Do OR nurses do any type of patient care?

[MikeyJ, RN]

I have had to do a few rotations in the OR (I am a nursing student) and I realized something today -- the nurses I have observed do almost NO patient care. The only time they did patient care was when they transported the patient to the OR and when they then transported the patient to the PACU. Otherwise they helped setup the OR, did a ton of charting, helped with technological issues during the surgery, and a few other odds and ends.

Is that typical of an OR nurse?

[GadgetRN71, ASN, RN]

We do patient care, although sometimes it is different than what a floor nurse would do. We do assesments of patients, put in foleys, prep the skin, do some patient teaching pre-op in some cases, mix meds, etc. Things that would maybe not seem to you like patient care would actually have great repurcussions if done poorly. Examples of this would be counts, time-outs, proper positioning of patients(you can cause nerve damage if the patient isn't positioned right) and making sure the patient's skin integrity is maintained, as well as sterility of the case. If it looks very easy, rest assured that you had a very skillful, competent circulator in that room.

I've seen OR nurses start IV's in the rooms if the anesthesiologist/CRNA needs an alternate one started. I've hung blood in the holding unit and participated in codes. Perhaps our biggest job is that of patient advocate-there may very well be times when you have to butt heads with the surgeon or anesthesia because proper protocols aren't being followed. That patient is helpless so advocating for them is patient care, IMHO.

Of course, we get our fair share of Code Browns in the OR too. That seems to be a universal thing in nursing.

[maeyken]

Well said!!

[brewerpaul]

Yeah, what Witchy said..

In our OR, RNs also do conscious sedation on local anesthetic cases including close monitoring of vitals. Even on local cases without CS, the RNs monitor vitals since there's no anesthesiology personnel to do it.

A good, observant circulator also monitors the sterile field for breaks in techniques-- I'm still a 6 month newbie, but I've already stopped Docs and techs when I've seen them break.

Circulators must learn all about properly moving and positioning patients, both to make the surgery easier for the surgeons and also to make it safer for the patient: limiting skin breakdown, reducing the risk of aspiration etc.

No, you're not handing out meds, taking vitals regularly, etc but make no mistake :circulating is most definitely nursing!

[sharann, BSN, RN]

I work in a PACU and while for a long while I thought the same, that OR nurses didn't do patient care. They do. They watch every move in the OR to protect the patient from harm. This is nursing, this is patient care. The OR nurses also do alot of technical things that other nurses rarely do. They setup a-lines. foleys as mentioned before, sterile techniche, and they lift heavy equipment all day long so the patient can get surgery. They work hard! There are many types of nursing care. Look at case managers who arrange miracles without physically touching a patient.

[TracyB,RN, RN]

Things may seem quite technical, but it is considered patient care. Everything in that room revolves around the patient, who is usually unconscious. We are the eyes, ears, and advocate for that patient, regardless of how much "care" you may or may not have seen. Most of our work is done behind the scenes.

When you get another opportunity to observe, pay special attention to the patient interview, the assessment, the chart review, etc etc... As OR nurses, we have honed our assessment skills. We have to. We have so little time with our patients while they are awake & they are literally putting their lives in our hands. We don't have time to review the chart at a whim. It needs to be done before that patient rolls back to surgery.

What you perceive to be a a lack of care, is actually a very well planned and orchestrated nurse - patient encounter.

If you are talking about things like foleys, iv's... you probably just observed some really short cases. We don't routinely insert a foley for a 1 hr surgery.... that's reserved for longer cases, total joint cases, or trauma patients (just a few examples & not an all-inclusive list.) Of course, things vary from case-case, or surgeon preference...IV's are usually by anesthesia...

Look a bit harder & you'll see what you missed...

[MikeyJ, RN]

Thanks for all of the replies! And I hope I didn't make it sound like it looked easy to me, because it didn't. The OR nurses I was with ran their butts off, but didn't understand how it was really patient care. However, I now see how patient care is involved.

Thanks! :)