Subject(s)
Operating Room Nursing , Humans , Nursing Records , Patient Care Planning , Preoperative CareABSTRACT
The intraoperative period has long been the missing link in the chain of continuity of care for the surgical patient. An intraoperative clinical nurse specialist who is able to work with patients, families, and health care team members preoperatively, intraoperatively, and postoperatively can effectively bridge the gap in care. Nursing care given to patients in the O.R. should be no different qualitatively from nursing care given sedated and/or unconscious patients in other nursing units. The C.N.S. in the O.R. can help make such care a reality through giving care to patients and families as a role model, directing care as an expert through written care plans or physical presence, doing formal and informal teaching of patients, families, and staff, and through research. Operationalizing the role of the C.N.S. for surgical patients during the intraoperative period requires the specialist to move out of the O.R. to assess patients and families preoperatively and to evaluate the postoperative results of care. Implementation of the specialist role in the O.R. clinical nursing setting is accompanied by the same frustrations and problems met by master clinicians in other nursing specialty areas.
Subject(s)
Nurse Practitioners , Operating Room Nursing , Family , Nursing Care , Postoperative Care , Preoperative Care , ResearchABSTRACT
New graduate nurses today come to their first positions in nursing with varying knowledge bases and minimal clinical nursing skills. Gone are the days when new graduates begin functioning fully in a budgeted position on day one of employment. Mastery of psychomotor, cognitive, and affective skills necessary for nursing practice must be acquired through experience in the work situation. The more complex the clinical setting, the more stressful is the period of learning. The O.R. can be a highly stressful place. The need for anticipation, planning and organization to provide efficient care with meticulous attention to detail is coupled with the need to perform smoothly numerous technical skills. Safe, humanistic care cannot be implemented unless the nurse is also able to assess each patient's individual biopsychosocial status, and identify his unique nursing care needs. In order to learn to cope with this level of complexity, the neophyte nurse must be provided with a planned, supportive experiential learning situation that also provides the time necessary to achieve a beginning level of mastery. The program in Basic O.R. Nursing described here was one attempt to provide such an experience for new graduates.
