Bad fit for the OR?

[CTRN2679]

i'm a new, second-career nurse and having been working on a med-surg floor for 5 months. it is an awful fit for me and i have never been so miserable in my life. i having been considering or nursing but am very concerned about whether this is the right fit for me. i want to make a wise decision. i wanted to become an or nurse when i first began nursing school, but there was a lot of pressure for me to begin my career on a med-surg floor. i thought i could handle med-surg for a year, but it turns out i can't.

i am very stressed out working in med-surg. i'm somewhat shy and this job has made me realize that i'm not as much of a "people person" as i originally thought. i get a lot of anxiety about performing direct patient care, dealing with the psychosocial issues of the patient, and dealing with families. i enjoy the technical side of nursing and feel much more at ease with patients who are not very oriented or conscious. although the constant multi-tasking and overstimulation certainly is overwhelming at times, i do not believe this is the main cause of my anxiety. anyway, whatever the cause, it has gotten so out of hand that i have started anti-anxiety medication and see a psychiatric nurse regularly. i just reduced my hours to part time and hope this will improve my stress level.

i am concerned about becoming an or nurse because some nurses have told me that or nursing is much more stressful that med-surg nursing. ("why do you think there is a shortage of or nurses?" i was told. "it's much more stressful than med-surg!") what is your opinion of this? while i'm sure it is stressful, i imagine it is a different kind of stress, one that my personality may be better equipped to handle. i enjoy the thought of working as part of a team of colleagues, instead of performing direct patient care alone. while i've heard that surgeons can often be mean to or nurses, i feel that this is something i probably could deal with and would likely improve as i gained more experience.

so what are your thoughts? if i can't handle the stress of med-surg, should i not even consider going to the or? i would appreciate any advice and thank you in advance for your input.

[#1rnstudent]

If you want to do it bad enough then it won't matter what other people say about it. My advice to you would be to request an observation day in the OR or a job shadowing day. Many places offer this, some with pay and some without. I always knew I wanted to work in the OR before I even started nursing school and I made it happen. I had to do 4 years in a degree program and then while working on a surg floor I had to do a 6 course program plus consolidation time when that was over before I was able to work in the OR. Most places I have heard of or read about want either a nurse with 2 or more years experience in an OR or a nurse who finished an OR program (or both!). Observing would be a good place to start. Then if you really like it you can email the OR manager and ask them about what is required to work there and how you can get your foot in the door.

Just my humble 2 cents. :) Good luck!

[linda2097]

O.R. nursing and med-surg are both very stressful for the first year. After that, O.R. nursing is probably easier than med-surg. You have only one patient at a time, the patient is unconscious most of the time, you see the family for only about 5 minutes, and once you bring the patient to recovery, you never deal with the patient again.

But.... O.R. nursing is very fast-paced, surgeons and coworkers will verbally abuse you, and there is a ton of stuff to learn.

Bottom line.... ALL types of nursing are stressful, but O.R. nursing is better than floor nursing AFTER you know what you are doing.

By the way, I don't like the fact that you are taking meds to deal with your job. You should exercise instead. Exercise is the best drug. Exercise, take hot baths, get a cat, rent funny movies, sleep a lot, etc.

[fracturenurse]

Nursing is very stressful....

I worked on Med-Surg and I personally found it less stressful than the OR... That is just me though. The OR gets CRAZY, staff is crazy, surgeons are crazy, anesthesia is crazy...I just had an anesthesiologist say the other day that "something is wrong with the people who work in the OR." He was referring to all of us including himself. At first I was offended, and then I thought about it. You have to have a backbone in the OR, and you must stand up for yourself...You work your booty off in the OR. If you are looking for a less stressful job, I don't think the OR is the answer!

Having said that...I left the OR for a couple of years to try school nursing and came right back. I can't imagine being anywhere else. It's my love, and if you ask any of us on this forum they will tell you the same thing. It's just where we belong.

I have to agree with Linda, anti-anxiety drugs are NOT the answer. I had anxiety problems years ago in nursing school and tried all those meds. Linda is correct...Exercise is the answer, if you run or work out after a stressful day you will feel so much better. Why do you think I once ran a marathon...LOL?

Good luck in whatever you decide to do, and keep us updated!

[MJN2007]

I have not worked on a med-surg floor since nursing school. Therefore, I can't really compare the two. But, I've been in the OR for almost two years and LOVE it. It does get stressfull, but it is a different stress from what you might encounter on "the floors".

