Floor to the OR?

[Reaz, BSN]

Hi there!

Sorry this is long, but I need a place to vent my thoughts.

So I just graduated nursing school 6 months ago and started on a surgical/tele floor at a big, trauma one level hospital. I know I am new (2 months now) and still have no idea what I am doing, but I do not like it AT ALL. I got the vibe in nursing school that bedside nursing was not for me. If I wanted to do anything at the bedside, I wanted ICU because I am a very detail oriented person who wanted to focus more attention on a smaller number of patients. However, I was talked into starting on a floor by a couple people so I could gain the basic nursing skills first. Well, I do not like it. I feel like I am running around, passing meds constantly, only focusing on tasks that need to get done versus actually understanding the patients story and plan. I think I am a really smart person, but I feel like an idiot on the floor. I make stupid mistakes, I feel like my preceptor thinks I am dumb (she is not encouraging in the slightest), and sometimes I leave feeling so defeated. Again, I know I am new and a lot of my feelings are normal as a new grad, however I really do not see myself enjoying this. I DREAD going to work.

OR is my PASSION. I have always been interested in the OR, since even before school. I don't know what it is, but I walk into an OR and I am just in the greatest mood. The reason I did not do OR nursing was because I immediately gravitated towards CRNA, and you need ICU experience for that, so I was planning to do ICU for 2-3 years, then go to school. However, I really do not even know if I want to do any bedside nursing at this point. The thought of staying at the bedside for that long makes me sad. The long hours, the weekends, the holidays, that really does bother me with bedside nursing too. I enjoy having every full weekend to myself to decompress from work, to see my friends/family, and forget about all that stress, and then relive it again during the normal work hours like everyone else does. In Chicago as a bedside nurse, you work every other weekend, every other holiday, thats it. The only thing that was pushing me towards CRNA was the money, and at this point, I have learned first hand that my happiness is more important than money. So now I am thinking about being an OR nurse. One. Patient. At. A time. Heck yes. I feel like you are a part of a team putting in all of your effort to focus on one patient at a time, and I love that. I know there is call, but depending on what the call schedule is like, I can probably deal with it. A M-F job with occasional weekends on call sounds like a dream to me.

My concern- I have heard that OR nursing is boring or just all documentation. Is this true?

Can you please tell me your experiences while working in the OR, or making the transition from the floor to the OR? Also, what is your call schedule like? I know all are different, but I want to get an idea as to what it can be. I live in Chicago, so a lot of big trauma 1 teaching hospitals, which means probably more call shifts.

Last thing. Is it too soon to transfer from the floor to the OR in the same hospital after only 6 months? I know it isn't that much experience, but I am so excited when I think about being in the OR. Waiting a year will be very hard.

[RN_amie_06]

Hi there! Don't lose hope just yet!

I have been an OR nurse for most of my nursing career, and I too had a calling for it before I got out of nursing school. I never wanted to work at the bedside. While I made the most of it, and looking back know it taught me a lot, it was just not for me. I also had considered CRNA, and left the OR for a year to go to the ICU for experience...hated every minute of it and went right back to circulating. The OR makes me happy, I don't know how to explain it to other people. It is one patient at a time, this is true. But, there is a very fast pace in the OR as far as turnover times between cases and such, so you definitely have to be prepared for that. I don't find the charting to be too much. I work for HCA and use Meditech, it takes me about 10 minutes to chart a case. Then, I am free during the case to watch and learn, and of course circulate the case ? We have a lot of fun in the OR, but that can vary depending on the staff!

As far as call, I have worked in hospitals with various call situations. If you work at a level 1 hospital, there is in house coverage 24/7. While you will still have call, it may not be as often or as strenuous. I have worked in rural hospitals where we had two teams, and did one week on, one week off (not called in often at all). In a typical hospital (for me), I had weekend call about once every six weekends. And shifts usually stagger, there may be the option to work 7-3, 9-5, 7-5, 12-12, etc...

Again, OR environments vary greatly. I did travel nursing and can vouch for that! But if you find yourself a good one, and most importantly a great group, it is an awesome place to work in my opinion!

[TinyDancer760, BSN]

When I graduated from nursing school I also thought I wanted to be a CRNA. I went straight to the ICU, worked hard, got my experience, then I married a soldier and ended up in a town hundreds of miles from any anesthesia schools. I am now an OR nurse and it was the best career move I could have made. Charting is the least of what I do. As a circulator I am responsible for the safety of everyone in the OR suite. Providing a safe environment of care for the patient and the team is a huge part of what I do. Removing hazards in the room, managing electrical cords, placement of equipment, patient positioning, all important things a circulator does. Knowing if a patient is medically safe to even have surgery is a big circulator responsibility too. I feel like more than anything, it is a risk management job. I think transferring after 6 months on the floor is perfectly appropriate. You gave it a fair shot, you hate it, don't dread going to work anymore. Transfer and do something you like doing.

[RN_amie_06]

Hi! I didn’t mean for it to sound like you should stay on the floor any longer, I’m sorry if it sounded like that ? I too only had about six months of floor nursing before I went to the OR. I would definitely start persuing open OR positions!

[Reaz, BSN]

5 hours ago, RN_amie_06 said:

Hi! I didn’t mean for it to sound like you should stay on the floor any longer, I’m sorry if it sounded like that ? I too only had about six months of floor nursing before I went to the OR. I would definitely start persuing open OR positions!

I didn’t you think sounded like that at all! I really enjoyed what you said:) Thank you for the info and advice!!

