Q: Drying Cannulated Instruments

I am looking for a company that sells air hoses to dry out cannulated instruments. Do any of you do this and if so can you tell me where you might have purchased one? I have searched on the web for days and have come up empty.

A: You can get a cylinder of air from your gas company and they can get you a hose and nozzle to attach to it. All you have to do is squirt the air down through the cannulation.

A: We use O2 tubing.

A: Call Healthmark at 800-521-6224.

Q: Smartphones

Should smartphones be eliminated from the OR?

A: We don’t allow any personal phones in the ORs. Our hospital policy states that no personal phones or personal wireless devices are permitted in any patient care areas – that goes for physicians as well. I wrote a memo to the physicians and staff from the Chief of Surgery and me citing that policy. I posted it in the staff and physician lounges and asked the clinical managers to review the memo with their staff and have the staff initial that the policy was reviewed with them and that they understand the expectations. After that the disciplinary process starts for people who ignore the policy. After the first offenders were counseled by their managers, the behavior changed. People respect what you check.

A: There should be a no cellphone policy, however, that would be hard to enforce because there are so many surgeons who go to many facilities and each may have a different policy. As we all know, they can be very disrupting when doing procedures. Many of our surgeons leave them in the surgery office and then get their messages at the end of the case. •

Q: Communication

Why is it so hard to communicate with one another? When the OR is crazy busy, everyone is getting along, and remembering stressful yet exciting times. When the OR is slow, people are quick to start gossiping. Any suggestions on stopping the gossip mill?

A: Perhaps you could try creating “no vent zones” and one “vent zone.” At one facility I put up “No Vent Zone” signs in the lounges and ORs and control desk, etc … and I turned a small supply closet into a “Vent Zone” with Zen-like features, including a plant, a lamp, a couple of chairs, etc. I introduced the program as a way to reduce the distractions around patient care. It was fairly effective.

Of course, keeping folks very busy helps them to focus on work and not gossip.

I remember one of my leaders very early in my career who used to round to all areas on slow days and if she found people hanging out she would send them home. If she found people stocking, cleaning, working on projects they got to stay. She never said much just rounded and sent folks home who were just hanging out. We got the message very quickly and people tended to keep themselves busy.

I’ve never forgotten that.

A: Put them to work cleaning, send them to another department to work, or send them home. Always works for me!

A: I try to keep them busy even if we are slow. I find that keeps it to a minimum. There are always plenty of policies to review, competencies and education boards. Keep them busy.

A: I recently became a trainer for lateral violence. In that program, we discussed the importance of having a response in your mind prior to an event, such as backstabbing or gossiping. For example, a nurse approaches a colleague and says, “Did you hear the news? Mary’s husband has been cheating on her, and they’re getting a divorce.” The colleague responds, “Sue, I don’t think we should be discussing Mary’s personal life at work. We have a procedure to prepare for — let’s focus on that task.”

Having a “ready response” for various common situations staff encounter in the workplace prevents that familiar feeling we have an hour later, thinking, “Gee, I should have said this or that.” It takes practice to have some “canned” responses ready for action. Ready responses can cut back on gossiping by stopping the promoter of the gossip dead in their tracks and allow for a re-focus on work-related tasks.

It’s not a cure-all, but food for thought.

A: That is a great response! I think all units experience the same issues when the schedule is low. Sad thing is we worry about how the physicians act and don’t recognize how we impact one another.

A: If you come up with something, pass it on. This seems to be a universal problem. You certainly can’t stop staff from communicating with each other, however, maybe giving them tasks to complete will help. There’s always something that needs to be done in the OR.

A: The staff needs projects to do, otherwise idle minds have time for belittlement and gossip. Of course you can’t stop people from talking

A: One of my nurse educator colleagues decided to adopt a program using a code word if someone was either unprofessional or using gossip. She was from the south, so her unit used the word “moonpie” to help her staff identify when a line had been crossed. It became a humorous way to redirect her staff. The signal word worked well in her unit.

A: Great idea! Thanks for sharing.

Q: Is OB ACLS Recommended?

A: Yes, in our institution.

A: All my PACU nurses are ACLS certified for all patients.

A: Yes, at Onslow Memorial Hospital it is required.

A: We do the C-sections in the OR. I require all the OR, PACU and ASU staff to be ACLS and PALS. You never know when you might need it. You also have a child with the section. We also are NRP.

A: All my OR and PACU nurses are ACLS certified.

A: We don’t do OB, but every RN in the surgery/PACU is required to be ACLS and PALS certified.

A: In my experiences, ACLS for all peri-op and maternal health RNs is required.

A: Our hospital does not require that PACU or L&D nurses be ACLS certified. However, it would be up to each facility to determine this and include it in their policy.

A: For clarification, the question is referring to “ACLS-OB.” It is a slightly different approach to the traditional ACLS, including an additional 6 hours of OB focus. I’m not personally familiar with the program or how popular it’s becoming (or not), but an online search will yield additional information. I found one website with references to St. Luke’s Hospital in Boise, Idaho, as being the founder of the program and also found other sites with conflicting information as to whether or not the program is endorsed by the AHA.

Endoscopy Procedures and Clothes

It is understandable that some patients are uncomfortable without their clothes on. It is also extremely difficult to do a colonoscopy on a patient that has shorts on, not to mention a cystoscopy. Is it acceptable to have patients keep their clothes on for endoscopy procedures? Of course not their pants, shorts, or underwear for colonoscopies. If a patient is not doing well, clothes can hinder rapid assessment of certain things. For example, it is challenging to locate a dislodged EKG wire under someone’s clothes? While trying to be patient friendly, are we doing more harm than good?

A: You also need to think about infection control with them wearing their own clothing into the suite.

A: We have our patients remove their clothing for endoscopies. It is more sanitary as well as safer.

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