more days off during the week.

I feel so torn right now, because I like working during the day, but don't really love the work I do. If I went back to L&D, it would be straight back to 12 hours Night shifts and would take a few years before I could get onto day shift.

Should I go back? Or just learn to love the OR? Do you think 8 months is too soon to judge whether I really like it?

Watched tons of videos about PACU and OR nursing and shadowed a nurse for half a shift for both. Now I can't decide which one to apply.
I tend more toward PACU but the fact that pts are in critical condition and the training is like ICU training made me hesitate the specialty.

If you work in OR or PACU please tell me about your experience. which one is less stressful? Why did you choose OR or PACU and what do you like/dislike about your specialty?