What do you think of a NEW RN trying the OR?

changeofpaceRN · Mar 5, 2009

I just saw another post linking this thread https://allnurses.com/operating-room-nursing/bad-fit-for-371059.html

anything else?

lozza_49 · Mar 30, 2009

I went straight from study to the OR, yes there is a lot to learn, but you will pick up the skills quickly and people will share their knowledge and experience with you. I'm still there after going in at entry level plus you can always go and do further postgrad periop studies:wink2:

Heogog53 · Mar 30, 2009

We have a ton of brand new nurses who come directly to the OR after graduation. They have a 6 month internship plus at least a 3 month orientation to the speciality area they are going to. My hospital has over 35 rooms, you see.

When I did my internship, it was 4 months and then voila- on your own. Smaller place; 12 rooms plus 2 OB suites. During the large hospital orientation, the RNs are always kept scrubbed at least half the time they are doing clinicals. The first month is just classroom, so assume about 1- 1/2 months of scrubbing of some sort. When I was in my internship, I got two weeks of scrubbing and then didn't get to even try to scrub again for a year. I contaminated two gowns and three sets of gloves before I could get to the table....

Once the new kids go to their areas, then they are taught an equal amount of circulating and scrubbing in their given area. They are monitored by whomever is scrubbing with them, RN or ST. We have more RN's than ST's but the distrabution changes from area to area.

I love to scrub big long messy traumas and massive abdominal cases. That's where I am most comfy.

As a new nurse, be ready to accept, depending on how long your internship and orientation last, that once on your own you will get extremely frustrated because you will have an imperfect understanding of whereever you are. It took me about two years from my start date in the OR to suddenly "get it". Granted, I may be a bit slow, but there is a steep learning curve once you are on your own til you find yourself.

Don't be discouraged; the same thing happens on the floors, in the ICU's, the speciality areas, the ER etc. It's called a reality check and you finally figure out what nursing really is, ratrher than the fantasy that got your through school. Stick with it, get over it and guess what- you emerge on the other end having a wonderful grasp of OR nursing that lets yo start to act as a higher and higher functioning RN til you are the preceptor and you remember what Doc so and so likes for closing skin.

I'd say go for it and have patience for yourself as you grow in your practice.

beanal · Apr 3, 2009

I think it is OK for a new grad to start in the OR as long as you have an good solid orientation with a nurse educator. I don't agree with new grads being shuffled around from nurse to nurse for the orientation process. It's confusing and potentially dangerous IMHO.

Also find out if you will have to specialize in one service right after your orientation. Unless it is general surgery I don't think this is a good idea if you will be taking call. For example if you specialize in GU and are doing cystoscopies all day how are you going to acquire the skills to circulate for an emergency ruptured abdominal aortic aneurysm while on call?

It's something to find out before you are place in this situation.

Heogog53 · Apr 4, 2009

I do agree with you about having a good nurse educator, a solid orientation program, and as much as is possible, staying with one nurse preceptor. However, due to varying shifts that so many of us work, that can be a bit of a crap shoot. In orientation, one works 7-330. However, the nurses here work 7-530, 7-730, 11-11, 9-9, 11-7a, 11a-7p, 3-1130, 1p-11p and I think I'm missing one more shift. So, even if you "stay" with your main preceptor, there will still be one day a week that the new nurse gets farmed out.

I work in a 35 room suite. We have teams, and everyone is assigned or chooses a team. The new nurse then gets training for that specialty and stays there most of the time. If you work in plastics/ENT/oralmaxillofacial, that covers a huge variety of procedures. Problem that comes up is when the new nurse is on call and thrown into a liver transplant with the re-assurance that "the docs are nice, all the charting is done, it'll be fine" and of course, things don't always work out that well....

I wish I had a good answer to that problem. In my OR, you are handed off from one specialty to another, one "primary" to another, both scrubbing and circulating. It doesn't matter if the stay in one area is one month of mixed scrubbing and circulating, most of the nurse residents are simply not happy with that completely off balance feeling as they just start to get the hang of it and then, whoooosh, are someplace else completely. It also doesn't help that some of the teams are very small and very tight, socially. There is a feeling of our team vs the rest of the teams, and that's not great.

Personally, experienced nurse or new grad, it is a lot to learn, since most nursing school curriculums hardly teach anything about the OR and rumor has it that we don't use a care plan of any sort. Makes it hard for anyone to really have the exposure to get a good feeling about diving in.

Just my rant and two cents.