Feeling a bit bored during lunch break and needing some friendly banters.
Ask away anything regarding operation, recovery and that sorts of thing.
[AMA] I am a theatre (operating) nurse
LDolladollabill on 01/02/2022 - 12:10
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What are the best and worst things about your job?
Best would be seeing a patient who had undergone multiple or extra long surgeries and hearing they are discharged or gone to rehab to get better.
Had a patient who was in hospital for about 6 months. He was driving with his hand outta the window and rollovered. His arm was fully amputated in the accident, and there was a tree branch that went through his head luckily missing vital parts.We managed to reconnect his arm after 18h for his arm and head surgeries. He went in for another 5-6 different stages of surgeries and now the latest i heard he is doing well in rehab.
Worst part would be death on the table especially when thr patient is young.When anaesthetist call it and we literally cant do anything else. Had a case when we have to open up the chest, give the heart a manual madsage with our hand, we keep tranfusing blood and at the end of thr day we nearly exhausted the whole state blood bank.
It must be so gratifying to be involved with successful surgeries that literally put severely injured people back together again.
I faint at the sight of blood so thank you so much and your colleagues for all that you do!
We were away in China and had a called from our daughter, who had not long started her second year placement in a private ortho ward and just wanted to tell us what had happened on her shift.
A nurse came in and asked if it was okay to leave the ward as her patient was being transferred and expected to pass away within a few hours, family not being able to be there.
Daughter was asked to pack up his belongings and take them to him. The AIN was a bit useless and couldn't wait to leave the room, so our daughter stayed with him, held his hand and just talked to him. He wrote notes to her as he couldn't talk and thanked her for staying.
We were very proud of her, thinking not many 19 year olds would be able to do that.
She messaged a few days later 'mum, mum, mum, mum - my patient survived!'
I asked which one and it turned out this chap had survived and was okay. It made her so happy and so pleased with her choice of career.
Your happy outcomes must outweigh the bad.
Do you think that unvaccinated nurses/doctors should be allowed to work and not be stood down?
This my sole opinion and not the general nurses opinion so take it as a grain of salt.
Before we even start our nursing/ dr degree, we have to be vaccinated against 7-8 different diseases on top of your child/infant vaccination. Diphteria, p rtussing Measles, mumps, rubella, chicken pox, tetanus, hep c, hpv, influenza just to name a few. So for me what is another vaccine. Some of these vaccine we have to get booster for. Influenza and DTP.
As a healthcare professional, we are to practiced on the best evidence based practice. And research is out there on the benefits compared risk.
Now regarding the mandate and if nurses/dr getting stood down. It comes down to why are they refusing the vaccine? As i previously mentioned we have to be vaccinated to different diseases anyway why is this any different?
Then their arguement will be " Oh because this vaccine is untested, unsafe etc." Then this nurse or dr has not been practising the best evidence based practice. I do not disagree that there are some adverse reaction on minority of population, just like how your humble paracetamol have adverse reaction to minority (kidney issues). But it has shown that the vaccine reduce viral load, reducing symptoms,spreadability. Remember vaccines are not cure.TLDR: No, in my opinion because they are not practicing best evidenced based practice
Do you ever get patients thanking you? The few times I've had surgery I always try to thank all the staff prior to being knocked out. I also like to try and say something funny after they've started the sedation.
Like you mentioned. We have very minimal time to spend with our patient prior they being knocked out. We occasionally get thank you but most of them are nervous for their surgeries. We rarely get any gifts from patients as the ward staff spend more time with them.
Thank you for your gratuity :)
My other question is have you had much experience with whipple procedures? I guess ICU for a day or so after, long recovery and all that?
Pancreateduodenoctomy is the proper name ( if i spelled it right) i have experience 5/6 times. Not as often as i would. This usually done by upper gi surgeon specifically hepato billiary.
Long surgery, a whole day case. We take out the distal (end bit) of stomach, common bile duct, gallbladder, pancreas and beginning of the small intestines. We reconnect them by a technique called roux en y anastomosis.
Basically the reason to do this any of the aforementioned part has cancer and we have to remove all the same organs that share the same blood supply.
