A successful nursing student practicum in an ambulatory surgery center

AORN Journal, August, 2006 by Linda M. Sigsby, Jolene Selzer, Terry Keenan Wilson

NURSING STUDENT ORIENTATION TO THE PRACTICUM

All of the students who select perioperative clinical sites for their practicum are assigned to one faculty member, an experienced perioperative nurse. Before this final semester course, students may have had a one- to two-day observation in an OR or may have had no previous exposure to preoperative, intraoperative, or postoperative care sites. Students will have learned about perioperative nursing care in didactic courses that focus on preparing a patient for surgery and postoperative care in a patient's room.

The focus of the practicum is on clinical experience, so at the beginning of the course the academic faculty member holds one two-hour seminar to bring all students together who are assigned to him or her. The purpose of the seminar is to introduce students to the course and give them a variety of important information about perioperative nursing, weaving the information into clinical and didactic course content. Professional roles such as scrub nurse, circulating nurse, and RN first assistant are defined, and anesthesia care providers, including anesthesiologists and certified RN anesthetists (CRNAs), are differentiated. This helps the students apply delegation of authority and adds clarity to their understanding of legal parameters of practice. On average, 80% of students from this baccalaureate program continue into graduate study, so advanced practice roles, including nurse practitioner, are discussed as well.

The importance of certification as a CNOR and membership in a professional association are emphasized as methods of establishing clinical expertise and staying current with changes in nursing practice. Copies of the AORN Journal are distributed to show not only manuscript content for evidence-based practice but also how to find perioperative employment around the nation.

At the conclusion of the practicum, students are expected to give a presentation on a perioperative nursing topic. Students select from a variety of topics that are of interest in preoperative, intraoperative, and postoperative situations and large and small perioperative environments (Table 1). Selecting presentation topics at this first seminar gives students ample opportunity to gather information throughout the semester. Some students also may choose their own perioperative presentation topic as the semester progresses.

In addition, the faculty member arranges brief meetings with students assigned to each facility to acquaint them with the units and work hours of their preceptor, expected apparel, and parking regulations. Time is always left for a question-and-answer period.

The practicum is purposely designed as a very independent experience for students. They are asked to write their own objectives that fit within the overall course objectives as a guide for their preceptor. One student may have goals that seem simple, such as gaming more confidence and skill in inserting IV lines. Another student may have goals that seem loftier, such as wanting to provide health care that is responsive to patients and family members of varying age groups and ethnic heritages. The staff preceptor works with each student to enhance the probability of achieving the student's goals. For example, the preceptor might work with the first student in preoperative nursing care to give the student more opportunity to insert IV lines, and the preceptor might give the second student opportunities to interact with patients of diverse ages and ethnicities.