wakyone

Our AORN book has magically reappeared and in the positioning section for lithotomy, the legs are placed in stirrups and removed from stirrups simultaneously, but when lowering to bed must be done one at a time.

Thanks so much for your reply-I guess the old dog must learn some new tricks...:)

I've ben in OR 35+ years. When transitioning patient from lithotomy to supine, I was taught to raise/lower both legs at the same time. The new nurses we recently hired say that the new way is to lower one leg at a time to decrease blood pressure drop. Our AORN standards book is MIA. Has anyone heard of this? Thanks

Our hospital has a local laundry service that will launder cloth hat for $.25 each. If you choose to do this, no disp. bouffant over it is required. This is completely on the honor system. Otherwise, we either wear disp bouffant over cloth cap or alone. I though I would miss cloth hats, but I don't and my hair looks much better at end of day!

We do nothing with the C-arm; not even position it or bring it in the room. If the doctor is impatient he can get it himself, which they never will. Scope of practice has never been mentioned; if any damage occurs to the C-arm with no rad tech present, repairs come out of OR budget, not Radiology's. So it's the $$$ talking.

Sorry, I'm not following-do you mean the rubber-type ones at target in kitchen supplies? I've only seen these in 12 inches. Where do you get them? And how do you tuck arms? Thanks

We have just started using eggcrates only under patients who will be in steep trendelenburg or reverse. We are basically making up this positioning as we go along until we find what works best. Anyone been using these? Do you put the drawsheet for arm tucking under the eggcrate or under patient? We have been taping it to the bed, but this is wrecking the mattress with tape residue. Company has no suggestions.......There are some very fancy ones with arm pads, Velcro straps to hook to bed, but these are very pricey so we just have a big roll we cut. Thanks

My hospital has recently gone to EPIC computer system which requires us to put all information about implants-exp. date, lot/serial # in computer, but we are also still filling out paper implant sheets. We nurses feel this is too much repetition, but supervisors says paper form is in case computer goes down. Help! We don't want to have to do so much duplicate charting. What is the rest of the world doing and can you help me with an argument to stop paper charting to take to my supervisor?

No we don't; probably what we need. The warming unit that the sales rep brought in was supposed to get to 70C and hold to make implant malleable.

We have the standard saline/blanket warmers, but this is not warm enough to make the implant malleable.

Doing an orbital fracture-the warmer that the sales rep brought in to warm the absorbable implant did not work. This was discovered when the Dr. needed the implant. He had me warm an unopened bottle of NaCl in the microwave for 2 min. It didn't explode, but is this the best practice? If I had known the the machine would malfunction I would've put a wrapped bottle in the autoclave for awhile. I am wondering about plastic debris from warming the bottle? How do you warm your saline and keep it sterile?

Worked nights when kids were little and never felt rested. I really think it's your circadian rhythm that determines your ability to do it.

Just read a great book on introverts/extroverts and realized one of the reasons I love OR nursing is-one case/patient at a time no matter how many add-ons are stacking up. I am in charge of my one room and that's perfect. ICU/ER is too much hoopla for me. I have done this for 40 yrs and the human body is still one of the most fascinating creations!

canesdukegirl-love reading your posts. Always very well thought out and have lots of information.

I worked nights in LTC when my kids were little and it was the hardest job I've ever had. People who makes the negative comments have never done LTC. You use all of your skills and knowledge because generally you have a whole unit to cover and no docs around. They become like an extended family; many have family who live out of town and you can see the gradual declines in health that you won't see in a hospital setting. I wanted to do LTC as a new grad and was advised against it because patients die, they do not get better and that might be too hard on a new nurse! I get irritated with the notion that ICU/ER nurses are at the top of the tier-different strokes for different folks. Good LTC nurses are hard to find-Congrats to you!

Absolutely not! We also have an implant "time-out" to verify the correct implant is handed in, but not by the sales reps.

In second line you spelled preceptorship wrong Good Luck

We are the same-absolutely no flashing unless there is no other replacement. If we have to flash between cases because all sets are in use, item must go through washer first.

We struggled with site marking for ureteral stones. We tried marking inner thigh since marking should be visible after draping-surgeons refused to go under the blankets to mark patients. Finally after a few more ideas, we settled on a blank wristband to be placed on the arm of the side of the stone. Visible when timeout is done and after draping. So far, working well

We have been using computer for OR/PACU charting for 2 yrs. Took some adjustment, but it is efficient, legible,great for generating audits and our IT person can adapt screens if we find a certain way works better. But I wish I had paid attention in typing class, because I still hunt and peck! But the #1 drawback in the OR is your attention seems to be drawn more toward the computer than the surgery in progress, especially on the short cases.

Hello all, I am new to this site, but not new to OR nursing. Been doing this since a little after the Beatles came to America!In the OR where I am working, the pre-op admission aide takes vitals and gets an EKG strip for the anesthesiologist. The lead placement has been determined by anesthesia, but does not take into account the type of surgery the patient is having. The leads are always wrong for shoulder cases, breast cases, etc. So in the OR we must change them. How do you handle this in your workplace?