Martha Stratton MSN, MHSA, RN, CNOR, NEA-BC Describe the formative years of nursing and AORN
Understand the contributions to the profession of nursing and Perioperative nursing in particular that AORN has made.
Evaluate the importance of the individual nurse’s involvement in AORN processes.
“Many think a nurse’s life one sweet poem of ‘gently stroking fevered brows’ and being repaid by ‘sweet smiles from the grateful patient’
Don’t start out with the idea that a nurse’s career is a serene, beautiful and easy one.
The calling of a nurse is a noble one, but remember there are many hardships to bear, many obstacles to overcome”
Jane Hodson in How to Become a Trained Nurse, 1898
Love of God & fellow creatures
Strength of body & mind
Belief that cleanliness is next to Godliness
Good education
Knowledge of human nature
Quickness of comprehension & action
Patience & perseverance
Jane Hodson in How to Become a Trained Nurse, 1898
If you enter the profession merely for financial profit, great will be your disappointment.”
Jane Hodson in How to Become a Trained Nurse, 1898 Sweep, mop and dust
Fill coal bin, kerosene lamps, clean lamp chimneys and trim wicks
Make your own pens – quills
Work 7AM – 8PM – except for 2 hours on Sunday
One evening off a week (after work) – or two if you go to church
Five cents a day increase after 5 years
Do Not: smoke, drink, get hair done at beauty shop, go to dance halls
Job description for a floor nurse in 1887
The nurse in the Operating Theatre was to: . Cleanse the room . Warm & ventilate the room . Supply hot & cold water . Cover the table & mattress with waterproof sheets . Place a sawdust box at the side or foot of table . Have instruments in a tray, covered with a towel so that the patient’s nerves would not be shocked by the sight of them.
Notes on Surgical Nursing, 1874, Dr. C.H. Barnes, England
Roman mythology: ◦ The goddess Fortuna was worshipped as Jupiter’s nurse and was prayed to for hygiene in the public baths.
The word NURSE: A reduced form of the Middle English nurice Which was derived from the Old French word norrice Which is from the Latin nutricius meaning nourishing
Aesculapius (son of Apollo and a mortal woman) was worshipped by Greeks as the god of medicine.
Temples honoring Aesculapius were built beside mineral springs
Temple attendants: Hygeia & Panacea daughters of Aesculapius
Temples became sanitariums Hygeia attending Aesculapius for the sick.
250 BC – India 1st documented school of nursing Open only to men
Crusades: Knights Hospitalers of St. John of Jerusalem a military- nursing order 1099 – 17th century
First true hospitals established in the 1700’s – operated by cities or monasteries as charitable organizations
Circa 1750, An illustration of an 18th century hospital • 1836 – Kaiserworth Deaconess Institute, Germany ◦ 1st recorded school of nursing in western civilization ◦ Florence Nightingale studied here for 3 months in 1851
Concept of nursing as a profession introduced by Florence Nightingale beginning during Crimean War in 1854
Florence Nightingale ◦ Notes on Nursing - 1859 Focused on infection prevention
Pasteur – Germ Theory – 1862 Florence Nightingale
Lister – wound infection prevention - 1865 Louis Pasteur
Joseph Lister
• 1860 – Nightingale Training School for Nurses – London
• “Experts” believed that infection arose spontaneously in foul air or from internal imbalances of the four humors (yellow bile, black bile, phlegm, blood)
The first nurse-advocate: Advocated for patients: o Crimean war o Advocated reform of the British Hospital system Advocated for nurses: ◦ Nurses to teach nurses ◦ Scientific principles “I attribute my success to this - I never gave or took any excuse.”
1861 - Dorothea Dix, Superintendent of Female Nurses, Union Army
1907 - Mary Adelaide Nutting & Isabel Robb
1901 – Congress Established the Army Nurse Corps
1923 - Yale University - the first fully autonomous nursing school
1925 - Yale University - first Bachelor of Science in nursing degree program
Dorthea Dix 1909 first curriculum guide for nursing published by the AHA ◦ Included recommendations for OR nursing
1903 – state registration for nurses ◦ Stilled called “trained nurse”
1917 Standard Curriculum Guide published by the National League of Nursing Education
1920 – Registered Nurse and RN
1873 – Linda Richards graduates from the New England Hospital for Women and Children Training School for Nurses and officially becomes America's First Trained Nurse
1879 – Mary Eliza Mahoney graduates from the New England Hospital for Women and Children Training School for Nurses and becomes the first African-American professional nurse in the U.S.
Mary Eliza Mahoney Earliest
“surgeons”
1st formal training
for physicians was in Greece in 700 Babylonian Magician-Surgeon B.C.
1842: First surgery performed in the U.S. under general anesthesia: ◦ Crawford Long, MD ◦ Used ether
Crawford W. Long • 1882 – the first “operation rooms” were constructed at a clinic in Germany.
