Thinking about OR....

[Cinnamongirl]

Hi all!

I am a new grad orienting on a general surgical unit....it has so far been my plan to stay on the unit for a year or so to get some good base experience and move on. I've thought about oncology some, but recently have been thing ALOT about OR, pre-op, or PACU.

I have done some research on the internet as far as duties in the OR, but the information I have found hasn't really satisfied me.

Can someone clue me in to the duties for scrub/circulating, etc.

Also, do you like OR? Did you start out on a med/surg and move to OR, and was it a good choice?

Sorry for all the questions, but I am not really loving my job on med/surg, so it is helping me to think about places I can transfer!!!

THanks!

[lily_lover]

Can someone clue me in to the duties for scrub/circulating, etc.

Also, do you like OR? Did you start out on a med/surg and move to OR, and was it a good choice?

I'm a circulator in a fairly busy OR. I love it, and I've done nothing else but OR. I was never too crazy about the med-surg floor, and I think more and more OR managers are willing to train a new grad without the floor experience. I'll try to give you a rough sketch of what I do on a daily basis-keep in mind that this is in no way comprehensive!

I pick up the paperwork and surgeon preference cards, and head to my room. I usually try to check to make sure I have all the equipment I need, and then I call for report on the patient. After I get report, depending on the size of the case and the amount of supplies to be opened, I'll either send for the patient or open and then send. I do the counts, and make sure the scrub has saline, water, ect, whatever they need, as well as local or other drugs. When the pt. comes to the door, I introduce myself, check them in, and help them move to the table. I usually end up holding crichoid? pressure for anesthesia, and once they have the tube in, I can put the cautery pad on, clip the pt if need be, prep them, and do the "golden moment." After the surgeon is scrubbed in, I hook up whatever equipment needs to be running, and organize my suture, ect to have it handy if they call out for something they don't have on the table.I try to organize the room, call the family, fill out the chart, do the counts, label the specimen, ect. When the surgery is done, I wash the pt. off, transfer them to the cart or bed, take them to pacu, report off to the recovery nurse, pick up my next chart, and do it all over again! I know that I've missed some things, but this is just a rough overview of what an OR nurse does on a daily basis. Some surgeries are a real PITA, and some aren't bad. My favorite ones are the living donor kidney transplants. I do general surgery, so I do the gyn, urology, ENT, vascular, and the "gut" cases which include the bowel resections, hernias, and gallbladder/appendix removal. Hope this helps you, and don't be afraid to try the OR. Life's too short to be miserable, and nursing is hard enough work without being on a floor/unit you have no love for.

[Cinnamongirl]

thanks Lily, for taking the time to share what you do.

I've looked online, and alot of the job descriptions are really generic and don't go into much detail.

I am thinking that I will try to see if I can shadow someone in the OR in the next couple months.

THanks again!

[maeyken]

I think it's a great idea to try and shadow someone in the OR. It's hard to get a good idea of it without being in the environment. In some hospitals, nurses scrub as well as circulate. I like both roles- it gives variety! :)

In terms of scrubbing, you sometimes assist with opening stuff (depending on how big the case is), then you go scrub, get gowned and gloved, and start to get your tables set up. For a small plastics case this can take all of 2 minutes. For a large uro or gen surg case this can take a lot longer!! Basically you arrange your table based on the sort of surgery you are doing. Once you're organized, you count with the circulator. You gown and glove the surgical team as they come in, then assist with draping the patient. You hand up instruments and supplies as needed, and ask your circulator for anything you don't have that you need. Then you hand up some more instruments, take away ones they are not using (putting them back on your table)... (repeat, repeat, repeat...) You hand off the specimen when the surgeon says you can (especially if it is going for a frozen section). As they are closing, you count again with the circulator.

I love the OR. I started off on a med/surg GI floor, which was a great experience, but about a year into it I realized that this was not something I could see myself doing for the rest of my working life. I'd always considered OR but figured I should get some floor experience first, so I did. :) I think I learned a lot of valuable things from working on the floor, and I don't regret the experience, but I am definitely glad I am in the OR now.

Any more questions... just ask away! :)