New OR Nurse Here

CIRQL8 · Apr 17, 2012

Congratulations!! I hope that you love it as much as I do. I would advise you of the following: Do not hold yourself to a high standard right out of the gate. There is a reason why the orientation period is so very long. There is A LOT to learn. There are dozens (if not hundreds) of procedures for you to learn ad well as dozens of surgeons who all perform the same procedure with some differences. There is a lot of technology to learn. Watch closely. See what is done the same way every time and build from there. A house is not built without a strong foundation. Get yourself a strong foundation. Speak up for yourself. If you feel that your preceptor is not teaching you well enough or if you do not get along with them, ask for a new one. Learn the basics of positioning. Learn the basics of electronics. Learn about grounding and electro cautery. Learn about suture and the differences. Take time to learn the instruments. Do not be satisfied knowing what everything is, know what it is used for, why and how. Well, I could go on FOREVER. I do not want to bore you. Just try not to get overwhelmed. It has been said that it takes 10,000 hours of doing one thing to become an expert at that thing. You will get more and more comfortable over time.

LovedRN, BSN, RN · Apr 18, 2012

Congrats!!! You are lucky. OR is hard to get in.

NP Sam · Apr 18, 2012

I too graduated in December and started my OR job just last month. Thanks for starting this thread so I can be helped also! Right now I am scrubbing and will be for at least six months before circulating.

Signorina, RN · Apr 21, 2012

I work as a scrub nurse in the OR too. I just started last month and it was really difficult for me because everything was so different from what I was used to. I made a lot of mistakes because i was always nervous. However, I am much more confident now and have scrubbed several times without supervision. Find someone who will put you through patiently. Congratulations!

lidleanjel · Apr 21, 2012

Not sure what your actual position in the OR will be but here is my view as a new graduate in the OR....

I have been in the OR as a Registered Nurse training to be a circulatory nurse for about a month. I think one of the first things to really understand is aspetic technique and the sterile field. Make sure you ask how to open items sterilely to the field because you will probably be helping "opening a case" and not necessarily do they remember you are new. Also if you are able to prepare yourself to what cases you will be in the next day do so, then you can at least look up the procedure and have idea of what they are doing and what complications there could be and sometimes figure out type of positioning will be used. So far for me, the surgical techs are very very information about sterile technique, how to open things, and what is going on. they also tend to have a little extra time then others at times. Always remember patient safety and it AlWAYS comes first. So after assessment before a case of the patient, the patient comes in and make them comfortable and safety belt them to the bed then help anestesiologist by hooking up patient to all monitors and helping anestesiologiest have items handed to them when needed for the intubation if needed, once the patient is asleep you are positioning and prepping the patient to the doctors request. Then its all about what the scrub team needs as a circulator until the patient is awaken and moved to PACU. When you have free time look at products and find out where things are located. I have also discovered anestesiologist typically really want to educate you, so you understand what they are doing and what they need from you. Do NOT be scared to ask questions.

Remember it will be very overwhelming at first and complete information overload. I have so much to learn in the next 7-11 months of my training, but I try to learn about as much as I can daily. And do not be offended or take anything personal when you are corrected and/or yelled out by fellow employees or if a doctor is going crazy over something.

A couple of good things to look at or books to read....

Perioperative Standards and Recommended Practices - (the bible of the OR)

Pocket Guide to the Operating Room

magazine - OR Nursing

I also have been trying to find a surgical tech willing to loan me some of their books to look at. I hear they have lots of helpful information.

Hope this helps a little. Its been pretty crazy for me. Kind of reminds me of nursing school because so much information is being thrown at you all at once.

betty67 · Apr 24, 2012

Thank you so much for your input! I wanted to be in the OR ever since my 1st semester of nursing school when I got to see an open heart surgery! I really love being in the OR so far! I have a great preceptor who is teaching me well. It is definitely a lot to learn. I will be concentrating on the Circulating Nurse role 1st then I will learn to scrub. I started with learning where everything is and picking for each case and then setting up the rooms. I am learning the equipment and how to use it as well. I just started today with learning the instruments so I know what they are for proper counts. I am doing all the time-outs and charting for our cases and learning how to multitask for the surgeries to keep things going smoothly. Everyone has been very welcoming in this OR. I met a lot of the staff when I did my mentorship which helps. I love being an OR Nurse!! :)

betty67 · Apr 24, 2012

I too graduated in December and started my OR job just last month. Thanks for starting this thread so I can be helped also! Right now I am scrubbing and will be for at least six months before circulating.

