AORN Foundation General Session – Marshall Goldsmith, Ph.D.
Are You Asking the Right Questions?
Dr. Marshall Goldsmith is one of the world’s leading executive educators, coaches, and authors. He is a pioneer in helping successful leaders achieve positive, lasting change in behavior. Dr. Goldsmith was the keynote speaker at the AORN Foundation General Session yesterday on a rainy day in Boston. During his talk, “Triggers: Creating Behavior that Lasts, Becoming the People and Organizations We Want to Become”, he reminded the crowd we all have triggers that derail us from our goals—an email, a person, a word, or even our own ego can distract us from our path toward change.
He got real with the audience from his opening quote, “Never confuse acquiring degrees with wisdom.” Dr. Goldsmith also recommended learning the difference between achievers and leaders – in yourself and others. Leaders think of others and how they can make them better and achievers maybe love winning just a little too much. However, setting (and reaching) goals for yourself and helping others achieve theirs is what does makes us happy and productive.
He asked the crowd to partner up with someone they didn’t know. One of the questions participants posed to each other was, “Tell me about a goal you’ve had and why you think you haven’t achieved it?” Following this, Dr. Goldsmith posed to the crowd, “So why do we so often get derailed in work and in life from achieving our goals”? He shared that we often get planning confused with doing. We set goals for ourselves to be better in our daily job, in our family life, and in our physical health but are easily distracted and often blame outside sources. He described triggers as, “any stimulus that may impact our behavior.”
How Do We Overcome These Triggers?
First, he told the crowd that you must realize you have a choice. You experience a trigger, which creates an impulse that causes a behavior. Where the change happens is when you understand that you have a choice between the impulse stage and the behavior stage. He also talked about coaching your perioperative team. He stressed that you (and your team) have got to be all in or it won’t work. “If they don’t care, don’t waste your time and if you don’t care, don’t waste your time.”
Dr. Goldsmith advised implementing a structure for change that you practice daily. He shared six questions to ask yourself every day and score yourself on your daily progress.
- Did I do my best to set clear goals?
- Did I do my best to make progress toward achieving these goals?
- Did I do my best to be happy?
- Did I do my best to find meaning?
- Did I do my best to be fully engaged?
- Did I do my best to build positive relationships?
Dr. Goldsmith also told the audience that if you want to have a good life, you have to live your own life. He stated, “The more hours you spend living vicariously through others, the less happy you are.” Don’t waste time on things you can’t change. He wrapped up by reminding the crowd to continually ask themselves, “Did I do my best?” as that’s what will matter in the end in both your personal and professional life.
AORN Congress - Second Forum
Government Affairs, Membership, Education & More
Members at the Second Forum on Tuesday heard first from AORN’s Government Affairs Manager Danielle Glover who presented a video of AORN’s testimony and the floor vote on the RN Circulator bill that was enacted in Rhode Island in 2016.
Glover reminded members that it can be difficult for non-nurses to understand our important patient safety issues. She stressed the value of member engagement with the government affairs department in support of the AORN policy agenda. Glover is excited that AORN has returned to Rhode Island this year with a bill requiring facilities to create a policy on the evacuation of surgical smoke. Also this year, AORN introduced in Vermont a bill to require an RN Circulator in every OR.
AORN’s Chief Financial Officer James Cousin next provided an update on membership trends, highlighting new growth in 2016 that hasn’t been seen since 2013. The national survey of periop nurses, conducted in the fall of 2016, revealed a need for AORN to focus on developing programs to support chapter engagement, strengthening its value proposition, and improving satisfaction ratings among next generations. Cousin presented several recommendations that would address areas of weakness and opportunities that will lead to better recruitment and retention results. He described one such effort already underway; nurses who are new to the perioperative specialty are now able to buy membership for $99 in their first two years of practice.
