My Summer In The Operating Room (kinda)
Inside the operating room once its been prepped and ready
Alright, so, it hasn’t been a whole summer, but more like a week (40 hours to be exact). I got the pleasure of picking up an elective (more like 3 electives) this summer and one being a perioperative elective where you get to work in the operating room and really get hands on with the patients and learn the roles of the nurses and intraoperative personnel. A lot of people will tell you that OR nurses aren’t “real” nurses and honestly, that rhetoric needs to die. It’s like, role shaming. Nursing is so vast and expansive that there’s no way someone could possibly make it unimodal. I suggest someone really learn the roles of as many nurses as possible while the opportunities present themselves. I, personally, enjoy my patients asleep.
If you’re wondering what I got to do, then you’ve come to the right place to learn about some insider tidbits that happen in the operating room. If you’re curious and want to explore the OR as I am, then here’s a slight inside look.
Let's Get Started!
My days started at 7am and ended at 3pm (per rules of my school). I'd come in and make sure to put on my shoe covers and a cap then head to the locker rooms and suit up in the hospital scrubs (no more street clothes allowed!). I'd look at the board and find my preceptor and then do my initial scrub/hand-washing then don my face with a mask. (Some steps are skipped, but this is basically my morning).
Some days could be slow or some jam-packed with back to back surgeries. I was able to see orthopedic surgeries where the surgeon amputated one half of a foot, fixed two ankles, and also repaired a fractured hip that was oddly shaped. Orthopedics really uses the hardware and it can get pretty gruesome. As much as I thought I wanted to go into orthopedics, it was a snooze fest and not always open surgeries (but there’s still some exciting stuff going on with prepping and monitoring as a circulator). A lot are laproscopic and use an x-ray machine called a C-Arm to get a view of where the pins and needles are going inside the patient’s body. It’s a lot of radiation popping in those surgeries so make sure you stay covered from thyroid to baby making parts.
Catheters, Skin Preps, Know Your Role and Shut Your Mouth...
I was able to get down and dirty (sterile, actually) and do some skin preps: wet preps which have betadine and can get real messy and chlorapreps which is usually just a stick you pop and let the fluids roll out onto the sponge and wipe away. I’ve prepped vaginas mostly because I was on a gynecology service...not fun. I never thought I’d see so much vagina in my life spread bald eagle, let alone have to do a wet prep on them. It was still a great experience to have and it definitely will get you over being shy about seeing patients in their birthday suits. I dealt with pregnant patients where we monitored the baby as well as the mommy and had to take precautions with the anesthesia and pain medications to make sure not to harm the baby. Overall, the gynecology rounds were pretty quick and to the point. So many things I learned about my own body just seeing the anatomy up close and personal. Who knew your ovaries and fallopian tubes were so tiny?! I mean, you think you know...then you have to identify them with your own eyes on a screen.
some supplies to be used for the surgery
My biggest moment thus far was a patient on isolation who was coming in for an appendectomy (that they CHOSE to have, wasn’t mandatory) and was having an exploratory procedure done of the abdomen for some pain. We began with a chloraprep and then I was thrown right into the scene by being asked to perform the foley catheter with a room full of medical interns, the surgeon, the CRNA, and my preceptor, as well as the scrub tech. The heat was on and I performed a seamless insertion without breaking sterility. My first penis of my OR rotation. FINALLY! Haha.
Aside from being inside the operating room and learning about all the different instruments and machines that keep things going, I learned about the role of the CRNA and the circulating nurse, as well as got some insight on the scrub techs. Everyone works as a team. Without communication an operation would NOT happen. Everyone has a job and everyone’s role is important. Being a circulating nurse means you are in charge of who comes in and out, what goes in and out of the patient as far as count is concerned, and making sure everything is set up and ready before a patient enters that room.
It was so interesting and also very scary to see how different patients react to anesthesia. Some patients actually end up moving in the OR while under and it calls for a reassessment of the drugs and making sure they’re completely under. It sounds scarier than it really is, though. It’s not like the horror stories you’ve heard, it’s simply just a call for a little more drug to be used (since drugs metabolize differently in different people). They don't recall a thing thanks to those cocktails and no harm is done to the patient.
From meeting my patient in the pre-op area and doing an assessment, as well as making sure the team has met with them and consent forms are all on file, to wheeling them to the operating room and prepping, to transferring them out to the post-op area and making sure they are taken care of the perioperative nursing roles are expansive and very much “REAL” nursing. Patient care is patient care. An asleep patient can’t tell you everything they feel and it takes skill to know exactly what each procedure requires and that everyone is doing their required role. Then to be able to take care of the patient post-operation is still nursing. From incision sites and being prepared in case there’s a complication dealing with the anesthesia used, there’s no shortage of nursing skills and assessment skills.
Did You Get To Scrub In?
YES! I spent a whole day with the scrub nurse/tech and was able to scrub in on the surgeries. It was definitely tough to not break sterility and sadly my first five minutes in, we had to throw the whole back table out while setting up. I don’t know why, but I was off kilter that morning.
Aside from that, gowning and gloving all the way to being right up on the patient and even helping with handing off instruments was extremely fun! Orthopedics took a turn for me this day, as I was able to be right there with the surgeon and ask all the questions. I also was able to help another aspiring high school student get acquainted to the OR. Each one, teach one!
All in all, scrubbing in is definitely no easy feat. You can’t scratch, can’t go just moving about all willy nilly. Definitely have to be careful! It was so nerve wracking, but worth it.
Is The Operating Room For You?
If you feel like the operating room is your calling, I definitely advise you to find a way to get in there and figure out if it is really for you. Some people find that they love working the floor more, and that’s just fine! I personally enjoy seeing specimen pulled out of the body and jarred, as well as watching the miracle of fixing things that are broken head on.
Happy nursing!
Where we separate from the family and send them
to wait as the operation occurs
- Begum, Over and Out! ;)
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