"Med-Surg first"..need advice from a student RN

Marie_LPN, RN, LPN, RN · Oct 3, 2006

In your opinion if I start out on the med surg floor will it help me become better in the OR especially when in comes to prioritization, organization, management, multi tasking and critical thinking skills (I am still struggling with that even though I am in my last semester already) before I go into the OR.

It could but then again there have been plenty of new grads that went straight to the OR after graduation and did just fine.

I am not the fastest learner but I know that in time I can learn all that –and how fast do they expect a new grad to learn and be able to be fully functional in the OR?.

Some facilities differ in their length of orientation.

Is the orientation for the OR exclusive only to circulating and scrubbing? what about pre-op and post op?

Most facilities, the OR training consists of scrubbing and circulating. PACU and pre-op are not part of OR training.

ortess1971 · Oct 4, 2006

IMHO, I don't think you need med/surg first. The OR is very different than the floors...What I think would be most beneficial is if you could get a job as a student nurse in an OR-that way, they could start training you to scrub, teach you the instruments, sterile technique etc. It is so important that you work in an area that you love..people who do what they like tend to have lower burnout rates. Good luck to you!! :nurse:

CIRQL8 · Oct 4, 2006

I went into the OR right out of school. 10 years later, and it is the best decison regarding my occupation that I have ever made!

Will med-surg help you in the OR? I don't think so. Maybe it will, but like anything else, opinions vary.

Med-surg will not teach you how to operate the OR table, or hook up the video monitors for laparoscopic surgery. Med-surg will not teach you about proper patient positioning, and how to avoid permanent nerve damage from incorrect positioning. Nor will you learn sterile technique (yes- I know all about sterile dressing changes. But you haven't seen surgically clean until you've prepped and draped a patient).

Perhaps you will become an expert at starting IV's or dropping NG tubes, but will most likely not drop an NG tube in the OR (thank goodness!), and opportunity to start an IV may not present itsself very often (dependant upon istitution).

And do not listen to the nay-sayers that claim that OR nuring is not nursing. It is nursing, but very different than any other. You will use nursing skills. You will use some of the same nursing skills as on the floor and also alot of nursing skills that you will never aquire on the floor.

You may not feel totally in your element for two to five years in the OR (but, that is probably so for any unit). As a matter of fact, I still learn something new every day. You will probably be orienting for 6 to 12 months (depending on your program), and still learning new procedures after that.

I am not sure what else to say - I feel as if I've already gone on too long.

Check out many of the other threads in the 'operating room nursing' section. You will learn more about this type of nursing.

Works2xs · Oct 5, 2006

As a new grad, I was faced with the same question. Talking to some of my instructors, there were the 2 obvious opinions.

One said that it would be good to have a couple of years of med-surg. She felt that it provided a good grounding for practice. And if I changed my mind regarding a desire to be in the OR, the experience would provide some flexibility in making a change.

Another instructor had the opinion that if you didn't want to do med-surg and thought another area was more in line with your interests, then why spend any time doing something that you didn't like? If you were inherently opposed to med-surg, then forcing yourself to do that wouldn't make you a better nurse. Rather, you'd be miserable and your patients would get less than than your best.

I can see value in either approach. So I relied on the Joseph Campbell approach: Follow your bliss. Like the OP, the OR really resonated with my interests. Higher interest translates to higher motivation to learn, work, and ultimately succeed (for me, anyways). So I choose to go straight to the OR. I'll let you know how wise that decision was in a couple of years, lol.

inspir8tion · Oct 5, 2006

Hi: I am a new RN, graduated in May, passed the NCLEX in July. Worked on a med/surg floor for 2 months and just started my OR program. I believe working med/surg gave me confidence that I could work med/surg... before that I thought I could never do it! OR is completely different. You do need time management skills, prioritization, organization, multi-tasking and critical thinking skills to do med/surg or OR or PAR. A lot of that comes with the OR training and I have heard from RNs that went through the OR training, that they did not really feel like OR nurses (that everything really did not come together) until they were working as OR nurses at least 2-3 months, and some for longer (like years).

In the OR you are learning asepsis, positioning, legalities, instruments and how to deal with a number of different personalities (the last true of anyplace you work, I guess).

In my institution in med/surg the nurse to pt ratio is 1:5. In the OR it is 1:1. Because I only have one pt to deal with at a time in the OR, I can be focused on that patient and not be spread out over 5 pts (some of which have a high acuity).

My instructor says that if you are just out of nursing school, you may not have perfected your IV start skills, your blood draws, your fingersticks, your hanging piggybacks, dropping NG tubes, etc. so there are no "skills to lose" (a common refrain).

I guess I am rambling. Anyway, I like what the other poster said about following your bliss - why do anything you don't want to do!? Life is too short.

Decide for yourself. If later on you find OR is not for you, you can be oriented back to med/surg - you're not stuck forever (or you can be a nurse that does not work in a hospital; there are a myriad of choices).