We prepare the patient for an extensive surgery, anaesthesia will be putting arterial line, multiple iv line, a possible CVC line, urinary catheter and anti embolism compression device.
Incision will be commonly just under your diaphram the shape of a rooftop.
We send all our patients post whipple to icu to make sure everything is ok especially monitoring leak from anastomosis. Usually patient go home after 4-5 days in the hospital
@Dolladollabill: Good to know how a lot of it works. Do you know how recovery goes after being released from hospital? Like I would think moving around such as going to the toilet, up/down stairs, getting in out of bed would be painful? Or perhaps near impossible?
The reason I ask is that I'm expected to undergo one this year. Unfortunately there's nodal involvement so a ampullectomy is likely ruled out.
@Clear: I am sorry to hear that you need a whipple, but i am sure you will be fine. Come and say hi after the surgery.
Unfortunately i dont deal with what happened after patient left the theatre department which i wish i can be involve a little bit more.
With most abdominal surgery we ask patient not to do any heavy lifting to prevent hernia, clear fluid only for couple of days post intestinal operation. You are to expectrd to have diarhea after meal specially as you no longer have gallbladder.
Go and talk to your doctor, its a major surgery. Ask all the questions you need to ask.
Good luck@Clear: High chance you will wake up with wound drains (prob 2). Anaesthetist will ensure your pain is under control, they may even perform a paravertebral block or high thoracic block. Surgeons will also infiltrate local anaesthesia just before they start closing. You will have a PCA pump (patient controlled analgesia) which delivers painkiller when you press a button. This plus on top of oral analgesia.
I believe in you.
You are to expectrd to have diarhea after meal specially as you no longer have gallbladder.
Is this something that'll last a lifetime after surgery or short term?
My surgeon has suggested that developing diabetes isn't expected as it's the head of the pancreas being removed and not the tail. Being under 30 and having all these massive life changes are scary.
@Clear: I have my gallbladder out so this come from my personal experience and in no comparison to a whipple.
Your body get used to the fact that you no longer have extra bile to store. So now my issue is if i have fatty food i get a bit of diarheaa. ( If im eating lots of deep fry food )@Dolladollabill: That's good to know. In a way it's a good thing that you can't have a lot of unhealthy food but in a bad way you miss out. Like being celiac I guess.
The best sleep I've ever had was under the GA during a surgeries. Whoever woke me up was the worst person, at least at that time ;) Any tips on how to prolong that sleep if I go under GA next time? Bribe the anaesthesiologist ?
The good sleep that you had usually because of Propofol. Unfortunately the job of the anaesthetist is to put you to sleep AND wake you up.
Becarefull, you dont want to do a Michael Jackson
I never thought of that, the fact that someone chose to wake me up after surgery. Nobody was in the room when I woke up so I just assumed you kind of sleep a bit after they turn off the anesthetic.
What i mean by waking up is the ability of you to breathe on your own after your airway device has been removed (lma or an ett).
So you might wake up on your own or have someone nudge you every now to rouse your breathing.
I second this, best sleep of my life
How much do you get paid, #usernamechecksout
I get paid a base rate of $45. This is of level 1.8 of public sector meaning all nurses in public get paid this rate after working 8 years on the job. Then there are penalty rates 15% afternoon shift. 35% night shift Saturday 50% Sunday 75%. ( You can actually google nurses award agreement). I also get small amount of compensation when I wear lead jacket (this thing is heavy yo).
I do 80h/ fornight. I do oncall roster one day a fornight.
Then you can go up into clinical position-management-director you name it which obv pay more.I like to be floor getting my hands dirty (no pun intended)
Nurses should get paid more for how much of an amazing job you do. I think it's undervalued because it's traditionally seen as a "women's" job. The last few times I've visited a hospital the nurses have been nothing short of amazing! Thanks for doing what you do!
Thanks, i dont mind extra dollar to spend on ozbargain :D
Never heard of this compensation of lead jacket… also I have never been paid it… (not a nurse though).
$2.14 an hour. I rather not wear it if i dont have to
Should have been a teacher and got paid a lot more.
