September/October 2008 The Official Publication of the American Nurses Association

Behaving badly? Obama Joint Commission issues alert aimed at improving earns ANA workplace culture, patient care endorsement

By Susan Trossman, RN iven his stances on important nursing and health care issues, GANA has endorsed Sen. Barack ticks and stones may break my Obama (D-IL) for president of the Unit- bones, but names will never hurt ed States. Sme. “As president, Barack Obama will Downplaying the effects of verbal bring real change to our health care sys- abuse has been the way of the world tem,” said ANA President Rebecca M. for decades in both the schoolyard and Patton, MSN, RN, CNOR. “Nurses are the workplace. But things are changing; consistently voted the most trusted pro- The Joint Commission recently issued fession by the American people, and we, a “sentinel event alert” that’s aimed at as a profession, trust that Barack Obama stopping rude and disruptive behavior will see that affordable quality health among health care professionals. care is made available to everyone.” “Intimidation and acting out behavior creates a high-stress environment that’s incompatible with the culture of safety that we’re trying to promote in health care,” said Grena Porto, MS, RN, ARM, CPHRM, a patient safety and risk man- agement consultant who serves on The Joint Commission’s Sentinel Event Advi- sory Group, which issued the alert. “It’s behavior that’s not limited to one group, and it’s been tolerated within health care Hearing of ANA’s support, Obama organizations for too long. said, “I am honored to receive the en- “One of the underlying drivers is dorsement of the American Nurses As- stress, partially because we have a staff- sociation. The nurses of America serve ing shortage. So people already come our country tirelessly, and I share their home feeling like they’ve gone several belief that we must bring affordable and rounds in a boxing ring. We don’t need to accessible health care to all Americans. add to it by allowing these behaviors.” cific sentinel (potentially harmful) event, 2009 and affect a range of organizations, My plan lowers health care costs for the describes its common underlying causes from hospitals to home health agencies average American family by up to $2,500 Long time coming and recommends ways to prevent occur- to laboratories. and finally makes health care work better rences in the future. “Most health care workers do their for American families than it does for the In promoting the alert, the Joint Commis- The Joint Commission also is intro- jobs with care, compassion and profes- drug and insurance companies.” sion noted that rude language and dis- ducing new standards requiring more sionalism,” Joint Commission President Added Patton, “Both Senator Obama ruptive behavior are not just unpleasant than 15,000 accredited health care or- Mark Chassin, MD, MPP, MPH, said in a and Senator Clinton spoke at ANA’s for health care professionals who may be ganizations to create a code of conduct statement. “But sometimes professional- House of Delegates in June about the on the receiving end, but they also pose that defines acceptable and unacceptable ism breaks down and caregivers engage need to move forward in unity to bring a serious threat to patient safety and the behaviors and to establish a formal pro- in behaviors that threaten patient safety. about real, much needed change to our overall quality of care. The Joint Com- cess for managing unacceptable behav- It is important for organizations to take a health care system, and our nurses re- mission issues an alert to identify a spe- ior. The new standards take effect Jan. 1, See Behaving badly on page 6 * See Obama on page 11 *

New book on faith A bridge between ANF NRRC chair community nursing countries built by nurses defines leadership p.7 p.8 p.11

For all the latest nursing news, go to www.NursingWorld.org Spending more quality time with my patients is important to me.

It’s about time…yours and theirs

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TERUMO MEDICAL PRODUCTS President’s President’s Perspective ...... 3 The future of health care is Perspective Letters to the Editor ...... 3 dependent on you… not just ANA In Briefs ...... 4 n a matter of weeks, we will witness a spectacular From the RN Files ...... 8 moment in United States history as we elect our next Donations at Work ...... 11 Ipresident and vice president. For the first time, either an African-American president or a female vice president president Jo Eleanor Elliott. She was president during the As the Web Turns ...... 12 will be elected. Despite the constant barrage of campaign times when ANA advocated for health care reform in the positions, responses and negative ads, I can not wait to ’60s. She was invited to the White House and was a wit- Political Nurse ...... 13 watch the election returns Nov. 4 and see whom America ness when the legislation creating Medicare was signed elects. into law. Nursing was there in the front row. CE Corner ...... 13 Throughout the years, ANA has occupied a front row Let me be clear: Despite all that ANA has achieved for Media Briefs ...... 15 seat in many of the activities that have gotten our coun- every patient and nurse in this country, this editorial is not DEPARTMENTS try and our profession to this historic moment. This year about ANA owning the political power in nursing. Our has been no different. ANA has had some “first” experi- patients, your practice, and your role as a registered nurse ences this year. We have had and continue to have direct require all of us to engage in the presidential and congres- access to most presidential candidates. Some candidates sional elections and even your local elections. Our organi- solicited ANA’s feedback on their health care platforms. zational affiliates provide great leadership and support to The Republican National Committee’s (RNC) Healthcare many nursing issues. At the Democratic and Republican Platform Committee invited the ANA president to meet national conventions this summer, both Association of Volume 40, No. 5 (ISSN 0098-1486) and discuss ANA positions during the RNC’s Healthcare periOperative Registered Nurses and American Associa- Published bimonthy: January/February, March/April, May/June, July/Au- gust, September/October and November/December. Copyright 2007 by Platform, which was presented at its convention. All can- tion of Nurse Anesthetists joined and partnered with ANA the American Nurses Association, 8515 Georgia Avenue, Suite 400, Silver didates would like to have ANA’s endorsement. in our health care event, which achieved more acknowl- Spring, MD 20910-3492, (301) 628-5000. Views expressed herein are not As ANA president, I joined Hillary Clinton on the cam- edgement and publicity for needed health care reform. necessarily those of ANA. The publisher reserves the right to accept or re- ject advertisements for The American Nurse. All advertisers in this publica- paign trail in Virginia and flew with her for almost six hours But as individuals and collectively, there is great politi- tion must employ without regard for age, color, creed, disability, gender, from Washington to Seattle on her private campaign jet. cal power to be realized this year in the races. You know health status, race, religion, lifestyle, nationality and sexual orientations. While traveling first class with the senator and her staff, that every vote counts. If you need convincing, I suggest Chief Executive Officer Linda J. Stierle, MSN, RN, CNAA,BC Director of Communications Laura Diamond ANA and the nursing profession had more than just a seat you talk with the nurses in Florida. To be perfectly honest Editor Phaedra Brotherton in the front row. In Seattle, in front of a capacity crowd, I and blunt, not all nurses vote. Yes, not all Americans vote Senior Reporter Susan Trossman, RN introduced Sen. Clinton. I shared with the audience that either. Still not a valid excuse in my mind. You know Production/Graphic Design Christy Carmody Circulation/Subscriptions American Nurses Publication Center, her history and proposed health care plan matched ANA’s what is at stake by not voting and selecting the candidates (800) 637-0323 desired future for quality, accessible, cost-effective health that best represent the plan and hope to lead the needed Director of Marketing Betty Whitaker care utilizing the full scope of practice for all registered reform in our country and health care system. ANA’s Web Advertising Sales Tony Ward, (301) 628-5210 President Rebecca M. Patton, MSN, RN, CNOR nurses, not just advanced practice nurses. I shared that site (www.nursingworld.org) provides a list of the candi- 1st Vice President Debbie Hatmaker, PhD, RN, SANE-A bedside nursing needs functional changes to maintain an dates who we have endorsed. Our process is fair and pro- 2nd Vice President Coleene “Kim” Armstrong, BSN, RNC adequate supply of RNs and that the senator understands vides a list of those we believe represent the best interests Secretary Susan Foley Pierce, PhD, RN Treasurer Marilyn Sullivan, DSN, RN, LNC, CPE and supports many of ANA’s initiatives and positions to of our patients and profession. Directors Barbara Crane, RN, CCRN support staff nurses. Yes, we are all busy. What nurse is not? We need to Karen A. Daley, MS, MPH, RN, FAAN Linda Gobis, JD, RN, FNP I am proud that our past ANA leaders recognized the vote and make sure our voice is heard. I plan to vote by Linda M. Gural, RN, CCRN opportunities and importance for ANA to be engaged absentee ballot. In fact, I have voted this way for several Carrie Houser James, MSN, RN, CNA, BC, CCE in our country’s political process. It is one of the many years now. It is sooooo easy. My schedule as a nurse chal- Florence Jones-Clarke, MS, RN Mary A. Maryland, PhD, APRN,BC, ANP reasons I joined ANA and my state association as a new lenges my ability to get to the voting booth on time. Polls Julie Shuff, RN, CCRN nurse. It is the reason many become and stay members. open after I leave for work and are often closed before I Kate Steenberg, BSN, RN, CCRN No other nursing organization has the number of front row get home. An absentee ballot ensures I can vote and I can Alice F. Wyatt, MSN, APRN-BC Margarete L. Zalon, PhD, RN, APRN,BC seat opportunities that ANA has. Though it is controver- do it at home and use resources like the ANA Web site. Editorial Advisory Board Cynthia Balkstra, MS, APRN, BC sial at times with our membership, ANA involvement has Think about the great impact this could create. Please Julia Rose Barcott, RN delivered results that no other nursing organization has encourage all nurses to vote—including by absentee bal- Nina Boardman, BSN, RN Diane Daddario, MSN, ACNS-BC, RN, BC, CMSRN achieved. ANA has invested your membership dollars lot—to ensure health care reform takes a front row seat Teresa Holland, MSN, RN, PMHCNS-BC to build the internal structure that has resulted in numer- with our representatives. n Jacquelyn Reid, MSN, RN, CNM Julie Stanik-Hutt, PhD, ANCP, CCNS, FAAN ous successes and milestones for ANA, the state associa- David Whitehorn, BSN, RN, CCRN tions, individual nurses, and most importantly, the patients Address editorial comment and inquiries to Editor, The American Nurse, we care and advocate for. Recently I visited with past 8515 Georgia Avenue, Suite 400, Silver Spring, MD 20910-3492 or, via e-mail, [email protected] Postmaster: Send address changes to The American Nurse, Central Bill- ing, American Nurses Association, 8515 Georgia Avenue, Suite 400, Silver Spring, MD 20910-3492 Letters To Subscription to The American Nurse is included with membership in a state nurses association and ANA direct membership. Subscription rate for Global issues nonmembers, $20 per year; for full-time nursing students, $10 per year. Sub- The Editor scriptions begin approximately six to eight weeks after receipt of payment. Just a small complaint about an article that appeared in Indexed by: International Nursing Index; Cumulative Index to Nursing and the informative July/August 2008 issue. I read about a Allied Health Literature; Hospital Literature Index of the American Hospital resolution passed by the ANA House of Delegates under Association. “Global Issues.” As if nurses’ plates aren’t full enough, Circulation: 157,000 The American Nurse is available in microform from University Microfilms we are now encouraged to jump on the politically correct sota where I live, the land has several times been under International, 300 North Zeeb Road, Ann Arbor, Mich. 48106. Periodicals global warming bandwagon. a mile of ice. Somehow it warmed up, and we actually postage paid at Silver Spring, MD, and additional mailing offices. ANA is Back in the ’70s I used to belong to the Sierra Club. use air conditioners in the summer. When the glaciers an equal opportunity employer. The Big Scare then was the Coming Ice Age! The hys- melted, there were no evil SUVs, no power plants, no The publication of any advertisement in The American Nurse is neither an teria then had us environmentalists worried about the airlines to carry delegates to conferences, and no hard endorsement of the advertiser nor of the products or services advertised. growing threat of glaciation. Now there’s been a com- working nurses hyperventilating and emitting the carbon plete flip flop, and it’s all about politics, money, control, dioxide Al Gore preaches will burn us all up – unless we more money and a Nancy Pelosi like urge to “save the buy from his carbon trading company. planet.” Let’s stick with the traditional, fundamental nursing Fortunately, many climatologists and people with just issues instead of wasting time and using energy pro- plum common sense are debunking this hoax. It’s the http://www.NursingWorld.org weather, stupid, and it changes all the time. In Minne- See Global issues on page 14 *

