New Grad Nurse in OR

[1m9s9s8]

Hi all! I came here seeking any and all advice.

I graduated school in December, passed my NCLEX in March, and Immediately took a job in the OR. during school, I never had an OR rotation so I had 0 clue what I was getting into. The reason I chose this position is because I never enjoyed med surg during my clinical rotations, I did not get the initial job I wanted on a pediatric ICU, and my ultimate goal is to end up in Psych; which doesn’t usually hire grad nurses so I needed a job to get me started. I had heard nothing but good things from the OR nurses about how much they enjoyed their job. They seemed genuinely happy, and as a grad nurse, that’s always a plus! (The floor’s culture was very important to me when searching for a job). Another main reason I chose this position is because of the 6-month long orientation, which included rotating through the services (neuro, vascular, cardiac) as well as pre-op, PACU, and other areas to familiarize yourself with the environment, while doing the Peri-Op 101 course. After four months, we would be able to choose a speciality and spend the next two months orienting in that specific area. That seemed like a sweet set-up to me so I didn’t hesitate to accept the job.

I am currently in week 3 of my orientation. Due to COVID, our orientation was cut in half, they already put us in our services (I hadn’t even been in a room when they did), and they want us to be ready to circulate our own rooms by end of June, beginning of July, because they believe a surge will be coming around that time and they want all hands on deck. As a new nurse, completely foreign to the OR, I’m already beyond overwhelmed. Now to know I have to be prepared in 3 months vs 6.... it has my anxiety through the roof. On top of this, the job itself isn’t what I expected. At one point I thought the lack of hands-on patient care would be better for me, but now I find myself missing it and enjoying the peri-op assessment the most out of the entire case. I don’t feel like the circulating nurses role is something I’d want to do long term, which makes it even harder to want to continue with this path.

For me, the transition is hard from nursing school because it’s nothing like what I was taught. It’s like starting entirely over in my nursing education. I feel like I lack the confidence that being a floor or ICU nurse to start would have given me, as far as dealing with doctors, whereas the other nurses I started with all came from floors/units and they seem to have more confidence. This is my first job in general, aside from waitressing through school, so confidence in the hospital in general is lacking for me. It’s something I’ve struggled with throughout school and something I knew would be hard in whatever first job I chose.

I feel like I may have made the wrong choice, but I can’t tell if this is due to just being an overwhelmed new grad, or because this really isn’t the right fit for me. My question to you all is: How do I know the difference between the two? What made y’all know the OR was a good fit? I’m at the point where I could still get a transfer waiver and be able to relocate to a unit or a floor, but I don’t want to give up on this job if it is just fear and anxiety that is causing the dislike for the OR. (Yes, I’m an over thinker) The other new nurses seem to be enjoying their roles and the job itself, so I’m not sure how I’m supposed to feel right now. If y’all have any similar stories or advice that could help me in any way, feel free to share! I’m just very confused and overwhelmed right now and anything would help.

[Rose_Queen, BSN, MSN, RN]

4 hours ago, 1m9s9s8 said:

I feel like I may have made the wrong choice, but I can’t tell if this is due to just being an overwhelmed new grad, or because this really isn’t the right fit for me.

It may be both. You are indeed overwhelmed as a new grad, but a job that expects you to be up and running independently without the right orientation is not a fit for anyone.

We are also having issues due to COVID. However, we are cancelling pretty much all electives that aren't life, limb, or major life consequences (we're still doing cancer surgery). We've already been up front with our orientees that we expect to extend their orientation due to lack of experience, not shorten it and expect them to be up and running!

[1m9s9s8]

1 hour ago, Rose_Queen said:

It may be both. You are indeed overwhelmed as a new grad, but a job that expects you to be up and running independently without the right orientation is not a fit for anyone.

We are also having issues due to COVID. However, we are cancelling pretty much all electives that aren't life, limb, or major life consequences (we're still doing cancer surgery). We've already been up front with our orientees that we expect to extend their orientation due to lack of experience, not shorten it and expect them to be up and running!

Thank you for your response. I feel that if management had approached this differently and instead extended our orientation, I may even feel better about the job and more likely to give it a chance. I feel like they’re just trying to do what’s best for the hospital and not considering the new nurse’s needs. I will bring this up to management and see what comes of it. Thanks again!

[joetheperformer]

Hey, I am in a very very similar predicament, except I graduated on September 2019. My orientation is also being cut short and I am expected to be out and circulating by myself in 2-3 weeks (making my orientation 4 and 1/2 months total). I literally told them HELL NAW, at least give me another month and a week (5 weeks).

With my orientation, I have been thrown around different cases, different surgeons, and different services even, which is NORMAL for OR orientation. However, only 4 and 1/2 months is not going to cut it for me.

When you say that other new nurses are seeming alright and not stressing too hard, well that's only because they hide it well. In truth, I am just as terrified as you, and so is everyone else I know. People will come down to the locker room and talk like everything is going fine and brag about how well their case went, etc. etc. What they don't tell you is the fact that they were just yelled at by the surgeon/their preceptor. The truth is, sometimes people cope by ignoring the bad stuff that happens and only convey the good stuff to others, ESPECIALLY TO THEIR PEERS.

