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5 Keys to Passing Surgical Smoke-Evacuation Legislation in Your State

A Conversation with Theresa Plante, BSN, RN, CNOR


4 Keys to Passing Surgical Smoke-Evacuation Legislation in Your State

March 24, 2019   

Rhode Island may be the smallest state in the Union, but we successfully passed legislation requiring all licensed hospitals and freestanding ambulatory surgical facilities to adopt policies to use a smoke evacuation system for surgical procedures that generate surgical smoke.

If we can do it, you can, too!

Here are five lessons I learned in my first experience working with legislators to advocate for perioperative professionals and our patients.

1. Find a Team

There is too much work involved in shaping a bill and getting it passed to go it alone. I worked closely with my nurse colleague Julie A. Greenhalgh BSN, RN, CNOR, and we made invaluable connections with AORN’s Government Affairs department, as well as the Rhode Island State Nurses Association to help us refine our approach and understand the legislative process, as well as who to talk to.

The AORN Government Affairs department provided tools and resources including template legislation, educational materials for legislators, fact sheets, grassroots support from colleagues in our state, and everything we needed to stay connected to legislators throughout the year.

2. Be Prepared to Educate

The most surprising thing nurses will learn in this process is the lack of information and knowledge legislators have regarding the dangers of surgical smoke. Some legislators have healthcare knowledge, but rarely have any understanding of what happens behind OR doors.

You have to be prepared to describe in detail what surgical plume is, what toxins plume contains, and the compounded exposure of surgical smoke for nurses and surgical technologists who spend as long as 12 hours in a day working in the OR. You also have to be extremely clear about how smoke evacuation technology works and how it is applied in the surgical setting.

3. Be Ready with Answers

The legislators we spoke with were interested in understanding the current research on the dangers of surgical smoke, so being ready with the data was important. They were also interested to know why doctors are not as worried about surgical smoke, and we had to explain that surgeons are focusing on the surgery at hand and not on evacuation equipment across the room. Also nurses and technologists spend many more hours exposed to surgical plume, which makes us more aware of our exposure.

4. Stay Connected

During a formal education presentation with legislators, you may get a question you don’t have an immediate answer to. That’s okay. Let them know you will get them an answer and then be very expedient in reconnecting with the legislator to share the answer when you find it. This can be a good way to maintain communication with legislators.

5. Be patient

The process to pass legislation can be slow and a legislative session can go fast so be prepared for several years of work ahead of you. Our first year of work in 2017 was to educate legislators, but the bill was tabled to address budgetary issues. We were ready the next year to re-educate as needed and push the bill through, which we did in 2018.

The time I spent in moving this legislation remains the most rewarding of my nursing career because it made me feel a part of something that positively impacts the lives of all surgical staff and patients.

Learn more about this journey to pass smoke-evacuation legislation with Plante and Greenhalgh during the author poster presentations at AORN Global Surgical Conference & Expo. More than 300 poster authors will be presenting their findings and work April 7-9 at the Music City Center in Nashville, TN.

Contact the AORN Government Affairs department for assistance with smoke-free legislation and advocacy .

Theresa Plante, BSN, RN, CNOR is a perioperative nurse at Our Lady of Fatima Hospital in Providence, R.I.