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Discussion

Operating Room as a new grad

So I recently started a fellowship new grad program about 5-6 weeks ago. And have spent about half that time in the classroom (orientation, arrhythmia, cardio) and the other half on the floor.

Today they told me I have about 1-2 weeks more on the floor and then they are going to be transferring me to the OR (I interviewed for it a few weeks ago)

This is my first nursing job, so im not really sure how much/difficult of a learning curve I have.

They DID tell me that the orientation (for the OR) would be like 6 months to a year. And that they use surgical techs for the scrubbing, although as a new grad they do make you scrub so that you can learn the role.

Any advice/opinions/suggestions/anything?

Ill add that this position is at a 250 bed community hospital, so I dont expect the cases to be ultra heavy. Although I know that bariatric and orthopedic surgery are what they are best known for

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    Also another thing I just thought of, and am kind of concerned about. Is yes they told me I got the job already into the OR, but im allergic to Latex (not anaphalctic allergic, but like nasty rash on my hands from wearing latex gloves)

    I know most hospitals "claim" to be going latex free, but i feel like most sterile gloves/ORs are almost completely filled with latex gloves

    Are they going to be reluctant/hesitant about me being in the OR because of my Latex allergies ?

    I mean ive worked as a surgical assistant in the past with surgeons before who wore latex gloves and never had an issue.

    Although in clinicals ive worn like latex gloves (over those crappy vinyl ones) and my hands had a nasty rash from it (not hives)

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    Most OR's are going toward Latex Free, since It's easier if the patient has a Latex allergy. Most non-sterile gloves are Latex free now, and they have to provide you with a Latex free option.

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    Most OR's are going toward Latex Free, since It's easier if the patient has a Latex allergy. Most non-sterile gloves are Latex free now, and they have to provide you with a Latex free option.

    Oh I know theyd have latex free options for me, i just wasnt sure if they wouldnt want me in the OR since I presume everyone else would be using Latex gloves (even though I dont think im "truly" allergic to latex)

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    (even though I dont think im "truly" allergic to latex)

    Just because you don't have an anaphylactic reaction to latex doesn't mean you don't have an allergy. A rash on the top of the hands is a very common sign of a latex allergy. Maybe you should go see an allergist. I work in the OR and have to wear latex free gloves. It's not an issue at all. There are a bunch of us with a latex allergy/sensitivity and we even have some surgeons who have a latex allergy as well.

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    Just because you don't have an anaphylactic reaction to latex doesn't mean you don't have an allergy. A rash on the top of the hands is a very common sign of a latex allergy. Maybe you should go see an allergist. I work in the OR and have to wear latex free gloves. It's not an issue at all. There are a bunch of us with a latex allergy/sensitivity and we even have some surgeons who have a latex allergy as well.

    Well I meant I dont get hives either. Although I certainly get the hand rash

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    Also I was told that they werent certain when my OR orientation will begin. That it "likely" will be in the next 2 weeks or so, although theyre not certain.

    So until then I will be working with my same preceptor on a medsurge unit.

    Is there anything specific I should be focusing on/working on while im on a medsurge unit to better prepare me for the OR?

    I know that my OR orientation is going to be VERY VERY long (and presumably thorough) but I figure im going to be extremely limited with my time on a normal medsurge unit so I should make the most of it

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    I have what I personally describe as a latex sensitivity. I won't have an anaphylactic reaction, but like you, I will get a rash. With the exception of our foley catheters, sterile gloves, and a few supplies used for cardiac surgery, the majority of our supplies are non-latex. I also work with several other people in the same boat as me. Our indicator glove (dark colored glove worn under the regular glove to show holes) are latex-free. I simply wear two pairs of these. There are latex-free gloves that are the same lighter color as the latex gloves, but I find them too thick and sticky to wear to scrub. There are also latex-free options for the foleys and the cardiac surgery supplies; they are more expensive and that's probably why we haven't completely switched to latex-free.

    As for what you should be focusing on while you're on the med/surg unit, I'll be honest- OR nursing is such a specialized area that I don't know that much would transfer over (disclaimer- I've never worked on a med/surg floor). You go from caring for 6-8 patients (or whatever your ratio is) to having a large team of people caring for a single patient. Some of the things you could focus on are surgical site infection prevention, DVT prevention, and other issues that can also be seen in the OR.

    To make the most of your OR orientation, set your own goals- don't expect your preceptor or the educators to make them for you. Obviously, set realistic goals, and that may mean just small steps in the beginning, such as placing the bovie plate and connecting monitors. I also highly recommend that you get a small pocket-sized notebook in which to keep notes. They can be surgery specific or surgeon specific. Because I work with only 4 surgeons (cardiothoracic surgery is its own team that doesn't float to other specialities), mine has little notes about surgeon quirks- such as Dr. X likes the large hemoclips but Dr. Y likes the small or Dr. Z is left-handed so the needles have to be loaded differently.

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    Appreciate the advice, the only thing I figured that I could really get the most out of on medsurge was to practice putting in foleys.

    I mean I have somewhat of a general idea about sutures/loading sutures as I worked for an oral surgeon so ive worked with like Vicryls and Chromic sutures.

    Sounds like the notebook thing definitely is going to be handy. Especially since such a big point they made during the interview process was the on call issue (and I live very close to the hospital) so I was assuming theyd want me to have one of the more rounded rolls so they can utilize me on call more.

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    Just keep trying and learning. Do everything they'll let you do, don't be afraid to make mistakes because even the very experienced RNs will contaminate or drop things, and don't ever let a doctor's ego get to you because they can just be children sometimes. If there is something you feel you need more experience or practice in, speak up. Whether you're scrubbing or circulating, it's better to learn the ins and outs of the actual procedure; it helps bring all the pieces together. Spending a little time in SPD helped with instrumentation and sets, too. I'm in my sixth month as a new OR nurse and am going into regular staffing soon. I've come so far from when I first started, and I'm so aware of how much further I still have to go. It's not a quick process learning, and people tend to be more understanding when they know you're new but eager and capable of learning.

    As for the latex allergy, it really is no problem, no matter what kind of reaction you have. Some people have reactions to the types of soaps we use. One doctor uses latex gloves but has a reaction to the cuffs on the gowns and has figured out how to get around that. They have to have non-latex allergies, not just for you but also for any patient with allergies, too. Seriously, it's no big deal at all.

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