AORN Alameda County, CA
President's Messages


NEW! Presidents' Messages Archives (From December 1995 - June 2001)


Establishing a Culture of Safety in Your Institution
December 2002 newsletter


It has been estimated that for each accident there are ten incidents. For each incident there are 100 near misses/close calls. For each near miss/close call, there are 1000 unsafe (latent) conditions…” (SSM, October 2002).

Increasingly, the health care industry is starting to realize that errors are due to systems failures. This is a new way of thinking about errors. The predominant culture of humiliation, shame, and blame is slowly being replaced by a "Blame Free" environment. It has been recognized that most errors occur because the system set up the health care provider for failure, and if it had not happened to a particular nurse, it most likely would have happened to another RN under similar circumstances.

Blame free does not mean that a health care worker can be negligent in his or her practice. It is however, an attempt to increase reporting of system issues. We are unable to fix problems if we do not know they exist. Investigations of errors in a Blame Free environment focuses primarily on processes, and not people.

Problems within systems may be thought of as "system pathogens." These pathogens include poor system design, poor procedures, lack of supervision, inadequate training, and understaffing. These are examples where an error is lurking in the shadows, waiting to happen. They are also opportunities for improvement, once brought to light.

The health care industry is notoriously behind other industries, such as the airline industry and the petroleum and chemical industries, in establishing a culture of safety in hospitals. When the Institute of Medicine published their report "To Err is Human," patient safety was all of a sudden on the forefront. Although we are all committed to patient safety, this is not something which happens overnight. Creating a culture of safety presents many challenges. We must recognize the presence of differing cultural perspectives might be the origin of misunderstandings, and ultimately establish the basis for sentinel events. It is important to realize that each culture has unique political skills and power tactics used for individual and collective purposes. We might concede that information sharing is not universal, nor consistent across cultural components in an organization. Consider the differences between perspectives of surgeons, nurses, techs, and anesthesia providers, and acknowledge that respect and trust between cultures vary according to the perceived status of the culture and the value of the contributions made by each cultural group.
One of the leaders concerning patient safety standards is the JCAHO. They mandate that leaders engage, lead, and provide resources for patient safety initiatives. The ultimate goal is to create a climate conducive to proactive patient safety efforts that engage all health care facility staff members, patients, and their families. Some of the 2003 patient safety goals published by the JCAHO includes improving the accuracy of patient identification, improving the effectiveness of communication among caregivers, and to eliminate wrong-site, wrong-patient, and wrong procedure during surgery.

A successful safety culture program reflects the characteristics of a true learning organization. Reporting is encouraged, as well as initiatives and innovative ideas. Responsibility tends to be shared. Engaged and involved key players at all levels will ensure an enthusiastic effort!

By Sophie Taylor, President


The President Speaks!
October 2002 Newsletter


Greetings fellow AORN members,

It was a pleasure seeing such a great turnout at our first meeting of the year. Thank you all who attended. We hope you will make our meetings part of your monthly professional practice update. Some things will be done differently in the meetings this year. For example, there will not be a “roll call” on all the committees for reports. Only those committee chairmen who get in touch with me to have their reports on the agenda will be giving their reports. This also brings me to my next point. The Legislative Committee needs a chairman. The person in this position would help keep the chapter updated in the legislative arena. To make this job easier, National AORN sends out updates every month. In addition, there are four ORNCC meetings to attend every year (optional, but strongly encouraged). ORNCC is a group made up of representatives from the various chapters in California. ORNCC pays very close attention to what happens in the legislature. In order to have input into the laws that affect our practice, we must be active and make sure our voice is heard. Other duties of this office include writing articles for the newsletter about the ORNCC meetings, and periodic updates if an issue is on the horizon. The time requirement is approximately two to three hours per month. Let me know if you would like to be a part of this committee. Contact information is on the last page.

Other updates:

* Perioperative Nurse Week is coming up November 10-16. The slogan this year is “Your safety is our job… We take it seriously” (don't ask me where they got that catch phrase from…). AORN members are encouraged to promote awareness of this week as an immediate follow-up to state and federal elections, establishing a base of contact with elected officials, community leaders, and public policy makers.
* The ballot for National Office 2003 is out. Bill Duffy and Anita Jo Shoup are running for President-Elect. Our chapter delegation wants to hear your opinion regarding who to vote for, and how you want us to vote on the issues at Congress.

I hope you all have a wonderful fall. Let us know if you have any plans for Perioperative Nurse Week so we can share these ideas with everyone.

