What do you like about OR nursing?

[Alex_RN, BSN]

I am a bedside RN and I shine when it comes to patient education, customer service, and the general areas of my specialty. I pride myself on doing a good job navigating my patients though their admission, especially upon discharge. I am curious about other areas of practice, though.

I had no info about OR nursing so asked the OR Educator about the upcoming Periop training program. It is a much bigger deal than I realized, like going back to school for six months. As an internal candidate and known entity, he tried to sign me up right away. I was a little overwhelmed.

I am going to go to an information session in a few weeks but from our talk, it sounds like it does not use my current strengths. Honestly, I have put a lot of energy into my current specialty and am not too interested in starting over.

I would appreciate hearing what people like about OR nursing, especially if they came from bedside nursing beforehand.

[MinneNurse, BSN, RN]

Hi there, I am a former bedside nurse turned OR Circulator! Hopefully I can answer some of your questions.

My first suggestion would be asking for a shadow day with a nurse in the OR so you can actually get a feel for what OR nurses do at your facility.

You said you shine in "customer service, and the general areas of my specialty. I pride myself on doing a good job navigating my patients though their admission, especially upon discharge." and that you don't think OR nurses use your current strengths.
I don't know what your speciality area is so I can't speak to that but I think all forms of nursing require customer service skills. In the OR we have to build a rapport with patients just as bedside nurses do but we have a much shorter time-frame to do that in. Patient education is no different. I meet my patient's for the first time during my pre-op interview and it is there that I have to build a relationship with them and provide education on the procedure and what they can expect going into the OR.

OR nursing is very different from floor nursing and my patient interaction is more limited. Some of my responsibilities as a circulating nurse include assisting with picking our case carts, setting up the OR, getting the required equipment and positioning devices, opening supplies and instruments to my scrub tech, gathering the ordered medications and handing them off to the sterile field, counting with my tech, and turning over the OR when the case is finished. In addition to what I mentioned earlier in terms of direct patient care I position the patient, place a foley catheter if ordered, assist anesthesia during intubation, and prep the patient's skin. I do all of the charting during the case while still watching and assessing the sterile field and I update the family during the procedure. There are many other things I do as well but this is a basic summary of what circulators do.

I always knew I wanted to be an OR nurse. I went to the floor to gain experience because the Peri-Op 101 program I wanted to get into required a year of acute care experience. I didn't mind floor nursing and I was good at what I did including the things you mentioned were your strengths. I had many co-workers tell me not to go to the OR, but my heart wasn't in floor nursing. I have never regretted leaving the floor, I only regret not going to the OR sooner. I absolutely love what I do. love being in surgery, I love learning something new everyday, seeing new cases everyday, I love making a difference in patient's lives that I can see first-hand, I love the fast pace, I love the variety, and I love working with my team.

The Peri-Op 101 program is a bit like going back to school because the OR is so different from the floor. When I first started I thought 6 months was so long, but you really need that time. It isn't an entire 6 months of class though, more of your time is spent in the OR with a preceptor learning.

You sound happy in your current position and as you stated you aren't interested in starting over, so why are you looking into OR Nursing?

[ctsurgeryscrubrn]

Hi Alex!

I started nursing school in the Operating Room. I did a 6-month Perioperative Nursing residency to facilitate the transition and was selected to scrub on our high-risk open heart team (mainly re-do re-do's, high-risk patients, aortic pathologies, emergent dissections, and long-run DHCA pump runs). I am now the lead scrub nurse on that team, and also take call with our L1 Trauma Surgery Rapid Response Team.

I always wanted to be an O.R. Nurse - from the first time I stepped in an O.R., I knew that the structure, complete focus on one patient, and teamwork played to my strengths and desires. As many say, "I didn't choose the O.R.; the O.R. chose me". In the O.R. (especially in high-risk CT), you have a group of people working in-sync to provide the highest level of hands-on care to give our patients the best chance of a better life (Surgeons, Fellows, Anesthesiologists, Perfusionists, PAs, RNs, and CSTs).

It was very nerve-racking when I first started as CT surgical teams aren't the most patient groups, but I found mentors on the team early on who encouraged me to take the criticism and unbelievable high expectations as a vehicle to be better - I'm not sure I would get that on a daily basis in another specialty. It is painfully obvious in the high-risk CVOR when somebody (no matter what role they have) is 'off'. It forces us all to treat 'excellence' as the expectation and not the aspiration.

I am lucky to work with the same team, which has its pro's and con's. However, it still amazes me how much action goes across over the sterile drapes with very little verbal communication. The hardest part then (and to this day) is losing a patient on the table. It's easy to lose sight of the fact that underneath all of the drapes and blood is a person with a family, with a personality, with hopes and dreams...that ended on our table. The hardest part for me is watching the team perform resuscitative efforts on the table that deep in my heart I know are futile.

Despite it all, there are cases I remember like yesterday...and they remind me why we give our all. I remember scrubbing a sweet 60-ish male's re-do open AAA repair (elective) - he knew it was high-risk. When we got in there, his aorta was unbelievable friable and it tore upon clamping. We cracked the chest to try thoracic clamping, but it was futile. I remember all 9 hours - drenched in sweat, blood, and sadness. I cleaned him up for his family.

Our stories from the O.R. are the extremes - impossibilities becoming longevity; risk becoming eternity. But, we win as a team and we lose as a team. There is a bond we share that makes the O.R. special to me and makes me want to always be a better nurse.

[scrubulator]

Hi! Im not a bedside nurse but still wanted to comment on what I like about the OR.

Im a big anatomy person so the OR is super cool. You get to see the craziest/coolest things-an adult heart beat on its own, a 1month old heart beat on its own, bullets being removed from the oddest of places (someones butt), remove an eyeball, see and touch someones brain, and hold a liver/lung/kidney etc. I consider it very much "behind the scenes" of the human body. Yes, most people think its gross but I think its super cool. Most people won't ever get to see that in a lifetime. Then you have these crazy cool lifesaving surgeries like transplant, imagine pre-opping a patient "hi sir/madam, can i have you confirm your name...DOB...allergies... and what are you here for?.... correct, a new kidney. I know you've wait 5 years for this moment". You can feel their nervousness/excitement, its so raw and palpable. Plus you get to be there to ensure it all goes smooth, you play a major part in this major milestone. You truly make a difference.

Plus, its one patient and one time. You can focus on your patient. You are there, the surgeon, anesthesia, and residents (depending on the hospital). So if *** hits the fan, you work together. True teamwork. I also work midshift so I get thrown everywhere but I like it. I can go from a hip replacement, to VATS to liposuction or mastectomy to ureteral stent placement to liver transplant. Its crazy cool and keeps me on my toes (while having the ability to always focus on one patient).

Hope that helps