kendraj

Hello! I also work as an RN in an outpatient ambulatory surgical center that specializes in Mohs. At our practice we have 1 Mohs surgeon, 3 RNs (including myself) and a MA to assist with surgery. In the morning before the MD comes in, we set up the rooms for the patients (setting up the sterile tray with instruments), draw up the anesthetic, and make sure the rooms are stocked with necessary supplies (cautery tips, gloves, gauze, etc). Once we get a patient, we review the patient chart, confirm the location of the skin cancer on the referring MD's pathology report, and document it on the sheet. We room the patient, ask questions verifying medical history/allergies, etc. and presence of skin cancer, explain the procedure, sign the consent, answer any patient questions take vital signs, and then confirm the location of the skin cancer with the patient using a mirror. After the spot is confirmed, we take a picture of it for our records, and cleanse the area with Iodine or Hibiclens (depending on the location/allergies). This is when we bring in the MD to talk to the patient, who will either numb the area or have us numb, and then take it out. He will then take the specimen to the lab where it is processed by a histotech (takes 1-2 hours for BCC, SCC and 3-4 for MM, MIS). This is when we cauterize, clean the area, bandage the wound, and send the patient to the waiting room. At the practice where I work right now we have 10-12 surgeries a day 4 days a week (the other day is a skin check/excision day), meaning I can see surgery on pretty much any part of the body at any time of the day (ears, noses, scalp are very common, but we also get a lot of trunk/shoulder/legs, etc - I've literally seen everything). We typically only send out closures to plastics when it's something as delicate as the eyelid, otherwise most of the closures are performed by our MD. Once the patient is clear (i.e. free of skin cancer), we bring the patient into a room, tell them the news, take another picture and get a measurement of the site, and then bring in the MD who decides the best way to close the area depending on what will look best for the patient anatomically and cosmetically (which could be a flap, graft, or letting it heal by second intention). He then marks what he will do and we numb, clean the area with Iodine or Hibiclens, and set up a sterile tray for the surgery. When assisting with the closures, we blot, cauterize, cut sutures, and use hooks to open up the wound for better visualization of a vessel if the MD is cauterizing. Once the closure is finished, we then clean the patient, take another picture and measurement, and bandage the area while giving the patient instructions. At the end of the day we do all of the charting for the surgeries, as well as another other visits we may have such as postops, skin checks, or consults. I find the practice I work at to be a very fast paced environment - there's always something to do and a lot that I've seen in my short time of working there. One extensive surgery that I was able to assist with was a paramedian forehead flap if you'd like to look it up to get kind of an idea of the types of surgery that can be done. Hope that helps!

Looked on my BON site 10 minutes ago and found out I'm officially a nurse! Won't have to pay for the quick results! Yayyyy!!!!

I took it today at 8am and got the good pop-up with 75 questions. In the same boat as you! Waiting to find out for sure is gonna be so hard but I think we did it! Congrats!!

Yes! I got the good popup, so hopefully that's a for sure thing!

Also took my test today at 8am, started a bit early and finished at 930 with 75 qs. Now just to wait!! ?

I feel the same way! I'm also graduating this May. If you're interested in nurse residency programs, certain hospital applications are already available. It's best to contact the hospitals you are interested in to see when their applications are available or to directly search nurse residency programs if you are flexible in going wherever a job is offered.