NIFA

I recently reviewed a number of articles on the evolution of Ambulatory Surgery including the recent thought-provoking article, “The ASC Surge”, in the Winter 2026 issue of OR Today.1 These articles prompted some reflection on the evolution of ambulatory surgery. When I began working in perioperative nursing in the mid-1980s our total joint cases, whether knees or hips, had a lengthy inpatient hospital stay. In comparison, total knee arthroplasties are now routinely scheduled as outpatient procedures for healthy patients and outpatient hip replacements are possible for some patients.

The modern history of perioperative nurses leading and managing operating rooms closely parallels the development of the perioperative nursing profession. Salazar tells us that Florence Nightingale spoke to the role of nurses working in surgery as early as 1860.(1,2) Schools of nursing, based on the Nightingale model, began to be developed in the 1860s, with all nurses in those schools training in the work of surgery.

This month I would like to highlight the findings of a recent literature review article by Ada Xie, Jed Duff and Judy Munday on the topic of perioperative nursing shortages.1 An integrative review of the literature gives us, “… a broader summary of the literature and includes findings from a range of research designs” to develop “… a holistic understanding of the topic, present the state of the science …” on a given topic.2

This month I would like to highlight the accomplishments of a colleague – Dr. Shelly Mason. She recently completed a Ph.D. with a perioperative nursing focus. Mason’s academic achievement is noteworthy on a personal level but there are important implications also for perioperative nursing.

This month I am returning to a familiar and recurring issue for operating room leadership, financial issues, and reference an article by Jakob Emerson Becker’s Healthcare Review.1 For the detail behind Emerson’s summary readers must go to the website of Kodiak Solutions, to request the free download of the cogent and informative full report on the potential revenue losses for healthcare facilities with the One Big Beautiful Bill Act (OBBBA).2

As we reflect on the circumstances that preceded the beginnings of the NP role we are now in similar times. It can be argued that the shortages of primary care providers which existed prior to the passage of the Affordable Care Act (ACA) have been exacerbated more recently by more insured patients seeking routine and preventive care.