AACN News—April 2001—Association News

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Vol. 18, No. 4, APRIL 2001


Choosing Future Leaders Is an Awesome Experience—and Responsibility!

By Mary Bryant, RN, MSN, CCRN
Marla J. De Jong, RN, MS, CCNS, CCRN, CEN
and Janet F. Mulroy, RN, MSN, CCRN
Members, AACN Nominating Committee

AACN is committed to making the right decisions to ensure that the association continues to succeed now and in the future. The magnitude of that commitment to integrity and quality is manifested in the annual nomination process.

As the three members elected directly to the AACN Nominating Committee by the membership at large for 2000-01, we are anxious to share with you how this process works. In doing so, we hope to convince you to do two things:

1. Vote for candidates presented on the 2001-02 ballot you should have received in March 2001. The wonderful people who have the courage and tenacity to complete the nomination process
deserve your consideration by participating in the election process. The deadline to cast your vote is April 20, 2001. Members now have two ways to vote—either by returning the paper

ballot or completing the process online at http://www.aacn.org.
2. Nominate yourself or a colleague for the 2002-03 ballot for the AACN Board of Directors, AACN Nominating Committee or AACN Certification Corporation Board of Directors. The
deadline to submit nominations is June 15, 2001.


To explain the nominating process, we must begin with the structure of AACN as a volunteer organization. All activities of the organization are centered on the core mission, vision and values of AACN. The individual traits or behaviors that drive the real work of the organization, in harmony with its mission, vision and values, are described in the AACN Leadership Framework. The Leadership Framework document accompanies the Call for Nominations online at http://www.aacn.org Click on “Membership,” then “Volunteer Opportunities.” This document can also be obtained via Fax on Demand at (800) 222-6329. Request Document #1073.

The Nominating Committee structure for our volunteer organization is unique in that three members, who are elected from the association’s general membership, work side by side with representatives from both the AACN Board of Directors and the AACN Certification Corporation Boards of Directors. Immediate Past President Anne W. Wojner, RN, MSN, CCRN, chaired the committee for 2000-01. Other members were AACN board members Connie Barden, RN, MSN, CCNS, CCRN, Margaret M. Ecklund, RN, MS, CCRN, CS, and Jessica P. Palmer, RN, MSN. Representing the AACN Certification Corporation were immediate Past Chair Kimmith M. Jones, RN, MS, CCRN, Secretary/Treasurer Jan Foster, RN, MS, CCRN, and Consumer Representative Joan O’Sullivan.

This committee came together for a weekend to receive a thorough orientation to the awesome responsibilities of the group. During this meeting, AACN’s mission, vision and values, along with the Leadership Framework, are emphasized as the foundation for all work done by the organization. This foundation is applied to the selection of candidates for all leadership positions.
Following is a summary of the steps that the Nominating Committee followed:

Nominations Review
Nominations are received from a variety of sources, including past and present AACN leaders, as well as self-nominations. Each nominee then receives a packet containing questions to answer in making a formal application to the committee. This packet allows each nominee to describe his or her qualities and experiences with AACN. In addition, the nominees complete several candid, “soul searching” questions about their ability to “live and breathe” the mission, vision and values of AACN while representing the organization. They are also asked to describe their own strengths and areas for improvement and to write a short essay on their vision for the future of critical care nursing. This thorough self-assessment provides significant information about each individual to the committee. In completing this packet, nominees are demonstrating a true commitment to AACN and the courage to place themselves in the pool of potential leaders for the organization.

Telephone Interviews
Phone interviews with each nominee are completed, using a standardized list of questions. Nominees are given the opportunity to expand upon the leadership and ambassador skills they possess and to describe their passion for critical care nursing. Transcripts of the phone interviews, which are taped, are distributed among all members of the Nominating Committee. In this way, all committee members hear the full responses to interview questions.

Reference Letters
Letters of reference on these prospective candidates are solicited from a number of sources, who provide feedback to evaluate the leadership abilities and ambassador skills of the individual nominees. These letters become the third tool used in the screening process.

Leadership Evaluation
Using these tools, the committee evaluates each nominee within the AACN Leadership Framework. Examples of behaviors that the committee is looking for are:
• Successful written communication skills
• Effective oral communication skills
• Examples of ability to handle conflict
• Previous successes in leading a group
• Demonstrated ability to negotiate and to achieve consensus
• Awareness of the mission, vision and values of AACN
• Willingness to serve AACN and to represent the mission, vision and values of AACN
• Willingness to adhere to the fiscal responsibilities of leadership in AACN

Candidate Selection
All candidates, regardless of the position for which they are applying, are evaluated by the same criteria. Once the pool of prospective candidates is chosen, the nominees are divided into their areas of interest. A separate ballot is selected for AACN and for AACN Certification Corporation. The nominees who have indicated they are willing to serve in more than one role are selected for the ballots, according to which role is the best match for their talents and the needs of the organization at the time.

Serving on the Nominating Committee is demanding, but rewarding work. We would describe it as “one of the most difficult assignments that you will ever love.” We were extremely honored this year to have such an outstanding pool of candidates from which to choose. We were awed by the stories shared of AACN members living the vision of critical care nursing across our country. We were inspired by the examples of leadership at both the local and national levels that are improving the opportunities for critical care nurses everywhere! Serving in this capacity is also a humbling experience. We felt lucky to have been chosen to serve.

What does this all mean for you? We need you to nominate yourself and others in your circle of influence for the 2002-2003 ballots. We also need you to take the time to vote! Carefully read the descriptions about each candidate, which are contained in the ballot booklets you received, and make selections that will ensure the success of AACN well into the future. We learned from the national presidential elections last fall that one vote can truly make a difference. Yours can, too.

