Is Your Perioperative Disaster Preparedness Plan Really Prepared? -- Martha Smith
I was very proud of the Perioperative Disaster Preparedness Resource Manual presented at Congress. It was written by the AORN Disaster Preparedness Task Force of which I was a member. I hope many of you will see it and use it as a resource manual for your perioperative setting. It can be ordered through the AORN Bookstore.
The above title was a session I attended and gained more information. It was presented by John Eiland, LTC, MSN,CNS, and he will be joining the AORN Task Force with future publications. The overview of his presentation is in the Congress Resource Manual (received by all attendees at Congress), with the list of resource web sites. His slides will also be posted on the AORN website.
His main points were using your resources and COMMUNICATION, WE cannot prepare for 30,000 casualties, but we can prepare for what we can do in our Hospital/Surgery Center. Start with the accidents you can expect...earthquake, freeway/railroad accident with haz. mat. spill. Prepare for what your system can handle.."What-if's". Have plan so you can make instant decisions during the crisis. Plan multi-organizational relationships, not on the dramatic. Confirm scope of plan buy in of participants. Have a paper drill walk through, use real time internal and multi agency drills. The words "Communication" and "Drills" were repeated.
Nursing Leadership: The Crucial Ingredient -- Betsy Workman
H. Ross Perot brought a very important message for health care to our Congress. He stated that the American public trusts nurses and physicians. They should be part of the grassroots organization to write the new national health care system. He recommended that we (as a nursing organization) become involved and support a new bill that Senators Orrin Hatch (R-Utah) and Ron Wyden (D-Oregon) are conceiving. The new bill will attempt to reshape health care in this country from the ground up. Perot said that the bill, using engineering principles, would enble health care leaders to go to the grassroots level (e.g. hospitals, physicians, nurses, and insurance companies) to find out how to design a new health care system As Perto stats"You are the Architects." Perot said that the only way to persuade patients, politicians and others that this system will work is for physicians and nurses to be its champion.
Congress News - Norma Jean Myatt
As a delegate, I was involved in the process of electing new leadership for AORN. Each chapter is allowed to send a certain number of delegates based on the number of members in their chapters. I attended forums where we met the candidates, and heard them speak, and voice their opinions on the current issues. For me it was a rewarding experience to be part of the process on a national level. The roll call for all 50 states was fun as it gave each state a chance to voice what they were famous for. We also got to trial a new electronic device, which allowed us to vote by pressing a keypad, then getting instant results, which were displayed on the large projection screens. The delegate hall was huge, and probably sat at least 8000 people, so big screens were necessary. On Thursday morning we voted, and then had a closing session in the afternoon giving us the results of the election. When not busy with the business of being a delegate, I attended several educational sessions, and also had time to meet with some friends. Saturday evening I attended the awards dinner, where our chapter received an award from the president. On Sunday night our chapter all met in Betsy Workman's hotel room, and had an "Oscar Night' party. Tuesday night found us at the navy pier, for a dance party. The week flew by, and I certainly had a good time.
A Big Thank You . . . -- Arleen Sakamoto, LT, USNR, Nurse Corps
During Congress, every chance I had, I thanked the uniformed Armed Forces personnel for serving our country. It seemed like such a small gesture. I can even seek them out when not in uniform. On my way to the Scanlon Party on the shuttle, I asked the person next to me, "Where are you from?" He answered, "Texas for now." That was a give away. I probed a little more to find out he was active duty Air Force. None of his colleagues were around, so he joined our table. We compared notes for about an hour on the Air Force vs the Navy (my background). Before leaving, it was a proud moment to shake his hand and thank him for serving.
I found a heart touching reflection to share: "They inspire us with their strength of character, courage under pressure and determination to succeed. They are our Heroes". Anonymous.
A Natural Appriach: Herbs for Stress and Anxiety - Jane M. Murphy, RN,CS MS, PNP
In this fast-paced world, few people are not under some type of stress or anxiety in their daily rountine. With herbal use on the rise, many consumers are looking to herbal remedies to help alleviate stress and anxiety.
