[wayover20]

Regarding my transfer to the OR from the ER....I am set to go there on 8-15. This morning the OR director called me to make the transfer official and I asked him about the OR periop course with regards to my pay rate. He said when any nurse goes to a new training course they automatically drop down to the starting RN pay rate which in this case is 17.00/hr. I told him that would be a 11.00/hr cut in pay for me and that would be VERY hard to take. He said since the course isn't scheduled again until January and I'm starting on site training next week, I won't have to take the course thus avoiding the pay scale problem.
Question: Is the perioperative course necessary or does a good on site training adequate?
Our hospital does not do hearts/lungs/brains and we are only a level 4 trauma center that transfers all traumas from the ER to a level 1.

[MissJoRN]

I started my hospital OR orientation when it was a new program with the understanding that I was supposed to take a community college course also. The orientee a few weeks ahead of me worked hard to convince us and the preceptors that it wasn't necessary for me to take. Apparently by the time the course rolled around I was "past" it, as I already was in the OR for a couple months and had completed my general, GYN, and another rotation, the closest course did general only with an entire evening devoted to gowning and gloving (I was scrubbing entire procedures independently) On the other hand I understand the scrub role was barely taught with heavy emphasis on circulating (a turn off for me) it may have been very beneficial to me if I was planning on pursuing a CNOR cert (I'm not) Anser in a nutshell- yes, IF you have good preceptors. Sounds like by the time the course comes around, you'll know where your orientation stands.

FYI, if you need to compare- my orientation was over 6 months (mostly because they did not consider it as 6 months Jan to June but rather thought of it as ~26 weeks- so I made up for lost holiday time, etc. Also my co-orientee who quit halfway through was having trouble and they tried to keep us both together as long as possible) I moved through general, GYN, vascular, eyes, neuro, ortho, and ENT always scrubbing then circing. Last few weeks to refresh all over and pick my weak points. I was given a cerain amt of freedom of time- there was no set "3 weeks scrub, then 3 weeks circ then move on" rather it depended on the cases available and my speed of grasping info (within reason) Of course, in my hospital a neuro rotation meant a lot of refreshment back to previously learned specialties since we don't have a steady flow of neuro cases. I had weekly preceptor meetings to discuss goals and progress. Alexanders textbook was strongly enc, and the OR has a copy, too. We had Alexanders and AORN standards reading assignments. Also did a day following a CRNA and Anesth. tech, day in central processing, holding, PACU, etc. Then my first couple of calls were partnered also.

This isn't a scare tactic but the truthful warning I wish I had known. Halfway through I became a little depressed and discouraged- I used to be a "good nurse" I oriented new grads and experienced nurses new to my floor, I could handle any assignment I was given (often the harder ones on my floor) I took charge, etc and then suddenly for 6 months straight everytime I almost understood something, almost felt yeah I can do this, I was plunged right back into something totally new. It's OK. Everyone feels like that. It does come together! Maybe it's just me, but I didn't take that too well, I kept reminding myself that it was OK, I was a good nurse, knowing I could always go back to the floor and be competent helped (of course that was never my plan!) I did do some prn shifts on my old floor and that kept my overall self image up; I tend to have a low self esteem and I think I needed that. Like I said, that's just me.

[wayover20]

THANKS MissJoRN! Great info and encouragement! I am gearing myself up to be a "new" nurse again, knowing nothing about the OR. But I am eager to learn. The good thing is several people that I've known in the hospital over the past 30yrs are there and ready to help me in my transition. Thank God!

[OnCall4Life]

It's hard to get well trained circulators in the OR. There just aren't enough courses out there that spend time in the OR. So if you have a chance to be trained in Surgery, go for it!! Like was stated earlier it will seem very overwheliming at times but once you get the hang of it you will feel more comfortable. I started out as a scrub tech then got my RN, BSN. Scrubing will always be my first love but I enjoy circulating as well. It was a big change going from scrub to RN. I had to develop a whole different mind-set. A good preceptor really helps. Insist on one and ask around the OR to see who would be the best and ask for that person. I know that most OR's believe in see one, do one, teach one. Don't let them do that to you. Stay in one area until you feel comfortable then ask to go to the next area. But with your ER experience that should help you a lot. Several of our circulators were ER nurses. And they are good because they can move fast in a crisis. Just make sure that they stress sterile technique because as a circulator it is your job to keep an eye out for breaks in technique. Good luck!!!