AACN News—May 2004—Association News

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Vol. 21, No. 5, MAY 2004


Member Recruiters Eligible for Rewards
New Campaign Under Way


AACN's Critical Links member recruitment campaign entered a new year May 1 as results of the 2003-04 campaign were tallied. (Final results will appear in the June 2004 issue of AACN News.)

The new drive, which ends March 31, 2005, 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, every participant is a winner. Anyone who recruits just one new member receives an AACN clinical or practice-related gift. But that's not all.

For every five new members recruited, participants receive a $25 gift certificate toward the purchase of AACN products or services. In addition, they are eligible for a drawing for a $100 American Express gift check in each month that they recruit a new member, as well as for three grand prizes of a $500 American gift check that will be drawn at the end of the campaign. Participants who recruit five or more new members will be entered three times.

Chapters are also eligible for prizes, including one complimentary NTI registration to be drawn each month. In addition, the chapters with the largest increase in membership and with the largest percentage increase in members during the campaign receive $250 gift certificates toward the purchase of AACN products or services, as well as a recognition certificate.

To 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.

To obtain membership application materials, call (800) 899-2226 and request Product #1316.

Critical Care Societies Promote �The Power of You' Letter-Writing Campaign

Join your colleagues May 17 through 19, during National Critical Care Awareness and Recognition Month, to educate Congress on the growing critical care workforce shortage and its implications for the future. AACN and three other critical care professional societies�American College of Chest Physicians, American Thoracic Society and Society of Critical Care Medicine�are partnering on a letter-writing campaign that outlines the crisis and calls for federal action. Through this effort, our collective concerns can be heard as one voice.

May 17 through 19, you can contact your congressional representatives through AACN's Legislative Action Center advocacy Web site and ask them to work with us. Letters will be available for you to sign and send electronically, or you can draft your own letter to express your concerns. Through this collective effort, critical care professionals can prompt health policy discussions to ensure the best critical care medicine for the future.

Nominations Invited for National Leadership Posts

Do you want to help lead AACN in achieving its mission and vision or do you know someone you think would provide strong and effective leadership?

Consider the national leadership positions that are available on the AACN Board of Directors, AACN Certification Corporation Board of Directors and the AACN Nominating Committee. Terms begin July 1, 2005.

Simply complete the nomination form that appears in the center of this issue of AACN News or that is available online at www.aacn.org > Nominations. The AACN Leadership Framework is also available online.

Following are the positions for which nominations are being sought. Reimbursement for travel as well as other expenses are provided for all of these national volunteer positions. Nominations close June 11.

AACN Board of Directors
(4 positions open, 3-year terms)
Accountabilities:
� Establish the vision, mission and values statements for the association
� Ensure effective organizational planning
� Effectively manage the association's resources
� Determine, monitor and strengthen the association's programs and services.
� Uphold legal requirements and ethical integrity
� Recruit and orient new board members and assess board performance
� Ensure effective communication between AACN and AACN Certification Corporation and other subsidiaries of the association
Qualifications:
� Active membership in AACN
� Active commitment to and understanding of AACN and its mission, vision and values
� Demonstrated leadership skills as defined in the AACN Leadership Framework

AACN Nominating Committee
(3 positions open, 1-year terms)
Accountabilities:
� Ensure the election process is in accordance with established procedures, policies and bylaws
� Conduct comprehensive interviews of nominees
� Review, synthesize and analyze nominee applications, references and interview transcripts
� Through group process, select candidates
� Communicate the committee's decisions and feedback to the nominees

AACN Certification Corporation
Director
(3 positions open, 3-Year Terms)
A director actively participates in governance to ensure the corporation's financial viability and growth; evaluate organizational outcomes based on established priorities and action plans; monitors the impact of corporation initiatives on patient care and healthcare delivery systems; articulates positions and policies to key stakeholders; and ensures a successful relationship between AACN and AACN Certification Corporation. Nominations for both nurse leaders and consumer representatives are being accepted for these positions.

For more information about the Call for Nominations, call (800) 394-5995, ext. 331, or visit our website.

AACN Nomination Process Offers Lasting Rewards

By Lt. Cmdr. John Whitcomb, RN, MSN, CCRN
United States Navy Nurse Corps
AACN Nominating Committee

When you nominate someone or someone nominates you for an AACN national office, it speaks volumes about what that individual represents and the potential you see in them. Having your name put forward gives you a sense of pride and exhilaration. It is personal recognition for the countless hours that have had an impact and made a lasting impression.

However, I get more satisfaction from nominating colleagues for awards, positions or special projects than when I myself am nominated. Nominating is a way I can express my gratitude for their commitment and dedication to the profession of critical care nursing.

When I was nominated for the AACN Nominating Committee, I was surprised and honored to be part of an organization that truly makes every effort to recognize its members. I was also touched that my colleagues saw in me something that was special and meaningful, and that I had something to give to AACN.
As if being nominated wasn't enough of an honor, being elected was an experience I will always treasure.

Are you wondering what the �secret code� to being in a leadership position within AACN is? I can give you the password: nomination. That means nominating someone you see as a leader with a �bold voice,� who is �rising above� others in his or her commitment to critical care nursing. That person could be you or someone you work with on a daily basis.

Although being nominated is an honor in other organizations, it is an even more special process in AACN. It sends a message that the individual exhibits the values of AACN, which include being an advocate, acting with integrity, collaborating, providing leadership, demonstrating stewardship, embracing lifelong learning, committing to quality, promoting innovation and generating commitment. Do you work with someone who exhibits these qualities? Take the next step and submit a nomination!

Nominations are now being accepted for positions on the AACN Board of Directors, AACN Nominating Committee and AACN Certification Corporation Board of Directors. The Nomination Form is inserted into this issue of AACN News and is also available online at www.aacn.org > Nominations. The deadline to submit nominations is June 11.

These positions are all important to the growth of the organization and to the individual being nominated. I assure you that, if you take the time to complete the paperwork, you will not regret it. Nominating colleagues is a gratifying experience that lets them know they are special, that they are recognized and that they do make a difference.

Be a Part of the Circle of Excellence
Annual Award Nominations Due July 15


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 or visit the AACN Web site.

Baxter Excellence in Patient Safety
Sponsored by Baxter Healthcare, this new 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.

AACN 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 honorarium.

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.

3M Health Care Excellence in Clinical Practice Award
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 Practice�Non-Traditional Setting
This 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 departments.

Excellent Clinical Nurse Specialist Award
This 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
This 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
This 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
This 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 award.

Research Abstract Award
This 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 expenses.

Mentoring Award
This 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
This 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.

Eli 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
This award recognizes nurses who demonstrate the leadership competencies of empowerment, effective communication and continuous learning, and the effective management of change.

Excellence in Education Award
This 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 symposium.

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:
� Nurse-Physician Collaboration
� Nurse-Administration Collaboration
� Nurse-Family Collaboration
� Multidisciplinary Team Collaboration

Media Award
This 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 families.

In the Circle
Award Recognizes Outstanding Mentors

Editor's note: The AACN Mentoring 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. Nominations for this award as part of AACN's Circle of Excellence recognition program for 2005 are due July 15. Following are excerpts from exemplars submitted in connection with the program for 2003.

Traci Hoiting, RN, MS, CCRN, ACNP, BC
Portland, Ore.
Providence St. Vincent Medical Center
In both her personal and professional life, Traci walks the vision the rest of us wish to see in others and ourselves.
She has been a mentor to me from her role as a charge nurse to her current position as director of nursing quality and education. I have seen her tireless, unwavering commitment to her own academic pursuits while balancing a busy work and family life.
Having the opportunity to see someone accomplish their dreams and maintain a steadfast commitment to the critical care nursing community is the greatest gift of hope that we have. Watching and learning how Traci handles failures as well as how she celebrates successes is one of the greatest gifts of a mentor.
I am fortunate to be guided by Traci in a way that has given me strength and wisdom that is something that I can now model for others.
Traci embodies the vision that AACN has for mentors. She actually lives the vision of AACN. She models the core values of our organization, and her recognition as a mentor is confirmation that integrity, compassion and excellence are the hallmarks of nursing.