By Sophie Taylor, President


Patient Safety First, Last, and Always
August 2002 Newsletter


“If 99.9 % were good enough:
-The IRS would lose over two million documents this year
-There would be a major plane crash every three days
-16,000 items would be lost in the mail every hour
-12 babies would be given to the wrong parents every day
-107 erroneous medical procedures would be performed each day.”

This was a quote from the “Patient Safety First” web site at www.patientsafetyfirst.org. Medical errors have been on the forefront ever since the Institute of Medicine (IOM) came out with their report “To Err is Human” which states that between 45,000 to 90,000 patients die every year due to human error. What has become increasingly clear is that the old “blame and train” environment does not reduce errors. The clear message from the IOM report is that safety is primarily a systems problem. Therefore, better systems have to be developed to help prevent errors, and these systems must be developed to ensure that clinicians can provide the effective care they intend to provide.

Are the policies and procedures in place to support the practitioner in their caregiving? For example, when a nurse monitors a patient undergoing moderate sedation (formerly known as conscious sedation), is there a policy in the facility that lists the criteria for a nurse to monitor the patient (i.e. ASA level) vs. when the anesthesia department is a better choice? If the policy states RNs can monitor patients up to an ASA II, and the nurse is faced with a level III patient, then the nurse can respectfully decline based on that particular protocol. This is a policy supportive of our practice.

Safe care ingredients include the identification of what works, ensuring the patient receives it, and delivering it flawlessly. Sounds noble in the world of managed care, cutbacks, drawbacks, downsizing and rightsizing. However, healthcare organizations are being forced to respond to the patient safety issues. Our friend, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) now issues Sentinel Event Alerts which the accredited hospitals have to act upon and respond to. One example which is relevant to the operating room is side and site issues. What is the best practice to avoid wrong site surgery? What safeguards do we have in place to protect the patient from having surgery on the wrong leg? This is a systems issue, and when something goes wrong, one has to look at that system. What are the checks and balances?

Improving communication in the surgical suite has proved to be a key issue. This includes involving the patient as part of the team. Nurses have been trying to accomplish this for years, and we have often been frustrated by external pressures such as rapid room turnover time (which sets us up for errors), and surgeons who rush us. AORN has had position statements on things like this for years, and I believe OR nurses are light years ahead of others when it comes to patient safety. We have always been advocates for those who cannot speak for themselves due to being under general anesthesia or heavy sedation. One last thought in error prevention is that a practice known to reduce errors in other industries is the limitation of work hours.

By Sophie Taylor




President’s Corner
June 2002 Newsletter


Dear distinguished colleagues,

It was a pleasure serving you at Congress in Anaheim this year. The arrangements were excellent, and classes were, for the most part, very interesting. The House of Delegates and the Forums were rather chaotic, and we debated some very important issues which I will talk about more in my Congress report.

Congratulations to Mary Ritchie (our newsletter goddess) for the AORN Chapter Newsletter Award for Intermediate-sized chapters! Mary works really hard at editing our newsletter (thank you so much!). The important thing about our newsletter is that it is of a consistently high quality. To keep this quality up, articles are encouraged from the membership.

AORN did a couple of things differently this year, which in my opinion were very innovative and forward thinking. They let student members attend Congress for free. This allowed one of our newest members, Jackie Cummings, to participate and discover what a fantastic organization we have!

Another new feature was Part I of a two-part leadership seminar (the second will be in Denver this summer). “Nuts and Bolts of Chapter Leadership” was presented by Louis Benson, PhD. The speaker had some concrete ideas for how to conduct meetings, recruit new members, and strategic planning. All this gave me some ideas for what to do in the future. We have to focus our precious energy in a couple of areas. Increasing membership will be at the forefront. Continuing to provide excellent educational sessions at the chapter meetings will also be a priority, as well as keeping current with the developments in the legislative arena. In the fall, I hope to kick off a membership drive. If everyone can bring one person to the September meeting, we would be off to a great start! I would like everyone to sign up as a membership ambassador. Let’s challenge ourselves to bring our chapter membership up to 200! For this to succeed, everyone has to help. Our chapter has a large number of RNs who will be retiring in the next few years. Ask yourselves what makes it hard for you to attend, and if there is anything we can do to help alleviate that.

The nursing shortage and overtime hours makes it hard for tired nurses to volunteer time. Some people have children who need their attention. Would child care during the meeting time be helpful to any of you? Let me know so that we can arrange for a baby sitter.

Times are changing, and we need to be proactive in order to thrive. We can make it happen, help it happen, and watch it happen!

