Behind Closed Doors: Eight Universal Laws of OR Nursing

Unchanging principles that make surgery go ‘round.

Soon after I started my career in the OR 42(!) years ago, the first Universal Law of OR Nursing grabbed me by my scrub jacket and shook me into a higher state of consciousness. You see, like many freshly minted surgical nurses, I had visions of dashing into those hallowed halls and saving lives, just me, myself and I. It only took a few sobering shifts in the OR to pfft perforate my overinflated ego and show me that it takes a team working together to put patients back together again. Since the Law of Teamwork slapped me upside my bouffant, I’ve observed 8 more Universal Laws of OR Nursing.

1. The Law of Foreign Bodies. For shrapnel, you usually hear, “I was minding my own business and some dude shot me.” Mr. Some Dude apparently has a nasty disposition and gets around. For a foreign body in a southern orifice: “I just sat down not watching where I was landing, and I sat on something.”

2. The Law of Smokers. Smokers truly believe a nicotine patch negates smoking.

“Do you smoke?”

“No, I used to, but I quit. See the patch.”

“That’s great. How long has it been since you smoked your last one?”

“6 o’clock this morning. Why?”

3. The Law of Love. The patient who tells you you’re cute and asks for your phone number is about to get his genital warts removed.

4. The Law of Pets. The next time you have an 85-year-old femoral fracture or bilateral malleolar fractures, start your pre-op assessment by asking the patient the name of his dog. Chances are that’s what brought him to your facility. It also breaks up the monotony of asking, “How’d you break your leg or ankle?”

5. The Law of the Dearly Departed. Should a patient warmly tell you that you took care of his mom or grandma or aunt, don’t ask how she’s doing. Most likely she’s dead. Just say, “I’m glad I was there.” Leave that can of worms alone.

6. The Law of Hearing Aids. A hard-of-hearing patient left his hearing aids, along with his glasses and extensive medication list at home. Corollary: If he is wearing his hearing aids, the batteries are dead or they’re turned off.

7. The Law of ‘Is There a Nurse in the House?’ You’re out with your non-medical friends eating, talking, laughing and having a good time. Suddenly someone at the bar hits the floor. The crowd starts shouting they need a doctor right in the middle of your first bite of crème brûlée. Your besties point at you and yell, “Over here, she’s a nurse. Look! Right here!” I almost choke on that bite I’ve been dreaming about all through dinner. (Confirms why you should always eat dessert first.)

8. The Law of Everything Old Is New Again. If you work in the OR long enough, you’ll witness most things circle back around (see surgeons and skullcaps) when the powers that be realize that the old ways weren’t so bad after all. Take, for example, EtO and Cidex, both of which are scheduled to make a comeback performance. Looks like I need to go to a couple of surgical conferences to see what other oldies but goodies will be making return engagements. OSM