I mentioned that I make a lot of lists, and today I organized the huge running to-do list I keep on my computer desktop. Now that I’ve started this blog about my nursing experiences, I also started a list about some things I may want to write about on here. This sounds really OCD, doesn’t it? *Sigh* oh well. My lists keep my scatter-brained head in line and help me get things done.
My first post was massive. This one will be shorter (at least by a little, promise).
The OR internship that I was accepted into at New Hospital requires that you attend a consortium. This is basically a bunch of classes that introduces you to the major principles and practices that are implemented daily in every OR, and our consortium started on Friday. Before this, all the new employees at New Hospital had to go to 2 days of general job orientation, on Wednesday I shadowed and observed nephrectomies all day (kidney or kidney tumor removals), and Thursday all the new nurses had computer training & more orientation. After all that general orientation it was nice to finally get down to some specific training that related to my purpose: to become a super awesome OR nurse.
So Day 1 at consortium: Learned about “surgical conscience” (always put the patient first). Learned about the electronic surgical unit (ESU), or Bovie, which lets surgeons cauterize and cut during surgery but are also the single greatest fire source in the OR. Learned about how the OR is set up and why, along with some key terms and names of supplies.
A few gripes. Perhaps it’s because I am a young new nurse and because nursing is not a second career for me, but I get very annoyed when other new nurses (or just nurses new to my field of nursing) come to orientations and meetings like this and talk talk talk. In that kind of setting I just want to get through the educational material and get out so I can go home, but these folks seem to see it as their personal opportunity to share stories and reminisce. To me, it’s quite frustrating and their contributions rarely seem to be of value to the lecture. Another thing: It was so cold in that room. I understand keeping the OR cold to decrease the spread of infection, but I don’t get why every lecture room that I go in has to be freezing. The place we went was very accomodating though – lots of free food. You will quickly learn that in the nursing world, food is abundant. Everybody gives us food. It’s great, unless you’re on a diet.
As in most classes, no matter how riveting the speaker is, sometimes you get tired or your mind wanders. During Day 1 of the consortium my mind wandered towards the differences between Hometown Hospital and New Hospital, and I came to recognize that most of these differences were based on each institution’s judgment calls about where to best use their budget. They are two very different hospitals – one is suburban, one is urban. They’re in different states with different laws, regulations, standards, and public expectations and attitudes.
Before I accepted the OR internship position at New Hospital, I had interviewed at several others. Maybe 4 or 5. Each of those interviews was for the same type of position in the different OR internship programs at these various hospitals, and each interview required that I come on a second day for what is called a “shadow” or “share” day. This is when you basically come in, change into their OR attire, stand in the corner and watch OR procedures all day. The purpose of this is to prove that you can handle the sights, sounds, and smells of the OR atmosphere without getting scared, passing out, or vomiting (all very frowned upon, naturally).
As a result of doing so many of these shadowing days while trying to land a job, I got to see a wide variety of OR arrangements and supplies. While I was shadowing at work on Wednesday of this week, I couldn’t help but think about some of the things that were blatantly absent in New Hospital’s OR. My observations of what was missing (don’t hate on me for not knowing the correct terms):
- Sponge counter bags
- Surgical helmets to which facial shields attach
- Electronic boards in the OR, PACU, & family waiting area that denotes where & in what stage of the surgical process a patient is in
- Re-usable sharps containers
- An OR-specific pharmacy
Other things throughout New Hospital that caught my attention:
- There’s no swipe-in, swipe-out system for attendance & time clocking
- Can’t dial 911 directly during emergencies, must dial a non-intuitive internal system number
- Use of disposable blue chucks instead of re-usable pink pads for incontinence
- Not a smoke-free campus
Now the reason that this doesn’t fluster or upset me is because of what I mentioned before about allocating the budget. By the way, as a new grad I felt that this was a rather astute observation on my behalf. For example, New Hospital may not have some of the things in that list, but the money that those items would have cost was instead spent on purchasing state-of-the-art robotic surgical technology which will better serve our patients. I’m okay with that. I must say also that New Hospital has the best customer service and employee satisfaction that I’ve witnessed anywhere.
