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Should They Follow Your Lead?
Despite the ups and downs of life in the OR, you say you'd recommend a career in surgery.
Daniel Cook
Publish Date: October 10, 2007   |  Tags:   Surveys and Polls

You might complain, moan and vent about life in the OR - but most of you wouldn't have it any other way. More than 87 percent of the 201 nurses and doctors who responded to our online survey said yes, given the choice, they'd recommit to all that is good and bad about a career in surgery and would recommend the same path to a child. But that endorsement comes with a caveat: The next generation should know what it's getting into. "They better stick a needle in their arm and open up a vein," says Cindy King, administrator of the Surgery and Endoscopy Center in Sebring, Fla., "because they're going to have to bleed right along with the patient to work in surgery." And as most of you said, they'll either love it, or they'll leave it.

Should they stay?
Karen Gabbert, RN, clinical director at the Surgery Center of Kansas in Wichita, is still excited to come to work every day, even after 25 years of Monday mornings. "As an administrator I can step into the role of pre-operative care, circulating nurse, scrub tech or recovery nurse as needed," she says. "There's tremendous flexibility in perioperative nursing."

It's that flexibility, that ability to multi-task on the fly, that makes members of surgical teams such valued commodities in a healthcare industry that sometimes seems more concerned with cutting costs than patients. "You can go anywhere you want and get a job in surgery," says Karri Hoopes, RN, a former OR nurse manager who now works on information systems at Uintah Basin Medical Center in Roosevelt, Utah.

"There are so many different specialties, groups of patients and settings to work in," adds Jennifer Olson, RN, BS, CNOR, the interim director of the Elkhart Clinic Endoscopy and Surgery Center in Elkhart, Ind. "There's a place for every clinical nurse in surgery to find work that suits her personality and interests."

Ms. Hoopes wonders if those already in the OR have adequately touted the positives of a life in surgery to those considering the same career. The current training programs in most nursing schools add to the problem by eliminating or cutting back on clinical OR time, and new nurses tend to gravitate toward the familiar: intensive care units, inpatient floors or long-term care facilities.

Maybe we need more ambassadors like David Pena, RN, director of surgical services at Sid Peterson Memorial Hospital in Kerrville, Texas. His life in the OR began quite by accident. "I was a medic in the army," he says, "and after a few weeks in a field unit I was told they needed help in the OR." He hasn't looked back, and today sells the positives of the OR with the aim of recruiting fresh faces.

Mr. Pena is constantly inspired by the opportunity to learn new skills in a technically demanding field, an inspiration that fuels his desire to keep talent in the OR. He's the first to adjust schedules when personnel issues arise, but this staff advocate doesn't stop there; he's made a few rent payments here, a new car part purchased there. "It's my military background," he says. "I always want to take care of my own."

Some find the OR by accident, others a little later in life, but most fall for it fast and hard. Lavinia K. Chong, MD, FACS, is one of the latter. Her parents pressured her to become the family's third-generation physician. Instead she rebelled, to a degree, by fleeing to her father's native England for a career as a financial futures trader. The pay was great for a recent college grad, but countless client dinners that rolled into early mornings at the local pub began to take a toll. "I was headed for life as an alcoholic," reflects Dr. Chong. "I didn't want that lifestyle to last into my forties."

If You Weren't Working in Surgery, Which Career Would You Try?

"If I were younger, owning a business - perhaps a tavern - would appeal to me."
Elizabeth Cianfrani, RN, BSN, MBA
Administrative Director
Shore Memorial Hospital Somers Point, N.J.

"Vet. I love animals and if I could do it all over, that is the career I would choose. I'd still be doing surgery and taking care of 'people.' They are just of the four-legged variety instead of two."
Joann Geslak, MBA
Director of Perioperative Services
Central Maine Medical Center Lewiston, Maine

"Filmmaker or architect."
John A. Grossman, MD
CEO
Grossman Plastic Surgery Denver, Co.

"Teaching junior high school science. I adore the age group. They remind me a lot of surgeons."
Lynda D. Simon, RN
OR Manager and Director of Clinic Nursing
St John's Clinic: Head & Neck Surgery Springfield, Mo.

"Wal-Mart greeter. No pressure to perform, or know everything about everything."
Margaret Froehle, ADN
OR Supervisor
Broadlawns Medical Center Des Moines, Iowa

"Professional race car driver. It requires total in-the-moment concentration, and one stays in very good physical condition."
Albert E. Cram, MD
Iowa City Plastic Surgery Iowa City, Iowa

"Aviation, because it has always been my passion."
Guillermo Montoya, MD, FACA
Medical Director
Foundation Surgery Center Dickinson, Texas

"Full-time writer. The world of literature (both fiction and non-fiction) is fascinating. As I've accumulated a few experiences over the decades and enjoy writing, it is rewarding to record these on paper to share with others."
Adam F. Dorin, MD, MBA
Medical Director/Anesthesiologist
SHARP Grossmont Plaza Surgery Center San Diego, Calif.

"I am a high school basketball coach. I would do it full-time if I did not work in surgery. I love sports, but the pay isn't supportive."
Brian Swallow, AD
Director of Surgical Services
Via Christi Regional Medical Center Wichita, Kans.