You may find that people who work in the OR have similar "strong" personalities and a somewhat warped sense of humor. This isn't a bad thing though! You don't know how well you may or may not fit until you get there.

If you shy away from dealing with patients and families, you can't avoid it in an OR. An OR nurse has to deal with very anxious patients/families and must develop a trusting relationship with them in a small amount of time. At my hospital, calling out to the family with updates during surgery is the OR nurses responsibility.

Also, remember that the OR nurse is the #1 patient advocate which requires you to have to stand up for your pt. This means you can't be afraid to challege the doc's you are working with. (when you develop great working relationships with them though, I often find that they respect what I have to say)

My advice is to go and shadow in the OR. See if it even feels right for you to be there. I knew from the second I stepped into the OR that it was "home." And if you love it but meet some challenges due to the learning curve, the best advice I can offer is to stick with it for at least a year. It's impossible to become a functioning OR nurse overnight.

Good luck!

[shaggie]

Working in the OR is a different kind of stress. I worked med-surg for many, many years as an LVN and then as an RN and always wanted to do OR nursing. I finally took the chance and went through an OR training course that my hospital offered. After two and a half years in the OR I can honestly say that I now truly love my job. You sound a lot like myself...I am also very technically oriented and enjoy the challenges of working in the OR. I also love the team work approach that is part of the OR. I know that I will always have back-up when needed.....something I did not have on the floor. If you want to try the OR then I say go for it! No harm in trying!

Good luck to you!

[SavannahSheila]

I have been a nurse for over 18 years. I have done work on the floors, units, dialysis and home health. I always wanted to try the OR since Nursing school. I was fortunate, at our hospital, to have an OR Residency for the Nurses. I would suggest you look around and see if a local hospital offers this program. The residency program is the way to go. They taught you for 6 months everything you need to function in the OR. Also, everyone says it will take 2 years to really feel comfortable in the OR setting. I agree with that. I have been in the OR for 9 years and don't have any plans to change. Good Luck.

[Heogog53]

I've been in the OR since 1982, more or less continuously. I tried a small company DON position-hated it. Tried being a private scrub-had to work in the office too- hated it.

The first two years are stressful- it is a completely different world than the rest of nursing. No matter how anxious you may feel about it at first, if you are an OR nurse, you'll know it. If you aren't, you'll also know it. There is no middle postion in regards to the OR.

I love it. I've had some illnesses recently me start to re-evaluate where else I could go in nursing. The answer was always the same; if I had to leave the OR, I have no idea where I would go.

Yah, the docs are nuts, the anesthesia crew is nuts, the cases go nuts, the staff is full of strong personalities, the families are anxious, and sometimes the patients are a bit on the looney toons side, but then, floor nursing can be much much worse in my opinion. You learn how to interface with all kids of nursing and other units, you learn what your docs want and have it on hand, you learn what the "natural" routine of an OR is. etc.

There are places(like my own) which takes nurses straight out of school for training.

I think shadowing an RN for a day(or perhaps a couple over a week-two weeks) will show you a good overview of how things do and don't work.

I've worked in five different OR's. Every single one of them shared the same issues; not enough instruments, patient delayed because of......, doctor have a PMS day and simply yelling at "you" because they are frustrated, turnoevers are fast enough, etc. And then you have days where the doc is fine, your cases go smoothly, communication is pretty good and life is good.

After awhile you begin to understand that most of the time, docs frustration at the case or other causes lead to the outburst(for most). It's mostly not personal at all.

You learn a lot of stuff every day, year in, year out. The technology is ever changing, as well as new procedures coming down the pike. If you work in a university/research setting, you may take part in developing prototypes for new and better instruments. You may also become one of the only nurses in your OR who know how to do a particular procedure, work equipment like a champ and are recognized for it and you end up teaching others.

Yes, it's a stange environment, but it's also a bizarre extended family, too.

As for being shy; after a certainamont of time, you get to know the staff/docs, etc and it's easier, because the staff and docs stay prety stable. The shy part is meeting the patient, asking your correct questions and helping them with with anxiety....but when a case goes well, there can be a great deal of talking and you can have a lot of fun with your family.

So, yes, I'd sure try it out. I was a critical care nurse- and a very good one before I went to the OR. I did feel stupid for the first two years, but one days everything just "clicked" into place. And though I have had to go through orientation and been the new kids at four more OR's, it's still the one part of nusring I love to do.

Pardon typos, just got off work and am tired.

[OR male nurse]

But.... O.R. nursing is very fast-paced, surgeons and coworkers will verbally abuse you, and there is a ton of stuff to learn.