Kathleen J. King, RN, ARNP, MSN, CCRN
Deerfield Beach, Fla.
North Broward Hospital District
Broward Community College
The Circle of Excellence Awards program prompted me to reflect on my nursing career and how I had found my career path, from a busy psychiatric office and attending nursing school to my current position as a clinical nurse specialist in emergency and pediatric intensive care. I quickly realized that key to my success is the mentoring relationship I have with Kathy King.

Through ventilator weaning rounds, Kathy taught me the true meaning of a nursing plan of care, evidence-based practice, incorporating creativity into clinical practice and encouraging me to pursue a graduate degree in nursing. She takes a positive approach to patient care problems, and her attitude as an eternal optimist is contagious.

I saw Kathy intermittently for several years and was always amazed that, during any interaction with her, I came away with new insight about nursing, clinical practice, research or professionalism.

My desire to seek the position in the pediatric ICU was because of my admiration for Kathy. Her ability to positively influence care, work collaboratively and increase nursing knowledge was inspirational to me. I wanted the opportunity to reach her nursing practice level.

Kathy is always open with me, imparting expertise and looking at care problems in a broad and objective manner. Through her guidance, I feel prepared to begin passing her legacy on to others, mentoring new CNSs and graduate nurses and following in my mentor's footsteps.

Bette Jean Johnson, RN, CCRN
Madison, S.D.
Bethel Lutheran Home
Bette has always been involved in fostering professional improvement. Active on multiple hospital committees, her mindset was that, if you didn't want to become involved in facilitating change, you had no right to complain.

After working with Bette for about a year, she began to encourage me to become more professionally active, both in the hospital and in AACN. So, I joined the Unit Nurse Governance Council, which led me to the hospital NCG, where I served as a member for two years, then vice chair and chair of the council. I also began to actively participate in the local chapter of AACN by committing to attend the monthly meetings and educational programs. I transitioned to program chair and joined the workshop committee before serving as vice president and then president.

Bette has been very influential in my professional life. She has encouraged me to do everything that has been important in my career.

Shirlien Metersky, RN, MSN, CCRN
Worthington, Ohio
Grant Medical Center
A critical care nurse for 22 years, Shirlien exemplifies the role of a mentor through her support of physicians, nurses, multidisciplinary staff and patients.

When I accepted the position as clinical outcomes manager, Shirlien took the time to share her knowledge and experience in the position with me while she transitioned into the CCU educator role. Without overshadowing my thoughts or ideas, she provided guidance and direction while teaching me how to process and interpret things differently.

In her role as CCU educator, Shirlien strives to create a best practice environment through research-based initiatives. She offers information without question or judgment of one's thought process and understands that increasing staff knowledge improves quality of care and patient outcomes. Shirlien is dedicated to supporting nursing staff in their professional growth, coaching them to submit and present poster abstracts.

As president of the Central Ohio Chapter of AACN, Shirlien encourages nurses to join national and local nursing organizations. Through her inspiration, I joined the national and local chapter and became secretary-elect. Shirlien continues to be a mentor, guiding me along with other board members in our new roles. Through her vision, Shirlien has helped to reenergize the chapter, making it stronger and more enduring.

A mentor leads by example, motivating individuals to meet personal and professional goals, despite obstacles in their quest for success. Shirlien demonstrates the ability to develop and enhance others' knowledge and skill through her encouragement of the staff as they reach for higher levels of achievement.

In the Circle
Award Honors Excellent Preceptor

Editor's note: 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. This award is part of AACN's Circle of Excellence recognition program. Nominations for this award for 2005 are due July 15. Following are excerpts submitted in connection with this award for 2003.

Corinne �Cory� M. Miller, RN, BSN
Raleigh, N.C.
Duke University Medical Center
I have spent the last 15 of my 18 years as a nurse in a cardiac ICU at a teaching hospital. Throughout my career, a major source of satisfaction has been precepting students. As a new graduate I had a preceptor who seemed determined to break my spirit and show me just how little I knew. At that point I became determined to combine my love of teaching and my passion for nursing into a mission: to foster a sense of healthy curiosity and learning that is unencumbered by fear or unfounded criticism for all students under my tutelage.

Each spring I work with senior nursing students. I try to teach my students more than just a set of technical skills. I aim to instill in them the essence of nursing, what makes our profession unique and important. Along with the standard goals of learning medications, assessment and technical skills, I emphasize the equally important goals of talking to patients and families about tough issues, being a patient advocate, and communicating effectively with the healthcare team.

I have designed a clinical rotation for my students that starts with caring for stable patients, then moving to stable-critical patients, critical patients and, finally, back to stable patients. This way, students can �put it all together� and be relatively autonomous in their care at the end of the rotation. I teach by asking questions and encouraging the students to ask questions, often incorporating humor to dispel any anxiety.

I am energized by my students. They challenge me to rethink the �whys� of my actions and inspire me with their fresh and inquisitive spirits. The relationships that were built through these interactions have spurred and motivated me to continue with my passions�nursing and teaching.

Eileen E. Pysznik, RN, BS, CCRN
Monson, Mass.
Baystate Medical Center
Near the end of Helen's orientation, we admitted Mr. B., an 84-year-old man who had recently undergone a bowel resection for cancer and was recovering on a surgical floor. He presented with poor color, no capillary refill and a grossly protruding abdomen, and was unconscious and breathing ineffectively. The surgical team arrived as we verified that Mr. B's systolic blood pressure was 40. In rapid succession, Mr. B. had warmed IV fluids running wide open, was intubated and placed on a ventilator, had Levophed rapidly titrated without improvement, and had an epinephrine drip started. While an arterial line and a pulmonary artery catheter were being placed simultaneously and labs were being sent, Mr. B's surgeon arrived and removed the staples from his midline abdominal incision. The incision opened wide, and a large amount of liquid stool poured out. While we suctioned and contained the stool to prevent contamination of the femoral lines, the surgeon arranged for the operating room to take Mr. B. as an emergency case. Forty-five minutes after arriving in ICU, Mr. B. was transported to the OR with a systolic blood pressure in the 40s.

During this ICU course, the charge nurse, Helen, and I performed as a well-coordinated team. Helen had previously had experience cautiously titrating vasopressors. Now, we collaborated to titrate the Levophed and epinephrine in a manner more appropriate to this situation.

When Helen and I returned from the OR, we spent time talking with the family. Then, Helen and I had time to review everything that had happened, stressing the importance of teamwork and not forgetting about the patient's family. Helen felt that it had been a great learning experience.

Rising Above
Rethink Recruitment and Retention Strategies for Critical Care

By Nancy Blake, RN, MN, CCRN, CNAA, Dave Hanson, RN, MSN, CCRN, EMT-P, and Susan Yeager, RN, MS, CCRN, ACNP
AACN Board of Directors

With the nursing shortage looming large, attempts to optimize recruitment and retention strategies are a priority for every organization. Today, this means that the needs of four distinct generations of employees must be weighed. Understanding the influences on each of these generations can help focus and optimize strategies to attract and retain nurses.

The Traditionalists
The Silent Generation, Veterans and Traditionalists are terms used to describe the 75 million people born between 1900 and 1945. Children of the Great Depression and World War II, this generation is known for strong traditional values of God, family and country. Their foundation of loyalty supports respect for authority, organizational structure, hard work and longevity at one workplace.

Recruitment and retention strategies for this group revolve around respecting the historical perspective and the political savviness these members bring to the organizational culture. Tapping into the brain trust of this generation by placing them in mentoring opportunities will entice this group to continue to make their maximum contribution. Acknowledgement for years of service, personal communication and flexibility in their work schedule, as well as financial acknowledgement, will provide a significant source of motivation for this particular generation as they transition into retirement years.

