AACN News—February 2001—Association News

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Vol. 18, No. 2, FEBRUARY 2001

Check Out the “Members Only” Web Site Content

The benefits of membership in AACN will soon become even richer, as valuable practice and education resources move behind the scenes into a “Members Only” area of the AACN Web site at http://www.accn.org, out of the purview of nonmembers.

Among the features that will be accessible only to members are the GenRx Medication Database; Cinahl Direct literature search; online clinical resources; award, scholarship and grant applications; and an exclusive preview of job postings for one week prior to their being
released publicly.

In the process of developing the “Members Only” area, AACN also updated and revamped its welcome page to accommodate a new look and improved navigational structure. If you have not visited in a while, take a look and give us your feedback. AACN continually seeks additional ways to respond to member needs and interests.
For an introductory period through Feb. 28, 2001, the “Members Only” area will be open to all visitors. However, starting March 1, 2001, access to this area will require a password. AACN members who have not yet registered for a password are encouraged to do so as soon as possible. The process is easy to complete online. You will receive your password within 24 hours.

If you are not a current AACN member, you may want to consider joining to continue to have access to these online resources, as well as the many other benefits of membership, such as journals and discounts on AACN resources and programs. You can join AACN online or by calling (800) 899-AACN (2226).

March 1 Is Deadline to Apply for National Volunteer Committees

Don’t forget. If you are interested in being appointed to one of AACN’s or AACN Certification Corporation’s national volunteer committees, the deadline to apply is March 1, 2001. Terms begin July 1, 2001. For more information, call (800) 394-5995, ext. 415, or visit the AACN Web site at http://www.accn.org.

Work Group Seeks Balance in NTI Program Selection

Participants at AACN’s National Teaching Institute™ in May 2001 will benefit from the hard work of a group of volunteers who spent an intensive two days combing through more than 700 speaker proposal abstracts submitted for presentation at the NTI.

Comprised of AACN members representing a range of practice focuses, the NTI Work Group carefully evaluated not only the timeliness and quality of content proposed, but also the balance of programming opportunities to accommodate the varied needs of critical care nurses who attend the NTI. In addition to sessions for the Advanced Practice Institute (API), which will enter its third year in conjunction with NTI 2001, the work group chose more than 200 speakers to present topics that address issues encompassing adult critical care, continuum of care, leadership, neonatal, pediatrics and trauma.

The work group met in July 2000 in Southern California, where the NTI and Critical Care Exposition is scheduled for May 19 through 24 in Anaheim, Calif. Members of the work group will also be available on site throughout the NTI to answer questions and assist participants with orientation and schedule planning.

The NTI Work Group is chaired by Nancy Blake, RN, MN, CCRN, CNAA, who is director of Critical Care Services at Children’s Hospital, Los Angeles, Calif. Other members of the group are Jo Ellen Craghead, RN, MSN, CCRN, Lori Kennedy, RN, BSN, CCRN, Kelly Machuca, RN, MSN, CCRN, CS-ACNP, Jodi Rogers, RNC, MS, CNS, CCRN, Amy Schueler, RN, MS, CCRN, and Mary Fran Tracy, RN, PhD, CCRN. Bertie Chuong, RN, MS, CCRN, is the liaison from the AACN Board of Directors.

Craghead is the nurse manager of a 26-bed telemetry unit at Audrain Medical Center, Mexico, Mo. Kennedy is a clinician I at Park Ridge Hospital, Rochester, N.Y. Machuca is an acute care nurse practitioner working in inpatient/outpatient cardiology at the Greater Los Angeles Veterans Administration Medical Center. Rogers is a clinical nurse specialist in the pediatric ICU at Children’s Medical Center, Dayton, Ohio. Schueler is a nurse practitioner in the Division of Cardiology at Ohio State University Medical Center, Columbus, Ohio. Tracy is a clinical nurse specialist at Fairview-University Medical Center, Minneapolis, Minn.

To register or for more information about the NTI, call (800) 899-AACN (2226) or visit the NTI Web site.  The discounted, early-bird registration deadline is April 10, 2001.

