Burned out with nowhere to go

Specialties Operating Room

Published

I've been an RN for about 9 months now, and I went straight to the OR out of graduation. I was very excited about it because I knew that's all I wanted to do. I started circulating on my own about 5 months ago, and things have been going downhill ever since. At my hospital, it doesn't seem like there's very much order. They'll constantly change things on us, and sometimes, they won't even tell those of us that it affects. There's not enough equipment to go around for everyone, so I have to make sure I get to work 15-30 minutes earlier than most of the staff just so I can get the essential equipment for my cases I'll have that day. Most of the time, people don't put that equipment back from the previous day, so it's even more frustrating figuring out where to look. After I've finally found what I need, I'll have to hide it in an area of my room to ensure that nobody comes in and snatches it at a time that I'm not in there. My work is also terrible about giving breaks. I work 5 days a week, and I probably get a break 1-2 mornings a week. In the entire time I've worked there, I've only been offered a break in the afternoon twice. If it was because we were that busy and shortstaffed, it wouldn't bother me so much, but most days that isn't the case. There are always people sitting in the break room doing nothing, especially in the afternoons when it is the hardest to get help when we need it. It's also nearly impossible to leave work on time. I come in early every single day, and I leave at least 15 minutes late most days of the week. Lately, it's been more like 30-45 minutes late almost every day, and I'm getting sick of it. My relief is available, they just show up late most of the time (occasionally not their fault, but most of the time it is), even on days when I specifically tell my supervisor that I have to leave on time for an appointment.

The job itself wouldn't bother me nearly as much if it weren't for all the crap that I have to put up with on a daily basis. This stuff has been building up and making me more and more frustrated every single day. I'm at the point now where I can't stand going to work because I know something is going to set me off and put me in a bad mood for the day. Whenever my supervisors ask me to stay late, I can never say yes because I can't be there any more than I absolutely have to so I don't lose my mind. Over the past few months, I've had a case of insomnia and headaches every day that just won't go away. I used to keep waking up in the middle of the night, freaking out and thinking I overslept (to the point where I would get out of bed and check another clock to make sure my alarm clock was right), but now I'm so used to it that I no longer think I overslept when I wake up at night and I just go back to sleep without thinking about it again. It happens every day though, and because of that, I can't remember the last day that I wasn't overly tired when I should be wide awake. I know that doesn't help with my extreme irritability at work, but I really think my job is the cause of all of this. I've never had problems like that before. I would look for a job elsewhere, but I've signed on with my hospital for 2 years, so I'm stuck. I can't afford to pay the money back, and I refuse to transfer to another department. Even though I hate my job, I do love the OR and I couldn't work anywhere else. What do you do in a situation like this?

muffin7

193 Posts

Specializes in OR, HH.

After nursing I too went straight into the OR. I loved it, but can sympathize with you. I left my first job for 12hr shifts and to get away from the "crap" only to go into more "crap." I have decided that I wm going to bite the bullet and do floor nursing . I want more patient contact and to be a more rounded nurse. OR is so specialized that the longer you stay in the less likely you will be able to do anything else. Wish you the best.

Heogog53

200 Posts

Specializes in CCU, OR.

Ah, my dear young OR nurse.

I've worked in five OR's over my career. The medium sized one, which was 12 rooms plus we did the c-sections upstairs was run about as tightly as any place I've seen since. Of course, the nurses got emotionally beat up on a lot by nursing admin and the docs. This was in the 1980's.

But we were organized as hell.

I worked at a 2.5 room OR(only did podiatry in the teeeny room), with military personnel. Not the best organized but we were a tight team(and besides, the junior enlisted STAYED until everything was done, even if that meant 11 pm).

Next place, a 35 room suite which was in chaos all the time, we had to find our special instruments ourselves and every two weeks taken them down and sort them out properly cos the instrument room couldn't recognize or count properly, we were so short of Bookwalter Retractors that the person who had to finish off the carts in the morning had to leave notes for each room about getting the following stuff washed and autoclavewd, then saving it for the next room when we were done so they'd have whatever it was, too. Speciality rooms changed from gen/vasc/below the diaphragm transplants to something else over night and all our stuff was moved, too- but we didn't always no where.

