I may be transferring from ER to OR but should I be concerned about this?

suzanne4, RN · Jul 23, 2005

You should do just fine. Remember that you knew these guys when they were just beginning to spread their wings, and they normally don't forget it.

It may actually make things much easier for you. Many walk on eggshells around the physicians when they first start in the OR, and if you already know them and what they are like, you are ten steps ahead of the others.

Good luck to you and let us know how you like your first days............When do you start?

lisa bear rn · Jul 23, 2005

....I have posted before about finally being totally burned out from many years of ER nursing and I just now got the guts to DO something about it! I have no desire to work ICU (done that), or the floors, or Telemetry so the only area that interests me is the OR. I didn't have a rotation in OR when I was in school so I have NO IDEA what it's like. I have always had a curiosity about OR and I heard ours was in dire need of help (they're leaving for better pay elsewhere), so I put in a transfer request. Tonight the OR director called me and we talked for about 20 minutes about what they needed, they're willingness to train me but tired of nurses staying 3-6 months then leaving etc. He was very honest about the grievences of the nurses that have left regarding pay and on call schedule due to not enough staff to rotate it, etc. But he also mentioned more than once about how some surgeons treat the "especially female" OR staff and how several nurses have left because of it. He said they are trying to get something done about it but these certain drs. bring big bucks into the hospital (same ol story) so the fight for change will be rough. The negatives he honestly shared with me about the job don't make me NOT want to try it, as I'm am fried to a crisp doing the ER thing and desperately want something that will keep me interested but get me "away" from "people" (I sort of feel embarrassed to say it but it's true).
I have over 30yrs in nursing (started when I was 18), and have developed a very thick skin. I am not one for getting my feelings hurt easily. But then again, I have never worked in the OR setting with the big egos that come with it. I knew these 3 surgeons when they started practicing and one of them was my surgeon when I needed it. I don't know if familiarity will help or hurt me as I start "new" in the OR.
I AM SO READY to learn something new but alot of other nurses say I won't like it because there is no "patient/family interaction" in OR. If that's true....GREAT...I'm ready for that too. I'm so burned out from the "interaction" I've done in the past 3 decades anyway.
Sorry for the long rant...my mind is racing as I leave an area I have loved but now am sick of, and start another knowing nothing about it and feeling like a new grad.
Can anyone share some pearls of wisdom with me to make my transition easier???

I transfered from the ER to Pacu, kind of similar, not quite the or, but it may be an easier transistion for you. While I worked in the pacu I would go back in the OR while waiting to recover the patient, and the circ. nurse would show me things that the OR circulator has to learn. Something to think about.

I did start to love surgery, either Pacu or OR, there's something about anesthesia that has my curiosity. If you have been a nurse for 3 decades, you can do it, just remember change can be stressful at first, but be open to it and you will do fine.

Lisa, RN, BSN nurse for 4 years

shodobe · Jul 23, 2005

It would be nice if the OR manager would let you come up and shadow somone for a few days. It is hard sometmes to put into words all the twists and turns of the OR. Do a search in this forum to see if there have been other discussions on this subject, I know there has been. I have been in the OR for 28 years and wouldn't do anything else. Your many years of experience in the Ed would be beneficial but the job itself is very different from the ED. Patient contact is very much like the Ed because you see the patient for a short time and usually never see them again whereas on the floor you see the same patients night after night after night. I personally like the one time contact only, but we do get repeat patients. Good luck with your choice. Mike

Marie_LPN, RN, LPN, RN · Jul 23, 2005

He said they are trying to get something done about it but these certain drs. bring big bucks into the hospital (same ol story) so the fight for change will be rough.

Aaaaaah, so what they were really saying was the more money you bring into the hospital, the crappier you can treat the staff...(if they're allowing that to happen to the staff)

Can anyone share some pearls of wisdom with me to make my transition easier???

Get good shoes.

I've also seen a few nurses that keep index cards with them with anesthesia's preferences (i.e. some want you to hold the ET tube until it's taped down, others don't, etc.), charge numbers, things to take care of, when certain kinds of pre-op antibiotics should be started, etc.

jkmillnurse · Jul 23, 2005

I think if you can shadow some one for a day or so to get a feel for the place. It will also depend on what you do. Are you going to circulate or scrub? Do you want to be a first assist? And is it the ER or nursing in general that you are burned out on?

wayover20 · Jul 23, 2005

I think if you can shadow some one for a day or so to get a feel for the place. It will also depend on what you do. Are you going to circulate or scrub? Do you want to be a first assist? And is it the ER or nursing in general that you are burned out on?