Baby Boomers
As Traditionalists approach retirement, Baby Boomers move into supervisory roles. Encompassing those born between 1946 and 1964, this is the largest generation at 80 million. Growing up during a period of economic growth, prosperity, Vietnam, women's liberation and the civil rights movement, this generation values personal gratification and material wealth, and they are optimistic regarding their ability to impact the world. These nurses are accustomed to working long hours to define themselves and to outshine their counterparts to get ahead in the workplace. Loyalty, dues paying and challenging the status quo are their means to move up the institutional ladder. Torn between their work ethic and familial obligations, they value an environment that recognizes their individual contributions while providing the flexibility necessary for them to juggle commitments. Managers who address them as peers and situations that provide individual acknowledgment are strong incentives for this group. Daily reminders of the impact their work has on the lives of patients and families will continue to drive this workforce into action.

Generation X
With the advent of women in the workplace, the 46 million Generation X or Baby Busters born between 1965 and 1980 became known as latchkey kids. Personal computers, single-parent homes and Watergate provided the foundation for this generation. Generation X values diversity, life balance and self-reliance while being distrustful of authority. Viewing work as a means to an end, this generation will likely hold multiple jobs during their career. An environment that provides them the opportunity to learn and grow their skills in a fun and flexible surrounding is likely to keep them grounded within the organization. Born in a technological boom, this group expects cutting-edge devices to support work and to supply immediate gratification. Building consensus in goal setting is important, but autonomy throughout the implementation process is key to this generation. This group will commit, provided there is a respect for diversity, and for coaching and career development opportunities.

Generation Y
The 76 million Nexters, Generation Y or Millennials born between 1980 and 2000 are considered by some to encompass the best of Boomer and Generation X qualities. Molded by technological advances and media, Nexters have been described as self-reliant, family-oriented, mobile and fun loving. Because of their command of technology, their world is without walls. Instant results, diversity and networking with a team to better the world are all patterns of thinking ingrained in this generation. The draw of this generation is evolving, but is thought to encompass the concepts of technology, flexibility, work/life balance, teamwork, fun and mentoring relationships.

Anticipating the retirement of Boomers and Traditionalists, hospitals across the country are responding with creative and innovative approaches to recruitment and retention. Appreciating that the younger generation of nurses will have many job opportunities and are impatient for instant results, innovative ways are now necessary in order to draw nurses to their organizations. John Peter Smith Hospital, Fort Worth, Texas, is among those leading the way.

Virtual Recruitment
As are other healthcare organizations, this 429-bed Level II trauma center has faced challenges in filling vacant nursing positions. This crisis peaked in winter 2002, when the nurse vacancy rate in the JPS Health Network reached 17%. At the time, the application process could have lasted months while managers waited for qualified applications, sifted through r�sum�s, interviewed interested applicants and waited for offers to be accepted.

To improve the application process, nurse executives decided to implement a focused strategic plan with the potential to recruit nurses from anywhere, anytime of the day or night. In February 2003, the organization officially launched an online virtual tour of the nursing division. Appreciating that nurses today live in a world without walls, the goal of this technology is to synergistically reach out to Web site visitors, influence them to apply and successfully recruit them into the JPS system. By implementing easy access and navigation, virtual tours of each unit, online applications and interactive opportunities between applicants and managers, this tool has enabled nurses from Alabama, Arizona, California, Florida, Hawaii, New York, Oklahoma, Pennsylvania and Utah to become a vital part of the JPS system. By �rising above� to see new possibilities, JPS has seen a 63% increase in online nursing applicants and reduced the hiring time to between 14 and 17 days. These efforts have resulted in a subsequent drop in the nurse vacancy rate to 5.9%, which is currently 3% below the local market.

Partnering With Education
Having enough nurses to fill vacancies is not just limited by a nurse's awareness of his or her own organization. As long as we have a shortage of faculty members, the nursing shortage is going to prevail.

Recognizing the need for a multipronged approach to alleviating the deficit, JPS has focused on treating another cause of the shortage, not just the symptom. The result is the Clinical Faculty Loan Program through which a qualified nurse is loaned to a school of nursing in the area. This nurse serves as a clinical instructor at the hospital to teach the clinical component of the nursing curriculum.

As a direct result of this creative partnership, 20 additional nursing students can be accepted into the nursing program without increasing costs to the school. This retention strategy has given JPS access to additional students for possible recruitment, which has the potential to save the organization money not only in recruitment, but also in decreased orientation time for new nurses.

RN Residency
Another example of how an organization is �rising above� to recruit and retain the younger generation is the Childrens Hospital of Los Angeles RN Residency Program.
Prompted in 1998 by the dwindling availability of experienced nurses, a graduate nurse turnover statistic of 36% at 12 months and a 24-month attrition rate of 56%, the institution began exploring a different means to attract and train their nurses. Through extensive analysis, the leadership team came to appreciate its failure in realizing the unique needs of the new generation of graduate nurses and the lack of understanding related to what should be taught to stimulate and support the new nurse orientee.

In response, the RN Residency Program was established. Applying the concepts of Patricia Benner's novice-to-expert model and lifelong learning, a comprehensive, 22-week program evolved over a five-year period. Curriculum development was accomplished under the guidance of a newly formed task force, composed of experts both in pediatrics and education. The group, led by vision and financial champion Mary Dee Hacker, RN, MBA, was armed with the goals of transitioning newly graduated RNs, facilitating safe, competent care, and enhancing commitment and retention within the organization. Incorporating this group's expertise into Hacker's vision of creating strong care providers by educating the workforce, a job analysis tool was created. The focus was to identify the knowledge base, duties and tasks each RN needed. After sifting through the data, an outline of the program evolved. Currently the RN Residency Program consists of the following components: classroom and skills, professional development with mentoring and debriefing services, and 650 hours of guided clinical hours among a variety of patient populations and nursing units.

The curriculum development portion of the job analysis was used to refine program content. Teaching focused on identified key components for the 200 hours of classroom and skill time, allowing instructors to focus on the important aspects of learning. Appreciating the desire for younger generations of nurses to refine their skill sets, professional development classes, including communication and conflict resolution, have subsequently been added to the clinical content. The mentor program allows the residents to work with a mentor who is outside their management core group. Debriefing sessions also assist in supporting the residents. These sessions, which are facilitated by an experienced social worker and noninvolved manager, provide an opportunity for residents to discuss their orientation in a safe, supportive environment. The mentoring portion, as well as the debriefing sessions, support the concept of a unified team committed to learning. This social concept has been shown to be highly important to younger generations.

The program has proven to be successful, with a turnover rate reduction in the first 12 months from 36% to 11% and after the second 12 months from 56% to 22%. The program's success has been a model for implementation at three additional children's hospitals, Loma Linda, San Diego and Childrens Hospital of Orange. Similar recruitment and retention successes have been realized in these organizations.

After five years and $9 million in research and clinical testing, the RN Residency Program is taking off in other areas of the country. It has graduated more than 500 pediatric nurse residents and is expected to save an estimated $15 million in the future. The latest addition to the program is the state-of-the-art Web portal. Recognizing the need for immediate results and cutting-edge technology for newer generations, this portal will allow for fast access to content, curriculum standardization, competency tracking and reports, and online program evaluation.

Adapting Efforts
Because of the distinct differences among Traditionalists, Baby Boomers, Generation X and Generation Y, healthcare organizations across the county are proactively adapting their recruitment and retention efforts to meet the needs of a diverse workforce. Although individual nurses don't necessarily fit the stereotypical profiles, knowing the basics will allow healthcare organizations to �rise above� and be more nimble in recruiting and retaining the best of the best.

Bibliography
1. Weston M. Coaching the generations in the workplace. Nurs Adm Q. 2001;25(2)11-21.
2. McNeese-Smith D, Crook M. Nursing values and a changing nurse workforce: values, age, and job stages. J Nurs Adm. 2003;33(5) 260-270.
3. Benner P. From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Menlo Park, Calif: Addison-Wesley Pub. Co; 1984.
4. Clausing S, Kurtz D, Predeville J, Walt J. Generational diversity-the nexters. AORN J. 2003;78(3):373-380.
5. Lancaster L, Stillman D. When Generations Collide: Who They Are. Why They Clash. How to Solve the Generational Puzzle at Work. New York, NY: HarperCollins; 2002.

