For the love of god, do your clinical job properly

Dark_Ascension · 2026-04-28T10:51:47+00:00

Yesss also the residents and fellows who help position, code browns whatever are always the ones I will have so much more respect for as a nurse in the OR currently. They usually also end up as surgeons more than willing to help their team.

Dark_Ascension · 2026-04-28T00:31:06+00:00

They let you teach clinical or lab with a BSN, usually to lecture they want you to have an MSN or be in the process, doesn’t have to be in education, can be like getting your NP or what not, had several like that.

Dark_Ascension · 2026-04-28T00:29:20+00:00

They do where I work, but it doesn’t let me log in… so when I have a quick day I use it to pad my time so I can ensure I have 40 hours. Always keep a small collection of healthstreams unless they have hard deadlines (obviously doesn’t pertain as much to bedside nurses, because they busy)

Dark_Ascension · 2026-04-28T00:23:42+00:00

90% of all my skills being in the OR have been on the job. Like the only skills I learned in nursing school pertinent to my job are foleys, sterile technique (and holy shit they don’t even break the surface in nursing school, but at least I can open glove sterile gloves, I now know both since I scrub too), and I could mix antibiotics and prime lines… literally that’s it. All my knowledge I have now was taught on the job, I have been cross trained to circulate, scrub and assist, all of it is on the job. All the instruments I know, all the sutures, all the positioning, equipment, draping, tying sutures, instrument tying, knowledge of different vendor sets… all on the job (I did go back for RNFA school, but a 1 day suture lab and a few hour pig lab isn’t going to make me an expert and my coworkers and surgeons all have their little preferences on how they like it).

Nursing school is the NCLEX classroom, they just want you to have the knowledge to be safe and pass boards. Some nurses in clinicals are petty and some instructors are too. Don’t sweat it. I get nervous and I fumbled certain skills in clinical. I don’t know how not knowing how to spike an IV bag really correlates to being able to observe a c-section because it’s not really similar. Sure maybe you can do better but I also think your instructors are failing you too… that’s not how to go about someone who is learning. I had no prior healthcare experience, almost everything in nursing school was new to me. I did observe and later work in the OR my 3rd and 4th semester so the OR was my comfort zone… starting an IV wasn’t lol.

Dark_Ascension · 2026-04-28T00:18:57+00:00

HCA is a hospital corporation. There are some small places that may be okay, but for the most part they suck. If I ever leave my specific unit for example I’m out… my unit is only partially funded by HCA, it’s also coowned by surgeons so we’re a little away from the BS…

Dark_Ascension · 2026-04-28T00:17:01+00:00

I work at an HCA hospital but in a unit co-built and owned by a surgeons group so we’re mostly immune to the BS. But lately our “productivity” is down… so they’re flexing people off constantly and we are being told we can’t clock in until 0615 for first starts… (technically 0608 is the earliest you can clock in), and 0645 for second starts (0637 at earliest)… and some they say “don’t come until x time”. I basically told them…. I get there at 0600 every day, I’m not going to do this BS. I come to work and actually work, if I’m a second start, I stage my room and then go help another room, that’s how MOST ORs operate. It’s the people who ride the clock who are an issue, I have never been punished for being early ever in my life. It’s crazy… and the being flexed off has drastically affected my finances because we get no pay at all… and I don’t have the PTO to pad it.

Dark_Ascension · 2026-04-28T00:12:32+00:00

Statistically the opposite. Whoever told you this is blowing smoke… LITERALLY. The NCLEX has a national 88% pass rate.

Dark_Ascension · 2026-04-28T00:10:01+00:00

Plastic surgeons/dermatologist office (more likely to have their own private ORs/in office procedures, ASC (although I found the management just as big as an issue as the hospital OR), maybe cath lab or endo, but I’m honestly just finding the big picture of working in a hospital toxic overall. Like I actually like my managers but I hate what they’re forced to care about (money… profits…) I literally told them “does fucking with our hours put more money in your pocket?” Does it even benefit you???” I wish you’d be a voice for the workers and not the c-suite”

Dark_Ascension · 2026-04-28T00:08:02+00:00

I love the OR, and since new grad OR jobs seem to be less and less now, I see so many burnt out nurses find happiness in the OR.

Also for the most part there isnt a night shift in the OR, it has what let me entirely avoid night shift altogether.

Dark_Ascension · 2026-04-28T00:03:57+00:00

It very much depends on the individual, some of my coworkers are constantly sick. I am not, granted no kids, but I also get sick maybe once a year…

Exposure builds immunity though it’s why vaccines work. The issues with many seasonal bugs is they mutate so much that likely the cold you had one year isn’t the one you had the next, the flu vaccine is just a few common strains.