Members Angela Walsh, MA, BSN, RN, CNOR and Jennifer Fencl, DNP, RN, CNS-BC, CNOR, presented on behalf of the AORN National Committee on Education, sharing learnings from the committee’s recent work on the bariatric tool kit. Walsh and Fencl emphasized the positive impact committees can have on patient safety and growing the professionalism of perioperative nursing. Charged with working on a bariatric component for membership education, the committee worked with AORN staff to conduct a literature search that led to the development of the bariatric tool kit. The tool kit will be supported by a bariatric surgery video that will be available in May. In their presentations, Walsh and Fencl emphasized how much they enjoyed the entire experience and professed that they expect to be lifelong friends.
Member Julie Cahn spoke on the bylaws committee’s upcoming proposal to require CNOR certification for eligibility to serve on the AORN board of directors. Cahn asked the membership to consider accepting perioperative certifications beyond the CNOR such as CRNFA, CSSM and CNS-CP, noting that such an amendment would give the NLDC the power to consider those nurses who’ve achieved advanced education and certification in the broader field of perioperative nursing.
Several members spoke to the pros and cons of a certification requirement. Other topics during the open discussion were regarding the availability of Q&A sessions with candidates, the continuing safety issues surrounding retained foreign objects, reduced membership rates for senior, long-term members and the importance of amplifying the value and influence of AORN to our many stakeholders, including legislators.
Rhode Island Legislator visits Exhibit Floor
Representative Joe McNamara, who sponsored the 2016 Rhode Island bill requiring an RN Circulator in every operating room, toured the AORN Global Surgical Conference & Expo Exhibit Hall floor yesterday morning with Mary Fearon, MSN, RN, CNOR, AORN perioperative practice specialist and the AORN Government Affairs Department. A longtime champion for nurses and Chairman of the House Health, Education, and Welfare Committee, Rep. McNamara came up from Rhode Island to learn more about the equipment perioperative nurses use on daily basis in the operating room.
Last year, Rep. McNamara sponsored the bill in Rhode Island that required an RN Circulator in every OR for the duration of the surgical procedure, so he is familiar with the important role perioperative nurses play in patient safety. This year, Rep. McNamara is sponsoring legislation in the House to require facilities to create policies requiring the evacuation of surgical smoke. Not only did Rep. McNamara have the opportunity to observe the different types of smoke evacuators utilized in hospitals, he was also able to see other products such as endoscopes, beds, and equipment used for safe patient handling.
“The opportunity for legislators to tour the exhibit hall each year during the AORN Global Surgical Conference & Expo is important because it allows them to better understand what perioperative nurses do, with what equipment they must be familiar, and how important perioperative nurses are to patient safety,” said Danielle Glover, AORN Government Affairs Manager. “The more that we can do to educate policymakers about the perioperative profession the easier it is for AORN to pursue our policy agenda.”
AORN represents perioperative nurses in front of state legislative and regulatory bodies and in Washington, D.C. where we promote our Policy Agenda and respond to policies impacting perioperative nursing patient safety in the surgical environment.
Surgical Fire Prevention, Suppression, and Evacuation
Everyone was taught at a young age what happens when there is a fire. If you are in a building, evacuate, and call the fire department. If you happen to be on fire, stop, drop, and roll.
But what happens when your OR, or your patient, catches fire?
About 650 surgical fires occur in a year, according to Darren J. Osleger, the speaker at the “Hot Topic! Surgical Fire Prevention, Suppression, and Evacuation” session on Tuesday morning. A lot of these surgical fires go unreported, he says.
Osleger says perioperative nurses need to know how to prevent a fire from occurring during surgery and how to suppress it quickly to prevent further injury or death to the patient if one does happen to break out.
According to Osleger, 21% of fires that occur in patients occur in the airway, and these types of surgical fires are the most deadly to the patient. About 65% of fires occur during head/neck/chest surgeries, he says.
When someone thinks of fire, Osleger says they think of heat. But in order for fire to occur, there has to also be fuel and oxygen in the environment. “Heat alone doesn’t cause a fire,” he said.
How oxygen is given to the patient, how the patient is prepped, and more can be factors in a surgical fire. He says everyone in the OR has a responsibility to keep the patient safe from surgical fires, and to know the protocol if a fire does break out.
