callbabe

I am a OR Nurse of 35 years, I have always scrubbed,circulated most cases. I have first assisted during alot of the cases also. I went thru a formal RNFA program almost 15 years ago to validate my experience. I do not believe there prerequisites are strong enough to enter a FA program. Two years is not anywhere near long enough.I have been Certified for 15 years. I work as a staff nurse, 90% of the time I am working as a RNFA. OB,General surg, GYN/ONC, Trauma is were I want to be. We did have a PA that worked for our trauma surgeons but they do not get much OR time to train, they are very good in the clinic, or rounding. I work with 3 surgical techs that work for a gen surg group, they are great, I fill in for them occasionally. They have many years of experience. I personally would not want someone with less than 10 years working on me.

I have a question that is not in reference to H& Ps, since you are from STL how are your surgical assistants credentialed. Do they have to be atleast a PA,NP, RNFA, to do wound closures, and everything that a great sugical assistant would do. I am from a medical center south of you and am trying to set up a new way of credentialing people the surgeons hire right off of the street. The surgeons will know that if they hire this type of person that they will not be allowed to do certain things that a clinically prepared person would be able to do. your info will be greatly appreciated.

I agree with the above, our policys are similar. IV access is only used with conscious sedation, and most surgeons do not even do anymore. Because they have to be ACLS trained. We do alot of MAC ( monitored anes care)

I am a baby boomer, and several of my nurse friends are older than me, my question is when do other places allow these older nurse to not take call anymore. Do they get shift preferences, any perks out there.

NO IT IS NOT I HAVE BEEN A NURSE FOR SOME 33 YEARS AND I HAVE BEEN SCRUBBING FOR EVERY ONE OF THESE. I HAVE CIRCULATED TO OVER THE YEARS, BUT NOW 65% OF MY TIME IS SCRUBBING. 50% OF THAT I AM WORKING AS AN RNFA FOR A GENERAL SURG GROUP/ AND I ALSO WORK FOR A GYN/ONCOLOGIST WE DO HAVE ALOT OF CSTs THAT ARE GREAT, SOME PRIVATELY EMPLOYED PAs. SEVERAL OF OUR RNs SCRUB IT MAKE THEM MORE FLEXIBLE.

FORGIVE ME BUT IF YOU ARE NEW TO THE OR, YOU DO NOT NEED TO BE THINKING ABOUT BEING AN FA JUST YET. IT TAKES YEARS OF EXPERIENCE AND YOU NEED TO BE A PROFICIENT SCRUB IN THE SERVICE THAT YOU WILL BE ASSISTING IN. IT IS ALSO A REQUIREMENT FOR THE RNFA PROGRAM YOU HAVE TO SHOW SCRUB CLINICAL COMPETENCY, THESE WOULD COME FROM YOU EMPLOYER AS PART OF YOUR ADMISSION TO AN FA PROGRAM.

in most states a bsn is not required to be an rnfa, you do have to have it to get your certification (crnfa) most insurance co do not require you to be certified. i went thru a rnfa program some 10 yrs ago and am still able to bill for my services. sometime in the near future if you want to bill medicare you will have to be certified as an fa.

One of my urologist wants a flexible cystoscope on the urology floor for hard cath placements,less traumatic. Also for pulling stents. My problem is how do I sterilize it and get it back there asap. Gas takes to long. Steris is ok but how do you maintain sterility. Cidex ok, same problem. Please tell me if anyone has the same problem and how did you fix it. FYI. we do not work around the clock so there would not be any staff to reprocess, unless we call a call person in. We can do this, but the above prolem still remains. Any help would be greatly appreciated.

I like the way you think, thanks for the info

Ditto

I work in a Level 111 trauma center. We do not staff 24-7. Nurses are given somethimes 24 to 48 hours to cover when taking call in the OR. We frequently work 18-24 hours doing elective an emergency cases. Do other hospitals work like this. Our management could care less as long as the work gets done. Does anyone else have to work like this.:angryfire

I would suggest that you get your BSN because in the near future you will be able to bill Medicare and some third party payors. Which will make you more marketable. Right now though it is not neccesary to have your BSN to practice. Most places do not require a certification, but it does show a level of competence. I would be happy to answer anymore of your questions. Also make sure if your are employed at a hospital that you have your own job description. I am employed by a Level II trauma center, I work as a staff nurse part of the time, I have clinical priviledges to work with any surgeon on staff that needs me. My salary changes when I am in my RNFA role. I also work privately for an GYN ONOCOLOGIST and bill for my services myself. Have a nice day.

I hate to burst your bubble but.... I have been an OR nurse for 33 years, and the last 10 I have practiced as an RNFA. I am very proud of my work and my peers respect me along with the surgeons I work with. If you are going to med school do not make a surgeon provided you could anyway. With your attitude I would not want to work with you good, great doctors know they cannot function without the help of nurses. I to work with some very smart, and very qualified CST. In the OR we all have our places and the techs should be behind a mayo. I learned how to scrub 33 years ago and have worked very hard to get were I am at. I do not think that nurses with a few years of experience should not be allowed to function as an assistant. I takes years of experience to be a proficent scrub, circulator, or a 1st assistant. If you make a surgeon and you hire a tech it will be be cause they will be cheaper, well you get what you pay for.

I need to know your policy in your facility about when you are no longer required to take call, mine is 55yrs no weekends or holidays. at 60 you may choose to not take call at all. Please any info will be greatly appreciated. I work in a Level 3 trauma center, in the OR. We do not staff around the clock.

Hey I agree for the most part, I have a reputable sales rep from a very good company telling my surgeons 1500 is ok, we do use gravity to by the way. The majority, 90% of our cases only last about 20 min. unless they are resecting something. Our fliuds usually are equal. under pressure fluid will take the easiet path, like the tube,os or perf.

The facility were I work now for some 22 years documents on the page where the irrigation fluids are written how much was used and how much was returned. Good collection is the clue. And gravity flow is important. Pressure infusion is dangerous. If you have a uterine perforation and do not know it you could have liters in the abdomen and not even know it. You should have an equal amount in that you have out. There is a safe limit like 1000-1500ml that you can have in with minimal problems but even that is pushing it. Bottom line you should document accurate I&O. Omissions are negligent. If I can answer any other questions, feel free.

I work in mid america and would like to know what the average on call average wage is. Right now I get 2.00/ hour to carry a pager. Time and ahalf if we work with a two hour min.

How do you feel physically after working 16-18-24 hours my longest was 28 in a row, and I was looking at another 20 hours possible. I just do not want to do it anymore, and yes your pts and mine deserve someone rested taking care of them. This is FYI my 31st year.

I am quite certain that I know the difference. I am not sure you do. If you are on at 7a to 7a on a sat or sun, and work more than 12 you should have relief. The institution where I work has progressively gotten better over the years, I use to cover from 1800 on friday until 0700 on Monday morning. Then they gave fridays to someone else. Then there is the weekend 48 hours. Now we have to cover 24 hours which is still to much. We are a trauma center, and sometimes run 2-3 rooms.We do not run a regular staff on weekends either. We have 2 nurses, 2 techs on, and sometimes have to call extra staff in. I have been working closely with my state nursing organization, specifically safe nurse practice. I believe 12 hours shifts will be here shortly. Or atleast I hope so. Mike you sound like you hate lazy nurses, me to except I am not one of them. I have worked long and hard over the years, and am just trying to make things better for future nurses.

I need to know how many of you also have to work 24hr shifts on weekends. Where you are at,you do not have to be specific, ex: state, city. If it is policy and how long it has been in effect. I am trying to gather statistics, for MONA. I have been working toward making these long shifts illegal. 12hours Max. I am a RN, I work in the OR, and have for a very long time. I believe that it will be a good retention tool also. As a very young nurse these hours did not bother me, but now 30 years later they do. Now I belive that it is not a safe working condition for my patients either. Mona believes that after 12hours a nurse should have an 8 hour rest period. Management just doesn't see it that way. Please respond so I can send my info to congress.

your are most certainly correct,but certification is not required to practice. it is something that will be necessary one of these days, for the independent rnfa who needs to bill medicare/medicaid. some are privately employed and there physcians pay there salaries. pending legislation if passed will provide for third party reimbursment, and at present depending on where you are at (state) most rnfa's are recognized by several insurance co. as healthcare providers. enough said, if you have any questions, feel free to ask.

The only real difference is that the PA can write drug orders,and are otherwise known as doctor wannabe's. Nurses can do everything else. The one really big thing that separates us is the nursing process. The PA does not know how th actually take care of the pt. We are taught that from day one. I have been a RN for 30+ years and a practicing RNFA for the last seven years. I went thru a formal FA program several years back for recognition for the work I was already doing. I looked into a PA program and was told that none of my credits for my RN license were applicable, and that I would have to start over. 28 month program. Dollars and cents. A PA if working privately for a physcian/and or surgeon can bill 30% of his fee. RNFAs can bill 20%. except that most insurance companies recognize PAs, very few recognize RNFAs. It is sad but true.

I HAVE BEEN READING ALL OF THESE THREADS, I THINK IT IS ASSOCIATE IN SURGICAL TECHNOLOGY. I AGREE WITH SHODOBE, TECHS HAVE THERE PLACE MOST OF THEM JUST DONT'T KNOW WHERE IT IS. I TO WORK WITH SOME REALLY GREAT TECHS, BUT THEY ALL TO OFTEN FORGET THAT THEY ARE BEING DIRECTLY SUPERVISED BY ME. I FILL ALOT OF DIFFERENT JOB ROLES, I SCRUB,CIRCULATE, FIRST ASSIST, AND HELP MANAGE 18 ORS,AND SOON TO BE 25. I HAVE BEEN A NURSE (RN) FOR 31 YEARS, AND HAVE WORKED IN THE OR ALL OF THESE. I AM A FIRM BELIEVER OF WORKING WITHIN YOUR SCOPE OF PRACTICE. IF FACILITIES ARE ALLOWING TECHS TO MIX AND ADMINISTER DRUGS THAN THEY ARE JUST AS RESPONSIBLE AS THESE DRS THE TECH IS TALKING ABOUT. EVERYBODY IS HELD ACCOUNTABLE. I VALUE MY LICENSE TO MUCH . IF I KNOWINGLY ALLOWED THIS I AM JUST AS RESPONSIBLE. WHICH I WOULD NEVER DO. ENOUGH SAID.