May 2017 • Volume 10, No. 5
From the Editor

Some 16 hospitals in Great Britain were simultaneously hit on May 12 by a cyberattack that locked healthcare workers out of their computer and systems, denying them access to patient records. Operations and appointments were canceled and ambulances were diverted to other hospitals.

The attack was carried out by “ransomware” circulated by email. A message on the screen read, “Oops, your files have been encrypted!” and demanded $300 to restore access. Fortunately, computers in US hospitals were mostly not at risk because of the hospitals’ good cybersecurity  practices, including automatic software updates. But what would you do if you opened your computer one morning and saw such a message?

The cyberattack story grew to front page news, affected many industries beyond health care, hitting computers in 150 countries and raising awareness about cybersecurity.

This situation is just one example of the degree to which health care—at least in the developed world—now relies on technology linked to the Internet. That’s the focus of this issue.

And for a little low-tech counterpoint, try our crossword puzzle on “obscure surgery,” including archaic and obsolete medical procedures.
Our student in the spotlight is Christine Hogue, RN, BSN, CNOR, of Bakersfield, CA. Read on for jobs we’ve collected for you and NIFA’s favorite links.



Julie Lancaster, Editor


International Cyberattack
Over the past several days the story of the massive cyberattack changed by the hour, as  reports flowed in from dozens of countries and, eventually, a cybersecurity researcher in the UK inadvertently stopped the attacks from spreading. For a quick overview, see this New York Times story, “What We Know and Don’t Know About the International Cyberattack,” by Russell Goldman.


The Internet of Things

The Internet of Things (IoT) refers to the Internet-connected devices beyond computers, iPads and smart phones: the various devices that have emerged thanks to advances in sensor and mobile technology.

In health care, those “things” include:

  • MRIs, CT scanners, lab test equipment, etc., connected to the Internet to enable remote monitoring and support
  • Self-tracking and remote monitoring products such as thermometers, glucose monitors, electrocardiograms, ultrasound, and more
  • “Smart” medicine dispensers that can remind patients when it’s time to take their medicine or order a refill, or that can upload information to the cloud and alert health care professionals when patients aren’t taking their meds
  • Edible IoT “smart” pills that can monitor medication regimens and health issues
  • Self-adjusting “smart” beds
  • Wireless communication technology in pacemakers

To read more about the Internet of Things in health care, see the following articles.
Forbes: 3 Ways The Internet Of Things Is Revolutionizing Health Care
Mobcon: The Medical Internet of Things
CIO: How the Internet of Things is Changing Healthcare and Transportation
Watchdog: ‘Internet of Things’ in education, health care dependent on regulatory framework

Closer to Home

Patient Records / Privacy
In the era of HIPAA, patient privacy and the security of people’s electronic health records are a chief concern when it comes to cybersecurity in health care settings.A friend of ours went into a hospital in a Midwestern city four years ago to give birth to her little boy.While she was there, someone broke into the hospital computers and accessed all patient information. The hospital neglected to tell anyone about it until a few months later (HIPAA requires health care providers to notify patients of such data breaches) and ended up buying one year’s worth of ID protection for the patients, including our friend, whose data had been compromised.Setting up and maintaining secure systems for patient data has become an increasingly important part of health care. Much as we’d rather get back to actual, hands-on patient care, it’s important for each of us to do our best to follow good hygiene in our Internet practices: having virus protection for our personal devices and computers, getting automatic software updates, checking security settings on social media, and maintaining impeccable password security.

Perioperative Puzzle: Obscure Surgery Crossword

Take a break from high tech with this month’s all-new crossword puzzle on “obscure surgery.”

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

Student Spotlight: Christine Hogue

Name: Christine Hogue

Credentials: RN, BSN, CNOR

Student Status: Current student

City & State:  Bakersfield, CA

Current Position:  Surgical services manager at Bakersfield Heart and Surgery Hospital

Where did you get your RN degree, and do you have a specialty?
I got my BSN from California State University, Bakersfield.

Why did you choose perioperative nursing?
Surgical rotation in nursing school and senior practicum in OR. Of all the courses in the nursing program, the OR was the only area I truly enjoyed. I started my career in the OR as a new grad and have loved it ever since.

What is one of the funniest moments you’ve seen at the table?
One time the general surgeon used his little finger to stretch a port site; next we all hear a pop sound and he turns to me (circulating) and asks me to call the ER for a splint. Not understanding why, I asked what for and he started laughing and told me he just broke his finger. He said he was embarrassed.

What is one technique or RNFA trick you’ve learned from NIFA that you will use for life?
Closing techniques can directly affect (both positively and negatively) patient outcomes. Good assisting techniques and the ability to foresee the next steps (surgeon’s needs) will shorten surgical times and thus the amount of time the patient is under general anesthesia.

How do you feel having your RNFA will impact your life/career?
Scrub into the sterile field as soon as possible, even if just observing. Learn as much as you can from the RN circulator and scrub personnel; they have years of experience in their specialty areas and can offer a significant amount of information pre, post, & intra-op. Also the scrub RN or ST has to be able to anticipate the surgeon’s needs and each step during the procedure; learning from them will benefit you the most.


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

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Disclaimer: The views expressed in this newsletter are strictly those of their respective authors and do not necessarily represent the views of NIFA. NIFA does not give any express or implied warranty as to the accuracy of statements made by our contributors and does not accept any liability for error or omission. It is the responsibility of all perioperative personnel to work within and adhere to their facility bylaws and individual scope of practice.