One Nurse's View of the Operating Room

OR Nursing

"Are you crazy! Why do you put up with this? I'm done." This is the response I have gotten from many nurses after their first 3 months in the OR. Operating Room nursing is not for everyone. The hours can be grueling, the stress overwhelming and the work exhausting.

Why then do I love it so much? Am I crazy? OK, maybe a's kind of prerequisite for working in an OR. Exhaustion becomes a way of life. You learn to eat when you can, drink when you can, sleep when you can and go to the bathroom when the opportunity arises.

You get stuck in a little room with 3-5 other strong personalities for hours on end. (More if you are a teaching facility, and have residents and med students present.) If you are the circulating nurse, you will need to orchestrate the actions into a cohesive whole. If you are the scrub nurse, you are on the front line any time something is missing or wrong.

Every second counts. You must be extremely efficient and be able to prioritize wisely. What needs to be done immediately, what needs to be done soon, and what can wait a minute. When to stop everything and when to hurry it along. How to do three things at once, and do them correctly. Decisions...Priorities...Multi-tasking, these are your challenges every moment.

Dowdy Dress Code

Did you want to look nice at work? Maybe the OR is not for you. Everyone has the same blue hair and we all wear masks. I have worked with people for months and not recognized them in a store. "Oh, I've never seen you in clothes before!" is a common greeting between OR people. Another is, "So that's what you look like with hair." You should see the looks you get from innocent bystanders when you are greeted this way.

The dress code is pretty rigid in an operating room. First, lets discuss jewelry. Jewelry is a nest of dirty, harmful, downright killer germs. Bet you never thought about what was growing in that dark, warm space under your wedding ring! Rings, bracelets and watches need to be removed.

Necklaces can break and fall into the area being operated on (what we call the wound). Please remove all necklaces. Same thing goes for earrings, please remove can cover your ears with your cap to keep them enclosed. Sounds sensible, but it really makes hearing harder.

I guess belly piercings would be OK to leave on...they are covered. I almost forgot these...they weren't very popular back in the day...

Lets discuss nails next. Nails are another place that harbor all those murdering germs. Especially those lovely fake nails and wraps. Get them off! Keep those nails natural, clean and no longer than 1/4 inch. Standards have changed slightly in the past few you can have polish on your nails, but make sure it is not chipped! Chipped nail polish can fall off into places we would rather it not go!

How about our scrubs. Nowadays, you see all these scrubs that are almost fashionable. What a breakthrough in nursing. Forget all that in the OR. We must change each morning into scrubs supplied by the facility...these are the ones that look like you are wearing a sack. divas...Run!

OR Equipment
OR Equipment
Chic Fracture Table (copied from:
Chic Fracture Table (copied from:

Some of the more Technical Aspects

The OR room shown is pretty messy, but I wanted to show a few (yes, just a few) of the pieces of equipment you will learn to operate and troubleshoot. The number one troubleshooting technique of an operating room nurse is...turn it off and turn it on. Surprisingly, it is number one because it usually works.

We learn to operate the multiple operating room beds. We call them tables between ourselves, and beds to the patients. Who ever heard of operating on a bed? There are the regular tables used for most procedures. There are fluoroscopy tables used when you need to x-ray the body. There are spinal tables and fracture tables. Some of these look like torture equipment! (See the picture of the Chic Fracture Table--Yes, you can really lay someone down on it...Skill required)

OR nurses also operate various lasers, warming devices, cautery units, anti-embolism units, cameras, light sources, drills, suction units, monitors, blood transfusion devices, positioning devices...I won't bore you with the entire list, I think you get the idea.

In the operating room, technical skills are as important as people skills.  Equipment necessary to the procedure has to function and function correctly.  Many pieces of equipment can harm the patient if not functioning correctly.  The surgery may have to halt at a crucial moment if something is not working.  All equipment needs to be checked prior to starting.

A simple set-up on a mayo.
A simple set-up on a mayo.
Femoral Nail Instruments (copied from:
Femoral Nail Instruments (copied from:

Instruments, Instruments, Instruments!

