OR Student Experience

KC CHICK · Feb 21, 2002

Yes, you're right...the OR is very demanding. I've also seen so much interesting stuff since I started as a grad nurse in June of this year. Of course, there are pros and cons to working in any department.

There is usually no previous experience necessary if applying for the OR as a new grad. In fact, my RN position in the OR is my first job ever in healthcare! I never even worked as a nurse tech while in school....the job I had at the time paid better and had better benefits. My hospital just started hiring nursing students as nurse techs in the OR. They help out where needed and can even scrub in to hold retractors. If you're interested, maybe a hospital in your area is doing the same thing.

As far as I can see...one of the main traits in a successful OR nurse is the ability to jump in and help the team. There is no heirarchy in the OR....everyone works together to get the job done. Hard workers are accepted....those who slack off usually don't last long. Make sure you ask lots of questions...OR people like to show off what they know.

Have fun at clinical,

Anne

mud · Feb 23, 2002

I guess, that with the current nursing shortages, you probobly don't need to have experience as an RN to get a job in the OR. However, you really should have at least 2 years in a surgical setting. Pretty much anybody would tell you the same thing. There are many skills lost when you go to work in the OR. So if you have no experience anywhere, those skill will be lost much faster. I am from Canada, but I am sure that you also have post-grad courses for operating room nursing. The one that I took was one year, part-time. You really should talk to more people. I am sure that Anne meant well. But the OR is not usually where one should go first in their nursing career. It is a whole different world. Besides, don't you think it would be interesting to work with the patients pre-op and post-op, to learn about illnesses, etc, and then go to the OR with at least a bit of understanding of what is being done, and why?? GOOD LUCK TO YOU

fergus51 · Feb 23, 2002

I was inspired to go into nursing by an OR nurse. She told me the most important qualities were a big bladder and good arches for all that time on your feet!:) I am L&D, so I only go in for c-sections, but I like the fact that there are set procedures which appeals to my obsessed with order side.

I am also from Canada and it used to be that new grads were never allowed in the OR, but that has changed. Our hospital now trains new grads with a year long program.

WI-RN2be · Feb 23, 2002

Thanks all for your thoughts. I am so excited about the OR now especially after today. I saw a knee scope with a TVO. The ortho doctor was wonderful as were the RN's in the room. Throughout the whole procedure they were asking if I could see and explaining what they were doing.

I am for sure going to work as a med-surge nurse for a couple of years until I feel comfortable with my assessment abilities. Then rotate to a different floor or two and then to the OR.

Isn't it great to feel like you have found your niche in life.

Thanks again for your responses.

Sarah

KC CHICK · Feb 23, 2002

Mud, I am truely glad that I got a position in the OR straight out of school. I wanted to avoid med/surg completely!

In my opinion, having experience on the floor does not give anyone an advantage going into the OR. Our OR has had better luck training new grads straight out of school than training experienced nurses off the floor. Why?? Like you said, they are two totally different worlds. If the OR is definately where one wants to go....why waste time concentrating on something you're not going to use? We get 9 months of training in the OR because there is SO much to learn.....RNs on the floor get 6 weeks if they're lucky.

OR nurses acquire different skills..... We have to be very, very fast and prioritize according to our need at the time. We get frustrated sometimes w/our pre-op RNs (who mean well). Why do pedal pulses on a patient who is coming in for a carpel tunnel release?? Why shave the abdomen ONLY of a patient who is coming in for an INGUINAL hernia repair?

Anyway, WI-RN2be ....I know you'll make the decision that's best for you.

Good Luck,

Anne:cool:

ORJUNKIE · Mar 2, 2002

The time is "long overdue" to disband the notion that going straight to the OR after school will harm your nursing abilities should you decide to move back to floor nursing. (although most folks never go back once they get a GOOD taste of the OR) You won't know if you like it until you've given it at least one good month! At that point, you should have a good grasp of team players' roles and responsibilities, how the patient flows through the periop process, the flow of an OR for the day, including acquisition of all equipment/supplies, setting up the room, assisting during the case (hopefully in the scrub role first) and turning the room over. If you are allowed to orient to scrubbing (insist on it) you should know basic sterilie technique, including gowning and gloving, how to move around the room without contaminating yourself, and general instrumentation for basic abdominal and gyne cases. That seems like a lot for one month but it comes together quickly. Don't stress yourself out about "how will I learn all the other specialties!" Build off the general abdominal cases. It will come naturally after that, I promise! Failure to be able to learn how to be an OR nurse is generally the result of a POOR orientation program! AORN has a book in it's library page called Core Competencies in the OR. Buy it and learn it! If you do, I guarantee, you will be one heck of a good OR nurse. My OR has incorporated this book into our orientation program and have not had a failure since! OR is all about TEAM-PLAY! You won't see this level of team play anywhere else in nursing. (and yes, I'm qualified to make that statement as I chose to be a float nurse right out of school so I could see which area of nursing I would like the most. Team play just isn't the same on nursing floors. I worked multiple areas for two years.) You must dig right in and show you are willing to help in whatever way you can, even if it is helping CLEAN the room, and you will score points quickly with your peers. Don't get defensive when suggestions are offered, even by the environmental service folks. A good unit secretary could run an OR! Listen to everyone and learn from them! I've heard all the "horror" stories about the "mean people" in the OR and have to laugh. Seems like I've met plenty of mean folks out on many a nursing floor in my time! Ha! In fact, with the lack of nurses today, and based on my discussions with other nursing floor managers, I can readily assure you that the floor nurses are dealing much more poorly with these issues than the OR. The OR has always had an element of stress to it so learning how to cope with stress is part of the job. It has also been proven that specialty area nurses such as those in the ER, ICU, and OR have the best critical thinking skills. You must be able to think and act quickly as surgical intervention opens up endless possibilities of patient responses. It's what makes it exciting. You will learn from each of these experiences and begin to recall and plan on how to deal with them as you care for subsequent patients. Working in the OR will afford you the BEST opportunity for learning about anatomy and physiology! You will do chart studies on all patients prior to going to the OR, in which you will need to know lab values and other diagnostic study results that assist you in the critical thinking skills necessary to prepare for the patient's surgical pathway. You will work with the latest technology imaginable. You will develop closer working relationships with physicians and peers than in any other area of nursing. You are highly respected when you show a determination to be the best you can be. You DO have contact with patients as so many are now managed surgically under regional anesthesia techniques. Your challenge is that you have a shorter window of opportunity to make your difference, but you still make one. These patients fear the worst: pain, possibility of learning they have cancer, loss of limb and/or other body parts, etc. Excellend pre-op interaction with patient and family are essential to the positive outcome for the patient. The list is endless! I love the OR! Over twenty years and still can't imagine doing anything else. WHEW!

