Surgical Oncology Nursing: Looking Back, Looking Forward.

OBJECTIVE: To provide a historical perspective in the development of oncology nursing and surgical oncology as critical components of today's health care system. DATA SOURCES: Review of the literature and Web sites of key organizations. CONCLUSION: The evolution of surgical oncology nursing has traversed a historical journey from that of a niche subspecialty of nursing that had very little scientific underpinning, to a highly sophisticated discipline within a very short time. Nursing continues to contribute its expertise to the encyclopedic knowledge base of surgical oncology and cancer care, which have helped improve the lives of countless patients and families who have had to face the difficulties of this diagnosis. IMPLICATIONS FOR NURSING PRACTICE: An understanding of the historical context for which a nursing specialty such as surgical oncology nursing evolves is critical to gaining an appreciation for the contributions of nursing.

Desenvolvimento do protótipo para apoiar o membro inferior durante o processo de antissepsia de fratura exposta / Development of a prototype to support the lower limb during the antisepsis of open fractures / Desarrollo de un prototipo para apoyar el miembro inferior durante la antisepsia de fractura abierta

Enquadramento: O aumento de pacientes com fratura exposta eleva o risco de infeção óssea. A infeção em sítio cirúrgico ortopédico constitui uma complicação grave. São utilizadas bandejas durante o procedimento de antissepsia da fratura exposta, passível de virar ou respingar na mesa cirúrgica e no chão, possibilitando a contaminação do campo cirúrgico e risco de queda do profissional no piso molhado. Objetivos: Desenvolver um protótipo para apoiar o membro inferior durante o processo de antissepsia da fratura exposta. Principais tópicos em análise: Projeto informacional. Foram levantadas informações para gerar soluções. No projeto conceitual foram construídos dois modelos de protótipos e testados em manequim, quanto à funcionalidade e design, permitindo apoio ao membro, irrigação sem respingos, destino adequado do líquido drenado e possibilitou a esterilização em autoclave. Na etapa projeto detalhado foi desenvolvido o desenho técnico e feito o registo da patente no Instituto Nacional da Propriedade Industrial. Conclusão: Após os testes, o modelo 1 apresentou vazamentos e não possibilitou a esterilização. O modelo 2 atendeu aos requisitos de funcionalidade e esterilização.(AU)

Background: The increase in the number of patients with open fractures increases the risk of bone infection. Orthopedic surgical site infections are severe complications. During the antisepsis of open fractures, trays can be turned over and spill on the surgical table and fall to the ground, increasing the risk of contamination of the surgical field and the professional's risk of falling in the wet floor. Objectives: To develop a prototype to support the lower limb during the antiseptic preparation of open fractures. Main topics under analysis: Informational design. Data were collected to create solutions. Two prototype models were produced in the conceptual design phase and their functionality and design were tested in manikins, providing support to the limb, allowing irrigation without splatter, adequate fluid draining and elimination, and autoclave sterilization. In the detailed design phase, the technical design was developed, and the patent was registered at the Brazilian National Institute of Industrial Property. Conclusion: After the tests, Model 1 showed leaks and did not enable sterilization. Model 2 met the functionality and sterilization requirements.(AU)

Marco contextual: El aumento de los pacientes con fractura abierta acrecienta el riesgo de infección ósea. La infección en la cirugía ortopédica constituye una complicación grave. Durante la antisepsia de una fractura abierta se utilizan bandejas, que pueden girar o salpicar la mesa de operaciones y el suelo, lo que hace que el entorno quirúrgico se contamine y que el profesional corra el riesgo de resbalarse con el suelo mojado. Objetivos: Desarrollar un prototipo para apoyar el miembro inferior durante la antisepsia de una fractura abierta. Principales temas en análisis: Proyecto informativo en el que se recogió información para generar soluciones. En el diseño conceptual se construyeron y se probaron dos prototipos en un muñeco, y se observó que la funcionalidad y el diseño permiten apoyar el miembro, irrigar sin salpicar, gestionar de forma adecuada el líquido drenado y esterilizar en autoclave. En esta fase del proyecto detallado se desarrolló el diseño técnico y se registró la patente en el INPI Conclusión: Después de realizar las pruebas, el modelo 1 tuvo fugas y no permitió la esterilización. El modelo 2 fue adecuado respecto a los requisitos de funcionalidad y esterilización.(AU)

Footprints and followers.

