Traveler Orientation: Operating Room Questions You Should Ask

Orientation as a traveler is going to be very different than as a permanent staff nurse. Since you are only at one location for 13 weeks and the hospital is probably desperately short-staffed, it isn’t uncommon to receive only 1 to 2 days of orientation or none at all. I find it helpful to ask the same questions every time I start a new assignment.

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And despite how many assignments I’ve been on, it always feels like I’m starting over. The main purpose of an Operating Room nurse is to know surgeon preference and where EVERYTHING is located. So here are the questions I ask whenever I arrive at a new facility:

What’s the layout of the OR rooms?

This is the first thing I do. I find out where Pre-Op is so I can interview my patients before surgery and ensure all the paperwork is in place.  I also like to see the PACU or Short Stay since the nurse is usually at the bottom of the bed directing it in the hallway while Anesthesia is at the head of the bed.

Pro tip: map the layout of the center core. With so many different services, a good OR will have each service equipment and supplies clustered together. While this is not always the case, I have found it helpful to take a piece of paper and draw out a small map of “most used items” until I get acclimated to the facility.

Where do I park on a daily basis?

It seems basic, but not asking could cost you time and even money. You should also find out if you need to park somewhere else if you’re called in at night.

What is the protocol for calling a code?

What does that facility say for “Code Blue?” I’ve also heard, “Dr. Blue,” “Anesthesia Emergency,” and “Color Blue.” Is there a code button or do you need to dial a number? It’s always good to be prepared for an emergency.

Where are the code carts and malignant hyperthermia carts?

Hopefully, you won’t have to use either, but you must know where these are so you have quick access to them in case you do.

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How do I order specimens?

Where do the specimens go and how do I log them in? Are there formalin-filled containers or do I need to take the containers and pour the formalin in myself?

Is the surgeon’s preference card up-to-date?

It’s okay to ask how good their preference cards are because if they aren’t correct, there isn’t any reason to follow them. In these cases, I typically make my own preference cards when I work with each surgeon. Many times, staff will ask to copy my cards before I leave. I paperclip them and stick them in a box in case I decide to return to that facility.

Is there a list of department numbers?

I always find it helpful to have phone numbers to the charge nurse, manager, Pre-op, PACU, X-Ray, Microbiology, Lab, Blood Bank…etc.

Who is in charge of ordering blood and is there an emergency blood protocol?

Some facilities leave ordering and checking blood up to Anesthesia. Other places have requested that the Nurse put in the order and call for the blood cooler.

Are the rooms positive pressure in the case of Airborne Precautions?

A couple facilities needed to have someone come down and put a sealed tent around the entrance of the OR doors. Are there precaution carts filled with gowns, gloves, and appropriate masks? Where are they located?

What is the policy for room turnovers?

I’ve been to one facility where the nurse was in charge of changing out the Anesthesia machine tubing and setting up the A-Line if needed. At another facility, the nurses were not allowed to help with turnover and weren’t allowed in the room until housekeeping personnel were finished. I didn’t know this and tried to help clean. I was reported to the housekeeping union for “trying to take their job.”

There are endless questions to ask, but I think this is a good start. You won’t be able to know everything when you start, but will figure it out as you go along. After traveling to 17 different hospitals, I’ve found most of the permanent staff members are very willing to help. If you find yourself in a bind, JUST ASK!