Welcomes New Members in Annual Campaign
Recruiters Add 4,462 to Membership Roll
second consecutive year, a nursing education
consultant from Oakland, Calif., was the top
recruiter in AACN's Critical Links
Although Carolyn Axt, RN, MS, MSN, again
receives a $500 American Express gift
certificate for her efforts, her students
are the ones who will benefit most. She
plans to stack her awards and add $100 she
reaped in one of the campaign's monthly
drawings to purchase CCRN review resources
to use with her students.
who recruited 69 new members, was a major
contributor to the 2003-04 campaign, in
which a total of 4,462 new members were
recruited by 1,504 individuals and chapters.
The new campaign, which will end March 31,
2005, is now under way.
employee of Kaiser Permanente, Axt is
responsible for providing training to large
groups of nurses in the northern California
region. She conducted five, 14-day training
sessions last year and six this year. All
her recruits have come from those classes.
member since 1976, Axt said she has always
espoused the benefits of membership in
professional associations, but became more
proactive last year.
took advantage of the five-or-more�member
discounted group rate and exposure to the
journals to which AACN members receive
subscriptions as part of their dues.
journals were really important in my
practice early," she said. "I thought, �If I
could catch my students early enough, get
them the journals, hopefully they would
said that, when she entered the Critical
Links campaign, her commitment had nothing
to do with winning prizes.
just been so easy," she said. "It hasn't
been work. It has just fallen in my lap. I
am just lucky to have so many contacts."
top recruiters and their totals are Becki L.
Fuzi, RN, CNS, MSN, CCRN (50), Dinah L.
Cooper, RN, CCRN (44), Kathleen M. Richuso,
RN, MSN (43), Ngozi I. Moneke, RN, BC, BSN,
CCRN (43), Catherine P. Rodgers, RN, ADN,
CCRN (38), Delmar Imperial-Aubin, RN, BS,
BSN (38), Stephanie C. Westbrook, RN, BS,
MEd (36), Jackie S. Yon, RN, MS, CCRN, CCNS,
ARNP (35), Doris J. Strother, RN, MN, MS, NP
(35), Lori A. Cox, RN, MSN, CCRN, ACNP, NP
(33), Beverly Ann Carlson, RN, CNS, MS (25),
Carol A. Grube, RN (25), Yvonne L. Thelwell,
RN (24), Paula A. Lusardi, RN, DNS, PhD,
CCRN, CCNS (23), Patricia M. Tanzi, RN (23),
Lydia C. Bautista, RN, BSN, CCRN (20) and
Paulita D. Narag, RN, ADN, CCRN (20).
Prize Drawing Winners
Critical Links membership campaign also
offers recruiters a chance to win valuable
prizes for their participation. The winners
in the 2003-04 campaign were:
prize-Rachel Banks, RN, Miramar, Fla.
(round-trip tickets for two to anywhere in
the continental United States, including a
five-day, four-night hotel stay)
prize-Margaret Flickinger, RN, Galesburg,
Ill. (round-trip tickets for two to anywhere
in the continental United States)
prize-Shona Patel, RN, BS, BSN, Durham, N.C.
(four-day-three-night hotel accommodations
anywhere in the continental United States)
addition, Lucille Hicks, RN, BS, CCRN, of
St. Louis, Mo., won the $100 American
Express gift card in the monthly drawing for
the final month of the campaign in March.
drive again offers valuable rewards to the
hundreds of individual and chapter
recruiters traditionally participating,
including a $1,000 American Express gift
check that will go to the top recruiter.
However, anyone who recruits just one new
member receives an AACN clinical or
practice-related gift. For every five new
members recruited, participants receive a
$25 gift certificate toward the purchase of
AACN products or services. Recruit a total
of 10 new members and receive a $50 gift
certificate. In addition, recruiters are
eligible for a monthly drawing to receive a
$100 American Express gift check in each
month that they recruit a new member. At the
end of the campaign, every recruiter who
enrolls at least five new members will be
entered into three drawings for grand prizes
of $500 American Express gift certificates.
qualify for the prizes and drawings, new
members must include the recruiter's name
and chapter, when applicable, on the
"referred by" line of the application.
Thanks for Sharing the Benefits of AACN
Following are the members who participate in
the 2003-04 Critical Links membership
to 20 Recruited
Stephanie Baker, Diane M. Bosen, Marylee R.
Bressie, Megan Brunson, Denise Buonocore,
Diane M. Casperson, Sandra J. Cornish,
Victor A. Duarte, Regina C. Echetebu, Jean
A. Endryck, Michelle A. Ernzen, Kathleen L.
Finn, Dorothy J. Flowers, Deslin Francois,
Carla J. Freeman, Kirsten F. Fritz, Kevin R.
George, Katherine A. Green, Lucille Hicks,
Michelle A. Jurgensen, Rachelle M. King,
Rhonda Lanclos, Linda J. Lopazanski,
Christina McCarter Cantey, Pauline J.
McNeece, Inocencia G. Mendoza, Julie S.
Miller, Joseph R. Newsome, Donna M. O'Neill,
Kathleen Quattrocchi, Irma N. Richardson,
Margaret R. Rollins, Marisue Rowe, Mary
Karen Sands, Jacqueline D. Smith, Maureen
Wood, Cynthia L. Zaletel.
A. Ascenzi, Rachel Banks, Angela J. Bentley,
Cathy L. Blonski, Laura B. Boehm, Toni J.
Boldy, Jeanne Ann Bolton, Cynthia L. Bond,
T. Lynn Brown, Barbara M. Bundage, Ana M.
Cabrera, Ma. Victoria S. Caluag, Yolanda W.
Carilimdiliman, Nancy M. Case, Lydia G.
Casteel, Evelyn C. Coen, Deborah J Conaway,
Joan E. Cook, Bonnie L. Curtis, Tamie R.
Davis, Mary Ann Degges, Anne C. Dunn,
Barbara M. Eachus, Nathalie M. Fleureau,
Barbara A. Foster, Barbara S. Frey, Tracy
Gregoire, Sharon V. Grupp, Marci Hageman,
Ma. Thelma C. Herrera, Jana W. Hough, Brian
Kathleen M. Johnson, Beryl E. Keegan, Janis
D. King, Betty C. King, Vivian M. Kish,
Vicky K. Knapp, Dawn Kregel, Maria A. Laxina,
Melanie Jane Leepers, Dawn LeQuatte, Brandi
Lidikay, Julie F. Locquiao, Jann M. McCann,
Michael T. McEvoy, Ann L. Mercer, Alice B.
Moulton, Linda Ann Novak, Jennifer L.
Patterson, Jill Poston, Lynn M. Purcel,
Shawn E. Ray, Susan M. Roberti, Donna B.
Sabash, Ian N. Saludares, Edna J. Schambers,
Laura B. Seay, Teresa J. Seright, Eunice K.
Simmons, Lynn Smith Schnautz, Angela St.
John, Deborah L. Truitt, Paula J. Varhol,
Barbara G. Wiles, Suzanne Williams, Sonia H.
Wisdom, Teresa M. Yee.
Charlotte R. Abbott, Christine L. Abboud,
Sakinah Abdulkhabir, Charlotte A.
Abercrombie, Jennifer E. Abfalter, Mary
Therese Crisostomo Acfalle, Eleanor Wilson
Adamo, Janet M. Adams, Christine E. Adams,
Rachel S. Addy, Geraldine Santos Aguila,
Tamkanat M. Ahmed, Gladys B. Alarva, Julie
A. Albecker, Jerilyn Alexander, Bethanne
Algie, Luis E. Almendras, Fe Neri Almendras,
Maggie Alonso, Maria E. Alsop, Heidi Alton,
Marie Anderson, Libby Leininger Anderson,
Marlo Scott Anderson, Lois K. Andrews, Amy
E. Antalick, Antonio L. Apostol, Aurea
Theresa Arca, Vickie Armstrong, Sharon Irene
Armstrong, Judith Leigh Armstrong, Kathleen
Arnold, Betty Arnold, Dennis Scott Arthur,
Michelle C. Ashby, Delia R. Askland, Ange
Assion, Sonia M. Astle, Ponrathi Rosalind
Athilingam, Angela Marie Aucoin, Marie Aue,
Karen K. Austin.
M. Baar, Charissa Gajete Bacena, Rebekah L.
Backowski, Louise Baclasky, Crystal G.
Badgett, Chad Aaron Bagley, Mary Ann L.
Bailey, Luz Tabago Bailey, Dina Bailey, Beth
M. Baker, Joan F. Baker, Marietta R. Balaan,
Linda I. Ball, Rachel S. Ball, Robin M.
Ballew, Shirleyann Balucanag, Christine M.
Banta, Michelle L. Barkley, Sheila A. Barr,
Beth Barranco, Darcy T. Barrett, Jill E.
Barrow, Tonya Marie Bartow, Jennifer A.
Basler, Kathryn Basnight, Sheila A. Batiste,
Susan L. Baughman, Claire Bautista, Sherry
E. Baxter, Esther H. Bay, Alyce H.N. Beard,
Kathleen M. Bechtel, Jeffrey Reed Beck, Judi
Beckman-Friedson, Jennifer Beckwith, Traci
Beebe, Shelly S. Begue, Linda Majo Belkas,
James C. Bell, Erin L. Bell, Deidre N.
Belton, Ellen O. Bender, Jennifer M. Bengel-Dunn,
Sue A. Benson, Donna M. Bent, Virginia
Bentley, Debra J. Bercaw, John Bergen, Jason
L. Beringo, Gail J. Beriswill, Kim B.
Bernhardt-Tindal, Annette Berning, O'Re L.
