AACN News—October 2005—Association News

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Vol. 22, No. 10, OCTOBER 2005


Hurricane Relief When Disaster Struck, Nurses Responded


When disaster struck the Gulf Coast, critical care nurses readily responded.

Some were on the front lines, devastated themselves but attempting to provide care under primitive conditions. Others came from states away to assist in any way they could. Yet others were at shelters set up outside the area to accommodate those displaced by the hurricane and the subsequent massive flooding. And, those who couldn’t serve in person found other ways to support relief efforts, whether through donations or offers to provide temporary housing.

Expressions of sorrow and support for those in the hurricane-ravaged area poured into the AACN National Office. For some, concern was heightened because of personal ties forged during the many AACN National Teaching Institutes in New Orleans, La.

“As a member of the NTI Work Group for 2005, our stay in New Orleans was even more pleasant owing to the Greater New Orleans Chapter of AACN,” wrote Alisa Shackelford, RN, MA, CCRN, who was planning to rally her chapter in Charlestowne, S.C., to assist. “When we were there, the New Orleans Chapter opened their arms and their hearts to us.

One nurse who helped evacuate patients told incredible stories of carrying patients down stairways and loading one on a mattress in the back of a pickup truck.

Katie Schatz, RN, MS, MSN, APRN, NP, NP-C, the Region 18 Chapter Advisory Team representative from Spokane, Wash., and a former clinical practice specialist at the National Office, was deployed to the Biloxi, Miss., area as part of a Federal Emergency Management Agency Disaster Medical Assistance Team.

As of Sept. 9, Schatz reported, the DMAT teams had seen almost 11,000 patients.

“Please let your colleagues know that they should be proud of our profession.” Schatz urged. “Nurses have just gotten together and driven down here to help. We have a lot of help (nurses) now, but will need more in the weeks to come.

“The people here are so grateful for all the help that everyone is sending. They are overwhelmed.”

Also in the area was Kiersten Henry, RN, BS, BSN, CCRN. (Her daily account accompanies this article.)

Dennis Cheek, RN, MSN, PhD, FAHA, a former NTI Work Group chair and a professor at Texas Christian University, spent time at a Red Cross shelter in his area.

Noting that an American Red Cross volunteer is on the TCU faculty, Cheek said that faculty and students were mobilized quickly as soon as she learned that patients would be coming in to the local hospital. They were busy assisting in the processing, including obtaining patient and contact information.

“On Saturday, many of the TCU nursing faculty received a crash course on disaster services and how to run/work at the four Red Cross shelters,” said Cheek. “I have been thrilled to work with these displaced New Orleans folks.”

Although Colleen Kenny-Strugala had sustained a broken leg and couldn’t physically help out, she wanted to do something. She offered nurses access to her condo in Myrtle Beach, S.C., as part of relief efforts.

And, Fred and Risa Benoit in Atlanta, Ga., were working on temporary housing for displaced nurses interested in permanently moving to jobs in the Atlanta area.

A “Special Needs Shelter” was set up at the Pete Maravich Center at
Louisiana State University. The scene was repeated at numerous locations
throughout the hurricane-ravaged Gulf Coast. Nurses were prominent on the scene.

Book Your Room for NTI 2006 in Anaheim

Reserve your hotel for NTI 2006 early! You may book your room beginning Oct. 17, 2005. The list of available hotels as well as rates and descriptions of the properties are available online at www.aacn.org > National Teaching Institute.

NTI 2006 is scheduled for May 20 through 25 in Anaheim, Calif. Additional information is posted on the Web site and continually updated.

On the Scene—One Nurse’s Day-by-Day Account

Editor’s note: Kiersten Henry, RN, BS, BSN, CCRN, a critical care nurse at Montgomery General Hospital, Olney, Md., responded with two of her colleagues, Rich Vallely, a respiratory therapist, and Andy Devine, RN, the emergency department director. Following are excerpts from her daily account of the experience.

Sept. 2
We headed to Baton Rouge and went to the Louisiana State University campus, where a “Special Needs Shelter” was set up, basically a hospital shelter, complete with code carts, a peds unit, etc. They were amazed that we had come from Maryland. They currently have 180 patients, with the expectation of 500 admissions today or tomorrow. They have critically ill patients and apparently had a code last night.

The plan that we heard from the head nurse was that they would get the less critical patients out, and turn the fieldhouse into a more critically focused hospital. They are also talking about turning the neighboring building into an ED. They were thrilled that we could lend our critical care expertise, and that we would take on the night shift duties. If we get the expected influx of patients, it will be a busy night triaging patients and providing care.

Sept. 3
We’ve just finished a 13-hour shift at our makeshift hospital at “P Mac,” LSU’s basketball stadium. The entire floor of the arena was transformed into a makeshift hospital, complete with designated units (ICU, peds, walkie-talkies), a pharmacy, a lab and an x-ray. School is canceled until Tuesday, so the LSU students are volunteering to serve meals, work in the supply room, empty urinals and change bedpans.

We saw a variety of patients and are still seeing those who are being plucked from their roofs by rescue helicopters. Our “unit” (the red zone) was an ICU complete with vents, an ABG machine and lots of med students. Here are some examples of the patients we saw (our job being to triage, stabilize and transport to the appropriate facility if necessary):

• A man who had been in his house (with 12 feet of water) for four days, and was GI bleeding
• An 8-year-old boy whose mother was burning alcohol for light when the bottle exploded, causing him a third-degree burn to the leg
• Several chest pain patients (all of whom ruled out for MI)
• A patient with hemorrhagic stroke that acutely decompensated, requiring rapid intubation and transport

There were many stories of people still being rescued by the Coast Guard, and others who spent days in the not-so-Super Dome. We did several transports to the hospital when the ambulance crew was not equipped for critically ill patients.

One man was a trach patient on a ventilator at home ... his daughter manually bagged him for two days (with some help from others). After several hours at the “hospital,” we found out that the daughter was a diabetic, and she had a blood sugar level of 450.

Sept. 4
Our “P Mac” hospital was inadvertently placed on diversion yesterday, so we got no patients during the day. The nurse-patient ratio was about 6-to-1 for a good portion of last night, until they figured out why we were not receiving patients. We did get several dialysis patients who hadn’t been dialyzed in about a week and some chest pain patients. The biggest difficulty seems to be sorting out the patients who were in nursing homes. We have no information on their baseline history, so we can’t sort out whether they have dementia or a change in mental status related to a physiologic cause. For that reason, they are critical until they are hydrated and we get labs back (or we confirm a history of dementia).

The onslaught of patients started at about 6, when school buses filled with patients started rolling in. We are starting to see people withdrawing from alcohol and drugs as well as lots of people with chronic issues that haven’t been addressed for months (hypertension, diabetes, etc.). Those who did have good medical care haven’t received their medications for days (antihypertensives, insulin, etc.).

I am really in awe of some of the nurses who are working hours on end, despite the fact that their hospitals are gone, their homes are gone. We have no idea of what the big picture is. We don’t know how many patients are left to come. We hear that 500 patients are coming, then four hours later we get 100.

We are tired, having worked 17 hours, but we’ll sleep and then go back tonight.

