cocothemonkey

Circulating a cardiac case, standard CABG X 4 with a radial arm harvest on a younger gentleman. Surgeon is a spaz, throws little fits and is about the most impatient man i've ever met. But it's more comical than anything, almost like a cartoon character, he really doesn't bother me. Well, the PA was done with the radial harvest and I went over to clean off his mayo stand and retrieve the countables. He had 3 empty suture packs but only two sutures. He's a high maintanance PA and comes into the room thinking he's one of the surgeons. I ask him how many sutures he was supposed to have. He said 3, that they're on the needleholders. I look again and can only find 2. He starts yelling that they're right there and that if I look i'll find them. Again I say you only have 2 here. Now the surgeon gets into the middle of it and tells us to be quiet and that he doen't want to hear another word about it. I tell him that there's a missing suture. He doesn't care. So I let it go for a few minutes and then casually start looking around the floor where the PA is standing. Suture is stuck to the bottom of his foot. I say loudly here it is and pick it off his foot. No apology, no nothing. I'm mad and was mad the rest of the case. Mad that the surgeon could care less that there was a missing suture. Mad that the PA insinuated that I was some sort of a moron and they thing was stuck to his foot the whole time. And mad that this moron left the case shortly thereafter and would have left me one needle short and could have tracked it into another case throwing their count off. Thoughts? Am I being oversensitive and should I have just let it go?

A NP first assistant and a surgical PA are roughly equivalent.

Never seen any nurse where I work wear one in the OR. Grab one from anesthesia if for some reason you ever needed one.

5-6 months

RNs are viewed more highly because of their versatility and the ability to legally do things techs can't do. Techs just have less responsibility, especially from a legal standpoint and more important from a patient care standpoint. That's not to say techs aren't valuable though.

I'd probably leave just to spite them.

1- orthopod 1- PA or SA 1- circulator 2- scrubs (one holds retractors)

Not judging you. If the situation is bad, paying them off may be money well spent.

Did you sign anything?

I would have told her to F off, but that's just me.

Probably not much you can do about it this time but atleast he knows you're not going to just sit back and take it. I tell you, surgeons can be some of the biggest a-holes on the planet. I've found they run either hot or cold, either really cool or really bad. I don't get it, nurses and techs are there to help them and some are not only unappreciative but downright hostile.

I've also had a foley balloon that wouldn't deflate, something defective with the valve maybe. Luckily I tested it before inserting it in the patient. Also why would someone else test your balloon for you. I've never had that happen to me. It only takes a few seconds to test the balloon. :dunno:

Have you ever been a circulator? We've had a number of techs go back to school to be nurses and were amazed at how difficult the job was and the things we do that few realize. They too were under the impression that we were nothing but glorified gophers until they actually stepped into the job. Or maybe it's the hospital you work at. We had a cardiac case go bad last week. I was the one doing the chest compressions and dictating jobs until the surgeon could get back into the room.

Watch a cardiac case that goes bad and tell me the patient wasn't lucky to have an RN in the room. A person who knows what to do and why it's being done.

How much time have you spent in the OR? You have a warped and incorrect belief on what OR nurses actually do. These checks are crucial after a carotid, patient doesn't leave until all four limbs are moving. Whether the PACU nurse does a post op check is inconsequential. There are many more examples but you just asked for one.

neuro and reflex checks after a carotid.

There should be an RN in every OR room. If it's not the circulator then there won't be one at all. Nursing training brings a totally different skillset and knowledge base than medical school or surg tech school. I think it's to the patient's benefit that an RN be in the room.

After 3 months, she really should have sterile technique down to second nature. An occasional slip up, maybe, but for it to be an ongoing thing, something is wrong. Some people just can't get sterile technique. That's about as basic as it gets in the OR and it's sadly why some aren't cut out to work there. You shouldn't have to watch her like a hawk 3 months in.

Is she the only person responsible for checking the patient's ID?

I'm assuming the nurse wasn't the one who ultimately realized this wasn't the correct patient? The nurse would probably be disciplined but not fired. Mainly because this was a breakdown at many levels. Things differ at different hospitals but if one person screws up and this can happen, then something's wrong. Where I work, anesthesia would be responsible as well, for bringing in the wrong patient and not checking the ID band with the nurse.

I don't see how it would be a problem as long as you don't scrub in. I can't envision a scenario where your blood would end up in a patient. I think the probability would be greater out on the floor.

Take it. I moved mine up two weeks. I just got flat out sick of studying. The extra two weeks would have done me no good after seeing the test.

My first ones were in my practicum in the operating room. Perfect learning situation, the patients were out cold.

Yeah, I passed with 75 questions. Wasn't at all confident that I passed though and left the testing center pretty pissed off about the whole affair. Like I said earlier, I think I could have studied for years and still not come across a lot of the things they asked. It's more how you think than what you know. Practicing questions and know how to eliminate choices even if you don't really know the answer is crucial.

I don't think you'll ever feel 100% ready. I knew it was time when I was just flat out sick of studying. Seemed like 90% of the stuff on my test was information I would have never studied if I waited 10 years to take it. It's more having the ability to figure things out than pure knowledge IMO. Frankly, I think the test is a waste of time and stress but what do I know.