GREAT responses all!!! Thanks for the encouragement! When the director and I talked last night, he did want me to spend a couple of days with them to see what 'they do' and see if it's really something I want to do. As far as I know, I'll be circulating. They do have a 5 month perioperative course also. I don't know anything about first assist. As far as my burn out... nursing is all I know and still love it and do an excellent job of caring for my patients. My present manager has said she does not want to lose me but has to respect my need to get out of the ED. I knew the time had come to get out when my frustration level reached an all time high, and I started to "notice" myself griping about EVERYTHING and hating the chaos and drama---which I used to revel in because it was challenging to be able to care for patients in that atmosphere. There is nothing like a busy ER and a part of me will miss it believe me.

It has taken a long time for me to accept the fact I need to find another arena to spend the last decade or so of my nursing career in. I don't like change so I kept trying other things thinking my attitude could change--including long vactions. The things about me that my coworkers would say like "you're so funny" or "I'm glad you're here today, you make the shift easier to get through" no longer are said. I'm grumpy and grouchy with a high frustration level at the simplest things. The "silly things" some people come to the ED for make me even more nuts than ever. And I KNOW it's the ED work because when I'm not there, I'm "myself" again. My daughter says when I call her from work that always I "sound mad". And that hurts because I'm a happy-go-lucky type of person. I was recently on 2 weeks vacation and 2 days before I was to return, I started to dread going back. THAT'S NOT RIGHT. I don't want to feel like that about my work.

I hope I'm not wrong about choosing OR, but like I told my best friend...."If I go there and I don't like it, it still won't be as bad as I feel right now staying here". I'll never know unless I try.

jkmillnurse · Jul 23, 2005

I think if you can shadow some one for a day or so to get a feel for the place. It will also depend on what you do. Are you going to circulate or scrub? Do you want to be a first assist? And is it the ER or nursing in general that you are burned out on?
GREAT responses all!!! Thanks for the encouragement! When the director and I talked last night, he did want me to spend a couple of days with them to see what 'they do' and see if it's really something I want to do. As far as I know, I'll be circulating. They do have a 5 month perioperative course also. I don't know anything about first assist. As far as my burn out... nursing is all I know and still love it and do an excellent job of caring for my patients. My present manager has said she does not want to lose me but has to respect my need to get out of the ED. I knew the time had come to get out when my frustration level reached an all time high, and I started to "notice" myself griping about EVERYTHING and hating the chaos and drama---which I used to revel in because it was challenging to be able to care for patients in that atmosphere. There is nothing like a busy ER and a part of me will miss it believe me.
It has taken a long time for me to accept the fact I need to find another arena to spend the last decade or so of my nursing career in. I don't like change so I kept trying other things thinking my attitude could change--including long vactions. The things about me that my coworkers would say like "you're so funny" or "I'm glad you're here today, you make the shift easier to get through" no longer are said. I'm grumpy and grouchy with a high frustration level at the simplest things. The "silly things" some people come to the ED for make me even more nuts than ever. And I KNOW it's the ED work because when I'm not there, I'm "myself" again. My daughter says when I call her from work that always I "sound mad". And that hurts because I'm a happy-go-lucky type of person. I was recently on 2 weeks vacation and 2 days before I was to return, I started to dread going back. THAT'S NOT RIGHT. I don't want to feel like that about my work.
I hope I'm not wrong about choosing OR, but like I told my best friend...."If I go there and I don't like it, it still won't be as bad as I feel right now staying here". I'll never know unless I try.

