ER to OR? Several questions - answers please!

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Warning! This is somewhat lengthy but I am looking for insight and opinions so please read on!

Some background info first:

I left a busy busy level 2 trauma center ED to take a local travel assignment in a much smaller ED. I was driving 70 miles to and from the trauma center(140 mile round trip), spending mucho on gas and basically losing money because of the drive. It was awesome experience, but it started to kill me financially. I am now working a 3-month assignment 2 miles from my home making great money, and the plan was to take this assignment and then when the assignment was complete, to sign on as a full time employee at the local hospital in the ED.

Then I ran into an old co-worker. Tonight she tells me she supervises a physician-owned surgicenter and loves it, and she wants me to come work with her. She's spunky and excited, and it sounds great. Day shift, 10-hr days, 4 days a week, no weekends or holidays. An opportunity to learn a new specialty, while still staying PRN at the trauma center (so maintaining the ER specialty/experience as well)... an opportunity to return to a normal sleep schedule as opposed to being full-time locally, yes, but working my choice of 3p-3a or 7p-7a, 3 shifts a week, rotating weekends and holidays.

So now I'm kind of torn. I am a "travel nurse" at the local hospital until august 12th, and then I have unofficially accepted a charge nurse nights position... but I'm presented with a great opportunity that part of me would like to look into.

With the price of gas, I hate to take another job where I will be commuting. The surgicenter is about 30 minutes from my home. The plus side to that is that 2-3 other nurses meet in MY home town as a central point and drive from the WalMart here to the surgicenter. So, I would end up driving 1-2 times a week. Not bad, and if I have to drive more than that I do have a pretty fuel-efficient SUV (Honda CRV). And, 30 minutes beats an hour and 10 minute commute that I *was* driving.

I guess all in all I am really leaning toward the surgicenter position, even though I haven't even been offered the job yet. I know in a way I'm getting ahead of myself, but my friend and former co-worker is the nurse in charge of the OR, so I think that the likelihood that I would be offered the job is pretty high. That said, I think the thing that I am most concerned about is "burning a bridge" at the local hospital that I have been offered a charge nurse position (on NIGHT shift, ugh) at.

Another factor that makes me want to take this job 30min away instead of the local one is that the local PRISON that my boyfriend is employed at is supposed to be closing in Feb 09. Which takes away all opportunity for work for HIM locally. Which means if we stayed in town after that, he would have to commute even farther than me to work... whereas if I worked at the surgicenter, we would have the option to relocate to a MUCH larger city, and he would have a lot of options.

So now that I've talked in circles this whole time, does anyone have insight to offer? What would you do? How do you handle this situation -- what do I say to the director of the ER/nurse manager who I have already told that I want to stay after my travel contract as a charge nurse? Help!!

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Specializes in Paramedic,ER, House Supervisor, OR, CVOR.

Once you go to the OR you will have a hard time going back to the ER. IMO. I have not worked in a Surgicenter though. Have heard it's a little like the ER in pace. I like the OR and am happy I changed from an ER nurse to an OR nurse. Now I just have to become a OR nurse that likes to Circulate.

Rod

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Once you go to the OR you will have a hard time going back to the ER. IMO. I have not worked in a Surgicenter though. Have heard it's a little like the ER in pace. I like the OR and am happy I changed from an ER nurse to an OR nurse. Now I just have to become a OR nurse that likes to Circulate.

Rod

Why do you say it would be hard going back to the ER?

I would be taking a position as a circulating RN. It sounds like something I'd enjoy. The surgicenter that I would be working at is private/MD-owned, so there are some nice perks, such as very inexpensive health insurance and profit-sharing bonuses.

I guess the only draw-back to working at the surgicenter is that it is 30-35min away from my home whereas the ER is 4-5min. But, all the other things (especially the opportunity to be on day shift) make up for that.

The main thing I'm stuck on is how to tell the ER nurse manager that I have decided to consider other options.

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Specializes in Paramedic,ER, House Supervisor, OR, CVOR.

I thought that too when someone told me. Can't explain fully but the having one patient at a time does figure into it a bit. Be sure and be honest and then you can feel good no matter what the outcome. Some will be happy that you have opportunities and others will be concerned on how your opportunities affect them.

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Specializes in OR.

If it were me I'd take the surgicenter position for the hours/shifts alone. I love working my set schedule. I have to take a call shift & weekend shift about once every 6-8 weeks and I am loving not doing every other weekend/holiday. In your case you wouldn't even have to worry about that. And the carpooling sounds great.

If you worked exclusively at the surgicenter without doing any per diem in the ER I think your would have a hard time going back to ER work after a period of time. But you can keep a per diem gig to maintain those skills.

No advice other than to just be honest with the ER Nurse Manager. Good luck:)

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Specializes in Nephrology, Cardiology, ER, ICU.

I'm going to be the dissenting voter here, it seems - lol! I would tell you to do what your heart tells you. If you want better hours then go for the surgicenter position. Can you shadow your friend at the surgicenter? That might give you a better idea of what the job entails.

I know that when I left the ER, I missed it terribly - still do 2 years later! Have kept my foot in the door by doing volunteer pre-hospital care.

Good luck - I agree difficult decision.

BTW Pontiac prison was on the news last night - there is a rally on Monday I believe.

