AACN News—May 2004—Opinions

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Vol. 21, No. 5, MAY 2004

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
President, AACN

Life must be understood backwards... but it must be lived forwards.
-S�ren Kierkegaard

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 enduring difference.

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 Nashville.

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.

Kathryn Bowns
Rosalie Burelli
Sarah Jane Creech
Rosalie Hammerschmidt Lanius
Adeline Jenkins
Cheryl Larson
Rose Pinneo
Diana Ray
Norma Shepard
Helen Shields
Barbara Siebelt
Carol Southern
Penny Vaughan
Dorothy Wheeler
Donna Zschoche

Collaborating Physicians
Robert Chesne
John Curry
Henry J.L. Marriott
Lawrence Meltzer
Fred Ownby
Alfred Soffer
Paul Unger

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