AACN News—March 2007—Association News

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Vol. 24, No. 3, MARCH 2007

Healthy Work Environments Take Center Stage at NTI 2007

The upcoming National Teaching Institute & Critical Care Exposition in Atlanta, Ga., May 19 through 24 offers an array of sessions inspiring nurses to take active roles in the improvement of their work environments. One of the unique ways this content will be delivered at NTI 2007 is through an innovative, interactive, three-hour mastery session featuring the play “Bedside Manners” written by actress/playwright Lisa Hayes and journalist Suzanne Gordon. This play illustrates the complex relationships and tensions between doctors and nurses that impact delivery of quality patient care and nurse retention and recruitment. Gordon and Hayes began collaborating on the project in 2003, after Gordon saw Hayes’ one-woman show “Nurse!” off-Broadway. “Bedside Manners,” with stark dramatic scenes punctuated by occasional comic relief, has been featured at the New York Academy of Medicine and Cedars-Sinai Hospital in Los Angeles. Its message clearly links to AACN’s ongoing efforts promoting healthy work environments. In the Mastery Session, Hayes, Gordon and AACN past president Connie Barden will lead group exercises and discussions. You won’t want to miss this session, or any of the other educational offerings at this year’s NTI.

AACN’s healthy work environments initiative was developed with the belief that all workplaces can be healthy if nurses and employers desire to address not only the physical environment, but also the less tangible barriers to staff and patient safety. This cannot happen without an understanding of the factors contributing to unhealthy work environments and a commitment to embrace solutions. The ingredients for success: skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition and authentic leadership are described in the AACN Standards for Establishing and Sustaining Healthy Work Environments.

Visit www.aacn.org/hwe to download this important document and learn more about this initiative.

New Interactive Healthy Work Environments Web Site Offers Enhanced Resources

The AACN Healthy Work Environments Web site has been enhanced to provide visitors a richer, more interactive experience. This new site is an important next step in AACN’s efforts to promote the AACN Standards for Establishing and Sustaining Healthy Work Environments and respond to growing interest in implementing the standards.

AACN believes that establishing and sustaining healthy work environments must be a priority if nurses are going to make their optimal contributions in caring for patients and patients’ families, because the link between healthy work environments and patient safety, nurse retention and recruitment, and the bottom line, is irrefutable. The Standards set out the ingredients for success—skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition and authentic leadership.

Content on the upgraded Healthy Work Environments Web site will be updated and refreshed regularly as new resources become available. From speakers and consultants well versed in the Standards to best practices and a discussion forum where issues and ideas can be shared, the resources are designed to further assist caregivers and their employers in implementing the standards.

Explore the resources at www.aacn.org/hwe.

Member-Get-A-Member Campaign Starts the New Year Right

In the first month of 2007, Susan Rogers, RN, DNS, MSN of Vienna, Va. held onto her overall lead of 64 new members recruited in the current campaign. And still in second place with 60 new members recruited in January was Ann Brorsen, RN, MSN, CCRN, CEN, of Sun City, Calif. Holding at third place was Diana Lane, RN, MSN of Hermitage, Tenn. with 49.

Other notable performance for January were: Judy Davidson, RN, CNS, DSNc, CCRN, FCCM, of San Diego, Calif. with 18 new members recruited; Kim Lucas, RN, ADN, BA, of Atlanta, Ga. with 16; Maria Podmore, RN, BSN, CEN, of Eastlake, Ohio with 15; and Debra Bradshaw, RN, MS, MSN, CNAA, FACHE, with 12. Kathleen Richuso, RN, MSN of Chapel Hill, N.C. checked in with eight new members recruited for the month; she’s now in fourth place overall with 39.

In chapter recruiting, the Greater Richmond Area Chapter added three new members to retain the overall lead with 78, while the Southeastern Pennsylvania Chapter added 14 new members, climbing to second place overall with 65. The Houston Gulf Coast Chapter also had a solid month, adding 11 new members for a third place overall total of 63.

These are among the 1,041 individuals and chapters that have recruited 4,241 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 into the drawing.

When individuals recruit new members, they are entered into a drawing for a $100 American Express gift check each month they recruit. Rowena Sneathern, RN, BSN, CCRN, of Sugarland, Texas won the gift certificate in January.

After recruiting their first five new members, participants will 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 January was the First Coast Chapter.

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

Voting: A Time to Let Your Voice Be Heard

By Linda G. Martinez, RN, MSN, APRN-BC, CMC
AACN Nominating Committee

With voting now open in the annual election for the AACN Board of Directors, I am reminded of the significance of taking part in this important privilege. It’s one that some too often may take for granted.

For example, I happened to be vacationing with my family in Puerto Vallarta, Mexico, when their national presidential election was going on. I was struck by the hundreds of people waiting in sweltering heat in long lines for their turn to vote.

It was an impressive example of democracy in action, and my husband and I took the opportunity to make the typical parental speech about the importance of taking the time to exercise one’s right to vote. In the Mexico election, the two top candidates were separated by less than 1% of the vote. It was a reminder of 2000, when the outcome of our own
presidential election hung on the voting results from just one state.

Now, it’s time to choose the new AACN president-elect, three new AACN board members and three members of the AACN Nominating Committee who will help select candidates for a future election. As a member of the AACN Nominating Committee, I can cite many reasons for you to take advantage of this opportunity. I can urge you to vote because committee members spent many hours reviewing applications and interview transcripts to select the candidates we believed would best serve the association at this time. Or, I can point out that each candidate spent many hours completing their application and preparing for their interviews. I can ask you to vote because the candidates are all willing to donate their time to the betterment of AACN and acute and critical care nursing.

We have a choice, and our votes count. And, voting is easy. For your voice to be heard, you can simply go online to cast your vote in the comfort of your own home or office. No long lines, no sweltering heat.

You can read about the candidates and their positions in this issue of AACN News (pages 11 through 14). Information is also available online.

Why Is There Only One Candidate for President-elect?

By M. Dave Hanson, RN, MSN, CCRN, CNS,
AACN President-Elect

Each year around election time, AACN members ask why there is only one candidate on the ballot for president-elect compared to the choice of candidates put forth for other leadership positions in the association. To answer this question, it is first important to know that there is a different process for selecting the president-elect candidate than the one used to select candidates for the AACN board of directors and nominating committee. Although procedures for evaluating nominee qualifications are similar in both processes, they differ in goals and guiding philosophies.

