ER to OR: the journey...

UnicornRN · Aug 31, 2014

I recently left the ER for the OR. The main reason I left was because the ER I worked in scheduled me for six 12-hour shifts in a row. I worked it for 9 months, and when I asked for my schedule to be broken up with a day off in the middle they said they couldn't accommodate me, so I transferred to the OR. The OR is a completely different world, just as the ER is completely different than the floor. My hospital has a PeriOperative RN training class, which includes Periop 101 from AORN (mostly online modules with a test at the end to help you learn about the AORN standards for the OR). In the OR, I may have 4-5 cases in a day, sometimes less. We see the patient awake for a few minutes, and everything else is done while they are sleeping. If you love teaching, and interacting with the patient and the family then the OR isn't really for you because there isn't much of that. My biggest challenge in the OR is the 'strong' personalities - and there are many versions of those. I don't find it to be as stressful as the ER, and you don't have the repeat drug seekers, the person that has had a sore toe for two weeks and decided today was the day it became an emergency, etc. We have trauma in the OR - gunshot wounds, car accidents - and it requires you to think on your feet, but it's not a constant adrenaline rush. If I were you I would try to do some job shadowing before jumping into the OR. It's an entirely different animal, and it's not for everyone.

sop832 · Sep 3, 2014

What is aesthetic nursing? Are you talking about in the OR, like reconstructive surgery, or pure cosmetic surgery?

target98765 · Sep 14, 2014

So, the OR is very technical, very little patient interaction and it can be super stressful. Throw in any revamping of the department (LEAN system, process improvement programs, etc) and you have a pretty grumpy OR staff. You have to be able to deal with all kinds of different personalities in the OR, because you are stuck with these people all day, which can make or break your day. You will potentially lose all your bedside nursing skills because they are not required in the OR as, most of the time anesthesia takes over the role of caring for the patient with some help with you. You will be lifting heavy instrument trays, moving anesthetized 200 plus pound patients and positioning them in various ways, you will have to know about keeping the patient safe while positioning as well as making sure you don't compromise the patient while they are in these positions so as not to cause nerve damage, compartment syndrome, etc. Then there are the OR techs who feel they "know" more than you do and are very critical of your performance in the OR, again, depending on your management, management will either listen to what these under educated people have to say when they are critiquing your skills or management will not listen to them being that these OR techs graduated from a one year OR tech program and have absolutely no credentials or certifications, but whatever on that one, but many of these OR techs were part of that "back to work" government program that trained single mother that were on government programs to enter the job market. Be prepared to be talked about when you are out of the room getting stuff because everyone in the room will talk about your shortfalls, and how much you suck as your job because most of the OR tech are buddies with the surgeons while you are relegated to be their gofer and just input the surgical record, once in a while you are needed, but not often. Good Luck.

Editorial Team / Admin · Sep 18, 2014

Many of the questions you ask will be very dependent on what a facility offers. Some facilities may offer the very structured orientation provided through AORN's PeriOp101. Others may have developed their own structured orientation. Still others may simply pair you with another nurse for several weeks. Some may have barely any orientation whatsoever.

Moving from the ER to the OR would be the same as any other change of specialty: apply for a job, wait for an offer, and accept or reject it. I highly recommend shadowing in the OR before making the decision to accept a position. Heck, you may even want to do it before you apply for a position. Many nurses who don't have some sort of OR experience don't really understand what we really do, and shadowing can give you a glimpse into not only that, but also to the environment of the particular OR you are shadowing in.