OR Manager April 2022 - 11

Human Resources
Overview of Nurse in Surgery Essentials
participants per week.
Wilkins works closely with Kimberly Jones,
MSN-Ed, RN, CNOR, RNFA, program director
for NISE. Jones monitors students' progression
and performance on quizzes and provides
regular feedback to Wilkins about each
nurse's progress. " The quizzes are very rigorous, "
Wilkins says. She and Jones collaborate
on students' clinical assignments to ensure
they fulfill requirements and meet individual
students' needs.
Readings and education videos are part of
Dianne Wilkins, MSN, RN, CNOR, surgical
services educator at Community Memorial
Health System in Ventura, California, has
been using NISE since June 2019; 15 nurses
have completed the training as of January
2022. The hospital has 15 ORs and performs
about 1,100 cases each month. Wilkins says
NISE is a streamlined program that involves
nurses in clinical experiences early in the
process, which she feels is a significant advantage
over other commercial programs.
" The clinical experiences correspond very
well with their learning, and from the first
week they are in the OR observing, " she says.
Although the online portion of the course is
designed to be completed independently,
Wilkins found it helpful to set up a computer
lab where students can work on learning
activities together. " They get more out of the
program that way, " says Wilkins, who also
spends 2 to 3 hours of individual time with
ticipants read about positioning, have
discussions via a PowerPoint presentation,
and watch a video, " she says.
" Then I take them into the OR to show
them available products and have them
practice by using simulation. "
The hospital, which has 36 ORs and
four procedure rooms, now runs four
courses a year, with 10 nurses in each
course. Usually, 25% of participants
are nurses from other specialties who
are new to the OR. The course, which
www.ormanager.com
the program, as are online reflective journaling
and videos that assess competency:
Reflective journaling. During the journaling
experience, participants respond to questions
related to the topic they are studying
to encourage them to think about how what
they learn relates to their facility's policies
and procedures. " It gets people thinking
about policies early in the process, " Jones
says. For instance, after learning about laser
safety, the participant might be asked about
the laser safety policy in their own organization
and what the laser safety officer does.
Participants also are encouraged to write
about what they observed in their clinical
experiences and how it relates to what they
learned. Journaling helps nurses develop
their critical thinking skills. For example, they
might be asked what happens when a policy
is not followed or a sponge count is wrong.
" The program gets them involved in clinical
very early in their orientation, " Wilkins says.
Video assessment. Behaviorally anchored
costs about $70,000 to run, averages a
2-year retention rate of around 90%.
Screening helps ensure participants
are truly committed to working in the
OR. Ceschini has candidates shadow
an OR nurse for 3 to 4 hours before she
and the OR managers interview them.
(During part of the pandemic, this was
replaced with a digital presentation, in
which she and her manager described
what it is like to work in the OR.) " We
can then talk with them about the experating
scale videos are used to assess competency
level. These provide a more objective
measure than preceptor observation. " Because
of OR shortages, people sometimes
say a person is ready to go when they aren't, "
Jones says. " A video assessment let's us
accurately determine level of competency. "
During the course, learners complete seven
videos on fundamentals such as prone positioning,
electrosurgical safety, and time outs.
Learners record the video, showing themselves
walking through each step, either on
their own or as part of a team. " They can
make it as fun or dry as they like, " Jones
says. For example, the orientee may use the
names of cartoon characters as patients.
She assesses how often the learner needed
prompting from the preceptor and how many
steps they missed. Additional learning needs
can be based on the results of this assessment.
Participants
have 8 months to complete
the NISE program. If they pass a final proctored
exam of 200 questions, they receive
a certificate and earn 70.8 contact hours
of continuing education credit. Wilkins has
made completion of the final exam optional.
Wilkins has used the program for both new
graduate nurses and for nurses new to the
OR. " I'm confident that nurses are learning
what they need to know, " Wilkins says. " It is
very self-driven and is working well. "
Learn more about NISE at https://www.
rnfa.org/niseprogram/.
rience and their perceptions about the
OR, " Ceschini says.
New to the OR
Nurses from other specialties typically
require as much orientation as nurses
new to the profession and the OR.
Some organizations have created nurse
fellowship programs, which are essentially
residency programs for nurses
transitioning from another specialty into
Continued on page 12
OR Manager | April 2022
11
Nurse In Surgery Essentials (NISE) is an evidence-based
orientation program for nurses
new to the OR that was developed by the
National Institute of First Assisting Inc and
the Competency and Credentialing Institute
(CCI). It is accredited thought the Accreditation
Board for Specialty Nursing Certification.
The program, which incorporates AORN
guidelines and standards, consists of six
structured units that participants can take up
to 8 months to complete, although 6 months
is more common. CCI developed the competencies,
which are based on a job analysis of
the OR nurse role.
https://www.rnfa.org/niseprogram/ https://www.rnfa.org/niseprogram/ https://www.rnfa.org/niseprogram/ http://www.ormanager.com
OR Manager April 2022

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