At least you are unionised AND organised.
Eg jmo doctors are too stupid to formally wear uniforms to get free clothes and laundering etc.You have to work hard and it's tiring, but it's still great pay. With these rates and penalties post 8 yrs you're making 100k-115k a year, which is more than 80% of the population earn. Not sure what teachers get paid, but I don't think it would be more then that.
@mdavant: I have never heard of any teacher working a 25 hour week. Maybe a casual teacher. The amount of hours you have to put in outside of class teaching is a fair amount
@boostpak: Many teachers in my family.
The award states 25 hours.
Many other professionals do unpaid overtime too.
No weekends ever. No late nights. No early starts. Govt protections.
25 hours a week, 40 weeks a year of bliss
@mdavant: I can almost be certain no teacher govt or not does 25 hours a week as a full-time worker and makes over 100k.
@boostpak: Well then you are ignorant of their award
Look up the qld teachers award. Page 37
I can guarantee you hundreds of teachers in qld work full time, 25 hours per week, with 10+ weeks holidays per year and make over $100k per year.
And fwiw, casual teachers in qld earn $83 per hour.
Dyor
@mdavant: Regardless of their award, there are no teachers doing 25 hours a week of teacher related work and earning over 100k. Teachers take their work home with them and do lots of office hours outside of classrooms, along with meetings etc. You're an ignorant …. if you think otherwise
@boostpak: I am from a family of teachers
I know very well what they earn.
I know that they do some extra work, and I clearly posted that earlier, and that almost all professionals do extra work.
I know that the qld award is 25 hours per week
I know teachers have to front up approx 40 weeks a year
And I know a casual qld teacher earns $ 83 per hour.The problem is you have made a poor point and will try to defend it though I provided you with the exact details which prove beyond doubt that a teacher does 25 hours paid work per week.
Meetings are included in the 25 hours. As per the award. ( Have you heard of the teachers union?)
Stop making things up. It makes it look like you didn't dyor, which I know you didn't otherwise you would be posting from an informed position.
@mdavant: https://www.theage.com.au/national/victoria/australian-teach…
your argument is failing by the second
@boostpak: Just pointing out facts.
The fact that some people fail to grasp the published, factual, accurate award is beyond me.
I just can't fathom how people can't read an extremely simple document.
Probably that 1000 hours a year teacher was too exhausted to teach reading over 13 years of education
@mdavant: "wittyusername on 08/02/2022 - 16:18new
+6
There is no job as tiring or challenging as secondary teaching, in my experience. I've worked retail, construction, mining and landscaping - these are all a breeze compared to a low socioeconomic public high school."@boostpak: Lmao
Though I am not a teacher (and believe it or not I respect teachers greatly)
When a casual us paid around $90 per hour, you gotta expect that the job isn't perfect.
$100k plus super for a teacher with experience at over $100 per hour is heaven. I wish I had the courage to retrain.
@mdavant: What are their annual leave and sick leave entitlements? What about their job security? They could be dropped tomorrow with no pay.
@boostpak: I know right, like any other casual doesn't deal with those risks /s
The point of pointing out the casual rate of a teacher was the obscene pay rate for a very easy bachelor qualification ( yes, the UAI and course are very easy)
How about you address the $100 per hour plus for a full time, contracted, almost impossible to be "dropped" permanent teacher.
Can you compare that to other bachelor qualified jobs?
If you ramp it up to normal working hours the pay rates for teachers are excellent.
@mdavant: If it were that true, then everyone would be running out there to become a casual/contracted teacher. I smell a rat.
@boostpak: If what is true?
The pay rate?
It is all included in the award, a legal document in the public domain.
The only reason teachers don't earn as much as some professionals is that they are limited to 25 hours per week.
If other people actually knew the hourly rate, they would be shocked.
Just like the ignorant denial shown amongst some posters, they just don't believe it, but it is a clear, undebatable fact.
Pics or it didn't happen… Can we see any light at the end of this COVID Tunnel……
Personal thought. 2 years. Possibly with annual vaccine that corresponds with multiple strain. Just like how every influenza vaccine every year has different 4 strains depending on which strain is rampant.
