carcha

Yeah I've had enough too, enough of the egos, lack of communication, expectations that OR nurses can be used in any part of a hospital, yet no other nurses are expected to come to the OR and scrub. I am sick and tired of lack of support from my managers, tired of the bad language, the volitile outbursts, the feeling that my stomach is in knots. I am sick of having to work on call, of the lack of appreciation. I am so tired of being expected to be able to fix any equipment that breaks down while the manufactures and maintenance people of this equipment are at home in their beds or out enjoying a meal with their partners because they dont work after hours. I am tired of the nurses who come to the OR because they "hated the units", and spend their time sorting out their duty roster or hogging the phone to speak to their boyfriends. I am tired of people who have worked in the OR as long as I have but refuse to take any responsibility and get away with it. I need a change!

Unlike most of my OR colleagues here I would caution you to think carefully. Having been in the OR for 25 years now I am at a point of giving it up. I dont think the job has changed at all, not a bit and I still love the job as much as I did when I first walked into an OR in 1980. However the politics now involved in the job make it very hard to tolerate. Over running of lists, impatient surgeons, abusive surgeons, junior nurses who are either great or have an attitude, rarely in between, long on call, far more demanding cases. I certaintly dont want to make it seem like OR nursing is awful but there are major pitfalls there. If you were 23 years old you may put up with a lot of the agro, however as a mature entrant do you think you can tolerate the politics. If I were to leave the OR now, which I am planning to I would look at a day surgery unit where the work is perhaps not as exciting but your life is your own and you know you wont be getting up out of your bed at 0330 to drive to work on a snowy, frosty, night . Just my humble opinion.

Rarely get home, so dont need to come back in, am there already

Yeah, same as Shodobe here. The guard stays until the patient is asleep. Handcuffs , leg irons off, guard leaves, stays at desk. Patient extubated, guard back at side leg irons on, depending on surgery, or handcuffs on. We never have the guard in the room, no need, patient is anaesthetised, intubated, what does an intubated patient do ?.

Yeah I saw this one too. My feelings are mixed as I believe if your going to bar code sponges why not other items?. I know a sponge is more likely to be lost then an instrument say, however, I feel in my heart its kind of a concept that will never take root, a surgical fad. From what I saw on TV it was very time consuming, almost slow motion. My other concern is that all attention will be on checking the bar coded items while perhaps slacking in other areas. I am a great believer in the human capacity to identify and solve a problem . I dont like the idea of OR nurses relying on this invention which if it malfunctions will bring serious consequences. Besides which, what exactly does this invention do?. It dosent make the surgical team more careful. It dosent stop other items being left inside the patient. It simply tells you if the entire set of sponges is removed. Lets face it my old brain has been doing that for 25 years. Personally I feel the only 100% guarentee of an item retained free patient is an x ray machine at the door of the OR room. Now thats a concept that has my vote!!!!!!!!!!!!

RNin2007, what an awful experience for you. May I ask why dident you go to your tutor and complain, I feel you would have been entitled to. Personally I adore having students as they keep me on my toes all the time. I usually first interview my student and determine their perception of the role of the perioperative nurse. Then we can plan a whole rota for their 4 weeks with me to ensure they get a total understanding of the environment, and hopefully may be interested in coming back to us. Even if they are not interested in the work I ask them to learn the basic airway management as that is a skill every nurse will use wherever you work. You got a bum deal.

I have a lot of friends who wear TEDS, however I went to an orthopod some years ago and had inserts made for my shoes which have really made a huge difference to me. I can wear the cheapest runners but with the inserts its like walking on air all day. Their expensive but worth every penny.

In London there are public, private hospitals, clinics, ect. You have to shop around for the best deal, just as you would do for anything else in life really I guess. Just because the internet tells you one thing dosent mean its the law everywhere. And to shock you further, I know there are people who make more then me. Like I said you have to shop around.

I cannot believe you all work so hard for so little money. Do you all belong to unions? You should get together and demand your worth. For holding the pager I expect $30 an hour. For working an hour on call I expect on a week night $ 85 an hour. I wouldent get out of bed for anything less.

