Orthopedic Surgical Nurse

[KristybayRN, RN]

Hi there! I will be new to the OR and will be placed in Ortho. I have tried to research this specialty but there is not too much literature out there. Any Ortho OR nurses out there that can provide me with some helpful tips, pros/cons?

[Rose_Queen, BSN, MSN, RN]

A lot of the general info for new to the OR nurses will also apply to ortho. A lot of the fundamentals are the same no matter the specialty. You can join AORN and get access to their journal, along with other member only resources. Their at-a-glance series in the journal is very nice, and includes procedures, positioning, and prepping.

[KristybayRN, RN]

Thank you Rose-Queen! I appreciate the tip.

[Anne Grello, BSN, RN]

Hello!

Ortho is great but can seem like a lot when starting out due to the variety of instrumentation sets, positioning equipment, incorporation of fluoroscopy, etc. required for different procedures. Once you learn Ortho, many of the other services seem much less complex in terms of set-up. Take notes to help you remember! If your facility allows, take a photo of the way the fracture table is set up before rolling a patient back, or how to pad the Jackson Flat-top for open clavicle fixation. Visuals always helped me remember better. If doing arthroscopy cases, watch those fluids during the case so they don't run out! The surgeons need that to see in the joint spaces. If doing a fixation, remember that no matter which bone it is, the surgeon will always need to expose the fracture and reduce it before fixation actually starts-that helps with knowing what instrumentation needs to be immediately available on the Mayo. Make sure your sets that are one-of-one (especially implants) are open and good to go (not contaminated) before rolling a patient back! Most important of all, ASK QUESTIONS! Reps have a lot of knowledge about the surgical procedures and instruments so do not be afraid to pick their brains as well. Good luck and have fun!

[KristybayRN, RN]

This is gold! Thank you for the advice and I’ll definitely use it ?

[tg2125]

@Anne Grello Is 100 percent correct! I am primarily and Orthopedic operating room nurse in a huge level one trauma OR and I can say for a fact that knowing orthopedics makes you the best Operating room and surgical tech/ scrub nurse as well. When ever I meet an experienced OR nurse or surgical tech and ask them what was the hardest specialty to learn they mostly always say ortho. We have the biggest set ups next to neuro and cardiac but have for more of an abundance of cases, positioning, instrumentation and equipment that we have to know. I also feel like scrubbing ortho requires you to actual know the procedure more compared to scrubbing other services. The surgeons expect you to know the steps and even if there is a rep in the room, having no understanding will always leave you multiple steps behind in the case. From total joints to spine, to ortho trauma, to hand, to sports its non stop learning. Knowing ortho makes you more marketable and also allows you to learn neuro surgery easier since half of neuro surgery is spine cases similar to ortho spine in many ways. I will save though try to learn a little of every service because that knowledge and experience makes you a more confident nurse in the OR. General, vascular, gyn have big complex cases as well! Circulating/scrubbing in any of those cases when the *** hits the fan isn't easy, as all the other services in the OR have far sicker patients compared to your common ortho patient.   

[KristybayRN, RN]

Thank you. It sounds like a challenge but I am ready for it! I will go through extensive training and learn how to circulate and scrub before being out on my own. My training will also include going to each service line and learning those procedures but will focus more heavily on Ortho. I appreciate your response.

[GrannyRN]

Help. I left an acute care hospital for a surgical hospital position RN. At the acute care hospital, Epic was the charting system and now the surgical hospital uses EMR. Epic had all the options available to me, cardiac, neuro parameters and now I am asked to type out neuro values, after blocks etc. I have been a nurse and am struggling with this. The wording on the EMR is confusing too. Thanks for your help or suggestions. 

[RickyRescueRN, BSN, RN]

 Hopefully your new employer will provide you with a comprehensive orientation including Periop 101 or some other type of residency. Definitely take notes and absorb everything that your preceptors and other members of the team teach you. Rose Queen has some great articles that she has posted for nurses new to the OR. Definitely read those. Give yourself at least a year or so to start feeling that you know things . I'm 4 years in as a nurse new to the OR specialty and daily I'm still learning which is great. Best of luck in your new specialty.