For me, I just go to work, try to learn as much as possible, and hope everything goes smooth. If I get yelled at (which I have gotten many times), I just stand back up and try not to take it home. I am afraid I might make a mistake. THAT IS ENOUGH. If you seek to improve, you can't go wrong with the future.

I hope that helped even just a little. Good luck! I'm sure you'll do fine. Also, definitely bring your concerns up to your managers.

Cheers fellow orientee!

- Bnz.

[1m9s9s8]

1 hour ago, joetheperformer said:

Hey, I am in a very very similar predicament, except I graduated on September 2019. My orientation is also being cut short and I am expected to be out and circulating by myself in 2-3 weeks (making my orientation 4 and 1/2 months total). I literally told them HELL NAW, at least give me another month and a week (5 weeks).

With my orientation, I have been thrown around different cases, different surgeons, and different services even, which is NORMAL for OR orientation. However, only 4 and 1/2 months is not going to cut it for me.

When you say that other new nurses are seeming alright and not stressing too hard, well that's only because they hide it well. In truth, I am just as terrified as you, and so is everyone else I know. People will come down to the locker room and talk like everything is going fine and brag about how well their case went, etc. etc. What they don't tell you is the fact that they were just yelled at by the surgeon/their preceptor. The truth is, sometimes people cope by ignoring the bad stuff that happens and only convey the good stuff to others, ESPECIALLY TO THEIR PEERS.

For me, I just go to work, try to learn as much as possible, and hope everything goes smooth. If I get yelled at (which I have gotten many times), I just stand back up and try not to take it home. I am afraid I might make a mistake. THAT IS ENOUGH. If you seek to improve, you can't go wrong with the future.

I hope that helped even just a little. Good luck! I'm sure you'll do fine. Also, definitely bring your concerns up to your managers.

Cheers fellow orientee!

- Bnz.

Thank you so much for your words! I appreciate it. I hope things start looking up for you and that you feel confident when coming off orientation. I’m glad you advocated for yourself and that you were able to extend your orientation. I recently spoke with management and we are working on a solution for my situation. We definitely are going through an interesting time as grad nurses, but hopefully it will only make us stronger!

Cheers!

[skydancer7, BSN, RN]

Hello! I SO feel your pain. I have been in the OR almost 10 years now, though it seems like only yesterday I was brand new and terrified. How is the culture? Are surgeons overall respectful or are you being condescended to and talked down to all the time? If its NOT a toxic environment, if you feel overall supported and if you are able to stick it out and get a year under your belt, you will be able to get a job anywhere anytime with OR experience. Not gonna lie, it is HARD the first year. It's hard to feel like you don't know what you are doing yet. The learning curve is so steep. It's totally normal and uncomfortable but it's going to feel like that in any new grad first year role, honestly.

The cool thing about the OR, versus med surg and other areas, is you are never alone. You always have anesthesia and the surgeon and the whole team watching the patient. I felt way less afraid I was going to miss something and harm a patient, with all those eyes on the patient, in the OR. If they start crashing, you have support right there right away. So as a new grad, that is a benefit. Med surg you have 5 patients and can't be everywhere at once... I felt way less supported there.

Is there a way you can advocate for yourself to get another few more weeks orientation? Or, can you pick a specialty and/or surgeon to focus on, so that you can gain experience and get comfortable in at least one area first? It would definitely be harder to try and get good at all of the specialties all at once, but if you could focus on say ortho, or general, that might help. At least until they can properly orient you to the rest.

Overall, I'd say if you feel well supported and it's not a toxic environment like some OR's can be, it might be worth sticking it out. If you feel like patient safety is not a huge issue, just your efficiency level, that will come with time. I hope this helps!

[skydancer7, BSN, RN]

Hello again, I just re-read your initial post. If you have until end of June and are able to focus on just one specialty area, you might be okay! Is it the "right" specialty for you? Hard to know. But a year of OR experience is a solid stepping stone in any case.

I HATED the OR for the first few years. 7 years later I tried med surg and realized I hated that MUCH, much much more. For me, OR nursing is the type of nursing I dislike the least (don't worry, I am back in school for a different approach to medicine) ? so it's hard for me to speak to how I knew it was the "Right fit" for me. It's just the specialty I kept getting hired into, because I had experience and the most comfort there. For me it was about finding an environment where condescending verbally abusive surgeons and nurse preceptors who eat their young were more rare and NOT an accepted norm. If you have found that in your OR, you found a gem and you should stick it out if you can.

If you are able to transfer into something you KNOW you will love, by all means go for it. But it might be worth sticking this out for a year.

Again, hope this helps ?

[1m9s9s8]

15 hours ago, skydancer7 said:

Hello! I SO feel your pain. I have been in the OR almost 10 years now, though it seems like only yesterday I was brand new and terrified. How is the culture? Are surgeons overall respectful or are you being condescended to and talked down to all the time? If its NOT a toxic environment, if you feel overall supported and if you are able to stick it out and get a year under your belt, you will be able to get a job anywhere anytime with OR experience. Not gonna lie, it is HARD the first year. It's hard to feel like you don't know what you are doing yet. The learning curve is so steep. It's totally normal and uncomfortable but it's going to feel like that in any new grad first year role, honestly.

