Behind Closed Doors


Now and Then, and Then Again...

Progress is a wonderful thing, but sometimes so is "if it ain't broke, don't fix it." In OR nursing, there have been some advances that make it hard to believe we did it the old way and others on which the jury's still out. Here's a history lesson for the youngsters and a walk down memory lane for us old birds.

Back then, we wore white nursing shoes or those green tennis shoes that looked like the old Keds.

These days, we wear whatever's comfortable that we can get away with under the dress code. A good idea, since those white shoes were murder on your feet and back.

Back then, student nurses had at least six to eight weeks of surgery rotation, while new grads starting work got six months' scrub experience and six months of learning to circulate. These days, student nurses observe a couple of days in the OR. New grads, if they choose to work in the viper pit, get three or maybe six months of orientation - if you can keep them that long after they've heard the older nurses talking about them behind their backs.

Back then, surgeons weren't always on time for procedures, so you'd call the medical exchange to send a loud, static-filled verbal message to their pager (which they didn't always answer). These days, they still aren't always on time, but they do have numeric pagers and mobile phones that do everything but cattle-prod them in the posterior to get them to the OR.

Back then, our surgeons thought they knew everything, and for all we knew, they did. These days, they still think they know everything, but - thanks to our required CEUs - we know they don't.

These days, we have educated, experienced, competent anesthesia providers, both MDs and CRNAs, both male and female. Back then, they were all MDs and all male, and the equipment was par for that time. It was nothing for an anesthesiologist to ask the circulator to squeeze the ventilation bag while he went to the doctors' lounge for a smoke.

These days, it seems like we're equipped with disposable everything. I'm particularly thankful for the single-use staplers for bowel surgery, the TA 30, 60 and 90 and the GIA. They've removed a great weight from my shoulders and an uneasy feeling from my gut. Back then, when instruments were metal and reusable, we'd reassemble them after cleaning and pray with the breath of our souls they wouldn't fall apart in the surgeon's hands and would function when the time came.

These days, all contaminated articles are handled with gloves (sometimes two pair) and grouped in fives and tens to make counting easier and more precise. Back then, bloody sponges were handled with bare hands and laid out on a green cloth wrapper to count. I trust we didn't skimp on the hand hygiene measures.

Back then, nurses certainly didn't use four-letter words. These days, a colorful vocabulary isn't just for surgeons.

Overall, it's a give-and-take. Whether it's now or then, though, I'm just glad to still be doing what I like best, and what gives me the opportunity for a laugh on the job.

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