AORN education
What students ask about work in the OR One of the many functions of a professional specialty nursing organization like AORN is recruitment of practitioners into its specialty area. At AORN Headquarters, we receive many letters requesting information about possible careers in OR nursing. Two of the most frequently asked questions are “What does a nurse in the operating room do?” and “Does one really need to be a registered nurse to work in the operating room?” The next most frequent questions regard the job market for nurses, schools for specialization, and financial aid available for students. Most of our inquiries are from high school students and student nurses investigating possible career areas. The rest of the inquiries come from interested friends, family, and nurses who are helping students make a career choice. For our members who are interested in recruitment of nurses for the operating room, the following information has been compiled to pass on to inquiring students. Job picture for nurses. The present employment picture for nurses is fairly bright. There appears to be a continuing shortage of practicing nurses to meet the ideal nurse-topopulation ratio established by the US Department of Health, Education, and Welfare.’ Some estimates indicate that the shortage will increase to 20.6% by 1980.’ More positions are now available in the south and north-central portions of the United States than in the Northeast and populated coastal areas.
gbJl
Salaries at a national average for nurses range from $709 to $876 per month for all categories of new graduate nurses as reported for 19741975~.~ Specialty educational programs. Most nurses working in the operating room are prepared in individual hospital in-service programs or on-the-job programs. AORN attempts to maintain a list of schools or programs that offer this kind of preparation, and this list is available to interested persons. Approximately 20 programs are known, ranging from basic ones to more advanced management preparation programs4 Financial aid. The best place to begin for a student seeking financial aid is with the financial aid officer at the particular school where he or she applies for admission. This individual is usually the most knowledgeable about what is available and where to apply. The National League for Nursing publishes a pamphlet entitled Scholarships and Loans for Beginning Education in Nursing.5 This pamphlet lists many sources of financial assistance for students preparing to become registered nurses and includes information on general education loans and scholarships for colleges and vocational schools. Requirements for becoming an operating room nurse. The basic preparation for a nurse to work in the operating room is completion of a general nursing education program. This can be at the associate degree level through a junior college, the traditional hospital-based diploma level, or the baccalaureate level through a senior college or university. These programs differ in focus, emphasis, and length of time required for completion. All prepare nurses for beginning practice, although the preparation for teaching, supervision, man-
AORN Journal, June 1978, Vol27, No 7
1277
agement, specialization, and for career mobility and career options varies with each type of program. After completion of a basic program to qualify to take the licensure examination to function as registered nurse, the student then must attend a postgraduate program in OR nursing or receive the appropriate experience in a hospital in-service or on-the-job program for acquisition of the skills necessary to work as a nurse in the operating room. Nursingin the operatingroom. Students are often confused about the role of nurses in the operating room. They frequently see it as primarily technical, rather than nursing. These are some of the points you might want to cover in discussing operating room nursing with students. Nurses in the operating room are professional nurses first. They apply basic nursing principles along with specializedknowledge in the controlled environment of the operating room. The focus is the patient and the assistance the nurse is able to provide. The nurse’s interaction with the patient is designed to utilize available resources to provide positive patient outcomes within the patient’s unique situation. Although the role may be intensely focused on the intraoperative phase, the nurse functions through the preoperative,intraoperative, and postoperative periods to provide continuity of care. To provide this important link in the continuous cycle of patient care, the nurse in the operating room begins with preoperative assessment of the patient. This initial assessment may include the patient’s family or significant others and is performed to meet the .needs of the patient by planning nursing care for his unique situation. The nurse may be required to supervise others in the operating room to implement the plan of care devised from the preoperative assessment. The categories of personnel may range from students, technicians, and aides to other registered nurses. Supervision needed to maintain the environment in which the surgical intervention occurs may range from temperature control to overseeing sanitation techniques to control and storage of sterile items. The nurse must possess the theoretical and practical skills in this wide range of areas. Manipulative skills and physical dexterity are also important. Nursing in the operating
1278
