Thursday, March 5, 2015

Requirements of an Operating Room Nurse - Circa 1968

This old mimeograph did not survive as well as the cap folding mimeo, it's faded in places, but still amusing interesting. I came into possession of little gems like this during morning report. We all gathered at 6:55AM each morning in an unused "observation room" in the operating room. The room did not have enough elevation and all that was visible from this vantage point was the backs of  the surgeons. Very poor planning, but the nurses had their very own "report room."

If there were student nurses rotating through the OR we received their hand outs too. I don't have a clue as to where documents, if you could call it that, were produced. It was unlike an email where there was an indication of where the directive originated. We always folded them up, stuffed them in our pockets to throw out when we got home. It's a miracle this product of a cranky old member of nursing abomination administration survived. I must have felt it had some special merit.

Maybe I was thinking that I could use that "Requirements for a nurse" paper as a defense in case I got in trouble (a constant fear)  or was disciplined for some heinous wrong- doing like having my fingernails 1mm too long. I reasoned that I could defend myself by saying that I never violated rule #3 by laughing in the hall outside the neuro room during a craniotomy. Luckily I never had to invoke the no laughing defense.

What strikes me most is the rigid authoritarian tone of this directive. It follows that old adage to control minor things when you cannot do anything about the big things. There is nothing here about the really important issues like infection control or reassuring patients. Big important things are bypassed.

Nurses had to wear pink scrub dresses. We were not allowed to wear the green scrub pants and shirts. This attire was reserved specifically for surgeons. On occasion the surgeons supply of scrub suits would be depleted. One day a surgeon showed up to scrub in one of our dresses. He didn't consider this unusual,  he was just using what was available. I wished that nurses could be this flexible and  more patient centered. Asepsis and technique was far more important than kind of slip you wore.

Circulating nurses had to check the furniture and equipment in each room every day before he first case. There was more "furniture" than equipment in the room. No electronics, except for an occasional "portable" EKG monitor that looked like a 2 foot section of sewer pipe with a mini Christmas tree light on the screen. We had 2 of these contraptions for 8 ORs.

The only equipment necessary for anesthesia was a precordial stethoscope, a hockey puck sized weighted scope that sat on the patients chest and a BP cuff. A stopcock enabled switching between the two. The only other devices that qualified as machines would be the suction and Bovie. It's amazing to me that things usually went very well with few problems.

Sometimes I think that I would love to scrub for just 1 more case, but then look down at my arthritic bovie burned finger and realize how crazy that notion is. It really is fun to remember the experiences. Time really does blot out the bad experiences and preserve the good. Aging can be good experience.

1 comment:

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