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What Do Operating Room Nurses Do?

Operating Room Article   (393,968 Views 147 Replies 1,220 Words)
by BethCNOR BethCNOR, BSN, RN (Member)

BethCNOR has 40 years experience as a BSN, RN and specializes in OR, ER, Med-Surg, ICU, CCU, Home Health.

1 Article; 6,255 Visitors; 60 Posts

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I have been an Operating Room Nurse since 1995. Previously, I worked in the Operating Room as a LPN/Surgical Technician from 1980-1994. I love working there. I do tire of hearing comments from other nurses that OR nurses don't really do nursing duties. You are reading page 5 of What Do Operating Room Nurses Do?. If you want to start from the beginning Go to First Page.

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Thank you for the post! It is my goal to eventually be in the OR, get my CNOR, then go onto RN First Assistant!

and subee... most facilities will not let you into OR nursing without previous RN experience AND periop training- be it outside training or in-house. The hospitals here don't even let you apply for their periop programs before you have 6 mos- 1 yr acute care nursing.

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conuan61 has 25 years experience and specializes in Anesthesia and Critical Care.

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I agree totally poetnyouknowit...Suggesting a "new kind of nurse" with a different license is just fragmenting the system more than it already is...we have LPNs (LVNs), RNs with ADNs, Diplomas, BSNs, MSNs and PhDs, DNSc (DNS), and DNPs. That's all we need now is to add another type of "Nurse" to the mix with a different license...that doesn't even make good sense. This is not emotion, it is true experience in the OR speaking! RNs have been providing HIGH quality care in the OR forever with very positive results. AORN is one of the strongest of the nursing organizations in our profession. I think that speaks for itself a great deal. Check the massive contributions RNs have made to military OR nursing too...war is where many discoveries are made to improve nursing and medical care.

And subee, I work in a facility where they train the 2 year associate degree surgical tech students from a community college...they are wonderful professionals and the OR would be hard pressed to function without them, but...their education is very technique based and is not specific to patient care (you know...what we RNs are supposed to be doing?) They are educated to assist the physician in the room and at the field...most of them have absolutely no idea what all is involved in the actual CARE of the patient before, during and after the OR. They have little to no pharmacology education beyond local anesthetics and do not practice using a system like our nursing process. Most of them also go through a 6 month orientation process upon graduation...they are not "up and running" when they graduate either. There HAS to be an RN involved in the case...if you have indeed worked for 30 years in the OR as you mentioned earlier, how can you not understand? You are suggesting that OR RNs do no more for the patient that a technician can do...I hope I never have surgery in your facility then...I hope you are never forced to have surgery in just such a set-up as you suggest either...I for one want an RN in my OR (and all the other appropriate professionals) whether I'm the CRNA or the patient. ANYTHING else is cheating a patient out of the care they deserve.

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subee has 45 years experience as a MSN, CRNA.

1 Follower; 17,729 Visitors; 1,715 Posts

I agree totally poetnyouknowit...Suggesting a "new kind of nurse" with a different license is just fragmenting the system more than it already is...we have LPNs (LVNs), RNs with ADNs, Diplomas, BSNs, MSNs and PhDs, DNSc (DNS), and DNPs. That's all we need now is to add another type of "Nurse" to the mix with a different license...that doesn't even make good sense. This is not emotion, it is true experience in the OR speaking! RNs have been providing HIGH quality care in the OR forever with very positive results. AORN is one of the strongest of the nursing organizations in our profession. I think that speaks for itself a great deal. Check the massive contributions RNs have made to military OR nursing too...war is where many discoveries are made to improve nursing and medical care.

And subee, I work in a facility where they train the 2 year associate degree surgical tech students from a community college...they are wonderful professionals and the OR would be hard pressed to function without them, but...their education is very technique based and is not specific to patient care (you know...what we RNs are supposed to be doing?) They are educated to assist the physician in the room and at the field...most of them have absolutely no idea what all is involved in the actual CARE of the patient before, during and after the OR. They have little to no pharmacology education beyond local anesthetics and do not practice using a system like our nursing process. Most of them also go through a 6 month orientation process upon graduation...they are not "up and running" when they graduate either. There HAS to be an RN involved in the case...if you have indeed worked for 30 years in the OR as you mentioned earlier, how can you not understand? You are suggesting that OR RNs do no more for the patient that a technician can do...I hope I never have surgery in your facility then...I hope you are never forced to have surgery in just such a set-up as you suggest either...I for one want an RN in my OR (and all the other appropriate professionals) whether I'm the CRNA or the patient. ANYTHING else is cheating a patient out of the care they deserve.

You still haven't made a cogent argument for having an RN in the room - just using vague generalizations. I happen to know that most OR nurses know NOTHING to VERY LITTLE about pharmacology since they don't have to give any drugs and what little pharmacology you do need to know could certainly be taught in an Operating Nurse program in a college setting - not helter -skelter on the job from people with no teaching credentials. RNS are NOT "educated" to assist the physician. Where was that question in the boards? They're taught a few technical tricks by people who aren't teachers. No there does not have to be an RN in the room - I understand perfectly. For right now, perhaps, there has to be an RN because we don't have anyone else, but when I had my surgeries, I was glad that it was minor and almost anyone would do. If I had to be on the table for a trauma, I want a good surgeon, a good anesthesia provider and a tech who served in the military. Those techs knew their stuff - they had to - they didn't have an RN to fall back on in the field. RN's were busy doing PATIENT care, not SURGEON care.

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conuan61 has 25 years experience and specializes in Anesthesia and Critical Care.

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"subee"...i have to stop this banter, but i have to say...your arguments are far from cogent also, except maybe in your own mind. i like to professionally spar as well as the next guy, but, just as your emoticons banging their heads on the wall show, you just seem to be angry about something in the or. i really can't understand your frustration over an established specialty branch of nursing that some of our colleagues choose to practice...unless of course you are an instructor in a cst program and are advocating for tech circulators.

i see by your profile that you are a crna with a msn...wow...i have to say i am very surprised! you realize, using your analogy, there is a subset of professionals out there that believe that anesthetists don't have to be nurses either. thus the evolution of anesthesiologist's assistants. obviously, you feel that they are better fit to deliver anesthesia than crnas since they are "specifically trained" to give anesthesia....none of that excessive, messy nursing knowledge clouding their practice. why go through all that nursing education first if you are just going to "give anesthesia?" do you really have to be an rn first? not by anesthesiologists' assessment. please......you really remind me of a couple of my crna instructors from many years back who felt that they had "risen above" the other rns in the or. i don't practice like that...they are my professional colleagues and i respect them for their patient care skills...unlike you. your facility must be very rough…our surgeons are respectful to our rns…this isn’t 1950 with “yes sir” and “no sir” just because they are physicians. we are all colleagues.

since you stated in your last post that military techs couldn't "fall back" on an rn because they were busy giving patient care, i am intrigued as to whether you have military background. i have several close friends who are military and my partner is an army crna who has served several overseas combat assignments . they tell me the army and navy are very pro-rn in the or when at all possible...my military or tech friends tell me that the rns in the military often directed some of the surgeons as to “where and when…” because they out ranked them (some of the career rns were majors, colonels, or lieutenant colonels) you act as though you don't truly understand or care to understand the difference between an or tech's and an or rn's responsibilities, yet you certainly must after 30+ years as a crna...i guess we simply have to agree to disagree.

so…similar to the curt way you put it...yes, there does have to be an rn in the or...i understand perfectly too. there always has been and there always will be...you know, busy giving excellent perioperative patient care, not surgeon care...surgeon care is the responsibility of the or techs and sas...

by the way, may i introduce you to "jeffthenurse"...you two have a lot in

common.

Edited by conuan61

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subee has 45 years experience as a MSN, CRNA.

1 Follower; 17,729 Visitors; 1,715 Posts

"subee"...i have to stop this banter, but i have to say...your arguments are far from cogent also, except maybe in your own mind. i like to professionally spar as well as the next guy, but, just as your emoticons banging their heads on the wall show, you just seem to be angry about something in the or. i really can't understand your frustration over an established specialty branch of nursing that some of our colleagues choose to practice...unless of course you are an instructor in a cst program and are advocating for tech circulators.

i see by your profile that you are a crna with a msn...wow...i have to say i am very surprised! you realize, using your analogy, there is a subset of professionals out there that believe that anesthetists don't have to be nurses either. thus the evolution of anesthesiologist's assistants. obviously, you feel that they are better fit to deliver anesthesia than crnas since they are "specifically trained" to give anesthesia....none of that excessive, messy nursing knowledge clouding their practice. why go through all that nursing education first if you are just going to "give anesthesia?" do you really have to be an rn first? not by anesthesiologists' assessment. please......you really remind me of a couple of my crna instructors from many years back who felt that they had "risen above" the other rns in the or. i don't practice like that...they are my professional colleagues and i respect them for their patient care skills...unlike you. your facility must be very rough...our surgeons are respectful to our rns...this isn't 1950 with "yes sir" and "no sir" just because they are physicians. we are all colleagues.

since you stated in your last post that military techs couldn't "fall back" on an rn because they were busy giving patient care, i am intrigued as to whether you have military background. i have several close friends who are military and my partner is an army crna who has served several overseas combat assignments . they tell me the army and navy are very pro-rn in the or when at all possible...my military or tech friends tell me that the rns in the military often directed some of the surgeons as to "where and when..." because they out ranked them (some of the career rns were majors, colonels, or lieutenant colonels) you act as though you don't truly understand or care to understand the difference between an or tech's and an or rn's responsibilities, yet you certainly must after 30+ years as a crna...i guess we simply have to agree to disagree.

so...similar to the curt way you put it...yes, there does have to be an rn in the or...i understand perfectly too. there always has been and there always will be...you know, busy giving excellent perioperative patient care, not surgeon care...surgeon care is the responsibility of the or techs and sas...

by the way, may i introduce you to "jeffthenurse"...you two have a lot in

common.

i'm just trying to have an intellectual debate and this is getting way to personal. but let me just revert to logic for a moment since no one has contributed to this as a debate - it's just a debate, not a personal attack on anyone. when its all socialized, the big government will be looking very closely at who does what. when i went to my np for routine maintenance check last week, i mentioned that i would like to work in a clinic (federally funded) like hers in another city. she told me that they don't use rn's - only lpn's (who took my blood pressure when i arrived in my little exam room) and np's. and before i give up on this, i will add that i'm much more active in my state nurse's association than i am with aana. i have one work site where i get to choose my room in the morning and nurses ask me to work in their rooms. i hang out with the rn's in their lounge - not in the anesthesia lounge because i like nurses. i work on a state committee with the most interesting people - all nurses who are real change agents. oh yes, i would never advocate for the anesthesia assistant because i am a certified nurse anesthetist who uses all my nursing experience every day - not just what they taught me in crna classes. i use every nursing course i took as an undergraduate (with the exception of nursing theory-ugh). so in the interest of decreasing the ugliness on this thread i quit.

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1,725 Visitors; 20 Posts

Thanks, this is great!

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CranberryMuffin specializes in Critical Care, Patient Safety.

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Thanks for the information!

I've been contemplating trying to become an OR nurse as a new graduate. Do you recommend doing this, or do you think it's better to get some experience first during more general adult med/surg care? I don't want to feel like I'm missing out on that, either, but I loved my OR experience while in school and think it might be the way for me to start my nursing career. Plus, I like the idea that having OR experience is something that can contribute to work in medical missions, something I want to do down the road...

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OR RN Ramone has 18 years experience and specializes in Surgery.

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I have had the pleasure of being a nurse for 14 years. I began my career working on a Med unit doing mostly gastroenterology and later switched to oncology. I have been working in the OR now for the last 8 years and have enjoyed it more than anywhere else I've worked as a nurse. I guess you could say that it "fits" or that it suits me and is what I want to be/do with my nursing knowledge. I think it's up to every one of us to find that place for themselves and to become the best nurse that they can for the sake of those we care for. I will admit that pharmacology is no longer one of my strongest skills because of the limited pallette of drugs that are used in the OR setting, but I am intelligent and skilled enough to use the references that are available when needed, is that not a skill that we all learned in nursing school? I have also had the pleasure of working in another country (Germany) for 6 years. For those of you who don't know, Germany has a social medical system. I can assure you that ALL non-physician staff members in a german OR are RNs, and my german friends find it amazing that we silly litigation happy Americans would ever allow "underqualified" personnel into the OR. We also have ventured into the 21st century where it has become quite possible and common for physicians to show respect and admiration for us lowly footfolk and I am anything but a lowly "gofer". I find it disturbing that the old disdain for fellow professionals has now shifted to sow discord among our very own ranks. To you new colleagues who are interested in the OR, I hope you find it to be challenging and rewarding! and to those of you who seem to believe a chimp could do my job, don't worry I'll treat you with the care and skill that all of my patients deserve and receive when you land on my table!

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1,473 Visitors; 13 Posts

Well done, most enjoyable read....it allowed 'outsiders' to take a closer look. Thank you.

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I agree, I don't see any high skill necessay to be an OR nurse. I know nurses who worked in OR several years and decided to transfer to the med-surg floor. They run back to OR in a matter of weeks, could not handle the floor, no organization skills, unable to care for 5 patients, having to call MD and report patient's conditions, they had hard time and from then, they respect what floor nurses do.

Edited by 2407

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I am offended that you think that an OR nurse need 6-9 months of training and they can just go to any floor and learn it in a couple of days. Do you really think that? I have worked floor nursing and worked in the ED also as an RN. If anyone can learn it in a couple of days, they should be working at NASA in a think tank! Cause they are def. a genius! P.S. I know and OR nurse that wants to transfer to a floor and needs more than a couple of days training and I dont think that speaks badly of her skills. Remember we dont have a doctor right there that we are assisting, we are doing the working on the patient and will call the doctor if needed.

Amen, 6-9 months training in OR, wow, some intensive care units don't train this long. Thinking that one can go to any floor and learn floor work in a couple of days is, false. What about organization skills, med administration skills, assessment skills, documentation, etc. No MD at bedside, we use our judgement and our critical thinking skill, I don't know if it is the same in Or. When I went to observe in OR the only thing an RN did was to insert a foley, did not talk to the patient. I am a pacu nurse now with 4 years of med-surg experience, OR nurses don't give us any report when they brought patient but CRNA or Anesthesiologist does. I respect all nursing specialties, and I admire OR nurses for choosing what they do.

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ChicagoNIT, I recently started in the OR after working 1 year in pediatric home health (no floor experience). From what I've seen so far, floor nursing has virtually nothing to do with OR (performance wise, that is). Several nurses I'm working with went straight to OR after school, simply because they knew that's what they wanted to do, career-wise.

Having said that...... my opinion is that it would be *better* to have some general med-surg experience before doing ANY other kind of nursing. I only recently came to this conclusion; the reason being is that it would be easier to put disease processes together, labs, general skills (foleys/IV's/etc) with some general floor experience. You will actually understand the WHY's of your patient, instead of just blindly following orders. Please understand this is coming from someone who absolutely KNEW she didn't want to be a med-surg nurse.... I preceptored the last semester on a med-surg floor, and unless the ratios change, I know I could never be a good med-surg nurse!

I wish the system would change so that new nurses could spend 1 year getting solid floor experience before attempting anything else; maybe buddying up with a seasoned nurse during that time, building confidence and gaining knowledge. Instead (and maybe it's the crappy economy), after boards, we are left to apply willy-nilly to wherever, just to get a job. Then we have to worry about getting pigeon-holed in a certain area. After about 9 months in home health, I worried sooooooooooo much about not being able to do anything else. And while I'm grateful for the chance to be great in an OR setting, I still feel like there are giant gaping holes in my learning. It is a completely different thing to study something for a test, spit it out to get a good grade, then it is to see it in real life!

I know this is part rant, but I've just been discouraged by the whole system lately. Everyone talks about overhauling the health care system, but I think the way nurses are trained needs overhauling, too...... for the sake of our patients and the sake of our careers.

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