Welcome to the world of OR nursing! Now sit down, buckle up, and hold on (Tips for new OR nurses)
So, you were offered that coveted OR position and accepted. Now, you're wondering just what it is you've gotten yourself into, or maybe you're a few days or weeks into your orientation and feeling overwhelmed.
How To Get Started As An Operating Room Nurse
STEP 1 Operating Room Nursing Is Different From Any Other Specialty.
As such, it is going to take time to get comfortable. Many will say that it takes at least a year to start feeling competent and confident in your abilities. Don't expect yourself to get everything right off the bat- it's going to take time and there is a steep learning curve.
STEP 2 There Are Going To Be Good Days And Bad Days.
Don't be too hard on yourself if you have a bad day- we've all had them, and even still occasionally have them as experienced nurses. The bad days might be those where your patient doesn't make it off the table or those where just when it felt like everything was clicking, it all feels like your first day again. Even experienced nurses have those kinds of day: new equipment is purchased, new procedures are developed, and we have to learn from point zero how use/do everything.
STEP 3 It's Okay To Feel Overwhelmed.
You've got a lot to learn, and it probably feels like too much at once. One of the tricks that helped me was to break the learning into chunks: spend a certain amount of time focusing on learning how to set up rooms and get them ready for the case. Then moving on to focusing on prepping and positioning. Some time spent focusing on implants. Another few days spent focusing on circulating while my preceptor did the documentation. Then, focusing on documentation. Finally, putting it all together and functioning as the primary circulator. Breaking it up into chunks made the learning seem much more manageable, easier to retain, and less intimidating. Find what works for you, present it to your preceptor, and go from there.
STEP 4 You May Have One Preceptor Per Specialty Or A Different Preceptor Every Day
Both have arrangements have good points and bad points. Working with one preceptor helps with consistency, both in what you are learning from them and ability to provide thorough feedback. However, working with multiple preceptors allows you to see more than one person's routine and figure out which one (or parts of both) works best for you.
STEP 5 Feedback Is Important.
So is goal setting. For each week of your orientation, set yourself a goal. Work with your preceptor in meeting that goal. If it's required, get written feedback on a weekly basis (or as the requirements state). Get verbal feedback daily from your preceptor. What did you feel you did well vs. what you need to work on as well as what did you preceptor think you did well and what could be improved.
STEP 6 Preference Cards Are Your Friends.
If you are able to find out the day before what cases and surgeons you will be assigned to, try to get copies of the preference cards ahead of time. Yes, this will involve some work on your end during non-work time, but it will make the following day go much smoother. The preference card will have information such as positioning, equipment needed, prepping, etc. This can help you walk into your shift knowing what you need to start your day and assist with time management.
STEP 7 Keep a small, pocket-sized notebook handy to write down useful/important information.
My notebook for my current position (that I have so well memorized that I don't actually carry it around with me anymore) has a list of important phone numbers such as blood bank, PACU, service line coordinators, charge anesthesiologist, and so on. It also has a cheat sheet for how to order blood products and intraop lab tests. And then there is a section for each surgeon I work with where I can write down little idiosyncrasies: preferred radio stations and things like that that wouldn't appear on the preference cards.
STEP 8 There Are A Lot Of Instruments And Sutures Used In Surgery.
You may want to look into some books, websites, or apps that have images of instruments, what they are used for, and any alternative names. It can be confusing when someone asks you for a kocher clamp when everyone else calls it an oschner. Yep, 2 names for the same instrument- and that doesn't include surgeon pet names. You may even find it helpful to spend a day assembling instrument sets in the sterile processing department to learn what instruments are called and which ones are in which set.
STEP 9 When Someone Goes Off, It's Almost Always At The Situation And Not Directed At A Single Person.
Surgery is routine to us, but it can still go real bad real quick. It's not uncommon to see a surgeon suddenly start using some impolite language (we have a few that could make a sailor/truck driver blush). Now, throwing instruments and directing personal tirades at staff is not okay, and a good management team will support their staff and ensure corrective action.
These are some of the tips that have worked for me throughout my OR career, which has included some specialty team changes from general/vascular to neuro to a hodgepodge of everything and on into cardiac. Hopefully you will find them helpful and others will add tips of their own to the list.
Best wishes as you embark on the next phase of your nursing career as an OR nurse!
