Student Interest in Perioperative Nursing Practice as a Career

AORN Journal, March, 2000 by Brenda Happell

A recent literature review suggests perioperative nursing is being threatened. The main factors contributing to this situation are the difficulty in attracting a sufficient number of nurses into the perioperative specialty and the increased use of nonnursing staff members in traditional perioperative nursing roles.

Recruiting sufficient numbers of perioperative nurses appears to be a widespread problem affecting Australia, the United States, and the United Kingdom.(1) This problem is attributed, in part, to university-based degree and diploma programs that removed perioperative nursing courses because of overcrowded curricula. Consequently, many nursing students are not exposed to perioperative nursing during their initial educational program. This lack of exposure is believed to decrease students' interest in pursuing perioperative nursing careers after graduation.

Using nonnursing staff members to perform functions traditionally fulfilled by perioperative nurses has had a profound impact on this specialty as well. Technical expertise required in the OR has led to confusion between nurses' and nonnurse staff members' responsibilities.(2) If perioperative nursing's primary focus was technical expertise, it would be difficult to argue against replacing nurses with nonnurse staff members.

Insufficient numbers of perioperative nurses and the use of nonnurse staff members in the OR are interrelated. For perioperative nurses to justify the importance of and need for their practice, they must be sure that sufficient numbers of graduating nurses will choose this specialty to fill future positions. Literature reviewed suggests this level of confidence currently does not exist.(3) If too few nurses work in the OR then it will be easier to have nonnursing staff members perform duties that nurses traditionally fulfilled.

Greater exposure to perioperative nursing would increase students' interest in this area of practice.(4) One study describes the success resulting from implementing a perioperative elective for undergraduate students.

Although this course is in its infancy, it has become popular among baccalaureate students. Incoming junior students are enthusiastic about an elective course that provides them an opportunity to focus on an aspect of nursing that is no longer available to them in most nursing programs. The morale of the OR nursing staff, particularly among the preceptors, has increased tenfold.(5)

The apparent success of this program is encouraging, but there is no guarantee that more students will choose perioperative nursing careers after graduation.

STUDYING PERIOPERATIVE CAREER CHOICES

The idea that nurses must meet the needs of a rapidly changing health care system frequently is espoused. To meet this goal, the profession must produce graduate nurses who are able and willing to work in various health care settings. Few studies, however, have examined career interests of undergraduate nursing students. Available research finds that student nurses and RNs are interested mostly in acute medical and surgical areas.(6) This trend was evident in the United States and the United Kingdom, suggesting that similar attitudes between these nurses may be more significant than differences. These studies are somewhat dated, though, and their reflection on the contemporary health care., scene is uncertain.

A more recent Australian study confirms the apparent popularity of more acute areas of nursing.(7) Perioperative nursing ranks as the third most popular choice for students beginning their nursing education. This research refutes another belief that awareness of and interest in perioperative nursing needs to be cultivated.(8) If these Australian study results are typical of undergraduate students' beliefs, maintaining students' interest in perioperative nursing may be more important than cultivating that interest.

More research is needed to gain a greater understanding of why student nurses choose specific practice areas after graduation. One current research project is investigating specific career interests of undergraduate nursing students and how they are influenced during their undergraduate program. To provide greater insight, a questionnaire will be administered to students at three stages during their undergraduate nursing education. This article describes the first stage findings of the study--career preferences of students beginning their nursing education. This stage of the study is to learn which specialties undergraduate nursing students are most interested in pursuing after graduation.

METHOD

The questionnaire used in this study was adapted from a tool developed in an earlier study.(9) The questionnaire comprised eight questions (ie, four open ended, four closed ended) and was divided into three sections. The pilot study indicated it would take approximately 15 minutes to complete. Information sought included

* demographic data (eg, age, sex, previous nursing experience),

* career preferences in nine areas of nursing practice (ie, operating theatre, pediatric, medical, psychiatric, intensive/critical care, geriatric, surgical, community health, midwifery) from most preferred to least preferred (ie, one = most preferred, nine = least preferred), and