2021 General Assembly Handbook
2021 General Assembly
Handbook
Table of Contents General Assembly Business Agenda ...... 2 General Assembly Officials ...... 4 Proposed General Assembly Standing Rules of Procedure ...... 5 Bylaws and Resolution Proposals Proposed Bylaws Amendment Proposals GA21-01: Term Limits for Board Members ...... 8 GA21-02: Institute a Minimum Ter for Filled Vacancies ...... 10 GA21-03: Proposal to Restructure the Nominations and Elections Committee ...... 13
Proposed Resolutions GA21-04: Federal Nurse Practice Act and Licensing in the United States of America ...... 43 GA21-05: CATN (Course in Advanced Trauma Nursing) in the Classroom ...... 51 GA21-06: Emergency Clinical Nurse Specialist National Certification ...... 55 GA21-07: Triage Challenges in Emergency Nursing and Conducting Research ...... 59 GA21-08: Training of the Emergency Care Assistive Personnel in the Emergency Department ...... 64 GA21-09: Increasing Community Resources ...... 66 GA21-10: Identify and Support Ways That Decrease Emergency Department Nurses Taking Work- Related Stress Home ...... 71
Appendices Appendix A – ENA General Assembly Reference Guide ...... 78 Appendix B – ENA Strategic Plan ...... 80 Appendix C – ENA and Affiliate Audited Consolidated Financial Statements 2020 ...... 84 Appendix D – 2021 ENA Committee Roster ...... 125
2021 ENA General Assembly
6:00-10:00 am Pacific Time 7:00-11:00 am Mountain Time 8:00 am-12:00 pm Central Time 9:00 am-1:00 pm Eastern Time
2021 General Assembly Business Agenda
TUESDAY, SEPTEMBER 21
8:00-8:15 am ...... General Assembly Call to Order Credentials Report Adoption of General Assembly Standing Rules of Procedure Adoption of Business Agenda 8:15-8:30 am ...... President Address & State of the Association 8:30-9:15 am ...... Open Reference Hearings GA21-01: Proposals to Amend Bylaws: Minimum Term for Filled Vacancies GA21-02: Proposals to Amend Bylaws: Term Limits GA21-03: Proposals to Amend Bylaws: Structure of the Nominations and Elections Committee GA21-04: Federal Nurse Practice Act and Licensing in the United States of America GA21-05: CATN (Course in Advanced Trauma Nursing) in the Classroom 9:15-9:45 am ...... BREAK 9:45-11:30 am ...... Open Reference Hearings GA21-06: Emergency Clinical Nurse Specialist National Certification GA21-07: Triage Challenges in Emergency Nursing and Conducting Research GA21-08: Training of the Emergency Care Assistive Personnel in the Emergency Department GA21-09: Increasing Community Resources GA21-10: Identify and Support Ways that Decrease Emergency Department Nurses taking work-related stress home 12:00 pm ...... Adjournment WEDNESDAY, SEPTEMBER 22 8:00-8:15 am ...... General Assembly Call to Order Credentials Report Adoption of Business and Consent Agendas 8:15-9:15 am ...... Consideration of Proposed Bylaws Amendment Proposals and Resolutions (Debate and Vote) GA21-01: Proposals to Amend Bylaws: Minimum Term for Filled Vacancies GA21-02: Proposals to Amend Bylaws: Term Limits GA21-03: Proposals to Amend Bylaws: Structure of the Nominations and Elections Committee GA21-04: Federal Nurse Practice Act and Licensing in the United States of America GA21-05: CATN (Course in Advanced Trauma Nursing) in the Classroom 9:15-9:45 am ...... BREAK
2021 ENA General Assembly
6:00-10:00 am Pacific Time 7:00-11:00 am Mountain Time 8:00 am-12:00 pm Central Time 9:00 am-1:00 pm Eastern Time
2021 General Assembly Business Agenda
9:45 am-12:00 pm ...... Consideration of Proposed Bylaws Amendment Proposals and Resolutions (Debate and Vote) GA21-06: Emergency Clinical Nurse Specialist National Certification GA21-07: Triage Challenges in Emergency Nursing and Conducting Research GA21-08: Training of the Emergency Care Assistive Personnel in the Emergency Department GA21-09: Increasing Community Resources GA21-10: Identify and Support Ways that Decrease Emergency Department Nurses taking work-related stress home
12:00 pm ...... General Assembly Adjournment
2021 ENA General Assembly
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2021 General Assembly
Officials
General Assembly Chair/President Ron Kraus, MSN, RN, EMT, CEN, ACNS-BC, TCRN Indiana Credentials Chairperson/Immediate Mike Hastings, MSN, RN, CEN Past President Washington President-Elect Jennifer Schmitz, MSN, EMT-P, CEN, CPEN, CNML, FNP-C, NE-BC Maine Secretary/Treasurer Terry M. Foster, MSN, RN, CEN, CPEN, CCRN, TCRN, FAEN Kentucky Directors Dustin Bass, MHA, BSN, RN, CEN, NE-BC North Carolina Joop Breuer, RN, CEN, CCRN, FAEN Netherlands Kristen Cline, BSN, RN, CEN, CPEN, CFRN, CTRN, TCRN California Chris Dellinger, MBA, BSN, RN, FAEN West Virginia Steven Jewell, BSN, RN, CEN, CPEN Texas Ryan Oglesby, PhD, MHA, RN, CEN, CFRN, NEA-BC Florida Cheryl Randolph, MSN, RN, CEN, CPEN, CCRN, FNP-BC, TCRN, FAEN California Emerging Professional Amie Porcelli, BSN, RN, CEN, TCRN Pennsylvania Chief Executive Officer Nancy MacRae, MS Illinois Parliamentarian Michael Taliercio Legal Counsel Kimberly Pendo
2021 ENA General Assembly
Standing Rules of Procedure of the 2021 ENA General Assembly
Given the transition to a fully virtual format from a traditional in-person General Assembly, the ENA Board of Directors, upon the advice of ENA’s Legal Counsel and Parliamentarian, recommend the following Standing Rules governing the virtual 2021 General Assembly for adoption:
GENERAL
1. The 2021 General Assembly will be conducted using the LUMI platform. Delegates will credential, vote, and join the speaking que using the LUMI platform. Individual connectivity issues will not be a valid basis for any Point of Order or a challenge to any votes.
2. Delegates may not share or “transfer” their LUMI login information if they are unable to attend the General Assembly proceedings.
3. The General Assembly order of business will be limited to a president address/state of the association, discussion, and debate/vote of proposals.
4. Delegates and alternates must attend all General Assembly meetings and complete the post General Assembly evaluation in order to receive a certificate of service.
RESOLUTIONS
5. Resolutions may be authored and submitted by the ENA Board of Directors, ENA committees, the Journal of Emergency Nursing Editorial Board, a state council or chapter, or by a voting ENA member, as outlined in the ENA General Assembly Standing Rules of Procedure.
6. The submission deadline for resolutions was May 24, 2021. Resolutions received after the deadline will not be considered.
COMPOSITION
7. State council delegates will be apportioned based on the ratio of members in the state or territory to the total ENA membership as of May 14 in accordance with the ENA bylaws. International delegates will be allocated in accordance with the ENA bylaws. ENA headquarters will send necessary information for designating delegates, alternate delegates and state captains to state councils.
8. Each state council must formally register delegates and alternate delegates in the state council’s online management area with ENA headquarters no later than June 25, 2021.
9. The state captain must be selected as soon as possible but no later than 75 days prior to the General Assembly.
10. The ENA Immediate Past President will oversee the credentials process.
11. A member registered as an alternate delegate may be transferred to delegate status, provided that no state delegation exceeds the maximum number of delegates allotted. All delegate changes must be submitted to ENA headquarters via e-mail to [email protected] by 12:00 ENA General Assembly Standing Rules of Procedure Page 1 of 3
pm Central time on September 16, 2021. No changes will be accepted following this deadline.
REFERENCE HEARINGS
12. The author (or their designee) of a resolution or bylaw amendment proposal has the right to speak first with respect to their resolution/proposal at the Reference Hearing for up to one (1) minute; such time will not be counted in the total time for discussion. The total discussion time allotted for each resolution or bylaw amendment proposal is ten (10) minutes. If there are speakers in the queue when the discussion time expires, the chair will take a vote on whether to extend discussion for an additional five minutes.
13. Amendments to resolutions or bylaw amendment proposals may only be submitted by the Resolutions Committee. Amendments to resolution or bylaw amendment proposals from the delegation will not be permitted.
14. Following the Reference Hearings, the Resolutions Committee will meet to determine amendments to resolutions or bylaw amendment proposals and will determine the resolutions or proposed bylaws amendments to be placed on a consent agenda (if any).
15. The Resolutions Committee will make any amendments to resolutions or bylaw amendment proposals available to the delegates as soon as possible following the reference hearings and completion of its work.
DEBATE & VOTING
16. The Resolutions Committee will determine the order in which the General Assembly will consider, debate and vote on resolutions and bylaw amendment proposals.
17. After being recognized, delegates and ENA past presidents must give their name and affiliation before beginning to speak.
18. A delegate may request that an individual without speaking rights be allowed to speak. A majority vote is required to grant the request.
19. The total debate time allotted for each resolution or bylaw amendment proposal is ten (10) minutes. If there are speakers in the queue when the debate time expires, the chair will take a vote on whether to extend debate for an additional five minutes.
20. The author (or their designee) of a resolution or bylaw amendment proposal has the right to speak first with respect to their resolution/proposal for up to one minute; such time will not be counted in the total time for debate.
21. No delegate may speak more than once on the same resolution or bylaw amendment proposal, nor longer than one (1) minute.
22. Debate shall alternate “pro” and “con,” to the extent possible. The Chair has the discretion to manage the queue to ensure fairness in the best interests of the assembly.
23. No motions will be permitted from the floor.
ENA General Assembly Standing Rules of Procedure Page 2 of 3
ADMINISTRATIVE
24. The Resolutions Committee is authorized to correct article and section designations, punctuation and references in the Bylaws, Election Rules, and General Assembly Standing Rules of Procedure as may be necessary to reflect the intent of the General Assembly.
25. Following the conclusion of the General Assembly, the draft General Assembly minutes will be sent electronically to all state captains and the ENA Board of Directors for a 10-day review and comment period. The minutes shall be subsequently approved by the Resolutions Committee.
26. The status of resolutions and bylaw amendments adopted by the General Assembly will be made available to the ENA membership through ENA publications.
ENA General Assembly Standing Rules of Procedure Page 3 of 3 Back to Top Proposal to Amend Bylaws
1 Proposal Number: GA21-01 2 3 Title: Term Limits for Board Members 4 5 Article and Section: Article VI Board of Directors, Section 4. Term of Office 6 7 Current bylaws language: 8 9 Section 4. Term of Office 10 Directors (with the exception of the immediate past president) shall serve for a three-year term of office, or until 11 such time as their successors are duly elected, qualified and take office. In order to provide for staggered terms, 12 at least two and no more than three directors shall be elected each year. The term of office shall commence on 13 January 1 each year following the election and terminate on December 31. 14 15 Proposed changes: 16 17 Section 4. Term of Office / Term Limits 18 A. Directors (with the exception of the immediate past president) shall serve for a three-year term of office, or 19 until such time as their successors are duly elected, qualified and take office. In order to provide for 20 staggered terms, at least two and no more than three directors shall be elected each year. The term of office 21 shall commence on January 1 each year following the election and terminate on December 31. 22 B. The Immediate Past President shall serve a one-year term in office, or until such time as their successor takes 23 office. 24 C. No director may serve on the Board of Directors for more than six (6) years, not including any time served to 25 fill a vacancy. 26 D. Notwithstanding anything set forth herein to the contrary (i) a director elected to serve as an officer may 27 remain on the Board until the conclusion of their term in such office and may complete their rotation through 28 the offices (i.e., President-Elect to President to Immediate Past President) despite the fact that such person 29 may have served on the Board for the maximum number of years; and (ii) a director completing their sixth 30 year as a director is eligible to run for an officer position. 31 32 Bylaws language if adopted: 33 34 Section 4. Term of Office / Term Limits 35 A. Directors shall serve for a three-year term of office, or until such time as their successors are duly 36 elected, qualified and take office. In order to provide for staggered terms, at least two and no more than 37 three directors shall be elected each year. The term of office shall commence on January 1 each year 38 following the election and terminate on December 31. 39 B. The Immediate Past President shall serve a one-year term in office, or until such time as their successor 40 takes office. 41 C. No director may serve on the Board of Directors for more than six (6) years, not including any time 42 served to fill a vacancy. 43 D. Notwithstanding anything set forth herein to the contrary (i) a director elected to serve as an officer may 44 remain on the Board until the conclusion of their term in such office and may complete their rotation 45 through the offices (i.e., President-Elect to President to Immediate Past President) despite the fact that 46 such person may have served on the Board for the maximum number of years; and (ii) a director 47 completing their sixth year as a director is eligible to run for an officer position. 48
2021 General Assembly Back to Top Proposal to Amend Bylaws
49 Rationale: 50 It is considered a best governance practice to institute term limits for Board service. Term limits encourage 51 increased opportunity for diversity and inclusion in leadership, allowing for new ideas and new perspectives on 52 the board and within decision-making. With staggered terms and term limits it enables the board to ensure a 53 balance of continuity, while avoiding stagnation that may occur with long terms of service. According to 54 Leading with Intent: 2017 Index of Nonprofit Board Practices, 72 percent of nonprofit boards have term limits. 55 56 Author(s): 57 2021 ENA Board of Directors 58 59 Supporter(s): 60 Arizona ENA State Council 61 Jean Proehl, ENA #10523 62 Jamla Rizek, ENA # 743653 63 Alicyn Gary, ENA #1652520 64 Agnes Kelly, ENA #47179 65 Kelly Hooper, ENA #1306954 66 Gretchen Mayer, ENA #22518 67 Philip Lerner, ENA #657795 68 Mark Goldstein, ENA #331450 69 Todd Haines, ENA #774122 70 Benny Marett, ENA #17179 71 Mel Wilson, ENA #23035 72 Patti Kunz Howard, ENA #25128 73 AnnMarie Papa, ENA #65692 74 JoAnn Lazarus, ENA #37139 75 Victoria Bradley, ENA #12893 76 Matt Powers, ENA #212707 77 Denise Bayer, ENA #48866 78 Diane Gurney, ENA #16982 79 Anne Manton, ENA #5079 80 Adam Johnston, ENA #1050433 81
2021 General Assembly Back to Top Proposal to Amend Bylaws
82 Proposal Number: GA21-02 83 84 Title: Institute a Minimum Term for Filled Vacancies 85 86 Article and Section: Article VI Board of Directors, Section 7. Vacancy 87 88 Current bylaws language: 89 90 Section 7. Vacancy 91 A vacancy that occurs in the position of director shall be filled in the following manner: 92 A. If the vacancy occurs between January 1 and before the completion of the current year’s election the vacancy 93 shall be filled by the person receiving the next highest number of votes in the previous year’s election with 94 the term ending December 31. 95 B. If the vacancy occurs after the current year’s election and there is more than six months left in the unexpired 96 term, the vacancy shall be filled by the person receiving the next highest number of votes in the current 97 year’s election with the term ending December 31 of the following year. 98 C. If all such persons decline to serve, if there were no additional candidates for that office during the most 99 recently concluded election, or if the vacancy occurs with fewer than six months left in the unexpired term, 100 the vacancy shall not be filled. 101 102 Proposed changes: 103 104 Section 7. Vacancy 105 A vacancyVacancies that occursoccur in the position of director shall be filled in the following manner: 106 A. Vacancies with twelve (12) or less months remaining in the unexpired portion of the term will not be filled. 107 B. A. If there is more than twelve (12) months remaining in the unexpired portion of the term and the vacancy 108 occurs between: 109 (i) after January 1 and beforeprior to the completion of the current year’s election the vacancy shall 110 be filled by the person receiving the next highest number of votes in the previous year’s election with the 111 term ending December 31. 112 B. If the vacancy occurs after the current year’s election and there is more than six months left in the unexpired 113 term, the vacancy shall be filled by the person receivingthat received the next highest number of votes 114 in(after the currentelected directors) in the previous year’s election with the term ending December 31 of the 115 following year.; 116 (ii) after the current year’s election, the vacancy shall be filled by the person that received the 117 next highest number of votes (after the elected directors) in the current year’s election; or 118 C. If 119 (iii) due to the election of such director as an officer, the vacancy will be filled in the current 120 year’s election for the unexpired balance of the term they were originally elected to fill by the person that 121 received the next highest number of votes (after the elected directors) in the current year’s election. 122 123 C. In the event (i) all such persons decline to serve, ifor (ii) there were no additional candidates for that 124 office during the most recently concluded election, or if the vacancy occurs with fewer than six months 125 left in the unexpired term, the vacancy shall not be filled. 126 127 D. Directors elected to fill a vacancy shall hold office for the balance of the term they are filling or until 128 such time as their successor is duly elected, qualified and takes office. 129
2021 General Assembly Back to Top Proposal to Amend Bylaws
130 Bylaws language if adopted: 131 132 Section 7. Vacancy 133 Vacancies that occur in the position of director shall be filled in the following manner: 134 A. Vacancies with twelve (12) or less months remaining in the unexpired portion of the term will not be filled. 135 B. If there is more than twelve (12) months remaining in the unexpired portion of the term and the vacancy 136 occurs: 137 (i) after January 1 and prior to the completion of the current year’s election, the vacancy shall be 138 filled by the person that received the next highest number of votes (after the elected directors) in the 139 previous year’s election; 140 (ii) after the current year’s election, the vacancy shall be filled by the person that received the next 141 highest number of votes (after the elected directors) in the current year’s election; or 142 (iii) due to the election of such director as an officer, the vacancy will be filled in the current 143 year’s election for the unexpired balance of the term they were originally elected to fill by the person that 144 received the next highest number of votes (after the elected directors) in the current year’s election. 145 146 C. In the event (i) all such persons decline to serve, or (ii) there were no additional candidates for that office 147 during the most recently concluded election the vacancy shall not be filled. 148 149 D. Directors elected to fill a vacancy shall hold office for the balance of the term they are filling or until such 150 time as their successor is duly elected, qualified and takes office. 151 152 Rationale: 153 ENA invests heavily in the onboarding of new board members to ensure strength of leadership and cohesive 154 team dynamics for optimal board performance. It typically takes at least one full year for a new Board member to 155 develop full competency in their role. Accordingly, a one-year term does not provide the new director with the 156 time necessary to achieve their full potential nor ENA the ability to maximize the resources invested. By filling 157 only those vacancies with more than 12 months remaining in the unexpired portion of the term being filled, such 158 newly appointed board member is afforded the best chance to succeed while maximizing ENA’s valuable 159 resources and the efficiency and functionality of the Board. 160 161 Author(s): 162 2021 ENA Board of Directors 163 164 Supporter(s): 165 Arizona ENA State Council 166 Jean Proehl, ENA #10523 167 Jamla Rizek, ENA # 743653 168 Alicyn Gary, ENA #1652520 169 Agnes Kelly, ENA #47179 170 Kelly Hooper, ENA #1306954 171 Gretchen Mayer, ENA #22518 172 Philip Lerner, ENA #657795 173 Mark Goldstein, ENA #331450 174 Todd Haines, ENA #774122 175 Benny Marett, ENA #17179 176 Mel Wilson, ENA #23035 177 Patti Kunz Howard, ENA #25128
2021 General Assembly Back to Top Proposal to Amend Bylaws
178 AnnMarie Papa, ENA #65692 179 JoAnn Lazarus, ENA #37139 180 Victoria Bradley, ENA #12893 181 Matt Powers, ENA #212707 182 Denise Bayer, ENA #48866 183 Diane Gurney, ENA #16982 184 Anne Manton, ENA #5079 185 Adam Johnston, ENA #1050433 186
2021 General Assembly Back to Top Proposal to Amend Bylaws
187 Proposal Number: GA21-03 188 189 Title: Proposal to Restructure the Nominations and Elections Committee 190 191 Article and Section: Article IX Committees, Section 2, B. Other Standing Committees, Nominations and 192 Elections Committee 193 194 Current bylaws language: 195 196 Nominations and Elections Committee. 197 1. Composition 198 a. The Nominations and Elections Committee shall consist of seven Voting Members elected to serve 199 on the Nominations and Elections Committee in the ENA national election: one member from each 200 of six regions who has not previously served on the Board of Directors, and one member who has 201 served on the Board of Directors. Nominations and Elections Committee members may only 202 represent the region in which they hold a voting membership. 203 b. The six regions shall be established by Nominations and Elections Committee policy. Each region 204 shall be composed of states with geographic proximity and relatively equal membership distribution. 205 c. A Nominations and Elections Committee chairperson shall be elected each year by the incoming 206 Nominations and Elections Committee. 207 2. Qualifications 208 a. Candidates must be a Voting Member in good standing and must have been a Voting Member during 209 each of the previous five years immediately prior to submitting their candidate application. 210 b. Candidates shall have served in an elected or committee position on the local, state or national level 211 within the previous five years. 212 c. Candidates must also have attended at least one ENA General Assembly within the previous three 213 years. 214 d. Members of the Nominations and Elections Committee may not run for or serve in any ENA board 215 position during their tenure on the Nominations and Elections Committee, and may not serve more 216 than two consecutive elected terms on the Nominations and Elections Committee. 217 3. Elections 218 a. Elections for the Nominations and Elections Committee shall be held annually. Members shall serve 219 for a three-year terms with terms beginning January 1 and ending on December 31, or until such 220 time as their successors are duly elected, qualified and take office. Voting Members shall be elected 221 to serve on the Nominations and Elections Committee each year. 222 b. All Voting Members shall have the opportunity to elect Nominations and Elections Committee 223 members by ballot from all regions. Candidates receiving the highest number of votes shall be 224 declared elected. In the event of a tie vote for a position on the committee, lots shall be drawn. 225 4. Overview 226 a. The Nominations and Elections Committee has general oversight of the national election. The 227 Committee shall solicit and mentor potential candidates and review national candidate applications. 228 b. The Nominations and Elections Committee will provide periodic updates to the Board of Directors 229 regarding the progress of their charges. 230 c. The Nominations and Elections Committee shall present a qualified slate of candidates to the Board 231 of Directors for its review and discussion prior to presenting the slate to the membership. Following 232 such review and discussion, the Nominations and Elections Committee shall present the slate to the 233 membership through publication in such ENA publications as determined by the Board of Directors 234 or its designee(s).
2021 General Assembly Back to Top Proposal to Amend Bylaws
235 5. Vacancies 236 a. A vacancy in the chairperson position shall be filled by a majority vote of the Nominations and 237 Elections Committee. 238 b. A vacancy of a committee member shall be filled by the candidate who received the next highest 239 number of votes from that region or as the past board member in the most recently completed 240 election. 241 c. In the event of a committee member vacancy from an uncontested election, a qualified candidate 242 must be nominated and elected by the state council presidents of the region affected by the vacancy 243 according to the Nominations and Elections Committee election process, meeting the same 244 requirements set forth in the bylaws as any potential candidate. 245 d. The committee position may remain vacant as approved by the Nominations and Elections 246 Committee if less than six months remain of the unexpired term. 247 248 Proposed changes: 249 250 Nominations and Elections Committee. 251 1. Composition 252 a. The Nominations and Elections Committee shall consist of the Immediate Past President and seven 253 Voting Members electedappointed to serve on the Nominations and Elections Committee in the 254 ENA national election: one member from each of six regions who has not previously served onby 255 the Board of Directors, and one member who has served on the Board of Directors. Nominations and 256 Elections Committee members may only represent the region in which they hold a voting 257 membership. 258 259 b. The six regions shall be established by Nominations and Elections Committee policy. Each region 260 shall be composed of states with geographic proximity and relatively equal membership distribution. 261 c. A Nominations and Elections Committee chairperson shall be elected each year by The Immediate 262 Past President shall serve as the chair of the incoming Nominations and Elections Committee. 263 2. Qualifications 264 a. CandidatesMembers of the Nominations and Elections Committee must be a Voting 265 MemberMembers in good standing and must have been a Voting Member during each of the 266 previous five years immediately prior to submitting their candidate application. 267 b. CandidatesMembers of the Nominations and Elections Committee shall have served in an elected or 268 committee position on the local, state or national level within the previous five years. 269 c. CandidatesMembers of the Nominations and Elections Committee must also have attended at least 270 one ENA General Assembly within the previous three years. 271 d. Members of the Nominations and Elections Committee may not run for or serve in any ENA board 272 position during their tenure on the Nominations and Elections Committee, (with the exception of the 273 Immediate Past President) and may not serve more than two consecutive elected terms on the 274 Nominations and Elections Committee. 275 3. Elections 276 3. Term 277 a. Elections forAppointed members of the Nominations and Elections Committee shall be held 278 annually. Members shall serve for a three-year terms with terms beginning January 1 and ending on 279 December 31, or until such time as their successors are duly elected, qualifiedappointed and take 280 office. Voting MembersThe Immediate Past President shall be elected to serve on the Nominations 281 and Elections Committee each yeara one-year term, or until such time as their successor takes office. 282
2021 General Assembly Back to Top Proposal to Amend Bylaws
283 b. All Voting Members shall have the opportunity to electIn order to provide for staggered terms, at 284 least two and no more than three members of the Nominations and Elections Committee members by 285 ballot from all regions. Candidates receiving the highest number of votes shall be declared elected. 286 In the event of a tie vote for a position on the committee, lots shall be drawn.shall be appointed each 287 year. 288 4. Overview 289 a. The Nominations and Elections Committee has general oversight of the national election’s key 290 purpose is candidate recruitment, selection and development. The Nominations and Elections 291 Committee shall solicit and mentor potential candidates and review national candidate applications 292 in accordance with procedures adopted by the Board of Directors. 293 294 b. The Nominations and Elections Committee is responsible for vetting candidates based on 295 competencies, key criteria and a formal interview process in accordance with procedures adopted by 296 the Board of Directors. 297 c. The Nominations and Elections Committee will provide periodic updates to the Board of Directors 298 regarding the progress of their charges. 299 cd. The Nominations and Elections Committee shall present a qualified slate of candidates to the Board 300 of Directors for its review and discussionapproval prior to presenting the slate to the membership. 301 Following such review and discussionapproval, the Nominations and Elections Committee shall 302 present the slate to the membership through publication in such ENA publications as determined by 303 the Board of Directors or its designee(s). 304 5. Vacancies 305 a. A vacancy in the chairperson position shall be filled by a majority vote of the Nominations and 306 Elections CommitteeBoard of Directors. 307 b. A vacancy of a committee member shall be filled by the candidate who received the next highest 308 number of votes from that region or as the past board member in the most recently completed 309 election. 310 c. In the event of a committee member vacancy from an uncontested election, a qualified candidate 311 must be nominated and elected by the state council presidents of the region affected by the vacancy 312 according to the Nominations and Elections Committee election process, meeting the same 313 requirements set forth in the bylaws as any potential candidate. 314 d. TheBoard of Directors, provided, however, a committee position may, in the discretion of the Board 315 of Directors, remain vacant as approved by the Nominations and Elections Committee if less than six 316 months remain of the unexpired term. 317 318 319 320 Bylaws language if adopted: 321 322 Nominations and Elections Committee. 323 1. Composition 324 a. The Nominations and Elections Committee shall consist of the Immediate Past President and seven 325 Voting Members appointed to serve on the Nominations and Elections Committee by the Board of 326 Directors. 327 b. The Immediate Past President shall serve as the chair of the Nominations and Elections Committee. 328 2. Qualifications 329 a. Members of the Nominations and Elections Committee must be Voting Members in good standing 330 and must have been a Voting Member during each of the previous five years immediately prior to
2021 General Assembly Back to Top Proposal to Amend Bylaws
331 submitting their application. 332 b. Members of the Nominations and Elections Committee shall have served in an elected or committee 333 position on the local, state or national level within the previous five years. 334 c. Members of the Nominations and Elections Committee must also have attended at least one ENA 335 General Assembly within the previous three years. 336 d. Members of the Nominations and Elections Committee may not run for or serve in any ENA board 337 position during their tenure on the Nominations and Elections Committee (with the exception of the 338 Immediate Past President) and may not serve more than two consecutive terms on the Nominations 339 and Elections Committee. 340 3. Term 341 a. Appointed members of the Nominations and Elections Committee shall serve three-year terms with 342 terms beginning January 1 and ending on December 31, or until such time as their successors are 343 appointed and take office. The Immediate Past President shall serve a one-year term, or until such 344 time as their successor takes office. 345 b. In order to provide for staggered terms, at least two and no more than three members of the 346 Nominations and Elections Committee shall be appointed each year. 347 4. Overview 348 a. The Nominations and Elections Committee’s key purpose is candidate recruitment, selection and 349 development. The Nominations and Elections Committee shall solicit and mentor potential 350 candidates and review national candidate applications in accordance with procedures adopted by the 351 Board of Directors. 352 b. The Nominations and Elections Committee is responsible for vetting candidates based on 353 competencies, key criteria and a formal interview process in accordance with procedures adopted by 354 the Board of Directors. 355 c. The Nominations and Elections Committee will provide periodic updates to the Board of Directors 356 regarding the progress of their charges. 357 d. The Nominations and Elections Committee shall present a qualified slate of candidates to the Board 358 of Directors for its review and approval prior to presenting the slate to the membership. Following 359 such review and approval, the Nominations and Elections Committee shall present the slate to the 360 membership through publication in such ENA publications as determined by the Board of Directors 361 or its designee(s). 362 5. Vacancies 363 a. A vacancy in the chairperson position shall be filled by the Board of Directors. 364 b. A vacancy of a committee member shall be filled by the Board of Directors, provided, however, a 365 committee position may, in the discretion of the Board of Directors, remain vacant if less than six 366 months remain of the unexpired term. 367 Rationale: 368 Appointment of the members of the Nominations and Election Committee by the ENA Board of Directors works 369 to (i) ensure a diverse group of the most qualified members are selected to serve; and (ii) remedies the conflict- 370 of-interest issues inherent in the current structure. Currently, the Nominations and Election Committee faces the 371 recurrent problem of committee members forced to recuse themselves from the work of the committee due to the 372 conflict of interest created by their service on the committee in the year(s) they are up for reelection to the 373 committee. It is difficult for the committee to do its work and perform its functions when 2 to 3 committee 374 members cannot participate due to a conflict of interest, leaving the committee without the important perspective 375 and contributions of such committee members. The proposed appointment process would reduce the conflict of 376 interest inherent with the committee managing its own election. 377 378 By having the Immediate Past President chair the committee, the committee will gain valuable insight into the
2021 General Assembly Back to Top Proposal to Amend Bylaws
379 workings of the Board and the experience and qualifications that make successful ENA directors. Best practice 380 indicates the importance of a dedicated group to ensure the development and availability of future leaders for the 381 sustained success of an organization. The proposed amendment clearly defines that the focus of the Nominations 382 and Elections Committee is on candidate recruitment, selection and development, which are the keys to ensuring 383 ENA’s continued success. It is important that the role of the committee is to develop, solicit and ensure the best 384 candidates are selected in order to meet the future needs of the organization. With the adoption of the proposed 385 amendments, candidate vetting will be done based on competencies, key criteria, and a formal interview process 386 in accordance with procedures adopted by the Board. The Nominations and Elections Committee will have the 387 authority to formally vet candidates in order to present a slate of qualified candidates to the ENA Board of 388 Directors for its review and approval. 389 390 Author(s): 391 2021 ENA Board of Directors 392 393 Supporter(s): 394 Jamla Rizek, ENA # 743653 395 Alicyn Gary, ENA #1652520 396 Agnes Kelly, ENA #47179 397 Kelly Hooper, ENA #1306954 398 Gretchen Mayer, ENA #22518 399 Philip Lerner, ENA #657795 400 Mark Goldstein, ENA #331450 401 Todd Haines, ENA #774122 402 Patti Kunz Howard, ENA #25128 403 AnnMarie Papa, ENA #65692 404 JoAnn Lazarus, ENA #37139 405 Denise Bayer, ENA #48866 406 Adam Johnston, ENA #1050433
2021 General Assembly Back to Top 1 BYLAWS 2 EMERGENCY NURSES ASSOCIATION 3 4 5 ARTICLE I 6 NAME 7 The name of this organization shall be the Emergency Nurses Association (ENA), a not-for- 8 profit corporation incorporated in the State of Illinois. ENA shall have and continuously maintain 9 in the State of Illinois a registered office and a registered agent whose office is identical with 10 such registered office, and may have such other offices within or outside of the State of Illinois 11 as the Board of Directors may determine. 12 13 ARTICLE II 14 OBJECT 15 Section 1. Purpose 16 The purposes for which the corporation is organized are educational, within the meaning of 17 Section 501(c)(3) of the Internal Revenue Code of 1986, as amended (“IRC”), including but not 18 limited to the advancement of emergency nursing through education and public awareness. 19 20 Section 2. Rules 21 The following rules shall conclusively bind ENA and all persons acting for or on behalf of it: 22 A. No part of the net earnings of ENA shall inure to the benefit of, or be distributed to, its 23 directors, officers, committee members or other private persons, except that ENA shall be 24 authorized and empowered to pay reasonable compensation for services rendered and to 25 make payments and distributions in furtherance of the purposes set forth above. 26 B. No substantial part of the activities of ENA shall be the carrying on of propaganda, or 27 otherwise attempting to influence legislation, and ENA shall not participate in, or intervene in 28 (including the publishing or distribution of statements) any political campaign on behalf or in 29 opposition to any candidate for public office. Notwithstanding any provision of these Bylaws, 30 ENA shall not carry on any activity not permitted to be carried on by: 31 i. a corporation exempt from federal income tax under Section 501(c)(3) of the IRC (or the 32 corresponding provision of any future United States Internal Revenue Law); or 33 ii. a corporation, contributions to which are deductible under Section 170(c)(2) of the IRC 34 (or the corresponding provision of any future United States Internal Revenue Law). 35 36 Section 3. Official Publication 37 The official publication shall be the Journal of Emergency Nursing (JEN), which shall reflect the 38 purpose, mission objectives and positions of ENA. 39 40 ARTICLE III 41 MEMBERS 42 Section 1. Responsibilities of Membership 43 Each member has the responsibility to support the purpose, mission, vision, values and 44 objectives of ENA. 45 46 Section 2. Classifications and Criteria. Membership may be granted to any individual who (i) 47 abides by these bylaws, the ENA Code of Ethics, and such other policies, rules and regulations 48 as ENA may adopt; and (ii) meets the criteria for membership set forth in one of the following 49 categories: 50 A. Voting Members – voting members shall be classified as national, international, senior and 51 military (“Voting Members”). Voting Members shall have the right to vote, hold elected office, 52 serve on the Board of Directors, serve on committees, and attend ENA’s meetings and 53 social functions.
9/26/2018 Emergency Nurses Association Page 1 of 14 Back to Top 54 1. National membership may be granted to any individual who is a professional registered 55 nurse licensed in the United States or its territories. 56 2. International membership may be granted to any individual who is a professional 57 registered nurse licensed (or the equivalent thereto) outside of the United States or its 58 territories. 59 3. Senior membership may be granted to a professional registered nurse who is age 65 or 60 older and licensed in the United States or its territories. 61 4. Military membership may be granted to a professional registered nurse licensed in the 62 United States or its territories who is currently serving or has been honorably discharged 63 or retired from the United States Armed Forces including Army, Navy, Marine Corps, Air 64 Force, Coast Guard, and Reserve Components. 65 B. Nonvoting Members – nonvoting members shall be classified as affiliate, student and 66 honorary (“Nonvoting Members”). Nonvoting Members shall be entitled to serve on ENA 67 committees and attend ENA member meetings and social functions. 68 1. Affiliate membership may be granted to any individual who shares interest in and 69 supports the purpose, mission and objectives of ENA but does not otherwise meet the 70 criteria for voting membership in ENA. 71 2. Student membership may be granted to any individual enrolled in a primary nursing 72 education program leading to eligibility for licensure as a professional registered nurse. 73 3. Honorary membership may be awarded to an individual meeting such criteria as shall be 74 determined by the president and the Board of Directors. 75 76 Section 3. Dues and Finance 77 A. The initial and annual dues for all ENA members and the time for paying such dues, and 78 other assessments, if any, shall be determined by the Board of Directors. Under special 79 circumstances, the Board of Directors, or its designee(s), may waive the annual dues and/or 80 assessments for any member or category of members. 81 B. The membership of any member who is in default of payment of dues or assessments for 82 more than three (3) months, or otherwise becomes ineligible for membership, shall be 83 terminated automatically, according to such rules or procedures as the Board of Directors or 84 its designee(s) shall establish, unless such termination is delayed by the Board of Directors 85 or its designee(s). 86 C. Members who have resigned or been terminated for non-payment of dues may only be 87 reinstated (i) if no more than three (3) months has elapsed since the date of termination; (ii) 88 upon payment of delinquent dues; and (iii) in accordance with such rules as may from time 89 to time be established by the Board of Directors. Former members not meeting the 90 requirements for reinstatement must reapply for membership. 91 D. Each state council and chapter shall receive an annual allocation for each dues paying 92 member within the state or chapter. 93 E. A surcharge may be added to the dues in some states by the state’s request. 94 95 Section 4. Disciplinary Action 96 A. Grounds for Discipline. ENA may discipline a member for any of the following reasons: 97 i. Failure to comply with these Bylaws, the ENA Code of Ethics, or any of ENA’s rules or 98 regulations; 99 ii. Conviction of a felony or a crime related to, or arising out of, the practice of nursing or 100 involving moral turpitude; 101 iii. Suspension, revocation, or forfeiture by any state, province, or country of the member’s 102 right to practice as a nurse; or 103 iv. Immoral, dishonorable, or unprofessional conduct considered prejudicial to the best 104 interests of, or inconsistent with, the purposes of ENA. 105 B. Procedures. Discipline may include, but not be limited to, censure, suspension, 106 probation, and expulsion. Disciplinary action may be taken provided that a statement of 107 the charges shall have been sent by certified mail to the last recorded address of the
9/26/2018 Emergency Nurses Association Page 2 of 14 Back to Top 108 member at least fifteen (15) days before final action is to be taken. This statement shall 109 be accompanied by a notice of the time and place of the meeting at which the charges 110 shall be considered, and the member shall have the opportunity to appear in person 111 and/or to be represented by counsel and to present any defense to such charges before 112 action is taken by ENA. Such disciplinary actions shall be conducted in accordance with 113 such additional procedures as may be established by the Board of Directors. 114 115 ARTICLE IV 116 OFFICERS 117 Section 1. Officers 118 A. There shall be three officers: President, President-Elect, and Secretary/treasurer. The term 119 of office shall commence January 1 each year and terminate on December 31, or until such 120 time as their successors are duly elected, qualified and take office. The President-Elect shall 121 succeed to the office of president at the conclusion of the term. Officers shall exercise the 122 duties and responsibilities required of a member of the Board of Directors and such 123 additional duties and responsibilities set forth below. 124 B. President. The President shall be ENA’s principal elected officer and shall, in general, 125 supervise ENA’s business affairs, subject to the direction and control of the Board of 126 Directors, by communicating with the Chief Staff Officer as necessary regarding ENA’s 127 business. The President shall be a member, without vote, of all councils and committees 128 with the exception of the Nominations and Elections Committee and except as otherwise 129 provided by these bylaws. The President shall (i) serve as the Chair of the Finance 130 Committee; (ii) serve as ENA’s official representative and spokesperson, except as 131 otherwise provided by the Board of Directors; (iii) appoint representatives to ENA’s affiliated 132 organizations and other positions as necessary; (iv) fill, subject to the approval of the Board 133 of Directors, vacancies on ENA’s committees; and (v) in general, perform all duties 134 customarily incident to the office of President and such other duties as may be prescribed by 135 the Board of Directors. The President shall succeed to the office of immediate past president 136 upon expiration of the President’s term of office. 137 C. President-Elect. The President-Elect shall assist the President and shall substitute for the 138 President when required. The President-Elect shall appoint chairs and members of 139 committees, and a Board of Directors liaison to each committee for the year following his/her 140 term in office as President-Elect subject to Board approval and shall in general, perform all 141 duties customarily incident to the office of President-Elect and such other duties as may be 142 prescribed by the Board of Directors. The President-Elect shall succeed to the office of 143 President upon expiration of the President’s term of office, or in the event of the death, 144 resignation, removal, or incapacity of the President. 145 D. Secretary/Treasurer. The Secretary/Treasurer shall be the principal financial officer and 146 secretary of ENA and shall perform all duties traditionally incident to the offices of Secretary 147 and Treasurer and such other duties as may be assigned by the President or the Board of 148 Directors. The duties of the Secretary/Treasurer may be assigned by the Board of Directors 149 in whole or in part to the Chief Staff Officer, or his or her designee(s). 150 151 Section 2. Officer Qualifications 152 A. Each officer must be a Voting Member and must have been a Voting Member during each of 153 the previous five years immediately prior to submitting a candidate application. 154 B. Each candidate for President-Elect and Secretary/Treasurer must currently serve as a voting 155 member of the Board of Directors. 156 C. Each candidate must submit to, and pass as acceptable, a limited background check. 157 158 Section 3. Election 159 A. In the event of a tie vote for the positions of President-Elect and Secretary/Treasurer, there 160 shall be a second balloting of ENA membership.
