Critical Care Survey Update: Second
Collection Cycle in Planning Stages
After
analyzing data submitted by facilities and
critical care units in response to the
landmark Critical Care Survey early this
year, AACN has decided to modify and
relaunch the process.
This
ambitious project, designed to profile
critical care units in the U.S., includes
gathering, analyzing and reporting key
variables affecting the critical care
environment, especially where critical care
nurses are concerned. The information
gleaned from the survey will help AACN and
critical care nurses in all roles better
define what makes a unit and a hospital a
humane and healing environment for patients
and nurses alike.
Data
collection on the first survey closed in
March. In analyzing the data, survey
investigators determined that the number of
completed surveys was insufficient to
provide reliable findings. However, the
surveys collected have been important in
informing modification of the survey tool
and of the delivery and online collection
mechanism. The survey has been streamlined
considerably, and additional features have
been employed to ease the burden on
respondents.
After
review and pre-testing are completed, the
modified survey is scheduled to be launched
this fall. Data collection and analysis are
scheduled to be complete by the end of 2003.
The survey report is expected to be released
in early 2004.
AACN
extends sincere appreciation to all of the
facilities that participated in the survey
and to the individual nurses who facilitated
the process. Those facilities that submitted
a completed survey for the first collection
cycle have received a personal thank you and
compensation for their efforts. As promised,
each of these facilities will also receive a
free copy of the survey findings when they
are available.
For the
latest updates, call the Critical Care
Survey Information Line at (800) 394-5995,
ext. 7337.
AACN Celebrates First Anniversary of ECCO
Program
It is
hard for us to imagine that just one year
ago this month we were announcing the
availability of our first major
Internet-based education program, the
Essentials of Critical Care Orientation (ECCO).
Since that time, more than 80 healthcare
sites across 30 states and in two countries
internationally have implemented the
program.
We have
been privileged to be a partner in
re-envisioning the critical care nursing
orientation process to incorporate this
educational tool. Following are some of the
responses we have gathered from program
users over the course of the year.
From Allina Hospitals & Clinics
Abbott Northwestern Hospital, Minneapolis,
Minn.
Megan Brede, RN, BSN, CCRN, nurse education
coordinator for cardiovascular critical care
We have
a lot of nurses who float between ICUs and
work with very different types of patients
so a broad base of skills is important. Once
we got to know ECCO we realized this program
offered the foundational information each
orientee needed while addressing the more
difficult pieces to teach (such as the
oxyhemoglobin dissociation curve) with
graphics and animation that made these
concepts clear. Visualization and action
really help in the learning process (you
won't find the Doll's Eyes animated in a
textbook like in the ECCO program).
St.
Francis Regional Medical Center, Shakopee,
Minn.
Heather Froehlich, RN, MSN, CCRN, learning
and development specialist
With
this solution, we can offer a structured
orientation into critical care written to
national standards that will always be on
the cutting edge. The program really is easy
to navigate. I have been in critical care
for 15 years and this is a much nicer way to
learn. I would recommend this program to
other hospitals.
From
Mercy Hospital, Miami, Fla.
Sonia Wisdom, RN, BSN, CCRN, nurse clinician
for critical care
The
educators determined that using the ECCO
program had the potential to reduce their
overall orientation costs by shortening the
classroom portion of the orientation program
by two weeks.
After
conducting an in-depth review of the
content, Wisdom indicated it was very
interactive and she liked the organization
of the learning material. In addition, she
thought the content was clear, consistent,
systematic and easy to understand and is at
an appropriate level for a new critical care
nurse.
From the U.S. Naval Hospital, Yokosuka,
Japan
Lt.
j.g. Noel Ysip, RN, BSN, Nurse Corps, United
States Navy, ICU staff nurse
ECCO is
a baseline assessment of critical care
knowledge and skills that can be used as a
tool for evaluating learning needs. It helps
in a big way in developing orientation
packets that can be tailored to the needs of
the unit. Improved patient care + decreased
acuity + staff satisfaction = patient
satisfaction.
Cmdr. Janet Hughen, RN, MSN, Nurse Corps,
United States Navy, department head,
Medical/Surgical Nursing
ECCO
has been an invaluable tool for us.
Ensign Daniel Yawn, RN, BSN, Nurse Corps,
United States Navy, Multi-Service Ward staff
nurse
If
you're stuck on the night shift, you get
some really quiet time between one and four
in the morning. You can make good use of
that time. Even on your off days, you can
log on from home. The availability and
flexibility of the program is first rate.
From Rush-Presbyterian- St. Luke's Medical
Center, Chicago, Ill.
Susan Huerta, RN, MS, director of nursing
systems
We
desired flexibility rather than being locked
into standard courses that could not be as
individualized. With the ECCO program, we
can be flexible in terms of when we offer
the course, and we can tailor the education
to meet each individual nurse's needs. One
of the benefits of using this program is we
don't have to ask nurses to come back to
work on a day off or to stay awake all day
after working all night to participate in an
orientation class. Since it can be accessed
24/7, nurses can progress through the
assigned modules in snippets, sitting for 30
minutes to 1 hour, whenever they have time.
