Making the Cut in Perioperative Nursing
Monday May 13, 2002
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Are You Ready for Perioperative Nursing?
Watson started her perioperative nursing career by getting her first job in labor and delivery. She points out that with the current OR nursing shortage, many facilities across the country are offering sign-on bonuses and paying for relocation costs and a variety of benefit packages that allow new graduates and less-experienced RNs from other fields to work in surgical areas. Many facilities are offering their own training program for new grads and nurses transferring from other units.
Perioperative nursing is a physically demanding job, requiring that nurses be on their feet for most of a full shift, as well as be able to lift and position patients safely. Watson says that excellent interpersonal skills are required to interact effectively with the entire surgical team and, most important, with the patient. In fact, surgery is an overwhelming experience for any patient, and the perioperative nurse needs to be able to bring high-touch to the high-tech part of this nursing field.
Watson says that RNs interested in perioperative nursing should be able to multitask because they need to know what's happening with the patient, the surgeon, the person scrubbed at the field, and the anesthesiologist, all at the same time. Being organized, able to prioritize, and able to think ahead to anticipate the surgical team's needs are paramount for success in this field, according to Watson.
A desire to mentor others is also important. "It is critical that we share our knowledge with those entering the field," says Watson. "We have to share the perioperative nursing 'story.' To bring others into the field, we need to teach and to share critical-thinking skills. If we don't share our practice by mentoring, the shortage is only going to get more acute."
Adapting to change is another significant part of the perioperative role. "The technology turnover is very fast," Watson says. "Different people come and go in and out of the OR, including a variety of students, physicians, residents, and frequently, industry partners. One has to be amenable to a very busy work environment."
All in a Day's Work
There are generally three career areas for perioperative nurses. The first is the clinician/staff nurse who provides care preoperatively, intraoperatively, and postoperatively. The second is the perioperative care coordinator who optimizes available resources to collaborate with the clinicians. And the third role is that of the advanced practice nurse who has a master's degree and integrates education and consultation with perioperative practice.
Watson says that most perioperative nurses begin the day by checking their ORs, anticipating the kinds of equipment and resources they'll need for the surgical patients assigned to that room and reviewing each patient's chart. "It is critical to the process of evaluating each patient that the preoperative assessment be done by an RN. An RN can key into all the things that will make the surgery as safe as possible."
The preoperative connection made by the nurse remains throughout surgery and into the postanesthesia care unit, according to Watson. "Patients need to know the nurse behind the mask," she adds. "Patients need to trust that while they can't speak for themselves, the nurse will advocate for them. And we must apply AORN standards to ensuring patient safety throughout the surgical process."
Teaming Up with AORN for Patient Safety
One of the most important bonuses in being a member of AORN, says Watson, is the educational resources available to members. "AORN offers them knowledge and background and a set of skills that they may not necessarily have," she says. "But once they have attended one of our conferences, they leave with enhanced knowledge and an improved skill set." Members can also consult "Member Talk" online, which can put them in contact with RNs who may be more experienced in certain areas.
With more than 40,000 members representing four generations of perioperative nurses, AORN also concentrates on legislative issues on behalf of both the nurse and the patient. "We, as an organization, believe that every surgical patient deserves a perioperative nurse by their side," says Watson.
As president of AORN, Watson plans to concentrate on the issue of patient safety. "I really want us to become even more active in promoting patient safety in perioperative practice," she says. "We, as nurses, have so much knowledge, expertise, and influence on the perioperative process that I hope we'll be able to do even more to improve patient safety."
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