Goodyear

Love the info...thanks guys!

Great job! hope to do the same soon! Ditto on the tips...

In the OR there are already robotic surgeries. It takes twice the manpower to do a robotic surgery and at least triple, if not quadruple the amount of time. Granted, this is a different kind of robotic system, but (at least in its younger years) robotic ER will take manpower.

The OR I work in is looking for nurses. We do not have the Periop 101 program though... I didn't go through it so I can't tell you the pros or cons. Do you know what they are?

I too have Malignant Hyperthermia, and it is not a problem. It is a cellular level protein defect and is only a factor when (and not even every time) anesthesia is actually administered to us, and only certain types (potent inhalants, muscle relaxants, and a few others.) You'll be fine as a CRNA so long as the anesthesia is for the patient. I joke, but really, don't worry---you'll be fine!

Wow. Thanks for the info everyone!

Great info!

FIRST----- I. am. sooooo. sorry. you are going through this. It is ridiculous. Second----Have you considered trying to get into a position more suited to someone just out of school? There is SO much we do not even dream about in school that is reality in the real world of nursing, that I wonder if this experience may be too much for you to start off with...and that it might change your ideas about nurses/nursing from here on out. In reading your post, I was STUNNED that they gave a new grad a position requiring 5 years experience---Service Line Supervisor or something of that nature? I personally feel that your license and newly earned reputation are at stake here, even before you have a chance to build on them! I would think it'd be a good idea to remove yourself from this situation; it sounds like a ticking bomb, for anyone and everyone involved. I hope I don't come across as harsh or critical.---I am truly NOT trying to be. I was shocked from the 3rd sentence on and had a feeling of panic, which I am sure you feel too. Take care of yourself, your license, and your future; find a position more suited to your newly earned confidence, license, and career. Best of luck to you my friend!!

Thanks for all the input! Our OR census is unusually high for this time of year, and we are having a hard time keeping up. We have an average of 25-30 cases a day. Wow, right? Supervisors who are only supposed to circulate in a dire need are stepping in, leaving things like board running and scheduling hangin'. Surgeons get REALLY mad when they have to wait on a team or can't schedule flip-flops because of low staff. To make up for it, they are scheduling weekends, which are supposedly for emergencies only. Two surgeons have stated they are taking more cases to neighboring hospitals and trying to run between the two to get things in. We cannot "be more productive" if you will, because there HAS to be a circulating nurse for EVERY case (I know most of ya'll probably already know this, but for those who don't I'm explaining some details) and the amount of time we spend on a case depends almost entirely on the surgeon. People are burning out at an alarming rate and rooms are not stocked, supplies not ordered, collateral duties not done, etc. It feels like things are hanging together by strings. We REALLY, REALLY need help, but there is nothing but numbers in their eyes when the subject comes up to mgmt. Sorry for the long-winded post, but I love my job, the people, and the work, but GEEESH---this is gettin' to me!

I work in a 20 room OR as a circulator. When I got hired, I had to wait almost a month for the position I would fill to be approved, etc, by management. Ok. I can live with that. NOW, though, we have had 2 nurses quit, one got let go, one transferred to another area, and one is moving into a supervisory position (open due to one of those that quit) and will not be circulating regularly, unless a need unable to be filled, arises. Soon, another nurse will be leaving for planned reasons. We went from 9-10 actively circulating nurses to 4 plus two new nurses (hired within the last couple months and not fully trained.) My question is, how hard is it for a department manager to justify filling and/or opening positions in such a situation? Call hours----are OVER the top right now, and burn-out is knocking on the door. Management seems to think we'll be ok since we have two new nurses (leaving us in a deficit of 3, then 4 once the last one leaves.) What does it take to open and advertise positions to get nurses to fill the vacancies that we have and really need to fill? Thanks!

No, the Drs are explaining the procedure, etc., and obtaining the pt's consent. When the pt comes to pre-op holding or day surgery we have to verify understanding of the consent, signatures, and ask if there are any questions about the procedure (in which case we get the surgeon), etc., before we take them back to the OR. For example: Pt has signed consent for a left simple mastectomy. I would say "hello my name is xxx and I am your nurse for this procedure. Can I get your name and birthdate?" (wait for response) "What is it you are having done today?" (wait for response) Most times the pt does not include which side or full information in their response, so I like to clarify and be sure of the EXACT procedure, site, etc, and the pt's understanding of their signature for it and any related consent for blood/products. These are the types of questions that I wonder who can be a translator for. I am learning the language, but in the meantime am using only RNs or Drs to help out.

AAALLLLL of these things are things the area supervisor and I discussed, and she thought it ok to use "whoever" works on the unit. Part of the reason she told me this, I think, is because she is the most fluent of the 3 nurses there and I had to use her at a time she would rather I didn't. Even having said that, though, it isa predominantly Spanish speaking area, and about every 5th patient doesn't or won't use English. The questions, etc I have to ask and get answers for are after the consent has been signed---I have to verify the sig, ask for questions, and give answers coherently, etc (prepare just before I take them to the OR). I still use RNs for it, and will continue to. The docs? Honey, if I were to trouble one of the divas, it'd be a very. big. deal. I am learning Spanish but in the meantime will continue to use licensed coworkers. THANKS for all the input!!