Berry, Cristina B. Berthelot, Michael F.
Beshel, Chera-Lei Betts, Pamela Ann Bialczak,
Janice K. Biros, Patricia A. Bishop,
Kimberly G. Bishop, Karen C. Bishop, Sandra
J. Bixler, Mara L. Black, Daniel J. Blair,
Tracy L. Blair, Penelope S. Blake, Michael
C. Blanchard, Zenaida D. Blanco, Bonnie L.
Blankenship, Robert G. Bledsoe, Pamela I.
Blee, Betty Nash Blevins, Tresa L. Bobbitt,
Molly Bolinger, Monica Bologna, Charmaine
Bond, Janis E. Boterf, Darlene A. Boudreaux,
Theresa R. Boulos, Pamela M. Bowser, E. Lois
Boyd, Becky L. Braddock, Celeste Braly,
Jeannette Branham, Cyndy E. Brasher,
Rosemary A. Bray, Deborah L. Briese, Sue
Bright, Susan Bright, Elizabeth A. Bright,
Debra L. Britt, Hugh Brooks, Josee Brousseau,
Terry L. Brown, Anne H. Brown, Deitra T.
Brown, Holly J. Brunacini, Sandra A.
Brunner, Anna C. Bruns, Kathryn A. Brush,
Matthew D. Bryant, Angela Dawn
Bryant-Blount, Dorota Bryk-Winks, Michelle
D. Bryson, Kelli M. Buchanan-Cassino, Linda
Bucher, Christopher Brian Bucklew, Shelly A.
Buck-Williams, Suzan L. Buetow, Beverly A.
Bull, Mona Ruth Bullard, Linda Louise Bunten,
Marsha D. Buntley, Larry Wayne Buntley,
Madeleine M. Burke, Laura Jean Burns,
Kathleen M. Burton, Jacquelyn C. Burton,
Marilyn L. Byrne.
Gruber Cabral, Deborah Cagen, Annette I.
Calcote, Marie Callahan, Karen M. Campano,
Karen Ann Campbell, Richard A. Campbell,
Margie Lynn Campbell, Ofelia Alcala Canela,
Alisa R. Caple, Catherine Caprio, Janis L.
Carelock, Neal E. Carey, Candy S Carlsen,
Allison Cecelia Carlson, Richard M.
Carpenter, JoAnn Carr, Maggie D. Carriker,
Darlene Carroll, Dawn M. Caruss, Denae Case,
Robert William Cass, Gail Castelli, Laura
Elizabeth Caster, Angela G. Cathey, Debra
Ann Catrambone, Pauline I. Caum, Julie
Cavaner, Lauren M. Chadwick, Pamela J.
Chapman, Leanna Chau, Kristina Cherry,
Patricia M. Chesmore, Margaret A.
Chiappalone, Belinda A Childers, Jody L.
Choate, Mi-jin Choe, Marcia L. Chorba,
Deborah Anne Chouinard, Mary E. Christian,
Eun-joo Chung, Vicki Lee Chupa, Kim Cibulka,
Charlene J. Cink, Monica Davila Cintron,
Florina L. Cirujales, Deirdre M. Citro,
Nanette M. Clark, Sara A. Clark, Kathryn V.
Clark, Kimberly A. Clark , Patricia Clark,
Sheri Lee Cleaves, Karen Y. Cliburn, Tracy
L. Cline, Carol Cloud, Patricia E. Cluthe,
Donna Cochran, Kathleen M. Cohen, Denise
Cole-Ouzounian, Caroline L. Collantes,
Marcia A. Collins, Jean Marie Collins, Marty
J. Collins-Johnson, John P. Compton, Karen
M. Conover, Virginia S. Cook, Diane Lynn
Cook, Kathleen D. Cooper, Beverly Cope,
Josephine Corcega Delgado, Bonnie J.
Corcoran, Erin K. Core, Gene B. Corliss,
Kelly Cornacchione, Randy J. Cornell, Mary
D. Cornish, Patricia L. Cortez, Lisa L.
Cossaboon, Kim Costello, Verna Jeanne
Cotton, Michelle Marie Coughlin, Susan B.
Covert, Laurene M. Cox, Stephanie L.
Cranfield, Iracema M. Crawford, Kim L.
Crawford, Nancy Crawford, Kathleen M.
Crecelius, Judith Marie Cremers, Sue Ann
Crisp, Mills E. Crosland, Marcus F. Crossan,
Jaydee Estacio Cu, Kelly C. Cullinane,
Kathleen D. Culver, Cindy L. Cunningham,
Mary Ann Cunningham, Elizabeth D. Curtin,
Cheryl B. Cusac, Teresa K. Cuthair, Jessica
D. Dailey-Filipkowski, Cynthia Ann Damboise,
Carol Y. Damico, Elaine Daniel, Patti A.
Daraskavich, Lori A. Daughenbaugh, Candice
D. Davidson, Diane B. Davis, Judith P.
Davis, Martha K. Davis, Ann Marie Davis,
Mary C. Day, Evelyn B. De Peralta, Patricia
E. Decker, Michael George Decker, Christina
M. DeCoskey, Tammy Sue Dees, Carla J. Degges,
Maria Emily DeGuzman, Bonnie L. DeJardin,
Violeta C. Del Rosario, Leilani J. Del
Valle, Alice Dela Cruz, Lilia L. Dela Cruz,
Jaime C. Dela Cruz, Mely C.M. DeLeon, Connie
Deloach, Genevieve F. Deltieure, Kathleen H
Denihan, Mary W. Dent, Glenn E. DePoy,
Heather DeSalvo, Sandra S. Deschane, Susan
Devlin-Varin, Kathy A. Dibbens, Diana Leslie
Dietz, Crystal Diane Diggs, Tammy B. Dingee,
Julie Leraun Dobbs, Ricchi S. Domingo, Linda
A. Donovan, Deri C. Dority, Sandra Douglas,
Brenda G. Downs, Karen A. Droter, Michele
Angela Dudley, Michael John Duffy, Edna A.
Dukes, Linda F. Dunbar, Gail W. Duncan,
Robin Duryee, Wayne A. Dwarica, Kimberly S.
Earl, Susan M. Earnhart, Rachel T. Easo,
Lisa Edwards, Fe Valledor Eguaras, Shirley
M. Eiben, Marie A. Eidam, Meray El-Ahdab,
Grace A. Elaro, Sarah A. Elchos, Krista L.
Elliott, Joan M. Ellis, Karen L. Ellmers,
Virginia Elminshamy, Gregory Shane Elmore,
Gretchen Lorraine Ennis, Maria G. Erica,
Deborah L. Erickson, Tracy Ann Esopa, Betty
J. Etherton, Linda Ethier, Melissa S. Evans,
Tracy R. Evans, Robyn S. Evans, Sheri B.
Everett, Zorena Ewing, Nancy J. Exstrom.
Madeline Faisca, B. Yvonne Fankhanel, Bev
Farmer, Anthony E. Farmer, Belinda Farrelly,
Maria Pilar Farzad, Mary C. Fassett, Beverly
J. Felder, Arieta R. Fernandez, Ferdinand C.
Ferrer, Matt Ferriolo, Jocelyn C. Fiedler,
Marian A. Finehirsh, Lora S. Fink, Deborah
A. Fischer, Manuel A. Fish, Debra A. Fisher,
Mary Jane Fleener, Margaret R. Flickinger,
Kelly Renee Flowers, Nancy M. Foley, Melissa
Dawn Foltz, Patricia D. Fonder, Sara M.
Ford, Kathy A. Foster, Melinda Foster, Laura
L. Fox, Shantha V. Franks, Tess Frankum,
Laura Leigh Frantz, Jennifer Lynn Franzwa,
Kimberly C. Fritz, Carolyn D. Frost,
Nicholas E. Frusciante, Satomi Fujii, Fred
Gabriele, Karen A. Gaertner, Ann M.
Gagliardi, Johane A. Gagnon, Kathleen S.
Gallichio, Vicki J. Galyean, Theresa Ann
Ganoe, Betty R. Garber, Tara J. Garcia,
Maria Haydee Ramirez Garcia, Michelle D.
Gargiulo, Julia K. Garrison, Valarie
Gatlin-Best, Annette L. Gee-Monahan, Devon
A. Geidner, Serena Geiger, Jane P. Gensaya,
Beverly E. George-Gay, Stephanie D. Geraci,
Patricia Ann Giesler, Megan Gillespie, Marie
C. Gilliland, Frances L. Gilliland, Jo Anne
Gillispie, Lisa N. Gingerich, Jill S.
Girard, Joan Marie Gleason-Scott, Barbara J.
Glenn, Deborah Gloskey, Sylvia Gomez, Diane
M. Gomez, Diane Marie Gomez, Girlynda
Gonzales, Abbie L. Goodban, Barbara A.
Goodwin, Jack W. Gootee, Laurie Arnold Gorby,
Bernice E. Gordon, Michele A. Gordon, Mark
C. Gosling, Shaunda R. Goss, Rose A. Goure,
Patricia G. Graham, Patti Graham, Nancy M.
Grant, Kim Green, Maureen T. Greene, Sy R.
