buck70

I tried to edit my post. I agree with Linda 2097 (the poster). The gowns were not designed for the circulator to tie them. There is still a potential that exists, for contamination, even if the circulator ties it "in the back." Scrubs sometimes move around a lot, and you can't be sure what their back touches and what it doesn't.............................

I totally agree. I ask the tech to cut the strings close to their gown, and then I tape the gown closed by taping it really low in the back. Like really low.................................

I agree with everyone that mentioned the plus of 1 patient at a time. You feel more in control being able to devote 100% of your time to your patient. The environment is much more controlled, and usually the docs treat you better because you can make or break them during a procedure.

We are having a debate in our OR: Can you "trace/track" Synthes plates and screws from a small frag set? If we have an implant that comes with a sticker, we put the sticker in an "implant log book," and on the permanent OR record on the chart. I write on the nurses' notes: 1 - 1/3 Tubular plate x 6 holes, and 3.5 cortex screws x 6 (for example). There is no Lot # or Serial # on the plates or screws. The Debate: should the RN write the plate and screws down in the "implant log book," and include the plate and screw numbers, e.g. 305.25? I keep saying the 305 # is a reorder #, NOT a number that means you can track that plate. HELP!!!!!!!

By the way, shodobe, if you are out there. We know you would use it, and say "F" it..........................Ha Ha. All in good fun.

I agree with Itshamrtym. If you can use some or most of the set-up for another case, that is okay. I know sometimes this isn't possible. 21/2 hours is too long to try to monitor a field. It is not recommended to cover a sterile field. The risk of contaminating it, that way, is higher than just leaving it alone. A sterile field becomes more and more contaminated (by the environment) the longer it is open. If you are doing a procedure, you can't help it; however, you can prevent, or slow, "time related" contamination by using the sterile field/set-up as soon after opening as you can. It is interfering with continuity of care to use an "aged set-up" on one patient, and a "fresh set-up" on another. Simply put: "use it, or lose it!" :wink2:

Thanks for the responses. I appreciate the different opinions. It almost sounds like a "personal" choice; however, recommended practices are proposed for a reason. I guess we can, personally, do the best we can, and hope that we are a good influence to others.................:wink2:

I know what the recommended practice (AORN) is. I also know what I was taught in tech school. Most textbooks say to keep the sterile field under constant surveillance. My question: how many of you guys follow this practice to the letter? We are having a debate in my OR. :argue: Like I said, I know what the texts all say, but "what is everybody else doing?" Thanks for replying. I just want to see how many folks are really doing it by the book.

Also, heather admitted to only 1.5 years experience, and I was simply trying to set a good example. However poor the communication was, her name being on the board, and her being assigned a room, was telling her, possibly in a passive way, that she was expected to work. I'm not saying this is okay. I'm very aware that working while fatigued is compromising patient safety. I'm also, in no way, taking up for the manager that had to "work."

Well, shodobe, with your many years of experience, I shouldn't have to mention what comes to mind when someone "assumes." I've experienced my fair share of **** poor management, in my humble 15 years, working in the OR; however, I never used "calling in sick" as a form of retaliation. My prior post was, mainly, set off by the posting that mentioned the nurse should have called in sick. I was simply trying to make a point, that communication could have been better, and that leaving a note, stating you need the day off, is poor form.

First, I do not agree with the post calling your situation a "sick call." That is not what sick days are for, and behavior like that is what forces some facilities to make staff use 2 personal days before they can use a sick day. Second, sounds like there was a communication problem. Maybe it would not have played out like it did if you could have communicated with your manager the possibility of working all night and, then having to work the next day. With your staffing, it sounds like you gambled taking two nights in a row, and lost. I probably would have had a contingency plan for working a lot SUN and MON, and being able to be off TUE.................. Third, sounds like you guys are short handed..................Feel your pain, though. Learn from this, and see managements' side, and just know "call is a crap shoot!" Hang in there.

If Hospital A is concerned enough about providing an effective orientation program as to offer AORN'S periop course, I would go with that. I would trust a facility that followed AORN'S standards over any other. Plus, a 10 month orientation will more adequately prepare a novice OR nurse. Good luck.

I'm not sure why, but in my OR, the anesthesiologist/anesthetist traditionally starts the IV if there isn't one, already. If we want to start one, however, they usually never object. I think a lot of us OR nurses are simply out of practice, and so we hesitate. (At least I do.) We have one or two RNs that like to, and they can start all they want. I don't think there is a policy against it.

In my OR, we have standing written orders (a check list). The surgeon signs and dates these orders, and we sign and date them. We check what we have done, and write N/A by the ones that do not apply (or draw a line through the ones that do not apply).