OR Job Interview

1. It took me a year and a half

2. never coded but it happens. Save the patient. If they die they dint have to worry about infection.

3. anesthesia, surgeon, tech, circulator

4. bovie and sooo many other things. Be patient. You won’t know it all in one day.

5. no. I use to. You will learn. Once you know the why you will be ahead of them.

6. must be a good communicator, stand up for what you think is right, how you decide to do it is up to you

On 6/23/2020 at 10:45 PM, Ciale said:

I've been an ED nurse for 10 years and am stepping out of my comfort zone and applied for an OR gig. I have an interview and all of a sudden am feeling very nervous! I have just a few questions:

1. How long did it take you to feel like you knew what you were doing?

2. How often do you code a patient? And how does that work exactly in a sterile enviornment?

3. Who exactly is in the room with you during the surgery?

4. What equipment will you be expected to operate?

5. Do you always feel like you have no idea what the surgeon is actually doing?

6. Despite my ED experience, but personality is very laid back and I dislike confrontation. Do you think thats a suitable personality for an OR?

1. I’m 4 months in. Some days I feel like I’ve got it, others I’m just trying not to lose it. Everyone says it takes at least a year before you feel like you know what your doing.

2. I haven’t had a patient code yet. A few have been difficult coming out of anesthesia. Some leave the OR still intubated (but most of those are patients who were brought from ICU already intubated. I’ve had one or two (that I know of) die in ICU after surgery. I’m sure we’d break sterile without a second thought to code a patient. Also with at least two physicians or a doc and a CRNA in the room, they’re going to lead the code.

3. Minimum is surgeon, circulator, scrub (surgical tech.), and anesthesia. I work in a teaching hospital and we almost always have a resident too. In a non teaching hospital the resident may he replaced by an RNFA - registered nurse first assist. It’s not uncommon though to have something like this (what I had today): attending anesthesiologist (stays until patient is under and then leaves unless there’s a problem), anesthesia resident (medical resident or CRNA), attending surgeon, resident surgeon, surgical fellow, medical student (sometimes two), scrub tech, scrub tech student or orientee, circulator nurse, circulator nurse intern; and you may also have a radiography tech and a Stryker (or other equipment) tech. So 4-12 people

4. Common equipment includes: electrosurgery unit (the “Bovie” though none of our ESUs are actual Bovie brand), suction (canisters connected to wall suction, or a Neptune), fluid warmer, light source for fiber optic surgical headlamp or scopes, RF wand for detecting lost sponges, ALPS to prevent VTE. There’s also lots of equipment that is used only on certain cases - like a perfusion machine for heart / lung cases, slush maker for organ transplants, pneumatic tourniquet, insufflator for lap cases, suction irrigator, etc

you have to know first where to put the equipment so it is accessible, has reliable power available, but also not in the way of the surgical team. Then how to set it up, turn it on, connect the appropriate accessories, and adjust the settings as the surgeon requests.

5. Not always, but most of the time. It helps to develop enough knowledge and awareness to anticipate what the surgeon wants before they ask for it, and to know what stage of the case they’re in. There are things that need to be done when they are starting to close the skin incision, for example.

6. They say OR draws a lot of type A personalities; but I don’t think it’s necessary. You do have to develop some assertiveness. I’ve heard horror stories about surgeons, but so far I’ve only seen two blowups, and both were aimed at residents not nurses.

good luck

The best advice I can give you (as a Flight nurse for 18yrs before transitioning to the OR) is get into a good PeriOp 101 program. The course and clinical experience over several months takes you from the very basics/foundations of peri-operative nursing practice to a place where you can function independently and more importantly , safely. The OR environment is 100% different from any other area in the hospital and is an entirely new skill set with a steep learning curve. I made the change after having been a RN for 24yrs (ICU, ER & Flight Nursing) and absolutely love it, especially scrubbing my cases in neurosurgery. Good luck