What I wasn’t prepared for the first time I shadowed in the OR

The first time I shadowed in the operating room, I was 18 years old, and the only thing I knew about surgery was what I had seen on Grey’s Anatomy. The night before going in, I pulled snacks that I can eat quickly between cases, I googled abdominal anatomy, and tried my best to get to bed early.

I had no idea how the operating room functioned in real life, let alone, how to shadow a surgeon.

Since then, I’ve come to learn that there are some things you can only learn once you are on site, which I want to share with many of you who may be preparing for your first time in the OR.

Here’s what I was unprepared for:

1. What to do when I walk into the operating room

Every OR team consists of many members including the surgeon, the scrub tech, the circulating nurse, and the anesthesiologist. There are also residents, nurse anesthetists, perfusionists and company representatives.

The sheer number of people all moving around to set the room up can be overwhelming the first time.

Tip: When you walk in, introduce yourself to everyone in the room without interrupting the flow, and ask if you should write your name on the board. Be aware of your surroundings and explain that it is your first time in an OR. More times than not, someone will be willing to explain the lay of the land when they have a moment.

2. Where to stand when you are not scrubbing in

On my first day, I did not know what to say or what to do. I walked and stood in a corner until an incredibly kind circulating nurse waved me over with a stool in her hand for me to stand on. Depending on the surgery there are different places to stand. Laparoscopic and robotic surgeries are convenient because any place you stand you will be able to see the screens and the detailed anatomy. Open surgeries can be a little tricky to find the perfect place to stand.

Tip: For open surgeries, my recommendation is to first check with the circulating nurse where they recommend you stand – they will know the best view for you without disrupting set up. Always ask before you stand somewhere, either the circulating nurse or the anesthesia team. If you are standing by anesthesia, let them finish their portion of setting up and then make sure you are cognizant of when they need to do things throughout the surgery.

In general, stand as close as you can without being too close to the sterile field as to make staff nervous. Do not be afraid to ask for one or more step stools.

3. The potential for being asked questions

As a medical student you learn that you need to be prepared to be asked questions by the attending or resident during the surgery. My first time in the operating room, even as a shadow, I was under-prepared for any general questions that could have been asked of me.

Tip: Ask the surgeon or scheduler when you are confirming the day you are shadowing them, what procedures you will be shadowing that day. The night before you go into the operating room, read up on the procedures – you do not need to know how to perform them, but it will help to understand the anatomy and the outline of what you will be seeing. If you have a basic understanding of these aspects of a surgery, it will make your learning experience more valuable, show your level of interest, and provide groundwork to ask questions.

The operating room is an incredible experience and place to learn, take advantage of every learning opportunity that comes your way!

Q&A

Should I know how to scrub before I shadow the first time?

In most cases, shadows do not scrub into surgery so not knowing how to scrub in is perfectly fine. If you are going to be scrubbing in, it is very important to know how beforehand.

What if I need to leave in the middle of the operation?

If you need to leave the room during a surgery, the first person you should inform is the circulating nurse. It is important to let someone know you are leaving and whether you will be returning.

What if I start to feel faint while shadowing?

Similar to the above, inform the circulating nurse. They will look out for you to ensure that you are safe in the environment. This happens to many individuals at all stages of their careers, so always announce when you do not feel well.

What should I wear on my first day?

You will have to change into surgical scrubs, so you are free to wear whatever you want to the hospital. Make sure you wear comfortable shoes, and I always recommend compression socks if you think you will be standing for long periods of time.

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Francesca Ponzini (Twitter: @PonziniF) is a medical student who wants to create a culture in surgery that is welcoming to all who want to be a part of it

The opinions expressed in the article is not affiliated with any institution, company or product. The article should not be interpreted as medical advice. Interested in writing for us? Send us your article at themodernsurgeon@gmail.com