There were interesting discussions at the February 3, 2001 ORNCC meeting - both during the meeting and at lunch. Every chapter is experiencing membership and activity problems. During the meeting, I sat between members of two chapters at extreme ends of the spectrum.

One RN was from a 68 member chapter (Sequoia). Sometimes, there are five people in attendance at a meeting. One time, there were 30 people. Geography plays a role in the attendance (some chapters cover great distances). Attitude does too. People work all day and then just want to go home and not be reminded of their roles as RNs. They simply want nothing to do with nursing after their assigned work shift and call duties. They have family obligations or simply obligations to themselves. They want free time and they�ll take it.

The other RN was from a chapter of 289 (L.A.). The attendance at their meetings was about 25-30 (my lunch companion told me this - she too was from L.A.). So their attendance averages 10%. Alameda County averages about 14% of the total membership who attends meetings. The local chapter where I live has superb speakers with two free contact hours and the turn-out has been about 14 people which I thought was sad (total membership is 105). But that turn-out is 13% of their membership. It�s discouraging to always see the same people and assume there�s widespread disinterest, but it�s not a local phenomenon.

Jane Kuhn of the L.A. chapter asked if people wanted to start a task force to see if there�s anything that can be done to spark interest in local chapter meeting attendance. L.A, San Gabriel, and San Fernando chapters hosted a joint meeting with President Brenda Ulmer as the speaker. The attendance was about 30 due to a torrential downpour that night. The traffic was a nightmare and the driving was dangerous so people living miles away stayed home. When Alameda County and Contra Costa County hosted President Patricia Seifert on a Saturday a few years ago, the attendance was nothing to brag about. The weather was fine and it was a Saturday. People simply seem to not be interested in contact hours, classes, or furthering their knowledge. Jane Kuhn wanted a task force to explore different ways to attract and keep interested nurses.

In talking with my new co-workers, the cost of membership is a deterrent. Leaving work and then returning to a two hour class (with two free contact hours and superb speakers) wasn�t enticing. What is the real reason? One nurse said she has to go home to her children. Yet she�ll stay hours overtime and work. But she won�t attend an AORN meeting - and she�s a new OR nurse still learning. My new OR has an OR training program where AORN membership is not mandated or encouraged. The OR manager and former manager are not members. One of the new trainees ignored the stack of AORN Journals I gave him to read (he has now returned to his original nursing unit).

I know I attended one AORN meeting when I first joined AORN when I was 21. That was my one and only meeting for the next 3 years. I viewed it as a coffee klatch at someone�s house and it was very boring and I saw nothing accomplished. When I moved to the L.A. area, I went to some AORN meetings where there were speakers and contact hours. But it seemed there was an old guard entrenched and I never became active. I wasn�t made to feel welcome but I also made no effort. There were only one or two others at work who attended meetings. I felt isolated and alienated from the group. When I moved to Northern CA, I attended meetings but was never truly active in Contra Costa or Alameda. I tried to join some committees but their goals and my goals differed. With one committee, we met in a restaurant bar (I couldn�t tolerate the smoke - back when smoking was permitted!) and the meeting started late (my pet peeve). The committee meeting took 15 minutes and then everyone wanted to go eat. I wanted to go spend time with my husband - not with a bunch of older women in a restaurant! Now that I�m one of those older women, I can see why we�re not attracting the younger nurses. Why spend two hours at a meeting when you can get your 30 contact hours in a home study course that you spend two or three hours completing? Why spend time driving and time away from your family or friends? Why interact with a bunch of older women/men who have no similar interests and use the meetings for socialization?

We have to offer something different to the newer OR nurses. L.A. is going to make their newsletter available only on the internet. We can�t do that because so few members have internet access. We also derive income from advertisers and we can�t advertise on our free web site (it�s against the rules). We really need to devise ways to make local chapter membership appealing to all ages of periop nurses (yes - �periop� - we need to solicit members from GI lab, cath labs, admit areas, PACU, etc.).

Submitted by Mary Ritchie

The History of Our History
February 2001

In the early 1940s, Edith D. Hall wrote a resource of operating room technique. Miss Hall also organized a two-day seminar in New York City to determine the needs for an organization of operating room nurses. The primary aims of the organization were to keep abreast of new methods and techniques, teach others in the operating room specialty, and all operating room nurses were to be included. The response was so great she continued her pursuit across the United States to appeal to all operating room nurses, through the operating room supervisors, to structure an operating room nurses organization.

The First!

The First National Conference of the Association of Operating Room Nurses was held at the Hotel New Yorker, New York City, February 1 to 3, 1954. The driving force in planning the meeting was Edith D. Hall, president of the Association Of Operating Room Nurses of New York City.

Success!

Plans for the conference were made in a surprisingly short time with no indication as to its success. When 1200 nurses registered the first day, it exceeded all expectations and was evidence the individual groups could support a national organization. By the end of the three-day conference, approximately 1700 nurses and 300 guests had registered.

Topics

Program topics included "The Surgeon and The Operating Room Nurse," "Methods of Improvement In the Operating Room," "New Trends in Surgery," "Better Planning of Schedules for the OR," "Positioning and Draping of Patient in the OR," (using a live model and the latest equipment) "The Surgeon�s Responsibility to the OR Nurse," "Training Surgical Tech Aides," Bacteria Must Not Survive," and "Problem Clinic."

Problem Clinic

Proving the most popular at this and succeeding conferences, the "Problem Clinic" was structured for members of the audience to ask questions relating to problems in their institutions. They could direct these questions to any member of a panel composed of a surgeon, anesthesiologist, director of nurses, operating room supervisor, operating consultant, bacteriologist, administrator, and sterilization authority.

Where Do We Belong?

What might be the forerunner of the House of Delegates sessions was a program "Where Do We Belong?" attended by a delegate from every AORN group. Representatives from the American Nurses Association, National League for Nursing, and local Associations of Operating Room Nurses discussed the relationships of the groups and the linking of AORN groups.

49 Exhibitors!

Delegates from each AORN group later supported future conferences when they voted to hold a second meeting January 24-27, 1955, in St Louis. A national planning committee was formed with Miss Hall acting as coordinating secretary. She in turn appointed a chairman of finances and advisory council. Approximately 49 companies exhibited products, which was a "new experience for the technical exhibitor," according to Miss Hall. "For the first time , a group composed solely of operating room nurses gave the exhibitors an opportunity to meet and talk details with those who actually use their products." Tours of hospitals and manufacturing facilities were available.

We�re the First!

In 1957, Alameda County and Contra Costa County formed the first AORN chapter in California. Officers were President, Marrian Anderson; Vice President, Avis Gibson; Secretary Barbara Whited; Treasurer, Margaret Jones; Board of Directors, Dorothy Hud, Evelyn Wade, Ardith Boughton, Dorothy Thompson, Clara Rafferty, Jacquline Moran, and Ruth Davidson.

We�re 44!

In 1961 Contra Costa County went out on its own. Alameda County alone remained the first chapter in California. We are 44 years old! This history has been taken from our chapter's files, kept by the historian.

Submitted by Martha See

The Golf Tournament That Nearly Was
October 2000

It was a great plan. We would have one great big fund raiser for the chapter. We would have a golf tournament. It had been successful for every chapter who had tried it before. It would work for us. We have a new golf course in the area and surely every golfer would want to try out the course. �But we�ve never done it before.� True, but perioperative nurses are resourceful and we could figure this out.

And we did. The Ways and Means Committee gave it their all. Kathie Shea secured the course and had volunteers recruited and ready to work the tournament. Mary Ritchie designed the flyers, posters, advertisements for the newsletter, and put it out on the web. Beth Mar finalized details for the tournament and made numerous phone calls and faxes to obtain sponsors. Ann Ceasri acted as treasurer. Martha See and Pam Reuling selected the luncheon menu. The committee assembled posters for chapter facilities. Prizes were obtained. (And they were great!)

Then came the painful realization that golfers were not signing up. We again pressed on, receiving either rebukes or empty promises of participation. We extended the deadline. We needed 60 golfers. We had 22, including three companies who sponsored a total of ten golfers. So we made the critical decision to cut our losses and canceled the tournament. Checks are in the process of being returned.

It is unfortunate that some of life�s lessons are learned through adversity. I hope the membership will make time to say a special thank you to those reps. who were there to support our chapter.

Thank you to Kathie, Mary, Beth, Ann, Pam, Martha, Sophie Taylor, Clenia Yadao, Donna Rodgers, and Evelyn Steen for all your efforts.

Submitted by Donna Benotti, Chairman of the Ways & Means Committee

Corporate sponsors
Stryker Endoscopy: Jim Garvin
Pacific Medical: Jerry Doll
Healthsouth: Karen Stevens, RN

Hole Sponsors
Paladin Medical (Holmium laser): John McIntyre
Synthes: Jay Wisner
Medtronic Sofamore Danek: Patrick O'Neill
Thomas L. Kelley & Associates: Thomas Kelley
3M: John Owen (John said to keep his check - a $100 donation to our chapter)

Donations to the Raffle Prize
Julie Patterson, RN: Individual donation $15
OsteoPacific: Brett Currier $15
Stryker Instruments: Bill Callanan (Bill said to keep his check - a $50 donation)

Companies sponsoring golfers
OsteoPacific: Brett Currier
Zimmer: Leo Hartford
Ethicon (J&J): David McDonald & Chris Dillavou

Submitted by Donna Benotti

The Intuitive Surgical da Vinci System
October 2000

Just down the road in Mountain View is a small company that has designed a system that promises to be the wave of the future in endoscopic surgery. The company - Intuitive Surgical. The system � da Vinci^TM. The FDA approved the system for use in July of this year. San Ramon Regional Medical Center is one of only five sites in the U.S. that owns the system and the only one west of the Mississippi.

On Wednesday, November 1, our chapter will sponsor an education program on the da Vinci^TM System at our regular monthly meeting. Circle the date on your calendar and make plans to attend with your colleagues to learn about this cutting edge technology.

In an effort to peak your interest, what follows is a brief description of the system�

The da Vinci^TM System is an electromechanical devise that allows the surgeon to more precisely perform endoscopic surgery. It consists of three basic parts all adjacent to the OR bed and patient! The surgeon does not touch the patient, but rather sits at a console that includes a computer, video monitor, and instrument controls.

This console is connected via hardware and software to mechanical arms that hold the endoscope and surgical instruments (e.g., forceps, scissors, electrocautery, etc.) in place. The arms are part of a patient side cart positioned at the O.R. bed.

The surgeon sits at the console and controls the position and movement of the surgical instruments within the operative field. Sitting at the console, the surgeon looks into a video monitor that provides a three-dimensional image of the operative filed and surgical instruments. While observing the image of the operative field, the surgeon can control instrument movement via hand-controlled manipulators directly linked via electronics to the motor driven arms that hold and actuate the custom instruments.

The software and hardware within the system precisely translate movements of the surgeon�s hands, wrists, and fingers to exact, complementary movements of the surgical instruments within the operative field.

Sound unbelievable? You bet! But it�s happening now in our own backyard. Come to the November first chapter meeting to learn more!

Submitted by Kathie Shea

Debundle This!
October 2000

Sometime ago I wrote a letter to Pete Stark in regards to cosponsoring HR 3911, direct Medicare reimbursement for certified registered first assistants, and I just received an answer. I am very disappointed in his response. He does not wish to be a cosponsor of this bill. I do not think he fully understands what the bill is about. He states, �While I am sympathetic to your desire to obtain direct Medicare reimbursement for certified registered first assistants, I have concerns. Such a change would certainly be an effective means of elevating pay for a career that I�m sure is under-reimbursed in our managed care dominated health care system today - and that is a worthy goal. But, the entire premise of Medicare�s reimbursement system for hospitals is to bundle the payments of the facility and to allow disbursement of those funds to be controlled by that facility. As we �debundle� more and more particular services, the cost-savings of the overall payment mechanism are diminished.� I also asked if we could arrange a meeting to discuss this topic and it was denied.

Submitted by Evelyn Steen

�I Wanna Say Something!�
October 2000

Parliamentary Procedure for Motions

Introducing A Motion

1. Rise and address the chair (e.g. �Madam President�).
2. Wait for recognition from the chair.
3. State the motion using correct phraseology (e.g. �I move that��).
4. Another member should second the motion without rising or gaining recognition. This does not mean the person seconding has to agree with the motion, just with the first speaker�s right to make the motion.
5. The chair states the motion as presented and calls for discussion.

Subsidiary Motions
(e.g. Motion to Amend)

* Modifies or changes the wording of the main (pending) motion.
* Adoption of the subsidiary motion does not adopt the main motion that is being amended; that motion remains pending in its modified form.
* If a subsidiary motion is accepted, the main motion as amended is read and discussed before a final vote on the motion, as amended.
* If the motion to amend is rejected, the pending motion remains worded as it was before the amendment was offered.
* The way a member votes on an amendment does not obligate him or her to vote the same way on the motion to which that amendment applies.
1. Rise and address the chair (e.g. �Madam President�).
2. Wait for recognition from the chair.
3. State the motion using correct phraseology (e.g. �I move to amend the motion by��).
a. To insert or add words:
* The motion should specify the exact place of insertion and the precise word or consecutive words (e.g. �I move to add the word all before the word delegates.�)
b. To strike out:
* (e.g. �I move to strike out the word only before the word Delegates.�)
c. To strike out and insert:
*(e.g. �I move to strike out the word only before the word Delegates and insert the word all.�)

Submitted by Kathie Shea

Sales Reps. in the O.R.
October 2000

�Don�t get too close to the sterile field.� �We�re taking an x-ray, you�ll have to leave the room for a moment.� �I�ll open that.� Do you ever wonder what training your sales representatives receive before they enter your OR? In talking with several reps, I have discovered that some have extensive training and others very little, mostly on-the-job from other reps.

This year you have the opportunity to develop a standardized credentialing process and a policy and procedure template for all facilities in Alameda County to use when admitting manufactures� representatives to the operating room. It�s a classic win-win situation. The reps win because they have the opportunity to receive the most current information and know what the expectations are in all of our facilities. Perioperative nurses win because the reps will be knowledgeable not only about their products, but will be better prepared to enter our ORs and will allow us less time to monitor their activities and more time to devote to our patients.

If this sounds like something you might enjoy being a part of, contact Kathie Shea (H) 510-339-2545, (W) 925-275-8485, [email protected], (H e-mail) or (W e-mail) [email protected]. We plan to meet about one to one and one-half hours once a month this year. Your voice and that of your facility is important! Contact Kathie today!

Submitted by Kathie Shea

Can�t We All Just Get Along?
October 2000

The holy grail is universal perioperative documentation.
The road there is fraught with �We don�t do it that way here!�

Dr. Susan Kleinbeck made a return appearance to our September chapter meeting. Dr. Kleinbeck has such an engaging presentation style that it�s a real joy to hear her speak.

Dr. Kleinbeck spoke about the Perioperative Nursing Data Set (PNDS) and how the PNDS makes universal perioperative documentation (UPD) possible. AORN of Alameda County was part of the UPD project and we (along with AORN of Kansas City) sought to determine the minimum that should be charted. Currently, documentation is individualized, inconsistent, undefined, and includes little nursing action that is taken in the perioperative setting. How can we prove the necessity for RNs in the OR if there aren�t standardized measurement tools?

Stymied From the Beginning!

The following is not an exact quote but close: �In scarcely an instance have I been able to obtain hospital records fit for comparison.� This was said by Florence Nightengale in 1863! We�ve had consistent documentation problems from the very beginnings of nursing!

It�s important to have standard documentation for the following reasons:
* performance can be compared across units
* to determine the cost of nursing interventions
* large scale outcomes research depends on consistent definitions
* quality indicators and benchmarks
* benefits of the RN can be demonstrated to policy makers, finance officers, and administrators
* visibility and viability
There is resistance to universal perioperative documentation. The usual �We don�t do it that way here� is widely heard. There are computerized records but they�re marketed with the special feature of individualization. �Make the computerized record just like your own printed record!� The result is computerized records that vary widely.

The Nitty Gritty

The goal is to make a universal computerized record. PNDS is the intellectual property of AORN so permission must be obtained from AORN to use it. The AORN Foundation has funded phase one of the universal record documentation study. Phase one was aimed at creating consensus as to the minimum perioperative nursing data elements required on any perioperative record. Phase two was to operationalize the minimum data elements to a written record and test. We�ve participated in both phases. Phase three is to set standards and test the computerized written record. The sections to this record include pre-admission, pre-op assessment, preparation before the OR, intra-op, and post-op before discharge. Dr. Kleinbeck then went through a periop record. The most notable change was the inclusion of the local anesthetic information on the record (to avoid unnecessary duplication on a separate anesthesia record). She also said the most contentious issue was what to name the item that carries the patient. Is it a cart, a stretcher, or a gurney? It depends on where you live! It was decided to call it a stretcher. Another issue that proved to be troublesome was the unwritten dictate that no mark in a box meant �no.� The written test record was trialed in rural, suburban, and city ORs that ranged in size from four to 22 rooms.

Periop Pt. Focused Model

Dr. Kleinbeck also showed a slide of Perioperative Nursing Documentation using the Perioperative Patient Focused Model. This model is based on research and is nationally recognized. It addresses all aspects of perioperative care. PNDS only focuses on perioperative patient care (which comprises three of the four quadrants of the model). PNDS covers nursing diagnosis, interventions, and outcomes (safety, physiological responses, and behavioral responses of the family and the individual). The patient is at the center of this model. The fourth quadrant of the model has structure elements, report cards, benchmarks and desired outcomes, and the health system as the four elements of the fourth quadrant.