9/26/2018 Emergency Nurses Association Page 3 of 14 Back to Top 161 B. All directors who are elected as officers shall have their unexpired terms of office filled by 162 the candidates who receive the next highest number of votes; the candidate receiving the 163 highest number of votes shall receive the position with the longest term. 164 C. A candidate for an officer position who is not elected shall continue to serve the remaining 165 unexpired years of the original term as a director. 166 167 Section 4. Vacancies 168 A. If the office of President becomes vacant, the President-Elect shall succeed to the office of 169 President for the unexpired term and shall subsequently serve the one-year term of office of 170 President to which elected. In such case, the immediate past president may remain as 171 immediate past president for a second year or the office may remain vacant for that year. 172 B. A vacancy in the office of President-Elect may be filled by a current member of the Board of 173 Directors, or remain vacant as approved by a majority vote of the Board of Directors. If the 174 vacancy is filled, the President-Elect shall not automatically assume the office of president 175 for the subsequent term. 176 C. In the event that the office of President and President-Elect are vacated during the same 177 year, the Board of Directors shall appoint an acting president to serve until the next 178 scheduled election, at which time an election will be held for both President and President- 179 Elect. 180 D. A vacancy in the office of Secretary/Treasurer may be filled by a current member of the 181 Board of Directors or remain vacant as approved by a majority vote by the entire Board of 182 Directors. 183 184 ARTICLE V 185 MEETINGS 186 Section 1. General Assembly 187 A. The General Assembly shall be composed of delegates from states territories, federal 188 districts, and international delegates representing the international members. 189 B. All Delegates, Alternates, International Delegates, and the International Alternate must be 190 Voting Members of ENA in good standing. ENA’s officers and directors may not serve as 191 Delegates, Alternates, International Delegates or the International Alternate. 192 C. The General Assembly shall be composed of 700 delegates apportioned as follows: 193 1. Neither the state nor international membership shall be allocated fewer than two 194 delegates, one of whom shall serve as captain. 195 2. In addition to the voting delegates, there shall be one nonvoting alternate delegate. 196 3. The remaining delegates will be allocated to the: 197 a. states based on the percentage the state’s membership is to the national 198 membership, as determined annually as outlined in procedures; and 199 b. international membership based on the percentage the international membership is to 200 the national membership, as determined annually as outlined in procedures. 201 D. International delegates will be selected by a point system developed by the board of 202 directors; the system will be administered and overseen by the ENA national office. The 203 members receiving the highest number of points will be selected. 204 E. In addition to the delegate and international allocation, ENA past presidents who are Voting 205 Members of ENA in good standing may attend, speak and vote at General Assembly 206 (except as otherwise set forth below). 207 F. Members of the Board of Directors, including Past Presidents serving on the Board, may 208 attend and speak at all meetings of the General Assembly but may not vote. 209 210 Section 2. Authority 211 The General Assembly is responsible for communicating member needs, providing feedback, 212 and input on issues relating to the practice of emergency nursing to the Board of Directors. The 213 General Assembly shall also approve, revise, or amend these bylaws in accordance with Article 214 XIV, and receive reports of the Board of Directors, committees and other volunteer groups,
9/26/2018 Emergency Nurses Association Page 4 of 14 Back to Top 215 receive reports of the findings of the annual financial audit, and transact such other appropriate 216 business as may properly come before the meeting. 217 218 Section 3. Quorum 219 The presence of a majority of the total voting delegates who have completed credentialing 220 procedures shall constitute a quorum for the transaction of business at any duly called session 221 of the General Assembly. 222 223 Section 4. Annual Meeting and Special Meetings of the Voting Members 224 A. The annual meeting of ENA’s Voting Members (“Annual Meeting”) will be held in 225 conjunction with the General Assembly. 226 B. Special meetings of ENA’s Voting Members may be called (i) at the request of the 227 President or any five (5) members of the Board of Directors; (ii) at the written request 228 of two- thirds (2/3) of ENA’s Voting Members; or (iii) by resolution of the ENA board of 229 directors. 230 C. Notice of any annual or special meeting of the Voting Members shall state the time, date, 231 place, and purpose of the meeting, and shall be delivered not more than sixty (60) and not 232 less than thirty (30) days prior to the date of such meeting, unless otherwise required by 233 applicable law. 234 D. The lesser of (i) ten percent (10%) of ENA’s eligible Voting Members; or (ii) one 235 hundred (100) eligible voting members shall constitute a quorum for the transaction of 236 business at any duly called meeting of the Voting Members, provided that if less than a 237 quorum is present, a majority of the Voting Members present may adjourn the meeting to 238 another time without further notice. 239 E. The act of a majority or more of the Voting Members present (in person or by proxy) at a 240 duly called meeting at which a quorum is present shall be the act of the Voting Members, 241 unless the act of a greater number is required by law, the Articles of Incorporation, or these 242 bylaws. 243 F. Mail/Electronic Voting. Voting by mail or electronic means shall be permitted to the full 244 extent permitted by the Illinois General Not For Profit Corporation Act of 1986, as 245 amended (the “Act”), for any item of business properly coming before the Voting 246 Members. A mail or electronic vote of the Voting Members may be called by the Board of 247 Directors. 248 249 ARTICLE VI 250 BOARD OF DIRECTORS 251 Section 1. Composition 252 The Board of Directors shall be composed of the following: three officers, seven directors, the 253 immediate past president serving as an ex-officio member for one year, and the Chief Staff 254 Officer serving as a non-voting ex officio member. No member may run for more than one 255 nationally elected position at a time. No member may hold more than one nationally elected 256 position at a time. 257 258 Section 2. Authority 259 The Board of Directors is ENA’s official governing body and is responsible for the management 260 of ENA’s affairs and shall have supervision, control and direction of ENA. To that end, it shall: 261 • Perform all duties entrusted to officers and directors of a corporation; 262 • Debate and determine ENA policy; 263 • Oversee ENA’s business and financial affairs; 264 • Determine ENA’s policies in accordance with these bylaws; 265 • Have discretion in the disbursement of ENA’s funds; 266 • Adopt such rules and regulations for the conduct of its business as it shall deem 267 advisable; 268 • Appoint such agents as it may consider necessary;
9/26/2018 Emergency Nurses Association Page 5 of 14 Back to Top 269 • Provide direction to and control over all ENA’s committees, unless specifically provided 270 otherwise in these bylaws; 271 • Provide strategic direction for ENA; and 272 • Provide leadership for all of the component divisions of ENA. 273 274 Section 3. Qualifications 275 A. Directors must be a Voting Member in good standing and must have been a Voting Member 276 in good standing during each of the previous five years immediately prior to submitting a 277 candidate application. 278 B. Candidates must have attended at least one ENA General Assembly within the previous 279 three years. 280 C. Each candidate must submit to, and pass as acceptable, a limited background check. 281 D. Candidates shall have served in an elected or committee position on the local, state or 282 national level within the previous five years. 283 284 Section 4. Term of Office / Term Limits 285 A. Directors (with the exception of the immediate past president) shall serve for a three-year 286 term of office, or until such time as their successors are duly elected, qualified and take 287 office. In order to provide for staggered terms, at least two and no more than three directors 288 shall be elected each year. The term of office shall commence on January 1 each year 289 following the election and terminate on December 31. 290 B. The Immediate Past President shall serve a one-year term in office, or until such time as 291 their successor takes office. 292 C. No director may serve on the Board of Directors for more than six (6) years, not including 293 any time served to fill a vacancy. 294 D. Notwithstanding anything set forth herein to the contrary (i) a director elected to serve as an 295 officer may remain on the Board until the conclusion of their term in such office and may 296 complete their rotation through the offices (i.e., President-Elect to President to Immediate 297 Past President) despite the fact that such person may have served on the Board for the 298 maximum number of years; and (ii) a director completing their sixth year as a director is 299 eligible to run for an officer position. 300 301 Section 5. Elections 302 Elections shall be held annually. All Voting Members shall have the opportunity to elect officers 303 and directors by ballot. Balloting may be by electronic means. Candidates receiving the highest 304 number of votes for each position shall be declared elected. In the event of a tie for the director 305 positions, lots shall be drawn. 306 307 Section 6. Meetings of the Board of Directors 308 A. Regular meetings of the board shall be held at least quarterly as determined by the board. 309 At least ten days’ notice shall be given to all members of the board. 310 B. Special meetings shall be held as called by the President or any three members of the 311 board. At least three days’ notice shall be given to all members of the board. 312 C. Meetings may be held in person or by electronic means, provided that all participants can 313 hear and speak to one another at the same time. 314 D. A majority of the voting members of the Board of Directors shall constitute a quorum for all 315 meetings. All decisions of the Board of Directors require an affirmative vote of a majority of 316 the Board of Directors present and voting at a meeting at which a quorum is present. 317 E. Voting members of Board of Directors (including the President) have the right and 318 responsibility to actively participate in board meetings by making motions, speaking in 319 debate and voting (unless precluded by a conflict of interest, as determined in accordance 320 with ENA’s conflict of interest policy).
9/26/2018 Emergency Nurses Association Page 6 of 14 Back to Top 321 F. Any action requiring a vote of the Board of Directors may be taken without a meeting if a 322 written consent, setting forth the action taken, is approved by all of the members of the 323 Board of Directors entitled to vote with respect to the subject matter thereof. 324 325 Section 7. Vacancy 326 A vacancyVacancies that occursoccur in the position of director shall be filled in the following 327 manner: 328 A. Vacancies with twelve (12) or less months remaining in the unexpired portion of the term will 329 not be filled. 330 B. A. If there is more than twelve (12) months remaining in the unexpired portion of the term 331 and the vacancy occurs between: 332 (i) after January 1 and beforeprior to the completion of the current year’s election 333 the vacancy shall be filled by the person receiving the next highest number of votes in the 334 previous year’s election with the term ending December 31. 335 B. If the vacancy occurs after the current year’s election and there is more than six months left 336 in the unexpired term, the vacancy shall be filled by the person receivingthat received the 337 next highest number of votes in(after the currentelected directors) in the previous year’s 338 election with the term ending December 31 of the following year.; 339 (ii) after the current year’s election, the vacancy shall be filled by the person that 340 received the next highest number of votes ( the elected directors) in the current year’s 341 election; or 342 C. If 343 (iii) due to the election of such director as an officer, the vacancy will be filled in 344 the current year’s election for the unexpired balance of the term they were originally 345 elected to fill by the person that received the next highest number of votes (after the 346 elected directors) in the current year’s election. 347 348 C. In the event (i) all such persons decline to serve, ifor (ii) there were no additional 349 candidates for that office during the most recently concluded election, or if the vacancy 350 occurs with fewer than six months left in the unexpired term, the vacancy shall not be 351 filled. 352 353 D. Directors elected to fill a vacancy shall hold office for the balance of the term they are 354 filling or until such time as their successor is duly elected, qualified and takes office. 355 356 Section 8. Resignation and Removal 357 Any director may resign at any time by giving written notice to the President. Any member of the 358 Board of Directors may be removed in accordance with the provisions of law and the Illinois 359 General Not For Profit Corporation Act of 1986, as amended, by the persons entitled to elect 360 such director, whenever, in their judgment, the best interests of ENA would be served by such 361 removal. 362 363 Section 9. Indemnification 364 ENA shall indemnify, as set forth below, and to the fullest extent to which it is empowered to do 365 so by the Illinois General Not For Profit Corporation Act of 1986, as amended, or any other 366 applicable laws as may from time to time be in effect, any person who, by reason of being or 367 having been a director, officer, employee, or agent of ENA, or who is or was serving at the 368 request of ENA as a director, officer, employee, or agent of another corporation, partnership, 369 joint venture, trust, or other enterprise, and who was or is a party or is threatened to be made a 370 party to any threatened, pending, or completed action, suit, or proceeding. 371 372 ARTICLE VII 373 CHIEF STAFF OFFICER
9/26/2018 Emergency Nurses Association Page 7 of 14 Back to Top 374 The administrative and day-to-day operation of ENA shall be the responsibility of a salaried staff 375 head or firm employed or appointed by, and responsible to, the Board of Directors. The salaried 376 staff head or, in the case of a firm, chief staff officer retained by the firm shall have such title as 377 shall be determined by the Board of Directors and shall be referred to in these bylaws as the 378 “Chief Staff Officer”. The Chief Staff Officer shall have the authority to execute contracts on 379 behalf of ENA and as approved by the Board of Directors. The Chief Staff Officer may carry out 380 such other duties as may be specified by the Board of Directors. The Chief Staff Officer (or firm, 381 as applicable) shall employ and may terminate the employment of staff necessary to carry out 382 the work of ENA. The Chief Staff Officer shall serve as a non-voting ex officio member of the 383 Board of Directors. 384 385 ARTICLE VIII 386 CONSTITUENT DIVISIONS 387 Section 1. State Councils 388 Voting Members of ENA who are licensed or reside within a particular state, commonwealth, 389 federal district, territory or possession of the United States (the “territory”) may be organized as 390 a constituent of ENA (each of which is referred to as a “State Council”). The Board of Directors 391 may authorize the establishment of State Councils which shall: 392 i. be organized and operated in accordance with these Bylaws, and such additional rules, 393 regulations and policies as may be adopted by the Board of Directors from time to time; 394 ii. fulfill criteria for affiliation as may be established by the Board of Directors from time to 395 time; 396 iii. enter into charter agreements with ENA, as determined by ENA; 397 iv. be issued a charter by ENA; and 398 v. organize and conduct their activities in such a manner as to establish its fundamental 399 alignment and functional compatibility with ENA. 400 401 A State Council’s general purposes and objectives shall be complementary and consistent, on a 402 local basis within its territory, with those of ENA and the State Council will advance the general 403 and specific purposes of ENA within its territory. All members of a State Council must be 404 members of ENA in good standing.
405 Section 2. Application for Recognition as a State Council 406 The Board of Directors, or its designee(s) shall adopt an application form and procedures to 407 facilitate the consideration of applicants seeking to be organized as a State Council. All 408 applicants must complete the application form and submit the application, along with the 409 designated fee, if any, to ENA’s administrative office. The Board of Directors or its designee(s), 410 shall review the application of all applicants and determine, based on the criteria set forth in 411 these bylaws and such other guidelines as the Board of Directors may prescribe, if applicants 412 meet the qualifications necessary for recognition as a State Council. 413 A. Charters for the operation of State Councils may be revoked by the Board of Directors 414 according to due process procedures established by the Board of Directors. Upon 415 revocation of a State Council’s charter, the State Council immediately shall remit all of its 416 funds (after satisfying any existing debts or obligations) and records to ENA national office. 417 B. No State Council or other entity shall use ENA’s name or trademarks in any manner 418 whatsoever unless duly authorized to do so by ENA pursuant to the terms of a written 419 agreement or policy. 420 C. ENA shall fund chartered State Councils pursuant to a formula determined by the Board of 421 Directors based on the State Council’s membership. 422 D. Each State Council shall be incorporated as a not-for-profit corporation, have a Board of 423 Directors, officers and bylaws in such form as shall be approved by the Board of Directors or 424 its designee(s). State Councils must maintain voting membership categories and criteria that 425 are identical to ENA’s. Any changes to a State Council’s bylaws require the prior written 426 approval of the Board of Directors, or its designees(s).
9/26/2018 Emergency Nurses Association Page 8 of 14 Back to Top 427 E. Each State Council may hold such meetings as it deems appropriate. 428 F. Members may belong to only one State Council. 429 G. A member of a State Council may transfer to another State Council by written request to 430 ENA.
431 Section 3. Local Chapters 432 Voting members of the same State Council that are licensed or reside within the same local 433 geographical territory may be organized as a local chapter by the State Council and each such 434 local chapter will be an integral part of such State Council (i.e., it shall operate and function as a 435 committee or special interest group of the State Council) (each of which is referred to as a 436 “Local Chapter”). The name, boundaries, eligibility requirements for Local Chapters, and policies 437 and procedures governing their operations, shall be determined by the State Council, subject to 438 the prior written approval of the Board of Directors, and such rules and policies as may be 439 adopted by the Board of Directors from time to time. A State Council is responsible for 440 overseeing and managing the activities of its Local Chapters and shall have the right to disband 441 or dissolve any Local Chapter it creates, with appropriate due cause. 442 443 ARTICLE IX 444 COMMITTEES 445 Section 1. Committees 446 ENA shall have committees appointed by the Board of Directors in sufficient numbers necessary 447 to address mission objectives, and positions of ENA. The President or an appointed board 448 liaison, as well as the Chief Staff Officer, shall serve as non-voting members of all committees, 449 except the Nominations and Elections Committee or as otherwise set forth below. 450 451 Section 2. Standing Committees 452 A. Executive Committee. 453 i. The Executive Committee shall consist of the President, President-Elect, and the 454 Secretary/Treasurer. The Chief Staff Officer shall be invited to attend and participate in 455 all meetings, without vote, of the Executive Committee, except those held in executive 456 session. The President shall serve as the chair of the Executive Committee. 457 ii. The Executive Committee shall have the authority to perform the business and functions 458 of the Board of Directors in between meetings of the Board of Directors, except as 459 otherwise set forth in these bylaws or Illinois General Not for Profit Corporation Act of 460 1986, as amended, reporting to the Board of Directors any action taken; but the 461 delegation of authority to the Executive Committee shall not operate to relieve the Board 462 of Directors or any individual officer or member of the Board of Directors of any 463 responsibility imposed by law. 464 iii. The Executive Committee shall meet in person or by conference call upon the request of 465 the chair or a majority of the Executive Committee. Each member shall have one (1) 466 vote. Two (2) members of the Executive Committee shall constitute a quorum for the 467 transaction of business at any duly called meeting of the Executive Committee; provided 468 when less than a quorum is present at said meeting, a majority of the members present 469 may adjourn the meeting without further notice. The act of a majority of the members 470 present at a duly called meeting at which a quorum is present shall be the act of the 471 Executive Committee. 472 iv. Any action requiring a vote of the Executive Committee may be taken without a meeting 473 if consent, setting forth the action taken, is approved by all the members of the Executive 474 Committee entitled to vote with respect to the subject matter thereof.
475 B. Other Standing Committees. 476 The Board of Directors may establish other standing committees to support ENA’s purposes. 477 Such committees shall include, at a minimum, a Finance Committee, Resolutions 478 Committee, and Nominations and Elections Committee. If a standing committee has the
9/26/2018 Emergency Nurses Association Page 9 of 14 Back to Top 479 authority of the Board of Directors, a majority of its members must be comprised of 480 Directors. Except otherwise set forth in these bylaws: the action establishing a standing 481 committee shall set forth the committee’s purpose, authority and required qualifications for 482 membership on the committee; 483 i. the Board of Directors, or its designee(s), shall determine the composition of ENA’s 484 standing committee; 485 ii. at all meetings of any standing committee, a majority of the members thereof shall 486 constitute a quorum for the transaction of business; 487 iii. a majority vote by committee members present and voting at a meeting at which a 488 quorum is present shall be required for any action; 489 iv. vacancies in the membership of a standing committee shall be filled by appointments 490 made in the same manner as the original appointments to that committee; 491 v. the Board of Directors or its designee(s) shall develop and approve policies and 492 procedures for the operation of all standing committees. All such policies shall be subject 493 to the approval of the Board of Directors; and 494 vi. all standing committees shall report to the Board of Directors. 495 496 Finance Committee. 497 1. The Finance Committee shall be composed of the President, the President-Elect, the 498 Secretary/Treasurer and the immediate past president. The Chief Staff Officer shall 499 serve as a nonvoting ex-officio member. 500 2. The Finance Committee shall: 501 a. Oversee the financial planning and management of ENA by ensuring that all fiscal 502 aspects are in order; 503 b. Oversee the independence of ENA’s audit functions and its compliance with legal 504 and ethical standards; 505 c. Oversee investment of funds; and 506 d. Make fiscal recommendations to the Board of Directors. 507 508 Resolutions Committee. 509 1. The Resolutions Committee shall be composed of six members serving three-year 510 terms, two appointed each year by the ENA President-Elect and ratified by the Board of 511 Directors. The committee chairperson shall be appointed by the President-Elect and 512 ratified by the Board of Directors from among the continuing members on the 513 committee. The terms shall be staggered and shall commence at the adjournment of 514 the General Assembly meeting following appointment. 515 2. The Resolutions Committee shall solicit, review, and present resolutions and proposed 516 bylaws amendments to the General Assembly. 517 518 Nominations and Elections Committee. 519 1. Composition 520 a. The Nominations and Elections Committee shall consist of the Immediate Past 521 President and seven Voting Members electedappointed to serve on the Nominations 522 and Elections Committee in the ENA national election: one member from each of six 523 regions who has not previously served onby the Board of Directors, and one member 524 who has served on the Board of Directors. Nominations and Elections Committee 525 members may only represent the region in which they hold a voting membership. 526 527 b. The six regions shall be established by Nominations and Elections Committee policy. 528 Each region shall be composed of states with geographic proximity and relatively 529 equal membership distribution. 530 c. A Nominations and Elections Committee chairperson shall be elected each year by 531 The Immediate Past President shall serve as the chair of the incoming Nominations 532 and Elections Committee.
9/26/2018 Emergency Nurses Association Page 10 of 14 Back to Top 533 2. Qualifications 534 a. CandidatesMembers of the Nominations and Elections Committee must be a Voting 535 MemberMembers in good standing and must have been a Voting Member during 536 each of the previous five years immediately prior to submitting their candidate 537 application. 538 b. CandidatesMembers of the Nominations and Elections Committee shall have served 539 in an elected or committee position on the local, state or national level within the 540 previous five years. 541 c. CandidatesMembers of the Nominations and Elections Committee must also have 542 attended at least one ENA General Assembly within the previous three years. 543 d. Members of the Nominations and Elections Committee may not run for or serve in 544 any ENA board position during their tenure on the Nominations and Elections 545 Committee, (with the exception of the Immediate Past President) and may not serve 546 more than two consecutive elected terms on the Nominations and Elections 547 Committee. 548 3. Elections 549 3. Term 550 a. Elections forAppointed members of the Nominations and Elections Committee shall 551 be held annually. Members shall serve for a three-year terms with terms beginning 552 January 1 and ending on December 31, or until such time as their successors are 553 duly elected, qualifiedappointed and take office. Voting MembersThe Immediate Past 554 President shall be elected to serve on the Nominations and Elections Committee 555 each yeara one-year term, or until such time as their successor takes office. 556 557 b. All Voting Members shall have the opportunity to electIn order to provide for 558 staggered terms, at least two and no more than three members of the Nominations 559 and Elections Committee members by ballot from all regions. Candidates receiving 560 the highest number of votes shall be declared elected. In the event of a tie vote for a 561 position on the committee, lots shall be drawn.shall be appointed each year. 562 4. Overview 563 a. The Nominations and Elections Committee has general oversight of the national 564 election’s key purpose is candidate recruitment, selection and development. The 565 Nominations and Elections Committee shall solicit and mentor potential candidates 566 and review national candidate applications in accordance with procedures adopted 567 by the Board of Directors. 568 569 b. The Nominations and Elections Committee is responsible for vetting candidates 570 based on competencies, key criteria and a formal interview process in accordance 571 with procedures adopted by the Board of Directors. 572 c. The Nominations and Elections Committee will provide periodic updates to the Board 573 of Directors regarding the progress of their charges. 574 cd. The Nominations and Elections Committee shall present a qualified slate of 575 candidates to the Board of Directors for its review and discussionapproval prior to 576 presenting the slate to the membership. Following such review and 577 discussionapproval, the Nominations and Elections Committee shall present the 578 slate to the membership through publication in such ENA publications as determined 579 by the Board of Directors or its designee(s). 580 5. Vacancies 581 a. A vacancy in the chairperson position shall be filled by a majority vote of the 582 Nominations and Elections CommitteeBoard of Directors. 583 b. A vacancy of a committee member shall be filled by the candidate who received the 584 next highest number of votes from that region or as the past board member in the 585 most recently completed election. 586 c. In the event of a committee member vacancy from an uncontested election, a 587 qualified candidate must be nominated and elected by the state council presidents of
9/26/2018 Emergency Nurses Association Page 11 of 14 Back to Top 588 the region affected by the vacancy according to the Nominations and Elections 589 Committee election process, meeting the same requirements set forth in the bylaws 590 as any potential candidate. 591 d. TheBoard of Directors, provided, however, a committee position may, in the 592 discretion of the Board of Directors, remain vacant as approved by the Nominations 593 and Elections Committee if less than six months remain of the unexpired term. 594 595 ARTICLE X 596 DISSOLUTION 597 In the event of dissolution of ENA, the net assets of the corporation shall be applied and all 598 liabilities and obligations shall be paid, satisfied, and discharged, or adequate provision shall be 599 made thereof. After payment of all liabilities and obligations, all remaining assets shall be 600 distributed to an organization or organizations organized and operated exclusively for charitable, 601 educational, scholastic or scientific purposes as shall at the time qualify as tax exempt under 602 Sections 501(c)(3) of the Internal Revenue Code of 1986, as amended (or the corresponding 603 provision of any future United States Internal Revenue Law). 604 605 ARTICLE XI 606 FINANCE 607 Section 1. Contracts 608 The Board of Directors may authorize any officer or officers, agent or agents of ENA, in addition 609 to the officers so authorized by these bylaws, to enter into any contract or execute and deliver 610 any instrument in the name of and on behalf of ENA, and such authority may be general or 611 confined to specific instances. 612 613 Section 2. Payment of Indebtedness 614 All checks, drafts or other orders for the payment of money, notes or other evidences of 615 indebtedness issued in the name of ENA shall be signed by such officer or officers, agent or 616 agents of ENA and in such manner as shall from time to time be determined by resolution of the 617 Board of Directors. In the absence of such determination by the Board of Directors, such 618 instruments shall be signed by the Secretary/Treasurer and countersigned by the President. 619 620 Section 3. Deposits 621 All of ENA’s funds shall be deposited to the credit of ENA in such banks, trust companies, or 622 other depositaries as the Board of Directors may select. 623 624 Section 4. Bonding 625 The Board of Directors shall provide for the bonding of such officers and employees of ENA as it 626 may from time to time determine. 627 628 Section 5. Gifts 629 The Board of Directors may accept on behalf of ENA any contribution, gift, bequest or devise for 630 ENA’s general purposes or for any special purpose. 631 632 Section 6. Books and Records 633 ENA shall keep correct and complete books and records of account and shall also keep minutes 634 of the proceedings of the Board of Directors. The books and accounts of ENA shall be audited 635 annually by accountants selected by the Board of Directors. 636 637 Section 7. Fiscal Year 638 ENA’s fiscal year shall be determined by the Board of Directors. 639 640 641 ARTICLE XII 642 WAIVER OF NOTICE AND ELECTRONIC COMMUNICATION
9/26/2018 Emergency Nurses Association Page 12 of 14 Back to Top 643 644 Section 1. Waiver of Notice 645 Whenever any notice is required to be given under applicable law, the Articles of Incorporation 646 or these bylaws, waiver thereof in writing signed by the person or persons entitled to such 647 notice, whether before or after the time stated therein, shall be deemed equivalent to the giving 648 of such notice. 649 650 Section 2. Electronic Communication 651 Unless otherwise prohibited by law, (i) any action to be taken or notice delivered under these 652 bylaws may be taken or transmitted by e-mail or other electronic means; and (ii) any action or 653 approval required to be written or in writing may be transmitted or received by e-mail or other 654 electronic means. 655 656 ARTICLE XIII 657 PARLIAMENTARY AUTHORITY 658 The rules contained in the current edition of Robert’s Rules of Order Newly Revised shall 659 govern ENA in all cases to which they are applicable and in which they are not inconsistent with 660 these bylaws and any special rules of order ENA may adopt. 661 662 ARTICLE XIV 663 AMENDMENT 664 Section 1. Proposals 665 Amendments to the bylaws may be proposed by the Board of Directors, state councils or under 666 the signature of ten Voting Members in good standing. Amendments proposed by a State 667 Council or under the signature of ten Voting Members in good standing are subject to the prior 668 review and approval the Board of Directors to assure that proposed amendments (i) are 669 consistent with ENA’s purposes, mission, values and objectives: (ii) have no adverse financial 670 impact on ENA; (ii) do not create inconsistencies or conflicts with other provisions of the bylaws; 671 and (iv) do not conflict with the requirements of ENA’s Articles of Incorporation or federal or 672 state law. Proposed amendments approved or introduced by the Board of Directors (collectively, 673 “Approved Proposals”) will be presented to the General Assembly in accordance with the 674 provisions set forth below in this article XIV. 675 676 Section 2. Submission Deadline 677 Proposed amendments must be submitted to ENA national office at least 120 days prior to the 678 General Assembly. 679 680 Section 3. Notice 681 Notice of all Approved Proposals will be submitted to the membership at least 60 days prior to 682 the General Assembly. Publication of the Approved Proposals in an ENA publication to on the 683 ENA website shall constitute adequate notice. 684 685 Section 4. Vote 686 In order to be adopted , Approved Proposals must be approved by a two-thirds vote of the 687 delegates present and voting at a meeting of the General Assembly. 688
9/26/2018 Emergency Nurses Association Page 13 of 14 Back to Top 1 BYLAWS 2 EMERGENCY NURSES ASSOCIATION 3 4 5 ARTICLE I 6 NAME 7 The name of this organization shall be the Emergency Nurses Association (ENA), a not-for- 8 profit corporation incorporated in the State of Illinois. ENA shall have and continuously maintain 9 in the State of Illinois a registered office and a registered agent whose office is identical with 10 such registered office, and may have such other offices within or outside of the State of Illinois 11 as the Board of Directors may determine. 12 13 ARTICLE II 14 OBJECT 15 Section 1. Purpose 16 The purposes for which the corporation is organized are educational, within the meaning of 17 Section 501(c)(3) of the Internal Revenue Code of 1986, as amended (“IRC”), including but not 18 limited to the advancement of emergency nursing through education and public awareness. 19 20 Section 2. Rules 21 The following rules shall conclusively bind ENA and all persons acting for or on behalf of it: 22 A. No part of the net earnings of ENA shall inure to the benefit of, or be distributed to, its 23 directors, officers, committee members or other private persons, except that ENA shall be 24 authorized and empowered to pay reasonable compensation for services rendered and to 25 make payments and distributions in furtherance of the purposes set forth above. 26 B. No substantial part of the activities of ENA shall be the carrying on of propaganda, or 27 otherwise attempting to influence legislation, and ENA shall not participate in, or intervene in 28 (including the publishing or distribution of statements) any political campaign on behalf or in 29 opposition to any candidate for public office. Notwithstanding any provision of these Bylaws, 30 ENA shall not carry on any activity not permitted to be carried on by: 31 i. a corporation exempt from federal income tax under Section 501(c)(3) of the IRC (or the 32 corresponding provision of any future United States Internal Revenue Law); or 33 ii. a corporation, contributions to which are deductible under Section 170(c)(2) of the IRC 34 (or the corresponding provision of any future United States Internal Revenue Law). 35 36 Section 3. Official Publication 37 The official publication shall be the Journal of Emergency Nursing (JEN), which shall reflect the 38 purpose, mission objectives and positions of ENA. 39 40 ARTICLE III 41 MEMBERS 42 Section 1. Responsibilities of Membership 43 Each member has the responsibility to support the purpose, mission, vision, values and 44 objectives of ENA. 45 46 Section 2. Classifications and Criteria. Membership may be granted to any individual who (i) 47 abides by these bylaws, the ENA Code of Ethics, and such other policies, rules and regulations 48 as ENA may adopt; and (ii) meets the criteria for membership set forth in one of the following 49 categories: 50 A. Voting Members – voting members shall be classified as national, international, senior and 51 military (“Voting Members”). Voting Members shall have the right to vote, hold elected office, 52 serve on the Board of Directors, serve on committees, and attend ENA’s meetings and 53 social functions. 54 1. National membership may be granted to any individual who is a professional registered 55 nurse licensed in the United States or its territories.
9/26/2018 Emergency Nurses Association Page 1 of 12 Back to Top 56 2. International membership may be granted to any individual who is a professional 57 registered nurse licensed (or the equivalent thereto) outside of the United States or its 58 territories. 59 3. Senior membership may be granted to a professional registered nurse who is age 65 or 60 older and licensed in the United States or its territories. 61 4. Military membership may be granted to a professional registered nurse licensed in the 62 United States or its territories who is currently serving or has been honorably discharged 63 or retired from the United States Armed Forces including Army, Navy, Marine Corps, Air 64 Force, Coast Guard, and Reserve Components. 65 B. Nonvoting Members – nonvoting members shall be classified as affiliate, student and 66 honorary (“Nonvoting Members”). Nonvoting Members shall be entitled to serve on ENA 67 committees and attend ENA member meetings and social functions. 68 1. Affiliate membership may be granted to any individual who shares interest in and 69 supports the purpose, mission and objectives of ENA but does not otherwise meet the 70 criteria for voting membership in ENA. 71 2. Student membership may be granted to any individual enrolled in a primary nursing 72 education program leading to eligibility for licensure as a professional registered nurse. 73 3. Honorary membership may be awarded to an individual meeting such criteria as shall be 74 determined by the president and the Board of Directors. 75 76 Section 3. Dues and Finance 77 A. The initial and annual dues for all ENA members and the time for paying such dues, and 78 other assessments, if any, shall be determined by the Board of Directors. Under special 79 circumstances, the Board of Directors, or its designee(s), may waive the annual dues and/or 80 assessments for any member or category of members. 81 B. The membership of any member who is in default of payment of dues or assessments for 82 more than three (3) months, or otherwise becomes ineligible for membership, shall be 83 terminated automatically, according to such rules or procedures as the Board of Directors or 84 its designee(s) shall establish, unless such termination is delayed by the Board of Directors 85 or its designee(s). 86 C. Members who have resigned or been terminated for non-payment of dues may only be 87 reinstated (i) if no more than three (3) months has elapsed since the date of termination; (ii) 88 upon payment of delinquent dues; and (iii) in accordance with such rules as may from time 89 to time be established by the Board of Directors. Former members not meeting the 90 requirements for reinstatement must reapply for membership. 91 D. Each state council and chapter shall receive an annual allocation for each dues paying 92 member within the state or chapter. 93 E. A surcharge may be added to the dues in some states by the state’s request. 94 95 Section 4. Disciplinary Action 96 A. Grounds for Discipline. ENA may discipline a member for any of the following reasons: 97 i. Failure to comply with these Bylaws, the ENA Code of Ethics, or any of ENA’s rules or 98 regulations; 99 ii. Conviction of a felony or a crime related to, or arising out of, the practice of nursing or 100 involving moral turpitude; 101 iii. Suspension, revocation, or forfeiture by any state, province, or country of the member’s 102 right to practice as a nurse; or 103 iv. Immoral, dishonorable, or unprofessional conduct considered prejudicial to the best 104 interests of, or inconsistent with, the purposes of ENA. 105 B. Procedures. Discipline may include, but not be limited to, censure, suspension, 106 probation, and expulsion. Disciplinary action may be taken provided that a statement of 107 the charges shall have been sent by certified mail to the last recorded address of the 108 member at least fifteen (15) days before final action is to be taken. This statement shall 109 be accompanied by a notice of the time and place of the meeting at which the charges 110 shall be considered, and the member shall have the opportunity to appear in person
9/26/2018 Emergency Nurses Association Page 2 of 12 Back to Top 111 and/or to be represented by counsel and to present any defense to such charges before 112 action is taken by ENA. Such disciplinary actions shall be conducted in accordance with 113 such additional procedures as may be established by the Board of Directors. 114 115 ARTICLE IV 116 OFFICERS 117 Section 1. Officers 118 A. There shall be three officers: President, President-Elect, and Secretary/treasurer. The term 119 of office shall commence January 1 each year and terminate on December 31, or until such 120 time as their successors are duly elected, qualified and take office. The President-Elect shall 121 succeed to the office of president at the conclusion of the term. Officers shall exercise the 122 duties and responsibilities required of a member of the Board of Directors and such 123 additional duties and responsibilities set forth below. 124 B. President. The President shall be ENA’s principal elected officer and shall, in general, 125 supervise ENA’s business affairs, subject to the direction and control of the Board of 126 Directors, by communicating with the Chief Staff Officer as necessary regarding ENA’s 127 business. The President shall be a member, without vote, of all councils and committees 128 with the exception of the Nominations and Elections Committee and except as otherwise 129 provided by these bylaws. The President shall (i) serve as the Chair of the Finance 130 Committee; (ii) serve as ENA’s official representative and spokesperson, except as 131 otherwise provided by the Board of Directors; (iii) appoint representatives to ENA’s affiliated 132 organizations and other positions as necessary; (iv) fill, subject to the approval of the Board 133 of Directors, vacancies on ENA’s committees; and (v) in general, perform all duties 134 customarily incident to the office of President and such other duties as may be prescribed by 135 the Board of Directors. The President shall succeed to the office of immediate past president 136 upon expiration of the President’s term of office. 137 C. President-Elect. The President-Elect shall assist the President and shall substitute for the 138 President when required. The President-Elect shall appoint chairs and members of 139 committees, and a Board of Directors liaison to each committee for the year following his/her 140 term in office as President-Elect subject to Board approval and shall in general, perform all 141 duties customarily incident to the office of President-Elect and such other duties as may be 142 prescribed by the Board of Directors. The President-Elect shall succeed to the office of 143 President upon expiration of the President’s term of office, or in the event of the death, 144 resignation, removal, or incapacity of the President. 145 D. Secretary/Treasurer. The Secretary/Treasurer shall be the principal financial officer and 146 secretary of ENA and shall perform all duties traditionally incident to the offices of Secretary 147 and Treasurer and such other duties as may be assigned by the President or the Board of 148 Directors. The duties of the Secretary/Treasurer may be assigned by the Board of Directors 149 in whole or in part to the Chief Staff Officer, or his or her designee(s). 150 151 Section 2. Officer Qualifications 152 A. Each officer must be a Voting Member and must have been a Voting Member during each of 153 the previous five years immediately prior to submitting a candidate application. 154 B. Each candidate for President-Elect and Secretary/Treasurer must currently serve as a voting 155 member of the Board of Directors. 156 C. Each candidate must submit to, and pass as acceptable, a limited background check. 157 158 Section 3. Election 159 A. In the event of a tie vote for the positions of President-Elect and Secretary/Treasurer, there 160 shall be a second balloting of ENA membership. 161 B. All directors who are elected as officers shall have their unexpired terms of office filled by 162 the candidates who receive the next highest number of votes; the candidate receiving the 163 highest number of votes shall receive the position with the longest term. 164 C. A candidate for an officer position who is not elected shall continue to serve the remaining 165 unexpired years of the original term as a director.
9/26/2018 Emergency Nurses Association Page 3 of 12 Back to Top 166 167 Section 4. Vacancies 168 A. If the office of President becomes vacant, the President-Elect shall succeed to the office of 169 President for the unexpired term and shall subsequently serve the one-year term of office of 170 President to which elected. In such case, the immediate past president may remain as 171 immediate past president for a second year or the office may remain vacant for that year. 172 B. A vacancy in the office of President-Elect may be filled by a current member of the Board of 173 Directors, or remain vacant as approved by a majority vote of the Board of Directors. If the 174 vacancy is filled, the President-Elect shall not automatically assume the office of president 175 for the subsequent term. 176 C. In the event that the office of President and President-Elect are vacated during the same 177 year, the Board of Directors shall appoint an acting president to serve until the next 178 scheduled election, at which time an election will be held for both President and President- 179 Elect. 180 D. A vacancy in the office of Secretary/Treasurer may be filled by a current member of the 181 Board of Directors or remain vacant as approved by a majority vote by the entire Board of 182 Directors. 183 184 ARTICLE V 185 MEETINGS 186 Section 1. General Assembly 187 A. The General Assembly shall be composed of delegates from states territories, federal 188 districts, and international delegates representing the international members. 189 B. All Delegates, Alternates, International Delegates, and the International Alternate must be 190 Voting Members of ENA in good standing. ENA’s officers and directors may not serve as 191 Delegates, Alternates, International Delegates or the International Alternate. 192 C. The General Assembly shall be composed of 700 delegates apportioned as follows: 193 1. Neither the state nor international membership shall be allocated fewer than two 194 delegates, one of whom shall serve as captain. 195 2. In addition to the voting delegates, there shall be one nonvoting alternate delegate. 196 3. The remaining delegates will be allocated to the: 197 a. states based on the percentage the state’s membership is to the national 198 membership, as determined annually as outlined in procedures; and 199 b. international membership based on the percentage the international membership is to 200 the national membership, as determined annually as outlined in procedures. 201 D. International delegates will be selected by a point system developed by the board of 202 directors; the system will be administered and overseen by the ENA national office. The 203 members receiving the highest number of points will be selected. 204 E. In addition to the delegate and international allocation, ENA past presidents who are Voting 205 Members of ENA in good standing may attend, speak and vote at General Assembly 206 (except as otherwise set forth below). 207 F. Members of the Board of Directors, including Past Presidents serving on the Board, may 208 attend and speak at all meetings of the General Assembly but may not vote. 209 210 Section 2. Authority 211 The General Assembly is responsible for communicating member needs, providing feedback, 212 and input on issues relating to the practice of emergency nursing to the Board of Directors. The 213 General Assembly shall also approve, revise, or amend these bylaws in accordance with Article 214 XIV, and receive reports of the Board of Directors, committees and other volunteer groups, 215 receive reports of the findings of the annual financial audit, and transact such other appropriate 216 business as may properly come before the meeting. 217 218 Section 3. Quorum 219 The presence of a majority of the total voting delegates who have completed credentialing 220 procedures shall constitute a quorum for the transaction of business at any duly called session
9/26/2018 Emergency Nurses Association Page 4 of 12 Back to Top 221 of the General Assembly. 222 223 Section 4. Annual Meeting and Special Meetings of the Voting Members 224 A. The annual meeting of ENA’s Voting Members (“Annual Meeting”) will be held in 225 conjunction with the General Assembly. 226 B. Special meetings of ENA’s Voting Members may be called (i) at the request of the 227 President or any five (5) members of the Board of Directors; (ii) at the written request 228 of two- thirds (2/3) of ENA’s Voting Members; or (iii) by resolution of the ENA board of 229 directors. 230 C. Notice of any annual or special meeting of the Voting Members shall state the time, date, 231 place, and purpose of the meeting, and shall be delivered not more than sixty (60) and not 232 less than thirty (30) days prior to the date of such meeting, unless otherwise required by 233 applicable law. 234 D. The lesser of (i) ten percent (10%) of ENA’s eligible Voting Members; or (ii) one 235 hundred (100) eligible voting members shall constitute a quorum for the transaction of 236 business at any duly called meeting of the Voting Members, provided that if less than a 237 quorum is present, a majority of the Voting Members present may adjourn the meeting to 238 another time without further notice. 239 E. The act of a majority or more of the Voting Members present (in person or by proxy) at a 240 duly called meeting at which a quorum is present shall be the act of the Voting Members, 241 unless the act of a greater number is required by law, the Articles of Incorporation, or these 242 bylaws. 243 F. Mail/Electronic Voting. Voting by mail or electronic means shall be permitted to the full 244 extent permitted by the Illinois General Not For Profit Corporation Act of 1986, as 245 amended (the “Act”), for any item of business properly coming before the Voting 246 Members. A mail or electronic vote of the Voting Members may be called by the Board of 247 Directors. 248 249 ARTICLE VI 250 BOARD OF DIRECTORS 251 Section 1. Composition 252 The Board of Directors shall be composed of the following: three officers, seven directors, the 253 immediate past president serving as an ex-officio member for one year, and the Chief Staff 254 Officer serving as a non-voting ex officio member. No member may run for more than one 255 nationally elected position at a time. No member may hold more than one nationally elected 256 position at a time. 257 258 Section 2. Authority 259 The Board of Directors is ENA’s official governing body and is responsible for the management 260 of ENA’s affairs and shall have supervision, control and direction of ENA. To that end, it shall: 261 • Perform all duties entrusted to officers and directors of a corporation; 262 • Debate and determine ENA policy; 263 • Oversee ENA’s business and financial affairs; 264 • Determine ENA’s policies in accordance with these bylaws; 265 • Have discretion in the disbursement of ENA’s funds; 266 • Adopt such rules and regulations for the conduct of its business as it shall deem 267 advisable; 268 • Appoint such agents as it may consider necessary; 269 • Provide direction to and control over all ENA’s committees, unless specifically provided 270 otherwise in these bylaws; 271 • Provide strategic direction for ENA; and 272 • Provide leadership for all of the component divisions of ENA. 273 274 Section 3. Qualifications
9/26/2018 Emergency Nurses Association Page 5 of 12 Back to Top 275 A. Directors must be a Voting Member in good standing and must have been a Voting Member 276 in good standing during each of the previous five years immediately prior to submitting a 277 candidate application. 278 B. Candidates must have attended at least one ENA General Assembly within the previous 279 three years. 280 C. Each candidate must submit to, and pass as acceptable, a limited background check. 281 D. Candidates shall have served in an elected or committee position on the local, state or 282 national level within the previous five years. 283 284 Section 4. Term of Office / Term Limits 285 A. Directors shall serve for a three-year term of office, or until such time as their successors are 286 duly elected, qualified and take office. In order to provide for staggered terms, at least two 287 and no more than three directors shall be elected each year. The term of office shall 288 commence on January 1 each year following the election and terminate on December 31. 289 B. The Immediate Past President shall serve a one-year term in office, or until such time as 290 their successor takes office. 291 C. No director may serve on the Board of Directors for more than six (6) years, not including 292 any time served to fill a vacancy. 293 D. Notwithstanding anything set forth herein to the contrary (i) a director elected to serve as an 294 officer may remain on the Board until the conclusion of their term in such office and may 295 complete their rotation through the offices (i.e., President-Elect to President to Immediate 296 Past President) despite the fact that such person may have served on the Board for the 297 maximum number of years; and (ii) a director completing their sixth year as a director is 298 eligible to run for an officer position. 299 300 Section 5. Elections 301 Elections shall be held annually. All Voting Members shall have the opportunity to elect officers 302 and directors by ballot. Balloting may be by electronic means. Candidates receiving the highest 303 number of votes for each position shall be declared elected. In the event of a tie for the director 304 positions, lots shall be drawn. 305 306 Section 6. Meetings of the Board of Directors 307 A. Regular meetings of the board shall be held at least quarterly as determined by the board. 308 At least ten days’ notice shall be given to all members of the board. 309 B. Special meetings shall be held as called by the President or any three members of the 310 board. At least three days’ notice shall be given to all members of the board. 311 C. Meetings may be held in person or by electronic means, provided that all participants can 312 hear and speak to one another at the same time. 313 D. A majority of the voting members of the Board of Directors shall constitute a quorum for all 314 meetings. All decisions of the Board of Directors require an affirmative vote of a majority of 315 the Board of Directors present and voting at a meeting at which a quorum is present. 316 E. Voting members of Board of Directors (including the President) have the right and 317 responsibility to actively participate in board meetings by making motions, speaking in 318 debate and voting (unless precluded by a conflict of interest, as determined in accordance 319 with ENA’s conflict of interest policy). 320 F. Any action requiring a vote of the Board of Directors may be taken without a meeting if a 321 written consent, setting forth the action taken, is approved by all of the members of the 322 Board of Directors entitled to vote with respect to the subject matter thereof. 323 324 Section 7. Vacancy 325 Vacancies that occur in the position of director shall be filled in the following manner: 326 A. Vacancies with twelve (12) or less months remaining in the unexpired portion of the term will 327 not be filled. 328 B. If there is more than twelve (12) months remaining in the unexpired portion of the term and 329 the vacancy occurs:
9/26/2018 Emergency Nurses Association Page 6 of 12 Back to Top 330 (i) after January 1 and prior to the completion of the current year’s election, the 331 vacancy shall be filled by the person that received the next highest number of votes (after 332 the elected directors) in the previous year’s election; 333 (ii) after the current year’s election, the vacancy shall be filled by the person that 334 received the next highest number of votes (after the elected directors) in the current year’s 335 election; or 336 (iii) due to the election of such director as an officer, the vacancy will be filled in 337 the current year’s election for the unexpired balance of the term they were originally 338 elected to fill by the person that received the next highest number of votes (after the 339 elected directors) in the current year’s election. 340 341 C. In the event (i) all such persons decline to serve, or (ii) there were no additional 342 candidates for that office during the most recently concluded election the vacancy shall 343 not be filled. 344 345 D. Directors elected to fill a vacancy shall hold office for the balance of the term they are 346 filling or until such time as their successor is duly elected, qualified and takes office. 347 348 Section 8. Resignation and Removal 349 Any director may resign at any time by giving written notice to the President. Any member of the 350 Board of Directors may be removed in accordance with the provisions of law and the Illinois 351 General Not For Profit Corporation Act of 1986, as amended, by the persons entitled to elect 352 such director, whenever, in their judgment, the best interests of ENA would be served by such 353 removal. 354 355 Section 9. Indemnification 356 ENA shall indemnify, as set forth below, and to the fullest extent to which it is empowered to do 357 so by the Illinois General Not For Profit Corporation Act of 1986, as amended, or any other 358 applicable laws as may from time to time be in effect, any person who, by reason of being or 359 having been a director, officer, employee, or agent of ENA, or who is or was serving at the 360 request of ENA as a director, officer, employee, or agent of another corporation, partnership, 361 joint venture, trust, or other enterprise, and who was or is a party or is threatened to be made a 362 party to any threatened, pending, or completed action, suit, or proceeding. 363 364 ARTICLE VII 365 CHIEF STAFF OFFICER 366 The administrative and day-to-day operation of ENA shall be the responsibility of a salaried staff 367 head or firm employed or appointed by, and responsible to, the Board of Directors. The salaried 368 staff head or, in the case of a firm, chief staff officer retained by the firm shall have such title as 369 shall be determined by the Board of Directors and shall be referred to in these bylaws as the 370 “Chief Staff Officer”. The Chief Staff Officer shall have the authority to execute contracts on 371 behalf of ENA and as approved by the Board of Directors. The Chief Staff Officer may carry out 372 such other duties as may be specified by the Board of Directors. The Chief Staff Officer (or firm, 373 as applicable) shall employ and may terminate the employment of staff necessary to carry out 374 the work of ENA. The Chief Staff Officer shall serve as a non-voting ex officio member of the 375 Board of Directors. 376 377 ARTICLE VIII 378 CONSTITUENT DIVISIONS 379 Section 1. State Councils 380 Voting Members of ENA who are licensed or reside within a particular state, commonwealth, 381 federal district, territory or possession of the United States (the “territory”) may be organized as 382 a constituent of ENA (each of which is referred to as a “State Council”). The Board of Directors 383 may authorize the establishment of State Councils which shall: 384 i. be organized and operated in accordance with these Bylaws, and such additional rules,
9/26/2018 Emergency Nurses Association Page 7 of 12 Back to Top 385 regulations and policies as may be adopted by the Board of Directors from time to time; 386 ii. fulfill criteria for affiliation as may be established by the Board of Directors from time to 387 time; 388 iii. enter into charter agreements with ENA, as determined by ENA; 389 iv. be issued a charter by ENA; and 390 v. organize and conduct their activities in such a manner as to establish its fundamental 391 alignment and functional compatibility with ENA. 392 393 A State Council’s general purposes and objectives shall be complementary and consistent, on a 394 local basis within its territory, with those of ENA and the State Council will advance the general 395 and specific purposes of ENA within its territory. All members of a State Council must be 396 members of ENA in good standing.