My mind decided to wander to other things as well during class. Primarily, I thought about how cool it was that I’m getting paid to learn. It’s like the Pleasantville version of college. I also thought about how I’m proud to be entering the nursing profession early in life with a Bachelor’s degree. Once in awhile I’ll run into someone who’s looking into attending nursing school and they will ask me – “Should I go to a 2-year Associate’s Degree (ASN) program or a 4-year Bachelor’s Degree (BSN) program?” Well, that depends on you. If you have any inclination that someday you may want to further your nursing education and go beyond being an RN, such as entering management or teaching, you will need your Bachelor’s Degree in nursing anyway. If you know that all you want is to be an RN for the rest of your days, an Associate’s Degree will do you just fine. Both programs will get you an RN license (if you pass boards).
My experience has shown, however, that most people who enter an Associate’s Degree nursing program end up taking 4 years to graduate anyway though because they have to wait for clinical spots, whereas Bachelor’s Degree programs rarely seem to have that same struggle. I don’t know if it’s because of the different connections the schools around my area had with the local hospitals, but it seemed like a shame to have spend the same amount of time in an Associate’s program as the people who went to the 4-year Bachelor’s program and not get the same diploma. At many hospitals there’s a pay difference that favors BSN graduates over ASN graduates, and most hospitals nationwide are pushing ASN’s to get their BSN anyway. Some places won’t even hire ASN grads.
If you’re one of those people (as I was) who think of nursing as a job that sticks you by the patient bedsides for the rest of your life, allow me to change your perspective. This may be particularly of interest to anyone who’s in that position of trying to determine if all they’re going to need is their Associate’s in nursing or if they should dive into a Bachelor’s track program (my preference, if you couldn’t already tell). In my Book of Lists, this list is titled “Nursing Career Options…For in case I ever get burned out.” I’m sure there’s more that I have down because nursing is such an incredibly varied profession. Below is my compilation of the many amazing things you can do and become as a Registered Nurse:
- Bedside Nursing (Med-Surg, Pediatrics, L&D, Psych, etc.)
- Specialize in one of those areas
- Surgical Nursing (Working in the OR like me, where patients are asleep & catheterized so they won’t make a mess on you, yay!) in a hospital or outpatient surgical center
- Become a Nurse Practicioner (many states allow you great autonomy, even prescriptive authority)
- Become a Legal Nurse Consultant or an Expert Witness (if you’re interested in nursing and law)
- Work for a pharmaceutical company either as a sales rep or working with research participants
- Can work in many settings (Hospital, community clinic, private doctor’s office, etc.)
- Work for National Institutes of Health or other government agencies
- Work for a professional nursing organization (such as the American Nurse’s Association, Sigma Theta Tau, etc.)
- Become a college nursing professor (my long-term hope) or part-time clinical instructor
- School nursing
- Nurse at summer camps, resorts, and cruise lines
- Travel nursing
- Work in nursing administration/management
- Become a nurse researcher
- Work in public health nursing (lobbying for health issues, etc.)
- Instruct NCLEX review courses
- And much, much more! (cheesy, I know)
Another thing I thought about during the consortium lectures which hadn’t struck me before was the realization that as a new nurse graduate, this may be the last time in my career in which I am so generalized in my nursing knowledge. This is a good thing, because it’s good to specialize and to focus in on one particular discipline of nursing in order to best serve my patients, but it’s also a bad or sad thing because I’m worried I will lose some of the knowledge that comes so easily to me right now once I’m not using it on a regular basis.
Right now I’m definitely using all of my cumulative nursing knowledge on a daily basis because I am studying to take NCLEX. This is my nursing licensing board exam and it’s coming up soon. I’ve taken the Kaplan course and that has definitely been helpful (free advertising for ya Kaplan, congrats), but naturally I’m still anxious. This test determines a few things: if I get to become a nurse, if I get to keep my job, if I have a livelihood… oh and just about everything else I have planned out for my future. I’m confident that I will pass, it’s just that at this point I want it to be over and done with.
PS – Please don’t think that I’m a slacker who didn’t pay attention at all during my consortium classes. I really did! Most of the time 
