1. Section Editor(s): Thompson, Elizabeth M. MSN, RN, CNOR

Article Content

Creating a safe environment is a primary focus in perioperative nursing, and it can be reasoned that the foundation of a safe environment is built on the relationships within the surgical team. I regularly see information focusing on the development of leadership skills and techniques. This may be oversimplified, but as I see it, it's leadership's primary purpose to promote a safe environment. Building relationships with the staff is an integral piece of creating the desired environment.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

Knowing the "front lines"

Intentional rounding is a technique that I've recently read about and is defined as a scheduled, routine, and purposeful walk through the organization (or in the case of the surgical suite, from OR to OR). The purpose of these rounds is to gain a better understanding of the practice at the "front lines," increase visibility and engagement of the leadership team, promote communication, and to show interest in the challenges the staff face.1


As an educator, I find it invaluable to conduct rounds on a routine basis and have made it a part of my daily practice. In addition to helping rooms get started in the morning, it's an opportunity to identify educational issues, promote communication, and to be accessible to staff. Furthermore, there may be value in going to the staff instead of having team members actively seek out leadership.


Staff may be skeptical at first, so communicating the intent of rounding and expectations sets the tone for positive experiences. Leaders can unintentionally draw lines between themselves and the staff. Routine rounding promotes collaboration with all staff members. In the OR-where the teams are multidisciplinary-it's an opportunity for leadership to engage with all of the disciplines, support practice, and provide clarification of the facility's policies and procedures.


Altering the approach

After reading more about intentional rounding, I decided to change my approach by making it more intentional. Instead of going into each room and asking team members if they needed any help, I added this question: "Do you have any questions or issues you would like addressed?" Although the change in approach was minor, the outcomes were significantly different. Staff became more thoughtful about asking practice issues or any other concerns. Using thought-provoking questions triggers the staff to think about their practice and gives them the opportunity to clarify.


Timely follow up

It's important to support the staff through timely follow up of the questions and issues they've identified during rounding. This helps to develop personal and professional relationships and promotes trust. Intentional rounding can be a valuable tool in the arsenal of the perioperative nursing leader. Building relationships encourages staff to speak up and increases overall involvement and engagement, culminating in a safer environment for all.


Elizabeth M. Thompson, MSN, RN, CNOR

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

Editor-in-Chief Nursing Education Specialist Mayo Clinic, Rochester, Minn. ORNURSE@WOLTERSKLUWER.COM




1. Marshall DA.Best Practice: leadership rounding on the front lines. 2013. [Context Link]