Operating Room  Nursing – What’s it like to work as an OR Nurse?

A Day in the Life…..
An Interview with Tammera Glenn, Operating Room Nurse Manager
Written by: Patrice Shields

Name: Tammera Glenn, RN, BSN, CNOR
Title: Operating Room/Post Anesthesia Care Unit Manager
Place of Employment: Lebanon Community Hospital,
Lebanon, Oregon
Educational Background: R.N., B.S.N, and C.N.O.R

Background: Tammera Glenn is a graduate of William Jewell College. After graduation in 1985 Tammera enlisted with the Air Force. As an Active Duty Air Force RN Officer Tammera spent time in San Antonio, Germany and Maine. In the Air Force Tammera went through a selective internship, working in a variety of areas within the nursing profession. In San Antonio she specialized in surgical trauma, in Germany, as a staff development officer in a multi -service unit, and in Maine coming off of active duty, she was a charge nurse. After the military, Tammera went directly to the reserves as a civilian and became an operating room nurse.

Q. What drew you to become an Operating Room/Post Anesthesia Care unit (PACU) Manager?
T.G. During my last semester in college, I worked in the Operating Room (OR), three days a week with a physician. I absolutely loved it. Since I had a lot of nursing experience from being in the military, I knew what happens to a patient before and after surgery. This helped me provide better care for patients. Since I’ve worked in so many different areas in the military, I became comfortable and complacent with a lot of areas in nursing. I still haven’t experienced that complacent feeling in OR nursing. Working in the OR is an ongoing learning experience, and I love the challenge of it. Managing multiple departments provides for different responsibilities. As a manager, I have the best of both worlds. I oversee several departments and participate in patient care, normally at least twice a week. I enjoy working with patients, and it gives me a break from the office.

Q. Specifically, as an OR/PACU Manager, describe what you do.
T.G. On a week to week basis, one of my responsibilities is staff scheduling. Should some staff members be on vacation or otherwise absent, I have to take that into consideration when planning staffing for that particular time period. Sometimes I fill in if we are short on staff, enjoying the opportunity to do patient care. On the management side, my responsibilities are in four departments, the Operating Room, Post Anesthesia Care Unit, Sterile Processing and Anesthesiology. I help budget these areas, to ensure that we have all the necessary equipment to make these units run effectively. I also perform employee evaluations and spend time as a manager troubleshooting as needed in my respective departmental areas. Additionally, I spend time participating in many committees, and go to staff scheduling meetings to make sure things run well. At least one week out of the month is dedicated to administrative work. Paper work is plentiful! I have enough paper work to last  for years! Many days, I end up taking a lot of paperwork home with me to complete.

Q. Give us an example of what a typical day on the job might be like as a staff OR nurse.
T.G. Usually, the day before, you’ll know what types of surgeries are scheduled for the following day. A nurse may be assigned to be either a scrub or a circulating nurse for a procedure. The Association of Operating Room Nurses (AORN) describes the role of both scrub and circulating nurses in the following fashion. Scrub Nurse: “The scrub nurse works directly with the surgeon within the sterile field passing instruments, sponges, and other items needed during the surgical procedure. The sterile field is the area closely surrounding the OR table, and the Mayo stand, or instrument tray. Surgical team members who work within the sterile field have scrubbed their hands and arms with special disinfecting soap and wear surgical gowns, caps, eyewear, gloves, and shoe covers. ” Circulating Nurse: “The circulating nurse’s duties are performed outside the sterile field. The circulating nurse is responsible for managing the nursing care within the OR. The circulating nurse observes the surgical team from a broad perspective and assists the team to create and maintain a safe, comfortable environment for your surgery. The circulating nurse makes sure each member of the surgical team performs in a united effort.”

Before entering the surgery or pre-op areas, nurses put on scrubs, talk to the patient, answer any final questions that they may have prior to surgery, and make sure that the patient understands the procedure and has signed all the appropriate consent forms. The nurse also reviews the patient’s chart, and finalizes preparations for the patient’s surgery. Sometimes a patient will have a tongue ring or item that’s been overlooked and needs to be taken out. As perioperative nurses, we have to be certain that the patient does not have anything on which could possibly interfere with the success of their surgery. We also have to be aware of all the state laws, rules, and regulations of hospitals, and those rules change frequently.

After all this, we take the patient into the surgery room, help put them to sleep, position them according to the surgery performed and prep the patient. Once surgery is done, the patient is taken to the Post Anesthesia Care Unit (PACU) Nurse where they will begin their post operative recovery. Then, we finish charting and finally, start the process all over again with another patient. In the middle of our normal surgical routines, we could have a trauma, which would change our whole assignment quickly. There is a high amount of stress in the Operating Room. The patient’s life is in the hands of the surgeon and surgical team. It’s important to be flexible and to understand that in the OR, we are all really there to provide care for our patients.