November 13-19 celebrates Perioperative Nurses Week, and nurses interested in this specialty area of nursing can find out more about what perioperative nurses do.
Minority Nurse recently spoke with Vangie Dennis MSN, RN, CNOR, CMLSO, vice president, Perioperative Services at AnMed Health Systems, and president of the board of directors of the Association of periOperative Registered Nurses (AORN) to find out more about this career path. Dennis says she started out like most nurses working on the floor and in different areas. “Then I got my first taste of perioperative nursing when everything was on-the-job training,” she says, noting how the specialty has evolved greatly over the last decades.
“Perioperative nurses are the traffic control in the OR setting,” she says. From start to finish, the perioperative nurse is simultaneously monitoring and caring for the patients while also tracking everything else going on in the room. It’s a responsibility nurses take personally. “You are the one looking them in the eyes during induction telling them, ‘You are going to be ok,’” she says.
Dennis says not everyone understands the role of the perioperative nurse–sometimes not even other nurses. She has heard others remark that perioperative nurses’ primary responsibility is to count instruments, and when that happens Dennis is happy to share her own experiences and knowledge to let them know the spectrum of the role. A perioperative nurse may have a small margin of opportunity to chat with or connect with the patient, but is the advocate for the patient the entire timeline of any procedure, she says. “Who else watches over them but the perioperative nurse,” she says. “A perioperative nurse has to be technically savvy, clinically capable, and emotionally sturdy to weather that intense and demanding work,” says Dennis. “They have to be on cue all the time.”
The perioperative nurse takes care of the physical environment of the patient to ensure safety so that means they need to know processes, products, equipment, and people. When the patient is asleep, they need to check that they are safely positioned and are responding well. They confirm the team is functioning in a safe manner–from the scrub tech to the surgeon; that team could even include working with robots. AORN has produced a video to help show the depth and breadth of this nursing specialty as well.
“We are basically one-on-one with the surgeon,” Dennis says. “Perioperative nurses are looking at the patient in the entirety–from the outset when they are holding a patient’s hand as they are given anesthesia and ensuring the correct instruments and communicating with the team,” she says. Perioperative nurses need to know every service line and go into the OR prepared for anything the patient might require. And nurses in the field who are drawn to specific areas of expertise, cardiology or orthopedics, for example, can also further specialize their expertise and training to meet the high demand.
With so much to know, the onboarding and training for perioperative nurses can take at least a year. “Repetition breeds competency,” says Dennis. And working at the bedside is an essential part of perioperative nursing. “I think sometimes the disconnect is that people say they want to work the floor or that they are afraid they won’t have a relationship with patients,” says Dennis. “But we are the primary advocates for patients. The connection is there, it is just the window of opportunity with the patient is smaller.”
Despite the long training, that doesn’t mean new grads can’t jump right in, says Dennis, noting that preceptors and simulation training are necessary resources, and that students become well versed in the perioperative guidelines for different facility types and ORs. AORN has a partnership with Chamberlain University that creates a cohort to prepare nursing students who are interested in perioperative nursing. Perioperative nurses are also needed out of the OR, says Dennis, noting that management roles help move the needle even more for the industry. Perioperative nurses’ experience is also needed in companies and organizations where they can use their expertise to help with materials management or sterile processing processes and products.
“Perioperative nurses look at the patient holistically,” says Dennis. “I just don’t believe there is any other mecca of nursing opportunities than perioperative nursing. Periop includes the full cycle of care for surgery.”