397 Section 2. Application for Recognition as a State Council 398 The Board of Directors, or its designee(s) shall adopt an application form and procedures to 399 facilitate the consideration of applicants seeking to be organized as a State Council. All 400 applicants must complete the application form and submit the application, along with the 401 designated fee, if any, to ENA’s administrative office. The Board of Directors or its designee(s), 402 shall review the application of all applicants and determine, based on the criteria set forth in 403 these bylaws and such other guidelines as the Board of Directors may prescribe, if applicants 404 meet the qualifications necessary for recognition as a State Council. 405 A. Charters for the operation of State Councils may be revoked by the Board of Directors 406 according to due process procedures established by the Board of Directors. Upon 407 revocation of a State Council’s charter, the State Council immediately shall remit all of its 408 funds (after satisfying any existing debts or obligations) and records to ENA national office. 409 B. No State Council or other entity shall use ENA’s name or trademarks in any manner 410 whatsoever unless duly authorized to do so by ENA pursuant to the terms of a written 411 agreement or policy. 412 C. ENA shall fund chartered State Councils pursuant to a formula determined by the Board of 413 Directors based on the State Council’s membership. 414 D. Each State Council shall be incorporated as a not-for-profit corporation, have a Board of 415 Directors, officers and bylaws in such form as shall be approved by the Board of Directors or 416 its designee(s). State Councils must maintain voting membership categories and criteria that 417 are identical to ENA’s. Any changes to a State Council’s bylaws require the prior written 418 approval of the Board of Directors, or its designees(s). 419 E. Each State Council may hold such meetings as it deems appropriate. 420 F. Members may belong to only one State Council. 421 G. A member of a State Council may transfer to another State Council by written request to 422 ENA.
423 Section 3. Local Chapters 424 Voting members of the same State Council that are licensed or reside within the same local 425 geographical territory may be organized as a local chapter by the State Council and each such 426 local chapter will be an integral part of such State Council (i.e., it shall operate and function as a 427 committee or special interest group of the State Council) (each of which is referred to as a 428 “Local Chapter”). The name, boundaries, eligibility requirements for Local Chapters, and policies 429 and procedures governing their operations, shall be determined by the State Council, subject to 430 the prior written approval of the Board of Directors, and such rules and policies as may be 431 adopted by the Board of Directors from time to time. A State Council is responsible for 432 overseeing and managing the activities of its Local Chapters and shall have the right to disband 433 or dissolve any Local Chapter it creates, with appropriate due cause. 434 435 ARTICLE IX 436 COMMITTEES 437 Section 1. Committees
9/26/2018 Emergency Nurses Association Page 8 of 12 Back to Top 438 ENA shall have committees appointed by the Board of Directors in sufficient numbers necessary 439 to address mission objectives, and positions of ENA. The President or an appointed board 440 liaison, as well as the Chief Staff Officer, shall serve as non-voting members of all committees, 441 except the Nominations and Elections Committee or as otherwise set forth below. 442 443 Section 2. Standing Committees 444 A. Executive Committee. 445 i. The Executive Committee shall consist of the President, President-Elect, and the 446 Secretary/Treasurer. The Chief Staff Officer shall be invited to attend and participate in 447 all meetings, without vote, of the Executive Committee, except those held in executive 448 session. The President shall serve as the chair of the Executive Committee. 449 ii. The Executive Committee shall have the authority to perform the business and functions 450 of the Board of Directors in between meetings of the Board of Directors, except as 451 otherwise set forth in these bylaws or Illinois General Not for Profit Corporation Act of 452 1986, as amended, reporting to the Board of Directors any action taken; but the 453 delegation of authority to the Executive Committee shall not operate to relieve the Board 454 of Directors or any individual officer or member of the Board of Directors of any 455 responsibility imposed by law. 456 iii. The Executive Committee shall meet in person or by conference call upon the request of 457 the chair or a majority of the Executive Committee. Each member shall have one (1) 458 vote. Two (2) members of the Executive Committee shall constitute a quorum for the 459 transaction of business at any duly called meeting of the Executive Committee; provided 460 when less than a quorum is present at said meeting, a majority of the members present 461 may adjourn the meeting without further notice. The act of a majority of the members 462 present at a duly called meeting at which a quorum is present shall be the act of the 463 Executive Committee. 464 iv. Any action requiring a vote of the Executive Committee may be taken without a meeting 465 if consent, setting forth the action taken, is approved by all the members of the Executive 466 Committee entitled to vote with respect to the subject matter thereof.
467 B. Other Standing Committees. 468 The Board of Directors may establish other standing committees to support ENA’s purposes. 469 Such committees shall include, at a minimum, a Finance Committee, Resolutions 470 Committee, and Nominations and Elections Committee. If a standing committee has the 471 authority of the Board of Directors, a majority of its members must be comprised of 472 Directors. Except otherwise set forth in these bylaws: the action establishing a standing 473 committee shall set forth the committee’s purpose, authority and required qualifications for 474 membership on the committee; 475 i. the Board of Directors, or its designee(s), shall determine the composition of ENA’s 476 standing committee; 477 ii. at all meetings of any standing committee, a majority of the members thereof shall 478 constitute a quorum for the transaction of business; 479 iii. a majority vote by committee members present and voting at a meeting at which a 480 quorum is present shall be required for any action; 481 iv. vacancies in the membership of a standing committee shall be filled by appointments 482 made in the same manner as the original appointments to that committee; 483 v. the Board of Directors or its designee(s) shall develop and approve policies and 484 procedures for the operation of all standing committees. All such policies shall be subject 485 to the approval of the Board of Directors; and 486 vi. all standing committees shall report to the Board of Directors. 487 488 Finance Committee. 489 1. The Finance Committee shall be composed of the President, the President-Elect, the 490 Secretary/Treasurer and the immediate past president. The Chief Staff Officer shall 491 serve as a nonvoting ex-officio member.
9/26/2018 Emergency Nurses Association Page 9 of 12 Back to Top 492 2. The Finance Committee shall: 493 a. Oversee the financial planning and management of ENA by ensuring that all fiscal 494 aspects are in order; 495 b. Oversee the independence of ENA’s audit functions and its compliance with legal 496 and ethical standards; 497 c. Oversee investment of funds; and 498 d. Make fiscal recommendations to the Board of Directors. 499 500 Resolutions Committee. 501 1. The Resolutions Committee shall be composed of six members serving three-year 502 terms, two appointed each year by the ENA President-Elect and ratified by the Board of 503 Directors. The committee chairperson shall be appointed by the President-Elect and 504 ratified by the Board of Directors from among the continuing members on the 505 committee. The terms shall be staggered and shall commence at the adjournment of 506 the General Assembly meeting following appointment. 507 2. The Resolutions Committee shall solicit, review, and present resolutions and proposed 508 bylaws amendments to the General Assembly. 509 510 Nominations and Elections Committee. 511 1. Composition 512 a. The Nominations and Elections Committee shall consist of the Immediate Past 513 President and seven Voting Members appointed to serve on the Nominations and 514 Elections Committee by the Board of Directors. 515 b. The Immediate Past President shall serve as the chair of the Nominations and 516 Elections Committee. 517 2. Qualifications 518 a. Members of the Nominations and Elections Committee must be Voting Members in 519 good standing and must have been a Voting Member during each of the previous 520 five years immediately prior to submitting their application. 521 b. Members of the Nominations and Elections Committee shall have served in an 522 elected or committee position on the local, state or national level within the previous 523 five years. 524 c. Members of the Nominations and Elections Committee must also have attended at 525 least one ENA General Assembly within the previous three years. 526 d. Members of the Nominations and Elections Committee may not run for or serve in 527 any ENA board position during their tenure on the Nominations and Elections 528 Committee (with the exception of the Immediate Past President) and may not serve 529 more than two consecutive terms on the Nominations and Elections Committee. 530 3. Term 531 a. Appointed members of the Nominations and Elections Committee shall serve three- 532 year terms with terms beginning January 1 and ending on December 31, or until 533 such time as their successors are appointed and take office. The Immediate Past 534 President shall serve a one-year term, or until such time as their successor takes 535 office. 536 b. In order to provide for staggered terms, at least two and no more than three 537 members of the Nominations and Elections Committee shall be appointed each year. 538 4. Overview 539 a. The Nominations and Elections Committee’s key purpose is candidate recruitment, 540 selection and development. The Nominations and Elections Committee shall solicit 541 and mentor potential candidates and review national candidate applications in 542 accordance with procedures adopted by the Board of Directors. 543 b. The Nominations and Elections Committee is responsible for vetting candidates 544 based on competencies, key criteria and a formal interview process in accordance 545 with procedures adopted by the Board of Directors. 546 c. The Nominations and Elections Committee will provide periodic updates to the Board
9/26/2018 Emergency Nurses Association Page 10 of 12 Back to Top 547 of Directors regarding the progress of their charges. 548 d. The Nominations and Elections Committee shall present a qualified slate of 549 candidates to the Board of Directors for its review and approval prior to presenting 550 the slate to the membership. Following such review and approval, the Nominations 551 and Elections Committee shall present the slate to the membership through 552 publication in such ENA publications as determined by the Board of Directors or its 553 designee(s). 554 5. Vacancies 555 a. A vacancy in the chairperson position shall be filled by the Board of Directors. 556 b. A vacancy of a committee member shall be filled by the Board of Directors, provided, 557 however, a committee position may, in the discretion of the Board of Directors, 558 remain vacant if less than six months remain of the unexpired term. 559 560 ARTICLE X 561 DISSOLUTION 562 In the event of dissolution of ENA, the net assets of the corporation shall be applied and all 563 liabilities and obligations shall be paid, satisfied, and discharged, or adequate provision shall be 564 made thereof. After payment of all liabilities and obligations, all remaining assets shall be 565 distributed to an organization or organizations organized and operated exclusively for charitable, 566 educational, scholastic or scientific purposes as shall at the time qualify as tax exempt under 567 Sections 501(c)(3) of the Internal Revenue Code of 1986, as amended (or the corresponding 568 provision of any future United States Internal Revenue Law). 569 570 ARTICLE XI 571 FINANCE 572 Section 1. Contracts 573 The Board of Directors may authorize any officer or officers, agent or agents of ENA, in addition 574 to the officers so authorized by these bylaws, to enter into any contract or execute and deliver 575 any instrument in the name of and on behalf of ENA, and such authority may be general or 576 confined to specific instances. 577 578 Section 2. Payment of Indebtedness 579 All checks, drafts or other orders for the payment of money, notes or other evidences of 580 indebtedness issued in the name of ENA shall be signed by such officer or officers, agent or 581 agents of ENA and in such manner as shall from time to time be determined by resolution of the 582 Board of Directors. In the absence of such determination by the Board of Directors, such 583 instruments shall be signed by the Secretary/Treasurer and countersigned by the President. 584 585 Section 3. Deposits 586 All of ENA’s funds shall be deposited to the credit of ENA in such banks, trust companies, or 587 other depositaries as the Board of Directors may select. 588 589 Section 4. Bonding 590 The Board of Directors shall provide for the bonding of such officers and employees of ENA as it 591 may from time to time determine. 592 593 Section 5. Gifts 594 The Board of Directors may accept on behalf of ENA any contribution, gift, bequest or devise for 595 ENA’s general purposes or for any special purpose. 596 597 Section 6. Books and Records 598 ENA shall keep correct and complete books and records of account and shall also keep minutes 599 of the proceedings of the Board of Directors. The books and accounts of ENA shall be audited 600 annually by accountants selected by the Board of Directors. 601
9/26/2018 Emergency Nurses Association Page 11 of 12 Back to Top 602 Section 7. Fiscal Year 603 ENA’s fiscal year shall be determined by the Board of Directors. 604 605 606 ARTICLE XII 607 WAIVER OF NOTICE AND ELECTRONIC COMMUNICATION 608 609 Section 1. Waiver of Notice 610 Whenever any notice is required to be given under applicable law, the Articles of Incorporation 611 or these bylaws, waiver thereof in writing signed by the person or persons entitled to such 612 notice, whether before or after the time stated therein, shall be deemed equivalent to the giving 613 of such notice. 614 615 Section 2. Electronic Communication 616 Unless otherwise prohibited by law, (i) any action to be taken or notice delivered under these 617 bylaws may be taken or transmitted by e-mail or other electronic means; and (ii) any action or 618 approval required to be written or in writing may be transmitted or received by e-mail or other 619 electronic means. 620 621 ARTICLE XIII 622 PARLIAMENTARY AUTHORITY 623 The rules contained in the current edition of Robert’s Rules of Order Newly Revised shall 624 govern ENA in all cases to which they are applicable and in which they are not inconsistent with 625 these bylaws and any special rules of order ENA may adopt. 626 627 ARTICLE XIV 628 AMENDMENT 629 Section 1. Proposals 630 Amendments to the bylaws may be proposed by the Board of Directors, state councils or under 631 the signature of ten Voting Members in good standing. Amendments proposed by a State 632 Council or under the signature of ten Voting Members in good standing are subject to the prior 633 review and approval the Board of Directors to assure that proposed amendments (i) are 634 consistent with ENA’s purposes, mission, values and objectives: (ii) have no adverse financial 635 impact on ENA; (ii) do not create inconsistencies or conflicts with other provisions of the bylaws; 636 and (iv) do not conflict with the requirements of ENA’s Articles of Incorporation or federal or 637 state law. Proposed amendments approved or introduced by the Board of Directors (collectively, 638 “Approved Proposals”) will be presented to the General Assembly in accordance with the 639 provisions set forth below in this article XIV. 640 641 Section 2. Submission Deadline 642 Proposed amendments must be submitted to ENA national office at least 120 days prior to the 643 General Assembly. 644 645 Section 3. Notice 646 Notice of all Approved Proposals will be submitted to the membership at least 60 days prior to 647 the General Assembly. Publication of the Approved Proposals in an ENA publication to on the 648 ENA website shall constitute adequate notice. 649 650 Section 4. Vote 651 In order to be adopted , Approved Proposals must be approved by a two-thirds vote of the 652 delegates present and voting at a meeting of the General Assembly. 653
9/26/2018 Emergency Nurses Association Page 12 of 12 Back to Top Resolution GA21-04
1 TITLE: Federal Nurse Practice Act and Licensing in the United States of America 2 Whereas, the COVID-19 pandemic and other large scale disasters with variability in geographic 3 emergency patient volume surges require emergency nursing response across state lines and mutual aid from 4 emergency nurses who are not licensed to practice in the region of need (Aguilera et al., 2020; Bell, 2020; 5 Cuadros et al., 2021); 6 7 Whereas, variations in nurse practice acts and state regulatory interpretations prohibit best-evidence 8 emergency nursing practice in some states (Ballard et al., 2016; Castner & Boris, 2020; Castner et al., 2013); 9 10 Whereas, rapid advances in teletriage and emergency telenursing render many physical state geographic 11 boundaries meaningless to potential pragmatic access to high quality telehealth care (Brown, 2021; Carlberg et 12 al., 2020; Doraiswamy et al., 2020; National Council of State Boards of Nursing, 2021; Rambur et al., 2019); 13 14 Whereas, interstate nursing licensure compacts exist in piecemeal fashion and are not utilized in a 15 systematic regional or multi-regional manner across the country (DePasquale & Stange, 2016; Rambur et al., 16 2019); 17 18 Whereas, travel and agency nursing across states and territories are routinely utilized for emergency 19 nursing workforce vacancy and staffing (Gottleib & Zenilman, 2020); 20 21 Whereas, the post-COVID-19 pandemic recovery period is projected to worsen emergency staffing 22 shortages and create timely urgency and priority for emergency nursing workforce staffing (National Council of 23 State Boards of Nursing, 2021); and 24 25 Whereas, inconsistencies in nurse practice act regulation, prohibitions, and interstate compact 26 participation limit patient access to best-evidence physical and telehealth nursing care in both non-disaster and 27 disaster conditions (DePasquale & Stange, 2016; Rambur et al., 2019). 28 29 Resolved, ENA will explore, with stakeholders (e.g. American Nurses Association, Nursing 30 Organizations Alliance, National Council State Board of Nursing) to determine their stance on federal nursing 31 licensure; and 32 33 Resolved, ENA will continue support furthering of state licensure compacts. 34 35 Resolution Background Information 36 In the United States and U.S. territories, the practice of nursing is defined and regulated by state nurse practice 37 acts. These nurse practice acts with regulatory rules and interpretive statements are designed to codify and 38 specify the legal limits of safe and competent nursing practice. These laws were enacted at the state level 39 beginning in the early 1900’s with substantial variations in expertise, board of nursing composition, amendment 40 processes, and prohibitions. Thus, the practice of nursing evolves at different rates in different states and 41 territories with variations that create a barrier for best-evidence emergency nursing practice. For example, nurse- 42 initiated protocols (also referred to as triage protocols, standing orders, complaint-specific protocols, advanced 43 triage orders, medical directives, and standing triage protocols) enhance the capability to provide timely and life- 44 saving care in the emergency department setting (Castner & Boris, 2020; Douma et al., 2016). However, use of 45 these protocols have been prohibited in the regulatory language of several states, placing emergency nurses in the 46 morally untenable position of providing lifesaving care they are competent to provide or withholding or delaying 47 the care to comply with outmoded state prohibitions on practice (Castner & Boris, 2020; Castner et al., 2013). 48 Emergency nurses are not able to practice to the full extent of their training and education consistently across the 49 United States and territories.
2021 General Assembly Back to Top Resolution GA21-04
50 51 A nursing scope of practice decision tree (Figure 1) was developed by the American Association of Colleges of 52 Nursing (AACN), the American Nurses Association (ANA), the American Organization for Nursing Leadership 53 (AONL), and the National League for Nursing (NLN) with the National Council of State Boards of Nursing 54 (NCSBN) (Ballard et al., 2016). This framework was designed to guide nurses, health care facilities, and boards 55 of nursing in ascertaining whether a particular activity fell within the individual nurse’s scope of practice. As 56 seen in Figure 1, state nurse practice level prohibitions are the foremost and initial constraint placed on 57 determining whether an activity is within a nurse’s scope of practice. Many progressive states have few or no 58 prespecified prohibitions on nursing practice. Instead, they acknowledge that nursing practice and competencies 59 may evolve faster than legal and regulatory activities could or should attempt to match as advanced nurse 60 training, competencies, and ongoing public need for nursing skills or professional care progress (Castner et al., 61 2013). This leaves those states with detailed descriptions of the demarcations of nursing practice or prohibitive 62 language to advance slowly through legal and political processes, rather than at the pace of scientific evidence 63 and nurse competency attainment. These variations and inconsistencies place quality care and patient safety at 64 risk where prohibitions limit nursing practice evolution at the pace of best-evidence intervention that are 65 poignantly relevant to the emergency nursing specialty. Specialties, such as the emergency nursing specialty, add 66 to the scope and standards of the basic registered nursing practice delineated by each state and territory, but there 67 few valid or evidence-based reasons for variations in base nurse practice prohibitions by state (Emergency 68 Nurses Association [ENA], 2017). Rather, reasons for variations appear outmoded and largely political, instead 69 of being based on sound scientific evidence that informs emergency nursing practice advancements. Thus, the 70 highly political nature of state licensing and scope of practice may be a patient safety issue in its own right, 71 limiting quality emergency care and telenursing along state lines. 72 73 The COVID-19 pandemic and other large-scale, multi-state disasters demonstrate a clear public health need for a 74 rapidly mobile emergency nursing workforce across state and territory lines with geographic variation in the 75 surge demands for emergency nursing skill (Aguilera et al., 2020; Bell, 2020; Cuadros et al., 2021; Veenema, 76 2019). While state executive branches and administrators may waive liability and licensing requirements in a 77 state of emergency or disaster, inconsistent nurse scope of practice in each individual nurse’s home state creates 78 an initial barrier to forming novel teams under disaster conditions and providing consistent levels of care. 79 Further, infection control practices during the COVID-19 pandemic resulted in a rapid deregulation, 80 reimbursement, and advanced demand for teletriage and emergency telehealth (Brown, 2021; Carlberg et al., 81 2020; Doraiswamy et al., 2020; National Council of State Boards of Nursing, 2021; Rambur et al., 2019). With 82 the ability to provide nursing care by telehealth in physically distant locations, the geographic boundary divisions 83 created by state-level nurse practice acts become largely meaningless to potential pragmatic access to high- 84 quality telehealth care. Thus, the surge capacity of the emergency nursing workforce is limited by the 85 experiential constraints imposed when the nurse originates from a state with prohibitive language on best- 86 evidence care, the potential delay in obtaining a license in a new geographic state or territory to provide mutual 87 aid, and the capability to provide telehealth to patients outside of the nurse’s state of origin. Not only do these 88 constraints limit disaster surge response, but they also limit the ability to meaningfully respond to non-disaster 89 demand and emergency nursing workforce vacancy and job turnover (Castner et al., in press; Gottleib & 90 Zenilman, 2020; National Council of State Boards of Nursing, 2021).
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91 92 Figure 1 Nursing scope of practice decision tree 93 Source: National Council of State Boards of Nursing. (n.d.). Scope of practice decision-making framework. 94 https://www.ncsbn.org/decision-making-framework.htm 95
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96 The emergency nursing specialty experiences among the highest rates of hospital job vacancy and turnover, 97 compared to other nursing specialties (Castner et al., in press; Gottleib & Zenilman, 2020). Travel and agency 98 nurses, often across state lines, have long been an essential strategy and workforce component to mitigate 99 emergency nursing staffing shortages and provide safe patient care (Gottleib & Zenilman, 2020). Providing 100 nursing care in different states on short-term contract can be delayed or even infeasible when states do not 101 participate in interstate compacts or the state licensing procedure is costly, prohibitive, or inefficient. Further, the 102 same emergency nurse with the same practice experience and training in one state may be prohibited from 103 practicing to the full extent of their training, experience, and education in other states with prohibitive language 104 (Ballard et al., 2016). Thus, state variations in nursing practice are exceptionally salient not only to the practice 105 of emergency nursing but in meeting sufficient workforce staffing requirements as well. 106 107 Interstate licensing compacts are agreements initiated among a group of states or territories that enable a nurse 108 with a license in one state to practice nursing in the compact states without obtaining a new, state-specific 109 license. Interstate compacts are not comprehensive as they are limited to political agreements among states. In 110 addition, a nurse must still abide by the nurse practice act and scope of practice in the state in which they are 111 delivering patient care. These compacts have been implemented in a piecemeal fashion, often without 112 consideration for the broad reach and access amenable to telehealth and have not been implemented in a 113 systematically regional or multi-regional manner across the country (DePasquale & Stange, 2016; Rambur et al., 114 2019). Until a federal level nurse practice act and licensing governing board is achieved, interstate compacts and 115 enhanced nurse licensure compacts provide an incremental solution to enabling nursing practice across state 116 lines. Evidence on telenursing and current compacts provides implications for the need to expand compacts 117 consistently to whole regions of the country, if not to all states and territories systematically (DePasquale & 118 Stange, 2016; Rambur et al., 2019). Federal systems of nursing practice are not new. Exemplars of well- 119 coordinated federal systems for consistent nursing practice across states can be found in United States Military 120 Treatment Facilities, Veteran’s Affairs Hospitals, and among networks of the Indian Health Service. 121 There are valid reasons for variations in nurse scope of practice to meet the unique demands of care in health 122 care provider shortage areas (HCPAs); low-income, socio-economic deprivation areas; rural and critical access 123 hospital service regions; and tribal systems. However, these variations are not bound by state and U.S. territory 124 geography. Prohibitive language in state level nurse practice acts and regulatory statements do little to meet the 125 demands of these areas where nurse training and experience may need to expand the individual practicing nurse’s 126 scope, rather than restrict or constrain practice. Therefore, this resolution proposes that ENA seeks to initiate 127 collaboration with three other key national nursing organizations in order to address the need for a federal 128 nursing licensing board and nurse practice act while furthering multi-state/territory licensure compacts. 129 130 Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: 131 This resolution builds upon ENA’s mission to advance excellence in emergency nursing by removing state 132 prohibitions and regulatory barriers to nurses in the specialty being able to practice to the full extent of their 133 education and training. This resolution builds on the current ENA strategic plan and practice environment goal 134 that emergency nurses will work in an ideal practice environment to provide the highest quality of emergency 135 care in the safest way by collaborating to reduce state-to-state variations that may limit the use of nurse-initiated 136 protocols and other best-evidence emergency nursing interventions. This resolution is also aligned with the ENA 137 clinical practice guideline of Crowding, Boarding, and Patient Throughput (ENA, 2018). 138 139 Financial Consideration/Operations Impact: 140 The scope of work outlined in the resolved clauses has a fiscal impact between $10,000-$25,000. Upon 141 final outcomes of General Assembly, initiatives will be evaluated for resource planning in alignment 142 with ENA’s strategic plan and operational goals. 143 144
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145 Professional References 146 Aguilera, R., Hansen, K., Gershunov, A., Ilango, S. D., Sheridan, P., & Benmarhnia, T. (2020). Respiratory 147 hospitalizations and wildfire smoke: A spatiotemporal analysis of an extreme firestorm in San Diego County, 148 California. Environmental Epidemiology, 4(5), e114. https://doi.org/10.1097/ee9.0000000000000114 149 Ballard, K., Haagenson, D., Christiansen, L., Damgaard, G., Halstead, J. A., Jason, R. R., Joyner, J. C., 150 O’Sullivan, A. M., Silvestre, J., & Cahill, M. (2016). Scope of nursing practice decision-making framework. 151 Journal of Nursing Regulation, 7(3), 19–21. https://doi.org/10.1016/S2155-8256(16)32316-X 152 Bell, S. A. (2020). Practice informs research and research informs practice: The making of a disaster nurse 153 scientist. Journal of Emergency Nursing, 46(5), 553–556. https://doi.org/10.1016/j.jen.2020.06.009 154 Brown, H. L. (2021). Emergency care EMTALA alterations during the COVID-19 pandemic in the United 155 States. Journal of Emergency Nursing, 47(2), 321–325. https://doi.org/10.1016/j.jen.2020.11.009 156 Carlberg, D. J., Bhat, R., Patterson, W. O., Zaatari, S., Chandra, V., Kolkin, A., Ratwani, R. M., Wilson, M. D., 157 Ladkany, D., Adams, K. T., Jackson, M., Lysen-Hendershot, K., & Booker, E. A. (2020). Preliminary 158 assessment of a telehealth approach to evaluating, treating, and discharging low-acuity patients with suspected 159 COVID-19. Journal of Emergency Medicine, 59(6), 957–963. https://doi.org/10.1016/j.jemermed.2020.08.007 160 Castner, J., Bell, S. A., Castner, M., & Couig, M. P. (2021). National Estimates of the Reserve Capacity of 161 Registered Nurses Not Currently Employed in Nursing and Emergency Nursing Job Mobility in the United 162 States. Annals of Emergency Medicine, S0196-0644(21)00195-5. Advance online publication. 163 https://doi.org/10.1016/j.annemergmed.2021.03.006 164 Castner, J., & Boris, L. (2020). State laws and regulations addressing nurse-initiated protocols and use of nurse- 165 initiated protocols in emergency departments: A cross-sectional survey study. Policy, Politics, & Nursing 166 Practice, 21(4), 233–243. https://doi.org/10.1177/1527154420954457 167 Castner, J., Grinslade, S., Guay, J., Hettinger, A. Z., Seo, J. Y., & Boris, L. (2013). Registered nurse scope of 168 practice and ED complaint-specific protocols. Journal of Emergency Nursing, 39(5), 467–473.e3. 169 https://doi.org/10.1016/j.jen.2013.02.009 170 Cuadros, D. F., Branscum, A. J., Mukandavire, Z., Miller, F. D., & MacKinnon, N. (2021). Dynamics of the 171 COVID-19 epidemic in urban and rural areas in the United States. Annals of Epidemiology, 59, 16–20. 172 https://doi.org/10.1016/j.annepidem.2021.04.007 173 DePasquale, C., & Stange, K. (2016). Labor supply effects of occupational regulation: Evidence from the nurse 174 licensure compact [Working paper 22344]. National Bureau of Economic Research. 175 https://doi.org/10.3386/w22344 176 Doraiswamy, S., Abraham, A., Mamtani, R., & Cheema, S. (2020). Use of telehealth during the COVID-19 177 pandemic: Scoping review. Journal of Medical Internet Research, 22(12), Article e24087. 178 https://doi.org/10.2196/24087 179 Douma, M. J., Drake, C. A., O’Dochartaigh, D., & Smith, K. E. (2016). A pragmatic randomized evaluation of a 180 nurse-initiated protocol to improve timeliness of care in an urban emergency department. Annals of 181 Emergency Medicine, 68(5), 546–552. https://doi.org/10.1016/j.annemergmed.2016.06.019 182 Emergency Nurses Association. (2017). Emergency nursing: Scope and standards of practice (2nd ed.). 183 Emergency Nurses Association. (2018). Crowding, boarding, and patient throughput. Journal of Emergency 184 Nursing, 44(2), 176–183. https://doi.org/http://doi.org/10.1016/j.jen.2018.10.011 185 Gottleib, J., & Zenilman, A. (2020). When nurses travel: Labor supply elasticity during COVID-19 surges 186 [Working paper No. 2020-166]. Becker Friedman Institute for Economics at the University of Chicago. 187 https://bfi.uchicago.edu/working-paper/2020166/ 188 National Council of State Boards of Nursing. (2021). NCSBN’s Environmental Scan COVID-19 and its impact 189 on nursing and regulation. Journal of Nursing Regulation, 11(4), S1–S36. https://doi.org/10.1016/s2155- 190 8256(21)00002-8 191 Rambur, B., Palumbo, M. V., & Nurkanovic, M. (2019). Prevalence of telehealth in nursing: Implications for 192 regulation and education in the era of value-based care. Policy, Politics, & Nursing Practice, 20(2), 64–73. 193 https://doi.org/10.1177/1527154419836752
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194 Veenema, T. G. (Ed.). (2019). Disaster nursing and emergency preparedness for chemical, biological, and 195 radiological terrorism, and other hazards (4th ed.). Springer Publishing Company. 196 197 Author(s): 198 New York State Emergency Nurses Association 199 200 Jessica Castner, PhD, RN-BC, FAEN, FAAN 201 ENA Member # 503401 202 716-417-7360 203 [email protected] 204 205 Jamla Rizek, MBA, MSN, RN, CEN, CPEN, NHDP-BC, NRP 206 ENA Member # 743653 207 315-491-7020 208 [email protected] 209 210 Supporter(s): 211 Karen Wiley, ENA #82169 212 Virginia Hebda, ENA #39963 213 Ann Yankay, ENA #87019 214 Donna Sowles, ENA #540247 215 Phyllis Parker, ENA #38420 216 Melaney Gordon, ENA #550730 217 Dawn MacMullen, ENA #587622 218 Joe Malenda, ENA #550860 219 Vepuka Kauari, ENA #205009 220 Mary Ellen “Mel” Wilson, ENA #23035 221 Sue Chalupa Breese, ENA #376547 222 Mary M. DaSilva, ENA #430121 223 Sandra Tetler, ENA #390415 224 Mickey Forness, ENA #7263 225 Eileen Breckenridge, ENA #103398 226 Mary Ann Teeter, ENA #12331 227 Marge Letitia, ENA #19020 228 Meredith Addison, ENA #22994 229 Brendan Kyek, ENA #1583277 230 Dr. Debbie Arbique, ENA #67876 231 Claudia E Garner, ENA #70500 232 Maureen O'Reily Creegan, ENA #6633 233 Eva Santiago, ENA #226511 234 Agnes Kelly, ENA #47179 235 Haylie Jo Wheeler, ENA #1458005 236 Al McLean, ENA #974739 237 Julie Miller, ENA #56917 238 Teri Riddle, ENA #798421 239 Karen Battaglia, ENA #106487 240 Nancy Moffett, ENA #1750438 241 Doris Price, ENA #1162283 242 Chris Gisness, ENA #17848
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243 Cheryl Ann MacDonald-Sweet, ENA #226547 244 Barbara Gibson, ENA #847705 245 Patricia Sica, ENA #68490 246 Kathleen Albert, ENA #107165 247 Carol Ceruzzi, ENA #62402 248 Christopher Benson, ENA #1091534 249 Georgette Salera, ENA #971900 250 Patricia Jess, ENA #38165 251 Tamira Balay, ENA #112048 252 Tiffany Johnson, ENA #868923 253 Kevin Moulin, ENA #817223 254 Lisa Dukes, ENA #682786 255 Mary Harwood, ENA #730848 256 William Schueler, ENA #477499 257 Aimee Lane, ENA #1866824 258 Brenda Snyder, ENA #1289595 259 Nancy Distelcamp, ENA #84415 260 Krista Anderson, ENA #1904806 261 Jennifer Hanish, ENA #725679 262 Taryn Amberson, ENA #884845 263 Annelise Johnson, ENA #788937 264 Dana Martini, ENA #721418 265 Derek Grassley, ENA #818914 266 Jean Proehl, ENA #10523 267 Harriet S. Hawkins, ENA #57250 268 Fred Neis, ENA #109820 269 Mariann F. Cosby, ENA #25957 270 Helen Passafiume Sandkuhl, ENA #6082 271 Sally K. Snow, ENA #9905 272 Ellen E. Ruja, ENA #3425 273 Mary Alice Vanhoy, ENA #51004 274 Dan Nadworny, ENA #561074 275 Louise Hummel, ENA #80504 276 Patricia Kunz Howard, ENA #25128 277 Thelma Kuska, ENA #29189 278 Cindy Hearrell, #58519 279 Nancy Mannion, ENA #22694 280 Jeff Solheim, ENA #101942 281 Carla Brim, ENA #464456 282 Patricia Clutter, ENA #5926 283 Rita Anderson, ENA#56587 284 Valerie Aarne Grossman, ENA #76446 285 Cheryl Randolph, ENA #74060 286 Vicki C. Patrick, ENA #9821 287 Chris Gisness, ENA #17848 288 JoAnn Lazarus, ENA #37139 289 Diana Meyer, ENA #54415 290 Meredith Addison, ENA #22994 291 Maryanne Portoro, ENA #20625
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292 Kelli Jones, ENA #912672
2021 General Assembly Back to Top Resolution GA21-05
1 TITLE: CATN (Course in Advanced Trauma Nursing) in the Classroom 2 3 Whereas, the Trauma Nursing Core Course (TNCC) was first released for students in 1986 and it is an 4 enduring opportunity which meets the basic education mandates for many Emergency Departments. 5 6 Whereas, experienced ED nurses who have taken TNCC multiple times do not have another ENA option 7 to meet their verification requirements. 8 9 Whereas, in many states TNCC is listed as meeting the requirements for Trauma Center designation. 10 Other courses such as the Advanced Trauma Care for Nurses (ATCN) course is listed as equivalent and is a 11 direct competitor for ENA. 12 13 Whereas, CATN was released in 1996, (updated in 2003 and placed in a strictly online format in 2011) 14 and is currently only utilized as a continuing education course. 15 16 Whereas, with the release of CATN II, the ENA found that members indicated “interest in the expansion 17 of knowledge related to the pathophysiologic processes in patients with acute injuries” and “inclusion of the 18 methodology necessary for complex decision making” (Sheehy, 2003) 19 20 Whereas, National ENA is in the beginning stages of updating CATN, and this update does not currently 21 include options for in person learning or the option of a verification. 22 23 Whereas, if adopted, this resolution is in direct alignment with ENA’s 2020-2025 vision and strategic 24 goals. 25 26 Resolved, that the ENA explore restoring CATN as an interactive learning opportunity; and 27 28 Resolved, that the ENA explore developing CATN as a verification course. 29 30 Resolution Background Information: 31 Currently, the standard trauma education of many emergency nurses includes TNCC. This course was first 32 released in 1986 and is now in its 8th edition. It is a gold standard for emergency nursing education. However, 33 many of our seasoned nurses have now had this 4-year verification many times. Our current TNCC 8th ed. 34 Manual states “The curriculum is designed for new trauma nurse learners to acquire essential knowledge and 35 skills. Post-course mentoring and support are essential to further develop and master trauma nursing expertise” 36 (Bratcher, 2020) 37 38 The Course in Advanced Trauma Nursing (CATN) was released in 1996 as an additional ENA offering. 39 However, this course was, and is still currently provided as continuing education only and does not include a 40 renewable verification. According to ENA’s own website, “CATN is an advanced course that goes beyond the 41 primary survey to focus on critical thinking and clinical decision-making to enhance trauma care. It includes 42 tools to anticipate complications early in the trauma continuum, resulting in better patient outcomes.” (ENA, 43 2021) 44 45 In its first two editions, CATN was initially a classroom-based course which included teaching in the flipped 46 classroom style. In 2011, it was updated to an online only format. In a meeting with National ENA, we were 47 unable to ascertain the current number of students taking either course. In addition, we hoped to compare data
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48 from current students taking the online version with the number of students that participated in the classroom 49 version. This data was not available. 50 51 Within our limited research capabilities, we attempted to review nationwide Trauma Center designation criteria. 52 Of those that we located, twenty (20) included TNCC as one of the courses which met the education criteria. In 53 eleven (11) states however, ATCN was listed as equivalent. Many states had other courses and continuing 54 education requirements. As many nurses take TNCC, they do not have any other ENA opportunity to meet their 55 educational requirements other than repeating the same course. 56 57 Currently, ENA is looking at the process of updating the current CATN course. However, in this discussion, the 58 option of a renewing verification is not part of the discussion. 59 60 It is understood that the cost of developing and maintaining a new verification course may be significant. 61 This is why the resolved clauses were created as an exploration of the concept. 62 63 Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: 64 65 This resolution, if adopted, appears to be in direct alignment with the vision, education goals, objectives and 66 strategies of the ENA. For review, the following excerpts, are directly from the National ENA’s 2020-2025 67 vision and strategic goals. 68 69 VISION: Be the premier organization for the emergency nursing community worldwide 70 71 • Emergency nurses practicing worldwide have the appropriate evidence-based resources needed to 72 provide the best care possible 73 • Emergency nurses globally have access to high quality education and resources to provide 74 excellent care 75 • Emergency nurses provide care using their full scope of practice 76 • Every emergency nurse receives the highest level of specialized training and education offered. 77 78 EDUCATION GOAL: Emergency nurses have the highest quality educational resources to provide the highest 79 level of care. 80 81 Objectives: 82 1. Expand research to increase the generation of new knowledge in emergency nursing 83 2. Expand the translation of best evidence into emergency nursing practice 84 3. Increase development and delivery of educational content for emergency nurses worldwide. 85 86 Strategies: 87 2. Identify and prioritize emergency nursing education gaps 88 3. Expand ENA core educational offerings for all levels of emergency nurses 89 4. Create new educational offerings that cover the breadth and depth of emergency nursing 90 91 Financial Consideration/Operations Impact: 92 The scope of work outlined in the resolved clauses has a fiscal impact between $10,000-$25,000. Upon final 93 outcomes of General Assembly, initiatives will be evaluated for resource planning in alignment with ENA’s 94 strategic plan and operational goals.