 

Table
Generation Year Influences Opportunity Motivators for Development Learning Style
Silent
Veterans
Traditionalist
1900-1945 Great Depression
WWII
Require patience related to technologic introduction, may need one-on-one rather than group setting related to skill development , Personal communication, financial acknowledgment, flexible scheduling, structure, ability to share knowledge with less experienced nurses Intimidated by technology, prefer pencil and paper classroom techniques
Baby Boomer 1946-1964 Vietnam, women's liberation, civil rights movement, economic prosperity Mentoring with technology, patience with younger generation choices to change jobs and desire to move quickly into a career path Individual acknowledgement, material wealth, ability to impact the world, flexibility Focus on lessons-learned style of case studies, classroom style learning with discussion
Generation X
Baby Busters
1965-1980 Personal computers, single-parent homes, latchkey, Watergate May need guidance when working within the confines of a group, lack patience with processes or multiple meetings, may lack sensitivity related to older generational lack of technology expertise, lack of authority trust, autonomy may be viewed as aloofness Cutting-edge technology, environment that supports skill set growth and career
paths, work/life balance, autonomy in creative solution development
Coaching, role play, Interactive CD-ROM or videotapes
Nexters
Generation Y
Millennials
1981-2000 Technologic advances, media May lack IPR skills and political savvy, may need mentoring related to being patient while learning to navigate political systems within an organization, may lack sensitivity of older generational lack of technology expertise Instant results, diversity, networking to better the world, trust authority figures, optimistic about the future, pursue lifelong learning Require more supervision with clear expectations, mentoring situations welcomed, technology-based learning combined with group support

Board Learning Partners Gain Insight Into Association Work

Volunteer Opportunity
Allows Members to
Share Experience

By Brenda Truman, RN, MS, MSN, NP, and Vicki Boyce, RN, MS, MSN

Imagine having the opportunity to sit at the table with AACN leaders as they discuss association business. It is truly an opportunity to �Rise Above� and appreciate AACN from another perspective.

The board's work is to steward the association's movements; look at trends for nursing, healthcare and professional associations; and ensure that AACN is on track to live our values, work within our mission and move toward achieving our vision.

As AACN Learning Partners, we were interested in learning more about the association and its leaders. After being selected from among applicants during last year's Call for Volunteers, we were offered the opportunity to participate in one of the scheduled national board meetings.

To enhance the experience, each Learning Partner is assigned a board mentor, who assists with social integration, answering questions and providing background information to help understand the process before and during the meeting. Materials are sent in advance to allow time to prepare for discussions, making the actual meeting time as productive as possible.

The meeting we attended in November spanned three days and included presentations by a variety of national office staff to update the board on various projects and provide background regarding the next strategic steps. The diverse geography, practice settings and specialties represented in the make-up of the board, as well as the contributions from key staff members, ensured that discussions were broad based. The outcomes of the discussions were then incorporated into the work plans for the staff, which reports back to the board at regular intervals.

Following are some of the impressions we came away with:
� The needs of the members are paramount. To put a twist on a familiar phrase, AACN is a professional association driven by the needs of its member.
� Volunteer contributions to AACN are truly valued.
� AACN is efficient in project design, implementation and follow through.
� AACN as an organization is highly regarded.
� The board members are truly functioning in their stewardship roles and both ask challenging questions of the staff and affirm the strategic plan of action.
� We are in capable hands in our volunteer and staff leadership.

If you are interested in this or other volunteer opportunities at the national level, register online in AACN's Volunteer Profile Database.

On the Agenda

Following is a report by AACN board member John Dixon, RN, MSN, on discussions and actions that took place during the board's March conference call.

Agenda Item: Strategic and Operating Plans
After discussing updates to the AACN Strategic Plan, the board reviewed the draft Operating Plan for 2004-05 to ensure that the association is on target and that its tactical plan is aligned with strategic goals. In operationalizing the Strategic Plan, the association continually scans the environment to identify and monitor changes as it focuses on adequate staffing, end-of-life and palliative care, and healthy work environments as priority issues.

Agenda Item: New AACN Certification Corporation Board Members
The board approved the following slate of candidates to serve on the AACN Certification Corporation Board of Directors: chair-elect (one-year term)�Judy Verger, RN, MSN, CCRN, CRNP, and directors (two-year terms�Kevin Reed, RN, MSN, CAN, BC, and Beth Martin, RN, MSN, CCNS, CNRN. The new terms begin July 1.
The selection of candidates for the AACN Certification Corporation board is part of AACN's annual Call for Nominations. However, the nominating process differs from that for the AACN Board of Directors and the AACN Nominating Committee, because AACN members at large do not vote on candidates for the AACN Certification Board of Directors. Because AACN is the sole member of AACN Certification Corporation, the AACN board is required to formally approve corporation candidates.

Agenda Item: Business Plan
In keeping with AACN values of embracing lifelong learning, the board discussed potential new products and additional markets with Wendy Berke, RN, BSN, MHA, AACN's director of professional practice. AACN continually seeks to provide the highest quality resources.

Agenda Item: Financial Report
After AACN Chief Financial Officer Michael Willett reviewed the financial highlights for the six months ending Dec. 31, 2003, the board approved the financial report as presented. Willett noted that the association remains financially sound as the end of the fiscal year approaches on June 30. Noting the success of NTI 2003 in San Antonio, Texas, Willett said AACN is looking forward to another strong NTI in Orlando, Fla., in May.

Protect Yourself, Your Family and Your Career


AACN encourages nurses to protect themselves with their own malpractice insurance. Did you know that, with Professional Liability Insurance from Marsh Affinity Group Services, a service of Seabury & Smith, you can double your protection without doubling the cost? For example, RNs pay $89 annually for $1 million per occurrence coverage ($6 million aggregate coverage) and $104 for $2 million per occurrence coverage ($4 million aggregate coverage).

What's more, applying for this coverage online just got easier with proliablity.com! Browse through �Quick Tips� and get answers to frequently asked questions, or get a free rate quote instantly. You can apply either directly online or download an application and mail it to the address shown.

To apply, get a quick quote or for more information, visit proliability.com or call (800) 503-9230 toll free.
Note: AACN members are eligible for a 10% premium credit through one of the following criteria: certification, 4 CE credits in risk management or employment at a magnet hospital.

For more information about this or other personal resources available to AACN members, visit our website.

Submit Abstracts Online for NTI 2005

June 1 is the deadline to submit speaker proposals, including chapter-related proposals, for NTI 2005, which is scheduled for May 7 through 12 in New Orleans, La. Abstracts can now be submitted online.

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

RN (March 2004)�In excerpts from her AACN News �President's Note� column, AACN President Dorrie Fontaine, RN, DNSc, FAAN, said, �Love and longing also point to the love and passion that critical care nurses bring to the work of meeting the needs of patients and families at the end of life ... Nurses everywhere long to make a difference and to meet the many needs of all who tug at our hearts each day.�

Carolina Nursing (Spring 2004)�An article in this alumni publication of the University of North Carolina noted that Immediate Past AACN President Connie Barden, RN, MSN, CCNS, CCRN, received the university's Chapel Hill School of Nursing 2003 Alumna of the Year award. In addition, AACN Board Director Mary Holtschneider, RN, BSN, MPA, was thanked for her valuable contributions as one of the school's board members.

