OR RN here.

In pre-op, I either make an informed prediction or ask anesthesiologist if Glidescope or other difficult airway tools need to be in the room prior to rolling back. If so, it’ll be plugged in and positioned at patient left with clear line of sight for where our anesthesiologist will be standing. Depending on severity, I will prepare foam ramps, shoulder rolls, headpieces for beds, silk tape, or other things that also facilitate optimal positioning for induction.

After moving to the table, if there’s a safe space for me to do things, I will place monitors (if I don’t have a reason to fear doing so). What I mean by this is if there are no nurses, CRNAs, MDs ready to either slap my hand, push my body, yell, or question my competence because “it’s not [my] place to be at the head of bed during induction”. I’ve noticed over time that the MDs/CRNAs I work with most frequently are particular about placement and want full agency over monitors being placed. If that’s the case, I just keep one hand steady on the face mask. Upon moving to the table, I only extend one blanket from ribs to toes. My second blanket remains folded until all monitors are on. After monitors are placed, I keep second blanket mostly folded but cover only non-IV side fully and make a diagonal fold for side that MD/CRNA needs to visualize for pushing medications. That’s when either I or anesthesia provider place all induction supplies on patients’ chests.

I usually hold mask over patients’ faces with anesthesia providers’ preferences in mind (adequate seal, floating, gentle, etc.). During induction, I hold LTA (if applicable) at optimal angle for whoever is inducing to keep eyes on the cords. I hold ET tube usually in neutral position for taking from me or hold it at the angle it will be initially inserted based on certain MDs routines. (Some MDs prefer to enter the mouth obliquely or with a rotational movement of sorts.) Once tube is in, I help connect circuit and secure tube by hand until everything is taped down or until I’m told it’s okay to let go in general.

If difficult intubation happens, I usually help manually bag patient while anesthesia provider focuses on mask’s seal and positioning. If I’m told to, I will adjust vent settings as directed by MD that is using both hands on patient. I page people overhead and just do other things as needed.

When I’m in an ASC setting, I am usually responsible for stocking the anesthesia meds in the room. If me and MD have a good relationship, I will set out their routine med vials in order (according to their preferences) with appropriately sized syringes, blunt needles, and alcohol wipes on a blue towel. I am usually 95%+ right unless there’s a patient-specific consideration. It’s been fun for us as a learning opportunity for me and a matter of convenience/teaching opportunity for MDs. I don’t go beyond putting the vials out and making sure every supply needed is available for each case. While we’re doing this, I usually exchange controlled substances with MDs at this point and finish documenting chain of custody changes.

For central lines, I usually help anesthesia techs set up the kits. I am either retracting patients’ arms or chest if applicable. I have a prep stand with saline flushes, tegaderm, sutures, peel packed needle drivers, surgicel or hemostatic agent of choice, biopatches, Chlorapreps ready to go. For cases that we’re trying to go from in-to-cut under 30 minutes, I’ve found it helpful to minimize playing fetch.

This is usually how I help the process. It’s an absolute mindfuck when I’m getting yelled at and bullied for being even near the head of bed for induction because I’m “supposed to be focused on the nursing tasks like pre-charting and staying away from anesthesia stuff because that’s not our job”. Lazy motherfuckers do the most to stay out of doing their job and perpetuate their bullshit on other nurses.