Sept. 6
Today was by far the most incredible day we have had. The trip to the airport yesterday was a bust. There were five healthcare providers for every patient, which just exemplifies the lack of communication that seems to occur here. We headed back to LSU yesterday evening. By the way, they told us that this is the largest ED (and the largest field hospital) ever erected in the U.S. We have treated lots of chest pain patients lately, as well as some with more chronic illnesses.

We were at LSU this afternoon when a medic came looking for help with gathering supplies. She told us that her crew and several MDs were going to set up a clinic for some of the New Orleans Police Department officers. We offered to assist and to transport supplies in our vehicle.

The station we were headed to is the 8th Precinct in the French Quarter. The officers are actually staging in the Omni Hotel a couple of blocks from the station, so that they have somewhere to sleep. They were very happy to see us, and we provided a lot of basic care (blood pressures, dealing with the rashes and cut feet that many of them had).

Several officers told us they had prescriptions (antihypertensives, diabetic medications, anti-seizure medications) that had run out. We tracked down as many officers as we could to find out who needed medications. There was a pharmacy two blocks from the station, so an officer drove us and served as our armed guard and “pharmacy assistant.” Many of the medications we needed had been looted, but thanks to the Tarascon pharmacopeia, I was able to find substitutions for all but two medications.

The police had commandereed the pharmacy and were obtaining many supplies there. Most of the narcotics had been looted, but the thieves left all of the amphetamines and the antidepressants. We collected over-the-counter medications and lots of antifungal creams as many people have athlete’s foot. We also took prescription bottles and medications so we could dispense them to the staff.

Back in the ballroom of the hotel, which is where our clinic was set up, we went to work substituting meds as necessary and preparing prescriptions. It was a great example of interdisciplinary teamwork, as I read out each person’s individual prescription, and three of the docs helped me with any necessary substitutions. I was pretty proud that I was able to find medications to substitute for almost all of the needed prescriptions.

We plan to head back there tomorrow afternoon to assist anyone that wasn’t there today, and then fly back Wednesday morning. Please keep these police officers in your thoughts.

Sept. 7
We are headed to the N.O. airport, where there are 9,000 sick patients with lots of Army folks and some civilian healthcare providers who are working 24-7. They are in desperate need of assistance. We are not sure when we will be back in Baton Rouge, but there is plenty of security, and the people left truly are sick.

This is my last Katrina update e-mail, as we arrive home today. It has been a long week, but we really feel that we contributed to assisting some of the victims of Hurricane Katrina.

We spent our last day and night back at the 8th Precinct’s temporary headquarters at the Omni Hotel. This time, we vaccinated all of the officers against hepatitis A and B, and tetanus. Some of them were out on patrol, so we waited outside the hotel. As teams of officers drove by (usually in the back of pickup trucks, with each officer carrying an assault rifle), we would snag those who needed vaccinations. By the end of the night, we had vaccinated about 40 officers. We also treated various minor ailments.

Kiersten Henry (in blue) assists in giving injections to New Orleans
police officers in the lobby of the Omni Hotel.

Membership Drive Ends March 31 Critical Links Campaign Near 1,500 Mark at End of August


Ann J. Brorsen, RN, MSN, AAS, CCRN, of Sun City, Calif., continued to hold onto her lead in AACN’s Critical Links member recruitment drive at the end of August, though Mary Beth Reid, RN, CNS, MN, PhD, CCRN, CEN, CRN, RN-BC, of Little Elm, Texas, came close in just her first month of recruiting. Brorsen’s total of 25 new members recruited was only two ahead of Reid’s 23, all recruited during August.

Their efforts contributed to a total of 1,472 new members recruited since the campaign began May 1. In August alone, 447 new members were recruited by individuals and chapters.

Also posting impressive totals in the campaign, which ends March 31, are Kimberly T. Rupp, RN, of Twinsburg, Ohio, with 18 new members recruited; Laura Jean Bergman, RN, BSN, of Detroit Lakes, Mich., and Julie S. Miller, RN, BS, BSN, CCN, TNC, of Whitehouse, Texas, each with 13; Caroline Axt, RN, MS, of Oakland, Calif., and Matthew Choate, BS, BSN, CEN, EMT, of Saint Johnsbury, Vt., each with 12; and Deslin Francois, RN, MS, CCRN, CEN, Brooklyn, N.Y., and Jill C. Markle, RN, BS, BSN, CCRN, of Montrose, S.D., each with 10. Rupp and Francois actually doubled their previous totals during August.

Other Totals
The following members have also recruited five or more new members in this year’s campaign:

Lydia C. Bautista, Angela J. Bentley, Betty Nash Blevins, Jeannine Brennan, Marylee R. Bressie, Deborah H Brown, Kathryn V. Clark, Carmen R. Davis, Elizabeth S. Dunning, Deborah L. Erickson, Carla J. Freeman, Barbara S. Frey, Ariana G. Gross, Lisa S. Guy, Amy L. Jones, Cristine P. Kramer, Cynthia M. LaFond, Maria A. Laxina, Paula A. Lusardi, Laura L. Madden, Nancy Lee Neal, Maria A. Nicasio, Linda Ann Novak, Benilda M. Oliquino, Phillip Y. Parcon, Iveline J. Pennie, Coleen K. Rakers, Kathleen M. Richuso, Susan M. Roberti, Donna B. Sabash, Cathy H. Schuster, Charlene Schwinne, Jamie M. Sicard, Linda G. Smiley, Cheryl A. Stacy, Leslie A. Swadener-Culpepper, Linda S. Thomas, Bonnie W. Wiggins, Maria Amor Wild, Jackie S. Yon, Faith Y. Young-Gouda and Pam Zinnecker.

Individual Rewards
All recruiters receive a $25 AACN gift certificate when they reach the five-new-member level and a $50 AACN gift certificate when they reach the 10-new-member level. They are also eligible for a monthly drawing to receive a $100 American Express gift check in any month they recruit even one new member. The gift check in the drawing for July went to Deborah L. Erickson, RN, MA, CCRN, of Augusta, Ga.

The top recruiter at the end of the campaign receives a $1,000 American Express gift check. But that’s not all. He or she is also eligible for the Grand Prize drawing for a $500 American Express gift check. A total of three grand prizes will be drawn, with anyone recruiting five or more new members during the campaign entered into all three drawings.
Note: For the recruiter to qualify for prizes and drawings, new members must include the recruiter’s name on the “referred by” line of the application.

To see the complete list of campaign recruiters and their totals, visit the AACN Web site.

Community Liaisons Share Perspectives With AACN Board Insight Gained on Governance, Key Initiatives Communicated Back


Mary Frances D. Pate, RN, DSN, APRN, and Robin L. Watson, RN, CNS, BS, MN, CCRN, APRN, CRN, have been selected to serve as community liaisons for the fall AACN Board of Directors meeting in November in Southern California.