AORN Says �No Thanks!�

AORN has rejected Dr. Kleinbeck�s model. AORN wanted universal documentation tested with 25,000 records. AORN is doing its research the reverse way. They are asking chapter presidents to obtain OR records from members and then to send them to National AORN. AORN then reads every OR record to identify the common data and entries.

Dr. Kleinbeck gave a fabulous presentation (as always). We received 1.5 contact hours, learned a lot, and had a good time. I was sorry to see only 27 people attended. Three of the 27 were members of San Francisco/Marin AORN. Two people were non-members (a traveling nurse and his currently unemployed OR nurse wife). So we had 22 of our own members attend this wonderful presentation. Dr. Kleinbeck flew in from Kansas City and I wish she could have seen a larger turn-out. I�ve said this in the past - a chapter meeting topic may look uninteresting - but it�s usually an excellent presentation 99% of the time. Come to at least one meeting and see for yourself!

Submitted by Mary Ritchie

Bye-Bye Now
October 2000

I left my heart in the beautiful Bay Area and took my body to the perpetually sunny, 74 degree Los Angeles area on September 8. I�ll truly miss the open spaces, the rolling hills, Mt. Diablo, the wildlife, and the changing weather of Northern CA. I will not miss Contra Costa County - the pollen capital of the entire Bay Area. I hope to become a healthy, fairly non-allergic person once again by living in a place where the the pollen count is almost non-existent. I lived down there for ten years (1976-86) and was thrilled to leave! But - the children and grandchildren are there - and those are good reasons for returning. (The RN wages are not one of them! Treasure your CNA membership! My pay cut is $12/hour!)

I will remain the editor/newsletter chairman/web manager until someone expresses a desire to take over. I would be thrilled to turn over the duties to someone. It�s very organized - all the groundwork is set. The hardest part is procuring advertisers - and most officers and members of the Board of Directors solicit enough advertising to pay for the year�s newsletters. If you have a Macintosh computer - that would be ideal since all my paperwork and forms are done in ClarisWorks. If not, you only have to copy the forms or make new ones. E-mail ([email protected]) or call me (310-944-9822) if you�d like to assume the newsletter and web site.

The Board of Directors and Committees are already busy planning an exciting year. First, there will be a trial of a new start time. Dinner will remain optional, but will begin at 6:00 p.m. The program will start 6:30 p.m.

The tentative schedule is as follows:
9/6 Universal Perioperative Documentation
10/4 Supracervical Hysterectomy
11/1 The Intuitive System
12/6 Holiday Surprise
1/10 Pain, The Fifth Vital Sign
2/7 Organ Donation
4/4 Bloodless Medicine in Surgery
5/2 Minimally Invasive Kidney Surgery
6/6 Installation of Officers

Notice the dates. Some meetings are not on the usual first Wednesdays. This is by intent!

I urge you to include a plan for your professional development in the new millennium. If you are unable to attend all meetings, pick one or two topics that interest you. If you haven�t attended a meeting, come and check us out. Except for December and June, all meetings will be at Eden - centrally located, free parking, and easy access to the conference rooms.

Submitted by Donna Benotti

The Board of Directors is interested in your opinion. Please complete the following survey and return to Mary Ritchie via e-mail ([email protected]) by August 22. Thank you. Submitted by Donna Benotti

1. I attend chapter meetings:
a. On a regular basis
b. Hit and miss
c. Never

2. I think the new time trial is a good idea. Yes No
It will affect my meeting attendance.
Positively Negatively N/A

3. I would attend more meetings:
a. If they were held on a different day, like _________.
b. If I worked a different shift.
c. If child care was offered.
d. If _______________________________________.

4. If child care was an option, I would
a. Use it. Yes No N/A
b. Recommend someone to do it.
c. Contribute to paying the provider. Yes No
d. Think the chapter should provide this service.
Yes No

5. I am interested in joining a committee.
Yes No Committee name________________.

6. I am interested in helping with the golf tournament. Yes No

Name______________________________________

Phone______________________________________

7. I just want the Board to know___________________

_________________________________________

___________________________________________

Name (Optional):

___________________________________________

Facility(Optional):

___________________________________________

___________________________________________

The operating room staff of Eden Medical Center wishes to offer a final tribute to a dear friend and colleague, Jo Bourguet, who died recently from cancer.

Josephine

Energetic and feisty,
A petite ball of fire,
Jo loved her life fully
Choosing not to retire.

Loving her work in surgery,
Tending those in distress.
Forty-five years at Eden
Truly put to the test.

She was quite a role model,
Dedicated and strong,
Standing up for what was right,
And conceding when wrong.

Jo would never just say
What you wanted to hear.
She�d express her own view point,
And she�d make it quite clear!

With her keen sense of humor
Our spirits she�d lift.
�A Pretty Girl� she�d croon, jesting
As we changed for our shift.

Or she�d sprint to the kitchen,
If time would allow,
And sing �Marie� sweetly,
As Marie served her chow.

Jo was a true leader,
Our mentor, our friend.
She lived her life with honor,
Right up to the end.

By Paula Bertaud (Paula is a former staff member who recently moved to Washington State. She was often encouraged by Jo to write poetry.) This originally appeared in the newsletter �Edenurse PRN� Volume 2, Issue 3, April/May 2000. This was submitted by Beth Mar.

I want to thank the membership for sending me to the Leadership Conference in Denver July 7 � 9. The conference was great and the weather was wonderful. I brought back some ideas from the conference and networking with other presidents, that I am anxious to share with you.

I arrived in Denver too late to go on the tour of The National AORN Building in Denver, but I can tell you from previous experience that it is wonderful and something we should be very proud of. I roomed with Judith Heard, president of the Modesto chapter - what a lovely person.

The conference started out on Saturday morning with introduction and opening remarks from our President, Brenda Ulmer, and then she gave us a history lesson on �The Changing World of Perioperative Nursing.� This was very interesting, it is amazing how far we have come in such a short period of time. Did you know that surgical gloves were first developed by a surgeon for his scrub nurse whose hands had become red and raw from the carbolic acid that they used to disinfect their hands before surgery? The next speaker was Tim Porter O�Grady who spoke to us on "E-Leadership: New Age, New Skills". Any one who knows Tim Porter O�Grady knows what a dynamic speaker he is, and he didn�t disappoint us. He talked to us on the transformation of the nurse leader�s role within a new social paradigm, going from the industrial to the socio-technical age. The nurse leader is going to be challenged to change both role and function. We will need to look at how changes in the health care industry and its impact on nursing will affect our nursing leaders. We then went to our individual break- out sessions where we discussed topics such as Chapter Strategic Planning, Recruiting and Retention for Chapters, Revitalizing Your Chapter, and Chapter Education Events.

Sunday, we started the day out with breakfast with our Board Liaisons (Donna Watson is ours) where we discussed issues of importance to the relationship of National to chapters.

Then we went to a General Session where Karen Sealander JD, talked to us on �The Importance of Organizing for Public Policy in Perioperative Nursing.� She gave us an update on AORN�s federal public policy agenda. The next session was on �Perioperative Nursing Data Set,� given by Donna Watson.

The conference was great and I would recommend that the chapter send the next president, as it will certainly help her during her year as president. The next conference is going to be held in Washington, DC, June 22-26, 2001. They will be combining three events; RNFA Forum, AORN Leadership Conference, and AORN Lobby Day. This event will be open to anyone who wants to go. National will only be picking up the tab for the conference fee and the food. The chapters or the individuals will have to pay for their airfare and hotel room. Start planning now and saving your money so a group of us can go.

Submitted by Evelyn Steen

Incident Reports (The Good Kind!)
April 2000

Kaiser Oakland

Kaiser Oakland is being considered for status as a regional center for doing intraluminal aortic stent graft placements as a treatment regimen for abdominal aortic aneurysms. Dr. Christopher Ceraldi of Kaiser Oakland has been training at Stanford Medical Center.

Our first abdominal aortic stent graft was performed on February 29 very successfully. Dr. C. Ceraldi, Dr. R. Gingery, Dr. S. O�Kuhn, and Dr. P. Radosevich (Radiology) were scrubbed. Rosalyn Bruce, surgical tech, and Theresa Castillo, radiology tech, were also scrubbed. Marilyn Hile, RN, was the circulator. Maria Evans, surgical tech, and Carrolyn Bryant, RN, were also present. Dr. M. Posner was the anesthesiologist. Several Stanford physicians were present. You all know how new procedures are in the beginning - at one point there were 18 personnel present. Our patient did very well and is now at home. Several more procedures are on the books.

One of our new hires and a recent graduate from the tech program at Mt. Diablo Adult Education took her certification exam and is now certified. Congratulations Lori Morrison, CST.

We are looking for two tech positions. One position is 11a.m. to 7 p.m. and the other is nights (12 a.m. to 8 a.m.). If you know of anyone, send him/her our way! Call 510-596-6235.

We are also sending two RNs to Kaiser Santa Clara to attend a Kaiser sponsored OR training program. The program begins March 6. They will be doing classroom work for several months before we get them back to our OR for their clinical preceptorship.

Larry Gerrans, Stryker Endoscopy rep, will be presenting an inservice on the video equipment on Saturday, April 8. We plan to have an intensive hands-on class. Stryker will provide a continental breakfast.

Submitted by Carrolyn Bryant

San Leandro Surgery Center

San Leandro Surgery Center is proud to announce the opening of Bay Area Pain Management. Bay Area Pain Management is the culmination of San Leandro Surgery Center�s involvement in providing pain management services to the community since 1992. Through our years of experience, we realized the need for a dedicated center that specializes in the evaluation and treatment of patients with difficult pain. We are fortunate to have a distinguished panel of pain management physicians.

Bay Area Pain Management�s primary objective is to provide a center of excellence in the East Bay. This is a new state of the art facility with the latest equipment and technology available. The nursing staff is experienced and provides outstanding patient care and service. The environment, while being clinically efficient, is attractive and friendly.

San Leandro Surgery Center is located at East 14th Street in San Leandro.

Submitted by Clenia Yadao

Summit Medical Center

Phyllis Holmes and her husband Bill are new grandparents! Actually, they�re super grandparents since they have twin grandbabies - Cole Davis (boy) and Madison Davis (girl) born on August 30, 1999. Cole and Madison are the children of Phyllis� son and his wife.

Submitted by Phyllis Holmes

Heartfelt Letter
April 2000

Dear Editor,

As I think about the article that needs to be written re: changes to the delegate policy, I am over-taken by thoughts of who will read this anyway? It's a beautiful day (and a week-end besides), so why should I trouble myself with writing something that most of the members will skip over? After all, why shouldn't I be just like everybody else? Only two persons responded to the questions I posed in the last newsletter, and you were one of them!

Well, to answer my own question, I'm not of the lemming mind set, and I would not be a very good role model for my children if I took the easy road or even sat down on it once in awhile. Commitment can be difficult when looked at from the perspective of convenience. After all, when is anything convenient? Certainly not attending a chapter meeting after a hard day at work, even when the topic is informative and the discussion energizing. And certainly not sitting at a computer when a voice is whispering in your ear, �Play hooky.�

Perhaps there was a lack of response to the delegate policy question because members needed more information. Yeah, that�s it! Maybe we need to publish it in its entirety - then every member can see what the requirements are to be a delegate and will want to be one!

And so, dear editor, please publish this policy now, before the delegates return from Congress and inundate you with articles for the next newsletter. Wouldn't it be exciting to have lots of first time delegates next year?

Thank you, Donna B.

Submitted by Donna Benotti

Delegate Policy
April 2000

This is the new delegate policy as revised by your Bylaws Committee. Input was solicited in the December newsletter (page 3) - and there was almost no response (two opinions).

Changes to the policy are bolded and underlined.

DEFINITION
1. Delegates shall represent the AORN of Alameda County Chapter at the annual National AORN Congress. Each local chapter is entitled to have one (1) delegate and one (1) alternate delegate. The number equivalent to one (1) delegate per chapter will be subtracted from the designated House of Delegates size of 1,500. The remaining delegates will be apportioned to chapters according to chapter size as of June 30. An alternate delegate is one who shall be seated in the delegate session only in the absence of the delegate. Once an alternate has been moved up to delegate status, that status is maintained for the duration of Congress.

2. The President and President-Elect serve as delegates and do not have to meet the criteria for eligibility.

3. The remaining delegates will be seated using the criteria for eligibility.

4. The President-Elect shall act as the Chairman of the delegates. In the event the President-Elect is not able to attend, the delegates will select a chairman.

CRITERIA FOR ELIGIBILITY
1. Has been an active member of the Alameda County Chapter for one (1) year preceding the annual Congress.

2. Has attended the business portion of a minimum of six (6) chapter meetings the previous fiscal year, from July 1 through June 30.

3. Has completed an Intent to Serve form by the close of the December meeting.

4. Has submitted earned points
a. on the approved Points Record form
b. by June 30th.

SELECTION
1. Delegates will be determined from eligible members using the defined points system. Members accumulating the highest number of points (in decreasing order) will be offered the opportunity to serve as delegates. When the full complement of delegates is reached, members accumulating the next highest number of points (in decreasing order) will be offered the opportunity to serve as alternate delegates.

2. In the event of a tie for points, delegate selection will be by lot.
3. Only eligible members will serve as delegates. In the event that there are insufficient, eligible members to fill the quota, the Chapter will not send a full complement of delegates.

RESPONSIBILITIES
DELEGATES SHALL:
1. Become familiar with and adhere to directives forwarded from Headquarters prior to attending Congress.

2. Attend all business and delegate activities at Congress. These include, but may not be limited to, "Meet the Candidates," "Candidates Caucus," forums, and all sessions of the House of Delegates.

3. Seek information on all issues under discussion and act in the interest of the Chapter.

4. Vote on all matters that come before the House of Delegates and for National Officers, Board members, and Nominating Committee members considering recommendations from the Chapter.
5. Interact with members from other Chapters and evaluate them in light of their leadership potential so that the Chapter may submit names of prospective candidates for elected office.

6. Attend educational sessions and exhibits at Congress.

7. Provide a comprehensive report to the Chapter following attendance at Congress. The chairman of the delegates will assign topics and determine deadline for reports.

8. Complete the AORN of Alameda County Congress Expense Report and return to the Chairman of the Delegates within one month (1) month following Congress.

9. Continue as delegates for the purpose of any special meeting of the National Association that may be called until the delegates are duly designated for the next annual Congress.

10. Serve as members of the chapter's Ways and Means Committee for the next fiscal year.

ALTERNATES SHALL:
1. Assume the same responsibilities as those of delegates except for #4 above.
FUNDING
1. The Board of Directors will determine the amount of delegate and alternate funding annually.

2. Delegates and alternates will receive funds post Congress after completing Responsibilities 1-8.

FAILURE TO FULFILL RESPONSIBILITIES
A delegate or alternate who fails to fulfill all responsibilities is ineligible to serve as a delegate or alternate delegate for the next three (3) years, and, therefore, will not be eligible for funding. Extenuating circumstances will be reviewed by the Board of Directors on an individual basis.

Note: Removed from the policy is the statement that delegates may not serve more than two consecutive years.

Submitted by Donna Benotti

RNFA News
April 2000

Kentucky has joined Rhode Island, Maine, Florida, Washington, and Minnesota in requiring Registered Nurse First Assistant (RNFA) reimbursement and recognizing the importance of perioperative nursing. That's now six states that recognize the importance of RNFA Reimbursement. The state of Kentucky now legally requires health insurance providers that pay for surgical assistants to pay registered nurse first assistants for surgical assisting performed.
From AORN Online

Something To Think About
April 2000

�Why should we need extra time in which to enjoy ourselves? If we expect to enjoy our life we will have to learn to be joyful in all of it, not just at stated intervals, when we get time, or when we have nothing else to do. It may be well that it is not our work that is so hard for us as the dread of it and our often expressed hatred of it. Perhaps it is our spirit and attitudes towards life and its conditions that are giving us trouble, instead of shortage of time... A feeling of pleasure in a task seems to shorten it wonderfully and it makes a great difference with the day's work if we get enjoyment from it instead of looking for all our pleasure altogether apart from it."
Laura Ingalls Wilder, 1919

From the March 4, 1999 Periop Listserv

Congratulations!
April 2000

The AORN 50th anniversary supplemental magazine that came with the March AORN Journal contained articles by local AORN presidents - Martha See of Alameda County, Cathy Nisen of Contra Costa County, and Miriam Pass of San Jose. There were some great stories in these pages and I encourage everyone to read these. Some of the articles brought tears and others brought recognition.

Repetitive Stress Injuries
April 2000

Dr. Andrew Stein (of Associated Orthopaedic Surgeons of Hayward) spoke to us on November 3, 1999 about repetitive stress injuries. The catch-all phrase �repetitive stress injuries� covers numerous conditions such as cubital tunnel syndrome, ganglions, carpal tunnel syndrome, and epicondylitis.

There was a two year study where they found a 40% decrease in carpal tunnel syndrome when workers broke every 20 minutes and stretched their arms and flexed their hands up and down and bent their necks to the side. All this movement helps the nerves slide in their sheaths. Exercise your nerves! They slide 1.5 inches!

Dr. Stein said there is no proof data entry causes carpal tunnel syndrome. This was news to many of us since everything we hear and read says the opposite!

Dr. Stein came up with another shocker. He told us to not sleep like girls! He said most girls sleep curled up with the arm and wrist bent. That traps your nerves. Sleep with your wrist and arm straight - like a man! This brought out a lot of laughter since many of us conceded we do sleep like girls - all curled up. Dr. Stein also suggested consulting a hand therapist to get tips on how to perform tasks ergonomically. He also suggested wearing a splint.

