Dancing the AORN dance

Dancing the AORN dance

MAY 2005, VOL 81, NO 5 President’s Message PRESIDENT’S MESSAGE Dancing the AORN dance C olleagues, it is a n honor to be your AORN President. Th...

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MAY 2005, VOL 81, NO 5

President’s Message

PRESIDENT’S

MESSAGE

Dancing the AORN dance

C

olleagues, it is a n honor to be your AORN President. The experience of following in the footstepsof previous great AORN leaders is awesome. I have spent years learning and growing under the tutelage of many of you. It now is time to show you that I have listened and absorbed what you shared with me. I believe I have insight and knowledge about perioperative practice and the issues that detract from perioperative nurses’ ability to provide quality patient care; however, it is not my job alone to take up the challenges that will affect our future. It is our job together. It is our shared responsibility to the perioperative nursing profession, and we must nurture it together to not only survive but thrive in the future.

A STRONGFOUNDATION Throughout my AORN journey, I have danced the AORN dance, and it has been a wonderful collaborative experience with many great dancers. It has been important to listen to the whispers of dancers who have gone before me and who have left a legacy of quality service to the members. All of these past leaders are part of the music of the dance. For example, President Brenda Ulmer, RN, MN, CNOR, showed me what a true lady of grace is and how to be strong and empathetic at the same time. She had the foresight to lead the Board in hiring our visionary Executive Director, Tom Cooper, CAE, who has directed stellar Headquarters staff members to support our progress. President Sheila Allen, RN, BSN, CNOR, CRNFA, was and is the proverbial optimist who always has a smile from deep within her huge heart. President Donna Watson, RN, MSN, CNOR, ARNP, FNP, demonstrat-

S h a m A. McNamara, RN

ed how to think out of the box and directed us in our patient safety dance. President Betty Shultz, RN, CNOR, danced us into many partnerships that have put us in the lead position on the chorus line. I was privileged to serve with each of these leading ladies who taught me lasting lessons that will help me serve each of you with intensified knowledge, critical thinking, heightened judgment, and compassion. The most current past President, William J. Duffy, RN, BSN, MJ, CNOR, was my most intense presidential dance partner, mostly because he It is our -job dances in double time no matter what the cadence. Being President-elect together to take gaveme the opportunity up the challenges to dance like there was no tomorrow. I have that will affect learned so much from this very bright, kind, perioperative and gentle man. He taught me lessons in nursing, and we strategy and how to play AORN chess. He must nurture empowered me to try out myPresidentia1 ski& so I that shared could walk before I had to run.He started his responsibility to succession plan before Michelle Burke, RN, suwive and MSA, CNOR, and I even ran for President-elect. thrive in the As candidates, we were aware of his plans, so future. whoever won could be I prepared to hit the ground running. I continued this new tradition with Paula Graling, RN, MSN, CNS, CNOR, and Mary Jo Steiert, RN, BSN, CNOR, the President-elect candidates for 20052006. Mentoring leaders will be a prime focus this year. AORN JOURNAL

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When you get to a certain level in this organization you reach a point where you have to challenge a good friend and seek the same office. I would like to acknowledge my running mate and friend Michelle Burke. She taught me to look at the lighter side in the midst of difficult situations. We jokingly told the rest of the Board that we were going to be co-presidents.We were going to wear the same outfit to speak in and give exactly the same speech. Indeed, t h s past year has been very much like a copresidency. President Duffy, confident in h s role, has kept me involved in every aspect of Association business and the plan for the advancement of the perioperative nursing profession. We have discussed goals and priorities so that there will be a seamless transition and a vision and strategic plan with longevity. In our current health care and association world, this is mandatory for continued success. We have become wonderful friends, and h s humor and insightfulness will be missed on the Board. I believe that President Duffy will go down in history as one of A 0 R ” s greatest Presidents.

