ICU to surgery center

Dang I was hoping someone else commented. I work in the outpatient Surgical Unit in a hospital, and recently interviewed at a Surgical center. I currently work 4 nine-hour shifts no holidays no weekends. I would say that this is the best schedule I have ever had, but there are downfalls.

1) Getting vacation time. Hard to trade when everyone has the same days off. I have to request my vacation time 6 months in advance and still don't always get it approved because there are other people wanting the same dates off.

2) Getting flexed. My hospital is non-union, so once the patients are done for the day, so are we. I work 4 days a week but I get paid sometimes like I work three.

3) Surgeons are jerks.

That being said, it will be a nice change! I would just make to sure to ask about benefits, getting flexed, and what the vacation schedule is like. I also have to say that my surgical patients are all surprisingly pleasant compared to working on the floor. I do not understand why they are so nice!

I come from an OR background, specifically cardiovascular/cardio-thoracic surgery. Outpatient vascular surgery with a salary sounds like a dream to me, but then again, I am a die-hard OR nurse. Outpatient surgery is just that, outpatient. You will have the most stable patients that are coming to surgery. You may also have a variety of surgical procedures that are quick to moderate in length, unlike lengthy vascular procedures that are often inpatient due to extensive comorbidities (TEVAR, bypasses etc.). No call for a specialty like this is practically unheard of. It is the reason I am no longer a CVOR nurse because your “on call-life” is usually very extensive and can cause you to be married to that job. So, in my eyes the pros and cons are:

PROS:

-SALARIED. Awesome. Period.

-No on-call or working late (hopefully), and this will probably ebb and flow because there may be days where you leave early. Similar to a call schedule. Like say Monday you leave an hour early because you are done with surgery for the day and Friday you stay an hour late because products or people or whatever is running behind. This could be looked at as a negative if you are salaried. Again, you will learn your time management (turnover, case length, prepping the OR at the beginning of the day etc. etc).

-Outpatient patients (the most stable surgical patient population)

-Specialty – no learning multiple surgical specialties. You will hopefully learn your surgeons inside and out (preference cards are golden, make or take notes of these!) within a couple of months of being there.

- No weekends, no holidays, no call. You have more of your life back..and if you have a family…or even if you don’t, this will eventually matter to you over time. Take advantage of these perks!

CONS:

-SURGEONS are like old baseball gloves, they generally don’t like change. They need to trust you to be competent. They are the captain of the OR, so do your best to always be attentive and always learning. They will be grouchy for awhile because you’re new and learning, which is totally normal. But if you learn their preferences and little idiosyncrasies they won’t want any other nurse doing their surgeries but you.

-Very specialized – If you love vascular surgeries this can be a pro. But being well rounded inside of the inpatient surgical realm is also helpful, especially with outpatient surgery.

-Outpatient surgery is usually fast paced: small, quick cases or moderate 1-2 hours max. This may not be the case with vascular, but this will include quick turnover times and constantly moving, but in a good way. I would say this is probably also a pro, considering what specialty you’re coming from.  

Personally, I loved outpatient surgery. I loved the pace, you will learn a lot. And changing specialties always gives me nausea and anxiety because it’s simply the unknown. So, I wish you the BEST of luck. Hopefully you’re going to love it!

On 8/7/2020 at 9:49 AM, BEERN19 said:

I’m a relatively newer nurse. I just reached my one year mark as an ICU nurse. I do feel burnt out and something very personal happened that really motivated to look elsewhere. I feel I needed a change for my wellbeing. I got offered an RN position in an outpatient surgery center primarily vascular procedures. It’s a salaried position, 4- 10 hour shifts no weekends, no call and they close for most major holidays. Anyone here work a similar schedule or come from a similar background? Change can be good but also very nervewracking. Some insight would be helpful. I’m a little iffy with a salaried job I’ve always been hourly. 

So I don’t know how helpful my opinion will be but I can definitely empathize with you moving from critical care nursing to the surgical side. I made a similar change....from ER nursing to pre-op/PACU and it’s been a fantastic change.  Critical care nursing whether in the ER or ICU can be traumatic over time if there is any type of trauma in your own life....surgical nursing is just SO different. I can spend time with my patients, actually take breaks, and not bring emotionally bring the trauma of work home with me.

Surgeons are not always nice but plenty of them are.....they do like things done a certain way.

There are lots of learning opportunities if you like that....I have learned a ton the last month or so.

You can take breaks! And it doesn’t take the physical toll on your body that critical care nursing does.

All in all, I think surgical nursing is pretty wonderful. Hopefully it will be a wonderful change for you too!