wilbur1

Thank you, CNurseGreen- I think that you are exactly right! Knowledge IS power-plus adding positions in this economy is next to impossible. If you are interested in sharing any of your competencies, I would be very grateful!

I really need some help here. I am a new manager of a Surgical Services Department at a rural hospital. All of this is new to me, but especially that of working at a small rural hospital where the "rules" seem to be quite different to that of a large hospital. What I am REALLY struggling with right now is trying to get a understanding of the OR RN's recovering their own patients. All that is required is that they be ACLS certified and receive a brief orientation. As we all know, just because you have earned your ACLS certification that doesn't guarantee that you have a clear understanding of the knowledge that is needed. We also do not have any designated PACU RN's-only the OR RN's. This whole thing just scares me to death-and keeps me awake at night. Unfortunately, this practice is not exclusive to just this rural hospital. There are other surrounding rural hospitals that perform this practice. Now, my background is exclusively in the operating room-I do not have Pre-op or PACU experience-but this doesn't seem right. My perception has always been that the PACU is an area that requires RN's that are skilled and well-versed in the many different scenarios that can go wrong. I don't see my OR RN's being that knowledgeable (not as knowledgeable as they should be, in my opinion). I am also pretty sure that these RN's have not taken a basic EKG course either. I know that rural hospitals tend to be much tighter with their money, thus forcing departments to have to take on many different roles. Am I off-base here? I have only been working at this hospital for a couple of months and am dealing with SO many issues. I am going to talk to administration about this next week, as I am gathering as much data as I can to support my position. I am going to present my findings and ask that the legal department look into this, as I really need to know what is right and what is wrong. Also-there is only 1 RN that is recovering each patient. From what I understand, there should be 2? Thank you.

I really need some help here. I am a new manager of a Surgical Services Department at a rural hospital. All of this is new to me, but especially that of working at a small rural hospital where the "rules" seem to be quite different to that of a large hospital. What I am REALLY struggling with right now is trying to get a understanding of the OR RN's recovering their own patients. All that is required is that they be ACLS certified and receive a brief orientation. As we all know, just because you have earned your ACLS certification that doesn't guarantee that you have a clear understanding of the knowledge that is needed. We also do not have any designated PACU RN's-only the OR RN's. This whole thing just scares me to death-and keeps me awake at night. Unfortunately, this practice is not exclusive to just this rural hospital. There are other surrounding rural hospitals that perform this practice. Now, my background is exclusively in the operating room-I do not have Pre-op or PACU experience-but this doesn't seem right. My perception has always been that the PACU is an area that requires RN's that are skilled and well-versed in the many different scenarios that can go wrong. I don't see my OR RN's being that knowledgeable (not as knowledgeable as they should be, in my opinion). I am also pretty sure that these RN's have not taken a basic EKG course either. I know that rural hospitals tend to be much tighter with their money, thus forcing departments to have to take on many different roles. Am I off-base here? I have only been working at this hospital for a couple of months and am dealing with SO many issues. I am going to talk to administration about this next week, as I am gathering as much data as I can to support my position. I am going to present my findings and ask that the legal department look into this, as I really need to know what is right and what is wrong. Also-there is only 1 RN that is recovering each patient. From what I understand, there should be 2? Thank you.

I really need some help here. I am a new manager of a Surgical Services Department at a rural hospital. All of this is new to me, but especially that of working at a small rural hospital where the "rules" seem to be quite different to that of a large hospital. What I am REALLY struggling with right now is trying to get a understanding of the OR RN's recovering their own patients. All that is required is that they be ACLS certified and receive a brief orientation. As we all know, just because you have earned your ACLS certification that doesn't guarantee that you have a clear understanding of the knowledge that is needed. We also do not have any designated PACU RN's-only the OR RN's. This whole thing just scares me to death-and keeps me awake at night. Unfortunately, this practice is not exclusive to just this rural hospital. There are other surrounding rural hospitals that perform this practice. Now, my background is exclusively in the operating room-I do not have Pre-op or PACU experience-but this doesn't seem right. My perception has always been that the PACU is an area that requires RN's that are skilled and well-versed in the many different scenarios that can go wrong. I don't see my OR RN's being that knowledgeable (not as knowledgeable as they should be, in my opinion). I am also pretty sure that these RN's have not taken a basic EKG course either. I know that rural hospitals tend to be much tighter with their money, thus forcing departments to have to take on many different roles. Am I off-base here? I have only been working at this hospital for a couple of months and am dealing with SO many issues. I am going to talk to administration about this next week, as I am gathering as much data as I can to support my position. I am going to present my findings and ask that the legal department look into this, as I really need to know what is right and what is wrong. Also-there is only 1 RN that is recovering each patient. From what I understand, there should be 2? Thank you.