Take Time to Relax During the NTI: Enjoy the Best of Sunny Southern California

AACN’s National Teaching Institute™ and Critical Care Exposition isn’t all work and no play. In fact, there are plenty of opportunities for NTI 2001 participants to take a break, relax and enjoy the sights and sounds of sunny Southern California.

Scheduled for May 19 through 24, 2001, in Anaheim, Calif., the NTI is set amid what is now referred to as the “new Anaheim,” a Disney-anchored resort area that is generating excitement among natives and tourists alike. This 1,100-acre garden district links the Disneyland Resort and the Anaheim Convention Center via pedestrian-friendly routes lined with hotels, shops, restaurants and entertainment venues. In fact, NTI participants could spend their entire leisure time in just this area and not run out of things to do.

However, the Southern California area is laden with attractions from the Mexican border to Los Angeles. You can visit these on your own or register for organized tours offered in connection with the NTI.

Visit the new Getty Center and its culturally rich art galleries. Or, take the “Best of L.A.” tour of Hollywood, Beverly Hills and Santa Monica. Enjoy Universal Studios Hollywood, the world’s largest, working movie and television studio, or see the Queen Mary and Long Beach Aquarium. Head south to San Diego and Tijuana or delve into some California history in San Juan Capistrano and Laguna Beach. Take the Newport Harbor cruise or sail to Catalina Island.

These are just a few of the many fun and interesting side trips you and your friends or family can take advantage of during your NTI stay. There are also Sea World, the San Diego Zoo and Wild Animal Park, or you might want to take a leisurely drive up the coast to Malibu and Santa Barbara.

For more information about or to register for NTI 2001, call (800) 899-AACN (2226), or visit the NTI Web site.

What’s New at the NTI

Although AACN’s National Teaching Institute™ and Critical Care Exposition continues to offer the long-standing quality and depth of programs, new features are continually being added to enhance the experience for the thousands of critical care nurses in attendance.

What’s new at NTI 2001? How about a chance to win a new car or bid on items in a silent auction? Maybe you are interested in pet therapy. If you are certified in critical care, would you like a place to relax and chat with other certified nurses? These are just some of the additions that are planned.

Both the silent auction and the drawing for a 2001 Hyundai Santa Fe sport utility vehicle are tied to fund-raising to benefit the AACN scholarship fund.

A pet therapy area where participants can learn more about this complementary therapy will be part of the Critical Care Exposition.

And, the Certification Oasis Lounge, sponsored by Clarian Health, is being set aside to accommodate the special needs and interests of certified nurses.


April 20 Is Deadline to Vote for AACN Board and Nominating Committee Candidates for FY02

Noon, April 20, 2001, is the deadline to vote for candidates for the FY02 AACN Board of Directors and AACN Nominating Committee.

Ballots, as well as information about the candidates, were mailed to all active AACN members. If you did not receive a ballot, call 800-899-AACN (2226).

In addition to returning the traditional paper ballot, you now have the option of casting your vote online via the AACN Web site at http://www.aacn.org. Click on the “Vote” icon and follow the instructions.

To use the online voting process, you must have the paper ballot you received. You will need both your AACN membership number and your election validation number, both of which are printed on the ballot you receive.


Following are the FY02 candidates

AACN Board of Directors
President-Elect
1-Year Term
Connie Barden, RN, MSN, CCNS, CCRN
Miami, Fla.

Director
3-Year Term
(Vote for 3)
Elizabeth J. Bridges, RN, PhD, CCNS
San Antonio, Tex.

M. Dave Hanson, RN, BSN, CCRN, EMT-P
Dallas, Tex.

Deborah B. Laughon, RN, BSN, MS, CCRN
Lakeland, Fla.

Carol Ann Puz, RN, BSN, CCRN
Pittsburgh, Pa.

Mary Fran Tracy, RN, PhD, CCRN
Eagan, Minn.

M. Terese Verklan, RN, PhD, CCNS
Missouri City, Tex.

Susan Yeager, RN, MS, CCRN
Dublin, Ohio

The newly elected members of the AACN Board of Directors will take office July 1, 2001. They will join incoming FY02 President Michael L. Williams, RN, MSN, CCRN, and returning directors Debbie Brinker, RN, MS, CCNS, CCRN, Bertie Chuong, RN, MS, CCRN, Dorrie K. Fontaine, RN, DNSc, FAAN, Lori D. Hendrickx, RN, EdD, CCRN, Rebecca E. Long, RN, MS, CNS, Kathleen McCauley, RN, PhD, CS, FAAN, and Jessica P. Palmer, RN, MSN.

Completing their terms on the AACN Board of Directors are FY01 President Denise Thornby, RN, MS, and Directors Margaret M. Ecklund, RN, MS, CCRN, CS, Pamela T. Rudisill, RN, MSN, CCRN, ACNP, and Fay M. Wright, RN, MS, CCRN, ACNP.

AACN Nominating Committee
1-Year Term
(Vote for 3)

Kathryn (Kathi) H. Barnes, RN, MS, CNS, CCNS, CCRN
El Paso, Tex.

Sandra K. Cunningham, RN, MS, CCNS, CCRN, CS
Stevensville, Mich.

Michael W. Day, RN, MSN, CCRN
Spokane, Wash.

Mary E. Holtschneider, RN, BSN, MPA
Durham, N.C.

Linda M. Tamburri, RNC, MS, CCRN, CNS
Long Valley, N.J.

Connie Sobon Sensor, RN, BSN, CCRN
Scotch Plains, N.J.

Charlene (Charlie) Winters, RN, DNSc, CS
Missoula, Mont.


Annual Meeting Set During NTI


AACN’s annual membership meeting is scheduled from noon to 1 p.m. on May 22, 2001, at the Anaheim Convention, Center, Anaheim, Calif.

