EricG

Read the following clearly and without bias please! You must report to your facilities corporate compliance people/ line if you choose not to follow immediate chain of command for whatever reason. DO THE RIGHT THING FOR all those involved! You will come out on top and more likely to be respected in the end. Just Do The Right Thing!!!!! It's so fundamentally basis it IS beyond the daily interpretation of the word BASIC. Adapt and move on. And keep your head down, eyes wide open. NO SURPRISES!

Oddly enough, Most, if not all of my dating in the recent past has been GYN patients from cases that I circulate. Does this seem like a problem? I've looked at it from all angles and can't find an issue! GOD NO!!!!!!!, lol My wife may just kill me for even jokingly posting this....... I dunno, maybe it's just periop services but I simply cannot imagine conversation even coming remotely close to one of a date (married or not). Sure, I have had my share of flirtatious patients and family members (sorry, I'm not bad on the eyes, lol) but there's no way in hell I would even think of walking that thin line, married or not! Plus, being honest with my fellow nurses, probably less than 1% of the patients that get to have me as a part of their perioperative experience do I even remotely find attractive based on my own interpretations of course.

LOL, YES, we all know it is wrong what she did. It's been stated in every single reply. What nobody is addressing is the fact that papergirl is a STUDENT and should just keep her focus on herself and her own development. Making comments to "jane, Dick and/or Janes hospital administration can do nothing to benefit papergirl. In the end it could cause issues down the road. (If you can, think beyond the HIPPA issue and what the many difficulties papergirl could encounter confronting or reporting) Again, 30 more posts on how wrong it is does not seem necessary as even the OP as a 3rd semester ADN student ALREADY KNOWS it's wrong. What does seem to be important is giving this young lady solid advice on how to handle the situation.

I'm probably going to get chastised for this comment, but my advice would be to continue on with nursing school and let Jane get herself into trouble at her place of employment. If by chance you end up working with her after you finish school and get to witness her violating HIPPA rules, deal with it at that time. Dick doesn't know any better and there is no reason to get in the middle of their relationship. I'm a bit surprised after so many comments saying basically the same thing that nobody has simply stated to chalk this up as a learning experience and worry about this sort of thing with your fellow students and people you actually work with. If you worked with her it would obviously require you to take some type of action. Given the current situation, it would be best for you to just let her employer catch her violating privacy laws.

Absolutely. It can be fatal. I don't recall how long ago, but it was fairly recent that a woman participating in a radio station contest for a video game died from drinking a huge amount of water. Try THIS LINK

We are using ChloraPrep (2% Chlorhexidine and 70% alcohol) which is basically a paint type prep for everything that doesn't involve mucosal membranes (still using betadine and hibiclens on gyn and butt cases). Pretty quick IMO. Its implementation has been interesting since it is a "180" from all our old prep rules! The only 10 minute bscrub/bsol prep I am doing is on penile implants and that 10 minutes feel like an hour, lol.

Probably more like 7% I would guess?

back pocket: mini trauma shears waistline: pen and ID badge That's it..........

I think the above sums up the entire situation. Sure, it makes for a great controversial post, but let's have the whole picture and not what you heard from a few rooms away. There are too many variables and unknowns to even utter the words "criminal activity", IMO.

If you weren't in the room and not a part of the OR team, I would advise against conjuring up any conspiracy theories that could come back to affect you in some regard. It could be as simple as the surgeon didn't want to close the abdomen post-code with open bowel. It's obvious you haven't been given all the facts surrounding the situation. If something was inappropriate, surely the people actually in the room (circ, scrub or anes) would have felt the need to fill out an incident report or speak to their managers/supervisors. What is the preliminary COD?

If neuro is easy for you, anything "south" will be surprisingly simple. Running bowel and looking for bleeders isn't much different than an ex-lap s/p perf aside from a bit of increased urgency. You're going to do a great job....

I'm going to have to disagree to some extent on the PCA. In Jan I had a single level fusion and was on a dilaudid pca post -op. It worked, but sucked. To maintain pain control I was essentially forced to stay awake all night to hit that button every 8 minutes. Fast forward to today and I am relatively pain-free (still alot of tylenol in my daily regime) and back working in the OR (actually went back after 8 weeks to light duty). After my own experience, I will never question a patient regarding pain having been there.

My sentiments exactly..... :)

My first year as a circulator I never scrubbed. Didn't really care to either. The last year I have scrubbed/assisted as many cases as I have circulated! I love assisting and would choose it over circulating now given the opportunity. Guess it's time to take a look at RNFA training.......

psalm 55, If you happen to run across that info I would love to see it. At my past facility, we didn't use scd's and teds nearl as much as the facility I am at now does. For cystos on 35 yr old low risk pts? C'mon..... I am trying to touch base with one of the GYN Attendings at my old place that was very up to date on dvt research and prophylactic use of devices in the perioperative setting. He drew the line at knee high's in high risk pt's. Also, many of our General Attendings gave heparin pre-op if it wasn't contraindicated instead of hose and scd's.

