Three assessment questions for a Perioperative Specialist
Perioperative care is an important practice in as far as health care is concerned. It comes
with various challenges that every health worker requires to understand. During the provision of
perioperative care, patients’ safety is the primary focus (Laws & Goudas, 2013). However, the
health care’s provider’s health is mostly forgotten. Perioperative placement poses a challenge in
the health of the nurses. To start with, nurses undergo not only physical injury but also they
experience emotional harm. These nurses are expected to work long shifts which sometimes
extend beyond twelve hours (ElBardissi & Sundt, 2012). This is attributed by the fact that nurses
mostly perform their duties while standing therefore predisposing them to musculoskeletal
Moreover, they are predisposed to infections. During the placement, one comes in contact
with secretions from the patient. Some patients may have hepatitis infections, while other may be
infected with HIV virus (Gillespie, Gwinner, Chaboyer, & Fairweather, 2013). Perioperative
nurses are usually separated from their family members for long hours this makes them suffer
from workplace related stresses.
The health of nurses is very critical since it determines the provision of quality care to
patients. There are workplaces which make nurses experience physical and psychological
damage. The improper work environment can predispose perioperative nurses to short-term or
long-term conditions (Laws & Goudas, 2013). These include musculoskeletal injuries, infections
and mental health changes. Long-term complications that may also arise include diseases such as
cardiovascular and neoplastic diseases.
THREE ASSESSMENT QUESTIONS 2
Factors that predispose to psychological damage include long working hours and long
shifts and also some nurses work overtime. It is believed that when nurses work for long, they
may end up affecting their sleeping patterns which in turn affects the length and quality of sleep
(Laws & Goudas, 2013). When working for long hours, time of social interactions with family
members and friends is depleted. This makes the nurses be separated from their families for long.
Physical injuries can result from some positions nurses are expected to assume when for instance
lifting patients. Many nurses end up complaining of backaches.
THREE ASSESSMENT QUESTIONS 3
Afkari, H., Bednarik, R., Mäkelä, S., & Eivazi, S. (2016). Mechanisms for Maintaining Situation
Awareness in the Micro-Neurosurgical Operating Room. International Journal of Human-
ElBardissi, A. W., & Sundt, T. M. (2012). Human factors and operating room safety. Surgical
Clinics of North America, 92(1), 21-35.
Gillespie, B. M., Gwinner, K., Chaboyer, W., & Fairweather, N. (2013). Team communications
in surgery–creating a culture of safety. Journal of interprofessional care, 27(5), 387-393.
Laws, T. A., & Goudas, L. (2013). Health workers Safety in the operating room: A systematic
review. ACORN: The Journal of Perioperative Nursing in Australia, 26(3), 10.
Nursing and Midwifery Board of Australia. (2010). Nursing and national competency standards
for Registered nurse.
THREE ASSESSMENT QUESTIONS 4
The nursing profession is governed by a professional code of ethics which stipulate the
roles and responsibilities of nurses during provision of care. Moreover, some ethical issues must
be considered. During the provision of care, nurses should be aware of the client’s rights. Every
patient has the right to confidentiality; this means that the information provided by the patient
should not be disclosed to anyone without their consent (Gold, Philip, Mclver, & Komesaroff, 2012).
Clients must be assured of confidentiality to prevent them from withholding any information that
might directly impact their health.
However, nurses usually face a challenge when the health of the client is compromised
especially when they are undergoing an operation. This may happen in case for a patient who
was undergoing an operation goes into a comma (Gold, Philip, Mclver, & Komesaroff, 2012). In as
much as the perioperative nurse might have promised to keep any information confidential, it
may necessitate disclosure of this information to the family members (Nursing and Midwifery
Board of Australia, 2014). However, this goes against the principle of confidentiality. There are
ethical principles which can guide the healthcare professions in the perioperative unit.
When a patient is undergoing surgery, and it happens that a particular body part requires
to be amputated, it is difficult for the health providers to make a proper decision parting the
outcome since the patient had not given consent. It, therefore, calls for the involvement of the
In the event the health of a patient on the operating table deteriorates, nurses are torn
between safeguarding the patient’s confidentiality or disclosing any information to the
THREE ASSESSMENT QUESTIONS 5
caregivers. Before admission into the perioperative unit, possibly when the patient is signing the
consent, it is important to ask them what information can be shared with the family members.
Therefore, it is important for the patients to understand that they may not be able to make
decisions when they have been with anesthetic agents (Gold, Philip, Mclver & Komesaroff, 2012).
Similarly, when they are in the theater, they may develop anxiety and tension, therefore, carry
out the wrong decisions. This, therefore, stresses the need to share information with the family
members (Wilson, 2012).
