Hello all and thank you in advanced for taking the time to read this. I am a brand new Dec 2015 grad and new to the OR. I finished Periop 101 March 25 and I have been in rooms since. Now, less than 4 weeks later my hospital has me being a circulator by myself in GEN and GYN cases on April 26 and 29 with more solo cases planned for the following weeks. I am being told someone is on standby just a phone call away but none of that makes me feel comfortable. I am terribly nervous about the pace that they are moving me along because our OR is so desperate for Circulators.
I signed a 2 year contract that the hospital values at $5,000. I drive 140miles every day of the week. I knew about the drive before, but felt that I was so excited that it would be worth it. Well...needless to say this has not been worth it. I didn't know that I had so little hands on with the patient and I'm desperately missing patient care.
I'm concerned about losing my license if I make a mistake since my orientation seems to be rushed along due to the OR wanting to open more rooms up.
I turned down an ICU residency program and I really regret turning it down. I re-applied for it and had an interview that went really well. No offers have been just yet. I just don't know if its smart for me to quit so quickly? If I should stay at least 6mo? If it is normal for me to be circulating solo so quickly?
Any suggestions would be greatly appreciated! Thanks in advanced!
I would bring up that your contract states 6 months. If they aren't giving that to you, and won't, I'd go to HR and tell them that you want to leave and you won't be paying them back due to that breach of contract.
The length of orientation is suppose to be 6mo. It was supposed to be classroom, videos, and preceptor. I've precepted with every last nurse we have in the OR. Everyone does things differently. There is no standard way. There is no new Orientee binder to refer to, they simply refer me to the Hospital Policy.
if you were told it was a 6 month orientation etc... They are the ones breaking the contract
if you were told it was a 6 month orientation etc... They are the ones breaking the contract
I am very nervous to start off my nursing career this way. I'm not sure about the backlash. And I've heard when you cause a ripple in my unit with the manager that she makes your life a living hell. And that was another fairly new nurse who told me that.
I am very nervous to start off my nursing career this way. I'm not sure about the backlash. And I've heard when you cause a ripple in my unit with the manager that she makes your life a living hell. And that was another fairly new nurse who told me that.
There's the rub. What do you do now? Do you a) look for work elsewhere and pay $5K for it (though yes, they are the ones who aren't holding up their end first), b) speak with someone about the terms of the contract (probably someone above your manager) and hold them to it, after which there is malicious behavior toward you for standing up for yourself; or c) suffer in silence, ride it out, and leave when you're done? It's a tough position. I would like to think that your bosses would stick to the terms of the contract without penalizing you for standing up for yourself, but that might not be realistic.
I guess the prudent thing would be to see if you get the ICU position, and then go from there. I am sorry you are in this unenviable position! A lawyer may indeed be helpful.
There's the rub. What do you do now? Do you a) look for work elsewhere and pay $5K for it (though yes, they are the ones who aren't holding up their end first), b) speak with someone about the terms of the contract (probably someone above your manager) and hold them to it, after which there is malicious behavior toward you for standing up for yourself; or c) suffer in silence, ride it out, and leave when you're done? It's a tough position. I would like to think that your bosses would stick to the terms of the contract without penalizing you for standing up for yourself, but that might not be realistic.
I guess the prudent thing would be to see if you get the ICU position, and then go from there. I am sorry you are in this unenviable position! A lawyer may indeed be helpful.
Pixie you really said it best! So, I think my plan will be to learn as much as I can while I'm there and plan to leave as soon as possible. $5000 isn't too bad when I can pick up hours and save on the drive. I have a tier plan to the jobs I'm searching for: 1-ICU/ER, 2-Step down units, 3-anything closest to home. I have a few things setup in case I do not get the ICU residency program. The good thing about the ICU residency is that it will not start until July so I will have 6mo experience from the OR.