By Sophie Taylor


President’s Corner
April 2002 Newsletter


As Congress 2002 gets closer, the delegation is preparing to represent you in Anaheim. Some really tough issues are on the agenda. Many of them have implications for bylaws changes. Should these occur, our chapter has to revise some of our bylaws as well. The House of Delegates (HOD) will hear updates from the Governance Task Force (GTF), and the One Member/One Vote Task Force (OMOV).


One Member One Vote

The OMOV in particular deserves some scrutiny. Initially, the OMOV was created by the AORN Board of Directors (BOD) as a result of an action taken by the HOD at Congress 2001 (Dallas, TX). The charge was to:
-Propose a process for a comprehensive review of the voting structure of the Association.
-Guide the process and make recommendations for the best structure and functionality for AORN's voting system.
-Present voting options with pros and cons, implementation approaches, ramifications, and budgetary implications.

The OMOV Task Force made the following recommendations to the BOD with subsequent need for a change of the bylaws:
1. Permit all past presidents of the Association attending Congress to serve as delegates.
2. Provide for representation of the Specialty Assemblies in the HOD.
3. Provide for representation of the Golden Gavel (past members of the BOD) in the HOD.
4. Replace standing committees and task forces determined on an annual basis.
5. Establish a mechanism for the HOD to act between annual Congresses.
6. Provide for broader representation in the election of Officers, Board Members, and the Nominating Committee by establishing a group of Extraordinary Voters (EV).

AORN conducted a survey to gain information from the membership about their feelings regarding the One Member/One Vote issue. This was done in the form of a survey in the Journal. Unfortunately, the return was much lower than expected (<1% of the membership responded), and those returned mostly indicated a lack of support for the OMOV issue. After that incident, there seems to have been a shift in the task force’s focus away from the topic of One Member/One Vote.

So what do these proposals mean? Regarding the past presidents serving as delegates and representation of Specialty Assemblies and the Golden Gavel:
It has not been made known how many past presidents are expected to attend Congress each year. Their expertise is valuable to the Association. However, some concerns have been raised regarding the erosion of local chapters. If they wish to participate as delegates, they can do so as chapter representatives. This goes for the Golden Gavel and Specialty Assemblies as well. One of my concerns is that the HOD will become grounds for those with their own agendas. Note the Golden Gavel would be allowed two (2) delegates, and each Specialty Assembly two (2). There are twelve (12) Specialty Assemblies. The proposed bylaws language states that these delegates “shall not serve as chapter delegates.”

Extraordinary Voters

It gets better. Instead of the One Member/One Vote, the task force recommended the establishment of a group called Extraordinary Voters (EV). It is called the “expansion of voice and choice.” This is how the Association wants to increase the participation of the membership in issues of governance and decision making. Because the outcome of the surveys was split in how to approach the OMOV issue, a “compromise proposal” emerged. The proposal would create a group of EVs from each state equal to 1% of the AORN membership in that state (note: not a proportion of the membership in that particular state, so larger states would technically have less representation than smaller states). This would equal approximately 400 voters nationwide. EVs should be members planning to attend Congress, but not as delegates. “Extraordinary Voters would be self-nominated and selected on a first-come, first-served basis.” Currently, AORN has a representative system in place. This means that each chapter sends a delegation to Congress which represents the interests of their members. “The intent of the proposal is to enable the Association to evaluate member interest in expanding participation in the voting process in a controlled manner that would also permit evaluation of the impact of that expansion.”


Standing Committees Sit Down

The proposal to replace standing committees with committees and task forces might help the Association to respond more efficiently to the needs of the members. “The new vision for AORN’s committee structure includes fluid and flexible, focused form following function, and fiscally sound.” This type of structure would maximize volunteer opportunities by fitting people to the issues and not issues to the people.

Along the lines of increased efficiency of committees, it is proposed that we establish a mechanism for the HOD to act between the annual Congresses. With the current structure, there is great length of time needed to make decisions and implement plans. It is difficult to conduct business in a timely fashion, so it is proposed that a delegate remains so until immediately before the next Congress. If an issue arises, then it can be managed sooner.

Needless to say, our delegation has some really tough decisions to make in April. We appreciate your input. I hope that this will help keep you all informed about what is happening in your organization.


By Sophie Taylor


President’s Corner
February 2002 Newsletter

Greetings and Happy New Year!

The year started off very nicely with a meeting about “Malignant Hyperthermia in the OR” presented by Donna Benotti. It is nice to get back to some sort of normalcy after the holidays. We also had our workshop which was a huge success with almost thirty people in attendance. Tying square knots and suturing on pig’s feet is a lot harder than it looks!

