New elective gives nursing students hands-on experience in the perioperative environment

Perioperative nurses care for patients before, during, and after surgery, but few nursing students are exposed to the specialty as undergraduates. Clinical assistant professor Dr. Donna Guerra is hoping to change that with a new elective offered by UAH’s College of Nursing.

UAH College of Nursing

Though it is the surgeon who actually operates during surgery, it is the perioperative nurses who provide the care before, during, and after. Their many responsibilities include everything from assisting patients with their admission to the surgical ward to monitoring them during and after the surgery to educating them about caring for and recovering from their surgical procedure. In short, these specialists are essential to the process. And yet, the demand for them has never been higher. As more and more perioperative nurses near retirement, the U.S. Bureau of Labor Statistics has forecast an increase of nearly 20% in the perioperative nursing job outlook by the year 2022.

To answer this demand, the College of Nursing at The University of Alabama in Huntsville (UAH) has introduced a new perioperative nursing elective comprising 15 hours of theory and 90 hours of clinical experience. The five-week course immerses students in the perioperative nursing environment, where they learn about the concepts relevant to operative and anesthesia standards of care. Upon completion, they are expected to be able to identify the role and responsibilities of perioperative nurses, as well as the components of the nursing process into the perioperative experience; incorporate the concepts of pain, physiological effects of surgical intervention, safety, cultural, and ethical decision-making; apply the principles of aseptic technique in the perioperative environment; discuss the process of disinfection/sterilization of surgical instrumentation and equipment; describe aspects of safety in the perioperative setting; and evaluate and interpret data metrics related to quality issues in perioperative nursing. They also become automatically eligible to precept in the Operating Room (OR) or the Post-Anesthesia Care Unit (PACU) on the Decatur Morgan Hospital’s main campus.

Seven students, pictured with Dr. Guerra (far left), completed the first iteration of UAH’s new perioperative nursing elective.

UAH College of Nursing

The elective is the brainchild of Dr. Donna Guerra, a clinical assistant professor in the College of Nursing. As a former perioperative nurse herself, she was familiar with the amount of work and dedication needed to specialize in the field. "For someone to go into OR after they’ve become a nurse, it takes a least a year of on-the-job training for them to be independently functional," she says, adding that, even then, there’s no guarantee they’ll stay. "It’s a high stress area, long hours, call, so they’ll get there and realize it’s not for them." By introducing the specialty to nursing students at the undergraduate level, however, she is hopeful they will be able to determine ahead of time whether or not they are interested in pursuing it as a career. "If you can expose students to the environment from the beginning, that’s a huge advantage – to the student and the hospital," she says.

With the backing of the College’s dean, Dr. Marsha Howell Adams, Dr. Guerra reached out to Decatur Morgan Hospital, where she had worked in the past and was familiar with the hospital’s inclusive work environment. "They were immediately on board," she says. Even better, they were fully supportive of the elective’s emphasis on actual, real-world experience that would allow the students to get an accurate understanding of the specialty’s demands. "Typically nursing students can go to the OR, but they can’t do hands-on activities – they’re in a corner watching," she says. "Because this is a clinical immersed in the setting, they can actually put their hands on the patient and work side by side with a nurse and a faculty member." The hospital also agreed to provide two OR preceptor spots and one PACU preceptor spot for students who completed the elective. "As a rural hospital, recruiting can be difficult," she says. "So they saw the benefit of this as a potential recruiting possibility."

The course was introduced for the first time this past summer, and the feedback from both the students and the hospital staff was positive. "The students loved it. Five of the seven said they were very likely to want to precept at the hospital’s main campus, which is huge in terms of recruitment," says Dr. Guerra. "I also did a survey of the nurses who worked with the students and most said they were very likely to want a student to precept. The results were really great." Now she is looking ahead to incorporating new, high-tech elements into future iterations of the course. "There are some big plans for simulation next time," she says, "like a full-scale one with a surgeon coming in and operating on a SynDaver Labs surgical model, which is a full-body surgical synthetic cadaver."

She’d also like to extend the course to more students, but given the challenge of juggling so many schedules – her own, the students’, and the hospital’s – that might have to wait. "This was my first elective and it took a year to do it," she says. "We’re just testing the waters!"