debbieuk, You left out a couple very important attributes of a circulator. We are the patients advocate during procedures. We are responsible for the safety of our patient, not just "support" for the rest of the OR team. I just felt the need to add that because many times I see circulators that, to myself, I question whether they practice the above comments. Now, as far as the OTP thing. Due to ~MY WIFE~ getting a huge job promotion and having to leave UF & Shands Jacksonville (My heart is still there), I am now working in a 9 OR "bread and butter" facility circulating and scrubbing on the rare occassion. The almighty dollar sucked me into this small facilty as opposed to Duke wihich is 20 min. away. After spending a year of my life knowing nearly as much about urology as the attendings I worked for due to their never-ending diligence and teaching me everyting I could absorb, I walk into work each day not knowing which service I will be working in. One thing I am thankful for is the one day my service didn't operate, I was working other services and of course trauma call at my former place of employment was always something new and exciting. (tinge of sarcasm, as we all know after a few GSW's, stabbings, MVC's too get pretty repetitive.) I miss my old job and my OTP (I really wasn't I swear ) status, lol. I miss being a part of our organ procurement team, I miss alot. But one thing I will take from this experience is the fact that I now circulate most every service and have had the opportunity to scrub more now that I have left a teaching facility. I now know I will do at least 10 lap chole's a week when I used to do one a month, lol. I look at this facility and my career as a professional another stepping stone. I can easily go to Duke, get hired into their Urology service and be in my comfort zone again, but I think I will stick this current job out just to be certain I will never be an OTP. I have said it before and I will say it again. A circulator should be able to work any service whether they are the best or not is of no consequence. It's the same basic outline we work from day to day, service not included. Interview pre-op and glean any extra info you can that may be pertininent but at the same time establish in 2-3 minutes a level of trust between either your patient or the family, assess, and sign off per your facilties policy. See them back in the room after anes. has already given them some versed and it's actually fun to chat it up with my patient. Typically I could never do that in my previous place of employment. I was alwaysy tracking down a resident for consent , etc, Our pace allowed me to review the chart, check for an h&p and a consent (surgical, blood) A a preceptor I always preached a 3 minute pt interview and assessment. But, there was this one day that based on a certain set of circumstances I spent way too much time with the family and patient in pre-op. His daughter and I were kinda flirting, etc.. (and I apologize if this brings anyone down, but I relive it continuously). Our first case was a Nephrectomy. I was very close with the surgeon (my team of course) and we were about 15 minutes late getting started over a resident not getting consent.As our CRNA and student are rolling into the room, my Urology attending and the Anes attending are openly arguing of the late start. My personal thoughts are that Dr X was pushing a bit and made a mistake. A couple silk ties on the renal artery slipped off. We went from smashing pumpkins to crickets pretty damn quick. The patient was lateral and we coouldn't open his chest. He had only dropped a liter of blood but he had an MI immediately. He had a history of cardiac issues and apperently other local hospitals decline to take the case. The longest 2 minutes of my life was walking downt eh hall to the isolation rooom where wwe had her husband for viewing and she was screaming "you killled my husband" the entire time. My post had gone on too long and I am rambling, for that I apologize. But nothing in my lifetime will ever make me forget the look on my attendings face when he asked me "now what do I do?" 4 grown men bawling their eyes out. I still talk to cj (my attending) as we bonded that day and have remained good friends. There is nothing routine about surgery and I am glad I faced the scenario so early in my career. ok, I am done running my mouth.

I hada DUI on my record from 1989 and it was a non-issue. Period. I think it will depend on how recent it was.......

Hey all, I am moving to Raleigh the first week of Dec. I am coming from a university-affiliated level one trauma center in Jacksonville, Fl (UF & Shands Jacksonville) where I was the Urology Team Coordinator/Leader (OR). I just was offered and accepted a position at WakeMed in Raleigh. Actually the Cary campus. Looking forward to a rewarding experience in NC, both work and life related. :)

Find out who the OR nurse manager or director is and try to contact them directly with a resume. You will be pleasantly surprised, I am certain........

I have accepted a permanent position in the Cary branch OR. (and psyched as hell, lol:D) I have a couple questions that I feel are best answered by current employees rather than HR. PLEASE pm me if you are willing to take less than 5 minutes to answer a couple questions that are important to me! :) Thanks in advance for your time! Eric

wow, they were great at what they "knew" and got fired for what they didn't? Interesting..... While I have no clue whatsoever what the reason is they were let go for, I doubt it was the "one trick pony" deal, lol. I mean, c'mon, if they were great at what they did, they could learn new tricks right? Just to clarify, I hate the OTP's. Truly I do...... but I am not against a TEAM approach that finds the same people working the same service repeatedly. After I took over our Urology service it went from most neglected (administrations words, not mine) to our happiest. Totally based on a team approach, consistency, and a good team that was always a step ahead of the surgeon as opposed to 2 steps behind. Specializing is not a bad thing as long as you have the foundation to do anything. Since we are a level 1 trauma center, anything and everything ~will~ drop in your lap sooner rather than later. Know your chit and no worries. :)

Any day I am here and my service has cases scheduled, it's what I circulate and with the same tech. Our attendings demand it. Having set teams may breed a few "one trick ponies" but you also end up with continuity and cohesive teams within each service. We're a teaching hosp/ level one trauma center and our attendings look for stability in the teams. Of course, that day or sometimes 2 a week that we don't have cases scheduled, then myself and the same tech will work anything they send our way quite happily and without issue. I am not condoning the 'one trick pony' as I don't consider myself one, but 80% of the cases I work are within my service.

Holly Springs is a nice growing area as well if you don't mind a little driving depending on where you want to work. Unfortunately, it appears that Duke is low on the pay scale compared to the other area hospitals. Def much less than WakeMed. There is a nice growing area just north of Raleigh called briarwood springs or something like that? It's the "development" name, I don't know the real name, lol. Just saw it when I was up there over the weekend. Seemed to be right in between Raleigh and Durham. It doesn't seem too bad getting around though. At 8am on Mon morning I made it from the Crabtree Mall area (Raleigh) to Duke in about 30 mins. I think it was 24 miles total. Not bad...... Everything is just a 20ish minute ride away on either 40 or 440, heh.

truesn, The links and info are appreciated! :)

If they follow the AORN periop 101 program, there are 26 modules to complete as part of your training. Ideally you will be paired with a preceptor from the onset and your didactic work will coincide with your clinical experiences. In our facility the periop 101 students spend a week of half-days in sterile processing learning instruments of basic trays.