There is just so many reasons why I don't want to stay at my current location. Safety doesn't seem to be priority (for me or the patient), breaks aren't given like they should, sometimes lunches aren't given until after 1p when you scheduled to leave at 3p. Major staffing shortage so your forced to stay late at least 2x wk in addition to being on call. I really just want to leave before I start call and lates.
Pixie you really said it best! So, I think my plan will be to learn as much as I can while I'm there and plan to leave as soon as possible. $5000 isn't too bad when I can pick up hours and save on the drive.
Your commute sounds horrible. I did that in the early 2000s, when I was living in the DC area. I had moved 50 miles west of my office building which wasn't bad, but then our company moved locations and that resulted in an 89-mile commute, one way, in the DC area. I was nearly homicidal at the end of the drive each way because it took me at least 1.5 hours no matter which way I went, and it was often longer. No good. I had been with the company for a decade but found something closer to home to save my sanity after they refused to let me telecommute all but one day each week (this was not a healthcare job ). After I submitted my resignation they scrambled and said I could telecommute all week, but at that point they'd burned the bridge. They had to hire two people to replace my skill set. Their loss!
Regarding the breaks/getting out late/etc., I have always worked ER so it's very unpredictable; I am very, very bad about taking my breaks. I seldom leave the floor, and it's a rare day when I'd get a lunch or take a break away from the ER. I would try to make it to the bathroom at least once. These things are not good for me. But I would imagine an OR is a more scheduled environment, though I am sure things come up that are unexpected or unscheduled. You might find that it's more difficult to get a break in the critical care environment, but that might be me projecting my bad no-break habits onto what I expect.
Your commute sounds horrible. I did that in the early 2000s, when I was living in the DC area. I had moved 50 miles west of my office building which wasn't bad, but then our company moved locations and that resulted in an 89-mile commute, one way, in the DC area. I was nearly homicidal at the end of the drive each way because it took me at least 1.5 hours no matter which way I went, and it was often longer. No good. I had been with the company for a decade but found something closer to home to save my sanity after they refused to let me telecommute all but one day each week (this was not a healthcare job ). After I submitted my resignation they scrambled and said I could telecommute all week, but at that point they'd burned the bridge. They had to hire two people to replace my skill set. Their loss!
The OR is a bit more predictable, but the our OR is extremely busy. We do about 30+ surgeries daily. Since Im up so early at 4am and have a breakfast shake at 5am and don't eat lunch until 1p, I usually start to feel very sick if I can't get something in before hand. I bring all my meals and rarely leave also just might need to bring finger foods!
You sound like you were handling a TON for your company! Your not usually appreciated until your walking out of the door!
First, I'm not sure what made you think that ICU and OR were going to be similar. Even if you spent a few hours in the OR, you should have had some idea.
That being said; I have been in the OR as circulator/scrub for 16 years. When we get a new hire, we first teach them the pre-op world (getting the pt history, start the IV, prep, charting, eMAR). That usually lasts about a week. I know that doesn't seem like a lot of time, but we are small, a permanent circulator doesn't spend a great deal of time in pre-op.
Then we give them a full 3 months training as a circulator. When I am training, I like to have them watch for a couple of days, then help, then try one on their own (with me in the room). You know, the whole "see one, do one, teach one". This will go on for several weeks. Then I will run the case and let them chart for a couple of weeks until they get more familiar with charting. When I feel they are ready, I have them run the case AND do the charting. I keep myself available in the room the whole time to ensure they are doing it correctly and in case they have any questions. I do not take the sink or swim approach.
Most specialties have their teams that they prefer, so on the special cases they get some training but more so on the cases that could be a "call back" case (d&c, lap appy etc). I constantly ask if they feel confident and comfortable with a case that I've assigned them. I ask for feedback about how they feel they are doing as to keep the lines of communication open.
Yes. There are many times too that we get to do hands-on pt care. Such as; hanging blood, assessing fluid intake, constant assessment of pt position and safety, assist anesthesia when necessary. Helping to ensure that the case goes smoothly and the scrub team has everything they need (have fed tums or juice to the surgeon a time or two). I've even done ACLS in the OR.
