circulating nurse = "go-fer" with no use for "real" nursing skills? - page 3

by RunnerRN2b2014

9,169 Views | 23 Comments

After 20 years of teaching, I'm back in school pursuing what I've always wanted to do: to be a nurse. I've always been interested in the OR and I am amazed at the number of RNs and fellow students who are trying to talk me out of... Read More


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    I was in the same position as a new grad just a few months ago. I was lucky to choice between a neurosurg floor position or an OR fellowship. There are times I still wonder if I made the right choice to not take the opportunity to develop my basic skills as a nurse (in fact, I could probably do quite well in any unit with a few years in that job), and if my experience really were just what ratona described, I'd be regretting it like crazy! I'm still learning and have had a lot of hiccups, but it's been an enjoyable experience so far. Some benefits to the OR are the instant gratification of fixing a patient's problem within a day, getting to work as a team on one patient instead of the lonely autonomy of 6 med-surg patients and endless documentation, and sedated patients while putting in foleys. I've also really come to appreciate just how much knowledge and problem solving skills are required as circulator or scrub. It's not floor nursing, no, but it's just as challenging mentally and, yes, physically.

    There are times where it seems thankless and mindless, and there are some people who are definitely not meant for the OR, but trust me. It's totally possible to have a bad periop nurse. Even in my inexperience, I can see them. The other nurses see them and expect the best. Just like in any other specialty in nursing, you are a patient advocate. Your job is to protect your patient who is in their most vulnerable state while under your care. You're the last face they'll remember seeing before being wheeled into the surgical suite. You're the one who makes sure everything runs as best as they can. Sometimes it's someone wanting their boobs done, and sometimes it's a 9 year old bleeding out of every orifice, and you're the one who convinces a doctor that his life can be saved. I've seen it, and it's beautiful.

    As for traditional nursing, I'm hoping after getting my BSN and CNOR-certified in a few years, I can also start doing pre-op or PACU. Then who knows?
  2. 0
    Quote from ratona
    I have to tell you I was in your shoes about 4 months ago. I just recently graduated as an RN in April and was hired an an OR nurse.I spent about a month reading this very same site and trying to understand what I was getting myself into. I am not trying to insult anybody out there but OR nursing is not for everyone. First of all you will spend your day reading preference cards and running around getting things for the tech who will say to you....You guys are the OR *******, you are the doctors ******* and you are our *******....and you know what....it is true! your day starts with your morning meeting around the core desk to get your assignment,then you run to your room to get preference cards to get an idea of what to get for the case but the catch is.... you have not idea of what it is you are supposed to get, then you start connecting things in your room(you spend most of the day trying to figure out where to plug things so it all runs smoothly)....no nursing yet! then you turn every single thing on to make sure it all works..bovie,suction, storz tower ,etc....does any of this sound like anything you learned in school?....anyway then you run to see your patient for about 15 minutes you make sure all signatures are in the chart, make sure blood is available etc(only part of the day where some nursing applies) the you take your pt back to the room. Anesthesia does all the work(iv, antibiotics,give blood ,etc) you only watch them at work. then when the doctor comes in after positioning you get to call a time out, they start, and you start documenting on the computer(no time to watch anything) then the tech starts asking for things, you get to run around the or like a mad woman and after it is all done you get to do it all over again....sounds like fun? not for me , my advise dont do it!!!! good luck!
    What you described is EXACTLY what I saw the RN doing the other day when I was shadowing. I was like I couldn't do this EVERY day! Lol I got bored after 25 mind there. Very repetitive.
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    Quote from pookyp
    What you described is EXACTLY what I saw the RN doing the other day when I was shadowing. I was like I couldn't do this EVERY day! Lol I got bored after 25 mind there. Very repetitive.

