Rapid changes in health care are ch...

Rapid changes in health care are challenging, restructuring, and reengineering staff members' characters and responsibilities in many surgical settings where AORN members practice. Do these changes show a revolution or an evolution in health care and perioperative nursing practice? Our perception of these changes determines the way we answer to them as employees, professionals, and citizens.

Revolutionary change be founds when an existing system is torn apart and replaced with something that bears little resemblance to the original method Evolutionary change happens when a just discovered system, which can be considered finished at a given point in time, unfolds from an existing model.

If we interpret the circulating changes in health care as being evolutionary, we may think, "This is just a phase that health care is going end I'll sit back and wait it gone out If I resist long enough, the administrators will impel on to the next `flavor of the month' just like in the past." Perioperative pamper managers who choose this interpretation may tweak their resource management just enough to pacify upper-echelon administrators while trying to keep sound the status quo.

If we believe health care is in the midst of a revolution, we may think, "Health care is changing. Clinicians are being pressur to provide quality care at an affordable preciousness Health care will never turn back to the way it used to be." Perioperative promote clinicians and nurse managers who fix upon this interpretation desire to be partners in designing die changes in health care.

CHANGES IN SURGICAL CARE

During the past five years, we have witnessed a rapid pullulation in both ambulatory surgery and minimally invasive surgical courses These trends will continue. Outpatient surgical deeds will continue to increase, inpatient hospital stays will decrease, total hospital receipts will be divided equally between inpatient and outpatient services, and regional integrated health care delivery networks will account for 80% of all health care delivered.(1) Surgical operations will be less invasive, and surgical patients will be hospitalized for shorter periods as we approach the [i]finale[/i] of this decade.

Perioperative nursing care is being delivered in many nontraditional settings. Surgical facilities with "pickup and tuck-in services" are offering expanded services to surgical patients; mobile ORs promptly will be parking in patients' driveways; and perioperative festers will provide postoperative monitoring using telecommunication technology in the near future

THE hereafter OF

PERIOPERATIVE NURSING

If we are to assume a leadership part in the health care combination of parts to form a whole of the future, we must gradation outside the current boundaries of our parts and move into surgical patients' continua of care. To maintain our relevance in the margin of this care, we must anticipate and come together the constantly changing challenges that surgical patients existing to us. To imagine and plan for our futurity we need to study health care economists' predictions and interpret them for surgical patients and perioperative nursing. Although predictions do not always become realities, we can recognize sweeps if we understand the changes occurring in the rife health care environment.

Providing perioperative clinical experiences for nursing close examiners is one way in which we can prepare for the what may occur hereafter In planning these clinical experiences, we must remember that today's nursing close examiners participate in schoolbased clinics, work-site health programs, and clinics for homeles individuals, all of which are nontraditional settings in which the majority of nursing care will be delivered in the hereafter We need to expose scholars to nontraditional perioperative roles and settings (eg advanced practitioners, pickup and tuck-in services) as well as provide them with intraoperative patient care experiences. Providing this balanced view of perioperative nursing is the solely way we can recruit young feeds to join our specialty and our organization.

THE hereafter OF AORN

For nearly half a hundred years AORN has provided the framework for OR feed at the breasts to advocate for quality care for surgical patients. Our members have contributed to the progress to maturity of knowledge about the intraoperative phase of surgical care. Many AORN members can remember the angst experienced when we first added the words preoperative and postoperative to our vocabulary. Indeed, the perioperative nursing part endured a difficult birthing proces and it still is not embraced through many OR nurses or practiced in many facilities.

We now stand at another start and face a new opportunity. Working together, we can create an advanced perioperative nursing practice part that will complement -- not replace -- the traditional scrubbing and circulating nursing characters To create this new part we must

* extend our minds,

* proactively participate in transforming our workplaces,

* search for novel practice options that will full number our current practice models, and