Periop RN marketability

FlyOR · Feb 7, 2010

I guess I am wondering about what your goal is in nursing. The OR is not the place to escape the needs of the patient. If anything you need to be more intuitive. You are that patient's defense system once they are under. They so much as break a fingernail and that's you failing. Pre op you need to be able to get across to someone who is about to be cut open that you are there for them, you won't let anything untoward happen to them and all in about five minutes. You take on doctors every day who are in a big hurry, you stand in front of moving stretchers to make sure paperwork gets to where it needs to be, you ask about post op pain management and advocate for special needs, you hear a pulse ox drop on a dime, you watch residents who don't know what a sterile fields is, and basically you develop eyes and ears in the back of your head and under your fingertips. And you run. Run. Run to get a missing piece of equipment, run to get a code cart, and run because everyone else is moving fast and you need to keep up despite the fact that your paperwork takes longer than the procedure. Call bells? Try a needy non communicative surgeon in the early morning. Assessments? You learn to read a chart in a minute and know past medical history, vitals, blood type, allergies and then critically think how it will affect the surgery.

I love the OR, and I went straight there from school, but I chose it because I like being a part of a team, I like the intensity and I basically knew that I wanted my future there longterm. I also came from a previous career where I had to click with people quickly, and I like the part of my job where I interact with the patient. If you aren't thinking of the OR longterm, I wouldn't go to the OR, because it does affect your marketability later. My nursing instructor advised against it for that very reason. I didn't listen because I knew I would love the work. At the same time, I know that if for some reason I decide later to leave, I will probably end up going to another specialty where they train you, such as ICU, basically because I will have lost med surg type skills.

Nursing school is full of grunt work, and I didn't love it either, but remember that's someone's mother, grandmother, grandfather etc laying there and you really need to remember that in the OR, because while they're sleeping, they belong to you.

GadgetRN71, ASN, RN · Feb 7, 2010

I guess I am wondering about what your goal is in nursing. The OR is not the place to escape the needs of the patient. If anything you need to be more intuitive. You are that patient's defense system once they are under. They so much as break a fingernail and that's you failing. Pre op you need to be able to get across to someone who is about to be cut open that you are there for them, you won't let anything untoward happen to them and all in about five minutes. You take on doctors every day who are in a big hurry, you stand in front of moving stretchers to make sure paperwork gets to where it needs to be, you ask about post op pain management and advocate for special needs, you hear a pulse ox drop on a dime, you watch residents who don't know what a sterile fields is, and basically you develop eyes and ears in the back of your head and under your fingertips. And you run. Run. Run to get a missing piece of equipment, run to get a code cart, and run because everyone else is moving fast and you need to keep up despite the fact that your paperwork takes longer than the procedure. Call bells? Try a needy non communicative surgeon in the early morning. Assessments? You learn to read a chart in a minute and know past medical history, vitals, blood type, allergies and then critically think how it will affect the surgery.
I love the OR, and I went straight there from school, but I chose it because I like being a part of a team, I like the intensity and I basically knew that I wanted my future there longterm. I also came from a previous career where I had to click with people quickly, and I like the part of my job where I interact with the patient. If you aren't thinking of the OR longterm, I wouldn't go to the OR, because it does affect your marketability later. My nursing instructor advised against it for that very reason. I didn't listen because I knew I would love the work. At the same time, I know that if for some reason I decide later to leave, I will probably end up going to another specialty where they train you, such as ICU, basically because I will have lost med surg type skills.
Nursing school is full of grunt work, and I didn't love it either, but remember that's someone's mother, grandmother, grandfather etc laying there and you really need to remember that in the OR, because while they're sleeping, they belong to you.

This is an awesome post...and I agree. Also, very few people want to leave the OR once they've been there a good amount of time. I can count on one hand the nurses I've known that have gone back to the floors..if I ever wanted to leave, I'd go to ICU or ER, like you said. So far, I have no interest in leaving the OR though. I've seen what those floor nurses go through, so even if I'm having a bad day, I figure a bad day in the OR is better than the average day on the floor!

