wayover20

Our OR has a preop holding area that is staffed by an RN 7a-3p then the circulator(s) manage that area. Now we are told that in-patients needing surgery after 3pm will be held in the pacu, not in the holding area which is right across the hall. Reason: no one to staff it and pts can't stay in holding alone. While I understand the reasoning, I don't think it's fair to the patient to see the goings on in pacu with pts waking up in pain, or vomiting, or whatever. To me that would just compound my preoperative stress. Not to mention the family members who are always allowed to be with the pt until they go to OR.We'll have to deal with them as well. Am I wrong to be against this idea?? My co-workers don't think it's a good idea as well but it seems like the higher ups already decided without input from us worker bees.

Glad to see you're doing great! Good luck in your schooling and hurry up and graduate....we need you out here!

Hello everyone! It's been a heck of a year so far starting with a devastating diagnosis of breast cancer in Jan.2007. Since then I've undergone surgery and chemo and everything that goes with that. I took 6 months off work during this time and when I returned to work in the outpatient surg. area I realized I couldn't see myself staying on much longer. It's sort of like "life REALLY is too short" so why not make that move I've been threatening to for a long time. Well a position came up in the PACU and I jumped on it and have been there for about 1 month and I love it! My background in ER prepared me well for the fast pace and critical care aspects. My preceptor says I won't need much more time in orientation but I want to keep her as long as I can. Well thanks for listening and I hope to learn all I can from this board.

I work in a day surgery unit doing pre and post ops only and work M-F. Although we work very close with pacu and or nurses, we don't rotate thru either of those areas.

Do your best to look polished and professional. Unfortunately too many nurses show up in jeans and t-shirt for interviews (we do peer interviews) and it looks as if they just stopped by on their way to the park. The total "package" is being assessed and speaks volumes for or against you.

As a female with over 30 years in the profession, I am certainly ready for more males to join the nursing ranks. Women are much too clickish and catty compared to males. As well, the males don't particularly care if they wear the lastest fashion in scrubwear, or if their nails/hair is in order. Yea, it's true.

Two of the nurses I work with consistently clock out at the end of our shift, and stay to chart. When I questioned why, they said "oh, to save the unit some money"....like it's some noble act or something. They have been there many years more than I and I fail to see what they're "saving the unit money" got them. We still don't have the supplies we need, the walls are in need of paint and the ice machine leaks. So where did that money go?? I REFUSE to be such a spineless person. Believe me, when I'm done, I leave but if I'm still working I'm getting paid for it.

My once not-for profit employer was bought out by the for profit Vanguard corporation and I can tell you the differences are enormous. I long for the good old days when every patient was given the best care with the best of equipment/supplies by nurses who weren't spread so thin because they were adequately staffed. If the $$ doesn't flow as fast and often as Vanguard wants, beware they will be on the march to cut supplies, cut staff, services, much quicker than any not for profit hospital I've ever worked in.

I see nothing but trouble on the horizon for us. Heck, as it is now...the other day I walked by our break room which is about 15 feet away from the desk, and there was a man sitting in there drinking coffee and eating cookies someone had brought in for us. I politely asked him if I could help him (not knowing what else to say) and he said "no, I'm just having a snack while the nurses check my wife in". THE NERVE!!! I asked him to please wait outside in the waiting area until we called him in, that this was the employee's lounge.