September/October 2008 n The American Nurse n www.NursingWorld.org  In Brief ANA has long advocated for the ethical A copy of the code is available on statute defines disaster medicine as - “pa recruitment of foreign-educated nurses. In ANA’s Web site at www.nursingworld. tient care” under circumstances when the April 2008, the association filed an amic- org in the “announcements” section. number of patients exceeds normal medi- us brief in New York supporting a motion cal capacities. The statute recognizes that to drop criminal charges against a group medical personnel should not bear civil of Filipino RNs. These nurses had been LA landmark legislation on liability for such disastrous situations un- charged with patient endangerment after disaster care less involved in intentional misconduct. resigning their positions. They have come H.B. 1379: This legislation sets up a Preventing unethical to be known as the “Sentosa nurses.” Louisiana was hit again – this time by disaster medicine review panel that would The nurses had been recruited by the Hurricane Gustav. But nurses and other render an independent opinion regarding recruitment Sentosa Recruitment Agency to work at health care professionals now have state medical judgment using scientifically reli- laws that will help protect them and their ANA, along with representatives of specific nursing home facilities on Long able evidence. It also states that the stan- patients during disasters that can cause unions, health care organizations, educa- Island. When they arrived in the U.S., dard of care of medical personnel is estab- extreme working conditions. tional and licensure bodies, and recruit- they discovered they actually were work- lished as “good faith medical judgment” Louisiana Gov. Bobby Jindal (R) re- ers released in September the “Code of ing for a staffing agency, Prompt Nurses given the disastrous circumstances under cently signed into law the last of three Ethical Conduct for the Recruitment of Employment Agency. Over a period of which the judgment was rendered. Further, pieces of legislation that will apply only Foreign Educated Nurses.” The code months, the nurses said, the agency re- the prosecuting authority will refrain from during declared disasters and cover phy- provides voluntary guidelines that aim fused to pay them according to the terms arresting medical personnel until the opin- sicians, nurses and other health care to ensure the growing practice of recruit- of their contracts. They also said they ion is rendered and any action is needed. personnel, including those coming from ing foreign-educated nurses to the United were not properly trained for their new other states. States is handled in a responsible and jobs and were required to care for more In passing these three bills without transparent manner. patients than they could handle safely. ICN names new CEO a single dissenting vote, the legislature “Recruitment of foreign-educated The code is designed to increase trans- recognized that care during disasters is David Benton has been appointed as the nurses to the United States is growing in parency and accountability throughout given under extraordinary circumstances new chief executive officer of the Interna- response to the U.S. nurse shortage,” said the process of recruitment and provides in conditions that are far from traditional, tional Council of Nurses (ICN) beginning ANA President Rebecca M. Patton, MSN, guidance to health care organizations and and that protecting medical judgment un- Oct. 1. RN, CNOR. “While there is disagreement recruiters on ways to ensure recruitment der such conditions is a necessity, accord- He takes over the key post from Judith over the causes of the nursing shortage is not harmful to source countries. ing to the bills’ supporters. A. Oulton who is stepping down after 12 and whether international nurse recruit- In addition to the ANA, the code has Organizations involved in passing the years at the helm. ment is part of the solution, there is wide- also been endorsed by numerous groups, landmark legislation are the Louisiana “We look forward to working with Da- spread agreement that if it is occurring it including the American Association of State Medical Society, the Louisiana State vid in his new role as CEO, as he contin- should be conducted in an ethical manner International Healthcare Recruitment, the Nurses Association and the Louisiana ues and advances the tremendous work of that balances diverse stakeholder inter- National Council of State Boards of Nurs- Nurse Anesthetists Association. Judith Oulton, leading nurses and the pop- ests. Adoption of this code will safeguard ing, the National Association for Home These measures apply to all cases of ulations they serve to quality health care the rights of foreign-educated nurses and Care and Hospice, several large recruit- declared disasters, such as terrorist acts, for all,” ICN President Hiroko Minami enhance high quality patient care, both ers, and multiple associations of foreign- chemical or petroleum plant explosions said. “His broad management experience, domestically and abroad. educated nurses. and pandemics, as well as tornados and special expertise in professional regula- other natural events. They were spurred tion and education are key assets for ICN by events surrounding Hurricane Katrina as we continue to strive toward our vision and the arrest of three health care profes- of leading societies to better health.” ANA takes action to protect sionals who stayed and served patients in In accepting the position, Benton said, need during the storm, only to be accused “This is an exciting and challenging time of criminal wrongdoing in the deaths of for nurses everywhere, as governments, Michigan RNs nearly 40 stranded and acutely ill hospi- health systems and international agencies address the human resource crisis and n Sept. 8, 2008, ANA and a former took this action based on a determination tal patients by the state’s then-attorney general. A grand jury ultimately found no global health priorities. The nursing role is president of the Michigan Nurses that it is important to protect members’ pivotal. Worldwide nurses are responding Association jointly filed a lawsuit rights and to enforce the national bylaws. cause for pursuing the allegations. How- O ever, several family members of patients with innovative solutions that need to be against the Michigan Nurses Associa- A former MNA president is also a shared, recognized and replicated. I look tion (MNA). The ANA action is aimed plaintiff in the case. MaryLee Pakieser, filed civil suits in the wake of the attorney general’s actions. Some of those civil suits forward to working with all our partners at protecting Michigan RNs’ rights under RN, MSN, FNP, has made a claim that to generate synergies of innovation and the ANA Bylaws and to protect members’ arises from MNA’s changing the status are still pending in Orleans Parish courts. Louisiana S.B. 330: This measure effort that will improve health outcomes rights to participate in making the funda- of all RN members who are not in MNA- for all and strengthen our profession.” mental decision of whether to end a state represented bargaining units to “associ- amends the state’s “Good Samaritan Stat- ute” to protect health care professionals Benton has served as consultant in association’s affiliation with the ANA. ate” members who cannot hold MNA of- nursing and health policy at ICN since The case is based upon MNA’s stated fice. The complaint alleges this change whether they are compensated for their work or not. This is an important change 2005, specializing in regulation, licensing effort to disaffiliate from the ANA, with- was done without the vote and consent and education. Prior to coming to ICN, out following the required step of getting of the affected non-bargaining unit mem- because most health care professionals are working during a disaster. The origi- he filled senior management roles across direct membership approval. bers, in violation of Michigan state law. a range of organizations over the past 20 The ANA Bylaws require that a con- The lawsuit asks the court to declare nal statute only offered civil protection if services were “gratuitous.” In addition, years. These roles included executive di- stituent member association (CMA) that a disaffiliation vote, if any, requires rector of nursing in posts in Scotland and wishes to disaffiliate may do so only with a two-thirds vote of the entire member- the measure protects medical personnel from “simple negligence” and only al- England; chief executive and accounting a two-thirds vote of its entire member- ship for passage and that the decision to officer at the National Board for Nursing ship. In the case of MNA, the decision disenfranchise Pakieser and other mem- lows liability for “gross negligence” and “willful misconduct.” Midwifery and Health Visiting of Scot- was apparently made by its board of di- bers violated Michigan law. The court is land; and regional nurse director, North- rectors, possibly with the advanced ap- asked to enjoin the actions taken by the S.B. 301: During disasters, reverse tri- age protocols are often put into use, with ern and Yorkshire Region, United King- proval of the MNA House of Delegates. MNA House of Delegates and executive dom. The ANA Bylaws require a membership board arising from powers and authority those patients not expected to survive be- ing the last to be evacuated. This measure He has received several awards and vote in order to ensure that the important granted to them under illegally adopted honors, including being presented with decision to cut longstanding ties with state bylaws. gives immunity for simple and gross neg- ligence by doctors and nurses, thereby, Fellowship of the Florence Nightingale ANA is based on the will of the members, If successful, ANA will preserve uni- Foundation in 2001 and awarded Fellow- and not the opinions of a few leaders. ty with MNA, and will assure that if a protecting them from civil damage to patients as a result of evacuation or treat- ship of the Royal College of Nursing of MNA is the first CMA to take steps to change is to occur in the relationship be- the United Kingdom in 2003 for his con- disaffiliate from ANA since the member- tween ANA and MNA, it will be based on ment (or failed evacuation or treatment) at the direction of the military or govern- tribution to health and nursing policy. ship vote requirement was adopted by the a proper process and the will of the mem- Based in Geneva, Switzerland, ICN ANA House of Delegates in 2005. ANA bership. n ment in accordance with “disaster medi- cine” protocols. For the first time, a state is a federation of 131 national nurses as- See In Brief on page 5 *