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95 Professional References: 96 Sheehy, S. e. (2003). Course in Advanced Trauma Nursing-II. (S. Sheehy, Ed.) Debuque, IA: Kendall / Hunt. 97 Bratcher, C., & all, e. (2020). Trauma Nursing Core Course (8 ed.). (J. Balnsfield, Ed.) Burlington, MA: Jones 98 and Bartlett Learning. 99 Emergency Nurses Association, (2021, 5 3). Course in Advanced Trauma Nursing (CATN), 2nd Edition. 100 Retrieved May 3, 2021, from ENA.org: https://www.ena.org/shop/catalog/education/online- 101 learning/course-in-advanced-trauma-nursing-(catn)/c-23/c-100/p-198 102 103 Author(s): 104 Eric Christensen BSN, RN, CEN, CPEN, FAEN 105 ENA Member #425963 106 303-947-6186 107 [email protected] 108 109 Christopher Fangmeier, MBA, BSN, RN, CEN, TCRN 110 ENA Member #715591 111 303-359-2228 112 [email protected] 113 114 Casey Zeigler RN, CFRN 115 ENA Member #123260 116 303-525-7362 117 [email protected] 118 119 Amy Boren MS, RN, CEN, CPEN, TCRN 120 ENA Member #766789 121 970-405-8356 122 [email protected] 123 124 Mike Archuleta MSN, RN, CCRN 125 ENA Member # 366155 126 [email protected] 127 128 Supporter(s): 129 Colorado ENA State Council 130 Wyoming ENA State Council 131 Maureen O'Reilly Creegan, ENA #6633 132 Wesley Davis, ENA #477669 133 Andi Foley, ENA #112569 134 Cathy C Fox, ENA #40470 135 Laura E. Gallagher, ENA #489038 136 Marcia K. Harmon, ENA #408734 137 Louise Hummel, ENA #80504 138 Julie Miller, ENA #56917 139 Tim Murphy, ENA #30447 140 Jean Proehl, ENA #10523 141 Ellen Ruja, ENA #3425 142 Joan Somes, ENA #5802
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143 Tiffiny Strever, ENA #101152 144 Mary Alice Vanoy, ENA #51004
2021 General Assembly Back to Top Resolution GA21-06
1 TITLE: Emergency Clinical Nurse Specialist National Certification 2 3 Whereas, specialty certification distinguishes nursing expertise both clinically and professionally (Board 4 of Certification for Emergency Nurses [BCEN], 2017; Stucky & Wymer, 2020); 5 6 Whereas, advance practice registered nurses (APRN) practice in the emergency care setting in two 7 different roles: the nurse practitioner (NP) and clinical nurse specialist (CNS) (Emergency Nurses Association, 8 [ENA], 2019a); 9 10 Whereas, APRN licensure requires an advanced nursing degree, clinical hours, and national certification 11 in the specialty. Historically, acceptable specialty professional credentialing mechanisms include examination or 12 portfolio (Institute of Medicine, 2011, Appendix D; Nursing License Map. 2021); 13 14 Whereas, NPs can achieve initial national certification of ENP-C through the American Academy of 15 Nurse Practitioners (AANP) Certification Board or recertify through the American Nurses Credentialing Center 16 (ANCC) as ENP-BC (RegisteredNursing.org), a national certification option for emergency CNSs does not exist. 17 This creates inequity and may prevent CNSs from practicing to the full extent and authority of their degree 18 within the emergency care setting (ENA, 2019a; Evans et al., 2018); and 19 20 Whereas, the American Nurses Association (ANA) has established that specialty professional 21 organizations are accountable for establishing the education, skills, and competencies required for entry into 22 specialty practice (2017). In 2011, ANA recognized ENA as the specialty professional organization for 23 emergency nursing (ANA, 2011). 24 25 Resolved, that ENA establish the education, skills, and competency requirements for nurses to be 26 credentialed as a CNS in the emergency setting; 27 28 Resolved, that ENA advocate for a national certification designation for emergency CNSs; 29 30 Resolved, that ENA explore strategic partnerships to enable equitable access to national certification for 31 emergency CNSs; and 32 33 Resolved, that ENA explore the development of a national certification mechanism for emergency CNSs. 34 35 Resolution Background Information: 36 As an ANA recognized specialty organization, ENA holds the authority and has the accountability to establish 37 the education, skills, and competencies for nursing practice within the emergency setting (ANA, 2017). ENA has 38 long supported professional certification, including publication of an established Emergency Nursing 39 Certification position statement, and developed strategic partnerships with the BCEN to support professional 40 certification for emergency nurses (2018). Further, ENA has long supported the advancement of the APRN 41 through the Institute for Emergency Nurse Advanced Practice advisory council, published an Advanced Practice 42 Registered Nurses in the Emergency Care Setting position statement (2019a), and has conducted research to 43 establish NP and CNS core competencies (ENA, 2011, 2019b). 44 45 The CNS competencies help inform education requirements; however, academic institutions need to determine 46 education requirements that result in the competency. 47
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48 There is strong evidence that APRNs are effective clinicians who provide safe, cost-effective care (ANA, 2014). 49 Several bodies support full practice authority and the removal of barriers to nursing practice, including the 50 National Academy of Medicine (formerly the Institute of Medicine [IOM]), the National Governors Association 51 (NGA), the Federal Trade Commission (FTC), the Bipartisan Policy Center, and the Veteran’s Health 52 Administration (VHA) (ANA, 2016). The CNS scope of practice and licensure varies depending upon regulation. 53 At this time, CNSs can now practice independently in 28 states and prescribe independently in 19 states 54 (National Association of Clinical Nurse Specialists [NACNS], 2019a). 55 56 The American Academy of Emergency Nurse Practitioners (AAENP) developed a strategic partnership to 57 advance the emergency nurse practitioner (ENP) specialty, thereby paving the way for professional certification 58 mechanisms (Evans et al., 2018). In doing so, the AAENP set forth a practical framework that could guide the 59 development of professional certification mechanisms (Evans et al., 2018) for emergency CNSs to permit 60 licensure and practice to full ability in the emergency setting. 61 62 NACNS is the professional organization for CNSs. To that end, NACNS has established foundational 63 educational and core competencies for entry into practice as a generalist CNS (2019b). However, emergency- 64 specific requirements remain with the ENA to establish. Similar to the AAENP example, it would be beneficial 65 to establish a partnership and collaboration with NACNS to refine the national verification mechanism for 66 emergency CNSs. 67 68 Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: 69 The mission of ENA is to “advance excellence in emergency nursing.” The vision is to “be the premier 70 organization of emergency nursing community worldwide,” with one of the descriptors being to have 71 “emergency nurses provide care using their full scope of practice.” One of the objectives of the community goal 72 of the strategic plan is to “increase collaboration and partnerships that advance emergency nursing.” The 73 establishment of a professional certification mechanism for emergency CNSs is in alignment with these goals. 74 75 Financial Consideration/Operations Impact: 76 The scope of work outlined in the resolved clauses has a fiscal impact of greater than $25,000. Upon final 77 outcomes of General Assembly, initiatives will be evaluated for resource planning in alignment with ENA’s 78 strategic plan and operational goals. 79 80 Professional References: 81 American Academy of Nursing. (2014). American Academy of Nursing: Improving health and health care 82 systems with advanced practice registered nurse practice in acute and critical care settings. Nursing Outlook, 83 62(5), 366–370. https://doi.org/10.1016/j.outlook.2014.07.003 84 American Nurses Association. (2011). Press release ANA recognizes emergency nursing specialty [Press 85 release]. https://www.nurse.com/blog/2011/08/23/ana-recognizes-emergency-nursing-as-specialty-2/ 86 American Nurses Association. (2016). Advanced practice registered nurses (APRN) [Policy statement]. 87 https://www.nursingworld.org/practice-policy/aprn/> 88 American Nurses Association. (2017). American Nurses Association recognition of a nursing specialty, approval 89 of a specialty nursing scope of practice statement, acknowledgement of specialty standards of practice, and 90 affirmation of focused practice competencies. https://www.nursingworld.org/~4989de/globalassets/ 91 practiceandpolicy/scope-of-practice/3sc-booklet-final-2017-08-17.pdf 92 Board of Certification for Emergency Nurses. (2017, September 18). Emergency nursing expertise and career 93 success linked to CEN certification in large-scale study [Press release]. https://bcen.org/news-releases/ 94 emergency-nursing-expertise-and-career-success-linked-to-cen-certification-in-large-scale-study/.
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95 Emergency Nurses Association. (2011). Competencies for clinical nurse specialists in emergency care [White 96 paper]. https://www.ena.org/docs/default-source/resource-library/practice-resources/other/competencies-for- 97 clinical-nurse-specialists-in-emergency-care 98 Emergency Nurses Association. (2018).:Emergency nursing certification [Position statement]. 99 https://www.ena.org/docs/default-source/resource-library/practice-resources/position-statements/ 100 encertification.pdf?sfvrsn=b3563eb6_14 101 Emergency Nurses Association. (2019a). Advanced practice registered nurses in the emergency care setting 102 [Position statement]. https://www.ena.org/docs/default-source/resource-library/practice-resources/position- 103 statements/advpracticeernursing.pdf?sfvrsn=e4186f66_26 104 Emergency Nurses Association. (2019b). Emergency nurse practitioner competencies [White paper]. 105 https://www.ena.org/docs/default-source/resource-library/practice-resources/other/practitioner-competencies 106 Evans, D. D., Hoyt, K. S., Wilbeck, J., Schumann, L., Ramirez, E., Tyler, D., & Agan, D. (2018). Embracing the 107 future for emergency nurse practitioners and specialty practice: Implications for research, clinical practice, 108 education and health policy. Journal of the American Association of Nurse Practitioners 30(10), 586–591. 109 https:/doi.org/10.1097/JXX.0000000000000123 110 Institute of Medicine (2011). The future of nursing: Leading change, advancing health. The National Academies 111 Press. https://www.nap.edu/read/12956/chapter/16#326 112 National Association of Clinical Nurse Specialists. (2019a). CNS scope of practice and prescriptive authority as 113 of 07.31.2020 [Policy statement]. https://nacns.org/wp-content/uploads/2020/08/PractPrescAuthority7.31. 114 2020.pdf 115 National Association of Clinical Nurse Specialists. (2019b). Statement on clinical nurse specialist practice and 116 education (3rd ed.). https://nacns.org/professional-resources/practice-and-cns-role/cns-competencies/ 117 Nursing License Map. (2021). Advanced practice registered nurse (APRN) career guide. 118 https://nursinglicensemap.com/advanced-practice-nursing/#:~:text=APRN%20Certification,for%20different 119 %20areas%20of%20specialty 120 Registered Nursing.Org. (2021). Emergency nurse practitioner certification. https://www.registerednursing.org/ 121 certification/emergency-nurse-practitioner/ 122 Stucky, C., & Wymer, J. (2020). Progressing toward specialty certification as the National Standard for Nursing. 123 Nursing Forum, 55(3). 531–534. https://doi.org/10.1111/nuf.12459 124 125 Author(s): 126 Carla Brim, MN, ARNP-CNS, PHCNS-BC, CEN, FAEN 127 ENA Member #464456 128 360-957-1067 129 [email protected]. 130 131 Jeannie Burnie, MS, APRN, AGCNS-BC, CEN, FAEN, FCNS 132 ENA Member #183908 133 513-560-3342 134 [email protected] 135 136 Supporter(s): 137 Ivy Thoman, ENA #451660 138 Jean A. Proehl, ENA #10523 139 Garrett Chan, ENA # 102476 140 Denise Campbell, ENA #411591
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141 Margaret J. Carman, ENA #202145 142 Nancy Denke, ENA #4207 143 Jacob A. Miller, ENA #579634 144 David T. House, ENA #468829 145 Scott E. Stover, ENA #71244 146 Chris Gisness, ENA #17848 147 Nycole Oliver, ENA #532022 148 Andi Foley, ENA #112569 149 Darleen Williams, ENA #29604 150 Karen Reilly Follin, ENA #79424 151 Diana Neubecker, ENA #185475 152 Andie Slivinski, ENA #660747 153 Cindy Reazin, ENA # 97857 154 William Fiebig, ENA #49953 155 Shelly Sherman, ENA #1284432 156 Sarah Taylor, ENA #512752 157 Maureen O’Reilly Creegan, ENA #6633 158 Renee Semonin Holleran, ENA #7937 159 Gabriel Campos, ENA #226571 160 Kelly Ashcraft, ENA #902201 161 Monique Jesionowski, ENA #872976 162 Judy Stevenson, ENA #303716 163 Valerie Aarne Grossman, ENA #76446 164 Linda Laskowski Jones, ENA #42215 165 Louise Hummel, ENA #80504 166 Mary Ellen “Mel” Wilson, ENA #23035 167 Glenine Collins, ENA #576700 168 Shawn Zembles, ENA #83483 169 Lisa Gilmore, ENA #123141 170 Roger Keddington, ENA #37690 171 Nancy Manion, ENA #22694 172 Harriet S. Hawkins, ENA #57250 173 Jessica Trivett, ENA #86800 174 Mariann Crosby, ENA #25957 175 Pat Clutter, ENA #5926 176 Diana Meyer, ENA #54415 177 JoAnn Lazarus, ENA #37139 178 Pamela Fox, ENA #4724 179 Jessica Castner, ENA #503401 180 William Schueler, ENA #477499 181 Benjamin Marett, ENA # 17179 182 Patricia Howard, ENA #25128 183 Thelma Kuska, ENA #29189 184 Ann Marie Papa, ENA #65692 185 Mary Jagim, ENA #33628 186 Paula Funderburke, ENA #72833 187 Maureen Curtis Cooper, ENA #28560
2021 General Assembly Back to Top Resolution GA21-07
1 Title: Triage Challenges in Emergency Nursing and Conducting Research 2 3 Whereas, triage decision-making is a critical element in emergency nursing. Triage is the initial 4 assessment and “eyes” laid on the patient and then “sorting” them and directing them to the appropriate level of 5 care; 6 Whereas, triage defines the trajectory of care, and incorrect decisions have been known to cause 7 significant delays and unseen decompensation. A triage RN is tasked with the important decision of assessing 8 how ill this person presenting may be. A challenge to accurate recognition is the placement of inexperienced, 9 new RNs in triage because of resource challenges with retaining quality, educated ED nurses (Ivanov et al., 10 2021; Wolf et al., 2018); 11 12 Whereas, even with the most seasoned RN’s there are minimal guidelines to support competency 13 development and accuracy; 14 15 Whereas, that ENA study and support the environment in which nurses function in the triage role as well 16 as study the effect of the environment on decisions made. 17 18 Whereas, that ENA conduct ongoing research to determine “competency” in the triage role and on the 19 minimum education, experience, and training required for competency in the triage role. 20 21 Whereas, racial, age, disability and gender bias can impede accuracy in triage decision-making by 22 causing nurses to ignore critical cues. Another challenge to the RN in triage is “triage fatigue” (Wolf et al., 23 2018), which can negatively affect decision-making. 24 There are currently many opportunities underway through ENA to study and investigate triage. The 25 following are a sample of some of this pending research: 26 27 • ENA has a program of research based on the 2020 ENA Delphi study. There is a decision fatigue study 28 that is currently IRB approved and about to go into data collection. 29 • Triage education for OB triage and the impact it has on correctly assessing acuity is IRB approved and 30 ready to enter intervention and data collection. 31 • Evaluation of a triage tiered system, which includes what screenings need to be done at triage and their 32 impact on acuity and maintaining safe patient care. 33 • There are other projects related to triage including the geriatric frailty screen. 34 35 Resolved, that ENA distribute a report on the state of the research on triage yearly. This would need to 36 include the year’s research plan, the studies in progress, and their stages of development. 37 38 Resolution Background Information: 39 ENA has a position statement posted titled Triage Qualifications and Competency” (ENA, 2018). This states that 40 nurses complete a “comprehensive, evidence-based triage education course and a clinical orientation with an 41 experience preceptor.” (ENA, 2018, p. 1). Ongoing competency and validation with chart audits are part of this, 42 but, in reality, inexperienced nurses are still placed in triage due to decreased allocation of nursing resources. In 43 2018 ENA purchased the Emergency Severity Index (ESI) course from. This course is a first step in ENA’s 44 ownership of education for triage, but it offers education on ESI and not triage decisions, critical thinking
2021 General Assembly Back to Top Resolution GA21-07
45 activities, and challenges. Triage acuity is not consistent since many will triage to the department or the provider 46 on duty, leading to poor decisions and undertriage of potential high-risk presentations (Sanders & Devon, 2016; 47 Arslanian-Engoren & Scott, 2016). 48 49 Special populations also pose an increased risk for undertriage. Contributing factors include minimal didactic 50 and clinical time in geriatric, pediatric, obstetric, and behavioral health courses in both pre-licensure and 51 continuing education. Other challenges to quick, accurate decision-making include a lack of educational focus on 52 patients who are autistic, have developmental delays, and those with “social issues” such as substance use 53 disorders and homelessness. This list is not inclusive by any means (Tam et al., 2018). The same authors cited 54 also looked at multiple retrospective studies and determined that experience of the nurse does not necessarily 55 correlate with accuracy in assigning correct ESI decisions. Ivanov et al. (2021) and Wolf et al. (2018) report that 56 the experience of the nurse does not necessarily correlate with accuracy in assigning correct ESI decisions. Their 57 research did find an increase in accuracy by nurses taking a triage refresher course and was also duplicated in a 58 study by Brosinski et al. (2017). Experienced nurses, despite years of clinical experience, may still be 59 functioning at the level of a novice RN (Wolf et al., 2018). Women who present with chest pain are often 60 incorrectly evaluated and triaged (Saban et al.,2019). Numerous studies demonstrate delays in women receiving 61 initial ECG testing, resulting in delays for interventional cardiac therapy (Arslanian-Engoren and Scott ,2016) In 62 this same study the study participants perceived barriers to prompt recognition and treatment of their conditions 63 that included time delays at entry, communication issues, and biases based on age and gender. 64 65 Racial biases in triage are well-documented; Hinson (2018) reports that high-risk presentations often went 66 unrecognized across their general population, while Schrader and Lewis (2013), Puumala et al. (2016), and Zook 67 et al. (2016), all noted undertriage in minority populations of all ages. Grossman et al. (2014) found significant 68 under triage in geriatric populations. Saban et al. (2019) report being female or having Arab ethnicity contributed 69 to a rating of ESI 3 when presenting with chest pain. 70 71 African American patients are more likely to be assigned lower triage acuity scores (TAS) by nurses than 72 Caucasian patients and are given lower TAS scores than Caucasian patients when they visit EDs during the same 73 time periods. In comparison to Caucasian patients, African American patients are 7% less likely to be assigned 74 an appropriate triage score, 10% less likely to be admitted to the hospital, and are 1.26 times more likely to die in 75 the ED or in hospital (Schrader &Lewis, 2013). 76 77 Bias has also been shown to play a role in pain management. Women are less likely to be perceived as needing 78 pain management for an injury than male patients, even after expressing the same level of pain and 79 demonstrating limited range of motion (Samulowitz et al.,2018). Adequate pain assessment needs to be assessed 80 as part of the triage process and, as per the ESI algorithm, pain can change the triage acuity score (ENA, 2018). 81 Samulowitz et al., 2018 discusses that females are more likely than men to be given a recommendation for 82 psychotherapy than pain management, in part because female patients are perceived as being more “emotional.” 83 Myths around the pain tolerance and decreased sensitivity of African Americans lead to disparities in pain 84 management: African-American patients are 14 percent less likely to receive opioid analgesics for traumatic or 85 surgical pain and 34 percent less likely to receive them for chronic pain (Dickason et al, 2015). Cultural 86 competency is embedded in current nursing education and pain is discussed as being an expression and can be a 87 function of “culture,” leaving many nurses with residual stereotypes that can delay appropriate pain identification 88 and management.
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89 Undertriage of trauma patients may result in unnecessary morbidity and mortality for these patients who do not 90 receive timely delivery of care. This challenges RN’s who need to balance this against excessive overtriage, 91 which results in overutilization of resources. This was demonstrated in a trauma triage study done at Vanderbilt 92 University but can hold true for triage of all patients (Stonko et al., 2018). 93 94 In a retrospective study, nurses were noted to have a triage accuracy of 59.8% (Ivanov et al., 2021). This agrees 95 and aligns with similar research studies. A program, “KATE,” using machine learning and natural language 96 processing in assessing ESI acuity had a higher accuracy for common high risk presentations using examples 97 from the ESI v. implementation handbook (Ivanov et al., 2021). KATE’s accuracy at two sites was 80% versus 98 41.3% for the emergency nurses. KATE or any program using machine earning (ML) could prove to be a useful 99 tool to assist nurses improve accuracy of triage but all would agree the clinical assessment, sometimes the 100 inherent “gut feeling” and experience of a skilled nurse can never be undermined or replaced with technological 101 tools. 102 103 Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: 104 The mission statement of the ENA is to advance excellence in emergency nursing through education, 105 networking, and advocacy and to embrace inclusion and diversity. 106 107 ENA has a current position statement outlining recommendations for assigning nurses to triage (ENA, 2018). It 108 states, “accurate triage decisions are important for successful emergency department (ED) 109 operations and optimal patient outcomes. (p. 1). It goes on to state competency is an ongoing validation process, 110 including ongoing chart review and clinician observation. Competency assessment is deemed to be left up to 111 individual institutions, and research demonstrates that there is limited data on qualifying or quantifying how this 112 can be carried out. 113 114 To mitigate the challenges of individual inexperience and chaotic environmental conditions and provide safe and 115 effective care for our patients, it is critical that the ENA develop standards for competency and provide the 116 education that brings nurses to a safe level of practice and to assure optimal patient outcomes for the public who 117 are entrusted to our care every day. 118 119 Financial Consideration/Operations Impact: 120 The scope of work outlined in the resolved clauses has a fiscal impact of greater than $25,000. Upon final 121 outcomes of General Assembly, initiatives will be evaluated for resource planning in alignment with ENA’s 122 strategic plan and operational goals. 123 124 Professional References: 125 Arslanian-Engoren, C., and Scott, L. (2016). Women’s perceptions of biases and barriers in their myocardial 126 triage experience. Heart and Lung, 45(3), 166–172. https://doi.org/10.1016/j.hrtlng.2016.02.010 127 Brosinski, C., Riddell, A., Valdez, S. (2017). Improving triage accuracy: A staff development approach. Clinical 128 Nurse Specialist, 31(3). 145–148.http://doi.org/10.1097/NUR.0000000000000291 129 Dickason, R., Chauhan, V., Mor, A., Ibler, E., Kuehnle S., Mahoney, D., Ambrecht, E., & Dalawchi, P. (2015). 130 Racial differences in opiate administration for pain relief at an academic emergency department. Western 131 Journal of Emergency Medicine, 16(3), 372–380. https://doi.org/10.5811/westjem.2015.3.23893
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132 Emergency Nurses Association. (2018). Triage qualifications and competency [Position statement]. 133 https://www.ena.org/docs/default-source/resource-library/practice-resources/position- 134 statements/triagequalificationscompetency 135 Grossman, F. F., Zumbrunn, T., Ciprian, S., Stephan, F-P., Natascha, W., Bingisser, R., & Nickel, C. H. (2014). 136 Undertriage in older emergency department patients—tilting against windmills? PLoS ONE, 9(8). Article 137 e106203. https://doi.org/10.1371/journal.pone.0106203 138 Hinson, J. S., Martinez, D. A., Cabral, S., George, K., Whalen, M., Hansati, B., & Levin, S. (2018). Triage 139 performance in emergency medicine: A systematic review. Annals of Emergency Medicine, 74(1), 140–152. 140 https://doi.org/10.1016/j.annemergmed.2018.09.22 141 Ivanov. O., Wolf, L., Brecher, D., Lewis, E., Masek, K., Montgomery, K., Andrieiev, Y., McLaughlin, M., Liu, 142 S., Dunne, R., Klauer, K., & Reilly, C. (2021). Improving ED emergency severity index acuity assignment 143 using machine learning and clinical language natural processing. Journal of Emergency Nursing, 47(2), 266– 144 278e7. https://doi.org/10.1016/j.jen.2020.11.001 145 Puumala, S. E., Burgess, K. M., Kharbanda, A. B/, Zook, H. G., Castille, D. M., Pickner, W. J., & Payne, N. R. 146 (2016). The role of bias by emergency department providers in care for American Indian children. Medical 147 Care, 54(6). 562–569. https://doi.org/10.1097/MLR.0000000000000533 148 Saban, M., Zaretsky, L., Patito, H., Salama, R., & Darawsha, A. (2019). Round-off decision-making: Why do 149 triage nurses assign STEMI patients with an average priority? International Emergency Nursing, 43, 34-39. 150 https://doi.org/10.1016/j.ienj.2018.07.001 151 Samulowitz,A., Gremyr,I.,Erikkson,E., Hensing,G.(2018). “Bravemen” and “emotional women”: A theory- 152 guided literature review on gender bias in healthcare and gender norms towards patients with chronic pain. 153 Pain Research Management. http://doi.10.1155/2018/6358624. 154 Sanders, S. F., & Devon, H. A. (2016). Accuracy in ED triage for symptoms of acute myocardial infarction. 155 Journal of Emergency Nursing, 42(4), 331–337. https://doi.org/10.1016/j.jen.2015.12.011 156 Schrader, C. D., & Lewis, L. M. (2013). Racial disparity in emergency department triage. Journal of Emergency 157 Medicine, 44(2), 511–518. https://doi.org/10.1016/j.jemermed.2012.05.010 158 Stonko, D. P., O’Neill, D. C., Dennis, B. M., Smith, M., Gray, J., & Guillamondegui, O. D. (2018.) Trauma 159 quality improvement: Reducing triage errors by automating the level assignment process. Journal of Surgical 160 Education, 75(6), 1551–1557. https://doi.org/10.1016/j.jsurg.2018.03.014 161 Tam, H. L., Chung, S. F., & Lou, C. K. (2018). A review of triage accuracy and future direction. BMC 162 Emergency Medicine, 18(1), Article 58. https://doi.org/10.1186/s12873-018-0215-0 163 Wolf, L. A., Delao, A. M., Perhats, C., Moon, M. D., Evanovich Zavotsky, K. (2018). Triaging the emergency 164 department, not the patient: United States emergency nurses’ experience of the triage process. The Journal of 165 Emergency Nursing, 44(3), 258–266. https://doi.org/10.1016/j.jen.2017.06.010 166 Zook, H. G., Kharbanda, A., Flood, A. B., Harmon, B., Puumala, S. E., Payne, N. R. (2016). Racial differences 167 in pediatric emergency triage scores. The Journal of Emergency Medicine, 50(5), 730–727. 168 https://doi.org/10.1016/j.jemermed.2015.02.056 169 170 Author(s): 171 Mary R. Harwood, MSN, RN, CEN 172 ENA Member # 730848. 173 (631) 942-5411 174 [email protected] 175
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176 Supporter(s): 177 Phyllis Parker, ENA #38420 178 Michelle Castiglione, ENA #928982 179 Marine Grennen, ENA #514034 180 Lisa Gaeta, ENA #891451 181 Mary DaSilva, ENA #430121 182 Erin Zazzera, ENA #464020 183 Deb Hellerman, ENA #780925 184 Rachael Mercorella, ENA #1933747 185 Stacy Hartcorn, ENA #1002398 186 MaryAnn Portoro, ENA #20625 187 MaryLou Killian, ENA #23501 188 Maureen M. Chernosky, ENA #110817 189 Nicoll Byrne, ENA #1715532 190 Brian Collins, ENA #987451 191 Christina Urbanick, ENA #1933765 192 Thomas Matthews, ENA #1933773 193 Nicole Petion, ENA #1610843 194 Julie Cohen, ENA #479951
2021 General Assembly Back to Top Resolution GA21-08
1 TITLE: Training of the Emergency Care Assistive Personnel in the Emergency Department 2 3 Whereas, the role of ancillary team members or Emergency Care Assistive Personnel (ECAP) in the 4 emergency department (ED) can vel called many interchangeable terms such as: Emergency Technician (ET), 5 Emergency Department Technician (EDT), Critical Care Technician (CCT), Clinical Assistant (CA), Emergency 6 Services Technician (EST), Patient Care Technician (PCT), etc., 7 8 Whereas, these ECAP’s hired to work in the ED may be high school graduates who have practiced as; 9 emergency medical technicians (EMT), phlebotomists, medical assistant’s (MA), corpsman, paramedics, nursing 10 students, or patient care assistants (PCA), 11 12 Whereas, the role of the ECAP is integral to the safe practice of emergency nursing, and 13 14 Whereas, individuals practicing in the role of an ECAP should have a standardized approach to the 15 required training to be competent in assisting the registered nurse (RN) in delivering emergency care. 16 17 Resolved, That the ENA will update or revise the existing Emergency Care Technician Curriculum 18 published in 2003 to guide the orientation and training for the ECAP. 19 20 Resolution Background Information: 21 In 2003, the ENA published the Emergency Care Technician Curriculum. The curricula served as a guide for 22 training of the entry-level emergency care provider. The text reviews various topics ranging from communication 23 and vital sign acquisition to delegation, body mechanics, and phlebotomy. This text that served as a valuable 24 resource to the emergency care team, has not been revised since 2003. 25 26 An expert panel convened by the National Council of the State Board of Nursing developed guidelines to 27 facilitate delegation in practice. This panel recognized that it is imperative that Registered Nurses (RN) clearly 28 understand the individual state practice acts regarding delegation. Throughout the guideline, the panel’s position 29 remains consistent that ECAP’s must have knowledge and competence of the delegated item. Successful 30 delegation is a result of clear communication, collaboration, and role clarity. 31 32 Further literature review revealed no additional evidence to guide ED nursing practice on orienting and educating 33 ECAP’s. 34 35 According to the ENA position statement regarding Staffing and Productivity in the ED, quality care is linked to 36 the appropriate staffing skill mix, including licensed and unlicensed care providers. Additionally, having the 37 proper staffing mix to include the ECAP can promote improved patient outcomes, along with patient safety, 38 nursing safety, nurse retention, and job satisfaction. 39 40 Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: 41 The ENA mission is to advance excellence in emergency nursing. Collaboration with healthcare partners is vital 42 to this aim. Furthermore, a team-based approach is critical to meeting high standards of care. The 2020-2025 43 strategic plan exemplifies these values. In order to deliver a collaborative team ensuring life-long learning and 44 delivery of excellent patient care, the education of ECAP’s must be a priority for the ENA. A standardized 45 approach to the education of ECAP’s may also add another avenue to enhance recruitment and retention of future 46 ED nurses. The revision of an orientation curriculum for ED ECAP’s will offer an additional opportunity to 47 increase ENA presence in every ED. 48
2021 General Assembly Back to Top Resolution GA21-08
49 Financial Consideration/Operations Impact: 50 The scope of work outlined in the resolved clauses has a fiscal impact of greater than $25,000. Upon 51 final outcomes of General Assembly, initiatives will be evaluated for resource planning in alignment 52 with ENA’s strategic plan and operational goals. 53 54 Professional References: 55 Baird, B. L., Berg, J., Cadwell, V., Ewald, P. J., Jackson-Bruce, C., Koran, Z., Niersbach, C., Scott, A., 56 & Santini, M. B. (2003). Emergency Nurses Association Emergency Care Technician Curriculum (1st ed.). 57 Jones & Bartlett Publishers. 58 Emergency Nurses Association (2021). Five year strategic plan. https://www.ena.org/about 59 Emergency Nurses Association (2021). Position statements. https://www.ena.org/practice-resources/resource- 60 library/position-statements 61 National Council of State Boards of Nursing. (2016). National guidelines for nursing delegation. Journal of 62 Nursing Regulation, 7(1), 5-14. https://doi.org/10.1016/S2155-8256(16)31035-3 63 64 Author(s): 65 Kathryn Gleason, MSN, RN, CEN 66 ENA Member #786912 67 513-509-6761 68 [email protected] 69 70 Jeannie Burnie, MS, APN, AGCNS-BC, CEN, FAEN, FCNS 71 ENA Member #183908 72 513-560-3342 73 [email protected] 74 75 Supporter(s): 76 Kristie Gallagher, ENA #442533 77 Andi Foley, ENA #112569 78 Bill Light, ENA #484897 79 Carla Brim, ENA #464456 80 Jeffrey A. Jones-Ritzler, ENA #430346 81 Nick Chmielewski, ENA #516473 82 Nancy Doolittle, ENA #775250 83 Ivy Thoman, ENA #451660 84 Megan Ellis, ENA #1525703 85 Rebecca Lemaster, ENA #1933388 86 Kim Schmeusser, ENA #329229 87 Aminda Seymour, ENA #173462 88 Maria L Ashdown, ENA #589643 89 Julie Shaw, ENA #49939
2021 General Assembly Back to Top GA21-09 Resolution 1 TITLE: Increasing Community Resources 2 3 Whereas, the Emergency Nurse Association (ENA) is comprised of a unique and diverse group of nurses 4 that serve the community in a variety of ways (McKee et al., 2018); 5 6 Whereas, ENA seeks different perspectives and experiences within emergency nursing and strategic 7 partnerships for practice improvement and inclusion (ENA, 2019a); 8 9 Whereas, advancements in emergency nursing and improvement in the lives of patients throughout the 10 world are impacted by the spirit of philanthropy (ENA, n.d.); 11 12 Whereas, community engagement requires not only education but strategic advocacy through 13 partnerships with stakeholders (ENA, 2019a); and 14 15 Whereas, community is one of the core goals of the ENA strategic plan, and ENA is indispensable to the 16 global community (ENA, 2019a). 17 18 Resolved, that ENA develop resources to help state councils and chapters engage members for 19 community outreach. 20 21 Resolution Background Information: 22 The landmark Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health 23 (2011) recognized the impact nurses have on improving the health of everyone in America. Nurses represent the 24 largest segment of the healthcare workforce, are considered the most trustworthy of all professions, and play a 25 huge role on the frontlines of care in our schools, hospitals, community health centers, long-term care facilities, 26 and other places (IOM, 2011). Nurses working in the community have long understood that to be effective in 27 contributing to improvements in the entire community’s health, they must assume the role of social change agent 28 (IOM, 2011). 29 30 In May 2021, the National Academy of Medicine Committee on the Future of Nursing 2020-2030 in 31 collaboration with the Robert Wood Johnson Foundation released “The Future of Nursing: 2020-2030”, 32 exploring how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, 33 utilizing technology, and maintaining patient and family-focused care into 2030. Specific focus areas include: the 34 role of nurses in improving the health of individuals, families, and communities by addressing social 35 determinants of health and providing effective, efficient, equitable, and accessible care for all across the care 36 continuum, as well identifying the system facilitators and barriers to achieving this goal, the role of the nursing 37 profession in assuring that the voice of individuals, families and communities are incorporated into design and 38 operations of clinical and community health systems, and the ability of nurses to serve as change agents in 39 creating systems that bridge the delivery of health care and social needs care in the community. In developing its 40 recommendations for the future decade of nursing in the United States, the committee drew from domestic and 41 global examples of evidence-based models of care that address social determinants of health and help build and 42 sustain a Culture of Health. 43 44 Nursing volunteers are needed in local and global communities for long-term, as well as short-term, services 45 (Dalmida et al., 2016). Increased globalization has made access to care increasingly difficult for the global 46 community, making the need for nurse volunteers of great importance (Dalmida et al., 2016). A lack of 47 understanding of a complex, contemporary society could have detrimental effects on social behaviors (Haupt et 48 al., 2018). Understanding these concerns and providing two-way connections can reduce negative impacts of 49 threats and emergencies, including public health emergencies, long-term health trends, and climate-related 50 impacts. Emergency nurses can reduce negative community impacts through education, connection, 51 communication, and community leadership.
2021 General Assembly Back to Top GA21-09 Resolution 52 53 To address this, ENA is in a unique position to connect emergency nurses with other nurses, as well as the 54 community, to promote education and well-being. Many ENA members already participate in events including 55 local, state, national, and international ENA events; non-ENA events such as CCRN or ANA conferences; 56 community events including staffing homeless shelters, safety education, and public health or safety at various 57 sporting events. While all of these activities are on-going, members may have difficulty finding these events as 58 they are frequently on third-party platforms, within private groups, or difficult to find on various web platforms. 59 Establishing a consolidated location where nursing and non-nursing volunteer events may be posted or shared 60 within the ENA community would increase connection through ease of locating activities, ideas for other forms 61 of engagement and service, public health involvement to positively impact the communities we serve, and 62 enhanced connection within the nursing community to promote our own community’s well-being, growth, and 63 development. Ideally, this would be hosted within ENA Connect as an interactive map with views of nursing and 64 non-nursing events as well as local, state, national, and international opportunities. 65 66 An example of how nurses can increase their impact can be seen through the Nurses on Boards Coalition 67 (NOBC), created in 2014, with a specific strategy of increasing the number of nurses serving in decision-making 68 positions in communities around the country. The coalition’s guiding principle is that building healthier 69 communities in America requires the involvement of more nurses on corporate, health-related, and other boards, 70 panels, and commissions (NOBC, 2021). Communities will benefit from the unique perspective of nurses to 71 achieve the goals of improved health. 72 73 Community engagement and service can take place in a variety of settings and to a diverse group of people, 74 including the vulnerable populations we serve. The needs of the community vary across the country and the 75 world. Nurses can work together to meet these needs and collaborate to provide care to the community (Dalmida 76 et al., 2016). Creating the community connection through service face-to-face, or even online, establishes a 77 strong base of collaboration and connection (Centers for Disease Control and Prevention [CDC], 2017). Social 78 media can be used to directly reach community members but also cross-promote activities (CDC, 2017). 79 Recognizing the emergency nursing community and encouraging it to establish connections and a relationship 80 with the community it serves has been encouraged intermittently, but with the last strategic plan update the 81 community focus shifted back to emergency nursing itself. Emergency nurses can make a cultural impact with 82 community engagement, which promotes community health and positive engagement. 83 84 Many emergency nurses are already involved in their community. Why not capitalize on this involvement of 85 what emergency nurses are doing in their geographic area and provide a platform to connect others with these 86 opportunities? Teen driver safety, child passenger safety, Stop the Bleed, CPR instructions to middle school and 87 high school students, volunteering at medical clinics, and volunteering at homeless shelters are some examples of 88 community engagement activities that emergency nurses can undertake. Community engagement also means 89 working collaboratively with and through groups of people with special interests and similar situations to 90 address. 91 92 Community engagement and cultural impact are mentioned in many ENA toolkits, position statements, and 93 documents. Ongoing community connection was highlighted in the Disaster Emergency Essentials Toolkit 94 (ENA, 2019b). Understanding cultural diversity and its importance for all levels of nursing practice was a main 95 point in the Cultural Diversity and Gender Inclusivity in the Emergency Care Setting position statement (ENA, 96 2018). Most published material focuses on specific populations, but care for the populations starts before the 97 bedside in the community. 98 99 Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: 100 This resolution aligns with ENA’s values and beliefs around the spirit of philanthropy. Philanthropy extends 101 beyond financial donations and involves charity in the form of actions that can impact the greater community 102 health (Grabor & Saylor, 2018).
