Appropriate student observation in OR or not?

Perpetual Student · Dec 8, 2011

If you had the schedule worked out in advance and can demonstrate such it should be an open & closed case in your favor. If his mother had been a patient on the med-surg floor would it have been inappropriate for him to care for another patient there?

If you scheduled him in the periop area just because his kid was having surgery I could see some room for criticism. It doesn't sound like that was the case, though. Even if it were, it'd be appropriate to place the blame on you as the instructor, not the student who did what he was supposed to.

Sometimes you have to take care of people you know. Esp. if they come in for an emergency surgery and you're part of the call team.

Good luck. I hope this shakes out OK for you and the student.

canesdukegirl, BSN, RN · Dec 8, 2011

i am a new practical nursing instructor and have a dilemma. i recently reassigned a student from amb surg unit observation day to the or for observation because the student's son was having an amb surg procedure. i felt that this would distance him from his child because the amb surg unit is very small.the student did not observe his son's or or come in contact with his chid during the clinical time. he also notified the or staff on his arrival at 0650 that his child would be in the one of the or rooms during his clinical time-scheduled for 0745. several of the or nurses came to update the student after the child's surgery and not one voiced their concern he was observing in one of the 5 or 6 rooms. i believe the surgeon saw the student leaving the or dept to go to lunch and complained.
you reassigned your student from asu to the main or because your student's son was having surgery in the asu. good call on your part. are the asu and the main or in the same building? did your student tell his son's surgeon that he would be in the or observing on the same day that his son was having surgery? if he didn't, he should have. given the unusual circumstances, it would have been a good idea for your student and the surgeon to talk about this before his or observation clinical. since this was a planned procedure, and you went out of your way to avoid your student being assigned to the asu, it seems to me that the surgeon was quite caught off guard by seeing your student in the or area. if i were in the surgeon's shoes, i likely would have been ill at ease as well. no parent is allowed in the or theater after induction. if the asu and the or are in close proximity to each other, then the surgeon has every right to complain.
during lunch, the student was asked to leave the or observation experience. my immediate supervisor was notified by the hospital's education liason and subsequently the student and i are both facing discipline.
i think it is rather heavy handed that you and your student are facing disciplinary action. a conversation involving you, your student, the hospital liaison, and your immediate supervisor would have been a better way to deal with this situation prior to disciplinary action.
the hospital and my supervisor are saying the student should not have been allowed in either of the areas on his son's or day.
and they are correct. parents cannot be in the or theater after induction. i have worked with many or nurses that have had to take the day off when their child is in surgery simply because of this rule. even surgeons have to reschedule their time in the or if their child has a planned surgery for that day.
there is nothing in the orientation packet from the hospital or in the student handbook that addresses this issue. the discilpline is based on the student "using his student status at an advantage to himself". i feel that is inappropriate to disclipline a student that discussed and followed direction from his master instructor.
also, i am not 100% convinced that i acted inappropriately.
comments please.

the policy that you are looking for regarding a parent's presence in the or after induction is likely in the form of an online policy that can be accessed only by employees of the hospital. you would not find this policy in an orientation packet from the hospital. you did what you should have, given the information you had. you did not act inappropriately, because you intentionally reassigned your student. you may not have know the hospital policy regarding this situation.

while i agree that you nor your student should face disciplinary action, i do agree with the hospital policy that no parent should be present in the or after induction, no matter the circumstance. there is a good chance that you were not privy to this policy if you are not an employee of the hospital, and that could be your saving grace.

if you or your peers do not have access to online hospital policies, now is the time to ask your supervisor to grant access. this scenario would have been completely avoidable if you were given access to the policies. i feel that you were proactive in reassigning your student, and were aware of the inappropriateness of him being in the asu during his son's surgery. i don't see where any fault lies with you or your student.

that being said, i think it would be prudent to have a discussion with your supervisor to ensure that this won't happen again. state that you need full access to policies at every clinical site you use.

i wish you the best!

canes

student987 · Dec 11, 2011

Note that I am just a student not a nurse: As it was not observing his sons procedure I do not feel like policies involving the parent not being in the room after induction apply (he wasn't in the room he was in a different room). I feel that the people disaplinning you are just trying to cover their butts

allnurses Guide · Dec 11, 2011

I don't see what happened as a problem, if there was a policy against you and your student should have been notified in advance.

I have been in the OR (different room of course) during my daughter's and grandson's surgery. It isn't a big deal if you stay professional and stay out of the room they are in.

jeckrn, BSN, RN · Dec 13, 2011

Question, why was the student doing clinicals the day his son was having a procedure? I know if one of my children is having a procedure I would be more concerned about my child then what was going on in the room I was assigned to. A little common sense would have gone a long way on this even if it is not written in a SOP.

As far as him in the OR the same day, no he should have not been there just like as someone wrote about what family member was on a floor that he was doing his clinical. It would be the same and should not be there. It is not good for the patients that he is taking care of or for his clinical experience.

allnurses Guide · Dec 13, 2011

Question, why was the student doing clinicals the day his son was having a procedure? I know if one of my children is having a procedure I would be more concerned about my child then what was going on in the room I was assigned to. A little common sense would have gone a long way on this even if it is not written in a SOP.
As far as him in the OR the same day, no he should have not been there just like as someone wrote about what family member was on a floor that he was doing his clinical. It would be the same and should not be there. It is not good for the patients that he is taking care of or for his clinical experience.

Why is it not good for him or his patients? We stress professionalism all the time. This is a way to show it. It is funny I have had physicians/surgeons and anesthesia providers that both have had to work while their kids have surgery and it has never been a problem. It is great if you can always be off for every little procedure that you child has, but it doesn't always work out that way.

jeckrn, BSN, RN · Dec 13, 2011

Being a provider or experienced nurse and working is different then being a student and going to class. Once you have the experience you know & understand what is going on and able to focus on work. When you are a student you are still learning and would be much harder since you do not have that experience and knowledge to fall back on. Also, the experienced providers also have line of communication to the surgeon doing the case that a student never will. You are right that we can never get all the time off we need, but he was a student not an employee. Yes, giving him the time off is a way of showing professionlism by taking care of your employee/student.

allnurses Guide · Dec 13, 2011

Being a provider or experienced nurse and working is different then being a student and going to class. Once you have the experience you know & understand what is going on and able to focus on work. When you are a student you are still learning and would be much harder since you do not have that experience and knowledge to fall back on. Also, the experienced providers also have line of communication to the surgeon doing the case that a student never will. You are right that we can never get all the time off we need, but he was a student not an employee. Yes, giving him the time off is a way of showing professionlism by taking care of your employee/student.

Then my question would be where does professionalism start? We will just have to agree to disagree. I don't see a problem with it, and currently I work with all sorts of students now in the OR.

jeckrn, BSN, RN · Dec 14, 2011

Professionlism starts by taking care of our own.

student987 · Dec 14, 2011

But he might not be able to miss a day of clinical. most nursing schools you fail on the first clinical miss even for a good reason (even if it is YOU who is sick or needs surgery let alone your child)

allnurses Guide · Dec 14, 2011

Professionlism starts by taking care of our own.

There can be lots of reasons why student needs to be in clinicals. He could have missed too many days already etc. Just different opinions, I guess, but either way there is no way that the student should be in trouble for this after getting approval from his clinical instructor.