    There is nothing boring about theOR for me...I am severely ADD too! A small hospital maybe but not a bigger one. I hate floor nursing and will never do it again! I even did ER nursing for awhile but nothing did it for me like the OR! Love it! Been there 6 years now. Just got my CNOR this year.
  4. 3
    Quote from ratona
    I have to tell you I was in your shoes about 4 months ago. I just recently graduated as an RN in April and was hired an an OR nurse.I spent about a month reading this very same site and trying to understand what I was getting myself into. I am not trying to insult anybody out there but OR nursing is not for everyone. First of all you will spend your day reading preference cards and running around getting things for the tech who will say to you....You guys are the OR *******, you are the doctors ******* and you are our *******....and you know what....it is true! your day starts with your morning meeting around the core desk to get your assignment,then you run to your room to get preference cards to get an idea of what to get for the case but the catch is.... you have not idea of what it is you are supposed to get, then you start connecting things in your room(you spend most of the day trying to figure out where to plug things so it all runs smoothly)....no nursing yet! then you turn every single thing on to make sure it all works..bovie,suction, storz tower ,etc....does any of this sound like anything you learned in school?....anyway then you run to see your patient for about 15 minutes you make sure all signatures are in the chart, make sure blood is available etc(only part of the day where some nursing applies) the you take your pt back to the room. Anesthesia does all the work(iv, antibiotics,give blood ,etc) you only watch them at work. then when the doctor comes in after positioning you get to call a time out, they start, and you start documenting on the computer(no time to watch anything) then the tech starts asking for things, you get to run around the or like a mad woman and after it is all done you get to do it all over again....sounds like fun? not for me , my advise dont do it!!!! good luck!
    I can understand why you may feel this way, because as a new OR nurse you do run your *** off at first. But pay attention to the experienced OR nurses around you and you should see that they're not running around nearly as much as you are. This is because over time you WILL convert those DPC's to memory and you WILL be able to anticipate the surgeons' and techs' needs. Setting up your room at the beginning of the day doesn't really take all that long. I look at the pick sheet on each case cart and pull all my suture, MIS stuff, etc for each case before morning report so that's less I have to do when turning over my room between cases. I also order all my meds for each case and pick up from pharmacy at the beginning of the day. You'll learn each procedure, and you'll learn how each surgeon does things during that procedure. You'll be able to anticipate when they might need more laps or suture. As for documentation? That shouldn't take you long to do. Charting takes me maybe 10 minutes tops. There are certain segments to the periop chart you can fill in before the patient even comes into the room (i.e. case attendance, cautery info) so that you can focus on that patient once they come through the door. You will develop the ability to multi-task, and you'll develop an "OR ear"- the ability to document while paying attention to the field and listening to your mumbling surgeon because let's face it, they're not gonna stop what they're doing and turn to you to ask for things. Last time I checked, multi-tasking is a big part of floor nursing too. So is organizing your time.

    I work in a pediatric hospital so anesthesia brings the patient into the room (I don't have to do a pre-op interview, but I do accompany patient to PACU for post-op report), this gives me time to help the tech set up the room. Like PP's said, once that pt rolls through those doors all your attention is on them. I assist my anesthesia personnel during induction. Since we're working on children, we use gas induction then insert the IV and put them deep with IV anesthesia (saves the kids and parents a lot of undue stress trying to place an IV pre-op). I assist with IV insertion, placing the BP cuff and pulse ox, and in the case of children toddler-aged and up I help with distraction techniques to try and keep them calm as they get the mask. This is the fun part. If it's a girl I might ask if she likes getting her nails done. If yes, I tell her let's paint your nails. I take her hand in mine and say now I'm putting the polish on. Can you smell the stinky nail polish? (this is where anesthesia switches the gas on.) This really helps calm my patient and makes induction a lot easier on us. If my patient is a boy then maybe he's flying a jet and he can smell the stinky jet fuel.

    I pay close attention to anesthesia monitors during the case as well. Intra-op hypothermia is a big issue nationwide especially with NICU patients, so I make sure the pt's temp doesn't get too low (or too high for that matter) by consulting with anesthesia before adjusting room temp or the Bair hugger. If you have a CRNA or anesthesia resident/fellow in the room who you watch like a hawk because you don't necessarily trust their competence, it is up to you to step up and call the attending into the room to assist them if they can't get the pt's sats under control.

    So in a nutshell, a good OR nurse can document, pay attention to the field, anticipate the needs of the surgeon/tech, monitor the patient's vitals/sats/co2, and document all at the same time. Oh, and keep med students/nursing students/other observers from contaminating the sterile field. If that's not nursing then I don't know what nursing is!
    FutureORCRNFA, ORSuite, and fetch like this.


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