When I was seven years old Daisy Ayris was busy setting up NATN. We all know that very little is ever gained in isolation and our founder had the support of many willing nurses at this time. Amongst those committed nurses taking up the gauntlet was a lady also from Yorkshire called Isobel Curry. It is indeed thanks to Daisy, Isobel and many others that the Association has grown, developed and blossomed into the inclusive Association for Perioperative Practice (AfPP), now in its 51st year of existence.

Historical trends influencing the future of perioperative nursing.

This paper explores the historical trends that have shaped the perioperative nursing specialty. The educational, societal, and political influences are examined through different historical periods. After, initially, being the first recognized nursing specialty operating room nursing was later removed from the nursing education curriculum. A debate as to whether perioperative nursing was simply a technical skill or actually "real" nursing was beginning and it continues to this day. Today, students' lack of exposure to the operating room, unsuccessful preceptorship programs, and poor working conditions are creating major recruitment and retention challenges. Because these historical trends have led to the decline of perioperative nursing, it is crucial for modern nurses to understand the factors that are influencing our practice and to make collective efforts to positively influence the future of our specialty.

Nursing's central role in the care of individuals with cancer: 1900-1940.

PURPOSE/OBJECTIVES: To document the central role of nursing care in the continuum of cancer awareness, treatment, and palliation from 1900-1940. DATA SOURCES: Primary sources were student nurses' lecture notes, hospitals' annual reports and other literature, and published materials of the period. DATA SYNTHESIS: Throughout the years reviewed, the warning signs of many types of cancer were included in nurses' education. Nurses were integral to the care and well-being of individuals diagnosed with cancer. CONCLUSIONS: In the first four decades of the 20th century, nursing care of individuals with cancer became increasingly technical and specialized. This article documents the nursing care that was practiced at the time. The issue of concealment of a cancer diagnosis affected nurses' care. Nurses were seen by the American Society for the Control of Cancer as key players in the public's awareness of cancer. IMPLICATIONS FOR NURSING: The care, skill, and knowledge of nurses were central to patients coping with a cancer diagnosis.

Driving forces that transformed the care of individuals with cancer from 1900-1940.

PURPOSE/OBJECTIVES: To identify driving forces that established the groundwork for a more dedicated approach to health care for individuals with cancer in the early 20th century. DATA SOURCES: Letters, books, and journal articles published in the early 20th century, as well as materials and communications from several archival sources. DATA SYNTHESIS: The increasing incidence of cancer cases and the building of cancer hospitals were among the dramatic forces in the late 19th century that contributed to the transformation of the clinical care of individuals with advanced cancer. Historical research provided evidence for the early development of the specialization of oncology nursing. CONCLUSIONS: In the late 19th and early 20th centuries, the stigma attached to cancer contributed to delays in diagnosis. The great majority of patients were diagnosed with advanced diseases that were incurable. Providing care to patients with cancer was a problem in hospitals and homes. Radical surgeries and the therapeutic use of radium placed unique demands on patients, their family caregivers, and nurses. Nurses adopted new roles and provided detailed bedside care routines; educated patients, families, and the public; published journal articles and textbooks; and advocated for change. IMPLICATIONS FOR NURSING: Early leaders provided the vision, established the foundation, and cultivated the passion for the emergence of specialized nurses to provide individualized care to patients with cancer. Oncology nurses and nurse leaders are needed to sustain the continual transformation of the specialty so that the individualized needs of patients with cancer are met.

Cancer nursing: the modern era.

PURPOSE/OBJECTIVES: To identify critical elements of the major shift in cancer nursing practice, education, and the expectations of professional nursing immediately following World War II that were precursors of contemporary oncology nursing preparation and practice. DATA SOURCES: General healthcare, medical, and nursing literature, particularly in the American Journal of Nursing, published after World War II and before the inception of the Oncology Nursing Society (ONS); archival materials in the collection of ONS; nursing history literature; and personal communications. DATA SYNTHESIS: Nurses in a wide variety of practice settings with varied levels of experience, including staff nurses, homecare nurses, and high-level leaders and decision makers of the time, were responsible for bringing attention to and addressing the challenges and joys of cancer nursing. CONCLUSIONS: Professional nursing in general and cancer nursing in particular underwent significant changes and a distinct paradigm shift in cancer nursing education and practice in the period of time surrounding World War II, which promoted the advancement of cancer nursing. IMPLICATIONS FOR NURSING: This historical review provides lessons for contemporary cancer nursing clinicians, executives, researchers, and educators with regard to imagining ways to approach issues, the necessity of collaboration and public-private partnerships, and maintaining the passion for this increasingly complex nursing specialty.