2021 General Assembly Back to Top GA21-09 Resolution 103 104 Community is one of the core goals for the 2020–2025 Strategic Plan. The focus of “community” must extend 105 past the community of emergency nurses to the community that we care for. Engaging with each other and the 106 community we care for before they reach the stretcher increases the positive impact that emergency nurses can 107 have on the community and health overall. 108 109 Financial Consideration/Operations Impact: 110 The scope of work outlined in the resolved clauses has a fiscal impact between $10,000-$25,000. Upon final 111 outcomes of General Assembly, initiatives will be evaluated for resource planning in alignment with ENA’s 112 strategic plan and operational goals. 113 114 Professional References: 115 Centers for Disease Control and Prevention. (2018). Crisis + emergency risk communication: Community 116 engagement. https://emergency.cdc.gov/cerc/ppt/CERC_CommunityEngagement.pdf 117 Dalmida, S. G., Amerson, R., Foster, J., McWhinney-Dehaney, L., Magowe, M., & Nicholas, P. (2016). 118 Volunteer service and service learning: Opportunities, partnerships, and united nations millennium 119 development goals. Journal of Nursing Scholarship, 48(5), 517–526. https://doi.org/10.1111/jnu.12226 120 Emergency Nurses Association. (n.d.). About ENA. https://www.ena.org/about 121 Emergency Nurses Association. (2018). Cultural diversity and gender inclusivity in the emergency care setting 122 [Position statement]. https://www.ena.org/docs/default-source/resource-library/practice-resources/position- 123 statements/culturaldiversity.pdf?sfvrsn=e85dc130_24 124 Emergency Nurses Association. (2019a). 2020–-2025 Emergency Nurses Association strategic plan. 125 https://www.ena.org/docs/default-source/default-document-library/enastrategicplan.pdf?sfvrsn=5c367de2_2 126 Emergency Nurses Association. (2019b). Disaster emergency essentials toolkit. https://www.ena.org/docs/ 127 default-source/resource-library/practice-resources/toolkits/disaster-emergency- 128 essentials.pdf?sfvrsn=285c37fb_6 129 Grabor, J., & Saylor, J. (2016). Influence through philanthropy: Engaging members and serving the local and 130 global community [Presentation]. Sigma Repository. http://hdl.handle.net/10755/620369 131 Haupt, B., & Connolly Knox, C. (2018). Measuring cultural competence in emergency management and 132 homeland security higher education programs. Journal of Public Affairs Education, 24(4), 538–556. 133 https://doi.org/10.1080/15236803.2018.1455124 134 Institute of Medicine (2011). The Future of Nursing: Leading Change, Advancing Health. The National 135 Academies Press. https://doi.org/10.17226/12956 136 McKee, A. T., Bramer, A., Lu, C., & Wood, A. (2018). 2018 Member needs assessment key findings and 137 recommendations. McKinley Advisors. 138 National Academies of Sciences, Engineering, and Medicine. 2021. The Future of Nursing 2020-2030: 139 Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press. 140 https://www.nationalacademies.org/our-work/the-future-of-nursing-2020-2030#communications-toolkit 141 Nurses on Boards Coalition. (2021). About. https://www.nursesonboardscoalition.org/about/ 142 143 Authors: 144 Shannen Kane, BSN, RN, CEN 145 ENA Member #1567064 146 919-500-2940 147 [email protected] 148 149 Lauren Plaine, MPS, RN, CEN 150 ENA Member #988223 151 757-717-4720 152 [email protected] 153
2021 General Assembly Back to Top GA21-09 Resolution 154 Nancy Mannion, DNP, RN, CEN, FAEN 155 ENA Member #22694 156 717-413-8363 157 [email protected] 158 159 Thelma Kuska, BSN, RN, CEN, FAEN 160 ENA Member #29189 161 708-257-4283 162 [email protected] 163 164 Supporters: 165 Florida Emergency Nurses Association, Penny Blake, MSNc, CCRN, CEN, ENA #425261, President 166 Susan Sheehy, ENA #11136 167 Merri Addison, ENA #22994 168 Jeffrey Murphy, ENA #454325 169 Maureen Lugod, ENA #826084 170 Chris Guisness, ENA #17848 171 Tibor Bajor, ENA #80582 172 Allison Helkmerichs, ENA #394200 173 Jean Proehl, ENA #10523 174 Karen Battaglia, ENA #106487 175 Marites Gonzaga-Reardon, ENA #111906 176 Kathryn Bowen, ENA #193553 177 Shawna Brantley, ENA #665612 178 Kelly Monestero, ENA #89756 179 Carol Tulley, ENA #473766 180 Vicki Bacidore, ENA #180955 181 Karla Nygren, ENA #492909 182 Mary Alice Vanhoy, ENA #51004 183 Benjamin Marett, ENA #17179 184 Susie Martenson, ENA #34201 185 Penelope Blake, ENA #425261 186 Carla Brim, ENA #464456 187 Sally Snow, ENA #9905 188 Jim Hoelz, ENA #32651 189 Juanita Vondenberg, ENA #928212 190 Julie Miller, ENA #56917 191 Patricia Kunz Howard, ENA #25128 192 Andi Foley, ENA #112569 193 CherylAnn McDonald Sweet, ENA #226547 194 Valerie Brumfield, ENA #433778 195 Ellen Ruja, ENA #3425 196 Mary Ellen "Mel" Wilson, ENA #23035 197 Lynn Visser, ENA #84104 198 Carole Rush, ENA #65519 199 Pat Clutter, ENA #5926 200 Mariann F. Cosby, ENA #25957 201 Pamela Fox, ENA #4724 202 Jessica Castner, ENA #503401 203 William Schueler, ENA #477499
2021 General Assembly Back to Top GA21-09 Resolution 204 Harriet S. Hawkins, ENA #57250 205 Cheryl Randolph, ENA #74060 206 Vicki C. Patrick, ENA #09821 207 Denise Bayer, ENA #48866 208 Sherine Villegas, ENA #1689309 209 Linda Larson, ENA #1951 210 Donna Mason, ENA #775275 211 Meridith Addison, ENA #22994 212 Cindy Hearrell, ENA #58519 213 JoAnn Lazarus, ENA #37139 214 Shawntay Harris, ENA #849084 215 Kyle Smith, ENA #1405392 216 Megan Parks, ENA #900270 217 Laura McDavid, ENA #1701865 218 Virginia Orcutt, ENA #381081 219 Christopher Barnes, ENA #759889 220 Abigail Coles, ENA #1468401
2021 General Assembly Back to Top Resolution GA21-10
1 TITLE: Identify and Support Ways that Decrease Emergency Department Nurses taking Work-Related 2 Stress Home 3 4 Whereas, emergency nurses work in stress-filled environments that can cause moral distress, burnout, 5 and a state of physical and mental exhaustion; ( Alomari et al., 2021; Cocker & Joss, 2016; Dekeseredy et 6 al.,2019; Duffy et al., 2015; Gomez-Urquiza, 2017; Machado, 2018; Morrison & Joy, 2016; Rozo et al., 2017; 7 Trudgill et al., 2020; Wolf et al., 2016; Wolf et al., 2020); 8 9 Whereas, emergency nurses provide care to traumatized victims which can cause secondary traumatic 10 stress/compassion fatigue; (Administration for Children & Families, n.d.; Figley 1995; ENA 2020; The National 11 Child Traumatic Stress Network, 2015; Wolf et al., 2016; Wolf et al., 2020) 12 13 Whereas, emergency nurses frequently suffer physical and/or emotional trauma due to work-place 14 violence which can cause post traumatic stress; (Emergency Nurses Association [ENA], 2019, Trudgill et al., 15 2020; Wolf, 2014) 16 17 Whereas, being exposed to, and experiencing, physical and verbal violence; dealing with inadequate 18 staffing, lack of support, and a sense of inability to provide safe and effective care can lead to behaviors 19 associated with primary/post and secondary traumatic stress/compassion fatigue; (Administration for Children & 20 Families, n.d.; Duffy et al., 2014; ENA, 2020; Figley, 1995; Freeman, 2021, Relias Media, n.d.; The National 21 Child Traumatic Stress Network, 2015; Rozo et al., 2017; Trudgill et al., 2020; Wolf et al., 2014; Wolf et al., 22 2016; Wolf et al., 2020) 23 24 Whereas, emergency nurses’ family members, friends, and significant others state that they can often 25 identify the type of day the nurse experienced based on behaviors exhibited by the nurse when they arrive home 26 from work; (Alhani & Mahmoodi-Shan, 2018;, Dekeseredy et al., 2019; J. Somes, personal communication, 27 March 4, 2020; J. Somes, personal communication, February 3, 2021) 28 29 Whereas, “connecting with family and friends to talk about work-related stress” is often recommended as 30 a method of coping with stress and promote well-being; (Allen & Palk, 2018; ENA, 2015; ENA; 2020; Health 31 Care Toolbox, n.d.; Marsac & Ragsdale, 2020; Tubbert, 2016); and 32 33 Whereas, emergency nurses’ family members, friends, and significant others have shared that there are 34 times when the emergency nurse talks about/shares the events of a work-related, stress-filled day, that it has lead 35 to stress within the family; (Dekeseredy et al., 2019; Morrison & Joy, 2016; Wolf et al,. 2016; Wolf et al., 2020). 36 37 Resolved, ENA will further investigate the causes and impacts of emergency nurses’ unmitigated work- 38 related stress which can lead to secondary traumatic stress (compassion fatigue) and post traumatic stress; and 39 40 Resolved, ENA will identify and support interventions that mitigate risk of, and increase ED nurses’ 41 ability to cope with, secondary traumatic stress (compassion fatigue) and primary/post traumatic stress to help 42 prevent them from taking work-related stress home.
43 Resolution Background Information: 44 During an ENA Chapter meeting in early 2020 (pre-COVID), a discussion about the increased stress on the job, 45 worsening work place violence, feelings of burnout, and the number of people leaving the ED had one nurse 46 saying “My kids have told me they can tell by the way I get out of the car what kind of day I’d had and if they 47 should stay clear!” Others noted they had family members who would react to attempts to talk about their
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48 workday by avoiding them, or leaving the room! One even shared that family pet avoided her! This generated 49 the question “What are we bringing home to our families?!” (Remember this meeting was pre-COVID and the 50 concern was not related to infection!) (J. Somes, personal communication, March 4, 2020; J. Somes, personal 51 communication, February 2, 2021) 52 53 An open discussion ensued with nurses listing workplace violence, lateral violence, inadequate staffing, lack of 54 management support, working without breaks, unsafe patient care situations, a concern from the nurses (from 55 various health care systems) that workplace support systems were not “trustful”, or “user friendly”, and the 56 inability to provide quality care as major causes of their distress. They felt this distress was being brought home 57 and inflicted on their families. Chapter leaders were asked to take action. Even though the Chapter was already 58 holding peer to peer meetings to provide a venue for nurses to talk about their distress, they offered two seminars 59 addressing work-related stress and ways to build resilience. The arrival of the COVID-19 situation required the 60 seminars (converted to webinars) to be expanded to include COVID-related stress and be presented virtually. 61 COVID-related stress became a focus, but the pandemic has only aggravated the non-COVID- related stress that 62 had prompted the original discussion. Members continued to ask about the risk to family members and non- 63 nursing friends becoming stressed as the result of being exposed to the stress the ED nurses were feeling and 64 bringing home. (J. Somes, personal communication, March 4, 2020; J. Somes, personal communication, 65 February 2, 2021) 66 67 One Problem – Two areas of Concern 68 Charles Figley is recognized as an expert in stress disorders and frequently cited. In his chapter on Compassion 69 Fatigue as a Secondary Traumatic Stress Disorder: An Overview (Figley 1995), he defines compassion fatigue 70 and secondary traumatic stress as: “the stress deriving from helping others who are suffering or who have been 71 traumatized” (Figley, 1995, p. 7). He states the terms Compassion Fatigue (CF), Secondary Traumatic Stress 72 (STS), and Secondary Traumatic Stress Disorder (STSD) can be used interchangeably, as the symptoms are the 73 same (Figley, 1995, p. 15). He points out that the Diagnostic and Statistical Manual of Mental Disorders (DSM 74 5) codes related to victims of physical or psychological trauma state that the “trauma can be the result of 1.) 75 caring for someone who has suffered trauma, 2.) witnessing trauma inflicted on someone, 3.) hearing about the 76 trauma suffered by another, or the 4.) result of trauma being inflicted on the person.” (APA, 1994, p.424, as 77 cited in Figley 1995, p. 4). Thus, he feels that nurses suffering from Post Traumatic Stress Disorder (PTSD) will 78 have behaviors similar to a nurse with CF and STS, as all three disorders have the same symptoms- it is the 79 source of the trauma (stress) that is being inflicted in a different manner (vicariously versus directed at/on the 80 nurse) (Figley 1995, p. 5). He felt the terms PTSD, CF, and SDS can be used interchangeably and that PTSD 81 should also be interpreted as Primary Traumatic Stress Disorder as every stress reaction is post by definition”. 82 (p.5 & 9) He also found that nurses favored being labeled as having “compassion fatigue” rather than being 83 labeled as having “secondary traumatic stress or a traumatic stress disorder”; as compassion fatigue had less of a 84 negative connotation (Figley, 1995, p. 15). 85 86 The Nurses’ Stress 87 The stressors identified by Chapter member members during the meetings were similar to findings reported in 88 literature. Multiple studies have shown emergency nurses work in stress-filled environments that caused moral 89 distress, physical and mental exhaustion, burnout, physical and emotional trauma, secondary traumatic stress 90 (compassion fatigue), and post traumatic stress (Allen & Park, 2018; Alomari et al.,2021; Cocker & Joss, 2016; 91 Dekeseredy et al., 2019; Duffy et al., 2015; ENA, 2015; ENA, 2020; Gomez-Urquiza, 2017; Hui et al., 2019; 92 Machado, 2018; Morrison & Joy, 2016; Rozo et al., 2017; Trudgill et al., 2020; Tubbert, 2016; Wolf et al., 2014; 93 Wolf et al., 2016; Wolf et al., 2020). ENA’s Campaign on “No silence on ED Violence” highlights an additional 94 work-related stressor for the ED nurse – workplace violence. (ENA website, n.d.) ED nurses are not only at risk 95 of suffering secondary traumatic stress (STS) while providing patient care; but over 70% of nurses state they
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96 have personally suffered physical injuries and even more reported suffering verbal violence, putting them at risk 97 of post-traumatic stress disorder (PTSD), which some also refer to as primary traumatic stress. (ENA, 2019; 98 Wolf et al., 2020) A third common stressor for ED nurses is “double duty care-giving”, when the nurse is 99 expected provide patient care at the job and when home has to provide care for older family members, or family 100 members who are ill (Dekeseredy et al., 2019; Gomez-Urquiza, 2019; Machado, 2018). Trudgill and Wolf have 101 labeled the stress of the ED nurse as “Post Traumatic Stress Disorder” (PTSD) when collectively describing the 102 various types of stressors encountered by ED personnel; from inadequate staffing, over-crowding, and providing 103 care for victims of gun violence, car crashes, witnessing human suffering to having to deal with workplace 104 violence (Trudgill et al., 2020; Wolf et al., 2020).Trudgill found that one in four emergency nurses met the 105 criteria for PTSD, but also noted a concern that her study’s findings likely were “underestimates of the truth” as 106 she found many ED personnel “chose not to participate for fear of their manager learning of their struggles” and 107 that information “consequently damaging their careers”. (Trudgill et al., 2020) The concern related to 108 management’s methods of dealing with work-place stress was also identified during ENA Chapter meetings as 109 well as been raised by emergency physicians (Freeman, 2021). The Chapter nurses identified they did not find 110 the workplace “support systems” as being “trustful”, or “user-friendly” and was one of the reasons the Chapter’s 111 Peer to Peer group had been started. (J. Somes, personal communication, October, 2019). Wolf addressed work- 112 place violence in “Nothing Changes, Nobody Cares: Understanding the Experience of Emergency Nurses 113 Physically or Verbally Assaulted while Providing Care” when she wrote that a “culture of acceptance around 114 workplace violence” persists and noted a lack of administrative support and judicial recourse leading to nurses 115 working under these conditions (Wolf et al., 2014) Is it any wonder that Emergency Nurses are bringing their 116 work-related stress home? 117 118 The Family being exposed to the nurses’ stress 119 Being “connected” and talking about work-related feelings with family members and friends are commonly 120 suggested approaches for creating resiliency and providing support for the emergency nurse (Administration for 121 Children & Families, n.d.; Allen & Palk, 2018; American Psychological Association [APA], 2012; APA, 2018; 122 ENA, 2015; ENA, 2020; Health Care Toolbox, n.d.; Marsac & Ragsdale, 2020; Tubbert, 2016). Yet, when one 123 considers the definition of compassion fatigue (CF) and secondary traumatic stress (STS), one must wonder if 124 this “connecting” to share feelings about work-related stress and the work-day’s events could lead to stress in the 125 nurses’ family members and non- nursing friends. No studies were found that looked specifically at the question 126 - are family members developing secondary traumatic stress (compassion fatigue) as the result of the nurse 127 bringing their unmitigated stress home? Figley in his chapter on Compassion Fatigue as a Secondary Traumatic 128 Stress Disorder: an Overview did note that “traumatized people complained that family and friends discouraged 129 them from talking about their traumatic experiences after a few weeks because it is so distressing to the 130 supporters. “ (Figley, 1995, p. 6) Figley also noted that an “emotional arousal appears to be associated with an 131 empathic and sympathetic reaction” and “simply being a member of a family and caring deeply about its 132 members makes us emotionally vulnerable to the catastrophes which impact them (the person). Families become 133 “victims” because of their emotional connection with the victimized family member.” (Figley, 1983, p. 12 as 134 cited in Figley, 1995, p.5). When emergency nurses bring their work-related stressors home and try to debrief by 135 talking about work with their family, or friends, they will most likely cause the family and friends to worry. The 136 worry can be about the psychological trauma being incurred by the emergency nurse, or concerns of the nurse 137 being victimized as the result of physical violence, staffing issues, perceived lack of support, and concerns of not 138 being an effective and safe care-giver (Alomari et al., 2021; Cocker & Joss, 2016; Dekeseredy, 2019; Gomez- 139 Urquiza, 2017; Machado, 2018; Morrison & Joy, 2016; Trudgill et al., 2020; Wolf et al., 2016; Wolf et al., 140 2017). Figley notes that “learning about unexpected or violent death, serious harm, or threat of death or injury 141 experienced by a family member or other close associates” can lead to traumatization without actually being 142 harmed, especially if they have an empathetic nature or concerned/care about the person (APA, 1994, p. 424 as 143 cited in Figley 1995, p. 4). Concerns about family members were highlighted by Figley when he noted: “nearly
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144 all the attention has been directed to people in harm’s way, and little to those who care for and worry about 145 them.” (Figley, 1995, p. 6). One wonders about the impact of emergency nurses sharing their feelings of stress, 146 or the family simply being aware of what has happened at work, on the nurse’s family. Studies note relationships 147 between family members and friends of the nurses have suffered due to the nurse’s work-related stress (Alhani & 148 Mahmoodi-Shan, 2018; Dekeseredy et al., 2019; Gomez-Urquiza, 2019; Machado, 2018). Behaviors ranging 149 from lashing out at family and friends to nurses isolating themselves from family, destroying relationships, and 150 taking their lives have been described even before COVID added to the stress (Administrations for Children & 151 Families, n.d.; Alhani & Mahmoodi-Shan, 2018; Dekeseredy et al., 2019; Duffy et al., 2015; ENA, 2015; ENA 152 2020; Figley, 1995; Machado, 2018; Marsac & Ragsdale, 2020; The National Child Traumatic Stress Network, 153 2015; Wolf et al., 2016; Wolf et al., 2020). Some nurses isolate themselves from the family in order to protect 154 them, leading to additional stress as the result of this withdrawal. (Figley 1995, p. 5) Figley notes this could 155 happen and it does appear that family members could be at risk of suffering secondary trauma (compassion 156 fatigue) as the result of the nurse bringing work-related stress home (Figley 1995, p. 9). During COVID-19 157 emergency nurses shared stories of how they would strip in their garage and shower prior to entering the home in 158 order to prevent exposing family members to the infection. Yet, how many ED nurses are “exposing” their 159 family to the stress of their work via their words and/or behaviors as they interacted with their family and 160 friends? 161 162 The request 163 An initial suggestion to ask ENA to investigate if the emergency nurses’ families were developing Secondary 164 Traumatic Stress and “fix” the family was altered to a more attainable request to investigate and support ways to 165 “fix” the emergency nurse. There are many studies that address ED nurse’s stress and methods to cope ranging 166 from building one’s own resiliency to seeking professional help (Administration for Children & Families, n.d.; 167 Allen & Palk, 2018; Alomari et al., 2021; American Psychological Association [APA], 2012; APA, 2018; 168 Cocker & Joss, 2016; Dekeseredy et al., 2019; Duffy et al., 2015; ENA, 2015; ENA, 2020; Gomez-Urquiza, 169 2017; Health Care Toolbox, n.d.; Hui et al., 2019; Machado, 2018; Marsac & Ragsdale, 2020; Morrison & Joy, 170 2016; Trudgill et al., 2020; Tubbert, 2016; Wolf et al., 2016; Wolf et al., 2020). ENA’s Topic Briefs on 171 Compassion Fatigue and The Well Nurse discuss stressors impacting emergency nurses, but also note that more 172 research needs to be done. (ENA, 2015; ENA, 2020) The Compassion Fatigue Topic Brief more focused on 173 stress during a disaster and related to double duty care-giving, but only minimally mentions the day to day stress 174 related to staffing issues, holding patients, lack of equipment, lack of support, and the moral distress when unable 175 to provide quality care (ENA 2015). It also did not address risk of harm due to work place violence that nurses 176 describe and studies show is occurring. (American College of Emergency Physicians [ACEP], 2018; ENA, 2019; 177 Wolf et al., 2014; Wolf et al., 2020). Methods a nurse can use to increase their own wellness and compassion 178 satisfaction were outlined in both Topic Briefs, but these methods notably often took initiative and energy on the 179 part of the nurse who has been described as “physically and mentally exhausted” (Duffy et al., 2014; ENA, 2015; 180 ENA, 2020; Wolf et al., 2016; Wolf et al., 2020). Several studies did made recommendations for support 181 provided by “enlightened” management. These recommendations included seminars and workshops on ways to 182 mitigate stress, secondary traumatic stress, and post traumatic stress provided by the work site, and included 183 work-sponsored counseling services, or peers working to create a safety net for the nurse ( Administration for 184 Children & Families, n.d.; Allen & Palk, 2018; APA, 2012; APA, 2018; Bride et al., 2004; ENA2015; ENA, 185 2020; Health Care Toolbox, n.d.; Hui et al., 2019; Marsac & Ragsdale, 2020; the National Child Traumatic 186 Stress Network, 2015; Tubbert, 2016; Wolf et al., 2020). However, other studies found ED personnel did not 187 always trust management when it came to reporting stress. They reported nothing seemed to take place to correct 188 the situation, and there seemed to be a stigma when admitting one needed help with stress. (ACEP, n.p.; 189 Freeman, 2021; Wolf et al., 2014) 190 191 It could be that family members are not at risk of developing secondary traumatic stress or compassion fatigue
2021 General Assembly Back to Top Resolution GA21-10
192 because the nurses are protecting their family members from the stress they are experiencing, or are taking 193 advantage of work-sponsored coping mechanisms in order to not take their work related stress home or inflict it 194 on their families and friends (Administration for Children & Families, n.d.; Allen & Palk, 2018; APA, 2012; 195 APA, 2018; Bride et al., 2004; ENA, 2015; ENA; 2020; Health Care Toolbox, n.d.; Hui et al., 2019; Marsac & 196 Ragsdale, 2020; The National Child Traumatic Stress Network, 2015; Tubbert, 2016, Wolf et al., 2020). 197 However, if this is not the case, it would seem reasonable to ensure that methods of helping the emergency nurse 198 cope with their primary/post (PTSD) and Secondary Traumatic Stress (compassion fatigue) are effective and 199 easily available, so the emergency nurse is not taking that stress home to families and friends. It would also 200 seem logical, if the nurses are not taking their stress home, there would be a trickledown effect of a decreased 201 risk of family exposure to stress and the development of Secondary Traumatic Stress or Compassion Fatigue. 202 To that end, we request ENA identify and support ways to decrease emergency nurses taking their work related 203 stress home. 204 205 Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: 206 Emergency Nurses work in a stress-filled environment that places the nurse at risk of Secondary Traumatic 207 Stress, as well as Post traumatic Stress due to work place violence (Administration for Children & Families, n.d.; 208 Alomari et al., 2021; Cocker & Joss, 2016; Dekeseredy et al., 2019; Duffy et al., 2015; ENA, 2020; Figley, 1995; 209 Gomez0Urquiza, 2017; Machado, 2018; Morrison & Joy, 2016; Rozo et al., 2017; The National Child Traumatic 210 Stress Network, 2015; Trudgill et al., 2020; Wolf et al., 2016; Wolf et al., 2020). This stress, if taken home 211 affects family life; as well as the nurses’ wellness and ability to provide quality care, and potentially retention 212 (ENA, 2015; ENA, 2019; ENA, 2020; Figley, 1995). By identifying and supporting actions that can decrease the 213 nurses’ risk of stress and be able to manage stressors that remain, the effects of work-related stress on the nurse, 214 as well as the family can be diminished. 215 216 Financial Consideration/Operations Impact: 217 The scope of work outlined in the resolved clauses has a fiscal impact of greater than $25,000. Upon final 218 outcomes of General Assembly, initiatives will be evaluated for resource planning in alignment with ENA’s 219 strategic plan and operational goals. 220 221 Professional References: 222 Administration for Children & Families. (n.d.) Secondary traumatic stress. U.S. Department of Health & 223 Human Service. https://www.acf.hhs.gov/trauma-toolkit/secondary-traumatic-stress 224 Alhani, F., Mahmoodi-Shan, G.R. (2018). Work-family conflict as a stressor in the lifestyle of nurses: A content 225 analysis. Journal of Nursing and Midwifery Sciences. 5(3) 79-88. 226 http://dx.doi.org/10.4103/JNMS.JNMS_26_18 227 Allen, R. & Palk, G. (2018) Development of Recommendations and Guidelines for Strengthening Resilience in 228 Emergency Department Nurses. Traumatology. 24(2), 148–156. http://dx.doi.org/10.1037/trm000014 229 Alomari, A.H., A., Collison, J., Hunt, L.,& Wilson, N.J. (2021). Stressors for emergency department nurses: 230 Insights from a cross-sectional survey. Journal of Clinical Nursing. 30:7-8 975-985 231 https://doi.org/10.1111/jocn.15641 232 American College of Emergency Physicians (ACEP). (2018) Violence in emergency departments is increasing, 233 harming patients, new research finds 234 Violence in Emergency Departments Is Increasing, Harming Patients, New Research Finds 235 (emergencyphysicians.org) 236 American College of Emergency Physicians (ACEP). (2020) Poll: Workplace stigma, fear of professional 237 consequences prevent emergency physicians from seeking mental health care. 238 https://www.emergencyphysicians.org/article/mental-health/poll-workplace-stigma-fear-of-professional- 239 consequences-prevent-emergency-physicians-from-seeking-mental-health-care
2021 General Assembly Back to Top Resolution GA21-10
240 American Psychological Association (APA). (2012). Building your resilience. 241 https://www.apa.org/topics/resilience 242 American Psychological Association (APA). (2018, October 14). Coping with stress at work. 243 https://www.apa.org/topics/healthy-workplaces/work-stress 244 Bride, B., Robinson, M., Yegidis, B., Figley, C.R. ( 2004).Development and validation of the Secondary 245 Traumatic Stress Scale. Research on Social Work Practice. 14(1): 27-33. 246 http://doi.org/10.1177/1049731503254106 247 Cocker, F., Joss, N. (2016). Compassion Fatigue among Healthcare, Emergency and Community Service 248 Workers: A systematic Review. International Journal of Environmental research and Public Health. 249 13(6). Article 618. https://doi.org/10.3390/ijerph13060618 250 Dekeseredy, P., Kurtz Landy, C., & Sedney, C., (2019) An Exploration of Work Related Stressors Experienced 251 by Rural Emergency. Online Journal of Rural Nursing and Health Care. 19(2). 252 http://doi.org/10.14574/ojrnhc.v19i1.550 253 Duffy, E., Avalos, G., Dowling, M. (2015) Secondary Traumatic Stress among Emergency nurses: A Cross- 254 sectional Study. International Emergency Nursing. 23(2):53-8. https://doi.org/10.1016/j.ienj.2014.05.001 255 Emergency Nurses Association. (2015) ENA The well nurse [Topic Brief]. https://www.ena.org/docs/default- 256 source/resource-library/practice-resources/topic-briefs/the-well-nurse.pdf?sfvrn=40cb75a3_6 the-well- 257 nurse.pdf (ena.org) 258 Emergency Nurses Association. (n.d.) Workplace violence – practice issues No silence on violence 259 campaign. https://www.ena.org/practice-resources/workplace-violence 260 Emergency Nurses Association. (2019). ENA Position statement on Violence and its impact on emergency 261 nurses. https://www.ena.org/docs/default-source/resource-library/practice-resources/postion- 262 statements/violenceintheemergencycaresetting.pdf?sfvrsn=49343551_12 263 violenceintheemergencycaresetting.pdf (ena.org) violence-and-its-impact-on-the-en-final-board-draft.pdf 264 (wordpress.com) 265 Emergency Nurses Association. (2020). Compassion fatigue. [Topic Brief] https://www.ena.org/docs/default- 266 source/resource-library/practice-resources/topic-briefs/compassion-fatigue.pdf?sfvrsn=40cb75a_6 267 compassion-fatigue.pdf (ena.org) 268 Figley, C. (1995). Compassion fatigue as secondary traumatic stress disorder: An overview. In C. R. Figley 269 (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the 270 traumatized (pp. 1–20). Rutledge, Taylor, and Francis Group. 271 Freeman, G. (2021) Help physicians, nurses overcome fear of seeking assistance for stress relief. Relias Media 272 www.reliasmedia.com/articles/147695-help-physicians-nurses-overcome-fear-of-seeking-assistance-for- 273 stress-relief 274 Gomez-Urquiza, J.L., De la Fuente-Solana, E.I., Albendin-Garcia, L., Vargas-Pecino, C., Ortega-Compos, E.M., 275 Canada-De la Fuenta, G.. (2017) Prevalence of Burnout Syndrome in Emergency Nurses: A Meta-analysis. 276 Critical Care Nurse. 37(5), e1-e9. https://doi.org/10.4037/ccn2017508 277 Health Care Toolbox. (n.d) Center for Pediatric Traumatic Stress. Self Care Tips to Prevent Secondary Stress. 278 Center for Pediatric Traumatic Stress https://healthcaretoolbox.org/selfcare-tips-prevent-secondary-stress 279 Hui, X., Kynoch, K., Tuckett, A., Eley, R., & Newcombe, P. (2019). Effectiveness of interventions to reduce 280 occupational stress among emergency department staff: a systematic review protocol. JBI Database System 281 Rev Implement Reports. 17(4) 513-519. https://doi.org/10.11124/jbisrir-d-19-00252 282 Machado, M., (2018). Secondary traumatic stress among emergency department nurses.) [Master’s Thesis, 283 Rhode Island College] James P. Adams Library Digital Commons. https://doi.org/10.28971/532018MM74 284 Marsac, M.L., & Ragsdale, L. B. (2020, May 21). Tips for recognizing, managing secondary traumatic stress in 285 yourself. AAP News. https://www.aappublications.org/news/2020/05/21/wellness052120 286 Morrison, L. E., & Joy, J. P. (2016) Secondary traumatic stress in the emergency department. Journal of 287 Advanced Nursing 72(11):2894-2906. https://doi.org/10.1111/jan.13030
2021 General Assembly Back to Top Resolution GA21-10
288 The National Child Traumatic Stress Network. (2015) Secondary traumatic stress a fact: sheet for organizations 289 employing community violence workers. https://www.nctsn.org/resources/secondary-traumatic-stress-fact- 290 sheet-organizations-employing-community-violence-workers 291 Rozo, J.A., Olson, D., Thu, H., & Stutzman, S. (2017) Situational factors associated with burnout among 292 emergency department nurses. Workplace Health & Safety. https://doi.org/10.1177%2F2165079917705669 293 Trudgill, D., Gorey, K., & Donnelly, E. (2020) Prevalent posttraumatic stress disorder among emergency 294 department personnel: Rapid system review. Humanities & Social Sciences Communications. 7, Article 89 295 . https://doi.org/10.1057/s41599-020-00584-x 296 Tubbert, S. J. (2016). . Resiliency in Emergency Nurses. Journal of Emergency Nursing. 42(1), 47-52. 297 https://doi.org/10.1016/j.jen.2015.05.016 298 Wolf, L. A., Delao, A. M., & Perhats, C. (2014) Nothing changes, nobody cares: Understanding the experience 299 of emergency nurses physically or verbally assaulted while providing care. Journal of Emergency Nursing. 300 40 (4) 305-310. https://doi.org/10.1016/j.jen.2013.11.006 301 Wolf, L. A., Delao, A. M., Perhats, C., Clark, P. R., Edwards, C., & Frankenberger, W. D. (2020) Traumatic 302 stress in emergency nurses: Does your work environment feel like a war zone? International Journal of 303 Emergency Nursing. 52, Article 100895 https://doi.org/10.1016/j.ienj.2020.100895 304 Wolf, L. A., Perhats, C., Delao, A. M., Clark, P. R., & Moon, M. D. (2017) On the threshold of safety: A 305 qualitative exploration of nurses’ perceptions to factors involved in safe staffing levels in emergency 306 departments. Journal of Emergency Nursing. 43(2),150-157. https://doi.org/10.1016/j.jen.2016.09.003 307 Wolf, L. A.., Perhats, C., Delao, A. M., Moon, M. D., Clark, P.R.,& Zavotsky, K. E. (2016). “It’s a Burden you 308 Carry”, Describing moral distress in emergency nursing. Journal of Emergency Nursing. 42 (1) 37-46. 309 https://doi.org/10.1016/j.jen.2015.08.008 310 311 Author(s): 312 Joan Somes PhD, RN-BC, CEN, CPEN, FAEN, NRP 313 ENA Member #5802 314 952 432 0815 home 952 426 2060 cell 315 [email protected] 316 317 Supporter(s): 318 Minnesota Emergency Nurses Association State Council 319 David Cheesebrow, ENA #66524 320 Jane Smalley, ENA #57413 321 Rebecca Englund, ENA #656678 322 Dede Koenekamp, ENA #79183
2021 General Assembly Appendix A Back to Top
ENA General Assembly Reference Guide
DELEGATION
1. Each state council shall determine its own method for delegate selection by using a point system, election or lottery.
2. Each state council is encouraged to take the following eligibility criteria into consideration in choosing its delegates: • Attendance at 50 percent of all scheduled meetings of the state council or local component since the previous General Assembly. • Service in an elected or appointed position at the local, state or national level during the prior three years; or • Participation in at least one of the following activities related to emergency nursing since the previous General Assembly: o Lecturer (other than that which is required in a professional nursing role) o Projects, such as public education, legislative involvement and chapter fundraising o Research in emergency nursing o Publishing on topics related to emergency care o Certification through the Board of Certification for Emergency Nursing (BCEN)
3. At least 30 days prior to the General Assembly, the ENA national office will send confirmation of delegate status to each delegate and alternate delegate. All proposed bylaws amendments, resolutions, rules and procedures will be made available on the ENA website.
4. Delegates and alternate delegates shall attend all business sessions of the General Assembly.
RESOLUTIONS
5. Resolutions must be submitted by the published deadline, to be considered during General Assembly.
6. Resolutions received at ENA headquarters will be forwarded to the Resolutions Committee, legal counsel, parliamentarian and ENA Board of Directors for review for compatibility with ENA’s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws and financial feasibility.
7. Resolutions that do not comply shall be returned to the authors with explanation.
8. Proposed resolutions submitted will be reviewed by the ENA Board of Directors for possible implementation prior to General Assembly.
9. The Resolutions Committee shall work with authors to combine proposed resolutions that have the same or similar subject matter.
10. Resolutions brought before the General Assembly shall include the exact text of the proposal along with
2021 ENA General Assembly Appendix A Back to Top
the financial considerations and operational implications. They may also include comments from the Resolutions Committee and the ENA Board of Directors.
BYLAWS AMENDMENT PROPOSALS
11. Bylaws amendment proposals received at ENA headquarters will be forwarded to the Resolutions Committee, legal counsel, parliamentarian and ENA Board of Directors for review for compatibility with ENA’s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws and financial feasibility.
12. Bylaws amendment proposals that do not comply shall be returned to the authors with explanation.
13. The Resolutions Committee shall work with authors to combine proposed bylaws amendments that have the same or similar subject matter.
14. Proposals to amend the ENA Bylaws shall include the exact text of the proposal. They may also include comments from the Resolutions Committee and ENA Board of Directors.
MISCELLANEOUS
15. The Resolutions Committee shall be authorized to correct article and section designations, punctuation and references in the Bylaws, Election Rules, and General Assembly Standing Rules of Procedure as may be necessary to reflect the intent of the General Assembly.
16. The draft General Assembly minutes shall be sent electronically to all state captains and the ENA Board of Directors for a 10-day review and comment period. The minutes shall be subsequently approved by the Resolutions Committee.
17. The status of resolutions adopted by the General Assembly will be made available to the ENA membership.
2021 ENA General Assembly Appendix B Back to Top 2020–2025 Emergency Nurses Association Strategic Plan
MISSION STATEMENT: To advance excellence in emergency nursing
CORE VALUES: Integrity Evidenced by openness and honesty in decisions, communications and actions
Diversity & Inclusion Evidenced by an organization that creates a culture and climate of mutual respect, inclusivity, and equity
Collaboration Evidenced by a professional community characterized by mutual respect, service to the benefit of others, and appreciation of our members’ contributions
Excellence Evidenced by a culture of inquiry dedicated to innovation, compassion, and global commitment to best practice
Credo Derived from the vision of our co-founders Judith Kelleher and Anita Dorr, our priorities are guided by these values and beliefs:
• Inclusion and the contributions of nursing, in • Emergency care evolves through lifelong learning collaboration with healthcare partners worldwide, and a culture of inquiry for the discovery and help explore innovative solutions to the challenges integration of evidence-based research into of emergency care delivery. emergency nursing practice. • Compassion is an essential element of the • Our Code of Ethics establishes and encourages emergency nursing profession. adherence to principles of honesty and integrity. • We should embrace inclusion, diversity and mutual • The spirit of philanthropy allows the advancement respect in all interactions and initiatives to promote of the profession of emergency nursing and the essential value of different perspectives and improves the lives of patients throughout the world. experiences within emergency nursing. • We place the highest value on our members • A team-based delivery of resources meet the highest for their contributions to the care of patients and quality standards of excellence for patients and their families, the emergency nursing profession, emergency nurses. and our organization. Appendix B Back to Top
Vivid Description of an Envisioned Future VISION Be the premier organization for the emergency nursing community worldwide
VIVID DESCRIPTION
Emergency Nurses Patients • Emergency nurses practicing worldwide have the • All patients (children, adults, seniors) receive high appropriate evidence-based resources needed to quality, specialized emergency care in all settings
provide the best care possible • Lower morbidity and mortality is demonstrated • Emergency nurses globally have access to for emergency patients as a result of leading-edge high quality education and resources to provide emergency nursing education and training provided excellent care by ENA
• Emergency nurses are working in an ideal practice • Patients receive expedited ED visits with streamlined environment admission to needed inpatient beds
• Emergency nurses provide care using their full scope The Public of practice • Legislators appreciate and advocate for the • Every emergency nurse receives the highest level knowledge and depth of care provided in the ED of specialized training and education offered • Emergency nurses provide a key voice in public ENA as an organization health epidemics • ENA is recognized as the preeminent worldwide • Communities are educated on injury prevention resource in emergency nursing to avoid preventable visits to the ED
• ENA is indispensable to the global community
• All emergency nurses are members of the ENA community
• ENA is the primary source of evidence-based emergency nursing resources and standards of care Appendix B Back to Top
Goals, Objectives & Strategies PRACTICE ENVIRONMENT GOAL: EMERGENCY NURSES WILL WORK IN AN IDEAL PRACTICE ENVIRONMENT TO PROVIDE THE HIGHEST QUALITY OF EMERGENCY CARE IN THE SAFEST WAY. Objectives: Strategies: 1. Improve quality and safety in emergency nursing 1. Develop and compile comprehensive institutional practice safety assessment and quality measures for emergency nursing 2. Prevent violence in the ED 3. Establish and disseminate standards for emergency 2. Lead efforts to develop and disseminate data and nursing practice resources to address workplace violence 4. Improve recruitment and retention of emergency 3. Establish and disseminate standards for emergency nurses nurses to provide care using their full scope of practice 4. Identify and disseminate best practices for emergency nursing staffing 5. Generate and promote new knowledge in emergency nurse wellness 6. Advocate for emergency departments to have the necessary resources and supplies for the highest quality, safe practice and safe care
EDUCATION GOAL: EMERGENCY NURSES HAVE THE HIGHEST QUALITY EDUCATIONAL RESOURCES TO PROVIDE THE HIGHEST LEVEL OF CARE. Objectives: Strategies: 1. Expand research to increase the generation of new 1. Identify research opportunities to meet the future knowledge in emergency nursing needs of emergency nurses 2. Expand the translation of best evidence into 2. Identify and prioritize emergency nursing education emergency nursing practice gaps 3. Increase development and delivery of educational 3. Expand ENA core educational offerings for all levels content for emergency nurses worldwide. of emergency nurses 4. Create new educational offerings that cover the breadth and depth of emergency nursing 5. Create the framework for the gold standard for emergency nursing orientation 6. Influence academia to include emergency nursing content 7. Ensure relevance of instructional design and delivery for all learners to match how and where they learn Appendix B Back to Top
COMMUNITY GOAL: ENA IS THE AUTHORITY AND PREMIER ORGANIZATION FOR EMERGENCY NURSING WORLDWIDE. Objectives: Strategies: 1. Increase membership 1. Evaluate membership categories 2. Increase collaboration and partnerships that 2. Strengthen member value proposition advance emergency nursing 3. Define strategic approach to partnerships and 3. Increase ENA presence in every ED organizations that advance emergency nursing 4. Expand the impact of the ENA Foundation 4. Increase ENA brand and product awareness in EDs 5. Expand the voice of the emergency nurse 5. Implement education and advocacy strategies for in healthcare policy and public health injury prevention and public health issues 6. Develop partnerships and a framework for emergency nurses to respond to disasters
CULTURE GOAL: ENA’S CULTURE IS DYNAMIC, ENSURING RELEVANCE IN A CHANGING ENVIRONMENT TO ADVANCE THE MISSION. Objectives: Strategies: 1. Utilize best-in-class technology to support 1. Implement new and emerging technologies to the development and delivery of leading-edge enhance the user experience education, research and practice resources and 2. Identify and implement best practices in governance member engagement 3. Strengthen support of State Councils and Chapters 2. Employ best practices in governance and leadership to provide best practices in strategic decision 3. Nurture and grow an organizational culture and making and leadership talent consistent with ENA’s values 4. Implement a comprehensive staff development 4. Manage expenses and resource utilization consistent program with ENA’s goals and objectives 5. Implement actions that advance diversity and inclusivity
930 E. Woodfield Road Schaumburg, Illinois 60173 847.460.4000 ena.org Appendix C Back to Top
EMERGENCY NURSES ASSOCIATION AND AFFILIATE
AUDITED CONSOLIDATED FINANCIAL STATEMENTS
YEARS ENDED DECEMBER 31, 2020 AND 2019
Assurance Assurance
LOCAL KNOWLEDGE, GLOBAL
EXPERTISE PKF Mueller | www.pkfmueller.com | +1 847 888 8600
Appendix C Back to Top
CONTENTS
PAGE
Consolidated Financial Statements
Independent Auditor’s Report ...... 1-2
Consolidated Statements of Financial Position ...... 3
Consolidated Statements of Activities and Changes in Net Assets ...... 4
Consolidated Statements of Functional Expenses...... 5-6
Consolidated Statements of Cash Flows ...... 7
Notes to Consolidated Financial Statements ...... 8-27
Supplementary Information
Independent Auditor’s Report on Supplementary Information ...... 28
Emergency Nurses Association
Statements of Financial Position ...... 29
Statements of Activities and Changes in Net Assets ...... 30
Statements of Functional Expenses ...... 31-32
Statements of Cash Flows ...... 33
ENA Foundation
Statements of Financial Position ...... 34
Statements of Activities and Changes in Net Assets ...... 35
Statements of Functional Expenses ...... 36-37
Statements of Cash Flows ...... 38
Appendix C Back to Top
1707 N. Randall Road, Suite 200 ■ Elgin, Illinois ■ 60123 Ph: 847.888.8600 ■ Fax: 847.888.0635 ■ www.pkfmueller.com
INDEPENDENT AUDITOR’S REPORT
To the Finance Committee of Emergency Nurses Association and Board of Trustees of ENA Foundation
Report on the Consolidated Financial Statements
We have audited the accompanying consolidated financial statements of Emergency Nurses Association
and Affiliate, which comprise the consolidated statements of financial position as of December 31, 2020 and 2019 and the related consolidated statements of activities and changes in nets assets, functional expenses and cash flows for the years then ended and the related notes to the consolidated financial statements (collectively, financial statements).
