One-Basic-Girl

I had only 10 months of med-surg experience before going into the program - which did not help for the program but helped when I was hired in an OR of a smaller hospital where there were no residents or students helping all the time. OR nursing is very different than floor nursing, with a different knowledge base and skillset. But being a patient advocate and understanding their conditions and needs are the same though! I went through their program in 2006 when it was cut from a 9 month program to a 5 month program (I don't know what it is now). I do wish I had been in the original 9 month program with more training in specialties. That said, it did give me a great basic OR training program, and I was exposed to procedures there that I would not see at a smaller hospital. As a teaching hospital there were many residents and students in the OR, with so many hands helping with the patient I did not get the full impact of the role of the circulator. I needed a bit more orientation when I went to a smaller community hospital. The Dartmouth OR training program was very thorough in its didactic teaching of all aspects of the circulating and scrub nurse roles, just a bit shy on the clinical training in each specialty. Go in with eyes open though - know that you will not be on a prime shift when you are finished training. They lost a majority of my training class because they misrepresented the shifts that new OR nurses would be given. The promise was to be put on day shift where the new OR nurse would have plenty of support starting out; the reality was a second shift position. The OR is a GREAT place to work, but there are different types of OR's - ambulatory care settings, small hospital OR's, trauma centers, teaching hospitals and medical centers. No matter where you start, don't feel stuck; there are many different types of OR settings, find the one that is right for you.

I graduated in 2006 and several of my classmates went directly into specialties - ED, ICU. Though I knew I wanted OR, I was told I needed the one year med surg experience. When I was not happy there, after 10 months, I found an OR with a training program, and they asked why I waited so long, that I could have come directly into the OR. With nursing shortages, specialty areas have to compete with one another for the nurses in the workforce. I think many nursing specialties are hiring directly into the specialty, with training programs specific to their needs. However, most will want someone who is highly motivated and very interested in that specialty, who perhaps did a capstone or final project with a focus to that specialty. It is a big investment for specialty training, so the interview process may be rather thorough to make sure it will be a good fit for the candidate and the department. Good Luck to all new grads!!

I agree with not.done.yet - if the time is there because it is part of the compensation package then it is there to be used as they see fit. I will occasionally take a day I feel something coming on to call out and rest - less exposure to others and less likely to get really sick. I also schedule periodic days off as a pick-me-up. Maybe you could encourage staff to schedule a day or two off before the schedule is set so they have something to look forward to and to break up their schedule. But be sure to cover with extra staff so there is no guilt or stress involved. I know some staff call in because they try to schedule an important day off 3 weeks out but are told to swap with someone. When they can't, they call in as sick. Sometimes they don't bother requesting because they know the answer, and don't want to look bad if they can't switch on their own then they call in. Having per diem's available to schedule for days staff need off is helpful with this. But, if you've been there, you know all this. Good Luck.

Recently we started using a staff meeting to pick numbers, then pick call for six weeks taking turns - going in ascending numerical order the first round, descending numerical order the second round, and the last round either ascending or a new pick of numbers. We use a large poster-board paper so that everyone can see the dates picked as they are picked, so all can plan and be ready for their turn to pick. This is done for weeknight call only, both trauma and regular call. Seems to work well, takes less time than one person trying to schedule everyone.