Orientation in the Operating Room (OR) is tough. There’s no other way to put it. The days are hard and the environment is overwhelming. You can be reduced to tears without warning due to frustration, anxiety, fear, attitudes of others, or just the sheer amount of information you’re expected to take in. And in such a specialized environment, nothing can prepare you for just how different the OR actually is compared to other areas in nursing.
This image sums it up, doesn’t it? There’s so much information to take in that it feels like more goes past you than you absorb. Do you feel like your head is spinning?
I. Get. It.
Orientation in the OR can really suck, if I’m going to just be completely honest. Yes, the OR is an exciting place to be and yes, most of the people that work in the operating room really, really love it. But when you’re new, you don’t know what you’re doing yet. You didn’t learn much about perioperative nursing in nursing school, and our department is totally different than any other department in nursing. Plus, there are so many people! All with vastly different personalities – and dealing with the people is sometimes the hardest part of working in the OR
So how do you handle such an intense environment? How can you set yourself up for success?
I could tell you a million different things, but we’d be drinking from the fire hydrant again. Although, if you’d like to read some really good advice from other experienced OR people, head over to my Facebook page and read all of the advice they’ve offered in this post.
Instead, what I’m going to tell you is incredibly simple. But, as simple as it is, it will require you to work, to think, and to be involved. It’s simple, not easy. So if you want to survive your orientation in the OR, here’s my advice…
Pay Attention
Paying attention requires you to be observant. That’s kind of obvious, right? But there are numerous ways that you can take what you’ve observed in one case and apply it to the next, all throughout the day. Think ahead, notice the similarities, and get involved.
Take a small task, confirm that you understand it correctly, and then volunteer to do it. Each of those small tasks builds on the next, until finally you’re running the whole room yourself.
In the beginning, you won’t know everything, and no one expects you to. What they do expect is motivation, willingness to work and learn, and the ability to apply what you’re learning to each case that you do. You can only meet those expectations if you’re fully engaged and paying attention.
On the other hand, if you don’t get involved and you aren’t paying attention, you’re likely to get “written off” by the staff in the room as someone who is uninterested – and then they aren’t going to waste their time teaching, they’ll just do everything themselves. Which leads to frustration for everyone.
Be engaged. Be present. And pay attention.
Take Notes
I can’t say this one enough. Take notes! Very few of us have a perfect memory, so don’t rely on your brain to remember every single thing. Keep a small notebook with you, and as you work with different surgeons and do different cases, write down the details that you need to remember.
Does the prep stand need to be set up a certain way? Does the surgeon like a certain type of music, or worse, no music? The things you might write down are endless. But, whatever it is about a particular case that you need to remember – write it down! You’ll be ready the next time you do this type of case, or work with a particular surgeon. You’ll look prepared and hopefully save yourself some running during the case if you know what you need ahead of time.
With time, experience, and repetition, you’ll get into a routine and you might not always need your notes. But don’t get rid of them! Keep them with you, or in your locker, so that when you can’t remember, or you do a procedure that’s out of the norm, you’ll have those notes handy for a quick reference.
Ask Questions
No one will ever know all that there is to know about the operating room. Guidelines change frequently, policies get rewritten, and new research always gives us updates to best practice. Which means that ALL of us are constantly learning new things. Questions are part of the learning process. If you don’t understand something, ask for clarification and the rationale. No one ever got hurt by a question. But we compromise patient safety when we don’t know or don’t understand what we’re doing but try to do it anyway.
And when you do ask the questions – pay attention to the answers. There’s a big difference between not understanding and not listening. If you need clarification – ask away! We want you to be confident in your ability to provide safe patient care and to function independently. But not listening only leads to frustration for everyone and potential for harm for our patients.
I understand that some of you may be really afraid to ask questions. Maybe you’re embarrassed, or you’re afraid you’ll sound stupid. But listen, I would rather you ask a question to ensure that you understand what we’re doing, than be afraid to ask, do something wrong, and hurt my patient. So ask the questions!
Be Teachable
If you don’t learn anything else about orientation in the OR, learn this. The OR is full of a variety of people, all with different levels of training, experiences, and expertise. And every single person can teach you something.
We tend to fall into the hierarchy trap in the O.R. due to education levels, licensing, and certifications. But, the person that has been working in the O.R. for 20 years has decades of hands-on experience that I just don’t have – and what they have to offer is valuable for my own improvement and education. That’s not something to be looked down upon just because they might be older or have a different job title than me.
Respect everyone, listen to their advice, and be open to constructive criticism. You’ll be better off because of it in the long run.
You Can Do This
I know it’s overwhelming and there’s so much to take in. But don’t give up. It can take over a year before you truly feel comfortable in the Operating Room. But with each passing day, your confidence will improve. And you’ll realize that even though orientation in the OR was hard and stressful at first, it was totally worth it. You’ll continue to build on that foundation for the rest of your career – because the learning will never stop. Before you know it, you’ll be experienced nurse, ready to pass your expertise on to another new, overwhelmed newcomer.
You can do this. 🙂
Melanie
P.S. Looking for more advice, insight and encouragement? Here are two more helpful posts:
Note: I referenced O.R. culture, but didn’t actually address it. Tackling the realities of our culture is a topic for another day, but definitely an area where we need to see changes made.
