RECRUITMENT FOR THE OPERATING ROOM Ann M . Cahill, R.N.

The problem of the ever-present shortage of the professional nurse in the operating room is becoming increasingly difficult because of the present trend in nursing education. Oper- ating room nursing per se in the majority of schools of nursing has either been reduced to such a brief experience that it is no longer meaningful, or has been deleted completely from the curriculum of the student. What an injustice to the patient! What a greater in- justice to the student of nursing!

Miss Ruth Sleeper, former director of the school of nursing and nursing service of the Massachusetts General Hospital, stated clearly in a talk to our AORN chapter that a school has the prerogative to determine its own curriculum regarding the education of the nurse. She encouraged OR nursing groups to take positive action in defining their specific role to encourage participation in this field of nursing.

It is an established fact that students are less apt to seek employment in specialized areas that are completely unfamiliar and threatening to them. If we cannot influence schools of nursing to retain operating room nursing in the educational preparation of the student nurse, then we must assume respon- sibility for this education on a graduate level through our own inservice educational pro- grams, utilizing audio-visual and program- ing methods.

Ann M. Cahill, R.N., is a graduate of Massachusetts General Hospital School of Nursing. She received her B.S. degree from Boston College School of Nurs- ing and is a candidate for her M.S. degree at Boston College. She has worked as an operating rnnm staff nurse, head nurse and ORS at Massachusetts Gen- eral Ilospital where she is presently a clinical instructor. Miss Cahill is a member of the ANA, the NLN, and AORN. This paper was prrsented at the AORN Congress iii Boston, 1968.

THE NEED Nursing care does not stop as the patient

goes through the OR door, to be resumed when the patient leaves the OR through the same door. It is an on-going continuum of patient care that is or should be guaranteed to every patient during his entire hospitaliza- tion including the duration of his time in the OR, be it 30 minutes, 300 minutes, or 600 minutes. The nurse within those doors is the same as her counterparts in other fields of nursing, with the same concern for her patient and the care he is to receive. However, in the OR there is a difference. The patient, in the majority of cases, is unconscious and unable to function for him- self. The nurse must be his guardian and his five senses, while he is unable to be the master of his own actions. She must be the protector of his rights and she must be aware of him as an individual at all times.

The grave problem that faces the OR super- visor today is the need for professional nurses as members of her staff to insure that care, and as Dorothy Ellison, OR nursing depart- ment head, New York Hospital says, “ . . . to provide for the professional succession in this clinical area.”l

The need for the professional nurse in the OR is obvious to practicing OR nurses. The complexities in this nursing area are increas- ing daily. The older, more debilitated patient, the highly specialized surgical procedures, the technological advances, revolutionary ap- proaches to old routines and increased num- bers of interdisciplinary team members make i t obvious that the nurse who has been edu- cated in the scientific method as the means of adding theoretical knowledge, who is re- search-oriented, who employs a problem-solv-

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ing approach, who has a sound background in behavioral sciences and who will bring to this field professional concepts of nursing, offers the proficiency and ability necessary in this clinical specialty. She, in turn, will find this clinical specialty stimulating, re- warding, and challenging.

DIRECT RECRUITMENT How can potential OR staff members be

reached? Having a sister as the manager of sales training in a large department store has made me aware of an approach that could be as beneficial to nursing as it is to retail- ing.

Each Spring, executive members of this store visit many of the colleges in the North- east, recruiting those interested in executive training in the retail field.

Hospitals are listed among the ten top in- dustries in the country and nursing is one of the major departments of these hospitals. Concerned with the problem of the acute shortage of the professional nurse in the operating room, I feel that we can benefit by copying retailing and, incidentally, all other major businesses, and literally go out recruiting the baccalaureate nursing graduate and the associate degree nursing graduate just as business does its potential executives. ( I do not mention the diploma programs because most of these are affiliated with hos- pitals and I feel we cannot interest graduates from one hospital into the employ of another hospital.)

Lucie Stirm Young, director of nursing, McKeesport Hospital, McKeesport, Pennsyl- vania, says, “There is little organized recruit- ment of the baccalaureate nurse . . . the new baccalaureate graduate with enormous po- tential for quality nursing.”’ At the present time, less than two per cent of the graduates of baccalaureate programs are entering the field of operating room nursing.

