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Communication in the OR—Know yourself
Communication in the ORKnow yourself
Rose Marie Mc Williams, RN
Communication is any act or behavior that results in an exchange of meaning. So communication, by definition, involves a t least two individuals, the sender and the receiver, and the primary purpose of communication is to e f f e c t i v e 1 y transmit information from the mind of one person to another with minimal distortion or loss of meaning. Let us examine the key phrases “transmit from the mind of one person to another” - it is not just making sound waves that run along an auditory nerve. No, there is t o be something more than just noise. Something is to reach the mind of the receiver with “minima1 distortion o r loss of meaning”. Rose M a r i e M c W i l l i a m s , rector
of
quarters.
education
at
RN, BS, i s assistant diAORN
National Head-
Ms. M c W i l l i a m s , a n OR supervisor f o r
17 years, studied a t St. Francis Hospital, Topeka, and St.
Mary’s C o l l e g e , Leavenworth,
Kans. She
currently i s studying for a master’s degree in mass communications a t Denver University.
September 1972
This sounds so simple, yet it is unbelievably complex. As an example, almost any word I use has multiple meaning and is therefore subject to distortion. What do you think of when someone says “kelly”? To some of you this means an Irish name; to others it means a protective pad; to some it means a hemostatic forcep. What do you think of when someone says “suture”? Some of you are thinking of plain cat gut, some chromic, some silk, some nylon; some may even think of dexon o r cotton. What about the word “pass”? Are you thinking of “pass” a t bridge, “pass”, as in football, o r are some of you thinking of a mountain pass, or a pass your date made at you last night ?
If we find four o r five meanings for each word, think how much this is multiplied when we put five ~ v o r d s together in a direction, o r sixteen
71
words in a memo. The possibility of distortion is multiplied. What about a few other things that increase distortion? What does stress do? On a particularly harried day, do you find yourself trying extra hard to listen to what a doctor is telling you regarding another emergency case? Why? Because the likelihood is greater that one of you is garbling the message. Those then are just a few examples of how distortion, the great enemy of communication, can occur. Let us now take a look at what happens in nursing, and specifically in OR nursing. Communication in nursing is a subject like Peace, Pollution, o r Women’s Lib. We talk a lot about it, but do very little about the problem i t represents. All of us take communication for granted. That is why most of us are so poor in this lost art. We all think we are communicating, and are highly insulted when someone says, “What do you mean?” or, “What are you really trying to say?” Nursing is one profession in which job satisfaction, happiness and success are dependent on the communication skills the nurse has developed. The day by day routine of the nurse’s work, whether she is an operating room supervisor or an OR staff nurse, consists of a series of interpersonal relationships - “interpersonal” meaning between persons another way of saying communication. The OR nurse is interacting in a variety of situations with many different kinds of people. But do you realize that less than 35% of our
72
face to face communication is carried out verbally. That means 65% is nonverbal! I recall a few experiences with nonverbal communication. One was long ago, and one fairly recent which I would like to share with you. When I was a senior in high school, it was decided that my tontils should come out, and that was my first introduction to the OR. I remember i t as well as if it happened yesterday. They dressed me for the OR and then wheeled me down the hall into surgery. I heard the doctor say, “Move her on to the table.” My hands were placed in restraints. With that, the doctor slapped something over my face and said, “Begin to count.’’ He started pouring the ethel chloride and I started fighting. Do you know what calmed me down? The nurse took my hand and squeezed it. With that I felt someone did care and I got through that terrible moment of desperation. What that nurse did was communicate. A more recent experience was a pleasant one w h i c h I enjoyed greatly. When the ballet troupe was in my home town recently, I had, for the first time, the opportunity of experiencing the full four acts of Swan Lake. I was impressed with the staging and beautiful costumes. But I was even more thrilled with the level of communication going on between the dancers, with no words spoken. I left feeling I had experienced a part of that communication with the dancers, reaching t h e audience through the expression of bodies.
