Hi everyone,

I'm a nursing student who is very interested in the OR and am pretty set on becoming an OR nurse. I'm starting an externship in an OR next month and am VERY excited!

However, the whole post-graduation as an OR nurse thing is still a little vague to me and I feel like I've heard 80 different opinions and stories about it.

What sort of certifications and advanced degrees are available to RNs who have only worked in the OR and would like to continue doing so? (I know of CNOR, though I'm not 100% sure all that entails, RNFA, nurse anesthetist, etc., but are there others??) What are the opportunities available for career advancement as an RN? (Not even necessarily in title, but how can you "work your way up the ladder" in the OR and become better?)

What's it like if, somewhere down the road, you want to go into another specialty that isn't related to the OR?

I hope these questions don't sound too crazy...just a student nurse here trying to figure out what nursing is REALLY like!! :) Any help is appreciated!

CRNA school requires ICU experience not OR, First assist req certification in OR nursing plus its own training-hth!

Thanks! What do you need to do to become CNOR?

To get your CNOR, you must have 2 years experience as an OR nurse, currently work in the OR, and have a certain amount of hours. There is a test to obtain the certification, which is good for 5 years. CCI is the company that does the certification. More info can also be found at the AORN website.

Two years experience plus studying the current policies and procedures from AORN. If you are a member of AORN, you get a discount on the cost of the test. If not a member, then you pay extra- which is esentially the cost of joining AORN!

That doesn't make you upwardly mobile. A BSN to start with, a CNOR and experience may, in small places, allow you to become a nurse manager. In a lot of larger places, and the ones who are Magnet status hospitals, you'll need an MA.

To become an RNFA, first of all, you have to work somelace that uses them! Then take the course, do the number of required clinical hours to keep up the certificate, etc.

To become a CRNA, you need a BSN first, then two years of ICE experience, then apply to MA level anesthesia school, during which you can't afford to work(trust me on this one), you are on call 24/7 with your preceptors in some places, and in others, you do the night shift emergencies all by your lonesome. However, it is an excellent investment; out of school in some places the starting pay today is 80-135k.

To go into management....well, that again depends on where you are located. BSN, MSN plus experience, etc.

Nurse educator for the OR, you need a Master's in nursing ed.

Just try doing the basic job for a bit and then see what you want to do.

Thanks so much for all the tips everyone!

My plan is to just start out and see where it takes me, I was just curious what options are out there.

Another question: some people in other fields have sort of tried to dissuade me from going into OR nursing, saying that once you start in OR it's really hard to ever get into any other form of "regular" nursing (floor nursing) since it's so different. Is that even true??

I understand that switching specialties (should I want to somewhere down the line...how am I supposed to know that now??) would be more difficult because of the huge difference in daily activities of an OR nurse vs. a nurse on a med-surg unit or something, but what's the real deal here? I've always had a special place in my heart for the ER, and I'd like to at least have the option of being able to work there somewhere down the line if I wanted to.

You know, I'm a new nurse in the OR and I got that song and dance about how I would be stuck there because I'd lose my clinical skills, but I really think it's just a matter of how you sell yourself. I want to be an NP down the line so I'll eventually change to a floor or unit.

Where I work, OR nurses put in foleys, prep, apply dressings, do quick patient assessments, and interact w/ patient and family, just like they do on the floor. Sure, you probably won't do IVs and you won't give a lot of meds, but that just means you might need to do a little studying and take an IV therapy course.

And you can always practice your assessment skills on friends and family or volunteer at a homeless shelter doing blood pressures, etc.

In the OR you can become an expert on sterile technique, an expert on multi-tasking, an expert on anatomy (if you scrub), an expert on dealing with difficult people, an expert on prioritizing (nothing says prioritize like 5 people all screaming at you to do something for them simultaneously), an expert on high-tech medical devices, an expert on debugging computer problems, etc. Depending on where you work, you also might learn about SWANS, arterial lines, chest tubes, balloon pumps--stuff that might scare the crap out of an inexperienced floor nurse. And when your patient asks you about their upcoming Nissen fundoplication or thymectomy you'll know enough about surgical terms and procedures to at least interact with them in a professional manner.

There will always be people who disagree with the idea of starting in a specialty area. In the end, you have to do what is right for you. Good luck!