Typical OR shift?

Editorial Team / Admin · Sep 5, 2015

A typical shift is really going to depend a lot on your facility. Is it a trauma center? Does the OR run 24 hours? How is it staffed for evening and night shift hours? If you want to know what a typical shift is like at your facility, you should ask for a day to shadow. That will give you the best picture of what your shift could look like.

I work in cardiac surgery at a level 2 trauma center. My typical shift begins with getting my room ready for the day: turning on equipment, pulling up cath films on the computer, signing into the EMAR and reading about my patient.

Then I go out to preop and interview my patient, verify procedures and surgeon, verify consents, and transport the patient to the OR.

In the OR, my first focus is on getting the patient over to the OR bed, connecting anesthesia monitors, and assisting the anesthesia provider during induction and line insertion. I am then responsible for inserting the foley, counting with the scrub person, and positioning and prepping the patient. During the procedure, I open additional supplies for the scrub person as they are needed, complete my documentation, and coordinate with anesthesia and perfusion as far as medications, blood products, and anything else. Once the surgery is finished, I am putting dressings in place, calling report to ICU, and helping anesthesia transport the patient to their ICU room.

Depending on the number of cases for the day and whether I am on call or not, I may only have one case during my shift. Sometimes, I'll start a second and be relieved by the call person. Sometimes, I am the call person and stay until all cases are finished. My record shift? It ended at 7:45 the next morning. Yep, that's right, more than a 24 hour shift. Not the norm, but definitely possible.

Definitely get the lowdown on required call hours, call response time (mine is 30 but there is another nearby facility whose cardiac team must be ready to go in 15 minutes), how often you get called in or have to stay late during the average week, etc. But again, the best way to see what a shift will be like is to ask for a day to shadow. I'm kind of surprised it wasn't offered as part of the interview.

European · Sep 5, 2015

Thanks Rose, my hospital is one of the leading medical centers in nyc not trauma center though, I wasn't offered a shadowing opportunity but I asked for one and they said ok, just have to arrange it now.

How do you go about choosing a specialty?

Editorial Team / Admin · Sep 5, 2015

When I first started working in the OR, I didn't have to choose a specialty. In our main OR, everyone takes turns doing everything. I had my favorites and not so favorites. Hated uro and gyn, ambivalent about ortho and neuro, and liked general and vascular. Hearts, on the other hand, are off in their own world. And that's where I found my niche in the OR. It may take some trial and error to find the right specialty team, but start with what interests you the most.

European · Sep 5, 2015

Thanks Rose, you're the best.

pixiestudent2 · Sep 5, 2015

I work at a trauma hospital, our ORs are staffed 24/7.

But only experienced nurses work the off shifts. I was hired strictly Monday through Friday 6:30am to 3pm. When I get off of my 6 month orientation I will work 2 8s and 2 12s, still m~f daylight.

Since we are so huge and have so many staff, we only have to take 4 hours of call per week.

European · Sep 6, 2015

Anyone else anything to add?

L8RRN · Sep 6, 2015

I worked in a Level 2 OR. Where I was, I only had 9 weeks of orientation and I had never worked in the OR before! I was a float, too, and moved between ortho, general, neuro, vascular, gyn, and even robot. There is a VERY steep learning curve and I wish I would have had more orientation time up front. I worked there almost 1 year then left for a different job, partly because I never really felt comfortable. Luckily, I worked with some really great nurses and scrub techs who helped me out, but a few found pleasure in making the new people look bad. I actually outlasted the new person before me and one behind me, too, due to inadequate training. I am proud to say I was never kicked out of a room, but it was hard at times not knowing what they were asking for and having to find it.

My absolute least favorite was ortho - mainly because of the prep. We had to prep the surgical site where I was, but I heard some teaching facilities have the residents do it. Second least favorite was brain related neuro stuff...spinal was fine.

Overall, it was a GREAT experience and nice environment. We had fun between cases and setting up for the next one. Some of the surgeons could be very difficult to deal with, but many were very nice. I would have potentially stayed if I had more orientation time to learn the different supplies and instruments, but it just wasn't where I was meant to stay.

Good luck!

Kooky Korky, BSN, RN · Sep 6, 2015

OR is great if you like not having much pt or family contact. In my first OR, at a teaching hospital with med students & residents and nursing students and PT, OT, etc. students, I enjoyed the atmosphere - except for the true B's - and they were myriad. Being a guy, I think I had it easier than the new female staff. But I still had my share of razzing and being put down. I had to learn to laugh it off & not take it too personally. I even figured out how to hit back and make the razzers look bad, which is not my normal personality. They laid off of me after I turned the tables.

I lasted there for a year but wish I'd stayed. (transferred to ER, BTW, which was also filled with B's and I didn't much like our junk ER). I would have arrived eventually to run the place. Oh, well...

In my 2nd OR, it was still a teaching hospital, but much smaller and quieter, less flamboyant, calmer egos (egoes?). A whole different atmosphere prevailed, despite still having plenty of drama. I was Evening/Night Charge. We finished up the day shift cases and handled

after-hours emergencies. I never got to scrub, being the only RN, and had to be available to help Anesthesia with meds. I loved the job for the most part, worked with some great people who are still my friends all these decades later.

I happened to enjoy big cases & fast cases, belly and ortho, kidney and chest, not quiet Eye or painstaking Plastic or Hand cases. Hated Cysto, Broncho, I know I would hate outpt and having to start all those IV's. Forget Open Heart - too many prima dona surgeons, nurses,

and techs.

Do check about Call. We had to be dressed & ready to work in an hour. There were no pagers or cell phones back then so we had to stay by a phone or in the hospital. We got off the day after we'd worked cases on call, but most hospitals need you to stay over and work the next day if you were already scheduled to do so.

Good luck.