brighidh

I'm in the OR. A) how long you've been out of the OR won't mean anything to the right OR manager because it's hard to get OR nurses. I know my place of employment would take that nurse and put her through at least a 3 month orientation and they'd be glad to do it. In fact, there would likely be competition to get you on board if you lived in an area with multiple hospitals. Next.... I think the bigger issue will be about why you're out of the OR. Were you injured? Sick? Taking a break? Family issues? If your reason for being out looks likes something that is a liability for the facility or likely to happen again, you're less of a safe bet and there will be more hesitation. thanks -- B

I work in and love the OR (circulate and scrub). I've gotten into a specialty I love, too, but I'm feeling a bit restless, as though I should be planning the next step. What I notice among different specialties is that they utilize either PAs or NPs as first assists and sometimes tap the hospitals surgical assist pool (staffed almost entirely by PAs). I feel as though I should be looking at one of these in order to advance my career. I talked to a surgeon I trust who laid out their expectations of NPs vs PAs. I talked to some folks from both career lines and really, I'm not any closer to knowing if one of these is the right path. The NPs say do FNP, the PAs say stick with NP since I'm already a nurse... though some also say go to PA school to have better pay and acuity of cases (interest generating). (Is this a reality, that PAs are better paid?) I just want to be in the OR the majority of the time, at the field, and not in an office seeing patients or chasing high acuity cases across the hospital as the majority of my hours. I've envisioned that I'd like to spend about 70% of my time at the field, but a 50/50 or 60/40 split is obviously not horrible. What I don't want (and what I do see) are NPs who come into the OR maybe once every few weeks to do one case with their surgeon and the rest of the time is clinic hours. I like where I am (hospital and specialty) and my specialty primarily uses NPs when they use them and I'd consider going that route, but I would want more surgical time. What would be an option here? I want to stay in the specialty, but spend more time hands-on surgically with patients and possibly do some work with research. Suggestions and help much appreciated!

I love the OR. I've gotten into a specialty I love, too, but I'm feeling a bit restless, as though I should be planning the next step. What I notice among different specialties is that they utilize either PAs or NPs as first assists and sometimes tap the hospitals surgical assist pool (staffed almost entirely by PAs). I feel as though I should be looking at one of these in order to advance my career. I talked to a surgeon I trust who laid out their expectations of NPs vs PAs. I talked to some folks from both career lines and really, I'm not any closer to knowing if one of these is the right path. The NPs say do FNP, the PAs say stick with NP since I'm already a nurse... though some also say go to PA school to have better pay and acuity of cases (interest generating). I just want to be in the OR the majority of the time, at the field, and not in an office seeing patients or chasing high acuity cases across the hospital. I've envisioned that I'd like to spend about 70% of my time at the field, but a 50/50 or 60/40 split is obviously not horrible. What I don't want (and what I do see) are NPs who come into the OR maybe once every few weeks to do one case with their surgeon and the rest of the time is clinic hours. When I suggested RNFA, I was told the one RNFA who was on staff was a pity case they took on because they knew her previous hospital was going to eliminate their program and they had a long history with her, so they 'took her in'. That was incredibly disappointing and the description was ... even more disappointing, but yay for her for at least securing a spot, right? I like where I am (hospital and specialty) and my specialty primarily uses NPs when they use them and I'd consider going that route, but I would want more surgical time. What would be an option here? Suggestions and help much appreciated!

I just finished the Zander Perioperative prep course and they gave high 90% first time pass rates for their course. Also recommended apps to do. I liked it.

I've heard different doctors make mention that patient A or B has this or that insurance and they either approve or mention how the insurance they have is sucky. From a health care perspective, what are some "good" insurance companies and which ones don't provide as well? I don't mean a good insurance company would cover every little option right down to a pedicure, but which ones will push for less proven drugs, fast discharge, deny certain procedures (oncology, reproductive), etc? What is the "feel" for those companies?