Nancy Silva, RN, MS, clinical nurse
specialist for surgical intensive care and
postanesthesia recovery
I think
participants have an increased comfort level
knowing that they'll have access to the
structured content once their orientation is
complete. This ability to review the
information provides support to new nurses
as they begin to work with patients.
From Martha Jefferson Hospital,
Charlottesville, Va.
Linda O. Lathan, RN, MSN, CCRN, FNP-C, nurse
educator
As a
small community-based institution seeking to
expand service lines and develop new
programs, we recognized that nursing
education was a vital part of each new
program's success. We were faced with
considerable time restraints not only due to
the short timeline for program
implementation but also nursing shortages as
well as nursing staff with limited
experience. For all new staff in the ICU,
the program was a part of their orientation
as is suggested by the ECCO schedule. Our
preliminary results reveal that the
orientees feel that it is a valued part of
their orientation. The flexibility of the
program has met our needs to date and has
allowed us to provide education to a greater
number of nurses than would be possible with
the traditional didactic method.
From Benefis Healthcare, Great Falls, Mont.
Kris
Lattin-Jackson, RN, MSN, CCRN, cardiac
clinical nurse specialist
As we
strive to keep up with changing educational
needs, we see this program as a powerful
adjunct to the classroom and preceptor piece
in providing the theoretical, didactic
information for a strong, critical care
education foundation. A strong educational
foundation causes better application at the
bedside, so the ultimate outcome is better
patient advocacy and improved collaboration
with physicians, which leads to improved
nurse/physician satisfaction.
From Lee Memorial Health System HealthPark
Medical Center, Ft. Myers, Fla.
Mary
Pat Aust, RN, BSN, director of ICUs
The
flexibility the program allows us to have is
the main benefit. Other benefits include
access to the gold standard of critical care
nursing knowledge and that the content is
continually reviewed and updated. I like
that I can track an individual's progress
through the program. One of the best
features for me is the ability to review
each individual's test results and discuss
the questions with them.
From the University of Kentucky Hospital,
Lexington
Karen Hall, RN, MSN, critical care staff
development specialist
The
education that occurs during orientation can
be overwhelming at times, due to the amount
of content the students are expected to
learn. Being able to go back into the
program to review content before taking a
test, or if something is unclear, is really
helpful. She added that the students like
the convenience of being able to use ECCO
from their homes.
From Denton Regional Medical Center, Denton,
Texas
Paul
St. Laurent, RN, BSN, CCRN, former critical
care educator
ECCO is
also a great recruiting tool for either new
or experienced nurses. What I like most
about it is the flexibility it gives us as a
facility and the fact that it allows us to
hire potentially exceptional nurses we may
have lost in the past.
Nurses Critical in Care of Rhode Island Fire
Victims
Editor's note: Mary-Liz Bilodeau, RN, MS,
CCNS, CCRN, CS, BC, is the Chapter Advisory
Team representative for AACN Region 1,
serving Connecticut, Maine, Massachusetts,
New Hampshire and Vermont, as well as Rhode
Island, where a deadly fire swept through a
crowded nightclub in West Warwick on the
night of Feb. 20, 2003. More than 100 people
were hospitalized with inhalation and burn
injuries. Bilodeau's position as the
critical care clinical nurse specialist and
acute care nurse practitioner for the Burn
Service at Massachusetts General Hospital,
Boston, which received some of the fire
victims, provided her a unique perspective
on the important role critical care nurses
played in caring for these patients.
Following is her account.
By
Mary-Liz Bilodeau, RN, MS, CCNS, CCRN, CS,
BC
Caring
for patients with burn injuries is both
physically and emotionally challenging, but
the commitment and compassion of critical
care nurses were again evident in the
aftermath of the Rhode Island nightclub fire
in February 2003.
As the
magnitude of the tragedy began to emerge in
the early hours of Feb. 21, seven area
hospitals were mobilized to accept multiple
burn patients. Rhode Island Hospital, Kent
Hospital and Miriam Hospital are located
near the scene of the fire. In neighboring
Massachusetts, Massachusetts General
Hospital, Shriners Burns Hospital, Brigham
and Women's Hospital, and the University of
Massachusetts Medical Center also received
injured patients.
As the
Chapter Advisory Team representative for
AACN Region 1, I was in contact with several
of the Rhode Island nurses.
Peter
Ginaitt, RN, EMT, who was responsible for
triage at the scene, explained that the
decision was made to use emergency
department nurses to assist with initial
assessment and triage.
"Their
nursing expertise and professionalism made
for an outstanding combination resulting in
effective triage," he said.
John
Fedo, RN, MSN, CCRN, CNA, a member of the
Ocean State Chapter of AACN in Providence,
R.I., who works in the ED at Rhode Island
Hospital, said the commitment of the nurses
in both the ED and the ICU was outstanding.
Staff worked long hours to provide care to
this very complex population, he said.
