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First day in the operating room: what I wish I had known
What to observe, how to move and which questions to ask when everything in the operating room is still new.
What I remember most clearly about my first weeks in the operating room is one feeling: everyone seemed to know what to do except me.
My colleagues moved as if every action were obvious. I felt lost. I did not know where to stand, what I could touch, which route to take or what the surgeon had just requested. I went home with many images in my head and very little clarity.
For a while I thought I was not suited to the work. Then I saw the flaw in that comparison: I was measuring my first attempts against people who had repeated those actions for years.
At first, I wanted to prove that I was capable
When you are new, you want to be useful rather than a burden. Just when you should ask a question, one thought stops you: “I should already know this.”
If I could go back, I would tell myself something very simple: ask.
“I do not know.” “Can you show me?” “Could you repeat that?”
A question takes a few seconds. Pretending to understand can create much more confusion. Mistakes are human, especially while learning, but that does not mean proceeding blindly. It means practising under supervision, recognising immediately what did not work and having the courage to say so.
Errors you acknowledge and analyse can become experience. Errors you hide, minimise or fail to understand are more likely to happen again.
Every action should have a reason
A colleague I respect taught me this. When you are new, standing still can make you feel useless, so you move, rearrange something and continually search for a way to help.
Over time, I started asking myself two questions:
“Why am I doing this?”
and, more importantly:
“Does it need to happen now, or can it wait?”
If I could not give a clear answer, stopping and observing for a few more seconds was often the better choice. Being operational does not mean moving constantly. It means doing the right thing when it is needed.
Speed comes after the map
During one of my first cases, a surgeon told me the cables were badly arranged: they crossed the working space and could become caught. I did not hear a technical correction. Inside, I heard a judgement about my ability.
With time, I learned to separate the two. The surgeon was showing me a consequence I could not yet see. The cables might restrict movement later in the operation. I did not lack intelligence; I lacked the experience needed to predict what would happen next.
Operational reasoning grows as you learn the spaces, sequences, instruments and movements. At first, you place a cable wherever it fits. Later, you ask how it will be used, what path it should follow and what may happen when the case becomes more demanding.
You are not slow because you are incapable. You are slow because you are still learning to see what experience has made visible to others.
What to do on your first day
I would focus on three things:
- observe the room before moving;
- ask whenever a request is unclear;
- accept that being new is a phase, not an identity.
The useful comparison is not with someone who has worked in theatre for fifteen years. It is with what you can see today that was invisible yesterday.
The next step
Once you can orient yourself in the room, look at the operating department as a complete flow.
Continue with A day in the operating room: what really happens from the first to the last case.