AACN News—May 1999—Association News

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Vol. 16, No. 5, MAY 1999


Gill Named to IOM Committee

Barbara A. Gill, RN, MN, chairperson of the AACN Certification Corporation Board of Directors, has been appointed to an Institute of Medicine committee that will examine technical and policy issues related to organ procurement and transplantation.

The 16-member committee was formed in response to a congressional request for the IOM to study the potential impact of regulations proposed by the Department of Health and Human Resources. The proposed regulations would require the Organ Procurement and Transplantation Network to adopt policies that would eliminate or minimize the allocation of organ donations by geographic region and increase reliance on medical necessity criteria.

Gill, a clinical nurse specialist with Abilene Cardiothoracic and Vascular Surgery in Abilene, Tex., will represent nursing on the committee, which also includes experts from the fields of surgery, internal medicine, epidemiology, biochemistry, statistics, ethics, pediatrics, health and law and sociology. Parts of the committee’s three scheduled meetings will be open to the public.

Specifically, the committee has been asked to examine the impact of the regulations on the following areas:
• Access to transplantation services for low-income populations and racial and ethnic minority groups
• Organ donation rates, the reasons for differences in those rates and the effect broader sharing criteria such as that based on medical necessity instead of geography would have on those rates
• Waiting times for organ transplants
• Patient survival rates and organ failure rates leading to retransplantation
• Costs of organ transplantation services

For additional information about this committee’s work, call (202) 334-1755 or visit the committee’s Web site at . For documents reviewed by the committee, contact the National Research Council Library at (202) 334-3543.

Award to Cite Adult ICU Design

August 15, 1999, is the deadline to submit applications for the 1999 ICU Design Citation award. This year’s citation will go to an adult ICU.

The citation was established by a joint committee representing AACN, the Society of Critical Care Medicine (SCCM), and the American Institute of Architects Committee on Architecture for Health to recognize critical care units that combine functional ICU design with the humanitarian delivery of critical care.

The winner receives a total of $1500—$500 from each of the sponsoring organizations. In addition, the winner receives registration for one person to attend each of the organization's annual meetings and a plaque to display in the unit.

Materials submitted each year by winning and runner-up entries are compiled into an ICU design video and booklet, which is a valuable tool for ICU design teams as they seek ideas. Another publication, titled Critical Care Unit Design &

Furnishing, is available to help team members make an optimal contribution from design conception to fruition. These resources are available from SCCM,

(714) 282-6000.

Applications for the ICU Design Citation award can be obtained by calling Kim Cantrell at SCCM, (714) 282-6047.

Get Published! Join Wyeth-Ayerst’s Nursing Fellows Reporter Program

Do you want to be published? Are you interested in developing your professional leadership skills?

The AACN Wyeth-Ayerst Nursing Fellows Reporter Program offers these opportunities. This 9-month fellowship is sponsored by Wyeth-Ayerst Laboratories in collaboration with AACN and the American Journal of Nursing.

Through the program, acute and critical care nurses participate as either mentors or fellows. Guided by the mentor, each fellow prepares an individualized fellowship project that includes attending AACN’s National Teaching Institute™ and Critical Care Exposition and developing a manuscript, which is published in a supplement to the American Journal of Nursing. The subject area for this project is cardiopulmonary.

Mentors are experienced acute and critical care professionals who help guide the fellows in further developing their clinical leadership potential, including professional writing that is directly related to clinical practice. Fellows are enthusiastic future leaders in the area of critical care nursing.

This program provides a structured way to develop professional writing skills, develop a mentoring relationship and receive financial support to attend the 2000 NTI, which is scheduled for May 21 through 25 in Orlando, Fla.

Applications must be received by July 9, 1999. For more information about the program and how to apply, call (800) 394-5995 to contact AACN Clinical Practice Specialist Michele Wolff, RN, MSN, CCRN, at ext. 414 or Research/Practice Associate Carla Stallworth at ext. 335.

