American College of Surgeons vs. AORN

[GravelRider]

https://www.bostonglobe.com/business/2016/08/31/hat-wars-flaring/abr7FuB9EZna1FRtECDR1K/story.html

My money is on AORN winning this one, but you've got to like the fact that at least the surgeons are willing to fight the nurses. The clipboard army is too powerful of a force. Small guerilla attacks like this may temporarily distract them, but the clipboards will always be victorious.

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[dhb]

https://www.bostonglobe.com/business/2016/08/31/hat-wars-flaring/abr7FuB9EZna1FRtECDR1K/story.html

My money is on AORN winning this one, but you've got to like the fact that at least the surgeons are willing to fight the nurses. The clipboard army is too powerful of a force. Small guerilla attacks like this may temporarily distract them, but the clipboards will always be victorious.

Nurses giving medical recommendations... you guys are F***ed

 

[jl lin]

Hair does harbor bacteria. This is not even questionable. Why risk it? Sound reasoning over p!ssing contests makes more sense for the patients.

 

[urge]

Hair does harbor bacteria. This is not even questionable. Why risk it? Sound reasoning over p!ssing contests makes more sense for the patients.

What do you propose to be done with the hairy ears of many surgeons? Ear bouffants?

 

[deleted126335]

Eyebrows and eyelashes?


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[Nivens]

I was in the OR on Friday with 6 people, 7 including the patient. The only one not wearing a bouffant was the circulator.

 

[psychbender]

F-it, spacesuits with self-contained breathing apparatuses for all. That'll cut down on infections and cost, right?

 

[GravelRider]

F-it, spacesuits with self-contained breathing apparatuses for all. That'll cut down on infections and cost, right?

Yup, the orthopedic surgeons never ever ever get wound infections or infected hardware.

 

[pgg]

Hair does harbor bacteria. This is not even questionable. Why risk it? Sound reasoning over p!ssing contests makes more sense for the patients.

The problem is that there isn't any evidence (i.e. "sound reasoning") behind the head-to-toe coverage the nurses have demanded.

The regulations requiring bouffants are the Good Idea Fairy at work, nothing more. Maybe a sprinkle of nursely power games mixed in.

You can't possibly have any idea how profoundly exhausting it is for us to endure evidence-free regulation after regulation conjured out of thin air by nurses' "sound reasoning" ...

 

[BLADEMDA]

There is no medical evidence behind this FORCED change of policy. In fact, all the evidence we do have shows the exact opposite of what the nurses claim. let's see what our govt. officials decide to mandate through decree that we must do.

 

[turnupthegas]

La Résistance!


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[jthedestroyr]

We lost the battle here, but on the weekends everyone reverts to caps when the clipboard nazis are gone.

 

[sleepallday]

Hair does harbor bacteria. This is not even questionable. Why risk it? Sound reasoning over p!ssing contests makes more sense for the patients.

How about some sound evidence?

 

[pgg]

Eyebrows and eyelashes?

The nurses at a hospital where I used to moonlight mandated long-sleeved shirts, because "skin squames" might fall off a person's arm. I don't now which online module in their DNP program introduced them to the term "squames" but it became the Word Of The Day for a solid month after they conjured the rule. What happened is some stupid Good Idea Fairy saw that CMS or JC was coming, and decide to pre-empt any possible hit by creating some ridiculous over-the-top rule to show how proactive we were about infection.

So they made surgeons wear long sleeves (in the OR hallways!!) up to the point where they scrubbed for the case. Circulating nurses and anesthesiologists had to wear a long-sleeved scrub jacket. Depending on the number of vowels in the day of the week, undershirts visible at the neck underneath scrubs had to be either "lint free" ... or they weren't permitted at all.

I don't know how many times I watched a nurse drag a drooping sleeve over a patient while doing surgical prep. When it was noticed, the area got re-prepped. I wonder how often it went unnoticed.

And what was I to do, as the anesthesiologist? Roll up my sleeves to scrub before placing a line, so my arms could be covered continuously ... or take the long sleeves off and leave them outside the OR? Here's what they told me: leave the scrub jacket outside, scrub, enter the OR, put on the gown, do the line, leave the OR, remove the gown, put the scrub jacket back on, and go back into the OR.

Absolute insanity.

All because some nurse thought it "made more sense for the patients" if every bit of skin of every person in the room was covered at all times.

 

[GravelRider]

A surgeon I know was reprimanded because he pointed out that the female clipboard carrier had some "upper lip fuzz" after she scolded him for not wearing a beard cover over his day old stubble. It has really gotten quite silly.

