Delegate Narratives - Nashville AORN - 2019

First of all, I just want to say how grateful I am to the chapter for choosing me to represent as a delegate at this year’s AORN conference. I had a wonderful time and learned so much, but I know it would not have been possible without the chapter’s support.

I enjoyed meeting so many like-minded people who are just as passionate about perioperative nursing as I am. It was also refreshing to see that so many others face similar situations in their facilities. I live in the little bubble of our own OR and the issues or successes we may have, but I learned we are no different from ORs around the country and around the world.

There were two sessions among the many I attended that really stood out to me. One was about preventing post-operative vision loss during prone surgeries presented by Muzuho OSI. I often am part of prone cases, so this session presented a lot of relevant information for me. The presenter discussed many case studies where permanent post-operative blindness occurred, including after five minutes of central retinal artery occlusion, and when a chlorhexidine solution used on the patient’s head dripped and pooled in the patient’s eye. He reiterated the importance of the role of the perioperative nurse to be aware of all aspects of the patient in surgery.

The other session that stood out to me was a special session with Colonel Nicole Malachowski. She is a retired Air Force colonel and former member, and first female member, of the Thunderbirds USAF air demonstration squadron. She was a phenomenal speaker who has overcome so much in her life to get to where she is today. One of the things she learned during her flying career was to loosen her grip when she hit turbulence, instead of doing what comes naturally—tensing and resisting. This can be applied to our careers and lives. Whenever we experience difficulties or changes that we may not agree with, instead of stressing and resisting, we can better approach the situation by being calm and flexible.

I enjoyed my experience at AORN tremendously. I felt as though I was contributing to the future direction and success of the AORN organization by attending congressional meetings, nominee presentations, and participating in voting for future board members, nominating committee members, treasurer, and president elect. I am grateful that I was taken in by Joslin, JD, Danny, Terri, Barbara, and Suzan and shown how to navigate the conference as a first-time attendee. I left with an increased vigor to contribute to the practice by participating in research and evidence-based practice decisions, working on a poster, and attending future AORN seminars held in our area. Thank you again for this wonderful opportunity!

Can we say that after every AORN Global Surgical Conference and Expo one can be reinvigorated, enthused and of course exhausting. I thrill of new information, new products and new friends to be made.

To be representing Dallas AORN as a Delegate is a distinct privilege that is taken seriously. I am proud to give my chapter a voice amongst the twenty-five thousand people there. As you may or may not be aware, AORN Guidelines have gotten a makeover. The 2019 book includes 33 guidelines for industry best practice. The updates include recommendations on:

·         Covering the sterile field during delays or portions that are not immediately in use. This is new to many of us, but has definite potential for maintaining a sterile field. Determining the need for physically monitoring the covered sterile field could be potential updates in facility policies. This would require that the table be positioned with the laminar air flow (a system of circulating filtered air in parallel-flowing planes in hospitals or other health care facilities).

·         Wearing a surgical helmet system when exposure to blood or body fluids is anticipated. I have only seen these hood/helmets used in total joints. I wonder what the reaction will be when this comes out.

·         Limitation of the surgical suite door opening. This is a battle we fight in a teaching facility constantly. We know that the foundation is there, but how can this be enforced? More to come from AORN Guidelines on this.

·         Safe patient handling and movement. Wight recommendations and seven ergonomic tools will help teams operate in specific scenarios, such as tissue retraction or a lateral transfer of a patient from a stretcher to a bed.

·         Design and maintenance: This guideline has been restructured to only address evidence-based design, construction, and maintenance in OR spaces.

·         Safe environment of care: Now, the guideline only addresses mitigating environment care risks in the OR.

·         Sterilization: The update provides more detailed and evidence-based practices within each step of the sterilization process.

·         Transmission-Based precautions: The guideline has been updated to address practice precautions to prevent transmission of pathogens in the perioperative setting.

As always, it is our responsibility to stay abreast of changes in our profession, and I wanted to share with you the latest information shared at this year’s conference.

Thanks to the AORN’s phone application, I was able to not only attend several presentations at the conference and gather evidence-based practice information for my research interest, but was also allowed the opportunity to watch videos of all the presentations. I ended up getting forty-five CE’s from the conference. Now you know why I am exhausted and excited to be there next year as your president. This conference reinforces my love for my career and my chapter.

This trip to Nashville represented my 35th AORN Congress. Thinking back to my first, one of the most exciting experiences ever!, I realize how very much has changed in my perioperative life.  When I attended for the first time, there were no concurrent sessions; we had a program with one choice per time slot and those not interested in “the business of the house” just had some free time. There was also a great deal of vendor-supported social activity, so it was a week of 19-hour days for my friend and me who missed absolutely nothing! I must admit that I like some of the changes that have been made over time: the addition of consecutive sessions and the move toward vendors investing in our education more than in our social lives.  I’m glad that we seem to be going back to treating the forum like a forum instead of a report-reading session. I do miss The Hub (a large room in which sessions already delivered were repeated as videos with headphones so attendees could listen to different presentation). That was an efficient way to use my time… no traipsing from room to room, though you do lose the opportunity to go to the mike and ask a question.