 September/October 2008 n The American Nurse n www.NursingWorld.org In Brief es, one of the largest groups of practicing students from groups underrepresented surveyed health care workers received a nursing professionals in the health care in nursing or from disadvantaged back- vaccination. In past years, influenza infec- Continued from page 4 industry. Medical-surgical nurses pos- grounds. Institutions receiving awards tions have been documented in health care sess specialized skills and knowledge of will use this funding to help secure new settings, and health care workers have the entire spectrum of nursing care. They faculty resources and provide mentoring been implicated as the potential source of promote excellence in adult health, pro- and leadership development resources to these infections. JCR challenges hospitals vide quality care for patients with diverse ensure successful program completion by to achieve higher vaccination rates among conditions and educate patients, families, scholarship recipients. their staff. sociations representing the millions of peers and other health care professionals. By bringing more nurses into the pro- The challenge began in September and nurses worldwide, and ANA is a founding This will be the second year for the fession at the baccalaureate and master’s will continue through the influenza season member. weeklong celebration. degree levels, the new scholarship pro- until May 2009. Hospitals that achieve “Medical-surgical nurses practice in a gram also helps to address the nation’s a vaccination rate of 43 percent or more RWJ Foundation variety of settings and care for a broad nurse faculty shortage. will be recognized for their dedication to range of patients,” said AMSN Presi- For more information, go to www. helping keep their employees healthy and names fellows dent Kathleen Reeves, MSN, RN, CNS, newcareersinnursing.org. helping to protect their patients. Vaccina- A Minnesota Nurses Association member CMSRN, who’s also a Texas Nurses As- tion of health care workers may help to and six other health professionals — all sociation member. “This is a perfect time Straight talk from nurses decrease the chances that they will get the with a wide range of academic and com- to thank medical-surgical nurses for all flu and pass it on to their patients. munity-based experience — have been that they do.” For parents of sick children, one of the “The Flu Vaccination Challenge high- named Robert Wood Johnson Foundation To participate in this annual celebra- most important measures of quality hos- lights for health care workers the value Health Policy Fellows for 2008 to 2009. tion, employers and facilities are encour- pital care is how well nurses communi- that flu vaccinations can have on patient Established in 1973, The Robert Wood aged to honor their medical-surgical nurs- cate about treatment, tests and pain man- safety,” said Barbara M. Soule, RN, MPA, Johnson Foundation Health Policy Fel- es. As in previous years, activities will agement. CIC, practice leader, Infection Preven- lows — the second-oldest active program include special events, luncheons, educa- In the July-August 2008 issue of Pedi- tion and Control Services, JCR. “Doctors, of the Robert Wood Johnson Foundation tion programs, special presentations and atric Nursing, Susan Hong, MS, FNP-C, nurses, technical and administrative staff (RWJF) — is designed to develop the ca- proclamations from local governments. RN, and her co-authors explore the rela- may care for patients with compromised pacities of outstanding mid-career health In addition to appreciating RNs during tionship between nurses’ communication immune systems including the elderly and professionals in academic and commu- Medical-Surgical Nurses Week, Reeves and pediatric parents’ satisfaction. The au- people living with a chronic disease. As a nity-based settings by providing them said AMSN promotes the event to spark thors studied the pediatric unit of a United professional devoted to ‘do no harm,’ flu with an understanding of the health policy interest in other nurses about the diverse States teaching hospital on the West Coast. vaccination gives me an opportunity to process. The program is administered by career opportunities available in the medi- The unit had received a lower than 50 per- help protect my patients by decreasing the the Institute of Medicine of the National cal-surgical field. cent ranking for nurse communication. chances that I will get the flu and pass it Academy of Sciences. For more information, go to www. According to the authors, parents pre- along to my patients.” Earning one of these prestigious posi- medsurgnurse.org. fer language they can understand – not The flu is a serious disease that can tions is Margaret P. Moss, PhD, RN, JD, medical terminology, as well as assurance potentially be fatal. The CDC’s Advisory associate professor and chair of the Lead- Scholarships to from caregivers in uncertain situations. Committee on Immunization Practices ership, Systems, Informatics and Policy They also want to build a sense of trust (ACIP) recommends an annual flu vacci- Co-operative in the School of Nursing at widen pipeline with nurses and health care providers. nation for a number of groups, including the University of Minnesota, as well as di- In the study, the researchers tested the adults at high risk of complications from Fifty-eight schools of nursing will receive the flu and those who are in contact with rector of Inclusivity and Diversity. funding through The Robert Wood John- hypothesis that patient and parent satis- Each year, fellows are selected on a faction ratings would rise if an inservice them, including health care workers. Ef- son Foundation (RWJF) New Careers forts to increase vaccination coverage competitive basis and leave their aca- in Nursing Scholarship Program, which to improve nurses’ communication was demic settings and practice responsibili- offered and if a handout was given to among health care workers are supported aims to strengthen the nation’s pipeline by various national accrediting and profes- ties to spend a year in the nation’s capi- of new nurses by providing financial aid parents regarding effective pain manage- tal. A three-month orientation program ment. The authors surveyed 50 randomly sional organizations including The Joint to students who enroll in fast-track nurs- Commission. Since Jan.1, 2007, the Joint is followed by a nine-month assignment ing degree programs, the foundation and selected parents of discharged patients in which fellows work in a congressional both before and after these interventions Commission has required accredited hos- the American Association of Colleges of pitals, critical access hospitals and long office or the executive branch. Following Nursing (AACN) recently announced. took place. the one-year experience, fellows return to In their findings, the authors report term care organizations to offer the influ- Scholarships of $10,000 each will be enza vaccination annually on site to staff their home institutions or practices to as- awarded to 706 nursing students in accel- there were positive trends in nurse com- sume leadership roles in improving health munication cited by the parents after the and licensed independent practitioners. erated programs during the 2008 to 2009 For more information, go to www. policy and management. academic year. interventions (an increase from 81.6 to “The fellows bring much needed prac- 85.3 percent in overall satisfaction), nurse FluVaccinationChallenge.com. JCR re- “Schools of nursing nationwide are ceived funding and other support from tical knowledge of the health care sys- grateful for the exceedingly generous com- instructions for treatments and tests (78 tem to Washington, DC, where they can to 82 percent) and for pain management GlaxoSmithKline for the challenge initia- mitment the Robert Wood Johnson Foun- tive. More resources also are available at help our nation’s leaders work to improve dation has made to help alleviate the U.S. (80.8 to 82.4 percent). care,” said Michael Painter, JD, MD, As a result, the pediatric units of the ANA’s Web site, www.nursingworld.org, nursing shortage by stimulating growth click on “occupational health” and then RWJF senior program officer and 2003- and innovation in baccalaureate and hospital now provide the handout to par- 2004 Robert Wood Johnson Health Policy ents of patients with pain issues, and the “influenza.” graduate nursing programs,” said AACN Fellow. “The ‘hands-on’ health and health President Fay Raines, PhD, RN. “As the authors recommend that future inservices care experience they bring positions them National Program Office for this ground- also may be a useful intervention, accord- Split decision to have a substantial impact on the na- breaking initiative, AACN was pleased to ing to the article, “Parental Satisfaction tion’s health care policy.” see the high caliber of funding proposals with Nurses’ Communication and Pain While physicians have indicated that the For more information, go to www. submitted by schools of nursing and de- Management in a Pediatric Unit.” economy, not health care, is the most im- healthpolicyfellows.org. lighted that so many students who need portant issue facing voters in the upcom- financial assistance will receive support as Get vaccinated ing election, they are split about the ne- Celebrate med-surg nursing they embark on their nursing careers.” cessity and implementation of a universal The RWJF New Careers in Nurs- Joint Commission Resources (JCR) has health care program. The Academy of Medical-Surgical Nurs- ing Scholarship Program was created launched a “Flu Vaccination Challenge” A new study from DoctorDirectory.com es (AMSN) has designated Nov.1 to 7 as to enable schools of nursing to expand to underscore the responsibility that hos- of more than 850 physicians of all special- “Medical-Surgical Nurses Week” to en- entry-level accelerated programs at the pitals have to help keep their employees ties was designed to assess attitudes on courage hospitals, facilities and other em- baccalaureate and master’s levels. Grant and patients healthy this influenza season. universal health care as it relates to the up- ployers to honor the nurses who provide funding is disbursed to schools of nurs- The challenge is designed to increase coming election. Regarding the upcoming compassionate care to adult patients and ing, and these institutions then award flu vaccination rates among health care election, 81.3 percent have formed party their families. individual scholarships to students. workers. According to the Centers for and candidate preferences based upon the This nationwide celebration will rec- Scholarship award preference is given to Disease Control and Prevention (CDC), in candidate’s stand on key issues. ognize and reward medical-surgical nurs- the 2005-2006 season, only 42 percent of See In Brief on page 10 *

