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I've left the OR

This is an update to my previous post. So I was orienting in the outpatient surgery center before I was to go to my permanent home, major OR, when I had an epiphany- I don't want to work in the OR. Now don't get me wrong. I love surgery. It's the coolest thing in the world, but I was disappointed with the responsibilities of the nurse. Don't get me wrong I am not downgrading the OR nurse or anything but I just really missed the hands on approach to nursing- passing medications, giving basic care, doing physical assessments etc. I also realized that I do not have the personality that it takes to be a good circulator. I don't feel that I am assertive enough to tell someone that they have broken sterile technique. To insist to an irate doctor that the policies must be enforced, etc. I was also very disappointed with the working dynamic of the group (hostility towards one another. Doctor screaming if the procedure took 10 seconds longer than he expected it to, No patience with people who are learning). In addition, I thought that I would like the structure and order of the surgical environment but I actually found it to be hindering to my learning. I felt as if I could not touch anything- including nonsterile equipment, and I was very frustrated because I couldn't even do the simplest things, such a putting a blanket on a patient without someone telling me that I did it wrong.

I was having all of these feelings coupled with the fact that there was a wrong side surgery performed during my stint as an OR nurse (I was not present in the room when it happened). Right site was marked, time out completed, Wrong limb operated on. This is the second time that this has happened in less than two years so you can imagine the level of stress and hostility present. I really had this strong feeling that this is not where I was meant to be. I was very disappointed about leaving because I really wanted it to work out but at the same time I was very relieved to go. In the month that I had been there I felt very lonely. The management was very supportive and said that I could come back at any time. I found a job on an ortho/neuro unit so that I can still be involved in some aspect of surgery, and I'm hoping to find a doctor who will let me shadow every now and then down to the OR. You guys do an awesome work in OR. I was daily in awe at how advanced medicine has become. Who knows maybe someday I will have the qualities it takes to make it in OR.

Don't worry about it! We folks are constantly evolving as people & professionals within nursing. Who really (honestly) knows where they'll be after graduation or in 2, 5 or 10 years? Finding your best fit is a trial & error process -- sometimes your ideas about a specialty differ significantly from the realities of a job, but you have to "try it on" for a while before knowing if it's the best place for you. You gave it a reasonable chance & then made a tough yet appropriate decision -- good job! Maybe one day you'll return to the OR, maybe not. No big deal. On to the grand adventure of exploring new areas!

As for the surgery performed on the wrong limb -- yikes! I would find that unnerving, too.

while i think you've made the best choice possible for yourself, i am saddened that or nurse education is so incredibly poor. being a preceptor for an rn transitioning to the or is a challenging notion, and so few have had the appropriate training to be teaching adult learners. i had similar problems in my training, too. while we did not have wrong site surgery issues, having what seemed to be a million people telling me how wrong i was (at anything), i had very little feedback about doing things right. of course, in my zeal to be perfect (my own little issue) i wondered if i ever heard anyone giving me praise when it was actually given.

granted, i have seen about 10 different experienced rns transitioning to the or in the past year, and i can see how some are definitely good for the job, and a few others are not. but i am telling myself to give them time. prioritization in the or is different from other specialties, and not always intuitive.

i guess i'm trying to say that there has got to be another way aside from the learner feeling 2 feet tall. i hope i can figure it out, and change things for the better.

hi everyone! i am a student graduating from a bsn program in december 05. i have been seriously considering a perioperative internship after graduation (i have interviewed in two seperate hospitals for the same type of program). it is a year long and offers didactic, scrub, and circulating experience in all of the specialties in the hospital's or. i have always loved being in the or... unlike my peers, i enjoy being covered from head to toe, enjoy the precision of it, the lack of meddling family member! i am an adult learner and have other experience outside nursing in dealing with "challenging" personalities. my concern is that i repeatedly hear that only a certain type of personality is a fit in the or. how do you know if that is you???? i have heard a million horror stories, but i'm still interested. most or nurses that i speak with about the or say that they love their jobs, they love the environment, and that they could never see themselves elsewhere in nursing. what exactly does it take to be good in the or? also, what kind of advanced practice options are there for rns? i would like to have room to grow into my career and wonder what there is for msn's in the or... besides education and administration. i had an interest in nurse anesthesia, but have heard that i would most likely spend years working in the icu (and should go there after graduation) to meet this requirement for entrance, which would keep me out of the environment that i love. any guidance?

... having what seemed to be a million people telling me how wrong i was (at anything), i had very little feedback about doing things right. of course, in my zeal to be perfect (my own little issue) i wondered if i ever heard anyone giving me praise when it was actually given.

granted, i have seen about 10 different experienced rns transitioning to the or in the past year, and i can see how some are definitely good for the job, and a few others are not.

hi everyone! i am a student graduating from a bsn program in december 05.

(snip)

my concern is that i repeatedly hear that only a certain type of personality is a fit in the or. how do you know if that is you???? i have heard a million horror stories, but i'm still interested. most or nurses that i speak with about the or say that they love their jobs, they love the environment, and that they could never see themselves elsewhere in nursing. what exactly does it take to be good in the or? also, what kind of advanced practice options are there for rns? i would like to have room to grow into my career and wonder what there is for msn's in the or... besides education and administration. i had an interest in nurse anesthesia, but have heard that i would most likely spend years working in the icu (and should go there after graduation) to meet this requirement for entrance, which would keep me out of the environment that i love. any guidance?

everyone has their own personality, even nurses in the or, but i think they mean that one must have a strong sense of self, knowing your own strengths and weaknesses, and able to draw on one's own self-confidence. this doesn't mean being cocky and arrogant, but when someone is impatient with you, you have to be able to see their impatience and not take it personally. yeah, they may be impatient with you, but you cannot let that fluster you and get you in a dither. there are a lot of young nurses that are scared to death to talk with a physician about a patient's care. in the or we work with physicians constantly. we have to be able to stand the friction that comes from being a devoted patient advocate, and pointing out breaks in technique, poor positioning, etc - even when it is the chief of surgery. luckily, my chief is likely to say "thanks" and go on. medical students or a resident might sass you. you have to be a like a lioness with her cub (the patient). this is the personality we mean.

as for your other question, there are msn roles in the or, but they can be limited. cns (clinical nurse specialists) develop quality control, education, and a few of our msn/cns nurses still scrub and/or circulate. rnfa's don't require advanced degrees, but i know of a few that have gone on to get their msn/np's to be more competetive and get better insurance reimbursement. the field is expanding all the time. crna's do get the best compensation, bar none, but as you said, the preparation is most likely to be an icu setting.

Your question about advancing your career in the OR, how about RNFA?

The first assistant has lots of responsibilities, including closing the skin after surgery!

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