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insa specializes in OR.

Second-career nurse, husband to an extraordinary wife, father to one special-needs child and one adopted child.

insa's Latest Activity

  1. insa

    Dashing a patient's hope or just being honest?

    I wonder if perhaps the patient asked the question in front of his family members because he wanted those family members to hear a nurse answer it. Sometimes it's not the patient who's in denial. Is it possible he was enlisting the OP to gently chip away at their denial?
  2. insa

    Is Weight Loss Surgery an Easy Way Out?

    Exactly! We don't tell surgical cancer patients they should eat better and exercise and see if that makes the tumor go away.
  3. insa

    Buying a new car for a new nurse ??

    Bear with me. There are several types of tires. Most cars come with all-season tires. Most people replace their tires with more all-season tires when the mechanic warns them their old tires are dangerous (or, let's face it, when the mechanic warns them they won't get an inspection sticker unless they replace the tires). There are also 3-season tires, that give more grip in wet or dry conditions, at the expense of not doing so well in the snow. There are also winter tires, which may not be so good in rainy and dry conditions (and they wear out very fast in these conditions), but get much better traction in snow. Why am I telling you this? Because winter tires and front-wheel drive perform better on snow and ice than all-season tires and four-wheel drive. So if you want to get to work safely year-round, you could start with a set of winter tires for your Honda, then get a set of three-season tires (or all-season tires) in the spring. (Yes, it's a drag that you have to store your winter tires, and you'll probably need to buy another set of wheel rims). You could spend a lot of money on a new car and still not fix your skidding in the snow problem. If you apply what I'm telling you above, you could fix the problem for $400-$1,000, which is a chunk of change, but much less than the cost of a reliable replacement car. Good luck!
  4. Hi everyone, This month (October 2014) the UK Nursing and Midwifery Council (NMC) revised its process for registering for nurses trained outside the European Union (EU). The short version is: this is streamlining the process. Instead of making applicants document some 4,600 hours of clinical practice in training and making everyone take a course, they're administering computer-based and practical nursing tests and you're eligible to take the test if you can pass the IELTS English test and demonstrate you're an RN in your country. More detail at NMC's Trained Outside Europe page. Is anyone in the new process yet? I started an application in the old process, and I don't think NMC will accept my US BSN because it doesn't have enough clinical hours. Side note: I guess that the reason for the change in process is that 4,600 clinical hours is a lot more than many programs demand. In the US, the only way to accumulate anything like that many hours in training is to do an ADN, which ironically, NMC won't accept! So: anyone have any insights yet?
  5. Are you a US nurse who's registered with the NMC? If so, I am curious about "initial registration." Specifically, what document is acceptable proof of the date of my initial registration? I naively thought that a copy of my Virginia license, certified at the US embassy in London, would be all they would want. But it has only an expiry date - it doesn't say when it was issued or when I first qualified. Any American nurses been through this? I'd be grateful to hear about your experiences. -insa
  6. canesdukegirl, this is such a good perspective. I wish I could have gotten this advice when was orienting in the OR! There are definitely those who will intimidate, bully, or try to establish pecking order by finding fault with what you do. And just because somebody (surgeon, preceptor, manager, tech, whoever) tells you to do something one day today, doesn't mean somebody else won't scold you and tell you to do the polar opposite thing tomorrow. None of the individual tasks in the OR are super-hard to learn. The hard thing seems to be learning the rythm and culture of the OR you're in. If you can show you're receptive in that way (think about how quickly you call time out, reply loud and clear to others who can't turn to look at you while they speak to you, hurry up and slow down at the right morments), you can learn to fit in. And you can remind yourself that the hazing (Otis elevator? Really?) and the condescension aren't good, aren't fair, and aren't something you can really do much about. Just resolve that you won't be that person when you're the veteran working with the newbie.
  7. insa

    States/Cities looking for New Grads?

    I graduated from UT El Paso, then moved to Virginia. It took me months to find work; all my classmates seemed to find jobs in town immediately. More than half of the population of El Paso speaks Spanish at home, so if you are bilingual that will help, but it doesn't seem to have been a requirement - non-Spanish-speaking folks seemed to do fine too. El Paso is kind of big and sprawling, and the desert environment isn't for everyone, but the people are friendly and it's one of the safest big cities in the US.
  8. Well, I'm off for Memorial Day but with all this good advice and perspective, I'm already looking forward to going back to work! Thanks so much to all who posted - I am very grateful.
  9. I'm struggling to relate to a colleague in my unit. I'm six months off orientation in the OR - because it's OR, we have to partner closely with another nurse or OR tech in the room each day. I have a nurse colleague who seems to be universally liked, caring, and very, very good at the work. And every time I work with her, I get immensely stressed. On the surface, our relationship is fine. Every time we work together, however, I encounter a constant stream of corrections. Yes, I still make mistakes - of course I do. Many more than she does. But every mistake seems magnified, every task I choose to do next is the wrong prioritization. While I was on orientation (and remember, OR orientation tends to be longer than on other units), I despaired because every partner I worked with seemed to do this to me all the time. Eventually another man on the unit took me aside and told me, You're doing fine - remember some people will have an interest in making you continue to seem incompetent to build themselves up. This was enormously helpful. Now, the combination of practice, my slightly increasing competence, an increase in confidence, and lots more practice, have got me to the point where I can function OK. I enjoy most days. When I work with this one person, can be like the worst days of orientation all over again. So: is this overwhelmingly respected and beloved co-worker picking on me? Is she just trying to help in a way that adds to my stress enormously? It only happens with one person. I really want to believe that she just wants to help - she has no need to "build herself up" in the unit. Everybody but everybody thinks she's terrific. But this only happens with this one coworker. It really only just crossed my mind that perhaps this is a male/female thing. I'm still optimistic that perhaps it'll get better as I get better at doing the work - I'm still very, very new at this. Guys: do you have any experiences or perspectives that can help?
  10. insa

