August 2024 • Volume 17, No. #8
From the Editor
Greetings!
In this issue we take a look at the “OR personality” and OR communication styles.
It all started when we interviewed Jerrilea Hubble, MSN, FNP-C, CNOR, RNFA, director of NIFA’s NISE (Nurse in Surgery Essentials) program and our flagship RNFA Program, for this month’s “Spotlight” profile. After many years in the OR, she has some interesting observations about OR communication styles. That conversation inspired us to look into recent research on the topic of OR communication.
This month we also bring you some NIFA news, including the introduction of NIFA’s own RNFA job board!
And scroll down for NIFA’s favorite links.
Enjoy!
Julie Lancaster, Editor
Photo by Adobe Stock
NIFA News
Things are popping at the NIFA office!
NIFA Launches Its Own Job Board!
Check out NIFA’s new job board that will give ongoing access to RNFA job opportunities nationwide. The job board has its own website, https://www.nifajobs.com, as well as being accessible from the main NIFA website, rnfa.org. We’ve included a jobs listing in this monthly newsletter for many years, but as of this issue, that will be replaced by the new job board!
Read more. . .
Recertification Awarded
NIFA’s NISE program (Nurse in Surgery Essentials) has just received re-accreditation from the Accreditation Board for Specialty Nursing Certification (ABSNC).
“ABSNC is the only accrediting body specifically dedicated to evaluating nursing Certificate of Mastery (COM) programs and the NISE program is one of only two accredited COM programs in the country,” says James Stobinski, PhD, RN, CNOR, CSSM(E), CNAMB(E), NIFA’s Senior Perioperative Advisor (photograph at right). “Through a peer-review mechanism, NIFA has achieved re-accreditation by demonstrating compliance with the most rigorous industry standards.” Stobinski was instrumental in working through the accreditation process.
RNFA Programs
Did you know that, in addition to NIFA’s flagship RNFA program, NIFA has developed the RNFA-PLUS program, the First Assistant Program specifically targeted to APRNs? The program includes three distinct phases: an online portion that addresses all the modules of the AORN Core Curriculum for RN First Assistants, the 5-day version of the SutureStar™ Workshop, and a surgical internship arranged at the student’s own facility. Eligible participants are nurse practitioners (NP), certified nurse midwives (CNMs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs).
Meanwhile, between now and the end of 2024, SutureStar® First Assistant 3-day and 5-day on-site, hands-on workshops are scheduled in four cities. There’s even a 3-day, all-virtual workshop scheduled in November (don’t worry about telling your friends; it’s practically sold out already). As of this writing, 11 workshops are planned for 2025 in cities ranging from Clearwater Beach, FL, to Santa Monica, CA.
Rude or Effective – What is the OR Personality?
NISE Program Helps Nurses Adjust to OR Communication Styles
By Jerrilea Hubble, MSN, FNP-C, CNOR, RNFA
A key aspect of the Nurse In Surgery Essentials (NISE) program is to give new graduate nurses a realistic expectation of the culture of the OR – how to talk to people, how to present yourself, how to manage stressful situations.
I wish there had been a program like this to help me mature back when I was 18 years old, the first time I walked into the OR. This program sets a foundation: the dos, the don’ts, the expectations, and how to learn from everybody, whether it’s good or bad. It’s learning how to communicate.
Sink or Swim
From the facility’s side, a lot of the people hiring new nurses today don’t prepare them well for the expectations of the OR. In some case they’re just taking a chance on someone because the river has run dry: they need warm bodies to perform these jobs. I don’t believe the employee retention rate would be as low as it is if these hiring individuals set these new grads up for better success.
When you’re on the business side of things and you see the numbers, it’s very easy to read a manual and put policies in place. But what’s difficult is to harness the talent that you’re hiring. And that’s what too many people don’t take the time to do anymore. They see the resumes come through: “Oh, this person is eager to be in the OR, great, let’s hire them, throw them to the sharks and watch them sink or swim.” They don’t prepare them, and that’s when they lose their employees.