For example, Osleger says the anesthesiologist should be responsible for turning off the gas, and the scrub nurse should be the first one to try to put the fire out on the patient using a cover and sweep technique, if applicable. In general, he says the surgeon should decide if the team should move the patient to another OR or stay put once the fire is out, or how to proceed if they can no longer contain the fire.
National response time for the fire department to get on scene is between 4 and 9 minutes, Osleger says. By the time firefighters get past security and to the site of the fire, it could be 13 to 14 minutes in total.
“13 minutes is a lifetime in an OR,” he said.
Here are his tips for creating policies that will help you and your team prevent and respond to surgical fires in your OR:
- Fire prevention procedures shall be in place
- - Include a fire risk assessment
- Fire procedures shall be developed which:
- - Complement the building fire protection features
- - Guide staff on various fires they will encounter
- - Provide clear roles and responsibilities for all staff
- Conduct annual surgical fire safety training for all members of the surgical team
Students Get Periop Practice in Hands-on Session
Some know they are heading into the OR, while others are curious about what it means to be a periop nurse, but all the students in Tuesday’s Hands-on Practice Session, part of the Student Program, got to experience some of the things periop nurses do every day.
“A lot of times, they don’t even get even half of a day in the operating room ,” Karen deKay, MSN, RN, CNOR, CIC, a perioperative nursing specialist with AORN said. “This is a way they can see it and try to learn what to do.”
The students rotated between stations that showed them proper hand hygiene, how to put on a gown and gloves, patient positioning, hair removal, prepping a patient, and received introductions to electrosurgery and endoscopic tools.
“The students have an opportunity to actually do hands-on skills that they would experience in an operating room setting,” Susan Root, MSN, RN, CNOR and manager of perioperative education at AORN said. “Putting on a pair of gloves can be really intimidating for a student the first few times they do it. Here they have an opportunity to practice in a safe environment.”
About 300 students were expected to attend the program on Tuesday, according to Root.
“I was actually just in the OR for the first time on Friday, and I wasn’t expecting to love it, but I did,” Kaleigh Halloran, a student from Danvers, said. She signed up last-minute to come to the conference so she could learn more about being a periop nurse.
Root says she had students contacting her before the conference, telling her how excited they were to get some hands-on training related to the OR.
“AORN is hoping this is that opportunity that will get them hooked [on periop nursing],” she said.
Outstanding Nurse Philanthropist 2017
Joanne Oliver, RN, BSN, CNOR was named the AORN Foundation’s Outstanding Nurse Philanthropist at Tuesday’s General Session. Joanne has been a member for over 50 years and has been a dedicated donor of her time and talent to the Foundation since its inception in 1991.
Poster Winners: Attendee Choice Awards
Evidence-Based Practice Poster (A Three-Way Tie)
#63 – Reduction of OR Traffic: An Evidence-Based Practice Approach by Kathleen A. Tugend, #66 – Time Outs – Best Practices by Mary Beth Perry and Lindsey A. Wildman, #74 – Whiteboard Counting Board by Steven T. Ference, Michelle Alemi, and Carmen Huynh.
#308 – Implementing a Laparoscopic Bowel Isolation Procedure: Nurse Makes Autonomous Decisions to Reduce Surgical Site Infections by Andrea Lacourciere, Agnieszka Moran, and Geraldina Guzzo.
These authors may pick up their certificates in Speaker Prep Room 255.
Steps to Health Winner
Congratulations to the AORN Foundation’s Steps to Health Challenge winner for Tuesday, April 4. The highest stepper was Samuel Cabrera with 42,678 steps! The overall weekly winner will be announced this afternoon.
Doubled Donations for Certified Nurses
Through the end of today, CCI will match any donation made by or in honor of a CNOR®, CRNFA®, CSSM® or CNS-CP® certified nurse up to $10,000. Stop by the Foundation booth and double your donation.
AORN Congress – Second House of Delegates & Closing Ceremony