AACN News—June 2007—Association News

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Vol. 24, No. 6, JUNE 2007


Survey Findings Released
Beacon and Magnet Designations Result in Healthier Work Environments


Nurses who work in organizations or units that have met or are pursuing the national excellence standard of a Beacon or Magnet designation report healthier work environments and higher satisfaction with their jobs, according to a study conducted by AACN, the Gannett Healthcare Group and the Bernard Hodes Group.

The results were released at AACN’s National Teaching Institute & Critical Care Exposition in Atlanta, Ga., in May. An article summarizing the survey results appears in the June 2007 issue of Critical Care Nurse, which is available online at ccn.aacnjournals.org.

Several past studies have found that healthy work environments—characterized by strong communication and collaboration between healthcare team members, among other factors—have a direct impact on increased patient safety and improved patient outcomes.

The Beacon Award for Critical Care Excellence was established in 2003 by AACN and recognizes individual critical care units as well as progressive care units that meet high quality standards, demonstrating exceptional care of patients and their families while fostering and sustaining healthy work environments. The Magnet Recognition Program was developed and is administered by the American Nurses Credentialing Center, an independent subsidiary of the American Nurses Association and recognizes healthcare organizations that demonstrate excellence in nursing care and professional nursing practice.

“This research shows that a core strategy of effective patient care and nurse satisfaction must include pursuing national Beacon and Magnet excellence standards. It’s not just a value-added benefit,” said Wanda Johanson, RN, MN, CEO of AACN. “The concrete evidence in this study shows that healthier work environments, higher job satisfaction for nurses, and thus better patient outcomes, are best achieved by organizations and units that pursue and achieve excellence standards.”

The survey of more than 4,000 acute and critical care nurses in all 50 states and the District of Columbia found the most significant differences related to collaboration and communication, support for professional growth and development, leadership and satisfaction, and patient outcomes. Nurse respondents in the survey consistently rated each of these criteria higher when working in Magnet organizations and Beacon units.

The study found that nurses who worked in Magnet organizations, Beacon units or those pursuing such designations were more satisfied with nursing as a career and with their current nursing positions. Respondents also found frontline managers, who represent vital leadership in an organization as they understand the vision and social structure, as having higher perceived skill levels in Beacon and Magnet organizations. For example:

• Seventy-one percent of respondents from Magnet organizations and 78 percent of respondents from Beacon units rated frontline managers as having excellent/good decision-making skills.
• Only 54 percent of respondents from organizations with no Magnet activity and 56 percent of respondents from units with no Beacon activity rated frontline managers with excellent/good decision-making skills.
Additionally, Magnet organizations and Beacon units as well as those pursuing these excellence designations are more supportive of continuing education and certification. In many instances, organizations and units in pursuit of excellence are more supportive than those who have already obtained the designations, indicating the need for sustainable efforts that continue after excellence designations are achieved.
• More than 50 percent of respondents from Magnet-pursuit organizations and approximately 60 percent of respondents from Beacon-pursuit units responded that their organizations and units pay/reimburse the initial certification exam fee.
• Meanwhile, only about 40 percent of organizations with no Beacon activity and 40 percent of units with no Magnet activity said their units pay or reimburse the initial certification exam fee.

These survey results continue to add evidence to the fact that healthy work environments, particularly as they pertain to communication, collaboration, and staffing, are related to increased patient safety and improved patient outcomes. At both the unit and organization level, nurses in the study rated the current quality of care as significantly lower in organizations and units that had not achieved and were not pursuing excellence designation.

Karen A. Hart, RN, BSN, senior vice president, healthcare division, Bernard Hodes Group, explains, “Results of this study verify what we have suspected for many years-that a commitment to excellence through programs such as Magnet and Beacon Unit recognition fosters satisfaction and thus retention of our valuable nursing professionals. Obtaining Magnet and Beacon recognition should be a core strategy of the proactive healthcare organization.”

Beth Ulrich, EdD, RN, FACHE, FAAN, senior vice president, Gannett Healthcare Group Consulting Services, and corresponding author of the study, adds, “These results offer compelling evidence to support what we have intuitively believed-the pursuit and achievement of excellence makes a positive difference in the health of nursing work environments and in nurses’ job satisfaction.”

Meet the 2007-08 AACN Certification Corporation Board Leadership


The AACN Certification Corporation is poised for a change in leadership July 1 as Kevin Reed, RN, MSN, CNA-BC, CPHQ, succeeds Rebecca Long, RN, MS, CCRN, CMSRN, as chair of the corporation’s Board of Directors.

Taking office with Reed as chair-elect is Beth Martin, RN, MSN, CCNS, ACNP. Returning to the board as directors are Damon Cottrell, RN, MS, CCNS, CCRN, APRN-BC, CEN, Maria Shirey, RN, MS, MBA, FACHE, CNAA, BC, Susan Helms, RN, MSN, CCRN, PCCN, and Carol Melman, consumer representative. Deborah Greenlaw, RN, MS, MSNc, CCRN, APRN, ACNP-CS, returns as board secretary/treasurer. Janice Wojcik, RN, MS, CCRN, APRN, BC, and Patricia Morton, RN, PhD, ACNP, FAAN, have been appointed to the board as representatives of the AACN Board of Directors.

Kevin Reed

Reed is director of clinical operations in neuroscience and critical care at Clarian Health, Methodist Hospital, Indianapolis, Ind. He is also adjunct faculty at the Indiana University School of Nursing, Department of Environments for Health, Indianapolis.

Reed earned his bachelor of science in nursing degree from Ball State University, Muncie, Ind., and a master of science degree in nursing administration from Indiana University.
He has been a member of AACN since 1987 and is a CCRN alumnus. He served on the AACN Board Advisory Team and is a past recipient of the AACN Excellence in Leadership Award, part of AACN’s Circle of Excellence recognition program. Reed has been a member of the AACN Certification Corporation Board since 2004. He was secretary/treasurer in 2005-06, on the Audit Committee for 2005-06, and was a member of the AACN Certification Corporation Nominating Committee for 2004-05.

In addition, Reed was involved in a partnership with AACN to develop a Professional Nursing Practice Model based on the Synergy Model and was instrumental in developing Clarian Health’s sponsorship of the Certification Oasis at the NTI.

Beth Martin

Martin is a nurse practitioner with Palliative Medicine Consultants, Charlotte, N.C.
She received her bachelor of science in nursing at Spalding University, Louisville, Ky., and her master of science in nursing in adult health at the University of South Florida, Tampa, before earning her post-master’s certificate as an acute care nurse practitioner from the University of South Carolina, Columbia.

As an active member of AACN, Martin has volunteered in a variety of roles, including on the CCRN Adult Item Writer Committee, Education Work Group, Faculty Advisory Team and as a member of the AACN Certification Corporation Board for 2003-05.

She is a member of the Piedmont Carolinas Chapter of AACN and a past member of the Gulfcoast Chapter of AACN.

State of the Association: A Letter to the Membership

Dear AACN Members,

Tracy, Johanson

In talking with many of you throughout the year, we realized that we have sometimes been remiss in sharing with you the overall progress of AACN and the leadership’s efforts on your behalf. We greatly appreciate your insight and would like to start a regular communication highlighting the association’s health and direction.

