Stick it out in the OR or not?

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I am writing to request some advice from other OR nurses. I am wondering if the challenges/frustrations I am dealing with are fairly normal - especially for a new nurse - or if it's an indication that the OR is a not a great fit for me.

I am a 2nd career nurse (BSN last May), so this is not my first professional job - but it is by far the most challenging job I have ever had. I started in the OR in August at a large teaching hospital. These are the challenges:

1) The amount of information I have to learn. It's overwhelming at times. I try to take notes, listen, and focus - and some days I feel like I am making some progress, but our service is huge and there are many different kinds of surgeries to learn. I am still on orientation (I'm part-time so it will take me longer) and there are many days that I wonder how I could have possibly handled a situation if my preceptor wasn't there. Honestly, the thought of being on my own and taking call makes me sick to my stomach. After six months on a job - even part time - I usually feel comfortable. I just don't in the OR.

2) I find learning in a fish bowl difficult at times. Although I do my best to just jump in there as much as I can, ask questions and remember that the residents are also learning, being picked apart in front of others can be discouraging.

3) I understand that surgery is stressful, and I try not to take it personally when the doctors and residents are (or seem) rude and condescending. I guess one of the reasons I wanted to try the OR is because I thought it was a team atmosphere and I love working in a team, but it usually doesn't feel like a team to me. I feel like a handmaiden sometimes and really wonder if the doctors understand and/or appreciate what the nurses do? Maybe they do see us as team members but because of the intensity of the OR and my own inexperience, I miss it.

On the upside, I adore my preceptor. She is very kind, competent and patient - never loses her cool with me. She said I will be a wonderful OR nurse and is very encouraging. I like our team's nurse manager and ANM - they seem to care about the team. The NM especially has been very good to me and I don't want to take advantage of the opportunity she's given me. For the state I live in the pay is fine and the benefits are wonderful. We have a union, but we also have mandatory overtime.

I'm not saying I hate it or I am leaving tomorrow. I want to do well and also want to enjoy working in the OR. I am just having a tough time right now and am trying to sort through my frustration to see what is just normal, first year as a nurse, learning in the OR is tough - or is it possible I am in the wrong place for my strengths/weaknesses?

Any thoughts for those who have had some of the same challenges and persevered or left the OR? Anyone else new and wondering if this is the right place for them too?

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Chole,

I wonder if your preceptor or nurse manager knows how you feel? the OR can feel overwhelming initially because there is so much to learn. Can you orient full time?

As to the condescending residents and surgeons; there is a fine line between not taking things personally, and allowing someone to be disrespectful and unprofessional - even in the learning environment. do a goole search on horizontal violence to learn more about curbing unwarranted disrespectful behavior in the OR.

I felt much like you do, during my orientation, I persevered and I am glad I did. Hang in there, it will get better.

Paula

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My first year in the operating room was the most stressful year of my life. What you are going through is totally normal.

Knowledge is power. If you want to make your job easier, read operating room textbooks in your spare time. Also, read preference cards in your spare time. Memorizing surgeon preferences will make your job much easier.

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Thank you for the words of encouragement. I haven't said anything to my nm or educator - I want to give it more time to see if it gets better. I had a really good day today and my preceptor said I did awesome (although I still feel pretty clueless and made my share of mistakes!). It's just helpful to know that this is pretty normal and to hear that it will get better. It gives me hope. Thanks for the advice about what I can do to make the job easier.

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I'm in currently in the same boat myself and I've decided that maybe going to a smaller OR would be a good thing for me. If in the end it doesn't work out for you at the large teaching hospital, lots of smaller ORs are hiring nurses.

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I disagree. Smaller O.R.'s often do not have first assistants, which means if you scrub, you will often have to first assist and scrub at the same time which is very difficult for a new nurse.

Surgeries usually take longer in teaching hospitals, which is less hectic for new nurses.

Like it or not, large teaching hospitals are the best place for new nurses. You have the most resources there.

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I disagree. Smaller O.R.'s often do not have first assistants, which means if you scrub, you will often have to first assist and scrub at the same time which is very difficult for a new nurse.

Surgeries usually take longer in teaching hospitals, which is less hectic for new nurses.

Like it or not, large teaching hospitals are the best place for new nurses. You have the most resources there.