Members attending will have the opportunity to meet and hear from AACN President Denise Thornby, RN, MS, and other members of the AACN Board of Directors. They will not only learn about AACN’s strategic plan for the future, but also hear reports on the work carried out by various national committees.

A fun feature that is being added to the annual meeting this year is drawings for prizes. Members who are present at the meeting will have the chance to win.


On the Agenda


Following is a report by AACN board member Dorrie Fontaine, RN, DNSc, FAAN, on discussions and actions that took place during the AACN Board of Directors Feb. 27, 2001, conference call.

Agenda Item: SCCM Meeting
AACN President Denise Thornby, RN, MS, reported on the recent Society of Critical Care Medicine (SCCM) meeting in San Francisco, Calif. AACN leadership representatives traditionally attend this meeting as part of the many collaborative partnerships with which AACN is involved.

Although this type of multidisciplinary affiliation is important as a positive and constructive approach to addressing issues facing healthcare, AACN is disappointed that SCCM chose to join other physician organizations in opposing removal of the federal requirement for a physician to supervise anesthesia administration in favor of allowing individual states and hospitals to determine the best way to deliver this care. Based on outcomes data, AACN and the nurse members of SCCM supported the removal of federal requirements and were unaware that SCCM was taking this position. Where state law permits, the new rule allows certified registered nurse anesthetists (CRNAs) to practice without physician supervision. The board agreed to send a letter to SCCM expressing disappointment about its position on this issue, as well as the fact that SCCM is advocating for a set nurse-to-patient staffing ratio in the ICU without consulting the expertise of its nursing partner.

Note: AACN has adopted a position statement titled “Maintaining Patient-Focused Care in an Environment of Nursing Staff Shortages and Financial Constraints.” For a copy of this statement, visit the “Practice” area of the AACN Web site at http://www.aacn.org or call Fax on Demand at (800) 222-6329. Request Document #2001. In addition, a comprehensive resource that addresses staffing issues is available from AACN. Titled “Staffing Blueprint: Constructing your Staffing Solutions,” this resource can be ordered by calling (800) 899-2226 or through the Bookstore online at http://www.aacn.org. Reference Item #300117. Price is $26 for members ($35 for nonmembers).

Agenda Item: Strategic Planning
In advance of the SCCM meeting, members of the AACN leadership team participated in a strategic planning meeting, Although the association’s long-range strategic plan is reviewed and updated each year, it is monitored on an ongoing basis to ensure that it reflects changes in the healthcare environment and that the association is positioned to be proactive on issues as they arise. AACN President-elect Michael L. Williams, RN, MSN, CCRN, reported on this meeting to the full board, noting that ways AACN can help address the nursing shortage and prepare for leadership succession were the main topics of discussion.

Agenda Item: AACN Certification Corporation Board of Directors
The board approved the following slate of candidates to serve on the AACN Certification Corporation Board of Directors: chair-elect (one-year term)—Margaret Ecklund, RN, MS, CCRN, CS; director (two-year term)—Beth A. Glassford, RN, MSHA, CHE; consumer representatives (two-year-terms)—Mindy A. Hecker and Thomas L. Hickey. These terms begin July 1, 2001.

The selection of candidates for the AACN Certification Corporation board is part of AACN’s annual Call for Nominations. However, once the nominations are received and screened, Nominating Committee members representing the corporation follow a separate path in evaluating and interviewing these nominees. The process differs from that for the AACN Board of Directors and the AACN Nominating Committee, because AACN members at large do not vote on candidates for the AACN Certification Board of Directors. However, because AACN is the sole member of AACN Certification Corporation, the AACN board is required to formally approve corporation candidates. Two members of the AACN board also are appointed to serve on the AACN Certification Corporation board.

The AACN Certification Corporation board is an excellent opportunity for people, especially those who are passionate about certification, to apply to serve at the national level.

Agenda Item: Circle of Excellence Awards
The board received nominations for and selected recipients of the Circle of Excellence Ross Products-AACN Pioneering Spirit Award and the Marguerite Rodgers Kinney Award for a Distinguished Career for 2001. Cosponsored by the Ross Products Division of Abbott Laboratories, the Pioneering Spirit Award recognizes an individual or group that has made far-reaching contributions in influencing the direction of acute and critical care nursing. The Marguerite Rodgers Kinney Award for a Distinguished Career recognizes individuals at the time of their retirement for a distinguished career and its significant impact on fulfilling AACN’s mission and vision.

Although most Circle of Excellence award recipients are selected by the Chapter and Membership Awards Review Panel, nominations for these as well as Honorary Member and Lifetime Member awards are submitted directly to the AACN Board of Directors.

Recipients of Circle of Excellence awards for 2001 will be announced in the May 2001 issue of AACN News, along with the Call for Nominations for awards for 2002.

Agenda Item: Board Terminology
To facilitate discussion and clarify the expectations associated with different types of business conducted by the board, the directors reviewed the terminology applied to agenda items and defined a standardized set of reference terms.

Following is an explanation of this agenda terminology:
• Present and approve items require a decision and are accompanied by formal proposals. Included are initiatives, governance-level policies and budgets. On this agenda, the AACN
Certification Corporation board candidate slate and the Circle of Excellence Award nominations were present and approve items.

• Present and discuss agenda items are part of the broader, ongoing policy level discussions that take place prior to an initiative or issue being brought to the board for a decision. Examples
of these types of agenda items are questions raised by work groups or other volunteer committees.

• Consent agenda items are those that require action, but that do not need additional discussion for understanding or consensus.
• Information only items are intended to inform or update the board. Examples of this type of item include reports on major liaison activities with political implications and reports of chapter
activities or issues. On this agenda, the SCCM meeting and Strategic Planning Committee meeting updates were information only items.


