Need advice...small hospital OR or big hospital OR

GadgetRN71, ASN, RN · Apr 9, 2011

I would say go for the bigger OR..you will get more experience, and the bigger places tend to be better about teaching. Sometimes in a small community hospital OR, you have people who have been there so long, they forget what it's like to be new.

Start big, get lots of experience, and then later, go to a small OR if you want. Good luck!:)

SandraCVRN · Apr 10, 2011

I was just the opposite, started in a 2 room OR. Got my feet wet with the limited number of docs and procedures, now lees then 6 years later I'm the CV lead nurse at a level 2. Go with your gut....

Good luck...

Who?Me? · Apr 10, 2011

Honestly-interview at both sized facilities and see how supportive each are of their new periop nurses. Ask how do they train-just circulate or circulate and scrub? How long is the training program? What kind of commitment do you owe the facility after training is done-some can be two-three years. Ask if you have to quit due to unforeseen circumstances--ie illness, family matter-do you have to pay anything back for the training due to not completing it?

Not having OR experience won't hurt you one bit if you are going into a program set up to train nurses how to be periop nurses. Places that train OR nurses tend to have staff, including docs, that are more tolerant of "newbies." Just be aware that nurses, techs, and physicians are people too-some are nice and some aren't-don't forget that OR nursing has its foundations in the same things that all speciality areas do: patient assessment, interpretation of labs, and an astute eye for details.

Good luck and best wishes. The OR is an exciting place no matter the size of the facility.

O-Rubee · Apr 21, 2011

Chellooo! I was faced with a similar decision... I decided to go with a Level I trauma center (for many of reasons Who?Me? mentioned), instead of a community hospital. When you make your decision... if you go with the smaller hospital, I'd love to compare orientation updates/stories with you at some point, just to see how our experiences differ (if at all)...

Take care! Ru-B

canesdukegirl, BSN, RN · Apr 22, 2011

Hey asdf80!

I have worked in both a small community hospital and a large Level 1 trauma teaching university hospital. I started out in the smaller hospital, and the training was sub-standard at best. Gadget hit the nail on the head when she stated that the preceptors at small hospitals tend to forget what it is like to be a "newbie" (I just HATE that term-it seems so condescending). My preceptor was a nurse who had been there since the first brick was placed, and her main focus was making sure that the new nurses were "put in their place" by mistakes that were made without the prior teaching necessary in order to circumvent mistakes. Her mindset was "sink or swim". It was horrendous. The docs in a small hospital want their cases done quickly and for the most part, don't want to take the time to teach. For example, I was working in a small OR and I was scrubbed in on a partial colectomy. I asked the surgeon a question pertaining to the disease process, and his answer was, "Canes, I am not here to teach you. I am here to get this case done and move on to the next. Sorry." This has just been my experience. I am hopeful that this is not the way it is across the board.

The university hospitals will usually have a "nurse residency" program that is VERY structured. You have both classroom time and hands-on training with preceptors from every service. You have a nurse educator who works with you one on one and you typically have only a small group per class. I feel strongly that this route is the best for nurses new to the OR. You get the "whys and hows" of surgery at every level. If you don't understand something, you can voice it without the fear of ridicule. You have other peers who are learning at the same rate that you are, and you get to discuss concerns, fears, rationales, etc. with your peer group.

My vote is for the large hospital.

nursinadream · Apr 23, 2011

Good for you for having 2 job offers. That's pretty special, there's plenty of cities large and small without jobs for new nurses. I have been in the OR in both, as others. I would go with the Big OR.

Deb

DUKE#1 · Jun 3, 2011

Hello all, I have recently found myself in a similar situation.....Job offer from a BIG university Operating Room or a smaller Operating room hospital, I too am a new grad & not really sure where to begin my career as an OR RN. One major concern I have is: the Bigger hospital I would be on a set team, like neuro, CT, plastics, etc & at the smaller hospital I wouldn't necessarily be on a team & would get to do a variety of surgeries.

Rntr · Jun 6, 2011

I couldn't agree more!

Rntr · Jun 6, 2011

This is also what happened to me when I went into the OR.... big hospital, pigeoned hole into a specialty.. never did get a good turn in Neuro..

NurseSnarky · Jun 6, 2011

Teams...there is something to be said of being a team. I've never been on one as I've worked in small ORs, but I work mainly with plastics and ortho with some eyes thrown in there. Gyne is not my forte for example. I do not work in those rooms very often as not many want to do plastics or ortho (and I do). Although I like the smaller hospital setting, I do agree with Canes as far as the structured teaching style. However, there are some smaller hospitals that are adopting this style of teaching. They might be few and far between, but they are out there. Adding too that I've worked at a BIG teaching hospital that claimed they had a structured program, but after the initial two weeks in the classroom, I was given to the OR nurses and chewed up and spit out. So ask about the culture of the OR...will you have a set preceptor...and a mentoring program? Why is there an opening...high turnover or surgery demand up?

I also think you should interview at both places and find out which would fit your needs and which would help you be the most successful.