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AORN Journal, Nov, 2002 by Jane Rothrock
Perioperative nurses may be ordinary people, but they are extraordinary nurses. During Perioperative Nurse Week, Nov 10-16, 2002, we celebrate our specialty and all that is good in our profession. Throughout history, we, as perioperative nurses, have refused to lower the bar on our professional practice standards. We have tackled difficult issues with collective energy and wisdom. We have politely declined offers from others to step in and solve our problems--and worked them out for ourselves.
HEALTH CARE AS A TEAM EFFORT
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One of the recommendations made by the Robert Wood Johnson Foundation regarding the current nurse shortage suggests reinventing work environments. (1) In part, there is a clarion call to foster cooperation among disciplines and place a high priority on health care as a team effort. In perioperative practice settings, the team is the essence of care delivery.
Perioperative nurses do not create professional silos. We have always worked in a culture of teamwork. We have a shared mission with our professional colleagues (ie, excellent patient care). We help each other as nurses, and we help the team achieve the best possible outcomes for the patients in our care.
We also understand the importance of helping novice perioperative nurses. Each of us can point to perioperative nurses who helped us early in our careers. Whether they were called buddies, preceptors, or mentors, these nurses helped us learn the work and values of perioperative patient care.
During emergencies, trauma, or national disasters, we each help our neighbor nurses. We can work tirelessly without food, sleep, or a break during such events, for we are like Milton's character in Paradise Lost. "Care sat on his faded cheek, but under brows of dauntless courage." (2)
THE QUALITY OF CARE
Care is at the heart of all nursing endeavors. Embedded in the nursing care we deliver is an organized body of knowledge, with sets of skills that relate to the science and technology of our practice.
Some would suggest that caring is an intangible part of perioperative nursing, and it is not as visible as the acts that require skill and technology. Most of us would dispute that statement, however, because caring is the core of our practice. We meet and recognize each patient as a unique individual and attempt to understand the human experience of his or her illness. We freely share tenderness, touch, and comfort with our patients. We hold a hand, dry tears, and provide a pillow and warm blanket as we engage in healing relationships. We are not just about sterilizers, instruments, and sutures. We are about caring practices that transcend aseptic or surgical technique. In the rush to be efficient, we relentlessly keep care sitting on our cheek.
ADVOCATING FOR OUR PATIENTS AND OURSELVES
Many times, market economics and cost management dictate constraints on our style of practice. In some instances, such constraints have led to collective bargaining. Historically, however, when nurses participate in a collective bargaining event, there are motives beyond mere money (ie, caring for and about patients, taking care). Consistent themes during different circumstances and different times have included poor working conditions, lack of professional respect, and inadequate salaries. Remedying each one of these components is necessary if we are to adequately and safely care for patients and take care of ourselves too.
Taking care of ourselves involves, in part, having the resources to engage in lifelong learning (ie, joining our professional association, attending some of its professional meetings). In 1918, it was noted "Nurses, we need nurses--a bleeding, wounded, sick and suffering world is calling." (3) That world still calls, and we still respond. To respond with excellence, we must have work environments that provide an orientation process, ongoing inservice programs, and other education to maintain and improve our competence and critical thinking skills.
DESIGNING OUR PATHS
"Life shrinks or expands in proportion to one's courage." (4) Each of us must live a life that allows us to expand ourselves. Life itself is a go and grow, give and get experience. Without growth, there is stagnation and a shrinking of meaning and purpose. We owe it to ourselves to take our own professional and personal inventory. Who are we as perioperative nurses? What fulfills us? What do we want from our nursing life, and what do we need in our personal life? Once we have identified those wants and needs, we have the ability to design a path to achieve them. Such a path may not be easy, but we can expand our lived experiences only if we have the courage. "Ah, yes--courage. If one only had that.... then life would perhaps be livable, after all." (5)
OVERCOMING OUR FEARS
In the perioperative nursing course I teach, each RN student must review an aspect of the history of perioperative nursing and relate it to what he or she understands to be an essential part of practice in 2002. Through the years, my analyses of student responses has revealed a stunning ability by these novice perioperative nurses to associate almost any historical area with patient advocacy. They have a clear, articulate understanding that their primary responsibility is to the patient.