By Mindy Clancy, RN-BSN
There is a common misconception regarding the duties and skills that are performed as a circulating nurse within the operating room. This biased ideology has existed for years, encompassing that surgical nurses do not have the same level of nursing skills in relation to other fields of health care. The stigma is largely related to the lack of knowledge within the medical community regarding the processes within surgical services.
We’ve all heard it before, if nurses go into the OR they will “lose their nursing skills,” or that they are not “real nurses.” This judgment has caused friction among colleagues within health care. However, this highly specialized area is genuinely just that, consisting of a specific skill set and requirements as a nurse. The vast array of surgical cases and OR settings create a large range of necessary nursing skills.
Through collaboration within the OR community, an overwhelming response of a multitude of opinions has been determined. Some find it advantageous to work on other floors within the hospital, such as medical surgical units, prior to going to the operating room. It is deemed important to obtain time management skills, basic skills, assessment tools and medication administration familiarity. However, the vast majority agree that despite your prior experiences, the expertise needed within surgery is unlike anything you will learn about prior to orienting to this service.
This concept was strongly proven throughout the difficulty and hazardous times of the pandemic. Nurses were forced into roles in various units. Their basic nursing skill sets enabled them to adequately and professionally do their best to care for the patients that needed their aid. Whether those skills were established in nursing school, the operating room or from years of experience on the floor, the influence that OR nurses were able to provide to the life-saving measures during the pandemic were absolutely invaluable.
Wendy Greene, a circulating registered nurse, stated that the bias can be regarded as “internalized nursogyny.” Dictating the prejudice that is held towards circulating nurses because others lack an understanding and have a false sense of knowing. Nurses have sworn by oath to their commitment, “To adhere to the code of ethics of the nursing profession; To co-operate faithfully with the other members of the nursing team.”1 All areas within health care possess pertinent knowledge towards their expertise, and as professionals we should honor and respect each other.
This stigma largely presents itself in a common scenario of dissuasion when nurses consider working as an operating room nurse. It is seen very typically within nursing school. The ambitious nursing students seeking out their passions and desires often receive disdainful judgment to their liking of surgical services. As a nursing professional, it should be the duty of professors and colleagues alike to promote each other to work within the areas that are found most interesting and exciting. The experience of burnout may be suppressed if an individual can find value in what they are doing. Respecting the varying opinions of the correct level of experience prior to the operating room is important on a circumstantial basis; however, we should be able to find a way in which to support each other without providing negative preconceived notions regarding this specific specialty.
Whilst discussing this topic with OR staff members, Torisetemisan Tenu stated, “General nursing is a mirage.” This concept supports that there is no standard of nursing that we are able to compare ourselves to, no level of nursing that one must reach before they are deemed valuable or competent enough to move forward in their career. Nurses are equals, working together towards the common goal of caring for patients. As health care professionals, all nurses play an integral role in the communities they serve.
It is important to understand that the skill sets used and built upon in the operating room are highly specialized to a particular degree and cannot be matched within other units. Depending on the facility, the levels of acuity may fluctuate, but one thing does not and that is the circulator’s commitment to patient advocacy and safety. Circulating nurses perform under high-stress situations using a vast array of assessment skills, knowledge base and communication efforts. Delivering superior care in high-pressure environments, leveraging critical thinking and time management, whilst maintaining patient safety as their first priority. A circulating nurse’s skills are strong as they passionately advocate for their patients, acting as their voice during their most vulnerable state. No matter the level of acuity, the attentiveness of a circulator towards the well-being of their patient is paramount.
As health care professionals, we should humbly accept that we are unable to fully understand the skills necessary to perform in various departments. In order to thrive within a successful hospital network, all encompassing parts should pay homage towards their importance in patient care. Superiority negatively impacts the mentality of the profession. There is no specific standard for the “perfect nurse;” however, a standard of inclusivity should be withheld.
1Vera, M. (2017, November 8). The Nightingale Pledge And Its Versions. Retrieved from Nurselabs:
