Help me pick a surgery to observe!!

Sbhayes09, ADN, RN · May 31, 2018

Thank you guys for all your input! I probably should have explained better about the choices. We were given a sheet to choose our top three requests. There's no guarantee that we'll get what we choose if it's not available, but they will do everything in their power to make it happen. This is at a teaching hospital so from what I can tell, the surgeons and most of the surgical staff were very accommodating and helpful at orientation. Here's hoping for a positive experience and for my OR rotation to mirror our orientation. I think I'm going to go with neuro, cardiothoracic, and trauma for my top three. I hate a lot of you had bad OR rotation experiences, hopefully you still found your niche :).

springchick1, ADN, RN · May 31, 2018

Thank you guys for all your input! I probably should have explained better about the choices. We were given a sheet to choose our top three requests. There's no guarantee that we'll get what we choose if it's not available, but they will do everything in their power to make it happen. This is at a teaching hospital so from what I can tell, the surgeons and most of the surgical staff were very accommodating and helpful at orientation. Here's hoping for a positive experience and for my OR rotation to mirror our orientation. I think I'm going to go with neuro, cardiothoracic, and trauma for my top three. I hate a lot of you had bad OR rotation experiences, hopefully you still found your niche :).

I didn't have a bad experience in the OR, I work in the OR so I know what happens when we have students. Everything Rose said is 100% correct. Orientees, new staff, big cases etc. it can be very stressful having a student observer in the OR. Just remember, the quickest way to get thrown out of the OR is tontoich something blue.

That's great that you get to list what you want to try and see. We were just thrown into a room. I already was working in the OR awhile I was in nursing school. I had to jbserve a plastics case and it may have been the most boring thing I did in schoolí ½í¸†

AnnieOaklyRN, BSN, RN, EMT-P · May 31, 2018

Honestly pick what interests YOU, we don't know what that is, only you do!! As another poster eluded to you really cannot see much of anything because there are to many people around the patient! I found OR time so boring, except for my medic when I got to intubate them and stand at the head with anesthesia if I chose to and observe from there where you could actually somewhat see.

Annie

ventmommy · May 31, 2018

Put what you are most interested in!! It could be an awesome experience!! When I was in RT school, an open heart was mandatory. I ended up going to a CABGx3, a total knee, a CABGx2 with valve replacement, a trach and PEG, and an open G-J. I got to intubate for two of them and I was at the head for most of them with a great view. The surgeon is the one that makes or breaks the vibe in the room. My hospital knows that I am super interested in seeing an organ harvest so I am hopeful that I will get to see that at some point.

That Guy, BSN, RN, EMT-B · May 31, 2018

CABG. I was able to see one as a student, standing on a stool over the pts head looking in to the chest the entire time while the CT surgeon explained what was going on. My legs/back/neck were killing me after those 5 hours but it sparked my love for all things cardiac.

Or if you are super lucky you could get trauma surgery. Old hospital I worked at would take their sickest trauma cases straight from the field to a special surgery suite. I had students with me who would see traumatic leg amputations/partial that we would finish, emergent splenectomy, open abdomens, cracked chests, etc etc. Just go with an open mind and dont be afraid to ask what the nurses think would be cool for you to see.

SC_RNDude · May 31, 2018

CABG. I was able to see one as a student, standing on a stool over the pts head looking in to the chest the entire time while the CT surgeon explained what was going on. My legs/back/neck were killing me after those 5 hours but it sparked my love for all things cardiac.
Or if you are super lucky you could get trauma surgery. Old hospital I worked at would take their sickest trauma cases straight from the field to a special surgery suite. I had students with me who would see traumatic leg amputations/partial that we would finish, emergent splenectomy, open abdomens, cracked chests, etc etc. Just go with an open mind and dont be afraid to ask what the nurses think would be cool for you to see.

I agree with all above. I would add that knee replacements are pretty cool, too. A lot of surgeries you can't see a whole lot as an observer, but with the knees there is a lot going on and an observer can see it all pretty well.

annabanana2 · May 31, 2018

As a student I got to observe a total knee and total hip. Both were very, very cool to see as a student. They let me scrub in for the knee and hold something in place (I can't remember exactly what) and help close the incision even. I was very lucky that the surgeon was perpetually thrilled to have students in the OR (the resident a bit less so, but we can't have it all). So far I haven't ended up in the OR but it did open my mind a little bit as prior to that experience I would never have even considered it.

Kooky Korky, BSN, RN · May 31, 2018

Usually you can't see much unless you are scrubbed in or standing at the head of the table with Anesthesia. Even then, hard to see.

How about a nice hemorrhoidectomy? lady partsl hysterectomy? Brain surgery? Hand surgery? Or, as others have suggested, a knee or hip?

