ASD

Ambulatory Surgery Department. I've been working here for the past 2 months now, ever since we moved back to Maryland. It's my old stomping grounds, having worked at this hospital, in this unit for 4 years as a nursing assistant while in college for my bachelors and nursing degrees. I spend my days either getting patients ready for surgery or getting them ready to go home if they are being discharged on the same day as their surgery (outpatient). Which portion I works depends on what 8 hour shift I'm assigned, and that all depends on what shift needs to be covered since I'm woking PRN or "as needed". I've been lucky in that my manager is giving me full-time hours. Just no benefits, which I don't need anyways as I'm covered through my husband's job.

It's a LOT of paperwork, but thank god the majority of it is computer charting! Definitely don't miss paper charting or having to translate and enter in the doctor's orders. The only drawback of this job so far are the 8 hours, 5 days/week shifts and the 0545 start time if I am assigned to pre-op patients that day(s). It's sucks having to wake up at 0400, but it's getting easier. Just need a cup of coffee and I'm good. Usually if I'm on the pre-op side of the unit for the day, I get an assignment that ranges from 6-8 patients, with usually two that we have to get ready for a 0730 case. Cases ranges from orthopedics, vascular, GYN, ENT, URO, pain management, angio, and endoscopy. We get a lot of GYN cases, and through the years I've realized that fibroids is something every women should look out for as they age, endometriosis sucks, and there are a lot of women walking around this country without their uterus. My responsibilities included getting the patient undressed to their birthday suit and into a hospital gown, making sure all the necessary labs are available or drawn, that there is a recent history & physical, that the consent is signed/witnessed,that the patient has been NPO, obtain a baseline set of vital signs and a brief admission assessment. Slap on an IV and some LR fluids and call it a day. Nothing left to do, but wait for the surgeon, anesthesiologist, and the OR nurse. Easy peasy. Well, unless your patient doesn't speak English (blue phone), or they take a million gazillion meds that you have to go over when they took last, or the patient is late and the surgeon wants to go now now now, or they have no veins. Another thing a love about this job is all the practice I get starting IVs. I'm actually not too bad *knock on wood*

Post-op for patients going home the same day is a different animal. There is usually a nurse that comes in at 8, 9, 10, 11, and sometimes 1pm. Today I was the 1000-1830 nurse. Patient assignment is pretty much on a first come first serve bases. We try to rotate who takes the next patient and keep the ratio to 3:1 max. Today I probably discharged about 8 patients and admitted 2 to the floors. Depending on whether the patient came directly from the OR or after a stent in the recovery room, we recover them from between 30 mins to 2+ hours. We make sure they're not so sedated and more on the alert and oriented side before giving them some "apple juice, cranberry juice, ginger ale, water, tea, or coffee" and "Graham or saltine crackers". Luxury, huh? Other responsibilities include, making sure they don't get nauseated, treating any nausea, they their oxygen saturations is within normal limits, that their pain in tolerable, and that all GYN and URO cases can pee. Oh, and that any patients having a colonoscopy can pass gas, or the words of one of my patients "you mean you want me to fart?", or else no crackers for you! Lol. In the end, if they meet all the criteria then we go over discharge instructions and prescriptions from the surgeon, take out their IV , and give them a free ride in a wheelchair to the car :)

It's a pretty sweet job. I'm really enjoying myself and learning a lot! It's definitely easier than being on the floors, but the craziness and ridiculous amounts of surgical cases we have on a daily bases makes up for it. Today was 61 surgical cases, tomorrow will be 63+! It's a big and busy hospital, but it's totally for me. I'll be in ASD for another month and then my next adventure a full-time nurse in the PACU will begin :)