When I was in nursing school, all I wanted to do was be an OR nurse. Well, I thought so anyway. I had become a scrub tech for the OB unit I worked on as a nursing assistant. I loved everything about the OR. The smell of the scrub soap, the comfy green scrubs, the shoe covers, the fact that I didn’t have to fix my hair. Boy, did I have a lot to learn. I decided to shadow in the OR one weekend with an ENT/facial plastic surgeon that a family member worked for.
Needless to say, I only made it through the first surgery- an eyelift (blepharoplasty). It was a lot different than the C-sections I was familiar with, but I hung in there. The second surgery was a 4 year old little boy that was scheduled for a tonsillectomy. I thought it be as simple as snip and clip~ I wasn’t prepared for all the blood, I became very faint and nearly passed out. I never did become an OR nurse, but I realized a lot about them from testing the waters.
Let’s face it, nurses really do call all the shots. Moreover, it takes a special person to become an OR (operating room) nurse. We all know that surgeons are very interesting to work with. Each surgeon has their favorite gloves, soap, instruments, and sutures.
Even though surgeons are brilliant in their craftsmanship, they can be somewhat needy. On a serious note, the OR is perhaps one of the most delicate environments in a hospital setting. It takes a highly skilled professional to ensure both clean and aseptic features of the operating room. Any deviation from standard operating procedure and the outcome of patient care can prove detrimental. Surgeons couldn’t perform their invaluable service without a quality OR nurse. Ever wonder why so many OR nurses have been in their positions for 15 plus years? They likely realize that their unwavering skillset compliments the roles of the surgeon, anesthesiologist and patient.
Aside from the fashionable caps they literally wear, the OR nurse has some variety in the duties they perform on an average day. Most OR nurses are assigned the roles of scrub or circulator. As circulator, the nurse coordinates all aspects of the patient care before, during and after the patient procedure within the assigned OR suite. The duties of the circulator include assisting with scrub ins, helping the anesthesiologist, maintaining supplies, reviewing the medical records, initiating time-outs, documenting vital signs, fluid and blood loss, and drawing up medicines. The most important responsibility of the circulator is to monitor for complete integrity of the sterile field. As the scrub nurse, one usually is the “first assistant” to the surgeon. While there will likely be a surgical tech assigned to most cases, the scrub nurse may stand in place if the procedure is complex or specialized. Scrub nurses generally assist with the closure of wounds, maintain sharps and gauze counts and pass instruments. The precision of knowledge required by scrub nurses come in time with a variety of experience. It is safe to say that no matter the assignment, the role of advocate takes precedence in the grand scheme of things. OR nurses often meet patients during sensitive times in their lives. They have to be able to work with all patients across the lifespan. From newborn to geriatric, trauma to elective, the OR nurse is required to meet diversity and culture at the door.
I cannot recall one nurse I’ve met who couldn’t recall one good or bad thing about their role. There are many advantages of being an OR nurse. OR nurses are an important part of the patient reaching goals toward the restoration of their health and well-being. Regardless if the case is a trauma or an elective cosmetic procedure, the OR nurse functions as an imperative factor of the patient outcome. This can be rewarding in and of itself. Another positive note about OR nursing is the variety of the work. Even if there are a vast number of simple procedures scheduled for that day, at any moment that suite could face meeting the challenge of a life-threatening obstacle. OR nursing also offers nurses to become specialized in certain areas of surgical care. A nurse may opt to work in ambulatory (outpatient) surgery or in the hulls of a Level I trauma center. The opportunity to advance in surgical nursing is favorable.
Now, of course, let’s be real. OR nursing is not for everyone. Because of sterile field being the most important variable within the OR, this often means the nurse may have to spend hours on their feet without a bathroom or lunch break. Constantly having on a mask made me feel a little claustrophobic. Standing up under those lamps made me sweat and it irritated me that I couldn’t just wipe the sweat from my brow (there goes that sterile field thing again). Perhaps the most necessary evil of all nursing is taking call. OR nurses generally have a call rotation and carry a beeper during their call. They have to be ready to report to the OR on a moment’s notice, and this can be a part of the job that is stressful.
All specialties within nursing require an active RN licensure. This is obtained through successful completion of the NCLEX-RN exam. An associate’s or bachelor’s degree is a general level of entry level nurses. OR nurses must have all the basic certifications like BLS/CPR, as well as advanced training like ACLS, PALS, and TNCC. Generally a nurse must have one to two years of nursing experience before working in the OR. OR nurse also have to participate in annual departmental and specialty competencies in order to practice in the surgical settings. These competencies likely include being checked off on maintaining sterile field, proper scrub techniques and understanding of patient safety protocols. As discussed earlier, a nurse may advance within surgical nursing and opt to become specialty certified as an AORN.
Traveling as an OR nurse can prove to be a highly exciting part of the job. OR nurses can go just about anywhere to seek employment. The foundations of quality surgical nursing should occur across the board, in every facility capable of providing surgical services. Traveling can be particularly favorable for the OR nurse that may seek gaining diverse experience. A nurse may wish to work in a more highly accessed facility because of the acuity of care, or they may opt to work in a more rural facility because of their critical need. When supply meets demand, whether in patient care or nursing needs, the pay, incentives and rewards of experience can prove to make the nursing profession exemplary.
By Jennifer Petrea, RN
Jennifer Petrea is a Registered Nurse from Concord, with clinical experience that includes critical care, ER, trauma, hospice & palliative care and case management. Jennifer is currently pursuing a Master’s Degree in Nursing and certification as a Clinical Nurse Leader. Jennifer also works as a freelance writer for various medical, health and fitness projects.