ENA Connection May 2014 by ENA Connection

the Official Magazine of the Emergency Nurses Association

connection

May 2014 Volume 38, Issue 5

LEAD US THERE

Calling on You as a Member to Guide and Grow ENA to Greater Heights LEADERSHIP CONFERENCE 2014 Coverage from Phoenix 28-46 ENA NATIONAL ELECTION SECTION with Candidate Profiles 12-22

SEVENTH EDITION The Premier Course for Trauma Care

TNCC offers interactive learning with scenario-based assessments. § A Systematic Approach to the Initial Assessment § Hands-on Training to Provide Expert Care § Evidence-based Content Developed by Trauma Experts § Patient Advocacy Regarding Pain Management and Family Presence 2 Day Intensive Course § 24 Chapter Comprehensive Manual § Hands-on Skill Stations 5 Online Modules § Special Population Chapters § 17.65 Contact Hours

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Visit www.ena.org/TNCC to find a course near you. The Emergency Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Dates to Remember May 1 - June 13, 2014 Application period for Emergency Nursing 2015 Conference Planning Committee May 6-7, 2014 Day on the Hill, Washington, D.C. May 13 - June 11, 2014 ENA National Elections June 1, 2014 Application deadline for 2015 ENA Foundation Board of Trustees

ENA Exclusives PAGE 6 Instructors’ Ideas Improve ENPC Delivery PAGE 8 Merger of Two ENA Committees Leads to New Member Resources PAGE 10 ENA’s in Steady Hands Regarding CNE PAGES 12- 22 ENA 2014 National Elections and Candidate Biographies PAGE 24 Tapestry Scholarship: The Fabric of Stronger Leadership PAGE 26 Meet ENA’s New Chief Development Officer PAGES 28 - 46 Leadership Conference 2014 Section 28 - 31 State and Chapter Leaders Conference 32 - 33 Night at the Movies 34 - 36 Opening Session 38 - 39 Educational Sessions 40 - 41 Poster Sessions 42 - 43 State Council Achievement Awards

Regular Features PAGE 4 Free CE of the Month PAGE 47 Board Writes PAGE 48 Perspectives

FROM THE PRESIDENT | Deena Brecher, MSN, RN, APN, ACNS-BC, CEN, CPEN

When You Can’t Remember I

t’s 10 hours into your very busy 12-hour shift. Your last meal was about 11 hours ago, and there is no end in sight. You are currently caring for a patient on a dopamine drip, and the physician orders furosemide. You stop for a minute and think, ‘‘Are these drugs compatible?’’ Our shifts are filled with nonstop action, distractions and interruptions. The patients we care for have a multitude of complaints, histories and medications, and their needs range from simple to extremely complex. As emergency nurses, we have to know a whole lot about a whole lot. It is virtually impossible to know everything. All of us forget critical pieces of information from time to time. Which drugs are compatible, what’s the dose for drug X, which kind of tubing do I use for albumin or how fast can I infuse drug Y? We have all asked these questions. Imagine walking out of the medication room and running into your nursing colleague Alex. Alex is taking care of a patient with a STEMI and is on his way back to the patient’s room. You quickly ask Alex, “Hey, furosemide is compatible with dopamine, right?’’ Alex looks up and responds “I think so’’ before he hurries off. Are you comfortable with his answer? How you manage this situation can be the difference between a potential life- or limb-threatening reaction and excellent patient care. Do you trust Alex or do you consult your hospital-approved drug-to-drug interaction resource? What if your question was related to which concentration should be used to flush a central line? Many times we rely on each other to answer quick questions instead of seeking out the reference for ourselves. Most of the time we get by. We make errors, but thankfully no harm comes from them. As a nurse, it’s up to you to seek out the correct resources you need to care for your patients safely. If you make a mistake because of incorrect information provided by someone else, who is accountable for the error? When is it OK to ask a colleague instead of consulting the policy and procedure manual or the drug reference? When you are unsure about something and it directly involves patient care, look it up. Be sure you are using the references that have been approved by your hospital.

It is the best practice and will help you keep your patients safe. Your colleagues are just as busy, tired, hungry and distracted as you are. Each of us is directly responsible for the safety of ourselves and our patients in the ED. The ENA position statement ‘‘Patient Safety in Emergency Health Care’’ helps define what the emergency nurse’s role is in creating a culture of safety in our work environments. ‘‘Going to the source’’ when you have a question is one of the many things we can do as emergency nurses to help ensure our EDs are as safe as possible for our patients. Next time you have a patient care question, what will you do to get the answer? Resource Jasti, B., & Saraf, P. (2011). Compatibility of parenteral furosemide with seventeen secondary drugs used in standard concentrations. International Journal of Pharmaceutical Compounding, 15(3), 259-261.

Official Magazine of the Emergency Nurses Association

Know what you’re looking at with pediatric shock when you take the latest free continuing education offering from ENA.

ENA Joins Vietnam War Commemorative Partner Program

Available to you starting May 1 . . . ‘‘When Children Are Shocking,’’ presented by Joyce Foresman-Capuzzi, MSN, RN, CCNS, CEN, CPEN, CTRN, CCRN, SANE-A, AFN-BC, EMT-P. (Credit: 1.0 contact hour.) You’ll review the most common etiologies of pediatric shock, distinguish the differing roles of vital signs in children vs. adults and come away prepared to interpret the subtle signs of pediatric shock to facilitate timely intervention. To take this and other eLearning courses free as an ENA member: •G o to www.ena.org/freeCE, where you’ll log in as a member (or create an account). • Add desired courses to your cart and ‘‘check out.’’ • Proceed to your Personal Learning Page to start or complete any course for which you have registered or to print a final certificate. • To return to your Personal Learning Page later, go to www.ena.org and find ‘‘Go to Personal Learning Page’’ under the Education tab. Please be sure you are using the e-mail address associated with your membership when logging in. If you have questions about any free eLearning course or the checkout process, e-mail elearning@ena.org.

ENA Connection is published 11 times per year from January to December by: The Emergency Nurses Association 915 Lee Street Des Plaines, IL 60016-6569 and is distributed to members of the association as a direct benefit of membership. Copyright ©2014 by the Emergency Nurses Association. Printed in the U.S.A. Periodicals postage paid at the Des Plaines, IL, Post Office and additional mailing offices.

NA recently became an official member of the United States of America Vietnam War Commemoration Partner Program, designed for communities and organizations to ‘‘assist a grateful nation in thanking and honoring our Vietnam veterans and their families’’ in honor of the 50th anniversary of the war. As a program partner, ENA received an official flag, a seal and a proclamation signed by President Barack Obama. According to the proclamation, the 50th anniversary observance is a 13-year program in which federal, state and local officials are called to ‘‘honor our Vietnam veterans, our fallen, our wounded, those unaccounted for, our former prisoners of war, their families and all who served with appropriate programs, services and activities.’’

Call for Emergency Nursing 2015 Conference Planning Commitee ENA members are invited to submit their applications for the Emergency Nursing 2015 Conference Planning Committee

POSTMASTER: Send address changes to ENA Connection 915 Lee Street Des Plaines, IL 60016-6569 ISSN: 1534-2565 Fax: 847-460-4002 Website: www.ena.org E-mail: connection@ena.org

Member Services: 800-900-9659 Non-member subscriptions are available for $50 (USA) and $60 (foreign).

online from May 1 to June 13. For the application and a call overview, go to www.ena.org and click on Get Involved.

Publisher: Kathy Szumanski, MSN, RN, NE-BC Editor-in-Chief: Amy Carpenter Aquino Associate Editor: Josh Gaby Senior Writer: Kendra Y. Mims Editorial Assistant: Renée Herrmann BOARD OF DIRECTORS Officers: President: Deena Brecher, MSN, RN, APN, ACNS-BC, CEN, CPEN President-elect: Matthew F. Powers, MS, BSN, RN, MICP, CEN

Secretary/Treasurer: Kathleen E. Carlson, MSN, RN, CEN, FAEN Immediate Past President: JoAnn Lazarus, MSN, RN, CEN Directors: Ellen (Ellie) H. Encapera, RN, CEN Mitch Jewett, AA, RN, CEN, CPEN Michael D. Moon, PhD, MSN, RN, CNS-CC, CEN, FAEN Sally K. Snow, BSN, RN, CPEN, FAEN Jeff Solheim, MSN, RN-BC, CEN, CFRN, FAEN Joan Somes, PhD, MSN, RN-BC, CEN, CPEN, FAEN, NREMT-P Karen K. Wiley, MSN, RN, CEN Executive Director: Susan M. Hohenhaus, LPD, RN, CEN, FAEN