I'm new to the periop area but not to nursing. After too many years in the ER, I am now working the preop holding area and I love it. A situation has come up and I'd like your thoughts to be able to just go with the flow or tell them why I think it's a crazy idea (not that it will do any good). In the preop area at the end of the hall we have 4 rooms that have been used to keep OR x-ray equipment, wheelchairs etc. Now the so called "higher ups" have decided to convert these rooms to ER "overflow" holding rooms for when there are admit pts in ER that no in-house bed is available for yet, be they ICU or med/surg pts. They say they will staff it with whatever type nurse is required to monitor those pts. My director has fought hard to prevent this from happening as these rooms in a pinch can be used for PREOP pts. when we are hit extra hard and need the bed space. But he's been overruled by an out of control nursing director making the decisions. One of my concerns is traffic flow and appropiateness of people walking around/thru the periop area. There is one door (in the preop area) that pts come thru from the waiting area to start their journey thru the periop area. It will still be the only door and now we'll have to deal with traffic control from family/visitors wanting to get down the hall to see the holding pts. As it is now, we have people visiting the preop pts and every so often if the desk is not manned, someone will still try to go thru the main OR doors! I can imagine the increase in traffic and problems we're going to have. The beds they are going to take are in the preop area and just feet away from the PACU area. I always thought the periop area was sort of a closed area because of the nature of OR. As it is now, we allow visitors to be with the preop pt as they wait to go back, but we can limit the number if needed to keep down the chaos. This area of rooms that are being taken has direct view into the PACU as well as the preop area. The route the visitors to the holding area will have is to pass the preop desk, make a left (if they go straight they will pass thru to MAIN OR), pass the preop running board, down the hall and to the right. If they make a left, they enter PACU where no visitors are permitted. Am I just overreacting or being too territorial?

As a former ER nurse, I vote NO to family members present during codes. There are never enough nurses, or the chaplain is still 1hr away, to tend to both the family and the patient. I cringed when I read a post that said families "deserve" to be present during a loved ones rescucitation efforts. NO ONE deserves any such thing. This is not a spectator sport. When my beloved mother was dying in the hospital (unbeknownst to us), she knew it and send us all home (demanded we go home to rest)....saying she would be alright. That night she passed away and to this day I know that by sending us home she was sparing us undue heartache at what was about to happen. She kept her pride and dignity as she always had. To have watched anyone pounding on her chest would have been an awful memory to deal with.

I'm four weeks new to the periop setting and was originally supposed to train as a circulator. After 4 days they begged me to instead work in the pre-op area and I've been doing great thru trial and error. One day we had given fleets enemas as ordered (x2) to a patient. When pt taken back to OR, the surgeon ordered 2 more enemas to be given in the OR suite while the patient was under anesthesia (urological procedure). I know I'm new to this but isn't that a no-no considering the OR environment??

As per my previous posts, I started in the OR just as I planned. I transferred from the ER and was ready for a totally new experience. Well, I spent the first 3 days shadowing my preceptor and taking notes of everything and wondering how long it was going to take to not feel nervous about it all. On the 4th day just before the first case started the OR director came to me and BEGGED me to go train in the pre-op holding area because the only 2 RN's there had turned in their termination notices and he had no one to work that area besides a trusted CNA. I responded "but I wanted to work in OR, not pre-op" and again he said this was an unusual circumstance because he didn't expect both RN's to quit, and my help there would be appreciated. Reluctantly I crossed the OR doors to the holding area. Much to my surprise I find that with my ER experience I am doing a great job of organizing the flow of patients in relation to how they're scheduled for surgery, gettting their IV's and any preop meds going, as well as making sure the preps are done, and all appropriate paperwork and labs are ready. It sounds simple but it isn't when you have 5 OR rooms going and several cases starting at the same time. The grouchy anesthesiologists don't help any either. But I don't let them get to me, I focus on my patients and make sure I do right by them. What is funny about all of this is that about 3 yrs ago, a friend of mine tried to get me to transfer to the preop area and spoke very pleasantly about it. I kept poo pooing the idea because it didn't strike me as a place I would like. Well I do like it and I think this is where my God wants me to be, despite myself. I am very happy here. I recruited a fellow RN to come work with me and she was interviewed and hired and will start soon. We will make an awesome team for this area. To top it off, there is NO call, closed holidays, flexible hours.

I saw that exact product at walgreens.....I'll try them, THANKS ALL!

