Akpywackett

The surgeon's job is to complete the H&P. The RN's job is to make sure it's there and says what it's supposed to. Diagnosis and planned procedure.

No it's like none of those things. Part of the job of the circulating nurse (RN) is to make sure the paperwork is in order, verify that the patient knows what's about to happen to them, and stop the proceedings if anything is amiss. It's part of the system of checks and balances that safeguard our patients from wrong site, side procedures.

If the patient is a day-stay, not an inpatient or emergent, and there is no H&P, I don't take them to the OR. My facility seems to think that the "H" is the diagnosis and the plan is procedure on the consent. But I've got to see a "P" as in physical from somebody, surgeon or anesthesia. Ideally, I want and H and a P from my surgeon dated within in 30 days and an update within 24 hours. It's not the RN's job to do them. But it is the RN's job to make sure they're on the chart. And if they're not...they don't go back. Make a surgeon late while they complete the H&P a few times and suddenly accurate and current H&P's appear. I think ensuring those things are on the chart are part of patient advocacy and hence a circulating RN's responsiblity.

Re: Foley Balloon Test I put a foley in today, and paid special attention looking for ridges after testing the balloon. If there were any, they weren't visible. I think ridges are a myth! haha MICRO-Ridges as in Microscopic...of course they weren't visible.

Count if you can...x-ray if you must. That is all.

I'd be interested in knowing also. I just went through our clean core looking for outdates. And even though the 'packaging' was still intact and 'sterility guaranteed' I had questions. Hopefully, we'll get an asnwer.

After inflation there are micro-ridges where micro-organisms can live, thrive and ride into the bladder.

Yup...they're much more effective and easier to use thatn scissors, kochers, clamps or bottle openers (they actually preserve the sterility of the rim) but I've only found them from rep. Do you have a rep for pain pumps? That would be the human to talk to.

No. It is this way everywhere and in every profession. Office refrigerators are disgusting and there is nothing to be done but get zen about it.

Been there, done that, paid the price (got moved from one specialty to another and chose to leave the facility) but my conscience is clear. If you can live with the silence then you have no problem. Unfortunately, it sounds like you're having an issue with keeping quiet.

Wow. Management gives you time to visit with family? I'd love to, but turnover times, baby...turnover times. :dancgrp:

The challenge in OR nursing is to gain trust quickly. I think OR nurses are probably more intimately tied to their patients than some floor nurses. You've got about 2-5 minutes to convince someone (and their family) that you're capable, confident, and that you're going to take good care of them when they can do NOTHING in their own defense. And sometimes you're the last person they ever talk to. So while the contact may be brief it can be very intense.

I think you did a lot for 3 days. Congratulations. As a new nurse and new to the OR, I think you were right to go to your OR educator first. She/he is directing your overall education/orientation to the OR correct? She/he could/should have counseled you on how to approach the situation. While direct communication with team members is important it's not always easy, especially when you're new. Exisitng team members sometimes have a tendency to disallow or try to discredit new team members feelings. "You've got to prove yourself" And it's easier to navigate if YOU have an advocate and in my opinion that should be the OR educator. That being said, the OR is also a lot of work. Physically and emotionally demanding. To be successful I think you have to have a pretty tough skin. And you are going to run into a lot of people that are "mean", "angry", "surly" "condescending" and just downright rude. Somtimes it's stress, sometimes it's ego and sometimes it's just not Grey's Anatomy, ya know? Unfortunately, it seems that in the OR there is a lot of drama. It doesn't have to be that way and it shouldn't be that way but my experience has been that it is that way. It can also be great. When the team is working together and you're kicking ass and taking names and some 'body' rolls into the room and you roll out a person. There ain't nuthin finer. I wish you good luck and perserverance. I'm always happy to see a new member join the club.

http://www.who.int/patientsafety/safesurgery/en/

I'm going to be graduating in December with an ADN. I've spent the summer working in a level I trauma center in the OR and just love it. I'm a competent scrub tech for minor general and orthopedic cases. I've lived in Seattle before and look forward to returning. To that end, I'm heading to Seattle next week (for a week long vacation) and have scheduled interviews with 4 hospitals, UWMC, Harborview, Virginia Mason and Multicare/Tacoma General. I'm leaning toward Tacoma because cost of living and commute time would be shorter than the downtown facilities (I'll be staying w/ family in Bonney Lake) and because the UW there has a 1 yr ADN to BSN program. Harborview, Harborzoo as I so fondly call it, is a sentimental favorite. My ex had many surgeries there...MANY... so it feels kind of 'comfortable'...was the first place I considered entering nursing. Yes, I have lunatic tendencies. :rotfl: UWMC would be a dream. That new Surgical facility gives me a medical (science geek)...umm...woody. But I don't think it's going to happen right out of school. I'm emotionally neutral on Va. Mason. Any insights locals can share would be appreciated. Thanks in anticipation.