MedSurg for 7 months transitioning to OR/PACU

Nurses General Nursing

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I am still a new grad with generally 7 months of MedSurg/Tele experience on the floor, 1:7/1:8 (nurse to patient ratio). I also had 2 months of training before hitting the floor (foley insertions, dressing changes, NG tubes, simulations/classes etc.). When i started the floor i was oriented for 5 weeks with different preceptors, then started my own assignment of 6 patients my 1st or 2nd week. Thereafter, I always had 7 patients, not including my new admits, sometimes i would have to chart on 8-9 patients because of my ER admits (I HAD TO BE QUICK). This all varied. our nurses normally take on 7-8 patients at once, sometimes 9. (we work day shift). By month 4 i Made 2 MED ERRORS within one week (this wrecked me) although it taught me soooo much i haven't made another error since (knock on wood!)and have been extremely careful !! I also thought that I always wanted to give my patients the best care possible!

as time went on, so far I have taken 8 patients once before, and these patients weren't simple. even with 7 patients sometimes i have critical labs, tube feeds, heparin ect.

I dont think my director/charge nurse ever thought that having to call a rapid sometimes at the same time of passing pain meds with 5 accu checks, sched meds at once really mattered. I do the best i can each and every day just to get through it. I prioritize as the day goes because things always change!

With all of this, I have never had so much stress, and lack of sleep due to anxiety dreading coming back into work not knowing what im going to get.The feeling never seemed to ever get better. I even work out regularly and do aerial to de-stress, because that's my passion. I had to start taking sleeping aids to help me rest the day before work because my mind would not shut off! This is when i started to think about leaving the floor to find something else...

Now (month 7), I just put in my 2 weeks because I was hired at an OR/PACU position in an outpatient surgical center. I am nervous but excited about this new nursing opportunity to come. I took on this position because it allows me to have a better schedule MON-FRI 7-3 pm (same pay) with me being able to do my passion job as an aerialist part-time.

ANY advice or thoughts about me doing this? I get alot of mixed feelings because everyone must find their own nitch in nursing but i just wanted to hear your thoughts? I want to grow as a nurse still and still follow my dream as an aerialist while im still young and still can do it! lol! I just want to do both and continue to grow in both! I have been an aerialist for 5 years performing in shows and just miss all of that! I just call myself flying nurse lol!

There is so much more to fill the gaps of this post but I wanted to get to the point! Basically, in 5 years i hope to work with for a transplant center, and eventually work behind the scenes in patient advocacy/transplant coordinator of some sort....

SORRY if this was too long to read:dead: but any thoughts/advice helps :geek:

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I love outpatient surgery. It is relatively easy and the hours are great. However it is taking care of basically healthy patients who are stable enough to tolerate a same day surgical procedure and go home 1 - 2 hours afterwards.

It is fast paced, you get good at starting IV's in pre-op. PACU is relatively easy, most patients come out of OR sitting up, on room air, chatting with their anesthesiologists or the OR nurse.

I honestly don't know if out patient surgery would be a good pathway towards working a transplant unit? Maybe do out patient surgery for a year or so then look into working in a transplant unit. Find out what their requirements are. You could work out patient a few years and transfer to in-patient acute care PACU to get more acute care nursing skills if that is what transplant units want.

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thank you so much! I was thinking of doing this kind of experience for a year or so since i can also get experience in both PACU/OR then transition back into a hospital when the time is right:) thanks so much for your input! Do you also think being a perdiem/PRN nurse doing something else in the right path would be good as well?

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thank you so much! I was thinking of doing this kind of experience for a year or so since i can also get experience in both PACU/OR then transition back into a hospital when the time is right thanks so much for your input! Do you also think being a perdiem/PRN nurse doing something else in the right path would be good as well?

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Do you mean work full time out patient surgery, plus working per diem somewhere else. Of course, yes, the more experience the better. I assume you are young and feel you can take the extra work on?

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Specializes in Critical Care; Cardiac; Professional Development.

Outpatient surgery is a very different specialty than working in a transplant unit. Honestly, it may harm your chances of breaking into that specialty, or at least make it take a little bit longer. You may wish to stay in acute care on a prn basis and work a couple of shifts a month.

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thank you so much for all your feedback! As I'm also continuing my research, i alos found that some nurses as they work in OR (periopertive settings) they get a CNOR/AORN certification to help boost their surgical specialty? maybe im understanding it wrong or many of you already have this credential, but I would like to return back to an acute care hospital eventually after working on this outpatient surgery center for about a year or so, do you believe this would also help me go back into an acute care hospital? thanks again you guys! this is helping me so much :)

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Specializes in OR, Nursing Professional Development.

Well, first for CNOR you need to have 2 years of experience and 2,400 hours of working as a perioperative nurse- and at least half of those hours need to be in the OR itself. Will it boost your resume? Yes. But working in an ASC split between 2 different areas, it may take longer to reach that experience requirement. CNOR is also maintained by CCI, not AORN. Credentialing programs and professional development opportunities for OR nurses

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Okay:) do you mean ASC by ambulatory surgical center? I was hired as full time at this facility so do you think it may take me longer than 2 years? If i do 2 years with gaining the experience and hours in PACU/OR I Can obtain the credentials correct? thank you!

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Specializes in OR, Nursing Professional Development.
Okay:) do you mean ASC by ambulatory surgical center? I was hired as full time at this facility so do you think it may take me longer than 2 years? If i do 2 years with gaining the experience and hours in PACU/OR I Can obtain the credentials correct? thank you!

You must meet both requirements, with 1200 of the 2400 hours in the OR itself. It will depend greatly on where you spend the bulk of your hours on when you will meet the requirement. And yes, ASC is ambulatory surgical center.

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I love that you are making your life fit your dreams by having the opportunity to work in a different setting and continue with your passion. You ought to experience that satisfaction. Good for you and good luck. Be blessed.

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