I've been in both, and some smaller ORs do have first assistants. Where I work at, they are in *every* surgical area from the main OR, ambulatory surgery, to the endovascular lab, and even some of the L&D OR suites.

The nurses in smaller OR's make excellent resources. So as a nurse in a smaller OR, you won't always be without resources. And even in large teaching hospitals, your resources go home after 4:00pm.

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I agree with Mikethern, definitely better at a larger hospital - it makes a HUGE difference having a first assist when you are still learning to scrub!

Chloe, hang in there! I am a second-degree BSN as well and went right to the OR, same as you! I also feel incredibly stupid and frustrated, and I haven't caught on as quickly as I did with every other job I have ever had.

The encouragement you are getting is wonderful - that's something I didn't have and I wondered the same - is the OR really for me? Take a walk around the other areas of the hospital. Believe me, that "at home" feeling in the OR never changed, especially after I went to other areas and even considered making a change. I was miserable even considering another area.

Yes, at 6 months you feel inadequate, but look at everything you've accomplished up to this point. Think back to your first day and marvel at how much you've learned since then!

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I'm so glad you started this thread! I am an older "new" nurse (45yo), and went straight to the OR. Three months into my orientation I had to have back surgery & was out of work for three months. I just started back this past week.

I was so scared to come back, but actually I was surprised at how much I remembered. I KNOW that once I actually know what I'm doing I'm going to love the OR. I also am the type that tends to succeed in my endeavors and succeed early. This entire experience had been a huge blow to my ego. I feel like a complete failure, even though I'm being told that I am where I'm supposed to be after 3 months--I want to be SUPERNURSE after one month :lol2: !!

I also think the constant pain from my herniated disk also contributed to my slowness in catching on in the beginning. Try learning something that may determine whether a person lives or dies while every single second is consumed in pain! Now with no pain, I find I have more energy to really concentrate on what I'm learning, and have developed some memory tools for myself.

I'm glad to hear that other new OR nurses have had the same feelings I have. Our instructor keeps telling us we're going to feel like fishes out of water for about a year.

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hi,

i have been qualified for a year now and i also went straight into the OR. we had a 6 month induction and 6 month consolidation and by God you need it!

i went through all the things you are going through but all i can say is stick with it it WILL GET BETTER. i have gone from the person in the corner scared to get in the way to scrubbing for a total hip (yesterday) i do trauma and on call now and feel part of a team.

there is still downsides for example one surgeon will not accept that people have to learn and will expect new staff to be as good/fast as an experienced nurse which can cause problems but thankfully our senior staff are very good at supporting you.

at 6 months in i seriously thought about giving up and that i was not suited to the OR but after talking to other people it seems that it is a common occurance..... so stick with it and you will be fine

hope this helps

debbie

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I'm skimming this post and had a few thoughts-

I started in a smaller/midsize hospital- it can be stressfull too. There a fewer procedures but being prepared to be on my own meant being prepared to take call independantly and some of the most important cases to get comfy with aren't done too often. I was expected to be ready to take call with a tech for "my" holiday, which happened to be 9 months after starting. Sounds like a long time, but...

Everyone says it will take 1 or even 2 years to really feel comfortable. That's full time.

I was really into orientation for the first 2 months, then hit a wall. My brain couldn't take any more new info and I was tired of always being ignorant. "dumb". Everyime I figured something out (or almost figured something out) it was on to the next new thing. Sometimes I was actually complimented- that's how my preceptor knew I was in that area too long, LOL

A great day was when our OR was short staffed one day. They asked if I would mind "working" instead of "orienting" that day. I was assigned to scrub a podiatry room. Easy peasy stuff but I really felt good after that. I knew something! :cool: For one shift I was an OR nurse, not a student. I felt human again. Likewise covering an extra shift on my old unit was good for my spirit. Somewhere in this world you are an expert on something. Remember that! This will come too!

The wacky thing is that OR appeals to perfectionists, which makes orientation that much harder on ourselves. We don't forgive our mistakes as newbies, and as we get comfortable we find it hard to forgive others- residents, anesthesiologists, rad techs, co-workers of all levels, and new nurses. Sorry!

of course, some of us do mean it more personally than others but that's another thread...

:deadhorse

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Thank you for all the advice and encouragement! I really appreciate it. Chloe

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