For board and nominating committee positions, a committee of appointed and elected members has independent responsibility to evaluate and select qualified candidates for the AACN ballot. Because AACN has a very diverse membership, the goal of this committee is to provide a choice of qualified candidates so members like you can vote for candidates who you believe best represent your interests.

On the other hand, the responsibility for evaluating and selecting a president-elect candidate lies with the AACN Board of Directors. AACN is a large, complex organization, and the board is obligated and in the best position to judge a candidate’s ability to effectively lead the association as president. Only one candidate is unanimously chosen because the board cannot effectively govern when leadership loyalties are divided. A highly collaborative, synchronous governing board is essential to the future success of the organization; it allows the association to work strategically toward achieving its mission and optimally serving members and constituents.

As an AACN member, you can be assured that the nominating committee and the board of directors follow similar high integrity processes. Each candidate presented to you on the annual ballot is highly qualified and capable of leading the association, continuing to foster our long history of strong leadership and significant progress.

Scene and Heard

Our Voice in the Media
Journal for Healthcare Quality (November/December 2006) – “Guest Editorial: Designing Healthy Work Environments With Intention” was written by Dorrie Fontaine, RN, DNSc, FAAN, former AACN president. In part, she concluded, “Health professionals yearn for the environment portrayed by the AACN standards. I am convinced that their yearning will trigger the emergence of authentic leaders to guide the way. As a result, evidence linking patient safety, nurse retention and a healthy work environment will continue to grow.”

Nursing Management (November 2006) – “Respect and Workplace Options Help Retain Aging Nurses.” Linda Bell, RN, MSN, AACN clinical practice specialist, wrote this article on retention. She noted, “Younger nurses will respect their aging colleagues if the nurse leaders of their facility hold them in high esteem. The steps facilities take to retain older nurses will have ongoing benefits to patients, the workplace and nursing’s future.”

Chest (November 2006) – “Changing the Work Environment in ICUs to Achieve Patient-Focused Care” was the title of an in-depth clinical commentary written by Kathleen McCauley, RN, BC, PhD, former AACN president, and Richard S. Irwin, MD, FCCP, former ACCP president. The writers stated that, “AACN’s Standards for Establishing and Sustaining Healthy Work Environments and the American College of Chest Physicians (ACCP) Patient-Focused Care Project are complementary initiatives that provide a road map for creating practice environments where interdisciplinary patient-focused care can thrive.”

Treasure Coast Newspapers (Nov. 11, 2006) – “Indian River County Thumbs Up, Thumbs Down” noted that the Critical Care Unit at Indian River Medical Center, Vero Beach, Fla., received AACN’s Beacon Award. “Our critical care unit has joined a very elite group, Barb Horne, the hospital’s vice president and CNO, told her staff in a memorandum.”

Nursing Management eNews (Nov. 15, 2006) – “Critical Care Nurses Stay in Field, Despite Abuse” was the lead story and included a link to the full article titled “New Survey Finds 87% of Critical Care Registered Nurses Committed to Staying in Field Despite Serious Challenges.” The AACN/Nursing Spectrum/Bernard Hodes survey of more than 4,000 critical care RNs was conducted to determine the health of critical care work environments and nurses’ satisfaction with their careers.

Arizona State University News (Oct. 25, 2006) – “HRSA Awards $1.3 Million Grant for Nurse Retention and Patient Care to ASU College of Nursing & Healthcare Innovation.” “In addition to creating a new ‘Center for Professional and Clinical Excellence’ based on AACN’s Synergy Model, nurse practice and patient outcomes will be enhanced through a variety of activities.”

NurseWeek (Nov. 15, 2006) – “Leading Critical Care Societies Partner to Advance Standards That Promote Patient Safety and Staff Retention.” The article noted that “three leading critical care societies today announced a cooperative effort to promote healthy work environments that foster safe, quality care. The American College of Chest Physicians (ACCP), American Thoracic Society (ATS), Society of Critical Care Medicine (SCCM) and Society of Hospital Medicine (SHM) have all joined AACN in embracing the AACN Standards for Establishing and Sustaining Healthy Work Environments as essential in overcoming circumstances and conditions that, among other things, contribute to medical errors and put patients at risk.”

Nursing Spectrum Specialty Edition (Nov. 1, 2006) – “Be Critically Prepared When Disaster Strikes.” Teresa Wavra, RN, MSN, CNS, AACN clinical practice specialist, was quoted as saying, “One of the guiding factors in working one’s way through uncharted waters is asking, ‘How can we do this in the safest way within our scope of practice?’ It’s important to anticipate and to learn from what has occurred in the past.”

Seattle Post-Intelligencer (Nov. 6, 2006) – “Atrium’s Chest Drain CE Program Now Exclusively Online.” “This self-study activity, approved by AACN and administered by Atrium free of charge, is designed to provide registered nurses with information about chest drainage.”

Journal for Nurses in Staff Development (November/December 2006) – “A Synergy Model of Nursing Education” was the title of an article about the history and use of the Synergy Model. “In 1995, AACN Certification Corporation undertook a comprehensive and systematic study of critical care nursing practice using the synergy model as the conceptual basis or framework. The model was originally developed to link certified critical care nursing practice to patients’ outcomes.”

Women’s Health Matters (Fall 2006) – “Norwalk Hospital Critical Care Nursing Team Receives National Beacon Award” included a quote from Mary Nolan, RN, vice president of Norwalk’s patient care services and nursing. She said, “This is a significant and very prestigious award. Our critical care nurses are true role models for the profession of nursing.”

Cardiac Insider (Fall 2006) – “Cardiac Monitoring: New Trends and Capabilities.” The article referenced AACN’s practice alerts on dysrhythmia monitoring and ST segment monitoring .

Our Voice at the Table

Mary Fran Tracy, RN, PhD, CCRN, CCNS, FAAN, AACN board president, President-elect Dave Hanson, RN, MSN, CCRN, CNS, and CEO Wanda Johanson, RN, MN, represented AACN at the Nursing Organizations Alliance (NOA) meeting in Memphis, Tenn. The NOA is a coalition of approximately 70 nursing organizations whose mission is to increase nursing's visibility and impact through communication, collaboration and advocacy.



Tracy, Hanson and Johanson represented AACN at the American Nurses Association (ANA) Organizational Affiliate meeting in Memphis, Tenn. Currently, there are approximately 16 national nursing organizations that make up the ANA Organizational Affiliate forum. As an organizational affiliate, AACN is actively involved at various tables to influence approaches to the challenges facing the nursing profession. At this meeting, AACN formally asked other members to endorse the AACN Standards for Establishing and Sustaining Healthy Work Environments.


