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A precepted perioperative elective for baccalaureate nursing students

AORN Journal, Dec, 2002 by Linda L. McCausland

Much has been written about the recruitment crisis in perioperative nursing. The current perioperative RN workforce is aging, and the former major source of replacements, the diploma nursing program, is almost extinct. (1) Perioperative nurses fear that the shortage of nurses interested in working in the OR will make it easier for managers to hire staff members who are not nurses to perform duties nurses traditionally perform. (2) This scenario is not unlike that in other practice areas experiencing a shortage of nurses. One important difference, however, is the lack of perioperative clinical experiences for student nurses, which could stimulate students' interest in perioperative nursing as a career. Those graduates who pursue perioperative nursing may be disillusioned with the role if they have not had previous perioperative clinical experience. Loss of a newly hired nurse during the lengthy orientation process is very costly for the hospital and frustrating to the perioperative manager. (3) Additionally, the contemporary roles of perioperative nurses and nurse managers are so demanding, BSN graduates are needed to fill them. (4)

More Articles of Interest: Implementing a perioperative nursing: elective in a Baccalaureate Curriculum; Student Interest in Perioperative Nursing Practice as a Career; Perioperative clinical learning experiences; Perioperative nursing course offers opportunities for learning; Key components of perioperative orientation

Authors of perioperative nursing literature have provided many explanations for the decline of perioperative experiences in nursing education programs. (5) Some of the influencing factors identified are the

* basic nursing program emphasis on generalist rather than specialist preparation,

* removal of perioperative content from nursing education due to overcrowded curricula,

* inaccurate perception of the perioperative role as purely technical rather than professional,

* view of the traditional role of the perioperative nurse as handmaiden to the surgeon, and

* lack of nursing faculty members qualified to teach a perioperative elective.

More than two decades ago, AORN initiated a project to promote perioperative nursing and encourage nursing student experiences in the OR. Since then, various courses, programs, and experiences have been launched and described in the literature. (6) Several models have been implemented, and most include both didactic and hands-on experiences. Nursing school faculty members and perioperative nurses have formed collaborative relationships to provide basic and advanced electives. Some are offered during summers, some between semesters, and others during the school year.

Today, the shortage of perioperative nurses remains, and most nursing education programs still provide very limited exposure to perioperative nursing, despite student interest in the perioperative role. The presence of a faculty member in the OR during student rotations has not been feasible for many reasons, such as necessary university faculty-to-student ratios and difficulty accommodating and supervising multiple students in the setting. One-to-one precepted experiences seem to be a more feasible alternative, assuming qualified perioperative nurses have the time and are willing to oversee student experiences.

That very interest was expressed in one community through an AORN chapter initiative to increase recognition of perioperative nursing and inclusion of perioperative nursing experiences in nursing school programs. Faculty members from local nursing schools were invited to a program that addressed these goals. A faculty member in a baccalaureate nursing program was inspired to collaborate with nurses from the chapter to develop a perioperative experience for interested nursing students. The faculty member contacted the chairperson of the educational initiative and became the faculty facilitator for a precepted perioperative nursing elective.

DESCRIPTION OF THE PERIOPERATIVE ELECTIVE

A one-credit elective clinical experience in perioperative nursing was arranged for students in a baccalaureate nursing program during the spring semester of their junior year. The students' schedules allowed one full weekday without classes to participate in the experience.

Goals and requirements. The goals of the experience were to increase students' knowledge of the perioperative nursing role and to allow interested students to determine whether they wanted to pursue a career in perioperative nursing. The three domains of learning (ie, cognitive, psychomotor, affective) were to be addressed during this educational opportunity. In the cognitive domain, students would gain knowledge and understanding of perioperative nursing by observing, participating in, and discussing the role. Psychomotor learning would take place by performance of basic perioperative skills in the actual setting under preceptor supervision. As students gained knowledge and skills, they would form beliefs and attitudes about perioperative nursing (ie, affective learning). Documentation of affective learning becomes evident when students reflect on the experience and compose their thoughts in log entries.

Before this experience, students received 13 hours of lecture on perioperative content in their fundamentals course. A one- or two-day observational experience in the OR was provided during their medical-surgical and pediatric rotations. The pediatric experience allowed students to accompany and observe patients through the preoperative, intraoperative, and postoperative phases of care. The opportunity to observe a cesarean section was provided to some students during their maternity rotation. Some students attended an open house program presented by the local AORN chapter in which a variety of surgical procedure setups were simulated and tours of the OR suite were conducted. Students were able to handle instruments and view equipment demonstrations.

Health Care Industry

A precepted perioperative elective for baccalaureate nursing students

AORN Journal, Dec, 2002 by Linda L. McCausland

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