AORN JOURNAL

AUGUST 1992. VOL 56, NO 2

Letters to the Editor

Responses to Physician Bondirig Editorial

I

just finished reading the “Editorial” in the May 1992 issue of the Journal. Because I have not had the opportunity to read the “red book” that Pat Palmer refers to, I do not wish to just read the “Editorial” titled “‘Physician comment on the majority of her concerns. bonding’-an insult to both physicians and There i? one item, however, that Ms Palmer nurses” in the May AORN . ~ o i t r r i dand I share addresses that I believe needs a response. This your frustration and anger at the ‘physician item is “turnaround time.” bonding‘ philosophy some hospitals espouse. 1 First and foremost, I personally do not view worked for such a hospital in which goals for turnaround time as a method of keeping surincreased physician “customer satisfaction’’ geons or anesthesiologists happy. I view it as a was a major, if not the major, goal for mantool to h e l p p r o m o t e good patient care. agers. I found that my philosophy differed, and Philosophically, I believe in rating this particuI believe I am one who will bend over backlar subject in levels of priority as follows. ward to make the system work for the sur1. Efficient turnaround time helps promote geon-to a point. reasonable start times. This cause-and-effect I found that attempting to meet their needs may help decrease patient and family anxiety only increased competition between area hospilevels or, at the least, may not contribute to eletals and led the physicians to believe they could vating anxiety by delays. Decreasing anxiety wield their power even more strongly. Patients’ levels for patients and their families is very wishes and those of staff members became secmuch a nursing concern. ondary. 2. Efficient turnaround time allows the nurse, 1 chose to move my expertise into industry, anesthesiologist, and surgeon to have the time where I can feel good about my contributions to they may need to obtain further information, patient care and the egos don’t get in the way. such as laboratory studies, or gather additional CAROLNICHOLS, RN, BSN. CNOR equipment. Most important, the patient will not SENIOR CLINICAL CONSULTANT, ENDOSCOPY BAXTER HEALTHCARE CORPORATION feel rushed in the final interview before he or she is taken into the operating room. Again, NILES, ILL this is a nursing concern for quality patient care. Eclitor‘s J F S ~ O X W .1 am sorry that the frustra3. Finally, achieving efficient turnaround tion led you to leave patient care, but I undertime to help accomplish agreed upon start time stand how the “fight” can sometimes be perdoes benefit the surgeon, but ask yourself what ceived as insurmountable. I hope you hold on issues are now being addressed? He or she may to your patient care-centered philosophy in have other surgical patients who need to be seen your current position.

I

AUGUST 1992, VOL 56, NO 2

preoperatively or postoperatively. Keep in mind these may be the same patients you have had or will have in your operating room with fears and concerns that also need to be addressed. We can promote good patient care by helping the physician have adequate time with these future patients; we can only hope that the surgeon will use this time effectively. In regard to office hours, we have all heard how surgeons must start on time because they have office hours. Stop and think that they are primarily seeing patients, and we may be helping their patients by running an efficient operating room. I believe keeping the operating room running on time promotes quality patient care by decreasing patient anxiety and allowing time for the establishment of a patienthealth care team relationship. CHERYL ALLEN,RN STAFF NURSE ROPERHOSPITAL CHARLESTON, SC Editor’s response. I agree with you. Efficient turnaround time is for the benefit of the patient, the surgeon, and the entire surgical team. My objection lies in the concept that “attending nurses” should be hired to take care of physicians, not patients.

A

s a registered nurse certified in both perioperative nursing and in health care quality, I read the “Editorial” published in the May 1992 AORN Journal with concern. Because I did not have the opportunity to read the study around which Ms Palmer centered her article, I can only interpret it through her comments. I agree with her premise that quality patient care is the core of the nursing profession. I disagree with her strong opinion that physician satisfaction is not a part of assuring quality patient care. Continuous quality improvement (CQI) has become a fact of life in health care and in all of American industry. Those who understand its concepts understand that it is not only a way of doing business, it is the only way to do business successfully. It is the reason Japan ran past

AORN JOURNAL

us in the automotive industry, and its principles are now becoming required, not just suggested, for health care organizations. To successfully implement CQI, nurses must give up their traditional adversarial relationship with physicians, and they have to give up the segregation of nursing from the other areas of the health care facility. They have to look at the whole process the patient moves through; for perioperative nurses, this process begins the moment the physician schedules the surgical procedure. One of the basic requirements of implementing CQI, whether in the health care industry or the automotive industry, is customer focus. This requires us to identify both our internal and our external customers. As our minds expand, we will realize that the patient is not our only customer. As perioperative nurses, our customers are admitting clerks, laboratory technicians, administrators, maintenance people, housekeeping people, and yes, even physicians. The list is long, and we should realize that the customer is anyone who needs something from us to do his or her job. We have one thing in common with all of these people-the job of providing the patient with what is needed to move through the perioperative process. Customer focus begins with customer identification and leads to customer partnership. It is customer partnership that leads to a collaborative approach to patient care. In my opinion, as health care moves in this direction, nursing will hold a powerful position on the collaborative team. It is by this means, not by angrily crying out that “my job is as important as yours,” that nursing will finally gain the recognition that has eluded it for so long. As the editor of the AORN Journal, Ms Palmer speaks as a highly regarded authority in her field. I find it an embarrassment to read her anger in an AORN Journal “Editorial” when, for years, I have counseled my staff to feel differently. I have always felt that a part of my commitment to delivering quality care to my patient is providing the surgeon with all of the tools he or she needs to do the job. This includes a well215

Responses to physician bonding editorial.

AORN JOURNAL AUGUST 1992. VOL 56, NO 2 Letters to the Editor Responses to Physician Bondirig Editorial I just finished reading the “Editorial” in...
164KB Sizes 0 Downloads 0 Views