Fedo
said that he also assisted in the burn unit
on several occasions. In addition, burn
nurses from different areas of the
country-members of one of the Burn Specialty
Teams from the National Disaster Medical
Assistance Team-traveled to Rhode Island to
augment staffing.
As the
clinical nurse specialist and nurse
practitioner for the Burn Service at
Massachusetts General Hospital, I am
privileged to work with an amazing group of
nurses. One of them is Emilyn Bellavia, RN,
BSN, CCRN, a senior staff nurse who was
working the unit the night of the fire.
A burn
nurse for more than 30 years, she began to
contact colleagues as soon as word came that
there were multiple burn casualties. Bob
Droste, RN, and Mike Wilson, RN, also senior
staff in the Burn Unit, arrived shortly
after the first two patients were admitted
at about 3 a.m. By morning, Massachusetts
General had accepted 10 patients. Another
arrived later that morning.
Bellavia said that being able to depend on
her colleagues made planning for this influx
easier.
"I knew
that we would rise to the occasion," she
said. "We always do."
As the
Burn Unit filled, patients were admitted to
the surgical ICU and the medical ICU. And,
for the first time in its history, the
pediatric Shriner's Burns Hospital accepted
adults, admitting four patients.
One of
the most difficult problems faced by the
staff at Massachusetts General was the
number of unidentified patients. Unit staff,
the nursing administration, Social Services
and Psychiatry worked for 36 hours straight,
until all the patients had been identified.
Nurses
in these units then began to forge
relationships with the patients and their
families, providing valuable support in this
crisis. The nursing expertise has guided
them through the numerous surgical
procedures, lengthy dressing changes and the
psychological impact of the injuries.
By
mid-April, all but the most critically
injured patients had been discharged, and
the one remaining patient continues slow
progress toward discharge.
The
extent of the contribution of every nurse
who touched the lives of these patients is
difficult to describe. As encouraged by
immediate past AACN President Connie Barden,
RN, MSN, CCNS, CCRN, they definitely used
their bold voices, fearless and essential,
to care for and to advocate for this
extremely complex group of patients. And
daily, they exemplify the "Rising Above"
theme of current President Dorrie Fontaine,
RN, DNSc, FAAN, as they continue to ensure
expert, compassionate critical care.
Scene and Heard
AACN
continues to seek visibility for our
profession and the organization. Following
is an update on recent outreach efforts.
Our
Voice in the Media
An
article titled "Fostering a Humane
Workplace," written by immediate past
President Connie Barden, RN, MSN, CCNS, CCRN,
was featured in the June 1, 2003, issue of
Nursing Spectrum. Barden stressed the fact
that a lack of collaboration creates danger
for patients. "Despite the shortage of
nurses, nurses regularly report disrespect
and non-collaboration in the workplace,"
Barden wrote in the article. "This type of
treatment used to be a given, a part of the
culture, but now we have to be vigilant to
ensure that everyone is respected." She
cited unhealthy work environments as a key
reason nurses turn away from the bedside.
An
article titled "Improving Care of Older
Americans," which appeared in the June 2003
issue of the American Journal of Nursing,
quoted AACN Practice and Research Director
Justine Medina, RN, MS. "Recent data show
more than half of all patients admitted to
intensive care units nationwide are over age
65, and at least 25% are over age 75,"
Medina said. "Despite this, critical care
nurses don't tend to think of themselves as
practicing geriatric nursing. AACN will use
its grant (from the ANA and the Hartford
Foundation) to broaden the geriatric content
in its certification exam for critical care
nurses ... to help nurses distinguish more
clearly between normal age-related
physiologic changes and pathophysiologic
changes."
In May
2003, a letter to the editor by AACN member
Jennifer Wagner, RN, MSN, CCNS, was printed
in the Canton Repository, Canton, Ohio. In
the letter, titled "Nurses Face Many
Workplace Challenges," Wagner noted that,
during the opening session of AACN's
National Teaching Institute and Critical
Care Exposition in San Antonio, Texas, then
AACN President Barden had challenged nurses
to use bold voices. "Nursing is faced with
the challenge of nursing shortages and
declining work conditions while striving to
maintain standards of care that are safe for
our patients and their families," Wagner
wrote. "To make a bold voice means
identifying challenges in the workplace,
collaborating with colleagues to find
solutions to the challenges and remaining
actively involved in the solutions. Although
this statement was directed at the members
of the AACN, making bold voices should be a
commitment of all nurses so that we can
create a healthy and caring work
environment."
The
June 3, 2003, Pacific edition of Stars and
Stripes featured ECCO, AACN's Essentials of
Critical Care Orientation program. Titled
"Online Program Brings Academic
Opportunities to Busy Navy Nurses," the
article focused on the benefits of the
program, which had debuted at the U.S. Naval
Hospital, Yokosuka, Japan. "Nurses can
complete required training on a schedule
they choose," the article noted. Ensign
Daniel Yawn, who recently completed the
program, was quoted as saying, "The
availability and flexibility of the program
is first rate."
