RN, MSN, MSHA
After I had eye surgery in 1974, I fell in love with the nurses who took such great care of me; it inspired me to pursue a career in OR nursing.
I started working in the OR in 1995, when a position became available at a Level I Trauma Center.
At the time, I was still in school pursuing my nursing degree, so I was working in the background as a secretary. That opportunity gave me insight as to what was going on behind the scenes in the OR as well as some of the various operating policies and procedures.
Once I graduated with an Associate’s Degree in Nursing (ADN), I began working full-time in OR nursing, my dream job!
Unfortunately, due to MAGNET protocols in hospitals, nurses with ADNs are now required to earn a Bachelor of Science in Nursing (BSN) degree to work in OR nursing.
Going back to school while working full time was challenging, but there are numerous programs that offer online learning opportunities and make it easy to get a BSN degree!
Beginning a career in OR nursing requires tons of training and a lot of patience.
New OR nurses go through a perioperative program to learn about their specific roles in the OR and how to perform them efficiently. The program can take up to two years for new nurses and usually about six to eight weeks for experienced OR nurses.
In many hospitals, there can be many services to learn, and this takes time because the instrumentation and equipment are different for each one. It could take up to a year or longer before the new nurse feels completely comfortable in the OR setting.
So, I mentioned there being specific roles in OR nursing, but what are they?
Let’s get into it!
There are two important nursing roles in the OR – the circulator and scrub nurses.
Nursing information and job resource, The Daily Nurse, defines the role of a circulating nurse as an individual who,
“ensures that surgical asepsis is adhered to during the surgical procedure, keeps track and conducts an inventory of supplies and equipment used during and after the surgical procedure, or calls for a time-out.”
On top of this, they also greet the patient before surgery and verify all consents and other paperwork.
Scrub nurses, on the other hand, work mainly within the sterile field at the surgical bed.
They pass instruments to the surgeon while ensuring the sterility of all equipment and supplies on their table. They also keep count, along with the circulator, of all the sponges, needles, and instruments used during a procedure.
Both the circulating and scrub nurses are essential members of the surgical team.
Deciding to pursue a career in OR nursing is only the first step.
This specialty alone has over fourteen different services:
Extensive list, right?
There is no limit to the exciting cases an OR nurse can be involved in, whether it is from the perspective of the circulating or scrub team!
OR nursing is a specialty within nursing for those who like to help their patients and see an instant result in their care.
Now sometimes, this is not always the case, but for the most part, we do our best to return patients to a better state of health than we first met them. That alone is quite rewarding.
The rumors are true, we only take care of one patient at a time!
It begins with greeting the patient in pre-op and ends with them being transported to the recovery unit. We do everything they need as far as positioning and making sure they are comfortable before going off to sleep.
At the end of a procedure, the OR nurse will assist the anesthesiologist in waking the patient up and moving them back to their original bed.
It is an honor to advocate for these patients while they are asleep and cannot speak for themselves.
This environment is fast-paced, and no two surgeries are ever the same.
There is never a dull moment in OR nursing.
We stay focused on what is needed to get the patient through the procedure safely and efficiently.
For example, a nurse could be scheduled for general service for the day, but an emergency comes in, and bang, she is off to do a broken femur.
Things can change at the drop of a hat in the OR.
We have been called from the emergency room several times to say they were coming with a patient right then, giving us only minutes to prepare the OR and get ready. Stressful? Yes, but at the end of the day, we do our best to help our patients.
With constant technological advancements, the OR continues to improve its procedural techniques and time per surgery, too!
Where taking out a gallbladder used to require a long incision across the lower right abdomen, now with laparoscopic surgery, it can be done in about fifteen to twenty minutes!
On top of this, robotics also allow for more precise and smaller incisions, which means less pain, lower chances of infection, and quicker healing times for the patient.
When training to become an OR nurse, one will learn that attention to detail is vital. One minor mistake can change the course of an entire procedure!
For example, I had a patient who woke up from a brain surgery with one pupil blown.
Anesthesia wanted to get them down to CT as soon as possible. I spoke up and told the anesthesiologist that when I interviewed the patient in pre-op, the pupil looked that way before the procedure.
I noticed and made a note of it in the patient’s chart, which alleviated some stress on everyone in the room. Those small details can make or break your day.
At the end of the day, teamwork is the backbone of the OR.
One room may have up to four people in it, maybe more, including the circulator, scrub nurse, anesthesia, and surgeon. Some rooms, depending on the hospital, may have a surgical assistant, a resident, student nurses, or medical students.
Teams can make for a great or bad day, so find out what everyone needs and make sure everyone works together toward the common goal of excellent patient care.
The scrub nurse and circulator should know what the surgeon wants before he even asks. A great circulator will know what the scrub nurse wants before they do. It is a sign of knowing your team and how you can best benefit them.
Can you see yourself in this environment?
A unique set of skills is required, but if you are open to learning new procedures and new ways to perform them, you will thrive in the OR.
Being calm in stressful situations, working with others, learning many different services and their instrumentation, advocating for your patients, and being highly organized are just a few of the job requirements.
If this sounds like you, please consider OR Nursing. It is a rewarding nursing specialty!
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