ICU to OR?

[Lucyinthesky]

I am an experienced ICU nurse (medical and surgical) and for the most part like my job but have been thinking about trying out another area in nursing, specifically the OR.

Pros to my current ICU job:

- I work with a great group of nurses and truly love the teamwork and support we give each other. I have never felt like I was on my own or didn't have someone I could ask for their opinion or help.

- I like that we have no residents or intensivists onsite and we are in total control of the assessment and interventions... but I love assisting with bedside procedures and working with the docs as a team

- I like caring for critical patients (RRT's, Codes, unstable pts)... maybe it's the adrenaline?! The more gtts, drains, and equipment the more interesting they are to me.

- I like that I learn something new almost every day that I work... there is always a new situation/diagnosis/med that I learn something from.

Cons to my current ICU job:

- every other weekend, every other holiday, flip flopping from nights to days

- caring for the same patient sometimes for months on end (some of our docs tend to keep them much longer than they need to be there and you feel like it is an LTAC instead of ICU). Seeing the same patients come back again and again with the same problem (I feel like I could recite their med list).

- having no ancillary staff on nights (no unit clerk, aid, pharmacy, transport, IV Team etc) in addition to having one less nurse according to our matrix... apparently patients aren't sick after 10:00pm as they all just go to sleep. On nights we draw all the labs, ABG's, do a 24 hour chart check, mix new gtts and antibiotics, give the baths, are the backup people for lab draws for the rest of the hospital, and the charge nurse has 1 to 2 patients always.

- Rarely do we get a true lunch or break (I know it is against the law) because it is so difficult to find someone to cover your patients with all of the extra responsibilities required. I usually grab my food and eat with my eyes at least on the monitors.

I am interested in OR nursing because:

- I would like to try something different, expand my skills and enjoy learning

- I loved my OR rotations in nsg school and tend to favor caring for surgical patients, and again I enjoy assisting with procedures... I even like doing sterile procedures (i.e. changing a central line dressing).

- the hours are more conducive to a family life and stable sleep patterns

I am nervous about OR nursing because:

- I am afraid of leaving a great working environment where teamwork is everything and going into an OR with some abrasive personalities and finding out I don't like it.

- I am afraid of losing my critical care skills which I happen to be proud of.

- Please, don't flame me but I have had people tell me it is a step down from critical care nursing and that I will be bored. I don't feel this way but having no OR experience how do I know if I'll like it?

any opinions/advice?

[PetiteOpRN]

I have seen RNs come from ICU/ER into OR, and it is very different. Most of them don't last long. They tend to be more interested in what the CRNA is doing than anticipating the surgeon's needs.

When a patient comes into the OR and needs a new IV, and the CRNA is struggling to find a viable vein, are you going to be able to go count instruments? Most ICU nurses want to grab an 18 gauge and give it a shot, which is not your role in the OR.

In a trauma center, OR is a 24-hour department too. There will be weekends and holidays. There may be rotating shifts.

The RN in most hospitals does not do much assisting. Most RNs in the OR (at least in my region of the US) do not even learn to scrub in. Some RNs learn to scrub and then it is a long, uphill battle towards becoming an assistant.

Shadow a circulator at your hospital for a few shifts (at least), because that is the role that nurses most often play in the OR.

Ask the surgeons who come through your ICU who they have assisting them in the OR. Is it an NP? PA? What kind of training do they have? Are they looking for someone in the forseeable future? Would they like a copy of your resume? Sometimes networking with the surgeons themselves is a more direct route toward actually assisting in the OR, depending on the facility.