Each year, PeriAnesthesia Nurse Awareness Week is celebrated in February (this year from February 6-12) and highlights the nursing care and work provided by perianesthesia nurses.
Perianesthesia nurses work alongside a patient as they are preparing for or recovering from a procedure that requires sedation. Nurses in this specialty are dedicated to patient safety and are responsible for monitoring and assessing patients as they move through the preparation and recovery processes.
Patients are often nervous when they’re having any kind of procedure and some are particularly anxious about anesthesia. As they conduct their range of duties, perianesthesia nurses are gathering medical and personal information from the patient, working with the team on the sedation process, and also working one-on-one with the patient to connect with them and keep them as comfortable as possible.
Knowing the entire process will be easier for the patient and the healthcare team if the patient is as relaxed as possible, the nurse will use communication skills to find subjects that a patient wants to talk about and will continually steer the conversation to those areas. Does the patient love to fish or have vacation plans they want to talk about? Maybe they have a habit like knitting or skateboarding or writing the next great novel–perianesthesia nurses will use questions they fine-tune over their years of experience to find that out. As the patient goes under sedation, that conversation will be calming. And perianesthesia nurses are already looking ahead to the patient’s period of recovery post-procedure to once again revisit those familiar topics. As the patient begins to come out of sedation, the perianesthesia nurse will be there with them and assessing them head-to-toe for any potential problems. As they are checking vital signs and looking for signs of pain, they will be talking with the patient to bring them to a more alert state.
As perianesthesia nurses are keeping a conversation going (even if it’s one-sided for a while), they will check to make sure the patient is breathing properly and that their vital signs are as expected, but they also use an extra level of awareness to look at everything from skin tone to muscle twitches to any indications of discomfort. Each patient will respond to anesthesia in a different manner, so these nurses will need to be aware of emotional changes or confusion as well as physical reactions including nausea or pain.
During pre- and post-procedure times, perianesthesia nurses must also extend that awareness to the entire area. As the patient’s advocate, they will be constantly monitoring equipment, surgical sites and dressings, and the patient’s comfort level.
And even though many people don’t realize the intense level of care they receive from a perianesthesia nurse, the care impacts their entire experience. Perianesthesia nurses will work after a procedure to communicate with the healthcare team about medications, recovery pace, or complications. They will need to conduct a comprehensive hand-off to the next nursing team if their shift ends before the patient is out of their care.
Perianesthesia nurses also communicate with families before the procedure to explain the process and what they can expect as the patient moves through the procedure and then they will communicate with them about post-procedure care, home care guidance, and expectations for recovery.
A perianesthesia nurse is a constant and steadying presence for anyone undergoing a medical procedure. This week’s PeriAnesthesia Nurses Week (February 1-7) acknowledges the nurses in this role and the work they do with patients in varied settings and under changing conditions.
Perianesthesia nurses are with patients throughout their entire procedure, although many patients don’t realize this. If you’re thinking about this career path, many nurses say they enjoy being a continuous presence for patients and enjoy being an advocate for them when they are not able to do that for themselves because they are sedated.
But nurses in this role also enjoy the close interaction with their patients. They gain satisfaction from being able to make their patients comfortable and less nervous about what’s happening. Perianesthesia nurses may not see their patients for a long time—the pre- and post-op when patients are most aware can be fast moving—but the impression they make is important. This career offers many choices where you can practice including hospitals, ambulatory care and day surgical sites, as well as pain management clinics.
According to the American Society of PeriAnesthesia Nurses, perianesthesia nurses are committed to patient safety and so they are always assessing a patient to watch for any changes at all. They are also responsible for helping the patient wake up from sedation and so their pre-op routine is often an information gathering process. During their pre-op interaction, they are gaining medical history but they engage patients in casual conversations about things that may seem random but are actually very precise. During this pre-op, nurses are finding out about the patient and learning about topics they will be able to mention in post-op to help the patients gradually awaken and be soothed by a familiar topic.
What might perianesthesia nurses ask? They can talk about anything from the patient’s career to their pets. They ask about family members, hobbies, travel, movies, books, or favorite routines. Over time, this becomes a highly developed skill in perianesthesia nurses’ toolbox as each nurse is able to find a conversational style that checks all the boxes of information they need to gather. They learn the subtle approaches for people who are especially quiet or those who are agitated or those who may be scared.
When the patient is sedated, the perianesthesia nurse is a constant presence and watches and monitors both the patient and all the equipment for any signs of change or potential trouble. As perianesthesia nurses work, their skill set during procedures is also fine tuned. They are watching for all the steady vital signs on monitors, but they also scan the patient to look for any even less obvious signs or signals. They are watching skin tone and feel, listening to the breathing patterns, and noticing muscle movements or changes.
