AORN JOURNAL NOVEMBER 1987, VOL. 46, NO 5

Editorial

Protect yourself: An article in this issue tells you how

or many busy operating room nurses, there F is little time to read professional journals, much less a good novel once in a while. Although I realize that time is precious for OR nurses, I sometimes suffer from the delusion that every perioperative nurse who receives the Journal reads each article in every issue. I know that the Journal is widely read and circulated among the staff members of many operating rooms, but I also know that some articles are often put aside to be read at a future date when there is “more time.” This issue will be no exception, I am sure.

When you open your issue each month, you may first turn to “The Last Word,” and then peruse the short columns. When you find time to read an article from start to finish, you might choose those articles that apply to your specific clinical practice first before glancing over the more unfamiliar material. If a particular article is longer than usual and lacks interesting pictures to catch your eye, you might skim it and promise yourself a more thorough review at a later date. Most of the time, that leisurely approach is

fine-but not this time. There is a lengthy article, devoid of pictures, in this issue. Despite its seemingly dull appearance, it should be the very first article you read, and you should reread it and lughlight s@c sections until you throughly understand the content. I am refemng to the latest set of “Recommendations for Prevention of HIV muman immunodeficiency virus] Transmission in Health-Care Settings” published by the Centers for Disease Control (CDC), Atlanta. This is one article you cannot skim at your leisure; you need to study the content because it directly affects your

practice and your health. Do not sit back and wait for someone in your OR to tell you what to do. Do not wait to read a question-and-answer segment of “Clinical Issues” about whether OR nurses should wear eye goggles or whether you need to take special precautions when cleaning an OR in which a patient with HIV was treated. You should know those answers, and you will know them if you take the time to become familiar with the epidemiological studies mentioned in the CDC guidelines. And do not just read them; make sure you implement the necessary precautions.

Every operating room nurse should be implementing the “universal blood and body fluid precautions” on a daily basis with every patient and in every situation that involves sharps and soiled instruments. If you are not doing so, you are being foolish and exposing yourself to unnecessary risk.

The universal precautions include wearing gloves anytime you touch the blood or other body fluids of a patient. I have heard nurses and dental hygienists say that they are too rushed to bother with gloves. “It doesn’t feel the same,” is also a common excuse. That, in my opinion, is as ridiculous as saying, “the patient will be offended if I take precautions,” which is another common refrain.

Take a look around your operating room. Is there a puncture-resistant container for proper disposal of scalpel blades? Have you stopped recapping needles and breaking them off the disposable syringes? Old habits may be hard to break, but you must.

Does your operating room manager stock

814

AORN JOURNAL NOVEMBER 1987, VOL. 46, NO 5

enough eye goggles so that you can wear them during procedures that are likely to generate splashes of blood or other body fluids? And are you wearing them consistently? Are the people who are responsible for the initial cleaning of instruments also wearing them?

The guidelines reprinted in this issue of the Journal address these issues, as well as many other precautions of importance to operating rmm nurses (eg, sterilization and disinfection, the survival of HIV after drying, serologic testing of

patients, and altering surgical procedures on HIV- infected patients). Read them. Learn what you can do to prevent e x p u r e and what might be an unnecessary ritual. Share the information with your colleagues. Distriiute photocopies or post a copy on the bulletin board. And when there is more time, read them again. You will not be sorry-

PAT NIESSNER PALMER, RN, MS EDITOR

Patients’ Expectations Can Affect Surgery Outcome How patients feel about upcoming surgery seems to be a good indicator of how quickly they will rec- over from surgery, according to a study at Vander- bilt University Medical Center, Nashville, Tern.

Fifty women between the ages of 18 and 45 who were scheduled to undergo either a tubal liga- tion or a diagnastic laparmpy participated in the study. The study originated becaw the physicians noted that an in& number of patients were opting for sameday surge% however, many ended up staying overnight because of minor complica- tions. The purpose of the study was to test the abil- ity to predict, before surgery, which patients were more sweptiile to patoperative complications, according to a spokesperson from Vanderbilt Uni- versity Medical Center.

Each patient completed a preoperative ques- tionnaire that included questions about her emo- tional state, anxiety level, and physical condition. Each person was then interviewed on three SUCCB-

sive days following surgery, and received a tele- phone 011 one month postoperatively to check on herprogress.

The researchers found that patients who expressed fears of postoperative physical discamfort experienced greater discomfort following surgery and took longer to rmver. With this knowledge, physicians at Vanderbih University Medical center concluded that they suggest to those patients that they use the more traditional recovery services, such as a hospital stay.

Film Review: Be Prepared to Speak I am sure many perioperative nurses have been asked to speak before a group of people and have been hesitant to do so. The videotaped guide, Be Prepared to Speak, is an excellent step- by-step instructional tool for public speakmg. After reviewing it, many nurses might be encour- aged to give a public speech. The package includes a study guide and instructor’s manual.

The videotape covers preparing to do a speech, writing it, and overcoming stage fright. The study guide reviews the three areas covered in the videotape and further breaks them down into 10 steps: knowing your audience, knowing the occasion, knowing your speaking environ- ment, pinning down your topic, brainstorming, researching, preparing a rough draft, transferring your speech to mental or written notes, practic- ing, and getting beyond nervousness.

A speaker’s checklist is designed for use when preparing a speech. The instructor‘s manual is provided so that the material can be presented as a class or workshop for a group of people.

For information about the VHS, Beta or 3/4- inch tap, write to Kantola-Skeie F’roductions, 16 13 Lyon St, San Francisco, CA 941 15, or call

BARBARA S. RUSYNKO, RN, BS, CNOR (415) 346-2428.

AUDIOVISUAL COMMITTEE

816