I've gotten a couple of PMs from members asking about a job as an OR nurse. In the interests of sharing those questions with anyone interested in a career as an OR nurse, I thought I'd start a thread for those questions to be posted. I'll check in regularly and answer the ones I can, and I'm sure the other regulars here in the OR forum will share their knowledge as well.
I'm sorry if this is a repeat question, i tried to read through most of the threads... 3 questions-1. i know the no cellphone policy at work but yet everyone keeps on their body, outta site outta mind kind of thing.. how strict is that ? and can you wear a watch...lastly a coworker mentioned to me about getting tele certified if i want to be in the OR? how valid is that?...thank you
Specializes in OR, Nursing Professional Development.
I'm sorry if this is a repeat question, i tried to read through most of the threads... 3 questions-1. i know the no cellphone policy at work but yet everyone keeps on their body, outta site outta mind kind of thing.. how strict is that ? and can you wear a watch...lastly a coworker mentioned to me about getting tele certified if i want to be in the OR? how valid is that?...thank you
The cell phone thing is going to vary by facility. It's gotten a bit more relaxed at mine- some surgeons would rather be texted than paged when we're ready for them to come back and get started. Watches, again, may vary. Absolutely not if scrubbing. If circulating, my facility does allow provided that it is covered by the warm up jacket sleeve. Tele certification- again, dependent on the facility. My facility does not require any kind of tele certification or even ACLS for the nurses. The rationale is that we have the anesthesia providers in the room and immediately available who all have ACLS and PALS.
This thread has been most helpful for me and has helped with my final decision to pursue the OR. As a Med/Surg Neuro unit nurse I am tired of being weighed down with 6 pts, countless admissions, multiple rounding, and quite frankly I have been run into the ground. I understand that this is still bedside nursing but the stress level would pale in comparison to being on the floor.
My biggest fear would be dealing with the surgeons and hearing horror stories. I know myself well and if you yell at me or try to get physical it won't end well for either one of us. Trust and believe I will defend myself but hopefully it will not come to or go to that extreme
In addition, I see the long term positive outcome. At my current hospital they offer a 2 year program that allows external and internal RNs to enter into a new field/speciality, receive any certifications (BLS, ACLS, EKG etc) and an extensive orientation (which can last up to 3-6 months). Furthermore, I would like to go into travel nursing to allow myself to have more of a flexible schedule, travel (internationally and domestically), increase my income, and vary my experiences
I am very interested in getting into OR nursing. My current experience is about 1.5 years on a PCU floor. I have a few questions:
1. Is it worth getting a job in pre/post-op as a way to get a better foot in the door for an OR position? Would a pre/post-op experience put me in a better position than others who have only done bedside nursing? Or should I just stick to PCU bedside until an OR position opens up?
2. Is work steady in OR and pre/post-op? Are nurses often called off due to not enough surgeries scheduled and thus not able to get enough hours? Will I need to get a PRN job in another department to make up for called off hours? Please address pre-covid and current covid as it concerns this. With covid currently going on and a possible second wave coming, will OR and pre/post-op nursing be reliable for hours or should I wait until we have a vaccine for covid?
3. Are there any certificates or education I can obtain to make me a better candidate? I've heard of the AORN Periop 101 exam. Can I get access to study material now, as a bedside nurse? Am I able to take this exam as a bedside nurse? A lot of places want OR experience or CNOR certification in applicants. Also, can I take the CNOR test and become certified now as a bedside nurse?
4. Is there burnout in the OR? If yes, how does it compare to burnout in bedside?
Specializes in OR, Nursing Professional Development.
2 hours ago, RN8819 said:
Is it worth getting a job in pre/post-op as a way to get a better foot in the door for an OR position? Would a pre/post-op experience put me in a better position than others who have only done bedside nursing? Or should I just stick to PCU bedside until an OR position opens up?
Unless you’re looking at a position where you would float between pre/intra/post op nursing, less job hopping is going to be more beneficial. While the positions all fall under the umbrella of perioperative, they are distinct.
