AORN education
Is self-sufficiency a cause of OR nurses’ isolation? OR Supervisor: Doris, I want to talk with you about some hospital committee appointments. The director is particularly concerned about completing the appointments for the hospital audit committee, the disaster planningcommittee, and the ad hoc committee to study implementationof primary nursing. Your name came to mind as one of the nurses who may be willing to serve. Are you interested? Staff Nurse Doris: You’re asking me? I don’t know anything about those committees or even who is on the committees. Can’t you ask someone else? I’m really not the type-I wouldn’t have anything to offer. An opportunity for nursing involvement outside the OR is presented and rejected. Is Nurse Doris disinterested or is it something else? hservice Educator: There’s an inservice this afternoon on the insulin-dependentdiabetic. Since you’re not assigned to a case, would you like to go? Staff Nurse Nellie: Diabetes? I’m not interested in that. Besides, I’ve got a big vascular case to pull for tomorrow. You know how upset Dr Vessel is if all his instruments aren’t there. How prevalent is this type of “isolation” in your work situation? A cursory search of the literaturefails to document the topic of isolation of OR nurses. However, it is a term not unfamiliar to many of us. OR nurses have been accused of hiding behind double doors and be-
@
hind masks, but personalobservations assure me that the trend is slowly reversing. The practice is still prevalent enough, however, to generate some concern. Priorto returningto school, iwas possessive of my specialty and believed no other area of nursing could be as important or require such a high level of cognitive ability. However, I found nurses in my post-RN baccalaureate program who were dedicated and intelligent and who were doing important things in their areas of nursing. I became aware of problems in their chosen areas and could relate to their anxieties and frustrations. I finally realized that OR nursing shares many commonalities with other areas of nursing, not the least is the care provided for the well-being of others. I think many of us are so involved with OR nursing that we have lost touch with the totality of the nursing profession. The underlying reasons for noninvolvement may be many. In a study of personalitytraits of nurses who choose a specialty area of nursing rather than general nursing, Saari found OR nurses showed higher tendencies toward (1) interest in factually oriented activities and (2) rejection of aesthetic tasks.’ The fact that OR nurses are reality oriented may explain their interest in factually oriented activities. Their preference to know “only the facts” lends itself to increased efficiency without a sensory overload of emotionality. Rejection of aesthetic tasks-those tasks evolving from emotion and feelings-can be interpreted as a refusal to let the affective domain interfere with the psychomotor skills needed to accomplish the job. The affective domain is the environment that emerges as a result of the feelings present. Can we stop to consider a patient’s fear of death as he arrives in our
AORN Journal, December 1977, Vol26, No 6
1019
surgical suite with a ruptured aortic aneurysm? We need to deal only with facts in many situations, and perhaps this type of reality orientation extends to other situations. For example, dealing with feelings is a great part of the practice of preoperative interviews and may be a basis for some of the personal anxieties leading to resistance to that practice. A study by Davis revealed the tendency of OR nurses to be highly self-sufficient and less oriented to group identification.2This may be one major factor contributing to noninvolvement of OR nurses-the self-sufficiency trait may lend itself to isolation and be compounded by the negative inclination to group identification. Davis also found that creative individuals, including nurses, tend to be resourcefuland to prefer their own decisions to those of others. Mauksch studied the personalities of professional nurses in general and found the profile of all nurses to include submissiveness, high need for blame avoidance, and a high need for succorance rather than n~rturance.~ Succorance can be viewed as the personal need for external recognition. We all enjoy positive reinforcement and at times actively seek it. Recognition is more valued when received from an authority figure (generally physicians) as opposed to approbation from peers. This value as appliedto nursing must be reversed if we are to progress as a profession. Our self-image needs a transfusion, and what better time than now-the Year of the Nurse and AORN's 25th anniversary. We can all recognize our need for organization and almost a compulsivenessfor routines in the work situation. Whether this is a characteristic of nurses who choose our specialty or an acquired trait subsequent to practice in the OR appears to be an area wide open for investigation. What does this really mean to us? Many operating room nurses become frustrated with nonproductive committees and state they "could accomplish the tasks themselves in one-half the time." Therefore, the unwillingness to be committee members or be involved in group activities surfaces. OR nurses find it hard to accept group or committee decisions. The opening examples may not demonstrate disinterest; instead, they may demonstrate self-sufficiency. Doris and Nellie may be exhibiting security in the base knowledge and
