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)

[Rose_Queen, BSN, MSN, RN]

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...

Our rooms are typically set between 65 and 72 degrees- almost exclusively on the lower end of that. There are certain cases that we do set the temperature much higher, such as traumas and certain types of cardiac cases where the policy is 80 degrees.

We do have cooling vests available for use if we need them. They are basically front and back pouches that hold ice packs. We can switch out ice packs on breaks or between cases if need be.

I exclusively circulate now and do not scrub, so I don't have to worry about the gown. Usually, I'm huddled in the corner by my computer wearing a scrub jacket if I was lucky enough to snag one in the morning or wrapped in a blanket swiped from the warmer.

On those few occasions in the past where I did scrub in because the brown stuff hit the fan, I did get hot sometimes. I'd have the circulator undo the back of my gown for a bit and that would usually help. I didn't wear the cooling vests.

Also, how much are you standing in one spot?

As a circulator, I'm able to sit, walk around, and sometimes I'm out of the room getting extra supplies. I tend to put in around 10,000 steps on a normal day, around 7500 steps on a lighter day, and 25,000 steps on a crazy day.

The scrubs do tend to stand in one spot, but you can also move around a little bit- shifting weight from side to side, just taking a few steps at the sterile field. It also depends on the types of cases- since I'm cardiac, our cases are fairly long vs an ENT room that may have cases lasting 30 minutes or less.

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.

Nope, not ridiculous questions. Just one of the parts of the job that most people don't think about.

[Rose_Queen, BSN, MSN, RN]

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?

How physically demanding the job is depends on the types of surgeries and the case load the hospital does, as well as scrubbing vs circulating. I do spend a fair amount of time sitting since my cases are longer. Other specialties have a lot of cases squeezed into their day and are making multiple trips between preop, OR, and PACU. The scrubs are on their feet for a fair amount of time and can be holding retractors or doing other things in the surgical incision. I can tell you that the first few times I scrubbed, my arms were shaking from holding retractors for so long.

[Rose_Queen, BSN, MSN, RN]

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

There are travel OR nurses. My facility does not use them anymore. It's possible to do so, but I'm not very knowledgeable about it.

[Rose_Queen, BSN, MSN, 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?

My hardest adjustment was just transitioning from student to practicing nurse. It was a lot to learn- what supplies are kept where was something important to learn because of needing to run for supplies when things changed or emergencies happened. The OR is the only thing I know as a nurse.

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

My specialty team is tiny- there are only 12 of us. We've got some great teamwork going, we all help each other out when we aren't assigned to a case, we all help each other out with covering call. I love my coworkers.

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)

There's a post in here (second page maybe? oops- it's post #29) where I posted a link to some of the previous threads about qualities of OR nurses/circulators. That'll help with what kinds of qualities/personalities we all have and look for in coworkers.

[Spiker, ASN, RN, EMT-P]

As an evening shift OR nurse, our staff was more limited, therefore, besides being a Paramedic (& comfortable running codes) I was ACLS, PALS, & ATLS certified. My surgeons& anesthesiologists knew this, & could count on me to automatically manage a code. It was often me telling the surgeon to pack the abdomen & start compressions, while I got another IV started, got PACU to bring the crash cart, called for blood, etc. Most OR codes are handled internally; we never pushed the code button unless nobody from PACU could help. As the OR RN, be sure everyone knows their roles, to insure maximum functionality & response in a code situation.

[Rose_Queen, BSN, MSN, RN]

Whew! You guys were full of questions this evening!

But keep 'em coming- I love sharing my role as an OR nurse.

[Rose_Queen, BSN, MSN, RN]

Most OR codes are handled internally; we never pushed the code button

We don't even have code buttons. All of our codes are handled by our own staff. The only thing we have outsiders involved in is a massive transfusion event. Then, we get help from the blood bank with transporters and if needed another nurse whose sole role is to manage the rapid infuser.

[springchick1, ADN, 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?

We do peer interviews where I work. It's where the pull 4-5 staff members to ask you questions but in return, you get to ask questions of us. We are typically very honest when questions are asked. All of our applicants who make it this far in the interview process also spend time shadowing.

[whutch72]

Ha! Im

[whutch72]

Ha! I'm a travel nurse too! (dread having to take a staff position to change specialties! lol)

[Spiker, ASN, RN, EMT-P]

Tomascz, I started as a GN on a strictly Surgical floor, back before the days of Same Day Surgery & Ambulatory Surgery Centers. We had patients come in the day prior for pre-op care, & of course stayed postoperatively for several days, depending on the surgical procedure. I had a great rapport with the surgeons this way, & learned all I could to properly & efficiently care for my patients. I took ACLS right away, & kept current. These days the patients who are hospitalized after surgery are more acutely ill; the same-day concept has made it that way, along with the insurance companies. Try to get into a job that has anything to do with the Operating Room; get to know the surgeons. "Alexanders Care of the Patient in Surgery" is a great resource book to learn a wealth of preoperative information. Getting your hands on AORN standards of care manuals is also helpful. OR's usually keep some on hand. As you go about your day-to-day care of your patients, take notes. Learn about various lines, drains, pain management, etc. We all learn something new everyday. Apply for OR positions as they come open. You may not get the first one you apply for, sometimes they get filled internally. But keep trying, you'll be gaining more experience as you go. Also, maybe you'll become friends with some of the staff; sit with them in the cafeteria, ask questions. We love to talk about our passion for surgery! You'll learn a lot that way. And when you do finally get your dream job in the OR, be assured you will be well-mentored, starting with basic concepts, then the procedures ranging from simple to complex. It takes at least a year to feel comfortable with everything. Before you know it, you'll be running a room, taking call, planning, prioritizing, organizing along with the best of us! Good luck!

[MereSanity]

I'm currently a travel nurse in the OR! Love it and get paid really well because it is such a specialized area.

MereSanity BSN, RN, CNOR