A precepted perioperative elective for baccalaureate nursing students

AORN Journal,  Dec, 2002  by Linda L. McCausland

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DISCUSSION

One of the benefits of this clinical offering was that students got to experience the role of the nurse in the OR rather than to strictly observe as they previously had done. One student even got to work one day with her preceptor in a management role. This was particularly valuable to this student who has good leadership potential.

Although this brief experience confirmed interest in perioperative nursing for many, it also helped some students learn that perioperative nursing was not for them. As one student stated, "I learned that being an OR nurse is not enough patient interaction for me; but I would not have learned that without this experience." Whether or not they ultimately maintained an interest in perioperative nursing, students benefited because they could transfer the skills and knowledge they learned to other areas of nursing practice. A few students received job offers based on this experience. Some students attended a local AORN meeting at the urging of their preceptor and faculty members. They were received warmly and were impressed with the meeting and program. Another positive effect was the response from

preceptors regarding the experience. When asked whether they would like to precept students in the future, the response was always "yes" or "definitely." Many expressed how much they enjoyed working with the students, how they learned from each other, and how they felt this was an opportunity to recruit new perioperative nurses.

Most students were able to achieve all of their requirements. The requirement to describe how perioperative nurses use the nursing process often was not addressed in the students' logs. This required that the faculty facilitator teach students to look for evidence of nursing diagnosis identification, treatment, and evaluation of expected outcomes. The nursing process terminology familiar to students was not as obvious in the practice setting. They were well aware of assessments performed, especially in the preoperative holding room, but in most settings, they did not see actual nursing diagnoses identified. With encouragement, they were able to identify common nursing diagnoses, such as knowledge deficit, anxiety, risk for injury, and pain, that nurses were using but not necessarily documenting as such. The interventions and evaluations also were clear after students applied the nursing process thought pattern. The faculty facilitator insisted on the inclusion of that requirement so students would see the comprehensive role of the RN in the OR; otherwise, students tended to focus on technical skills, just as they do in many other clinical experiences.

Problems encountered. Considering the large number of students (ie, 67) who have completed this elective, the problems and concerns were minimal. Two of the concerns already have been mentioned (ie, student interest in anesthesia, failure to follow through with arrangements). Additionally, in one setting, a student did not have a set preceptor but was assigned to several different nurses by the OR liaison. This limited the student's experience because each nurse was unaware of what the student already had learned and done, which kept the student from moving forward. That problem was related to staffing circumstances at the time and has not occurred again.