Because of our strength of numbers, expertise and knowledge within our ranks, and our national influence, AACN can achieve critical goals for members and the profession that may be difficult or impossible for individuals to achieve alone. All of us together contribute to this strength and the ability to make the impossible, possible.

As AACN leaders, we know that an unwavering commitment to serving our mission and the needs of our community of acute and critical care nurse members is deeply embedded in the history and culture of AACN. It is lived out in each decision made and each initiative undertaken.

Critical to fulfilling this commitment is ensuring the association is financially positioned to be able to invest in richer membership benefits and to quickly respond to changes in the nursing environment and the evolving professional needs of members. We’d like to focus on this aspect in this message.

Faithful, good stewardship of the association’s financial assets has paid off, putting AACN in a secure and sustainable financial state. Because of this, we are pleased to report that:

- Our membership dues remain the lowest among comparable organizations with similar or lesser member benefits. In addition, dues have remained at $78 for nearly 10 years, with consistent enhancements to the membership benefits package even in the face of higher operational costs.

- Member fees for certification exams have not changed for a decade and those for member recertification have remained unchanged for 14 years, despite hundreds of thousands of dollars in investments to develop new exams, programs and service enhancements. These fees remain among the lowest compared to like organizations.

- NTI registration fees have remained consistently lower than industry benchmarks over the past few years, even with higher prices for conference facilities and services. We have heard how important NTI is to you as a forum for premier education as well as an opportunity for rejuvenation and inspiration.

- While keeping fees low, AACN is also able to invest significantly in national activities that help establish and sustain healthy work environments, which you have strongly validated is essential for you professionally and for the safety of your patients.

- We are able to fund multiple groups of national experts to develop practice alerts, protocols and other evidence-based resources that you have confirmed are essential to your practice.

- We were able to invest more than $1 million in development of the groundbreaking Essentials of Critical Care Orientation (ECCO) program, offering it to your hospital at a fraction of the cost of comparable programs and at a higher quality. An additional $750,000 has been invested in a joint venture with our partner, the American Organization of Nurse Executives, to provide a similar orientation program for nurse managers. Both of these resources arose from your feedback and need for standardized, efficient and high-quality education resources.

- Since 2000, AACN has awarded more than $1.1 million in scholarships to support educational advancement and career enrichment of members.

- We are currently investing more than $250,000 to implement a state-of-the-art Web site rich with electronic tools, resources and interactive forums. You have told us that, because you are juggling multiple demands at work and home, one of your highest priorities is easily accessible, just-in-time resources that you can count on as the standard.

- You have also confirmed that continuing education is very important to you in keeping up with changes in practice and maintaining certification and licensure. We are excited to let you know that another membership enhancement is on the horizon for next month. On July 1, AACN members will be able to obtain unlimited continuing education (CE) certificates through the entire AACN online CE library and CE articles in all AACN publications, free of charge. Yes, free of charge and in unlimited quantity.

This is the power of being in an association. This is the power of a strong community of acute and critical care nurse members, who together can accomplish for ourselves what none of us can accomplish alone.

We hope this information is useful and will help you in evaluating how your association leadership is at work for you. We know we have much more to do as the pace of change continues unabated. You have our promise that we will remain steadfast in our commitment to listen deeply to your issues and needs and to respond with a bold voice and be assertive in
providing support and resources.

In closing, we extend our deepest gratitude to you for your commitment to our AACN community. The invaluable, often heroic work you do on behalf of patients, their families and your healthcare organization every day does not go unrecognized. Please write to us at insights@aacn.org and let us know how the association can continue to enrich your membership and work effectively on your behalf.

Warm Regards,


Mary Fran Tracy, RN, PhD, CCNS, CCRN, FAAN
President


Wanda Johanson, RN, MN
Chief Executive Officer

Scene and Heard


Our Voice in the Media
Nephrology Nursing (January/February 2007) – “President’s Message: Healthy Work Environments” noted that “one organization that has contributed greatly to defining, creating, and sustaining healthy work environments is AACN … These standards can be used as a foundation for other organizations to build upon when discussing work environment realities. On Dec. 7, 2006, the ANNA (American Nephrology Nurses Association) Board of Directors voted to endorse these AACN Standards. I encourage you and all members of your organization to become familiar with the details of the standards as well as their critical elements, to assess how your organization is performing with respect to the standards and to implement strategies to assure that the standards are always met. It takes a whole healthcare organization working together to create a healthy work environment.”

CHEST Physician (July 2006)—“President’s Report: The Importance of Healthcare Teams” included positive feedback from Dr. W. Michael Alberts, FCCP, former president of the American College of Chest Physicians (ACCP), about his attendance at NTI in Anaheim, Calif. In part, he wrote, “If you ever have a chance to attend the AACN meeting, by all means attend (and more importantly, advise your ICU nurses to attend). I was very impressed, not only by the quality of the program, but the vast array of subject matter and presentations. I was most impressed, however, by the enthusiasm of the attendees. The feeling was almost palpable.”

Nursing Spectrum (Feb. 16, 2007)—“Brent’s Law Letter” advised that “Doing a literature search in nursing and other print media, including a review of publications and position statements, such as … AACN … would also be helpful. AACN’s Web site has a Public Policy link that is quite informative.”

Nursing Economics (Jan. 1, 2007)—“Staff Engagement: It Starts With the Leader” included a section on the AACN Standards for Establishing and Sustaining Healthy Work Environments: “AACN includes Meaningful Recognition as the sixth standard a culture must demonstrate to be judged a healthy work environment. This doesn’t mean just a routine pat on the back or chocolates. Meaningful recognition means that the true essence and uniqueness of the individual is recognized and honored.”

Oklahoma City’s Nursing Times (Feb. 5, 2007)—“Integris RN Receives National AACN Nurse Manager Award” indicated that AACN is “a national organization that sets the standards for critical care, acute care and progressive care nursing.”

ENA Connection (March 2007)—“January 2007 Board Meeting Actions and Highlights.” The Emergency Nurses Association’s board of directors “approved support of the AACN Standards for Establishing and Sustaining Healthy Work Environments.”

Newswise (Feb. 28, 2007)—“Medical Societies Endorse New Critical Care Workforce Bill.” The Critical Care Workforce Partnership, a collaboration of the nation’s leading critical care societies, today endorsed the Patient-Focused Critical Care Enhancement Act.” Mary Fran Tracy, RN, PhD, CCRN, CCNS, FAAN, AACN board president, was quoted as saying, “AACN is deeply concerned about the physician and nursing shortage. Providing optimal care to acutely and critically ill patients and their families requires the expertise of both professions. The issues surrounding this dwindling healthcare workforce must be addressed now and for the long term to ensure that the needs of acutely and critically ill patients can be met, now and in the future.”

CHEST Physician (February 2007)—“Creating Healthy Work Environments: Skilled Communication” by David Maxfield, director of research for VitalSmarts, is the second in a series of articles about AACN’s standards for a healthy work environment. He wrote that “Nurses must be as proficient in communication skills as they are in clinical skills. This is the conclusion of a blue-ribbon set of scholars convened by AACN.”

Advance for Nurses (Feb. 19, 2007)—“Aspire to Greatness: Empowering Nurses to Demonstrate the Difference They Make for Patients and the Organization” was co-written by John Dixon, MSN, RN, CNA, BC, former AACN board member. “The ASPIRE program is based on the AACN Synergy Model for Patient Care that is a central element of the BHCS (Baylor Health Care System) Professional Nursing Practice Model. Basic to Synergy is the recognition that nursing practice is the integration of knowledge, skills, experience and attitudes, and when linked to the patient needs and characteristics, creates a synergistic process resulting in safe passage and optimal patient outcomes.”