Pulling on the diversified expertise of its elected membership, the board thoughtfully discusses and considers all aspects of issues related to the needs of members. Every viewpoint is heard.


Influencing Practice: Make Building Leadership Skills a Journey


Editor’s note: The following feature is dedicated to providing information and tools to help you influence your practice environment.

By Michael L. Williams, RN, MSN, CCRN
Member, Leadership Development Workgroup
and AACN President-Elect

Being a leader is easy, when times are easy. Being a leader is much harder, when times are tough. And, times are particularly challenging for critical care nursing right now.
Individuals skilled as leaders in the past (“old leaders”) may not continue to be relevant leaders. In fact, the development of leadership skills is a continuing journey where a person is always learning, always developing and always evolving as a leader. This journey never ends. Instead, successful leaders know that lifelong learning of leadership skills is crucial.

AACN has long been an advocate for leadership development and in providing leadership development opportunities for its members. The critical care environment is fertile ground for honing one’s leadership skills. The Leadership Institute, Leadership Connections and Center for Leadership Excellence are examples of AACN’s commitment to helping its members develop as leaders. Many other organizational activities also allow members to develop as leaders. For example, serving on an AACN committee or in a chapter leadership role can build the skills needed to lead effectively. Leadership skill development is always needed, not only for the “new” leader, but also for the “old” leader!

What leadership skills are key in this new century? AACN has chosen to define leadership as “the ability to influence others.” In fact, AACN’s Leadership Framework is a template that can be used by anyone wanting to develop as a leader. However, this framework must be interpreted, massaged and finagled to meet the particular needs of each individual. Although the AACN Leadership Framework is a written document, it should never be viewed as static and unchanging. Instead, as the critical care and healthcare environment change dynamically, the skills and the relative importance of an individual skill changes. Thus, the framework must be viewed and used as a dynamic “template,” instead of as
a recipe.

The Leadership Framework document is available online at http://www.aacn.org. Click on “Membership,” then “Volunteer Opportunities.” This document can also be obtained via Fax on Demand at (800) 222-6329. Request Document #1073.

For the past few years, the AACN Leadership Development Workgroup has analyzed this Leadership Framework, along with AACN initiatives that offer leadership opportunities, feedback from members and current leaders in critical care nursing, and a survey of members at the 2000 NTI. In shaping a focus for leadership skill-building, four primary skills have been identified as key—self-awareness, conflict resolution, navigating change and dialogue skills. The group plans to develop tools and resources to assist
members as key influencers. (See list below.)

As you continue your leadership journey, use AACN’s “key leadership skills” and AACN’s Leadership Framework as your map and compass. Take advantage of these tools to build and develop yourself as a current and future leader.

Finding a “leadership coach” can also be helpful. This person can help to reveal your hidden influencing skills and mold them to best serve you and others for whom you provide care. Make certain that your coach is suited to you and is someone you trust to provide honest feedback in a constructive, growth-enhancing way. The members of the AACN Board of Directors use the philosophy of “grow-grow” or lifelong learning, seeking constant feedback so that we can blossom and share our influence with others.


Definitions of Key Influencing Skills

• Self-awareness is personal wisdom—the understanding of one’s values, beliefs and attitudes, and the impact they have on one’s responses and behaviors.

• Dialogue is a process to encourage the free flow of ideas within a group that seeks to discover insights that are not attainable individually to uncover a base of shared meaning.

ª Navigating change involves a deliberate process to respond to an internal and external issue or problem. It means having the skills and abilities to develop a plan to respond to that
issue or problem.


• Conflict management is working through opposing views among groups of individuals in order to reach a common goal.Leadership Lessons Learned: Leadership Competencies Are Found
in Everyday Skills and Activities


Leadership Lessons Learned: Leadership Competencies Are Found in Everyday Skills and Activities

Hendrickx

Editor’s note: Following is the seventh in a series of articles by members of the AACN Board of Directors on leadership lessons they have learned from their experiences.

By Lori Hendrickx, RN, EdD, CCRN

Much has been written about the types of skills and behaviors that lead to effective leadership. In fact, AACN has developed a leadership framework to identify key competencies that are recommended for potential leaders in the organization. In addition, the growing number of leadership topics presented at conferences indicates that leadership development is an important concept in healthcare.

When I became a member of the AACN Board of Directors, I also became aware that I used leadership skills in my work and home environments that were transferable to my role on the board. Since joining the board last year, I have continued to monitor and refine these skills.

At the end of February, I was reminded of the behaviors that I use frequently at home, which translate to my leadership roles. I had awakened to 10 inches of snow that had fallen overnight, adding to the nearly 70 inches that had already fallen this winter in my part of South Dakota. Because shoveling snow had not been part of our plans that morning, I realized that to get out of our driveway, we would have to be flexible and alter our routine to meet the immediate needs of our “organization” (aka my family). Based on past experiences, I knew we had learned to be prepared for changes in routine and had the necessary equipment and manpower needed to deal with the unexpected.

Although we had the manpower necessary, I clearly recognized that I would need to use a fairly direct style of delegation to rouse my children and husband and complete the task ahead of us. I am not autocratic by nature. However, as a leader, I knew I would once again need to be flexible. As we began the process of clearing the driveway, it was evident that we had developed a shared vision, which is a key characteristic of a successful leadership team.

As the work continued I realized several other of my leadership competencies are transferable. I also became aware that there was clearly diversity in the styles of each team member’s approach. While my youngest son tended to push snow away, another emptied bigger scoops onto the already high piles in the yard. I found that my smaller shovel was helpful in carrying scoops to the lower piles, where I didn’t have to throw heavy snow as high. My husband’s approach of paying attention to detail dictated that he follow us and clean up the snow that fell from our shovels. Despite the variety of approaches, we all met our goals and cleaned our respective areas.

