Throughout a nurse’s education, they are given exposure to caring for patients in units like critical care and pediatrics, but most nurses never work inside of an operating room (OR) during their standard training. Nurses interested in working in the OR generally complete extensive training in perioperative work. However, because this training requires great time dedication, OR nurses start their careers at later ages. Today, the average age of OR nurses is nearly 50 years old, with many nurses nearing retirement in the next two decades.
To establish the next generation of perioperative nurses, Pennsylvania Hospital holds the Gateway to the OR program.
In collaboration with the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center, Gateway to the OR is a bridge for nurses interested in pursuing a career in the OR. They are provided with the necessary resources and training to learn the fundamental principles of perioperative nursing.
“We’re thinking of succession and planning in the OR,” said Frances Strauss, DNP, MBA, MHA, RN, CNOR, NE-BC, clinical director of Perioperative Services. “We need to think ahead of staff retiring and begin thinking about how to acquire the talent.” Each cohort consists of three to four participants. Applications are open to any nurse in the area with a Bachelor of Science in Nursing or a valid Pennsylvania RN licensure who has a passion to be a nurse in the operating room. At the completion of the program, the nurses become a member of one of the operating room teams at either PAH, HUP, or PPMC.
“It’s a highly competitive program with so many qualified candidates applying,” said Margaret Vance, MSN, RN, CNOR, clinical nurse education specialist and facilitator of Gateway to the OR. “We want to make sure we’re putting a lot of time and energy into their training, and also discuss goals they have and what they hope to accomplish through the program.”
The accelerated six-month orientation begins with reviewing different educational modules that cover every aspect of the perioperative setting, such as the preoperative, intraoperative, and post-anesthesia phases. Participants are taught environmental cleaning, sterile techniques, and medication administration, and they are paired with a preceptor who monitors their training and is available for questions throughout the program. Along with receiving feedback from these instructors, participants can build skills in shadow experiences with other roles in the OR, allowing them to see the full scope of patient protection. To conclude the program, the participants engage in an interactive simulation, exemplifying a real-life emergency situation.
“We announce that there is an emergency and that they’re needed immediately. They run to the hallway and the pressure is on,” Vance said. “I time them to see how fast they’re able to set up and if they’re prioritizing the right actions in an emergency situation. After two minutes, I bring back our simulated patient, whether they’re ready or not, which gives them a real sense of pressure and urgency.”
After the final simulation, the group has a debriefing session to discuss opportunities for improvement, while also highlighting the participants’ achievements throughout the program.
“At this point, they’re able to set up the OR for patients in such a short amount of time compared to when we first prepared the space, which took about a half hour,” said Vance.
Due to the high demand for the program, the program plans on transitioning the six-month orientation to quarterly cohorts, allowing more nurses to gain OR experience in a given year.
“I’m always happy to hear how well our participants are doing when we receive feedback about the program,” Strauss said. “They gained the independence and skills to become successful OR nurses and they’re now flourishing in their roles.”