BridgetJones

Not sure why you would need to when the physician is the one who is actually administering the medication to the patient. We just chart what meds we dispensed to the field. X-ray and specimen orders we put in the computer as verbal orders.

Maybe not totally on topic with this thread but I thought it was funny... Surgeon: Can we have a couple stools over here, please? (Referring to the rolling things you sit on.) ::pause:: I like the soft brown ones. Me: Sorry, all we have are the tarry black ones. Scrub (laughing): Can you push that stool in for me? Me: I thought you were supposed to push stools out! And on it went.

I'm in peds and I love it! I get lots of variety doing neonates up to 18-year-olds, and everything from cranis and spines to ear tubes.

I've had one patient code and die in the OR (s/p AAA repair, general surgeon wanted to do a "decompressive laparotomy"). I had only been off orientation a short time and the nurse in charge was not an experienced charge nurse. The next day she told me that I should have sent the body back up to ICU so we didn't have to deal with the paperwork and calling Gift of Life! (Even though the family didn't want to see him-they had already said goodbye.) Good grief!

When anesthesia asks you to get them another bag of LR when you're all the way across the room doing something else. Seriously, if the patient is stable they can get it themselves!

I wear MBTs, the Mary Jane kind. They are SO comfortable!

When a surgeon or resident's pager goes off the second they scrub and they want you to fish it out of their back pocket and answer it before you do anything else. Surgeons who bug me about answering their pager and then sigh and roll their eyes when the field doesn't have such-and-such and of course I would have taken care of it had I not been answering their pager. In the middle of a TEF repair while I'm at the head of the bed drawing up atropine for the anesthesiologist while the baby's sats keep dropping into the 50s, the resident says, "Can you check my beeper?" AAAHHHH SERIOUSLY! Sometimes I think they are only tuned into one thing! Anesthesiologists who can't find their own stupid lead. They have to ask me to go get it right as the tech and I are draping the C-arm and hooking things up. You would think they would have some time to go get it themselves while they're tapping their foot waiting to bring the patient in. Anesthesiologists who look up from their crossword and ask me if I've called PACU while I'm busy putting in orders for cultures. Last time I checked, the circulator was not the only person in the room who knew how to use a phone! Techs who think that they run the room.

Oh no Canes, no offense whatsoever! I was wishing I had something funny to post too, but I don't right at the moment. It takes more than a joke about screwing to offend an OR nurse...

Have you thought about the OR? One patient at a time, you always have lift help and there are a lot more options for shifts...lots of 8-hour days available. :-) Even better is peds OR where most of the patients are small-ish. I hated floor nursing too but now I can honestly say I love my job.

I was seriously obsessed with the show ER when I was in high school and I wanted to be just like Abby Lockhart. Don't know if I thought I would snag Noah Wyle or what, but here I am in nursing (but working in the OR and not about to date a doctor).

It's been a while now, but I'm pretty sure there was no end title CO2. As far as anesthesiologists doing cases by themselves goes, we have a couple "cowboys" but most of them are really good about asking for help when things start to get hairy (usually when they've tried a couple blades and the bougie didn't work either). Sometimes they'll have another anesthesiologist in the room before induction if they anticipate a difficult intubation. Also a lot of times there are MD/CRNA pairings in rooms so they're doubled up anyway.

Makes sense!

Yeah, it was an uncuffed ET and the kid had some lung problems and had come down on bi-pap. I guess I was just uncomfortable because a lot of the other staff aren't confident in this particular provider and I wasn't sure how long a baby could tolerate having a really low O2 sat.

I called into a room I had just been in where I knew there was a peds high risk anesthesiologist and asked if she could please come in and make sure things where ok. I felt bad asking her to leave the patient in there, but they were in the middle of a long case and that kid was stable. By the time she came in, my anesthesiologist had re-intubated (without any bag-mask ventilation, mind you) with the next size tube and the sat was 30. The doc that came in checked tube placement and made a couple adjustments on the anesthesia machine (I don't remember if it was gas, pressure, or what), and the kiddo starting coming back up. I asked her later if I had done the right thing by calling in some back-up and explained that I really just wanted to avoid a code situation. She said, "yeah...in another couple of minutes you might have been coding him." She said that I did the right thing but next time could I please find someone in a closer room. Chances are that things would have turned out fine if I hadn't called in back-up, but my gut was saying that things weren't quite right, and I made a split-second decision. Luckily all was well in the end. :-) I sure was shaking for a few minutes after that, though...