Manag ement’s Responsibility for the Financial Statements
Management is responsible for the preparation and fair presentation of these financial statements in accordance with accounting principles generally accepted in the United States of America; this includes the design, implementation and maintenance of internal control relevant to the preparation and fair presentation of financial statements that are free from material misstatement, whether due to fraud or error.
Auditor’s Responsibility
Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the financial statements are free of material misstatement.
An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in
the financial statements. The procedures selected depend on the auditor’s judgment, including the assessment of the risks of material misstatement of the financial statements, whether due to fraud or error. In making those risk assessments, the auditor considers internal control relevant to the entity’s preparation and fair presentation of the financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entity’s internal control. Accordingly, we express no such opinion. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by management, as well as evaluating the overall presentation of the financial statements.
We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion. -1-
Certified Public Accountants ■ Business & Financial Advisors Offices in Elgin, Chicago, Orland Park, Sarasota & Philadelphia
PKF Mueller is a member firm of the PKF International Limited family of legally independent firms and does not accept any responsibility or liability for the actions or inactions of any individual member or correspondent firm or firms. Appendix C Back to Top Opinion
In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Emergency Nurses Association and Affiliate as of December 31, 2020 and 2019, and the changes in their net assets and their cash flows for the years then ended in accordance with accounting principles generally accepted in the United States of America.
Elgin, Illinois July 16, 2021
-2- Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE CONSOLIDATED STATEMENTS OF FINANCIAL POSITION DECEMBER 31, 2020 AND 2019
ASSETS
2020 2019 Current assets: Cash and cash equivalents $ 1,560,378 1,741,436 Accounts receivable, net of allowance for doubtful accounts of $152,575 and $197,000 for 2020 and 2019, respectively 1,644,616 1,707,684 Grants receivable 16,909 16,723 Other receivables 74,053 47,188 Current portion of mortgage receivable 60,251 - Inventory 34,986 50,552 Prepaid expenses and other current assets 957,577 943,648
Total current assets 4,348,770 4,507,231
Property and equipment, net 11,885,260 12,266,872
Property held for sale - 2,450,000
Mortgage receivable, net of current portion 1,813,749 -
Investments 20,827,589 19,826,403
Total assets $ 38,875,368 39,050,506
LIABILITIES AND NET ASSETS
Current liabilities: Accounts payable $ 321,627 773,746 Wages and benefits payable 554,371 944,905 Accrued expenses 465,904 612,605 Credits on customer accounts 76,741 230,910 Assessments payable 822,900 1,330,139 Line of credit 1,099,209 1,099,209 Current portion of deferred revenue 2,676,587 2,579,300 Current portion of bond payable 337,586 337,313
Total current liabilities 6,354,925 7,908,127
Long-term liabilities: Interest rate swap agreement 1,209,973 712,437 Deferred revenue, net of current portion 1,284,361 1,182,892 Bond payable, net of current portion 8,872,932 9,210,518
Total long-term liabilities 11,367,266 11,105,847
Total liabilities 17,722,191 19,013,974
Net assets: Without donor restrictions: Undesignated 17,033,882 16,292,887 Board-designated 2,444,174 2,427,354
Total without donor restrictions 19,478,056 18,720,241
With donor restrictions 1,675,121 1,316,291
Total net assets 21,153,177 20,036,532
Total liabilities and net assets $ 38,875,368 39,050,506
The accompanying notes are an integral part of the consolidated financial statements. -3- Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE CONSOLIDATED STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS YEARS ENDED DECEMBER 31, 2020 AND 2019
2020 2019
WITHOUT DONOR WITH DONOR WITHOUT DONOR WITH DONOR RESTRICTIONS RESTRICTIONS TOTAL RESTRICTIONS RESTRICTIONS TOTAL Support and revenue: Courses $ 12,137,728 - 12,137,728 14,897,385 - 14,897,385 Membership dues 4,583,459 - 4,583,459 4,258,905 - 4,258,905 Conferences 867,804 - 867,804 3,333,411 - 3,333,411 Publications 584,984 - 584,984 760,483 - 760,483 Marketplace 506,938 - 506,938 586,580 - 586,580 Sponsorships 278,250 - 278,250 499,010 - 499,010 Royalties 155,369 - 155,369 515,554 - 515,554 Other 256,654 - 256,654 480,881 - 480,881 Grants 181,735 - 181,735 80,988 - 80,988 Paycheck Protection Program grant revenue 1,938,315 - 1,938,315 - - - Mailing lists 3,960 - 3,960 19,781 - 19,781 Contributions 193,892 450,342 644,234 128,764 421,128 549,892 Donated services 75,000 - 75,000 95,000 - 95,000 Special event revenue, net of direct expenses - - - 52,389 - 52,389 Net assets released from restrictions 261,351 (261,351) - 340,158 (340,158) -
Total support and revenue 22,025,439 188,991 22,214,430 26,049,289 80,970 26,130,259
Expenses: Programs, grants and scholarships 14,299,399 - 14,299,399 17,871,999 - 17,871,999 Management and general 7,095,121 - 7,095,121 8,111,964 - 8,111,964 Fundraising and development 462,763 - 462,763 453,258 - 453,258
Total expenses 21,857,283 - 21,857,283 26,437,221 - 26,437,221
Increase (decrease) in net assets - before other income 168,156 188,991 357,147 (387, 932) 80,970 (306,962)
Other income (expense): Interest expense (378,564) - (378,564) (403, 661) - (403,661) Investment income, net 1,915,759 169,839 2,085,598 3,124,439 203,474 3,327,913 Loss on interest rate swap agreement (497,536) - (497,536) (427, 846) - (427,846) Loss on disposal of property held for sale (450,000) - (450,000) - - -
Total other income 589,659 169,839 759,498 2,292,932 203,474 2,496,406
Change in net assets 757,815 358,830 1,116,645 1,905,000 284,444 2,189,444
Net assets, beginning of year 18,720,241 1,316,291 20,036,532 16,815,241 1,031,847 17,847,088
Net assets, end of year $ 19,478,056 1,675,121 21,153,177 18,720,241 1,316,291 20,036,532 The accompanying notes are an integral part of the consolidated financial statements. -4- Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE CONSOLIDATED STATEMENT OF FUNCTIONAL EXPENSES YEAR ENDED DECEMBER 31, 2020
PROGRAMS, GRANTS MANAGEMENT FUNDRAISING AND SCHOLARSHIPS AND GENERAL AND DEVELOPMENT TOTAL
Payroll expenses: Salaries and wages $ 5,416,146 3,189,000 - 8,605,146 Employee benefits 743,590 433,757 - 1,177,347 Payroll taxes 401,152 218,721 - 619,873
6,560,888 3,841,478 - 10,402,366
Operating expenses: Bank charges and credit card processing fees - 361,651 909 362,560 Advertising and promotion 106,572 251 2,389 109,212 Discount on sales 142,192 - - 142,192 Bad debt expense 35,160 - - 35,160 Computer 223,389 780,161 - 1,003,550 Conferences 627,462 91,741 850 720,053 Cost of goods sold 1,343,693 - - 1,343,693 Depreciation and amortization 359,425 117,967 11,722 489,114 Fulfillment and warehousing services 210,333 - - 210,333 Grants and scholarships 330,408 2,640 381,562 714,610 Insurance 57,912 46,494 - 104,406 Miscellaneous 31,958 69,565 - 101,523 Postage, freight and shipping 238,061 9,630 87 247,778 Printing 242,936 12,344 251 255,531 Professional services 965,007 845,119 30,448 1,840,574 Provision for UBIT 1,316 - - 1,316 Public relations 9,211 156 - 9,367 Recruitment fees - 38,017 - 38,017 Stipends 101,969 137,000 - 238,969 Supplies and equipment 35,965 101,422 553 137,940 Temporary workers 35,010 86,949 - 121,959 Training 31,649 120,736 - 152,385 Travel 127,094 102,215 1,780 231,089
5,256,722 2,924,058 430,551 8,611,331
Occupancy expenses: Building maintenance 114,796 71,991 7,783 194,570 Depreciation 135,870 85,207 9,212 230,289 Insurance 12,537 7,862 850 21,249 Real estate taxes 155,014 97,212 10,509 262,735 Rent 45,514 31,629 - 77,143 Telephone 2,622 1,645 178 4,445 Utilities 54,278 34,039 3,680 91,997
520,631 329,585 32,212 882,428
Assessment expenses: State/chapter membership dues 543,738 - - 543,738 ENPC/TNCC 1,417,420 - - 1,417,420
1,961,158 - - 1,961,158
$ 14,299,399 7,095,121 462,763 21,857,283
The accompanying notes are an integral part of the consolidated financial statements.
-5- Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE CONSOLIDATED STATEMENT OF FUNCTIONAL EXPENSES YEAR ENDED DECEMBER 31, 2019
PROGRAMS, GRANTS MANAGEMENT FUNDRAISING AND SCHOLARSHIPS AND GENERAL AND DEVELOPMENT TOTAL
Payroll expenses: Salaries and wages $ 5,425,344 3,598,339 - 9,023,683 Employee benefits 1,130,052 722,663 - 1,852,715 Payroll taxes 404,695 245,559 - 650,254
6,960,091 4,566,561 - 11,526,652
Operating expenses: Bank charges and credit card processing fees - 427,023 276 427,299 Advertising and promotion 156,716 - - 156,716 Discount on sales 174,041 - - 174,041 Bad debt expense 39,553 - - 39,553 Computer 159,406 672,581 - 831,987 Conferences 2,205,102 270,099 11,154 2,486,355 Cost of goods sold 1,830,712 - - 1,830,712 Depreciation and amortization 311,679 130,190 12,038 453,907 Fulfillment and warehousing services 271,831 - - 271,831 Grants and scholarships 489,341 - 382,019 871,360 Insurance 55,441 51,066 - 106,507 Miscellaneous 113,767 82,135 - 195,902 Postage, freight and shipping 276,250 3,890 404 280,544 Printing 309,658 11,728 6,400 327,786 Professional services 634,521 575,624 - 1,210,145 Provision for UBIT 51,852 - - 51,852 Public relations 26,455 450 - 26,905 Recruitment fees 1,125 68,819 - 69,944 Stipends 143,690 142,000 - 285,690 Supplies and equipment 58,797 109,706 1,007 169,510 Temporary workers 211,305 39,632 - 250,937 Training 38,026 222,051 - 260,077 Travel 566,415 315,733 1,026 883,174
8,125,683 3,122,727 414,324 11,662,734
Occupancy expenses: Building maintenance 135,800 97,001 9,700 242,501 Depreciation 124,850 89,178 8,918 222,946 Insurance 10,007 7,148 715 17,870 Real estate taxes 204,813 146,296 14,630 365,739 Rent 42,434 33,342 - 75,776 Telephone 8,499 6,071 607 15,177 Utilities 61,094 43,640 4,364 109,098
587,497 422,676 38,934 1,049,107
Assessment expenses: State/chapter membership dues 527,315 - - 527,315 ENPC/TNCC 1,671,413 - - 1,671,413
2,198,728 - - 2,198,728
$ 17,871,999 8,111,964 453,258 26,437,221
The accompanying notes are an integral part of the consolidated financial statements.
-6- Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE CONSOLIDATED STATEMENTS OF CASH FLOWS YEARS ENDED DECEMBER 31, 2020 AND 2019
2020 2019 Cash provided by (applied to) operating activities: Change in net assets $ 1,116,645 2,189, 444 Adjustments to reconcile change in net assets to net cash applied to operating activities: Depreciation and amortization of property and equipment 711,884 669,061 Amortization of debt issuance costs 7,519 7,792 Loss on interest rate swap agreement 497,536 427,846 Loss on disposal of property held for sale 450,000 - Bad debt (recovery) expense (44,425) 33,466 Realized and unrealized gain on investments (1,633,845) (2,737,409) Contributions restricted for investment in endowments (63,104) (106,009) Decrease (increase) in assets: Accounts receivable, net of change in allowance for doubtful accounts 107,493 187,485 Grants receivable (186) (16,723) Other receivables (26,865) (108) Inventory 15,566 64,275 Prepaid expenses and other current assets (13,929) (280,183) Increase (decrease) in liabilities: Accounts payable (452,119) (15,666) Wages and benefits payable (390,534) 120,438 Accrued expenses (146,701) (90,198) Credits on customer accounts (154,169) (399,374) Assessments payable (507,239) (286,401) Deferred revenue 198,756 23,000
Total cash applied to operating activities (327,717) (209,264)
Cash provided by (applied to) investing activities: Purchases of property and equipment (330,272) (574,043) Payments received on mortgage receivable 126,000 - Purchase of investments (3,506,307) (2,740,647) Proceeds from sale and maturities of investments 4,138,966 4,476,502
Total cash provided by investing activities 428,387 1,161,812
Cash provided by (applied to) financing activities: Collections of contributions restricted for investment in endowments 63,104 106,009 Payments on line of credit - (8,382) Payments on bonds payable (344,832) (344,832)
Total cash applied to financing activities (281,728) (247,205)
Net increase (decrease) in cash and cash equivalents (181,058) 705,343
Cash and cash equivalents, beginning of year 1,741,436 1,036,093
Cash and cash equivalents, end of year $ 1,560,378 1,741, 436
Noncash investing transaction: Mortgage receivable from sale of property held for sale $ 2,000,000 -
Other cash flow information: Interest paid $ 378,564 403,661
Income taxes paid $ 5,849 53,000
The accompanying notes are an integral part of the consolidated financial statements.
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 1 - NATURE OF OPERATIONS
Emergency Nurses Association and Affiliate (Organization) consists of Emergency Nurses Association (ENA) and ENA Foundation (ENAF).
ENA is a not-for-profit, professional association whose mission is to advocate for patient safety and excellence in emergency nursing practice. ENA, whose national headquarters is located in Schaumburg, Illinois, was founded in 1970. Paid membership is approximately 43,500.
ENAF was established in 1991 to operate exclusively for charitable, educational and scientific purposes relating to emergency nursing. ENAF activities benefit emergency nurses, patients and the public through provision of undergraduate, advance practice, doctoral and continuing education scholarships and research grants.
NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES
Basis of Presentation
The consolidated financial statements have been prepared on the accrual basis of accounting in accordance with accounting principles applicable to not-for-profit organizations and in accordance with accounting principles generally accepted in the United States of America.
Principles of Consolidation
The accompanying consolidated financial statements (collectively, financial statements) include the accounts of ENA and ENAF. The sole voting member of ENAF is ENA. Since ENA has control of the ENAF Board, accounting principles generally accepted in the United States of America require that the financial position and activities of both organizations be consolidated. All significant interorganizational transactions and balances have been eliminated in consolidation.
Cash and Cash Equivalents
For purposes of the statements of cash flows, the Organization considers all highly liquid instruments with an original maturity of three months or less to be cash equivalents.
Accounts Receivable
Accounts receivable consists of amounts due from Trauma Nursing Core Courses (TNCC), Emergency Nursing Pediatric Courses (ENPC), the sale of advertising space in various ENA publications and royalty arrangements with vendors for ENA educational offerings. Management reviews the aging of the course receivables to determine the level of allowance for doubtful accounts to establish against the course receivables. As of December 31, 2020 and 2019, no allowance was deemed necessary for non-course receivables.
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED
Inventory
Inventory is stated at the lower of cost or net realizable value, determined by the first-in, first-out (FIFO) method. As of December 31, 2020 and 2019, there was no allowance for obsolete or excess inventory recorded.
Property and Equipment
Property and equipment is stated at cost and is depreciated and amortized over the estimated useful lives of the related assets using the straight-line method. Purchases greater than $2,500 are capitalized to property and equipment. Costs of repairs and maintenance are charged to expense as incurred.
Property Held for Sale
Property held for sale is recorded at the lower of cost or estimated fair value. During the year ended December 31, 2019 it was determined that the property held for sale was not impaired. On August 21, 2020, the property held for sale sold for $2,000,000 resulting in a loss on sale of $450,000 for the year ended December 31, 2020.
Investments
Long-term and short-term investments in marketable securities with readily determinable fair values are presented in the financial statements at fair value. Short-term investments are those with a maturity of greater than three months but no more than one year. Long-term investments with a maturity of greater than one year are mutual funds or equity securities. The fair values of investments are based on quoted market prices, when available, for those investments. Both realized and unrealized gains and losses are reported as investment income in the consolidated statement of activities and changes in net assets. The Organization's investments are exposed to various risks, such as interest rate, credit and overall market volatility. Due to these risk factors, it is reasonably possible that changes in the values of investments will occur in near term that will materially affect the amounts reported in the consolidated statements of activities and changes in net assets.
Credits on Customer Accounts
Credits on customer accounts represent overpayments on accounts of ENA course directors relating to course fees. These overpayments are not automatically refunded, but instead are held on the account until the course director provides instruction as to the disposition of the credit. The credits are typically applied to future courses.
Assessments Payable
Assessments payable are amounts due to ENA State Councils and Chapters for their share of paid memberships and course fees. Assessments are calculated and paid quarterly.
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED
Interest Rate Swap Agreements
Interest rate swap agreements are reflected at fair value in the Organization’s consolidated statements of financial position and the related portions of the debt being hedged are reflected at an amount equal to its carrying value.
Under accounting principles generally accepted in the United States of America, not-for-profit entities may elect to use a simplified hedge accounting approach to account for interest rate swap agreements that are entered into for the purpose of economically converting a variable-rate borrowing into a fixed- rate borrowing. Under this approach, the statement of activity charge for interest expense is similar to the amount that would result if the Organization had directly entered into a fixed-rate borrowing instead of a variable-rate borrowing and a receive-variable, pay-fixed interest rate swap. The Organization elected to use the simplified accounting approach.
Net Assets
Net assets, revenues, gains and losses are classified based on the existence or absence of donor or grantor imposed restrictions. Accordingly, net assets and changes therein are classified and reported as follows:
Net Assets Without Donor Restrictions – Net assets available for use in general operations and not subject to donor-imposed restrictions. Currently the ENA Board of Directors (ENA Board) has designated funds for ENAF endowments as well as to fund projects that fall within the criteria of the ENA spending policy. The ENAF Board has also designated funds for the ENAF endowments.
Net Assets With Donor Restrictions – Net assets subject to donor-imposed restrictions. Some donor- imposed restrictions are temporary in nature, such as those that will be met by the passage of time or other events specified by the donor. Other donor-imposed restrictions are perpetual in nature, where the donor stipulates that resources be maintained in perpetuity. Donor-imposed restrictions are released when a restriction expires, that is, when the stipulated time has elapsed, when the stipulated purpose for which the resource was restricted has been fulfilled, or both.
Concentration of Credit Risk
The Organization maintains its cash in bank deposits which, at times, may exceed federally insured limits. The Organization’s uninsured cash balance was $836,511 and $1,156,576 at December 31, 2020 and 2019, respectively. The Organization believes it is not exposed to any significant credit risk on cash.
The Organization maintains its investments in broker accounts which, at times, may exceed federally insured limits. As of December 31, 2020 and 2019, the Organization’s uninsured investment balance was $19,844,076 and $18,926,091, respectively. The Organization believes it is not exposed to any significant credit risk on cash or investments.
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED
Revenue from Contracts with Customers
The Organization derives a significant portion of its revenue from revenue sources that involve contracts with customers. Those sources include courses, membership dues, conferences, publications, marketplace, sponsorships, royalties and other revenue. Revenues are recognized when control of these goods or services are transferred to its customers, in an amount that reflects the consideration the Organization expects to be entitled to in exchange for those goods or services. The Organization does not have any significant financing components as all payments are received within a year of the services being provided. Costs incurred to obtain a contract will be expensed as incurred when the amortization period is less than a year. All contracts contain specified pricing for each performance obligation thus allocation of the transaction price is not necessary.
Disaggregation of Revenue from Contracts with Customers
The following table disaggregates the Organization’s revenue based on the timing of satisfaction of performance obligations for the years ended December 31:
2020 2019
Performance obligations satisfied at a point in time $ 14,153,707 20,119,009 Performance obligations satisfied over time $ 5,217,479 5,213,200
Revenues from performance obligations satisfied at a point in time consist of revenues from courses, conferences, publication advertising revenue, marketplace, event sponsorships and other revenues. Revenues from performance obligations satisfied over time consist of membership dues, publication editorial support and profit sharing, corporate engagement council sponsorships and royalties.
Performance Obligations
For performance obligations related to courses, control transfers to the customer at a point in time. Courses occur on specified dates and course fee revenue is recorded when the course is held. Revenue from the sale of manuals is recognized upon shipment to the customer.
For performance obligations related to membership dues, control transfers to the customer over time. The Organization offers membership categories of one year, three years, five years and lifetime. Revenue is recorded in equal installments as control is passed to the customer over the term of the membership. The Organization has determined that the average career span of an emergency professional is thirteen years and recognizes lifetime memberships over a thirteen-year period.
For performance obligations related to conferences, control transfers to the customer at a point in time. Conferences occur at specified dates and revenue is recorded at the time the conference is held.
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED
Revenue from Contracts with Customers, Continued
Performance Obligations, Continued
For performance obligations related to publication advertising revenue, control transfers at a point in time. Revenue is recorded at the time the advertisement is printed or advertising service is performed. For performance obligations related to publication editorial support and profit sharing, control transfers to the customer over time in equal installments as control is passed to the publisher over the term of the agreement.
For performance obligations related to marketplace, control transfers to the customer at a point in time. Revenue from marketplace is recognized upon shipment of goods to customers.
For performance obligations related to event sponsorships, control transfers to the customer at a point in time. Events occur at specified dates and revenue is recorded at the time the event is held. For performance obligations related to corporate engagement council sponsorships, control transfers to the customer over time. All obligations associated with corporate engagement council sponsorships are satisfied in the year in which the contract was obtained.
For performance obligations related to royalty revenue, control transfers to the customer over time. The Organization recognizes royalty revenue using the output method based on terms agreed upon in contracts established with customers. The Organization receives a percentage of gross income in exchange for a customer’s usage of the Organization’s name and logo. The Organization also receives commissions based on net revenue generated for promotion of a job board on the Organization’s website.
For performance obligations related to other revenues, control transfers to the customer at a point in time. For the year ended December 31, 2019, a significant portion of the other revenues related to postponing the close date of the property held for sale.
Conference fees received in advance are deferred until the conference takes place. Course fees received in advance are deferred until the course takes place. Membership dues received in advance are deferred until the period to which the dues relate. The deferred amounts as of December 31, 2020 and 2019 are included in deferred revenue on the consolidated statements of financial position.
Contributions
The Organization recognizes contributions when cash, securities or other assets, an unconditional promise to give, or a notification of a beneficial interest is received. Conditional promises to give, that is, those with a measurable performance or other barrier, and a right of return, are not recognized until the conditions on which they depend have been substantially met. Contributions received are recorded as without donor restrictions or with donor restrictions, depending on the existence and/or nature of any donor restrictions. Contributions not collected at the end of the year are disclosed as pledges receivable and are recorded at their estimated fair values. They are subsequently valued at the present value of future cash flows. All contributions are expected to be collected in one year or less.
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED
Contributions, Continued
All donor-restricted support is reported as an increase in net assets with donor restrictions, depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or a purpose restriction is accomplished), net assets with donor restrictions are reclassified to net assets without donor restriction and reported in the consolidated statements of activities and changes in net assets as net assets released from restrictions.
Accounting Estimates
The preparation of financial statements in accordance with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenue and expenses during the reporting period. Actual results could differ from those estimates.
Income Taxes
ENA and ENAF are exempt from federal and state income taxes under Internal Revenue Code Section 501(c)(3). ENA pays unrelated business income tax on advertising revenues derived from various ENA publications, as well as sponsorship revenues that provide marketing opportunities for the sponsor. Unrelated business income tax (UBIT) for the years ended December 31, 2020 and 2019 amounted to $1,316 and $51,852, respectively. Provision for UBIT expense is included in programs, grants and scholarship expense on the consolidated statements of functional expenses.
Management has concluded that as of December 31, 2020 and 2019, there were no uncertain positions taken or expected to be taken that would require recognition of a liability or disclosure in the consolidated financial statements. The Organization would account for any potential interest or penalties related to possible future liabilities for unrecognized income tax benefits as income tax expense. The Organization is no longer subject to examination by federal, state or local tax authorities for periods before 2017.
Functional Expenses
The costs of program and supporting service activities have been summarized on a functional basis in the consolidated statements of activities and changes in net assets. The consolidated statements of functional expenses present the natural classification detail of expenses by function. Accordingly, certain costs have been allocated among the programs and supporting services benefited.
The financial statements report certain categories of expenses that are attributable to more than one program or supporting function. Therefore, expenses require allocation on a reasonable basis that is consistently applied. The Organization utilizes a direct coding methodology for a majority of their expenses, however, expenses classified as occupancy expenses on the consolidated statements of functional expenses are allocated on the basis of estimates of time and effort.
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED
Changes In Accounting Principles – Fair Value Measurement
In August 2018, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement, which modifies certain disclosure requirements for reporting fair value measurements. The Organization adopted ASU No. 2018-13 as of January 1, 2020. The adoption did not have a material impact on the Organization’s disclosures related to the fair value measurements.
New Accounting Standard – Leases
In February 2016, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) No. 2016-02, Leases (Topic 842). The FASB also subsequently issued additional ASUs, which amend and clarify Topic 842. The most significant change in the new leasing guidance is the requirement to recognize right-to-use assets and lease liabilities for operating leases on the statement of financial position. The ASUs are effective for fiscal years beginning after December 15, 2021. Early adoption is permitted. The Organization is currently evaluating the methods of adoption allowed and the effect that adoption is expected to have on its financial position, results of operations and cash flows and related disclosures.
Management Evaluation of Going Concern
In accordance with accounting principles generally accepted in the United States of America, management performed an evaluation to determine if adverse conditions or events, considered in the aggregate, raise substantial doubt about the Organization’s ability to continue as a going concern for the one-year period from the date the financial statements were available to be issued. Management’s evaluation did not identify any conditions or events raising substantial doubt about the Organization’s ability to continue as a going concern for the period from July 16, 2021 to July 16, 2022.
Subsequent Events
Subsequent events have been evaluated through July 16, 2021, the date that the financial statements were available for issue.
In February 2021, the Organization received a second Paycheck Protection Program loan in the amount of $1,938,315. See Note 16.
In March 2021, the Organization received notice that the Small Business Administration authorized full forgiveness of the first Paycheck Protection Program loan, which legally released to Organization from the loan obligation. See Note 16.
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 3 - LIQUIDITY AND AVAILABILITY
The following tables reflects the Organization’s financial assets as of December 31, 2020 and 2019, reduced by amounts not available for general expenditure within one year. Financial assets are considered unavailable when illiquid or not convertible to cash within one year, because donors have imposed restrictions on the use of the funds, or because the governing board has set aside the funds for a specific operational contingency reserve.
Liquidity and Availability as of December 31, 2020 Less: Funds Financial Assets Funds Not Restricted by Available for Total Per Convertible to Less: Funds Board for an General Statement of Cash Within One Restricted by Operating Expenditures Financial Position Year Donors Reserve Within One Year
Cash and cash equivalents $ 1,560,378 - ( 218,259) - 1,342,119 Accounts receivable, net 1,644,616 - - - 1,664,616 Grants receivable 16,909 - - - 16,909 Other receivables 74,053 - - - 74,053 Investments 20,827,589 - ( 1,456,862) ( 2,444,174) 16,926,553
Total financial assets $ 24,123,545 - ( 1,675,121) ( 2,444,174) 20,004,250
Liquidity and Availability as of December 31, 2019 Less: Funds Financial Assets Funds Not Restricted by Available for Total Per Convertible to Less: Funds Board for an General Statement of Cash Within One Restricted by Operating Expenditures Financial Position Year Donors Reserve Within One Year
Cash and cash equivalents $ 1,741,436 - ( 46,751) - 1,694,685 Accounts receivable, net 1,707,684 - - - 1,707,684 Grants receivable 16,723 - - - 16,723 Other receivables 47,188 - - - 47,188 Investments 19,826,403 - ( 1,269,540) ( 2,427,354) 16,129,509
Total financial assets $ 23,339,434 - ( 1,316,291) ( 2,427,354) 19,595,789
The Organization’s endowment funds consist of donor-restricted endowments. Income from donor- restricted endowments is restricted for specific purposes. As of December 31, 2020 and 2019, donor- restricted endowment funds were not available for general expenditure.
The Organization’s board-designated endowment of $1,835,515 and $1,925,444 as of December 31, 2020 and 2019, respectively, is subject to an annual spending rate of 5% as described in Note 12. Although the Organization does not intend to spend from this board-designated endowment (other than amounts appropriated for general expenditure as part of the ENAF Board’s annual budget approval and appropriation), these amounts could be made available if necessary.
During 2020, the ENAF Board designated funds for utilizing reserves to support COVID-19 relief. At December 31, 2020, there was a balance of $106,749 with this designation. Although the Organization intends to spend these funds in support of COVID-19 relief, these amounts could be made available if necessary. -15-
Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 3 - LIQUIDITY AND AVAILABILITY, CONTINUED
Additionally, the ENA Board has designated funds within the parameters of the ENA spending policy for utilizing reserves on identified projects. At December 31, 2020 and 2019 there was a balance of $501,910 with this designation. Although the Organization intends to spend these funds in accordance with the ENA spending policy referred to above, these amounts could be made available if necessary.
As part of the Organization’s liquidity management plan, cash in excess of current needs for expenses are invested in mutual funds. Investments are released to cover operating expenses as needed upon management approval. Additionally, the Organization maintains a line of credit that if deemed necessary can be drawn upon to cover operating expenses (Note 7).
NOTE 4 - PROPERTY AND EQUIPMENT
The useful lives for purposes of computing depreciation and amortization are as follows:
Buildings 40 years Building improvements 30 - 40 years Equipment 5 years Program development 3 - 7 years Furniture and fixtures 15 years Computer software 3 - 7 years
Property and equipment is summarized as follows as of December 31, 2020 and 2019:
2020 2019
Land $ 1,492,112 1,492,112 Buildings 2,948,699 2,948,699 Building improvements 5,969,138 5,969,138 Equipment 262,170 262,170 Program development 913,206 815,584 Furniture and fixtures 1,297,835 1,286,753 Computer software 5,032,211 4,810,643 17,915,371 17,585,099 Less accumulated depreciation and amortization ( 6,030,111) ( 5,318,227)
$ 11,885,260 12,266,872
Depreciation expense of property and equipment charged to operations was $525,363 and $525,913 for the years ended December 31, 2020 and 2019, respectively. In addition, the Organization amortized development costs (included in programs, grants and scholarship expenses) for the years ended December 31, 2020 and 2019 in the amounts of $186,521 and $143,148, respectively.
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 5 - MORTGAGE RECEIVABLE
On August 21, 2020, the Organization entered into a real estate sale agreement with a third party. The Organization agreed to provide financing for a portion of the purchase price of the property sold, which amounted to $1,900,000. The mortgage receivable is stated at unpaid principal balance, less an allowance for loan losses. As of December 31, 2020, an allowance was not deemed necessary. Certain insurance coverage is required and the policies must name the Organization as additional insured.
Interest on the note is compounded annually and accrues at a rate of 4.00% annually from September 1, 2021 through August 31, 2023 and at a rate of 5.00% annually from August 31, 2023 through the maturity date. Interest on the loan is recognized over the term of the loan and is calculated using the interest method on principal amounts outstanding. No interest was received for the year ended December 31, 2020. The Organization’s practice is to charge off any loan or a portion of a loan when the loan is determined by management to be uncollectible due to the third party’s failure to meet repayment terms, or for other reasons.
NOTE 6 - FAIR VALUE MEASUREMENTS
Accounting standards generally accepted in the United States of America establish a framework for measuring fair value. That framework provides a fair value hierarchy that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1 measurements) and the lowest priority to unobservable inputs (Level 3 measurements). The three levels of the fair value hierarchy are described below:
Level 1 Inputs to the valuation methodology are unadjusted quoted prices for identical assets or liabilities in active markets that management has the ability to access at the measurement date.
Level 2 Inputs other than quoted prices included within Level 1 that are observable for the asset or liability, either directly or indirectly such as:
• Quoted prices for similar assets or liabilities in active markets; • Quoted prices for identical or similar assets or liabilities in inactive markets; • Inputs other than quoted prices that are observable for the asset or liability; • Inputs that are derived principally from or corroborated by observable market data by correlation or other means.
If the asset or liability has a specified (contractual) term, the Level 2 input must be observable for substantially the full term of the asset or liability.
Level 3 Inputs to the valuation methodology are unobservable and significant to the fair value measurement.
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 6 - FAIR VALUE MEASUREMENTS, CONTINUED
The asset’s or liability’s fair value measurement level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. Valuation techniques used need to maximize the use of observable inputs and minimize the use of unobservable inputs.
Following is a description of the valuation methodologies used for assets and liabilities measured at fair value. There have been no changes in the methodologies used at December 31, 2020 and 2019.
Mutual funds: Valued at the closing price as reported by the fund. Mutual funds held by the Organization are open-end mutual funds that are registered with the U.S. Securities and Exchange Commission. These funds are required to publish their daily net asset value (NAV) and to transact at that price.
Interest rate swap: Valued using both observable and unobservable inputs when available and can generally be corroborated by market data.
The methods described above may produce a fair value calculation that may not be indicative of net realizable value or reflective of future fair values. Furthermore, while the Organization believes its valuation methods are appropriate and consistent with other market participants, the use of different methodologies or assumptions to determine the fair value of certain financial instruments could result in a different fair value measurement at the reporting date.
Assets and liabilities reported at fair value consisted of the following at December 31:
Fair Value at December 31, 2020 Level 1 Level 2 Level 3 Total Assets: Mutual funds: Fixed income: Broad domestic $ 4,559,119 - - 4,559,119 High yield bonds 5,684,903 - - 5,684,903 Short-term bonds 37,323 - - 37,323
Equity: Domestic large cap 5,445,110 - - 5,445,110 Domestic small/mid cap 1,040,214 - - 1,040,214 International equity 1,981,176 - - 1,981,176 Emerging markets 2,079,744 - - 2,079,744
$ 20,827,589 - - 20,827,589
Liability - Interest rate swap $ - 1,209,973 - 1,209,973
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 6 - FAIR VALUE MEASUREMENTS, CONTINUED
Fair Value at December 31, 2019 Level 1 Level 2 Level 3 Total Assets: Mutual funds: Fixed income: Broad domestic $ 4,492,275 - - 4,492,275 High yield bonds 5,099,422 - - 5,099,422 Short-term bonds 220,060 - - 220,060
Equity: Domestic large cap 5,181,790 - - 5,181,790 Domestic small/mid cap 1,001,768 - - 1,001,768 International equity 1,859,880 - - 1,859,880 Emerging markets 1,971,208 - - 1,971,208
$ 19,826,403 - - 19,826,403
Liability - Interest rate swap $ - 712,437 - 712,437
For the years ended December 31, 2020 and 2019, there were no significant transfers in or out of Level 3.
NOTE 7 - LINE OF CREDIT
The Organization has a $2,500,000 unsecured line of credit. This line expires on December 21, 2021 and bears interest at 1.5% plus 30 day LIBOR (2.50% at December 31, 2020). The outstanding balance on the line of credit was $1,099,209 at December 31, 2020 and 2019, respectively.
Restrictive covenants imposed under the line of credit require the Organization to maintain an unrestricted cash and investment to total fund debt of not less than 1.25 (ENA only). As of December 31, 2020 and 2019, this covenant was met.
NOTE 8 - BOND PAYABLE
On December 21, 2017, a Series 2017 Industrial Revenue Bond (Bond) was issued by the City of Watseka. The aggregate principal amount of the Bond is $10,000,000 and the proceeds of the Bond were used to finance the purchase of the land and building in Schaumburg, IL. The maturity date of the Bond is December 21, 2047.
The Bond bears interest at variable rates throughout the life of the bond. As of December 31, 2020, the interest rate on the Bond is 1.19%. The Bond requires monthly payments of $28,736.
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 8 - BOND PAYABLE, CONTINUED
The Bond agreement requires the Organization to furnish audited financial statements 270 days after each year end.
There were debt issuance costs of $123,194 related to the bond issuance. Amortization expense for the years ended December 31, 2020 and 2019 was $7,519 and $7,792, respectively.
During 2018, the Organization entered into a $10,000,000 interest rate swap agreement with a bank to fix the rate on the variable rate bond and to manage the borrowing costs. The interest rate swap agreement has a termination date of December 10, 2027 and a fixed interest rate of 3.61%.
The settlement value of the interest rate swap at December 31, 2020 and 2019 was a liability of $1,209,973 and $712,437, respectively. The settlement rate was estimated using a present value calculation of the swap's remaining estimated cash flows, not adjusted for any nonperformance risk.
The Bond payable as of December 31, 2020 and 2019 consisted of the following:
2020 2019
DEBT ISSUE DEBT ISSUE PRINCIPAL COSTS NET PRINCIPAL COSTS NET
Bond $ 9,310,336 99,818 9,210,518 9,655,168 107,337 9,547,831 Current portion 344,832 7,246 337,586 344,832 7,519 337,313
$ 8,965,504 92,572 8,872,932 9,310,336 99,818 9,210,518
Principal payments due on Bond payable during each of the next five years are as follows:
2021 $ 344,832 2022 344,832 2023 344,832 2024 344,832 2025 344,832 Thereafter 7,586,176
$ 9,310,336
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 9 - OPERATING LEASES
The Organization is obligated under certain operating leases, primarily for certain office space and office equipment which expire on various dates until 2025.
Total rent expense under all operating leases amounted to $107,465 and $104,346 for the years ended December 31, 2020 and 2019, respectively.
The aggregate future minimum lease commitment on these leases as of December 31, 2020 is as follows:
2021 $ 95,138 2022 78,537 2023 63,682 2024 65,343 2025 67,055
$ 369,755
NOTE 10 - RETIREMENT SAVINGS PLAN
ENA has a 401(k) defined contribution retirement savings plan (Plan) available to substantially all of ENA’s employees. ENA matches up to 4% of each employee’s contribution to the Plan. The Plan also has a discretionary profit-sharing component. ENA’s discretionary profit-sharing contribution is determined annually based on the fiscal results of the organization with input from staff and the Board. In 2019, ENA’s profit-sharing contribution was 5% of each qualified employee’s salary. In 2020, there was no profit-sharing contribution. ENA’s contribution is funded on a current basis. Total contributions to the Plan in 2020 and 2019 were $256,285 and $679,760, respectively.
NOTE 11 - COMMITMENTS AND CONTINGENCIES
The Organization has entered into a number of contracts with various vendors for space, hotel accommodations and ancillary services for future meetings. Minimum estimated cancellation fees are as follows:
2021 $ 1,297,238 2022 127,992 2023 - 2024 2,040,450
$ 3,465,680
The $1,938,315 Paycheck Protection Program loan and its forgiveness are subject to examination under the terms of the agreement with the Small Business Administration for a period of six years from the date the loan is forgiven. The Organization is not currently under examination nor has the Organization been contacted. -21-
Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 12 - ENDOWMENTS
The Organization's endowment includes three board-designated endowments established for the ENAF and fourteen donor-restricted endowment funds primarily for the general operating purposes of the Organization, as well as for specific programs and scholarships. Net assets associated with endowment funds are classified and reported based on the existence or absence of donor-imposed restrictions.
Interpretation of Relevant Law
The State of Illinois adopted the Uniform Prudent Management of Institutional Funds Act (UPMIFA) on June 30, 2009. The Organization has adopted a spending policy that requires the preservation of the fair value of the original gift as of the gift date of the donor-restricted endowment fund absent explicit donor stipulations to the contrary.
As a result of this policy, the Organization retains in perpetuity (a) the original value of initial and subsequent gift amounts (including promises to give net of discount and allowance for doubtful accounts) donated to the endowment and (b) any accumulations to the endowment made in accordance with the direction of the applicable donor gift instrument at the time the accumulation is added. Donor-restricted amounts not retained in perpetuity are subject to appropriation for expenditure by the Organization in a manner consistent with the standard of prudence described by UPMIFA.
The Organization considers the following factors in making a determination to appropriate or accumulate donor-restricted endowment funds:
• The duration and preservation of the fund • The purposes of the Organization and the donor-restricted endowment fund • General economic conditions • The possible effect of inflation and deflation • The expected total return from income and the appreciation of investments • Other resources of the Organization • The investment policies of the Organization
Strategies Employed for Achieving Objectives
To satisfy its long-term rate of return objectives, the Organization relies on a total return strategy in which investment returns are achieved through both capital appreciation (realized and unrealized) and current yield (interest and dividends).
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 12 - ENDOWMENTS, CONTINUED
Spending Policy and How the Investment Objectives Relate to Spending Policy
The Organization has a policy of appropriating annually no more than 5% of the prior three-year average of the fair market value of the endowment, including any capital appreciation and/or current yield. In establishing this policy, the Organization considered the long-term expected return on its endowments. This is consistent with the Organization’s objective to maintain the fair value of the endowment assets held in perpetuity for a specified term as well as to provide additional real growth through new gifts and investment return. Donor-restricted endowments are spent in accordance with the donors’ requirements; distributions are made for purposes that conform to the donors’ stated intentions.
Funds with Deficiencies
From time to time, certain donor-restricted endowment funds may have fair values less than the amount required to be maintained by donors or by law (underwater endowments). There were no funds with deficiencies for the year ended December 31, 2020 and 2019.
