Got in, now more ?'s!!

MissJoRN, RN · Jan 14, 2006

1- (the easier question) I love my crocs in the OR, I went through "Dusty Klogs" very comfy but too heavy and not to easy to run in and a New Balance shoe that I liked OK. I think there will always be some discomfort with scrubbing a long case no matter the shoe. I try to take a few extra steps to "walk" around my little area (you'll see what I mean) and have a step stool available just to prop one leg or the other on... sometimes it's next to me, sometimes I kick it behind me. Sometimes I do little leg exercises (almost like ballet class from my elementary days, LOL) to stretch my legs and back and that helps (just don't kick the surgeon!)

2- sometimes I want to say prepare to feel stupid, it's a little extreme but trying to learn to be an OR nurse is a long process. Everyone says it takes 2 years to feel comfortable... not reasssuring when you know you'll be on-call in 6 months, LOL. As a "quick learner" I'm sure you'll "get it" just remember to be easy on yourself! There are times as a circulator that involve quick bursts of activity- several things need to be done... all at once. You'll get a nice little routine going eventually, it takes time, and 4 years later I sometimes forget dumb things the difference is now I've learned to laugh it off! Rest assured that no matter how "slow" you are there is a slower experienced person, I really learned to respect myself when I came off orientation and had the chance to really observe someother people and see that a lot f my problem was being to hard on myself! (I still am, of course but I have perspective now) This seems minor, but one area that is troublesome in my OR is getting used to finding supplies. On the floor, it's easy... even in a new unit you pick it up fairly quickly, right?

In the OR, there are so many many types of supplies used... some general, some very specialized and it's hard to remember- is that kept in the room, was it restocked last time? Supply room, which rack, which bin? Do I have to call central? Besides on the floor I never had a surgeon make a last minute decision that he wanted to item now, or had something suddenly contaminated! Some ORs have runners who will be a great asset. Take down time to look things over, and if practical in your OR, volunteer to check stock, put away supplies, do the weekly dusting... anything that gets you more familiar with where things are kept and what's available.

I really appreciated that I had nursing experience before I came to the OR, not that I "needed" the experience, but because on a bad day I still knew that whatever went on in the OR I was still a good nurse. I had that basic confidence. I knew if I failed as an OR nurse (of course I didn't!) I was still a nurse, a good one, and that couldn't change. Taking a few prn shifts on my old floor (and helping students or new nurses there) really helped keep everything in perspective!!

Nothing is meant to worry or frighten you! You have so much interest and are already so keen to learn that I expect you'll do well! I just hate seeing a new, intelligent nurse get down because he or she thinks she's the first person to be "slow" or "forgetfull" !! Have fun!!:balloons:

NoCrumping · Jan 15, 2006

MissJo, thank you!!!

I, too, have a thing about being hard on myself, but I made an "agreement " with myself to be patient.I know OR is a dynamic place, and I will only hinder my success if I bog myself down with being too hard on myself.....I come from NICU, and thats a whole other story!!! I am "used to" working under stressful environments (as premies are trying to die every 20 min or so, maybe more!!!), so I can only hope this is a benefit to me. I just really want to be good at what I do, as everyone does I am sure.

Thanks again, you'll be hearing from me again, no doubt... I love this place....

Marie_LPN, RN, LPN, RN · Jan 15, 2006

Hello.
I will be starting orientation in the OR soon...(thanks to everyone who previously answered my "common questions")
I have another, 2 actually!!!
1) whats the best shoe? I am leaning toward "Crocs", but I know everyone says they are comfortable, but do they give proper support to prevent your back and legs from aching? I had birkies b4,they were mediocre, and danskos, which made me always twist my ankle, just standing, so I am in need of recommendations!!!
2)I know OR nursing is fast paced, and I also know it is hard for a preceptor to be doing her job, in that environment, and also be teaching you at the same time. I basically learn quick, but my question is, will it be different this time? Is it harder than most areas to learn because of this?(being so fast paced) Be honest!!! I want to know what I will be dealing with..
Thank you again, guys!!!:kiss

Shoes are up to the individual. You'll have to try a few before you find what you like, but i WOULD suggest trying out a pair of used Danskos before purcahsing a new pair. Some people complained that their heel would roll in them, and at least you can wear the used ones at work, and if you find out you don't like them, then you didn't lose much money.

I do not recommend Birkies for the OR, way too peopel i work with had them and said they made them miserable.

I wear Crocs, with an extra arch support (any shoe i get i have to put extra arch support in), and my legs NEVER ache, and the arthritis in my feet hasn't create pain for months).

Bottom line, in whatever shoe you get, make sure it has a grip to the floor. The floor can get messy.

