AORN Education and Event Calendar

October 10 - 12:
Multispecialty Conference, Las Vegas, NV: Advanced Technology, Cardiothoracic, Neurosurgery, Orthopedic, Pediatric, and RNFA specialties.
November 8 - 9:
Perioperative Nursing 2002: Quest for Knowledge, Philadelphia, PA: The latest important issues in perioperative nursing and healthcare will be discussed.
December 2 - 4:
Seventh Annual Conference on Infectious Diseases, Roswell, GA. This conference brings together a nationally recognized faculty of infectious disease professionals.

Important Phone Numbers

AORN Headquarters: (800) 755-2676
Customer Service: (800) 755-2676 Extension 1
AORN web site: www.aorn.org

New in the Periop Bookstore

* 2002 Edition of AORN's Standards, Recommended Practices, and Guidelines. Also available with a study guide.
* AORN - Emergence and Growth, a history of perioperative nursing and the evolution of AORN (a great Christmas gift!).
* Perioperative Nursing Data Set (PNDS), Second Edition. This is an ANA-recognized text of standardized terminology with a chapter written by our own fabulous Kathie Shea!

Congress Volunteer Coordinator Needed for San Diego 2004

AORN is looking for a volunteer coordinator to serve as the Congress 2004 Volunteer Coordinator. This person will be the liaison for the members of California who wish to serve as volunteer hosts for the San Diego Congress. Nominations were due by October 1 to Emerald Magana, Congress Program Manager, by e-mail at emagana@aorn.org or by fax (303) 755-5494.

Periop Nurse Week Product Alert

Perioperative Nurse Week is November 10-16. Specialty products are available at the AORN web site. The theme this year is: "Perioperative Nurses: Your safety is our job… We take it seriously." Products include calculators with the AORN logo, sports bottles, travel mugs, key chains etc.

Christmas Ornament Ideas Needed

AORN President Donna Watson is asking the chapters to send a Christmas ornament to be displayed at Headquarters. Send the ornament to: Lisa Wyant, AORN, 2170 South Parker Road, Suite 300, Denver, CO. 80231-5711

By Sophie Taylor, President

Thank you Jack Carnes, Spine Specialist of DePuy AcroMed for the gracious donation of two gift certificates for luxurious pampering at the "Piedmont Springs" on Piedmont Avenue in Oakland. 

Just when you thought you didn’t make a difference…a special thank you to
Karin’s Kwik Print, 122 Parrot Street, San Leandro for giving the chapter a reduced rate for our stationary and CE certificates just because we are nurses. The manager, Dzung Vu, recognizes that "Nurses work so hard to make the world a better place." And thank you, Mr. Vu, for a most unexpected gift - a lifted spirit from the surprise recognition.

Thank you Steve Budill and Stryker Endoscopy for the $500 donation to our chapter!

By Sophie Taylor and Donna Benotti

Minimally Invasive Total Hip Replacement!
April 2002 Newsletter

In late March San Ramon Regional Medical Center became the site for California's first minimally invasive (MI) total hip replacement. The case was circulated by our chapter's own Joy Chau, RN, CNOR.

Two small (two inch) incisions were made for the procedure instead of the typical 10-12 inch one. Besides the obvious cosmetic benefit, the pain and recovery time are significantly decreased as muscles are spread instead of cut. San Ramon's 74-year-old patient was out of bed the day after surgery and ambulating on his second post-op day!

Dr. Carol Hutchinson performed the surgery as part of a national trial involving physicians in Chicago, Port-land, OR, Baltimore, Ft. Meyers, FL, and Pittsburgh. About 90 MI hip replacements have been performed at these centers since February 2001.

By Kathie Shea

March 10, 2002 Letter of Thanks
April 2002 Newsletter

Dear Mary,

I am writing to thank you for the CRNFA pin you sent on behalf of the AORN of Alameda County chapter. It was a pleasant surprise to receive it.

I am ever grateful for the unconditional support I received from my friends and peers at Eden Medical Center and for their willingness to help me in attaining the required hours needed to sit for the certification examination. They all were, and are, integral to my success.

Thank you once again for the pin and congratulatory note.

Sincerely,
Linda Vassallo, CRNFA

Editor: Linda recently attained her certification as an RN first assistant.

Scholarships Available!
April 2002 Newsletter

Our chapter gives scholarships to our members or nursing students for education pertinent to perioperative nursing practice. Previous scholarships have been given for registration at World Congress, college courses, RNFA programs, and intensive continuing education classes.

Scholarship applications may be obtained by calling Susan Sykes (510) 430-1422; Donna Benotti (510) 655-4000 Ext. 2723. Completed applications must be returned by May 4, 2002. The scholarship(s) will be awarded at the June AORN meeting.

Change Process in Organizations
April 2002 Newsletter

Change is never easy, and frankly can be very disrupting in the lives of members of an organization. But change can also provide an opportunity to improve the situation, and possibly save an organization from becoming a dinosaur with subsequent extinction.

This paper will explore a change process currently under way in my professional practice association (AORN) using Stewart Gabel’s approach. The Association of periOperative Registered Nurses (AORN), is a voluntary organization that supports registered nurses (RNs) in achieving optimal outcomes for patients undergoing operative or other invasive procedures. “AORN is the global leader in promoting excellence in perioperative nursing practice.” (AORN web site: www.aorn.org) This organization is composed of over 40,000 perioperative nurses in the U.S. and abroad. AORN members participate in more than 340 chapters across the United States, and Puerto Rico, 12 specialty assemblies (such as the Cardiovascular Specialty Assembly), and 25 state councils. I currently serve as President of Alameda County Chapter, and as such have had the opportunity to learn more about the AORN restructuring process.

Background

One has to know a little bit about the structure of AORN in order to understand the proposed changes. Members are the heart of the Association. Leadership is emphasized and member participation is the key to its success. Local chapters are the base units. Chapters are the source of nominations for the national Board of Directors (BOD), and the Nominating Committee. Many states form state councils to help the chapters coordinate legislative and education activities.

The highest governing authority is the House of Delegates. Local chapters select delegates to the House, which meets twice during the annual AORN national Congress. Decisions made by the House guide the BOD, national committees, and Association staff.

The House of Delegates also elects the Nominating Committee, which develops the slate of candidates for the twelve member BOD and the six member Nominating Committee. The BOD is elected by the membership through delegates. Officers include the President, President-Elect, Vice President, Secretary, and Treasurer (AORN Chapter Resource Manual 2001-2002, p.A-4).

The AORN board hires an Executive Director to administer the activities of the Association according to policies established by the House of Delegates and the BOD. Approximately 100 staff members work at National Headquarters in Denver, CO, responding to the needs of the members. Included in the staff are perioperative nurses, librarians, editors, and world wide web administrators among others.

All members are eligible to serve on a National Committee. There are a number of them, such as the Bylaws Committee, Continuing Education Approval Committee, Legislative Committee, Membership Committee, National Committee on Education, Nursing Practices Committee, Nursing Research Committee, Recommended Practices Committee, and the Scholarship Committee.

AORN also has a Foundation which is the philanthropic arm of the organization. The mission of the Foundation is to provide funds for education and research to enhance perioperative nursing and patient care. Funds are secured from AORN members, chapters, state councils, individuals, industry and other foundations (Chapter Resource Manual, 2001, p. A-5).

The Problem

With such a great structure in place, one might ask why we need to make changes. Times are changing, and new information is becoming available at a rapid rate. Like any other organization, we too are struggling to keep the membership numbers up. The average operating room nurse is 47 years old. In addition, the organization has five generations of nurses in it, from the very young to the very old. How do we attract new members when old ones retire or pass away? How do we cater to new nurses? Young members come to a voluntary organization for different reasons than, for example, the baby boomers. What can we do to keep the organization dynamic, up-to-date, and interesting? Hence the Governance Task Force (GTF) was formed.

The Governance Task Force

Looking toward the future and considering the trends in nursing and other professional associations, President Brenda Ulmer announced the formation of the GTF at the 2000 Congress. The charge to the Task Force was to “guide AORN through the process and to make recommendations regarding the best governance structure and functionality for AORN.” (Second Forum Presentation; Introduction for Discussion Points, 2001, p. 1) A consulting firm which specializes in association governance, was hired to provide assistance. “The scope of the work focused on all aspects of the structure, the processes, and enfranchisement of the major entities of the governance of AORN, including the BOD, House of Delegates, Chapters, State Councils, and Specialty Assemblies.” (Second Forum Presentation, 2001, p. 1) Some of the discussion points the task force was concerned with had to do with the following major issues:
-perceptions of what novice nurses value
-strengths and weaknesses of current structural and governance components such as chapters, state councils, and specialty assemblies
-the House of Delegates
-implications for AORN’s future

The GTF decided early on that membership participation and input was needed in the strategic design of AORN’s future. These major issues were established as an attempt to have ongoing dialogue with the membership about opportunities for growth as well as potential problems. “This is a proactive stance in positioning essential topics for discussion to ensure the membership is active in participating, determining, and hopefully preventing potential problem areas for the Association in the near future.” (Second Forum Presentation, 2001, p. 2)

The GTF established a number of key goals and objectives. They state that “AORN of the future will be an association that:
-Maintains viability
-Retains its current membership
-Experiences an increase in membership
-Utilizes streamlined decision making
-Maximizes resources
-Provides resources to nurses that enhance the delivery of care to patients and their families.” (Second Forum Presentation, 2001, p. 2)

In addition, the GTF also created a catchy slogan: “Your Voice, Your Choice” to help emphasize that member input is very important to them.