"Why don't you try the threader from the Mitek anchor set?", I asked.  "What the hell is that?!", the doc answered.  

OR nurses need to know the names and location of thousands of instruments.  There are instruments that are used by most specialties, but also specialized instruments used by one or the other.  There are instruments for General surgery, Orthopedic, Podiatry, Plastics, Vascular, ENT (ears, nose & throat), Eyes, GYN/OB, Laser, Endoscopic, and on and on. 

Thinking outside the box is a skill of the experienced OR nurse.  You need to think of new ways to use old things constantly.  Every person is different inside, literally!  No two operations are the same.  Sometimes what you usually use, doesn't work...creativity is a must!

The Guts of the Matter
The Guts of the Matter

Let's Wrap this Up

I didn't realise I had so much to know and do as an OR nurse!  I didn't even touch on the personalities you encounter.  (I'll do that in another.)  As I said before, OR nursing is not for everyone. 

You need to love a challenge, have high energy, be able to think on your feet and hit the ground running.  Doctors yell at you every time something is missing or something goes wrong.  You are the unseen nurse.  No-one remembers your care, because they were asleep for it.

You need to have a very strong ego, everything will be your fault the instant it happens.  Later, you may get an apology...but in the instant you just let them rant.  I was taught that one of the ways I perform my job as patient advocate is to let them yell.  It was explained to me this way...better they yell at me, than their hands shake in the wound.  Much better!  Let them get it out!

However, it is also the only place in nursing that has such instant gratification!  Some-one's gallbladder is making them sick, take it out...there, they are cured.  The baby will die if it is not delivered now, take it out...there, the baby lives.

Although the docs yell a lot, they learn to depend on you and respect you more than if you were a floor nurse.  They perceive you as being smarter, more reliable.

You are challenged every day.  You learn something every day.  It is an ever changing, never static or dull, environment.  You have to BE there mentally and physically 100% at all times.  As I say, not for everyone, but I seem to thrive on it. 

Prior to becoming an OR nurse, I never stayed in the same place for longer than 3 years (and that only twice).  Things would become boring...same old, same old.  That is never a day in the OR!  I have been in the OR for 15 years and still love it.

Comments 53 comments

Peggy W profile image

Peggy W 7 years ago from Houston, Texas

Great write up K@ri! I remember with laughter the comments like "I didn't recognize you with your cloths on," etc. Inside joke for sure. What you forgot to mention is the great jokes which lighten the tension. In the days when I was an operating room nurse, I heard a daily new batch of jokes that I would try and remember long enough to repeat to my husband when I would get home.

k@ri profile image

k@ri 7 years ago from Sunny Southern California Author

Thanks! I will get to that another day, although maybe just one. Here is one that I use to describe surgeons:

What is the difference between a surgeon and God?

God doesn't think he's a surgeon.

ethanol2323 profile image

ethanol2323 7 years ago from Bay Area, California

Scary job. Good article. ^^

k@ri profile image

k@ri 7 years ago from Sunny Southern California Author


Thanks, love your hubs ethanol!

mamakaren 7 years ago

Great article--great writing style! Nursing isn't my gig, but you go, girl!!

k@ri profile image

k@ri 7 years ago from Sunny Southern California Author

Thanks mamkaren! I never thought nursing was my gig until I started. I must say, all these years later, I still LOVE it!

Proud Mom profile image

Proud Mom 7 years ago from USA

I'll be back in a minute. I have to go scrub my rings.......

St.James profile image

St.James 7 years ago from Lurking Around Florida

OR nurses are the life blood of the surgical floor.

I used handle all the surgical electronics. Once you can show them you know what you are doing, and you can be counted on to handle your part of the team. You are then in a tight circle of trusted, caring and wonderful people.

I miss that strong, working atomosphere. It was a no BS mentality, but it was the best group of people I have ever worked with.

Proud Mom profile image

Proud Mom 7 years ago from USA

I don't know if nurse anesthetists would qualify as an OR nurse, but I ended up with one during an emergency C-Section whose humor and understanding LITERALLY saved my life.   I remember him every Christmas with a little gift. 

