After organising, chairing and teaching on a recent multidisciplinary workshop on postoperative pain in Munich, I was to attend a Beer Hall in the centre of this fine city. As I sat there, sipping the occasional aliquot of fine German lager, I found myself pondering over many things. As a result of tiredness and intellectual exhaustion, my recollection of my thoughts at that time is not complete.

The speciality of anaesthetic and recovery nursing has grown from a foundation of hard evidence that the majority of anaesthetic complications occur in the post operative period, and there is a need for a highly trained and experienced nurse with skills and expertise in caring for patients during this critical period. This development during the late 60's and early 70's was shaped by anaesthetists and has over the years been continually developed and enhanced by nursing. Post Anaesthetic nursing practice is now an integral part of the perioperative process, with some suggesting that recovery nursing is largely distinct from the other perioperative skills and should be treated as such in terms of education and planning.

Jane Bovey has long been a member of BARNA, and has recently left her job in the private sector as a recovery nurse to work with an agency. Jane decided to write a column in the journal to express concerns felt by many nurses working in anaesthetics and recovery. Jane also wanted to promote debate on some contentious issues, and welcomes replies to her column. If you have a reply, send an email: [email protected] or BJARN, 6 Bromyard Avenue, Walmley, Sutton Coldfield, B76 IRQ. The views expressed in this column are entirely of the author, and do not necessarily reflect those held by the British Anaesthetic & Recovery Nurses Association.

As we start out on our path into the millennium, there are a number of key issue we need to consider about our future in nursing. Whilst many readers may groan at such a statement it is worth remembering the difference between nursing at the beginning of the last century and today. Clearly nothing is static, change is inevitable and, if we want to be proactive in leading change, we need to consider the options open to us now so that we drive the agenda for nursing in this century rather than letting others do as has sometimes been the case in the past.

A few incidents have recently made me sit back and reflect on the perception the general public has of the nursing profession. The first incident centred on a discussion about the levels of wages between the industrial sector and the NHS. Apparently, experienced distribution transport managers are in equally short supply as are anaesthetic and recovery nurses. In a large organisation a transport manager would have similar work patterns and responsibilities as that of a Charge Nurse or Sister in a busy operating theatre. The going rate for such hard to find skills is about £35,000 basic - not bad at all. However, when I asked the individual how much they thought a charge nurse or sister got paid, they replied ‘oh, about £30,000 these days.’ After I had picked myself off the floor and told him the true value, he was horrified. He had been left with the impression that nurses had had a ‘good deal’ in the recent pay awards - I wonder where that information came from?

Whilst there is a multitude of literature available on the efficacy of continuous epidural infusions following major surgery (Buggy & Smith 1999, Rawal 1998, Macintyre & Ready 1997), little attention is paid to the administration of these infusions. Some hospitals keep patients in HDU/ITU (Audit Commission, 1997) following surgery because of problems in administration of epidural infusions on the ward. This article describes an innovation in epidural administration which has been successfully implemented in two NHS Trusts. The system is safe, cost effective and allowed us to use our existing syringe pumps.

The new millennium has now arrived in style, with appropriate hype and fireworks we are truly in the dawn of a new age. However, if you were working I have been reliably informed that Cuba will be holding the ‘true’ millennium party in twelve months time. At the end of 1999 it was a time for reflection and the year looking forward into the future of 2000. What of anaesthetic and recovery nursing? What does the future hold?

Chicago Illinois, home to both IFNA and AANA, this year hosted the 6th world congress for nurse anaesthetists. The largest convention for this nursing speciality the world has ever seen. Over 3000 delegates from over 22 countries attended this 5-day conference, encompassing clinical workshops/ presentations, management/education forums, political debates together with an impressive commercial exhibition and a poster presentation. I was fortunate indeed to replace Clara Bradshaw on this occasion as the UK National Representative and it was an experience that I will not forget.