Do surgery suite doors serve as professional barriers? Operating room nursing is still seen as iso- lated from the mainstream of nursing by other nurses. The doors to the surgical suite are not only an aseptic barrier, but a professional barrier as well.

This was brought home to me as I listened lo Margretta Styles, the keynote speaker at Con- gress. She is dean of the College of Nursing, University of California, San Francisco. Con- fessing that she is somewhat out of touch with operating room nursing, she went on to say, “You should be embarrassed that you have permitted yourselves, a sizable contingent within our profession, to recede from the sights of me and others like me.”

She lauded AORN for its leadership, strat- egy, cohesiveness, and innovation in role definition, but she cautioned, “Your delibera- tions and decisions cannot occur in isolation, but must occur within the general context of nursing and health care in general.”

Her comments may have jarred some in the audience. Do OR nurses see themselves as isolated? Perhaps not. Yet sometimes we can learn from how others see us, even if we do not accept it as the full truth.

As an Association, AORN has developed strong contacts with other nursing and health care organizations. We have increased our interaction with the American Nurses’ Associa- tion (ANA) and other specialty nursing organi- zations, in part through the Federation of Specialty Nursing Organizations and ANA. AORN’s leadership has fostered interchange

Bd Editorial

with other organizations. The Association sees itself as a leader among nursing organizations and as outspoken on issues.

But in the hospital, operating room nurses are isolated by the walls of the surgical suite. Those who have little or no contact with OR nurses still see OR nursing as primarily techni- cal. A study by the Western Interstate Com- mission for Higher Education, prepared for a federal nursing manpower project, has pro- jected that in the future, 100°/~ of the nurses in the OR will be associate degree or diploma graduates. The study sees no need for bacca- laureate-prepared nurses. This is the only specialty for which this is true. Yet, at the same time, operating room nurses have endorsed the baccalaureate as the entry level for nursing practice. It is ironic that operating room nurses see a need for a baccalaureate nurse in the operating room, but their colleagues do not. Is this because other nurses do not know that operating room nurses are giving patient care?

Operating room nursing can often be under administration rather than nursing service. Styles mentioned this. Although most nurses seem to preferthis arrangement, it can hamper cooperation among nurses and separate OR nursing from the rest of nursing.

This professional barrier affects the con- tinuity of care for patients. On occasion when we talk with surgical nurses on the unit, we find they have little contact with OR nurses. They express interest in having OR nurses come to the unit to talk with surgical patients. I recently attended a meeting of the Association for the Care of Children in Hospitals (see report in this Journal). There are many pediatric nurses and therapists who are preparing children for surgery. I heard several times that these health care professionals would welcome more par-

AORN Journal, August 1979, Vol30 , N o 2 201

ticipation from operating room nurses. If the OR nurse has not seen a patient before he comes to surgery, there is a distinct break in the continuity of his nursing care. This can be especially difficult for children, who have de- veloped a rapport with unit personnel but must leave that support at the OR door. Two child life therapists at Bellevue Hospital, New York City, have dared to cross the barrier of the OR doors. They accompany the children they have prepared for surgery into the OR and stay with them until they are asleep. It took some cour- age. They were told by their colleagues, “They’ll never let you stay.”

I realized the extent of this professional barrier when I recently examined Principles of Nursing Care for the Pediatric Surgery Patient (Little, Brown, 1976). It describes preoperative and postoperative nursing care but makes vir- tually no mention of intraoperative nursing care. Surgical procedures are explained, but the only mention of operating room nursing I could find was under open heart surgery. It said, “The nurses in the operating room per- form a variety of very important functions in the teamwork by helping the surgeons, anes- thesiologist, and the cardiologists.” A pediatric nurse or student reading this book would have no concept of what the nurse in the operating room does or how she might establish con- tinuity of care with operating room and recov- ery room nurses.

The lack of OR experience for students as a break in thecontinuity of care for patients was discussed at the Deans’ Conference at Head- quarters in June (see report in this Journal). How can nurses give total care unless they know what happens in surgery? When 41 % of hospital patients have surgery, how can you have continuity of care when you remove that critical part of the patient’s care from the stu- dent’s experience? asked AORN President Barbara Gruendemann.

The Deans’ Conference was an important step in breaking down the wall between OR nurses and educators. The deans were in- terested in the perioperative role and receptive to the idea of OR nursing as a vehicle to the many facets of nursing.

In explaining the perioperative role to the deans, Clifford Jordan, who served on the Project 25 and 26 Task Forces, said he be- lieves that OR nursing should be holistic, in-

cluding the preoperative, intraoperative, and postoperative periods. Repeating his com- ment from his keynote address at the 1977 Anaheim Congress, he said, “It is time to break down the walls of the OR, either real or sym- bolic, and get the OR nurse out of the OR to where the patient is before he comes to the OR and where he goes after he leaves the OR.” For Jordan, the perioperative role helps nurses do that.

It may not be necessary to break down the walls, but perhaps the door should be opened more frequently for OR nurses to go to the unit and for nurse colleagues to enter the OR.

Elinor S Schrader Editor

Cornell-NY Hospital graduates last class After providing nursing education for 102 years, the Cornell University-New York Hospital School of Nursing, New York City, graduated its last class this spring. Joint commencement ceremonies with the class of Cornell University Medical College were held May 23 for 104 nurses who received baccalaureate degrees.

The last class brought to 4,377 the number of students who had graduated from the institution. The first commencement was held in 1878 for seven women who had completed an 18-month training program at what was then called the New York Hospital Training School. The school became an integral part of Cornell University and first awarded the degree of Bachelor of Science in Nursing to eligible graduates in 1942.

feelings of faculty and alumni on the closing of the baccalaureate program for financial reasons. ”All of us feel a great sadness that today’s commencement marked the closing of this school, which has produced many nursing leaders in its 102-year history,” she concluded.

Dean Eleanor Lambertsen expressed the

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