NTI Evening Event: Have Fun at Knott’s Berry Farm

You will want to take time to relax and enjoy Southern California while in Anaheim for NTI 2001. There is plenty to see and do. However, an evening at one of the area’s most popular attractions will be included in your NTI registration.
The annual Participant/Exhibitor Event at NTI 2001 will be a private party on May 23 at Knott's Berry Farm, which offers a little something for everyone, regardless of age.
Thrill seekers can experience a wild ride on Ghost Rider, rated the best wooden roller coaster in the west. Other rides include Supreme Scream, which takes riders 30 stories up before taking them back down in three seconds, and Montezooma's Revenge, which goes from 0 to 60 mph in three seconds.

If thrills aren’t for you, you can take it a little easier aboard the steam-powered Calico Railroad or journey back to the old west aboard an authentic Stagecoach.
Or, you can enjoy a variety of entertainment, including a live Country Western band, the Wild West Stunt Show and the Mystery Lodge, a multisensory, one-of-a-kind Native North American attraction.
You can also stroll through an array of shops and sample a variety of foods.

Each NTI registrant will receive a voucher, which can be exchanged for a ticket to attend this event. Additional tickets for guests of participants can be purchased for $17.50 for adults and $14 for children. Children under the age of 2 will be admitted free.
Free shuttles will be available throughout the evening between Knott’s Berry Farm and NTI hotels. Companies exhibiting at the Critical Care Exposition contribute a portion of their booth fees to sponsor the Participant/Exhibitor Event.

Leadership Lessons Learned: Take Time to Listen; Dialogue Enriches Decision Making

By Connie Barden, RN, MSN, CCRN, CCNS

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

As a member of the AACN Board of Directors, I have learned many lessons regarding leadership. However, learning how meaningful dialogue can enrich a person’s leadership skills is perhaps the most valuable lesson I have learned.

Because the board’s varied activities occur in different formats, communication may take place face-to-face, via conference calls, electronically by e-mail or individually in several venues. You never know when the opportunity for dialogue will present itself.
Time is always set aside at AACN board meetings to “dialogue” on topics of importance to the association’s current or future work. When I first joined the board, I prepared for these discussions by studying background materials sent in advance of the meeting, researching topics and attempting to formulate “my opinion” on the subject. I believed that my job was to come to the meeting prepared to state my case.

I soon discovered that I had a lot to learn about what dialogue truly means. The Merriam-Webster Dictionary defines dialogue as “talking together, a conversation; interchange and discussion of ideas, especially when open and frank, as in seeking mutual understanding or harmony.” Although I had arrived at board meetings prepared and sure, I quickly discovered that through dialogue, I could learn much on any topic.

As I observed and listened to the discussions on various topics, I realized that my predetermined opinion and ideas were not as important as my openness and willingness to listen to the opinions and ideas of others—to truly seek mutual understanding within a group where varied points of view were expressed. Of course, reading and preparation are important to all the board’s work. Yet, preparing for the dialogue surrounding this work requires a willingness to learn and to change your mind when appropriate. This experience has convinced me that the beauty of dialogue is in this willingness to listen, to be open to ideas, to learn something new, to admit that I might not have all the answers, to reconsider what I think and to consider a new approach. The richness is in the dialogue, not in the decision being made.
AACN’s Leadership Development Work Group has identified the leadership skills that are most important to all AACN leaders as they seek to make positive changes and influence others. Dialogue was among the skills chosen. I can attest that the group is on track in emphasizing this skill. The ability to be prepared as well as to be open and willing to listen and learn is one of the most effective skills that leaders of the future can develop.

The next time you are at a meeting at work or in connection with a volunteer activity, perhaps even your next AACN chapter meeting, notice how you are engaged in dialogue. Are you truly open, listening, willing to change your opinion, willing to try a new approach and valuing what others say? If you are, you have truly mastered the art of dialogue through conversation and through the interchange of ideas toward mutual understanding. Dialogue is a great leadership skill!

Connie Barden is a clinical nurse specialist and coordinator of cardiovascular services at Mercy Hospital, Miami, Fla.

Scholarship Applications Must Be Postmarked by April

Are you completing a bachelor of science degree in nursing or a graduate program? AACN has scholarship funds available to help you achieve these goals.

