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Patient Care in the OR is Different, Not Non-Existent

It's Perioperative Nurses' Week! I'm so thankful for each and every one of you. I know the days are long and the shifts are hard, but making a difference for your patients every time you show up to work. You're a rockstar and I appreciate you.


I wrote a blog post in 2019 about patient care in the OR, and I think it really resonates with all of us as we celebrate this week. Patient care isn't absent in the OR, it's just different. I've shared it here for you today as a reminder that what you're doing matters. Perioperative nursing makes a difference, and your commitment to patient care is recognized. Thank you!


Patient Care in the OR is Different, Not Non-Existent

I haven't answered a call light in 11 years. The most use my stethoscope gets is when my kids pull it out to play doctor, or when I'm listening to my children's lungs when they're sick. I don't spend an entire shift assigned to the same 4-5 patients and I don't know what they love, what they hate, or what they plan to get back to when they leave the hospital. I only get about 5 minutes - maybe 10 - to talk to my patient before we roll back to the OR. And, they spend most of their time with me asleep.


As perioperative nurse, I work in a very specialized field. Alot of the skills I learned in nursing school and then practiced when I worked on the floor just don't apply in the OR. But while my skill set is unique, my goal to provide the safest and best care for my patients is the same as every other nurse. How I care for my patients, though, is very different. But different does not mean non-existent.


So what do OR nurses even do?

First, don't use this picture to answer that question! There are so many misconceptions about OR nursing. Yes, we've all worked with nurses that are trying to hook up with a doctor - but that's not exclusive to the OR. And if you watch any medical show - well, don't. They've got it all messed up.


But, that picture of what floor nurses think we do is spot on. I've spoken to nurses from other units who don't think that OR nurses even do patient care, or they just don't really know what all we do. Nurses in orientation have left the OR because they said that they "just really missed patient care." New grads are discouraged from coming straight to the OR for fear they won't develop their nursing skills or learn "proper" patient care. Obviously, there's a misconception that feeds the idea that there isn't patient care in the OR.


I'm a Circulating Nurse. Everything that I do revolves around patient care, patient safety, and efficiency. I'm not always scrubbed into a case - like the picture above makes it look. Most of the time I'm not. But everything I do in the OR is geared toward caring for my patients.


What does patient care in the OR look like?

Patient care is:

  • Being the voice for your patient when they can't speak for themselves

  • Having an accurate and complete consent - and only doing what the patient has agreed to

  • Breaking down an entire case during set-up, even though it causes a delay, because every patient deserves a proper sterile field, and contamination puts them at risk

  • Proper positioning before a procedure to protect skin, nerves, and sensitive areas - and taking the time to do it right, even if the surgeon wants to rush you

  • Prepping the surgical site correctly, with the correct type of prep solution, and maintaining aseptic technique

  • Leading (sometimes enforcing) the Time-Out - making everyone stop, one last time, to make sure that everything is correct before the incision is made

  • Not being afraid to yell, "STOP!" when you see an error

  • Adhering to policies regarding surgical counts to avoid retained surgical items and future complications for your patient

  • Communicating your patient's allergies to your team to avoid any issues with latex or giving the wrong meds

  • Knowing your patient's labwork - will they need blood? Is it available?

I could keep going. But, I don't need to make an all-inclusive list. Instead, I hope you see that patient care is the undercurrent of what we do EVERY.SINGLE.DAY. Yes, it looks different. But the OR is different.


Maybe we should move past the idea that patient care is only defined by a pre-approved list of specific tasks. Instead, let's remember that, regardless of specialty, we're caring for the whole patient. Patient-centered care is going to look different across the spectrum of specialties that we call nursing. And yet, we all share a common goal: provide the best and safest care for every one of our patients, every single day.


Ya'll keep up the great work out there,

Melanie



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