St. John's Wort (SJW): The Latin name Hypericum means "over an apparition," a reference to the belief that the herb was so obnoxious that evil spirits would depart the premises quickly upon taking a whiff.
SJW, the name has it's origins in christian folklore. One belief held that the red spots on the leaves appeared during the anniversary of St. John's beheading and symbolized his blood.
For anxiety and nervousness, the Amish did not traditionally take it internally as a remedy for depression. Instead, they hung the herb over the barn door or house door to keep out witches and their spells.
In 2000, SJW was rated #2 in the U.S. and Europe as top herbs used (Drug Store News). GerbalGram reported $56 million retail sales for this top selling herb in 2001. It has active constituents that exhibit strong antiviral activity against different flu viruses and herpes simplex virus types 1 & 2. Oil based preparations of SJW have been historically recommended for the topical treatment of burns and wounds. Today, the most common use is for mild to moderate depression.
People with fair skin should avoid exposure to strong sunlight and sources of ultraviolet light while taking SJW. There are known durg interactions with certain antidepressants such as selective serotonin reuptake inhibitors (Prozac, Zoloft) and tricyclics (imipramine, amitriptiline). It may reduce absorption and blood levels of drugs such as digoxin, cyclosporin, indivir, theophylline and warfarin.
SJW is one of the many herbals for perioperative nurses should be aware of, concerning the possible consequences.
Other herbals listed and talked about for stress and anxiety were: chamomile, American ginseng, Asian ginseng, kava kava, passionflower, and valerian.
Aromatherapy is the therapeutic use of essential oils, derived from plants. Nurses in the United Kingdom are insured by the Royal College of Nurses to use essential oils, topically, and inhaled, for improved patient care, without a doctor's specific instruction. Aromatherapy is used by nurses in Australia, New Zealand, Canada, Germany and Switzerland. More than 30 states in the U.S. allow the use of complementry therapies (including aromatherapy) as part of holistic nursing care.
Aromatherapy can produce both psychological and physiological effects. The psychological effect of aroma can be rapid and may be relaxing or stimulating depending on the chemistry of the essential oils used. Jane Murphy listed the following essential oils for stress and anxiety: bergamont, jasmine, juniper, true lavender, lemon balm, orange blossom, and Ylang Ylang.
Various herbal teas in their packages were distributed amongst the lucky birth months announced. Then we had a fun exercise trying to determine different aromatic essential oils that were passed around
Thank you for allowing me to serve as a Delegate for the San Francisco/Marin Chapter this year.
It was another fabulous Congress. The education sessions I attended were absolutely first-rate.
Our own, Linda Groah, is phenomenal. She presented several outstanding leadership/management sessions.
Congress in Chicago -- Sylvia Durrance
Congress in Chicago was great. I was fortunate to be able to arrive Thursday evening to assist with Nominating Committee booth set up Friday morning. The layout this year was a bit different. On entering the McCormick Place Convention Center, the Registeration Area, the Exhibits and the Bookstore were all adjacent to each other. A Resource Center was set up immediately in front of the entry to the exhibits with open carrels in a large open circle for all the national committees, The Foundation, Opportunities, and other member sevice groups. The center of the circle contained couches and chairs for members to relax on. Starbucks(R) coffee, soft drinks and water was provided for the members.
Snow in Denver slowed the arrival of a number of AORN staff members and volunteer members assisted with setting up and manning the resource booths on Friday. I was privileged to assist Presiden-Elect Betty Schultz in setting up the AORN Traveling Museum. It was exciting to be able to actually touch some of the museum items and to see some of what goes on before all of us arrive to enjoy Congress.
The Convention Center is huge and two wings were connected by a bridge with a view of the river on one side and the magnificent Chicago skyline on the other. Registration, the Exhibits, the Bookstore and the Resource Center were on one end of the bridge, and the general session hall, research posters and headquarters offices were at the other end. Classrooms were located on both wings. This year a Life Style Pavilion was set up adjacent to Headquarters. There were exhibits of jewelry, books, cosmetics, artwork and chapter items for sale. This area was open from Friday until Monday to avoid interfering with the health care exhibits.
