by Susan Langlois, R.N.
May 22nd, 2009
I think that operating room nursing is a specialty that is often overlooked as a legitimate form of nursing because our patients are not perceived as being “in our care” but rather in the care of the surgeon and the anesthesia personnel. Therefore, our role is diminished somehow. In all honesty, that way of thinking shows a lack of awareness of the mind set of OR nurses who see themselves as the ultimate patient advocates for patients who cannot speak for themselves.
In truth, to be capable patient advocates OR nurses need to be forceful team members in that operating room. To do this, we really need a comprehensive knowledge of all aspects of operating room patient care. This includes an understanding of the impact on the patient of the anesthesia care as well as an understanding of the anatomical and physiological effects of the actual surgical procedure being performed. This is especially important in orthopaedic surgery, where, in many cases the surgeon is going to “take it apart and then put it back together”. We want to understand how this is going to be done and the expected outcome and challenges for our patient. I remember many years ago when non-reamed intramedullary nails were first available. Some surgeons continued to ream anyway. I thought to myself, I must not understand the purpose of this reaming – I had always thought it was so the surgeon could get such a snug fit for that nail that it would not rotate in the canal since, in those days, locking that nail was not an option. So I did an informal study of the surgeons and found out that they continued to ream because that was what they had always done and were just in a learning curve for these new locked nails. I did notice that, over time, these surgeons did stop reaming but the explanation was not as scientific as I was thinking it might be!!!
Susan Langlois, R.N. recently retired from active nursing after forty years as an OR nurse. She has had a vast experience at several hospitals, starting with a U.S. Army hospital in Fort Benning, GA and ending with the Cape Fear Orthopaedic Center in Wilmington, N.C. She has been a tremendous resource for OrthopaedicList.com for many years.