An
article written by Tina Wiseman, AACN
education resource specialist, was published
in the June 24, 2003, issue of Vital Signs,
a publication of the Sun-Sentinel Company
serving southern Florida. Titled "Essentials
of Critical Care Orientation: Leveraging the
Power of the Internet for Nursing
Education," the article quotes Sonia Wisdom,
RN, BSN, CCRN, nurse clinician for critical
care at Mercy Hospital, Miami, Fla., as
saying, "(ECCO) allows us to provide ongoing
education, even when an educator is not
present … We can trust that the content is
current, evidence-based theory provided by
the leaders in critical care education-AACN
… Virtually all the preparation to teach a
class is done because objectives, outlines
and other handouts such as CE certificates
are already built into the program. This
really shortened the prep time for the first
implementation."
The May
6, 2003, issue of the Dallas Morning News
featured an article titled regard what
becoming a CCRN requires. The article noted
that, though certification isn't mandatory,
AACN supports it because it denotes
demonstrable knowledge in the specialty and
a higher standard of care to patients,
employers and other nurses. Certification
also enhances patient safety and nurse
recruitment and retention.
Teresa
Wavra, RN, MSN, CCNS, CCRN, AACN clinical
practice specialist, was quoted about AACN's
position on staffing ratios in the June 1,
2003, issue of Critical Care Alert, a
publication of Thomson American Health
Consultants. She explained, "AACN's position
is that staffing ratios depend on the needs
of the patient and the competency level of
the nurse. Each patient has unique needs,
and just conforming to a staffing ratio
doesn't guarantee a level of patient care."
Citing AACN's position paper titled
"Maintaining Patient-Focused Care in an
Environment of Nursing Staff Shortages and
Financial Constraints," Wavra said it is
difficult to determine the potential effects
of adhering to the staffing ratios as
mandated by law.
In a
June 16, 2003, news release, Nellcor
announced that it had partnered with AACN
and the American Organization of Nurse
Executives to facilitate the donation of
Nellcor pulse oximeters and educational
resources to 150 U.S. schools of nursing.
Nellcor will donate an N-395 Pulse Oximeter
and educational materials to each of the
schools selected by AACN and AONE. Each
school will also have access to the
expertise of Nellcor's field-based team of
hospital clinical consultants.
An
article titled "A Primer on Critical Care
Nursing" appeared in the May 2003 issue of
Healthcare Purchasing News. The article
discussed NTI, the role of critical care
nursing, where AACN members practice, how
the nursing shortage affects critical care
and the future of critical care nursing. In
the same issue, the Washington Report noted
that AACN had submitted written testimony to
the Institute of Medicine's Committee on
Work Environment for Nurses and Patient
Safety.
The "AACN
Update" section in the May 2003 issue of
Chest Soundings, the American College of
Chest Physicians newsletter, included
information on the NTI, AACN's testimony to
the IOM, AACN's first critical care survey
and its white paper titled "Safeguarding the
Patient and the Profession: The Value of
Critical Care Nurse Certification."
AACN
President Dorrie Fontaine, RN, DNSc, FAAN,
was interviewed on KCSN radio, Northridge,
Calif., about family presence during
resuscitation and invasive procedures. She
discussed research sponsored by AACN and the
Emergency Nurses Association regarding the
fact that few hospitals have a policy
allowing family members to be present during
CPR or invasive procedures. The findings
were published in the May 2003 issue of the
American Journal of Critical Care and in the
June 2003 issue of the Journal of Emergency
Medicine. AACN supports a policy of family
presence to better meet patients' and
families' needs.
AACN
member and volunteer Pat Carroll, RN, BC,
MS, CEN, RRT, was interviewed on the CNN
Headline News for Your Health segment about
antibiotics.
During
the NTI, Fontaine was interviewed by Jim
Leonard of the National Public Radio station
in San Antonio, Texas, about the need for
critical care nurses, what they do and how
they are helping the city recruit interested
high school students and advising them about
the benefits of a career in critical care
nursing.
Janie
Heath, RN, MS, CS, CCRN, ANP, ACNP, a member
of the AACN Board of Directors, was
interviewed on the Lillian Brown show on the
National Public Radio station in Washington,
D.C., about the role of the critical care
nurse and how to become one and why. Other
topics focused on the work environment,
including AACN's involvement in solutions
for the nursing shortage, patient safety,
and quality of care at the end of life.
Our
Voice at the Table
Ramón
Lavandero, RN, MSN, MA, FAAN, AACN director
of Development and Strategic Alliances, was
an invited panelist at a celebration to
honor retiring Indiana University School of
Nursing Dean Angela Barron McBride.