I am in some desperate need of finding written documentation (guidance statements) on the following topics: *Cardboard in the OR-does this mean no cardboard in the entire department (PACU, Pre-op, CS, etc)? What kinds of cardboard are banned? What about the cardboard boxes that hold fiberglass casting-basically, how far are we supposed to take this? Isn't this also a violation under the state fire authority? *Meds in multi-dose bottles-do you use them? If not, what do you do with any extra medication that is left at the end of the case (off sterile field)-example: tetracaine eye drops-you only use a few drops. Do you use the bottle for all remaining patients, toss it, or give it to the patient? What about antibiotic ointment and KY? I appreciate the help. I am looking for "Best Practice" statements from reputable professional organizations and how these issues are dealt with at each of your facilities.

Thanks for the advice. The last thing that I want to do is be a pariah but I honestly feel like I don't have a choice here. It has been life or death for me because of this situation. Also, for the record, I am seeing both a psychiatrist and a psychotherapist because of this. I had to go on FMLA because of this and had "desensitizing" homework assignments that I had to complete before I could tolerate (to some extent) even being in the building before my actual return date. This entire thing has been a nightmare.

Sigh! This is a very long and complicated situation. Basically, I have been forced to leave a job that I love because a few people in management do not like me and have made my life hell. This situation has affected me so much that I can't let it go when I am not at work. It affects every aspect of my life. I even considered ending my life because of the mental anguish and fear that I have for these people. Needless to say, I have left this facility. It took a while because I really loved my job and am darn good at it. Now, because I was written up I can't transfer to another job within this corporation (it is a major one in my area). Given the economy, the job search is not going well. I need to know if anyone has filed any legal suits against an employer for mental abuse and if there are any great resources out there. This situation has scarred me so badly that at times I have considered leaving the profession. Upper management and administration are sticking by the people in management who are involved in this and are not supporting me at all. Thanks.

I just wanted to let everyone know that I passed my boards!! It feels so strange--like I was expecting to feel smarter or something.:balloons: I just wanted to thank everyone for their support and prayers!! Wilbur

I studied from a variey of different books and I have to say that the Kaplan book was the best at teaching me how to read the questions. I took a course from Meds publishing and wasn't extremely impressed. I also bought some audio tapes to listen to in my car--they were better than the class because I could review them whenever I wanted--they cost less also (got them on ebay for $20--20 audio cassettes and a cd rom).

Well, I took my boards this morning. I am SO glad that is over with!! I got 75 questions--which is what I thought I would get for some reason. I guess I wasn't surprised when the test shut off but I still felt like crying!! The 2 1/2 hour drive didn't help. I kept thinking aout every possible scenario. I couldn't even tell you if I got the last question right-I think I blocked it out. The wait is going to kill me!! Do you know of anyone who failed at 75? O am so unsure. Thanks for your thoughts and prayers!!! :)

Hey Everyone! I am taking my boards in 2 days and am terrified!! I am trying really hard to relax and not get all worked up about it but I can't sleep without thinking about it and dreaming about it and I woke up today with a horrible stress headache. I am terrified that I am going to be physically ill when it comes time to take the test!! I have studied my but off and have improved my practice test scores since I started studying 8 weeks ago but I still have the feeling in the back of my mind that I will fail. I know that you must be positive about the test and I have been telling myself everyday that I will pass--I'm not sure that I believe it though. I just can't let my husband and kids down--they have sacrificed so much for me already. Any tips about the test or relaxing before and during the exam would be greatly appreciated. If God wants me to be a nurse, then I will pass. I know that I have done as much as possible on my end--now it's up to Him. Thanks!!

I am about to graduate in May--yeah!! My problem is this--I have been a Certified Surgical Tech at my hospital for a while. I really loved it there and was planning on working there when I graduated. I even bragged to my classmates what a great department it is to work in. I thought that I would be a shoe in for sure. I applied there in March-after I talked to the manager of the unit in December and she told me to apply- and hadn't heard anything. I kept calling to check on the status of my application, and was told that the manager had it and they would get back to me. They never did.. I called them again last week and was told that I would not be offered an interview. I was utterly shocked! I didn't see this coming at all! I called the manager because I wanted to know why-I mean, I have a right to know! I was told that because of my absences early in my career due to depression and pregnancy-that I would not be a good nurse for them. She told me that she "asked" what everyone else thought and they agreed. I have been working there once a month to keep my seniority and no one has ever said anything to me. They have even asked me where I want to work and I said "here". I bet they were laughing at me! I told her that I won a scholarship from that hospital and had a huge number of Drs. and nurses give me excellent recommendations--she said they were probably lying! I am an excellent tech and I thought I was a good person but she has made me second guess every compliment that I have ever had! To make matters worse, a friend of mine applied for the job--knowing how badly I wanted it-and took it. I am taking this very personally and am thinking of ending the friendship. She has absolutely no experience! I need advice on how to deal with this. I had an interview today at another hospital-45 min away- and I can't get excited about it. I am afraid that I will never be able to let this go. Sorry this is so long!!

Hi Everyone! I have an interview this week with a Level I Hospital. Can anyone give me any advice on interviewing? I am going to graduate this May and have been a Cetified Surgical Tech for the past 6 years. Also-can I expect to earn the bare minimum nursing wage if I have OR experience as a tech and want to continue to work in the OR-in a different hospital? Any tips would be greatly appreciated.