Discussion points were established based on all the information collected by the consulting firm with subsequent recommendations, and from dialogues with the membership. If the organization chooses to act upon these recommendations, some sweeping changes in the entire organization will be necessary. For example:
-Should there be a full revision of the bylaws?
-Should we investigate methods to structure the House differently to allow for broader representation? (The current system only permits the business of the House to occur at Congress once a year).
-Should there be a review of the need for all officer positions? Are the officer positions reflective of the future needs of AORN?
-Should we explore removing the standing committees from the bylaws to increase flexibility? Some committees that exist may be duplicates of staff functions.
-Is there a way to more widely disseminate information about association work and process? For example, posting of bylaws, strategic directions, etc. on the web site and the changes as they occur?
-Should we investigate mechanisms related to the balloting/election of Board Members and the Nominating Committee? Would a “one member, one vote” be a better system vs. the current system where delegates vote on behalf of their chapters?
-Should the association create the opportunity for members to choose where they will connect to the organization? Traditionally, when members join, they become part of a chapter. Now there is an on-line e-chapter. Concerns are that this will further erode the chapters that are already struggling with decreased meeting attendance.
-Student nurses are AORN’s future. Headquarters staff should be charged to explore different methods for students to join our association and to be involved.

Activities of the GTF since these discussion points were developed and presented at the Congress in Dallas, TX, 2001, have included studies of other professional organizations such as their by-laws and voting system. A membership survey in June was distributed in the AORN Journal. To facilitate communication with the chapters, a GTF liaison was assigned to each chapter. Three subgroups were established to focus on the key issues identified by the preliminary membership survey results - membership access, restructuring of the House of Delegates, and review of the existing AORN committee structure.

An action plan was established. Focus groups will be utilized to assist in guiding and testing the process and theories as they develop. The BOD was updated at a meeting in October for further recommendations and guidance in the next steps in the process.


Extensive communication with the chapters is planned by use of the AORN web page, direct mail to chapter presidents and via the GTF liaisons. “Education to the membership will ensure that every member is knowledgeable and has the tools to express Your Voice, Your Choice.” (AORN web page).

Affiliation and Credibility

When this information was presented at Congress, my delegation was shocked. Then we were up in arms. Following Congress, we invited Linda Groah, RN, one of the task force members and a past national president, to come and speak to us informally about the proposed changes. She also took the opportunity to hear our concerns and suggestions. Gabel (2001) calls this “affiliation” a part of the pre-change. The “leader must assure others in a sincere manner that he or she recognizes their anxieties and is in the process of joining with them to find solutions.” (Gabel, 2001, p. 40) The GTF has made it a point over and over again that the membership’s input is very important to them. They also made every attempt to ensure that information was gathered by hiring a consulting firm. Success or failure in this new endeavor is shared. This is also a very good strategic move on behalf of the GTF. If there is failure to achieve the goals, then blame can also be shared.

Part of the pre-change is credibility. According to Gabel (2001), credibility is “the perceived appropriateness of the individual for the task at hand.”
(Gabel, 2001, p. 49) By appointing some high ranking members of the organization as well as other people with expertise in the organization, the GTF had the credibility needed for the task.

Source of Need for Change

The source of the need for change is multifaceted. As mentioned earlier, the membership is decreasing. That also means that revenue from dues is lower. In addition, in order to cater to everyone, we have to satisfy the individual member’s needs, no matter how young or old. One size does not fit all. We have to attract new members. The organization is not in a state of crisis yet, but unless the association is pro-active, it might be unable to respond to changes in a timely fashion with the current slow-moving structure. The Association realizes that voluntary organizations of the future will have to keep up with the accelerated information super-highway, and they are concerned with putting all those structures in place to ensure the continued existence of AORN.

Initiating

“Thorough evaluation of the organization and its potential from numerous perspectives (e.g., financial, programmatic, marketing, public relations, contracting) should be undertaken as part of early or pre-transitional phase planning.” (Gabel, 2001, p. 69) The results are used to guide transitional planning and implementation. As mentioned earlier, the consulting firm and the GTF talked to staff at headquarters, and individual members as part of their assessment of the perceived needs of the organization.

Determining the Change

The information gathered was discussed by the GTF via conference calls and meetings at Congress. From this, the “discussion points” were formulated. Gabel states that “there likely will be considerable information of both quantitative and qualitative types developed to address these conceptual and operational questions.” (Gabel, 2001, p. 79) One has to prioritize what is really important when determining the extent of the change, especially if a large overhaul of the organization is a likely outcome. At this point in the process, Gabel does not recommend large involvement on the part of regular members, but rather a “small executive or transitional team is the most likely group to work on final aspects of a transitional plan or report.” (Gabel, 2001, p. 79).

Communicating the Change Upward

The GTF continually updated the BOD of their progress. According to Gabel (2001), information should be shared with the GTF’s Board of Directors first, prior to sharing the plan with the membership (Gabel, p. 85). The reason for sharing information upward first, is so that the BOD can be informed of what the GTF is doing, and the board can make additional recommendations if needed.

Communicating the Change Downward

When the BOD was informed and the transition plan approved, it was time to inform the membership of the results of the evaluation, the assessment of the Association’s strengths, weaknesses, and resources to address these. “Dissemination of information may be done through various means, large meetings, smaller unit meetings, individual discussions, memoranda and the like.” (Gabel, 2001, p. 86). The work of the GTF was announced at a large group meeting with approximately 400 people attending the House of Delegates at Congress in March 2001. As mentioned earlier, a small group meeting with our chapter occurred also to further explain the needs for the proposed changes. In my case, anxiety about the changes was relieved by the repetition of information given to me earlier at the large meeting. Many other sources were available to me as well. Written handouts outlining the plan, and the AORN web site are some examples. Any of the members of the task force can be e-mailed or contacted to give suggestions to or to ask questions of. The chance to give input to someone who listened and took notes was greatly appreciated. I think the members who attended the small meeting all understood the need for the change.

Gabel (2001) sets forth criteria regarding when to have large vs. small group meetings. He says that “in general, it is advisable to inform larger groups of the broad outlines of the organization’s approach toward restructuring or change, and to foster and support questions and concerns from various perspectives by members in larger meetings. The larger group format is followed by smaller group meetings that are based on function or organizational structure.” (Gabel, 2001, p. 87). I think this philosophy was followed by AORN.

Implementing Change and Maintaining Credibility

AORN has only begun this process, and full implementation has not yet occurred. Necessary changes will be implemented if feasible. Because the Governance Task Force has been so thorough in their approach, I feel confident the transition will be successful, and that credibility will be maintained.

References

AORN Inc, (2001). AORN chapter resource manual 2001-2002. Denver, CO. AORN Inc.

Gabel, S. (2001). Leaders and healthcare organizational change: Arts, politics and process. New York, NY: Kluwer Academic/Plenum Publishers.

By Sophie Taylor

Are You Giving Your Practice Away?
April 2002 Newsletter

Kathie Shea and I have the pleasure of providing an introduction to the operating room to Stryker Endoscopy representatives as part of their intensive training program. This class is conducted in an OR so the trainees have the opportunity to discuss (in addition to the didactic portion of the class) OR etiquette, to walk in unrestricted, semi-restricted, and restricted areas, and to learn more about the roles of the surgery staff.

Trainees have a variety of backgrounds and come from all over the United States. We have even had some international participants. Some are brand new and some have been reps for other companies. Some have never been in an OR while others have much experience. In addition to the didactic, Kathie and I pose different scenarios that the reps may be involved in. In the discussion that follows, there is much sharing that takes place. It was during the last class that we learned the following.

”Here, Do My Job For Me”

In an effort to "help the circulating nurse," some reps have been asked to perform functions that are beyond their scope of practice. Perhaps the most common request is to sterilize the instruments they have brought in for a case. I am referring to those three or four instruments that are taken into the center core and flashed. We asked the reps who had performed this task if they had been trained to do so. Of course the over-whelming response was, "No." When asked if they knew which cycle to select for the instruments, most did not know there were different cycles or what they were for. But the most distressful fact was when they said that nurses expected them to do this. We were told it was considered a service and if the reps excused themselves from performing this task, the nurses were quick to point out that their competitors did it.

When we delegate tasks to reps (or others), it is important to remember their scope of practice. The presence of the health care industry representative in the operating room is certainly necessary and appreciated for education, training, and technical support. If nurses ask reps to perform functions that are outside their scope of practice, we are not only compromising the safety of our patients, we are also putting the reps and ourselves in harms way.

Push A Button, Any Button

There is more to sterilizing an instrument than putting it in a sterilizer and pushing a button. Each facility has policies and procedures that must be followed. Staff must demonstrate they are competent to prepare the item for sterilization, select the correct method of sterilization (steam, Steris, Sterrad) and the correct cycle (if applicable). We must know how to operate/abort the sterilizer and know that parameters have been met. And don’t forget about biologicals and documentation! Why then, would it be acceptable for a health care industry representative to do this? What is their scope of practice?

Thanks But No Thanks!

Case in point. Not too long ago we had a new rep come to my hospital who was buddied with an experienced rep. The new rep had worked as a surgical technologist in a previous life. Without asking anyone and because she wanted to help the staff, she removed and contaminated a sterilized item from the Steris, and then put her instruments in. Because she did not know our policy, she did not know we required biological monitoring in that load. What began as a sincere desire to be helpful resulted in delaying two ORs while corrective measures were made. What I hope this demonstrates is the need to be vigilant in your practice. Patient safety cannot be treated casually. The perioperative registered nurses’ responsibility is to advocate for our patients. Yes, we are busy. But we are not so busy as to abdicate our roles.

By Donna Benotti

Donna Finally Gets Closure!
February 2002 Newsletter

We had 25 attendees at the January 19 workshop. Following a delicious continental breakfast, participants learned about suture material, including function, materials, tensile strength, absorption rate, patient conditions affecting absorption, and selection of suture material. (Did you know the FDA mandates a five-year expiration date on absorbable sutures, but there is no expiration on nonabsorbables?) We learned about needle design, how clamping too close to the needle can affect the suture, and even what those needle abbreviations mean. (Did you know that BB stands for "Blue Baby" and RB is short for "Renal Bypass?" I just love these fun facts!)

Hog Tied

Knot tying was a fun part of the morning. We learned general principles of knot tying and then had great hands-on time with our own stations learning to tie square knots, surgeon’s knots, and instrument ties. (I must say the video we watched for this portion was a bit confusing. The speaker, who really described each step in incredible detail, would lose me half way through each knot by referring to the thumb and index finger as the first and second digits. Once I stopped listening to him and just did what he was doing it was so much easier.)

