Few professions have more job security than nursing. There’s a tremendous need for all nurses, but perhaps nowhere greater than in the operating room, which makes the perioperative (“periop”) program between Mount Saint Mary’s and UCLA such a tremendous partnership.
A small group of undergraduate students spend the summer between their junior and senior years in a two month, 32-hour-a-week immersion program with a combination of didactic and clinical learning situations unique for students who are still a year away from graduating and taking their licensing exams.
Lauren Fujihara, nursing clinical placement director at the Mount, was the clinical nurse specialist at Ronald Reagan UCLA in perioperative services when her path first crossed that of Leah FitzGerald, PhD, FNP-BC and the Fletcher Jones endowed chair and dean of nursing.
“Before I met Leah, I proposed this program to some other schools, and no one was interested,” says Fujihara. “It really took an open-minded perspective. But Mount Saint Mary’s nursing vision is to be innovative and address the workforce needs of the time.”
And the need for periop nurses is great. “Between 2013 and 2019, the median number of vacant, fulltime positions went from 3%-6%,” says Fujihara, “and the average age of the perioperative nurse is 47 years old. So within the next five to 10 years, the workforce will definitely be depleted. The projected workforce shortage in perioperative nursing is going to be more dire than in any other specialty, and the reason is that this is a specialty that’s not commonly offered to nursing students in an undergraduate curriculum. Without exposure in undergraduate programs, the nursing student may not even consider perioperative nursing as an option.”
That was the situation for Gail Angelli Daclan ‘21. “I didn’t realize nurses could participate as much as they can in the operating room,” she says. “I thought that a periop nurse would just set up the instruments or do the assessments for the patient, but we learned so much along the way and I really like that aspect of it. No one case is the same and you approach them differently and work with different teams all the time. You learn small things about each case every day, and I just like that aspect of growth.”
The Mount begins exposing its undergraduate nursing students to the perioperative environment during their sophomore year, when many have a one- or two-day observational experience in perioperative services. “A lot of nursing programs across the country have removed observation days in OR [operating room] nursing completely,” says Fujihara, “so you can understand why it’s increasingly difficult to recruit into the specialty. But there’s so much you could do with a perioperative nursing background.”
Fujihara said that one of the reasons she and FitzGerald worked to get this program going was that they thought this would be a small way to contribute to steering more students toward periop nursing. “Leah and I also published an article about this program in the Association of Operating Room Nurses Journal, the specialty journal for perioperative nurses,” she says, “in order to share the information so that it could be replicated, because it has been sustainable and very successful for both the university and the hospital. We heard from the publishers that it was the most widely read article that month on their electronic portal.”
After five consecutive summers, 18 Mount students have taken advantage of this program, which evolves a bit with each reiteration. Originally limited to the hospital’s main operating room, students now also are assigned to the medical procedure unit, where a lot of diagnostic and therapeutic endoscopy procedures are performed. This past year, the program expanded yet again to include the ambulatory surgery center. The number of students participating depends on how many clinical preceptors (instructors) are available, but the numbers have grown each year as more locations are involved and this past summer had five take part.
There’s much more interest in the program than there are openings. Many students apply and go through the interview process for one of the coveted slots. But this program doesn’t just benefit Mount students; it’s a recruitment opportunity for the hospital and gives staff there an opportunity to evaluate the students as potential future new-grad candidates.
Most of the 18 students who have participated in this program applied for jobs at UCLA after obtaining their nursing license (a few went back to their hometowns). All of them were hired. “When I worked on the service side, I probably had the primary voice in hiring the new grads for the OR,” says Fujihara. “We hired a disproportionate number of Mount students, and I think it’s just because of the way they’re prepared, and their motivation for going into the profession comes through. It’s been a really great partnership.
“This program gives the students a really good look into whether this is something they want to pursue,” she says. “It’s a very unique environment. It’s very fast paced, dynamic, with a lot of different interprofessional team members, and high stress. But the students do very well.”
“Applying for the program was probably one of the best choices I’ve made because it really did give me the experience I needed to be more confident in my nursing skills,” says Marlene Alcantera ‘21. “When you are doing regular clinicals, you always start fresh. You’re always new, and you always have to gain that trust from everyone around you. But in this program you always build, especially since you’re going every day. You build upon what you’ve learned and you continuously grow and get better as long as you push yourself and don’t limit yourself.”
“A nurse needs to, in a very short amount of time, create a relationship and obtain trust with the patient and their family. We may only have five to 10 minutes to interview the patient before surgery and gain their trust that we’re going to be the one who is going to be taking care of them during the surgery.”
It’s fascinating for Fujihara to listen to the student accounts regarding when they first go into the operating room, as many don’t realize that it’s not just an observational learning experience but a very participative one.
“It was really fun,” says Jasmin Diaz ‘21. “It was a lot more than we expected. The very first day they said that if I wanted to try something out, they would guide me and I could do it. They would tell me what an instrument is called and that I could hand it over when they called for it. It was a lot more engaging.
“It was pretty nerve wracking on day one. I was surprised I could really touch things. It’s really a great learning environment, and everybody really wants you to learn and participate. With the people, it was really easy to get comfortable. Everybody was really a mentor, even those who weren’t your preceptor.“
The range of experiences is what Vincent de la Luna-Tabanera ‘21 appreciated most. “I think it’s a really great program,” he says, “because you get to experience both an inpatient setting where patients are more critically ill and the outpatient setting where you have more interaction with the patients because they’re a little healthier.”
What Jerica Magbitang ‘21 enjoyed about the experience was how dynamic the OR is. “No one person can learn everything about the operating room,” she says. “There’s always going to be new surgeries, there’s always going to be new technologies. There was a new robot, and we all had to learn about it. I like that in the OR everybody is a student, including the surgeons. The whole team is continuously learning.”
NOTE: Check the newsroom in the days ahead for more information on these student’s backgrounds, what led them to pursue nursing as a career, and what they’ve gained from this partnership with UCLA.