What exactly is ACNP? I'd love to eventually become RNFA, but I'm on cardio/vasc/thoracic team -- which precludes me from scrubbing in. I could swap out to general and scrub in much more easily, in any other specialty, actually, but I want to stay on CVOR. It seems most of the job listings I see want nurses who scrub and circulate. Can't lie that I'd also like to see $100k+ without having to become a CRNA. I've been considering either PA or NP, too, in order to get there. I thought the only option was FNP, though.

Thanks for the feedback, nurses. I really do appreciate it.

I've been placed on the cardio-vascular-thoracic in my OR. I've been told that CVOR is high-demand, can write my own ticket after a year's experience, etc. Maybe train to do transplants, etc. However, the situation is a high-stress one due to personnel and I'm wondering if it's worth it. I can move to another hospital later, no prob. I'm looking for feedback from people who are /have done CVOR and what job outlook is like, what pay rates are (motivational), and if all teams are stressful due to the nature of the job bringing (possibly) out the worst in folks or if this might be isolated.

I came online tonight to look for this very topic because an RN in the OR told me recently that he had to have 5 years experience scrubbing before he could pursue RNFA. This was very depressing to me as a nurse who mostly circulates. Do I have a shot at becoming an RNFA without much experience scrubbing? He said NIFA was the certifying body, too.

Thank you, all -- I really appreciate the feedback and have made notes on all that you've suggested. Things are getting easier each day and some of this is coming automatically, now. Still some needs work. Thank you, again!

This greatly interests me because I'm working as a PeriOp Nurse and will be cross training to PACU soon, but I honestly love what anesthesia/CRNAs do. I definitely see what they're doing since I'm turning over patients with them all day long -- and it looks much less back-breaking and like I could do it longer than I likely will as a PeriOp nurse. Only, I don't want to go to ICU and in order to get there, I figured that was the only way. How did she manage this?

Are you referring to a specific specialty? What's yours? Thanks -- B

I'm still in orientation. Each nurse I'm paired with does things differently, some do things others don't and attitudes are totally across the board. I get a routine down that works well paired off with whatever nurse I'm with and a few days later, I'm with someone new and I find I'm forgetting my gloves before moving a patient, or I didn't think to get warm blankets or I forget whatever other thing it is that's actually just thrown off by the new routine. I feel like I'm running around with my head spinning. When I was in nursing school, there were a lot of sites and youtube videos that talked about how to prepare for your clinical day, how to use or personalize whatever brain sheet they suggested, what things to carry in your pockets to cut down on your running time, etc. I'm looking for something similar. I NEED something -- a checklist, a framework, something that will help me get a routine down so that I don't miss steps, so that I'm not fetching gloves multiple times, or forgetting to pull/administer meds to the scrub tech in a timely manner... just something. Suggestions? thanks.

After orientation, we are supposed to pick 3 specialties we want to primarily staff in. I'm finding that I'm drawn to the specialties that have the nicest doctors in them. Doctors who don't scream at you or who don't have arrogant attitudes. And that's not what I planned. I'm finding that the specialties I was most interested in (Ortho, #1) is staffed by people with big egos and short fuses. Things I would never have considered (like Eyes) are staffed by ... dare I say it... people with manners. Has anyone else noticed this trend? Another nurse told me yesterday that she speculated that the refinement needed for eye surgery could not be accomplished by someone who threw instruments when frustrated and so it was a self-selecting situation.

I understand, nurse482488. I'm sorry it didn't work out for you, but seriously -- you faced it and tried and that's worth a lot. Just yesterday, I took turns crying and laughing my butt off, throughout the day. I wish..no...hate... no... I DESPISE that this is going to take so long to 'get'. For everyone I've asked, to a person they say minimum amount of time to become comfortable in the OR is one year. Ooooooh, that stings. And I can't soften the fact that I am completely over being on an emotional roller coaster all the time. If it isn't my preceptor or instructor, it's the doctors and their private staff. Not to say there aren't a lot of them that are awesome. In the end, I think I'll pick a specialty based on the characters of the doctors in that section.