I bought a pair about 3 weeks ago but now they're not as "cushiony feeling"as when I first got them. If it wasnt' for my heel, they would be great. Thanks for the suggestion Jessica! Marie, I've tried alot of stuff but never the gel pads. I'm going to try that next. Thanks. Hey Penny....about the birkenstocks...this nurse I work with today just got a brand new pair, the only thing she ever wears and loves them. But this nurse weighs 100lbs soaking wet. Don't the hard soles hurt after a while? I know I know, LOSE WEIGHT!

I know...I need to lose weight... I am trying. In the meantime, I'd love to hear what kind of shoes you all wear to keep comfortable. I've use skechers, new balance, nike, all the popular ones, but my right heel is aching like crazy. Not my toes, not the flat part of my foot, but my heel. And it's worse if I sit for a few minutes then get up and walk. YIKKKEESSS the pain! After walking (hobbling) a few minutes, I'm OK. I had an xray done, no heel spur found. I guess it could be plantar fascitis but it's only on the heel. Feels like I'm stepping on a rock. Ibuprofen doesn't help (that's odd) but plain tylenol does so I pop that 3 times a day. Can't afford not to walk/work so any suggestions for good shoes??

Thank You!! You all are so awesome!

During the past 3yrs, we have gone from a non-profit to FOR profit after being bought out by a corporation. And they are squeezing nurses hard to do more with less staff. Us oldsters believe they'd love to see us out of here to replace us with cheaper newer nurses. Alot of us have been very loyal to this hospital and it was truly "like family" for so many years. Well those days are over and we have crummy equipment, horrible staffing (but many more demands for better customer service), and except for the yearly evaluation that they try HARD not to give over a 2%....no pay increase for the past 3 yrs. The management stinks all the way to the top but they have this "no negative attitudes or comments" tolerance. Other than this it's a GREAT place to work! (heh heh). I was ready to leave myself but was so burned out from ER that I felt they owed it to me to train me in another specialty, on their dime :chuckle . If I want then I 'll stay another few years and if not then I've learned OR and I can go anywhere I want.

And I think I did ok. I tried to stick to my preceptor, didn't touch anything or do anything I wasn't sure of. At one point my precpt. had to leave the room for a minute while they were preparing a pt for a kyphoplasty and the surgeon put several paks of drapes in my hand (at that time I didn't know that's what they were) and said "open these". I said "and do what with them??....just so you know this is my first day here and I know NOTHING". He replied, "just open them and put them on this table....they don't have to be sterile". So I did. The anesthesiologist was a grouch and a whinny baby. One of his grips was that the pt that was to follow this case was a diabetic and NO ONE had called to tell him the pts fasting glucose was 175. He had the circ. call the preop and give 5 units of insulin NOW. He continued to gripe about one thing or another during this 1 1/2hr case. Then we get the next case...the diabetic pt, and when the surg is completed and the pt taken to PACU, an accucheck is done and guess what, it's 26mg/dl!! He orders a half dose of D50 and stays by her bedside until it comes back up. Duh. Well, I'm excited about this. I know I made the right decision and want to learn everything I have to to be the best I can. The hospital I'm at has A LOT of problems and have lost and continue to lose experienced nurses in ER, OR, ICU as well as the floors. Recently ICU lost 9 nurses with at least 10 yrs experience each. The OR has lost 6 nurses and 3 techs. ER lost 3 nurses (one of them ME!) and more threatening to leave. I know there are problems in the OR but I will focus on learning all I can and give it my best shot.

THANKS MissJoRN! Great info and encouragement! I am gearing myself up to be a "new" nurse again, knowing nothing about the OR. But I am eager to learn. The good thing is several people that I've known in the hospital over the past 30yrs are there and ready to help me in my transition. Thank God!

