Periop 101 Program Questions!

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Hi everyone!

I am starting an OR fellowship at a large Pennsylvania network hospital in November. I feel that some of the program details are still a little vague; the job posting isn’t super thorough, and most of the information I’ve gleaned has come from reviewing other OR fellowship webpage’s that have more information. I was also very focused on my responses during the interview, so afterward my recall wasn’t the best…oops!
Anyway, I was wondering if anyone here can tell me the “typical” format of a 6-month Periop Program!? We will be following AORN’s curriculum, and I take it that one day a week we will be in the classroom. Is the 6-month program typically inclusive of orientation? Also, because I am a new graduate nurse with no floor experience, can you possibly tell me how residency is incorporated into the program? What does residency entail for this kind of position?

I know not every program is the same, but any insight you can provide based on your experience is GREATLY appreciated. 

Thank you so much!

On 2/25/2021 at 8:38 AM, QqGgKk said:

Hi MrsMig,

I read your post on 2020 and I am wondering if you have anything related ro the training program to share? Or thoughts related to working with the preceptors?

Hello

As I previously mentioned, this is a small hospital so there is no set routine. With that said, I am finalizing periop on-line modules independently and being precepted elsewhere (OR and some PACU). I have one module left to complete and will start studying as I have until 5/26 to complete my 3 attempts to pass the final test. Honestly, I'm not a fan of the periop modules as modern technology has come so far but yet it seems antiquated in it's format but it's easy enough. I have the 2020 AORN Guidelines for Periop.

In the OR, I have been trained as circulator in these specialties: Endoscopy, General, Orthopedics, Ophthalmology, OB/GYN, and Podiatry. I am currently at my 6 month mark and am taking on-call solo with 'buddy call.' Of course, I still have lots to learn until I'm seasoned and confident. I think Ortho is the most overwhelming d/t positioning, implants & MD preferences and OB/GYN is also involved when multiple repairs need to be performed. We also do emergency c-sections as this hospital is just small. But I feel it's going well and I'm being told the same. Of course there's been times when I feel things didn't go smooth either on the preceptors side or mine but overall, I'm learning a lot and the group I work with are dedicated and knowledgeable. 

Any tips or tid-bits of knowledge?

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5 minutes ago, MrsMig said:

Hello

As I previously mentioned, this is a small hospital so there is no set routine. With that said, I am finalizing periop on-line modules independently and being precepted elsewhere (OR and some PACU). I have one module left to complete and will start studying as I have until 5/26 to complete my 3 attempts to pass the final test. Honestly, I'm not a fan of the periop  modules as modern technology has come so far but yet it seems antiquated in it's format but it's easy enough. I have the 2020 version of this to use as a study guide AORN Bookstore

In the OR, I have been trained as circulator in these specialties: Endoscopy, General, Orthopedics, Ophthalmology, OB/GYN, and Podiatry. I am currently at my 6 month mark and am taking on-call solo with 'buddy call.' Of course, I still have lots to learn until I'm seasoned and confident. I think Ortho is the most overwhelming d/t positioning, implants & MD preferences and OB/GYN is also involved when multiple repairs need to be performed. We also do emergency c-sections as this hospital is just small. But I feel it's going well and I'm being told the same. Of course there's been times when I feel things didn't go smooth either on the preceptors side or mine but overall, I'm learning a lot and the group I work with are dedicated and knowledgeable. 

Hope that answers what you were looking for?

Hello @QqGgKk! I thought I’d add my two cents in addition to @MrsMig’s comment since I’m almost 5 months into my OR orientation! I completed my AORN Periop 101 course (I too did all the modules) and will take a final exam later this month. While I enjoyed the course in general, I find the best way to learn the OR is by far just being in it and practicing the skills there. I am a little nervous to take the final exam because of course it will be “by the book,” which I need to study more LOL but overall the course material was manageable.

In terms of preceptors- I have a main/assigned preceptor, but I am often with different people due to differences in my assigned preceptor’s schedule and what cases are going on each day. I  am learning to scrub and circulate- to date I have mainly been scrubbed, and I have done very little formal circulating (I think my hospital figured it would be best to start circulating after completion of the Periop course). Right now I can scrub GYN, general, cysto, vascular, podiatry, and plastics, and so far this is fine with me because I love scrubbing! I highly recommend learning to do both if you can.

I don’t have FORMAL complaints about my preceptors, but I will say that being with different people can somewhat complicate things. I mirror my skills/set up based off of who I was with at any given day, which someone else can find incorrect at a later date LOL I just take this for what it is & know that I will be able to do my own thing once I’m off orientation! Communication is KEY- please tell your preceptors upfront what you do and do not feel comfortable doing within any given case (I.e. draping...I initially found this skill challenging). I find that some won’t listen to you regardless LOL but at least that information was communicated upfront, and they usually just end up helping me more than I’d like (which is of course better than not at all). 