The AACN Board Community Liaison Program (formerly the Board Learning Partner Program) is intended to give AACN members insight into the governance and key initiatives of the association. In addition to sharing their perspectives with the board, they share what they learn within their communities.
Each community liaison is assigned a current board member to assist them prior to and during the meeting. Teaming with Pate and Watson for the fall meeting are board members John Dixon, RN, MSN, CNA-BC, and Jodi E. Mullen, RNC, MS, CCRN, CCNS.

Following the meeting, the community liaisons will carry out a number of activities, including writing an article for AACN News. They will also speak and distribute information at local or regional meetings as well as at their hospitals and schools of nursing.

The AACN Board Community Liaison Program is part of AACN’s local action initiative and is designed to be a mutually beneficial relationship for the board and the liaisons.
Pate and Watson were selected to serve as liaisons from AACN’s online Volunteer Profile Database (www.aacn.org > Volunteer Opportunities) following a call for volunteers to serve in this capacity.

If you are interested in this or any other volunteer opportunities, simply complete the database profile at www.aacn.org > About AACN > Volunteer Opportunities.

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
Health Communication (July 2005)—CEO Wanda Johanson, RN, MN, was coauthor of an article titled “Information Seeking and Compliance in Planning for Critical Care: Community-Based Health Outreach to Seniors About Advance Directives.” The article was a follow-up to a field experiment investigating factors that encourage senior citizens to explore critical care choices and to complete an advance directive when approached through a community-based outreach. The intervention featured a detailed, home-based guide and subsequent telephone counseling.

News & Views-University of Maryland Medical Center (July-August 2005)—“Trauma Nurses Speak at NTI” was the title of an article about staff involvement at the NTI in New Orleans in May. The front page featured a photo of the NTI Work Group, including Chair Dennis Cheek, RN, MSN, PhD, FAHA, and AACN board member Caryl Goodyear-Bruch, RN, PhD. “According to other staff who attended this year’s NTI, the 2005 NTI was a wonderful opportunity to network and share the R Adams Cowley Shock Trauma Center with critical care nurses nationwide,” the article noted.

AORN Journal (July 1, 2005)—An article titled “Benefits of Professional Nursing Organization Membership” described the importance of lifelong learning and joining a professional nursing association. AACN and its Web site information were listed.

Advance for Nurses (July 4, 2005)—“Resolving Conflicts: Communication and collaboration are key to building cooperative, productive nursing staff” was the titled of an article indicating that “just as studies can determine the causes of problems, they can also lead to solutions.” For example, the article noted that AACN had released “a study-based set of standards for achieving skilled communication and collaboration among nurses and other caregivers.” The six standards put forth in the AACN Standards for Establishing and Sustaining Healthy Work Environments (www.aacn.org/HWE) were also listed.

Nursing Management (July 18, 2005)—AACN President Debbie Brinker, RN, MSN, CCNS, CCRN, was interviewed for an articled titled “On Transformation.” She discussed the AACN Standards for Establishing and Sustaining Healthy Work Environments, the meaning of her “Engage and Transform” presidential theme for the year and resources to assist nurses in their “transformation.”

NurseWeek (July 18, 2005)—“Safe Passage—Feeding Tube Insertion Teams in the ICU” was the title of an article noting that AACN had issued a Practice Alert on Verification of Feeding Tube Placement (www.aacn.org > Clinical Practice > Practice Alert) in May. “Though some nurses consider the blind insertion of post-pyloric feeding tubes ‘Nursing 101,’ the task’s potential dangers prompted AACN to issue a practice alert …” the article noted. “The directive underscored the need for radiographic confirmation of proper placement of feeding tubes inserted blindly in critically ill patients before use for feeding or medication.”

Association Management (Aug. 1, 2005)—An article titled “The Three Islands of Change” considered how strategy, tactics and people help move associations forward. The article noted that AACN applied for and received the California Prospector Award, part of California’s Malcolm Baldrige program. Tracy Barron, AACN director of business development and integration, said the feedback that was included with the award identified AACN’s strengths and opportunities for improvement. AACN’s leadership team then developed a list of strategies, including data integration and a focus on advocacy, the article explained. Dana Woods, AACN director of marketing and strategy integration, was also quoted as saying that “in the areas of organization voice, advocacy and awareness, our invitations to the decision-making tables have expanded dramatically.”

Advance for Nurses (Aug. 1, 2005)—An article titled “Room to Grow: Eastern Connecticut Health Network makes the most of nursing talent with its CNS residency program” cited a January 2004 AACN News article by Mary Lou Sole, RN, PhD, CCNS, FAAN. The article stated that “clinical nurse specialists are becoming more common and increasingly valued, particularly within the acute care setting, where they support and enhance patient care.” The article also pointed out that, though the number of CNS programs has increased, there are still not enough CNSs to fill available positions.

Salisbury Post (Aug. 3, 2005)—The Rowan Roundup column noted that Susan Helms, RN, MN, MS, CCRN, a critical care nurse specialist in the critical care division of Rowan Regional Medical Center, had been appointed to the board of directors of the AACN Certification Corporation.

Springfield News-Leader (Aug. 9, 2005)—An article titled “Medical Movers” announced that Rebecca E. Long, RN, MS, CCRN, CMSRN, was named chair-elect of AACN Certification Corporation.

Hoovers (Aug. 11, 2005)—An article titled “Heart Hospital Embraces Digital Initiative” noted that Oklahoma Heart Hospital is home to one of 10 units that received AACN’s “prestigious Beacon Award for Critical Care Excellence” this spring. In addition to this major media outlet, the article appeared in many medical publications, including Health and Medicine Week and Heart Disease Weekly.

Sunday Republican (Aug. 14, 2005)—The “People in Business” feature announced that Paula Lusardi, RN, PhD, CCRN, CCNS, a critical care nurse specialist in the Level 1 Trauma ICU at Baystate Medical Center in Springfield, had been elected to the AACN Board of Directors. The article also noted that Lusardi’s unit had won AACN’s Beacon Award for Critical Care Excellence twice.
Washington Times (Aug. 18, 2005)—AACN Clinical Practice Specialist Teresa Wavra, RN, MSN, CNS, CCNS, was quoted in an article titled “Acute Renal Failure Surprisingly Common.” She noted that specific renal failure percentages are difficult to pinpoint because there are more than 30 definitions. “Your percentage may be up or down based on what criteria you’re using.” Wavra also said that acute renal failure can occur during septic shock and described sepsis as “the bane of a lot of critical care nurses.” The article indicated that AACN is a sponsor of the American Sepsis Alliance Campaign, which promotes the prevention and early detection of sepsis.

Our Voice at the Table
Johanson and Dorrie Fontaine, RN, DNSc, FAAN, past AACN president, represented AACN during a conference call of the Critical Care Collaborative. Continuing its work to advance patient-focused care through collaboration among all professionals caring for acutely and critically ill patients and their families, the collaborative has established an alliance with the Complexity Institute at Northwestern University, Evanston, Ill. The goal is to study the essential elements of teamwork in critical care in the context of the Complexity theory and to promote improvements.

Johanson represented AACN at a meeting of the leadership of the American College of Chest Physicians, Society of Critical Care Medicine, American Thoracic Society and AACN in Northbrook, Ill. The leaders met to discuss the continuing efforts of their organizations to address critical care workforce shortages. In addition to the nursing shortage, data were reviewed confirming the impending shortage of physicians who are experts in the care of critically ill patients. Strategies were defined to mitigate the shortages.

