1. Section Editor(s): Roberts, Dottie MSN, MACI, RN,C, ONC, CNS, Editor

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International Alliance meets in Telford at SOTN conference

At the invitation of Deborah Wheeler, chair of the Royal College of Nursing's Society of Orthopaedic and Trauma Nursing (SOTN), Immediate Past President Sheri Stormer represented NAON at the recent conference entitled Bridge to the Future held in Telford, Shropshire, England. Approximately 250 nurses from the United Kingdom, Canada, Bermuda, Malta, and the US participated in the conference. Ann Bourgeois, president of the Canadian Orthopaedic Nurses Association (CONA), also attended.


Prior to the conference, Ann and Sheri were included in SOTN's first strategic planning session. One goal impacting the International Alliance of Orthopaedic Nurses was the plan to implement the OPTIONS program in the UK. This goal was warmly received by SOTN members when presented during the conference, and there were numerous volunteers to assist with this effort.


Keynote speakers included two Members of Parliament, Peter Bradley and David Wright, as well as Roswyn Hakesley-Brown, president of the Royal College of Nursing. Themes of presentations included utilization of information technology, research priorities, pain assessment and PCAs, computerized documentation, and integrated care pathways-topics familiar to NAON members as well.


SOTN nurses also enjoy their social activities. One evening, a disco offered entertainment. The formal conference dinner was held at the Royal Air Force Museum at Cosford, with cocktails being served in a WW II vintage hanger full of planes from that era.


Ann Bourgeois and Sheri took time to visit the Sir Robert Jones-Dame Agnes Hunt Orthopaedic and District Hospital in nearby Oswestry. Dame Agnes is known for establishing the first orthopaedic hospital for children in the UK and is considered the founder of orthopaedic nursing. One of the honored attendees at the meeting was 90-year-old Mary Powell, a retired orthopaedic nurse who trained under Dame Agnes and then went on to become Matron (Director of Nurses) at the Oswestry hospital for 12 years. Mary is a vibrant woman who kept up very well with her younger colleagues at the conference slowed only slightly by her cane, or stick as she called it.


The networking opportunities at this meeting again confirmed that we orthopaedic nurses have much in common, regardless of where we practice, where we live, the health care system in our country, or the idiosyncrasies in our common language.


Sheri Stormer, RN, BSPA, ONC


NAON Immediate Past President


Parsons earns Trust Research Scholarship to explore orthopaedic care in US

Gail Parsons, Advanced Nurse Practitioner in Orthopaedics from The Dudley Group of Hospitals, West Midlands, England, recently spent 2 weeks in North and South Carolina and Atlanta, Georgia, visiting hospitals to explore models of assessment and preparation of patients who are awaiting elective hip and knee joint replacement surgery.


I began my journey from Gatwick, London, to Columbia via Philadelphia to meet Dottie Roberts-Clinical Nurse Specialist at Palmetto Health Baptist Medical Center, newsletter editor for NAON, and president of ONCB, amongst many other important roles. Dottie was to be my companion and guide for the next 2 weeks. I had met Dottie the previous year when she had visited the Trust and spent some time in the orthopaedic assessment unit.


Dottie had very kindly arranged a very full itinerary centered on my needs, which included a memorable visit to the beach at the weekend! We found ourselves discussing orthopaedic issues whilst sunbathing in the heat of 100 degrees. Who says we should not mix business with pleasure?


Durham, home of the prestigious Duke University Medical Center, and trendy Chapel Hill in North Carolina (the center of the nation's tobacco industry), were to begin my trip. Duke is a center of excellence for joint replacement surgery. Here I was able to meet a physician's assistant who was responsible for preparation of patients for elective joint replacement surgery, liaison throughout the patient's hospital stay, and also for their initial review in the outpatient department. Patients' length of hospital stay was relatively short and the PA provided advice for the patient when required. Here I was shown around the medical center and a wealth of patient information materials was shared. This was a truly memorable day.


