November 2020 • Volume 14, No. 11

From the Editor

November is National Diabetes Month. As a perioperative nurse, you have undoubtedly encountered some aspects of diabetes mellitus (DM), such as wound care, vision issues or potential amputations in your patient population.

Overweight and obesity are key players in the development of type 2 diabetes and are prevalent among individuals with Type 1 DM. There are many unknowns about how the connections work, and much research is being done about that—not to mention about the relationships between diabetes and COVID-19. But for this issue, we take a closer look at obesity and how it affects perioperative care.

By the way, the ObesityWeek® conference took place virtually earlier this month. Hosted by The Obesity Society, the annual conference attracts thousands of attendees from 40+ countries, including clinicians, care providers, clinical researchers, educators and more. Their website has many resources for learning more.

This month our Student in the Spotlight is Sasha Caves, MS, APRN, FNPC, RNFA, of Dallas, TX.

Scroll down for jobs we’ve collected for you and NIFA’s favorite links.

In this year of great demands for all of us, and no one more than healthcare workers, we at NIFA wish you a safe and restorative Thanksgiving.

Julie Lancaster, Editor

Fast food photo: Christopher Williams on Unsplash


Taking It on the Road

During the pandemic, some facilities are concerned about sending their employees off to RNFA classes in a different city.

So, for 2021, besides our scheduled classes, NIFA has opted to bring a custom SutureStar Workshop (ROAD CLASS) to your facility or ASC!

Our first ROAD CLASS will be presented at UC Davis Medical Center in Sacramento, CA. January 15-17, 2021. Call 800-922-7747 for information.

Other News

More People Can Access Surgery. That’s Great For Them, Awful For The Planet

“If the health sector globally were a country, it would be the fifth [largest] emitter of greenhouse gases,” Susan Wilburn, international sustainability director at Health Care Without Harm, is quoted as saying in this article on Particularly prone to greenhouse gas emissions are surgical, obstetric, and anesthesia care in rich countries. As these lifesaving services become more widely available in low and middle income areas, concern increases for the impact on the environment.
Read more . . .

Diabetes News

Could A Simple Surgical Procedure Fix Insulin Resistance?

Duodenal mucosal resurfacing produces some of the metabolic benefits of bariatric surgery but in a few-hours-long outpatient procedure. This procedure removes the overgrown lining of the duodenum to restore “regular hormonal function.”
Read more . . .

Bariatric Surgery Cuts Pancreatic Cancer Risk Among Type 2s

Long-term remission of diabetes in patients who undergo bariatric surgery isn’t the only reason surgeons are recommending the procedure. A study of 1.4 million patients found that those who had “undergone bariatric surgery were significantly less likely to develop pancreatic cancer than people who had not had it,” as reported in
Read more . . .

Photo (top two): Kendal, H Shaw on Unsplash. Bottom: Shutterstock.

Obesity in the Operating Room

Periperative Care of the Obese Patient

“Obesity has become an increasing problem worldwide during the past few decades,” reads the opening of this abstract in the January 2020 British Journal of Surgery. The study analyzed recent literature about best practices in perioperative strategies for working with obese patients. 
Read more . . .

Obesity Increases OR  Times in Patients Undergoing Primary Hip Arthroplasty

“Two-thirds of the adult population in the United States above the age of 60 years are ‘pre-obese’ or ‘obese,'” reads this journal article from Stanford University Medical Center and the University of Pennsylvania. “Furthermore, the prevalence of obesity is projected to increase by >33% over the next 20 years. The current obesity ‘epidemic’ has had a great impact on healthcare resources, and its effects will increase further as the incidence of obesity continues to rise.”
Read more . . .

Intraoperative Positioning and Care of The Obese Patient

This 5-page PDF from Plastic Surgical Nursing on the obese patient covers preoperative care, equipment selection (e.g., heavy-duty OR tables), intraoperative care, positioning the patient, and more.
Read more . . .

Photo: Adobe Stock


General Surgery in Obese Patients – Tips and Tricks

Dimitrios Stefanidis, M.D., reports to the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) on obesity trends in the U.S. He also discusses strategies for ventral hernia repair.
Watch video . . .

Safe Handling of Bariatric Patients

Informational video on the safe handling of bariatric patients from the Duke School of Nursing.
Watch video . . .

Student Spotlight: Sasha Caves


Student Status
Current student in NIFA’s RNFA program

City & State
Dallas, TX

Current Position
I am currently a nurse practitioner working in plastic surgery.

Where did you get your RN degree? 
I received both my BSN & MS from Texas Woman’s University

How did you come to choose perioperative nursing?
I did an externship during the last summer of nursing school in the OR and fell in love.

What is the scariest (or funniest) moment you’ve ever seen at the table?
[The facility] was out of medium scrub pants and the surgeon had to wear XLs. Needless to say, his pants fell down during the case and we finished the case up with his pants down.

What is one technique or RNFA trick you’ve learned from NIFA that you will use for life?
Hitch technique to secure drains.

Jobs Front

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

NIFA – Office Hours

Monday-Thursday, 8:00am – 4:00pm
Friday, 8:00am – 3:00pm

Practice Resources

Here are several of the most-in-demand sites for our students, prospective students and grads:

MD Edge Surgery News: Specialty News and Commentaries, Videos and More
RNFA Scope of Practice by State (PDF)
ACS List of Cases that Require an Assistant at Surgery, 2020 (PDF)
Perioperative Nurse Links (state nursing boards & professional associations)
APRN Nurse Links

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.

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