After two hours, we had nearly completed our task and the perseverance of the group was evident. Each team member had been motivated to accomplish a common goal and the collective action resulted in a more efficient, timely achievement of the outcome. After the snow was removed, I faced my tired team and asked: Now wasn't that great exercise? As they groaned and headed for the house, I realized that optimism in the face of pessimism had been another useful competency.

My final thought about the skills that were transferable that day was that a good leader maintains hope for the future and for the continued success of the organization. I am confident that spring will bring not only a new set of challenges, but also a sense of accomplishment and satisfaction in knowing that, by combining strong leadership skills with a quality team, numerous obstacles were overcome in the tasks we faced this winter.

Lori Hendrickx is associate professor with the College of Nursing at South Dakota State University, Brookings, S.D.


Silent Auction at NTI to Benefit Scholarships

Shhh! This event is silent, though we don’t want to keep it quiet. A silent auction to benefit the AACN scholarship fund will be held at the National Teaching Institute™ and Critical Care Exposition in May 2001 in Anaheim, Calif.

AACN currently awards $150,000 in scholarships each year, including academic scholarships and continuing education scholarships.

Auction items will be displayed in the NTI Resource Center. Satellite displays will travel to special events, including Network Night, the Advanced Practice Institute Reception and the President’s Reception.

Bidding, which is done by writing offers on a bid sheet alongside each item, begins May 19 and closes on May 23. Winning bids will be announced on May 24. NTI registrants will receive the auction catalog in advance. Ask a colleague who is attending the NTI to share the catalog and make bids on your behalf.

Donations of auction items are invited in a variety of categories—art and photography; educational conference registrations and products; personal electronics; computer hardware and software; cosmetics or spa services; books; sports equipment and clothing; entertainment; retail gift certificates; restaurant gift certificates; travel.

If you would like to donate a gift to the silent auction or have questions, contact Darval Bonelli at (800) 394-5995, ext. 531; e-mail, darval.bonelli@aacn.org.


Partners in Healing: Celebrate Critical Care Awareness and Recognition

May is National Critical Care Awareness & Recognition Month, a time to focus on and celebrate the important care you provide for critically ill patients and their families.
“Critical Care—Partners in Healing” is the theme of the 2001 celebration, which is sponsored by the Foundation for Critical Care to recognize the collaborative contributions of nurses, physicians and other healthcare providers. AACN joins the Foundation for Critical Care as a strategic partner in sponsoring this annual celebration.

The “Critical Care—Partners in Healing” logo has been incorporated into an array of awareness and recognition products, which can be used to enhance the visibility of critical care and to highlight the profession. These products can also be customized with your institution or chapter logo.
Critical care nurses continue to develop innovative ways to increase awareness of critical illness and recognize the healing that interdisciplinary partnerships bring to their communities. Unit displays and daylong, hospital-wide health fairs are only a few of the celebration activities. Appreciation gifts bearing the year’s logo are an affordable way to recognize each member of the healthcare team.

To request the 2001 National Critical Care Awareness & Recognition Month product guide, or for more information about this celebration, call the Foundation for Critical Care at (800) 906-3366.

Annual Design Citation to Honor Pediatric Unit

Aug. 15, 2001, is the deadline to submit applications for the ICU Design Citation. This year’s award will be presented to a pediatric critical care unit, where functional ICU design has been combined with the humanitarian delivery of critical care.

The ICU Design Citation, which is part of AACN’s Circle of Excellence recognition program, is cosponsored by AACN, the Society of Critical Care Medicine (SCCM) and the American Institute of Architects Academy on Architecture for Health. Recipients are awarded $500 by each of the sponsoring organizations, as well as registration for one person to attend each of the organization’s annual meetings or conferences. In addition, a plaque is presented to display in the unit and to the architects.

Materials submitted by recipients of this award, as well as those of runner-up entries, have been compiled into the ICU Design Video and Booklet. Each year, additional projects are added.

The notebook and video packages are valuable tools for ICU design teams looking for ideas ranging from space planning to details. Critical Care Unit Design & Furnishing is a guidebook that helps team members make an optimal contribution from conception of the design to its fruition. These products are available by calling SCCM at (714) 282-6000.

Applications for the ICU Design Citation for 2001 can be obtained by calling Debby Clarke at (800) 394-5995 ext. 371.


Write a Winning Cover Letter!

Editor’s note: Following is another in a series of articles by Career Development Services on ways AACN members can maximize their career strategies and build their portfolios.

By Rosemary Westra, RNC, MS
Manager, Continuing Education
and Career Development Services

Once you have completed an effective resume and are ready to submit it, don’t forget to include a cover letter. A well-written cover letter not only identifies the position for which you are applying, but also serves as a vehicle for conveying your enthusiasm for the position and the skills you have to offer. Following are some tips to ensure that your cover letter helps to present a professional package:
• Write a cover letter that is no more than one page in length, and printed on the same quality of paper as the resume. A concise cover letter demonstrates that you are focused, and also displays your communication skills.
• Address the letter to a specific person, never to a facility or department. If you are unsure about the contact person, call the facility to obtain this information.
• State the position for which you are applying exactly as stated in the ad for the position.
• Explain where you learned about the position, such as through a journal ad or via the Internet.
• Briefly describe your past experience and accomplishments and why these experiences make you an ideal candidate for this position. Do not restate what you have presented in your resume. Instead, highlight the accomplishments that make you the ideal candidate for a position.
• Include contact information and convenient times to contact you.
• Proofread, proofread, proofread, not only for spelling errors, but for grammatical errors as well. Also, ask a friend or colleague to proofread your cover letter.

