Carliestarling

Wow! That is very scary! What was the inmate doing that the guard felt warranted pulling his weapon? Wasn't the inmate sick and (weakened) in the first place? I notice you said he was shackled to the bed--How much damage could he have done? Officer's forget that we nurses handle unruly, sometimes violent and confused patients all the time--without any weapons! Although the Guard's intent may have been to protect you, it seems he went too far, and in fact put you in danger. I would have reported that, and I hope you did! I am glad for the protection most Correctional Officers provide, not only for Staff, but for the safety of other patients as well. After reading the post from MIC!, I am reminded that MOST CO's have more knowledge than we, as nurses have, regarding the criminal mind, and just how far one might go for a few moments of freedom. Also, the CO's who use common sense, and cooperate with nursing staff are our best allies when handling patients who are also prisoners. As to ambulation, I agree with someone who earlier stated that prisoners should ambulate in private areas of the hospital. None of us would want a prisoner who just had abdominal surgery to develop an ileus, and if we communicate with the guards the rationale behind ambulation, I am sure none of them would refuse. Thanks to the OP for this enlightening article. It is definitely something that facilities should have P&P in place for.

There's also Manatee Community College-- they have just received accreditation to offer four year programs as well as the ADN, and they will be known as State College of Florida as of July. Here's a link to the nursing program: http://www.mccfl.edu/pages/172.asp They have campuses in Bradenton and Venice.

As an LPN, you could be able to scrub. I've worked at a couple of places that had LPN's employed as scrubs.

Just wondering. What states allow CST's to circulate? I'm surprised more RN's (or AORN) aren't pitching a fit about that. And what is there for a "supervising" RN to do between 2-3 rooms? Once the case is going, what need is there for them if there's a CST circulating? Just for someone licensed to hold accountable if something goes wrong? Because there is no way CRNA's are going to want to be held accountable for the whole room when their one to one pt. care is so important and requires their full attention. Not being confrontational here, just trying to understand what's evolving out there. Thanks.

MJN, While I agree with most of your post, I have to chime in about the part about patient/family/nurse interactions on med-surg vs. OR. Since you haven't had to work med-surg since nursing school, maybe you forgot. LOL! As you say yourself, the OR nurse has to gain a pt/family trust in a very short amount of time, as opposed to the floor nurse who spends their entire shift with them. The floor nurse may have 5-6 patients, one needing blood, one on CBI, one needing straight-cathed, tube feedings, some needing labs, etc.. They also have the dreaded call light to deal with, but not always a CNA available. And invariably, there will always be at least one anxious or needy patient/family member who holds onto that light like its a set of worry beads. The Nurse has all these orders to carry out, and even as she walks by the anxious pt's room she's getting nasty looks from family members who think she should drop everything to get momma some ice or fluff her pillow--or more pain meds because its been almost an hour since she got her last dose. Things like that make floor nursing extremely frustrating, because we all want to make our patient's happy and there's usually not enough time or staff to do it. (Never mind all the customer service BS being handed down from admin--when we're staffed appropriately, customer satisfaction will improve--but I digress). Compare that to the brief interview/assessment the OR nurse does before anesthesia calms the pt with a little versed and we wheel them off. It's really much easier in that one respect. It's also one of the reasons I went back to the OR. Not the primary one, because I just love the OR, but it's a biggie in terms of making my life as a nurse better. At times, I truly feel bad for my fellow nurses who work the floors--they do so much, and get so little credit for it. There should be a National Med-Surg Nurses week, just to recognize the importance of this field of nursing, and to show appreciation for a truly underrated group of professionals. I am not saying this to be disagreeable or anything, I just figured I'd remiind you (and any other nurses lucky enough to be in the OR and away from the floors) what it's like out there. The OP states that dealing with pt's and their families one to one is something he is not comfortable with. Well, when comparing OR nurse/pt interaction to the floors nurse/pt interaction. The OR Nurse is clearly at an advantage. Now, dealing with crazy co-workers in the OR is another story. )

Ummm. what do you mean by RN home urine? And why would an RN's urine be worse than anyone else with a UTI's urine??

Get a job in the OR--Where the occasional "code browns" are few and far between. Although it does happen--watch, I probably just jinxed myself and will encounter a huge one tomorrow.