Next was a small place- one cysto room and four OR's. We were supposed to only run one shift a day, but from the frist day I worked there, til the last, our schedule grew about 400%, and suddenly the call people didn't go home til 11 pm, if then and had to come inthe next am to work. If took months for us to get funding for a 10-6 shift and much more for a real 3-11 shift and oh, yah, adding a second team of call nurses on.

Now I work in another large university hospital. The entire system is out of control, needs to be gutted and changed. Changes are now being made like crazy, almost day to day, turnover was constant for the first four years I worked there, no one knew where stuff was kept, or where it went, etc.

I thought I was the stupidest person in the whole OR for my first two years. I'd been a top ICU/CCU nurse before I went to the OR. I cried, I was full of anxiety and couldn't understand what was going on around me cos communication was so poor.

The technologies of the 80's and 90's were primative; lap choles were just starting to be done and we had to use the gyn's instruments cos there weren't any laprascopically designed instruments yet.

Now technology is such a challenge all by itself I'm amazed that anyone who dedcides to come to the OR ever makes it thorugh the program. Dunno if I could start in the OR today.

I know I'm longwinded, but things haven't really changed in the last 30 years. What happens is finally you start to adapt.

In the meanwhile, instead of making verbal complaints to your head nurse/supervisor, start writing up the people who relieve you that late. Do it every day and after a short amount of time, the risk management or legal or budget departments are gonna take notice.....and they in charge, whoever they is, may start kicking ass big time behind closed doors.

And, what other kind of nursing would you prefer to try if you had the option? Get out of nursing, look for another OR job in a different place? Because the smaller the unit, especially the free standing day surgeries; they work together as a team. It's obvious that your management is lousy and doesn't support their nurses. They need to get an attitude adjustment from up above, so you may have to write a letter to the president of thehosp or the VP in charge of financial/budget, especially in this day and age where they are talking about cutting everyine's budget and jobs........

I do suggest taht you start working out very hard; kick box, yoga, lift weights, job, walk fast, spend at least 30 minutes a day doing nothing but some kind of release for yourself. It'll keep you stronger mentally and physically. Take Tai Chi, or some other martial art that will let you focus in the absolute NOW and drain off that tension.

Take the GNC Gold Vitamin, too- it's got tons of B's in it, and if you are stressed, you burn thorugh the B.

Gardening is a good outlet,as well.

What you have going on is a large mess of reality sucks, not what they taught all of us in nursing school, whther we are Diplomas, ADN's or BSN's. Try to take better care of yourself, instead of complaining, suggest a survey be done an how much itme is wasted between cases finding instruments or whatever, and why...you know an empty OR is a very expensive proposition. Try to work in a pro-active manner, suggesting that "we need to findout how to speed things up bwtween cases".....that may get you somewhere else too- noticed by the good guys in management....

And if you do propose and then follow through with that research, get to present it to some comittee to make the OR more productive(both monitarily and in actual time), you'll make your bosses look good...like they were working on it all the time. Keep copies of all your work, and then when it's time to leave, you will have some offical research that you did on your resume.

I wish you well. My hospital is actually divided into four OR areas; The Main one, with about 20 rooms, a small four room suite directly across the hall, and then a woman's and childrens suite separated from that, and two floors up, is what was the L and D labor rooms, now turned into a five OR suite.

We have at least as many supply rooms and each area handles its instruments diferently. We are all the same department, but broken up into one huge group and then three smaller ones. We are not a team across the geographical devide, either. The smaller places are very tight within their areas, and there are a few more smaller servies in the huge area that keep to themselves tooo.

Pretty odd, the OR life.

Obviously it has worked for me for that bunch of years, cos I'm still doing it.

write back if you need a shoulder to shout to!

Specializes in Operating Room.

OP, just know that not all ORs are as toxic as yours. I also don't agree that once you've been in the OR a while, you can't do anything else. I've known several RNs that went to different areas after being in the OR for 20+ years and they did fine. I am able to float to several areas,(never get pulled though, except in rare cases) but I know very few floor nurses that can float to the OR. The worst thing you can do, IMO, is go to the floors because they have it bad there. You think you don't get a break now?

