AACN News—October 1998—Association News

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Vol. 15, No. 10, OCTOBER 1998

Prospectus for 1999 Critical Care Exposition Available in November

The Exhibit Prospectus for the 1999 National Teaching Institute™ (NTI) and Critical Care Exposition will be available in November 1998. The 1999 conference is scheduled for May 16 through 20 in New Orleans, La., with exhibits open May 18 through 20.

In addition to details and deadlines on exhibiting arrangements, the prospectus provides demographics on the thousands of critical care nurses who attend the NTI and visit the exhibits as well as information about the Exhibits/CE Program, advertising, and other promotional opportunities.

To request an Exhibit Prospectus or find out more about exhibiting opportunities, call (949) 362-2000.


Proposals Sought for Symposium

Paper, projects, and case studies are being sought for “ICU 2010: A Critical Care Design Symposium,” which is scheduled for April 1999 at Texas A&M University, College Station, Tex. December 1, 1998, is the deadline for submissions.

An interdisciplinary panel will select research reports and case studies for presentation and roundtable discussion. Suggested topics include clinical context, treatment protocols, nursing models/staffing, monitoring decisions, communications, point of care, medical equipment, pharmacy, environmental research, healing environments, postoccupancy evaluations, and nosocomial infection.

Sponsored by the Center for Health Systems and Design at Texas A&M University, the interdisciplinary conference is jointly presented by AACN, the AIA Academy of Architecture for Health, and the Society for Critical Care Medicine.

For more information, contact Mary McDonald, American Institute of Architects, Academy of Architecture for Health PIA, 1735 New York Avenue, NW, Washington, DC 20006-5292.


The Essence of Nursing Is in Touching Another’s Soul

By Fran Loscalzo, RN, BSN

One of the most challenging and rewarding experiences of my 25-year nursing career was providing care for J.N. and her family. This 12-year-old girl was admitted to our telemetry unit for a cardiac evaluation.

She had been healthy—active in school sports and church activities—until she began experiencing shortness of breath, fatigue, chest pain, and an intolerance of exercise. After a week of cardiac testing, J.N. was diagnosed with severe hypertrophic cardiomyopathy (HCM), with a mid-cavity obstruction. J.N.’s cardiologist called an interdisciplinary conference with the parents, the primary nursing team, and the social worker to discuss the outcome of the tests and his plan for treatment. I still remember the look on her parents’ faces as the physician discussed the devastating news that their only daughter had a cardiac condition and probably would not survive without a heart transplant.

J.N. was discharged from the hospital and placed on limited activity. I remained in contact with the parents and J.N. by phone. Within 2 weeks, her case was accepted by another facility and she was placed on the transplant list. Because J.N.’s symptoms worsened over the next 4 months, it was decided that she should return to our hospital to await her heart transplant.

The uniqueness and complexity of J.N.’s case challenged many of the traditional boundaries of nursing and medicine. I sought out the expertise of 6 associate nurses to participate in planning J.N.’s care and address issues such as control of her environment, fear of abandonment, continuous vigilance of her cardiac status, lack of social interaction with children her own age, fear of dying, incorporation of the family’s cultural needs into her care, and boredom because of restricted activity.

Mrs. N. was allowed to stay with J.N. for the duration of the hospital stay. She withdrew as a full-time nursing student, but kept her part-time job as a nursing assistant at another hospital until she was needed full time to care for her daughter after the heart transplant.

J.N.’s nursing care team worked with other disciplines to try to make J.N.’s hospitalization as close as possible to normal life. Physical therapy monitored exercise on the unit, and recreational therapy created diversional activities to overcome boredom. J.N. was enrolled in our hospital school, with instruction provided in her room Mondays through Fridays. The social worker was a resource to the family for financial and emotional support. A psychiatric nurse liaison was included, so that J.N. and her mother could discuss issues with someone who was not a direct caregiver. We encouraged J.N. to decorate her hospital room with items from her bedroom at home.