September/October 2008 n The American Nurse n www.NursingWorld.org  (the most common), nurse manager, other havior seems to be more about personal- lined in ANA’s Code of Ethics for Nurses Behaving badly RN, patient or other person. Although 47 ity type than just working under stressful and “provide a framework to assist nurses Continued from page 1 percent said their facility had zero toler- conditions. in upholding their obligation to practice ance policies in place outlawing this type Dianne Felblinger, EdD, MSN, in ways consistent with appropriate ethi- of abuse, only one in four nurses reported WHNP-BC, CNS, RN, believes incivil- cal behavior,” according to the AACN stand by clearly identifying such behav- that their facilities were fully committed ity is far more prevalent in nurses’ work- standards document. The document iden- iors and refusing to tolerate them.” to enforcing them. places than actual bullying. She defines tifies critical elements of skilled com- Since it came out, nurses who have incivility as a behavior of low intensity, of munication, for example, noting that been exploring the issue for several years ambiguous intent to harm and in violation organizations’ policies should eliminate say that much of the press around the alert On the case of workplace norms. It includes behaviors abuse and disrespectful behaviors in the has focused on bad behavior on the part A developmental pediatric nurse practi- such as refusing to work collaboratively, workplace. It also requires facilities to of physicians. tioner, Judith Vessey, PhD, CRNP, MBA, gossiping and emotional tirades. establish systems in which individuals Porto, founder and principal of QRS FAAN, began delving into the world of “Civility matters, and it needs to be and teams formally evaluate how com- Healthcare Consulting, LLC, explained teasing and bullying in relation to its ef- part of orientation and annual continuing munication affects clinical, financial and that studies have shown that physicians fects on children. The Boston College education programs, like CPR and blood- work environment outcomes. who act out have a more profound effect, nursing professor has since been engag- borne pathogens,” said Felblinger, also an Another standard calls for nurse leaders because of their relative power. ing in a series of studies on nurses and expert on inappropriate workplace behav- to embrace, as well as authentically live There also have been several celebrat- bullying with an eye toward developing iors and a professor at the University of and engage others in achieving a healthy ed cases reported in the media of physi- effective interventions to ensure a better Cincinnati’s College of Nursing. work environment. Among the elements cians having temper tantrums. Case in workplace. However, she noted that when bullying needed to meet this standard is one that point: In August, the Boston Globe wrote In one of her occurs, the targets requires facilities to develop mentoring about an orthopedic surgeon who threw a more recent proj- “Civility matters, and it needs of abuse wait an av- programs for all nurse leaders. Another pair of scissors in the OR, narrowly miss- ects, Vessey and erage of 22 months states that facilities give nurse leaders the ing a nurse. colleagues created to be part of orientation and before they report it. financial and human resources needed to Many nurses can speak to their reluc- an online, 30-ques- annual continuing education Nurses and others sustain a healthy work environment. tance to phone certain physicians for fear tion, nationwide who are bullied can “AACN believes that maintaining a of incurring their wrath. Nurses exploring survey to capture a programs, like CPR and experience a great healthy workplace is a shared responsibil- workplace bullying, however, say their snapshot of the ex- bloodborne pathogens.” deal of anxiety and ity between the individual and an organi- colleagues must look beyond the nurse- periences of RNs, depression, as well zation,” said Lavandero, a member of the physician relationship when developing including staff nurs- — Dianne Felblinger, EdD, MSN, as post-traumatic Guam Nurses Association. “An organiza- and implementing the new Joint Com- es, educators and WHNP-BC, CNS, RN stress disorder and tion can establish all the policies it wants. mission standards and alert recommenda- administrators. The physical problems. But if it doesn’t foster the positive devel- tions. survey also included an open-ended ques- And then there is the issue of patient opment of the skills needed and individu- “When I heard about the Joint Commis- tion that allowed nurses to expand freely care. als don’t embrace them, it’s a senseless sion alert, I was absolutely thrilled and felt on bullying in the workplace. Nursing requires quality teamwork, policy. It’s also unethical” it was long overdue,” said Col. John Mur- She defines bullying specifically as and a direct cause and effect of bad be- Porto was instrumental in creating ray, PhD, RN, CPNP, CS, FAAN, presi- something that is repetitive, has a real or haviors on patient outcomes is not always the alert and knows that health care or- dent of the Federal Nurses Association perceived power differential between the obvious, according to Vessey. ganizations have been reticent to admit (FedNA). In 2006, FedNA successfully person doing the bullying and the targeted If nurses are dissatisfied with their jobs that they may have a workplace culture gained support from nurse leaders nation- person, and has an intent to harm. (Lateral because of the work environment, they problem. wide for a resolution introduced at ANA’s or horizontal abuse takes out the power don’t want to go to work or be fully en- “I saw this as a huge issue while work- House of Delegates and aimed at stopping differential, but still is designed to cause gaged. This leads to an unstable and dis- ing with facilities to establish a culture unhealthy work behaviors, such as bully- upset. Harassment has many of the same engaged workforce and ultimately poor of safety and build teamwork,” Porto ing, hostility, lateral (peer-to-peer) abuse, qualities of lateral abuse, but is covered patient care conditions. said. “There was a lot of denial. Or if a intimidation and abuse of authority. by a set of legal protections.) Added Felblinger, “In health care, nurse complained, a colleague or manager FedNA introduced the HOD resolu- “At the time, we didn’t think we’d get we’ve always taken a stern approach to would say, ‘Oh grow up — so he’s a jerk. tion because nurse members recognized many responses to the open-ended ques- our roles, because what we do is so seri- Just do your job.’” bad workplace behaviors as an escalating tion, but two thirds of the nurses respond- ous and important. But how we treat our- She added that nursing supervisors of- problem occurring in all settings where ed and wrote paragraphs and even pages selves and each other are tied to patient ten enabled abusive behavior by assum- nurses practice, learn, teach, research and describing their experiences,” said Vessey, safety and quality of care. So changing ing a referee role and not a focusing on lead – and in hospitals and academic insti- a Massachusetts Association of Registered the culture would be very, very helpful to stopping the abuse — particularly when it tutions, large and small, rural and urban. Nurses member. “Many of the nurses talk- health care professionals and patients.” came to working relationships with physi- Murray frequently speaks on work- ed about lateral violence or harassment. In cians. place bullying throughout the United their minds, it’s all the same.” “None of the professions have taught States and beyond. And when nurses Through their research, they discov- Education and enforcement their students how to talk with someone who’ve been in abusive situations ap- ered that nurse-to-nurse bullying is a ma- AACN has been a leader in working to who gets out of control, or how not to get proach him afterward, none describe their jor problem in need of evidence-based promote healthy workplaces for RNs — out of control themselves,” Porto said. perpetrators as physicians. Instead, they interventions. She added that individuals devoid of bullying, condescending behav- “Training and education are important, but generally mention nurse leaders, such who are most at risk for being bullied are iors, a refusal to answer questions, angry that doesn’t change the behavior by itself. as nurse managers and executives. Also those who are different from the group, outbursts and physical contact. You need zero tolerance, and it has to be nurses who report problems may not be such as new nurses, float nurses or those In 2004, the association issued a posi- enforced. That’s what is called for in the taken seriously. of a different race, ethnicity or gender. tion statement calling for zero tolerance alert. Ramon Lavandero, MSN, MA, RN, The fact that nursing is a traditionally toward abuse. In that position statement, it “And discipline is an appropriate re- FAAN, director of Communications and female profession that exists in tradition- noted than 12 percent of nursing turnover sponse to this type of behavior,” she con- Strategic Alliances for the American As- ally hierarchal environments doesn’t help. was directly attributed to factors associ- tended. “If somebody throws a knife at sociation of Critical-Care Nurses (AACN) “When bullying others, boys have ated with verbal abuse. A year later, the you in the OR, it shouldn’t be a ‘let’s go has seen the lack of follow through on re- tended to use fisticuffs, and girls have association produced the AACN Standards get a cup of coffee and talk about this’ re- ports of abuse and hopes the Joint Com- used social toxicity [for example, ostra- for Establishing and Sustaining Healthy sponse.” mission alert will serve as a galvanizing cism or manipulation through gossiping Work Environments, the first national stan- To help put an end to intimidating and force for workplace change. and rumor-spreading],” Vessey said. “And dards to address key workplace practice disruptive behaviors among physicians, In 2006, AACN co-conducted a work- if social toxicity worked for them in sixth components. These include the need for nurses, pharmacists, therapists, support place survey of some 4,000 critical care grade, it may work for them on the unit.” nurses and other health care profession- staff and administrators, the sentinel event nurses, who averaged 17.5 years of ex- Through his interactions with nurses, als to achieve skilled communication, true alert recommends that health care organi- perience. Sixty-five percent reported ex- Murray said that a prime factor behind collaboration and meaningful recognition zations take 11 specific steps, including periencing at least one incident of verbal health care professionals participating in of what each group brings to the table. the following: abuse in the past year from a physician rude, condescending or other abusive be- The standards support provisions out- See Behaving badly on page 12 *

 September/October 2008 n The American Nurse n www.NursingWorld.org New book from ANA on faith ANA CEO takes part community nursing in interview series

n 2005, the ANA and Health Ministries Association co- inda J. Stierle, MSN, RN, CNAA,BC, chief published Faith Community Nursing: Scope & Standards executive officer of ANA took part in the Iof Practice. These standards articulated the professional Lhealth08.org Kaiser Family Foundation inter- expectations of faith community nursing for all care levels view series Viewpoints: The Health Care Debate with and settings. A faith community nurse promotes health as various leaders of organizations representing health wholeness within a faith community—its groups, families and care providers, insurers, policymakers, employers, individuals—through the practice of nursing. Knowledgeable labor unions and consumers. She shared her views in both nursing and spiritual care, the faith community nurse on shortcomings in the nation’s health care system provides spiritual care for a faith community in the context of and how it could be improved. its values, beliefs and practices, whatever its faith traditions “Comprehensive health care reform is one of the may be. most pressing issues facing the nation today,” Stierle Now, ANA has published a second book on faith com- said. “Lack of health security and access to afford- munity nursing: Faith Community Nursing: Developing a able health care should be a priority for the incoming Quality Practice, by Carol J. Smucker, PhD, RN, and Linda administration, especially since there are 47 million Weinberg, DNSc, RN, CRNP, contributing author. Grounded people uninsured in the U.S.” in ANA’s Faith Community Nursing: Scope & Standards of With the general election campaign entering its Practice, this new book is an authoritative, balanced and in- final two months, health08.org, the Kaiser Family depth guide to faith community nursing practice and the daily Foundation’s Web site for election news, analysis and challenges and realities of working in a faith community set- events, is presenting seven additional interviews with ting. Organized as a quick reference for the busy faith com- health care leaders exploring what they think the next munity nurse, the book includes information for developing a president and Congress should do to make the health quality health ministry program in a faith community. In the system work more effectively and what they think book, the authors describe their personal experiences working the biggest hurdles are to improving health care. in Christian and Jewish congregational settings to emphasize In these new interviews, Kaiser’s Jackie Judd talks the variety of faith community settings, types of positions and with leaders from the American Academy of Fam- diverse educational backgrounds of faith community nurses. ily Physicians and the Partnership to Fight Chronic To find out more about Faith Community Nursing: Devel- See Interview series on page 14 * oping a Quality Practice, Faith Community Nursing: Scope & Standards of Practice and other ANA publica- tions, go to www.nursesbooks.org. n ANA Foundation of Nursing Package Upgraded EVERY Nurse Should Have It! The upgraded package contains the March 2008 release of the Guide to the Code of Ethics for Nurses: Interpre- tation and Application. This new 200- page book contains the full text of the Code of Ethics for Nurses with Inter- pretive Statements. It guides nurses in understanding the specific implica- tions of the ANA Code of Ethics.

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September/October 2008 n The American Nurse n www.NursingWorld.org  From the A bridge between countries built by nurses RN Files

By Susan Trossman, RN

raveling to Vietnam from Colorado and Wyoming is not exactly a quick nurse from The Children’s Hospital in trip. But Sara Jarrett, a Colorado Denver, CO — traveled to Ho Chi Minh T City in Vietnam to assess both nursing Nurses Association (CNA) member, and Mary Behrens, a Wyoming Nurses Asso- conditions in hospitals and nursing edu- ciation member, have made that 20-plus cation programs. hour, multiple-stop plane trip routinely “What we learned is that nurses were over the course of more than a dozen struggling to provide health care with years. minimal resources,” Jarrett said. “For The two’s goal – along with other nurse example, they had no way to clean tubs educators from around the United States that were used to treat burn patients, so — has been to help nurses in Vietnam patients experienced a lot of infections build more comprehensive, nurse-run ed- and pain.” (The organization ultimately ucational programs, and in turn, strength- shipped boxes of bleach, among other en nursing care delivered in hospitals and supplies, to the facility.) in their communities. And along the way, Jarrett and her colleagues also deter- Jarrett, EdD, RN, and Behrens, MSN, mined that although nurses in Vietnam RN, FNP-BC, have made lasting friend- had bachelor’s degrees, they were trained ships that also fuel their desire to return Mary Behrens, seated on left, works with graduate students in Vietnam who were primarily by physicians and were very again and again. tackling community assessment projects. limited in their scope in practice. Physi- Photo courtesy of Mary Behrens cians generally viewed nurses more like assistants who must follow their orders – In the beginning … cations to Vietnam. She knew its found- meeting the health care needs of the coun- a belief not unlike that held in the United States many years ago. Jarrett became involved in this U.S.-Viet- ers, Connie and Ted Ning, through an try by just sending supplies and equip- “The nurses were very eager to move namese nurse collaboration through an earlier humanitarian project — Friends of ment,” Jarrett said. So in 1991, she and their profession forward and update their organization called Friendship Bridge, Children of Vietnam — which provided two other Friendship Bridge volunteers knowledge,” Jarrett said. “What we want- which in 1989 created a program to send support to orphanages during the war. — CNA member Kathleen Whitney, MS, much-needed medical supplies and medi- “We soon realized that we were not RN, ANP, and Karen Terry, MS, RN, a See RN Files on page 9 *

