Nancy Lane Konda, RN
Staff development for RR nurses
As nurses become more specialized, the need for staff development pertinent to specialty areas increases. Nurses who function in these area8 must assume responsibility for meeting this need if they are to maintain professional status. Staff development for nurses in the recovery room can be accomplished by a n individualized program using the nursing process as a framework.
Nancy Lane Konda, RN, is a nursing education consultant. She received her BSN from the Cornell University-New York Hospital School of Nursing in New York City. This article was originally delivered as a lecture at a postanesthesia recovery room symposium for continuing education sponsored by the University of Californiu, Irvine. 664
“he program, consisting of courses on subjects appropriate to nursing practice in the recovery room, is conducted separately from regularly scheduled inservice classes. When possible, however, resources available through the inservice department should be used, especially if CEU (continuing education unit) are to be granted participants. The plan can be flexible and may be used to develop impromptu sessions. The four-step nursing process provides an ideal framework for expansion of a staff deveIopment proposal. 0 Assessment determines the SMS educational needs. 0 Planning develops a program contingent on those needs. 0 Implementation is the actual presentation of the program. 0 Evaluation is made at various phases of the program and may determine changes in direction. The first step is assessing staff needs. Involving the entire staff promotes motivation. People are generally more cooperative in a project they believe meets their needs; therefore, it is essential to determine the areas in which they sense weaknesses and where job fulfillment is not met. The following methods may be used
AORN Journal, October 1977, Vol26, No 4
in assessing needs in the recovery room. Distribute a questionnaire to the staff offering a choice of subjects and encourage suggestions. Have the respondents sign the questionnaire to stimulate future personal involvement. Have a suggestion box available. Suggestions should also be signed. Review policy and procedure manuals. Compare actual practice with the written procedures. Interview former patients of the recovery room. Seek the advice of surgeons and anesthesiologists. The second step is the planning phase. A staff development committee with a designated leader should be set up to insure orderly development of the program. This is essential even if the recovery room staff is small. This committee should choose the subjects to be covered based on the needs analysis. Those subjects most frequently requested and those directly related to recovery room nursing practice should receive priority. New drugs, equipment, and operative procedures should be discussed as well as reviews of drugs, equipment, and procedures in use. This is especially important for new staff members. Once subjects are chosen, they should be researched. Textbooks are obvious resources. Several appropriate ones should be kept in the recovery room covering such subjects as recovery room nursing, drugs and compatibilities, respiratory care, and operative procedures. Nursing journals are also valuable resources, and some have excellent programmed instruction units. Some journals may refer to other resources through reviews of books and audiovisual materials. The American Association of Criti-
cal-Care Nurses has prepared a Core Curriculum for Critical Care Nursing, which may serve as a guide for a program.' The association has reviewed numerous audiovisual materials appropriate to critical care nursing and may be helpful in locating specific material. Local colleges and universities also may have books or audiovisual materials available through the nursing department or the audiovisual department. A national organization supplying audiovisual information is AVLINE, a computer-managed reference file of audiovisual materials. The file contains summaries of programs reviewed by experts and is managed through the National Library of Medicine, Bethesda, Md. This service may be obtained from any medical library serviced by MEDLINE. Pharmaceutical and medical equipment companies provide excellent sources of information and materials, including brochures, pocket cards, posters, and audiovisual aids. If they have audiovisual materials, they may loan them with a projector, or they will present a class on the subject in question. Many times company representatives have no direct contact with the staff nurse; if this is the case, the hospital purchasing agent can supply names of local representatives. Many hospital supply organizations also have nurses on staff to provide inservice classes about their materials. Finally, the talents of the recovery room and operating room staff members can be used in teaching courses. For example, a recovery room nurse might review the purpose of postoperative oxygen therapy or teach a new procedure. The anesthesiologist might discuss breath sounds or muscle relaxants. A surgeon might present a new operative procedure. The pharmacist could explain a new drug.
AORN Journal, October 1977, Vol26, N o 4
665
nstruction may be tailored to individual recovery rooms.