Greene, Deborah L. Greenlaw, Karen Grevious,
Jerry A. Gronberg, Rhonda L. Grose, Ariana
G. Gross, Timothy Joseph Groth, Donna B.
Kristine L. Hagans, Claudia A. Haile,
Charlene A. Haley-Moyer, Lois Hamill, Karen
J. Hamilton, Karen L. Hamilton, M. Beth
Hammer, Leslie A. Hammond, Tamara K. Hand,
Joy Hansel, Kim Hanson, Maria Molar Haque,
Eileen C. Harden, Tara L. Hardinge, Kathy
Hare, Lucinda S. Harmon, Paige E. Harriott,
KellyJane Harris, Janet Harris, Diane
Harris, Evelyn M. Harris, Patricia L. Harth,
Eric Hartigan, Jane L. Hartman, Kathleen
Hartmann, Teresa Hartseil, Billie J. Hauanio,
Peggy Sue Haupt, Lisa Marie Hauss, Cynthia
Hawkins, Dawna Hawksworth, Tod A. Hazlett,
Jeanne M. Heatlie, Donna J. Hegle, Derrick
Michael Heldt, Richard A. Hemphill, Lori D.
Hendrickx, Belinda D. Henriksen, Cynthia C.
Heroy, Susan Hession, Noni Heywood, Linda L.
Hickey, Peggy J. Hicks, Cynthia S. Hielscher,
Shawna L. Higgins, Linda M. Higgins, Alisa
M. Hilinski, Amy K. Hill, Christopher D.
Hillman, Margaret M. Hines, Carol M. Hinkle,
Laurie Hinz Gover, Mary D. Hoagland,
Kimberly S. Hoang, Deborah B. Hobson, Davy
Dwayne Hobson, Diane L. Hockett, Alfred
Edward Hocking, Bernadette Hoffman, Paula
Hofmeister, Jeni Kate Holley, Kathryn Lee
Holling, Sharna L. Holloway, Vicki L.
Holman, Deborah E. Holman, Deborah M.
Holmberg, Karen R. Hontucan, Steven Jay
Hooker, Ellen Faith Hopkins, Michael J.
Hoskin, Paula P. House, Fred Kenneth House,
Veronica Hudson, Helen Catherine Hughes,
Zondra Hull, Carolyn M. Hunsche, Cheryce G.
Hunsinger, Aaron C. Huston, Donna Hyacinthe,
Eden S. Ibay, Elena Icreverzi, Tina O.
Ikwuezunma, Aida A. Imperio, Michael James
Ingalsby, Sherry Inge, Paula A. Innis,
Kathryn Irving, Jean C. Isaac, Kathryn A.
Jackson, Annamma Jacob, Christy L. Jacobi,
Annie P. James, Joseph Janosy, Natacha
Jean-Noel, Christopher O. Jenner, Rhonda Rae
Jensen, Robert F. Jezyk, Pamela S. Johnson,
Vicki D. Johnson, Grace A. Johnson, Jodie G.
Johnson, Jeremy Johnson, Jeremy L. Johnson,
Paula Johnson, Barbara L. Johnston, Pamela
J. Joines, Michelle M. Jonas, Karla L.
Jones, Ronald L. Jones, Delia Sablaya Jones,
Melissa Douglass Jones, Stephanie R. Jones,
Teresita E. Jones, Mary Sheree Jordan,
Messalina Charisse Jordan, Sharon V. Jordan,
Leela J. Joseph, Rachel A. Joseph, Mary M.
Joyce, Meredith M. Joyner, Patricia M.
Juarez, Rosemarie Juergensen, Cynthia V.
Jugo, Basem M. Jumaa.
K. Kadner, Jennifer P. Kahler, Darcy Kalles,
Kathleen M. Keane, Marilyn Keefe, Mary J.
Keegan, Melissa Keeton, Linda Kehn, Margaret
M. Kelleher, Beverly J. Kelley, Ellen
Kelley, Robert J. Kelly, Patricia Anne
Kelly, Jodie L. Kennedy, Lori E. Kennedy,
Frances Ann Kenney, Marcia Kent, Donna S.
Kerner, Diane Myers Kessler, Karen A. Kesten,
Patricia H. Kettle, Jennifer Ann Keuth,
Becky Allyn Kiely, Jennifer A. Kilgore, Ok
Kum Kim, Mabel Kuupua Kim, Kathleen J. King,
Nancy D. King, Nancy C. King, Anne M. Klahre,
Julie C. Klarich, Marlene M. Klein, Janet A.
Kloos, Kelly Marie Knapp, Debra L. Knight,
Lori Susan Koethe, Terra E. Koroll, Kathleen
J. Korza, Mary Grace Kostenblatt, Holly A.
Kraft, Grant Carla Krahl, Robert Kramer,
Allan S. Kristiansen, Joanne M. Kuszaj,
Christopher Douglas Kyle, Lisa N. Lacasse,
Paulette M. LaConte, Pamela Lacy, Arnold
Suguitan Lagoc, Deborah Lee Lalinde, Lou
Ellen Anne Lallier, Mary Ann Lambert,
Michelle Lambert-Webb, Lisa Lea Lampkin,
Sheila A. Lanciault, Julia E. Langan,
Constance May Lanphear, Karen E. Lantier,
Dianna L. Lape, Jennifer A. Larkin, Jose
Ramil R. Lasala, Stanley M. Lash,
MonicaPilar Lawrence, Scott M. Lawson,
Gretchen A. Lee, Patricia M. Lee, Jason C.
Lee, Celeste Lynnette Lee, Peachy Delaflor
Legayada, Mary T. Leidner, Patricia A. Lello,
Kathy Renee Leonardo, Jo M. Lerner, C.
Preston Lewis, Robin L. Lillibridge, Mary O.
Lindamood, Kristi Anne Link, Janet M.
Linton, Laura L. Lipp, Rena N. Litt, Theresa
D. Loan, Cynthia A. Lockhart, Karen J.
London, Carol A. Long, Juanita Lopez, Judith
A. Losi, Jennie M. Love, Sarah Elizabeth
Love, Lisa Lovette, Judith H. Lower, Terry
L. Lucas, India S. Luke, Maria Morena A.
Luna, Tracey Lund, Kari Marie Lutz, Nhieu
Thanh Ly, Becky Le Ly, Andree F. Lybeck,
Maxine E. Lyons.
M. Mack, Dianne L. Mackert, Holly Macklay,
Stephanie L. Macon-Moore, Pamela S. Mages,
Laura Diane Magos, Anne L. Maguire, Susan
Cathrena Mahoney, Regina E. Mailey, Andrea
M. Maimone, Rosita Y. Maley, Beverly C.
Maloney, Joyce L. Maly, Laura Mamchur,
Gloria Mangaroo, Michele L. Manning, Neal E.
Manuel, Judy A. Manuel, Loretta A.
Marcantonio, Midge A. Marcy-Brennan, Lori E.
Markham, Nicole A. Marks, Ruth Ann Marr,
Juliette Marrin, Carolyn Ann Martin,
Kimberly S. Martin, Amy S. Martin, Dea Ann
L. Martin, Cindy Leigh Martin, Elizabeth
Martin, Virginia M. Mason, Mary A. Mathews,
Kelley Anne Mathews, Mary Ann Matteson, Fe
E. Matthews, Lindsey A. Maynard, Lenora M.
Maze, Loretta M. McBride-Fleming, Pamela J.
McCabe, Kathleen A. McCarthy, Kathleen M.
McCarthy, Mary L. McCarthy, Patricia A.
McCauley, Michelle Kelly Mccauley, Elizabeth
McClure, Katrina D. McCurley, Kelly Marie
Mccutcheon, Ryan W. McDonald, Jodi Patricia
Mcduffie, Heather McEachren, L. Jennifer
McFarlane, Elizabeth L. McGarr, Cinthia Ann
McGarry, La Donna Dale McGohan, J. Patrick
Mcgovern, Sharon Lynne Mcgregor, Jeannie
Theresa Mcgurran, Virginia Lynn Mcintyre,
Tracie Lynn Mckay, Stephen C. McKeeman, Mary
G. McKinley, Joyce E. McKinney, Cedric J.
McKoy, Diane L. McLean, Dee A. McMichael,
Dennise C.L. McPherson, Patricia A. McQuade,
Petra McWhorter-Green, Theresa M. Meeks,
Kirsten Meister, Elsa Mejia, Darla J.
Melander, Maria T. Mendoza, Alpha M.
Mendoza, N. Lynne Mercer, Lori C. Merrill,
Alyson Faye Messina, Cary J. Metternich,
Cheryl E. Meyer, Sharon Evelyn Meyers, Raul
G. Meza, Lorraine Micheletti, Joann
Mickelson, Estrella P. Mijares, Deborah J.
Mike, Jennifer L. Miller, Julie K. Miller,
Patricia Miller, Leanna R. Miller, Dylan K.
Miller, Kevin C. Millet, Cassidy R. Mincer,
Christine M. Mincey, Nicolette C. Mininni,
Catrice M. Minjarez, Margaret M. Mirabella,
Jaclyn Melissa Mitchell, William Carson
Mize, Candice R. Mohar, Magdalena Ella
Monahan, Rachel E. Monday, Laura Frances
Monette, Jeri Linda Monical, Barbara A.
Montagnino, Lori A. Monte Besselman, Dianna
L Moone, Bonita L. Moore, Vicki D. Moore,
Laurie E. Moore, Mary Grace Moore, Kelly
Moore, Susan Marie Morella, Jacqueline Ann
Morgan, Carol J. Morris, Valerie Morris,
Susan E. Morrissey, Jennifer L. Moser,
Theresa Mulherin, Cynthia A. Mullis,
Michelle Munro, Paula Murray, Diana L.