You Asked
Q:If I submit my resume electronically, should I include a cover letter?
San Diego, Calif.

A:Yes, a cover letter should be included with resumes submitted electronically. Although you may put the position title on the “subject” line, such information may get lost when the cover letter is printed out. So, be sure to include the title of the position for which you’re applying in the first paragraph of the letter, and preferably the first sentence.

Q:Should I mention in a cover letter that a colleague recommended that I submit my resume for a particular position.
Portland, Maine

A:Absolutely! Nothing speaks louder for a candidate than a personal endorsement from a colleague who is currently employed at a facility.

CDS welcomes your questions about career development. E-mail your questions to westra@travcorps.com. Selected questions will be answered in future columns.

Public Policy Update

Nursing Shortage
Hearings are underway in Congress to examine why the United States is experiencing an acute shortage of registered nurses. Sens. James M. Jeffords (R-Vt.) and John F. Kerry (D-Mass.) announced that they plan to propose legislation aimed at bolstering the nursing ranks. Called the Nursing Reinvestment Act, the bill would provide funding for education and mid-career training. According to Kerry, the proposal would include an outreach campaign to attract young people into the field, as well as financial support for institutions that provide advanced training for nurses in specialty fields.

A new federal survey on the growing shortage of nurses portrays a stagnant workforce with a dramatic slowdown in nursing school enrollments. Since 1996, the total number of nurses has increased barely 5%, down from a 14% increase between 1992 and 1996. Since 1983, the number of nurses under the age of 30 has declined by about 41%. The average age of nurses is now over 45, which means that many nurses will retire just as baby boomers hit Medicare age.

According to an analysis released by the American Healthcare Association (AHCA), demand for nursing services in the U.S. will far outstrip the supply, particularly among the nation’s nursing homes. As a result, there will not be enough nurses to maintain even current staffing levels at skilled nursing facilities. The staffing shortage could, in turn, cause a problem of access to care, particularly for the elderly, the report states. The report follows continuing debate on Capitol Hill over establishing minimum staffing ratios for nursing homes.

The federal government will need to step in and do more to alleviate a national nursing shortage, said Sen. Tim Hutchinson (R-Ark.), who led a Senate Health, Education, Labor and Pensions Subcommittee on Aging hearing on the issue in February 2001. Presiding with him was Sen. Barbara Mikulski (D-Md.).
The Senate hearing featured testimony by Kathy Hall, RN, MS, executive director of the Maryland Nurses Association; Dianne Anderson, RN, MS, president of the American Organization of Nurse Executives; Georges C. Benjamin, MD, secretary, Maryland Department of Health and Mental Hygiene; Linda Hodges, dean, College of Nursing, University of Arkansas for Medical Sciences; and Brandon Melton of Denver, Colo., on behalf of the American Hospital Association.

Hutchinson said he would work with various nursing groups in formulating proposed legislation to reverse that trend. Among the possibilities are a greater forgiveness of student loans and more financial incentives for those who teach nursing skills. Members of the senator’s staff said his efforts to increase the number of nurses are getting strong interest from Democrats who have a similar goal. Sen. Hillary Clinton (D-NY), who noted that the nursing shortage is particularly acute in New York State, discussed issues related to the shortage, whistleblower protections, stagnant wage growth and mandatory overtime. “There is research that demonstrates … that nursing care determines patient outcomes,” Clinton said. For more information on the testimony, visit www.senate.gov/~labor/index.htm.

AACN is committed to making the issue of nurse staffing a national priority and has joined with representatives from the ANA and other specialty nursing organizations in proposing a legislative agenda directed at offering solutions to the shortage.

Health Funding
President Bush has announced he will seek a $2.8 billion increase in funding for the National Institutes of Health (NIH) for the next fiscal year. “We recognize the federal government plays a very important role in researching cures for disease and, therefore, our budget increases the NIH budget for 2002 by $2.8 billion, the largest increase in that department’s history,” the president said at a meeting with Mitch Daniels, director of the Office of Management and Budget. White House spokesman Ari Fleischer said that Bush believes the money will help the NIH do a better job and have more resources to cure and fight diseases.

The President’s 207-page budget plan, called A Blueprint for New Beginnings, also includes recommendations for:
• A reduction to Health Professions’ funding, which provides training grants to institutions—These training grants were created almost 40 years ago, when a physician shortage was looming. To reflect changing priorities, the budget will recommend focusing resources on the Health Professions’ grants that address current health workforce supply challenges, such as the impending nursing shortage and improving diversity in the health professions.
• Reforming the National Health Service Corps (NHSC)—The NHSC management reform will examine the ratio of scholarships to loan repayments, as well as other set-asides, to provide maximum flexibility in placing NHSC providers. The administration will also seek to amend the Health Professional Shortage Area definition to reflect other nonphysician providers practicing in communities, which will enable the NHSC to more accurately define shortage
areas and target placements. To further avoid overlap in the provision of healthcare, HHS will enhance its coordination with immigration programs, including the J-1 and H-1C visa programs, which review applications for foreign healthcare providers practicing in underserved communities. The NHSC initiative will also encourage more healthcare professionals to participate in the NHSC by making scholarship funds tax-free.

• Strengthening the healthcare safety net for those most in need—The budget recommends a $124 million increase for community health centers. This increase is the first installment for a multi-year initiative to increase the number of community health center sites by 1,200.
• Medicare spending for drug costs for seniors and the disabled by $153 billion over the next 10 years, plus an initial $3 billion for fiscal 2001—This spending includes a four-year program to help states subsidize medications for people with the lowest incomes or the highest expenses. The grants would continue until Congress overhauls Medicare to expand drug benefits to all recipients and ensures that the program can handle the 77 million baby boomers expected
to begin their retirements in a decade.

