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ShariDCST

ShariDCST

CST in general surgery, LDRs, & podiatry
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ShariDCST specializes in CST in general surgery, LDRs, & podiatry.

I was an LPN student in 1977 and '78. Unable to finish due to complications of pregnancy. EMT later, and then CST for 15 years from 1993 to now. Now retired due to R Rotator Cuff injury leaving severely decreased ROM in right arm permanently.

ShariDCST's Latest Activity

  1. Curious - Who is "dianah" and why is she editing my page? The bottom of my page says "Last edit by dianah on Mar 1 : Reason: misspelling, add comment". I put that there myself when I corrected something - but my name isn't "dianah"....
  2. ShariDCST

    Feeling light headed while scrubbing

    Speaking from two different angles here. One involved 2 years of Air Force Jr ROTC in High School, involving lots of marching and mostly standing in formations outside for long periods of time. The first rule we learned was to not lock your knees while standing in formation, especially when it's warm. That's the easiest way to find yourself on the ground in a faint or make yourself nauseous. So make sure you are not unconsciously locking up your knees while standing for longer periods or when the rooms are particularly warm, which seems to happen frequently in certain circumstances. Move your feet around a little, and bend your knees from time to time, and if that's the issue, it should help out a lot. Speaking from an OR learning environment ~ Other advice regarding eating enough is right on the money, especially early in the day, and plenty of protein and carbs. Even peanut butter crackers and bananas and yogurt is better than Starbucks alone for breakfast. Your brain runs on glucose, and it's running on overtime while you're in such a high-stress learning-intense environment, so don't forget to feed it! I used to precept Surgical Tech students and RNs in the scrub role, and my first question after greetings each morning was "Have you had a good breakfast?" Those who had, did well. Others who hadn't, not as well. I started keeping peanut butter crackers or cheese crackers in my locker, and a package of those could make the difference the first morning. After that, a decent meal was prerequisite for coming in my room! There are lots of things you will be exposed to in the OR that you will almost never see outside of it, so don't be surprised if sights, sounds or smells or even associations that you never considered in advance produce troubling effects. I never ever was squeamish about anything anywhere, including blood, but my very first day observing in an OR, I found myself sitting outside in an anteroom, woozy from the smell of the Bovie smoke. I talked myself back in there twice, and refused to give in to it. It takes time to develop any kind of comfort level with new things, so be kind to yourself, and don't let anyone else bully or hound you into it before you're ready. If it seems to take longer than you feel should be "normal" then address it with someone with whom you have confidence.
  3. I worked in many different sizes and types of facilities, from 3 OR county hospitals, to major metro teaching hospitals to a private 2 OR surgery center, and about everything in between. (I wasn't a "job hopper" ~ I worked as a "temp" or Traveling Tech for several years, in addition to some stints as a regular full or part timer.) A 30 minute turn over at any of them would have been a luxury. But, it depends on where you are, what kind of cases you do, and what sort of turnover help you have. One nice mid-range facility I temped at had a button on the wall inside each OR. When your case was over, and your patient ready to be moved, you rang the bell the same number of times as your room number. Turn over/housekeeping staff was waiting at your door to come in and move your patient, clean the room and set it up for the next case. Frequently any equipment you would need for your next case was waiting outside your door too, and brought in when the room was clean. They had quite a training program to learn what was what, where to put it, and how it all got handled! Nursing went with the patient out to PACU, and then to PreOp to take charge of the next patient, or if there were 2 RNs (usually) 1 came back to help get the room opened and going for the next case. Surgical Techs took care of getting instrumentation down to the dirty room, take a potty break as needed, pick up the next case cart and bring it in to open. (That is if someone hadn't beaten you to it, and was already opening the room by the time you got back to it!) The RN not bringing the patient was helping to open the room and do counts, while the other RN brought the patient. It worked beautifully, nobody stressed, and we were always well under 30 minutes at the same time. When my time was up covering for a couple of maternity leaves, I really hated to leave! Everyone was friendly, and we all helped out each other. Another place, there were a couple of docs always up our behinds for "FASTER FASTER!" turnovers. One had a habit of standing in the doorway and looking at the clock and patting his foot while watching us do all the work (grinning, of course.) Of course he was also frequently in the way. I broke him of it when I started handing him the mop, or a full trash bag to take out and down the hall. When he figured out that I was always going to put him to work if he continued to stand there, he began making himself scarce between cases! We also never had over 20 minute turn over times. There are lots of other stories, but it all boils down to who's in charge and whether or not they have your back or are only interested in kissing someone elses's ass while protecting their own at your expense. Employee and patient safety should always be #1 on the Hit Parade! Unfortunately, the almighty $ is what rules the game these days. Your only protection is to have each others' backs, and help out whenever and wherever you can. And the #1 rule in Healthcare is "Document document document!" If 30 minute turnovers are impossible to do safely, then make sure they know why! Find out where the process is failing you, and have brainstorming sessions on how to fix it. Try out what makes sense, and can be done safely, and if it works, incorporate it into your routine. (The "you" being collective here ~ not individual.) If not, throw it out and try something else. For instance: If you have to run all over hell and gone for supplies everytime the room gets turned over, figure out how to make turnover packs, or have a cabinet arranged to have all those supplies in one place. Linens, disposable trash/linen bags, suction cannisters and tubing and anesthesia circuits, and whatever else you use to change out the room. There's all kinds of ways to consolidate work. You have to figure out what works best for you. Good luck!
  4. ShariDCST

