hodgtd

I routinely circulate for Whipples. The needle count is usually over one hundred. My process: I write the number of needles added at any one time (and total number) on a white board, save the wrappers by folding them over the stack of wrappers I have previously given and write the total number on the top wrapper in the stack. The stack of wrappers acts as a check to the white board numbers. It seems like a lot of extra work but the redundancy of the system has saved me from many seemingly incorrect counts (ex. addition errors). It also provides a record of what was given and how many at any one time (cross referenced between the stack and the white board). This can be checked against the packages that the scrub also saves. When I'm busy I say out loud the number of needles added and the total, throw the wrappers I've just given on my workstation, and because they are not neatly wrapped around the stack it's a reminder to write the total on the white board and the charge sheet when things settle down.

the situation: I work in an OR (30+ rooms/Level 1 trauma) in which RN's with little experience are forced into working night charge with very little training. We staff nights with one nurse, one scrub and one support staffer (runner). The RN performs both charge and circulating roles. We have one or two other call teams depending on the night. Our holiday shifts are chosen by those with the most seniority first, least seniority last. Charge shifts are part of the available shifts to chose from so they are usually the last to go. Therefore, this holiday weekend had 3 RN's with little experience in this role (one 2 weeks off of orientation, the others 2 months and 6 months - all of which were new grads coming into the OR). Weeknight call has also meant being called in to perform the charge role due to trouble finding reliable staff for the shift. Training for the role consists of a one and 1/2 hour course on booking cases (newly instituted and given once) and 4 hours of shadowing the charge early in orientation. The other experience I had was due to begging the charge to let me shadow when census was low (not often, and I'm competing with others who are after the same experience). I've had multiple co-workers tell me it is up to me to continually push for charge shadow experience because there is no formal system to ensure that and RN even know how to book a case. Basically it's motivation by fear of failure. Is this typical of most OR's of similar size/trauma level? How much experience is necessary before taking on charge responsibilities? Do charge nurses take charge call (ours do not)? Is it expected that every RN should be able to perform all charge duties?