Nurse brings smoke evacuation program to Dosher

This article originally appeared in Star News Online.

Kim York has made changes at nearly every place she has worked, and Dosher Memorial Hospital is no exception.

York, an operating room nurse and the director of surgical services, took on the difficult task last year of creating a program to eradicate harmful surgical smoke from the operating rooms at Dosher.

When lasers and other electrosurgical devices cut through tissue during surgery, noxious plumes known as surgical smoke are created. Doctors use electrosurgical tools in some way during 90 percent of all surgeries. The smoke not only smells bad, but it’s harmful to the surgeon and nurses in the OR who breathe it in.

York noticed the pungent smell when she first became an OR nurse 11 years ago.

“I remember that first day just how offensive that smoke was,” York said. “Even then, I said something to my supervisor, ‘Can’t we do something about this? This is horrible to breathe.’”

York, 61, got a late start in nursing. Her first career was with the Natural Resources Conservation Service under the Department of Agriculture in Kentucky and North Carolina. She implemented change through major projects such as writing a trail guide book and getting grants to treat soil erosion for struggling farmers.

After working in the field for 13 years, York decided she wanted a change.

“I just mulled over it, actually for a few months, and I said, ‘You know what? I’m gonna do the nursing thing — my dad always thought that I would be a good nurse, and I am really good with caregiving,’” York said.

York attended a two-year nursing program at a community college and loved it immediately, especially when she could observe in the OR. After she got her degree, she tried to get hired as an OR nurse, but it wasn’t easy.

“Being older, trying to get into an operating room with no experience — the two just don’t go together,” York said.

York finally landed a job as an OR circulating nurse — caring and managing for the surgical environment and patient during surgery — at a hospital in Kentucky.

As she moved from hospital to hospital, she continued to be a trailblazer. At Novant Health Brunswick Medical Center, she introduced new hospital-wide protocol for preoperatively warming patients to prevent surgical hypothermia.

York came to Dosher in 2016 and, in March 2017, became the director of surgical services. Soon after she arrived at Dosher, the Association of periOperative Registered Nurses (AORN) released information about the dangers of surgical smoke, revealing that one day of exposure to surgical smoke is equivalent to smoking between 27 to 30 unfiltered cigarettes.

After years of inhaling the offensive and dangerous fumes, York decided to do something about it.

York received permission from her supervisor and multiple boards and committees to start trialing smoke evacuation tools. She said many of them had no idea about the dangers of surgical smoke.

“Across the board, I think people were shocked that this was even occurring in any hospital, and especially ours,” York said. “Everyone was very supportive of doing something about it.”

That is, everyone except surgeons who were reluctant to change their ways.

Teaming up with other nurses, York replaced the reading material in break rooms with literature about the risks associated with surgical smoke. She placed the trial smoke evacuators on break room tables, forcing surgeons to pick up the devices so they could clear a lunch spot.

York said her gift of persuasion eventually got through to the surgeons.

“I just have a knack sometimes for talking people into things,” she said.

Her efforts caught the attention of the media and the medical world — the AORN Journal invited her to write an article, Outpatient Magazine and the AORN gave awards to Dosher for the smoke evacuation program, and Stryker Corporation made a video about smoke evacuator tools featuring York.

Very few hospitals in the country have smoke evacuation programs, despite the AORN reporting that perioperative nurses are twice as likely to report respiratory illnesses as the general public.

Because of this, York’s work isn’t done. Her AORN article will be released this month, and she recently went to Raleigh to talk to legislators about implementing laws to protect surgical staff from the smoke.

York wants to implement other change as well — she wants to create protocol regarding surgical environment emergencies, like the power going out. She said it’s just part of her nature to create change.

“Every job I’ve ever had, I always do something I think is worthwhile,” York said.

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