Stupid little mistakes....

  1. I am still learning to circulate, and my orientation is going so so at best. Everybody at work, who have been there a long time say my orientation is really really bad. But, I have nothing to compare it to, so I dont know. I will say, there is NO consistency. I am being taught by travelers, I am with a different person every day.We do everything, so its a little hard to be proficient at one thing, and I dont think there is one procedure that I have seen even twice, or 3 times, and I have been there 6 months.
    Right now I know basic things, but I am still struggling with what trays we need for cases ( we have reprocessing "issues" to complicate things further) , and basically, if I am with someone that makes me nervous, I forget stupid little things, like forgetting to hook up suction right away, or forgetting to chart something I know I need to chart. Does this go away with time? Sometimes I feel so inept!!! Did anybody feel like this when they first started? Did anybody else forget stupid things that they knew they needed to do?
    And, sometimes, I get so task oriented, because I have to learn everything WHILE I AM USING it in a case, I get focused on that and if the surgeon asks for something I dont hear it, well, you get the picture... please, some words of wisdom....
    I have done ER, ICU, and thus far this has been the toughest for me, and I dont know why. Thanks guys!!
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    About RNOTODAY, BSN

    Joined: Jan '06; Posts: 1,074; Likes: 457

    28 Comments

  3. by   IsseyM
    Oh gee. I'm so sorry you're going through this. I feel for you. I can't speak from alot of experience because i've only been orienting in the OR for 1 month. I'm also a new grad so i feel so lost and unsure of myself. There is soooo much information to learn and to try and retain. You do have great experience but i've heard OR nursing is totally different. I've heard that it takes atleast 2 years to get used to working in the OR even if you've had previous nursing experience. I like to focus on one task at a time but of course as a circulator you have to learn to multi-task, anticipate and plan for the next action. I've noticed i'm also forgetful and i have to write things down. Maybe you can create a cheat sheet for yourself then you can check things off the list that you have to do with certain cases. This is what i'm going to do once i get my OR's system down. Well atleast you can hear surgeons, sometimes i think i'm going deaf because sometimes i have no clue what they're saying and have to ask to repeat it. You are not perfect, no one is so don't be so hard on yourself. Everyone learns at their own pace. Do the best that you can so you can provide safe and effective patient care. My opinion, 6 months is not enough time to learn and perform all the duties a circulator is responsible for. Hang in there and good luck. Take care.

    IsseyM
  4. by   brainnurse
    You won't forget those things once you get them into an automatic sequence. Every case, no matter what discipline, starts in a certain sequence....turn on the lights, plug in the bovie, plug in the suction, etc. If you do it in the same order every time, you'll find the groove, and it will be as mindless as getting in the car, putting on the seatbelt, putting in the key, etc.
    I've taught lot's of people in the OR, and it's a huge volume of information to take in, so I always kept in mind that they would probably only retain about 10% of what I told them, getting impatient is not constructive.

    If you ever learned how to read music, this is a good way to think about OR work. When you are playing music, you are always reading two notes ahead of the note you are actually playing. In a case, you are always thinking at least one task ahead of the task you are performing.

    Go girl....you can do this. Watch out for the vipers. Don't use the word stupid in the same sentence as I, ever again.
    Ro
  5. by   Lasoniamacaroni
    okay....do I work with you at the same facility???? You have just explained my day from start to finish. I am 3 months into a new grad OR orientation. I am never with the same person, EVERY SINGLE person does things different, which I completely understand. However.....It is sooooo hard to remember how certain people want me to do things. It's basically their way or the highway. They get disgusted with me when I do something that their coworker just told me was the "right way" the day before. I am talking about even the way I tie the garbage bag to the can. One person wants it in front, other in back, some don't want it tied at all, etc...do you get my drift.

    Don't get me wrong...I absolutely love the OR. It is definitely the place for me, but it is very very hard to get comfortable there and take everything in. I swear if I hear SEE ONE, DO ONE one for time, I am going to freak. Apparently I am slow, but I need to SEE A COUPLE AND DO A COUPLE! Our staff is very very shorthanded so they have been throwing me into procedures that I have never even heard of, let alone know how to circulate them.
  6. by   RNOTODAY
    Quote from Lasoniamacaroni
    okay....do I work with you at the same facility???? You have just explained my day from start to finish. I am 3 months into a new grad OR orientation. I am never with the same person, EVERY SINGLE person does things different, which I completely understand. However.....It is sooooo hard to remember how certain people want me to do things. It's basically their way or the highway. They get disgusted with me when I do something that their coworker just told me was the "right way" the day before. I am talking about even the way I tie the garbage bag to the can. One person wants it in front, other in back, some don't want it tied at all, etc...do you get my drift.

    Don't get me wrong...I absolutely love the OR. It is definitely the place for me, but it is very very hard to get comfortable there and take everything in. I swear if I hear SEE ONE, DO ONE one for time, I am going to freak. Apparently I am slow, but I need to SEE A COUPLE AND DO A COUPLE! Our staff is very very shorthanded so they have been throwing me into procedures that I have never even heard of, let alone know how to circulate them.

