BethCNOR

Don't listen to Peggy!

You need to establish your "own groove". There are things that you do for every single surgery, no matter the specialty. Getting a routine will help you feel a little more organized. Just remember to go with the flow when somebody interrupts your pattern.

Your desire to be an OR nurse is obvious in your writing here, so it probably came across in your interview.

Ah, another example of the OR eating their young! I don't know why this happens, but it does. I try really hard not to do it, but have to admit, I have been guilty of it. It takes a long time to learn the OR and to feel comfortable. I tell all the newbies I orient that it will probably take a year. I agree with what canesdukegirl told you (even though I don't prefer her college selections. lol). Keeping a pocket notebook is a great idea. Nobody can remember everything. I've been doing this for 28 yrs and I still need notes. You will remember more and more as your experience grows. Just keep doing what you are doing and the staff will come around. For whatever reason, OR people make you prove your worthiness. Just remember that your patient is your #1 priority. Hang in there and good luck.

I have to agree with the advice you have already been given. Get the heck out of Dodge. I hope there are other hospitals in your area. How has this OR passed JCAHO certification? I work in NC and I have come to accept that things are about 10 yrs behind the times of other states I have worked. Your situation is just downright dangerous. The only time not doing a count is acceptable is for a "crash through the door" trauma. Then x-rays are taken. OMG, I thought it was bad here. Good luck and DO GET OUT OF THERE!!

Yes, they go through training. Many ORs offer residency programs for new grads. The courses last 6-9 months and are classroom and clinical orientation. I hope you get the chance to work in the OR. It's a great place to work.

That's an interesting question. I see no reason to go to surg tech school. You can get books to help you learn more about the OR. Alexander's is basically the bible of the OR. It covers all aspects of the OR. Scrubbing is a "practiced" art. The more you do it, the better you get at it. I worked as a scrub tech (LPN) for 15 yrs, before going back and getting my RN. I think scrubbing makes you a better circulator because you know how it feels to stand there helpless until the circulator can retrieve what you need. Scrubbing helps you to anticipate what will be needed on the field. Ask your preceptor lots of questions, even if you think they are dumb. There are no stupid questions, just stupid people that don't ask. There is always something new to learn in the OR. I've been in the OR for 28 yrs. and I'm still learning. Good luck to you and welcome to the great world of the OR!!!!

A hundred years ago (well, OK, 30 yrs. ago) when I started in the OR, there was this concept called "on the job training". Now they have internships or nurse residency programs. Check into the availability at your hospital or other hospitals in your area. These programs are usually about 6-9 months and involve both classroom and clinical experiences. Good luck to you in your quest to join the OR. It's a great job!

Congratulations to you! My best advice to you is to buy a pocket notebook and keep notes on every surgeon's likes and dislikes. Surgery is difficult to learn because there is so much to learn. Don't get discouraged. Pay attention to what is going on around you. Don't be afraid to ask questions. If you're not comfortable with something, ask for help. When someone offers tips to you, don't respond by saying "I know" because you don't really know. It's going to take at least a year before you really start feeling comfortable with your skills. The OR is a great place to work and gets under your skin. I've been in the OR for 27 yrs. I tried other areas of nursing when I felt a little burnt out, but it wasn't long before I was right back in the OR. The grass is definitely greener in the OR. There's always new stuff to learn so it doesn't get stale. Keep us posted with your progress!

I'd be exhaused, too, with all that going on. I work in a big university hospital and we don't have much of that. We have to work off service frequently and work with nurses and techs from other teams on our cases. It just doesn't make for a safe patient environment when everyone is bickering or backstabbing. It makes my day go better and faster if I help that off service person with the "tricks" of a particular surgeon or case he/she is not familiar with. Sounds like you're working in an "all about me" OR, not an "all about the patient" OR. I wish you well, there are better ORs out there with better managers that support their staff.

I'm sorry you're are having a bad time in your OR. That's a shame. I have worked in ORs like that. I didn't stay. Maybe it has come with my many years in the OR, but when someone starts to talk down or nasty to me, I look them straight in the eye and say, "I know you're not talking to me like that!". Usually stuns them enough to stop and think about what they are saying. They will either apologize or keep on ranting. Their ranting will bring my supervisor to my room (at my bequest). This behavior is not tolerated at our hospital. I wish you well in your educational endeavors. I'm sure you'll be a great NP.