Healthcare.Monster.com (Feb. 20, 2007)—“How Nurses Can Help End Horizontal Hostility” was picked up by about 75 television outlets across the country and included a link to AACN’s HWE Web page. Deborah Mills, BSN, CNO, at Memorial Hospital in Martinsville, Va., said, “Creating a healthy organizational culture has to be a vision that comes from the top. If your hospital hasn’t done so already, encourage it to adopt the standards outlined in AACN’s Healthy Work Environment Initiative …”

Our Voice at the Table
Tracy

Tracy spoke about her theme “Powered by Insight” and presented “From Nightingale to Today: Evidence-based Practice at the Bedside” at the 2007 Odyssey on Critical Care Nursing Conference sponsored by Virginia Commonwealth University Medical Center, Richmond, Va.

Hanson

Dave Hanson, RN, MSN, CCRN, CNS, AACN president-elect, was the keynote speaker and presented “Igniting the Power Within: the Art of Mentoring” as well as a clinical breakout session titled “Making the 12 Lead ECG Connection” at the annual Visions Symposium, sponsored by AACN’s Greater Kansas City (Mo.) Chapter. Mary Stahl, RN, MSN, APRN, BC, CCNS, CCRN, AACN board member, presented a breakout session on “Prostacyclins in the Management of Pulmonary Arterial Hypertension.” Hanson and Stahl also presented a national AACN Update and answered participants’ questions.

Stahl

Tracy spoke at the 33rd Annual Midwest Conference sponsored by AACN’s Northwest Chicago Area Chapter. She gave the keynote, “Powered by Insight” and also presented "From Nightingale to Today: Evidence-based Practice at the Bedside.”

Hanson presented two breakout sessions at the 33rd Annual Midwest Conference sponsored by AACN’s Northwest Chicago Area Chapter. One was titled “Acute Coronary Syndrome: Triage, Evaluation and Management” and the second was “Powered by Insight: Identifying the Elements for Establishing & Sustaining Healthy Work Environments.”

Kaplow

Roberta Kaplow, RN, PhD, CCRN, CCNS, AACN board member, spoke on “Coagulopathies in the ICU” and the “AACN Synergy Model for Patient Care” at the 33rd Annual Midwest Conference sponsored by AACN’s Northwest Chicago Area Chapter. Many attendees were interested in how to implement the Synergy Model in clinical practice and academic settings, and others were in various phases of implementation.

Morton

Patricia Gonce Morton, RN, PhD, ACNP, FAAN, AACN board member, and Hanson toured the 17-bed combined ICU/CCU at Good Samaritan Hospital in Baltimore, Md. They also met with members of the collaborative multidisciplinary team that cares for acutely and critically ill patients.

Helms

Susan Helms, RN, MSN, CCRN, PCCN, AACN Certification Corporation board member, was the keynote speaker at the 3rd Annual Cardiovascular Symposium held at Wake Forest Baptist Medical Center in Winston Salem, N.C. Her presentation was titled “Powered by Insight With Certification.”

Reed

Kevin Reed, RN-BC, MSN, CNA, AACN Certification Corporation chair-elect, attended the American Board of Nursing Specialties (ABNS) Assembly in Costa Mesa, Calif., with Dana Woods, AACN director of marketing and strategy integration, Carol Hartigan, RN, MA, AACN certification programs strategist, Patty Uy, MBA, AACN certification manager, and Karen Harvey, RN, MSN, AACN certification specialist. ABNS members, which are nursing specialty certification organizations, meet at this biannual assembly to address common issues of interest and advance specialty certification.

April Campaign Brings AACN a Shower of New Recruits


April was a productive month in AACN’s Member-Get-A-Member campaign.
Widening her overall lead and going over the century mark with 102 new members recruited as of the end of April, Ann Brorsen, RN, MSN, CCRN, CEN, of Sun City, Calif., had a great month with 22 members recruited. Holding in second place with 64 new members recruited was Susan Rogers, RN, DNS, MSN, of Vienna, Va. Adding eight in April, Kathleen Richuso, RN, MSN, RN-BC, of Chapel Hill, N.C., took over third place with 57 members recruited, with Diana Lane, RN, MSN, of Hermitage, Tenn., holding in fourth place with 49 members recruited.

Eun Goldstein, RN, BSN, MA, CCRN, FACC, CVRN, of Palatine, Ill., burst on the scene in April, bringing 23 new members into the fold. Also of note was Ngozi Moneke, APRN, MS, CCRN-CMC, ANP, CRN, NP, RN-BC, of Freeport, N.Y., who had an outstanding recruiting month with 22.

In chapter recruiting, the Three Rivers Chapter had a huge month, adding 62 new members to the AACN roster. This vaults them into fourth place overall in the campaign, with 85 as of the end of April. The Greater Richmond Chapter added five new members to stay in the overall lead with 115 new members recruited. The Houston Gulf Coast Chapter also checked in with seven new members to hold onto second place with 96. In third place, with 90 new members recruited is the Southeastern Pennsylvania Chapter, which added nine in April.

They are among the 1,473 individuals and chapters that have recruited 6,454 new members since the campaign began May 1. The campaign ends Aug. 31, 2007. The recruitment period was extended for this year’s campaign to move the program to a 12-month cycle in the future.

Participation in the Member-Get-A-Member drive offers the opportunity for recruiters to receive valuable rewards, including a $1,000 American Express gift check that will be awarded to the top individual recruiter. The top recruiter is also eligible for three Grand Prize drawings for $500 gift certificates. Every recruiter who enrolls five new members during the program will be entered in the drawing.

In addition, as individuals recruit new members, they are entered in a drawing for a $100 American Express gift check each month they recruit. Sean G. Smith, RN, BS, BSN, EMT-B, won the gift certificate in April.

After recruiting their first five new members, participants receive a $25 gift certificate toward AACN products and services, and $50 after recruiting a total of 10 new members.
The chapter recruiting the most new members during the campaign will receive a $1,000 honorarium check. The winning chapter is also eligible for Grand Prize drawings for three $500 honorarium checks for their chapter treasuries. In addition, chapters are eligible for monthly drawings for a free NTI registration any month they recruit a new member. The winner for April was the Greater Reading Chapter.

To see the full list of recruiters and their totals, visit the AACN Web site at www.aacn.org > Membership.

With Additional Gratitude


The April 2007 issue of AACN News recognized the remarkable generosity of those whose gifts supported the AACN Scholarship Endowment and other association initiatives during the previous year. Thanks to these gifts, the endowment grew to more than $914,000 during 2006.

In lieu of accepting a personal honorarium for speaking engagements, AACN board members and other association leaders request that a tribute gift be made to the Scholarship Endowment or another initiative of their choosing. During 2006, this time and talent contributed more than $31,000 for which AACN and our scholarship recipients are most grateful. The donor and honoree names, which were not announced in April, are shown below.

