The IOM Report on the Future of Nursing: What Perioperative Nurses Need to Know

The 2010 Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health, continues to be the most-viewed report in IOM history. Nearly three years after its publication, there are action coalitions of nursing and non-nursing agencies in 50 states and the District of Columbia collaborating to move the eight recommendations for action forward. There is much work to do to reshape health care delivery in the United States, and the IOM has identified nurses as key leaders in driving the reform. Every nurse must be educated on the key messages of the IOM report and become involved in moving these recommendations forward as well as in educating others on what needs to be done. AORN and perioperative nurses have a key role in voicing the unique needs of perioperative patients and in ensuring that perioperative patient care is represented in reform activities.     

Stories from the operating room: moral dilemmas for nurses

This article explores stories related by perioperative nurses when asked to describe ethical judgements and subsequent actions that affected patient outcomes. A total of 214 patient care situations were analysed for moral actions taken and moral outcomes achieved in the perioperative arena. Content analysis of the patient care situations revealed a wide variety of ethical issues. Concerns about informed consent and quality of care were the most frequently identified issues. Respondents reported that 7% of patients underwent unwanted procedures and that positive moral outcomes were achieved in 65% of situations. It is of concern that, despite the fact that more than two-thirds (69%) of the respondents reported undergoing ethics education, only 27% could relate a story of an ethical situation.     

Ethics in perioperative practice--principles and applications

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this first of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the first statement, which emphasizes respect for people. AORN J 75 (April 2002) 818-824.     

Educational opportunities from the Center for Perioperative Education

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this third of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the fourth provision statement, which addresses nurses' accountability and responsibility. AORN J 75 (June 2002) 1094-1099.     

Ethics in perioperative practice--advancing the profession

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and should be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this seventh of a nine-part series that is designed to help perioperative nurses relate the ANA code to their own area of practice, the author looks at the seventh statement, which emphasizes commitment to the profession. AORN J 76 (Oct 2002) 654-656.     

Ethics in perioperative practice--promoting health,welfare, and safety

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and should be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this eighth of a nine-part series that is designed to help perioperative nurses relate the ANA code to their own area of practice, the author looks at the eighth statement, which emphasizes nurses' responsibility to promote the health, welfare, and safety of all people. AORN J 76 (Nov 2002) 866-870.     

Ethics in perioperative practice--values,integrity, and social policy

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and should be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this final article of a nine-part series that is designed to help perioperative nurses relate the ANA code to their own area of practice, the author looks at the ninth provision, which emphasizes the responsibility of professional nursing associations to maintain the value and integrity of the profession. AORN J 76 (Dec 2002) 1047-1053.     

Ethics in perioperative practice--duty to foster an ethical environment

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this sixth of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the sixth statement, which emphasizes the nurse's duty to promote a working environment that enhances quality patient care and fosters the values and behaviors that form the foundation of ethical practice. AORN J 76 (Sept 2002) 490-497.     

Ethics in perioperative practice--patient advocacy

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this second of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the third provision statement, which addresses nurses' position as patient advocates. AORN J 75 (May 2002) 941-949.     

Distilling the Antecedents and Enabling Dynamics of Leader Moral Courage: A Framework to Guide Action

Intelligent, robust and courageous nursing leadership is essential in all areas of nursing, including mental health. However, in the nursing leadership literature, the theoretical discourse regarding how leaders recognise the need for action and make the choice to act with moral purpose is currently limited. Little has been written about the cognitions, capabilities and contextual factors that enable leader courage. In particular, the interplay between leader values and actions that are characterised as good or moral remains underexplored in the nursing leadership literature. In this article, through a discursive literature synthesis we seek to distill a more detailed understanding of leader moral courage; specifically, what factors contribute to leaders’ ability to act with moral courage, what factors impede such action, and what factors do leaders need to foster within themselves and others to enable action that is driven by moral courage. From the analysis, we distilled a multi-level framework that identifies a range of individual characteristics and capabilities, and enabling contextual factors that underpin leader moral courage. The framework suggests leader moral courage is more complex than often posited in theories of leadership, as it comprises elements that shape moral thought and conduct. Given the complexity and challenges of nursing work, the framework for moral action derived from our analysis provides insight and suggestions for strengthening individual and group capacity to assist nurse leaders and mental health nurses to act with integrity and courage.     