I
After the subjects have been established and the resources explored, the next step in planning is to determine the mode of presentation. Basically, the subject will influence the manner of presentation, but the following are some means that may be used. A brief lecture could include visual aids such as charts, drawings, and pictures from journals. A question-andanswer period promotes involvement. Discussions could focus on subjects covered in journal articles read by staff members. The discussions could be directed toward applying the subject matter to recovery room nursing practice. Programmed instruction units, an excellent means of independent study, are readily available and relatively inexpensive. These could be used for individual instruction when the patient load permits. Nurses could be rotated through a specific unit. This type of instruction may be tailored to individual recovery rooms. Audiotapes can be incorporated in a lecture/discussion or in a programmed instruction unit. Audiotapes of significant seminars at conventions and symposia are commercially available through several companies. A lecture presented to the recovery room staff might be recorded for later use. Audiovisual programs can include slides with an audio cassette, a filmstrip with an audio cassette, 16 mm 666
motion pictures, and video cassettes. These presentations require a schedule, a preview of the material, and preparation of a classroom. Any combination of the above modes may be used. For example, an anesthesiologist might present a lecture and discussion on breath sounds followed by an audiotape illustrating some common sounds. The final step in the planning stage is proper use of available time. The key is flexibility. The program should have presentations prepared in advance for use on an impromptu basis during an unexpected 10- to 15-minute quiet time. When possible, classes should be slated in advance, taking into account the surgery schedule. Obviously, programs by outside people and incorporating audiovisual materials need to be scheduled. The next step, implementation, is determined by the subject, mode of presentation, and the recovery room schedule. These are some basic rules to follow. 0 Announce the session. Be sure that all involved personnel are aware of times and places of classes. 0 Start and end promptly. 0 Be brief but allow for breaks when lengthy sessions are planned. 0 Arrange for a quiet place when possible.
AORN Journal, October 1977,Vol26, No 4
Prepare all materials in advance as needed, eg, blackboard, chalk, charts, equipment to be demonstrated, and audiovisual materials. Evaluation, the final step, should be involved throughout the previous three phases as in the nursing process. Ultimately, the entire staff development program should be evaluated by testing, practical evaluation, peer review, and reassessment of the needs analysis. Testing is a reliable method provided proper questions are formed and responses assessed. An alternative to a structured examination might be an essay evaluation by participants. Practical evaluation, ie, on-the-job observation, is more applicable to this staff development program. For example, a nurse who has completed a breath sounds course might be asked to identify the breath sounds of a patient known to have ronchi. Peer evaluation is another evaluation tool. Each staff member might evaluate another’s grasp of new information. For example, after a demonstration of a new respirator, the participants could each demonstrate in turn as the others evaluate. To complete the cycle, a review of the original needs analysis will determine if all the subjects are covered. In essence, were all the needs met? If some were not met, the planning and implementing stages need to be corrected. Within this framework of the nursing process, a recovery room staff development program can be inaugurated independently of the regular inservice curriculum. It would be a program pertinent to recovery room nursing practice both in subject and scheduling. It would be flexible, creative, and stimulating and should ulti0
mately improve patient care and job satisfaction. 0 Not., 1. American Association of Critical-Care Nurses, Core Curriculum for Crirical Care Nursing (Irvine, Calif: American Association of Critical-Care Nurses, 1975). RdMWlc# Dunn, Rita, Dunn, Kenneth. Practical Approaches to Individualized Instruction. West Nyack, NY: Parker Publishing CO, 1972. Lorig, Kate. “An overview of needs assessment tods for continuing education.” Nurse Educafor (March-April 1977) 12-26. McConnell, Edwina A. “After surgery: How you can avert the obvious hazards and the not-sck obvious ones, too.” Nursing ’77 (March 1977) 32-39. Yura, Helen, Walsh, Mary B. The Nursing Process: Assessing, Planning, Implementing, and EvaluaHng. New York: Appleton-Century-Crofts, 1973.
Women physicians tagged superwomen Women physicians who practice medicine while fulfilling the role of wife and mother are “superwomen,” according to a report in the Journal of the American Medical Association. Studying the productivity of men and women physicians, Marilyn Heins, MD, Wayne State University School of Medicine, Detroit, concludes there has been an increase in productivity of women physicians in the past 10 to 20 years. At the same time, more women in medicine married and had children. Dr Heins studied the working habits of groups of men and women physicians and determined that women physicians work nearly 90% as much as men physicians. The difference is largely due to time out for child bearing and child rearing by the women physicians, she says. At the time of the survey, 96% of the men and 84% of the women were practicing medicine. Most of those of both sexes not working were ill or retired. Only 7% of nonworking women physicians were not working for reasons related to marriage, child birth, or child rearing.
