Money $ or Happiness :-) Please OR Nurses. I need advice. Should I Leave the ED?

[vblaides]

I'm a Nurse of 4 years, my whole career as an ED Nurse at a private hospital (level 2 center) in midtown manhattan NYC (1 hour drive to get there), now making around 83K yearly after 4 yrs of service. If I went to days, my pay would be around 77,600K/yearly. I work 13 (12hr night) shifts a month. May not seem like much in the scheme of things, but it's tiring and i've been feeling burnt out.

The situation/dilemma.

Now I was offered a position as an OR Nurse in an Operating room in a municipal city hospital (trauma level 1) 4 miles from my home in brooklyn (10 minute drive to get there), making around 67-70k/yearly. A 7-10k pay cut to work. Working 5 (8 hours shift) 3p-11p, alternating weekends. The nurse manager told me, I'll receive a minimum of "A YEAR of training" before I'm on my own.

I don't know what to do. I understand sometimes it's very difficult to transfer to other specialties. I think especially the OR is difficult to get into, because hospitals don't want to train. Maybe this is a misconception I have about transferring and being trained to the OR.

Should I take the leap, hence taking a pay cut.

Should I take the leap because in the future I will be more marketable, hence will probably be able to make more money later on in my career.

One other aspect. I'm intending on perusing my BSN as well, a brick and mater nursing program that offers an online track that's fairly inexpensive, around 10k for the whole program to graduate.

Benefits - Pvt vs Municipal

Pvt hospital pay 18 credits a year( No cap on cost)

Municipal city hospital pays 1500/year towards tuition reimbursement.

Any insight or advice anyone.

[Isabelle49]

Every RN I know who has worked in the OR will not work anywhere else. They LOVE it and it is a hard place to get into.

What are your plans after you receive your BSN?

[vblaides]

Thanks!! Isabelle49! I kinda thought it's hard to get into.. Does everyone else agree with Isabelle.. Is the OR hard to get into?

I really don't know what I plan to do after my BSN. It's taken me almost 5 years to come to a decision to go back for my BSN. Seems like I may remain in the hospital setting til retirement.

[Rntr]

If you have never followed anyone in the OR I suggest you do.. the OR is a different bird regardless of level I or what.. I work OR and I would not work another area...otherwords, I do NOT float outside of the OR... not because I can't but because I choose not to.

If I can answer any questions for you please feel free to write me through here.. I traveled in the OR for 10 yrs and now looking to work outside of the hospital altogether, it's possible, which I am starting a new horizon soon...

[pedicurn, LPN, RN]

Thank you PediCurn, Ashley, L8RRN, gingermom, bugsy2902 and madwife2002.

I do enjoy the ED, I just feel I'm a little burnt out. The work is doable, and I excel and handle my patients well, and believe I'm a good teamplayer. But I think I'm a bit burnt out with Emergency Services.

I do have an interest to work in the OR.

Health insurance are both covered by both hospitals. I park on the street in manhattan so no parking cost. I can probably do the same for the brooklyn hospital.

Vacation in manhattan hospital is 4 weeks, brooklyn hospital 3 weeks.

Bugsy2002, I think that's a great idea for me to shadow, I will ask to do this next week.

Pedicurn- I'm single, not a club/party person, mid-thirties here, been all my partying and clubbing in my twenties.

Guys I'm wondering- How many of you have experience in more then one specialty. Is it a value to have experience in two specialities that are so different?

ED and OR are completely different.

Thanks for that vblaides

Permanent 3-11 can be socially isolating but if there's the strong possibility of change later - then ok.

Two specialities are good for the nurse as help to increase hrs if you are after more money. My coworkers who do this are interested in picking up more work on their days off. Also ofcourse you would have stronger employment prospects so job security would be boosted.

However it can be a hassle getting up to speed in the second speciality. Employers usually want fulltime commitment while working in the second speciality plus there will be expectation to commit to relevant study / courses / certification.

Can be hard to juggle with maintaining the first speciality - maintaining current experience at sufficient level to work in all areas of ER plus all your normal ER certification.

I don't think the two complement each other much ? Some procedural stuff in the ER eg surgical airway ..... but would guess you would know that stuff anyway.

But wouldn't let that stop you taking up OR. If you are interested in the field and feel content re the change - go for it and good luck !!