What do you think of my personal favourite Covid conspiracy theory? Covid was kicked off by an over-worked public system Nurse to get governments to take notice and start properly funding the health system again ;)
As much i believe in unicorn
The Spanish Flue lasted only 2 years, with todays technology you would have thought it would have been nipped in the butt earlier……I believe this was introduced for a purpose, I don't think this was part of nature…It's too smart…Some evil at hand but too much politics to find out what really happend….The day we found out the Chinese had it we should have al closed our borders to contain it there….
Much respect to you OP and others in your field.
My wife is an ICU nurse and I've been doing my best to support her since the pandemic.
I hope you are able to take some leave soon. Keep fighting the good fight. <3
Feet and shoulder massages go along way. And you might be rewarded ;)
What course did you do, how’d you get in and what year 12 subjects?
If you don’t respond that’s what ok.I was actually a mature aged student. I had my first degree which was irrelevant and I had no science background for year 12 (it wouldnt matter tbh coz it was 8 years out of school)
So i looked up which Uni has the best reputation of nurse graduates which is Notredame in WA. I had a simple interview and i got in.
I will be honrst with you my first year of Bachelor of nursing was a struggle because i had 0 human anatomy background while these younglings are fresh out of school.Once I finished I applied into the Public sector Graduate program and I got into one of the tertiary centre. I was offered a spot into theatre and the rest is history.
Theatre placement is probably the most niche specialty in nursing as it is a whole new world. The degree you did train you to be a ward nurse not theatre which is highly specialised. It takes 2 years just to complete different specialty rotation.At the moment we are short of theatre nurses both in public and private, we have been training up people with little or no experience. It is a niche and if you are interested there are opportunities.
Best of luck in your career and please know that everyone supports the medical fraternity. My wife is the Nurse Unit Manager of a very busy and dedicated Covid-19 ward in south western Sydney and has been for 2 years (pre-Covid she was the respiratory care NUM). The last 2 years have been absolute hell for her. Please keep fighting the good fight, but make sure you take some leave when you get the chance OK!
Kudos to her. Make sure to take a break with her. Small things make nurses happy. Colorfuly scrubs, silly socks, fugly crocs
One of my close friends is a nurse and he graduated just before Covid hit, however he got relatively lucky with his experience as he managed to work through various wards that weren't overly impacted.
Unfortunately, he's already hating his job because of the constant bullying from the other nurses, doctors etc. He says it's all very cliquey, especially the nurses, and he's tried on numerous occasions to be friendly, but the other nurses still target him, complain to NUM or in charge if he's missed something instead of them just bringing it up with him then and there.
OP, does this abuse and bullying align with your experiences? Why don't nurses support each other?
The stories he's told me make the hospital working environment sound absolutely awful.
Some ward or specialties are definitely more toxic than others. My wife is a nurse as well and her workplace is toxic.
I have experienced it when I started as well. Even surgeons were reluctant to work with junior theatre nurse. Best to find a good senior mentor and improve yourself. At the end of the day we are patient's advocate and its our main priority.
If he is unable to cope i suggest moving to diff ward. Beautiful thing about nursinf is there are limitless option. There is even an independent nurse who drive around in community. Option are limitless for nusing and he hasnt find the right one yet
Thanks for sharing. My daughter is in her last year at Notradame in Sydney. I’ll share her this article. It’s a very noble profession and I’ve yet to encounter a nasty nurse, having had heaps of operations in the past.
All the best for her. Its difficult but rewarding
My wife has just started her EN course, so have shared this AMA with her.
What are your thoughts on a good stethoscope for student nurses that will last a while? Currently looking at either the Littmann Classic III or maybe spend a few more $ for the Cardiology IV if one pops up on OzBargain :)
I am the wrong person to ask abt stethoscope. I bought mine of ebay for my uni degree and now its collecting dust. I just use thr hospital one lying around if i need one.
stick with classic or even a spirit/rappaport - they do the job, chances are you'll lose it at some point. on one of those all hands on deck ward nursing shifts last thing you want to do is to have to worry about where your expensive steth is. for most doctors it's a rare day that you would need a cardio over a classic, and that's probably limited to your cardiology rotations, in a BPT exam or to impress your bosses that you picked up a grade I murmur that's academic at best
A classic is fine.
