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Health Care Industry

Governing our profession

AORN Journal, Feb, 2005 by William J. Duffy

There is an old saying I believe in that says the world is governed by those who show up. In our country's governance, as well as in nursing's governance, I have seen the people who dedicate time and effort to the process shape the tone and rules. Those of us who sit on the sidelines can only complain when things are shaped in a way that is not comfortable for us.

Our last presidential election was a classic civics lesson. Americans went to the polls in record numbers and chose our leaders. Those who did not vote wasted an opportunity to shape history because, once again, the election came down to a single state determining the outcome.

NURSING GOVERNANCE

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Nursing governance is similar to our nation's governance. A few dedicated members of our profession work hard to shape policy, and there is a critical core of nurses who are interested in and participate in debates and discussions and who voice their opinions. Participation by this critical core of nurses is what lends legitimacy to our decisions. The voice of the grassroots members must be included in a decision if that decision is to become part of our nursing practice. The few leaders who write rules cannot change the course of our profession unless our grassroots members support changes in their practice. You, as an owner of our profession, must be involved.

Unfortunately, many nurses view perioperative nursing not as a profession but as a job. They complain about what is wrong with nursing, but they do not lift a finger to help make our profession better. I sometimes shake my head in wonder at these colleagues. They do not see that the future of nursing will have a direct effect on their professional and personal lives. They act as though they are powerless and whatever someone else or some group says is what must be done. They either have not recognized that some day they may be a patient and will need a strong nursing profession to make sure there are high standards for patient care, or they believe that their health care experiences will be fine no matter what happens to the profession of nursing. I think reasonable people would see either of those choices as a risky gamble.

SHAPING THE FUTURE

It is time to ask yourself what type of nurse you are. Are you a nurse who is interested in the future of our profession, or are you a nurse who is okay with whatever is put into place as long as you receive a salary? Are you interested in making perioperative nursing stronger, or are you just holding on until you retire? Are you interested in the legacy you leave the next generation of perioperative nurses? I am asking because it is time for you to decide what your role will be aswe work to shape the future of perioperative nursing.

During the next two months and at Congress in April, AORN members will be discussing the Association's position on key issues that affect the perioperative nursing. Each member will have to decide whether he or she wants to participate in this process and help shape the future of our profession.

FOCUSING ON ISSUES

Colleagues, at Congress last year, the Board of Directors promised you that we would spend the year focusing on issues that affect our practice environment. I believe the Board has kept its promise with National "Time Out" Day and with several proposed position statements on key practice issues. For the past nine months, committees and task forces made up of your peers have been working hard to develop position and guidance statements on such issues as

* fatigue from working long hours or on call without sufficient recuperation periods,

* the orientation of nurses to the perioperative environment,

* the role of the scrub person,

* entry into the practice of perioperative nursing,

* fire prevention,

* care of the patient with implanted electronic devices, and

* establishing minimum RN: surgical technologist staffing ratios for direct caregivers.

For too long, perioperative nurses have been silent about issues such as these that permeate our profession. Somehow, in our efforts to balance the needs of the patient, the surgeon, and our employers, we forgot to address the needs of nurses looking for guidance on how to achieve that balance as safely as possible.

Our silence has allowed external forces to influence individual practice environments, and I believe that, as a result, cracks are starting to appear in the safety net of our health care system. As the owners of our profession, it is time for us to establish our position on how to manage these and other practice issues.

PROPOSED POSITION STATEMENTS

This issue of the AORN Journal contains proposed position statements on several key practice issues that will come before the House of Delegates in New Orleans (see page 297). Please read these statements and their rationales, and then discuss them with your colleagues at work and in your chapter. We do not need a wordsmith review of these statements; we need a critical assessment of whether they are appropriate positions for perioperative nurses to take.

Health Care Industry

Governing our profession

AORN Journal, Feb, 2005 by William J. Duffy

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