Rae83

I have been a nurse for 4 1/2 years. I started on ICU for 2 years and transferred to open heart surgery. I love the OR. I am now the OR educator at my facility. I will tell you that it is a completely different type of nursing than what you have on ICU. In ICU you have one or two patients that you know everything about and spend anywhere from 8-12 hours a day caring for. In the OR you have many patients come and go in one shift...not to mention they are not conscious (for the most part)...If you are able to I would suggest talking to the manager of the OR and see if you can spend a couple of days shadowing an OR nurse to see if it is something you are interested in doing full time. Good Luck!

I have been an OR nurse for 2.5 years. I work in Open Heart surgery and it is DEFINITELY NOT BORING!!!:redbeathe As stated above you have to think and make decisions on a dime. Every area in nursing has its ups and downs. Some days are slower than others, but being a circulator is a very important job in the OR. The patient may not remember you after the case, but 9 times out of 10 the family does. The first time a family member or patient tells you "thank you for saving my life" it will totally be worth it. Give the Or a try and make the decision for your self it is definitely not a waste of education there are many opportunities to advance in the OR. Good luck in all you do and have fun!!

You mentioned SCIP, just curious what are the SCIP guidelines on prepping? We have several SCIP guidelines we follow, but I haven't heard anything about prepping. We use Betadine solution and scrub single use bottles), as well as duraprep. If a pt is allergic to betadine we use hibaclinse or zepherin (sp?) solution. I had no idea that increasing the temp causes break down of the betadine solution. We have one tech that puts the bottle of betadine in her warm water to make it more comfortable for the patient :uhoh21:. Our heart surgeon uses Iodine tincture and he has zero sternal infections. The only chloraprep we use comes in the central line kits. Maybe I should do some looking into different preps....Then again I never really hear of many of our pt's getting incision site infections....probably will get the ol' "if it ain't broke don't fix it" run around...

We do not do a fluid balance on TUR's The only case I have had a surgeon request a fluid balance on is endometrial ablasion.

Stick with it and give yourself time to adjust :-) I have been in the OR for a little over 2 years now and it really does take a year to get into the swing of things and be confident in your abilities. One of these days things will just "click". For me it was like someone flipped a switch and I knew I was finally getting it. Everyone has their own way of doing things in the OR and trust me there are many ways to do things and get the same results in the end just keep your patients safety and well being at the top of your priorities and the rest will come. I agree that hearing the surgeons gets easier once you get used to what they are going to be asking for. Give it more time

At my facility we get $3/hr standby plus 1.5 if we get called in. I am on the heart team and each person is on call 14 days of the month (every other weekend). We get paid a one hour minimum when we clock in call back. I am in Indiana.

We have some chloroprep that is tented so that you can see where you have prepped as opposed to the clear prep, but other than that I have never seen any other discoloration.

ooops there are 2 pages stage 4 ulcer trach or rectal tube

ooops there are two pages ...... I think I would have to go with stage 4 pressure ulcer trach or rectal tube

vomit definately trach or colostomy

We only wear masks in the actual room after sterile supplies are opened except for clean cases. I have been told the same thing about the patient not wearing mask because it is their germs. I have also heard that after about 15 minutes of wearing the same mask the only thing it is doing is protecting the person wearing it from splash and splatter because the material becomes moist from breathing and allows germs to pass....now whether or not that is true I don't really know, I haven't personally researched it. I don't see the point in wearing a mask all the time, but I did hear of a facility that requires OR personnel to wear masks ANYWHERE in the OR except in the pt holing area and PACU.....crazy huh.

One of the great things about nursing is that there are so many different specialty areas inside and outside of the hospital setting. If the hospital setting is not for you maybe you could consider home health care or being a school nurse, industrial nursing, or a doctors office. In the hospital setting you could consider surgery, recovery, OB, or nursing education. I would also have to agree that there is a big difference in being an RN and a CNA. From personal experience the reward in nursing comes when a patient looks you in the eye and says "thank you for saving my life". On the other hand nursing isn't for every one and there is no shame in admitting that it is just not the job for you, but I still agree that before you give it up completely get some professional help and make sure that nursing is really the root of your anxiety. You have already come so far. Congrats on your ADN and the best of luck in everything you do!!

First off read you policy, second refer to your drug book and if you are still uncertain or don't have time to look it up call your pharmacist that is what they are there for. No question it stupid especially when it comes to caring for your patient.

