Lose Nursing Skills??

$fracturenurse$ · Oct 13, 2008

Ugh! I don't know why other nurses feel you lose your skills in the OR? Yes, when I got out of school I did go to Med/Surg, and eventually transferred to the OR. OR is a different type of nursing, but you will always have those skills! I've been in the OR for over 10 years and the only time I felt like I was losing my skills was my brief stint as a school nurse. Talk about losing skills...There seems to be a common belief that we don't do anything in the OR, I get it all the time. I was at a party once and an ER nurse and me almost came to blows because she thinks we sit down and never move. If they only knew...A girl I work with said her nursing instructors told her she was making a big mistake going to the OR, said they didn't do anything. I did enjoy my time on the floor because I saw a lot. We did ortho, telemetry, rehab, etc. I know plenty nurses who have been in the OR since graduation and they never look back. If you love the OR, go...But that's just my opinion!

shodobe · Oct 13, 2008

Losing skills due to going to the OR. Very interesting. My skills only have gotten better in many ways over the years because I spend alot of time correcting mistakes floor nurses make. I of course don't know alot about new drugs and maybe newer attitudes and thoughts on some patient conditions, but that is OK. Nothing wrong with spending a little time on M/S, but if you really want to work in the OR your skill levels in many ways will exceed anything you might do or learn as a floor nurse. Each specialty has their level of comfort and knowledge but nursing in general stays pretty much thesame.

GadgetRN71, ASN, RN · Oct 14, 2008

Mistake that many nursing students make...listening to their nursing instructors. That sounds like a horrible thing to say but in many cases, these instructors have not been in the field full-time for years. They also may not know anything about the various specialties, and may have pretty strong biases against some of them.

My maternity instructor hated OR nursing and hated OR nurses. So, she was always making snide little comments about the OR to me(I was working as a surg tech while in school). :down:

OP, you will gain many skills working in the OR, and we OR nurses do nursing care. I assess pts, do skin care, change colostomy bags on occasion, put in foleys. I know how to interpret labs, and even put in an IV here and there(rarely though). I get to scrub too.

I'm telling you, most of the nurses that trash talk about the OR couldn't hack it..that maternity instructor I mentioned earlier? Found out later she did some OR time-only lasted 3 months! :cool:

Scrubby · Oct 14, 2008

There is a lot of misconception about us. While we don't do drug rounds, look after 6 patients and their zillion family members there is plenty of nursing care going on. The other nurses who say we don't do anything have probably never worked in the OR and are just plain ignorant.

We do dressing changes, we clean patients up (yes we even wipe bottoms on occasion!), we make sure that they are positioned properly and give pressure area care. While we don't give IV meds, oral meds, we do ensure that any medication such as local anaesthetic etc is checked and documented.

The only reason I'd recommend going to a med/surg area before OR is to learn basic nursing skills like manual handling and patient assessment. Because of the fast paced environment there is often little enough time to teach nurses how to scrub and scout. Having to teach them the very basics of nursing care would be almost impossible. It's also not really fair on the learner because out on the wards you don't have an audience of surgeons, anaesthetists and other nurses watching you and pressuring you to hurry up like you do in the OR. It would be too intimidating and would put enormous pressure on the learner and the teacher.

Fun2, BSN, RN · Oct 14, 2008

If you're like every other nursing student, chances are, your "skill" level isn't high anyway when you finish.

What are you loosing that you can't relearn if needed?

Virgo_RN, BSN, RN · Oct 15, 2008

I must admit I'm ignorant about OR nursing. When I first began my prereqs to get into NS, I always pictured myself in the OR. Once I began NS, the emphasis in clinicals is on the nursing unit, and we only got a two day rotation, in our second year, in the OR. On my first day, I got to watch a lady partsl hysterectomy and an open abdominal exploration on a woman in her third trimester. My second day, I got to watch the Holy Grail of operations (for me), a 3 vessel CABG.

I remember being so excited to actually get to be in the OR. But then, the experience left me flat. I'm not sure what it was specifically, but I left the experience feeling that I might get bored, doing the same thing over and over again.

Now, after a little over a year on the nursing unit, I'm finding myself revisiting the idea of the OR. One of the main reasons is that I find the constant interruptions of actual patient care to be very taxing and unwelcome. When I really need to be starting a blood transfusion and the family member is harassing me about what medications I'll be giving Grandma tonight, and how hungry she is and can't I get her some low sodium broth, I'm thinking "I can only do one thing at a time. Would you like me to get some low sodium broth, or put some blood in her so she doesn't go into V Tach?". And yet, I have to smile pretty and not **** off the family member because then I am the Mean Nurse and they might complain, or if something goes wrong, sue.

I come from a technical background, so machinery doesn't scare me. In my old career, I was responsible for banks of highly technical broadcasting equipment that required the ability to perform precise operations, and in depth knowledge of settings and calibration in order to be good at my job, and I was. I had to synthesize a large amount of data and coordinate it so that the equipment operators could make sense of it. I created a database in Access, when I didn't even know the program at all, but just kept at it until I knew the program inside and out and had created a database/worklist that became the standard for my workplace because it was so efficient and effective.