[Reaz, BSN]

6 hours ago, TinyDancer760 said:

When I graduated from nursing school I also thought I wanted to be a CRNA. I went straight to the ICU, worked hard, got my experience, then I married a soldier and ended up in a town hundreds of miles from any anesthesia schools. I am now an OR nurse and it was the best career move I could have made. Charting is the least of what I do. As a circulator I am responsible for the safety of everyone in the OR suite. Providing a safe environment of care for the patient and the team is a huge part of what I do. Removing hazards in the room, managing electrical cords, placement of equipment, patient positioning, all important things a circulator does. Knowing if a patient is medically safe to even have surgery is a big circulator responsibility too. I feel like more than anything, it is a risk management job. I think transferring after 6 months on the floor is perfectly appropriate. You gave it a fair shot, you hate it, don't dread going to work anymore. Transfer and do something you like doing.

Thank you so much:)) I appreciate you commenting! I think I will pursue transferring after 6 months.

[Zordon]

After nursing school, most of the jobs available to new grads dried up due to the housing crash. I ended up working the med surg floor for a little over 3 years. Finally an opening in the Operating Room opened and I was able to transfer. I say transfer out as soon as an opportunity opens up. If you find an opening after 3 months of working I say take it.

As far as working the weekends and holidays, you would still have to do your part. I work a weekend every 6 weeks, and take 2 night calls every month. Stress is still there but it's different in the OR.

[Reaz, BSN]

10 hours ago, Zordon said:

After nursing school, most of the jobs available to new grads dried up due to the housing crash. I ended up working the med surg floor for a little over 3 years. Finally an opening in the Operating Room opened and I was able to transfer. I say transfer out as soon as an opportunity opens up. If you find an opening after 3 months of working I say take it.

As far as working the weekends and holidays, you would still have to do your part. I work a weekend every 6 weeks, and take 2 night calls every month. Stress is still there but it's different in the OR.

Working every Xth number of weekends is fine with me as long as its better than every other weekend. Thanks for commenting! I am so tempted to look for a job at 3 months haha I just feel too bad leaving that early. I feel like I would be judged by everyone on my floor. I would still feel bad leaving after 6 months. I need to think about myself first though (I am a huge people pleaser- hence why I am a nurse lol).

[FurBabyMom, MSN, RN]

It is totally possible to move from the floor to the OR. I would, if possible, plan not to leave life as a floor nurse until you've reached a year on that unit. You never know what lies ahead, and a full year of experience is more desirable than less than that.

I've been in periop well over 5 years, and am at a point where I'm not sure if I want to stay in the OR or venture out. I just have to make up my mind about it. I have enough years in the OR that I can always come back. It's very different but that is why I love it. I love the clinical care, I love the patients, I love my coworkers...but I don't know the best way forward right now.

Some of these concerns - scheduling, call, etc., will only be revealed - at the earliest - in the interview process. Every facility is different in so many ways...

[ctsurgeryscrubrn]

@FurBabyMom What do you like most about the O.R.? If I wasn't in a dedicated scrub role on the CT team, I'm not sure that I could stay in the O.R. long-term.

[FurBabyMom, MSN, RN]

On 7/1/2019 at 1:00 PM, ctsurgeryscrubrn said:

@FurBabyMom What do you like most about the O.R.? If I wasn't in a dedicated scrub role on the CT team, I'm not sure that I could stay in the O.R. long-term.

Working where I work - there are no two days that are exactly the same. Life really is like a box of chocolates. Some days it's a scheduled day of something that seems benign. Others it's decidedly not that kind of day. I've long since learned that there is no such thing as a "routine" (insert any procedure here).

I like scrubbing but I also like circulating. It's a challenge to get patients and families to trust you based off a 5 minute interaction. It's also nice to be a bit of a grounding presence - helping someone feel comfortable when we're getting ready for induction or providing reassurance getting to talk to the patient's family during surgery.

One of the things about being a great circulator is being able to read a situation and know what will likely happen "if this happens, then that" or "if that happens, then this" is kind of a cool mental challenge. Admittedly, you get this as a scrub too - and are a better circulator if you scrub, but as a circulator you have to work on getting what might be needed and prioritizing what first. As the person with access to the phone/paging system - you learn when people "have it" under control, and when they don't (and you have to call in reinforcements). In general, you learn to keep it really under control yourself even when your instinctual response is otherwise (rude people, clueless people, etc).

I also like getting to help teach students and residents, and precepting new staff is (mostly) fun. I also like the fact that the surgeons I work with are so willing to teach us (the staff) what is going on...what they are doing, why, what an alternative might be, etc. In general, my coworkers (OR staff, surgeons, anesthesia) are part of what I really like about work.

[gingernursegirl, BSN, RN]

I will echo what others have said. I had my LPN and worked rehab for 6 months before finishing my RN. I felt much of what you have expressed in terms of running around passing meds. My preceptorship (capstone) was in ICU, and while I loved it and found it interesting, the ICU has a very different culture. My preceptor was extremely mean and so were the other nurses. I also wanted to do CRNA. I got hired into same day surgery and OR (I work pre-op, OR, PACU, and post-op...just not usually in the same shift ;)) at a small community hospital. It's great! I love circulating so much more than I expected! I originally got trained into same day first and all the other nurses were very discouraging about working in the OR and how I would hate it (I am cross-trained to all areas while the other nurses are not). But guess what? I love the OR! I feel like the OR is a game of freeze tag. When you're "free" you run around and do everything in a hurry (organized chaos, ha) and then when you "freeze" it is very chill. Hard to explain, but that's my best!