The nursing practice is driven by the needs of patients and their family members, the needs of health care systems and the needs of society. Today’s greatest challenge nurses face is envisioning and delivering high quality nursing care while continuously decreasing the cost of delivering care. In perioperative nursing, the roles of the perioperative nurse practitioner and the perioperative clinical nurse specialist (CNS) have developed to provide sound future-oriented leadership, expert clinical knowledge and skills, and individualized patient-centered care to specific patient populations
The older practice of medicine was empirical, though theories were formed to suit the visible results. Physiology was in the beginning stages, and chemistry was hardly known, the natural cause of diseased action had not been observed. With the advancement of the first two, and correct observations of the nature, cause, phenomena, and duration of certain diseases, certain principles which now form a very good guide to a rational practice have been evolved.in past ages the perioperative environment was crude ,hand washing and boiling of instruments was not known. Then came the recognition of the importance of hand washing, gradually cloths, instruments and dressing were thoroughly cleaned. Practices of sterilization came in as they were developed. Rubber gloves were introduced in 1891 and later the face mask followed. Nurses had minor duties like administering anesthesia, sutured and tied, placed drains and removed dead and devitalized tissue.in following years nursed roles increased to instrument nurses, x-ray department to surgery prep and later on when professionalism came in students were exposed to the practice of perioperative nursing.as the responsibilities of the operating room nurse expanded to include care in the preoperative and postoperative periods, the term perioperative was recognized as more appropriate. The preoperative phase is the period that is used to physically and psychologically prepare the patient for surgery. The length of the preoperative period varies. For the patient whose surgery is elective, the period may be lengthy. For the patient whose surgery is urgent the period is brief. Diagnostic studies and medical regimens are initiated in the preoperative period. Information obtained from preoperative assessment and interview is used to prepare a plan of care for the patient. Nursing activities in the preoperative phase are directed toward patient support, teaching and preparation for procedure .perioperative nursing has changed over the years since its conception, with advancements in technology and practices. There are some big changes in the nursing field in the last 50 years such as, uniform, salaries, job demand, the roles of nurses, the different roles for men and women nurses. Today’s operating room nurses have a different role than what they did in the past. They have a new name (perioperative nurses) to encompass all three phases of surgery (the pre-, intra-, and post-operative stages). They provide, manage, teach and study the care of patients undergoing surgery or other invasive procedures