Patients have a right to make decisions regarding their health and therefore, perioperative
nurses should respect since its emphasis on the importance of keeping confidentiality (Berman et
al. 2012). In case any information is disclosed without the patient’s consent, the patient may suffer
psychologically on realizing it. Patients may take legal action in the event of bleach of
confidentiality (Gold, Philip, Mclver, & Komesaroff, 2012).However, in some situations, it may be
important to share patient’s information with other health care professionals to safeguard their
health. This would mostly apply in case a patient to undergo an operation has hepatitis or HIV
THREE ASSESSMENT QUESTIONS 6
Berman, A., Snyder, S.J., Kozier, B., Erb, G., Levett-Jones T., Dwyer, T., Hales, M., Harvey, N., &
Stanley, D. (2012). Kozier and erb’s fundamentals of nursing (2nd ed.). Vol 2, NSW: Pearson
DeKeyser Ganz, F., & Berkovitz, K. (2011). Surgical nurses’ perceptions of ethical dilemmas, moral
distress and quality of care. Journal of Advanced Nursing, 68(7), 1516-1525.
Gold, M., Philip, J., Mclver, S., & Komesaroff, P. A. (2012). Between a rock and hard place: Exploring
the conflict between respecting the privacy of patient and informing their carers. Internal
Medicine Joiurnal, 39(9), 582-587.
Ingravallo, F., Gilmore, E., Vignatelli, L., Dormi, A., Carosielli, G., Lanni, L., & Taddi, P. (2014).
Factors associated with nurse’s opinion and practices regarding information and consent. Nursing
Ethics, 2(3), 259-313.
Nursing and Midwifery Board of Australia. (2014). Nursing and national competency standards for
Petronio, S., & Sargent, J. (2011). Disclosure Predicaments Arising During the Course of Patient Care:
Nurses’ Privacy Management. Health Communication, 26(3), 255-266.
Wilson, R. (2012). Legal, ethical and professional concepts with in the operating department. National
Institute of Health, 22(3),81-5.
THREE ASSESSMENT QUESTIONS 7
Surgery disrupts the body image even when the surgical results are optimal. I noted
during my placement that those patients who underwent surgery experienced social isolation and
depression after surgery. This was attributed by patient’s different perception on illness. It came
to my realization that patients who underwent cardiac surgery experienced social, emotional and
spiritual fears. This was attributed to the patients having a cultural meaning of the heart as an
organ responsible for emotions and controls life (Griffin & Yancey, 2011).The perioperative
environment takes the patient away from the family home exposing him to unknown situations,
bright lights, strange sounds and technical language. I also noted that previous hospital
experiences and personal issues such as unemployment family responsibilities may have adverse
impacts on the outcome of the surgery (Hanna et al., 2012).
I realized during my placement that in the perioperative phase, nurses have a great
responsibility in addressing patient’s perception on about the outcome of surgery. Most patients
had anxiety and fear which was directly related to death threat, threat to change of health
condition and separation from their family members. I happened to interact with a patient who
was waiting to be done craniotomy and he had fears that the operation would have changed his
life. I appreciated that nurses were vigilant in handling these fears. After surgery, most patients
were grateful to the nurses for the information they were provided with since it provided them
with better coping skills hence faster recuperation. These patients therefore changed their
perception about illness and recovery after surgery
THREE ASSESSMENT QUESTIONS 8
I noted that during the perioperative period that, preadmission contact, provision of
relevant education and information, proper communication skills and maintaining patient privacy
are factors which provide security and patient satisfaction (Reynolds & Carnwell, 2012).
Minimal nurse contact, lack of personalized care and lack of information about the surgery, type
of anesthetic agent and recovery are associated factors to the dissatisfaction of the patient.
Therefore, it is important for the nurse to attend to the patient’s expectation to surgery. In the
perioperative period, the nurse should attend to patients concerns, attend to medical needs as well
as emotional, social and spiritual concerns (Griffin & Yancey, 2011)
My experience during my placement enlightened me that surgery can have physical and
psychological change s which can have consequences on the life of the patient after surgery and
have different meaning on health, illness, and death (Berman et al., 2012). Nurses have a role in
respecting the patient’s values and beliefs and provide support to family members and patients.
Health professionals should understand the perceptions of the patients regarding illnesses and
recuperation so as to enhance their recovery.
THREE ASSESSMENT QUESTIONS 9
Berman, A., Snyder, S.J., Kozier, B., Erb, G., Levett-Jones T., Dwyer, T., Hales, M., Harvey, N.,
& Stanley, D. (2012). Kozier and erb’s fundamentals of nursing (2nd ed.). Vol 2, NSW:
Pearson Sydney Australia.
Griffin, A., & Yancey, V. (2011). Spiritual Dimensions of the Perioperative Experience. AORN
Journal, 89(5), 875-882.
Hanna, M. N., González-Fernández, M., Barrett, A. D., Williams, K. A., & Pronovost, P. (2012).
Does patient perception of pain control affect patient satisfaction across surgical units in a
tertiary teaching hospital?. American Journal of Medical Quality, 27(5), 411-416.
Reynolds, J., & Carnwell, R. (2012). The nurse-patient relationship in the post-anesthetic care
unit. Nursing Standard, 24(15), 40-46.
Tan, K., Konishi, F., Kawamura, Y., Maeda, T., Sasaki, J., Tsujinaka, S., & Horie, H. (2011).
Laparoscopic colorectal surgery in elderly patients: a case-control study of 15 years of
experience. The American Journal of Surgery, 201(4), 531-536.