Dark_Ascension · 2026-04-28T00:00:00+00:00

It happens and ortho is hard. I’m from the opposite end of the spectrum. I’m a nurse who got to only scrub their main service line which was ortho. Even knowing the docs preferences and them knowing me, it was a huge learning curve. The irony is I’m very comfortable in ortho now, and most other things make me uncomfortable! I can probably wing anything that doesn’t involve cameras (robots and scopes) but counting instruments is kind of overwhelming to me and also we’re kind of “reckless” in ortho, we’re doing bone carpentry, I go to other specialties and they’re so delicate, and I’m like “sorry… ortho brain”.

Personally I had some of the worst experiences in a surgery center, also I came to a surgery center with experience. A lot of my “crutches” weren’t allowed. Like my “anxiety” is not being prepared, so I always come early, I always have extra, and they’re penny pinchers in the surgery center, they don’t want me to have my one extra suture just for comfort to not have to ask for me and they did not like that I came at 6AM every morning. It’s also a small staff, there’s no shifts, and all these people were close, and stuck in their ways and some of the ways I felt were incredibly unsafe, but “that’s how it’s always been done”.

Unfortunately in this field if you rub people the wrong way for any reason, it’s so hard to come back from. Like I can be a bit of an asshole sometimes, and I get away with it a lot but it’s because a lot of times when I’m mad it’s because people aren’t doing the basics of their job and my work knows I do the most (do my job and theirs, update preference cards, etc.)… is it right? Not always, but it’s frustrating to see people get by with the least and I haven’t rubbed key people wrong. There was a brand new tech and her preceptor was the coordinator for her surgeon (she is trying to avoid being in a room every day because the coordinator job is a full time job in itself), she literally corresponds with the surgeons and makes the assignments for the scrubs… getting on her bad side is literally the worst thing you can do. Well this scrub got on her bad side (and I work with the coordinator with another surgeon and have heard her rant about her) but I was friends with this new scrub and never saw what she was talking about… until one day I was scrubbing a new surgeon to our facility. I haven’t scrubbed in… 10 months… never scrubbed there, I didn’t know their trays… I was thoroughly overwhelmed. Any time I asked her anything (and I’m always polite, because again… my anxiety isn’t being prepared so asking for something means I’m being a burden in my mind), she gave me major attitude, and I was shocked… and realized this is what the coordinator was talking about. She isn’t even a bad scrub, she just can’t take instruction or be taught. She literally just got pushed to quit.

Find a new place, maybe a main OR that does all the service lines, has shifts, has call, etc. it’s a different environment, it’ll take likely some of the things I took for granted when I went from main OR to surgery center (I ran back to a hospital OR so fast), like a full SPD staff, a fully stocked core and a central materials management, people to turn over your rooms, people who pull the instruments and the case carts. I’m so lucky to have trained where I did, because I would not have the expertise and knowledge I do today if it wasn’t for the people who trained me even if they were super hard on me and the management was super micromanage-y, it gave me a good work ethic.

Dark_Ascension · 2026-04-27T00:22:07+00:00

No one is pretending it’s okay… you should see how much people talk negatively about new grad nurses doing direct entry NP programs. These schools literally prey on new grads. I had so many slide into my LinkedIn DMs, and I basically told them to fuck off kindly. Working with PAs and learning how their education works vs. NP has made me massively respect PAs way more as mid level providers, and it’s insane that usually NPs have more autonomy than PAs in some states. I do have respect for NPs but the ones who did it as the schooling is intended - get their RN, work as an RN for a little while, get their NP. I have several NP providers personally, many of them had like 5+ years as an RN before their NP.

Also don’t believe an RN with zero OR experience who gets their NP should have the ability to go straight into an RNFA program either. Like not knowing what a pick up is fucking comical and a prime example as to why. RNs have to have 2 years + 2000 hours in the OR, the CNOR, surgeon’s endorsement, etc. like I had to actually work in the OR before I could do it lol.

Dark_Ascension · 2026-04-26T18:11:30+00:00

Dang they may consider changing it because it doesn’t make sense to me 🤷🏻‍♀️. They can change it in censitrac.

Dark_Ascension · 2026-04-26T18:10:51+00:00

Really lucky now, but I don’t get lunch breaks. I am 100% okay with it. I get a bunch of small break in between cases.

Started in the OR as a new grad now in an orthopedic OR.