Maria Shirey, RN, MS, MBA, CNAA, BC, FACHE, AACN Certification Corporation board member, presented a concurrent session titled “Authentic Leaders Creating & Sustaining Healthy Work Environments for Nursing Practice” at the 6th International Conference: Healthy Workplaces in Action 2006, sponsored by the Registered Nurses’ Association of Ontario (RNAO), in Toronto, Canada.


Nancy Blake, RN, MN, CRN, CNAA, and Lori Hendrickx, RN, EdD, CCRN, former AACN board members, represented AACN at the T.I.G.E.R. (Technology Informatics Guiding Educational Reform) Summit in Bethesda, Md. The meeting was convened to identify best practices related to information/knowledge management and to determine effective technology capabilities for nurses.


Julie Miller, RN, BSN, CCRN, AACN board member, presented “Creating a Healthy Work Environment” at an Education Retreat sponsored by Trinity Mother Frances Health System in Tyler, Texas.

Miller presented a one-day Critical Care Workshop in Modesto, Calif. on 12-Lead ECG Interpretation; Unraveling Oxygenation Principles; Titrating Vasoactive Medications; and Amazing Case Studies.

Miller presented a one-day Pulmonary Workshop in Modesto, Calif. on Wheezes, Pops and Whistles; First-Glance Assessment: Nursing Actions for Patient Safety; Pulmonary Lab Values; Ventilator Care: Beyond SIMV; and Ventilator Case Studies.


Miller spoke at an AACN Region 15 Collaborative Meeting in Dallas, Texas. Her topic was “Creating a Healthy Work Environment.” She also co-presented an AACN Update with Hanson. John Dixon, RN, MSN, former AACN board member, spoke about the AACN Synergy Model.




Mary Holtschneider, RN, BSN, MPA, former AACN board member, Jan Teal, RN-BC, MSN, CCRN, chapter adviser for Region 5 (N.C./S.C.), Beth Martin, RN, MSN, CCNS, CNRN, former AACN Certification Corporation board member, and Debby Greenlaw, RN, MS, CCRN, NP-C, AACN Certification Corporation board member, presented an AACN national update at the 4th annual Down by the Boardwalk conference, presented by the Coastal Chapter and held in Myrtle Beach, S.C. They discussed healthy work environments, certification news, the Beacon Award, NTI and practice alerts. Teal also updated attendees on events in the region.

Circle of Excellence Awards Applaud Those Who Make a Difference

Spotlight the art and science of acute and critical care nursing by nominating yourself or a colleague for an AACN Circle of Excellence Award.

The nominating process opens March 15, with nominations due July 15, 2007.

All recipients are presented a plaque, announced in AACN News and on the AACN Web site and honored at the National Teaching Institute & Critical Care Exposition.TM Most also receive honorariums and complimentary NTI registration. For specifics, check the Circle of Excellence Awards Guide (www.aacn.org > Awards, Grants & Scholarships.)

Following are brief descriptions of the award criteria:
These awards recognize local and regional leadership that furthers AACN’s mission and vision and represents the contributions of individuals and groups.

Leadership Awards

Excellent Nurse Manager Award
Recognizes nurse managers who demonstrate excellence in coordination of available resources to efficiently and effectively care for acutely or critically ill patients and their families. Successful applicants will address how they promote the following: an environment of professional involvement, development and accountability, collaborative problem solving, empowerment, leadership to transform thinking, structures and processes to address opportunities and challenges, communication, and how they serve as a catalyst for successful change.

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 or advocate. Successful applicants will address how they demonstrate the following: the utilization of positive teaching strategies, effective communication skills, creating a positive practice setting, sensitivity to the learning needs of preceptees, clinical competence, effective feedback and problem-solving skills.

Mentoring Award
Recognizes individuals or patient care unit staff who develop and enhance another’s intellectual and technical skills, acculturating them to the professional community and modeling a way of life and professional achievement. Nominators will address how their mentor served in the mentoring role by providing for upward career mobility; boosting self-esteem; sharing a dream; giving vision; providing advice, counsel and support; introducing corporate and organizational structure; teaching by example; imparting valuable information and giving feedback on progress.

Excellence in Leadership Award
Recognizes nurses who demonstrate the key leadership competencies of empowerment, effective communication, continuous learning and the effective management of change. Successful applicants will address how they demonstrate lifelong learning strategies; encourage risk taking; see change as a process and not an end; identify ways to support and enhance others’ strengths; demonstrate creativity in problem analysis and generation of solutions; demonstrate congruence in words and actions; challenge traditional assumptions and rules; and champion the perspective of the consumer.

Elsevier Excellence in Education Award
Recognizes nurse educators who facilitate the acquisition and advancement of the knowledge and skills required for competent practice and positive patient outcomes in the care of acutely and critically ill patients and their families. Successful applicants will address how they promote critical thinking, consider individual learner needs, create a learning environment and positively affect a learner or group of learners.

Community Service Award
Recognizes significant service by acute and critical care nurses, either individuals or groups, who make a contribution to their community. Successful applicants describe a service that demonstrates responsiveness to their community’s concerns and issues. The awarded community service projects a positive image of critical care nursing.

Media Award
Recognizes print, broadcast and Web-based media excellence in the portrayal of healthcare providers, especially acute and critical care nurses, contributing to a healthcare system driven by the needs of patients and their families. Successful entries will present relevant nursing and healthcare topics to large audiences of consumers – the general public, patients and families. Accuracy, realism and technical qualities are important factors in the selection of entries.

AACN Certification Corporation – Value of
Certification Award
Recognizes contributions that support and foster the advancement of certified nursing practice in critical care. Successful applicants will show how they have accomplished some or all of the following: increased the number of certified nurses; increased the renewal and retention of certified nurses; influenced the preparation or ability of nurses to qualify for certification; increased public awareness and promotion of the value of certified nursing practice; and contributed to research validating the impact of certified nursing practice. Applications will be evaluated for innovation; scope of impact in relation to the nominee’s sphere of influence; quality of work; and rate and/or indicators of success.

Datascope Excellence in Collaboration Awards
Honor innovative contributions to collaborative practice by nurses caring for acutely and critically ill patients and their families. Successful applicants will show how they have accomplished some or all of the following:
• Contributed to optimal patient outcomes
• Advanced the use of nursing knowledge and expertise to influence patient care decisions
• Implemented innovative evidence-based strategies for patient care
• Cultivated an environment of respect for the unique contribution of each healthcare team member
• Increased family participation in patient care and decisions
• Developed shared governance practices and policies
• Improved communication and conflict management
• Improved team satisfaction
• Increased nurse recruitment and retention
• Increased patient satisfaction
• Impacted organizational success
Applicants may apply in the following collaboration categories:
• Nurse-Physician Collaboration Award
• Nurse-Administration Collaboration Award
• Nurse-Family Collaboration Award
• Multidisciplinary Team Collaboration Award

Excellence in specific roles and focus areas within nursing is recognized by these awards that honor local and regional impact along with those who reach beyond.

