The week began for me with 2 days of meetings, as Country Representative for the International Federation of Nurse Anesthetists in the United Kingdom. The Practice and Education committees also meet in the days prior to the congress, where they were working on the accreditation programmes, surveying practices from all the member countries and revising the education and practice standards to name but a few of their tasks.
The CNR (Council of National Representatives) is a really good meeting as you learn so much of what is going on in the world of anaesthetics from around the world. There are now 38 member countries, the latest to be Indonesia, Ethiopia and Afghanistan.
If you have read the Chair's letter, you will know that British Anaesthetic and Recovery Nurses Association put in a bid to host the 2016 World Congress of Nurse Anaesthetists (WCNA). This entailed almost 2 years of work, site visits, number crunching and research to determine the most beneficial site to hold the congress. We decided on Glasgow as the destination, knowing that we were up against Norway as our competitor. During day 1 of the meeting, the chair of the CPC (Conference Planning Committee) of the IFNA gave his presentation on his findings of the two sites, Bergen in Norway and Glasgow in Scotland.
I was then allowed, along with Norway, to present Glasgow and BARNA's commitment to host the congress together with the benefits to our members, the IFNA and world of anaesthetic nursing. I then had 24 hours to talk to the other country representatives and concrete our intentions in their minds for the vote the following day.
Day 2, the vote took place. Adrenaline, hope and fear all rolled into one rendered me positively tachycardic!
Imagine how absolutely delighted I was when the vote was 11–17 in our favour! Now the hard work begins!
The 2014 congress is in Tunisia then it will be Glasgow in 2016. This is a great opportunity for BARNA and our members. This is a very prestigious event and has never been held in the United Kingdom before. BARNA is committed to making this a very successful congress and we dearly hope that you will travel this journey with us and share in the benefits, knowledge and warmth from around the world, which I know it will bring. I feel that hosting this congress is a lasting legacy to the recognition of anaesthetic nursing in the United Kingdom.
Now to the congress itself:
The flag ceremony is always exciting, stimulating feelings of patriotism, pride and honour, carrying the Union flag to its resting place on the stage. It is quite a spectacle to see all the flags from the member countries adorning the stage headed by that of the IFNA.
Music holds a very important part of life in Slovenia and the Ljubljana Mandolin Orchestra did not disappoint. We were subject to a delightful performance with an equally delightful conductor who played his clarinet, in many parts, ending up with no more than a whistle!
Of course, my mind was now on the Opening Ceremonies in Glasgow and how many pipers would be appropriate!
The keynote speech, given by Dr Polona Selic, PhD, was very interesting and thought provoking. She spoke about ‘Anaesthetic Nurses: Stepping towards a New Professional Development’. Dr Selic has a very interesting background, as Forensic Psychologist, Counsellor to the Human Rights Ombudsman of the Republic of Slovenia, and lecturer and researcher at the Department of Family Medicine to name just some of her achievements.
She spoke about the requirements of anaesthetic nurses and the restructuring of the areas of responsibility between healthcare professionals, due to the reorganisation of healthcare services in many countries. Therefore the issues of professional conflict between nurse anaesthetists and anaesthesiologists, nurse's aspirations, self-assessment and the possibilities in turnover of nurses were raised.
She talked about the fact that many countries are anticipating a shortfall in the supply of anaesthesiologists and how they are to examine working models from other countries that work with fewer physicians and more nurse anaesthetists. It is the turn of the anaesthetic nursing profession to be well prepared and competent.
Part of the take home message from this presentation was, that aside from its higher purpose of making a difference to the health of society, there is a need to join forces in our nursing profession and to focus on the development of professional competencies through a well-established educational system.
More research is needed on role construction and professional development, and the outcomes should make healthcare organisations and decision makers change their perceptions, and value nurses also as clinical leaders in care teams.
In the words of Benjamin Franklin, ‘We must, indeed, all hang together or assuredly we shall all hang separately’.
There was a varied and interesting programme, which was very well put together in categories. The multiple trauma patient incorporated resuscitation, preparation and experiences from a nurses and ambulance crew's perspective.
Flow monitoring, management and organisation, education and practice, simulation training, evidence-based practice in anaesthetic nursing, new techniques and drugs, ethics surrounding organ donation, the elderly patient and pain management, prevention of intra-operative hypothermia were just some of the topics covered.
I was fortunate enough to moderate the paediatric session and was able to introduce Alison Twycross who presented on ‘Managing Peri- and Post-Operative Pain in Children’. Alison also spoke at the ICPAN (International Conference for Perianaesthesia Nurses) in Toronto last year, and she has also spoken at our own BARNA Conference. It was a pleasure to have been able to introduce her to the WCNA and to hear her speak again on this very popular subject. It struck me that so many of us are still afraid to give what we consider as adequate pain relief to children for fear of overdosing them or causing some kind of adverse event. The recovery room is the perfect environment to be able to manage their pain in a secure and safe place. We must believe in what we do and have the confidence and conviction to carry it through.