We have a RRT at our facility which includes an ICU nurse, Respiratory therapy, float nurse, and supervisor (if able). We have had it for about three years and I think that in the beginning the floors were unsure of when to utilize this team, but over the years the criteria and utilization of the RRT has been tweaked and is really beneficial now that staff is more aware of what it is and what they need to do. Just give it time and it will get better. Educate, educate, and educate some more

Yep that sucks!! However all part of the job. When I was orienting to ICU I was helping clean up a C-Diff patient and when we rolled her to her side and I started to clean she coughed and splattered me all across the chest with C- Diff poo. I'm sure the look on my face was priceless as all the other nurses in the room had to hold back their giggles. The kicker was that after I got myself all cleaned off I later realized it was dripping off my name badge. Another time I was helping with a trach patient and he coughed and a huge mucous plug went flying by me head...but that was a near miss thank God. I'm sure it will happen again sometime....devastating now great story later.

Thanks for the info. I will definitely check out the website. Our situation is that our surgeon uses A LOT of micro needles and has a tendency to throw them on the field or off the field if the tech isn't "fast enough" in getting them from him. So at the end of the case we occasionally are missing a 7-0 or 8-0. Our policy is that if a count is incorrect than we have to do an x-ray before the patient leaves the room. So we follow procedure and do an x ray and the surgeon gets mad (putting it lightly) and says that it is ridiculous to even count them because you can't see them on x ray and even if you could he would not go back into the chest over a micro needle!! And because there is an incorrect count we have to do an incident report. My DOSN says well " if you can find supporting literature that these needle are not visible under x-ray then we will consider a revision until then count and report, and he (the surgeon) can just deal with it"

I was wondering if anyone can tell me whether or not micro needles (8-0, 7-0) can be seen on fluoroscopy or hard plate x-ray. I work in open heart surgery and often use SEVERAL micro needle. We currently count all needles, but I have been told that the micro needles can't be seen on x-ray so there is no point in counting them. I have no problem either way, but was just curious if anyone else has any in put on this. I guess what I want to know is whether there are places that don't count micro needles, and if there is literature that says they are or are not visible on x-ray.

We count hypos, but I don't think everyone counts FRED....I do...I have always been told that "if the nurse wants it counted its counted, if the tech wants it counted its counted" So if you feel it is something that needs to be counted your tech should not tell you it doesn't need to be. I would rather take the two extra seconds to count something than chance it getting left behind just because "the policy says".

I have worked in the OR for 2 years now and have had the opportunity to help train new employees and have students shadow as well. From my point of view that room is "my room" I am responsible for maintaining sterility and safety. I am "territorial", but I also remember that when I was learning I made mistakes too. I always try to explain things in advance instead of after the fact. I found that it was more receptive to ask my preceptors " Can you show me the correct way to do...I haven't done/seen this before" and that shows your interest in learning yet not stepping on toes. And i would tell my preceptor at the beginning of the day " I want to do the prep on this case, will you watch to make sure I do it correctly" Once you let your co-workers know that you are dependable and trustworthy I'm sure you will gain their respect and trust.

Would there be any way to maybe annotate your name or initials into the documentation that way you know you documented it. We do that where I work. We have McKesson as well, but the program we have shows when changes were made and by whom.

I agree, I tuck the draw sheet under the patient and use gel pads or foam to protect the elbow and wrist. I also use sleds which slide under the mattress for two reasons 1) help keep the arm from slipping or coming untucked (especially on larger patients) and 2) to keep surg/asisstants from leaning on the patient.

Thanks to all for the info and good luck, Lovablevn, on your first round of IVF!!

Thank you for the info. I have another question if you don't mind...Did you have the ovarian drilling procedure done more than once?

Did the ovarian drilling make your periods more regular? That is one of the reasons I am considering the procedure as well as ttc. I pretty well stopped having periods (maybe every few months) and want them to be more regular. My husband and I have been trying for about a year now and started one cycle of IUI but dr cancelled the cycle and suggested IVF but we are trying other less expensive means first. I haven't talked to my OBGYN about it yet just trying to get some basic info on it first. I appreciate the info.

I was just wondering if anyone has heard of or undergone the procedure of ovarian diathermy aka "ovarian drilling". I am considering this procedure as treatment for PCOS, but wanted to get the opinion of my fellow medical professionals on the subject. Any info is much appreciated.