How Much Can I Make? - Career Insights For Your Job Search
Jobs & Career Insights with Mirav Ozeri
Your inside scoop on the job market. Whether you’re chasing your first job, switching careers, or dreaming of being an entrepreneur, this podcast gives you the career advice you actually need.
We go beyond the job titles—breaking down what careers are really like, how do you brake in, how much you can earn, and the skills it takes to succeed. From career insights to real-world job stories, you’ll hear from people who’ve navigated the in and out of the job market and came out on top.
If you’re exploring new career possibilities or just want practical, straight-up job advice, this is the podcast for you.
Nominated for 2025 Women Podcasters award.
How Much Can I Make? - Career Insights For Your Job Search
Inside the Operating Room: An OR Nurse's Career
OR Nurse
Ever wonder what really goes down behind those mysterious operating room doors? In this episode, longtime OR nurse Patti Columbia Walsh spills the tea on her 40-year career in one of the most high-stress, high-stakes jobs in healthcare. Spoiler alert: it’s not like Grey’s Anatomy.
From anticipating a surgeon’s every move to staying cool during full-blown medical emergencies, Patti takes us inside the fast-paced, no-room-for-error world of the OR and the emotional weight of the job.
If you're curious about a job in nursing, this episode is packed with career insights, real talk and heart. Listen now!
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Music credit: Kate Pierson & Monica Nation
We have robotic surgery that we do with, which I am fascinated by that. The surgeon can be over here and the patients here and be doing the operation from the other side of the room. It fascinates me.
Speaker 2:Yes, we're going to talk about robotic surgeries and others. Welcome back to how Much Can I Make? I'm your host, mara Vo Vozeri. Today I'm going to chat with my friend, patty Columbia Walsh, who's been an operating room nurse for 40 years. I really want to know what it's like to work under high pressure in such high-stake environment. I don't think I could do this, can you? So let's find out what really goes on behind those OR doors. Patty, thanks a lot for doing it.
Speaker 1:Oh, thank you for having me. I appreciate it. I appreciate it as well.
Speaker 2:First, let's start with how did you become an operating room nurse?
Speaker 1:When I was in nursing school I never liked the bedside with patients because I became attached to the patients and it was very difficult for me to watch people who were sick every day. So I decided that the OR was for me, because a patient comes in, we take care of them and we never see them again, and that was more. It was easier for me to become a nurse doing that type of nursing and also I was told when I was going through a rotation of the OR in nursing school I was told by an OR nurse that you should do not become an OR nurse. You're never going to do it and that also gave me a lot more inspiration of going into something that I was told I couldn't do.
Speaker 2:Why did they think you cannot do it?
Speaker 1:Well, it was my second day in the OR that I couldn't glove and gown myself, which is something we do, and it was the second day. And she just just a typical OR nurse who the older nurses who eat their young.
Speaker 2:So wait, let's back up for a second.
Speaker 1:How many years did you have to study? I was in the school for four and a half years, two for regular schooling and two and a half for nursing school. You don't go into a specialty until you graduate from school and you choose what specialty you want to be in. And you always wanted to be a nurse, always wanted to. No, actually I wanted to be a school teacher. But Sister Miriam, when I was in Catholic school, told me I did well in the sciences. I should become a nurse rather than a teacher, and that's exactly why I became a nurse. You have to listen to those nuns and that's exactly why I became a nurse.
Speaker 2:You have to listen to those nuns, okay, so what exactly do you do as a nurse in an operating room?
Speaker 1:So in the OR it's interesting, you know we get the room ready for any particular case.