All joking aside, these rules have become kafkaesque. It really does distract from patient care. We are so focused on these absurd rules that do nothing to improve outcomes that we lose sight of doing things that could improve outcomes.

 

[Arch Guillotti]

A surgeon I know was reprimanded because he pointed out that the female clipboard carrier had some "upper lip fuzz" after she scolded him for not wearing a beard cover over his day old stubble. It has really gotten quite silly.

Was it a plastic surgeon?

 

[Man o War]

A surgeon I know was reprimanded because he pointed out that the female clipboard carrier had some "upper lip fuzz" after she scolded him for not wearing a beard cover over his day old stubble. It has really gotten quite silly.

All joking aside, these rules have become kafkaesque. It really does distract from patient care. We are so focused on these absurd rules that do nothing to improve outcomes that we lose sight of doing things that could improve outcomes.

I would not have been able to stifle my laughter at this one....

 

[soorg]

So sick of this unbelievable bull****. What the f#$k was wrong with the caps that have been worn for centuries? Pretty soon they'll be demanding a "provider" shower with ChloraPrep before coming within 15 feet of a patient. I want to know what studies AORN has conducted on this issue, and how they've come up with these brilliant new regulations, all under the guise of "patient safety."

There is no doubt in my mind that AORN is a terrorist organization that will stop at nothing to advance their agenda of medical establishment enslavement with their kooky rules. And like the sheep that we are, we sit and take it. Unreal.

What should be occurring in every hospital in the US is a revolution where the doctors (the ones who are versed in actual science and not feel-good hodge-podgery) make the decisions regarding patient safety, for it is us and our specialty societies who are the ones conducting the actual research on what makes for best patient care and outcomes. Until that day, medicine will continue to be a farce-a proverbial runaway train crashing into a station of submission by ignorant, power-hungry pseudo-overlords with their goddamn clipboards.

 

[deleted59964]

the caps are not the issue here.

nurses with mediocre education & no evidence, dictating to surgeons and anesthesiologists - now thats the problem.
please for the love of god, put these nurse bureaucrats in their place now or it will only get worse.

 

[Sterling5.0]

I'm just pissed that I spent 4 years looking for an awesome blue digital camo hat and now I can't walk near an OR because the bouffant cap I'm wearing instead, isn't adequately covering my manliness.

In all seriousness, this current beuracracy of "nurses" has been detrimental to patient care with their BS jump through the hoop politics and is going to continue this downward spiral for a generation unless it can be resolved. So frustrating.

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[drmwvr]

My favorite thing to do in the whole wide world is causing the phrase "....because it's the patient's own germs" to issue forth when I point out that a bearded patient with no surgical mask has passed less than a meter from a back table covered with implants, screws and instruments. His hopping over to the table with a grunt and cough is similarly seen as unrelated to the controversy.

Sigh...

 

[Robotic Wis-Hipple]

One of the hospitals I go through has seen the clipboard horde essentially outlaw tape. It started with forcing you to throw away any roll of tape after it had been sat "within 12" " of a patient or touched by your dirty gloved hand after that gloved hand had touched a patient etc. Basically everytime you taped an IV that roll got trashed. Now, to minimize waste they buy little single use rolls of tape complete with maybe 6" of tape on the roll (I'm sure these worthless rolls are cheaper :/ ). But then, because they've never actually done our job they have no idea that 6" of tape isn't adequate to hold an ETT in place, so the old rolls of tape are literally being carried in pockets and hoarded like gold bullion.

 

[jl lin]

What do you propose to be done with the hairy ears of many surgeons? Ear bouffants?

The surgical bouffants cover the ears. Plus, we have bearded surgeons that have head/face coverage that resemble Hazmat gear--surgeon head and beard covers.

 

[jl lin]

the caps are not the issue here.

nurses with mediocre education & no evidence, dictating to surgeons and anesthesiologists - now thats the problem.
please for the love of god, put these nurse bureaucrats in their place now or it will only get worse.

Yea. This is over the top. It's not like they are telling to perform one surgical approach over another. Tempest in a teapot.

 

[jl lin]

One of the hospitals I go through has seen the clipboard horde essentially outlaw tape. It started with forcing you to throw away any roll of tape after it had been sat "within 12" " of a patient or touched by your dirty gloved hand after that gloved hand had touched a patient etc. Basically everytime you taped an IV that roll got trashed. Now, to minimize waste they buy little single use rolls of tape complete with maybe 6" of tape on the roll (I'm sure these worthless rolls are cheaper :/ ). But then, because they've never actually done our job they have no idea that 6" of tape isn't adequate to hold an ETT in place, so the old rolls of tape are literally being carried in pockets and hoarded like gold bullion.