2 hours ago, RN8819 said:
Is work steady in OR and pre/post-op? Are nurses often called off due to not enough surgeries scheduled and thus not able to get enough hours? Will I need to get a PRN job in another department to make up for called off hours? Please address pre-covid and current covid as it concerns this. With covid currently going on and a possible second wave coming, will OR and pre/post-op nursing be reliable for hours or should I wait until we have a vaccine for covid?
There is no one size fits all answer. My facility is currently swamped to the point of offering incentive pay for extra hours. During COVID when electives were cancelled, most staff were redeployed to other areas as electives were cancelled. Is it possible we will see electives cancelled if COVID surges again? Absolutely. However, nothing is certain as to what will happen.
2 hours ago, RN8819 said:
Are there any certificates or education I can obtain to make me a better candidate? I've heard of the AORN Periop 101 exam. Can I get access to study material now, as a bedside nurse? Am I able to take this exam as a bedside nurse? A lot of places want OR experience or CNOR certification in applicants. Also, can I take the CNOR test and become certified now as a bedside nurse?
As someone with no OR experience, you are not eligible for the CNOR exam. Eligibility requires two years of experience and 2400 hours of intraoperative work. Periop 101 is beneficial if it includes clinical experience to support the didactic learning. Orientation will cover what is needed- many facilities use Periop 101 as part of orientation. It is also expensive- AORN charged $995 per seat in 2019, and it likely went up for 2020 (lower price per seat if buying many) and if you were to take it through a community college you would likely be paying more than that due to tuition and fees. Get it as part of employment instead.
2 hours ago, RN8819 said:
Is there burnout in the OR? If yes, how does it compare to burnout in bedside?
I am a med surg nurse for 1.5 years and looking for change (I am also a second career nurse). I have considered other specialties including ER, ICU, ambulatory care (I was also working per diem at a clinic for a few months before COVID) and OR but feel the OR may be best fit for scheduling wise ( more day shifts than nights) and the fact its just 1 patient at a time (I average 7 and even 8 patients prior to COVID). I am also interested in ambulatory surgery but would like to work a little bit longer in the hospital. Do you feel med surg is adequate enough preparation for OR? With a few years experience would I be able to transfer to different but related areas such as pre op, post op/PACU, or ambulatory surgery? What are advancement opportunities for RNs with primarily periop experience? The few OR nurses I have spoken with seem to enjoy OR and have been there for many years which leads me to believe turnover is relatively low in OR nursing but I want to know my options especially if I go for my MSN (I am not interested in CRNA). I recently applied to some periop fellowships and waiting to see if I would be considered. Thanks in advance!
Specializes in OR, Nursing Professional Development.
7 hours ago, thecareerchanger said:
Do you feel med surg is adequate enough preparation for OR?
OR is unlike any other specialty of nursing out there. No other specialty will prepare you for the OR. It’s why the orientation is so long. AORN’s position statement states “AORN believes the duration for orientation of a novice perioperative RN may be 6 to 12 months”. Now in some settings, that would be overkill (for example, single specialty positions where you would only work in that specific specialty) but in others it’s necessary.
8 hours ago, thecareerchanger said:
With a few years experience would I be able to transfer to different but related areas such as pre op, post op/PACU, or ambulatory surgery?
Generally, PACUs seem to prefer critical care experience. Some may even require it. However, there are no absolutes so it could be possible.
8 hours ago, thecareerchanger said:
What are advancement opportunities for RNs with primarily periop experience?
There’s the RNFA route. Alone, it’s not advanced practice provider like NP or CRNA, but it is an expanded role. I’ve worked with nurses who have gone on to become NPs and then returned as an employee of the surgeon practice as a first assist with the additional advanced practice provider duties in addition. There’s leadership and management- in my facility there are specialty coordinators who are responsible for a subset of surgeries (such as plastics, urology, General, etc) that are equivalent to the assistant nurse manager role in other units. And the nurse manager of the entire department that they report to. There’s also informatics- we use Epic which has a specific navigator for periop. And education (my current role) because surgery changes a lot. When I first came to the OR, bowel cases were almost exclusively an open procedure and robots didn’t exist. Now, laparoscopic and robotic are leading the way.
