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!
Specializes in Vascular,Heart team, Urology,Gen...
WOW....... I can feel your frustration and anger through your posting. First as an RN who has spent over 30 years in an OR, may I apologize for the "others" that are not helping our profession. My advice would be to first, take a deep breath and then when you go to work if you have not spent time in the central processing area (or wherever the instruments are cleaned and assembled) ask to spend a few days assembling your instrument sets. This should make you more aware of what is in the set's and what they are called. Talk to your preceptor and verbalize the needs that you have. Keep notes. One of the best things that people I have oriented have done is keep a notebook.(size doesn't matter) write down doctor's names, employees names, glove sizes anything that is difficult for you to remember write it down. Now the next part may not sit well with you, but here it goes. Try not to be to defensive.....I know... but the time to be asking about "all of the things that your opening" is not the best time to ask so many questions. After all, the patient deserves an operation that is going to happen on time. I believe that a new person in the OR should also scrub before they circulate! you should be with an experience individual (RN or Tech)this is the perfect place to see what the heck is happening.You would see what the instruments are used for.It also allows the surgeon's to get to know you.If you are not comfortable with gowning and gloving then take stuff home and practice.(after you have had the demonstration on the correct way to do it) Also, check out AORN and look into some of the great resources that are available. On closing it is important to know that we need new nurses in the operating rooms because the rest of us are getting OLD..... so hang in and all the best to you.
Amen!!! After over 8 years of experience in the OR I still have trouble understanding scrubs when they mumble. It is critical that we support our newbies. I have seen more quality, caring nurses chased from the OR by coworkers with no patience and it only adds to our shortage of qualified OR nurses. We were all new to this very overwhelming environment and need to support each other instead of bringing each other down.
It really does get easier. One day you will look back when everything is old hat and say, "why was my head so full when it all seems so easy now". It's a lot to learn, it truly is. The stress of the job doesn't make it any easier. I also found that the scrub techs were more willing to teach than the circulators. Learn from any possible source.
Thank you for your post! I am a new circulator AND a new grad a month into orientation and it can be overwhelming! I have had 3 preceptors over the last month and I am beginning to understand why it is so challenging. You are correct in stating that there is no education for the OR in school and we are starting fresh in the department, unless you have worked in the OR before. Now, on the floor as a new nurse, it seems that generally you have some autonomy in taking care of patients, but in the OR there are MANY eyes watching you at all times. When prepping the patient whether it's a foley or preparing the surgical site, there is the anesthesiologist, scrub tech, preceptor, and possibly the Dr. and a PA, sometimes tech students AND nursing students AND possibly a rep if it's an ortho or CV case. IT IS NERVE WRACKING to have that many eyes on you watching!!! Some days it feels like everyone is on your case about one thing or another. I keep telliing myself that I've only been in the OR for a month and I am still VERY new and can't know it all yet. Some days I have felt like beating my head up against a wall, but for the most part I truly am enjoying it and am looking forward to the day when I'll be off orientation and on my own. It is tough to be a preceptor and the newbie. I have told my preceptors that I know it is challenging and requires patience to do all the teaching. I've been on the receiving end of some negativity and it stinks, but I certainly know how NOT to treat the new people. For the most part, it has been great! I work with some knowledgeable people and am learning from everyone. My hats off to all OR nurses out there. So many people think that circulators have it easy, but BOY ARE THEY WRONG! It is an EXTREMELY CHALLENGING JOB!!!
Thanks again for bringing this topic up!! I needed to hear it!!!
I am also a new grad and will be starting my first day in the OR tomorrow morning. I am scared and excited all in one. I found your post very helpful and will make sure that I print it out to keep with me during my orientation. I have a great OR manager and great feeling about the facility I am working at. I forsee some hardships in the future, but am looking forward to the challenge. Thank you to all the OR nurses out there.
When I trained as a new surgical RN we actually had a surgery educator and specific teaching. The first 6 weeks we went to class for 8 hours and learned sterile technique and such. We also went to Central Sterile part of the day and put together the instrument trays. That is how we learned the names of the instruments. They next six weeks we actually scrubbed the cases. We learned to pass instruments to the surgeons and assisted in the various services. The last six weeks we learned to be a circulator. I transferred back to the sister hospital (they finally lifted the hiring freeze) after the first week learning to be a circulator. Although some people knew this, most did not. I would hear things like, "I thought you where an experienced circulator". I would have to explain that the sister hospital did things differently when it came to training. Actually their training program was great and taught me alot. I still tell my new circulators to go to central when it's slow and help them put together trays. I also tell them to look at the surgical instrument ordering book. Last but not least, always carry a pocket notepad and write everything down.
Specializes in Postpartum, Antepartum, Psych., SDS, OR.
Amen!!! After over 8 years of experience in the OR I still have trouble understanding scrubs when they mumble. It is critical that we support our newbies. I have seen more quality, caring nurses chased from the OR by coworkers with no patience and it only adds to our shortage of qualified OR nurses. We were all new to this very overwhelming environment and need to support each other instead of bringing each other down.
It is difficult to understand anyone when they mumble, wheather it is the Scrub person, RN, Dr. Or anyone else that chooses to do so. We can hear you, but not understand you. We should support our newbies, no matter what their job title is, or initals.
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Thanks for this reminder. I try to circulate and scrub as if it is with a new grad--I so remember being new and some of the setups I encountered!