Dr. Stein said there was a relationship between thumb arthritis and carpal tunnel syndrome. Finally, these conditions are covered by workman�s compensation.

Dr. Stein�s presentation was very informative and entertaining and I just covered the highlights.

By Mary Ritchie

Language Most Foul
February 2000

This came from the Periop Listserve via Dr. Dean Edell's web page (which had some errors which I corrected with information from the source) via the British Medical Journal.

"Believe it or not, there's been a study into the swearing habits of surgeons in the operating room.

One interesting finding was that surgeons indeed undergo a transformation and use more foul language once they're gowned and gloved.

British researchers secretly monitored 100 physicians during elective surgeries to find out how much they swear, rating cussing into three categories ranging from mild swear words such as "bloody hell" to so-called four-letter obscenities. Five surgical specialties were compared using a point system of one to three based on the foulness of the words.

When it came to the top swearing group, orthopedic surgeons won hands down. They received an average of 16.5 swearing points for an eight-hour surgical day, compared to 10.6 points for general surgeons, 10 for gynecologists, and 3.1 for urologists.

Orthopedic surgeons swear every 29 minutes, almost twice as often as the swearing rate of surgeons overall, according to this study published in the British Medical Journal in December 1999.

The award for the least foul language goes to the mild-mannered ear, nose and throat specialists whose average operation lasts only 34.4 minutes compared to 51.7 minutes for the orthopedic surgeons.

I can guess why orthopedic surgeons lead in the swearing study. It's probably because their operations last longer and tend to be more frustrating. They also use tools such as saws and screwdrivers, and as any weekend carpenter can tell you, using such devices can put you in a foul mood.

Source: British Medical Journal, December 1999"

This little tidbit came from the Periop Listserve and I posted it at work and told an anesthesiologist and an orthopedic surgeon (doing a spinal fusion) about it. The anesthesiologist was incensed that researchers couldn't spend their time on something more productive, who paid for this study, what's the world coming to, etc. The orthopedic surgeon (who never uses foul language) couldn't believe it. He was stunned and remained stunned throughout the day!

By Mary Ritchie

Widespread Use of Parametric Release by Industry
February 2000

The concept of parametric release,the releasing of sterilized product without using biological indicators (BIs), may be new to those of us in the hospital setting but has been a long-established practice in both the medical device and pharmaceutical industries.

Traditionally, hospital sterilization has been tied to biological indicators. The BIs are tested and calibrated against known physical measurements such as time and temperature. So that in fact, BIs are really a secondary reference, and physical measurements are the primary reference. For hospitals, The Association for the Advancement of Medical Instrumentation (AAMI) guidelines requires the use of biological indicators in every load containing implantables. Hospitals are further guided by AAMI in other routine uses of biological indicators. There is no authority that grants or approves parametric release to industry. The decision to use parametric release rests with each medical device manufacture. While the FDA and AMMI do not technically "approve" this type of release, both organizations recognize it and provide guidelines for its use.

Parametric release is recognized by the FDA and is defined as: "A finished device release procedure based solely on effective control, monitoring, and documentation of the sterilization process cycle in lieu of performing finished product or biological indicator testing." The Association for the Advancement of Medical Instrumentation (AAMI) also recognizes parametric release by stating: "Where reliable process measurement and control can be documented for the entire manufacturing process, and correlated with sterility assurance, terminally sterilized items can be considered for release in accordance with delivered process parameters." What this means is that the product may be released as sterile without the routine use of biological indicators provided cycle specifications are met and documented.

Parametric release does not require special testing, only confidence in the product process. The steam sterilization process used in industry is no difference from hospital-based sterilization but the measurement equipment is more refined. For example, there are redundant sensors (microprocessors) that record the sterilization cycle separately from the process controller and there is a load probe placed in the center of a product that monitors the physical measurements of the sterilization process. The advantage of a load probe is that conditions with product, rather than just the chamber, are known.

Should perioperative nurses still look for physical signs such as a chemical indicator or heat sensitive tape to help gauge that a product has met sterilization? If it is sterilized in-house, you bet! However, if you receive products from a manufacturer and these "familiar" items are missing, you should question the manufacturer to determine if indeed they are using parametric release.

Submitted by Kathie Shea

Star Search
February 2000

Last December, our monthly speaker was Verlie Carmack-Collins, RN, MA. Verlie is a staff RN at Alta Bates Medical Center in the operating room. She completed her BSN and Master's course work for clinical psychology at Holy Names College. Verlie is in the process of completing a total of 3000 clinical hours to obtain her MFCC. She has been practicing accupressure since l991. Verlie is certified by the Accupressure Institute in Berkeley.

I'm amazed that Verlie has been able to work four days a week, take call, go to school, spend time with family and friends, and obtain all her degrees and certificates in such a short period of time.

Verlie has many years of experience and a variety of qualifications. She cares for her clients mind, body, and soul. If you are interested in any of her services, please feel free to contact Debbie Tung at Alta Bates.

Now that I have said what I should have said at the December meeting, let me continue with this article.

Verlie is a talented member of our organization and I'm sure she is not the only one. As program chairman, I would be very interested to meet other members who have a talent they would like to share with the membership. Although it is very interesting to listen to medical topics at the meetings, I think it would also be interesting to hear what our members do outside of their careers. So, if you would like to share your passions with us, please let Debbie Tung know, and you too, can be one of our speakers at the monthly meetings.

Submitted by Debbie Tung ([email protected])

Minimally Invasive Neurosurgery
February 2000

Those of you who did not attend the September meeting missed a real treat. Not only did we hear a fantastic program, but we were actually able to see the high tech equipment that is used for these cases! Eden's Chris Lynn RN, assisted by Beth Mar and Ann Cesari, brought down the navigation system and an OR table that had a model of a patient's head positioned in a Mayfield headrest. During his presentation, Dr. Lawrence Dickinson would insert an electrode into the model and we were able to watch a simulated brain navigation and surgery on the monitor.

The Minimally Invasive Neurological Surgery (MINS) program is a "comprehensive, multidisciplinary, disease specific management strategy that encompasses inpatient and outpatient services. The initial focus of the program is the treatment of intracranial mass lesions (brain tumors, vascular malformations) and spine disorders. The goal of the MINS is to create a seamless treatment process that results in the patient's rapid return to all previous activities" (Dr. Lawrence). The speaker gave us an overview of MINS including how advancements in technology have impacted MINS. Anatomical resolution by MRI, refinements in hardware, software, and contrast agents, along with developments in interactive image-guided capability mean that the surgeon has the ability to pinpoint anatomy so that there are smaller incisions, is less tissue disruption and therefore, better results for the patients. Patients experience smaller wounds, shorter procedures, less tissue manipulation and injury, more complete resections, less postop pain, and an accelerated recovery.

Dr. Lawrence discussed pre, intra, and post care from the patient's perspective. Patient education is paramount in the MINS program. It was especially exciting to learn that all this is being done locally, at Eden. How wonderful that patients are able to stay in their community and do not have to travel great distances for treatment and follow-up care. I was impressed that patients typically go home the next day!

By Donna Benotti

Christmas Greens
February 2000

A special THANK YOU to all those elves who are making spirits bright this Holiday Season and to all of you who made purchases. The elves who took the orders, collected the money, and who will be distributing the greenery are:

• Alameda - Diane Pasquini
• Eden - Ann Cesari
• Kaiser Hayward - Martha See
• San Ramon - Kathie Shea
• Summit - Donna Benotti
• TriValley - Clenia Yadao
• Washington - Evelyn Steen
• Washington Surgery Center - Donna Rodgers
• Valley Care - Nelda Devine

By Donna Benotti

San Ramon Becomes Trailer Trash!
February 2000

I took a tour (conducted by Kathie Shea) on October 8 of San Ramon Regional Medical Center�s new Mobile Surgery Unit (MSU). Kathie wrote an article about it in the October newsletter (and it�s on our web site), and I don�t want to repeat everything she said but I want to give my impressions of it.

It�s huge. It�s a semi-trailer truck with both sides expanded out. It�s parked outside their Emergency Room. It has one operating room but for emergencies/disasters, three OR tables can comfortably fit into the very large OR. And speaking of disasters - if FEMA (Federal Emergency Management Agency) needs the MSU for a disaster area, they get it immediately - along with a crew from San Ramon! Earl, the driver and MSU deployment man, will be busy unpacking the MSU and setting it up so the San Ramon OR crew will have the opportunity to orient the new crew in the disaster area where things are and how they operate. Once the new crew is oriented, the San Ramon folks can return home. That�s part of the rental agreement.

We started the tour by walking up the partially completed wooden ramp still under construction. There�s an elevator but they also wanted a ramp. We entered the reception area where there�s a door to the walk-through bathroom (the door on the other side of the bathroom leads into the pre-op/recovery area). The bathroom is huge and can accommodate wheelchairs. Patients may change clothes there. Then we entered the pre-op/recovery area. Pre-op has one gurney and recovery is opposite with two gurneys. There�s a desk and a scrub sink with a window into the OR. There is storage everywhere you look. Whoever uses the MSU can set up the carts and drawers in whatever configuration they want. San Ramon was still in the process of setting up when I took the tour. The MSU�s air conditioning was working full blast which was a relief in that San Ramon Valley desiccating heat! The MSU has everything a hospital has. The OR is very large and will accommodate video equipment easily. Everything is state-of-the-art.

The clean and dirty utility rooms are off the OR . The OR is in the middle with pre-op/recovery on one side and the utility rooms on the other. There�s a combination pre-vac/gravity displacement autoclave in the clean utility room that accepts full size trays (it looks small!). There�s even a pass-through window between the clean and dirty utility rooms. There�s an area in the dirty utility room where trash and dirty linen may be placed for pick up by the hospital. The bags are placed in a closet-sized room and the door is closed. This room is accessible from outside the MSU so no one is disturbed by this process. It reminded me of an airplane�s servicing routine. The bathroom even reminded me of an airplane�s - only on a luxury scale and five times as large!

San Ramon is using the MSU for about six weeks while they remodel an OR to increase services. Kathie has invited all of us to take a tour of the MSU. Give her a call at work (925-275-8485). The San Ramon crew to work in the MSU is currently working on a name for themselves. All I�ve heard so far is �Trailer Trash!�

You can see a photo of the OR in the MSU at the MSU web site. The photo doesn�t show the very nice Bechtold spotlights. The door to the right of the pink-top desk in the photo leads to the clean utility room. An unseen door to the left of this desk leads to the dirty utility room. The door (not shown) directly opposite the clean utility room leads to pre-op/recovery. The MSU was very impressive and I enjoyed my tour very much! And the air conditioning was terrific!

By Mary Ritchie

What You Missed!
February 2000

The October 6 meeting was great! Lt. Col. Roberto A. Penne, MD spoke to us about Hyperbaric Medicine. It was fascinating. I was only aware of the single hyperbaric chambers that resemble coffins with nice curved, clear tops. Travis Air Force Base by Sacramento has a 26-bed hyperbaric chamber! A nurse is in the chamber with the patients - and hearing the benefits of the chamber - everyone should volunteer for that duty! There have been occasions when they�ve used all their beds. There was a warehouse full of carbon monoxide which poisoned people. They were sent to Travis and utilized all 26 hyperbaric beds. And yes, even though it�s military, they take civilian patients (for non-emergencies too).

Treatment in the hyperbaric chamber takes two hours even though the poisons disappear within 23 minutes. It sounds like hyperbaric medicine is beneficial to everyone no matter what your diagnosis. Research is being done on the benefits of hyperbarics for those who have had acute MIs, CVAs, sports injuries, head/spinal injuries, acute central retinal artery obstruction (99% retained pre-obstruction eyesight with hyperbarics vs. 98% blindness without hyperbarics!), multiple sclerosis, and Lyme Disease. Currently, hyperbaric treatment is used for diabetics and burn patients, and people requiring skin grafts.

The 26-bed hyperbaric unit at Travis cost almost $8 million. Medicare pays $350 per treatment. The operational costs are $58,000. Two other Air Force bases have large hyperbaric chambers - San Antonio, TX and Dayton, OH.

Dr. Penne said he was happy to conduct tours of the hyperbaric chamber. We hope to have a tour planned February 5 (Saturday).

I came away with the impression every hospital should have a hyperbaric chamber. The benefits are fabulous - even the side effects are great! Dr. Penne mentioned the diabetic patients (who of course have decreased circulation) benefited from the increased circulation due to the higher oxygen pressure. The hyperbaric chamber has the same effect as Viagra. Male diabetics love the hyperbaric chamber. What a wonderful side effect!

By Mary Ritchie

Various Articles That Used to be on the Home Page

Stop Child Abuse!

Would you like to make a donation to a very worthy cause? Children Requiring A Caring Kommunity - C.R.A.C.K. is an organization that started as a grass-roots effort to do something about drug-addicted women giving birth to drug-addicted babies. The following information is taken directly from their web site.

�Donations allow us to continue our efforts and start chapters throughout the country. Your donation of any size matters greatly and is appreciated by us.

CRACK'S Project Prevention is the brainchild of Barbara Harris. Her program is voluntary, and women can choose either long term or permanent methods. For each volunteer of our birth control plan, the $200 cash offer is said to be the driving force that allows individuals to think about refraining from pregnancy while they struggle with drug and alcohol use.

Drug addicted women in California have been asked to use birth control for years, but few have done so, many say due to lack of information. Tubal ligations are paid for by the state, allowing women to undergo the procedure for free.

Accepting our cash offer is just the beginning! Each woman (or man) must complete CRACK paperwork, return it to us (offer good for 60 days after receiving paperwork), make an appointment with a physician, be counseled by the medical professionals, and wait out a mandatory 30 day period required by the state. She must then keep her appointment to actually undergo the procedure. This procedure may seem simple to many, but for a person controlled by addiction, the road to successful completion of our program is difficult!

Once the candidate completes the birth control procedure, which is verified by our staff, he/she will receive the $200.

C.R.A.C.K. offers these incentives:

• $200 Norplant (5 year birth control)
• $200 Tubal ligation
• $200 IUD
• $200 Vasectomy
• $200 Depo-Provera ($200 paid over the period of one year.)

Every woman that chooses to use birth control does so by choice, we do not talk anyone into making that decision, the decision is up to her and her doctor.

To help you spread the word, we have prepared many written materials. Call our office and request flyers to distribute in your area to local hospitals, police departments, probation departments, drug treatment programs, and to social workers. Our organization is available for speaking engagements for your club or organization, please call for scheduling arrangements. (1-714-236-0217, 1-888-30-CRACK, or e-mail [email protected]

We are a 501C3 organization. Tax ID#330731572"

Current statistics of people who have taken this opportunity to save the life of a child (by not producing a drug-addicted baby that will be neglected, abused, or end up in the foster care system):
43 white women
43 black women
15 Hispanic women
1 Native American woman

Eliminate Household Hazardous Waste (HHW)!
New Mercury Thermometer Exchange Program

Bring your mercury thermometer to Mary Ritchie at any AORN chapter meeting and you�ll receive a brand new digital thermometer as a replacement at the next meeting - or it can be mailed if you�ll pay the costs.

My husband and I just took an old car battery to our local HHW collection facility in Martinez (we live in Contra Costa County) and we were given a pamphlet about the new mercury thermometer exchange program that started September 18. I think it�s great! Let's get rid of mercury - the environmentally safe way!

"Small amounts of mercury reach the water environment when mercury thermometers break in household sinks and the mercury flows into the sewer system. Wastewater treatment facilities are highly effective at removing organic waste, but cannot remove all the toxic metals like mercury. These toxic metals can bypass treatment and flow into the Bay."

"Even small amounts of mercury from thermometers combine with other sources of mercury that have been deposited in the Bay over the years. The build up of mercury in San Francisco Bay can threaten human health as it accumulates in fish." The preceding quote was taken from the mercury thermometer exchange program flyer.

Searching the internet for HHW sites in Alameda County disappointed me since the latest listing of collection sites and dates ends in June. There is one site each in Oakland, Hayward and Livermore and you must call for dates and times. Please visit Alameda County Household Hazardous Waste. And if you're in Contra Costa County, please visit Contra Costa County Household Hazardous Waste.

"The Alameda County Household Hazardous Waste facilities are free and available by appointment to any resident of Alameda County. The facilities accept most types of household hazardous waste, including:

• Paint, stain, varnish, thinner, adhesives
• Auto products such as old fuel, motor oil, oil filters, batteries
• Household cleaners and sprays
• Garden products such as pesticides and herbicides"

For further information or an appointment to drop off your household hazardous waste in Alameda County, call 510-670-6460.

Safe Staffing For California!

"The California Nurses Association today (Oct. 10) hailed the signing of landmark legislation that will make California the first state in the nation to require safe hospital staffing..."

"AB 394 requires the State Department of Health Services to adopt regulations establishing minimum, specific, and numerical licensed nurse-to-patient ratios for all hospital units as presently exist for intensive care units and operating rooms. It also prohibits hospitals from requiring unlicensed, minimally trained personnel to perform nursing functions such as invasive procedures, patient assessment, patient education, or administration of medication."

This bill also includes a provision for a one nurse minimum in each operating room.

Read all about it at the CNA Press Release Page

You Can Make A Difference!

The Board of Medical Quality Assurance (BMQUA) was the entity that exempted Kaiser Hospitals from using UAPs (unlicensed assistive personnel) for surgical assisting 20 years ago. They had no authority to do this.

1. CNA (California Nurses Association) did an informal pole for Kaiser asking if surgical assistants should be first assisting and if so, what would they be allowed to do. The survey showed an overwhelming no.
2. IF YOU HAVE A UAP FIRST ASSISTING, YOU NEED TO CALL THE DEPARTMENT OF HEALTH SERVICES (DHS) AND TELL THEM YOU ARE AT HOSPITAL _____, ADDRESS, AND YOU HAVE A UAP PRACTICING MEDICINE.
3. Anesthesia techs also need to be looked at in terms of what they do.

