Change specialties? learn more? feel dumb!?

Editorial Team / Admin · Aug 8, 2020

9 hours ago, RN1.618 said:
I feel like being here has really limited my knowledge of some of the basics.

The first thing I'll say is something I said on another thread:

On 8/3/2020 at 9:12 AM, Rose_Queen said:
Are there skills you use on a med surg floor you won’t use in the OR? Absolutely. Will you learn skills the nurses on a med surg floor don’t know? Absolutely.
Every specialty is going to use skills specific to it and not use others that you may have learned in nursing school. That doesn’t make any specialty greater or less than another.

9 hours ago, RN1.618 said:
for the most part I am doing well and learning more each day. There is a cloud that hangs over me though. Some days are good and I feel useful but, most days I feel like I just get supplies and help transfer patients. I really feel dumb some days too

I'll be honest and say even those of us who have been doing this for years have those days too.

9 hours ago, RN1.618 said:
Especially while helping anesthesia. I don't know the equipment to help out there most times. They will mention things to me about meds or physiology and expect me to know and I don't.

Did your orientation include either Periop101 from AORN or dedicated time learning about anesthesia? If not, this may be something you'll have to learn on your own. See if your unit educator/manager has a copy of Alexander's Care of the Patient in Surgery- there will be information about anesthesia in there. This is something you can also reach out to your educator about and request additional information.

9 hours ago, RN1.618 said:
I've done 8 IV's in my one year as a nurse, 5 of which were successful.

Guess what? I've been a nurse in the OR for 15 years and have never started an IV! Don't beat yourself up on something you aren't seeing frequently enough to keep your skills up on.

9 hours ago, RN1.618 said:
f I was in a different department would that help? I feel like I can do and learn more somewhere else. I feel so inadequate most days and I want to be knowledgeable in my field.

It may or it may not. When you go to a new job and especially a new specialty, the learning curve is steep. This is especially true of OR nursing because you barely get any exposure (if any) to it in nursing school.

Final thought:

OR is truly a different world from what you learned in nursing school and what you may have experienced in any other specialty. It takes a year to even feel comfortable; it may take another to actually feel competent.

RN1.618, BSN, RN · Aug 8, 2020

Thank you for the insight. I did have periop 101 but, the section on anesthesia was brief. I would appreciate a more in depth description, especially with the meds. I definitely can look these things up and I will. I truly want to be aware of all that’s going on around me or as much as possible. I appreciate your advice and it will help me through my doubtful days. ?

scrubulator · Aug 14, 2020

I too went straight into OR from school. It was somewhere I wanted to be. That being said, it's really hard and some days I hated going to work. Theres a HUGE learning curve. I assure you, we all have felt that way and we get it. It's only a year in, give yourself grace.

My advice: its OK not to know. You're a year in, make sure you know what YOU are doing before you venture out and figure out what anesthesia is doing.

I also suggest to slowly build relationships with the doctors. Side rant:: SOME Anesthesia personal like help upon intubation so go up there and offer to help. Hand them the tubing once they see the vocal cords since they need to focus on the visualization, withdraw the stylet, or give them the ET tubing . Some won't like it but I know some who LOVE it when we help, just ask.

Thats how you build relationships, little things. The ones you eventually feel comfortable around, ask them your burning questions. They most likely won't judge. Also it may just be me, but I think CRNAs do a beautiful job explaining things in layman terms. Second side rant: I guarantee you 90% of the people exchanging "glances" will forget what you said. I've heard my fair share of stupid, but you remember the "stupid stuff" more than "who said the stupid stuff".

On 8/8/2020 at 12:58 AM, RN1.618 said:
I don't have the opportunity to use much critical thinking here and it bothers me. Some

^^^^^ I get it. It may not seem like critical thinking cuz thats not what we were taught in school but it still counts. Again, you're a year in. You gotta have a sturdy foundation, take this time to build it. After 2 years, maybe go into cardiac or trauma surgery. Now thats critical thinking. Get certified. Hell, maybe do travel nursing and see if you can swim in new environments.

RickyRescueRN, BSN, RN · Aug 17, 2020

Have you thought about doing ICU for a year or two , or even having a Per Diem job in the ICU ? That will help you immensely with knowledge on various analgesic, sedative and paralytic agents as well as hemodynamic monitoring and physiology in critical care. I spent the first 23 years of my career working in various ICU settings, Trauma/ED and as a Flight Nurse. Been in the OR over a year now and often find that all that experience benefits me a lot .

RN1.618, BSN, RN · Aug 17, 2020

I have considered it. My hospital offers a fellowship for critical care nurses. I’d have to start all over again, like a brand new nurse. I went through a fellowship for the OR for 6 mo and I would have to do the same for ICU. I’d be willing to do it if it would make me a more well versed nurse. Very scary though. ICU seems to be a floor that’s very involved. I would love to be able to use critical thinking skills. How would I know if ICU is for me though?