Never Ask a Surgeon Their Glove Size: The Importance of the Preference Card

Looking back, as a novice nurse, I didn’t fully grasp the value of what was being imparted to me: the importance of the preference card. Now, when I emphasize its significance, I describe it simply as the recipe for the case. Just as you would need specific quantities of ingredients and a precise order of steps to bake homemade chocolate chip cookies, the preference card provides us with the necessary details for a surgical procedure. 

By diligently reading and adhering to the instructions on the preference card, you fulfill two crucial roles on your journey as a perioperative nurse. First, you demonstrate to your team members—fellow RN circulators, surgical technicians, or scrubbed nurses—your dedication to learning the procedure and adapting to the unique techniques of each surgeon. This common language fosters quick rapport with your scrub partner, facilitating critical communication about instrument sets, supplies, and equipment. With experience, these details become second nature, enabling you to anticipate needs such as trocar sizes, instrument sets for open cavity cases, or specific closing sutures for different surgeons. 

Second, following the preference card helps you quickly establish trust with the surgeons. As a new nurse in the OR, whether in a scrub or circulator role, it’s natural to feel your competence is being scrutinized. Using the tools available, like the preference card, ensures you’re well-prepared for what a typical case entails. If you still have questions after consulting the card, you can approach the surgeon with confidence, seeking clarification on specific aspects of the procedure. For instance, if the card indicates performing the surgical skin prep from the umbilicus to the knee for an inguinal hernia repair, you can confirm this with the surgeon and inquire about any additional requirements based on the size of the hernia. 

Entering unfamiliar surgical procedures as an orientee or recently trained nurse can be daunting. Utilize the preference card as a resource to alleviate fears and position yourself to anticipate the needs of the surgical team. Additionally, don’t hesitate to provide constructive feedback to the editors of the preference card – whether they may be a service line lead, supervisor, or manager. Inform them of any necessary changes so they can update future preference cards accordingly. Each of us plays a crucial role in utilizing, enhancing, and ensuring these cards are accurate. After all, we should never have to ask our surgeons their glove size.