Perioperative RNs and teams are among the most resilient , resourceful , and compassionate professionals in all of healthcare .”
— Erin Kyle ,
DNP , RN , CNOR , NEA-BC
equipment and other supplies related to supply chain difficulties that resulted from the pandemic . Because healthcare professionals were faced with using ‘ medical countermeasures ’ to respond to the pandemic that were not in line with evidence-based guidelines , standards of practice , and PPE instructions for use , we knew it would be important to do the work to make clear how these practices were not in line with conventional practices . Of course , there was the concern that these countermeasures might become comfortable and familiar , and we wanted to be sure to make it clear that these are not practices that should continue outside of the context of the health emergency .”
Alvino and Caughell ( 2021 ) also remind us that perioperative personnel are masters of identifying and addressing risks even in highly variable and continually evolving situations : “ The COVID-19 pandemic has forced healthcare workers to assess infection exposure risks critically in the perioperative environment and to determine suitable interventions and mitigation strategies . As healthcare system and facility subject matter experts and key partners gather more information about SARS-CoV-2 transmission and exposure risk , they will make frequent changes to recommendations to help create a safe , evidence-based clinical practice environment . Although these frequent changes are necessary because of the novelty of the virus and the evolving science , the fluctuating recommendations can be confusing to healthcare workers and the public at-large , thereby undermining rapid and complete adherence .”
Complimenting clinical curiosity were the nerves of steel that perioperative nurses exhibited daily during the pandemic .
“ Perioperative RNs and teams are among the most resilient , resourceful and compassionate professionals in all of healthcare ,” says AORN ’ s Kyle . “ Challenges are part of daily life for perioperative teams and surrender without a solution is never an option . When the chips are down , whatever the reason , having a perioperative RN on the case is always in your favor .”
Flexibility on the part of perioperative and other surgical services personnel was also an asset . At the onset and continuance of the COVID-19 pandemic , many perioperative nurses had the opportunity to test their skill sets in the non-surgical arena , as support personnel to overwhelmed inpatient wards . At a large academic medical center in the Northeast , perioperative nurses were deployed to intensive care units and general care units , and perioperative areas ( such as post-anesthesia care unit bays ) were converted into temporary intensive care units ( ICUs ).
As Hemingway and Silvestri ( 2021 ) report , “ When the novel coronavirus SARS-CoV-2 began spreading globally and resulted in the COVID-19 pandemic , it became paramount for healthcare leaders to mitigate the effects of the surge in sick patients overburdening healthcare systems . When a pandemic is bearing down on a healthcare facility , an all-hands-on-deck staffing model is essential , and perioperative nurses are well-suited to rise to such a challenge .”
Perioperative nursing practice specialists at this academic medical center were tasked with preparing and educating OR nurses for inpatient care in a short period of time . As Hemingway and Silvestri ( 2021 ) explain , “ Perioperative nursing is highly specialized , skilled nursing care that includes patient assessment , advocacy , and safety ; technical skills ; and familiarity with complex equipment and instrumentation . Operating room nurses possess a vast body of knowledge , including knowledge of unique concepts ( sterility , patient positioning ) that benefit the surgical patient and the perioperative team . Depending on the surgical specialties offered at an individual facility , it can take as long as two years for a new OR nurse to become fully independent on the job . Considering the wide range of knowledge and skills that are needed to assist with complex surgical procedures , an experienced OR nurse is invaluable to surgical patients and hospitals .”
Regarding a deployment strategy , Hemingway and Silvestri ( 2021 ) explain that , “ Most of the RNs from perioperative services and other procedural units were initially deployed to the labor pool at the hospital for assignment . Personnel managing the labor pool deployed perioperative RNs to the triage call center and the respiratory illness clinic . They also assigned CSTs , OR assistants , and OR nurses to ‘ proning ’ teams that were on call to assist with turning patients prone and then supine in the ICUs . One perioperative nursing practice specialist was assigned to the proning teams as a resource for positioning injury prevention . Labor pool managers also deployed CSTs to ICUs as part of the infection control monitoring team that ensured staff member safety during the process of donning and doffing personal protective equipment . The CSTs did not engage in patient care on inpatient units .”
They continue , “ Perioperative leaders identified any RN with ICU experience within the past five years as well as PACU nurses from the main campus and satellite ASCs as eligible to work in the ICUs or to fill in for nurses on other inpatient units ( medical-surgical , step-down ) who had been deployed to ICUs . The hospital offered a four-hour ICU refresher course for any nurse who had ICU experience within the past five years ; perioperative nurses with recent ICU experience were eligible for deployment to the ICUs after taking this course . The remaining OR nurses were broadly categorized as general care RNs . The intention was for the OR nurses to supplement the inpatient units that had deployed their RNs to ICUs . After arriving on a general care unit , the OR nurses supported other unit-based RNs or received a typical patient assignment according to the general care model . Although many perioperative staff members were deployed , surgical patients continued to receive necessary care in the ORs . Experienced teams of clinicians remained on the perioperative unit to care for trauma , transplantation , stroke , and oncology patients requiring surgical procedures .”