The OR can be a stressful place—especially when you’re new.
The difference between a tough day and a successful one often comes down to a few small things no one explicitly tells you to get.
Here are the 5 things I now consider non-negotiable.
1. Compression Socks
It is actually quite likely that your instructors mentioned the importance of compression socks around one-hundred times during your training. But if you are like me, you mostly ignored them. My first job at 16 years old was in banking, where I had to stand for 8+ hours, so, naturally, I thought standing didn’t bug me. Two problems with that thinking: I’m no longer 16, and even then, I was never standing in one place for hours at a time.
The OR is an extremely physical environment. As CSTs, sometimes we are holding retractors or other instruments and cannot move our bodies for long stretches of time. Even lifting a foot or shifting our weight can cause too much movement during delicate points of the procedure.
This is where compression socks come in. Good compression socks provide progressive compression from your ankle to your calf, with more compression at your ankle and relatively less compression in your calf. Normally, veins rely on muscle contraction to help move blood back up toward your heart. But in the OR, when you’re standing still for long periods, that process slows down—and blood starts to pool, leading to fatigue and discomfort. Compression socks help to make up for that lack of muscle contraction and overcome the effect of gravity.
Several studies have shown the efficacy of wearing medical compression stockings (MCS) rated at 15-20 mmHg or 20-25 mmHg for individuals who work long shifts (8-12+ hours) while standing (Blazek et al. 2013; Garcia et al. 2023; Rabe et al. 2018). Ultimately, wearing compression socks not only will help relieve any pain you feel after long days in the OR, but future-you will thank present-you for taking the time to prevent varicose veins or chronic venous insufficiency (CVI).
There are many options available, but here is one I’ve used by LEVSOX. They are relatively inexpensive and come in many patterns and designs to help customize your OR wardrobe.
LEVSOX Compression Socks I’ve used.
2. An array of Scrub Caps
Like many things in life, the right number of scrub caps is n+1, where n is the number of scrub caps you currently own.
Let’s be honest. The OR is a place of conformity. The headwear you choose to don may be the only piece of personality you get to display. If your facility allows, I say use it.
I like to pick fabric designs that showcase something I love and/or are funny. I have caps for the kids with Pikachu and Hot Wheels as well as caps for adults such as Dunder Mifflin and “Bears. Beets. Battlestar Galactica.” for The Office fans out there. A vascular fellow and I both have banana caps (hers happens to be pink and mine blue) that we both like to wear. Scrub caps are one of the easiest ways to break the ice with surgeons and staff.
When looking for scrub caps, Etsy will be your friend. I purchased a number of caps from BwwBag and really liked them.
3. Two Pens (Always Two)
If you bring one pen to the OR, you effectively have zero pens. I can’t tell you how many times I have been asked for a pen by the surgeon or someone else. And as things go, I may or may not get that pen back. This is why I always carry two pens. Every time.
I started this habit during my time in Labor & Delivery since I was also running the desk, but found it very helpful in the OR as well. I purchase a box of 7mm Pilot G-2 gel pens and leave them in my locker. When I change into my scrubs, I put two in my shirt pocket. More than a few times, I have had someone borrow a pen, comment on how much they liked it, and told them they could keep it. It’s a great way to make a friend. And you can never have enough friends in the OR.
There are a bunch of great pens out there. This one strikes the balance between great and cheap:
Pens I buy by the box and store in my locker.
4. Badge Buddy
“Who are you?”
In the OR, that question—whether spoken or not—matters. While you should always try to introduce yourself to everyone, many situations just don’t allow this, at least right away. Patients and other OR staff don’t just want to know your name; they want to know your role.
Enter the customizable badge buddy.
A badge buddy hangs lower than your badge to clearly identify your role. My badge buddy roles have included “OB TECH”, “SURG TECH STUDENT”, and “CST”. Don’t underestimate the power of colors as well. In Labor & Delivery, my pink “OB TECH” badge buddy clearly identified me, especially when I left the L&D suite to run labs or help out on other floors or in other departments, especially where it is very important not to misidentify me as an RN or nurse.
If your facility already uses these, great! But even if you have one provided to you, a customizable badge buddy has some additional benefits. Most customizable badge buddies offer you the ability to customize the white area that will be hidden by your badge. This is a chance to write something meaningful or something you need to easily reference. I like to use this space to write my name. This means that even if my badge is backwards, patients and other staff can still read my name. In the healthcare environment, I award points for using my name, even if you just read it off my badge. 😊
Here is a badge buddy I have used many times. I even made a black “Shadow” buddy to help people know when I was shadowing. I got a lot of great comments for it!
Bonus: If you need to punch your badge so that you can wear it with a badge buddy, this is a punch that I have purchased that has worked great. I definitely used it with my student ID while I was in clinical rotations.
5. Eyewear Strap (Glasses Strap)
Finally, the eyewear or glasses strap. Regardless of whether you wear prescription glasses or safety glasses in the OR, everyone needs something to secure them in place. We all know the surgeon who has to have their glasses pushed back up every hour by the circulator. There isn’t much we can do about that, but as CSTs, we need to decrease our dependence on the circulator as much as possible. They already do so much for us!
There are a lot of different designs, but this is one that has served me well. I purchased the 16 inch version, but could probably have also used the 14 inch version as well. As a prescription eyeglass wearer, I like this design. I am able to push the rubber ends onto the ear pieces of my glasses easily every day, place my glasses on my head, and tighten the cables by simply separating the knobs. I am comfortable all day and have no need to adjust my glasses. When I go to remove them at the end of the day, they slide easily off. I also appreciate that there is no tail to swing around or potentially cause contamination.
None of these items are complicated—but together, they make a big difference in how prepared and confident you feel in the OR.
Most of what makes you effective as a CST isn’t taught in a classroom—it’s learned through experience, often the hard way.
Hopefully this helps you skip a few of those lessons.
References
Blazek, C., Amsler, F., Blaettler, W., Keo, H. H., Baumgartner, I., & Willenberg, T. (2013). Compression hosiery for occupational leg symptoms and leg volume: a randomized crossover trial in a cohort of hairdressers. Phlebology, 28(5), 239–247. https://doi.org/10.1258/phleb.2011.011108
Garcia, M. G., Roman, M. G., Davila, A., & Martin, B. J. (2023). Comparison of Physiological Effects Induced by Two Compression Stockings and Regular Socks During Prolonged Standing Work. Human factors, 65(4), 562–574. https://doi.org/10.1177/00187208211022126
Rabe, E., Partsch, H., Hafner, J., Lattimer, C., Mosti, G., Neumann, M., Urbanek, T., Huebner, M., Gaillard, S., & Carpentier, P. (2018). Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement. Phlebology, 33(3), 163–184. https://doi.org/10.1177/0268355516689631