My Advice on Becoming a Safe and Competent Perioperative Nurse

I am an educator at Atrium Health Pineville, which is a busy, growing 12-bed OR in Charlotte, NC. We have new Periop 101 students every March and August, so I am often assisting students and preceptors with how to handle both clinical and nonclinical situations. One of the common questions I am asked by novice nurses is, “When will I know everything I need to be a safe and competent perioperative nurse?” Here is how I respond to those nurses.

Feeling like you do not know everything can be extremely concerning and cause stress and anxiety. First and foremost, I want to tell you that these feelings are normal. In fact, you won’t ever know everything because you learn something new every day. Let me share my own personal story about being new and gaining confidence.

I was an expert ICU nurse, and when I transferred to the OR, I became a novice nurse again. I had no idea how to care for the perioperative patient. I could help anesthesia because I knew drips and lines, but I did not know much about anesthetic meds. I thought I would never understand or learn all the positioning, equipment, and instruments that I needed to know when working in the OR. After about a year, I began to feel more confident with the aid of my mentors and preceptors. I realized I was confident during my fifth year as a perioperative nurse as I continued to learn the procedures in the CVOR where I worked. Once I began participating in my local AORN chapter and attending conferences and seminars, my confidence grew even more. Yours will too. Be patient with yourself and glean all that you can from your preceptors and mentors.

A Few Tips

Keep in mind that every case has the following elements: equipment, bed setup, positioning needed, and instrumentation. What changes is the procedure and how you set up those items for that procedure. Your preference cards are your “care plan” for that procedure—use them. Take your own notes to reference and help you remember specifics.

Here are just a few other items to throw in your tool kit to help increase your knowledge and confidence:

• Keep a notebook for notes about your cases.
• Take photos of the setups with your phone to review later to prepare for the next case.
• Get a copy of Alexander’s Care of the Patient in Surgery, which is an excellent resource to review procedures, instrumentation, and the perioperative nurse’s role.
• Share what you have learned from a specific case or event with your peers and ask them to share what they have learned.
• Join AORN (or maintain your AORN membership), become active with your local chapter, and take advantage of educational opportunities to stay informed about guideline updates and new processes and procedures.
• Get a copy of the AORN Guidelines for Perioperative Practice or borrow the one on your unit.
• Continue to seek advice from your mentors and peers and identify new learning opportunities, such as learning the scrub role or to circulate more advanced procedures.

AORN Resources

If your facility has a subscription to eGuidelines+, you can access:

• Guidelines for Perioperative Practice | AORN eGuidelines+
• Instruments at a Glance | AORN eGuidelines+
• Positioning at a Glance | AORN eGuidelines+
• Procedures at a Glance | AORN eGuidelines+
• Room Setup at a Glance | AORN eGuidelines+
• Skin Prep at a Glance | AORN eGuidelines+