An opportunity to provide the family financial relief was presented when the local Heart Association expressed interest in sponsoring a 5K run to benefit a sick child. This was a perfect chance to reach out to the community and rally support for J.N.’s cause. The healthcare team became involved in this community fund-raiser for J.N., and many staff members from the hospital participated in the run, which raised more than $9000 toward J.N.’s hospital expenses.

Issues such as differences in cultural beliefs and norms were also addressed in care conferences. Although J.N. and her brothers were born in the United States, her parents were from Nigeria and maintained many traditional Nigerian customs. Incorporating these customs was identified as an important part of J.N.’s care. J.N. and her mother were allowed to plan her daily schedule including school, periods of rest, and uninterrupted time for morning devotions. On Sundays, her father and brothers, accompanied by some of their church members, sang and prayed in J.N.’s room.

The transplant nurse and I shared information on J.N.’s emotional and medical status. Members of the transplant team were invited to our institution to present a lecture on heart transplants and to network with J.N.’s healthcare team.

During her 7-month stay, J.N. formed lasting relationships with the staff on our unit. My relationship with J.N. and her family was strong as advocate, nurse, mentor, teacher, and, at times, surrogate mother.

Some of my favorite times with J.N. were when I took her and a portable heart monitor off the unit to a quiet spot, where we would have a soda and talk about life. J.N. discussed her innermost thoughts, fears, and concerns about her future.

J.N. celebrated her 13th birthday on our unit with more than 50 of her friends and family. J.N. and her family also celebrated Thanksgiving and Christmas in the hospital. We placed a Christmas tree in her room and decorated her door with lights. A Christmas fund was established for the family to allow for gifts for J.N. and her brothers on Christmas day.

J.N. also had “down” days when she wondered if she would ever go home and participate in normal, fun activities. To help distract her from these feelings, the nursing care team obtained permission for J.N. to use a computer, not only for school work but also to “surf the net.” J.N. connected to the Make-A-Wish Foundation, which granted her request to redecorate her bedroom at home with new furniture, a television, and numerous teddy bears. In addition, J.N. enjoyed pet therapy sessions. She developed a special bond with the dogs that came to visit and uplift her spirits.

Finally the call came that a heart was available. There was a flurry of activity, with staff surrounding J.N. to wish her good luck. The family asked me to come to the transplant hospital that evening. The family and I waited with J.N. as they prepped her for the operating room and waited for the heart to arrive. I left after J.N. went into the operating room, but received a call when I arrived home that J.N. did not get her new heart because the organ was not a good match.

J.N. and her family were devastated. J.N. was now in a new environment, depressed, and starting to wonder if she was going to get a heart. I made weekly visits to J.N. and her mother at the new hospital. Wanting to continue some of the unique approaches we had found successful in caring for this family, I shared J.N.’s plan of care with her new healthcare team.

Three months later, J.N. received a heart. In the months that followed, J.N. and her family slowly started to piece together their home life. I hosted a celebration for J.N. and her family, so that the staff and community members who were praying for J.N. could share in her recovery.

In addition, I presented a testimonial at a religious celebration hosted by J.N.’s family. The room was filled with more than 500 friends and family, many dressed in beautiful, colorful Nigerian outfits. As I spoke, I realized that the essence of nursing is in touching another’s soul.

My relationship continues with J.N. and her family. As a freshman in high school 5 months following the transplant, she tried out for the cheerleading squad. Her life has returned to normal, but will be forever changed.

Teleconference on Music Therapy and Medicine

Music Therapy & Medicine, A National Satellite Broadcast,” will air from 1 to 3 pm (EST) on April 27, 1999, at more than 100 locations throughout the United States and Canada.

Jointly sponsored by AACN, the Department of Veterans Affairs, and the American Music Therapy Association (AMTA), this unique program is the first of its kind to specifically address the practice of music therapy in medical settings.

Music therapy is an established healthcare profession that uses music to address the physical, emotional, cognitive, and social needs of children and adults with disabilities or illnesses. Highly trained, nationally certified music therapists build on the power of music, using it in a focused and concentrated way for healing and change.

