BMW10

Interesting discussion...but as with any insurance it's better to have and not need than need and not have! If you've done no wrong NO ONE gives a rip whether or not you have insurance--they're coming after you, that is their right. And if you haven't made an error, just defending yourself can be exceptionally costly, even if you leave it up to your hospital to provide council. In most cases, win or loose, they WILL come after you for any expenses they incurred because of your involvement. It has been my experience, though, that nurses have more to fear from their employers than patients. All the malpractice coverage in the world won't help you if you've been wrongfully terminated and your 'in its back pocket' Union sides with management. I was even advised to NOT seek Unemployment Compensation because it would "look bad for my case" and be a show of "bad faith." At age 59 with 37 years tenure you'd think I would have been smart enough to get my own lawyer. But, then, I'd never been fired before. Once you've been stripped of your dignity, pride and basic trust, loosing your full pension and accrued benefit days (275!) with no chance of rehire ANYWHERE seems insignificant...until you sign up for Skimpy Social Security when your savings are depleted. THEN it matters.

Sorry, but in the real world you will be expected to be correct 100% of the time. I carried a 4-point, passed NCLEX with flying colors, worked for several decades before making "an error" that cost me my job, my career, my dignity, my life. If you haven't passed your boards by now, you likely will NOT. Wake up, see the light, get on with your life. Nursing is not in your future.

Have you made your choice? You've likely already had your interviews so which impressed you most? Did you look at Genesys?

Bottomline, POLICY dictates where, what, why, when, and how you count. Period. In our case CSR/Sterile Services set up our 'system' of counting instruments so it became more of an inventory-management tool than safety issue...with less than positive outcomes. Focus was on to whom to point the finger when sets came up short or were not assembled (or returned) in an orderly fashion. It did not help that the Materials Manager would entertain NO input from the OR and, indeed, eventually became the OR Supervisor in spite of the fact that she had zero nursing or, even, any OR experience whatsoever. She was a Data Processor hired to program the newly installed computer system and as such was, or became, in complete control of the OR. And we let it happen because everyone was too busy or too tired or too pig-headed to take command of our destiny and insist upon being involved. Duty called and we hung up!

Few if any from Havasu seem to post here but if they did I'm sure everyone would say, "Good Luck and welcome aboard!" No unit at HRMC is more in need of help than the E.R.---which is also perhaps why there is such a turnover of staff, especially since Life Point took over less than three years ago. They are long on demands, short on gratuities. Afterall, cheaper is always better. And, believe me, your time will be very inexpensive! But......the community is GREAT, weather just about perfect, and the tired old hospital staff is usually pretty supportive of anyone who can pull their own weight. But cop an attitude and you'll soon be very miserable. Again, good luck to you!

I hear ya', Tracy. We, too, started with just entering specimens and looking up labs. But Pathology refused to come on board (still had to submit full documentation with each specimen) and the lab could send results only to the patient's floor so we had to call around anyway. G-u-r-r-r. When we finally initiated computerized charting it was cumbersome, time-consuming, and repetitive ad nauseum (from two pages to 16 or more, which had to be duplicated for both OR and Anesthesia). The program had been set up by the Sterile Services manager so was geared more to time charges and tracking of inventory than 'continuity of care' issues. We never felt like we were charting, just billing. All-in-all, major problem was never having a dedicated IS person with knowledge of the OR handy to troubleshoot. We 'elders' unfamiliar with anything "computer" had a tough time accepting the concept of computerized charting but I think it would have been less intimidating had only someone been willing to teach us old birds how to fly. After three decades in the OR my evals suddenly displayed "incompetent using modern technology" and "needs to learn how to type to speed up charting." Cisco finally did me in and I had to transfer out of my beloved OR. I retired at the first opportunity.

To Mary54, the sales person who wants to know more about the O.R.: Check out AORN's certification program for sales reps. Indeed, many O.R.'s require you to present credentials that prove you've taken the AORN course AND kept up to date on area O.R.'s changing policies and procedures as they affect your role in the O.R. or on a particular case. Every hospital takes a different view on the presence of a sales rep in the O.R. but ALL should appreciate the fact that you've done your homework and show up prepared to take your proper place. Good luck to you.

