National Association of Clinical Nurse Specialist News President’S Message Carol Manchester, MSN, RN, ACNS, BC-ADM, CDE

Clinical Nurse SpecialistA Copyright B 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins DOI: 10.1097/01.NUR.0000443072.05277.7a News National Association of Clinical Nurse Specialists

National Association of Clinical Nurse Specialist News President’s Message Carol Manchester, MSN, RN, ACNS, BC-ADM, CDE

his is my last address as President of the National As- Our association and our members continue to be chal- Tsociation of Clinical Nurse Specialists (NACNS). It has lenged by competitive demands, market pressures, and been an honor and privilege to serve you this year. I sin- insufficient demonstration and evidence of productivity cerely thank you for this opportunity, for your support and outcomes specific to CNS practice. This year NACNS and constructive criticism, and for your commitment to will focus significant efforts on our membership for growth nursing, to advanced practice and the role of the clinical and sustainability. The strategic plan outlines goals and nurse specialist (CNS), and to this organization. I wish to tactics that will drive the work of the organization over acknowledge the Board of Directors who worked tirelessly the next 5 years. The board is aware of the choices each on your behalf including Les Rodriguez, Peggy Barksdale, of you must make professionally, and it is our hope that Rachel Moody, Tanya Williams, Anne Muller, Cecelia Gray, you continue to recognize the importance and value of Ann Hysong, Ginger Pierson, Gayle Timmerman, Fiona belonging to the one organization that fully supports your Winterbottom, and Jan Fulton. Melinda Mercer-Ray, exec- professional role. Intentional work will be done to pro- utive director, and Jason Harbonic, managing director, are mote the unique value the CNS brings to interprofessional exceptional individuals who have contributed in countless teams and healthcare delivery. The work of the Cost and waystotheprogressandsuccessesNACNShasmade. Outcomes Task Force is one effort to assist all CNSs to As I reflect on this past year, the one constant has been measure, analyze, and evaluate their work. We have called change. The nature of the healthcare landscape is evolv- upon our faculty and schools to enhance curriculum, pro- ing with the enactment of the Affordable Care Act, insurance viding a foundation for the CNS to be prepared for program exchanges, medical homes, and accountable care organi- development and creating a business case. zations. Despite of the months of planning and prepara- Recognition of success and accomplishment is impor- tion that took place prior to 2014, implementation has tant, and at our annual meeting, we collectively celebrated been less than optimal. Yet, it is clear healthcare reform our award winners. I am pleased to report that we have had was and is needed. As the government, organizations, pro- a record year of individuals stepping forward to volunteer viders, and clients go forward with resolve to optimize pro- for committees, task forces, affiliates, and leadership posi- grams and the safety and quality of care delivered, the fear tions. This trend is encouraging and confirms NACNS is of the unknown consequences and unforeseen changes acting on issues that are important to our members. Efforts that will occur is palpable. For the CNS, there is significant to incorporate diverse backgrounds, experiences, and spe- opportunity to lead and guide. However, this can be chal- cialties within our working groups have been made and lenging and uncomfortable. The role of the CNS will con- will continue. Collaborations with other organizations have tinue to evolve over the next few years in ways we cannot expanded this year, and new partnerships are being ex- imagine now. It is essential for each of us to actively posi- plored. One such effort will be charged to the Research tion ourselves to define the scope of our practice and guide Committee to seek opportunities for NACNS to engage and the future. energize our membership in the work of PCORI (Patient- Centered Outcomes Research Institute). There may be other The author reports no conflicts of interest. professional nursing organizations NACNS can partner with

