New grad...OR vs. working the floor

Dreamer-RN · Jul 18, 2008

kindred,

I cannot give much advice on working on the floor vs. OR. However, I have some experience with working in an OR unit through my externship.

If I was in your shoes, I would pay little attention to the sign-on bonus. I see this as icing on the cake. I would pay more attention to the benefits and the pay (in addition to the culture and environment). That is what matters in the long run. The commute is also something to strongly consider. I suggest to get all the information you can before committing to one of the hospitals in order to make the best informed decision you can.

From my limited experience with floor nursing (clinicals), the OR can be a very busy environment. Therefore, I would not say it is easier, it can be as challenging as the floors despite one is working with one patient at a time.

I think once you have all the information you need, you can better determine whether it is worth it to accept the OR offer or not (worth doing the on-call and driving 80 miles round-trip, etc.).

MereSanity · Jul 18, 2008

Well, I work in the OR and I LOVE it. I worked for awhile on the floor and was bored out of my skull. The OR seems to work well for those with a bit of ADD. It's fast paced and deals with some pretty interesting personalities. I LOVE my job. :redbeathe I got no sign on btw.

Tiffany, RN, BSN · Jul 18, 2008

Well the only experience I have with floor nursing is clinicals and my externship. I enjoyed the floor, but it was the hours that I did not enjoy. So after I graduated in May, I accepted a job in the OR. I've only been orienting for a week but so far, I love it. The people are nice and very professional and the workload is lighter than some ORs because we staff 2 nurses and 2 techs in each room. I work 7-3 Mon-Fri with call. The pay cut from not getting shift or weekend differentials is something you might want to consider too. Other new grads working on the floor probably take home $300-400 more each pay period. But to me, its worth it to have a "normal schedule" rather than more money. Also watch out for those large sign-on bonuses. The amount often shows how desperate the department is for new staff (I.E. with a $5000 sign on bonus, you can bet you will be working short-staffed A LOT.) So take all those things into consideration before making a decision. Best of luck!

StarlightRN · Jul 19, 2008

I have worked on a med surg/oncology floor for 3 years. I have just started a job in the OR, which is what I have wanted for a long time. I can't really compare yet, but I know many nurses that have worked on the floor and then went to the OR and absolutely love the OR, and say they would never go back to working on the floor. Turn over in the OR is next to nothing. Usually when nurses go to the OR they stay until they die or retire. Turn over on the floor is very high. That should tell you something right there. I'm not saying OR is easier, it's just a totally different kind of enviroment.

Best of luck to you.

Shay1 · Jul 20, 2008

I currently work in the OR- I would not say it's easy. (Graduated in May as well). It is a very phyiscally demanding job. You have to always be aware of your field, what is going on during the procedure, as well as anticipating what may be needed. Sometimes you have to run out of the room to run and grab more sutures, or another instrument. It's a very different type of floor nursing (from my limited experience). You don't do any IV's, listening to lungs, heart sounds etc. What I love the most about my job, is I am the person who is the voice for the patient while they are under. You are watching always for their safety and optimal outcome for them. You pick them up in pre-op and are with them until you drop them off in recovery. The patient doesn't really get to know what you do for them while they are out. Your are protecting them from falls (off the OR bed) from contaimination of your field, and always always watching to make sure every needle, blade, and sponge is not left in the patient.

I also think that you have to have a strong personality to work with the surgeons sometimes. Alot of times they take their moods out on the RN's / techs in the room. You have to be able to be handled getting yelled at and remain calm and still do your job. Not being afraid to stand up and say someting if you feel something isn't safe or in the best intersted of your patient is also important.

Hope that helps.

Scrubby · Jul 21, 2008

I too used to think the OR was so much easier than the wards. In some ways it is because you don't have to put up with annoying family members, doctors rounds etc BUT the OR is certainly not easy. A completely different environment with it's own set of problems.

If i were you I'd be finding out about what the on call requirements are before signing on.

humblecirculator · Jul 21, 2008

I worked the 'floors' for about 7 years before transferring to the OR (I've been in the OR for about 4 years now). I would have to say that the OR is NOT easier, just different! Yes, you only have one patient at a time, but that doesn't mean that the work load is easier. There are different skill sets that a perioperative nurse develops vs floor nursing skill sets; yet some skill sets are interdisciplinary. Some people think that the OR is a cake job, but take it from me, it isn't. The technology in the OR alone would make a 20 year floor vet cringe (I've seen it happen!!)

Like some other posters have mentioned, there are BIG personalities in the OR and you really do have to let words go in one ear and out the other-otherwise you'll go home crying everynight and eventually quit. You can't be afraid to speak up when you see something wrong or when you have a 'gut feeling' about something. I've learned that most surgeons can respect the job you do if you do it with moxy!!

I have to disagree with one of the posters who mentioned that you don't start IVs, listen to lung,heart,bowel sounds, etc...because that depends on the facility that you work at. I still do a quick assessment of my patient-listen to their 'sounds', look at their skin, are they A&Ox3, etc...perhaps I'm a bit overbearing, but I just don't take the AD's word.

I think as a new grad, the floor might be a good place to start because you'll get your feet wet in the hospital environment and not as a student. Unless you know yourself really well and think that you can make a go of the OR.

I wish you good luck and welcome to :nurse: ...the most noble of professions!!

TALK-OF-MIAMI · Jul 22, 2008

Basically my advice to u would be do what is best for u. If your are a night person then Hospital A would be your best bet. Other then that just make the best choice possible

ShariDCST · Jul 25, 2008

consider where you think you want to be in one year - and in five years, and go where you feel the best fit. the higher sign-on bonuses are always a red flag to me - you have to wonder why they offer so much more money for one job than another. the answer to that is generally based on supply and demand. there are many nurses who want to work or and can't get in because of low turnover in the department and the requirements they have to get into their orientation program - but i don't see them clamoring to work nights on a telemetry unit! hence - the bigger "bait" to get folks to do the job. they don't have to offer as much - and frequently don't offer anything at all - to get nurses to apply to their rare and highly treasured opportunities to work in the or.

the commute is definitely something to consider though. i don't know where you live or what kind of weather you normally deal with throughout the year, but if you live where the winters are deadly cold and blizzards are the norm rather than the exception, then think about what accomodations you'll have to make to be available on call within their time limit. most places have a 30 minute response time requirement - what arrangements are available to you to be able to make that happen? is there a friend nearby you could bunk with on call nights? does your hospital offer call night rooms? some do, especially in open rural areas where there is a great distance between one town and the next. is there a cheap motel - not too cheap - close to the hospital where you can spend your nights on call? can you be away from home at all on call nights? if you get called in, of course you'll be away - but perhaps not for the entire night. you have to consider too how they staff the call shift. does your on-call begin at the end of your shift and end at the beginning of the next day shift? i've worked in places that do that - including all weekend, from friday afternoon to monday morning. some hospitals break call backs into shorter shifts and "spread the load" as it were, if they are lucky enough to have enough staff to do that. smaller hospitals may not have that latitude.

i know i've put a lot of emphasis on the call back aspects of the position - but it is a significant issue if you take that job. you have to be able to accomodate their requirements to do the job, and if there's something you simply can't provide, then it's better to know it up front, than later on when they put you on the call schedule.

best wishes to you as you embark on a wonderful career!

shari