This is a busy time of year as Congress in Anaheim is drawing near. The delegates are:
Mary Ritchie, Kathie Shea, Donna Benotti, Evelyn Steen and me. Remember that it is required by the bylaws to turn in your points in order to attend as a delegate.

It is also the time of year when we start thinking about who will be replacing the officers. If you have an interest in serving on a committee or holding an office, please contact me or anyone on the nominating committee. It is a very rewarding opportunity, and I found that the benefits far outweigh the work that I put in. We are all very busy, and juggling many responsibilities are common place in this day and age. However, I encourage you to help the organization by volunteering some of your time, and besides, OR nurses are very good at multi-tasking, so accept the challenge! One of my instructors in nursing school used to say if you want something done, ask a busy person and I think that even though we are busy, we know how to organize ourselves to get things done.

On a personal note, I have just started my research class for my Masters in Nursing Administration. It is an overwhelming class, but nurses need to be consumers of research. One good reason for this is when policy is about to be made, and it is based on a study, we know if the research is valid. Imagine if policy is based on flawed data, then the consequences can be devastating, and the impact on our profession can be far reaching. So learning how to critique research is a good thing.

One last thing: I want to announce that our chapter will be receiving an award at Congress! At this point I don’t know which award it is because headquarters is keeping it a secret, but I will let you know as soon as I know more.

Submitted by Sophie Taylor


Presidential News
December 2001



I was asked to write about myself - to let the members of our chapter know who I am and where I came from. Well, here it goes.

I was born in Sweden the year after the sixties ended. A very fine vintage indeed. I did the things other kids did - went to school, played sports on occasion, and had no real worries. In high school, I specialized in clothes making, and spent four years making dresses, jackets, skirts, blouses, and pants custom made for different clients.

At the same time, I worked as a costume dresser in a theater where they performed Andrew Lloyd Weber’s “The Phantom of the Opera.” It was quite a fun job, not unlike the operating room I discovered later, and maybe that’s why the Brits call the OR suite the “theatre” (guess who the primadonas are). I did this for two years while being a full time student.

In late 1989, I met the man who two years later became my husband, and I immigrated to America when we got married. Later that year my son David was born (1992). Shortly thereafter, I started taking my pre-requisites for nursing school at American River College in Sacramento where we lived at the time. As it was impossible to get in to Sacramento State University, I applied at Cal State Hayward and got accepted for fall quarter of 1995. So we moved down to Hayward. Nursing school was a lot of hard work (this is supposed to make us super nurses). During the course of nursing school, I was invited to join Sigma Theta Tau International Honor Society of Nursing. This was one great reward for all the sweat and tears, long nights and extreme sleep deprivation.

My professors always emphasized how important it was to be active in your professional organization, so when I finally graduated (the greatest reward!), and started working, I joined AORN.

After graduation, I started looking for a job. I had done my preceptorship in ICU and independent study in the OR. I knew for sure that ICU was not for me, so I pursued OR managers around the Bay Area asking them for an opportunity to come and work in the OR. This was about three years ago, and the shortage was not as extreme as it is today. Luckily, I was hired at Eden Medical Center, and they trained me. Beth Mar was my preceptor, and she taught me so much (love you Beth). She also invited me to come to the AORN meetings, and the active members smelled new blood. Before I knew it, I was on the Board of Directors. The following year I was President-Elect, and now of course, I’m the President.

For personal reasons (in 1999), I took a position at Kaiser Oakland as a staff nurse in the OR. They offered me a day shift, and this worked better with my family life, so off I went. At Kaiser, I’ve been very fortunate to precept students. It’s been a great way to refresh the basic skills necessary to function in the OR. Besides, I got a new best friend out of the deal (who by the way now is active in AORN as well).

As if my life wasn't busy enough, I started work on my Masters Degree in Nursing Administration a year ago. It is very interesting though, and hopefully one day I can use those skills to improve working conditions for nurses. In addition, being your President has been more work than I ever imagined, although it is so much fun, and trust me, I get way more back than I put into it. For example, going to Congress, and leadership conference in Washington DC. I can’t wait for the next Congress in Anaheim. I know that one will be a smash hit for sure! So that’s me in a nutshell!

By Ann-Sophie Taylor


President’s Corner
October 2001


It was very exciting to kick off the fall program with Dr. Smallhorne’s speech about plastic surgery. Attendance was great, with some new faces in the audience. We are so excited to have you and we hope that you come back for more in the months ahead. Felicia Williams was the happy recipient of the facial donated by Dr. Smallhorne as a raffle price (lucky her!!!).

Need A Lift?