WI-RN2be · Mar 3, 2002

Whew is right :)

Thank you so much. I am so looking forward to being done with school and actually start working as a nurse. I was so impressed with the staff in the OR Dept. I can't believe how much of a team effort there is. It really showed me what team work is all about for a positive outcome.

The OR was probably the first time (I do have another degree in the healthcare field) I have actually seen nurses enjoy what they do and working together. Yes that huge element of stress is there but they deal with it. I think it is also because they have a strong Manager that stands up for them. They see her putting out 110% and not sitting behind her desk all day and they feel respected and are willing to do the same for her.

Thank you again for your great words of wisdom.

Sarah

shodobe · Mar 10, 2002

I still think nurses who have spent time on the M/S floors are an asset.I can tell the ones who have and haven't done the deed.I do get tired of assuming one knows all the little things you need to know when you look at the patient's chart.Sometimes you can tell that they don't know all the ramifications around bad lab values or even looking at an x-ray.I know alot of this comes with just plain experience but I do get tired of telling some of them what to look for.Just my opinion. Mike

Yes, I spent a year on a M/S floor before going to the OR, 25 yrs now!:)

Marijke · Mar 23, 2002

I think a little life experience is the best prep for taking an OR job. Having some general nursing experience could be part of this life experience. The best asset however, is being a team player, a critical thinker and a good communicator. That combined with some basic technical insight is all you need.

I always believed any OR RN should have at least a couple of years general experience, but my ideas have changed during the last month. I am at present percepting a nursing student in his last month of nursing school and he has what is needed to become a good OR RN, without the couple of years experience. This while I have seen RN's come from the floor with many years of experience who fail misserable at becoming a good OR RN.

Marijke

Y2KRN · Mar 28, 2002

WI-RN2be,

Hello,

I am glad to hear that you think you have found your niche. I would suggest as the others to go for the gusto if you want to be an OR nurse. I actually was an Surgical Tech, when I went to nursing school and thought that I was going to be an OR nurse. Only to find out my niche was in the ER. I guess what I am saying is that you go with your gut instinct they are usually right on the money!

I feel like I grew up in the OR and I always visit this thread to see how the OR nurses are doing these days. You will learn a lot in the OR and team work is the true key!! The ER works as a team pretty well but, OR nurses and techs would not survive if they didn't work as a team. Good-luck to you!

Y2KRN

stevierae · Mar 28, 2002

Dear RN2be--

DO INSIST that they let you learn how to scrub, and scrub all areas, not just get stuck in one.

I was a corpsman in several areas before I went to OR tech school in the Navy, then went to nursing school and went straight back to the OR in 1981. Med surg in the Navy and in nursing school was enough, thank you very much.

But anyway--when I went back to the OR as a nurse, we were an almost all RN staff, and we could all fulfill both roles, and very well. If you did not know how to scrub a case, you spoke up, and backscrubbed with someone until you were proficient. This was a trauma hospital and you could NOT take call until you were proficient in all areas, both scrubbing and circulating.

These days, I see a trend toward charge nurses who are in charge of ENTIRE SPECIALTIES, yet have never scrubbed a case in that specialty, or in ANY area, for that matter--AND THEY HAVE NO INTENTION OF LEARNING TO DO SO. I have always felt that, unless you scrub yourself, you will not be able to anticipate the needs of your scrub. The circulator should be the most experienced person in the room, in both areas.

If you confine yourself to circulating ONLY, this is what happens:

You won't be able to help out a new scrub, or registry scrub, who is unfamiliar with the instrument trays in your O.R.

You will be clueless as to his or her need for a break, although you will make sure that someone gives YOU one.

If an instrument is missing, you will not be able to suggest something else that would do in a pinch.

Another bad trend: nurses who confine themselves to ONE SPECIALTY, and never learn anything else, so they panic when they get an emergency or another type of case in their room. Then everybody has to play "musical chairs" that is, rearrange their room assignments, to accomodate them. Don't let them stick you into, say, "eyes" or "urology," then wake up one day, 3 years down the road, and realize you've never done a crani or an orthopedic case.

Good luck to you!