LOL... this is an understatement. I put on my teflon scrubs every day when I come into the O.R.

[Carliestarling]

I have not worked on a med-surg floor since nursing school. Therefore, I can't really compare the two. But, I've been in the OR for almost two years and LOVE it. It does get stressfull, but it is a different stress from what you might encounter on "the floors".

You may find that people who work in the OR have similar "strong" personalities and a somewhat warped sense of humor. This isn't a bad thing though! You don't know how well you may or may not fit until you get there.

If you shy away from dealing with patients and families, you can't avoid it in an OR. An OR nurse has to deal with very anxious patients/families and must develop a trusting relationship with them in a small amount of time. At my hospital, calling out to the family with updates during surgery is the OR nurses responsibility.

Also, remember that the OR nurse is the #1 patient advocate which requires you to have to stand up for your pt. This means you can't be afraid to challege the doc's you are working with. (when you develop great working relationships with them though, I often find that they respect what I have to say)

My advice is to go and shadow in the OR. See if it even feels right for you to be there. I knew from the second I stepped into the OR that it was "home." And if you love it but meet some challenges due to the learning curve, the best advice I can offer is to stick with it for at least a year. It's impossible to become a functioning OR nurse overnight.

Good luck!

MJN, While I agree with most of your post, I have to chime in about the part about patient/family/nurse interactions on med-surg vs. OR. Since you haven't had to work med-surg since nursing school, maybe you forgot. LOL! As you say yourself, the OR nurse has to gain a pt/family trust in a very short amount of time, as opposed to the floor nurse who spends their entire shift with them. The floor nurse may have 5-6 patients, one needing blood, one on CBI, one needing straight-cathed, tube feedings, some needing labs, etc.. They also have the dreaded call light to deal with, but not always a CNA available. And invariably, there will always be at least one anxious or needy patient/family member who holds onto that light like its a set of worry beads. The Nurse has all these orders to carry out, and even as she walks by the anxious pt's room she's getting nasty looks from family members who think she should drop everything to get momma some ice or fluff her pillow--or more pain meds because its been almost an hour since she got her last dose. Things like that make floor nursing extremely frustrating, because we all want to make our patient's happy and there's usually not enough time or staff to do it. (Never mind all the customer service BS being handed down from admin--when we're staffed appropriately, customer satisfaction will improve--but I digress). Compare that to the brief interview/assessment the OR nurse does before anesthesia calms the pt with a little versed and we wheel them off. It's really much easier in that one respect. It's also one of the reasons I went back to the OR. Not the primary one, because I just love the OR, but it's a biggie in terms of making my life as a nurse better. At times, I truly feel bad for my fellow nurses who work the floors--they do so much, and get so little credit for it. There should be a National Med-Surg Nurses week, just to recognize the importance of this field of nursing, and to show appreciation for a truly underrated group of professionals.

I am not saying this to be disagreeable or anything, I just figured I'd remiind you (and any other nurses lucky enough to be in the OR and away from the floors) what it's like out there. The OP states that dealing with pt's and their families one to one is something he is not comfortable with. Well, when comparing OR nurse/pt interaction to the floors nurse/pt interaction. The OR Nurse is clearly at an advantage. Now, dealing with crazy co-workers in the OR is another story. )

[Heogog53]

The OR staff, anesthesia and docs become a family of sorts, sometimes the most dysfunctional group you'll ever meet, and sometimes the funniest folks in the world.

One thing about being in the OR, is that after a period of time, you start to recognize everyone behind their masks, then you learn to read eyes, and recognize anyone from the way their scrubs fit. You notice that the jokes that are made include you, and that you start to work closely with a bunch of docs or anesthesia personnel. The OR, that secret world behind the double doors, becomes familiar to you and you discover all the interesting nooks and crannies where bits of equipment, disposable supplies, sometimes instruments are cached.

I'd say, go for the OR. Depending on the size of the OR, you may actually have a bit of time to get to know your patient and families. If you are walking past pre-op and see some patient shivering on a guerney, or slipping off the bottom of it, you'll probably ask if you can get a warm blanket or help move the patient back up and be more comfortable; that speaks volumes to the people who have been moved to pre-op and are now waiting, without their family members to offer comfort. Once you find your "sea legs", it's a comfortable place to work out of, because we outnumber the patients/families, so you're an insider looking out, rather than being a floor nurse who is always outnumbered and feels like the outsider looking in(at least, to my way of thinking).

Good luck.