Promacta

No, you keep calling simple facts, statements, and the way things work at my facility as "excuses". A "tale"? You`re being comical at this point.

I have also stated the solution numerous times which you think isn't the solution apparently. Adequate training and competency. But apparently you would rather keep accusing me of "just making excuses".

Furthermore, if surgery is surgery than pediatric, neurosurgery, cardiothoracic surgery, etc are all the same and don't require specific training for those specialties? No... that`s not how it works. Each specialty requires specific training for that surgery role. To think a circulator can just jump into anyone without the training is mind blowing and a massive patient safety issue.

Not excuses. Yet again, legitimate reasons. You're lack of knowledge regarding the role is apparent. As the circulator you are responsible for all of those aspects and many more especially when its a critical situation. If I am not responsible for any of those aspects, which is apparent in your eyes, who is going to do all of those things? Maybe it works differently at your facility but not mine.

Not the same thing LOL. I don't know medications to give a pregnant/postpartum patient. I don't hemorrhage medications for c-sections. I don't know education to provide to a postpartum patient. I don't know how to do fundal checks. I don't know how to provide breastfeeding education. I don't know how to provide care to a newborn. I don't konw how to do tones via doppler. I am not PALS or ACLS certified. etc etc etc... Just a few examples why I am unable to fulfill the role.... OB is a specialty for a reason...

LOL I don't know what your deal is at this point. The principal argument is still the same regardless of how you are trying to spin it. Management has not provided a solution to becoming trained and competent in C-sections. How can you say that's okay? How can appropriate care be given without necessary training and skills?

Never said I wasnt willing. You must just be overlooking where I've mentioned numerous that I haven't recieved the training to fulfill this roll nor has management provided solutions to the training issue

Because I don't circulate OB services that occur in another department...

Understandable, but as I keep stating our management has not provided any solutions to being or staying competent in this role.

I don't scrub in the OR. Orientation to the unit does not solve the problem. Not knowing where supplies are is not my "low-level" excuse. I am not making excuse I am stating facts that I am not orientated, trained, or competent to perform a C-section placing the patients at undue increased risk. Management has not provided a solution on how to stay competent in C-sections.

So you're saying L&D nurses can also come down to the OR and circulate any case? OB has their own call team and we have been told time and time again that they are adequately staffed. However, they still call us. I even heard recently that their call person was able to refuse the call and then we got called in. Of course L&D nurses have less OR experience but they have substantially more experience with C-sections as it is the only case they have to do. In the end, I am not trained or competent to be apart of a C-section.

I never said these cases are "so scary"? I am not able to receive adequate training for C-Sections because we do not do them in the OR department. They are done on a different floor. This provides the OR staff with no exposure to them. We do not see a large case load of C-sections to begin with. We may have a couple to a few a week at best. This provides very limited opportunity to see a C-section at all. Even, when an opportunity presents itself it is further limited by us being tied up in an OR room.

Not receiving proper training in a specialty that I have never worked and placing patients safety at risk is making excuses?

Its one of many examples. At the end of the day, I have not received adequate training to fulfill the role which places mother and baby safety at risk

I have not received adequate training nor is it a department I am familiar with. I`m not going to put my license on the line when I get called in for a C-section and it goes sideways. Everyone in the room will be expected to be proficient in their role and I would not be able to. For example, I don't even know where the departments Omnicell is or supplies.

I work in the operating room as a circulating nurse of a smaller rural hospital (5 ORs). We are on call throughout the week and on weekends. Currently, when we are on call we are also on call for the OB department to assist in C-Sections. However, as a nurse that doesn't scrub I have no experience, skills, or adequate training related to anything occurring during a C-section. Despite myself and others giving pushback regarding this issue the director is hard set on forcing us to be on call for another department and to be in the room during a C-section. How can one go about fixing this issue? Our associate managers have tried to fight the issue as well with no head way made. My current plan of action is to talk with HR during my next shift. Along with this, I have made it explicitly known that I will be refusing. There are currently no repercussions and the director has mentioned that it will be addressed when the time comes.

Hello, at my facility when you are on call you are also on call for OB (mostly c-sections that are not done in the OR). You're not on call to fulfill a circulator role but to scrub into the case and assist. I do not scrub in the OR and I have only scrubbed into 2 C-sections in the last 3 years. I am not competent in this role but I am still forced to take call. I am wondering the legalities of this? Can a facility force someone with a license to fulfill a role that they do not have experience or competencies in?