The good news is that you as an OR nurse are in demand, even in this crappy economy. There are other places to work. If it gets really bad, I'd take the chance and leave anyway. No job is worth your health and sanity.

If you have a union, try talking to them. I agree with making a stink about the late reliefs also. If you really love the OR, don't let these jerks scare you away from it. You could get your 2 years and do travel OR nursing. Stay strong. I know it can be hard, I worked in a very toxic environment for 2 years as well. The positive thing about it is I'm practically bulletproof. I learned not to give a rat's hienie about what some maladjusted, bitter harpy thinks.

I love the OR, but it's not for the meek..you learn to choose your battles and it gives you a backbone of steel. Good luck!

Heogog53

200 Posts

Specializes in CCU, OR.

I must agree with your concise post(as opposed to my rambles). As an OR nurse, you can travel and get paid a lot for bonuses- or should you choose to move to a place that will pay you relocation and 10-20k signon bonus.

However- in my area of the country, I have noticed that job offers are drying up in all areas of nursing, except nursing homes. I believe that with the economy going to hell, even if you work for a non-profit community, private for profit or a state university med center, more nurses who escaped the nursing life for whatever else have come back to support their families as the guys have lost their jobs. The hospitals have all started to gear up to hold on tight and freeze hiring for a couple months to a couple years, depending on how soon things start to loosen back up.

So, you might just be stuck as an OR nurse in that OR for the two years. Put the time to good use and learn like crazy, so when you leave you'll know that YOU made them teach you everything YOU wanted. That makes you a much more versatile hire, anywhere.

I also came into the OR after spending two and half years working ICU/CCU, so I had lots of other skills which still ocme in handy today. My hospital program would not take new grads; you had to have two years of experience.

Part of what you are hitting right now is the reality shock that every nurse I've ever met runs into during their first two years. Especially floor nurses. When I got out of school, the average pt load of a day nurse was 8-12 patients. Try to cope with that! I got pulled from the ICU one evening to a med/surg floor; I didn't know until half the shift was over that there was NO CHARGE NURSE at all! The other nurses had made my assignment and gave me three of the worst patients on the whole floor. I didn't get my 4 pms passed, 6's got lumped into the 8's and only about half the treatments got done. After that, I said you can send me home for three days of suspension if you like, but I am never gonna work the floor again.

Squirrel, I like your brass....I bet no one gives you **** more than once.

Lost girl- osmeitmes you have to confront people before they will stop treating you badly and taking advantage of you.

They relieve you late? Call the front desk, the supervisor, and fill out an incident report. If you have an appointment that is after work and they have been depriving you of that right, that may be a legal issue that the hospital can't be seen as having. Decide that you'll work late once this week and stick to it. I got seduced into staying to do double shifts early in my first two nursing years, until I realized that the only one who was happy about this was the nursing supervisor who didn't have to cover that shift anymore- my counterparts thought I was nuts to do that. Finally, I learned to just say NO and after awhile, they stopped asking me every day.

Scrubby

1,313 Posts

Specializes in Operating Room Nursing.

OP I can definately sympathise with you on the equipment situation. We have similar issues at work, we only have 4 laparoscopic equipment trolleys and when they book 6 OR's with laparoscopic cases in there is always chaos and people get cancelled because you can't do a lap chole if you don't have the right equipment. We have brought this problem up with administration to either get us enough equipment or stop booking too many lap cases.

We also don't have enough quivers, light handles and switching pens to go around and we have to resort to hiding and in some cases stealing stuff form other operating rooms. It's childish but what else can you do? But the unit still manages to run somehow...

A few years ago I felt pretty much the same as you. Angry because my relief hasn't arrived, I would dread going in to work, I would outright lie and say I have appointments I need to go. Nowdays I have adapted as Heogog has described, I feel at home in the OR, I couldn't imagine working anywhere else.

Now my advice is to take some annual leave. The insomnia, irritability at work and headaches sound to me like you need some time to refresh and focus on getting back to normal.

Does your break room have a phone? If you need relief then ring the break room and tell these lazy nurses to get their butts down there now.

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