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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.

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