Renee Narducci, Kirsten Nelson, Ami Nelson,
Adalynn Celine Nesjan, Minnie Marcel
Newbegin, Sharon M. Newton, Rose Mary
Nguyen, Linda J. Nicholson, Jayne Nickell,
Bradley Dean Nielsen, Theresa Nino, Aminah
Nitura, Vivian F. Norman, Sheri A. Norman,
Nicole M Norris, Laura L. Northstrum, John
N. Ntagha, Immanuel U. Nwalupue, Christina
Dale Nye, Martha A. Nykiel, Linda
Nylander-Housholder, Silvia E. Oakes,
Michele Jennette Oakins, Barbara Odin,
Nicholas R. O'Hearn, Rita C. O'Keefe, Anna
Olah, Louisa P. Olmo, Meghan A. O'Neil,
Lauren Deborah O'neil, Jeannette Orr, Marie
L. Ortaliz, Cathy S. Osgood, Daisy L.
Ostrowicki, Prudence M. Osunero-Lanuza,
Angela Dawn Ott, Amy J. Ottman, Susan M.
Ouellette, LaDeana Kaye Oueslati, Carol J.
Owens, Kathryn Owens, Lynn D. Owensby,
Catherine Pachorro, Jane Brekke Paige,
Sandra A. Pakulski, Gloria Palawar, Mary O.
Palazzo, Vickie S. Palm, Stephanie L. Palm,
Deborah Panozzo Nelson, Julie Parisien, C.
Lorraine Parsons, Deborah A. Pascua, Michael
Pasquale, Lance S. Patak, Sarah M. Pataluna,
Shona R. Patel, Julia P. Paul, Roanna F.
Payne, Kathleen Klein Peavy, Trina M. Pecina,
Dawn M. Peets, Pamela Ann Peine, D. Lyn
Penton-Cooper, Molena Peregrino, Lorena I.
Perez, Linda A. Perkins, Elizabeth M.
Perpetua, Nicole Ann Peter, Karen Y.
Petersen, Janet Peterson, Mary A. Pezzuto,
Leslee Pfaff, Melissa L. Pfeiffer, Thu Lan
Pham, Leslie Vito Pham, Dorothy R. Phelps,
Gemma S. Philbert, Kelly M. Piasecki,
Theresa Picione, Laura K. Pierce, James
Edgar Pittman, Lorraine Plaikner, Colleen O.
Planchon, Pamela Pleiter, Dawn Plouffe,
Patricia Rae Pollack, Elizabeth A. Pollock,
Melanie C. Polzin, Jodie R. Porter, Jeanne
M. Porter, Erin Porter, Myra K. Porthouse,
Jeannette M. Powers, Susan Pozzuto, Barbara
Lynn Presnell, Jan C. Preston, Cynthia Gail
Price, Gail A. Principe, Bradley J. Prior,
Barbara Proffitt, Lori L. Profota, Debra L.
Pronitis-Ruotolo, Donna M. Proulx, Karen S.
Provenzano, Diana M. Pryer, Sofia S. Puerto,
Karen L. Pyle.
Lou Quattlebaum, Debra L. Queen, Terri
Queen, Juan R. Quintero, Kenneth Lee Quiroga,
Erlinda A. Quiroz, Jennifer L. Rabalais,
Melissa Radosevich, Rosalynn G. Rafols,
Cindy L. Ramberg, Marlowe Abad Ramirez,
Dianna Leora Alberta Ramsey, Rosie L.
Randolph, Isabel Ranft, Susan B. Rasmussen,
Carol A. Rauen, Melinda N. Ray, Diane L.
Razo, Martha Reed, Cache Reed, Rhonda Reed,
Rita Christina Regan, Karen A. Reynolds,
Kelly D. Reynolds, Karen Rezendes, Marilyn
Rich, Jacquelyn F. Richards, Celeste B.
Richards, Barbara Richards, Don D. Richards,
Deborah Elaine Richards, Linda L.
Richardson, Vicki A. Riddle, Mary Ann Riesco,
Sheri Ann Riggs, Helen T. Roach, Alina
Mihaela Robert, Elin Roberts, Kathryn E.
Roberts, Darlene Roberts, Allyson Crawford
Robertson, Frank Johnny Robinson, Faith Joy
Rodenhouse, Sophia C. Rodgers, Aimee Johanna
Rodriguez, Marlyn Deborah Rodriguez, Elena
Denise Rodriguez, Barbara C. Rogers, Nancy
A. Rohde, Laureta A. Rosario, Susan K.
Rossetti, Kelly L. Rossler, David G. Rotz,
Michael John Rouse, Dawn Rubin, Cecilee
Marie Ruesch, Valarie Rumbley, Nancy J.
Russ, Charlotte M. Ryan, Jennifer Ryan,
Denese Terese Sabatino, Jonathan C. Sague,
Lilibeth R. Sagun, Margarite Salinas-Watt,
Sarah O. Sanburn, Rachel Sanchez, Virginia
R. Sanders, Catherine M. Saniuk, Kathryn G.
Sapnas, Mercedes C. Sarmiento, Lisa C. Sarno,
Ma Geraldine Sarte, Mary M. Sattaur, Barbara
E. Sayre, Gail A. Schaefer, Dawn M. Scherer,
Nancy M. Schildt, Russell N. Schivley,
Pamela S. Schlicher, David Ralph Schmidt,
Maureen Schmidt, Paul A. Schroeder, Dee D.
Schultz, Patrick Schultz, Susan M. Scollan-Boring,
Frances E. Scott, Lynn A. Scott, Sylvia S.
Sebastian, Barbara A. Secrest, Rebecca Jean
Seiler, Bridgett Byrd Sellars, John T. Selph,
Christina K. Sentz, Susan B. Sepples, Detra
Sessions, Susie Sha, Rose B. Shaffer, Linda
M. Shain, Lindsey Shank, Lisa Sharot, David
John Shea, Cate Sheahan Morrison, Patricia
A. Shipsey, Amy Shirato, Audrey C. Short,
Amy Brighetta Shyshnyak, Ken Siedel, Leeann
Sievers, Lynn M. Simko, Machell Chree Simms,
Nancy R. Simpson, Milarosa Tubang Sinahon,
Daljinder Kaur Singh, Anita M.
Siscoe-Hapshie, Robelisa Nillo Sistoso,
Tonya Ellis Skeen, Kerry C. Skurka, Karen
Slak, Kimberly A. Slattery, Patricia A.
Smart, Virginia Smith, Barbara A. Smith,
Jean H. Smith, Frances Moon Smith, Lisa
Wentworth Smith, Christine R. Smith, Barbara
A. Smith, Stacey E. Smith, Sharnel A. Smith,
Brian Smith, Rhonda Smith, Tamara L. Smith,
Demeetria Smith, Cheryl Frances Smith, Peggy
Ann Smith, Paulette Smith-Kimble, Janis
Smith-Love, Dana M. Smith-Ruggles, Catherine
M. Snelson, Tanya Elizabeth Snider, Jovita
C. Solomon-Duarte, Deborah J. Solvay, Lynn
Sonderman, Edward Sonnen, Joan M. Sonnier,
Katrina J. Souza, Nan Spawr-Seaton, Diane
Jean Spenner, Heather Sperling, Tracy Adele
Spies, Mary Michel Spiro, Joan M. Spitrey,
Laurel D. Spooner, Pamela I. Spooner, Erin
Lynn Springer, Diane St. Pierre, Teresa A.
Stackhouse, Sandy F. Stahl, Terri Lea
Stampher, Mary K. Stanley, Pat D. Stanton,
Angela R. Starkweather, Ellen Stein, Cynthia
L. Steinbach, Elaine E. Steinke, Stacy E.
Stelling, Diane J. Stempek, Julie S. Stenger,
Barb Stettner, Janice L. Stevens, Elaine T.
Stevens, Jeanette R. Stevens, Margaret
Stevenson, Mary C. Stewart, Carlette H.
Stewart, Melinda Stibal, Gayle F. Stinnett,
Christine Stinson, Doug Stobbe, Ellen M.
Stokinger, Barbara M. Stone, Alexandra Lynne
Stone, Brenda F. Styles, Marcia N. Suckie,
Marie H. Sudsbury, Annabelle Tukay Suguitan,
Brenda Sullivan, Teresa Sullivan, Amy Marie
Summers, Grace Suner, Cindy L. Suplinski,
Hayley Ronyce Suratt, Teresa F. Swift.
Marie Tack, Gloria Morales Taduran, Brenda
L. Taft, Aleine C. Talladen, Christine M.
Tanner, Susan Taylor, Amy Taylor, Edna
Victoria Taylor, Jan H. Teal, Viviane L.
Teixeira, Roxanne Telford, Gerry Tenn, Linda
L. Terrano, Sarah Holt Tew, Cathy Jo Thalken,
Martin L. Thiede, Linda C. Thomas, Lillie
Ruth Thomas-pitts, Cathy J. Thompson, Nancy
Thompson, Scott David Thompson, Anne Louise
Thompson, Teresa G Tipton, Miriam Cacha
Tivar, Marie T. Todd, Susan K. Tokh, Kathryn
I. Toliver, Thelma J. Torri, Suzanne B.
Tovar, Gina M. Traina, Debbie Travis, Storm
L. Treanor, Stacey E. Trefts, Rebecca L.
Trenkamp, Jennifer Trevena, Cathie J.
Tribble, Jason L. Tricker, Nicole L.
Trieste, Charlene T. Trimeloni, Michele S.