[The gloves of love].

INTRODUCTION: Thin rubber gloves were used for the first time in the history of medicine at the end of 1889. On the occasion of the 120th anniversary of that event at the end of 2009, the great importance of that discovery for the development of surgery in general should be emphasized once again. The surgical gloves were invented and introduced by a famous American surgeon Dr. William Halsted from Johs Hopkins Hospital in Baltimore (USA). DR. WILLIAM HALSTED AND MISS CAROLINE HAMPTON: This significant innovation actually occured thanks to the romance between Dr. W. Halsted and his scrub nurse Miss Caroline Hampton, later his wife, Mrs C. Halsted. According to the antiseptic practice of that hospital the hands of the operating personnel had to be desinfected in mercuric chloride which damaged the skin of nurse Caroline who developed a bad case of dermatitis, and because of that she considered abandoning the hospital. This prompted Dr. Halsted to contract Goodyear Rubber Company to produce thin rubber gloves to protect Caroline's hands and to keep her in his vicinity. They proved to be very satisfactory and soon Dr. Halsted's assistants too began to wear sterilized rubber gloves routinely. COMMENTARY AND CONCLUSION: Although it was not until later that the importance of rubber gloves in preventing infection was realized these "gloves of love" soon entered into general surgical practice and proved to be of the greatest importance for the development of asepsis and aseptic surgical work.

The influence of Nightingale rounding by the liaison nurse on surgical patient families with attention to differing cultural needs.

This article is a tribute to Florence Nightingale whose book Notes on Nursing was published 150 years ago in 1860. Nightingale was a proponent of rounding on patients to ensure their environment contributed to healing. Patients and their families experience greater satisfaction when a registered nurse rounds on them. The liaison nurse provides the connection between a surgical patient and the family in the waiting room. This activity promotes communication and spiritual support for family members who will participate in patient care both during hospitalization and after the patient returns home. Nursing theorists support the interconnectedness that takes place during rounding. Story theory directs the nurse to connect with the patient's story so that holistic care, recognizing body, mind, and spirit, can take place. High-touch/low-tech as practiced in Asia includes nurse-family interaction, integrating knowledge about the patient's history and preferences with nursing assessment, planning, interventions, and evaluation of care. Nursing diagnoses support critical thinking for the nurse during rounding and interaction with family members. Hospice care includes family stories, humor, and the comfort of presence of loved ones.

Field expediency: how army nurses in Vietnam "made do". An ability to improvise is a valuable nursing skill, on and off the battlefield.

In the early years of the Vietnam War, when resources were in short supply, nurses improvised in the field to provide care to the sick and wounded under extremely adverse conditions. This "field expediency" was the result of nursing knowledge as well as flexibility, creativity, audacity, and pragmatism. Nurses in other settings--for example, those practicing in remote areas, in developing nations, or during natural disasters--may also find themselves facing severe shortages or too few essential supplies or a lack of equipment. Familiarity with the methods associated with field expediency will help nurses adapt quickly--on the battlefield and off.

Surgical nurse practitioners as registered nurse first assists: the role, historical perspectives, and educational training.

Advanced practice nurses (APN) who practice in the surgical subspecialty areas may have the opportunity to expand their scope of practice to include first assistant at surgery. Surgical APNs who practice as registered nurse first assistants (RNFA) should seek credentialing and apply for institutional privileges to assure the consumer of competent providers. Credentialing as an RNFA documents the educational learning process and skills acquired, and recognizes this area of expertise. The role of the APN as an RNFA at surgery is practiced within the specialty area of perioperative nursing which includes preoperative, intraoperative, and postoperative care. In this study, the nurse practitioners describe the role of the RNFA, its historical evolution over wartime, the required educational training, and the benefits of the role for patient care. The surgical nurse practitioner who undertakes training and education as a surgical RNFA is in an excellent position to provide patient care across the surgical continuum.