Yeah, like most of the other postings we do the check x-ray in the unit. Our guys feel that as we hook the line up to the monitor immediately they can tell by the reading where the line is. However they do the x-ray afterwards. If we put in a line for unit purposes only ,ie the patient is not actually coming to the OR we do the check immediately in the PACU.

Passing this all on to James, thanks again

Well heres my own contribution to this posting for what its worth. I have found that the new grads who spend 12 months gaining management on the units before coming to the OR are far far better then the straight from school nurses. I believe this is because once u qualify as an RN and work on the unit you cease to be a "student", are given responsibility and mature quickly as a person and professional. However when student nurses come to the OR immediately after qualifying they are again "students" while they gain experience. The difference is astounding I have found. I must say I am really disapppointed with your viewpoint of us being so "task orientated". Do you believe we look at our clients as bodies without souls. I am not being picky just disappointed. I have comforted a 39 year old mother of 2 kids this week who has months to live. I have sat with an elderly woman whose husband has left her for a younger woman. Two nights ago I held the hand of a man with a AAA. I knew his chances were slim as he was put under anaesthetic so wanted him to feel the warmth of another human in an otherwise clinical environment. He died and after I laid him out I then had to bring his family through to see him and answer questions and look after them until the viewing was over. Task orientated is when you believe that handing inanimated objects to a surgeon is the most important function in the OR. In fact our role is and should be assessing our whole environment, the people in it and managing to make sense of the chaos. That requires a lot more then using your hands and making quick decisions. It requires instinct, maturity, compassion, humanity. Perioperative nurses are a breed of their own. I guess I'm biased. I hope you go into the OR Las vegas, but dont concentrate on the smaller picture, take it all in.

Thank you both of you, I passed the info onto James and he's quite worried as he had hoped to go to ottowa soon. He dosent think he can start the whole thing in London but what can he do. And why do canadian hospitals recruit foreigners if they cant work for several months after they get there?. How can he live while waiting for this check to come through. I totally understand having the check done and welcome it but it takes so long. Perhaps he will try elsewhere for the moment. Thank you for your speedy reply. From James and I.

[color=sandybrown] my friend james recently passed his canadian exam. we both work in london, u.k. james has gotten his registration form but its asking for a criminal record check. if he waits until he gets to ottawa to do it can he work in the meantime because he says according to the police it takes ages to get it through. thank you from james, and i.

I guess I am biased on the topic or RN's and techs but this is a classical example of someone not trained to do a job being allowed to go outside their expertise and now wanting the same pay and recognition as the RN. The first poster is a competent scrub tech. Obviously knows their stuff about SCRUBBING. The second poster I took an interest in with the music degree Spyder is again competent at their job but again due to staff shortages, idiot RN's who dont realise that the buck stops with them so matter , has been placed in a position they shouldent have been placed in EVER. And forgive me Spyder, theres always a choice like "I am not qualified to run an OR, I do not have the necessary qualifications to do so, this hospital could get sued by a patient if it was discovered that a tech with a music degree is running the place", at least that is what I would have said and then refused to come on shift until a qualified member of staff was around. So yes there was a choice. Anyway my point if I can get to it is that, I truly believe that theres not a tech out there who cant become an RN. So instead of trying to make equal money by scrubbing well for the surgeons and becoming their favourite person because you can anticipate their every need, or instead of taking charge when it must be quite inappropriate for you to do so and telling us that even if the RN was there you would be given the responsibility, go and do your RN. PLEASE, GO AND DO YOUR RN AND STOP TRYING TO SAY A TECH IS THE SAME. ITS NOT IN THE EYES OF MANAGEMENT, ITS NOT IN THE EYES OR YOUR CO WORKERS WHO ARE RN'S AND BELIEVE IT OR NOT ITS NOT THE SAME IN THE EYES OR PATIENTS. For those techs who choose to stay as techs, enjoy their jobs and respect the difference between us, I salute you.