Trinka, Teresa M. Truckenmiller, Jason
Trudell, Barbara J. Trushaw, Melissa Tsay,
Aida C. Tuason, Tracy A. Tullio, Jackie
Turner, Irene D. Turner, Linda L. Turner,
Robert G. Turner, Donna M. Tydings, Michael
Uhl, Tristan E. Ulmer, Janette F. Ursolino,
Ozzie Uruena, Jean L. Uy, Regina M. Vachon,
Janine Vallen, Monica Van Staden, Valerie K.
Van Valkenburg, Johnnilynn Vanboxtel, Debra
M. Vanderkamp, Marsha L. Vaughan, Lynnith A.
Velasco, Elaine M. Ventresca, Carolyn
Verdejo, Leslie L. Vermilio, Judith A.
Vezner, Paul M. Vicencio, Richard W. Vitrano,
Valerie S. Vogeler, Ashley E. Voght, Laurie
Jean Volkmuth, Leah Carla Wacksman, Sandra
J. Wakai, Annette Walblay, Christie
Margrette Walden, David S. Walker, Maria R.
Wallace, Elissa Marie Walsh, Barbara K.
Walsh, Kathryn Mary Walsh, Chris Claire
Walsvik, Linda Walter, Sherry L. Walter,
Billie Jean Walters, Jennifer M. Walters,
Charlene L. Walton, Mary Kate Wargo, Cheryl
Warren, Brian Scot Wasem, Barbara J.
Washington-Knight, Eileen V. Weatherby,
Sharman L. Weaver, Judy K. Webb, Rebecca M.
Webb, Holly L. Weber-Johnson, John Crawford
Welch, Candice Renae Wells, Carolyn Sue
Welsh, Nancy E. Werren, Jennifer Lynn Wessol,
Jill A. West, Sharon L. West, Paula Katrina
West, Linda L. Weston Kramer, Christine G.
Westphal, Jane C. Whalen, Arllys B. Wheeler,
Anita J. White, Jennifer L. White, Bob
Whitter, Melissa W. Whittington, Steve Brian
Widmar, Maria Amor Wild, Linda Carole
Wilkins, Judi I Wilkinson, Karen R. Willard,
Sue A. Williams, Michael L. Williams,
Elizabeth J. Williams, Sharlyn K. Williams,
Vicky M. Williams, Douglas A. Willis, Naomi
Dolores Willis, Martha Delle Wilson, Judith
L. Wilson, Patricia L. Wilson, Jackie G.
Wilson, Michael D. Windham, Annette T.
Winkler, Susan J. Wirth, Jennifer Lynn
Wisnefski, Jeanne W. Woelfel, Julie M.
Wojtkowski, Barbara S. Wolfe, Charlotte L.
Wolfe, Michelle E. Woodham, Paula A.
Woodlief, LuAnn Woods, Kathleen B. Wright,
Jodi M. Wright, Christine Elaine Wynns,
Larraine A. Yeager, Elaine A. Yellen,
Shelley A. Young, Linda I. Young, Erwin Yson,
Kathryn Zarnesky, Jerry Zebrowski, Michael
A. Zeiler, Mary Jane Zellinger, Jill S.
Zemke, Julie Lynn Zepnick, April Yi Yu
Zhuang, Sherry Lynn Zimmerman, Elaine
Zimmerman, Pam Zinnecker, Carolyn Zinnerman,
Karen R. Zwerneman, Dennis M. Zwilling.
NTI Posters Accessible Online
weren't able to attend this year's National
Teaching Institute and Critical Care
Exposition, you can still sample some of the
rich knowledge-sharing that took place by
viewing the Research and Creative Solutions
Posters online at www.aacn.org > Clinical
Practice > Research.
Organized by category, the posters present
information related to a variety of topics,
including administration, cardiology,
education, end of life, pulmonary, grants,
direct patient care management, healthy and
healing work environments, management,
multidisciplinary rounds, orientation,
patient satisfaction, precepting and
mentoring, recruitment and retention,
research awareness, and nursing students.
is the deadline to submit Research and
Creative Solutions abstracts for NTI 2005 in
New Orleans, La.
Scholarships Support Continuing Education at
of paired participants experienced the NTI
as Vision Partners, a scholarship program
under which an AACN member shares the
opportunities available at the NTI and the
benefits of AACN membership with a
nonmember. In addition to the scholarship,
the nonmember also receives a one-year AACN
Following are the recipients of this year's
AACN Vision Partners Scholarships:
Kerr, RN, CCRN Fazila Di Giulio, RN
Lynchburg General Hospital Lynchburg General
Lynchburg, Va. Lynchburg, Va.
Maloney, RN, MSN, CCRN, CNS Kimberly Dillon,
Fairview Hospital EMH Regional Healthcare
Cleveland, Ohio Loraine, Ohio
Morgan, RN, MSN, CEN, CNRN Jennifer Lane,
Wellmont Holston Valley Wellmont Holston
Center Medical Center
Kingsport, Tenn. Rogersville, Tenn.
Pozar, RN, BA, BS, CEN, CCRN, CFRN Leonard
Guardian Air Transport Sacred Mountain
Winslow, Ariz. Tuba City, Ariz.
Schell-Chaple, RN, MS, CCRN, CCNS Annette
Stralovich-Romani, RD, CNSD
University of California University of
Burlingame, Calif. Antioch, Calif.
Wroblewski, RN, MSN, MLIS John Nikitas, PhD
Dickinson Hospital Cooley Dickinson Hospital
Deerfield, Mass. Belchertown, Mass.
A. Nale, RN, BS Tammy J. Trulove, RN, MSN
Medical Center Conway Medical Center
S.C. Conway, S.C.
Green, RN, BSN Vanita Masters, RN
River Community Hospital Mad River Community
McKinleyville, Calif. Kneeland, Calif.
Kruithof, RN, MSN, CCRN Timothy Price, RN,
Spectrum Health Spectrum Health
Kentwood, Mich. Grand Rapids, Mich.
R. Larson, RN, BSN, CAN, BC Kathryn A. Haack,
RN, MSN, ARNP, FNP-C
Medical Center Mercy Medical Center
City, Iowa Sioux City, Iowa
Medical Products Scholarships
Medical Products, Inc., also continued to
support NTI education scholarships for AACN
members who are striving to balance their
professional lives and family obligations
with their pursuit of graduate degrees.
Receiving these scholarships this year were:
M. Bosen, RN, MS, MSN, CCRN
Joseph Mercy Hospital-Oakland
Willis, RN, BS, BSN, CCRN
Christine A. Boev, RN, BS, BSN, CCRN
Coliseum Medical Center
Nurse Competence in Aging NTI Scholarship
Nurse Competence in Aging Continuing
Education Scholarship was funded by a grant
from the John A. Hartford Foundation
Institute for Geriatric Nursing. The
Smith, RN, BSN, CCRN
will write a brief article describing how
the NTI experience and the knowledge
acquired has improved her commitment or her
practice in caring for acutely or critically
ill older adults.
five-year Nurse Competence in Aging
initiative funded by an Atlantic
Philanthropies (USA) Inc., award to the
American Nurses Association through the
American Nurses Foundation, represents a
strategic alliance between ANA, the American
Nurses Credentialing Center and the John A.
Hartford Foundation Institute for Geriatric
Nursing, New York University, Steinhardt
School of Education, Division of Nursing.
Be a Part of the Circle of Excellence
Annual Award Nominations Due July 15
is the deadline to nominate yourself or a
colleague for an AACN Circle of Excellence
Award for 2005. The recipients will be
recognized at AACN's National Teaching
Institute and Critical Care Exposition, May
7 through 12, 2005, in New Orleans, La. In
addition, all recipients are presented a
personalized plaque. Some also receive
honorariums, monetary awards or
complimentary registration, airfare and
accommodations to the NTI.
Following is brief information about these
awards. To obtain a Circle of Excellence
awards application, call (800) 899-2226 and
request Item #1011, or visit the
Practice and Research Awards
Baxter Excellence in Patient Safety
Sponsored by Baxter Medication Deliver, this
award will recognize patient-care teams that
have made significant contributions toward
patient and caregiver safety in acute and
critical care. Recipients will describe
innovative approaches used to develop new
and revised processes that encompass safety
and improve the quality of care at the unit,
hospital or health system level. They will
show clear evidence of active collaboration
among team members validating their success
by presenting evidence-based outcomes.
Excellence in Caring Practices Award
Presented in honor of John Wilson Rodgers,
this award recognizes nurses whose caring
practices embody AACN's vision of a
healthcare system driven by the needs of
patients and families. Recipients
demonstrate how they have encompassed AACN's
values and ethic of care in their practice.
Health Care Excellence in Clinical Practice
Sponsored by 3M Health Care, this award
recognizes acute and critical care nurses
who embody, exemplify and excel at the
clinical skills and principles that are
required in their practice.
Excellence in Clinical
award is designed to recognize excellence in
the care of critically ill patients in
environments outside of the traditional ICU/CCU
setting. Eligible applicants include, but
are not limited to, nurses working in home
healthcare, progressive care, telemetry,
catheterization labs and emergency
Excellent Clinical Nurse Specialist Award
award recognizes acute and critical care
nurses who function as clinical nurse
specialists. Applicants must be CCNS
certified and, in addition to demonstrating
the key components of advanced practice
nursing, illustrate how they have been a
catalyst for successful change.
Excellent Nurse Practitioner Award
award recognizes acute and critical care
nurses who function as nurse practitioners.
Applicants must be ACNP certified. In
addition to demonstrating the key components
of advanced practice nursing, recipients
illustrate how they have served as a
catalyst for successful change.
