Typical days as an OR nurse?

[HGP831]

I'm finishing up my first year in nursing school, and I'm trying to narrow down what specialty I want to choose. I'm interested in OR nursing, but I don't really know that much about what an OR nurse actually does. Would anyone be willing to give me an overview of your typical workday, and kind of tell me what your normal tasks are? Thanks so much!

[4_Sq]

Arrive @ work early start my day with a coffee!

Get morning report from charge nurse.

Find out anything unusual on the Operative slate e.g. Malignant Hyperthermia patient, Latex allergy, Difficult Intubation, and so on.

I know my assignment in advance so I have already checked what cases we will be doing for the day, and reviewed procedure ahead of time if I am not sure.

Alternate scrub and circulate roles with the other nurses in the room.

Check all equipment and supplies for day are picked for cases and ready to go.

There is a specific Surgeon's preference card for each surgical procedure.

Essentially this is like a giant Dr. order sheet.. it tells you what the requirements are for each type of surgery and lists all the product numbers and instrument sets and basic case notes for that surgery.

They are generated on the computer, and will be given to the CSD department personnel so that they can pick all required items preoperatively.

Check all packaging and instruments for sterility.

Depending on service that I am working in for the day, may need special instrument carts with case specific instruments as well as case carts which have all of the sterile instruments and supplies I need for each case.

Make sure that the operating room table is set up (case specific)

Make an IV or set up arterial line if necessary.

Gather drugs required for the case (each case)

If I am circulating nurse, check in OR patient, identify patient check through the chart for all of the required data

eg: ECG, blood work, consent, OR Checklist complete, history.

Check fasting status, check procedure with patient, then again, there will be a time out (surgeon to lead, as soon as I bring the patient to the room)

If there is an extra nurse to set up the scrub nurse, then I continue my focus with the patient.. Otherwise, I set up the scrub nurse, open sterile supplies to him/her and perform an instrument count

Then I begin the electronic chart for that patient, pull up their record and make sure correct patient entered etc.

Make sure anesthetist, surgeon, and scrub ready for patient, then I will bring the patient to the theatre.

At this time I am assessing how the patient is feeling about the impending surgery, and whether or not they have had time to have

all of their questions answered. This is the time where you can provide a lot of support and reassurance to the patient.

I bring them into the OR, and positon them on the OR bed. Attach all monitors, and call for the surgeon, anesthetist and assistant.

Surgeon performs time out with the patient. (Specifics of time out performed always) x3.

Once with patient participation and surgeon leading.

Next after patient anesthetised and after surgical prep is complete.

Last time out after case is complete.. to make sure it was done according to what was expected outcomes, correct count etc. etc.

Assist with intubation and any other requirements for help that the anesthesiologist might have.. Eg.. assist with spinal, general, epidural, block or what ever else is required of me.

Catheterize patient according to specific requirement.. eg.. lengthy surgery..

Make sure patient is safely positioned.. all prominences padded, etc, etc.

Apply compression stockings for a lot of the patients.. surgery specific

Prep the patient with surgical prep solution.

Know the steps of the surgery and be able to anticipate the requirements of the surgical team.. eg

bleeding.. know what hemostatic agents I may have to call for.. sutures. ties.. clips etc.

Make sure that I am listening at all times to patient monitors, anesthetist, scrub team, and calling for any supplies or

assistance we might need.

We work as well oiled machine.. OR is team work at it's finest.. You have the number of staff required to safely care

for the patient.

The experts are all there working at the same time.. usually you are not needing to call 2nd surgeon in, but you can if you need to.

You can also call for extra help for anesthesia if required. EG.. another anesthetist, respiratory, etc etc.

I have just given you a very basic run down of what one OR procedure is like.. depending on the length of each surgery, you may do quite a few cases in a day, or you may do one case that takes the entire day.

The OR is always challenging, and a very technical place to work.. I think it is fun fun fun.. and it is nice to feel this way about your work.

No 2 cases are ever the same..different patient.. different anatomy.. I could go on and on but I won't..

I have left out the scrub role,, I am writing a book here..

I hope that I have given you a little bit of an idea what the OR can be like..

Oh, and I forgot to mention.. sometimes we play really nice music!

Good luck in your career choice!