Now I agree with ^ this (you). That is ridiculous.

 

[jl lin]

My favorite thing to do in the whole wide world is causing the phrase "....because it's the patient's own germs" to issue forth when I point out that a bearded patient with no surgical mask has passed less than a meter from a back table covered with implants, screws and instruments. His hopping over to the table with a grunt and cough is similarly seen as unrelated to the controversy.

Sigh...

LOL. I am an equal opportunity protector from needless addition of microbes...so I think body hair and such is secondary to keeping the patient safe, as much as is possible, from infection--even the patient's own hair. Dear Lord. Cover it up or cut it off. It will grow back.
Why is there so much extremism in thinking among people?

 

[chocomorsel]

Yea. This is over the top. It's not like they are telling to perform one surgical approach over another. Tempest in a teapot.

Where is the evidence?

 

[dhb]

Why is there so much extremism in thinking among people?

Because of people like you

 

[Psai]

LOL. I am an equal opportunity protector from needless addition of microbes...so I think body hair and such is secondary to keeping the patient safe, as much as is possible, from infection--even the patient's own hair. Dear Lord. Cover it up or cut it off. It will grow back.
Why is there so much extremism in thinking among people?

Evidence?

Or are you practicing what you preach by shaving your nares, your eyelashes, your upper lip stubble, your cheek fuzz and your ear hair? Hair harbors bacteria you know.

****ing insanity, how have we come to the point where stupid groups of people have stupid meetings about stupid nonissues to create stupid edicts? I'm tired of nurses and their ****. Please go back to taking care of the patient instead of sitting around on instagram all day and telling the poor medical assistants to do your work. Leave me alone.

 

[ChiDO]

Our level 1 recently required all OR personnel to wear long-sleeve short disposable jackets over the scrubs while in the OR hallways, rooms, ect. Haven't seen any surgeons/residents wear them yet. Although some nurse nazi did yell at me for walking into CPD to get some extra gloves without one on.

Another interesting random tidbit about "infections" and nurses. I was prepping a patient with chloroprep stick and used the end of it to push a blanket away that got too close to the sterile area I was prepping. As I proceeded to continue to prep, the nurse ran over and told me that I had "contaminated" the prep stick and the rest of the patient. i just grabbed a new stick for the sake of speeding up. After the case, I asked the nurse isn't the patient's leg "unsterile" that I am prepping, thus by touching the prep stick to the leg, I "contaminated" the prep stick....just silence

 

[urge]

Talking about made up stuff, can anyone tell me why you need to wear a paper gown when visiting a contact isolation patient but you are required to remove it to transport the patient around the hospital?

 

[jthedestroyr]

Evidence?

Or are you practicing what you preach by shaving your nares, your eyelashes, your upper lip stubble, your cheek fuzz and your ear hair? Hair harbors bacteria you know.

****ing insanity, how have we come to the point where stupid groups of people have stupid meetings about stupid nonissues to create stupid edicts? I'm tired of nurses and their ****. Please go back to taking care of the patient instead of sitting around on instagram all day and telling the poor medical assistants to do your work. Leave me alone.

Talking about made up stuff, can anyone tell me why you need to wear a paper gown when visiting a contact isolation patient but you are required to remove it to transport the patient around the hospital?

I love how they do a "terminal clean" on the room, yet we push that patient through the same halls as all the other patients. Then again, "nurse science," isn't really science. I love reading their science board "research projects" at the VA. I know elementary science projects done better.

 

[pjl]

We told our nurses who presented this dress code to politely "F off" and wrote a policy stating what was appropriate dress in our ORs.

At this point, all nurses have to follow their silly policies, and all physicians, midlevels, and techs can continue to dress in the usual manner.

When the Joint Commission comes knocking, if they tell us we fail due to following our policy, we will join the other 2/3 of the hospitals in our city to no longer use the Joint Commission as our accrediting body. That is, unless they can present scientific evidence of the inferiority of our way. We are FAR below average infection rates.

Some of us actually waste time and energy fighting these issues, which is sad, but every day I put on my scrub cap, I feel a little happier.


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[Ronin786]

We told our nurses who presented this dress code to politely "F off" and wrote a policy stating what was appropriate dress in our ORs.

At this point, all nurses have to follow their silly policies, and all physicians, midlevels, and techs can continue to dress in the usual manner.