• Increasing access to substance abuse treatment services—This plan seeks to close the treatment gap by providing a $100 million increase for the Substance Abuse and Mental Health Services Administration as part of a broader $111 million initiative.
• Targeting areas of health risk—The budget proposes including approximately $400 million for existing activities for innovative healthcare improvement projects in state and local communities.

Total spending for the major portion of the Health and Human Services Department programs, excluding Medicare and Medicaid, whose funds mostly rise automatically, is proposed at $55.45 billion in fiscal year 2002. This is an increase of about $2.8 billion over this year. With the slated $2.8 billion increase for NIH, other programs as a group in the department would see slightly less money than they did this year.

Nursing Duties vs. Union Eligibility
The U.S. Supreme Court recently heard oral arguments in the appeal of the National Labor Relations Board (NLRB) vs. Kentucky River Community Care, a closely watched labor dispute at a psychiatric facility that could affect institutional providers employing registered nurses. The case, on appeal by the NLRB, involves six nurses who work at one of Kentucky River’s residential psychiatric treatment centers in Pippa Passes, Ky. This is the first time the court has tackled the issue of nurse supervisors since it affirmed a lower-court ruling in 1994 that found nursing home licensed practical nurses to be supervisors because they oversaw nursing assistants.

If the court decides that certain nurses with supervisory functions are ineligible for collective bargaining, the decision could present hospitals and other healthcare employers with new ammunition to defeat union organizing by nurses. If the justices uphold the lower court’s ruling, nurses could be considered supervisors if they direct others in dispensing medicine, serve as the highest-ranking employee in a building, address staff shortages and move employees among units as needed.

These are the same reasons cited by the 6th Circuit Court of Appeals in declaring the nurses ineligible. At small nursing homes and treatment centers, which often have fewer nurses handling numerous tasks, such a ruling could completely exclude nurses from labor unions. In 1999, the 6th Circuit Court ruled that the nurses were, in fact, supervisors who were ineligible to join a proposed collective-bargaining unit at the facility and that supervisors are not protected by the National Labor Relations Act, which gives workers the right to unionize. A central issue in this case is whether nurses use independent judgment or supervisory discretion on the job, that goes beyond their professional judgment in treating and directing the care of patients. Such discretion would make them supervisors because they would be acting in the interest of their employer.
Lawyers are hopeful that the Supreme Court opinion will offer clearer guidance on what duties should be considered independent judgment, enabling the NLRB to better decide who is a supervisor. Some of the broader issues raised by the case are whether the courts should defer to the NLRB in deciding supervisory status and whether the NLRB or the employer has the burden of proving that an employee can be excluded from a bargaining unit. In the case before the court, the NLRB has ruled that the psychiatric center’s nurses are not supervisors and, therefore, are eligible for collective bargaining. The employer, Kentucky River, refused to bargain with the union, and when the NLRB ordered the company to do so, it appealed to the 6th Circuit Court.

Injury Prevention
The American Hospital Association (AHA) has developed a sharps injury prevention guide that provides information about how to comply with federal needlestick safety regulations issued by the Occupational Safety and Health Administration (OSHA).

Two key areas of the new law are involvement of frontline workers in the identification and evaluation of safe needle devices and a requirement for a log of sharps injuries in healthcare settings. By April 18, 2001, hospitals and health systems will be required to solicit the front-line workers’ input on sharps devices.

To help its members comply with the new log requirement, AHA has designed a model sharps injury log that can be modified for individual facility use. The log requests information regarding the sharps device used, location and severity of the injury, and the procedure in which the injury occurred. The advisory and guide are available in the members’ section of the AHA Sharps Safety site at www.aha.org/needle.

Patient Safety
The Institute of Medicine (IOM) has released the long-awaited follow-up to its 1999 report on medical errors. An IOM notice previewing the report, titled “Crossing the Quality Chasm: A New System for the 21st Century,” states that research on the quality of care reveals a picture of a system that frequently falls short in its ability to translate clinical knowledge and technology into practice. As currently structured, the healthcare system cannot consistently deliver effective care in a safe, timely and efficient manner, the report continues. The IOM proposes a bold overhaul of the U.S. healthcare system and a strategy to address serious shortcomings in the quality of healthcare available to Americans.

To read the report, visit http://www.nap.edu/books/0309072808/html/. For more information on Medical errors and Patient Safety visit AAHRQ at www.ahcpr.gov/qual/errorsix.htm.

Pain Policy
The University of Wisconsin Pain & Policy Studies Group has announced the availability of a new pain policy resource, titled the “Annual Review of State Pain Policies 2000.” This review summarizes and comments on each new or amended state statute, regulation and medical board policy affecting pain management that was adopted in the year 2000. It also includes the full text of all the new policies and an appendix containing the Federation of State Medical Boards’ “Model Guidelines for the Use of Controlled Substances for the Treatment of Pain” (Model Guidelines). The annual review is available at .

Men’s Health
Rep. Randy “Duke” Cunningham (R-Calif.) has introduced H.R. 632, the Men’s Health Act of 2001, which would create a federal office of men’s health. Lives would be saved, the bill says, if men, their families and healthcare providers were better educated about detecting male health problems early.
According to the bill, a “silent health crisis” is plaguing men. Life expectancy at birth is six years less for men than for women, according to the National Center for Health Statistics. Each of the top 10 causes of death in the United States kills men at a higher rate. Death rates from heart disease and cancer, the nation’s two main killers, are 1.8 and 1.4 times higher in men.
Men’s health advocates say they would like to see the same kind of health office women have already had for a decade. The federal Office on Women’s Health, established in 1991 under the Secretary of Health and Human Services, spent most of its $15.5 million budget last year on public health education efforts, according to Wanda Jones, the deputy assistant secretary for women’s health who heads the office. Some women’s health advocates, including Jones, support a similar office for men. Such an office, she says, would “help men overcome a socialized resistance to outreach and education.” Others, including Rep. Connie Morella (R-Md.), say there’s no need for a men’s office because federal health research and policy already focus disproportionately on men.
Cunningham’s bill, cosponsored by 27 Democrats and 25 Republicans, awaits action in the House Energy and Commerce Committee, which has jurisdiction over public health issues.