I'd imagine those being operated on wouldn't know about all the OR nurses have done for them.   It's good for this to brought to us civilians' attention.

I just sacrificed my toothbrush and some hydrogen peroxide to de-germ my ring. Don't tell me if it's not possible for HP to do the trick. In this case, I'll settle for "ignorance is bliss".

Now, I have to go the store for a new toothbrush...... 

k@ri profile image

k@ri 7 years ago from Sunny Southern California Author

Proud Mom, I have known female babies to be named after a male anesthesist...Royce. That is probably the greatest acknowledgement ever! Christmas gifts are REALLY nice also.

I will try to write more about OR nursing. I guess this is what I know best.

Thanks for reading!


k@ri profile image

k@ri 7 years ago from Sunny Southern California Author

St. James,

You are right...I haven't gotten there in my stories yet, but the best part of being an OR nurse is the sense of family you get!

Of course, as you say, you must PROVE what you know. No-one in an OR will let you go unproven...or untried. They test you every moment, and love you more each time you test correctly.

Thanks for your comment on the no BS mentality. I like to think OR nurses have no time for this...however, as I said...some may.

I like to think I have a no BS mentality...wouldn't we all?

Thanks again for your support of our unremembered forces...the OR Nurse!

Joyce_the_VA profile image

Joyce_the_VA 7 years ago from Michigan

Great hub! Makes me want to be an OR nurse. :)

k@ri profile image

k@ri 7 years ago from Sunny Southern California Author

Joyce, It's a great job, if you can put up with it! Try it, maybe you'll love it! :)

maggs224 profile image

maggs224 7 years ago from Sunny Spain

I have a tendency to pass out at the sight of blood mine or someone else’s it doesn’t seem to matter. Everyone knows if it is an emergency where there is blood involved better steer clear of me. Like when my husband cut the ends of his fingers off with an electric saw he held his hand behind his back asked for a clean towel and then asked me to get our son. I admire you and the work that you do in the OR, to be able to do all that you do and have the skill to communicate it so well through your skill as a writer is talent indeed. I am glad that you have found the place where you are both happy and productive. I loved the hub, I enjoy your writing style.  

k@ri profile image

k@ri 7 years ago from Sunny Southern California Author

maggs, As you can probably guess, blood doesn't really bother me. It is my children who are bothered by it. When they cut themselves I have to hide it from them while I bandage it! LOL, they would probably pass out also. They know to just wrap it and call me.

Lisa 7 years ago

I have worked in the OR for 27 years and I truly enjoy it! It is the most rewarding job that I have ever done. There is so many sayings and humor that goes along with the job.....

k@ri profile image

k@ri 7 years ago from Sunny Southern California Author

Lisa, Thanks for your comment! I still love it after all these years! And I agree, so many sayings and such a lot of humor, it's the best place in the world if you can put up with it!

Haunty profile image

Haunty 7 years ago from Hungary

Once I had someone complaining about all the yelling of certain docs. If only I knew your smart line about shaking hands earlier.

Great insight! I thoroughly loved it. :)

Haunty profile image

Haunty 7 years ago from Hungary

...and I forgot to say I have the pocket guide to the operating room book and it's insanely great!! 1500 pages full of surgical procedures. :)

k@ri profile image

k@ri 7 years ago from Sunny Southern California Author

Haunty, Thanks for reading. Next time you'll know to tell them, all in a day's work in an OR. I agree the pocket guide is wonderful! :D

RNMSN profile image

RNMSN 7 years ago from Tucson, Az

too cool K@ri!!!too funny actually saw that whose line is it as well on tv!!

k@ri profile image

k@ri 7 years ago from Sunny Southern California Author

RNMSN, I'm glad you enjoyed it! Thanks! :D

Rochelle Frank profile image

Rochelle Frank 7 years ago from California Gold Country

I am glad there are people like you who enjoy and are good at this job.

I have a couple of friends who are retired ER nurses, who had similar but different stories-- they may not have all of the technical challenges, but they do sometimes interact with patients and their families.