When the Joint Commission comes knocking, if they tell us we fail due to following our policy, we will join the other 2/3 of the hospitals in our city to no longer use the Joint Commission as our accrediting body. That is, unless they can present scientific evidence of the inferiority of our way. We are FAR below average infection rates.

Some of us actually waste time and energy fighting these issues, which is sad, but every day I put on my scrub cap, I feel a little happier.


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More hospitals need to start shunning the Joint Commission. A bunch of crooks and frauds that need to continuously find irrelevant issues to justify their existence.

 

[GravelRider]

More hospitals need to start shunning the Joint Commission. A bunch of crooks and frauds that need to continuously find irrelevant issues to justify their existence.

That's the key, though. You can't be the one "rogue" hospital that shuns the joint commission. The problem that's occurring in some areas is that the city or state's department of health is picking up on some of these rules. They are threatening to shut down entire ORs for a period of time if there is not 100% compliance on rules such as dress code. This has already happened at some prominent NYC hospitals.

 

[Pooh & Annie]

We told our nurses who presented this dress code to politely "F off" and wrote a policy stating what was appropriate dress in our ORs.

At this point, all nurses have to follow their silly policies, and all physicians, midlevels, and techs can continue to dress in the usual manner.

When the Joint Commission comes knocking, if they tell us we fail due to following our policy, we will join the other 2/3 of the hospitals in our city to no longer use the Joint Commission as our accrediting body. That is, unless they can present scientific evidence of the inferiority of our way. We are FAR below average infection rates.

Some of us actually waste time and energy fighting these issues, which is sad, but every day I put on my scrub cap, I feel a little happier.


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Your hospital needs to be VOCAL about its infection rates if when the JC fails you so the rest of us have someone to cite. Many of us would love to dump them.

 

[Sterling5.0]

DNV Accredation > State Health Boards > Nazi nursing

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[Psai]

We told our nurses who presented this dress code to politely "F off" and wrote a policy stating what was appropriate dress in our ORs.

At this point, all nurses have to follow their silly policies, and all physicians, midlevels, and techs can continue to dress in the usual manner.

When the Joint Commission comes knocking, if they tell us we fail due to following our policy, we will join the other 2/3 of the hospitals in our city to no longer use the Joint Commission as our accrediting body. That is, unless they can present scientific evidence of the inferiority of our way. We are FAR below average infection rates.

Some of us actually waste time and energy fighting these issues, which is sad, but every day I put on my scrub cap, I feel a little happier.


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Never understood why we have to pay a bunch of idiots to dictate stupid rules that actively obstruct patient care. And people go around all worried about their edicts as if we aren't paying them for recommendations by clipboard warriors who don't understand **** about science,

 

[Planktonmd]

These self proclaimed organizations like AORN, JACHO, and others are the main cause for the degradation of the medical profession. Actual patient care is no longer our first priority because most of our day is wasted on adhering with silly policies and performing stupid rituals they keep inventing.
They truly make retirement such a pleasant idea and at the same time make you feel so sorry for those just starting their careers now.

 

[Nivens]

Deleted

 

[Psai]

Once again, only person in the OR right now not wearing a bouffant is the circulator.

Just sayin.

But hair bacteria tho

 

[Onefellswoop87]

Once again, only person in the OR right now not wearing a bouffant is the circulator.

Just sayin.

But talk to him/her about it, and you have just then singled the circulator out. Feel the wrath of the clipboard army now that you've just made a hostile work environment. Do as I say, not as I do.

 

[deleted50478]

Never understood why we have to pay a bunch of idiots to dictate stupid rules that actively obstruct patient care. And people go around all worried about their edicts as if we aren't paying them for recommendations by clipboard warriors who don't understand **** about science,

Because nobody wants to do the paperwork for CMS approval directly and cut out the unnecessary abusive middleman.

 

[drmwvr]

Talking about made up stuff, can anyone tell me why you need to wear a paper gown when visiting a contact isolation patient but you are required to remove it to transport the patient around the hospital?

When I asked that same question I was told that it "stigmatized" the patient to be seen transported through the hospital by so gowned and gloved personnel. Not trying to be cheeky. That's what she really said. Crazy part was that it was with a straight face.

 

[KurtBrie]

We removed JACKOFF from our facilities and went with state accreditation.

This also removed the HIGH cost to have JACKOFF which in no way provides any recognition.

Even in a big market, patients dont know what they are, they dont care and it likely wont impact their choice. Same thing with this BS magnet status. Waste of money in a system which is looking for ways to save it.