OR nursing.... "real nursing"

TracyB,RN, RN · May 24, 2006

When I went back to school for my ADN transition from an LPN, we had to choose an area to "precept" for a total of 40 hours. I basically had to beg & plead to get to the OR. I was hooked from day 1. I agree that there should be more exposure to the OR while in nursing school. Left for a while & did LTC, physical rehab & then back to surgery. While I didn't have loads of experience in the OR, I truly felt like I was back home.

I don't feel like any less of a nurse b/c I'm not working the floor anymore. Sure, each area of nursing has it's own stressors & skill sets. But in the OR, the nurse is truly the patient's advocate. The patient is usually sedated, paralyzed & it is up to that nurse in the room to anticipate every need for that patient.

Darth Nightingale · May 25, 2006

i have a question...... do any of you think that or nursing is not 'really" "nursing" at all? i mean what we do is important, but, when you compare it to the other areas of nursing, i think it is so very different. "

i'm not a nurse so i wasn't going to respond.. but for some reason this question resonates with me... so i respond....

what is nursing? i'm mean take a crna that says they do what a md does in the or. why is one practicing medicine and another practicing nursing. what is medicine? is a surgeon practicing medicine? what about a psychiatrist? what about an fnp who works along side a family doctor. who is practicing what.. and why? ... and does it really matter what it is called... (other than for billing purposes:(

is this a "rose by any other name issue?" i dunno. i'm still a student and would like to know what i'm getting into... or would be getting into if i went into or nursing? whatdaya think?

subee, MSN, CRNA · May 25, 2006

Operating room nurses who provide direct patient care work with the patient, other health care professionals, family members, and caregivers in planning, implementing and evaluating treatment. During surgery, the RN may serve as the scrub nurse, passing instruments, sponges and other items; the RN also may serve as the circulating nurse, managing the overall nursing care in the OR--observing the surgical team from a broad perspective and assisting the team in creating and maintaining a safe, comfortable environment
Operating room, perioperative nurses, are relied on for their professional judgment and critical thinking skills. They are vital to planning, implementing and evaluating the treatment of patients. Roles include, circulating nurse, scrub nurse, and RN first assistant, who assists the surgeon during surgery.
You will practice basic surgical nursing skills, including verifying proper consent, scrubbing, gowning and gloving; wound dressing, and heart and lung assessment, managing the patient receiving moderate sedation, assisting the anesthesia provider with induction and intubation, Sponge and instrument count, documentation of all events, laser safety for patient and staff, monitoring placement and length of usage for pheumatic tourniquets, proper patient positioning, specimen care and handling, maintaining sterile field. trouble shooting all equipment used in procedure.......
I can see your line of thought about the special OR RN training after the core nursing courses. I wonder if that would ever come to play. As you mentioned, we are all "older". I am 48yo, and sometimes I feel like I am one of the youngest! The 6 month orientation and poof they are gone. We all get tired of that. It does take a "special" type of person to make it in the OR. You must have high self esteem and confidence in yourself. But mostly, the patience to gain that while orientating. I understand your point of view, on no basic nursing skills needed, but I still disagree and feel like I am NURSING every day. I have no idea how to fix the shortage problem. Maybe a special extension course after graduation for GN's or RN's to attend (like you mentioned) to gain a certificate and then pay an OR nurse differential for certification? Just my ramblings here as I am TIRED from a long day in surgery!
EDIT: Subee: Please elucidate what skills you use in the OR (not PACU) that are specifically R.N. skills only OKAY, OKAY I just proved you right, I see, after re-reading my post! Dag Nabbit!

I KNOW you're tired after a long day in the OR - all my upper body joints are going from lifting patients all day long. I see ALL the nurses getting very tired and frustrated and many are pulling back to part-time. We're in crisis mode now and I'm holding my breath until the summer vacations start. Lots of mandatory OT. I think 1000 cases per room per year is a lot, but maybe I'm wrong. We have NO WHERE to look for trained OR nurses. That's why I'd like to see ADN programs graduate a class in two years ready to work in any OR.

