Uro-DaVinci

Glad to see some posting action! How about sharing things you have learned. Take positioning for a robot prostate...what is you usual set-up? We use lithotomy with th patient ultimately placed in a very steep head down position. We have had some patient slipping problems if all things are not done exactly correctly. Some neuropathies have resulted. We pad the inside of the Yellofins with foam, strap them down and the put foam on the outside of the Yellofins to further protect the patient. We used to put foam on the bottom and the top of the legs inside the fins but ended up with some pressure problems especially as the patients have on SCDs. We use foam (eggcrate) under the right arm, a gel pad around the left arm and eggcrate on top of it. Both arms are tucked at the sides with the draw sheet. Eggcrate is placed under the sacrum as well This works most of the time however with morbidly obses patients we do have problems getting the positioning to work securely and without cutting off circulation to the arms. Any suggestions? How do you folks do it? What equipment do you use? Lessons learned? Thanks!!

This is an interesting thread and the number of replies shows that it is a sensitive subject to both Tech and RNs. As I am sure it has been said somewhere before, there are legal issues here. In the state in which I practice it is illegal for a non-licnesed person, even if they are duly certified, to give medications. The Techs (God bless them!) in our facility cannot even mix medications that have been dispensed to their field by the RN (example: surgeon want 1% Lidocaine equally mixed with 0.5% Bupivacaine). There are legally defined responsibilities assigned to the RN and the RN is accountable and can lose a license with regard to those responsibilities - it has nothing to do with capability or ability - it has everything to do with assuming responsiblity. I want to scrub some day - so I need the training or go back to school to get it.

Thanks for the post - I too am considering traveling for OR positions. Any advice you seasoned travellers have will be of help. I have a friend who has done some travelling as an OR nurse - three times. First contract was a nightmare for him - charge nurse in a busy OR for a year with all the responsbility and no authority - he hated it and swore never to take an inital contract any longer than 13 weeks. His second travel position was wonderful - small 4 OR hospital, worked as a circulator and learned to scrub, took an RNFA class and made friends with some surgeons who taught him lots. He extended his contract at that facility a number of times for about 1.5 years. Third travel assignment turned into a full-time position at Barnes-Jewish in St. Louis. Seems happy. Share people! Thanks and Merry Christmas to all!!

Welcome to the wonderful world of the OR. First, expect to feel and BE overwhelmed for a while . . . . about 3 - 4 months. Try to learn as quickly as possible the who, what, when, where and why of the procedures to which you will be assigned. For example if the surgeon says I need a TA60 - what is that? where is it kept? Who knows what it is and where it is kept? What else do I need with that - reloads? Who is asking for it? - because that surgeon may call it a TA60 but in reality the thing is marked TX60. Learning the individual surgeons lingo and preferences is key (Who?) The why of these things will come with time and experience. Anticipate, anticipate, anticipate!!! Read a book like Alexander's Care of the Patient in Surgery to get a feel for the routine steps of the procedure. If you have to go get say a 4.0 suture get at least two or three more of that suture and have it in the room. Check all equipment to make sure it is functional. Be a boy or girl scout - be prepared for anything. Only experience and time will put this all in perspective for you. It WILL take time, be patient with yourself. Best of luck! Hope you love it.

In my facility the patient cannot be brought back to the OR until the surgeon is in the hospital AND the H & P is updatedon the day of surgery by the surgeon or the MDA.

Yes - We have a DaVinci robot and it is used exclusively by our Urology group for prostatectomies and some nephrectomy procedures.