The next hands-on application was equally fun, and of course, educational. Again, participants had their own porcine station. The pig’s feet had multiple incisions to close. We did interrupted and running closures, and we had the opportunity to close with Dermabond (a surgical adhesive) and skin staples.

Pig’s Feet and Goodies Galore!

The workshop was a large success. Evaluations were very positive. Each participant left with Ethicon’s Wound Closure Manual and Knot Tying Manual, a knot tying station, a screen saver for their computer monitor, four contact hours, and new knowledge. The chapter made $958.48 after expenses.

Thanks!

Thank you to all who made it possible:
Participants: for supporting the chapter activity (two had received information from the web site).
Our speakers: David McDonald, Ethicon Clinical Account Manager - manuals and other handouts, knot tying stations, and sutures. Christopher White, Ethicon Endo-Surgery Sales Account Manager - screen savers and staples
Education Committee: Beth Mar and Ann Ceasri - site procurement, audio-visual aids, coffee; Mary Ritchie - flyer, publicity; Evelyn Steen - all scissors and kellys, juices; Kathie Shea - bagels and smears; Sophie Taylor - paper products; Donna Benotti - program coordinator, CE certificates, fruit, knot tying material, pigs feet.

My thanks and appreciation to Lunardi Meat & Parenti Poultry (570 Williams Street, San Leandro), who had their drivers make a special run so that nurses would have what we needed for a successful workshop.

Submitted by Donna Benotti

Lack of Oversight in Tissue Donation Raising Concerns
February 2002 Newsletter

Donations of organs like hearts and livers are regulated zealously, but when it comes to human tissues - ligaments, tendons, bones, skin and other body parts - there is little oversight. This situation worries a growing number of experts, who fear that improperly handled tissue can transmit dangerous or even lethal infections.

Clostridium sordellii

A 23-year old student in Minnesota, Brian Lykins, died in November, after being given donor knee tissue the Centers for Disease Control and Prevention later determined was infected with Clostridium sordellii, a close relative of the bacteria that cause gas gangrene. Since his death, the centers have turned up six more cases of clostridial infections in knee surgery patients around the country.

Dr. Warren King, an orthopedic surgeon in Palo Alto, CA., said he knew of four people in California alone who developed life-threatening clostridial infections after surgery involving donor tissue. One was a patient referred to him, Alan Minvielle of Aptos, CA., who almost died of gangrene after an earlier operation to repair an injured knee. Antibiotics saved him, but Mr. Minvielle now has a limp and cannot handle the big cement trucks he once drove for a living. His only hope for a full recovery is a knee replacement, but doctors advise against it - the bacteria that caused his gangrene may be dormant in his tissue, and more surgery might activate them and kill him.

Who’s to Blame?

Officials from companies that provide donor tissue generally attribute the infections to ambient bacteria in hospital operating rooms. But other experts say the cases point to serious holes in the system to monitor the trade in donor tissue.

Whole organs like hearts, kidneys and livers can be taken from only a small number of donors who are brain-dead but on life support. Organ procurement organizations work closely with hospitals to match donors and recipients, following strict federal guidelines.

Unregulated Industry

By contrast, tissue banks obtain bone, skin, blood vessels and valves, corneas and other body parts from many organizations, including universities, hospitals, morgues and even funeral homes. Many of the banks are highly reputable national or regional organizations, which take great care to recover tissue from donors who are free of disease. Some are small local charities working with a single hospital or university. But, increasingly, donor tissue is being collected, processed and sold by subsidiaries of for-profit companies, in a rapidly growing industry that is largely unregulated.

Who’s Keeping Score?

There is no central registry of people who receive this tissue, so it is not clear how many tissue transplant recipients are being harmed. Last year, tissue banks distributed more than 750,000 grafts, and there were few reports of serious complications. Donor tissue unquestionably saves lives and helps thousands of people each year with a growing list of life-enhancing products like knee ligaments and bone cement.

But the lack of oversight is worrisome, according to experts like Dr. George F. Grob, a deputy inspector general at the Department of Health and Human Services, who testified on the issue before Congress last year. Though an industry group sets voluntary guidelines, most tissue banks are not members and many set their own guidelines. As a result, Dr. King of Palo Alto said, tissue may be obtained by poorly trained technicians who may not keep it germ-free. Some of the standard treatments used to kill bacteria in processed tissues are not effective against clostridia, the major problem in knee surgery cases.

“Fees” OK - Not Sales

It is illegal to sell body parts. But it is legal to charge "reasonable" fees for collecting, shipping, processing, marketing and implanting them. Reasonable fees are nowhere defined by any federal agency, but a typical human body is now widely estimated to be worth as much as $220,000 in useful parts.

According to Senator Susan Collins, Republican of Maine, who was chairwoman of a hearing on tissue bank practices in May, a decade ago tissue industry revenues were $20 million a year. By 2003, she said, revenues are expected to reach $1 billion. In 1994, 6,000 people became tissue donors; in 1999 there were 20,000. Tissue from one donor, she said, can be used by 50 to 100 people.

Bones = Big Business

The engine driving this growth is biomedical innovation. A handful of companies have patented techniques for turning tissues into extremely useful products, like bones that are tooled into special shapes or ground into powders and pastes.

Manufacturers market these products aggressively to hospital purchasing agents, said Dr. Theodore Malinin, director of the University of Miami Tissue Bank, who is critical of the path the field is taking. Surgeons using them do not always know where they come from, he said.

Big Brother NOT Watching

Federal oversight of tissue banking remains limited. In 1997, the Food and Drug Administration made final a rule requiring tissue banks to test for H.I.V. and hepatitis B and C, take the donor's medical history and keep records. But the agency does not set standards for donor age or health, and does not limit how long after death tissues may be procured, nor does it set minimum training standards for people who recover tissue.

At some tissue banks, only pathologists or physicians are allowed to recover tissue in sterile operating rooms. At others, local technicians are trained by the bank, which sets its own standards, to remove tissue in settings like funeral homes.

Not California?

The American Association of Tissue Banks sets standards for its 75 members. But when the F.D.A. began asking tissue banks to register with it early last year, 350 organizations signed up, some of which were not known to the agency or the association. Only two states, New York and Florida, license and inspect tissue banks. At least 100 tissue banks have never been inspected or regulated by any state or federal agency, Senator Collins said.

A year ago, the Office of the Inspector General, an investigative arm of the Department of Health and Human Services, reported that when F.D.A. inspectors did visit tissue banks, they found serious deficiencies in screening and testing practices. The F.D.A. has proposed new rules for good tissue practices and donor suitability, but it may be several years before they are adopted. Until then, the agency can intervene only in cases of H.I.V. or hepatitis B and C.

By Sandra Blakeslee. From “The New York Times” January 20, 2002. Submitted to the Periop Listserv January 20 by Chip Moore of Getinge/Castle, Rochester, NY. Subtitles are this editor’s.

Still Using Powdered Gloves? Why?
February 2002 Newsletter

Read the article Starch Powder Contamination of Surgical Wounds in the Archives of Surgery, August, 1994, Volume 129, pg. 825-828. Also in Surgery, Gynecology & Orthopedics, December, 1990, Vol. 171, 521-527, The Hazards of Surgical Glove Dusting Powders is also a great article. Both state the washing of gloves does not remove all of the powder/cornstarch from the gloves. These are great articles to post with the surgeons to read. After these articles were posted, none of the surgeons questioned the move to powder free gloves. (These articles are not on the Internet - Ed.)

Sherry Gamble <sgamble@rmh2.org>
"An Electronic Forum for Perioperative/OR/Theater Nursing World Wide" <periop@u.washington.edu> January 16, 2002.

Words Can Heal
February 2002 Newsletter

“Words Can Heal is a national campaign to eliminate verbal violence, curb gossip, and promote the healing power of words to enhance relationships at every level.”

“At a time when so many feel that outside events are beyond their control, we offer concrete tools and know-how to dramatically rebuild our communities and relationships through the words we speak and the way we communicate. At a time of national crisis, as we re-evaluate our lives and re-order priorities, the Words Can Heal message resonates even more forcefully.”

“Words Can Heal has captured the imagination and commitment of an unprecedented coalition. Our board includes the top leadership, leading diplomats, Wall Street's most influential CEOs, America's leading clergy, Hollywood celebrities and community leaders of every stripe...”

Please visit www.wordscanheal.com to learn more. You can buy a handbook or view the handbook (free) on the Internet or download it in PDF (1 MB).

“I pledge to think more about the words I use.

I will try to see how gossip hurts people, including myself, and work to eliminate it from my life.

I will try to replace words that hurt with words that encourage, engage and enrich.

I will not become discouraged when I am unable to choose words perfectly, because making the world a better place is hard work.

And I am pledging to do that, one word at a time.”

A “Workplace Kit” and a “Family Kit” are offered (free downloads). I’ve read the short handbook and am very impressed and chastened. As one who doesn’t suffer fools gladly, I am quick with sharp (and unfortunately hurtful) comments. This web site and its contents has made me much more aware (through its use of stories and examples) of alternate behaviors and thinking. I recommend it. If you don’t have access to a computer, contact me (marymac@hotpop.com) and I’ll mail the information to you.