The hands on workshops are always very popular, which included spinal and epidural insertion, difficult airway and ultrasound. I had the opportunity to perform a crycothyroidotomy on a pig's trachea (without the rest of the pig I hasten to add). Poor piggy I know, but it was a very beneficial and unique experience.
Cadaver airway workshops had also been arranged, which I believe was for the first time at this congress and must also have been a very unique experience for those who participated.
At the close of the congress, along with the formal ceremonies, we heard an account of ‘The Great East Japan Earthquake’ from Mai Taki, from St. Mary's College of Nursing, Fukuoka, Japan. Mai had been involved in some of the rescue missions directly following the earthquake. The photographic evidence was so powerful it took your breath away. There were some pictures the staff had taken from the roof of their hospital, watching the tsunami as it approached. It was incredible they survived, but alas, many of the patients and other staff did not. It is impossible to even try to understand the horror that must have been going through their minds.
There are 31 countries around the world with nuclear power plants, and Japan has a staggering 54 of them in 18 different locations. It is no wonder that a disaster of this magnitude happened as the result of an earthquake. As Mai said, nuclear plant accidents must be prevented, but if they occur, rapid response by governments based on each country's guidelines is necessary. It is also vital that healthcare workers must have knowledge of radiation as it is highly likely they will be exposed and health must be maintained at all cost.
Mai's talk was followed by the final closing talk. Lučka Kajfež Bogataj, Nobel Prize winner, from the biotechnical faculty, University of Ljubljana. She spoke about the ‘Planet Which Doesn't Grow: Impediment for Expansion, Challenge for the Development’.
This was a fascinating yet frightening presentation. It made you realise that as human beings we do not treat our planet with the respect it deserves, and that one day, we will exhaust it.
Anthropogenic pressures on the Earth System have reached a scale where major environmental change can no longer be excluded. Science already sets planetary environmental boundaries within which humanity can operate safely.
As Lučka said, prosperity today means nothing if it undermines the conditions on which prosperity tomorrow depends. The talk went on to speak about how the earth cannot grow, yet we are exceeding beyond our planetary limits.
In conclusion though, we must re-evaluate our old assumptions about what is possible and recognise that living within ecological limits is the non-negotiable basis for our social and economic development. We have a choice to set down our own limits, rather than have the planet set them for us.
Ljubljana as a destination is the most beautiful, relaxing place to be on a sunny summer's day. The river runs past with numerous riverside café's, the sound of music all around and the chatter of people just having a really relaxing time. There are no cars to get in the way because the central part of the old town is for pedestrians only. Church bells ring often, clearly audible amongst the other sounds of a very lovely and friendly town.
A trip to Lake Bled is highly recommended, where high on top of a rock you will find a beautiful Medieval castle that takes you back in time almost to fairytale proportions. I am only thankful that we started at the top and went down the 400-metre rock face rather than up, otherwise I may not have been in a fit condition to write this report, let alone return to England! I am eternally thankful to the very kind taxi driver who suggested this move. I think he was speaking from experience from some of his customers!
The excursion to the Postojna Caves was a real treat. The caves are a network of 20 kilometres of passages, galleries and chambers into which experienced guides have accompanied more than 31 million visitors in the last 188 years.
It is the largest cave in the ‘classic karst’ and is the most visited cave in Europe. In 1872 railway lines were laid and electricity was connected in 1884. Your visit starts on the cave train, which is quite an exciting experience, and with the lighting the caves lend a mystical, magical atmosphere. It is of geological magnificence in a very unique way, a true underground world just waiting to be discovered.
You are dazzled by the wealth of speleotherms, calcite formations, stalactites and stalagmites in many shapes and sizes. The constant temperature is 8–10 degrees, and apparently there are 99 different types of species living in the caves. Luckily we only saw one of these, the ‘human fish’ safely dwelling in an aquarium!
I also learned, if my memory serves me correctly, the stalagmites only grow one millimetre every 10 years, so only a centimetre every one hundred years. Some of the stalagmites and stalactites were enormous. It did make you wonder how the world looked when they started to grow and how long they will be able to keep growing, especially reflecting on Lučka Kajfež Bogataj's talk.
Well, I appear to have learned more than just an anaesthesia-related subject!
I hope you are all as excited as we are in BARNA at the prospect of hosting the 2016 WCNA Congress. It is not possible to relate to you in a report such as this, the feeling of warmth and interest I received from so many people, and the welcoming atmosphere that was felt throughout the whole stay in Ljubljana. I have tried, and I hope that you can take something away with you and start planning your trip to Glasgow in 2016. Ljubljana in 2012 was a truly splendid experience!
