Stress level for a circulator?

GadgetRN71, ASN, RN · Dec 23, 2007

I am *seriously* considering a switch from ICU to OR in the VERY NEAR future! I am so burned out/stressed out due to high acuity on our unit.....running on adrenaline (sometimes scared out of my mind) for 12 hours is exhausting to say the least!
**On a scale from 1 (least) to 10 (most) what is your typical stress level in the OR?**
**When a case is stressful (patient codes for example) how bad does it get for the circulator?**
I love my 3 day 12 hour shifts and worry about the 8 hour 5 day a week grind...but to have my weekends and holidays available again...to sleep in my own bed every night again....it would be worth it.
I have observed in the OR where I am considering...the staff was amazing and really nice...the orientation is 24 weeks!
I have read through the forums and it sounds like if I have prepped the room properly, know my stuff (important) and anticipate any possible needs of the surgeon I should be great...is that a correct assumption?
Sorry for all the newbie questions.....I am really afraid of making the "leap" and any information that you could provide would be EXTREMELY helpful!
Feel free to send a PM!!
TIA!
Jenny

The stress level can get pretty high, because even the most run of the mill surgery can turn bad very quickly.You'll have multiple people all wanting something at once(the scrub, anesthesia, the doc) and even if you've planned well, there's always something else they want.

On a scale of 1 to 10, I give it a 7 or an 8.(on a typical day!) Also, you will be expected to take call so there may be a weekend or holiday that you'll have to work. You'll get called in at 2 am sometimes so your nights aren't always yours either.

I love it, but it has its own challenges. I'm not sure I would call the OR "low stress" at any rate. Good luck to you whatever you decide.

shodobe · Dec 23, 2007

For the first 10 years or so my stress level might have been around 7-8, depending on the day. The past 20 years it has gone down to a 2 if a very busy day. I just don't get stressed out that much anymore. My stress at work mainly comes with dealing with the surgeons and their personalities and not the cases themselves.

IsseyM · Dec 23, 2007

Hi Jenny,

To answer your questions,

Because i've only been an OR nurse on my own less than a year my stress level everyday is about 7. When i get thrown in cases i've never done before and there is nothing or limited info. on the surgeon's preference card my stress level is about a 10. It also increases when i know i have to work with a surgeon who is very impatient/mean or when i get patients from ICU who are in really bad shape. Pediatric cases increase my stress level also, newborns especially.

It can get really bad for a circulator. Like Witchy said, multiple people wanting stuff all at once. When i have anesthesia asking for more fluids, drugs or to order blood, get blood gases and then surgeon needs a certain kind of instrument you don't have & you have to call overhead or run for it or if they're passing off specimens that need processing quickly, scrub needs more lap sponges, irrigation....etc...it can get really crazy. There are some cases you need two circulators. One time i circulated a case and asked my charge to send in a 3rd circulator because so much going on.

I work 5 8hr day shifts with weekends and holidays off. However i have to take one weekend a month and i have to sign up to work 1 major holiday a year. There are some OR nurses who work 4 10hr shifts and some work 3 12hour shifts with 1 8hr shift to make up their 80 hours if they want. We have a call schedule and we have to sign up for a certain amt of hours per week, if we don't the charge will assign us.

The OR staff-like family, its all about teamwork. Nice people even though there are a couple bad apples. From what i've seen OR orientation is the longest out of other fields of nursing, average 7-9 months because its totally different than any other type of nursing.

And yes you are right, you have to make sure you have prepared your room for the appropriate procedure, know your stuff (sometimes you don't know and mostly wing a case but you have to atleast know the basics) and anticipate what the surgeon will need..thats a biggie. I'm always thinking if this happens then they will need this, i also have alot of backup instruments and supplies in my room for the just in case scenario. Some people think its a waste of time to have extra stuff in the room you don't need, but i'd rather be prepared because you will run like a chicken with your head cut off if you're not and you will have a pissed off surgeon.

Congrats on deciding to make the leap. I don't think i could ever do ICU, makes me really nervous. When i was in school i didn't feel comfortable caring for ICU patients and i would freak out everytime my nurse left me by myself, especially if they were on vents. You're constantly thinking and wondering if you dotted your i's and crossed your t's. Good luck and keep us updated.

