Doreen Wagner, PhD, RN, CNOR
Professor of Nursing at WellStar School of Nursing, Kennesaw (Ga.) State University. AORN member and perioperative nurse since January 1986, and CNOR since 1989.
Driven to research around the science of nursing, Doreen Wagner and her team conducted the first known study to explore the relationship between unplanned perioperative hypothermia, the most common perioperative complication, and the development of postoperative delirium in a large heterogeneous non-cardiac surgery population. She spoke with AORN about the impacts and importance of nursing research.
Since I was a child, I always asked questions and anticipated a response. Nursing research is asking nursing-related questions and looking for responses that may impact patients, practices, or health policies.
In my studies of unplanned perioperative hypothermia findings showed that longer periods of unplanned hypothermia were protective against development of postoperative delirium in older patients; but it was a contributing factor to postoperative delirium in younger patients, particularly the sicker patients (ASA class 4).
This new study revealed an unexpected and complex relationship between unplanned hypothermia, age, ASA class, and the development of postoperative delirium.
We need to explore the physiology associated with the impact of unplanned hypothermia on postoperative delirium across the lifespan. My research team plans further exploration of the risk-to-benefit of the known adverse effects of unplanned perioperative hypothermia as it relates to postoperative delirium.
What Keeps You Going?
It’s taken me 25 years after completing my master’s thesis on the history behind the decline of clinical experiences in the OR to break through academic barriers that I’ve experienced. Through an academic-practice partnership, I am proud to say there is now an elective course that allows nursing students to experience the OR with 90 clinical hours of a hands-on approach. Students can request their final clinical experience in the OR which leads to another 172 hours of perioperative clinical experience. Thirty percent of students who have taken this course are now practicing perioperative nurses. Even those who did not choose the OR have said they will use everything they learned in all other nursing care areas.
It motivates me every day to know that this perioperative clinical experience provides students with excellent multi-professional communication skills, true teamwork abilities, and recognition of what patient advocacy really looks like.
Why Do You Love Teaching?
As a professor, I can see my influence, sometimes on a daily basis. I teach research to undergraduate and graduate students, and I teach two undergraduate nursing electives – one being the perioperative elective.
By sharing my knowledge, I feel I can make a difference and even help guide the next generation into their future nursing career. The true reward comes from watching nursing students learn, develop, and apply the knowledge and skills that I have taught them. Being in academia, I am also able to pursue my own passions because I can research what interests me, which today includes: Nursing Students’ Perceptions of Learning in a Perioperative Dedicated Education Unit and Postoperative Delirium and Unplanned Perioperative Hypothermia in Surgical Patients. Most recently, I received an AORN Foundation research grant to conduct an Investigation of Unplanned Intraoperative Hypothermia Patterns and Relationships in Surgical Patients Warmed with Forced Air: A Secondary Analysis.
The university campus provides a thought-provoking atmosphere filled with inquisitive minds and eager students. I also get the pleasure of visiting most of the hospitals in the metro-Atlanta area since they are my clinical sites for student learning.
What Advice Would You Give Your Younger Nurse Self?
I would tell that young nurse to continue her education as soon as possible! I have wished many times that I had not waited so long to get my advanced degrees. Furthering my education opened my mind to all that nurses can do – and it’s a lot more than many nurses even recognize. I can honestly say that I’m enjoying being a nurse more now than I ever knew was possible back in my younger nurse days.
Guideline That’s Had the Most Impact?
I may be a bit biased, but I feel that the Guideline for Prevention of Unplanned Patient Hypothermia has had much impact on perioperative practice and patient outcomes in the last decade.
Tip for Nurses Interested in Research
Nurses interested in conducting research should critically read research publications. Research literacy can help you understand and use the best evidence available for practice as well as develop an original idea for a research study.
For numerous resources, look to the AORN website for information about the AORN Research Priorities that address building perioperative science so that evidence can drive our practice and promote positive patient outcomes.