Applications for the BSN Completion and Graduate Completion Educational Advancement Scholarships for 2001-02 must be postmarked by April 1, 2001.

These scholarships, which are financed by contributions to the AACN Annual Fund, provide recipients $1,500 per academic year. At least 20% of the awards are allocated to qualified ethnic minority applicants.
The scholarship money may be applied toward tuition, fees, books and supplies, as long as the recipient is continuously enrolled in a baccalaureate or graduate program accredited by the National League for Nursing (NLN) or Commission on Collegiate Nursing Education (CCNE).

Applicants for these scholarships must be RNs and members of AACN, and have a cumulative GPA of 3.0 or better. They must be currently working in critical care or have worked in critical care for at least one year in the last three years.

Applicants for the BSN Completion Scholarship must have junior or upper division status for the fall semester. Applicants for the Graduate Completion Scholarship must be currently enrolled in a planned course that leads to a master’s or doctoral degree.

The Eli Lilly Company has contributed $5,000 to fund and administer three of these Educational Advancement Scholarships for critical care nurses to obtain bachelor of science in nursing degrees. Eli Lilly is a member of AACN’s Partners with Industry corporate giving circle.

For more information about or to obtain an application for an Educational Advance Scholarship, call (800) 899-AACN (2226), or visit the AACN Web site at http://www.accn.org. Applications are also available from Fax on Demand at (800) 222-6329. Request Document #1017.

Support Educational Advancement

AACN earmarks Annual Fund money to assist nurses in pursuing education in the practice of critical care. In addition to educational advancement scholarships, the fund supports professional development programs, including scholarships for AACN’s National Teaching Institute.™ If you would like to contribute to this scholarship fund, call (800) 899-2226.

NTI Registrations Awarded in Drawings

Congratulations to recent winners of complimentary registration to the National Teaching Institute and Critical Care Exposition, May 19 through 24, 2001, in Anaheim, Calif. They are Pamela Parker, RN, BSN, CCRN, of Prestonsburg, Ky., and the Nassau County Chapter of AACN in Mineola, N.Y.

Parker received her prize by completing an online survey regarding redesign of the AACN Web site and the “Members Only” area, which is now available as part of AACN’s member benefits package. Everyone who completed the survey was eligible for the drawing to receive the NTI registration.

The Nassau County Chapter was among chapters that completed their roster updates by the fall deadline. All chapters that met the deadline were entered into the drawing.

Nursing Coalition Surveys Students About Attitudes

Children who have an extraordinary experience with the healthcare profession, such as a sudden family illness, accident or emergency room visit, generally have a strong desire to enter the profession, according to a recent focus group study commissioned by the Nurses for a Healthier Tomorrow coalition, of which AACN is a member.

Interviews with more than 1,800 school-aged children across the nation revealed that most have a positive view of doctors and believe that “wanting to help others” is a primary reason to enter the healthcare field. However, older children expressed concern about the financial stability of the U.S. healthcare system and children of all ages tended to view nursing as a “girl’s job.”

Nurses for a Healthier Tomorrow is working to heighten awareness about the looming nursing shortage and the opportunities that await those who seek a career in nursing. The coalition plans to use the results of the study to develop a national campaign designed to boost the attractiveness of nursing as a profession.

According to the recent study, most children interested in the healthcare profession wanted to become a doctor, though they cited reasons that also apply to the nursing field. These reasons included a desire to “do good,” assist with research on a disease, “wanting to solve people’s problems,” or wanting to re-pay a positive extraordinary experience. Older students viewed being a doctor as a profession, while nursing was viewed as a technical field.

Children surveyed viewed nursing as an important supportive position in the healthcare field, but were unsure of a nurse’s education level, responsibilities and opportunities for career advancement.

Additional information about Nurses for a Healthier Tomorrow can be found online at http://www.nursesource.org.

