ICU to OR, any advice?

  1. 0
    I have been working in a community hospital ICU and have an interview this week for a position as an OR nurse in a level 1 trauma center. I'm very excited and would really like to make the transition.

    I'm hoping there are some ICU to OR nurses out there who can share their advice/wisdom with me. The closest I've been to OR nursing was a brief stint in nursing school clinicals and the bedside procedures we do in ICU. Can any of you paint me a picture of a typical day?

    TIA for any input!

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  2. 15 Comments...

  3. 0
    Hello Nursgirl

    I don't have an answer to your question but is wondering if you can answer long have you worked in the ICU before applying for the OR position? I am currently working in the MICU/SICU for about 8 months now as a new nurse. I'm really interested in the OR but really want to go to a periop seems like there are no more of these programs...

  4. 0
    I've been in ICU for a couple yrs... I'm not sure about the periop program, I just know that the manager did tell me over the phone that there is typically 6 months orientation for someone with no OR experience, possibly more and it's tailored to the individual.
  5. 0
    Im currently an OR nurse and I've had my rotation in the ICU way back. In the OR, you need to be focused and observant. You have to be able to be attentive and keep your attention to the things the surgeon is doing in order to anticipate the next instrument to hand them. sometimes they dont say a thing a just reach their hand out to you and they expect you to know what they want.
    You also have to be thick-skinned. Surgeons tend to yell at you when you get it wrong -- its just their way of venting out. Dont and never hold grudges.

    There are days when you dont get to sit down your entire shift because of long surgeries but there are slow days too. Like no surgeries at all.
  6. 1
    thank you for your input Monica08!! I got the job and started this last Monday. So far I LOVE it.. of course I am still in the beginning stages of training with the 3 other RNs that got hired with me. We are training to circulate first and eventually will be trained to scrub. It is a HUGE OR where I work.. it took most of the week for us just to be able to get used to it and find our way around LOL It is like a giant maze of OR suites and supply rooms and anesthesia rooms and perfusionist rooms.
    I was thrilled to get to observe and help out in 4 open heart surgeries yesterday. I'm sure for many of you that is something you've seen many times and are used to but for a nurse like me who is new to the OR it was awe inspiring!! I am constantly amazed at the coordination among all the various team members in the OR. I have learned so much in just this first week that it feels like my head might explode. LOL
    I am loving every minute of it and will be mindful of your advice to not take things personally!
    mzkede likes this.
  7. 0
    oh I should add that as we go along in our training we will eventually be assigned to a specialty....
  8. 0
    nursgirl, That is great, You got the Job! I have a question about your interview process. How did that go? What type of things did you get asked?
    Also how is your orientation organized? Sounds like you start out general but what does that mean. Are you attached to certain nurses all day? Any details would be appreciated. Thanks for your info inadvance.
  9. 1
    ummm well I was asked all the typical questions such as "why do you want to work in the OR?" and "why do you want to work for this facility?". I was also asked if I would be able to be at work and clocked in within 30 minutes of receiving a page if I was on call. They asked me to describe a time when I was in conflict with a coworker or did not agree with their actions, how did I handle it, etc... lots of different questions where I was asked to basically tell them a story about a time that x/y/z happened and how did I handle it...

    I was interviewed by the manager, then went to a separate room and was interviewed by a representative from HR, and then by the OR educator. The whole process took about 1 1/2 hrs..

    our training to this point has been general to OR and as we go along I'm told we will be assigned to a specialty and then will have more training within that specialty.
    hxk06 likes this.
  10. 2

    I am currently an OR nurse, for about 9 years, and I have been in the ICU for about 2 years now and I currently work in both areas. I am currently active duty Air Force and I work on a Surgical ICU unit where we get neurosurgical, trauma, cardiothoracic, and renal transplant patients. On my days off, I work as an OR nurse in the civilian sector. I like ICU but I love the OR. I went to ICU to gain the experience I would need for CRNA school. As a result, I was accepted into a civilian CRNA program. I didn't want to go through the military CRNA program. I found a program that fit my needs and even allow students to take their core courses online before they start the program if they choose, which allow students to focus just on their anesthesia courses with a reduced course load of about 6-9 credit hours a quarter versus the 15-18 credit hout requirement of the military's anesthesia program. I will be separating from the military next year to start my anesthesia program and I am so excited.

    I knew of an ICU nurse who went to the OR but from my experience, I see more OR nurses going to the ICU to get the experience needed for CRNA school. When I was stationed in Germany, I would say about 40% of the Army CRNA's were prior OR nurses. I think I have a great advantage over ICU nurses who don't have OR experience since as OR nurses, we know the flow of the OR cases. We know the anesthesia equipment and we assist on many of the regional blocks, spinals, and epidurals. The ICU component really helped bridge the hemodynamic monitoring, medications, and ventilation management of the critically ill patient. I enjoy working both areas and have no problems working both. I often find that because of my ICU experience, the anesthesiologists at my OR civilian job tend to ask me to help setup their a-lines, Vigileo and other monitoring devices, which really isn't my job as an OR nurse but I don't mind helping. I remember doing a case and as soon as the monitors was applied on the patient, the pt had EKG changes. I grabbed the EKG machine but the OR nurse assigned to the room and the surgical PA did not know how to place the EKG electrodes. I jumped in and less than 5 mins we had the EKG done. I see lot of OR nurses tend to feel uncomfortable caring for ICU patients especially when its time to prepare postop for the pt to return back to the unit. Many forget about the transport monitor, ambuy bag, and O2. From the ICU, we go on transports all the time to CT and MRI.

    You will enjoy the OR internship process. You will get to learn how to circulate and scrub very interesting cases. As bedside nurses, we kind of know what's going on w/pts in the OR but as OR, we know the specifics about the various implants used for patients. We know how they are positioned and how it could affect them postop. As ICU nurses, we know patients that are on APRV ventilation, who require surgery, will need to have their vent taken with them to the OR since anesthesia machines don't usually have this capability for this type of ventilation or they may have to be placed on CMV-assist control, which some patients on APRV don't tolerate too well. I really enjoy the OR and ICU.

    Best Wishes
    RUBY2623RN and LovedRN like this.
  11. 0
    I went from SICU to PACU then to the OR. The shift hours were better and so I would say that I got experience taking care of a multiple of post surgical critically ill patients and then worked very closely with anesthesia in the PACU. My ICU skills have made me invaluable to the OR. I now know how to put all the pieces of patient care and education together because of the knowledge and experiences I obtained through the years. I have no anxiety when surgeons ask for things because I know the cause and effect relationships, and ditto for anesthesia. I will tell you it took several years to feel confident and speedy in the OR, but I did enough bedside procedures in both the ICU and PACU to understand sterility and working fast. I think that your skills with drugs, drips, emergency situations gives you a leg up that other nurses who never worked in the ICU will never have. So take an OR course and internship and go for it.

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