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in comparative clinical effectiveness research. KAR Associ- ing nurses and focuses primarily on their personal lives, ates has represented us extremely well on the Hill, and PR rather than their work as nurses. Solutions had increased the public’s awareness of NACNS. The National Association of Clinical Nurse Specialists These things are just a sampling of the positive steps made (NACNS) called on MTV to cancel the show on the grounds this past year. that it is demeaning to nurses and detrimental to efforts Change, challenges, celebrations was the theme for this to address the nursing shortage. Several other nursing past year. I thank you for accompanying me on this jour- associations, including National Nurses United, American ney. The annual report of NACNS and the presentation I Nurses Association, Canadian Nurses Association, and gave at the annual meeting can be found on the NACNS Change.org, have also urged the network to chancel Website.IfyouwereunabletobeinOrlandowithus,please the show, pointing out that its portrayal of nurses is offen- take the time to review what has been done, see our award sive and may harm efforts to encourage young people to winners and volunteers, and view the strategic plan for the enter the profession. next 5 years. It is my hope that you will be pleased. In a letter addressed to MTV President Stephen Fried- man, NACNS President Carol Manchester wrote: AFFILIATE OF THE YEAR 2013 As an organization representing nurses, we at the Congratulations to the California Association of Clinical National Association of Clinical Nurse Specialists Nurse Specialist as the affiliate of the year. The California are deeply disappointed in MTV’s decision to air the Association of Clinical Nurse Specialists (CACNS) started in reality television show ‘‘Scrubbing In.’’ This program the late 1980s, formerly as the Southern California CNS Net- portrays nurses in a disrespectful and unfair light work when a group of clinical nurse specialists (CNSs) work- for purely salacious purposes. We urge you in the ing at Kaiser Permanente in Fontana, California, banded strongest possible terms to cancel it. together to share expertise. Over the past 33 years, the As the largest group of healthcare professionals, CACNS has grown from a handful of members to 192, and nurses are central to providing and improving our we have changed our name to reflect participation by all nation’s healthcare. As you must be aware, the interested CNSs in the entire state of California and to be United States is facing a shortage of nurses, and there more in synch with the NACNS. Our organization has fluc- are efforts underway across the country to encourage tuated some with the economic times and continues to young people to enter nursing and increase grow significantly in numbers and scope from the small be- enrollment in nursing schools. A television program ginnings. Efforts are credited to a membership body with that intentionally reinforces negative and antiquated vast expertise and also to a board of officers and directors stereotypes about nurses and that shows them in the who coordinate all activities. worst possible light does nothing to support those A large and multitalented group has created an energy efforts, and, in fact, serves to do the opposite. that has seen them through significant growth as they strive At a time when our nation needs nurses more than to keep members abreast of the legislative and political ever, this program is denigrating and demeaning changes affecting the role of the CNS locally, regionally, the members of what has been shown time and again and nationally. One major goal was to strengthen their ties to be one of the most trusted professions in the with the National Association of Clinical Nurse Specialists, United States. ‘‘Scrubbing In’’ does a serious and they proudly state that 51% of their members are also disservice to nurses, nursing students, our healthcare members of NACNS. In addition, several members currently system, and our nation as a whole. hold positions within NACNS or actively participate in the APRN (advanced practice registered nurse) Coalition and NACNS 2014 Conference, The Best Kept SecretVThe the California Action Coalition, illustrating their continued Clinical Nurse Specialist Contribution to Quality Care, commitment to national organizational efforts. It has always March 6 to 8, 2014 been their philosophy that there is power in numbers. They It is time to consider your plans to attend the NACNS 214 all value the significant impact the role of the CNS plays in Conference. The conference offers the opportunity for you a variety of clinical and academic settings and how the mar- to network with your colleagues as well as enjoy the sunny riage of the NACNS and CACNS organizations will help us resort environment of the Orlando World Center Marriott continue to see this to fruition. and of course the many activities in Orlando. Conference registration and lodging information will be available soon. The National Association of Clinical Nurse Specialists Room rates at the Orlando World Center Marriott will be Encourages Cancellation of MTV Show ‘‘Scrubbing In’’ available for $189 per night for single or double rooms. For On October 24, MTV began airing a new reality show about specific questions about registration or hotel accommoda- nurses that has caused uproar in the nursing community. tions, please contact the NACNS office at 215-320-3881 or The show, ‘‘Scrubbing In,’’ features a cast of young travel- [email protected].

