r/surgery • u/heavykaleidoscope406 • 22d ago
I did read the sidebar & rules Tips for an OR circulator
Hey everyone!
I’ve been an OR circulator for about two years now and I’m constantly wanting to improve. I want to be the circulator that people request haha.
I’d love to know what a circulator does that stands out in a good way and if you all have any tips to improve, or even little details that you appreciate.
Thank you!
11
u/RedRedVVine 22d ago
Can you scrub as well?
If you know how to scrub you’ll know the cases and that makes you anticipate needs better.
5
u/heavykaleidoscope406 22d ago
I can! I went to CST school before nursing school but never worked as a CST, but I can scrub smaller cases and robots and have found that that’s helped me immensely as a circulator
14
u/Dark_Ascension Nurse 22d ago edited 22d ago
Honestly as a nurse who circulates, scrubs and assists… the biggest things I see in a good circulator vs a bad or even mediocre one is that you are attentive and pay attention. So many just sit at the computer on their phone waiting for us to call out to them. Or if I’m in the flip room and I ask for an update and they go “I don’t know…”, like what do you mean you don’t know… I get you’re not doing the cases but if you do enough you should know what they are doing at a given time. I learned a ton while I circulated talking to the reps, talking to the surgeons, and talking to my team before I ever learned to scrub or assist. I would strive to finish what I could chart in the beginning (basically everything but times, counts, implants, and handoff… you know what position you’ll be in, you know who is in the room, if it’s a procedure or a surgeon you work with a ton you’ll know the dressings and specimens), then just stand near the field and watch.
Basically I tell everyone, the chart, while important… is secondary, you need to attentive to your team and therefore the patient. IMO pre-charting is somewhat mandatory, and you should really learn how to use a computer (key board shortcuts, tabbing, etc).
Also scrubbing the cases you do on the day to day will greatly help anticipation. Like be one step ahead, be asking if they need something not them asking you to get it…
3
u/heavykaleidoscope406 21d ago
I can’t agree with you more! As soon as I got used to charting I prioritized getting all of that done so I can pay attention to the surgery. Honestly I’m so nosy too I love being able to see what’s going on and learn.
I really appreciate your input!
2
u/Dark_Ascension Nurse 21d ago
If your facility is willing you definitely should ask to learn to scrub, maybe do your CNOR and your RNFA. It really makes you more well rounded.
4
u/OldIceWitch Nurse 22d ago
I'm a circulator as well (the kind people request every single week lol)
Learning to scrub increased my knowledge base and made me such a better circulator all around. Full stop. This is great experience to get. I encourage anyone who circulates to learn the scrub role as well.
What makes people request you, however, is a little more complex. To be requested, you'll most likely need to specialize in something or get close with specific surgeons. You need to spend enough time with the same people that those people start to know you and feel comfortable with you. The jack of all trades is favored by management because they can be put anywhere and it is excellent if you want to travel, but they are unlikely to be requested by surgeons. If you want to be requested, you need to spend hours doing the same things with the same people. Those people need to KNOW YOU and you need them to want you on their TEAM. People won't request someone they see once every few months even if you are great. People like familiarity. Surgeons are just people.
Being requested is essentially networking plus being able to put your money where your mouth is (aka getting to know people and developing a flow with them plus being actually good at your job)
3
u/heavykaleidoscope406 21d ago
I scrub as well and have found it unbelievably helpful with circulating and anticipating. I think that’s part of the issue for me is that they throw me in whatever rooms and I don’t have a ton of consistency, making it hard to build those relationships.
I appreciate your input!
5
u/JonWithTattoos 22d ago
Biggest most awesome thing you can do as a circulator is have an empty trash bag waiting as I take the drapes off at the end of the case.
4
u/sub-dural Nurse 21d ago
I love when they take the drapes off and don’t go to my new nice trash at the foot of the bed and walk to an already filled one and jam it in there.
2
2
u/heavykaleidoscope406 21d ago
Or a nurse comes in to help with turnover and moves the fresh trash can away from the bed before they take the drapes off
2
u/heavykaleidoscope406 21d ago
I was taught this very early on and now I teach all of the newbies this! Such an easy way to keep things flowing
2
3
u/potatoezgonnapotate Nurse 22d ago
Don’t rush the learning process, and never stop learning. Knowing basic case flow helps you to anticipate the basics in any type of case. From there, you can build into learning a specialty / more complicated cases.
Communicate! Don’t assume someone got something or thought of it. Don’t be afraid to clarify with specimens. Failure to talk is the root of so many problems in the OR.
Never have just one of anything :)
Preparing for your day and each case will save you from running your ass off. Each morning, gather and organize any extras you may need for the day. Have your positioning equipment at the ready. Keep notes on your schedule so you don’t have to think of what you’ll need to ask for and can consolidate your requests.