Above $1,500
West Michigan Chapter-AACN-In Honor of Roberta Kaplow

$1,000-1,499
American College of Endocrinology-In Honor of Denise Buonocore, Broward County Chapter-AACN-In Honor of Debbie Brinker, Clarian Health Partners-In Honor of Mary Fran Tracy and Kathy McCauley, Greater Memphis Area Chapter-AACN-In Honor of Joy Speciale and Debbie Brinker, Greater Milwaukee Area Chapter-AACN-In Honor of Mary Fran Tracy, Greater Rochester Finger Lakes Chapter-AACN-In Honor of Denise Buonocore, Greater Washington Area Chapter-AACN-In Honor of Mary Fran Tracy, Maine Medical Center-In Honor of Kathy McCauley, Northwest Chicago Area Chapter-AACN-In Honor of Debbie Brinker, Northwest Washington Evergreen Chapter-AACN-In Honor of Kathleen M. Schatz and Debbie Brinker, Shriners Hospitals for Children-In Honor of Wanda Johanson, South Central Connecticut Chapter-AACN-In Honor of Dave Hanson, Roberta Kaplow and Mary Fran Tracy

$750-999
Chesapeake Bay Chapter-AACN-In Honor of Mary Fran Tracy, Cleveland Clinic Foundation-In Honor of Debbie Brinker, Dallas County Chapter-AACN-In Honor of John Dixon, Dave Hanson and Julie Miller, Greater Kansas City Chapter-AACN-In Honor of Mary Fran Tracy, Greater Richmond Area Chapter-AACN-In Honor of Debbie Brinker, Monticello Chapter-AACN-In Honor of Debbie Brinker, Sacramento Area Chapter-AACN-In Honor of Debbie Brinker

$500-749
Bronson Methodist Hospital-In Honor of Dave Hanson, Central Indiana Chapter-AACN-In Honor of Debbie Brinker, Greater East Texas Chapter-AACN-In Honor of Julie Miller, Greater Twin Cities Area Chapter-AACN-In Honor of Mary Fran Tracy, Horizons Region 1 Symposium-In Honor of Denise Buonocore and Debbie Brinker, Hospital and Healthsystem Association of PA-In Honor of Kathy McCauley, Inland Northwest Chapter-AACN-In Honor of Kathy McCauley, International Association for Exhibition Management-In Honor of Randy Bauler, Joint Commission-In Honor of Kevin Reed, Mt. Rainier Chapter-AACN-In Honor of Debbie Brinker, Nursing Spectrum/NurseWeek-In Honor of Wanda Johanson, Providence Everett Medical Center-In Honor of Debbie Brinker, Region 6 Chapters of AACN-In Honor of Debbie Brinker, Renown Regional Medical Center-In Honor of Kathy McCauley, Rochester General Hospital-In Honor of Mary Holtschneider, South Florida Gold Coast Chapter-AACN Program-In Honor of Mary Fran Tracy, Southeastern Pennsylvania Chapter-AACN-In Honor of Kathy McCauley and Mary Fran Tracy, Spectrum Health, Butterworth Campus-In Honor of Kathy McCauley

$250-499
Bitterroot Chapter-AACN-In Honor of Debbie Brinker, Carolina/Virginia Chapter of the Society of Critical Care Medicine-In Honor of Debbie Brinker, Greater Louisville Chapter-AACN-In Honor of Dave Hanson, Hill City Chapter-AACN-In Honor of Mary Fran Tracy, Metropolitan Orlando Chapter-AACN-In Honor of Kathy McCauley, Northern New Jersey Chapter-AACN-In Honor of Janice Wojcik

Up to $249
Albemarle Area Chapter-AACN-In Honor of Mary Holtschneider, Central Pennsylvania Chapter-AACN-In Honor of Janice Wojcik, Coastal Chapter-AACN-In Honor of Mary Holtschneider and Deborah Greenlaw, Dymaxium, Inc.-In Honor of Kathy Peavy, Heart of the Piedmont Chapter-AACN-In Honor of Mary Fran Tracy, North Shore Medical Center-In Honor of Paula Lusardi, Sacred Heart Medical Center-In Honor of Debbie Brinker, Smoky Mountain Chapter-AACN-In Honor of Mary Holtschneider

Members on the Move


Sorce, Bauler, Shirey


Stahl, Reed, Williams, Lusardi

Professional
Julie Stanik-Hutt, PhD, ACNP, CCNS, was named president-elect of the American College of Nurse Practitioners, Washington, D.C.

Melissa Fitzpatrick, RN, MSN, FAAN, past AACN president and past chair of AACN Certification Corporation, has been named vice president and chief clinical officer of Hill-Rom, Cary, N.C.
Lauren R. Sorce, RN, MSN, CCRN, CPNP-AC/PC, FCCM, was appointed to the Society of Critical Care Medicine Planning Committee to assist in the development of multiprofessional conferences. She also received a Presidential Citation from SCCM.

Maria Christabelle Castro, BSN, RN, CCRN, completed her master of science in healthcare administration and was also named nurse manager of TCU at the Veterans Administration Medical Center in Dallas.

Randy Bauler, CEM, AACN’s corporate relations and exhibits director, recorded a podcast titled “Growing Event Sponsorships” for the Healthcare Convention Exhibitors Association (HCEA).

Maria Shirey, RN, MS, MBA, CNAA, BC, FACHE, AACN Certification Corporation board member, wrote an article titled “Moral Intelligence for the Leader and Entrepreneur” for the March 2007 issue of Clinical Nurse Specialist.

Jovita Solomon-Duarte, RN, MSN, CCRN, CRN, was appointed diversity coordinator for the School of Nursing at Thomas Edison State College in Trenton, N.J. She will manage a $600,000 federal grant awarded to the school.

Mary Stahl, RN, MSN, APRN-BC, CCRN, CCNS, AACN board member, co-authored “Ventricular Assist Devices in the Adult,” which was published in the April/June 2007 edition of Critical Care Nursing Quarterly.

Honors
Kevin Reed, RN-BC, MSN, CNA, AACN Certification Corporation chair-elect, passed the CPHQ exam and became a Certified Professional in Healthcare Quality.

Michael L. Williams, MSN, RN, CCRN, CNE, former AACN president, received the Leader of Leaders Award at the National Student Nurses Association’s annual meeting in Anaheim, Calif.

Susan Litt, RN, PCCN, became the first RN to pass the PCCN exam on her step-down unit at Emory University Hospital, Atlanta, Ga.

Linda Pellico, PhD, RN, received the Excellence in Caring in Chronic Illness Award from the Yale School of Nursing Center for Excellence in Chronic Illness Care, New Haven, Conn.

Paula Lusardi, RN, PhD, CCRN, CCNS, AACN board member, was a scientific reviewer for the first-ever TriService Nursing Research Program Evidence-based Practice Proposals review in Washington, D.C.

Marita Titler, PhD, RN, FAAN, delivered a keynote address, “Innovations and Translation Science,” at the 3rd Annual Research Symposium sponsored by the Center for Self and Family Management of Vulnerable Populations.