Practice & Research Awards

Baxter Excellence in Patient Safety Award
Recognizes patient-care teams that have made significant contributions toward patient and caregiver safety in acute and critical care. Recipients will describe innovative approaches used to develop new and revised processes that encompass safety and improve the quality of care at the unit hospital or health system level. They will show clear evidence of active collaboration among team members validating their success by presenting evidence-based outcomes of their safety initiatives.

Excellence in Caring Practices Award—
In Honor of John Wilson Rodgers
Recognizes nurses whose caring practices embody AACN’s vision of creating a healthcare system driven by the needs of patients and their families. Successful applicants empower patients and their families by addressing the following: helping patients or families understand and cope with illness; offering avenues or possibilities of understanding, increasing control and acceptance of a difficult experience; or demonstrating vigilance, persistence and commitment to the patient and family’s life or well-being. Successful applicants also make the patient’s problem approachable and manageable through the patient’s own ability to face and cope with the problem. These applicants will demonstrate how they have encompassed the AACN values and ethic of care in their work.
Note: This award was established in 1984 in the name of Marguerite Rodgers Kinney’s late father, John Wilson Rodgers. It was the care of the nurses during Rodgers’ illness and at the end of his life that inspired Kinney, a former AACN president, to recognize the artistry of nursing as well as honor her father’s memory.

3M Health Care Excellence in Clinical Practice Award
Recognizes acute and critical care nurses who embody, exemplify and excel at the clinical skills and principles that are required in their practice. Successful applicants will address how they have successfully integrated the following into their practice: standards of care, patient advocacy, holistic care, collaboration and coordination of care, leadership, inquiry and critical thinking, values and ethics.

Excellence in Clinical Practice—
Non-traditional Setting
Designed to recognize excellence in the care of acutely and critically ill patients that takes place in environments outside the traditional ICU/CCU setting. Successful applicants will demonstrate that their patients were acutely or critically ill and address how they have successfully integrated the following into their practice: standards of care, patient advocacy, holistic care, collaboration and coordination of care, leadership, inquiry and critical thinking, ethics and values. Eligible applicants include, but are not limited to, home healthcare nurses, progressive care nurses, telemetry nurses, catheter lab and emergency nurses.

Dale Medical Products Excellent Clinical Nurse Specialist Award
Recognizes acute and critical care nurses who function as clinical nurse specialists. Successful applicants will demonstrate the key components of advanced practice nursing including: leadership, advanced practice clinical skills, research application, evidence-based practice, outcome-focused practice, cost containment, quality assurance, mentoring, problem solving and communication with patients, families, staff and systems. Additionally, they will illustrate how they have served as a catalyst for successful change.

Excellent Nurse Practitioner Award
Recognizes acute and critical care nurses who function as nurse practitioners. Successful applicants will demonstrate the key components of advanced practice nursing including: leadership, advanced practice clinical skills, research application, evidence-based practice, outcome-focused practice, cost containment, quality assurance, mentoring, problem solving and communication with patients, families, staff and systems. Additionally, they will illustrate how they have served as a catalyst for successful change.

Excellent Nursing Student Award
Recognizes nursing students whose activities during nursing school have promoted the value of nursing and reflect the AACN vision of creating a healthcare system driven by the needs of patients and their families where critical care nurses make their optimal contribution. Successful applicants will show how their leadership has transformed thinking, structures and/or processes to address opportunities and challenges as well as how they collaborated with key stakeholders to create synergistic relationships to promote common interests and shared values.

Excellence in Research Award
Recognizes nurse researchers or nurse-led collaborative research teams that are furthering the mission, vision, values and research priorities of AACN in the acute and/or critical care setting. Successful applicants will describe the research project(s), original or replicated, the outcome of the project(s) on patients and families, and/or the change in practice that occurred as a result of the project(s).

AACN, SCCM and AIA ICU Design Award
The ICU Design Award for adult and pediatric ICUs is cosponsored by AACN, Society of Critical Care Medicine and American Insitute of Architects. The award was conceived to identify and recognize a critical care unit already in operation whose design demonstrates attention to both functional and humanitarian issues. With a focus on planning and design characteristics rather than process or administrative features, recipients demonstrate: a commitment to creating a healing environment, a commitment to promoting safety and security, a commitment to efficiency and attention to innovative, unique aesthetic and creative design features

To obtain an application, contact Carol Prendergast at the Society of Critical Care Medicine at (847) 827-6826; eprendergast@sccm.org.


Dear Fellow AACN Members:
Voting is now open in AACN’s annual election for the Board of Directors and Nominating Committee. We encourage each of you to make your voice heard by casting your ballot in this important process.
Voting is a fundamental membership benefit that allows you to help choose the future leaders of your professional organization. As nursing leaders within AACN, we don’t need to tell you the importance of a strong leadership for AACN.
These are the individuals who will be responsible for setting the strategic direction of the organization. They will speak on your behalf in a wide range of settings to ensure the voice of acute and critical care nurses is strong and influential. They will proudly promote AACN as the gold standard in acute and critical care.
Today, we ask you—our most committed AACN colleagues—to exercise your leadership by evaluating the candidates and using your voice to vote in the election. Your vote will make a difference.
Please take the time to review the candidate information presented here. Additional candidate information can be accessed directly from the online ballot.

