career growth in the OR

  1. im trying to decide on what field i should go to. i loved working in the OR as a student. i am now deciding whether i want to be an OR nurse or a crna. I would prefer working in the OR for now, instead of the ICU which is the requirement to get into a crna program, which i am also not in any hurry to apply to. If its as fulfilling as i think it is then I would gladly stay in the OR.

    Aside from being a circulating / scrub nurse, are there any other positions available for nurses in the OR? Is there a career ladder in there or does one remain to be a circulating / scrub nurse?

    Thanks for the help nurses!!!
  2. Visit kalayaan profile page

    About kalayaan

    Joined: Aug '06; Posts: 114

    11 Comments

  3. by   Rezidentura
    There are several opportunities in my hospital.

    The obvious step, or clincal ladder.

    Team Leader or Clinical Coordinator

    Nurse Educator

    Operative Manager.

    None of these positions would compare to the pay of a CRNA but they are possibilities
  4. by   elcue
    These are totally different disciplines of patient care. I think that if you don't like critical care, you won't like being an anesthetist. It's intensely one-on-one.
    Although an OR nurse also focuses on one patient, the focus is broader. The circulator is more of a team leader, organizing and conducting everything for each case, as well as for the day's schedule for that OR. The CRNA is more narrowly focused on one patient's physical needs.
  5. by   Rezidentura
    I would say it's as fullfiling as you want to make it. Personally I love the OR but I take the time to learn every detail I can about all the equipment, read all the time about my specialty and take an active and engaged role in the procedures even if I'm not the scrub.

    It's the only place where you can get instant gratification for making the patient better.
  6. by   kalayaan
    thanks everyone! it took a while to get a reply, but it was worth the wait.
  7. by   peddler
    I've only been in the OR for 8 months, but I too am looking forward to moving on. The two years I spent in ICU and the two years I spent in the ER really made me engage my brain and my type-A take-charge tell everyone what to do personality is more in-tuned with something besides counting bloody rags, checking consent forms, and being responsible for crap that a surgeon does to a pt. Don't get me wrong; in the OR we have it so easy that I often tell coworkers that this job really isn't a RN position (and then I get the usual earful). The "earful" is always from a long-term OR nurse or someone who walked into the OR straight out of college and doesn't know anaphylaxis from prophylaxis. But that's ok. Not everyone is meant to diagnose and treat and save souls. I do find it amazing how many of my counterparts are scheming right along with me though to get back to nursing.

    Good luck in whatever path you choose. I think CRNA would be an incredibly hard program to get into, much less succeed in if you get into an OR nurse groove. I'm steadily losing all of that incredibly hard to get knowledge like normal PAWP, CVP, ICP, CCO, RAP, and the like. I spend much more time listening to staff anesthesia teaching residents than I do to "can I get whatever on an SH".

  8. by   ortess1971
    Quote from peddler
    I've only been in the OR for 8 months, but I too am looking forward to moving on. The two years I spent in ICU and the two years I spent in the ER really made me engage my brain and my type-A take-charge tell everyone what to do personality is more in-tuned with something besides counting bloody rags, checking consent forms, and being responsible for crap that a surgeon does to a pt. Don't get me wrong; in the OR we have it so easy that I often tell coworkers that this job really isn't a RN position (and then I get the usual earful). The "earful" is always from a long-term OR nurse or someone who walked into the OR straight out of college and doesn't know anaphylaxis from prophylaxis. But that's ok. Not everyone is meant to diagnose and treat and save souls. I do find it amazing how many of my counterparts are scheming right along with me though to get back to nursi
    Good luck in whatever path you choose. I think CRNA would be an incredibly hard program to get into, much less succeed in if you get into an OR nurse groove. I'm steadily losing all of that incredibly hard to get knowledge like normal PAWP, CVP, ICP, CCO, RAP, and the like. I spend much more time listening to staff anesthesia teaching residents than I do to "can I get whatever on an SH".
    Ok, first of all, I know perfectly well the difference between anaphylaxis and prophylaxis. Secondly, no RN diagnoses patients and we do quite a bit of life saving in the OR. OR nursing is what you make it-I've found the nurses who hate the OR are the types to sit their butts down in the corner, read a magazine while the case is going on etc..A third of our CRNA's were once circulators, so it can be done with an OR background. I truly feel badly for you that you are unhappy with your job-the one thing I wish is that those nurses who hate the OR for whatever reason(bored, can't hack it, etc) wouldn't insult those of us who love what they do. I AM an RN, I'm proud of what I do, and I'm proud of the nurses(and techs!!) I work with. We work plenty hard in the OR and we're not mindless drones. I've had a patient code on a cysto case due to a poorly placed spinal, and let me tell you, the OR and PACU nurses saved that patient. There were only 6 of us there(this happened at 10 pm) and the anesthesia doc was running around in a panic.(he placed the spinal without an IV running, and the patient wasn't on a monitor) That 78 year old gentleman lived, and it was because of the intelligence, quick thinking and teamwork of the nurses. LOL, I reread my post and it is an "earfull" but I just had to put my 2 cents in...Signed, A Proud OR Nurse...
  9. by   CuttingEdgeRN
    :yeahthat:
    ORTess, YOU GO GIRL!
    PS: There's no since debating that subject with a Die Hard unhappy with their job type person though. Just be glad they aren't your co-worker
  10. by   crackerjack
    I've only been in the OR for 6 months and entered as a new grad. There are many aspects of being a circulator that can appear to be a 'gopher' or pure mechanical work but if one cares to look deeper at things, all that we do is centered on patient care. The largest roles the circulating RN plays are that of patient advocate and safety management. I've had to insist with surgeons/anesthetists/residents/med students on certain things to ensure patient safety. Making sure the consent is signed may seem like clerical work but it's the last check of the nurse in identifying correct patient, correct procedure and correct site...ok, second to last, last is the time out. Checking a patient, while doing all that 'clerical' feeling stuff, simple things like querrying labs, consent, allergies and such play very important roles in patient care. I've had a surgeon and anesthesiologist who had overlooked/forgotten that our patient was allergic to dye and were going to proceed with an IOC without precautions. Sometimes it feels so silly and rote to ask for the millionth time that day to a patient who's heard it at least 3 other times the last time they had anything to eat or drink but it could be the one where lo and behold, that 'one more time' it is asked and we learn that "oh, I had a breakfast burrito this morning but that was a long time ago" (real case scenerio, 1.5 hrs since that 'little' breakfast burrito btw) and then get furious when the case is cancelled. Making sure the equipment is available and in working order for the physician is another aspect of patient treatment, ensuring the needed tools are available to make this patient better is crucial. "Counting bloody rags" ensures one isn't left in the patient to cause harm, sometimes fatal. Sure, anyone can count but is the orderly going to care as much if there's one missing, would the orderly just assume there was a miscount or that one had been tossed in the trash, would the orderly even mention the discrepancy? Now as an RN, we know better than to make those assumptions. As an RN we know what must be done to either find it and account for everything, even if that requires an x-ray to locate it. Sure, patient care in the OR is vastly different than ICU or ER nursing, it is highly specialized.