Hi Patrick! I started as a Nurse Tech in the OR. In my hospital we were given the AORN's peri-op 101 courses along with an extensive preceptorship. I got to scrub in and second assist (hold retractors, suction, etc..) and I was trained to circulate the room. If you are a technically inclined person, the OR will be great for you. But bear in mind, it is entirely different than any other kind of nursing. Don't expect to be giving meds very often, other than pouring meds to the field. (lidocaine, marcaine, etc..) Your pt. assessment will be quite different from what you learn in nursing school as well. You wont have much atonomy, as the Dr/Anesthesia is always there. You'll put many foleys in though! ) Now a days, most hospitals utilize RN's as circulators, preferring to use Certified Scrub Techs in the scrub role. It's cheaper for the hospital, and since techs aren't legally allowed to do many of the things RN's are licensed for, it makes sense financailly for the hospital to keep the RN's free from the field. However, as anyone will tell you--an OR RN should know how to scrub, because there are times when they will be called upon to do so--in an emergency when no scrub techs are available. Also, it benefits all when a nurse understands the surgery, because she can then best anticipate the needs of the team. But unfortunately, that is a skill set fewer and fewer nurses are learning these days. What to expect from an average day in an OR? Well, you will go in, change into your scrubs, and be ready for report. This is not anything like a report you'd get one to one--like on the floors--but it's usually a group report--updates on equiptment, things like that. At this point, you look at the board, and get your assignmnet for the day. Next, if you're in the role of circulator for the day, you'll go to your room with your scrub and make sure all the equiptment is up and running, and all supplies and instruments are ready for the first case. You'll look over the Dr's preference cards and find out how to position your patient, what meds to pull, type of positioning aids needed, type of prep, foley or not, etc.. You'll help the scrub tie their gown, you'll pour their meds and count with them, and if they have everything they need, you'll go to pre-op and check your patient. This includes a quick assessment, and a check of their chart for consents (have to be SIGNED!), pregnancy tests, allergies,labs, orders, and a recent H&P. You'll do a brief interview with your patient, and once you know the Dr. is in house and anesthesia is ready, you'll bring your pt back to the room. Next, you get your pt onto the OR table, and stay by anesthesia's side until the pt is under. Then, once anesthesia's satisfied, you can begin to position the patient. You have to be very careful during positioning, and bear in mind that a patient can sustain nerve or pressure injuries secondary to improper positioning, so this is very important. (I probably pad too much). You'll need to apply a bair-hugger to maintain patient temperature, as hypothermia is a major concern also. So, now that the patient is positioned, it's time to hustle, as by now the Dr. is probably scrubbing up at the sink just outside the room, and will come in and stare at you (maybe even complain) if you are taking too long. Now's the time to apply the bovie pad (attaches to the cautery device) to make sure the pt is grounded. (Bovie burns are another risk). Then comes the foley (if ordered) and the prep. (Careful with using too much prep, you never want alchol based preps to pool on a pt--once again--risk for burns/fires). Now back away from the patient, tie up the doctor and let the scrub come in and begin draping--creating the sterile field. But DO NOT allow anyone to begin to even think about picking up an instrument until you have the entire room's attention: Time Out! Read the consent, verify correct patient using two indentifiers, correct side/site, any allergies, any implants or special devices/equiptment available, and the antibioics used. Now scramble to plug in everything that the scrub throws off the field, and be on standby for anything else that may be needed. During this time, you can chart. But unless your scrub is really good and knows the case and surgeon really well--you'll probably have to get up several times to deliver instruments/supplies to the field. Once they start to suture the pt, you'll need to count with your scrub again. (If any counts are wrong--notify the surgeon at once--they may have to get an X-ray to be certain nothing was left inside the patient if the counts cannot be reconciled). Hopefully there was time to chart everything--once the Surgeon leaves the room, make sure the scrub has all the dressings they need, and assist as needed. Don't move the patient until you get the okay from anesthesia--remember nursing basics--ABC's come first. Anesthesia is truely running the show from behind the curtain, and while you are paying attention to everything else, they are maintaining an airway and blood pressure. Finally, it's time to get the patient over to PACU, and give them report along with anesthesia. During this time the Orderlies come in and (if its a small OR, the nurse/scrub) turn over the room for the next case. Then, the whole thing starts over. Somedays, depending on the nurse tech program you're in, you'll get the chance to scrub in. You should get a good six months before you'll be confident to perform in this role on your own, and since you wont get to do it every day, you may never get to be as completely confident as the scrub techs are. But that's okay--learn what you can from the scrubs, many are passionate about their jobs and are willing to teach someone who really wants to learn. And some days, especially in the beginning--you'll have computer time. This is when you'll be working with the AORN modules. I know you'll be dying to get into the rooms, and classroom days will seem unbearable, but remember--you're getting paid to learn, and soon enough you'll be in the rooms every day. Best of luck to you on your interview! Let us know how it goes!

ARGF!! MY posy disappeared! I'l try again. Congrats on your new and improved healthier and (aroma-improved) lifestyle! I see you have had some awesome suggestions, but I had to add mine.... 1) Gather all your ashtrays and butts and throw them in an empty coffee can. Add H20, cover. When the urge is overwhelming, open that can of death and take a big whiff. Remember, this is how you smell to your children!! 2) When the urge to retreat hits, treat yourself--even 1 hr smoke-free deserves a reward so take it! I liked to treat myself with a cuppa herbal tea (celestial seasonings worked for me) and serve it in my best china cup. (Old Country Roses) 3) This is hard, but try to stay away from your smoking friends for a few weeks. Initially the smell of them may make you vulnerable, then disgusted-- but eventually you'll get used to it. Just try not to be preachy. Good job! You deserve a pat on the back!:yeah: