From the OR to the ER: How To Decide Which Nursing Specialty to Focus On

Even if you plan to be a nurse for the rest of your life, you probably won’t stay in the same specialty forever. While changing your specialty can seem frightening, especially if it is your first time, it’s a very common thing for nurses to do. If you specialize in the operating room, you might think the emergency room would be a great place for you or vice versa. ER and OR nursing are two areas that have a lot of overlap but still remain distinct. If you are thinking about making the transition to one or the other, here is what you need to know to make the decision.

First, it is important to know the definition of each specialty.

Operating Room
OR nursing is one of the highest-paying specialties. These nurses play a crucial role in patient advocacy and safety. An OR nurse must be confident in their ability to speak up when needed for patient safety issues or ethics. They also need to be highly skilled and must keep operating rooms clean and sterile at all times.

Emergency Room
ER nursing is a specialty that requires nurses who are quick on their feet. These nurses will encounter patients who could be in critical condition and have life-threatening injuries. If you thrive in a fast-paced and high-energy environment, then this is the specialty for you.

The main differences between ER and OR nursing revolve around the number of patients you will see on a given day and how predictable your workflow will be regularly. In the ER, you have to prioritize far more than in any other field because you are exposed to more people with a wide range of illnesses and injuries. You could have four critical patients simultaneously and will need to prioritize their assessments and interventions and get those things done on time. On the other hand, the OR will see a set number of people per day, and you’ll have the predictability of knowing which conditions they’re dealing with. Other differences include communication styles and skill developments, which we will talk about next.

Communication Styles
Working in the emergency room can give you more freedom to interact with patients alone and assess their illness. You have more of a say in their treatment, but if you need to consult with a doctor, you’ll have to find or page one, which can slow things down.

In the OR, the doctor is already with you in the operating room, so they can answer any questions as they occur. Although you won’t get alone time with the patient this way, communication with the doctor will be a lot faster. With no lingering questions, the flow of your shift will be smoother.

Skill Development
All registered nurses continue to develop their skills while on the job, so the ER or the OR environment will focus on different ones. The emergency room deals with a lot of patient care like triage, assessment, and regularly checking on their condition. You’ll have more practice with IV skills and exposure to a broader range of acute illnesses and medical conditions.

The operating room is more task-oriented than patient-oriented since the patient is unconscious. However, you will learn to administer certain medications, control bleeding during surgery, step in when complications arise, and suture incisions.

Although these two specialties have their recognizable differences, ER and OR nursing require similar skills. Critical thinking and problem-solving, effective communication, and the ability to stay calm under pressure are all qualifying characteristics for a nurse in either field. These specialties both entail long shifts and might require nurses to be on-call from time to time.

Both ER and OR nursing can lead to future career growth, depending on what you want to do. Making the transition to one or the other can feel intimidating, but the opportunities waiting for you will be worth it!

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