Perioperative nurses, constantly pressed to work harder and faster, find taking the time to be present with their patients virtually impossible and virtually unsupported by Operating Room directors and hospital administrators alike. The demand to perform increasingly complex nursing tasks and technological skills in decreasingly less time has left perioperative nurses emotionally exhausted, depersonalized, and demoralized—all predictors of professional burnout, all predictors of declining patient care.

The unique training of Operating Room nurses means nurses from other disciplines cannot easily replace them. Hospitals cannot afford to lose perioperative nurses at a time when a nursing shortage threatens the care of an aging population that requires increasingly higher incidents of surgical intervention.

Surgery is serious business and patients deserve surgical nurses who are present and in the moment for quality nursing care. Presence by perioperative nurses in the context of their patients is a safety measure. It is possible to prevent a number of errors through nursing presence before surgery when nurses provide a moment or two of distraction-free time with their patients. It is during the application of presence when patients are able to think and communicate clearly to Operating Room nurses that errors may be avoided.

Surgical patients benefit from nursing presence in countless ways. Perioperative nurses are the single group of professionals in the department of surgery responsible for nursing the whole patient; that is considering each patient as having a unique blend of medical, social, and psychological concerns. The holistic approach to patient care is a hallmark of Operating Room nurses’ practice as surgery requires one-of-a-kind care regardless of how routine the surgery is. Pre-surgical presencing by perioperative nurses does much to over ride the stress-pain-stress-more-pain cycle. Surgical nurses who are present are best at offering this valuable intervention. Surgical nurses who are present provide emotional support and comfort for each patient exclusively. Finally, surgical nurses who are present ultimately bear witness to the event of surgery.

This dissertation discusses the need for presence by nurses generally and perioperative nurses specifically. The dissertation also expands coverage of nursing presence to include outward signs of presence as seen by patients and inward signs of presence as felt by nurses as well as barriers to presence and the financial cost of nursing presence.