Also consider getting support stockings. I have thigh-high ones (my thighs would hurt after 10 hourrs), and it's made SUCH a difference!

grimmy, RN · Jan 16, 2006

[color=darkslategray]as for the comment about preparing to feel stupid, well....yeah, that. i guarantee there will come a time, about 3-6 months into the internship when you will say "what did i get myself into?" sometimes you'll be offered a break (if you're lucky and well-supported) and i hope you will find a space to really take a break. don't turn one down. not at that stage.

very little about the or is intuitive. as a circulator, prioritization is key, and it takes a long time to get it down. as a scrub, timing and knowing the procedure is key, and that takes almost as long a time to understand. some cases will feel like you have lost your timing, your hearing, and equilibrium. give yourself a break, and allow yourself to be a learner. no one has ever learned it overnight. some surgeons will make you feel like you should, but most have never been a nurse, and fewer still will admit to ever having been a resident! my biggest piece of advice - don't ever lie. don't ever say that you know something when you don't. be honest, say "i don't know." you will learn, but it won't be at the expense of a pt's life or well-being. ask for help when you're in over your head.

you're going to do fine. practice stress-management techniques and take care of yourself. make your home-quality time count. when you need a day off, take it. when it comes, you'll know. then you'll start to schedule regular time off - it's important to do it.

ORSmurf · Jan 16, 2006

I was a scrub/LVN for 8 years and got my RN May '05. I started orienting to circulate in June... and I'm still learning! I knew there would be a lot to learn and it would take time, but I am at the point of wondering if I should have done some Med/Surg first. I love the OR - everything about it - the teamwork, the fast pace, the technology... but it is pretty frustrating to try to feel like I don't know what I'm doing so much of time. One thing I've found helpful, is keeping a journal during the orientation. I write down specifics to each Surgeon and Anesthesiologist, set-up hints and stuff like that. The tough part, is actually finding time to write stuff down! The cases that I really could use a lot of notes for, I'm too busy to stop and write things down - just take a few minutes when you can to jot stuff down. I've gone back to those notes so many times. Of course, things change quickly and just because they wanted it one way before, doesn't mean they'll want it that way next time.

I agree with all the advice to be patient with yourself and be good to yourself in your off time. Get a massage once a month if you can - maybe get a pedicure once in a while (especially when you're learning to scrub).

Good luck :)

Christine

P.S. I'm pretty much on my own already, but "feel" like I'm still orienting since I still feel unsure much of the time.

Marie_LPN, RN, LPN, RN · Jan 16, 2006

I agree, take any and every opportunity to write stuff down.

I even took one of those white paper towels and wrote stuff down with the surgical marker while setting a case up, and threw the towel on a non-sterile table for later (all clean of course).

MissJoRN, RN · Jan 17, 2006

I forgot about keeping notes! I did a similar thing as in nursing school- I kept my notes on file cards which I sorted in a (almost pocket-sized) coupon organizer.There was a section for each specialty- I think I color coded them too- red vasculcr, pink OBGYN, yellow urology/renal. Sometimes I only got a few notes down, othertimes I filled more than one card but they were specific to Dr and case- a "map" of my mayo, preferred type of forcep, etc, where the monitors go, positioning tips, anything I learned that wasn't on the "official" OR preference card. I also had one section for general equipment tips- how to set up the neuro stealth, fx table, settings for insufflation, anything! Good idea, ORSmurf!

NoCrumping · Jan 18, 2006

smurf, missjo, marie,

thanks..... I am "kiind of" a new grad, as in I have not worked the whole 3 years I have been out of school (and when I did , it was in NICU), so I am kind of "accustomed" to feeling stupid most of the time!!!!

I was just so worried that I will be a bumbling idiot in there with the whole team pissed at me, and me knowing there is someones life on that table depending on my NOT being a bumbling idiot!!!

I am prepared to have patience......and to come here for advice, etc...

We are in "nursing orientation" , in a classroom, for 2 weeks, but my official OR orientation starts beg. of FEB. :rolleyes:

nubes · Jan 18, 2006

Guys, when I have read your responses I remembered why I love OR nursing!!

I've been in OR 1 year and half now, Ortho theatres exclusively except when I'm on call. I came right after training, but had a little experience of agency under my belt. Altho it was only being in charge of an elderly's home, it did a lot towards boosting my confidence, and makes me know that I am a good nurse in spite of team members sometimes making you feel ignorant.

I'm beginning to feel more confident now and ready to explore other specialities. Sometimes I would leave, but when it comes down to crunch time I love OR too much!!:rotfl::rotfl:

LadyT618, MSN, APRN, NP · Jan 18, 2006

Congrats Nocrump!!! I'll be starting an OR Nursing Residency Program beginning of March!! I'll be here a lot to get some more advice from our more experienced OR nurses here. I cannot wait!! I'll be leaving the CTU to go to the OR. "New grad" from June '05. Good Luck!!

NoCrumping · Jan 18, 2006

Congrats Nocrump!!! I'll be starting an OR Nursing Residency Program beginning of March!! I'll be here a lot to get some more advice from our more experienced OR nurses here. I cannot wait!! I'll be leaving the CTU to go to the OR. "New grad" from June '05. Good Luck!!

Congrats to you too LadyT!!! I can give you a heads up!!!

How long is your orientation?