Two months in...

Editorial Team / Admin · Jan 17, 2015

There are a few sayings about OR nursing:

1. It takes a special personality to do it. If you think about it, nursing is about helping people get to their optimum level of health. In the OR, we are actually causing acute damage (incisions and whatever else) to fix bigger problems. Some people find not so positive ways to deal with that disconnect.

2. It takes a year to finally feel comfortable in the OR. Corollary: Sometimes, you're still going to have days where it feels like you're a newbie again even with years of experience. Technology changes and new techniques are brought into the OR, such as robotic technology. Quite honestly, your two months is a mere drop in the bucket when talking about comfort and competence.

As for your situation, it sounds like the management there has let some of the personnel interaction get a bit out of hand. It's not like that everywhere. Whether you should change to another unit is something only you can decide, but be aware of what consequences that could bring- are you even allowed to transfer to another department? Some facilities require a set amount of time in a department before another transfer can be approved- you may want to check with your HR department or unit manager to see if it's even a possibility. If it's at another facility, how does that affect your chances of being rehired at your current facility should you ever want a position at it in the future?

If you do decide to remain in the OR, there are a few methods that may help you with instruments and surgeon preferences. It will involve a little work on your own time, but that's part of learning a new position. There are several sites and even a few apps that can provide pictures of instruments with names and purposes and even a quiz to test your knowledge. Spending some time in the sterile processing department can help- putting sets together can reinforce not only what the names of instruments are but on what procedures they might be used. Many departments use computer tracking to assemble sets, including pictures of what the instruments looks like. Keeping a small pocket sized notebook available at all times can also be a help in learning surgeon preferences that aren't necessarily on the preference cards. Although I rarely carry it around, I created one for my current position that had little hints about preferred radio stations, specific extra instruments to have on hand, this surgeon sits for that procedure, etc.

OR nursing can be a very rewarding career, although that is definitely affected by the people you work with and the support you receive. Some ORs are better to work in than others. Either way, only you can decide your future career path.

MeiLana · Jan 18, 2015

There are several sites and even a few apps that can provide pictures of instruments with names and purposes and even a quiz to test your knowledge. Spending some time in the sterile processing department can help- putting sets together can reinforce not only what the names of instruments are but on what procedures they might be used.

I'd really love some pointers on online resources, apps, sites, quizzes!

--Mei

FurBabyMom, MSN, RN · Jan 18, 2015

I'd really love some pointers on online resources, apps, sites, quizzes!
--Mei

A suggestion I found helpful that my manager gave me when I was orienting? Print a copy of the count sheet for sets you use on your service (we don't generally have to count instruments on our service but the sheets are useful). Our count sheets include the instrument/part number from the manufacturer. If you search online you can generally find photos. They include no patient info - it's strictly info/inventory that CPD and the OR use...

Nurse Sasha · Jan 25, 2015

Hang in there, as others have stated it does take time to be comfortable in the OR (actually most new areas/jobs). Actually many ORs find the Nov. & Dec. Extremely busy times so you actually jumped in at the wildest time of the year - no wonder you have been overwhelmed! Is there an active chapter of AORN in your area? I have found AORN to be a great resource as well as an excellent networking opportunity - AORN.org & the monthly magazine is full of info too. Good luck!

Travel_RN_0714, MSN, RN · Jan 25, 2015

I started an OR position as a circulating nurse in mid November and so far I'm not loving it. At first the nurses were very aloof and cold to me and would often shoot me down or ignore what I was saying... Behaviors that I have come to expect from a majority of surgeons that I have worked with in the past when I did med surg, but not behaviors that I would desire in my fellow nurses. Lately they have warmed up to me an include me in more things, but I feel jaded toward them now. I can definitely handle strong personalities and bad behavior, I don't often run screaming from that. But it felt a bit much.
Recently I have now been feeling overwhelmed that I will never understand instruments and positioning and all the minute details of surgeon preference.
I voiced my concerns to my manager, and he assured me that the first "year" would be hell, and it'll get better after that... I'm not sure that I am prepared for this!! My manager told me that I am doing way better than would be expected of someone this far along in training, and is adamant that I will make a great or nurse.
I am now at a crossroads. About 50% of the time I enjoy my work, and the other half I feel drained and unhappy. I have recently been offert a ccu position that weirdly pays more, but I will be back to having that stressful pt load and all that comes along with bedside nursing. But when I did med surg before this, I felt fulfilled and good at my job.
Can I ask if anyone else has had similar experiences? And am I crazy for leaving this or opportunity? Should I wait it out more? I know it is a steep learning curve, but I feel like I bit off more than I can chew?!

Hey... guess what... you are completely NORMAL. Welcome to the world of O.R. nursing. All I can say is hang in there as it gets better. As your OR manager told you about the first year being hell... I have to agree. OR nurses can be total jerks with Alpha personalities. Once you get the hang of how it all works, you won't want to work in any other department. I get asked soooo many times by a patient as I'm wheeling them back to the OR for their surgery "do you like your job" I tell them no.. I don't like my job... I LOVE my job. To me, working in the OR is the coolest job ever. We get to work with state of the art equipment... work in a secure environment where most of the staff of the hospital have NO idea what we do behind the Operating Room department doors. I've talked with nurses that have worked in my hospital for 25 years and don't have the first clue what we do in the OR..... All I can stay is stick with it. It's a rewarding career. You can always fall back and work on the Med/Surg floor, but it takes years to learn how to become an OR nurse.

SarahClaire · Jan 25, 2015

Thank you all for your words of encouragement!! I was very nearly on the edge of leaving, but your advice to hang in there convinced me to stick it out for a while longer and now I'm glad that I did. I've realized that each day is getting easier, and things are starting to click more. There are definitely things that leave me thinking "what the hell was that?!?" But overall I'm now convinced I made the right choice- and you're right I can always go back to med surg, but surgery is so hard to get into, and I feel blessed that they are taking the time to train me :)