Appointments can be set up with collegiate schools of nursing to arrange for group or

individual discussions with interested stu- dents. Adequate time should be allocated for exploration of all the variables in this field. The recruiter should be sufficiently pre- pared to answer questions pertaining to staffing policies in general, and to her area in particular. Prospective staff members must be given a realistic picture of the responsi- bilities and functions of the nurse in the OR and not the glamorous image that is por- trayed through television and other enter- tainment media.

INDIRECT RECRUITMENT There is a more subtle method of recruit-

ment that all of us, still fortunate enough to have students in our operating rooms, prac- tice daily. It is our own every-day perfor- mance; our concern for our patients or lack of it; our exemplary clinical performance or lack of it; our participation as a contributing member of the team or lack of it that can greatly influence the student without either the graduate or the student consciously being aware of the effects of said performance.

“The students of today aren’t like they used to be.” You often hear this old chestnut, and it’s true. They are not like they used to be. They are sharper, they are better pre- pared, and they are more inquisitive. They seek “the what,” “the why,” and “the how.” They still possess the bubbliness, the en- thusiasm, and the interest that is ever present in the young. They are still looking either consciously or unconsciously for their ideal, the model by which they can pattern their performance. Members of the nursing staff in the OR can be the model that they emu- late. Concern for the patient, high standards of performance, receptivity to students, in- terest in teaching (which I believe is inherent in all responsible OR nurses), and a sense of team effort and team participation are all attributes that blend to attract the student as a potential member of the OR staff.

As professional nurses, committed to this

J u l y 1968 51

clinical specialty, I feel we must do everything we can to stimulate the interest and the actual participation of the new graduate and the soon-to-be graduate in this field of nursing.

KEEPING THE NEW RECRUIT Assurance must be given that the new staff

member will receive ample orientation. This assurance cannot be so many empty words. Definite time must be allocated for the educa- tion and development of this beginning mem- ber of the staff. The cooperation and under- standing of the surgical staff members and the medical administration of the hospital are most important for the success of a program such as this. The necessary inservice program should be inclusive and on a continuum basis. Classes and experiences should be current, dynamic and progressive to maintain interest and provide satisfaction.

One cannot expect this new team member to become an expert overnight. An adequate period of time is needed to insure her a sufficient interval to gain the necessary knowl- edge, experience, and expertise in this vital, clinical field.

We must keep in mind that no system of recruitment has ever been fully successful, but we can be optimistic. We can strive continu- ally to improve in the further development of our inservice programs by remaining flexible, receptive to innovations, and adap- tive to scientific developments and techno- logical advances.

Direct and indirect recruitmen1 of new graduates and soon-to-be graduates, pride and enthusiasm in professional performance, and improving our inservice programs can be our major endeavors; our broad range goals in our commitment to operating room nursing.

REFERENCES 1. Ellison, Dorothy, “The Technical And The Pro- 2. Young, Lucie Stirm, “The New Baccalaureate fessional in Operating Room Nursing,” AORN Jour- Graduate in Nursing Service,” Nursing Outlook, nal, VI, Dec., 1967, p. 70. XIV, Nov., 1966, p. 49.

COMMISSION ON NURSING EDUCATION The Commission began its work in March, 1%7, and the following functions for the Commission are stated in Article XIV, Section 7 of the ANA Bylaws:

a ) Evaluate relevant scientific and educational dvelopments, changes in health needs and practices, with reference to their implications for nursing education. b ) Estahlish the scope of the Association’s responsibility for nursing edura- tion. c ) Develop standards of nursing education and devise methods for gaining their acceptance and implementation through appropriate channels. d ) Encourage and stimulate research in all areas of nursing education. e l Formulatr policy and recommend action concerning federal and state legislation in the field of education.

THE COMMISSION’S PLAN OF WORK: FOUR AREAS OF NEED The Commission began by identifying four broad areas of need which would define its frame of reference and plan of work: 1 ) the need to delineate the “sphere of influence,” responsibility, and authori- ty of nurses 2) the need to identify inadequacies in the current system of education and health care 3) the need to identify the purpose and essential characteristics of education for nurse practitioners 4) the need to identify functions for baccalaureate and associate degree graduates.

52 AORN Journal