room requires knowledge both of sophisticated technology and of the physical, natural, and behavioral sciences. The nurse must be able to perform these highly technical functions, for only tools that are properly used can produce the best results for the patient. Teaching functions are a large portion of the duties of the OR nurse. The employment of the principles of teaching and learning is necessary in the supervisionof others in giving care. The nurse is the role model for student nurses who rotate to the operating room.The teaching of paraprofessionalsis a daily activity through maintenance and enforcement of principles and practices. As a segment of teaching, consultation to staff nurses in planning the preoperative and postoperative regimens of care is a link in providing total patient care. The intensive team relationship and the time limit of the surgical interventionmake the working relationships demanding on the nurse in the operating room. The day-to-day and hourto-hour stress of responsibilityfor patient care in a critical situation makes the environment of the operating room highly stressful. Nurses in the operating room are caring for patients in crisis or who are suffering bodily loss or critical illness. A high degree of stamina and interpersonal competence are also required in dealing with patients in altered states of consciousness produced by anesthesia or medication. Skills needed by the nurse in the operating room include a good understanding of the communication process since surgery is a team function, each member contributing his own expertise. The responsibilityof the nurse is to coordinate and maintainthe surgical environment and interactions. Your prospective students may want to know what attracts most nurses to the operating room? With honest appraisal, a large number of nurses may be attracted by the use of tools and technological gadgets used in day-to-day situations. A student once remarked that the nurse in the operating room required an unusually high expertise to function efficiently in providing patient care because of the highly complex equipment used. Along with the technology, however, should be warmth and concern for the patient as an individual. The nature of surgical intervention is such that immediate results are visible and the pa-
AORN Journal, June 1978,Vol27, No 7
tient’s prognosis for recovery is usually established before he leaves the operating room. The contribution of the nurse to the total team functioning is identifiable and necessary for successful patient outcomes. How then does nursing in the operating room differ from nursing in other areas? When one removes the specialized knowledge, the role function is basically the applicationof nursing in a different environment. We need to actively support nursing students to pursue careers in the operating room. One way to do this is to remove the mystery from the OR nurses’ functions. Being able to present informationsuch as this to studentswe counsel could be critical in our recruitment efforts.
Notes 1. Stuart H Altman, Presentand Future Supply of RegisteredNurses, DHEW publication(NIH) 72-134 (Washington, DC: US Government Printing Office, 1971) 156. 2. Patricia M Nash, Evaluation of Employment Opportunitiesfor New LicensedNurse, DHEW publication (HRA) 75-12 (Washington,DC: US Government Printing Office, 1975) 63. 3. Facts About Nursing 74-75 (Kansas City, Mo: American Nurses’ Association, 1976) 104. 4. Patricia Knowles, Mary E Crawford,Rosemary Bercham, “Three approaches to specialty courses OR nursing,” AORN Journal 24 (November 1976) 900-930. 5. Scholarshipsand Loans for Beginning Education in Nursing (New York: NationalLeague for Nursing, 1976).
Bradley J Manuel, RN, MS AORN program specialist
Recommended national standards policy A recommended national standards policy for the United States has been releasedfor public review and comment by the National Standards Policy Advisory Committee (NSPAC). One major objective is to establisha cooperative relationshipbetween government and the private sector to ensure that the nation’s needs for standards are competently met using due process principles. The United States has considerable public and private capability for developing standards. What it lacks, the Committee believes, is a national policy to ensure that these resources are used most effectively, economically, and equitably in the national interest. Absence of an agreed-upon policy may well be the reason for some dissension that has occurred in this field in the last few years. According to NSPAC, the recommended policy is a reasonablestart toward a nationally accepted standards policy. It delineates due process criteria to be observed in national standards writing activities, emphasizes the need for cooperation between the public and private sectors, and defines a recommended role for each in standards activities in general and in those activities applicable to health, safety, and the environment. Establishment or
1280
identification of standards coordinating centers in government and in the private sector is recommended. So are mechanisms for initial and final appeals. Other policy provisions cover funding of consumer and small business participation in standardization, performance standards, technological innovation, and forecasting and measuring effects of standards. NSPAC is an independent group comprised of some 30 representatives of government, organized labor, public interest groups, trade associations, industry, professional societies, standards writing bodies, testing laboratories, and consumers. The American National Standards Institute (ANSI), the coordinator of the voluntary standards system in the United States, initiated the policy development program in 1977. ANSI did not provide any policy guidance and is not directly representedon the committee. Funding came from more than 50 organizations, and expenditures are controlled by NSPAC. To be effective, a national standards policy must be accepted by affected interests. NSPAC is using every available means to obtain the widest possible public review and comment on the recommended policy to prepare a final document that will represent a broad national consensus.