I've been in the OR for almost 30 years and preference cards have always been a sore spot. The nurses where I work make changes to the preference cards and the team coordinators and a few designated people (I am one) make the changes to the cards. The catch in our computer system is if the case has already been scheduled it will still get the "old" card. The updated card won't show up until a case posted after the changes have been made to the card. It's frustrating. I get a lot of cards to be updated with the same changes I have previously made. It's just because the case was scheduled first. How does the saying go? If you aren't part of the solution, you're part of the problem. I wish you luck with the formidable task you have decided to tackle.

Good luck to you in your educational endeavors. Being a scrub tech before becoming a nurse will help you become a better circulator (in my opinion). The pre-req's are the basic required college courses needed before you enter the nursing program. The things like math, A&P, microbiology, humanities, etc. I scrubbed for 15 yrs. before I went back to school. Wish I had done it sooner. Cilla.bella gave good advice. Have fun!!

I agree with Linda. They may also want you to take a refresher course since you've been out of nursing for a while.

Check at your hospital to see if they have a nurse residency program for the OR. Many hospitals require at least 1 yr of experience if not 2. AORN offers a perioperative course. Check their website. http://www.aorn.org Good luck!

I've seen one in 3 yrs. at our hospital. Most of them are done at the ambulatory surgery center.

You are welcome. Good luck in becoming an OR nurse. We need you.

where do nursing students get scrub and circulating experience in the nursing programs? I want to recommend that school. Most get a day or 2 of observation. From your response, I take it you are a scrub tech and probably a good one. I thought I could do it all when I was a tech, too. My opinion=nope, couldn't.

Jeff, I'm really glad that your surgery went well and that overqualified gofer that took care of you didn't have to do any work while you were under anesthesia. Where have you practiced your 33 yrs. of nursing? A radio show? Are you even practicing nursing? I am disappointed you don't feel there is a need for a registered nurse in the OR. Have you worked in the OR? Yes, I only have a short time to develop a rapport with my patients, but believe me, I do. I try to make them feel more at ease before they come to the room. I explain what will happen to them when they get to the OR. Yes, I only have one patient at a time, but that patient gets 100% of my attention. No, I don't need a BSN to hold a patient's hand, but I do need compassion, something that it sounds like you are quite lacking. The OR has its own care plan so it is NOT written on the floor. I cannot tell you how many times I have discovered discrepancies in consent, labs, and NPO status that should have been caught on the unit, but weren't. I agree, PACU nurses should be critical care nurses. Some are, some aren't. I appreciate your comment, but I do wholeheartedly disagree with you. It's just my opinion.

Are you KIDDING me?

LOL I have to agree with Mike. They do make hypoallergenic masks. Ask for those. I didn't know they still made cloth masks!

I agree with SophiaO, it takes a long time to acquire the skills to pass efficiently. Your head nurse probably was trying to encourage you, but I think she may have taken the back door to get there. She may have even told the other person you were the better one. Stay with it. Time is an important factor in the OR. I tell every new person in the OR and student, that it takes a year or more to start to feel comfortable. Hang in there.

How on earth did we get off on this tangent? The problem seems to lie in the fact that not all techs are educated the same, just as all RN's don't receive the same level of education. Not all states require techs to be certified. Not all RN's are certified, either. This is what needs to be addressed and with the same fervor as this discussion. We can argue or discuss all day long between ourselves and get no results or we can get involved in the Grassroots movements involving these issues. How many of you have contacted your representatives at either the state or federal level? There is legislation being considered.

Our OR has 8, 10, & 12 hr. shifts. Then there's "call". Your shift could be up to 24 hrs. then. There are laws that say you shouldn't work more than 16 consecutive hrs., but that doesn't always work. I remember one Labor Day weekend that I was on call. We worked 38 hrs. straight. We couldn't get anyone to come in and give us a break. My circulator and rhe anesthesiologist finally stood together and said we couldn't safely do any more surgeries until we got some sleep. I was exhausted. We took a 6 hr. break, then did 2 more cases. What a weekend.

A tie and a free tie are the same. They are lengths of suture without a needle. When they as for a tie or free tie, they want it placed in their hand. They may ask for a tie on a pass or passer. This means one end of the tie is clamped in a hemostat or tonsil clamp. A stick tie or suture lig is suture with a needle. It is used to suture around a vessel in order to tie it off. Hope that helps.