Interprofessional working and learning in a UK operating department

Perioperative nursing in public university hospitals: an ethnography

BACKGROUND

In recent years, perioperative nursing has received ongoing attention as part of an interprofessional collaboration. Perioperative nursing is constantly faced with new challenges and opportunities that necessitate continual updates of nursing knowledge and technical skills. In light of the longstanding relationship between nursing and technology, it is interesting that few studies with this focus have been performed. Therefore, our research question was: What is the content of perioperative nursing and how do nurses facilitate the interaction between nursing care and technology in highly specialized operating rooms in public university hospitals?

METHODS

An ethnography involving participant observations and interviews was conducted during a 9-month study period. The participants comprised 24 nurses from 9 different operating wards at 2 university hospitals in different regions of Denmark.

RESULTS

Patients were addressed as either human beings or objects. Likewise, the participants' technical skills were observed and described as either technical flair or a lack of technical skills/technophobia. The different ways in which the technical skills were handled and the different ways in which the patients were viewed contributed to the development of three levels of interaction between technology and nursing care: the interaction, declining interaction, and failing interaction levels.

CONCLUSION

Nursing practice at the interaction level is characterized by flexibility and excellence, while practice at the declining interaction level is characterized by inflexibility and rigidity. Nursing practice at the failing interaction level is characterized by staff members working in isolation with limited collaboration with other staff members in operating rooms. Considering that the declining and failing interaction levels are characterized by inflexibility, rigidity, and isolation in nursing practice, nurses at these two levels must develop and improve their qualifications to reach a level of flexible, excellent interaction. Nurse leaders must therefore refocus their skills on proficiency in perioperative nursing.

The Invisible Nurse-Behind the Scenes in an Australian OR

THE DWINDLING NUMBER of RNs choosing to work in the OR has been caused by many factors, such as restricted undergraduate exposure to the perioperative experience and fewer postgraduate opportunities. PRESSURE TO IDENTIFY alternative health care workers to replace RNs in the OR is escalating to a point where the role of the perioperative RN, as currently understood, is threatened. FINDINGS from an Australian ethnographic study suggest that both patients and non-nursing colleagues have limited appreciation of the contribution that perioperative nurses make. THE NEED FOR NURSES to take a proactive stance on this subject is discussed within the context of professional and structural change.