What Do Operating Room Nurses Do?

I think if you have not worked in the OR you would have that perspective. I did and then when working in the OR I realized just how much OR nurses do. I have been in the situation, more than once, when a surgeon wanted to do something a paitent had not consented for or they were taking questionable actions. A licensed professional is more likely to skillfully find a way to negotiate through these issues. A surgical tech that simply does what the surgeon wants is not going to be a great patient advocate.

Jeff, Jeff,Jeff not being an OR nurse you have NO perspective on what we do. Being a sales rep for healthcare products is like being a used car salesman, not much talent needed. Too many supervisors I have dealt with aren't too bright and I always wondered what qualities were needed to be one. Staff nurses, please don't get me started. Too many mistakes on their part lead me to believe they aren't paying attention to their patients and not doing their job. Educator, been there done that. So you can see everything you have done really isn't all that hard and anyone could do it, even a Technical person. Maybe doing a radio show is really for you because nursing might be a bit to hard for you. Don't trash something you haven't even tried because you really don't have the right to do it. Join the club and really see what is involved,until then keep your opinions to yourself because it only makes you look foolish. Maybe I'll try radio, it doesn't sound to involved.

Well, well, well! I see where you, Jeff, are in "health care" sales???? Hmmmmmmmmmm...You sell health care? Anyway, moving on...I have been an OR nurse for 21 years. I am not a gofer, never have been AND I have continued to deliver first rate, first hand care.
I have never stepped back from direct patient care. As far as what an OR nurse does...yes we scrub..and we circulate. Most patients who have surgery are NOT coming from the floor..they are coming in from home AND I am the last person in line to make sure that everything is correct prior to OR entrance. You are making a mistake in Assuming that everything is "ready" when I go to see the patient. The anesthesia and operative consents are often wrong...or not there at all....the labwork is missing or out of date....I could go on but won't. If a pre-op nurse or floor nurse knows an OR nurse is going to check behind them...do you think that everything is always done? WRONG again.
In addition to making sure everything is on the chart to proceed. I have done everything in the OR to get ready for the scheduled case. Now, keep in mind that in the OR I don't do the same rote thing everyday...I may work NEUROSURGERY doing complex craniotomies or spine fusions. So, in addition to patient care I have to adjust/balance the microscope, set up the navigation system, AND the system used for recording the procedure at some places oh, and yea I forgot to mention that I am responsible for making sure that all the equipment/instrumentation is ready as well. Of course this is in addition to getting the TEDS/SCD's on and getting the foley in and getting the Bair hugger on, oh and padding the patient so there is no injury to the patient during the procedure. Oh and lets not forget about the documentation and the specimen/specimens, right?
I may be doing UROLOGY, ORTHOPEDICS, PLASTICS, VASCULAR, CARDIAC, GYN, ENT, TRAUMA, GENERAL, TRANSPLANTS...well you get the idea.
Consider all the different procedures under just one service? how the setup is different for each AND consider that if your are circulating you are the ONLY person in the room to TROBLESHOOT/FIX the problem...like a monitor stops working or something happens to the equipment. What you gonna do then? You have a nasty neruosurgeon in the middle of someone's brain and the CUSA stops functioning?
How about starting an IV on a baby who is being masked down by anesthesia?

Well, lets refocus now....
I forgot to mention all the mistakes I have caught in the OR...here are a few examples:

I found out that the neurosurgeons at one hospital were using intrathecal gent. and the pharmacy was diluting with water instead of saline...WOW Hypotonic solution on the brain. Gotta hate that..

Or how about the time I went to check my patient in to go back to the OR and the H&P stated that the patient had Von Willebrands disease and NOBODY set up factor VIII for the patient??? WOW crisis averted there

OR lets see....how about the time that an orthopod was having trouble with a case and the resident asked for an implant that was stainless steel and were were using titanium implants??? Don't want to mix those alloys. Stainless steel and titanium...well they just dont go together.

OR lets see.....How about the time that I was going to be circulating on a liver transplant and there was ABO compatibility BUT NOT HLA compatibility..That just slipped by everyone elses eyes.

Or how about the time the SALES REP was trying to get me to open up an implant that was for the right tibia instead of the left? you have to watch the laterality there, man.

Or how about the time I took care of a patient with a mitochondrial disorder and anesthesia was hanging Lactated Ringers instead of Saline? Wow...don't want to give LR (end product of metabolism ) to those patients..

Or how about the time the surgeron was about to inject too much marcaine on a baby.....

I would continue but have made my point.... after taking care of actual patients for 21 years in the OR...I know my OR nursing...


I don't agree with some types of nursing BUT I don't insult them either..

Great article. I have been wondering what an or nurses day looks like as I have concidered it as a next step in my career.
Thanks!

Shodobe, I'm neither a used car salesman nor a sales rep, I'm a Master's prepared RN with many years of staff, management, education, and home care experience who happens to have a radio show on a major Philadelphia, PA station. Actually, radio is an extension of my teaching career; instead of talking in front of 50 students at a time, I'm talking to thousands of people at a time. Many of my guests have been nurses.

And how many years have you been an OR nurse for?

I am offended that you think that an OR nurse need 6-9 months of training and they can just go to any floor and learn it in a couple of days. Do you really think that? I have worked floor nursing and worked in the ED also as an RN. If anyone can learn it in a couple of days, they should be working at NASA in a think tank! Cause they are def. a genius! P.S. I know and OR nurse that wants to transfer to a floor and needs more than a couple of days training and I dont think that speaks badly of her skills. Remember we dont have a doctor right there that we are assisting, we are doing the working on the patient and will call the doctor if needed.

Well written. As a fellow RN, CNOR, I too have run into this attitude from other nurses who work outside the OR. Much of the attitude stems from not understanding what happens in the OR and just seeing us walk in and out of the hospital in street clothes. They don't see the sleepless nights with call cases or not leaving at 3pm because the patient is still being operated on. They see the docs laughing with us, sometimes, versus yelling at us about being woken up for patient condition changes. They don't see an entire room full of people going quiet as mice when the patient is going south fast.

There are reasons for being in the OR and reasons for staying on the floor, in home health, etc. Nursing is such a varied field that we can all find our niche. My just happens to be the OR.

I truly enjoy being in the OR and missed it the last couple of years when circumstances lead to me working outside of it while my family was stationed (military) overseas. Now back stateside and heading back to the OR.

Thank you once again for the well written essay on OR nursing.

As for the OP, interesting post! I was wondering what duties the OR nurse actually performs. After reading this thread, I get the feeling that you might not get enough credit because if you are successful in your job the doc gets all the glory, not you. I wish OR nurses were able to have a bigger scope and be able to be more hands-on and involved rather than just sitting back and being "preventive". I have always been intrigued by surgeries but don't want to be a doctor just to explore that passion.