On transitioning to the OR....is best to start in a large teaching centre?

[ruralgirl08]

Hi...I am considering moving to the OR from a Med-surg floor. I have applied to a OR post-grad program which starts part-time, and it has a clinical component (so you choose the hospital to do this in.) The 12hr shifts have become too much for my 1 hr commute & my husbands line of work does not make it easy either.

I work in a large teaching hospital. Do you think its better to start off an OR career in a larger centre with a large variety of surgeries?

I may eventually apply to a small community hospital which is only a 30mins drive, though it is much harder to get into. Will the large teaching centre experience be considered a strong asset if applying to a smaller community hospital down the road?

[ruralgirl08]

Hi, I haven't got any replies yet. So I wanna rephrase (de-clutter) the question.

Is it better for a new OR RN to start off in a large teaching/trauma centre, then to begin a career in a small community hospital? Will it make the nurse more marketable?

Thanks for the responses.

[cinn05]

It depends what your goal(s) is... which may not be clear to you until you actually experience the different areas of surgery. I transferred from NICU to OR and it was a sweeping and dramatic difference. Going from an ICU environment where there was hands-on care and a lot of personal responsibility for patient welfare to transitioning to a much more interdependent and collaborative sort of care took a lot of getting used to. That said, I would recommend starting out in a hospital with a bigger OR/ER/census because then you will truly get a wide smattering of cases. I had a 6 month orientation which barely felt enough (but was). In the hospital I was in, there were 2 floors dedicated to OR. On one floor, RNs were assigned to a specialty (after going through orientation and kind of learning and being exposed to all specialties). On the other floor, RNs were expected to be able to circulate all specialties on that floor after going through orientation. At a smaller hospital, you may not even be exposed to some specialties and especially not to some emergent/trauma cases because at least in our area, it was the community hospitals that transferred any type of trauma surgery to us. They didn't want to touch it.

So, think about your goals. You'll figure it out.

[Rose_Queen, BSN, MSN, RN]

There are pros and cons of both.

Teaching hospital- More variety, so you'd learn more. Residents- can be pro or con (usually slower, so you have more time to focus on steps when you first start, but can get boring as you get oriented- I would scratch out my eyes if I was in a room full of lap choles that all took 3 hours to do, also frequently rotate, so there's always new faces). More personalities to deal with. You'd get to experience traumas/emergencies moreso than a small community hospital where those kinds of things are transferred out.

Community hospital- if no residents, cases typically can get done faster. Fewer personalities to deal with, which can lead to better teamwork. Same docs, so you know if they want something, but it just hasn't been changed on their preference card. Don't get the experience with emergencies/traumas since they might go to larger hospitals.

I currently work in a large community hospital, level 2 trauma. Very rarely see residents, and if they are in the OR, they are only assisting, never primary. Some people work in the same specialty every day, I rotate through all of them except cardiovascular. I love the variety, I love that I know what to expect with each surgeon, and most days I love the people I work with.

[ruralgirl08]

Hi, thanks for the feedback, sort of similar to the floor nursing in that, it may be better to start off in a large teaching/trauma centre, early in the career.

I think I will try and get the training were I work, and then maybe go to a community hospital. Thanks again.