    OR call

    Wow. To be perfectly honest, it sounds like a disaster waiting to happen. It looks like there are two options. Either Adminstration keeps on blindly as they are, simply hoping nothing bad ever happens to anyone, and putting their necks out for trouble, or some kind of mandatory coverage is established. I don't know where you are, or what kind of population your hospital is serving, but in today's litigious climate, it wouldn't take much to generate a major lawsuit, while someone suffers the physical consequences. None of this is on you of course, but it sounds to me like whomever is in charge of it all needs to wake up. With only one OR it would certainly seem there isn't big demand, but the fact that it's there at all generates an expectation of service. I can't imagine a 21st century facility that wouldn't be able to cover its OR "off shift." Unless it's turned into some sortof "Surgery Center" for legal purposes, that doesn't provide 24/7 care. I'm curious what the docs think about the inconsistent coverage? Wishing you good luck!
  5. ShariDCST

    OR call

    Curious ~ what makes the difference between a weekend that has scheduled call and one that doesn't? Now, before anyone says "it means one weekend is covered and one isn't" that's not at all what I mean. Obviously if some weekends have been scheduled, why aren't all of them? Does it have something to do with who is making out the schedule? With who has already worked and who hasn't? Also, I'm having trouble with the concept of not "wanting" call because one has already done their three 12's. Call has always been over and above the hours already scheduled for regularly worked shifts from 7A to 7P, and I have worked just about every size hospital, from major metro teaching hospital to small county hospital (one where OR call began at 3P on Friday and ended at 7A on Monday when your regular shift began, and another even smaller where almost everything got sent to a larger metro area facility about 15 miles away on weekends), to surgery center. Nobody (almost) really "wants" call in addition to their shifts, but it's always been part of the job. There needs to be at minimum a scrub person and a circulator, where the circulator (or RN scrub) or even a floor nurse can double up as PACU nurse. How are the weekends being staffed now when nobody "picks up" an unscheduled weekend? Who comes in? How are they located, and what happens to the patient in the meantime?
  6. ShariDCST

    Skin issues for a 'new' ST

    If your new ST has completed training and is now an employee, then she must have done her school labs and clinical experience (or externship) already. If she did not have skin issues with the scrub solutions and/or gloves elsewhere, can you find out what she used that did work for her? I assume that non-latex options are already being explored, since I don't know what your facility already uses. (Some are already totally latex free.)
  7. ShariDCST

    Patient complaints after being in stirrups

    I was a CST for a group of 12 Podiatric Surgeons at their surgery center for over 5.years, and for the procedures you mentioned, no stirrup was ever used. In fact, it would have made the whole procedure very awkward and clumsy, and would have served no purpose at all. An ankle distractor, as previously mentioned, was used for ankle arthroscopies, but no stirrups were used for anything procedure-related.
  8. ShariDCST

    Phrases and puns unique to the OR (Tales of a new OR nurse)

    Most of the time the propofol is known as "Milk of Amnesia"! Great stuff - I have had it myself and it always does the job with no bothersome side effects.
  9. ShariDCST

    On call... 24 hours??

