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haileyquinn

Tips for Your First Day in the OR


The OPERATING ROOM can be a pretty intimidating place if you've never set foot in it before. But in reality -- it's pretty fun. There's usually music playing and lots of chattering and you're elbow-to-elbow with the surgeons, assisting and asking questions (if all is going well).


The general framework of most operations: the room is prepped, the patient is rolled in, anesthesia is begun, time out is performed, and the incision is made... after the incision is closed, the site is dressed , the patient is woken up from anesthesia and extubated, transferred to the hospital bed and wheeled to post-op.



The general setup of the OR:


People who are sterile: Surgeon and assistants (ie: you, resident, med student), the patient (isolated under sterile drapes), scrub nurse (first to scrub in and sets up the equipment, they hand the surgeon and team the operating tools and help with operations)

People who are not sterile: Anesthesia providers (usually behind the partition), the circulating nurse


Here are some tips I've learned along the way:


Before the operation:

  1. Come prepared: read up on the patients and the operations that are going to be performed, watch youtube videos and know your anatomy! You should ALWAYS know your patients name, history, and reason for operation.

  2. Practice your suturing beforehand too. You can use pigs feet, cows tongue, or just a suture kit from amazon.

  3. Be sure to wear comfortable shoes before heading out and I NEEDED those compression socks. Seriously on days I didn't wear them, I could feel a noticeable difference. I linked my favorites shoes and compression socks here.

  4. Meet the patient before the operation if possible. Introduce yourself, ask them how they're feeling or if they have any questions, help them feel more at ease by being with them during anesthesia and rolling them back to the OR.

  5. Stay hydrated. I LOVE Liquid IV. I usually would drink it while hiking or before hot yoga classes, but it works great for being on your feet all day too.

  6. Eat whenever possible! Low blood sugar during a 5 hour surgery is no fun. As someone who doesn't usually eat breakfast, I definitely had to create a new habit. On the go I really liked drinking protein shakes, bars/carbs and fruit to stay full as long as possible.

  7. Go to the bathroom before.

  8. Prior to the operation, find your OR room and introduce yourself to the staff, pull your gown and glove size and write your name on the whiteboard

    1. ie: Hailey Quinn - Medical Student (on the whiteboard), Gown Size: Large (if you're tall and have long arms you should consider L or XL), Glove size: 6.5 (& on OBGYN I would always double glove with 7s and 6.5s)

In the OR:

  1. Once you walk behind the red line you MUST be wearing a scrub cap or bouffant.

  2. In the OR, you should have on: hospital scrubs, bouffant/scrub cap, mask, and goggles. If you're on OBGYN service, make sure to wear those goggles and shoe coverings because things can get pretty messy.

  3. Get there early and scrub in at the beginning of your shift. Most providers will scrub in by washing their hands and for every proceeding operation, they will use Avagard hand gel. Every hospital is different though so a good rule of thumb is to just do whatever your preceptor does.

    1. Here's a good video on how to scrub in

    2. If you're unsure of what the doctor wants, tell them: "I’ve scrubbed in before, but each hospital seems to have different ways to do it, so if you see something I could be doing differently, could you please let me know?"

  4. The golden rule: once you are scrubbed in (gowned and gloved and sterile), STAY STERILE. Belly up against the table, be as close as possible & rest your hands on the drapes over the patient. Your hands arms and waist up are sterile, your back and shoulders aren't (see pic below).

  5. Whenever passing something/someone sterile/the sterile field/anything blue, pass from your front. Don't drop your hands to your sides, don't touch your face, don't itch your nose or readjust your mask if it fogs up. You can ask a nurse who isn't scrubbed in to help make adjustments if need be.

  6. If you're nervous about passing out, make sure not to lock your knees! It gets really hot in the OR once you are gowned and gloved up, so the less the layers, the better. But if you feel like you're seriously going to faint, ask to step away. The last thing the surgeon needs is another patient to worry about!

  7. Make sure your phone is on silent.

  8. Ask questions when appropriate and read the room. Sometimes I found that if I asked a bunch of questions, I would avoid getting pimped as much lolz

  9. Some surgeons will have different preference so just do your best to learn them. Once you're scrubbed in, you'll likely be retracting, holding scopes cameras, tools, anything that will help make the surgeons view better and make their work easier. Some other tasks I've been able to help with include: suction, apply pressure, cut sutures, close making incisions, scalpel, bovie.

After the operation:

  1. Be friends with the nurses and scrub techs. Not only is it fun to make new friends and be apart of this community, they know how to suture super will and will often help you learn so you can look like a rockstar in front of your attending. Pro-tip: bring donuts.

  2. Stay behind to help clean up and transfer the patient. Another way to make quick friends is to not act like a know it all. Ask the scrub tech and nurses how you can help. Scrub techs can be pretty particular so make sure you're being helpful, not being in the way or making their lives more difficult.

    1. Some things I've helped with: transferring the patient on and off the OR table, grabbing supplies, helping gown others, helping prep the patient, grabbing the bed outside the room, transferring the patient, helping clean up, taking out the trash.

  3. Don't leave anything in your pockets! When you change out of the hospital scrubs at the end of the day, they will go into the hamper and anything in those pockets will be lost forever. RIP my airpods.


So good luck, have fun in there, and, most importantly, MAINTAIN THE STERILE FIELD!!


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