May 2024 • Volume 18, No. #5

From the Editor

This month, stress is our topic under the microscope.

Stress and struggle are inevitable parts of life; without them a life doesn’t amount to much (think of a baby chick that doesn’t have the oomph to peck its egg open). But the body’s fight-or-flight responses should be balanced by periods of “rest and digest.”

Instead, many of us are dealing with long-term stress (see the American Psychological Association’s report, Stress in America, 2023). And some of us are steeping ourselves in a tea of constant stress hormones. That can take a toll on the body, causing inflammation and affecting the heart, digestion, sleep, weight gain, and stroke. For the mind and spirit, effects can include emotional exhaustion, fatigue, sadness, apathy, feelings of inadequacy and more.

For nurses and healthcare workers, some of the worst stressors of the pandemic are now, thankfully, behind us. But plenty remain. In itself, nursing can be inherently emotionally taxing and physically draining. Add staffing shortages, changing workplace expectations and roles, and the blistering pace of technological change. Then there’s whatever’s going on in your personal life, not to mention in the world.

Every generation has had its own stresses, but it seems to me that our parents and grandparents had a lot less stuff to keep track of – not just physical stuff but also masses of information that it seems we need to know (or want to know right now) – in our always-on, always-connected, instant-access environment. I also think they did a better job of spending healthy “down” time than many of us do.

In this issue we bring you some research about the phenomenon of stress in the OR, some suggestions for reducing it, and a few tips for dealing with your own stress.

Our Student in the Spotlight is Sarah Gruhn, RN, CNOR, of Greenwich, CT.

Scroll down for jobs we’ve collected for you as well as NIFA’s favorite links.


Julie Lancaster, Editor

Photo by Pedro Figueras on Pixels

Stress in the OR

Reducing Stress in the Operating Room: Stress Relief for the Patient

From aspects of comfort in the operating room to patient communications to family support, this is a thoughtful article by a cataract surgeon about addressing stress levels for patients as well as staff.
Read more. . .

3 Physical Changes for a Calmer, Less Distracted OR

Rosemary Field, MS, APRN, AOCNS, of the Cleveland Clinic, and her colleagues investigated the way perioperative team members were affected by working in an OR specially designed to create a tranquil patient experience. The article appeared on the AORN website in June 2022.
Read more. . .

Minimizing Interruptions and Distractions During Surgical Counting

A 2021 study published in the Joint Commission’s Journal on Quality and Patient Safety focused on interruptions and distractions during surgical counting. Interruptions in the operating room lead to fewer safety checks, reduced teamwork and communication, and greater stress and perceived workload.
Summary of the study, including tips on reducing distractions and interruptions . . .

Influencing Well-Being in Perioperative Nursing: The Role of Leaders

This article from the October 27, 2021, AORN Journal, examines ways that leaders can support well-being and resilience in health care staff through caring about people, cultivating individual relationships and team social connectedness.
Read more. . .

Photo by Bess Hamiti on Pixels

Countering Your Own Stress

Too busy to take your foot off the gas pedal? Think again. There are many small interventions you can make to start breaking the cycle of continual stress. You can stretch your arms above your head, fingers interlaced, and take a deep breath right now. You can reach out to a neighbor or friend tonight and talk about what’s going on in your life. You can plan a visit to a park or garden this weekend. Think you know all the tips? We think you’ll find a few surprises in the links below.

Photo by Pixabay on Pixels

In The Spotlight: Sarah Gruhn


Student Status
Current student in NIFA’s RNFA program

City & State
Greenwich, CT

Current Position
RNFA at Greenwich Hospital

Where did you get your RN degree?
Pace University, New York

How did you come to choose perioperative nursing?
When I was going through nursing school, I didn’t connect with any of my clinical opportunities. I was worried I had made a mistake in choosing nursing. In my junior year, I got to do an externship that allowed me to be in the OR. I had entirely forgotten that the OR was an option for nurses. My school had a peri-op elective class, fortunately. So, I applied to be there and loved every minute of that clinical experience. I loved the variation day-to-day and all the opportunities to learn and observe.

What is a unique, funny or scary moment you’ve seen at the table?
One day, I was scrubbing a spine case with one of our more irascible surgeons. The case had not been going well, and he was in a mood. At one point, when he was under the microscope, I needed to take a second to mix a new SURGIFLO®. Things were tensely quiet, I had gotten distracted for a moment when mixing, and I forgot to fully tighten the luer-locks together. I went to mix, and the SURGIFLO® exploded directly into the surgeon’s eye under the scope. He flew backwards and, after a lot of cursing, he started laughing. It broke the tension for the rest of the case, and he has never let me forget it.

What is one technique or RNFA trick you’ve learned from NIFA that you will use for life?
Dean showed us how to lock an Aberdeen knot, and it really boosted my confidence in those knots. I used to worry about pulling them through accidentally, and now I know they’ll be secure no matter what.

How do you feel having your RNFA will impact your life/career?
I’m going to have very different opportunities moving forward. I’ll get to be more directly involved in the surgeries and advance my clinical skills greatly. I am also more likely to travel with my RNFA than I was as a circulator.

Jobs Front

Click here for the RNFA job postings we’ve collected for you this month.

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:

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, 2020 (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.