Carol Hartigan, RN, MA, certification programs strategist, and Karen Harvey, RN, MSN, certification specialist, represented AACN Certification Corporation at the annual meeting of the National Council of State Boards of Nursing in Washington, D.C. Issues discussed included criminal background checks for licensees, the importance of clinical instruction in prelicensure nursing programs, delegation and assistive personnel, collecting data on nursing practice breakdown and advanced practice regulatory issues.

AACN board member Patricia Gonce Morton, RN, PhD, ACNP, FAAN, attended a meeting of the American Academy of Nursing at Vanderbilt University School of Nursing in Nashville, Tenn. Members discussed the future of nursing education and the aging nursing faculty as well as academic initiatives, such as the clinical nurse leader and the doctor of nursing practice.

Janie Heath, RN, MS, CCRN, ANP, ACNP, immediate past AACN board member, represented AACN at a task force meeting in Washington, D.C., of the National Organization of Nurse Practitioner Faculties. The panel consisted of 22 representatives from national nursing associations and certifying bodies for nurse practitioners. They convened to develop doctorate of nursing practice competencies for nurse practitioner education.

If you or your chapter has reached out to the media or other groups to promote AACN and critical care nursing, we’d like to know. E-mail your information to Judy.Wilkin@aacn.org.

In the Circle Dale Medical Excellent Clinical Nurse Specialist Award


Editor’s note: Sponsored by Dale Medical Products, the Excellent Clinical Nurse Specialist Award honors acute and critical care nurses who function as clinical nurse specialists. Following are excerpts from exemplars submitted in connection with this award, part of the AACN Circle of Excellence recognition program, for 2005.

Cheryl Herrmann, RN, MS, APN, CCRN, CCNS
Peoria, Ill.
Methodist Medical Center of Illinois
Gone are the days of doing cardiac surgery on young, low-risk patients. So, as cardiac CNS, I knew my challenge was to improve outcomes in high-risk patients. To understand the patient population I began chart audits on patients who had returned to the cardiovascular ICU or who had expired. Several key root causes were identified.

I was instrumental in implementing a series of actions. Seven high-risk categories were identified, and evidence-based algorithms were developed to teach critical thinking and improve care. I taught the “Care of the High-Risk CABG” class for staff to learn to apply algorithms. One report sheet was developed to follow patients throughout their stay. I led staff to implement a PI project called “Walk to Recovery.” Staff identified that activity on CABG patients was not being achieved because of recovering cardiac catherization patients and high-acuity CABG patients on the same team. My “bold voice” idea after attending NTI 2003 was a progressive care unit. Networking and utilizing research/EBP articles, I developed criteria and sold the idea for creating a PCU within the telemetry unit. Nine beds were designated progressive. Over 18 months, the actions we implemented have significantly improved outcomes for cardiac surgery patients; returns from 5C to CVICU, LOS and mortality decreased.

As a CCNS, I wasn’t the only one who made a difference; it was the whole team. My CNS role was leading the team and providing tools to improve outcomes. The highlight for me was seeing the team make a project poster and enthusiastically share the results with coworkers. On our Magnet site visit, staff shared with the appraiser their CABG story and, with pride and ownership, told how “We Made a Difference!” (Methodist attained Magnet Status in August 2004.)

Paula A. Lusardi, RN, PhD, CCRN, CCNS
Longmeadow, Mass.
Baystate Medical Center
Paula juggles the many roles of the clinical nurse specialist in our unit. One example that illustrates Paula’s excellence is her work focused on end-of-life issues. With growing staff interest, Paula formed a “grassroots” ICU bereavement group to help families deal with the loss of their loved ones. Consequently, we developed pamphlets on grieving and sent cards to bereaved families.

Families contacted the ICU thanking us for helping them during such a difficult time. With the success of these simple family supports, Paula collaborated with our Spiritual Services department to broaden the bereavement project hospital-wide. Staff interest in unit end-of-life issues continued. We formed a multidisciplinary ICU team to focus on issues such as withdrawal of support and getting patients home from the ICU to die. A comfort care algorithm for withdrawing support from the dying patient is now in use in our unit and other units as well. In collaboration with Hospice, we developed guidelines to send patients directly home from the ICU to die in familiar surroundings.

Last fall, Mr. C. had end-stage lung disease and wanted to die at home with his adult daughters, wife and grandchildren by his side. Although Mr. C. lived 60 miles from the hospital, we facilitated this process. Mr. C.’s wife said it all in a letter to Paula: “You gave my husband and our family the best gift in the world. He died at home, in his chair, with all of us by his side. Thank you.”

Thanks to her ability to bring diverse professionals to the table, to educate others in the latest research while keeping patient and family needs first, Paula has ensured that end-of-life issues are an integral part of ICU care at Baystate Medical Center.

Hildy Schell-Chaple, RN, MS, CCRN, CCNS
Burlingame, Calif.
University of California, San Francisco Medical Center
She was 29 years old, had just finished nursing school and had taken her boards. Two weeks after an elective ASD repair, she developed ARDS and was transferred 200 miles to our hospital for definitive management.

I met with her twin sister and the pulmonologist the day of her admission to discuss the plan of care. I explained what ARDS is and reassured her that the nurses, intensivists and respiratory therapists are experts in the care of patients with ARDS. I answered her question of, “How long will she be in the ICU?” by saying it could be one week or several weeks, and that we expected peaks and valleys along the way.

To facilitate continuity of care, I make a point of making an early connection with these patients and their families, because the likelihood of a prolonged ICU stay is high. At the bedside I reinforce assessment priorities for patients with ARDS, including how and where to palpate for crepitus and the importance of monitoring plateau pressures. This patient’s plateau pressures were 40 cmH20, and the night RN noted crepitus of the neck during an assessment. This resulted in an X-ray that revealed a new pneumothorax and the need for insertion of a chest tube. This early detection led to early intervention and potentially minimized the more serious complication of a tension pneumothorax with hemodynamic compromise or arrest. She was in our ICU for five months, transferred to a ventilator weaning facility and endured a long rehab course.

During one of her visits after discharge, we discussed her recall of people and events, her challenges after discharge and her hope to practice nursing in the future. She was pleased to hear that I use her case to teach critical care nurses how to care for patients with ARDS. She has since told her story at various nursing conferences.