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COURSES

Instructors’ Ideas Improve ENPC Delivery By Amy Carpenter Aquino, ENA Connection

streamlined version of the fourth edition of the Emergency Nursing Pediatric Course is approaching completion, made possible by two ENA members with decades of pediatric emergency nursing and ENPC instruction experience working with ENA to make enhancements and improve the course delivery. ENPC Fourth Edition provides emergency department personnel with the knowledge and tools needed to prepare for pediatric patients, following the Guidelines for Care of Children in the Emergency Department created by ENA, the American Academy of Pediatrics and the American College of Emergency Physicians. Rebecca Steinmann, MS, RN, CEN, CPEN, CCRN, FAEN, clinical nurse specialist, and Harriet Hawkins, RN, CPEN, CCRN, FAEN, resuscitation education coordinator, both work at Ann & Robert H. Lurie Children’s Hospital of Chicago, which offers ENPC every other month. After noticing some areas where the course delivery could be streamlined to assist both students and instructors, they sent their questions to ENA, which supported a pilot study at their facility. Hawkins and Steinmann sent their recommended modifications to national ENA. ‘‘We haven’t changed content,’’ said Hawkins, acknowledging the great work of the work team that developed the course. ‘‘The changes were in response to the fact that there were issues with the delivery of the course.’’ Said Steinmann: ‘‘We were

trying to make it more interactive by incorporating a lot of the skills — the ones that were being done in half-hour increments at the end of Day 1 — into the lectures, to make the entire day more interactive.’’ Hawkins explained how in the actual practice of the class, moving 20 or so students through the eight small stations was very difficult. ‘‘Even if the station itself takes 15 minutes, you have to have moving time,’’ she said. Since many of the skill stations were actually discussion stations, Hawkins and Steinmann decided to try holding the discussions with the entire class to share the information with everyone at the same time. ‘‘By taking some of the skills and putting them into the lectures where they were being discussed, that kind of broke up the lectures a bit,’’ Steinmann said. ‘‘Instead of just hearing somebody talk for 45 minutes, they were also given the opportunity to brainstorm a little bit and throw out their suggestions.’’ ‘‘So when we do a lecture on the rhythms, for example,’’ Hawkins added, ‘‘at the end of it we’ll have a little scenario where they talk about what they do.’’ In January, the pair held an ENPC pilot at their facility, incorporating

The 2009-2012 ENPC Revision Work Team members are as follows: • Nancy Denke, MSN, RN, FNP-C, ACNP, FAEN, chairperson • Paul C. Boackle, BSN, RN, CCRN, CEN, CFRN, CPEN, CTRN • Angela M. Bowen, BSN, RN, CPEN, NREMT-P • Cam Brandt, MS, RN, CEN, CPEN, CPN • Julie L. Miller, RN, CEN • Dianne Molsberry, MA, RN • Deena Brecher, MSN, RN, APN, ACNS-BC, CEN, CPEN, ENA board liaison • Tiffiny Strever, BSN, RN, CEN, ENA board liaison their changes. Steinmann said the class was well-received. ‘‘They definitely liked the interactiveness of the lectures,’’ Steinmann said. ‘‘Traditionally, we thought of lectures as somebody sitting up there talking; now, in the shock lecture, part of the discussion is having them talk about what the different types of distributive shock are.’’ Hawkins added, ‘‘The reality is that sitting in a class for eight hours is not what nurses normally do, and it’s hard for anyone to sit for that long. So what we’re trying to do is more conversations with them, more interaction.’’ At a second ENPC class Hawkins held March 20-21 at Lurie Children’s Hospital, the class time was down to nine hours per day, including one hour for lunch. She also noted a big improvement in the pass rate. ‘‘We hope that people find that having a little bit more interaction works out well for everyone. It seems to work out well for us,’’ Steinmann said.

May 2014

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Potential complications may include local or systemic infection, hematoma, extravasations or other complications associated with percutaneous insertion of sterile devices. References: 1. Rogers JJ, Fox M, Miller LJ, Philbeck TE. Safety of intraosseous vascular access in the 21st century [WoCoVA abstract O-079]. J Vasc Access. 2012;13(2): 1A-40A. 2. Paxton JH, Knuth TE, Klausner HA. Proximal humerus intraosseous infusion: a preferred emergency venous access. J Trauma. 2009;67(3):1-7. 3. Cooper BR, Mahoney PF, Hodgetts TJ, Mellor A. Intra-osseous access (Ez-IO ® ) for resuscitation: UK military combat experience. J R Army Med Corps. 2007; 153(4):314-316. 4. Dolister M, Miller S, Borron S, et al. Intraosseous vascular access is safe, effective and costs less than central venous catheters for patients in the hospital setting [published online ahead of print January 3, 2013]. J Vasc Access. doi:10.5301/jva.5000130. *Research sponsored by the Vidacare Corporation. Teleflex and EZ-IO are trademarks or registered trademarks of Teleflex Incorporated or its affiliates. © 2014 Teleflex Incorporated. 2014-2673

CLINICAL PRACTICE

Together Makes It Better

Merger of Two ENA Committees Leads to Meaningful New Member Resources By Amy Carpenter Aquino, ENA Connection

NA members have access to meticulously researched and reliable resources for their practice, including clinical practice guidelines (CPGs), CPG synopses and translation-into-practice (TIP) recommendations. The resources are available to download from the Research and Practice sections of www.ena.org. These resources are the result of the work of several ENA members who belong to the Clinical Practice Guidelines Committee, which was formed when two committees merged in 2013. Susan Barnason, PhD, RN, APRN, CNS, CEN, CCRN, FAHA, FAAN, FAEN, was a member of the Emergency Nursing Resources Development Committee and in line to chair the committee in 2013. Janis Farnholtz-Provinse, MS, RN, CEN, chaired the 2012 Clinical Practice Guidelines Committee. They shared how combining the two former committees into a new Clinical Practice Guidelines Committee created a strong, dynamic force for providing documents that are meaningful to emergency nursing practice. Among the new committee’s charges was determining how to combine their efforts to benefit the entire ENA membership, taking into consideration that members from the two former committees were used to approaching things from different angles. ‘‘We had this common perspective about how do all of our resources that we’re producing through ENA . . . compare and contrast with each other?’’ Barnason said.

Susan Barnason

The former ENR Committee, for example, was focused on producing clinical practice guidelines, which are evidence-based documents that facilitate the application of current evidence into everyday emergency nursing practice. As described in the document outlining requirements for CPGs, preparing a CPG is a complex and rigorous process. ‘‘It’s a lengthy document,’’ Farnholtz-Provinse said. ‘‘It’s a resource one would go to for a thorough understanding of a particular emergency nursing-related topic. The ENR Committee created these very comprehensive and detailed documents that summarized the literature. They graded and leveled all the evidence and wrote a guideline for practice.’’ The translation-into-practice document, which was the focus of the original Clinical Practice Committee, is more practice-based. ‘‘It’s something that’s easy to use, easy to translate for nurses to share among each other about best practices,’’ Barnason said. ‘‘The whole idea was to bring forward to the emergency nurse the best practices that can be applied to procedures and processes, as opposed to a clinical guideline, which may be more robust.’’ The third document the group examined was the CPG synopsis, which used to be a document called the executive summary. The new CPG synopsis now serves two purposes, Barnason said. One is as a summary of a CPG developed by the CPG Committee; a CPG synopsis provides emergency nurses with a succinct resource that can ‘‘get to the meat of the CPG very quickly.’’ The second use is as a summary of existing evidence or guidelines that have been published by others.

Janis FarnholtzProvinse

May 2014

Call for International Delegates to the 2014 General Assembly

One example of a CPG synopsis is on the topic of pediatric dehydration. The document, which is under review, is based on ‘‘really strong guidelines that were already out there,’’ Barnason said. ‘‘There was no need to recreate the wheel, but rather pull it into the context of answering the clinical question that pertained to the emergency nurse, and then using the existing guidelines to frame best practices for the emergency nurse.’’ Farnholtz-Provinse said she was proud of the work of all former and current committee members. Being on an ENA committee is ‘‘an awesome process that I am honored to be a part of,’’ she said. She is especially pleased with the first TIP on right-sided and posterior electrocardiograms and that she has been able to share the resource with other clinicians in her role as a clinical nurse specialist. ‘‘It’s really fun when staff grab me and say, ‘I have to do one of those right-sided and/or posterior EKGs — can you help me?’ ’’ Farnholtz-Provinse said. ‘‘I’m proud to be able to say, ‘If you have to do this when I’m not here, here’s ENA’s website where you can pull it up and reference it whenever you’d like.’ ’’ Barnason said last year was exciting, as the new CPG Committee realized the goal of the ENA Board of Directors to combine efforts and focus initiatives under one umbrella. ‘‘I can’t tell you what a wonderful year we had as we reflect back on 2013,’’ she said.

ENA will appoint five international delegates and one alternate international delegate to the 2014 ENA General Assembly in Indianapolis, Oct. 8-9. The ENA General Assembly meets annually before the start of the ENA Annual Conference, determining official association policy and positions by reviewing, debating and voting on proposed bylaws amendments and resolutions. In mid-May, the international delegate application, criteria and instructions will be posted at www.ena.org in the Members Only section within the General Assembly link. International members are given the same level of participation status as all national delegates to provide direction and stewardship on important emergency nursing issues to ENA. For questions or assistance, contact the ENA Executive Services department at execoffice@ ena.org or 847-460-4095.

