Periop Talk

At the foundation of any clinical relationship is trust: trust between clinicians and patients, trust among the interprofessional team members, and trust between a new hire and the preceptor. Building a trusting relationship between the new hire and preceptor takes time, but there are some things that a preceptor can do to develop the trusting relationship.

Be Explicit About Expectations
Expectations within nursing practice are often divided into two buckets: the written competency-based activities and the unwritten rules of practice. Quite different from nursing school curriculum, where grades are generated on very specific evaluation criteria, the OR requires new hires to integrate into the culture of daily practice that varies among services and surgeons. The idea that the same procedure can differ due to a surgeon’s preference for instruments is a concept with which new hires struggle.

Create Opportunities for Clinical Experiences
One of the most challenging aspects of precepting is entrusting clinical care to the new hire. Preceptors often find themselves in close proximity of the new hire because they cannot relinquish control of patient care, which presents challenges when the new hire is nearing the completion of the orientation period. Additionally, preceptors question whether or not the new hire is competent to practice independently and, therefore, can be entrusted with patient care.

Form an Environment of Feedback
New hires require feedback from their preceptors to correct behaviors and grow professionally. The preceptor should establish the frequency and format of feedback delivery, such as by summarizing feedback at the end of each shift, taking time to emphasize what went well and what needs improvement.

Create a Psychologically Safe Environment
Psychological safety, according to Edmundson and Lei, is the “perceptions of consequences of taking interpersonal risks in a particular context such as a workplace.”3 Psychological safety occurs when the orientee can anticipate how the preceptor gives feedback, responds to questions, and acts as a backup when the team asks specific questions regarding the procedure or care of the patient. Providing a structure for how feedback will be given and inviting the orientee to give feedback about the preceptor’s style of teaching can help create a psychologically safe environment, as can encouraging the orientee to ask questions in a place where others will not overhear the questions and make judgments about the orientee’s knowledge level. Another way for the preceptor to foster psychological safety is to stay close by the orientee, especially early in the orientation period, to help answer questions that team members may ask.

Take a look at written rules versus unwritten rules, action steps to develop clinical experiences, and download a feedback form at: https://www.aorn.org/the-stitch/article/building-trust-with-your-new-hire

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The physical design of the surgical suite should support safe patient care, efficient movement of patients and supplies, and workplace safety and security. The surgical suite includes the preoperative, intraoperative, and postoperative patient care areas and support areas, including central and satellite sterile processing areas, administrative areas, waiting areas, and staff areas. In this episode of Periop Talk Lisa Spruce, sr. director of evidence based perioperative practice at AORN, and Erin Kyle, editor-in-chief, guidelines for perioperative practice at AORN. give periop nurses a preview of the Design and Maintenance Guidelines changes and talk about why they are so important. 

Surgical smoke is the by-product of using energy-generating devices (e.g., electrosurgery units, powered surgical instruments), and it is full of carcinogenic and mutagenic cells. AORN speaks with Scott Hantz, a firefighter and perioperative director of nursing at the Miller Family Heart and Vascular Institute at the Cleveland Clinic, about the dangers of surgical smoke and how the AORN Center of Excellence in Surgical Safety: Smoke Evacuation program and Go Clear Award is making the OR a safer, healthier place to work. 

What are the three biggest changes to the Guideline for Medication Safety? It all depends on your facility, but labeling, hazardous medication and antibiotic oversight were three issues that really stood out to guideline author Julie Cahn, sr. perioperative practice specialist at AORN. Medication errors are preventable but continue to occur despite regulations, governmental resources and oversight, recommendations from professional organizations, and accreditation body standards. Elimination of medication errors is important because these errors can cause patient harm, reduced patient confidence in the health care system, and increased costs. 

Traveling nurses are here to stay. Join AORN President Vangie Dennis and Board Member Becca Vortman for a conversation with a staff nurse and a traveling nurse about how changing your approach to periop team culture can help ease challenges created by staff shortages and improve satisfaction.

What are the new assessment tools and how is technology helping us reduce surgical patient injuries? Hear about practice changes from the AORN Sr. Director of Evidence-Based Perioperative Practice Lisa Spruce. 

AORN President Vangie Dennis MSN, RN, CNOR, CMLSO speaks with Molly, a Millennial O.R. nurse-turned-clinical educator about how the “trophy generation” helped evolve perioperative teams - and the challenges and opportunities of a 5-generation workplace.