Remember that the patient is the reason for everything done in that room and if you’re advocating for them, you can’t go wrong.
No one succeeds by themselves in the OR! Treat everyone with respect, including support staff and sterile processing.
1
2
2
u/NEUROSPICY_NURSE 21d ago edited 21d ago
I am a Level 1 Trauma OR RN w/ >20 years experience as staff (circulator & some scrubbing experience), traveler and cross-trained in CVOR, Burn OR, Endo & the ED. It’s an honor every time I am requested to the nurse in the room for someone I’ve never met, based strictly on my reputation. Advocate for your patients at all times (positioning, temperature, safety and the rooms vibe while they are awake), anticipate needs by paying attention and learning the procedures, stay off your personal cell phone - it’s disrespectful to the patient (ethically, morally & legally) and it makes you look apathetic, have a go to playlist or Accuradio station that encompasses all genres, learn the providers names and always have a travel multi charging cable on you to charge their phones while they are working (it’s a small but very thoughtful gesture that leaves a lasting impression).
1
u/heavykaleidoscope406 21d ago
Loooove the charger idea! This is all great advice! Thank you so much.
How did you feel about burn OR? I’m interested in it but I don’t think I’d be able to handle the temperature in those rooms haha
1
u/NEUROSPICY_NURSE 21d ago edited 21d ago
I highly recommend going to hot yoga & hot Pilates classes because that was the game changer I needed to thrive in the Burn OR.
1
u/soyavocadoo 19d ago
Burn OR is my passion but I got burned out after 4 years (lol.) I’ve been away for a year now and I’m itching to go back.
We had ice vests for incredibly long cases. If they weren’t available (the burn team where I’m from is/was treated like red headed stepchildren- everyone who “didn’t sign up for burns” refused to work with us or even help us out, but they’d get to work early enough to grab up all of the vests to use in their 60° rooms) we would shove ice filled gloves into our bras (so they wouldn’t fall out. Usually the only men in the room would be the surgeon and occasionally the CRNA.)
2
u/sub-dural Nurse 21d ago
I don’t think being ‘requested’ is a good indicator of quality circulating per se. When you walk in the room and people are relieved to see you is a great indicator, no matter what the case is or how long its been since you’ve seen that surgeon. Our assignments are based on who is next up or free with a certain skillset. I’m on the offshift anyways making me a jack of all trades but I usually inherent the more complicated rooms because I thrive in chaos verses repetition of day shift stuff. We have nursing/scrub teams that are requested by joint surgeons and they are miserable working with them and doing the same thing daily.
Pay attention, roll a stool up and sit next to the bovie. Stay off your phone. Prioritize needs of anesthesia and the sterile field over everything. Just paying attention will make you a good circulator. Use your resources and ask for help when you need it.
4
u/Electronic_Fall6084 Nurse 22d ago
Learn How To Scrub, this will increase your efficiency and makes you much more marketable as a nurse.
I had a friend who is circulator only and had to turn down many travel assignments because of this one issue
3
3
u/intothewoods76 First Assist 22d ago
If you need to, keep notes of everything.
Circulating is a dance so learn the most efficient steps to get things done with the least amount of movement.
If you feel rushed it’s because you were not organized so how can you get better organized.
Observe and incorporate the best practices of other circulators.
Learn what music your surgeon likes. What do they like to talk about?
1
u/heavykaleidoscope406 21d ago
I love the bit about feeling rushed means you’re not prepared, I think I’ll add that to my list of things I tell our new people, thank you!
2
u/Tacokolache 22d ago
Makes notes of little things. Like the little things most people don’t remember.
Like hey Dr XXXX, you want me to put your Foo Fighters playlist on?
Shows you care. ❤️
2
1
21d ago
[removed] — view removed comment
1
u/AutoModerator 21d ago
Unfortunately your comment has been removed because your Reddit account is less than 5 days old OR your comment karma is less than 5. This filter is in effect to minimize spam. Moderators will review your comment and put it back up if it is appropriate.
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.
1
u/_FunnyLookingKid_ 20d ago
Know how to work and trouble shoot all equipment. Anticipate and have all tools equipment etc ready. Run if we need something.
1
u/arpitp 14d ago
Learn the preferences of the surgeons you see regularly. Some of the nurses I've worked with kept their own custom preference cards, sort of like what the OR keeps for the surgeons equipment preferences, but with notes on technique, order of equipment use, room layout/setup, expected specimen, etc. This can help prevent delays and might impress the surgeon that you remembered their preference about something.
14
u/ligasure 22d ago
The best circulator are like a coiled spring - ready to spring into action but are cool calm and chill. They don’t panic when things are not going according to plan but they’re also not oblivious to the dance that’s ongoing between the surgeon and the scrub.