Programs for nursing students and faculty members of schools of nursing offer specialized instruction: Tuesday, March 25, to Wednesday, March 26, 2003 - Student And Faculty Programs

AORN Journal, June, 2003 by Nikki Parker, Nancy K. Kuehl

Special programs for nursing students and faculty members of schools of nursing were presented at this year's Congress. Students were allowed to attend Congress free of charge and invited to a networking breakfast and a special one-day program designed to introduce them to the OR. Faculty members were invited to attend the networking breakfast and a three-hour session about the Perioperative Nursing Data Set (PNDS) and using the OR for clinical experience.

STUDENTS LEARN ABOUT PERIOPERATIVE NURSING

More than 200 students attended a special Congress program designed just for them on Wednesday, March 26, 2003. The program consisted of three parts--didactic instruction, which focused on aseptic technique, electrosurgery, and patient safety; an assignment; and hands-on instruction. Joy Don Baker, RN, PhD, CNOR, CNA, welcomed attendees to the program, saying, "You represent the people who are going to take care of us."

A student's view. Tracy Albanese, a student from Shepherd College in Shepherdstown, WV, attended Congress with her professor, Kathleen B. Gaberson, RN, PhD, CNOR. At the member ambassador recognition breakfast held at the 2002 Congress, William J. Duffy, RN, BSN, MJ, CNOR, Treasurer, won complimentary registration, airfare, and lodging for the 2003 Congress. As a Board member and resident of Chicago, Duffy gave his prize to Dr Gaberson so she could bring a student.

"As a student, I really enjoyed the sessions on different surgeries, patient safety, and ethics," said Albanese. She explained that although she learns about general principles and basic techniques in school, Congress allowed her the opportunity to apply this information in a concrete way. When asked whether she plans to practice in the OR, Albanese said, "I still feel wide eyed. Everything's new." She did, however, say that a positive clinical experience in the OR and experiences at Congress have "definitely encouraged me to lean toward the OR."

Aseptic technique. Dr Gaberson discussed definitions related to aseptic technique, related recommended practices, and principles and application of aseptic technique. Protecting patients from infection "is one of the most important things perioperative nurses do," according to Dr Gaberson. She told students, "We have to report all breaks in aseptic technique immediately." She also explained that an item either is contaminated or it is not--there are no gray areas.

Of nursing standards and recommended practices, Dr Gaberson told students, "Organizations make a conscious decision they are going to adhere to them." Standards relate to technical practice and represent what nurses should do in ideal situations. Recommended practices relate to various issues, including traffic patterns. "Did you know the perioperative nurse has to be a traffic manager?" Dr Gaberson asked.

One principle of aseptic technique Dr Gaberson discussed is that the edges of anything that encloses sterile contents are considered unsterile. "This is a very strange principle," she said, explaining that when anything is opened, it becomes a sterile field, and the inside of the wrapper is considered sterile to within 1 inch of the edge. "In reality, this is not the way it goes," Dr Gaberson commented, alluding to the fact that if tested in a laboratory, this would not be a hard and fast rule.

Electrosurgery. Judith Eagan, RN, BS, CNOR, discussed the basic principles and clinical applications of electrosurgery; safety concerns when using electrosurgery, and recommended practices related to electrosurgery. She told attendees that an electro-surgical unit is the most hazardous medical device used on a daily basis, but it is used because "the pros outweigh the cons."

Eagan gave an overview of the basic principles of electricity. She explained its properties, the frequency spectrum, different types of waveforms, and the differences between monopolar and bipolar surgery. Monopolar surgery uses one electrode that delivers electricity to a patient and collects it somewhere on his or her body. Bipolar surgery has both active and return poles in one instrument (eg, forceps). "Inherently, bipolar is safer," Eagan said.

In relating information on electrosurgery to nursing practice, Eagan said, "The hospital staff is responsible for maintaining this equipment." There have been many changes and advances in technology, but not all hospitals have the most recent equipment, so being familiar with these principles is important. Nurses also should be aware of the issue of flammability because "it is possible in the right circumstances to start a fire," said Eagan. Three things are needed to start a fire--heat, fuel, and oxidizers. In the OR, surgeons typically provide the heat, nurses the fuel, and anesthesia care providers the oxidizers. "[Fires] occur frequently in the OR, so it requires the vigilance of the staff," Eagan said.

Possible adverse outcomes resulting from the use of electrosurgery include patient return electrode burns, alternate site burns, ignition incidents, and injuries caused by the effects of stray current. According to Eagan, health care professionals never discuss the potential for electrosurgical burns when having patients sign consent forms. "Imagine how happy you'd be," she said.