a President’s message

tions and practices. But operating room nurs- ing practice has been expanding into the preoperative and postoperative phases of pa- tient care for some time.

The definition has generated excitement

Perioperative role,

OR nursing’s future certification shape

v

because the Proiect 25 Task Force has taken When I was asked to speak on the future of operating room nursing at a recent workshop sponsored by the San Fernando Valley Chap- ter, I had an opportunity to dream about the ideal tomorrow. Every operating room will be a model of excellence, and every operating room nurse will be the knowledgeable, skilled, and dedicated epitome of perfection. As I pre- pared the paper I was to present, I became engrossed in the reality of our current practice. While my idealistic dream of perfection for the future will never really exist, I do believe the present can be better and we can come closer to that dream.

Like other health care disciplines, nursing faces philosophical, scientific, and technologi- cal changes, while at the same time trying to retain its balance in responding to the humanistic needs of both patients and nurses. We are continually confronted with proposals for change in our present practice that tend to create conflict if they are not incorporated smoothly into our familiar routine. For exam- ple, we are asked to make a decision concern- ing the minimal educational requirement for entry into practice as a registered nurse-a decision which will have a profound effect on nurses in the future.

At our recent Congress, delegates approved the definition of a perioperative role for the operating room nurse. This definition is not revolutionary. I am sure there are some nurses practicing in the operating room who see the perioperative role as a whole new set of func-

the current role and defined a total role for the OR nurse. The newness of the role is in the extension of responsibility beyond the arena of the OR to a greater extent than has been prac- ticed. Also, the role is defined in purely nursing functions. Preparing for each patient’s unique needs will still be the inportant function of the registered nurse practicing in the operating room.

But a definition does not create an operating room nurse. Practice must give substance to the definition. This year, a Project 26 Task Force will facilitate the smooth transition of the role into practice.

By whatever path we enter professional nursing, it is still a unique blend of knowledge and skill that exists in a world of real people. These people require a “carer” who has the ability to translate scientific principles into a personalized plan of care. This plan of care is designed to restore and maintain an accept- able state of mental and physical well-being, or to facilitate the acceptance of those limitations that cannot be altered.

The decision of a registered nurse to func- tion in a specialized area must be based on knowledge of that specialty and the definition of the role. If the registered nurse in the operat- ing room is not permitted to function within the scope of that role, she is being cheated. In turn, the nurse is cheating the patient if he or she cannot bring into play all the information and skill necessary to achieve the desired goals for the patient’s well-being.

AORN Journal, July 1978, Vol28, No 1 9

Closely related to the perioperative role is the decision of the House of Delegates to ap- prove a certification program and establish the Council on Certification, As we have discussed certification as a validation process for operat- ing room nurses, I have sensed and heard concern expressed by OR nurses about their ability to become certified.

Most of us have obtained our skills on the job. Postgraduate programs in operating room nursing have been few, and recently the number has dwindled. For the most part, the “school of experience” was a good one. We have a great number of highly skilled operating room nurses to prove it.

Then, what will certification accomplish? It is my belief that this validation process will be the catalyst that will clearly identify the practice of OR nursing. For the nurse who successfully achieves certification, it will confirm his or her base of knowledge and skills. It will also provide a means of identifying areas of defi- ciency. The title, “RN, Certified,” implies the possession of knowledge essential to the specialized practice of OR nursing. For the patient, the public, the employing agent, and our physician and nurse colleagues, certifica- tion will be tangible, visible evidence of profes- sional achievement and accountability.

One of the decisions to be made by the Council on Certification, with input from the committee on test specification, item review, test review, and the item writers group, will be concerning the body of knowledge essential to operating room nursing. Once this has been determined, a series of seminars will be con- ducted by AORN to provide guidance and in- struction in the essential areas of operating room nursing practice. These seminars will assist the applicant in preparing for the exam.

The certification process will emphasize that operating room nursing practices are per- formed in accordance with sound scientific principles, for example, the care of the diabetic patient includes special protection of pressure points. We each utilize basic medical-surgical knowledge to a far greater degree than we recognize.

With the definition of the perioperative role of the operating room nurse and the certification process, it will no longer be necessary for the nurse to be at a loss for words when asked to describe what the operating room nurse does.

What we do will change if there is a need for change, but that change will be based on a better understanding of the principles in- volved. We may also be able to translate more easily the theoretical definition of our specialty into daily practice.

Jean E Davis, RN President

Pension plan decision supported by ANA The United States Supreme Court has ruled in Manhart v City of Los Angeles that pension plans requiring women to contribute a greater portion of their salaries than men because women live longer is illegal.

ruling, in which ANA filed an amicus curiae brief, Anne Zimmerman, ANA president, stated that “ANA is strongly committed to the eradication of all forms of discrimination on the basis of race, sex, and other arbitrary classifications. We are encouraged by the court’s action in correcting these pension inequities.”

The American Nurses’ Association has filed nine Equal Employment Opportunity Commission sex discrimination charges across the country contending that existing pension plans in which costs and benefits are based on separate actuarial tables are illegal. In 1975, ANA filed suit in a Federal District Court charging the University of North Carolina, Chapel Hill, and Teachers Insurance and Annuities-College Retirement Equity Fund with sex discrimination in the university’s pension plan. This litigation was stayed pending a resolution of the Manhart case.

In commenting upon the Supreme Court’s

10 AORN Journal, July 1978, Vol28, No 1