Mary Fran Tracy
AACN President

Debbie Brinker
AACN Nominating Committee

Meet the Candidates


Candidate for President-Elect

Caryl Goodyear-Bruch, RN, PhD
Critical Care Clinical Nurse Specialist and
Clinical Assistant Professor
University of Kansas Hospital and the
University of Kansas Medical Center
Kansas City, KS

Experience and Activities
• Member since 1981
• AACN Certification Corporation Board of Directors, 2005-06
• AACN Board of Directors, 2003-06
• AACN Board Community Liaison, 2002
• Chair, Education Work Group, 2001-02

Greater Kansas City Chapter
• CEU Coordinator, 2005
• Co-Chair, Education Committee, 2003
• Co-Chair Elect, Education Committee, 2002

• Member, Housing Grant Selection Committee, City of Independence, Missouri, 2006
• Paul Harris Fellow, Rotary Club, City of Independence, Missouri, East, 2004
• Member of the KUMC Graduate Council, 2005-present
• Member of the Doctorate of Nursing Practice Task Force, 2005-present
• Nurse Anesthesia Education, student progression and retention and curriculum committees, 2001-present
• Member, City of Independence, Missouri Advisory Board of Health, 2000-present

Issues Statement
Verbal and physical abuse, disrespect from colleagues, lack of effective communication and critical care teams speaking lip service to collaboration are just a few of the symptoms of the devaluation of nursing threatening our sustainability. AACN has embraced the challenge to change this environment with the establishment of relationship-centered standards. Even with great strides in creating better work environments, we continue to suffer these symptoms. The most vital aspect of these issues is the unknown and thus, devaluation of, the nurse-patient relationship. There is a substantial gap between what the public thinks we do and what we really can do with our knowledge and skill set. Even other healthcare professionals lack value of the nurse’s impact on patient care outcomes. True collaboration among critical care professionals will only occur with acknowledgement of the unique contributions of nurses and the value of our work.
Our future lies in those willing to disseminate the importance of our knowledge and skills with patients and families and the public, to hold firm our commitment to effective communication, and engage others in true collaboration. AACN leads the way in promoting environments necessary for optimizing contributions, seeking data to support critical care nursing practice, and creating opportunities for nurses to state their contribution. However, we all must create more concerted efforts to promote the recognition of our role in healthcare institutions. AACN and critical care nurses must advocate our value in caring for the critically ill patient by creating opportunities for action. Without recognition of nurses’ contributions, the symptoms of abuse, disrespect, and lack of effective communication will continue to impact patient outcomes and contribute to the nursing shortage. The shortage and other outcomes of unhealthy environments may last until we determine how we will best market our work and its impact on patient outcomes.

Candidates for AACN Board of Directors (Vote for 3)

Judith “Ski” Lower, RN, MSN, CCRN, CNRN
Independent Lecturer
and Consultant
Retired Nurse Manager,
Neuro Critical Care Unit
John Hopkins Hospital
Baltimore, MD

Experience and Activities
• Member since 1977

Chesapeake Bay Chapter
• Lifetime Member and At-Large Member of the Board, 2001-present

• State of Maryland’s Commission on the Crisis in Nursing, 2000-05
• Steering Committee and Vice-Chair of the Public Relations Committee and Critical Care Representative, Maryland Nursing Workplace Commission, present
• Advisory Board for Advance for Nurses and
Nursing2005, 2003-05
• Editorial Advisory Board for the newly created American Nurse Today

Issues Statement
I would love to see AACN address the issue of nurses being unable to meet the needs of the patients (as defined by the standard of care) given the available resources (whether pure numbers or degree of skill/experience). I chose this topic because I believe it is the #1 safety issue, although one that is rarely acknowledged. It can lead to uncivil behavior between doctors, nurses and administrators, and is often the reason nurses make the decision to leave the bedside not only because of safety but because they cannot deliver the kind of care they want to (not just safe, but compassionate care) and they feel powerless to change it. Nurses will give and give and when they have nothing left to give, are tired and frustrated, they leave. As the number of nurses decrease as the demand for service increases and hospitals struggle to meet their financial goals and remain viable, this issue may well become a healthcare crisis. Beds are only closed because there are no nurses. AACN has done much to champion safety, to provide structure for healthy work environments, but more needs to be done. The individual charge nurse on an off shift or weekend must be given the authority and the tools to objectively navigate through this situation while keeping all patients safe, relationships intact, and the financial interests of the institution in mind. These need not be mutually exclusive. But, it will require a change in thinking, a new road map, creative, collaborative consensus building and some determined champions for the patients. I can think of no organization that fits that requirement better than AACN.

Patricia A. McGaffigan, MS, RN
Senior Director, Critical Care Strategy
Aspect Medical Systems, Newton, MA

Experience and Activities
• Member since 1981
• Lifetime Member (Awarded 2001)
• Nominating Committee, Co-Chair, 2001-02

• Society of Critical Care Medicine, Member 1999-present
• Business Ethics Council, 2005-06
• Coalition for Critical Care Excellence, Member 2002-05
• Executive Council, 2004-05

Project Teams
• High Reliability Joint Taskforce with Anesthesia Patient Safety Foundation (Leader)
• Simulation Taskforce (Leader)
• Closed Loop Technology (Member)
• Advisory Panel on Patient Safety, Coalition Liaison, 2004
• Invited Guest, Anesthesia Patient Safety Foundation Clinical Alarms Workshop/Consensus Meeting, 2004

Issues Statement
All men can see these tactics whereby I conquer, but what none can see is the strategy out of which victory is evolved.
—Sun Tzu

As the pacesetter in critical care, AACN must be relevant and responsive to the current needs of members while designing blueprints and building plans for future relevance. AACN must champion excellence and advancement in strategic planning to assure our progressive relevance and undisputed leadership in critical care.
What differentiates adequacy in strategic planning from excellence in strategic planning? The strategic planning process of an undisputed market leader is personified by an unwavering passion for relevance, richness and responsibility.
Undisputed leaders believe in strategic planning, and embody a unique attitude and commitment to the process. They regard strategic planning as the foundation for their organizational direction, and they are explicit in communicating the process to their members. They invite participation and critical review from a wide berth of knowledgeable individuals and teams. In order to outpace their past success and relevance, they encourage insightful anticipation, bold imagination, and proactive innovation.
Undisputed leaders “know” and are authentic to their focus. They have a clear and committed vision that serves as the basis for their existence and grounds their strategic and tactical decisions.
Undisputed leaders develop structures and programs for effective execution and evaluation of the strategic plan. They implement “line of sight” systems to guide individuals and functional teams in amplifying their priorities and aligning their goals, and to ensure consistency and clarity of communication.
AACN believes in the importance of strategic planning. We “know” and are authentic to our focus on patients and families and optimizing contributions of critical care nurses. We have demonstrated excellence in execution and evaluation. Our continued quest for excellence in strategic planning will fortify our association’s potency and transformational relevance.