Fourth Edition

The Authoritative Course for Pediatric Emergency Nursing • Pediatric Assessment Triangle • Early Intervention • Family Presence 2 Day Intensive Course 23 Chapter Comprehensive Manual Hands-on Skill Stations Contact Hours Available 4 Online Modules

Take the Course Today! www.ena.org/ENPC

The Emergency Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

ENPC Ad_Connection_half_05 2014.indd 1

Official Magazine of the Emergency Nurses Association

4/9/14 11:52 AM

ACCREDITATION

ADAPTING ADEPTLY

With CNE Ever Changing, ENA’s in Steady Hands By Amy Carpenter Aquino, ENA Connection

NA is accredited as both an approver and a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. As the ANCC lead nurse planner and nurse peer review leader for ENA, Janet Crawford, MSN, ACNS-BC, DNC, is responsible for ensuring that all of the continuing education ENA provides through its own courses, and the courses it approves for other entities, meet the criteria established by ANCC. ‘‘Our accrediting bodies always want to know how we are doing,’’ Crawford said. The process of applying for ANCC accreditation starts with a very detailed and descriptive self-study. That process ‘‘changed completely’’ in 2013, Crawford said. ‘‘Now, units must not only describe what we do, but we have to give empirical evidence — proof — and that has been the challenge around the country.’’ ENA hired Crawford in May 2013 to guide the organization through the

new ANCC accreditation process. Crawford, an ANCC appraiser, has been involved with CNE since the 1980s, including a longtime position as the designated nurse planner for the massive Cook County (Ill.) Bureau of Health Services. All of that experience has taught her to anticipate one thing from ANCC and CNE: progressive change. ‘‘It has always changed, because it improves and it’s enhanced over time,’’ she said. ‘‘They learn more, and they see better ways to look at the importance of education beyond academic learning, so it’s improved beautifully.’’ ENA state councils and chapters applying for CNE for a course or conference never have to worry about keeping up with ANCC criteria, though. Since changing everything last year to meet ANCC’s new approver unit criteria, ENA has created a completely electronic approval unit form that can be easily updated. ‘‘Our unit is flexible, and it’s adaptive,’’ Crawford said. ‘‘It’s easy to change according to ANCC. When they come out with a change, we make the

ENA Supports AAN Guidelines on Prevention of Stroke in Nonvalvular Atrial Fibrillation

he American Academy of Neurology has said that patients with nonvalvular atrial fibrillation are at increased risk of ischemic stroke relative to age-matched patients without NVAF. ENA supports the evidence-based guideline updates of a 1998 AAN practice parameter on stroke prevention in nonvalvular atrial fibrillation. According to the summary, this updated guideline reviews

Janet Crawford, MSN, ACNS-BC, DNC change. If a program is in a fixed state, it can never, ever achieve ANCC criteria, because it’s impossible to make changes. We should never be at a point where we say, ‘Oh, they’re making a change,’ because they’re always going to make changes, as well they should.’’ All updated forms and information are available for members to easily access at www.ena.org. The CNE website also served as the basis for Crawford’s presentation when ANCC appraisers evaluated ENA this year. She said there is good reason why CNE requirements and criteria are so strict, to the point that the educational product needs to be pristine. ‘‘There are high stakes,’’ Crawford said. ‘‘Continuing education makes a difference in the life or death of a patient. ... We can’t really fully learn at the bedside, so it’s through continuing education, away from the bedside or stretcherside, that we can learn and improve patient care and enhance professional nursing development.’’

the evidence published since 1998 with regard to the detection of NVAF in patients with stroke and new therapies for the prevention of stroke in patients with NVAF, with a focus on two questions: 1) For patients with cryptogenic stroke, how often do various technologies identify previously undetected NVAF? 2) For patients with NVAF, which therapies that include antithrombotic medication, as compared with no therapy or with another therapy, reduce stroke risk and severity with the least risk of hemorrhage? The guidelines are available at www.aan.com/ guidelines.

May 2014

SAMHSA’s National Prevention Week Coming May 18-24

NA is proud to support the Substance Abuse and Mental Health Services Administration in observance of the 2014 National Prevention Week. National Prevention Week is a SAMHSA-supported annual health observance dedicated to increasing public awareness of, and action around, substance abuse and mental health issues. This observance is powered by communities nationwide that host prevention-themed events to: • Increase the visibility of behavioral health and the benefits of prevention. • Provide a forum to educate the public. • Create opportunities for networking and collaboration. This year’s Prevention Week theme is ‘‘Our Lives. Our Health. Our Future.’’ SAMHSA provides a toolkit to help organizations plan a prevention-focused event in their community as well as carry out prevention activities year-round. The toolkit includes: • Fun, easy event ideas (including ideas for school, volunteer, sporting, leisure, workplace and policy activities). • Planning recommendations (including information on identifying and working with partners and volunteers). • Tips and tools for event promotion (including templates for traditional and social media outreach and promotional items such as fliers, images and pocket cards). • Fact sheets about the six themes of National Prevention Week. • Budgeting tips and suggestions. • A glossary of behavioral health terms.

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Sunday, May 18 Prevention and Cessation of Tobacco Use

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Monday, May 19 Prevention of Underage Drinking

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Wednesday, May 21 Prevention of Alcohol Abuse

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Thursday, May 22 Prevention of Suicide

The Emergency Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Friday, May 23 Promotion of Mental Health Go to beta.samhsa.gov/prevention-week for more information.

GENE Ad_Connection_half vertical_05 2014.indd 1

Official Magazine of the Emergency Nurses Association

3/26/14 10:05 AM

Vote in the ENA National Elections!

he 2014 election for national ENA Board of Directors and Nominations Committee positions begins May 13. The following 10 pages feature candidates’ biographical information, photographs and replies to the position statement question. Only ENA voting members (classified as national, international, senior and military) as of May 1 are eligible to vote in the 2014 election. ENA members will be able to vote for president-elect, secretary/treasurer, two director positions and three regional openings on the Nominations Committee.

Members’ Right to Vote Voting is each member’s opportunity to ensure that the association remains strong. State and chapter leaders are encouraged to promote awareness of the 2014 ENA National Election candidates to all state and chapter members. Getting the vote out is your call to action.

Voting ENA members may only cast their votes online. On May 13, ENA’s election vendor will send a broadcast e-mail with voting instructions to all members who have an e-mail address on file at the ENA national office. Members will be able to access the online ballot directly via the e-mail. Due to the extensive number of e-mails being sent, it may take 24 to 48 hours to receive your e-mail. If you have not received an electronic ballot by May 19, please contact the Executive Services office at 800-900-9659, ext. 4095, or at elections@ena.org.

May 13 - June 11

Completed online 2014 election ballots must be received by noon Central time June 11. There will be no exceptions.

Meet the Candidates To meet your national election candidates, visit www.ena.org/ election. Candidates appear in the random order by balloting category as determined before the Candidates Election Forum. This candidate order will remain the same in any ENA publication, on the election ballot and on the ENA website. All candidates have submitted biographical information and a statement to the membership and responded to a position statement question. Board of directors candidates also participated in the Candidates Election Forum at ENA Leadership Conference 2014 in Phoenix. Members are encouraged to view the video files available at www.ena.org/election.

Candidates on Facebook ENA is encouraging candidates to use the Elections Event Page on ENA’s Facebook page for campaigning activity. This dedicated event page is strictly related to the elections, allowing individuals to easily start conversations and respond to previously posted comments. To access the event page, simply visit ENA’s Facebook page and click on the Events box (second box from the right), where it will list all upcoming ENA events. Click on the 2014 ENA Election link to view the targeted content. This forum provides a neutral environment for the candidates to

campaign and for members to ask questions and provide support of the candidates.

Candidate Publicity and Campaigning ENA believes the candidates for ENA national office must have equal opportunity to access the entire membership. In order to maintain a professional atmosphere and in fairness to all candidates, as well as to prevent disparity during the campaigning process, ENA will promote the integrity of the elections process by providing an environment of neutrality which is intended to inhibit any real or perceived impropriety regarding elections. Refer to the ENA Election Rules at www.ena.org to reference ENA’s campaigning rules.

Election Results The results of the election will be published on the ENA Members Only website and in the August issue of ENA Connection and announced at the 2014 General Assembly at the formal installation ceremony. Contact Nominations Committee members by visiting the ENA website at www.ena.org/about/ elections/NomComm.

May 2014

— President-Elect — Kathleen E. Carlson, RN, MSN, CEN, FAEN Hampton, Virginia

San Antonio, Texas

CURRENT EMPLOYMENT Staff Nurse, Emergency Department, Sentara Virginia Beach General Hospital, Virginia Beach, VA

EDUCATION MSN, 1987 Western Connecticut State University, Danbury, CT BSN, 1983 Western Connecticut State University, Danbury, CT Diploma, 1972 Stamford Hospital School of Nursing, Stamford, CT

PROFESSIONAL CREDENTIALS/CERTIFICATIONS CEN TNCC Instructor-Trainer; ENPC Instructor-Trainer ACLS Instructor-Trainer; PALS Instructor-Trainer

NATIONAL 2011-2013 2010 2009-present 2008-2009 2008 1999-present 1990-2009 2004-2006 1997-1999 1989-1993

ENA Board of Directors Contributor Emergency Nursing Orientation (ENO) 2.0 Fellow, Academy of Emergency Nursing Co-Editor, Emergency Nursing Certification Review (ENCR) Judith C. Kelleher Award Journal of Emergency Nursing, Contributing Editor, Emergency Nursing Review Column Co-editor, CEN Review Manual Task Force (all 4 editions) Leadership Conference Committee Annual Conference Committee Member, National Standing Committee on Education (Chairperson 1992-1993)

STATE 2001-present 1999-2001 1999-2001 1981-1999 1989-1991 1991

Virginia ENA New York ENA New York State Conference Committee (Chairperson 2001) Connecticut ENA (President 1995) Connecticut State Conference Committee (Chairperson 1990) Chairperson, New England Regional Symposium

LOCAL 2001-Present 2004-2009 2003

Michael D. Moon, PhD, MSN, RN, CNS-CC, CEN, FAEN

Tidewater Chapter (Virginia) Tidewater Chapter, State Representative New York State Council, Special Recognition Award

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? I believe it is essential to pay attention to detail. Whether caring for a patient or looking at a spread sheet it is important to remain focused on the task at hand. In order to obtain an optimum outcome, we must ask relevant questions, if the issue remains unclear, to fully understand areas of concern and explore options.

CONFLICT OF INTEREST DISCLOSURE No conflicts disclosed.

Information in candidate biographies published exactly as submitted by the candidate.

