New grad straight to OR - bad idea?

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So I am a senior in nursing school and will be graduating at the end of this year. Up until a few months ago, I had no idea what specialty of nursing I wanted to get into, so I thought I would just start in med-surg since that’s what everyone seemed to be advising. However, a few months ago, I came across a video of an OR nurse describing her role, and it got me really interested. Fast forward three months, and I have decided that I am interested in becoming an OR nurse. I have not shadowed yet, but I will in just a couple weeks.

There are a few things that appealed to me about the OR. One of them is the teamwork aspect of it. I have always preferred working in a team to working independently. With floor nursing, although you have support available if you need it, you are primarily responsible for your patients, you are usually alone in the room with them, and you often have to make independent judgment calls regarding their care. I dislike this about floor nursing.

Another thing I like about the OR is being able to focus entirely on one patient at a time. I work as a CNA on a med-surg floor right now, and I see the nurses constantly running around from room to room, juggling 4-6 patients and all their family members. I enjoy patient interaction, but I think that this constant cycling through new patients and family members every shift would burn me out fast. This is especially true because I am an introvert. Lastly, I am fascinated by surgery and anatomy. I have spent hours watching videos about different types of surgeries over the past three months since deciding that I’m interested in the OR.

That said, I have a few concerns that I’m wondering if anyone might speak to. Firstly, I’m worried about being able to get a job in the OR as a new grad. I know that OR residency programs exist, but I’m not sure how competitive they are (I live in a major metro area), and I will have an ADN, not a BSN, although I have a BA as well. I have requested OR placement for my senior practicum, so if I get it, hopefully that will improve my chances.

Another concern is whether or not it’s a good idea to start out in the OR. Although I would learn a ton of new things, part of me feels like it’s somewhat of a shame that I wouldn’t be putting to use so much of what I’ve learned in nursing school – doing H2T assessments, med passes, starting IVs, etc. If I started out in the OR and decided years later that I wanted to do a different type of nursing, I imagine I would be totally unequipped and would be as clueless as a new grad, even with years of OR experience (except for foleys and charting). I wonder if people who start out in the OR have difficulty changing specialties a few years into their career because hiring managers think their OR experience is too irrelevant. I also wonder if my lack of experience as a floor nurse would put me at a relative disadvantage in the OR compared to nurses who came into the OR with years of floor experience.

Finally, I wonder if I have the “right” personality for it. I have read numerous posts on this site saying you have to have a super strong personality and thick skin to work in the OR. I am not quite sure what to make of this. I understand that situations in the OR can be very intense, and that OR nurses are likely to get yelled at by surgeons from time to time. However, I kind of feel like you have to have a strong personality and thick skin to work as a nurse in any specialty. As I said, I am introvert. But I am NOT shy. I am an introvert in the sense that constantly meeting and interacting with new people burns me out quicker than my more extroverted peers, which is one reason why floor nursing appeals to me less. But I am not afraid to speak up and advocate for my patients, even if it means stepping on some toes. In general though, people perceive me as being a little more reserved and cool-headed; I am not someone who wears their emotions on their sleeve. I have been yelled at plenty by patients and it usually doesn’t bother me much. But that’s not the same thing as being yelled at by a doc or even another nurse, and that’s never actually happened to me in my short time as a nursing student and CNA. I think that I could probably get used to it over time.

Wow, I didn’t mean to write so much, but if anyone’s reading this, I would greatly appreciate some feedback/advice!  

Specializes in RN, CNOR, Neuro crani/spine.

Way tougher than a floor staff position.

Specializes in oncology.
On 7/7/2021 at 4:07 AM, kubelkabondy said:

the idea of working on a med-surg floor for a year while doing my BSN is really unappealing to me. I just don't feel like the floor is a good fit for me, and I also feel like the skills I'd gain there would for the most part not even be applicable to working in the OR.

Critical thinking skills like evaluating urine output?, skin turgor, pressure points, patient education and communication with the patient, the OR staff and the patient's family? How about organization of tasks? If you really want OR that is great but realize that after the patient leaves the OR arena they go to the med-surg floor.  What input could you have to make the transfer easier on the patient, family and subsequent nurses. 

Skills gained anywhere may be handy when needed. 

Specializes in oncology.
12 minutes ago, NeuroORRN said:

Way tougher than a floor staff position.

We all want to say OUR POSITION no matter where in the hospital is the toughest. It just does not work that way, although there is always a lot of boasting..I wonder who wins when the nurses brag among themselves as to who has the toughest job. 

