Determining our destiny through connectedness - Association of Operating Room Nurses - Column

AORN Journal, June, 1998 by Ruth P. Shumaker

As your AORN President, I believe that the choices we make determine our destiny. Making the right choices, together, is accomplished with elements for success that are currently in place. These elements include a talented and diverse membership, a committed and visionary board of directors, strong industry supporters, and a Headquarters staff that has always met challenges with resolve and vision. I have chosen committee responsibilities, new task forces, and foreseeable priorities to strengthen our Association's viability and destiny.

STRENGTHENING OUR FOUNDATION

The theme for the 1999 AORN Congress, "Bridging the Centuries," symbolizes our move into the future. The oldest bridge still standing in Rome was built in 62 BC. It is still standing because it was built on an extensive foundation that must support the weight of what is crossing. AORN also has an extensive foundation, the strength of which will continue to be tested many times.

Nursing's strength has also been tested over the centuries. During the postwar era, there were significant changes to both society and health care. The demand for health care and the need for health care workers grew during the 1960s and prepared us for the next decade. By this time, health care was the third largest industry in America, with some evidence that hospitals had become grossly overused. From 1980 to 1990, depending on one's vantage point, health care was in either the best or the worst of times. Cost in general became a major concern. Hospitals became more businesslike in their governance and management. Alternative care delivery settings such as surgical centers opened their doors. Managed cue was promoted as one viable solution to health care utilization and expense, Today, we are faced with the challenge of moderating increases in health care expenditures without affecting quality.

After experiencing the 45th AORN Congress in Orlando, Fla, talking to fellow perioperative nurses and sharing ideas, I sensed a collective strength and enthusiasm from our members. Although these feelings have been renewed at previous Congresses, the difference this time was a sense that perioperative nurses are prepared, more than ever before, to manage health care challenges with foresight and vision--a sense that we are in control as we have never been before. These feelings reminded me of a story told by Charles Swindoll that reinforces the benefits of using collective strength and persistence.

A mother and her nine-year-old son attended a performance of the famous composer-pianist, Paderewski. The affair was a high-society extravaganza with tuxedos and long evening dresses. The mother was hoping her boy would be encouraged to practice the piano if he could hear the immortal Paderewski at the keyboard, and forced him to attend.

The son became weary of waiting and squirmed constantly in his seat. As his mother turned to talk to friends, her son slipped away from her side, drawn to the ebony concert grand Steinway and its leather tufted stool on the huge stage flooded with lights. The boy sat down at the stool, placed his small, trembling fingers in the right location and began to play "Chopsticks." The crowd hushed until they saw what was happening and began to shout: "Get that boy away from there! Where's his mother? Who'd bring a kid that young in here? Somebody stop him!"

Backstage, the master overheard the sounds on stage and put together in his mind what was happening. Hurriedly, he grabbed his coat, rushed toward the stage, and without one word of announcement, stooped over behind the boy. He began to improvise a counter-melody to harmonize with and enhance "Chopsticks." As the two of them played together, Paderewski kept whispering in the boy's ear, "Keep going. Don't quit son. Keep on playing. Don't stop. Don't quit."'

PERSISTENCE IN OUR ENDEAVORS

Combined talents of the boy and the master resulted in a collective strength. Along with persistence--a "don't quit" attitude--they turned what was perceived as a negative situation into something positive. As we seek ways to manage changes, we are sometimes left with a feeling of insignificance--like playing "Chopsticks" in a huge concern hall. During times like these, working together, using our unique skills, supporting each other, persistence, and showing enthusiasm can provide just the right touch at just the right moment.

Perioperative nursing as we know it today may not exist in the future. The traditional OR may not endure--we can no longer expect the patient to come to us. Surgical procedures will take place in areas within and outside of the hospital, including radiology and emergency rooms, physician's offices, and nursing units. Perioperative nurses must be prepared to care for those patients and contribute tools (eg, standards and recommended practices) to provide the best care possible.

STRATEGIES FOR CONNECTEDNESS

During the last year, the Board of Directors persisted to develop plans to ensure connectedness between perioperative nurses. They continued work from the previous year to address the diversity, mobility, and desire for choices by perioperative nurses. The Board's vision for our membership to be informed and influential inspired further examination of ideas that would provide a strong and connected membership. At Congress, the Board shared several strategies to meet member needs for connectedness.