Lost Nurse in the OR

TNT_RN09, BSN, RN · Jul 12, 2019

11 months on orientation?

Horseshoe, BSN, RN · Jul 12, 2019

You have had multiple jobs and didn't like any of them. Maybe you just don't like working? Or like many people, you think the job should be fun (most jobs are not fun, that's why it's called "work")? Perhaps nursing just isn't the right field for you.

Like the poster above me, I'm also confused-an 11 month orientation?

I work in a private elective surgery OR, and there are definitely times when I'm not as "fulfilled" as I'd like. But there are many up sides to it-among them the fact that you have ONE patient to deal with at a time. Compared to some of the high patient to nurse ratios I'm reading about these days, that in and of itself is worth all of the negatives.

Golden_RN, MSN · Jul 12, 2019

If I'm reading correctly, you've had 4 jobs in 3 years. That's not ideal.

If you liked the OP PACU where you worked through an agency, why don't you pursue a FT job like that?

I totally understand taking a job for the pension, but you shouldn't be miserable every day either.

I have been a nurse for over 20 years and have yet to find a job where I am fulfilled, it's not too easy/not too difficult, everyone is nice, workload is reasonable, offers a pension, etc etc etc. Realize that no job is going to offer us every ideal thing we desire, and stick with it long term.

Editorial Team / Admin · Jul 12, 2019

14 hours ago, TNT_RN09 said:
11 months on orientation?

That's a bit extreme even for the OR, but OR orientation is generally 4-9 months depending on the number of specialties the new nurse is expected to be able to function in as well as whether the nurse will circulate only or both circulate and scrub. Our nurses are expected to do every specialty except cardiac and only circulate. The planned orientation is 6 months 1 on 1 with a preceptor and 2 months with a resource person for every 2-3 fresh off preceptored orientation nurses.

OP, the saying about the OR is that you either love it or you hate it. It sounds like you definitely do not love it, and would not be happy staying. Leaving the OR to help in SPD when on orientation screams red flag to me- it's time to look elsewhere.

NedRN · Jul 12, 2019

Some internships are 18 months. I was in orientation for close to 9 months (always third person in room) in a large teaching hospital rotating through all the services scrubbing and circulating. So yes, it is quite a shift going from orientation to being on your own and a bit scary (I was also excited at the same time), but you will find you have learned more than you think. Lots of resources just feet away in the hall or the next room, and of course your scrub (or circulator), anesthesia provider, and surgical staff in the room.

As a traveler, even twenty years later, I keep being thrown into surgeries I've never seen before, and basic OR nursing rules! Plus it is amazing what comes back to you from even brief exposures to services.

As far as politics go, that happens in any job setting. In the OR, you are dealing with more mashups than most units. But this is something you need to learn how to deal with. Ideally, you stay professional and don't let your emotions rule and don't participate or listen to gossip or negativity. Easy for me to say I know, but there are books you can read to learn the ropes on coping and thriving at work that are universal to all jobs with personal interactions.

No doubt your hospital has specialties like cardiac, neuro, or ortho for which you can choose to be on a team. That will focus your energy on fewer types of cases, and also reduce the number of people you are dealing with. Just a thought.

TriciaJ, RN · Jul 12, 2019

OP, your entire post makes me picture a high-energy, low-focus person who needs to work on follow-through. (I of course could be dead wrong; that's just the impression I get.)

I do think OR is not for you. If you're finding yourself "playing hooky" during your lengthy orientation, that's your sign to look for the exit. At the very least, it's not fair to your coworkers to be putting time and energy into you that will likely not pay off.

You say you love nursing, but have not liked any of your jobs except one really short-term one. Maybe you just weren't there long enough to start hating it, too. You might want to clarify for yourself what you love about it and what you hate; knowing yourself better will help you move forward.

The basic motivations for working in the first place are that we like eating food and we like living indoors. Everything else is secondary: we like to have good medical insurance, we like the idea of a pension someday, we like to feel fulfilled by what we do and we like having friends. You would be very fortunate to find a job that gives you all of these things while not sucking you dry with the work load.