Submitted by Mary Ritchie and www.wordscanheal.com

Ask The Candidates!
February 2002 Newsletter

Ask the Candidates - Questions and Answers
www.aorn.org/meet/AskTheCandidates.htm
www.aorn.org/meet/answers.htm

Meet the Candidates
www.aorn.org/meet/default.htm

“Ask the Candidates is now live!! To access, go to www.aorn.org/meet. Click onto the candidate you wish to ask the question to and scroll down to write and send your question. The Nominating Committee will be receiving these questions and forwarding them to the candidates. As we get the replies, they will be put online so all can see the original question and reply. Please remember to be patient with us and the candidates because this is a new process and we may need to work out the kinks. Also remember to ask questions pertinent of the position the candidate is running for. This will be a good trial for all of us in preparation for the Town Hall Meeting at Congress. This Committee is excited to bring you changes and connect you closer to the candidates. We also would like to thank everyone at headquarters, especially Arwa Hurley, who is working closely with us on this project.”
Linda Savage, RN,BS,CNOR, Chair Nominating Committee. MemberTalk, January 8, 2002

“To make it easier to access Ask the Candidates you can click on under “What's New” and the “Quick Find” on the AORN home page (www.aorn.org). We would also like to let all the members know that to help keep the volume to a minimum for the candidates and ourselves (after all we do work also), any duplicates or questions that are very similar will not be posted. Remember, you will have plenty of opportunity to ask the candidates questions at Congress and we are only going to try this method for one month. Then the candidates can start concentrating on getting ready for Congress. Thank you again for your cooperation in this Q & A.”
Linda Savage, RN,BS, CNOR, Chair Nominating Committee (Savlinda3@aol.com). MemberTalk January 9, 2002.

This is such a great opportunity for those members who can’t attend Congress. You can learn about our National leadership. Become more in tune with your national organization!

Operating Room Nursing Council of California (ORNCC)
February 2002 Newsletter

Luncheon at AORN Congress in Anaheim

April 22, 2002
1130-1300
Anaheim Convention Center
Room 201 A &B

One contact hour
(CA BRN # 03457)

“Current Legislative Issues in CA”
Tricia Hunter, RN, MN
Lobbyist for The Flannery Group, a public relations firm in San Diego that tracks legislation and regulations that affect the nursing profession.
OR nurse for 24 years
Former CA Assemblywoman
For more information about Tricia Hunter:
www.nursezone.com/Stories/SpotlightOnNurses.
asp?articleID=7984

Objective:
Identify legislative issues important in the RNs’ workplaces.

Menu:
Grilled Portabello mushroom
Caesar salad with smoked chicken and roasted red peppers
Chocolate decadence cake with raspberry chambord sauce

Cost is $40 (lunch and contact hour)
payable to ORNCC.
Respond by April 5.
Mail check and information (name, address, telephone number, and RN license number) to:
Vicki Contryman
20315 Trails End Road
Walnut, CA 91789-1838

Congratulations New CRNFA!
February 2002 Newsletter

Congratulations to Linda Vassallo of Eden Medical Center who has worked really hard to get the hours to sit for the CRNFA board and passed the exam! 

Congratulations New CNORs!
February 2002 Newsletter

Ramona Bell
Kyuja Kim - Alta Bates
Fredrick Rodriguez - Summit

The chapter now has 74 CNORs and 2 CRNFAs (Linda Vassallo and Karin Selbach)

Keep up the good work!

Submitted by Sophie Taylor


Welcome!
February 2002 Newsletter

Corinne Casey-Lyons - Eden

Betty Chen - Kaiser Oakland

Meoneta Clark - Highland

Avril Green - Kaiser

Jerrie Pierson - San Leandro

Mary Salisbury - East Bay Surgery Center

Welcome Back!
Dorothy McIntosh

Tidbits
February 2002 Newsletter

AORN Congress: April 21 - 25 in Anaheim. Let Sophie know if you will be attending. Call 510-596-6235 or e-mail nursingnotes@aol.com.

Scholarships are available. See details on page 2.

May chapter meeting is May 8.
Please note the date change for the May meeting. Plan now to attend meeting on the second Wednesday of the month (May 8). Hear what the Congress delegates learned! Learn who the new National officers are (check our web site after Congress for immediate updates).

Our web site is located at www.geocities.com/alamedacounty.

WASHINGTON, DC - The US Food and Drug Administration (FDA) has approved Dermabond - a glue specifically designed to seal surgical cuts without stitches. The glue reportedly keeps out bacteria as well.

Distributed by Ethicon Products, a division of Johnson & Johnson, the glue reportedly keeps dangerous pathogens, such as staphylococcus, pseudomonas, and enterococci, out of open wounds.

The glue is made by Closure Medical, based in Raleigh, North Carolina. Posted 1/18/02 www.infectioncontroltoday.com/hotnews/21h18134318.html

There’s been a recall by Ethicon for certain lot numbers for improper sealing of the package so the Dermabond ampule may not be sterile.

Is Jewelry Removal/Taping A Sacred Cow?
December 2001 Newsletter

In 1968, electrosurgery was revolutionized by isolated generator technology. The isolated generator isolates the therapeutic current from ground by referencing it within the generator circuitry. In other words, in an isolated electrosurgical system, the circuit is completed not by the ground but by the generator. Even though grounded objects remain in the operating room, electrosurgical current from isolated generators will not recognize grounded objects as pathways to complete the circuit. Isolated electrosurgical energy recognizes the patient return electrode (the grounding pad) as the only pathway back to the generator.”

“By removing ground as a reference for the current, the isolated generator eliminates many of the hazards inherent in grounded systems, most importantly current division and alternate site burns. “
ValleyLab’s Principles of Electrosurgery
www.valleylab.com/static/pofe/pofes16.htm
www.valleylab.com/static/pofe/pofes1.htm

“If the circuit to the patient return electrode (grounding pad) is broken, an isolated generator will deactivate the system because the current cannot return to its source.” So why are we still concerned about alternate site burns?

“Generators with isolated circuits eliminate the hazard of alternate site burns but do not protect the patient from return electrode burns. Historically, patient return electrode burns (grounding pad burns) have accounted for 70% of the injuries reported during the use of electrosurgery. Patient return electrodes are not ‘inactive’ or ‘passive.’ The only difference between the ‘active’ electrode (the cautery pencil) and the patient return electrode (grounding pad) is their size and relative conductivity. The quality of the conductivity and contact at the pad/patient interface must be maintained to prevent a return electrode site injury. “
www.valleylab.com/static/pofe/pofes17.htm

Don’t we all use isolated generators? Why are we still obsessed with alternate site burns caused by jewelry? Swelling is a legitimate concern. Alternate site burns are not a concern unless you don’t have isolated electrosurgical units. And if you don’t, why not? This is the 21st century in the San Francisco Bay Area!

If rings cannot be removed, that means they’re very tight fitting and won’t get lost (or stolen). Why tape them? If they’re not in the surgical field and there’s no danger of fingers swelling later, why tape or remove rings? If they’re loose and/or valuable, they should be removed! I’ve seen non-removable jade bracelets that wouldn’t slide over a patient’s wrist covered with plastic tape! It’s illogical!

If a body piercing is in the surgical field, it must be removed. I’ve had patients reluctant to remove umbilical rings (they’re difficult to reinsert and the patient must return to the specialist who inserted the ring). If the surgery is anywhere except the abdomen, why must the umbilical ring be removed? If it’s a spinal surgery, cover the umbilical area with gauze or a towel and tape so no one accidentally pulls on the ring when turning the patient. Tongue piercings are generally removed due to the danger of dislodgement if the patient will be intubated. If the patient will be masked, then why not leave it in place? Let’s protect the patients but use some common sense too!

There was a jewelry question/answer in the AORN Journal (August 2001, Vol. 74, No. 2, page 249). Dorothy Fogg, RN, MA said all body jewelry should be removed and ORs should purchase ring spreaders and closers. She suggested visiting a body piercing establishment to become familiar with all the various types of piercings (and removal and reinsertion tools). She suggested pre-op interview questions about body piercings and clear communication on your facility’s policy so there are no day-of-surgery surprises.

By Mary Ritchie

Tidbits
December 2001 Newsletter

Felicia Williams has been appointed to the Board by the Board of Directors. She replaced Jonas Israel.

Accept the chapter challenge: Donate one dollar per member for the AORN Foundation. A collection was taken at the December meeting. If you werenít present at this meeting and wish to donate, please send your money to the AORN Foundation or to Treasurer Ann Ceasri, 944 Kingston Avenue, Piedmont, CA 94611-4338.

The AORN Foundation is a 501(c)(3) charitable and educational foundation created in 1991 by AORN. Its mission is to ïsecure resources and administer assets that provide support for meeting AORNís strategic goals in education and research.E It programs are supported by contributions from members, chapters, state councils, industry and individual donors. Contributions are tax deductible as charitable expenses within the limits of the law. AORN Foundation, 2170 South Parker Road, Suite 300, Denver, CO 80231-5711. (800) 755-2676, AORNFDN@aorn.org.
www.aorn.org/foundation/behalf.htm - benefits of giving.

Congratulations to Phyllis Hellwig who won a one yearís AORN membership at the November 7 chapter meeting (in celebration of Perioperative Nurse Week).

Welcome New Members!

Jacqueline Cummings

Yvonne Davis
Kaiser Oakland

Carmen Towan
Washington

Angela Vela
San Ramon

Operating Room Nursing Council of California (ORNCC)

What Can We Do For You?

History
Promote communication relative to professional nursing issues.
Act as a resource organization.
Collect and disseminate information of importance on nursing issues.
Serve as a resource for perioperative nurses.
Foster an assembly for consultation, advice, or discussion.
Work collaboratively with other professional organizations.

What We Do
Legislative (like legislation relating to periop RNs, California RNs and womenís issues).
Networking with other periop RNs.

When We Meet
February (the first Saturday)
Annual luncheon at AORN Congress
May (third Saturday)
October (first Saturday)
Council meetings are open to all AORN members. Meetings are selected at various locations throughout the state (north, central, and south).

Visit our web site at www.orncc.org (available only with Microsoft Explorer).

Contact Marilee Brehm, Chairman for 2000-2002, at marileeb@innercite.com or 530-622-1652 (home phone) for more information (or to arrange a speaker for your next meeting).

Associate Member
You must be an RN and an AORN member who wishes to participate and pays annual dues of $35 (dues are for the calendar year no matter when you pay - so if you join in January, you get the full year for $35). An associate member attending a meeting has one vote.

If youíd like to join, you can find membership forms at www.orncc.org (with Microsoft Explorer only). If you have Netscape, contact me (marymac@hotpop.com or 310-944-9822) and Iíll send the form to you.

