OR Team

Brain Dump

/ Marjorie / Leave a comment

I woke up this morning with what I call “The Overwhelm;” the feeling of being trapped under the snow after an avalanche. I can’t dig myself out. I’m struggling to breathe. I can’t seem to find a way out. Outside the sun is shining and the birds are singing, a sign that Spring is around the corner. Yet, I am on the Struggle Bus.

I know this is temporary. The beacon inside me says, “Keeping digging.”

There is no rescue team. I must rescue myself…

Digging

Last October, I was optimistic about my new job. At this point, I am questioning my decision about staying in OR nursing and working for a large institution. Whatever I thought I learned during my two and half month sabbatical between jobs, I have quickly forgot. The Overwhelm has a way of taking over sometimes and I never know when it will hit.

The new gig has been challenging and frustrating, so much that I actually considered calling my old manager to see if I could do an agency stint down there. I left my last job because I no longer wanted to live in that city. I left because I didn’t want to see the parade of gun violence victims brought into our OR. Do I really want to go back to that even on a part time basis? I don’t know…

“Don’t it always seem to go, you don’t know what you’ve got ’til it’s gone.” ~ Joni Mitchell

I miss the relationships I had with people – my fellow staff members, physicians, ancillary staff, the trust that was built through difficult times. I miss having a supervisor who rolled up her sleeves and helped the people she led. I miss having a supervisor that encouraged my creativity and appreciated my contributions to the department. I miss having charge nurses that were on the same mission as the staff – not to just keep the schedule moving, but to put the right staff in the right rooms. I miss the resources we had that helped us focus on patient care: the equipment guys, the sterile processing runners, the supply chain techs that would fill our supply lockers in the rooms. I miss the layout of my last OR which was open and helped facilitate a relationship with the Command Center. After all, the people in charge should know the staff and their skills.

Reality

Yes, I’m mourning the Past and I am trying to accept my Present. BUT WHAT ABOUT MY FUTURE? I don’t believe that I need to accept my current situation as my future. I am actively searching and meditating on what is next for me. I don’t think it involves OR nursing. I don’t think it even involves nursing. After all the hard work I put into getting my nursing degree, the blood, sweat, and tears I poured into every OR nursing job I have ever had, I am ready to give this all up for a little less sorrow and a little more joy.

The Year 2023 has already been a hard one and it’s only the beginning of March. The Universe slapped me in the face with the deaths of three strong women – my aunt, my friend, and my partner’s mom. A question emerged from the heartbreak, “What do you want for YOUR LIFE?”

Search

I am looking for the courage to face what is and what could be. I know there is no easy way out. But what is harder is staying in a joyless situation. I have more questions than answers.

Has healthcare changed so much that I won’t be able to find happiness in my work? Or is it me? Have I been changed by what I have witnessed over 17 years of OR nursing that the passion and fire I once had is beyond revival? Is it selfish for me to want to take care of myself and relinquish the honor of taking care of patients? Do I still love nursing enough to find another role outside of a OR staff job? What has enabled long-time nurses to stay in this line of work for as long as they have? Do I really need to leave the OR, nursing in general, or do I just need a therapist?

Beyond

Sometimes work takes over my life. I have to remind myself about the things that bring me joy on the outside: my partner, my dog, my family and friends.

Why do I always forget about this? Why is my identity so tied to my work?

I am exploring a new venture: starting my own business. This is separate from me being an investor in my significant other’s business. This will actually be MINE. Well, technically “OURS” – my business partner (another nurse friend), and me. I am starting work on the business plan today. It’s going to be a secret for a while until we are, God-willing, ready and able to launch.

I need to stay in this job for now. I need to find a way to fend off The Overwhelm. I want more joy in my life. And I know that I need my family and friends more than ever.

The good news is they have always been there. I just have to ask for help.

Help!

Return To ME

/ Marjorie / Leave a comment

For eight months, I have been silent. It’s not that I don’t want to write… When I am just about to pull out my laptop, something gets in my way. It’s my To Do List, the telephone, the need to tidy my surroundings before I do something that requires sitting. More accurately, I get in my way. The excuses are really my tendency to procrastinate. I know that this will be good for me – to write and get everything off my chest.

I am so much better than before. Truly. Seriously. I promise I am.

What has helped me over the last several months, is that I finally put myself first. I leveled up my meditating game and have been making breakthroughs thanks to Dan Harris and crew at Ten Percent Happier. I have been doing MORE – more yoga, more listening to music, more cooking, more sitting down and doing NOTHING. It was a struggle not to feel like I should be doing more and being more “productive.” Thankfully, I came to the realization that, even if I was doing “nothing,” that that was actually SOMETHING for me and my mental health.

Meanwhile, things at work are interesting. COVID brought on different challenges, but then we all got used to the way we had to live our lives (N95 masks, all the PPE, negative pressure rooms, etc.). In the last six months, came another change – the loss of staff to lucrative agency contracts. My former co-workers have not been traveling out of state, just staying local. In fact, it feels like all the big hospitals in the city have just exchanged staff. We have been lucky to get some talented nurses who are very nice and fun to work with. Agency work isn’t for everyone, so we have added new staff as well. As a result, I have been teaching – A LOT. I actually enjoy it, but it doesn’t hurt that we get extra pay for precepting.

