Soon to be new grad BSN...should I work below license while waiting for position to open?

Specialties Operating Room

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Hello all,

So I am currently completing my BSN in a second degree program. During the last 3 years, I have been working as a Unit Secretary/PCT at a trauma 2 hospital near my house. I think I would like to be an OR nurse, and this hospital offers an OR nurse fellowship (and accepts new grads). I've spoken to a few people in our OR, and was basically told I would be accepted, except they are on a hiring freeze until we launch EPIC in March. I graduate August 1 of this year. They do have numerous Operating Assistant positions open now however....my question to you is this- should I see if HR will allow me to take one of these positions and wait until this fellowship opens up/get experience in the OR? Or should I just look elsewhere? This hospital is 20 min from my home and I know it and the people here very well. It also offers a pension after being an employee here 5 years. Thanks in advance!

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Specializes in OR, Nursing Professional Development.

March is a long way away. I would not be willing to work below my level of licensure for that long (if at all). One of the biggest issues with working below your license is that your employer restricts you to your job duties while the BON expects you to act to the level of your licensure.

Additionally, if the OR assistants in your facility are doing the same duties as they are in mine, you aren't gaining any experience. They are responsible for helping to move/position patients and assisting in room turnover. They are not in any way involved in the procedure itself.

Personally, I'd look elsewhere. There are no guarantees in life, and you don't want to hold out for a position in March that you might not get- then you'd be an even staler new grad with no experience.

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Speaking of guarantees, I would agree to wait until March for a fellowship with a guarantee. You would certainly be nuts to do so without it. I'd also try to find another fellowship and if you do, tell the hospital they will lose you without immediate employment as an RN, even if it means medsurg until the fellowship starts.

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Specializes in Nursing Professional Development.
Speaking of guarantees, I would agree to wait until March for a fellowship with a guarantee. You would certainly be nuts to do so without it. I'd also try to find another fellowship and if you do, tell the hospital they will lose you without immediate employment as an RN, even if it means medsurg until the fellowship starts.

I like the idea of seeing if you can work something out with your employer. They might be willing to hire you as a nurse, go through a general nursing orientation -- perhaps even cross train to PACU -- and get you some RN experience before starting the OR fellowship. At least discuss it with them. All they can do is say "No."

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Specializes in DHSc, PA-C.
March is a long way away. I would not be willing to work below my level of licensure for that long (if at all). One of the biggest issues with working below your license is that your employer restricts you to your job duties while the BON expects you to act to the level of your licensure.

Uhh, this statement is not correct. The BON doesn't care if you are working below your level of licensure, just don't ever work ABOVE your level. They will care about that. If said statement was true that means no NP could never also then go work as a floor nurse.

I worked front desk at a hotel during school and continued to work "below my level" (is it me or does that just sound like something a snobby person would say) as a front desk hotel clerk for 3 months while waiting for licensure and credentialing.

So, to the OP if you want to work at this same hospital and have to wait until March, then that is what you do. Certainly, if you can temporarily go to this OR assistant job and get exposure to the OR staff, that would be a big benefit. Even though you won't be doing RN duties, you will still be around your future co-workers and this has to be of some benefit to be familiar with your working environment prior to starting the RN fellowship.

Just my streets smarts is all I have to base my statements and opinions on.

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Specializes in OR, Nursing Professional Development.
Uhh, this statement is not correct. The BON doesn't care if you are working below your level of licensure, just don't ever work ABOVE your level. They will care about that. If said statement was true that means no NP could never also then go work as a floor nurse.

Actually, the BON will not care if you are working below the level of your licensure. However, should something happen to a patient and the nurse does not act as a prudent nurse should, the nurse can face disciplinary actions. It's not that it's not allowed to happen, but rather what risks one is willing to take should one become stuck between a rock and a hard place involving scope of the job and scope of the RN license.

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How badly do you need income? It might take you longer than until March to find another RN position.

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Specializes in RN-BC, SCRN.

It's sort of uncanny how I am in the same position as the original poster. I am finishing my BSN end of July. I actually have been in a periop program for the last two semesters as part of my education as a pipeline to the OR, I've basically already done most of Periop 101 as part of my BSN. I've been a member of AORN for almost a year as a student. However the closest hospital to me, where I am doing practicum in the OR has no open spots for me, even though the hospital org accepted me into their official new grad periop program. They offered me a spot at a hospital 2 hours away from my house that i can't accept (how would I ever take call). There are several other nearby hospitals within the org that I was willing to go to, but they are full on staff right now. No, moving is not an option for me.

My options would be to wait until Spring for openings in other programs, or take one of the many other offers in new grad residency non-OR programs I got in the meantime. In the end I took a Med Surg job in neuro at another organization that has great pay, great benefits and yes, I will be fully vested in pension in 5 years if I stay with the org that hired me (which has the best reputation in my metro area). The same org wanted me for their periop program this Fall, but it starts Aug 1st, and I won't be licensed yet, and their next cohort is also in the Spring. So though it's not my passion, I'll get some valuable bedside experience and move into periop later. It's hard, because it's not what my goal was, and I have a lot of knowledge that I won't get to use for awhile, but it's the best option that will in the end benefit me most as a new grad in the long run. Some nurses likely could afford to wait, but I'm an older grad and I don't want unnecessary gaps in my resume. I also can't afford not to work and the org I signed with (1 year contract) lets me start work the week after I graduate as an extern, moving into the residency program when I pass boards. Gotta think about those pesky student loans. Just some stuff to think about.

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If your passion is OR, I'd take the offer two hours away. I get you don't want to move so think of it as an extended travel assignment. Eventually (and likely within a year) an OR position will open locally (lots of old OR nurses). Costly, but rent two hours away - perhaps a house share will work so you can go home often. Sacrifice and paying your dues is common at the beginning of any new career.

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Hmmm, I wouldn't like the idea of working for less when I know I could be making more, plus like someone said above, March is a long time from now. Have you tried applying for other RN positions within the facility? Surely as long as you are within the network, the OR position will remain open to you. I'd talk to management to see how that would work out. Best of luck!

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