In the South there was clearly a tremendous feeling of friendliness from the American people. Patriotism was very prominent, American flags dawning almost every home. As Mark Twain put it in 1882, "In the South, the (civil) war is what AD is elsewhere; they date everything from it". The war is the focus point for countless museums and shrines, and the Confederate flag "Stars and Bars" remains conspicuous everywhere. Hospitals in South Carolina which I was able to visit included Palmetto Baptist Medical Center and Sisters of Charity Providence Hospitals, which had medical/surgical units incorporating orthopaedic surgical patients. Patient education and expectation of goal achievement were of paramount importance here. Patients were very keen to share their experiences to benefit other patients and were also keen for me to ask questions (to hear my English accent, I was told!). As a visitor from England I was treated somewhat like a famous personality here. I had the opportunity to meet consultant surgeons and members of the multidisciplinary team all contributing to the patients' surgical pathway.


Atlanta, the birthplace of Dr. Martin Luther King, Jr., and the venue for the 1996 Olympics, was overflowing with history and a population of 3.5 million. The six-lane traffic-all going in the same direction-was a truly amazing sight to see. Piedmont Hospital prided itself in being a center of excellence for joint reconstruction surgery, utilizing the International Education and Reference Site Program for Orthopaedics and Stryker Howmedica Osteonics products. Here I was able to work with Connie Whittington, senior research nurse in orthopaedics. This visit was a wonderful conclusion to my trip. I was able to meet patients who were awaiting surgery, spend time in the assessment unit center, and explore staff roles such as that of the anesthetic assessment nurse. I collected a wealth of information, documentation, and literature, and formed some very valuable relationships.


My sincere gratitude goes to Dottie Roberts, who provided this excellent itinerary and who has become a dear friend and colleague. We traveled many miles together ensuring that not a minute was wasted! I have returned to England with some very valuable information and a wealth of exciting ideas to share with my orthopaedic colleagues. This has enabled me to review current practices and initiate the change process to improve patient services.


Gail Parsons


Advanced Practice Nurse


The Dudley Group of Hospitals


West Midlands, England


HOD approves associate member category

NAON's 2002-2003 House of Delegates has approved a bylaws revision that establishes an associate member category. The revision pertains to bylaws Article III-Membership, Section 1, Classes of Membership, which now will read:


Article III-Membership, Section 1. Classes of Membership


E. An Associate Member shall be an individual who participates in the practice of orthopaedic care or who supports the purpose of this association. An Associate Member shall have all privileges of the General Member except the privilege to vote, make nominations, hold office, or serve on committees or exercise delegate power.


This action was achieved by response to ballot mailed to 190 NAON delegates on August 26, 2002. On the deadline date of October 1, 2002, 133 ballots were received for a 70% return rate. The breakdown of ballot responses is:


129 Support the bylaws revision


2 Not in support of the bylaws revision


2 Refer to the onsite House of Delegates in Orlando (May 2003)



In keeping with the bylaws Article IX, Section 1.C, the outcome of the voting process indicates the approval of the revision.


The NAON Bylaws and Policy Committee and the NAON Executive Board acknowledge the delegates in exercising their year-long voting power and thank them for their participation.


Barbara Shoemaker MSN, RN


Chair, Bylaws and Policy Committee


ONCB Connection

ONCB plans 15th anniversary celebration

When people ask me what "ONC" stands for, I proudly explain the initials and always add that ONC is the only orthopaedic certification program in nursing. Because we are so proud of our certification, ONCB is looking forward to the Orlando Congress in May to celebrate the 15th anniversary of our program. We always appreciate a reason to recognize and celebrate ONCs, and our 15 year anniversary has provided us with a perfect opportunity. Fueled by many wonderful ideas generated at the ONC luncheon in Las Vegas, ONCB has been working hard to make this a fun and memorable event.


While we may not be literally dancing to the music, we plan to have a great time at Congress and will note this milestone in a number of ways. The highlight of the week will be the ONC recognition luncheon, which promises to be a lively and humorous event. Because laughter is an important part of nursing and any nursing celebration, we have invited Susan McGinnis, BSN,CCRN, actress and critical care nurse, to entertain us with her one-woman show which has been touted as taking the audience "from laughter to tears to laughter again."