Submit a Speaker Proposal for NTI 2002

March 15, 2001, is the deadline to submit speaker proposal abstracts for AACN’s National Teaching Institute™ in 2002, which is scheduled for May 4 through 9 in Atlanta, Ga. In addition to clinical and other educational topics, proposals that address the skills critical care nurses need to influence their practice and the care of critically ill patients are encouraged. These topics, which were identified by the Leadership Development Work Group based on a survey conducted at NTI 2000 in Orlando, Fla., include dialogue skills; conflict resolution; managing and effecting change; developing personal wisdom; and an awareness of the values, beliefs and attitudes critical care nurses possess. Speaker proposal packets can be obtained by calling Education Associate Edie Carpenter at (800) 394-5995, ext. 364; by visiting the AACN Web site at http://www.accn.org, or by calling Fax on Demand at (800) 222-6329 and requesting Document #6019.

International Congress of Intensive and Critical Care Medicine Set for Australia

The 8th World Congress of Intensive and Critical-Care Medicine will be presented by the Australian College of Critical Care Nurses and the Australian and New Zealand Intensive Care Society in Sydney, Australia. “Intensive Care In the New Millennium” is the theme.
The dates are Oct. 28 through Nov. 1, 2001. AACN is a cosponsor of this conference.

On the Agenda

Following are decisions and discussions that took place during the AACN Board of Directors’ November 2000 meeting.

Agenda Item: Chapter Web Site Pilot Program
Five AACN chapters are participating in a Web site pilot program in which AACN will provide the tools for chapters to design their own sites. The plan is for AACN to host the sites and provide chapters with their own Web addresses. Participating in the pilot are the Southeastern Pennsylvania Chapter (SEPA), New York City Chapter (NYC), Greater Toledo Area Chapter, Northeast Wisconsin Chapter and Los Angeles Chapter. Once the test phase is completed in February, 2001, other chapters will be invited to participate.

Agenda Item: Liaison Framework
The board reviewed the current liaison structure for collaboration with other associations and special interest groups, including the criteria for establishing liaison relationships and how to determine appointments to various groups. These liaison relationships are part of AACN’s agenda to define public policy priorities and strategies toward achieving its mission and vision. Through these relationships, AACN is able to increase its influence and advocacy efforts on a variety of issues and its visibility and voice in the public policy and regulatory areas.

Agenda Item: Strategic Planning
The board reviewed the association’s strategic plan to validate its current relevancy in meeting the needs of members and whether changes are warranted. An environmental scan was presented to help identify key issues and trends that should be incorporated into future strategic and operational planning. The Strategic Plan for FY02 is scheduled to be considered by the board at its April 2001 meeting.

As a gauge of progress toward initiatives that are linked to the strategic plan, the board was updated on the status of several projects, including the campaign to increase awareness of AACN, AACN Certification Corporation and the value of critical care nursing; the upcoming National Teaching Institute and Critical Care Exposition in May 2001; practice resources, such as the Standards of Acute and Critical Care Nursing Practice, pocket references and protocols; the staffing position statement; educational resources, such as the second edition of the Basic Orientation to the Care of the Acute and Critically Ill Patient and Web-based xtendEd continuing education program; and the demographic census of AACN members;

Agenda Item: Call for Volunteers
After reviewing ongoing national volunteer committees, the board approved the addition of new groups to the FY02 Call for Volunteers. Added were the Progressive Care/Intermediate Care/Stepdown Unit Task Force, the Nurse Managers Advisory Team and the Nurse Managers Think Tank.

Agenda Item: Annual Audit
The board reviewed and approved the annual audit report presented by the accounting firm, Deloitte & Touche. The firm found that the association’s financial statements accurately reflect the financial position of the association and that the association follows generally accepted accounting principles.

Electronic Resumes Require Special Formatting

Editor's note: Following is the fifth 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

In addition to conventional resume formats, the technology age has added new choices in the form of the electronic resume. Two types of electronic resumes—e-mailed and scannable—will likely be encountered. This article will focus on formatting and presentation changes that should be made to e-mailed resumes.

Today’s job applicants must be prepared to e-mail their resumes to prospective employers, either directly or via Web sites. The ability to successfully e-mail your resume demonstrates that you are computer and Internet competent—skills that are increasingly attractive in today’s job market.

The major differences between conventional and electronic resumes are the use of language, formatting techniques, graphic elements and paper quality and color.

