Saturday, March 27, 2010

Precepting A New Nurse Resident In The OR

Does your operating room offer a nurse residency program for nurses wanting to work in the operating room? It's an exciting adventure to be sure. I work at UNC Hospital in the operating room. There is a good nurse residency program there. Experienced nurses, as well as new graduate nurses, are accepted into the course. The first few weeks are all classroom. Subjects include sterile technique, instrumentation, sterilization, and just about anything associated with the operating room's daily routines. After the nurse residents complete the classroom portion, they start the clinical portion of the program. I am a primary preceptor for the clinical portion of the nurse residency program. A new group has just started the clinical phase of their training.

As a preceptor, I try to take the first day to learn about the needs and educational desires of the trainee. It does me no good to use visual cues if they are a tactile learner. I ask them to give me a list of things they think are important for them to learn the first day and we go from there. I stress the importance of patient care and safety. I teach them that their focus is the patient, not the computer. Unfortunately, they are so locked in on the charting, that the patient becomes secondary at times. I work on this all day the first day. I think positive reinforcement is an essential tool to teaching.

There is so much to learn in the OR. I remind each student I have that they are not going to learn everything in a day, week, or month. I tell them that I have been in the OR for 28 years and I am still learning. With all the changes that occur in surgical procedures and equipment, learning is a constant process in the OR.

Our nurse residency program is not long enough, in my opinion. Each new resident only gets three weeks in each specialty. The first week is circulating, the second week is scrubbing, and the third week is the choice of the resident as to whether they want to scrub or circulate. Now my specialty is General Surgery and Urology. General surgery has General GI surgery, Surgical Oncology, and Trauma. Urology can be broken into several categories as well. There are open cases, Robot cases, and cysto. It is very difficult to cover these 4 arenas of surgery in just 3 weeks. My personal opinion is that these new residents should get 3 weeks in each of these surgical specialties, but I don't make that decision.

My priorities for teaching include patient safety, patient comfort, prioritization of tasks, maintaining the sterile field, and the importance of accurate documentation. I stress to each nurse resident that it will take them about a year before they start to become confident in their skills. I encourage them to establish a routine that helps them remember the steps to take in starting a case. I instruct them in the things they need to do for a case regardless of the specialty. There are certain things you do all the time.

1 comment:

  1. Beth,
    I am a Perioperative Educator in PA. RN's are required to have one year of medical- surgical experience before coming to the OR in our facility. Our orientation is six months long with rotation throughout all specialties. I cover all the basics with the RN's as well during the first week in combination with review on the unit. The RN's begin with the circulating role and eventually the scrub role in most of the specialties. We have found that some specialties require more time than others and have adjusted our orientation schedule to provide the RN's with the skills they need.
    I agree with you in respect to the amount of information that OR nurses are required to know. I too tell the nurses that they will not be comfortable until at least a year after orientation. We never stop learnign in the OR, especially with the constant changes in technology!