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emergency cases - what's your record?
ORIF wrist 6.5 hours cervical decompression and fusion with instrumentation 10 hours (went beyond my shift!) nothing is ever short where I work LOL
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New to OR - is misery, frustration, and anger typical?
Sounds like you work at my hospital. The only thing that keeps me going is the thought to "Keep Calm & Carry On". I hope things improve for you. Sometimes docs are nasty like that to new people just because they can be.
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X-rays and eyes
Thanks Mike! :) I scrub and circulate. It depends on how many residents there are, sometimes I am close to the beam, sometimes I am not. I just worry that my eyes are like the windows to my brain. I need them. I cover myself from neck to knees, but I wonder about my eyes. Will talk to our product rep and see what they have and maybe still get myself a pair.
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X-rays and eyes
The other day I was talking with a resident and he mentioned eye protection that is radiation resistant (x-rays). I had never heard of this, nor thought about it, until then. But it made sense to me. I spend a lot of time in ortho where C-arms are used most of the case, if not most of the day. I cover my neck down to my knees with the lead that the hospital supplies. What about my eyes? I found some glasses online that are lead-based and are supposed to protect one's eyes from the x-rays. If I have another 30 years or so to spend working in the OR, which I love, then do you think it is worth investing a few hundred bucks in a pair of x-ray resistant glasses? How long do you think the glasses would last before becoming unable to protect my eyes from the rays?
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brand spankin' new......
Learn everything you can from everyone you will meet in the OR. Everyone does things differently. Be patient with yourself. I've been working in the OR for 2 years now, and I still have not scrubbed or circulated for everything yet. Ask your clinical educator what book(s) they would recommend. I learn more from experience and surgical technique booklets the product reps have, than I do from textbooks (especially with ortho). Some days working in the OR are great, other days I wonder why I didn't call in sick. Overall it is amazing to be there. Good luck! Oh, and get a good pair of comfortable shoes because you will be on your feet all shift.
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If you have rec' d the H1N1 vaccine - please report
Got it last week. Arm was sore and muscle felt tight for 4.5 days afterwards. Was not sore going in, but within a few hours it got sore! Could not lift arm above head for same - 4.5 days. Was worse than getting tetorifice booster!!! Not looking forward to regular flu shot. Would rather not have either flu shot but don't want to be off work without pay, should an outbreak occur.
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trying to chose specialty, what if I want to change?
Do what makes you happy. If you find you have changed and want to pursue another area after some time, then change. Be happy. Have fun. Lord knows it is hard some days. Good luck!
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What's the easiest job in the operating room?
Depends on the patient, the comorbidities, the type of surgery and risks involved. Anyone of those jobs could be the hardest at any part of the case. Also depends on the people one is working with. Is the surgeon mean? Is the nurse mean? Are there any people orienting in the room? I think orientees have the hardest time in the room since they are new to the situation(s). So... it depends.
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New to OR, help me on basic concepts
When it comes to the instruments, try this book: http://www.amazon.com/Instrumentation-Operating-Room-Photographic-Manual/dp/0323043100/ref=sr_1_9?ie=UTF8&s=books&qid=1241967440&sr=8-9 Start with a gen surg major tray and build from there. That is how I started. This book is pretty good and has a lot of pictures in it. I have several other tool books for OR but this one is the best by far. Even my clinical educator saw it and was amazed - she ordered a bunch of copies for the other new people, when I was new. Alternatively, you can get that above book with another one here: http://www.amazon.com/Alexanders-Patient-Surgery-Instrumentation-Operating/dp/0323027164/ref=sr_1_1?ie=UTF8&s=books&qid=1241967440&sr=8-1 Alexander's covers the basics, including but not limited to: instruments and surgeries, patient preparation, positioning, sutures, etc. It's a great basic book, one that I got for myself just after completing my perioperative program. Wish I would have had Alexander's instead of the Berry & Kohn I was required to get. Oh well. I learn, I manage, I survive and I carry on to nurse another shift. :)
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Break room and refrigerators
I prefer not to use the fridges at work. I never use the microwaves, as they are dirtier. I'm tired of cleaning up other peoples' messes in the rooms, and I'm not about to do it in the fridges/microwaves if I don't use them. It feels like the breakroom is a dorm most days. LOL
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Surgeons who don't know what they are doing
Does he really not know what he is doing or is he working with a new/different to him set of instruments to get the job done? Sometimes going to a new facility means relearning how to do things with different methods. :) Then again, maybe he really is clueless. There is a certain person whose name I'd want tattooed to my chest with the phrase "never let xxx touch me" because I am convinced they are clueless. :S
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Documenting Implants
A lot of our screws come from a bin, and each screw has no identifier number on it so I don't know how we are supposed to track the screws. Plates at our facility have a number in the tray, but I think it is just a reorder number too. We write that one down anyways. Some special screws (lag or compression types, etc.) come packaged separately and they have stickers in the boxes, so that makes life a lot easier. If only we could get away with writing ORIF of (limb goes here) with plate and screws. LOL
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Allergic Dermatitis to surgical scrubs - any advice?
I don't like using the waterless stuff because it leaves my hands and arms itchy, dry and with red blotches all over. It gets worse with each application and the product rep told me to keep using it when I asked her about it. ***? It also gives me a headache by the end of the day. I like the traditional scrub brushes that come in the package with the little, plastic nail pick. Isn't CHG associated with a lot of unpleasant side effects? Perhaps your facility could get scrub brushes without CHG in them. Ours has them. If you love OR nursing then you should not have to sacrifice scrubbing because of the products your facility is using. Can they get something else ordered in? :-o
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clamp question...
I have never seen the fancy openers. Kochers have been cumbersome and the bottle opener idea has been a godsend. Besides, if the rim sterility were being compromised then why don't all hospitals provide these fancy openers to all of us nurses?
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Tying gowns after the spin card has dropped
If it drops down and I am unsterile, then I grab the bottom-most tip of the tie and grab it very tightly, then the sterile person grabs a good portion at their end, which is still considered sterile. They spin and then we pull HARD. Since they are disposable gowns at my facility, the material snaps and the gowned person can then tie themselves up.