Disinfection of arthroscope criticized In “Arthroscopy to diagnose knee disorders”, (April 1978), it is stated that the arthroscope is soaked in activated glutaraldehyde for 20 min- utes between cases.

The latest information I have on activated glutaraldehyde is that sterilization takes ap- proximately ten hours and disinfection takes place in ten minutes. An instrument is sterile or unsterile, and one soaked for 10, 20, or 60 minutes in activated glutaraldehyde is un- sterile.

The practice of introducing an unsterile ob- ject into a joint is just not acceptable in our present state of awareness and responsibility. Proper care of sophisticated and expensive instruments in commendable, but how about proper care of the patient? An orthopedic sur- geon using an unsterile instrument like that and a surgical nurse giving him one-for shame.

Betty Rogers, RN Salinas, Calif

Editor’s note: For further discussion of the question of sterilization vs disinfection of ar- throscopes, see AORN Journal (December 1977), “The experts research: Q & A,” pp 1125-1 126, and AORN Journal (January 1978), “Surgeons discuss problems in asep- sis,” pp 86-87.

First assisting can be part of nursing role The question whether the OR nurse should function as first assistant to the surgeon in the operating room demands comments. Nurses who say, “This is not nursing,” will surely jeopardize themselves as they did in the past when the physicians were looking for help.

Think back over the past few years and the question of physician’s assistant. We decided that we were nurses, not anyone’s assistant,

least of all a physician’s assistant. We balked at terminology; closed our eyes to the real future, needs, and trends; and plowed on in our own self-righteous way, resisting and denying. Had we stepped in early when the need arose, we could have set our own ground rules. Now we have nurse practitioners who have a great potential to nurses, to adhere to the nursing process, to concern themselves with the pa- tient’s physical and mental well-being. We also have the physician’s assistant, who is less qualified but who, when asked to do the job, acts as a team member. This less-qualified person usually receives more pay although less qualified. Ask your personnel office staff, and they will probably tell you that

1. physician’s assistants and nurse prac- titioners are interchangeable, or

2. actually, physician’s assistants are better qualified and trained for the role- “College background, you know, whereas nurses just have nursing.”

We must not let this happen again in the operating room. I beg you to poke your nose outside the OR doors and look at those hospi- tals and facilities using physician’s assistants and nurse practitioners. Those working closely with the practitioners and physician’s assis- tants will tell you that nine times out of ten the nurse practitioner is by far the more valuable person.

With advances in medicine and technology, we must move forward and experience role changes. Nursing has gone through many phases, from soothing the fevered brow and car- rying out the physician’s orders without ques- tion to using our acquired nursing knowledge to make judgments regarding functions of human anatomy and physiology and making definite decisions and plans for patient care. Is it then so inconceivable that in the near future someone will have to assist the surgeon in the OR as part of a team? Why cannot this be a part of nursing care? Are we going to step aside once again, we who are qualified, and let the less qualified physician’s assistant or tech- nician assume these roles for us?

28 AORN Journal, July 1978, Vol28, No 1