surginurse

Hello...I am an RN who relocated from Baltimore to Vegas. What a shock! Things are very different here. I was an OR nurse, till I came here. After 18 months working in this town I left the OR for a claims examiner position. In my opinion, the nursing shortage is much worse here. The nurses are unionized (which is a whole new concept for me), and I hear St. Rose has the best union packages, in town. I have been to the Sienna campus, and it is nice. One of my friends worked there (in the OR) and her only reason for leaving was too much on-call, as she has a baby at home. Be prepared for some terrible traffic, and (even worse) terrible seafood! LOL! Oh how I miss those steamed crabs! I heard St. Rose's new campus (San Martin) will have a neuro program. They are scheduled to open next month. That's all I know about St. Rose...hope it helps a little.

Oh how true... I taught an ACLS class to a bunch of new residents the last week of June. 2 weeks later, I had a spleenectomy, and guess who comes to my room for rounds? I asked for the chief surgical resident (whom I knew from the OR), and told him I didn't mind them doing "rounds" but no-one but him was allowed to touch me!!!

Am I missing something? Doesn't your facility use preference cards of some type? Every OR I've worked in had some type of preference card system. All the "little differences" should be noted on the preference cards. If they stay in your notebook, or in someone's head, how is anyone else supposed to use this knowledge?

I believe the going rate is around $27-29/hour, maybe more with experience. I don't know much about the working environment, as I lived in Baltimore. My grandfather had his chemo there, once a month, for several months, and I would go with him. The staff were wonderful to him. They didn't seem overly stressed, and had plenty of time to spend with him. My grandmother, aunt, and uncle still live there, and they rave about this hospital. The only other hospital even close, is Atlantic General. They only have a handful of beds, as it's usually a stop-over to another hospital. This one is much less busy in the winter, but; very hectic in the summer. I have a friend who just went to work in their OR, and so far, she loves it. Atlantic General is located in Berlin, which is about 20 minutes from Salisbury, where Penninsula General is. So sorry I can't provide you with more details. Best of luck to you. Maryland is a beautiful state, and there's lots to see and do, especially for families. I really miss it, as I recently relocated to Las Vegas. I won't miss the snow, tho! LOL!! Make sure you try the steamed crabs!

So sorry, I don't know their ratios, I worked at a different hospital, in the OR. I did my OR Consortium at Carroll County General, and it seemed like a very friendly place to work. It was just too far from where I lived.

Any of the Medstar hospitals have a good critical care course. They are Good Samaritan, Harbor Hospital, Franklin Square Hospital, and Union Memorial Hospital.

Penninsula General Hospital is located on the Eastern Shore of the state. This is approximately 2 1/2 hours from Baltimore. The communities nearby that hospital are Salisbury, Berlin, and Ocean Pines. Ocean Pines is the nicest, but further away ( around 30 minutes). The big benefit is you're really close to the shore, and can enjoy the summers (just the traffic sucks during the summer).

Villa Julie College, and Notre Dame both have evening programs, and accept transfer of credit.

Hi, You didn't mention your area of practice. Hagerstown is in the northwest part of the state. Carroll County General Hospital is one of the closest to Hagerstown, and a short commute from PA. The average salary is around $27-29/hr.

Yes, this was a larger OR ( 10 inpatient/ 6 outpatient). I was referring to add-ons for the same day. The committee reviews add-on cases, on a monthly basis (those already performed). If they determine that a specific surgeon is adding "emergent" cases they feel are not really emergent, they address this with the surgeon, who then must be referred to the Chief, if (and only if) the charge nurse and anesthesiologist deem the potential add-on not to be of an emergent nature. It has nothing to do with "picking and choosing". It has been a great way to reduce the number of surgeons who manipulate the system to obtain OR time for their own convenience. This has reduced the amount of revenue spent on paying overtime, and leaves the team available for true emergencies. No more explaining to a surgeon that his crani will have to wait until the "emergent" lap chole is finished. We have one team in house, from 7pm - 7 am, for emergencies, and no on-call team. So sorry for the mix-up.

It's no fun being on the other side of the bed rail. I had a spleenectomy for a splenic aneurysm, 5 years ago. I was greatful for the amazing care I received. I especially appreciated those that explained things, and didn't just assume that I knew because I'm a nurse. We must treat our patients as if we would our family. The payoff is priceless.

Our facility utilizes a "neutral zone" to prevent sharps injuries. The docs put used sharps on the zone (usually a magnetic mat), and do not directly hand used sharps to the scrubbed person.

We recently completed the big changeover from hand-written to computerized charting. We use the PICIS system. At first, it was difficult. Some of our nurses had never used a computer, and all attended a class just for that. Our computers are basically a laptop, on a movable cart, that can be lowered when sitting, and raised when standing, as well as unplugged, and moved around the OR suite, even moved from the suite, to another area. Once everone was used to them, it was great. Charting was much faster, especially when templates are used. The drop-down menus were easy to navigate, to change info. We did create a position for an IT Resource Nurse, whose job is to keep all the preference cards, templates, etc. up-to-date. She also now precepts new staff to the system, and assists anyone having problems with the system. Our charts print out in PACU, and there is a computer there, in case of last minute charting. Our turnover rates did not change, but; there were many other advantages. Billing was much easier, and more accurate. We could track surgeon's actual times, not their "stated" times. Pretty much anything we needed to track could be obtained quickly.

