OR vs. ER nursing

IsseyM · Aug 22, 2006

Gee that is a toughie. I can relate because i felt the same way you did. I was torn between working the OR and ER after graduating. I felt lost because i did not want to do Med/Surg and that was the only area hospitals were hiring at the time. All my friends who graduated with me had jobs lined up already except me and one other friend. I also didn't think i would get hired in the OR as a new grad. And like you, for some reason i felt more drawn towards the OR. Luckily patience paid off and my mother found exactly what i was looking for online.

My friend who graduated with me in May had the same feelings. Its funny because we wanted to work together in the same hospital but i ended up getting hired in the OR with a 2 year commitment and she got hired in the ER with a 2 and half year commitment at a different hospital. The training you mentioned is exactly what were going through right now.

I don't have any experience working either except what little rotations i had during nursing school. I can tell you right now that i like the OR because i can focus on 1 patient at a time. I also like that the doctor/surgeon is right there in the room with me so if something comes up i can ask right away instead of having to look for or page him/her. I definately love surgery, love watching it and if i could would want to be a surgeon. I like that i can choose to work 5 8-hour shifts, 4 10-hour shifts or 3 12-hour shifts. I also like that i can precept with a nurse for 3-6 months before i'm on my own. I feel the OR is like a well orchestrated play and of course the surgeons usually bring in their IPods and play music. What other area in the hospital can you work while listening to music? Now what i don't like about working the OR is that surgeons can be mean, impatient and yell at you. The thing is you have to be cool and not argue back, of course you stand up for yourself and your patient in certain situations. Also i don't like the fact of being on call. I've met nurses who have left the OR because they got tired of being on call. My hospital requires you sign up for 8 hours of call a week, actually 2 4-hour shifts a week.

Now the reason why ER was my other option is because i like fast paced-adrenalin rushing-busy environment. I like that you are exposed to a variety of people with a variety of diagnosis. You meet some very interesting people. You also build strong assessment and IV skills. If you're thinking about working Med/Surg or ICU one day then the ER would prove most useful for experience. Also if you like patient interaction the ER is great for that. In my OR i only see the patient awake for 10-15 minutes then they are knocked out, unless of course its a procedure when they're awake.

I could of applied to work in the ER like my friend did but for some reason i felt more drawn toward the OR so i went with my gut instincts.

Your gut instincts are usually right so do what feels right to you. As far as the driving goes, it is nice to be able to get to work in 10 minutes but i would drive 45 minutes to a job that i really was drawn to. I'm really looking forward to what advice or suggestions the experienced nurses here will give you. I wish you the best and please keep us updated. I would really like to know which position you picked and how its gonna work out. Take care and good luck.

IsseyM

lynnr_98, BSN, MSN, RN · Sep 8, 2006

Hi IsseyM! Thanks for your input regarding my question. I just thought I'd give you an update...

I was kind of hoping that I wouldn't be offered both jobs so I wouldn't have to choose between them. Luckily, that came true and I was only offered the job in the OR which I was more drawn to anyway. I begin hospital orientation on 10/16 and the OR classroom training begins 10/23 and lasts 6 months. I am so excited..but also scared at the same time. I have a little anxiety problem that normally isn't a problem for me but now I'm feeling anxious about the possibility of panicing during clinical training. Hopefully, I'll do okay and not get too nervous (or at least not show it)! I'll keep you posted on how I do.

BTW...How is your training going? When did you start and how much longer do you have until you're on your own? It sounds like my training will be very similar to yours. I'm interested in your opinion as to what to expect, advice, etc.