    Your call requirements depend entirely on the facility where you work, their staffing levels, the kinds of cases and surgeons they have and so on. Every facility has its own quirks and idiosyncracies concerning who takes call, how long, how often, what your callback time limit is (how many minutes to get there when called in), how much your call pay is (pay just to BE available), how much you make if you do get called in per hour (different from call pay - this what you get if you actually do get called), the minimum number of hours for which you get paid if you do get called in, the breaks between end of call and beginning and ending of your next shift, availability of call (sleep) rooms, motels, hospital-provided apartments, etc., etc., ad infinitum. The best source for information about what your particular expectations should be will be your nurse managers and coworkers. I used to scrub in a medium-sized county hospital OR that only had day shift regular staff. Everything else that happened between 2:45 PM and 6:45AM was done by THE call team of one scrub tech/CST and one RN circulator. Weekends began at end of shift Friday, and ended beginning of shift Monday morning. So, we had many instances of scrubbing round the clock, (especially when one particular Ortho doc was covering call - it seemed he would never actually schedule anything - all his cases got done in the middle of the night! And I'm not kidding!) including techs doing our own instruments up, until it was time to start the next day. If you could be spared, you'd get sent home first thing, if not, you sucked it (and a lot of caffeine) up and kept on with it until they could send you home. We had a 30 min callback limit to get there. The call pay realy stacked up - I had quite a few paychecks that showed much more in call pay than regular earnings. But I was too tired to enjoy it! After I left there (this was early-mid 90's) they finally decided they were too busy to keep that up, and started forming a second shift to help spread the load. This was also before the significant proliferation of free-standing and hospital owned Ambulatory Surgery Centers. They have one of those now too, and get the lion's share of the surgical cases that used to go through the regular OR's via the Day Surgery section. Not too surprisingly, a vast mass exodus of staff fled to their facility. The only things that get done now at the hospital are the total joints, and anything else the patient must be admitted for afterwards. Check with your managers and coworkers to get a feel for their requirements, and their actual needs, which are frequently NOT the same thing. Also, when you will be expected to start taking call. You have to be able to work fairly autonomously in order to function well during some emergency in the middle of the night, so it could very well be up to a year before that happens, depending, of course, on where you work. I spent time traveling as a CST as well, and no two places had the same needs. Call frequency also varies depending on available staff, so adding several nurses to the mix can make it less frequent for everyone. Good luck!
  10. ShariDCST

    gowning and gloving technique

    Or you could just open gloves first, putting them on the bottom under the gown. No need then to slide things round, less risk of contamination, and is an easier flow to work from top to bottom. This is the method we were taught by a seasoned OR nurse/instructor in our 2 year program and by our clinical instructors, and the one I used for over 15 years.
  11. ShariDCST

    gowning and gloving technique

    Never did it either way actually. There shouldn't be anything on top of your gown at all except a towel before going out to scrub. I always gowned and gloved myself, so gown had to be accessible first (after the sterile towel of course) and gloves were close by already thrown out on the table or in a basin, but you can't pick up and move gloves from the top of the gown without contaminating the whole thing. (Once you touch them to move them out of the way, where do you put them down?) So, you can have both open, and nobody has to give you anything as long as you're gowning then gloving yourself, and as long as you can get to the gown first without contaminating either one.
  12. ShariDCST

    "Really...all I need is a bovie and a hemostat"

    I used to scrub at a small county hospital with 4 OR's, one of which was a dedicated eye/cataract room. So we usually just counted the other three. There was a female GYN surgeon who absolutely had to have every posssible instrument in the building for every single case, no matter how simple. She would actually come in the room early while the scrub was settting up to see if she might possibly think of something that wasn't already there. "Dr Kitchen Sink" was the running joke for her. The circulators were sick unto death of running for, and opening up, everything she decided she wanted on a whim, "just in case" it might be needed immediately. We (scrubs) were sick of having to send half the department downstairs for processing after her cases, and possibly leaving other surgeons short of something for their own cases. Usually, if they wanted/needed something that wasn't available at the moment, they knew she had been there first! (Some things the scrub and circulator agreed to refuse to open, but have available in the room IF she needed - but almost never did - because we knew it would be needed for another case/doctor later on that day.) One of the nurses came in one day with the little plastic kitchen sink out of her daughter's dollhouse. We wrapped it up and sent it through EO processing. When it came back, we took it in the room for her first case of the day. As soon as we got started with some simple thing or other, the nurse opened the lithtle pack and passed it to the scrub's mayo. "There - now you have everything you could possibly need for your case!" There surgeon looked at it, and laughed. "Yeah - my husband has always told me I'm high maintenance!" From then on, she was a lot less demanding, and the "kitchen sink" was a subject of laughter from then on....
  13. ShariDCST

    What's The Weirdest Name You've Heard A Patient Name Her Baby?

    -Working where I do now (since having to retire from the ORs due to several physical limitations which seem to want to stick around permanently) I got a call the other night from an obviously middle-aged sounding woman who needed to speak promptly with her son Anthony's doctor, because of some emergency or other. We are required to ask for the caller's name and their relationship to the patient. She said her first and last name, and while the last name was easy enough, I was sure I had not heard her first name right, so I asked her to spell it for me. She said it again, and then spelled out "A-r-t-i-f-i-c-i-a-l".....................
  14. ShariDCST

    What's The Weirdest Name You've Heard A Patient Name Her Baby?

    "...wonderful parents..." ????????? That's the most puzzling part of your statement, actually......time to cash yourself a "reality check.":rolleyes:
  15. ShariDCST

    What's The Weirdest Name You've Heard A Patient Name Her Baby?

    She did inform some of the inqusitive folk - "The dash ain't silent!" Too bad she wasn't - silent, that is........
  16. ShariDCST

    What's The Weirdest Name You've Heard A Patient Name Her Baby?

    Oh for goodness sakes - it's "La-ah"! Can't you spell?? :rolleyes: