Working with new circulators

[Sammy25]

I've seen lots of posts on this site about new OR nurses trying to cope with orientation. It seems like people who have worked in the OR their whole lives sometimes don't see the whole picture and expect fresh new grads to think and work like they have been their 20 years, and that really frustrates me! I know that doctors and nurses want things to go fast and proficiently without disruption in the room, but it takes a lot of time, and I mean A LOT of time for a circulator or scrub to get used to things, and that does not give any excuse for yelling, cursing, or even rolling their eyes at them, which I have seen way too much. I know it can be frustrating, but they are trying, and it just produces frustration, anger, and additional stress for everybody. As an RN, we don't have an "operating room" class in nursing school so when we come in we have to learn a whole new language. My suggestion is that when a new RN comes in, that you get to know them and help them out... and here is some other suggestions to help them learn and develop their skills...and to save time especially for those scrubbin in..

1. When getting the room ready, explain things as you guys open. Tell them what kind of instruments you are currently opening and what they are used for. Point out and name items on the cart that they possibly need opened during the procedure so when asked for them they don't get confused and are searching around.

2. When asking for something, say their NAME and SPEAK CLEARLY, don't just muffle out words. Even though we are trying to tune in to you guys, voices can be muffled behind masks and we don't know if you are having a conversation or asking for something. Also, we might not understand names of instruments you are asking for and their names can be funny...like "tenotomy, or debakeys, or other weird names so be clear and articulate.

3. Also when asking for something, tell them where to find it and describe it. Tell them what it is and if it's on the cart, in the closet, in the core, or if you need to call down to instruments. When I was new there were many times when the scrub would muffle something I didn't understand and would roll their eyes at me when I asked them to repeat it...and then yell at me when I couldn't find it right away... and then roll their eyes again when I gave it to them.... yea please don't do that it makes us feel like "you know what"

If you guys have any other suggestions please feel free to post them here!

Sara Beth

[Marie_LPN, RN, LPN, RN]

Very good post.

[kyd007rn]

:yelclap: :yelclap: Thank you Thank you Thank you!!!!!! :thankya:

I am new to the OR as well I have been training since August. And man it's a hard thing. Just last week I had 2 scrub tech who mumble and rolled their eyes because I asked them to repeat what they said. For God sake man people forget so quickly that they once were new grads as well.

your post was just excellent! I may print this and show it to omy educator! You said everything I have wanted to see, hear and have doing my training!

Thanks

[Texasaggie43]

I can relate to everything that you are saying. I have been in the OR twenty years. Even though it goes on and I hate to admit it, the OR is the #1 place where Nurses truly eat their young. I really have no explanation as to why this happens. You have to learn to develop a thick skin or you won't make it in this field of Nursing. It is a very high stressed area to work in to begin with. There are good mentors and preceptors in the OR. You just have to make sure that you are placed with them during your orientation period. I will never forget the Nurse that oriented me. I give her all credit for making me the OR Nurse that I am today. Good luck to you and remember it is all right to give out but don't give up!

[IsseyM]

Thank you so much for posting this. This is awesome and should be posted on the bulletin board in every OR, emailed to OR nurses, shared in staff meetings, etc. Orientation is very hard and it only makes it harder if our preceptor doesn't want to teach or doesn't have the patience. A mean/rude preceptor can ruin your day and take the joy out of learning. We do bring up issues with our clinical educator but some times we keep it among ourselves because we're afraid of retaliation....which one of the gals in my class has already experienced. I wish more OR nurses were more understanding, supportive, encouraging, nurturing, sweet as honey and patient as Job from the Bible. LOL! Oh wait, that would be in a perfect world. Well, so far i've only had 2 preceptors that fit this description. Once again thank you for posting this.

[dturcotte]

Hello,

I was very interested in the above threads and am wondering if the surgical masks also play a role in the communication issues. Do you feel the muffled voices behind the masks pose a safety risk?

Best

[nurseontheloose]

one thing that helped me out, was, i had a scrub tech, that took the time one day while pulling for a case, to expain exactly what the instrument/equipment was going to be used for. so the next time they asked for something (behind the muffled mask) i was able to get it and know exactly what they needed. ie all the different ports you need for a laprascopic case.

[valifay]

Great post! I think more people need to be understanding of new grads. I have seen many poeple training that have no business doing so. Some people jsut don't want to do it and get stuck with a new grad which only makes tihngs worse. But, you have to stay strong and not let their attitudes effect you. Also, I think alot of the times the ST is overlooked when a new nurse is training. Don't be afraid to ask them questions about what they are doing and why. They often know more about the instruments and set up than the circulator and the doctor...

[Ann-RN]

Yes, I relate to your post. I am new to OR just about a month and during my first few days of orientation, the senior nurses in the OR didn't bother to orient me. As if they're expecting me to know everything, hello! im just new here! A month after my orientation, I've adjusted to the routines in the OR, I know the instruments etc.. and now what I'm hearing are comments from these seniors regarding me... I know they're just jelous of me because surgeons happened to like how I work... "terror" doctors never yelled at me even if it is my first time to assist them on a procedure I never handled before. One surgeon even commented how good I was and compared me to my colleagues, I know they heard that and I started to feel "oh my gosh, he should not compared me, because I know my co-workers would not like me even more". I also observed 1 senior adding extra charges to patient's bill which the patient never used while in the OR, like the general anesthesia, the patient only used 10cc of it but the senior nurse charged the patient 20cc.. I know we should be pt advocate, and I don't like seeing things this way. I work in the OR professionally but my seniors do not and I think that is why they hate me so much.

[tinkerbell06]

Thank you so much for the post. I am new to the OR also and I wish I was more like some of the others that learn things quickly in the OR. Unfortunately being a new RN grad and new to the OR is causing me to be a little bit slower than most. I found out in my experience that some of the scrub techs have been more helpful than the circulators. If the RNs would think back on how it was when they first started, maybe they would take the time to teach. I think orientation would be better if you could stay with a good preceptor for several weeks and then rotate through different services. There is so much to learn, don't get too down on yourselves. Everyone keeps telling me it takes one full year to feel more comfortable and two years to maybe get the hang of it.

Good luck to all the new OR circulators, they say it gets better.

[Siouxz2]

THANK YOU for this post! You have summed up all my frustrations very succintly. I was 3 months into my 6-month orientation when I had to have back surgery for a herniated disk. When I go back, I will have been gone about 3 months or so. I am having anxiety attacks every day, worried about what I've forgotten and fearing I'll be back at square one.

I have struggled every day of my orientation. I especially had a hard time understanding what was being said through the masks. I knew I had a hearing loss, but when I went to get tested I found it was moderate to severe! Now I have hearing aids in both ears. Hope that helps matters a bit.

Also, amen about the surg techs! When I first started in the OR out of nursing school, I made a vow to treat EVERYBODY with respect. Those ST's have saved my hide a number of times. I value their knowledge. They are very good friends to have. Much of the time they are kinder than the nurses who are orienting me.

[SandraDeeRN]

I will be going to the OR next month and I am nervous about all of the above. My hospital doesn't hire new RN's into the OR you have to have a min of two years on med surg to work there which I have. I don't know how much of a difference that will make though. The OR is a whole new world....