I hope this information helps! 

 

1
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2 minutes ago, cr71890 said:

Hello @QqGgKk! I thought I’d add my two cents in addition to @MrsMig’s comment since I’m almost 5 months into my OR orientation! I completed my AORN Periop 101 course (I too did all the modules) and will take a final exam later this month. While I enjoyed the course in general, I find the best way to learn the OR is by far just being in it and practicing the skills there. I am a little nervous to take the final exam because of course it will be “by the book,” which I need to study more LOL but overall the course material was manageable.

In terms of preceptors- I have a main/assigned preceptor, but I am often with different people due to differences in my assigned preceptor’s schedule and what cases are going on each day. I  am learning to scrub and circulate- to date I have mainly been scrubbed, and I have done very little formal circulating (I think my hospital figured it would be best to start circulating after completion of the Periop course). Right now I can scrub GYN, general, cysto, vascular, podiatry, and plastics, and so far this is fine with me because I love scrubbing! I highly recommend learning to do both if you can.

I don’t have FORMAL complaints about my preceptors, but I will say that being with different people can somewhat complicate things. I mirror my skills/set up based off of who I was with at any given day, which someone else can find incorrect at a later date LOL I just take this for what it is & know that I will be able to do my own thing once I’m off orientation! Communication is KEY- please tell your preceptors upfront what you do and do not feel comfortable doing within any given case (I.e. draping...I initially found this skill challenging). I find that some won’t listen to you regardless LOL but at least that information was communicated upfront, and they usually just end up helping me more than I’d like (which is of course better than not at all). 


I hope this information helps! 

 

I agree, I wish I was being taught to scrub but only circulating. In our hospital it's just not feasable.

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Specializes in ICU, Trauma, CCT,Emergency, Flight, OR Nursing.
On 2/25/2021 at 5:59 AM, QqGgKk said:

Hi RickyRescueRN,

Is this one?

Surgical Technology: Principles and Practice - 7th edition

ISBN13: 9780323394734

ISBN10: 0323394736

https://www.textbooks.com/Surgical-Technology-Principles-and-Practice-7th-Edition/9780323394734/Joanna-Kotcher-Fuller.php?CSID=2QOKBWJCJ2U232TADDQTTCSOB

Yup that is the one!

 

On 2/25/2021 at 5:50 AM, QqGgKk said:

Is this one?

Alexander's Care of the Patient in Surgery, 16th Edition

https://evolve.elsevier.com/cs/product/9780323479141?role=student

 

Yes that is the correct book.

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Specializes in ICU, Trauma, CCT,Emergency, Flight, OR Nursing.
22 hours ago, cr71890 said:

Hello @QqGgKk! I thought I’d add my two cents in addition to @MrsMig’s comment since I’m almost 5 months into my OR orientation! I completed my AORN Periop 101 course (I too did all the modules) and will take a final exam later this month. While I enjoyed the course in general, I find the best way to learn the OR is by far just being in it and practicing the skills there. I am a little nervous to take the final exam because of course it will be “by the book,” which I need to study more LOL but overall the course material was manageable.

In terms of preceptors- I have a main/assigned preceptor, but I am often with different people due to differences in my assigned preceptor’s schedule and what cases are going on each day. I  am learning to scrub and circulate- to date I have mainly been scrubbed, and I have done very little formal circulating (I think my hospital figured it would be best to start circulating after completion of the Periop course). Right now I can scrub GYN, general, cysto, vascular, podiatry, and plastics, and so far this is fine with me because I love scrubbing! I highly recommend learning to do both if you can.

I don’t have FORMAL complaints about my preceptors, but I will say that being with different people can somewhat complicate things. I mirror my skills/set up based off of who I was with at any given day, which someone else can find incorrect at a later date LOL I just take this for what it is & know that I will be able to do my own thing once I’m off orientation! Communication is KEY- please tell your preceptors upfront what you do and do not feel comfortable doing within any given case (I.e. draping...I initially found this skill challenging). I find that some won’t listen to you regardless LOL but at least that information was communicated upfront, and they usually just end up helping me more than I’d like (which is of course better than not at all). 


I hope this information helps! 

 

That is great to hear that you are training to scrub. I spent a complete year in the scrub role and it made me a much better, insightful circulator . Most large academic hospitals have their nurses scrub and circulate and to be hired now where I work you mast be willing to scrub and to undergo scrub training in order to be hired.  Good luck for the rest of your OR journey.

 

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Specializes in Trauma hospital/Acute Care/Ambulatory.
On 3/16/2021 at 4:24 PM, RickyRescueRN said:

That is great to hear that you are training to scrub. I spent a complete year in the scrub role and it made me a much better, insightful circulator . Most large academic hospitals have their nurses scrub and circulate and to be hired now where I work you mast be willing to scrub and to undergo scrub training in order to be hired.  Good luck for the rest of your OR journey.