Joining in our celebration will be past ONCB presidents and ONCs, from the recently certified to 15-year certificants. We look forward to having all ONCs join us so that they can be recognized for their accomplishment and help us celebrate excellence in orthopaedic nursing. Come and join the celebration as we recognize and honor the past and share with you our vision for a very bright future for orthopaedic nursing certification.


Kathy Rourke, BSN, RN-C, ONC


ONCB Director


Practice Corner

Making patient education documentation easier

With JCAHO wanting more in-depth patient education documentation, our facility developed a Patient Education Interdisciplinary Record pathway that complements our Nursing Assessment pathway in our computer charting.


Our pathway starts with learning needs assessment, which documents communication and comprehension abilities of the patient such as primary language spoken and sensory deficits. Educational needs address the type of education given, such as pre-op, post-op, diabetic, wound care, or diet. We then select the patient education topic from a list that includes diet/nutrition, discharge instructions, medications, pain management, and rehabilitation techniques. Drug/food interaction concerns are addressed, along with who is being taught (patient or family member) and teaching standard being used (e.g., nutrition, surgery: spine, or surgery: TJR). Family participation is documented; for example, was the family interested, not concerned, or not available?


Interventions include class discussion, written/printed instruction, or return demonstration. The outcomes section conveys the response to teaching; for example, did the patient verbalize understanding, return the demonstration correctly, or seem uninterested in the teaching? The record concludes with referrals and rehab reviews with authentication by a licensed therapist.


The documenting nurse may choose from standard general text or free text to address specific needs of the patient. Standard general text is based on the Standards of Care for each discipline that are documented in our library screen. Documentation is required a minimum of every 24 hours, and pre-operative classes may also be documented on this screen. This time-saving screen has made documentation more complete.


Julie Welcheck, RN, ONC




Patient Education Special Interest Group


The NAON Foundation can now be reached at 856-256-2431. Fax (856-589-7463) and email ( remain the same.



Connie Whittington has proven, like NAON's other past leaders, that there is indeed life after serving as association president. Since she finished her term of office at the Nashville Congress in 1994, Connie has logged a number of personal and professional achievements. She returned to school in 1997 to participate in the RN-MSN bridge program, earning her degree from Georgia State University (Atlanta) in 2002. In her role as orthopaedic nurse researcher at Piedmont Hospital (Atlanta), she's been involved in stimulating, practice-changing studies such as a comparison of epidural and IV analgesia following total knee arthroplasty. Connie has developed patient education programs on arthritis, osteoporosis, and fall prevention for use in the Piedmont community. She has a busy speaking schedule, presenting at nursing workshops around the country. She also serves on NAON's Mentoring Task Force to support future association leaders, and was recently appointed to the Editorial Board for Orthopaedic Nursing.


Connie's trip to the NAON presidency-and beyond-actually began with the sure knowledge that she wanted to be a nurse. "When I was a little girl, I wanted to be a nurse," she remembers. "When I was in high school, I still wanted to be a nurse." Her parents, who were at first unsure of this career path for their daughter, quickly came to support her attendance at Piedmont Hospital School of Nursing (Atlanta). As a student nurse, Connie also worked as a nurse aide in the hospital. "I was suctioning a man's trach in room 381," she smiles, "and I met my husband." Ed Whittington was working part-time on the respiratory therapy team as he completed his college education. The two married in 1971, and Ed shortly left the country on a military assignment while Connie finished her last year of training.


After completing her licensure exam, Connie joined her husband in Germany and accepted her first nursing position in the ICU at Landstuhl 2nd Army Hospital. She was the only civilian nurse in the hospital, and she rotated with the military staff through all three shifts. "I learned how to use whatever I had at my disposal when we ran out of things that today we think we can't do without. That's where I learned to think outside the box," Connie remembers.