There were many great presentation, but the one I enjoyed most took place post Congress at the annual President's Breakfast and Leadership Session where the new president gives the committee charges. The educational presentation was called "Come on Baby, Light My Fire". Donna Wright, RN,MS, who is a Staff Development Specialist/Consultant with Creative Health Care Management, presented it. The objectives were to identify ways to put the fire back into daily work, discover strategies to fire up team and spread the fire to other departments for better collaboration. Ms. Wright's presentation was presented in a humorous manner that had everyone crying with laughter. A point she made that had a great deal of meaning for me is that there are two roles in health care: M for management (setting direction, philosophy, and expectations and supporting staff growth and development - managers, directors, department heads, vice presidents, etc.) and S for service (direct service to patients and routine supervision - care providers, charge nurese, team leaders, etc,). She stressed that these roles balance each other. You can either have a capital M or a capital S, but you cannot have both capital letters. The point is that you have to recognize what role you are in and work in collaboration with members of the other team to support each other. In other words, you must develop balance. She also spoke about a method of team development in which staff members ask each other "what have I done to make your work a success today?". This daily exercise leads team members to develop by seeing the difference that even small acts make on the lives of others. While none of this was new material, the manner in which it was presented struck home for me. Ms. Wright also included a bibliography which I plan to make use of.
AORN Congress History - Kate Gustafson
The first gathering of OR Nurses was fifty years ago in New York. They met to exchange information and ideas. The first four years the organization was called a Conference and the fifth year the meeting became known as AORN.
the AORN Congress sites were chosen by local groups bidding for the location. Gordon Marshall, editor of "Hospital Topic Magazine." was responsible for planning, and along with the local committees, who did a lot of the work from1954 to 1973. The system changed in 1973 when AORN headquarters staff members planned and carried out the events of the congress. The organization was growing.
Many activities contributed to the energy of congress. The Delegates' Breakfast turned into meet the Candidates, and running for office eventually lead to the House of Delegates.
Many things affected education at Congress, including the status of women and the evolving needs of Nursing. The topics at Congress have always been on the cutting edge of the times.
Also don't forget the entertainment of the meetings. It started out with Davis and
Geck having coffee at the first "Conference". The first exhibitor's party was held in 1957. Later cocktail parties, Bingo night, and Fashion shows. Exhibitors elegant dinners where wonderful evening after a day of classes and exhibits.
The first Keynote speaker for AORN was in 1962 and the first awards were given out in the same year.
Things have really evolved through the years with merging and cost containment. It was nice to hear about years gone by.
Surgical Techs Support Perioperative Nurses! - Alice Erskine
At the Opening Session of AORN's 50th Congress in Chicago, representative of several professional associations brought greeting to the members. Sandra Edwards, President of the Association of Surgical Technologists (AST) made a statement that brought the house ot its feet: "The Assocation of Surgical Technologists believes that every patient deserves a Perioperative Nurse and a Certified Surgical Technologist!" For those of you who have seen the battles with the Health Care Financial Administration (HCFA), and state legislators over keeping the registered nurse in the O.R., this is a miracle.
But why the change in policy by the surgical techs? There were several factors that have redirected the priorities of the AST.
1. AORN now supports the Registration of Surgical Techs. This means more recognition for ST's but also more regulation of their education and practice.
2. Nurses have more political clout than ST's. At the state level, ST's are finding it an uphill battle to obtain licensure and other forms of recognition. This is because Perioperative nurses have as their allies many other nurse associations who support their cause. And nurses vote more often than other political groups
3. Technological advances in the O.R. have skyrocketed necessitating 'Someone' to act as a Resource. The AST would like that 'Someone' to be the ST since their focus is already technological. To that end, the AST has made major revisions to the Core Curriculum for the ST to include such topics as Physics, Robotics, Computers, Electricity and Electronics.
With this change in policy, AORN and the AST are ready to sit down and work toward making the O.R. a safer place for their patients. One place to start is to make it mandatory that every ST be certified. Research shows that certification is associated with better patient care. Certification requires the ST keep a record of continuing education. Registration of ST's would require certification. This is why AORN supports Registered Surgical Technologists.