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 CDC_AUT_HCP_halfpage_TAN.indd 1 September/October 2008 n The American Nurse n www.NursingWorld.org5/6/08 10:03:33 AM were so anxious to learn, and they taught Behrens said she would not have From the RN Files us how to do with so little.” learned about the nurses’ hardship had Continued from page 8 One example of nurses’ resource-sav- it not been for an informal conversation RN Files ing is their ability to successfully perform the nurses had with her friend, who had sterile procedures using one glove, ac- accompanied her on this most recent trip ed to do is give them the help they needed cording to Behrens. and who was originally from Vietnam. in the beginning, so they could go on to Behrens also was a little worried about Ultimately, Behrens helped the nurses create positive change in their profession whether the nurses would be able to prac- learn how to more effectively scan docu- and in patient outcomes.” tice their advanced skills in the clinical ments to see whether they were useful ties, including serving on the ANA-PAC Collegiality and learning went both setting, because of the physician-domi- and therefore needed to be printed. board. ways. nated health care model. However, the In terms of the community projects, But the commitment they have to the “During that first trip, the nurses did Vietnamese nurses successfully com- one group of graduate students chose to program, the nurses and the country runs everything they could to make us feel pleted their head-to-toe exams of patients, focus on improving dental care among deep. comfortable and welcomed,” Jarrett said. and the physicians seemed to accept – and school-aged children. The nurses’ re- Jarrett’s connection to Vietnam was “And the longer we were there, the more respect – the nurses’ abilities. sourcefulness led to them getting a model sealed when she became involved in sup- open and candid they were about the stark porting the orphanages there during the reality of their working conditions. They war, as well as in efforts to help place also were very proud about the care they children who were airlifted from Vietnam were able to give in spite of those condi- during the historic “baby lift” in 1975 tions.” when U.S. troops were pulling out. She When Jarrett and her fellow-Colorado and her husband also adopted two chil- nurses returned, they formed the Friend- dren, first in 1972 and then in 1975, which ship Bridge Nurses Group. They then en- heightened Jarrett’s link to Vietnam. listed the help of about 25 nurse educators History also played a role in Behrens’ nationwide to teach a post-baccalaureate involvement. certificate program for nurses in Vietnam. “My husband served in Vietnam in The program was developed in collabora- 1967 and 1968, and I was at home with tion with leaders in that Southeast nation a small child,” she said. “He and I were so the coursework would meet educa- quite affected by the war, and felt that we tional and regulatory criteria, as well as always would be. So when I got the phone nurses’ needs. call asking me if I would be interested in The nine-course program was launched participating in this educational project, I in 1995 at the University of Medicine and said I’d love to. Pharmacy in Ho Chi Minh City. Courses “And every time I go there, I find it included advanced health assessment, difficult to leave. I’ve made wonderful nursing research, nursing leadership and friends, and I’ve seen tremendous prog- community health. About 30 Vietnamese ress in nurses’ knowledge and in health nurse educators and nurse administrators care practices.” from provinces within the southern por- During her stay, Behrens usually vis- tion of Vietnam participated in the initial its different orphanages – often bringing program over the course of about four medications, clothes and contributions. years. This April she went to a residential school, Over the next few years, the Nurses Behrens and other volunteers leave medicine and toys for the roughly 200 chil- Maison Chance, which offers vocational Group, which now has more than 60 nurse dren in an orphanage in Ho Chi Minh City. training to children with disabilities. educator volunteers, offered the post-bac- Photo courtesy of Mary Behrens Jarrett also tries to squeeze in other calaureate program in the northern part of activities, from participating in a ribbon- Vietnam and again in the southern sec- cutting ceremony for a new outpatient tion. It then implemented a scholarship Looking beyond the classroom, Beh- of a tooth and a large supply of tooth- surgery center to seeing sights around the program to send Vietnamese nurses to rens recalled also feeling somewhat brushes donated from the Colgate Co. country to sharing meals with former stu- Thailand to earn their master’s degrees. frightened about how she as an American Another group tackled a project aimed dents. More recently, the Nurses Group and their would be received in post-war Vietnam. at preventing type 2 diabetes, which is a “People want to share with you, have Vietnamese colleagues developed a mas- But neither she nor any of the nurses trav- growing problem in Vietnam caused by you meet their families and learn about ter’s program in nursing – the first ever eling there ever encountered a problem. increased protein intake and – ironically their culture,” Jarrett said. in Vietnam – that earned government ap- Over the years, Behrens has taught — better nutrition. Looking back at her first trip to Viet- proval. Eight graduate students started the many classes in Vietnam, including se- Jarrett also went back in June to work nam, Jarrett recalls being asked by the two-year program in September 2007. nior-level management, research and with the graduate students to develop nurses if she would ever come back; an community health nursing. And this their theses. ongoing partnership seemed like a lofty The experience April, she worked with graduate nurses “The master’s program is not a replica- goal. But the program continues, al- to help them complete their community tion of what we know here in the States,” though travel and other rising costs are an Among the early volunteers was Behrens, health projects, assist them with their Jarrett explained. “It’s more like a com- increasing concern. who went to Vietnam in 1995 to help English skills and begin their research bination clinical nurse specialist-nurse “Except for a few small grants early teach the first round of post-baccalaure- projects. leadership program with a focus on acute on, it’s really been an all-volunteer proj- ate courses – specifically advanced health As often is the case, Behrens learns care.” ect – all done from the heart,” she said. assessment. She came prepared, bring- more about the nurses’ struggles and the This fall also marks the beginning of a Since 1995, the activities of the Nurses ing her students current textbooks and unique health needs of the country’s pop- new class of graduate students, who this Group have been organized and directed stethoscopes – both rare commodities at ulation with each trip. time number 18. by a three-person steering committee: the Vietnamese facility. (Nurses were ac- For example, Behrens recently discov- Jarrett, Whitney and CNA colleague, customed to sharing one stethoscope for ered that although the nurses had access Bonded Faye Hummel, PhD, RN, CTN. They are an entire unit.) to 10 computers in their library, they had now exploring resources to help sustain “The first time I went there, the nurses no available printer. So they had been Jarrett and Behrens have gone back the program and also hope to some day sat very rigidly — taking notes and not downloading numerous research articles to Vietnam every other year since the share the graduate model they devel- asking any questions,” Behrens said. “It to memory sticks and then printing them Nurses Group began. It hardly seems like oped with other Third World countries. took some role modeling to get them to out at a local photocopying shop. That they would have the time considering For more information on the Friendship feel comfortable interacting more with practice was both costly and time-con- both have full-time academic positions Bridge Nurses Group, go to www.friend- me and working in small groups. But they suming. and engage in many professional activi- shipbridge.org. n

September/October 2008 n The American Nurse n www.NursingWorld.org  In Brief als and pharma industry clients. For more base from 2003 to 2006. This is the largest Category A for “potential for error” to Cat- information about this study, go to www. known list of look alike, sound alike drug egory I for “death”). Continued from page 5 doctordirectory.com. names in the world based on actual medi- The Drug Error Finder is one compo- cation error reports. nent of USP’s response to the Institute of “As more medications are approved Medicine’s 2006 report, Preventing Medi- New tool to help prevent for market each year and become avail- cation Errors, which calls on the govern- med mix-ups able to Americans, the opportunity for ment and public health organizations to potentially dangerous or even deadly er- address medication errors resulting from The U.S. Pharmacopeial (USP) Conven- rors due to drug mix-ups from look alike similar labeling and packaging, as well as Physicians were asked if they believe tion recently announced a new drug safety or sound alike names becomes increasing- confusingly similar drug names. that universal health care insurance will tool designed to help patients, caregiv- ly high,” said Diane Cousins, RPh, USP significantly improve access to health care ers, pharmacists, physicians and others in vice president of health care quality and for all Americans. Their responses were avoiding medication errors that may occur information. “While one drug name may New master’s program to quite polarized with 38.8 percent indicat- because of drug names that look alike or be nearly identical to that of another drug, address nursing faculty ing no improvement while 33.8 percent sound alike. the two could be used for completely dif- feel that it would significantly improve This “Drug Error Finder” is a search- ferent conditions. This presents a major shortage access to health care. Just over 44 percent able database of almost 1,500 commonly public health threat, and we think this new The master’s program at The University feel that there is no evidence to support used drugs reported to be involved in tool can play an important role in helping of Texas at Arlington School of Nursing that expanding insurance coverage is a medication mix-ups in the U.S. health care to reduce patient risk associated with this (UTASON) has added a master of science cost-effective way to promote health. system since 2003. The database is avail- problem.” in nursing education program to not only Do they believe that health care insur- able at no cost at www.usp.org/hqi/simi- One example of a drug involved in such answer the escalating nursing shortage in ance should be mandated for all Ameri- larProducts/drugErrorFinderTool.html. errors reported to MEDMARX is Cloni- Texas and across the nation, but to also cans? Again, the group was split with 42.7 It is derived from a list of 1,470 unique dine, a high blood pressure medication. In address a shortage of nursing faculty. percent of responders for mandated cov- drugs that were implicated in medication actual instances reported to USP, this drug This new program prepares nurses to erage and 40.2 percent against such man- errors due to brand or generic drug names was confused with multiple drugs, includ- practice as nurse educators in schools of dates. And when asked how a universal that look or sound alike and reported to ing Colchicine (used for gout), Cetirizine nursing and health care delivery systems. health care system should be funded, less USP’s MEDMARX®—an anonymous (an antihistamine), and Clonazepam and Emphasis is on the knowledge and skills than 10 percent feel it should be funded database used by hospitals and health care its brand name, Klonopin (used for anxi- needed to develop curricula, teaching by the federal government, with nearly systems across the United States to report, ety and seizures). skills and evaluation strategies. Gradu- 60 percent preferring some combination track and analyze medication errors—or To use the Drug Error Finder, type in ates will be eligible to take the National of state, federal, employer and individual to USP’s Medication Errors Reporting the name of the particular drug of interest. League for Nursing Certified Nurse Edu- contributions. Program. The list was included in USP’s In addition to rapidly generating a list of cator Examination following two or more This survey was conducted as an in- 8th annual MEDMARX Data Report, re- medications that have been confused with years of full-time employment in the aca- dependent research study by DoctorDi- leased in January 2008, which examined that drug, the tool will also allow users to demic faculty role. rectory.com, Inc., a marketing services more than 26,000 error records related to see the severity attributed to the reported For more information, go to www.uta. company serving health care profession- similar drug names submitted to the data- errors involving the drug (ranging from edu/nursing. n