I guess a part of me fears that my colleagues would see my moving to the OR as throwing in the towel and admitting that I can't hack it on the floor. The thing is, I don't know if I even want to hack it on the floor. I know I'm a good, competent nurse, but I'm just not feeling like I'm where I want to be. I want to find my passion. I want to love my job. I want to focus on patient care instead of pleasing family members whose judgment of good patient care has nothing to do with the fact that I'm keeping their family member safe, but whether or not they have a mustard stain on their gown. I want my technical skill to be the measure of my nursing care, not how "nice" I can be in the face of rude, demanding family members.

shodobe · Oct 15, 2008

As far as I am concerned you are taking a step up the ladder. Obviously your so-called colleagues don't even have a clue on what goes on in the OR. They have their comfort zone to doing the same old thing basically day after day with little variations. OR nursing has a different aspect every day especially if you work in a large OR, 15 rooms or more. Don't ever question yourself about your aspirations and why you want to climb the nursing ladder. Mostly your colleagues don't want to take on the challenge because let's face it, OR nursing isn't for everyone. Good luck on "your" choice.

Virgo_RN, BSN, RN · Oct 15, 2008

Thank you for your comments. There is one OR position posted, but it states "A minimum of 1 year current experience as an OR staff nurse required. Ability to independently scrub and circulate major cases in a full service OR.". Well, obviously I do not have that experience or that ability yet. Do you think I should apply anyway, in case they are willing to train the right candidate, or just to get my name in there for future openings?

Thanks in advance. You've been very helpful so far.

$fracturenurse$ · Oct 15, 2008

I have to agree with the comment that going to the OR is moving up the ladder. I agree wholeheartedly!!! Working in the OR is challenging and involves patient care as well. I do agree that a plus is not having to deal with the family as much...I remember too well trying to take care of 6+ patients and having family follow me around wanting this and that while I am trying to start blood, help a doc, etc. I would NEVER go back to the floor...It's been 10 years, and trust me they never viewed it as "throwing in the towel."

As far as going to the OR without experience? You need to talk to the director. I called the director when I wanted to move and she told me, "no." They then hired me for a PACU position and was slowly orienting me to the OR. Then they got the Periop 101 program and the rest was history. They might be willing to train you. Just tell them how motivated you are. Good luck.

SummerGarden, BSN, MSN, RN · Oct 15, 2008

op: i want to chime in too. this is a very good thread, btw.

i am a soon to be new grad with an opportunity i did not think i would get and that is to start in the or. i heard the rumors about skills etc. too. however, i work as an extern on the floors. i have a lot of skills now (i could not pass meds as an extern but in school i do fine in that area as well)!!! however, like the rns posted, the one thing i have noticed on the floors is the problem with time managing everything, which is impossible to do for one person because families and other activities interrupt.

i would also like to say i felt like i was "throwing in the towel" too a few weeks ago until i had a very good conversation with a wise old man (my dad) who asked me why i would torture myself to do something i do not want to do (to continue to work med-surg) when i have an opportunity to work in an area i like? my only response is peer pressure from instructors, rns, and my peers.

before nursing school i did not even know what med-surg was and i would have laughed if anyone said i would do it for a living. i do not like the number of patients i get. five to six on one shift at a time is ridiculous. i also do not like the fact that i have family members who are rude, mean, and angry accusing me of things behind my back or to my face while i am trying to work. did i mention that i am not a nurse yet????

so, with that said, if i am offered a job on the or i am taking it without question! i worked in the or as a tech and as an extern before moving to med-surg. i liked it.... i was not bored... i was always challenged to perform efficiently (safely and quickly) and i lived up to the challenge.

don't be afraid to lose skills.... most or nurses do not work outside of the or their entire career unlike nurses in other specialties that get bored or overwhelmed/burned-out and move on.

shodobe · Oct 15, 2008

Thank you for your comments. There is one OR position posted, but it states "A minimum of 1 year current experience as an OR staff nurse required. Ability to independently scrub and circulate major cases in a full service OR.". Well, obviously I do not have that experience or that ability yet. Do you think I should apply anyway, in case they are willing to train the right candidate, or just to get my name in there for future openings?
Thanks in advance. You've been very helpful so far.

Yes, I think you should apply because it is becoming very difficult for most hospitals to adhere to that requirement, Experince OR nurses tend to stay at one location for many years. I myself have been at the same hospital for 31 years!!!!! The OR nurse seems to want to stay in one OR and not really move around. The travelers you see have mostly less than 5 years of experinece and like to move around the country. Older, much more experienced nurses usually have a spouse who have retired and they want to see the country.THe OR nurses I work with now have no less than 15 years at the hospital. We have been trying to hire an RN for over a year and have had no success in keeping one. The ones we have hired just don't work out and er finally had to settle for a ST. You see, we have an ALL RN staff. So, your hospital might have trouble filling this position with an experienced nurse. I would approach the NM and show your enthusiasm and willingness to learn. You never know. I would give you a chance.