New to USA operating room

[marie88]

Hi everyone,

I'm new in USA, I been working in UK in the OR, I usually work in outpatient surgery where I was doing scrub and circulate in ophthalmic and ENT cases. Now I'm here in USA, they put me in main OR, which is 17 OR suites. I was so overwhelmed with the OR, as if it is my first time to work in OR. They have ortho, neuro, vascular, gen. surgery, cardiac, peds, cases. I am used to UK style where loads of nurses in the room to include also some orderlies. But here in USA, it's one scrub tech and one RN. And if the stuffs you need are not in the room either to call an orderly to get it or page overhead. I'm still on my orientation, could somebody give me advice as new in USA and new to main OR. I was thinking of transfering to ambulatory units but the experiece I'm getting in the main OR makes me a complete OR nurse. Only thing I"m scared to be alone in OR, my orientation will finish soon. What will I do? Is it all the same setting everywhere in USA?

Is anybody here work from other country like UK then to USA? How would you compare the work?

I'm so familiar with the instruments coz they do call different names from what I learned in UK. I got my book 'Instrumentation for oerating room". Any sugestion?? Especially the ortho cases I'm so confusion with the implants.

Can somebody help me. I can not learn everything in just few months. Any websites about operating room. Your help is so much appreciated. Thanks a lot. :balloons:

[zuzi]

I don’t know in USA, but from are I am from, we used splint and cast for the most synthesis and realignment fractured bones with screws and plates, or only with Ender or Kuncher centromedular sticks or metal wires, for grafts surgeries…I don’t remember now many…they are a lot. Ask who will do the splinting or casting, do you have tech, how do you contact him, be prepared before! Or you will do by your self?

Ask your self…”IF they will let this surgery without cast or splint or immobilization….COULD IT BE DAMAGE?” If the response will be YES, be sure that they can require a cast there.

Oh Yes and ideea to talk with surgeron before the surgery is GREAT, ask about the surgery and what aditional material he need it, don't let him to see that you are scared (some of them could be little jerks) but in the same time be honest with you and with him if you don't know about, be professional, ask him what number of screws he want, if he need them (he can mesure aprox over the Rx) how many he belive that will need it, what other altenative of surgery he will consider if the main one could not be applied (from some resons)..be prepared for other altenatives, if he will use electric coagulation or prefer ligatures (prepare all), think and talk with him before surgery...is good! Be professional!

Belive in your self...you are a good.. a good surgery ortho nurse! Zuzi hugs you!

[TracyB,RN, RN]

Usually, we will splint for ORIF's (open reduction internal fixations) of extremities... Sometimes a full cast, sometimes, just a posterior mold with Ace wrap. We'll splint extremities. If we're using pins, plates, screws we have the splinting materials nearby. Depending on size of extremity or patient, the splint material may vary. May use the rolls of plaster cast material... smaller on smaller patients or arms (2-3 inch usually) & 3.5-5 inch if a lower extremity... Know what I mean.

If we do Ex-Fix (External Fixation) we usually just wrap the pin sites. Some docs like Adaptic, others like Kerlex soaked in Betadine PAINT. Another one of those surgeon preference things, LOL

We have a plastic surgeon that uses the Wilson frame. I'm not a fan b/c I worry about the frame slipping. I really like the Jackson with the spine top for prone surgeries. It's very intimidating at first, but once you get used to it, it's not so bad. Just have to remember that patient safety is first & foremost & never let anyone rush you when setting up that table. Our surgeon is the bomb. He helps & as long as he knows we're not lollygagging around, he is always so helpful.

Ugghgh, I can't wait till this stupid medical leave is over & get my butt back to work.... I miss it so much. Geeez, how weird is that?

[umakemesmile]

We use many of Synthes products. Synthes make a great chart of what plate and screws are used where. If your faciltity does not have ask the rep for one. This helped me alot in my early days, esp. on call. They also have charge sheets so you can keep track of what being used during the case.

Preference cards are a bible, but only if they are kept up to date. (My pet peave at my facility.) But I learned only by doing over and over.

I agree with TracyB, ask for more time in the speciality you have trouble with. I think sometimes in a muti-speciality OR you are a jack of all trades-master of none. And my motto is: They can only kill you once. LOL