Integrating into a new role as a nurse in the OR is no small task. The amount of new information that you are expected to learn is daunting. The OR is not just a different type of unit or specialty—it’s an entire culture change. The way you approach your existence as a nurse can be upended the minute you set foot into the OR for the first time. At this point in your life, I expect that you felt as if you had a handle on simple tasks, such as counting, but even tasks that you’ve been well-versed in since childhood take on a whole new meaning when you enter an OR.
My Advice to You
As an RN of 12 years, I am occasionally asked to give advice to newcomers in the OR. Unequivocally, the best advice that I can give is this: Take care of your scrub person! Your scrub person is the direct link between you and the patient. If they have what they need, the surgeon has what they need. If they are not stressed, they present a calm front to the surgeon; this can directly affect how your day and the case goes.
When you’re trying to assimilate into your new role in the OR, you will need a lot of resources. A lot of what we do in the OR is not taught in school, and I find that few nurses are fortunate enough to get an OR rotation prior to signing up for the job. Your scrub person is going to be well-versed in the procedure that you are performing and have intimate knowledge of the case. They should have a strong grasp of the various equipment, supplies, and even medications that you are going to need. If you take the time to go out of your way and make sure they are well taken care of at the field, they will reciprocate that to you. Countless times my scrub person has saved me from an embarrassing moment by giving me a subtle look to remind me of a step in the case or warn me about some impending need of the provider.
How to Do It
“How do I take care of my scrub person?” you may be asking. It’s simple. Be the teammate who you want to work with. Show up early and help them open the room. Prioritize and focus on getting the minute details of the procedure right. Perhaps your scrub person overlooked an item that you know they’ll need. Bring it to their attention. Double check the preference card to make sure that, as a team, you aren’t missing anything important. If your scrub person is new, point out surgeon-specific details that they may not be unapprised of. Pay close attention to the surgical field and the supplies on it, so you can actively try to anticipate the needs of your scrub person. For example, once you have some experience, you can look at the surgical field and have a needed suture in your hand before it is even asked for.
Learn to read your scrub person’s social cues and react to them. Maybe it’s tense at the field and they need to vent. A good exchange of “The look” can work wonders to blow off steam. By picking up on stress in their voice, you can tell when they are asking for something and you need to literally run for it, or when you may have an extra 30 seconds because they anticipated the need and there is more time. The longer I work in surgery, the more I learn that there is a secret, but universal, OR sign language. I know hand signals for “cut or scissor,” “get me another stitch,” and “I am ready for a break.” I have heard that an extraordinary amount of communication is based on nonverbal cues, and this cannot be more true than when working in surgery.
Strengthen the Bond
Ultimately, developing a good working relationship with your scrub person is one of the best things you can do in the OR. Think of the bond you form as a chain, and a chain is only as strong as the weakest link. If you work actively to strengthen that bond and be a good teammate, your chain grows stronger until you are unbreakable. As a unified force, you and your scrub person can tackle any case together. Put in the effort and before you know it, cases won’t be so daunting. Your clinical knowledge will grow exponentially. Your rapport with the surgical team will get better. Pretty soon, you will be able to reciprocate all the help you received, and you’ll be the one helping your scrub person when they need it.