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".
In these OR settings, there is often a hierarchy: surgeon, anesthesia (often the CRNA, who is the advance practice nurse, and who knows far more about the patient's vital signs than the RN circulator), then comes the surgical technician, or scrub, and at the bottom of this hierarchy, the RN circulator.
In such OR settings, when the surgeon asks, "How is the patient doing?" The surgeon wants anesthesia (CRNA) to provide the information, not the RN circulator, who could possibly not have a clue, especially if said circulator had to leave the room for an instrument, said scrub forgot to pull prior to the surgery.
If the patient needs meds, such as for blood pressure, heart rate, etc., the CRNA is the advance practice nurse, and will be administering such drugs. Basically, they are the primary nurse in the room. As a circulator, you will be the secondary nurse. You will be charting, helping position the patient, going get stuff from outside the OR (which was forgotten, or is unexpectedly needed), checking the paperwork (consents, H&P, etc.), and setting up the OR with the scrubs.
When the surgeon, CRNA, or scrub politely asks (or yells), "I need...!" It's your job to fulfill their needs...not the other way around.
In such OR settings, don't think, "I'm the RN! I'm in charge of this operating room." No. You are not in charge of the operating room. The surgeon is the captain of that ship, or operating room. Then comes anesthesia (usually CRNA). Then the scrub, who is working with the surgeon, and anticipating, or relating the needs of the surgeon. Then comes you...the RN.
So why have a RN in the operating room? Because some states mandate their be a RN in the operating room, as a circulator, who may assist (often assisting the CRNA, when the patient crashes) during emergencies. But, laws are not written in stone. Could these state mandates change? Sure. In Australia, the nurse (RN) works in the position as a scrub, and the surgical technician works as the circulator.
So do operating rooms need registered nurses (barring state mandates)? In my humble opinion, No. Registered nurses are not needed in the operating room. Surgical technicians can easily perform the duties done by a circulator. They do it in Australia. Just a matter of time, probably, until RNs are phased out of the OR.
So, thinking of being a circulator? Consider what career growth and potential you may have. Want to be a RNFA? Your gonna have to learn suturing and instrumentation...scrub work...that's their area of expertise. They don't teach such things in nursing school. Want to be a surgical nurse practitioner? Helps to have scrub experience...otherwise you are in the same position of not knowing the basic suturing and instrumentation. See the trend? Career advancement in the operating room is rooted in knowing how to scrub if you're a RN. Even if you want to be the OR manager. Never scrubbed? Then let's see how much respect you will have among your subordinates.
Sure there are all RN ORs, in which even the scrubs are nurses. But scrubbing is the badge of honor.
Still thinking of being a circulator? Good luck.
SandraFenway
38 Posts
OR nurses may do all the things you say. It depends on where you work and your commitment level. There's no deeper assessment of the patient than putting your hands inside. Think about it.