MP RN

Ah, yes. I can't do that obviously. Did you ? They didn't lay out their own rationale to the staff impacted by this it looks like.

I don't know what the standards are in the state/province you live, but with mine, before you "report" somebody to management b/c of an issue you see or have with them, you are supposed to attempt to resolve the conflict yourself with that person directly. So unless you feel you have enough to go forward to this person with, it might be a case of "he/she's a dick", and just unfriend or delete them.

???

So your OR has the typical 20 air exchanges/hr then. Guidelines reveal at that rate of air exchange, it would take 14 minutes for the air to be considered 99% "clean" of airborne pathogen such as Covid. 21 minutes for 99.9%. Curious how your workplace settled on 3 minutes, or a single air exchange. Very little airborne pathogen would theoretically be removed from circulation at that point.

Also, consider that there are studies that suggest the false negative rate on Covid swabs are estimated to be between 20-30%- that lends even more credence to this use of PPE.

There is Covid in the communities here, and a few long term care facilities have had staff and Pt outbreaks. When you consider the insidiousness of Covid- that many people can carry it with no outward symptoms at all (up to 30% !!) and be shedding virus at the same time.. protecting yourself only against symptomatic individuals is not going to be effective. We are at the point of protecting ourselves from the symptomatic and asymptomatic people. You didn't follow up about what your facility does after the Pt is intubated in the OR. Does the surgical team come in soon after that? What are they wearing?

What is absurd about it? You didn't support this with anything. Your CRNA is the only person wearing N95 during aerosolyzing procedure? What has the assistant been wearing during intubation? And then what- everyone else comes in shortly after? Aerosolyzed virus is in the air still, it isn't droplet precs immediately after the tube is secured. Sure, there is no NEW aerosolyzed virus since the system is closed once tube is secure and connected. But that room should be considered airborne precautions still. There are studies that show Covid can be airborne for 2 hours after aerosolyzing procedure.

Hey everyone, Hope everyone is doing well and keeping safe. Just wanted to compare/contrast what everyone's OR's are doing through the COVID pandemic? My hospital is relatively small, with 4 OR theaters. We do a decent variety of cases normally- OB/gyne, general, eyes, endoscopy and a few others. We have currently suspended all our elective cases, with the exception of limited/select time-sensitive cases- ie, known bowel Ca's which can't wait long, known breast Ca's. Currently every Pt in the hospital is being treated as droplet precautions. We have some Covid in our community- ppl isolating @ home and the like, but the storm hasn't hit us yet. Every day more and more Diagnoses though, so it's coming. Here, any GA is being intubated across the hall in an ICU negative pressure room. They are then brought to the OR for their surgery. Once the case is finished, we bring them tubed, back to the negative pressure ICU room- with Anaesthetist and 1 PACU RN, both in full Covid PPE (boots, gown, N95, gloves, goggles, hood, faceshield). There Pt gets extubated. 30 minutes after extubation, the staff can doff/remove the full PPE and go back to regular droplet precs (gown/gloves, surgical mask with eye protection). I feel bad for anyone in/around the epicenters. Just wondering what everyone elses OR practices have been during this trying time?? Are you intubating in the OR's? What precautions/changes have been implemented? Trying to stay ahead of the curve in terms of prevention and safe practice. Stay safe everyone, and support each other.

As alluded to, the whole point of the 30 minute window is to be ready to respond to high acuity/emerging cases. If your drive already estimates 30-32 minutes, and there are times and instances you are worried you won't be able to make it, you should let them know before you take that job. They may be able to accommodate or assist in helping you with someplace to stay during your call periods. The 30 minutes time isn't just to make it into town. It's to be changed, have your case picked/opened/counted and ready. This is for emergent cases. Depending on your hospital, this will include stat c-sections, where literally a few minutes can mean a life changing outcome. If your loved one was on the table for something like this, would you be okay having a nurse on call who has doubts they can make it on time?? Maybe there's snow, or traffic, or who knows.. and they didn't make it into the OR for 45+ minutes? That would be unacceptable and unprofessional.