AORN Journal,October 1977, Vol26, No 4
667
Staff development for RR nurses
As nurses become more specialized, the need for staff development pertinent to specialty areas increases. Nurses who function in these area8 must assume responsibility for meeting this need if they are to maintain professional status. Staff development for nurses in the recovery room can be accomplished by a n individualized program using the nursing process as a framework.
Nancy Lane Konda, RN, is a nursing education consultant. She received her BSN from the Cornell University-New York Hospital School of Nursing in New York City. This article was originally delivered as a lecture at a postanesthesia recovery room symposium for continuing education sponsored by the University of Californiu, Irvine. 664
“he program, consisting of courses on subjects appropriate to nursing practice in the recovery room, is conducted separately from regularly scheduled inservice classes. When possible, however, resources available through the inservice department should be used, especially if CEU (continuing education unit) are to be granted participants. The plan can be flexible and may be used to develop impromptu sessions. The four-step nursing process provides an ideal framework for expansion of a staff deveIopment proposal. 0 Assessment determines the SMS educational needs. 0 Planning develops a program contingent on those needs. 0 Implementation is the actual presentation of the program. 0 Evaluation is made at various phases of the program and may determine changes in direction. The first step is assessing staff needs. Involving the entire staff promotes motivation. People are generally more cooperative in a project they believe meets their needs; therefore, it is essential to determine the areas in which they sense weaknesses and where job fulfillment is not met. The following methods may be used
AORN Journal, October 1977, Vol26, No 4
in assessing needs in the recovery room. Distribute a questionnaire to the staff offering a choice of subjects and encourage suggestions. Have the respondents sign the questionnaire to stimulate future personal involvement. Have a suggestion box available. Suggestions should also be signed. Review policy and procedure manuals. Compare actual practice with the written procedures. Interview former patients of the recovery room. Seek the advice of surgeons and anesthesiologists. The second step is the planning phase. A staff development committee with a designated leader should be set up to insure orderly development of the program. This is essential even if the recovery room staff is small. This committee should choose the subjects to be covered based on the needs analysis. Those subjects most frequently requested and those directly related to recovery room nursing practice should receive priority. New drugs, equipment, and operative procedures should be discussed as well as reviews of drugs, equipment, and procedures in use. This is especially important for new staff members. Once subjects are chosen, they should be researched. Textbooks are obvious resources. Several appropriate ones should be kept in the recovery room covering such subjects as recovery room nursing, drugs and compatibilities, respiratory care, and operative procedures. Nursing journals are also valuable resources, and some have excellent programmed instruction units. Some journals may refer to other resources through reviews of books and audiovisual materials. The American Association of Criti-
cal-Care Nurses has prepared a Core Curriculum for Critical Care Nursing, which may serve as a guide for a program.' The association has reviewed numerous audiovisual materials appropriate to critical care nursing and may be helpful in locating specific material. Local colleges and universities also may have books or audiovisual materials available through the nursing department or the audiovisual department. A national organization supplying audiovisual information is AVLINE, a computer-managed reference file of audiovisual materials. The file contains summaries of programs reviewed by experts and is managed through the National Library of Medicine, Bethesda, Md. This service may be obtained from any medical library serviced by MEDLINE. Pharmaceutical and medical equipment companies provide excellent sources of information and materials, including brochures, pocket cards, posters, and audiovisual aids. If they have audiovisual materials, they may loan them with a projector, or they will present a class on the subject in question. Many times company representatives have no direct contact with the staff nurse; if this is the case, the hospital purchasing agent can supply names of local representatives. Many hospital supply organizations also have nurses on staff to provide inservice classes about their materials. Finally, the talents of the recovery room and operating room staff members can be used in teaching courses. For example, a recovery room nurse might review the purpose of postoperative oxygen therapy or teach a new procedure. The anesthesiologist might discuss breath sounds or muscle relaxants. A surgeon might present a new operative procedure. The pharmacist could explain a new drug.
AORN Journal, October 1977, Vol26, N o 4
665
nstruction may be tailored to individual recovery rooms.