Adventures Down Under Part Two
ïKia-OraE - ïGood MorningE
By Clenia Yadao
December 2001 Newsletter

(L to R) Donna Rodgers, unknown AORN member, Clenia Yadao at International Fellowship Night
(L to R) Donna Rodgers, Maori warrior, Clenia Yadao at World Conference

Midweek at World Conference on Surgical Patient Care in Christchurch, New Zealand, Donna Rodgers and I were still going strong. After our usual breakfast (yogurt, canned pears, peaches, prune juice, coffee, and tea), we walked to Town Hall for another day of educational sessions.

The general session speaker was Kay Ball Past President of AORN). Her presentation was ïHazards in Surgery: Is It Risky Business?E She identified several risks and offered measures to control or eliminate them. She emphasized that hazards should not be ignored and that continuous education of staff, surgeons, and everyone involved is a must. The afternoon sessions were a repeat of the Tuesday afternoon sessions.

Thursdayís general session was about infectious organisms and multi drug resistant organisms with emphasis on Creutzfeldt-Jakob Disease (CJD). mad cow disease, and tuberculosis. As perioperative nurses, we were encouraged to be aware of the presence of infectious organisms and how to prevent their spread. In the afternoon, a panel of nursing leaders from Great Britain, Australia, and the Untied States (Cynthia Spry, Past President of AORN) discussed the global nursing shortage. They discussed (as the key elements to the shortage) the elevation of nursing as a profession. The level of entry into nursing must be a bachelorís degree to be competitive in the 21st century.

On Friday, Irene Quad (from Malaysia) and Cynthia Spry brought us back to issues concerning the nursing profession. Both speakers challenged the attendees to make a difference and raise nursing to a professional level. For closing session, Gay Williams (New Zealand) delivered a very inspiring and challenging message. She said that nurses, particularly perioperative nurses, ïshould lead the way and make a difference for the future is ours.E Her parting statement was ïVision without action is merely a dream. Great ideas without action remain just that - great ideas.E

The conference ended with all the attendees singing ïEverywhere You GoE which was written by Hilda McClutchie from Wairan Hospital in New Zealand. We bid our good-byes to old and new acquaintances, extended our gratefulness to the New Zealand perioperative nurses and promised to meet again someday, somewhere.

ïBody Piercing is Becoming a Very Popular Body ArtE was one of the Clinical Improvement and Innovation posters that caught my attention. It is a global issue.

After the conference, Donna and I ate fish and chips then hopped on a bus for a tour of Christchurch. Who was on the bus but fellow perioperative nurses from Canada and the Untied States. For the midafternoon break, we stopped at a cafe for cappuccino, tea, chocolate cake, carrot cake, and ice cream, and watched seagulls fly over the misty Pacific Ocean. We also exchanged experiences of the conference week and of the different tours that we had taken. Our tour brought us to Mona Gardens where daffodils and tulip trees were in bloom. It was early spring down under (in September).

Warmth & Kindness of Aussies

In the wee hours of September 8, Donna and I were set to continue our journey/holiday to Australia. We boarded Air New Zealand for a three and one half hour flight across the Tasmanian Sea to Sidney. We arrived safely into a warmer climate. While waiting for our ride to the hotel, an ambassador woman approached us and assisted us with our ride and also suggested places to visit in Sidney. We were very impressed with her kindness. We knew that we were in a real adventure when we arrived at our hotel (next to an adult book store!) and discovered Bill Clinton was in town.

As usual, Donna and I went looking for fish and chips. Because the weather was nice, we walked to the harbor and found our fish and chips. This time we had it with Victoria bitters. Determined to enjoy the day, we boarded a ferry to Manly. Sidneyís skyline reminded us of San Francisco and we discovered later that Sidney is San Franciscoís sister city.

For our cultural entertainment, we saw ïTales of HoffmannE at the Sidney Opera House. Testing our sense of direction, courage, and knowledge, we boarded a bus to the Opera House (we remembered the Aussies are left-side-of-the-road drivers!). Not yet familiar with the Australian money, I handed all my coins to the driver and he selected my bus fare. He was very helpful in giving us directions and telling us which bus to take back to our hotel. This was a long day for Donna and me. Sidney was two hours behind New Zealand.

September 9. After breakfast (our meals were very important to us), we walked to the Rack, bought souvenirs in an outdoor market (yes, we looked for bargains), discovered the Queen Victoria Building with shops, cafes, and a beauty salon. We pampered ourselves with feet massages, pedicures, and waxing. In the afternoon, we joined a city tour which included Bondi Beach and the 2000 Summer Olympic Park.

September 10. We took the Blue Mountain tour. We walked 200 steps to a waterfall lookout; had tea and biscuits; had lunch with pink and white cockatoos on the mountain ridge; and visited a coal mine by riding a gondola and a tram. Then we went to a wildlife park where we saw kangaroos, koala bears, crocodiles, exotic birds, and owls. It was an enjoyable but exhausting day.

September 11. We boarded Ansett Airlines to Cairns for the Great Barrier Reef. The weather was lovely at 88 degrees. Our hotel room overlooked the Pacific Ocean, mountains, and palm trees. What a joy! We walked into town for ice cream and found a place to dine. How about coconut rice and local fish for dinner. Yum!

September 12. As I was coming out of the bathroom that morning, Donna informed me the World Trade Center buildings in New York were on fire. The caption of the TV screen said ïAmerica Under Attack.E We were both stunned and looked at each other and said, ïWhat now?E We managed to get dressed and went down to the restaurant for breakfast. As we sat down to eat, Donna started crying and in no time we were both in tears.
We boarded our bus to Port Douglas where we had to catch a boat to the Great Barrier Reef. As we approached Port Douglas, the bus driver pointed out the reportersí vehicle that was parked outside the hotel where Bill Clinton was. At this time, the devastation of the World Trade Center buildings, the airplane hijackings, and the terrorism was news. The support of the Australian people was overwhelming. The Australian flag was at half mast. People who discovered we were from the USA expressed comforting words. Before our boat headed out into the ocean, there was a moment of silence for America. Both Donna and I were touched with this gesture and felt safe here away from home. There were also memorials where candles, flowers, notes, and American flags were placed.

Australia is 19 hours ahead of USA time so thatís the reason we heard the terrorism news on September 12 and not the eleventh.

September 13. We joined a tour of the Daintree Rainforest (we were in the tropical part of Australia). It reminded me of the Philippines with tropical animals, birds, flowers, and fruit. On our way to the rainforest, we stopped at Port Douglas. Our tour guide informed us Bill Clinton was picked up by Air Force Two to return to the USA. At the rest stop, there was a chapel and they distributed a pamphlet (ïPrayer for AmericaE). It said ïAs you reflect on the devastation in the nation of America, you may find the following scriptures and prayer points helpful to pray through and meditate on. Father God, help me to pray. Help me to understand what is happening in the world. Help me to hear what you are saying at this time.E The pamphlet then had Psalm 23, Psalm 46, Haggai 2:6, 2 Chronicles 7:14, Jeremiah 29:11, Romans 12:19, and it ended with the Lordís Prayer.

We cruised a river where we saw crocodiles, kingfishers (birds famous for their plunging dives when fishing/hunting for food), tropical plants and flowers. On our way back to Cairns, we stopped for delicious homemade ice cream made of tropical fruits.

September 14. We were packed and ready to return to Sidney and then to the USA. The morning news said Ansett Airlines had folded! We were advised to go to the Qantas Airlines office to try to get a flight to Sidney. We waited an hour at the office and were then told to go to the Cairns airport and then to the Air New Zealand office. The Air New Zealand staff informed us all international flights were canceled and there was no date when flights would resume. So we spent a day at the airport and learned the next flight to Sidney was in four days. It was definitely a stressful day. We returned to our hotel and made reservations for four more days. The hotel manager gave us 40% off our room rate!
Our four days were definitely spent well. We swam, ate, drank, walked, and read. I finished reading ïHarry Potter - Prisoner of AzkabanE and Donna had to buy a new book.

September 19. We boarded Air New Zealand in Sidney (bound for Los Angeles). It was a 13 hour flight. We noticed only people with airline tickets were allowed in the airport. We had to show our passports and our luggage was searched at least three times.

All in all, it was a terrific, enjoyable, fun adventure / journey / holiday but we were so happy to be back home home again!

Performance Improvement through Pollution Prevention (P2) November 2, 2001
By Ann Melamed RN
ïHealth Care Without HarmE
415-333-7401
annmelamed@earthlink.net

This conference, held at the Association of Bay Area governments (ABAG) meeting room in Oakland, was a culmination for the Bay Area pollution prevention pilot program. Originally began in 6 hospitals: Childrenís, UCSF, John Muir, Eden, Sutter-Delta, Kaiser Walnut Creek, it has expanded to many others.

* Keynote speaker Bernita McTernan, Senior VP of Sponsorship, Mission, and Community Benefits for CHW, opened the program with a vision of a cleaner, more sustainable health care industry. It was great to have a senior person from CHW, it will help CHW to expand this work.

* Jack McGurk, Chief of the Environmental Management branch of the CA Department of Health Services spoke about many success stories in this pilot. Some examples he spoke about included mercury elimination, new cleaning techniques that are safer and more effective, waste minimization, better sorting of waste, and importantly: hospitals saving money. Jackís presentation was visual, animated fun and interesting. Jack is in charge of medical waste management across the State. His focus on partnership with hospitals and training medical waste inspectors to promote pollution prevention (P2) is wonderful and exemplary.

* Davis Baltz, the California coordinator for Health Care without Harm (HCWH) spoke about the membership, mission and goals of HCWH. Davis stressed the human health impacts of mercury and dioxin and the problems that medical waste creates in the environment.

* Lacy Friedman Vasquez, the hazardous materials specialist from Contra Costa County Health Department, highlighted her work: "JCAHO Performance Improvement through Pollution Prevention." This tool offers practical tips on getting JCAHO "points" for your P2 work. For example: by eliminating mercury in your hospital you donít need a spill kit or need to know how to clean a mercury spill. Another of Laceyís projects is red bag waste signage. Our goal was to create a sign that would minimize unnecessary items getting thrown into the red bag waste. The signs have been sent to all hospitals throughout California.

