Hi There,
As you have found out he OR is very task oriented.
Everyone has a way to do things, good and bad.
Like nursing school, just do it the way they do it.
When you are on your own you will take the good and bad and make it your own.
First things first... What kind of case are you setting up for?
You and your scrub tech should be doing things at the same time. You also need to be there to tie them up.
Scrub tech is setting up their sterile field. You are not responsible for the sterile field, only that no one breaks it. They have a list of things that they have to get for the case. This should include gloves, blades, gowns... and things as part of there set up. You may help by opening things for them, but for the most part they will do the set up. You don't have to know what they do, that's their job and don't do it for them.
Look at what they are opening. This will clue you in on what you need to set up.
Talk about the case with the scrub tech while you are setting up. This will help both of you make sure you've got everything.
You live and die by your scrub tech. If they are good you wont need to support them. If they are bad you are going to be VERY busy during the case :)
You will never go wrong with Head to Toe, Top to Bottom.
Head
Anesthesia is at the head.
They are responsible for the machine but I will set it up before they get in by hooking things up.
Every Case!!! O2, Suction, EKG leads, Fluid warmer
Middle
Set up your tower - Top to bottom
Power up equipment and make sure its working.
Irrigation - Bovie - Insulflation - Camera - Light-source (All depends on the case) - Monitors
Arm boards - Safety Belts - Pillows - Padding
Toes
SCD (Venadynes)
That should take you all of 5 minutes.
You can count if the tech is ready but most of the time they wont be.
Don't worry... you will have time to count and your tech knows that it has to be done and will let you know when they are ready. Don't be pushy... your tech is your team mate... remember what I said... "You live and die by your scrub tech"
Now you can really look up the patient.
Look at what you set up, make sure you've got what you need for the case.
What meds do you need? That depends on the case but your case card should have them written down so go and grab them now. In general its a very short list of two or three items. Don't open anything. MD's are notorious for changing things up. If you grabbed the wrong item you can return it. You don't have to give them to the field now but have them in the room.
Don't stress... your scrub tech will ask you for the meds when they need them.
Anesthesia should have come into the room at some point during your set up and you can have a quick conversation about the case and the patient and anything that they need.
Before you leave the room ask if everyone is ready for the patient.
The problem with being precepted is that their are two of you doing the tasks and you will never get a routine down until you are on your own. Their is so much to do that it just makes it easier with two of you doing it.
Take it all in. You will be stressed and their is nothing you can do about it except embrace it. You will forget something. You will have to go under a drape to hook up a bovie pad. You will have to run and get something. Even the most experienced nurse forgets something because they get distracted.
Its okay... Breath... You will get through it... I promise
