Hospital OR job vs. hospital outpatient surgical center job?

CheesePotato, BSN, RN · Jun 1, 2012

Hi guys! I need some advice. I have no OR experience, but I am interested in transitioning to surgical nursing (a long shot I realize, lol). I have the opportunity to apply for both a hospital's inpatient OR as well as the same hospital's outpatient surgical facility. Which is better for a new OR nurse?
Ideally, I would like to transition to outpatient in the next few years, however, I am willing to try to get my feet wet inpatient if that's truly best. I will probably apply to both jobs, but just in case I end up with the option...which should I choose? Any advice is greatly appreciated. Thank you!

What is best? Honestly? Who can say. Everyone has their own preference of what they enjoy doing and experiencing.

Provided your hospital situation is similar to mine, it's all about acuity. Outpatient is more like local cases and little procedures and the hospital is...well...yeah, I don't mean to sound snooty saying "real surgery" but um....yeah...."real surgery."

::wrinkles nose:: Outpatient surgery.....meh. Not my cup of tea.

Also, there are different call requirements and hours to consider as well, i.e., Outpatient probably has no call requirements and is Monday - Friday with banker's hours, whereas Hospital has a call requirement, turn-around time requirement to boot and hours that may vary based upon department need, team specialty, etc.

Personally, I would apply for both (interview skills are always something worth practicing), get a feel for the department, gather your data and then make a decision.

Not sure this is what you were looking for in an answer.

Ever feel like you forgot to put on pants? Yeah...that's about where I am right now.

Editorial Team / Admin · Jun 1, 2012

I would apply for both, and ask for a shadow experience at both as well. You never know what you may learn, such as the workplace environment and which appeals to you more. It would also let you see what procedures are done where. Our outpatient surgery center isn't just local cases, although they do them. They also do a lot of hernias, lap choles, eyes, ortho video surgeries, etc. They also have to rotate through preop, OR, and PACU/postop, so that may be something to look into as well.

Personally, I would never be happy in an outpatient setting where it's all about get 'em in, get 'em out, get the next one in. I like my inpatient OHS job where yes, the longer cases do tend to get tedious at hour 7 or 8, but I love the complexity of my patients' health history and just the procedures themselves.

LovedRN, BSN, RN · Jun 2, 2012

Apply to both of them. You might learn that one fit you more than another.

Yeah, an outpatient center is like the post above said but I am just an observer in surgery center.

bonquilt · Jun 6, 2012

I think you would get a better experience base in the hospital OR. You can get a year or two in that OR, then maybe try outpatient. I've worked in both, and at this point in my career/life, I prefer ambulatory surgery centers (20+ years, over 50 yr. old). But I really think, as a new OR RN, you'd get a much better foundation in the hospital.

pacunuse2009 · Jun 6, 2012

You should shadow someone in Or first at both places to see if it is really what you want to do.

skiellach · Jun 6, 2012

As an "old" OR nurse, I firmly agree with the majority of the above responses. An OR nurse needs a solid foundation in aseptic technique relative to the inpatient operating room and experience with its myriad of procedures. Plus, most hospitals have one day surgery, similar to the outpatient facilities.

Once you feel familiar with the world of OR nursing and it becomes comfortable to you, you can then opt for a job in an outpatient facility. Best wishes.

anononurse · Jun 7, 2012

Good solid hospital experience first- you will be a much better nurse w/a strong & diverse hospital background. Then, outpatient later- and you can do "little" procedures such as Laparoscopies, Tonsillectomies, a large variety of Plastics, including Face/neck lifts, Abdominoplasties, Breast Reductions & Augmentations, & Liposuction; also Mastectomies, Hernias, a multitude of orthopedic surgery including the new partial knee replacements, general surgeries, some vascular cases, back surgeries, dental, GYN, Urology, ENT including corneal transplants, anterior & posterior vitrectomies, cataracts, & endoscopies, etc. to name just a few surgeries/procedures not considered "real". Also, epidural injections, pain clinics & blood transfusions. The age of your patients can be anywhere from 3 mos old to 100. No, there's no call, but you are expected to arrive anywhere between 6-7 a.m. & stay anywhere from 4-10 p.m. - depending on whether or not you have any 23 hr overnight patients & when the night staff can relieve you. Oh, and there will be add-on cases & surgeons running late & rides that can't pick up their family member until long after you're ready to leave. Having a critical care background is a plus, since you will need to be proficient in assessment skills, be able to recognize complications quickly & know when a patient may have to return to surgery. Oh, yes, you must also work independently & know what to do in a code situation w/out a hospital supervisor or respiratory dept. or ER doc to come to your rescue. (no, anesthesia does not hang around long after they turn the patient over to you, contrary to popular belief). Knowing how to manage an airway is a requirement. Flexibility is a must, b/c "bankers hours" & low acuity patients are a nice fantasy that administration may promise you but never happens in the real world- unless you work in the office. A surgery center is where you want the MOST skilled & experienced staff IMO, having worked both hospital & surgery centers for over 20 years. Good luck. :)

happygrandma3 · Jun 7, 2012

I agree w/you, anononurse! & I'd like to add that a surgery center is NOT the place to GET experience!! Where I work you MUST have a minimum of 5 yrs experience in whichever area you want to work, b/c we are NOT going to "train" you- we have neither the time nor the staff for that. As far as being a nurse administrator or manger, well you'd better know your stuff & be willing & able to jump into ANY area at a moment's notice- ESPECIALLY the OR!-- if you're weak, the staff & the surgeons will figure you out in no time. Good luck to you!! Good experienced managers are in short supply, so go for it!!