Datascope Excellence Collaboration Award


Datascope Excellence in Nurse-Administration Collaboration Award
Editor’s note: 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. Recipients of the award are:

Debbie J. Arnett, RN, MSN
Glendale, Ariz.
John Lincoln Deer Valley Hospital
Debbie is a critical care nurse who has practiced for over 20 years; she is currently the critical care educator at John C. Lincoln Health Network. Debbie has increased our organization’s success by supporting a number of communication techniques in cooperation with administration. Her efforts have shaped the way we communicate with patients, and in turn patient satisfaction has increased tremendously. Debbie’s collaboration with administration has been instrumental in quelling the nursing shortage. Debbie improved the Nurse Extern program coursework and has helped nurses who have been out of the profession for years re-enter nursing with confidence. She assures their success through individualized assessment, training and mentorship. When our hospital administrators chose to recognize certified nurses, Debbie embraced the idea and designed classes to encourage nurses to take the CCRN and CEN exams. Successful results include a pay increase and enhanced professional pride. Debbie has dramatically influenced the use of nursing knowledge and expertise to improve patient care decisions. As the Code Team Committee chair, Debbie revealed some areas needing improvement. The post-code survival rate for our hospital has now rocketed to 16%, compared to a national average of 5%. Debbie has also initiated multiple protocols to increase nurse autonomy and improve patient outcomes, which were approved by administration. Debbie is a friend, a mentor and a leader. She has changed the lives of nurses and the patients we serve through her collaboration with administration.

Vision Team
Indianapolis, Ind.
Clarian Health Partners
“TEAMWORK IS NCC. TOGETHER EVERYONE ACHIEVES MORE!” are the words you see on a bright yellow banner, as you walk into our unit. All staff and management wear pins as a reminder of this commitment to our patients, their families and one another. More than two years ago, our managers asked a few nurses on our unit to form a committee that would focus on developing a positive, professional, collaborative work culture. In October 2003, eight nurses met and formed The Vision Team of Neuro Critical Care. Our managers support leadership through work groups and committees, which promotes a feeling of ownership in our work environment, rather than having management mandate the decisions. The Vision Team collaborated for a year to develop a teaching tool that would educate the staff on professionalism and the expectations for working on NCC. With the motto “Teamwork is NCC,” we formulated 38 corresponding words, giving definitions and unit-specific examples to match each letter in the motto. With the support of our managers, we planned two retreats and gave our presentation. The Vision Team is committed to being effective decision makers, reaching our goals and being role models for our unit. We continue to search for positive, creative ways to embrace our motto. This team has definitely had a positive impact on our unit. Our turnover rate for the first quarter of 2005 was 1.5%, compared to 7.6% for year-end 2004. In the words of John C. Maxwell, “Teamwork gives you the best opportunity to turn vision into reality.”

Critical Care Cardiovascular Unit
Barrington, Ill.
Advocate Good Shepherd Hospital
Ms. K woke up with an irregular heartbeat and severe pain between her shoulder blades. Following emergency cardiac catheterization, doctors discovered she had coronary artery disease and needed a bypass. What makes this scenario unique is that if Ms. K had presented one week earlier, these services could not have been offered at our hospital. She would have been transferred to another facility with the accompanying delay in treatment. Ms. K felt lucky to have been treated immediately. After several years of gathering statistics, surveying the market, obtaining the certificate of need and developing construction plans, the day was here. The excitement of our first case was palpable. No one questioned if we were ready – we knew we were! Maybe our confidence was achieved after the clinical and educational preparations. Maybe it was the clinical simulations with volunteer patients that helped us approach this first patient with certainty. Maybe it was the camaraderie with other nurses in surgery and the cardiac lab as we readied the program. Whatever it was, we had the confidence to care for Ms. K. Post-operatively Ms. K required intra-aortic balloon counterpulsation and titration of vasoactive infusions. The next day she was extubated, the intra-aortic balloon was removed and she went to cardiac rehabilitation. After her successful surgery and recuperation, Ms. K visited the hospital. Nursing staff in the cardiovascular unit were gratified to see her, and knew the outcome would not have been possible without the vision and effort of our administrative leaders.

Datascope Excellence in Nurse-Family Collaboration Award
Editor’s note: 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. Recipients of the award are:

Phyllis S. Hergenhahn, RN, ADN, CCRN
West End, N.C.
First Health of the Carolinas
Mrs. L. was transferred to our CCU in cardiogenic shock and on life support, after an MI. Another nurse was taking care of her. Mrs. L’s six children, ages 17 to 28, overwhelmed with anxiety, became confrontational and demanded greater access to their mother. How frightened they were! I asked them what they wanted to do most for their mother. They replied, “We want to give her all our love.” I explained how they could transform their fear and sadness into a loving energy that would allow them to let her go peacefully. I asked them to focus on their feelings of love, allowing these feelings to expand in their hearts, and to mentally send these thoughts, through their hands, to their mother. I asked them to imagine these thoughts were a powerful energy, healing and comforting. We gathered around their mother’s bed, carefully finding a place for our hands. Such beautiful energy poured out of her children. Later, now motivated and engaged, they talked about their bedside experience and wanted to repeat it. I showed them how to send their healing love from the waiting room when visitation wasn’t possible. Returning to work after several days off, I was surprised to see Mrs. L’s family. They excitedly told me their mother was getting better and they had sent her their loving energy again and again. They felt they had contributed to her recovery. This experience strengthened my belief in creatively preparing an area in Intensive Care that invites family participation and addresses their unique needs.

Sandra M. Jones, RN, BSN, CCRN
Seven Lakes, N.C.
First Health of the Carolinas
The death of a patient is far-reaching. Nurses and many others work together to provide a healing environment for the patient and family. In the past, when a patient died nursing care ended. The family went home to deal with their grief as best they could. The staff dealt with the loss by focusing on the next patient. At NTI 2001, a Bereavement Program was presented to help families and staff who had their hearts invested in these patients. Before leaving NTI, a co-worker and I spoke about going forward with the program in our units. We decided to make a bereavement book and sympathy cards for families. I found bereavement bags for personal items, and bereavement charms would be sent on the anniversary of the death. We asked the chaplain, Behavioral Services and Hospice staff for input. Our Marketing Department representative helped with design and production, and the unit secretary and Materials Management assisted us as well. When the program was unveiled, we invited all nursing staff to a Bereavement Reception where two family members of previous patients offered their opinions on the program. Staff then received packets to take back to their units to begin their own programs. After that meeting, the motivated staff of four units decided to begin a program right away. The Foundation Board agreed to fund the Bereavement Program for two years. Through this collaboration, we now have nine units providing bereavement care.

Coronary Care Unit
Washington, D.C.
Washington Hospital Center
What began as a regular day for Mr. L. came to a crashing halt when he suddenly collapsed at home. His quick-thinking 17-year-old son performed CPR while waiting for paramedics to arrive. Mr. L. was rushed to the Washington Hospital Center, where the medical team had to move quickly to save the patient’s heart muscle and prevent neurological damage. The team of nurses in the CCU, together with our attending physician and clinical specialist, raced to save Mr. L.’s life. We provided an innovative treatment modality called Hypothermia for Cardiac Arrest. This technique decreases body temperature, which reduces the possibility of further neurological damage. During this critical period, Mr. L.’s family was advised of the seriousness of the situation as well as the plan of care. At these times, the family can be traumatized, so we sat with them and answered all their questions to help alleviate their stress. In emergency situations, family members often feel guilty or second-guess their actions. In this particular case, the patient’s son was blaming himself for his father’s condition; he felt that he caused his father’s cardiac arrest. The nurses in the CCU were sensitive to this situation, and each time the son visited, we praised him for the quick thinking that saved his father’s life. Our nursing team applied their clinical expertise to give Mr. L. and his family hope in a time of uncertainty. Today, the only lingering sign of Mr. L.’s brush with death is some mild amnesia; he has resumed his career and maintains an active lifestyle.

