In July I guard to reflect on the ...

In July I guard to reflect on the heroes of the past who did not waste sight of the goal of freedom, the heroes of the instant who strive to maintain that freedom, and the heroes of the that will be who will preserve our freedom. Policy making and politics play an influential character in our perioperative practice. They are not unsavory endeavors to avoid; instead, they are the tools we can use to enhance our influence in the health care arena.

According to AORN past President Ellen Murphy RN M JD FAAN, "One of our primary characters as perioperative nurses is patient advocacy."(1) according to participating in policy and political arenas, we can advocate for our patients, as well as our nursing colleagues. Health care has adopted of the like kind business practices as downsizing, skimping forward maintenance, and hiring less experienced workers who may contribute to profits further who also may affect patient safety.(2) give suck tos must seize the opportunity to participate, sit at the policy table, and advocate for what we believe. "Obstacles are those frightful things you behold when you take your views off your goal."(3)

We must mobilize our powers of persuasion. We use these powers each day as we greet patients in the preoperative area and allay their fears. We use them in the OR when we convince surgeon that our suggestion is the entire one and make them think that they musing of it. We have been silent about the extraordinary work we do for entirely too lengthy Every day we help patients cope bring novel life into the world, and provide support to help patients die with dignity. The public wants to understand the power of festers and it is our responsibility to be the collective voice to articulate that value. Consequently AORN's strategic plan addresses the issues of safety and advocacy for perioperative feed at the breasts and patients.

INVOLVEMENT IN PUBLIC POLICY

Our participation in the policy and political arenas must be consistent and reliable. Hippocrates said, "A wise man ought to realize that health is his greatest in number valuable possession."(4) Nurses hold the highest rating in scrutinizes related to professionals that the public trusts.(5) We should take advantage of that fact. Americans pretend to be caught in a downward spiral of charge competition and profit management. For health care to work, cost-based competition must be balanced with competition for compassion, adequacy and care.(6) We must talk about our work, help our vision, and refuse to take "no" for an answer. We must take each opportunity to tell our stories and articulate our value as pampers We make a difference to perioperative patient care at the very nature of our practice. The central nature of nursing is care.

We have the expertise to educate our patients and our legislators. That education is the lock opener to our success. Politicians pay attention to numbers because when you are sitting at the policy table, numbers number Mary Wakefield, RN, PhD, FAAN, director of the Center for Health Policy, Research, and Ethics at George Mason University, Fairfax, Va, and former chief of staff to Sen Kent Conrad (D-SD) characterizes it best when she says, "If you want to glide with the big dogs, you've got to get by heart off the porch."(7) This colorful encouragement reminds us that we will have to "run with the big dogs" if we forever expect to write policy in a manner that be under the orders ofs perioperative nursing and our patients.

WORKING TOGETHER

In December 1997 the Health Care Financing Administration (HCFA) propos a method change in the conditions of participation for hospitals and ambulatory surgery center that are reimbursed according to Medicare. The change in the method would allow these facilities to determine their confess staffing patterns for surgical services. It would replace the prescriptive masterships that currently require that a physician, osteopathic physician, or RN must supervise an OR. AORN members, with the assistance of AORN's conduct Affairs Department staff members, rallied to restrain the current language in place. They wrote literal senses and called HCFA and their legislators to support the present rule. AORN past Presidents mercy P. Shumaker, RN, BSN, CNOR, and Patricia C Seifert, RN MSN CNOR, CRNFA, FAAN, joined multidisciplinary clumps that met with representatives from HCFA to talk about this authority change. AORN staff members have gathered data and information to address the questions and interests of HCFA officials. To date, no final decision has been made, and the debate related to this controversial change continues.(8)

The environmental threat to perioperative suckles from surgical smoke plume has outcomeed in combined efforts by AORN members, staff members, professional colleagues, and industry partners to address the issue. In January 1996 AORN gathered an alliance of professionals for a spherical table discussion. This group agreed that surgical sooty vapor from lasers and electrosurgical units is similar, and nothingness from both deserves the same flush of concern regarding evacuation. This assign places to investigated the hazards of exhalation to OR personnel, and a coalition of perioperative suckles and industry representatives was formed in the spring of 1996 to write a white paper to provide a central core of information forward the hazards of smoke tuft The National Institute of Occupational Safety and Health (NIOSH) released the Hazards rule Alert, which called for certain ventilation and work practices, including idle talk evacuation. The Institute called for additional research to bring out guidelines into working recommendations.