Mid Atlantic health congress

Atlantic City, New Jersey was the setting for the Mid Atlantic Health Congress on May 23-25, 1972.

The program was excellent and high- lights of the Congress were presentations by Jack Hahn, Art Linkletter, Eleanor Lambert- sen and Shirley Chisholm.

Jack Hahn, the past President of the American Hospital Association stated in his presentation entitled "Mr. President, Mr. Congressman," that there is a need to de- fine national health care policy. The fed- eral legislation passed in the last decade has more health care legislation than in any other period, but still no policy. In America, health care i s a study in contrast . . . from great transplant centers to the other extreme, in certain geographical areas, where people are sti l l dying of universally conquered diseases. He stressed the need for a separate department in the federal government to handle the health care of the nation. Na action i s expected on this proposal this year.

The subject of "Drug Abuse" was dis- cussed by Mr. Art Linkletter, well known TV personality. Mr. Linkletter's daughter died of an overdose of LSD, several years ago and since then he has become an expert on drugs, addicts, and available measures to help the user. He began by telling some of his famous "kid" stories which were most amusing and well received by the large audience. He then traced the drug pattern

Patricia A. Rogers, RN AORN Board Member

in history from the days of patent medicine to the present time. There are at least four to five thousand "mind bending'' drugs on the market today. The average medicine cabinet holds approximately 27 varieties of medication for the average family. The American people believe that anxiety relief is "just a swallow away".

He related the tragic story of his daugh- ter and ended by saying that no home in America is without the danger of a child becoming a drug addict. He listed nicotine and alcohol as the most widely used "mind cripplers" in this country and then came the barbiturates, followed by heroin.

August 1972 81

The year 1960 began the era of change in this country concerning drugs. . . rock and roll music and the people who popularized it were national heroes to our kids and some of these people were users. He went on to say that the guilt belongs to the medical field, to doctors and to the family. Physicians give too many pills, too easily, too fast . . . reducing pills, sleeping pills, etc. . . . Patients take too much self-medica- tion. Families share the blame - frag- mented living, moving too much, allowing too much freedom for their children, and they are too concerned with the pursuit of money.

He concluded by speaking of the good things that are happening that will help this problem such as: hospitals are accept- ing the drug patient for treatment, families are becoming concerned, the government in passing more legislation on drug control, methadone clinics are established, halfway homes and their like are in operation.

Mr. Linkletter did not agree with all of these measures but stated at least some- thing was being done. He predicted a swing away from the drug scene but stressed our responsibility in this. He felt that the future was hopeful and optimistic.

Dr. Eleanor Lambertsen, Dean, Cornell University, School of Nursing, discussed the "Expanding Role of the RN vs the Physi- cians' Assistant". She began by stating that nursing has a common base universal to everyone. All specialties are born at this broad base. Nursing practice description parallels that of the physician assistant. In the beginning, the basic concept of the role of the physician assistant had its origin in the shortage of physician manpower. This was a new field of health care and in no way was meant as a replacement for established personnel. It was not meant to drain nursing. The use of the physician as- sistant would permit development of new health patterns tary corpsmen.

and open careers for mili-

The classical definition of the physician assistant is, one who i s selected, trained, and reports directly to the physician and i s capable of performing functions, usually done by the physician. The need for clarity revolves around the word fundions (diag- nosing, treating, operating, and prescrib- ing, etc.).

The three types of physician assistant are:

Type A - General Care Physician's As- sistant: independent, but limited by com- plexity of patient's problems. (This is true of many types of health workers.)

Type B - Specialist Assistant: one who i s prepared for a particular circumscribed area of practice. Example: orthopedic as- sistant, he does not have a broad scope of medicine. This person started years ago as "Joe", the orderly in the ER. Now we find him in x-ray, surgery, etc.

Type C - "On the job assistant"; one who i s trained for a specific function.

Nursing is mainly concerned with type A. We claim we function as such indepen- dently and interdependently.

Dr. Lambertsen then cited the recently passed New York State Nursing Practice Act. In essence, she was saying, as she con- cluded, that we must be capable of in- novating practices to be in extended care roles, with collegial relationships, rather than subservient needs. She cited nursing

practice in the coronary care units as an example.

"How the Public Looks at Hospitals and The Health Care Field", presented by the honorable Shirley Chisholm - Congress- woman, NY State. This lady i s a tremen- dous speaker, with powerful impact. She stared that health in this country has be- come a political issue and yet, health care is the basic right of all individuals. No legislative plan offers a solution to our health care needs. Some of that remain unresolved are:

the problems

August 1972 83

1) Most people cannot seek help in a hospital or from a physician until they are actually ill.

2) Screening programs for identifying i l l - ness, especially among the poor, are insufficient.

3) Few young doctors are attracted to rural America or to the inner city.

4) State and Federal programs have had little effect on offering minimal health services to the poor. As long as we permit doctors to run the show, the system of health care will not work.

Interesting to me was the care given by secret service agents in providing security for Congresswoman Chisholm. It seemed unusual within a health congress setting. I found the entire meeting a good learning experience and was indeed proud to be AORN's representative.

-Patricia Rogers, R.N. Member AORN

Board of Direcfors

Survey on ICU published The results of a comprehensive national survey of intensive care nursing conducted by RN Magazine show that the intensive care unit ( I C U ) is probably the most spectacular hospital de- velopment in decades: bu t i t has its problems.

Chief among them is doctor/nurse relationships, wi th such existing situations as misuse of the ICU by doctors, including unnecessary admissions and delay of discharges beyond necessary l imits: the inept physician and the overbearing nurse: vague lines of responsibility. (When asked, "Who 's in charge in the ICU?" frequent answers were, "Most ly it 's the head nurse," or " N o one real ly knows.")

The survey also surfaced problems of conf l ic t ing orders. (Nurses must dea l w i th the professional images of medical students, interns, residents and attendings, not to mention specialists.) Also noted was the " A d o m ond €ve Syndrome," or how the wise nurse handles the doctor in the ancient male/ female batt le. And f ina l l y , the "Kingdom Complex," or how one avoids thinking the ICU i s a world of its own.

RN Magazine published the survey findings on doctor-nurse problems in the ICU in its M a y issue.

R N Magazine's survey, one of the most Comprehensive ICU surveys ever made, queried 2,500 directors of nursing at hospitals of 100 beds or more and produced 1,111 va l id replies. Outstanding among the survey findings are fhaf 95 percent of all responding I C U / C C U ' r do not have a physician present at all times, and only 65 percent even have a doctor "on call" around the clock. It was found that it i s the registered nurse who keeps the ICU in operation and, in many cases, carries out sophisticated l ife-saving procedures routinely wi thout the presence of a doctor.

"There's l i t t l e doubt about i t , the lCU/CCU is the heart of today's hospital and it i s the registered nurse who real ly runs it," says Richard F . Newcomb, f d i t o r of RN Magazine. "Wi thou t the RN, there could be no lCU/CCU, but the nurse needs help; not wi th her pro- fessional duties, which she knows we l l , bu t wi th fhose unsolved problems of authority lines and doctor/nurse relationships. The RN survey shows clearly where the problems l ie; nurses and doctors must now solve the problems, to provide the pat ient w i th the care he has a r ight t o expect."

Fufl results of the RN Magazine survey are being published in a series of f i ve bimonthly articles which began in January and w i l l conclude w i th the September issue. In addi t ion, results are being published in a book designed pr imari ly f o r medical, hospital, and nursing school l ibraries. The book w i l l contain all 34 tables, plus fu l l representative answers on the greatest problems and concerns facing the ICU.

August 1972 85