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huckfinn

huckfinn

All Surgical Specialties
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huckfinn specializes in All Surgical Specialties.

huckfinn's Latest Activity

  1. huckfinn

    Nervous About Weekends & Call

    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!
  2. huckfinn

    Nervous About Weekends & Call

    Abdominal Aortic Aneurysm
  3. 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.
  4. huckfinn

    What are you using for vag preps?

    Technicare is a great bacteriocide. Too good actually. Be sure to wash the vagina 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 vagina. 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!
  5. huckfinn

    Re-sterilizing Off-pump CABG supplies

    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.
  6. huckfinn

    Verbal abuse in the OR

    Once I had this anesthesia doc who was pissed b/c the aids didn't hop to when he ordered them to fetch a prep table to put his non-surgery related laptop on. I asked him if he planned on returning it to it's assigned place when he was through for the day. He escallated and started loud whining and complaining, slamming stuff about and getting nasty about my questioning his omnipotence and personal intentions.......I covered my ears and started singing "I can't hear you. I can't hear you." and continued until his jaw fell to the floor and he was quiet. I then offered that if I behaved in the same manner in which he is accustomed to behaving and spoke to others as he does, I would be fired and in some environments arrested for threatening and unruly behavior. And I refrained from doing so at this time for those reasons. I then proceeded to tell him that I would appreciate the same attitude and treatment he expected to receive. I repeated and allowed him to answer my original question as to intention of returning the prep table to it's assigned room when he was finished. Not only did he return the table when he was done for the day, but had a case of Harry and David pears sent to my home, offered me his box to see The Phantom of the Opera when it toured in our area and has treated me with the highest respect from that event to present (several years). Writing people up for their inappropriate behavior will get you more of the same as well as contempt from those who hear the stories ABOUT YOUR IMPOTENT ACTIONS. TELL THOSE JERKS WHAT BEHAVIORS YOU EXPECT AND ACCEPT NOTHING LESS! THEIR MOTHERS WOULDN'T STAND FOR THEIR RUDE BEHAVIORS AND YOU SHOULDN'T EITHER! Nuff sed.
  7. huckfinn

    Re-sterilizing Off-pump CABG supplies

    The FDA certifies companies to provide reprocessed "single use" supplies. The certification requires validations that the item meet or exceed the original equipment manufacturer (OEM) specifications for that product as indicated in the original FDA approval to the OEM. Also required is that the item is proven to be sterile. Also that the reprocessor carry liability insurance to cover any adverse situations related to the use of the product. In effect the reprocessor becomes the OEM for that product and assumes all liability for it. In some instances I think the reprocessed item is better than a new one. OEM usually only tests a certain quantity in a product batch and then claim the batch to be acceptable. Have you ever had a brand new product fail right out of the package and wonder WHY? Ever heard of product recalls?The reprocessor must test each product and certify it as meeting the OEM specs for form and function. With that being understood and done under the strict supervision of the FDA, reprosessing makes sense. The previous arguments for not using reprocessed products lead me to ask the questions......Why are we using surgical instruments over and over and not asking the same questions regarding their cleanliness, expert tested quality certified and sterility? Are your processing techs factory trained quality control experts? Isn't the lumen of a mini ureteroscope only 1mm or less and 40cm long? There aren't brushes to fit down those things. Do your instuments ever come out of a "sterile" package from processing with valves closed, clamps locked and scissors closed? Do you refuse the entire set or just the ones that don't "seem" OK because you don't want to tell the doctor that the entire set will need to spend 2 hours in processing to meet your standard of care issues while you wait with the patient asleep on the table? Consider just flashing it you say?????...You didn't flash for every other case that day or even every other item used for that case! OK! My sleep deprived rant is finished. I am not invested in nor do I work for a reprossing company. I am a 20 year OR Nurse veteran. I am proud to say I am now a Healthcare Value Analysis Professional! My goal is to make healthcare affordable. Isn't it a shame that caregivers can't afford to buy their own product because of BIG MEDICAL SUPPLY MANUFACTURER. MEDICAL INSURER AND PROFESSIONAL LITIGATOR GREED? Give me a properly reprocessed item any time. At least I know it has been tested once and worked correctly! HUCKwww.ahvap.org
  8. huckfinn

