JULY 1984, VOL 40, NO 1 AORN JOURNAL

Legklat ion AORN member sees other side

on state board of nursing

0 Where do you start if you want to become politically active?

With a conviction. That’s where AORN member Tricia Hunter started several years ago. She was alarmed about a bill in her home state of California that would have eliminated the RN majority on the board of nursing and created a “career ladder” outside the traditional academic system. The bill was popularly known by its numberCB 666. Hunter joined the thousands of other RNs who mobilized to defeat it.

Today Hunter is a member of that board. She is one of the five RNs who makes decisions about the licensing, education, and discipline of nurses in her state.

How did she win appointment by the gover- nor? By using the tested formula for political success-working hard and gradually building support. After the defeat of SB 666, Hunter continued to monitor activities of the Board of Registered Nursing. Having served as president of AORN of San Diego County, she became active in the California Nurses’ Association (CNA) and later served on its legislative com- mission.

At the same time, she got to know her local legislators and worked on political campaigns. She joined Republican Associates, a group of young professionals.

Then in 1982, a new Republican governor, George Deukmejian, was elected. Many of the nursing board’s controversial policies had been developed by members appointed by the previ- ous governor, Democrat J e w Brown. Soon Governor Deukmejian had the opportunity to

appoint two new board members. Hunter was ready. CNA asked her if she was

interested, helped her apply, and endorsed her candidacy. She received support from every Re- publican legisator in the San Diego area and from other Republican leaders. The appointment was a reward for groundwork she had laid.

With the honor came a great deal of work. She conservatively estimates that her board respon- sibilities take about 30 hours a month, plus time to digest the 8-inch-thick packet she receives before each monthly meeting.

“I was already familiar with the major is- sues,’, she said, “so the transition was relatively easy for me.

“I’m glad I knew about the issues beforehand because you see a different perspective on the board. It pays to be able to see both sides.”

The burden is eased by a supportive employer. Hunter has flexible hours as nursing education coordinator for the operating moms at Stanford University Medical Center.

What were the surprises of being a board member?

The number of discipline cases was one, with many involving drugs. The board must decide when to revoke or suspend licenses and handles at least 20 cases a month.

“Some nurses bare their souls at the hearings, and you can sympathize because they are making serious attempts to correct the problem. But in other cases, such as when a patient has been harmed, you can’t feel sympathy.”

The hardest issue has been a policy for RNs on prescribing and dispensing medications. The

AORN JOURNAL JULY 1984, VOL 40, NO I

board’s position is at odds with that of the attor- ney general, and it must decide how to resolve the issue.

She believes the work is worthwhile. “You have to get involved or take what you

get,” she said. “That almost happened with Governor Brown.” And, she added, “Nurses had better wake up to the fact that legislation and regulation will control our practice.”

0 The Environmental Protection Agency (EPA), after proposing a ban on the use of ethylene oxide (EO) six years ago, announced new precautions for its use on April 18. The agency will also continue its study of the chemi- cal and issue a final position statement later.

Hospitals will have to install equipment de- signed to cut down on worker exposure. That equipment includes gas-line hand valves, “cap- ture boxes” over floor drains used in sterilizer drainage, aerators, and upgraded ventilation sys- tems. Requirements will be stated on new EO product labels. Most changes will take effect in about four months, but a few will not be effective until 1986.

Evidence of EO’s harmful effects has mounted in the last several years. Studies have shown a cancer risk in both animals and humans, and the chemical has also been shown to cause genetic mutations. There is evidence of adverse reproductive effects, such as decreased fertility and spontaneous abortion, but it is less clear.

Last year another federal agency, the Occupa- tional Safety and Health Administration, pro- posed limiting EO exposure to one part per mil- lian (ppm) averaged over and eight-hour period. The current standard is 50 ppm over an eight- hour period, which experts agree is too high. EPA supports the proposal, and AORN has en- dorsed it.

The problem is that there is no good substitute for EO as a sterilant despite its hazards. AORN and other groups have pointed out that patient care could suffer if EO were not available to sterilize certain items.

Another problem is that exposure to EO varies greatly from hospital to hospital, making it dif- ficult to write a standard rule. Some hospitals

have a number of EO sterilizers, while others have only one. And the number of daily cycles varies. Exposure also varies according to how and where the equipment is installed and how it is operated.

One thing seems sure-you can expect to see stricter rules on EO use.

0 Nursing organizations testifled in April be- fore the US House subcommittee that is consid- ering renewal of the Nurse Training Act and other health manpower legislation. On hand were the American Nurses’ Association, Na- tional League for Nursing, and American Asso- ciation of Colleges of Nursing (known as the Tri-Council for Nursing) as well as the American College of Nurse-Midwives .

Mitzi Duxbury, RN, dean of the University of Illinois School of Nursing, spoke for the Tri- Council. Citing a shortage of nurses in leader- ship positions, she proposed a 1985 funding level of $22 million for advanced nurse training. She also recommended

0 $20 million for nurse practitioner programs 0 $15 million for special projects (including

funds for nurses reentering practice, educa- tion of paraprofessionals, student recruit- ment, and continuing education)

0 $15 million for student financial assistance and professional traineeships

0 $1 1 million for demonstration projects to promote collaboration between educators and practicing nurses $5 million for nursing fellowships.

Subcommittee Chairman Henry A Waxman (D-Calif) said he expected the reauthorization to go smoothly.

PATRICIA PATTERSON LEGISLATIVE COLUMNIST