Mary Bylone, RN, MSN, CCRN
Assistant Vice President, Patient Care Services
The William W. Backus Hospital, Norwich, CT

Experience and Activities
• Member since 1998
• Ambassador since 2003
• Chapter Advisory Team, 2006-08
• Spring AACN Board Liaison, 2006-07
• Board Advisory Team, 2004-06
• Scholarship Review Panel, 2005-06
• Awards Review Panel, 2004-07
Southeastern Pennsylvania Chapter
• Member since 1990
• Immediate Past President, 2005-06
• President, 2004-05
• President-Elect, 2003-04
• Board of Directors, 2002-03
• Served on Financial Oversight, Education, Informatics, TRENDS Sub-Committee, and Research Committees

South Central Connecticut Chapter
• Member since 2006

Southern Shore Chapter
• Member since 2000

• Coach, Board Member, Vice-President, East Vineland Little League, 1997-04

Issues Statement
The publishing of the AACN Standards for Establishing and Sustaining Healthy Work Environments set the stage for every critical care nurse to look closely at their workplace to find evidence of these standards or identify opportunities for improvement. When I read the standards, I realize that a key factor to their success starts with the leadership of the unit. Despite the obvious importance of this key position, nurses are promoted every day into management positions because of their clinical competence alone. Many are left to figure out a management style and some are set up to fail. Why, then, aren’t we paying more attention to this process of selection and development? Why aren’t we insisting that resources be available for the new leader to utilize as they move into their new role? When will we step in and establish standards for “Management Competence”? The work done on the Healthy Work Environment clearly spells out the need to commit to the development of nursing leaders, yet healthcare organizations are not adequately addressing this situation. As I travel around speaking to nurse leaders, I hear consistently of the lack of management development that is available to them. Internal development programs are missing, time away from the job is discouraged and financial reimbursement is minimal. As a professional organization, we need to ensure the opportunity for management growth through mentoring and continued education. At the end of the AACN publication on the healthy work environment, there is a “call to action.” That call is addressed to all of us to “fulfill our obligation … where excellence is the goal.” My goal is to bridge the gap utilizing the resources and credibility of AACN. We cannot have a healthy work environment without excellence in management. Every nurse deserves to work for a competent manager.

Joy M. Speciale, RN, MBA, CCRN
Nurse Manager
Westlake Hospital, Melrose Park, IL

Experience and Activities
• Member since 1987
• Scholarship Review Panel, 2006
• Award Review Panel, 2006
• Chapter Collaboration Circle of Excellence Award Winner, 2006
• Creative Solutions and Research Abstract Reviewer, 2005-06
• Spring Board Community Liaison, 2005
• Spring Board Advisory Team, 2005
• Fall Board Advisory Team, 2005
• Co-Chair, Multi Region Meeting (Region 8, 10 and 13), 2004 and 2005
• Chapter Advisory Team, Region 11, 2004-06
• Chapter Advisory Team, Region 10, 2003-05
• Fall Board Advisory Team, 2004
• Ambassador, 2000-present

Northwest Chicago Area Chapter
• Member since 1987
• Marketing and Health Policy Director, 2006-07
• Past President, 2004-05
• President, 2003-04
• Board Member since 1998
• Midwest Conference Hotel Liaison 2005-07
• Midwest Conference Chair, 2002 and 2005
• Midwest Conference Co-Chair, 2003
• Midwest Special Projects, 2004

Greater Chicago Area Chapter
• Member since 1991
• Board of Directors, 2000-02

Chicago West Suburban Chapter
• Member since 2001

Southside Chicago Chapter
• Member since 2005

• American Association of Heart Failure Nurses (AAHFN) member since 2005
• National Catholic Nurses Association member since 2000
• Illinois Organization Nurse Leaders (IONL) member since 2006

Issues Statement
A major issue affecting not only critical care, but also the entire healthcare industry is the prevalence of medical errors. The Institute of Medicine (IOM) reports in “To Err Is Human: Building a Safer Health System,” as many as 44,000 to 98,000 people die in hospitals each year as the result of medical errors. Patient safety has become first and foremost in the minds of patients, families, healthcare workers, hospital administrators and the general public.
In today’s fast-paced, high-acuity environment, the potential for error is always present. Issues like staffing shortages, longer working hours and higher patient acuity have been associated with an increased risk of medical errors. The IOM report stated, “The key to reducing medical errors is to focus on improving the systems of delivering care and not to blame individuals … research has shown that system improvements can reduce the error rates and improve the quality of health care.”
As critical care nurses, we must take leadership roles in the solution to this growing issue. Because not all errors can be prevented, it is necessary to focus on systems that diminish the risk of failure. We need to create an environment that looks for system breakdowns without continually looking for blame. We need to reduce the consequences of error in the medical setting by continuing to pursue evidence-based practice. Our patients deserve a culture of safety! Our colleagues deserve a culture of safety! AACN will continue to be a leader in education for their members and the public. We must maintain high standards of professional practice excellence to ensure patient health and safety. We must be a leader to maintain a environment that focuses on patient safety, fail-safe systems, and credibility with accountability for our own actions.

John J. Whitcomb, PhD, RN, CCRN
Nurse Scientist
National Naval Medical
Center Portsmouth
Portsmouth, VA

Experience and Activities
• Member since 1995
• Chair, Advanced Practice Nurse Work Group, 2004-05
• Nominating Committee, 2003-04
• Board Advisory Team, 2002-03
• Advanced Practice Advisory Team, 2002-03

Tidewater Chapter
• President, 2006-present

San Diego Chapter
• President, 2004-05
• President-Elect, 2002-04

• Member, Society of Critical Care Medicine
• Member, Sigma Theta Tau Zeta Mu at Large 154 Nursing Honor Society
• Member, Emergency Nurses Association
• Advanced Cardiac Life Support Program Director/Affiliate Faculty
• Trauma Nurse Core Course, Course Director/Instructor
• Fundamental Critical Care Support Instructor
• Presenter, San Diego Critical Care Intern Program

Issues Statement
Nurses are the backbone to the healthcare system and to maintain that position is to keep education and evidence-based practice alive. One key issue affecting critical care nursing today is that of education through support, commitment, critical thinking skills, the ability to lead and have an in-depth understanding of the science of nursing. Providing and facilitating education within critical care nursing is a necessity as we enter a time of short staffing, retiring nurses and new critical care nurses exploring the critical care arena. Education is an extremely important part of a professional career as it demonstrates a commitment to the profession. Critical care nurses use critical analysis and knowledge dissemination on a daily basis with those in our numerous health care settings locally and around the world.
The current climate of the nursing profession is we are facing a nursing shortage, organizations are downsizing or restructuring and nursing schools have waiting lists due to diminishing faculty. So the question is how do we maintain our force and overcome barriers so nurses obtain the critical knowledge that is needed to keep the profession moving forward and meet the needs of our profession.
We accomplish this with champions in all areas of nursing to help facilitate this forward movement. Champion nurses at the bedside, they are critical to this effort of identifying and implementing evidence-based practice. These champions are the ones who question a practice and ask, “Shouldn’t we be being doing this based on the evidence available?” We find this evidence through readings, educational conferences, and advanced education. It is crucial that we continue to question practice utilizing the resources available. Leaders within our organizations need to implement strategies that help facilitate nurses gaining access to the opportunities available that support this commitment.