Randy
Bauler, AACN exhibits director, was selected
by the American Society of Association
Executives to attend its Future Leaders
Conference in Maryland. The three-day
conference was attended by about 60
executives from nonprofit companies. In
addition to formal presentations,
team-building exercises, small discussion
groups and networking opportunities were
provided. Bauler also led a concurrent
session titled "How to Make Advance Space
Selection Work for You" at the Healthcare
Convention & Exhibitors Association's annual
conference in Palm Springs, Calif. Assisting
Bauler was Kimberly Buckley of Freeman
Decorating, Anaheim, Calif. The session
explored the benefits and challenges of
offering advance selection of exhibit space.
Letter to JAMA Demonstrates Effectiveness of
Bold Voice
As this
monthly "Scene and Heard" feature
demonstrates, critical care nurses can use
their bold voices in many ways. A recent
example that pointed up the strength just
one bold voice can have appeared in the May
issue of AACN News in the form of a letter
written by longtime AACN member Robert
Welton, RN, MSN.
His
comments echoed his letter to the editor of
the Journal of the American Medical
Association (printed April 2, 2003) in
response to an article titled "Why This
Nursing Shortage is Different," which
appeared in JAMA on Dec 4, 2002. Welton was
addressing two statements in the JAMA
article-specifically "as long as hospitals
... disrespect their nurses in general"
(page 2744), and "it is clear that hospital
management will have to pay significantly
more attention to improving the working
conditions of nurses than they have in the
past" (page 2744).
Welton
responded that "physicians' behavior can
have profound effects on nurses' working
conditions and job satisfaction. Simply
telling a nurse that he/she did a "nice job"
with a patient, or "that was a great save,
thanks" can help nurses feel good about both
their work and their jobs." He also
discussed the impact of disruptive physician
behavior on working conditions and job
satisfaction by saying, "Comments intended
to intimidate, undermine confidence, imply
incompetence, or verbal abuses beyond the
bounds of fair professional comment can do
more than ruin nurses' entire shift; they
also undermine essential teamwork and
collaboration."
It is
clear that Welton used his bold voice to
point out that physicians have a major role
in influencing nurses' working conditions.
AACN encourages members to use their
articulate, professional "bold voice" in the
same way to get our messages out to the
public.
Myth Versus Fact
Setting the Record Straight About Liability
Insurance
Myth:
All professional liability plans are the
same.
Fact:
Different plans have different coverage
limits.
Although the purpose of professional
liability plans is to protect you in the
event of a lawsuit, how you are protected
can differ. In fact, two plans with
identical coverage limits can be different.
For example, some companies reimburse you
for expenses if you are sued. The AACN
Professional Liability Insurance Plan pays
for you, so you do not need to pay anything
up front.
To make
obtaining individual coverage easier, AACN
sponsors a professional liability insurance
plan for its members. For additional
information, contact Marsh Affinity Group
Services, a service of Seabury & Smith, 1440
Renaissance Dr., Park Ridge, Ill.
60068-1400; phone, (800) 503-9230. Or, visit
the AACN Web site at
http://www.aacn.org
> Membership > Benefits > Personal
Resources.
Numbers Continue to Build in Member
Recruitment Effort
With 13
new members recruited, Ngozi I. Moneke,
RN-BC, BSN, CCRN, of Freeport, N.Y.,
maintained her lead in AACN's Critical Links
member recruitment campaign as of the end of
June. However, a new name showed up near the
lead as a result of June recruitment
numbers.
Catherine P. Rodgers, RN, ADN, CCRN, of
South Daytona, Fla., joined Caroline Axt,
RN, MS, of Oakland, Calif., and Linda J.
Lopazanski, RN, CCRN, of Fords, N.J., each
at 10 new members recruited. Close behind
were Barbara M. Eachus, RN, BSN, CCRN, of
Philadelphia, Pa., at nine new members;
Victor A. Duarte. RN, of Fort Collins,
Colo., at eight; Kathleen M. Richuso, RN,
MS, MSN, of Chapel Hill, N.C., Maria A.
Laxina, RN, MA, MS, Nutley, N.J., Dawn
Kregel, RN, BS, BSN, of Denton, Texas,
Teresa J. Seright, RN, ADN, CCRN, of Minot,
N.D., and Dawn LeQuatte, RN, of Denver,
Colo., all at seven; Betty C. King, RN, MSN,
AA, of Encino, Calif., Cathy L. Blonski, RN,
of Danbury, Conn., and Marisue Rowe, RN, ADN,
of Jacksonville, Ark., all at six; and
Barbara M. Bundage, RN, MSN, of Long Beach,
Calif., and Diane M. Casperson, RN, BSN,
CCRN, of Beresford, S.D., both at five.
Their
efforts helped boost the total number of new
members recruited by both chapters and
individuals to 522 since the campaign began
May 1.
The top
individual recruiter when the campaign ends
March 31 will receive a $500 American
Express gift certificate. All individual
campaign participants receive an AACN pocket
reference when they recruit their first new
member. After that, individual recruiters
receive $25 gift certificates toward the
purchase of AACN resources when they recruit
five new members and $50 AACN gift
certificates when they recruit 10 new
members.
Each
month, members who have recruited at least
one new member during the month are also
entered into a monthly drawing for a $100
American Express gift certificate.
