5 Nursing Skills Needed to Work in the Operating Room

operating room skillsBy Erin Wallace

What operating room skills are needed to be a successful OR nurse? Whether you're considering a career as a scrub nurse, circulating nurse or RN first assistant in the OR, all nurses who work in the operating room need to have a specific skill set. 

The nursing skills needed to work in an operating room include hard and soft skills. Catherine Burger, RN, BS, MSOL, NEA-BC, says that although registered nurses in the operating room need a basic set of nursing skills, gained through their education in nursing school, the role as an OR nurse is quite specialized.

Learn what nursing skills are needed to work in the operating room and what you need to know to provide direct patient care.

5 Critical Operating Room Nurse Skills

1. Sterile techniques

Burger says that OR nurses must have “impeccable sterile technique to reduce any chance of contamination of the surgical environment. Staff who work in the OR must complete rigorous training and annual skill validation to ensure they are competent to prevent patient infection and injury in the operating suite.”

2. Adequate education
According to Burger, “OR nurses must be educated in each surgical procedure in order to anticipate the needs of the surgeon to efficiently pass instruments or devices needed during the operation.”
3. Communication skills
Verbal and nonverbal communication skills are essential for success in any nursing role, but in particular, they're an important nursing skill needed to work in an operating room. 
Kari Poulsen, who has been an operating room nurse for 25 years, wrote in an article that tensions run high in the operating room at times, and OR nurses “need to speak calmly and professionally while others may be angry or upset.”
Patients in particular, Poulsen points out, may be fearful before their operation. OR nurses are able to communicate to the patient in ways that help ease their fear. 
4. OR nurses must be alert and observant
“Nurses in the operating room must stay alert at all times,” writes Poulsen. 
“They observe the sterile field throughout the surgery. By observing the sterile field, they have supplies ready when needed. [For example], if the scrub nurse is down to two lap sponges, a good OR nurse has a pack in hand waiting for the scrub to ask for it. Being proactive is accomplished by observing and being alert for any change or break in sterile technique.”

5. Be an advocate for patients

Catherine Burger, RN, points out an OR nurse's important role as patient advocate and says it's an essential operating room nurse skill needed in an operating room environment.

“The OR nurse must have the confidence and empowerment to speak up to the surgical team when the patient is at risk,” she says.

“For example, before the surgical wound is closed, the staff count all of the dressings, gauze, instruments, etc, in order to ensure nothing is left inside the patient. If the count is wrong, the OR nurse must speak up and insist that the item be located prior to wound closure. Nurses must also speak up if there are any discrepancies in the surgical process to avoid 'never-events' such as a wrong-site surgery.”

These are just a few of the operating room nurse skills needed to work in an operating room. Many more are learned through experience and providing quality patient care.


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