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I was an ER nurse for 10 years, and never dreamed of leaving. We moved about two and a half years ago and there were no day or evening shifts available in the local ERs so I branched out. I happened upon an opening at a surgery center and started in the PACU and now am the nurse manager. I will never go back to the hospital!!!! The shifts are great, the patients are pleasant, the doctors are all easy to work with. The pace is right on track with all ERs I have worked in (level I&II trauma centers), but the acuity is no where near ER level obviously. Any chance you could shadow a nurse for a couple of days in the OR? The main thing I have learned is sterile field in the ER is NOT sterile field in the OR!! I am not a circulator, but have oriented and found my ER skills are best utilized in the Pre-op, PACU and procedure rooms. Best of luck in your decision!

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I'm going to be the dissenting voter here, it seems - lol! I would tell you to do what your heart tells you. If you want better hours then go for the surgicenter position. Can you shadow your friend at the surgicenter? That might give you a better idea of what the job entails.

I know that when I left the ER, I missed it terribly - still do 2 years later! Have kept my foot in the door by doing volunteer pre-hospital care.

Good luck - I agree difficult decision.

BTW Pontiac prison was on the news last night - there is a rally on Monday I believe.

I am going to shadow her... and I do miss the ER I originally left down there, but I am PRN and have been picking up hours... the drive is just WAY too much!

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Go where you will be HAPPY. Nursing in any form has it's challanges but, an unhappy nurse, is NEVER "good".

Choose for yourself, you mention a boyfriend....

NOT a husband, or fiancee Unless you have serious, committed, "date set" kind of plans with him, you must choose for yourself! Two of the young nurses that came into our OR in the past, engaged, broke them, and went on to other people in their lives with in months of starting in the OR.

Ok, be honest about the job offer. Thank the person who offered it, but tell them honestly that you have been offered a job that you are really excited about, that will offer a whole new knowledge base and you feel you have to accept the challange

to further your nursing base.

Ok, small surgi-centers...

have good and bad points...

Remember the Doctors own them for profit...your pay comes out of THEIR pocket,

so don't waste one supply, or be seen grabbing a quick cup of coffee, on their time!

Sure you might get free lunches, and ice cream day...

but what about pension plans, 401K, 403B, can you take vacation when you want, or only when they shut down? Who would cover you? What happens if you get sick or injured? What about raises? My friend has been at one over 3 years... "things are a little slow, our expenses have gone up, we can't afford to give raises or hire new people, so you will all have to work harder and cover that position till things are better, and maybe then we can talk about a raise....."

She is coming back to the hospital next week. No nights, weekends or call is fine... but there are other draw backs....

So look before you leap, do it with joy, and do what makes you happy and fulfilled as a nurse!

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Specializes in ED, ICU, PACU.

Truthfully, you just don't seem to thrilled about having to do nights & that would be your downfall, if you were to take the charge position.

Isn't there a clause in your travel contract that says you cannot work for them for a certain period of time after the contract? If not, you could always say that your agency may cause legal problems for you and them if you were to go staff. It might be the most gracious way to bow out and leave yourself open to return if the surgicenter doesn't work out.

Look at the PACU position as a way to expand your knowledge base as a nurse. At the very least, you would gain valuable experience which you could take back to ER nursing, if you chose to go back.

Personally, I am getting sick of the ER management ruining good care being given to patients. As charge, you may just find yourself in a position designed to be the fall guy for internal problems with the night shift & may just find yourself fired in a short time. As a traveler, you can avoid these type of politics, to a certain degree. As staff, you are right back in the middle of the politics. :twocents:

Good luck to you whatever you decide.

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Thank you EVERYONE for your input!

We discussed my "job offer" at the local ER, and I simply asked if the manager ever found out what my wage would be. Turns out she chose to announce that I was going to be "the new charge nurse" about 3-4 weeks ago, prior to ever discussing salary or benefits with me. I simply said that I would have to think about it, after finding out what they are offering hourly, and she seemed surprised. Unfortunately, I don't accept positions prior to talking about money, superficial as that may seem. :p

So, I'm still thinking about it. I was a little irritated that she felt the need to announce my taking the position prior to my taking the position, and now she has also divulged several personal (however petty) details of my personal life to several of the FT nurses. They have come to me and asked questions, mentioned, "Why would (she) tell us about (this)?" and I am wondering the same thing.

At this point I do NOT trust this person at all, and am really not thrilled about working for someone like that.

Will keep you all posted!

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Specializes in ED, ICU, PACU.
Thank you EVERYONE for your input!

We discussed my "job offer" at the local ER, and I simply asked if the manager ever found out what my wage would be. Turns out she chose to announce that I was going to be "the new charge nurse" about 3-4 weeks ago, prior to ever discussing salary or benefits with me. I simply said that I would have to think about it, after finding out what they are offering hourly, and she seemed surprised. Unfortunately, I don't accept positions prior to talking about money, superficial as that may seem. :p

So, I'm still thinking about it. I was a little irritated that she felt the need to announce my taking the position prior to my taking the position, and now she has also divulged several personal (however petty) details of my personal life to several of the FT nurses. They have come to me and asked questions, mentioned, "Why would (she) tell us about (this)?" and I am wondering the same thing.

At this point I do NOT trust this person at all, and am really not thrilled about working for someone like that.

Will keep you all posted!

All I can say and what you probably know already-GO WITH YOU GUT INSTINCT.

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