Authors

  1. Seible, Barbara J. RN, CNOR, MSN

Article Content

The OR can provide a tremendous learning opportunity for nursing students. One of the most important elements to ensure a good rotation experience is clear communication. Students may fear that they're in the way and not know what they should do or how they can help. Briefly explain some of the basic OR suite procedures to the student: Proper OR attire, no food or drink in the OR rooms, layout of the surgical suite (unrestricted, semirestricted, and restricted areas), radiation protection during X-rays in the OR (lead aprons and thyroid shields), and infection control principles.

 

To help a student relax and feel welcome, introduce him or her to the OR team and briefly explain each team member's role. Relieve a student's fear of getting in the way by telling him or her where to stand during the case. This may vary depending on the type of procedure and equipment needed.

 

It's helpful to determine the student's level of knowledge and experience. Will the student be in the OR suite for a single case, 1 day, or for an extended clinical experience? Encourage students to ask questions and let them know the proper time to ask their questions, for example, wait until the anesthesia provider has intubated the patient and secured the airway before asking any questions.

 

Teaching about the OR

One goal for all students rotating to the OR is to increase their ability to function in a sterile environment, and many students require a lot of guidance in this area. It's important for the student to know the rationale behind the implementation and maintenance of sterile technique. It's also imperative that nurses reinforce the importance of following the Association of periOperative Registered Nurse's Perioperative Standards and Recommended Practices.1

 

Students scheduled for longer OR rotations may be assigned to the scrubbing role with an OR team member. The sterile technique principles learned during this time will be used for all future situations requiring sterile technique throughout the student's career. Offer a few tips about the principles of sterile technique: All items within the sterile field must be sterile, don't reach over the sterile field, unsterile persons may not touch items or areas of the sterile field, and consider all items or areas of doubtful sterility to be unsterile. This time also allows the student to work with basic instruments, learn the importance of their arrangement on the instrument tray or table, how to hand them to the surgeon, and proper care.

 

Throughout the case, additional teaching may include procedure specifics, such as a review of the patient's history, lab and X-ray results, rationale for implementation of safety principles related to the patient's status and procedure, skin assessment, legal aspects of identifying the patient, confidentiality and documentation, medications used, facts to communicate to another department, sharing the importance of the team's relationship, and how to implement stress management.

 

Positive attitudes

Finally, it's often the attitude of the staff that the students remember most. Keeping conversation positive is very important. Some nurses use their break or time after a case to share more about it with students. This is usually a more relaxed environment to ask questions. Depending on the individual surgical patient and procedure, it may not be possible during the surgery to spend very much time with the student, but students will appreciate an explanation, no matter how brief, as they're not always able to understand the seriousness of the procedure or status of the patient. OR

 

REFERENCES

 

1. Conner R, Reno D, eds. Perioperative Standards and Recommended Practices. Denver, CO: AORN Inc; 2008. [Context Link]