HRM672 · May 25, 2006

Thanks for your replies. CuttingEdgeRn, I found your description particularly interesting. I have been (slowly) reading back through the posts to get more information about new grads in the OR and I have seen numerous descriptions of the job, but your post brought up a few new things.

Honestly, the OR just sounds great to me. I am working on a floor now as a nurse extern and it's fine, but it's not something I love. I know that my job now isn't the same as that of a nurse, but I can't really see how the flow and pattern of my day would be much different.

I know the crunch is on in the OR even more so than in other areas, and you can't simply float nurses from other units. I know the work is physically and mentally hard, it must be exhausting to be short handed. I'm glad that, despite this, everyone I have spoken to (or read a post from here) seems to enjoy the OR and take great pride in working there.

It sounds like the place to be.

CuttingEdgeRN · May 26, 2006

Thanks for your replies. CuttingEdgeRn, I found your description particularly interesting. I have been (slowly) reading back through the posts to get more information about new grads in the OR and I have seen numerous descriptions of the job, but your post brought up a few new things.
Honestly, the OR just sounds great to me. I am working on a floor now as a nurse extern and it's fine, but it's not something I love. I know that my job now isn't the same as that of a nurse, but I can't really see how the flow and pattern of my day would be much different.
I know the crunch is on in the OR even more so than in other areas, and you can't simply float nurses from other units. I know the work is physically and mentally hard, it must be exhausting to be short handed. I'm glad that, despite this, everyone I have spoken to (or read a post from here) seems to enjoy the OR and take great pride in working there.
It sounds like the place to be.

:welcome:

YES, I wouldn't want to work in any other area! I still love the adrenalin rush of a true emergency rolling in at a moments notice and watching co-workers (including the MD's and CRNA's) working together like a fine symphony, with out one persons thoughts on anything else but saving that patient. We have good management, awesome anesthesia care team, and (for the most part) professional surgeons. We band together when a Surgeon gets an attitude and he/she quickly learns it isn't worth alienating us! We have 27 operating rooms and do all surgeries excluding transplants. Yes there is WAY too much call! (no escaping that!) And some days we are short staffed and a full lunch break is only a dream. That's when your co-workers give up part of there lunch break to give you part of a break also! If my tech hasn't had a break, I scrub in for a few while they run for the P'nut butter crackers and bathroom. The anesthesia provider is happy to open any needed suture or supplies durring this time (as long as the room is well stocked!) The charge nurse is only a yell away if trouble arises durring this time. We do have some "unhappy" staff that insist on being miserable , but that happens everywhere.

smk1, LPN · May 26, 2006

ok so this is a dumb question, but hey i am student so I'd rather ask here than get strange looks from the instructors or nurses at clinical...How do you guys go to the bathroom? For long cases do you insert an indwelling catheter? I know when i am at clinical i rarely have time to go to the restroom for those 8 hours, so i drink far less fluids...but i still have to go usually once. Also what about eating? do you get relieved? I would get lightheaded and hypoglycemic after about 6 hours of no food mid day. also what happens if you get a light cold and have a runny nose? do you take something to completely dry you up so there isn't a sterile field issue (because you obviously can't blow your nose). And after reading Marie's thread awhile back about some feminine problems while working, i just got to thinking about all of you OR nurses (and docs and whoever else) and how you manage your body functions during the longer cases?

sunnyjohn · May 26, 2006

Hehehe...I remember a couple of time I had to pee so bad I almost asked for a catheter!!! :lol:

You do get break eventually. Sometimes if you have that terrible doc, or case, folks may try to avoid coming in, but people are pretty fair since they know how it feels to be scrubbed in or circualting and have to pee. I've had folks cut short their lunch to give me a break.

