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THE EMPOWERED NURSE

THE FACE

This feature captures empowered nurses’ inherent abilities to assess creative solutions and provide innovative approaches to problems.
Such proactive, evidence-based interventions spur change rendering positive impacts on care delivery, work environments and, ultimately,
the lives of patients and families. Empowered nurses on the front lines are the faces of innovative health care.

An Interview with a VUMC Nurse hopes nurses in other areas can translate the template to serve
them in their specific practice areas.
Innovator: Natalie Stewart-Mast from

MCJCHV Perioperative Services Article written by Elizabeth Card, MSN, APRN, FNP-BC, CPAN,
CCRP, FASPAN
Nurses are natural innovators, exploring creative solutions
for unresolved problems. “Innovation is seeing what everybody
has seen and thinking what nobody has thought.” — Dr. Albert,
Szent- Györgyi
Natalie transitioned from working nights to days in the op-
erating rooms a few years ago. The pace of preparing an operat-
ing room (OR) for a surgical case was much faster than she was
accustomed to. She longed for a tool to guide setting up the OR
safely and efficiently. In 2016, she created a checklist to better or-
ganize these tasks. She realized that if she imagined the OR as
the face of a clock with noon facing the OR table, she could
quickly stay on task while setting up by preparing each piece of
equipment (e.g. surgical carts, suction) or completing task (e.g.
notifying team members, securing needed medications) round-
ing the room in a clockwise fashion.
Inspired by the efficiency of this new method, she often
sketched the face of the clock as she precepted new nurses. With
the encouragement of her manager Maria Sullivan to formalize 12- Is your bed ready for your patient?
1- Have you spoken with anesthesia?
her method, Natalie created a two-sided instrument she calls the
2- Do you need your boom set up for your case start, do you need lead?
“OR clock.” The “OR clock” is a single sheet of paper with the 3- Have you communicated with your surgeon?
face of a clock with each task marking the 12 numbers/steps in 4- Have you started all necessary programs for your case?
preparing the OR on the front page and the checklist located on 5- Did you pull necessary supplies from the core including drugs?
6- Is your case cart completed and in the room with necessary pans included?
the flip side. Natalie shared that her parents are artists, and she
7- Do you have all necessary equipment in the room and is it oriented
grew up sketching, so she easily sketched out the “OR clock,” appropriately for your case?
complete with illustrations of each piece of OR equipment. 8- Helped your scrub or first assist open for the case?
Her handmade, innovative tool is friendly to different learn- 9- Have you discussed with your scrub if they are ready to bring the patient
back?
ing styles as well as being functional art. Several copies of the
10- Do you have your positioning aids close and available for your case start?
“OR Clock” have been placed into the ORs at MCJCHV for Did you turn on your Bovie machine and is your suction hooked up and
nurses to refer to, and even seasoned nurses may turn to the ready to attach to the field?
“OR clock” to keep them organized when preparing for rarer, 11- If you have completed all of these steps, then your room is properly set
up and you’re ready to go!
complex cases.
In 2019, Natalie presented a poster on the success of the
“OR clock” at the Association of Operating Room Nurses Na-
tional Conference where a reporter for Outpatient Surgery mag-
azine interviewed her. The story was published in the January
2020 issue. Natalie stated the “OR Clock” continues to evolve,
and she is creating additional clocks for other surgical time
Natalie Stewart-Mast, BSN, RN
points. Recently, she was contacted by a nurse educator from the CSL Perioperative Services MCJCHV
ICU about adapting the “OR clock” for the ICU nurses. Natalie natalie.k.stewart@vumc.org