Hi Sam! Congratulations! I will be concentrating on the circulating role 1st then learning to scrub. How is scrubbing going? I will be really nervous when I get to that part.

betty67 · Apr 24, 2012

Not sure what your actual position in the OR will be but here is my view as a new graduate in the OR....
I have been in the OR as a Registered Nurse training to be a circulatory nurse for about a month. I think one of the first things to really understand is aspetic technique and the sterile field. Make sure you ask how to open items sterilely to the field because you will probably be helping "opening a case" and not necessarily do they remember you are new. Also if you are able to prepare yourself to what cases you will be in the next day do so, then you can at least look up the procedure and have idea of what they are doing and what complications there could be and sometimes figure out type of positioning will be used. So far for me, the surgical techs are very very information about sterile technique, how to open things, and what is going on. they also tend to have a little extra time then others at times. Always remember patient safety and it AlWAYS comes first. So after assessment before a case of the patient, the patient comes in and make them comfortable and safety belt them to the bed then help anestesiologist by hooking up patient to all monitors and helping anestesiologiest have items handed to them when needed for the intubation if needed, once the patient is asleep you are positioning and prepping the patient to the doctors request. Then its all about what the scrub team needs as a circulator until the patient is awaken and moved to PACU. When you have free time look at products and find out where things are located. I have also discovered anestesiologist typically really want to educate you, so you understand what they are doing and what they need from you. Do NOT be scared to ask questions.
Remember it will be very overwhelming at first and complete information overload. I have so much to learn in the next 7-11 months of my training, but I try to learn about as much as I can daily. And do not be offended or take anything personal when you are corrected and/or yelled out by fellow employees or if a doctor is going crazy over something.
A couple of good things to look at or books to read....
Perioperative Standards and Recommended Practices - (the bible of the OR)
Pocket Guide to the Operating Room
magazine - OR Nursing
I also have been trying to find a surgical tech willing to loan me some of their books to look at. I hear they have lots of helpful information.
Hope this helps a little. Its been pretty crazy for me. Kind of reminds me of nursing school because so much information is being thrown at you all at once.

Thanks for the tips and the books to get! :)

betty67 · Apr 24, 2012

Congratulations!! I hope that you love it as much as I do. I would advise you of the following: Do not hold yourself to a high standard right out of the gate. There is a reason why the orientation period is so very long. There is A LOT to learn. There are dozens (if not hundreds) of procedures for you to learn ad well as dozens of surgeons who all perform the same procedure with some differences. There is a lot of technology to learn. Watch closely. See what is done the same way every time and build from there. A house is not built without a strong foundation. Get yourself a strong foundation. Speak up for yourself. If you feel that your preceptor is not teaching you well enough or if you do not get along with them, ask for a new one. Learn the basics of positioning. Learn the basics of electronics. Learn about grounding and electro cautery. Learn about suture and the differences. Take time to learn the instruments. Do not be satisfied knowing what everything is, know what it is used for, why and how. Well, I could go on FOREVER. I do not want to bore you. Just try not to get overwhelmed. It has been said that it takes 10,000 hours of doing one thing to become an expert at that thing. You will get more and more comfortable over time.

Thank you for all of your input! I do love it so far! I think I always will. I have been told that you either love it or you don't.

NP Sam · Apr 24, 2012

Scrubbing is going good. I have had to help circulate at times so I call myself a scrubulator. Before scrubbing in (unless I am doing a case by myself) I help with getting the patient situated in the room. I have SOOO much to learn. So far I can scrub some general cases by myself. I think my next area to learn will be ortho. I was terrified of scrubbing because when I scrubbed during school I got very lightheaded and almost hit the floor. That hasn't happened once since I started working. Maybe I am way too busy dancing or laughing at all the dirty jokes . The key (for me) to scrubbing is keeping your ears open at all times and watching the needles. Those needles move around the field fast. Please post periodically to let us know how you are doing! Us newbies gotta stick together:D

lidleanjel · Apr 27, 2012

I did the same thing is nursing school with getting lightheaded, but I think the difference is really remembering to breathe and you definiatedly have a different mind set when actually working in the OR.

Another tip resently realized. Make sure you listen to everything during a case. Keep open ears. Notice the sound of the monitors and recognize changes, listen to make sure suction is working or cautery machine is working. Listen for changes within the envionment such as one minute the surgeon is talking to scrub staff and everything gets quiet for more than a minute. Make sure to watch screens also because if all you see is a lot of red, there may be a problem.