zerby1470

Exactly.

Had a pt's spouse who was making fun of the pt's parts during our pre-op interview, pre op TKA. She and SO talked about how if the girls wearing the pretty hats started laughing, that meant the blankets were off. When we said that he would be getting warm blankets prior to getting sleepy, she responded that she hoped that we could work while laughing hysterically. He laughed. I felt a little bad for the patient...if my SO mocked my body prior to surgery, I would be angry. I guess different people deal with things different ways.

I am sorry that you work in such a teamwork unfriendly environment. At my facility, nurses and techs are assigned to assist the surgeon during the procedure and scrub in with the doc. The assistant, regardless of title will help with all of the above things. And, if assigned to the case where the doc brings a PA or such, the "assistant" helps the circulating nurse in any way allowed. I am a CST, and have spent an entire case on hustle mode to help my team mate the circulating RN. I do not claim to be able to do their job as effectively as they do, but help is help. It requires a team to make an operation a success, and to expect or allow any less is bad for our patient. I understand the scope of my knowledge and training, and to provide any less is unjust to those who trust me with their care. It is sad that you are expected to provide all that you can without support.

Western Iowa - non profit 6 OR's, Level 2 trauma $1.50 per hour weekdays, $2.00 weekend. Four hour guaranteed call back at time and a half. No specialty pay.

"My" doc is back on thursday and I will ask if it is a specific technique, or just how he learned it in school.

We have two Uro's that will do this. Incision, exposure, finger, voila. As a matter of fact, one will warn the assistant not to get anywhere near the urethra because they might "take the fun part away" from him. Both are rather old school in technique. It gets the prostate out, but I am curious of the long term effects, like ED or incontinence. It's a little surreal to watch.

My two faves are very dissimilar on the surface, like Ed's. Spines and urology. Spines for me are very technically challenging for me, lots of stuff, and both delicate and brutal at the same time...going from saws and drills to gently moving a nerve root...and the post op outcomes! Someone with debilitating pain and drop foot having surgery and then leaving with a significant increase in quality of life...wonderful! And then there is urology...my other love! You can live without limbs, or without a colon, but you need your kidneys. Watching a kidney pink up and produce urine...that is the magic of the body working, and it's amazing. Even the simple procedures...stones and such cause such a great deal of relief to the patients, it's worth it! Even 'spadias repairs on kids...they are just plain fun to do, and rewarding. Least favorite is eye procedures. I get squeamish at pointy objects being used on eyes. Yes, I realize that they are the same type of things used on a ureter, but I can't stand it. And they are so short and hectic usually. Ah well, at least in my OR we have people that are fond and proficient in all of our areas, so even with the lack of "teams" the patients get the best care available to them!

If you are doing anything solely because you are paid well, you will likely be unhappy. Find what you love, and find a way to be comfortable with it. Will you live for money, or use money to live? Also, in my experience, the CRNA's ARE nurses at the bedside...of the OR bed. But first and foremost, they are damn good nurses.

At my facility we do not allow parents into the OR. We do pre op Versed, and start IV's in the older kids. The little ones get their IV's after induction. We seldom have issues with needing to restrain the little ones, but in the case that we do, we use the "smother" technique that you described. FWIW, My DD, age 4, has surgery on her genitals last year at an affiliated hospital. She cooperated with an IV preop, and I was offered the choice to go back since I was not an "outsider". I chose not to. My DD was comfortable with my explanations of what was going to happen, and I had no urge to see her fasiculate. I can only imagine how disturbing it would be for a parent to see if they didn't know what they were seeing. DD remembers a positive experience from surgery...she got three cool stickers on her chest, did great on the muscle tester (BP cuff) "cus the doctor (CRNA for the record) said that it was the biggest muscles he had ever seen, mommy!", and blew up the green balloon SO BIG!. And then got graham crackers and juice afterwards. I believe based on her experiences that the only thing that I would have contributed would have been letting her feel my anxiety over her procedure. So to answer your question, we do not use the blanket method, not have I seen it used. I have used and seen the "smother" method, and it works well for us.

I second what ewattsjt said. I am glad that you got some answers from your EGD ( I spend time on the GI forum) but there are too many variables here to give an answer. Best of luck to you!

Thank you. It is not comparing apples to apples. Both have skills that are brought for the operating room, some can to both, some cannot. But a good, well working and well trained team is in the best interest of the patient, regardless of the name that you give the roll. There are techs that I would let work on a family member in an instant, and nurses that I would not either. The inverse is also true, regardless of the role. If you are working with your best skills for your patient in the role that you are assigned and trained, the entire procedure does well.

That is disgusting. At my facility the OR scrubs C-sections. I work in the OR, FWIW. I was called in for a full term IUFD placental abruption, 3 prior sections, mom contracting. Doctor handled baby same as all of our other sections, baby was cleaned and given to dad to hold, doctor (and staff) prayed with the family. There were tears. And that is the routine were I work....I am not sure that I would be able to tolerate it any other way. If you can't be respectful of those with no voice and their families, how can you be in this line of work?

If the patient is going to wind up with a hamburger looking urethra, the ribs on the foley aren't the issue. I work with a reasonable group of Uro's, and while they agree that there is an issue of ribs on the silicone, it is less essential than the proper sizing and placement of the catheters. And verifying that it can be easily removed is easier than dealing with the tactile differences.

I have seen the flip side as well. I wanted a non medicated, limited interventional birth. And no C-section. Period. My doc was aware of my intentions, and supported me. I was induced after 8 weeks of bedrest at 37 weeks for pre-eclampsia. My time on bedrest bought my daughter time, but did not relieve my symptoms. BP through the roof and shedding protein like no other. So, I get my cervadil and pit drip. BP 228/114. Virtually no changes after a few hours. Pit gets cranked up higher. After 24 hours, dr offers a section. Am adamant that I don't want one, deal with the pain as I had planned. At 30 hours, I am dilated to a 4, consent to AROM. Get my internal monitors, still no pain meds. BP got worse with headache and nosebleeds increasing. At 32 hours, all my support staff were kicked out of my room by my nurse, because my blood pressure spiked (I don't know what it was exactly, but she mumbled "oh christ" when looking at my monitor, and she was a seasoned L&D nurse). At 34 hours I got a reluctant epidural to try to lower my BP. At the time I had a raging nosebleed, and visual disturbances. I was dilated to a 4 . 2.5 hours later I had a NVD. I was in a different profession when I delivered, so did not necessarily understand the gravity of my situation I was in. And while I am glad that I got a vag birth, and thank the gods that it turned out well, I am horrified that the severity of my situation was not explained to me by my doctor - I has high blood pressure and a bloody nose, whats the big deal, right? FWIW, I was induced on a friday, and delivered on Mothers Day, so my doc was in house a LOT over the weekend. But I also realize that my experience is the exception not the rule, and I feel for the women that have the power of their bodies to birth taken from them in the matter of convenience!

The Schlein is similar to the beach chair positioner that you were describing, WitchyRN. We have not used the McConnell positioner, but love their arm holder!