Dissertation/Thesis Abstract

A focused ethnography: Experiences of registered nurses transitioning to the operating room
by Brinkman, Mary Adams, Ph.D., Widener University School of Nursing, 2013, 213; 3570586
Abstract (Summary)

The operating room (OR) is a unique setting and specialty area of nursing practice that requires optimal orientation and education to render safe and efficient patient care. Unfortunately, there will be a significant shortage of nurses in the operating room in the next five to ten years. The need for new nurses in the operating room is essential as many OR nurses in the workforce will retire within the next five years. Currently, most nursing programs no longer offer perioperative courses in their curriculum. Subsequently, this trend has led to the need for hospitals to educate and orient new nurses to their operating rooms. As hospitals educate their own OR nurses, retention following orientation becomes a priority.

The purpose of this study was to explore nurses' experiences as they transition to a new area of nursing practice, the operating room. A qualitative focused ethnography was conducted using Leininger's ethnonursing research method. Fourteen RNs transitioning to the OR agreed to participate in this study. The OR was a first time experience for the RNs. The setting was a large teaching hospital located in an urban area. Observations and interviews were conducted with the RNs to explore their experiences as they transitioned in the OR.

The RNs' transition included learning the didactics of OR nursing through the web-based AORN Nursing 101 online computer course, practicing skills learned in a simulation laboratory, and rotating through surgical specialty areas under the supervision of an RN preceptor. Influences that facilitated the RNs transition to the OR were the

positive learning experience, perception of belonging and acceptance into the OR culture, stimulating environment, supportive personnel, collegiality among peers, and presence of nursing in the OR. Influences that hindered the RNs' transition to the OR were inconsistency in precepting, being in a hostile environment, limited exposure to the OR prior to the RNs' transition, and an overwhelming environment. Meleis' Transition model emerged in the RNs' experiences of transitioning to the OR.

The need to educate nurses in the operating room is essential to assure safety and positive outcomes for the surgical patient. Structured perioperative courses implemented by hospitals or with partnerships with nursing programs can enhance the education, transition, and retention of nurses new to the OR. The importance of a nurse educator having an advanced degree with experience in the OR specialty was essential in coordinating and mentoring nurses transitioning to this new practice area. RNs who are prepared to precept were vital in the education and retention of these RNs. The need for consistent preceptors was recognized as an essential factor to the RNs' successful transition. The findings contribute to evidence-base practice for the design and implementation of perioperative programs for new nurses.

Indexing (document details)
Advisor: Patterson, Barbara
School: Widener University School of Nursing
Department: Nursing
School Location: United States -- Pennsylvania
Source: DAI-B 74/10(E), Dissertation Abstracts International
Subjects: Nursing
Keywords: Experiences of transitioning, Nurses' experiences, Operating rooms, Registered nurses
Publication Number: 3570586
ISBN: 978-1-303-15752-3
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