08/27/2026
“Most importantly, I promised her that I would stay by her side until she was asleep. That simple promise became the foundation of trust between us.” - J.D. Buchert, MSN, M.Ed., MS, RN, CNOR, CPHQ
⭐ One of the most powerful moments of my perioperative nursing career involved a patient in her 30s with significant developmental disabilities whose cognitive capacity was similar to that of an 8-year-old child. As her circulating nurse, I immediately recognized the overwhelming fear and anxiety she was experiencing about surgery. The operating room environment, the unfamiliar faces, and the uncertainty of what was about to happen were terrifying for her.
Before we entered the operating room, I sat with her and explained, in terms she could understand, exactly what would happen. Most importantly, I promised her that I would stay by her side until she was asleep. That simple promise became the foundation of trust between us.
Once in the operating room, the pace of activity increased. Members of the surgical team began preparing for the procedure and requested medications and supplies that had not been previously anticipated. As they attempted to engage me in those tasks, I remained focused on the patient. In a firm but respectful tone, I explained that my commitment to this patient took precedence in that moment and that I would address their requests as soon as she was safely under anesthesia.
I held her hand. I continued speaking calmly to her. I reassured her that she was safe and that I was keeping my promise. Only after she was asleep and intubated did I turn my attention to the additional needs of the team.
Several days later, her parents sought me out. They shared that their daughter repeatedly talked about how someone stayed with her and protected her. For the first time, she was not frightened by her surgical experience. She remembered that she had not been abandoned and that someone had kept their word. Knowing she had an advocate at her side transformed her perception of surgery and reduced the fear she carried into the experience.
This experience embodies what AORN's Guidelines for Perioperative Practice teach us about advocacy. Advocacy is not simply ensuring policies are followed or documentation is completed. It is recognizing and protecting the physical, emotional, psychological, and developmental needs of every patient, especially when they are at their most vulnerable.
In that moment, the most important intervention was not obtaining supplies or medications—it was preserving the patient's sense of safety, dignity, and trust. The guidelines remind us that the circulating nurse serves as the patient's voice and protector when the patient cannot advocate fully for themselves.
That day reaffirmed for me that advocacy is not an additional task in perioperative nursing, it is the essence of our role. Every patient deserves to know that someone is there solely for them. Sometimes the most meaningful care we provide is simply keeping a promise. ⭐
What’s one of the most memorable moments you’ve had at work? Share it in the comments below!
Our Periop Portraits series shines a spotlight on the incredible folks within our perioperative community! Share your story at: https://bit.ly/441hYHZ
