Can't find a happy medium

daVinciNurse · Dec 21, 2010

Next time you have someone questioning why a patient is not in the room on time, remind them you are the NURSE IN CHARGE OF YOUR OR, and you will bring your patient to the room when the room is READY to accept a pt. I had anesthesia on my case one day, and I finally looked at the anesthesia doc and said "If YOU were my pt, I would NOT bring you to the room either, as I don't have everything I need for our pt right now." He stopped, considered what I said, and finally admitted that I was right and he was wrong. He never gave me grief again. And that particular case, I was holding up as we were missing a certain guidewire (NONE in the dept, but someone was in radiology frantically searching for one to borrow). And don't you know, the FIRST thing the surgeon wanted was that very guidewire. It all comes down to pt. safety. Had another pt that I was being rushed to bring to the OR, and I, the circulating nurse, am the ONLY one who asked the pt when the last time she ate/drank--she'd had a FULL breakfast 5 hrs prior. Had to delay her another hour or 2 to keep her safe (it was NOT an emergency case). I was so ****** that day that anesthesia (MD) was on my case to get the pt to the OR, but had not fully assessed the pt. And of course, I didn't get any thank you or anything from that doc. But I know in my heart I DID THE RIGHT THING FOR MY PATIENT. The longer you are in the OR, the more experiences you have, the more efficient you will become. Hang in there, take a prn floor job if you really want to, but there is not enough $$ in the world to make me want to do something of that nature again!

canesdukegirl, BSN, RN · Dec 22, 2010

Dude, I totally get where you are coming from. I used to work on a busy med/surg floor as well. The OR is just a different beast. You have a different skill set to learn. You almost can't compare the two. While it may seem like you are only the "OR waitress", you actually do have to know a few things to be an effective OR nurse. For example, as a floor nurse, you know that a side effect of Toradol is bleeding, right? So when you hear the anesthesiologist ask the surgeon after a bloody prostatectomy case if he can give Toradol, you know that red flags should be going up. And you also know that when a pt is allergic to PCN, we should probably give clinda instead of Ancef. You also know that when the suction canister has reached 500ccs and no irrigation has been used, that MAAAAYBE it's time to do an ABG and get some blood in the room. You know from working on the floor that we should intubate an elderly pt who has sustained an intertrochanteric fx on the stretcher instead of moving them to the OR bed first. You also know which nerves will be compromised in certain positions, and will plan for that.

There is so much that goes on in the OR. Your floor experience will come in handy in ways that you have yet to realize. Have you scrubbed in yet? That's where the fun is! If you haven't, ask to do this. It is awesome to see anatomy right there in front of you in full color.

Hang in there. It will get better, and you will feel like a real nurse again, I promise.

Argo · Dec 23, 2010

if you just came to surgery a few months ago and are flying solo already then you probably are a little bit slower than a nurse with a few years under their belt. The more experience you get the quicker you will be at knowing that you are prepared for your next case. Typically if I have a few cases back to back I will get everything I need for those cases in the room before the first case. Typically we schedule our ORs with moderately similar cases TF each other. Take pride in finding out where everything in your OR is located from positioning equipment to supplies to instrumentation, this will make you that much faster and confident to take a patient to the OR. I pride myself in being able to turn rooms over for pretty much any TF case through preperation in 10 minutes or less with the right team. You should be waiting on anesthesia and snapping your fingers at them to hurry up. Look at the schedule a day or two in advance and know that you have all the supplies and equipment needed for your case that will happen the next day. You can blame your manager or whoever you want but YOU will be the one taking the heat. It is so much easier to just KNOW that you have it than to assume you have it and dont.....

With time you will get quicker and more knowledgable..... dont let them get you down, try to use it as constructive criticism and dont take it so personal...

solneeshka, BSN, RN · Jan 2, 2011

I don't think the OP's point is that she would like to be faster at turning rooms around; her point is that she doesn't really feel like a nurse anymore working in the OR. And I do know what you mean, OP. I worked the floor for a year and moved to the OR last summer. It is the opposite end of the universe from floor nursing, and I do miss it (even though I hated it). I solve the problem by doing just what you suggested - I pick up shifts on my old floor about twice a month. At the end of every single one of those shifts, I think to myself, "I am SO GLAD that I don't work here anymore!" But it does satisfy my need for acuity. I feel like it keeps me in touch with clinical nursing and more direct patient care, and my assessment skills. It also keeps me fresh if I ever decide to move out of the OR. As an OR nurse, I feel like I spend a lot of time on the computer and fetching supplies, and very little time with what is supposed to be my patient. They are two ends of an extreme, and I think I may need to look for a regular job that is somewhere in the middle. I've thought maybe dialysis nursing. Who knows? What a great field that we have so many options available to us with just one education!