Excellent Nursing Student Award
award recognizes nursing students whose
activities during nursing school have
promoted the value of nursing and reflect
the AACN vision of creating a healthcare
system driven by the needs of patients and
families, where critical care nurses can
make their optimal contribution. Individual
students or groups of students are eligible
to apply. Recipients receive a complimentary
three-year AACN membership.
Excellence in Research Award
award recognizes nurse researchers who are
furthering the mission, vision and research
priorities of AACN. Recipients of AACN
research grants or NTI research abstract
award recipients are not eligible for this
Research Abstract Award
award recognizes research abstracts that
display outstanding merit and particular
relevance to critical care nursing.
Recipients are selected from among the
research and research utilization abstracts
submitted for the NTI. Abstract submissions
must be received by Sept. 1. Successful
applicants receive $1,000 toward NTI
Value of Certification Award
Sponsored by AACN Certification Corporation,
this award recognizes contributions that
support and foster the advancement of
certified nursing practice in critical care.
Recipients are also presented a $500
award recognizes individuals or groups who
develop and enhance another's intellectual
and technical skills, acculturating them to
the professional community, and modeling a
way of life and professional achievement.
Excellent Nurse Manager Award
award recognizes nurse managers who
demonstrate excellence in coordination of
available resources to efficiently and
effectively care for acutely or critically
ill patients and their families.
Lilly & Company Excellent Preceptor Award
Sponsored by Eli Lilly & Company, this award
recognizes preceptors who demonstrate the
key components of the preceptor role,
including teacher, clinical role model,
consultant and friend/advocate.
Excellence in Leadership Award
award recognizes nurses who demonstrate the
leadership competencies of empowerment,
effective communication and continuous
learning, and the effective management of
Excellence in Education Award
award recognizes nurse educators who
facilitate the acquisition and advancement
of the knowledge and skills required for
competent practice and positive patient
outcomes in the care of acutely and
critically ill patients and their families.
Marsh-AACN Community Service Award
Cosponsored by Marsh Affinity Group
Services, a service of Seabury and Smith,
this award recognizes significant service by
acute and critical care nurses, as
individuals or in groups, in making a
contribution to their communities that also
projects a positive image of critical care
nursing. Individuals or groups selected for
this award may choose to receive either one
complimentary NTI registration or up to $500
toward speaker fees for an educational
Datascope Excellence in Collaboration Awards
Sponsored by Datascope, these awards honor
innovative contributions to collaborative
practice by nurses who care for acutely and
critically ill patients and their families.
At least one of the collaborators must be an
active AACN member. Each recipient is also
presented a $1,500 honorarium. Applications
are accepted in four categories
Multidisciplinary Team Collaboration
award recognizes broadcast and Web-based
media excellence in the portrayal of
healthcare providers, especially acute and
critical care nurses, contributing to a
healthcare system driven by the needs of
patients and families. Successful entries
present relevant nursing and healthcare
topics to large audiences of consumers,
including the general public, patients and
recipients will be announced in AACN
publications and at AACN's 2005 National
Teaching Institute and Critical Care
Exposition, May 7 through 12 in New Orleans,
recipients are presented a personalized
plaque. Some also receive honorariums,
monetary awards or complimentary
registration, airfare and accommodations to
For the Record
Klein, RN, MSN, NP, was coauthor with Amy
Schueler, RN, MN, MSN, CCRN, APRN, NP, of an
article about submitting NTI speaker
proposals that appeared in the April 2004
issue of AACN News. Klein's name was omitted
from the byline on the article.
Scene and Heard
continues to seek visibility for our
profession and the organization. Following
is an update on recent outreach efforts.
Voice in the Media
(April 2004)-The "AACN Update" featured
excerpts from the "President's Note" column
by AACN President Dorrie Fontaine, RN, DNSc,
FAAN, who discussed the new AACN Practice
Alerts that will set the clinical standard
for all acute and critical care units.
(April 2004)-A special report and
corresponding white paper outlining the
state of critical care medicine in the
United States and strategies to prevent a
crisis in the delivery of critical care
services was published. The report was
issued by the Critical Care Partnership,
comprised of AACN, American College of Chest
Physicians, American Thoracic Society and
Society of Critical Care Medicine. A March
29, 2004 news release headed "Medical
societies report critical care crisis in
United States: Critical care societies make
federal appeal to address impending health
care workforce shortage" was picked up by
several outlets, including PR Newswire, PR
Newswire Europe, Los Angeles Times, Seattle
Times, CBS MarketWatch, Dallas News,
NurseWeek and chestnet.org.
Online for Nurses (April 12, 2004)-An
article titled "Infection of the Heart:
Learning Signs, Symptoms and Prevention
Strategies for Endocarditis" noted that AACN
Certification Corporation has announced a
change in the CCNS eligibility requirements.
Effective March 1, all candidates for the
CCNS exam were required to have 500 hours of
academically supervised practice hours.
(April 2004)-Randy Bauler, CEM, AACN
exhibits and sponsorships director, wrote an
article titled "The Power and Influence of
Exhibitions" for the official publication of
the International Association for Exhibition
Management. "The exhibition industry, which
each of us is privileged to work in, should
be proudly talking-indeed shouting-about the
power and influence of exhibitions," he
wrote, adding that exhibitions continue to
be strong, results-oriented events that
increase sales, marketing and education.
Bauler is also a member of the IAEM board of
Management (April 2004)-An article titled "A
Vital Sign of the Time: CIS Software" cited
a 2001 estimate by AACN that nurses spend up
to 30% of their time-or 12 hours of a
40-hour week-attempting to obtain necessary
information to provide patient care.
Soundings (April 2004)-In an article titled
"How I Would Like 2003-2004 to Be
Remembered," Richard S. Irwin, MD, FCP,
president of the American College of Chest
Physicians, announced the collaboration
between AACN and ACCP on a five-year project
called "Partnership to Develop
Interdisciplinary Models of Patient-Focused
Care." AACN also joined the Board of
Trustees of the Critical Care Institute,
ACCP's repository for critical care
educational products and functions. "With
AACN joining the CCI as a member of the
Board of Trustees, the CCI has the potential
to become an important voice for critical
care in the Untied States," Irwin wrote.
CardioDynamics News Release (April 22,
2004)-"CardioDynamics Co-Sponsors Inaugural
International Acute Heart Failure Meeting"
was the heading of a news release that
announced the company's plans to exhibit its
ICG BioZ systems at upcoming conferences,
including AACN's 2004 National Teaching
Institute and Critical Care Exposition in
Orlando, Fla., in May. Outlets publishing
the release included Business Wire, Hoovers
Online, Yahoo News and Verizon Online.
Voice at the Table
Fontaine was joined by AACN board member
Janie Heath, RN, MS, CCRN, ANP, ACNP,
Practice and Research Director Justine
Medina, RN, MS, and Public Policy Specialist
Janice Weber, RN, MSN, in attending the
American College of Chest Physicians' 11th
Annual Capitol Hill Caucus in Washington,
D.C. Among the issues that representatives
of AACN and ACCP addressed with senators,
representatives and their health legislative
staff were the critical care workforce
shortage, COPD Caucus initiative to raise
public awareness about chronic obstructive
pulmonary disease and promote policies that
improve the lives of COPD patients, and FDA
regulation of tobacco.
Certification Director Carol Hartigan, RN,
represented AACN Certification Corporation
at the Alliance for Nursing Accreditation
meeting in Chicago, Ill. The meeting was
cohosted by the American Association of
Colleges of Nursing and the National
Certification Corporation for the Obstetric,
Gynecologic and Neonatal Nursing
Specialties. The group meets twice annually
to bring together faculty groups and
certification organizations to discuss
national issues related to advanced practice
education and regulation.
Hartigan attended the National Organization
for Competency Assurance annual Legislative
Fly-In Day and quarterly board meeting in
Washington, D.C. As a member of the NOCA
Board of Directors, Hartigan met with
representatives of the offices of Sens. John
Edwards (D-Mass.), Patty Murray (D-Wash.)
and Pat Roberts (R-Kan.) to discuss the
value of certification as well as issues
facing critical care nurses.
Hanson, RN, MSN, CCRN, treasurer of the AACN
Board of Directors, delivered the keynote
address at Bridging the Gap Symposium 2004.
The title of his presentation was "The
Unique Contributions of Critical Care
Nurses: Weaving Our Stories in the Tapestry
of Life." The Three Rivers and the
Suspension Bridge chapters of AACN
cosponsored this annual critical care
President-Elect Kathleen McCauley, RN, PhD,
CS, FAAN, spoke on "ICU Nursing: The Scope
of Practice in 2004" at the South Jersey
Healthcare fifth annual Critical Care 2004
Symposium at Cumberland County College,
McCauley presented the "Rising Above"
keynote address for the Trends in
Trauma/Cardiovascular Nursing conference,
cosponsored by the Southeast Pennsylvania
Chapter of AACN and the Drexel University
Office of Continuing Nursing Education.
represented AACN at the first National
Summit of the Nursing Leadership Task Force
on Tobacco Control at the Agency of
Healthcare Research and Quality in
Rockville, Md. Approximately 30 national
nursing leaders networked, shared ideas and
developed action plans for their
organizations to engage in tobacco control
Kwilecki, president of the Volusia-Flagler
Chapter of AACN, Kim Martin, secretary, and
member Donna Griffis visited a community
group to discuss the role of the critical
care nurse, how to be a more effective
consumer of critical care services and what
to do if a family member is in the critical
board director Nancy Blake, RN, MN, CCRN,
CNAA, spoke on "Bioterrorism: What a
Pediatric Nurse Needs to Know" during the
General Session of the Society of Pediatric
Nurses Conference in Las Vegas, Nev.
or your chapter has reached out to the media
or other groups to promote critical care
nursing, we'd like to know. E-mail your
What's Coming Up in the July Issue of the
American Journal of Critical Care
Strategies for Behavior Change in Patients
With Heart Failure
Critical Care Research: Weaving a
Appropriately Timed Analgesics Control Pain
Due to Chest Tube Removal
Documentation on Withdrawal of Life Support
in Adult Patients in the ICU
Subscriptions to Critical Care Nurse and the
American Journal of Critical Care are
included in AACN membership dues.