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10 September/October 2008 n The American Nurse n www.NursingWorld.org Donations ANF 2008 NRRC chair defines leadership in the moment at Work

standing so that I could extend to others ory for Nursing with Mary Jane Smith, By Holly Blackledge, Director, and move the process along.” PhD, RN. Story theory, a middle range American Nurses Foundation Florida Atlantic University Christine theory developed by Smith and Liehr, E. Lynn College of Nursing is where guides her practice and research. She has his past August, the American Liehr serves as associate dean for nurs- studied story as an intervention, story- Pearce, PhD, MPH, FNP-BC, serving as Nurses Foundation (ANF) award- ing research and scholarship and profes- centered care and story as an outcome vice chair. ANF wishes Liehr continued Ted 30 Nursing Research Grants sor. Her research focus includes explor- measure using qualitative and quantita- career success in nursing research and (NRGs) totaling $190,106. These grants ing the importance of stories in nursing tive analysis methods. She believes that education. ranged from $3,500 to $20,000, awarded practice; capturing bodily experiences stories are both powerful entities for Since 1955, the ANF, as the phil- by the 12 members of the ANF Nursing by real-time measures, such as ambula- chronicling and creating health, and for anthropic arm of the ANA, has been in Research Review Committee (NRRC). capturing substantive data guiding nurs- the business of promoting the welfare The 2008 NRRC was chaired by Patricia ing practice. and well-being of nurses, advancing the Liehr, PhD, RN, who is serving her third One of Liehr’s currently active re- nursing profession and enhancing the and final year on the committee. Liehr search endeavors is analysis of stories of public health. This vital work is pos- joined the NRRC in 2006 and served as health from Pearl Harbor and Hiroshima sible through the nurse researchers who NRRC vice chair for 2007 and chair in survivors to be developed as a youth-fo- proudly call themselves ANF Scholars. 2008. cused DVD, “Two Sides of the World Over the past 53 years, ANF has award- Liehr’s responsibilities focused on War II Story: Surviving the Aggression ed more than $4 million to more than leading the NRRC forward not only in of War.” Her decade-long research rela- 1,000 beginning and experienced nurse reviewing and awarding grants to the tionship with colleagues in Japan estab- researchers. Many of these ANF Schol- highest quality applicants, but also in lished a base for this cross-cultural anal- ars have gone on to become leaders in ensuring the integrity of the overall pro- ysis. Liehr has received many awards, nursing research, the profession and their cess. She accomplished this with pro- including recognition as a Robert Wood own communities. fessional grace. On Aug. 25 and 26, the Johnson scholar; an American Journal For more information on the ANF, 2008 NRRC met by conference call to re- of Nursing book of the year award for visit www.ANFonline.org. ANF is a view the 114 applications ANF received the first edition of Middle Range Theory not-for-profit, 501(c)3, organization. for funding. After two days of focused for Nursing; and selection as a visiting Donations are tax-deductible to the full- review, the NRRC recommended to the scholar to Tokyo Metropolitan Institute est extent allowed by law. Donations to ANF Board of Trustees that 30 grants be of Gerontology. In 2009, Chlan will ANF support the ANF Nursing Research awarded to the nurse researchers whose step in as the NRRC chair with Patricia Grants Program. n studies met requirements for funding. Along with NRRC Vice Chair Linda Chlan, PhD, RN, Liehr was applauded by the NRRC members for having steered the process well and for continuing to Patricia Liehr Honor A Nurse Giving the Gift of Recognition! build the future of the NRG review pro- cess that transitioned to the conference The American Nurses Foundation invites you call model in 2007. Truly, it was her own tory blood pressure; the links between and/or friends to give a special Nurses Week philosophy that summed up the success stories and real time measures; and cul- of this year’s process: “It served me well tural perspectives that define one’s view gift of recognition by making a special tax- to stay in the present bringing all my at- of health. deductible $100 contribution to the ANF! tention to the discussion as it was occur- Liehr is known for her middle range ring. It was hard to do but from that base, theory work and has recently co-edited Your special nurse will be recognized I was most able to know where I was the second edition of Middle Range The- in the November/December issue of The American Nurse for all to see! Contact ANF at 301-628-5227 or on the Web at www.ANFonline.org Obama health practitioner workforce, including to make your gift by check or credit card today! loan repayments, improved reimburse- All contributions and information must be received no later than Continued from page 1 ment and training grants. He has a history of advocacy for nurs- October 31, 2008! es and patients. In the Illinois Senate, he Please print sponded, ‘Yes we can.’ helped lead efforts to protect nurses and “Nurses represent the largest group of improve the quality of health care. In the Donor name: ______health care professionals in this country, U.S. Senate, he cosponsored the “Safe Donor Address: ______and working together, we can use our Nursing and Patient Care Act,” which power in the voting booth to make health limits mandatory overtime for nurses to Address 2: ______care a priority, and make Barack Obama true emergency situations. And as presi- Phone number: ______the next president of the United States.” dent, he has promised to sign this impor- Obama is committed to signing univer- tant legislation into law. Email address: ______sal health legislation by the end of his first ANA has been making presidential en- Mastercard/Visa #: ______term in office that ensures that all Ameri- dorsements since 1984. The endorsement Expiration date: ______cans have high quality, affordable health process includes sending a questionnaire care coverage. He recognizes that nurses on nursing and health care issues to all Signature: ______play a critical role in every aspect of pa- of the Democratic and Republican candi- Please Honor: ______tient care, and the nursing shortage ranks dates, an invitation to all of the democratic Name/Credentials as one of the most pressing issues facing and republican candidates for a personal the health care system. Obama’s health interview and an online survey of ANA’s Checks payable to ANF care plan includes expanded funding membership regarding which candidate is to improve the primary care and public most supportive of nursing’s agenda. n Mail to ANF Lockbox: ANF, PO Box 504342, St. Louis, MO 63150-4342

September/October 2008 n The American Nurse n www.NursingWorld.org 11 Pandemic flu preparedness: isit NursingWorld.org to see As the Web working together to prepare now what’s new on nursing’s most Turns Vpopular Web site. Get up-to- the-minute nursing news, by nurses for he ANA is a proud supporter of the of pandemic influenza is real, and Amer- nurses, by signing up to receive the ANA Take The Lead: Working Together to ica needs leadership from respected com- e-newsletter, NursingInsider, at Nurs- TPrepare Now co-branded toolkit de- munity members to prepare our towns ingWorld.org/SpecialPages/NewsLet- This article describes research conduct- veloped by the U.S. Department of Health and cities, reduce the impact of pandemic ter/SignupforANAeNewsletters.aspx. and Human Services (HHS) and the Cen- flu on individuals and families, and re- ed to elicit faculty perceptions of facilita- ters for Disease Control and Prevention duce or even prevent serious damage to tors and barriers for implementing a new, (CDC) along with input from community the economy. evidence-based, safe patient handling cur- leaders. It is designed to provide nurses or Pandemic preparedness efforts are an OJIN: The Online Journal riculum module at nursing schools. their organization with key information and important part of community leadership. A recently contributed article to the tools to help them understand the threat of The ANA continues to represent nursing of Issues in Nursing topic Nursing Shortage: Is This Cycle Different? is “Addressing Nurse-to-Nurse a pandemic and prepare for it now. at many policymaking tables to discuss New Topic: “Professional Pathways in The toolkit is available to ANA mem- pandemic preparedness and the role of Bullying to Promote Nurse Retention,” by Nursing: Options to Seek, Start and Sus- Carol F. Rocker, MHS, RN. bers at www.nursingworld.org/Home RNs in responding. ANA has been ac- tain a Career” pageCategory/NursingInsider/Archive_1 tively involved in policy discussions Another popular topic, The Multigen- /2008NI/July08NI/CDCPandemicFlu related to the prioritization of pandemic New on previous topics: erational Workforce: Boomers and Xers Toolkit.aspx and provides the following: influenza vaccine; clarifying the level and Nets, Oh MY!, also received a new ar- • Information about pandemic flu of respiratory protection necessary to New to topic Nurse Safety: Have We Ad- ticle. “The Integration of Technology into • Ready-to-use and ready-to-tailor protect health care professionals during dressed the Risks?, “Faculty Perceptions Nursing Curricula: Supporting Faculty resources prepared by HHS and a pandemic event; and identifying strat- of Implementing an Evidence-Based via the Technology Fellowship Program,” CDC egies for building surge capacity within Safe Patient Handling Nursing Curricu- by Lawrette Axley, PhD, RN, CNE, de- • Ideas and materials to encourage the health care system to meet the signifi- lum Module” by Gail Powell-Cope, PhD, scribes a technology fellowship program organizations to prepare and to cantly increased demand that a pandemic ARNP, FAAN, Nancy Hughes, MS, RN, designed to address the challenges facing encourage other leaders to get in- event would place on the system. Carol Sedlak, PhD, RN, CNS, ONC, CNE faculty who did not “grow up” in the com- volved ANA has also partnered with the Trust and Audrey Nelson, PhD, RN, FAAN. puter age. n • Outreach materials such as sample For America’s Health to educate RNs newsletter articles and templates about pandemic influenza and how it dif- that can be tailored for activities fers from the annual influenza season. Preparing for a pandemic influenza someone else’s position in jeopardy if a outbreak involves everybody. The threat See Pandemic flu on page 14 * Behaving badly facility’s policy seems too rigid. Continued from page 6 Felblinger recommended educational programs that utilize both case studies and role playing that can be accomplished • Educate all health care team mem- through online and small group participa- bers about professional behavior, tion. including training in basics, such as “Through those programs, nurses also being courteous during telephone can learn how to deal with abusive situa- interactions, business etiquette and tions — whether it’s something that is said general people skills; or done under stress or not. We all should Careers with Mass Appeal • Hold all team members accountable be able to give meaningful apologies for modeling desirable behaviors, where one offers regret, takes responsibil- Chairperson of the Department of Nursing and enforce the code of conduct ity and offers a remedy to correct what’s consistently and equitably; occurred. College of Nursing and Health Sciences • Establish a comprehensive approach “And a person getting an apology also to addressing intimidating and dis- has the option of accepting it or not.” The Department of Nursing invites applicants for a tenured faculty member to serve as ruptive behaviors that includes a As for other policies that health care Department Chairperson, beginning fall 2009. Applicants must demonstrate excellence in zero tolerance policy; strong in- teaching, an established program of research with external funding, and distinguished service facilities develop as a result of Joint Com- to qualify for an appointment to the rank of associate or full professor with tenure. volvement and support from physi- mission alert, Felblinger said they must The Chairperson must have significant administrative leadership experience, excellent cian leadership; reducing fears of be practical, helpful and useful for nurses communication skills, outstanding team building and collaboration skills, and an understanding retribution against those who report working at the bedside. And they must be of higher education management policies and practices. Applicants must possess an earned intimidating and disruptive behav- measurable to ensure they are effective. doctorate in nursing or a related field and be eligible for RN licensure in Massachusetts. iors; and empathizing with and Preference will be given to applicants with funded research and peer-reviewed publications “We know there’s a problem,” Fel- apologizing to patients and families blinger said. “We’ve looked at it enough. focused on enhancing the health-related quality of life of urban populations of all ages and who are involved in or witness in- targeted to healthcare quality, health policy, and populations at risk for healthcare disparities. Now we need the interventions.” We are particularly interested in applicants who will strengthen our initiatives in cancer care, timidating or disruptive behaviors; Concluded Murray, every health care critical care, women’s health, physical activity and child health, healthcare quality or health • Determine how and when disciplin- organization has a responsibility to its policy, and who are committed to working with a diverse student population in an urban setting. ary actions should begin; and nurses to ensure that they all feel safe in The College is committed to excellence in teaching and research and the Chairperson will have • Develop a system to detect and their workplaces and feel safe to report an a significant role in ensuring these commitments continue to be met by members of the receive reports of unprofessional abusive act. Department. The BS and MS nursing programs are accredited by the Commission on Collegiate behavior, and use non-confronta- “The nursing shortage isn’t a good ex- Nursing Education. The MS and recently implemented Doctor of Nursing Practice programs tional interaction strategies to ad- cuse for bad behavior,” he said. “We’re focus on the preparation of nurse practitioners and acute/critical care clinical specialists. The dress intimidating and disruptive not doing our profession any good if we PhD program focuses on the intersection of nursing and health policy. For more information, behaviors within the context of an visit www.cnhs.umb.edu use that as an excuse.” organizational commitment to the For more information on the alert, go To apply, please send a letter of interest and curriculum vitae to: health and well-being of all staff Search #10594, Dr. Jacqueline Fawcett, Chair, Faculty Search Committee, to www.jointcommission.org. For more and patients. on AACN’s standards, go to www.aacn. College of Nursing and Health Sciences, University of Massachusetts Boston, When determining workplace actions 100 Morrissey Boulevard, Boston, MA 02125-3393. org/hwe, and for more on strategies, see The search will continue until the position is filled. that deal with bullying, however, care Murray’s article in the July issue of Ameri- must be taken to not unwittingly escalate can Nurse Today. n The University of Massachusetts Boston is an Affirmative Action, Equal Opportunity, this behavior and drive it underground, Title IX employer. Vessey noted. Colleagues who are being Susan Trossman, RN, is the senior reporter for bullied, for example, may not want to put The American Nurse.