If you are having a hard time, go to your supervisor and tell them you are not ready to fly solo. It's up to you, but the OR can be a truly exciting place if you don't give up on it.
I also do PACU. That could be an option for you. Includes more of the ICU monitoring skills.
First, I'm not sure what made you think that ICU and OR were going to be similar. Even if you spent a few hours in the OR, you should have had some idea.
That being said; I have been in the OR as circulator/scrub for 16 years. When we get a new hire, we first teach them the pre-op world (getting the pt history, start the IV, prep, charting, eMAR). That usually lasts about a week. I know that doesn't seem like a lot of time, but we are small, a permanent circulator doesn't spend a great deal of time in pre-op.
Then we give them a full 3 months training as a circulator. When I am training, I like to have them watch for a couple of days, then help, then try one on their own (with me in the room). You know, the whole "see one, do one, teach one". This will go on for several weeks. Then I will run the case and let them chart for a couple of weeks until they get more familiar with charting. When I feel they are ready, I have them run the case AND do the charting. I keep myself available in the room the whole time to ensure they are doing it correctly and in case they have any questions. I do not take the sink or swim approach.
Most specialties have their teams that they prefer, so on the special cases they get some training but more so on the cases that could be a "call back" case (d&c, lap appy etc). I constantly ask if they feel confident and comfortable with a case that I've assigned them. I ask for feedback about how they feel they are doing as to keep the lines of communication open.
Yes. There are many times too that we get to do hands-on pt care. Such as; hanging blood, assessing fluid intake, constant assessment of pt position and safety, assist anesthesia when necessary.
Your OR is quite different than mine. The circulator only does the pre-op assessment, bring patient back, position, make sure scrub team has everything they need and chart. That is literally ALL that I do. I wish I did what you stated you hospital allows the circulator to do.
And my only comparison I have for the OR to the ICU, is the focused attention on few patients at one time. I wish my OR wasn't so limited. I think had my experience been different than maybe I would feel differently
sounds pretty straight forward to me. You have a contract, they are not honoring it. I would double triple and quadruple check the fine print though, before bringing this up and pushing further than your manager. I would also note somewhere her response to you when you did question it.
I would also highly encourage shadowing one of the ICU nurses where you are looking, or any further position in general. You have no idea how some facilities and floors are different from school.
Thank you for your reply. I have voiced my concern to the manager. She said if I think that I'm going to working with a preceptor for 6mo that is simply not going to happen. That was her exact words, once I get one area I will work solo there and move on the more with a preceptor. So say I have a GEN case I have those then I will do those solo and she will add in ORTHO with a preceptor. I just don't agree. As far as the distance, I signed up for the distance so that isn't a problem, it only sucks when your not happy. I get up at 4am and home by 5p every day...if I was kinda happy with my situation then it wouldn't matter.
The job not being what you expected and the drive being long are not good reasons to quit, but the hospital violating your contract and putting your license at risk is. I looked into OR at my last job change, but there weren't many openings and all wanted experience. What I did find out is that standard orientation is AT LEAST six months, and I was told it's normal to not feel fully comfortable for a year.
I second the recommendation to get an employment lawyer. They should not be allowed to penalize you for breach of contract, because they did so first. The fact that they cut off your orientation is probably proof enough, but try to create some written documentation of the fact that cutting orientation short was not your choice and something you are not comfortable with. "If you didn't document it, it didn't happen" applies to a lot of non-nursing situations as well. E-mail is a great tool for that.
). After I submitted my resignation they scrambled and said I could telecommute all week, but at that point they'd burned the bridge. They had to hire two people to replace my skill set. Their loss!
BittyBabyGrower, MSN, RN
1,823 Posts
I would bring up that your contract states 6 months. If they aren't giving that to you, and won't, I'd go to HR and tell them that you want to leave and you won't be paying them back due to that breach of contract.