A successful nursing student practicum in an ambulatory surgery center

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

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To enhance learning, each student is required to watch videos and read selected reference materials that are available in the facility. In addition, textbooks purchased by the FSC are loaned to students for use during the practicum. The textbooks contain pertinent readings followed by multiple-choice questions to help students apply nursing knowledge in the ambulatory surgery setting. Students are expected to synthesize classroom and clinical information and apply it to patient care during surgical procedures.

Perioperative nurse preceptors are assigned to offer continuous specialized mentoring in each setting and role. Preoperative preceptors work with students to help them develop skills in patient assessment, IV insertion, medication administration, preoperative teaching, and patient and family member counseling. Intraoperative preceptors emphasize critical thinking skills regarding the necessity of using sterile technique and the importance of room management as a circulating nurse. Postoperative preceptors demonstrate how to perform postanesthesia assessments, airway management, pain assessments, and postoperative teaching. Preceptors facilitate each student's ability to meet his or her objectives while delivering patient care. Students also shadow the charge nurse and manager to learn about the complex applications of leadership and management skills used in this environment.

Students work closely with the preceptors as they begin to transition to independent practitioners in all three perioperative areas. Students advance from working with low-acuity ASC patients to working with more complex patients and setting priorities for care based on patient and family medical histories. As students complete the scheduled rotations, they are allowed to choose areas for additional learning based on their goals. Some students may decide to spend additional time working in one of the three perioperative settings or shadowing a nurse in a management position. Others may choose to observe the role of an advanced practice nurse, such as a CRNA.

If the preceptor is not able to work some days during the semester, attends a professional meeting, or has other work-related obligations that preclude student attendance, students can work on their presentation topics. This activity provides students with a focus in the absence of their preceptor.

The academic faculty member rotates weekly among the perioperative sites to see what activities the students are engaged in and evaluate the interaction between the preceptors and students. Students also communicate with the faculty member weekly via electronic clinical logs. A student often will communicate more thoroughly during a retrospective moment at home than during his or her rotation in a clinical environment. A typical clinical log may include a student's comments about the activities he or she has performed, feelings about his or her progression, clinical situations that resulted in an increase or decrease in his or her confidence, and the relationships he or she has with staff members or patients.