Congratulations to Review Panel Appointees

Scholarship Review Panel

The following individuals have been appointed to the AACN Scholarship Review Panel. Panel members take part in the selection process of AACN scholarship recipients.
Jeremy Layne Alexander, RN, BS, BSN
Lillian V. Ananian, RN, MS, MSN
Helene M. Anderson, RN, ADN, BA, CCRN, CRN
Mary P. Aust, BSN, MHM
Donna M. Bader
Kathleen H. Baker, RN, BSN, MBA, CCRN, CNRN
Laurie A. Baumgartner, RN, MSN, CCRN
Kathryn A. Beauchamp, RN, MS, MSN, CCRN, APRN, CRN
Iris A. Boehnke, RN, CNS, MS, MSN, CCRN, CCNS, CS, CEN, NP
Pamela J. Bolton
Marylee R. Bressie, RN, CNS, MS, MSN, CCRN, TNCC
Joseph Michael Brookes, RN, BSN
Susan E. Brown, RN, BS, BSN, CCRN
Kathleen M. Burton, RN, BS, BSN, CCRN, CRN
Mary A. Bylone, RN, BS, AD, CCRN, CNA, CRN
Steve Campbell
Donna M. Caretti, RN, CNS, MN, MS
Paula M Carson, RN, MS, MSN, CCRN, APRN
Lyne Chamberlain, RN, BSN, CCRN
Lynne M. Chevoya, RN, MSN, CCRN, NP
Damon Cottrell, RN, CNS, MS, CCRN, CCNS, APRN, CEN, CRN, RN-BC
Jo Ellen Craghead, RN, MSN, CCRN
Michael W. Day, RN, CNS, MS, MSN, CCRN
Nancy J. Denke, RN, MS, MSN, CCRN, APRN, CRN, NP, RN-BC
William M. Donnelly, RN, BSN, MBA, CCRN, CRN
Sharon R. Drummeter, RN, BN, PA, RN-BC
Charles A. Fisher, RN, RN-BC, MS, MSN, CCRN, APRN
John A. Forrant, RN, BSN, CCRN, CRN
Jane J. Fox, RN, ADN, CCRN
Roberta A. Fruth, RN, MN, PhD, CNA, CNAA
Mary Anne O. Galbreath, RN, ADN, BS, CCRN
Julia K. Garrison, RN, MSN, CCRN, PCCN
Beth A. Glassford, RN, MS, MHSA, CHE
Barbara Goldberg-Chamberlain
Helen Gonzales-Kranzel, RN, MN, MS, MBA, CCRN, APRN
Debra A. Hagler, RN, CNS, MSN, PhD, CCRN, APRN, RN-BC
M. Dave Hanson, RN, CNS, MSN, CCRN
Brenda K. Hardin-Wike, RN, CNS, MS, MSN, CCRN, CCNS, CRN
Jane Harper, RN, CNS, MS, MSN
Patricia A. Harris, RN, BS, BSN, CCRN, CWCN
Joan B. Harvey, RN, MN, MS, CCRN
Todd L Hicks, RN, BS, BSN, TNCC
Laura M. Hinson, RN, BS, BSN, CCRN
Tanya A. Huff, RN, MS, MSN, CCRN
Michelle S. Jans, RN, MS, MSN
Susan Kathleen Jones, RN, MS, MSN, APRN
Lisa A. Kinder, RN, MSN, CCRN
Karen J. Knight-Frank, RN, CNS, MS, MSN, CCRN, CCNS
Donna K. Kruse, RN, MS, MSN, CCRN-CMC-CSC, PCCN
Michele L. Lanza, RN, BS, BSN, CCRN
Beatrice B. Leyden, RN, BS, BSN, CCRN
Lynda C. Liles, RN, BSN, MS, CCRN
Joanne M. Liptock, RN, CCRN, CRN
Sandra G. Liva, RN, RNc, MA, MSN
Laura K. Magstadt, RN, BS, MN
Sarah A. Martin, RN, MS, MSN, CCRN, APRN
Linda G. Martinez, RN, CNS, MN, MS, CCRN, APRN, CRN, APRN-BC
Shawn M. McCabe, RN, MS, MSN, APRN
Margaret M. McNeill, RN, MS, MSN, CCRN, CCNS
Diane J. Mick, RN, CNS, DNS, PhD, CCNS, APRN, RN-BC
Kathleen A. Mitchell, RN, BS, MSN, PhD, CCRN
Debra A. Moroney, RN, MS, MSN
Julie C. Nelson, RN, BSN, MA, CCRN, CRN
Lisa Gingerich Ochoa, RN, BS, BSN, CCRN, CRN
Jeanne M. Papa, RN, MA, MN, CCRN, CRN
Kathleen Klein Peavy, RN, MS, MSN, CCRN, CRN
Deborah J. Pool, RN, MS, MSN, CCRN
Carol A. Puz, RN, BSN, MS, CCRN, CRN
Tamara Redden, RN, MN, MS
Carolyn S. Reilly
Diane Elizabeth Renaud, RN, MSN, CCRN
Marcheta L. Rodgers, RN, RN-BC, MS, MSN, CCRN, APRN
Joyce W. Roth, RN, MS, MSN, CCRN, CNA
Karen Claycomb Saunders, RN, BSN, MSN, RN-BC
Shyang Yun Pamela Shiao, RN, ND, PhD
Debra L. Siela, RN,LVN, DNS,ScD, CCRN, CCNS, CS, RRT, RN-BC, APN
Monica C. Simpson, RN, CNS, MS, MSN, CCRN, CCNS, APRN, CRN
June Marie Smalec, RN, BS, BSN, NCC, TNCC
Alethea A. Sment, RN, BS, BSN, CCRN, CRN
Connie Sobon Sensor, RN, MNSc, MS, CCRN
Christine L. Sommers, RN, MN, MS, CCRN, CCNS, CRN
Joy M. Speciale, RN, MBA, CCRN, CRN
Gina E. St. Jean, RN, BSN,AA, CCRN
Nancy Lynn Stark, MS, MSN
Angela R. Starkweather, RN, ND, PhD, CCRN, APRN, CRN, RN-BC
Leslie A. Swadener-Culpepper, RN, CNS, MS, MSN, CCRN CCNS, CRN
Kimberly M. Tauscheck, RN, BN, BS, CCRN, CRN
Linda S. Thomas, RN, MS, MSN, CCRN
Hilaire J. Thompson, RN, CNS, MSN, PhD, ACNP, APRN, CNP CNRN, NP, RN-BC
Sandra S. Thornhill-Alvarez, RN, MS, MSN, CCRN, CRN
Melissa A.L. Thorson, RN, MS, MSN, CCRN, CCNS, APRN, CNRN
Joni R. Vaughn, RN, BSN, BHS, CNRN
Bernadette Waldrop, RN
Susan Ward, RN, BSN, CCRN
Tamara Lynn Wardell, RN, MS, MSN
Angela E. Watson, RN, AD,AAS, CCRN-CSC, CRN
Cynthia L. Webner, RN, CCRN, RN-C
Eugenia C. Welch, RN, BN, CCRN
Larraine A. Yeager, RN, BS, BSN
Rebecca A. Yurek, RN, BS, BSN, CCRN, TNCC

