Dec 5th, 2007 by Terry
The Operating Room is a whole other universe, and all the usual rules that apply in the outside world tend to fall away in here. That is not to say that the OR is a bad place; quite the opposite, it is a very orderly and territorial environment. It lost its circadian rhythms just moments after its inception, and everyday life depends on the cooperation and interfacing of many different people and departments to help the OR schedule reach its completion for the day. Only to begin all over again tomorrow. So, what follows is a guide to how life is conducted and the rules of etiquette that people live by behind the big double doors with the sign that reads: RESTRICTED TO OR PERSONNEL ONLY
- Sleeping patients have the right of way. Stretcher traffic in hallways dictates that the anesthetized patient should always go first.
- IVs are inserted in the non-dominant arm, when possible.
- Patients are never moved or repositioned without the anesthesia provider giving the count: Ready – 1, 2, 3!
- Every member of the OR care team is also a member of the contamination police. If you observe a break in sterility, it is your responsibility to announce this to every one in the room. ASAP
- When the sponge or needle count is off, it becomes EVERYONE’s responsibility to fervently look for the missing object.
- The surgeon is the captain of the ship. He/she brought the patient to us, and will manage the patient postoperatively, too, and after discharge. If the surgeon wants the room cold, it will be cold. If he/she wants music during surgery, toons will be procured.
- “Be nice to the people you meet on the way up, cuz you’re going to meet the same people on the way down.” We are all important and vital, and no operation can happen without everyone working together. This includes, but is not limited to, the surgeon, anesthesia, the nurses, OR techs, orderlies, management, lab, and maintenance. It takes a village . . .
- As the anesthesia lightens and the patient awakens at the end of the case, all music and extraneous conversations and NOISE come to an end, to enhance a smooth and quiet wakeup and transition for the patient.
- In the OR, you get rewarded for working efficiently and in a timely manner by getting the add-on cases.
- If you are cold, long sleeve shirts from home are unacceptable to wear under your scrub top in the OR, but warm-up jackets from home are fine.
- Women must make sure that every strand of their hair is covered under an OR bonnet, but men can wear OR caps where the scalp hair around their ears and back of their head is exposed.
- Showering, cleaning out your navel, and brushing your teeth are GOOD THINGS to do before any OR procedure.
- Leaving all jewelry (including tongue rings), polished nails, and makeup at home is always the right policy.
- Passing gas after a colonoscopy is ALWAYS DESIRABLE and doesn’t really count as real flatus.
- Pulling out your own IV is frowned upon; pulling out someone else’s IV will not help you win friends in the OR environment.
- Knowing what medications you take makes everyone’s life easier, and making a list of them is a prudent idea.
- If you are having same day surgery and you don’t have a ride home, don’t bother coming.
- Nothing to eat or drink after midnight includes lozenges, juice, candy, gum, and coffee with or without cream.
- Asking questions about your impending procedure is healthy for you and helpful for us to know your knowledge deficits. If you don’t want to know, that’s okay too.
- If you know where your best vein is, we will probably find it. The vein they usually find for taking blood may not be the best vein for threading a longer IV, please remember that.
- You may think you’re immune to the stuff, but we’ve never met a human being yet who we have not been able to “knock out.” Some take more, some take less, but everyone goes to sleep with our drugs if we want them to.
- Try to be a good historian. We are very interested in your allergies, if you have any: to drugs, to food, to dye. If you dawdle in recreational substances (alcohol, street drugs, scripts), we will not report you, but we need to know. The medications we give you will interact with what’s already in your bloodstream. For your personal safety, be honest with us. It’s all confidential. That’s the law.