Receiving the American Express gift
certificate in the drawing for June was
Vicki A. Riddle, RN, of Hamilton, Ohio.
In
addition, all recruiters are eligible for
prize drawings that offer round-trip tickets
for two to anywhere in the continental
United States, including a five-day,
four-night hotel stay; round-trip tickets
for two to anywhere in the continental
United States; and four-day-three-night
hotel accommodations in the continental U.S.
To
participate, recruiters must have their
membership number included in the referral
line of the membership application or the
chapter name for chapter referral credit.
PDA Center
PDA
Version of Drug Guide Released
You can
now purchase Lippincott Williams and
Wilkins' 2003 Nursing Drug Guide through the
AACN PDA Center. And, through Sept. 30, you
can save 15% when you purchase the latest
AACN Reference/Drug Guide Bundle. In
addition to the Nursing Drug Guide, you will
receive Griffith's 5-minute Clinical Consult
for only $99. This new bundle is available
in either Palm OS or Pocket PC formats. To
order online, visit
http://www.aacn.org
> Bookstore > AACN PDA Center > Special's
and What's New.
Preview Audio-Visual Tutorials
For a
preview of some of the exciting new
tutorials that will demonstrate, via case
study, the use of a PDA in nursing practice,
visit the online AACN PDA Center. Select
"PDA Tutorials" to check out the Adult
Critical Care Preview Tutorial. Up to six
tutorials are in development, with the first
two scheduled to be available in September.
Apply for ICU Design Citation by Aug. 15
Aug. 15
is the deadline to submit applications for
the 2003 ICU Design Citation, part of AACN's
Circle of Excellence recognition program.
Cosponsored by AACN, the Society of Critical
Care Medicine and the American Institute of
Architects Committee on Architecture for
Health, this award recognizes ICU designs
that enhance the critical care environment
for patients, families and clinicians.
In
addition to a $1,500 cash award-$500 from
each of the sponsoring organizations-the
recipient is provided complimentary
registration for one person to attend the
organization's annual meeting and a plaque
to display in the unit.
For
more information, contact the Society of
Critical Care Medicine at (847) 827-7659.
In the Circle: Award Recognizes Excellence
in Leadership
The
AACN Excellence in Leadership Award, part of
the AACN Circle of Excellence recognition
program, honors nurses who demonstrate the
leadership competencies of empowerment,
effective communication and continuous
learning, and the effective management of
change. Following are excerpts from the
exemplars submitted in connection with the
awards for 2003:
Donna Cheek, RN, MSN, MHA, CCRN
Nags
Head, N.C.
Outer Banks Hospital
Role
models have been important in shaping my
dreams, visions and achievements by
encouraging participation, independent
decision making and constructive feedback.
They have motivated growth instead of
complacency.
The
maturing of my leadership skills over the
years has been premised on the philosophy
that, until you walk in another person's
shoes, do not cast stones. I continue to
support and encourage this philosophy today.
As I
have moved through various leadership roles,
I have learned to accept that leadership
rewards are not as tangible as those
received at the bedside. They come in
different packages and present results, such
as staff taking hold of an idea and seeing
it through to completion, a nurse
accomplishing CCRN certification and mending
peer relationships by utilizing
communication skills.
I had
the opportunity to be part of planning a
hospital in an area where population
fluctuated dramatically, environmental
challenges were seasonal and the closest
acute care facility was an hour and a half
away. We opened the hospital with an
interdisciplinary approach to patient care,
giving each healthcare provider an equal
opportunity to contribute to the philosophy
rooted in transformational leadership. We
experienced both successes and challenges.
From a
diploma graduate to a dual master's
degree-prepared nurse and from a staff nurse
to vice president of clinical operations, I
have been blessed with role models and
mentors who helped shape me.
Through
their guidance, I have learned that to lead,
you must have someone to lead. Without staff
support and involvement, I realize I would
not be able to achieve my vision. It is
always a team effort, and it is my
obligation to demonstrate congruence in my
words and actions to encourage growth and
participation. As I continue my journey in
leadership, I commit to encouraging
involvement from every member of the
healthcare team in the hope that I too will
earn the title of role model and mentor
along the way.
Lisa
Pettrey, RN, MS
Columbus, Ohio
Grant Medical Center
Lisa
Pettrey not only has the ability to convey a
sense of vision, but also illustrates the
mission in such a way that mobilizes and
excites others in moving forward to meet the
goals of the organization. One of Lisa's
strengths is conflict resolution, and her
mentoring of staff members in managing
conflict has enhanced their leadership
abilities. She has helped to create a team
atmosphere within the institution, which has
helped to align the workforce. Lisa has
taught her management staff personality
trait recognition, which allows them to
understand individual and team dynamics. She
has assisted her managers in facilitating
staff retreats away from the workplace.
Lisa
inspires others to strive toward a higher
level of achievement. She fosters continuous
learning through role modeling and providing
opportunities for growth. Many staff have
been encouraged to submit for awards and
poster presentations at local and national
conferences. Although these were new
experiences for her staff, they always felt
that Lisa was there with guidance and
support.
