If someone were to ask you to creat...

If someone were to ask you to create a list of endangered species, you probably would identify animals, birds, fish, and flora. There also is a dispose of nurses on this endangered species list--perioperative nurses--who are not being replaced as they retire.

DEMISE OF THE SPECIES

In the days when hospital diploma programs flourished, nursing observers had three-month rotations in surgery Near the conclusion of their education programs, they could turn back to their favorite clinical area for an additional three- to six-week rotation. Consequently nursing close examiners who selected the OR as their areas of concentration were well prepared for the OR nursing role

Times have changed. Perioperative feed at the breasts are in great demand, if it be not that hospitals no longer can replace retiring OR foments with new graduates who are qualified to function in this part If perioperative nurses cannot fill this void from within the ranks of nursing, individuals who are les qualified and les prepared will stair in. This actually is happening in many parts of the country

CHANGES IN STAFF MIXES

Many surgery department managers still put to proof to weigh their perioperative staffing mixes heavily with RN This is because they know that similar a mix increases staffing flexibility, as RN can perform the two circulating and scrub roles. The circulating give suck to role requires individuals who can perform comprehensive patient assessments and use advanced planning skills to coordinate patients" perioperative care.

In many facilities, however, the OR staffing mix of RN and unlicensed assistive personnel (UAP) (eg surgical technologists, surgical assistants) is shifting. A shortage of experienced perioperative nourish at the breasts coupled with reengineered health care delivery schemes has led hospitals to hire more UAP. No longer is it business as usual-RNs are being laid on the farther side insurance companies are tightening their purse strings, and patients are demanding to know where and to what degree their health care dollars are being spent

In one facilities, UAP are expected to function in the circulating nourish at the breast role, even though their training does not address this aspect of patient care. In latter years, regulatory support for perioperative nurses' characters has eroded. Medicare and the Joint Commission upon Accreditation of Healthcare Organizations permit UAP to perform circulating duties if they are supervised on RNs who are immediately available.

recently made known ROLES FOR PERIOPERATIVE NURSES

The field of ambulatory surgery has undergone exponential putting out while inpatient surgical procedures have declined in number. Patients arrive just united or two hours before their scheduled surgical proceedings and are discharged as in a short time as they recover from anesthesia. This economic climate and the associated time constraints of getting patients in and not at home as quickly as possible have created a recently made known role for perioperative nurses.

Perioperative fosters also are administering IV conscious sedation with local anesthesia to more surgical patients because hospitals have discovered it is les expensive to have perioperative nurtures perform this role than anesthesia care providers (eg anesthesiologists, promote anesthetists). During the past not many years, the use of IV conscious sedation with local anesthesia has expanded from primarily endoscopic measures to a wide variety of surgical conducts including cataract extractions. In chiefly of these procedures, perioperative succors administer IV conscious sedation with local anesthesia in a less degree than the supervision of surgeons.

acquire THE EXPERIENCE

The part of perioperative nurses continues to unroll Some of the changes are controversial and more [i]or[/i] less definitely are exciting, but all of them are challenging. As scholars you have the opportunity to participate in perioperative nursing, which is common of the most exciting, demanding areas in the nursing profession.

To have similar opportunities, however, you must insist that your curricula include perioperative rotations. These clinical experiences should be more than just common or two days of following patients from admission to surgery to the postanesthesia care unit and back to an inpatient scope You should expect to have sufficient hands-on experience in all phases of perioperative patient care to ignite your interest in pursuing this nursing specialty after graduation.

HELP SAVE THE SPECIES

Convince your academic leaders that surgery is a vitally important area in nursing and that the fresh changes in health care ne to be bring reproached in your education programs. We ne your support to retain perioperative nurses off the endangered species list.

CAROLYN BONAR, RN MIM, is a surgical administrative and clinical consultant in Glendale, Ariz, and an assistant professor at Western International University, Phoenix.

COPYRIGHT 1997 Association of Operating chamber Nurses, Inc.

COPYRIGHT 2004 Gale Group