Ask an OR nurse (Questions about what we do or how to become one of us)

[Rose_Queen]

I've gotten a couple of PMs from members asking about a job as an OR nurse. In the interests of sharing those questions with anyone interested in a career as an OR nurse, I thought I'd start a thread for those questions to be posted. I'll check in regularly and answer the ones I can, and I'm sure the other regulars here in the OR forum will share their knowledge as well.

So, what would you like to know about OR nursing?

Edited to add: Tips for new operating room nurses

Edited again to add: Soooo, you're observing in the operating room (O.R.)...

Edited yet again to add: What do Operating Room Nurses Do?

(I just keep refinding older threads that are good resources)

[Gottago]

Worked OR and PACU. Understand your bad image as glorified go-fear, and sometimes it is that, but there is often much more needing to be done, particularly in terms of setup that is not seen nor known by nurses who have not worked in the OR. I sometimes compare it to being a stage manager trying to gather all participants on the stage, and ensuring they have what is needed to be successful in their roles, along with the equipment, drugs, prep, drains (such as Foley,chest tube,etc.), and, if your facility still has one foot in the Stone Age, tons of paperwork, the OR nurse needs to fulfill their own duties. It's a team effort, but as an OR nurse, your focus is not strictly on performing your own duties to provide care for your patient, but also being aware of what your other team members need to provide care in terms of their role. It can be a huge juggling act with many needs needing to be met at once (then you feel like a short order cook being bombarded with several orders at one time from several different people).

When giving report to the PACU nurse, particularly in terms of vitals and meds given to maintain blood pressure,etc., the OR nurse is not the person to ask. I've had many PACU or ICU nurses ask why I did not know this information; or, what was the patient's heart rhythm, etc. Then have to explain, why those questions are best answered by anesthesia, and only have the eye roll, exasperated sigh, or more contemptuous response as a result.

Working PACU, for me, often is less stressful, UNLESS, as in any department, the patient starts crapping out. When I make the point of less stressful, I am meaning, my focus as a PACU nurse can be more concentrated, and I can give more undivided attention to my patient. We all have our role to play, and every job can have its good and bad.

[Spiker, ASN, RN, EMT-P]

Hit us with whatever you want to know! 33 years in the OR here!

[jdenni12]

What are some signs of an ill managed OR? For example, what questions can I ask in the interview phase, that will alarm me to run far away because the place is unsafe?

[Tomascz, ASN, RN]

I too have been shooting for an OR job. I applied for 4 different positions in and around the OR at one hospital last night as a new grad, hoping to land any position near the OR, hoping to up my long term chances of actually working in the OR. Where's the best place to start?

All I know is that I really have liked every chance I've had to work in the OR as a student (something about the structure and focus; I am ADD) but have no idea how to sell my worth (what to emphasize or avoid) to prospective coworkers/supervisors, specifically as relates to that environment. It would help if I knew ahead of time what they were looking for.

My critical thinking skills are good; I'm always willing to take the initiative but need training to know what to do with that (obviously); I keep my [stuff] together under fire without much effort (it's just a mode I drop into automatically); etc, etc.

Given my druthers I'd rather work my way in from least complicated to more intensely complicated (I prefer to build competency as I go as opposed to jumping in the deep end in the dark with my hands tied behind my back; not that I haven't done that, it's just not what I prefer). Anyway. I'm all ears.

Thank you for doing this too, BTW!

[Rose_Queen, BSN, MSN, RN]

What are some signs of an ill managed OR? For example, what questions can I ask in the interview phase, that will alarm me to run far away because the place is unsafe?

Well, I'm not sure that asking questions in an interview will reveal signs of an ill managed OR as the interviewer is going to put their best foot forward. However, I highly recommend asking for a day to shadow in the OR as part of the interview process. This can allow you to see how staff members interact with each other, how surgeons treat staff (do they throw instruments?), and other little insight into the culture of the OR.

[Rose_Queen, BSN, MSN, RN]

I too have been shooting for an OR job. I applied for 4 different positions in and around the OR at one hospital last night as a new grad, hoping to land any position near the OR, hoping to up my long term chances of actually working in the OR. Where's the best place to start?

All I know is that I really have liked every chance I've had to work in the OR as a student (something about the structure and focus; I am ADD) but have no idea how to sell my worth (what to emphasize or avoid) to prospective coworkers/supervisors, specifically as relates to that environment. It would help if I knew ahead of time what they were looking for.

There's a few traits that we look for in nurses as coworkers- not sure how it is at other facilities, but we have both management and regular staff participate in interviews.