Good luck! :nurse:

lostfromlatex · Oct 7, 2006

Hi KattsRN,

I would strongly suggest at least a year of med-surg. You will be putting all the didactic and clinical to it's test. Should you not like the O.R., you have wasted precious time. Get a good foundation first, then you can use it as a stepping stone. I did Med-Surg for a couple of years, then went into O.R. nrsg. The only drawback at this day and age, is that most O.R.s utilize Surgical Techs, which eliminates the scrub role of the nurse which is what I love to do the most. Good Luck with your future!!

inspir8tion · Oct 8, 2006

Just read this post by happylush who has just finished the first week of OR orientation. In part, it says, "It feels like I may as well have not even gone to nursing school or worked on the floor for that matter, because nothing I have learned really seems like it applies to much right now other than my assessments of the patient"

https://allnurses.com/forums/f39/first-week-orientation-finished-feeling-overwhelmed-183244.html

inspir8tion · Oct 8, 2006

Just read this post by happylush who has just finished the first week of OR orientation. In part, it says, "It feels like I may as well have not even gone to nursing school or worked on the floor for that matter, because nothing I have learned really seems like it applies to much right now other than my assessments of the patient"
https://allnurses.com/forums/f39/first-week-orientation-finished-feeling-overwhelmed-183244.html

I thought it applied to your question.

:nurse:

StakRN · Oct 11, 2006

Hi ! thank you so much for all the replies...really appreaciate it...I will surely take into consideration all of your opinions and experiences..now I am more sure to go into OR nursing...I even asked my instructor jokingly if I could just stay in the OR for the rest of the semester =)

I know that no job is perfect..but I would sure like to wake up everyday knowing that I will be doing what I love most..after all this would be long term..and like what inspir8tion said "why do anything you don't want to do!? Life is too short" and yes what's good about nursing is that if I find that OR or another area is not for me ...there are other choices.

I still have 6 weeks of clinicals left and that would be med/surg and 1 day in the ER, so we'll see how I do in those areas..(well med/surg, I already know that I don't see myself in-but I don't want to speak too soon ,still have 5 weeks left).

Oh if anyone knows, for the job interview for the OR-just curious what type of questions they ask, and what they look for, or how they determine who they hire and if it's very competitive getting hired

Once again , thanks for the support, opinions and encouraging words...can't wait to graduate and pass NCLEX.

RNOTODAY, BSN, RN · Oct 11, 2006

This is my philosophy. I HATE med surg. So, of course, I gravitated to an area nothing like it. I am in the OR now. And I can honestly say, that there is nothing on a med surge floor that you NEED to learn there. You will put in foleys in the OR, but you can learn there just like on the floor. And prioritizing? Its different in the OR. Yes you have to prioritize, but not for 6-8 pts at a time. It sooo different, my answer is NO, dont do med surge, just because you think you HAVE to, you absolutely do NOT. However, if you want to give it about 6 months in med surge, just to get your feet wet, get used to BEING a nurse, then go ahead, if thats what you think you need. Me, I would never have done that, becaue like I said, I hate med surg.

IsseyM · Oct 12, 2006

Hi ! thank you so much for all the replies...really appreaciate it...I will surely take into consideration all of your opinions and experiences..now I am more sure to go into OR nursing...I even asked my instructor jokingly if I could just stay in the OR for the rest of the semester =)
I know that no job is perfect..but I would sure like to wake up everyday knowing that I will be doing what I love most..after all this would be long term..and like what inspir8tion said "why do anything you don't want to do!? Life is too short" and yes what's good about nursing is that if I find that OR or another area is not for me ...there are other choices.
I still have 6 weeks of clinicals left and that would be med/surg and 1 day in the ER, so we'll see how I do in those areas..(well med/surg, I already know that I don't see myself in-but I don't want to speak too soon ,still have 5 weeks left).
Oh if anyone knows, for the job interview for the OR-just curious what type of questions they ask, and what they look for, or how they determine who they hire and if it's very competitive getting hired
Once again , thanks for the support, opinions and encouraging words...can't wait to graduate and pass NCLEX.

HI KattS! You got some great advice. I've heard alot of different opinions on, to do Med/Surg or not before entering the OR. I personally don't care for Med/Surg. I knew for sure i did not want to be responsible for more than 4 patients at a time. Way too much room for error and losing your license. I have friends who have taken care of anywhere from 6-12 patients as new grads!!! Its insane.

I was stuck between the OR, ED, and ICU (newborn or adult). I chose the OR because i like surgery and because i can focus on one patient at a time. I didn't want to waste a whole year doing something thats not my cup of tea. I've heard from numerous OR nurses how much they hated Med/Surg and would never go back. I have yet to hear an OR nurse tell me she/he loved Med/Surg and would go back.

Some of the questions you may be asked for your interview may be:

1. Tell us about yourself

2. What made you decide to go into nursing?

3. Why are you interested in working in the OR?

4. How would you handle a conflict with a co-worker?

5. Are you able to deal with strong personalities? Because the OR is full of them.

6. Name some good qualities (about yourself)

7. Do you have any weaknesses?

8. How do you handle or deal with stress?

9. Are you good at troubleshooting or problem solving? Example: OR is full of instruments, equipment, and electronics that can malfunction.

Good luck!

IsseyM