Appropriate student observation in OR or not?

[ELS 1957]

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.

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. 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.

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.

[jeckrn, BSN, RN]

I agree that the student should not be in trouble. He went where he was assigned. Any issues about him being in the OR should be between Hospital Ed., his nursing school, & the instructor.

[canesdukegirl, BSN, RN]

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

While you offer a good point that the discipline of both the instructor and the student are the result of "CYA" mentality, hospital policies in this situation might not have been clear to the instructor if she was not given access to them. Hospital policies regarding the presence of parents in the OR theater are not going to be found in an orientation packet, which is why I feel so strongly that disciplinary action was NOT the best choice in this situation.

The surgeon was CLEARLY angered by seeing the parent of his pt in the OR theater. I suspect the reason why he was so irritated was because he was blindsided by seeing the parent of his pt in the hall of the OR. If the student had talked to the surgeon prior to his son's surgery and explained that he would be present in the OR theater on the day of his son's surgery, then the surgeon would at least be aware.

Most hospitals have a policy that no parent may be present in the OR theater (meaning the entire OR, not just the room) after induction. This is pretty standard. Sometimes exceptions are made in the case of employees who are working in the OR at the same time a family member is having surgery. It is always good etiquette to inform the surgeon that you will be working in the OR that day simply to let them know to expect to see you in the hallway, in the lounge, at the front desk, etc. It is courteous to do so, and everyone will be on the same page. Surgeons HATE surprises...you can take that to the bank!

Surgeons can be temperamental. They like to KNOW what to expect. If this surgeon knew that the parent was observing in the OR that day, I would bet the farm this would be "much ado about nothing". But he was surprised by the unexpected sighting of the student. All of this could have been avoided had a discussion occurred.

I strongly believe that the OP and the student should NOT be facing disciplinary action. The OP deliberately reassigned her student, showing a good faith effort in professionalism. OP, I applaud you for proactive thinking, and implementing a plan to avoid the VERY dilemma you now face. Your student was following your instruction. I honestly do not see how either of you can be held responsible for an infraction of policy if you were not privy to the policies. I wish you the best with this situation, as it is a grey area.

OP, I encourage you to examine this situation, and research policies across the country to find the median standard for this scenario. It is interesting, and poses a multi-faceted proposition regarding ethics. A presentation about this would be very informative not only to your students, but also to your fellow instructors.

[pyocianik]

Shouldn't be a problem if the hospital admin. use their common sense.

Problem is that common sense is very hrad to find in admin and even more in hospital admin...