Inside the Operating Room: An OR Nurse's Career

How Much Can I Make? - Career Insights For Your Job Search
Host: Mirav Ozeri | Guest: Patty Columbia Walsh (OR Nurse, 40 years)
Date: August 5, 2025

Episode Overview

This episode dives into the fast-paced, high-pressure world of operating room (OR) nursing with veteran OR nurse Patty Columbia Walsh, whose experience spans four decades. Host Mirav Ozeri explores what it takes to work in this specialty, the emotional highs and lows, the realities of the healthcare system, compensation, automation’s impact, and the skills vital for success. Listeners get an honest, behind-the-scenes look at a career often romanticized on TV but rarely understood in practice.

Key Discussion Points & Insights

1. Path to Becoming an OR Nurse

• Initial Motivation and Training
  • Patty shares she switched to the OR because bedside nursing was emotionally difficult:
    "I became attached to the patients and it was very difficult for me to watch people who were sick every day. So I decided that the OR was for me because a patient comes in, we take care of them and we never see them again." (00:54)
  • Nursing school: 4.5 years (2 general studies, 2.5 nursing). Specialty choice happens after graduation. (01:53)
  • Influential moment:
    "I was told by an OR nurse that if you do not become an OR nurse, you’re never going to do it. And that also gave me a lot more inspiration of going into something that I was told I couldn't do." (00:54)

2. The OR Nurse's Role & Daily Routine

• Types of OR Nurses
  • Circulator: handles non-sterile duties and supplies instruments to the sterile field. (03:09)
  • Scrub nurse: maintains the sterile field, passes instruments directly to the surgeon. (03:41)
• Responsibilities
  • Prepping the OR for complex surgeries, especially neurological and spinal, ensuring every specific instrument is ready.
  • Fast-paced environment:
    "The surgeon wants you to move as quickly as you possibly can. They want to get in the room... they don't like to wait." (05:10)

3. Skills & Traits Required

• Technical Knowledge
  • Knowing every instrument by name; "each service" (e.g., vascular, GYN, neuro) uses different sets (03:50).
• Emotional Resilience
  • Ability to withstand being yelled at under pressure:
    "You have to be strong with that because surgeons… are under a lot of stress… they start losing their mind, yelling at you... It's not personal." (16:24)
• Adaptability and Speed
  • The biggest challenge is matching the ever-faster pace:
    "No matter how fast you work, it’s not fast enough. Every OR nurse knows exactly what I’m talking about." (15:12)

4. The Reality of the OR: High-Stakes and High Stress

• Emergency Situations
  • Vivid stories of major bleeding in surgery:
    "I have been present where surgeons have nicked the vessel and the patient starts bleeding profusely… there is a button in the operating room that you have to push... everybody who's within the operating room suite will come running." (07:15)
• Emotional Impact
  • Traumatic stories, especially involving young patients:
    "A young girl, 18, was in a motor vehicle accident… they were giving all blood products to try and save her, and unfortunately, she… And it was devastating to me... they said, 'If you're going to let this affect you every time... you're never going to make it in the OR. This is how we survive.'" (18:20)
  • Touching pediatric case:
    "His brain was coming through the skull... he was only 7 years old and he died... That was another difficult. He died because… we were doing a procedure on him... I've never forgotten the kid." (19:50-20:41)

5. Compensation, Work Hours, and Hospital Culture

• Salary Figures & Pay Practices
  • First job paid $11.50/hr; now new nurses start at around $73,000/year with benefits (11:22-11:43).
  • On-call shifts pay $5/hour and time-and-a-half if called in, but recent cuts reduced guaranteed minimum pay (10:10-10:41).
• Workload
  • 8-hour shifts (7.5 hours work, 45-minute unpaid lunch). "Four to five surgeries a day" is typical (09:45).
• Corporate, Fast-Food Approach
  • Corporate hospital culture described as factory-like:
    "It's not about patient care anymore… it's a factory now… breaks my heart." (12:04-13:01)
  • Union vs non-union differences in benefits and security (11:43).

6. Technology & The Future: Automation and Robotics

• Robotic Surgery
  • Increasingly common, especially for general and gynecological procedures:
    "The surgeon can be over here and the patient’s here and be doing the operation from the other side… we set up with the different instruments on the robot arms… the surgeon is… controlling it with arms or… remote controls…" (14:05-14:47)
  • Impact on staffing:
    "This can take a job away from a nurse. Yes… But they need somebody to set that up for them. So they're still wanted." (14:49-15:08)

7. Rewards, Connection, and Advice

• Most Rewarding Part
  • Comforting anxious patients before surgery:
    "Seeing people… before they go into the operating room and they're crying because they have breast cancer… just holding their hand and making them laugh… that's the most rewarding thing for me." (22:47)
• Advice for Aspiring OR Nurses
  • "Of all the nursing, I think the operating room is the best… You really get to know the human body from head to toe and literally see it… all the nurses are together… I love the OR. I would never leave." (21:58-22:02)
  • Adrenaline is key:
    "You like the adrenaline rush? Absolutely love it. I might complain that we have to move. Like, I like that... but they pretty much run us into the ground." (22:33)
• Sense of Camaraderie
  • Most patients don’t remember OR nurses, but occasional recognition is special:
    "He said, 'Thank you.' And that made me feel wonderful… The OR you get medication that cause amnesia before you go in… So they don’t remember anything… Maybe that’s a good thing." (21:11-21:51)

Notable Quotes & Memorable Moments

• On the Reality of the OR:
  "It's not about patient care anymore… it's a factory now… and it breaks my heart because it's not about a person. It's about get them in, get them out." (12:04)
• On Emotional Survival:
  "If you’re going to let this affect you every time when this happens, you’re never going to make it in the OR. This is how we survive." (18:59)
• On Speed:
  "No matter how fast you work, it’s not fast enough. Every OR nurse knows exactly what I’m talking about." (15:12)
• On Technology’s Impact:
  "This can take a job away from a nurse. Yes… But they need somebody to set that up for them. So they're still wanted." (14:49)
• On the Job’s Reward:
  "Just holding their hand and making them laugh is that’s the most rewarding thing for me… I understand that. And just to have them smile makes me happy." (22:47)
• Lighthearted Moment, Taking Down TV Myths:
  "And the surgeons aren’t as good looking as they are on TV. Just saying. Closing statement." (23:34)

Timestamps for Important Segments

• 00:54 – How Patty became an OR nurse and her early challenges
• 03:09 – Difference between circulator and scrub nurse roles
• 05:10 – What a typical day looks like in the operating room
• 07:15 – Emergency bleeding and crisis management
• 11:22 – Nurse salary, benefits, and impact of union vs non-union
• 12:04 – Shift from patient care to factory-like hospital culture
• 14:05 – Rise of robotic surgery and its implications
• 15:12 – Biggest challenge: the constant demand for speed
• 18:20 – Coping with patient death and witnesses to trauma
• 19:50 – Memorable, emotionally impactful cases
• 21:58 – Advice to aspiring OR nurses and what makes the job special
• 22:47 – Most rewarding part: helping patients through fear

Summary Tone

Patty’s tone is honest, direct, and laced with dark humor—a coping mechanism for the emotional toll of her work. Mirav steers the conversation with curiosity and empathy, providing a conversational flow that balances hard truths about healthcare with moments of warmth, camaraderie, and even levity.

This episode is an unflinching inside look for anyone considering, or simply curious about, a high-stakes, underappreciated frontline role in healthcare.