* Susan Wilburn, from the American Nurses Association, talked about front line workers. Did you know that the health industry is more dangerous than mining or construction? (not a surprise to our many injured nurses) It is important to involve front line health care workers in P2 decisions, and to integrate OSHA regulations with P2.

Lovely boxed lunches were provided and, since it was a beautiful day, most of us sat outside on the terrace. This was a great opportunity for networking. It was interesting, for example, to sit and chat with the medical waste inspectors. They are also involved in the terrorist and anthrax response. I was impressed that so many of these folks were able to make it to the conference, considering their added work load since 9-11.

The afternoon program consisted of a panel of folks highlighting different aspects of their P2 work.
*Jim Schweikhard from Stanford talked about the reusable sharps containers that they use. These heavy red containers are reusable, the company takes them, empties, cleans and disinfects the containers and returns them to the facility. This diverts enormous amounts of plastic from the waste stream. It is an automated system so no-one handles the used sharps.

*Ken Harman spoke about mercury elimination at Sutter Delta Medical Center. They eliminated all mercury except for the small amount in fluorescent bulbs.

* Sister Mary Ellen Leciejewski spoke about blue wrap and other plastics recycling that they're doing at Dominican Hospital in Santa Cruz.

* Jose Watson talked about solid-waste segregation at Kaiser Walnut Creek. He spoke about involving front line workers and enlisting their support E from whom he got many excellent ideas.

* Laura Vanetek from B.Braun explained about the problems with PVC, including Di-2-Ethylyhexyl Phthalate (DEHP) contamination in medical products, and the creation of dioxin during incineration of PVC medical products. All B.Braun products are PVC-free and DEHP-free.

* Rick Parker - microfiber mopping systems, reduces the amount of disinfectants and waste water produced. The microfibers attract dirt, and very little water or disinfectant is needed. The mop heads are changed for each room, and then are laundered. They can be reused thousands of times. The mop is so light, it really makes other cleaning products look medieval.

* Another service that Rick is going to offer: when he delivers medical products to hospitals, he is willing to pick up their blue wrap and plastics to take to Marathon Recovery in Oakland for recycling. Jack McGurk is facilitating this.

* Stephanie Davis gave waste segregation tips

* Steve Kubo, with Department of Health Services, made comparisons about cost and efficacy of P2 programs. Key thing to emphasize is that, in the long run, it saves money to be environmentally responsible.

* Other key items: Heidi Hall, Director of the Office of Pollution Prevention and Solid Waste, from USEPA Region 9, was really impressed with the importance of involving workers and NURSES in P2. I was really happy to hear her say that she was going to look into the PVC issues more, especially about the plasticizer DEHP.

* Chen Wen, who is with the Federal EPA Office of Pollution Prevention, came from Washington, D.C. to attend. It was great to have him there. He spoke with me about how important it is to have NURSES involved and that he was hoping that we will help them distribute an independent study module on P2 that EPA is developing with ANA.

Venders included:
AERC.com INC M. Gutierrez (mercury recovery) 510-429-1129
Alliance Medical Corp. (Reprocessing of SUDs): Steve Wilson 415-377-9465
B. Braun Medical Inc. (non PVC, non-DEHP IV products) Laura Vanetek 916-660-2558
Clean Source (micro-scrub mopping and plastics/blue wrap pick-up) Rick Parker 408-501-3296
Marathon Recovery (plastics & blue wrap recycling) Doug Spitzer 510-636-4191
Surgical Express/SRI (cart system using reusables and disposables) 209-982-5800
RSI Consulting (recycling consulting firm that contracts with haulers of all types of recyclables and solid waste) Susan Compton 818-865-0620.

We had a good turn-out, I believe that we had about 10 nurses who got CEUs from AORN. Many, many thanks to Carrie Ewing and Sandra Wienholz and the Board for supporting this event and providing CEUs. Carrie was at the booth and sold hats and candy, it was a great opportunity to have AORN in the public eye.

Nurses need to be at the table, shaping the direction of Pollution Prevention in hospitals. We all know who keeps the hospitals going. A clean and healthy environment is basic health care and disease prevention, in other words, basic nursing. Nurses are among the most respected professionals, we must maintain our visibility and our credibility while this work moves forward. Kudos to AORN SF/Marin for your involvement!

If you are interested in more support for P2 projects at your hospital, you can call Steve Kubo at the CA Dept. of Health Services: 916-327-6056 (skubo@dhs.ca.gov)

Health Care Without Harm has a Nurses Work Group. Our main work involves education and promotion of nurse leadership in all aspects of HCWH: PVC elimination, mercury elimination, alternative technologies for waste treatment, non-toxic products, waste reduction and other topics. If you are interested in joining our work group, we have one conference call a month, usually on the 2nd Wed. around 11:30 am. Let me know if you would like to be added to the email list. annmelamed@earthlink.net

Presidential News
December 2001

I was asked to write about myself - to let the members of our chapter know who I am and where I came from. Well, here it goes.

I was born in Sweden the year after the sixties ended. A very fine vintage indeed. I did the things other kids did - went to school, played sports on occasion, and had no real worries. In high school, I specialized in clothes making, and spent four years making dresses, jackets, skirts, blouses, and pants custom made for different clients.

At the same time, I worked as a costume dresser in a theater where they performed Andrew Lloyd Weberís ïThe Phantom of the Opera.E It was quite a fun job, not unlike the operating room I discovered later, and maybe thatís why the Brits call the OR suite the ïtheatreE (guess who the primadonas are). I did this for two years while being a full time student.

In late 1989, I met the man who two years later became my husband, and I immigrated to America when we got married. Later that year my son David was born (1992). Shortly thereafter, I started taking my pre-requisites for nursing school at American River College in Sacramento where we lived at the time. As it was impossible to get in to Sacramento State University, I applied at Cal State Hayward and got accepted for fall quarter of 1995. So we moved down to Hayward. Nursing school was a lot of hard work (this is supposed to make us super nurses). During the course of nursing school, I was invited to join Sigma Theta Tau International Honor Society of Nursing. This was one great reward for all the sweat and tears, long nights and extreme sleep deprivation.

My professors always emphasized how important it was to be active in your professional organization, so when I finally graduated (the greatest reward!), and started working, I joined AORN.

After graduation, I started looking for a job. I had done my preceptorship in ICU and independent study in the OR. I knew for sure that ICU was not for me, so I pursued OR managers around the Bay Area asking them for an opportunity to come and work in the OR. This was about three years ago, and the shortage was not as extreme as it is today. Luckily, I was hired at Eden Medical Center, and they trained me. Beth Mar was my preceptor, and she taught me so much (love you Beth). She also invited me to come to the AORN meetings, and the active members smelled new blood. Before I knew it, I was on the Board of Directors. The following year I was President-Elect, and now of course, Iím the President.

For personal reasons (in 1999), I took a position at Kaiser Oakland as a staff nurse in the OR. They offered me a day shift, and this worked better with my family life, so off I went. At Kaiser, Iíve been very fortunate to precept students. Itís been a great way to refresh the basic skills necessary to function in the OR. Besides, I got a new best friend out of the deal (who by the way now is active in AORN as well).

As if my life wasn't busy enough, I started work on my Masters Degree in Nursing Administration a year ago. It is very interesting though, and hopefully one day I can use those skills to improve working conditions for nurses. In addition, being your President has been more work than I ever imagined, although it is so much fun, and trust me, I get way more back than I put into it. For example, going to Congress, and leadership conference in Washington DC. I canít wait for the next Congress in Anaheim. I know that one will be a smash hit for sure! So thatís me in a nutshell!

By Ann-Sophie Taylor

Adventures Down Under
Part One: The Kindness of Kiwis
October 2001 Newsletter

I remember sitting at the closing session of Helsinkiís World Nursing Conference in 1999, viewing a travelogue featuring the next locale, New Zealand. It showcased bungee jumpers, hang-gliding, jet boats, natives with frightening face paint and I thought to myself, ïGuess Iíll pass on that one!E Flash forward two years and Iím seated aboard Air New Zealand with Clenia Yadao en route to Christchurch. Go figure!

Getting There

The flight itself was daunting. We left on a Friday afternoon and arrived Sunday morning. After a quick hop to LAX (Los Angeles airport), it was a 12-hour flight to Auckland, the countryís capital that is located on the North Island. Then we flew another three hours to Christchurch on the South Island. Somewhere over the Pacific Ocean, we lost a Saturday, presumably as we crossed the International Date Line, which was shortly after traversing the equator. It was all a bit confusing, but I was told weíd get the day back when we came home. Where do these lost days go anyway?

There

It was drizzly when we arrived in Christchurch. I tried to squelch thoughts that Iíd just traveled two days to experience the dreariness Iíd grown up with in Tacoma, Washington. We were driven to our hotel on the left-hand-side of the road and I felt like I was in the UK. We were exhausted, but forced ourselves to stay awake so we would be able to sleep that night and get our internal clocks reset. We walked in the gray drizzle to a restaurant across town for an early dinner, got lost walking home (adding untold miles to our trek) and fell into bed at 5 p.m. Sound boring? We told ourselves it was really 10 p.m. our time.

Even The Animals Dress!

The next day began a week of touring. We were shuttled to the local train station to board a coach for Dunedin along the southeast coast of the South Island. My only other experience with a train was the Reno ïFun TrainE - and it wasn't! (Too slow.) Our present journey turned out to be very enjoyable. The train was clean and comfy with decent food and good visibility. We crossed over the Canterbury Plains, home to numerous sheep and horses that wore ïjacketsE to protect them from the cold. It was, after all, the end of winter/beginning of spring. On one side of the coach was the ocean; on the other side were snow-capped mountains. New Zealand was looking better already!

Water of Leith

Dunedin is a surprisingly quaint and charming town with a distinct Scottish flavor. Its claim to fame is the University of Otago, virtually unknown to us. It is New Zealandís oldest university, whose 18,000 students help to enhance Dunedinís cultural and intellectual reputation. The campus is spectacular, largely due to the Water of Leith, a small river that winds through it.

Yellow-Eyed Penguins!

