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.”
Perioperative nurses are an essential part of any surgical team. This week’s Perioperative Nurses Week spreads awareness of this career path while also educating the public about this vital operating room role.
Nurses in this role fill a pre-op and post-op need while also remaining with the patient during a procedure. According to the Association of periOperative Registered Nurses (AORN), they are the eyes and ears for the patient while a procedure is going on, but they are also helping prepare the patients emotionally and physically beforehand and helping them during the immediate recovery. They impart a sense of calm and caring while using precise nursing skills to constantly assess what’s happening with the patient.
In this role, nurses simultaneously gather vital patient health information, communicate effectively with the patient and the patient’s loved ones, and continually monitor the patient during all stages of pre-to-post op for a smooth and safe surgery. Periop nurses may do many tasks at once, but their focus on the patient must remain absolutely unwavering.
Because they are charged with monitoring the patient as they are going though surgery, periop nurses have to have a keen ability to know when something has changed. They remain alert for fluctuations in heart rate or blood pressure that will appear on the monitors. But they also must watch the patient to notice any signs of distress or change that monitors may not pick up like a subtle change in the patient’s breathing pattern or skin tone or muscle activity.
Periop nurses are the advocate for the patient at a time when they are most vulnerable and unable to advocate for themselves. An acute sense of perception and a dedication to patient care and advocacy are hallmarks of nurses in this role. Nurses who are with patients throughout a surgical procedure must also have excellent critical thinking skills and have the confidence in their professional skills to act immediately and not second guess what they are noticing.
If you’re a nursing student and thinking of this as a career, you’ll need varied hands-on nursing experience so you can develop your skills. Taking swift, decisive, and accurate action is part of the job and something the medical team and the patient depend on. If you think this career path matches your goals, you can begin building your nursing skills with this as a focus.
Aside from exacting medical skills, periop nurses also have a special ability to connect with people so they are able to help them through any anxiety about what’s happening. They have an innate sense topics that people want to talk about and that will help both soothe their nerves while also giving valuable information about who they are and what their lives are like.
This might seem like chit-chat, but it helps the nurse in a couple of ways. The answers to questions can give the nurse a few things to talk about as the patient is coming out of anesthesia and needs something familiar to grasp in conversation. A patient who told a story about a spouse or a pet will likely be happy to do that again in post-op.
Answers to other questions might also offer insight for the nurse as treatment plans are being figured out. Maybe a patient is concerned about getting medication or doesn’t understand some previous instructions. Periop nurses know how to get important information from patients that will help them recover faster and improve their outcomes.
Periop nurses have a valuable skill set that balances professional excellence with unsurpassed interpersonal communication. If you have periop nurses on your team, celebrate all they do this week. And if you’re a periop nurse, notice how your hard work makes a patient feel more relaxed while you know you are offering excellent care.
With millions of surgeries taking place annually across the nation, a career as a perioperative nurse is one that is both secure and exciting. This week’s recognition of Perioperative Nurses Week (November 10-16) lets people know about the critical work these nurses do throughout a surgical process.
Perioperative nurses serve the vital role of helping patients before and after surgery to ensure they are safe, informed, and comfortable. These nurses also take on the role of being the patient’s advocate when they are in surgery and unable to speak for themselves.
Organizations such as the Association of periOperative Registered Nurses (AORN) are excellent resources of information and education in this career. Perioperative nurses depend on a variety of medical, critical thinking, social, and analytical skills every time they report to work. No day is every the same as the one before, and perioperative nurses know even routine surgery isn’t always routine.
With this responsibility, perioperative nurses are experts at understanding how a human body reacts under surgery and how human emotions can be unpredictable pre- and post-surgery.
Patients see perioperative nurses before they go into the OR. All the talk that goes on isn’t just idle chit chat, as perioperative nurses have specific expertise in chatting with patients to find out more about them. They are naturally interested in learning more about the patient, but they are also looking for information they can use when the patient is coming out of anesthesia.
People can become confused, agitated, happy, or sad when they are waking up from surgery, and an experienced perioperative nurse knows just how to guide the situation so the patient feels safe, is medically stable, and can get reoriented. Nurses will use the information they gained pre-op to talk to the patient. Maybe the person likes golf or talked about family or mentioned a quilting habit. Bringing up those familiar and happy associations helps patients enormously and also makes a nurse’s job easier. Managing a patient who is calmer makes their recovery easier, faster, and safer.
Many people don’t know the nurse who cares for them before and after surgery is also present by their side during surgery. During Perioperative Nurses Week, nurses can make a point to let people know of the complexities of this role.
They are patient advocates, but they are also a core part of the surgical team as well. Nurses in the surgical suite must be experts at preventing problems and spotting any issues immediately. With their attention fully on the patient, they are in charge of noticing if a patient is reacting poorly to any part of the process. They keep track of the monitors to see blood pressure, oxygen levels, and heart activity, but they have to continually assess the patient visually. They will notice any change in the patient’s physical body—from breathing patterns to skin color changes—that could indicate a problem.
The perioperative nurse relies on a toolbox that holds a little bit of everything—an intense focus, up-to-date medical skills, keen attention to the patient, social ease, and compassion—to help patients through surgery.
If you’re a perioperative nurse, take some time this week to celebrate the care you give your patients, the teamwork you contribute, and the way your work elevates the entire nursing profession.
See Our Champions of Nursing Diversity
Sign up now to get your free digital subscription to Minority Nurse