In our O.R. we resolved the conflict of when it was okay to drop the mask during a procedure by requiring ALL masks up at ALL times in the room, case ongoing or not. Droplets remain air-borne 30-45 minutes...plenty of time to turn the room over into another 'more sterile' procedure. And if the doc is raising a plume with that laser or bovie, better be sure that mask is high-filtration to protect YOU against those carcinogens!! And it's not about doing what's right only if you might get caught, rather 'safe practice' for all concerned.

It's not the 'incorrect' counts that cause a problem, rarely do they go unresolved. It's the uninvestigated 'correct' counts that slip through the cracks and come back to haunt us FOREVER! The sponges never found are the ones no one had to search for...until it's too late. As a former OR nurse with nearly 40 years in the OR who lost her job and career and pension and any chance to rehire at age 59 over a raytec used as a post-D&C tamponade, admittedly placed by the doc after all counts were recorded, I can attest to the fact that IF policy dictates that the nurse signing the OR record is accountable for all entries they are, indeed, responsible for EVERYTHING. Check your job description. If you wish to take the credit for running your room, you'll need to accept all blame as well. The more money you make, the more 'responsible' you become. Sadly, the underpaid and overworked, unappreciated scrub techs are more aware of how the game is played than their stressed-out circulators. Too, if your employer and/or union has an established 'progressive discipline' clause along with a zeal for ALL incident reports to generate disciplinary action...doesn't take long to weed out the undesirables. But even one unresolved count is unacceptable, five is outrageous!! HAS to be intentional methinks.

You go, girl! Tough decision, I know, but you won't regret moving on and starting afresh. And now that you're out of there please consider reporting the incident if for no other reason than to CYA! What's to loose?

I think you should try to keep your feet wet, if only one weekend each month. Experience, while helpful, does not mean much if it is not recent and current. Too, even if you meet the required CEU's your certification will be suspended once you remain unemployed for two years. And if you haven't worked in an OR for two of the last five years, you'll have to recertify altogether. Most agencies won't try to place you unless you can prove your knowledge is up-to-date and your skills well maintained--difficult when completely away from the OR for an extended period. Too, once you loose your CNOR you loose your clout and no longer meet the documented standard expected of an experienced OR nurse. Yes, you know more now than you did as a new grad. But after a few years away from the OR, the playing field becomes pretty level for all applicants.

Oh, dear. I must be older than even bratt1. I recall bargaining up from an offered $1.25 to $1.29! an hour back when our stockings were cotton or silk and the hospital laundered and stiffly starched our uniforms so we wouldn't wear them on the street. Surely someone here remembers those removable clip-on buttons. Or never, ever sitting in a patient's room---certainly not on the bed---under any circumstance, ever. Never.

And you're older yet if you remember saving those I.V. bottles (well, not the blood bottles just those from the D5W or NS) for tube feedings which the kitchen whipped up. Baxter used to have a screw 'top' and bigger tubing with a roller-adjust. It worked well when we couldn't use a pump because the patient was in an oxygen tent. Remember those? You're also an old nurse if you remember those cumbersome privacy screens which we had to drag out when 'overflow' patients were parked for days in the hallways. Standing up or relinquishing one's seat to a white coat, however, is NOT ancient history and is, in fact, STILL expected behavior today. And don't you dare take your charting into the doctors' dictation/conference room. No way!!

I agree, there seems little difference amongst the programs since they all use the same hospitals for clinicals. But Mott is the most affordable and USED to allow you to apply before you actually complete your prereq's so you don't have to languish in idle-mode while waiting to get into the nursing program. Many 'on the list' drop out before their name comes up so hopefully you'll be enrolled pretty soon. Meanwhile, though, you could have already been half-way there had you jumped into U of M's program straight away. A four-year degree will take you farther and credentials from U of M give you added clout. Too many nurses fail to go on for their BSN or MSN once they start working. Anymore, in spite of shortages of RN's in the workplace, an ADN is just not enough. Oh, you won't have a problem hiring in to your dream position. In fact, employers prefer paying reduced wages Associate or Diploma grads. But you won't be able to get very far or have real impact until you can begin to put a few initials behind that RN. And by the time you finally get around to finishing your degree...well, it's like starting all over again. Good Luck to you!