I support the concept of the one member/one vote approach to a democratic organization, though I realize it means that the majority will still rely on the organization’s active participants (far fewer in number than the passive members) to make decisions for them.  We’re appalled at the small number of votes cast, but it makes sense when you realize that today’s organizational members joined, to a great extent, for what they GET from an organization, not because they want to assume the responsibility of running the organization. We’re all MUCH busier than we were in my early professional years, and with the implementation of electronic communication, our choices for involvement mushroomed to nearly infinite.  Those who look upon the past as the good old days will just have to realize that they were different, not better – and stop criticizing!

My Congress experience is much different these days.  Since I’m not a clinician, and I have access to lots of clinical educational material through my CE Provider Unit, I concentrate on those presentations that focus on professional topics, like Cecil King’s presentation on Ethics, Michelle Deck’s (always delightful) presentations on ways to do a better job of things we need to do anyhow, and the general sessions whose speakers’ messages apply to all of us.

The most compelling talk I heard this year was Nicole Malachowski’s Pushing the Envelope: Being the Best When It Counts. I was both mesmerized with her experience as a female military officer and impressed with her successes. I mean, the THUNDERBIRDS, for heavens sake!! I was totally unprepared for the rest of her saga and the real reason for her talk. It’s hard to imagine the physical and emotional challenges she faced when dealing with a life-threatening condition that made no sense and a healthcare system that had no answers. I’ve never met him, but I think her husband is an angel for being there for her when she needed his support, his help, and his commitment … since he couldn’t understand what was happening to her any more than she could!

I believe that talk resonated with me because I believe so strongly in being there for others when you can be. I’m excited for our chapter that we have young members enthusiastic about perioperative nursing and willing to help the chapter become the resource that our young perioperative nurses need.  Those of us who have been keeping the chapter warm for them for so many years are cheering, and not necessarily from the sidelines! It’s fun being led by the young… it’s as much of an adventure for me as being led by my mentors when I was new.  It’s been a good year for Dallas AORN… and I’m looking forward to the exciting ones yet to come.

Okay, going to be honest here, when I initially stated that I want to go to AORN Expo, I thought “what have I done? and what do I expect to achieve?”  I just agreed to spend a whole lot of money and time and for what, exactly.  Sure, this was a great opportunity to learn, see new technology and network with other nurses like me; the age-old mantra, blah, blah, blah.  We hear this all the time and it means little or nothing at the end of day.  Yes, just a little jaded and like most professionals with ten plus years under their belt, more than a tad cynical.

Yes, bad news first, going to Expo is expensive.  As the days of institutions investing in staff training and networking that does not provide an immediate benefit to an institution or fulfill a regulatory requirement are gone.  So, yes, there are the costs of registration, travel, food and hotel. While there is help in the form of grants and stipends from individual chapters such it is limited but IT DOES EXIST.  So do the research, AORN Foundation does provide help.

Now, the good news, WOW, So worth it!  The scale, scope and energy of Expo are amazing.  Did not hurt that the venue was a beautiful southern city full of history and rich in tradition that much like our profession has had to reinvent itself into something modern and relevant to those it serves.

Continuing education, not just the standard vendor canned stuff that we normally see and to a certain extent dread, but presentations from our colleagues from all over the world, USA, Canada, UK, Netherlands, Israel and Australia, and every specialty with real world stories of a need to help those under our care, need to understand, need to address a problem and need to share what has been learned. Some of the stories were funny, some were heart wrenching, but all told with the authority of experience.  These addressed how to reduce OR turnover times, staff engagement, how to better collaborate with our Sterile Processing, Anesthesia, and Physician Colleagues.  How to Read and Understand Research Articles for Application to Practice so we can answer that age-old question “show me the evidence.”  Finding out the latest practices for Eye Surgery: Procedures, Complications and Prevention.  Hot button issue but an issue near and dear to the heart, Fostering an affirming Environment of Care for Transgender and Other Gender Nonconforming Patients which made a gay man confront issues in a new way.

Vendors brought their collective “A” game.  Latest technology demonstrated by those who helped engineer the product.  Giant manufactures such 3M, Aesculap, BD, Johnson & Johnson, KCI, Medline, Medtronic, Molnlycke, Smith & Nephew, Steris, Stryker, and Zimmer all brought their newest devices for hands on demonstrations.  Sponsored simulations and mock ups of real world scenarios to use a variety of devices.  Vendors provide hundreds of educational seminars to address Smoke Free ORs,”Go Clear.” Safe Positioning of Patients, as our patient populations grow larger and robotic devices needs, the newest protocols to address Surgical Site Infections, “ERAS.”  Of course, new ways to better handle, take care of and process sterile instruments.

Finally, the most important but hardest to define, networking with our fellow nurses.  To hear that we are not alone, to share war stories, to discuss solutions found with other nurses who understood exactly our experiences.  The energy and power gained by being in the presence of thousands of nurses.  To put on pink gloves, blue scrubs and dance till you drop with a thousand other nurses while being videoed for the cause of breast cancer is a memory that will never leave.  The desire to grow, to do better and to educate has ignited a fire that this old jaded and cynical professional did not believe could ever be rekindled.

Yes, AORN Expo was so worth it.

Joslin provided a unique narrative. Click here to enjoy