Awards Review Panel

The following individuals have been appointed to the AACN Awards Review Panel. Panel members take part in the selection process of AACN award recipients.
Jeremy Layne Alexander, RN, BS, BSN
Lillian V. Ananian, RN, MS, MSN
Helene M. Anderson, RN, ADN, BA, CCRN, CRN
Mary P. Aust, BSN, MHM
Kathleen H. Baker, RN, BSN, MBA, CCRN, CNRN
Laurie A. Baumgartner, RN, MSN, CCRN
Kathryn A. Beauchamp, RN, MS, MSN, CCRN, APRN, CRN
Thomas Black, RN, BS, BSN
Iris A. Boehnke, RN, CNS, MS, MSN, CCRN, CCNS, CS, CEN, NP
Pamela J. Bolton
Marylee R. Bressie, RN, CNS, MS, MSN, CCRN, TNCC
Joseph Michael Brookes, RN, BSN
Susan E. Brown, RN, BS, BSN, CCRN
Kathleen M. Burton, RN, BS, BSN, CCRN, CRN
Mary A. Bylone, RN, BS, AD, CCRN, CNA, CRN
Steve Campbell
Paula M Carson, RN, MS, MSN, CCRN, APRN
Lyne Chamberlain, RN, BSN, CCRN
Garrett Chan, RN, CNS, DSN, PhD, APRN, CEN, RN-BC, APN
Randeen L. Cordier, RN, MS, MSN
Damon Cottrell, RN, CNS, MS, CCRN, CCNS, APRN, CEN, CRN, RN-BC
Jo Ellen Craghead, RN, MSN, CCRN
Michael W. Day, RN, CNS, MS, MSN, CCRN
Nancy J. Denke, RN, MS, MSN, CCRN, APRN, CRN, NP, RN-BC
William M. Donnelly, RN, BSN, MBA, CCRN, CRN
Sharon R. Drummeter, RN, BN, PA, RN-BC
Charles A. Fisher, RN, RN-BC, MS, MSN, CCRN, APRN
John A. Forrant, RN, BSN, CCRN, CRN
Ruth Foster, RN, MN, MS, CCRN
Jane J. Fox, RN, ADN, CCRN
Roberta A. Fruth, RN, MN, PhD, CNA, CNAA
Mary Anne O. Galbreath, RN, ADN, BS, CCRN
Julia K. Garrison, RN, MSN, CCRN, PCCN
Beth A. Glassford, RN, MS, MHSA, CHE
Barbara Goldberg-Chamberlain
Helen Gonzales-Kranzel, RN, MN, MS, MBA, CCRN, APRN
Debra A. Hagler, RN, CNS, MSN, PhD, CCRN, APRN, RN-BC
Brenda K. Hardin-Wike, RN, CNS, MS, MSN, CCRN, CCNS, CRN
Jane Harper, RN, CNS, MS, MSN
Patricia A. Harris, RN, BS, BSN, CCRN, CWCN
Joan B. Harvey, RN, MN, MS, CCRN
Todd L Hicks, RN, BS, BSN, TNCC
Laura M. Hinson, RN, BS, BSN, CCRN
Tanya A. Huff, RN, MS, MSN, CCRN
Michelle S. Jans, RN, MS, MSN
Susan Kathleen Jones, RN, MS, MSN, APRN
Karen J. Knight-Frank, RN, CNS, MS, MSN, CCRN, CCNS
Donna K. Kruse, RN, MS, MSN, CCRN-CMC-CSC, PCCN
Michele L. Lanza, RN, BS, BSN, CCRN
A. Renee Leasure, RN, CNS, MS, MSN, CCRN, APRN, CRN, APN-C, APN
Lynda C. Liles, RN, BSN, MS, CCRN
Joanne M. Liptock, RN, CCRN, CRN
Sandra G. Liva, RN, RNc, MA, MSN
Laura K. Magstadt, RN, BS, MN
Sarah A. Martin, RN, MS, MSN, CCRN, APRN
Linda G. Martinez, RN, CNS, MN, MS, CCRN, APRN, CRN, APRN-BC
Shawn M. McCabe, RN, MS, MSN, APRN
Patricia Lynn McGugan, RN, BSN, CCRN-CSC
Margaret M. McNeill, RN, MS, MSN, CCRN, CCNS
Diane J. Mick, RN, CNS, DNS, PhD, CCNS, APRN, RN-BC
Kathleen A. Mitchell, RN, BS, MSN, PhD, CCRN
Julie C. Nelson, RN, BSN, MA, CCRN, CRN
Lisa Gingerich Ochoa, RN, BS, BSN, CCRN, CRN
Jeanne M. Papa, RN, MA, MN, CCRN, CRN
Kathleen Klein Peavy, RN, MS, MSN, CCRN, CRN
Carol A. Puz, RN, BSN, MS, CCRN, CRN
Tamara Redden, RN, MN, MS
Carolyn S. Reilly
Diane Elizabeth Renaud, RN, MSN, CCRN
Lisa M. Roberts, RN, BS, BSN, OCN
Marcheta L. Rodgers, RN, RN-BC, MS, MSN, CCRN, APRN
Joyce W. Roth, RN, MS, MSN, CCRN, CNA
Karen Claycomb Saunders, RN, BSN, MSN, RN-BC
Shyang Yun Pamela Shiao, RN, ND, PhD
Debra L. Siela, RN, LVN, DNS, ScD, CCRN, CCNS, CS, RRT, RN-BC, APN
Monica C. Simpson, RN, CNS, MS, MSN, CCRN, CCNS, APRN, CRN
June Marie Smalec, RN, BS, BSN, NCC, TNCC
Kathryn R. Small, RN, MS, MSN, CCRN, ACNP, APRN
Alethea A. Sment, RN, BS, BSN, CCRN, CRN
Connie Sobon Sensor, RN, MNSc, MS, CCRN
Christine L. Sommers, RN, MN, MS, CCRN, CCNS, CRN
Joy M. Speciale, RN, MBA, CCRN, CRN
Gina E. St. Jean, RN, BSN, AA, CCRN
Leslie A. Swadener-Culpepper, RN, CNS, MS, MSN, CCRN, CCNS, CRN
Kimberly M. Tauscheck, RN, BN, BS, CCRN, CRN
Linda S. Thomas, RN, MS, MSN, CCRN
Sandra S. Thornhill-Alvarez, RN, MS, MSN, CCRN, CRN
Melissa A.L. Thorson, RN, MS, MSN, CCRN, CCNS, APRN, CNRN
Joni R. Vaughn, RN, BSN, BHS, CNRN
Bernadette Waldrop, RN
Susan Ward, RN, BSN, CCRN
Cynthia L. Webner, RN, CCRN, RN-C
Eugenia C. Welch, RN, BN, CCRN
Larraine A. Yeager, RN, BS, BSN
Rebecca A. Yurek, RN, BS, BSN, CCRN, TNCC

In the Circle: Excellence in Clinical Practice—Non-Traditional Setting Award

Editor’s note: Part of the AACN Circle of Excellence recognition program, the Excellence in Clinical Practice—Non-Traditional Setting Award honors excellence in the care of critically ill patients in environments outside of the traditional ICU/CCU setting. Following are excerpts from exemplars submitted in connection with this award for 2005.

Susan M. Wright, RN, BSN, CCRN
Dexter, Mich.
University of Michigan Health System
A pleasant surprise I have experienced as a ventricular assist device coordinator has been learning about the elderly living with VADs. At age 79, Mr. F was in a randomized clinical trial for long-term therapy versus continued medical therapy. He was randomized to the LVAD, beginning our three-year journey.