    New signs to post at the door

    [/b] Thou Shalt Not Whine!
  9. huckfinn

    Male nurses who cook

    Yes. Doing the show with Rachael Ray would be way too much fun. Cooking up a wonder to rival Bobby flay would be supreme. Shouln't be too hard...he usually has char all over his dishes anyway. Don't think I could ever get used to eating carbon with every meal. Tips....Don't store your acidic foods in metal cookware. It pits the surface. NEVER NEVER NEVER use soap to clean your iron pots and pans. It ruins the seasoning you have worked so hard to build, makes them rust and imparts a funny taste to everything you cook in it until properly seasoned again. Like Emeral (sp?) says pork fat is a good thing!!!
  10. huckfinn

    prep solution question

    Mike, Perhapse your infection control pratitioner or OR Educator could help you out. There is also a vast resource at AORN. They usually have an article on the subject annually. AJN and other professional journals also address this from time to time. GOOD LUCK! TAKE ACTION TO IMPROVE YOUR DEPARTMENT PRACTICES! If you don't you'll be letting your patients and all the rest of us down.
  11. huckfinn

    prep solution question

    Grimmy, Have you ever read the contents of a shurclens prep container? NO ANTIMICROBIAL or MICROBIOCIDAL AGENTS there! Not much more than purified water. Using that to prep before going throught that staph ridden nose and into the brain? How do you avoid infections? Shurclens should only be used for removal of gross contaminants from trauma and other "dirty" type precleaning. Maybe your docs don't really know what they are asking for when they request the stuff. OR Nurses often find these things out when they investigate the rationale for a doctor's choice of one solution over another. Surgeons are often very greatful, when educated about their choices. It demonstrates that you have their patient's best interest and positive outcome in mind. Boy, and won't you be the model of patient advocacy!
  12. huckfinn

    prep solution question

    Do all of you who use alcohol allow the use of electrosurgical devices? There is an incredible fire hazard there! CHG and PCMX should never be used on mucous membranes. Phisohex is known to cause cancer. All prep solutions should be allowed to dry on the skin before draping...how many surgeons are willing to watch the stuff dry? NONE! WOW so many restrictions! We use Betadine Paint for all vaginal procedures and urological unless there is a sensitivity. Technicare is another good one and is OK to use on mucous membranes and open wounds. Additionally, it is not rendered inactive by blood as betadine is. Technicare has it's down side. NOTHING will stick to the skin after it has been applied. It does such a good job at killing microbes that unless extra care is taken to rinse it out of the vagina, the patient ends up with a yeast infection. I still like betadine the best.
  13. huckfinn

    Nursing without the "yukkies".

    So you're saying....If your family members are farting and puking and pissing and pooping and snotting all over the place, you are out the door? Consider what you might be doing as things you would want done on your own mother's or even your own behalf. It doesn't sound quite as bad now does it? Get over all the bodily substance stuff and focus on the caring! You can do just about anything if you look at the BIG picture and put it all in the proper perspective. In addition to seeking another line of work does someone need to just GROW UP?
  14. huckfinn

    sleeping staff

    I don't condone sleeping at work. I have been told however, in union establishments "shop sterwards" tell you if you are caught sleeping you should raise your eyes skyward and say "AMEN". Apparently you can't be fired or written up for taking time to pray. Either way you get it in the end.
  15. huckfinn

    NCLEX "easy" question??

    You were all very lucky. I took the test all toooooo long ago and had to answer about a thousand questions over 2 eight hour days. Hard, easy, trial questions,all of them. All while hoping I didn't skip one and throw off the little dots on the answer sheets. Y'all are lucky to have it work the way it does now.
  16. huckfinn

    is it oriented or orientated?

    I jist got to AXE you one more time afore I finish my EDUMACATION. You gonna hire me, right?