Kingbandit

What is the AORN & JAHCO's position on multiple rooms? Our management has allowed a surgeon to have 3 rooms, cause he's fast and had a lot of cases. I requested a different assignment, I didn't want my lisence to be at risk.

You may have seen hundreds of people die before, but when its a patient under your care you feel like screaming. You have so many emotions, I for one kept replaying the code over and over trying to find my mistakes. I didn't nor did anyone else, you just can't fix dead hearts. No code is fun, but new nurses should be at least observing if not participating in the code. Any experience is good experience. I feel we all have a time to go, I just don't want mine happening around well trained nurses, we're just to good nowadays.

I have a unique perspective, twas a scrub tech for 10yrs, then a RN for 6yrs. The education for surgical tech was 1 1/2 years at a community college. I graduated with an associates degree. The core curriculum was all about instruments and how they interact with different tissue. Our pharmacology was very basic, locals, antibiotics, heparin. We took anatomy where we dissected a cat. Most of our education is through 360hrs of clinical experience.I've known many people who work their whole career who work as techs. They start around $16/hr and max $25/hr. In my state the ADN & BSN are considered equal. I have both. Neither degree had any formal training for the OR. The most you could hope for is a day of observation. As you know, nurses start around $24/hr. Most stub rns are former techs or trained on the job. Most RN's who scrub work in orthoor open heart. Hospitals like the rn in these services because they can staff a room with 3 rns and have it covered all day without needing to send any other staff for breaks/lunch. Our open heart team use nurses exclusively.

The OR nurse must be able to recognize the possible/real injuries, and have all instruments ready. You will learn assessment skills, as well as circulating skills. The trauma nurse should get their ACLS certification if they want to transport trauma pt's. If you scrub, traumas will teach you how to set up a case quickly. Most trauma centers love OR nurses who can circulate and scrub.

Thanks, I have been there 10 wks and I feel comfortable enough to move to off shift training. Each one of my service preceptor's have signed off, but the manager is making me stay in orientation for 6months. I just want to move on and be productive. The charge nurse uses me to relieve for lunches without a preceptor. I had to act contrite today during a trauma because the preceptor was new and she tried but I had to do most of the case, but I wanted a good review. I was a surg tech for 10yrs an ER rn for 6yrs, I can't count how many traumas I've done.

Which services are new nurses oriented to in your facility? How long is the typical orientation? Does your facility orient to other shifts (evening, nights, weekends)? Are services/teams chosen or do new nurses get to pick. Are your teams picky about who they let in (hearts, eyes, robot)?

I'm sure by now you have heard the old "go do med-surg first" I love the OR because: 1) Drs love teaching for the most part 2) You get to see some pretty cool things 3) Awesome stories 4) usually you get to work with a certain service/team 5) You can make a boatload of $$ if you take call all the time 6) scrubs are provided 7) wide variety of shifts 8) NOONE dies in the OR (old joke, used to do cpr until pt in ICU)

I started my healthcare career as a nurses assistant. I then graduated as a surgical tech. I held this role for 10 years. I spent 6 years in the ER and was looking for a change. I knew the pace, cases,doctors,staff, & management. If I had gone anywhere else it would not have felt as right as my return has felt. My skills as both a with tech (cases, instruments), and ER (assessment, ACLS) have made a great fit for the OR.

When I first started, I was quizzes not only about dosage calcs, but also drugs themselves. Like mechanism of action for beta-blockers, nitro. Reversals of opiates-arcane, denzos-flumazicon. Side effects of certain meds like calcium channel blockers-angioedema. Most tests are assessments of what you need to learn. Simply ask if you should cram or take it blind and truely assess your weaknesses.

Thanks, I wish staff had more support in protecting our pts right/health, but drs say I'll take my cases elsewhere and management backs down. It happens anytime we have staff vs Dr, we lose.

Our hospital uses the universal protocol time outs. We still have several drs who treat it as staffs delaying cases, others get upset to just turn down the music or anesthesiologist who won't hang up the phone to verify the information from the wrist band. Does anyone else have these issues? How do you/your hospital deal with this? Does any one use 2 time-out pre-prep, pre-cut?

I agree with caliotter I start with Dr then, if they say call me "Pete" I will drop the Dr. I find it difficult when they become staff, to go back to Dr though. But I'm working on it.

usatoday.com/news/health/2010-04-16-nurse-doctors_N.htm Cut and paste the link above. YES Today published a piece about the healthcare reform bill might lead to an expansion of advanced degree nurses role in caring for the millions of soon to be insured. The article talks about the obvious push-back they face from physicians. I'm all for nurse getting the respect they are deserved. Physicians have historically looked down on PhD nurses as just nurses, but they have put in just as much if not more, in the classroom. Plus they are trained to look at. a patient as whole and not just treat the symptoms.