Because Mr. F has been living alone, he arranged to live with family members, who were taught about LVAD operations and emergency procedures. Managing the LVAD turned out to be doable for Mr. F. What was difficult was adjusting his life to living with his children.

Eventually, Mr. F found an assisted living center near the hospital where he could live independently and where he was happy. Staff training included everyone from administrators to the chief, in case an emergency arose. A few emergencies did arise, with one being the most serious of LVAD alarms—the “red heart,” indicating device end-of-life. Mr. F executed his LVAD training beautifully, until he was transported to our emergency room.

Eventually Mr. F became frail and lost interest in activities that he had enjoyed. Despite his LVAD, his overall condition deteriorated and he chose to have hospice care until his death.
I learned a great deal from Mr. F. I learned how to manage patients from a great distance. I also learned how to overcome staff resistance to new technology, such as an LVAD, and to expand my advocacy skills. I learned that the elderly are capable of managing new technology. Most of all, Mr. F reinforced the value of listening to the patient and taking into account all aspects of the patient’s health, not just his or her age.

Critical Care Air Transport Team
Lackland AFB, Texas
Wilford Hall Medical Center (59th Medical Wing)
Our critical care air transport teams consist of a critical care nurse, a respiratory therapist and a critical care physician. CCATT nurses work in environments unlike any other. We begin our “shifts” with an alert page, and provide nursing care in an environment that tilts, vibrates and often is pitch black to thwart enemy ground fire. Our ICUs are inside Air Force cargo aircraft, departing austere locations such as Afghanistan or Iraq via rigorous tactical take-off maneuvers. Our patients may have experienced multiple traumas, including head injuries, severe burns, traumatic amputations and abdominal injuries, and might have been victims of rocket-propelled grenades or improvised explosive device.

We accept our critically injured patients, up to six at a time, either directly from helicopters or field hospitals. We enable the journey for our wounded warriors to the next echelon of care to begin very soon after their initial injuries, allowing brave soldiers, marines and airmen to begin the recovery process and see their families sooner. With sometimes only an hour to anticipate needs and prepare for the long flight to definitive care facilities, our nurses must often improvise and employ ingenuity to compensate for the conveniences of traditional ICUs.

Our CCATT nurses are an important link in a caring chain that begins in the Middle East and ends back on U.S. soil. At times, situations tested our emotions, as it’s never easy to see one of your own in the patient role. It is always moving to see the sights and sounds of Air Force aircraft opening to reveal their most precious cargo – America’s sons and daughters in the caring hands of CCATT nurses. Although we likely may never see our patients again after our missions, their faces and these experiences are ingrained in us forever.

Capt. Darcy Mortimer, RN, MSN, CCRN
Verona, N.J.
Wilford Hall Medical Center
My experience as an intensive care nurse was invaluable during one of my first flights as a critical care air transport nurse. At the Baghdad field hospital, the patient was a 24-year-old soldier severely injured in a car bomb explosion. His injuries included bilateral, below-the-knee amputations, an eye injury and second/third degree burns to his face and arm. I have never seen a person so severely injured, let alone one of our soldiers. But I couldn’t think about it. He was hypotensive, tachycardic, hypovolemic and anemic.

Air transport was very challenging because inherently it placed the patient at risk for complications. This solder was ventilated with a stable respiratory status, but he was too unstable to tolerate altitude changes with his severe anemia. He needed blood immediately. The field hospital’s blood supply was depleted, so a call was made for blood donations. While I started the patient on a vasopressor and fentanyl drip, two soldiers donated blood. I considered the need for the patient to be in a hospital versus our mobile environment with his unstable hemodynamic status, anticipated possible in-flight complications and considered my limited medications/supplies.

The whole blood, still warm, was handed to me. My internal nursing red flags went up. I considered whether I could support him in the event of an in-flight blood transfusion reaction. Was this transport safe? The answer was “yes” to all these questions, and we could support him. The patient improved during the eight hours we cared for him.

Upon reflection, I am thankful for my nursing experience and knowledge base. It helped me to use the principles behind the practice to be successful in this unique environment. I must be vigilant to be a true patient advocate in uncertain and chaotic situations because others may lose focus of the patient. I am proud to have served this man who serves his country.
Note: Capt. Mortimer also received the 3M Excellence in Clinical Practice Award.

Submit Abstracts Online for NTI 2007 in Atlanta, Ga.

June 1, 2006, is the deadline to submit educational program speaker proposals, including chapter-related proposals, for NTI 2007, May 20 through 25 in Atlanta, Ga. Abstracts can be submitted online at www.aacn.org > Education > Speaker Materials/Information.

Do You Receive Critical Care Newsline?


If you are not receiving Critical Care Newsline, AACN’s weekly e-mailed newsletter, simply e-mail your name, street address and e-mail address to enewsletter@aacn.org. Please indicate whether the street address is for home or work and, if for work, the name of your employer.

What’s Coming Up in the American Journal of Critical Care

• Factors That Enable or Complicate End-Of-Life Transitions in Critical Care

• Family Presence During Resuscitation: A Critical Review of the Literature

• Critical Care Providers’ Perceptions of the Use of Vasopressin in Cardiac Arrest

• Development of the American Association of Critical-Care Nurses’ Sedation Assessment Scale for Critically Ill Patients

Subscriptions to Critical Care Nurse and the American Journal of Critical Care are included in AACN membership dues.

Looking Ahead


October 2005

Oct. 17 National Teaching Institute and Critical Care Exposition Housing Bureau now open. The list of available hotels as well as rates and descriptions of the properties are available online at www.aacn.org > National Teaching Institute.



December 2005

Dec. 1 Deadline to apply for the 2007 AACN Distinguished Research Lecturer Award. The recipient will present the Distinguished Research Lecture at the NTI 2007 in Atlanta, Ga.



January 2006

Jan. 1 Deadline to apply for the AACN-Philips Medical Systems Grants. Areas of inquiry, selection criteria and submission instructions are available online at www.aacn.org > Research > Grants.



May 2006

May 20-25 National Teaching Institute and Critical Care Exposition, Anaheim, Calif. For more information, visit the AACN Web site.

PDA Center


Check Out This PDA Software for Palm OS and Pocket PC Devices

ClinTrials
(ACCF Clinical Trials Database)
This clinical practice support tool from the American College of Cardiology Foundation is designed to synthesize current cardiovascular research findings for busy physicians and healthcare professionals. Study results were gathered by a prominent editorial team from a variety of peer-reviewed publications and professional meetings. Updated monthly, this PDA application was developed by the ACCF to bring these important trial results to you, when you need them, where you need them. Price: $69.95

Essentials of Diagnosis & Treatment in Surgery
Authored by Gerard M. Doherty, MD, and published by McGraw-Hill Companies, Inc., this electronic pocket guide features bulleted, high-yield information on more than 400 common surgical diagnoses. With key equations and formulae, a clinical pearl per topic, plus references, this reference truly is essential in critical care.

This is the quickest review of surgical diagnosis:
• Short, bulleted points for 400 surgical diagnoses
• Key equations, calculations and formulae
• Includes orthopedic, reproductive, renal, cardiovascular, GI and respiratory problems; and other common conditions

Price: $39.95

Visit the AACN PDA Center at http://aacn.pdaorder.com/welcome.xml and choose the “What's New” link.

