newbie OR traveler?

suzanne4, RN · Dec 9, 2005

I highly suggest that you get more experience under your belt. Most of the OR positions that I have seen available have been on teams for major neuro cases, or open heart, as well as in the smaller community facilities, where you also will need to be able to do ortho, peds, vascular, what ever walks in the door.

These are even the types of agency assignments that are usually available for per diem shifts, as well.

Most of the OR travellers that I have worked with have had at least five years of experience or even more.

SFCardiacRN · Dec 10, 2005

3 years is usually considered the minimum.

shodobe · Dec 10, 2005

Lots of experience is the usual but I have talked with some travelers that have agencies that will place them in facilities that have the cases that will best benefit them. So if you have no knowledge of OHs or neuro they won't send you to facilities that specialize in that. It may restrict your choice of hospitals but it shouldn't keep you from traveling. We had a recent traveler that ONLY circulated! That was the wierdest. I thought ALL travelers had to do both. I guess I were wrong! Mike

Marie_LPN, RN, LPN, RN · Dec 10, 2005

Orthopedics. The biggest gripe a few years ago when my facility had travelers was that they knew nothing about ortho, scrub-wise.

grimmy, RN · Dec 10, 2005

i'm sure this has been discussed before in one context or another-sorry. how much experience should i have before traveling in the or? i have two years right now, but i've only learned neuro, gyn, plastics, smaller general cases (breasts, lap chole, bowel resections, hernias) and i scrubbed eyes when i was still in nursing school. i currently work in a large 40+ or teaching hospital. is that enough to start traveling? can you specify which services you'll work? if i could pick up 1 or 2 more services before starting to travel what would you suggest? also, how long does it take to set up your first assignment? i've heard 4-6 months.
thanks for the input!
:snowman1:

i can't answer the last question, but for the first, i have to agree with the others. give yourself another year and try to branch out a bit. learn some vascular procedures (have you seen how many vascular clamps there are, and what they're called?!? :eek: ) i agree that ortho is important, too. if you want to be very much in demand, do cardiac and thoracic. since you are already in a very large hospital, you've got some learning options open to you. most travel assignments (i work with quite a few travelers) won't allow you to pick and choose specialties unless its for a specific team (like cardiac or neuro-spine).

grimmy, RN · Dec 10, 2005

lots of experience is the usual but i have talked with some travelers that have agencies that will place them in facilities that have the cases that will best benefit them. so if you have no knowledge of ohs or neuro they won't send you to facilities that specialize in that. it may restrict your choice of hospitals but it shouldn't keep you from traveling. we had a recent traveler that only circulated! that was the wierdest. i thought all travelers had to do both. i guess i were wrong! mike

yeah, that one gets me, too...we don't allow any of our "permanent" rns to circulate only - why would we hire a traveler for beaucoup dollars to only circulate?? that blows me away.

Marie_LPN, RN, LPN, RN · Dec 10, 2005

(have you seen how many vascular clamps there are, and what they're called?!? )

heck, some of the surgeons don't even know what they are called. i've gotten so many finger puppet demonstrations with the phrase "the clamp that looks like this" i've lost count.

RN34TX · Dec 10, 2005

Lots of experience is the usual but I have talked with some travelers that have agencies that will place them in facilities that have the cases that will best benefit them. So if you have no knowledge of OHs or neuro they won't send you to facilities that specialize in that. It may restrict your choice of hospitals but it shouldn't keep you from traveling. We had a recent traveler that ONLY circulated! That was the wierdest. I thought ALL travelers had to do both. I guess I were wrong! Mike

One of the largest (they claim to be THE largest) travel nursing agencies actually advertise some of their positions as "Circulate only."

I just figured that they needed more people to circulate than scrub but apparantly not from the comments I've seen here.

Marie_LPN, RN, LPN, RN · Dec 10, 2005

One of the largest (they claim to be THE largest) travel nursing agencies actually advertise some of their positions as "Circulate only."
I just figured that they needed more people to circulate than scrub but apparantly not from the comments I've seen here.