Datascope Excellence in Nurse-Physician Collaboration Award
Editor’s note: 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. Recipients of the award are:

Brandee A. Fetherman, RN, BSN, CCRN
Rockaway, N.J.
Morristown Memorial Hospital of the Atlantic Health System
At MMH, we are schooled in the application of a project management strategy known as Crew Resource Management (CRM), which uses the key concepts of team building, planning, execution and learning. This strategy, originally employed by the aviation industry, is a philosophy of communication and teamwork along important junctures of a project where problems are most likely to obstruct progress. I formed a team of physicians and began planning the development of standardized admission order sets for a 22-bed medical/surgical/trauma unit. The vision of the team was to have every ICU attending physician utilize our standardized order sets when admitting a patient. We focused on the goals of increased collaboration, better communication and care planning between the nursing and physician staffs. This included development of a culture of safety for the patients to minimize the risk of complications. Our mission was to include in the order set protocols for DVT and GI prophylaxis, sedation and pain, and the control of hyperglycemia. Standardized order sets would also eliminate handwriting legibility issues. We targeted the medical and trauma populations for our first trial. By September 2004, I began collecting data about patient outcomes using the new standardized order sets. Positive outcomes included a decrease in mortality of 5% in the medical and trauma populations. The incidence of DVT and stress ulcers also decreased, and the mean length of stay was reduced by 0.73 days. My personal reward is the positive change in the outcome measures identified and the gratitude of the house staff residents.

Kirsten R. Pyle, RN, CCRN
Irvine, Calif.
Hoag Memorial Hospital Presbyterian
In 2002, Hoag combined the Intensivist program with the Cerner Project IMPACT database, which was to be launched by one of our critical care charge nurses. Kirsten developed a program to follow protocol implementation and outcomes with ad hoc queries, control charts and statistical analysis. Collaboration between Kirsten and the medical director ensured facilitation of high-functioning, professional multidisciplinary work. We targeted disease management, process changes and the development of a nursing-focused approach to care, including daily multidisciplinary rounding, utilization of a “daily goals checklist,” VTE and stress ulcer prophylaxis, implementation of the “Surviving Sepsis Campaign,” an improved critical care triage system, evidence-based infection control initiatives, glycemic control, P & P’s written for patient safety and an electronic medical alert for non-critical care patients developing sepsis. We have now achieved 100% compliance with multidisciplinary rounding, utilizing the daily goals sheet. Reductions in rates of VAP, CLBSI and Foley Associated UTI’s have been notable. Critical Care LOS reduction, percent of patients admitted with ICU level of treatment and mortality rates in sepsis have improved appreciably. Progress was also measured in comfort care death percentages and survival to discharge for patients who had successful CPR showing better than the comparison. Reductions in re-intubation rates, premature extubation rates and hypoglycemia related to the intensive IV insulin drip were noted. Most important, the overall APACHE 11 standardized mortality ratio has improved to 0.82 from 1.14 in CCU and 1.62 in ICU. Combining nursing and physician departments that believe in teamwork has led to many achievements and transformed our critical care units. The results have been sustained over a two-year period.

Hypothermic Coma Team
Evansville, Ind.
Deaconess Hospital
In May 2003, a team of critical care nurses from the Cardiovascular Intensive Care Unit and Dr. David Harris, a pulmonologist, embarked on a mission to develop a Hypothermic Coma Protocol to be utilized on all post-cardiac arrest (ventricular fibrillation or ventricular tachycardia) patients exhibiting signs of neurologic insult. Two articles published in the February 2002 issue of the New England Journal of Medicine contributed to the development of this evidence-based practice. The nurse-physician team rallied to educate the emergency medical service first responders in the Tri-State area, the Emergency Department at Deaconess Hospital, the other intensive care nursing units and the responding team of cardiologists. As of February 2004, 13 patients had been evaluated according to the protocol, and three patients did not meet the criteria for induced hypothermia. In all, 10 patients met the inclusion criteria for using the protocol; nine survived and had complete neurologic recovery. This nurse-physician-led collaborative team has spoken locally and nationally regarding the Hypothermic Coma Protocol. Their partnership also resulted in a case study presentation being published in the February 2005 issue of the American Journal of Nursing. Nurse-physician teamwork has changed the standard of care for the post-cardiac arrest patient in our region to an evidence-based practice protocol with demonstrated positive neurologic outcomes. Similarly, the project has strengthened the working relationships between nurses and physicians, enhanced the trust and respect for nursing knowledge, improved the practice environment for nurses and laid the groundwork for ongoing collaboration.

Datascope Excellence in Multidisciplinary Team Collaboration Award
Editor’s note: 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. Recipients of the award are:

Medical Intensive Care Team
Kalamazoo, Mich.
Bronson Methodist Hospital
Our 14-bed Medical Intensive Care Unit (MICU) multidisciplinary team includes the staff RNs, intensivists, nurse manager, clinical nurse specialist and administrator, along with Pharmacy, Dietary, Respiratory Therapy and Infection Control personnel. Daily rounding allows all team members to offer input for advancing patient care. This collaborative team also facilitates the implementation of evidence-based practice bundles (VAP, CR-BSI, Severe Sepsis/Septic Shock) to improve outcomes. The team used creative techniques to implement these bundles, with the assistance of the staff RN champions who provided the education. VAP prevention included an evidence-based protocol as well as a cake decorated with figures representing key protocol components. To ensure compliance with CR-BSI prevention requirements, a checklist was placed on our line cart as a reference and tracking tool. A video starring multidisciplinary team members was professionally produced to increase awareness of early sepsis management. In addition, a sepsis clinical pathway utilizing the Surviving Sepsis Campaign guidelines was developed to encourage efficient delivery of evidence-based care. A Daily Goals Sheet, completed during team rounds, focuses on patient issues and develops plans to discharge the patient from the MICU. Annual admissions rose by 160 patients with an additional 13.3 patients admitted monthly. Length of stay fell by 0.9 day/month, average ventilator days fell by 0.89 and VAPs declined to 1.6/1000 device days. CR-BSIs have been all but eradicated at a rate of 0.15/1000 line days. Through utilization of the sepsis video and pathway, compliance with each guideline rose 20%-30%, and there was a decrease in mortality of 11%. Staff satisfaction was at an all-time high of 98% with a turnover rate that fell from more than 10% to about 2%.

Stroke Multidisciplinary Team
Tallahassee, Fla.
Tallahassee Memorial HealthCare
Tallahassee Memorial Hospital was recently approved by The Joint Commission as a “Designated Stroke Center.” Although the application process began about a year ago, the foundation for developing protocols and staff has been in place for some time. This foundation was based on our Stroke Team and especially our CNS, with a collaborative protocol developed by a passionate physician-champion. Our Stroke Team includes a dedicated stroke nurse from the VNICU and the floor, a physical therapist, occupational therapist, speech-language pathologist, clinical dietician, case manager, social worker, pharmacist, service line administrator, organization improvement advisor, music therapist and student interns. The use of evidence-based guidelines and ongoing staff in-services allowed the latest research to be incorporated into treatment conversations and therapeutic applications. The tradition of a block nursing assignment did not serve the needs of our stroke population. I, as the nurse manager, agreed with our physician that stroke patients needed a consistent nurse. Stroke nurse assignments are based on diagnosis and not location. Since we began the application process, the Stroke Team has developed scripts and standardized questions for its daily team rounds to help focus on key clinical and curative issues. Since implementing our team approach to stroke, the average length of stay has dropped one full day. Our daily multidisciplinary emphasis on collaboration versus competition and on conversation versus confrontation has not only improved patient outcomes but has led to a camaraderie previously unknown. This group of clinicians in individual “silos of care” has been transformed into a highly motivated team of stroke experts … a true circle of excellence.

