“Reflections on the Future”

Sue K. Reaves, C.C.P.
Bowie, Texas

It is indeed an honor to be allowed to present the Thomas G. Wharton Memorial Lecture.

In 1983, Charles C. Reed gave a eulogy to Tom’s memory. For me, the most profound statement in that eulogy was that Tom Wharton was a gentleman. The dictionary defines gentleman as a polite, gracious, considerate man with high standards of propriety, correct behavior, refined habits, gentle manners, and a sense of responsibility.

Tom was indeed a gentleman and for those of us privileged to know him, those attributes are what allowed him, a nonperfusionist, to have such a profound impact on our profession. He showed us, on many occasions how to cut through the trash and come up with solutions to questions and problems in a gentlemanly fashion.

His female counterpart must surely have been my grandmother, Anna Roland. She was a health care worker during the days when nurses were only allowed to provide menial care. She lived through the Depression, two world wars, and the loss of a soldier son. She endured many surgical procedures for cancer before her death. But during her life she always maintained high standards of propriety and dignity. Although she died when I was a young teenager, I remember her constantly preaching, ”When all else fails, remember to be a lady.” She probably went to her grave worrying about my future, not knowing that her lessons had indeed cleared the barriers of my hard head. At that time, I was a tomboy, and education was not my main focal point. As time went by, I became aware of how little I knew and how much I needed to learn.

As a new surgical nurse at the Arkansas Baptist Hospital in Little Rock, I was drafted one day to help Charlie Reed with the pump. Armed with my grandmother’s influence, I went to Operating Room Four only to find what I thought must surely be a room full of maniacs. The surgeons were throwing things, the anesthesiologist appeared to be in a coma, Charlie was being very loud, blood was welling up in the room, and the nurse was looking for the phone number of the morgue. I knew right away that if I was going to maintain any sort of gracious composure in that setting, I needed further education. I would certainly have benefitted from a perfusion school, but none existed at the time. Even the term ”perfusion” was barely a word at that time. We were “pump techs.” My only option was to enroll in graduate school at night and to do the best I could to locate the information I needed to pursue a career in perfusion.

But the evolution of my career is not the issue today. The issue is securing the future of perfusion education, thereby securing the future of our profession, as we know it. Perfusion schools have come far since first opening their doors. Technical standards and minimum caseloads have been set. Clinical competency has been defined and evaluated. Last year The Academy membership developed and published a “white paper” on optimum standards for perfusion education. It included all manner of technical skills to be taught prior to graduation. But what can only be taught by example and osmosis are indeed the issues which will insure our professional survival. Unfortunately, these issues cannot be mandated because they are very simply the characteristics of ladies and gentlemen.

During the education process we must, first and foremost, stress the importance of patient advocacy. We are there to protect the patient from harm, whether it be in the form of technical inadequacy or greed. Too often the more we get, the more we want. Greed and avarice tend to make us forget that patient advocacy also includes insuring that patients receive the best care possible at the lowest reasonable cost. We must set an example for our students to learn ethical conduct in the hospital.

There is an old saying, ”Do as I say, not as I do.” Unfortunately, that saying implies the mentality of a sheep. This is not the case with intelligent perfusion students. We must teach by example and expect our students to follow in our own ethical footsteps. We must teach high standards of propriety and correct behavior. Babies are not born knowing how to act in a hospital setting. This is learned behavior. People must be taught that egotism and temper tantrums have no place behind the pump, and that calm, conscientious behavior is always the order of the day.

We need to, somehow, coach our students through difficult situations and teach them to accept the responsibility for their actions. When we do the wrong things, we must accept the fact that we may hurt someone. When we say the wrong things, we need to be ready to admit the error and correct it when possible. If we can treat each other with gentle manners, hopefully, those who follow in our footsteps will learn by our example.

Finally, we must teach our students that education does not end with a certificate.

In our changing world, we know the importance of being aware of current affairs. The same is true of perfusion education. Fortunately, the American Board of Cardiovascular Perfusion forces us to attend meetings. What it does not do is force us to listen and learn.

This is also only taught by example. I sincerely hope that the perfusion world sees The American Academy of Cardiovascular Perfusion as the body setting that example.

If we as educators fail to impart the intangible aspects of education, I fear that we as a profession will fail to thrive and survive, and will only become, once again, ”pump techs.” We must remember that the past is always underfoot and we must tread very carefully toward the future.

Adhering to the examples set by my grandmother and, later, Tom Wharton has led me through a twenty-seven year career during which I never lost sleep wondering if I had done the right thing. As this phase of my career comes to a close, I cannot help but reflect on the bad times and the good times. The good far outweigh the bad and the greatest honor is surely being allowed to chair this august group. For that I would like to thank the Academy membership.

I can only hope that The Academy will continue to teach, by example, the sustaining principles of dignity and propriety which will lead perfusion very carefully into the future.