President's Note: Rising Above: New
Questions, New Opportunities
Still 'Reaching Out to Help Each Other'
In Celebration of AACN's 35th Anniversary
By Dorrie Fontaine, RN, DNSc, FAAN
Life must be understood backwards... but it must be
AACN�s 35th anniversary. What an extraordinary
opportunity to find out whether rising above really works. How reassuring to see
that it does.
Where were you in 1969? I was enrolled in my first
clinical course at Villanova University when, thanks to space program
technology, monitored coronary care units sprang up in hospitals across the
United States. There was one small problem. Nobody had any idea what the monitor
was saying or what he or she was supposed to do. With physician colleagues,
nurses began to develop hospital-based cardiac care courses. A small band in
Nashville, Tenn., went further.
"[The patients] were afraid and alone most of the
time. It made us aware that if those patients were going to receive the care
they needed, it was going to be up to the nurses," founder Norma Shepard
recalled in a 1993 panel discussion. "We also knew what we were doing, but what
were they doing over there in Arkansas and Massachusetts, in New York and
Pennsylvania and California?"
They Saw a Bigger Picture
Although AACN�s founders didn�t call it rising
above, they did just that. They saw a bigger picture and the value of shared
learning. And, for the first of many times in our association�s history, they
scanned the care environment by collecting the names of cardiac care nurses and
mailing a now famous postcard inviting those nurses to form "some sort of an
organization for the primary purpose of exchanging information about the care of
the patient." Today, AACN sets its strategic direction by continually and
systematically scanning the environment as it affects the healthcare of acutely
and critically ill patients and their families.
The astounding 85% response rate led to a Nashville
symposium for 300 nurses; 600 showed up, hungry for knowledge and exchange. The
momentum was unstoppable as the Nashville band of nurses and collaborating
physicians set about to organize AACN as the American Association of
Cardiovascular Nurses. Only to rise above once again and recognize that
patients-and their families, of course-are integrated systems that cannot be
artificially separated. "But these patients have lungs also," said founder
Rosalie Hammerschmidt Lanius. "We�ve got to look at this body as a whole."
Actual or potential life-threatening illness turned out to be the common thread,
so AACN�s name changed to American Association of Critical-Care Nurses.
We Learned Together
Rising above, I see how AACN has learned as an
organization, just as individual nurses do. First, we learn the individual
systems. Next, we learn how they interrelate. Finally, we grasp how they are in
fact a finely woven whole.
First, AACN learned about critical care at the
bedside. We defined roles, a core curriculum, procedure manuals and practice
protocols, a national conference. Next we learned about how critical care
relates to unit and hospital systems. We developed care standards, education
standards, certification, grants and scholarships, award-winning publications,
clinical learning resources.
Today, we have become an essential element in the
fabric of our nation�s healthcare. The undisputable and indispensable leader in
acute and critical care nursing. Each step in our learning represents a building
block that has led to AACN�s unequivocal role as an essential contributor to the
life-saving work that acute and critical care nurses do for society.
Collaboration, the 7th Example
"Why can�t we get our arms around true
collaboration?" I asked in my January column, citing six examples that suggest
we�re getting closer. Here�s the seventh. "We reached our arms across the
country to help each other," recalls founder Penny Vaughan, now a cardiology
advanced practice nurse at Vanderbilt University Hospital. "And, we were
collaborating with physicians," she says, "even though we really didn�t know
that word at that point. But nurses and physicians alike did know that
successful patient outcomes were 100% on the shoulders of the nurse, because
that is who would be at the bedside."
Rising above and looking backward. Isn�t it clear
how AACN�s founders themselves rose above? Objectively and truthfully, our
founders saw their current realities for what they were. They gained insight.
Armed themselves with better knowledge. Used that knowledge with confidence and
strength to focus on courses of action and solutions that have indeed made an
Rising above, I see how our vision-of making our
optimal contribution in a healthcare system driven by the needs of patients and
their families-has been embedded in the fabric of the organization since 1969.
Even if we didn�t put it into words until 1992.
Core Issues Endure
I see how our core issues have become progressively
better defined, gaining clarity from each president and board of directors. Look
at every president�s NTI address and you�ll find a reassuring continuity of core
issues. Issues that have evolved within the context of environmental changes and
new knowledge acquired by continually rising above.
Patient and family needs. Education and
certification for critical care nursing-now embracing care beyond the ICU.
Evidence-based practice-now expanding into highly successful practice alerts.
Family visiting-now including presence during CPR and invasive procedures.
Ethical dilemmas-now including palliative and end-of-life care. Collaboration
with physician colleagues-now expanding into the launch of a new Critical Care
Institute with the American College of Chest Physicians.
"We reached our arms across the country to help each
other." Looking back we understand that we continue to live our founders�
courageous legacy. They prepared us well for a future of reaching out to each
other. A future that inspires us to be the best we can, fueled by knowledge.
Knowledge that meets the needs of patients and families. Knowledge that creates
the healthy work environments where we all want to work.
So happy birthday, AACN! So many of us have enjoyed
turning 35 right along with you. Learning from your style and grace. Inspired by
your passionate commitment for the clinical work we do each day. And living
forward each day with you by our side-for another 35 years at least!
A special thanks to Garret Chan for pointing me to
Kierkegaard�s wisdom. And to Marion Leahy, who has read each of these columns
and passes along comments to her daughter, past President Marianne Chulay.
Editor�s Note: Historical information and quotes
are drawn from the transcript of "Visionary Leadership: Forum With the AACN
Founders," a panel discussion at the 1993 AACN Leadership Institute in
They Made the Dream Come True
The American Association of Critical-Care Nurses is
the dream come true of our founders and their physician colleagues. We salute
those who continue with us and honor the memory of those who have passed on as
we celebrate AACN�s 35th anniversary.
Sarah Jane Creech
Rosalie Hammerschmidt Lanius
Henry J.L. Marriott