I
After the subjects have been established and the resources explored, the next step in planning is to determine the mode of presentation. Basically, the subject will influence the manner of presentation, but the following are some means that may be used. A brief lecture could include visual aids such as charts, drawings, and pictures from journals. A question-andanswer period promotes involvement. Discussions could focus on subjects covered in journal articles read by staff members. The discussions could be directed toward applying the subject matter to recovery room nursing practice. Programmed instruction units, an excellent means of independent study, are readily available and relatively inexpensive. These could be used for individual instruction when the patient load permits. Nurses could be rotated through a specific unit. This type of instruction may be tailored to individual recovery rooms. Audiotapes can be incorporated in a lecture/discussion or in a programmed instruction unit. Audiotapes of significant seminars at conventions and symposia are commercially available through several companies. A lecture presented to the recovery room staff might be recorded for later use. Audiovisual programs can include slides with an audio cassette, a filmstrip with an audio cassette, 16 mm 666
motion pictures, and video cassettes. These presentations require a schedule, a preview of the material, and preparation of a classroom. Any combination of the above modes may be used. For example, an anesthesiologist might present a lecture and discussion on breath sounds followed by an audiotape illustrating some common sounds. The final step in the planning stage is proper use of available time. The key is flexibility. The program should have presentations prepared in advance for use on an impromptu basis during an unexpected 10- to 15-minute quiet time. When possible, classes should be slated in advance, taking into account the surgery schedule. Obviously, programs by outside people and incorporating audiovisual materials need to be scheduled. The next step, implementation, is determined by the subject, mode of presentation, and the recovery room schedule. These are some basic rules to follow. 0 Announce the session. Be sure that all involved personnel are aware of times and places of classes. 0 Start and end promptly. 0 Be brief but allow for breaks when lengthy sessions are planned. 0 Arrange for a quiet place when possible.
AORN Journal, October 1977,Vol26, No 4
Prepare all materials in advance as needed, eg, blackboard, chalk, charts, equipment to be demonstrated, and audiovisual materials. Evaluation, the final step, should be involved throughout the previous three phases as in the nursing process. Ultimately, the entire staff development program should be evaluated by testing, practical evaluation, peer review, and reassessment of the needs analysis. Testing is a reliable method provided proper questions are formed and responses assessed. An alternative to a structured examination might be an essay evaluation by participants. Practical evaluation, ie, on-the-job observation, is more applicable to this staff development program. For example, a nurse who has completed a breath sounds course might be asked to identify the breath sounds of a patient known to have ronchi. Peer evaluation is another evaluation tool. Each staff member might evaluate another’s grasp of new information. For example, after a demonstration of a new respirator, the participants could each demonstrate in turn as the others evaluate. To complete the cycle, a review of the original needs analysis will determine if all the subjects are covered. In essence, were all the needs met? If some were not met, the planning and implementing stages need to be corrected. Within this framework of the nursing process, a recovery room staff development program can be inaugurated independently of the regular inservice curriculum. It would be a program pertinent to recovery room nursing practice both in subject and scheduling. It would be flexible, creative, and stimulating and should ulti0
mately improve patient care and job satisfaction. 0 Not., 1. American Association of Critical-Care Nurses, Core Curriculum for Crirical Care Nursing (Irvine, Calif: American Association of Critical-Care Nurses, 1975). RdMWlc# Dunn, Rita, Dunn, Kenneth. Practical Approaches to Individualized Instruction. West Nyack, NY: Parker Publishing CO, 1972. Lorig, Kate. “An overview of needs assessment tods for continuing education.” Nurse Educafor (March-April 1977) 12-26. McConnell, Edwina A. “After surgery: How you can avert the obvious hazards and the not-sck obvious ones, too.” Nursing ’77 (March 1977) 32-39. Yura, Helen, Walsh, Mary B. The Nursing Process: Assessing, Planning, Implementing, and EvaluaHng. New York: Appleton-Century-Crofts, 1973.
Women physicians tagged superwomen Women physicians who practice medicine while fulfilling the role of wife and mother are “superwomen,” according to a report in the Journal of the American Medical Association. Studying the productivity of men and women physicians, Marilyn Heins, MD, Wayne State University School of Medicine, Detroit, concludes there has been an increase in productivity of women physicians in the past 10 to 20 years. At the same time, more women in medicine married and had children. Dr Heins studied the working habits of groups of men and women physicians and determined that women physicians work nearly 90% as much as men physicians. The difference is largely due to time out for child bearing and child rearing by the women physicians, she says. At the time of the survey, 96% of the men and 84% of the women were practicing medicine. Most of those of both sexes not working were ill or retired. Only 7% of nonworking women physicians were not working for reasons related to marriage, child birth, or child rearing.
AORN Journal,October 1977, Vol26, No 4
667
