Team?: By whose standards All my life I have believed one should op- pose ideas with other ideas, not personal attack. But Crile Doxher, MD, (Mt Vernon, Illinois) truly tempts one to deviate from this practice. His characterization of the team approach as a surgeon's panacea i s too unrealistic and inflammatory to elicit objectivity from nurses.

According to his articles "Every surgeon needs his own OR team" (Medical Surgical Review February-March, 1972) and "Con-

tinuity of Care of the Surgical Patient" (OR Tech January, 1972) the perfect OR team

consists of the surgeon, a certified physi- cian's assistant, a certified OR technician and an anesthesiologist. "These four peo- ple and only these four people, direct the management of the surgical patient from the first clinic visit to the hospital admis-

sion, throughout the surgical procedure, post-operative in-hospital course, a n d throughout the out-patient follow-up." His only mention of a nurse, other than to at- tach the title "office nurseN to his certified technician, is to say, "Having my pre-op patients . . . upset by well-meaning nurses was particularly worrisome. . . . For all

their good intentions, they were doing more harm than good."

Is i t possible this surgeon can dismiss so lightly the contribution of professional nursing to the care of patients? Is he seri- ous when he implies that those four people alone can adequately assume the respon- sibility for planning and implementing total patient care? Such omnipotent divin- ity, I suppose, should be viewed with great respect and reverence. Perhaps OR nurses should shake with fear and trembling as Belshazzar did when he saw the hand- writing on the wall, prior to his demise. But I for one do not react in fear. My first re- action, I must admit, was anger and frustra- tion, but then after second thoughts, my reaction was one of concern for patients who are threatened with deprivation of their right to quality professional nursing care.

The author did not acknowledge that nurses had in any way made a contribution to the care of his patients. Who is respon- sible for the safe environment in which this "perfect team" perform their autonomous feats? Are surgeons not aware that nurses devote their time and expertise to teach, train and condition OR technicians so that

June 1972 11

all those responses do seem to come so automatically?

Is he aware that the circulating nurse is an important part of that team, or i s her role 50 obscure to him that it escapes his notice?

This surgeon refers to his gross income totalling more than $300,000.00 annually. He explains that through "considerable negotiation" he arranged to have each hospital pay a fee for the services of his OR Tech. Will he influence others to move in this direction? He pilots his own plane, and describes what seems to be a very at- tractive, efficient and lucrative way of practice.

The article leaves many questions un- answered. In the financial area one won- ders whether the economies of this team practice might not also result in increased costs. For example, would a liability insur- ance carrier raise rates without the protec- tion of registered nurse personnel? In what

position i s the hospital placed when it al- lows unlicensed personnel not employed by the hospital to use its facilities? Are pa- tients in jeopardy of losing hospital insur- ance benefits as a result of such an ar- rangement? Are his patients aware that the person in his office labeled "office nurse'' i s not a nurse?

This is not to deny that there are advan- tages to the team concept. The problem with the Doxher approach is that, in de-

parting from the traditional, it throws out the baby with the bath.

As Dr. Doscher so aptly put it, his a p

proach may not be the ideal model. I agree

and say simply thank goodness the ma- jority of surgeons are still dedicated to quality patient care which includes the pro- fessional nurse as a member of the team.

0 -Betty Thomas, RN

Human rela+ions lab for nurses The seventh annual "Human relations laboratory for nurses and other members of hospital ar health care teams" wi l l be offered by UCLA Extension, June 25-30, at Rieber Residence Hall on the UCLA campus.

Basic and advanced conferences, designed t o help leaders release their fullest potential by practicing administrative and human relation skills, wi l l meet separately but simultaneously and relate at certain points.

Participants wi l l be involved in both general sessions and small group meefings throughouf the program conducted by specialisfs in applied human relations and sociaf sciences, who are widely experienced in the use of laboratory methods for leadership development.

Students wi l l learn through examination of actual experiences of group life. Work w i l l take place mainly in small groups led by a psychologists, psychiatrist or social scientist. In general sessions, speakers wi l l focus on specific concerns and needs expressed.

The week-long residential program i s co-sponsored by the UCLA School of Nursing and University Extension's Division of Continuing Educdion in Al l ied Health and Department of Conferences and Consultation.

The fee i s $295 for either basic or advanced conferences. Two units of professional credit may be earned for each.

Further information i s available by writing the Department of Conferences and Program Consultation, Room 515, University Extension, UCLA, Los Angeles, CA 90024, or telephone (213) 825-4801 or 825-2401.

12 AORN Journal