A Nurse With Attitude

Where Dark Cynical Humor, Nursing Issues, and Politics Seem to Merge

An Moment in OR #3


Political Correctness and the hurdles we must endure will eventually destroy this country…

As an OR nurse, everyone is under tremendous pressure to work faster, have better times and quicker turnovers between cases. Anything to save time,  go faster and enhance efficiency and, in turn, save money.  Management realizes that operating room time costs,  in the neighborhood of $45 dollars a minute.  Anything we can do to speed things up is considered saving money.   Along with all of this rush-rush mentality, we are also in charge of all the medications.  Before each case, we have to check out all of the correct meds in the correct amount and in the correct concentration as fast as possible.  If we make a med error, we are not only screwed, but  suddenly unemployed.  We also have to have the correct instruments for the case.  Some instrumentation is very specific,  and the case cannot be done without them.  We also need to arrange the correct supplies to get the patient into the correct position for the needed procedure.  If anything is wrong or missing, it all lands on the neck of the circulating nurse.  Even if the doctor is not correct in the procedure, it’s the nurse at fault.  The circulating nurse is like the captain of the ship and responsible for everything that occurs in the room.  Within the turnover period, the circulating nurse must check all of the paperwork.  The nurse must confirm that the written paperwork, the legal consent, and the actual patient all say the same thing prior to ever bringing the patient back to the room. Once the patient is in the room, the circulating nurse is suddenly the OR police or, as the hospital calls it, “the patient advicate,”  and is responsible to make sure that the surgeon does only what is written on the consent and no more.

The turnover, or the cleaning and sterilizing process to remove the blood,  bone chips and dirt between patients, is always expected to be less than thirty minutes. Thirty minutes…  I mean,  think about it, do you think  the maid at  “Holiday Inn” take less than 30 minutes to clean the room before you check  in?  And when she does clean that room, is it really, really clean?  I mean, clean enough to do surgery and still not get a surgical site  infection, or catch some illness from the previous patient?  I don’t think so.  So, why is this a hard and fast expectation for us nurses in the operating room?  …Because it saves money.

Because we are required to be in a rush, everyone has their own special tricks  to save time and to enhance their own efficiency.   We try to get everything ready and set up prior to the patient ever entering the room.  This saves time, heck everything we do is engineered to save time. … and therefore money.  In all of this hurry and fury, I still have time to have fun.   In an atmosphere of political correctness and a continual bombardment of “tolerance,” if you’re not really alert, it’s easier than ever to stumble into a PC minefield.   Here’s  a story about a PC  mis-step that brought a smile to my hecktic and stressful day…


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