Linda Bucher, RN, DNSc
Associate Professor
University of Delaware School of Nursing
Newark, DE

Experience and Activities
• Member since 1987
• Faculty Advisory Task Force, 2002-04
• NTI Work Group, 2001-02

Southeastern Pennsylvania Chapter
• Member since 1988
• Research Committee,
• Research Grant Review Subcommittee, 2004-present
• Treasurer, 2002-03
• Treasurer-Elect, 2001-02

• Abstract Reviewer for Sigma Theta Tau International
• Member, Editorial Advisory Board, Nursing2006 Critical Care

Issues Statement
One issue that I believe affects critical care nursing today relates to the overall health of our membership and our society. From its inception, AACN has focused on the needs of acutely ill patients and families. AACN has excelled as a professional specialty organization and offers a plethora of exceptional resources to enable critical care nurses to make their optimal contribution to the care of patients and families. Looking beyond these accomplishments, we see a population that is aging, a nursing shortage that is increasing, and a country’s health that is seriously in danger. Yet a well established national health promotion and disease prevention initiative called Healthy People has existed for over 15 years. The current initiative “challenges individuals, communities, and professionals—indeed, all of us—to take specific steps to ensure that good health, as well as long life, are enjoyed by all” (www.healthypeople.gov). We are a nation blessed with almost unlimited means and choices. Critical care nurses have an established record of being expert at restoring health—it is imperative that we also become expert at promoting health—starting with our own.

As a professional organization, AACN has the resources and ability to become a notable force in the movement to achieve the Healthy People 2010 goals. This could be accomplished by formally identifying health promotion and disease prevention as an AACN initiative. Many of the focus areas that should be of specific interest to critical care nurses include diabetes, cancer, heart disease and stroke, physical activity and fitness, nutrition and obesity, and tobacco use (for starters). By challenging our members to personally embrace and widely promote a healthy lifestyle, AACN is essentially making their optimal contribution to the achievement of our members’ and nation’s health.

Candidates for AACN Nominating Committee (Vote for 3)

Mary K. Jaco, RN, MSN, CNAA
Nursing Director, Inpatient Services
Shriners Hospitals for Children, Galveston, TX

Experience and Activities
• Member since 1991
• Healthy Work Environment Work Group, 2006-07

• Bilingual Advanced Burn Life Support Instructor
• Crucial Conversation Instructor
• American Burn Association, Program Committee

Issues Statement
I believe that having a healthy work environment in which to practice is a priority for critical care nursing today. So many challenges that the critical care nurse faces daily revolve around the work environment. Each nurse wants to provide the best care for the patients; however mistakes do occur when staffing is not adequate, when communication is stifled, when nurses are not part of the decision-making process. If we are not successful at implementing change and creating healthy work environments, I believe nurses will continue to leave the profession at alarming rates. Why not work to ensure that nurses are respected and valued every day by their colleagues, by the physicians, by administration? I believe that the Healthy Work Environment initiative is an important issue for AACN to continue to address because AACN is an exceptional voice for the critical care nurse. AACN gains strength as its members speak out about concerns, as board members travel throughout the nation to listen to nurses and by staying abreast on current issues in health care. AACN should continue to use this strength to voice concerns in the right place to the right people. We want a better place to work, an environment of respect, where we can provide the best care for the patients and their families. AACN can help make that happen.

Kathleen (Kathy) Klein Peavy, RN, MS, CCRN
Critical Care Clinical Nurse Specialist
Southern Regional Medical Center
Riverdale, GA

Experience and Activities
• Member since 1987
• Chapter Advisory Team, Co-Lead, 2006-present
• Awards Review Panel, 2005-06
• Chapter Advisory Team, Lead, 2005-06
• Fall Advisory Board Team,
• Scholarship Review Panel,
• Chapter Advisory Team, Region 6, 2003-05
• Chapter Advisory Team, Co-Lead, Region 11, 2004-05
• Fall Board Advisory Team, 2004-05
• Spring Board Advisory Team, 2004-05
• AACN/CCRN Ambassador 2000-present

Atlanta Area Chapter
• Member since 1999
• Immediate Past President
• Secretary 2003-04
• President, 2002-03
• President-Elect, 2001-02
• Chair, NTI Tee-shirt Committee, 2001-02

• LifeLink of Georgia, Director Advisory Board since 2002; Legislative & Bylaws Committee
• National Association of Clinical Nurse Specialists, member since 1997
• Atlanta Area CNS Group, member since 2004

Issues Statement
One key issue affecting critical care nursing today as well as the entire health care industry is ineffective communication. While Healthy Work Environments address many essential factors, skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition and authentic leadership, without skilled communication we will continue to struggle in our environments and continue to have similar outcomes until we clearly address, practice and encompass the competencies required to be skilled communicators.

Critical care nurses need to be equipped with the knowledge, skills and attitudes to effectively advocate for patients, families and the profession of nursing. We must be able and willing to articulate the issues that impede our ability to be successful. “Work arounds” are no longer acceptable. Silence is not an option. We need to be skilled communicators clearly articulating not only the problems, but offering viable solutions and the willingness to pursue successful resolution.

According to the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Sentinel Event Statistics (March, 2006) root cause analysis consistently cites lapses in communication as the number one reason for sentinel events resulting in unexpected occurrences potentially or actually involving death or serious physical or psychological injury. If we are to live the mission, vision and values of AACN and truly live our contribution, we must embrace communication as a necessary skill, be vigilant in its use and commit to continuous improvement despite the hectic, rapidly ever changing healthcare environment. Skilled communication is essential to the very existence and future of professional nursing practice.

