Prepare before you get to the OR
by knowing the patient thoroughly and having a basic understanding
of what is planned. Avoid stereotyping the nurses as “cranky,” the
surgeons as “egotistical,” and the medical students
as “clueless” by learning the OR routine. Be alert,
attentive, and, above all, patient. Don’t be afraid to
admit to the scrub nurse and the circulating nurse that you’re new
in the OR. They are usually happy to help you follow correct procedures.
The members of the OR team include the surgeons, anesthesia staff,
and the nursing staff. Members of the surgical team are the surgeon,
surgical assistants, students, and scrub nurse or technician responsible
for the instruments, gowning the surgical team, and maintaining
a sterile field. The circulating nurse acts as a go-between between
the sterile and nonsterile areas.
Sterile areas include the front of the gown to the waist, gloved
hands and arms to the shoulder, draped part of the patient down
to the tabletop, covered part of the Mayo stand (the small table where
the most commonly used instruments are kept), and the top of the
back table where additional instruments are kept. The sides of the
back table are not considered sterile, and anything that falls below
the level of the patient table is considered contaminated.
In the OR everything is geared toward maintaining a sterile field.
Use of sterile technique begins in the locker room. Change into
scrub clothing. Remove your T-shirt, tuck the scrub shirt into the pants,
and tuck the ties of the scrub pants inside the pants. In some hospitals
scrub clothes are allowed on the wards, provided they are covered
by a coat or other form of gown; check your hospital’s
requirements. If you wear scrub clothing out of the OR, be sure
that it is not bloodstained.
Pass into the surgical anteroom to get your mask, cap, and shoe
covers. The mask should cover your entire nose and mouth. Full hoods
are necessary for men with beards. The cap must cover all of your
hair. Because of universal precautions, protective eyewear is required
while you are at the operative field. If you wear regular glasses,
use a mask with adhesive at the bridge of the nose to prevent fogging.
Tape the glasses to your forehead if you think they may be loose
enough to fall onto the table during the operation. Do not wear
nail polish, and remove any loose jewelry, watches, and rings before
scrubbing. Make sure that shoelaces are tucked inside the shoe covers.
At most hospitals you do not have to wear the mask in the hallway
of the OR suite, but you do have to wear everything else. The mask
must be worn in the OR itself, near the scrub sinks, and in the
substerile room between ORs.
Find the OR where your patient’s procedure is taking
place, and assist ...