A Medical Worker Anonymously Revealed Operating Room "Secrets" That More People Should Know, And It's Wild
If you've ever wondered about what goes on in the operating room — whether you've been a patient or not — then your curiosity is about to be satiated.
Recently, I spoke with an anonymous certified surgical technologist (CST) and asked them to share the OR secrets and good-to-knows that many people aren't aware of, and they're a mix of fascinating and shocking. For those unfamiliar, a CST is the person who sets up an operating room before a procedure and is considered to be a surgeon's "right-hand man." A surgical technologist is expected to know just as much about the procedure as the surgeon and is responsible for a number of tasks, such as passing instruments, draping the sterile field, and more.
Here are the confessions based on their personal experiences working as a surgical technologist at an outpatient center focusing on elective surgeries:
1.The top dogs are actually sales reps.
"This obviously depends on the specialty, but surgeons are typically not the breadwinners in the OR. Ever heard of a medical sales rep? Yup, they make all the money. I even heard a trauma surgeon joke, 'The surgeon drives a Tesla, and the rep has a Lamborghini for each day of the week.' Reps are essential in the OR; a good rep can make all the difference in a case. So, if you're someone with business sense, loves anatomy, and loves being on call 24/7, this may be a career path for you."
2.The "do not eat" instructions before a procedure are put in place for a reason.
"Please take the 'do not eat' instructions seriously! The anesthesia you are given can make the muscles relax in your throat and cause you to aspirate, which is when food or liquid in your stomach travels back up and enters your lungs. I have seen patients who lied about eating before surgery, which resulted in complications with intubation. They vomited while under anesthesia, and we had to cancel their procedure. For future reference, all pre-op and post-op instructions are crucial."
3.OR staff inhale a lot of smoke.
"OR staff is exposed to surgical smoke every day since we use electrocautery to stop bleeding during a procedure. Yes, as the patient, you are grounded with a gel pad, typically on your thigh. Shockingly, one day in the OR is equivalent to smoking 27 cigarettes. Luckily, hospitals in certain states are implementing smoke-free operating rooms for staff safety. These are definitely things to consider when looking into careers in the OR."
4.The stereotype of surgeons being egotistical and rude isn't 100% incorrect.
"First things first, yes, some surgeons have personalities you would just like to never encounter…ever…for the rest of your life. Yes, you will encounter physicians who wake up angry 100% of the time and take it out on staff no matter how well cases go. How do we deal with this? Honestly, just growing thick skin, leaning on your fellow staff members, and sometimes just ignoring their bad attitudes. On the bright side, surgeons with unpleasant personalities only make up about 20% of the physicians I work with. The rest are amazing and even develop personal friendships with the staff. These are the physicians we appreciate because it makes for a better working environment and even translates into their patient care."
5.Some surgeons lack confidence in their procedures, so it's essential to take the time and look into who might be overseeing your operation.
"Please, do your research! I have seen surgeons go into cases with little to no confidence or even knowledge about the procedure, and unfortunately, have negative patient outcomes. Please go to someone who specializes in whatever you need done, especially if your procedure is elective."
6.There is definitely music playing in the OR.
"We are totally jamming out during surgery! Just kidding…kinda. I have never met a surgeon who operated without music playing in the background. Music in the OR is so important: it sets the vibes, puts everyone in a good mood, and makes the case go by faster. As for what gets played, we usually put on stuff from the '80s and early 2000s. Classic rock, reggae, and The Red Hot Chili Peppers are crowd-pleasers, though."
7.Patients get charged for EVERYTHING.
"Ask for itemized billing after a procedure. Typically, surgical technologists never see or contribute to patient charting, but what I do know is that patients, unfortunately, get charged for everything we use, whether it is billed in overall OR fees or individually. You are charged for everything, from the gloves we use to the tools."
8.Radiation exposure is an everyday thing.
"OR staff is exposed to x-ray radiation pretty much every day, depending on your specialties. I scrub orthopedics. In almost every case, we have X-ray machines to ensure we are placing implants in the most accurate position possible. Because of this, we wear lead aprons to cover our bodies — specifically, we are concerned for our thyroid and reproductive organs. It is also highly recommended that people wear lead glasses as radiation can lead to eye cataract development."
9.Lastly: Operating on the "wrong side" would require a lot of incompetence.
"Never worry about us operating on the wrong side. There is such a slim chance this will ever happen because we have so many checks and balances in place. First, in pre-op, procedural consents are signed, and the limb/organ the team will work on is specified. Next, the surgeon meets with you and marks their initials on the correct limb. Next, as you walk back to the OR, you are introduced to your OR team, and we confirm your name, date of birth, allergies, and what procedure we are doing with you while you are awake (this may vary with trauma cases or emergent cases, but I have little experience in those cases so I am only speaking on elective surgeries here).
Once you are asleep, we drape our sterile field, the doctor marks his incision site with a sterile pen, and the entire team pauses for a universal timeout. During this timeout, the nurse states your name, date of birth, allergies, the correct procedure, if any special medications such as antibiotics were given, whether or not there is a fire risk for the procedure, that there is fluid on the field, and that any and all implants are in the room. The surgeon, anesthesiologist, and surgical technologist must agree, and then an incision is made."
I don't know about you guys, but my brain feels bigger after learning these things. If you work in the OR, do you have any confessions or wild facts you'd like to share? Let us know in the comments, or you can anonymously submit your story using this form!
Note: This submission has been edited for length and/or clarity.
