From the Editor

Did you participate this year with thousands of perioperative nurses on June 10 in observing Time Out Day?

If you don’t know about it, National Time Out Day is an awareness campaign powered by AORN that reminds practitioners to ensure patient safety by taking “Time Out for Every Patient, Every Time.”

Check out AORN’s special report on prevention of wrong-site, wrong procedure and wrong person surgery, complete with case studies and resources for educating the perioperative team.

Also, click here for a very informative 9.5-minute podcast from the “Take 5 with the Joint Commission” series, discussing the most common time-out errors, universal protocol and wrong-site surgery.

For this issue of the eNews, we’re zeroing in on spinal fusion surgery, a technique used to join two or more vertebrae. Spinal fusion is most frequently done in the lumbar spine. Read on for news, videos, apps and a crossword puzzle designed to test your knowledge of lumbar spine anatomy and surgical procedures.

Our Student in the Spotlight is Sandie Nies, RN, BSN, of Fate, Texas. And you’ll also find our collection of current RNFA job openings and favorite resource links. Enjoy!



Julie Lancaster, Editor



Advances in TLIF Surgery

Surgeons are making advances in minimally invasive techniques for Transforaminal Lumbar Interbody Fusion (TLIF) surgery.

Here are three reports of interest:

  • A technique developed by Michael Wang, MD, a  spine surgeon at the University of Miami Health System, allows “awake” minimally invasive TLIF. Read more…
  • A complex, percutaneous minimally invasive and image-guided TLIF surgery done at SUT Hospital in Pattom, India. Read more…
  • A study published in the Journal of Spinal Disorders and Techniques compares minimally invasive TLIF to the open procedure for obese patients. Read more…

Surgical Videos

Spinal Fusion Surgery

Spinal Fusion Surgery for Relief of Chronic Lower Back Pain, performed by John Ciccarelli, MD, at Shawnee Mission Medical Center. In this MedlinePlus / ORlive / Broadcast Med video, the surgeon explains the surgery as it is carried out; the site allows you to click to view a transcript of his explanation at the same time.

Suturing a Grape

Not particularly pertinent to spine surgery, but have you seen this video from the Da Vinci Surgery® YouTube channel in which a surgeon uses a Da Vinci robot to stitch up a grape

Perioperative Puzzle: Spinal Fusion

RNFA+Crossword Spinal FusionTest your knowledge of spine anatomy and spinal fusion surgery with this month’s crossword puzzle.

When you’re ready to check your answers follow this link to see how well you did. Good luck!


App and Website

Spine Pro III from, LLC, contains high-quality animations detailing disease states and injuries/treatments of the spine. Compatible with iPad.

We want to give a SpineSearchLogo.gifshout out to Spine Search, a recruitment and educational source for spine professionals. This company was founded by Nicola Hawkinson, DNP, RN, RNFA, a 2008 graduate of NIFA’s RNFA program. Spine Search is a recruitment company that dedicates its services exclusively to the spine community, building a database of over 6,000 spine professionals nationwide. If you’re interested in working in spine surgery, you should know about this site.

In the Spotlight

Sandie Nies
Name: Sandie Nies
Credentials: RN BSN
Student Status: Current NIFA RNFA student
City and State: Fate, TX
Current Job: Baylor UMC Dallas Roberts/Truett OR Supervisor Weekend Nights
Where did you get your RN degree?
Covenant Hospital (formerly Methodist) School of Nursing, Diploma, 1996; West Texas A&M University, Canyon, TX, Bachelor of Science in Nursing, 1998
Why did you choose perioperative nursing?
I spent 6 weeks as a new nurse on pedi oncology and knew I wanted a change. My cousin was an OR supervisor and invited me into the OR. I fell in love with Open Heart Surgery and have stuck with it.What is the funniest or scariest moment you’ve ever seen at the table?
Funniest–Ummm, I don’t think I’m allowed to say it on paper . . . LOL. Scariest–We had a trauma come to the OR that was a stab wound to the left chest. The knife blade penetrated the left ventricle and then missed the LAD just distally by mm. The trauma surgeon had cracked the chest in the ER via an anterior thoracotomy. The patient presented to the OR with the trauma surgeon plugging the hole in the left ventricle and the resident performing internal cardiac massage. I assisted the cardio thoracic surgeon in a femoral cut down to access the artery and vein to go on bypass. The patient became more hemodynamically stable after multiple transfusions and the repair was able to be made to the left ventricle. The patient went to the unit and did survive the traumatic injury.What is one technique or RNFA trick you’ve learned from NIFA that you will use for life?
There are so many. The loop locking technique, the Vegas knot, the EVH class (endoscopic vessel harvest) rocked. I want to take the leg home! Lots of extra tidbits, too many to list.How do you feel having your RNFA will impact your life/career?
It will drastically enhance my OR skills and improve my performance. I am hoping it will lead to a cardio thoracic(CV) RNFA position.

Job Front

Click here for the RNFA job postings we’ve collected for you this month.

NIFA Office Hours
Monday-Thursday 7:30am – 5:00pm (Fridays 7:30am – 4:00pm).