Typical Day at Hospital Ambulatory Surgery

kngl · Mar 1, 2014

I worked as a new grad in an ambulatory surgery center. Truthfully I think the only way I picked it up so quickly was because I also worked there as a PCT before graduating. The daily pace can vary a lot! Some days there is down time and other days you are running your behind off. Priority setting and efficiency are key to caring for your patients safely and discharging swiftly when the patient is ready. Common situation: patient #1 has an 8/10 pain and a BP of 180-110s, patient #2's assessment is now 15 minutes late with no tech in site to grab a set of vitals, patient #3 is crazy anxious to leave after being there 10 minutes because they want a cigarette so badly...meanwhile they're still on 3 L of O2.

Granted not every moment of every day is like this. You may still get to go home 2 hours early because you ran for 3 hours then poof where did all the patients go? I do believe it would be difficult for a new grad to transition to ambulatory surgery with no prior experience, but not impossible if you feel your priority-setting skills and efficiency are up to par. Good luck!

brownbook · Mar 1, 2014

They are both great jobs. Our hospital ambulatory surgery center and endoscopy center was combined into one unit. I had been a nurse for 20 years before ambulatory nursing, however I had been in administration for 5 years so was really nervous about what skills I had lost.

Honestly it is really pretty easy. The patient has been seen by his primary MD, his surgeon or gastroenterologist, and gets assessed by the anesthesiologist. So they do not even enter the ambulatory surgery center if these doctors think they are not basically healthy enough to not need to be admitted to a hospital. So you are taking care of healthy patients for relatively minor procedures.

It can be very fast paced, the center makes it money by doing a lot of procedures every day.

Paperwork and speed can take priority over patient assessments. Of course they must be assessed but remember they have already been deemed healthy. You will be doing very limited patient assessments.

In surgery the unconscious patient is giving up all their care to us. You must be their protector, are they signing the correct consent for the correct body part. When did they eat, are the allergic,.......the OR or pre-op check list is critical. Once the patient is unconscious it is too late to discover that they did eat, or are allergic to such and such.

You may need to start IV's, but in some places anesthesiologists do this.

There is tons more to know, consider. Look over PACU nursing for some ideas about PACU nursing. But realize SOME of the PACU responses are referring to acute care major surgery PACU nursing. What they say may not apply at all to ambulatory PACU nursing.

You will probably need ACLS.

jiacarin · Sep 19, 2014

Hey umslalum! I'm a new grad as well, and I accepted an offer to start in the ambulatory surgery unit within a local hospital.

I wasn't sure about it myself to be honest. I'm thinking of future opportunities in case this program ends after a year and there's no permanent full-time position available. I applied through this program for a med-surg position, and I was told this unit is med-surg level too. After some Googling, I found an orientation packet for junior fellows for the same hospital, and the unit was mentioned! It gave me a tiny bit of an idea of what the RN would do in this setting, but I'm still nervous about it.

I've heard and read a lot of good stuff about the experience you can get, but I'm also concerned that it would be too fast for me to properly learn as a newbie. For my unit, it sounds like I'll be able to practice my skills with IVs, medications, EKGs, labs, etc. I'll also be able to work both pre-op and post-op (after PACU stabilizes the patient) from what I've read. I do have years of non-RN experience in a SNF, so I'm counting on the flexibility I gained in that position, and applying it to this position. Since I have no nursing experience, I imagine it would be a struggle to keep up and know right off the bat what important things to look for with each case... Like kngl said, I worry the experience would be too much for a new grad. The person who interviewed me really stressed that it was fast paced, and one of my interview questions asked about how to deal with angry patients too. I've read here that usually more experienced nurses will move into these positions? I'm told the unit I'll be on sees both inpatient (requiring hospital admission) and outpatient (same-day surgeries), so I'm hoping this will count for acute experience as well... I've read other nurses say it won't count, and others saying it will. Crossing my fingers that it will so I'll have options, just in case.

I'm just as uncertain about the opportunity as well, but we should remember that this is exactly that! It's an opportunity. I intend to keep my skills and knowledge base up as much as possible while in this program so I can either stay or move on after the year is up. I'm really hoping that I'm a good fit though, and that I can stay beyond that year. Good luck with your interviews!

catdog5 · Oct 20, 2016

How did everything turn out with being a new grad in an ambulatory clinic?