What Do Operating Room Nurses Do? - page 2

I'm here to set the record straight. I am as much a RN as the next nurse and I do patient care. Operating Room Nurses assess, diagnose, plan, intervene, and evaluate their patients just like... Read More

  1. by   Jeffthenurse
    Thank you for a well written, informative, thorough article. I still feel however, that OR nurses are overqualified for the position. Any nurse would be overqualified. The patients are only in the OR for a short time, informed consent, NPO status, the chart, tests, have already been checked several times up on the unit, and "the nurse develops a rapport!!", yeah, for about 2 minutes! Most of the assessment part involves being a last second secretary. Diagnosis? The care plan has already been written up on the unit; education will be done on the unit----the patient isn't going to remember much about whatever you will teach them. ...."Holds the patient's hand to comfort them...", aaawww, you really need a BSN for that! I feel different about nurses in the recovery room. They're often Critical-Care nurses. I'm speaking from being a patient and from 33 years of nursing experience. It's just my opinion and I thank you again for your article.

    I plan to discuss this again on my radio show on an AM station in Philadelphia, PA in the future. I just never saw the need for a Registered Nurse in the operating room. Often, you're just a gofer.
  2. by   BethCNOR
    Jeff, I'm really glad that your surgery went well and that overqualified gofer that took care of you didn't have to do any work while you were under anesthesia. Where have you practiced your 33 yrs. of nursing? A radio show? Are you even practicing nursing?

    I am disappointed you don't feel there is a need for a registered nurse in the OR. Have you worked in the OR?

    Yes, I only have a short time to develop a rapport with my patients, but believe me, I do. I try to make them feel more at ease before they come to the room. I explain what will happen to them when they get to the OR. Yes, I only have one patient at a time, but that patient gets 100% of my attention. No, I don't need a BSN to hold a patient's hand, but I do need compassion, something that it sounds like you are quite lacking. The OR has its own care plan so it is NOT written on the floor. I cannot tell you how many times I have discovered discrepancies in consent, labs, and NPO status that should have been caught on the unit, but weren't.

    I agree, PACU nurses should be critical care nurses. Some are, some aren't.

    I appreciate your comment, but I do wholeheartedly disagree with you. It's just my opinion.
  3. by   AZ_LPN_8_26_13
    Quote from Jeffthenurse
    Thank you for a well written, informative, thorough article. I still feel however, that OR nurses are overqualified for the position. Any nurse would be overqualified. The patients are only in the OR for a short time, informed consent, NPO status, the chart, tests, have already been checked several times up on the unit, and "the nurse develops a rapport!!", yeah, for about 2 minutes! Most of the assessment part involves being a last second secretary. Diagnosis? The care plan has already been written up on the unit; education will be done on the unit----the patient isn't going to remember much about whatever you will teach them. ...."Holds the patient's hand to comfort them...", aaawww, you really need a BSN for that! I feel different about nurses in the recovery room. They're often Critical-Care nurses. I'm speaking from being a patient and from 33 years of nursing experience. It's just my opinion and I thank you again for your article.

    I plan to discuss this again on my radio show on an AM station in Philadelphia, PA in the future. I just never saw the need for a Registered Nurse in the operating room. Often, you're just a gofer.

