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Vol. 23, No. 2, FEBRUARY 2006

Public Policy Update

Support for Nursing Shortage Relief
AACN is among Americans for Nursing Shortage Relief organizations that signed a letter encouraging President Bush to increase funding for Nursing Workforce Development programs authorized under Title VIII of the Public Health Service Act.

The letter pointed out that the $153 million appropriated by Congress during the last serious nursing shortage in 1974 is the equivalent of $592 million in today’s dollars—approximately four times as much as the government is now spending.

“Without an infusion of funding that can really make a difference, the nursing and nursing faculty shortages will continue at the expense of the health and well-being of this country’s citizens,” the letter said.

The letter noted that circumstances surrounding the Hurricane Katrina disaster showed that nurses are a critical component of the federal healthcare response to major emergencies and disasters. In the case of a major emergency, nurses have and will continue to be called upon to triage, provide immediate care and, when needed, assist with chemoprophylaxis (oral or injectable medications/vaccinations) of hundreds of thousands or millions of Americans.

Registered nurses and advanced practice registered nurses will also be called on to respond in the event of a pandemic avian flu outbreak, the letter continued. Unlike a tornado or hurricane, a pandemic outbreak would involve a broad and sustained resource strain that would make it difficult to shift resources between states, deeply affecting the nation’s ability to deliver primary and surgical healthcare to patients who need it. Communities nationwide must have sufficient numbers of nurses, APRNs and other healthcare providers to respond to the many healthcare challenges driven by a potential avian flu pandemic.

“Nurses are a vital resource for our nation, and yet federal funding lags far below the need,” the letter said.

“The projected loss of a large segment of the currently practicing nurse population is a loss of not just a member of the workforce, but also a loss of expertise.”

The current nursing shortage, the letter noted, is further complicated by the fact that schools of nursing continue to suffer from a growing shortage of faculty, which prevents these institutions from admitting more students. This condition is not expected to improve in the near term, because an adequate number of nurse educators are not now in the pipeline to replace aging and retiring faculty.

New Group Focuses on Healthcare for All
The new Citizens’ Health Care Working Group will be listening to feedback from Americans—in person and online—before creating a plan to make healthcare work for all Americans. Created by federal statute, the group will forward its recommendations to the president and Congress. Community meetings are under way across the country through April.

Learn more about healthcare in America and locate a community meeting in your area online at www.citizenshealthcare.gov.

Nurses Still Number One
The Gallup organization’s 2005 Honesty and Integrity Survey again ranked nurses at the top.

With the exception of 2001, nurses have been the highest-rated profession since being included in the poll in 1999.

For more information about these and other issues, visit the AACN Web site.

Event Launches Beacon Award Challenge

A special event hosted by the Greater Washington Area Chapter of AACN focused attention on the AACN Beacon Award for Critical Care Excellence.

At the dinner event, attended by 350 nursing leaders from 30 hospital affiliations in the greater Washington, D.C. area, a challenge was issued for units to seek AACN Beacon Award for Critical Care Excellence status. Each of the hospital affiliates represented was eligible for a one-time, $500 gift contribution to use toward the Beacon Award application fee.

The AACN Beacon Award for Critical Care Excellence gives national recognition to units that attain high standards for quality, exceptional care of patients, and healthy, humane and healing work environments. The units that achieve this award exemplify healthy work and care environments, help set the benchmarks and guide other critical care units.

The award criteria are based on recruitment and retention; education, training and mentoring; evidence-based practices; patient outcomes; healing environments; and leadership and organizational ethics.

To learn more about the AACN Beacon Award for Critical Care Excellence, visit the AACN Web site.

In attendance at the dinner were (from left, photo above) Joan Stanley of the American Association of Colleges of Nursing; Heather Russell, president of the Greater Washington Area Chapter; past AACN President Connie Barden, who was keynote speaker; past AACN board member Janie Heath, Beacon Committee chair; AACN President Debbie Brinker; and Joyce Johnson, senior vice president of operations at Georgetown University Hospital and GWAC Beacon dinner partner. Past AACN board member and Beacon
Committee Chair Janie Heath (right)
recognized Georgetown University Hospital
for its first Beacon Award unit. Representing
the medical ICU were (from left) Mary Herold,
nurse manager; Doris Tavares, nurse manager;
and Lisa Miller, staff nurse.

Moral Distress Tool Kit Enhances Instruction

A tool kit designed to support instructors/facilitators in presenting the 4 A’s to Rise Above Moral Distress Framework is now available from AACN.

Included in the tool kit are:

• PowerPoint presentation with facilitator notes
• A facilitator handbook with learning objectives, preparation suggestions, an outline of the PowerPoint slide show and notes, and suggested activities and questions to facilitate discussions. Three case studies with facilitators’ guide and questions to assist in applying the 4A’s to Moral Distress Framework to practice are also included.
• Participant handouts
•The 4 A’s to Rise Above pamphlet

The goal of the facilitation guide and PowerPoint presentation is to provide the facilitator with interesting activities and questions that will actively engage participants in the learning process.

Price is $40 ($50 for nonmembers). The product number is 140332.

To order, visit www.aacn.org > Bookstore.

Practice Resource Network


I work in a telemetry unit where we are being asked to treat 12- to 16-year-old patients who are obese and, in many cases, as large as adult patients. With so many more children being obese now than in the past, at what age is a child considered an adult? These young patients may be of sufficient BMI to treat as an adult pharmacologically and physiologically, but what about emotionally? Can you help answer this question?

Event Launches Beacon Award Challenge


This is an area of great debate around the country because there is no national standard regarding this issue. Before treating a pediatric patient in your unit, here are some things to consider:

• Are the nurses on your telemetry unit competent to meet the emotional, psychological and learning needs of pediatric patients? If not, what would it take to get to that level of competence and maintain it? If you admit these patients infrequently, it may be of more risk than benefit to the hospital to place these patients on your unit.
• Can the dysrhythmias you are monitoring be managed/treated the same way in the obese child as in an adult? If treatment is different, do the nurses in your unit know how to provide those interventions? Another key point: Are patients being followed by cardiologists who specialize in treating children or adults?
• Would pediatric patients be treated in an environment that is safe for them? Be sure to consider all aspects, including adolescent curiosity and behaviors.
• What does your unit’s scope of service document indicate? Are pediatric patients included in case your unit is visited by a regulatory agency?
• What are the hospital’s policies regarding patient placement? If an incident occurred during the pediatric patient’s treatment, hospital policies should be reviewed to determine if internal standards had been met.
• Does your risk management department have input into this issue? They would have to defend issues arising from the placement of pediatric patients.
These are just a few of the concerns raised by your inquiry. If treating obese pediatric patients in your unit becomes routine, it might be beneficial to ensure that your unit has answers to the questions listed.

Do you have a practice question? Call the AACN Practice Resource Network at (800) 394-5995, ext. 217.
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