PDA Summer Specials
July 31, 2004, you can save up to $249 on
PDA hardware and software
Palm Tungsten T3 Bundle
Palm Tungsten C Bundle
Palm Tungsten E Bundle
bundles include your choice of device plus:
EKA Pocket Survival Guide
Cardiac Medications Pocket Reference
Hemodynamics Pocket Reference
Leather Belt-clip Case
Software Select 1-Year Subscription
Software Only Packages
Critical Care Software Bundle
Palm OS or Pocket PC
Pocket ICU Management
Evidence-Based Critical Care
Assessment Software Bundle
LAB Values Pocket Reference
Cardiovascular Assessment Pocket Reference
Nursing IV Drug Handbook
Monthly Super Savers from AACN's Catalog
excited to offer this monthly Super Saver
promotion, featuring catalog resources at
significant discounts. These Super Saver
prices are valid through July 31, 2004. To
be eligible for the Super Saver price,
orders must be received or postmarked by
July 31. Check this feature monthly to
discover additional values for your nursing
Optimizing Hemodynamics:Quick Tips for Drug
(#NCE3593703A or #NCE3593703C)*
Explains how preload, afterload and
contractility are appropriately manipulated
with fluids and drugs to treat hypo-
cardiogenic and vasogenic shock. Also
describes the indications, actions,
administration and nursing considerations
for many titratable agents, including
Dobutamine and Nitroprusside.
$13, Nonmember $13
$10, Nonmember $10
$15, Nonmember $15
$12, Nonmember $12
Initials That Spell Disaster: ARDS, ATN, and
(#NCE3553703A or #NCE3553703C)*
Analyzes and describes the normal stress
response and the exaggerated response that
occurs with ARDS, ATN and DIC. Also
describes the role of the critical care
nurse in caring for the patient with ARDS,
ATN and DIC. Includes study guide and 3.5
contact hours of CE credit.
$22, Nonmember $22
$17.50, Nonmember $17.50
$26, Nonmember $26
$19.50, Nonmember $19.50
Catheter-Related Bloodstream Infection:
Minimizing the Risk
(#NCE3133703A or #NCE3133703C)*
Describes the pathophysiology of
catheter-related bloodstream infection,
distinguishes between infection and
colonization of central venous devices and
lists two clinical interventions to minimize
the risk of catheter-related infection based
on current evidence. Includes study guide
and 2.0 contact hours of CE credit.
$13, Nonmember $13
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*Non-returnable. Please allow 7-10 days for
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Check Out These New Resources
your AACN library with products offered by
AACN's Product Catalog. New to the catalog
is the Crucial Conversation series. These
products will help you and your team develop
the tools necessary to create and maintain
healthy dialogue, even when you're angry,
scared, or hurt. Also new to the catalog is
Protocols for Practice: Symptom Management
in Acute and Critical Care. To learn more
about these products or other new products,
Deadline to submit applications for funding
by the AACN Small Grant Program. Available
are the AACN Clinical Inquiry Grant,
End-of-Life/Palliative Care Small Projects
Grant and Medtronic-Physio-Control Small
Projects Grant. To find out about AACN's
research priorities and grant opportunities,
AACN Web site
or e-mail firstname.lastname@example.org.
Through-July 12 CCRN certification
examination unavailable at AMP assessment
Deadline to submit nominations for AACN
Circle of Excellence recognition awards. To
obtain a Circle of Excellence awards
application, call (800) 899-2226 and request
Item #1011, or visit the
AACN Web site.
The application is also available on Fax on
at (800) 222-6329. Request Document #1011.
September 1 Deadline to submit the Research
and Creative Solutions abstracts for NTI
2005 in New Orleans, La. The application,
resources are available online.
In the Circle
Award Honors Excellent CNSs
AACN's Circle of Excellence program, the
Excellent Clinical Nurse Specialist Award
recognizes acute and critical care nurses
who function as clinical nurse specialists.
The award for 2003 was sponsored by Oridion
Capnography. Nominations for this award for
2005 are due July 15. Following are excerpts
from the exemplars submitted in connection
with this award for 2003.
Powers, RN, MSN, CCRN, CCNS, CNRN
Clarian Health, Methodist Hospital
presented in septic shock from pneumonia.
She was hypoxic, hypotensive, in renal
failure, in respiratory failure, metabolic
acidosis, hepatic dysfunction and DIC. With
her profound respiratory failure, the
decision was made to use kinetic therapy and
prone positioning to improve her respiratory
status. She had a pulmonary artery catheter
and a Quinton catheter with CVVH, was
hemodynamically unstable and on multiple
vasoactive drips. She had improved
significantly after being treated with
Xigris. Unfortunately, due to purpura
fulminans from DIC, she still did not have
much perfusion to her extremities.
was apparent that she would survive this
illness, a family discussion took place to
discuss options for L.'s care; her family
decided to continue with aggressive care.
Unfortunately, she required bi-lateral
above-the-knee amputations and bilateral
below-the-elbow amputations. This presented
major ethical concerns for the nursing
staff. The overall theme among the nursing
staff was that they would never want to live
the many ethical concerns with L., her
physical condition did continue to improve.
A tracheostomy was placed, and CVVH was
discontinued as her renal status improved.
L. was transferred to our pulmonary floor,
her tracheostomy was removed and she was
discharged to a local rehabilitation
discharge, L. and I discussed her hospital
stay, how close to dying she had come and
the unfortunate outcome of losing her
extremities. Commenting that she was happy
to be alive, she didn't question anything.
She believes everything happens for a
reason. She thanked all the nurses and me in
as a clinical nurse specialist offers the
opportunity to not only impact patient
outcomes across the system, but also to be
involved in the complexities of managing
extremely ill patients. As a clinical nurse
specialist, I have the opportunity to impact
patient's lives on a daily basis. This is
truly an honor.
Nancy Richards, RN, MSN, CCRN, CCNS
Baldwin City, Kan.
Saint Luke's Hospital
America Heart Institute
Kansas City, Mo.
a 57-year-old, 270-pound man with end-stage
cardiomyopathy. He had just experienced his
second myocardial infarction and was on
vasoactive medications, an intra-aortic
balloon pump and ventilator. In speaking
with his family about left ventricular
assist device implantation, I used a mock
device to demonstrate how it looked and
other teaching aids to explain its function.
Time was allowed to answer their many
questions. Because he could be discharged
with the device, I emphasized the role of
family in his recovery and care.
Teaching began as soon as H. received his
LVAD. Device basics were explained. We put
H. in charge of infection control (don't let
anyone touch you without washing their
hands) and safety (keep your hand pump with
you always). Staff continually explained
what they were doing with the device, and by
the time he was transferred to telemetry, he
was ready to start caring for it himself.
dietician included H. and his wife in meal
planning for healing and weight loss.
Physical therapy implemented strength
training and conditioning routines. Nurses,
transplant coordinators, the medical
cardiovascular CNS and I worked with H. and
his family to prepare for home LVAD
management. His rural community was prepared
with electrical readiness, and home safety
was ensured; home health was arranged and
local EMS training occurred.
goal was to be home for Thanksgiving-he was
discharged the day before. After five months
at home, his LVAD started to fail. A second
LVAD was implanted. He recovered
beautifully, and luckily a donor heart
became available 12 days later. He was
success was due to a healthcare team
providing quality, patient-focused care
driven by the needs of a very special
patient and his family. I am honored to have
been part of that team.
Award Honors Nurse Practitioner
AACN's Circle of Excellence recognition
program, this award honors acute and
critical care nurses who function as nurse
practitioners. Applicants, who must be ACNP
certified, demonstrate the key components of
advanced practice nursing and how they have
served as a catalyst for successful change.
Nominations for this award for 2005 are due
July 15. Following are excerpts from the
exemplar submitted in connection with this
award for 2003.
Kathy G. Supple, RN, MSN, ACNP, CCRN
Tinley Park, Ill.
G. Supple is recognized as a true expert in
the field of burn care, not only within our
institution, but also nationally. One of the
most highly regarded members of the Burn
Team, she is knowledgeable, possesses expert
clinical skills and is enthusiastic and
motivated in the field of burn care.
contribution in the advanced practice role
to the survival of T.G., a 35-year-old male
burn victim, is immeasurable. T.G. sustained
a 93% total body surface area burn after an
accident involving a chemical solvent. His
chances for survival were minimal, but Kathy
had a different feeling about this patient.
