OR nurse wants to go to ICU

Ruby Vee, BSN · Aug 25, 2009

hi everyone,
i am still a new grad rn, passed the nclex in july and in orientation in the or. i did 1 year of student nursing here and i used to think this was what i wanted to do. now i am uninterested and not challenged, and i feel like i am wasting my education and nursing skills. i just feel like this is not nursing, and i really miss the patient interaction. i would really love to work in the icu and they do accept new grads at my hospital. my question is should i stick it out here for a year so i don't waste all the time and money put into training me? i feel like it would be very rude to leave while i am still on orientation (ours is 6 months-1 year). the other question is that do you think i should go to a med/surg floor for 1 year before applying to the icu to get my skills and time management down? i am just so unhappy with the or, but feel guilty because i should be lucky to even have a job. thanks in advance.

since you're still on orientation, talk to your preceptor and/or manager now. they may be able to help you transition into another position, either med-surg or icu. i know this is an unpopular position these days, but i really think a year or two on med-surg before going into icu is valuable. you learn so many skills you didn't master in nursing school . . you may find that med-surg is your passion after all. your patients are awake and interactive. if you still want to go into icu, at least the learning curve will be far less steep. you'll already have learned the basics, you'll be able to add on the skills specific to icu without having to learn them all at the same time. good luck!

ruralgirl08 · Sep 10, 2009

Hi,

I was just wondering, what about the OR didn't you like? Why did you chose the OR in the first place? I am myself torn between pursuing ICU/OR, or doing one first and then eventually the other. I originally trained in ICU and it rocked, loved it. But I went to get some Med/surg experience first, sometimes I regret this decision, but I have learned alot of basic skills along the way.

Did you feel like the OR was an end of career stop? Did you feel like you were using your nursing knowledge and critical thinking? Was there any pt. teaching involved in this role?

I know enjoy the challenges of critical patients. How often do close calls happen in the OR? Would you ever consider going back to OR later in your career?

Any feedback would be great.

XingtheBBB, BSN, RN · Sep 14, 2009

How far through orientation are you? Usually they would prefer you leave before they invest any more time and money training you for something you don't want to do. Do they do weekly orientation conferences with you? Bring it up. I know what you mean. I loved OR but I missed my skills. I think it will be easier for you to get into ICU before you have too much OR experience.

XingtheBBB, BSN, RN · Sep 14, 2009

Did you feel like the OR was an end of career stop?

I did. It doesn't have to be but my hospital was not providing any avenue to proceed... I would have like to become an RNFA

Did you feel like you were using your nursing knowledge and critical thinking? Was there any pt. teaching involved in this role?

There is some patient teaching in holding. Then they get Versed on the way down the hall. They'll never remember anything you told them so it's just psyching them up for the OR type teaching. Sometime I'd find knowledge gaps and call their post op nurse to give them the heads up and tell the surgeon to write for case management or diabetic education. The more nursing knowledge you have to use, the smoother everything goes. But I've seen some nurses fly through with no critical thinking or common sense. They just turf all the stuff that requires thinking.

I know enjoy the challenges of critical patients. How often do close calls happen in the OR?.

There are always close calls. But not alwys in the way you mean. And your role is so different. A lot of our patients are or become hemodynamically unstable. Amazing to see someone so alert and pink in holding and need to set up an aline and order blood because you know they'll get hypotensive soon. So you co-sign the blood if you're circulating and set up the line if you're the holding nurse... or tech. But that's it. It's all the responsiblity of anesthesia. Your job is to keep track of the sponges and make sure the doctors have the correct sutures and instruments so they can fix the underlying cause ASAP. You needed the knowledge of the procedure to have that stuff on hand and the speed to run for anything unexpected.

Would you ever consider going back to OR later in your career?

Yes. Hopefully as a SRNA, though! Actually, I would consider working in OR in a surgi center or something where I could split my time between OR and PACU.

ShyViolet · Sep 14, 2009

Even if you are still on orientation, it is better to move now than to wait. If you don't want to be there, you're not doing anybody any favors. If you're only a few months in, it's still early enough to bow out gracefully. I would just make sure to talk it over with my preceptor and unit educator to ensure that you don't burn any bridges and that you communicate why you're interested in transferring, as you will probably be relying on them for a recommendation to another unit.

I work in an ICU myself; I started as a GN and the learning curve is incredibly steep. But it is manageable. I feel like I use everything I learned in nursing school every day, and two years later I still spend part of every day looking up something I'm not familiar with or looking more in depth into something I already knew about. I still come home and read my school text books so that I can learn more about what I'm doing.

Med/surg nursing can be a good way to learn basic skills and organization, but they way you organize your day in the unit is completely different from the floor.Just because your patient load is smaller, doesn't mean that your workload is. There is almost no room to delegate tasks, and you have to do very frequent vitals and assessments. The two are really very different worlds and being good at one doesn't necessarily translate to being good at another. I've seen incredible ICU nurses start out as GNs. I've seen experienced floor nurses who go back to the floor before they finish their ICU orientation. And I've seen every situation in between.

I personally had, and continue to have, zero interest in being a med/surg nurse. Critical care was the reason I went to school, and it's my vocation. As far as patient interaction, I have the happy obligation of reassuring patients and their loved ones during a time of crisis, and helping them to gain the knowledge they need to help them through it. I see so many situations, and I have to tailor my approach for each family.

Whatever you choose, we need more nurses in the ICUs and on the floors who understand that patient interaction, and treating a person (not a problem) is the heart and soul of nursing. It's what makes us what we are and not just doctors' servants.