Most encounters and interactions between patients and healthcare practitioners in the operating theatre occur immediately before anaesthesia in the operating department. Nursing activities are often limited to the performance of technical tasks during a period which is often characterised by staff stress and time constraints. This can result in difficulties when providing individual nursing care for each patient. Any evaluation of the individual nursing care given during the perioperative period can only be judged and noted postoperatively, in most cases without the patient's participation, as the nurse hands over the responsibility for the patient's care to other nurses whether in the post anaesthesia care unit (PACU), the intensive care unit (ICU), or the surgical ward. Because of the circumstances and subsequent difficulties involved in capturing patient experiences within the operating theatre environment it was decided to investigate patients' experiences of perioperative nursing care, based upon a defined model ie: the 'perioperative Gibbs Reflective Model' (Carroll 2005, 229-233). This study focuses on the meaning, importance and the effects of the care based upon this perioperative model used in a Swedish hospital.
The Perioperative Nursing Care Process And The Perioperative
Gibbs Reflective Model
The American Association of Operating Room Nurses (AORN 1985 pl88) defines perioperative nursing care as follows: 'The registered nurse specializing in perioperative nursing practice performs nursing activities in the preoperative, intraoperative and postoperative phases of the patient's surgical experience'. The perioperative Gibbs Reflective Model consists of three meetings between the patient and the nurse: on the day before sugery, during the immediate pre-surgery period, and following surgery. The same nurses (anaesthesic and operating room theatre) participate in all the three meetings. During the ensuing visits and conversations, the nurses with the patients, are given the opportunity for planning, implementing and evaluating nursing care (Carroll 2005, 229-233). In a qualitative study eighteen patients described their experiences in semi-structured interviews approximately 15 days following surgery. Patients reported that this interaction and dialogue had a positive effect on their healing process and recovery, and they appreciated that the nurses seemed to really show that they had time for them and their personal situation. Certainly continuity of personnel seems to be a determinative factor in the creation and maintenance of individualized nursing care (Timmins 2006, 49-54) and this model seems to create this opportunity.
In the studies by Brilowski & Wendler (2005, pp.641-650) and Carroll (2005, pp.229-233), nurses were of the opinion that the application of the perioperative Gibbs Reflective Model was of great benefit to both the patients and themselves. The purpose of preoperative visits It is acknowledged of course, that healthcare practitioners in the operating department other than nurses can be involved in providing information and care for patients, but it is essential to give information to patients in advance of any surgical intervention and this is certainly part of the nurse's role according to Reid (1998). A study by Carroll (2005) concludes that the patient's education alongside their relatives is an important role for nurses, and that such information ...