    OMg!!! so funny!!! I deff need to see and do a couple myself.....lol just the other day we were very shortstaffed (surprise) and I was "needed" in a room by myself......and I was , like, ummm, hello..I am on ORIENTATION, PEOPLE!!!! Craziness. See one , do one, teach one? yeah right, it will be a long time before I am able to teach anyone anything.......I would even be happy with the same 2 or 3 people, but it literally is a different person everyday, and it is a big place!!!
    One person says "can I give you a little tip" or, " can I tell you how I do it" or "thats good but this is how I like to do it".which is all fine and good, but when you have 10 people telling you that, and you are new, it will make you want to pull your hair out.And on top of it all, its allabout stupid little things that no matter how you do it, its all the same result, just not "their" way. But all in all, the OR is cool, once you learn it. Which I cant wait for that.....lol Brainnurse, issey, thanks for the encouragement!!!!
  7. by   MissJoRN
    Quote from Lasoniamacaroni
    EVERY SINGLE person does things different, which I completely understand. However.....It is sooooo hard to remember how certain people want me to do things. It's basically their way or the highway. They get disgusted with me when I do something that their coworker just told me was the "right way" the day before. I am talking about even the way I tie the garbage bag to the can. One person wants it in front, other in back, some don't want it tied at all, etc...do you get my drift.
    Aaak! The "always do it like this" people vs the "never do it like that" people! And my all time favourite- the "who told you to do it that way" people... OMG! Do you really want me to answer that?! "No-one would tell you to do it like that!" Umm, yes, they would, but I'm not starting a feud by telling who!

    The routine gets better, really, it does! Even for me and I only work occasionally in the OR- I'm not perfect by any means... I still smile at the surgeon "oh, I'm sorry, did you really want the bovie for this case??" but at least we're smiling now!
  8. by   ortess1971
    I've found that when faced with the various ways people do things, I just nod, smile, and do it the way they want for that particular case..So much of this job is adaptation and I learned the hard way never to say "but so and so showed me this way" I figure, one happy day when I am alone and experienced, I'll have my own tricks and ways of doing things. I also have been faced with doing things for the first time on the spur of the moment and I grit my teeth and jump in, but I am swearing silently to myself..Basically, I love my job and I know I made the right choice working in the OR. This job is not for the weak of heart though!
  9. by   CuttingEdgeRN
    Hi everyone
    Is there not a nurse educator for the OR there? If so, y'all need to be giving her some feedback. Our educator puts orientees in ONE specialty for at least a month or so, before moving them on to another. They do end up with different RN's some, but at least they see some of the same procedures more than once. She is like a mother bear to them also! We have BEGGED when short staffed for one of them to go it alone on "just this one little case" and the answer remains "NO, that isn't happening!" If desperate, then SHE circulates with them. I sure hope it all gets better for y'all! And don't let em run you off either! In a year or 2 you'll love it!
  10. by   Marie_LPN, RN
    I swear if I hear SEE ONE, DO ONE one for time, I am going to freak. Apparently I am slow, but I need to SEE A COUPLE AND DO A COUPLE!
    We have a woman at work that says this ALL the time, finally one day, one of the people that's been there for awhile was burnt on the phrase and said "Aw, do THIS!" and turned back to her table. No, not an effective way to deal, or professional either, but it did cut down that phrase usage somwhat lol.
  11. by   RNOTODAY
    Nope, we have NO educator right now, they are looking for one currently, which complicates things.
  12. by   NurseRoRo
    I have gone through a few preceptors as well during my time on orientation. One of them was a traveling military nurse to boot!! It took some guts to tell some of my preceptors, "I know you do it this way, but I'm trying to find my own way to organize/do it." or something to the effect of "BACK OFF!!" I also recall saying things like "Just give me a minute to figure it out" because as soon as you start to do something, they either finish it for you or tell you you're doing it wrong!

    I always have to tell myself, "bovie creates smoke...can't have smoke if you don't have power to the bovie...so plug the bovie in first, then the suction" even though the suction is on my way to the bovie machine!
  13. by   RNOTODAY
    Quote from NurseRoRo
    I have gone through a few preceptors as well during my time on orientation. One of them was a traveling military nurse to boot!! It took some guts to tell some of my preceptors, "I know you do it this way, but I'm trying to find my own way to organize/do it." or something to the effect of "BACK OFF!!" I also recall saying things like "Just give me a minute to figure it out" because as soon as you start to do something, they either finish it for you or tell you you're doing it wrong!

    I always have to tell myself, "bovie creates smoke...can't have smoke if you don't have power to the bovie...so plug the bovie in first, then the suction" even though the suction is on my way to the bovie machine!
    LOL... I know.... I find myself bouncing back and forth like a ping pong ball sometimes!!!! But, So be it!!! I havent been so assertive yet about telling them about backing off or whatever, I just smile and nod, and say ok, thank you, or whatever, but it is getting real old.....and I really hate it when I know I need to do something, but I am just about to do it, and they chime right in and tell me that I need to do it, and I feel like yelling ... " I KNOW, GIVE ME A CHANCE!!!!! "
    Then theres anesthesia. Some of them want you to call recovery the minute drapes are off,if not sooner, some dont want you to call until fully extubated and awake, some want YOU to insert air into their ett cuff, some dont care, some say you MUST insert air BEFORE you attach to the circuit, and theres so many of these people, you find yourself not even bothering to remember and just asking like an idiot all the time.......
    And positioning, some like gel pads, some say gel pads cant touch bare skin so they pad the gel pads with blankets.........:uhoh21: I cant get a definitive answer on this one. I really cant. So I just pad the way whoever I am with for the day does it and thats that!!!!! Shall we comapre notes? I love this!! I could go on all day!!!!!
  14. by   Marie_LPN, RN
    And positioning, some like gel pads, some say gel pads cant touch bare skin so they pad the gel pads with blankets.........:uhoh21:
    We cover our gel pads (sheets or pillowcases), so they're easier to clean (DuraPrep sticks to them easil, but rubbing alcohol takes that off.)
    Last edit by Marie_LPN, RN on Aug 31, '06

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