Operating Room Advice From an Operating Room Nurse
Proverbs are concise sayings or axioms containing wisdom and common truths used in specific situations. These adages show that others have been in this same situation and survived. We have a few in the operating room that are short, sweet, and to-the-point.
Time is money in most businesses, but in an operating room, time is life. Aside from the obvious goal of a successful surgical outcome, the goal is to do every possible thing to decrease the patient's time under anesthesia. While other businesses count time in hours or days, operating room personnel count time in seconds. A three-minute wait is considered an eternity—even 30 seconds is a long time. Thus, we have certain proverbs to live our days by.
1. Better to have it and not need it than to need it and not have it.
Operating room nurses like to be prepared. You need to have everything you, the surgical team, or anesthesiologist may need available. During surgery is not the time to be running around looking for things. One of the traits of a good circulating nurse is being prepared for almost any eventuality.
Things happen in surgery, but with experience, you learn to be proactive in your preparedness. Knowing the significant lab and test results, the history of the patient, the disease progression, and the surgeon's preferences will give the nurse valuable information. The surgical procedure takes less time when the circulating nurse is prepared.
I have been told several hundred times in my life, "We probably won't need that." The statement is true about 50% of the time. But to save the three minutes during the other 50% of the time, I will have it available. Better to have it and not need it, than need it and not have it.
2. The enemy of good is perfect.
I know you thought good and perfect were on the same side—standing there in the lineup of values side by side. We can judge our performance as bad, poor, good, or perfect. How then did perfect become the enemy of good? Maybe it is the enemy of bad or poor, but good and perfect are on the same side of the continuum.
Not so in surgery. In surgery, perfect may be the in-road for poor or bad. Good is good, but to continue to try for perfect takes too much time and often makes things worse. Usually, a person comes into the operating room in some state of bad. Changing the bad to good is a great improvement. Mucking around looking for perfect can be deadly.
3. Sooner begun, sooner done, sooner lunch time comes.
Occasionally, a surgery will be canceled one or two days before it is scheduled. When this happens we have to move someone up into that spot. People often tend to dig their heels in at this late date. Little changes become major issues.
Having surgery takes a great deal of preparation. You have to get time off from work. You have to find someone to drive you and take care of you after. You have to be mentally prepared. Now, suddenly someone is asking you to change your plans. You have to make sure the person driving you can change the time. More importantly, you suddenly have less time before the knife cuts!
This is when I say, "Sooner begun, sooner done, sooner lunch time comes." If you have ever had surgery, you know that you cannot have anything to eat or drink for hours before. This is very difficult on children and older individuals. The sooner in the day you can go, the sooner you can have something to eat and drink.
4. Better to be lucky than good.
Sometimes in surgery, good will only take you so far. At times, you need all your skill, dexterity, experience, and yes, luck. Most people in an OR can be pretty superstitious about some things. One of these is bragging. We know Murphy's Law all too well: "Anything that can go wrong will go wrong." And we all know that saying how well everything is going will tempt fate to bring on Murphy's law. That is why we don't say how good we are; we just leave it at the old adage: "Better to be lucky than good."
5. All bleeding stops eventually.
You can also say, "Everything ends eventually." Although this may seem like a very morbid thought, it is often enough to diffuse a tense situation. Frustration and stress cut down on your ability to think clearly and make sound decisions. In the operating room, we use humor, often morbidly, to relieve stress and frustration. Of course, timing is everything!
The Surgical World
I hope you enjoyed this glimpse into the world of surgery. It is often stressful, always challenging, but mostly rewarding. You learn to think on your feet, bend with the wind, and have the skin of an elephant. It is the one place in nursing that you either love completely or refuse to put up with.
For More Information on Operating Room Nursing
- - AORN - Association of periOperative Registered Nurses
The Association of Perioperative Registered Nurses AORN empowers the OR Nurse with education standards of practice and peer networking
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
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© 2009 Kari Poulsen