Joan Driscoll, RN

OR nurses as researchers

The concept of clinical nursing research is not new. I t is as old as the art and spirit of nursing. Since the beginning of civilization, men and women dedicated to the care of the sick have recorded their findings. There is evidence of this in both the Old and New Testaments. Epistles and letters written during the Holy Wars and the Crusades deal largely with the subject of wound healing and the treatment of disease. During the Crimean War, Florence Nightingale carefully documented her thoughts, ideas, and findings establishing a foundation for the practice of nursing. Using the adage, “No one person has all the answers to everything; and there is no one pool of wisdom,” as a guide, nurses can enlarge their individual pools of wisdom if they share their thoughts, ideas, and expertise with other nurses. The largest group of health professionals in the nation, nurses have begun to experience the

Joan Driscoll,RN, a charter member of AORN, is supervisor, support services, OR, New York University Hospital and Medical Center, New York City. A graduate of Lenox Hill Hospital School ofNursing,she has a B A fromNew York University.


scope of “nurse power” and to visualize professional and individual growth potential. Nurse power can be exhibited and used in many ways; however, a most effective way is through nursing research. In recent years, nurses in all areas of the profession have been encouraged individually and collectively to participate in research projects since it is a n effective way of sharing knowledge. Roget cites exploration, investigation, inquiry, and search as synonyms for research. A pioneer and authority in the field of nursing research, Lucille Knotter, RN, EdD, has added examination, scrutiny, and study. In her opinion, scientific investigation will ultimately lead to a search for new knowledge. Although all involved nurses perform the simple activities of the research process, most are intimidated because they feel that they do not have the training, time, or resources to do research. This premise is wrong because nurses are constantly involved in research projects arriving at conclusions by trial and error and processes of elimination. Because they are “doing research on the hoof‘ and do not realize they are actively involved, they do not document or formalize their findings. Products are resource material, the hospital, a laboratory, and nurses are researchers.

AORN Journal, February 1976,Vol23, No 2

The phrase, “highly scientific endeavor,” generally associated with research, can act as a deterrent to the inexperienced nurse-researcher. The belief, that to practice research one requires highly specialized training, can also inhibit simple, independent research at the clinical level. Pressures of working and living tend to influence nurses to be spectators rather than participants. Today, however, it is not sufficient to be merely a spectator. Nurses must convince themselves that there are areas of research in which they can participate. The antidote for frustration and resentment is expression; therefore, it is important to learn to express feelings and ideas in a constructive way so they can be communicated to others. The OR nurse who evaluates a product or analyzes practice is in effect applying rules of inquiry and logic. Therefore, in operating room nursing, research is constant and ongoing because some form of testing is required by most premises and hypotheses. Although true scientific research uses rigid rules and requires formalized training, beginning nurse researchers can obtain results by using the following three Rs as guidelines: 0 reading 0 recording 0 relating. It is essential that operating room nurses be continuous researchers since the nature of their work and environment requires exploratory activities. According to Abdullah and Levine, research is in practice when: 1. a procedure or topic has been developed for research 2. new facts are discovered 3. relationships among facts are discovered 4. methods are being described and explored.

Further, “Research ascertains that new ideas or new knowledge can stand scrutiny and tests to rule out bias and change elements.” In OR nursing, a large segment of nurses are dedicated agents of change; therefore, research is constantly in motion. New knowledge and findings are willingly shared with nurse-colleagues, but there is a reluctance to document and publish findings. Research is in effect when trial and error methods are being used and results evolve suddenly and informally. Nurses are involved in research in any nursing unit where a nurse desires to enhance her learning, be inquisitive, and make constructive change. Painful experiences have taught operating room nurses that valid reasons must be presented whenever change is required. It is not sufficient for a nurse to say, Yt’s right because I believe it is.” Scientific reasoning must produce a logical answer. If the powers that be must be convinced before change can be implemented, it is the responsibility of nursing to make inquiry and supply valid reasons. Barbara Minckley, RN, DNSc, a former member of the AORN OR Nursing Research Committee, believes OR nurses who desire to depart from repetitive action and desire change do research. She also believes that for research to be meaningful, nurses must collaborate and share their knowledge in a centralized way. Research can be abstract, statistical, or clinical. The individual nurse must decide which type she is best prepared to do. To practice or participate in research, Knotter believes it is absolutely essential to keep a n open mind, examine current practice, and scrutinize findings to discover implications for improving nursing practice. Change must be viewed in the right perspective. If nursing goals and at-