Regarding my transfer to the OR from the ER....I am set to go there on 8-15. This morning the OR director called me to make the transfer official and I asked him about the OR periop course with regards to my pay rate. He said when any nurse goes to a new training course they automatically drop down to the starting RN pay rate which in this case is 17.00/hr. I told him that would be a 11.00/hr cut in pay for me and that would be VERY hard to take. He said since the course isn't scheduled again until January and I'm starting on site training next week, I won't have to take the course thus avoiding the pay scale problem. Question: Is the perioperative course necessary or does a good on site training adequate? Our hospital does not do hearts/lungs/brains and we are only a level 4 trauma center that transfers all traumas from the ER to a level 1.

Thanks for the input and encouragment! This has been a really tough decision to make leaving what's been "my home" for many years...the ER. But I feel relieved I have done it. I just got off the phone with a fellow ER nurse that been doing it for 25yrs and she's also burnt to a crisp, but scared to make a change. I won't try to talk her into leaving there cuz that's her's to decide, but talking to my ER friends only solidifies my decision to go to OR. Thanks.

Hello again! I have previously posted regarding my need for change after many years in the ER, by possibly going to PACU, then maybe Cath Lab (it didn't happen) and then trying for the OR. Well....it's happening! Next Monday I will start on the job training in the OR, and in January I will go to the formal 6 month program. I was just wondering though, since I am going to the "training program", do I maintain my same pay or what? After all, I am at the cap of the staff RN salary and make $27.90/hr. Don't get me wrong...if I had to take a cut during training, I would (I just paid off my house!) just to learn OR. I know this is a question for my manager or the HR dept, I just thought I 'd ask here and see what your experience has been. Is it typical to lose seniority pay while in training?

Poor Wayover having to ciphon through all of these opinions! I wonder what she chose to do...Inquiring minds want to know! So sorry....been working too much OT! Well check this out....I put in for a transfer to the CL, was called in by the director for an interview. I spent 1 1/2 hrs there as we talked and toured the area. He was very interested and said he would get back with me. A week passed and I called him and he told me that one of his "pool" nurses was thinking of taking the full-time slot but hadn't decided yet. I told him that I would be willing to take the pool slot if I had to, but I really wanted to get in there. He said he would get back with me as soon as this nurse made up his mind. So 2 more weeks go by and still no word. I emailed and asked "do you want me or not?" and he replies "don't be discouraged...it's just that my pool nurse hasn't decided yet". I have decided not to wait any longer. If this director is such a wimp that he can't get his pool nurse to make up his mind, then I need to move on. I made it very simple for him saying I would do the pool OR the fulltime position so what's the problem? This has been WEEKS now and the slot remains open, unfilled. My "friends in high places" there at the hospital tell me that this CL director recently got reamed due to going over budget often. I'm thinking that maybe he saw I have reached the "cap" of the staff RN salary and maybe I was too expensive to hire(?). Just a thought since the interview went so well. I just wish he had the b***s to tell me the truth and not just keep putting me off. So anyway....I'm not going to call him anymore. My next place of interest (actually the only other place of interest) was the OR as a circulating nurse, so I went and interviewed there, and I'm going to start working on 8/15/05 and in January going to the formal 5 month course. Thanks for the input though guys. It sure looked interesting. I hope this OR thing works out and I have found a new home until I retire. If not, the only other place I would try is the Cath Lab.

I'm an ADN nurse and I have never had the desire to spend thousands of dollars more to get the BSN only to make 50 cents/hr more for it. I work in the ED along with BSN's and even one MSN prepared nurse and only because of my 30 + years of nursing am I able to run circles around them, not because of any degree I have or don't have. I look at the BSN as a gateway to management positions or a step towards advanced nursing practices.....neither of which appeal to me personally. I think my nurse manager knew what she was doing when she graduated with a BSN, spent 2 months as a staff nurse then took her first nurse manager position. The problem came when she became our nurse manager in the ED and didn't know what it meant to triage or charge, didn't know how to titrate drips or lavage a patient. But that's how it is in our hospital....show me the degree and you have a leadership position regardless of what your experience is. (But that's a whole different topic....sorry) Anyway, doesn't bother me any. As long as you pull your weight and keep things moving in the unit, you can keep the 50 cents.