Perioperative Nurse Residencies

Great! You got the call back and they want you. Whether or not you start before you take your NCLEX, there are a few guidelines for nursing residencies, especially in the OR.

First, this is a real-life nursing job. Whether you’ve had a real job before, had a nursing job before, or never worked a day in your life besides school, this is completely different. Now that you’ve finished with school, you’re back in for more! This time there’s more at stake and there are a whole lot of relationships, connections, and bridges you need to harness.

This is where life gets tricky. How many times did you procrastinate and do that assignment late because you knew you could? Now every day you have something due, and it is mostly mental and physical muscle memory, not a tangible paper essay.

How many times did you sleep in a little, roll into class late, maybe talk to your professor once a month? Now every day you must be on time according to the clock, every day you are accountable for your actions, and every day you speak to the person who will pass or fail your perioperative nursing abilities.

How many times were you able to tell your family that the hard part will be over after this weekend, after this month, after this semester? Now you are in the grind, and maybe you can ask for a month to get in the swing of the schedule or warn them during your new independence you will be stressed, but this is it. This is what a real life nursing job is going to be.

Now, do not let me scare you. Your educator is human and so are your managers. Calling ahead of time and warning them that the kids were throwing up (you were throwing up), the car did not start, or you simply forgot your alarm will give you points as long as you do not call every day. The hospital actually wants you to succeed, it costs a lot more than you realize to train you so why would they want to fire you?

Say it with me – you will be an amazing perioperative nurse. You just have to go through the training and forgive yourself for needing to learn. Unfortunately very few nursing schools will teach towards perioperative nursing, and fortuantely for you, that makes your skillset rare and sought-out.

Perioperative residencies generally last 6-9 months and operate 7-3 Monday through Friday. You will most likely not get 3 12 hour shifts, and believe me, you probably do not want them. You may trade shifts and precept during off shifts. In the middle you may review services or scrubbing cases, and by the end you should feel very confident in your ability to perform a case (even if there are some hiccups).

Hiccups are normal. Everyone has them. Just recognize and own your mistakes as soon as you realize them.

Another startch difference between OR residencies is that there is no time for preceptor-preceptee matching. You would not want it either. Even if you got along great with your preceptor, they cannot be experts in each speciality and that discomfort far ouweights the benefits of having a preceptor that fits your learning style.

Adapt. You are a nurse first. If they like to talk and you like to read, write everything they say down. Do not focus on the computer, because charting takes time you can practice later. Watching everything your preceptor does and visualizing his or her flow will let you take in what you like, and discard what you do not.

Focus on learning every aspect of why they do what they do when they do it, as much as how they do it. This goes for circulating and scrubbing cases, although both roles are important and have similarities, there are huge differences and skills for each.

If you learn to scrub, scrub first if you can. Learn the process of the case, learn the body language of surgeons under pressure, and learn how to small talk, pass instruments, and listen to the anesthesia beep.

If you understand the surgical process, listening from 15 feet away in your circulator corner will be that much easier. Still, watch the surgeon’s body language and listen to the anesthesia beep, but listen when the small talk dies down and look on the screen if you are in a laparoscopic case or have a camera light handle.

Remember that as a circulator, you are responsible for every single moment in that room. It is for that accountability and responsibility that the managers hired. You seemed confident, in charge, and willing to stand up for your patients. They trust you. I trust you. Your patient needs you.

Take in whatever your preceptors say and do, and practice your flow as soon as you are able. You can always start in the middle or take over during lunch, in fact, I encourage not always starting from the beginning because you will not always start from the beginning. Make yourself uncomfortable so you get familiar and comfortable with that anxiety.

Always take the opportunity to do instead of watch. Try to teach when you feel confident in your own abilities.

Never, ever, let someone give your learning experience away to a medical student.

When your residency is done, it is a big deal! Congratulations on achieving something not many will do in their lifetimes, even if they did pass NCLEX. You are a perioperative nurse, and we rely on you to keep us safe when we cannot speak for ourselves.

Thank you for choosing this profession. We need you here.