umakemesmile

Lol Yes I have a problem kepping quiet about important issue's. I feel the pt's deserve good care and by not keeping up with technique, policies, or competencies reflects on the pt's. If new hires don't have a good orientation they learn wrong from the get go. It's not their fault. But a new job is out of question so, I'll just have to come here from time to time and vent. Thank goodness we have this site!

Your right about the market. I just feel neglagent by turning the other cheek. It would be tough starting all over, losing vacation time and benefits esp. at 54. I hope this isn't the feelings I'm going to have the rest of my career. Thank you so much for responding. I guess I just need to hear from others.

I have worked in the OR for 19 years but I'm lost and don't know the correct direction to go. I have always prided myself in following AORN standards and facility polices. I have my CNOR out of 15 other nurse's there's 1 tech out of 16 certified. It's never been a bother to me, I only can take responsiblity for my own professional standards. Here's the rub, manager's in the past always promoted ongoing education. Our current manager of 3yrs doesn't care to be bothered with such things. I feel no support about the staff. The easy way around problems is to ignore them. The manager has no experience prior to this. She was part of our staff and was the one who would cut corners, not follow policy, not even check arm bands of pt's. Yet because she's an outgoing, and a "brown noser" ( I'm sorry i can't think of a better term) and she was the only applicant, she got the job. I have tried to be supportive of her as she learns the ropes of management but I see no effort being made on her part. I will give an example: She has never written policies before, I have. I was the department educator before he took the job. So she asked if I would update our policies using a new format the hospital was developing. I said sure if given the time. I started doing the research and changing the policies. Then I would get them back because the commitee changed their mind on the format, 3 times. I told the manager I would wait until the final decision was made before doing all work over and over. She came to me with the final answer. The nursing director said "just put the title in and say See Current Standards. OMG! I couldn't do it. I could only picture the new staff person trying to learn the policies and then trying to find the most current books to follow. I told her maybe someone else would be better to do it. Our sterile technique has dropped off because very few ppl follow it any more. So our infection rate is going up and she's wondering why. I've tried to tell her about all the breaks in technique I've observed but to no avail. I feel it is her responsibility to learn standards and asceptic technique. She says she's too busy with department finance's etc. Going to the director of nursing is a no-no, besides he has no exprience with the OR. Do I look for a new job and walk into someone else's mess? Do I become the sqeeky wheel and badger them and maybe get let go? Or do I die inside a little and let it take it's course. After 3 years with the manager, the snowball has become an avalache. It's sad to watch and I'm learning to hate the job I've loved for so many years.

My boss let me know of a mangement position he's thinks I would be good at and I am seriously considering applying. It's for the Amb. Surgery Dept at my hospital. I think he's telling me something. LOL I currently work in the OR, have done many jobs, ie staff education, policy and procedures, competencies, set-up a bariactric program, brought new products and reviewed finanical end of products. In my last review I told my manager that I felt there is no where else for me to go in my dept. and I'm at the top of the wage scale. I feel I could do a good job but, I'm not sure what a day in the life of a manager is like. I have worked in the Amb. Dept when they have been short staffed but no true experience. What can I expect going into a management position? I understand they may ask me to take a cut in pay due to lack of experience. How would I negoicate and interview for the position? And just in general, would like to hear from the experienced managers what their job is like. Thanks for any and all input

We all know that flashing is a no-no. But one that just can't be helped. We try not to run full sets, but pull out the neccesary items and complete the set with peel packed stuff. Lowering the amount of flashing items. Don't know how good that is but that's what we do. We do add a catagory 5 strip to whatever we flash. One of a kind ortho sets like small frags, hip pans etc. get a biological and we are suppose to wait till it can be read. If a surgeon can't wait, we have a form he has to sign off on stating that he knows the set set will be used before the test is back. We still use open pans with mesh bottoms. We put contents and inital the sterilzer tape,so it can be traced backed if there is a problem.

Those feelings are normal. Learning the OR takes time. Do you have a good staff that supports you or are you left to figure things out on your own? I once left a job after 3mos. because the staff was not supportive in helping me learn the ropes of their facility.(and other things) It was just not right for me. Where I currently work we all help newbies where we can. Just being supportive can make or break someone's experience. There are still days I go home feeling bad because of a stupid mistake I did. It happens to everyone. Talking it out with someone does wonders. Do you get to start IV's on occasion? We start IV's on all our sedation pt.'s and ped's on occasion just to keep our skills up. I admit the OR is different than floor nursing, we don't have the same kind of pt. contact. Are you a structured kind of person who like's a routine?(That's not meant as a negative) Or are you someone who like's the challenge of not knowing what's going to happen next? From my experience I have found the OR to be a challenging job, and I like that. Not knowing if a case will run smoothly or turn sour and trying to be ready for the unexpected. I have worked the floor too, but found the OR to be my niche. I hope this helps you and wish you good luck!

You missed my point. I know we are not "above the law" and after 16 years of doing this I have developed a watch ahead and around attitude when driving in for an emergency. The speed limit was 55, I was doing 62. The reason I said "jerk" is because that is how this officer is viewed by his fellow officers that I know.(live in a small town where everyone knows everyone) Our OB-GYN's do the hand off the license and have the police follow. I'm always weary of the conditions of the road and others. Esp. at "bar time". My point was, do any others have something in place to help them get to the hospital in a critical sitiuation? I thought maybe a sticker in our back window or by the plates to signify an emergency response.

