Med/Surg to OR? Help!

Specialties Operating Room


Hi all,

Sorry this is kind of long but more details helps I think and I'd love your thoughts!!

I am hoping you could give me some further insight into some pros and cons regarding making a switch from med/surg to OR.. I have only been a nurse a little over two years and have worked at a smaller hospital on a med/surg floor and am also cross-trained to float to our IMCU. I work a 0.9 FTE 12 hour day shifts 0700-1930, every third weekend and every other holiday, but I almost never leave on time and the days turn into 13-14 hour shifts at times because we have poor staffing and poor managerial support systems. I have been considering for some time now to move to another hospital system as well as department because on top of our crappy management, I just don't know that med/surg, constant bedside nursing, is for me. It's fast pace and the long days can go by quickly but I rarely find myself coming home saying I had a "good" day. Some days I feel like I was awful at my job because I did not have nearly enough time to really get to know or understand what is going on with my 6 patients - just being pulled in every direction which makes me feel like things get missed! Upset families, difficult or needy patients...I start to lose my patience. :/. My husband points out to me all the time how I don't seem satisfied and is also encouraging me to pursue new opportunities prior to having kids.

In school the OR always interested me and I did a clinical rotation in an OR as well. I recently job shadowed in the OR of another hospital system, a little closer to home, and enjoyed it. Deep down I feel that I could really enjoy the working environment of the OR - including sleeping patients and less patient family interaction! The biggest thing holding me back I feel is the change in hours.. while the 12 hour shifts can get super long and I feel beat (and sometimes not safe!) it is also nice to have more days off throughout the week. The OR position available at this time is 1.0 FTE so 8 hour days M-F with 3 weeknights on call per month and every 8th weekend on call. My husband works a normal M-F 0700-1730 job and thinks I would learn to appreciate the routine of getting up at the same time daily and being done in the afternoons, he might be right, but I am hoping some of you can tell me first hand how it is working OR hours and in the OR environment and if making such a switch is worth it?!?

ANY thoughts and advice is appreciated!! Thanks!

Specializes in Operating Room.

Personally, I love 5 8's which is what we call it in the OR. The charting is straight forward, the EMAR/orders are straightforward and the best part about your shift is if you have questions your physician/surgical team is right there to clarify. On the other hand, you may have a sleeping patient but you will have your physician/surgical team who will depend on you for just about everything AND you will be the first person in their line of fire/cursing and blame if something isn't just so. There are just different stressors that you may have to get used to. You are orchestrating the entire OR from preop and PACU and even other areas like sterile supply, anesthesia assistance and sales/vendor reps during surgeries. I clock in at 0645 and I am in my car at 1515 LATEST. There is never staying late to chart for 2-4 hours afterwards unless you are doing some kind of outpatient cases, in which case I would say maybe 30 minutes or so just to double check everything and that is me saying that because I know nurses need to do this in order to CYA. Also, working a shift like 7-3 for example, your relief or call team should be there around 2:30-2:45 latest to get report and take over the surgery and this is precisely the purpose of call teams so if the chart or the work isn't complete, then you will report off to the oncoming/on-call surgical staff and at that point is when I would do a once over of my charting, but again, it isn't as tedious as Q2/Q4 head to toe assessments, PIE notes, etc. etc. on the floor.

What type of hospital will depend a lot on how often you are utilized for call. Smaller hospitals generally (and I say this very loosely) don't have crazy cases going on in the middle of the night. But there ARE cases that are urgent/emergent and need to be in the OR, so when on call pack breakfast, lunch and dinner because you may have to work right through your shift without getting a chance to go home. For example, I work 7-3 but Billy Bob is here from 7-5 so my call wouldn't start until 5pm when he is to go home for the day because he isn't on call. At that point the OR would call me to come back to work and relieve him if surgery was expected to go past 5 and I would leave when the case was finished. If there is not a "late person" I would start my call right at the time my shift would end which would be 3pm. Also, just because they call once when you are on call doesn't mean they can't call you six times until you aren't on call anymore. I have been called back three times in the same call shift. Generally rule of thumb is expect longer days with big, trauma and teaching hospitals. These hospitals can run late cases, transplants, operate all hours of the day or night and increase your call if their department is short-staffed.

I personally despised floor nursing because of what you are going through. I worked consecutive 12s just to get away from the hospital as much as I could. A fellow nurse always used to say this to me and I agree, "I will take my worst day in the OR over my best day on the floor anytime."

Call is entirely different and being a floor nurse I am not sure how well versed you are about what it entails. You don't have resources readily available on-call like you do on a regular Monday morning. Consider it like a ghost town when you are on-call and that is how you will have to orchestrate your surgery for those shifts. 3 days and one weekend every two months is minimal call so just know your resources, where things are, how to get a hold of people and what to do in emergencies like MH/RRT/Codes and you should be fine. Weekend call is usually 48 hours starting from 7am Saturday to 7am Monday if you take the entire weekend. Best of luck.

Specializes in OR, Nursing Professional Development.

I work in an OR where we have 8, 10, and 12 hour shifts. The vast majority of people work 8s, simply because that is the department need. Even when we have a 10 or 12 hour shift opening, it isn't quickly filled because most people know they will walk out at 1530 (unless on call and additional staff above the standard second shift staff is needed). I think that the OR is one of those rare departments where it takes a lot for your shift to go beyond the scheduled time (with the exception of those on call days). When I was in direct care, I loved my 8s. Out the door by 1530, home shortly thereafter and had the bulk of the afternoon and evening to do whatever.

I am a previous med-surg nurse that made the change to OR and I have never regretted it. I worked in med-surg for 2 years, then changed to OR about 7 years ago. I shadowed a little bit in the OR before making the switch, so I could be sure of what to expect and it sounds like you have done the same. My opinion is that OR nursing is pretty "love it or hate it" with not a lot of in-between. My OR friends and I love it. The RNs who realized they hated it, moved on to other fields.

ORs typically have variable shifts. I have worked three 12-hours, four 10-hours, and five 8-hour shifts and there are advantages and disadvantages to them all. The most important consideration to me when I was starting in the OR is to have a proper, lengthy orientation and a supportive environment when I was off orientation. It can be a stressful place and I felt like a new grad again when I started in the OR from med-surg.

Hope my rambling helps in some way. I think OR nursing is pretty dang awesome!

Thank you so much for your detailed response!' It's very helpful and takes away some doubts! I've read a few threads on here about switching to the OR and I've seen the "taking a worst day in OR over a best day on the floor anyway" a few times so it must be a consistent thought!

Specializes in Operating Room.

I worked night shift(7p-7a) for 8 years on the floor and moved to the OR 2 years ago. BEST THING I EVER DID FOR MY CAREER!!! OR nursing is the best kept secret of hospital nursing.

Specializes in Dialysis Nurse.

Here is how I break it down medsurg vs OR.

No call light, no IV peeping

No confused, combative, and needy patients

No constant pain meds.

No 15 people trying to call you on Vocera or over the phone.

No family members

No rude patients

No calling the doc in the mid of the night for a Tylenol

No 3hr of charting after the shift is over (happened a lot)

1 patient at a time vs 4-6.....

Skills in medsurg cannot help you in OR

If you are a nurse, you know how bad these things are.

Med/surg is a huge turn off for me. I can't name a single thing that I like about it except on good days when you sit around

and having potluck.

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