How to Prepare for
Your First OR Case
Nervous about watching surgery? Here is everything you need to know: what to wear, where to stand, what to say, and how to handle blood and stress.
Get PreparedReality Check
Everyone is nervous before their first case
Your brain adjusts by case 2-3. The anticipation is worse than reality.
What to Wear
Scrubs
Hospital provides them. Ask OR staff where to change.
Change in locker room, not hallway. Bring underwear/undershirt.
Shoe Covers
Disposable blue booties over your shoes
Put on BEFORE entering OR suite. Don't track in.
Hair Cover
Surgical cap or bouffant (all hair must be covered)
Even facial hair needs covered in some ORs.
Mask
Surgical mask (sometimes N95)
Wear it properly - cover nose AND mouth.
Eye Protection
Safety glasses or face shield (for splash protection)
Not optional - blood and bone fragments can spray.
What NOT to Wear
Jewelry, nail polish, perfume/cologne, open-toed shoes
These violate sterile protocol.
Physical Preparation
Eat Something Light
Empty stomach + standing for 2 hours = passing out
Toast, banana, protein bar. Not a huge meal.
Stay Hydrated
Dehydration makes lightheadedness worse
Drink water before, but don't chug right before case (you can't leave to pee).
Use Bathroom Before Scrubbing
Once case starts, you can't leave sterile field
Seriously. Even if you don't think you need to.
Get Good Sleep Night Before
Tired + blood + standing = recipe for fainting
7-8 hours minimum.
Where to Stand
Back of the Room (First Time)
Best vantage point, can step out if needed
Stand near door. Not too close to sterile field.
Behind Surgeon (Once Comfortable)
See what they're doing, hand instruments when needed
Don't lean over patient. Stay out of light.
Near Instrument Table
Quick access to trays, can help scrub tech
Don't touch anything without asking first.
NEVER Stand
Blocks view, contaminates field, gets in the way
Between surgeon and light source, in front of anesthesia, touching sterile drapes.
What to Say (and NOT Say)
✓ Good
- "Where would you like me to stand?"
- "Is it okay if I observe from here?"
- "Can I help with anything?"
- "Thank you for letting me observe."
- Nothing at all (silence is often best)
✗ Bad
- "Wow, that's a lot of blood."
- "I feel dizzy."
- "How much longer will this take?"
- Talking about lunch plans
- Asking medical questions mid-procedure (save for after)
How to Handle Blood and Surgical Stress
Focus on Instruments, Not Blood
Watch the surgeon's hands and tools, not the wound
Your brain processes "medical procedure" better than "open body"
Breathe Normally
Don't hold your breath. Steady, calm breathing.
Holding breath = less oxygen = lightheadedness
Unlock Your Knees
Stand with knees slightly bent, shift weight occasionally
Locked knees = poor circulation = passing out
If You Feel Lightheaded
Step back immediately, tell scrub tech, sit down if needed
Better to leave for 2 minutes than pass out and disrupt surgery
OR Protocol (Don't Violate These)
Sterile vs Non-Sterile
Blue drapes = sterile. Don't touch. Everything else is fair game (mostly).
Touching sterile field with non-sterile hands = case contamination
Hands Above Waist
Once scrubbed in, keep hands above waist level at all times
Dropping hands below waist = contamination, must re-scrub
No Talking Over Sterile Field
Bacteria from your mouth can contaminate the field
Leaning over patient while talking = infection risk
Ask Before Touching Anything
Implants, instruments, trays - ask scrub tech first
Touching wrong tray = contamination, wasted implants
Smells to Expect
Cautery (Burning Flesh)
Like burnt hair mixed with BBQ
This is the one everyone mentions. It's distinct.
Breathe through your mouth if needed.
Bone Dust (Ortho)
Metallic, dusty smell when sawing bone
Less intense than cautery, but noticeable
It dissipates quickly.
Antiseptic (Betadine)
Strong iodine smell from surgical prep
Actually kind of reassuring - smells "medical"
You get used to this one fast.
First Case Timeline
before
- 30 min before: Arrive at hospital, check in with OR staff
- 20 min before: Change into scrubs, put on hair cover
- 10 min before: Meet surgeon/scrub tech, confirm case details
- 5 min before: Enter OR, find your spot, put on mask/eye protection
during
- Patient wheeled in: Stay out of the way, observe setup
- Anesthesia induction: Patient goes under, positioned on table
- Surgical prep: Betadine scrub, sterile draping (strong smell)
- Incision: This is it. Focus on instruments, not blood.
- Procedure: 30 min - 4 hours depending on case
- Closure: Stitching up. Almost done.
after
- Document what was used (implants, instruments)
- Thank surgeon and OR staff
- Clean/restock trays if needed
- Debrief with mentor: What went well? What questions do you have?
Warning Signs (Act Immediately)
Tunnel Vision or Ringing Ears
Step back NOW. Sit down. Tell someone.
These are pre-fainting symptoms. Don't tough it out.
Feeling Hot/Sweaty
Step away from OR lights, loosen mask slightly
OR lights are hot. Combined with stress = vasovagal response.
Nausea
Leave OR immediately. Don't vomit in sterile field.
Better to leave than contaminate the case.
Mental Preparation
- This is a medical procedure, not gore - reframe it as professional
- Surgeons do this every day - it's routine for them
- You don't need to watch every detail - it's okay to look away
- By case 3, your brain recategorizes this as "work" not "scary"
- Everyone feels this way first time - you're not weak
The Day After
Debrief What You Saw
Helps your brain process and normalize the experience
Talk to mentor, write notes, watch similar procedure videos
Don't Judge Yourself
Feeling squeamish is normal and doesn't mean you can't do this job
Most reps feel this way. It gets easier fast.
Schedule Case #2 Soon
Don't let anxiety build. Get back in quickly.
Within a week if possible. Momentum matters.
You Got This
Thousands of device reps went through their first case nervous and came out fine. By case 3, it is just work. Find device sales opportunities and start your career.
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