1. Operating Room Nursing

2. What is OR nursing?
An OR nurse is considered a periOperative nurse that is responsible for the care of the patient before, during and after surgery.
The circulator is required to be a registered nurse- nonsterile to help anesthesiologist and surgeon during surgery
Depending on the hospital, an RN can also be trained to scrub.

3. Team Work The operating room consists of a team. This includes
The surgeon
The anesthesiologist
The surgical scrub technicians
The RN circulator
Potentially a Physician’s Assistant and/or sales representatives

5. Specialities
There are different specialities that exist in the OR and differ depending on the hospital
General
Gynecology
Ear, Nose and Throat (ENT)
Dental
Plastics
Vascular
Orthopedics

6. Responsibilities Before surgery
Ensuring the OR has the proper equipment, any positioning devices, and the operating room table is in correct position, anesthesia circuit and suction is hooked up, BAIR warmer and sequential compression devices (SCD’s) are readily available
Counting sharps and sponges (instruments if needed) with the scrub person
Pulling medications such as local and antibiotics
Reviewing the patient’s chart to ensure the history and physical is within 30 days, the surgical consent has been signed within 60 days, and the day of surgery note has been entered by the surgeon.

7. Preop Interview
It is the nurses responsibility to interview the patient preoperatively and verify
identity, surgical procedure, marked if surgery consits of laterality (ie right or left), allergies, if they are on a beta blocker that it has been taken within the past 24 hours, any metal implanted in the body, and the last time they had anything to eat or drink, they do not have anything on that can be removed (ie dentures, jewlerly etc.)
The patient has spoken with both the surgeon and anesthesiologist and they have no questions before taking them back to the operating room

8. Responsibilities cont.
In the operating room
Assisting the anesthesiologist with hooking the patient up to monitors, administering oxygen and intubating the patient
Positioning the patient, hooking up the BAIR warmer, SCDs, cautery pad if needed, prepping the surgical site
Tying up the scrub techs and surgeon
Hooking up equipment cords needed on the sterile field
Conducting a Time Out that verifies the correct patient, surgical procedure, laterality, allergies, available blood products if needed, DVT prophylaxis, implants/special equipment in the room and any concerns

9. Responsibilities cont.
During surgery
Charting
Opening needed supplies to the sterile field
Getting additional supplies
Assisting the anesthesiologist as needed
Handling specimens and cultures
Performing first and final counts with the scrub tech during closing if applicable

10. https://www. americanmobile. com/travel-operating-room-or-nurse-jobs/

11. Responsibilities cont.
After surgery
Calling postop/PACU to alert them of our arrival
Transferring patient onto stretcher
Assisting anesthesiologist as needed with emerging the patient from anesthesia, any complications, extubating etc.
Helping to transfer patient to postop/PACU

12. ANA Code of Ethics Provision 3
“The nurse promotes, advocates for, and protects the rights, health, and safety of the patient” (ANA, 2016).
Provision 8
“The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities” (ANA, 2016).

13. Patient Interaction
As operating room nurses we have a short amount of time before surgery to interact with our patients
It is important that in that short amount of time we show compassion to ensure the patient we will be their advocate while they are under anesthesia

14. Communication
In the operating room effective communication is imperative between the anesthesiologist, surgeon, and nurse to ensure the patient’s safety.
“Poor communication between team members in OR is regarded as risk factors for mishaps and complaints” (Kumar, Har Dash, & Chawla, 2013, p. 373).

15. Communication cont.
Airway, breathing, and circulation are priorities and must be monitored throughout the surgery.
If the patient has to be intubated again due to complications, a new IV is needed, blood products are necessary, and additional medications are needed; the anesthesiologist and nurse must work together as a team.
During the surgery the anesthesiologist and nurse are usually the only two unsterile team members in the operating room.

16. Communication cont.
Communication between the surgeon and anesthesiologist is important as well.
For example, the surgeon should ask the anesthesiologist if it is acceptable to proceed with the start of the surgery.
The anesthesiologist might have the surgeon momentarily stop surgery due to a change in patient condition.

17. Is the Operating Room the right nursing for you?
Enjoy working as part of a team
Schedule Monday-Friday with oncall after hours and on weekends
Interested in anatomy, surgical procedures and sterile technique
Detail oriented with strong communication skills

18. Nursingtogether.com

19. References
American Nurses Association. (2016). Code of ethics for nurses with interpretive statements. Retrieved from
Kumar, M., Har Dash, H., & Chawla, R. (2013). Communication skills of anesthesiologists: An Indian perspective. Journal Of Anaesthesiology Clinical Pharmacology, 29(3), doi: /