Submitted by Kathie Shea from the May ORNCC meeting (see the minutes of this meeting in the Legislative Committee Reports section).

Please Note: You can also write a letter to your nurse manager, director, risk manager, QA/PI department, etc. to inform them of surgical technologists assisting in the O.R. You, as the RN, can be held liable for the STs' actions (assisting - working outside their scope of practice).

Call the Department of Health Services for the State of California at 1-800-554-0352. This is in the telephone book in the Government Pages under the State Government Pages (blue edged pages near the front of the phone book). There's NO reason to not call!

Have A Heart (Pin)!
National Nurses' Week (May 6-12) is Coming!
National RN Recognition Day is May 6
National Student Nurses' Day is May 8

Wouldn't you love to have (and give) a heart-shaped red enamel pin edged with gold color? In the center of the heart is a light blue mask with trailing mask ties. Surrounding the edges of the heart are the words, "Behind the mask a nurse with heart." The first three words are at the top of the heart and the last four words are at the base of the heart. All the words are evenly spaced around the curves. The lettering is gold colored. The pin is one inch in length and one inch across.

Each pin is $4. Contact me [email protected] with your name, address, and number of pins for ordering! What a great gift for Nurses' Week (May 6-12)! Get one for every OR nurse! Get some for those nursing students interested in the OR!

Shipping and handling charges: $1.50 - 1-3 pins

Please add appropriate shipping and handling charges to your total pin order (pins are $4 each).

Make checks payable to AORN Alameda County.

Please contact me for the mailing address.

Only 3 pins left as of March 14, 2000!!! That's the end. No more! Order now!

Illegal First Assisting!

"OR Nurses - Be on the look out: acts of unlicensed surgical technicians could subject you to discipline"

This is an excellent article about surgical techs first assisting in surgery by Shannon Sutherland, RN, JD, CNA Regulatory Policy Specialist. This is part of the California Nurses Association Web Site.

Seifert Says!
December 1999

This is a brief overview of the decisions of the AORN Board of Directors during its fall Board meeting, held October 20-23, 1999 at Headquarters. Significant decisions were made related to the future strategic direction of the Association.

By Patricia Seifert, National AORN President

In Memoriam
December 1999

A long time member of AORN of Alameda County, Jackie was always interested in what was happening in her chapter. She had served on many committees, had held several offices, including chapter president in 1971, and had served as a delegate to numerous Congresses. This is where many of us would see her in recent years-on the exhibit floor at Congress, being the entrepreneur with her flash pans. She was always interested in the chapter business and happy to see that Alameda County was represented.

Although she was born and raised in Nebraska, she graduated from St. Luke's Hospital in Denver. She worked at St. Luke's in San Francisco, then came to Peralta Hospital in Oakland before settling at Vesper Memorial Hospital in San Leandro where she was the Director of Surgery for over 20 years.

She is survived by her son Garth, four grandchildren, and two great grandchildren.

Jackie will be missed by all.

By Donna Benotti

Out Of The Blue!
December 1999

Who would have thought that the chapter's web site would lead to monetary gain? Well, it has. Eric Masingale, the new Director of Sales Training for Stryker Endoscopy in Santa Clara, contacted our web manager after perusing our site. He wanted to provide his trainees some in-hospital introductory experience. Mary made the referral, Kathie Shea and I developed an introductory course (content included attire, traffic patterns, infection control, and so on), and on Halloween afternoon we gave it at Summit!

Thank you, Eric and Stryker Endoscopy for the generous $500 donation to our chapter. And thank you, Mary Ritchie, for the outstanding web site and the opportunity to partner with industry.

By Donna Benotti

Bulletin From The BOD
December 1999

The chapter has been challenged by the New Orleans chapter to donate $1 per member to the Habitat for Humanity House that is to be built during Congress. This translates to $192. After much discussion, the Board of Directors (BOD) thoughtfully decided to contribute to a local charity/organization. We have been contributing to A Friendly House, a women's shelter in Oakland. The BOD knows how involved the members are and that perhaps the membership would like to make suggestions. Please e-mail your suggestions, with rationale, to the president, Martha See, [email protected]. Thank you.

By Donna Benotti

(FYI: Other local charities: East Bay Habitat For Humanity - Oakland and Alameda (Local Habitat For Humanity). You can donate online! To arrange a time to volunteer simply call Krysta Morgenthaler, Resource Development Manager at 510-251-6304. East Bay Habitat for Humanity, 2619 Broadway, Oakland, CA 94612

Visit CRACK's web site at: C.R.A.C.K. Call 714-236-0217, 1-888-30-CRACK, or e-mail [email protected].)

News From Around The East Bay
December 1999

OR Table Assembly - an OR table completely disassembled and �broken� must be reassembled and made. The most accurate (neatly made and aligned sections) and complete assembly with the fastest time wins.

Draping in the Dark - a blind-folded participant will drape a supine team member�s arm with a tourniquet towel (no clips!), stockinette, extremity drape, and cover the arm boards with a mayo cover. Verbal clues may be given by all team members. The fastest and most accurate draping wins.

Sterile Supply Slalom - a quantity (17) of formerly sterile supplies will be presented to each participant who must determine the best way to hold all the supplies at once - in one hand - without dropping anything. The items must be held away from the body with only one hand used to carry. The participant must then run/walk a slalom course of ring stands. The winner will be the one who finishes the course with the fastest time with the most items still in his/her possession.

Asepto Syringe Race - fill an asepto syringe and squirt it an OR table length into a pitcher. The winner is the one who fills the pitcher with the most water in one minute.

By Mary Ritchie

We have many job openings in the OR right now. We have many RN and technician positions with varied shifts. Questions? Call Carrolyn Bryant at 510-596-6391.

Several Kaiser Hospitals are in the talking phase about doing an in-house RN OR training program. We would not start this until after January 1, 2000.

We celebrated National Surgical Technologist Week by having a cake on September 20. The cake was huge and was enjoyed by all.

By Carrolyn Bryant

Halloween and Legislative News!
October Home Webpage

The ORNCC (Operating Room Nursing Council of California) is having a meeting October 30 (almost Halloween!), Saturday from 10 until 3. It�s in San Francisco at the Hyatt Regency Embarcadero in the Seacliff Room. The lunch is $35. There are no contact hours BUT the speaker is Jackie Speier, (D-Daly City) who will discuss the current legislative issues affecting nurses in California. She is the author of SB450 and SB595 which are nursing/health care related bills currently making their way through the legislature. She has a special interest in health care related issues, has been a co-author on many other bills, and will provide you with legislative insights.

Anyone may attend. The $35 may be sent to Sylvia Durrance (e-mail [email protected] for her address). The other cost will be parking - or just take BART!

News From Around The East Bay
October 1999

Beginning October 4th we will be adding an additional operating room in the form of an on-site Mobile Surgery Unit (MSU). The MSU is a state-of-the-art, fully self-contained, triplewide trailer containing a preoperative unit, operating room, PACU and Sterile Processing area. The total inside area is approximately 1000 square feet. The operating room size is HUGE - 16ft x 22ft, large enough to accommodate any amount of equipment needed. The MSU, manufactured by Mobile Medical International Corporation, has its own HVAC system with positive pressure, multiple air exchanges, and HEPA filtration, two steam sterilizers, and a communications system that provides telemedicine capabilities and instant electronic access to our medical center's admitting, medical records and lab departments among others. We will be using the MSU for at least six weeks as a "replacement" operating room while we extensive remodel of one of our operating rooms. The MSU has several other uses including: rural outreach, international health care delivery, prison healthcare, disaster response and military applications. To learn more about the MSU (and see interior pictures) log on to the Mobile Medical International Corporation website at: http://www.mobile-medical.com.

At the beginning of the summer we participated in the filming of an updated AORN video on Malignant Hyperthermia. A tremendous amount of time and effort on the part of our OR and PACU personnel went into the making of the video. It took nine hours of filming the first day and four hours the second day to produce the 20-minute video! The video is now out of post-production and ready for purchase. Should you view the tape, you might recognize chapter members Kitty McCartney, Bob Harding, Susie Stuhr and Kathie Shea who are prominently featured in the video. Those of you who know Kathie personally will recognize the beautiful blonde "patient" as Kathie's daughter Kelly!

This fall we will begin a minimally invasive cardiac surgery program. Procedures to be performed will include coronary artery bypass graft and valve replacement using a small/partial median sternotomy or one-two inch costal incision. We are very fortunate to have as our lead cardiac surgeon, Dr. S. Bakhshay, who has performed and taught the technique of minimally invasive cardiac surgery on patients and in hospitals throughout the world. The majority of these procedures will be performed on a beating heart without using the heart/lung machine. The benefits for the patient are obvious - less pain, decreased chance of infection, decreased hospital stay and avoidance of post "cardiopulmonary bypass sequelae."

Don't miss the February chapter meeting that will feature an education program on minimally invasive cardiac surgery.

By Kathie Shea

(Interested in San Ramon Regional? Take a tour of the hospital! You can start in the OR by visiting http://www.tenethealth.com/SanRamon/yh/tour4).

Kaiser Oakland currently has three students doing a clinical rotation in our OR. Chris Bolla, RN, is attending the Hospital Consortium program based in Burlingame. She is now in the scrubbing phase of the program. In mid-October, she will move into the circulating phase. We also have two students from the Surgical Technology Program of Mt. Diablo Adult Education. they are Denise Hicks and Janelle Schacht. All students will finish their programs in December 1999. We are glad to have them at our facility and are we're trying to see that they get the best experiences for their future careers. By Carrolyn Bryant

Surgical Technologists Week, September 19-25, was celebrated in grand style at Summit thanks to the hard work of Daisy Ricafrente, RN. Daisy solicited donations from MDs, reps, RNs, and others to create a week long celebration. Daisy works 1030-1900 and came in early every day to set things up. Others also helped. Margaret Vitry was the margarita mix master on Wednesday.

• Monday - continental breakfast
• Tuesday - ice cream social
• Wednesday - hot dog stand (complete with margaritas - alcohol-free of course - made with the cardiac slush machine
• Thursday - desserts galore
• Friday - sandwiches to go (four different kinds of sandwiches, chips, drinks)

By Mary Ritchie

Desperately Seeking...
October 1999

Would you like to be the newsletter editor and web site manager for AORN Alameda County? I've been the editor since 1993 and developed the web site in 1997 and I'm ready to retire! I feel I've done both for long enough and it's time for new blood with new ideas. If you volunteered now, you could take over gradually or all at once - what-ever you wanted to do! I will offer whatever assistance and guidance you want. Everything is very organized and well documented so it'll be easy to just jump right in. If you have a Macintosh computer, I can transfer all the forms that go along with the editor job. If you have a non-Mac, then you can copy the format I used or create something new (I use ClarisWorks which is a Mac program).

It only makes sense for the newsletter editor to also manage the web site since the editor will have all the information for the newsletter and only needs to code it into html to post it to the web site. I can teach you how to manage the web site in one hour or less. I use the simplest html coding and it's a basic format. Or you can change the entire web design to fit into a template and not bother with html coding.

If you have the slightest interest in doing this, please e-mail me ([email protected]).

By Mary Ritchie

Donna Saves A Life!
October 1999

Donna Benotti saved a life! Amidst the celebrations for Surgical Technologist Week at Summit, Donna came to the rescue of Renee Farrar, our relief desk coordinator. Renee had improperly swallowed a hot dog, choked, gave the universal distress signal, and Donna jumped up and performed the Heimlich Maneuver on Renee. The results were excellent with spewed hot dog (which Donna cleaned up!). The clincher of this story is that Donna is a CPR instructor who uses the hot dog as her standard example for a child who's choking and needs airway management or clearance. Was it kismet Donna was the one to the rescue of the hog dog choker? I've made light of this due to the weird hot dog connection, but seriously - Donna should be congratulated for her fast reaction and professionalism. Thanks, Donna!

By Mary Ritchie

I had always dreamed of visiting Scandinavia. Being of one-half Swedish and one-half Finnish descent, I was naturally curious about the homeland of my ancestors. So, when I discovered there was to be a World Conference on Surgical Patient Care in Helsinki this year, I knew I had to go. I set out on my own, a daunting prospect, given the distance and the language barrier. Fortunately, I met a fellow OR nurse from Brooklyn, NY, my second day there and had a companion for the entire week. We hooked up with two other nurses, from New Jersey and Florida, respectively, and the four of us became fast friends.

The conference opened on Monday morning with the president of each country's OR nursing organization parading into the conference center, each carrying their country's respective flag. It was an impressive display. The conference was entitled "The Essence of Perioperative Care" and was hosted by the Finnish Operating Room Nurses Association (FORNA) in cooperation with AORN. Kristiina A. Junttila, RN, served as the main moderator and was assisted in her duties by Patricia Seifert, RN.

The format of the World Conference was like that of National Congress, with education sessions, research poster displays, and exhibits. The classes are presented in English by nurses worldwide, with headphone translations available as needed. Tours of the area were offered on the weekends before and after the conference, as well as during the week. These included a Helsinki city tour, a visit to Estonia, and even a three-day excursion to St. Petersburg, Russia, to name but a few.

For me, the highlight of the conference was the International Fellowship Night on Monday evening. Nurses wore the native costumes of their country for a colorful night of food, fellowship, and fun. The Best International Dress award was presented to the charismatic duo from Zimbabwe who wooed the audience with their moves. Oh, did I mention that there was a band and dancing?

I found Helsinki to be an embracing city and its inhabitants friendly and helpful to visitors. We had a delightful tour guide named Tuula on several outings. She strongly denied the claims made by "60 Minutes" that the Finns are depressed and rarely smile. They tend to be reserved, but that's just their nature, she explained.

Helsinki has a Russian feel combined with modern, functional architecture. Finland was under 600 years of Swedish rule before being taken over by Russia, from whom it gained its independence in 1918. This relatively recent emancipation has produced a fierce nationalism in its people and pride in all that is Finnish. The country has a primarily socialist economy with a very high tax rate, but a 99% literacy rate and very little crime. During my stay, it was daylight for 20 hours each day and I was told it was safe to walk anywhere in the city.

My last weekend in Scandinavia, I took an overnight ferry to Stockholm. It was a 14-hour journey. These ferries are actually the size of cruise ships and there are two competing lines, the Viking and the Silja. I spent eight hours exploring Stockholm before making the 14-hour return voyage to Helsinki. I was surprised to discover that Stockholm is made up of many islands connected by bridges. Sweden is a monarchy, as reflected by its architecture.

My Silja ship docked at the harbor in Helsinki near the open-air marketplace, a delightful display of fresh produce, handicrafts, and seafood. I boarded the tram to take me to the Holiday Inn, where I would meet my friend to share a taxi to the airport. She was returning from St. Petersburg and we traded tales of our weekend adventures. I was completely charmed by Helsinki. The World Conference was an experience I will always treasure and I think the friendships I made will be with me for a long time to come. I recommend the adventure to anyone.

Submitted by Donna G. Rodgers

Leadership Conference
August 1999

One of the privileges of being in a leadership position of AORN is getting a trip to Denver to see the Headquarters building, meet the staff and attend the Leadership Conference, all paid for by AORN. On June 11 I flew from Oakland to Denver. At the Denver airport I met up with Arlene Sakamoto who attends some of our meetings but belongs to another chapter. We took a shuttle bus to the downtown Marriott Hotel. After checking in we took one of the hourly tours of the headquarters followed by a reception. We saw all the former presidents pictures on the wall in one hall, and an unusual wall hanging made of surgical retractors welded together in the reception room. We met staff and saw where the journal was being written.

My roommate Cathy Nisen, who is Contra Costa County's president, arrived later. She took the 5:00 headquarters tour. We went to dinner at a fabulous Italian restaurant a couple of blocks from our hotel. Saturday we attended the conference in a ballroom in the hotel. It was preceded by a lovely breakfast in an adjoining ballroom. It was fun meeting and talking to some of the other 330 chapter leaders from across the country. Patricia Seifert our national president lectured on "The True Value Of The Perioperative Nurse." "Demonstrating Expertise and Validating Wisdom" by Patricia Brenner completed the morning. After a lovely lunch we met in small groups. A more formal dinner where national officers and representatives sat with us at each table to tell us of future plans and receive feedback, completed the day. Their idea is that the Foundation may not be able to fund the conference so they may have regional conferences. We told them we really want to come to Denver. Seeing the headquarters is a real benefit.

Sunday morning we had a continental breakfast with AORN Board Liaisons followed by an interesting talk on "Effective Conflict Management Skills" then small group discussions of our choosing. I chose "Help For First Time Presidents," and "Revitalizing Your Chapter." In our packets we received the handouts for all 14 sessions. The conference ended at 1:00.

I had arranged to meet some dear friends I hadn't seen for years. We went to lunch for a couple of hours before I caught the shuttle to the airport.

It was all a very worthwhile experience. I realize that our chapter is so much more organized than some and that headquarters will send help to chapters who need it. Thank you AORN for sending me.

By Martha See, President

A Plea!
August 1999

Hello Colleagues,

This such a popular medium for sharing information and ideas, so I'd like give you an update on what I've been doing and pass along some comments I've received from friends, colleagues, and associates.