1020
expertise in their specialty and the inability to accept the challenge of group identification, that is, identificationwith other nurses and the nursing profession. Operating room nurses have numerous areas of expertise that could and should be shared. How can we go about dispelling the description of isolation in our specialty? We can beccme involved in hospital or community committees such as CPR training programs, hospital audit committees, hospital research committees,and infection control committees. We can become active in state nurses associations and the American Nurses' Association, or we can participate in local high school career days, Red Cross first aid classes, medifairs, blood pressure screening projects, and community disaster-planning committees. I strongly believe in the need for specialists in nursing, such as geriatric nurse practitioner, oncology nurse, and operating room nurse. I do not believe we should practice our specialty to the exclusion of nursing itself. If we can understand and appreciate the contribution of operating room nursing to nursing, the term isolation may become a thing of the past, and nursing educators may be compelled to acknowledge that an operating room nurse is indeed a nurse committed to nursing and not solely to operating room nursing.
Janet Sabbe, RN A 0 RN credentialing coordinator Notes 1. Retta Saari, "The nurses' choice of specialization in the light of some personality traits," The Yearbook of Nursing I X (Helsinki, Finland: The Foundation of Nursing Education, 1972). 2. Dorris Horton Davis, "Personality traits of registered nurses and relationship to creativity," 1974. 3. lngeborg G Mauksch, "Paradox of risk takers," AORN Journal 25 (June 1977) 1289. Suggested reading Muhlenkamp,A F, Parsons, Jean L."Characteristics of nurses: An overview of recent research published in a nursing research periodical."dourna/of Vocational Behavior 2 (July 1972).
AORN Journal, December 1977, Vol26, No 6
Is self-sufficiency a cause of OR nurses’ isolation? OR Supervisor: Doris, I want to talk with you about some hospital committee appointments. The director is particularly concerned about completing the appointments for the hospital audit committee, the disaster planningcommittee, and the ad hoc committee to study implementationof primary nursing. Your name came to mind as one of the nurses who may be willing to serve. Are you interested? Staff Nurse Doris: You’re asking me? I don’t know anything about those committees or even who is on the committees. Can’t you ask someone else? I’m really not the type-I wouldn’t have anything to offer. An opportunity for nursing involvement outside the OR is presented and rejected. Is Nurse Doris disinterested or is it something else? hservice Educator: There’s an inservice this afternoon on the insulin-dependentdiabetic. Since you’re not assigned to a case, would you like to go? Staff Nurse Nellie: Diabetes? I’m not interested in that. Besides, I’ve got a big vascular case to pull for tomorrow. You know how upset Dr Vessel is if all his instruments aren’t there. How prevalent is this type of “isolation” in your work situation? A cursory search of the literaturefails to document the topic of isolation of OR nurses. However, it is a term not unfamiliar to many of us. OR nurses have been accused of hiding behind double doors and be-
@
hind masks, but personalobservations assure me that the trend is slowly reversing. The practice is still prevalent enough, however, to generate some concern. Priorto returningto school, iwas possessive of my specialty and believed no other area of nursing could be as important or require such a high level of cognitive ability. However, I found nurses in my post-RN baccalaureate program who were dedicated and intelligent and who were doing important things in their areas of nursing. I became aware of problems in their chosen areas and could relate to their anxieties and frustrations. I finally realized that OR nursing shares many commonalities with other areas of nursing, not the least is the care provided for the well-being of others. I think many of us are so involved with OR nursing that we have lost touch with the totality of the nursing profession. The underlying reasons for noninvolvement may be many. In a study of personalitytraits of nurses who choose a specialty area of nursing rather than general nursing, Saari found OR nurses showed higher tendencies toward (1) interest in factually oriented activities and (2) rejection of aesthetic tasks.’ The fact that OR nurses are reality oriented may explain their interest in factually oriented activities. Their preference to know “only the facts” lends itself to increased efficiency without a sensory overload of emotionality. Rejection of aesthetic tasks-those tasks evolving from emotion and feelings-can be interpreted as a refusal to let the affective domain interfere with the psychomotor skills needed to accomplish the job. The affective domain is the environment that emerges as a result of the feelings present. Can we stop to consider a patient’s fear of death as he arrives in our
