Changing specialties

  1. Hi all,
    My husband and I are considering traveling after I finish my NP degree. At the earliest it would be January 2019 but possibly March 2019. We are considering purchasing an RV, my husband would work while I stayed with our two small children. It would be for both the experience and the money.
    My husband has been an ICU nurse for approximately 9-10 years. He is considering transferring to the OR for the experience. We have researched and it looks like the OR makes a considerable amount more than the ICU specialty. He would need to transfer fairly soon in order to gain the experience to be able to travel in the next 1-1 1/2 years. Does anyone have any thoughts about this? My other question is whether or not you are required to take call as a traveler in the OR?
    Thanks so much for any help you can provide!!
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    About ck32

    Joined: Feb '11; Posts: 52; Likes: 7

    10 Comments

  3. by   NedRN
    Call is almost always a requirement. It is unlikely one and a half years in the OR will be adequate for traveling. Some internships are over one year. ICU and many other specialties are relatively easy to travel with and require little facility orientation, assuming a familiar pt population. OR is very difficult and requires a much longer unit orientation than any other specialty I can think of. Without the proper foundation of experience, adapting to a new hospital, new surgeons, new surgeries, a new location for the 10,000 items you need to retrieve quickly in surgeon time (far less than real time), different patient flow and interactions with pt locations pre and post op, surgeon preferences, staff preferences and so on would be overwhelming for a new traveler. If you can travel only to the easiest assignments like very small hospitals with a couple of rooms, or a free standing ambulatory surgery center, a year and a half would be OK for the average nurse. Those jobs are in the minority. But your ICU experience will help you in very small facilities as some of those are looking for an OR nurse that can also recover.
  4. by   ck32
    Thank you so much for sharing your experience!! This is similar to what I was thinking, however without actual travel experience, I wasn't sure. I truly appreciate the feedback:-)
  5. by   NedRN
    You can certainly check in the OR forum for more views on the topic, but I'm quite happy that I didn't travel until I had three years of experience. Mind you, I would have been fine after two years (everyone is different of course), but I wanted extra experience in CVOR. Which subspecialty as it happens now, often pays a premium for travelers and in any case is a huge resume enhancer.

    Over the past twenty years, I would say that ICU and OR are on an even keel for pay on average. It is true that OR has been "hot" for the last three years or so, but that fluctuating condition is not worth a shift by itself. If your husband wants a change and likes the OR, by all means. Otherwise, he is likely to make a similar amount as a traveler in the ICU over time. Both require extra training, abilities, and experience and so will pay more than say medsurg.
  6. by   CameToSlay
    There is no reason to belittle med-surg nurses. They have plenty of marketable abilities and experience, and are highly sought after by hospitals, since they could not run without inpatient units.

    I have seen some very high-pay med-surg assignments advertised lately.
  7. by   NedRN
    In no way did I belittle medsurg nurses. We were discussing compensation for travelers and I simply pointed out that generally nurses with more training get paid more. ICU>telemetry>medsurg for example. The number of medsurg nurses has been declining for years with a shift to DRGs, shorter hospital stays and home care, so it is clearly less in demand than other specialties.
  8. by   CameToSlay
    You should really stop talking about what you don't know. That would be like me saying "There's really less demand for OR nurses right now, because there are so many outpatient surgical centers". Is that what is going on in your specialty?

    The truth is that many med-surg units are full, but with sicker patients. There is plenty of demand for nurses who are capable of managing a 5-6 patient assignment on a med-surg floor, and they are often compensated very well for it. I have seen many assignments for 48 hour positions, offering some of the HIGHEST rates (of all) because of the overtime factor.

    Also, med-surg nurses have as much training as ICU or OR nurses. All travel positions require 1-2 years of experience in the field being applied for. There are plenty of hospitals hiring new grads directly into the OR or ICU, who can get a year or two of experience in the same time it takes a telemetry or med-surg nurse.
  9. by   NedRN
    Quote from CameToSlay
    You should really stop talking about what you don't know. That would be like me saying "There's really less demand for OR nurses right now, because there are so many outpatient surgical centers". Is that what is going on in your specialty?
    Well, yes and no. There certainly are more outpatient surgeries every year versus inpatient surgeries, at both hospitals and free standing surgery centers. But shifting surgeries from inpatient to out patient does not reduce the need for OR nurses. It does however, reduce the need for medsurg nurses.

    Quote from CameToSlay
    I have seen many assignments for 48 hour positions, offering some of the HIGHEST rates (of all) because of the overtime factor.
    You do realize that working 48 hours increases pay over 36 hours for all specialties? I'd be very surprised if you can find a 48 hour medsurg travel assignment that pays more than a 48 hour ICU assignment. Crisis rates can change things up, but crisis rates for medsurg are very rare outside of strikes and very troubled hospitals (like MLK in Los Angeles that shut down) and those of course bump up other specialties as well.

    Quote from CameToSlay
    Also, med-surg nurses have as much training as ICU or OR nurses. All travel positions require 1-2 years of experience in the field being applied for.
    You are conflating training and experience. Typical OR orientation is 9 months. Out of school, I applied for an ICU job in a large Chicago hospital that offered an 18 month internship. Many medsurg nurses get only one month. Depends on the size of the hospital of course for all specialties including medsurg.
  10. by   nursenat197
    Hi there! I just happened to see this. I'm not sure what the answer would be for the OR, but maybe a nurse recruiter from one of the travel nursing companies would be able to tell you how much experience facilities expect or require. I'm a med/surg/telemetry travel nurse who started after just one year of experience in a hospital. I'm sure it requires more for the OR, but maybe not as much as you'd expect. There are so many companies to choose from and you might already know this, but many nurses work for multiple companies. So I'd say it's worth it to just give one a call and ask that question to see what advice they might have; you might be surprised! Hope this helps and good luck!

    Natalie
  11. by   NedRN
    Actually, OR is "hot". So desperate facilities may take someone with less experience than optimal simply because they don't have other options. One thing unique about the OR is that if they don't have staff, they lose money they could have made on surgeries. They may also lose surgeons who leave for well staffed facilities. Absent staffing ratio union rules or state laws, other departments can simply increase the workload. Not possible to scrub and circulate in two rooms at once! Maybe in a MASH surgery tent, but at a huge cost to sterile technique that could never be tolerated in a first world OR.
  12. by   CameToSlay
    Telemetry and med surg are also "hot" (less egotistical perhaps) and nurses have no trouble finding assignments that pay very well.

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