I attended AORN's Exhibitors Advisory Committee (EAC) recently, and was pleased by the continuing support our industry colleagues provide. We discussed the 1999 Congress and plans for 2000 (they have made a very generous contribution toward General Colin Powell's presentation at the 2000 Congress). One very important item that I want to share with you is industry's support of your purchasing power through the unique knowledge and experience you bring. One person told me that they often request comments and feedback from nurses, but many times they get responses such as, "I don't make decisions," or "We're on contract." This is the kind of opportunity to demonstrate our expertise that we can't afford to pass up! Please, colleagues, support each other and patients by filling out the questionnaires, responding to surveys, and providing verbal feedback. Be recognized for the expert you are!

By Patricia Seifert, National AORN president
From May 25, 1999 MemberTalk (AORN member list-serve)

From National...
August 1999

AORN Center for Nursing Practice regarding Proposed Recommended Practice, Safety Through Identification of Potential Hazards in the Perioperative Environment.

Please be advised that the above proposed Recommended Practice along with the Comment Form is now available for review on AORN's web site at the following address: www.aorn.org/proposed/hazards.htm. Or it may be ordered on our FAX ON DEMAND service, (800) 755-7980, document #5226. If you do not have either method available to secure this document, please notify Joyce Davis at (800) 755-2676, x334 and I will send it in hard copy. The proposed Recommended Practice on Positioning will become available for review by the middle of August. Please use the same reviewing methods for all future proposed Recommended Practices. AORN wishes to thank you for all your input on the Recommended Practices that go out for review. The value of your expertise allows us to continue to produce recommended practices of the highest quality.

By Joyce Davis, Center for Nursing Practice, AORN

Congratulations!
August 1999

Congratulations to the CNORs on their 20th year anniversaries! Congratulations to these long-standing CNORs who have maintained continuous certification as operating room nurses since the inception of OR nursing certification. Everyone listed was certified in September 1979.

• Ann Ceasri
• Constance Dana
• Phyllis Hellwig
• Beth Mar
• Kitty McCartney
• Stephanie Reddell
• Betty Rosenheimer
• Jacklyn Takahashi-Schuchardt

The eight listed above were the pioneers certifying in the first year certification was available.

There were 28 RNs certified in the 1980s and 49 were certified in the 1990s. We have no CRNFAs.

We have a total of 85 CNORs as of December 31, 1998.

Poetry Corner
August 1999

Have you ever wanted to scream and bail
when confronted with hard-as-rock skin and nails?

The skin and toenails that are chipped and rough
that snag on TED hose even when cuffed.

Here to your rescue is the plastic bag...
slip over the toes to eliminate snags.

(Slip the TED hose bag over toes for easy application - then pull out!)

Poem by Mary Ritchie. Technique from Calvin Benton, MD who learned it from nurses at Eden Medical Center, Castro Valley.

AORN Online News
August 1999

The Proposed Recommended Practices for "Positioning the Patient in the Perioperative Practice Setting" (www.aorn.org/proposed/position.htm) is online and available. Comments are requested. Deadline for comments: August 20.

By Dan Sjogren, National AORN

Surgery in the Volcano's Shadow
April 1999

Why would you go to Colima, Mexico at the foot of an active volcano? Well, a group of Summit nurses and doctors and others have just done that and returned with great stories of daily events and adventures. Carol Donovan, Maria Cam, Vicky Christophe, Iyana Amayani, Fleurette Guze, Dr. Andy Moyce, Lois Marmott, and Dr. Robert O'Connor comprised the group from Summit that went with International Medical Assistance (IMA). IMA is a voluntary medical service group in Mexico lead by Dr. and Mrs. Roberto Rodriguez. We were joined by about 80 other doctors, nurses, and general helpers from all over the United States.

The plans for a trip like this were set in motion months ago when surplus or damaged supplies were gathered and stored in two sites (supplied by the hospital) in Summit South Pavilion. Then the work started sorting all these supplies and rewrapping gowns, surgical drapes, gloves, etc. The supplies were all resterilized by Central Processing Department (CPD) at Summit South and North Pavilions. This help was wonderful and a big thanks goes to Jeff Aldea and Ricky Jackson and all their willing staff. Now the packing started and the supplies found their way into 30 some boxes.

We all arrived in Manzanillo in the state of Colima, Mexico on Saturday evening, February 13, 1999. We were welcomed by the Governor and his wife and by the Secretary of Health. This welcoming included the usual speeches, etc. but also the serving of a fantastic seafood buffet which included the best octopus we�ve ever eaten. Later that night, we were bussed to Colima, the capital, which was in the glow of the volcano.

The fun began on Sunday morning when we turned an unused surgicenter into a three O.R./30 bed hospital. The boxes were unpacked, supplies sorted, and O.R.s arranged and made ready for Monday morning. We had one anesthesia machine, one O.R. table and one pretty good sterilizer. What more could we want?

The O.R. table had stirrups, so it was dedicated to GYN. In two weeks, we did about 45-50 hysterectomies and AP repairs. They were all done with spinal anesthesia and an ambu bag as back-up because the anesthesia machine was dedicated to ENT and children�s cases such as hernias. The O.R. table for ENT was an old fashioned gurney - the kind you can lift the top off. The importance of this comes later. This was in room one.

The second operating room was about half the size so we could put only one gurney in it. No room was lost with an anesthesia machine since we didn�t have one. Another ambu bag supplied venilatory support.

With supplies and packs all neatly arranged, Monday morning saw us doing our first cases. We finished the first day with ten to 12 cases behind us. The next day, we about doubled that number and we were soon up to 25-30 cases per day. All went well with many happy faces - well, maybe not the children with T&As or hernias!

Recovery was a challenge too. We had one small room in which we had two beds and a crib or a gurney. This was first stage. Second stage was in the dormitory of an orphanage down the hill. The beds, however, were only six inches off the floor. This made for some interesting nursing care. The route to this second stage was about one block down a hill, and six people were needed to carry the top of the gurney (minus the legs and wheels) over the grass, up three steps, and then to one of the six inch high beds.

Many cases were memorable, but one day the GYN doctor was removing a basketball-sized tumor and Dr. Andy Moyce was at the other table doing a mastoid surgery through a microscope when everyone went over to see the tumor, leaving Andy alone. His question to us all was, "What's going on here? Am I chopped liver?"

There were other events to warm our hearts. There were several children we were able to fit with refurbished hearing aids. The expressions on their faces will not be easily forgotten.

Social events were numerous. We had a wonderful barbecue at the base of the volcano. The fire on top of the volcano was spectacular in the night sky. A special ballet of native dance was performed for us. Many said it rivaled the folkloric dance ballet in Mexico City. The final meal was a steak dinner with a mariachi band provided for our enjoyment.

The final weekend was in Manzanillo with fun on the beach and in the pool.

So why go on a medical mission to Colima? For me, all of the above, and especially because Jesus said we should love God above all and love your neighbor as yourself. Our neighbor is, I believe, anyone standing before me. This love overflows among all the participants in the team and all the patients who come to us for help.

The next trip is the last two weeks in February, 2000 to Valladolid near Cancun. Interested?

By Robert O'Connor, MD
Anesthesiologist at Summit Medical Center, Oakland, CA
510-869-6581

Scholarship Winners!
April 1999

The Board of Directors of AORN of Alameda County awarded a $100 scholarship to each of the following people to attend the 1999 AORN Congress to be held in San Francisco March 28 - April 1:

• Diane Brophy
• Karin Selbach
• Marsha Conner
• Ferne Spector
• Nelda Devine
• Ann-Sophie Taylor

They are all first-time Congress attendees. To be eligible to receive the scholarship, each person must submit a post-Congress article about her experience to the newsletter editor by May 20.

By Kathie Shea

What's Up Nurse?
April 1999

Kaiser Ambulatory Surgery Center, Pleasanton
Lila McAlhany recently retired and is enjoying the golden years traveling, taking fun classes, and experiencing leisure living.
By Lila McAlhany

Healthsouth Surgery Center of Castro Valley, Castro Valley
Welcome to Veda Knight, Administrator. Veda came from Ralph K. Davies Medical Center and now lives in Dublin. Veda, we look forward to your joining the Alameda County chapter and seeing you at the meetings.
By Clenia Yadao

San Ramon Regional Medical Center, San Ramon
We�re building a new outpatient surgery center.
By Marsha Conner

Valley Care Medical Center, Pleasanton
Cindy Noonan, RN, MSN, CNOR, was promoted to Vice President of Patient Services. Our new Director is Judy Kramstra, RN, MSN, CNOR. Our new Nurse Manager is Julie Panis, RN. Julie was the former evening charge nurse. Valley Care bought Valley Surgery Center. Julie and Judy are now over both ORs (the hospital and the surgery center) Beth Combs, RN, former Director from Valley Surgery Center, moved to Roseville.
By Nelda Devine

April 1999 Newsletter Submission

Our deepest fear is not that we are inadequate.
Our deepest fear is that we are powerful beyond measure.
It is our Light, not our Darkness, that most frightens us.
We ask ourselves, who am I to be brilliant, gorgeous, talented, fabulous?
Actually, who are you NOT to be?
You are a child of God.
Your playing small does not serve the World.
There is nothing enlightened about shrinking so that other people won�t feel insecure around you.
We were born to make manifest the glory of God that is within us.
It is not just in some of us; it is in everyone.
And as we let our own Light shine, we unconsciously give other people permission to do the same.
As we are liberated from our own fear, our presence automatically liberates others.

Nelson Mandela, 1994 Inaugural Speech

Submitted by Brian Donohue,
District Sales Manager
Skytron Surgical Lights & Tables
Sales & Service

A Helping Hand
No appearance in the April 1999 newsletter due to lack of space

AORN and the Washington State Council of Perioperative Nurses hired a lobbyist to assist them with defeating a bill for the registration of Surgical Technologists(ST). The lobbyist was invaluable and both the House and Senate bills passed with the desired wording. This strict registration bill allows STs to fall under the Uniform Disciplinary Act which provides a mechanism for the state to track people performing this role anywhere in Washington State. The lobbyist earned $10,000. National AORN is paying $5000. The State of Washington nurses have to pay the other $5000. By March 2, they have raised $1500. If anyone would like to contribute to this worthwhile cause, please send a check payable to AORN to: AORN, 2170 South Parker Road, Suite 300, Denver, CO, 80231-5711. Attn: Candace Romig. Please mark "For Washington State Lobbyist."

From the March 2 Periop Listserve, posted by Anita Shoup

Are You Happy Being A Nurse?
No appearance in the April 1999 newsletter due to lack of space

"Ann Landers has periodically featured letters from Registered Nurses across the country, and also Canada in her advice column. Many of these letters point out the challenges and frustrations Registered Nurses face in today�s managed care environment. A recent letter, written by an individual in Quebec, ran on January 27, 1999."

"This writer speaks about how nurses must 'continuously fight for the basic tools to do their job � authority, recognition, and respect. The financial rewards aren�t great either. Nurses care for patients when they are most vulnerable�the nurse is there to calm the fears of a man before his surgery�.' Landers� response was, in part, 'I've had a ton of letters with a litany of complaints. The profession is clearly in a state of jeopardy. And now, I would like some suggestions on how to fix it.'"

"If you have a thought or two on how to 'fix it' and want to share it with Ann Landers, you may write her at: Ann Landers, c/o Creators Syndicate, 5777 West Century Boulevard #700, Los Angeles, CA 90045-5600."

"Or, you can e-mail Ann Landers http://www.creators.com/lifestyle/landers/writelan.asp."

National AORN would like to hear from you, too. Please add a "cc" to your message and send it to Janet Paulson, AORN Headquarters, 2170 South Parker Road, Suite 300, Denver, CO 80231-5711. Or e-mail to [email protected].

Visit AORN Online to view the letters to Ann Landers from disgruntled nurses: http://www.aorn.org/nsgtoday/ann_landers.htm.

From AORN Online

Christmas Greens Sale
February 1999

Thank you to all of you who purchased Christmas Greens during our Fall fund raiser. Not only did you beautify your homes or those of family and friends, but you also helped the chapter raise $622.50! A special thank you to those who took orders, collected money, counted out the facility orders, and distributed the greens:

• Carrolyn Bryant, Kaiser Oakland
• Darlene Geach, St. Rose
• Ann Kintz & Beth Mar, Eden
• Pam Reuling, Cal State Hayward
• Donna Rodgers, Washington
• Jo Sakaldasis, Retired
• Martha See, Kaiser Hayward
• Kathie Shea
• Jacklyn Schuchardt, John Muir
• Karen Stevens, Health South
• Debbie Tung, Alta Bates
• Clenia Yadao, Health South

By Donna Benotti

THE INVITATION
February 1999

It doesn't interest me what you do for a living.
I want to know what you ache for,
and if you dare to dream of your heart's longing.

It doesn't interest me how old you are.
I want to know if you will risk looking like a fool for love,
for your dreams, for the adventure of being alive.

It doesn't interest me what planets are squaring your moon.
I want to know if you have touched the center of your own sorrow,
if you have been opened by life's betrayals
or have become shriveled and closed from fear of further pain!
I want to know if you can sit with pain, mine or your own;
without moving to hide it or fade it or fix it.
I want to know if you can be with joy, mine or our own;
if you dance with wildness and let the ecstasy fill you to the tips
of your fingers and toes without cautioning us
to be careful, be realistic, or to remember the limitations of being human.

It doesn't interest me if the story you're telling me is true.
I want to know if you can disappoint another to be true to yourself,
if you can bear the accusation of betrayal and not betray your own soul.
I want to know if you can be faithful and therefore be trustworthy.
I want to know if you can see beauty even when it is not pretty every day,
and if you can source your life from God's presence.
I want to know if you can live with failure, yours and mine,
and still stand on the edge of a lake and shout to the silver of the full moon, "YES!"

It doesn't interest me to know where you live or how much money you have.
I want to know if you can get up after the night of grief and despair,
weary and bruised to the bone, and do what needs to be done for the children.

It doesn't interest me who you are, how you came to be here.
I want to know if you will stand in the Center of the Fire with me and not shrink back.

It doesn't interest me where or what or with whom you have studied.
I want to know what sustains you from the inside when all else falls away.
I want to know if you can be alone with yourself,
and if you truly like the company you keep in the empty moments.

-- Oriah Mountain Dreamer, Indian Elder

Submitted by Brian Donohue (of Skytron) in memory of his mother Clare Donohue

Abandonment of Patients
February 1999

�Inquiries have been received by the Board of Registered Nursing (BRN) regarding which actions by a nurse constitute patient abandonment and thus may lead to discipline against a nurse�s license.

For patient abandonment to occur, the nurse must:

a) Have first accepted the patient assignment, thus establishing a nurse-patient relationship, and then

b) Severed that nurse-patient relationship without giving reasonable notice to the appropriate person (e.g. supervisor, patient) so that arrangements can be made for continuation of nursing care by others.

A nurse-patient relationship begins when responsibility for nursing care of a patient is accepted by the nurse.

Refusal to accept an assignment or a nurse-patient relationship is not considered patient abandonment by the BRN. Failure to notify the employing agency that the nurse will not appear to work an assigned shift, and refusal to work additional hours or shifts would also not be considered patient abandonment by the BRN. Once the nurse has accepted responsibility for nursing care of a patient, severing of the nurse-patient relationship may lead to discipline of a nurse�s license.

The RN who follows the above BRN advisory statement will not be considered to have abandoned the patient for purposes of Board disciplinary action. However, it should be noted that the BRN has no jurisdiction over employment and contract issues.

From the California Board of Registered Nursing
Submitted by Donna Benotti

Sutures - A Historical Perspective
February 1999

"The use of linen strips and animal sinews for wound closures and for ligatures is described in the literature as far back as 3000 BC in the Edwin Smith Papyrus. Since then, many materials have been used for these purposes: dried gut, dried tendon, strips of hide, horsehair, human hair, bark fibers, and textile fibers of various kinds."

An ant is set on the margin of the open wound and promptly sinks its claws into the wound. The edges are then drawn together and the rear claws of the ant grip the other side of the wound. The insect is then beheaded and the shriveling of its body draws together the edges of the cut. The ant, even in death, will not release its grip."

Reprinted with permission from Linda Groah. From "Second Edition Operating Room Nursing Perioperative Practice," by Linda Groah, RN, MS, CNOR, pages 305-306. Subtitles are the web manager's and were not part of the book.

What is a Registered Nurse First Assistant?
February 1999

A registered nurse first assistant (RNFA) is a technically skilled and highly educated nursing professional. The RNFA gives direct patient care as part of the perioperative nursing process. The RNFA role includes preoperative assessment, teaching (in non-teaching institutions), wound exposure, tissue handling, obtaining hemostasis, suturing, and in some institutions, postoperative assessment and wound care.

It has been nationally recognized that a qualified registered nurse is the best person to fill the role of first assistant in the absence of a surgeon. This idea has been embraced by the following groups: American College of Surgeons, Association of Operating Room Nurses (AORN), American Nurses Association, and all state boards of nursing. Surgical technologists in California are not qualified to be first assistants.

To become an RNFA, a registered nurse must meet specialized qualifications based upon licensure, certification, work experience (at least two years perioperative nursing), and advanced education.

The course is six days of didactic lectures and is very rigorous. The classroom work covers the history of RNFAs, taking histories, physical reports, suturing, and postoperative evaluation of the patient. The lectures are informative and helpful.

The class size is limited to twenty. My class had fifteen. This size allowed for individual instruction in an informal atmosphere.

After the class work, I started on my required internship under the supervision of Dr. L. Thompson, a cardiac surgeon on the staff of Children�s Hospital in Oakland, CA.

By Mary Elder
(Elder is employed by Children�s Hospital and works as an RN first assistant intern)

Technicians Assisting?
February 1999

I was given the following information after someone read the article in the December newsletter, �Technicians Assisting? In Berkeley?� This article can be found by scolling down this page.