OR male nurse · Jan 1, 2008

You just have to keep it all in perspective, be able to multi-task. When the tech is asking you for a zillion things at once, I try to break the ice and let them know they are starting to tick me off by saying. "you want fries with that ?" Being an OR nurse can be really stressful, but you learn to roll with it, play the game and come out on top keeping in mind that it's all for the patient asleep on the table.

justjenny · Jan 1, 2008

Thanks for the replies.

I realize there is obviously a high stress level...but I am surprised to get responses of above 8! Seriously!

My reality in my current job is this: *I* am the one responsible to do EVERYTHING (and still chart) depending on the situation and how unstable the pt is...it can often be too much! Luckily we help each other out whenever possible.

My perception of OR - stress and all - is that *I* am not the one tying off bleeders or doing chest compressions or whatever....I am assisting as best as I can to ensure a good outcome for the pt. (by making phone calls, getting more fluids, getting equipment or instruments, etc.)

Does that make sense?

Basically, I am used to bedside procedures and setting up equipment, positioning pt, etc. "doing what I am told" but MY STRESS comes from the day to day events of an ICU where there is NO ONE else at the bedside and *I* am making all of the decisions - and possibly waiting for a doc to show up to take over if the pt is crashing. (those brief moments waiting for assistance feel like a lifetime!)

In the OR - I would never be alone and that feels like so much more of a relief. I am thick skinned and once I am through orientation and am comfortable I feel like I am fast on my feet. I am not sure about when multiple requests are made at the same time...I guess it is simply priority...knowing which request is most urgent at the time and moving on from there (or growing another set of arms...??)

Do I have a grasp of what I am getting myself into? If not - someone give me a wake up call AND QUICK!

Jenny

GadgetRN71, ASN, RN · Jan 2, 2008

You don't really have a perspective on how stressful the OR can be until you are in there. Is it an 8 every single day?-no, but a case can start out a 4 and zoom right up to a 10 in about 5 minutes. Also, some of us OR nurses scrub as well, so it might not always be circulating that you have to worry about. As a circulator, you are held responsible for everything that happens in that room.

This is my attempt at the reality check that you asked for, but like I said before, you get the true perspective once you are doing it.

We had a patient code before we were about to do a cysto case(poorly placed spinal!) and I WAS doing compressions..If you are scrubbed, you may not be tying off bleeders yourself but you have to be able to pass the suture material in a quick manner. You have to be able to anticipate, and in a trauma, that can be hard, because things don't always go by the book.

Or nursing is stressful IMO, but I love it. Like some of the more experienced nurses said, it goes down with time but never goes away completely. Good thing I'm an adreneline junky!

Like I said before, the OR is also not a 9-5 type job. You may be mandated to finish a case and call is always expected of you. In some facilities, this can be quite a lot of call depending on staffing. I have been called in at 7am on a weekend and didn't get to leave until 2am the following day, for instance. This can be stressful to your body and your relationships LOL..(I get very snappish with lack of sleep)

sandiegojames · Jan 8, 2008

Yes the OR can be quite stressful, but I think having your ICU experience will be a tremendous asset, one of our new hires came from the ICU for our training program and has done exceptionally well and has advanced more quickly than his peers. So I'll bet your experience will help a lot in dealing with patient emergency related stress. But moving from the ICU, where it is just you, to a team environment with basically all "type A" people with relatively little patience will be a real adjustment compared to the ICU.

There can be a lot of call, and the job is very different. But it really is a fun place to work if you are smart, like to learn new things and get along well with others.

justjenny · Jan 12, 2008

UPDATE:

I interviewed and hired in for the position! I start in two weeks!

:w00t:

Interestingly enough...when discussing my ICU experience and knowledge, the manager actually told me I blew her away and that she could never do my job in the NICU. She seemed quite impressed and said that I was a "real nurse"

!?!?!?!

Then, during my tour around to meet people, after she introduced me to someone as a NICU nurse, she did the Bill and Ted "we're not worthy" bow to me....I left that interview floating on clouds!

Now, to live up to the very high expectations that have been set for me....I feel pretty good knowing that my manager is VERY nice!

Jenny

GadgetRN71, ASN, RN · Jan 14, 2008

Congrats, Justjenny!!!:cheers: Good to have another OR nurse on board. Try to learn as much as you can and be gentle with yourself-it's a new environment and it can take up to 2 years to feel truly comfortable.