We scheduled ourselves for a tour of the Otago Peninsula, which juts out east of Dunedin and divides its harbor from the Pacific Ocean. We chose to view the yellow-eyed penguin, an endangered species found only in southern New Zealand. This involved a bus ride through paddocks of sheep, some with newborn lambs. These wobbly lambs were adorable and my most vivid memory of New Zealand. Simon was our tour guide and he led us on foot over sand and through camouflaged trenches to where we could view the penguins, unseen, through openings in the sides of the trenches. The yellow-eyed penguin is an anti-social animal that colonizes beachside to breed in the protected environment preserved by the local conservationists. It was a privilege to view this precious species.

Scenery!

We headed to the west for Queenstown next via the scenic Taieri Gorge Railway, which penetrates rugged high country. A bus ride from Pukerangi completed the trip. Queenstown is New Zealand's most popular and commercialized year-round resort. Yet it is also an idyllic spot attractively set beside the deep blue Lake Wakapita and bordered by craggy mountains. We spent a day touring Milford Sound, a spectacular fiord whose steep sidewalls boast towering waterfalls. A gondola ride in town provided a breath-taking view of the entire village and surrounding beauty. One evening we experienced a Maori dinner concert and learned about the life New Zealandís original inhabitants. We left Queenstown via Mount Cook National Park, home to the Southern Alps and New Zealandís highest point, Mount Cook. Its permanent cover of snow and ice provide dramatic contrast to the turquoise, glacier-fed lakes Tekapo and Pukaki stretching below.

By the time we returned to Christchurch, we were in awe of the natural beauty of New Zealand and enamoured by the kindness and graciousness of its people, the Kiwis. It was the perfect frame of mind to begin our conference.

Down To Business

Sunday, September 2, was Fatherís Day in New Zealand. It was also the day registration materials were available at Town Hall for the World Conference on Surgical Patient Care. We scanned the sea of heads for familiar faces and were greeted by Anita Shoup, National Board Member, and her spouse and another couple who had also been on our tour of the previous week. Materials in hand, Clenia and I strolled through town to our hotel at Cathedral Square. Though it was still cool, we were grateful it was no longer raining.

The next day, Monday, was opening session, attended by 1400 registrants. In dramatic fashion, a Maori warrior offered a welcome challenge to international representatives, then welcomed them to New Zealand, or Aotearoa in their language, as friends in peace. This was followed by Maori musicians performing traditional songs, to the delight of all. Wendy Longhurst, chairperson of the Perioperative Nurses Association of the New Zealand Nurses Organisation, introduced representatives of 37countries who joined her onstage. Mr. John Doig, a Christchurch gynecologist, sang the New Zealand national anthem. The mayor of Christchurch gave a welcoming message, as did Sheila Allen, AORN President. Dr. Marion Jones, Associate Dean, Auckland University of Technology, presented the keynote address entitled ïPerioperative Leadership for the New Millenium.E The relatively new auditorium was comfortable, reverential and the conference was off to a great start.

Clenia Loses Her Shirt

A general session on reprocessing issues was followed by concurrent sessions on work-related occupational illnesses/injuries, transplantation and contributions of the perioperative nurse. International Fellowship Night was scheduled for that evening at Hagley Park. Originally planned as an outdoor function, it was relocated beneath a giant tent due to inclement weather. Costumes were perhaps less elaborate than usual because of the chill, but spirits were not dampened. Americans were encouraged to wear the T-shirt of their favorite baseball team, so I supported my Giants and Clenia, her Athletics. During the course of the evening, Clenia lost her shirt, so to speak, because she was asked to trade it with a Kiwi wearing a New Zealand shirt! The band was awesome, token gifts were freely exchanged between countries and a good time was had by all.

Tuesday morningís general session was on the reduction of errors. It was especially poignant because the first presenter had lost his young adult son to a tracheal fire sparked during routine outpatient laser surgery for a vocal cord lesion. Afternoon concurrent sessions focused on quality, interprofessional relationships, and best practices and clinical outcomes. An International Federation of Perioperative Nurses networking session was available in the late afternoon, focusing on sterilization and disinfection issues.

Tuesday was also the opening day of exhibits. Fifty-three industry colleagues were present at the 2001 World Conference and generously provided sandwiches, drinks, and afternoon tea to attendees, in addition to their cutting-edge displays.

Hokey-Pokey Ice Cream

The non-educational highlights of our day were hokey-pokey ice cream, a New Zealand must-have, and an Art Centre play we took in on the way home. It was entitled ïTake a Chance on Me.E We did, and it was a fun way to end a very satisfying day.

See Part Two by Clenia Yadao in the December newsletter.

Submitted by Donna Rodgers

Buy Christmas greens!
Call Donna at 510-352-5064
E-mail Donna at dbenotti@juno.com
Money and orders are due November 7.
Greens will be delivered the beginning of December.

Surgical Facilitiesí Reps
October 2001

People have retired and/or changed positions so itís time again to establish who the reps are for the various hospital ORs and surgery centers. E-mails were sent to 15 members in early September asking them to be facility reps. If you see your name here and donít want to be a rep, please contact me (marymac@hotpop.com). A rep is responsible for posting the newsletter on the bulletin board for all to see to garner interest in our chapter and itsí activities. By posting your newsletter, the chapter saves the cost of copying and mailing an additional 27 issues to the ORs and surgery centers in Alameda County. You are also expected to post the monthly meeting flyers if you work in Alameda County. Those are the two responsibilities we ask of you! Please help! Thank you!

If youíd like to be a rep at one of the places with a vacancy, please let me know (marymac@hotpop.com). The meeting notices will only be sent to those reps working in Alameda County. Everyone is welcome to attend our meetings but it seems the greater the distance, the smaller the attendance (and the meeting information is in each newsletter). We want to share our information with all members and their facilities in all areas of the Bay Area. Thank you!

Alameda - Diane Pasquini
Alta Bates -Julie Patterson
Childrenís - Darilyn Harrell
Childrenís Surgery Center - VACANT
Dameron - Gwen White
East Bay Surgery Center - Gwen Schmitz
Eden - Ann Ceasri
Good Samaritan - Lina Schmidt
Highland - Kate Sharp
John Muir - Jacklyn Schuchardt
Kaiser Fremont - Denise Gerbi
Kaiser Hayward - Nina Cervantes
Kaiser Oakland - Ferne Spector
Kaiser Richmond - Ila Ahern
Kaiser Surgery Center Pleasanton - VACANT
Lucille Packard Childrenís - Rosy Gerochi-Daniel
Mt. Diablo - Kenneth Rush
Plastic & Reconstructive Surgery Center - George Dutchover
St. Maryís - Lady Wahleithner
St. Rose - Theresa Mitchell
San Francisco Fertility Centers - Karen Volpe
San Francisco General - Celerina Valiente
San Leandro - Ed Laris
San Leandro Surgery Center - Clenia Yadao
San Ramon - Andrea Andress
San Ramon Outpatient - Lorena Chew
Santa Clara Valley - Sharon Malindzak
The Surgery Center - Pat Kubo
Summit North - Joan Chamberlain
Summit South - Maria Cam
Sutter Delta - Barbara McCarthy
Sutter Solano - Ligaya Riego
Sutter Tracy Community - Marla Yockey
Tri-Valley Surgery Center - Karen Stevens
UCSF - Sara Buckley
ValleyCare & Surgery Center - Denise Bickert
Washington - Evelyn Steen
Washington Outpatient - Donna Rodgers
Webster Surgery Center - Amy Saft

Total = 39 places where newsletters will be posted!

Alameda County - 24
Contra Costa County - 5
San Francisco County - 4
Santa Clara County - 3
San Joaquin County - 2
Solano County - 1

Submitted by Mary Ritchie

Perioperative Nurse Week November 11-17, 2001
October 2001

ïPerioperative Nurses: Caring Today, Preparing for TomorrowE

In memory of all those who lost their lives in the World Trade Center buildings, the Pentagon, the airplanes, and for all those firefighters and police officers who lost their lives in the line of duty. Our heartfelt feelings and prayers are with their loved ones.

Fa La La La La...
October 2001

Yes, itís really that time of year again. Where does the time go? School has started, Halloween is almost here, and Christmas catalogs have started arriving. Sooo, once again it is time for the ever-popular CHRISTMAS GREENS sale. Packets will be available at the October chapter meeting or anytime from Donna Benotti (510-352-5064). Orders and money are due to Donna at the November 7 chapter meeting. Delivery is the first week in December. We will be selling wreaths (bows are included), garlands, centerpieces, and kits. The kits can be used to make your own arrangements for doors, tables, or fireplace mantels. Packets contain detailed instructions so there is no mystery to selling the greens. The greenery is fresh and fragrant. A wonderful gift for the person who has everything or is downsizing their possessions! Money raised goes toward chapter expenses. Please support your chapter. Pick up a packet for your facility or sell as an individual. Spread good cheer!

By Donna Benotti, Ways & Means Committee

Dear Editor
October 2001

Dear Editor,

The year got off to a great start. Sophie is bound and determined to start and end on time, and to make the business portion as interesting as possible. Hopefully the earlier meeting time will cause an increase in attendance because nurses will get home earlier. We had 30 attend Dr. Smallhorneís program on ïReversing the Effects of Facial Aging.E An excellent speaker, she included assessment of facial features and what the goals were of the different procedures. Those in attendance were very enthusiastic and asked many questions which were graciously answered. I think the entire audience (except for our president and maybe four others) was figuring out how to stage our procedures.

I took the opportunity to speak to the fall term junior student nurses at Samuel Merritt College this month. It was an introductory class to perioperative nursing. We discussed the history of perioperative nursing, the role of the professional perioperative nurse, their clinical rotation through surgery, staff expectations of students, and studentsí expectations of staff. (Ah, Project Alpha is alive and well!) Not that Iím the ïBe All, End All,E but I love to share my passion. I wonder how many of these students will really feel welcomed in the O.R. they are assigned to, or will be encouraged to choose periop for their Senior Synthesis, or will even have the stamina to remain in nursing. I wonder what attitudes they will encounter during their rotation.

