Day in the Life of an Operating Room Nurse

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Outline

Overview

Who is the operating room nurse?
1. AKA
  1. Surgical nurse
  2. Perioperative nurse
2. Work in the surgical/procedure setting
3. Provides care
  1. Before, during, after surgery
4. Roles
  1. Circulate
    1. Non-sterile person in OR
  2. Scrub
    1. Assist surgeon with instrumentation

Nursing Points

General

A day in the life
1. Circulating RN/Scrub RN
  1. Obtain assignment for the day
    1. Morning of or night before
  2. Prepare OR
    1. Equipment
    2. Supplies
    3. Implants
    4. Positioning devices
    5. Instrumentation
  3. Collaborate with OR staff
    1. Preoperative surgical count
      1. Needles
      2. Sponges
      3. Instrumentation
  4. Maintain sterile field/environment
2. Scrub RN only
  1. Scrub hands/arms
  2. Gown and glove
  3. Assist surgeon
    1. Instrumentation
    2. Suturing
    3. Retracting
3. Circulating RN only
  1. Review your patient
    1. History
      1. Previous surgeries
    2. Medications
    3. Medical problems
    4. Allergies
    5. Paperwork
      1. Consent forms
      2. History and physical
      3. Provider orders
  2. Bring patient to OR
    1. Assist with
      1. Lines
      2. Intubation
      3. Catheters
    2. Prep surgical area
    3. Perform “time-out”
  3. Maintain
    1. Patient’s position during surgery
    2. Thermoregulation
    3. Communication with family
    4. Retrieve supplies/instruments
  4. Assist with
    1. Emergence from anesthesia
    2. Transfer to PACU
      1. Report to PACU RN

Assessment

Pros
1. Immediate results visualized
2. Every day is different
3. Exciting
4. One patient at a time
5. Work with a team
Cons
1. Can be on-call
2. Extreme pressure
3. Fast pace
4. Very physical

Therapeutic Management

Specialty certifications/education
1. Certified Nurse Operating Room (CNOR)
  1. Validates knowledge/skills of OR setting
    1. Must have
      1. RN license
    2. Work in perioperative nursing setting
      1. 2 years of experience
      2. 50% intraoperative
  2. Take and pass exam
2. Registered Nurse First Assist (RNFA)
  1. Advanced training to assist in surgery
  2. Must have
    1. BSN
    2. CNOR
  3. Complete clinical hours

Nursing Concepts

Teamwork and collaboration
Patient-centered care
Clinical judgement
Safety

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Transcript

Hey guys! Today I get to talk to you about what it is like to be an operating room nurse! This is something that I know a ton about as I have been an OR nurse for over 10 years! This is definitely a very specialized area of nursing and I have found that you either love it or hate it….and I have always loved it! Hopefully, I will be able to give you a little insight into what it is like to work in this area as a nurse!

Ok so first off you need to know that the operating room nurse is also known as an OR nurse, surgical nurse, and the newest term is the perioperative nurse. The OR nurse works in the surgical or procedure setting and we provide care before, during, and after surgery. The operating room nurse can either circulate which means they are the only unsterile team member (besides anesthesia) in the operating room or scrub which means they assist the surgeon with instrumentation and the surgical process while being sterile.

So lets take a look at a typical day for both the circulator nurse or the scrub nurse. So for both of these roles you will obtain your assignment and this can be the morning of or even the day before. Where I work we find out our assignment for the next day the day before which is great because it allows the OR staff to prepare the OR in advance. We also prepare for our assigned surgeries by gathering equipment, supplies, implants, positioning devices, and instrumenation for the surgery. In both the circulator and scrub nurse role there is collaboration that takes place by performing a preoperative surgical count and maintaining the sterile field and environment before and during the surgery.

When we take a look at just the role of the scrub nurse in this role the day would begin with the scrub nurse scrubbing hands/arms, gown and gloving, assisting the surgeon during the procedure with the passing of instrumentation, suturing, and retracting. The scrub nurse is a sterile person in the operating room who is responsible for protecting and maintaining the sterile field.

