As the number of cases we handled and services we offered increased, so, too, did our stress levels. Feeling our staff was reaching a breaking point, I turned to yoga for help. I've found that a group yoga class is a great way to wash away the stress at the end of a busy surgical day and help us tune in, chill out and shape up - all at the same time - before we head home to our personal lives. Here's what's worked for us. We found a yoga instructor who'd come to our facility once a week from 4:30 p.m. to 5:30 p.m. for a reasonable price: $48 for each of 10 one-hour sessions. Her only request was that at least 10 of us participate. We use our conference room to practice the postures, breathing exercises and meditation. So far, it's been a great success. An added benefit of yoga is that it's brought us closer together, forging a new level of collegiality and support.

Flavel Rogers, RN, MSHA
Nurse Administrator
Glasgow Medical Center ASC
Newark, Del.
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The benefits of total-body prepping
Because we often perform liposuction at multiple sites during one procedure, we investigated then implemented a total-body skin prep. The total-body prep is done on a standing, awake patient. We're careful to prep so that the solution doesn't run onto already-prepped skin. When we lay the patient supine, we wrap her in two sterile half sheets (how low you wrap depends on how far down the body the procedure will go; we usually only wrap to the knees) and use sterile Coban to hold them on. So the whole body, except for the hands, lower arms and head, is sterile. We've found the advantages far outweigh the drawback of the patient's having to stand while you do the prep:

• Saves time. It only takes a minute more to do the total-body prep initially. We don't have to re-prep and re-drape in the middle of a procedure, which saves time because you don't have to do a new prep when changing the patient's position.
• Saves money. This technique eliminates the opening of new drapes, gowns and gloves; we still only use one prep kit, so our prepping solution costs haven't gone up.
• Reduces infection. There's no break in sterile technique because the procedure is never interrupted.

Patricia C. Trotta, RN
OR Manager
The Plastic Surgery Center of Maryland
Lutherville, Md.
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Prevent allergic reactions with tape-free kit
Quite a few of our outpatients are allergic to tape. As a result, we've incorporated a tape-free kit in our pre-op/PACU area that includes stretch bandages and gauze bandages and other tape alternatives for securing, for example, IVs and dressings without risking allergic reactions and skin tears from using tape. Some patients can also tolerate a film dressing, such as OpSite, which is also included in the kit.

Lucy Smith, RN, ACLS, NRP, TNCC
Staff Nurse
Madison St. Joseph Health Center
Madisonville, Texas
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