Feeling completely useless in the OR! Please help!

[nurserrv]

I have been working in the OR over a year now. I was hired as a new grad and did the peri op 101 course. It was exciting at first but now I have been having negative feelings about my job for a long time for several reasons. First one being the unpredictable attitudes of surgeons. I get anxious and feel like I have to walk on eggshells around some of them. Second is how the nurses don't seem to be treated as a valued member of the OR team. I feel like I'm just setting rooms up for surgeons and fetching things for different people. And remember i started as a new grad so now I feel like I seriously know NOTHING about pt conditions and I surely don't know how to intervene if an emergency is taking place (at my facility, it usually anesthesia personnel that do that) and THAT is what bothers me the very most. I know at my facility if I want to switch to the floor they will give me an orientation so I'm not worried about that. I know someone can teach me the skills/knowledge you gain on the floor. Im just worried about the actual switch. OR nurses get paid more than floor nurses where I am (don't know why, I feel like their job is more difficult) and I wouldn't have my cozy M-F 8 hour day shift with weekends and holidays off with real morning breaks and full 30min lunch break. I would be asking for heavy patient load and a long stressful 12 hour shift (possibly nights, which i don't want as I will have a baby soon and my BF works days as a teacher). But it is KILLING me that I'm losing nursing skills I barely had fresh out of school. I feel useless in codes (anesthesia usually takes over) or even if a patient is having something like chest pain, vomiting, or is just really unstable I have NO idea what to do. All I know if bovie settings, OR materials, instruments, counting, prepping surgical sites...etc. I don't know how to intervene when the patient really needs it. I wish i could pick up something PT but I already work 5 days/week. I want to switch to something else for the skills and knowledge but I'm afraid I will end up making a mistake and be another burned out, angry floor nurse. PLEASE HELP! ANY ADVICE!

[xoemmylouox, ASN, RN]

Well I wouldn't go changing anything until after the baby is here. Maybe you could ask to have more responsibility? Or go PRN elsewhere. I will warn all areas have their pros and cons. Your skill set will vary depending on where you work. It's not often you maintain all of the same skills you obtained during school. Typically you don't use certain ones as often and in exchange learn new ones.

[Cat365]

I agree w previous poster. You can use your maternity leave to decide, but I probably wouldn't change pregnant/with an infant. That's already a lot of stress. Add learning a new nursing job.

Use this his time period to sock some money away and then consider your options.

You our have to decide if the opportunity to gain skills is worth the loss of pay. Remember that your priorities may change after you have the baby.

However, no jobs use all your nursing skills.

[nutella, MSN, RN]

If you are already pregnant or planning on a family soon your priorities will change.

You need to keep that in mind. I do not see that what you are doing is not useful or less than on the floor. It is a different work you do but it is to the benefit of the patient who needs surgery. OR seems to be one of the areas that are still very hierarchical and where it takes some while until you are established and respected equally. You write that you are not willing to give up some of the advantages of working in the OR - which is fine - but I do not see how you would be happy on the floor. I know many nurses who went to the OR right out of nursing school and who never regretted it. They feel that they are valued, their knowledge is helping the patient and surgeon to achieve a goal, and they participate in councils, education and so on.

Once you have family, you will be stressed out with less sleep, worries, and so on and probably appreciate the less intense setting more - it is also easier to find babysitter/childcare during regular work hours.

[Rose_Queen, BSN, MSN, RN]

Okay, let's talk about those surgeons and their attitudes. Are they getting frustrated at a situation or making it personal against staff? There is a difference, and you shouldn't need to feel like you're walking on eggshells. With some of them, it comes down to you needing to tell them to cut the crap.

Now, about those nursing skills. Each specialty is going to have its own skill set. Yes, you learned skills in nursing school that you aren't using in the OR. But you're also learning skills that are unique to the OR- quick assessments (you may not think you're doing them, but you are- or at least should be- skin, anxiety, needs for special positioning equipment or padding, etc), cognitive function and education- do they really know what they're having done and why? Things like that.

Emergencies. Yes, that is primarily anesthesia- they're already managing the airway and medications. You're more of traffic control to get rid of all the unneeded lookyloos and doing the documentation. All parts are equally important, and require a team. The same is true of emergencies on the floor- the floor staff start BLS and then the code team arrives and runs them.

My final thoughts: nurses either love the OR and never leave or hate it and get out as fast as they can. Only you can decide which category you match. Additionally, it takes a lot of time to truly feel confident and competent- there's a reason OR orientation is one of the longest (if not the longest) specialty orientations.

Best wishes on whatever path you choose.

[nutella, MSN, RN]

Okay, let's talk about those surgeons and their attitudes. Are they getting frustrated at a situation or making it personal against staff? There is a difference, and you shouldn't need to feel like you're walking on eggshells. With some of them, it comes down to you needing to tell them to cut the crap.

Now, about those nursing skills. Each specialty is going to have its own skill set. Yes, you learned skills in nursing school that you aren't using in the OR. But you're also learning skills that are unique to the OR- quick assessments (you may not think you're doing them, but you are- or at least should be- skin, anxiety, needs for special positioning equipment or padding, etc), cognitive function and education- do they really know what they're having done and why? Things like that.

Emergencies. Yes, that is primarily anesthesia- they're already managing the airway and medications. You're more of traffic control to get rid of all the unneeded lookyloos and doing the documentation. All parts are equally important, and require a team. The same is true of emergencies on the floor- the floor staff start BLS and then the code team arrives and runs them.

My final thoughts: nurses either love the OR and never leave or hate it and get out as fast as they can. Only you can decide which category you match. Additionally, it takes a lot of time to truly feel confident and competent- there's a reason OR orientation is one of the longest (if not the longest) specialty orientations.

Best wishes on whatever path you choose.

I think OR is a great specialty - I almost ended up in the OR ! My last clinical before graduating from nursing school was 4 weeks long in the dermatology OR of a major teaching hospital. I really enjoyed it! I was asked to apply but the ICU where I had a very long clinical just before the derm OR offered me a job so I grabbed that on. Years later I thought about OR again but by that time I felt I was too old to get into such a specialized area. OR nurses rock!