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  1. Cupec, Pamela Ann MS, RN, ONC, CRRN, ACM
  2. President of NAON, 2013-2014

Article Content

As you are paging through your copy of the Orthopaedic Nursing Journal, I truly hope that you are swirling some ice in your glass, holding it carefully to avoid the condensation trickling onto the pages, and relishing these moments to get caught up in your professional reading. Welcome to the July/August issue of the journal, with the nice healthy dose of summer at hand that we wait for all year long.

Pamela Ann Cupec, MS... - Click to enlarge in new windowPamela Ann Cupec, MS, RN, ONC, CRRN, ACM, President of NAON, 2013-2014

With the summer time upon us, and correspondingly, the warmer weather, our movements become a bit more deliberate. The younger kids are still running around at the pool, to summer activities like art classes and day camp, band practice, and sleep overs at friend's houses. There is the coordination of the family vehicles with the family members with summer jobs and the ones home from college. Many of us are also caring for our elderly parents, so making sure that they keep their level of activity up as well as their level of hydration. With the gloriously beautiful days, clear blue skies, and daylight lasting until 9 p.m., we just want to get outside and do as much as possible.


The theme this year is Ever Growing, Ever Strong, Ever Green, and part of that is to be strong, not only as the organization, but personally strong, to serve as role models for our patients, for our families, and in our communities. As orthopaedic nurses, we are on the front lines to promote activity and physical exercise. Our patients have some type of impairment in function and our focus is in the restoration of mobility to their prior level of independence. We teach activity and exercise to our arthritic patients, our patients with metabolic bone disorders, those with their new joints, and those after their fractures. Exercise is crucial in staving off the advancement of osteoporosis, aids in the maintenance of joint movement in osteoarthritis, and general preservation of mobility and function.


For our patients, we make sure that they attend physical and occupational therapy sessions and provide educational materials and resources. There are packaged programs such as Fit to a T, developed by the US Bone and Joint Initiative, to bring the message of exercise and bone health in the prevention and decrease of osteoporosis. For our younger patients, there are educational programs geared to early emphasis on activity, bone health, and prevention of injuries, such as the PB&J Program (Protect your Bones and Joints, also from the US Bone and Joint Initiative).


As orthopaedic nurses, we understand that arthritis is one of the greatest causes of chronic pain and disability in the United States. The cost of care, lost wages, and disability was determined to be more than 128 billion in 2003 alone; that number has substantially increased in the past decade. (Movement is Life Summit report, 2010.) By the year 2030, it is estimated that the number of Americans affected by arthritis alone will rise from 46 million to 67 million. The onset of arthritis is accelerated by obesity; in a 20-year span, 70% of obese adults with mild osteoarthritis will develop into a severe advanced end-stage disease, compared to just 43% of nonobese adults (Movement is Life Summit report, 2010). It is part of our role as orthopaedic nurses to work to decrease this disparity and to encourage mobility and prevention of the disabling effects of arthritis and obesity form the lack of activity.


What about ourselves, the caregivers? Not only are we giving care during our work day, but caught up in the care of other generations, of our children and of our parents that we may neglect to heed our own advice. We are great at teaching our patients, our friends in the community, but may short change ourselves. At sporting events in the neighborhood, we may be the ones at the medical tent, providing assistance with the strains, sprains, and dislocations, but we should be the ones out on the field as well.


We have redesigned our workflow and tend to spend more time behind a computer terminal, whether it is in charting, passing medications, or printing out discharge instructions and educational materials. Physical therapists tend to do the bulk of ambulation with our patients, and hospital units are better designed for ease of access to supplies, equipment, and medications. Most orthopaedic units have incorporated the physical therapy gyms either on the unit or at the end of a hallway, to encourage patients to be more mobile by either propelling themselves via wheelchair or using their walker with our assistance. It is much better than transferring into a wheelchair, to begin the series of sitting and waiting; for transport, for completion of exercises, for transport back.


Redesign of the work place also helps conserve our daily steps. Instead of wasting steps by trying to locate that bedside commode or a wide based walker, it is right in the patient room or in a centrally based supply room. Much of the data we need to do our daily tasks and delivery of care is found in our portable computers, or attached to our med carts, so we can have everything right at our fingertips.


As we earn higher degrees and advance in our careers, more time is spent during the work day at a desk, in front of a computer, or sitting in meetings. Getting home late from work leaves little time for exercise, with getting dinner together, children to after-school activities, checking in on our elderly parents or neighbors, and spending a little down time with our spouses or significant others.


Perhaps it is ever more important to break out of the cycle and do more for ourselves and start to pay attention to our needs, such as increasing physical activity and exercise. There are a growing number of people who are considered obese. The nation has grown in size, literally, and has become far more sedentary than even a generation earlier. As orthopaedic nurses, we are well versed as to the effects of obesity and the increase of osteoarthritis, and the greater prevalence of joints that need to be replaced. We are aware of the longer recovery periods for our heavier patients, the more complications with wound healing and decreased mobility. This patient population presents to our facilities with greater medical comorbidities, such as diabetes, decreased renal function, and respiratory issues. In a few years, we are the nurses who will become the patients who require orthopaedic procedures to restore our mobility and functional independence. It is our duty as orthopaedic nurses not to become the statistic that we are teaching to prevent. As we age and remain in the workforce longer, we must be sure to preserve our own musculoskeletal health. A survey released in 2010 by the Federal Division of Nursing discovered that the average age of nurses was 46 years, up from 45.2 years of age in 2000. The time is now not only to encourage, motivate, and teach activity and mobility to our patients, our families, and our loved ones, but to show by example and incorporate more movement in our own lives.


So, dear reader, in the great summer days ahead, save your reading and desk work for when it is dark out, and take care of yourself first. Roll up your sleeves, grab your tennis shoes, head for the open road, the tennis courts, the swimming pools, down to the baseball field, and simply, get moving. Oh yes, finish that frosty cold beverage since it will be all the more refreshing after a lovely workout.


Becoming stronger and more active people, not only as orthopaedic nurses but for ourselves, for our patients, for our families, and for the communities that we serve is the key message we wish to convey.


Ever Growing. Every Strong. Ever Green.