Originally posted by teebutter
I am a nursing student right now and I am really interested in surgery and hope to be involved in it someday. I was just wondering what exactly OR nurses do. I appreciate any information you'd like to share. Thank you.
You will read and hear and learn about the many things we do; as you sort it all out, never forget this:
OUR PRIMARY ROLE IS THAT OF PATIENT ADVOCATE.
THE CIRCULATING RN IS IN CHARGE OF THE ROOM.
THIS DOES NOT MEAN THAT HIS/HER ROLE IS LIMITED TO ASSUMING RESPONSIBILITY FOR THE UNLICENSED PERSONNEL IN THE ROOM, ALTHOUGH THIS IS PART OF HIS OR HER ROLE.
I AM TYPING THIS IN CAPS (SHOUTING!!!) BECAUSE EVEN EXPERIENCED OR RNS TEND TO FORGET THIS.
There are, unfortunately, OR nurses who either by commission or omission--often because they don't want to make waves or be branded "troublemakers---" don't actively advocate for their patients--they will complain in the nurses' lounge about how they don't feel a case should have gone forward because of factor A, B, or C, causing or contributing to an unsafe patient care situation--but that is as far as it goes. The case proceeds regardless, with the nurse praying that nothing goes wrong.
In reality, as the nurse in charge of the room, the circulator should be actively taking whatever steps are necessary to ensure a safe patient care situation.
This may mean going head to head with the anesthesiologist and the surgeon--diplomatically, at least at first; we are, after all, a team--and stating that, until factor (or factors) A, B, C is in place that she will not circulate the case. (I will say "she" from now on just for the sake of convenience.)
She should not even bring the patient to the room when a patient care situation is suboptimal or downright unsafe.
She can go up the chain of command if her concerns fall on deaf ears at this level--that is, starting with the charge nurse at the desk, the OR manager, the chief of the service, the chief of anesthesia, the chief of surgery, the hospital administrator and risk management, the hospital ethics committee, and, of course, involving the patient and his family or other support sytem in the decision as to when, how, and WHETHER to proceed.
This, I think, is our role and responsibility in informed consent--not to obtain it; not to explain risks and alternatives--that is the joint responsibility of the surgeon and anesthesia---- but to let the patient know that the operating room scenario may enfold in a different manner than he has been led to believe--he has a right to know and a right to participate in the decision making as to how, when, or IF to proceed under the current conditions.
I think to allow a case to go forward under suboptimal patient care conditions without informing the patient of the full truth of the situation is abysmal, and in my opinion constitutes nursing negligence.
I would rather quit--or even be fired-- than to feel as if I am powerless to ensure quality care for my patient, or to feel as if I have to ask permission of "the desk" to "do the right thing."
Unfortunately, "the desk" is often under pressure to keep cases moving and to keep the surgeons--their moneymakers-- happy at any cost; even when it means sacrificing quality patient care.
Any operating room nurse in this discussion area can tell you his or her war stories about how quality patient care often comes secondary to keeping cases moving and surgeons happy, at least on the part of O.R. management.
Maybe you will become an O.R. nurse, and will go into the profession with your role as patient advocate deeply ingrained, because you were wise enough to ask about what our primary role is, and I suspect will listen. I commend you.
I would love for you to print this, as well as the other responses you get, out and bring them to your clinical group for what I am sure will be a lively discussion and an excellent learning experience.
Let us know your clinical instructor's thoughts, as well as those of your fellow student nurses.