cherston1

1. You can make mistakes regardless of your years of experience. 2. +Surgical conscious applies to nursing too. 3. It's better to admit mistakes and correct them than not to. 4. Live the golden rule every day. 5. You can work your shift with 4 hrs sleep. + Surgical conscious is when you are alone in the O.R. and something becomes contaminated and you fix it or replace it and not just leave it because no one saw you contaminate something.

I know this is how mommy does it.

I am fairly new to home health. I am a former scrub tech turned RN. I got tired of all the bullying, harassment, etc which can be found in hospital settings. So I found a smaller home health agency and signed up. I work night shift due to sciatica. Moving from a unionized hospital to a small home health agency I took about a $10 cut in pay. some may find that alarming. However, I LOVE IT!! No one breathing down my neck, I can properly assess the patient, discuss client care with the on coming shift or the clinical director who is available by phone or text. I can work as much or little as I want. I have 3 clients and 2 of them are about 24 and 20 miles from my home. The 3rd is 4 miles. It's true that you don't work if your client is hospitalized or dies, but I enjoy the slower pace. I'm doing care you usually don't see on a regular basis like trach's, ventilators, colostomy bags, urostomys, Hoyer lifts etc. I am a valued member of a team. That is what I like about home health. Believe me when I say that the cut in pay is worth not coming into work and putting up with a shark pool. I hate snarky (shark +snarly) nurses who make other people look bad so they look better, not to mention the hospital politics etc.

Since I AM a conceal carry, I thought I'd leave my thoughts. I live in Washington state and in my state to have a CC permit you must go thru criminal background checks (state and FBI) AND Mental health checks. So if you've done a stint at the looney bin or the psych ward NO Permit. I have always felt that everyone needs to carry some form of protection. There are those that don't believe in guns which is fine. I have a .380 auto which I keep mainly in my car. It won't do any good if someone starts shooting up the store I'm in and I left my gun in the car. There are also Stun guns, tasers etc. Some criminals are more afraid of a police taser than a gun. My point is that there are many ways to protect yourself. As a caregiver, I believe that we should be allowed to carry if we decide to. I also believe in being responsible about it and taking classes to learn when and how to use your firearm. I also carry in my lunch bag an 8 million volt stun gun. It's so loud that it made me jump when I first discharged it. It is made by stun-tec and is rated as one of the best. they make a flashlight version for $100 which would be easy to carry at work and come in handy when doing night shift. One has only to look to Chicago to see what happens when you have extremely tough gun laws....You get the HIGHEST Murder rate in the country. WHY????? Simple, Criminals DO NOT FOLLOW THE LAW!! Once everyone understands that, maybe they'll stop whining about gun laws. Reduce the guns to the people and crime increases. THAT is something our forefathers understood when Britian denied the people guns, soldiers were taking over homes, livestock and doing what ever they wanted. Once the people began to carry guns, the British could no longer do what they wanted. Same applies to Criminals. Shoot the *&%$^$%!!! in my opinion.

Another good program you might consider is available at www.legalnurse.com they have a 6 day seminar available, but I am currently doing the DVD program at my own pace. I did a lot of research of this company and they have good marks with the BBB and they also have a 6 month money back guarentee. They have 3 programs to choose from and you only need to be a nurse for 2 years. You also have a certification exam you can take after the course to be a CLNC. That is what I am going for. You might also look into that program.

These are all excellent comments, however, I've been in this situation and yes the O.R. tends to eat their young. Maybe that is why I'm thinking of leaving. The best thing you can do is request from the manager that you be given a regular preceptor. Two at the most. It is counter productive to have a new preceptor every day while you are trying to learn. Secondly, most O.R nurses will agree that AORN standards are the GOLD standard of nursing practice. So I would get a current copy of their standards (which should be available in your department) and memorize how to insert a foly according to AORN. Then when someone questions you about what you are doing, you can state that you are doing it according to AORN. But also be open to suggestions. Sometimes asking someone to show you how they do it helps tell them you are willing to listen. Sometimes too what is happening is not a put down of your technique, but instead they might be trying to see how "open" you are to suggestions or how well you do under pressure. You might also ask the preceptor of the day to watch your sterile technique to make sure it is correct, sometimes that tells the nurse that you are aware of how important it is to keep things sterile. Hopefully after they watch you several times and realize you know what you're doing they will leave you alone. But having one preceptor would also help. :)

Basically what you need to do is follow Hospital policy regardless of what you think. Another thing to do is also check the policy of AORN which for most is considered the gold standard of nursing operating room practice. As long as you are following hospital or AORN standards you are fine. If you don't, well you are ripe for an attorney later. Remember, it is YOUR license on the line because the surgeon will blame THE NURSE or the SCRUB. If this continues to happen, you might need to report it to your manager if you can't address the surgeon personally about this. Something other hospitals have done is to not pass closing suture to the surgeon until your first count is done, but that can be a problem. Other hospitals have mandated an x-ray on all open cavity patients regardless of if the count is correct. Counts also go faster if your scrub is organized. It's a scrubs responsibility to keep track of instruments that go into the patient, so if one is missing it is the scrub who has not kept track very well. I can say that because I used to be a scrub. But I agree that any time you have a count that is off, it is an event and needs to be reported. If it is not reported, your surgeon will continue to ignore counts. Just remember to always follow hospital policy and you won't be involved in a trial and suddenly be with out a license. Also if an event happens, DONT talk to anyone about what happened. Since anything you say to someone else can be used in a court against you. As can what you write. So also be careful about the notes you keep after an event.

Hi Blue: Ok, First let me say that I've been in the O.R. for about 15 years (give or take) Most of that has been as a scrub tech. I went back to school about 3 yrs ago and got my RN license. When I graduated, I naturally went into the O.R. With my experience as a scrub, I was perfect for the position...or so I thought. So from someone who is in the same shoes as you are, here is some sage advise I wish someone had given me. What you need to do is to get a regular med surg position (you know, taking care of patients on the floor like you did in Clinicals) But I want to be in the O.R. you say...So here is WHY you need to be a "Floor" nurse FIRST! As a new grad, you are taking baby steps so to speak, regardless of how good you were as a student. You NEED to FIRST learn to be a nurse. That requires you to practice assessments, time management, giving meds, lab values etc. All the basic critical thinking skills you will need as a nurse. Second, you need to refresh your Surg Tech skills. I would recommend a surgical tech school for that of at least 11 months to 1 year in duration that is accredited or you can get a job as a surg tech. or take the certification exam for scrub techs. I recommend that you keep working on the floor as a staff nurse for 2 years. You need to be able to automatically look at labs and know when they are off, or dangerous. You also need to know medications and which ones react to each other and so on. You also need to organize your time and nothing will help with that than taking 5 patients on the floor. I didn't understand at first why this was necessary, but having been in both roles in the operating room now, I understand that you need at least one year of nursing experience under your belt before considering a nursing job in the operating room. Some hospitals offer a peri-operative 101 course, but that is very basic and is meant for people who have NO previous operating room exposure. I wish I had worked on the floor for a year, it would've made my transition easier. It is also hard sometimes to remember what is a scrub tech role and what is a nurse role. If you are lucky to get an awesome preceptor, you won't find it too hard, but the realities of the O.R. are anything but. I don't have to tell you how cut throat the O.R. can be, and believe me, I've worked in wonderful O.R's too. You need to be fast, complete your assessment of the patient quickly and also set up the room quickly. As the nurse in the room, you will be doing a lot more that you did as a tech. So if this is really where you want to be, do it right and work on the floor for a year before you consider going back to the O.R. you will save yourself a lot of headaches later. Cherston1