How long are orientations in your hospital?

crackerjack · Nov 8, 2006

I was a new grad in May and begain working in the OR then. We had scattered classes with unit and hospital orientation for about 8 weeks then the next 6 weeks were in AORN's periop 101 course that had us running back and forth between 2 hospitals. Since then we've had orientation to specialties for 3 weeks each. The problem I'm running into is that we are a very small hospital (8 OR rooms in the main and 4 at our one-day surgery center) so even when on a specific specialty we very often end up working cases on something else so everything is very scattered. Also, due to the same small nature, we are doing a set of specialties together (ortho/cysto or gen/plastics/gyn). The last 2 weeks I've been in vascular but have only done 2 vascular cases. All that said, we are expected to be on orientation until the first of the year before we begin taking buddy call and start working on our own during regular shifts. That's flexible with our level of proficiency, can be longer as needed. However, I've been in rooms by myself a good bit lately. There's usually someone I can call on for help, usually our charge nurse - when he can be found. When I've been totally uncomfortable with doing a case on my own, I've put my foot down and insisted I have a preceptor in the room. When I'm comfortable with things, I will do the case but make sure my charge knows if I need help I'll be yelling at him down the hall but usually I talk to one of my preceptors that has been really great to work with and let her know I may need some help and she's always more than happy to help. I'm not ashamed to ask one of our techs about instruments that seem to have vanished into thin air or whatever. Most of them are great and more than happy to show me where to find something and once I've had to find something in a crunch like that, I don't forget it and can get it on my own from then on. As long as it hasn't been moved, again. Things are forever moving.

The things I have the most trouble with are physicians or nurses that say for such and such we always do ___...and I'm good at doing what I'm told, then the next time I do what I'm told I discover *this* case is an exception and am either ridiculed for not asking/for assuming or for reading/not reading the preference cards. If I ask, I shouldn't have...if I follow the pick sheet, I shouldn't have...if i ask on the chance the preference cards is wrong, I should've read it.

All said though, I'm feeling more comfortable and sooner than I thought I ever would. I know I still have plenty to learn and it will come with time but it's nice to know all 6 names for something and be able to put my hands on it and know who might use it and why. None of which names are written on the pkg label, of course. I'm thankful that our orientation is expected to be long, there's already enough pressure from docs, techs, residents, attendings, med students of all flavors and such to learn, do, know, etc. I'm really trying to work, find and maintain my own routine for making sure everything gets done like it should and in a timely manner and am finding that as much as my preceptors want me to learn and do, they have a hard time letting me find it and end up stepping in and sharing the work so I have a tendancy to get my room together, get meds, see the patient and run it all by her as I'm doing things while letting them know as long as they are ok, I'm ok and I'll holler when/if I need help. More and more they're ok with it and have stuck to being an outside circulator of sorts. This has worked well in that I have help if needed but can function as independently as possible and learn to shoulder the work of the entire case and be able to work solo when orientation is over. January comes soon enough! I am getting unsolicited feedback from many that I'm doing great and advancing faster than they expected for a new grad (been a loooong time since they had new grads in the OR). Still, there are the days where I feel like I stepped into quicksand and wonder if I have been making any progress at all....those days are becoming fewer and further between though.

Ok, I know this rambled on much more than the question asked for, my apologies.