What are the biggest pros and cons of working among 5 different generations today? AORN President Vangie Dennis MSN, RN, CNOR, CMLSO speaks with Mary-Kate, a Gen Z periop nurse at a large New York hospital, about hurdles of being the youngest member of an OR team and challenging her generation’s stereotypes. 

AORN leaders, like perioperative nurses everywhere, agree food can be the highlight for celebrating Perioperative Nurses Week. Listen in as Board President Vangie Dennis, Vice President Darlene Murdock, and Board Director Megan Nolan share some additional ways to have fun, bond with colleagues, and connect with the community. Spoiler alert: they love the food, too!

#PeriopProud

AORN President Vangie Dennis MSN, RN, CNOR, CMLSO speaks with Wellstar Health System Assistant Vice President of Ethics, Advance Care Planning and Spiritual Health Jason Lesandrini MA, PhD(c), FACHE, HEC-C, LPEC about better preparing yourself to manage situations that go against the grain – from patient consent disputes to DNRs to unusual staffing ratios and more.

Going “against the grain” of our patient care training during COVID-19 created moral injury in nurses. But a body of evidence proves that using very simple strategies will help you manage how your body reacts to stressors – and they are techniques available to everyone. AORN President Vangie Dennis MSN, RN, CNOR, CMLSO has a conversation with periop nurse and mind-body medicine practitioner Dr. Margaret Below PhD, RN, NE-BC about the small, deliberate, and fundamental steps you can do every day in the perioperative suite – and at home – that relax and calm your body, and the reasons why these techniques work.  

AORN President Vangie Dennis MSN, RN, CNOR, CMLSO and periop nurse and mind-body medicine practitioner Dr. Margaret Below PhD, RN, NE-BC talk about micro-episodes of joy, gratitude and other simple, proven steps that will change how your body reacts and how you feel. They challenge nurses to try these two small steps over two weeks and see how they help you feel better.

The President’s Corner is a series of conversations between AORN President Vangie Dennis, MSN, RN, CNOR, CMLSO, and colleagues across the country about issues most important to AORN members and the perioperative community.

In Episode 1 “Nursing Uncharted – The Staffing Shortage” Vangie speaks with David Wyatt, PhD, RN, NEA-BC, CNOR,  past AORN President and Chief Nursing Officer of the University Hospitals at the University of Texas southwestern Medical Center in Dallas about what’s unique in today’s nursing shortage – and where do we go from here. Yes, shortages have been around in nursing for decades – but the pandemic has been a “great revealer” of deep-rooted issues that facilities need to address, from workplace violence to staffing flexibility. Hear ideas that are working today to change the staffing outlook. And hear why David is optimistic in the new generations of periop nurses.

June is Pride Month and, to help raise awareness around inequities in healthcare, transmale Nik Unterkircher, MA, UX/UI, DEI Practitioner at AORN, talks candidly with Vice President of Nursing, Renae Battie’, MSN, RN, CNOR. They discuss common challenges transgender patients face in the binary world that will help nurses more fully understand patient anxiety, the potential for misdiagnosis, and small steps nurses can take to improve the transgender patient’s experience.

The Joint Commission and AORN’s CEO Linda Groah discuss the challenges and solutions for an effective Time Out. Learn more. 

How do nurse leaders and their teams break through complex, chaotic, and broken systems – with widespread burnout – to transform their fast-paced hospitals and ASCs into sustainable caring cultures? 

Join us for AORN’s Fireside Chat, a live conversation about solutions to the most-asked question from perioperative nurses and leaders today: How do we rebuild from compassion fatigue, moral distress, and exhaustion – and create a place for perioperative teams to thrive? 

National nurse experts will discuss practical approaches that are helping meet the needs of five generations in the workforce, including Millennial and Gen-Z nurses who report that “wellbeing” is a top priority. 

Cleveland Clinic Director of Surgical Nursing Dena Salamon, MSN, RN speaks with AORN virtually about how her health system confronted and acted to prevent unintentionally retained surgical items across more than 50 ORs. Her advice: “Just do it.”

Leveraging technology to prevent the devastating impacts from RSI on your patients – and your staff – is easier than you think. “It really does enhance your workflow. I can’t imagine NOT using it,” says Cleveland Clinic Director of Surgical Nursing Dena Salamon, MSN, RN. Hear how and why her system chose to use technology to support the OR team.

Why are so many of America’s most-trusted professionals frustrated and angry – and what can we do to reconnect with our passion for nursing? A periop nursing conversation and live Q&A with Dr. Phyllis Quinlan, AORN CEO Linda Groah, and AORN President Holly Ervine.