floor nursing vs. OR nursing

IBleedGreen · Dec 12, 2012

I'm in the same situation. New grad, almost done with probationary period, hate floor nursing or maybe just the unit I'm on. Enjoyed watching surgery in school. Wondering what surgery/ OR nursing is all about.

roser13, ASN, RN · Dec 12, 2012

I'm not an OR nurse but I can tell you a little. The Or nurse you describe was the "circulator" who is not scrubbed in to the procedure. There is also likely a "scrub" who is either a CST or a nurse and who does participate in the procedure by handing instruments or holding instruments. OR nurses must be prepared to stand for long periods of time scrubbed in. They must not mind only dealing with the patient as unconscious. In other words, if you enjoy personal interaction with your patients, you will not get much of that in the OR. The OR nurses that I know enjoy the fact that an MD is always in the room - there will never be life-threatening emergencies without a physician in charge.

Nurse ABC · Dec 13, 2012

You will do a lot of just getting stuff. You will have to get a lot of stuff quickly as the surgeon yells at you to hurry up. Some surgeons will expect you to know what they need without even telling you. You will be under pressure to gets pts in and out quickly. There's are a zillion different surgical instruments and supplies you have to learn and where they are located so when a surgeon had an issue or a life threatening problem going on he/she will expect you to find an item within seconds. Some surgeries go very fast so you're hustling to get all the computer documentation done while getting stuff for everyone which is stressful. Other times surgeries go on for literally hours so you sit there bored to death hoping someone will ask for something so you'll have something to do. Our hospital hires scrub techs who actually assist the surgeon with the surgery. My favorite part was interviewing the patient, bringing them back, and getting them prepped. The rest of the time I just felt like a gopher. You will either love it or hate it. You need a strong backbone that can handle stressful situations and surgeons yelling or complaining all the time. I don't love floor nursing but I like it ten times better than the OR! As a circulator you'll be responsible for setting the room up for surgery, interviewing the patient, making sure papers are signed and checklists are done, bringing the patient to the OR, helping anesthesia get the pt to sleep, transferring the pt on and off the table, prepping the pt, inserting foleys, positioning the pt, tie gowns for sterile people, getting drugs ready and giving them to scrub techs, hooking various cords up to equipment and getting it turned on and in the proper place, accepting specimens, labeling them, transporting them, all the computer documentation, counting instruments and sponges, getting suture and other supplies asked for ( there's always a lot), getting pt dressings applied, transporting them to post-op and giving report, helping clean the room and get it ready for the next surgery, etc. I'm sure I've missed things but that's a lot of it. The surgeries were neat to watch the first few times but after a while not so much. If that sounds like something you think you will like then try it. We always relieved each other for lunch and breaks. Some days we were forced to stay over and other days got to leave early. I found it very stressful and overwhelming most of the time. Orientation takes 6-9 months if that tells you how much there is to learn! Good luck!

BostonTerrierLover, BSN, RN · Dec 13, 2012

Just wanted to say, if you think the floor is rough, let me introduce you to a few colorful Surgeons who eat new RNs for breakfast, I'll pass (Surgery/OR Nurses are made of something tougher than Boston), just give me directions to your ER!

But if your really thinking about it, and interested, I wish you the best of luck in ALL your ventures. OR takes a special breed, and they have my utter respect:snurse:!!!

I'll be in the ER, Hope it works to your happiness,

-Boston(who was a floor nurse before Emergency Department)

somenurse · Dec 14, 2012

Yes, (as explained by Roser13 above)there is a difference between the scrub, who stands still for hours and hours, and the circulator. She's right, it can vary from hectic to boorrrinnng. But, yes, you can end up with doctors all up in your face hollering around.

You are often in one windowless room for the vast bulk of your day, which makes me antsy, personally, but, might suit you.

Various types of surgeries involve different things, too, like, i have a pal who loves assisting with ortho surgeries, and another who dreads helping in ortho surgeries. it can vary a lot, depending on what surgery you are doing.

There are other fields you might want to look over, if floor nursing isn't your favorite thing.

IV team can be fun, run all over the whole house, getting into everything that is going on, a lot of independence, no annoying coworkers (or for only brief interactions usually) and often, a fairly linear type of day. Also can be hectic, stressful, etc, but, imo, it's a bit less usually, than floor nursing. The paperwork is less, and little interaction with doctors yelling.

PACU, (recovery room) can be nice work, imo, especially if you are rotated throughout the other depts (pre-op, and discharge areas). Especially in outpatient surgery centers, you can find that often, their staff is cross-trained to work all 3 of those depts, which adds to the fun of the day, imo.

