Standard Orientation?

[Moochini M]

Hello all!

I work in a Hudson Valley NY level 1 trauma center OR. I recently transferred in from a med-surg/tele unit after 1.5 years there - I'm still in the same hospital. I've been in the OR now since the beginning of May. My first 2 weeks, I just shadowed since we didn't have an "official" educator yet - her first official day as educator was June 1st. Up until then, she was still acting as head nurse of the children's OR. Mid may is when I began Periop 101. To make a long story short, I only just recently begun scrubbing and circulating. I have had 1 week scrubbing with a preceptor, and almost 2 weeks now circulating with a preceptor. All in general cases, mostly lap chole and hernia repair procedures.

My issue is this... This past Monday, there were many call ins and I was scheduled to scrub in a gastric sleeve case alone - with NO preceptor and only a circulator in the room. I told them I was uncomfortable scrubbing alone with this particular surgeon, so they switched me to a thyroidectomy and had me scrub with the educator. Now I see tomorrow I am scheduled to scrub in another thyroidectomy ALONE. Is this right?? Is this how it works in other hospitals? I feel like I am being used as staff and haven't even gotten half of an orientation (I was initially told orientation would be a year... a month into it, and they are telling me orientation will be 6 months...)....

Am I just being a big baby? I am curious how it works in other hospitals. Do they have new to OR nurses learn scrubbing and circulating and put them to each role alone after a week of scrubbing? Or is it this way in my hospital because we are so short staffed with so many call ins?

[lm2009]

In our OR, the preoperative program last six months, so nurses new to the OR (new grads and nurses with no OR experience) must work with a preceptor (RN or CST) for the first six months of their employment. The day after they finish their six month orientation, they may be asked to "fly solo" with a strong RN or CST to help them out in the room. Our Charge RN and Educator don't like to overwhelm the newbies, so they usually keep them with preceptors (for the first week at least) and start with them breaking the Circulator and Scrub in the room (so they get a few hours on their own and build up that confidence). Our Educator is great and keeps track of what kinds of cases her students have seen over the six months and discusses with their preceptors their progress and ability. We are always short and stretched, but until those six months are up, those new RNs are untouchable, even if they have done the same procedure twenty times.

[Argo]

It's not ok but it's happens. Sometimes when your in charge you have to do what you can until you get to much push back.

Really though, a simple thyroid with a surgeon that has been given an explanation of the situation should be fine. Do not go into it without having the charge/manager/you talk to the surgeon. It makes a huge difference if they are told up front.

Also know that this suffering, if you chose to suffer, will make you stronger in the end.

[springchick1, ADN, RN]

See one, do one, teach one. That's our motto😷

[SandraCVRN]

Our nurses don't scrub and they are still in orientation for about 9 months. Towards the end of each rotation they may break or lunch their preceptor but that's it. Doesn't matter how short we are. It's taken a few years to change this throw them to the wolves mentally but I think people are finally starting to get it.

I wouldn't want you scrubbing a surgery being performed on me. Good luck.

[Moochini M]

I wish our educator was like yours. She is new to the role, so I don't hold it against her. But she has no idea what cases I've circulated on or scrubbed on. I am thankful that she does have the assignment changed when I bring up it being way outside my skill level, ie, scrubbing alone when I've scrubbed on a handful of cases.

I forgot to mention that we get approximately 1-2 cases done per shift, so it's not like I'm learning a lot each day. I don't get exposed to many cases, sometimes as little as 5 a week. Our OR wastes an incredible amount of money, and it worries me a bit. But that is an entirely different topic! So while I may have the time of a few months behind me, I don't necessarily have the exposure or experience. I can't say I'm in favor of the "see one, do one, teach one" mentality. Even our gallbladders are complicated and high risk, as I work in a level 1 trauma center, and I will be working evenings - the time when resources are much less than the day shift. I don't expect to feel 100% comfortable or confident once I'm off orientation, I know that takes time to build, and even then I think it rare for someone to feel 100% confident, but I want to at least be functional and a bit comfortable.

Thank you for your replies. =)

[Argo]

I work weekends as a traveler currently and at a regional trauma center on nights. I'm 100% confident that I know what to do in any given situation. When you work at busy hospitals doing alot of various cases in all specialties with sick patients you get confident alot quicker.

Once you get the time in the rooms you will get there but you also have to be confident in yourself and what you can do.

[SandraCVRN]

So how's it going?

Sent from my iPhone using allnurses.

[Moochini M]

It is going mostly well, Sandra, thank you! There are still times when I am used as staff, but they've really limited the occurrences and I definitely feel much more confident in what I can do. I've moved on from general surgery to vascular now, but I still get thrown in to general once in a while when there is a big open belly case, which I don't mind at all! What I find a tad bit worrisome is that I am slated to have 3 more months on orientation when I still have neuro, ortho, and possibly have some cardiac to get through. I'm not sure if ENT gets it's own little time or if it is lumped with general.

I guess there is no sense in worry about 3 months from now. I'll just have to see how things are then. Thank you guys =)