Gastroenterology vs. OR

[brownladyRN]

I've been working in Med-Surg for about 6 months now. It's my first job as a nurse since graduating last spring. There is an opening in outpatient gastroenterology and OR (pre-op and circulating nurse). I would strongly like to move on from med surg (because i feel its not for me) but not sure which one I should apply to because both interest me. I would like to hear experiences from others and what to expect from both.

[Rose_Queen, BSN, MSN, RN]

I would highly recommend spending a day observing in both areas if possible. While there are some similarities, there are a lot of differences as well, not only in the distinct specialties but also in facilities.

I work in cardiothoracic surgery, so here's what my typical day is like:

0630: Clock in and report to my assigned room.

0630-0645: Get the room set up. This includes turning on monitors to display hemodynamics, setting up surgical equipment (suction, electrosurgical unit, endoscopic vein harvest equipment, etc. Review patient chart in computer system- check consents, read surgeon consult, check labs, etc). Obtain patient's cath lab films/CT/other required studies.

0645-0700: Interview patient in preop, confirm surgery/surgeon/allergies, explain what I'll be doing to get them ready in the OR. Ensure anesthesia has been out and obtained consent. Ensure preop antibiotics are available/started (some are given in OR later due to length of prep time in OR; others have longer infusion time and have to be started in preop). Transport patient to OR.

0700-0800: Assist patient in transferring to OR table. Attach monitoring leads, defib pads, etc. Assist anesthesia provider if necessary (usually not, as we have anesthesia techs assigned to each case). Count instruments, sponges, and sharps with scrub person. Insert foley after patient asleep. Do as much documentation as possible while anesthesia inserts monitoring lines. Position and prep patient for surgery.

0800-end of case: Continue documentation. Open supplies for field as needed. Check and give/retrieve necessary blood products and medications (perfusionist can't leave room- circulator must retrieve any additional needed medications). Apply dressings, assist in moving patient to bed and transport to ICU.

Okay, so that's incredibly oversimplified, but gives you a general idea. For some specialties where cases are much shorter, the process is lather, rinse, repeat over and over and over again- a surgeon with a day of lap choles can knock out 6-7 in a single 8-hour shift (no residents/students, and our surgeons can do a lap chole 20 min. skin to skin).

Each facility is going to be different based on what staffing patterns are like (nurses scrub and circulate? only circulate?), type of surgery, etc. There's also going to be a lot of differences in working environment. I work with a surgeon who pretty much ends each phone call by hanging up without saying good-bye (not to be rude, that's just the way he is- didn't learn social skills very well). Then we've got the surgeons who want us to call them by their first names and hang out with us at the bar vs. the ones who come from an older generation where it's Dr. So-and-so and socializing with the nursing staff is not the norm.

Here's an article another poster wrote about what OR nurses do: https://allnurses.com/general-nursing-discussion/what-do-operating-426443.html