huckfinn

IsseyM- I agree with TakeTwo. The charge nurse will not let you get into trouble. Unless that person has a cowboy/girl mentality about emergencies. Nobody wants to get overwhelmed when the case gets tough. Remember your basic knowledge and put it to practicle use. All of the most advanced surgical procedures and emergency situations are dealt by switching your basic OR nursing knowledge application on autopilot and adjusting to the situations as they change. Most of all believe in yourself! Everyone can smell your self doubt and it makes them nervous!

Abdominal Aortic Aneurysm

I know of a CV SurgeryPA who got a blood drop splash in the eye. She was wearing safety glasses with side protectors but somehow the drop got around. The drop was infected with a herpetic virus. It blinded her dominant eye.

Technicare is a great bacteriocide. Too good actually. Be sure to wash the lady parts out with lots of water or saline after the case or your patient is likely to get a yeast infection. The sustained kill of the prep slows repopulation of normal flora which ofter leads to yeast growth. I can't believe anyone uses CHG or phisohex in the lady parts. Sure it does a nice job at killing germs but the labeling specifically contradicts use in mucous membranes. Don't invite a liability claim when you have other options!

Straight to the bone and wear Kendall knee high TED's when I can get the rep. to comp me some. Too expensive to buy. My legs really feel good after a 10 hour day on an epoxy over concrete OR floor. and now that I think about it I feel real sexy putting them on in front of all the studs I work with. But I do digress.....

Ferret, OH HO! The double en'tandre. Seriously...major lubrication helps the cath go in easier. Have you ever got the thing halfway in and hit a dry spot? Yes that applies to both situations. OUCH! Incidently, the lubrication/penetration bit came from a urologist. And, NEVER EVER cut the valve off to do routine draining of the balloon. That action removes your option of exploding a balloon with intentional over-inflation if you can't deflate with a syringe. Also a urologist's tip.

Tory, I'm curious. You are a nurse at only 19years old? That is an amazing accomplishment! So you graduated HS at 16 or 17 and then completed your AD and state boards by 19? Your school must not have had the multi-year waiting period to enroll in the nursing program. You are all that! Huck PS TO ALL: I find the whole catheterization thing much easier to handle mentally if you just think of it as another routine clinical procedure. Give good instructions, tell the truth about the discomfort;) :wink2: and get on with it. Always remember: Lubrication is the key to penetration!

Please read the spirited exchange from other members on this very subject. There is also a discussion on the AHVAP website. Remember to think about stringent gov. regs and science. Leave your emotions on the platform this is a wild ride. https://allnurses.com/forums/f39/re-sterilizing-off-pump-cabg-supplies-114768.html Huck

Get in contact with the manager of the OR at the place you would like to work. Applications go through HR and end up in the nursing pile, sometimes never to be forwarded to the OR. Get the contact info and make the call. You have everything to gain and who knows, they might need you right now and the OR folks don't even know you are out there. GOOD LUCK! Huck

The insuflators have a pressure control mechanism that adjusts the gas volume and pressure dependent on the machine settings. Anyway, have you considered the gas displacment of a 5 or 10 mm instrument? Multiply the length that is actually in the trocar by the instrument diameter. A 35 cm 10mm instrument would only account for 35ml of Fluid volume. 35cc ic not a lot of gas considering it takes several liters of gas to distend an abdomen. Does it take a clinical study and associated research report to make that statement? No offense intended on the CRAP statement, just my loss of impulse control in my quick reply. Huck

Joke: Do you know what the first thing a surgeon's spouse does with their a**hole when they wake up in the morning? Dress 'em up and send 'em to work.

For cleaning and steam penetration. The pressure equalization story is crap.

Offer them you credentials and additional abilities re: languages and anything else you think of that puts you ahead of the rest and then say you are only looking for day shift employment. If you really feel those are the only hours you are willing to take, say so! Otherwise you will get the offer you get. On the other hand.....if you really want to work there, tell them you will take what they have and option for the first available day shift position. You will need to understand that seniority and other special needs may put you way on the bottom of the shift change list. Whatever you decide, if they offer you the next opening on days from another less than desirable shift make them put it in print. Good Luck!

In surgery many a nurse will cut the balloon port off of a foley instead of aspirating the fluid out before pulling the cath out. I once saw a nurse pull on the foley and cut the whole thing. Up the cath stub shot into the bladder. Had to delay the crani until a urologist could be found to do a cysto to remove the retained foley piece. WOW>>>She never lived that one down!

Oncall, On the reprocessing of items-It is up to the clinical site as to use or not to use. The fact that the FDA certifying the individual items for the number of times it can be used, is a scientifically investigated process. Not just some guy saying I can resterilize this stuff and doing it. Some hospitals actually reprocess for themselves in accordance with the FDA guidlines. Who ever does this becomes the liable party. I hope you don't think the OEM is going to step up and say: "It is our fault." when a patient got injured while using their product. If there is a law suit everybody will be named and the oem will not send a lawyer to accept the blame or represent you. I also agree with you that a metal instrument is the best option economically. However, we use lots of disposable stuff where a reusable instrument is the better option financially. Are all of your docs using steel trocars? In my perfect world they do. Reality says they don't and won't. The reprocessors do know how the things are supposed to work and must assure that every piece works as specified. They have physicians and nurses on their staffs for consultation. Reprocessors are required to have all of the technical data and design information that the OEM used to make it and the item must leave the reprocessor meeting the exact OEM spec. Do you think the Malasian, Mexican, Brazilian or other third world native that works in the manufacturing facility knows how to use the thing they make and can assure that every one of the thousands they made that day work exactly as specified? No! The OEM is only required to select a sample from that batch and test those. They then either accept or reject the others in the batch base on the few tested. Again....reprocessors must check each and every item and accept or reject each one. Emotion of some of the parties posting here must be removed. Poopsiebear thinks reusing things is disgusting. Don't we reuse things every day? As far as liability goes-Thinking you are not liable for using a hopital processed re-usable instrument and you will be liable for using a reprocessed item is silly. Yes, a reusable device is the best option but not always possible. Sometime a disposable is required to be used. If it can be reused shouldn't it? It may be more economical to throw things away but due diligence is required before making those decisions, not just paranoia over liability issues and thinking reprocessing is disgusting.