DNRme

From a first year ortho resident, in July; "But I'm the doctor". Oh, how we laughed and laughed.

I graduated from a diploma school in 1984. I still believe it was tbe best way to get a nursing education. Here are a few of my gems: -NG to low Gomco suction -3 bottle chest tube water seal -Working as a GN for months -Preop coctail:demerol/vistaril/atropine.. .everyone got it. -NO pumps! -metal bovie pads -Punching in with actual time cards -Cardex care plans

And they seem to think that being thrown out of the room is punishment... Nope, it's a reward! Lol! I aspire to be thrown out of a room!

I have been in the OR for a looooong time. I would always prefer to scrub. Since I am hired as an RN and they are paying for an RN, I rarely get the opportunity. They can pay a CST half of what they pay me. Even if you are scrubbed, if you are an RN, you are held to that standard. Finish school, and get a little experience under your belt. Don't sell yourself short. There is a reason anyone can scrub but an RN must circulate. Your patient needs you in that role.

My facility does not, also a trauma center. After I said I could not do another case after doing an organ procurement on and 5 month old child abuse victim (with healed burns and fractures), I was asked what was wrong with me.

I have worked in both areas. There is NO way the OR is less physical, in fact it may be more so. Think about wearing lead all day. I do a lot more heavy lifting of instruments and moving of equipment than I did in the ICU. I rarely had to go under the bed to move things... it is an every day occurrence in the OR. You don't always have a surgeon who helps to move a patient. Patients can wake up crazy, I have had to lay across someone's legs to keep them safe more times than I can count (safety straps are not foolproof). Most ORs have an on call schedule. You will be up all night. That takes a physical toll. Ask to shadow and see what you think.

It must be accepted where you work. It would NEVER fly at my hospital. I work in a trauma center and we are all there for the patient (with rare exception). If I leave the room, they will give a suture and let me know. If they have their hands full, I will answer their pager. You, along with your nursing management, need to take control of the situation. I would have walked back into the room and handed the anesthesia person one armboard and put the other on myself. You cannot be a doormat if you don't lay down.

Our chief of surgery once told me "If his momma didn't teach him right, we are certainly not going to." Where I work, complaints from staff about physicians are taken seriously. If this is the worst you get from him you need to chalk it up to bad parenting. You need to develop a thick skin to be successful in the OR.

Self explanatory

Excellent way to approach the situation! Generally, the difference between a good day and a bad day is one's attitude.

They will treat you they way you allow them to treat you. You need to assert yourself, in a nice way. When they walk in the room there is nothing wrong with asking them to open their gloves or an extra gown if you need them to. We ARE a team in the OR. There is also nothing wrong with asking them to write their names when they enter a room. I work in a large university teaching facility and we have so many people rotating through that there is no way I could know all of their names. No need to worry about what the residents think.

I have been certified for 15 years. Each time I have found it more economical to retake the test as opposed to getting the CEUs. I most recently took the test last year. IT WAS HARD! The other times I have taken the test I felt it was very reflective of the work that we do in the OR. This third time taking the test was much different. There seemed to be a lot of focus on pre and postop. I work in a large teaching hospital and for better or worse, don't do that part of patient care. Good luck to you. Even though you are not happy to be doing this, it is very worthwhile.

If your caskets do not have filters, how does the steam penetrate? I have never seen any without filters. If there is moisture in a casket with filters, how do we know it did not happen after sterilization... spills or the like? I would always go under the assumption it is contaminated. You will always be safe.

I think simply sending the thank you note will set you apart!

I went to the OR from ICU and I really think there is no better training. I knew how to deal with airway issues, lab results, aseptic technique and so much more. It is also a real pressure cooker area, so I knew I could handle that aspect. Plenty of shifts with no time to sit down, dealing with families and paitients in crisis situations. Good Luck

You can't find a good book about OR skills? Your OR should have reference books and/or you should. The best place to start for the last million or so years is Alexanders Care of the Patient in Surgery.

Don't go to the OR thinking it will be any less physically demanding that the unit. I found it to be just the opposite. You will still be moving the 300 lb. patient, only now they are under anesthesia. You will also be crawling on the floor, carrying absurdly heavy trays, moving beds and video towers, working with power tools and knowing how to do cases in every specialty (the surgeon does not). I happen to think the move from critical care to the OR is a great way to go. You bring a wealth of knowledge, but it is a whole new world behind the double doors. Your ability to work in a pressure charged situation will be helpful. Critical thinking skills are invaluable. I was talked into going to the OR by a couple of physicians who saw that I would go to the procedure room and do any procedure. That was >20 yrs ago. As far as the blood and guts goes, we all have our weak spots. Vomit, stool, mucous, pus....that's just Tuesday. During most regular cases, there is not much gore. I work at a trauma center, though, so all bets are off with that. Last week I gave one patient 58 units of blood product during a 3 hour case. If you have been successful in the ICU for any period of time, the OR becomes almost a natural fit.

It seems that the author of the policy has never actually done a long case. "OK, lets stop this 4 hour surgery now, time to stretch your legs!":confused:

I work 12s. As long as I am here, I might as well get it over with. I can't imagine going back to 5 days a week!

just finished a food impaction:barf02:. We seem to get a fair amount of foreign bodies.....everywhere... tons of open fractures-ex fix., im nails

This never ceases to amaze me. I took responsibility for my learning when I was new in the OR. If you do something and don't understand why, buy an "Alexander's" and read! I was told that I had 6 mos to orient to the OR. At that point I was expected to be on call, with backup, for another month, then on my own. I have seen people who after 6 mos will say "I don't do neuro", or vascular, or whatever. If you are learning, you need to make your manager aware of the cases you still need to learn. Accept responsibility for your own career.

:barf01::barf01:

I is your first, but probably not your last. You should feel bad, because our surgical conscience makes us. No one is any worse for the wear, though. You did the right thing. I think the person who left a potentially contaminated item there is more of at fault. A couple of years ago, after about 20 years in the OR, I did something unbelievably dumb. My scrub was driving me crazy asking for things not yet needed, I was in charge, no secretary, so the phone was driving me crazy. Anesthesia was bugging me to rush the patient to the room. The scrub asked for more gloves (she already had enough to start) and so I put them on her back table.....unopened!!!!! Of course that's when they bring the patient to the room. We looked at one another, laughed and fixed it. No harm, no foul.

OK, you are right, the behavior is inappropriate. Now back to reality. As an OR nurse you need to develop a thick skin. It is rarely personal & the outbursts never occur in front of anyone who matters to the problem child. They are usually reacting to a situation and have never learned appropriate behavior. That said, if it does become personal, document, document, document. Don't let it go at the OR manager level. Hospital administration does not want to have a "hostile work enviornment" because they will lose if anyone proves they knew about a problem and ignored it. A spine surgeon, who brings tons of cases, was recently disciplined for his treatment of the preop holding nurse. She was documenting his refusal to mark his patients and he went ballistic. He was suspended from the hospital for 3 months:yeah: and had to attend anger mgmt.

Hospitals in Monmouth Cty do pay significantly less than those in NYC. If you live here, though, the difference in salary will be made up in commuting costs and time wasted commuting.