The list of fears people have about surgery is long and varied. With the help of a perianesthesia nurse, those concerns–about the procedure itself to pain afterwards (and all the worries in between)–can be alleviated. As a patient ally before, during, and after a procedure, perianesthesia nurses are the patient’s voice when they aren’t able to advocate for themselves.
This week celebrates PeriAnesthesia Nurse Awareness Week (February 7-13) to help people understand this nursing specialty as a career and as a patient-focused presence throughout a procedure. Sponsored by the American Society of PeriAnesthesia Nurses, this week helps highlight the professional work of the nurses who patients depend on but often don’t realize exactly what they do.
The biggest surprise for many patients is that in many organizations perianesthesia nurses remain by their sides throughout the entire procedure. They are the nurses who assess them and administer care in the often-nervous times right before a procedure. Once the patient is under sedation, perianesthesia nurses remain with the patient throughout the procedure to continually monitor their progress and care for them when they aren’t able to speak.
Once the patient moves to recovery, perianesthesia nurses continue their careful assessment and monitoring all while they are helping a patient emerge from anesthesia. And while patients might remember the beginning and ending of the process, they often are surprised to know their perianesthesia nurse remained with them the entire time.
If you’re interested in a career as a perianesthesia nurse, your attention to hands-on details like assessing equipment or the patient’s vital signs must be exacting. Your focus on the patient is unrelenting because they are under sedation for the majority of the time you might be with them.
Other skills that are more difficult to quantify are the perianesthesia nurse’s true superpower. As a perianesthesia nurse, you need to become an expert at monitoring the most subtle changes in a patient–often the things that could go unnoticed during a busy procedure. You’ll become the expert on noticing the most minor change in the patient’s breathing or coloring. You’ll notice if something just seems off or if the patient seems to be in or approaching even the most minor distress.
During procedures, nurses in this role are comfortable acting fast, speaking up quickly, and persisting to ensure their concerns are acted upon. They know the patient can’t speak up and so they take this responsibility to heart. When they are with a patient, perianesthesia nurses are efficient at gathering information while making the patient feel more at ease when they are awake and as an essential part of the surgical team. It’s a tough balancing act and nurses in the role say they develop certain approaches over time that work best for them.
They excel at engaging patients in casual conversation in pre-op that also gives the nurses information they need to provide the best care. While chatting about hobbies, family members, music, or cooking might seem like offhand talk before surgery, perianesthesia nurses direct the conversation with purpose. They are constantly looking for topics patients are especially happy to discuss. It helps reduce the patient’s anxiety about the procedure, and the nurse uses the information as part of an overall approach. When the patient is emerging from sedation in recovery, they can be confused or feeling unwell. They might wake up agitated or emotional. As nurses monitor the patient’s status, they will bring up those same topics to help the patient come to with familiar conversation. In the recovery period, nurses will also assist with pain management and will watch for signs the patient is ready to move out of recovery.
If you’re thinking of work as a perianesthesia nurse, find out as much as you can about what your day will be like and how nurses sharpen their skills for this work. The work with patients is direct, but it’s not the same as other specialties as patients often are hazy on the details of what’s going on around them. But your high-quality nursing care and role as an advocate are meaningful and rewarding.
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.
If you are interested in a career as a perianesthesia nurse, you’ll find the challenges of the position range from using your advanced nursing skills in urgent situations to incorporating the most basic hands-on comfort skills. Charged with caring for patients at critical pre- and post-procedure points, perianesthesia nurses must be able to multitask, to identify and respond to patient conditions immediately, and to do this all with a calm demeanor to help keep patient stress at bay.
Perianesthesia nurses especially enjoy their work caring for patients before and after procedures that require any anesthesia. Before a procedure, they are the nurses who are there to find out any information that could have an impact on the anesthesia care. With more and more patients appearing with several health conditions, they have to factor in variables like medications, physical condition and limitations, and emotional stability in their patient assessment. While they are assessing and gathering information, they are also providing a calm and unwavering support to help nervous patients know they are in trusted hands.
Perianesthesia nurses are also there when patients come out of anesthesia and are sometimes confused, uncomfortable, or even nauseated or vomiting. Post-procedure, nurses are once again continually monitoring a patient, assessing vital signs, reassessing existing health conditions, and at the same time, offering that hands-on caregiving that helps patients feel safe. Perianesthesia nurses then help determine how a patient can safely move to their next place whether that is to home, another hospital, or another care facility.
Many perianesthesia nurses say they have perfected a way to develop a rapport with patients that can build the trust necessary for completing such a long task list in a short time and under pressure. Once a nurse has identified a topic that helps the patient relax, they can begin conversations about family, pets, schooling, movies, or books that are both informative for nurses and distracting for patients. Many nurses also say they use those nuggets in the conversation to help bring a patient out of a drowsy and sometimes confused anesthesia.
For those considering this branch of nursing, ASPAN offers many resources and is an excellent reference to find out information about certification (through the American Board of Perianesthesia Nursing Certification, Inc.) that must be renewed every three years, scholarships for education, career resources, mentoring opportunities, conferences, and up-to-date anesthesia information.
This week, recognize and appreciate the perianesthesia nurses on your team. Their skills often help the entire procedure proceed smoothly and safely.
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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