The OR being a clean environment full of clean edges, and sterile surfaces during a case, is a dearth of places to write. There just isn’t a lot of paper to write anything. Stacks of paper are frowned upon because they can be dust catchers. And blood can go flying, especially during a total hip.
You could theoretically write on the back of the schedule or the preference card. Those pieces of paper are handy. And since the schedule or the preference card is only printed on one side, the entire back side of the page is empty. Plenty of room to make notes.
The whiteboard is also a place to write. On the bottom, under the patient’s name, birthday, procedure, surgeon and allergies, there can be 18 inches of space. I use the whiteboard to write down things all the time; I note down times, and results from the pathologist if doing a frozen, I write down information while I am on the surgeon’s phone answering a page, I write down the name of the specimens, especially if the surgeon is rattling them off too fast for me to input the orders. If the case is over too quickly and I have not finished charting, I will take a picture of my notes and refer back to the picture when I am finishing charting. I very carefully do not take a picture of the patient’s name or detail and I delete the picture after I am done.
That’s why I don’t like to make important notes that I have to address and complete on the back of a schedule or preference card, there is the potential for too many HIPAA violations. And I’d rather not lose my job for a violation. And it is not appropriate for the patients to have their information bandied about.
I am not talking about notes that are about the patient.
I am talking about notes to yourself about future self things.
The to do lists, the next case notes, the reminders about picking up little Timmy from afterschool event. All the things.
There is a dearth of writing materials in the OR. In a pinch, I have been known to write on my scrubs, or on my hand. I routinely keep a post-it on the back of my badge for when I need to take notes.
Another widely used writing paper that all the OR nurses and techs know about is the gown card. This is a 2.5 in x 4.5 in card that is attached to the gowns to allow the wearer to turn in a sterile manner.
These gown cards are useful as hell.
And I cannot keep from collecting them. They are that useful. I have about 10 in my locker at all times, and about 500 at my house because invariably they go home with me.
Things that I have on the gown cards on my desk:
- to do list for home
- to do list for work
- to do list for school
- Dispatches from the Evening Shift notes. This comes in handy on Sundays
- Cookie Thursday is a Thing themes
- Cookie Thursday is a Thing recipes
- Christmas list
- A reminder for the free library classes I have signed up for
The point is that the gown cards are really useful. And a recyclable resource that is self propagating. This is because there are at least 2 gowns opened per case, more if there is a break relief, or a PA.
I could make notes on my phone but I don’t like to be seen by the surgeon “playing” with my phone. It’s just not a good look.
This makes me analog in a digital world. And that is okay.