The first thing I was told was to get to the restroom as soon as you can after you break scrub 'cause Lord knows when you'll get to again! I have learned to use the restroom, and eat a half a sandwich and granola bar in 5.369 minutes! I also drink less during work. My bladder also stretched. Don't know how true it is, but my instructor told me a lot of older OR nurses have bladder issues from holding it so long. (she was a hoot!)

The longest I've gone without being relieved was 5 1/2 hours.

I had a "female problem" once. Thank GOD scrub gowns cover the bottom! If your nose runs and your medicine failed you, well you suck it up, literally (or you hope your circulator takes pity on you and finds someone to relieve you to do your thing)

I rememeber once not taking off my mask at the end of a case. They were so busy setting everything up to wheel the patient out I had not a second to stop. Besides I was taught to stay sterile until you could no longer here the wheels of the stretcher in the hall. The patient had be wheeled out and the surgeon in front of a room full of residents asked me why I was still wearing a mask. He kept needleing me 'til I had to admit I had a face full of boogers. Boy did that crack us up!

Marie_LPN, RN, LPN, RN · May 26, 2006

How do you guys go to the bathroom?

The longest i've gone is 7 hours 45 minutes (looooooooong multi-level spine case). I think the reason why i was able to is that i was sweating also, so i didn't have an exploding bladder. I also avoid coffee if i know i'll have a busy day.

I'll ask for relief if necessary. Had one incident where i asked for relief, and the charge nurse kept saying no for hours, resulting in an embarrassing issue that everyone in the room saw. She no longer works for our facility (i think the surgeon had something to do with that dismissal as well):).

smk1, LPN · May 27, 2006

The longest i've gone is 7 hours 45 minutes (looooooooong multi-level spine case). I think the reason why i was able to is that i was sweating also, so i didn't have an exploding bladder. I also avoid coffee if i know i'll have a busy day.
I'll ask for relief if necessary. Had one incident where i asked for relief, and the charge nurse kept saying no for hours, resulting in an embarrassing issue that everyone in the room saw. She no longer works for our facility (i think the surgeon had something to do with that dismissal as well):).

thanks. We are hoping to get to go to the OR in the fall, (though i would imagine that it is just an observatory type of thing...) I have always been intrigued by the idea of OR nursing but since i have had a baby i just can't hold it all day like i used to. Hopefully we'll get the chance to see what goes on and how the nursing staff operates (so to speak).

surgerynomore · May 27, 2006

I have a question...... Do any of you think that OR nursing is not 'really" "nursing" at all? I mean what we do is important, but, when you compare it to the other areas of nursing, I think it is so very different. I was thinking the other day, I dont even bring a stethoscope to work!!! I have no need for one, dont start IV's, dont give any meds, although I retrieve them from pyxis, give them to the field, abx to anesthesia, etc..... but.....not that I cant say I mind this, as I have really no interest at all in med surg floor type nursing.....which is why I guess I was drwan to the OR.but what do you all think? My manager even said, in a half joking way, "this is not nursing, this is the OR!!!"

I agree with you, it is not all nursing. They are more glorified goofers for the scrub, who is working under the RN's license. The scrub (if not prepared) can have the circ. running her/his ass off. The OR nurses are more of a PCT preparing the room, possitioning the PT, helping anesthesia, and paper work. Been there/done both!

Marie_LPN, RN, LPN, RN · May 27, 2006

I agree with you, it is not all nursing. They are more glorified goofers for the scrub, who is working under the RN's license. The scrub (if not prepared) can have the circ. running her/his ass off. The OR nurses are more of a PCT preparing the room, possitioning the PT, helping anesthesia, and paper work. Been there/done both!

Amazing. Had i said that (which i wouldn't have, because that's not what i think), i'd get ripped a new one. :cool:

subee, MSN, CRNA · May 27, 2006

Amazing. Had i said that (which i wouldn't have, because that's not what i think), i'd get ripped a new one.

Certainly not my me!