CVICU to OR?

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Hey everybody,

I have been in a CVICU for a little over a year and a half.  This was my first job out of school.  While I have adjusted for the most part and enjoy some aspects of my job, I knew from the start that I was not a fan of bedside.  I am doing my best to really give myself time on this unit to absorb, as there is so much to learn.  It has been a wonderful opportunity but soon I'd like to transition into another area.  While the grass isn't always greener, I feel ready to try a different path in this career.

I've thought about cath lab recently, but since I was younger I have always wanted to be an OR nurse.  Anyone switch from ICU or something similar to the OR? If so, how did it go?  I know they are quite different and both very stressful in their own way.  I would love to hear about anyone that has transitioned into the OR!  Thanks! 

 

 

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Specializes in OR, Nursing Professional Development.

I have not transitioned from another unit to the OR (came into the OR as a new grad) but I do help with facilitating the orientation of all of our new staff. 

The one big thing I will say seems to be the worst for those transitioning with nursing experience is that it is a whole new world and the orientation for an experienced nurse new to the specialty is identical to that of a new grad. What can be translated from inpatient floor nursing to the OR is minimal. A lot of nurses with experience elsewhere seem to have absurdly high expectations for themselves when coming to the OR. It’s not a bad thing they want to be successful but they need to be realistic about where they’re coming from and the new reality. There’s no equivalent of oh the new ICU nurse worked for years on the step down unit, so they won’t need as much orientation as a fresh grad. 

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I disagree with the notion that there is very little translatable between the ICU / stepdown / floor and the OR.  I do agree that it is a significant learning curve, especially if you will be learning to scrub. If you pursue this, to be successful, you will have to give yourself grace to learn - and it will take a year to feel comfortable. Transitioning from one role to another really does require a year before you will be a competent novice. Not that you can't be off orientation before then, but it takes until about a year before it all clicks.

As an ICU nurse, there are many medications you will be familiar with their use, indications/contraindications, etc., compared to nurses coming from another background or coming to the OR as a new grad. Many of the meds anesthesia typically gives will be meds you understand without much effort - paralytics, pressors.  The same can be said for management of an ET tube / vent / central access. You'll be familiar with just about every line / drain used in the OR (probably the only new thing would be cardiopulmonary bypass which is similar to ECMO and specifically is similar to VA ECMO but not 100% the same).

Nurses that come from the inpatient units are often a little better at communicating with patients / families - OR nurses who went straight to the OR tend to take a longer time to develop this skill (it comes, but with more effort than if it were already a skill).  Experienced nurses often understand prioritization, delegation and emergency situations better than OR nurses without other experience. Experienced nurses often - but not always - because it truly depends - understand better when and why we might "ignore a policy" (usually in the rare situation where an exemption applies).

With that said - almost anyone is teachable. Almost anything is teachable. Your attitude and interpersonal skills are the things which are hardest to correct - we can teach just about anyone how to do any specific concrete skill. Everyone who works at it - new grad or experienced RN - can be successful with the right orientation, right resources and right effort.

I went from neuro stepdown to the OR. Feel free to reach out with questions - shoot me a PM.

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On 9/6/2020 at 9:10 PM, FurBabyMom said:

Thank you so much for your thoughtful response! It is nice to hear this and I agree, I think attitude and drive to learn plays a large role in anyone's success in entering a new nursing field. I do have a few OR questions and will definitely PM you!  ? 

 

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On 9/6/2020 at 9:10 PM, FurBabyMom said:

For some reason it won't let me send a private message at this time! I guess my biggest question is I am unsure how to apply for an OR position seeing that almost every job opening requires two years experience.  Should I apply anyway? What are your thoughts!  Thank you so much.

 

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On 9/8/2020 at 12:16 AM, bhy7124 said:

 

Hmm.  Not sure why you couldn't send a PM earlier - I just tried and it looked like it would let me PM you.

You certainly can apply, the worst they can do is say no.  If they have a training program / take new to OR staff, they may redirect your application or encourage you to apply when those positions are posted. With that said, the economy is fairly uncertain right now.  Hospitals are trying to reduce costs and generally not liberally hiring.  I wouldn't be surprised if most places aren't taking as many new to OR staff at this time.  Right now is kind of a difficult and uncertain time for health care and the economy in general.

Does your CVTICU do bedside procedures?  As in, any times you all have to open chests / abdomens waiting for the OR to arrive, or do you all cannulate for VV ECMO? If you do any of those things, highlight that if you get a phone call.  If your unit does that but you haven't learned - ask to learn.

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Specializes in OR, Nursing Professional Development.
On 9/8/2020 at 12:16 AM, bhy7124 said:

For some reason it won't let me send a private message at this time! 

You need 15 posts before PMs are available 

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Specializes in ICU, Trauma, CCT,Emergency, Flight, OR Nursing.

I've been in the OR for almost 2 years now after having spent my whole 23yr career as a RN in ER/Trauma, All the ICUs and Flight nursing for the last 10 years. Rose Queen is spot on when she states that as experienced nurses we put so much pressure on ourselves being the novice in the OR. Having worked in the critical care environment for so long, I was used to making decisions and performing interventions etc barely without thinking about it. It essentially is going from being a Proficient (Benner) back to being a novice and trust me that can be really hard sometimes as one wants to prove oneself as being competent and knowledgeable , however that takes time. I can now circulate most run of the mill cases on my own and dare I say, reasonably competently. My specialty is neurosurgery and so have been scrubbing craniotomies and deep brain stimulation and peripheral nerve cases for the past 10 months. I am started to train as a scrub RN in spine now which is another big learning curve, but I am loving it and loving the challenge of learning new skills from my very supportive, knowledgeable and skilled OR colleagues. I think that has been key for me. Being in an accepting , encouraging and positive learning environment with preceptors and colleagues who enjoy teaching (Im also in a large academic hospital so the 'teaching' environment permeates everything ) Best of luck in your journey. I'd encourage you to go for it.

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