[MBrnbsnmha/ed]

Hello,

You need to do what is going to make you happy AND then the money will follow. Just a suggestion why not take on the new job and remain prn in the ED to keep your foot in the door just in case things do not work out in the OR. Yes, it is great to have more the one specialty under your belt for growth and up coming opportunity. Good Luck.

My first passion is always the ER but as time progressed I became burnt out and moved to ICU. I always love the ER BUT I have the stress on the body over a long time. Good luck again.

[canchaser, BSN, RN]

What about OR on call pay? Will there be any to help offset the cost? After chasing money the last 2 years in 2 different paths, I say go for the happiness, unhappiness/ stress will killyou or make you very sick. Life is so short, tomorrow isn't promised so go for what makes you happy.

[skylark, BSN, RN]

OR seems to be something that nurses either love or hate.

And the ony way to find out is to try it.

Can you work a few shifts as a agency nurse, just to see what whether its something you would want to do?

And don't forget to factor in the cost savings in fuel, etc, in working locally. 4 miles is close to enough to ride a bike, then you can not only be healthier but also save a fortune not having a car.

I love ED, been over 10 years, and would not work anywhere else.

Someone on this forum made a comment a while back that ED nurses are all ADD and OR nurses are all OCD. THere' s a lot of truth in that, maybe figure out your personality type as well to see if you could manage the predictable and planned nature of OR.

[Rntr]

You can' "work" a few shifts in the OR without training... it's not something that you can just go and get oriented to. OR requires alot of training and the best thing to do is to follow someone in the OR to see what they actually do.

[Florencebyondthepale]

Shadowing is a great idea. Will you be trained to both scrub and circulate? What type of OR? Ambulatory surgery, Level 1 trauma center or lower? The type of OR will determine not only what type of cases you see, but also the amount of call you will take and what schedule you will have. It can be difficult to train in the OR and go to school, let alone do both of those things and be prn in the ED. I had to let my floor prn position go a few months after I completed my OR internship because it was too much to juggle with the on-call schedule.

It takes about two years before you are comfortable in the OR. The first year is all training and learning. The second year is building skill level and even after there are always areas that you may not ever feel comfortable in unless you specialize in that area (cardiac surgery, for example). The bonus to gaining OR experience is that you can go anywhere you want. It seems that hospitals are always looking for experienced OR nurses. The drawbacks I see in the OR is that you cannot establish as much of a connection with your patients (the ED may be similar in that regard). You interview the patient prior to surgery, stay with them at the bedside until they go to sleep and when they wake up. If you are scrubbing, then there really is no chance to get to know the patient. You also lose some of your autonomy in the OR. You also have to be very assertive. I would shadow and see if it appeals to you after you shadow. Ask about the surgeons...who throws temper tantrums (and instruments)? How collaborative are they with the nursing staff? Ask about the nurses. Make sure you're going into an environment that is receptive to new learners.

[NurseSnarky]

I love the OR and I've worked other areas as well...ED being one that I like and miss at times. But the OR can be fast paced and technical and it can be more "structured" than the ER in that there is a schedule compared to, you don't know who's coming in the door at the ED. I do believe you have to be a bit ADD in the OR as well because you have to keep moving, going, thinking. Also having ED experience or ICU as well is very helpful in the OR. You still use your assessment skills just differently. You work with Anesthesia closely and they appreciate a nurse who has assessed on the fly (ED) and can tell them things they've missed. You help with intubation and if it's not going well, you can anticipate to help them out...again a bonus for them as it's easier to have a nurse who knows how to help in an emergency than needing to call another anesthesia provider to help and that takes times, etc. On the 3-11pm you will see scheduled cases that run late or that are scheduled late as well as traumas and emergencies. Those last ones can satisfy your need for a little adrenaline too. I just want to say the biggest difference at first you may see or experience is the docs. Docs in ED work side by side with you and you develop a camaraderie that is different than any other setting. The OR...the docs have to get used to you (some anyway...some are friendly right off the bat)...and their trusting you is different. They need to know that you can anticipate what they need, get what they need asap and that you will have their backs (don't know how else to describe it). They are operating and they can't leave the table...so they need you. It's trust built up over time whereas in the ED you have to learn to trust each other pretty quickly. But you still get that camaraderie. Autonomy in the OR can be important to nurses as well. It's YOUR ROOM and you run it...so in order to do so well, you learn and learn (a year is GREAT for orientating). Again I LOVE the OR. The patients? I develop a rapport and bond in a very short amount of time, but there are many times I will see people back and they remember me and I them. It is rewarding.