Help! I may get fired!

[Siouxz2]

I am a new OR nurse (July 2006). Graduated from nursing school 6/06, and am 45 years old.

I had a meeting yesterday with our teacher practictioner about their "concerns" with my work and learning curve.

Apparently, I'm not "putting together" everything I know and running a room smoothly, in a timely matter. They say I'm relying too much on the surg techs, and that someone else has to do the tasks that I don't do. Let me state for the record that I am not lazy in the least, nor am I stupid! Unfortunately, though, all of their observations are right on the money.

I get myself so worked up about getting everything right that I freeze and forget everything I know when the time comes. Also, one little mistake will send me into a tailspin so that I can't do anything right afterwards, and the entire case just goes into the toilet. I can't seem to "think out of the box" when something goes wierd in a case.

They also said that I was inattentive to the field, which is patently untrue. I have a pretty severe hearing loss and am trying to get my hearing aids adjusted so that they work well in the OR. I have repeatedly told the people I work with to call me by name first so I know they're talking to me and then speak to me loudly. But it seems this is ticking a lot of people off, because they see my poor performance and probably think that my "hearing loss" is just an excuse (it is not).

Yesterday, they asked me if I was happy there. Every day, even on the bad days, I think to myself how fortunate I am to have such an amazing job. I don't want to have to leave, but I need to be realistic too.

Is this something I can work through, or is my personality such that I will never be a good OR nurse? I was also raised during the time when doctors were God, and you would never question or disagree with them. I know everybody says to "just suck it up," "never let them see you cry," "get a thicker skin," etc.

Unfortunatly, that is easier said than done. It is not how I am hard-wired. BTW, my patients love me. They find me very caring and comforting. It's the rest of the job I can't seem to get a grip on.

Sorry this is so long. I just don't know what to do. Thanks

[a32mag4mag]

Would it be possible for you to work in the pre-op or holding area? The patients could benefit from your caring andcomforting ways to prepare them for surgery. Good luck!

[subee, MSN, CRNA]

Would it be possible for you to work in the pre-op or holding area? The patients could benefit from your caring andcomforting ways to prepare them for surgery. Good luck!

Not bad ideas and you've only been in the OR for a year so you haven't lost a lot of skills yet. But from what I read of the OP's first comments, she's only worked in the OR and knows nothing else - I think this was new grad to the OR assignment. I can't think of another area where hearing is more important. Our electrical overload or grounding alarms are pretty dull, they go off rarely but they're just one example of the sounds you have to pick up (sometimes not always easy to find!) and react to in a room filled with artificial sounds. How can you know that you 'love" the OR when you haven't tried anything else? If you enjoy patient contact, go somewhere else where the patients are awake.

[anne74]

Honestly, I don't think the OR is your niche. It's not that you're not a competent nurse, you're just in the wrong area. And maybe it's not that you can't do OR, but it's the unit itself and the people there that you don't jive with.

I worked on a specialty high stress med/surg unit for my first nursing job and I was a disaster. It all started with my first preceptor who was terrible - constantly ridiculed me, yanked things out of my hand, told me I was too slow, etc. - she ruined my confidence right off the bat, making me so nervous I made MORE mistakes. I eventually got a new preceptor, which was slightly better, but I just never fit into that unit. Even the personalities there didn't fit me. So I transferred to a new unit within my hospital and I love it now. Everything just fits better, and it's pretty rare now when I make a mistake.

Sounds like your talents are with patient interaction, and it's not being put to good use in the OR with knocked out pts. You're not quitting - you've been there a whole year now, gave it a good shot, it probably wasn't a good match from the start so find somewhere else where you can thrive. And you will!

[rn/writer, RN]

I have only a slight hearing loss, but I still need to be able to see people speaking. Seems like working in an environment where people's mouths are covered by masks as your first nursing job is just asking for trouble.

I would suggest getting your nursing legs under you and your confidence built up before taking on such a challenge. This is in no way is a reflection on your intelligence, just an acknowledgment that it is difficult to compound demands and come out on top.

I'm thinking PACU might be a good place to spread your wings.

If not that, then there must be many other places where they could use a hard-working, intelligent, dedicated nurse. Find your niche. It's out there.

[sunflrz321]

What concerns me here is that your reported strengths as a nurse don't seem to match up with your current job- and when these don't match, neither you nor your manager wins. And I have a feeling that while you may have enjoyed your job thus far, you will enjoy it less and less as you worry more about upsetting or disappointing your bosses. Just think, if you like this position as much as you do, how much more will you love a position where you are exercising your strengths and gifts. (Don't worry, you will still be challenged, no matter where you go).

God gifted you with a certain set of strengths-don't be afraid to exercise those. And don't stay in your current position because you have to prove something to yourself or anyone else. In other words, don't fight your own nature, work with it.

[suzanne4, RN]

Just to add on to what others have said here:

The skills that you have learned will always belong to you. They will never be taken away or lost. You have excellent skills at setting up a sterile field, and that can be used in many more areas that you are aware of.