CICU Outcome Facilitation Team
Milwaukee, Wis.
St. Luke’s Medical Center
The Outcome Facilitation Team (OFT) process in our unit creates a multidisciplinary environment to identify and meet patient needs. We strive to reduce length of stay, clarify priorities of care, identify risk factors and eliminate barriers to health and well-being. Each patient is reviewed daily by a multidisciplinary team directed by nursing and incorporating input from social services, nutrition services, speech therapy, physical therapy, occupational therapy, pharmacy services, utilization management, respiratory therapy, chaplaincy and physicians. Through this collaboration, infection control concerns and unit needs are highlighted and resolved. Evidence-based practice is supported and reviewed frequently. The OFT process has been invaluable for stress ulcer prophylaxis, pressure ulcer prevention, promotion of advance directives, DVT prophylaxis and development of standard protocols for patient care. By having all disciplines at the table, we create comprehensive and individualized patient care objectives. These objectives can then be realized quickly and efficiently to provide quality care and minimize cost. Long-term patients with complex medical needs typically have multiple medical consults as well as rehabilitation, social and spiritual needs. The OFT process supports the medical needs of the patient by involving the E-ICU doctor and nurse. The E-ICU is an off-site interactive team who reviews patient vitals, labs, assessment data and orders to improve outcomes. The E-ICU doctor and nurse are present via teleconference during OFT rounds to provide a unique perspective, which promotes interdisciplinary partnership and fosters healthy relationships among staff. We reduced our ventilator-associated pneumonia and central line infection rates to zero and continue to maintain high patient satisfaction scores.

Dale Medical Products Excellent Clinical Nurse Specialist Award

Editor’s note: Sponsored by Dale Medical Products, this award recognizes CCNS-certified clinical nurse specialists in acute and critical care. Following are excerpts from exemplars submitted in connection with this award for 2006:

Mae Centeno, MS, RN, CCRN, APRN, BC
Plano, Texas
Baylor University Medical Center
Based on her clinical knowledge and experience, Mae knows that patients do better when they evaluate their weight on a daily basis. Through her educational efforts, patients know to call Mae if they experience fluctuations in their weight. Given this information, Mae has intervened early to avoid emergency visits and hospitalizations for many of these patients. Mae and another nurse assessed that while hospital discharge teaching was good, identification of barriers to treatment compliance was often not addressed. They discovered that patients will often say they will weigh themselves daily, but will not tell the nurse they do not have a scale nor can they afford one. Mae wrote a grant proposal to our foundation to fund scales for these patients. The grant was funded and scale distribution began. Data show readmission rates for these patients have been cut by almost 50%, which has resulted in financial savings for the medical center and improved care compliance and quality of life. Mae’s practice as a clinical nurse specialist has established a critical link between actions and outcomes. Additionally, she has worked to create safe passage for patients along the healthcare continuum. While the magnitude of her efforts may transcend her patients’ full understanding, they know “Miss Mae,” as they affectionately call her, is a trusted and reliable source. Through her expertise, leadership and diligence, this nurse-managed clinic has achieved impressive outcomes and developed a reputation as a center of excellence. Mae is truly living her optimal contribution to patients and families and transforming their care.

Dea Mahanes, RN, MSN, CCRN, CCNS, CNRN
Charlottesville, Va.
University of Virginia Hospital
As I walked in, I was amazed to see 15-year-old “James” playing computer games. That may not sound unusual for a teenager cooped up in the hospital, but for this teenager it was incredible. James had suffered a severe traumatic brain injury (TBI) in a snowboarding accident just 10 days earlier. James required a craniectomy for clot evacuation and cerebral edema soon after arrival at the hospital, and was one of our first patients to receive a brain tissue oxygen (PbtO2) monitor. As a Neurocritical Care CNS, I advocated for this technology, arranged education and provided evidence-based algorithms to guide treatment decisions. James experienced a decrease in PbtO2 soon after surgery. Led by the ICU nurses, the team followed the algorithms and instituted aggressive treatment to keep his PbtO2 levels above the critical threshold even as his ICP rose. A CT revealed clot re-accumulation, and James returned to the OR. He continued to receive aggressive, evidence-based management post-operatively. As part of our efforts to improve neurological care for TBI patients, PbtO2 monitoring has served as the impetus for nursing education and empowerment, treatment protocols and collaboration among team members. Nurses have become powerful advocates for improved TBI care. Patient outcomes are rewarding, as is seeing nurses discover their “bold voice” and the impact they have on patient care. My goal is that all our TBI patients benefit from the same organized, collaborative, evidence-based care that James received. My efforts exemplify my role as a CNS, but much work remains. If I become frustrated, I remember James and realize I’ve already made a difference.

Louise Thompson-Zielke, RN, MSN, CCM, CCRN, CCNS, APRN, ANP-C
Charlotte, N.C.
Gaston Memorial Hospital
An RN is one who engages in critical thinking to save a patient’s life. I know that clinical and practical knowledge/experience has to substantiate what that credential signifies. I believe in certification. I was the first RN certified in ACLS when I began practicing over 20 years ago. If you do not pass the first time (which I did not on the CCNS exam), try again. Not passing does not mean you do not “know your stuff.” Not trying again means you’ll never know if you “could have.” I helped facilitate optimal outcomes for a pregnant 21-year-old (with her first child) who had a ruptured gallbladder requiring an emergency caesarean section and cholecystectomy. She was in SIRS/ARDS within 24 hours requiring vasopressors, after adequate fluid resuscitation. Her P/F ratio was 78 on 100% FiO2. I collaborated with OB/pharmacy/infectious disease/surgery to evaluate for Xigris administration and to have a PA catheter inserted to help guide DO/VO evaluation. She received PRBC’s to maintain hemoglobin, inotropes to improve cardiac output and early enteral feedings. Even with this aggressive management, we were unable to wean her from FiO2. We implemented a proning protocol I developed. We proned her every four hours, and her oxygenation improved remarkably. Her husband brought the baby in every day and laid him on her chest. Even though heavily sedated, she became less tachycardic and her oxygen saturation increased. With exceptional nursing care, a mother’s will to survive and a higher power, she was transferred to a rehabilitation facility six weeks later. She does not remember her stay in ICU, but we know she is our “miracle.”

July 15 Deadline to Submit Awards Nominations


Spotlight the art and science of acute and critical care nursing by nominating yourself or a colleague for an AACN Circle of Excellence Award for 2008. The nomination deadline is July 15, 2007.

For more information, check the Circle of Excellence Awards Guide (www.aacn.org>Awards, Grants & Scholarships).

Sign on to the International Year of the Nurse Resolution


Please join your colleagues worldwide in the “Nightingale Declaration for Our Healthy World” by helping to promote a United Nations Resolution to designate 2010 the “International Year of the Nurse,” as well as 2010-20 the “UN Decade for a Healthy World.” AACN is among the sponsors of this endeavor.

