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Perioperative nursing is facing a severe shortage. Demand for college-educated perioperative nurses is increasing, but few American baccalaureate programs prepare graduates to replace retiring clinicians. In this cross-sectional survey, perioperative leaders describe an urgent need for academic nursing attention with initiatives in baccalaureate nursing programs to provide nursing students meaningful perioperative experiences and to generate future nurses. Implications for nursing education and the economic impact on health systems are posed.
Given the complexity of modern surgery, safe surgical care depends heavily on experienced, college-educated clinicians to promote optimal patient safety (Association of perioperative Registered Nurses [AORN], 2015; Institute of Medicine [IOM], 2011). The specialty of perioperative care is experiencing a shortage of nursing personnel (both staff and leadership) that is decades in the making and is unprecedented in modern health care. The shortage will exacerbate swiftly in the next 3-5 years due to retirements and attrition (Ball, Doyle, & Oocumma, 2015; Sadler, 2017).
Concomitant with the aging workforce is the diminution of educational opportunities in baccalaureate nursing curricula for perioperative nursing specialization. Indeed, academic nursing appears to have abandoned or at least marginalized the perioperative nursing specialty (Bacon & Stewart, 2018; Beitz, in press; Graduate Nursing, 2019; Tschirch, Leyden, Dofrene, & Land, 2017). Thousands of hours of lost expertise are combining with constrained approaches to replacing these clinical experts to catalyze a healthcare crisis. Economic consequences may be occurring from this shortage in terms of inability to staff a full operating room schedule.
Patient Safety and Surgery
Surgeries in the United States are growing yearly as Americans age and chronic illnesses multiply. By the year 2030, one in five Americans will be 65 years of age or older. Recent data note that 46 million inpatient surgeries are performed yearly in the United States with an additional 53 million outpatient procedures in ambulatory sites (Martin, 2011; Weir, Steiner, & Owens, 2015). As surgery rates grow by 1%-2% each year (Bacon & Stewart, 2017; Ball et al., 2015), the need for baccalaureate-educated nursing personnel including operating room (OR) leaders to maintain patient safety is mounting (Sherman, Patterson, Avitable, & Dahl, 2014). In recent decades, schools of nursing have substantively decreased and/or eliminated perioperative specialty education despite compelling need.
Multiple reasons have been suggested for the lack...