Nursing is an integral part of the healthcare system, encompassing the promotion of health, prevention of illness and the care of patients of all ages in all health care and community settings. In recent years, nursing understaffing and burn out has become increasingly prevalent, leading to a severe shortage of nurses in Ontario and Canada.
In our April installment of the 2022-2023 Speaker Series, we connected with Dasom Kang, a perioperative nurse at St. Joseph's Health Centre, Toronto to explore some of the less well-known roles in nursing and the future of nursing education. This written interview will explore the world of surgical nursing, some of the common misconceptions about the field, and the future of nursing education and the profession of nursing as a whole.
UTIHI would like to dedicate this interview to all of our nurses and frontline health workers.
Please enjoy this interview!
Dasom Kang is a Registered Nurse at Unity Health Toronto. She obtained her Bachelor of Science in Nursing from McMaster University in 2014 and has worked at multiple hospitals in Ontario since. Currently she is pursuing her Master of Nursing degree from Athabasca University. She hopes to become an Advanced Practice Nurse in the future. She currently works in the Cystoscopy clinic at St. Joseph's Health Centre, Toronto.
Can you tell us a bit about yourself and your path that led you to where you are today?
I did my Bachelor of Science and Nursing at McMaster University and after graduating I worked in a lot of hospitals - Fort Erie, Saint Catherine's, Milton, and now Toronto - on various medical surgical units. I did bedside nursing for about 6 years, and then my hospital sponsored me to take the perioperative program in 2020. So, I took that and now I'm working in the operating room. I've been a nurse for almost 9 years now.
What is surgical nursing?
Surgical nursing is basically providing care for the patient before during and after surgery. In the operating room at my hospital there are 2 roles: a circulating nurse or a scrub nurse. The circulator is a registered nurse and they’re kind of in charge of making sure the patient is safe. They do the safety checklist, help with the intubation and document the whole operating case. They're also in charge of the room, and anything pertaining to the safety of the patient and surgery outside of the sterile field. The scrub nurse is in the sterile field with the surgeon, and they assist by setting up the table with instruments, passing the instruments and sponges and such, and it's usually a registered practical nurse.
In the cystoscopy clinic I work in, it’s kind of a unique system because we also recover our patients. So I'm also working in the PACU, which is a post anesthetic care unit. I would provide post anesthetic care to the patient until they're stabilized from the anesthetic, and it's usually a one-to-one ratio, because these patients are very acute and they could go into respiratory depression at any moment.
Why did you decide to go into surgical nursing?
I have been in the field of medical surgical nursing which I really enjoyed. It's a lot of direct patient care: you get to really support the patient and talk to them, to give the medications, and wound care and all those things. But I wanted to try something different, and the operating room just seems like a whole different kind of nursing than what people think nursing usually is. It was really difficult in the beginning, because it's a very fast paced environment, and everyone is on a schedule. You have 8 hours to do a certain number of cases, and you must do it, or the surgeries get canceled, and that causes a whole other set of problems. It's a very interesting environment and I'm really glad I made the change.
What are some common misconceptions about your field?
Well, I’ll first talk about some of the misconceptions I’ve heard about the operating room. I think a lot of people think being a perioperative nurse is not “real nursing” because it's not like standard bedside nursing. They also think it's very technical; you're just handing out instruments or setting the room up. But after doing both bedside and operating room, I don’t think that’s the case. You can still be very compassionate and provide good nursing care as a perioperative nurse. I'm in charge of this one patient that I’m bringing into the operating room, and I'm talking to them, I'm comforting them and their family members before surgery because they're completely terrified. During the operation, we take care of all their pressure points by putting wedges at the joints, we're protecting their skin and making sure they don't develop any pressure ulcers or anything like that. And after the surgery, I'm recovering them, and I'm directly providing care to them. So I think people need to know that perioperative nursing is very much providing direct patient care as well. You're not going to lose all your nursing skills; you can still put in IVs in the operating room, and you can still do your head-to-toe checks and communicate with patients.
In general, I think a lot of people think that nursing is basically just babysitting patients, or just taking care of them. But the care that we provide such as giving medications, starting IVs and blood transfusions and stuff like that require a lot of medical knowledge. Nursing is more than babysitting, because that is something I that I've heard before, and I just don't think that's correct at all.
Nursing is more than babysitting, because that is something I that I've heard before, and I just don't think that's correct at all.
You recently went back to pursue your masters in nursing. What made you decide to do so?
To be honest, I always wanted to further my education and I think nursing is one of those jobs where there's so many roles that I didn't even know existed. I just entered the world of perioperative nursing, but I think in the future I would like to go into a position where I can make a change. Eventually I want to be an advanced practice nurse (APN) which is basically an agent of change who brings change to clients, practice settings, and organizations to improve safety, promote positive health outcomes and reduce costs. I really want to be an APN, because if I, as an individual can make positive changes in organizations and further improve patient care and patient satisfaction, that would make me feel like I'm really making a difference.
After working as a nurse for so long, I can see so many things in the organization that I want to change. But right now, as a staff nurse, I’m not able to make those changes. So I would like to obtain my masters and get into a role in management or upper level areas so I can make some changes.
Would you say not having a masters would be a barrier to getting into those positions?
I think so, because a lot of these positions like nurse educators, nurse, manager, or even nurse director, require a masters to get the job. So yeah, it is a barrier, and to be honest, I feel like in the future they will only have more requirements and I think we're starting to see that happening.
What do you hope the feature of nursing and health care in general will look like in Canada?
My hope for the future of nursing is that it remains a respectable profession. Especially recently… Two weeks ago, I was out picketing to get better wages and staffing and because we wanted to repeal the bill that's capping our wages at a 1% increase. I feel like right now there's really high turnover; I was reading this article that said about 55% of nurses in the first year of nursing are quitting, and this is probably because of poor staffing and burn out. I feel like we need to make nursing better supported because I'm scared that a lot of young people, and people who are interested in nursing will no longer be interested, because it just looks so bad. I hope that in the future it's still a profession that people want to go into, and I hope that there can be changes that can make that happen.
I'm scared that a lot of young people, and people who are interested in nursing will no longer be interested, because it just looks so bad. I hope that in the future [nursing] is still a profession that people want to go into
Right now, there is a big shortage of perioperative nurses, and it is causing surgical delays and stuff like that. I feel like operating room nursing is not really brought up when you're doing your Bachelor of Nursing; I don't think I remember ever being exposed to it really, because all of my placements were on the floors where you provide bedside nursing and stuff like that. I'm doing something about promoting recruitment right now and one way to recruit more nurses into the operating room could be just exposing it more in schools and increasing placements. There's something called a Nursing Graduate Guarantee program where new nurses get a guaranteed mentor for 6 months and a full-time job. If they could provide more placements in the operating room, it would really help with this perioperative nursing shortage.
This interview was edited for length and clarity.