Jan Powers, PhD(c), RN, MSN, CCRN, CCNS, CNRN, CWCN
Director of Clinical Nurse
Specialists and Critical Care Clinical Nurse Specialist
St. Vincent Hospital
Indianapolis, IN

Experience and Activities
• Member since 1991
• AACN Research Work Group,
• Scholarship Review Panel, 2005
• Advanced Practice Work Group, 2002-03

Central Indiana Chapter
• President-Elect, 2006

• National Association of Clinical Nurse Specialists
—Research Committee, 2006
—Nominating Committee, 2004-06
—Central Indiana Affiliate Chair, 2002-06
• Society of Critical Care Medicine
—ICU Design Task Force, 2005-present
—Chair, Task Force for Nursing Workforce Issues, 2002-03
• Editorial Board, Nursing Made Incredibly Easy, 2003-present
• Adjunct Faculty, Purdue University School of Nursing, 2001-present
• Adjunct Faculty, Indiana University School of Nursing, 1999-present

Issues Statement
The AACN initiatives for creating a healthy work environment along with ensuring evidence-based practice and promoting certification resonate very strongly with me personally. I think these initiatives will allow empowerment of nurses and improve professional judgment and decision-making skills. Unfortunately, I am reminded too often of situations where nurses are relegated to a role of simply following doctors’ orders and not valued for their important assessment and decision-making skills. One example involves the proposed regulations about limiting medication range orders. Although aimed at patient safety, I am concerned that this will stifle the professional decision making of nursing. I have been in discussions about limiting range orders, and my response is that “nurses are licensed professionals trained in assessment skills and should be allowed to make clinical judgments as to what is the best treatment for the patient.” Especially true for the critical care nurse, involved in complex decision making daily, the extreme of these regulations may be a “slippery slope” resulting in nurses unable to titrate drips without specific orders, ultimately to the detriment of patient care. Everyone knows that patients react differently depending on their current environment and psychological or emotionally well-being; the nurse who spends the most time with the patient should be the one to make the skilled assessment necessary for these decisions. Limiting range orders for medications will limit nursing judgment. In order to assure patient safety, I think it is more important to provide mentoring at the bedside to assure appropriate decision-making skills are present. We also need to encourage and empower nurses to collaborate more effectively with other disciplines at the bedside, for it is at the bedside that nurses make their most significant contributions to patient care and we need to provide the support needed for this to occur.

Teri Lynn Kiss, RN, MSSW, CCRN, CFRN
Assistant Professor
University of Alaska Anchorage-Fairbanks Outreach Site
Fairbanks, AK

Experience and Activities
• Member since 1988
• NTI Work Group, 2005-06
• Spring AACN Board Community Liaison, 2000
• Board Advisory Team, 2002-03
• Recipient, Excellence in Leadership Award, 2004

Fairbanks North Star Chapter
• Newsletter Editor, 2002-06
• President, 1998-03

• Alaska Nurses Association Statewide Nursing Education Conference
—Program Chair, 2003-04
—Member, 2001-02
• Founder and Executive Director, Critical C.A.R.E., Inc., 2001-04

Issues Statement
Mr. B., a multi-trauma victim, was admitted to ICU post-operatively with multiple drips, drain tubes and on the ventilator. The CCRN assigned to him implemented a plan of care incorporating VAP-avoidance guidelines, DVT prophylaxis and effective pain management.

Such is the power of evidence-based practice!
The AACN vision promotes EBP: using the best information available applied to an individual client situation to achieve the highest attainable outcome. AACN consistently provides resources to enhance evidence availability and supports nursing research. Why, then, do some practitioners maintain long-held patterns of behavior and fail to incorporate best practices in the clinical environment?

I believe by eradicating barriers to EBP implementation, AACN can continue to lead the parade of excellence. Identified barriers include: lack of knowledgeable mentors, lack of education about the research process, lack of knowledge regarding research article critiques, and feeling overwhelmed by the process. Active educational efforts have been shown to be more effective in changing practice than passive dissemination of information.

My proposal is to establish an Evidence Based Practice Institute as part of NTI. Teaching the steps of EBP integrated with clinical practice scenarios would effect changes in attitudes, skills and behaviors. The EBP Institute would be participant-driven through ‘real world’ cases brought for active learning. Follow-up and support for the participants could be provided by an AACN EBP Mentoring Bureau. This outreach effort would solidify the skills learned at the “institute.”

My rationale for the proposal stems from the support EBP lends to the art of clinical interpretation, insight and judgment. Using good evidence reduces clinical uncertainty and allows optimal contributions to result in optimal outcomes.

Mr. B. survived his hospitalization, developed no complications and was discharged with an almost normal level of functioning.

Such is the power of evidence-based practice!

Pamela J. Bolton, RN, MS, ACNP, CCNS, CCRN, PCCN
Critical Care Nurse Practitioner/Clinical Nurse Specialist
Good Samaritan Hospital, Cincinnati, OH

Experience and Activities
• Member since 1987
• Chapter Advisory Team, 2006-present
• Awards & Scholarships Review Panel, 2005-06
• Board Advisory Team, 2003-04
• Advanced Practice Advisory Committee, July 2002-03
• Editorial Board Member, AACN Advanced Critical Care, 2001-present

Greater Cincinnati Chapter
• President, 2005-06
• President-Elect, 2004-05
• Treasurer, 2000-04
• Research Chair, 2000-04

• ICU Design Citation Award Committee, Society of Critical Care Medicine, 2005-present
• Secretary, Tri-State Assembly of Advanced Practice Nurses, 2004-06
• Secretary, Sigma Theta Tau International Honor Society of Nursing, Beta Iota Chapter, 2003-05

Issues Statement
I believe that AACN should examine the universal bed concept as this could significantly affect the delivery of nursing care in the ICU environment. The universal bed concept involves utilizing the same bed and environment throughout a patient’s hospital stay, requiring that the nurses provide the level of care required at each given phase of recovery. This is a viable option for a homogenous patient population. For example, in the cardiac population this model is effective as the care is more definitive, these patients have shorter lengths of stay, and the majority of the population follows a pattern of care. However, in the heterogenous patient population (i.e., multi-traumatized, complex abdominal surgical patient, medical patient with multiple chronic medical conditions), the course of care is often complicated by unexpected events leading to unpredictable lengths of stay and a less definitive pattern of care. It has been the view of my colleagues that this model does not meet the needs of the heterogenous population. However, this may be the care delivery system that meets the needs of this more complex population as immediate resources are available with changing acuity. The concerns of combining progressive and critical care patients are all staff must be critical care trained, assignments may frequently need to be adjusted based on acuity (i.e., admissions and discharges), and continuity of care is not necessarily guaranteed due to nursing shortages, 12-hour scheduling, and use of prn, travel, and agency nurses. Based on the universal bed concept, higher acuity patients will be intermingled in the environment, which may interfere with the rest and recovery of lower acuity patients. This care delivery concept demands research-based evidence in order to support its use in the critical care environment. Patient and nurse satisfaction must also be examined.

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