Periop Talk Association of periOperative Registered Nurses (AORN)

Still in crisis mode from the pandemic and its aftermath, many nurses are feeling tired and somewhat disgruntled, and may be looking for greener pastures.
However, the journey toward “greener grass” can begin without hopping the fence, suggests Jill Graham, BSN, RN.
As a surgical services co-educator (and her team’s unofficial counselor and mediator), Graham made it her mission to foster a less toxic culture in nursing, starting with her own practice.
She realized that “culture healing will not happen until we as individuals choose something different and commit to making a difference in our little bubble of culture.”
She gave us four excellent ways nurses can make basic changes in mindset that can ignite and spread a culture of healing.
Don’t Add to NegativityRepeatedly bringing up a colleague's mistake doesn't make anyone feel good. When you choose not to dwell on a colleague's mistake, you are respecting their humanity. If there is a conversation that needs to happen to process an event, go privately to a trusted coworker, but be careful not to let it degenerate into a bashing session. Instead, focus on finding solutions.
Shut Down the RacetrackWe often let our mistakes play over and over in our head or engage in the same disheartening interactions with coworkers. Make a conscious choice to stop dwelling on it. To do this, acknowledge how the situation makes you feel, determine to have a conversation (if needed), and then move on. Ultimately, avoid defining your coworkers, or yourself, by their mistakes.
Recognize Things Aren’t All BadCulture only begins to heal when we objectively see the truth of what is happening. Even on a 'bad' day, there are many things to be grateful for: coworkers, camaraderie, positive patient outcomes, your abilities, and technology, among others. When you frame your day differently, you genuinely start to feel better and lighter.
Just SmileResearch shows that simply smiling can bring your mood up as well as those around you. It may feel fake (especially behind a mask), but there is always something to smile about. The more you focus on being the positive change agent, the more you will see positivity.
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In this episode of Periop Talk AORN gives a sneak preview into the new High-Level Disinfection Guideline and how these key changes will impact your daily practice. Perioperative nurses play a vital role in the disinfection process:
Enhanced communication: Ensuring seamless handoff of devices to decontamination with details about pre-treatment and device condition.Verification before disinfection: Introducing a crucial step - cleaning verification testing with magnification and the use of borescopes for a deeper look.The importance of drying: We'll explore new research highlighting the importance of thorough drying for all lumens of instruments and scopes before storage.Perioperative nurses are key players in upholding aseptic technique and ensuring patient safety throughout the surgical journey. Their role in high-level disinfection contributes significantly to preventing infections and promoting positive patient outcomes.
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The opportunity to start fresh in a different department is a gift. Once you are there, take advantage of everything and everyone. Staff are designated to help teach you the art and science of their practice, so be physically, mentally, and emotionally present to absorb every bit of it. Understand that there are many ways to accomplish the same task and be open to a new way. Keep the best of what you learn and add it to your toolbox. Start to build your own practice with the help of others. Remember that every unit is full of various personalities and styles. They each contribute to the uniqueness of the department and should enhance, rather than inhibit, your growth. Sidebar 1 provides tips for transitioning from an expert to a novice nurse.
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This updated Guideline for Safe Environment of Care provides new and revised recommendations on developing fire safety plans, performing fire risk assessments, fire safety training, establishing latex safety programs and chemical safety plans, among others. The purpose of this guideline is to maintain a safe environment of care for perioperative patients and personnel and prevent injuries or harm by mitigating the risks associated with all the topics covered within this guideline. This episode of Periop Talk features guideline author Renae Wright, perioperative practice specialist at AORN, and Lisa Spruce, sr. director of evidence based perioperative practice at AORN.

Get the 2024 Guideline book: AORN | Order 2024 Guidelines for Perioperative Practice

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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

There's more Periop Talk at: https://www.aorn.org/about-aorn/aorn-newsroom/periop-talk

#ornurse #nurselife #nurse #healthcare
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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. 
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