Ned!!

Specialties Travel

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Hello hello hello!!

ok I need your advice! I've been at the same assignment for 5 months. I love this city so much I don't want to leave just yet. Hospital said they would like me to join the team and they can put me in any Specialty I choose. Circulating nursing is the most lucrative bc of the on-call pay, so I think I may go for it because of that reason, and if I decide to travel in 2 years, it's a good specialty to have. I feel lucky that they are willing to train me in this, most hospitals want you to already have experience in whatever specialty you apply for, so I do feel blessed. But this hospital is super small community based hospital, they do General surgeries (chole, basic ortho,etc). No open hearts or anything big. Will this limit my options if I decide to travel in 1-2 years? Maybe it will open doors for me if I apply at other "big" hospitals that do open hearts, or will it not matter to them in your opinion??

When you say super small, do you mean 2 operating rooms? That is what I would mean. How many rooms do they have? Do they do neuro, totals, ENT, eyes, vascular? How long is the orientation they are offering and are they utilizing a nurse educator and AORN's training materials (called something like Periop 101)?

I'm not sure that random OR experience will help you get on an open heart team. It is much more likely to happen in house where they can evaluate your performance first hand. In my case, although I expressed an interest in open heart early in my training, the team did not express an immediate interest in me. After I got out of orientation, I was not on a specific specialty team but served as more of a general float. After the CVOR saw how I performed, particularly in crisis situations, I was invited to join them.

While my experience will not be everyone's, I don't think there is much doubt that a large teaching hospital will provide you a much better grounding and training in a specialty. From what I've observed, you are more likely to land in such a program without prior experience in that specialty. In other words, if you go for your current opportunity, you may miss out on more formal training in the future. In the case of my training at University of Maryland, it was 8 months scrub and circulate. The entire time, I was third person in the room - never left alone. While I don't believe this is the best way to learn, I mention it only to point out the resources that were thrown at me - 8 months with no value or productivity returned to the hospital.

I've certainly met good to great OR nurses that came from small hospital backgrounds, it is a harder route to follow than being spoon fed and having access to more services. As this is not really a travel question, you may be able to get a better variety of answers in the surgical forum - indeed if you browse the threads there, I'll bet you can find many that address this very question as it should be common for the graduating nurse.

As far as travel goes, surgery is a good specialty. Pays higher than most, day shift only. Downsides are that 12 hour jobs are scarce (except in open heart and even there). The big downside for many is call, but apparently you find that is a plus. A final downside is that you will not have as many locations available to you as say ER. ER or MS nurses can fill needs at very small hospitals and towns where the OR usually has to be a certain critical mass before needing contingent staff.

Oh, and yes, unless your hospital is super small, you should be able to travel with two years of experience. The first few assignments may come as quite a shock, particularly if your current hospital has poor practices and limited services. But if you survive them, you may thrive.

Small as in 4 operating rooms total. I know they do some ortho cases (ORIF, rotator cuff) but I am not so sure about knee replacements, eye surgery, vascular. Mainly gallbladder, ORIF, appendectomy, laminectomy type cases. I realized after I posted this that I need to wait at least a year anyhow bc of the agreement that I signed with my agency (shoot). So over the next few weeks I may apply at one of the big teaching hospitals here (Chicago) for Cardiac circulating. If nothing comes up, I will continue to travel for a year as a Stepdown nurse and make contact with folks at this hospital when it's almost time.

Thank you for responding Ned. I couldn't believe the pay package they told me I'd get for any call that I signed up for. Big bucks!! they said tgw training would be 6 months total and ID learn all areas (ortho, gyne, general) in those 6 months.

There are a lot of great hospitals in Chicago! Right out of school I interviewed at one that had an 18 month ICU internship and rotated you through something like 11 ICUs. I didn't get it but there was a mild economic downturn at the time and jobs for new grads was very tough. Plus I had high standards, I only wanted a major teaching hospital.

I'm curious about the call details you were quoted. In many places it is just 2 to 4 bucks an hour to "carry the beeper" and overtime if you get called in. In fact the call pay stops when you get called in. The best deal is in the San Francisco Bay area where you get half pay for being on call, and an additional time and a half if you are called in (effectively double time). Now that is big bucks!

It was 5/hr to carry the pager and time1/2 if you are called in.

That is about as low as it gets!

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