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Nurses: Iowa law needs to change to ensure patient safety

BY JENNIFER DELGADO | APRIL 14, 2009 7:40 AM

A group of Iowa nurses wants to change the wording of a current state standard to ensure patient safety.

The Association of periOperative Registered Nurses asked Iowa legislators to maintain the rule of staffing one operating room nurse to every surgical room.

But the Legislature failed to pass the measure, and some nurses say the current bill can be misinterpreted.

Nationally, more hospitals are allowing operating-room technicians to take on the traditional responsibilities of the circulating room nurses, who are in charge of patient safety and coordinate the flow of information between all individuals in the surgical room.

Most technicians have one year of post-high-school education, while nurses are required to have degrees and specific training, said Jane Krogmeier, the state legislative head for the Association of periOperative Registered Nurses.

“We are the eyes and ears of patients while they are asleep,” she said.

Some operating nurses said they don’t want to see the national trend come to Iowa.

“I think that if that happens, we are regressing,” Krogmeier said. “We feel it’s a nursing job — it’s for the safety of the patient.”

In Iowa, there are roughly 500 operating-room nurses registered with the association. Nationally, there are more than 45,000.

Despite budget cuts, UI Hospitals and Clinics officials said there has been no discussion of changing the rule requiring a circulating room nurse in each surgical room. UIHC employs the equivalent of 93 full-time operating-room nurses, which includes part-time employees.

“I think the university hospital respects and values registered nurses functioning as the circulating nurse,” said Victoria Steelman, an advanced practice nurse supervisor.

Kathleen Parrott, a UIHC nurse manager, said UIHC won’t break the state standard.

“We don’t intend to do that for patient safety reasons,” she said.

Still, state budget cuts and a nurse shortage have some people worried officials may change their mind. Advocates said the wording of the current standard can be misinterpreted.

“Right now, it’s OK, but, if hospitals wanted to, nurses could be in numerous rooms,” said Anne Troyer, a UIHC staff nurse and a periOperative Registered Nurse member. Troyer said an operating-room nurse “could oversee as many as four surgical rooms” at one time.

Advocates said they believed lobbyists had a lot of power and influence in failing to pass the bill.
“Lobbyists for hospitals don’t want to be told how to staff their operating room,” said Linda Goeldner, the executive director for the Iowa Nurses Association.

In the meantime, some association members said, they will continue to educate legislators about the importance of passing the bill. They plan on reintroducing the bill next January.

“We’ll get it passed,” Krogmeier said. “It’s just a matter of time.”


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