Let’s keep attendance up. Perhaps you have been thinking about coming to our meetings, but have not been able to for various reasons (transportation, child care, etc.). Let us know how we can help you. There are people willing to ride share, and discussions have been on-going about child care at the meetings. I would also like to encourage those who regularly attend to invite their co-workers. Many places have traveling nurses who might be interested in coming, as well as new grads and other interested members/non-members. Ask, and you might receive...

On A Personal Note...

I haven’t had a chance to thank the Scholarship Committee from last year for granting me a scholarship to attend school. Thank you. The funds will be used to pay for my tuition at CSU Hayward where I am currently working on my Masters degree in Nursing Administration. I think this degree will open many doors where I can use my skills for the improvement of peri-operative nursing.


Updates From National

Celebrate Perioperative Nurse Week November 11-17, 2001. The theme from AORN is “Caring Today, Preparing for Tomorrow.” Many products can be ordered from AORN. (www.JimColemanLtd.com/aorn or customer service at 847-963-8100).

AORN’s Lobby Day 2001 was extremely successful! Mark your calendars now for another historical event: AORN’s Lobby Day 2002 will occur June 10-11 in Washington, DC. For more info, contact Jim Irwin 800-755-2676, or e-mail jirwin@aorn.org. This will be held at the same time as the RNFA Forum (June 8-9).


Corporate Relations

The AORN Board of Directors has approved the formation of a Corporate Relations Department within AORN. The purpose of this department is to strengthen the relations with our corporate partners since there has been a decline in financial support from the industry in recent years. The corporate relations department will be responsible for coordinating all financial activities with AORN’s corporate partners who have a vested business interest in peri-operative nursing, including exhibits and sponsorships for Congress, advertising in the Journal, and all other sponsorship of AORN activities. It will also provide a single point of contact within AORN for our corporate partners, as well as forging links between our corporate partners and AORN leadership. In addition, it is intended to nourish and strengthen our corporate partner relationships by insuring that our corporate partners receive appropriate recognition for their support of AORN, its activities, and its members.

Money, Elections, and Legislative News

We are in need of developing new revenue sources as well, because our traditional sources remain flat, while the needs of the members have increased. The board feels that the growing public concern about the nursing shortage makes this a perfect time to connect with individuals/organizations who have had positive OR experiences, with foundations, and with unrelated corporations to solicit their support for peri-operative nursing.

Now there is a new feature on the www.aorn.org web site. “Meet the Candidates” is a place where you can get information regarding those running for national office.

Sign up for legislative updates from AORN’s new legislative analyst Burke Beu. Request the newsletter “Legislative News!” by e-mailing bbeu@aorn.org or call 800-755-2676 x 233
.
Finally, I would like to personally welcome two new members: Diana Habra, staff nurse at Kaiser Oakland, and Jody Gilman, interim manager at Eden Medical Center. I know both of them, and I am so pleased to have you in our chapter. Also heard that Eden has hired a new manager; congratulations!

Submitted by Sophie Taylor


A New Beginning
August 2001


Dear Chapter Members,

Thank you all for the opportunity to serve you this coming year. The June meeting was a fun-filled event at a little winery on Palomares Road. The food and wine were great (thank you Donna Benotti for all your hard work organizing everything), and the company was excellent.  I was so pleased to see that the leadership from Eden Hospital (Rose Corcoran, Vice President of Nursing Care Services, and Jodi Gilman Interim Manager of the Surgical Services) took an interest in our organization by attending.  

One objective I would like to achieve this year has to do with increasing our membership. This is a concern of every chapter in our organization.  As you might know, the average O.R. nurse's age is 47, and there is a critical shortage of nurses right now.  We all have to do our share by training new RNs and show enthusiasm about our work.  When we do this, we can take the opportunity to involve them in chapter activities.

New nurses (as well as seasoned ones) need to be involved in their professional organization.  AORN provides many opportunities for professional as well as personal growth.  One such opportunity was the Leadership Conference in Washington, DC which I recently attended.  I got to meet some remarkable people in our organization. I learned a great deal about how the organization works, and who is who. Hopefully all this information can be used to enhance our chapter.  However, I cannot do this all by myself.  Take the time to think about volunteering.  Even if it is just one hour here or there, or just come to one of our monthly meetings.  They are educational, provide one contact hour, and allow for networking and professional exchange.  Did I mention that they are fun too? I hope to see you all soon.

Submitted by Sophie Taylor


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Updated January 5, 2003

Created January 24, 1998 by Mary Ritchie, RN, CNOR

Association of periOperative Registered Nurses, Alameda County, California

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