Circulator AORN standards

Editorial Team / Admin · Jan 25

Circulator positions computer so that they can face the field. Documentation is only done when the sterile team is situated, and will be stopped at any point if the team needs something/the patient needs something. Not documenting at all during the case has only been done in crazy situations like traumas/life and death emergencies, and I've been known to scribble times on my pants leg to document when the patient is stabilized. However, when possible documentation, as in other areas of nursing, should be done as close to real time as possible as long as it doesn't affect patient care.

Remember that in the OR, the patient has an entire team taking care of them. Yes, the circulator needs to be attentive to the field, but there is a surgeon and a scrub person at minimum (usually more) who are part of the sterile field and also being attentive to needs. After all, on the floor, the nurse isn't constantly in all five patients' rooms monitoring without stop - there are times the circulator will need to leave the room (such as running specimens to lab/pathology, getting additional supplies that weren't anticipated because things change, etc.).

Abby Suh · Jun 26

There is a lot of mandatory checkboxes that are not booleans in the chart (meaning not a yes or no), that have to be checked in order to complete the chart (at least in Cerner), so I will go through in the beginning of the case after the timeout and check all those, I try to put my people in before the case but time doesn't always permit. After that, generally you're just adding times, specimens, implants, tissues, etc. so like things that should take you 1-2 minutes tops to throw in, if it's a time, it's one mouse click. I always look up the next one and see what paperwork is uploaded, again, like 1-2 minutes tops. Where I worked our computers did face away from the field, it was on a counter and no way to move it, because of that I never sat when I charted, if I sat it was because the case was hours and I was sitting and facing them. Generally all I need to finish is the handoff to PACU after and that was usually entering a name and a couple drop downs. Then I would start the process again, making sure stuff was in, throwing people in, go through the door to holding, get meds, then out the back door there to the ORs. Personally I did not interview the patient until before I rolled but this was a common practice in ortho where I worked because they were cut throat on turnovers, so it was always open, check vendor trays, interview and get the patient. In other service lines I would interview on my way back from PACU because they often wanted you to get them up to void and there's no vendor trays.

This practice is probably frowned upon in multiple ways (technically some pre-charting) but I stay ahead and attentive, like my goal is to not be buried in the paperwork. I have scrubbed with nurses like that and it's really difficult, to the point the case is finished and I just need to help them out because they're drowning, and then they disappear in the PACU, when we're opening for the next one because they still have their specimen (that I ended up grabbing a specimen cup and putting it in for them) and they haven't entered it into the computer, or took it to the path room, cannot count because they're nose deep in the chart. REALLY BAD.

I guess I should preface when I say 1-2 minutes tops entering things in... I type like 80 WPM. I see some nurses hunting and pecking slowly and not using some shortcuts.

Where I work now is paper charting... pretty god awful with no way to get ahead either.