A tech was showing me a trick one of the surgeons had taught her to help differentiate Lidocaine and Marcaine on her field at the same time (this is in addition to the required labeling). I thought it was clever. Then I mentioned that methylene blue should be used with caution for patients with renal impairment and the surgeon immediately wanted new Lidocaine, and told the tech that methylene blue should only be added to non-injectables.
I felt sorry for the tech, 'cause the warning is for severe renal impairment. We administer methylene blue all the time when working near the ureters to help visualization. A little bit of methylene blue in Lidocaine is not likely to cause an issue in a patient with healthy or mildly impaired renal function when it is being infiltrated, not even delivered intravenously.
Also, techs from out of state have experienced a different scope of practice than we enforce in Washington state. Some other states allow counts, dispensing fluids and medications to the field and even suturing by surgical techs. Washington is quite restrictive on the practice of surgical techs and techs from out of state sometimes want to practice outside of these restrictions, since they have safely done so elsewhere.
I have one more week of scrubbing, then I will be back in class for a couple of days and then we start our adventure in learning the role of the circulating nurse. I can hardly wait. It is exciting and a bit scary at the same time, and I think I am ready.
I think upcoming blog posts may contain a bit more substance into what it is to be a perioperative nurse. I'll be learning the new role, with theory to consider while caring for my patients. It will be a tremendous growth period.
On another topic, finally road the scooter into Seattle (and back). I hadn't had the opportunity to scout the route, so it was quite an adventure. I almost ended up on I-5 without intending to, then I did end up on I-5 without wanting to be there. I got off right away, then realized that I had no idea how to get back on route, and I was running out of time. I considered the 5 miles I would need to be on I-5 to get to the exit I normally take, then went for it. It wasn't as bad as I thought it might be. There are more motorcycles on I-5, I think, than on our smaller freeways on the Eastside. Drivers kept their distance, didn't cut in front of me or follow too closely, and the wind buffeting wasn't as horrible as I have encountered on previous jaunts onto the freeway. I still don't think I will repeat that experience any time soon.
Coming home was another adventure. I kept heading north and east until I managed to find my way to the UW main campus area. From there I kept following the shore of Lake Washington and found myself going through Sand Point. Eventually the road took me to Lake City and I was finally in territory that I felt more comfortable in. I have driven to and through Lake City many times, I knew my way home from here! I now also know a better route to get to Seattle when I need to ride in because my carpool is telecommuting.
BSN school is going well, but I do have to not let one of my group members get to me so much. She talks non-stop, quickly, asks questions but doesn't really give you time to respond before she talking on the next topic. It's only another 7 weeks.
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