    New OR nurse needs some advice

    I'm 6 months out from my OR orientation. The truly terrible days are coming much less frequently now. It really does get better. My orientation was supposed to be nine months, but it stretched out to almost eleven, even though my unit is perenially short-staffed. If you're not ready, you're not ready. Everything else I could say has already been said by other posters, but I will add this: I have found Evernote to be quite useful as a way to keep my notes organized. I write hints sheets on individual surgeons, on specific types of cases, and on some of the less frequently used instruments. It's especially good for instruments because you can take photos with your phone. The pace is so fast that I seldom look back at one of my notes before I'm doing a case; I think just the act of writing the notes helps me absorb the content more effectively. But it is nice to have that reference. Remember everything with Evernote, Skitch and our other great apps. | Evernote Good luck!
  11. insa

    gowning and gloving technique

    Gloves on top of gown, slide towel and gown out. The rule that was stressed when I was learning was that you can't put your gloves or gown on the sterile field with other supplies. They must be on their own surface, and the gown wrapper then becomes your mini-field for picking up the towel (if needed), gown, and gloves.
  12. insa

    OR Internship... homework???

    Well, I can't tell you what your internship will be like. But mine had tons of reading, homework, computer modules, an essay, a presentation, and an exam that many people failed on the first attempt. It was Periop 101 from AORN, BTW.
  13. insa

    Seeking OR Nurse advice

    I'm just coming up on one year in the OR. It's my first nursing job. Definitely harder than school for me. I recommend "Pocket Guide to the Operating Room" by Maxine Goldman. I bought the Kindle edition so I can read up on cases on my smartphone (though as other posters noted, don't be tempted to get your phone out during a case). The App I used most is Evernote - great for making out preference cards for surgeons or cases, and also useful for snapping photos of instruments with my cellphone (again, not during a case) to teach myself the instrument names.
  14. insa

    has anyone left the OR for the floor? or after 1 year?

    Hi dontcallmeamurse, How's it going since you posted in July? I'm about to start working independently in my OR after 10 months of orientation, and I'm still not sure if it's the right place for me. But I have several compelling reasons to stay put for now: Hours: if I wasn't working 7-3 weekdays, who would pick up my son from school? The "grass-is-always-greener/out-of-the-frying-pan" question: this is my first job in nursing. Would I be happier in a different nursing job? I have no way to know. My indenture: I agreed to stay two years after they trained me. And what other nursing job is going to offer a new grad a 10-month orientation? I don't think I'll ever be one of the cool kids in my OR. I feel as if there will always be people looking at me wondering why on earth the manager ever hired somebody as slow and stupid as me. I hate the feeling I sometimes get that my employer wants me to look after doctors more assiduously than patients. I wonder if the OR is ever the right place for an introvert like me. But I'm making it work. Just about. Where's your head at?
  15. insa

    What to do with your rings when you scrub?

    I use a small carabiner that I bought at Walgreen's. It's versatile: usually I clip it, with my wedding ring, to my car keys and leave everything in my locker. If you didn't want to leave it in a locker, you could use the carabiner to secure it to a necklace or ID badge lanyard. I'm a guy, so I can't comment on how it would feel clipped to a bra strap. But I think it's a least as secure as a safety pin, wherever you attach it, and 100% less likely to stick me.
  16. insa

    New grad in the OR

    I am in the same position. Even with the benefit of a formal training program, it's tough being a new nurse in the OR, and I rather sense that I am already seen as "the slow one" in comparison to the other new nurse hired with me. To some extent, showing a willingness to mop floors and take out the trash, especially as the circulator, who is on the hook for a quick turnover, is going to help. On the other hand, keep in mind that you are expected to delegate appropriately - if you need to get on with something else, you need to figure out the right way to tell one of the orderlies that the room needs to be turned over. Other than that, I've found it helps to talk to as many people as you can - strike up those conversations in the break room, even if it doesn't come naturally. If people ask about how it's going, tell them about something that went well for you recently, then think of something that didn't go as well and ask that person how they would have dealt with that situation. That's the best way I can think of to show that you're getting it (even if, like me, it may be coming slowly) and that you're eager to learn.