Richmond Times Dispatch (March 7, 2004)�AACN was quoted in an article titled �Healthcare Job Needs Growing/Companies Offer Programs, Benefits and Plans to Attract and to Retain Employees.� �Nurses and nursing staff represent the biggest employment demand,� AACN said. �For the first time, registered nurses top the U.S. Bureau of Labor Statistics list of occupations with the largest projected 10-year job growth. The demand is expected to rise from 2.3 million in 2002 to 2.9 million in 2012.�

CrucialConversations.com�Fontaine was quoted in the �Testimonials� section of the Web site. In part, she said, �I'll continue to dream of a critical care unit where nurses consistently speak up about patient care with physicians and with other colleagues without feeling intimidated. Getting better at my crucial conversation skills is one way I can make this happen.�

Nursing Management (March 2004)�CEO Wanda Johanson, RN, MN, was one of the authors of an article titled �Bringing end-of-life care out of the shadows.� The article urged readers to �join the nursing community in acting as a change agent and adding palliative care to your nursing practice,� and discussed the resources available. The authors also said, �Nursing organizations, through the Nursing Leadership Academy for Palliative and End-of-Life Care and its resulting Palliative and End-of-Life Care Nursing Community have taken the initiative to integrate palliative and end-of-life care into their organizations' agendas and everyday practice. Together, these organizations have committed to one vision, one voice, in a clear and deliberate statement.�

Nursing Management (March 2004)�A column titled �Ones to Watch� noted that AACN won the 2003 Spotlight Award for Excellence from the League of American Communications Professionals in both the speeches and advertising campaigns categories. The column also listed the new board of directors for Sigma Theta Tau International, which includes AACN Certification Corporation Chair Suzanne Prevost, RN, PhD, CNAA, who was elected to a two-year term.

Our Voice at the Table
Barden and Johanson participated in the strategic planning committee meeting of the American College of Chest Physicians in Marco Island, Fla. Because 85% of critical care medicine is delivered by pulmonary-critical care physicians, ACCP is implementing a new Critical Care Institute to enhance current activities, develop new initiatives and strengthen advocacy efforts related to the care of critically ill patients and their families. AACN has joined ACCP as a foundational partner in the development of this new Institute to ensure a strong and unified voice for critical care in the U.S. This meeting provided an opportunity to explore the desired future of the Institute and the potential for education and policy development.

Roberta Kaplow, RN, PhD, CCRN, CCNS, AACN Certification Corporation board member, Carol Hartigan, RN, MA, certification director, and Karen Harvey, RN, MSN, certification specialist, attended the American Board of Nursing Specialties meeting in Phoenix, Ariz. Twenty-three certifying organizations shared initiatives and current priorities. Among the topics discussed were common legal issues and current trends facing certifying organizations; organizational autonomy; generating alternate revenue repurposing products; and advanced practice certification and licensure issues. In addition, reports were shared from the JCAHO Healthcare Professional Education Roundtable and the Citizens' Advocacy Center Continuing Competency Initiative. Kaplow also serves as co-chair of the ABNS Research Committee.

Fontaine spoke at the combined presidents' session at the Society of Critical Care Medicine's 33rd Critical Care Congress in Orlando, Fla. Her topic was �Healthy Work Environments Prevent Malpractice.� The presidents, or their representatives, from SCCM, ACCP, ATS and AACN met to discuss collaborative initiatives.

Kathleen McCauley, RN, PhD, CS, FAAN, AACN president-elect, was the keynote speaker at NurseFest 2004, sponsored by the Lehigh Valley Chapter of AACN in Pennsylvania. Her presentation was titled �Rising Above: We all can make a difference.�

The Central Pennsylvania Chapter of AACN hosted a regional symposium called �Rising Above: Facing the Challenges of Critical Care.� The closing speech was presented by AACN Board Member Carol Puz, RN, BSN, MS, CCRN, on �Blazing the Trail to Healthy Work Environments.� She focused on collaboration and creating a vision to move forward. The Region 3 meeting, facilitated by Chapter Advisory Team representative Janice Wojcik, RN, MS, MSN, CCRN, APRN-BC, took place the following day. Puz presented an update on national AACN activities, including NTI, the PCCN certification exam for progressive care nurses and AACN's electronic newsletter, Critical Care Newsline.

Past AACN board member Nancy Munro, RN, MN, CCRN, ACNP, was elected as a national affiliate representative for the 2004-05 Nominating Committee of the American College of Nurse Practitioners. AACN is part of a national affiliate group of organizations that regularly discuss common issues and recommend members for election to the ACNP board or nominating committee.

AACN Board Director Nancy Blake, RN, MN, CCRN, CNAA, attended the San Fernando Valley Chapter Spring Symposium. She discussed critical care nursing issues with many AACN members and met with nursing students who were very enthusiastic about their chosen profession.

Award Cites Excellence in Education

Part of AACN's Circle of Excellence program, this 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 acute and critically ill patients and their families. Bard Medical Division sponsored the award for 2003. Nominations for this award for 2005 are due July 15. (See page 7.) Following are excerpts from the exemplars submitted in connection with this award for 2003.

Stephen D. Krau, RN, PhD
Nashville, Tenn.
Middle Tennessee State University
Vanderbilt Medical Center
With the advances in technology and the extraordinary means by which it is possible to prolong the lives of patients, critical care nurses are faced with myriad, ever-changing issues and situations. As nurse educators, our role is to help students explore the dimensions of not only their nursing knowledge, but also their values and beliefs that impact the care they provide in any critical care situation. Understanding these beliefs, and having a sense of �self� in stressful situations can enable the nurse to effect positive patient and family outcomes.

One day, at the end of clinical rounds in the ICU, I told a student what an extraordinary job she had done. She looked at me and said, �But, my patient died.�
I could only answer, �Yes, she died, but look how she died. All that could be done was done, and she died peacefully and comfortably. She died in the presence of a daughter who loves her and in the presence of one of the most caring and compassionate future nurses I can ever hope to know. I only pray that when it is my time, there is someone like you taking care of me and my family. No one could ask for more.

�Nurses touch lives in a most intimate way. We are privileged to be with patients at the most sacred times in a life, from birth to death. It's all about caring and touching the lives of other human beings, wherever we encounter them. Critical care nurses are positioned to touch the lives of patients and their families during times of their greatest and most profound need. We have the opportunity to impact their lives in ways we may never totally know, or appreciate.�

Brenda Lynn Morgan, RN, BScN, CNCC(C)
London, Province Ontario, Canada
London Health Sciences Centre
S. described her experience prior to having her AVM removed. Its location made blindness a significant risk. She was visibly upset as she questioned whether she had �correctly� supported her children. Despite being advised against it, she decided to tell her young son about her surgery and risk for blindness. Shortly afterward, she found him crying. �If you go blind, how will you know what I look like?� he asked. �I will still be able to touch your face and recall your beautiful image,� she assured him. Several months post-op with vision intact, she still fretted over her decision.

We explored her son's potential response had he not been prepared and blindness occurred. We talked about children's need to receive honest, age-appropriate information, and to be reassured of a parent's love and affection. In reflection, S. received affirmation of her handling of the situation, and a weight was lifted from her shoulders.

At age 53, J. was on inotropes, CRRT and IABP therapy after a myocardial infarction. He was conscious during his family's visits. Shortly after they left, he deteriorated to the point that nitric oxide and neuromuscular blockade were required. His chance for survival was considered negligible. I notified the family of the change of events. Although they planned to return after dinner, I gently suggested they shouldn't wait. I then negotiated to hold off paralysis until the family arrived, making it possible for them to speak to the patient one last time. During a bereavement call one month later, his wife indicated that she now understood why I wanted the family to talk to John when I did. She was grateful that she had the chance to say goodbye.

Critical care educators must encourage nurses to identify opportunities to promote family recovery; it is an important and rewarding part of our role.

Mary Lynn Brown, RN, BSN, MSN, PhD
Knoxville, Tenn.
University of Tennessee College of Nursing
In 1978, I became a clinical instructor and found I had the same passion for teaching as nursing. I loved the students' excitement for knowledge. By emphasizing caring and a commitment to learning, I found endless opportunities to make a difference to students and patients. This philosophy required encouraging and mentoring outside of classroom and clinical time.

I organized study groups to encourage learning. My passion for teaching was ignited when struggling students succeeded. Students needed someone to go beyond the standard level of teaching to show them they are valued as nurses. One example was when two minority students failed their first exams. The course coordinator asked me to advise them to drop the clinical course. I disagreed and instead encouraged the students to attend my study groups. Both students attended, passed the course, and graduated. I had another student excel academically but was unsure about nursing. She said she would give nursing one more semester. After a few days of clinical, she was more interested in nursing. At graduation, she expressed her appreciation of my help in developing her passion for nursing.