    Don't get me wrong, many orderlies who have worked in the OR for a while have come to realize that a miscount is a serious issue that must be addressed and could probably tell you what has to be done. We have some who are knowledgeable enough to know this, we have one who couldn't care less. That's why the RN has to take care of what seems like a demeaning task to some.

    We have a scrub at our facility who has made a point of telling me, and everyone else I'm sure, that in her opinion the circulator is nothing more than a glorified typist (we chart electronically). Yet when I voiced concern over a patient scheduled for a life/death procedure who had a K+ of 2.8, she looks at me and tells me she hasn't a clue what that means and I may as well speaking Greek. Go figure, the receptionist wouldn't know either but as an RN I do and can prepare for what we will likely face in the OR with this patient who couldn't wait until things improved.

    I have learned a TON of things since entering this field but know that I have a ton more to learn and am enjoying every minute of it. I look forward to the day when I can be confident in most any OR moment, efficient and proficient at what I do.
  11. by   ortess1971
    Quote from crackerjack
    I've only been in the OR for 6 months and entered as a new grad. There are many aspects of being a circulator that can appear to be a 'gopher' or pure mechanical work but if one cares to look deeper at things, all that we do is centered on patient care. The largest roles the circulating RN plays are that of patient advocate and safety management. I've had to insist with surgeons/anesthetists/residents/med students on certain things to ensure patient safety. Making sure the consent is signed may seem like clerical work but it's the last check of the nurse in identifying correct patient, correct procedure and correct site...ok, second to last, last is the time out. Checking a patient, while doing all that 'clerical' feeling stuff, simple things like querrying labs, consent, allergies and such play very important roles in patient care. I've had a surgeon and anesthesiologist who had overlooked/forgotten that our patient was allergic to dye and were going to proceed with an IOC without precautions. Sometimes it feels so silly and rote to ask for the millionth time that day to a patient who's heard it at least 3 other times the last time they had anything to eat or drink but it could be the one where lo and behold, that 'one more time' it is asked and we learn that "oh, I had a breakfast burrito this morning but that was a long time ago" (real case scenerio, 1.5 hrs since that 'little' breakfast burrito btw) and then get furious when the case is cancelled. Making sure the equipment is available and in working order for the physician is another aspect of patient treatment, ensuring the needed tools are available to make this patient better is crucial. "Counting bloody rags" ensures one isn't left in the patient to cause harm, sometimes fatal. Sure, anyone can count but is the orderly going to care as much if there's one missing, would the orderly just assume there was a miscount or that one had been tossed in the trash, would the orderly even mention the discrepancy? Now as an RN, we know better than to make those assumptions. As an RN we know what must be done to either find it and account for everything, even if that requires an x-ray to locate it. Sure, patient care in the OR is vastly different than ICU or ER nursing, it is highly specialized.

    Don't get me wrong, many orderlies who have worked in the OR for a while have come to realize that a miscount is a serious issue that must be addressed and could probably tell you what has to be done. We have some who are knowledgeable enough to know this, we have one who couldn't care less. That's why the RN has to take care of what seems like a demeaning task to some.

    We have a scrub at our facility who has made a point of telling me, and everyone else I'm sure, that in her opinion the circulator is nothing more than a glorified typist (we chart electronically). Yet when I voiced concern over a patient scheduled for a life/death procedure who had a K+ of 2.8, she looks at me and tells me she hasn't a clue what that means and I may as well speaking Greek. Go figure, the receptionist wouldn't know either but as an RN I do and can prepare for what we will likely face in the OR with this patient who couldn't wait until things improved.

    I have learned a TON of things since entering this field but know that I have a ton more to learn and am enjoying every minute of it. I look forward to the day when I can be confident in most any OR moment, efficient and proficient at what I do.
    Wow, I bet we OR nurses could take over a small country if we tried!!!! Excellent post!!!
  12. by   LKG6
    Quote from ortess1971
    Wow, I bet we OR nurses could take over a small country if we tried!!!! Excellent post!!!
    :roll
    Katie
  13. by   cwazycwissyRN
    Quote from ortess1971
    Wow, I bet we OR nurses could take over a small country if we tried!!!! Excellent post!!!
    umpiron: [FONT="Fixedsys"]What they said Great post crackerjack

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