Megan Muñoz is finishing up nursing school at Chamberlain University’s Addison, Ill., campus. She just finished her clinical, and will graduate with her BSN in September. Unlike many BSN students, however, Ms. Muñoz is OR-ready thanks to a new program called Practice Ready. Specialty Focused. Powered by a $1.2 million grant from the American Nurses Foundation’s Reimagining Nursing Initiative, this new nurse education pilot model, developed in collaboration with the Association of periOperative Registered Nurses (AORN), is offered at no additional cost to Chamberlain nursing students. Its goal is to reduce first-year perioperative nursing turnover by exposing students to clinical rotations before they graduate, and thus making them better prepared for the realities of work in surgical units.
You can read more about Megan and the program in this month’s cover story on the nursing shortage and how the surgical industry is responding to the resulting staffing crisis.
Here's more from our full discussion with Ms. Muñoz:
Outpatient Surgery Magazine: Tell us about yourself and your journey to become a perioperative nurse.
Ms. Muñoz: I grew up in and out of hospitals my whole life, basically. I was diagnosed with a disease at a really young age. I had my first surgery when I was 14 years old. I had an orthopedic surgery. It was a scary event, especially being a kid. People are working on you and you don't really know what's going on. And it doesn't get any easier when you’re an adult, you know?
I went through high school and then I thought I wanted to go into pharmacy at first. But I just didn't like that there was no people interaction, no hands-on patient care. So I switched to nursing. I went to school in the Philippines for a couple years, just to get a different kind of experience in life. Then I took a detour. I did marketing for a little while. I started marketing for a plastic surgeon. I saw what he did and I thought to myself, “Hey, why don't you get into surgery?” That's where I started to scrub. And now I'm here.
What caught your attention about working in the OR?
I like the very controlled environment as opposed to the other aspects of nursing. You kind of know what to expect. I like to be prepared for things, and this is one of those areas where you can be prepared. I also like the camaraderie, which seems to be different from any other floor. When you're on the other floor, you're kind of working alone and on your own. You have your colleagues to come help you with things. But in the OR, everyone's there for you, and you are all there working together to complete this task.
Also, patients are very vulnerable at this time. They're super scared, everyone's really nervous. I talk a lot, and I hope that helps. It's nice to be there when the patient is in that state because I personally know how that feels. I know what it's like before going into surgery and how scary it is. And it's not just the patient, it’s their whole family. Their whole family is there, they're all nervous, and the patient is in their own feelings, but they also have to be strong for the people around them. I just want to be there for people the way that they were there for me.
So the ability to use your empathy for good purpose, as well as the collaborative team-based environment, were what really appealed to you about nursing in the OR?
Yes, those are my two favorite things.
If you didn't have the experience you had with that plastic surgeon, would a career in surgery have ever occurred to you?
No, not really. I always wanted to do some sort of patient care. I just didn't know exactly what I wanted to do. I also liked the emergency room, but the OR just did something different for me, you know?
What drew you to Chamberlain University and this program?
My mom has been in healthcare for 40 years. She’s in ICU and works kidney transplants. She's administration now, just below the director of her floor, and she has had students from here before. She said, “Why don't you try this school? I’ve heard really good things about it, they're really supportive. It’s expensive, but just go for it.” And I ended up really liking it. They've just been super supportive and they give us a lot of opportunities. They introduced this AORN program about six months ago. They said, “Do you want to do this? You get a clinical for it. You just have to take an extra course for it on top of your schedule.” So it's an added class, but it's pretty manageable. I was on the fence about it, and then I just decided to do it.
There’s an online component and a live component of this program. How does it all work? What is the structure of the program?
It’s 16 weeks of online courses. You do a module per week. The module probably takes about an hour, and then you do a quiz afterwards for every week. After your 16 weeks is over, you have a final exam. You have to meet a benchmark, but it's very doable. You have support, in that you have an instructor who keeps up with you if you're falling behind or if you have any questions. It's very interactive, and they give you quizzes like along the way as well. It kind of looks like an interactive eBook.
What were some of the topics covered in the modules?
Everything from safety to infection control to donning and doffing PPE. The machines, the sterile field, how nurses are supposed to document… everything that goes on in the OR.
After that you moved to an onsite clinical opportunity. Tell us about that.
For your last set of clinicals, you’re supposed to be precepted. What was nice about our site is we got to rotate through different areas of the perioperative suite, so we weren't restricted to just the operating room. We were in day surgery, we were in the operating room, we were in PACU, we were in the cath lab. We switched through them for the eight weeks, and they actually kept us for the extra four for Capstone. That's our last very last course in nursing school. Our hospital site let us stay for the remaining four clinicals.
How many hours per week were the clinicals?
It’s 12 hours a week that you're supposed to do. For us, we had to do two days a week because the OR hours don't run 12 hours usually. Your preceptor is usually only there for eight to three, and then they do a shift change. So we would do two days a week for eight weeks. It ended up being more like 16 hours a week.
What did you take from that experience of working in a live situation?
I wasn't really surprised by anything except maybe the camaraderie. I didn't realize how many people were working together, because before I had worked in such a small operating room, really a procedure room with just me, the doctor and another person. This was such a team effort, everybody working together towards what needs to get done. I just felt like everybody was there for each other. You really felt it.
In general at nursing school, are “soft talents” like collaboration and effective communication taught?
We talk about therapeutic communication stuff, but in general you can't really “textbook” that, at least if you want it to be real, you know? I don't think it's really anything you can learn from a textbook. I got to apply some of it as far as what's inappropriate to say and what's appropriate to say. But other than that, not really. I think the biggest shock when people come out of school is that they don't know how to interact with patients, with doctors. That's one of the biggest struggles that people have. This program facilitates that kind of transition, and I thought that was pretty beneficial.
Are you now 100% certain that surgery is where you want to be?
I’m going to be somewhere in surgery. I really liked same-day surgery, especially pre-op and recovery. It's not like the OR, but you still get to interact with the patients more so than when you're in the OR. They're sitting there feeling anxious, so it's nice to be able to sit provide patient care, talk to them about how they're feeling, kind of calm them down as best as you can.
Any specialties in particular that attract you?
I liked ortho. I liked cardiac. Really, I liked it all, just being in that environment.
Do you envision yourself as a circulating nurse?
I would like to do more. Advancing and being a first assist would be the dream.
What value have you gotten out of this program?
I just thought it was a really good experience. People should really take advantage of it if they have the opportunity. I feel like it's a good opportunity to see what it's about and whether it’s something you're interested in, because now would be the time.
In the long term, do you envision yourself in a leadership or administrative position?
Maybe when I get a little bit more confidence.