Perioperative nurses stretch the boundaries.

Keynote speaker at the NZNO Perioperative Nurses' College conference in Auckland in August was Australian adjunct associate professor Jane Gordon. She spoke to around 240 delegates about exploring the boundaries around the perioperative nurse.

Currently the executive director clinical services at Sydney's Wentworth Area Health Service, Gordon reflected that contemporary issues of clinical governance, consent, informed consumers, competencies and patient safety all affect how we practise. She challenged us to always be the best we could and stressed that every member of the operating team had a responsibility to ensure that the four "Cs" were followed for every patient--correct patient, correct side, correct procedure and correct equipment. A nursing code of conduct should include putting patients first by putting aside our point of view; treating colleagues with respect in spite of our point of view; working constructively in a team; and informing the patient in a way they can understand. She concluded by saying that if change were too complicated, it would not happen. All nurses needed to take an active rote in change if they were to make a difference. Gordon also spoke tater in the day on her recent experiences in the Middle East, commissioning a hospital in Qatar.

Auckland-based doctor Sven Hansen gave a very practical session entitled "Practical Resilience: The secret of an integral daily practice". He described resilience as a "bucket of resources", with the best way of managing it to build a careful rhythm and ritual into one's life. Everyone, and especially those in demanding and pressured jobs, needed time to attend to their physical, emotional, cognitive and spiritual health, he said. Good lifestyle management included a good exercise programme, regular, healthy meals, and time for relaxation.

American clinical wound specialist Suzy Scott-William spoke on combating the serious problem of operating room-acquired pressure ulcers. The cost of such ulcers to hospitals in the United States was $10 billion annually. These ulcers were linked to morbidity, pain, osteomyelitis, mortality and increased hospital stays. High risk factors included age, length of surgery time (over three hours), nutrition, hydration, vascular disease, low weight, mobility status, and co-morbidities like diabetes. Scott-William strongly recommended using a pressure reduction pad under the patient for all surgical procedures and stressed that the important rote of the perioperative nurse in maintaining skin integrity.

Dot Davidson from Wellington won the Baxter free paper session with a presentation on suturing within operating theatres.

Other events at the three-day conference included a celebration of 30 years of publication of the perioperative nurses' journal The Dissector. Next year's conference will be held in Palmerston North in September.