If an RN witnesses unlicensed personnel performing first assistant duties which include: clamping, cutting, and/or tying tissue, using cautery, using power equipment, pounding/hammering orthopedic nails, manipulating tissue, and/or injecting medication, the RN should report these actions.

Reports should be sent with specific details (surgeon, facility, patient�s name, medical record number, date, procedure, functions performed, name, and title of unlicensed person) to:

The facility�s Risk Management department or the facility�s attorneys.

The Department of Health Services
One Almaden Blvd. Ninth Floor
San Jose, CA 95113
408-277-1784

Questions can be referred to:
Shannon Sutherland, RN, JD
California Nurses Association
1100 Eleventh Street Suite 200
Sacramento, CA 95814
916-446-5019 extension 15
FAX 916-446-6319

If this is happening (techs assisting), then the tech should be listed on the paperwork as the assistant and the RN should cover himself/herself by reporting this unlawful assisting to his/her supervisor. The RN should also complete an incident report to protect himself/herself legally (that all the correct reporting steps were taken). Please be proactive and educate the MDs that they cannot legally have a tech assist them.

By Mary Ritchie

News Flash! News Flash!
February 1999

Although the formal comment period to HCFA has passed, it is NOT too late for nurses and concerned citizens to voice their concerns regarding the rule changes proposed by HCFA - mainly the rule that would eliminate the requirement of having a registered nurse supervise the activities in the OR. So if you have NOT made a response or would like to respond again, you and your friends, neighbors and relatives are encouraged to contact your Congressional representative and request that they ask HCFA Administrator, Nancy- Ann Min DeParle, to retain RN supervision in the OR. Again, the talking points are that it is critical to the health and safety of surgical patients that assistive personnel who perform scrub and circulating tasks in the OR be supervised by professional RNs. Otherwise, the quality of patient care and surgical outcomes will suffer. If you or a loved one are in the vulnerable position of undergoing surgery, you should be able to rely on the skills, knowledge and expertise of the RN in the OR.

By Pam Reuling

Scholarship Raffle Winners!
February 1999

Lavender Hill Bed and Breakfast in Sonora - Pam Reuling, RN, of California State University at Hayward

Earthquake Preparedness Kit (donated by Earthquake Safety, Inc. of Berkeley) - Pam Reuling, RN, of California State University at Hayward

Basket from J. P. Strawbottoms - Pam Reuling, RN, of California State University at Hayward (Yes, believe it or not, Pam won all these prizes - and the tickets were shaken, mixed, and agitated!

$100 cash - Pat Kubo, RN - The Surgery Center, Oakland

Basket from Scott�s of Jack London Square - Pat Kubo, RN - The Surgery Center, Oakland (Yes, Pat won two prizes even with all the tickets extremely well mixed!)

Florist Gift Certificate (donated by Renwick-Wolfe of Alameda) - Susan Sykes, RN, Summit Medical Center

Basket of Chocolates - Donna Benotti, RN, Summit Medical Center

Mary Kay Basket (with socks and lotion) (donated by Marie Felis) - Karin Selbach, RNFA

Poinsettia - Cleo Pharr, RN, Summit Medical Center

Thanks to everyone for your support of the Scholarship Committee in buying and selling tickets! Congratulations to all the winners! To all the non-winners - there�s always next year!

Technicians Assisting?
In Berkeley?*

*With apologies to the Berkeley Farms advertising agency who coined �Farms? In Berkeley?�

Shouting, screaming, and rending of clothes - it all happened at the November 4 chapter meeting. There were quite a few new faces in the audience and an excellent turn-out for the presentation on �Unlicensed Assistive Personnel in the Operating Room� by Shannon Sutherland, RN, JD. What a volatile topic!

Shannon brought a thick packet of supporting documentation that she had obtained as the California Nurses Association (CNA) regulatory policy specialist. The packet was 14 pages (double-sided) and what follows is a small sample.

*Letters from the Department of Health Services to Shannon Sutherland about complaints concerning specific actions at hospitals. These actions include an orthopedic technician suturing and injecting local anesthetics.

*There was a March 25, 1998 memorandum to all Department of Health Evaluator Supervisors from Shannon Sutherland regarding operating room assistants at Kaiser hospitals. (The operating room assistants at Kaiser are surgical technologists under another name.) This addressed a formal complaint by CNA against the General Acute Care facilities of Kaiser Northern California. They have used electrocautery, used drills and other power equipment, hammered orthopedic nails, and sutured incisions for closure.

*There was an April 1998 Legislative and Regulatory Alert from the Association of Surgical Technologists (AST). It stated the California Assembly passed Assembly Bill 695 by a narrow margin (41 to 36). It said if this bill was passed by the Senate, it could limit the role of surgical technologists. �Because the state of California does not currently license, certify, or recognize in regulations the scope of practice of surgical technologists, this legislation may also be used to limit the use of surgical technologists.� This alert interested me enough to look into the AST web site. The following was obtained from the AST web site (www.ast.org).

By Mary Ritchie

OR Nurse Week - November 8-14

Summit Medical Center

OR Nurse Week was one long celebration in the Summit OR, North Pavilion! Daisy Ricafrente, RN, organized a very large bulletin board with 5x7 photos of us from nursing school days and titled it "Glory Days." That was a lot of fun.

Two of the surgical techs (Annelies McNair and Jennifer Nelson) organized the food and gifts for the week. We started on Monday with muffins, danish, cinnamon rolls, fruit, milk, and orange juice at our 7am education class (Dr. Miriam Warner�s presentation �Caring for Asian Patients�). They repeated this for the afternoon crew at their education meeting at 2pm. They also provided a jar filled with injection needles (for us to guess how many needles were in the jar), a word scramble game (it was the hardest word scramble I�ve ever seen!), and a contest to list 12 nurses by seniority. It was a lot of fun. The contest lasted all week and prizes were awarded to the winners on Friday morning. Tuesday was Build Your Own Nachos Day, Wednesday was Root Beer Float Day, Thursday was Italian Food Day (pastas, garlic bread, salads), and Friday was a raffle with the distribution of many gifts. Annelies and Jennifer expended a tremendous amount of time and energy for OR Nurse Week. We Summit OR nurses extend our most sincere appreciation to them and to all the surgical techs who generously contributed with gifts, time, food, and money. We also thank our generous anesthesiologists and the Physician�s Assistants Group (Ann Whisenat, Cathy Dunning, and Carl Olmstead) who contributed financially and generously. Thank you all! We all had a great time.

By Mary Ritchie

Alta Bates Medical Center

Alta Bates celebrated OR Nurses' Week with our peers leading off the celebration with a dessert party. The staff from PACU and SDC organized a potluck dessert party for the OR staff. I was very touched by this gesture and would like to personally thank Karen Machado, RN, for organizing this dessert party for the OR staff. Karen is a PACU nurse. It 's nice to know that my peers (the PACU and SDC) appreciate us (the OR) enough to throw us a party. Thank you.

Alta Bates' management and the U.S. Air Force co-sponsored a luncheon for the OR staff on Friday. Apparently, our manager, Kathy Crummey, RN, entered Alta Bates in a raffle and we won a lunch. Along with the delicious luncheon, Kathy gave each OR nurse a lapel pin. The pin is gold with a yellow stone (I believe that they are one carat yellow canary diamonds!) which states ABMC operating room nurse. I appreciated the lunch and gift.

By Debbie Tung

RNFA Legislation Update
October 1998

I just returned from the AORN Specialty Assembly Forum in New Orleans, land of Southern hospitality, good food, and good music. After the first day of seminars and a visit to the House of Blues, an RNFA from Eureka and I went to the Cafe du Monde for coffee and beignets. Our eight-block walk back to the hotel was accompanied by the arrival of tropical storm Francis. Mother Nature was showing us her stuff. Visibility was about a foot and because I am blind without my glasses (which were covered with blowing rain), I had virtually no visibility. It was pouring and pelting us sideways as we ran through the warm rain, stepping in puddles to our shins. We laughed the whole way as my much-too-serious life's agendas washed away. We were kids again - young, wet, and giddy. Upon entering the lobby of the Marriott, a bellhop handed each of us a towel. My long denim jumper weighed at least 50 pounds and we were rapidly soaking the red carpet as we stood there laughing. Then the bellhop began to laugh. Then two women waiting for a taxi were affected. For 20 minutes, five adults were stricken with the contagion of out-of-control laughter, truly the world's best medicine.

It became clear to us that this handful of RNFAs in California couldn't afford the power necessary to get these bills through the House and Senate. To get a legislator to sponsor us, we realized we really needed a big organization to sponsor us. To condense months of work, I will get to the point. CNA (California Nurses Association) is sponsoring us.

So please get your pens and stationery ready - we'll let you know who to write to and hopefully have a number on the bills soon, with a sponsor from the House or Senate.

Meanwhile, I wish everyone a run-in-the-rain, be-a-kid-again kind of laugh. We need more of those!

By Karin Selbach

"You Can Walk the Walk, but Can You Talk the Talk?"
October 1998

This presentation by Dr. Susie Kleinbeck on September 2 was dynamic and enthralling. Not more than 30 people attended the presentation and I felt sorry for all those who stayed home. If you thought perioperative nursing data elements was going to be a dry topic, you were grossly mistaken. Some of the highlights follow.

Submitted by Mary Ritchie

Board of Registered Nursing Report
October 1998

The summer issue of the Board of Registered Nursing (BRN) Report contained information regarding continuing education certificates. This information, verified by me with the BRN, has resulted in the way the chapter issues continuing education certificates.

Effective at the September chapter meeting, certificates will be completely filled in by the provider. This means that you must pre-register to receive a certificate at the close of the program. Please include your RN license number on the dinner check. If you choose to not attend the dinner portion of the meeting, call Donna Benotti (510-352-5064) and leave your name, complete address, and license number on the recorder. If you choose to attend at the last minute, bring a self-addressed, stamped envelope and your certificate will be mailed to you. Another alternative is to pick up your certificate at the next month's chapter meeting.

By Donna Benotti

Whoops!
October 1998

A "Bridge Pin" disappeared at the September chapter meeting! There was a box on a table with a display of the Golden Gate pins (with red and white rhinestones set in gold metal). The pins cost $15 each. We hope someone accidentally took one pin to examine and took it home by mistake. If you find yourself with a bridge pin that you didn't pay $15 for, would you please return it to Beth Mar? You may mail it to her at Eden Medical Center, 20103 Lake Chabot Road, Castro Valley, CA 94546, Attention Beth Mar, Surgery-Operating Room. You may also return the pin at a chapter meeting. Thank you.

By Mary Ritchie

Do Tell!
October 1998

Kaiser Oakland

We are trying to get a group tour for World Conference in 1999 (in Helsinki, Finland). Suggested countries for the tour are Denmark, Sweden, Norway, Finland, Poland, and Russia (St. Petersburg - possibly Moscow). The tour would be about one month long. We need names of interested people so we can have a definite number to work with. If you're interested, send your name, address, phone numbers, and number of people interested to: Carrolyn Bryant, 1905 Burbeck Avenue, Richmond, CA 94801. Please contact me soon - we need to finalize the countries to tour and decide on one travel agent.

Kaiser has been taking students for clinical rotation from Hi Tech Institute in Sacramento and from a new tech program at Mt. Diablo Adult Education in Concord. Two Hi Tech students have been hired. Our next Mt. Diablo students will begin their rotation in October.

Submitted by Carrolyn Bryant

Tri-Valley Surgery Center

Congratulations to Sherry Darilek - graduate BSN!

Submitted by Sharon Reid

Alta Bates Medical Center

We have a new Director! Welcome to Nancy Walker.

Submitted by Debbie Tung

Summit Medical Center

"Marilyn Chow, DNS, RN, FAAN (vice president of patient care services), has been appointed to the National Advisory Council on Nurse Education and Practice of the Health Resources and Services Administration by Donna Shalala, secretary of Health and Human Services. The council advises Shalala on matters relating to nursing education and practice." Congratulations to Marilyn for this prestigious appointment!
From "NurseWeek," August 10, 1998, Volume 11, Number 16, page 8.

Submitted by Mary Ritchie

Attention Autumn Lovers!
October 1998

Access Pennsylvania's web site for live shots (changed every 30 minutes!) of the fall foliage!

Healing Hurts
August 1998

When we think about healing we think about surgical wounds, explaining to our patients and their loved ones the approximate course of events as a surgical patient on the day of surgery. Or, if you are lucky, you are able to share that knowledge with them prior to the day of surgery. I never imagined what the meaning of the word healing would come to mean on a professional level until July 3rd.

Submitted by Claire Rozman
Former active chapter member and past president (1993-1994)

Steps To a Successful Job Search
August 1998

Are you contemplating a job change? Making the transition from one position to another may take some planning. Formulating your approach ahead of the actual job interview will make the difference between landing the desired position, or simply having to take a job because it was the only opportunity offered. When job hunting, provide yourself with a written checklist to map your job search progress. The three step process outlined below will help you successfully execute a plan providing you with the opportunity to acquire a position that meets both your personal and professional needs.

����������

• Where am I now, with regards to my career?
• Where would I like to be?
• What types of skills can I bring to a new position?
• What types of additional or ongoing training might I need?
• Am I willing to invest the time/money or other resources required into obtaining the needed skills?
• Am I willing to consider relocation for a position that offers upward career mobility?
• If so, what areas would work best for my career and my family?
• How soon will I be available for a new position?
• Who will I need to consult before making my final decision?

With regards to goals consider the following questions:

�

• What type of position is best suited for me at this stage of my career? (Make sure to consider all the data you've obtained in the assessment phase.)
• What hours am I available to work?
• Am I willing to travel, and if so, how many days a week are acceptable to be away from my family?
• What salary do I desire? (Be realistic in this stage considering your geographic location, skills and prevailing market salaries for others with similar skills and qualifications.)
• When can I reasonably be expected to begin a new job?

By planning your job search effectively, you will increase the odds of landing a new position in which your skills, qualifications and experience will be utilized in a way which benefits both you and your new employer.

Submitted by Lee Powers

Lee Powers, RN, BSN is the Director of Recruitment Services for Advance By Design Medical, a Nationwide Medical Recruitment firm headquartered in Colorado. Ms. Powers may be reached at phone number (970) 243-3109 or via e-mail at [email protected]

None of the content of this article may be reproduced, stored in a retrieval system, or transmitted in any form without the express written consent of the author.

The Future Holds Marvelous Things...
August 1998

The 1998-1999 year will get off to a bang with a dynamite program on the Perioperative Nursing Data Set. Dr. Kleinbeck presented a similar program at the 1998 Congress. She is the administrator of our research grant which you will also hear more about. Being able to define our unique contribution to the care of the surgical patient is essential if registered nurses are to remain in the OR. You will not want to miss this meeting!

Meetings will once again be held on the first Wednesday of the month at Eden Hospital Medical Center (Thank you Ann Kintz and Beth Mar for making the arrangements.). Exceptions are in December (the holiday meeting will be at Strizzi's in San Leandro), April (no meeting due to Congress the previous week), and June (installation of officers with the locale to be announced). Meals are optional. We will be trying the "Garden of Eden" in September and October. Advance reservations are cheerfully accepted.

• September: Data Elements
• October: Robotics
• November: Risk Management
• December: Stress Reduction and Stress Management
• January: Spinal Fixation
• February: Minimally Invasive Vein Harvesting
• March: To be announced
• May: Perimenopause
• June: Installation of officers

Just a word about programs. I often hear nurses say that a particular topic doesn't interest them so they choose not to attend a meeting. I have found that I always learn something new, and I usually can apply it before the next meeting. If you limit what you will do, you limit what you can accomplish. I hope you will look over the tentative topics and find at least one that interests you. Mark your calendar now. Promise yourself that you will invest this time in yourself. Your Board of Directors would like to see you at all the meetings!

Submitted by Donna Benotti

San Francisco/Marin
August 1998

On July 1, Evelyn Steen, Kathie Shea, Pam Reuling, Clenia Yadao, Pat Kubo, and I represented our chapter at a special ceremony across the Bay. While I enjoy the pomp and circumstance of any ceremony, I am glad that AORN of Alameda County was well represented on this occasion. Not only was our National President, Ruth Shumaker, the installing officer, but I believe it is important to support the efforts of those like incoming President Sylvia Durrance, who will not only be responsible for running the affairs of her chapter, but will also be responsible for coordinating the volunteers at the 1999 Congress.

There was an impressive turnout for this meeting and those that were present were treated to a spectacular view of the Bay Bridge and surrounding area on this crystal clear evening. Chapters in attendance included Alameda, Contra Costa, San Jose, even the Redwood Empire, and the host chapter (of course!).

At my age I am not easily impressed, but I most assuredly was impressed by the sheer number of their Board of Directors. Women and men, experienced and novice, employed and retired, there are even two secretaries! May they all maintain their enthusiasm and serve their chapter with joy and creativity.

Submitted by Donna Benotti

Leadership Conference
August 1998

Once again I was privileged to attend the Leadership Conference in Denver, June 6-9, and it was great! This is where you learn what National has planned for the following year and a chance to network with chapter presidents from all over the country.

You arrive Friday evening and a tour of AORN Headquarters is planned for the evening. Seeing Headquarters is such a treat. One is amazed at how large the building is much less how big the operation is. When you leave you know that AORN is a big time operation and has much to offer us. Since I went last year I chose not to take the tour and to spend some quality time visiting and networking with Lydia Sweigart a former member of our chapter who know lives in Fort Collins Colorado. It was wonderful seeing her again and talking about old and new friends. It was interesting to find out how things are done in Colorado compared to California. We really have a top notch chapter.