8 hours ago, thecareerchanger said:
The few OR nurses I have spoken with seem to enjoy OR and have been there for many years which leads me to believe turnover is relatively low in OR nursing
Anecdotally, that seems to run along generational divides. As with many other areas, the younger staff seem to want to keep changing things up, go on to advanced practice roles, etc. The “old guard” are the ones who never leave. I’ve been in the OR since the mid 2000s, and I am still nowhere near the top of the seniority list. Some of the nurses have been here longer than I’ve been alive! However, that’s definitely not true of younger nurses- we seem to get them for 5 years max.
Specializes in OR, Nursing Professional Development.
1 hour ago, Katya944 said:
Hey! Wanted to ask is the periop training always M-F 7-3? Or is there flexibility for 12 hour shifts during the fellowship?
That will be very facility dependent. We actually have a variety in my facilities. One area is strictly 0700-1530 M-F until the end of orientation when we incorporate off shift orientation. Another area is only open 0700-1730 and the majority of staff are hired for 10 hour shifts. They do orient on their 10 hours, with the day off for the week being the day with the least number of surgeries. Another area will orient day shift 0700-1530 but if hired for night shift will move to night shift halfway through on 12 hours.
Specializes in OR, Nursing Professional Development.
It's time to dust off this thread, because the inbox is starting to see some more action!
A member asked:
Quote
Hi there, I just finished a 4 month orientation but still feel inadequate. I become a deer in headlights and others I'm OK. I'm trying to find a way to navigate through this. I'm a list person but can't seem to get a routine down. I worry about where to put stuff, is a megadyne OK or use a grounding pad, worry about prep.
looking for advice to be more prepared and not worry so much.
Many thanks!
Let's break this down into a couple of points, starting with how you're feeling now that you're off orientation. Guess what? This is perfectly normal!
Completing orientation doesn't mean that you now know everything and will do the job perfectly. It means, just like passing NCLEX did, that you have been deemed to have the minimum competence required to function independently. And, you are going to make mistakes. What matters is that you learn from them. Remember, you are never alone in the OR- your scrub person, first assistant, surgeon, and other staff are resources that are already in the room with you. Your charge nurse and leadership team are resources that are only a phone call away.
General consensus is that it's going to take a solid year, if not two, before you truly feel comfortable in the OR. And, you will (or at least should) continue learning right up until the day you leave the OR. I still learn new things constantly.
If you're a list person, go ahead and make yourself a checklist- I had one of the orientees decide she needed one, so she made it as a badge buddy and shared it with her orientation class. You may find yourself referring to it less and less the more experience you gain, but if it helps now, the effort would be worth it.
Where to place things and how to prep- don't forget that the surgeon's preference card will have lots of valuable information. If, for some reason, this info isn't included on the preference, try using a small pocket sized notebook and make a section for each surgeon you work with. This is the one I carried around for years.
Megadyne vs. bovie pad... I have never used a Megadyne pad! Bovie pads (or, technically, return electrodes) have been the only thing I've worked with. You'll need to seek guidance from those resources above ?.
Key thing to keep in mind: now that you aren't with a preceptor, your routine is no longer being influenced by theirs. Find one that works for you! Just give yourself time to get there.
NutrixLA624 , BSN, RN
16 Posts
I'm sorry if this is a repeat question, i tried to read through most of the threads... 3 questions-1. i know the no cellphone policy at work but yet everyone keeps on their body, outta site outta mind kind of thing.. how strict is that ? and can you wear a watch...lastly a coworker mentioned to me about getting tele certified if i want to be in the OR? how valid is that?...thank you