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NICU- now learning OR!
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justjenny specializes in NICU- now learning OR!.

justjenny's Latest Activity

  1. justjenny

    Terrified in the OR

    i have to disagree with you. simply being human means there is no guarantee of being error free. the issue is more legal and ethical than anything. even with a pharmacology class, that doesn't mean that an st can pass meds....especially a paralytic! (the op mentioned succ) and in a court of law the st has no license to go after...it will be the licensed personnel in the room that will be sharply criticized and will lose their license and possibly have other penalties. it's not that your logic is incorrect, it is just not the law. jenny
  2. justjenny

    makes you think

    During a family trip to Disneyland I saw a similar child at the table next to us during dinner. I was "fixated" on that child and all I could think was how many of the babies that I care for will turn out like this???
  3. justjenny

    What Do you Like and Dislike About the NICU??

    I worked in the NICU right out of nursing school. It was the most rewarding job I have ever had in my life. I often felt proud when I left for the day, HOWEVER, it was also the HARDEST job that I have ever had! (emotionally, spiritually, not physically) I finally had to leave because I just couldn't stay. (I know, sounds stupid) Too many sick babies...dying babies...the same babies that I took care of day in and day out and had grown very attached to! One family had a baby that would require lifelong care...I spent HOURS teaching them her care and encouraging them...and they decided to give her up for adoption at 4 months of age...it just broke my heart! I have sooo many good stories, yet I have so very many SAD stories. One mom was so upset when her daughter was having a "bad" day (lots of lab draws for blood gases,etc.) and she just yelled at me "NO ONE SHOULD GET USED TO SEEING BABIES IN PAIN LIKE THIS!" and it really hit home for me...because we HAD to get used to it! There were some days that all I did was cause a child pain (at least in my eyes) suctioning, poking (IVs and labs) even with the quickest, most skilled "hands on" some babies have such sensitive nervous systems that I truly felt that I spent the last 12 hours torturing babies! Whew! Sorry for the vent! Jenny
  4. justjenny

    Surgery hats are KILLING my hair!

    I use cloth hats. For now the circulators can wear them. Anyone scrubbed must wear a disposable elastic one over it. Some sites: http://www.greenscrubs.com http://www.blueskyscrubs.com (pricey) HTH Jenny
  5. justjenny

    What exactly does "First Assist" mean?

    What I think you should know (and feel comfortable about) is that most First Assists are privately hired (at least at our hospital) which means they work with that surgeon day in and day out (which means they work very well together!) Is the FA going to do the nephrectomy entirely? No. Will they assist however needed? Yes! HTH Jenny
  6. justjenny

    "No self- respecting nurse"

    I have to think too...because I came from an ICU situation...and compared to THAT job - I barely feel like a nurse anymore (ducking from flying objects!) :chair: We didn't have assistants where I worked, we did ALL patient care, of course ALL charting. ALL LAB DRAWS, Assessments, secured ET tubes, gave all meds, titrated drips, started IVs, on and on and on! I LOVE the OR and feel that my job is VERY important, however, it really is nothing compared to what I used to do. No assessment (sure we still assess in our head...but not "officially") , no IVs, virtually no meds unless you count locals or abx irrigation.... Jenny
  7. justjenny

    Terrified in the OR

    I personally don't feel comfortable in that situation. My first response would have been to call for either (1) another CRNA to the room or (2) another MDA I do not care that the MDA was instructing the ST to do this....UNLESS the ST was also an RN. I also do not care that the ST draws up meds on the field. When a pt crashes...we normally have AT LEAST 2 CRNAs and 1 MDA in the room until they are stabilized. (you need people for meds, blood, etc.) my .02 Jenny
  8. justjenny

    Revising Our Periop Countpolicy

    Trying to remember specifics to try and help.... (1) the ST is always responsible for an "inventory count" upon starting and finishing a case - even when a full instrument count is not required. (2) we always count "the small stuff" (sharps, sponges, small items) (3) any scope possible open gets a full instrument count in the beginning and only a full instrument count if you actually open (4) full instrument count required when will enter a cavity (peritoneum, uterus, etc.) (5) mandatory xray at end of case for cases with multiple personnel changes and/or more than (5???) packs of sponges open (having a brain fart right now can't remember exact number) regardless of correct counts. (6) all counts must be with two OR staff with at least ONE being an RN (except for inventory count previously mentioned) HTH Jenny
  9. justjenny

    My first contamination (I feel bad) LONG

    Just the other day, While circulating a total knee, the PA on the case looked at how much saline was left in the lavage bag and without thinking reached out and touched it! I called her on it and she changed her gloves - no harm done. Later, she said she was so embarrassed and wasn't even thinking when she did that. It happens to the best of us! :) Jenny
  10. justjenny

    Disinfecting cuffs?

    Same for us. CPD cleans them. they don't get gross because they are fully covered with the 1000/1010 or 1015 drapes Jenny
  11. justjenny

    Placement of nerve monitoring electrodes

    anytime a case is boarded with nerve monitoring the hospital contracts an outside company to come in and apply the electrodes and they also monitor the screen, etc. and communicate with the surgeon. I believe at other hospitals in the area they have people in house that are specially trained but I wouldn't personally TOUCH those electrodes without a full orientation/training on their use!! Jenny
  12. Hello! Just wondering what types of things/equipment is used to position patients safetly when they will be in extreme positions. Example: today I circulated colo-rectal cases....pt will be in extreme trendelenburg and up in stirrups. The whole belly was involved in the surgery and the legs are up in the air, so no safetly belt (gulp!) and we used a beanbag and "pegboard" to secure the patient. My personal, "newbie" opinion is that it is not as secure as I would like. I was told "years ago we just taped them to the beds" as if that matters about what we do NOW.... Any examples of extreme positions and the SAFEST way to stabilize arms, legs, etc. to keep a patient from falling off the OR bed when it is tipped every which way? I really want to investigate some of our current practices and present something to my manager on suggestions for ensuring patient safety when it comes to positioning. Thanks! Jenny
  13. justjenny

    prepping solutions

    There are different types of chloraprep. The most common is tinted orange, but there is a clear and also a blue tinted one. The clear makes it too hard to see where you have prepped and the blue makes post op RNs crazy because they can't always tell if its the prep (which should not be washed off after surgery) or if it is really the patient...so orange is the most common. Jenny
  14. justjenny

    Advice from circulating nurses...

    I would recommend observing in the OR for at least one day. Sometimes this is possible while still in school - talk with an instructor. There is at least one textbook that is very helpful - but I wouldn't recommend it if you aren't actually starting a job in the OR. Some people go straight to the OR from school....my personal opinion is that you REALLY should "work the floors" for at least one year before going to the OR. It is not a requirement, but I personally think it makes for a better and "well rounded" RN...and of course there are probably tons of people who disagree with me... Just my Good luck Jenny
  15. justjenny

    Anesthesia incident on OR Nursing Record?

    It is part of our keystone briefing to have the circulator verify what ABX are given and when...not only is it a safety check, but it is now a reimbursement issue...if meds are not documented within an hour of incision payment can be withheld.... As far as the tourniquet, while I agree with you...the machine is usually right next to the CRNA and it is easiest for them to put it "up" and "down" for us, and yes, we chart it...but it is a courtesy to announce the tourniquet times (and a part of keystone) Jenny
  16. justjenny

    do u really need a foley?