MelissaRN

I had a weird case. This lady had suffered an intracranial bleed and had held on and held on in a coma on a morphine drip for almost a week. The family had been at her side non-stop and had been trying to get in touch with a son that had been estranged from the patient for 20 years. They couldn't get in touch with the estranged son and were exhausted sitting at the bedside so they decided to say their goodbyes and go home. I did my initial check of the patient at 7:00 right after punching in and decided to give her a bed bath and turn her before passing 8:00 meds. So after bathing and turning her I went about my business and then checked on her again in passing while giving out meds in the next room, yup she was gone. I was on the phone with the doctor to tell him of her passing when on the other line the ESTRANGED SON was calling to check on her status. He called within 5 minutes after I found her dead. It was so weird. It seemed like she had been hanging on and finally gave in after her daughters said their goodbyes. Another weird thing about this case was that when the doctor decided to put her on a morphine drip the pharmacy had made an error and mislabeled the morphine and the nurses didn't catch the error for an hour after it was hung and she had gotten twice the dose of morphine. She managed to survive for days after that error was made. Another night we had this lady that had been up all night long restless and constantly ringing out to be repositioned or helped to the bathroom. She kept saying something was wrong. Of course the nurse thought she was just being a pain. She was there for some orthopedic surgery. Well in the wee hours of the morning the tech put her on the toilet and then went back to check her and she had died and had bile coming out of her mouth. Very strange.

When I was a new orientee I found that I was bored because I was doing things as I learned them and not doing everything at once. Once you get your own assignment and you don't have a preceptor doing things behind the scenes then you'll find that you have more than enough to do. I would definately get used to doing ADL's and getting the hang of those because they will be part of your responsibility along with passing meds, assessments and doctors' orders. You can't always have a tech to rely upon to help with the ADL's, especially on nights. I do 12 hour days 7a-7p and it can get draggy at times, but I LOVE having four days a week off and having long stretches off to do what I want to do. There is never going to be the "perfect shift" you have to give some to get some. They call it work for a reason.

I'm thinking that perhaps this new nurse isn't ready for a full assignment yet? Yes she didn't do her job correctly and yes she copped an attitude, but why is she made to feel defensive?? I'm sure this isn't the first mistake she's made due to a fulll assignment and lack of experience. I think it's setting new people up for failure when they don't have the experience to be able to handle a full assignment yet they are given one anyway just because they graduated an accredited school and passed the boards.

As a nurse we know from schooling what could happen as the result of a clamped off carotid artery (which is what they do during an endarterectomy) so it's essential to know BEFORE leaving the room that the patient wasn't compromised during that time that the artery was clamped off. Not all surgeons will use a shunt or have EEG monitoring brain activity during the surgery.

I've never seen a doc throw instruments, they will slam them down on the table sometimes, but never throw. I think that it's really dangerous to throw instrumets or knives or needles, we take such effort to avoid getting stuck with contaminated sharps and to deliberately put someone in danger of hepatitis or AIDS is unthinkable. We have one doc that has quite a red headed temper and one day he messed with the wrong nurse lol. This lady has been nursing in the OR longer than this guy was alive. Anywhoo, he started giving her $hit about not taking care of the music and putting his CD's in the player. Well she was busy doing patient care (gasp!) and said to him "I'm not a DJ". Well he hit the ceiling and told her to get the f--- out of the room. She headed straight to the dept. head's office to write him up. LOL. We mostly have to take verbal abuse from the docs. A lot of their anger is justified but they tend to take it out on the wrong people. We've had cases booked wrong and not know until we get in the room, or certain instruments that the doc wanted for a case weren't communicated to us when the case was booked. That sort of thing.

We do neuro checks after the carotid surgery is finished. We have one particular doctor that likes to keep the back table and scrub sterile until the patient is awake and he sees that the patient is moving all four limbs.

