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Holistic practice is a tradition of excellence in perioperative nursing
NOVEMBER 1997,VOL 66, NO 5 CL I N I CA L EX E MPL A R
Holistic practice is a tradition of excellence in perioperative nursing Edifof‘s nufe: This column in the Journal focuses on outstanding examples of skilled perioperative nursing practice. Clinical exemplars capture h e inferpersonal, ethical, and clinicaljudgments that perioperative nurses make in actual practice.
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s perioperative nurses, we have multiple opportunities to help people and touch their lives. Often, these people are our colleagues. A perioperative nurse colleague of mine recently was scheduled for a minor surgical procedure that was to be performed with local anesthesia. She received the usual, good-natured ribbing from her peers about the “long, sharp needles” that would be used to administer local anesthesia. Sensing that she was more anxious than expected about her upcoming surgical procedure, I took her aside one day to ask if she had questions or particular concerns. Although my colleague had worked in this area of surgery for at least five years, she had very little idea of what to expect. She was relieved to be able express her fear of pain and her uncertainty about being able to tolerate the procedure with just local anesthesia. We discussed the advantages of local anesthesia, and I reviewed the anesthetic administration procedure (eg, size of needles used, amount of pain she might experience). I then took her to an empty OR suite and placed a pneumatic tourniquet on
her arm to demonstrate the amount of discomfort she could expect during surgery. I explained the amount of time that each step of the procedure would require and what discomfort she could expect at each phase. She was surprised and relieved that the procedure would be so brief and the expected pain would be minimal. I gave her some casting material and reminded her to bring it with her on the day of surgery. As luck would have it, the day of my colleague’s surgery was fraught with challenges. The first procedures of the day ran late, and I had to coordinate other surgeons and the procedures that followed, organize equipment, and inform anesthesia care personnel and the other nurses of multiple schedule changes. At last everything was ready for my colleague’s procedure. I tried to give my colleague as much control as possible over her anesthesia administration and preparation for surgery. For example, she had the choice of receiving her injections of local anesthetic in the privacy of the OR suite rather than the busy preoperative holding area, and she chose the latter. ELAINE “BERT” M. VERMEITE, RN, CNOR, is a clinical nurse level II, Day Surgery Center, Concord Hospital, Concord,NH. 913 AORN JOURNAL
I ensured her privacy and provided support as the surgeon administered the local anesthetic. My colleague tolerated the injection well and commented that the pain was less than she expected. She chose to walk to the OR suite and be an active participant in achieving a position of comfort on the OR bed. The surgical team members spoke frequently with my colleague as they prepared for the procedure. I selected a soft music station on a portable radio and placed it near the OR bed to help her relax. Her posture and normal vital signs attested to the success of these relaxation-promoting interventions. When the procedure was completed and the special casting material was applied to my colleague’s arm,we turned off all the OR lights. My colleague’s glowin-the-dark cast amused her greatly, and she was still laughing as I transferred her to the postanesthesia care unit. Later, she thanked me for helping her feel less anxious about her surgical procedure and for making the experience tolerable. I was gratified that I could make a difference. I believe my flexibility in planning, my ability to coordinate the OR on that hectic day, and the time I took to help a colleague all contributed to a positive experience for everyone involved. It is this tradition of excelfence in perioperative nursing that we are celebrating during OR Nurse Week. A
Holistic practice is a tradition of excellence in perioperative nursing Edifof‘s nufe: This column in the Journal focuses on outstanding examples of skilled perioperative nursing practice. Clinical exemplars capture h e inferpersonal, ethical, and clinicaljudgments that perioperative nurses make in actual practice.
A
s perioperative nurses, we have multiple opportunities to help people and touch their lives. Often, these people are our colleagues. A perioperative nurse colleague of mine recently was scheduled for a minor surgical procedure that was to be performed with local anesthesia. She received the usual, good-natured ribbing from her peers about the “long, sharp needles” that would be used to administer local anesthesia. Sensing that she was more anxious than expected about her upcoming surgical procedure, I took her aside one day to ask if she had questions or particular concerns. Although my colleague had worked in this area of surgery for at least five years, she had very little idea of what to expect. She was relieved to be able express her fear of pain and her uncertainty about being able to tolerate the procedure with just local anesthesia. We discussed the advantages of local anesthesia, and I reviewed the anesthetic administration procedure (eg, size of needles used, amount of pain she might experience). I then took her to an empty OR suite and placed a pneumatic tourniquet on
her arm to demonstrate the amount of discomfort she could expect during surgery. I explained the amount of time that each step of the procedure would require and what discomfort she could expect at each phase. She was surprised and relieved that the procedure would be so brief and the expected pain would be minimal. I gave her some casting material and reminded her to bring it with her on the day of surgery. As luck would have it, the day of my colleague’s surgery was fraught with challenges. The first procedures of the day ran late, and I had to coordinate other surgeons and the procedures that followed, organize equipment, and inform anesthesia care personnel and the other nurses of multiple schedule changes. At last everything was ready for my colleague’s procedure. I tried to give my colleague as much control as possible over her anesthesia administration and preparation for surgery. For example, she had the choice of receiving her injections of local anesthetic in the privacy of the OR suite rather than the busy preoperative holding area, and she chose the latter. ELAINE “BERT” M. VERMEITE, RN, CNOR, is a clinical nurse level II, Day Surgery Center, Concord Hospital, Concord,NH. 913 AORN JOURNAL
I ensured her privacy and provided support as the surgeon administered the local anesthetic. My colleague tolerated the injection well and commented that the pain was less than she expected. She chose to walk to the OR suite and be an active participant in achieving a position of comfort on the OR bed. The surgical team members spoke frequently with my colleague as they prepared for the procedure. I selected a soft music station on a portable radio and placed it near the OR bed to help her relax. Her posture and normal vital signs attested to the success of these relaxation-promoting interventions. When the procedure was completed and the special casting material was applied to my colleague’s arm,we turned off all the OR lights. My colleague’s glowin-the-dark cast amused her greatly, and she was still laughing as I transferred her to the postanesthesia care unit. Later, she thanked me for helping her feel less anxious about her surgical procedure and for making the experience tolerable. I was gratified that I could make a difference. I believe my flexibility in planning, my ability to coordinate the OR on that hectic day, and the time I took to help a colleague all contributed to a positive experience for everyone involved. It is this tradition of excelfence in perioperative nursing that we are celebrating during OR Nurse Week. A