muddmz11

This makes me feel better. Im excited to see more complex histories (who'dve thought, right?). I just hope I made the right decision. But based on how long I've felt like I needed to get more out of my job, I think I did.

Hi all I've been working in outpatient surgery as my first real nursing job since since graduation. We do primarily plastics, but a hernia or nerve here or there. Over time I grew tired of the same routine tasks and feeling like I'm not a "real" nurse, so I just recently accepted a hospital OR position (it is not a trauma hospital, if that is relevant). I will be circing obviously but also scrubbing (which I haven't done at all). My question: what advice do you have to deal with the transition? it is intimidating, almost like I am starting all over as a brand new grad.. I really do enjoy *most* of the people and surgeons I work with, and I know the holidays and weekends off with no call are desirable - but I couldn't ever shake that feeling that I needed to learn more and be better at what I do - to put into perspective, I loved the intensity and autonomy/knowledge base when I precepted in the ICU. So this adds a bit of nervousness to an already nerve wracking thought of being new in a hospital OR. thanks in advance for any input or advice!

I would say to think about what you excelled in during nursing school. What did you enjoy that might suit you for plastics? Think of whatever the job requirements are - if you are in the OR, attention to detail; if you are the surgeon's "assistant" during office hours, personality. I started brand new in a plastic surgical center, and I played up my friendly personality. I think that when you are directly interacting with patients (pre-op, PACU, or office hours) this is important as this is a group of people undergoing elective surgery or procedures, and let me tell you, you will see ALL kinds of personalities coming in. The luxury of this setting is you can "dote" a little more on the patients, whereas in a crazy and hectic hospital setting with more "critical" needs (not to say you never have critical needs in PS but you know what I mean) you don't get as much time to do so. I appreciate being ale to connect with and educate my patients prior to and after their surgery. I work in the OR too. I am "meeker" than most OR nurses but I am building the skin I need to keep me going in that environment. This is where personality needs to be more assertive and you need to be more task-oriented. Good luck with the interview!

Honestly, the days I've been working there recently have been busy, but great. In comparison to the PCU job, it makes the management and hour issues look minimal. I think it's just very sad that as nurses we should "accept" such terrible work environments! In what other jobs do people make such sacrifices - especially when patients lives are involved - because "that's what we get"? I really think it is important to enjoy the place you work for and to feel like employees are valued... seems like a pipe dream in this field.

Thanks everyone for the replies. Honestly, at the surgical center, all of the staff routinely voices our troubles. We really do work together well to make ends meet and make things smooth for our sometimes demanding surgeons. What does make it to staff meetings is seldom addressed, and though our manager(s) (we've switched) are very nice and nurse-friendly, they are often too accepting of the mighty surgeon's demands. Our surgeons own the practice so they dictate whatever change they want at the drop of the hat, often for $$ purposes. That is the unfortunate thing that we can't change. As far as management in the hospital, I kind of got "red flags" because of simply observing how management dealt with the nurses. And surely if EVERYONE on the floor does not like what they are doing, well... that must be some kind of sign for sure. I firsthand saw an issue that involved a COPD patient being assessed for a watch - several nurses and our clinical educator agreed he needed to be on one for a severe fall risk (he KEPT getting up was already listed as high risk) along with a change in mental status that we were looking into. He was given ambien the night prior. One manager (she is apparently a head honcho of some sort) came and just eyed the patient, said that we would "have to see" about a watch, and left. Well the RN in charge of that patient got in trouble because they claimed she directly opposed that manager's orders to NOT use a watch, which DID NOT HAPPEN. The unit manager had allowed us to use a tray table as restraint. I explained the interaction exactly as I had seen to the unit manager, along with several other nurses, but the manager was quick to interrupt and state the "wrongdoings" of the nurse. That nurse was my preceptor... who later in my orientation, quit. And FYI, that patient ended up rapid responding on us later and being intubated in the ICU. These types of incidents with no nurse advocacy are what worry me. And the sheer workload with no assistance is ridiculous. The patients require more care than can be safely given. I refuse to work in unsafe conditions where I feel like my license is jeopardized on a daily basis.

Hi everyone. I'm a graduate of an associate's program from May 2010. I got my very first job doing flu shots (yippee) in October that year. Luckily, I was recruited by an acquaintance for a job at an outpatient surgical center in February 2011. People told me it's a great opportunity, you're lucky to get that kind of job... etc. It started out great, but over the past year we've had management issues like crazy. We lost a bunch of nurses due to either staff cuts or RNs leaving on their own terms. We've gone up and down with our staffing because management tried to cut costs, but then realizes sometimes it is unsafely low. And there is other petty office type drama to deal with. I do enjoy the actual JOB I do, but that environment felt like a circus at times. So that being said, I decided to put some applications in to hospitals just in case anyone would call me for a job - not expecting anything as all us new grads know you "need experience" to get jobs! I was picked up for a job on a "stepdown"/PCU floor at a smallish local hospital, with a not-so-hot reputation. I was pretty enthused and I changed my status at the surgery center to per diem to begin working at the hospital. What a nightmare. I don't know how to gauge my feelings, so I want to speak with other experienced nurses here. First off, our patient ratio would be 1:6 patients. Some patients are unstable; some are stable but are required to stay on the floor till cardiology clears them (all patients are on tele). I felt "okay" after a few weeks of working with my preceptor and going up in my patient load, but in honesty I felt like the job we had would not be feasible without BOTH of us being there. Between your patients who are constantly getting up (and being refused a watch) to the unexpected rapid-responses, to calling the physicians 8,000 times to clarify orders/get new orders/find the COVERING dr for the one you are trying to reach.... I don't know how it's done! I try not to base my opinion off of others, but EVERY nurse was unsatisfied with work. Some wanted to stay on the unit and transfer out after getting experience, but the writeups seem liberal there and you can't transfer within 6 months of a writeup, or something of that nature. In addition, I had 4 different preceptors in a few weeks, and the main one I was designated to follow ended up quitting. The management seems to be involved in petty BS rather than actually listening to nurses. I'm pretty devastated that this is my first "hospital" experience. I told my clinical educator that the particular floor was not in my heart and I really, really did not enjoy it. I never wanted to go into med surg anyway and this felt like it to me. I think the expectations are unrealistic, not to mention there is ONE aide for all patients (up to 36), and if anyone needs to be on a watch, they pull your aide!! That experience put BEAMS of light on the surgery center. I told them how things are going, so thankfully I am picking up some hours there in the mean time. I am meeting with HR at the hospital next week to discuss the possibility of switching floors, but I don't really know what to do. I'm concerned that all work environments might be as bad and I am a firm believer in ENJOYING your job and feeling COMFORTABLE with your management. I cannot just muddle through a job - it takes too much of a toll on me, because it is a part of your every day life and the stress is just miserable. I may be young, but I'm an adult, and a professional - and I deserve to be treated as such. I would appreciate any input from experienced, or even new, nurses on this subject.