The best shoes for the OR: clogs for standing still

Most nursing shoe advice is about walking: miles of hallway, cushioning that bounces you along. The OR team has the opposite problem. You stand in one spot for a three-hour spine case, shifting from foot to foot, while fluid occasionally lands on your toes. A soft, bouncy running shoe is lovely for the first category and a little mushy for the second.

So this guide is about OR shoes specifically: support for standing still, closed toes and heels, surfaces that can be wiped, washed or even autoclaved, and the shoe covers for the really messy days. For running shoes, wide fits and general sizing, see our main nursing shoe guide.

Why standing still is harder than walking

When you walk, your calf muscles squeeze blood back toward your heart with every step. Stand still and that pump mostly stops, so blood pools in your lower legs. That is the heavy, puffy feeling at the end of a long case.

A review of prolonged standing research in Rehabilitation Nursing describes AORN’s recommendation that caregivers should not stand for more than two hours continuously without fatigue-reducing measures. AORN’s own ergonomic tools list those measures: anti-fatigue mats, sit-stand stools, a footstool for one foot, and supportive footwear. Ask for the mat and the stool. Choose the shoes yourself.

What an OR shoe needs

• A firm, supportive footbed. For standing still, firm and stable often feels better by hour three than soft and squishy.
• A rocker sole. It helps you roll your weight around without taking a step, which is handy at the table.
• Closed toe. Things drop in the OR, including sharp things. A closed toe is a dress code basic almost everywhere.
• A surface that cleans. Leather, rubber or closed foam. Mesh soaks up whatever lands on it.
• Grip. NIOSH counts slips, trips and falls among the most common causes of lost-workday injuries in hospitals, and OR floors get wet. Look for real tread.

Canada’s workplace safety center (CCOHS) adds the fit basics: match the shape of your foot, hold the heel firmly, leave the toes room. Your feet swell during a long case, so do not buy them snug.

Best OR clog: Dansko Professional

There is a reason you see so many of these in OR changing rooms. The footbed is firm, the rocker sole lets you shift weight easily, and the leather wipes clean. Many owners get years out of a pair, which softens the hit of the higher price.

The catch is the open back. Some people love the easy slip-on; others feel their heel lift or worry about rolling an ankle. Check your OR’s dress code too, since some ask for a closed heel or a heel strap.

Autoclavable: Calzuro

Calzuro makes rubber clogs aimed squarely at operating rooms. Sellers list them as autoclavable and machine washable, which means you can actually clean them rather than just wiping off the obvious bits. Choose the version without holes for a closed upper.

Two cautions. They are firm and plain inside, so plenty of people add their own insole. And only put them through an autoclave if your department says that is allowed and follows the maker’s temperature limit. Sterile processing has opinions about what goes in their machines.

Budget and hose-down clean: Crocs On-The-Clock

Fully closed, with no holes, light, slip resistant and easy to rinse in a sink. It is the cheapest way to get a dedicated OR pair, and a good second pair to rotate so each one dries out between shifts. Support is basic, so add an insole if your arches complain.

Add support: insoles

A structured insole turns a plain clog into a supportive one and moves between pairs. It is the cheap upgrade for the Crocs and the Calzuro. If you have ongoing foot pain, a podiatrist can tell you what your feet need, which beats guessing.

Shoes and socks work as a team

Your shoes handle your feet. Compression handles the blood pooling in your calves. For long cases, many people step up to firmer 20 to 30 mmHg socks. If you have diabetes, nerve damage or a circulation condition, ask your doctor before going that firm. The compression sock guide explains the pressure numbers.

Shoe covers for the messy cases

OSHA’s bloodborne pathogens standard requires shoe covers or boots when gross contamination can reasonably be expected, and it names orthopedic surgery as an example. Your facility provides them, but if your room keeps running out, a box of your own is cheap. Choose non-skid soles. Plain shoe covers on a wet floor turn every step into figure skating.

Boot-height covers protect your ankles and socks on the really wet cases.

After the shift

After hours in firm clogs, a thick, soft recovery slide feels very good on the walk to the car and around the house. It is not for the OR (open shoes never are), but it is a nice way to end the day.

For bigger recovery buys, from foot massagers to compression boots, see the recovery guide.

Keep a pair just for the OR

Most OR teams keep their OR shoes at work, in a locker, and wear something else to and from the building. It keeps whatever you stepped in at work, at work. It also means your OR shoes only see clean floors and the occasional splash, and they last longer.

Clean them on a routine: wipe the uppers after a messy case, wash or disinfect as your facility allows, and let them dry fully. Two pairs on rotation make that easy.

When to replace them

• The tread is worn smooth, especially at the heel
• The footbed has a deep dent or the rocker has flattened on one side
• Aches you had solved have come back
• A crack in the upper that holds fluid

Clogs last a long time, but not forever. A worn rocker can tip you sideways without you noticing.

What to skip

• Mesh running shoes as your OR pair. Comfortable, but they absorb fluid and are hard to clean properly.
• Holey Crocs or open-toe anything. They fail most OR dress codes for good reason.
• Very soft, squishy shoes for long cases. Great for walking, wobbly for standing still.
• Your commute shoes. Keep OR shoes for the OR.

The quick version

1. A firm, supportive, closed-toe clog that wipes clean, kept at work
2. A second pair to rotate, or an insole to upgrade a budget pair
3. Compression socks for long cases
4. Non-skid shoe covers for messy cases
5. Something soft for after the shift

Your OR’s dress code and sterile field policies always come first.