Do’s and Don’ts as a Newbie in the OR

As a newbie in the OR, the key do’s and don’ts include thorough preparation, effective communication, and maintaining a positive attitude to make sure a smooth transition into clinical practice. The CRNA Club emphasizes that understanding airway management, medication mechanisms, and teamwork are essential to success. If you’re wondering what schools are really looking for, we actually talked about this on the podcast (Ep 1: "What CRNA Schools are REALLY looking for in an applicant").

What Are the Essential Do’s for Newbies in the OR?

Integrated or front loaded, by the time you reach the operating room you could have a lot of knowledge on anesthesia, the challenge is now how to translate that knowledge to practice. Preparation will help ease your nerves and show your preceptor that you’re invested in your learning! Important topics to review are airway anatomy, airway management techniques, top drawer and emergency medications.

Know your doses and most importantly mechanisms of actions of each of the drugs. If you want a structured review, our Learning Library has a full lesson called CRNA History + Types of Anesthesia that can help reinforce these concepts. Depending on your program and clinical expectations you may have to make a care plan on the first patient of the day or for all your cases of the day.

Knowing what is expected of you is the first uphill battle, so be clear on all expectations. If you have access to your patient’s charts from home, do a thorough review of their history and why they are getting the procedure. You want to understand their current medical history, pay special attention to any past surgical and anesthetic history which could provide great insight into what you may do.

As far as preparing care plans, I highly recommend Anesthesiologist’s Manual of Surgical Procedures by Richard Jaffe. It has in depth explanations of procedures including, anesthetic considerations, patient pain level expected, blood loss and all information on pathophysiologies that would lead to a patient having this procedure.

Ask Questions
When your preceptor inevitably pimps you on a question that you have no idea where they even got it from, say “I don’t know, but I can look that up and get back to you.” These are trained anesthesia providers with years of experience, whatever answer you’re gonna make up is not going to suffice. Be confident in what you know and have the humility to learn what you don’t know, it's why you’re there after all. Sometimes you can even curtail the pimping by leading with, “Can you explain to me why you like to do ______ that way?” Again, curiosity shows you’re invested in learning and expanding your knowledge. If you’re just at the start of your journey and want a step-by-step guide, check out our How to Become a CRNA resource.

What Are the Key Don’ts for Newbies in the OR?

Let Stress Affect Your Communication
Often easier said than done! You’re under a lot of pressure in, and outside, the operating room. Everything is new, there’s alarms going off you have never heard, you're running on no sleep and you feel slightly overstimulated.

Going from being a competent ICU nurse to now being out of your element completely, is humbling to say the least. What would be best is to lead with a deep breath anytime these feelings arise. Saying “thank you” to everyone who does something for you is key, you want to be remembered as a team player by everyone, not just anesthesia.

Lead with a smile and openness and you’ll be shocked at how many people are willing to help you. At the beginning there will be a lot of leaning on your preceptors, anesthesia techs, nurses, operating room staff etc. to first get acclimated to a new environment. As you get more self-sufficient with time, you’ll start to find your stride but always remember everyone is a teacher if you allow them to be. For more on how to navigate these early challenges, we covered "3 things I would have done differently BEFORE applying to CRNA school" on Apple Podcasts.

Break the Sterile Field
Asides from your anesthesia colleagues, the surgical team often takes great care and preparation in creating their sterile field. They are also a part of your team in the operating room and you want the circulator, scrub nurse and surgeon on your team as well. Please be mindful of sterile technique and even how to hand them supplies if you’re called upon to do so. Review a youtube video on sterile technique if need be! Just remember, anything blue is not for you!

What Should You Take Away From Your First OR Day?

In the end, the best SRNAs are those who come prepared with a positive and open attitude to clinical. As a newbie, there is more out of your control than in your control. If you focus on leading with kindness, you’ll make your transition a bit smoother. Find one thing a day that you feel confident you did well and don’t let the losses get you down for too long. If you’re still researching what you’ll need to apply, our CRNA School Requirements page is a helpful tool.

Want to know more about attending AANA meetings and how to network? Plus meet up with other applicants at events so you don’t have to go alone? We’ve got resources and networking opportunities for you inside our CRNA Club Membership!

For more information, check these trusted resources: American Association of Nurse Anesthesiology (AANA), Bureau of Labor Statistics. If you’re curious about salary and compensation, we broke it down on the podcast (Ep 4: "CRNAs make HOW MUCH?!") and there’s a full Salary lesson in our Learning Library.

Our Final Thoughts

Starting in the OR can feel overwhelming, but with preparation, curiosity, and kindness, you’ll find your confidence grows each day. Remember that everyone in the OR is part of your learning journey, and The CRNA Club is here to support you every step of the way. If you want to dive deeper into the profession, the Profession Overview lesson is a great place to start.