The Whittingtons returned to the States in 1973, assigned to Shaw AFB (SC). Connie worked briefly in ICU/CCU at Toomey Hospital in nearby Sumter before she and Ed returned to the Atlanta area for good the next year. Connie returned to Piedmont Hospital as an ER nurse. "One day," she says, "they came down and asked me if I wanted to be head nurse in orthopaedics." The hospital was opening a new unit, and Connie's orthopaedic experience in the ER gave her the confidence to accept the new position. "I fell in love with it!" she remembers. "I had a mixed staff from all over the hospital, most of whom had never done orthopaedics before. Literally, we all learned together."


After 2 years, she had the opportunity to transition to office practice and became a first assistant for Dr. John Garrett. As a hand specialist, Dr. Garrett performed some of the first replantation surgery in Atlanta before his practice evolved into sports medicine. Connie's focus became patient education-helping patients to understand their diagnoses and treatments. She also worked with another orthopaedic surgeon for several years before choosing a new path as an independent consultant in surgical education. Although she began working on a BSN at Kennesaw College (Kennesaw, GA), Connie was lured from school by an orthopaedic surgeon who offered her the opportunity to design and oversee building of a freestanding OR for arthroscopic and sports medicine surgery.


With that great project completed by 1992, she was ready to go back to the hospital setting. She returned to Piedmont Hospital after writing a job description for a clinical pathways coordinator. In addition to being hired for that position, Connie served as a resource nurse for orthopaedics. Almost 7 years later, she accepted a new challenge to work with the Department of Orthopaedics in developing a Total Joint Center. Connie now coordinates activities for the center and also assists in research for the department.


When asked about her involvement with NAON, Connie first identifies the role that Clara Donahoo played in her professional development. Clara mentored Connie during her nurse's training. "I always admired her ability to provide the right kind of care and support for patients. She was very intuitive," Connie recalls. "She was always teaching-would ask questions in a way that was never demeaning." Several years later, when Connie returned to the hospital setting, she also joined ONA. When chapter members encouraged her to speak about her orthopaedic nursing experiences, Connie presented a session on arthroscopic procedures at an Atlanta workshop. "I became very encouraged and enthused to share my knowledge with someone else," she says of this start on her speaking career.


Connie was chapter president when the association dissolved. The Atlanta nurses continued to meet, however, and to hold educational offerings. With 1-month-old son Matt in her arms, Connie briefly appeared at the founding meeting for NAON in Atlanta. "I told them I'd do anything they needed me to do for the growth of the organization," she remembers. Connie served on various task forces in the early years of NAON, and chaired the Congress Education Committee for the first Orlando event. "I very much wanted to serve on a national level," Connie says. She earned her prized ONC in 1988 and ran for national office three times, ultimately winning the vice president's seat on the board. Then she was chosen by the members as president-elect in 1992. As immediate past president, Connie represented NAON at the National Federation of Specialty Nursing Organizations (NFSNO). She was elected president of that organization during the busy time of health care reform in Washington, DC, and was honored to lunch at the White House to discuss nursing issues with President Clinton.


Through it all, Connie's anchor has held in her family, her church, and her music. Older son Chris is a middle school music and choral teacher who lives nearby with his wife Tiffany and toddler James. Matt recently completed his degree in graphic design and is back at home briefly while he evaluates career options. Connie sings with several choirs at the First Methodist in Smyrna (GA). She and Ed are in their 16th year as counselors for the youth choir, which travels a week each summer on a mission trip in the US. She also celebrates 11 years as part of a unique women's a cappella group known as the Prune Sisters that sings at special events. "We're much too mature to be raisins!" Connie laughs. "Give me a brown garbage bag, black tights, a white turtleneck, sunglasses, and red tennis shoes...we're the life of the party!"



Figure. Gail Parsons... - Click to enlarge in new windowFigure. Gail Parsons (center) meets with Ronnie Browne (left) and NAON Past President Connie Whittington at Piedmont Hospital (Atlanta).
Figure. CONA Preside... - Click to enlarge in new windowFigure. CONA President Ann Bourgeois (left), RCN SOTN Chair Deborah Wheeler, and NAON Past President Sheri Stormer enjoy a visit to the RAF museum (Cosford, England) during the Telford meeting.
Figure. Connie Whitt... - Click to enlarge in new windowFigure. Connie Whittington