Training nurses to be skilled in the operating room

Maridel Asuncion never found her niche during nursing school. Her education focused on different units in the hospital and nothing really piqued her interest.

Asuncion’s mom, who is an operating room nurse at RWJBarnabas Health, always spoke passionately about her job, so when Asuncion discovered the New Jersey-based system offered OR training for nurses as part of orientation, she applied. Her education didn’t give her much exposure to the OR and she saw a future there.

“A lot of the OR nurses I met, they plan to stay in the field for a long time. Low turnover rates say a lot about the job,” she said. 

After spending five weeks in the OR simulation lab in April, Asuncion is now a full-time OR nurse and continuing her orientation at Newark Beth Israel Medical Center, one of RWJBarnabas’ 11 hospitals.

Since 1999 the system has offered the training opportunity for its employed nurses as well as recent graduates in order to build a pipeline of nurses with spe-
cific OR skill sets, which 
aren’t taught extensively at most nursing schools even though the demand is high. And earlier this year, the system took the program a step further by building a simulation lab in an unused OR complete with mannequins and other equipment.

“We saw that we had a great program here, but we knew the simulation aspect was missing,” said Mary Beth Russell, vice president of the Center for Professional Development Innovation and Research at RWJBarnabas Health.

Research shows the more a person repeats a task, the more likely it will be done accurately and confidently, Russell said. The simulation lab allows nurses to practice skills multiple times without the risk of harming a patient. “It gives the nurses the chance to build confidence and competence while working in an environment that is free of consequences,” she said.

With a nurse retirement boom on the horizon, coupled with a population that’s living longer and potentially using more services, the RWJBarnabas training program addresses a need to keep the pipeline of OR nurses flowing.

A 2014 report from the Association of periOperative Registered Nurses found that 64% of perioperative nurses plan to retire by 2022. Students typically aren’t exposed to the specialty during nursing school so they often don’t consider it a career option, Russell said, adding, “We need to fill the void.”

The simulation lab, which was built at the system’s RWJ University Hospital Rahway (N.J.), was completed in January and 60 nurses will be trained there by the end of the year. Asuncion and 12 other nurses made up the first cohort.

More nurse training programs have started to form at universities over the past few years, but an offering like the one available at RWJBarnabas is still unique. The nurses are hired at the system before they start the program, which is part of their orientation process. The program is also available for currently employed RWJBarnabas nurses who want to make a career change.

Orientation lasts for six months and includes classroom learning and five weeks in the simulation lab. The students continue to meet for five months for more lessons as part of orientation, but they work in the OR at their respective hospitals with a preceptor.

During the simulation portion, students are taught the basics of how to set up a procedure, including how to prepare the patient for surgery and how to properly handle and use surgical instruments. 

Asuncion said the training helped her feel prepared. “I don’t think I would feel as confident starting in the OR if I didn’t have the five weeks of hands-on simulation and classroom,” she said.

Russell declined to disclose how much RWJBarnabas paid to build the simulation lab but said it wasn’t “millions of dollars.”

RWJBarnabas plans to expand the simulation program to other clinical staff like respiratory therapists and nursing assistants. “The ability for the entire team to work in collaboration and in tandem is essential to safe delivery of care for the patient,” Russell said.

“The main point of all of this really comes back to patient safety, experience and comfort,” she added.