Lisa
demonstrates creativity with problem
analysis and solutions. She sees change as a
process rather than an end and incorporates
her ideology that continued improvements are
needed to establish high standards of care.
She facilitates use of current
research-based literature in the development
of practice guidelines and has taught staff
to challenge traditional assumptions.
Lisa's
positive, "can do" attitude has become an
important part in the daily struggles of
managing change. Assessing possible issues
through her daily routine of walking rounds
throughout the units, she elicits feedback
from staff to better visualize the "big
picture" of coordination of patient care
efforts and workplace issues.
Juan
"Ray" Quintero, RN, MSN, CCRN
Yorktown, Va.
Virginia Commonwealth University Health
System
My area
of responsibility had a negative reputation.
Health providers did not want to work there,
and the staff was fragmented with agency
nurses and supplemental staffing. I knew
that things would not change if I could not
rally the staff in a new direction that
would involve an accepted vision with goals.
I
pulled together a leadership council of
staff with diverse talents, skills and
experience. Our goal was to become a model
unit, have satisfied staff and provide the
best care. The council gave me the power to
negotiate with all applicants. I was able to
recruit three ICU nurses from other
hospitals, because I was able to negotiate
and meet their quality of life needs. We
soon had nurses who volunteered to perform
payroll, help with education, do scheduling,
coach staff and perform quality improvement.
I made myself available 24 hours a day,
seven days a week, using the numerous calls
as opportunities to teach and, more
importantly, convince my staff I would be
accessible.
At the
end of the first year, we were 85% staffed,
the orientation was fully operational, the
leadership council was effective, and much
of the staff had volunteered for the many
roles that we needed. I give most of the
credit to my staff. The bottom line is that
best practices have been initiated, quality
care is provided and best outcomes are
achieved.
On the Agenda
Following is a report by AACN board member
Janie Heath, RN, MS, CS, CCRN, ANP, ACNP, on
discussions and actions that took place
during a June 2003 board conference call.
Agenda Item: NTI Report
The
board received a preliminary report on NTI
2003 in San Antonio, Texas, sharing feedback
on what went well and what can be enhanced.
The board was pleased with the attendance,
which substantially exceeded projections.
The
board has a strong interest in ensuring that
AACN's major annual conference is the best
it can be. A variety of measures, both
qualitative and quantitative, are used each
year to assess how the NTI can best meet the
needs of the critical care nurses who
attend. The opportunity to talk with key
speakers and award recipients, as well as to
connect with members, is essential to the
board's ongoing efforts to help ensure that
AACN continues to be the undisputed leader
in critical care nursing education and
resources.
The
board also discussed the importance of the
opportunity to meet with and strengthen
relationships with industry partners.
Agenda Item: Open Dialogue
The
board had the opportunity to review a draft
of a white paper being prepared by the
American Association of Colleges of Nursing
on the role of the clinical nurse leader.
The diversity of the board's composition,
which reflects different areas of expertise,
including clinical and academic education,
provided insight into the document, with
discussion focusing on possible future
nursing roles and models. The board will
continue to monitor progress on the new role
and delivery models of care and looks
forward to an opportunity to be involved in
future discussions.
Agenda Item: Critical Care Survey
The
board also was updated on the status of the
Critical Care Survey, which is being
modified in preparation for relaunch later
this year.
Are You Committed?
• To
identify the most pressing challenge in my
immediate work environment.
• To
initiate the dialogue with my colleagues to
find solutions to this challenge.
• To
remain actively involved in the solutions
until they are working.
If so,
you can make your pledge to do so online.
The effort is part of the "Bold Voices"
initiative launched by immediate past AACN
President Connie Barden, RN, MSN, CCNS, CCRN.
What's Coming Up in the American Journal of
Critical Care
•
Incidence, Timing, Symptoms, and Risk
Factors for Atrial Fibrillation After
Cardiac Surgery
•
Evaluation of Chemical Dot Thermometers for
Measuring Body Temperature of Orally
Intubated Patients
•
Gastric Feeding in Critically Ill Children:
A Randomized Controlled Trial
Subscriptions to Critical Care Nurse and the
American Journal of Critical Care are
included in AACN membership dues.
Looking Ahead
August 2003
August 15
Deadline to apply for ICU Design Citation.
For more information, contact the Society of
Critical Care Medicine at (847) 827-7659.
September 2003
September 1
Deadline to
submit research and creative solutions
abstracts for AACN's 2004 National Teaching
Institute and Critical Care Exposition May
15 through 20 in Orlando, Fla. To obtain
abstract information and forms, visit the
AACN Web site.
October 2003
October 1
Deadline to submit proposals for the AACN
Evidence-Based Practice Grant. To find out
more about AACN's research priorities and
grant opportunities, visit the AACN Web
site. The grants handbook is also available
from AACN Fax on Demand at (800) 222-6329.
Request
Document #1013.
October 1
Deadline to
apply for the AACN Clinical Practice Grant.