Visit the ’99 NTI in New Orleans, La., Online

If you aren’t able to attend AACN’s 1999 National Teaching Institute™ and Critical Care Exposition in New Orleans, La., you can at least get a peek online at what’s going on.
NTI News, the conference daily newspaper, can be accessed each day during the NTI, May 16 through June 20. NTI News Online can be accessed through the AACN Web site at
http://www.aacn.org or the NTI Web site at .

Although the photographs and articles won’t equal the experience of being there in person, members who can’t attend will at least be able to feel as though they are a small part of this premier educational event.

June 11 Deadline to Submit Nominations

Nominations of individuals to serve on the national AACN Board of Directors, AACN Nominating Committee and AACN Certification Corporation Board of Directors are due June 11, 1999, for terms beginning July 1, 2000.

A self-addressed nomination form was included in the April 1999 issue of AACN News. The form is also available in the “Volunteers” area of the AACN Web site at http://www.aacn.org or via Fax on Demand at (800) AACN-FAX (222-6329). Request Document #1540.

For the AACN Board of Directors, nominations are invited for president-elect, treasurer, and three directors. In addition, AACN is inviting nominations for three positions on the Nominating Committee.

For the AACN Certification Corporation Board of Directors, nominations are invited for chair-elect, one director, and one consumer representative.
Nominations must be received or postmarked by June 11, 1999.

These positions may require different time commitments. Support services and reimbursement for travel as well as other expenses are provided for all. Nominees for all AACN positions must be AACN national members.

Following are brief descriptions of the positions:

AACN Board
President-Elect
One 1-Year Term
Nominees must have served at least two years on the AACN Board of Directors. During the term, the president-elect works to become familiar with the duties of the president and consults with the president to prepare for continuity and a smooth transition of leadership. The president-elect also assumes presidential accountability in the absence or inability of the president to act. From the nominations submitted by the membership, the Board of Directors selects the candidate who is placed on the ballot.

Treasurer
One 3-Year Term
As a member of the Board of Directors, the treasurer must demonstrate not only the qualifications of a director, but also an awareness of financial systems. The treasurer chairs the Finance and Audit Committee. In collaboration with the AACN national office team, the treasurer ensures that the committee and the Board of Directors review and monitor the use of AACN’s financial resources in accordance with AACN’s mission, values, and priorities.

Directors
Three 3-Year Terms
In addition to representing the needs of the members, board members establish priorities for AACN, based on its mission and vision. They help to ensure general and financial viability and growth, as well as promote high-intensity care continuum. The position also affords numerous opportunities to network with other professional colleagues, consumers, and healthcare policy makers.

AACN Nominating Committee
Three 1-Year Terms
Members review the applications and references of those nominated for the positions to assess competencies before submitting the slate of candidates to a vote by the membership.

AACN Certification Corporation Board
Nominees for the AACN Certification Corporation Board are not required to be AACN members. However, at least two board members must hold current certification by the AACN Certification Corporation and a majority of board members must hold an active RN license in the United States. The Nominating Committee considers these credentialing requirements in selecting candidates.

Chair-Elect
One 1-Year Term
The chair-elect works to become familiar with the duties of the chair and consults with the chair to prepare for continuity and a smooth transition of leadership. He or she performs all duties of that position in the chair’s absence.

Director
One 2-Year Term
Directors actively participate in governance including the following: ensuring the corporation’s financial viability and growth, evaluating organizational outcomes based on established priorities and action plans, monitoring the impact of corporation initiatives on patient care and healthcare delivery systems, articulating positions and policies to key stakeholders, and ensuring a successful relationship between AACN and AACN Certification Corporation.

Consumer Representative
One 3-Year Term
Consumer representatives actively participate in governance including the following: ensuring the corporation’s financial viability and growth, evaluating organizational outcomes based on established priorities and action plans, monitoring the impact of corporation initiatives on patient care and healthcare delivery systems, articulating positions and policies
to key stakeholders, and ensuring a successful relationship between AACN and AACN Certification Corporation. In addition, this position champions the perspective of the consumer by exploring issues related to healthcare and their potential effect on consumers, along with the value and relationship of professional certification as a method of protecting the public.

