All Content by CIRQL8
-
Your impression of a nurse working on an ambulance
RN's routinely staff the air ambulances. Why not one on wheels??? I'd prefer a CCRN working in tandem with a paramedic versus the paramedic alone. Both bring valuable experience and knowledge to the table and I'll bet increase the odds of a meaningful recovery for a trauma victim. Shame on ED staff for looking down upon ambulance staff regardless of credentials.
-
Choosing a Specialty
Had a 3 week rotation in surgery in nursing school. Knew right then and there perioperative nursing was for me. Fortunate enough to get into the OR right out of school! Been there ever since.
-
Ask a CRNA any question you want
Comment is late, sorry.... But.... I'm not an NP but the reason surgeons like PA and NP asissyung is because they can dictate the procedure, write post op orders, and assist with pre and post op clinic visits. For some, assisting in the OR (which may sometimes be more than simply holding retraction) and closing skin is wee worth the education and training.
-
Severe doubts about being a nursing major
All i can tell you is that I absolutely love nursing. There are so many different areas of nursing to choose from (and you get a little exposure to lots of the areas in school; but not all). Just look at all the different forums here. The anxiety you mention is not uncommon in university/higher education students. The pressure for success is great no matter your major or chosen profession. I would like to think that shows an inner drive that you have. That being said, if your anxiety is running your life to the point where you begin to feel helpless against it, I would suggest speaking with a professional. A school counselor, a school psychologist, your physician. Someone.
-
Ridiculous medical mistakes on TV
forgive if a repeat: an episode of ER I remember, Goose (Dr Greene but he'll always be goose to me) was intubated nasally during brain surgery and was awake and speaking.
-
New grad interested in operating room nursing
It is much more common today than just 10 years ago that the OR is both able and willing to accept a new grad to the department. As an OR nurse (lifelong) i encourage all student nurses preparing to graduate to apply to the OR if that is where you find your main point of interest. As a matter of fact, from my 18 years in the OR I have noticed that experienced nurses from non-procedural areas that transfer to the OR have a more difficult time in the transition. One main reason is the experienced and expert RN hates to be the newbie and hates to start over feeling like they are new grads yet again. When the experienced RN sticks with the OR and becomes an expert in perioperative nursing they do very well and thrive. But the same can be said for the new Grad. Management journal articles have shown proof that in order to be an expert at one thing, one must work 10,000 hours at that one thing. That's 5 years of full time work to truly be an expert.
-
Actual discussion between scrub and surgeon
MD: "Are we on a 30-degree down scope?" CST: "Ya" MD: "How do you know?" CST: "It says on the console" MD: "Ya, I know but I'm not sure" 😳
-
L/D RN learning to scrub for c/sec
Don't personally know of any but some hospitals, especially in large markets, offer a PeriOperative training course. Some charge. Come provide entry level pay. None guarantee that you will find a job in an OR arena. But those that perform the best many times are offered jobs at the place that does that training. Other ORs would be salavating to hire a nurse that's already been through periop training. I've seen threads about it in the operating room nurse specialty section. I'm Trying to introduce a program like that here in my town, in my hospital. But I'm not sure how well it will take off. Expensive to start up and to run.
-
L/D RN learning to scrub for c/sec
I am a PeriOperative nurse. While I freely admit that routine c/sects are done in the birthing unit we do the occasional c in the main OR. For high risk mothers. Cardiomyopathy, full blown eclampsia, etc. (Anesthesia wants them near the equipment and materials that we have right at hand). Our L&D dept empoys two full time surgical technologists that have graduated approved programs. They are familiar with aseptic technique and the instruments. But all they do are c's. No way could they come to main OR and do a different case. Our overnight techs cover for emergency c's. They have a couple RNs trained to scrub. It is my belief that running an OR (c-sect or otherwise) takes a trained PeriOperative nurse. It is furthermore my belief that a scrubbing RN needs to be properly trained in aseptic technique for scrubbing, gowning, and gloving not only themselves but the rest of the operative team. Good knowledge of the instruments and how to handle is also a necessity. And how to maintain a sterile field. A section is different from other surgeries. The speed is much quicker. The health the the unborn child is of utmost importance and generally cut to deliver time is only a few minutes. 10 at most. One must be able to hold up under that pressure and be able to handle unplanned things such as hemorrhage. That being said, our dept tends to train each other. I guess that works. In the 18 years I've been at my institution there's been no complications. But one doesn't learn to scrub in a day. Rome wasn't built in a day!! So it is said.
-
Blood color with IV starts
Excellent points.
-
Can some one help me out with this question
ABC and D. Temp does not contribute to b/p. Stress can elevate b/p. Heart rate and b/p can be related to compensate for each other. Appetite .... Hmmmm. Maybe not. But hunger can lead to stress can affect b/p. Especially if malnutrition is a factor. And exercise for sure. One that exercises regularly may have a normally lower b/p. Or may be elevated immediately after exercising. Just like very fit athletes have a lower resting heart rate they may tend to run in the lower end of normal for a resting b/p. Come to think of it, body temp can affect b/p. But only to the extreme like with heat stroke or hypothermia. When the body goes into shock the b/p drops and the heart rate increase.
-
Length of employment
18 years. Same hospital. Same department. Since passing NCLEX. Today's grads are more ME focused. They expect good hours and good position. No one graduates anymore expecting and accepting entry positions. They tend to bounce around looking for that nursing utopia. A lot of it is one's attitude. Not all of it of course. But a lot.