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Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. NACNS Comments on Veteran’s Health crete steps must be taken to help stem the tide of abuse, Administration Nursing Handbook 1180.03 misuse, and diversion of all opioid products, but the FDA In September, NACNS sent a letter to the Department of recommendation that calls for the wholesale up-scheduling Veteran’s Affairs Secretary Eric Shinseki to comment on of hydrocodone-combination products is a blunt and impre- the Veterans Health Administration (VHA) updating of the cise tool that will in the end prove to do more harm than VHA Nursing Handbook 1180.03. The VHA is a leader in good. In our letter, we asked Secretary Sebelius to reject healthcare delivery and is moving to more fully utilize the the FDA recommendation and engage in discussions with APRN including the CNS. This draft of the VHA Nursing the full prescribing community to come up with reasonable Handbook recognizes APRNs, including CNSs, as licensed strategies to find a more targeted and less harmful approach independent practitioners. In our comments, we reinforced to combatting opioid diversion, abuse, and misuse across unique and advanced level competencies that the CNS pos- America. sesses that can meet the increased needs of improving quality and reducing costs in our healthcare system. We spoke to NEWS FROM OUR AFFILIATES the CNS as leaders of change in health organizations, devel- California Association of Clinical Nurse Specialist opers of evidence-based programs to prevent avoidable com- 2013 Members Achievements plications, coaches of those with chronic diseases to prevent California Association of Clinical Nurse Specialist (CACNS) hospital readmissions, and facilitators of teams in acute care held their annual conference, ‘‘Changing Healthcare One and other facilities to improve the quality and safety of care, CNS at a Time,’’ on October 26th at Northbay HealthCare, including preventing hospital-acquired infections and reduc- Fairfield, California. ing length of stays. In addition, we noted that there are grow- Terri Ares, PhD, RNC-NIC, CNS-BC, presented ‘‘The ing numbers of CNSs providing Medicare Part B services to Professional Socialization of Students in Clinical Nurse beneficiaries and have prescriptive privileges in most states. Specialist Programs’’ at the 18th Joint Southern California NACNS also highlighted the need for the VHA to con- Chapters of Sigma Theta Tau InternationalVNursing Odys- sider some modifications that would allow the CNS section sey Conference 2013 in San Diego, California. of the VHA Nursing Handbook to be more closely aligned Pam Bellefeuille, MN, RN, ACNS-BC, CEN, Clinical Pro- with the state implementation of the APRN Consensus fessor, UCSF, has 2 abstracts/posters accepted to the 14th Model. We specifically identified the challenge that certain International Meeting on Simulation in Healthcare Confer- CNS groups face with the lack of population certification ence January 25 to 29, 2014: ‘‘The Art of Science: Unfolding examinations in their specific area of practice. Case Study Simulation Based on a Theatre Approach’’ NACNS will continue to monitor the progress of the VHA’s (Pam Bellefeuille, Dan McGuire, and Wes Cayabyab) and Nursing Handbook 1180.03. ‘‘Emotional Impact of Active versus Observational Roles During Simulation Learning’’ (Pam Bellefeuille, Sandrijn NACNS Joins Numerous Healthcare Organizations van Schaik, and Amanda Sanders). Expressing Concern Over FDA’s Promotion of Kelli Jackson, MSN, RN, CNS, CCRN, is presenting her Up-Scheduling of Hydrocodone Products poster, ‘‘Do We Respect Patient’s Wishes at End of Life?’’ The diversion, misuse, and abuse of opioids have reached at the January Society of Critical Care Medicine conference unacceptable levels in certain parts of the United States and in San Francisco, California. in an effort to reduce this problem, the US Food and Drug Ann M. Mayo, DNSc, RN, FAAN, in November 2013, was Administration (FDA) has sent a letter to the Department featured as keynote speaker at the annual San Diego of Health and Human Services asking for efforts to re- Evidence-Based Practice Institute & Consortium for Nurs- classify hydrocodone-combination drugs as Schedule II ing Excellence. The title of her presentation was ‘‘The Road controlled substances. Because of the impact this move Forward: Sustaining Nursing Evidence-Based Practice.’’ would have on access to care and the ability of many non- Patti Radovich, PhD, RN, CNS, FCCM, in November 2013 physician providers to prescribe pain relief medications had an oral presentation at the American Public Health As- for their patients, NACNS and these organizations in de- sociation Annual Meeting in Boston on ‘‘Risk Perception claring this action would ‘‘I irrefutably have serious Related to Communicable Disease Among International health consequences for patients.’’ Overall, reclassifica- College Students.’’ She has also been asked to be a member tion would severely limit patient access to effective pain of the NACNS Task Force on Alarm Fatigue. treatment and would, in some cases, completely eliminate Elizabeth Scruth, PhD, MPH, RN, CCNS, CCRN, will be the ability of some types of providers to deliver treatment to inducted as a fellow into the College of Critical Care Med- their patients when they need care and during a critical time icine in January at the Society of Critical Care Medicine in the healing process. conference in San Francisco. In addition, she has the fol- Of course, it is important to underscore that NACNS, and lowing publication, ‘‘Post Intensive Care Syndrome,’’ in these partner organizations, wholeheartedly agree that con- the December/January issue of the Clinical Nurse Specialist