Then the nurse and patient will be in post-op as sedation wears off and the patient wakes up. The unpredictable nature of post-op is another situation perianesthesia nurses are ready for. As they are monitoring the patient, they use those nuggets of information they discovered in pre-op to help the patient get oriented. And for all the work they have done, perianesthesia nurses say that some patients may not remember their presence or understand the nurse has been there the whole time. So self-motivation is a big career skill—nurses in this role find meaning in helping patients and understand the situation might not lead to any recognition from the patient.
The PeriAnesthesia Nurse Awareness Week is celebrated this year from February 4-10 and is a time when nurses in this specialty are recognized for the work they do. The week also allows an opportunity for education about the specialty and the type of care these nurses deliver.
The American Society of PeriAnesthesia Nurses (ASPAN) is an important resource for nurses who work in the perianesthesia realm and those who are considering this specialty. Many people know perianesthesia nurses as part of the essential surgical team, but they are also intricately involved in pain management procedures that involve anesthesia.
Perianesthesia nurses are present during all aspects of anesthesia care. They work with patients during pre- and post-operative care. They also monitor and advocate for patients during procedures. As a perianesthesia nurse, one must remain vigilant for any signs of difficulty in the patient, so nurses are constantly monitoring vital signs and breathing.
Because of the careful and meticulous preoperative care, these nurses also know how to monitor visually to make sure the patient is tolerating the procedure well. If there are any problems, nurses are there. When patients are recovering from a procedure, the nurse continues to monitor their recovery as the anesthesia wears off. They are a professional medical presence and a calming personal presence as well.
As with other specialties, certification is important for perianesthesia nurses as the challenges of medications, patient health, and procedure can make for a complex situation. All ages of patients undergo anesthesia, so nurses need to have training and experience with every age from newborns to the very elderly.
Conditions can make people more frail and the potential for an allergy or a bad reaction to anesthesia is always present. Remaining educated with the latest information and evidence-based practices is critical in this specialty.
As a perianesthesia nurse, time is especially important during patient interactions. They have a short window of time to assess a patient, put that person at ease, and find a common thread or conversation point that can be used during postop care. Often perianesthesia nurses will try to find an interesting detail about the patient and use that as a conversation point to help orient patients after procedures.
Some perianesthesia nurses work in pain management, helping patients and monitoring them closely as they receive different anesthesia, some of which is not entirely sedating, for pain. In this case, they act as advocates as patients manage the procedures and the effects of the anesthesia.
If you’re a perianesthesia nurse, celebrate all you do this week. If you have perianesthesia nurses on your team, give them recognition for the essential role they play in your organization and in patients’ lives.
According to Armi Holcomb, RN, BSN, CPAN, and immediate past president of the American Society of PeriAnesthesia Nurses (ASPAN) perianesthesia nursing is one of the most well-rounded areas of nursing. For that reason, she sees the field as exciting and satisfying for both personal and professional reasons.
Perianesthesia nurses always have to weigh several different factors when treating each individual patient.
“We see people before surgery and have to know about their preexisting conditions or any medical conditions they have to make sure the surgery is safe,” she says. “We are the patient’s first line of defense.”
Perianesthesia nurses, who administer care during the transition times of pre- and post-surgery, are especially aware of the recovery room care.
Holcomb, who has practiced in many settings including med-surge and ICU, says perianesthesia nursing is her niche. “We see the whole patient,” she says. And then, she says, the perianesthesia nurses are there to help patients transition safely after surgery. “We make sure they can transfer to home, to inpatient, or to the ICU,” she says.
As medical care becomes more advanced and complex, the patients nurses see are also generally more acute. Many have coexisting conditions that can have a big impact on surgery and anesthesia. Because of that, these nurses have to always be on top of trends and research. “We have to be life-long learners,” she says, noting that perianesthesia nurses have to keep current with physical health, pharmacology, and surgical needs.
“All of that weighs in and it’s critical thinking,” says Holcomb. Perianesthesia nurses never back away from asking questions and will always advocate for patients, says Holcomb. And they are a tight bunch. ASPAN emphasizes mentoring and sharing knowledge among members.
If you are a perianesthesia nurse or work with one, take time this week to reflect on all you do. Celebrate with colleagues and do something to honor your own work (Holcomb says her organization will celebrate nurses with goody bags and a luncheon among other things).
And if your state doesn’t have a proclamation for this week, you can always advocate for one. ASPAN even offers a sample proclamation to guide your efforts.
Congratulations to all the perianesthesia nurses!
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