What we've run into is an emergent life-or-death case comes through the door, and of course there's that one person that says "oh i don't know how to do that." Nevermind they've been there 20 years, but they don't know how to do that.

That happened a month ago on a ruptured AAA. The pt. did survive (miraculously), but we almost ran into a problem because, what a surprise, only certain nurses scrub on these things. Luckily people acted quickly, but this staff problem could have been prevented.

I see 2 people at fault for this:

1) An effort is not necessarily made to train all people for all things, a fault of management, but i wouldn't say a total fault. Granted, we have core people for TJR, but everyone should know what to do for the emergent cases, especially those on call.

2) We have people (who have been working at this OR for 10+ years) that the first thing they say when they hear, just an example, that a ORIF DHS hip is posted is "oh i don't know how to do that. Someone else will have to do it." So, of course, someone who's done several of them sets it up, assists, etc., as usual. Yet the same people that say they don't know how to do it certainly are not asking to learn how, and will avoid it if they can. It's not necessarily emergent, however, it is one of the most common call cases we get.

(What i'd really love to know is how someone can be at a facility for over 10 years, taking night call once a week, taking call for every 9th or 10th weekend, in a 17 room OR that only runs 1 room on the weekends and nights, and be completely clueless about anything beyond general surgery??? Surely somewhere in that call time, you've seen a broken hip??)

If there is something i want/need to learn, i ASK. I do not want to be left high and dry on my call times when there is no one to ask any questions to. Plus, to look at it this way, i get more training, more experience, more value, more job security.

I've even offered to show someone how to do something if they say "i don't know how". I get the answer of "maybe later". Yeah, right. :rolleyes:

In other words, experience in all specialities all around would be best, to try an avoid getting a crash course in the future.

RN34TX · Dec 10, 2005

Marie,

I hear you on that one!

I work in both PACU and ICU. Keep in mind that PACU functions as an ICU overflow, so technically, all of us should be ICU comfortable in addition to PACU functions.

Every couple of weeks, I hear the same thing:

"Oh, there's a trauma/craniotomy/ or acute MI or whatever coming in because all of the ICU's are full. I'm assigning it to your slots because ICU is your area."

Or "This patient is coming in with a Swan so I'm giving it to you."

I'm not the most fancy high tech ICU nurse in the world who can take open hearts or anything that rolls through the door, but I at least try to learn and float to other ICU's on my off days and get in on whatever I can.

It's not right to punish me for it by giving me the heaviest patients while nurses who have been there for many years with BSN's and CPAN certifications are making a LOT more than I am while selecting the easiest "lap chole" or "I & D" type cases that are day surgery cases going home the same day.

grimmy, RN · Dec 11, 2005

heck, some of the surgeons don't even know what they are called. i've gotten so many finger puppet demonstrations with the phrase "the clamp that looks like this" i've lost count.

i work fairly regularly with two thoracic surgeons who use their own specific type of vascular clamp - one of them (a) is calm, never yells, the other (b) is a hothead. anyway, i taught one of the orientees to always give dr. a the renal-pedicle clamp and dr. b the 3/4 semm. and, if you're not entirely familiar, they look pretty darn similar at first glance. well, the poor orientee gave dr. b the renal pedicle, and dr. b glared at me, "didn't you tell her i use the 3/4 semm?!?" poor kid. she piped up, "they look so much alike." he proceeded to give her a lecture on how they are not alike. :rolleyes: about all i can remember most days are the aortic coarct clamp, debakey, satinsky, and cooley clamps. when i do aaa's or thoracic aa's, i show them the assortment, and let them choose for themselves. when the spit hits the fan, a straight debakey will always work.

oh, and then there's the vascular surgeon who refuses to use castroviejo needleholders - he insists on a very long and fine rider...he calls the cv's "candy-a$$ needleholders." :chuckle