OFFERING THANKS No man or woman is an island and I have had strong, loving support from so many while traveling on my perioperative nursing and AORN journey. My husband, John, is always at my side. This man provides a constancy that

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Think about the number of patients and fellow peiioperative nurses you have shared your talent with and how far that touch of hope has reached across the globe. allows me the freedom to become the person I want to be. I want to thank my daughter, Brighid, and her husband George Guenther, and my son Ken. My kids often were happy to see Mom go, but they were even happier to see me come home. I also want to thank my mom, Rita Hotnich, who is always with me in spirit, and my dear friend Doris Chalfant, RN, who is the kind of nurse I want to be. I also have been fortunate to have danced with two wonderful chapters during my AORN life. My natural chapter, in which I was born as a perioperative nurse, is AORN of Western New York. My adopted chapter, which has always treated me as one of their own, even though I talk funny, is Capital AORN of North Carolina. These nurses are my colleagues at work, and they, along with all my surgical services staff members, will hold down the fort this year and continue to provide the high quality of patient care at WakeMed Health and Hospitals, Raleigh, NC. They make me look good everyday, and my gratitude to these people can never be

expressed in a manner sufficient to reward their support and caring. Thank you all.

THEAORN DANCE It now is our time to dance together as AORN colleagues. I love music, and I have a favorite song by Lee Ann Womack called I Hope You Dance.’ I encourage you to listen to the words of this song and let yourself explore all of your potential in your profession, AORN, and, most importantly, in life. The song speaks about a sense of wonder. There is no time when patients are more vulnerable than when undergoing an operative or invasive procedure. Our patients have varied backgrounds and experiences, much like the practitioners who care for them. These patients trust that we have the education and understanding to create a positive experience and outcome for everyone. Think about the number of patients and fellow perioperative nurses you have shared your talent with and horn, far that touch of hope has reached across the globe. AOR”s mission is to furnish you with the resources to provide optimal care while working with the surgical team, the patient, and the practice location.

THESENSE OF HUNGER One of the song lyrics says, “Always keep that hunger.”’ I challenge managers and directors to take A 0 R ” s position statements on RN orientation, staffing

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President’s Message

It is the

ratios, on call, and the RN in the scrub role and convince their administrators of the need for reasonable staffing to provide safe care to patients and safe working conditions for nurses. These are living documents to support your ability to manage your environments. This year, we will develop position and guidance statements on orientation of surgical technologists. It is the perioperative RN who delegates the scrub duties to th~spractitioner and the nurse educator who provides orientation; therefore, it should be AORN that sets the parameters and supports the RN in preparing to take responsibility for delegating the scrub role to an unlicensed assistive practitioner. The staffing ratios and RN orientation position statements proposed this year support RN participation in the scrub role. Do not give up your position in this role; maintain your skills so there is no question of your ability to delegate these skills. A position statement on the role of the RN in the education of unlicensed assistive personnel also is being developed this year. No one is going to convince me that a certification in surgical technology supersedes an RN license and a CNOR.

SAFEWORKPLACES Another lyric says, “. . . never take one single breath for granted,”’but our perioperative colleagues are running out of breath. We need to step

penbperative RN who delegates the scrub duties to the surgical technologist and the nurse educator who provides 0n;entation; therefore, it should be AORN that sets the parameters and supports the RN.

ance statement on this issue to aid managers and support perioperative nurses. The task force will have major players with vested interests in achieving implementation of a just culture and will include representatives from the American College of Surgeons and the American Society of Anesthesia. Now is the time to make perioperative nurse safety as important as patient safety, or both will be compromised.

REACHINGOUTGLOBALLY up and define the parameters of a safe workplace. The Workplace Safety Task Force has been charged with developing a position statement and guidance statement on ergonomically healthy workplace practices for the perioperative environment. This will include requirements for patient transfer, instrument tray weights, and collaboration with the American Nurses Association’s Handle with Care Program. We will continue to collaborate with national agencies, such as the Occupational Safety and Health Administration and the National Institute for Occupational Safety and Health. In the process of developing ”no blame” or ”just response” cultures in our workplaces, it has become apparent that facilities are struggling with defining a “just response” to errors. A management task force will create a position and guid-

Womack’s song says, ”I hope you still feel small when you stand beside the ocean.”’ As I have traveled around the world representing AORN this past year, there were times when I felt small as an individual perioperative nurse; however, our position in the international perioperative community was repeatedly clarified for me as many of our global colleagues expressed their appreciation for the support and guidance AORN provides. Our Panama nursing colleagues have thanked us for having vision, tenacity, and dedication and for opening the doors for Latin American countries. World Congress, which is in Barcelona, Spain, in September, and our second annual Pan American Conference will further our reach of caring while expanding our own exposure to cultural diversity. It is an inspiring experience to collaborate with our nurse colleagues AORN IOURNAL