    I disagree with just about everything you've written. From what I understand, when things go wrong, they can go wrong fast, and in an immediate life/death way. Nothing is guaranteed or assured. If I were a patient, I'd want those OR people to be the most "overqualified" people I could have (I dislike that term intensely - an HR hiring manager's "buzzword"). You make it sound like OR nurses are mere caretakers, and I don't buy it for a second. So you have a radio show eh? I avoid talk radio nowdays for many reasons - most of what they preach I'm not buying.......
  4. by   Jeffthenurse
    I have been practicing nursing for over 33 years as a staff nurse, nursing supervisor, nurse manager, educator, preceptor for new nurses and/or students, clinical instructor, and health care sales rep, and all of these jobs entailed more than holding someone's hand or fetching NSS or D5W for the doctor! And yes, I am practicing now as a home care nurse which also entails more thought and expertise and critical-thinking than talking to a patient for less than 2 minutes.
    I went into broadcasting so I can highlight nurses' expertise and put nursing into a good light for a change. I've had many nurses on the show in the past 6 months, talking about a variety of topics. I believe that nurses in the operating room just highlights doctors feelings that nurses are just handmaidens and can be pushed around. That contributes to the overall feeling in this country that nurses are insignificant. Look at the assault rates in emergency rooms and on med-surg units. Physical violence directed at nurses is on the rise. There are many reasons for it and one of them is that nurses aren't respected. Maybe if nursing was dominated by male nurses it would be different. Maybe we should take over! Then we'll trade----operating room staff will not be nurses and hospital administrators will be nurses. That's a good deal....maybe we should look into it.
  5. by   desertnurse222
    Oh, boy,are you gonna get it! You didn't seriously just play the gender card (in addition to insulting your peers! )Are you trolling or what?!!!
  6. by   Jeffthenurse
    No, I'm not trolling for anything. I've had this feeling about OR nurses for a long time and this site and Beth's article gave me an opportunity to voice my opinion. I'd rather see an educated, experienced nurse working in an area where she or he can use that education rather than in an area where anyone with only a high school education can do the job. Since I've never worked in an OR my perspective of the issue will be different from someone like Beth (the original poster). And I do have compassion for the patients. And yes, I have undergone surgery, and had my hand held by an OR nurse, and it was comforting. But it could have been done by an OR tech without an RN background.
  7. by   subee
    Worked in OR's for 30 years and cannot justify paying an RN for a technical job. When the feces hits the fan, anesthesia and surgeons make the calls - not the nurses. You don't have to have an RN education to be smart, competent and able to think on your feet (and improvising would be good too) - all qualities which go far in the OR and could be better taught in a 2 years framework dedicated to the sciences and skills exclusively needed in the OR. Its way to expensive for institutions to "break-in" RN's. New grads should be able to be up and running immediately because they've had student experience scrubbing and circulating in their college program. You say you assess skin color? What it is exactly that you DO about it - what is it that is uniquely nursing?- What is is that you can do that anesthesia or surgeon cant? What was the nursing board question that covered that uniquely nursing activity? RN's are simply the wrong people in the wrong place. Patients deserve people with an education totally dedicated to the OR.
  8. by   BethCNOR
    where do nursing students get scrub and circulating experience in the nursing programs? I want to recommend that school. Most get a day or 2 of observation. From your response, I take it you are a scrub tech and probably a good one. I thought I could do it all when I was a tech, too. My opinion=nope, couldn't.
  9. by   efy2178
    Quote from Jeffthenurse
    Thank you for a well written, informative, thorough article. I still feel however, that OR nurses are overqualified for the position. Any nurse would be overqualified. The patients are only in the OR for a short time, informed consent, NPO status, the chart, tests, have already been checked several times up on the unit, and "the nurse develops a rapport!!", yeah, for about 2 minutes! Most of the assessment part involves being a last second secretary. Diagnosis? The care plan has already been written up on the unit; education will be done on the unit----the patient isn't going to remember much about whatever you will teach them. ...."Holds the patient's hand to comfort them...", aaawww, you really need a BSN for that! I feel different about nurses in the recovery room. They're often Critical-Care nurses. I'm speaking from being a patient and from 33 years of nursing experience. It's just my opinion and I thank you again for your article.