It has now been two months since RNMommy2 relayed her frightening story. Hopefully she listened to all the solicited advice, especially from Jolie and Linda. And if she did not, indeed, remove herself from her dangerous situation then report the illegal activities to appropriate authorities...well, shame on RNMommy2. Her job AND career, nevermind patient safety, are in jeopardy. If her supervisor, who may not even be an RN so in which case has no license to loose, gets wind of recent discussions she has reasonable cause to fire this RN for NOT stepping up to the plate so therefore is 100% responsible and accountable for any consequences. I know. Been there, done that. I lost my job and tenured pension, was on the street at 59 after nearly four decades in the O.R. because of an 'error' committed by a tech under my 'supervision'. If you are the only RN in the room you are fully responsible for everything that transpires "on your watch." Period. Not reporting it and failing to accept responsibility for someone else's behavior, be he subordinate or supervisor, will come back to bite you where the sun don't shine!! You cannot undo nor correct, only get out then try to rectify. Hopefully that has happened.

Where does trainer 2070 work? I tried to line up employment in Havasu prior to relocating from Michigan, was offered nowhere near what her new grads make...and I have 37 years experience in the O.R.!!

Good point, river, in regard never leaving the chart unattended. Most patients just want a quick glance at their most recent lab work and to review what the doctor is saying about their progress, anyway. They can get that done while I'm checking their vitals or hanging another I.V., which is why I always take the chart with me on rounds. But I worry when nurses like burn out declare that "it is against our hospital policy" to allow a patient to view their record, "patients don't even understand the most simple things" and "families are not looking to understand but to find reason to file a law suit" and "let their lawyer do the chart review." Worse, burn out actually believes "Where I work MPOA means nothing unless the patient has been declared mentally incompetent by the physician." Talk about raising the red flag of INFORMED CONSENT!

burn out seems aptly named. Goodness, what a low opinion of her/his patients' intelligence as well as disregard of their motive to be actively involved in their own or a loved-one's care. Too, burn out's facility appears to have a few outdated policies re: patient and patient-advocate rights. Or, perhaps, burn out has simply overlooked HIPAA rules and MPOA guidelines that give patients very specific RIGHTS to view, copy, even add their own information (to correct or clarify) to the chart and or any record on file. They do not, however, have a right to any on-the-spot explanation or interpretation of what has been charted and most nurses would be well-advised to refer all requests for interpretation to the patient's physician.

Can't BELIEVE no one has responded to your inquiry before now. Hopefully you have found the position of your dreams...and have by now accepted that the best O.R. nurses have a strong Critical Care background. There's no better place to test your new wings than tucked under a pair of ICU'ers. They'll appreciate your fresh knowledge and enthusiasm and you'll be grateful for their experience and expertise. Even if you have an OR Tech background, so supposedly would 'fit' right in at most O.R.'s, I'd encourage you to FIRST polish your critical care skills. In fact, many O.R.'s require at least a year of floor experience to apply for any open position. One should know their way around the facility and be comfortable with that hospital's routines well in advance of sequestering themselves behind those O.R. doors. Once there you'll be rather isolated from the rest of the world. That said and done, check out Beaumont's excellent O.R. orientation. They used to have a program starting in June and used to accept new grads when space permitted. If that fails, try U. of M.'s outstanding Critical Care Certification program. There's none finer. Good Luck to you!

I agree, Lou, and believe you answered your own question.

cancelled response to question: "what errors?" n/a to forum topic

I agree, the patient SHOULD have access to their chart. But I know that many frown on such a practice. I'd like to take the proposition one step farther: Should the patient be allowed to enter THEIR OWN comments? Case in point: My Mom was readmitted for a nasty post-op infection and dehissance of her joint incision three days after removal of her skin staples. Needless to say, the repair broke down and she required even more major surgery after the infection cleared. We asked for, and received from Medical Records (weeks post-discharge), copies of her OP notes and progress reports so we'd have them available for the consulting specialist. We were surprised to discover how many errors had been entered into the record...and how impossible it would have been to make appropriate corrections weeks later.