Assessments of an OR Nurse

[Dempather, RN]

I'm currently an ER nurse with some experience on tele. I'm considering a shadow experience in the OR or an eventual change over. Can somebody explain some of the tasks one would experience throughout the day? Do you perform assessments (lung sounds, heart sounds, bowel sounds) as a scrub nurse or circulating nurse like you would on the floor? I'm assuming in a sterile env't, you wouldn't carry stethoscopes... yes? no?

My understanding is that you assist the surgeons with instruments, count supplies.... but I could be missing a lot ( I have a feeling that I am ) :) Thanks!

[linda2097]

....... Do you perform assessments (lung sounds, heart sounds, bowel sounds) as a scrub nurse or circulating nurse like you would on the floor? I'm assuming in a sterile env't, you wouldn't carry stethoscopes... yes? no?

We do none of those things, and we never use stethoscopes. Our assessments include interviewing the patient, studying their charts, and assessing skin condition.

OR nursing is very technical. It's like being a car mechanic except that we work on priceless human beings. There's a ton of things to learn in the OR. It's a lot harder than it looks.

[lilla_fjaril]

I'm training as a scrub nurse so here's a list of some of the things I've been learning:

-verify patient ID, allergies, and consent form

-Proper sterile scrub and gowning/gloving

-Learn enough about every procedure to be able to set up instruments that the surgeons will likely need in the order they will probably need them.

-Know the various names for all of the above instruments.

-Gown and glove the surgeons and residents

-perform counts w/ circulator

-Prepare sterile drapes and help drape the patient

-Stay ahead on supplies during the procedure so you have everything the surgeons need within arms reach

-Constantly, CONSTANTLY take the electrosurgical unit (Bovie) and put it back in the safety holder so the patient doesn't get burned and the drapes don't catch on fire

-Constantly, CONSTANTLY be on the lookout for sterile field breaks. A head hits the light cover, a med student bumps the back of a surgeon, etc.

-prepare drains and dressings

-load knife handles and suture

-retract, cut suture, assist the surgeon w/ minor procedures

-Label specimens

Circulators do a ton of stuff but off the top of my head they:

-adjust the bed for the patient and procedure

-check on the patient prior to procedure. make sure patient has no questions. assess patient's psychological state and try to help them stay calm.

-stay with patient during induction of anesthesia

-perform counts

-make sure 'time out' is done

-check ID/allergies/consent

-open sterile supplies

-prep the surgical site

-document during the procedure

-make sure everyone has everything they might need throughout the whole procedure. fetch footstools, gather additional supplies, adjust the radio, turn lights off and on, answer the phone, answer pagers, try and anticipate needs (which involves understanding the surgery) to stay ahead on supplies, control bovie settings, set-up and troubleshoot video/endoscopy equipment

-give status updates to patient family

-call PACU or the unit and give a patient report to receiving nurse

I'm sure others can add to this list :)

[#1rnstudent]

When I circulate, my lowest priority is the pager. I'm working in that room at that time, for that patient. Pagers distract me from my work. Unless it is the emergency/trauma pager, I don't usually answer it because I am too busy. There are always sufficient numbers of residents in teaching hospitals that the lowest in seniority can unscrub to answer it.