Because conventional resumes are read primarily by people, they must “flow” well and be visually appealing. However, to be electronically transmitted, e-mail resumes must be designed in a plain text file format (ASCII). A conventional resume that has been saved as a word processing file will likely be unreadable when e-mailed, because of changes in graphics and formatting, including characters, fonts and margins.

Following are tips to help you successfully prepare and send an e-mail resume:
1. Use a standard word processing application to compose your resume, but save the file as a text-only document. Using the “save” command, or “save as” command if converting the document from another format, save the document in ASCII or MS-DOS. Be certain that the file name includes the .txt extension at the end. ASCII Text or MS-DOS can be read by any Web browser or e-mail program.
2. Set the document margins at 0 and 65 characters.
3. Use a fixed-width typeface, such as Courier.
4. Begin the resume with your most important assets, so that the person reviewing it will not need to scroll down the page to determine your strongest “selling points.”
5. Use a “hard” return (enter key) at the end of each line.
6. Identify yourself, as well as the job title or job reference number, in the e-mail “subject line.”
7. Proofread for typos and misspelled words. Remember that the spell check tool does not always recognize misspelled words, so ask a friend or colleague to proofread your resume.
8. Check for formatting problems by e-mailing the resume to yourself first.
9. Make hard copies of your resume on quality paper stock. If you are called for an interview, you will want to provide a professional-looking copy.
10. Use the “enter” key or space bar to indent, center or create white space.
11. Use asterisks (*), plus symbols (+), dashes (-) and capital letters for emphasis. Plain text does not recognize formatting such as bullets, bold face or italics.
12. Follow up with an e-mail message or a telephone call approximately one week after e-mailing your resume.

C.A.M. of Denver, Colo., asked: If I send an electronic resume, should I include a cover letter? The answer is, “Yes.” The resume and cover letter should be sent in one file. Remember to include key information such as how you learned about the position, your qualifications, the position for which you are applying and what you can bring to the organization.

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

Next: The scannable resume.

Join AACN With a Group and Save!

Nurses who join AACN or renew their membership as a group of five or more receive a discount on the membership fee.

The group discount program applies to members or affiliate members, as well as to international, student and emeritus memberships.

New and renewing groups of members or affiliate members pay a $69 membership fee per year instead of the $78 annual individual fee. Groups of international members pay $92 per year instead of $104, and groups of student members or of emeritus members pay $46 instead of $52.

This group rate applies only to one-year memberships, and full payment for all members in the group must accompany applications. Membership certificates will be mailed to the individual placing the order for distribution to all members of the group.

For more information about this new program or to obtain a group membership application form, call (800) 899-AACN (2226), or visit the AACN Web site at http://www.accn.org.

Public Policy Update

106th Congress Wraps Up
The 106th Congress will be remembered for such issues as its efforts to impeach President Clinton and futile fights over healthcare and education policy. The lame-duck session ended with Republicans and Democrats belatedly agreeing to a final $1.8 trillion budget for Fiscal Year 2000. Included is $109 billion for labor, health and education programs. The budget was approved unanimously in the Senate and by a 292-60 vote in the House.

The healthcare field can expect an additional $37 billion over five years from the 1997 Balanced Budget Act (BBA). The omnibus package contains not only beefed-up Medicare and Medicaid programs, but also the State Children’s Health Insurance Program (SCHIP) Benefits Improvement and Protection Act of 2000 (BIPA).

Among the last details to be worked out between Democrats and Republicans was funding for social programs. Other issues that were resolved are:
• Federal health research programs, which congressional Republicans have pledged to double in five years, received $20.3 billion, $2.5 billion more than last year. The increase goes to the National Institutes of Health.
• The Centers for Disease Control and Prevention received nearly $4 billion, $825 million more than in FY 1999.
• Payments totaling $35 billion, which were cut in the 1997 budget balancing act, were restored for hospitals serving disadvantaged patients and other healthcare providers that rely on Medicare funding.
• In a compromise to ease passage of the budget, Republicans gave up their fight to stop new workplace safety rules and Democrats abandoned their demands for amnesty for illegal aliens. Republican lawmakers had tried to block the Clinton administration from issuing new ergonomic standards for workers in jobs that make them susceptible to repetitive stress injuries. Instead, they hope that President George W. Bush will halt the new rules by executive order.