Hi everyone, I'm a ciculator in the OR and I was hoping to run a situation I had recently past some anesthesia professionals. I was doing a case on a 3 or 4 kilo NICU kid with some chronic lung issues with an anesthesiologist who is fresh out of fellowship. She pushes the drugs, masks the kid with an oral and nasal airway in (he doesn't look like the easiest mask ever, but he's ventilating ok), and intubates. There's a little CO2 on the capnography and minimal chest rise. The kid's sat starts dropping quickly, and pretty soon he's down to 27. The anesthesia provider is ventilating and listening for lung sounds and his sat isn't coming up AT ALL. She stands there going, "I know I'm in, the tube is foggy....maybe I should try a bigger tube..." all while she continues to listen to his chest. I know you risk trauma to the airway with reintubating and all, but I was really starting to sweat. This tiny kid hovered around 27% for at least 45 seconds. I've assisted in dozens of high-risk pediatric inductions and I've never seen a seasoned anesthesia provider let a kid stay hypoxic that long. I realize that this doc has lots of training that I don't and I should probably give her the benefit of a doubt, but I feel like I need to advocate for my patient if a newbie is in over his or her head!

I started off on an LTACH unit (sort of a long-term tele/ICU stepdown unit with vent wean, wound, and dialysis patients). After the first six months I was REALLY not enjoying it...all I wanted to do was work in surgery, which I had been wanting to do since school. Even though there were hiring freezes all over the place, I got into surgery through a connection and left my unit after about a year and three months. I just passed my 1 year anniversary of working in the OR and I still LOVE it! There are still bad days of course, but a good majority of the time I enjoy what I do. It is interesting, challenging, and also rewarding without a lot of the physical and emotional strain that comes from working on a regular floor. I still learn something new every day, and I consider myself incredibly lucky to be able to say that my job is fun and I look forward to going to work.

We are supposed to get a 15 min break am and pm (in reality they're more like 20), and for lunches the 8 hour people get 30min and the 12 hour people get 45. When it works that way most people are happy, but lately staffing has been tight, we've had to open extra rooms in the afternoons (added cases, one room is behind, etc), so a lot of times the day shift people don't get afternoon breaks. 1300-1915 is a looong time without a break! I like my shift now (1100-2300) because I can pee/grab a bite when I need to in between giving other people breaks and I'm not just stuck somewhere! Sometimes in the evenings we can put our feet up a bit if things are slow, so that's another perk. I don't feel guilty about it, because there are always those nights where I run my little tail off in a hepatic resection where the patient is bleeding, don't get a break, have to do an emergent crani, and get out late!

We have a neurosurgeon that will cover the field with a sterile towel, break scrub, and go downstairs to the cafeteria to eat. Everybody else just stays in the room and waits for him to get back! I don't think he goes to the cafeteria anymore, though...one time a patient's family saw him down there.

Thanks, that made a lot of sense! I had forgotten about the "path of least resistance" principle. It's been a while since high school physical science. ;-)

So I had a patient come in today for minor abdominal surgery and she was still wearing her bra. After she was asleep I took it off to be on the safe side (I know metal conducts electricity and we were going to use the Bovie), but I was wondering if any of you know whether it's technically necessary to take it off. In theory, if you put the grounding pad near the incision site, wouldn't the energy flow through that and out of the patient? I think I will continue my no bra policy just to be safe, but I have see anesthesiologists leave facial piercings in....

Well then, I'd like to see them set up for an emergency crani or do anything helpful during a difficult intubation. I've done both and I think the OR is easier in some ways, but I still have some long days working very hard. Overall, I'm getting paid the same to do a job I enjoy much more, so I don't really care what anybody else thinks!

Botched abortion at 20 weeks. The placenta and the baby's head were still in the uterus.

Actually, leaving this unit might be the best thing that could happen to your nursing career at this point. It sounds like the culture is completely toxic and nobody wants to be a positive mentor to you. These nurses need a reality check: what brand new nurse is going to be completely organized and not have any questions? Best of luck finding a unit that is a better learning experience for you!

I think that if you like the OR enviornment and you're willing to work as part of a team and jump right in and learn the job you'll fit right in. There's not really one type of person best suited for the OR...at least I work with all kinds of different types. :) If you like the OR you should go for it. And as a bonus, you already have a "backbone" from your military training and it won't bother you so much the first time a surgeon yells at you!

Yeah, I think it's a little redundant as well, but hey, I just work there. Thanks for the suggestions, they helped a lot!