Nursingal

I got my ORT in the Army, then when I got my RN, I stayed in the OR. Had to learn PACU.....but, I know I'm definatly not a floor nurse...I'm where I need to be.

I need some advice on how you do things in your hospital... 1-do you wipe the room down prior to the first case/day? 2-how do you count lap choles? do u do a pre-inst. count? 3-do you count on arthroscopy's 4-how intensive is your clean up between eye cases? 5-do you store sterile and nonsterile items together? 6-giving meds to thesterile field..do u look at it and allow a tech to poor or give for you or, is this strickly an RN duty...even if the RN is supervising it. 7-are techs allowed to have earrings in and not covered? 8-can they wear long sleeve, home laundered shirts under their scrub top? I'm sure I can think of more later but, this will be a start. Thanks...

Well, I suppose the good thing is that we don't have a really high infection rate. It's pretty amazing what the body can go through. However, I do try and really watch the techs to see what is going on. I hate to make it an RN vs. Tech issue but, if I don't trust them....I have to watch them. I just wish we had more back up than we do. I'm thinking it may be time for me to move onto a new town and job. Not for sure but...guess it's one thing I'm thinkin of. Thanks for all your words.

At our hospital, we finally hired 2 more RNs but for the last 2 years, there has only been 3 of us covering 24 hour call. How it works is....We work 7 - 3:30 Monday thru friday...40 hours/week. Then, we start call after 3:30. If a room is running late or there is an ad on, the oncall people do it. We basically have to do at least 1 full weekend/month and then 5 - 7 weekdays/month. When we do our weekends, we still don't get more time off. Since we have more nurses now, if we work past midnight, if enough people are scheduled the next day, we get to take the day off....FUN!

Maybe I need to vent or maybe I made to much out of the situation but if someone could give me honest insight as to what I could/should have done, I'd appreciate it. We use surg. tech's at our hospital. Some are very very good at their jobs and some THINK they are very very good. This tech is one of them that feels she is just as knowledgeable as the nurses. Constantly trying to do our job and I feel over stepping her bounds. Not just with the nurses but the docs as well. One time, a doc was on the phone and she started bovieing. We were doing a bowel case for cryin out loud! So today, I was with this tech...we start our cases at 7:30. We were doing a lap nissen and at 7:30, she decided to go and smoke. Well, I went and got the pt. and brought them into the room. No doubt, that made her angry and quit a bit behind. So....what happened? She was movin so crazy and fast, not lookin at what she was doing. Trying to squeeze by unsterile people and things. And, on one of her squeezes, she of course contaminated herself. So, I had her change. I told her she needed to slow down a bit. Then, as I was pluggin in the camera, light cord ect....she went by me and again, contaminated herself. I again had to tell her. So what does she do??? She wants to cover it with a towel and towel clips. She contaminated the front of her gown.. I made her change it. Then, the light source put a hole in the drape (she did this last week also). So, that was just the beginning. When they were getting ready to start the case, the dr. was insulflating the belly w/ a verres needle. Well, it just wasn't working right and so they were having me trouble shoot the insulflator. Well, it seemed to be working ok on my end. As long as it wasnt hooked up the the trocar, it worked. When they put it on the trocar, it stopped working. Finally, it worked but, not without her tellin me to do certain things to the insulflator. The Doc finally decided that maybe the trocars weren't long enough. (this is a brand new doc and we ordered a bunch of stuff in for him.) So, The tech tells me that they used some the week before. So, I went out to look. With no luck of course, When I asked her where they were kept, she had no idea but just knew we had them. After almost 10 minutes of looking, I find out that we don't have them and we were trialing them last week! (Which brings us to another problem of the techs constantly sending us out of the room for items and being unable to find them because the item wasnt put in the proper place.) So, I come back in the room and for the 2nd time, the light is right on the drape again. I felt really uneasy about the case....So, being the "professional" I am...I switched rooms with another RN. I know that that was probably chicken **** of me but, I really didn't feel good about things. After the case, I was going in to give the nurse a break and clean up the room. I walk toward the room and the Dr. is scrubbed out...and the 2 techs were closing. The pt. had 3 trocars still in his belly. I couldn't believe it and it seemed so wrong to me. Where does our responsibities begin and end? And, how do we get back in control? I could go on and on with the problems and can guarentee that when I was a tech, I certainly wasn't allowed to act that way. I'm at a loss. And to top it off, my supervisor told me I needed to get the book "don't sweat the small stuff". What do I do????