Besides my full-time teaching responsibilities, I returned to critical care. This sharpened my clinical skills. I also volunteered to coordinate and teach in a comprehensive critical care course for area healthcare institutions. Nurses can lose sight of their passion by being caught up in performing tasks. I hope I have encouraged students to long for the passion of caring for others.

Award Recognizes Nursing Students

Editor's note: The Excellent Nursing Student Award, part of AACN's Circle of Excellence recognition program, honors nursing students who have promoted the value of nursing and who 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. Nominations for this award for 2005 are due July 15. (See page 7.) Following are excerpts submitted in connection with these awards for 2003.

Danielle Avery Curtis, BSN
Ward, Ala.
Capstone College of Nursing
University of Alabama
My summer internship in the surgical ICU offered me opportunities and enriching experiences. I was able to use my last summer before graduation in a beneficial manner not only for patients, but also for myself. As I prioritized my time, my nursing position climbed to the top of the list.

Each week brought forth diverse patients with various diagnoses and levels of difficulty. The patient I will always remember was a woman with a ruptured AAA repair. Caring for this patient taught me volumes of knowledge about central venous lines, ventilators, vasoactive medications and many other aspects of critical care. As I had the opportunity to work with her numerous times, I began to polish my clinical skills.

Although I was grateful for this experience, what this patient taught me went deeper than the hands-on practice of nursing care. She taught me the importance of acknowledging a client's emotional requirements. This patient allowed me to discover patience, determination and love through her own recuperation and her family's concern for her.

What I learned that summer helped me realize that the key to patient care extends beyond a client's physical needs. I now look to my patient's psychological and emotional needs and appreciate his or her demands. Each patient is distinct. That in itself makes a nurse's profession more rewarding.

Now I can observe patience, determination and love in my patients, as well as my fellow students, teachers and coworkers. No lesson can be more valuable.

Sarah A. Nalle, RN, BSN
Knoxville, Tenn.
University of Tennessee College of Nursing
Throughout the course of my baccalaureate education, emphasis was placed on a holistic approach to patients, focusing not only on physical care, but also addressing the individual's psychosocial, emotional and spiritual needs. These priorities are often overlooked in routine patient care. In fact, the impact of a holistic approach to nursing was intangible to me until I provided care for a critically ill client.

This patient had undergone cardiac catheterization and the placement of three stents. After experiencing respiratory distress, she was intubated to ensure stability. Although she showed progress and was able to be extubated the next morning, she and her family remained understandably concerned.

The morning of her transfer to the step-down unit, she started having chest pain. The cardiologist requested a consultation with the cardiac surgeons, and the patient's distress grew increasingly apparent.

Recognizing the family's need for emotional support and reassurance, I spent as much time as possible speaking with the patient and family to answer questions, provide necessary information and allay their fears about surgery. I kept an optimistic view and encouraged the family to do the same until a decision was made regarding the possibility of surgery. Explanations and expectations were simple yet realistic, and surgical outcomes were addressed. I encouraged the family to visit more frequently than official visiting times permitted, and provided some diversional activities for the patient.

As the day passed, my patient and her family maintained an optimistic attitude, and their outlook improved significantly.

This situation taught me the power of positive thinking, and that a holistic approach to nursing encompasses more than just a patient's physical health during hospitalization. I was content to know that, even as a nursing student, I had a significant impact on a patient's care. I continue to use these principles as I now begin my career in nursing.

Look Who's Using ECCO! Web-Based Orientation Expands

Following is the list of ECCO users as of mid-April 2004:

Alabama
East Alabama Medical Center (HealthStream)

Alaska
SEARHC Mt. Edgecumbe Hospital

Arizona
Tucson Heart Hospital (MedCath)
VA Medical Center (VISN 18)
Banner Desert Medical Center
Tuba City Regional Health Care Corporation
Sierra Vista Regional Health Center

California
Naval Medical Center San Diego
Regional Health Occupations Resource Center-Butte College
Stanford University Hospital
Sutter Coast Hospital
VA Palo Alto Health Care System
UCSD Medical Center
Salinas Valley Memorial Healthcare System
St. Mary's Medical Center-Long Beach
Cottage Health System
Mt. Diablo Medical Center
Northridge Hospital Medical Center
Heart Hospital of Bakersfield (MedCath)
VA Medical Center (VISN 22)
O'Connor Hospital
Seton Medical Center-Daly City
Fresno Heart Hospital
Kaiser Permanente-San Diego
Palomar Pomerado Health
Fresno Community Hospital and Medical Center
Sierra Vista Regional Medical Center
El Centro Regional Medical Center (HealthStream)
Enloe Medical Center (HealthStream)
St. Joseph Mercy-Oakland-Trinity Health (HealthStream)
Good Samaritan-San Jose (HealthStream)

Colorado
Eastern Colorado Health Care
Grand Junction VA Medical Center
Boulder Community Hospital
Poudre Valley Health System
Centura-Porter Hospital (HealthStream)
Memorial Hospital Colorado Springs (HealthStream)
Presbyterian St. Luke's Medical Center (HealthStream)

Connecticut
Yale New Haven Hospital
Waterbury Hospital
Lawrence & Memorial Hospital
Hospital of Saint Raphael

Florida
Broward Community College
Lee Memorial Health System
Mercy Hospital Miami
H. Lee Moffitt Cancer Center
VA Medical Center, Miami
VA Medical Center, NFSG Veteran Health System
Lakeland Regional Medical Center
Orlando Regional Healthcare
Sacred Heart Health System
St. Joseph's Hospital, Tampa
VA Medical Center, Bay Pines
Oak Hills Hospital
Leesburg Regional Medical Center
BayCare Health System
Munroe Regional Medical Center
Sarasota Memorial Health Care System & Sarasota Memorial Hospital
Florida Hospital Fish Memorial

Georgia
Memorial Health University Medical Center-Savannah
Phoebe Putney Memorial Hospital
Gwinnett Medical Center-Lawrenceville
VA Medical Center, Atlanta
South Georgia Medical Center

Hawaii
Kapiolani Medical Center at Pali Momi
North Hawaii Community Hospital
Kuakini Medical Center
Kapiolani Medical Center for Women & Children-Hawaiian Pacific Healthcare

Idaho
St. Luke's Regional Medical Center
Saint Alphonsus Regional Medical Center
West Valley Medical Center
Magic Valley Regional Medical Center

Illinois
Sherman Hospital
Scott Air Force Base, 375th Medical Group
Rockford Memorial Health System
Swedish American Hospital
Memorial Medical Center-Springfield
InteliStaf Healthcare
Heartland Regional Medical Center
Evanston Northwestern Healthcare
Rush University Medical Center (MC Strategies)
Oak Park Hospital (MC Strategies)
Deaconess Women's (MC Strategies)

Indiana
VA Medical Center, Indianapolis
Goshen General Hospital
Parkview Health System
St Francis Hospital & Health Center

Iowa
Great River Medical Center
St. Luke's Regional Medical Center

Kansas
Mercy Regional Health Center
Providence Medical Center
Hayes Medical Center (HealthStream)

Kentucky
University of Kentucky
Norton Hospital
Ephraim McDowell Regional Medical Center
Hardin Memorial Hospital (HealthStream)

Louisiana
Dauterive Hospital
Lake Charles Memorial Hospital
Greater New Orleans Chapter-AACN
MedCath-Louisiana Heart Hospital
Christus-Schumpert Health System (HealthStream)

Maine
Maine General Medical Center
Central Maine Medical Center

Maryland
Suburban Hospital
Wing Memorial Hospital Medical Center

Massachusetts
Good Samaritan Medical Center
Emerson Hospital

Michigan
Crittenton Hospital Medical Center
Mercy General Health Partners-Muskegon
St. Mary's Mercy Medical Center/Trinity Health (HealthStream)