For more information about leadership opportunities and the Call for Nominations process, contact Maheaba Baloch, volunteer associate, at (800) 809-2273, ext. 228.

Chapter Programs Abound in the Spring

Greater Memphis Area Chapter President Robert Bartlett is shown with AACN President Mary McKinley (center) and Greater Memphis Area Chapter President-elect Stephanie Van Arsdale. The occasion was the chapter’s 25th anniversary dinner celebration.

By Mary G. McKinley, RN, MSN, CCRN
President, AACN

I know that spring has sprung—not because of the blooming flowers or the budding trees, but because of the number of spring seminars scheduled by AACN chapters.

My time has been hectic, beginning with a Board of Directors conference call in February. We reviewed the association’s current operational plan, as well as the progress made toward goals we set at our November board meeting. The work accomplished is certainly impressive as we move through the fiscal year.

I returned to the road in March with a visit to lovely Spokane, Wash., where I was invited to present at the Spokane Chapter’s spring symposium. Although we were greeted in the morning by a blanket of new snow, these critical care nurses never missed a beat! Most were on time and ready to go.

This symposium was my first experience with a telemedicine conference. Julie Hoerner, who coordinated the symposium with Dianne Molsberry, was gracious enough to show me the ropes on where to stand and which microphone to use as we broadcast the meeting to another hospital that was three hours away.

I was also treated to tours of two Spokane area hospitals—Sacred Heart Medical Center and Deaconess Medical Center.

Michael Day and Bobbi Emerson, chapter president, were my guides at Sacred Heart, where I had the opportunity to see an impressive piece of transport equipment called MOBI (mobile ICU). This intensive care stretcher includes all the equipment that could possibly be needed to transport a critically ill patient including a balloon pump, full monitors, IV pumps and a ventricular assist device.
Bobbi was joined by Debbie Brinker as my guide at Deaconess, where the tour included the “treehouse,” a specially designed structure in the pediatric area.

I was able to also enjoy some of the conference sessions, which included topics on herbal therapy and pet therapy—complete with several live pets! At dinner with some of the chapter members, I was treated to a piece of huckleberry cheesecake. I enjoyed it so much that Libby Zadra and the group treated me to a bag full of huckleberry jelly beans!

I then journeyed to Cleveland, Ohio, for the 19th annual Cleveland Clinic Symposium—Dimensions in Cardiovascular Care. This clinic has always been on the cutting edge of research and care for patients with cardiovascular problems. Nancy Albert and Ellen McErlean made their coordination of the conference appear effortless.

My tours while in Cleveland included the Cleveland Clinic. Nancy, who works in the area of heart failure and transplantation and is currently developing in-depth protocols for the care of these patients, was my guide. Because the Cleveland Clinic has been a referral agency for my home base hospital in Wheeling, W. Va., I was interested to see where we have sent our patients. I was also taken on a red carpet tour of Metro Health Medical Center by Diane Fritsch and Debbie Klein, who shared information about their burn and trauma units.

An afternoon session, where I could meet with local chapter members, was built into the conference. We had a lively meeting reviewing what is happening at AACN. Monica Weber, Lake Erie Chapter president, facilitated the meeting. We also dined at Sans Souci, where the topic of conversation was current efforts to reengineer and redesign healthcare. It seems that no place is immune from change!

I next visited the south and Augusta, Ga. It was wonderful to leave 30-degree weather and snow and land in 70-degree weather, with flowers everywhere. With the Masters golf tournament only a couple of weeks away, Augusta was certainly putting on its finest!

The occasion for my visit was the Central Savannah River Chapter’s spring symposium, coordinated by Bill Jackson. I was thrilled to see at least 20 student nurses in the audience. This opportunity to encourage and mentor students in critical care was headed by Chapter President Beverly Gay, who is the students’ instructor. I asked the students if they were getting extra credit or if they were required to attend. They said they were not, and simply viewed the symposium as a great opportunity to learn.