Nursing is obviously very challenging on many levels.

Thank God (and the lesser gods-surgeons) that there are people willing to take on these challenges.

Very interesting hub.

k@ri profile image

k@ri 7 years ago from Sunny Southern California Author

Rochelle, It's one of those jobs you either love or don't do...and I do love it! Thanks! :D

Lea 6 years ago

I love it...!!!

I am a newly RN, and i love OR during college days...

and on Jan.25,2010, my training as an OR nurse starts...

and oh my goodness!... training fees cost me $150 per month...

and yet, i don't get any salary from it... because I am only a trainee as they say...

oh well! I suppose I'll just enjoy myself the whole training session and learn as much as I can... ^___^

boo31 6 years ago

Student nurse here. Love your hub.

I am in the OR a few days this clinic rotation. I never could imagine all a nurse knows (I am in an LPN Program and feeling a bit overwhelmed) but I do have to say I was and am impressed by OR nurses. I was also impressed with the way the surgeon(only saw one)knows all of the staff(fulled gowned and masked)--very important to pull off the surgery!!!! I guess we all have our off days but you must be present 100 %...very vital to the job. I will be putting this job as a strong possibility when I become a nurse. I love challenges!

Now, I know what to write more on my made me think outside of the box. Thanks for the great writing!

k@ri profile image

k@ri 5 years ago from Sunny Southern California Author

Cherle, I'm go take a look! Thanks for the link. And thanks for the compliment. :D

Lea, I would have paid to be here also. I love the OR. Being an OR nurse has really helped during these hard times. People still have accidents or need their gall bladders out. I hope you love it!

boo31, If you love challenges, then the OR is the place to be. You must wear many hats and walk the edge of many a precipice, but it is very rewarding. And can be quite fun! :D

Aisla profile image

Aisla 5 years ago from Norway

Great hub and one that really shows the importance of nursing.

Sarah(Guest) 5 years ago

Hey Kari! My name is Sarah, I am currently a Nursing student and I am doing an argument paper for my composition class that needs to be in APA format. My subject, I chose, was the cost of oil affecting the cost of equipment and supplies in hospitals. And I found of few things you said about how the equipment HAS to work, and work well, great, and would like to quote you in my paper. If it is alright with you, I would like to know your First and Last name. (APA format reqirments) If this is possible, you can email me directly at

Thank you!!



gino@ph 5 years ago

really loved ur presently on a OR nurse training program ryt now..i really can relate to ur article..just 3 months inside an or and i already can feel the fun and the strong sense of family here. hope u can write more article bout ur experiences in OR for us new buds of OR nurses..thanks

Lori 5 years ago

just wondering how you got into OR nursing without experience??? i have 7 yrs nursing with last 5 in ER. cannot get past experience???? UGH. thoughts?

sara 5 years ago

some people says that OR nurse is not a nurse because they just give the instrument to the doctor so my question is what you will learn in OR as operating nurse

thecnatraining profile image

thecnatraining 4 years ago from Vancouver

Looks intense! thats why OR nurse makes the big bucks! I guess it desires on the person personal goals in terms of earning. Lots of other nursing options out there! Great hub and point of view for others!

3 years ago

You're stupid to put up with such abuse, idiots

Olga 3 years ago

Thanks for shring this article I want to be an OR nurse, more than ever now.

Nancy 24 months ago

I was an OR nurse for 45 years and loved it.

Snakesmum profile image

Snakesmum 24 months ago from Victoria, Australia

Sounds very stressful, and I think I'm glad I'm not even a nurse, let alone an OR nurse. Not for everyone, obviously. Very interesting article though.

Jen 24 months ago

Don't forget about your surgical tech and surgical assistant! We are right there getting yelled at too. It's a team effort and the entire team must have strong personalities or you will never make it in the OR. Sometimes those strong personalities clash, but in the end we all depend on each other to get through every surgery.

Yvonne 23 months ago

I've worked in the OR for 35 years, still loving it! From the first day I knew it was my calling.