CURRENT EMPLOYMENT Clinical Faculty and Associate Professor University of the Incarnate Word, San Antonio, Texas

EDUCATION PhD, 2013, Texas State University-San Marcos, San Marcos, Texas MSN, 1995, University of Texas Health Sciences Center at San Antonio, San Antonio, Texas BSN, 1987, Texas Tech University Health Sciences Center, Lubbock, Texas

PROFESSIONAL CREDENTIALS/CERTIFICATIONS CEN, TNCC-Instructor, ENPC-Instructor, ACLS

NATIONAL 2009-present 2007-present 2004, 2013-present 2002-2006, 2012-present 2002, 2012 2000-2001, 2010-2011 1990-1993, 1995-2001, 2007-2008, 2010

Item Writer, BCEN Fellow, Academy of Emergency Nursing ENA Representative, ACEP Clinical Policies Committee Director, ENA Board of Directors ENA/ENA Foundation Taskforce Member, Resolutions Committee Delegate, General Assembly

STATE 2011-2012 2000, 2010 1997-1999 1997-1998 1990-1992, 1995-1996, 2007-present

Member, Delegate Selection Committee President, Texas ENA Chairperson, Resolution Committee Treasurer, Texas ENA Delegate, Texas ENA State Council

LOCAL 2011-present 1991 1990 1989-present

Parliamentarian, San Antonio ENA President, Austin ENA Treasurer, Austin ENA Member, Austin/Hi-Plains/San Antonio ENA

OTHER 1998-present 1988-present 1988-present

Member, American Association of Critical Care Nurses Member, Sigma Theta Tau Member, American Nurses Association

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? The essential attribute that is required to enhance ENA’s mission is dedication of emergency RNs to be advocates for the specialty. ENA must have a presence at the local, state, and national levels. Safe Practice and Safe Care requires each of us to be active in the dissemination of evidenced-based practice and current research. We must provide all emergency RNs with quality, clinically relevant education. We must also help mentor our emerging professionals into the specialty; role modeling behaviors that we expect from ourselves as well as from other emergency RNs. We must have passion to do what is right for our patients and to make our systems of health care safer.

CONFLICT OF INTEREST DISCLOSURE • Item Writer for the CEN examination offered by the Board of Certification of Emergency Nursing

Official Magazine of the Emergency Nurses Association

— Secretary / Treasurer — Karen K. Wiley, MSN, RN, CEN

Ellen “Ellie” H. Encapera, RN, CEN

Omaha, Nebraska

Aiken, South Carolina

CURRENT EMPLOYMENT

Staff Nurse Emergency Department, Alegent Creighton Immanuel Medical Center

Retired, Staff Nurse I over four decades of experience; Patient Care Coordinator, Charge Nurse, part-time Educator with 21 years in emergency nursing.

EDUCATION

MSN, 2007 Nebraska Wesleyan University Lincoln, NE BSN, 2004 Creighton University Omaha, NE ADN, 1978 College of Saint Mary Omaha, NE

Diploma in Nursing, 1969 Hospital of the University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania

PROFESSIONAL CREDENTIALS/CERTIFICATIONS

CEN 1984-2016

CEN

NATIONAL

NATIONAL 2012-2014 2011 2011 2009-2010 2009-2010) 2000 2010-2008, 2006, 2004, 2001

ENA Board of Directors Member, Emergency Department Behavioral Health Committee Annual Conference Speaker Emergency Department Violence Work Team (Chairperson Member, Government Affairs Committee Delegate, General Assembly

STATE 1997-Present 2010, 2001 2009, 2000 1999 2000-2013

Nebraska ENA State Council President Nebraska ENA State Council President-elect Nebraska ENA State Council Secretary Nebraska ENA State Council Government Affairs Chairperson Nebraska ENA State Council

OTHER 2000-Present 2000-Present 2004-Present 2009, 2012 2012

American Nurses Association Nebraska Nurses Association Sigma Theta Tau Nebraska Nurses Association District 2 Positive Image of Nursing Award Nebraska Nurses Association Outstanding Achievement in Nursing Award

What attribute is essential to enhance ENA’s Mission of Safe Practice and Safe Care? The attribute that is essential to Safe Practice and Safe Care is courage. It takes courage to lead; it takes courage to admit mistakes and find solutions; it takes courage to keep members foremost in our minds and never stray from the purpose of ensuring that all of ENA’s courses and all of our resources are the highest quality. It takes courage to speak up, in the boardroom at our national office, and hallways of regulators and legislators in state capitals and Washington DC, but that is how Safe Practice and Safe Care will be achieved.

CONFLICT OF INTEREST DISCLOSURE Nebraska Nurses Association District 2 Legislative Committee Chairperson

2011-2015 2005-2010 2007-2008 2006, 2009 2004 2001 1999-2000 1991-2010

ENA Board of Director Member, ENA Nominations Committee Chairperson, ENA Nominations Committee National ENA State Council Achievement Award for Best Membership Practices Member, ENA State Council and Chapter Relations Work Group Member, ENA International Task Force Member, ENA Membership Committee General Assembly Delegate

STATE 1998-2011 1998-2010 1997-2011 1996-1997

Chairperson, California State Membership Committee Delegation Coordinator California ENA State Council Member, California ENA State Council Education Committee Secretary, California ENA State Council

LOCAL 1998-2011 2000-2011 1993-1994,1999 1990-1991

Chairperson, Orange Coast Membership Committee Member, Orange Coast Education Committee President, Orange Coast Chapter Secretary, Orange Coast Chapter

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? Integrity is an essential attribute to enhance ENA’s mission of safe practice and safe care. Defined as the “adherence to a code of values”, integrity is both an essential attribute and personal choice. Safe care demands a personal pledge to adhere to all appropriate regulatory and practice standards. Nurses must value, respect and support a culture of safety within the practice arena, to protect patients and staff from injury and harm. Modern nursing practice is highly technical, complex and more demanding than ever before, requiring both precision and honesty of actions. If and when errors occur, reporting contributes to both process improvements and prevention of harm. It takes courage and personal integrity in nursing practice to contribute to a culture of safety and a pledge to do no harm.

CONFLICT OF INTEREST DISCLOSURE No conflicts disclosed.

Information in candidate biographies published exactly as submitted by the candidate.

May 2014

— Director — Tiffiny Strever, BSN, CEN Glendale, Arizona

Sondra Heaston, MS, NP-C, CEN, CNE

CURRENT EMPLOYMENT

Provo, Utah

Trauma Program Manager Maricopa Integrated Health Systems, Phoenix, Arizona

CURRENT EMPLOYMENT Associate Teaching Professor Brigham Young University College of Nursing

Arizona Air National Guard Phoenix, Arizona

EDUCATION

Nurse Practitioner Premier Family Medical Urgent Care

BSN, 2004 Graceland University, Lamoni, Iowa RN, 1985 North Iowa Area Community College, Mason City, Iowa

EDUCATION

PROFESSIONAL CREDENTIALS/CERTIFICATIONS CEN Instructor for TNCC, ENPC, CATN, CPST, BLS ACLS, PALS Provider

General Assembly Delegate Chairperson, Leadership Conference Member, Nominations Committee ENA Board of Directors Topic Reviewer “IOM” Report Member, Injury Prevention Workgroup Member, Alcohol Awareness Instructor Council

STATE 2011-13 2007-08 2006-Present 2006-Present 2006 2005-06 2003-05 2002 2001-06 2000-01 2000-04, 2006 1998-2006

PROFESSIONAL CREDENTIALS TNCC Instructor, CEN, Certified Nurse Educator (CNE), Fundamental Critical Care Support Course Instructor, ACLS, BLS

NATIONAL 1998-2007, 2011-13 2013 2011-13 2008-10 2006 2005-06 2001-02

MS, 2005 – Brigham Young University, College of Nursing, Provo, Utah BSN, 1989 – Weber State University, School of Nursing, Ogden, Utah AS, 1987 – Weber State University, School of Nursing, Ogden, Utah

Chair, Arizona Quality, Safety and Injury Prevention Member, Arizona Injury Prevention (Chair, 2007) Member, Arizona Trauma Committee Member, Arizona Pediatric Committee Chair, Missouri Government Affairs Committee Missouri State Council Past-President Missouri State Council President Missouri State Council President-elect Missouri Pediatric Committee Member Missouri State Council Secretary Member, Missouri Injury Prevention (Chairperson, 2000-04) Member, Missouri Trauma Committee (Chairperson, 1999-2001)

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? I believe that the attribute most essential to Safe Practice and Safe Care is integrity. Integrity is simply doing the right thing even when no one is looking. It’s taking accountability when a mistake is made and “owning” it. If everyone has the integrity to acknowledge mistakes we can proactively make the changes needed to decrease potential mistakes, therefore ensuring safe care and safe practice.

CONFLICT OF INTEREST DISCLOSURE No conflicts disclosed.

NATIONAL 2014 2013

Member Annual Conference Planning Committee ENA Board Mentoring Program Participant

1994, 1996-2002, 2006-2009, 2011-2013 General Assembly Delegate 1998, 1999

Nominations Committee

STATE 2012, 2013 2009-2010 2006-2008 2000 1998, 1999 1997 1997-2000

President, Utah State Council Historian/Student Nurse Liaison, Utah State Council Secretary/Treasurer, Utah State Council Immediate Past President, Utah State Council President, Utah State Council President-Elect, Utah State Council Education Committee Member, Utah

LOCAL 1997 1996 1995 1994

Immediate Past President, Northern Utah Chapter President, Northern Utah Chapter President-Elect, Northern Utah Chapter Secretary/Treasurer, Northern Utah Chapter

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? As nurses, managers and healthcare providers in emergency departments we face many difficult issues. It is imperative as individuals and as a professional organization that we have moral courage in order to promote safe practice and safe care. This requires a commitment to stand steadfast in doing the right things and making the right decisions. Theodore Roosevelt said, “Knowing what is right doesn’t mean much unless you do what is right”.

