There has always been close collaboration between orthopaedic surgeons and orthopaedic nurses in the daily management of patients. In emergency units, outpatient clinics, orthopaedic wards and the OR, orthopaedic surgeons and nurses have worked together and focused on developing quality teamwork that safely supports patients throughout their stays.
During the past decade, most health care institutions have been asked to improve their production, reduce the number of beds, reduce length of stay in the hospitals and change treatments from those that require an in-hospital stay to ambulatory, same-day surgery. We have been asked to institute much of this change with a reduced number of employees, particularly a much smaller nursing staff. This evolution in the delivery of orthopaedic care also has been implemented in my clinic.
However, during that same time, my hospital and several other institutions also reorganized and realized its teamwork, which involves nurses, physiotherapists and secretaries, was essential to attaining a greater level in collaboration. With this reorganization, aside from the surgery itself, which remains the responsibility of and is still performed by the orthopaedic surgeon, everything related to the patient is now openly discussed by the team. It is also decided by the team which team member, most logically, should perform each of the needed actions at any given point in time.
Effect of nurse involvement
This new process has affected several actions at our institution, and everyone has welcomed it. Patients now score their satisfaction with treatment higher than before, and nurses at my hospital acknowledge they now have a greater responsibility in the overall management of patients. In addition, the physiotherapists have more involvement in the overall treatment of patients on a per-case basis, and the secretaries on the team have moved from being employees who do clerical work to team members who are more service-oriented.
Following the implementation of those changes, our orthopaedic nurses have started to handle some activities the orthopaedic surgeons used to handle. For example, our nurses now handle most pain treatment programs. Although this work does not involve the surgeon, it is certainly carried out as part of the surgeon’s area of responsibility. Also, discharge from our clinic is no longer a decision made solely by the surgeon. The team decides on the discharge criteria, and the nurses and physiotherapists ultimately determine whether a patient is ready to leave.
EFORT offers Nurse Day
From the nurses’ activities to their basic, as well as treatment-specific, orthopaedic knowledge that relates directly to patient care, such changes were needed in our hospital’s orthopaedic department. The European Federation of National Associations of Orthopaedics and Traumatology (EFORT) has realized a similar need exists elsewhere and thereby created its Nurse Day that will take place on 1 June during the EFORT Congress in Geneva. During the educational sessions, orthopaedic nurses will meet and share their experiences and knowledge. They also will be able to participate in the other sessions scheduled during the 3-day EFORT Congress.
Recently, EFORT has placed a greater emphasis on the education of orthopaedic nurses. Nurse Day has grown in scope since it was initiated in 2011 at the EFORT Congress in Copenhagen, Denmark. To further support orthopaedic nurses, a scientific nurse committee was established within the Congress organization under the leadership of nurse and associate professor Ami Hommel, RN, CNS, of Lund, Sweden.
We look forward to a greater number of orthopaedic nurses taking part in Nurse Day at the EFORT Congress this year and at future EFORT Congresses.
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- Per Kjaersgaard-Andersen, MD, is Chief Medical Editor of Orthopaedics Today Europe. He can be reached at Orthopaedics Today Europe, 6900 Grove Rd., Thorofare, NJ 08086, USA; email: email@example.com.
Disclosure: Kjaersgaard-Andersen reports no relevant financial disclosures.