Endowment net asset composition by type of fund as of December 31, 2020:
WITHOUT WITH DONOR DONOR RESTRICTIONS RESTRICTIONS TOTAL
Board-designated endowment funds $ 1,835,515 - 1,835,515
Donor-restricted endowment funds Original donor-restricted gift amount and amounts required to be maintained in perpetuity by the donor - 1,003,528 1,003,528 Accumulated investment gains - 453,334 453,334
$ 1,835,515 1,456,862 3,292,377
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 12 - ENDOWMENTS, CONTINUED
Changes in endowment net assets for the year ended December 31, 2020:
WITHOUT WITH DONOR DONOR RESTRICTIONS RESTRICTIONS TOTAL Endowment net assets, January 1, 2020 $ 1,925,444 1,269,539 3,194,983
Investment return, net 194,071 168,219 362,290 Transfer of board-designated endowment funds to COVID-relief fund ( 200,000) - ( 200,000) Appropriation of endowment assets for expenditures ( 84,000) ( 44,000) ( 128,000) Contributions - 63,104 63,104 ( 89,929) 187,323 97,394
Endowment net assets, December 31, 2020 $ 1,835,515 1,456,862 3,292,377
Endowment net asset composition by type of fund as of December 31, 2019:
WITHOUT WITH DONOR DONOR RESTRICTIONS RESTRICTIONS TOTAL
Board-designated endowment funds $ 1,925,444 - 1,925,444
Donor-restricted endowment funds Original donor-restricted gift amount and amounts required to be maintained in perpetuity by the donor - 940,423 940,423 Accumulated investment gains - 329,116 329,116
$ 1,925,444 1,269,539 3,194,983
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 12 - ENDOWMENTS, CONTINUED
Changes in endowment net assets for the year ended December 31, 2019:
WITHOUT WITH DONOR DONOR RESTRICTIONS RESTRICTIONS TOTAL Endowment net assets, January 1, 2019 $ 1,658,894 1,000,906 2,659,800
Investment return, net 338,200 203,474 541,674 Appropriation of endowment assets for expenditures ( 71,650) ( 40,850) ( 112,500) Contributions - 106,009 106,009 266,550 268,633 535,183
Endowment net assets, December 31, 2019 $ 1,925,444 1,269,539 3,194,983
NOTE 13 - NET ASSETS WITH DONOR RESTRICTIONS
Net assets with donor restrictions consist of the following:
2020 2019 Endowments: Karen O’Neil Endowed Scholarship Fund $ 120,921 109,337 New York State September 11 Endowment Fund 157,364 143,831 Judith C. Kelleher Memorial Endowment Fund 144,721 123,264 Anita Dorr Memorial Endowment Fund 2,309 1,932 Jeanette Ash Endowed Scholarship Fund 60,836 49,751 Richard Wynkoop Scholarship Fund 49,137 37,944 Elizabeth B. Moore Memorial Fund for Scholarships 141,359 129,771 Texas Endowed Scholarship Fund 129,261 106,308 Mildred Fincke Memorial Endowed Scholarship Fund 27,955 12,378 Joan Eberhardt Endowed Scholarship Fund 55,617 51,090 Peggy McCall Fund 28,258 25,000 Jeff Solheim International Endowment 15,000 - Gracen Brooke Oglesby Pediatric Fund 1,075 - Castner and Spencer Family Research Fund 4,696 - General Endowment Fund 518,353 478,933 1,456,862 1,269,539
Purpose restricted contributions 218,259 46,752
$ 1,675,121 1,316,291
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 14 - NET ASSETS RELEASED FROM DONOR RESTRICTIONS
Net assets released from restrictions during the years ended December 31, 2020 and 2019, because donor restrictions were met by satisfying the stated purpose or time or other event are as follows:
2020 2019
Scholarships $ 182,525 340,158 COVID-19 relief 78,826 -
$ 261,351 340,158
NOTE 15 - IMPACT OF COVID-19
In March 2020, the World Health Organization declared the outbreak of a novel coronavirus (COVID-19) as a pandemic, which continues to spread throughout the United States of America. Due to the impact of COVID-19 and the resulting decision to move to a virtual meeting in 2020, the Organization saw a temporary decrease in course fees, conferences, publications, and sponsorships. Management continues to actively monitor the global situation in order to mitigate any potential future impact on the Organization’s changes in net assets and financial performance. In 2021, previous revenue declines experienced in 2020 have since rebounded.
NOTE 16 - PAYCHECK PROTECTION PROGRAM LOAN
On April 5, 2020, the Organization received proceeds in the amount of $1,938,315 under the Paycheck Protection Program (PPP). Established as part of the Coronavirus Aid, Relief and Economic Security Act (CARES Act), the PPP provides for loans to qualifying businesses in amounts up to 2.5 times the business’s average monthly payroll expenses. PPP loans and accrued interest are forgivable after a “covered period” of 24 weeks as long as the borrower maintains its payroll levels and uses the loan proceeds for eligible purposes, including payroll, benefits, rent, and utilities. The forgiveness amount will be reduced if the borrower terminates employees or reduces salaries during the covered period. Any unforgiven portion of a PPP loan is payable over two or five years at an interest rate of 1%, with a deferral of payments for 10 months after the end of the covered period.
Given Congress’ intent to have the proceeds of the PPP loans forgiven by meeting specific criteria, The Organization has elected to treat the PPP loan in accordance with the conditional government grants model in accordance with FASB ASC 958-605. The Organization initially recorded the loan as a refundable advance and subsequently recognized PPP grant revenue in accordance with the guidance for conditional government grants; that is, once the measurable performance or other barrier and right of return of the PPP loan no longer existed. The Organization has recognized $1,938,315 as Paycheck Protection Program grant revenue on the consolidated statements of activities for the year ended December 31, 2020. On March 4, 2021, the Organization received notice that the Small Business Administration authorized full forgiveness of the PPP loan, which legally released to Organization from the loan obligation.
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Appendix C Back to Top EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS YEARS ENDED DECEMBER 31, 2020 AND 2019
NOTE 16 - PAYCHECK PROTECTION PROGRAM LOAN, CONTINUED
Pursuant to the 2021 Consolidated Appropriations Act (CAA), the Organization applied for a second $1,938,315 PPP loan and received the funds on February 1, 2021. The loan is intended to be forgiven if the proceeds are used to cover eligible expenses enumerated in the CAA, including that at least 60% be used to cover eligible payroll expenses. In addition, the Organization must maintain employee and compensation levels. The loan carries an interest rate of 1% and has a maturity date of February 1, 2026. The Organization intends to comply with all requirements to qualify for loan forgiveness.
NOTE 17 - RECLASSIFICATIONS
Certain amounts in the 2019 financial statements have been reclassified to conform with the year 2020 presentation.
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Appendix C Back to Top
S U P P L E M E N T A R Y I N F O R M A T I O N
Appendix C Back to Top
1707 N. Randall Road, Suite 200 ■ Elgin, Illinois ■ 60123 Ph: 847.888.8600 ■ Fax: 847.888.0635 ■ www.pkfmueller.com
INDEPENDENT AUDITOR’S REPORT ON SUPPLEMENTARY INFORMATION
To the Finance Committee of Emergency Nurses Association and Board of Trustees of ENA Foundation
We have audited the consolidated financial statements of Emergency Nurses Association and Affiliate as of and for the years ended December 31, 2020 and 2019, and our report thereon, which expresses an unmodified opinion on those consolidated financial statements appears on pages 1 and 2. Our audits were conducted for the purpose of forming an opinion on the consolidated financial statements as a whole. The supplementary information is presented for the purposes of additional analysis and is not a required part of the consolidated financial statements. Such information is the responsibility of
management and was derived from and relates directly to the underlying accounting and other records used to prepare the consolidated financial statements. The information has been subjected to the auditing procedures applied in the audits of the consolidated financial statements and certain additional procedures, including comparing and reconciling such information directly to the underlying accounting and other records used to prepare the consolidated financial statements or to the consolidated financial statements themselves, and other additional procedures in accordance with auditing standards generally accepted in the United States of America. In our opinion, the information is fairly stated in all
material respects in relation to the consolidated financial statements as a whole.
Elgin, Illinois July 16, 2021
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Certified Public Accountants ■ Business & Financial Advisors Offices in Elgin, Chicago, Orland Park, Sarasota & Philadelphia
PKF Mueller is a member firm of the PKF International Limited family of legally independent firms and does not accept any responsibility or liability for the actions or inactions of any individual member or correspondent firm or firms. Appendix C Back to Top EMERGENCY NURSES ASSOCIATION STATEMENTS OF FINANCIAL POSITION DECEMBER 31, 2020 AND 2019
ASSETS
2020 2019 Current assets: Cash and cash equivalents $ 1,229,456 1,449,630 Accounts receivable, net of allowance for doubtful accounts of $152,575 and $197,000 for 2020 and 2019, respectively 1,635,317 1,702,666 Grants receivable 16,909 16,723 Other receivables 74,053 47,188 Current portion of mortgage receivable 60,251 - Due from affiliate - ENA Foundation - 7,900 Inventory 34,986 50,552 Prepaid expenses and other current assets 957,577 943,648
Total current assets 4,008,549 4,218,307
Property and equipment, net 11,880,046 12,259,640
Property held for sale - 2,450,000
Mortgage receivable, net of current portion 1,813,749 -
Investments 16,911,006 16,215,232
Total assets $ 34,613,350 35,143,179
LIABILITIES AND NET ASSETS
Current liabilities: Accounts payable $ 294,106 766,377 Wages and benefits payable 554,371 944,905 Accrued expenses 465,904 612,605 Credits on customer accounts 76,741 230,910 Due to affiliate - ENA Foundation 6,245 - Assessments payable 822,900 1,330,139 Line of credit 1,099,209 1,099,209 Current portion of deferred revenue 2,676,587 2,579,300 Current portion of bond payable 337,586 337,313
Total current liabilities 6,333,649 7,900,758
Long-term liabilities: Interest rate swap agreement 1,209,973 712,437 Deferred revenue, net of current portion 1,284,361 1,182,892 Bond payable, net of current portion 8,872,932 9,210,518
Total long-term liabilities 11,367,266 11,105,847
Total liabilities 17,700,915 19,006,605
Net assets: Without donor restrictions: Undesignated 16,410,525 15,634,664 Board-designated 501,910 501,910
Total without donor restrictions 16,912,435 16,136,574
Total liabilities and net assets $ 34,613,350 35,143,179
See Independent Auditor's Report on Supplementary Information.
-29- Appendix C Back to Top EMERGENCY NURSES ASSOCIATION STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS YEARS ENDED DECEMBER 31, 2020 AND 2019
2020 2019 Support and revenue: Courses $ 12,137,728 14,897,385 Membership dues 4,583,459 4,258,905 Conferences 867,804 3,333,411 Publications 584,984 760,483 Marketplace 506,938 586,580 Sponsorships 278,250 499,010 Royalties 155,369 515,554 Other 256,654 480,881 Grants 181,735 80,988 Paycheck Protection Program grant revenue 1,938,315 - Mailing lists 3,960 19,781 Donated services 75,000 95,000
Total support and revenue 21,570,196 25,527,978
Expenses: Programs, grants and scholarships 13,640,569 17,410,480 Management and general 7,041,150 8,048,522 Fundraising and development 451,413 432,991
Total expenses 21,133,132 25,891,993
Increase (decrease) in net assets - before other income 437,064 (364,015)
Other income (expense): Interest expense (378,564) (403,661) Investment income, net 1,664,897 2,698,611 Loss on interest rate swap agreement (497,536) (427,846) Loss on disposal of property held for sale (450,000) -
Total other income 338,797 1,867,104
Change in net assets 775,861 1,503,089
Net assets without donor restrictions, beginning of year 16,136,574 14,633,485
Net assets without donor restrictions, end of year $ 16,912,435 16,136,574
See Independent Auditor's Report on Supplementary Information.
-30- Appendix C Back to Top EMERGENCY NURSES ASSOCIATION STATEMENT OF FUNCTIONAL EXPENSES YEAR ENDED DECEMBER 31, 2020
PROGRAMS, GRANTS MANAGEMENT FUNDRAISING AND SCHOLARSHIPS AND GENERAL AND DEVELOPMENT TOTAL
Payroll expenses: Salaries and wages $ 5,034,584 3,189,000 - 8,223,584 Employee benefits 743,590 433,757 - 1,177,347 Payroll taxes 401,152 218,721 - 619,873
6,179,326 3,841,478 - 10,020,804
Operating expenses: Advertising and promotion 106,572 251 969 107,792 Discount on sales 142,192 - - 142,192 Bad debt expense 35,160 - - 35,160 Bank charges and credit card processing fees - 361,651 - 361,651 Computer 223,389 774,501 - 997,890 Conferences 627,462 90,895 - 718,357 Cost of goods sold 1,343,693 - - 1,343,693 Depreciation and amortization 359,425 115,949 11,722 487,096 Fulfillment and warehousing services 210,333 - - 210,333 Grants and scholarships 54,500 2,640 381,562 438,702 Insurance 57,912 46,014 - 103,926 Miscellaneous 31,958 69,565 - 101,523 Postage, freight and shipping 237,948 9,120 - 247,068 Printing 242,936 11,919 - 254,855 Professional services 963,922 823,551 24,948 1,812,421 Provision for UBIT 1,316 - - 1,316 Public relations 9,211 156 - 9,367 Recruitment fees - 38,017 - 38,017 Stipends 101,969 137,000 - 238,969 Supplies and equipment 35,803 98,472 - 134,275 Temporary workers 35,010 84,951 - 119,961 Training 31,649 120,736 - 152,385 Travel 127,094 84,699 - 211,793
4,979,454 2,870,087 419,201 8,268,742
Occupancy expenses: Building maintenance 114,796 71,991 7,783 194,570 Depreciation 135,870 85,207 9,212 230,289 Insurance 12,537 7,862 850 21,249 Real estate taxes 155,014 97,212 10,509 262,735 Rent 45,514 31,629 - 77,143 Telephone 2,622 1,645 178 4,445 Utilities 54,278 34,039 3,680 91,997
520,631 329,585 32,212 882,428
Assessment expenses: State/chapter membership dues 543,738 - - 543,738 ENPC/TNCC 1,417,420 - - 1,417,420
1,961,158 - - 1,961,158
$ 13,640,569 7,041,150 451,413 21,133,132
See Independent Auditor's Report on Supplementary Information.
-31- Appendix C Back to Top EMERGENCY NURSES ASSOCIATION STATEMENT OF FUNCTIONAL EXPENSES YEAR ENDED DECEMBER 31, 2019
PROGRAMS, GRANTS MANAGEMENT FUNDRAISING AND SCHOLARSHIPS AND GENERAL AND DEVELOPMENT TOTAL
Payroll expenses: Salaries and wages $ 5,043,325 3,598,339 - 8,641,664 Employee benefits 1,130,052 722,663 - 1,852,715 Payroll taxes 404,695 245,559 - 650,254
6,578,072 4,566,561 - 11,144,633
Operating expenses: Advertising and promotion 156,716 - - 156,716 Discount on sales 174,041 - - 174,041 Bad debt expense 39,553 - - 39,553 Bank charges and credit card processing fees - 427,023 - 427,023 Computer 159,406 667,060 - 826,466 Conferences 2,205,102 269,045 - 2,474,147 Cost of goods sold 1,830,712 - - 1,830,712 Depreciation and amortization 311,679 128,172 12,038 451,889 Fulfillment and warehousing services 271,831 - - 271,831 Grants and scholarships 409,841 - 382,019 791,860 Insurance 55,441 50,586 - 106,027 Miscellaneous 113,767 81,973 - 195,740 Postage, freight and shipping 276,250 3,746 - 279,996 Printing 309,658 11,224 - 320,882 Professional services 634,521 549,854 - 1,184,375 Provision for UBIT 51,852 - - 51,852 Public relations 26,455 450 - 26,905 Recruitment fees 1,125 68,819 - 69,944 Stipends 143,690 142,000 - 285,690 Supplies and equipment 58,797 105,751 - 164,548 Temporary workers 211,305 38,034 - 249,339 Training 38,026 222,051 - 260,077 Travel 566,415 293,497 - 859,912
8,046,183 3,059,285 394,057 11,499,525
Occupancy expenses: Building maintenance 135,800 97,001 9,700 242,501 Depreciation 124,850 89,178 8,918 222,946 Insurance 10,007 7,148 715 17,870 Real estate taxes 204,813 146,296 14,630 365,739 Rent 42,434 33,342 - 75,776 Telephone 8,499 6,071 607 15,177 Utilities 61,094 43,640 4,364 109,098
587,497 422,676 38,934 1,049,107
Assessment expenses: State/chapter membership dues 527,315 - - 527,315 ENPC/TNCC 1,671,413 - - 1,671,413
2,198,728 - - 2,198,728
$ 17,410,480 8,048,522 432,991 25,891,993
See Independent Auditor's Report on Supplementary Information.
-32- Appendix C Back to Top EMERGENCY NURSES ASSOCIATION STATEMENTS OF CASH FLOWS YEARS ENDED DECEMBER 31, 2020 AND 2019
2020 2019 Cash provided by (applied to) operating activities: Change in net assets $ 775,861 1,503, 089 Adjustments to reconcile change in net assets to net cash applied to operating activities: Depreciation and amortization of property and equipment 709,866 667,043 Amortization of debt issuance costs 7,519 7,792 Loss on interest rate swap agreement 497,536 427,846 Loss on property held for sale 450,000 - Bad debt (recovery) expense (44,425) 33,466 Realized and unrealized gain on investments (1,295,465) (2,213,769) Decrease (increase) in assets: Accounts receivable, net of change in allowance 111,774 192,253 Grants receivable (186) (16,723) Other receivables (26,865) (108) Due (to) from affiliate - ENA Foundation 14,145 (1,895) Inventory 15,566 64,275 Prepaid expenses and other assets (13,929) (280,183) Increase (decrease) in liabilities: Accounts payable (472,271) (21,618) Wages and benefits payable (390,534) 120,438 Accrued expenses (146,701) (90,198) Credits on customer accounts (154,169) (399,374) Assessments payable (507,239) (286,401) Deferred revenue 198,756 23,000
Total cash applied to operating activities (270,761) (271,067)
Cash provided by (applied to) investing activities: Purchases of property and equipment (330,272) (574,043) Payments received on mortgage receivable 126,000 - Purchases of investments (3,113,487) (2,331,312) Proceeds from sale and maturities of investments 3,713,178 4,070,449
Total cash provided by investing activities 395,419 1,165,094
Cash applied to financing activities: Payments on line of credit - (8,382) Payments on bonds payable (344,832) (344,832)
Total cash applied to financing activities (344,832) (353,214)
Net increase (decrease) in cash and cash equivalents (220,174) 540,813
Cash and cash equivalents, beginning of year 1,449,630 908,817
Cash and cash equivalents, end of year $ 1,229,456 1,449, 630
Noncash investing transaction: Mortgage receivable from sale of property held for sale $ 2,000,000 -
Other cash flow information: Interest paid $ 378,564 403,661
Income taxes paid $ 5,849 53,000
See Independent Auditor's Report on Supplementary Information.
-33- Appendix C Back to Top ENA FOUNDATION STATEMENTS OF FINANCIAL POSITION DECEMBER 31, 2020 AND 2019
ASSETS
2020 2019 Current assets: Cash and cash equivalents $ 330,922 291,806 Accounts receivable 9,299 5,018 Due from affiliate - ENA 6,245 -
Total current assets 346,466 296,824
Property and equipment, net 5,214 7,232
Investments 3,916,583 3,611,171
Total assets $ 4,268,263 3,915,227
LIABILITIES AND NET ASSETS
Current liabilities: Accounts payable $ 27,521 7,369 Due to affiliate - ENA - 7,900
Total current liabilities 27,521 15,269
Net assets: Without donor restrictions: Undesignated 623,357 658,223 Board-designated 1,942,264 1,925,444
Total without donor restrictions 2,565,621 2,583,667
With donor restrictions 1,675,121 1,316,291
Total net assets 4,240,742 3,899,958
Total liabilities and net assets $ 4,268,263 3,915,227
See Independent Auditor's Report on Supplementary Information.
-34- Appendix C Back to Top ENA FOUNDATION STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS YEARS ENDED DECEMBER 31, 2020 AND 2019
2020 2019
WITHOUT DONOR WITH DONOR WITHOUT DONOR WITH DONOR RESTRICTIONS RESTRICTIONS TOTAL RESTRICTIONS RESTRICTIONS TOTAL Support and revenue: Support: Contributions $ 575,454 450,342 1,025,796 510,783 421,128 931,911 Special events revenue, net of direct expenses - - - 52,389 - 52,389 Net assets released from restrictions 261,351 (261,351) - 340,158 (340,158) -
Total support and revenue 836,805 188,991 1,025,796 903,330 80,970 984,300
Expenses: Programs, grants and scholarships 769,588 - 769,588 575,648 - 575,648 Management and general 215,044 - 215,044 226,340 - 226,340 Fundraising and development 121,081 - 121,081 125,259 - 125,259
Total expenses 1,105,713 - 1,105,713 927,247 - 927,247
Increase (decrease) in net assets - before other income (268,908) 188,991 (79, 917) (23, 917) 80,970 57,053
Other income: Investment income, net 250,862 169,839 420,701 425,828 203,474 629,302
Change in net assets (18,046) 358,830 340,784 401,911 284,444 686,355
Net assets, beginning of year 2,583,667 1,316,291 3,899,958 2,181,756 1,031,847 3,213,603
Net assets, end of year $ 2,565,621 1,675, 121 4,240,742 2,583,667 1,316,291 3,899,958
See Independent Auditor's Report on Supplementary Information.
-35- Appendix C Back to Top ENA FOUNDATION STATEMENT OF FUNCTIONAL EXPENSES YEAR ENDED DECEMBER 31, 2020
PROGRAMS, GRANTS MANAGEMENT FUNDRAISING AND SCHOLARSHIPS AND GENERAL AND DEVELOPMENT TOTAL
Operating expenses: Advertising $ - - 1,420 1,420 Bank charges and credit card processing fees - - 909 909 Computer - 5,660 - 5,660 Conferences - 846 850 1,696 Depreciation - 2,018 - 2,018 Grants and scholarships 657,470 - - 657,470 Insurance - 480 - 480 Postage, freight and shipping 113 510 87 710 Printing - 425 251 676 Professional services 111,843 182,641 115,231 409,715 Supplies and equipment 162 2,950 553 3,665 Temporary workers - 1,998 - 1,998 Travel - 17,516 1,780 19,296
$ 769,588 215,044 121,081 1,105,713
See Independent Auditor's Report on Supplementary Information.
-36- Appendix C Back to Top ENA FOUNDATION STATEMENT OF FUNCTIONAL EXPENSES YEAR ENDED DECEMBER 31, 2019
PROGRAMS, GRANTS MANAGEMENT FUNDRAISING AND SCHOLARSHIPS AND GENERAL AND DEVELOPMENT TOTAL
Operating expenses: Bank charges and credit card processing fees $ - - 276 276 Computer - 5,521 - 5,521 Conferences - 1,054 11,154 12,208 Depreciation - 2,018 - 2,018 Grants and scholarships 461,519 - - 461,519 Insurance - 480 - 480 Miscellaneous - 162 - 162 Postage, freight and shipping - 144 404 548 Printing - 504 6,400 6,904 Professional services 114,129 188,668 104,992 407,789 Supplies and equipment - 3,955 1,007 4,962 Temporary workers - 1,598 - 1,598 Travel - 22,236 1,026 23,262
$ 575,648 226,340 125,259 927,247
See Independent Auditor's Report on Supplementary Information.
-37- Appendix C Back to Top ENA FOUNDATION STATEMENTS OF CASH FLOWS YEARS ENDED DECEMBER 31, 2020 AND 2019
2020 2019 Cash provided by (applied to) operating activities: Change in net assets $ 340,784 686,355 Adjustments to reconcile change in net assets to net cash provided by (applied to) operating activities: Depreciation of property and equipment 2,018 2,018 Realized and unrealized gain on investments (338,380) (523,640) Contributions restricted for investment in endowment (63,104) (106,009) Increase in assets: Accounts receivable (4,281) (4,768) Increase (decrease) in liabilities: Accounts payable 20,152 5,952 Due (to) from affiliate - ENA (14,145) 1,895
Total cash provided by (applied to) operating activities (56,956) 61,803
Cash provided by (applied to) investing activities: Purchases of investments (392,820) (409,335) Proceeds from sale and maturities of investments 425,788 406,053
Total cash provided by (applied to) investing activities 32,968 (3,282)
Cash provided by financing activities: Collections of contributions restricted for investment in endowment 63,104 106,009
Net increase in cash and cash equivalents 39,116 164,530
Cash and cash equivalents, beginning of year 291,806 127,276
Cash and cash equivalents, end of year $ 330,922 291,806
See Independent Auditor's Report on Supplementary Information.
-38-
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2021 ENA VOLUNTEER GROUP ROSTER, CHARGES AND CRITERIA
Table of Contents 2021 GENERAL CRITERIA ...... 2 ADVOCACY ADVISORY COUNCIL ...... 3 AWARDS COMMITTEE ...... 3 CLINICAL PRACTICE GUIDELINES COMMITTEE ...... 4 COURSE ADMINISTRATION FACULTY ...... 4 DIVERSITY, EQUITY AND INCLUSIVITY COMMITTEE ...... 5 EMERGENCY DEPARTMENT OPERATIONS COMMITTEE ...... 6 EMERGENCY MANAGEMENT AND PREPAREDNESS COMMITTEE ...... 6 EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL ...... 7 EMERGENCY NURSING QUALITY MEASURES DEVELOPMENT WORK TEAM ...... 7 EMERGENCY NURSING ADVANCED PRACTICE ADVISORY COUNCIL ...... 8 EMERGENCY NURSING CONFERENCE EDUCATION PLANNING COMMITTEE ...... 8 EMERGENCY NURSING EDUCATION ADVISORY COUNCIL ...... 9 EMERGENCY NURSING RESEARCH ADVISORY COUNCIL ...... 10 EMERGING PROFESSIONAL ADVISORY COUNCIL ...... 10 EMERGING PROFESSIONAL LIAISON ...... 11 ENPC REVIEW COMMITTEE ...... 11 GERIATRIC COMMITTEE ...... 12 INTERNATIONAL ADVISORY COUNCIL ...... 12 LANTERN AWARD COMMITTEE...... 13 LANTERN AWARD REVIEWERS ...... 13 PEDIATRIC COMMITTEE ...... 14 PEER REVIEW EDUCATION COMMITTEE ...... 15 POSITION STATEMENT COMMITTEE ...... 15 QUALITY AND SAFETY ADVISORY COUNCIL ...... 16 RESOLUTIONS COMMITTEE ...... 17 TNCC REVIEW COMMITTEE ...... 17 TRAUMA COMMITTEE ...... 18 APPENDIX A: ...... 19
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2021 GENERAL CRITERIA Back to Top General Criteria for all committees (unless specifically noted) is as follows: • Strong attention to detail and the ability to meet deadlines • Professional writing and editing skills o Writing and/or editing samples may be required for consideration • Ability to provide expert and time-sensitive feedback on documents from external entities, as requested by the Association, on behalf of the President • Proficient in Microsoft Office Suite (Word, Excel, PowerPoint) • Ability to use ENA Connect for committee activity (online) • Timely response to email and phone calls • Ability to participate in meetings via online video conference, phone or in person o Some committees require attendance at onsite meetings, requiring travel (expenses paid by ENA) o Review and agree to ENA’s travel policy and guidelines if applicable o Agree to participate in online video conferencing or conference calls and share documents via ENA Connect • In general, committee meetings, video conferences and conference calls are scheduled during ENA business days of Monday through Friday, however these meetings may take place outside of the general timeframe as needed. • Be accountable to ENA’s committee code of conduct, communication standards.
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Back to Top ADVOCACY ADVISORY COUNCIL
Name Position State Position Term Service Term 1. William Schueler, Chair OR 1/1/21 – 12/31/22 1/1/20 – 12/31/23 MSN, RN, CEN, FAEN
2. Amie Porcelli, RN, Member PA 1/1/21 – 12/31/21 1/1/19 - 12/31/21 CEN
3. Danita Mullins, Member AR 1/1/20 – 12/31/21 1/1/20 – 12/31/21 MSN, RN, CEN
4. Debby Rogers, MS, Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 RN, FAEN
5. Lauren Plaine, BSN, Member VA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 RN, CEN
6. Mona Kelley, MSN, Member TN 1/1/21 – 12/31/22 1/1/21 – 12/31/22 RN
Board Liaison: Kristen Cline Staff Liaison: Rob Kramer
2021 Charges: 1. Review and identify public policy as it relates to advocacy in emergency nursing Generate ideas for program development and implementation related to government relations and advocacy. Assist in prioritizing advocacy efforts based on ENA’s organizational priorities 2. Provide assistance to ENA State Government Affairs Chairs for assigned states
2021 Specific Criteria: • Must have extensive knowledge of public policy issues affecting emergency care and emergency nursing at the state and federal levels • Demonstrated advocacy involvement with ENA State Council/Chapter • Ability to serve for a two-year term • One onsite meeting at Day on the Hill required
Back to Top AWARDS COMMITTEE
Name Position State Position Term Service Term 1. Melanie Gibbons Hallman, DNP, RN, CRNP, CEN, ACNP- Chair AL 1/1/21 – 12/31/22 1/1/21 – 12/31/23 BC, ENP-C, FNP-BC, TCRN, FAEN 2. Kevin Jennings, BSN, BS, RN Member MO 1/1/21 – 12/31/21 1/1/19 - 12/31/21 3. Marcia Harmon, BSN, RN, CEN Member NE 1/1/20 – 12/31/21 1/1/20 – 12/31/21 4. Vanessa Lozada, BSN, RN, SANE-A, SANE-P Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21 5. Regina Newby, BSN, RN, CEN Member OK 1/1/20 – 12/31/21 1/1/20 – 12/31/21 6. Tameka Poston-Myricks, MSN, BSN, RN, CEN Member AL 1/1/20 – 12/31/21 1/1/20 – 12/31/21 7. Anthony Thomsen, BSN, RN, CEN, NREMT-P, NRP Member IA 1/1/20 – 12/31/21 1/1/20 – 12/31/21 8. Abigail White, MSN, BSN, RN, CEN, ACCNS-AG Member IL 1/1/20 – 12/31/21 1/1/20 – 12/31/21 9. Linda Arapian MSN, RN, EMT-B, CEN, CPEN, TCRN, Member MD 1/1/21 – 12/31/22 1/1/21 – 12/31/22 FAEN 10. Louise Hummel MSN, RN, CNS, CEN, TCRN, FAEN Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 11. Jennifer Williams-Cook, BSN, RN, CEN, CPEN, CFRN, Member MS 1/1/21 – 12/31/22 1/1/21 – 12/31/22 NRP, TCRN 12. Barbara Gibson, BSN, RN, CEN Member TN 1/1/21 – 12/31/22 1/1/21 – 12/31/22
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Back to Top
Board Liaison: Terry Foster Staff Liaison: Ellen Siciliano
2021 Charges: 1. Encourage award application submission 2. Review awards and their applicable criteria and provide recommendations for revisions 3. Review and score eligible candidate applications
2021 Specific Criteria: • Must be able to participate in reviewer training and utilize the electronic award scoring tool • Experience at a state or chapter level at ENA • Ability to serve for a two-year term • No onsite meeting required
Back to Top CLINICAL PRACTICE GUIDELINES COMMITTEE
Name Position State Position Term Service Term 1. Annie Horigan, PhD, RN Chair GA 1/1/21 – 12/31/21 1/1/18 – 12/31/22 2. Janet Kaiser, MSN, BSN, RN, CEN Member VA 1/1/18 – 12/31/21 1/1/18 – 12/31/21 3. Lisa Gilmore, DNP, MSN-ED, RN, APRN, FNP, CNS, EMT- Member MO 1/1/19 – 12/31/21 1/1/19 – 12/31/21 P, CEN, CPEN, CFRN, ACCNS-AG, ACCNS-P, FNP-C, NREMT-P 4. Kathy Van Dusen, MSN, RN, CEN, CPEN, NHDP-BC Member CA 1/1/19 – 12/31/21 1/1/19 – 12/31/21 5. Judith Bradford, DNS, MSN, RN, FAEN Member MS 1/1/21 – 12/31/21 1/1/21 – 12/31/21 6. Robin MacPherson-Dias, MS, BSN, RN, CEN, CPEN, Member CA 1/1/21 – 12/31/23 1/1/21 – 12/31/23 CCRN, TCRN 7. Andrea Perry, MSN, BSN RN, CEN, CPEN, CNL, MICN Member CA 1/1/21 – 12/31/23 1/1/21 – 12/31/23 8. Alison Camarda, MSN-ED, BSN, RN, CEN, CPEN, SANE Member VT 1/1/21 – 12/31/22 1/1/21 – 12/31/22 9. Andrea Slivinski, DNP, RN, CEN, CPEN, ACNS-BC Member NC 1/1/21 – 12/31/22 1/1/21 – 12/31/22 10. Andrew Slifko, DNP, MBA, RN, EMT-B, NEA-BC Member NJ 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Terry Foster Staff Liaison: Altair Delao
2021 Charges: 1. Develop evidence-based clinical practice guidelines 2. Recommend topic areas for future clinical practice guidelines development 3. Review and update existing clinical practice guidelines as appropriate
2021 Specific Criteria: • Formal training in research and evidence-based practice translation required • Must have current emergency department experience • Must have capacity to review significant numbers of scientific articles and other literature, conduct literature searches and be able to critically analyze and discuss the results of the literature searches including a working knowledge of evidence ratings • Must be able to write clearly, professionally, and within the time constraints of the CPG process o Scientific writing samples are required as part of submission process • Doctoral degree preferred, master’s degree required • Ability to serve for a three-year term • Two onsite meetings required
Back to Top COURSE ADMINISTRATION FACULTY
Name Position State Position Term Service Term
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1. Amy Boren, MS, BSN, RN, CEN, CPEN, TCRN Chair CO 1/1/21 – 12/31/22 Back1/1/21 to – 12/31/2Top 3 2. Kristine Powell, MSN, RN, CEN, NEA-BC, FAEN Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21 3. Jennifer Taylor, MSN, RN, EMT-B, CEN, TCRN Member TN 1/1/20 – 12/31/21 1/1/20 – 12/31/21 4. Cathy Fox, RN, CEN, CPEN, TCRN, FAEN Member VA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 5. Sonya Drechsel, BSN, RN, CEN, TCRN Member MN 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Melanie Doster, MSN, BSN, RN, CEN Member NC 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Chris Dellinger Staff Liaison: Nicole Williams
2021 Charges: 1. Review course administrative procedures and provide recommendations on an ongoing basis 2. Recommend disciplinary action of Course Directors and Course Instructors as necessary 3. Provide recommendations for course implementation based on various course delivery models 4. Serve as ambassadors on ENA Connect sites for Course Directors and Instructors
2021 Specific Criteria: • Must be TNCC and ENPC Faculty • Experience in working with ENA educational programs • Ability to serve for a two-year term • Willingness to engage in online TNCC and ENPC communities consistently • No onsite meeting required Back to Top
DIVERSITY, EQUITY AND INCLUSIVITY COMMITTEE
Name Position State Position Term Service Term 1. Anna Valdez, PhD, MSN, RN, CEN, CFRN, CNE, Chair CA 1/1/21 – 12/31/21 1/1/21 – 12/31/22 FAEN 2. Hershaw Davis, Jr., MSN, RN Member MD 1/1/21 – 12/31/22 1/1/21 – 12/31/22 3. Jennifer Bevacqua, RN, CPNP-AC, CPNP-PC Member OR 1/1/21 – 12/31/22 1/1/21 – 12/31/22 4. Tangela Faulk, RN Member NC 1/1/21 – 12/31/22 1/1/21 – 12/31/22 5. Jo Tabler, MSN, BSN, RN, CEN, CFRN, AGCNS- Member IN 1/1/21 – 12/31/21 1/1/21 – 12/31/21 BC 6. Carlton Purvis, BSN, RN Member TN 4/1/21 – 12/31/21 4/1/21 – 12/31/21 7. Kaleena Soorma, RN Member NY 1/1/21 – 12/31/21 1/1/21 – 12/31/21
Board Liaison: Ryan Oglesby Staff Liaison: Nicole Williams
Charges:
1. Assess the experiences of emergency nurses related to DEI within the emergency nursing community and ENA 2. Determine barriers and challenges to promoting DEI within the emergency nursing profession and ENA community 3. Implement strategies, with ENA Board approval, to improve DEI within the ENA community
Specific Criteria: • Must have current ENA membership • Ability to serve for at least a 6-month term • Must be comfortable with virtual engagement via online meetings, email and document sharing • Experience working within, creating or the desire to impact the development of an environment that values and encourages diversity of thought, experience, demographic backgrounds and identifies
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Back toBack Top to Top EMERGENCY DEPARTMENT OPERATIONS COMMITTEE
Name Position State Position Term Service Term 1. Beth Estep, MSN, RN, CEN Chair OH 1/1/21 – 12/31/21 1/1/20 – 12/31/22 2. Rita Anderson, BSN, RN, CEN, FAEN Member AZ 1/1/21 – 12/31/21 1/1/19 – 12/31/21 3. Denise Bayer, MSN, RN, FAEN Member CA 1/1/20 – 12/31/21 1/1/20 – 12/31/21 4. Jonathan Green, DNP, RN, NP, CEN, CCRN, ENP-C, FNP- Member NJ 1/1/20 – 12/31/21 1/1/20 – 12/31/21 C 5. James Thomas, MSN, RN, CEN Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Susan Domagala, RN Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Chris Dellinger Staff Liaison: Cathy Olson
2021 Charges: 1. Provide subject matter expertise related to emergency department operations/management 2. Identify, recommend, and/or develop evidence-based best practices for emergency department leadership to improve patient and staff safety in emergency care settings and provide evidence-based recommendation for creating a safe work environment 3. Review and provide feedback on educational content and other ENA initiatives as requested
2021 Specific Criteria: • Must have a good understanding of systems, organization and management of operations in the delivery of emergency care • Experience in a leadership role in an emergency care setting • Ability to serve for a two-year term • No onsite meeting required
Back to Top EMERGENCY MANAGEMENT AND PREPAREDNESS COMMITTEE
Name Position State Position Term Service Term 1. Angie Lee, MSN-ED, RN, CEN Chair NY 1/1/21 – 12/31/22 1/1/20 – 12/31/23 2. Brian Rogers, MSN, BSN, RN, CEN Member PA 1/1/21 – 12/31/21 1/1/19 – 12/31/21 3. April Burge, MSN, RN, EMT-B Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21 4. Paul Mikita, BSN, RN Member NJ 1/1/20 – 12/31/21 1/1/20 – 12/31/21 5. Grace Burgos, PhD, MSN, BSN, RN Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21 6. Wendy Wheeler, BSN, RN, EMT-B, CEN, CPEN Member CT 1/1/21 – 12/31/22 1/1/21 – 12/31/22 7. Taryn Amberson, MPH, BSN, RN, CEN Member HI 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Mike Hastings Staff Liaison: Monica Kolbuk
2021 Charges: 1. Provide subject matter expertise on emergency management and preparedness 2. Identify best practices for all patient populations related to emergency management preparedness 3. Identify, recommend and develop resources for emergency management and preparedness
2021 Specific Criteria: • Must have knowledge and active involvement in emergency management, planning, application and evaluation • Ability to serve for a two-year term • No onsite meeting required
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Back toBack Top to Top EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL
Name Position State Position Term Service Term 1. Jeffrey Maler, BSN, RN, EMT-B, CEN, TCRN Chair TX 1/1/20 – 12/31/21 1/1/20 – 12/31/22 2. Gina Slobogin, DNP, MSN, BSN, AND, RN, APRN, FNP, Member PA 1/1/21 – 12/31/21 1/1/19 – 12/31/21 EMT-B, EMT-P, APRN-BC, FNP-BC, NHDP-BC, NREMT-P, PHRN 3. Justin Beal, RN, EMT-P, CEN, CPEN, CFRN, NREMT-P, Member WV 1/1/20 – 12/31/21 1/1/20 – 12/31/21 PHRN, TCRN 4. Kay-Ella Bleecher, MSN, RN, APN, CRNP, CEN, FNP-C, Member PA 1/1/20 – 12/31/21 1/1/20 – 12/31/21 NREMT-P, PHRN, FAEN 5. Deborah McCrea, EdD, MSN, RN, EMT-P, CEN, CFRN, Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22 FNP-BC 6. Andrew Bowman, MSN, BSN, RN, APRN, NP, ACNP, EMT- Member IN 1/1/21 – 12/31/22 1/1/21 – 12/31/22 P, CEN, CPEN, CFRN, CTRN, ACNP-BC, ACNPC, CCRN, CCRN-CMC, CVRN, NREMT-P, NRP, TCRN
Board Liaison: Mike Hastings Staff Liaison: Stephanie Klavon
2021 Charges: 1. Provide subject matter expertise on emergency medical services as it relates to the emergency nurse 2. Review and recommend resources to promote collaboration between EMS providers and emergency nurses 3. Review EMS initiatives to improve population health and provide recommendations as relevant to emergency nursing
2021 Specific Criteria: • Must have current or recent experience as an EMS provider (basic, advanced, pre-hospital RN, flight nursing that does 911 response) or be in an EMS leadership or education position • Ability to review and respond to assigned documents related to EMS and emergency nursing, sometimes on urgent timelines • Ability to serve for a one-year term Back to Top
EMERGENCY NURSING QUALITY MEASURES DEVELOPMENT WORK TEAM
Name Position State Position Term Service Term 1. Kathy Baker, PhD, RN, NE-BC Chair VA 1/1/21 – 12/31/23 1/1/21 – 12/31/23 2. Elizabeth Tedesco, DNP, RN, CEN, PHRN Member PA 1/1/21 – 12/31/23 1/1/21 – 12/31/23 3. Kathleen Zavotsky, PhD, RN, CEN, ACNS-BC, CCRN, Member NJ 1/1/21 – 12/31/23 1/1/21 – 12/31/23 FAEN 4. Shenee Laurence, MPH, BSN, BS, RN Member CA 1/1/21 – 12/31/23 1/1/21 – 12/31/23 5. Shuba Samuel, PhD, MSN, BSN, RN, FNP, CEN, CNE, Member MI 1/1/21 – 12/31/23 1/1/21 – 12/31/23 FNP-BC 6. Anna May, MSN, MBA, BA, RN, CEN, CPEN Member NE 1/1/21 – 12/31/23 1/1/21 – 12/31/23 7. Elizabeth Brennan, EdD, MSN, Med, BS, ADN, RN, CEN Member PA 1/1/21 – 12/31/23 1/1/21 – 12/31/23
Board Liaison: Dustin Bass Staff Liaison: Catherine Olson, MSN, RN Research Lead: Lisa Wolf, PhD, RN, CEN, FAEN
2021 Charges: 1. Provide subject matter expertise on emergency nursing quality improvement 2. Research current evidence for best nursing practice to improve patient outcomes in the emergency department 3. Recommend pertinent, evidence-based emergency nursing quality measures to be developed 4. Develop introductory set of emergency nursing quality measures 5. Draft and refine process for testing of measures.
