I would like to congratulate everyone on another terrific Congress. All the planning and hard work by our NAON staff and volunteer members helped make this year's Congress memorable, at least for me. As I assume my role as NAON's 37th president, I am still truly honored and humbled by the faith you have placed in me to lead NAON for the next year. My personal goal is to complete the work you have tasked me with so that, together, we can fulfill NAON's mission of advancing the orthopaedic nursing specialty through excellence in research, education, and nursing practice.
I have been an orthopaedic nurse for 43 years, and many have asked why I chose orthopaedics as my nursing specialty. I do not believe I chose orthopaedics, but rather orthopaedics chose me. I was the typical chubby toddler and child, and when I was 7 years old, I suffered the first of dozens of patellar subluxations and dislocations that afflicted both my knees for nearly 20 years. I had my first plaster cylinder cast (remember those!) when I was 7 years old, and I can still remember how hot the cast was as the doctor was applying it.
In the 1960s, the only treatment for chronically subluxing patellas was the cylinder cast. I spent my childhood in these casts, and I know what it is like to have the darn cast slide and cause blisters on my Achilles tendons. I know what it is like to have plaster crumbs irritate my skin and cause sores. I also learned to climb trees with the cast on and how to wrap my leg in plastic so I could wash myself. I was 11 years old when I had my first surgery, the Hauser procedure, where they moved the bone where my patellar tendon was and screwed it more medially. I went on to have another Hauser procedure 5 years later and then several lateral releases. Over the years, the chronic injuries to my knees led to arthroscopies for meniscectomies and, finally, bilateral total knee replacements in 2014. I could be the poster child for orthopaedic patients and surgeries!
Many people talk about the nurse who was a role model for their career development in orthopaedics. I certainly had a mentor, but I also had a negative role model, and those negative role models are as powerful as the positive ones. When I was 16 years old and in the hospital recovering from my second Hauser procedure, there was this really mean nurse who made me cry every day when she was trying to teach me to crutch walk. Looking back, I realize I was a whiny 16-year-old girl who really wasn't happy that the magical summer I had planned on turned into the endless summer of casts and immobility. But I swore that I would never be the kind of nurse who was mean and ugly to the patients. I would like to think that I succeeded in that.
Those are the reasons why I became an orthopaedic nurse. I can only believe that my personal experiences guided me to what I truly believe was and still is my calling. Never did I think that this 43-year journey would lead me to the NAON presidency. In my 33 years as a NAON member, I served NAON in several chapters and multiple roles and often rotated the roles every year. I often thought how difficult and impossible it would be for someone like me to ever be elected to NAON's board much less the president role, but here I am.
As I was mulling over possible themes for my presidency, I began thinking of where NAON was and where NAON is now. Today, NAON is a robust organization, with nearly 6,200 members who are committed to providing expert orthopaedic nursing care. Our impact on orthopaedic patient care cannot be emphasized enough, and I want to thank all of you for your dedication to your patients. Your presence at Congress was a testament to your quest for obtaining the knowledge you need to provide expert orthopaedic nursing care across many settings with your patients' best interests in mind.
As nursing moves toward more evidence-based practice, the theme of my presidency became clearer. Culture, courage, and competence are critical concepts in today's fast-paced and hectic orthopaedic nursing world. Merriam-Webster's Dictionary defines culture as:
* The beliefs, customs, arts, etc., of a particular society, group, place, or time;
* A particular society that has its own beliefs, ways of life, art, etc.; and
* A way of thinking, behaving, or working that exists in a place or organization. ("Culture," n.d.)
Most people immediately think of "culture" as different ethnic groups that populate the globe. NAON has long recognized that orthopaedic nurses need to be able to communicate with patients from various cultures in order to effectively deliver the care that patients require and deserve. The NAON Education department has been busy converting educational material into Spanish to meet the growing needs of Hispanic communities within the United States.
Culture can also be used to describe an organization such as NAON, whose culture is showcased in our mission statement. Finally, culture refers to a mind-set that permeates a workplace such as a hospital where the culture of safety is a driving force. The culture of safety can be found in NAON's Safe Patient Handling and Mobility Courses that have been updated and will be ready for our members shortly. The Patient Safe Handling Algorithms have been updated and are available to members for complementary download on the NAON website.
Courage, the ability to try to do something that you know is difficult or dangerous, isn't just something you go looking for like the Cowardly Lion from the Wizard of Oz did. Courage is the mental or moral strength to venture, persevere, and withstand danger, fear, or difficulty ("Courage," n.d.). Courage is fighting for your patients' rights and wishes or telling the orthopaedic surgeon he broke sterile technique. Orthopaedic nurses face dangers every day; short staffing, lateral violence, unsafe work environments, and so forth. Some days, it is especially difficult to get out of bed and go to work, but somehow we gather the courage to get up, go to work, and provide excellent nursing care to our orthopaedic patients no matter what we are personally enduring.
Several years ago, Dr. Jennifer Embree, president of the Indiana State Nursing Association, spoke at Congress about lateral violence and how it can impact patient care. It takes courage to change a culture that allows this sort of workplace violence to occur. It takes courage to speak up and formulate a plan that helps eradicate that kind of poisonous behavior in the workplace. I firmly believe that each and every one of you embodies that type of courage; courage for your patients and to do what's right.
Finally, competence. Competence is defined as the ability to do something well. It is also the quality or state of being competent ("Competence," n.d.). Cultural competence is a skill that is needed so that our patients from different cultures receive the sensitive and thoughtful care that they deserve.
In nursing, competency usually refers to a specific skill or skill set needed to safely and accurately assess and manage patient care. Many of you have developed a competency skills checklist that you use to orient nurses to your orthopaedic units. Maybe, you use these checklists to annually reassess the staff's competencies in skills and/or procedures deemed to be critical for safe patient care. Competency must be learned, fostered, and applied in everything we do.
How are these skills identified? They are identified through evidence gleaned from research on best practices. These research findings have the strength to change practice, and NAON is committed to advancing orthopaedic nursing research so that we can continue to build our body of knowledge and implement the best practices.
The NAON Research Committee has been busy defining and refining the process by which nurses interested in conducting orthopaedic nursing research can submit applications for funding for their projects. Start thinking of some areas of your practices that may benefit from research, and be on the lookout for the NAON Research Committee's call for proposals in the late summer or early fall this year.
At this year's NAON Congress, participants had the opportunity to learn about and demonstrate competency in neurovascular assessment. The Advanced Practice Nursing Workshop also gave participants the ability to demonstrate skills needed by orthopaedic advanced practice nurses. NAON is committed to providing our members various methods to acquire and demonstrate skills in the workplace.
As we begin another year, let us come together to celebrate the cultures that unite us. Let us have the courage to change negative behaviors or environments that lead to poor patient outcomes. Let us embrace the research process that discovers best practices and competencies that we, as orthopaedic nurses, use to deliver outstanding nursing care.
References