Switch from the floor to the OR?

Hello FutureResearchRN,

So you're ready to make the switch. Perioperative nursing is a completely different realm of nursing. I worked on the floor and in the emergency department prior to becoming a circulating nurse in the cardiovascular OR. I always had an affinity towards the OR and it was my dream job. I enjoy every aspect of the surgical procedure and I am now learning to scrub. I will be honest in advising that there is minimal to no patient interaction. You will loose many of your nursing skills since they are not utilized in the OR. Most IV's are done by the anesthesia staff. Foleys are put in by OR techs. You will forget many of your medication protocols. Most likely you will begin as a circulating nurse. As a circulating nurse you are pretty much the butler of the OR. You will learn many instruments some with 4-6 different names. You will learn to cater to the likes and dislikes of the surgeons - their music, their instruments, their positioning etc. Many of the seasoned OR nurses are rude, unfriendly and walk around with an heir of superiority. Don't let that deter you.

Coming from the floor and with my experience in the fast paced ED, I was pretty sharp in the OR. For me the change was painless. The hardest adjustment for me was getting used to the constant profanity. The OR is fast paced, however the stress level is manageable and quite different than the floor. I made it my duty to talk with my surgeons in order to learn their preferences. I kept a log for each one. I always researched my procedures, viewed videos on youtube and played with programs like touch surgery and heart doctor to fine tune my knowledge and skills.

Some floor nurses find the OR to be boring. They miss the patient interaction and the practice of typical nursing skills. Before transitioning you want to think about your ultimate goal as a nurse. Will working in the OR contribute to that career goal. I plan to be a first assist, then get my FNP and continue to work in different OR specialties like Ortho.

So to be a excellent OR Nurse, in my opinion you need to have the following:

* Be thick skinned

* Be able to handle confrontation

* Be able to de-escalate situations

* Be opened to criticism

* Be flexible

* Have a good memory

* Have good muscle memory

* Be ok with standing for long periods of time

* Be able to cater to surgeons idiosycracies

* Be able to delegate

* Be able to know when to say NO!

I wish you the best of luck in your decision. I hope my 2 cents helps. I miss the ED sometimes so I pick up shifts once in a while. You may have that same option to pick up shifts on the floor. You're either going to hate the OR or absolutely love it!

All the best!

You will loose many of your nursing skills since they are not utilized in the OR. Most IV's are done by the anesthesia staff. Foleys are put in by OR techs. You will forget many of your medication protocols.

In my OR, the circulating nurse or whoever is assisting with the surgeon (resident or medical student with supervision/permission) will place the Foley. We have Surgical Technologists ("scrub techs") but not "OR techs", per se. Scrubs have gone to school and are certified. Everything else mentioned is true and applies for my facility as well.

If you hate it, it will be easy to go back to the floor. Getting into the OR isn't always easy and if you burn a bridge, you may not get another chance.

In our facility, OR nurses are foley experts and some are excellent at IVs. BTW, pet peeve of mine: You'll still do nursing. You will be watching the monitors and listening to the suction and calling blood bank to see f they have units available- you'll know things are going South without anyone telling you. You will learn the art of safe pt positioning, a huge responsibility. You'll open supplies before anyone asks because you know what is needed. A good circulator is in tune with the room and anticipates every need, just like a good floor nurse evaluates each patient. I wouldn't say it's a butler, though, unless a butler knows how to charge paddles. It's too easy to not see what a good OR nurse is doing if she/he is doing it right. Hmm, Maybe we are like butlers... Nah, I'm kidding. Seriously, though, butlers? That's very short sighted, I don't agree with that statement.

Oh, and OR nursing is extremely physical, you will find yourself on your hands and knees crawling around moving bovie pedals and the like. It's not for delicate flowers/ butlers. You will do whatever it takes to see your patient through the extemes of surgery. OR nurses tend to be matter of fact and brusque as they perform their duties. What else, ... I like what you say in your post and think you should seriously consider the OR especially if interactions with family frustrate you. It's very nice to be behind double doors sometimes!

You DO have patient interaction, and it is the perfect amount for me. You talk to the patient in prep area and when they enter the OR. Then the anesthesia provider takes over and the general anesthetic or sedation takes effect. My "personality tests"show that I am task oriented, so the technical aspects and the "only one patient at a time" really works for me. Some nurses think that OR nurses are stuck up, rude and mean. At the risk of bragging, I'm not. I'm a really nice person, but I will raise a fuss if I see patient care compromised. That is our task, the care of the patient when they are at their most vulnerable.

Thank you to all who replied to this thread, every comment was very helpful to me in making my decision. I am happy to say that I accepted the OR job :) I am very excited to make the transition. Thanks again!

Thank you to all who replied to this thread, every comment was very helpful to me in making my decision. I am happy to say that I accepted the OR job :) I am very excited to make the transition. Thanks again!

Congrats!! I also accepted a position and will start the PeriOp 101 course on July 11th! Can't wait!