“Molly Brown, RN” (aka “Unsinkable MB” – both are pen names) blogs at Blood, Guts, and Coffee. She works in the Operating Room (OR) as an Assistant Clinical Nurse Manager.
Molly has been in her current position for over 6 years. “My cousin who is an OR nurse peaked my interest in surgery while I was in nursing school. During my leadership clinical, I observed a few surgeries. The first one was a CABG (heart bypass surgery); it was love at first incision. I started in the OR right out of school, moved up the ranks in my hospital system from Staff Nurse to Specialist (over one service), then was promoted to Assistant Clinical Nurse Manager (over 4 specialties).”
Molly starts her morning by doing rounds and helping her services get their day started. She helps to open sterile instruments, gets supplies and equipment, assists with positioning patients and checks in with surgeons and staff. Throughout the day she offers support when needed by troubleshooting issues with instrumentation, equipment, and supplies. She also tends to anything that comes up with patients, staff, and physicians. She provides lunch relief when short-staffed. When she finally makes it to her desk, she works on various department and hospital initiatives, writes staff evaluations, tries to answer voice/email, and coordinates with vendors who might have to bring in instrumentation/equipment that has been requested by surgeons.
What frustrates you about your job?
No matter how hard I try, sometimes I just can’t make everyone happy.
What about your job makes you proud to be a nurse?
Although my direct patient care is a bit less than when I was a staff nurse, I am proud to know and to see that I can still make a difference in the quality of care by being a voice when decisions are being made at the administrative level. Also, I’m proud that with my experience of working at Level I Trauma Center, I still have the critical skills of being a scrub nurse or circulating nurse when an emergency case comes in.
Do you feel you receive adequate support for your responsibilities?
My manager has been my mentor for quite a while. She understands the challenges I face because she has been in my position before and has helped in my transition into this role.
What is something a nurse who does not work in your particular field might find surprising about your job?
In other departments, many nurses don’t consider surgical nursing “real nursing.” I suppose it’s because we don’t do what people typically think of as nursing – passing meds, taking vitals, etc. Spend a day with us and you will find that we still have to perform assessments throughout our care, understand positioning (since we can’t turn patients in the middle of a long surgery), as well as maintain normothermia. While we don’t pass meds, we utilize medications intra-operatively, which requires an understanding of contraindications as well as what to administer in case of toxicity. Surgical nurses use their nursing knowledge to be a voice for the patient who is sedated and can’t speak for themselves. Like our colleagues in other units, we perform the most important nursing skill — provide comfort at the bedside before patients “go to sleep” and again when they wake up from anesthesia.
Staff nurses are paid by the hour, plus call pay (when “on call”). If they’re called in, then it’s time and a half (with or without differential, depending on what time). I am an Assistant Clinical Nurse Manager – paid by the hour, but no over time (just straight time). My official hours are 6:45AM to 3:30PM. Because our department is undergoing a lot of change, I’ve been known to work a few 12 hour days here and there (self-imposed!). Managers and Directors are salaried.
Molly says that for the most part she’s able to accomplish almost everything she needs to do in the time she has, but adds that surgical nurses tend to be perfectionists and she tends to stay over. She further states that “teamwork is crucial in the surgery department and not just in the actual operating rooms. For our unit to run smoothly, we need to work closely with the staff, surgeons, anesthesiologists, and other departments (Sterile Processing, Radiology, Pharmacy, ICU).”
As for extra training or certifications, Molly says that her hospital system provides frontline leadership training in the first six to seven months of the job as well as ongoing mentoring. She also has a business degree and previous experience in Corporate America, which has proven to be an asset to her in her current position.
And lastly -
One of the biggest complaints given by hospital unit-based nurses is that they rarely have time to eat or go to the bathroom. Do you find that to be the case with your job as well?
Surprisingly, yes! With all the troubleshooting that I do between operating rooms (supporting my team) and the meetings I have to attend, someone has to remind me to slow down and take care of myself.
Thanks to Molly for answering my questions about what nursing is like in the OR from the perspective of an assistant manager!
If you are or know of a nurse that works in a nontraditional setting and are interested in being interviewed, email me at firstname.lastname@example.org. My post about this project and a list of interviews done so far is linked here.