-
Lab Values Help
Holy cow Going way back here. But speaking as an OR nurse, why get a lab to see if there's post op infection? I wouldn't worry about an infected wound unless there was heat and redness, maybe accompanied by purulent drainage and/or fever. However, bleeding in the uterus wouldn't be outwardly noticed until perhaps a liter or more were lost unless she was dilated. Bleeding can also occur within the abdominal cavity and not be noticed until she were to become hypotensive, tachycardic, or pale and feel that feeling of impending doom. Is it common to look at the HCG post delivery like they do after a tubal pregnancy? Don't know the answer to that one.
-
Nursing Pins
The pin was a part of senior tuition when I went. We all got a pin. Our pins are (were? This was 1997) quality jewelry. 12 karat gold I think. Expensive. And our initials were stamped in the back of the pin. Some of my coworkers place their pins on their badges. Others do not. I do not. But I think I may one of these days. I like having it even though it's in the jewelry box. It's a symbol of my hard work to survive the hell of nursing school. Every program's pin is different so is also a conversation piece. (Where did you go to school?). And although we are explained the meaning of every etching in the pin (it all means something) I couldn't tell you a single iota of my pin's meaning. All that to say: ya! Go for it. Get it. It's a symbol (if nothing else) of your hard work.
-
Blood color with IV starts
I have no citations for you on this, but perhaps some venous blood remains more oxygenated than others. Perhaps it's the lighting. Also, everyone is different and this could certainly include one's blood with color variations. Other factors can include the quantity of usable vs end of life cells at that particular point in time. A larger amount will also absorb more light than a smaller amount in the tube, or in the hub. A larger amount will appear darker due to that fact. And in the case of just a bit of blood in the tube or spilled from the hub - not all RBCs give up their oxygen supply before returning to the heart and lungs. It depends on what percent of the blood at that particular time in that particular place remains oxygenated. So many variables. Just tell them "everyone is different. We're all the same that way"
-
So how does it feel like to be a male nurse
I am a man and I am proud to be a nurse. I am no different than my female colleagues. I am not a male nurse nor am I a murse. I am a nurse. Educated and licensed. And Damn good at what I do (peri operative nursing). Why does is seem that the man must defend his choice to be a nurse more so than a female must defend her choice to be a physician? Do your research about being a nurse just as you would to be anything else. Do what is right for you. Funny story if I may... When I first moved to my home, the men of the corner homes were out speaking. Me among them. They wanted to meet the new neighbor. They asked me what I do and I informed them that I work in surgery. Oh! They exclaimed. Are you an anesthesiologist or a surgeon? No, I answered, I am a nurse. There was perhaps 30/45 seconds of silence and one of them said "there's nothing wrong with that!" I had to laugh as I said "no, there's not".
-
lithotomy position
Interesting. What about proper anatomical positioning. Isn't it better for the hips and nerves to lower slowly and simultaneously? I think the physicians and anesthesia would take issue with one leg at a time.
-
Want to be an OR Nurse! How?
When you see an OR position open, apply. Even if it states OR experience preferred or required. Speak with the OR manager directly. It's not easy getting OR nurses with experience. Your enthusiasm may make them look at you twice. From my point of view, the OR is simply the best area to work.
-
Revisit: PA or RNFA
I know only what I've heard. Some states/insurance companies allow the RNFA to bill like a NP or PA. However, the NP and PA can do H&P dictate and do more pre and post operatively than the RNFA. That is what most surgeons are looking for. But not all.
-
I received this email from a professor. I was a little shocked. Opinon?
In the "old days" (years before I was in nursing school) the students DID line up and they WERE inspected. The dress code was adhered to to the letter and those that did not match up went home to correct the infraction. When I was in nursing school piercings were limited to one per ear, must be in the lobe, and only for the females. No earrings for the men. Body ink had to be covered. Or go home. Uniforms were to be in good condition. Excess wrinkles were spoken toat least we weren't sent home for that. And this was in the mid-80's. Call me old fashioned, but the professional appearance of the medical professional is of utmost importance. As children grow to high school students and are able to make their own decision about tattoo and piercings, they fail to realize the importance of the appearance of the professional in the workplace. Perhaps a letter to the offending parties would have been more appropriate. But there was nothing inappropriate about that letter.
-
Cedar Sinai OR training?
Maybe this is a clue as to what it would be like when you start working there with questions about work, getting annual reviews, raises, vacation requests, etc. Sent from my iPad (so excuse any typos and autocorrects!!) using allnurses.com
-
On-call in the OR
Yes we have two teams on call. General and ortho. We take turns being on first vs second call every two weeks. Very rarely does it come down to specialty. Most of us can do a bit of everything. Sent from my iPad (so excuse any typos and autocorrects!!) using allnurses.com
-
Passed the CNOR exam
Congrats! Yea! Sent from my iPad (so excuse any typos and autocorrects!!) using allnurses.com
-
OR Positions in Southern California
I agree to try travel nursing if you can. Stick with hospitals in the areas that you are interested in for long term employment. Sent from my iPad (so excuse any typos and autocorrects!!) using allnurses.com
-
attention: senior nurses
Refusal to listen to preceptors. Failure to realize there may be more than one right way to do something. Failure to realize what they are doing is poor technique. Doing something three or four times and not asking for help if they need it. And still doing it wrong. Sent from my iPad (so excuse any typos and autocorrects!!) using allnurses.com