With greater public awareness of music therapy has come an increasing demand for more comprehensive information about its clinical impact, research and scientific base, and methods of program development and integration. The National Satellite Broadcast is designed to address these needs by educating medical personnel and healthcare practitioners on the clinical benefits and applications of music therapy.

The broadcast will focus specifically on the scope of music therapy applications in medical settings, current research and case studies, and methods of funding and support. The 2-hour teleconference includes a live panel discussion and interaction from in-studio and downlink site audiences. Continuing education credit for nurses will be offered.

The teleconference panel includes representatives from critical care nursing, music therapy, research, case management, and healthcare administration.

The AMTA represents more than 5000 professional music therapists in the United States who, through the application of music, treat approximately 1 million people with disabilities or illnesses in hospitals, clinics, nursing homes, hospices, rehabilitation centers, and other settings.

For more information about “Music Therapy & Medicine, A National Satellite Broadcast,” visit the AMTA Web site at http://www.musictherapy.org, or contact Tamara Zavislan, AMTA director of development, at (301) 589-3300; fax, (301) 589-5175; e-mail, Zavislan@musictherapy.org.

Tossing Around Possibilities for Life

Christina Harrison,RN, BSN, MS, , decided that the best way to illustrate the key points of her speech at the 1998 National Teaching Institute™ in Los Angeles was to toss potatoes at the audience.

These weren’t just ordinary spuds. Harrison gave out 10 ’taters—one for each of the 10 possibilities for daily life outlined in her talk, titled “Consider the Possibilities: Build on Your Assets.”

She peppered her talk with personal and professional anecdotes, and between each point, she peppered the audience with a potato.

“Perception is reality,” she said. “What we’re doing is influenced by our own perceptions and the perceptions of others. You are what you think you are.”

To further illustrate her point, Harrison passed three kaleidoscopes around the crowded auditorium.

“We can change the picture by turning our perspective one way or another. Everyone has the ability to turn things around just by looking at a situation differently.”

She then made her case for each of the 10 possibilities. Among them was to eliminate the impossible. For example, Sally Jesse Raphael was fired 18 times in 30 years before finally getting her own talk show. “By using persistence, nothing is impossible,” Harrison said.

“Practice asking and listening. You’d be amazed at what you hear. Most every answer we search for is out there somewhere, and someone’s probably tried it before and made it work. Go out and find what works, and ask people what they think.” Listening, she added, is an art.

“Don’t neglect to look important. We nurses go places looking shoddy, but you can always spot the salesmen when they come into the hospital because they’re dressed up and looking good. We have the responsibility to the patients we take care of to look pleasant and act like we have some pride.”

“Everyone can build cathedrals—especially nurses.”

She told the story of three people working on a building. One said he was breaking rocks. Another said she was earning money. The third said she was building a cathedral. Their answers depended on how they viewed their jobs.

“There is no higher calling,” she emphasized, “than intervening in people’s lives. You’re not doing a little task, you’re building cathedrals.”

Putting each possibility into practice isn’t easy, she confessed, but it can be done. Calling the 10 potato-holding audience members to the front, she gave them each a straw and asked them to push it through the potato. As the audience cheered them on, 9 people surprised themselves by putting Harrison’s first possibility to work: believing it can be done.

“Be greater than you think you can be,” she said, “and be proud of what you never thought you could do.”

Earn CEs Online! Opportunities Expanded

Earning continuing education credits is now easier and quicker for nurses who take advantage of online CE opportunities.

AACN recently expanded the CE area of its Web site. At the AACN home page, choose "Earn CEs" to access the extensive list of content areas that are available. New articles from AACN Clinical Issues, Critical Care Nurse, and the American Journal of Critical Care as well as other AACN-approved articles are posted every week.

Even the CE application can be submitted electronically. CE certificates are sent via e-mail within 48 hours of the receipt of test fees.

Included in the CE online program are the following content areas:
• Administrative/Regulatory
• Cardiovascular
• Case Management
• Endocrine
• Ethics/Legal/Public Policy
• Medications/Fluids
• Monitoring
• Multisystem
• Neurologic
• Pediatrics/Neonatal
• Healing Environment/Psychosocial
• Respiratory
• Sedation/Pain Management

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