druse

Operating room Clutter vs Infection Control?????? I had a question asked about our operating room equipment clutter, does it prevent proper cleaning of the room? General practice includes setting up the rooms for the next days cases, however an environmental service attendant come in the night to terminally clean. The attendant has not voiced an opinion, however someone else's opinion is that there is too much equipment in the rooms and should be kept out of the room until the time period prior to the case. What are some of your thoughts?

If you're an OR nurse manager, or director I'd like to share some conversation maybe ask questions, let's talk!

Does your intra-op record contain a place to document a delay, and delay reasons for starting of a case?

Thanks! I hate that this even occurred! The CRNA & I have talked following the event, and all seems fine, however this has occurred before(probably will again), he has threatened me, and others. I don't intend to pursue this further really because I'm just not that type of person(the sueing type). I didn't grow up that way. I can go into further details if you're interested in hearing or reading about this situation as to why I've been painted as being the bad guy. It's probably entertaining to some, but not to me. I don't want to give a false impression of our facility.

Thanks for your replies. Another question? Just curious, I'm not the legal guru, but what right do I have for any legal action against the CRNA for his threats?

Male/female doesn't play a role here.

There was one RN in the room with the CRNA, and I & two others came in to help (I am an RN, another RN, and one scrub tech), when we noticed the patient waking up disoriented. The safety belt was on and the patient was trying to sit up, following a Septoplasty. The patient was coughing and blood was splattering everywhere, with each cough. I grabbed a towel and held it up to the patients mouth & nose with my right hand, left hand grabbed the patient behind the neck. An RN opposite side of the bed was assisting me in trying to calm the patient. The CRNA was at the head of the bed with a grin, and doing nothing. The patient became more combative and stated "let go of me, someone's gonna get hurt". The RN opposite me let go & backed away, I kept talking to the patient trying to orient him and shouted to the CRNA to give him something. The CRNA responded "don't tell me what to do, you're not my boss" and then proceeded to threaten me that he was going to hit me. I said "go ahead". I'm still holding the patient trying to keep him on the bed. The CRNA still focussed on me continues to threaten me and state that he's settle this later (implying something like we'll take care of this in the parking lot after work like he's gonna kick my *** or something). I said "anytime". Evidently there was a personality conflict that the CRNA was harboring and this event cause him to vent with personal threats. Afterwards after conferencing with the Anesthesiologist, Director and the others in the room I am painted the picture as the "bad guy". (All of the staff in the room were female exept for the CRNA, and I) My question is concerning myself if after I touched the patient, if I were to let go, and the patient were to fall off the bed or sustain an injury in any way, is that considered to be neglect upon my part? I am also concerned about the role of the CRNA in this scenerio. I am aware of ethics and the responsibility of the CRNA to assess the patient regarding status of airway, history,...etc, but during an episode like this shouldn't the CRNA have had some resposibility in assisting so that the patient doesn't follow through his disorientation and start swinging and hitting nurses, by maybe sedating the patient. Just curious.

During the time a patient is waking up from anesthesia and is disoriented, becomes combative. If a nurse goes into the room and initially helps to restrain the patient, and then abandons to assist (because of risk of being hit), is this considered to be neglect if the patient is injured by a fall or otherwise due to his combativeness? Also what is the expected legal role of the CRNA in this situation?

Sometimes that's the hardest part, getting everyone on the team to be a part of the team all of the time. We will occassionally flip flop rooms to attempt to speed up our day, but it requires everyone to be on the same page of optimism. Some people are very opposed to flip flop and think it's a waste of time and will voice this opinion. This negativity undoubtably will effect others and cause skepticism which in turn will effect the efficiency of the outcome. Sometimes everyone is clicking together and it's like being a part of a machine, and that's when it's great. Believing helps, so hang in there!

I had no intentions to belittle you or in no way compare an outpatient surgery center to a full blown OR, however your main post was inquiring about mopping, and my answer is YES I mop, and have ever since I started my career in the OR setting. My point is that I am in this business to provide a service to my customers, (the patient, the physician, and my fellow co-workers, and to the facility). It is not beyond me to mop, clean, take out the trash, or whatever the task may involve, sometimes that's what it takes and is all in a days work. I don't mean to rain on anybody's parade!

Before I graduated I volunteered at an operating room for two weeks, wrote a report and earned one college credit for my time. I did gain some really good insight to what the role of a nurse was in the OR and decided that's what I wanted to do. I am so glad I spent that time.

I think it really makes a difference depending on the type of cases you're doing, but there are some things that can be done to possibly help you achieve the fastest turnover time you are capable of. These things are (not implying that you are not doing any of these) 1. Check all of your cases at the begining of the day, in order to be prepared for your last case as well as your first equally. 2. Make a plan and communicate with your team members (circulator, scrub, anes, crew in the next OR, etc...) 3. Keep your room picked up during the case in order to help the turnover to be as painless as possible. 4. Thank other people who help you (others will help you if it's not like pulling teeth) 5. Gather needed supplies early, don't wait until in between cases 6. Stay organized as possible throughout the day 7. Anticipate the possibilities of what could go wrong, (what if's) 8. Communicate with the outside, (Pre-op, Recovery, Co-ordinator) to keep informed. 9. Use your resources (ask for help if you need it, before you need it)

I've worked in an outpatient surgery center, going on year seven. I think it's the best of both worlds, however you loose the experiences of those big cases. I like the amount of time off I have not having to answer call. We have a unique situation where if we wanted to work call for the adjoining hospital we can,and earn overtime as well, but it's an individual choice.

I'm a supervisor in an outpatient surgery center and I mop the floors (as well as other duties) during room turnover. Our turnover time is an average of 10-15 minutes. Yeah, I joke about it, having my BSN, CNOR, RT, and I spend quite a bit of time mopping floors(ha,ha):chuckle . Unfortunately that's how things are!

How many times, or how much time is inappropriate for a circulator to step out of the OR during a case for additional supplies or whatever?