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worldwide to advance the profession and enhance safe patient care. As the global leader in perioperative nursing, we also will develop a position and guidance statement on environmental responsibility.

generations, however. We are going to have to actively go into the high schools and grade schools to generate interest in nursing. These generations are techies; they want to make a difference and are into volunteerism. We have what they want, but we need

REACHINGOUT ”Whenever one door closes, I hope one more opens.”’ I know many of us feel that the door for including a perioperative nursing experience in nursing school curricula has closed, but there are numerous perioperative elective courses being offered in colleges and universities across the country. We will move forward with the approach that a perioperative experience can provide nursing students with an opportunity to acquire specific medical and surgical skills mandated in the curricula (eg, aseptic technique, anatomy, physiology, catheterizations, critical thinking and prioritizing in a high stress environment). Learning to function in a true team spirit will help these nurses in every aspect of their career. The OR and procedure rooms are melting pots for life-long slull development for these students. Open your doors, and reach out to your local nursing schools. AORN‘s academic liaison wdl be providing us with objectives and a skiU list faculty members can use for students who follow a patient through the OR. Reaching out to nursing students will not provide us with attention from younger

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We are going to have to actively go into the high schools and grade schools to generate interest in nursing among these age groups. We have what they want, but we need to educate them on what we can offer.

to educate them on perioperative nursing and what we have to offer; therefore, t h s year’s Perioperative Nurse Week theme will be “Vital to Care; Knowledge to Share.” I hope that you will use the resources the Perioperative Nursing: Introduction at High School Level Task Force develops to go visit a class-

room. Share with students your expertise on hand washing, bones and muscles, and the surgical experience. They are waiting to hear what we have to offer in terms of minimally invasive surgery, robotics, and stereotactics. We also need younger generations on our committees and task forces. I have appointed X and Y generation members to 78% of the committees and task forces, and 36% of all appointees are new members this year. The volunteer force has been charged with new blood and has been asked to develop 16 webbased education programs, and six continuing education programs and to identify at least 32 practice issues, 11 position statements, three guidelines, four guidance statements, and three sets of competency statements. We are loolung at another productive year of supporting and advancing perioperative nursing, and we will do it together.

MENTORSHIP Womack’s song asks us to ”give faith a fighting chance.”’Mentoring is a prime value of this organization. I have been fortunate to have many of our leaders take me under their wing and express their faith in my ability. President C y n h a Spry, RN, MSN, MA, CNOR, appointed me to the Legislative Committee and started my national journey. She has been there for me, quiet and strong. Linda Groah, RN, MS, CNOR,

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and the role that perioperative CNAA, FAAN; Trish Seifert, nurses play in the safety of RN, MSN, CNOR, CRNFA, our patients. FAAN; Vicki Pierce, RN, CNOR Kay Ball, RNl BSN, S ~ NPRIORITIES G MSN, CNOR, FAAN; Carol Tyler, RN, BSN, CNOR; and “Never settle for the path Ruth Schumaker, RN, BSN, of least resistance.”’ Legislation that ensures the RN in CNOR, have many times offered guidance and pearls of the circulator role must be energized and electrified in wisdom. I feel strongly that tlus kmd of support needs to be accessible to potential leaders through a formal mentorPast leaders of ing program. We will kick this program off at the Leadership AORN have offered Conference, which is structured to promote leadership me guidance and in perioperative nursing. Our goal is to connect members pearls wisdom, who wish to achieve leadership roles in this organization and I feel strongly with one of ow past Golden Gavel leaders for support that this kind through knowledge and sharing wisdom. support needs to We also need to continue our faith in the partnerships be offered to we have developed. Many of these partnerships have potential leaden advanced under the umbrella of our Patient Safety First inithrough aformal tiatives. Patient safety will remain at the top of AORN’s mentoring program. priority h t . National “Time Out” Day, June 23, will be celebrated again this year. We will collaborate with our part- all 50 states. We need to protect every perioperative ners on the Council on Surgical and Perioperative nurse. This is our numberSafety to educate nurses, surone legislative priority. We no geons, staff members, and longer are going to continue patients about the importance to only react to legislation or regulation that threatens our of the time out ritual in prescope of practice. venting wrong site surgery We place such a high value and other errors. You, A0R”s grassroots members, on this that we will be adding resources to enhance our cuzwill be asked to go to your respective state legislators and rent Government Affairs Department. A state grassinform them of this initiative