AORN Journal, June 1978, Vol27, No 7
What students ask about work in the OR One of the many functions of a professional specialty nursing organization like AORN is recruitment of practitioners into its specialty area. At AORN Headquarters, we receive many letters requesting information about possible careers in OR nursing. Two of the most frequently asked questions are “What does a nurse in the operating room do?” and “Does one really need to be a registered nurse to work in the operating room?” The next most frequent questions regard the job market for nurses, schools for specialization, and financial aid available for students. Most of our inquiries are from high school students and student nurses investigating possible career areas. The rest of the inquiries come from interested friends, family, and nurses who are helping students make a career choice. For our members who are interested in recruitment of nurses for the operating room, the following information has been compiled to pass on to inquiring students. Job picture for nurses. The present employment picture for nurses is fairly bright. There appears to be a continuing shortage of practicing nurses to meet the ideal nurse-topopulation ratio established by the US Department of Health, Education, and Welfare.’ Some estimates indicate that the shortage will increase to 20.6% by 1980.’ More positions are now available in the south and north-central portions of the United States than in the Northeast and populated coastal areas.
gbJl
Salaries at a national average for nurses range from $709 to $876 per month for all categories of new graduate nurses as reported for 19741975~.~ Specialty educational programs. Most nurses working in the operating room are prepared in individual hospital in-service programs or on-the-job programs. AORN attempts to maintain a list of schools or programs that offer this kind of preparation, and this list is available to interested persons. Approximately 20 programs are known, ranging from basic ones to more advanced management preparation programs4 Financial aid. The best place to begin for a student seeking financial aid is with the financial aid officer at the particular school where he or she applies for admission. This individual is usually the most knowledgeable about what is available and where to apply. The National League for Nursing publishes a pamphlet entitled Scholarships and Loans for Beginning Education in Nursing.5 This pamphlet lists many sources of financial assistance for students preparing to become registered nurses and includes information on general education loans and scholarships for colleges and vocational schools. Requirements for becoming an operating room nurse. The basic preparation for a nurse to work in the operating room is completion of a general nursing education program. This can be at the associate degree level through a junior college, the traditional hospital-based diploma level, or the baccalaureate level through a senior college or university. These programs differ in focus, emphasis, and length of time required for completion. All prepare nurses for beginning practice, although the preparation for teaching, supervision, man-
AORN Journal, June 1978, Vol27, No 7
1277
agement, specialization, and for career mobility and career options varies with each type of program. After completion of a basic program to qualify to take the licensure examination to function as registered nurse, the student then must attend a postgraduate program in OR nursing or receive the appropriate experience in a hospital in-service or on-the-job program for acquisition of the skills necessary to work as a nurse in the operating room. Nursingin the operatingroom. Students are often confused about the role of nurses in the operating room. They frequently see it as primarily technical, rather than nursing. These are some of the points you might want to cover in discussing operating room nursing with students. Nurses in the operating room are professional nurses first. They apply basic nursing principles along with specializedknowledge in the controlled environment of the operating room. The focus is the patient and the assistance the nurse is able to provide. The nurse’s interaction with the patient is designed to utilize available resources to provide positive patient outcomes within the patient’s unique situation. Although the role may be intensely focused on the intraoperative phase, the nurse functions through the preoperative,intraoperative, and postoperative periods to provide continuity of care. To provide this important link in the continuous cycle of patient care, the nurse in the operating room begins with preoperative assessment of the patient. This initial assessment may include the patient’s family or significant others and is performed to meet the .needs of the patient by planning nursing care for his unique situation. The nurse may be required to supervise others in the operating room to implement the plan of care devised from the preoperative assessment. The categories of personnel may range from students, technicians, and aides to other registered nurses. Supervision needed to maintain the environment in which the surgical intervention occurs may range from temperature control to overseeing sanitation techniques to control and storage of sterile items. The nurse must possess the theoretical and practical skills in this wide range of areas. Manipulative skills and physical dexterity are also important. Nursing in the operating
1278