In addition to his young age, she recognized
he had a huge support system, deep sense of
spirituality and commitment among his family
Developing a special relationship with T.G.
and his family, Kathy served as the liaison
between the patient, family and Burn Team
throughout each phase of his injury. During
the emergent phase, Kathy's role was mostly
supportive. Using her advanced burn
knowledge, she was able to explain and teach
the family about what was happening during
the first 72 hours. During the acute phase,
which lasted most of his eight-month
hospitalization, Kathy demonstrated intense
advanced practice skills.
orchestrated his care with all members of
the Burn Team. She set up schedules for his
dressing changes and therapy sessions,
providing instruction to the nurses for his
complex dressing change needs. She involved
social work and chaplain services when
necessary. Kathy also worked with the sales
representatives from the company that
provided the specialized autografts that
were used. During the rehabilitative phase
of care, Kathy coordinated his transfer to
the rehab hospital and served as an ongoing
resource to the rehab physicians.
was finally discharged to home after 10
months of hospitalization, and Kathy
continued to maintain a close relationship
with T.G. and his family.
Award Recognizes Excellent Media
AACN's Circle of Excellence program, this
award recognizes print, broadcast and
Web-based media excellence in the portrayal
of healthcare providers, especially acute
and critical care nurses contributing to a
healthcare system driven by the needs of
patients and their families. Nominations for
this award for 2005 are due July 15.
Following is the exemplar submitted in
connection with this award for 2003.
Surgical-Trauma ICU at Mission Hospital
Pediatric ICU at Children's Hospital of
Mission Viejo, Calif.
Mission Hospital and CHOC at Mission
are times when everything comes together to
create an incredible outcome. A 17-month-old
boy sustained a severe traumatic brain
injury when he was run over by an SUV. Some
say it was a series of extraordinary
coincidences and others believe the power of
prayer was impacting the events that day.
the accident, the child was in
cardiopulmonary arrest. CPR was started at
the scene by a physician and nurse who were
at a nearby library. Paramedics arrived
quickly to stabilize and transport the child
to Mission Hospital's Trauma Center. Members
of the Mission Hospital surgical ICU and
Children's Hospital of Orange County
pediatric ICU were called to action.
Arriving with a Glasgow Coma Score of 3,
Anton was resuscitated while his parents
were heard fervently praying in the hallway.
same time, the neuro CNS, who was at home,
was overcome by an urge to call the
hospital. Listening to the trauma ICU nurse
describe the baby's condition, the CNS
relayed important information on new
technology capable of measuring brain tissue
team took the child to the OR, where
intracranial pressure catheters and the
innovative new oxygen monitor were inserted
into his brain. The critical care nursing
team from these two hospitals worked
diligently to provide expert care,
integrating the new oxygen monitoring into
his care. Although the prognosis was bleak,
the team never gave up in their quest to
maximize Anton's recovery potential. The
pediatric ICU nurses and neuro CNS
assimilated the new technology into the
child's care, providing his brain with
critical oxygen delivery. Despite a 1%
chance of survival, he emerged from his coma
12 days later and responded to his
environment. His progress continued and he
is a happy, normal toddler today.
story was featured on a Lifetime TV show
"Beyond Chance," Discovery Health Channel's
"Medical Miracles," and in the Guidepost
Magazine August 2002 issue. In each of these
stories, the integral role of critical care
nursing was highlighted. The nurses' goal
was to optimize the outcome of a child and
provide support to a family in which little
hope of a meaningful recovery had been
given. The stories provided the public with
an inside view of the science and art of
professional nursing practice.
Award Cites Initiatives to Meet Patient and
AACN's Circle of Excellence Awards program,
the Innovision Award recognizes initiatives
and programs that innovatively and
collaboratively meet the needs of families
of the acute and critically ill. Following
are excerpts from the exemplar submitted in
connection with this award for 2003.
Sentara Norfolk General Neurosciences ICU
Neurosciences ICU at Sentara Norfolk General
Hospital treats thousands of critically ill
patients every year. Its expertise can be
measured in decades, rather than years.
joined the unit in the 1970s, accompanied by
her husband B., who had accepted a position
in the uncommonly known practice of organ
procurement. Both became revered leaders in
their respective fields-he in organ
procurement, she in nursing. B. became
widely known around the world as a true
pioneer in organ donation for
sunny afternoon, he hurtled into disaster.
An automobile accident. Apparent neck
injuries. Helicopter to the Trauma Center,
and a transfer to the neurosciences unit.
Despite a gifted team of talented souls
giving it their all, B. succumbed to
colleagues and employees were devastated,
but made a pact to continue the miracle he
had created in his life and sealed with the
ultimate endorsement by giving his own
organs and tissues for those who needed
neurosciences unit now faced the difficult
task of taking care of B. and his family and
the staff who had spent many days over the
last several years of their lives with or
near him. The unit was thrust into the role
of caretaker, despite their own personal
loss, their own personal grief. Individually
and collectively, the nurses had to put all
knowledge and experience into one of life's
most difficult tests: losing someone close.
healthcare team provided the skilled
critical interventions to which they are so
Award Recognizes Nontraditional Settings
Editor's note: Part of AACN's Circle of
Excellence recognition program, the
Excellence in Clinical
Practice-Non-Traditional Setting Award
recognizes outstanding care of critically
ill patients in environments outside of the
traditional ICU/CCU setting. Nominations for
this award for 2005 are due July 15.
Following are exemplars submitted in
connection with this award for 2003.
Karen Balonis Brewer, RN, BA, BSN
United States Air Force
cardiothoracic clinical nurse coordinator in
a large medical facility, I thought I had
seen every possible reaction a patient could
have to diagnosis. Then I met M. When she
was advised that the mass in her lung should
be removed, she simply said, "I will be OK"
and left the room.
primary role is to manage, facilitate and
coordinate care for critically ill cardiac
and thoracic surgical patients. In M's case,
I did not have the chance to conduct a
complete pre-operative evaluation needs
assessment during her appointment. I knew
little about this patient, yet her simple
words, "I will be OK," tugged at me. Without
surgery, her cancer would spread. Did she
really understand the severity of her
learned that M's husband was terminally ill
and that she was his primary caregiver. At
the time she was diagnosed, her husband was
being hospitalized for sepsis. I realized
that M's main concern was for her husband.
Although M's husband was not a patient on
our service, I became involved in his care.
At the same time, I tried to talk with M
about her prognosis. One day, she asked me,
"Why are you so interested in my husband's
health if you work in the surgery
department?" "Because you are," I answered.
then on, M and I talked about everything.
Many personal issues were revealed in the
weeks that followed. M had her surgery.
Resectable lung cancer was the official
finding. Arrangements for continued care for
both M and her husband were made, always
keeping in mind to include their valued
wants, needs and beliefs.
importance of addressing the patient's
emotional and social concerns, not just her
medical condition, was truly exhibited in
M's case. Every day, nurses have an ethical
responsibility to ensure that our critically
ill patients reach their optimal health
outcome. This can be achieved only by
assuring that the personal needs of the
patient and their family members are not
overlooked. M strengthened my belief that to
truly envision the future of nursing, we
must always examine and treat the patient as
Beth Earley, RN, MSN, NP-C, CCRN
University of Rochester Medical Center
Clinic has integrated many of the principles
of critical care into an outpatient setting.
We now safely administer IV diuretics,
inotropes and other therapies, often
allowing a patient to avoid a trip to the
emergency department. Not having to carry
out a barrage of unnecessary repeat testing
saves the valuable time and efforts of
several healthcare workers, and the patient
saves hundreds of healthcare dollars.
Critical care nursing was my first love. The
CHF Clinic is my new passion. The fact that
a synergistic relationship exists between
the two gives me a great deal of
satisfaction. The fact that critical care
nursing continues to evolve to meet the
needs of our ever-changing healthcare system
and population gives me a great deal of
nurses, it is our responsibility to help
patients achieve and maintain their optimal
level of health, and research-based,
nurse-run clinics are an excellent way to
meet this objective.
A. Martin, RN, MSN, CCRN
University Medical Center
Critical care nurses are challenged with
patients not seen in traditional settings.
My role as a neurosurgery clinical nurse
specialist has evolved into multiple
settings, including operating room,
outpatient clinic, nursing units, emergency
department and ICU. Our patient population
includes brain tumors, traumatic brain
injuries, advanced Parkinson's disease,
essential tremors and intractable epilepsy.
Patients seize in clinic hallways, arrest in
MRI and develop arrhythmias as a result of
18-year-old intractable epilepsy patient who
had been seizing since age 2 months, was
referred for placement of a vagal nerve
stimulator (VNS). During our pre-op
interview, VM's mother stated that VM had
developed high fever and "shaking all over"
at age 2 months. The cause was undetermined
during hospitalization. VM continued having
follow-up, the doctor told VM's mother the
seizures were volitional attention grabbers.
Angry, VM's mother asked, "How does a
2-month-old baby do this on purpose?" At age
4, following multiple office visits and
hospitalizations, an EEG revealed seizure
activity, and anticonvulsants were begun. VM
continued daily breakthrough seizures with
mother related her story, she became less
angry. I realized that no one had previously
allowed her to express her feelings.
a good candidate for VNS. However, blood
work revealed a bleeding time greater than
25 minutes. PT, PTT and INR were normal.
Prolonged bleeding times occur in patients
taking Depakote, but VM was not taking it.
neurosurgeon requested hematology
consultation but, in reviewing VM's
activities, I discovered VM had been eating
three to four baked garlic bulbs per week.
Having read an article indicating excessive
garlic intake can cause prolonged bleeding,
I realized VM needed to stop eating garlic.
Three weeks without garlic brought VM's
bleeding time to normal. Surgery was
Critical thinking, combined with listening
to a frustrated mom, resulted in a
successful solution without expensive
consults. VM did fine with surgery and for
the first time was seizure free.