So again, we are reminded how much goes on nonverbally, by gcsture, by touch, by silence, by eyes, by expression, by body postures-
AORN Journal
many ways. We communicate by gestures. Movement of the hand, or a preoccupied walk is communication. What the employee communicates to you when he comes to see you and sits slouched in a chair is a form of nonverbal communication. How many of you have thought
How can we help what he hears? Conversation should be minimal. There is no place for abrasive or angry words. The sounds he does hear should be calm, reassuring, and if directed to him in the form of instructions, should be clear and easily understood.
stand, not saying a word. The room became quiet. And still, the professor said nothing. Then the class began to grow uncomfortable and quiet. The impact of silent communication was far greater than a chastisement of the noisy group. Now, let us combine some of our verbal and nonverbal theories and apply them to our work in the OR. What is verbal? The many thousands of words we use every day in the OR. Who hears them? Everybody-often many more than the person for whom they are intended. Many more receivers to filter the information means that there is a greater possibility of misconstruing the message. Let us limit our remarks to the patient as receiver. What does he hear of the verbal OR communication? He hears voices he does not recognize; he hears an unfamiliar language. “Open another Balfour.” “You had better give me another blade.” “1’11 probably need more sponges.” “Give me ten peanuts.” Do we have any idea what that last statement alone can convey? Peanuts-in an operating room?
What can we communicate to him by touch? By demonstrating confidence, yet concern, a s we physically help him to transfer from the cart to the table; helping him feel human and not a n auction piece a s we position him for a cysto; by supporting his head for just a moment a s he goes from full pillow to the awful flatness of no rdlow. We could mobably do more reassuring by deIiberately placing our hand on the patient’s arm or shoulder as we greet him in the OR. This is less necessary if we effectively use the many times we have body contact with the patient as a means to communicate to him.
September 1972
These thoughts are brief, yet you can readily take some of your own experience and find similarities, I feel certain. The point of concern is: 1) communication is so important that i t cannot be taken for granted. We have t o look a t our skills or lack of skill and 2) the OR is an area where communication is carried on in multiple ways and can have significant impact on patients, staff and physicians.
73
We have looked at the different ways to communicate, now let us look a t some of the things that throw up barriers and prevent communication. According to Carl Rogers, a leading psychotherapist and psychotherapy researcher, the major barrier to effective communication is the tendency to evaluate. That is, the barrier to mutual interpersonal communication is our natural tendency to judge, to evaluate, to approve or disapprove the statement or opinion of the other person or group. As an example of this tendency to evaluate, note how you react to the following statement: My position regarding certification of nurses for relicensure is t h a t certification should be mandatory and that we should begin this immediately. Almost invariably you either agree or disagree with this statement. You evaluated the statement from your own frame of point of view-your reference. Although the tendency to make evaluations is common in almost all interchange of language, it is even more evident where feelings and emotions are deeply involved. So, the stronger our feelings, the more likely it is that there will be no mutual element in our communication. Do you remember as children the types of arguments we had? The voices became louder as the argument progressed and no one was hearing what was really being said. Sides were taken and everyone was yelling. Adult communication is very similar. What could be a stronger evaluative statement than the child yelling “You’re blind as a bat!” Do we let the child in us effect our communication?
74
We cannot eliminate our feelings. We would not want to. But we need to recognize their ability to affect communication, to recognize in ourselves the sense of rising feelings which decrease mutual understanding. We could improve communication, o r better still, we could communicate if we t r y to put ourselves in the frame of reference from which the speaker is speaking. Instead of judging and evaluating, we should be saying “What is this person saying? Why is he saying it? What is he feeling?” As an example, let us take thc subject of bussing. If you have discussed this subject in a group, I am sure it was not long until you knew the firm stand everyone has taken on this issue. It is now an emotional issue and very little communication goes on regarding this subject. However, if I place myself in the role of a mother with four children, all of whom are being bussed, I might find myself understanding why t h i s mother thinks the way she does. Also, if I place myself in the educator’s shoes and listen objectively, I might come away more convinced that bussing a t this time, is a good thing, for it is a beginning. It is very difficult to communicate when a topic reaches this level of emotionalism, and to overcome this barrier takes mature, adult people who can recognize the barrier and begin to break it down. Other communication barriers to be alerted to are money, ethnic o r color differences, or social class. Take just a minute to think on these differences.