I've been doing this a little over a year and I really enjoy my work hours which are three 12 hour shifts, only one weekend every 5 weeks and not as much holiday work. I worked the floor for over a year and it was a miserable time. Patient care was a joke and there was never enough time to get it all done, plus the hours sucked. As an OR nurse you're part of a team. Everyone jumps in and does their part and I never feel like I'm alone struggling. There's always a good resource person that can help you out if you get in trouble. The anesthesia team is awesome and we have some really great scrubs. The surgeons can be jerks but they are like dogs, don't show them fear. I have found that ignoring the snarky remarks and going about my business makes them back off more than being confrontational. Truly I think the OR is one place where MOST people are there because they want to be and generally enjoy their jobs which makes for a nice environment. Yes ego's do get the best of some, but you get that everywhere. Ask questions, help out your team and that includes cleaning the rooms and mopping floors when you have time and everyone will go out of their way to help you.

I work in a hospital that's the "trauma center" for a wide area in our state. Nights can be dull or they can get slammed. They get alot of emergency appy's, emergency splenectomies from car crashes, broken bones, the occassional AAA's etc. We have a team that works nights and we all have to take call in case of multi traumas. We also have a couple of weekend teams that work too, we handle a lot of inpatients that need to come back for internal bleeding or AV shunt declots, crani's that sort of thing. I take ALOT of call by choice because it's excellent money and a chance to get experience handling the emergent cases. During the day they have their more experienced people handling the big gun emergencies. Weekends are good for that too. As a nurse or a scrub it's important to be able to handle whatever comes crashing through the door, so I highly encourage people to take that extra call and those weekends. We never, never, never do elective stuff on the weekends, we have our hands full enough handling all the disaster ortho traumas that couldn't be done during the week because the patients weren't stable enough. In the summer you really get burnt out with drunken people that decide to get on motorcycles and then we have to try to put them back together. I lost count of how many limbs I've seen hanging by flesh. Blech!! Weekends can be dull or downright crazy, there's never a happy medium, but it's what we do!!

I for the most part enjoy my job as an OR nurse. The only piece missing is that I can't scrub and haven't come up with a way that I could consistently learn. We have a scrub tech program so they don't have time to drain the nurses consistenly. The techs where I work make really good money if they have the drive. We have scrubs that have been doing this job for years, are awesome and get paid what nurses starting out get paid. The ones that are paid well are phenominal. I get a little frustrated when I'm trying to help out the people in the surgical field and another tech will say "oh go do your nursing stuff" I'll run for them. I know she's just being helpful, but I hate hearing "your nursing stuff". The paperwork is frustrating and we all advocate that the paperwork is secondary to patient care.:balloons:

I worked for a year as an acute care RN on a ortho/neuro floor. The stress and constantly trying to coordinate care for several patients at once was tricky especially when you had new admits and post ops on top of all that. The OR is stressful but at least you have other members of the team there helping you out. My time in accute care helped me to be able to strengthen my assessments skills and I saw first hand how important proper positioning on the OR table is to avoid skin break down. As for putting in IV's. Well we don't do that in the OR, but heck when I was on the floor I was always so busy I had to get a resource nurse to come up and give me a hand. I just like the pace of the OR and the fact that we don't have to work as many weekends and holidays as you do on the floor.

I've been working as an OR circulating nurse for about 9 months. My orientation was long (about 6 months) and I still feel like a rookie. I think that being able to function in any kind of capacity as a circulator after 6 months is a huge accomplishment. We're basically learning 20+ years of technological advancements in that short amount of time. It's not an easy job and you're basically all things to everyone from the patient, surgeon, the scrub to the anesthsia team. If the role of the nurse circulator looks easy it's because there are nurses that have been dedicated to the job for 20+ years and they work hard to make it all run smoothly and have a lot of patience with us newbies. Oh and let's not forget those old school surgeons that feel that the best way to teach a newbie is to yell, rant and rave at them!! :chuckle

The BON might have something to say about "the nurse dose".

Associates Degree in Medical assisting.

I really love my New Balance slip ons. The are like sneakers but slide on. The part that goes over the top of the foot stretches so they don't dig into your feet. Everyone is always asking where I got them. I bought them online at Brown's New Balance store.

I worked nights for a year and I never felt right. I'm on day shift now and am a happy camper. Feels good to sleep at night and wake up to the birdies in the morning.