Congress also passed H.R. 4577, the Consolidated Appropriations Act, which increases funding for a number of key healthcare programs. The bill increases Medicare’s hospital payments by $14 billion over five years and Medicare funding for skilled nursing facilities by $1.6 billion. The nursing facility payments, which are tied to verifiable increases in nurse staffing ratios for skilled facilities, also require the facilities to post, in a visible place, a daily report on the number of licensed and unlicensed nursing staff directly responsible for resident care in the facility.

In addition, the bill asks the Medicare Payment Advisory Commission to study the appropriateness of Medicare reimbursements for services provided by nurse midwives, nurse practitioners, clinical nurse specialists and physicians assistants, and increases funding for nursing education and research programs. Funding for the National Institute of Nursing Research will increase by 16.5%, to $104.3 million, in FY 2001 and funding for Nurse Education Act programs will increase by 16.6%, to $76.5 million. The nurse loan repayment program was level-funded at $2.2 million for FY 2001.

New Congress Convenes
When the 107th Congress convened in January 2001, it was more evenly divided than in decades. In fact, the Senate has never been divided 50-50 between Democrats and Republicans. Eleven new senators and 41 new House members were among the 434 House members and 100 senators sworn in.

Republicans now hold a 221-211 edge in the House, though a vacancy created by the death of Rep. Julian Dixon (D-Calif.), is expected to be filled with a Democrat appointment. In the House, 218 votes are needed to pass legislation. Because of debate rules in the Senate, 60 votes are needed to move any major bill.

Because Republican Vice President Dick Cheney holds the tie-breaking vote in the Senate, Republicans have control of both congressional chambers for the first time since 1995. For the first time since 1955, when Dwight D. Eisenhower was president, the Republicans also control both Congress and the White House.

In a gesture of cooperation, Republicans allowed Democrats to chair Senate committees for the first 17 days of the new Congress, while Democrats were still in the majority, because former Vice President Al Gore was still in office. Nevertheless, Bush’s excruciatingly close presidential election victory over Gore, who won the popular vote by 500,000 votes but lost in the electoral college, added to the sense that neither party had a popular mandate with which to govern.

HCFA Issues Rules
The Health Care Financing Administration (HCFA) recently announced regulations for Medicare payment to hospitals for the training of nurses and allied health professionals and clinical psychologists.

The final rule on payments to hospitals for the costs of nursing and allied health education was published in the Federal Register on Jan. 12, 2001.

The rule addresses HCFA’s overall payment policy for provider-operated, approved nursing and allied health education programs under Medicare. It clarifies policies previously established in the Provider Reimbursement Manual and other documents, but not specifically addressed in current regulations. In addition, HCFA announced a proposed rule on Medicare reasonable cost payment to hospitals for the costs of clinical psychology training.

Under federal law and existing regulations, Medicare pays on a reasonable-cost basis for a participating hospital's net costs of approved nursing and allied health education programs, if the provider operates these programs. The cost of these approved education programs are excluded from the inpatient hospital prospective payment system and from the target amount calculations subject to a rate-of-increase ceiling for hospitals and hospital units excluded from the prospective payment system.

The final rule on nursing and allied health education programs announced finalizes a proposed rule issued by HCFA in 1992 and includes criteria for determining whether an education program is provider operated and, therefore, eligible for reasonable cost payment.
In addition, the regulatory provisions carry out a requirement specified in the Omnibus Budget Reconciliation Act (OBRA) 1989 and implement changes required by OBRA 1990 to specify allowable costs for approved educational activities and establish when these costs would be eligible for pass-through under the prospective payment system.

The nursing and allied health education regulation proposed in 1992 addressed criteria to define provider-operated approved nursing and allied health education programs and to identify the net costs associated with payments for these programs. HCFA also proposed to grandfather reasonable cost payment for the clinical training costs of certain nonprovider-operated programs to comply with the requirements of OBRA 1990. In addition, HCFA proposed to clarify the policy for determining which nursing and allied health educational activities are considered normal operating costs of a provider.