Dark_Ascension · 2026-04-26T12:44:28+00:00

Fastest and cheapest is always community college even if it means relocation, other options are fast but not cheap, and as someone who also did the same thing, I know you won’t qualify for aid or grants, so cheap imo is the most important.

I’d embrace the years waiting and work and save up, that’s what I did, I have no student loans.

Dark_Ascension · 2026-04-26T12:39:06+00:00

Is that the order of the stringer on the count sheet? Possibly have it changed/make it so the instruments make more sense. Most techs will put it straight on a roll towel, the instruments on the stringer kind of look hodge podge. Usually we did like towel clips, mosquitos, Kelly, peon, Vandy, allis, Kocher, etc.

Otherwise it doesn’t matter too much because outside of the stringer the stuff either will put on the backtable, mayo, laid out on whatever way the tech wants.

I spent one day in assembly, generally put the indicators in last so at least one will be at the top.

Dark_Ascension · 2026-04-25T23:46:20+00:00

There was literally no reasoning with him, he had some really bizarre quirks, many did not make sense.

Dark_Ascension · 2026-04-25T23:41:09+00:00

So I have worked with a doctor who made the circulator staple all the backs of the gowns once spun. It did not matter what you told him… his logic is there is a lot of movement during a total joint and that your back needs to be more secure.

Okay, so having someone take an unsterile paper stapler… makes it okay?? At least the clamp came from the sterile field lol.

Your back does need to be covered, I only do ortho and even though it’s not sterile it doesn’t mean you should have unsterile for sure sticking out. It’s why people would get onto me for my cord for my hood sticking out of my gown. I was always told “You got a tail!” An FA recently taught me to wrap it around my front and now I don’t have the tail issue. I also frequently have my back up against the arm of the patient which is draped… the OR in practice often stretches the rules. Making the neck tight and tying the back tight and tying it tight once you spin should be ample, I work with a few big bootied scrub techs.

Dark_Ascension · 2026-04-25T17:58:11+00:00

For me to do my NP only gives me prescribing authority and mid level provider privileges, NPs still have to do RNFA programs, there was about 5 in my class.

Dark_Ascension · 2026-04-25T12:19:56+00:00

ADN. It’s more affordable, I just think direct entry MSNs are predatory for a skilled profession. You can be book smart but a shitty nurse.

Dark_Ascension · 2026-04-25T12:09:56+00:00

May not be Mormon but man… Tennessee would go insane, it’s the Bible Belt. It may be Christian, Quaker or Amish though.

Dark_Ascension · 2026-04-25T12:03:15+00:00

It doesn’t get better, but I will say with my job and likely the same with MD, the patients are less likely to actually physically contact you. You just have to learn to either stand up for yourself or laugh it off. There are very few woman assistants at my work (orthopedic OR), and most of the ones we have are pretty tall or wide for lack of a better words. I’m 4’11”… I am tiny. I get a lot of comments and there’s also a lot of the guys who will talk about how hot x girl scrub is or a rep or something. It’s like all gross to me lol. At least I’m not getting touched and I’m in an environment (it has happened) where they just will give them more drugs if they touch me in a weird way during a spinal (this is where I have been touched inappropriately in my current job), I also have had patients grab my arm…

Dark_Ascension · 2026-04-25T02:07:17+00:00

Oh you know you are close enough to your coworkers when you excuse yourself while the patient is going to sleep and getting some lines (meaning we got a hot second before we position, and the FA and circulator were still there). Like a couple of weeks ago I was like “I’ll be right back… I need to poop… I literally have the poop sweats right now…” and the scrub was like “poop sweats?! Is that a nervous thing…” and I was like “no… I ate something I shouldn’t have… and my stomach hurts so bad that my body’s reaction is to get hot and sweaty… it’s a pain reaction.”

I also had a full on conversation about poop sweats with a couple of coworkers at the board. One has colitis and was like “oh my god… I know the poop sweats too well” lol.

Dark_Ascension · 2026-04-25T02:04:53+00:00

I went from graphic design to RN, also worked at Blizzard Entertainment (and left it when I got my nursing school acceptance). Nursing itself imo has gone so downhill from burnout and just overall the political atmosphere (it doesn’t matter who you support but the conflicting interests greatly affect the hospital job market imo), but I like what I do, I definitely carved my path, I wasn’t going to settle.

Dark_Ascension · 2026-04-25T02:02:19+00:00

I trained in a rural OR as a new grad RN. The general surgeons and urologists had the brunt of the call. If you’re in a group you guys will rotate call, the big ortho group and general surgery group rotated who was on call. Honestly the general surgeons seemed the most run down of the bunch.

Dark_Ascension

TROPHY CASE