PACU can be hectic, but, imo, it's not the spread as far around/not as many types of interruptions, that floor nursing has. PACU has a nice lil rhythm to it, imo. The pt arrives unconscious, and you walk them out of the room later. sweet. Usually, in a PACU, you only have 2 patients or so, lotta teamwork, too, so if you have to, you can dedicate yoursefl to one pt who is in need.

Not a ton of paperwork compared to floor nursing. But, it is probably hard for a new RN to get into PACU, though. I almost always got my lunch break when i work PACUs. (rare in nursing, really)

Out patient surgery center PACUs,

are way less stessful, imo,

than in-house PACUs, for many reasons. Less paperwork, the surgeries are being done on stable, healthy pts usually, who are healthy enough to go home in a few hours. In house, you care for acutely ill patients, with multiple issues, and the surgeries you are recovering them from, can be intense.

The pre-op areas are more hectic than PACU, imo, but less than floor nursing is, imo. but, pre-op can be fun work, too, but, can be very fast paced. You take a person in their coat, and have them ready for OR in a certain number of minutes.

The discharge areas of an surgery center, is almost always pleasant work, a lot of patient teaching. Usually very low stress, imo, but, you do have to be able to manage all manner of post op equip (Always something new coming out of that OR!!) and field all kinds of various questions, which takes a lil while to learn all that.

Getting a job where you can rotate throughout the day amongst all 3, is great job, imo.

Another area you might not have thought of, that tends to be slower paced/not as scattered, are the Pain management depts of a hospital. Often, you spend the day assisting with numbing injections into spines, but, these are usually (hopefully) fairly brief procedures. There are other procedures and types of pts, too. but Hardly ever feel scattered there, imo, and not a ton of paperwork, and the docs don't seem as stressed out as some surgeons sometimes do.

A fascinating form of nursing, that i think is not so hectic,(moments of hectic, though) and not a lot of paperwork, either, and almost never ever feel scattered, is doing the IV sedates for Interventional Radiology, wow, that is some amazing stuff. But, unlikely a new RN would be hired, but, keep that one in mind for later on. You sit at head of bead, watching monitor, and giving the drugs to keep the patient properly sedated for usually brief but amazing procedures being done by the Dr and the techs, and occasionally, a 2nd RN is assisting them, too.

Big screens with the body under fluroscopy, fun to see.

Another less hectic dept, imo, is Cardiac rehab. Often these depts slightly resemble gyms, with health equipment. Lotta recovered cardiac patients walking on treadmills. When this dept is hectic, it is REALLY hectic, (like a pt has MI or stroke, but, this doesn't happen that often, really, the pts are screened and approved to participate) but, nice thing is, you just ship that pt to ER within minutes. Otherwise, that dept is pretty low stress, imo.

Neuro rehab depts have some of those same traits, but, is harder than cardiac rehab, imo. More lifting, and often, the patients have way way more ongoing medical issues to deal with.

Or, you could consider home health, which has it's own stressors, but, is often seen by many to be far less stressful than hospital nursing is. Some forms of HH you go home to home all day,

other ways to do HH is you spent entire shift at one home. Lotta pediatric HH out there, too. some of the HH patients can be very complex, vents, tube feeds, tubes of all kinds,

but, you've only got the one patient. Its nice to be able to all the extra things you often don't have time for, and you get to know the pt and the fam very well, too.

Some HH will take new RNs, and some won't.

I myself find ECF nursing to be very difficult, the sheer number of patients i am responsible for takes my breath away, and even just one "event" can blow your whole shift, but, there are some who think ECF nursing is less stressful than acute care.

I find ER or ICU way easier, for me, personally, to have only 2 patients in ICU, or 3 or 4 in ER (depending)

is always easier for ME personally, than a giant long line of patients, hee hee. I am in awe of my fellow nurses who CAN care for 20,30, or 40 patients, though. (i can't even keep them all straight, ha ha!!) But many nurses rock at it, and say the stresses are less or different than acute care.

Also,

keep in mind, some of the things you are finding overwhelming or difficult, will get a bit easier with practice, too.

Once you get some experience, you will have more options, i think.

anyway, hope this helps you get some more ideas of areas that *might* be less hectic/ less scattered for you.

SandraCVRN · Dec 15, 2012

To the OP, the OR as you know is completely different from the floor. In my opinion since you are already on the floor get your year or two then try to get into the OR.

Last fall when the OR had me pulling my hair out I thought I would go back to the floor, LOL, that lasted for 7 months. I went back to my sleeping patients with their families out in the waiting room. I had OPTIONS, most of my co-workers (the ones that have only worked in the or) only have the option to go to a different facility. Also, not all palces put up with yelling surgeons. If they do it, off to anger management class....of course if something hits the fan and there is just a reaction to that, well that's a different story.

I still go up to the floor every now and then, then I remember why I went back to the OR.

Good luck in whatever you decide.

To Jean, great post!!!