I have discussed barriers, but have not mentioned the one most obvious, and probably the most serious, and that is the inability or the unwillingness to listen. Listening and hearing are not synonymous. The hearing of sound is the first step in the listening process. The second step is the attachment of meaning to the spoken word, sound and silence. Educators, in recent years, have expressed concern that the act of listening is near becoming a lost ability. We have been accused of being a nation of nonlisteners. It is said that in a group of ten Americans, nine are talking and one is waiting t o talk. The average American speaks at the rate of 125 words per minute, but he thinks a t the speed of 400 to 500 words per minute. The different rates and ways of speaking and thinking create problems for both the listener and the speaker. In communicating, we must be alert and attentive. We must guard against not listening. We must not think too far ahead of the person we are talking to. As a result of a study made on personal communications, it was found that, on the average, 75 per cent of a person's waking hours is spent in verbal communication, 30 per cent in talking and 45 per cent in listening. Yet most of us do not know how to listen. The act of listening requires that we do more than just hear. When we are poor listeners, we become impatient; we do not give the speaker a chance. We say the subject is dry, o r that the speaker is a bore. This always excuses us from listening. Not only do we listen this way in church
Scptenibw 1972
and in program sessions and lectures, we often do this on a one to one basis as well as in group discussions. We just turn the speaker off. This is one reason why we seldom come away from a meeting feeling t h a t we have gained any knowledge or have had any of our problems solved. Let us stop blaming others and come to realize t h a t we share in that blame. Remember, a good communicator is a good listener.
As listeners, we must first learn to be comfortable in that role. Listening is similar to observation. It combines what one hears, what one understands and what one remembers. When listening, here a r e some of the cues you should pick up from the speaker: 1) the choice of words, 2) repetition of key Lvords, 3) rise and fullness in the tone of voice, 4 ) hesitant o r aggressive expression of words and ideas. Especially as nurses, we should be able to catch the softness o r harshness of tone. You listen for the feelings, needs and goals that are expressed and to clues to the feelings, needs and goals which are not openly expressed. Dr Peplau calls this creative listening. She compares it to the listening of music. You listen for the themes and variations, the change in tempo, the variation of instruments used, the loudness and softness. All of these listened to make the listener aware of what the composer, as well others, are trying to communicate to us. There is no harder place to listen than the operating room. This is something the OR supervisor should be very aware of and she should have a place where she can go to carry
75
out the function of listener. This place must be free of distractions and at a time when she can give her undivided attention to the speaker. Nurses I have supervised, always knew if they had my attention when telling me something, for remember, hearing sound is only the first step in listening. To summarize, I know that a broad subject like this is like covering the waterfront in a rowboat, or in our jargon, like putting in a Smith Peterson nail using Senns for retractors. Both mean taking on a big job with a small instrument. But, we should remember that the nursing profession depends so greatly
on communication that we cannot take for granted that we do i t well. We do not always do so well; we are busy: we are preoccupied; we have deep feelings; we tend to evaluate. We can do better with the OR patient in the fields of verbal and nonverbal communication. We can impress the way we reassure, support, and inspire confidence. We must remember the affect of distortion in our communications, and the vital role of the listener. We must also remember that communication is a give and take process which requires constant attention if it is to be effective.
0
Hoffman inuugurafed as new AMA presidenf C.
A. "Carl" Hoffman,
MD, was inaugurated as the American Medical Association's ( A M A ) president
in San Francisco recently.
Dt. Hoffman, 68, has been president-elect for tho past
12 months. A practicing urologist
in Huntington, West Virginia, Dr. Hoffman was born in Ironton, O h i o in 1904. Dr. Hoffman received
his certificate in pharmacy (PHC) i n 1925 from Ohio State University.
H e received his bachelor's degree from Marshall University in 1931 and his medical degree from the University of Cincinnati in 1935. The doctor was president of the Cabell County Medical Society and was president of the West Virginia Medical Association during 1957-1958. Dr. Hoffman served as a delegate from
West Virginia t o the A M A from 1958 t o his election t o the AMA board of trustees in 1969. H e was chosen secretary-treasurer of the association in 1970. In his specialty, Dr. Hoffman i s a past president of the Mid-Atlantic Urological Association. H e served for five years as treasurer of the American Urological Association and became the 64th president of that association. H e was a co-founder and the first president o f t h e American Association of Clinical Urologists. H e i s a fellow of the American College of Surgeons and the International College of Surgeons.
Dr. Hoffman chaired the A M A ' s Commission on Professional Liability during the 1970 medical malpractice crisis. H e has been appointed t o the special Health, Education and Welfare Commission on Medical Malpractice ordered by President Nixon. H e served as a working member of the National Commission on venereal disease that presented
i t s report t o President Nixon in February o f 1972, recommending sweeping changes t o stem an epidemic of venereal disease raging throughout the country. I n 1972, Dr. Hoffman received the Distinguished Alumnus Award from Ohio State University. In 1969, he was awarded a Distinguished Alumnus Award from Marshall University where he i s a member of the school's Advisory Board of Regents and was treasurer of the Marshall Foundation, which administers a scholarship fund. He was recently awarded an Honorary Doctor of Science Degree from Marshall University.