I had planned a workshop for November, but the meeting place fell through. Hopefully the wound closure workshop will occur January 19. Wouldnít you like to come up and suture a pigís foot?

If all goes well, the ïholiday surpriseE for December will be about workerís compensation (did you catch the P.C. term?), how to work smarter and advocate for yourself. Iím so glad you update our web site so members can be informed of changes that do occur.

By the way, just want you to know that Iím still soliciting for newsletter ads. Wouldnít it be great if each facility were to secure an ad?

Well, Ms. Editor, itís time to sign off. Thank you for continuing to keep us informed. I just love to receive my newsletter. XOXO, DB

Submitted by Donna Benotti, Vice President

Get Caught in the Web!
October 2001

Have you seen our web site lately? If you want all the latest news and updates, check our chapterís web site at www.geocities.com/alamedacounty. Itís set up in a basic style with no bells or whistles (itís the Shaker style of all web sites!). Itís plain and simple for faster loading and viewing and easier navigating.

Hereís whatís at www.geocities.com/alamedacounty:

Current Information
Chapter Meeting Information and Directions
Vendor Policy - NEW! This is fabulous!
Newsletter Advertisers 2001-02
Newsletter Deadlines/Ad Sizes/Costs/Information
2001-2002 Officers & Committee Chairmen
Contact Members and Hospitals
Continuing Education Classes
Newsletter Items
Presidents' Messages
Newsletter Articles
Legislative Committee Reports
Latest Legislative News
Research Committee Reports
Committee Reports
Chapter Meeting Minutes
Board Meeting Minutes
Reports/Varied Topics
Links
Certification News
2001 AORN Congress Reports with Photos
1997 - 2000 AORN Congress Reports
Join AORN Alameda County!
Chapter Bylaws
2002 AORN Congress - See the Poppy Pin Here!

Information dates back to May 1997. Current information is listed first. Updates are made frequently and noted with the date of the revision. Each of the 22 listings has a date of the latest revision.

I use Netscape Navigator and the background is white. Unfortunately, the background appears blue on Microsoft Explorer. If anyone knows how to correct that - please let me know! I want white backgrounds!

Submitted by Mary Ritchie

Achievements!
October 2001

The June 2001 Ethicon Point of View magazine has an article by Denise Bickert, a member who works at ValleyCare in Pleasanton. The article is titled ïConnecting with Telemedicine.E She is also starting her second year of a two year term on the Ethicon Point of View Board this month.

POINT OF VIEW Magazine is one of the leading nurse publications in the United States. It has a 40-year history of being a voice for nurses on issues that are pertinent to their needs. POINT OF VIEW is published for Operating Room, Obstetric and Emergency Department professionals by ETHICON, INC. and Ethicon Endo-Surgery, Inc. Complimentary subscriptions are available upon request by calling 1-800-211-4131. The magazine is published three times a year in May, August and November.

Kathie Shea just finished her draft manuscript for the second edition of the PNDS (Perioperative Nursing Data Set). Susie Kleinbeck is the editor. Kathieís chapter is about application of the PNDS in daily periop practice. Hopefully it will be published by Congress.

Welcome!
October 2001

Rhondda Etheredge -
The Surgery Center

Jody Gilman - Eden

Dianna Habra - Kaiser Oakland

Bret Stover - Eden

Celerina Valiente -
San Francisco General

Marla Yockey - Sutter Tracy

September 11, 2001
What You Can Do...

To make a blood donation, please call 1-800-GIVE-LIFE or contact your local blood service organization. To help the victims of this and other disasters through a financial contribution, call 1-800-HELP-NOW to make a credit card donation. You can make a secure online credit card donation at: www.redcross.org /donate/donate.html.
You can also mail a donation to the American Red Cross, designating ïDisaster Relief FundE on the memo line of the check, at the American Red Cross, PO Box 37243 Washington DC 20013.

The Federal Emergency Management Agency (FEMA) is urging those interested in helping victims of the terrorist events to give blood or cash donations. Those interested in giving blood should call the American Red Cross blood donation hot line, at 1-800-448-3543. The American Red Cross can accept cash donations through 1-800-HELP NOW, and the Salvation Army can accept financial contributions through 1-800-SAL ARMY. Persons who wish to donate their services should contact their local American Red Cross office. FEMA does not accept donations, but works closely with volunteer agencies that provide a wide variety of services after emergencies, including child care, crisis counseling, sheltering and food. For more information about voluntary organizations active in disasters, go to www.nvoad.org.

Doings In D.C.
August 2001

As your chapter leader, I went to Washington, DC to learn more about our organization and some strategies to help improve our chapter. The conference was combined with the RNFA Forum and Lobby Days (AORN is lobbying Congress to get Medicare reimbursement for RNFAs). Here are some of the highlights:
Foremost, I think that the opportunity to network with the top leadership of AORN was the most rewarding aspect. President Sheila Allen was there along with Donna Watson (President-Elect), the board, and nominating committee.

It was interesting to attend the RNFA forum to learn about some of the issues they struggle with. However, the issues faced by hospital-based RNFAs are very different from those RNFAs working for surgeons in office-based practices. Classes at conferences in the future will probably address these different practice situations.

Susie Kleinbeck was present to speak about ïHot and Cold Research.E Nurses need to be consumers of research, and one way to do this is to do a meta-analysis. It is something we can all do in our spare time (!). Start with a topic of interest, then gather a number of articles on this issue, read them, critique them, and see what trends (if any) become evident. This information can be used in our everyday practice, we can use it to educate our managers regarding the need to change obsolete methods, and perhaps even save our hospital money.

The actual leadership conference consisted of lunch with the Board of Directors where we interacted with our board liaison (Debra Tanner). Following lunch, Cynthia DíAmour (a leadership coach and President of People Power Unlimited) spoke about strategies to stimulate enthusiasm, creativity, and commitment among the chapter leaders and our colleagues. The focus was on building effective teams and applying more successful membership development activities. Components of leadership are governance and management. Governance has to do with strategy, long range thinking and looking into the future. Management involves delegation, organization, communication, fiscal responsibility, and patience. Because we have so many different generations in our organization (Generation Me, Generation X, Baby Boomers, etc.), it is difficult to cater to all of them and keep everyone interested. Generation Me for example, when looking into an organization he or she wishes to join asks: ïWhatís in it for me?E Cynthia DíAmour says that there are three different reasons why people come to meetings:
1. Personal/Professional Development
2. Contribution to a Greater Good
3. Belonging to a Community.

So the key is to be trilingual. We need to be attentive to people and what they are looking for when they come to our meeting for the first time. By interacting with them we can figure out which category they belong to and introduce them to members involved in that particular activity. The two secret weapons to keep people coming are a caring attitude, and fun meetings. Most organizations are struggling to keep their membership numbers up. We can all do our share by inviting co-workers to meetings, hand out membership applications, talk about membership benefits, and how much fun our meetings are. Donít be discouraged if people say no. We just have to find out what their ïhot-buttonsE are. By doing that we can keep our membership numbers up, and be dynamic, fun, and a great community resource for perioperative registered nurses!

Submitted by Sophie Taylor

A Letter!
August 2001

Dear Colleagues,

In June 2000 I finished my MS degree and Acute Care Nurse Practitioner (ACNP) at UCSF. I had focused on Trauma/ER at school and had 14+ years of experience in the Trauma Department at Eden Medical Center. Included, as one facet of my job, was first assisting on emergent trauma OR cases. It seemed only natural to me, being in an educational mode, to check into the RNFA program. I didnít qualify via the regular route progression but as a NP I could take the class. The interesting thing is that as a NP in California you donít need any OR experience to first assist. You only require a surgeon who wants to hire/use/teach you and will sign for your Medical Staff Privileges request forms.

Knowing the surgeons that I do, and the professionalism that I intended to portray, I felt it was better to obtain as much official education and training as available, before I went to them looking for a job/work. I went through Professional Nursing Seminars in Taos Ski Valley, NM, whom I recommend, for my lecture/didactic content and arranged to do my 120+ hours of internship at Eden. I was able to intern with surgeons working on General, Trauma, Orthopedic and Neurosurgical cases. Each time assisting was a challenge as well as encompassing a broad range of experiences.

It took over three months to get through the political enmeshments and get to start my internship. The best thing I did was to go to the Vice-President of Patient Care Services (Rose) who cleared the way in a week. I was allowed to put up a letter of explanation, in the OR, looking for cases, but it was my association with the Trauma Department that finally worked. At first it was tough; I was new to the surgery and to most of the OR crews. It wasnít too long before they started to teach me more about sterile technique, patient positioning, and insightful thinking ahead on the case. I tried to learn anything. I know I got a few cases because they mentioned my name when an assist was being looked for. Some even kept up on my hours ïcountdownE and I got to feel more at home.

Iím not sure if it was just the way things work at Eden, or my poor communications, or the fact that each of the surgeons I worked with were helping me with OR hours and didnít need or want to hire someone in an assist role. This was their patient and I was trained and used more along the lines of what I viewed going on with other surgeons - you come in, assist, and leave - there was little, if any, pre and post operative patient training. The RNFA class prepares you to become more involved in patient care with H&Ps, pathophysiology, laboratory work and follow-ups.

I would like to say ïThank youE to all those in the OR who took their time to help me. Iíd also like to suggest that any RNFA, CRNFA, or person planning on becoming one that they go back to school and obtain their MS and ACNP. Youíve already made a commitment to nursing and to your patients - these will only enhance your abilities.

Sincerely,
Michael Adams, MSN, RN, ACNP, APRN, BC, CEN, CCRN, (awaiting my RNFA)

Thank You!
August 2001

Iíd like to thank the Scholarship Committee and the members for the $300 scholarship I received to attend the AORN World Conference in Christchurch, New Zealand in September. I plan to write a report about the trip and all I learned and experienced. Please look for it in the October newsletter. Iím sorry Iíll miss the first chapter meeting of the year but Iíll be in New Zealand at World Conference. Thank you for assisting with the financing of this trip!

Submitted by By Clenia Yadao