You left out a couple very important attributes of a circulator. We are the patients advocate during procedures. We are responsible for the safety of our patient, not just "support" for the rest of the OR team.
I just felt the need to add that because many times I see circulators that, to myself, I question whether they practice the above comments.
Now, as far as the OTP thing. Due to ~MY WIFE~ getting a huge job promotion and having to leave UF & Shands Jacksonville (My heart is still there), I am now working in a 9 OR "bread and butter" facility circulating and scrubbing on the rare occassion. The almighty dollar sucked me into this small facilty as opposed to Duke wihich is 20 min. away. After spending a year of my life knowing nearly as much about urology as the attendings I worked for due to their never-ending diligence and teaching me everyting I could absorb, I walk into work each day not knowing which service I will be working in.
One thing I am thankful for is the one day my service didn't operate, I was working other services and of course trauma call at my former place of employment was always something new and exciting. (tinge of sarcasm, as we all know after a few GSW's, stabbings, MVC's too get pretty repetitive.)
I miss my old job and my OTP (I really wasn't I swear ) status, lol. I miss being a part of our organ procurement team, I miss alot. But one thing I will take from this experience is the fact that I now circulate most every service and have had the opportunity to scrub more now that I have left a teaching facility.
I now know I will do at least 10 lap chole's a week when I used to do one a month, lol. I look at this facility and my career as a professional another stepping stone. I can easily go to Duke, get hired into their Urology service and be in my comfort zone again, but I think I will stick this current job out just to be certain I will never be an OTP. I have said it before and I will say it again. A circulator should be able to work any service whether they are the best or not is of no consequence. It's the same basic outline we work from day to day, service not included. Interview pre-op and glean any extra info you can that may be pertininent but at the same time establish in 2-3 minutes a level of trust between either your patient or the family, assess, and sign off per your facilties policy. See them back in the room after anes. has already given them some versed and it's actually fun to chat it up with my patient.
Typically I could never do that in my previous place of employment. I was alwaysy tracking down a resident for consent , etc, Our pace allowed me to review the chart, check for an h&p and a consent (surgical, blood) A a preceptor I always preached a 3 minute pt interview and assessment.
But, there was this one day that based on a certain set of circumstances I spent way too much time with the family and patient in pre-op. His daughter and I were kinda flirting, etc.. (and I apologize if this brings anyone down, but I relive it continuously). Our first case was a Nephrectomy. I was very close with the surgeon (my team of course) and we were about 15 minutes late getting started over a resident not getting consent.As our CRNA and student are rolling into the room, my Urology attending and the Anes attending are openly arguing of the late start. My personal thoughts are that Dr X was pushing a bit and made a mistake. A couple silk ties on the renal artery slipped off. We went from smashing pumpkins to crickets pretty damn quick. The patient was lateral and we coouldn't open his chest. He had only dropped a liter of blood but he had an MI immediately. He had a history of cardiac issues and apperently other local hospitals decline to take the case. The longest 2 minutes of my life was walking downt eh hall to the isolation rooom where wwe had her husband for viewing and she was screaming "you killled my husband" the entire time.
My post had gone on too long and I am rambling, for that I apologize. But nothing in my lifetime will ever make me forget the look on my attendings face when he asked me "now what do I do?" 4 grown men bawling their eyes out. I still talk to cj (my attending) as we bonded that day and have remained good friends. There is nothing routine about surgery and I am glad I faced the scenario so early in my career.
ok, I am done running my mouth.