In Atlanta, I had a wonderful tour coordinated by Nancy Stark of the Medical College of Georgia. A highlight of the tour was the new Children’s Medical Center, where Barb Meek showed us around. The facility, which includes a full medical information library for parents with access to the Internet, is beautiful, spacious and open, and complete.

We spent an evening at the French Market Grille, where we had time for some informal talk. The group insisted I try a local favorite called Cajun Popcorn—otherwise known as crawfish. It was delicious!

My presentation to the group was titled “Currents of Change.” Representatives of the local media attended, and one reporter interviewed me at length following the presentation. The next morning, the chapter meeting was front page news! This was an excellent opportunity to share the perspective of nursing with the media and help give a voice to what it is that nurses do.

April found me in my home state capital of Charleston, W. Va., where the Greater Charleston Area Chapter sponsored a meeting titled “Critical Care—A Capitol Idea” in the rotunda of our beautiful state capital building! There could not have been a more perfect setting for the voice of nursing to be heard. I was introduced to the participants by Bobbi Hatfield, one of West Virginia’s nurse legislators. Bobbi served with my husband David when he was in the West Virginia House of Delegates, so it was nice to catch up with an old friend. Debbie Wylie was the coordinator of the event, which was attended by more than 20 nurses from the area.

I was also treated to a tour of Children’s and Women’s Hospital by Denise Millot, who is president-elect of the chapter. Lorrie Lewis, the current president gave an opening presentation that highlighted the accomplishments of the chapter this year.

Appropriately, the next stop on my travels was Memphis, Tenn., where I attended the Greater Memphis Area Chapter’s spring symposium, planned by Elaine Fetzer. I had begun my presential year by attending the chapter’s 25th anniversary dinner celebration, which was planned by Janet Mulroy, Public Policy Advisory Team representative, and Bob Bartlett, chapter president, who served as my escort. Shortly after I returned from the spring event, where Bob served as my escort, I was saddened to learn of his death.

Now the time has arrived for AACN to turn out its finest at the 1999 National Teaching Institute™ and Critical Care Exposition, May 16 through 20, in New Orleans. I hope I see you there!

Managing Credit Essential to Increase Net Worth

Debt plays a larger role in women’s lives today than ever. In fact, Merrill Lynch’s Ninth Annual Retirement and Financial Planning Survey found that approximately nine in 10 women have some type of outstanding debt— significantly more than just a few years ago. The median amount of their credit was more than $90,000.

However, when it comes to building financial security and wealth, many women focus on managing their assets without considering the effect liabilities can have on their financial plan. A more effective way to increase net worth is to manage both assets and liabilities. By integrating smart credit strategies into your financial plan, you could reduce your expenses, lower taxes, avoid disrupting a well-planned investment strategy and increase opportunities for asset growth.

When Borrowing Makes Sense
Paying off debt is often more an emotional goal than a sound financial strategy. When you have a cash or large purchase need, using credit can actually help you increase your net worth. As a rule of thumb, always compare your potential investment earnings to the interest paid on borrowed funds. When the potential investment return is higher than the financing costs, borrowing may make sense.

Home Financing
The purchase of a home can affect your monthly budget for 15 to 30 years, but its effect on your net worth can continue much longer. For this reason, selecting a home-financing option that can help you achieve both immediate and long-term financial goals is important.

Mortgage financing alternatives have multiplied in recent years. In addition to traditional 15- and 30-year fixed-rate loans, you can find adjustable-rate and fixed-to-adjustable-rate mortgage programs that offer a variety of options to suit your individual needs. Interest-only payment mortgages can increase the tax deductibility of interest expense and reduce monthly payments to increase cash for other needs such as investing. Low- or no-down payment mortgages can help you keep more assets invested, so you can continue to earn potential returns and defer capital gains taxes.

To select the right mortgage, factors such as your risk tolerance, return on investments, length of time you plan to be in your home, and your current and future cash flow and tax situation should be considered. Ask your lender to show you comparisons of the initial, monthly and overall costs of the mortgage programs you are considering and how they affect your financial plan.