In the final rule on nursing and allied health education, HCFA generally is adopting the provisions of the 1992 proposed regulation, with some modifications. HCFA is adopting as final the criteria that it proposed to use to identify nursing and allied health education providers. Specifically, the provider must:
• Directly incur the training costs
• Directly control the program curriculum
• Control the administration of the program, including collection of tuition
• Employ the teaching staff
• Provide and control both classroom instruction and clinical training, where classroom instruction is a requirement for program completion.

HCFA is adopting as final the proposed changes to the regulations to provide that the clinical training costs of certified registered nurse anesthetists (CRNAs) who are medically directing student anesthetists during surgical procedures are not allowable under the pass-through provision for reasonable cost payment if the CRNA may bill for the services under the Medicare Part B CRNA fee schedule.

In response to public comments, HCFA has deleted the out-dated listing of approved, accredited programs. The regulation now states that all programs must be recognized by the appropriate accrediting body or continue to maintain their accreditation status to receive Medicare payment for nursing and allied health education activities on a reasonable cost basis. A determination as to whether a provider-operated program not already approved meets the definition of an approved program will be made by the Medicare fiscal intermediaries.
The final policy on nursing and allied health education becomes effective 60 days after its publication in the Federal Register. Because this regulation incorporates policies already in use, its impact on the number of professionals being trained is likely to be minimal.
For more information on these rules, visit the “Public Policy” area of the AACN Web site at http://www.accn.org.

Wisconsin Governor Picked as Health Secretary
President Bush’s choice for secretary of the Department of Health and Human Services, Wisconsin Gov. Tommy Thompson, will oversee the nation’s largest civilian bureaucracy, with control over Medicare, the Food and Drug Administration, the Surgeon General’s Office, the National Institutes of Health and a network of social programs for low-income, sick and elderly Americans.

There was general agreement that Thompson’s appointment will dramatically change the focus of the social services agency. With direct influence over some of the biggest policy challenges in the federal government, he would manage a fiscal 2001 budget of $423 billion, 63,000 employees and more than 300 programs that cover an array of social issues touching the lives of virtually every American.

Major issues facing Thompson include how to revamp the $210-billion-a-year Medicare program to cover prescription drugs, how tightly to regulate the tobacco industry and discourage smoking among young people, whether to push more seniors to join health maintenance organizations and ethical issues, such as whether to continue the current federal policy that permits research on embryonic stem cells. An abortion opponent, he would also help shape the administration’s policies on family planning, especially the controversial effort by conservatives to expand abstinence-based sex education and reduce funding for programs that teach contraceptive techniques.

Issues Facing the 107th Congress

Education Bush supports a $1,500 voucher that students in failing public schools could use to seek a private-school education. Many Democrats oppose the voucher program, arguing that it would drain money away from public schools and leave them in even
worse shape.

Taxes Bush proposes a $1.3 trillion, 10-year tax-cut package that includes income tax rate reductions. Republicans argue that huge budget surpluses and a slowing economy justify sweeping tax cuts. Democrats say they would support a
much smaller tax cut targeted to help families pay for needs such as education and childcare. They argue that budget surpluses should be used to pay down the nation’s $5.6 trillion debt.

Energy Bush, a former oilman, has said he will put forward an energy policy to boost domestic production and reduce U.S. dependence on foreign oil. Among other moves, he proposes opening the Arctic National Wildlife Refuge in Alaska to more oil
exploration. Democrats are likely to raise environmental concerns.

Medicare and Bush proposes reforming the Medicare healthcare program for
Prescription Drugs the elderly and disabled to provide more choice and private-sector alternatives, including plans that offer prescription drug benefits. Those choosing the prescription drug benefits would pay in Medicare premiums, and Bush's plan would help
low-income elderly people pay the cost and provide catastrophic coverage after $6,000 in out-of-pocket payments. Democrats have proposed broader prescription drug coverage through Medicare, expressing concern that insurance firms would
compete for the healthiest people while the sickest and those in rural areas would have a tough time getting coverage.

Patients’ Bill of Rights Democrats may try again to push through Congress a patients’ bill of rights that would change federal law to allow consumers to sue their health maintenance organizations (HMOs). Legislation that would do that won bipartisan support in
Congress. It passed the House. A much more limited right to sue passed the Senate and the two sides never worked out their differences. Bush says he backs a patients' bill of rights, but did not endorse the bipartisan House plan. HMOs and other
health insurers have lobbied hard against lawsuit provisions.