    I plan to discuss this again on my radio show on an AM station in Philadelphia, PA in the future. I just never saw the need for a Registered Nurse in the operating room. Often, you're just a gofer.
    I think if you have not worked in the OR you would have that perspective. I did and then when working in the OR I realized just how much OR nurses do. I have been in the situation, more than once, when a surgeon wanted to do something a paitent had not consented for or they were taking questionable actions. A licensed professional is more likely to skillfully find a way to negotiate through these issues. A surgical tech that simply does what the surgeon wants is not going to be a great patient advocate.
  10. by   shodobe
    Jeff, Jeff,Jeff not being an OR nurse you have NO perspective on what we do. Being a sales rep for healthcare products is like being a used car salesman, not much talent needed. Too many supervisors I have dealt with aren't too bright and I always wondered what qualities were needed to be one. Staff nurses, please don't get me started. Too many mistakes on their part lead me to believe they aren't paying attention to their patients and not doing their job. Educator, been there done that. So you can see everything you have done really isn't all that hard and anyone could do it, even a Technical person. Maybe doing a radio show is really for you because nursing might be a bit to hard for you. Don't trash something you haven't even tried because you really don't have the right to do it. Join the club and really see what is involved,until then keep your opinions to yourself because it only makes you look foolish. Maybe I'll try radio, it doesn't sound to involved.
  11. by   mikez6868
    Well, well, well! I see where you, Jeff, are in "health care" sales???? Hmmmmmmmmmm...You sell health care? Anyway, moving on...I have been an OR nurse for 21 years. I am not a gofer, never have been AND I have continued to deliver first rate, first hand care.
    I have never stepped back from direct patient care. As far as what an OR nurse does...yes we scrub..and we circulate. Most patients who have surgery are NOT coming from the floor..they are coming in from home AND I am the last person in line to make sure that everything is correct prior to OR entrance. You are making a mistake in Assuming that everything is "ready" when I go to see the patient. The anesthesia and operative consents are often wrong...or not there at all....the labwork is missing or out of date....I could go on but won't. If a pre-op nurse or floor nurse knows an OR nurse is going to check behind them...do you think that everything is always done? WRONG again.
    In addition to making sure everything is on the chart to proceed. I have done everything in the OR to get ready for the scheduled case. Now, keep in mind that in the OR I don't do the same rote thing everyday...I may work NEUROSURGERY doing complex craniotomies or spine fusions. So, in addition to patient care I have to adjust/balance the microscope, set up the navigation system, AND the system used for recording the procedure at some places oh, and yea I forgot to mention that I am responsible for making sure that all the equipment/instrumentation is ready as well. Of course this is in addition to getting the TEDS/SCD's on and getting the foley in and getting the Bair hugger on, oh and padding the patient so there is no injury to the patient during the procedure. Oh and lets not forget about the documentation and the specimen/specimens, right?
    I may be doing UROLOGY, ORTHOPEDICS, PLASTICS, VASCULAR, CARDIAC, GYN, ENT, TRAUMA, GENERAL, TRANSPLANTS...well you get the idea.
    Consider all the different procedures under just one service? how the setup is different for each AND consider that if your are circulating you are the ONLY person in the room to TROBLESHOOT/FIX the problem...like a monitor stops working or something happens to the equipment. What you gonna do then? You have a nasty neruosurgeon in the middle of someone's brain and the CUSA stops functioning?
    How about starting an IV on a baby who is being masked down by anesthesia?

    Well, lets refocus now....
    I forgot to mention all the mistakes I have caught in the OR...here are a few examples:

    I found out that the neurosurgeons at one hospital were using intrathecal gent. and the pharmacy was diluting with water instead of saline...WOW Hypotonic solution on the brain. Gotta hate that..

    Or how about the time I went to check my patient in to go back to the OR and the H&P stated that the patient had Von Willebrands disease and NOBODY set up factor VIII for the patient??? WOW crisis averted there

    OR lets see....how about the time that an orthopod was having trouble with a case and the resident asked for an implant that was stainless steel and were were using titanium implants??? Don't want to mix those alloys. Stainless steel and titanium...well they just dont go together.

    OR lets see.....How about the time that I was going to be circulating on a liver transplant and there was ABO compatibility BUT NOT HLA compatibility..That just slipped by everyone elses eyes.

    Or how about the time the SALES REP was trying to get me to open up an implant that was for the right tibia instead of the left? you have to watch the laterality there, man.

    Or how about the time I took care of a patient with a mitochondrial disorder and anesthesia was hanging Lactated Ringers instead of Saline? Wow...don't want to give LR (end product of metabolism ) to those patients..

    Or how about the time the surgeron was about to inject too much marcaine on a baby.....

    I would continue but have made my point.... after taking care of actual patients for 21 years in the OR...I know my OR nursing...


    I don't agree with some types of nursing BUT I don't insult them either..
    Last edit by dianah on Oct 27, '09 : Reason: TOS pm to member
  12. by   annacat
    Great article. I have been wondering what an or nurses day looks like as I have concidered it as a next step in my career.
    Thanks!
  13. by   Jeffthenurse
    Shodobe, I'm neither a used car salesman nor a sales rep, I'm a Master's prepared RN with many years of staff, management, education, and home care experience who happens to have a radio show on a major Philadelphia, PA station. Actually, radio is an extension of my teaching career; instead of talking in front of 50 students at a time, I'm talking to thousands of people at a time. Many of my guests have been nurses.
    Last edit by sirI on Oct 29, '09

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