Refinancing a high-interest-rate mortgage can also bring significant savings. For example, the monthly payment on a 30-year, fully amortizing $100,000 mortgage with a fixed rate of 10% is $877.57. If the mortgage is refinanced at 7.5%, the monthly payment is reduced to $699.21, a savings of $178.36 a month and $2,140.32 a year that can be used for other needs.

Personal Credit
For many women, personal credit comes in the form of unsecured credit cards and personal bank loans, often with annual interest rates as high as 18% or more. These rates are high, because no collateral is put up to secure the credit.
You may be able to obtain a lower rate and cut your credit costs by 50% or more by securing your credit with eligible securities in your portfolio or with a home equity line of credit.

A securities-based loan or a home equity loan or line of credit can be used for many purposes such as financing corporate stock options, financing or refinancing car or boat loans, refinancing loans with higher interest rates, paying education costs, paying taxes, or renovating your home.

In our survey, only 34% of women, compared to 46% of men, regarded borrowing against investments as a smart strategy, but the prudent use of margin can be a good way to meet your portfolio objectives. With securities-based lending, you can borrow up to a certain percentage of the current market value of your eligible securities, typically 50% to 95%, for various terms at fixed or adjustable interest rates.

By pledging eligible securities as collateral for your loan, your portfolio remains intact, allowing your investments to continue earning interest and dividends throughout the term of the loan. You also defer possible capital gains taxes and retain possible growth potential by not liquidating your securities. However, if the market value of your securities declines, you may have to deposit additional funds or securities. When margin is used to purchase taxable investments, the interest expense may be tax deductible up to your net investment income, or fully deductible if used for business purposes.

When you establish a home equity loan or line of credit, you can usually borrow up to 80% of its value at a rate that is only 1 or 2 points above the prime rate. The interest expense on a home equity line of credit may be tax deductible on loans up to $100,000. By consolidating large outstanding debts at a lower rate, you can free up your cash for other needs or pay off the outstanding balance sooner.

Business Financing
If you are a business owner, financing is one of the most important elements of an effective cash-management system. Reducing the cost of your credit and identifying the most effective credit programs can enhance your business’s profitability and your personal net worth.

Business-financing options might include a revolving commercial line of credit to help you even out seasonal cash-flow fluctuations, purchase inventory and meet other short-term needs; term loans to provide medium- to long-term financing for expanding or purchasing facilities, purchasing equipment or making acquisitions; specialized commercial real estate financing for purchasing or refinancing owner-occupied or income-producing property; securities-based financing to enable you to use eligible securities in your business or personal portfolio to secure financing; or mezzanine or equity financing when your business requires additional capital beyond your senior-debt financing capabilities.

The next time you talk to your financial adviser about investments, ask about financing options as well. The most effective way to increase your wealth is to pay equal attention to both sides of your balance sheet.

Call (888) ML-SAVES (657-2837), ext. AACN (2226), for more information on this and other financial issues or visit the area set up exclusively for AACN members by Merrill Lynch from the AACN Web site at http://www.aacn.org.

May Marks Critical Care Awareness, Recognition

May is National Critical Care Awareness and Recognition Month. Focusing on the theme of “Healthcare from the Heart,” the month is set aside to recognize nurses, physicians, and other healthcare providers who are involved in the care of critically ill patients as well as to emphasize the importance of patients and their families, hospitals, corporations, and communities.

For more information about National Critical Care Awareness and Recognition Month, or to request a product guide, call the Foundation for Critical Care at (800) 906-3366.

National Nurses Week Observed May 6-12, 1999

Nursing: Healing from the Heart” was the theme for National Nurses Week, May 6 through 12, 1999. Sponsored by the American Nurses Association, the observance highlights the diverse ways in which registered nurses, the largest healthcare profession, are working to improve healthcare.

National Nurses Week began on May 6 with RN Recognition Day and ended May 12, the birthday of Florence Nightingale, the founder of nursing as a modern profession.

Celebrating 30 Years

Critical care nurses have always cared for the most vulnerable patients and their families. As we all know, the healthcare environment and the practice of critical care has changed dramatically over the last half of this century, yet our values and the focus of our practice has remained constant. This steadfast commitment has always been the true power and strength of our practice.

