Nine Tips for the Rookie RN Circulator

Precision, focus, and attention to detail are essential in a high stress setting like the OR. Being a rookie RN circulator can be difficult, especially if you work on complicated surgeries. As a new RN circulator, you can use the nine tips in this article to thrive in your role. 

1. Be Prepared

Preparation is the first step in managing challenging procedures. Know the patient’s medical history before the surgery. Why does your patient need this surgery? Are the patient’s lab values concerning? Try to learn your surgeon’s preferences. Use your scrub person as a credible resource. Ensure that your OR has everything it needs and that everything is working correctly. Does your electrosurgical unit work? Do you have implants? Learn the critical points of the procedure and prepare for any potential problems. If you aren’t sure, check with your scrub person or other colleagues. You can ask, “What are some critical points in this surgery?” or “What should I keep in mind for this case?” 

2. Create a Routine 

As soon as your patient transfers onto the OR bed, place the safety strap. When the patient is draped, it’s time to set up the electrosurgical unit and suction, give the scrub person a kick bucket, and ensure the trash can is close enough. 

3. Communicate

Any surgical team must have effective communication. You will need to communicate with your team, especially the surgeon, anesthesia professional, and scrub person. For example, you can say, “I have to run to the core to get more sutures. Will you be okay for a minute?”  When a laparoscopic case is just beginning, you can ask, “Do you want the room lights off yet?”  

4. Keep Your Cool

Even during challenging procedures, an RN circulator must maintain composure. You are an essential surgical team member. Some surgeons can create a difficult environment, and it will be hard to keep your cool. You shouldn’t give into it! Instead, breathe deeply and keep your attention on your patient. That is why you are there.  

5. Be Flexible

Complex surgical procedures frequently need fast thinking and adaptation. Be flexible and adjust to changing circumstances. This can entail altering the surgical strategy or making do with what is on hand. Is the laparoscopic surgery emergently converting to an open surgery? Does the scrub person need lap sponges? Suction? A different set? A different retractor? Always be prepared to intervene and take charge if necessary. 

6. Keep an Eye Out for Details 

Any surgical environment requires meticulous attention to detail. Be attentive to every detail and ensure everything is noticed. Be aware of the patient’s vitals. Don’t stay behind a desk; instead stand where you can see the surgery. Scan the field. How’s blood loss? Did your patient’s arm move from the arm board? Does your scrub person need anything? Is there trash to pick up? What’s going to happen next? How can you prepare for it? 

7. Be Patient

Some surgeries are a marathon, some are a sprint. You will need to have patience because some surgeries may take longer than expected. Keep in mind that the team will need to spend the required time to do the surgery appropriately because the patient’s safety is the priority. 

8. Take a Break

Long-term high-pressure work environments can be mentally and physically exhausting. You’ve got this! Taking a break to recharge when you can is crucial.  

9. Maintain Your Concentration 

It is easy to become distracted or lose concentration. Some of the best RN circulators make it look easy, but we all started with the same overwhelming feelings. Your patient and the team depend on you.

AORN Resources

AORN Members can access: 

• The Role of the RN Circulator in a Navigated Posterior Spinal Fusion - AORN Journal 

If your facility subscribes to eGuidelines+, you can access: 

• Room Setup at a Glance | AORN eGuidelines+ 
• Team Communication Guideline | AORN eGuidelines+