 

Hi RickyRescueRN,

I just finished my first month out of the seven month training program. Everything went pretty much like what you have commented. You have provided very useful information on theory ( textbooks and peri-op modules with the exam) and practice ( clinical rotations). The two books that you recommended are worth every pennies. I read the CST book to prepare for scrub role while reading Alexzander’s for circular role. My facility also use Berry &Kohn’s operative room technique that I will recommend to newcomers like me too. As for as the clinical rotations, I am content with the team members for most of the parts but experienced some concerns over the safety issues. I wonder why the ESU evacuation suction is not used and where the laser eye protection/ lead eye protection wear are if any. I don’t want to be perceived as being overly critical or picky on the working environment but I do feel concerned with environmental hazards for the healthcare workers sometimes. Other workers don’t seem to care or deny the hazards despite knowing the harmful effects of some equipments. How will you address the issue while keeping harmony with the team members and good relationship with the facility. Any tips? Or any websites for purchasing the laser and lead eye protection wear recommended?

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Specializes in OR, Nursing Professional Development.
22 minutes ago, QqGgKk said:

I wonder why the ESU evacuation suction is not used

Unfortunately not all facilities have adopted this strategy yet. However, there are several states looking at legislation requiring its use. If you are in a nurse residency, this might be a good EBP project to tackle.

 

24 minutes ago, QqGgKk said:

where the laser eye protection/ lead eye protection wear are if any

Please ask this question! There are regulatory bodies that require access to this... also find out who your laser safety operator is. As for lead eye protection, I will say that the only people I've worked with who have requested this option (everyone can, most don't) are those who are working with x-ray day in and day out like cath lab.

1
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Specializes in ICU, Trauma, CCT,Emergency, Flight, OR Nursing.
On 2/25/2021 at 5:59 AM, QqGgKk said:

Hi RickyRescueRN,

Is this one?

Surgical Technology: Principles and Practice - 7th edition

ISBN13: 9780323394734

ISBN10: 0323394736

https://www.textbooks.com/Surgical-Technology-Principles-and-Practice-7th-Edition/9780323394734/Joanna-Kotcher-Fuller.php?CSID=2QOKBWJCJ2U232TADDQTTCSOB

Yup, that's the one. Really helped a lot not just for scrubbing but also OR nursing in general.

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Specializes in ICU, Trauma, CCT,Emergency, Flight, OR Nursing.
On 5/31/2021 at 10:05 AM, QqGgKk said:

Hi RickyRescueRN,

I just finished my first month out of the seven month training program. Everything went pretty much like what you have commented. You have provided very useful information on theory ( textbooks and peri-op modules with the exam) and practice ( clinical rotations). The two books that you recommended are worth every pennies. I read the CST book to prepare for scrub role while reading Alexzander’s for circular role. My facility also use Berry &Kohn’s operative room technique that I will recommend to newcomers like me too. As for as the clinical rotations, I am content with the team members for most of the parts but experienced some concerns over the safety issues. I wonder why the ESU evacuation suction is not used and where the laser eye protection/ lead eye protection wear are if any. I don’t want to be perceived as being overly critical or picky on the working environment but I do feel concerned with environmental hazards for the healthcare workers sometimes. Other workers don’t seem to care or deny the hazards despite knowing the harmful effects of some equipments. How will you address the issue while keeping harmony with the team members and good relationship with the facility. Any tips? Or any websites for purchasing the laser and lead eye protection wear recommended?

Wow, thanks so much for the update on how you are doing. Safety in the OR is paramount as both the health of our patients and ours depend on working in a safe environment. We advocate for our patients and our colleagues in this role. Check up on your institutions policies in terms of laser use and the laser Time Out and preparations of the room for use of lasers . There are very specific factors that must be adhered to. I think the JC (joint commission ) also check on these areas during a site inspection. If your policies dictate measures that must be taken, then first inform your team to follow policy and should they refuse to do that, inform your director and document an incident report for unsafe behaviour / practice. 

With regards to Smoke/ plume evacuation, until each state has legislation in place ( as Rose Queen mentioned in her reply ) , Oregon just became the 4th state with such mandates, we really just need to be champions in our own work places. If I am scrubbing, I always have a "mini square " smoke evacuator or a smoke evacuating ESU/ Bovie set up. I educate my residents and fellows and some attendings on the dangers of toxic plume and many of them are now following my lead fortunately. Luckily our new Chair of neurosurgery is a believer so I am working with him to make it a practice standard within our service line.  So, be a change agent in your workplace. 

Sounds like you are doing great. Thanks so much for giving us an update and we look forward to hearing more from your new journey!

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