Hey! Just wanted to say that I hope you're still working towards getting into OR nursing! I didn't go into the OR at first (even though there was an OR that was hiring!) and part of me regrets that, because I knew in school that the OR was awesome. I think that the OR is a good place for new grads to start. Like many people have said, it's like starting from ground zero, so having floor experience really isn't too much of an advantage. What I will say is that it's good to know the expected or potential of patients to know how to give better care - taking care of post op patients or working in a skilled nursing facility can help with teaching (since some patients will ask post op questions when you go to get them) and can help you improve your care in the OR (like knowing the ramifications of pressure injuries and infections, knowing what recovery is like). But you've probably already seen a good amount of that in clinicals. 

Surgeons may yell, but it's okay, you'll just brush it off and develop some thick skin. You'll run into the occasional one with a god- like complex who is just a jerk most of the time, but those have been far and few between. It also really depends on how your OR handles surgeons who behave poorly. I worked in one OR that let surgeons get away with murder, but the next OR I worked in (the current OR I'm at), it's not really tolerated. At the end of the day, the yelling just doesn't matter. I would have stayed at my first OR job, we just moved due to my husband's work.

You also don't need to have a super aggressive or extroverted personality to work in the OR. I've worked with all sorts of people. Just be yourself, stand your ground when you need to, stick up for patient safety always, and be willing to learn and be flexible. I worked in long term care for 4 years before going to the OR, worked in an OR for a year, moved and found a job in a clinic for a year, moved again and got an OR job again (husband was in the military and the job choices were limited!  - thus the clinic). The learning curve is steep when first going into the OR, but getting back into it is like riding a bike, so know that you can do other things and do them successfully if you want to leave the OR in the future. 

Best wishes! 

Ornurse12, thank you for your words of encouragement!  I am a LONG way out, as I am only in my first semester of nursing school. I do worry that out of school I will need to just take a job to get started and get experience, but then have a difficult time breaking in to the or to get experience. I live in the SF Bay Area, which doesn’t seem to have many internships or new grad residencies in the OR (at least not that I’ve been able to uncover yet).
 

How did you get your first position in to the OR, since you didn’t start there?  I want to be sure that I am able to “get my foot in the door” when opportunities come up.  I know that nursing school doesn’t really expose you to the OR setting.  During this Summer, I’m hoping to approach some local ORs or surgeons to see if I might be allowed to shadow just to get more familiar with facilities in the area. I’m hoping that may be a good way to start “networking”, as well as being able to see more of what it’s like in the OR. My husband works in the OR regularly as a device rep for a device that requires close collaboration between the surgeon and rep, and I am familiar with the challenges you mentioned due to listening to his stories.  Luckily, I have worked for quite a few extremely difficult bosses, where I had to keep my cool when my boss would get very upset/take her personal issues out on her employees, so I think I have thick enough skin for this position. But we’ll see!  

It's never too early to think about your future options! Glad to hear that you're thinking about your interests and goals so early along. 

I honestly just was looking for an OR job and applied to the hospital in town that was hiring a couple of nurses for the position. That's a pretty lame way of telling my job hunting story, but that's really just it. The OR I worked at was in need of nurses and very willing to train new, willing workers. The OR I currently work at only hires nurses with experience in the OR, though, all depends on the facility. I live in the Midwest, so things may be different in California, but it seems like nurses are in high demand everywhere anymore, so hopefully you won't have a hard time landing a job that you want. I do think it's a great idea to see about getting your foot in the door though shadowing and precepting. You may find it a more difficult to shadow or precept in the OR compared to the floor since we usually want less traffic in a room and less people to contaminate the field. But I bet that if you precept in a place that's actively looking to hire, you may find that they'd be happy to precept as that would be some free training. With anything it never hurts to try! Even if a position says that "experience is preferred", apply anyway! Worst thing that could happen is that you'd get denied. Also, if you can't get into the OR to precept or whatnot, going to pre op/same day surgery would be another good option - it's always good to see the whole of the picture.

If you have to get another nursing job right out of school, that's just fine! You may just find an area that is "your" area of nursing that you didn't expect to really enjoy. Plus, you'll find plenty of OR nurses who worked on the floor or elsewhere before changing on over to the OR (and then maybe leaving a few years down the road to pursue another interest). Nursing is so versatile, there's an area for just about everyone. 

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