The cool thing about the OR, versus med surg and other areas, is you are never alone. You always have anesthesia and the surgeon and the whole team watching the patient. I felt way less afraid I was going to miss something and harm a patient, with all those eyes on the patient, in the OR. If they start crashing, you have support right there right away. So as a new grad, that is a benefit. Med surg you have 5 patients and can't be everywhere at once... I felt way less supported there.

Is there a way you can advocate for yourself to get another few more weeks orientation? Or, can you pick a specialty and/or surgeon to focus on, so that you can gain experience and get comfortable in at least one area first? It would definitely be harder to try and get good at all of the specialties all at once, but if you could focus on say ortho, or general, that might help. At least until they can properly orient you to the rest.

Overall, I'd say if you feel well supported and it's not a toxic environment like some OR's can be, it might be worth sticking it out. If you feel like patient safety is not a huge issue, just your efficiency level, that will come with time. I hope this helps!

Hi there! Thanks so much for taking the time to respond.

Although we were put into a specific specialty, we were still having to do the peri-op 101 program. So even though we were focusing on one area, we weren’t getting a lot of OR time. I had been in a room a total of 4 times since starting a month ago... on top of trying to incorporate peri-op, due to the amount of orientees we had and decline in surgeries due to COVID, not all of us were able to get in on our services. Many of us were being made as “extras” or given other busy work. So after 1 month there, I couldn’t imagine having been prepared in the next few months.

As for the culture, I wouldn’t say it’s entirely toxic. The nurses that had been there for 10+ years were very comfortable with the surgeons and knew how to not piss them off. As for us newcomers, it was as if we didn’t exist. And any little thing we did wrong, it was like the end of the world. a lot of people addressed this saying “oh in time they’ll want to get to know you.” And that bothered me. I did transition in the ICU as a STUDENT nurse and doctors gave me more respect than the surgeons did as a registered nurse. On top of this, the nurses I had precepted with all had negative things to say about management. Which I’m sure can happen on any floor, but these nurses clearly felt they weren’t being heard. I had a good experience with the manager and they listened to me, heard me, and helped me find a solution. But I could see why others felt the way they did. It was just a lot to go into as a graduate nurse, the weirdest time to start, and I felt like the training program was inadequate and did not suite my needs. I’m sure others will thrive but it was not what I needed and I felt strongly about that.

I went and spoke with my manager, advocated for myself, and said I didn’t feel as though this was the right “fit” for me as a graduate nurse with no experience or confidence. She understood and granted me a waiver, so I was able to transfer into another position in which I think will be much more beneficial for me in the long term of my career! Thankfully it all worked out.

Thank you for the advice — it’s so appreciated!

[1m9s9s8]

15 hours ago, skydancer7 said:

For me, OR nursing is the type of nursing I dislike the least (don't worry, I am back in school for a different approach to medicine) ?

I’m so glad you found something you enjoy!! My heart is elsewhere (psychiatric nursing) and I think this made it even harder to pursue the OR knowing I wanted to be somewhere else. That is one thing I love about this field — the options are endless!

good luck to you and thank you!

[RNMikeMiller]

As a nurse, you should do whatever you can to protect patients' modesty and dignity. Many patients value modesty. Think about how you would feel if you had to strip naked in front of a bunch of people. Listen to patients' concerns about modesty carefully and work hard to meet their wishes. Many people don't feel comfortable having certain parts of their body exposed to the opposite sex except for spouse. They are not crazy. Many people would not be comfortable using public restrooms with people of the opposite sex. Do not take it personally. Many patients who are modest welcome care from opposite sex nurses for procedures that do not involve handling or exposure of private parts. One man shared that he would prefer a male nurse with a little experience than a female nurse who had 30 years of experience for intimate procedures. The number one priority should be the patient and the number two priority should be the patient's family. Listen to their wishes for modesty and work to accommodate them.

If a male patient requests an all-male nursing team for surgery, please work hard to accommodate his wish. You should allow the patient to wear as much as he can. For example, there is no reason for a person to take his/her underwear off for many types of surgeries. One man had a wrist reconstruction surgery with his pants left on. There is no need to catheterize a person for many surgeries such as knee, wrist, etc. Be sure you ask a male patient if he wants a male nurse for intimate procedures such as catheterization. Be sensitive to a male patient if he says no that he doesn’t want a female nurse to do intimate procedures on him such as urinary catheterization.

[Deborah segerson, BSN]

I totally agree. I've worked in surgery for several years. Our ASC has a policy that states patient’s are to remove any under garment, I'm guessing this is because of fire/burn risk. I had a 16 yr old that didn't want to remove her underwear, she was having breast surgery - I simply told her that she could leave them on but she would be at risk for a burn. Thank you for sharing and looking out for patients in their most vulnerable situations. ?

[skydancer7, BSN, RN]

CONGRATS, so glad you will be able to transfer! Sounds like that might work out best for you. Wishing you the best! Wish I would have gotten out of the OR sooner, but it got me to where I am today, so there's that ?