O.R. Orientation

  1. I am curious about the type and length of orientation any of you have received.

    I started in the O.R. mid-September, and to date have had about 4 hours of classroom orientation (a mixed group of RNs and NAs) which was a review of sterile technique. Basically, we were just placed in rooms with a different person and type of case each day, and expected to pick out the best techniques of each nurse and learn the routines (sometimes you don't know what you don't know, which makes it even tougher). We also spent a day in Sterile Processing and a half-day in our core workroom.

    I feel as though this has been trial-by-fire, and that those of us who started a few months ago have been cheated out of an orientation that gives us the knowledge to function optimally. Everyone keeps saying how incredibly well I'm doing, but I still feel very much out of my element. I have run rooms alone, but am stressed to the max when it happens, and have contemplated moving back into another clinical setting. I would really like to hear from some of you who have some experience with OR nursing as well as what your orientations were like. Bear in mind that I have NEVER worked OR before.......Thanks for letting me rant a bit
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  2. 22 Comments

  3. by   AZBOUND-ORNURSE
    I started out as a Surgical Tech first before becoming an RN in the OR. As a Tech, it took me at least a year after graduation to feel comfortable working in the OR and scrubbing cases alone. After I became an RN, I left the OR and spent a year and a half working in Telemetry and ICU. I then returned to the OR and spent another year on orientation for that. I still feel at times that I was rushed (even though it was a year) through orientation. I guess because I had already had previous experience there.
    The OR is a very demanding and highly specialized area of nursing. You will feel more comfortable as time progresses. Just hang in there and don't be afraid to learn new things (no matter how long you work in an OR, there will always be something you haven't seen or done before). You write that you just started mid- September and already running rooms on your own!! I think that says it all, you are doing well just like everyone is saying.
    The hospital I work at didn't put a time frame on my orientation and also did not have classroom instruction either at that time.
    Please don't give up on the OR just yet!!! Let me know how things go!!
  4. by   chartleypj
    Bestblond
    Like you, I received very little orientation to the OR. I applied and accepted a postion without ever having worked in an OR, shortly after graduating from nursing school. Our facility had no standard, consistant teaching plan. The first year was exceedingly challenging. I also learned the hard way. Surgeons screamed a lot, some even threw instruments.
    If you are sure this is the place for you perhaps you should ask the manager to pair you with the same RN for your circulating experiences. You need to ask for what you want/need. Let them know how enthusiastic you are about working there and hopefully they will nuture your interest.
    I would also strongly suggest you learn to scrub; a good scrub makes a great circulator.
    Join AORN, The Assocation of perOperative Registered Nurses in your state.
    AZ Bound is right, this is demanding and highly specialized. It is also a very rewarding place to work.
    Good luck,
    Paula
  5. by   spineCNOR
    As AZ-bound says, it take a full year , at least, to become really comfortable. The OR is totally differenct from any other area of nursing as you well know!

    Many OR's, sounds like yours may be one of them, are giving new people haphazard orientations becuase the department is busy and short-staffed. You will need to be assertive to get the orientation you want and need. Are you keeping up with your cases- how many of what type of case, and whether you were with a preceptor or alone? This can help you think about what services or cases you need more experience with, and discuss this with your education person/manager. When you do talk with ed person/mgr be sure to emphasize your interest in the department, and how giving you a through orientation will benefit THEM and the department.

    Sounds like you need to be more patient with yourself- it is very difficult for any experienced nurse to go from an area of nursing where they are a pro to an area where they are a total novice. You have had the courage to get this far, so just take it one day at a time. You may not think so now, but the day will come when you are a pro in the OR!

    Good luck and keep us posted on your progress!
  6. by   Shevalove
    I am going to be starting a OR orientation at the end of this month. It is supposed to be 9 months long and takes new graduates as well as experienced nurses.
  7. by   DIPLOMATICRN4HIRE
    When I first started in the OR I came from the step down and cvicu units, at a cardiovascular surgeons request. Me and 4 others went wide eyed into the area thinking it was just like it was "Upstairs" WRONG. Went into the "orientation" was intended to be 1 yr. well with in a week it was whittled down to 16 weeks then down to 9. We barely knew the instruments. My first case scrubbing was a Double Plif, and the Surgeon was left handed and yelled at everything I did. Im talking in your face blood curdling screams. I did the case and minus a nervous break down showed up for work the next day. It got easier and I learned that If Im going to learn it I will have to learn it myself because there wasnt a soul there that had the time to teach me because we were so short staffed. It took a few months to figure were things were.... KNOW WHERE YOU SUTURE IS..... and kling to a great scrub they will show you the ins and outs of where things are located. Follow another nurse in the OR and if your not in a case get in one and watch. You will be surprised when you pick up things. 4 yrs later look at me I scrub hearts, brains,backs,knees,hips,guts. You name it I can scrub it circulate it or if need be Be the fairy god mother to it.
    Take a breath , take nothing personal, and take no crap.
    You will do fine.
    Zoe
  8. by   hollyxuk
    hi, I am pleased to read everyone elses experiences. I am a qualified nurse, with no experience in OR (or Theatres as we call it in england) and start a new job in a couple of weeks time. Its a challenge, very scary but exciting. The manager says it usually takes about 9 months to a year before you are fully competent. Its nice to hear other peoples experiences. Any advice on how to survive those first nerve racking shifts?
  9. by   Shevalove
    hollyxuk...I am a nervous wreck but extremely excited too!! Good luck!!
  10. by   Sarah, RNBScN
    Our facility offered 6 wk. mentorship with a seasoned OR nurse whom you worked with. If you required longer, they would give you what was need. Some places offer a min. of 6 months. Ask what your orientation includes and don't be afraid to ask for more if it is required.
  11. by   Heather_B
    Orientation in our hospital for scrubs is a 6-month period. After that 6 months, you're supposed to be ready to take call one night a week and every fourth weekend. (We have 5 scrubs and 5 circulators that take call.)
  12. by   rnmomof1
    Hi, I am new to this site as well as new to the Operating Room. I am 1month into my orientation and I too am very overwhelmed. I am told it takes at least 1 year to start to feel comfortable, but to build a tough skin when doctors become impatient. My nursing history has been 8 years of OB so this is all new to me. The hospital I am working gives a 20-25 week orientation.
  13. by   or man
    As a surgical services manager, I have a detail orientation plan for all new nurses and tech which include a orientation package which must be completed. There is no set time table for our nurses but most feel comfortable in about 6 to 9 months. Our circulator have some one with experience present at all time until they feel comfortable doing cases alone. As a nurse manager I must assure that our patient standard of care is never compromise, and to be quite honest anyone who has not gain a level of competence in the operating room should not be allow to circulate a room by themselves under any circumstances.
  14. by   KarenHalse
    I think it is interesting to read the replies to this question. When I was training in the OR I had to learn it with another nurse that was experienced. No classroom instruction at all. I did not learn to scrub and have never really wanted to either. I just don't care to stand in one place for long cases...I do believe you can be a good circulator if you pay attention to the field, learn what is happening, learn the instruments and the docs..
    One thing we had to do was keep a log of the cases we did. I think this is important because it will help you to know where you need more experience.
    I like most of the people here found the OR to be very stressful. I left it after 3 years and spent many yrs doing other things but now I am back and I will stay this time.

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