Looking Back at Critical Care
In 1953, when Dr. William McClenahan proposed to dedicate space for concentrated nursing care of critically ill patients, his hospital’s management only reluctantly agreed to cooperate. Yet despite his institution’s misgivings, it was clear that his proposal was an idea whose time had come. By 1965, more than 90% of hospitals with 500+ beds opened intensive care units, with smaller hospitals not far behind.

AACN Begins
In 1969, AACN founders imagined an inclusive organization committed to the investigation, education, and communication about caring for the critically ill. The forward thinking of our founders and the continual visionary focus of the AACN leaders of the past 30 years has positioned us as an organization helping our members make a difference in the lives of the critically ill.

Today and Beyond
AACN is the world’s largest specialty nursing organization with over 65,000 members. The rich history of our organization gives us a strong foundation comprised of insight, confidence, courage and commitment to continue to extend our vision and values into the future for today, and tomorrow’s critically ill patients, wherever they may be.

AACN Founders
Kathryn Bowns • Rosalie Burelli • Sarah Jane Creech
Rosalie Hammerschmidt • Adeline Jenkins
Cheryl Larson • Rose Pinneo • Diana Ray
Norma Shepard • Helen Shields
Barbara Siebelt • Carol Southern
Penny Vaughan • Dorothy Wheeler
Donna Zschoche

Collaborating Physicians
Robert Chesne • John Curry
Henry Marriott • Lawrence Meltzer
Fred Ownby • Alfred Soffer • Paul Unger

Excerpts of this summary were taken from Critical Care Nursing: A History; Authors: Julie Fairman & Joan Lynaugh; University of Pennsylvania Press; 1998. This book can be purchased, along with the limited edition 30 year anniversary pin, in the NTI Bookstore or the AACN Resource Catalog.

Disability Plan Now Available From Maginni

A new disability income plan offering monthly benefits of $1000, $2000, or $3000 is now available to AACN members.

AACN and Maginnis & Associates have arranged to offer this new group insurance plan, which is administered by Albert H. Wohlers & Co.

All AACN members and and their spouses or domestic partners under the age of 60 are eligible to apply for the disability income plan if they have worked at least 30 hours a week for the past 90 days and have not been hospitalized in the last six months.

The monthly benefits are payable for up to five years to those who are disabled by a covered accident or up to one year to those disabled by a covered illness. These benefits are payable in addition to income from other sources for up to 70% of the insureds monthly salary.

For more information about the AACN Disability Income Plan, contact Albert H. Wohlers & Co., 1440 N. Northwest Highway, Park Ridge, IL 60068-1400; phone, (800) 503-9230; e-mail, cusv@ahw.com.


Currents

Nurse of the Year Awards
Romac HealthCare is accepting nominations for 1999 Nurse of the Year awards. Two awards will be presented, one to an RN and one to a licensed practical or vocational nurse. The awards are cosponsored by Briggs Corporation and the American Board of Quality Assurance and Utilization Review Physicians. The deadline to apply for either of these awards is August 13, 1999. For more information, visit the Romac Web site at www.romac.com; call toll free (877) 687-7309; or e-mail nurse-award@romac.com.

Information printed in “Currents” is provided as a service to interested readers and does not imply endorsement by AACN or AACN Certification Corporation.

AACN Unveils Revised Resource Catalog

AACN is unveiling a revised Resource Catalog this month. To request a copy, call (800) 899-AACN (2226) or e-mail info@aacn.org. The catalog is also available in our online bookstore at http://www.aacn.org.

This new version of the catalog includes many new products and prices, plus monthly specials that you won't want to miss.

In addition, in honor of AACN’s National Teaching Institute,™ National Nurses Week and National Critical Care Awareness and Recognition Month, we are making a VERY limited time special offer. We will waive shipping and handling fees on any AACN Resource Catalog orders received between May 14 and May 21, 1999. To take advantage of this special offer, you can place an order online, phone in your order, fax in your order, or make sure that your mailed order bears a U.S. postmark date between May 14 and May 21, 1999.

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