To find out more about AACN's research
priorities and grant opportunities, visit
the AACN Web site. The grants handbook is
also available from AACN Fax on Demand at
(800) 222-6329. Request Document #1013.
October 1
Deadline to
apply for the AACN-Sigma Theta Tau Critical
Care Grant. To find out more about AACN's
research priorities and grant opportunities,
visit the AACN Web site. The grants handbook
is also available from AACN Fax on Demand at
(800) 222-6329. Request
Document #1013.
Janus View
Editor's note: All that we do is rooted in
our past, and we have much to learn from the
leaders who have gone before us, paved the
way and laid the foundation. To strengthen
this connection, members of the AACN Board
of Directors have interviewed some of our
past leaders. For this month, immediate past
board member Rebecca E. Long, RN, MS, CCRN,
CNS, interviewed Sandra B. Dunbar, RN, DSN,
FAAN, a member of the AACN board from 1984
to 1986 and president for the
1986-87 fiscal year. Dunbar is currently
professor of nursing and the Charles Howard
Candler chair within the Nell Hodgson
Woodruff School of Nursing at Emory
University, Atlanta, Ga.
Long:
What lessons did you learn from your
experience on the AACN board?
Dunbar:
I learned many things! I learned to look at
nursing and nursing issues from a broader
perspective. Working with a dynamic board of
directors and national office staff was a
great experience in teamwork. I learned the
elements of putting an idea forward with
justification, developing a project budget
and then succinctly presenting a proposal. I
also learned the value of setting priorities
and focusing organizational activities on a
strategic direction.
Long:
What do you consider to be the board's
greatest accomplishment during your tenure?
Dunbar:
We laid the foundation for many important
initiatives that are continuing today.
AACN's role in research and developing
research priorities began. We initiated the
first national study group on suctioning and
later conceived the idea of Thunder
projects, initially heparin locks and
intermittent IV access. AACN also had a key
role in developing international
collaboration, including inter-
national conferences, during that time.
Outstanding conferences in London, the
Hague, Netherlands and Montreal, Canada,
come to mind as highlights. Our goals were
to bring critical care nurses from across
the world together to share research and
best practices, and to network. We also
established initiatives around education and
scholarships to deal with the nursing
shortage during those years. Another
important activity related to the
integration of critical care nursing into
baccalaureate programs, because it
previously had been deemed specialty,
master's content.
Long:
What was the most challenging aspect of
serving on the board?
Dunbar:
Meeting the diverse needs of the
constituency of our members. Critical care
nurses practice under a great umbrella of
specialties, which includes diverse
settings, patient populations and roles.
This must be an incredible continuing
challenge for the organization.
Long:
What was the most exciting aspect of serving
in this role?
Dunbar:
The opportunity to work with AACN's dynamic
and talented leaders was wonderful. I still
value these colleagues and friends from
across the country. Making good decisions,
both from a professional and financial
perspective, was also exciting. In addition,
the strides we made in nurse-physician
collaboration and strengthening our
relationship with the Society of Critical
Care Medicine stand out.
Long:
What was the most rewarding aspect of
serving in this role?
Dunbar:
Meeting members from everywhere was
incredible. Being part of an organization
that made a difference in people's
professional and personal lives was the most
rewarding.
Long:
What are you doing now?
Dunbar:
In my position at Emory University, I
coordinate the PhD in Nursing program,
teaching and mentoring doctoral students.
I'm also involved in several ongoing
research studies that are externally funded.
One, which is funded by the National
Institutes of Health, is testing
psychosocial interventions for patients with
implantable cardioverter defibrillators. The
other study, which is funded by the American
Heart Association, is examining a
family-focused intervention for heart
failure patients.
I'm
also just completing my term as the program
chair for AHA's Council of Cardiovascular
Nurses. This committee plans the invited and
abstract components of the scientific
sessions. I am the chair of the
cardiovascular nursing component of the
Asian-Pacific AHA conference, scheduled for
June in Hawaii.
Long:
How do you find balance between volunteer
and leadership activities and the rest of
your life?
Dunbar:
So many exciting things are going on in
nursing that you could be busy every minute
of the day. As I have continued to struggle
to maintain the right balance, I have tried
to become involved in professional
activities that require less travel,
allowing me to spend more time with my
family. My husband, David, our 15-year-old
daughter Lindsay and I enjoy hiking, biking
and kayaking. We are involved in church and
community service activities, including
delivering Meals on Wheels on holidays and a
recent mission trip to Costa Rica.
Long:
In these unsettled times in healthcare, do
you still think it is important for nurses
to belong to organizations such as AACN?
Dunbar:
It is absolutely important for nurses to
benefit from all that an organization such
as AACN offers. Being up to date, staying
abreast of new ideas and networking are all
available through this organization. I
believe it's also important to be part of a
group like AACN that is setting standards
and influencing policy. In addition, the
chapters provide creative outlets that may
not be available in the workplace for nurses
to learn and grow in many different
capacities.
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