Becoming Politically Active - Toots Sweeney
One of the most interesting sessions that I attended at our 50th AORN Congress in Chicago was this one - on how YOU can become more active in politics - local, state, and federal.
The three speakers were "Burke Beu, legislative Analyst for AORN in Denver, Fred Franko, Director of State Public Affairs for AORN IN DENVER, and Melody Mena, a perioperative nurse from Georgia.
They stated strongly that it is vital for registered nurses to increase their political awareness, and to become more involved in public policies - RNs must be at the table in forming legislation that affects our practice, and the well being of our patients, and the whole area of community health care.
RNs have the specific knowledge and the skills and they are viewed extemely favorable by the public and our elected officials - therefore, they have the ability and the clout to affect political outcomes. We, as nurses, know what will and will not work. However, nurses do not exercise their individual and collective power - we must get more involved!
Some avenues of involvement suggested were:
1. Be an informed voter and vote!
2. Know the issues
3. Identify yourself as an RN
4. Volunteer on compaigns
5. Volunteer to work the polls on election day
6. Call, write, or e-mail your elected officials - local, state, and federal - delvelop a relationship
7. Attend lobby days in Sacramento and in Washington, DC.
8. Become a medical resource for elected officials
9. Testify at hearings on bills relating to nursing - write letters to the editor of local papers
10. Run of office yourself or encourage other RNs/colleagues to do so AND support them with time and money
As Melody stated, "You can't learn to swim untilyou get into the water!" She became politically active a few years ago, and is now running for county commissioner - "If we can't find someone else to support our views and to do what needs to be done, then we must be willing to do it ourselves!'
As nurses we know the value of persistance - it's hard to beat a person that never gives up. Become that person - becoming politically active is just another venue of being a patient advocate.
YOU can and will make a difference - become politically active and involved.
PNDS Has Multiple Applications: Ethics, Education, Benchmarking, and More - Shelley Carroll
As usual, I attended all the sessions I could on the Perioperative Nursing Data Set. The first was "Health Care Ethics for the Next Generation presented by Cecil A. King, RN, MS, CNOR from the University of Washington Medical Center. Cecil listed the ethical issues in perioperative nursing: 1) cost containment; 2)prolonging life; 3) informed consent; 4)irresponsible / incompetent / impaired colleagues; 5) staffing; and 7) standards of practice. He discussed the PNDS ethical outcome indicators of safety, freedom from asquired injury, and behavioral responses of the patient and family. He also pointed out that one of our hard tasks will to be to respect the rights of others to make choices with which we do not agree. Cecil presented the Four-Box Method of Analysis, from Jonsen, Siegler, and Winslade's Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine. It lists questions for ethical considerations in the four areas of Medical Indications, Patient Preference, Quality of Life, and Contextual Features. This was an intriguing discussion about a difficult subject.
I also attended the faculty program presentations on "Integrating the Perioperating Experience," which included Susie Kleinbeck's presentation on "The Perioperative Nursing Data Set" and "Utilizing the OR for Clinical Experience." This material was not new to me, but it was interesting to hear both the presentations and the faculty responses and discussion.
"Using PNDS to Develop a 'Balanced Scorecard' for Benchmarking Quality Indices" was presented by Renae N. Burchiel Battie, RN, MN, CNOR from the University of Washington Medical Center, and Annette M. Dopp, RN, MN, CNOR from Evanston Hospital in Illinois. They pointed out that it is impportant to 1) share data that is comparable; 2) set standards across settings; 3) make correlations; and 4)use PNDS outcomes to connect clinical activities with financial indicators. Pertinent quality indicators need to be identified in the clinical, operational, financial, and institutional quadrants of the Value Compass, particularly looking at procedures that are high risk, high volume, and / or high cost. PNDS outcome indicators tie together policies, competencies, and standards / plans of care.
For me as a clinician, the application of the PNDS to documentation that is measurable and comparable across settings is its primary advantage, but, as you can see, it has many more and varied applications!
Once again, thank you for allowing me to represent you as an AORN Congress delegate.
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