The next day, Saturday, was a very full day starting at 0730. The topics and speakers were great. Marilyn Moats Kennedy spoke to us on "Cross Generation Motivation." She talked to us about the changing values in the workplace and how to better manage and motivate across the generations. The second session of the day was on Industry Relations. Ellen Murphy and some members of industry, Brigid Scanlon-Elynck, and Dan Marsh, discussed strategies for industry and nursing to form partnerships. We had a networking lunch where several AORN chapter award recipients talked about factors that contributed to their chapter success. To end the day AORN President Ruth Schumaker discussed leadership characteristics and styles, and provided us with her vision for the following year. One of her big agenda items is to visit as many of the local chapters as she can. Getting down to the grass roots is a big issue with Ruth. There were also reports from the Board task forces on state councils and the AORN name.

On Sunday we had breakfast with our board liaisons. In the final session, attorney Bill Walters talked about legal issues and concerns for chapters. The last part of the morning was spent in breakout sessions on a variety of topics related to chapter management. Then it was the long flight home.

I want to thank the chapter and the Foundation for providing the opportunity for me to attend this very worthwhile conference.

Submitted by Evelyn Steen

The 1999 Congress is in San Francisco!
June 1998

The 1999 Congress in San Francisco needs about 250 volunteers to be visible and assist Congress attendees with meeting and session locations, answer various questions, work in the NetCafe and work on the exhibit floor. Congress locations are the Moscone Center and the adjacent Marriott Hotel (close to BART).

Sylvia Durrance held a brief brain-storming session following the ORNCC meeting at the Sheraton Hotel in San Diego on May 30.

If you'd like to volunteer at Congress, please e-mail Sylvia at [email protected] with your name, address, phone numbers, e-mail address, fax number, etc.

Submitted by Mary Ritchie

Congratulations!
June 1998

Congratulations to the CNORs on their 15th - 19th year anniversaries! We received the complete listing of CNORs from National in April. We'd like to congratulate these long-standing CNORs:

Since 1979:

Constance Dana

Phyllis Hellwig

Ann Kintz

Beth Mar

Kitty McCartney

Stephanie Reddell

Betty Rosenheimer

Jacklyn Takahashi-Schuchardt

Since 1980:

Ila Ahern

Susan Groark

Since 1981:

Kathie Shea

Since 1982:

Helen Feick

Since 1983:

Judith Geoghegan

We have a total of 81 CNORs.

The Exchange
June 1998

Summit Medical Center

Azmina Koorji received her CNOR in April. Congratulations, Azmina! Azmina also graduated from Chapman University with a Bachelor's in Health Science in May. She is continuing with her education (Master's) in June. Go for it, Azmina!

Summit was on national TV on Thursday night, April 23. Dan Rather's "48 Hours" profiled several pioneering medical feats. Dr. Laslo Tamas was filmed in the South Pavilion OR implanting a stimulating electrode into a woman's brain. She had Parkinsonian tremors uncontrolled by medication. The electrode will now eliminate the tremors on one side. National TV stars are: Dr. Tamas, Michael Halperin, MD, anesthesiologist, Maria Cam, RN, Fred Rodriguez, RN, and Clay Mosby, ST. Whenever the camera wasn't on the surgeon or the patient, it seemed to focus on Clay (a lot!). I think the camera crew and the editing people were captivated by Clay's cap in vibrant primary colors! Clay was the only bright spot in the room! (Maria also wore a cloth cap but it had muted colors.)

Nurses Week was celebrated in grand style in the OR. The STs organized various donors (MDs, PAs, STs, etc.) to provide us with huge sandwiches, salads, chips, drinks, and a huge cake on May 8. Earlier in the week, our manager gave us beautifully packaged lottery tickets, cookies, and various gifts. What a week! Thanks everyone!

Surgical Technologist Week was also celebrated with a week of food on every day (provided by the RNs) to show our appreciation for our STs.

We welcomed a new hire - Lisa Shebell, RN. Lisa is a great addition to the group!

San Ramon Regional Medical Center

Congratulations to Bob Harding, RN, Director of Surgical Services. Bob was a prominent figure on the back cover of the May issue of "Diablo Magazine" in an ad for the hospital. Bob was also a presenter at Congress in Orlando (read the Congress Reports for more information).

Alameda Hospital

Karin Selbach, RNFA obtained her BSN from St. Mary's College in May. Congratulations, Karin!

Submitted by Mary Ritchie

Nursing School the Second Time Around: College
April 1998

The first day of my first class two years ago at St. Mary�s, the teacher gave seat assignments. I went to her after class and requested that my seat be moved to one near the window since I occasionally have hot flashes. Being a woman born the same year as I was, she graciously granted my request. I knew then that nursing school was going to be different the second time around.

My co-workers in the Emergency Room have, on the other hand, provided me with support and respect, flexibility in scheduling, ears for listening, shoulders to cry on, and hugs to help me continue forward when I would rather have laid down and pulled the covers over my head. I am honored to work with this group of knowledgeable, dedicated, and compassionate men and women.

Twenty-five years ago, I earned a diploma in nursing. They said then that I was �trained.� Now they say I have been �educated.� Lay persons who have watched the struggle for two years are appalled to hear it won�t make a bit of difference in my status or salary. It may someday make a difference in RNFA reimbursement, and then again, it may not. But I will have a college degree and be one step closer to developing my full potential. I am also acutely aware of the barriers which prevent us from reaching the possibilities of our individual selves and of our profession, and being aware is the first step in crossing over those barriers to defeat the inequities of our profession.

Submitted by Karin Selbach

We Won!
April 1998

I attended the 45th annual AORN Congress in Orlando March 29 - April 3 (where I coincidentally turned 45!). I received the the most wonderful birthday present at the Opening Session on Sunday morning! I was greeted by our delegation with shouts of �Congratulations!� I inquired what they meant by that (�Huh?�). Alameda County was listed in the program for the Opening Session as the winner for the newsletter award for the intermediate-sized chapter!

It was a great issue because of the great submissions! Thank you all for making this newsletter award possible! Let�s win next year too! Send your articles in now!

Thank you everyone for making this award possible for us in its first year. We won Honorable Mention (along with 24 other chapters) in 1997 in the pilot program for Newsletter Awards.

We received a plaque on March 31 stating we are the winners for the 1998 Intermediate Chapter Newsletter Award. I�ll bring the award to the May and June meetings.

Thank you everyone for making this possible! Please keep those great articles and committee reports coming!

Submitted by Mary Ritchie

Thanks!
April 1998

The 1998 Newsletter Awards were chosen from a field of 60 submissions. A panel of experts from AORN Headquarters participated in a double review process and selected �The Cutting Edge� as the winner for the intermediate sized chapter.

Thanks everyone!

Submitted by Mary Ritchie

Facility News
April 1998

Healthsouth TriValley Surgery Center

Welcome to Noreen Hansen, RN, OR Manager.

The Surgery Center staff helped make Christmas special for a single mother and her baby boy by donating toys, clothing, scripts, and cash instead of exchanging gifts.

And last but not least, the staff was wined and dined at Barrone�s Restaurant in Pleasanton.

Submitted by Clenia Yadao

Summit Medical Center

It was final as of March 26! Summit has been purchased by Sutter and we�re now �sisters� with our Berkeley neighbor, Alta Bates Medical Center. We�re also affiliated with Eden Medical Center since they too are a Sutter sister (but not as close in distance as Alta Bates). We�re told Sutter will honor existing contracts.

Submitted by Mary Ritchie

Don�t Judge A Meeting By Its Title!
December 1997

The conference room at Eden Medical Center once again had an impressive display for the October meeting. The five square tables (seating six to eight) were arranged as if they were in a restaurant. They were covered with crisp white linen tablecloths which were topped with sheets of yellow plastic. Each table had a basket of small fruits and vegetables artistically arranged. The baskets were surrounded by fall flowers, leaves, and small jalapeno peppers. This arrangement complimented the topic for the evening - health. The Boston Market box dinner of ham and side dishes was great.

The speaker, Michael Colburn, DPM, was entertaining and informative. He spoke for one hour and 45 minutes because no one wanted to tell him he was 45 minutes over the time limit because he had such informative material to share in his entertaining and captivating manner. I know a lot of people missed a terrific meeting because they thought something titled �Introduction To Antioxidants� wouldn�t be interesting. And it was presented by a podiatrist! Were you ever wrong! Dr. Colburn spoke to us last year about plantar fasciitis so we knew he was a great speaker if he could make feet fun and interesting. He did the same thing October 1 with vitamins. He explained his interest in vitamins, told us stories of patients he�d seen amazing results in once they started vitamins, and discussed many vitamins and their benefits. And he told a few stories (�Please, let me tell one more!�).

Here�s a summary of the vitamin information from Dr. Colburn. (There�s also an excellent article in the October 1997 magazine, Health. The article is �Nature�s Pharmacy� by Burkhard Bilger, pages 64-72.)

Ginkgo Biloba is for memory and peripheral circulation.
Glucosamine/Chondroitin Sulfate is an �arthritis cure.� It helps rebuild cartilage.
Echinacea Purpura is an immune booster and should be taken at the first sign of cold symptoms.
Coenzyme Q-10 is for energy. It�s a powerful antioxidant.
St. John�s Wort is nature�s Prozac. It�s a natural antidepressant.
Alpha Lipoic Acid lowers blood sugar and increases T cell counts in AIDs patients.
Vitamins A, C, and E are antioxidants. Antioxidants grab free radicals (which injure cells) to prevent cellular damage.
GLA (Gamma Linoleic Acid) is an essential fatty acid (in evening primrose oil).
Using 480 mg. of GLA and 600 mg. of Alpha Lipoic Acid reverses peripheral neuropathy (Dr. Colburn has seen this work).
Garcinia Gambogia is nature�s diet pill. It�s called Citromax in the USA. It gives a feeling of fullness.
Garlic decreases blood pressure and cholesterol.
Caffeine depletes calcium!

Read labels and become informed before you start taking any medicines!

I was so impressed by this presentation that I went to Price/Costco and bought seven bottles of pills! And my husband and I are actually taking them!

Unfortunately, the attendance at this meeting was a disappointment. So, let this be a lesson - don�t judge a meeting by its title. This was a great presentation!

There are still raffles at every meeting with the numerous prizes related to the speaker�s topic.

The business meeting was fast so we were still able to leave at 9 p.m.

The November meeting was quite festive. The Project Alpha Committee acted as hosts and all wore the OR Nurse Week green T-shirts with the logo. Each table was decorated with white tablecloths with a centerpiece of green, blue, and orange balloons with the OR Nurse Week theme imprinted. The balloons were weighted to the tables with matching colored ribbons anchored by bags filled with York peppermint patties in autumn colored wrappers. We were told to take the balloons and candy with us at the end of the meeting. The raffle awarded four OR Nurse Week posters, an OR Nurse Week coffee cup, and socks with a nursing theme. The non-poster items were presented in small bags with the OR Nurse Week theme, �OR Nurses Lighting The Path To The Future.� The posters featured a photo of a bust of Florence Nightingale with the following statement: �Surgical patients rely on the skills, knowledge, and expertise of perioperative registered nurses. As technologies have advanced, the tools perioperative registered nurses use to care for patients have changed, but the fundamentals of perioperative nursing care are timeless. These fundamentals create the quality care surgical patients have relied on in the past and expect in the future.� An AORN video about perioperative nursing was shown. Project Alpha Committee tried to have the video shown on TV but all the stations refused because we are an organization and not a non-profit group.

Steven Kazan (an attorney) spoke to us about latex litigation. What is the employer obligated to do? �Not much.� The employer must have insurance for workman�s compensation. That�s their obligation.

Here�s an interesting fact - if you experience death as a result of a latex allergy, be sure to die within 240 weeks of your diagnosis. If you live longer than that, you�ll miss the death benefits of $125,000 to $160,000. If you�re entitled to vocational/rehabilitation benefits, the top amount is $16,000. That doesn�t buy a lot of schooling or retraining.

Wearing non-latex gloves yourself won�t help if everyone else is wearing latex due to respiratory contamination.

What happens to the nurse who can no longer work in his/her chosen area? �Sue the b_____s.� (The speaker is a latex litigation attorney)

�Unreasonable Danger Rule� means you can sue the latex glove manufacturer.
�Design Defect� means if someone is injured by a product while using the product in its intended manner, you can sue. This is a California rule.
�Ordinary Negligence� is failure to use ordinary or reasonable care.
�Failure To Warn� is just what it says. Mr. Kazan showed us some warnings on latex glove boxes.

In summary, Mr. Kazan said it would be good for hospitals to go latex-free because it would save money in the end.

For some great latex information, visit the web site, �Latex Allergy Links� which is a a comprehensive, up-to-date listing of latex allergy-related sites on the Internet. The address is: http://pw2.net com.com/~nam1/latex_allergy.html. Leave no spaces in the address. I found this site in May or June and it is one of the best in my opinion. This site also contains information about latex testing. The address is: http://pw2.netcom. com~nam1/latex_allergy/test.html. Or you can access the latex allergy link at the bottom of AORN Alameda County�s home page (www.geocities.com/HotSprings/9007).

Submitted by Mary Ritchie

What�s The Scoop?
December 1997

TriValley Surgery Center

Bonnie McCartney passed her CNOR exam. Congratulations!

Submitted by Clenia Yadao

Washington Hospital

Washington Hospital is pleased to welcome three RNs to its Operating Room staff.

Nataly Semionov is originally from the Ukraine where she received her nursing instruction. She spent a few years working in Israel and most recently hails from Toronto, Canada, where relatives still reside. Her fluency in Russian will come in handy with Ukrainian emigrants who visit our facility.

Yolanda Ramirez is a new graduate RN who received her degree from California State University at Hayward. Following graduation, she enrolled in two 300-hour clinical rotations through the OR at Stanford Hospital. Washington Hospital's busy OR and complex caseload can present quite a challenge for the inexperienced practitioner. We took a chance with Yolanda and she�s proving to be a valuable member of our OR team.

Suzanne McAuliffe was born at Washington Hospital and is a native of the Bay Area. She has also resided in Washington State, where she received her education and worked in an OR in Tacoma for several years. We�re glad she has returned to her roots and decided to join our OR staff.

Our hospital has yet another new face in surgery. Ron DelPape is an RN (medical/surgical) at Washington who is enrolled in the San Mateo perioperative RN program. This is a 12-week course, with three weeks of didactic followed by nine weeks spent in the clinical setting at one of the consortium hospital�s ORs - in this instance - ours. His main focus is circulating and he is also learning the basics of scrubbing.

It isn't easy finding qualified RNs to work in the OR, as we all know, and Washington Hospital has explored different avenues in its quest for personnel. Speaking as one of its staff nurses, I'm glad they did and I welcome the help!

Submitted by Donna Rodgers

Summit Medical Center

Summit Medical Center had a pot luck lunch on Friday, November 14 in honor of OR Nurse Week. We were also given surprise gifts for two days during morning report. Names were drawn and great prizes were distributed. The technologists were also included in this event. There were home baked goodies provided by our manager and charge nurse during the week too.

Submitted by Mary Ritchie

Pleasanton Ambulatory Surgery Center

Kaiser Surgery Center has adopted a family for the holidays. A mother and her two boys have been selected. The selection was accompanied by a wish list and their ages. Food, clothing, toys, and money have been contributed. We are in hopes that this will be a joyous season for them.

Submitted by Lila McAlhany

Washington Hospital

Washington Hospital celebrated OR Nurse Week all week long. Lunches were provided for the staff everyday by either the doctors or our industry friends. We placed posters showing the many ways OR nurses care for patients and had cake and punch for the public served by OR nurses.

Submitted by Evelyn Steen

Nursing School Regains Accreditation!
OR
Nursing Students Need Waitressing Skills per NLN
December 1997

The October issue of this newsletter contained a story about Keuka College in Keuka Park, NY and detailed the woes of its nursing program and loss of National League of Nursing (NLN) accreditation. One of the shocking details of its nursing program was having its students work as waitresses during their field periods instead of working and learning in hospitals or nursing homes.

The October 24 issue of the Finger Lakes Times informed us that Keuka�s appeal of the denial was successful and accreditation was granted on October 22. The NLN denied accreditation August 14 and the college immediately appealed. There were 50 students in the program and 20 to 25 left as a result of the initial accreditation denial.

Also on October 22, Margaret England, the former head of the nursing department at Keuka, sued Keuka for $4.2 million.

An alumnus sent me Keuka�s recent annual letter to alumni. The president discussed Keuka�s nursing program and its problems and stated the program has suffered because most high school graduates opt for two-year programs instead of four-year BSN degree programs like Keuka�s. I interpret this statement to mean that it wasn�t worth Keuka�s time and financial commitment to maintain the standards of the nursing program due to declining enrollments. However, that�s my interpretation which could be incorrect.

The biggest shock in the president's letter was reading, �Perhaps the biggest challenge now being planned is to group all arts and science courses for nursing students in their first two years, leaving the junior and senior years to concentrate on nursing studies. This will help the school attract transfer students wishing to become nurses, while better organizing the curriculum...� I was under the impression all BSN programs were designed with electives the first two years and nursing courses the last two years. It was that way 25 years ago in other BSN programs in that area. Keuka obviously prefers to do things differently. Mix up the courses and send nursing students to restaurants to wait tables to gain skills needed in nursing.

Has anyone received any tips from customers (patients) lately?

In summary, Keuka College has been fully accredited through 1999. How sad.

Submitted by Mary Ritchie

Nursing School Loses Accreditation!
October 1997

Keuka College is in trouble. Keuka College is in the small hamlet of Keuka Park in the Finger Lakes region of Central New York State. It sits next to Keuka Lake and has a lovely campus that is in a picturesque, rural setting. Who could ask for more? Keuka�s nursing students, that�s who!