So when we look at the circulating nurse role after preparing the OR for the day and collaborating with the other surgical staff members the circulating nurse will review patient information including the medical history, previous surgeries, medications, medical problems, and allergies. A super important part of the circulating role is to verify the presence and proper completion of consent forms, history and physical, and provider orders. Once the patient’s surgical site has been marked by the provider the patient is brought to the OR where the circulating nurse assists anesthesia with induction and intubation then the patient is positioned, catheters are placed and then prepped or cleaned. The circulator performs a surgical “time-out” to verify the correct patient, procedure, and site. During the procedure the circulator maintains communication with the patient’s family, patient position, thermoregulation, and retrieve supplies and instruments for the sterile team. The circulating nurse with the scrub will verify the surgical count is correct before closing the patient. Once the procedure is complete the circulator assists with emergence from anesthesia and transfers the patient to PACU and gives report on the patient and the procedure performed.

What are some of the pros of surgical nursing? So one of the reasons why I love this field is because you see results immediately…most of the times a patient comes in to the OR with an issue and when they leave that issue is no longer there! Another thing I love is every day is different! It really isn’t ever boring….although this is a reason why some people do not like this field! It definitely takes a good amount of time to feel comfortable especially when there are so many surgeries and surgical specialties to get used to like plastics, ortho, spine, CV, general, ob/gyn, ent, etc. Another awesome thing about OR nursing is you only have one patient at a time guys!! If you work on a med surg floor I am sure this is music to your ears possibly taking a ridiculous amount of patients at a time! One final pro is that you work in a team meaning you are never alone, there is always a helping hand or support person right with you!

So what about the ugly of surgical nursing??? So depending on where you work you may have to be on call for those emergency surgeries in the middle of the night which I can tell you are absolutely no fun at all and get old fast! There also can be extreme pressure in the OR…let me give you an example….so I am sure you all have that one provider, physician, or surgeon that you are just not crazy about or lets be honest just not like. Well can you imagine coming into work and seeing that you have to work with this particular provider for an entire shift in a room with no windows…..just you and them! Guys in the OR there is no escaping or hiding in a patient’s room or only communicating by phone. There can definitely be a lot of pressure if you do not get along with your team. Also guys surgery can be a very fast paced environment with little to no rest! This is definitely the case where I work in fact we just had a couple of nurses who were new to surgery leave for this reason. Also the surgical environment is very physical which personally is a reason why I like it but for some it can be a lot. You move patients all day, push large equipment, and pick up and carry heavy instrument pans and trays.

Let’s take a look at some certifications that are specific to the operating room nurse. So this first one is the CNOR certification which stands for Certified Nurse Operating Room which basically means you are an expert in this field. So to gain this certification you must have an RN license, have 2 years of surgical setting experience with 50% of this time being in the intraoperative setting. After all prerequisites are completed you can sit and hopefully pass the CNOR exam!

So another specialty certification specific to the OR is the RNFA or Registered Nurse First Assist which is an a nurse who has received advanced training to be able to assist in surgery. The prerequisites for this certification include a BSN and also the CNOR certification which I just talked to you about. Finally there are quite a number of clinical hours that must be completed to obtain this role.

Ok guys lets review! The OR nurse is also known as a surgical nurse or perioperative nurse who cares for a patient before, during, and after surgery, and they can circulate or scrub. In the circulator and scrub role the assignment is obtained, the OR prepared, and the sterile field maintained. In the circulating role the nurse reviews the patient, bring to OR, and prepare and protect patient during surgery. Pros include immediate results, each day is different, one patient at a time, work with a team. The cons include being on-call, extreme pressure, fast pace, and physical. Certifications include the CNOR and RNFA.

A few nursing concepts that we can apply to the Operating room nurse’s day include patient centered care as we have one patient at a time, safety as this is always the main goal of the OR nurse, and teamwork and collaboration as a OR nurse can not work without their team!

Day in the Life of an Operating Room Nurse

You're watching a preview. 300,000+ students are watching the full lesson.

Included In This Lesson

NURSING.com students have a 99.25% NCLEX pass rate.

Outline

Overview

Nursing Points

General

Assessment

Therapeutic Management

Nursing Concepts

Unlock the Complete Study System

Used by 300,000+ nursing students. 99.25% NCLEX pass rate.

Transcript

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