CONFLICT OF INTEREST DISCLOSURE No conflicts disclosed.

Information in candidate biographies published exactly as submitted by the candidate.

Official Magazine of the Emergency Nurses Association

— Director — Kristen Connor, BSN, RN, PHN, CEN Orangevale, California

EDUCATION BSN, 2008 - California State University, Sacramento, California ADN, 1994 - Palomar College, San Marcos, California

PROFESSIONAL CREDENTIALS/CERTIFICATIONS ACLS, BLS, CEN, MICN, PALS, TNCC

NATIONAL - LIFETIME MEMBER 2012 2012 2009-2013

Recipient, ENA Rising Star Award Member, Membership and Component Relations Committee General Assembly Delegate Treasurer, California State Council Treasurer-Elect, California State Council Member, Education Committee, California State Council Member, Government Affairs Committee, California State Council Sacramento Chapter Representative, California State Council

LOCAL 2010-2011 2009-2010 2010-2012 2009-2011 2008-2009

President, Sacramento Chapter President-Elect, Sacramento Chapter Chairperson, Government Affairs, Sacramento Chapter Chairperson, Newsletter, Sacramento Chapter Chairperson, Membership, Sacramento Chapter

OTHER 2013-present 2013-Present 2013 2012-Present 2010-2016

Member, American Nurse Association/California Member, National Association of Professional Women Recipient, Professional Woman of the Year, National Association of Professional Women Liaison, Graduate Nursing Student Academy, American Association of Colleges of Nursing Member, American Association of Critical-Care Nurse

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? Integrity, honesty and transparency of the Board of Directors are all necessary attributes for ENA’s mission to be carried out successfully. Members must feel confident that every person who serves on the Board embodies these qualities in every action and personal encounter. As a lifetime member of this organization, I believe in the mission and the collective wisdom of the membership. I fight for what is right. I also know that I have the integrity, honest and transparency the membership so strongly desires from a director.

CONFLICT OF INTEREST DISCLOSURE No conflicts disclosed.

Information in candidate biographies published exactly as submitted by the candidate.

Cornish, NH

CURRENT EMPLOYMENT Principal and Clinical Nurse Specialist, Proehl PRN, LLC, Cornish, NH Per Diem Emergency Nurse and Life Support Instructor, Dartmouth-Hitchcock Medical Center, Lebanon, NH Per Diem Emergency Nurse, Gifford Medical Center, Randolph, VT

EDUCATION BSN 1980 University of South Carolina, Columbia, SC MN 1986 University of Washington, Seattle, WA

PROFESSIONAL CREDENTIALS/CERTIFICATIONS CEN; CPEN; TNCC Faculty; ENPC Faculty; ACLS Instructor; MOAB

STATE 2013 2012 2012-present 2009-present 2009-2010

Jean A. Proehl, MN, RN, CEN, CPEN, FAEN

NATIONAL 2011-12 Emergency Nursing Resources Work Group: Member, Chair 2009-10 Course Development for Underdeveloped Countries: Chair 2009 Clinical Practice Guidelines Work Group: Member 2006-08 Academy of Emergency Nursing Board: Chair-Elect, Chair 2006-07, 2009 President’s Advisory Council: Member 2005-06 Awards Work Group: Chair 2001-04 ENPC/TNCC International Faculty: Member, Chair 2000 Elections Process Committee: Chair 2000 International Issues Work Group: Facilitator 2000 Immediate Past-President 1999 President 1998 President-Elect 1997 Secretary-Treasurer 1996-97 BCEN Board of Directors 1993-94 ENA Foundation: Trustee-at-Large 1993-96 Director-at-Large 1989-92 Trauma Nursing Committee: Member, Chair 1991-92 TNCC International Faculty: Member 1990-91 Trauma Special Interest Group: Chair 1983-87, 1989-92, 2002-04 General Assembly Delegate

STATE – NEW HAMPSHIRE 2011-13 Government Affairs Chair 2009-11 200-01 New England Regional Symposium: Program Chair

President

OTHER – NATIONAL ENA AWARDS 2007 2006

Foundation Pillar Award President’s Award

2001 1988

Judith Kelleher Award Education Award

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? ENA will continue to be a vital and powerful influence in emergency care by ensuring the involvement of stretcher-side nurses at all levels of ENA activities. Grassroots members must be substantially and integrally involved in policy-making, planning for the direction of the Association, and the development of educational courses and resource materials.

CONFLICT OF INTEREST DISCLOSURE • Elsevier: Nursing Advisory Board Member; Senior Clinical Reviewer, Mosby’s Nursing Skills; book editor • Wolters Kluwer: Editor, Advanced Emergency Nursing Journal • Vidacare: consultant (ad hoc) • Spouse is an Ad Hoc statistical consultant to Ironwood and Olympus

May 2014

— Director — Margaret (Marge) C. Letitia BSN, RN, CEN, EMT-P Manchester, Connecticut

CURRENT EMPLOYMENT Clinical Educator Emergency Department Saint Francis Hospital and Medical Center Hartford, Connecticut Staff Per Diem Nurse Manchester Memorial Hospital Emergency Department Manchester, Connecticut

EDUCATION BSN - 2005 University of Hartford West Hartford, Connecticut RN Diploma - 1975 St. Francis Hospital School of Nursing Hartford, Connecticut

PROFESSIONAL CREDENTIALS/CERTIFICATIONS CEN, ACLS Instructor, ATLS Course Coordinator, ENPC Instructor Faculty, PALS Instructor, TNCC Instructor Faculty

NATIONAL 2011-2013, 1986-2008 General Assembly Delegate 2013 TNCC 7th edition Content Reviewer 2009-2011 Member Annual Conference Committee 2005-2006 Member Emergency Management and Disaster Committee 2001-2002 Member Government Affairs Committee 1997-Present Contributing Editor / Abstract Reviewer Journal of Emergency Nursing 1998-1999 Member Membership Recruitment and Retention Work Group 1991 National ENA Nursing Practice Award

STATE 2014 2012 2011, 1990 2009-2010 2008 2001-2005 2000-2012 1997 1994-1999 1987-2004

Connecticut ENA State Council TNCC State Chairperson Immediate Past President Connecticut ENA State Council President Connecticut ENA State Council Connecticut ENA State Council Newsletter Editor New England Regional Symposium Chairperson Connecticut ENA State Council Government Affairs Chairperson Connecticut ENA State Council Annual Conference Committee Connecticut ENA State Council Excellence in Education Award Connecticut ENA State Council Fund Raising and Marketing Chairperson Connecticut ENA State Council State Trauma Committee

OTHER 2003 2003 2001-Present

Karen O’Neill Professionalism Award New England NDMS Distinguished Team Member of the Year CT-1 DMAT Member Connecticut-1 Disaster Medical Assistance Team (CT-1 DMAT)

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? As stated in Healing with the Heart, the best attribute is “Being Present”. Presence is engagement with choice and personal responsibility. This presence will allow focusing on this mission complexity while seizing the opportunities to make this work.

CONFLICT OF INTEREST DISCLOSURE No conflicts disclosed. Information in candidate biographies published exactly as submitted by the candidate.

J. Jeffery Jordan, MS, MBA, RN, CNE, EMT-LP, FAEN Macomb, Oklahoma

CURRENT EMPLOYMENT Staff Nurse On-Call Staffing of Southern Oklahoma, Coalgate, Oklahoma RN to BSN Coordinator/Instructor East Central University, Ada, Oklahoma

EDUCATION MS, 2010 Southern Nazarene University, School of Nursing, Bethany, OK MBA, 2006 University of Phoenix, Phoenix, AZ BSN, 1997 Texas Woman’s University, School of Nursing, Denton, TX AASN, 1990 Oklahoma State University, Nursing Department, Oklahoma City, OK

PROFESSIONAL CREDENTIALS/CERTIFICATIONS CNE, EMT-LP, TNCC Instructor

NATIONAL 2009-2012 2010-2013 2006-2008 2004 2004 2001-2004

Chairperson, Resolutions Committee General Assembly Delegate ENA Board of Directors Secretary/Treasurer Board of Certification for Emergency Nursing Management Board Secretary/Treasurer ENA Foundation Management Board ENA Board of Directors (Secretary/Treasurer, 2004)

STATE 2014-2015 2012-2013 2010-2011 2003-Present 2000 1999 1998

President, Oklahoma State Council Immediate Past President, Oklahoma State Council President, Oklahoma State Council Member, Oklahoma State Council Past President, Texas State Council President/CEO, Texas State Council President-Elect, Texas State Council

LOCAL 1998 1997

Past President, Dallas Co. Chapter, Texas President, Dallas Co. Chapter, Texas

OTHER 2007–Present Sigma Theta Tau International 2008–Present American Association of Critical Care Nurses What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? The attribute essential to the enhancement of ENA’s mission is commitment. Commitment to our mission, commitment to our members, and commitment to our patients and the public we serve. The mission of our organization is driven by our membership’s passion for providing care and compassion to their patients. Our board members should have the integrity and fortitude to listen to our membership’s request for the education and tools they need to continue their mission of providing safe practice and care to their patients. The board should insure continuation of our mission with sound business models, transparency, and fiduciary acumen.

CONFLICT OF INTEREST DISCLOSURE No conflicts disclosed.