According to the Finger Lakes Times in Geneva, NY (Sunday, August 24, 1997 edition), Keuka College has lost accreditation for its nursing program. Keuka was put on probation in May 1995 and was given until May 1997 to have an action plan to remedy the deficiencies in the nursing program. They hired a clinical psychologist, Margaret England, in June 1996 to set up a self-study and begin corrective actions. When England filed a negative report (how could it be positive?), her problems with the college began. (England recommended the college invest $3 million in the program or discontinue it for one year for restructuring.) Her problems continued with her suspension complete with a security guard escort off campus! A review board found her innocent of any wrongdoing but the college president is intransigent in his stand. But this article is not about England and the injustices done to her but about the nursing program.

The college has 60 students in its nursing program. One student already left because she foresaw trouble with the lack of professors. The same few people taught a wide variety of courses.

In 1995, the National League of Nursing found deficiencies in 11 of 20 criteria. In 1997, there were only four deficiencies. The site team recommended accreditation but the commission review board denied it. There were shortcomings in administration, staff shortages, improper progress of students through courses, and a poor pass rate for the state board licensing exam. In 1995, eight of 13 students passed the boards! That�s a 62% success rate. In 1996, four of eight students passed (50% success rate)! The national pass rate for boards is 90%. The rate in New York is 84%. Keuka was turning out some poorly prepared students! Students with grades of C and C- were advanced. As we know, we build on what we learn and if something isn�t learned, the foundation of knowledge is unstable.

Keuka�s nursing program was founded in 1942 and the nursing program was one of the top 25 in the nation. Keuka has had poor accreditation reviews periodically since 1979! Definitive corrective action wasn�t taken until 1996!

The vice-president of the college said there is no longer a nursing shortage and there are reduced enrollments. �That lack of interest reflects the changing role of nurses within health care and is not unique to Keuka, said McKenzie.� This sentence makes no sense to me and it�s a quote from the newspaper though it�s not a quote from McKenzie. I interpret it to mean that there are fewer nursing students so Keuka has let the nursing program standards slide because the investment isn�t worth the return.

One of the problems with the curriculum was the placement of students during field periods. �While some nursing students worked at hospitals and nursing homes, others worked as waitresses.� Yes, you read that correctly. There is only one hospital and one nursing home close by but there are many other hospitals within a one hour drive. I was surprised the students were going to nursing homes where experience would be limited - but waitressing? Did the curriculum planners think nurses were glorified waitresses? Did they know about critical thinking and judgment skills and knowledge and collaboration with other health care providers? I support and applaud the denial of accreditation for the simple reason Keuka assigned nursing students to waitressing jobs for their field experience.

We fight to elevate the image of nursing, to be professionals - and then a college nursing program sends its nursing students to practice waitressing skills to prepare them to be RNs with BSNs!

Submitted by Mary Ritchie

First Meeting Of The Year Starts Off Pink!
October 1997

Our first chapter meeting of the 1997 - 98 year had an auspicious beginning. Sit back and relax as I set the scene for you.

As I entered the Eden Medical Center Conference Room, I was in shock. This was a conference room? The five square tables (seating six to eight) were arranged as if they were in a restaurant. They were covered with crisp white linen tablecloths which were topped with sheets of pink plastic. Each table had a large bouquet of deep pink flowers with yellow centers (zinnias?) in the center. The deep, soft armchairs were more comfortable than those at the Hilton. And the view! I can�t describe what a mood elevator it is to be able to see the sky drifting into twilight and the trees swaying in the breeze through windows that encompassed one entire wall. When I�m in an enclosed area all day, then attend a meeting in the evening, it�s refreshing to be able to experience some sense of nature and the outdoors. After regaining my senses, I gravitated toward the table laden with food from Boston Market and drinks from Price/Costco. The box lunch of turkey, mashed potatoes with gravy on the side, vegetables perfectly cooked, cornbread, and apple frenzy for dessert was great! I brought my own Diet Coke because Donna Benotti had purchased healthy Crystal Geyser flavored waters and juices.

The speaker, Rhonda Elliot, was entertaining and informative. Her business, �Organized By Design,� deals with office and residential organizing systems, time management, space design, paper flow systems, and clutter control. The cover of her business brochure says, �Will you be able to find this brochure a week from today? If not, call (510) 426-9540 today!� I thought that was quite imaginative. What a way to start the year! Now we all know how to be organized and clutter-free. Rhonda discussed time wasters we should identify and eliminate. such as interruptions, over-committing, and procrastination. She also discussed storing things according to zones. Items used daily are in Zone A (within arm�s reach). Zone B is for items used daily to weekly and should be close by in files or cabinets or on counter tops or shelves. Items used weekly to monthly are in Zone C and are stored in nearby cabinets outside your workspace. Zone D is for items used once or twice a year. Zone D is the attic, basement or garage.

Here�s a valuable definition we learned from Rhonda: Clutter is another name for homeless items.

The business meeting was short and to the point. There were quite a few people at the meeting who hadn�t attended before or hadn�t attended for an eon. That was nice.

Eden Medical Center is a central location with safe parking. The conference room is steps from the parking lot. It was a nice change to have the hallway all to ourselves to sign in and collect agendas and other papers. The Hilton hallway always had people from other meetings milling about. Eden was also less disruptive than the Hilton. There was no noise from other rooms like we experienced last year at the Hilton.

Try to attend at least one meeting this year! The food and setting are completely different. The dinners are only $8 and are great (and dinner is optional), the atmosphere is 100% better, and the programs are great. And you can�t beat the company!

Submitted by Mary Ritchie

Facility News
October 1997

Summit Medical Center

Courtney Allen-Gentry, a former surgical technologist, just received her new RN license! It�s really inspiring to witness that kind of enthusiasm and excitement! Congratulations on obtaining your license to be a Registered Nurse, Courtney!

Midge Turner, one of our anesthesia technicians, became one of the first group of certified anesthesia technicians recently. Congratulations, Midge!

Submitted by Mary Ritchie

TriValley Surgery Center

Congratulations! TriValley Surgery Center - a special kind of place, a special kind of care - was accredited for three years by the Accreditation and Association for Ambulatory Health Care.

The Center welcomes Randy Todorovich, RN, administrator and Leslie Kawamoto, RN, staff nurse, operating room.

Submitted by Clenia Yadao

ASC Network Corporation

Welcome to Kathie Shea who is the new Director of Nursing at East Bay Medical Surgical Center in Castro Valley.

Congratulations to Peggy Zampetti who is the administrator at East Bay Medical Surgical Center. Karen Stevens is now the Director of Special Projects for ASC and is based at the Blackhawk Surgery Center. Congratulations!

Submitted by Clenia Yadao

Kaiser Hospital, Oakland

Carrolyn Bryant obtained her Masters degree in Health Services Administration in June. Carrolyn is now the perioperative educator. Congratulations, Carrolyn!

Submitted by Mary Ritchie

I Remember When
October 1997

In recognition of OR Nurse Week November 9-15, the chapter acknowledges the efforts of Jackie Guillion, Lila McAlhany, and Pauline Sanger for documenting the early years of AORN of Alameda County. Following is an excerpt from our Historian's Book:

�In 1957, Alameda and Contra Costa County established the first AORN chapter in the state of California.
Important events:

• The great decision over bylaws.
• Should OR Supervisors come to the meetings?
• When and where do we have the meetings?
• How much money for dues? $1.00 or $2.00?�

Officers:
President: Marrion Anderson
Vice President: Avis Gibson
Secretary: Barbara Whited
Treasurer: Margaret Jones
Board of Directors: Dorothy Hund, Ardith Boughton, Evelyn Wade, Dorothy Thompson, Clara Rafferty, Jacqueline Moran, Ruth Davidson

Chapter Presidents:

• 1957-1960 Marrion Anderson
• 1961-1962 Avis Gibson
• 1963-1966 Barbara Whited
• 1967-1970 Diane Ernst
• 1971-1972 Jackie Guillion
• 1973-1974 Viola Nies
• 1975-1976 Bonnie Davis
• 1977-1978 Peggy Melgard
• 1978-1979 Evelyn Childress
• 1979-1980 Ann Kintz
• 1980-1981 Melody Montgomery
• 1981-1982 Alice Cheney
• 1982-1983 Belen Cooper
• 1983-1984 Jacklyn Takahashi
• 1984-1985 Jane Vosloh
• 1985-1986 Beth Mar
• 1986-1987 Betsy Lindsay
• 1987-1988 Cynthia Corsi
• 1988-1989 Roberta Young
• 1989-1990 Kathie Shea
• 1990-1991 Clenia Yadao
• 1991-1992 Pat Rodriguez and then Barbara Burke
• 1992-1993 Patricia Nelson
• 1993-1994 Claire Rozman
• 1994-1995 Beth Mar
• 1995-1997 Donna Benotti
• 1997-1998 Evelyn Steen

Submitted by Donna Benotti

AORN World Conference
October 1997

I flew into Toronto on Sunday evening. Toronto is a lovely, modern city. It is so clean. Everyone (or most everyone) dresses so nicely.

Opening session was very nice. It was very nice to see the flags of all the participating nations. The procession was led into the hall with bagpipes.

The keynote speaker addressed changing O.R. issues and how advancing technology will continue to change the way surgical nursing will be practiced in the future.

The educational sessions were varied and interesting. The developed countries have similar concerns: safety, trash handling, the environment, and increasing technology and how it affects our nursing and our lives. The developing countries are much more concerned about the basics. One physician from Africa expressed concern about post-operative infections and the lack of trained and qualified O.R. nurses.

The exhibits were interesting. I had a �shopping list� that I was looking to fill. One item was a non-alcohol, non-Betadine prep solution for mucosal preps. And I found it! It is always very nice to see the latest supplies and equipment all in one place.

Another great aspect is meeting nurses from all over the world. The next World Conference (in 1999) will be in Helsinki, Finland. The World Conference after that (in 2001) will be in Christchurch, New Zealand.

Total registration as of noon Thursday, September 11, was 2153.

Submitted by Carrolyn Bryant

Leadership Conference 1997
August 1997

I would like to thank the AORN Foundation and our chapter for sending me, as president-elect, to the Leadership Conference in Denver, Colorado June 6 - 8.

I had the opportunity to meet and network with presidents and presidents-elect from all over the country, as well as National officers and Board members.

Friday evening we were bused from the hotel to AORN Headquarters. There we were given a tour of the building and were treated to a reception with some of the National officers, Board members and some of the Foundation members. I was amazed at how large Headquarters is and how much business goes on there every day. We should be very proud to be part of AORN. AORN is a multi-million dollar business.

Saturday started at 8:00 a.m. and ended at 5:00 p.m. The keynote speaker was Beverly Malone, RN, PhD, FAAN, president of the American Nurses Association. She spoke to us on �Leadership in Turbulent Times.� She discussed nursing�s place in the current health care environment and some of the characteristics of leaders. Jeannie Botsford, RN, MS, CNOR, AORN President, talked to us about �Making a Difference Through Patient Focused Care.� In the afternoon we broke up into groups and talked about declining membership and fund raisers and how each chapter was handling those issues. There seems to be a common problem among all the chapters as to how to get members to come to meetings and how to raise money to cover chapter expenses. Some chapters had some interesting ideas and some that made them large sums of money, such as a bingo night, golf tournaments and dances. The last speaker of the day was Steven Aichele who spoke to us on �Strengthening Relations Between Perioperative Leaders and Industry.� According to Steven Aichele, industry wants a willingness on our part to become a better business partner, to have an understanding of the power of information and the ability to effectively use it and to always be the patient�s advocate.

Sunday morning was spent with Bonnie Denholm, RN, MS, CNOR, Chapter Relations Coordinator. She went over chapter standards and resources and gave us some tips on running chapter meetings and strategic planning.

I came home feeling very proud to be part of this organization and our chapter. Through networking with other chapter presidents, I came home with some new ideas on fund raising and member retention.

One of the highlights of this trip was that I had the opportunity to visit and have dinner with Lydia Sweigart our former secretary who moved to Fort Collins, CO several months ago. She is working at a hospital about 20 minutes away from her house and loves it. She says the one thing she misses about California is the wages. We are much better paid than they are in Colorado.

Submitted by Evelyn Steen

New Nurse in the O.R.
August 1997

After the first day of my O.R. rotation at John Muir Medical Center, I realized that I wanted to be a perioperative nurse. After I graduated and received my RN license, I discovered that becoming one was not so easy. There was a shortage of training programs, but I was not discouraged by this unsuccessful search. So, I continued to be involved in anything that had to do with the practice by joining the AORN and becoming an O.R. volunteer at Summit.

Through both of these activities, I found my leads -- Suzanne Clouser, a Summit staff nurse, and the AORN Center for Perioperative Nursing Education. With their help, I contacted Southwestern College Perioperative Nurse Training Program in Chula Vista, California. My timing was just right because I was accepted two weeks before it started. I received a great deal of support from the Summit staff. I was especially encouraged when Donna Benotti offered to become my clinical preceptor for my last semester if we could arrange for a contract between the school and Summit.

The program was a one-year commitment, divided into three semesters. The Fall semester was comprised of four days of theory and didactic. During the morning sessions, there were lectures from the history of surgery to sub specialties of surgeries (i.e., general, gyn, laparoscopic, urology, etc.). The afternoon sessions were devoted to skills lab time. The topics ranged from from basic to complex (surgical hand scrub to mock TAH case set-up). We had lecture and lab exams. Passing score was 70% for the lecture. The lab component was three-parts: quiz, instrument identification and return demonstration for skills of the week.

For the Spring semester, we were placed in clinical sites according to our skills and the facility's needs. My placement was at Kaiser San Diego. Four days a week, I was fortunate to scrub and circulate on a variety of procedures. One day a week, we continued with our theory class. At the end of the semester, I had a total of 372 clinical hours from all the different preceptors. I was also able to rotate through the Central Processing department.

My last semester is at Summit Medical Center. Currently, I have been assigned to scrub and circulate according to the day's schedule. For the past few weeks, I have been asked a lot of questions and these have helped me reflect on where I am in my career. I AM HAVING THE TIME OF MY LIFE. So many things to discover and challenges to face are a few things that keep me going. I am inspired with the dedication and talent I encounter on a daily basis. No matter how much I have gained thus far, I am humbled by the fact that I still have a lot to learn. TO EVERYONE WHO HAS HELPED ME ALONG THE WAY, MY SINCEREST APPRECIATION.

Postscript: After I am done with the program, I will receive a Certificate of Achievement and work full-time as a Summit Surgical Services staff nurse. My return has been like a homecoming. It truly is great to be HOME.

Submitted by Daisy Ricafrente

Editor�s Note: Daisy finished her program July 31 and treated all of us at Summit to a bagel extravaganza. Daisy became a Summit employee August 12. She�ll need the shortest orientation in the history of the O.R.!

Program Notes
August 1997

Yes! We listened to what YOU (the membership) were saying, and we have made a change! We will be trying something new. NEW LOCATION, NEW IDEAS FOR DINNERS.

The Program Committee members did a lot of investigating of different sites this summer. Of course, cost was a consideration, as was a separate meeting room with privacy and good acoustics, free AV equipment, safe parking, central location, and easy freeway access. Some of the potential sites included:

1. Holiday Inn, Pleasanton: $250 for room, $0 if meals purchased. Meals cost $21.28.
2. Wyndham Garden Hotel, Pleasanton: $200 for room, $0 with meals. Buffet $23 - $26, plus tax and tip. Plated $17 - $28, plus tax and tip. AV rental is additional.
3. Dublin Park Hotel: $150 room, $0 with meals. Buffet $21.95 plus. Plated $15 - $17 plus tax and tip. Microphone included, but additional charge for AV equipment.
4. Pleasanton Hilton: No room charge with meals. Plated $19 includes tax and tip.
5. Radisson, Union City: Remodeling.

We looked at different hospitals as possible sites, but Eden really won because of its central location, easy freeway access, free/safe parking, and no charge for meeting rooms. (Thank you Ann Kintz for reserving the rooms!)

We decided to continue to plan for meals so that those members who come directly from work will continue to do so. Cost of meals was higher on the criteria list than ambiance, so we decided that simple, light meals would be acceptable. And since we all are working, keeping the choices simple and the serving uncomplicated would be best. There is no food service at Eden after 6:30 p.m., so Pam Reuling made calls to local caterers. (Thank you, Pam.) Therefore we have decided to try boxed meals provided by the local Boston Market since they could meet all the aforementioned criteria and they would deliver.

The down side of this plan is that it will require some organization. (Attend the September meeting and learn how to accomplish this!) Because Eden is not a restaurant, there will be NO extra dinners available. Of course, it is not necessary to purchase a dinner in order to attend. Those wishing to attend the meeting only should come a little before 7:00 p.m.

Those desiring a dinner need to have their reservation into Lila McAlhany (5649 San Antonio St., Pleasanton, CA 94566) one week before the meeting. Should you have a change in your working schedule and decide to come at the last minute, Eden's cafeteria does serve food until 6:30 p.m.

During this trial period (September through November), we welcome your input. We will be having dinner meetings in December and June. Do let committee members know what you think.

Other plans for the year include exchange meetings with the Contra Costa County Chapter. We have invited them to our pre-Congress March meeting. We are waiting for the official invitation, but the unapproved plan is that we will attend their February meeting.

Our kick-off September meeting will be action packed. Not only will we be trying a new site and new boxed dinners, but we will be introducing the new Officers, Board, and Committee Chairmen. We are also recruiting new members and encouraging all to attend and check us out. Those bringing a perioperative nurse to the meeting will receive a ticket to participate in a special drawing. See you September 3rd!

Submitted by Donna Benotti