Same day surgery to Main OR

[rikomom]

I just passed Peri OP final exam yesterday and started wondering maybe I should have started in main OR.

I am not a new grad. My background is about eight years of med/surg, float, telemetry, and ER. I recently transferred to same day surgery (SDS) with 6 month training in OR.

So far, it is quite challenging in OR. I am comfortable only pre op assessment part! OR is very different from other areas I went through but it is very interesting to me. I don't or cannot say I love it yet but I want to put myself through tough time.

As a novice OR nurse, SDS OR is challenging. I am learning so much stuff from each case every day. I haven't even scrubbed yet. However, I know most nurses in the SDS are from main OR and they tell me I am missing so much stuff.

When I cannot find a right suture in the stock room, I feel like I know nothing. I miss head to toe, physiological assessment of nursing....

I am asking "why am I doing this?" I was already doing a charge nurse for three years and I was the one orienting new nurses.

It is luxuary to learn something new and still get paid. I tell myself someday I will feel comfortable enough to be an OR nurse.

It is up and down.

I spoke to a main OR nurse yesterday who transferred from ICU. She told me that if I started in main OR, I would have utilized my experience more than in SDS type of patients. Now, I started wondering what if I transfer to main OR later on.

I appreciate any thoughts or advice.

[NurseSnarky]

SDS is very fast paced for sure, but I'm not sure how you'll utilize more of your experience in the Main OR. I've been in both and honestly I'm using more of my CC, Tele, ICU, ER experience in SDS than I did in Main OR. It is a lot of info to take in that is true...and there have been some days I've thought I would never get up to speed. I now have a better understanding of suture for instance. Could I suggest a suture..no, but I know the different sutures, the numbers, a PS-2, PS-3, etc. Sutures really were last on my list to think about. I work very closely with the STs as I would not be were I am today without them. You have to be a team and that is very different from med/surg or tele.

[brownbook]

Main OR is going to have sicker patients. They may have cardiac drips, central lines, a-lines, etc. You will be hanging blood. Surgeries are going to be longer. You would eventually be exposed to trauma patients, trauma surgery. There will be types of surgeries you will never see in SDS.

Get good and comfortable in SDS. After a year or so in SDS if you really want to be a main OR nurse you will most likely be able to transfer over easily.

There are a lot of drawbacks to working the main OR. More often the cases seem to run longer or have add ons that run late. You would eventually have to be on-call for off hours, weekends, nights, holidays, etc. The money is great but I don't know if it is worth the stress?

Being a good SDS nurse who can handle 6 - 8 cases in an 8 hour shift is quite a skill that a main OR nurse might have a hard time with, being more used to only 4 cases in one shift.

It is like any type of nursing, a good med/surg nurse versus an ICU nurse. A good LTC nurse versus a med/surg nurse, a peds nurse feeling uncomfortable with anyone over 14 years old. Every type of nursing has its special areas. Being good at one, well you can't be good at all and shouldn't worry that a SDS nurse is "missing" so much not working main OR

[rikomom]

Thank you NurseSnarky.

Yes, I agree with you SDS is very fast paced which I like about. I mentioned about sutures before but I know it is not the first thing I am worried about. As you said, it is not about suggesting a suture. In ER or other floor nursing, I used to suggest doctors or others something. Maybe I had more autonomy although I know it was coming from my experience.

This is my third week as a circulator with a preceptor and the journey just started.

I guess I am just missing the part of being independent. Yes, you need to be a team in OR. It is not a "code" but it is kind of the same kind of situation since everybody takes care of one patient. I need to know what I am supposed to do while others take their parts.

I won't give up and will take time to see if I really enjoy OR or not.

Until then, I just need to study and learn everyday.

I must say that people from main OR don't like the idea I got into SDS without any experience in OR. SDS is a quite popular place to work although the schedule was not my reason to take the position. Thanks for your inputs.

[rikomom]

Thank you Brownbook. After I read you, I just felt much better. Yes it must be true. It is just like the difference between ICU and med/surg or others. It is a big challenge to handle so many cases in eight hours. Quick turnover. Quick charting. That is a quite skill. I will keep it in my mind, your word, "I shouldn't worry a SDS nurse is missing so much not working in OR". Thanks.