Questions about OR fellowship?

offlabel · Jan 11, 2023

There is a national program called Periop 101 that is pretty popular. If it's anything like that, they'll present you with everything you'll need to know to walk into an OR for the first time. I wouldn't worry too much about prepping because they'll surely have a very different focus for you than you're able to anticipate...that said, by 'fellowship', do they mean a basic orientation/training for nurses wanting to work in the OR? I know what a fellowship is for physician training, but what is a 6 month orientation 'fellowship'?

Lusashi, BSN, RN · Jan 13, 2023

I am a year into my OR nursing career. I did the same as you and studied Alexander's for several months before I started my residency. I felt like it really helped my foundations and made things less surprising. I wouldn't recommend reading anything about the specific surgeries, though. Experiential training is the only way you will learn a surgeon's techniques and preferences. The anesthesiologist will primarily be responsible for giving medications, but reviewing common formulations of local anesthetics might help. I think it's great you are already learning instruments. I didn't do that until the scrub portion of my training, which was about six months in. Knowing names of things is a huge part of learning curve, haha. Judging by the fact you are taking your learning so seriously and being proactive, I can tell you are going to be an excellent OR nurse. Just give yourself a lot of grace. The learning curve is steep, and getting exposed to different procedures and scenarios is the only way to improve. Good luck!

**emergenceRN17, ASN, BSN, RN** · Jan 17, 2023

Will you be both scrubbing and circulating?

eah8y4 · Jan 20, 2023

emergenceRN17 said:

Will you be both scrubbing and circulating?

Circulating mostly but told I will have the opportunity to scrub if I'd like to learn it.

flower808s, RN · Jan 22, 2023

You may want to know some basic medications as a circulator so if your patient has medication allergies you know what to avoid. Other than that, you will learn as you go. Good luck!!

eah8y4 · Jan 25, 2023

Lusashi said:

I am a year into my OR nursing career. I did the same as you and studied Alexander's for several months before I started my residency. I felt like it really helped my foundations and made things less surprising. I wouldn't recommend reading anything about the specific surgeries, though. Experiential training is the only way you will learn a surgeon's techniques and preferences. The anesthesiologist will primarily be responsible for giving medications, but reviewing common formulations of local anesthetics might help. I think it's great you are already learning instruments. I didn't do that until the scrub portion of my training, which was about six months in. Knowing names of things is a huge part of learning curve, haha. Judging by the fact you are taking your learning so seriously and being proactive, I can tell you are going to be an excellent OR nurse. Just give yourself a lot of grace. The learning curve is steep, and getting exposed to different procedures and scenarios is the only way to improve. Good luck!

Thank you for your reply!
People around me are trying to talk me out of it, saying "surgeons are ***" and things like that. What are your experiences like with surgeons? What's your favorite and least favorite things about OR nursing?

eah8y4 · Jan 25, 2023

flower808s said:

You may want to know some basic medications as a circulator so if your patient has medication allergies you know what to avoid. Other than that, you will learn as you go. Good luck!!

Thank you! Can you tell me what you like and dislike about OR nursing?

**emergenceRN17, ASN, BSN, RN** · Jan 25, 2023

eah8y4 said:

Circulating mostly but told I will have the opportunity to scrub if I'd like to learn it.

That's wonderful. I am a circulator but can definitely say that had I learned to scrub first, it would have made the understanding of circulating a bit easier. Try to do both if you can. You will be more marketable and it will help everything come together too.

flower808s, RN · Jan 25, 2023

eah8y4 said:

Thank you! Can you tell me what you like and dislike about OR nursing?

I like working with all different members of the surgical team and the level of interaction with the patient and the family. Each day varies, I can have hectic days and I can have slower paced days. What I especially like is the feeling of satisfaction I get at the end of the day—I feel like I actually accomplished something. In contrast to floor nursing, when I would leave and see the same patient day after day I wouldn't feel the same sense of accomplishment. The biggest challenge would be working with different strong personalities. Even still, I would take my worst day in the OR over my best day on the floor.

Lusashi, BSN, RN · Jan 25, 2023

Yes, I've noticed people like to say a lot of things about the OR. Knowing what I know now, I would never trust someone's opinion who does not work in the OR. Yes, surgeons can be ***. So can literally anyone. Usually it's a key few who give everyone trouble. It's no big deal and often they do warm up to you once they get to know you.

Something I like and also don't like about the OR is how social it is. It's super team-based and there is always help around you. It can be quite fun. The bad thing is there is also sometimes drama, backbiting, etc. And "strong personalities". This all gets better as you get to know people around you.

Can't beat 1:1 ratios. It's great having everyone focus their attention on 1 patient at a time.

That said, most of your relationship-building is with your team, not the patient. I like building patient relationships so that would be a "dislike" for the OR. You only get an awake patient for a short time. Still, you get to be there for the patient when they are super vulnerable, and putting them at ease is rewarding.

The biggest dislike/challenge for me is the time pressure. There is always pressure to get things done quickly, turn over the room, etc. You as the circulator have to learn to be quite assertive when your "spidey senses" indicate that things are moving at an unsafe speed. Your team counts on you to keep a holistic view on what is going on, and to make sure the patient is safely positioned - preferably before they are prepped and draped.

Mostly I am very satisfied with my job and I'm glad I went straight for what I wanted instead of going med/surg or another specialty. You get to build good relationships with doctors and pick their brains all the time. It's super high tech with lots of new learning all the time. It's pretty physically exhausting. You're moving around heavy equipment, patients, beds, etc all day. At the end of the day I thank everyone on my team and that is very rewarding.