My backup is a classic and main is a cardiology 3, though the cardiology is better I agree that losing it hurts more.
how long do you actually take to scrub in, and is there any surgeons you secretly can't stand and made their life difficulty on purpose?
We perform a 5 minutes hand wash as our first wash of the day using antiseptic solution either Betadine or Chlorhexedine. This consist of
1 minute wash up to above your elbow
Cleaning your nails with a nail pick
2 minute wash with sponge/brusb up to your elbow
2 minutes wash up to your forearm
The whole proces takes about 8 minutesAny subesequent wash is 3 minutes wash.
Or you can use alcohol based rub (skinman 180 or 90) . As thr name says Either 3 minutes or 1.5minutes.I would never make their life difficult during operation. Its unethical. Our first priority is patient safety, and we achieve that by assisting the surgeons as best as we could.
Outside the theatre i have had many banters. We are not their slaves, its a stressfull environment but we are working as a team. Not one member is less important
Have you ever had to deal with a severed penis ????
Not yet. We have perform Penectomy (cutting the penis) commonly for penile cancer.
We received quiet a few indigenous pt who has gone under male contraception (whistlecock) which mean they make an incision under the penis so when they ejaculate it goes down. And sometimes it goes wrong and they came with massive bleeding.
Another common case would be Priapism. It means you are getting a boner that cant go down(usually caused by recreation drugs). That thing would actually go purple almost black. To fix it you shove long ass needle or use a blade on the side of your penis to drain the old blood out. I crossed my leg everytime i see it.
Ever see anyone other than the patient pass out during surgery? (Surgeon, nurses due to fatigue or something else). What are the contingencies for this?
Students faint quiet often. We just ask them to sit down and give them something to drink. Now in terms of fatigue during surgery for long cases
- Anaesthetist they get relieved by fellow anaesthetist
- Surgeon will tend to stay for the whole time. When we know its going to be an extensive case. They prob will take 15m-30 break when it is not a crucial step. So what we do is we would cover the patient with sterile plastic so they dont lose body heat.
The longest case i have been involved in is a 20h case. A young apprentice accidentally chop all 8 fingers off with a band saw. 3 consultants were taking turn.
- For the nurses. 2 roles exist in theatre Instrument nurse and circulating nurse. Instrument who is scrubbed and sterile, while circulating who do the runaround settinf things up. Both of these nurses are responsible for the surgical count.
We try to stay for the whole case if possible, because if another nurse to relieve us we have to do a changeover count, which can disturb the operation.
For extralong cases, the instrument nurse would be relieve by the circulatinf nurse.
If the case goes over our shift, it depends. Lets say 1730. If the case is near completion we tend to stay til the end and claim overtime. Because performing a changeover causes delay and errors to occur. It all depends if its appropriate to do changeover or not during crucial moment of the surgery.
On the aforementioned 20h surgeries, there were 4 changeover counts occured.
I hope this make sense
Why did you decide to be an operating nurse? Is it more stressful than being a ward nurse? How would you compare the experience compared to a ward nurse? Do nurses generally want to be in the theatre or in wards (is it seen as more prestige to work in surgery)?
It is no more prestige than any other area. All nurses are as important in their specialties. However there are some areas that are definitely more challenging in their own right. Different areas require different set of skills. Even in theatre nursing itself there are different specialties that require different skills.
Let me put this into perspective: someone who likes constant, controlled environment will probably like elective ortho. Vascular requires lots of hand dexterity dealing with wires and catheters. Ophthalmology will deal with fine instruments.
I Did not choose to be a theatre nurse, I was allocated to during my graduate program and I chose to stay.
I have only been a theatre nurse, recovery and ICU. All of these require diff set of skills, recovery and ICU have a lot of independent in looking after patient care and noticing deterioration of patient quickly.