AACN’s Medicopeia for PDA: Save up to $258!
Medicopeia: This PDA Does It All!
The newest, most advanced PDA solution is now available! Designed exclusively for AACN and bedside nurse clinicians in many areas of practice, AACN Medicopeia, Critical Care Nurse Edition, makes installing, registering, unlocking and managing your PDA and applications a thing of the past. Say goodbye to serial numbers and manually unlocking codes with this exciting program.

With the all-inclusive AACN Medicopeia package, you’ll receive a Palm PDA (choose from the Tungsten T5, the new Tungsten E2 or the powerful, just-released LifeDrive Mobile Manager) pre-loaded with drug monographs on thousands of medications (including integrated weight-based dosing calculators), clinical references, tools and calculators, all updated and unlocked automatically every time you synchronize your device.

And, as an exclusive for AACN Medicopeia users, you’ll have access to the weekly AACN Critical Care Newsline, providing you up-to-the-minute press releases, alerts and information, simply by synchronizing your device.

If you already have a PDA device, you can still subscribe to AACN Medicopeia. Here is what you will receive for only $129 (annual renewal only $109):

Davis’ Drug Guide with Integrated Calculators
ER ICU Toolbox
Pocket ICU Management
Cardiac Medications E-reference
Critical Care Assessment E-reference
Hemodynamic Management E-reference
MedCalc
MedRules
Adobe Acrobat Reader for Palm OS
Special AACN Resources for Adobe Reader
AACN Critical Care Newsline
Lifetime Technical Support

The Palm Tungsten T5 device, complete with the above software, is only $439, a savings of $248 (if individually purchased; annual renewal fee is $109).
Medicopeia with the Tungsten E2 is just $309, a savings of $228 (if individually purchased; annual renewal fee is $109) and Medicopeia with the LifeDrive Mobile Manager is just $528, a savings of $258 (if individually purchased; annual renewal fee is $109).

Find out more by visiting the AACN PDA Center at http://aacn.pdaorder.com and choosing “What’s New!” Note: Medicopeia package is not currently recommended for Mac computers.

Tungsten E2
The new, brighter color display of the E2 makes it easy to see your schedule, contacts and nursing software programs, indoors or out. And, with better color saturation, your photos and video clips come to life in rich, dazzling color. 32MB of memory is included, and the new “flash” memory helps protect the information on your handheld—even if you don’t have time to recharge. Also included are Bluetooth Wireless technology and Documents to Go, allowing you to create and edit Word and Excel documents on the fly.
Device alone is $249. Best value when purchased with AACN Medicopeia, Critical Care Nurse Edition.

LifeDrive Mobile Manager PDA
AACN is proud to introduce the LifeDrive Mobile Manager. Experience the future of handheld computing! Take five years’ worth of appointments, your entire contact database, your to-do list and hundreds of memos with you everywhere, thanks to a 4GB hard drive and built-in personal organization software. And, load all your clinical nursing software or Medicopeia too! The LifeDrive comes equipped with both Bluetooth and WiFi Wireless programs so you can check e-mail or surf the Web.
Device alone is $499. Best value when purchased with AACN Medicopeia, Critical Care Nurse Edition.

For more information, visit http://aacn.pdaorder.com/welcome.xml > What’s New or call (800) 462-0388.

New Products From AACN

CCRN Adult Review Course on DVD
This comprehensive review program was produced from the 2005 NTI preconference and is based on the Adult CCRN Exam Blueprint. In addition to sharing test-taking strategies, experts present an overview of cardiovascular, endocrine, gastrointestinal, hematology/immunology, multisystem, neurological, pulmonary and renal topics. A review of the content of the CCRN exam, including the Synergy Model, is provided. This is an excellent review course for critical care nurses preparing for the CCRN exam. Included are DVDs, a comprehensive study guide and 16 hours of continuing education credit. Courseware is also available on audio CD and audiocassette. The CD-ROM version will be available in November 2005.
Product #301965
Member price: $200; Nonmember price: $275

CMC and CSC Review Courses on CD-ROM!
Presented with full-color slides and audio narration, these two new courses provide an in-depth review that will help prepare you for these two new certification exams. Visit the online Bookstore for detailed information and pricing at www.aacn.org/BookstoreSpecial.

AACN Home Theatre on CD-ROM
Presented with digital audio and full-color slides, you will experience clinical presentations presented by experts in their field. Choose topics such as Fulminant Liver Failure, the ABCs of the CBC in Critical Care, Hepatitis A-E and More, Alphabet Soup: Digesting Cardiovascular Clinical Trials and Rising Above the Ventricles: Management of Atrial Fibrillation. Visit the online Bookstore for detailed course descriptions and to view a sample of each presentation. All sessions are approved for CE credit for a nominal additional fee. The AACN Home Theatre on CD-ROM library will grow on a monthly basis, so be sure to check the Bookstore specials page to see what’s new. Visit www.aacn.org/BookstoreSpecial.

CE Audio Programs From 2005 NTI
More than 50 new CE-approved audio CDs from the most popular NTI sessions are now ready for purchase. Visit www.aacn.org/BookstoreSpecial to view a detailed description of these audio courses, available on audio CD or audiocassette.

Monthly Super Savers From AACN’s Catalog Products

These Super Saver prices are valid through Oct. 31, 2005. To qualify, orders must be received or postmarked by Oct. 31, 2005.

AACN Essentials of Critical Care Nursing
(#128750)
Covering basic to advanced critical care concepts, this easy-to-use, evidence-based resource provides the essential foundation for the nursing care of critically ill patients. It is the ideal reference for nurses beginning their critical care experience as well as experienced nurses who may use the book as a user-friendly resource for both essential and advanced concepts. ECG rhythm interpretation and treatment and pharmacology also make it an excellent resource for progressive care nurses.
Regular Price
Member: $56.95
Nonmember: $59.95
Super Saver Price
Member: $53.95
Nonmember: $56.95

AACN Essentials of Critical Care Pocket Handbook
(#128751)
This practical, clinically oriented pocket handbook provides the essential information needed for quick reference in intensive care, coronary care, PACUs, telemetry units and other critical care settings.
Regular Price
Member: $28.95
Nonmember: $29.95
Super Saver Price
Member: $26.50
Nonmember: $27.65

AACN Home Theatre on CD-ROM
Rising Above the Ventricles: Management of Atrial Fibrillation
(#190011)
Complete with digital audio and full-color slides, this resource, targeted for APNs and critical care nurses who care for patients with atrial fibrillation, provides a comprehensive review of the latest information regarding the classification, epidemiology, mechanisms and clinical characteristics of AF. A key outcome for the participants is an enhanced understanding of AF and its treatment options, both pharmacological and nonpharmacological, to allow optimal patient management and outcomes.
A total of 2.0 contact hours of continuing education credit is available for an additional fee of $7.
Regular Price
Member: $22
Nonmember: $25
Super Saver Price
Member: $19.50
Nonmember: $22.50

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www.aacn.org


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