of

of

roots coordinator will develop a template and training materials specific to a nurse-based grassroots organization. This person will train and support each state coordinator and the grassroots network for state and national issues advocacy. A researcher and resource development specialist will keep us abreast of issues surfacing and help us develop proactive opportunities to advance AORN’s legislative agenda. Past President DdTy will chair the Legislative Committee. He has been passionate in protecting the role of perioperative RNs, and I believe he and youl the grassroots members, will dance us home on this one. Lobby Day will be held during Congress 2006 in Washington, DC,and our legislators will experience the power of our numbers and the energy of our influence during our national meeting. You, their constituents, will take them to the Exhibit Hall to demonstrate the profusion of technology available and discuss with them the importance of keeping pace with advancements to maintain the standard of patient care. In addition, the Specialty Assembly Futures Task Force will continue to examine the structure of specialty assernblies and the value they provide to the members. They also will look at reorganization of the specialty assemblies and research potential representation through these bodies. Th~s work will come to the 2006 AORN JOURNAL

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Figure 1 The logo for the 2006 AORN Congress celebrates diversity

House of Delegates for your review and decision.

DANCINGI N THE FUTURE We have spent the past year celebrating our value, and we will continue the celebration in 2005-2006. We will celebrate diversity. The theme for the 2006 Congress is Diversity: Patient Practitioner Practice. We will complete the dance in Washmgton, DC,where t h s theme will be demonstrated by the Congress logo (Figure 1).In t h s logo, the four cultures of the world are represented by the skin colors white, black, yellow, and red. The pictures in the logo symbolize four generations, including 0 Traditionalists (that’s my mom); 0 Boomers (Ernest Singley, RN, OR supervisor);

Xers (Yan Yan Lustria, RN, BSN, perioperative staff nurse); and Yers (AORN chef financial officer James Cousin’s daughter, Jada, who we are assured is being raised to be a perioperative nurse). The circular red and blue ribbons depicted bind us all together as people-different, but one in ow humanness. Our differences will build strength in the committees, task forces, and initiatives we take on and complete this year. Our energy and impetus will take us forward as we

accelerate to Irish jig speed. As perioperative RNs, we dance the foxtrot daily. We are agile in our moves as we manage patient care in ORs across the globe. We have the responsibility to coordinate the patient care team to provide safe, quality care and optimum patient outcomes. AORN will continue to support you in your role. I ask you to join me in the dance toward our future. A future that will respect and care for every patient safely through the preservation of perioperative nursing. Together, anything is possible. SHARON A. MCNAMARA RN, MS, CNOR

PRESIDENT

NOTE 1. M D Sanders, T Sillers, I Hope You Dance, L A Womack (Nashville: MCA, May 23,2000).

Nanobacteria Possible Culprit in Kidney Stone Formation at the National Aeronautics and Space Steria,cientists Administration (NASA) have identified nanobaca self-replicating, mineralizing agent, as a potential cause of rapid kidney stone formation among astronauts who travel i n space, according to a Feb 14, 2005, news release from Blackwell Publishing, Malden, Mass, publishers of Kidney Internotional. Trials to examine nanobacteria were conducted a t NASA i n a bioreactor chamber that simulates the microgravity environment of space travel. Under these conditions, nanobacteria were found to multiply five times faster than under normal gravity conditions. This finding supports earlier discoveries that microbes behave differently i n weightless environments. Nanobacteria also was shown to be a possible infectious risk for crew members living i n close quarters.

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Nanobactena was discovered i n the 1990s and has been found in the calcium phosphate cores of kidney stones. It also has been detected in other conditions, including Alzheimer‘s disease, heart disease, prostatitis, and some cancers. With the potential for longer exploratory space missions and longer exposure to the elements of outer space, health is a major concern for astronauts. Further testing for the presence of nanobacteria i n human bodies can help reduce the risk for kidney stone formation in astronauts and also would benefit nearly one million Americans who are treated for kidney stones each year, according to the release. Infectious Microorganism Linked to Kidney Stones and Other Diseases (news release, Malden, Mass: Blackwell Publishing, Feb 14, 2005).