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and accepted for publication ‘‘Transformation of Quality in Ann Busch, liver transplant program CNS at the Portland Kaiser Permanente Northern California,’’ by Adams C, O’Brien, (Oregon) VA Medical Center, presented ‘‘Liver Failure Is and Scruth E. More Than Alphabet Soup,’’ at the Annual Conference of Diane Solic N, RN, ACNS-BC, CPAN, CAPA, has become the Greater Portland Area Chapter of the Academy of board certified and secured a position at Sharp Memorial Medical-Surgical Nurses on October 28, 2013. Hospital as CNS of Acute Care Surgical. Kathleen Dunn, spinal cord injury CNS at the VA San Ann Rocha, MSN, PhD(c), RN, CNS-BC, a member of the Diego Healthcare System, recently completed her men- NACNS Conference Steering Committee as well as the Ed- torship of a staff nurse in the 9-month San Diego Evidence- ucation Committee, wants to alert members to the annual Based Practice Institute. She and her fellow (mentee), conference coming up on March 6 to 8, 2014, in Orlando, Anna Cunningham, BSN, RN, presented a poster and plat- Florida. The Education Committee will be hosting a precon- form presentation at the Institute graduation and sixth ference on ‘‘Optimizing Educational Partnerships Between annual San Diego EBPI conference, titled ‘‘Oral Care Schools of Nursing, Clinical Agencies, and Preceptors.’’ and Hospital-Acquired Pneumonia in SCI Patients’’ in Submitted by Diane Barkas, MSN, RN, ACNS-BC, CCRN November, 2013. Donna Fritz, oncology CNS at the Denver (Colorado) VA The Oklahoma Association of Clinical Nurse Specialist Medical Center, was selected as an item writer for the On- The seventh Annual OACNS (Oklahoma Association of Clin- cology Nursing Society for their new online chemotherapy/ ical Nurse Specialists) Pharmacology Conference will be held biotherapy course. She attended item writer training in April 10 to 12, 2014, at INTEGRIS Baptist Medical Center in October in Pittsburgh, Pennsylvania, and has submitted Oklahoma City. Nurses completing the entire conference 25 additional questions for the examination to date. will be awarded 12 to 15 Pharmacology Level B continuing Reggie Horwitz, critical care nurse educator at the Durham education hours. All advanced practice nurses are welcome. (North Carolina) VA Medical Center completed her Adult- For additional information, please visit www.oacns.org. Gerontology Clinical Nurse Specialist Post-Master’s Certifi- cate Program at the University of Detroit Mercy’s McAuley Veterans Affairs (VA) Virtual Affiliate School of Nursing in December, 2013. 2013 Members Achievements Submitted by Kathleen L. Dunn, MS, RN, CRRN, CNS-BC Beverly Bell (staff development CNS) and Elizabeth Reid (wound CNS) were members of a research team at the Birmingham (Alabama) VA Medical Center, which re- MEMBERS NEWS ceived 1 of 10 national VHA Office of Nursing Services CALL FOR NEWS ITEMS Innovation Awards for 2013. The project, entitled ‘‘Reduc- If you have information you want to share about your- ing Incontinence Associated Dermatitis (IAD) Using the self, your NACNS peers, or your affiliate/affiliate peers, VA-TAMMCS Improvement Model,’’ has resulted in the please send the news item to Tanya D. Williams at tanya reduction of their acquired IAD rate in the MICU to zero. [email protected].

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