Recently our OR started pushing our Dr's to use Chloraprep. Last week one of our ortho Dr's demanded the nurse prep an open femur fracture. His reasoning was that he had reformed a pre-scrub with a chlohexidine scrub brush. The nurse refused and he proceeded to prep himself. Afterward, th Dr wrote up the rn she has not heard back from management yet but she's afraid she'll get in trouble. Everyone that has heard the story backs her because the manufacurers instructions state not to use on mucous membranes, eyes, ears, or open wounds. What are your thoughts?

Our management is making it a requirement to transport its to/from ICU or ER. My take is I'll go to any class that they will pay for.

I work in q 600 bed inner city hospital, our OR has 20 rooms. ACLS is optional, but due to magnet status management is willing to pay for any nurse interested in taking it. Even though we never "code" a pt in the OR, every nurse, CRNA, & Dr should know basic meds and heart rhythm identification. And any facility with peds should require PALS.

The most important thing is consistency, always set up the same no matter what the case is. That way it becomes rote memory. Next is to organize by need, if the first thing the Dr needs is Allison clamps don't have retractors ad the first instrument. Keep your sharps off the mayo you can catch a sleeve on a knife or needle very easily. Finally practice, never turn down an opportunity to scrub even if its an easy case. Good luck.

Our policy is tape or pre-printed labels only, even iv bags. No one will give me any rational except its policy. I still use my sharpie on the tape.

In my state (Ohio) they are viewed as the same thing licensure wise. The facilities in town have different views, my facility makes the designation that nurse managers must have a minimum of a BSN. We have Magnet status. One of their forces of magnetism is a ratio of BSN trained nurses. When I started as an ADN, I viewed my career as just another job and a series of tasks. While receiving my BSN, I saw the big picture. Twas there not just to do things, but to also advocate for the pt and help the Dr's reach the best possible diagnosis/treatments. I did change how I approached a person.

In my state (Ohio) they are viewed as the same thing licensure wise. The facilities in town have different views, my facility makes the designation that nurse managers must have a minimum of a BSN. We have Magnet status. One of their forces of magnetism is a ratio of BSN trained nurses. When I started as an ADN, I viewed my career as just another job and a series of tasks. While receiving my BSN, I saw the big picture. Twas there not just to do things, but to also advocate for the pt and help the Dr's reach the best possible diagnosis/treatments. I did change how I approached a person.

1) able to leap tall buildings with a single bound. Seriously, able to visualize the big picture. 2) good customer service (pt, family, Dr, staff, & reps) 3) able to multi-task. 4) does not know everything, but. knows where to get the info. 5) knows anatomy nearly as well as the med students (easier to anticipate/estimate length of case to keep room running well) 6) immunity to most non-life threatening illnesses. 7) mania (gets a lot done with very little sleep) 8) able to withstand a doctor yelling while realizing they are not mad at the nurse but at the situation. 9) a bladder the size of a Volkswagen. 10) ambidexterious (able to prep or place folly with both hands) 11) flexibility you may not always get your favorite service/doctor 12) strong hands and knees you'll be on them often if your doing your job right 13) great assessment skills you may have to spot a pt going south before anesthesia or the Dr see them 14) never-ending quest to learn 15) a questioning mind, our practice only advances because we ask is this truely the best practice 16) team player 17) no social/family life (call) 18) not color blind (if its blue or red, don't touch it)

I was hired as a surgical tech in 1994, straight out if school. After 10 years I got my nursing license. I chose to go elsewhere to learn skills I knew our nurses rarely used like starting/using iv's, ACLS, sedation, cardiac monitoring, & ventilated care/use. Now don't get me wrong, techs make great nurses since they know that side of the table they can be better prepared. I think all nurses should spend a minimum of 4 weeks scrubbing most of the services. Good luck with both careers.

This just my opinion. I have an unique perspective on things. I began as a sure tech then got my ADN. I realized I wanted to create a varied set of skills, so I chose to enter critical care. The experience I received really can't be taught. I never would have learned these skills if I had remained in the OR. I tell new grads to take the opportunity to learn whenever you have the chance. The RN's role has been frequently placed in jeopardy by competing specialties, rising healthcare costs, and ever increasing nurses salaries. We have given up many of the roles our fellow nurses practice daily. Today rather than be the person who basically ochestrates the majority of a patients care, we compete with techs, CRNA, aides, PA's, RNFA, & FA. We rarely even stick in an IV. If I was you, no matter how much it. sucks go get your feet wet then come back and show your true colors.

I would add, you can clean up any bodily fluid, wash your hands, then go eat. We can gross anyone out with our stories. You have little tragic no matter what the shift

#1 carry scissors & hemostats. #2 know the anatomy, if you know why your doing the case its easier to imagine what you need. #3 Understand the different future types so when they ask for something you can be q step ahead. #4 Relax and enjoy everyday. #5 Always remember doctors aren't always yelling at you, don't take it personally (unless you screwed up, just own up to it).