I've only been in the OR for 6 months and entered as a new grad. There are many aspects of being a circulator that can appear to be a 'gopher' or pure mechanical work but if one cares to look deeper at things, all that we do is centered on patient care. The largest roles the circulating RN plays are that of patient advocate and safety management. I've had to insist with surgeons/anesthetists/residents/med students on certain things to ensure patient safety. Making sure the consent is signed may seem like clerical work but it's the last check of the nurse in identifying correct patient, correct procedure and correct site...ok, second to last, last is the time out. Checking a patient, while doing all that 'clerical' feeling stuff, simple things like querrying labs, consent, allergies and such play very important roles in patient care. I've had a surgeon and anesthesiologist who had overlooked/forgotten that our patient was allergic to dye and were going to proceed with an IOC without precautions. Sometimes it feels so silly and rote to ask for the millionth time that day to a patient who's heard it at least 3 other times the last time they had anything to eat or drink but it could be the one where lo and behold, that 'one more time' it is asked and we learn that "oh, I had a breakfast burrito this morning but that was a long time ago" (real case scenerio, 1.5 hrs since that 'little' breakfast burrito btw) and then get furious when the case is cancelled. Making sure the equipment is available and in working order for the physician is another aspect of patient treatment, ensuring the needed tools are available to make this patient better is crucial. "Counting bloody rags" ensures one isn't left in the patient to cause harm, sometimes fatal. Sure, anyone can count but is the orderly going to care as much if there's one missing, would the orderly just assume there was a miscount or that one had been tossed in the trash, would the orderly even mention the discrepancy? Now as an RN, we know better than to make those assumptions. As an RN we know what must be done to either find it and account for everything, even if that requires an x-ray to locate it. Sure, patient care in the OR is vastly different than ICU or ER nursing, it is highly specialized.
Don't get me wrong, many orderlies who have worked in the OR for a while have come to realize that a miscount is a serious issue that must be addressed and could probably tell you what has to be done. We have some who are knowledgeable enough to know this, we have one who couldn't care less. That's why the RN has to take care of what seems like a demeaning task to some.
We have a scrub at our facility who has made a point of telling me, and everyone else I'm sure, that in her opinion the circulator is nothing more than a glorified typist (we chart electronically). Yet when I voiced concern over a patient scheduled for a life/death procedure who had a K+ of 2.8, she looks at me and tells me she hasn't a clue what that means and I may as well speaking Greek. Go figure, the receptionist wouldn't know either but as an RN I do and can prepare for what we will likely face in the OR with this patient who couldn't wait until things improved.
I have learned a TON of things since entering this field but know that I have a ton more to learn and am enjoying every minute of it. I look forward to the day when I can be confident in most any OR moment, efficient and proficient at what I do.