There are almost always trade-offs involved. The big money usually involves back-breaking workloads. The low-stress jobs often come with low pay and poor benefits. But no matter where you go, nursing has its definite downside. It's not for everyone.

You might want to find a position that's comparatively low-stress and just do it for two years. Spend that time learning to focus and apply yourself. When it feels too crappy try reminding yourself how good it feels to have a roof over your head and some food in the fridge.

You'll gain some perspective and more realistic expectations of any job. Hopefully by that point you'll have a better idea of where you want to be and can start working toward getting there. Start saving a certain percentage of your pay and talk to someone about a Roth IRA and other retirement planning. That'll mitigate having a job with a poor pension plan.

Your job will likely never be all things to you. You have to find ways to get some of the things you need outside your work. Good luck.

KNest18, BSN · Jul 13, 2019

19 hours ago, TriciaJ said:
OP, your entire post makes me picture a high-energy, low-focus person who needs to work on follow-through. (I of course could be dead wrong; that's just the impression I get.)
I do think OR is not for you. If you're finding yourself "playing hooky" during your lengthy orientation, that's your sign to look for the exit. At the very least, it's not fair to your coworkers to be putting time and energy into you that will likely not pay off.
You say you love nursing, but have not liked any of your jobs except one really short-term one. Maybe you just weren't there long enough to start hating it, too. You might want to clarify for yourself what you love about it and what you hate; knowing yourself better will help you move forward.
The basic motivations for working in the first place are that we like eating food and we like living indoors. Everything else is secondary: we like to have good medical insurance, we like the idea of a pension someday, we like to feel fulfilled by what we do and we like having friends. You would be very fortunate to find a job that gives you all of these things while not sucking you dry with the work load.
There are almost always trade-offs involved. The big money usually involves back-breaking workloads. The low-stress jobs often come with low pay and poor benefits. But no matter where you go, nursing has its definite downside. It's not for everyone.
You might want to find a position that's comparatively low-stress and just do it for two years. Spend that time learning to focus and apply yourself. When it feels too crappy try reminding yourself how good it feels to have a roof over your head and some food in the fridge.
You'll gain some perspective and more realistic expectations of any job. Hopefully by that point you'll have a better idea of where you want to be and can start working toward getting there. Start saving a certain percentage of your pay and talk to someone about a Roth IRA and other retirement planning. That'll mitigate having a job with a poor pension plan.
Your job will likely never be all things to you. You have to find ways to get some of the things you need outside your work. Good luck.

Hi guys back again and wanted to respond to everyone, just to clarify, I was PD at one of the jobs which was PACU for the 2 months at the same time working at the surgical ambulatory center for the year. (After I was at medsurg) I would agree with some of what you all who shared stating that I need self reflection! I just bought a home and about to get married and I feel like lately during this time in my late 20s I have been asking my purpose ? The reason why I love nursing is the patient and nurse rapport. I am a. Dry caring person in nature! No one in my family is a nurse.. When I was ever bedside including medsurg, pacu, or any patient interaction for that matter I love making the patient feel safe. I loved speaking up for them and doing the right thing I had to do when it came to their care.. I loved learning things that help SAVE the patient meaning being hands on and learning what helps a patient get better and I would actually love to finally be able to have the critical thinking skills to have the doctor trust in my medical decision making... of that makes any sense?? I guess my approach in all of this is figuring a job that is much more rewarding than being so taxing and so stressful... but nursing comes with that stress, I don’t want to be a mean nurse or rude to my patients.. I want to remain who I am.. I guess the OR I see at my institution is very hard to ground break without people thinking I’m not worthy since I’m new in the OR and they think all the nurses are like each other (Majority started only in the OR and never went anywhere else) so with that I get frustrated at times. With the people I’m with, I let my emotions get involved and I AM TRYING to not let others persuade my worth... I love a team environment and I think I let that go when I was on medsurg... but on the other end the work was very vigorous! Now I’m learning a new job (that doesn’t intrigue me because I want more learning in critical skills) and now less team work...

thank you guys so so much for all of your honest responses... I just wish the work was perfect in health care but I reality we ourselves as nurses make the best of what we can when we are In The workforce! I just have to hope for liking this job maybe and giving it a chance and maybe if I still don’t like it find another that I semi enjoy more than this?

