ACS meeting is opportunity to build collegiality Fog and sunshine. Benevolently inconsistent weather. Stone towers and sweeping bridges. Skyline and shoreline. Elegance and funky chic. Flying in a jumbo jet to riding a cable car.

These contrasts are San Francisco, the host city for the 64th Annual Clinical Congress of the American College of Surgeons (ACS) held Oct 16 to 20. Elizabeth Reed, RN, Board member, and I represented AORN at the meet- ing, attended by nearly 13,000 surgeons and 9,000 spouses, exhibitors, and guests.

The intense and impressive program was divided into general sessions, specialty ses- sions, postgraduate courses, audiovisual pre- sentations, forums on surgical problems, and a myriad of scientific and technical exhibits. There was something for everyone, ranging from a lecture on “Medicine, politics, and soci- ety” to an in-depth postgraduate course on “Surgical physiology of the pediatric gastroin- testinal tract.” A potpourri of events, including California wine tours, oriental palate pleasers, and lectures, were part of the special women’s program, intended for surgeons’ spouses.

I am impressed by the leadership and or- ganization of the College. The past year’s activities, directed by outgoing President Frank E Stinchfield, MD, FACS, New York City, and officers are numerous, and the con- tinuing leadership of ACS Director C Rollins Hanlon, MD, FACS, and the ACS staff is obvi- ous.

Throughout the week, I witnessed the esprit de corps among the surgeons, their respect for

s President’s message

each other’s accomplishments, and their de- fense of common goals. I admired pre- sentations in which they quoted from each other’s studies and used solid research data to clarify and advance their work.

The ceremonies were colorful, rich in tradi- tion, and showed reverence for past leaders in surgery. The opening ceremony was a pro- cession and introduction of officers and guests, featuring a historical talk about Philip Syng Physick, the father of American surgery. Beth Reed and I were privileged to be a part of the procession, introduced as AORN repre- sentatives and associates of ACS. This formal recognition was thrilling, because it sym- bolizes our close daily working relationship and our many common goals, both for local hospitals and nationally.

Several themes seemed to run through many of the presentations-economic and political struggles, autonomy, free enterprise, governmental regulation, and independence. Threats of governmental controls were dis- cussed many times. Speakers from health care systems outside the United States warned that certain types of national health insurance deter innovation. One speaker de- picted the “centralized fossilized care in Great Britain” as the antithesis to quality medicine. Another advised US surgeons to become in- fluential in the political process and remain leaders in the planning phases of new delivery systems in health. “Personal tithing of time” was recommended to surgeons as a means of getting their message to the public. “We must also get to the movers and shakers in the legis- lature,” he continued.

The operating room environment was dis- cussed before a standing-room-only audi- ence. Draping and gowning materials, antimi-

AORN Journal, January 1979, Vol29, No 1 9

crobiai agents, air quality, OR attire, and cleanup procedures are obviously of concern to practicing surgeons. AORN has struggled with many of the same issues, and the pro- gram, especially the question-and-answer period, was reminiscent of some of our own AORN Congress programs.

These environmental problems, so common to both surgeons and OR nurses, can best be solved when both groups participate and there is a consensus on standards.

During the week, we attended ACS commit- tee meetings where the issues of aseptic barriers, OR environment, and illumination in the OR were analyzed. Continuing studies in all these areas are indicated. AORN’s opinions were sought and respected.

The exhibit area was always busy. The technical exhibits were similar to those at AORN Congresses, but the scientific exhibits occupied a much larger space. Many displays were continuous audiovisual presentations of new surgical techniques and instrumentation. For example, a display of clamping instru- ments used in hysterectomies, showing pres- sure levels and tissue injury, recommended a new clamp, shown to be effective in reducing trauma and compressive force to tissues. AORN’s booth, in the scientific section, at- tracted many surgeon visitors.

“What’s new in surgery” is a popular session that summarizes latest developments in 12 specialties. We learned that coronary bypass surgery studies are accumulating, showing the increasing respectability of this procedure. (A full report on this program is published in this issue.) Host resistance was discussed several times during the week as a great concern to surgeons and a factor in infection and wound healing.

San Francisco is a city of contrasts, and so is ACS-a contrast of old and new, the past and the future. Perhaps another contrast is the old and new relationships between surgeons and OR nurses. We have a strong alliance in see- ing patients through surgery. As one surgeon told me casually, “Let’s not steal each other’s turf.” I replied, “Our turf is common, and let’s keep it this way.”

I feel honored to have been a guest at the ACS Congress representing AORN. My feel- ings of collegiality with surgeons have pleas- antly increased, and we will continue to work

together. Another step to building our collegial rela-

tionship will take place May 7 to 9 in Chicago, when ACS and AORN cosponsor a sym- posium on the OR environment. The sym- posium, consisting of five sessions, will be coordinated by the ACS Committee on Operat- ing Room Environment, of which Jerry Peers, RN, AORN executive director, is a member. Topics will include: infection, management of the OR area, environmental methodology, safety, and present and future status of regu- lations and accreditation concerning the OR environment. Registration will be limited to ap- proximately 100 surgeons and 100OR nurses, in teams of two from the same institution. A surgeon-nurse team must attend together. AORN is excited about this venture, believing it is one of many joint projects that will benefit surgeons, nurses, and ultimately, the patient. It is a fine example of our professional associa- tion. After all, who knows the OR environment better?

Barbara J Gruendemann, RN, MS President-elect

ANA and staff union agree on contract The staff of the American Nurses’ Association (ANA) was scheduled to return to work Nov 1 after being on strike for six weeks. Among other provisions, their new contract calls for pay raises and a union security clause.

According to the union, a major issue in the strike was unwillingness of the ANA management to agree to an agency shop clause. In an agency shop, employees must either join the union or pay a service fee equivalent to union dues. The union said the same provision is in many contracts ANA negotiates for nurses.

The new contract does provide for an agency shop but allows present employees to opt out during the first five days after the contract is signed. Those who do not wish either to join the union or pay a service fee may donate an equal amount to a nonreligious charity.

10 AORN Journal, January 1979, Vol29, No 1