A knowledge comparison of nursing students in perioperative versus other rotations

AORN Journal, Oct, 2004 by Linda M. Sigsby, Hossein N. Yarandi

The value of indirect care as a clinical Learning activity should not be underestimated. Indirect patient care, such as watching as the anesthesia care provider threaded an endotracheal tube through vocal cords and into the main stern bronchus, gave students a better understanding of anatomy and how and why to auscultate Lung sounds. Seeing the immediate effects of IV push medications ted to a high degree of respect for that medication delivery method. Observing a variety of surgeries improved students' understanding of anatomy, physiology, and pathophysiology, especially as it related to performance of health-assessment techniques. Seeing a liver that was enlarged, lumpy, and fibrous because of cirrhosis helped students understand how they might someday be able to effectively palpate an abnormal liver. Participating in surgical procedures also gave students repeated opportunities to interact effectively with other health care providers, including administrators, anesthesia care providers, surgeons, pathologists, x-ray technicians, and surgical technologists.

In addition to completing preparation information about their patients, students also composed relevant care plans. Some used actual nursing diagnoses, including

* acute pain related to total hip replacement as evidenced by patient's reported score of eight out of 10 on the pain scale;

* anxiety related to fear of the unknown as evidenced by patient clutching nurse's hand and crying; and

* hypothermia related to anesthesia, room temperature, and skin exposure as evidenced by tympanic temperature of 960[degrees] (35.56[degrees]C).

Students also submitted potential nursing diagnoses with appropriate supporting subjective and objective data, goals, nursing interventions, and evaluations, Potential nursing diagnoses included

* risk for impairment of skin integrity related to positioning during Long procedure or pooled skin preparation solutions,

* risk for surgical burns related to use of electrosurgical unit, and

* risk for fluid volume deficit related to blood Loss during surgery.

Linda M. Sigsby, RN, MS, is an assistant professor of nursing, College of Nursing, University of Florida, Gainesville, Fla.

Hossein N.Yarandi, PhD, is an associate professor, College of Nursing and Biostat Unit, University of Florida, Gainesville, Fla.