The Back Door Essay

1785 words - 8 pages

In August of 1984, I entered nursing school. It was kind of through the back door. My mother was the owner of a local day care center and had an affiliation with the school of nursing. This was influential in my acceptance to nursing school through the back door. The nursing students would rotate through the center to see “well” children as part of their education. This enabled them to observe and understand the normal growth and development of a child. After my three years there, I graduated and the world was my oyster.[1] I was offered positions in various specialities at every institution I applied.
I chose to work at a prestigious teaching institution. I wanted to work in an ...view middle of the document...

Today, sixteen years later, I seek the “front door” to my anticipated position as a first assistant at a great hospital where nurses are a vital part of the process. Our Magnet status is a revered way of life not just a banner on the lobby wall.
The old adage “necessity is the mother of invention” holds true.[2] The need for the expanded role of the registered nurse and many people's versions of this expanded role has lead to the need for the standardization of the role of the registered nurse first assistant. I will discuss the evolution of the registered nurse first assistant as the needs of the surgeon, nurse and patient invented this expanding role.
Throughout history, the tragedies of war have lead to the great progress in patient care and outcomes. For example, triage systems were developed during World War II and trauma systems during the Korean and Vietnam wars.[3] This holds true for the evolution of the nursing profession as well. At times of war, as most can only imagine, supplies as well as personnel are limited. Such shortages in surgeons rendered the need for operating room nurses to expand their role at the operative field especially close to the battle fields. During time of peace, in the traditional operating room setting similar circumstances arose. Surgeons found themselves in need of “another set of hands” and found that they were without another available surgeon. Another purpose for surgeon's employing a personal first assistant was to provide continuity of care for himself in the OR and the patient throughout their care. Having an assistant familiar with the entire process of the patient's perioperative course was beneficial to the patient and surgeon alike. Thus, the onset of nurses being trained to assist the surgeon began. The practice of physicians hand selecting nurses to assist them has been occurring as far back as the early 1900's. However there are down sides to this method of attaining an assistant. Not all surgeons who need an assistant are able to comprehensively educate the personnel. Time limitations, lack of ability and or interest in training can render many difficulties. Having only one perspective and the limited scope of one speciality is limiting to the assistant and the scope of their contributions to the surgeon and patient alike.
The thrill of being a substantial contributor in a time with the most severe circumstances such as war is indescribable. To be selected to first assist by your institution or a private surgeon is an honor. Reaching for your goals to grow professionally and demonstrate your abilities is invigorating. Having an established path to achieve your goals is a privilege. In May of 1900, a women named Carwalander Jones spoke at the Third Annual Convention of the Associated Alumnae of Trained Nurses. In this address she said, "When I was a girl, nursing was either considered a gift, like a good voice, or an occupation, like cooking. Every...

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