Your idea for setting up your counts again sounds great. I'm sure you'll iron out any wrinkles. I couldent agree with you about the extended time counting. May I ask what does your scrub do while the surgeons are closing the wounds now?. The count should take up no more time then no count. I would suggest that you all discuss when you will do your counts following the surgery to make sure your all on the same page, especially the junior nurses who may never have counted before. I find that a lot of nurses do their final count far far too early when its possible for a foreign object to be retained I also feel you should drum into your junior what to do when the first count is incorrect, ie do not keep handing over sutures in the hope the missing sponge is found. I dont mean to preach but these simple incidents have almost been the down fall of at least 5 of my colleagues over the years, good luck from us in london and happy counting!

After many years in the OR I have decided that nurses are their own worst enemy. We rush between cases, run down corridors, do two tasks at once, miss meal breaks, so on and so forth. Lets face it we are the ones to blame when we stress ourselves out so much that we end up worrying that we have forgotten something. I am guilty of exactly the same thing but am improving rapidly to a point that I completly shut my room for an hour last week so that all the nurses could have a decent lunch break as we had no relief. Lets start to look after ourselves and not worry about the surgeon being happy that we've finished or started their list on time. This problem is global, I really think as nurses we are somehow conditioned to believe that the most important result is surgeon satisfaction. Now I look for patient, nurse and surgeon satisfaction and if it means a short delay, so what the work gets done but by less stressed nurses.

My only advise and this is following experience in North America is to get both your job discriptions and compare them. Then if any tech disrespects you or your role you should take the discription and show it to the tech. When its written on paper you will find a lot of people will back away, they dont have a leg to stand on. Anyone who thinks this will cause a bad atmosphere should read the original posting to realise that the atmosphere couldent get worst. Be firm, you have worked hard for your license, dont risk it to keep another person happy

Hi Sara, congrats on your RN. I dont know if this is any help but some years ago I lived in North America and like you presented my C. V. to several hospitals with little results. Then a friend advised me to ring the O.R. supervisor direct and what do you know, I was offered a job starting the next week. Prehaps things have changed since my day but it cant hurt.!

In the OR I work in all the nurses here, and we have only RN's working throughout the OR have been told that if they knowingly reuse a one off item then they and not the hospital will take full responsibility and can be sued. After all the hospital is doing nothing wrong technically by just re sterilizing items. Its the OR staff who open it to use it on a patient who is committing the offence. Think about it. THROW IT OUT!!!!

We had this situation in one of the OR's I worked in some years ago and the student was asked to leave. I was happy with that decision. I personally do not agree with non professionals being part of such a critical environment. I can only hope that student nurses and doctors have been vetted as to how to behave in the Operating Room. Who vets the school children. I do not want school children in the operating room when I have to have surgery, I therefore will also respect other peoples dignity. As for patients not complaining I feel most people dont want to appear awful to the nursing and medical staff so dont complain. At those times we must step in.

We dont even operate without 4 RN's in the room. For us here in my workplace only RNs care for the patients throughout their perioperative experience. The only non nursing staff who touch a patient here is the porter who helps move the patient from the table. We also do not have non nursing medical staff enter the room once the procedure has begun. For me thats the future of nursing.

yeah, sticky one this. I guess my only suggestion is to start all over again with her and see how she does. My guess is that as a very junior nurse she feels the pressure from all around her to perform to their standards and she is screwing up because she must feel isolated from this group. I also think the S.T. needs a talking to because its easy to pick on a new person when you have worked in the same environment for a million years and know everything. My only suggestion is to take this nurse aside and really go over everything with her from scratch. Then have her explain the rationale for her actions to you. I feel you should also let the teams know that she is learning. I always believe they will follow the example of the nurse in charge and if they see that your not happy with her work, they wont be either. If everything else fails be honest with her and let her know the OR may not be the place for her. A willingness to learn does not mean success.

I feel everything everyone says is correct, the "old days" patient reflected a more complient society. However, I will say I believe the modern patient has a better understanding of the risks associated with being a patient. Personally I adore the modern patient as they let us know what they do and dont want and this enables us to plan our care around both their and our agenda. I used to get so tired in the old days trying to guess what the patient wanted. Now they tell me, how simple can that be?

hi Higgy, well James wrote to the ontario board of nurses in late early summer and it took about 10 weeks for all the paperwork to go through. He had to get a lot of transcripts through from UK to Canada ect, references, . That took a while to get it all moving but I think 10 weeks isent bad. Good luck, and bon voyage!