Official Magazine of the Emergency Nurses Association

— Director — Marylou Killian, DNP, RN, FNP-BC, CEN

Mary Kelly Jagim, MS, RN, CEN, FAEN

CURRENT EMPLOYMENT

Moorhead, MN

Saint Francis Hospital Emergency Department

CURRENT EMPLOYMENT

EDUCATION

Chief Nursing Officer Infinite Leap

DNP -, 2011 MGH Institute of Health Professions, Boston, Massachusetts FNP - Post Masters, 1995 Russell Sage College, Troy, NY MS - (Nursing), 1991 Russell Sage College, Troy, NY BSN - 1985 Excelsior College (Formally University of the State of New York, Albany, NY RN -1975 Albany Medical Center School of Nursing

EDUCATION

NATIONAL 2014: Clinical Policy Guidelines Committee 2011-2013 ENA Board of Directors 2010: Course Administration Faculty 2003: State Issues Work group 2000: Chairperson Ethics Committee 1997-1998: Lead Editor- Standards of Emergency Nursing Practice Revision Task Force 1986,1992-1994,1996 -2010 General Assembly Delegate

STATE 2014: 2009- 2010, 1997 2006-2007, 1998 - 2004-2005 - 2003: 2003: 2002: 2001: 1998-2000: 1995:

Chairperson Advanced Practice Nursing Committee Member,- Conference Committee Chairperson- Conference Committee Chairperson-Professional Development Committee Chairperson- Professional Issues Committee Immediate Past – President New York State Council President New York State Council President –Elect New York State Council Treasurer New York State Council Pediatric Chairperson

LOCAL 2009-2010 2002-2008: 2001: 2000: 1993-1994: 1992: 1986-2000

Secretary Mid –Hudson Chapter Treasurer Mid- Hudson Chapter President Mid- Hudson Chapter President – elect Mid- Hudson Chapter President Adirondack Chapter President – Elect Adirondack Chapter Education Committee- Berkshire Chapter

OTHER

MS, Nursing, 2013-North Dakota State University BSN, 1984-University of North Dakota

PROFESSIONAL CREDENTIALS/CERTIFICATIONS CEN, FAEN, Lean Healthcare Green Belt

NATIONAL ENA 2003-2013 2008-2002 2001 2005-2006 2003-2006 2004- 2007 2002 2001-2003 1997, 2003 1994 – 1997

General Assembly, attended as Past President ENA Board of Directors ENA President ENA Foundation Chair ENA Foundation Board of Trustees Key Concepts in Emergency Department Management Curriculum Task Force Chair, Elections Process Committee Staffing Best Practice Work Group National Government Affairs Committee National Highway Traffic Safety Administration Injury Prevention Coordinating Committee

STATE, NORTH DAKOTA 1991-1995, 2002-Present 1995-1996 1996, 2003, 2005 2002, 2004

Government Affairs chair Nurse Practice chair President President Elect

OTHER 2012-Present 2003-Present 2012 2008 July 2006 2005 2004-2006 2001-2004

American Association of Nurse Executives Sigma Theta Tau International Technical Expert Panel, CMS ED Patient Survey National Quality Forum ED Consensus Standards Committee Testified before Congressional Subcommittee on the Emergency Care Crisis: A Nation Unprepared for Public Health Disasters Judy Kelleher Award Recipient Institute of Medicine Committee on the Future of Emergency Care in the U.S. Health System Nursing Organization’s Alliance Coordinating Team

American Association of Nurse Practitioners Nurse Practitioner Association of New York State Sigma Theta Tau 2003 New York State ENA Anita Dorr Award 1998 New York State ENA Special Recognition Award

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? I believe the most important and essential attribute to enhance ENA’s mission of Safe Practice and Safe Care is a commitment to emergency nursing and the patients we serve, above the needs of us as individuals. In order to be an effective leader, we need to put our personal needs and goals secondary to the needs and goals of the organization.

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? To enhance ENA’s mission of safe practice and safe care a person needs the abilities to: view situations from a global perspective; continually question the status quo; accept others feedback; reevaluate situations; and adjust plans accordingly.

CONFLICT OF INTEREST DISCLOSURE No conflicts disclosed.

CONFLICT OF INTEREST DISCLOSURE • Clinical advisor for TEVA Pharmaceuticals • ANCC External validation committee for the Emergency Nurse Practitioner portfolio certification program • Co-author of chapter in book on emergency medicine management published by McGraw-Hill

Information in candidate biographies published exactly as submitted by the candidate.

May 2014

— Director — Stephen J. Stapleton, PhD, MS, RN, CEN Normal, Illinois

CURRENT EMPLOYMENT Assistant Professor Mennonite College of Nursing at Illinois State University

EDUCATION PhD, 2010 University of Illinois at Chicago College of Nursing MSN, 1994 Aurora University BSN, 1982 Saint Louis University MS, 1980 Western Illinois University BS, 1979 Western Illinois University

PROFESSIONAL CREDENTIALS/CERTIFICATIONS CEN ENA Board Mentoring Program RN Core Competencies in Emergency Care Work Team Leadership Conference Institute for Emergency Nursing Research General Assembly Delegate

STATE 2013-2014 2011-2012 2009-2010 2009 2005-2007

Lexington, Kentucky

CURRENT EMPLOYMENT Operations Manager, Emergency Services University of Kentucky Chandler Hospital EMS Training Coordinator, Lexington Division of Fire and Emergency Services

EDUCATION ADN, 1978 Salem College, Salem, WV BSN, 1983 University of Kentucky, Lexington, KY MSN, 1990 University of Kentucky, Lexington, KY PhD, 2004 University of Kentucky, Lexington, KY

PROFESSIONAL CREDENTIALS/CERTIFICATIONS

NATIONAL 2013 2010-2011 2009-2013 2008-2009 2007-2013

Patricia Kunz Howard, PhD, RN, CEN, CPEN, NE-BC, FAEN, FAAN

Immediate Past-President, Illinois ENS State Council President, Illinois ENA State Council President-elect, Illinois ENA State Council Communications Committee Evidence Based Practice Committee

CEN; CPEN; NE-BC, TNCC Faculty; ENPC Faculty; ACLS Instructor, PALS Instructor, PEPP Course Coordinator

NATIONAL 2013, 2012, 1997, 1990-94 2013 2011-2012 2011-2012 2007-2010, 2000-03 2006-2008 2000-2006 1994-1999 1992-1993

General Assembly Delegate Chairperson, Trauma Committee Chairperson, Future of Nursing Workgroup SBIRT Regional Mentor ENA Foundation Board of Trustees (Chairperson, 2010) Crowding Workgroup (Chairperson) ENA Board of Directors (President, 2005) Annual Conference Committee (Chairperson, 1998-1999) Pediatric Committee (Chairperson, 1993)

STATE

OTHER 2010-Present BCEN CEN Exam Construction and Review Committee 2007-2009 BCEN CEN Item Writer American Nurses Association Midwest Nursing Research Society What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? Communication is key to Safe Practice and Safe Care. We use several forms of communication (verbal, non-verbal, and written) when we are at the stretcher-side working as a team while we assess and stabilize patients. We also use several communication formats when we are away from the stretcher-side to promote our practice through the media, legislation, evidence base practice & research.

CONFLICT OF INTEREST DISCLOSURE No conflicts disclosed.

Information in candidate biographies published exactly as submitted by the candidate.

2013 2000-2003 1998-2000, 1991-2 1996-1997 1994-1995 1993

Government Affairs, Kentucky State Council (Chairperson, 2013) Pediatric Committee Kentucky State Council (Chairperson) Treasurer, Kentucky State Council Education Committee Kentucky State Council (Chairperson) Trauma Committee, Kentucky State Council (Chairperson) President, Kentucky ENA State Council

LOCAL 1986-2004

Education Committee (Chairperson, 1988-2002), Bluegrass Chapter

OTHER 2011 2005-2008 2006-2010 1992-present

Judith A. Kelleher Award Member, Nursing Organizations Alliance Coordinating Team Member, ANA Congress on Nursing Practice and Economics Sigma Theta Tau, Delta Psi Chapter

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? Trust is critical to ENA’s mission of Safe Practice and Safe Care. Emergency nurses are trusted to care for patients during their most vulnerable life events. As such, emergency nurses should be able to trust evidence presented to them as members of a member organization, regardless of whether it relates to current best practice, fiduciary responsibilities, or advocacy events.

CONFLICT OF INTEREST DISCLOSURE No conflicts disclosed.

Official Magazine of the Emergency Nurses Association

— Director — Margaret (Peggy) M. McMahon, MN, APN. NP-C, CEN, FAEN

Sherri-Lynne Ann Almeida, Dr.PH, MSN, M.Ed, RN, CEN, FAEN

Williamstown, NJ

Houston, Texas

CURRENT EMPLOYMENT

Emergency Nursing Consultant

Senior Consultant Blue Jay Consulting Orlando, Florida

EDUCATION RN, 1966 – Philadelphia General Hospital School of Nursing, Philadelphia, PA BSN, 1973 – University of Pennsylvania, Philadelphia, PA MN, 1980 – University of Washington, Seattle, WA Post-Masters FNP, 2011 – University of Medicine & Dentistry of NJ, Stratford, NJ

EDUCATION

PROFESSIONAL CREDENTIALS/CERTIFICATIONS

CEN; TNCC & ENPC Instructor; FNP

CEN; FAEN; PALS; ACLS

NATIONAL 1975-1984, 1993, 1998-2013 General Assembly Delegate 2008-present Senior Clinical Editor, Journal of Emergency Nursing 2011-2012 Member, ENA Future of Nursing Work Group 2006-2007 Editor, Disaster Management & Response 2004-2005 Member, Academy of Emergency Nursing Work Group 2001-2003 Member, ENA Leadership Conference Committee 1999-2001 Member, ENA Work Group on Research Utilization 1997 Chair, ENA Task Force on Clinical Delegation 1994 Chair, ENA Task Force - Role on the Emergency Nurse 1993 Member, Scientific Assembly Committee 1988 Member, ENA Research Committee 1987 ENA President 1984-1985 Secretary, National ENA Board of Directors 1981-1983 Chair, EDNA Scientific Assembly Committee 1978 Chair, EDNA Nominating Committee

STATE 2012-2013 2013 NJENA 1997-2001 1990 1979-1983 1975-1979

NJENA Nursing Research & Practice Committee Emergency Preparedness Committee Member, NJENA Emergency Care Conference Committee Chair, WA State ENA Nurse Practice Committee President, WA State EDNA Chair, WA State EDNA Education Committee

LOCAL 2004 1998-1999 1989

Coordinator, Jersey Shore Emergency Nursing Course President, Jersey Shore Chapter Education Coordinator, Pacific Slopes ENA

OTHER 1995

National ENA Judith C. Kelleher Award

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? Integral to ENA’s accomplishment of its mission is a commitment to Service Leadership at all levels of the organization. Service Leadership embodies a philosophy and practices of caring for and about others as one’s first priority.