12 September/October 2008 n The American Nurse n www.NursingWorld.org

PUBLICATION American Nurse SIZE 4.5” x 5.25” SCREEN 100 lpi WO # 117525 IO # 571984 NOTES Political Count on it: Nurses’ votes matter Nurse

election in 2008 will be no exception to islative success. If elected to Congress, By Rachel Conant and Hilary Hansen the recent tight races we’ve seen. ANA’s foot is already in the door, and we Senior Political Action Specialists Despite the historical importance of have a connection in the dis- the presidential election and the excite- trict – you. n Tuesday, Nov. 4, Americans ment of the congressional races, what ex- Volunteer on a campaign will elect our next president of the cites ANA most about the 2008 election is on either a full-time or part- Despite the historical importance OUnited States. This will be a his- that it’s another chance to bring pro-nurs- time basis. In this capacity, of the presidential election and the toric election on many levels – this is the ing advocates to Washington. there are a myriad of proj- first presidential race since 1952 in which With recent elections being decided by ects that the campaign will excitement of the congressional neither an incumbent president nor incum- a few hundred votes, it is imperative that need your help on. Walking races, what excites ANA most bent vice president is on the ballot. This ANA members are not only registered around precincts to hand out election is the first in history in which two to vote, but that they actually do vote on literature, making phone calls about the 2008 election is that sitting senators are running against each Nov. 4. In fact, most states allow resi- around the district, helping it’s another chance to bring other. Further, in this presidential elec- dents to vote early in the general election with various events and town tion, the winning party will have either so they are not waiting in long lines on hall meetings, or providing pro-nursing advocates an African American or a woman on the Election Day. Also, if you know that you assistance at the polls on ticket. will be traveling on or around Election Election Day are just a few to Washington. The nation is captivated by what will Day, remember to fill out an absentee bal- things you can do based on no doubt be an exciting presidential elec- lot. Check with your local election board your schedule. lation in the upcoming 111th Congress. tion. But along with that historic race, to find out your state’s regulations. By voting on Nov. 4, you could help Remember that every state has differ- 435 U.S. House of Representatives seats There are other ways ANA members bring pro-nurse advocates to Capitol Hill. ent voter registration deadlines. Also, and 33 Senate seats are up for election. can get involved and make a difference Legislators elected in November will be many states allow residents to vote early. Along with those congressional races, in this year’s election – adopt a pro-nurs- confronted with a bevy of issues that af- To find out more information about your there will be 11 gubernatorial races across ing candidate. As a registered nurse in the fect not only nursing, but health care in state, visit http://www.canivote.org/. This the country. community, it is crucial for you to learn general. Some of these issues include nonpartisan Web site is run by the Na- Sadly, you often hear people lament, about the candidates running for office in nurse staffing, education funding and tional Association of Secretaries of State. “Why should I vote? My vote doesn’t your district and where they stand on nurs- health care reform. Without maximum Let’s make nurses’ voices the difference count!” But think about this: During Alas- ing issues. During the campaign season, voter turnout from ANA members, their in the mid-term elections. Volunteer for ka’s primary on Aug. 26, Rep. Don Young there is no better time to research their po- friends, families, colleagues and even pa- a campaign. Make sure friends, fami- beat a challenger by a mere 145 votes out sitions on the issues and to start to build tients, it will be impossible to elect legis- lies and colleagues are registered to vote. of the 84,000 cast. During the 2006 mid- a relationship with them – especially if lators who will pass nurse-friendly legis- Vote on Nov. 4. n term election, Rep. Rob Simmons (R-CT) they are non-incumbents. ANA members lost his congressional seat by a mere 83 helping to elect pro-nursing candidates to votes. Political experts think the general Congress is vital to ANA’s continued leg- REGISTERED NURSE (RN) CE Corner New online CE available DO YOU WANT TO BE PART OF THE BEST? Current Approaches to Managing Atrial Fibrillation How up-to-date is your knowledge base? JOIN OUR TEAM!! The most common sustained cardiac ar- Caring for Chronic Wounds: A rhythmia, atrial fibrillation (AF), is reach- Knowledge Update ing epidemic proportions. No matter The Paralyzed Veterans of America (PVA) is currently seeking where you practice, you’re bound to care Wound care is a lot more sophisticated a full-time Registered Nurse to be the Associate Director (RN) than it used to be. Here’s what you should for patients with AF. Learn to: for our Medical Services Department in Washington, DC. • Explain the pathophysiology of know about assessing and managing atrial fibrillation (AF). chronic wounds. Learn to: • Identify how to assess a patient for • Explain how to assess a chronic The successful candidate should have a minimum of two AF. wound. • Identify factors that affect wound years experience working with spinal cord injury or dysfunction • Differentiate heart rate control and (SCI/D). Familiarity with the Department of Veterans Affairs’ heart rhythm control in AF man- healing. agement. • Describe how to prepare the wound organizational structure, case management techniques, and • Discuss nursing interventions for bed. clinical record interpretation is desired. BSN, and/or manage- patients with AF. • State factors related to the choice and use of dressings. ment training is a plus. Applicant must be able to generate a 1.6 contact hours, including 0.5 pharma- professional site visit report. We offer a competitive salary, out- cology contact hours, are provided by 1.5 contact hours are provided by ANA. standing benefits, some travel, and a Monday thru Friday work ANA. The American Nurses Association is ac- week. Send resume with cover letter and salary requirements The American Nurses Association is ac- credited as a provider of continuing nurs- credited as a provider of continuing nurs- ing education by the American Nurses to: [email protected] or fax to (202) 416-7633. EOE. ing education by the American Nurses Credentialing Center’s Commission on Credentialing Center’s Commission on Accreditation. PVA is a Washington, DC based non-profit veterans service Accreditation. ANA is approved by the California Board organization dedicated to serving individuals with spinal cord ANA is approved by the California Board of Registered Nursing, provider number injury/disease. of Registered Nursing, provider number CEP6178. n CEP6178.