This is one thread with links to 2 other threads that have what qualities some of us are looking for.

As for where to start, are you already employed as a nurse? If so, you may have access to internal applicant only job postings. You'll have already established an employment history with a facility. Other than that, look at facilities that offer periop residencies or structured orientation programs- they may only post jobs at certain times as the programs are scheduled. Other facilities may find themselves in need that they continuously run orientation programs.

Anyway. I'm all ears.

Thank you for doing this too, BTW!

Glad you're interested, and you're quite welcome.

[whutch72]

I've been an MS/T nurse for about 6 years. I've always been interested in OR but my concern is honestly being gowned up like I'm working in an isolation room for hours on end.

Honestly, how do you do it??

Is the room temp set to 20 degrees??

If I have on a mask and gown for 30 minutes I feel hot and sick like I'm going to pass out...

Is OR nursing something I could even consider?

Also, how much are you standing in one spot?

I would be hot from the cap, gown, and mask, locking my knees and dropping like a lead balloon..

My questions probably sound ridiculous, but these are honestly things that prevent me from even considering any sort of OR position.

[LadybirdRN]

Similar question as above. I'm 49 a med/surg tele nurse where we are often understaffed and frankly, it's hard on my body. I get off work and my back and left hip hurt. How physically demanding is the job?

[Nurse Leigh]

I've been an MS/T nurse for about 6 years. I've always been interested in OR but my concern is honestly being gowned up like I'm working in an isolation room for hours on end.

Honestly, how do you do it??

Is the room temp set to 20 degrees??

If I have on a mask and gown for 30 minutes I feel hot and sick like I'm going to pass out...

Is OR nursing something I could even consider?

Also, how much are you standing in one spot?

I would be hot from the cap, gown, and mask, locking my knees and dropping like a lead balloon..

My questions probably sound ridiculous, but these are honestly things that prevent me from even considering any sort of OR position.

I swear I could have written this post!

Also curious to know how well OR nursing fits in with travel nursing?

[pixiestudent2]

I've been an MS/T nurse for about 6 years. I've always been interested in OR but my concern is honestly being gowned up like I'm working in an isolation room for hours on end.

Honestly, how do you do it??

Is the room temp set to 20 degrees??

If I have on a mask and gown for 30 minutes I feel hot and sick like I'm going to pass out...

Is OR nursing something I could even consider?

Also, how much are you standing in one spot?

I would be hot from the cap, gown, and mask, locking my knees and dropping like a lead balloon..

My questions probably sound ridiculous, but these are honestly things that prevent me from even considering any sort of OR position.

OR circulators don't wear gowns. I'm always freezing. Just mask and a hat, and I find those don't contribute any warmth unfortunately haha.

Temp is set in the sixties.

[RatherBHiking, BSN, RN]

I was one that hated the OR! I thought I would like it and I did learn a lot but I don't ever want to work in one again. Yes the nurse does a lot of gofer type things but the pressure is on that nurse when the surgeon says whatever he's using isn't working and wants the nurse to go find something else. There's tons of different instruments, sutures, equipment, etc that the nurse is expected to know how it works and where it is quickly. It takes a long time to learn every surgical specialty.

The surgeons I worked with were extremely full of themselves and would yell if the wrong music was on, if the candy they liked wasn't there, or even if they messed up something in the surgery themselves. It was always someone else's fault. I understand the pressure they're under but throwing instruments across the room or cussing people out is not helpful to anyone. We usually had nurses crying every day-even the ones who had been there over 20 years. One new one had a nervous breakdown. The nurses and scub techs were really bad about talking smack about other behind their backs. I decided life was too short to deal with such a toxic environment all the time. Hopefully it's not like that everywhere. I wasn't willing to take a chance to find out.

The perks were we got a mid morning break, lunch break, free coffee and soda, and free snacks 99% of the time. We also got to leave early quite often which is good unless you need the money. In that case you could always pick up extra on call shifts. It was interesting to watch surgeries and it was nice to be their for your patient. You learned which surgeons were good and which to avoid if you ever needed surgery. Easy to deal with sleeping patients. Everyone worked as a team. Usually straight days and off on holidays except call. I think it could be a great place to work if it was in a supportive environment.

i don't miss the hats and masks although they came in handy on bad hair days!

[cracklingkraken, ASN, RN]

Thanks Rose for this thread! It's been very informative thus far. Question:

1. What was the hardest adjustment for you coming into the OR with no previous OR experience?

2. What is your favorite part(s) about the OR?

3. What kind of personalities fit well in the OR? (I tend to be more soft-spoken and reserved, but I make sure I know my stuff and I'm a quick learner)