Student Nurses in the Peri-Operative Areas

Many hospitals allow student nurses to rotate through their peri-operative units, including pre-op centers, watching a surgical procedure, and patient care in the post-operative (PACU) setting. Students are excited about these experiences, and peri-operative staff can have a significant impact on the quality of their experience and the knowledge they will take with them into their careers. An experienced nurse mentor has a bounty of insight to offer a student, bridging the theory of the classroom to actual practice and assisting the student to make the critical transition from knowledge to application. However, many peri-op nurses struggle with student mentoring as they are also meeting specific unit goals and turnaround times.

For many peri-operative nurses, nursing school is a distant memory. With nursing programs in constant change, staff may not be comfortable with mentoring these students, instead relegating them to the periphery to merely watch and greatly diminishing their experience. Our purpose with this opinion piece is to offer our experiences as nurse educators to assist staff nurses to have a positive role in shaping the next generation of nurses.

Nursing programs vary resulting in student nurses having a wide variety of learning needs, skills, and restrictions. Most have demonstrated and passed competencies such as medication administration, urinary catheter placement, peripheral intravenous (IV) placement, and therapeutic communication through their courses, and are ready for hands on assessment, planning, and interventions. It is appropriate to ask the student for their list of skills and procedures that they are permitted to perform, and for what skills their clinical instructor needs to be present. Schools also differ in guidelines for their students, such as some do not allow their students to administer controlled substances, so do not assume that every student can perform the same task.

A common misconception is that the student is working “under” the license of their clinical faculty. Since clinical faculty are most often not employed by the clinical site, they may not be familiar with specific facility policies, and cannot be with every student for every procedure. Therefore, the staff RN should assure that what the student is doing matches what they would be doing. Think of the students as an extension of your own hands, or an extra pair of hands. When I am mentoring a student as a staff nurse, I stay with the student for assessments, observe and sign all documentation, and observe all medication prep and administration. I do allow the student to do as much hands on psychomotor learning as possible, such as placing EKG leads, head to toe assessments, using IV pumps, teaching use of incentive spirometer, and assessing efficacy of pain and nausea management. Utilizing clinical judgement, practicing prioritization, delegation, and communication are major student objectives that are focused on during their programs. Even if the students do not do these directly, their RN can have them state what they would do and receive appropriate feedback.

Finally, acknowledging what they do well will encourage and motivate students. When the students feel capable, they will absorb more and enjoy the process. In addition, their confidence will grow, and they will have a higher level of engagement in school and in practice. Remember, all perioperative nurses were once students and mentoring these students will benefit our profession in the future. Using these techniques have resulted in many positive student outcomes. Students share with us that they were able to learn and apply theory, had a great day, and end their experience excited about their chosen profession.

Jessica Gentes, MSN-L, RN, BSN, CPN

Jennifer Nopoulos, MSN-Ed, RN, CPAN

Jessica Gentes and Jennifer Nopoulos are AzPANA board members, certified PACU RNs, and faculty for nursing undergraduate and graduate programs in Arizona.

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