CW1978 · Feb 8, 2010

I have no delusions about the patients in the OR: I know they are my priority. I have an amazing way with patients bc they can tell I am genuine and compassionate, and they are treated by me as if they were my kin. I just happen to prefer caring for them while they are unconscious. And yes I know I will be interacting with them whem they are brought to the OR, and afterwards when they go to the PACU. Those small conscious interactions are just fine with me. Despite the oft egomaniac surgeons, I love working with a team, am very efficient, a great multitasker, and get on well with new people quickly. I have loved my limted OR experience in school, and would jump at the chance to go to the OR right out of school. That being said, I am still quite inexperienced as a nurse (I'm not graduating til Aug '10) and dont feel I have seen enough to really "know" what specialty is for me. I just "know" I preferred OR over Med-surg, OB, Oncology, LTC, and SNF. I can't say I'll never want to switch specialties, but as I always plan ahead and cover all my bases, I thought it wise to know what it might be like to change specialties later should I want to.

I appreciate your feedbank, thanks :up:

MERRYWIDOW46 · Feb 8, 2010

In my experience it is difficult to go back once you have been in the OR for a long time. Especially for someone who never worked in any other area.

I worked with an OB tech who came to the OR when our facility shut down it's OB service. She worked as an OR tech while finishing her RN/BSN. 10 years later, she wanted to do something different. She could NOT get hired by anyone. They stated she had no REAL nursing experience. Make your own choices, but choosing a speciality shouldn't be based on the level of consicousness of the patient population. Good Luck.

shaomai · Feb 8, 2010

As an OR educator, I highly recommend working as a floor nurse before specializing in anything. I believe that you should learn basics, organization, prioritizing, critical thinking, etc before going to the OR. I notice a difference between new grads and experienced nurses that orient to the OR. It can increase your marketability. I did 18 months of med-surg before I went to the OR and it was the best thing I did. Best of luck to you in all you do!

GadgetRN71, ASN, RN · Feb 9, 2010

I have no delusions about the patients in the OR: I know they are my priority. I have an amazing way with patients bc they can tell I am genuine and compassionate, and they are treated by me as if they were my kin. I just happen to prefer caring for them while they are unconscious. And yes I know I will be interacting with them whem they are brought to the OR, and afterwards when they go to the PACU. Those small conscious interactions are just fine with me. Despite the oft egomaniac surgeons, I love working with a team, am very efficient, a great multitasker, and get on well with new people quickly. I have loved my limted OR experience in school, and would jump at the chance to go to the OR right out of school. That being said, I am still quite inexperienced as a nurse (I'm not graduating til Aug '10) and dont feel I have seen enough to really "know" what specialty is for me. I just "know" I preferred OR over Med-surg, OB, Oncology, LTC, and SNF. I can't say I'll never want to switch specialties, but as I always plan ahead and cover all my bases, I thought it wise to know what it might be like to change specialties later should I want to.
I appreciate your feedbank, thanks

:up:It sounds like the OR would be for you and FWIW, I' have known several nurses who went from OR to other areas..most of them went to ER, ICU and other specialties. But,like I said before, most of us OR nurses realize that we have it pretty good. You could not not pay me enough to get me to work the floors..I have much respect for med/surg nurses. But, they deal with demanding families, rarely get breaks, have too many patients. And contrary to what your instructors or some here may tell you, OR nurses are real nurses. We assess patients, give meds, and even start IVs once in a while. Critical thinking is a must, because no 2 surgeries are the same..there is no such thing as "minor" surgery either. I put in a mean foley with impeccable sterile technique, if I do say so myself.

IMHO, new grads often do better than former floor nurses when orienting to the OR...they have no bad habits or preconceived notions. Floor experience is really not going to help you all that much..it might for some things. I know in my orientation group..the 2 nurses that really had a hard time making it were the former med/surg nurses. They had a hard time because they were approaching things like they were still on the floor. This idea that you have to have a year of med/surg is seriously outdated and I swear some places tell you this because they have a shortage of people willing to work med/surg. Also, I've known people who figured that they'll go to the OR after a year..problem was, to get into the periop program, they needed a reference from their boss. The bosss wasn't willing to give up a nurse, so they gave them a lukewarm reference. Many places won't let you transfer right away, or if you have a write-up in your file, you have to wait longer.

I say, if you are offered a spot in a peri-op program as a new grad, take it. It's a great oppourtunity. Good Luck!

tring520 · Apr 16, 2010

I've had coworkers who started out as new grads transfer to the ICU, NICU, L&D, NP school, etc. It's not impossible. That's the beauty of nursing - you can go anywhere. It depends on the hospital and glowing recommendations from your managers, directors, even docs.