AORN Journal, December 1977, Vol26, No 6
1019
surgical suite with a ruptured aortic aneurysm? We need to deal only with facts in many situations, and perhaps this type of reality orientation extends to other situations. For example, dealing with feelings is a great part of the practice of preoperative interviews and may be a basis for some of the personal anxieties leading to resistance to that practice. A study by Davis revealed the tendency of OR nurses to be highly self-sufficient and less oriented to group identification.2This may be one major factor contributing to noninvolvement of OR nurses-the self-sufficiency trait may lend itself to isolation and be compounded by the negative inclination to group identification. Davis also found that creative individuals, including nurses, tend to be resourcefuland to prefer their own decisions to those of others. Mauksch studied the personalities of professional nurses in general and found the profile of all nurses to include submissiveness, high need for blame avoidance, and a high need for succorance rather than n~rturance.~ Succorance can be viewed as the personal need for external recognition. We all enjoy positive reinforcement and at times actively seek it. Recognition is more valued when received from an authority figure (generally physicians) as opposed to approbation from peers. This value as appliedto nursing must be reversed if we are to progress as a profession. Our self-image needs a transfusion, and what better time than now-the Year of the Nurse and AORN's 25th anniversary. We can all recognize our need for organization and almost a compulsivenessfor routines in the work situation. Whether this is a characteristic of nurses who choose our specialty or an acquired trait subsequent to practice in the OR appears to be an area wide open for investigation. What does this really mean to us? Many operating room nurses become frustrated with nonproductive committees and state they "could accomplish the tasks themselves in one-half the time." Therefore, the unwillingness to be committee members or be involved in group activities surfaces. OR nurses find it hard to accept group or committee decisions. The opening examples may not demonstrate disinterest; instead, they may demonstrate self-sufficiency. Doris and Nellie may be exhibiting security in the base knowledge and
1020
expertise in their specialty and the inability to accept the challenge of group identification, that is, identificationwith other nurses and the nursing profession. Operating room nurses have numerous areas of expertise that could and should be shared. How can we go about dispelling the description of isolation in our specialty? We can beccme involved in hospital or community committees such as CPR training programs, hospital audit committees, hospital research committees,and infection control committees. We can become active in state nurses associations and the American Nurses' Association, or we can participate in local high school career days, Red Cross first aid classes, medifairs, blood pressure screening projects, and community disaster-planning committees. I strongly believe in the need for specialists in nursing, such as geriatric nurse practitioner, oncology nurse, and operating room nurse. I do not believe we should practice our specialty to the exclusion of nursing itself. If we can understand and appreciate the contribution of operating room nursing to nursing, the term isolation may become a thing of the past, and nursing educators may be compelled to acknowledge that an operating room nurse is indeed a nurse committed to nursing and not solely to operating room nursing.
Janet Sabbe, RN A 0 RN credentialing coordinator Notes 1. Retta Saari, "The nurses' choice of specialization in the light of some personality traits," The Yearbook of Nursing I X (Helsinki, Finland: The Foundation of Nursing Education, 1972). 2. Dorris Horton Davis, "Personality traits of registered nurses and relationship to creativity," 1974. 3. lngeborg G Mauksch, "Paradox of risk takers," AORN Journal 25 (June 1977) 1289. Suggested reading Muhlenkamp,A F, Parsons, Jean L."Characteristics of nurses: An overview of recent research published in a nursing research periodical."dourna/of Vocational Behavior 2 (July 1972).
AORN Journal, December 1977, Vol26, No 6
