Mandated to Work Surgery With 1 Day Orientation

[Nurse Beth, MSN]

Dear Nurse Beth,

I work on anoutpt site for a large hospital system. It's a ASC site doing minor outpatient surgery. We have been given a mandate by our manager that we will now have to work one day a week at the main hospital. We were granted one day there to "orient" and then we are expected to be in an operating room functioning like the rest of the staff.

I am concerned about my license and I have never worked at the main hospital before. We are all very concerned that we will be put in situations where we are unable to respond appropriately because we have not been properly oriented. What do you think about this situation? We were told it was volunteer, however, we were told it was going to be mandatory in a few weeks and we may as well start going. It's a large hospital site with 40 operating rooms.

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Dear Mandated to Work Surgery,

I would be concerned as well. It also seems this is a risk for the organization if you have not been adequately oriented.

On the other hand, my background is not peri-operative and is it possible that being an experienced ambulatory surgical center nurse plus one day's orientation is sufficient? It seems unlikely.

Without knowing more details, or what cases and/or role they expect you to perform in, it's hard to answer. Will you be scrub, or circulating?

Have you been oriented to specialty cases? Will you have to take call (less support)?

AORN has a Position Statement on Orientation that you need to read. See if you believe you have been provided the orientation AORN recommends.

If you are still concerned, gather your thoughts and speak to your manager about your specific concerns and offer a possible solution. If more orientation is needed, how much more is needed? And what type of experience? Is there an orientation checklist that other nurses complete that you haven't ?

Hope this helps guide the situation.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

[Rose_Queen, BSN, MSN, RN]

It would depend on what types of cases they would expect you to do when at the hospital. It is not at all uncommon for patients having the exact same types of surgery that happen at an ASC to have them in a hospital setting for one reason or another- insurance coverage, medical history, known difficult intubation, etc. A responsible facility would not expect you to go from an outpatient setting to cardiac with a day's orientation. However, the ability to do cases like hernia repairs, lap choles, and other surgeries seen in an ASC is certainly within your skills. It is not uncommon for my facility to "borrow" staff from either our women's facility or one of the ASC facilities when the hospital is in need of staff- but the charge nurse always ensures they are in a room where the cases match their knowledge.

[sjhancock]

What type of education manuals are available to train RN's to scrub?

[Froggybelly]

I agree that it's very common to rotate between "the big house" and ASCs with little to no orientation. They will give you the small cases and in a hospital with 40 operating suites, there will be plenty of people to ask if you need an item or a phone number.

[SallyRNCNOR]

As a long time RN and a long time CNOR I will state with equivocation, that a one day orientation to the main OR is not sufficient and I believe that your manager is just doing what she is told, instead of what is right. This will be setting her staff up to fail and significantly jeopardize safe patient care. I believe that this is being done by administration, because the main OR is chronically short staffed. Many Administrators wrongly believe that a nurse is a nurse and can substitutue anywhere in the hospital. This is wrong. I strongly urge you and the rest of your RN co-workers to get together and en masse refuse to do this citing that this would jeopardize patient care and you don't feel safe to perform in this capacity. They cannot fire you for refusing an unsafe assignment. This has to be brought to the attention of the Hospital Administration. If your Manager won't stick up for you. Then your whole department inb masse should pay the Hospital administrator a visit and voice your concerns.