The influence of context on role behaviors of perioperative nurses

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USING A CASE STUDY APPROACH, researchers conducted a focused exploration of the role of perioperative nurses.

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DATA WERE COLLECTED in three different hospitals during 358 hours of observation and 34 hours of interviews with 35 nurses. Researchers also analyzed nursing documents, including the care plans of 230 patients.

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FINDINGS SHOW that various contextual mechanisms are influential in the role performance of perioperative nurses.

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THIS STUDY HIGHLIGHTS the importance of providing adequate support for perioperative nurses to perform their role in an intensely stressful environment. Patient-focused leadership and the promotion of a caring philosophy are needed to strengthen perioperative nursing and, ultimately, improve patient care. AORN J 80 (December 2004) 1103-1120.

     

Stigmatization Behavior of Pre-Registration Nurses: Do the Self-Determined Psychological Needs Influence This?

Background/problem: Stigma and stigmatization are important concepts in the area of mental health and illness. Nursing and nurse education are continuously examining ways to understand and address the stigma toward people with a lived experience of mental illness. While the negative influence of stigma is understood, the variables that influence these behaviors are emerging. An area may provide insight into aspects that influence stigmatization of pre-registration nurses is motivation. Previous research has illustrated that individual motivation can significantly predict and influence work-related behaviors and actions across a range of work settings. Therefore, the purpose of this study was to examine the predictive influence that the motivational needs, as espoused by Self-Determination Theory, play in the stigmatization of pre-registration nurse toward people with a lived experience of mental illness. Approach: A total of 168 pre-registration nurses completed two surveys that measured support for their psychological needs and their stigmatization of people with a lived experience of mental illness. Outcomes/conclusions: Using a regression analysis, some psychological needs significantly influenced the stigmatization of pre-registration nurses. Results illustrate the potential importance of psychological needs in the training of the future nursing workforce.     

Optimizing second shift OR staffing

In surgical suites when ORs sometimes run late, nurse anesthetists or perioperative nurses may be scheduled to work a second shift to cover procedures. Nurse anesthetists' OR workload in the afternoons can differ from that of perioperative nurses. At the end of long procedures, times to transport and stabilize patients can be considerable. This article shows that optimal second-shift OR staffing is the same for nurse anesthetists and perioperative nurses when assessed using anesthesia billing data and OR information systems data respectively. Managers do not need hospital information systems staff members to provide data from both anesthesia billing and OR information systems to make second-shift staffing decisions. One or the other is adequate. AORN J 77 (April 2003) 825-830.     

Self-study: an effective method for bioterrorism training in the OR

DURING A BIOTERRORIST ATTACK, health care professionals must be prepared to respond appropriately, but many perioperative nurses do not receive adequate education about bioterrorism.ONE PERIOPERATIVE NURSE led a survey project to determine how prepared perioperative nurses were to respond during a bioterrorist attack and whether a self-study module would help increase participants' self-rated levels of preparedness.THE RESULTS SHOWED that perioperative nurses generally felt unprepared to respond to a bioterrorist event. After reading the self-study module, nurses from facilities that both did and did not provide education on bioterrorism reported increases in self-rated levels of preparedness. AORN J 87 (May 2008) 915-924. © AORN, Inc, 2008.     

Practice and education: partnering to address the perioperative nursing shortage

WITH THE GROWING SHORTAGE of nurses in the workforce, perioperative leaders are facing a significant challenge in recruiting new nurses who are committed to perioperative nursing.ONE MEDICAL CENTER in northern Florida developed a successful summer externship program to introduce nursing students to the perioperative environment. The program incorporates both didactic and clinical experiences.STUDENTS WHO COMPLETE the program are better prepared and motivated to choose a career in perioperative nursing. The retention rate for nurses from the externship program who were hired into the OR in which the program was conducted was 89% after two years. AORN J 86 (August 2007) 259-264. © AORN, Inc, 2007.