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2021 Specific Criteria: Back to Top • Must have knowledge and/or experience in emergency department quality improvement and benchmarking of data • Must have strong understanding of nurse-sensitive quality indicators • Master’s Degree strongly preferred. • Experience in emergency nursing leadership or education preferred • Knowledge and experience in nursing research preferred • Knowledge and experience in nursing informatics or EHR data retrieval desired
Back to Top EMERGENCY NURSING ADVANCED PRACTICE ADVISORY COUNCIL
Name Position State Position Term Service Term 1. Nancy Denke, DNP, RN, ACNP, CEN, ACNP-BC, CCRN, Chair AZ 1/1/21 – 12/31/21 1/1/20 – 12/31/22 FNP-BC, FAEN 2. David House, DNP MSN BSN BS RN APRN CRNP FNP Member AL 1/1/21 – 12/31/21 1/1/19 - 12/31/21 CNS CEN ENP-C FNP-BC 3. Kimberly Brandenburg, CEN, CPEN, APRN-BC, FNP-C Member NE 1/1/20 – 12/31/21 1/1/20 – 12/31/21 4. Tresa Zielinski, DNP, RN, APRN, CPNP-PC Member IL 1/1/20 – 12/31/21 1/1/20 – 12/31/21 5. Steve Branham, RN, ACNP-BC, CCRN, ENP-C, FNP-BC Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Scott Stover, DNP, MSN, MBA, APRN, CNS, CEN, ACNS- Member FL 1/1/21 – 12/31/22 1/1/21 – 12/31/22 BC, CPHQ, NEA-BC 7. Jacob Miller, MS, ACNP, FNP, CNS, CFRN, CCRN, Member OH 1/1/21 – 12/31/22 1/1/21 – 12/31/22 NREMT-P 8. William Fiebig, DNP, ARNP, CEN, AGACNP-BC, ENP-C, Member SC 1/1/21 – 12/31/22 1/1/21 – 12/31/22 FNP-BC, FNP-C, NREMT-P
Board Liaison: Jennifer Schmitz Staff Liaison: Margaret Carman
2021 Charges: 1. Provide subject matter expertise for advanced practice nursing issues 2. Generate ideas for advanced practice nursing program development and implementation in accordance with ENA’s strategic plan 3. Review and provide feedback on educational content and other ENA initiatives as requested 4. Collaborate with conference education planning committee to enhance the APRN conference experience
2021 Specific Criteria: • Must have experience in advanced practice in emergency or urgent care settings • Evidence of scholarly activities such as developing evidence-based practice protocols, developing or conducting nursing education, implementing evidence into practice, evaluating outcomes (patient/population, nurse, or systems level), and/or publications is required • Certified nurse practitioner or clinical nurse specialist preferred • Doctorate of Nursing Practice or other appropriate advance degree required • Ability to serve for a two-year term • Onsite meeting required
Back to Top EMERGENCY NURSING CONFERENCE EDUCATION PLANNING COMMITTEE
Name Position State Position Term Service Term 1. Teresa Dodge, RN, BSN, CEN Co-Chair NY 1/1/21 – 12/31/21 1/1/21 – 12/31/21 2. Rachael Smith, MSN, RN, CEN, CCRN, TCRN Co-Chair CT 1/1/21 – 12/31/21 1/1/21 – 12/31/21 3. Melinda Elayda, MPA, BSN, RN Member CA 1/1/20 – 12/31/21 1/1/20 – 12/31/21 4. Heidi Gilbert, BSN, RN, CEN, SANE Member OK 1/1/20 – 12/31/21 1/1/20 – 12/31/21 5. Jill LeBeau, RN Member CO 1/1/20 – 12/31/21 1/1/20 – 12/31/21 6. Sarah Sargalski Munier, MSN, RN, CEN Member MD 1/1/20 – 12/31/21 1/1/20 – 12/31/21 7. Brett Pickens, DNP, MSN-ED, BSN, ADN, RN, CEN, CPEN, Member MS 1/1/20 – 12/31/21 1/1/20 – 12/31/21 CNE
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8. Bradley Rund, MSN, BSN, AS, RN, EMT-P, CEN, CPEN, Member IN 1/1/20 – 12/31/21 Back1/1/20 to Top– 12/31/21 CFRN, NREMT-P 9. Brent Seus, RN Member MO 1/1/20 – 12/31/21 1/1/20 – 12/31/21 10. Kirk Tapia-Bobst, MSN, RN, CEN, CPEN, PHRN, TCRN Member IL 1/1/20 – 12/31/21 1/1/20 – 12/31/21 11. Marie Yabut, MN, RN, CEN Member WA 1/1/20 – 12/31/21 1/1/20 – 12/31/21 12. Christopher John Fernandez, BSN, RN Member ON 1/1/21 – 12/31/22 1/1/21 – 12/31/22 13. Jamie Stephens-Davenport, MSN, RN, CEN, CPEN, Member KY 1/1/21 – 12/31/22 1/1/21 – 12/31/22 TCRN 14. Jason Carter, MSN, BSN, AND, RN, EMT-P, CEN, CPEN, Member OK 1/1/21 – 12/31/22 1/1/21 – 12/31/22 NREMT-P, TCRN 15. Kifah Awadallah, DNP, MSN, BS, RN Member OH 1/1/21 – 12/31/22 1/1/21 – 12/31/22 16. Nycole Oliver, DNP, RN, APRN, CEN, ACNPC-AG, FNP- Member AR 1/1/21 – 12/31/22 1/1/21 – 12/31/22 C, FAEN 17. Chantel Knox, MSN, RN, CEN, TCRN Member MD 1/1/21 – 12/31/22 1/1/21 – 12/31/22 18. Traci Mcgregor, MBA, BSN, RN, CEN, NE-BC Member ID 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Ron Kraus Staff Liaison: Rashonda Legault
2021 Charges: 1. Identify key learning outcomes and content for education relevant to emergency nursing 2. Explore and implement innovative learning approaches to enhance the overall ENA conference experience 3. In collaboration with advanced practice advisory council and other organizations as appropriate, create a plan to include content designed for advanced practice nurses, including pharmacology and relevant clinical and professional development issues based on member feedback and needs assessment
2021 Specific Criteria: • Highly recommended that applicants have attended the Emergency Nursing 2019 to observe meeting processes and flow of events • Must be available to attend the annual Emergency Nursing conference o Willingness to work throughout annual conference as session monitors o Ability to walk long distances and participate in conference activities as scheduled o Suggest that applicants not participate as delegates or alternate delegates at the 2021 General Assembly to avoid scheduling issues • Experience in program planning and/or nursing education • Knowledge of the American Nurses Credentialing Center (ANCC) Guidelines for continuing education • Onsite meeting required at the ENA office • Ability to adapt to quickly to new technology • Ability to serve for a two-year term
Back to Top EMERGENCY NURSING EDUCATION ADVISORY COUNCIL
Name Position State Position Term Service Term 1. Wesley Davis, DNP, APRN, CEN, AGACNP-BC, ENP-C, Chair WY 1/1/20 – 12/31/21 1/1/19 – 12/31/22 FNP-C 2. Barbra Bachmeier, JD, MSN, APRN, NP-C, FAEN Member IN 1/1/20 – 12/31/21 1/1/20 – 12/31/21 3. Julie Slack, PhD, RN Member MI 1/1/20 – 12/31/21 1/1/20 – 12/31/21 4. Meredith Holder, MSN-ED, RN, CEN, TCRN Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 5. Victor (Matt) Pearson, RN, CEN, CPEN, CCRN, TCRN Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Dana Kemery, EdD, MSN, RN, CEN, CPEN, CNE Member NJ 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Steven Jewell Staff Liaison: Nicole Williams
2021 Charges: 1. Provide subject matter expertise for educational products and other initiatives
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2. Generate ideas for educational products, program development and implementation Back to Top 3. Assist in prioritizing the content development initiatives based upon the ENA Strategic Plan 4. Review and provide feedback on educational content as requested
2021 Specific Criteria: • Must have extensive knowledge about and experience in nursing education • Knowledge of adult learning principles • Experience with various educational delivery methods, including live, enduring, online, and/or distance learning • Must have a minimum of a Master’s degree in Nursing • Ability to serve for a two-year term • No onsite meeting required
Back to Top EMERGENCY NURSING RESEARCH ADVISORY COUNCIL
Name Position State Position Term Service Term 1. Paul Clark, PhD, MA, RN Chair IN 1/1/20 – 12/31/21 1/1/19 – 12/31/22 2. Courtney Edwards, DNP, MPH, RN, CEN, CCRN, TCRN Member TX 1/1/19 – 12/31/21 1/1/19 – 12/31/21 3. Kimberly Johnson, PhD, RN, CEN Member OH 1/1/19 – 12/31/21 1/1/19 – 12/31/21 4. Christian Burchill, PhD, RN, CEN Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 5. Michael Moon, PhD, MSN, RN, CNS-CC, CEN, FAEN Member VA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Michael Callihan, PhD, MSN, RN, EMT-P Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22 7. Stephanie Frisch, PhD, MSN, RN, EMT-B, CEN, CCRN, Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 PHRN 8. Tania Strout, PhD, MS, BSN, RN Member ME 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Ryan Oglesby Staff Liaison: Lisa Wolf
2021 Charges: 1. Provide subject matter expertise for the advisory council 2. Assist in development and implementation of 5-year research strategic plan 3. Assist in prioritizing the advisory council’s programs based upon the ENA Strategic Plan 4. Collaborate with ENA Foundation to review research grant proposals 5. Participate in developing research protocols, analyzing data and contributing to manuscripts 6. Participate in development and writing Understanding Research column for Journal of Emergency Nursing (JEN) 7. Participate in review of ENA Clinical Practice Guidelines 8. Participate in review of abstracts and posters to be presented at the annual conference.
2021 Specific Criteria: • Writing sample may be required as part of submission • Must have extensive knowledge about and experience in nursing research • Evidence of scholarly activities such as developing proposals, conducting research, dissemination, and/or implementing findings into practice is required • Interest in collaborative research with other members of the Advisory Council • Must have a minimum of a doctorate, will consider those enrolled in PhD programs • Ability to serve for a two- or three-year term in order to collaborate meaningfully on research projects • Onsite meeting required
Back to Top EMERGING PROFESSIONAL ADVISORY COUNCIL
Name Position State Position Term Service Term 1. Mica David, BSN, RN Chair GA 1/1/21 – 12/31/21 1/1/20 – 12/31/22 2. Haley Brown, BSN, RN, EMT-B Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21 3. Norma Hernandez-Ramirez, MSN, RN Member CA 1/1/20 – 12/31/21 1/1/20 – 12/31/21
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4. Alexus Moore, MSN-ED, RN Member VA 1/1/21 – 12/31/22 Back1/1/21 to –Top 12/31/22 5. Amie Porcelli, BSN, RN, CEN, TCRN Member PA 1/1/21 – 12/31/21 1/1/21 – 12/31/22 6. Robert Ramos, BSN, RN Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22 7. Oneka Hill, BSN, BS, RN Member MI 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Ryan Oglesby Staff Liaison: Matt Hessler
2021 Charges: 1. Help assess and engage the needs of emerging professional members 2. Evaluate whether any new benefits or resources are necessary to support the needs of emerging professionals 3. Advise ENA on the best channels to communicate with this membership group 4. Advise on opportunities for expanding engagement of emerging professionals 5. Serve as the planning team for the emerging professionals event held during annual conference
2021 Specific Criteria: • Must have five years or less experience in emergency nursing at the time of appointment • Must be comfortable with virtual engagement via online meetings, email, and document sharing • Ability to serve a two-year term • No onsite meeting required
Back to Top EMERGING PROFESSIONAL LIAISON
Name Position State Position Term Service Term 1. Amie Porcelli, BSN, RN, CEN, TCRN Member PA 1/1/21 – 12/31/21 1/1/21 – 12/31/21
Staff Liaison: Ashley Schuring
2021 Charges: 1. Provide the emerging professional perspective and key insights through active participation in all Board meetings 2. Serve as a non-voting liaison to the ENA Board of Directors for a one-year term 3. Participate in person at all Board meetings during the year and attend the State and Chapter Leaders Orientation and Day on the Hill 4. Participate in Board projects and workgroups as assigned 5. Provide an update/seek commentary on issues facing emerging professionals during the ENA Update with the Board of Directors at the annual conference 6. Simultaneously serve as a member of the Emerging Professional Advisory Council for one year and serve as Chair the following year 7. Draft an end-of-year report on the experience as an Emerging Professional Liaison and support the transition of the role to a new emerging leader 8. Other mentoring/shadowing opportunities may include: a one-on-one meeting with the ENA president and shadowing a Board Liaison during a state visit and/or volunteer group call (with permission)
2021 Specific Criteria: • Must have five years or less experience in emergency nursing at the time of appointment • Be a current ENA member in good standing • Previous experience in an ENA State Council/Chapter leadership position or ENA volunteer position is recommended • Cannot be a sitting member of the ENA Board of Directors • Must be able to commit to attending in-person meetings and various video conferences as needed • Must be comfortable with virtual engagement via online meetings, email, and document sharing
Back to Top ENPC REVIEW COMMITTEE
Name Position State Position Term Service Term 1. Cam Brandt, MSN, RN, CEN, CPEN Chair TX 1/1/21 – 12/31/22 1/1/21 – 12/31/23 2. Patricia Kunz Howard, PhD, RN, CEN, CPEN, NE-BC, Member KY 1/1/21 – 12/31/22 1/1/21 – 12/31/22 TCRN, FAEN, FAAN Emergency Nurses Association add date 11
3. Ashellee Street, BSN RN Member ND 1/1/21 – 12/31/22 Back1/1/2 to1 Top– 12/31/22 4. Claudia Phillips, MSN-ED, RN, CEN, CPEN Member NM 1/1/21 – 12/31/21 1/1/21 – 12/31/21 5. Stefanie Miller, MSN, RN, CEN Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Justin Milici, MSN, RN, CEN, CPEN, CCRN, CPN, TCRN, Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22 FAEN 7. Elizabeth Bryant, MSN, RN, CEN, CPEN, NE-BC Member KY 1/1/21 – 12/31/21 1/1/21 – 12/31/21 8. Lisa Smotrich, RN, CCRN, RN-BC Member FL 1/1/21 – 12/31/21 1/1/21 – 12/31/21
Board Liaison: Terry Foster Staff Liaison: Katrina Ceci
2021 Charges: 1. Provide subject matter expertise for the Emergency Nursing Pediatric Course (ENPC) 5th ed 2. Serve are subject matter experts (SMEs) in the quarterly Agile Revision process 3. Provide content review of course material and recommendations for course content edits
2021 Specific Criteria: • Must have subject matter expertise in pediatrics • It is desired that this work team represents diversity in experience, including pediatric nurses representing children’s hospitals as well as nurses representing general hospitals providing emergency care to pediatric patients • ENPC 5th ed Course Instructor or Course Director verification required • Ability to serve for a 12-month term
Back to Top GERIATRIC COMMITTEE
Name Position State Position Term Service Term 1. Joan (Michelle) Moccia, DNP, MSN, RN, ANP-BC, CCRN Chair MI 1/1/21 – 12/31/22 1/1/21 – 12/31/23 2. Aaron Malsch, RN, MSN, GCNS-BC Member WI 1/1/21 – 12/31/21 1/1/19 - 12/31/21 3. Jaimie Ostrom, MSN, BSN, RN, CEN, CNL Member TX 2/1/21 – 12/31/21 2/1/21 – 12/31/21 4. Lisa Gaeta, MSN, BSN, RN, CEN Member NY 1/1/20 – 12/31/21 1/1/20 – 12/31/21 5. Suszanne Deyke, MSN, RN CEN Member NE 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Patricia Primmer, RN Member NJ 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Joop Breuer Staff Liaison: Katrina Ceci
2021 Charges: 1. Provide subject matter expertise related to geriatric emergency care 2. Identify and recommend resources to promote geriatric readiness in the emergency department 3. Revise, edit and develop resources for geriatric emergency care as requested
2021 Specific Criteria: • Must have subject matter experience in Geriatrics (elderly) population and be willing to serve on collaborative projects • Research and/or performance improvement background recommended • Experience with development and evaluation of education for bedside emergency nurses preferred • Ability to write clearly, professionally, and within established timelines • Ability to serve for a one-two year term Back to Top INTERNATIONAL ADVISORY COUNCIL
Name Position Country Position Term Service Term 1. Dawn Peta, BSN, RN Chair Canada 1/1/21 – 12/31/21 1/1/19 – 12/31/22 2. Walter Sergio Lugari, BSN, RN, ATCN Member Germany 1/1/20 – 12/31/21 1/1/20 – 12/31/21 3. Marc Marquez, RN Member Australia 1/1/20 – 12/31/21 1/1/20 – 12/31/21
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4. Margaret Dymond, BSN, RN Member Canada 1/1/20 – 12/31/21 Back1/1/20 to –Top 12/31/21 5. Adam Johnston, BA, RN, CEN Member ND 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Gunilla Lundgren, RN Member Sweden 1/1/21 – 12/31/22 1/1/21 – 12/31/22 7. Vanessa Gorman, MSN-ED, BS, RN, CCRN, FAEN Member Australia 1/1/21 – 12/31/21 1/1/21 – 12/31/21
Board Liaison: Joop Breuer Staff Liaison: Missy Norwick
2021 Charges: Charges to be developed upon 2021 committee formation and presented to the Board for ratification at a future date.
2021 Specific Criteria: • Strong understanding of ENA • Understanding of local and global nursing issues • Ability to participate in virtual and in-person meetings in the United States. Onsite meeting at annual emergency nursing conference required • Ability to serve for a two-year term
Back to Top LANTERN AWARD COMMITTEE
Name Position State Position Term Service Term 1. Tyler Babcock, MSN, MBA, BSN, RN, CEN Chair PA 1/1/21 – 12/31/21 1/1/20 – 12/31/22 2. Jennifer Van Cura, DNP, MSN, MPH, MBA, RN, CEN, Member CO 1/1/21 – 12/31/21 1/1/19 - 12/31/21 CPEN, TCRN 3. Ma Cecilia Reyes, BSN, RN Member NC 1/1/20 – 12/31/21 1/1/20 – 12/31/21 4. Debra Rodriguez, MSN, BSN, RN, SANE Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21 5. Chris Rankin, DNP, MSN, BSN, RN, CEN Member OH 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Lucinda Clos, RN Member MI 1/1/21 – 12/31/22 1/1/21 – 12/31/22 7. Natalie Heywood, RN Member AZ 1/1/21 – 12/31/22 1/1/21 – 12/31/22 8. Will Stewart, MSN, RN, EMT-P, CEN, NE-BC Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22 9. Diane Heine, DNP, MSN, BSN, ADN, RN, CEN Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22 10. Theresa Diloy, MSN, BSN, RN, CEN, CPEN Member VA 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Dustin Bass Staff Liaison: Ellen Siciliano
2021 Charges: 1. Review and recommend revisions for Lantern Award program materials as requested 2. Review and score eligible Lantern Award applications 3. Provide substantive and supported comments/feedback for Lantern application responses
2021 Specific Criteria: • Must be able to participate in reviewer training and utilize the online reviewer tool to evaluate Lantern applications • Deadlines and activity are heaviest between January-July; must have capacity to review a significant number of applications within an eight-week period (April-May) and participate in video conference meetings during June and/or July to create applicant feedback letters • Excellent writing skills required in order to provide content for inclusion in applicant feedback letters. • Ability to serve for a two-year term • No onsite meeting required
Back to Top LANTERN AWARD REVIEWERS
Name Position State Position Term Service Term 1. Carol Fridal, MS, RN, EMT-B, CEN, CLNC Chair IA 1/1/21 – 12/31/22 1/1/21 – 12/31/23
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2. Christina Kelly, BSN, RN, CEN Member PA 1/1/20 – 12/31/21 Back1/1/20 to – Top 12/31/21 3. Kimberly Mueller, BSN, RN, CEN, CPEN Member IA 1/1/20 – 12/31/21 1/1/20 – 12/31/21 4. Mary Beth Tucker, RN, CEN, CCNS Member GA 1/1/20 – 12/31/21 1/1/20 – 12/31/21 5. Marina Andrade, BSN, RN, CEN Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21 6. Heidi Webber, RN Member MO 1/1/20 – 12/31/21 1/1/20 – 12/31/21 7. Mary Collins, RN Member OH 1/1/21 – 12/31/22 1/1/21 – 12/31/22 8. Deborah Schwytzer, DNP, RN, CEN, RN-BC Member OH 1/1/21 – 12/31/22 1/1/21 – 12/31/22 9. Hanna Gerke, RN, CEN Member NJ 1/1/21 – 12/31/22 1/1/21 – 12/31/22 10. Karla Nygren, MSN, MBA, BA, RN, CEN, CPEN, CFRN, Member SD 1/1/21 – 12/31/22 1/1/21 – 12/31/22 CCRN, CPN, TCRN 11. Kimberly Treaster, MSN, RN, CEN Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Dustin Bass Staff Liaison: Ellen Siciliano
2021 Charges: 4. Review and recommend revisions for Lantern Award program materials as requested 5. Review and score eligible Lantern Award applications 6. Provide substantive and supported comments/feedback for Lantern application responses
2021 Specific Criteria: • Must be able to participate in reviewer training and utilize the online reviewer tool to evaluate Lantern applications • Deadlines and activity are heaviest between January-July; must have capacity to review a significant number of applications within an eight-week period (April-May) and participate in video conference meetings during June and/or July to create applicant feedback letters • Excellent writing skills required in order to provide content for inclusion in applicant feedback letters. • Ability to serve for a two-year term • No onsite meeting required Back to Top PEDIATRIC COMMITTEE
Name Position State Position Term Service Term 1. Gail Schoolden, DNP, RN, APRN, CNS, CPEN, ATCN Chair MD 1/1/21 – 12/31/21 1/1/20 – 12/31/22 2. Katherine Logee, MSN, RN, NP, CEN, CPEN, CFRN, CNE, Member CA 1/1/21 – 12/31/21 1/1/19 – 12/31/21 FNP-BC, PNP-BC 3. Karen Kaskie, BSN, RN, CEN, CPEN, CFRN Member SD 1/1/20 – 12/31/21 1/1/20 – 12/31/21 4. Tristen Palumbo, MSN, MBA, BSN, RN, CPEN, CPN Member LA 1/1/20 – 12/31/21 1/1/20 – 12/31/21 5. Caleb Jacobs, MSN, RN Member WA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Sara Daykin, DNP, RN, CPEN, TCRN Member NM 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Cheryl Randolph Staff Liaison: Cydne Perhats
2021 Charges: 1. Provide subject matter expertise related to pediatric emergency care 2. Identify, recommend and/or develop resources for care of the pediatric patient in emergency care settings 3. Review and provide feedback on educational content and other ENA initiatives as requested
2021 Specific Criteria: • Must have subject matter experience in pediatrics • Experienced nurses representing children’s hospitals as well as nurses representing general hospitals that provide emergency care to pediatric patients desired • Current ENPC provider status • Ability to serve for a two-year term • No onsite meeting is required
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Back toBack Top to Top PEER REVIEW EDUCATION COMMITTEE
Name Position State Position Term Service Term 1. Charlene Draleau, MSN, RN, CPEN, CPN, RN-BC Member RI 1/1/20 – 12/31/21 1/1/20 – 12/31/21 2. Mariann Cosby, DNP, MSN, MPA, RN, CEN, CCM, LNC, Member CA 1/1/20 – 12/31/21 1/1/20 – 12/31/21 NE-BC PHN 3. Candi Miller-Morris, MSN, RN, CNS, CEN, CCRN Member NM 1/1/20 – 12/31/21 1/1/20 – 12/31/21 4. Shuba Samuel, PhD, MSN, BSN, RN, FNP, CEN, CNE, Member MI 1/1/20 – 12/31/21 1/1/20 – 12/31/21 FNP-BC 5. Melissa Scott, PhD, MSN, BSN, ADN, RN Member NC 1/1/20 – 12/31/21 1/1/20 – 12/31/21 6. Joan Somes, PhD, MSN, RN, CEN, CPEN, RN-BC, FAEN Member MN 1/1/20 – 12/31/21 1/1/20 – 12/31/21 7. Jonathan Willis, MSN, RN, CEN, CPEN, CCRN-K (Adult), Member IN 1/1/20 – 12/31/21 1/1/20 – 12/31/21 TCRN 8. Mary Zaleski, DNP, RN, CEN, RN-BC, FAEN Member MD 1/1/20 – 12/31/21 1/1/20 – 12/31/21 9. Crystal Miles-Threatt, MA, BSN, RN, CEN, CCRN-K (Adult), Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 TCRN 10. Genevieve Wessel, MSN, BS, RN, NP, CEN, AGACNP- Member IL 1/1/21 – 12/31/22 1/1/21 – 12/31/22 BC, TCRN 11. Janis Farnholtz Provinse, MS, BSN, RN, CNS, CEN, Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 TCRN, FAEN 12. Marie Garrison, MSN, RN, EMT-I, CEN Member OH 1/1/21 – 12/31/22 1/1/21 – 12/31/22 13. Nicole Price, MSN, ANP, CNS, CEN, CPEN, TCRN Member WA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 14. Sarah Rueda, RN Member MD 1/1/21 – 12/31/22 1/1/21 – 12/31/22 15. Sherine Villegas, RN Member NY 1/1/21 – 12/31/22 1/1/21 – 12/31/22 16. Caroline Meza, MSN, RN Member NJ 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: N/A Staff Liaison: Kim Cheramie
2021 Charges: 1. Serve as peer review members of the ENA’s accredited Approver Unit CNE applications 2. Participate as pilot study subjects for ENA's accredited Provider Unit’s newest products or activities 3. Serve as content reviewers for ENA's accredited Provider Unit ongoing CNE activities
2021 Specific Criteria: • Experience with the American Nurses Credentialing Center’s criteria for continuing nursing education • Ability to independently review, on average one to two continuing education applications and required forms submitted to ENA’s approval unit each month, occasionally requiring a quick turn-around. The number of submitted applications and required forms varies each quarter. • Mentor new members through at least three CNE applications of varying complexity • Ability to serve for a two-year term No onsite meeting is required
Back to Top POSITION STATEMENT COMMITTEE
Name Position State Position Term Service Term 1. Elizabeth Stone, MSN, RN, CPEN, FAEN Chair NC 1/1/20 – 12/31/21 1/1/20 – 12/31/22 2. Brenda Braun, MSN, BSN, RN, CEN, CPEN, FAEN Member NJ 1/1/20 – 12/31/22 1/1/20 – 12/31/22 3. Carla Brim, MN, RN, CNS, CEN, PHCNS-BC Member WA 1/1/19 – 12/31/21 1/1/19 – 12/31/21 4. Alison Day, PhD, MSN, BS, RN, FAEN Member UK 1/1/20 – 12/31/22 1/1/20 – 12/31/22 5. Ann Marie Papa, DNP, MSN, BSN, RN, CEN, NE-BC, Member PA 1/1/19 – 12/31/21 1/1/19 – 12/31/21 FAEN, FAAN 6. Kathryn Rogers, MSN, RN, CEN, CPEN, CPHQ, NEA-BC, Member OR 1/1/19 – 12/31/21 1/1/19 – 12/31/21 TCRN 7. Sharon Vanairsdale, DNP, MS, RN, APRN, NP, CNS, CEN, Member GA 1/1/20 – 12/31/22 1/1/20 – 12/31/22 ACNS-BC, NP-C, FAEN, FAAN
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8. Jennifer Williams, PhD, RN, ACNS-BC Member MO 9/23/19 – 12/31/21 Back9/23 to/19 Top – 12/31/21
9. Jean Proehl, MN, RN, CEN, CPEN, TCRN, FAEN, FAAN Member NH 1/1/21 – 12/31/22 1/1/21 – 12/31/22
10. Joanne Navarroli, MSN, BS, RN, CEN Member AZ 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Steven Jewell Staff Liaison: Monica Kolbuk
2021 Charges: 1. Recommend subject matter experts to collaborate with ENA committees and work teams in developing new position statements 2. Review, revise, develop and/or recommend for archive, Position Statements for ENA Board approval 3. Collaborate with external organizations on Joint and Supported Position Statements at the direction of the ENA Board of Directors
2021 Specific Criteria: • Capacity to review significant number of scientific articles and other literature, conduct literature searches, and be able to critically analyze and discuss the results of the literature searches • Ability to write clearly, professionally, and within the timelines established by the PSC process o Academic writing sample using APA format and editing sample will be required as part of submission • Master’s degree required; Doctoral degree is preferred. • Previous experience on the Clinical Practice Guidelines Committee, IENR Advisory Council or Journal of Emergency Nursing (JEN) Editorial Board is preferred • Ability to participate in at least one video conference call each month • Ability to serve for a three-year term • No onsite meeting is required Back to Top QUALITY AND SAFETY ADVISORY COUNCIL
Name Position State Position Term Service Term 1. Robert Kentner, MSN, RN, EMT-P, CEN, CPHQ, NREMT- Chair NE 1/1/21 – 12/31/21 1/1/20 – 12/31/22 P, TCRN 2. Elizabeth, EdD, MSN, Med, BS, ADN, RN, CEN Member PA 1/1/21 – 12/31/21 1/1/19 – 12/31/21 3. Leann Briggs, BSN, BA, RN Member KS 1/1/20 – 12/31/21 1/1/20 – 12/31/21 4. Vivianna Carter, BSN, RN, TCRN Member MO 1/1/21 – 12/31/22 1/1/21 – 12/31/22 5. Joshua Monsivais, BSN, RN, CEN Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Kayla Lott, MSN, RN, CRNP, CEN, FNP-C Member AL 1/1/21 – 12/31/22 1/1/21 – 12/31/22
Board Liaison: Mike Hastings Staff Liaison: Cathy Olson
2021 Charges: 1. Provide subject matter expertise on quality, safety and injury prevention relevant to emergency nursing practice 2. Generate ideas for program development and implementation for quality, safety and injury prevention in accordance with the ENA Strategic Plan 3. Review and provide feedback on initiatives, practice resources or other documents as requested
2021 Specific Criteria: • Must have knowledge about and experience in quality, safety, and/or injury prevention • Previous experience in implementing quality, safety and/or injury prevention activities • Ability to serve for a two-year term • No onsite meeting required
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Back toBack Top to Top
RESOLUTIONS COMMITTEE
Name Position State Position Term Service Term 1. Daniel Misa, MSN, RN, CEN, CPEN Chair NJ 1/1/21 – 12/31/21 1/1/19 – 12/31/22 2. India Owens, MSN, RN, CEN, NE-BC, FAEN Member IN 1/1/19 – 12/31/21 1/1/19 – 12/31/21 3. Christopher Parker, MSN, BSN, RN, CEN, CPEN, CFRN, Member VA 1/1/20 – 12/31/22 1/1/20 – 12/31/22 CNL, NRP, TCRN 4. Cody Staub, RN Member WA 1/1/20 – 12/31/22 1/1/20 – 12/31/22 5. Todd Haines, MSN, BSN, RN, EMT-I, CEN Member TN 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Gina Slobogin, DNP, MSN, BSN, AND, RN, APRN, FNP, Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 EMT-B, EMT-P, CEN, APRN-BC, FNP-BC, NHDP-BC, NREMT-P, PHRN, TCRN
Board Liaison: Jennifer Schmitz Staff Liaison: Ashley Schuring
2021 Charges: 1. Conduct annual call for resolutions and bylaws amendments 2. Provide assistance to resolution and bylaws authors submitting a proposal 3. Ensure submitted bylaw amendments and resolutions adhere to ENA guidelines and formatting requirements 4. Review and provide feedback regarding the resolutions and bylaws amendments guidelines and supporting materials for submission of a proposal 5. Lead the reference committee hearings and assist with debate and vote during the onsite General Assembly meeting 6. Deliberate and determine final recommendations and potential amendments for consideration during day two of General Assembly
2021 Specific Criteria: • Experience with the resolutions and bylaws process on the local, state, or organizational level • Prior attendance at one ENA General Assembly as a delegate • Working knowledge of Roberts Rules of Order • Two onsite meetings required. One held at the ENAoffices and one held at the ENA annual emergency nursing conference • Ability to serve for a three-year term Back to Top TNCC REVIEW COMMITTEE
Name Position State Position Term Service Term 1. Sheila Silva, DNP, RN Chair MA 1/1/21 – 12/31/22 1/1/21 – 12/31/23 2. Jim Sullivan, MSN, RN, CEN Member TX 1/1/21 – 12/31/21 1/1/21 – 12/31/21 3. Julie Miller, BSN, RN, CEN Member KS 1/1/21 – 12/31/22 1/1/21 – 12/31/22 4. Melanie Crowley, MSN, RN, CEN, TCRN Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 5. Julie Tseh-Willcockson, RN Member CO 1/1/21 – 12/31/21 1/1/21 – 12/31/21 6. Rebecca VanStanton, MSN, RN, CEN, CPEN, TCRN Member MI 1/1/21 – 12/31/22 1/1/21 – 12/31/22 7. Judy Stevenson, DNP, MS, BSN, RN, APRN, CNS, CEN, Member OK 1/1/21 – 12/31/21 1/1/21 – 12/31/21 CPEN, ACCNS-AG, CCRN, NHDP-BC, TCRN
Board Liaison: Cheryl Randolph Staff Liaison: Katrina Ceci
2021 Charges: 1. Provide subject matter expertise for the Trauma Nurse Core Course 8th ed 2. Serve as subject matter experts (SMEs) in the quarterly Agile Revision process 3. Provide content review of course material and recommendations for course content edits
2021 Specific Criteria: • Must have current emergency department experience, including care of the trauma patient
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• Must be a current TNCC course director Back to Top • Experience with development and evaluation of education for bedside emergency nurses preferred • Ability to serve for a 12-month term Back to Top TRAUMA COMMITTEE
Name Position State Position Term Service Term 1. Justin Winger, PhD, MA, BSN, BA, RN, PHN Chair CA 1/1/21 – 12/31/21 1/1/19 – 12/31/22
2. Justin Heinrich, MSN, RN Member PA 1/1/20 – 12/31/21 1/1/21 - 12/31/21
3. Casey Hill, MSN, RN, CEN, TCRN Member NH 1/1/20 – 12/31/21 1/1/21 - 12/31/21
4. Julie Tseh-Willcockson, RN Member CO 3/1/20 – 12/31/21 3/1/21 - 12/31/21
5. Sonny Ruff, DNP, MSN, BSN, ADN, RN, APRN, FNP, Member MS 1/1/20 – 12/31/21 1/1/21 - 12/31/21 CEN, ENP-BC, FNP-C 6. Olivia Smoak, BSN, RN, CEN Member FL 1/1/21 – 12/31/22 1/1/21 – 12/31/22
7. Vientiane Pajo, BSN, RN, CEN, TCRN Member FL 1/1/21 – 12/31/22 1/1/21 – 12/31/22 8. Eric Cohen, BSN, RN, CEN, TCRN Member NY 1/1/21 – 12/31/22 1/1/21 – 12/31/22 9. Tonya Barnard, BSN, RN, CEN Member LA 4/19/21 – 12/31/21 4/19/21 – 12/31/21
Board Liaison: Kristen Cline Staff Liaison: Monica Kolbuk
2021 Charges: 1. Collaborate on the ongoing updates and revisions of ENA’s trauma related courses 2. Provide subject matter expertise related to trauma emergency care. 3. Collaborate on the development of trauma and/or injury prevention resources
2021 Specific Criteria: • Must have subject matter experience in trauma and be willing to serve in collaborative projects • Must currently be providing emergency care to trauma patients • TNCC Instructor status preferred, not required • Ability to serve for a two-year term • No onsite meeting required Back to Top
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APPENDIX A: Back to Top
FOR REFERENCE: ENA FOUNDATION VOLUNTEER GROUPS (ENA Foundation volunteer group participants selected by ENA Foundation Board)
ENA FOUNDATION FUNDRAISING COMMITTEE – ENA Foundation Committee
Name Position State Position Term Service Term 1. Melane Marsh, BSN, RN, CEN, SANE Chair NV 1/1/21 – 12/31/21 1/1/21 – 12/31/21 2. Regina Newby, BSN, RN, CEN Member OK 1/1/21 – 12/31/22 1/1/21 – 12/31/22 3. Erin Dees, MSN-ED, MSN-L, RN, CEN Member MS 1/1/21 – 12/31/22 1/1/21 – 12/31/22 4. Mickey Forness, BS, RN, CEN Member NY 1/1/21 – 12/31/22 1/1/21 – 12/31/22 5. CherylAnn MacDonald Sweet, BS, RN, CEN, CPEN Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Karla Nygren, MSN, MBA, BA,RN, CEN, CPEN, CFRN, Member SD 1/1/21 – 12/31/22 1/1/21 – 12/31/22 CCRN, CPN, TCRN 7. Barbara Gibson, BSN RN CEN Member TN 1/1/21 – 12/31/22 1/1/21 – 12/31/22 8. Melissa Easdon, MBA, BSN, RN, CEN, CPEN Member AR 1/1/20 – 12/31/21 1/1/20 – 12/31/21 9. Todd Haines, MSN, BSN, RN, EMT-I, CEN Member TN 1/1/20 – 12/31/21 1/1/20 – 12/31/21 10. Howard Miller, BSN, RN, NREMT-P, PHRN Member PA 1/1/20 – 12/31/21 1/1/20 – 12/31/21 11. Jeff Solheim, MSN, RN, CEN, CFRN, TCRN, FAEN, FAAN Member OR 1/1/20 – 12/31/21 1/1/20 – 12/31/21
Board Liaisons: Michael Loughran and Jessica Mathieson Staff Liaison: Lise Jinno and Meghan Higham
2021 Charges: 1. Promote and strengthen the culture of philanthropy 2. Champion fundraising efforts with and for the ENA Foundation in your community and state 3. Provide advice and guidance to the Foundation Board of Trustees with respect to the mission, and strategic outlook, of the Foundation as it relates to raising money to further the mission 4. Provide advice and guidance to state officers and fundraising chairs as it relates to raising money to further the mission of ENA 5. Develop a network of resources
2021 Specific Criteria: • Collaborate with the ENA Foundation and the ENA Foundation Board of Trustees to assist in local and state fundraising and program initiatives • Participate in the promotion of the State Challenge, ENA scholarships and research grants, and engage in ENA fundraising activities • Establish and maintain annual fundraising initiatives at the state level through collaboration with the State Council officers and fundraising chairs and plan for adequate resources to maintain or expand fundraising efforts • Maintain communications about current and ongoing fundraising activities with ENA Foundation, ENA Foundation Board of Trustees, and other ENA State Fundraising Chairs • Network within the state and with other similar organizations on fundraising and development initiatives in venues such as ENA annual, regional, and local conferences, meetings, coalitions, task forces and work groups • Participate in ENA Foundation fundraising events at ENA conferences, if attending • Ability to serve a two-year term • Have fundraising experience and preferably responsibilities/roles within their local Council or Chapter
ENA FOUNDATION RESEARCH GRANT COMMITTEE – ENA Foundation Committee
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Name Position State Position Term ServiceBack to TermTop 1. Nancy Mannion, DNP, MS, RN, CEN, FAEN Chair PA 1/1/19 – 12/31/21 1/1/19 – 12/31/21 2. Christine Russe, MSN, RN, CEN, CPEN, TCRN, Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22 FAEN 3. Gina Slobogin, DNP, RN, CEN Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 4. Sarah Abel, DNP, RN, CEN, FAEN Member IN 1/1/21 – 12/31/22 1/1/21 – 12/31/22 5. Andi Foley, DNP, RN, APRN, EMT-B, CEN, ACCNS- Member ID 1/1/21 – 12/31/22 1/1/21 – 12/31/22 AG, TCRN, FAEN 6. Shawntay Harris, MSN, MHA, MBA, BSN, RN, CEN, Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22 CPEN, NE-BC, TCRN 7. Sharon Jones, EdD, MSN, RN, CEN Member NJ 1/1/20 – 12/31/21 1/1/20 – 12/31/21
Board Liaison: Nancy Mannion Staff Liaison: Lise Jinno and Meghan Higham
2021 Charges: 1. Review and score applications for ENA designated research grants and seed grants. 2. Provide guidance and strategic outlook for future research as it relates to engaging ENA membership on available research and successful funding of research 3. Actively engage and champion ENA research and seed grant activity at organizational, state, local and community levels.
2021 Specific Criteria: • Participate in video conference calls for training and review of research grants • Promote research grants to members at the state and local level • Maintain communication with the ENA Foundation Board of Trustees member and ENA Foundation staff regarding the grant review process • Contact research grant recipients, providing constructive feedback to unsuccessful applicants regarding application process • Collaborate with other ENA entities to identify resources for seed grant awardees • Network within the state and with other similar organizations on the promotion of research grants and development initiatives in venues such as, ENA annual, regional and local conferences, meetings, coalitions, task forces, and work groups. • Have research experience • Participate in ENA Foundation fundraising events at ENA conferences, if attending • Ability to serve a two-year term
ENA FOUNDATION SCHOLARSHIP COMMITTEE – ENA Foundation Committee
Name Position State Position Term Service Term 1. Jim Hoelz, MS, MBA, RN, CEN, FAEN Chair PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 2. Chris Gisness, MSN, RN, APRN, FNP, CEN, FNP-C, TCRN, Associate GA 1/1/19 – 12/31/21 1/1/20 – 12/31/21 FAEN Chair 3. Deborah McCrea, EdD, MSN, RN, EMT-P, CEN, CFRN, FNP- Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22 BC 4. Patrice Christensen, BSN, RN Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 5. Louise Hummel, MSN, RN, CNS, CEN, TCRN, FAEN Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 6. Joyce Foresman-Capuzzi, MSN, RN, CNS, EMT-P, CEN, Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 CPEN, CTRN, CCNS, CCRN, PHRN, SANE, FAEN 7. Vicki Patrick, MS, APRN, CEN, ACNP-BC, FAEN Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22 8. Harriet Hawkins, RN, CPEN, CCRN, CPN, FAEN Member IL 1/1/21 – 12/31/22 1/1/21 – 12/31/22 9. Melanie Gibbons Hallman, DNP, RN, CRNP, CEN, ACNP-BC, Member AL 1/1/21 – 12/31/22 1/1/21 – 12/31/22 ENP-C, FNP-BC, TCRN, FAEN 10. Audrey Snyder, PhD, RN, ACNP, FNP, CEN, ACNP-BC, Member NC 1/1/21 – 12/31/22 1/1/21 – 12/31/22 CCRN, FNP-BC, FAEN, FAAN, FAANP 11. Amy Boren, MS, BSN, RN, CEN, CPEN, TCRN Member CO 1/1/21 – 12/31/22 1/1/21 – 12/31/22
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12. Laura Wilson, MSN-ED, RN, CEN Member NY 1/1/21 – 12/31/22 Back1/1/21 to –Top 12/31/22 13. Alexus Moore, MSN-ED, RN Member VA 1/1/21 – 12/31/22 1/1/21 – 12/31/22 14. Roger Casey, MSN, RN, CEN, TCRN, FAEN Member WA 1/1/20 – 12/31/21 1/1/20 – 12/31/21 15. Kelly Collins, BSN, RN, CEN, CPEN, SANE Member ME 1/1/20 – 12/31/21 1/1/20 – 12/31/21 16. Carol Fridal, MS, RN, EMT-B, CEN, CLNC Member IA 1/1/20 – 12/31/21 1/1/20 – 12/31/21 17. Mary Harwood, MSN-ED, RN, CEN Member NY 1/1/20 – 12/31/21 1/1/20 – 12/31/21 18. Christina Kuehster, MS, RN Member CO 1/1/20 – 12/31/21 1/1/20 – 12/31/21 19. Thelma Kuska, BSN, RN, CEN, FAEN Member IL 1/1/20 – 12/31/21 1/1/20 – 12/31/21 20. Patricia Nierstedt, MS, RN, CEN, TCRN Member NJ 1/1/20 – 12/31/21 1/1/20 – 12/31/21 21. Hannah Thadeo, RN, CEN, CPEN, TCRN Member CA 1/1/20 – 12/31/21 1/1/20 – 12/31/21
Board Liaison: Jim Hoelz Staff Liaison: Lise Jinno and Meghan Higham
2021 Charges: 1. Review and score applications for ENA designated scholarships 2. Provide guidance and strategic outlook for future scholarships as it relates to Foundation direction 3. Champion ENA academic scholarship activity at the all levels of the organization. 2021 Specific Criteria: • Participate in video conference calls for training and review of academic scholarships • Maintain communication with the ENA Foundation Board of Trustees regarding the scholarship review process • Contact scholarship recipients • Participate in the committee evaluation process and provide feedback on application and scoring rubric tools • Network within the state and with other similar organizations on the promotion of academic scholarships and development initiatives in venues such as, ENA annual, regional and local conferences, meetings, coalitions, task forces, and work groups • Participate in ENA Foundation fundraising events at ENA conferences, if attending • Ability to serve a two-year term
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