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Health Care Industry

When resources are scarce, consider growing your own

AORN Journal, August, 2005 by Joann Geslak

It seems all health care facilities, from large level one trauma centers to small community hospitals, have one thing in the common--an inability to increase par levels of staff members with properly trained perioperative nurses. Rather than search for this hard-to-find commodity, educators should consider educating their own perioperative nurses. This endeavor requires thought and planning, a desire to teach, and experienced coworkers who will help mentor fledgling nurses. Educators designing a perioperative course need to consider the basic factors that are vital to success, including

* the program plan,

* preceptor selection and preparation, and

* program structure.

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THE PROGRAM PLAN

There are a few basic factors to consider when developing a training program plan. These include class size, student characteristics, program length, and materials.

CLASS SIZE. How many students can the program accommodate without overwhelming the educator, staff members, and students? This depends on the size of the facility and the resources available. If the facility is a 20-room OR, more resources will be available to accommodate a larger class size than if an OR has only six or seven rooms.

STUDENT CHARACTERISTICS. Who will be accepted into the program? A program can be designed for all RNs, regardless of experience level. Experienced RNs from other fields can be excellent candidates for a perioperative program because they usually have the ability to organize and prioritize. Graduate nurses also are good candidates. These nurses still are in a learning mode, and they tend to absorb material and ask questions of the educator. Students in an internship program can be RNs with doctoral degrees or recently graduated nurses.

In the OR, an RN with more education will not necessarily be a better nurse than a peer who has less education. Educators interviewing potential candidates should look for enthusiasm and a desire to work in the OR because the OR is not for everyone. It takes an individual with a certain type of personality to fit into the perioperative world.

In addition, students learn in myriad ways. An increasingly mature population is returning to the workforce or choosing nursing as a second career. As a result, students have different philosophies and backgrounds, which can be challenging for educators. A young, new graduate may have the same amount of education as his or her peers in the program but may not have the same work or life experience. This is important to consider when designing a program. What may be easy for an RN with years of experience will not come as easily to novice nurses. Likewise, computer-based training may be easy for younger graduates but intimidating to more mature RNs.

PROGRAM LENGTH. How long the program should last depends on the amount of time needed to cover required materials in the classroom and hone skills in the clinical area. For example, educators in large teaching hospitals must consider the number of students rotating through difficult specialties (eg, open heart procedures, acute neurosurgery). Increased acuity in a specialty requires more didactic time and clinical experience. This time must be incorporated into the program while the course is kept on a specific time schedule. A six-month program usually is sufficient.

MATERIALS NEEDED. Some students learn visually and by reading while others must handle instruments and actually experience the process. Supplies for a program, therefore, should include both books and sample equipment to meet RNs' individual learning needs.

Educators developing the framework for a perioperative nurse training program, may find it helpful to use a guide, such as AORN's "Perioperative Nursing Course 101." This basic training program can be customized to suit any facility. Perioperative training also can be offered to surgical technologists, although modifying a course for surgical technologists may require adding or deleting certain parts of the program.

PRECEPTOR SELECTION AND PREPARATION

Having seasoned perioperative staff members serve as preceptors to students is vital to the success of a perioperative nurse training program. Motivating seasoned veterans to teach can be an arduous task that requires creativity and patience, however. Not every perioperative nurse wants to teach, and some may offer many reasons for not wanting to take on this responsibility, including the following.

* Effect on procedure turnover time--Teaching takes time away from the job at hand. Some staff members fear that the increased turnover time will affect their performance evaluations.

* Insecurity on the part of the perioperative RN--Regardless of his or her expertise in a certain specialty, the preceptor may have feelings of inadequacy as an instructor.

* Apathy--Some perioperative staff members prefer to just come to work, do their jobs, and go home.

* Personality conflicts--In their haste to make an impression on perioperative staff members, some students inadvertently "step on toes" or contaminate the atmosphere. This is one reason educators should make rounds and always be available to students.

Health Care Industry

When resources are scarce, consider growing your own

AORN Journal, August, 2005 by Joann Geslak

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