The Perioperative or ‘OR’ Nurse is an individual who works with the patient being prepped for surgery, their family, and as a member of the interdisciplinary care team. The operating room nurse helps to evaluate the patient, then plan and implement various steps to, during, and beyond surgery. Nurses who enjoy direct patient care and a good deal of change may enjoy spending time in the OR.Top of FormConsistently looking for job postings in the perioperative role throughout local hospitals or medical networks is the most effective way for nurses to find a position that they’re interested in applying for.Newly graduated and licensed nurses may have to complete an internship that includes both a didactic and practical component before being deemed ready to fulfill the role independently.Experienced nurses who approach the role from a different specialty and background will have a similar lengthy orientation and learning curve to the operating room nurse role but it may be shorter, depending on their prior knowledge and experience.What Are the Education Requirements for an Operating Room Nurse?Perioperative nurse positions require that the applicant have an RN license in good standing. This can be achieved, at minimum, by completing a 2-year Associate’s Degree in Nursing (ADN) program. A BSN is not required for all operating room nurse positions although it is preferred by employers. Some employers may require than an applicant agrees to complete his or her bachelor’s degree within a certain timeframe after hire.Perioperative nursing positions are typically open to new graduate RNs who have successfully completed an internship program, as well as to experienced nurses with at least one year of bedside experience.Any Certifications or Credentials Needed?The Association for Perioperative Registered Nurses (AORN) has a list of the various certifications available for the different roles within the OR:CNORfor perioperative RNsCRNFAfor First Assistants who assist the surgeonCSSMfor Bachelor’s educated OR ManagersCNS-CPfor Master’s educated Clinical Nurse SpecialistsWhere Do Operating Room Nurses Work?The perioperative nurse typically works in a hospital, outpatient surgical clinic or physician’s office.Roles of an Operating Room or Perioperative NurseThe terms ‘Operating Room’, ‘OR’, and ‘Perioperative’ nurse are actually umbrella terms for a few different roles in the surgical department:Pre-Op RNIntra-Op RNPost-Op or PACU RNPre-Op Nursing RoleThe Pre-Op nurse performs the necessary duties to prepare the patient for a surgical procedure. These may include collecting vital signs and a health history, starting intravenous catheters (IVs), performing a detailed head-to-toe assessment to ensure the patient’s condition is stable for surgery, verifying that the appropriate paperwork is complete, and providing emotional support and teaching to the patient and family.Intra-Op Nursing RoleThe Intra-Op nurse works inside the operating room and different roles are in place for this role, as well. The nurse may be assisting the surgeon working as a Circulator to ensure a sterile and controlled environment. This nurse also ensures all necessary personnel, equipment, and supplies are readily available, as well as completing necessary paperwork and being sure anyone who enters the OR is a necessary and documented addition to the environment.Post-Op Nursing RoleThe Post-Op, or PACU nurse works in the recovery room and receives the patient from the operating room immediately after the surgical procedure. The patient will be either just waking up from anesthesia or is now awake but very sleepy still. The Post-Op nurse monitors for complications during this process. Usually, a patient remains in the recovery room for 1-3 hours depending on the patient’s condition and the standards of the hospital. The PACU nurse then either discharges the patient home or transfers them back to the floor of the hospital or ICU where safe care will be continued.What Are the Roles & Duties of an OR Nurse?Coordinates use of supplies, instrumentation and equipment for operative careEnsures equipment is functioning correctlyMaintains patient safety standardsMonitors, records and communicates patient’s condition and needs with the interdisciplinary teamManages overall care of the patient before, during and after the surgical procedureAdvocates on behalf of the patientDocuments preoperative and intraoperative care to be delivered in accordance with the surgeon, hospital, and regulatory agenciesEvaluates, remediates and documents the surgical environment for aseptic meritProvides patient care with an understanding of age, culture-specific needsAddresses the biological, emotional, developmental, psychosocial and educational status of the patient and his or her family and seeks to address concernsCoordinates professional development within their practicePerforms core job functions with minimal supervisionOperating Room Nurse Salary & EmploymentEven with the emphasis on preventative care, perioperative nursing roles are expected to increase by about 19% into the next decade, according to the Bureau of Labor Statistics. While job growth rates vary throughout the country, locating close to busy hospitals and teaching facilities might mean higher rates of perioperative opportunities and room for advancement as opposed to less urban regions.The median salary for an operating room nurse is $66,713 with a range of $49,419 – $93,569. Location, experience, education, and certifications affect salary. 

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Discussion Topic: Polypharmacy and Policy
The incidence of PolyPharmacy, or the use of five or more medications on a daily basis, is common in the US particularly among the elderly population. It occurs for a variety of reasons, including the need to treat multiple conditions, the patient obtaining treatment from numerous physicians, and a lack of communication among those physicians about medications prescribed. PolyPharmacy increases the risk of adverse drug effects and increased costs to patients. Formulate a policy to reduce the practice of multiple drug prescriptions. What tools might be included in the design phase of the policy process to increase the probability of success? What research from other countries could be helpful in addressing this issue? Support your reasoning.

Overview of the Mechanisms of Kidney Function
Ms. Cornwall is admitted with pyelonephritis. She has chills, and her temperature is 101°F. She is complaining of flank pain, frequency, and dysuria. Her urine has white blood cell casts and shows growth of Escherichia coli (E. coli).
Based on the above scenario, answer the following questions:
Why does she have bacteria and white blood cell casts in her urine? Include the pathophysiological response of body for your analysis.What are the differences when comparing prerenal acute renal injury, intrarenal acute renal injury, and postrenal acute renal injury? Give examples of each and pathological processes related to each disease process.

Complete a cause-and-effect diagram to analyze the possible causes of late delivery of parts ordered from a supplier. Match each number in the chart with the corresponding reason. Note: Each answer choice will only be used once. 20 Sepier Inafficint capaity hadeguate recrdeeping points 011112 Lute deliveries Wreng Trafic infemations Breakdewe Misng infematin Sheduing Capacity Delivay Orders Ntem Number Cause (Click to select) (Click to select) II (Cick to select) III Weather Poor scheduling Late to supplier