CONFLICT OF INTEREST DISCLOSURE

BSN, 1981 – Fitchburg State College, School of Nursing, Fitchburg, MA M.Ed, 1995 – Bridgewater State College, Bridgewater, MA MSN, 1990 – University of Texas – Houston, Houston, TX Dr.PH, 1998 - University of Texas – Houston, Houston, TX

NATIONAL 2013-2015 2010-2013 2010-2013 2009, 2000 2006-2008, 1997-1999 2003 2002 2001

Clinical Practice Guidelines Committee Annual Conference Planning Committee General Assembly Delegate ENA Board of Directors (Secretary/Treasurer) ENA Board of Directors Immediate Past President ENA Board of Directors President ENA Board of Directors President-elect ENA Board of Directors

STATE 1996 1995 1994 1993

Immediate Past President Texas State Council President Texas State Council President-elect Texas State Council Treasurer Texas State Council

LOCAL 2004, 1993, 1990 2003, 1992, 1990

President, Houston Chapter President-elect, Houston Chapter

OTHER Academy of Emergency Nursing American Association of Critical Care Nurses American College of Emergency Physicians - Public Health Committee American Organization of Nurse Executives American Nurses Association Sigma Theta Tau What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? ENA has worked to move our emphasis from addressing errors to promoting safety through widespread system changes. The message in To Err is Human was to prevent, recognize, and mitigate harm from error. Developing a culture of safety in learning organizations, understanding the limits of human factors, and appreciating the reasons for comprehensive reporting mechanisms are all essential attributes in the preparation of nurses to be participants in 21st Century healthcare.

CONFLICT OF INTEREST DISCLOSURE • Employed by Blue Jay Consulting who provides interim management and performance improvement services to emergency departments throughout the United States.

No conflicts disclosed. Information in candidate biographies published exactly as submitted by the candidate.

May 2014

— Nominations Committee — REGION 1 Robyn R. Larkin, RN, BSN, CEN

REGION 3 Terry M. Foster, MSN, RN, CCRN, CEN, CPEN, FAEN

Fruit Heights, UT

CURRENT EMPLOYMENT

Taylor Mill, Kentucky

ED Charge nurse/Educator Davis Hospital and Medical Center in Layton, UT

CURRENT EMPLOYMENT

EDUCATION

Critical-Care Clinical Nurse Specialist, Emergency Department St. Elizabeth Medical Center, Edgewood, Kentucky

BSN-2005 University of Phoenix ADN-1978 Weber State University

EDUCATION

PROFESSIONAL CREDENTIALS/CERTIFICATIONS CEN; TNCC Instructor; ENPC Provider; PALS Instructor; ACLS Instructor

NATIONAL 2005-2013

PROFESSIONAL CREDENTIALS/CERTIFICATIONS

Utah Delegate

CEN, CPEN, CCRN, ACLS Instructor, PALS Instructor, TNCC Instructor, ENPC Instructor

STATE 2010-2014 2007-2009 2005-2007

Utah State Secretary and Membership Chair Utah State President Utah State Secretary/Treasurer

LOCAL 1999-2006

No. Utah President/Secretary

OTHER 2005-Present 2003 1989

2012-2014 2011 2009 2001 2000-2001 1986-1987 1984

Nominations Committee Fellow, Academy of Emergency Nursing Recipient, Judith C. Kelleher Award Lifetime Achievement Award Member, National Membership Committee Member, Trauma Committee

Kentucky Emergency Nurse of the Year

LOCAL

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? ENA is the strongest advocating body for ED nurses. ENA promotes safe practice and care by being active in government affairs both nationally and locally by voicing concerns about health related practices transforming across the U.S.. By having 40,000+ members, it makes this body of nursing have a strong voice on a stance for safety in ED nursing care practice. No conflicts disclosed.

NATIONAL

STATE

Sigma Theta Tau Utah ENA Emergency Nurse of the Year EMS Award Nurse of the Year

CONFLICT OF INTEREST DISCLOSURE

MSN, 1997, Critical-Care & Trauma Nursing, University of Cincinnati, Cincinnati, Ohio BSN, 1994, Graceland College, Independence, Missouri RN Diploma, 1981, The Christ Hospital School of Nursing, Cincinnati, Ohio LPN, 1977, Booth Memorial Hospital School of Practical Nursing, Covington, Kentucky

2010-2014 2008-2011 2007 2002-2007 1993-1995 1990-2012 1990-2004 1986-1987 1985-1986

Member, Board of Directors, Greater Cincinnati Chapter Member, Emergency Nurses Day Committee Emergency Nurses Day Award, Greater Cincinnati Chapter Member/Faculty, Emergency Nurses Education Consortium Member, Workshop Committee, Greater Cincinnati Chapter Hospital Representative Chair, CEN Review Workshop Committee, Greater Cincinnati Chapter President, Greater Cincinnati Chapter Vice President, Greater Cincinnati Chapter

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? The success of the safe practice/safe care mission is contingent on nurses working in an honest environment where the admission of medical errors will not result in disciplinary action. Many nurses are afraid to report such incidents. There needs to be a culture of acceptance, encouragement and coaching for all emergency nurses who report adverse patient safety situations.

CONFLICT OF INTEREST DISCLOSURE No conflicts disclosed.

Information in candidate biographies published exactly as submitted by the candidate.

Official Magazine of the Emergency Nurses Association

— Nominations Committee — REGION 5 Lucinda W. Rossoll, MSN, RN, CEN, CPEN, CCRN

REGION 5 E. Marie Wilson, MPA, BSIT, RN Westbrook, Connecticut

Lebanon, New Hampshire

CURRENT EMPLOYMENT

Consulting Parliamentarian Self-employed

Bedside Registered Nurse Alice Peck Day Memorial Hospital, Lebanon, New Hampshire

EDUCATION

EDUCATION BA, 1974, University of New Hampshire, School of Liberal Arts, Durham, New Hampshire BSN, 1980, University of Rhode Island, School of Nursing, Kingston, Rhode Island MSN, 1980, University of New Hampshire, School of Nursing, Durham, New Hampshire

PROFESSIONAL CREDENTIALS/CERTIFICATIONS CEN; CPEN; CCRN; TNCC Instructor; ENPC Instructor; PALS; ATCN Provider

NATIONAL 1998, 2002, 2005, 2007-2013 Nominations Committee 2012-1014

General Assembly Delegate

STATE 2004-2012

Treasurer, New Hampshire Council of the Emergency Nurses Association

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? Being a strong, educated leader who is dedicated to safe patient care is essential to promoting ENA’s mission of Safe Practice and Safe Care. This leader can be an individual, a group of individuals including members of our organization or more importantly, our organization working as a whole. I will address this issue using our organization as an example, but the following attributes could be applied to an individual or a small group. We (ENA) need to be articulate and to be able to work within the financial constraints that are becoming more common. To accomplish this we need to become more innovative and flexible without compromising patient care. ENA needs to be a leader and work with the organizations that continue to put constraints on our care without input from those who practice at the bedside. This may mean revisiting some of our nursing practices, looking to see if they are indeed evidenced based and contribute to safe patient practice and care. With these attributes ENA can continue to be a leader in promoting safe practice and safe care in the future.

CONFLICT OF INTEREST DISCLOSURE No conflicts disclosed.

1985, MPA, University of Hartford, West Hartford, Connecticut 1982, BSIT, Central Connecticut State University, New Britain, Connecticut 1958, Diploma, Union Memorial Hospital, Baltimore, Maryland

PROFESSIONAL CREDENTIALS/CERTIFICATIONS NATIONAL 1999-2001, 2004, 2010-2014 Resolutions Committee (Chairperson 2001 and 2013) 2001 Task Force on Elections Process 1999 End of Life Work Group 1993-1994 EMS Committee (Chairperson, 1995-1996) 1988 Ad Hoc Committee on Elections, Chairperson General Assembly Delegate, numerous years 2008,1993.

STATE (TWO-TIER STATE) 1993 1994 1992-1998 1995-2000 2000-2003

Connecticut State Council, Vice-President Connecticut State Council, President Connecticut State Council Board of Directors Journal of Emergency Nursing, EMS Section Editor Journal of Emergency Nursing; Assistant Editor

OTHER 2008 2008

Certified Professional Parliamentarian #225, American Institute of Parliamentarians Professional Registered Parliamentarian, National Association of Parliamentarians

What attribute is essential to enhance ENA’s mission of Safe Practice and Safe Care? The essential attribute to enhance ENA’s mission of safe practice and safe care is the ability to look at all aspects of our practice in a holistic way. Just as holistic nursing encompasses the physical, mental, and socioeconomic aspects of our patients’ care, these same powers of observation and analysis can be used to take a fresh look at our professional organization.