Oh and last thing, 11 months training that is very all over the place (been with all sorts of nurses but haven’t found trust in any of them, just found some that have good nursing OR habits and others not, it in actuality I have no vent to because of the attitudes and resistance to new people.) me and the their new girls that have been in training hasn’t had good guidance, we are just kinda in charge of our own learning ... we finish in about a week!!

TriciaJ, RN · Jul 13, 2019

OK. I'm getting more of the picture. You love what nursing actually should be and you hate the soul-sucking grind that it's become. You also sound like a sensitive person - in tune with the needs of others but are quickly depleted by extraneous commotion.

I can now see what the OR has to offer you: a measured pace working with one patient at a time. The downside is you don't get to develop much rapport with your patients. It also sounds like an orientation necessitating a lot of self-direction in a chaotic place, also stressful.

Is this a place you can see yourself working in for at least another year? Is it worth making a go of it? If you stick around and get good at it, you will eventually be in a position to start changing the culture from within. Learning not to let others dictate how you feel about yourself is a worthwhile lifelong lesson. It's very helpful to get positive feedback from others; it's even more helpful to not rely on it.

I think you are self-reflective enough to find your own way. And congratulations on your upcoming marriage!

NedRN · Jul 13, 2019

If you like patient interaction, inpatient OR is certainly wrong. Consider a physician practice for a low stress (usually) work environment with high personal interaction and teamwork. Pay is less, but if you find a physician with a private OR, you have found a great niche after your two years ( or less) in the OR. RNs are too expensive for many kinds of practices, but many states mandate an RN for surgery. Plastic surgeons often have a private OR.

TriciaJ, RN · Jul 13, 2019

1 hour ago, NedRN said:
If you like patient interaction, inpatient OR is certainly wrong. Consider a physician practice for a low stress (usually) work environment with high personal interaction and teamwork. Pay is less, but if you find a physician with a private OR, you have found a great niche after your two years ( or less) in the OR. RNs are too expensive for many kinds of practices, but many states mandate an RN for surgery. Plastic surgeons often have a private OR.

I think this is great advice. If you can pull it off it might offer the best of both worlds, work environment-wise.

adventure_rn, MSN, NP · Jul 15, 2019

You've received some fantastic advice from other posters.

I do want to add one extra point. You said that the pension was a selling point for you. If you quit this job right before or soon after the completion of your ridiculously long orientation, you may burn bridges with this facility. Orienting new grad/new-to-specialty nurses with typical 3-4 month orientations costs $50,000+; your manager may have spent upwards of $100,000 training you. Your unit has sunk a ton of money into your orientation, all of which will be lost if you quit right when orientation ends. Even if you're eligible for rehire, your manager may be pretty irritated; s/he is the first person other managers will talk to if you apply for another job at that facility.

It sounds like the specialty may be a bad fit for you. However, if you really want to have the option to get another job at this hospital system in the future (especially given the pension benefit), it may be in your best interest to tough it out for another year. You've already quit one inpatient job after less than a year (your new grad med-surg position). There are only so many hospitals in a given area; if you continue to burn bridges by quitting jobs soon after orientation, you may be extremely limited in your future practice settings (especially because hospitals frequently buy up smaller outpatient practices and absorb them into the larger system).

In addition, it seems like part of your concern (along with questioning if this field is the right fit) comes from your fears about being ready to come off orientation. This is a common experience for anybody who is new-to-specialty in a high-intensity field; it can be terrifying when the training wheels come off, and it will suck sometimes, but it gets better as you stick with it. There will be times that you feel dumb; that's a normal part of learning a new specialty, and that's ok as long as long as you learn from your mistakes. No matter the field, it will get easier.

Sidebar, @NedRN, it is so intriguing to hear your 'origin story.' I've read hundreds of your posts on the Travel Nurse forums and never realized that you're in the OR.