76
A O RN Jozirnal
Rose Marie Mc Williams, RN
Communication is any act or behavior that results in an exchange of meaning. So communication, by definition, involves a t least two individuals, the sender and the receiver, and the primary purpose of communication is to e f f e c t i v e 1 y transmit information from the mind of one person to another with minimal distortion or loss of meaning. Let us examine the key phrases “transmit from the mind of one person to another” - it is not just making sound waves that run along an auditory nerve. No, there is t o be something more than just noise. Something is to reach the mind of the receiver with “minima1 distortion o r loss of meaning”. Rose M a r i e M c W i l l i a m s , rector
of
quarters.
education
at
RN, BS, i s assistant diAORN
National Head-
Ms. M c W i l l i a m s , a n OR supervisor f o r
17 years, studied a t St. Francis Hospital, Topeka, and St.
Mary’s C o l l e g e , Leavenworth,
Kans. She
currently i s studying for a master’s degree in mass communications a t Denver University.
September 1972
This sounds so simple, yet it is unbelievably complex. As an example, almost any word I use has multiple meaning and is therefore subject to distortion. What do you think of when someone says “kelly”? To some of you this means an Irish name; to others it means a protective pad; to some it means a hemostatic forcep. What do you think of when someone says “suture”? Some of you are thinking of plain cat gut, some chromic, some silk, some nylon; some may even think of dexon o r cotton. What about the word “pass”? Are you thinking of “pass” a t bridge, “pass”, as in football, o r are some of you thinking of a mountain pass, or a pass your date made at you last night ?
If we find four o r five meanings for each word, think how much this is multiplied when we put five ~ v o r d s together in a direction, o r sixteen
71
words in a memo. The possibility of distortion is multiplied. What about a few other things that increase distortion? What does stress do? On a particularly harried day, do you find yourself trying extra hard to listen to what a doctor is telling you regarding another emergency case? Why? Because the likelihood is greater that one of you is garbling the message. Those then are just a few examples of how distortion, the great enemy of communication, can occur. Let us now take a look at what happens in nursing, and specifically in OR nursing. Communication in nursing is a subject like Peace, Pollution, o r Women’s Lib. We talk a lot about it, but do very little about the problem i t represents. All of us take communication for granted. That is why most of us are so poor in this lost art. We all think we are communicating, and are highly insulted when someone says, “What do you mean?” or, “What are you really trying to say?” Nursing is one profession in which job satisfaction, happiness and success are dependent on the communication skills the nurse has developed. The day by day routine of the nurse’s work, whether she is an operating room supervisor or an OR staff nurse, consists of a series of interpersonal relationships - “interpersonal” meaning between persons another way of saying communication. The OR nurse is interacting in a variety of situations with many different kinds of people. But do you realize that less than 35% of our
72
face to face communication is carried out verbally. That means 65% is nonverbal! I recall a few experiences with nonverbal communication. One was long ago, and one fairly recent which I would like to share with you. When I was a senior in high school, it was decided that my tontils should come out, and that was my first introduction to the OR. I remember i t as well as if it happened yesterday. They dressed me for the OR and then wheeled me down the hall into surgery. I heard the doctor say, “Move her on to the table.” My hands were placed in restraints. With that, the doctor slapped something over my face and said, “Begin to count.’’ He started pouring the ethel chloride and I started fighting. Do you know what calmed me down? The nurse took my hand and squeezed it. With that I felt someone did care and I got through that terrible moment of desperation. What that nurse did was communicate. A more recent experience was a pleasant one w h i c h I enjoyed greatly. When the ballet troupe was in my home town recently, I had, for the first time, the opportunity of experiencing the full four acts of Swan Lake. I was impressed with the staging and beautiful costumes. But I was even more thrilled with the level of communication going on between the dancers, with no words spoken. I left feeling I had experienced a part of that communication with the dancers, reaching t h e audience through the expression of bodies.