AORN Journal, February 1976, Vol23, No 2


titudes are equated t o value, change w i l l be easier. T o achieve a high degree o f efficiency, all movement m u s t be in a definite direction. T o search constantly, t o be a researcher, and t o document findings for others t o share i s moving toward a higher goal. In research, one encounters repetition. T h i s i s t i m e consuming and can cause discouragement. There is, however, a positive power in repetition n o matter h o w boring. Repetition teaches discipline andhelps t o discover skills. In t h e operating room, nurses are called upon daily t o h e l p unravel problems and to find a better or easier way of doing things. The barrier t o discovery i s t h e failure t o recognize situations as they r e a l l y are. If one has a r e a l desire t o search and learn, barriers t o discovery can be surmounted. Operating room nurses often feel that l i f e i s a continuous process o f problem solving. Inhumandynamics, it i s important t o find t h e cause o f a problem and t h e n seek a solution. T o research a problem whether it be patient oriented or technical, i s a rewarding learning experience. In addition t o being patient oriented, nurses m u s t be intellectually curious t o t h e p o i n t where t h e y are action oriented. 0 References

Abdullah, Faye G, Levine, Eugene. “The aims of research.” AORN Journal (1965). Knotter, Lucille. ”Research-Nursing.” AORN Journal (November-December 1965) 73-75. Minckley, Barbara. “Nursing research.” AORN Journal (October 1969, April 1971) 86, 50-51. Ramshorn, Mary. “Small ‘r’ in nursing research.” NYSNA Journal 3 (December 1972). Rhea, Ralph. Undy Schooi Publications.


Heart abnormality may explain “crib death” An inherited heart irregularity seen in the electrocardiogram(EKG) may help account for sudden, unexpected infant death, accordingto a report delivered at the November annual scientific sessions of the American Heart Association. The so-called Sudden Infant Death Syndrome (SIDS), or “crib death,” is the largest single cause of death in newborns between one week and one year of age. It kills about 10,000 apparently healthy infants annually in the United States by mechanisms yet unknown. However, a study by a team of scientists from the National Heart and Lung Institute, Bethesda, Md, now suggests that some cases of crib death may be caused by a specific inherited abnormality in the electrical signal that makes the heart beat. The abnormality is defined as a “prolonged Q-T interval.” This refers to an abnormal lengthening of a portion of the squiggly-lined electrical signal as recorded by the electrocardiogram and designated by the letters Q and T. Suspecting a fault in the heart beat as a culprit, the investigators measured the electrocardiogramsof 42 sets of parents who had at least one infant succumbto SIDS. They found 11 of the 42 sets of parents (26%) with “prolonged Q-T intervals” on the EKG, a proportion significantly higher than that observed in the general population. Moreover, in families with a parent demonstrating this prolongation, the same abnormality was observed in 40% of the siblings of infants who died suddenly. In addition, one infant with “near-miss’’ SIDS showed marked Q-T interval prolongation after an episode of cardiac arrest at seven weeks of age. The investigators emphasized, however, that the data is still only suggestive. Definite confirmation of the link between Q-T interval prolongation and SIDS will require large, prospective studies. Coauthorsof the report were Barry J Maron, MD; Chester E Clark, MD; Robert E Goldstein, MD; Russell S Fisher, MD; and Stephen E Epstein, MD.

AORN Journal, February 1976, Vol23, No 2

OR nurses as researchers.

Joan Driscoll, RN OR nurses as researchers The concept of clinical nursing research is not new. I t is as old as the art and spirit of nursing. Sinc...
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