Quote from Pam RN
The OR is most definitely a more structured environment then a MS floor. The autonomy is less since you are part of a team to get the surgery done. .
"The autonomy is LESS?" :uhoh21:
How do you figure? The circulator is in charge of the ROOM--you are expected (and you had BETTER, otherwise you don't belong in an operating room) to make patient care decisions quickly, using experience, education and critical thinking skills as well as gut instinct, and not have to run for the policy and procedure manual or ask "the desk" how to proceed. This is why most of us are IN the OR, and why we STAY in the OR--we are confident enough in our abilities to make patient care decisons unassisted, and we appreciate the autonomy we are given to do so. On the med-surg floor, an RN couldn't even put TEDs or SCDs on a patient without getting an order. In the OR, it's a nursing decision, in the interest of optimal patient care--and prevention of DVT and possible PE. Our judgment is respected and trusted.
And structured--no, I don't agree with this either. The OR is probably the most fun place to work in the hospital. (Shhhh--it's a secret--don't tell, or everybody will want in...) Cases, for the most part, are repetitious, and truth be told can be pretty damned boring--so, most OR environments where I have worked are pretty kick back and sociable in the rooms. We know what we are doing, so we don't have a need to make a huge production out of something we have done hundreds of times before and will do hundreds more times. We also know each other pretty darned well--whereas, on the floors, things can be pretty superficial.
I've worked with people who say they came from ORs where they couldn't even TALK in the rooms--because some tighta** manager felt that talking would contribute to post-op infections due to droplet spread--that old sacred cow--I would rather die than have to work in a miserable environment like that.
Also--our role before and during induction involves a lot more than simply "comforting" our patients. Our role is standing directly next to anesthesia and assisting with induction, starting an IV, giving drugs, or masking if necessary, and essentially acting as a right hand to anesthesia, especailly if something goes wrong. Soemtimes I see new circulators who walk aroud the room during induction, or count, or are running in and out of the room getting fluids or instruments from the flash or the core, or are at the counter charting, or seem to feel that their only role is to hold the patient's hand--and I have to wonder--were they never taught to set priorities? Were they never taught that their place during induction is up there assisting anesthesia, and they should remain there until he has the tube taped in place, breath sounds and ventilation and end tidal CO2 are within normal parameters, and he gives them the go ahead to leave?