Minnesota
Allina Hospitals & Clinics
Methodist Hospital-St. Louis Park
St. Cloud Hospital
St. Joseph's Medical Center, Brainerd
Immanuel-St Joseph's-Mayo Health System
St. Mary's Duluth Clinic Health System (St. Mary's Medical Center & Miller Dwan Medical Center)

Mississippi
Keesler Medical Center AFB
Baptist Health Systems
Kings Daughters Hospital

Missouri
CoxHealth
Freeman Health System
St. Anthony's Medical Center
Southeast Missouri Hospital

Montana
Benefis Healthcare
Frances Mahon Deaconess Hospital
VA Montana Healthcare System

Nebraska
Good Samaritan Health System
BryanLGH Medical Center
Nebraska Medical Center

Nevada
Southern Hills Hospital
Washoe Medical Center

New Hampshire
Mary Hitchcock Memorial Hospital
St Joseph's Hospital
Parkland Medical Center

New Jersey
Atlantic City Medical Center
CentraState Medical Center
Valley Hospital

New Mexico
University of New Mexico Health Sciences Center

New York
St. Mary's Hospital
Cayuga Medical Center at Ithaca
Sister of Charity Hospital
Our Lady of Mercy Medical Center
Champlain Valley Physicians Hospital (HealthStream)

North Carolina
Cape Fear Valley Health System

North Dakota
Altru Health System
Trinity Hospital-Minot (HealthStream)

Ohio
Department of Veterans Affairs Medical Center, Cincinnati
Fireland Regional Medical Center
MedCath - Heart Hospital of Dayton Ohio
Wood County Hospital
Grant Medical Center
Ohio Health Corporation on behalf of Riverside Methodist Hospital Campus
Kettering Medical Center
University Hospital of Cleveland Ohio
Mt Carmel West Hospital

Oregon
Oregon Health and Science University
Providence Medford Medical Center

Pennsylvania
DuBois Regional Medical Center
Polyclinic Hospital (Pinnacle Health)
Washington Hospital
Butler Memorial Hospital
Chambersburg Hospital & Waynesboro Hospital
St. Luke's Hospital & Health Network

South Carolina
Greenville Hospital System (HealthStream)

South Dakota
MedCath-Heart Hospital of South Dakota
Sioux Valley Hospital & University Medical Center

Tennessee
Middle Tennessee Medical Center

Texas
Denton Regional Medical Center
Shriner's Hospital for Children
Methodist Healthcare System of San Antonio, Ltd.
Harris Methodist Hospital-Ft. Worth
Presbyterian Hospital of Plano
University Hospital-San Antonio
Hendrick Medical Center
University of Texas Health Center at Tyler
VA Medical Center-Central Texas Veterans Healthcare System
Brooke Army Medical Center, Fort Sam Houston
Methodist Hospital (Willowbrook Hospital, Sugarland Hospital and San Jacinto Methodist Hospital)
Osteopathic Medical Center of Texas
Shannon Medical Center
JPS Health Network
Del Sol Medical Center-HCA (HealthStream)

Utah
HCA St. Mark's Hospital
VA Medical Center Salt Lake City

Vermont
VA Medical Center White River Junction

Virginia
Northern Virginia Community College
Martha Jefferson Hospital
Bon Secours Memorial Medical Center
Centra Health
VA Medical Center Salem
Maryview Medical Center
CJW Medical Center Johnston-Willis Campus (HealthStream)

Washington
Kadlec Medical Center
Sacred Heart Medical Center
Yakima Valley Memorial Hospital
NorthWest MedStar
Northwest Workforce Development Council
Capital Medical Center
Madigan Army Medical Center Consolidated Education (Tacoma)
Providence St. Peter Hospital
St. John Medical Center
Sunnyside Community Hospital (HealthStream)

Washington D.C.
Walter Reed Army Medical Center

West Virginia
Princeton Community Hospital
Sunnyside Community Hospital (HealthStream)
Wisconsin
St. Vincent Hospital-Green Bay
Clemente J. Zablocki VA Medical Center
Wausau Hospital
Wisconsin Heart Hospital
ProHealth Care ( Waukesha Memorial Hospital and Oconomowoc Memorial Hospital)
Columbia St Mary's Training Center
Gundersen Lutheran

Wyoming
Campbell County Memorial Hospital
Powell Valley Healthcare
Cheyenne VA Medical Center
Department of Veterans Affairs-Sheridan

Canada
Queen Elizabeth II Hospital, Grande Prairie
Prince George Regional Hospital

Japan
U.S. Naval Hospital, Yokosuka

Puerto Rico
VA Medical Center-San Juan Puerto Rico

�Stating' the Facts
ECCO Now in Use in 46 States, 3 International Sites

To find out who is using ECCO, visit the
AACN Web site at www.aacn.org > ECCO.

Award Recognizes Outstanding ICU Design

Cosponsored by AACN, the Society of Critical Care Medicine and the American Institute of Architects Committee on Architecture for Health, the ICU Design Award recognizes ICU designs that enhance the critical care environment for patients, families and clinicians. Aug. 15 is the deadline to submit applications for the 2004 ICU Design Citation. (See page 7.) For more information, contact the Society of Critical Care Medicine at (847) 827-7659. Following are excerpts from the exemplars submitted in connection with this award for 2002.

Harris Methodist Fort Worth Hospital
Adult ICU Team
Fort Worth, Texas
The ICUs at Harris Methodist Fort Worth Hospital include a 22-bed medical-surgical unit, 22- bed neuroscience unit and a 20-bed trauma unit located. These units have direct connection to the emergency department, operating room, CT scanner and blood bank. The goals of the project were to create an environment of healing for the patients and family members, along with a staff and physician friendly workplace. The process to create such an environment was directed by a Critical Care Steering Committee. Eight subcommittees involved 150 staff members and physicians in the planning and implementation process. These committees were critical in planning the details of the operations for these new critical care environments.

Ceiling mount equipment and gas columns are used to provide 360-degree access to the patient by staff and physicians. This design allows for room flexibility to meet the patient, family and staff needs. The room design permits an abundant amount of natural light and great visibility of the patients by staff members. Physician and staff workspace is available in each patient room, outside of each room, as well as the traditional nurse station concept. The ICU area is designed to accommodate bringing the technology to the patient instead of having to transport the patient. A patient monitoring system with Internet capabilities networks throughout all three units. There is digital imaging capability on each unit with the ability to provide digital processing of films in the tower. This project was a great team effort.

McGill University Health Center, Montreal General Hospital
Intensive Care Unit
Montreal, Quebec, Canada
The ICU renovation project at Montreal General Hospital brought together three geographically separate and specialized units that had not been renovated in 25 years into a state-of-the-art, 26-bed combined medical, surgical and trauma unit. The renovation was an enormous demolition and construction project, but also a major professional challenge to cross train and integrate three distinct, highly specialized nursing teams.

The project manager, Ron Evans, and architect, Sheila Theophanides, of the firm Fichten Soiferman, worked closely with the ICU nurse manager, Colleen Stone, and the director of critical care, Ash Gursahaney, to design a unit that optimized the use of space, light and functionality within the constraints of an old building.

During the design phase, a life-size model of two patient rooms with a workstation was constructed to provide the staff with the opportunity to make written comments and suggestions on how they wanted the patient rooms to be designed. The use of moveable power columns suspended from ceiling-mounted articulating arms provides all healthcare professionals with 360-degree access to the patient, which is especially important when invasive procedures are performed or resuscitation is required. The single-room concept provides privacy for patients, decreases the noise level for staff and minimizes the risk of transmission of infection. The use of large glass panels between every patient room and sliding glass doors allows staff to visualize patients. The extensive use of interior glass, the old building's large exterior windows and a palette of soft colors and natural wood add an overall feeling of tranquility. There is a large staff lounge with a beautiful view of downtown and access to a roof terrace. The improved facility has also increased the recruitment and retention of nurses.