CD-RN · Sep 8, 2006

Hi, I have worked in the ED and the OR, and I think the decision should be based on how long you have been a nurse, whether or not you enjoy patient care, and what direction you want your career to take. Also, what type of hospital you would be working in makes a difference. Is the OR job at a Level I Trauma Center, a primarily cardiac facility, or a small community hospital? What about the ED position; how many patients do they see a day? Is it primarily cardiac, trauma, or a mixture of both? Is this an ED where you will see pediatrics? If you are a new RN, I would encourage you to go first to the ED and gain patient assessment and skills before going to an environment where you are not directly involved in patient care. The ED is a super place to learn alot and see alot, and it can be alot of fun! You are then able to take those skills and apply them to another area of nursing or broaden your education and follow a career as a nurse practitioner, flight nurse, etc. The OR is a very different entity, and although it has is pros also, I felt it was very limiting, didn't offer much autonomy, and was extremely task oriented. You definitely have control over your environment. I worked on the cardiovascular surgery team, and although it is very exciting to be involved in cardiothoracic surgery, as an RN you are doing paperwork and retrieving instruments. The interesting stuff is happening on the table! Basically, you coordinate the room so that the surgery flows smoothly for the surgeon. If you see yourself in a more controlled environment with a set routine (although things in the OR CAN get out of control-especially in a Level I Trauma Center!), then the OR could be perfect for you. You must remember that if you choose the OR first, then when (or even if) you decide to move to another area of nursing, you will again have a full orientation, because a surgical orientation is much different than other areas of nursing. Obviously, I am biased towards the ED, but only you can know what's right for you. Go with your heart. Do what you love in nursing, and you'll never go wrong! Best of luck to you!

IsseyM · Sep 10, 2006

Hi IsseyM! Thanks for your input regarding my question. I just thought I'd give you an update...
I was kind of hoping that I wouldn't be offered both jobs so I wouldn't have to choose between them. Luckily, that came true and I was only offered the job in the OR which I was more drawn to anyway. I begin hospital orientation on 10/16 and the OR classroom training begins 10/23 and lasts 6 months. I am so excited..but also scared at the same time. I have a little anxiety problem that normally isn't a problem for me but now I'm feeling anxious about the possibility of panicing during clinical training. Hopefully, I'll do okay and not get too nervous (or at least not show it)! I'll keep you posted on how I do.
BTW...How is your training going? When did you start and how much longer do you have until you're on your own? It sounds like my training will be very similar to yours. I'm interested in your opinion as to what to expect, advice, etc.

Hi Lynn, congrats on getting the position in the OR. It probably was meant to be for you. Things seem to work out that way sometimes. I also have a little anxiety problem. As far as my training, i have great days and not so great days. I've been training for 8 weeks now going on 9. My first 2 weeks i learned most of the surgical instruments where they do all the decontamination and sterilization. Then i went to other floors for 2 weeks to learn how you admit surgery patients and all the teaching/paperwork involved. I've been doing classroom for the past 4 weeks full time 4 days a week. We have one clinical day in which we practice what was lectured in class that week. Class lectures supposed to be for 6 weeks and then you go to the OR 5 days a week. Lectures involve all the AORN content such as Safety in the OR, Electrosurgery, Wound Healing, Scrubbing, Gowning and Gloves, Positioning, Perioperative Assessments, Surgical Instruments, Sutures and Needles, etc. After that we have a 3 month orientation as a circulator and a scrub nurse. After that we precept with different nurses strictly as a circulator for another 3 months. And you are with someone until they feel you can handle a case on your own. They give you up to a year to catch on, if not they let you go.

I am literally scared to death of being on my own.

So far i've gotten to fill out paperwork, transfer patients from beds to OR bed and back. Transfer patients to PACU. Set up positioning devices for OR bed. Do sponge/blade/needle counts. Get sutures, sterile instruments and supplies for scrub techs and surgeons. Get medications, IV bags, supplies for the nurses and anesthesiologists. Insert Foleys. Open up sterile packages for sterile field. Tie up gowns for surgeons and scrub techs. Assist with intubation. Hook up SCDs, ESU, Baer Hugger, Headlights, Suction. I'm sure i've done more but this is all i can remember for now.

If i were you i would recommend you start reading to help you be better prepared. I'm not sure if they told you what textbooks you will need but the textbooks required for our class, "Alexander's Care of the Patient in Surgery" and AORN's, "2006 Standards, Recommended Practices and Guidelines."

It is kinda tough reading every single day after you get out of class or clinicals. I'm so tired that all i want to do is veg out and watch tv. Well take care and i can't wait to hear once you start. We can share our experiences and vent to each other. LOL.

IsseyM