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  1. jackandjill123

    Losing and Finding Identity in High-Stakes Surgery

    @Sirl - can we get her to write more great content!?!? What a talent.
  2. jackandjill123

    Losing and Finding Identity in High-Stakes Surgery

    Wow wow wow! This girl is a phenomenal writer. Her message is clear and her willingness to expose her vulnerabilities brings humanity to our tough profession. I love her writing style and her two articles thus far reach far beyond O.R. Nursing. Any chance she'll be a regular guest contributor? This article was discussed by many in our surgical lounge today - love it, love her!!!
  3. jackandjill123

    AAA Ruptures

    I have been scrubbing more vascular cases lately, which includes "stat cases". Anybody have much experience with AAA ruptures in the operating room? I've found them to be very sad and feel helpless in the despair.
  4. jackandjill123

    Engagement Rings in the O.R.

    I recently got engaged. Looking for any recommendations on how to keep my devotion to my fiancee close to me, but still be able to plunge my hands into two sets of gloves (6's over 6.5's LOL). Does anybody wear it on a chain or something else or just leave it at home? Seems so silly.
  5. jackandjill123

    Interested in CVOR nursing

    Hi - I took it upon myself to make a guide that really tries to outline what it takes to get into CVOR and more importantly, what it takes to thrive. I have been so disappointed when very talented OR nurses shun the opportunity to scrub in the CVOR rooms. Yes, it is one of the most intense jobs in any hospital...but it should be, right? Yes, you have to sacrifice time to take call and help resuscitate life into patients who have aortic dissections...but no amount of money can replicate the feeling of knowing you were integral to it, can it? Yes, patients will expire on your table - before your very eyes as you fight...but you were the one fighting for them, weren't you? I am so inspired by nurses who look at CVOR as a challenge and not as a 'danger zone'. I've been humiliated in the CVOR - was it right? No, but when you start to understand what's on the line, it's mind-blowing. I'll never forget my older sister's friend when we wheeled her in for a re-do AVR / MVR - being able to hold her hand for that walk will be in my heart forever. Knowing that I was with her takes away the pain of what ensued. But, I couldn't think of anyone else that would have done as much for her as we did - we fought and fought and fought...and lost. I live with guilt, but much hope too.
  6. jackandjill123

    Help getting in OR

    Hey there - my friend will be opening her state-of-the-art plastic & reconstructive surgery practice in Dallas in September. She is looking for a scrub nurse who she can train from the ground up and eventually have her become her first assist for all of her major cases. I saw this post and your location, and thought I might pass it on.
  7. jackandjill123

    Shock Trauma OR Offer!

    This is all coming so fast. I was recently offered a chance to scrub on our open-heart team full-time. I had interviewed at Shock Trauma at UMMC a while back, but never heard back, so figured (as most would) that they had moved on to other candidates. I just got an email this morning offering a full-time position as.... I am so overwhelmed and have a lot of praying to do as I know He will provide me the guidance to make the right decision. So blessed to have choices... "Clinical Nurse II - Shock Trauma Operating Room Work under direction of attending trauma surgeon and senior surgical residents First / Second assist in Level I trauma cases in the O.R. Assist in the trauma bay on resuscitative operative procedures Assist in bedside cases (ex-laps, resternotomies, and other invasive procedures) in the SICU and ICU Perform initial physical exams, document data, and schedule laboratory tests Work as part of multi-disciplinary code team to deliver life-saving measures including bilateral thoracotomies and open cardiac massage Liaison between the trauma bay and operating room to ensure room set up for emergency intervention Participate in chopper retrievals of critically ill patients into the trauma bay from the helipad Perform all elements as indicated by ACLS, including external chest compressions, defibrillation and monitor meds Participate one weekend per month on SICU Code Team Help coordinate logistics between medical staff and pastoral care after patient expirations Attend and participate (as needed) in resident M&M sessions Assist with operative dictations (as needed)
  8. jackandjill123

    Surgical Missions (?)

    Hello all - I was recently asked to participate as a scrub nurse on a Cardiothoracic Surgery mission in Tripoli, Libya. I've always dreamed of doing something like this, but i certainly have pause. I've heard much about other types of surgical missions for things like cleft palates, etc., but never something with the acuity of CT Surgery. I know CT Surgery missions are not new, but based on my research, as expected, they do lose patients on the table. Has anybody done a CT-specific mission and any experiences that they would be willing to share and whether they would do it again? It sounds like a phenomenal opportunity, and I certainly want to help, but based on the background materials I've been given thus far, many of the surgeries seem very tenuous and lack many of the basic resources we are afforded in our CT rooms here. Thank you.
  9. jackandjill123