Watching my friends leave to pursue agency contracts has been hard. I completely understand why they are doing it, but still… It feels a little like breaking up.

Inevitably, I think that I will be going the agency route too. My boyfriend and I have been talking about moving to another state, so for now, I am putting agency opportunities on hold. Thoughts about leaving my current job make me sad, but things have changed so much that one way or another, it will never been what it once was.

Yes, change is inevitable. I have to accept this and be willing to let go of my comfort zone. The way I choose to look at the state of nursing and the uptick in agency staff is that I am increasing my network of nurse friends. Operating Room Nursing is such a small world. There aren’t many of us out there, so it stands to reason that I will eventually work with my friends again! And I’m good with that.

With all the changes in my personal life, professional life, and the world in general, it feels like I found my center and ready to ride whatever wave comes next.

A Not-So-Routine Routine

/ Marjorie / Leave a comment

During the Monday through Friday work week, I work four ten-hour shifts.  On those work days, my alarm goes off at 5:00 AM.  And the routine starts…

5:00 AM – Jump out of bed and get ready for work.  Brush my teeth, blah, blah, blah.

5:30 AM – Feed the Doggie and take her out.

6:00 AM – Drive like a bat out of hell to the hospital.  [CUE:  Upbeat dance music.]

6:25 AM – Arrive at work, throw lunch box in one of the overstuffed refrigerators, get scrubs from the scrub machine, change into scrubs and OR-use-only Sanita clogs, put my hair up and put on one of my cute scrub caps.

6:40 AM – Grab a quick coffee in the lounge with my co-workers.

6:53 AM – Clock in and head down to the OR.

7:00 AM – Check for my assignment at the Command Center/Charge Desk.

And this is where the routine ends.

Operating Room Nurses are typically assigned to one room where there are several cases scheduled.  These are usually procedures that fall under their primary specialty (e.g., Orthopedics, General Surgery, Urology, etc.).  However, most operating room nurses are cross-trained in the other specialties, therefore, the assignment may not be in the primary specialty.  Or maybe it’s a room with a variety of procedures that fall under a variety of specialties.

Not only does the assignment vary in specialty, but it varies in role.  There are two staff members needed to set up for a procedure:  A Circulating Nurse and a Scrub Nurse/Surgical Technician (a.k.a. “Scrub Tech).  Operating Room Nurses can either be a Circulator or a Scrub.  A Surgical Technician can only perform in the scrub role due to their training and licensure.

Scrub Nurses/Scrub Techs are responsible for preparing the sterile field.  She or He performs a surgical scrub on both hands and arms at a scrub sink (just like on TV), then puts on a gown and gloves with proper aseptic technique.  The sterile field consists of a sterile drape covering a large table with a setup of items that are needed to perform the procedure (supplies and instrument). The Scrub sets it up so that instruments and supplies can be passed to the surgeons when they need it.  Knowing how to set up for a variety of procedures is a skill learned on the job – starting with an intense orientation.

In the role of Circulator, the nurse performs a patient assessment in the pre-op holding area.  It involves a checklist of questions that have also been asked by other providers.  It is our version of Checks and Balances.  Patients get an overview of what they can expect when they are brought to the OR.  Family and friends of the patient can also ask questions.  I call this, for my readers of a certain age, my “Julie McCoy, your Cruise Director” moment. In the OR, the Circulating Nurse’s work continues with helping the Scrub, sometimes the Anesthesiologist/CRNA, and works around the sterile field (circulator = circulate = circle = around) supporting the surgical team throughout the case.   Eyes and ears are always alert.  Circulating means helping coordinate and facilitate case progress, documentation, and whatever else is needed to provide safe patient care.

Anyway, back to getting my assignment…

Wait, what am I doing?

Every day, my assignment is a surprise to me. The Charge Nurse/Manager/Team Leaders put together the initial draft of the assignment sheet the day before, but it always seems to change the morning of, based on call-offs and schedule changes.  I have learned my lesson to avoid checking the day before because I don’t want to get myself unnecessarily upset or excited about the next day.  Pointless, really.

On the days I am in my specialty, I am in my comfort zone:  Orthopedic Surgery.    In the Main OR of my hospital, the procedures we perform the most are total hip or knee replacements, repairing broken bones, fixing someone’s spine, and even taking out cancerous bone and tissue.  I work with the surgeons and residents that I know well and my partner is usually someone from my specialty team (nurse or scrub tech).  When you have the “regular team” together, there is a flow that is like….a symphony.  I love that feeling.

Outside of my specialty, I am fine, but I am on extra alert for any nuances that are unfamiliar.  While this sounds scary to some people, the beautiful thing about working in surgery is the amazing teamwork we have with our staff.  My co-workers are excellent resources when I am in a bind or when I just want just-in-case information.  It is reassuring to know that someone has my back!

Today is my day off which means I return to work tomorrow.  What will I be doing?

I have absolutely no idea.

All I know is that there definitely will be coffee in the morning.