So again, we are reminded how much goes on nonverbally, by gcsture, by touch, by silence, by eyes, by expression, by body postures-
AORN Journal
many ways. We communicate by gestures. Movement of the hand, or a preoccupied walk is communication. What the employee communicates to you when he comes to see you and sits slouched in a chair is a form of nonverbal communication. How many of you have thought
How can we help what he hears? Conversation should be minimal. There is no place for abrasive or angry words. The sounds he does hear should be calm, reassuring, and if directed to him in the form of instructions, should be clear and easily understood.
stand, not saying a word. The room became quiet. And still, the professor said nothing. Then the class began to grow uncomfortable and quiet. The impact of silent communication was far greater than a chastisement of the noisy group. Now, let us combine some of our verbal and nonverbal theories and apply them to our work in the OR. What is verbal? The many thousands of words we use every day in the OR. Who hears them? Everybody-often many more than the person for whom they are intended. Many more receivers to filter the information means that there is a greater possibility of misconstruing the message. Let us limit our remarks to the patient as receiver. What does he hear of the verbal OR communication? He hears voices he does not recognize; he hears an unfamiliar language. “Open another Balfour.” “You had better give me another blade.” “1’11 probably need more sponges.” “Give me ten peanuts.” Do we have any idea what that last statement alone can convey? Peanuts-in an operating room?
What can we communicate to him by touch? By demonstrating confidence, yet concern, a s we physically help him to transfer from the cart to the table; helping him feel human and not a n auction piece a s we position him for a cysto; by supporting his head for just a moment a s he goes from full pillow to the awful flatness of no rdlow. We could mobably do more reassuring by deIiberately placing our hand on the patient’s arm or shoulder as we greet him in the OR. This is less necessary if we effectively use the many times we have body contact with the patient as a means to communicate to him.
September 1972
These thoughts are brief, yet you can readily take some of your own experience and find similarities, I feel certain. The point of concern is: 1) communication is so important that i t cannot be taken for granted. We have t o look a t our skills or lack of skill and 2) the OR is an area where communication is carried on in multiple ways and can have significant impact on patients, staff and physicians.
73
We have looked at the different ways to communicate, now let us look a t some of the things that throw up barriers and prevent communication. According to Carl Rogers, a leading psychotherapist and psychotherapy researcher, the major barrier to effective communication is the tendency to evaluate. That is, the barrier to mutual interpersonal communication is our natural tendency to judge, to evaluate, to approve or disapprove the statement or opinion of the other person or group. As an example of this tendency to evaluate, note how you react to the following statement: My position regarding certification of nurses for relicensure is t h a t certification should be mandatory and that we should begin this immediately. Almost invariably you either agree or disagree with this statement. You evaluated the statement from your own frame of point of view-your reference. Although the tendency to make evaluations is common in almost all interchange of language, it is even more evident where feelings and emotions are deeply involved. So, the stronger our feelings, the more likely it is that there will be no mutual element in our communication. Do you remember as children the types of arguments we had? The voices became louder as the argument progressed and no one was hearing what was really being said. Sides were taken and everyone was yelling. Adult communication is very similar. What could be a stronger evaluative statement than the child yelling “You’re blind as a bat!” Do we let the child in us effect our communication?
74
We cannot eliminate our feelings. We would not want to. But we need to recognize their ability to affect communication, to recognize in ourselves the sense of rising feelings which decrease mutual understanding. We could improve communication, o r better still, we could communicate if we t r y to put ourselves in the frame of reference from which the speaker is speaking. Instead of judging and evaluating, we should be saying “What is this person saying? Why is he saying it? What is he feeling?” As an example, let us take thc subject of bussing. If you have discussed this subject in a group, I am sure it was not long until you knew the firm stand everyone has taken on this issue. It is now an emotional issue and very little communication goes on regarding this subject. However, if I place myself in the role of a mother with four children, all of whom are being bussed, I might find myself understanding why t h i s mother thinks the way she does. Also, if I place myself in the educator’s shoes and listen objectively, I might come away more convinced that bussing a t this time, is a good thing, for it is a beginning. It is very difficult to communicate when a topic reaches this level of emotionalism, and to overcome this barrier takes mature, adult people who can recognize the barrier and begin to break it down. Other communication barriers to be alerted to are money, ethnic o r color differences, or social class. Take just a minute to think on these differences.