Cell Phones
According to a study released by the Mayo Clinic, cell phones cause limited interference in the operation of medical monitoring devices. The laboratory study involved external cardiopulmonary monitoring devices and cellular phones. Clinic researchers reported that in 54.7% of the tests performed, some degree of interference occurred. In 7.4% of the tests performed clinically, important interference generally occurred when the phones were placed within 1 to 1.5 meters of the tested device. Cell phone-related interference was detected in ECG tracings displayed on monitors and in the operation of a mechanical ventilator.

In an editorial accompanying the study, clinic researchers noted the limitations of the study and acknowledged that additional testing of such phone use in hospitals is needed to determine to what degree the laboratory findings can be applied to a clinical environment. The researchers recommended that cell phone use in the vicinity of medical electronic devices be restricted, especially in areas where patients are particularly vulnerable, such as intensive care units and operating rooms, until there is reasonable proof of safety. The study and editorial were published in the Mayo Clinic Proceedings, January 2001, Vol 76, No. 1. To read the study visit: .


Want to Be Published? Be a Wyeth-Ayerst Fellow

Do you want to be published? Are you interested in developing your professional leadership skills? The AACN Wyeth-Ayerst Nursing Fellows Program offers these opportunities.

This nine-month fellowship is sponsored by Wyeth-Ayerst Laboratories in collaboration with AACN and the American Journal of Nursing (AJN).It provides acute and critical care nurses who want to serve as either mentors or fellows with an opportunity for professional leadership development with a clinical focus.
Through the program each fellow is guided by a mentor in preparing a personal fellowship plan, which includes completing an individualized project, attending AACN’s National Teaching Institute™ and Critical Care Exposition and developing a manuscript that is published in a supplement to the AJN. Since its inception in 1992, 209 mentors and fellows have participated in this program.
Mentors are experienced acute and critical care nurses who are help guide the fellows in developing clinical leadership skills, including professional writing. Fellows are acute and critical care nurses, at any level of experience, who have demonstrated clinical leadership potential and are interested in developing their writing skills.

Each pair of mentors and fellows will work together to produce a manuscript on a current cardiopulmonary topic. These will be published in a supplement to the May 2002 issue of AJN and showcased at the NTI in May 2002 in Atlanta, Ga., where mentors and fellows will be honored
at the annual AACN Wyeth-Ayerst convocation ceremony, reception and dinner.

In addition to the recognition that comes with publishing an article in a national nursing journal, fellows will receive registration, travel and lodging for the 2002 NTI. Mentors attending the 2002 NTI will receive complimentary registration and a $500 educational grant.
Applications for the 2001-02 class must be postmarked or faxed by June 22, 2001.

To obtain an application, call (800) 899-2226 or AACN Fax on Demand at (800) 222-6329 and request Document #2005. Applications are also available online at http://www.aacn.org.

For more information, call (800) 394-5995 for AACN Clinical Practice Specialist Kathleen Schrader, RN, DNSc, CEN, at ext. 372, or Research Associate Dolores Curry at ext. 377.

Visit www.aacn.org: Valuable Resources Available Online

Free access to the GenRx, CINAHL and Medline databases is just one of the many benefits that AACN members now enjoy online. As of March 1, 2001, valuable practice and education resources were moved to a “Members Only” area of the AACN Web site at http://www.aacn.org.
Access to this area requires a password, for which AACN members can register online. The process is easy to complete. You will receive your password within 24 hours.

The GenRx medication database is a one-stop resource for powerful technology, unbiased prescribing information, reliable drug interactions and easy-to-understand patient information.

The CINAHL link provides AACN members and direct literature search of the CINAHL database as, well as a journals database and current awareness database.

In addition, AACN members have access to online clinical resources; award, scholarship and grant applications; and an exclusive preview of job postings for one week prior to their being released publicly.

Looking Ahead

April 2001

April 20 Ballots for FY02 AACN Board of Directors and AACN Nominating Committee candidates must be received by noon. In addition to returning paper ballots mailed to members in March 2001, online voting can be completed by visiting the AACN Web site athttp://www.aacn.org. Click on the “Vote” icon.

May 2001

May 1-31 National Critical Care Awareness and Recognition Month. “Critical Care: Partners in Healing” is the theme. To request the 2001 National Critical Care Awareness & Recognition Month product guide, or for more information about this celebration, call the Foundation for Critical Care at (800) 906-3366.

May 1 Deadline to submit proposals for the $5,000 American Nurses Foundation (ANF) grant, sponsored by AACN. For more information, contact ANF at 600 Maryland Ave., SW, Suite 100W, Washington, DC 20024-2571; phone, 202-651-7298; e-mail, anf@ana.org.

May 19-24 National Teaching Institute and Critical Care Exposition, Anaheim, Calif. For more information or to register, call (800) 899-2226 or visit the NTI Web site.

May 22 AACN Annual Meeting, noon to 1 p.m., Anaheim Convention Center.

June 2001

June 15 Deadline to submit nominations for candidates for the AACN Board of Directors, AACN Nominating Committee and AACN Certification Corporation Board of Directors. Forms can be obtained by calling (800) 899-2226 (request Item #1540) or via the AACN Web site at http://www.aacn.org. Click on “Membership,” then “Volunteer Opportunities.”

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