Thanks for your reply!! Let me add some information on my problem. When prepping to go to the OR, I have to verify signatures, understanding, ask for questions, etc, some things not on the consent proper. We have the phone in service, but being in such a heavily hispanic area, it isn't used and is very expensive, not to mention that in the 5 to 10 minutes we have to get to the OR from holding, I don't think it'd work. I am one of very few who do not speak Spanish, but I do want to be certain those I'm told to use--OR scheduling secretaries, with access and rights to the info, and the CNA's that assist in getting them and the paperwork ready--when I need them are acceptable.

I seem to remember the discussion being along the lines that an unlicensed person may or may not understand the terms and concepts used, and therefore may incorrectly (however slightly) "mis"translate... What holds up in court, I guess?

I don't speak Spanish well at all (yet) and work in an OR, where consents are our bread and butter. We have a LOT of Spanish speaking patients, and I run into a language barrier from time to time. The area supervisor tells me to just use a secretary or CNA to translate, but is that legal? I think I remember being told that consents, being what they are and carrying the weight they do, can only be translated (as in this instance) by another equally licensed professional, or better. Can anyone help shed some light on this or throw out suggestions where I might be able to get information on what is right? Thanks!

Hmmmm....I'm curious too!!

Make it clear you are a fast learner and able to multitask---there is a LOT to learn, but it is definitely very doable if you apply yourself. Being flexible and able to adapt to last minute (and multiple, sometimes) changes is a plus. Being a new grad, I would think they'll be looking for a strong interest in the area, basic knowledge of what you might be doing, and confidence--you'll be dealing with diva surgeons 1 to 1. Not sure about the portfolio, but good references are an absolute win, I think, in any situation!

It might not hurt to "set the tone" early on a new unit just to be safe. When making the assignments let them know you will check and they will be held accountable, then follow through. Before long you'll be known for it and won't have to do it each and every time; You'll just have to "update" people on your expectations. Good luck--I've worked with CNA's who were rarely even around let alone taking care of pts!

SAME thing happened to me, but it was BEFORE all the paperwork! I was told IN the interview I had the job and HR would be contacting me soon. 5 days later I called HR and was told the hiring mgr had not submitted an offer. Waited 3 more days and still nothing. 5 more days and HR called to let me know the position had to be approved by upper mgmt and they would do it in 3 days. 3 days later I called---3 more days. All this while I had put in 3 calls to the new mgr with no return call. FINALLY after WEEKS of waiting I got the offer and then was told to wait for employee health to call and schedule my screens, etc. ANOTHER week and a half later....! I was a bit nervous until the day I started orientation, needless to say, since this was the only job I had applied for and was watching other good jobs go away while I waited. It's hard to not be anxious. It was a combination of things in my case, not the least of which was my mgr is a one legged man in an a** kickin' contest. I don't think it'd hurt to continue to try reaching the new mgr or trying to visit her/him at a time when you think things wouldn't be too busy. It'll show them you're definitely interested and ready to go. Try not to give yourself and ulcer...the process SUCKS!!

Maybe try takin' a look at the shoes runnin' around the hospital---or hospital(s) that you might want to work at. The hospital I work at has a very specific dress code about scrubs, shoes, and headwear (I'm in OR) and it is NOT enforced in most units. There are maybe 3 units that go (somewhat) by the dress code, and I'm glad I waited instead of going by the policies they put out!! Just my though... CONGRATULATIONS on your upcoming graduation! Trust yourself and your knowledge when it comes to the boards!

You might discuss it with her, and/or an instructor you trust to handle it graciously. It would be a good opportunity for an instructor (BEFORE y'all are nurses) to reiterate the importance of confidentiality and HIPAA to your class. We had a student get kicked out of the program for talking about a pt (no names, etc) at the hair salon and the person in another chair happened to over hear and was related to said person. There was enough info discussed that the family member knew who the pt was and reported the student to the director of the program. She got the boot the next day. This stuff really needs to be taken seriously, and I totally get what you're struggling with as far as being a student, but if it were a family member of yours and she disclosed info to a curious stranger, it'd be upsetting. You aren't in school to make friends, and now is a good time to start advocating. Good luck--sounds like you're on a good track!

gOOOd Question FlyOR...I'm interested in the replies!

Oooops! I just read my op RE: the "enter here" tattoo and it isn't very clear... Pt was the mother of MANY kids, the biopsy was cervical, and the drape was over the nether region....

A young woman in for a biopsy. After removing the drape "Enter Here" was seen tattooed above the.....entrance.

NeoNurse Do you find it is a pretty standard there to hire anyone with a pulse? It seems scary... especially in an intensive care area.