A Day in the Life | Circulating Nurse
An operating room nurse’s day is nothing like a nurse who works in any other unit. There really isn’t a comparison other than a nurse in IR or cath lab, but those are also procedural areas.
An OR nurse is also called a ‘circulator’. This is because they are responsible for ‘circulating’ the room during each surgery. I’ve heard people say “the OR would be too boring as a nurse” because they imagine the nurse sitting in the corner charting and that’s it. Well, you may have a day here and there like that, but most days are far from that. I’m going to walk you through a ‘normal’ day for me.
Normal Day as A Circulating Nurse
0645-0700 | Arrival, clock in, get changed for the day
0700-0705 | Morning meeting in lounge
0705-0720 | Get the room ready for your first patient of the day. ALWAYS help the scrub open the field unless time absolutely does not allow. (ENT days start at 0715)
0720-0729 | First patient should be arriving— the CRNA gets the first patient of the day at our facility (unless pediatric, then both the CRNA and RN go)
0730-? | Once the patient arrives, perform interview and validate consent is correct.
(Supine position, safety strap {generally across thighs; this is procedure dependent})
-Assist the anesthesia team with induction
-Position patient if differs from supine
-Foley if indicated
-Prep the patient (if alcohol based prep, WAIT 3 MINUTES!)
-If you haven’t already counted, this is the perfect time to do so. *Some hospitals have a policy that states the count must be performed prior the patient entering the room.
-Perform timeout (more on this in the future)
-Get items thrown off the field plugged in and ready for use
-Once the procedure has started and you have a minute, begin to document everything you’ve done since the patients was wheeled in the room
-Listen and watch the surgical field at all times to anticipate needs and know what’s going on. DO NOT be a nurse that steps back into the corner and disassociates from the room. You’re there for the patient and the team- show it.
-Be the ‘go for’ (AKA gopher) for anything needed during the procedure that isn’t opened to the sterile field at the start.
-Continue to document as necessary during the procedure
-If the length of procedure requires, update the family (remember this directly effects patient experience scores - why this matters).
-Once the procedure is wrapping up, you should have already counted a time or two depending on what procedure.
-After procedure is complete, assist with dressings if indicated.
-Assist anesthesia with emergence.
-Help patient back to stretcher.
-Transfer to PACU or Phase II- dependent on procedure)
-Get ready to do it all again a few more times each day.
Circulating Nurse Responsibilities
There are SO many other things the circulator does throughout a regular day. Things that just seem to ‘happen’ without even thinking about them. Always ensuring patient safety, constant glove grabs, warm blankets, warm fluids, grabbing this and that, opening things to field. Returning unused supplies and equipment. Helping others when you can. Giving breaks. Cleaning assignments. The list goes on. In the future, I intend to break each ‘task’ down and explain the rationale behind all that we do as a nurse in the OR.
Some of My Favorite Things
There is a sense of camaraderie in the OR, when you spend 8+ hours in the same room with the same group of people day in and day out you build that trust and learn to have fun even through the tough days. If you have any question on what it’s like as a nurse in the OR— shadow! I cannot imagine working in another unit, I truly love my role in surgery and love being a part of the team. A lot of people think working with surgeons would be terrible, and while sometimes it is, for the most part the surgeons are just like us. Last week, I heard a surgeon tell the surg tech “You’re right” about what retractor he may want for the next procedure and I cracked a joke like we all couldn’t believe he said that. His reply (while laughing) was “come on you’re all my colleagues, not subordinates”. But, he’s right. Gone are the days of surgeons treating everyone like they are a piece of sh—dirt with no knowledge or expertise. One of my favorite parts about surgery is getting to listen to music all day long. Louder than you’d expect too. RNs are the ‘DJs of the OR’. I have a handful of curated Pandora and Spotify stations to play dependent on the team. I can go from listening to ‘Notorious B.I.G. Radio’ to ‘Third Eye Blind Radio’ to ‘N*SYNC Radio’ throughout the day. I will say the least listened to genre at my facility is Country- unless you’re with the Ortho bros. Having a bad day? Crank that music up during the turnover and have a little party with the team, you’ll feel better. Ask me anything about the OR— I’m an open book!
