By James X. Stobinski, Ph.D., RN, CNOR, CNAMB, CSSM(E)
As the chief executive officer of the Competency and Credentialing Institute (CCI), I frequently interact with nurse leaders and often our conversations turn to staffing challenges. Most of the perioperative leaders I have spoken with have said that they are having difficulty hiring the needed staff including perioperative nurses and surgical technologists. These anecdotal reports are reinforced by a 2022 survey (Saver, 2022). Saver reports that surgical volume has rebounded to pre-pandemic levels or higher for many operating rooms but staffing challenges are restricting the work of surgery.
A confluence of events has brought us to this point. The pandemic has likely pushed many experienced nurses to leave the profession and many perioperative nurses were among that group. Although the exact demographics of the perioperative specialty are not well known, we have anecdotal evidence at CCI based on the record number of certified nurses who have recently retired their credentials. Our evidence is that experienced perioperative nurses for the first time in their career were furloughed or lost employment entirely during the pandemic. In addition, other seasoned perioperative nurses, who fell into high-risk categories based on age, chose to retire versus providing care for COVID-19 patients in other units such as the ICU as part of team nursing.
From the 2020 National Nursing Workforce Survey we know that there may be as many as 470,000 nurses in the United States that have perioperative nursing as a significant part of their work either in their primary duties or as their secondary specialty. (Stobinski, Maio & Homme, 2021, p. 22). This is 11.2% of the active American nursing workforce and includes perioperative and perianesthesia nurses (Smiley et al, 2021). With the rebound in surgical volume a record number of nurses are being hired into the OR and there are thousands of nurses in orientation to the specialty including recent graduates. This hiring and orientation activity is a challenge, but CCI believes it is also an opportunity.
A recent article in Outpatient Surgery detailed the collaboration between Chamberlain University and AORN for a perioperative nursing course for pre-licensure students (Paone, 2022). There is also a smattering of senior practicum experiences available. In a similar vein, the CCI nurses teach BSN pre-licensure students at Edgewood College in Madison Wisconsin. All these approaches increase exposure to perioperative nursing, but we do not know the long-term impact of any of these approaches. The current staffing shortfalls present an opportunity to evaluate and refine the approaches listed above.
There is an opportunity for additional research into how perioperative nurses enter the specialty and acquire skill over a career. Few studies have attempted to study the effectiveness of orientation programs to perioperative nursing. Many facilities, perhaps one-third of all orientation programs used, are developed by the facility (Stobinski et al. p. 23). At CCI, we believe these diverse programs should be studied and compared and the evidence used to continuously strengthen and refine our orientation methods. We also believe that the effectiveness of an orientation program can also be measured by the competency of the graduates.
I have described some complex research challenges in this column which represent an opportunity to re-shape and strengthen the perioperative nursing specialty. Perioperative nursing is staring down some great challenges at present. Thecurrent surgical staffing issues are among the most severe I have ever seen but I am confident that perioperative nursing will meet this challenge. I also believe there are opportunities present in these trials for those willing to try new approaches, to do the research and gather the evidence to support our specialty.
– James X. Stobinski, Ph.D., RN, CNOR, CNAMB, CSSM(E), is CEO of the Competency and Credentialing Institute (CCI).
References:
- Paone, J. (2022) Help is on the way. Outpatient Surgery Magazine.
- Saver, S. (2022). Survey: Surgical volume returns for many ORs, but staff shortages remain. OR Manager, (38)9. (Pp 1, 5-9).
- Smiley, RA, Ruttinger, C, Oliveira, CM, Hudson, LR, Allgeyer, R, Reneau, KA, Silvestre, JH, Alexander, M. (2021). The 2020 National Nursing Workforce Survey, Journal of Nursing Regulation, (12)1, Supplement, (S1-S96) ISSN 2155-8256, https://doi.org/10.1016/S2155-8256(21)00027-2.
- Stobinski, JX, Maio, S and Homme, C (2022). Results of a competency assessment study of OR nurses in the US. OR Manager, 38(6). 22-25. Accessed: June 21st 2022 at: https://www.nxtbook.com/accessintelligence/ORManager/or-manager-june-2022/index.php#/p/24
