Thinking of being a circulator?...Think twice.

Whoa. It sounds like you've had a very bad experience. Ive had a good experience so far. I just started in the OR 3 months ago and one of my favorite parts of the job is that I feel like I am an equal among the team. It takes the orchestration of every single team member from pre-op holding, through surgery, and in post-op to take a patient safely through surgery. That includes environmental services and sterile processing technicians too! I feel that everyone in my workplace is respected. I would highly recommend to anyone to work in the OR... I love it.

I do agree with you OR dude that scrubbing is important. I think learning to scrub has made me a better circulator as far as learning to anticipate what the surgeon needs. I would be disappointed if they stopped using RNs in my workplace to scrub.

Actually, my current work environment is not toxic. I've worked in various ORs. This is my opinion, after working in the OR for over 15 years. Team work? Yes. There is team work. But there is a hierarchy. Do you think as a RN you are equal to the surgeon? Or anesthesia (CRNA)? Or the scrub? Who gives the orders? The hierarchy dictates who gives the orders. That's not toxic. That's the structure or hierarchy of the OR. Respectfully I submit.

I agree working in an OR, wherein you are taught (on the job training) to scrub, provides valuable learning experience. Validating my point...a badge of honor (and insight into the surgical field). And, I'd agree an all nurse OR does provide a more egalitarian OR environment. But my focus was on working strictly as a circulator, and my opinion that the basis of OR nursing is scrubbing, in terms of career advancement.

Congratulations to those nurses who receive on the job training as a scrub. Does your training equate to the surgical technician's training from their academic program? That's a personal question, which can only be answered by the individual.

Nonetheless, my humble opinion remains: the registered nurse's role is not vital to an operating room. The operating room can exist without a registered nurse, and barring state mandates, surgical technicians can replace a registered nurse in the operating room.

Also, if you are a registered nurse, and you want to become a RNFA, surgical nurse practitioner, or OR manager, then it is preferred that you have scrub experience, and preferably having gone to school for surgical technician, then become a registered nurse. On the job training may not provide the background experience to advance into these other career prospects.

Thus, scrubbing is the cornerstone to working or advancing in the OR.

Thinking of being (working strictly as) a circulator?...Think twice (especially a new grad RN).

I'm glad to hear that your work environment is not toxic. I have to respectfully disagree with your point that nurses are not vital to an operating room. Nurses use evidence based practice to promote patient safety in the operating room. We coordinate the administration of blood products. We pass medications off onto the sterile field. We interview the patient and note concerns for the patient such as PT/INR for patients on blood thinners. We prevent injury from improper positioning, electrical sources, or burns. We are the ones who say "hey doc, lets wait another minute for the prep to dry prior to draping to prevent an OR fire". We oversee the room with patient safety in mind and with background knowledge as a nurse. I would say our position is vital and not replaceable.

Just my two cents!

Amistad has described most of the role of an O R Nurse. However the other information is vital;

1-The level of education of an OR Nurse- not technician who only scrubs- is now a BSN. In addition we also have an additional level of expertise defined in the CNOR level of practice. Scrub tech education is limited and not patient centered. It is anatomy and technical orientation to how to provide what the Surgeon needs and how to clean it.

2-There is a scary and infuriating phenomenon that plays out when there is a newer RN circulator and a seasoned Scrub tech. The scrub will be able to lead the RN ad usually manipulates the situation to make themselves look and feel more important.

I have been an RN for 30 years and worked in the OR in all roles for 25 years. We rarely had scrub techs so the RNs learned both roles.We are a team that relies on each other but frequently we act like a dysfunctional family.

RNs in general take enough crap from people. I resent people who don't share their knowledge and choose to use it as a weapon. That is what the scrubs learn to do and victimize the new nurses and sometimes are abusive by blaming the nurses(while they are out of the room) for what they themselves forgot to provide. It is never pretty when I find out someone is trying that on me.

The best validation for seasoned circulators is when a scrub achieves their RN and now has to learn the circulator role. What goes around comes around.

Ninety percent what we do circulating almost anyone can do. The other ten percent is the reason we have RN's in the room. As others have stated we see the big picture and not focused on what the present task being preformed at the moment. I describe an OR team like a ship. The surgeon is the Captain, anaesthesia is the Navigator, scrub tech is the Engineer, and the circulating nurse is the Executive Officer (XO). The XO is the second most important person on a ship because without the XO' s coordination the ship would not move.

RN's are taught the why not the how. SCD' s are a good example, techs know they are needed by most do not know they need to be on before induction.

I do agree with the original poster and new grads should not go to the OR, then again I do not think a new grad should go to any specialty area since they need to learn the skill of nursing not the book of nursing which what a new grad knows.

I'm a nursing student and hope to be an OR nurse. Just started as a tech at a major teaching hospital and I love it. It's a whole different world.

I'm glad to see a healthy discussion. I would like to add, many see the role of a circulating nurse as being the purview of a registered nurse. However, as I mentioned, look south to our Aussie friends and see the roles reversed...the tech being the circulator, and the scrub being the nurse (registered). The roles are so easily reversed, if only you change your location. It works there. Blood/drug administration (most often done by the advanced nurse in the OR, CRNA, here in the good 'ol USA); and, the other tasks (such as prepping the patient, passing meds/instruments to the sterile field, etc. are done by our Aussie surgical technician brethren. So easily is it to switch roles...which still leads to the conclusion...a registered nurse, serving as circulator, is not needed in the OR. For the 90% of a circulator's duty, yes, I agree, anyone can do, and for the other 10%, the advanced practice nurse, CRNA, is available and more than capable of performing. Let's not be so geocentric...no worries, mates.

You can not compare what nurses do in other countries to what we do in the US. After serving with nurses from several different countries most do not work at the same level as we do. When I took a soldier to a German ED he was triaged by the ED doctor not the nurse. The doctor preformed almost all the duties which an ED nurse would do. I am not saying we are better than nurses from other countries but just have a different scope of practice.

No disrespect intended...sincerely. Can't compare?...comparisons are made all the time, and made with different parts of the world all the time. Sorry, but I beg to differ.

Thinking of being a circulator?...(especially for new RN grads)...consider carefully. If you will only circulate, and you will be working in an OR with surgical technicians, or scrubs, who do not have a nursing background, then you may find yourself answering to, not supervising, surgical technicians, who may harbor resentments towards you being "the nurse".

The RN does not and never has supervised the scrub. Yes, there are a few scrubs out there who may resent you for being the nurse but, the majority of the scrubs I've worked with aren't like that. There are also nurses out there who think they are better than scrubs because they are "the nurse".

You also need to realize that a scrub tech with years of experience is more knowledgable about things in the OR than the brand new nurse. My manager actually puts new nurses just off orientation with the strongest scrubs so that the scrubs can help them and answer question.

The OR is all about teamwork. If you are that miserable at your job, maybe you should start looking for another job.