"I would like to be an archaeologist, as I love history and am fascinated by ancient civilizations."
Shirley Ramey, RN
Nurse Manager
ASC of Burley Burley, Idaho

"Interior design, because I'm an awesome home decorator. I tend to have an artistic, visual mind. I did not go to college for that because I am more visual and could not draw if my life depended on it."
Kelly Koch, BSRN
Surgery/Recovery Nurse, Assistant DON
Arizona Advanced Surgery Center Scottsdale, Ariz.

Why I'd recommend a career in surgery...

Work is challenging and provides a sense of accomplishment

52%

Being part of a highly skilled team

16%

It's not boring - every day is different

12%

Helping patients is truly satisfying

8%

SOURCE: Outpatient Surgery Reader Survey, May 2007, n=173

She went to medical school and today has her own plastic surgery practice. A love of technology and problem solving has kept her in the OR. "What used to take me six weeks to close a wound, I can now do in 10 days," says Dr. Chong, adding that she loves to formulate an operative strategy, implement it and watch the outcomes blossom. "I am fortunate to be able to enjoy the cognitive, physical and financial aspects of my practice, which has developed in a direction compatible with my personal life."

Or should they go?
Bullies in the OR still exist, says Janis Gartner, director of St. Joseph's Hospital and Health Center in Dickinson, N.D., and are a very real issue that can chase talented workers into other fields or specialties. She believes things haven't really improved that much since her first day in the OR nearly 44 years ago. "The throwing of instruments has stopped, but some surgeons are still abusive in their words or mannerisms," she says.

Everyone we spoke to - literally - said a strong personality and a thick skin are essential to dealing with the other strong personalities that occupy the same OR as you. Prima donna surgeons are traditional targets, but nurses and techs share at least some of the blame for slinging a few verbal jabs. Whoever is to blame, dealing with highly-strung people in stressful situations isn't for everyone. "Physicians and RNs can get really bossy and feel like they're the star of the show," says Ms. Hoopes. "We have to realize that we're part of a team and be more respectful of one another."

You also need a good amount of savvy, says Teresa Lute, RN, CNOR, perioperative clinical educator at the Southern Ohio Medical Center in Portsmouth. "You have to pick and choose your moments," she says, "and realize that people react differently to the stressful situations of surgery. You get as much respect as you give."

An employment recruiter once contacted Ms. Hoopes, asking her to clean up a poisoned OR environment dominated by an abusive surgeon who allegedly struck a nurse. She couldn't accept the offer, but had a simple solution to the problem. "I told them that if I were to take the job, I'd demand to bring along one nurse in particular," she says. "If a surgeon hit her, he'd be picking himself up off the floor."

While stronger personalities are typically more inclined to succeed, even wallflowers can surprise themselves when push comes to shove. "I never knew what I was capable of," says Tammy Haeb, ASN, bariatric and vascular team leader at Elkhart General Hospital in Elkhart, Ind. "I was considered a quiet person when I started in the OR. I've been told that's not the case anymore."

The promise of financial security leads some into the OR. Yet despite a successful and profitable career, Adam Dorin, MD, MBA, anesthesiologist and medical director at the SHARP Grossmont Plaza Surgery Center in San Diego, Calif., says today's financial climate prevents him from recommending a similar career path. "With increasing workloads and increasing numbers of non-paying patients, a medical profession can be difficult to sustain economically," he explains. "After 12-plus years of strenuous post-high school education and training, a doctor should not have to work 80- to 100-hour weeks to remain financially solvent."

Why I wouldn't recommend a career in surgery...

Salaries don't compensate for responsibilities and workloads

31%

Reimbursement trends don't bode well for future revenues

23%

Difficult surgeons and staff are tough to handle

23%

Daily schedules are overwhelming and getting worse

12%

SOURCE: Outpatient Surgery Reader Survey, May 2007, n=173

Steven J. Smith, MD, a surgeon at Parkwest Plastic Surgery in Knoxville, Tenn., agrees. "The price is too high for the rewards," he says. "I'd be just as happy being a money manager or developer."

Many teens view surgical careers as status symbols and only consider the potential financial rewards. "Our young people aren't going to accept and do many of the things those of us who are retiring were committed to doing," says Ms. Gartner.

That change in attitude between generations, she says, isn't necessarily an indictment of today's youth, but rather a realistic look at the current work culture. Ms. Gartner believes younger nurses value hard work and financial security, but put an equal emphasis on free time and having a life outside the OR. She would ultimately recommend a career in surgery, but not before painting a true picture of what goes on behind closed doors. "They need to make an informed decision before they get into something that frustrates [them] or burns them out."

A life sentence
For some, a career in surgery fulfills a dream. For others, it makes dreaming possible "It's exciting to see how new techniques work and the new ideas that are being developed in the many different specialties," says Ms. Lute. "Procedures that were unimaginable when I first started working are commonplace today. The one thing that keeps me here is wanting to see what's going to happen next."

The stress and daily pressures are the same reasons you'd recommend the OR life to others. It's stressful. It's exhausting. It's addictive. "Working in the operating room is a very rewarding job," says Joann Geslak, MBA, director of perioperative services at Central Maine Medical Center in Lewiston. "It's not for everyone, but for those interested in this field, it can be a lifelong career. Once we enter this world, we never leave."

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