I just curious to see if anyone has the same problem we do. You get called in for a "true emegency" and get pulled over for speeding. This happened to me awhile ago. Got called in for a leaking Triple A, got pulled over, explained situation and received the ticket anyway (jerk). :angryfire I wanted to ask him "what if it was your family member"? Had to take time off to go to court. My surgeon and my employer gave me letters explaining why it's important in those situations for us to get to the hospital ASAP. Long and short, it was dismissed. I went to the police dept. afterwards and spoke with the captain and asked what we could do differently. He told me there was nothing we can do. Police get lights and sirens, volunteer fire get lights. Why can't surgical personel get something put in place to signify they are on the way to an emergency? The only time I speed is for Life and Death emergencies.

Our preference cards are treated as standing orders. If the card says SCD's, then that is like a written order. As are the med's and equipment on the card.

I too used to do that, had to change. LOL

I wish we could go back to having beepers and cell phones left at front desk. It's a pain trying to do all the things we're supposed to do + answer cells and beepers. Management won't back us tho, so we're stuck. My priority is to the pt. so I ignore them till I can get to them. MD's get huffy but tough, I ask them "who's more important at this point?" They usually back down.

We use Hibicleans despite the bottle warning. I have shown our OB-GYN's the bottle and they have decided to still go ahead and use. So I deem it under Physican preference. Last I looked, here is what I found in AORN standards. Please correct if I am wrong. 2 seprate preps should be done. Abdominal first,covered with a drape and then lady partsl prep. I think also they state it should be 2 separate prep trays. I have 6 sponges + 3 stick sponges in my prep + 4 paper drapes. Hibicleans should be used as follows: Scrub 2 min., blot and rescrub 2min. I take 1st and 2nd sponge and scrub abdomen, Blot, 3rd sponge rescrub, Cover with second drape and leave in place while I do vag. prep as usual. I believe the rationnel behind leaving the abdomen covered is to prevent contamination of the first prep of possible splashing. Another nifty little trick I do is to tuck a bag under the pt.'s buttocks and i drop the used sponges into the bag.

WI 16yrs exp. 37.25/hr + beneies 1.5 x call back 3.00/hr call pay weekday 5.00/hr weekends (can't figure that one out) 1.5 after 40 hr worked I guess I'll stop complaining. Except to say that we can't tell a surgeon that elective call case's won't fly.

We too have the same problem. Our only help has come from other staff. We look after each other by offering the call team to come and take over to give a break if they get slammed. We have 1 call team per night/weekend, no back up. I, myself, don't bounce back like I used to. The 22 hour days take their toll. We are first out the next day IF schedule allows. CRNA's get next day off regardless. Which I've never been able to figure out. They have a staff of 7, we have a +20 staff and we can't have the next day off. Recently AORN has been talking about this very problem. That staff not work longer then 12 hours without a break. Looks good for us but the flip side is more call due to having to have a back up team avail. I think I like being able to say to the call team "hey I'm around this weekend if you get hit" rather than being mandated to take extra call and get stuck not being able to go do something on my weekends.

Thank you for the info. It clears up alot of questions being raised at our facility.

No, I'm talking about a scrub tech who has attended a first assist. program. He has no license. I can't find any state practice info for a scrub tech.

I had the same concerns before I took the exam. We are a rural hosp. I used the CNOR study books avail.,Alexander's and AORN standards. They should be all you need.

Hi all, need some input. Does anyone know or know where I can find info on Scrub-First Assist? We have a scrub who recently finished the program and is being allowed to inject local. I thought you needed a license to inject, but it's been a long time since I was in school and things change in our field often. He has not become certified yet, but has plans to sit for the test. Any input is welcome. Thanks in advance

Hardware is sent with pt. if they want it. After it has been disinfected and sterilzed. Only sent to Path. if MD deems it so. Absenteism? HA!! here there are no worries for the repeat call in's. Officially, 3 call in's per quarter is supposed to be when action is taken. We do local's with no IV's.

Ours are tucked in one of the folds of the paper wrapper.

We have been using Meditech for 6 years. I think the whole trick is in the training you get. We got very little training. Baptisim by fire as usual. It's a pretty good program, but also the only one I've used.

My montra "They can only kill me once" and "No case lasts forever". All I can really tell you is to do the best job you can. Some surgeons seem to relish in making new ppl feel incompatent. Hang in there. And say to yourself "They can only kill me once" if nothing else it'll make you chuckle.

I tuck a garbage bag under the pt.'s butt when in lithotomy. That way I can drop prep sponges right into the bag and the mess is directed there too. The bed and floor stays clean. :)

We did a really fun interactive presentation where I work. We held it on a day the the surgeon's had a late start. Staff was put into teams. The teams had to go to different stations thoughout the department. Each station had different goals. 1 had an table fire, 1 had an ET tube fire, staff had to find locations of extinguishers and fire alarms, etc... There were prizes along the way of chocolate etc, and team to finish first got something like free lunch in the cafeteria. Got LOTS of positive feed back from this. Also it was written up in an AORN newsletter. (Tho I can't remember which one) Our former manager came up with this I think she based it off the Amazing Race series.

I would like to hear from others about where they are at in their OR experiences. I have been working in the OR for 15 years. I'm at the top of the wage scale $32.00/hr plus call pay, so I'm making good $$ from what I read my hospital is above the norm in pay. Here is my problem. I have nothing left to aspire to. Being at the top of the wage scale I can only look forward to cost of living raises for the NEXT 15-20 yrs till I retire? I have many jobs and lots of experience but do not have a BSN which many orgaizations want. Going back for BSN means retiring with a student loan And at the age of 50 it's just not appealing to back to school. I hate call! We do more "emergent scheduled cases" than REAL call cases. I can't see myself doing this when I'm 60. Too hard on my body. Our small hospital is growing fast and the work load is increasing without increasing staff. We are adding new doc's to staff every year. I thought about traveling, family obligations and age are a deterant. What would you do if you were in my place? (and don't say quit complaining, LOL)