Because nine times out of ten, when I hear that someone has quit the OR, what I hear from them is, “It is so stressful, and people are so rude in the OR.”
Efficient and Direct
And I start laughing to myself, and I say, “That’s an OR personality. It’s not that we’re rude, it’s that we’re direct. We don’t have time for hour-long conversations, and sometimes we don’t have the ability to explain in the moment what’s needed. We just say we need this suture now, period, and you have to understand that that means there’s an emergency.”
It’s about developing thick skin, developing the rules put in place by AORN and getting people to understand that it’s not about what’s happening at that moment that you have to listen to. It’s: “what’s the outcome for that patient going to be if you don’t have all of your thought processes in line for the next step?” You have to always be two to three, sometimes four, steps ahead of the surgeon, the first assist, the anesthesia; you’ve got a lot of responsibilities controlling that room.
When I’ve had these conversations with students, it’s always, “I wish someone had prepared me. I wish someone had told me.” “I love the OR but I can’t deal with the personalities,” or “I didn’t understand why things were done like this.” And my perspective is: shame on the facility.
But when everyone is working together in an efficient, streamlined way, there is an incredible feeling when finishing one of those crash-and-burn cases, knowing that your team functioned in Olympic-style synergy to save someone’s life!
Articles on Surgical Team Communications in the OR
Emotions and team communication in the operating room: a scoping review
“Training in healthcare team communication has largely focused on strategies to improve information transfer,” begins the abstract for this article published in March 2023 in the journal Medical Education Online. “We aimed to identify literature reporting on the emotional aspects of OR team communication.”
Read more . . .
Enhancing Interprofessional Collaboration in Perioperative Setting from the Qualitative Perspectives of Physicians and Nurses
“Communication failures were a leading cause of sentinel events in the operating room due to communication breakdowns between physicians and nurses,” reads the abstract for this 2021 article from the International Journal of Environmental Research and Public Health. The article reports on a study about the perspectives of surgical teams on interprofessional collaboration and improvement strategies.
Read more . . .
Communication and relationship dynamics in surgical teams in the operating room: an ethnographic study
This study of surgical teams in Denmark looked at four different types of collaboration in interdisciplinary surgical teams: (1) proactive and intuitive communication, (2) silent and ordinary communication, (3) inattentive and ambiguous communication, and (4) contradictory and highly dynamic communication. The study was published in 2019 in the journal BMC Health Services Research.
Read more . . .
Student Spotlight: Jerrilea Hubble
Credentials
MSN, FNP-C, CNOR, RNFA
Student Status
Graduated from NIFA’s RNFA program in 2013
City & State
Cleburne, TX
Where did you get your RN degree?
Cisco College, ADN; University of Texas-Arlington, BSN, MSN
Current Position
NISE (Nurse In Surgery Essentials) Program Director,
RNFA Program Director, Onboarding Coordinator
We caught up with Jerrilea the other day to chat about the path that led her to her current position at NIFA. “Without NIFA, I wouldn’t have had my career,” Jerrilea said. “In fact, I was ‘supposed’ to be a doctor.”
Read more . . .
NIFA – Office Hours
Monday-Thursday, 8:00am – 5:00pm
Friday, 8:00am – 4:00pm
Practice Resources
Here are several of the most-in-demand sites for our students, prospective students and grads:
NEW! RNFA Job Board
MD Edge Surgery News: Specialty News and Commentaries, Videos and More
RNFA Scope of Practice by State (PDF)
ACS List of Cases that Require an Assistant at Surgery, 2023 (PDF)
Perioperative Nurse Links (state nursing boards & professional associations)
APRN Nurse Links
Disclaimer: The views expressed in this newsletter are strictly those of their respective authors and do not necessarily represent the views of NIFA. NIFA does not give any express or implied warranty as to the accuracy of statements made by our contributors and does not accept any liability for error or omission. It is the responsibility of all perioperative personnel to work within and adhere to their facility bylaws and individual scope of practice.
