Am I able to become an OR nurse?

idahostudent2011 · Jun 9, 2011

The first thing is take a step back and take a deep breath. The OR is a different beast. You are only a month into your orientation. There is a lot of stuff to remember, especially instrumentation. You will make mistakes, forget what you are doing in the middle of the case, contaminate sterile stuff accidently, even experenced nurses do that. Don't try to hurry, make sure every step is taken and don't let the doctors bug you. You still have a preceptor so pick her brain on how she puts the cases together and what she does to remember all the steps to the case. What you are going through is all a learning experence. Good luck!

canesdukegirl, BSN, RN · Jun 9, 2011

The OR is incredibly hard to learn. There are so many rules and all of them must be followed to the Nth degree. It is a lot to take in.

After my first month in the OR, I also felt like a total failure. My preceptor was not the most encouraging person, and made comments all the time that deflated any sort of self esteem that I had. She told me that she expected me to fail.

Review your Alexander's text and if you can get your hands on the Operating Room Technique text, take a look through that. You will find a plethora of information that can help you understand the rationale of procedures. It helped me a great deal.

Hang in there. You are not a failure. This is difficult stuff. It takes a while to learn it all.

rikomom · Jun 10, 2011

Thank you so much for sincere advice and encouragement, canesdukegirl and idahostudent2011. These comments made me so much encouragement.

Probably I took this job without checking enough to know about OR. I questioned myself why I needed to switch my position to such a new area.

I don't want to give up. I want to believe I can do this. Your words mean so much. I will try to take time to learn. I will utilize another 4 months of training as much as I can to get skills from others. I will review Alexander.

Maybe I will post again later whenever I need to cry or vent my feeling. I was so disappointed at myself the other day. Thank you and thank you for replying to me!!

canesdukegirl, BSN, RN · Jun 10, 2011

Please don't let disappointment in this first phase of your learning keep you from working in the OR. Have you ever heard of the phrase "Don't let one strike out keep you from playing the game"? This is very sound advice.

As I mentioned before, there is SO much to learn in the OR. If you keep at it and prepare yourself the night before the case by reading about the procedures you will be doing the next day, review the things that you learned during the last shift you worked, and go through your text to help you identify instrumentation, you will be better prepared. A good defense is a good offense. Meaning, the more you prepare, the more confident you will be when entering the OR at the beginning of your day.

I am sure that you are already aware that the preference cards are not always correct. It has always been a pet peeve of mine that preference cards are so difficult to change, because they are in essence our recipe for making a smooth case. When I first realized this, I started to keep a small palm sized notebook in my pocket to make notes regarding surgeon preferences. I divided the notebook out into services, then further divided the services into surgeons. I listed things out that would help me:

General Surgery Tab

Dr. O

7.5 Microptic and 8.0 Biogel gloves

Pager #

MD #

Lap Chole

Positioning: Regular bed, tuck right arm. SCDs and foley. Egg crate foam at heels.

Pharmacy: Lidocaine 1% plain mixed with 0.25% Bupivacaine with epi 1:200,000 in a 1:1 concentration, Omnipaque in the room in case of cholangiogram

NaCL for irrigation

Instruments: Major basket, Lap Chole basket, Endohemolock appliers, 10/30 scope, 5/30 scope, HD camera

Supplies: L-hook cautery, Endokittners, Pulse Lavage, Hassan trocar, three 5mm bladeless trocars, pneumoneedle

Additional notes: Likes towers at the head of the bed. Bovie footpedal to right of surgeon, step stool to left. Likes music. Call for next pt when surgeon takes specimen out.

You get the idea. These notes will provide you with a working knowledge that you understand. You can never go wrong if you make these notes during a case and then add them to your notebook later.

Hang in there honey. You will get it. Be patient with yourself, and be confident. Good luck to you!

Argo · Jun 10, 2011

just curious, why would he tuck the right arm on a lap chole? lol

NurseSnarky · Jun 10, 2011

I could have written your post too. And as others have written...it's not uncommon. The OR is difficult, but that's why there is a longer orientation and a preceptor by your side. I joked with my coworkers and docs that I was "on the list" (meaning not in a certain room/procedure because I was new and not always "getting it". Humor was my way to cope until I got up to speed.). I question myself as well and my confidence was PRETTY LOW there for awhile. My very supportive coworkers have just reminded me that I'm doing great...so I need to work on my confidence. Docs will have new people "removed" or ask them not to participate for various reasons and although I know it's hard not to, it's not personal. You just say, "okay, not today" and observe, do paperwork. :)

Editorial Team / Admin · Jun 11, 2011

just curious, why would he tuck the right arm on a lap chole? lol

Our surgeons do it for a couple of reasons- to facilitate c-arm access for IOC and if they should go open, there's space for someone to stand and hold a retractor. Some also tuck both arms for a lap appy.

Argo · Jun 11, 2011

Makes sense. Never seen anyone do that. Lap Appy I've seen left arm tuck for camera holder.

canesdukegirl, BSN, RN · Jun 11, 2011

Argo, this particular surgeon stands on the right of the patient, has his assistant on his right side and only uses one monitor-for every laparoscopic case. So we gotta make room for the whole party!

GadgetRN71, ASN, RN · Jun 13, 2011

OP, even seasoned OR nurses contaminate items. The important thing is that you know you contaminated it and that you speak up about it. That's called "surgical consciense". It means that everyone in the room needs to acknowledge their mistake and remedy it, rather than stay silent. It's for the good of the patient.

You're only 4 weeks in..this stuff will come to you. I know it's hard, but try to ignore the dirty looks. Some people forget what it's like to be new.

Good luck!!:)

Mr. & Mrs. RN · Jun 14, 2011

Yes, I second the notes. Make em for every case. Maybe ask your preceptor if she can do all the charting for a while so you can focus on learning the cases and writing yourself notes. If you've got the charting down, no need to keep practicing every case. Also, I would ask your preceptor to let you be a little more independent. I found that when they stood in the corner of the room with their mouths shut, or stood outside of the room, I became more confident in my abilities. I was able to tell myself that I got that case started all by myself. Go over the case with your preceptor before it starts. Tell the preceptor "I'm going to do X,Y, and Z....What am I forgetting?" Then ask what you could have done better after the case.

Most people will tell you it takes a good 2 years to feel like you know what you're doing. I'm almost to 2 years in the main OR and there's still a number of new things I learn every day I work.