    Futile ressusitation

    Hi amzyRN - I think this is an excellent discussion topic and one that we all seem to go through all-too-often. I just finished my perioperative nursing residency and spend 3-4 weeks at an L1 trauma center, where we, as O.R. nurse were often called down to the trauma bay or more often, the SICU (both peds and adults) for bedside surgeries. I absolutely hated the trauma cases where I was literally on top of the patient pounding on his / her chest with no chance at ROSC, but they had brought the family in (another controversial topic). I don't know how to say how I felt other than...I hated them watching me. That was heartbreaking to me. I experienced my fair share of bedside ex-laps on children and those were the absolute worst. Our rooms had scrub sinks outside so the parents would be watching us wheel in all of this intimidating equipment and then see us 'gear up' before going in. The parents were often asked to go to the lobby, but on rare occasions they were able to stay outside the room...even though they couldn't see what was going on. A couple times, we had opened the bellies of children with aggressive abdominal cancers and when they went into PEA, the attending wanted the team to proceed with a thoracotomy - i still cry thinking of those cases watching someone just massage and massage and massage with no change on the monitor... I know the surgeons like to say, "We did everything we could", but I often wonder if they should slightly rephrase it to..."We did everything we SHOULD."
  10. jackandjill123

    Perioperative new grad residencies

    Hi there - always happy to lend the insights I've picked up along the way of becoming a perioperative scrub nurse. I am so inspired by your dedication to further your education. I hope to follow. The lead FA on our hire-risk cardiac team is a DNP, ACNP, RNFA, CNOR, BSN. She is pretty young, but her accomplishments and technical excellence in cardiac surgery have won her the same respect as our attendings. She was an instructor during my nurse residency and one of the reasons I fell in love with the O.R. It may be corny, but I truly believe that having 'our plates full' is the only way to pursue what sets our souls on fire. It's such an amazing time to be a perioperative nurse.
  11. jackandjill123

    Circulating vs. Scrubbing

    I think some of this depends on specialty. For example, my institution only has RNs as scrubs on the cardiac, open vascular, and complex neuro cases. Not sure that it was ever written as rule, but CSTs don't scrub those cases here. I just scrubbed an open thoracoabdominal AA repair and we had 3 nurses scrubbed-in.
  12. jackandjill123

    OR nurses, was it your calling?

    I love O.R. nursing - about 3 years in now (new grad BSN that did a perioperative residency). I was groomed early on to scrub our high-acuity cases (CT, Trauma (open - mostly damage control ex-laps), open vascular, etc.). I think for me, it was a case of "the O.R. chose me". During clinical rotations, I 'thought' I wanted to do Peds, but as it turned out, no other specialty grabbed me like the O.R. did. The way that 'time stands still' in surgery is mesmerizing to me - I like the immediate gratification and being able to participate at the intersection of the mind and the hands. I have been offered a position to go f/t scrub on our high-risk cardiac team, and highly considering it. I would like to pursue my ACNP and RNFA one-day for sure. I do know that my experience is unique and that most RNs are only circulating at many institutions. I specifically chose my nurse residency program because of how much scrub time it affords its RN residents. I think it's critical to make your desires known upfront when you begin searching for jobs. I know a lot of RNs that scrub >50% of the time and most sought positions where that was possible.
  13. jackandjill123

    Glasses with masks

    A lot of nurses on our service have started wearing the full length face shields. They are the ones with the foam padding and the strap on top. The benefit it that the shield isn't attached to the mask so it won't really fog up and you get far more protection coverage too. If those are not available, I have flipped the shield part of the mask and tied it on my forehead to avoid fogging up during a case - it's similar to the full length shield in that it's tied around the forehead.
  14. jackandjill123

    Perioperative new grad residencies

    Hi Kelly - I did the 'Nursing Residency - Perioperative Track' at Dartmouth-Hitchcock right out of school. It's a 9-month program and I will say, one of the best things I ever did! It's definitely intense, but you get thrown into a lot of 'fires' in a variety of high-acuity specialties with a safety net (usually a preceptor or experienced RN in that specialty). I scrubbed a lot of high-stakes cases and got to be 'on the team', but in a learning environment. I credit the program with enabling me to excel when I started my f/t job in the OR. I can't imagine what it would have been like if I didn't have the residency program to start with. I've been offered to become a dedicated scrub nurse on our high-risk cardiac team and attribute that opportunity with knowing how to be an effective team member during the residency program. Best wishes!
  15. jackandjill123

    Cardiac Team - Pros / Cons

    Anybody with Cardiac Scrub Experience? I was recently offered a role on our high-risk cardiac team as a scrub. Our CT team is very 'defined' and does not have practitioners (especially nurses) moving between scrubbing and circulating. I've done 3 years as a perioperative nurse (right out of school) and love it - my split of time has been approximately 60% Scrub / 40% Circulating. I did very much enjoy CT. Our high-risk cardiac team specifically does adult re-do's, all DHCA cases, patients with aortic pathology (e.g., marfan's), open thoracoabdominal repairs (elective and dissections), etc. I think I'm ready for this move and excited to be hand-picked for such a high-stakes team, but still nervous by the thought of being in such a high-stress environment exclusively. However, I continue to remind myself that this is what I always had been training for... Any thoughts would be welcomed!