Switching from OR to ICU?

Specialties MICU

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Has anyone (or know someone who has) successfully transitioned from working in the OR to the ICU? I'm an RN circulator in the operating room and I want to go to CRNA school so I'm looking at ICU jobs but I'm not sure how to best market myself and be successful in the transition. There are lots of clinical skills that I haven't done since nursing school...

Hi. I know several nurses who made this transition. You sound like you've been in the OR for some time. The nurses I know who went to ICU did it early, before the 2-year mark. They "sold" their experience with procedural set-up and the sterile field to the managers. Another selling point was their experience with the surgeons, very valuable in any unit which has a SICU component. (Everyone I know who made this transition did it as an internal transfer, not to another hospital, so it was feeling comfortable with the hospital's own surgeons that made a difference.) Another point is that they were used to working as part of a team to manage a patient. They also were candid about wanting more time doing nursing skills. One of them told me that she said in the interview that she was was tired of having all her patients unconscious.

They won't be too worried about your lack of skills, because that can be taught. Make sure you tell them how good you are at putting in Foleys :D We don't do all that many IVs in ICU, so if you have pre-op IV placement skills, that will be a plus.

A word of advice. If you are considering CRNA school, please keep that very quiet when you are interviewing for an ICU position. The manager will be looking for nurses who can stay long term, not a nurse who is planning on two years and out.

I personally moved from OR to SICU. The transition was a little rough, but it turned out pretty good. I love my new area and new hospital.

After working at a Level 1 trauma center OR for 4 years, I basically ditched all my basic nursing skills and became an surgery/procedure oriented RN. Therefore, keeping track of I&O and checking new orders were challenging tasks once I started in SICU. It took me 4 months to finish the orientation, and some days I felt I was even worse than a nursing student in terms of nursing skill; but finally got a hank of things here after orientation. I was hired at another Level 1 trauma center SICU, things are even better at the new place.

Friendly co-workers and generous manager were a big plus during my transition. Yes, OR nursing is very different than other areas, and that's why some ICU nurses feel OR nurses know "nothing" (especially when ICU nurses trying to get report from OR nurses). OR nurses are good at putting in foley, and we are good at setting up and assisting bedside procedure. Surgeons usually are impressed that you got everything prepared for them.

Specializes in Cardiac/Transplant ICU, Critical Care.

Props for wanting to go to CRNA school! But first on the docket is getting the ICU experience. I have trained a few people who have been in the ORs and transitioned to the Units. The area that I feel that they struggle the most with is nursing judgment and critical thinking. I feel that being in the OR it is all about procedures and close monitoring of vitals and I/Os and reporting that. But in the ICU it is more about what you are going to do about that information and what you can expect to see.

I'd say the best thing to say is that "I have experienced almost everything there is experience in the OR setting and want to learn more and grow more as an RN. I have a lot of experience working with surgeons and my procedure setup game is flawless so if I have to help setup for a central line insertion I can be more hands on and also if the team has to do a bedside washout of an open chest I can help out much more."

When you get on the unit try to experience as much as possible and don't just do it, process it, ask yourself why the team wants to do something in a certain way or what the rationale was behind it, and then actually ask them. When you see the nurses do something, ask them to explain how they came to their conclusion and why they decided to do the thing they did. I feel like coming from the OR your nursing judgment and critical care thinking will not be as sharp because you haven't necessarily had to make those decisions or experienced those things before.

In any case good luck and keep us posted!!!

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