• 1891 – the first modern OR in America at Roosevelt Hospital in New York
Dr. Nicholas Senn wrote A Nurses Guide for the Operating Room in1902
1916 - The Operating Room, A Primer for Pupil Nurses written by Amy Armour Smith
32 postgraduate courses in OR technique in 13 states in 1922
The cap and mask go on first and not last Dry sterilize scrub brushes (instead of boiling) Boil instruments after every operation Patching holes in linen is imperative Wrapped packages should be carried well out from the body Fan fold linen Disinfect water faucets each morning No dressy street shoes allowed in the OR Mop floors with 3 separate mops and solutions: soap, water, and carbolic Avoid leaning over a sterile field – wrap arm with sterile towel to wipe surgeon’s brow
AA Smith, The operating room: A primer for pupil nurses. 1916 Charles Chamberland invented the first autoclave in 1884 in France
Heat sterilization began being used in the U.S. in the late 1880’s.
• 1st formally recognized specialized OR nurse was Caroline Hampton, RN – hired by Isobel Robb
• Not until the early 1900’s was OR Nursing fully recognized as a separate nursing specialty. • 1930 - Minneapolis/St. Paul area st ◦ 1 organized group of OR nurses began
meeting.
• Affiliated with
Minnesota League of Operating Room 1930 Nursing Education:
• The OR group
meetings were 1930 Automobile interrupted by WW II
• 1947 – Group of OR supervisors began to meet in Dallas, TX
• November,1949 – New York – a formal organization of OR Nurses was
organized. Kansas City, Missouri, General Hospital 1950
• February, 1949 – AORN of New York was formally commissioned. ◦ 56 OR nurses made up the membership
• Organizations spread throughout the country: ◦ Boston ◦ Baltimore ◦ Philadelphia ◦ Chicago ◦ Shreveport
OR Nursing – first journal published by AORN in 1960
The debut of the AORN Journal in 1963
Standards for Administrative and Clinical Practice in the Operating Room booklet published in 1965
6 years before ANA published basic nursing standards
1st: Edith Hall’s apartment on West 18th Street in NYC - 1949-1962
2nd: 151 East 50th street, NYC 1962- 1973
3rd: Madison Avenue, NYC 1996- 1973
4th - Mississippi- Galena building in Denver 1973-1992
5th (final??) headquarters: South Parker Road, Denver 1992 – present day
• Set the standards for Operating Room practice – no matter what your role is in the OR.
• Provided thousands of educational events and opportunities.
• Helped shape legislation and regulations at the state and national level.
• Name change in 1999 to reflect broader scope of “periOperative” practice.
AORN will be the indispensable resource for evidence-based practice and education that establishes the standards of excellence in the delivery of perioperative nursing care.
Our mission is to promote safety and optimal outcomes for patients undergoing operative and other invasive procedures by providing practice support and professional development opportunities to perioperative nurses. AORN will collaborate with professional and regulatory organizations, industry leaders, and other health care partners who support the mission. AORN is the official voice of Perioperative Nursing
It is the basis of everything you do in the Operating Room – no matter your role in the OR ◦ AORN’s Guidelines
You can play a part in determining the structure of perioperative nursing practice ◦ Through your chapter ◦ Through the on-line site Member comments on Guidelines and Position statements ◦ Through national participation
AORN is affiliated with 48 national and international healthcare and patient safety groups. ◦ ANA, ANCC, AAMI, ACS, ANIA, CDC, CMS, IOM, NANDA, NIOSH, NPSF, NQF, OSHA
AORN is at the table advocating for Perioperative patient safety & quality as well as worker safe environments.
The Association of periOperative Registered Nurses (AORN) is the national association committed to improving patient safety in the surgical setting.
AORN is the premier resource for perioperative nurses, advancing the profession and the professional with valuable guidance as well as networking and resource-sharing opportunities.
40,000+ perioperative nurses from around the world are members of AORN
“We” are You!! Syntegrity – PNDS
Evidence rating of guidelines ◦ National Guideline Clearinghouse
Ambulatory Surgery Division
Center for Nursing Leadership
Universal Access – differentiation of membership
Expanding/Differentiating our Business model
Major investments in technology What if Perioperative nurses didn’t join or support AORN?
What impact would that have on our profession?
What impact would that have on your OR?
What entity would: Research evidence-based practice
Compile guidelines based on that evidence
Coordinate with other national and international organizations for safety for the Perioperative patient
Disseminate information to Perioperative nurses around the world
Driscoll, J. Preserving the legacy: AORN 1949-1989. Association of Operating Room Nurses, 1990
Glass, L K, Murphy, E K. AORN: Emergence and growth. Association of periOperative Nurses, 2002