Social Security Reform During his election campaign, Bush proposed partially privatizing the Social Security retirement program by establishing individual accounts. In the face of strong opposition from labor unions and their Democratic allies, Bush placed the proposal
on the back burner, calling for a commission to study it. Under his plan, about 2% of Social Security tax revenues would be deposited into individual accounts for workers who would direct how the money is invested

Defense Spending and Congress is expected to go along with Bush's call for increasing
Missile Defense Program defense spending, but his strong support for a missile-defense program is likely to meet some resistance from lawmakers concerned about the multibillion dollar cost and whether the technology is workable. The proposal is also strongly opposed
by U.S. allies concerned about sparking an arms race, as well as by Russia and China.

Campaign Finance Republican Arizona Sen. John McCain and Wisconsin
Reform Democratic Sen. Russell Feingold are expected to make an early push for their bill to overhaul the nation’s campaign finance laws by banning unrestricted soft money donations and placing limits on issue advertisements. The House has approved
the measure in each of the last two years but it has died in the Senate, where a bare majority of senators supported it but were unable to muster the 60 votes needed to break a Republican filibuster and force an up-or-down vote on the proposal.


The Omaha System
“The Omaha System: A Key to Practice, Documentation, and Information Management” is the title of a seminar scheduled for March 23 and 24 in St. Paul, Minn. The program is cosponsored by the Bethel College Nursing Department and Martin Associates. For more information, call (651) 635-2475; e-mail, martinks@msn.com, or visit the Bethel College Web site at www.bethel.edu/cgcs/Seminars.htm#Omaha.

Critical Care Review
A CCRN Review and Comprehensive Critical Care Review Course will be presented April 26 through 28 and May 10 through 12, 2001, in Santa Barbara, Calif. The course is sponsored by Cottage Health System. Conducting the course will be Maurene Harvey, RN, MPH, CCRN, FCCM, a lifetime member of AACN and president-elect of the Society of Critical Care Medicine. For more information, call (805) 682-7111, ext. 3517.
Call for Abstracts
Abstracts or poster presentations are being invited for two programs that will be presented Sept. 24 through 26 in Columbus, Ohio. “Healthcare Management, Staff Development & Education” and “Quest for Excellence: Critical Care and Medical Surgical Nursing” are the titles. Abstracts and posters should be submitted to the Ohio State University Medical Center, Center for Professional Development, Abstract Committee, 1375 Perry St., Suite 03, Columbus, Ohio 43201; phone, (614) 293-3341; e-mail, mcanarney-1@medctr.osu.edu. Additional information is available online at www.osumedcenter.edu/cpd. The deadline for submissions is March 1, 2001.

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

Look Ahead

March 2001

March 1 Deadline to apply for appointment to AACN and AACN Certification Corporation national volunteer committees. For more information, call (800) 394-5995, ext. 415, or visit the AACN Web site at http://www.accn.org.

March 1 Passwords required to access designated “members only” content of the AACN Web site at http://www.accn.org. Members can request passwords online.

March 1 Applications for the AACN Evidence-Based Clinical Practice Grant must be received. To obtain an application visit the “Research” area of the AACN Web site at http://www.accn.org. Applications can be downloaded from the Web site.

March 15 Deadline to submit speaker proposal abstracts for AACN’s National Teaching Institute,™ May 4 through 9, 2002, in Atlanta, Ga. Speaker proposal packets are available from Education Associate Edie Carpenter at (800) 394-5995, ext. 364, or by visiting the
AACN Web site at

April 2001

April 1 Deadline to apply for AACN BSN Completion and Graduate Completion Educational Advancement Scholarships. For more information or to obtain an application, call (800) 899-AACN (2226), or visit the AACN Web site at http://www.accn.org. Applications
are also available from Fax on Demand at (800) 222-6329. Request Document #1017.

April 10 Postmark deadline to register for NTI 2001 at the discounted, early-bird price. For more information about the NTI, call (800) 899-AACN (2226), or visit the AACN Web site at http://www.accn.org

May 2001

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.

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