Best Kept Secrets of the OR- Frequently asked questions that new staff have part 1

Awhile ago I asked everyone I could in the OR to contribute questions that new nurses might have. And I was not disappointed.

During this limited series I am going by each person’s response.

The questions run the gamut from existential to practical.

For this first post in the series I asked myself what would be the questions I expect new nurses to have floating through their heads at least once.

I wrote down two questions that I know I had when I started in the OR.

The OR was different back then. At least for me.

It was a 3 room OR but we only had enough staff for two of the rooms. The big autoclave was only run once a day, maybe. The rest of the time we made do with flashing. That is the immediate use steam sterilization to those who don’t know. Being people who are keen to use acronyms where there has not been a call for one this is shortened to IUSS. Otherwise known as the flash.

Bear in mind that this was over 20 years ago and the policies that are in place now around flashing were not yet written.

It was 2001 and I had fought mightily to get my senior experience in nursing school in the operating room. The school really didn’t want me to do it, they wanted me to be a good little med-surg nurse. Little did they no. But I finally prevailed. And I showed up for my first experience day as an almost graduated ADN nurse. This was it, the final hurdle.

Only to find there were no scrubs in my size available.

As an aside, most ORs provide the scrubs to the workers. Because no one wants to take home dirty scrubs and wash them in your own washing machine. Also because no one wants to bring in home germs (AKA outside germs) into our as clean as possible rooms.

But there were no scrubs in my size available. I wore scrubs that were two sizes too big. I just shrugged and rolled up the sleeves and pants.

My preceptor for the day was a ditzy blond who took me through the admittedly small department and introduced me to the unit secretary, to the cleaner, to the PACU staff, to the boss, to the charge nurse and, finally, to the surgeon who was preparing to start a case.

The surgeon looked down their long nose at me from their superior height and sniffed. To the preceptor they murmured that perhaps I could hug the wall. Or watch from the hallway.

The preceptor just laughed and said that I wouldn’t cause any trouble.

They led me into the room, explaining all the lights and colors and sounds as the scrub tech opened supplies while watching me.

For those who do not know, the OR can be overwhelming at first. It is cold. It is bright. It is loud. I shrank back into my too big scrubs and just watched.

My preceptor positioned me next to the window. Yes, the OR had a window. Mind blowing to me all these years later. They left to interview the patient and check with the anesthesiologist and told me to just watch the scrub tech.

They left the room after warning me not to touch anything blue.

The scrub tech didn’t say one word to me.

My first question to myself, after I was finished being overwhelmed with the noise and the cold and the light, was “Where do I stand?”

After all, I didn’t want to interrupt the scrub tech or the surgeon or the anesthesiologist or the patient.

All these years later, knowing that where do I stand was my first question in the OR, I am careful to reassure any tourists I get in the OR (these are what I call the outsiders in the OR) that if they accidentally touch anything blue we could fix it as long as we know.

I have other rules for the newbies. But that is the first one. Stand where you aren’t going to touch anything blue.