I started in the OR in ophthalmology about 6 months ago and I really love the OR environment, many wonderful things about it, and I hope to stay here for the duration of my career. One thing I'm not in love with about ophthalmology, though, is that the cases are usually so fast. Many days, it feels like I'm spending most of the day in a nevery-ending cycle of opening cases up then shutting them down, running back and forth to holding, laying instruments out, packing them up, laying them out, packing them up. Especially if I get assigned to one of these cataract guys for the day, it can really get to feeling like a factory.
I know it's way too soon to move on, but I'm plotting my next move in my head...I'm wondering what people in other services think about this. I think I would love to work in cardiothoracic: If I'm going to work with surgeons who act like it's life-and-death, it may as well actually be life-and-death! I also think trauma would be really interesting because by definition, it's unplanned and could be such a variety of issues, whereas ophthalmology for the most part is very predictable, and there are only a handful of procedures that we do routinely.
I would appreciate any comments any of you have that could shed light on whether I should be content where I am, or if I should look to a different service. If there are pros/cons that I'm overlooking, please share!
Dec 6, '10
Different strokes for different folks.
I like the surgery to last at least as long as the paperwork. I have been floated to facilities to do ECT, which takes about 3-4 minutes per case. Drove me crazy. I stopped charting during the cases and made notes on a pull card and did all the charting at the end of the day.
Cardiothoracic is a taste that I never acquired. There is too much down time, especially on big open hearts. Yes, you're cooking labs and checking glucose pretty frequently, but as the circulator there's quite a bit of down time (start and finish are chaotically busy). As the scrub, there's a learning curve...LOTS of new instruments, especially if you haven't done vascular. But at a certain point it becomes pretty routine. The cases are done the same way every time.
A cardiothoracic case is just another case (same with trauma).
Did you get to rotate through all the services? Were there any other services that you enjoyed?
Dec 7, '10
Where I'm at the heart guys are pretty quick. Our room time is about 3 hours for cabg with valve. I like the cases. There is enough busy work to keep you occupied and with a 7:30 start time its lunch time before you know it. Usually eat on the way back from the unit then start the next case. Overall With computer charting I like anything with a 15 minute surgery time. With paper charting Ill really do anything an be happy as a circulator.
Dec 7, '10
[quote=PetiteOpRN;4671768]Different strokes for different folks.
I like the surgery to last at least as long as the paperwork. quote]
Exactly what I was going to say. I hate short excisions and hemorrhoids as well as most eyes for that reason. But I also hate long routine surgeries or sloooow surgeons where I feel like I'm sitting on my hands all day. I love a big open belly or vascular case that keeps me busy in one place for a while.
Dec 7, '10
Well, I was *supposed* to rotate through other services, but that never materialized. Eyes are pretty different from everything else, totally different instrumentation and equipment, so my then-manager said there wouldn't be much benefit to going through the other services. But I can always ask to shadow.
Like you mentioned, I get really frustrated with the cases that don't last as long as the paperwork (which is many of them). It feels like this mad rush to get all the charting and paperwork done, when what I really want to do is focus on the patient.
Dec 8, '10
Ok, the "totally different instrumentation" line can be used to some extent to describe every service.
If you did not have a chance to rotate through each service, your orientation was inadequate. If there is an emergency and you are the only one available for an emergency crani or organ retrieval or five-finger reattachment, you are up a creek. I would take this issue up with management. If it is their policy to train you on all services and they failed to do so, they need to remedy the situation. Then, once you have a better idea of what each service is like, you can decide what really is the best fit.
Dec 10, '10
I like long cases for the most part, especially when you're in a good room. When I was a tech it was the same, believe it or not.
Dec 14, '10
I love really long cases like neuro or plastics. Ortho is ok as well. I hate doing eyes and ENT cases. I try and stay away from open belly cases since I hate counting instruments. I love the OR, which is where I moonlight on my days off from the military. In the military I work as an ICU nurse. Been in the OR for 7 years now and in the ICU for 7 months. If it wasn't for me trying to go to CRNA school, I would just stay as an OR nurse. I really do not enjoy the job working as an ICU nurse when it comes to dealing with families....some who can be very difficult to work with. The hemodynamic monitoring, troubleshooting vents, and the frequent assessments I love. I look forward to moonlighting in the OR at my second job since it's a mental break from the ICU. When I leave from the ICU, I am just mentally and physically drained. I honestly can't see how some ICU nurses work in that field for 5 and 10 years. I know if I don't get selected for CRNA school in 2013, I am definitely leaving the ICU to work full-time in the OR.
Air Force RN
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