The declaration is being circulated and signed by millions of nurses, healthcare professionals, educators and other caregivers around the world. To participate, go to www.nightingaledeclaration.net and sign the document online.

The worldwide commitment by nurses, midwives, other health workers and concerned citizens is designed to build a grassroots-to-global foundation of support for the UN Resolutions and an “Action Plan” to implement them locally, nationally and internationally.

In addition to AACN, initial sponsors include the American Nurses Association, Sigma Theta Tau International, Johns Hopkins University School of Nursing, University of Minnesota School of Nursing, Decision Critical, Inc. and Nurse-Theorist Dr. Jean Watson.

Eli Lilly and Company Excellent Preceptor Award

Editor’s note: Sponsored by Eli Lilly & Company, the Eli Lilly and Company Excellent Preceptor Award recognizes preceptors who demonstrate the key components of the preceptor role, including teacher, clinical role model, consultant and friend/advocate. Following are excerpts from the exemplars submitted in connection with this award for 2006.

Catherine S. Lawrence, RN, MSN, CCRN
Fayetteville, N.C.
Cape Fear Valley Health System
By establishing an environment of honesty and respect for co-workers, as well as patients and families, Cathy exemplifies what it means to be a nurse and a preceptor. Upon arrival in the surgical ICU after surgery for injuries sustained in a car accident, Paul, a 15-year-old, was unresponsive, on a ventilator and had an intracranial pressure catheter. His CT scan showed multiple areas of contusions and hemorrhages in the brain, with swelling.

Cathy gave Paul’s family and friends the courage and hope they needed during this difficult time. She would frequently call the family to update them and explain the care he was receiving. Cathy assured them they could call or visit any time. She encouraged them to talk to Paul about school and home and to bring in pictures and other items, so his hospital room would feel more like home.

After more than a week, Paul was brought up from the pentobarbital coma, and to everyone’s surprise, he was alert and oriented. When his family came to see him that morning, he was sitting at his bedside. Carol, the new nurse, had never worked with such a seriously injured patient, but Cathy’s patience, compassion and ability to explain complex procedures helped her learn. Paul and his family have returned many times since his stay in the SICU, and he always seeks out Cathy to thank her. To us, Paul was a “miracle,” and to him and his family, Cathy was his “Guardian Angel.”

Darla J. Melander, RN, ADN, CCRN
Minneapolis, Minn.
University of Minnesota Medical Center, Fairview
I’ve been a critical care nurse for 27 years and a preceptor for most of my career. I want to pass along my body of knowledge and skills to help newer nurses understand what critical care nurses can accomplish.

I like to ask preceptees how they learn best. It’s important to observe them to discover if they understand the rationale behind the skills. Coaching needs to be adjusted to accommodate each preceptee. Sometimes a weakness can hide the strengths within.

After spending a few weeks in orientation, Kathy was assigned to me for evaluation. She seemed to be overwhelmed and couldn’t remember instructions long enough to progress to the next step. Other preceptors said, “She just doesn’t get it.” She seemed intimidated by experienced nurses and physicians.

After two days, we had a frank discussion. I was open with my concerns about her fearfulness and that she needed to grasp and remember the information given to build on it and progress in the medical ICU. I explored her knowledge base by questioning her understanding of patient conditions and found she had strong assessment and intervention skills. I encouraged her to “jump in” for her patients, doing what she knew to be right, to advocate for them and to discuss patient care with all members of the collaborative team. Kathy received my recommendations and has proven to be efficient and thorough as well as capable.

Pamela E. Trench, RN, BSN
Southwick, Mass.
Baystate Medical Center
Our clinical nurse specialist and clinical educator asked me if I would be interested in orienting a new graduate in the unit's pilot program for new graduates. Did I want to take on this responsibility? What if I failed in helping this new nurse make it through orientation? How was I going to accomplish this?

After much soul searching and wondering if I wanted to accept the challenge, I realized I had been a new graduate when I started working in the ICU, having worked only 10 months as an RN. Remembering my journey as a new nurse, I decided I wanted to help this new nurse succeed.

Because this was a pilot program, there was no manual to follow. It was up to me to determine what would work. I realized that to make this a success, I needed to continually remember what it was like for me when I was a new nurse and a new critical care nurse.

This Month’s Featured AACN Products


The Clinical Practice of Neurological and Neurosurgical Nursing, 5th Ed. (#128637)
This edition of the award-winning classic prepares its users for delivering expert care in a most challenging nursing specialty. It addresses neuro anatomy, assessment, diagnostic evaluation and management of the complete range of neurological disorders for which nurses provide patient care, including trauma, stroke, tumors, seizures, headache, aneurysms, infections and degenerative disorders, and features new chapters on neurological critical care and peripheral neuropathies. This edition has been thoroughly revised to reflect evidence-based practice standards of care. It includes separate pathophysiology sections in each chapter; new resource guides, such as Internet sites and professional and patient information sources; key points summaries; and nursing research features.
Regular Price
Member $78.70; Nonmember $82.95
Super Saver Price
Member $69.50; Nonmember $73.50

Spinal Cord Anatomy and Common Pathology (#301513)
This DVD offers a comprehensive review of the normal structures and pathways of the spine, spinal cord and supporting coverings. Potential pathologies and disease entities will also be identified as each area is examined.
Regular Price
Member $28.95; Nonmember $29.95
Super Saver Price
Member $25.25; Nonmember $27

Correlative Neuro Anatomy and Brain Dissection (#301512)
This two-hour, full-color DVD program allows you to study neuro anatomy and brain dissection at your own pace. The content includes discussion and exploration of the skull; meninges; spaces between the coverings; the blood supply and drainage; the lobes of the cortex; basal ganglia and diencephalon; thalamus and hypothalamus; brain stem and cranial nerves; and the cerebellum. Potential problems such as common vascular anomalies and traumatic injuries are also presented. Clinical examples are provided to help create a frame of reference for the material and to enhance patient assessment skills. The DVD format provides detailed graphics and the ability to pause, bookmark or quit the program.
Regular Price
Member $28.45; Nonmember $29.95
Super Saver Price
Member $25.25; Nonmember $27

Browse our selection of new products at www.aacn.org/bookstorespecial > New Products

Coming Soon...

AACN’s Biannual Strategic Customer Research Study

AACN will soon be conducting our regular survey to better understand how satisfied you are with the initiatives we are undertaking and how we can better meet your needs.

When you receive the e-mail invitation to participate, please help us better serve the nursing community by completing this survey. It should take no more than 15 minutes of your time. Thank you in advance for your participation.

Do You ReceiveCritical Care Newsline?


Each week, AACN’s Critical Care Newsline delivers updates on the latest news and important information via e-mail.

If you are not receiving Critical Care Newsline, 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.

Is Your Unit a Beacon of Excellence?


The AACN Beacon Award for Critical Care Excellence shines national recognition on units that attain high standards for quality, exceptional care of patients, and healthy, humane and healing work environments. The award is also available for progressive care units.
The Web-based application process asks you to evaluate your critical care unit in six areas:
• Recruitment and retention
• Education, training and mentoring
• Evidence-based practices
• Patient outcomes
• Healing environments
• Leadership and organizational ethics
Applications, which may be submitted at any time, are evaluated on a quarterly basis. Awards are granted twice a year. The application fee is $1,000 per unit.
For more information, visit the AACN Web site at www.aacn.org.
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