The year was 1974, and I was an adolescent hospitalized for 5 days with strep throat, generalized weakness, joint tenderness, and swelling. The differential workup included rule out of rheumatic fever. The diagnosis was confirmed; I was placed on bed rest, antibiotics, and a prednisone taper that fortunately led to a positive outcome without heart valve involvement. That episode of care is burned in my memory, as I recall a gap in the delivery of nursing care at my bedside. Something was missing, but I was too naive to understand or identify it. I'd be lying if I said this experience drove me to a career in nursing; it did not, but in hindsight it played a role as I weighed college and career path options. I can say, with absolute certainty, even when I chose orthopaedic nursing as a career, the thought of becoming NAON's 40th President never enter my mind until deep into my journey. It is still hard to grasp. I welcome the challenge and hope to fulfill the invitation to lead. Many things are possible if you are passionate and stay engaged.
I am humbled and privileged to serve as your President during NAON's 40th year! Lordy, Lordy, look who's turning 40! That's right, 40! I looked back at the history on our NAON website and saw that in 1980, Nancy Hesselbach and Barbara Fiehler gathered with fellow orthopaedic nurses at the AAOS Annual Conference to develop an orthopaedic nursing specialty organization that would meet the needs of their members. They established and incorporated NAON on April 14, 1980 (NAON, 2019). Forty years is a long time, and many of our past and current members have contributed to the rich history of success. Leader volunteers have come and gone, and as I accept the gavel I'd like to share who I am with you and set the stage and theme for the upcoming year.
I was hired as a new licensed practical nurse (LPN) in October 1980. So, 1980 was not just the start of NAON, it was also the beginning of my nursing career at the Hospital for Special Surgery (HSS) in New York City. Like the founders of NAON, I too was determined to build a strong and firm orthopaedic nursing foundation with a focus on research, education, and practice. I found those values and much more at HSS. In 1980, orthopaedic patient care was primarily delivered through a fee-for-service model, with novel procedures such as total knee replacement new to the marketplace. The average length of stay for total knee replacement at my institution in 1980 was 14 days! Nothing has changed, right?
HSS has a great reputation and has produced quality leaders in many orthopaedic subspecialties and disciplines. I am proud to build upon the NAON/HSS nursing legacy. I learned a lot as an LPN at the bedside but soon realized a career in nursing with greater opportunity would require higher education. I went back to school and kept learning. I became a registered nurse (RN) and moved from inpatient to the postanesthesia care unit (PACU). I assessed and managed pain, as well as postoperative nausea and vomiting, and was introduced to research at the bedside.
I worked hard, became a skilled clinician, and climbed the clinical ladder. I took on more unit responsibilities and applied for the vacant PACU nurse manager position. I was turned down. I did not have my BSN. My chief nurse embraced the message from the American Nurses Association (ANA) Board of Directors who approved a proposal for the Magnet Hospital Recognition Program for Excellence in Nursing Services (American Nurses Credentialing Center, 2019). She had a vision and began to operationalize the Magnet journey recommending all RNs, not just nurse managers, seek BSN degrees, join specialty organizations, and pursue certification.
So, I joined NAON in 1991, studied and passed the Orthopaedic Nurse Certification examination in 1992, and have been certified since. I became more actively engaged in NAON. I also began course work toward my bachelor's degree and left the PACU for a nurse coordinator position, still at HSS. I was given the keys to the hospital during evening and night tours, was responsible for staffing, emergency admissions, pharmacy, and blood bank. I learned about interdisciplinary communication and team building and enjoyed mentoring and coaching nursing staff, but this role was removed from direct patient care. Not a great fit for me; I wanted something else.
My career path diverged again in 1995, when I was hired as an office practice nurse clinician by Richard Laskin, MD, a total joint replacement surgeon. He introduced me to the care of surgical patients across the continuum. I was an orthopaedic navigator before the title and role came into play. Dr. Laskin, a surgeon, encouraged and pushed me to become a more engaged and active member of NAON. With his support, I attended my first NAON Congress in Dallas in 1995. It was eye opening. I was hooked and have attended every Congress since.
I began to attend Orthopaedic Nurses of New York (ONNY) chapter meetings and networked with others who welcomed me into the fold and advocated for deeper NAON engagement. I volunteered and chaired the Total Joint Special Interest Group from 1999 to 2001 and became the ONNY Chapter President in 2000. NAON offered so much. I learned, taught, networked, researched, improved practice, traveled, and made lifelong friends.
There were so many opportunities to serve NAON as a volunteer, and I took advantage. I discovered a passion for teaching and started to present posters and podium sessions. I became a content reviewer of NAON educational products and cochaired an Allied Heath Program at the 2006 AAOS meeting. My writing skills improved, which led to manuscript submissions and a published chapter in NAON's Core Curriculum. This continued engagement inspired me to seek advanced education and graduate school. Because I was entrenched in NAON, I was privy to the NAON Foundation scholarship dedicated to the memory of Katie Greatrix. Katie was an active and founding member of NAON's Pittsburgh Chapter.
I applied and received this full tuition, graduate education scholarship in 2007 and will be forever grateful to the Greatrix family (Mr. and Mrs. William Recker) and the NAON Foundation for their overwhelming generosity. As part of the scholarship criteria, I needed to submit a "Statement of NAON contribution," or how I planned to give something back to NAON. The following is an excerpt from my statement: "I see myself as a future leader somewhere within the NAON family. I expect to remain active on both the local and national levels and would consider pursuit of a future role on the NAON Executive Board." Today, 11 years later, the plan continues to move forward. Chills ran up my spine when I realized that the 2020 Congress, my Presidential year, would be held in Pittsburgh, Katie's hometown. I never met Katie, but she will be there with me in spirit!
To me, staying involved and engaged became second nature and I turned my volunteer efforts to the Orthopaedic Nurses Certification Board (ONCB). Like the NAON foundation, the ONCB is a long-standing partner of NAON with multiple common interests, beliefs, and values. My tenure with ONCB began on the recertification committee and quickly led to committee chair, board member, Director, and President in 2010-2011. I gained knowledge about item writing, testing, and the world of certification. I developed a greater understanding and more in-depth appreciation of nursing excellence, camaraderie, leadership, and a commitment to lifelong learning.
I am grateful for HSS nursing, my patient education team, and all the interprofessional colleagues and hospital administrators who embrace a culture of continued growth and the pursuit of excellence. As Magnet leaders, Trish Quinlan, Stephanie Goldberg, and Jennifer O'Neill supported, guided, and continue to encourage me to follow my passion and the NAON leadership pathway.
So, now you know more about me, my journey, and the role NAON has played in my career. NAON has so much to offer and can be the vehicle to drive YOUR nursing practice and advance YOUR career opportunities. You can learn so much while developing lifelong friends, mentors, and professional support resources. I met and have gotten to know so many great people along the way.
The continued success of NAON will not come easy. It will require many of us to continue our volunteer effort, commitment, and spirit of community. In addition, we need an infusion of energized and more actively engaged members. I sense the momentum building as the role of the orthopaedic nurse navigator continues to develop and members continue to share best practices with each other across the country. This role has empowered nurses to become more autonomous and demonstrates the value associated with improved care coordination. These nursing functions were absent during my rheumatic fever episode in 1974. As I recall, nursing practice was much more task-oriented back then. My nurses were very nice as they delivered basic care, dispensed my prednisone, changed bed linens, and enforced the doctor's orders for bed rest when I would sneak away. They did not coordinate care through an interdisciplinary approach but rather waited for the admitting physician to write the discharge order.
The nursing profession continues to change and find its way in the multidisciplinary healthcare environment. We now have many more nurses with advanced degrees practicing in the field across the continuum. Orthopaedic nurses are everywhere! With a unified and engaged membership, NAON can fulfill our mission to advance the specialty of orthopaedic nursing through excellence in research, education, and nursing practice (NAON, 2019). Healthcare reform in the musculoskeletal sector is needed and inevitable. Who better to lead that charge than 5,600 NAON nurses?
My NAON presidential theme for 2019-2020 is "Engage Your Core." It is purposefully ambiguous with multiple interpretations and meanings, but I hope it inspires and creates a common purpose and message for NAON members to become more "Engaged."
Some thoughts about this theme:
* Engage your Core passion and drive to become a more professional orthopaedic nurse. Get a peer to join NAON!
* Engage your Core leadership values. Step up to serve by joining a NAON committee or seek a leadership position.
* Engage your Core team at work. Submit an abstract to next year's Congress or encourage orthopaedic certification.
* Engage your Core nursing knowledge. Share NAON best practices with your interprofessional team to enhance quality care.
* Engage your Core metrics. Outcomes can demonstrate the value of orthopaedic nursing and care coordination.
NAON will find ways to build upon the success of the last 39 years. This past year the board approved a budget that invests in member education benefit with a new education platform that will enhance our delivery of quality educational products and services. To address our declining membership, a tiered membership structure was introduced to attract students and maintain a growing population of retired members, while offering general and premium memberships to address more individualistic needs. We will continue to evaluate improvement efforts and ensure that NAON membership offers great value.
In conclusion, I want to thank every NAON member for the opportunity to serve as president of this exceptional organization and challenge you all to "Engage Your Core," whatever it means to you from now until we gather again in Pittsburgh in May 2020! NAON needs you to engage and stay engaged!
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