halcion

The other thing to consider is that if you only flare up a couple times a year, the chances of them being during a long case is pretty slim. If it starts before the case does you can just go off sick, or switch to circulating. I work in a small hospital with no ER; with no critical cases the worst that would happen if a nurse broke scrub is the surgeon might get peeved by the delay. The point about stress is a very interesting one. I definitely agree that you may need to take additional measures when you first start to keep things under control during that stress, but on the other hand if this really does turn out to be your dream job you might find that the condition resolves even further. It won't be easy, but if you are certain this is what you want to do, then as others have mentioned looking at the workplace you choose could make it possible to work around.

Thanks for the links guys! I am happy with the choice of Informatics, but without any courses available here I am unsure of the best approach - post graduate study in IS or HIM? Just try and get a job in the field based on work experience doing coding or anything I can? If it was 10 or 15 years ago in the US and you were trying to get a job in Nursing Informatics what would have been the best way?

Hi guys, looking for some of your expert advice! Previously I worked as a Systems Support Analyst for a large home health organisation. Basically this involved Level 2 support and low level analysis for mobile and telehealth apps and also the database which the entire organisation used (not just clinical but also HR, Finance, etc). I fell into this role due to being an "expert user" of the system in an admin role, and had no IT qualifications. During this time I completed my BN and had intentions of going on to do a Masters in HIM. So now I am an RN with 2 years experience across wards, PACU and OT. This has been fairly disruptive for my clinical skills, but it has meant that I've been able to see a good range of the potential for application of technology in healthcare. Now I am looking to marry the two worlds, and realise that the records management side of HIM is not what I am looking for. I'd prefer a role that more closely reflected my old position ie more systems support and analysis, but at the same time I'd like a more clinical focus than I had before. Basically I have no idea where this leaves me.. I'm considering a Grad Cert in IT, but worry this would just confuse potential employers whereas the word "health" in a HIM qualification would spell it out for them. I'm in Australia where it's all so new that I want to make it as easy as possible to get employed.. Any ideas?

I guess it's all relative. In someone with no OR experience surgical nursing would probably look a lot more attractive than medical or non-hospital experience. I mean, you're familiar with names of procedures, types of drains, types of dressings, which patients are going to need a catheter put in or antibiotics charted; all different little things that would help with the circulating nurse role. Sure they're all minor, but if you're going to hire someone without OR experience then you don't want to have to start with explaining what an BKA, or TAH BSO is.. yunnow? :)

What everyone else said, if we leave the hospital e.g. go outside for a smoke break then we need to change out of scrubs completely back into street clothes/regular nurse uniform.

During a gynae case I handed up some suppositories, and wanted to go get some KY but the surgeon looked poised to insert, so I asked, "Is there time for me to get some lube?" *dead silence* in the OR Surgeon says, "There's always time for lube!"

More than a few minutes? Far out. As I said I haven't been a nurse for long, but I did my first year at the state's number one trauma centre and saw a little and worked in PACU. In that year under NO circumstances did I see sats that low without bells and whistles. Literally, with the exception of laryngospasm in that time I never saw a patient get that low. Extra measures were put in place WAY before 73%. But those measures were jaw support, suction, non-rebreather, bagging, and.. call a doctor... Funding was cut, nurses lost jobs, and I was lucky to find a Recovery job in a provincial private hospital. And I don't know if it's just the new experience of working in OR, the extra experience I'm exposed to by working only with consultants, or that they're less up to date, but things have definitely changed. There is one anaesthetist who doesn't pre-oxygenate patients prior to intubation. So say you start with sats of 96%, by the time you have propofol and relaxants on board you've got a patient in the mid 80s when he STARTS attempts to intubate. If it's a difficult intubation then you're in the 60's or 70's by the time the ET is in place. At first I was terrified - the only time I've seen a person that color actually recover is from laryngospasm (which was treated by eager RMOs) but at this private hospital there's this culture of obsequiousness to doctors and no says a word and even if I do I am not sure that in going to senior staff members anything is achieved.

I have been doing anaesthetic nursing for a few months and this is only my second year nursing, so pretty green on all fronts and don't know when I'm overreacting. I remember freaking out at sats of 94% not that long ago So tonight I had a patient with good sats pre op but obesity. The anaesthetist used a "Supreme" LMA and a couple of minutes later the sats were low 90s. Another couple of minutes and they were high 80s. After some pointed looks from me he checked the airway, the connections, the sats probe etc. Surgery hasn't started yet but is about to and he lets them commence. Sats are now mid-80s, patient is starting to cyanose. The anaesthetist tells me it's because he gave 20 of morph (but the patient has an airway and is being bagged and the BP is fine??). He's hand ventilating the patient and seems pretty attentive but completely unconcerned. I get my team leader, by the time she's arrived sats are 73% and she relieves me. I go back in later to speak to my team leader about something else and the sats are still low 80s (it's been over an hour now) and everyone seems completely unconcerned and say that they think he probably has sleep apnoea so will be going to HDU overnight. I wonder if I am completely insane, sleep apnoea with an LMA?? And am I overreacting about sats hovering around 80 for a couple of hours? So my question is SpO2 - how low for how long is unacceptable?