And true, it is hard to understand someone in a mask, even with good hearing. You may wish to look at an area like PACU, or think outside the box, such as special procedures, or even a GI lab. You would still be using many of your same skills, but the pressure would not be on you, and I think your comfort level would improve significantly. The GI lab does many of the same procedures that are done in the OR, patients are usually awake or slightly sedated, so that you can use more of your skills with them, etc.

I suggest that you try and shadow an RN in a couple of these areas and see if they are a better fit for you. Do not think of the OR as wasted time for you, but making you a better nurse and adding to your skill set.

You want an area where you can usually read lips, or at least be able to if there are issues with your hearing. Makes it easier on everyone, and then all are relaxed.

Please think over these suggestions that we have made and keep up posted as to what you decide to do.

Best of luck to you.

[HeatherB,CST]

Your story reminds me of a situation that I experienced in my previous career as a hairstylist. Hope it sheds some perspective for you.

For years, I was a stylist in a very high-end salon in Southern CA. I was very much at the top of my game, very well trained, talented, charged an arm and a leg, the whole bit. A few years ago, hubby and I decided to move to semi-rural NC to raise the kids and help support my brother who was very sick (he recently had a successful kidney/pancreas transplant..YAY for the OR!). After moving, I still wanted to do hair, and was offered a job managing a small chain "quick & cheap" type salon. I thought, of course, I can do this with my eyes closed, I am the best of the best, piece of cake!

BOY was I wrong. I was so poorly suited for that job, it made my head spin. I'm far from lazy, but this place ate me alive. My strengths were in building relationships with my clients, and attention to detail. No room for any of that in this salon, taking 15 minute appointments...all of a sudden my strengths became my weaknesses! I sheepishly admitted defeat after a few months and high-tailed it back to a high-end salon. I have a lot of respect for the hard work that those stylists did. I couldn't hack it, and I've styled magazine covers.

My point is this. What makes you good at one thing may make you not as good at another. If good rapport with patients is your strength, use it to its fullest advantage! I'm not trying to talk you out of the OR. Just know that you may find another part of the hospital that isn't such a struggle where you can THRIVE instead of just SURVIVE. You sound like a great nurse who is working hard to do as much as you can for your patients. You will do very well, I know. Best of luck to you!

Heather

Surgical Technology Student (and much more humble former hairstylist)

[GadgetRN71, ASN, RN]

There is an RN in our OR who has a hearing loss and he is now an RNFA so it can be done..very hard to do, but possible. Also, don't let anyone tell you that your personality is a "bad fit" for the OR...IMHO, the OR could use personalities that are a little less harsh. The freezing up thing may cause some problems but that could be due to the fact that you know people are riding you. In my opinion, don't give up just yet-sit down with your manager and figure out what you can do to get past your fear. And you know, you have a years experience under your belt, if you don't like your environment but still want to work in the OR, find a job somewhere else. OR people can be some of the most maladjusted, evil people out there but not all of us are like that. I'm pulling for you..Good Luck!

[rn/writer, RN]

To Siouxz2:

Care to give us an update? I hope things are better for you.

[Bluehair]

I agree with the OP, don't think of it as giving up. The training you have had so far can prove quite valuable elsewhere. You could always work in PACU or Same Day Surgery, now that you have an understanding what goes on 'in the back'. Other areas for consideration might be interventional radiology. I worked in a Cath Lab as a circulating nurse for the radiologists while they performed procedures in a sterile environment. Not quite so high paced as the OR, and the radiologists were really nice. Still had to set up sterile fields for the procedures, etc. but the patients were awake or had only a mild sedative.

I think it is relatively uncommon for a nurse to go into a specific field and stay there their entire career. When was the last time you met a nurse who worked in ICU for 20-30 years. Yes, they are out there, but they aren't nearly as common as ones that work there 2-4 years and move on to something else.

Good luck in whatever you decide to do!!!

[bklynborn]

Maybe they will be willing to work with you if you ask........don't give up. Ask for a mentor to help you get up to speed.............ask where and how you need to improve, then tell them you loveit there (if you do) and ask for help.

[smiles04]

DO I HAVE A STORY FOR YOU sorry not short. I have a friend 50 yrs old recently went to nursing school. She seemed nervous and unsure alot. Sweet as can be. Had the doctors are god syndrome too. She worked tele and lots of mistakes here and there. Stressed to the max. She just could not deal with the infinite details and people coming at her constantly. I kept telling her to go a route suitable for her. She thought of it as failure. She needed to recognize her weaknesses and successes. Well she got fired eventually and was out of work a while. Low and behold she found HOSPICE she loved it was compassionate. The schedule worked for her. The families love her and it is so positively rewarding. I know how you love surgery I did too in school but I have kid the oncall and shift didnt work for me. loved med surg but I hated the stress with tons of patients not enough of me for the patient load. You might really love disease management you talk to people on line or on the phone for insurance comp or clinics. What about home health its more relaxed or how bout couplet care with mom and baby. just your description says your stressed. Do you really want to live your life with this drama every day. Dont be afraid of something new. Good Luck. Weve all been there at one time or another.