OR nurse vs. PACU nurse?

[Yunikat, BSN, CNA, RN]

Hello! I am back!!! ( Of course, no one knows me anymore!)

I am a nursing student at the University of Texas at Arlington and I will finish my last year of nursing school in December 2019. I can't believe my nursing journey is ALMOST OVER. I have posted so many questions on this website before I get in nursing school & program. Time really flies!

Just to give you a brief background about myself:

Becoming an RN has been my dream job in my early 20s, so I started preparing to get into the nursing school from 2012.

I got CNA certification and finished my prerequisites classes from Community College in Austin.

Once I got accepted in UTA in 2016 as a transfer student (not nursing school yet), I worked at Nursing home for about 4 months and then I started working at THR (Texas Health Resource) in PCU cardiac floor as a PCT about 3 years.

I finally got accepted in UTA Nursing program in January 2018. It was the BEST day of my life. 50 percent of my dream comes true.

Okay, my story does not end here!

Nursing school has been really tough!!! There was a time that I cried a lot due to high stress and overwhelming, especially in my first year of nursing school. I also learned a lot about the reality of nursing while I am working as PCT as well. I realized my passion was fading.

But I did not want to give up nursing.

I mean, I could not give up.

Nursing is the only career I've always been dreaming about and with passion.

I did not even know what I want to do for my life without nursing because that is the only thing I am highly interested in and wanted it for so long time. So from this time, I sought out to find the specialty where I have a passion and highly interested in.

In my Senior 1 semester, I had a chance to go to observe in the Operating Room during clinical, and I fell in love in OR like a first love. I was thrilled. My clinical site was a teaching hospital (UT Southwestern), so it was even more interesting that the Surgeon was teaching medical students during surgery. I think it was the most memorable clinical day throughout nursing school so far for me.

Therefore, I realized Operating Room is my passion for a nursing career, so I applied for a PCT job in UT Southwestern in PACU where it is close to OR (because OR do not hire PCT).

Now I am working at PACU in UT Southwestern as a PCT and I really enjoy working here!

Now my nurse residency opens soon and now I am curious about 2 things.

Question 1: which unit ( OR/ PACU) would be good to start as a new graduate RN to gain and learn a nursing skill for a long term?

I love learning and I like face-paced setting. I am 98% sure that I am going back to school to get MSN, but I do not know what specialty I want to do yet. If I can, I would definitely get the specialty with surgical.

Question 2: What are the MSN options for OR or PACU?

Thank you for your time and reading my long post (haha..)

I appreciate your feedback ?

[Rose_Queen, BSN, MSN, RN]

Generally, PACUs do not take new grads and instead prefer ICU experience. My facility used to take new grads; now, they're considering not even taking those with only med/surg experience.

You will learn skills in any unit you choose. Some say you lose skills in the OR- not exactly true. Sure, there's some you won't use, but you gain others and can learn/relearn down the road with a specialty change.

MSN for the OR tends to be either advanced practice as a first assistant with seeing patients outside of the OR, management, informatics, or education. The only MSN nurses I've seen in PACU were NPs who were from a group that was consulted or working with the surgeon and taking care of discharge assessments/orders or informatics. There are the occasional MSN degreed nurses working at the bedside- I was one for several years but did not get paid additional.

[Yunikat, BSN, CNA, RN]

15 minutes ago, Rose_Queen said:

Generally, PACUs do not take new grads and instead prefer ICU experience. My facility used to take new grads; now, they're considering not even taking those with only med/surg experience.

You will learn skills in any unit you choose. Some say you lose skills in the OR- not exactly true. Sure, there's some you won't use, but you gain others and can learn/relearn down the road with a specialty change.

MSN for the OR tends to be either advanced practice as a first assistant with seeing patients outside of the OR, management, informatics, or education. The only MSN nurses I've seen in PACU were NPs who were from a group that was consulted or working with the surgeon and taking care of discharge assessments/orders or informatics. There are the occasional MSN degreed nurses working at the bedside- I was one for several years but did not get paid additional.

Thank you so much for your feedback ?

[Didizain]

pacus usually hire experienced RNs but i saw a place recently that had a pacu fellowship

[Yunikat, BSN, CNA, RN]

1 minute ago, Didizain said:

pacus usually hire experienced RNs but i saw a place recently that had a pacu fellowship

I asked this questions because my unit, PACU where I work, hires new graduate nurses :)

[Didizain]

thats great! did it work out for you

[Yunikat, BSN, CNA, RN]

Just now, Didizain said:

thats great! did it work out for you

Not yet ! I am still a PCT in PACU ?

My hospital just opened the nurse residency in this week, and I applied to OR and PACU units for my interest fields. I know OR was my passion but now I am observing PACU nurses while I am working with them, I realized they do a lot of critical thinking. I talked to coworkers, and they love PACU and it will give me a lot of knowledge, which I love it because I want to improve my critical thinking. But some nurses told me they like OR and OR would give me more experience than PACU

I only went to OR just for clinical. So I do not know about OR much ....

So I was curious which unit I can keep your nursing school and get more experience... but everyone gives me different answers.

Therefore, I posted a topic to get to know more information ?

[Ca_Rn_Qd]

Hey there! I was an OR nurse and I now do pre op and pacu, mostly pacu. I would say as a new grad I would most definitely start in pacu. Just because you’ll be getting that necessary critical thinking experience most nurses need to get into pacu first. I love the OR, it is much different than the pacu though. Hope all goes well for you!

[FurBabyMom, MSN, RN]

Good luck! What is meant to be will be!

Other than that, it's a total crapshoot. Some people say you don't/can't learn critical thinking skills in the OR, but I think it depends on the person. I started neuro stepdown then went to the OR after a year. There are some things that you don't so much of in most facilities as an OR nurse (same is true for PACU). But despite some folks saying you gain/use no skills as an OR RN, that's wholly untrue if you're doing your job correctly.

Regarding MSNs in OR and PACU - some are APRNs. We have some APRNs with our anesthesia group who mostly do pre op stuff. We have some APRNs with our surgery groups who mostly see patients in clinic and some round in house. Very few APPs (PA or APRN) scrub and first assist in my facility as we have surgical residents. MSNs also show up in admin roles in perioperative services. Magnet facilities prefer a BSN or higher for managers, MSN/equivalent or higher for director or senior admin roles. In addition, we have MSNs or equivalents in education, informatics, quality, etc., roles.

My role is part admin part clinical. Paid more than before, mostly due to experience level not so much degree. Got my MSN so it's out of the way, and I don't need to be time pressured into obtaining later on based on a position's requirements. However, I got my MSN the cheapest way possible (spreading tuition reimbursement out as long as possible) so there's that...