Top 5 Confidence Killers in the OR—And How to Beat Them

Confidence in the OR isn’t just a nice-to-have—it’s a must. But even the most passionate and dedicated OR nurse can find their confidence shaken from time to time. Whether you're a novice still learning the ropes or a seasoned nurse stepping into a new role, there are common pitfalls that can chip away at your sense of capability.

Here are the top 5 confidence killers in the OR—and how to crush them before they crush you.

1. Not Knowing the Procedure

The Killer: Nothing rattles your nerves faster than feeling unprepared for a case. You fumble through your setup, second-guess instrument choices, and rely heavily on others.

The Cure:
Prepare like a pro. Review the procedure beforehand—even if you’ve seen it before. Look up videos, read the surgeon’s preferences, and familiarize yourself with the equipment. When you know what’s coming, you can anticipate instead of react.

🛠 Pro tip: Keep a running log or “cheat sheet” of common procedures and surgeon-specific preferences for easy reference.

2. Fear of Speaking Up

The Killer: You see something wrong—or feel uncertain—but you're too intimidated to speak. Maybe you’re the newest nurse on the team or you’ve been shut down before.

The Cure:
Your voice is your license. Patient safety depends on your courage to speak up. Confidence builds when you stand by your training. Practice assertive communication using tools like SBAR (Situation-Background-Assessment-Recommendation) to structure your input clearly.

🗣 Pro tip: Start small. Ask clarifying questions during setup or briefing. As you grow more comfortable, you’ll find your voice when it counts most.

3. Getting Flustered by Criticism

The Killer: You’re corrected—sometimes sharply—by a surgeon or senior nurse, and suddenly you feel two inches tall. It haunts you for the rest of the case (or the rest of the week).

The Cure:
Reframe feedback as fuel. The OR is high stakes, and feedback can be blunt. Don’t internalize it—analyze it. What can you learn? What will you do differently next time? Mistakes are part of mastery, not a measure of your worth.

🧠 Pro tip: After the case, write down what happened and what you’ll do next time. This shifts your mindset from “failure” to “lesson.”

4. Being the Newbie in the Room

The Killer: Everyone else seems to know what they’re doing. You’re just trying to keep up. Imposter syndrome sets in fast.

The Cure:
Own your role—and grow from it. Every expert was once a beginner. Instead of hiding your inexperience, use it as motivation. Ask questions, stay curious, and show up early. Confidence is built rep by rep.

🤝 Pro tip: Find a mentor. Having someone to debrief with, ask questions, and lean on can be a game-changer.

5. Trying to Do It All Alone

The Killer: You don’t ask for help because you don’t want to look weak—but now you're overwhelmed, behind, and stressed out.

The Cure:
Teamwork is not a weakness—it’s a strength. The best ORs run like a symphony, not a solo act. Communicate with your team, lean on techs and fellow nurses, and delegate when appropriate.

🧩 Pro tip: Start your day with a quick huddle. A simple “What can I do to support you today?” goes a long way in building trust and collaboration.

Final Thoughts

Confidence in the OR doesn’t come from perfection—it comes from preparation, persistence, and perspective. Every tough day, every challenging case, every mistake is a stepping stone toward becoming a stronger, more competent nurse.

So the next time your confidence takes a hit, remember this: You belong in that OR. Not because you’re perfect, but because you care, you show up, and you’re committed to learning.

🩺 The OR isn’t for the faint of heart—but you’re not faint of heart. You’re building confidence that’s unshakable. One case at a time.