I have discussed barriers, but have not mentioned the one most obvious, and probably the most serious, and that is the inability or the unwillingness to listen. Listening and hearing are not synonymous. The hearing of sound is the first step in the listening process. The second step is the attachment of meaning to the spoken word, sound and silence. Educators, in recent years, have expressed concern that the act of listening is near becoming a lost ability. We have been accused of being a nation of nonlisteners. It is said that in a group of ten Americans, nine are talking and one is waiting t o talk. The average American speaks at the rate of 125 words per minute, but he thinks a t the speed of 400 to 500 words per minute. The different rates and ways of speaking and thinking create problems for both the listener and the speaker. In communicating, we must be alert and attentive. We must guard against not listening. We must not think too far ahead of the person we are talking to. As a result of a study made on personal communications, it was found that, on the average, 75 per cent of a person's waking hours is spent in verbal communication, 30 per cent in talking and 45 per cent in listening. Yet most of us do not know how to listen. The act of listening requires that we do more than just hear. When we are poor listeners, we become impatient; we do not give the speaker a chance. We say the subject is dry, o r that the speaker is a bore. This always excuses us from listening. Not only do we listen this way in church
Scptenibw 1972
and in program sessions and lectures, we often do this on a one to one basis as well as in group discussions. We just turn the speaker off. This is one reason why we seldom come away from a meeting feeling t h a t we have gained any knowledge or have had any of our problems solved. Let us stop blaming others and come to realize t h a t we share in that blame. Remember, a good communicator is a good listener.
As listeners, we must first learn to be comfortable in that role. Listening is similar to observation. It combines what one hears, what one understands and what one remembers. When listening, here a r e some of the cues you should pick up from the speaker: 1) the choice of words, 2) repetition of key Lvords, 3) rise and fullness in the tone of voice, 4 ) hesitant o r aggressive expression of words and ideas. Especially as nurses, we should be able to catch the softness o r harshness of tone. You listen for the feelings, needs and goals that are expressed and to clues to the feelings, needs and goals which are not openly expressed. Dr Peplau calls this creative listening. She compares it to the listening of music. You listen for the themes and variations, the change in tempo, the variation of instruments used, the loudness and softness. All of these listened to make the listener aware of what the composer, as well others, are trying to communicate to us. There is no harder place to listen than the operating room. This is something the OR supervisor should be very aware of and she should have a place where she can go to carry
75
out the function of listener. This place must be free of distractions and at a time when she can give her undivided attention to the speaker. Nurses I have supervised, always knew if they had my attention when telling me something, for remember, hearing sound is only the first step in listening. To summarize, I know that a broad subject like this is like covering the waterfront in a rowboat, or in our jargon, like putting in a Smith Peterson nail using Senns for retractors. Both mean taking on a big job with a small instrument. But, we should remember that the nursing profession depends so greatly
on communication that we cannot take for granted that we do i t well. We do not always do so well; we are busy: we are preoccupied; we have deep feelings; we tend to evaluate. We can do better with the OR patient in the fields of verbal and nonverbal communication. We can impress the way we reassure, support, and inspire confidence. We must remember the affect of distortion in our communications, and the vital role of the listener. We must also remember that communication is a give and take process which requires constant attention if it is to be effective.
0
Hoffman inuugurafed as new AMA presidenf C.
A. "Carl" Hoffman,
MD, was inaugurated as the American Medical Association's ( A M A ) president
in San Francisco recently.
Dt. Hoffman, 68, has been president-elect for tho past
12 months. A practicing urologist
in Huntington, West Virginia, Dr. Hoffman was born in Ironton, O h i o in 1904. Dr. Hoffman received
his certificate in pharmacy (PHC) i n 1925 from Ohio State University.
H e received his bachelor's degree from Marshall University in 1931 and his medical degree from the University of Cincinnati in 1935. The doctor was president of the Cabell County Medical Society and was president of the West Virginia Medical Association during 1957-1958. Dr. Hoffman served as a delegate from
West Virginia t o the A M A from 1958 t o his election t o the AMA board of trustees in 1969. H e was chosen secretary-treasurer of the association in 1970. In his specialty, Dr. Hoffman i s a past president of the Mid-Atlantic Urological Association. H e served for five years as treasurer of the American Urological Association and became the 64th president of that association. H e was a co-founder and the first president o f t h e American Association of Clinical Urologists. H e i s a fellow of the American College of Surgeons and the International College of Surgeons.
Dr. Hoffman chaired the A M A ' s Commission on Professional Liability during the 1970 medical malpractice crisis. H e has been appointed t o the special Health, Education and Welfare Commission on Medical Malpractice ordered by President Nixon. H e served as a working member of the National Commission on venereal disease that presented
i t s report t o President Nixon in February o f 1972, recommending sweeping changes t o stem an epidemic of venereal disease raging throughout the country. I n 1972, Dr. Hoffman received the Distinguished Alumnus Award from Ohio State University. In 1969, he was awarded a Distinguished Alumnus Award from Marshall University where he i s a member of the school's Advisory Board of Regents and was treasurer of the Marshall Foundation, which administers a scholarship fund. He was recently awarded an Honorary Doctor of Science Degree from Marshall University.
76
A O RN Jozirnal