In response to: a) I have zero interest in working labour and delivery. There are a lot of, shall we say, rural and/or mennonite families who start having kids at 15 years old. Not my cup of tea... and up until the last few minutes before delivery, the L+D nurse is back there by themselves (they ring a loud buzzer or call on the phone when they want the backup L+D nurse to join them). b) I have already worked on the medical floor; I have picked up the odd shift there over the years. The air conditioning is broken, and since this is a small hospital, every single patient that requires isolation is over there. Every single private room, and usually every semi-private room too- are always full of MRSA, VRE, CDiff, (or some combination of all 3).. or some other pt that requires isolation. On top of being the hottest floor in the hospital, you are constantly gowning and gloving and sweating your ass off. I have a 3 year old son at home, and while I don't mind working there occassionally when warranted, I won't put myself fulltime into that and risk bringing it home to my little one. The floor has a horrible turnover rate not only with RN/RPN's, but also has had 3 different unit managers in the 4 years I've worked there. It's a mess. The morale is terrible, the management admits the A/C doesn't work, but over 4 years the answer has always been, "we're looking into it" (aka, it probably doesn't fit the budget to fix the A/C in a 50+ year old hospital). Pt's, staff, families have complained, and nothing has changed. c) the other options. This hospital has a funny rule of, "family members are not allowed to work together". It makes sense in a bank to me, but a hospital? Since my fiance shares ICU/ER, I can't work in either of those departments. That leaves Medicine (out of the question), LTC (if I wanted to work nursing home type job I'd apply at one), Day Surgery (everyone applies there for the 7-3 shift, it will be many years before I'd have the seniority to get in there), and OR/RecRoom. OR/Rec is what I'm leaning towards... but I have to take the OR course obviously, and then I would start part time, as well being on-call. I can handle that. It's likely what I will do. d) I was PO'd enough at being declined, and felt taken advantage of, that I considered it. The next hospital is a fair commute though, and I really love my coworkers. My fiance loves her job as well, and we'd likely have to sell our house, uproot, etc. It's a high cost to pay as a family. I am preferring to avoid that type of thing.

So, I am a male RN, have been nursing for a little over 6 years now. My fiance I met in school, and she is an RN as well. I consolidated in, and continued to work on a surgical floor after graduating, and after 2 years of getting our feet wet, we decided to move to a smaller, almost rural type hospital that has about 55 acute care beds, a 1 floor of people awaiting placement and LTC. When we applied at this hospital, my fiance went on to work in the ER, and I applied to work the surgical floor. This small town hospital was literally ecstatic they were able to grab 2 young RN's at the same time, and they basically told us we could work anywhere we wanted. 4 years ago I was orientated to the surgical floor. Now since this is a small hospital, the surgical floor is also the Labour & Delivery floor. There are about 400 deliveries a year here, so sometimes there's 2 or 3 preggos on the floor, sometimes none at all. The floor requirements are, a minimum of 3 L+D RN's at all times (night and day shift both), but there are always 4 RN's for both shifts either way. After 6 months or so of working, I was asked if I had interest in training to work the L+D aspect. I replied no, it's not really my interest. Which was fine, no issue was made of it. I have worked part time for the past 4 years now- getting almost FT hours. I am now #3 in seniority for the part time staff on my floor. Trouble is, hours are drying up. They have created a few extra FT spots, so PT hours suffer. I have had a few cheques with 20 hours or less on them. This isn't good, b/c we bought a house a few years ago. My fiance has a FT spot for over a year now, and I applied for the latest FT posting on my floor. All the job postings I have ever seen always state requirements are both surgical and L+D. There is 1 other RN on my floor who does not have L+D training; she has been working here for 2 year longer than I have. We do not work the same shift together. She also just finished a temporary (1 year) fulltime spot for one of the girls who was off on pregnancy leave- and now works part time like I do. Anyway, Human Resources contacted me, feigned not knowing I had no L+D experience/training, then DENIED me the position, stating I didn't meet the necessaries in the job posting, and I would need to have L+D training in the future to accept any fulltime spot. So I approached my unit manager about being denied the fulltime spot, and she basically told me "I need my L+D complement". I replied, even when I'm working, you have it. I am the 4th RN, there are always 3 L+D girls working with me no matter what. She replied she has to pay overtime whenever one of the L+D's I am scheduled with calls in sick. I basically asked her outright, do I have a future on this floor beyond the part time spot? I asked, how did I even get accepted to work on this floor if I had no L+D experience 4 years ago? I said I felt taken advantage of, because if they would have told me when they were first interviewing me 4 years ago, "you can work PT but we'll never hire you FT- unless you get L+D trainining", obviously things would be different. Now I have 4 years of part time seniority on the floor I love, and I can't use it for anything. She offered me to work FT on the medical floor- I don't want to even go into that- that floor is such a poor work environment it's not even funny. I respectfully declined. So, I am basically doomed to work part time on my floor unless I take the Labour and Delivery course and start working that aspect. I should note I have my neonatal resuscitation training always up to date and current. Another thing that leaves a bad taste in my mouth is, I have applied for the last few FT postings, and my manager has known about it, but said nothing to me. Those positions were taken by PT girls who were ahead of me in PT seniority. It is only when it was basically my turn to get the FT spot, and I approached her about being denied, that my manager even bothered to tell me I would need to do that training to get FT. I had my staff review with her about 6 months ago and even back then she said nothing to me about it, despite knowing I had been applying for FT positions. She even told me how much she loves having me work on the floor and how I'm a good role model and she appreciates that I am willing to work as charge nurse when they call in sick. She states she feels so confident when I am working b/c she says my assessment skills are so great, and blah blah blah, she went on and on about loving me during my staff review. So, do I have a right to be upset about this.. or should I just suck it up? I am pretty sure I will lose any grievance filed, b/c I don't have the qualifications (L+D) for any job position posted on my own floor. Yet somehow I've worked here for 4 years without a problem.