Something that's not down in the pelvis, abdomen, or chest. Eye, bronchoscopy might be good as far as being able to see anything.

The OR is where you really learn to appreciate sterile technique, cardiorespiratory care, and the reason patients have post-op pain.

Eat before you go, especially if the case will be longer than an hour or so.

Stay out of everyone's way and don't touch anything, say anything, do anything, or even think about these things.

The start of a case is extremely busy, so is the end. A circulator might be working more than 1 room, God forbid.

A lot of very strong personalities work in the OR. Expect them to be cranky. Sorry to generalize, that's just been my experience.

There are also plenty who enjoy students and teaching. Just don't be surprised if you run into the opposite.

Be sure to express gratitude for your experience.

guest940422 · May 31, 2018

Little known fact... you can crash the OR just about any time you want once you are a nurse (on your day off) just by asking the surgeon if they mind you observing their operation and sending out some emails. Any time I've changed units and they've have a particular operation they specialize in, i've made this request stating I am interested in observing to take what I learn back with me and apply it to my post op bedside care. I have never been turned down.

Don't feel like this is your last chance ever to get in the OR without being hired.

That being said, the same idea stands for clinicals. If you are interested in being a peds nurse go to pedi OR... no matter what you see, you'll have a better understanding of what the patient went through before the PACU dropped them off and what complications you should be looking for.

I wouldn't go to GYN unless the hospital in question does some really out there procedures.... you're going to see c-sections and tubals in your ob-gyn rotation so don't waist your OR rotation on that.

Think about what your hospital specializes in, trauma, burns, plastics, cardiothoracic are all great... but if you are at a regional hospital they might not have any cases for you to see. If you are at a level 1 trauma center in a major city... trauma and burns will be popping. If you are in a private for profite hospital in a high socio-economical community, you'll get vascular, cv, ent, robotics, and ortho. If the hospital has a 12 bed pedi unit and a 4 bed picu don't waist your time with peds unless they have a strong day surgery program.

You're only going to be able to get out of the hospital what they have to offer. Also don't be afraid to ask to see another interesting case happening down the hall on clinical day even if you weren't assigned to it. Just be polite. The worse thing that will happen is they'll say no.

.... and don't touch anything blue

BlueShoes12, BSN, RN · May 31, 2018

Definitely cardiothoracic! When I was in nursing school, I got to watch an aortic valve replacement and removal of a benign mass from someone's lung - it was fascinating. I stood on a stool right behind the patient's head for the whole 3-hour procedure and had a great view. The PA and surgeon explained exactly what they were doing and pointed out specific anatomical landmarks. Great experience for someone who landed in a step-down ICU where we get a lot of post-op patients with complications - makes you understand why patients hurt so much after surgery!

Rainbow_RN, BSN, RN · May 31, 2018

The first surgery that I saw was a spinal I&D. Interesting, but not the most interesting thing I've seen. I'd recommend everybody to see a CABG or aortic root repair, but I'm partial to cardiac

FurBabyMom, MSN, RN · May 31, 2018

I work in the OR. I personally think it will be best to ask the educator or charge nurse (whomever is helping you) which room is the best room to observe in. Especially on your first day(s) until you get a better feel for what is going on. I'm not sure how much exposure you'll have to the OR because I'm unfamiliar with your "rotation". Like others have said - there could be issues with infection prevention, etc... We have patients on airborne precautions from time to time, and almost no students are fit tested for N-95 masks so if you chose neuro, and the neuro room is on airborne precautions, you probably won't get that option. Then again, other instances are patients on clinical trials (I work in an academic center). Some trials, staff unfamiliar with the protocol are not even allowed in the room - so students would be a no go either.

We often have students and observers of all kinds. It's great, we love it. But sometimes are not good times for students. Some providers (anesthesia or surgery) are not good teachers and/or are not "great" with new people. I work in a level 1 trauma center - and I have had orientees and observers with me when I've either had cases not going well or gotten the definition of an emergent case. I've had to move observers to other rooms before, or ask them (or even staff early on in their orientation) to hang out on the periphery of the room because of the situation before.

Even the best teachers (surgeon, anesthesia, staff - whatever role), the most patient and clear communicators do not always handle things not going well in an optimal manner. And that's okay - but sometimes it's just not optimal for new or extra folks. I'm not advocating hostile workplaces, just saying that sometimes one person in the room is not at their "absolute best" and an extra person may not be the best option. Totally different if the person is ALWAYS or consistently like that. Our educators and managers always ask the staff in the room if it's appropriate for an additional observer to be in the room. Our managers and educators know the surgeons and staff, but they may not know what's been going on in a room if we're placing someone to observe after first cases have went back and started (generally this happens with nursing, OT, PT, speech, etc students).