A successful nursing student practicum in an ambulatory surgery center

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

A combination of the compact space in ASCs, increased interaction with family members, increased numbers of infants and children as patients, and higher demand for patient teaching for outpatient procedures compared to inpatient procedures requires students to interact with patients and their family members using humor and good communication skills. The ambulatory setting's soft pastel colors and ambient lighting, along with health care providers' congenial attitudes toward patients who are wearing street clothes and relaxing in recliners, encourages an easygoing approach to patient care during what is usually a frightening, high-anxiety time for most patients. If a holiday is near, staff members may be wearing Mardi Gras beads, shamrocks, or Easter Bunny ears. Within this positive atmosphere, however, the seriousness of surgery, critical assessments, and organizational skills is not lost. Students learn to combine the important responsibility of competent perioperative care with the upbeat experience of holistic care.

Students who complete this outpatient clinical experience may or may not elect to work in an ASC or inpatient perioperative facility after graduation, but the skills they learn are relevant to more than just the OR or the postanesthesia care unit. (1) Nursing concepts of patient care practiced in perioperative nursing, such as patient safety, pain management, and patient positioning, are applicable across clinical settings. A health assessment and medical history are fundamental to patient care, and evaluation of laboratory test values occurs in every clinical area, including the OR.

Students are not the only ones who gain from this experience. The practicum also provides an opportunity for perioperative staff members to scrutinize these soon-to-be new graduates as possible perioperative employees. When a promising student has been identified, staff members go out of their way to help the student become employed as a perioperative nurse. Staff nurses have been known to make arrangements to shuttle a student to the main hospital for occasional clinical opportunities and interviews with appropriate personnel. Students seeking perioperative employment have been supported not only by nurses, but also by anesthesia care providers and surgeons, all of whom may provide written and verbal testimony of the student's abilities. The determination of these health care providers has created perioperative opportunities when there were no open staff member positions.

As the clinical manager of the FSC looks to the future when the construction of new and larger facilities will be complete, eventual staffing needs are a concern. Current staffing policies do not allow the FSC to directly employ new graduates, which results in the loss of good prospective perioperative nurses. As a result, staff members now are seeking ways to rewrite facility policies so that new graduates can be hired. In addition, FSC administrators recently began negotiating with the College of Nursing to increase the number of student placements after the new, larger facilities are completed in an effort to attract more graduates to the perioperative setting. The ultimate goal is to create a supply of young, energetic nurses who are interested in ambulatory surgery patient care and will promote the ideals of a Magnet-status institution.