You might like the first assistant. To me circulating is kinda boring, but with being an FA, you actually do some surgery. I was planning on going to the floor when I graduate in Dec., but the people here are trying to get an OR Asst. position approved. That would get my foot in the door for the FA position.

shodobe · Jul 23, 2005

Every program has different ways to train. I would hope that you would be train not only to circ but also to scrub. Scrubbing is great and a break from circulating. Circulating isn't always boring, especially in a tough vascular or trauma situation. Where I work we all basically first assist because none of the surgeons get assists. The only thing I don't do, legally, is suture. But I could, no big deal. Get your basics down first then move on to things like FA or even an RNFA, which is basically the same thing. Give it a try, the OR can be a very challenging place. The best nurses in any hospital is always an OR RN, but then I am a little biased. Mike

carcha · Jul 24, 2005

What worries me wayover20 is that this director has warned you about specific problems and what sounds like quite serious problems. Poor working relations between nurses and surgeons and remember in the OR both teams work together for hours at a time, so if the atmosphere is fraught with tension it will be worst for you as you also have the stress of learning a new speciality, new staff, new methods and new routines. Also the on call concern is of huge importance, can you do a lot of on calls or do you have family committments?. I do not worry about your professional skills, I'm sure with your experience you'll be great. However it sounds like this director was honest and upfront. Personally I would stay where I am and tell the director to contact me when the problems he mentioned were sorted. It may be tough working in the ED but there you have seniority and you know the environment, in the or you will be almost a junior. Better the devil you know.....................................

wayover20 · Jul 24, 2005

What worries me wayover20 is that this director has warned you about specific problems and what sounds like quite serious problems. Poor working relations between nurses and surgeons and remember in the OR both teams work together for hours at a time, so if the atmosphere is fraught with tension it will be worst for you as you also have the stress of learning a new speciality, new staff, new methods and new routines. Also the on call concern is of huge importance, can you do a lot of on calls or do you have family committments?. I do not worry about your professional skills, I'm sure with your experience you'll be great. However it sounds like this director was honest and upfront. Personally I would stay where I am and tell the director to contact me when the problems he mentioned were sorted. It may be tough working in the ED but there you have seniority and you know the environment, in the or you will be almost a junior. Better the devil you know.....................................

While I've never had to take call in the ED, it's not something that worries me at this point. I'm the single mother of a 21yr old that's pretty much "on her own" in that she works part time and goes to college (taking pre-nursing courses no less) with her own car. I've never been married--except to my work. Like I've done in the ED, work any shift, weekends or weekdays no matter.

I am concerned about the way he described them. He stated that the surgeons were male chauvinists and made it known. The ED has it's fair share of them and I'm no shrinking violet believe me. Making a change like this is scarey enough and the added stress of knowing how they treat nurses is no help. But I don't know what else to do cuz I am totally done with ED work. If I leave the hospital and go agency, I still only know ED. I want out of that field. I HAVE to learn another skill and that's the area that interests me.

I'm pretty tough, and I think ....no, I'm READY to take the chance. I will focus on learning and take the jabs for what they are, words aimed at either "testing" me, annoying me or trying to break me. As long as they don't touch me in anger I think I can deal with it. The only man who EVER hit me in anger was my drill sargeant in boot camp who hit me over my helmetted head with a metal rod as he screamed at me. I looked straight ahead and just waited for it to end. I was made squad leader of the platoon. The only thing he broke me from was from constantly smiling!

Thanks for your advice CARCHA and believe me I considered not doing it because of that. But when I compare the positives to the negatives of making this change, I still come up with GO. The ED has poor management, awful staffing, etc etc. and I'm sick of it. I'll focus on learning all I can and if it works out that I can't take the treatment, then I'll take what I learned to another one. The meanest dr. can't keep me from learning.

JaneRNBSN · Aug 7, 2005

What worries me wayover20 is that this director has warned you about specific problems and what sounds like quite serious problems. Poor working relations between nurses and surgeons and remember in the OR both teams work together for hours at a time, so if the atmosphere is fraught with tension it will be worst for you as you also have the stress of learning a new speciality, new staff, new methods and new routines. Also the on call concern is of huge importance, can you do a lot of on calls or do you have family committments?. I do not worry about your professional skills, I'm sure with your experience you'll be great. However it sounds like this director was honest and upfront. Personally I would stay where I am and tell the director to contact me when the problems he mentioned were sorted. It may be tough working in the ED but there you have seniority and you know the environment, in the or you will be almost a junior. Better the devil you know.....................................

It worries me too! Something has to be done about how surgeons treat nurses and ORTs. After years of being humiliated and belittled in front of my collegues and taking call 7-8 days a month, I am totally burned out and retired after only 6 years as an RN. I have had it.