News / Periop Café


June 22, 2021



Rene Holden, MSN, CNOR, RN  

When Rene Holden was widowed in 2013, she was left to raise two teenaged boys alone. When her children were younger, she and her husband would take them on special trips every other year to get to as many States as possible. It was her youngest son who suggested she travel nurse; he reminded her that she loves to see new places, is good at her job, and it paid more, something she needed after going from two paychecks to one. One of the aspects she loves about being an interim is that it often involves streamlining processes, something she has a gift for.   


What is your priority on a new assignment? 

I don’t like coming in and telling people what they’re doing wrong. I like to see what they’re doing to start with and then go from there. Using my resources, research, and guidelines, I say, “Let’s try this and see if that works.” You must know how to approach people. Everyone has a voice and should be treated equally. You need to learn how people acknowledge feedback. People are resistant to change so you have to put things into perspective for them. This is what we’re doing now, this is where we want to go. In whatever way we decide to get there, it will be a team effort. 

What metrics illustrate a well-run OR?

You’re looking at two things. FCOTS and turnover time. At one of my last assignments, the turnover time was 58 minutes when I arrived. When I left, it was 30 minutes. There was no process for cleaning the ORs methodically, so we created one. We went from using non-disposable items to disposable, which is evidence-based practice.  

For FCOTS, we realized that the staff didn’t have the time to get these large cases started on time. The first case is supposed to start at 7:30. They would come in at 6:45, huddle at 6:50 or so, and then get into the OR at 7:00. So, we began starting at 6:30. Occasionally, we had one case that didn’t start on time, but most of the cases were on time and that improved our FCOTS.  

What are some ways to grow volume?  

You have to see where your moneymakers areThat’s tricky because you have to look at your entire community of surgeons and see which service lines have the best income potentialThere may be one doctor doing most of the cases, but are they making money? Sometimes administration knows which surgeons and specialties can grow, but they need help with creating a plan of action.  

Do you have any advice for a nurse manager who gets promoted to director role?

Well, before you promote someone you need to get a consensus within the department on whether that’s a good fit or not. Assuming all is good on that front, a manager stepping into a director role needs to realize it’s not an eight-hour a day, 5 days a week job. It’s 24/7. There’s not a lot of downtime, you’re always in it. You’re the face of the department. You have to take care of your staff, your surgeons. They need to feel you’re doing your best for the department. 


For Fun

Anything you always bring with you on an assignment?

I always bring pictures of my boys and a scrub hat from my school, the University of Alabama. The hat is a good ice breaker!

What do you for stress relief while on assignment? 

I watch TV and swim. I try to stay at a hotel that has a pool. I also love going to the beach. When I was in Florida, I would keep a chair in my car and go sit on the beach and read or take a walk.