room requires knowledge both of sophisticated technology and of the physical, natural, and behavioral sciences. The nurse must be able to perform these highly technical functions, for only tools that are properly used can produce the best results for the patient. Teaching functions are a large portion of the duties of the OR nurse. The employment of the principles of teaching and learning is necessary in the supervisionof others in giving care. The nurse is the role model for student nurses who rotate to the operating room.The teaching of paraprofessionalsis a daily activity through maintenance and enforcement of principles and practices. As a segment of teaching, consultation to staff nurses in planning the preoperative and postoperative regimens of care is a link in providing total patient care. The intensive team relationship and the time limit of the surgical interventionmake the working relationships demanding on the nurse in the operating room. The day-to-day and hourto-hour stress of responsibilityfor patient care in a critical situation makes the environment of the operating room highly stressful. Nurses in the operating room are caring for patients in crisis or who are suffering bodily loss or critical illness. A high degree of stamina and interpersonal competence are also required in dealing with patients in altered states of consciousness produced by anesthesia or medication. Skills needed by the nurse in the operating room include a good understanding of the communication process since surgery is a team function, each member contributing his own expertise. The responsibilityof the nurse is to coordinate and maintainthe surgical environment and interactions. Your prospective students may want to know what attracts most nurses to the operating room? With honest appraisal, a large number of nurses may be attracted by the use of tools and technological gadgets used in day-to-day situations. A student once remarked that the nurse in the operating room required an unusually high expertise to function efficiently in providing patient care because of the highly complex equipment used. Along with the technology, however, should be warmth and concern for the patient as an individual. The nature of surgical intervention is such that immediate results are visible and the pa-
AORN Journal, June 1978,Vol27, No 7
tient’s prognosis for recovery is usually established before he leaves the operating room. The contribution of the nurse to the total team functioning is identifiable and necessary for successful patient outcomes. How then does nursing in the operating room differ from nursing in other areas? When one removes the specialized knowledge, the role function is basically the applicationof nursing in a different environment. We need to actively support nursing students to pursue careers in the operating room. One way to do this is to remove the mystery from the OR nurses’ functions. Being able to present informationsuch as this to studentswe counsel could be critical in our recruitment efforts.
Notes 1. Stuart H Altman, Presentand Future Supply of RegisteredNurses, DHEW publication(NIH) 72-134 (Washington, DC: US Government Printing Office, 1971) 156. 2. Patricia M Nash, Evaluation of Employment Opportunitiesfor New LicensedNurse, DHEW publication (HRA) 75-12 (Washington,DC: US Government Printing Office, 1975) 63. 3. Facts About Nursing 74-75 (Kansas City, Mo: American Nurses’ Association, 1976) 104. 4. Patricia Knowles, Mary E Crawford,Rosemary Bercham, “Three approaches to specialty courses OR nursing,” AORN Journal 24 (November 1976) 900-930. 5. Scholarshipsand Loans for Beginning Education in Nursing (New York: NationalLeague for Nursing, 1976).
Bradley J Manuel, RN, MS AORN program specialist
Recommended national standards policy A recommended national standards policy for the United States has been releasedfor public review and comment by the National Standards Policy Advisory Committee (NSPAC). One major objective is to establisha cooperative relationshipbetween government and the private sector to ensure that the nation’s needs for standards are competently met using due process principles. The United States has considerable public and private capability for developing standards. What it lacks, the Committee believes, is a national policy to ensure that these resources are used most effectively, economically, and equitably in the national interest. Absence of an agreed-upon policy may well be the reason for some dissension that has occurred in this field in the last few years. According to NSPAC, the recommended policy is a reasonablestart toward a nationally accepted standards policy. It delineates due process criteria to be observed in national standards writing activities, emphasizes the need for cooperation between the public and private sectors, and defines a recommended role for each in standards activities in general and in those activities applicable to health, safety, and the environment. Establishment or
1280
identification of standards coordinating centers in government and in the private sector is recommended. So are mechanisms for initial and final appeals. Other policy provisions cover funding of consumer and small business participation in standardization, performance standards, technological innovation, and forecasting and measuring effects of standards. NSPAC is an independent group comprised of some 30 representatives of government, organized labor, public interest groups, trade associations, industry, professional societies, standards writing bodies, testing laboratories, and consumers. The American National Standards Institute (ANSI), the coordinator of the voluntary standards system in the United States, initiated the policy development program in 1977. ANSI did not provide any policy guidance and is not directly representedon the committee. Funding came from more than 50 organizations, and expenditures are controlled by NSPAC. To be effective, a national standards policy must be accepted by affected interests. NSPAC is using every available means to obtain the widest possible public review and comment on the recommended policy to prepare a final document that will represent a broad national consensus.
AORN Journal, June 1978, Vol27, No 7
