Jane1988

I work in a small rural hospital with a two bed OR. Our orthopedic and general surgeon frequently schedule cases with known or suspected MRSA organisms to I & D the wound. For years the OR staff knows to clear the room of any unneccessary equipment in order to avoid any contamination by the infected organism. Recently we had a situation in which this was not done and the patient arrived, too late to clear the room. This brought up a discussion if clearing the room is necessary and recommended by AORN. Unfortunately we have been unable to find this information in our AORN standards book. Any ideas? Also, related to these types of cases, when we leave the room we take off and throw away our hats, shoe covers, and masks before proceeding down the sterile hall. What is your policy?

Our small OR consists of orthopedic and ENT doctors. Our staff complies very well with hospital and JACHO policies regarding time out. However, our doctors may attempt to start the case without aknowledging the time out. Also, who is in charge of annoucing the time out? The circulator may announce "time out", however most of the time the CRNA does the time out. We attempt to wait until past prepping before starting "time out", but we usually announce before drapping. This insure everyone is in the room - if it is a case the doctor wants to drape.

Although I am not a school nurse, I have substituted myself at our middle school and junior high school. I guess the biggest reason is it hard to find good help is the pay. I was paid less per hour that my 8th son gets for tutoring in the afternoon. However, if it were for not going back to school myself I would susstitute again. My husband and I felt the advantage to getting to know the teachers and likewise them getting to know me were outweighed by the payscale. Maybe you can approach nurse/moms with this long-term incentive. Question: What is your school district's policy on someone other than a LPN/RN giving medicines if you can not find a replacement? I found out our district allows other personnel to give meds if it only for a short time (one or two days).

I agree with jwk in that when padding you are protecting from nerve damage versus skin damage. The most susceptible nerves are the ulnar and the sciatic nerves. The ulnar can be damaged when your pt lies supine with arms postioned on the bed or on the armboards. This type of nerve damage is the most frequent c/o to anesthesia resulting in legal actions. The sciatic nerve may receive compression in Fowler's position. In our two-room OR, we primairly use foam (looks like eggcrate material), pillows, gel-pads, bean-bag device, and more pillows. We also use a helmet system for pts in Fowler's, but this may be for positioning and not for skin protective purposes. Any ideas for shoulder arthroscopy postitioning? This part of the surgery is a nightmare.