September/October 2008 n The American Nurse n www.NursingWorld.org 13 and was subsequently passed by the 2008 2008. This is a wonderful achievement. Letters To Global issues HOD. In life, we prepare for many events I would also like to thank those in- The Editor Continued from page 1 that may or may not happen, however dividuals who were instrumental in the using the best evidence at the time indi- formulation and passage of this model. cating a threat. ANA strives to provide Their contribution to the advancement moting Chicken Little theories that are information to the RNs about issues that and future development of advanced nothing more than fraudulent messianic impact their practice and public health. practice nursing is very important. faiths. Hopefully the worst case scenarios I recently wrote a letter to the member The ability of our current nursing edu- — Larry Clifford, RN will not come to pass. In the meantime, of the Connecticut Society of Nurse Psy- cation and practice leadership, ANCC, Member, Minnesota Nurses Association the global climate change resolution will chotherapists about the adoption of these and National Council of State Boards of help nurses be aware of the possibilities policies as they pertain to psychiatric and Nursing to rapidly come to consensus Editor’s Note: At the 2008 HOD, del- and also actions that can be taken to pro- mental health nursing practice and certi- in a remarkably short time and integrate egates adopted a measure introduced by tect the environment for a healthy planet fication. the multiple currents of belief about “ad- ANA and the Delaware Nurses Associa- as has been rooted in nursing history. I attended the meeting held at the In- vanced practice mental health nursing tion to address the challenges associated We would invite you to review ANA’s ternational Society of Psychiatric Nurses practice” into an approach that meets the with global climate change. ANA was Environmental Principles for Nursing conference in the Spring of 2008 in Louis- needs of patients — our ultimate goal, af- asked to encourage constituent mem- Practice with Implementation Strategies. ville, KY, attended by the board of directors ter all — is to be commended. ber associations to support local public There is much opportunity for nurses to of the International Society of Psychiatric- It is important to remember that the policies that endorse sustainable energy positively impact the environment, such Mental Health Nurses, American Nurses CNS role is being respected in the accep- sources to reduce greenhouse gas emis- as being involved in an environmental Credentialing Center leaders, and many of tance of the “new” psych/MH NP model. sions, as well as initiatives to decrease task force at your state nurses association the deans and chairs of psych nursing from The CNS-prepared psych/MH practitio- the health care industry’s contribution to or on a green team at your workplace. schools of nursing across the U.S. that of- ner will continue to be an important pres- global climate change. fer MSN programs in psychiatric nursing. In this meeting the issues of licensure of ence in the care of mentally compromised patients. Response from Nancy Hughes, director Consensus model NPs and CNSs were discussed. Another important issue addressed in of ANA’s Center for Occupational and It should be noted that the MSN pro- this summary is the right of doctorally Environmental Health: for APRNs applauded grams represented at this meeting offered multiple models of NP programs with dif- prepared NPs or CNSs to use the des- Thank you for taking the time to express I want to personally thank ANA for its fering preparations. The model of CNS ignation of doctor (Dr.) in their nursing your opinion. I would like to address the advancement of the APRN Model Act/ programs from which many experienced practices, if they so choose. Currently, concerns you recently sent to ANA about Rules and Regulations that recognizes MSNs in psych nursing graduated, to my the American Medical Association is the issue of global climate change. the Consensus Model for APRN Regula- knowledge, is no longer being offered. contesting this right, specifically for the Because there are disease implications tion, Licensure, Accreditation, Certifica- The new model of NP meets the grow- doctorally prepared nurse. that will impact health care including tion and Education, which was endorsed ing need for nurses prepared to assess and On behalf of all CNS and NP-pre- nurses, ANA’s resolution was developed by the ANA Board of Directors in June treat individuals with chronic mental and pared psych/MH nurses, I want to thank physical illnesses. the nursing leaders in the U.S. for their The boundaries of these conditions are important work on this issue that will af- often blurred and require assessment by fect the care of mentally compromised clinicians with a broader educational and patients for years to come. clinical preparation than those of either — Pat D. Barry, PhD, APRN traditional mental health or medical nurs- (ANCC P/MH board certified) ing practitioners. n

Interview series Pandemic flu Continued from page 7 Continued from page 12

Disease. Upcoming interviews are with An educational brochure on pandemic the American Academy of Pediatrics, influenza, It’s Not Flu As Usual: What the American College of Cardiology, the the Nursing Community Needs to Know American Hospital Association and the About Pandemic Influenza, is available National Women’s Law Center. online at www.nursingworld.org/Homep- Four highlight videos compiling lead- ageCategory/NursingInsider/Archive_ ers’ views on access to health care cov- 1/2008NI/Apr08NI/Pandemic FluPre- erage, affordability, private vs. public paredness.aspx. plans and the potential for change from Also, ANA took part in the “Pan- the first set of interviews in the series are demic Flu Take the Lead” campaign ad also available. with ANA President Rebecca M. Pat- The series covers a variety of health ton, MSN, RN, CNOR, and American care issues, including covering the 47 Medical Association President Ronald million uninsured Americans, reducing M. Davis, MD. For more information, health care costs, improving access to please visit http://www.nursingworld. care, enhancing the quality of health care org/ HomepageCategory/NursingInsider/ and changing the tax structure to allow Archive_1/2008NI/Apr08NI/Pandemic- more people to purchase their own insur- FluPreparedness.aspx. ance. Government alone can’t prepare the Webcasts and podcasts of the inter- nation for pandemic flu. As leaders in the views and highlight videos can be ac- community, nurses can play a powerful cessed on health08.org and on the Foun- role in encouraging patients and others dation’s YouTube page. n whom you represent to prepare by pro- viding information and guidance and by preparing themselves. n

14 September/October 2008 n The American Nurse n www.NursingWorld.org working with state and local legislators on nation’s 240,000 advanced practice regis- By Mary McNamara Media Senior Public Relations Specialist health care issues. tered nurses (APRNs) and physicians. ANA President Rebecca M. Patton, Briefs New York Times focuses on MSN, RN, CNOR, was quoted in Medical Health care highlighted News Today on the action. “ANA is grati- safety of nurses on the job fied that Congress has renewed their sup- in presidential campaigns port for maintaining reimbursement for Workplace violence is on the rise, and APRNs and physicians, preventing a cut the U.S. nursing workforce.” Health care professionals, interest groups health care professionals are at risk. A that could have severely limited access to She noted that last year the federal and lobbyists are making an effort to en- July 8 New York Times article examined care. We look forward to continuing our Nurse Education Loan Repayment Pro- sure health care remains front and center the disturbing trend of workplace violence work with Congress on expanding access gram turned away 93 percent of applicants, in the presidential campaign. Modern and what nurses are doing to protect them- to quality care, as well as expanding and and the Nursing Scholarship Program de- Healthcare examined some of the groups selves. According to the federal Bureau of improving the medical homes demonstra- nied 96 percent of applicants. making their presence felt at the two polit- Labor Statistics, half of all nonfatal injuries ical conventions. Among them was ANA, tion project to include APRNs and health resulting from workplace assaults occur in care practitioners.” which sent staff and a representative of health care and social service settings. Keeping patients and its political action committee to both the Nurses and other personal care work- Democratic and Republican conventions. ers bear the brunt of such attacks, with 25 Lawmakers examine nurses healthy “We believe health care and our issues injuries annually resulting in days off from nursing shortage At hospitals across the country, nurses are are bipartisan issues,” Rose Gonzalez, work for every 10,000 full-time workers leading the way in bringing lifting equip- MPS, RN, ANA’s director of government — 12 times the rate of the overall private When the House Judiciary Subcommittee ment to hospitals. It ensures patients are affairs, told Modern Healthcare. ANA sector, according to the bureau. on Immigration, Citizenship, Refugees, lifted safely, and nurses and other health also hosted a panel on health care reform Nancy Hughes, MS, RN, director of Border Security and International Law care professionals have less risk of on with several other organizations. “Speak ANA’s Center for Occupational and Envi- held hearings on the need for work visas the job injury. In a Sept. 4 article, “Smart Out: If I had one minute with the next ronmental Health (COEH), described her for highly skilled workers, they called Move,” the Tennessee Commercial Appeal president” was attended by policy ex- own experience with on-the-job violence upon the ANA for its perspective. examined the trend of safe lifting equip- perts, health care professionals, industry when she was attacked in the emergency Nursing Spectrum covered the hear- ment. Nancy Hughes, MS, RN, director of leaders, celebrities and the media. room by a patient high on drugs. She was ings, where ANA’s new director for nurs- ANA’s COEH, said ceiling lifts are com- Nurse.com took a closer look at both hit in the chest hard enough to require sur- ing practice and policy, Cheryl Peterson, fortable for patients and easier for staff than candidates’ health care plan in their Sept. gery. “It was quite a traumatic event, but I MSN, RN, spoke. “It is inappropriate other mechanical devices. “They’re the 8 piece, “Which Plan for America.” Cyn- didn’t get much support where I worked,” to look overseas for nursing workforce best,” she said. thia Haney, JD, senior policy fellow at the she said. “The doctor I was working with relief when the real problem is the fact The article cites several factors in the ANA, weighed in, calling Barack Obama’s said, ‘Don’t be a wimp,’ sort of take your that Congress does not provide sufficient need for lifting equipment: the aging U.S. plan “most consistent with the American lumps and don’t worry about it.” funding for domestic schools of nursing; populations means hospitalized patients Nurses Association’s policy for healthcare Some states are considering legislative the U.S. health care industry has failed to are sicker and more likely to need assis- reform” because it “guarantees high-qual- fixes. Last year New Jersey and Oregon maintain a work environment that retains tance to move, the nursing population is ity affordable healthcare for all.” passed legislation that requires health care experienced U.S. nurses; and the U.S. gov- aging, and rising obesity rates mean that The article mentioned that both candi- facilities to assess the dangers of work- ernment does not engage in active health health care professionals are moving dates promise to bring health costs down place assault and develop programs to ad- workforce planning to build a sustainable heavier people. and help pay for their plans by promot- dress it. Many nursing organizations argue nursing and health professions workforce The article references the Bureau of ing increased competition among drug that staffing levels could also be a solution for the future.” Labor Statistics, which shows that regis- and health insurance companies and by to reducing violence. Peterson also said, “Over-reliance on tered nurses, and nursing aides, orderlies investing in information technology, co- foreign-educated nurses by the health care and attendants are among the occupations ordinated care and disease management, industry serves only to postpone efforts to at the greatest risk for on-the-job strains wellness and prevention programs, and Congress overturns address the needs of nursing students and and sprains. n health education starting at school levels. presidential veto; passes Both support mental health parity, a strong public health system, and making health Medicare legislation care costs transparent. The “Medicare Improvements for Patients ANA’s Safe Staffing Campaign The article stressed that while health and Providers Act” (H.R. 6331) received care remains an issue during the campaign, overwhelming support in the House, and how much reform actually occurs won’t passed in the Senate by a veto-proof mar- be seen until weeks and months after the gin. The legislation, which took effect July ballots are cast. The article went on to urge 1, would reverse a 10.6 percent reduc- nurses to get involved in the process by tion in Medicare reimbursements for the

The American Nurse is the official newspaper representing the nation’s registered nurse population with a circulation of 157,000 nurse members of the American Nurses Association. In addition, 26% of its ADVERTISEreaders pass it along to other nurse colleagues. Its read- ers are qualified, professional and influential nurses who are on the forefront of health care. This market has the purchasing power to make buying decisions. That’s one of the reasons they read The American Nurse! To Advertise in The American Nurse, please call our advertising coordinator at (301) 628-5210 or During ANA’s 2008 biennial House of Delegates meeting in Washington the week visit our Web site, www.NursingWorld.org. of June 23, ANA placed this advertisement at the Dupont Circle Metro station to bring attention to ANA’s Safe Staffing Campaign.

September/October 2008 n The American Nurse n www.NursingWorld.org 15 ana_ad_forpub.pdf 8/30/06 12:22:04 PM

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Visit the ANA’s new Nurse’s Career Center and experience the advanced features and benefits:

Personal Profile Page: Create your own security protected site complete with URL. Search nursing jobs in Résumé Wizard: your neighborhood or Upload or create multiple résumés and make them across the country at this searchable and visible to top employers. one-stop resource for Job search:

C Free, fast, confidential access to a credible selection of quality registered nurses.

M targeted employer opportunities.

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A member of HEALTHeCAREERS Network

Find a NEW world of opportunities at www.nursescareercenter.com www.nursescareercenter.com ● 888-884-8242 ● [email protected]