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Professionalism in Perioperative Nursing

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1. Introduction

Perioperative nursing can be defined as the provision of nursing care by a Registered Nurse preoperatively (before), intra-operatively (during), and postoperatively (after) to a patient undergoing an operative or invasive procedure. It is practiced today in many different areas, e.g. hospital operating rooms, interventional radiology suites, cardiac catheterization laboratory (room in a hospital where diagnostic imaging equipment is used to support the catheterization procedures) surgeon offices, endoscopy suites, ambulatory surgery centres and emergency trauma units. (Brien. B, 2011). A Perioperative nurse work in the operation room (OR) and have very limited contact with the public rather than an interaction between peer so there will be many personalities they have to face due to work in the confined environment.

A definition of OR in the 1998 by Reavis & Sandidge (Shields & Werder 2002, p.3) is a complex system that combines personnel, technology, patients and pharmacodynamics in a physical environment coordinated to yield specific patients outcomes. The patient’s safety and welfare are entrusted to the perioperative nurse from the moment of arrival in the perioperative environment until departure and the transfer of responsibility care to another professional health care team member. Meanwhile, Brien.B, (2011) tells us that the core nursing skills of perioperative patient care was involving critical thinking, aseptic technique but the procedure performed under sterile conditions, working with diverse patients and evidence-based practice to ensure that quality care is delivered. It also involves maintaining safety, educating patients, adhering to legal guidelines, policies and procedures' ensuring that care is administered in an ethical way. Perioperative nursing evolves their work practices to keep pace with development whilst retaining their basic love of caring for people.

‘Not all angel has wing, they wear scrub’. This quote really touches my heart every time I see it posted on social media pages, such as facebook and Instagram. It reminds me to the world of perioperative nurse. Luckily, perioperative area of nursing is very exciting, ever-changing and always developing. Technologies, drugs, anaesthetics and operating procedures change, but ultimately the care of patient changes little. Therefore, this essay will explain briefly how perioperative nurse can relate their professionalism to the challenges they face at their workplace.

2. Definition of professionalism

According to Learner's dictionary (2018), professionalism is the skill, good judgment, and polite behavior that is expected from a person who is trained to do a job well. In Leonard’s (2018) opinion, professionalism is a component of the concept of work ethic, which describes how a person comes to work and conducts himself on the job. In other words, professionalism can be described as the nature of the ability, skill, manner of execution of something and others as appropriate to or done by a professional.

3. Literature Review

Cheryl, L. & Mee (2003) stated that perioperative nurses are also known as operating room (OR) nurses, perioperative nurses work closely with surgical patients, family members, and other health care professionals to help plan, implement, and evaluate patients' treatment. Their role in OR is more technical nature than nurses on the wards. Within that technical function, they have a responsibility and accountability for performance of special role, which includes instrument and swab counts, maintenance of aseptic technique, correct use of equipment such as diathermy, endoscopes and lasers, and appropriate patient positioning (Tanner, A. & Anderson. M, 2002). This was supported by Pape in the year 1999 (Tanner, A. & Anderson. M, 2002) that to function effectively in the perioperative setting, OR nurse need patience, knowledge and skill in problem-solving techniques, conflict resolution and communication techniques. The aim of this literature review is to describe nursing perception and actual practice of perioperative nurse in operation room.

4. Characteristics of professional perioperative nursing

A person must meet certain criterias when being evaluated on professionalism. Same goes to perioperative nurses. Below are several characteristics of perioperative nurse to achieve their professionalism.

4.1 Knowledge and skill

First and foremost, a perioperative nurse must improve themselves with knowledge, skills and medical care in line with progress and the development of current medical technology. Perioperative nurse must be knowledgeable and mastered some expertise from theoretical, practical and clinical. They applied the knowledge and use the theoretical or evidence-based rationale to practice or using information and evidence from nursing and other disciplines to be practiced. For example, perioperative nurses always refer to National Operation Room Nursing Audit book as their guideline in their workplace. By referring to this book, they are audited every month to improve their skill and knowledge.

4.2 Adherence to code ethic

Second, they must adhere to code ethics in making a clinical judgment by following the standard of professional conduct and a study of principles in the right and wrong practice is essential for nurses to achieve a brilliant working standard. A literature review by Chitty K & Beth P. in the 2007 (Shahriari, M. et al 2013) stated that they need ethical knowledge to conduct their appropriate function to manage situations and to give safe and proper legal and ethical care in today's changing world. For an example, the most fundamental of work ethic principles is respecting a patient's autonomy. A perioperative nurse respects the dignity and value of patient that will go on surgery equally such as a worthy individual by ensuring they receive the best service before, during and after surgery based on the written consent of the patient himself regarding the operation regardless of personal attributes or medical condition.

4.3 Accountability

The College of Nurses of Ontario (2006), defined accountability as taking responsibility of their own actions including errors and ensuring their practice is consistent with practice standards, guidelines and all legislation appropriate to the profession. As well as they must take action in situations where patient safety and well-being are compromised and report any unsafe and unprofessional behaviour. For an example, a perioperative nurse is responsible for checking the safety of diathermy plate and machine before it is attached to



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