Erik 23 months ago

Working in the OR is fascinating and is a great base to go anywhere in the hospital you want. The problem is the politics. OR's are cliquey. 97% of people are nice, professional, teamwork oriented people. Then there's the 3% of nasty, conniving, lazy, gossips who will lie to management about anything for what they perceive are reasons that will get them ahead. Which brings me to management. Most managers can't do, therefore they try to manage. Turnover in that area is huge. As soon as you get a dynamic, teamwork oriented, visionary, they leave and you end up with some dolt with no healthcare management education whatsoever. They have the personality skills of a piece of lint.

Jean 23 months ago

I worked in the OR for 43 years and never tired of the position. Missed it though when I retired. Did the full spectrum, Ortho, Heart, Vascular, In service training, ENT, Plastics, Brain, you name it and I learned so much and hopefully taught our young nurses what it means to be a "good OR nurse".

Robin 23 months ago

So proud to be an O.R. nurse. There is nothing like it!

k@ri profile image

k@ri 23 months ago from Sunny Southern California Author

Sorry Sarah, it's been a while since I have had internet. Thank you so much for asking.

k@ri profile image

k@ri 23 months ago from Sunny Southern California Author

I lucked out, going to a diploma school. I talked HR into trying a new program of hiring an OR nurse from the new grads. It only lasted 2 years. but I did get in.

k@ri profile image

k@ri 23 months ago from Sunny Southern California Author

It is a very specialized area. You cannot be an OR nurse and not continue to just learn different skills than a floor nurse.

k@ri profile image

k@ri 23 months ago from Sunny Southern California Author

I don't know many OR nurses in it for the money. There is no amount that can compensate for missing Christmas morning with your children. However, despite the cons, it is an endlessly rewarding and stimulating profession.

k@ri profile image

k@ri 23 months ago from Sunny Southern California Author

Team is EVERYTHING in the OR!

k@ri profile image

k@ri 23 months ago from Sunny Southern California Author

Took me one day observing as a student to know I was made for it! :)

mimi 19 months ago

I accepted a position in the OR a week ago and I start at the end of the month (my current floor insists I complete the current schedule). Since I have a little time to kill are there any resources (books, organizations, etc) you would recommend so I can get started with learning for the transition from med-surg to OR?

Elmer Speer 9 months ago

I was an OR nurse for 30 years. Sometimes being the only male was an interesting challenge. I would not trade a day of my experience with any of the team members I worked with. They were all terrific. I am blessed because of all of them.

ann jones 5 months ago

Retired OR nuse. I always told others that you either love it and thrive in the OR or you don't . And generally find out very quickly !

The most important "life lesson" I learned was to always be courteous and kind to team members as you, if not today , but, count on it, one day you will need them!! They will bail you out on call one night when you can't stand for another minute, find the instrument the doc is screaming for, or just walk in and relieve you so you can pee!!

God bless all OR staffs.

Best fun, greatest laughs, and best friends in my world .

Love your post

Pat 3 months ago

I've been in the OR for 48 years- 7 as a tech the rest as a nurse/manager/director and now back to my love...nurse. You either love it or hate it..not much in between I wouldn't trade for any other area!!

kevisc 3 weeks ago

Hi guys. I'm Jay. 23 years old. I just started my OR journey this week and to be honest, I'm quite excited, nervous and anxious at the same time. I don't have any floor/unit experience prior to entering OR that's why I'm hesitant at first but OR is my dream specialty area since i was a student. I'm always excited every time i enter the OR and always looking forward to the cases i'm going to handle. Right now, we're still having our orientation with my new colleagues. I know being an OR nurse is hard and you must be mentally, physically and emotionally fit and I would love to learn everything, i mean everything from the toughest operation to the tiniest instrument known.

Being inexperienced is maybe my hindrance right now in pursuing this dream but My Love for OR i greater and i'm very much looking forward in working with surgeons, anesthesiologist, technicians and co nurses.

Also I just want to ask for advice from you guys because as i was reading the comments section, lots of people are experienced in this field. I would really be thankful


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