Robbone

Couldn't have said it better myself, canesdukegirl! It is the critical thinking process using all the eclectic knowledge you have gained and the responsibility you have accepted that sets the OR RN apart. No, you don't HAVE to be an RN to be a patient advocate but let's be honest, out of the 4 people that comprise an OR team, who do you think has the agenda where the patient and patient safety is at the top of their list? Hint: Probably the one that is not getting paid on a case by case basis. This topic may have been overdone here but the question is STILL asked and those of us who are CLEAR about our role will continue to answer.

No way!! Why a lap I wonder? Hoping to sue????? You win for the most bizzare story!

I get flaky scalp from the disposables, too! Must be one of the chemicals used in the manufacturing or something. I misspoke about the cover-ups......put those ON and take your hats OFF when you leave the hospital. Patients LOVE colorful hats especially peds. You don't look so scary if you have Tweety Bird on your head! I think not trusting your staff to launder their caps is like not trusting your staff to renew their license. It is just part of being a professional and being responsible. I think you can have the best of both worlds if you create the right culture. Maybe I'm wrong but I think that is still possible.

OK, nowhere in the AORN Recommended Standards of Practice do they directly address cloth OR hats. I say as long as your cloth hats are clean, carried in a protective cover and donned in the locker room, it covers ALL of your hair (b/c that is WHY you wear a hat) and you sign a form that you PROMISE TO KEEP YOUR HEAD OUT OF THE WOUND cloth hats, like shoes, have yet to prove as a source for contamination. The problem with scrubs and jackets is that one person's idea of "clean" and another's could be way different. Not only that, when you wear your clothes IN from home, all the contaminates from your home and car/bus are on those scrubs. Pet hair, dandruff, baby drool, MRSA and who knows what else are on those scrubs. There is actually research to back that up (culturing of scrubs). Besides, who wants to wash those scrubs with the family laundry in the family washing machine? Water has to be a certain temp to kill pathogens and home laundry just doesn't cut it. I think hospitals allow home scrubs for financial reasons alone. It is really not best practice. About the turban issue? I think they wear those out & about, too so I can see where they are required to cover them up. Cloth hats, like cover-ups, should be worn only in the hospital. When you leave the hospital, take them off!

OK, first off, don't fall for the Otis elevator trick. Orthopedic surgeons think that is hilarious. Second, there is only ONE kind of sterile sleeve no L or R residents think this is hilarious...whatever. Now, I hope you get to scrub as well as circulate 'cause that's the role that gets you hooked on surgery and teaches you the most about surgery. Circulating teaches you about being a pt. advocate and being the queen of everything.... just like the song. If you get to scrub-in, keep your eye on the surgical field as much as possible and ask questions 'cause surgeons LOVE to teach new nurses about surgery. It also builds rapport. Alexander's "Care of the Patient in Surgery" is a great textbook. I also recommend Berry & Kohn's "Operating Room Technique" to build fundamentals especially if you get to scrub. Get your assignment the day before and look up the procedure so you get to look smart by knowing a little about what's happening. When you are new in the OR, you sort of get amazed and overwhelmed (aka deer in headlights phenomenon) so PREPARE ahead of time. Relax and you will learn more. NEVER skip breakfast. Even a protein bar on the way to work it's better than nothing. I hope you like the OR and have good experiences. I have spent a working lifetime there and some days I miss it (but not the calls @ 2 am). Take care of yourself so you have a long and prosperous career as an OR RN! Good luck!

Once an OR nurse always an OR nurse. It gets in your blood, ya know. I had a love/hate relationship with the OR for years. It is just that way with us. There's politics on the floor, too. Take a break, learn something new but you'll be back! Yeah, I have to agree that 12 hr. shifts in the OR (especially if you have to take call, too) would drive anybody crazy! Good luck! CU soon!

Ahhh the joys of searching for missing countables. The cuff of the mayo stand drape is notorious for harboring all sorts of items. Best practice is to unfold that cuff........

You bring up a good point. I have been in the OR for almost 30 yrs. I started as a scrub tech but I felt I always THOUGHT like a nurse. So, I became one. As a tech, I didn't just focus on the sterile field, I would challenge myself by also thinking of the equipment, positioning devices, meds (back in those days you could just pull them off of the shelf) and even the paperwork (yes, we had paper back then). The less my nurse had to "fetch" the better I felt my performance was. However, NOTHING prepared me for the day I was the RN in the room and realized the buck stopped with me. All of a sudden I was accountable for everything and to everybody! While the rest of team was bantering back and forth, I had to FOCUS because the buck stopped here. Oh, I knew the nuts and bolts of preparing for a case, the procedures and even some of the staff but what about when there was a nick in the femoral artery during the case or a difficult intubation? My best answer to you is this: it's all fun and games 'till someone gets their eye poked out. By that I mean 99% of the time things go the way they are planned in surgery (with a few variables) BUT that 1% of the time when things go South and it gets......crazy where everybody is freaking out someone has to be the voice in the wilderness. That takes drawing on everything you've learned in college, your identity as a professional and as a patient advocate. As an RN you have a scope of practice independent of what the surgeon, scrub tech or anesthesia provider thinks your role is. That's how the law, as the nurse practice act in your state, views the RN role. It is no longer a legislative matter that the circulator in the OR be an RN but it has become the standard of care. If you have ever had to front-off a surgeon or an anesthesiologist to advocate for your patient, then you know first hand that you have to be secure in your professionalism and clear about your role. Am I as much fun in the room and popular as I used to be? Probably not but my patients are safe and get the best nursing care possible no matter what happens or who else is there. I sleep soundly at night!