PDA Center

Just Released! AHA/AACN ACLS Cardiac Arrest e-Reference
This Palm OS version of the Cardiac Arrest Pocket Reference Card provides algorithms for ventricular fibrillation/pulseless ventricular tachycardia, pulseless electrical activity and asystole; rapid sequence intubation protocol; and tables for drug-induced cardiovascular emergencies. This product is a joint project of AACN and the American Heart Association. The Cardiac Arrest e-Reference is an alternative way for healthcare providers to quickly access information for management of cardiac arrest.

You can purchase this latest e-Reference from the AACN PDA Center for just $12.50. Pocket PC version coming soon. Additional e-References from AHA/AACN are currently in production.

Save on the 2004 Pocket ICU Management Guide
This new publication provides comprehensive information, from coverage about unstable ICU patients with life-threatening disorders (e.g., shock, MI, cardiac arrest, thromboembolic disorders) to disorders additionally presented as a problem, not simply a diagnosis. You will find sections on evaluating fever in the ICU, recognition, managing hypoperfusion states, diagnosing and managing barotraumas, and recognizing catheter infection. Each topic area or organ system includes a summary that outlines proper evaluation and workup of pertinent body fluids and function. The pocket ICU Management Guide is a must-have resource.

Purchase this resource (for both Palm OS and Pocket PC) from AACN's PDA Center and save $10 off the retail price. Pay only $40 through May 31.

15% off Pocket ICU Management and ER/ICU Toolbox Bundle
We have bundled this new ICU Management Guide with an excellent essential program, the Medical Wizard's ER/ICU Toolbox. This pocket ICU/ER Toolbox bundle is only $80.49, saving you over 15% off individual prices ($94.99). This offer is good through May 31.

Special Price on Ultimate Drug Guide and ER/ICU Toolbox Bundle!
AACN has packaged Medical Wizards new Ultimate Drug Guide for both Palm OS and Pocket PC with another great resource, the ER and ICU Toolbox. Based on the Davis's Drug Guide for Nurses, the UDG offers substantial functionality that is not available in other drug guides. And, unlike similar products, the UDG contains the entire content of the Davis's Drug Guide for Nurses, not just the drug information sections. Tools, such as unit conversion calculators, are also incorporated. By merging drug references with calculation tools, the UDG allows nurses to seamlessly access drug information and calculate drug dosages for any patient. Twelve months of free upgrades come with purchase. The ER and ICU Toolbox is a premium medical calculator and rapid reference for emergency and critical care health professionals. More than 13 modules are available, including ACLS protocols, adult drips, emergency meds and fluid wizard.

Through May 31, you can purchase this ER Toolbox/Ultimate Drug Guide Bundle for only $82.99 ($94.98 when purchased separately).

PDA Online Demonstrations
Check out the new PDA online demonstrations, which show you how to use a PDA device and guide you through an exploration of the abundant software programs available for your practice.

AACN Corporate Circle

AACN sincerely thanks all sponsors for their support, including Corporate Circle Members who sponsor year-round activities. AACN also thanks the many NTI exhibitors who provide sponsor support for the National Teaching Institute� & Critical Care Exposition every May.

AACN appreciates and recognizes that NTI sponsor support enhances the annual conference and helps to keep affordable registration fees for participants.

Corporate Circle Members

Titanium Level
AACN and NTI Support valued at $500,000 and above

Nellcor/Tyco Healthcare

Gold Level
AACN and NTI support valued between $100,000 and $249,000

Philips Medical Systems

Silver Level
AACN and NTI support valued between $50,000 and $99,999

Edwards Lifesciences
GE Healthcare
GlaxoSmithKline
InteliStaf Healthcare
KCI
ZOLL Corp.

Bronze Level
AACN and NTI support valued between $10,000 and $49,999

3M Health Care
Abbott Laboratories
ALARIS Medical Systems
American Heart Association
Aspect Medical Systems
B. Braun Medical
Baxter Healthcare Corp.
Cardioynamics-The ICG Co.
Clarian Health Partners
Draeger Medical
Eli Lilly & Company
The Freeman Companies
Healthcare Purchasing News
Hill-Rom
Masimo Corporation
Millennium Pharmaceuticals/ Schering Corporation
Monster
Nursing Spectrum/Nurse Week
Ross Products-Division of Abbott Laboratories
Sage Products
Stryker Medical
Welch Allyn

Corporate Circle Associates

AACN and NTI support valued $9,999 and below

ADVANCE Newsmagazine
American Journal of Nursing
Atrium Medical Corp.
Bard Access Systems
Biosite
Dale Medical
Dallas County Chapter of AACN
Datascope Corporation
Fain & Company
Florida Hospital Association
Honor Society of Nursing, Sigma Theta Tau International
Integra NeuroSciences
John A. Hartford Foundation Institute for Geriatric Nursing
Lexi-Comp
Lippincott Williams & Wilkins
Marsh Affinity Group Services, a service of Seabury & Smith, Inc.
Medical Wizards Corporation
Medtronic
palmOne Inc.
Pepid LLC
R. Adams Cowley Shock Trauma Center
St. Luke's Episcopal Health System
Scios Inc.
Skyscape Inc.
SLACK, Inc.
Spacelabs Medical Inc., an OSI Systems Company
Tenet
Tyco Healthcare/Kendall
Yale School of Nursing

Thanks to All Who Responded to Critical Care Survey

The data collection phase of the AACN Critical Care Survey officially closed on March 31. AACN is sincerely grateful to the facilities, units and volunteers who collaborated to complete the surveys. The facilities invited to participate represented a random, stratified sample of hospitals across the country, and the response rate was strong.

Release of the report of key survey findings is planned for late summer. Each facility that participated in the survey will receive a complimentary copy of the report.

In addition, each unit that participated in the most recent round of data collection was entered into a drawing for the Ultimate AACN Resource Kit, which is valued at more than $5,000. We are pleased to announce that the cardiovascular-surgical ICU at Piedmont Hospital in Atlanta, Ga., is the recipient of this prize.

If you have questions about the survey, call (800) 394-5995, ext. 7337, or e-mail ccsurvey@aacn.org.

Monthly Super Savers from AACN's Catalog Products

Celebrate critical care nursing with one of this month's super savers! These super-saver prices are good through June 30. To qualify, orders must be postmarked on or before June 30.

Critical Care Nursing: A History (#330100)
This book traces the evolution of critical care nursing from battlefields and hospital recovery rooms to today's modern units, revealing the important place critical care occupies in America's complex healthcare delivery system and the crucial role specialized nursing has.
Regular Price
Member $16.50, Nonmember $17.50
Super Saver Price
Member $13.50, Nonmember $15

Patient Safety
With the strong focus on medications and patient safety, we are highlighting two products that will help to support you and your colleagues in achieving the JCAHO Patient Safety Goals.

Medication Administration Protocol
Set of 7
(#180160)
This series is designed to present the latest knowledge on various considerations of medication administration. The set includes Delivery of Aerosolized Medications, Alternative Routes of Drug Administration, Intravenous Drug Delivery, Oral Drug Administration in the Intensive Care Unit, Closed-Loop Control of Drug Delivery, Pediatric Drug Delivery and Portable External Infusion Devices Protocol. Nonreturnable.
Regular Price
Member $75, Nonmember $94
Super Saver Price
Member $60, Nonmember $72

From Error to Advocacy: Creating and Showcasing Cultures of Safety
(NCE2553703A or NCE2553703C)
Identifies the characteristics inherent to a culture of safety, contrasting and comparing those characteristics that define a personal work setting. Also discusses national mandates for establishment of cultures of safety in healthcare, highlighting specific areas for development within a work setting. Includes study guide and 2.0 contact hours of Category O CE credit.
Please allow 7-10 business days for delivery, as this product is shipped directly from National Nursing Network. Non-returnable.
Regular Price (cassette)
Member $13, Nonmember $13
Super Saver Price
Member $10, Nonmember $10
Regular Price (CD)
Member $15, Nonmember $15
Super Saver Price
Member $12, Nonmember $12

(800) 899-2226
www.aacn.org

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