A nurse can have all of the clinical competence in the world, but she'll be a poor fit for your facility if she doesn't have what I call the ASC Mentality. Good ASC nurses are cast from a different mold than hospital nurses are. They tend to be more flexible, more team-oriented and more comfortable with chaos.
Not for every nurseThe pace of ASC life is not for every nurse. I cannot stress strongly enough that you hire nurses who can be flexible, regardless of their credentials.
An ASC nurse does not typically have the luxury of a biotech staff to troubleshoot equipment, a risk manager or an infection control supervisor. She can't expect to be relieved at 3 p.m. because that's when her shift ends. She has to learn to do whatever it takes to keep the place going, stay on schedule as much as possible, make do with fewer supplies and help turn over cases quickly, while still paying attention to maintaining a customer service-oriented approach.
Team players only, pleaseASC nurses must work as a team and not be territorial. At my facility, there is no differentiation between a pre-op nurse, an OR nurse and a PACU nurse. Our nurses are trained to work in every area and to be jacks-of-all-trades.
There's good reason why some ASCs prefer to hire newly graduated RNs rather than experienced RNs. Although experienced nurses are often easier to orient in a short period of time, they are also prone to having problems adjusting to the pace of the work and the lack of ancillary support. It is especially difficult to retrain an OR nurse - as OR nurses by nature tend to be territorial - to learn to work as a team member covering and supporting every area of the facility without "boundary lines."
With new RNs, you'll need longer for orientation, but it's worth it if the newly graduated RN has the ASC mentality. New nurses tend to be more motivated to become the type of nurse you want them to be, typically work for less money and stay with you longer. You can train new nurses to work the OR for every specialty you service, function in PACU and sterile processing areas, and troubleshoot equipment problems. The demand for new RNs is very high, and they can basically choose anywhere they want to work. So be prepared to "sell" your facility to them.
Beyond the resumeThere are no simple solutions to hiring good nurses in light of the nursing shortage and the tight economic realities, but these fundamental guidelines can help you improve your chances of hiring and keeping a nursing staff that gets the job done at your ASC. Just remember that no matter how impressive a nurse's resume may look, if she does not seem capable of being flexible and adaptive, she is not right for the facility.
Contact Ann Geier at ageier@mindspring.com.