Check with all the hospitals in your area, directly. I worked at my facility for 2 years before I found out we had a perioperative program! With the current shortage most bigger hospitals have training programs, or are fast developing one!

Crocs are the best. They sell them at the mall for $39.99. I also found them online for the same price, just doing a Yahoo search.

When did they stop the Practice CD? When I took the exam (January 2003) they sent it with the packet when I registered. As soon as I received the packet, I took the practice test. That helped me determine my weaknesses. I then borrowed a book of AORN Standards, and concentrated studying only the areas I needed to improve. Overall, I spent only 2 days preparing for this exam. Maybe I'm the exception here, but; although it was a challenging exam, I felt alot of the questions were pretty much common sense for the experienced OR nurse. I had only 2 years experience when I took this. Don't rehash info you already know, and concentrate on your weaknesses, and you'll do fine. Good Luck!

Most hospitals have Clinical Nurse Educators. Find out if you have one, and use that valuable resource. You should be able to borrow any reference material, without having to pay. If you haven't already, consider joining AORN, as they are a wonderful resource.

Our facility recently improvised a committee to review all "add-on" cases, to try to get a handle on this problem. We have to classify all cases as elective, urgent or emergent. The "add-ons" are reviewed monthly, by the committe which consists of Chief of Surgery, Chief of Anesthesiology, OR Manager, Surgical Services Director, and Post-Anesthesia Manager. The committee identified surgeons who abused the policy of adding non-urgent/emergent cases as such, and were informed their add-on cases would be referred to the Chief of Surgery, for a "go-ahead", if anyone on the team (nursing or anesthesia) questioned the urgent/emergent nature of the case. It was interesting to see the number of "urgent/emergent" lap choles, appendectomies, etc. decrease dramatically. Most of the "offenders" didn't want to have to explain to the Chief why their lap chole patient, who had been in the hospital for 2 days, was suddenly an emergency add-on. Also, we had 1 surgeon famous for calling around 10-11 pm to add-on an "emergency" for 6 am, the next morning, knowing the scheduled cases start at 7am. After the first review, his early morning "emergencies" stopped all together.

These are so true! Don't forget to use those larger blue bowls to take salads for picnics, or pot-lucks........you don't have to worry about getting them back!!

Having worked in both ED and OR, I would think a new grad would need more M/S experience for the ED. How can anyone function comfortably in that fast-paced, critical-care environment, without some basic nursing assessment skills under their belt? I think that may be one of the reasons ED nurses burn out so fast. As far as the OR goes, it is completely different then any other type of nursing. There is so much to learn, and even seasoned nurses learn something new everyday! Most larger facilities offer extensive orientation to the new OR nurse, new grad or not. The facility I worked for provided a 6 month "consortium", as orientation into the OR. This consortium included several hospitals in the area, and provided alot of clinical experience with scrubbing and circulating. I would highly recommend this type of training to a new grad. As for including PACU training as part of the OR training, I agree with you, that I thought they were 2 different specialties. Maybe this particular facility feels having their OR staff cross-trained may help ease their stafiing problems. I would find out, up front, how often you would be expected to "float". If you're not comfortable with their response, make sure you let them know.

A big part of the problem is there are others who will just "put up with it". Many nurses feel they can't do anything about this problem, because they have no support from administration. I say, document each and every occurence, and keep a copy. When you have a mountain of paperwork, take it through the proper channels, going all the way to the hospital CEO. When nothing happens, get a lawyer and sue for harrassment, not just the surgeon, but; the facility that allows this behavior to continue. Maybe if we hit them where it hurts, they'll finally begin to address this problem. I recently left an OR Charge Nurse position, where part of my job was to intervene with these kinds of problems. Within 3 months the behaviors of certain surgeons drastically reduced. I would personally address the offending behavior, with specific examples. Making sure I let them know that type of behavior would not only lead to further documentation to the Chief of Surgery, but; cause them to lose the experienced team they so rely on. I have received apologies from most, and even lunch provided once a month from one particular surgeon group. Overall, my team knew they didn't have to "put up with it". We also had a surgeon who was assigned as "OR Surgeon Liason", who we could go to if problems persisted. He worked, in tandem, with the Chief of Surgery to address unprofessional behaviors. The OR Team needs to be committed to not allowing themselves to be abused, and be willing to confront these situations when they arise.

Hi, I am a recently relocated OR RN, moving from the East Coast to Las Vegas. In regards to your resume, just be truthful with the type of experience you have. Most managers will be very flexible with "feeling you out" during your orientation, and adjusting accordingly. If you're comfortable doing certain tasks, speak up and say so. The hardest part is learning the location of supplies, and learning the new staff. Include in your cover letter the fact that you will be relocating, and the dates you expect to be available. Most larger hospitals offer relocation expenses, and some even have connections with real estate agents, and apartment managers to assist you with the move. Do include your current license information with your resume. I would suggest you immediately get the info for licensing in the state you will be relocating to. Some states require fingerprinting which could take up to 4 months to complete the process. I know in Nevada, they do issue a temporary license to cover until the fingerprint results are obtained. Hope this helps. Best of luck to you. Relocating to a new town can be very intimidating, but; it's also very exciting. Surginurse