Speaker 1:We have, Like I do, spine surgery and neurosurgery mostly and the setup for these particular procedures is quite a lot Instrumentation, making sure the room has everything that the surgeon wants for the procedure, and then, once all that's set, the patient comes into the room and literally I probably see the patient for literally about three or four minutes and then the anesthesia puts them to sleep. I'm a circulator and there's a scrub nurse, so the circulator is dirty, the scrub person is clean. What is a circulator? What do you do? So whatever the doctor wants or the scrub tech wants in the room, anything they need on the field, I get it and then I give it to them in a sterile technique where I have a package that's not sterile but then I open up the package and what's in the package is sterile. I have a package that's not sterile, but then I open up the package and what's in the package is sterile and then the scrub tech takes it from me. I used to scrub but unfortunately my hands react to rubber now.
Speaker 2:So I can't scrub, but I actually enjoyed scrubbing when you scrub, you mean you scrub the patient.
Speaker 1:No, no, no, I'm sorry. So you have to scrub your hands clean, yes, from the top of your fingers all the way down to your elbows.
Speaker 2:Okay.
Speaker 1:And then once you then you go in with a sterile towel, you dry your hands off, arms off and put on a gown and gloves and then at that point you're sterile.
Speaker 2:Okay.
Speaker 1:I prefer doing that. So, yes, that's the intro. You have to know every name of every instrument, which is pretty impressive, because we have six different services vascular GYN. Every one of them has a different instrumentation that they use that you have to have the knowledge of. When the surgeon asks you, first of all, he's not supposed to turn around and ask you for an instrument. All he does is this Sometimes, if you're very good at what you do, you know what he wants before he even asks for it, when you've been doing it for a while.
Speaker 2:So when he puts out his hand, you're supposed to know what instrument he needs.
Speaker 1:Yes, you should know, like, if you're, and if you see that he's cutting a suture, you give him a scissor. He doesn't have to ask for it. You should know that. So you watch every step of the surgery. You have to, as a scrub person, as a scrub nurse or tech, okay, you have to be in the operation. You can't be looking around. You have to be present the entire time.
Speaker 2:And how long did you have to go through training?
Speaker 1:So six months. I actually had a phenomenal training at Westchester County Medical Center when I became a nurse, and for six months you go through multiple services general surgery, urology surgery, gyn surgery, neurosurgery, vascular surgery and all these six services. We were trained each month in a different service in order to learn it.
Speaker 2:So what is a day in your life like at work?
Speaker 1:It's pretty hectic because in the operating room the surgeon wants you to move as quickly as you possibly can, so they want to get in the room, they want to make sure everything in the room is there for the procedure and they don't like to wait. It's important that before I go into the room that there's a sheet that tells you everything that the doctor wants in the room, that you have to be sure that you have that in the room before you're permitted to bring the patient back. Once you have everything set, that's when you bring the patient back.
Speaker 2:So you get the list the day before there's a list no.
Speaker 1:So every morning when we get into work there's a cart that's filled with the instrumentation and everything that you need for that procedure. So there's central supply which picks the cases of this list that we get every morning. They pick everything for the case. When we get the case we make sure that everything they picked is in that cart because they don't get yelled at. We do so. We make sure everything that is supposed to be in that cart's in that cart and then, once we realize that, we go into the room and we set up the room.
Speaker 2:So you work closely with anesthesiologists, with a surgeon who else the anesthesiologists we help once the patient.
Speaker 1:They're starting to put the patient to sleep. We stand with the anesthesiologists to help hold the endotracheal tube before they place it. We make sure it's placed before we even start prepping the patient for the surgery and then I work with the surgeon and with the scrub tech and anyone else who happens to be in the room that might be needed for the procedure.
Speaker 2:Do you ever cringe when you see them opening up somebody?
Speaker 1:I don't cringe when I see surgery. I do cringe when I see patients that have allowed themselves to have growths on their body for a year and then they come into the OR and they're massive and you can't imagine that these people actually were living with this.
Speaker 2:Wow.
Speaker 1:That's very difficult for me to watch because I cannot for the life of me understand why anybody would do that. I don't know if it's because they don't have health insurance or what the reason is, but I it's scary sometimes for me, does it ever?
Speaker 2:happen that in the room you have an emergency situation? Yes, what happens then? Tell me.
Speaker 1:So we do a procedure that's called ALIFT, an anterior lumbar interbody fusion, where you go through the abdomen and you have a vascular surgeon and spine surgeon. The vascular surgeon is responsible for getting access to the lumbar wherever in the spine that we're operating on, and because you have a vascular surgeon opening up to get to the lumbar area for the spine surgeon there's a lot of vessels that are very, very important that you don't nick, and I have been present where surgeons have nicked the vessel and the patient starts bleeding profusely.
Speaker 2:What do you do then?
Speaker 1:Literally, there is a button in the operating room that you have to push when something like that happens, because then everybody who's available within the operating room suite will come running and help out With getting blood, with doing whatever it is that's needed to save the patient. Wow, it's happened to me probably two times in my career.
Speaker 2:Were you scared.
Speaker 1:Oh, petrified. Petrified because I mean, even when you're petrified and you look at the surgeon and he's beside himself because the bleeding is unbelievable, it scares you. Because he's scared he's the one that's responsible for I mean, all of us in the room are responsible for saving the patient, but in reality it's really his technique that's going to save that patient.
Speaker 2:Wow, so you worked with many different surgeons. Everybody Do you have favorites.
Speaker 1:Yes, dr Solari, he's a spine surgeon. I call him my boyfriend. No, he's wonderful. I've worked with him for 11 years. I am always in his room. If I'm not in his room, he gets upset. So when I take off today, I work. He works on Mondays, so I'm not there today and I'm sure he's asking where's Patty. But no, him and I work well together because I know his speed and we work very quickly together. What's the average time of an operation? So it depends on the operation. But in the hospital, which is very difficult for nurses and techs is that we are required a certain amount of time to get the next patient in the OR.
Speaker 1:So in other words, if a case ends, we have 30 minutes less than 30 minutes to get the next patient in setting up the entire room and some of these cases we have 15 instrumentation that we have to open up in a sterile way in order for the person that's scrubbed to take it from us. And it takes time. But the cases it depends on what the case is Like. A lift anterior lumbar interbody fusion takes anywhere from an hour and a half to two hours.
Speaker 2:How many surgeries can you do a day?
Speaker 1:Depending on the speed of the surgeon, four to five a day. So it's go, go, go from the time. It's no, no, go from the time. No, you get 45 minute lunch and that's all you get. You move constantly, you're in movement and it's an eight hour shift. It's an eight hour shift. Yeah, seven and a half hours and we have a 45 minute lunch. So they don't pay us for a lunch.
Speaker 2:They don't pay you for a lunch. No, they don't.
Speaker 1:They're not very nurse friendly.
Speaker 2:Is your job a union job?
Speaker 1:No, it's not. So they can literally change whatever they want. For if, like we, were getting paid four hours for call time, they took an hour away from us. If we got called in, we would automatically get paid four hours. They took an hour from us. What do you mean If you're on call? So if you're on call, you get paid $5 an hour on call, every hour you're on call, and if you get called in, you get time and a half. If you're there for two hours, they would pay you for four hours, but they took an hour away from us. So now we only get paid if we go in for just three hours.
Speaker 2:Why would you be on call if you are on on on every day?
Speaker 1:for you have to. You have to take call. It's part of your job. You have to. You don't have a choice, so that's after work hour the call. Usually I take it on the weekends because I'm not monday through friday. I prefer not to work right after my shift is over. If they want me to stay, I prefer not to do that. So I take call. You take the call yourself.
Speaker 1:You choose to take what you want as long as it's available and I usually take it on a saturday, sunday, so you have to negotiate your own salary. When I went in, when I first went to work there, I told him I wanted to get the salary I was getting in New York, because Jersey does not pay nurses the way they do in New York. And they gave it to me. What's the average salary of a nurse? When I started nursing, I was getting paid for the first job I ever had $11.50 an hour, what that's, I know. I couldn't even live on it. It was ridiculous. And now I do do. Well, now Do I think I should be making more? Absolutely. But the newer nurses coming in, brand new nurses are making $73,000 a year as a brand new nurse, with all the benefits and everything with all the benefits.
Speaker 1:When I was in New York, I worked under unions all the time and they were great because they got us better health insurance, better vacation time, sick time where this is a battle every day for all of us, they could take whatever they want away from us.
Speaker 2:Wow, do you see a change now that a lot of hospitals are becoming corporations or part of a corporation?
Speaker 1:Well, that's why, exactly so when I was telling you the way they want to move, move, move. It's not. It's not about patient care anymore. Be honest with you. It has become a factory. I mean, there are surgeons that are doing 14 total joints, like in 27 minutes it goes, it's, it's ridiculous and we cannot move fast enough for these men. We're always being told why isn't the patient in the room? Yet? It's, it's ridiculous, it's, it's not, it's a factory. Now. And it breaks my heart because it's not about a person, it's about get them in, get them out, get them in, get them out.
Speaker 2:Is that because you're in a big hospital, you think it's different.
Speaker 1:No, I think what you said. It's a corporation now and it's all about making money. It's not about patient care anymore. When I walk through the ER, there are people it looks like a mass unit that are out in the hallways. I mean I'm talking 50 patients because there's not enough room. They just keep on taking them. It's a business, it's a corporation. It is not about caring for the patient anymore.
Speaker 2:Many times they say oh, you know, the doctor sent me said I need surgery, I don't really need, they want the money. Do you see cases like this? When people come in, they open them up and then, oh, you don't need to be here.
Speaker 1:I have a. Well, I have a problem when there's a 96 year old man coming in for a major vascular surgery. I have a problem with that because, first of all, it's almost a six hour surgery and there's no there's no guarantee it's going to work. So why put a 96 year old man through that if it's not necessary, six-year-old man through that if it's not necessary? I've seen it that I don't think it's necessary. But you know, as much as they'd like us to be patient advocates, they don't want us to be patient advocates. They want us to be quiet, do our job and go home and do you think the doctors feel it's really bad?
Speaker 2:also the surgeons.
Speaker 1:Oh, I think, the surgeons. The only thing the surgeons feel bad about or are bothered by is that we don't move fast enough.
Speaker 2:Really Wow.
Speaker 1:You can actually talk to any nurse that I've ever worked with. That would say the exact same thing I'm saying, do you see?
Speaker 2:more and more operation moving to automation, to AI doing some of it.
Speaker 1:We have robotic surgery that we do with, which I am fascinated by that. The surgeon can be over here and the patients here and be doing the operation from the other side of the room. It fascinates me. But we're doing a lot of robotic surgery now, with knee surgery and mostly general surgery, GYN surgery.
Speaker 2:So in that case, who gives the instrument? The robot takes itself.
Speaker 1:So no, so the machine that we use, the robot that we use, we set up with the different instruments on the robot arms, so all the arms have the instrument that's needed and the surgeon is over to the side controlling it with arms or, you know, remote controls that they could do from the other side of the room. It's really fascinating. This can take a job away from a nurse. This can take a job away from a nurse. Yes, wow, yes, yes, because basically, when they put once the scrub tech has put all the arms on the robot, they're just waiting for the procedure to be done, just sitting there waiting for it to be done.
Speaker 1:But, they need somebody to set that up for them, so they're still wanted.
Speaker 2:What's the biggest challenge of your job?
Speaker 1:It's working faster. Really, it's just you just can't move fast enough. You can't make. That's my biggest challenge. Is the speed that, no matter how fast you work, it's not fast enough. You can't make that. That's my biggest challenge. Is the speed that no matter how fast you work, it's not fast enough. And every OR nurse knows exactly what I'm talking about. That's the challenge.
Speaker 2:You mean to give the instrument faster? No, no, no.
Speaker 1:To turn over the rooms. So, in other words, when I say turn over the rooms, you do an operation, get that patient out of the room, start cleaning up for the next case, get the next one in, get that one in, pass them out, get the room ready, get the next one in. It's like so you have to clean the room, or do we don't have to clean the room? We have a lot of ancillary help MSTs, medical, surgical staff that will get the equipment that we need for the room and environmental services will clean the room. Then we just go into the room and that's where we do all of our setup. You do go out between cases because you got to get the dirty instruments out and you have to make sure the patient goes to recovery room and you hand in your papers and charges to the front desk. So you get like 10 minutes out of the room, but then you have to scrub again, then you have to hurry up and start all over again. It's repetitive, basically.
Speaker 2:What would you say that the character trait or the skills that one needs to have in order to be a nurse in an operating room?
Speaker 1:You have to be, have the ability to be yelled at and you have to be strong with that, because surgeons and I get it they're under a lot of stress. You know they're operating on somebody. They, you know, trying to either save that person or, you know, help them in any way they can. And they're under a lot of stress and I understand that. So when you don't have something there for them or they hit something that they shouldn't hit, they start losing their mind, yelling at you and you literally have to. Just it's not you, it's not personal, it's just that's the way it is in the operating room and you have to be fast and if you're not fast a mover, then the operating room isn't for you.
Speaker 2:Do you also see kids being?
Speaker 1:operated on. No, I don't do children that often, but when I see them in the holding area before they have surgery, I go over and fist pump them just to make them smile.
Speaker 2:Is it emotionally more difficult to work on a kid than work on?
Speaker 1:a Depends on what the surgery is. I mean, if it's something that like brain tumor or something that's, you know, catastrophic, yeah, I have a hard time with that. With any patient that you come in and you know we do frozen sections on people who are having breast surgery. Frozen section is you take the specimen of the cancer that they found and they send it for frozen and the frozen section they'll call you and the pathologist will tell you exactly what they found. And if it's cancer and they're 32 years old and it's metastatic, it breaks your heart. You're in that room and you're. You feel it. You feel it in your heart. And although I told you that I don't like to be on the floors because I don't get attached to patients in the OR, it's not as you don't get attached to patients In the OR, it's not as you don't get as attached, but it does affect you.
Speaker 1:When you hear bad news about a patient's life, you know, oh, when somebody dies on the operating room, that, or if they have metastatic cancer or something like that, it's hard to hear. You know your heart sinks, you know. Did it happen to you that somebody died in the operation Years ago? It was just County Medical Center, a young girl 18, was in a motor vehicle accident and she got hit in the side. Beautiful girl, I'll never forget it, she was gorgeous.
Speaker 1:I was fairly new in the operating room and they were giving all blood products to try and save her and unfortunately she died and it was devastating to me. And the room was filled with people. And then you know people are laughing. You know we're wrapping the young girl's body and they're laughing and I just stopped for a minute. I go, you guys, this woman's dead. How do you do this? How can you laugh? Where's humor in this? And you know what they said. If you're going to let this affect you every time, when this happens, you're never going to make it in the OR. When this happens, you're never going to make it in the OR.
Speaker 1:This is how we survive, wow, and that's exactly what they said and they were right. And when they told me that, that is exactly what I learned, because I lost a lot At Westchester County Medical Center, it was the number one trauma center. We were losing patients all the time Through motor vehicle accidents, ATV accidents, just multiple things, and it was hard.
Speaker 2:So how do you come out of this? At the end of the day, you come home and you have all these images in your mind.
Speaker 1:You just say a prayer for them and that's it. I mean, you just learn to live with it. You know it does bother me. I can remember names of patients that I took care of, that died in the OR, that broke my heart. But you know, as sad as it may sound, it's a job, you know, unfortunately. But it does affect me. I'm not going to lie and say it doesn't affect me, but I can't let it affect me all the time because I'd never go to work.
Speaker 2:Any case that sticks out in your mind more than others.
Speaker 1:A little boy at Westchester County Medical Center. There was a terrible bus accident and he had a skull fracture and the brain was coming through the skull and he was only um seven years old and he he died. And another young man, he was crushed by a fire truck, in between a fire truck and a car. He was 19. We did like six surgeries on him and he lost from his pelvis down.
Speaker 2:Oh, my god his fit.
Speaker 1:He kept on getting gangrene from the um, from the accident, from. Gain green is when the tissue starts dying. Ooh, and we removed both of it from his hip, his legs, from his hip down and we actually did a penectomy. If you can imagine what is that. They removed his Penis, His penis, yeah, and that crushed his soul and he ended up dying as well because the gain green just kept on going up. He was 19.
Speaker 2:Up dying as well because the gangrene just kept on going up. He was 19.
Speaker 1:Marshall was his name and that was. I'll tell you that was about 30 years ago and I've never forgotten the kid. That was another difficult. He died because we saw him all the time. Every time we saw him we were doing a procedure on him. So that's not something that we normally do see them so often, but him, because he had multiple because of the gangrene. We actually had to keep on removing the gangrene from his body.
Speaker 2:Wow, that's a terrible story. Do you ever run into ex-patient or family member out on the street or anywhere?
Speaker 1:There are patients that I'll be out somewhere and they said, oh, you took care of me in the OR and I'd be like how do you even recognize me? Because we can't even recognize each other with the hat on and the mask and everything else. He said something about you. I just recognize you and he said thank you and that made me feel wonderful, but not all the time, because they don't remember the OR. They remember the holding area, the OR you get medication that cause amnesia before you go in to relax, you make you feel less anxious, so they don't remember anything. And then they go to the recovery room. So the OR never, like holding area, will get gifts and cards. Recovery room will get gifts and cards, not the OR, because nobody remembers us and maybe that's a good thing.
Speaker 2:I don't know, that is funny, yeah. So what advice would you give somebody that want to break into nursing and become an operating room nurse?
Speaker 1:Of all the nursing, I think the operating room is the best.
Speaker 2:Really why.
Speaker 1:I really do because for multiple reasons, I think it's a real specialty. You really get to know the human body from head to toe and literally see it. You know all the nurses are together, we work together, we work well together, and I think that's a little different on the floor, maybe because we could be in rooms next to each other and we could just help each other out. I love the OR. I would never leave and I've never wanted to be in management. I never wanted to not be in the OR. So I enjoy being present. You like the adrenaline rush, absolutely Love it. I love running around. I might complain that we have to move. I like, like that, but not everybody, not a lot of people like that, but I understand that they pretty much run us into the ground.
Speaker 2:So what is the biggest reward of your job?
Speaker 1:Seeing people who are in the holding area before they go into the operating room and they're crying because they have breast cancer, any type of cancer. They're scared and just holding their hand and making them laugh is that's the most rewarding thing for me. I love to see them smile, laugh. I just want to take that anxiety away from them and I get how they're feeling. I mean, I've been there with breast cancer so I know they're frightened. I understand that, and just to have them smile or just makes makes me happy, makes you happy, makes them feel better, and they're really very appreciative too when they feel that you understand them.
Speaker 2:All right, then. On that note, thank you so much for doing it. Thank you, marav I appreciate it, it's interesting to speak to somebody that actually lives it and not just on TV.
Speaker 1:Yes, and the surgeons aren't as good looking as they are on TV. Just saying Closing statement. All right, thank you, thank you.
Speaker 2:Barav. Okay, that's a wrap for today. If you have a comment or question or would like us to cover a certain job, please let us know. Visit our website at howmuchcanimakeinfo. We would love to hear from you. And, on your way out, don't forget to subscribe and share this episode with anyone who is curious about their next job. See you next time.
