Is OR Nursing always difficult???


Hello everyone. Im a recent nursing graduate and just passed my NCLEX 2 months ago. I landed an OR job at an Ambulatory unit in NYC and not sure if Im just retarded or how fast Im supposed to grasp things.. Ive been there for 2 weeks now..although Im getting the hang of things such as paper work, certain procedures etc I feel like there is so much things to learn and wonder how I am ever gonna adjust to everything and remember all the doctors preferences, medications for certain surgeris and so on. :( Yesterday we did Arthroscopy(first time for me) with a Dr Ive never worked with, and i was so confused on how to deal with the machine set up, tubing set ups and medications

My manager and two Surgeons said that Im learning fast, but I still feel incompetent. This is very different from things I learned from nursing school. I actually enjoy surgeries and OR work but Im afraid if I can ever get the hang of it or does it take longer than a few weeks to know it all??


267 Posts

Don't worry too much. There is a reason that orientation to the OR is so long- because it is a whole new world with so much to learn. If your manager says you are fine then believe her/him!

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Rose_Queen, BSN, MSN, RN

6 Articles; 11,345 Posts

Specializes in OR, Nursing Professional Development. Has 18 years experience.

It absolutely takes longer than a few weeks to learn it all! The general consensus is that it will take a full year to feel comfortable in the OR, but believe me, even after a decade I have days where it feels like I'm back at square one: new technology (such as robots) and new procedures are introduced, and everyone is learning from the ground up.

However, there are some small things that you can do to help, and this is one of my responses to someone who was feeling how you do:

I've been in the OR for 10 years, although I've switched specialty teams a few times during that career. Things that I found helpful:

1. Knowing what cases I would be on for the following day. This allowed me to get copies of the preference cards so that I could look them over at home (yep, that's right, at home- homework doesn't end with graduation).

2. Breaking the learning into chunks. This day, focusing on setting up the room. That day, focusing on prepping and positioning. Some other day, focusing on documentation. Much easier to absorb and retain when not getting so overwhelmed by trying to do everything.

3. Keeping a small notebook handy to write down useful/important information. My notebook for my current position (that I have so well memorized that I don't actually carry it around with me anymore) has a list of important phone numbers such as blood bank, PACU, service line coordinators, charge anesthesiologist, and so on. It also has a cheat sheet for how to order blood products and intraop lab tests (a necessity when changing from paper to EMR). And then there is a section for each surgeon I work with where I can write down little idiosyncrasies: preferred radio stations and things like that that wouldn't appear on the preference cards.

4. Understanding that OR nursing is a whole other ball game- school has very little exposure (typically a single observation day) and it's extremely different than working on a med surg floor or any other type of unit. There's a common saying that it takes a year to begin to feel comfortable working in the OR. Don't expect yourself to get everything right off the bat- it's going to take time and there is a steep learning curve.

5. Along with #4, understand that there are going to be good days and bad days. The bad days might be those where your patient doesn't make it off the table or those where just when it felt everything was clicking, it all feels like your first day again. Even us experienced nurses have those kinds of day: new equipment is purchased, new procedures are developed, and we have to learn from point zero how use/do everything.

6. There are a lot of instruments and suture used in surgery. You may want to look into some books, websites, or apps that have images of instruments, what they are used for, and any alternative names. It can be confusing when someone asks you for a kocher clamp when everyone else calls it an oschner. (Yep, 2 names for the same instrument- and that doesn't include surgeon pet names.)

7. Understand that when someone goes off, it's almost always at the situation and not directed at a single person. Surgery is routine to us, but it can still go real bad real quick. It's not uncommon to see a surgeon suddenly start using some impolite language (we have a few that could make a sailor/truck driver blush). Now, throwing instruments and directing personal tirades at staff is not okay, and a good management team will support their staff and ensure corrective action.

So take some time, look around the OR forums, and you will find a lot of tips to survive that "what did I get myself into" feeling.

Xaldin4life RN

141 Posts

Wow, Thanks everyone for the response. Your words of advice makes me feel better. I thought maybe I was doing something wrong, lol.

Junebug59, RN

217 Posts

Specializes in Main O.R. and CVOR. Has 43 years experience.

be careful using the word retarded.... i got my head literally chopped off here using that word. some people need to get a life. anyway good luck!!!


391 Posts

Specializes in ICU, PACU, OR. Has 37 years experience.

When you first start you are afraid of everything-experience makes you competent. You are a novice. Open your ears and eyes and learn what you appreciate in nursing practice and what you would not want to emulate. There are nurses today that would never be my role models, despite their years of experience-others I would still like to learn from.

The key to growing as an OR nurse is the learning. It never stops.

It takes a year or more to feel fully confident that you can be put in any case and perform well. Give it a chance.