Not many nurses enjoy theatre as well, its a small team environment, working close with consultants, it can be highly stressfull, and we have minimal patient interaction.
Does this answer your question?
Have you ever participated in a surgery which didn't go as planned, (like found some other issues after opened up the patient), or worse resulted in loss of life?
Yes. Sometimes scan does not show thr full picture.
We call it open and close. Meaning after the surgeon open the belly it looks worse than what the scan shows. Surgeon will get second opinion and decide not to go any further causing possible bleeding and further complication.Table death also occur rarely due to complication and yes i have experienced it. All surgical death on table or 24hours post surgery are coroners case.
If you are interested you can read coroner's inquest that get published yearly. It is interesting and its available publicly. Its called From Death We Learn
https://ww2.health.wa.gov.au/Reports-and-publications/From-D…
How good are you at sudoku?
Oh sorry. Wrong thread , I was thinking about night shift nurses.
(Tongue in cheek)
Anaesthetist are amazing at sudoku and crosswords.
And just sit and listen to the beep ;)
Do you get a better tax rate or higher superannuation?
No
I have a friend who is a theatre nurse who said overall they get a better yearly outcome with regards to both (this is vic)
Most nurses working in hospital can getsalary sacrifice which technically reduce your tax i guess but its not massive tax cut compared to military
Why is it required for day-surgery patients to be only in a hospital gown (even without undies)?
I had a friend go in for a day surgery on an issue in the knee - went in with the hospital gown and undies but came out only in the gown.
Also, when you pull down the undies of the patients do you giggle on how clean/dirty down there is?- Easy access for emergency. All surgical gown design that it can be easily taken off. We might have to put defib plate, access to urinary catheter, femoral puncture.
- We do not want to soil your personal clothing. It can be with blood, wash, or antiseptic prep solution. Lets say your friend who had a knee surgery, we will always clean more than we need to. We would be painting his leg from his thigh all thr way to his ankle. We will keep your undie in a plastic bag and return it.
If the surgery requires GA i take them off when they are asleep. If its only sedation, i ask them to take it off themselves and i just look busy :)
We dont really pay attention on how clean ur undies, we use plastic bag to grab it and roll it inside asap
From all the babbling patients do while coming out of anaesthesia, what are the top 3 things weird/funny things you of heard?
- Patients getting flirty with me.
- Patient weed on me
- Patient eho got annoyed because i woke them up from their beautiful sleep and dream. And starts talking nonstop about his dream
Is it true that theatre nurses have nothing in between the ears?
Im training a whole bunch of nurses and the theatre nurses loves repeating the fact above about themselves. 😂
Ehhhh????
What are the different coloured scrubs in QEII? I see all green, all blue but never actually asked the question to a doctor before
Usually Dr wear green as a "uniform".
In Procedural area (theatre, cath lab, endoscopy) staffs wear blue. Thats is as far as i know from 4 diff hospitals that i have been.
I'm getting surgery soon, Is there anything I should do to prepare myself physically and mentally? What are some common side effects of anesthesia you have seen in patients?
Sorry to butt in - not OP - but when our daughter had her scoliosis surgery I had heard that the GA can reduce muscle strength, so we took her to the gym to work on her core strength beforehand…especially with how her muscles on one side of the spine were going to be stretched. I was surprised when the instructor doing her plan also included arm strengthening, but he pointed out that she'd be using a rollator afterwards to walk, so arm strength was also important.
The physios at the hospital were very happy with her and said it was good for her recovery that we'd done that.
Mentally just relax. It is ok to be nervous, talk to support person. Dont let anxiety eat you. Have some good sleep.
Physically eat nutritious and light the night before fasting. Exercise, stop smoking if you do. Dont take supplements unless you have checked with the Doctor,, especially fish oil is No No. Vitamin C is good to take.
The most common side effect will obviously be Pain and PONV ( post operative nausea and vomiting), common side effect will also be sore throat from the airway device.
There will be anti emetic, analgesic charted for you. And you will not leave recovery until everything has settled.All the best :)
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Academic? Retail? Medical company rep?
I need to know also hahaha