CONFLICT OF INTEREST DISCLOSURE • Work periodically for A Great Meeting, Inc., the provider of parliamentarian services to ENA. I work as a contracted provider of personal services, principally creating documents and copywriting. I hold no management or ownership position with the company.

Information in candidate biographies published exactly as submitted by the candidate.

May 2014

ENA FOUNDATION

The Fabric of Stronger Leadership Training at ENA Conferences Made Possible Thanks to Tapestry Scholarship By Amy Carpenter Aquino, ENA Connection

he Leadership Tapestry Scholarship is one of the ENA Foundation’s professional development education scholarships designed to meet member needs for short-term, focused education. Created in 2008 by Cindy Lefton, PhD, RN, in honor of Denise (King) Bayer, MSN, RN, CEN, FAEN, the scholarship covers conference registration fees, travel and hotel accommodations and minimal expenses for recipients. ‘‘I think Denise had a really important message about leadership and how important it was to nurses at all levels,’’ said Lefton, a clinical education specialist at Barnes-Jewish Hospital in St. Louis, who created the scholarship the year Bayer was ENA president. ‘‘It was something she was really passionate about and a good message for the membership.’’ Bayer, a vice president at Blue Jay Consulting, said exposure to leadership training is vital for new nurse leaders, as many do not receive that type of professional development from their employers. Often the best clinicians are promoted to leadership positions without receiving the necessary education or support around leadership development. ‘‘A lot of leaders do learn by trial and error and by being thrown into the fire, if you will, and that’s a really hard way to learn a skill,’’ Bayer said. ‘‘You hope that you would come by it

2014 Leadership Tapestry Scholarship recipients met scholarship founders Denise Bayer, MSN, RN, CEN, FAEN (third from left), and Cindy Lefton, PhD, RN (second from right), at the Leadership Conference in Phoenix. From left: Ann B. Townsend, DrNP, RN, ANP-C; Molly Bridget Delaney, PhD, MBA, RN, CEN, CPEN; Kelly Mills, BSN, RN, CEN; and Angela Hodge, MSN, RN, ACNS, CEN, CHEP, EMT-P. naturally to a certain degree, but whether you do or don’t, we all would benefit from some formal education around leadership in our roles.’’ Bayer added that she hoped that ENA will maintain a strong leadership focus at its annual national conference, which will be called the Emergency Nursing Conference beginning in 2015. ‘‘I believe that people stepping into leadership roles really need that,’’ she said. Lefton said leadership education is critical to the evolution of emergency nursing, especially in this time of major changes in health care delivery. ‘‘Every specialty organization, at some point, is going to come to the health care reform table with some ideas on how all this should be structured,’’ she said, ‘‘and emergency nursing needs to be there and they need leaders to be there — not only at the table but taking all of that information and disseminating it down to the stretcherside nurse.’’

Leadership development will be important at all levels of emergency nursing, from those sitting at the table to those leading from the stretcherside, Lefton continued. ‘‘You’re not going to have any say if you don’t make an ongoing commitment to educate, to allow people to grow and develop, and that’s the purpose of this scholarship,’’ she said. Two 2014 Tapestry Scholarship recipients, who attended the Leadership Conference in Phoenix on March 5-9, shared how receiving the scholarship helped their professional development:

recently accepted a position as an ED resource nurse educator. Over the past several months prior to my arrival, the ED had undergone some management and staffing changes. My goals for attending the ENA Leadership Conference were to become a TeamSTEPPS® trainer and initiate TeamSTEPPS to my ED group; to begin

May 2014

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Call for Nominations: 2015 ENA Foundation Board of Trustees Application deadline is June 1. Visit enafoundation.org for more information. group of those hurting as well. It hurts us all to know we want to do the right thing but don’t always have the time to give every patient everything he or she wants. I learned that ENA cares about us and wants to help. I learned that resources are tight everywhere. I watched a movie that gave me hope — hope in knowing that we are not alone. Phoenix was a breath of fresh air

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• Reviewed by leading toxicologists, including editing by Rick Dart, M.D., Immediate Past-President of the American Association of Poison Control Centers and a Deputy Editor for Annals of Emergency Medicine. • Special section on anaphylaxis. • You won’t find help on management of severe envenomation in the drug literature, but you’ll find it here.

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never dreamed I would go to the ENA Leadership Conference in Phoenix. It was like going to a weekend spa for my emergency nursing career. I could relax and learn about the ED topics that ‘‘called’’ to me. It changed my view about transparency. One suggestion was to mount a suggestion box for staff and open it at staff meetings. Staff know that any concern they put in it will be addressed in front of all. I learned it is OK not to have all the answers and to laugh at ourselves. I learned that other ED nurse managers have the same problems I do and that everything that goes wrong is not my fault. I learned details about how teamwork can help reduce variation and that teams can also provide loyalty, support and camaraderie. I heard others voice their frustrations and felt I was in a support

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a platform of research and evidencebased practice in the ED; and to gain knowledge through networking with other ED leaders and educators in the areas of professional development. The ENA Foundation scholarship provided me with the opportunity to attend the conference in Phoenix to achieve these goals. I can honestly say that I would not have been able to attend at this time without the ENA Foundation support. Once I got to the conference, I learned so much from the poster presentations, the research lounge and the lectures. I found ENA to be an organization with engaged leaders and other passionate members who are committed to the emergency care of populations, wherever these needs exist. I am grateful for the opportunities that the ENA Foundation scholarship afforded me. — Ann B. Townsend, DrNP, RN, ANP-C, New Jersey

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“This needs to be on the resource shelf in every Emergency Room and Intensive Care Unit in the country.” – Ed Hall, M.D., F.A.C.S., C.W.S., South Georgia Surgical Associates

Official Magazine of the Emergency Nurses Association

DEVELOPMENT

GROWING FROM THE WORD ‘GO’ “ENA is a really great opportunity to impact health care on a large scale. What better way to do that than with those who are our front-line entryway to health care for a lot of people — through our emergency nurses?’’

New Chief Development Officer Wastes No Time Taking Members’ Pulse By Amy Carpenter Aquino, ENA Connection

magine being welcomed to your new job by more than 1,000 stakeholders. That was the experience for Terrence Sykes, who spent his first two days as ENA’s new chief development officer at Leadership Conference 2014 in Phoenix. ‘‘It was really fun in the sense that I got to meet people right away and see what was important to them,’’ Sykes said from his office at ENA national headquarters in Des Plaines, Ill. He particularly delighted in time spent walking with members to and from the convention center and the opportunity to ask, ‘‘Tell me, why are you a member?’’ Having members share their stories about what ENA has meant to them throughout their career, talking to exhibitors on the Exhibit Hall floor and sitting in on educational sessions all gave Sykes a well-rounded snapshot of how the organization makes an impact on the profession of emergency nursing. ‘‘I was really grateful to meet everybody,’’ he said. ‘‘Everyone was just very kind and gracious and didn’t hold me to remembering all the names of people I had just met. I met some good people and appreciated interacting with the board. Everybody has been really excited about where we can go, where we can take this and how we can best support our membership through the foundation.’’

TERRENCE SYKES, New ENA Chief Development Officer

Determining how to make the most lasting impact has been Terrence Sykes’ goal since entering the development profession 17 years ago. He credits professors who inspired him to think about how he could affect his community — particularly one who challenged him to explore how he could build on and improve what was around him. ‘‘She said, ‘You know, Terrence, it’s not important what kind of house you have or what car you drive … but really, what did you put back in the life of other people?’ ” he said. ‘‘So I’ve always tried to do that in my development profession.’’ Sykes’ career has included roles as executive director for the United Way of Kankakee County in Illinois and vice president of development for Advocate Christ Medical Center and Hope Children’s Hospital in Oak Lawn, Ill.,

as well as development positions with Ronald McDonald House Charities and the Chicago Zoological Society. He credits his first job after college, in the management program at Enterprise Rent-A-Car, with getting him where he needed to be mentally. ‘‘I can remember coming out, and I had a suit on, and they said, ‘We need you to go out back and clean a car.’ I said, ‘Excuse me, did I hear you right?’ ’’ he said, laughing. ‘‘But I learned an awful lot of what it meant to be on a team, why it was important and how everybody has their role. It really helped shape my idea of my role as part of a team and my responsibility as a manager, so I was grateful for that experience.’’ Sykes’ new role at ENA, where he leads both the ENA Foundation and the ENA development team, will call on him to put all his experience into play. ‘‘I see a more visible foundation. I see a more robust foundation,’’ he said. ‘‘I see us getting more donors, challenging ourselves to be more and standing on the shoulders of the folks

May 2014

who came before us. Partnering with the ENA Board of Directors and the Foundation Management Board, I’m excited because I see there’s a lot of opportunity for us to grow, and that’s what I hope to bring — a consistent growth that makes everybody happy when they see the revenue.’’ Sykes looks forward to capitalizing on the strengths of ENA and the ENA Foundation — which he identifies as the devotion and energy visible in the boards, staff and membership — and facing the challenges of the current economic climate. ‘‘How do we best meet the needs of our members, best meet the needs of people when it comes to providing them with safe care and providing our nurses with [resources for] safe practice? How finances play a role in that is a challenge,’’ he said. The other challenge he sees is increasing the visibility of ENA and the ENA Foundation, in ensuring that

people are aware of the role the organizations play every day in providing safe practice and safe care. Asked what success would look like for the ENA Foundation and ENA development, Sykes pointed to opportunities for growth in ENA’s membership in relation to what the foundation can produce in scholarship and research grants; steady growth in annual giving dollars, major gifts and planned giving; and exhibits and sponsorships growing in a way that is meaningful to the organization. All of which brings Sykes back to the lesson from that professor who challenged him to build, grow and make an impact on his community. ‘‘For me, ENA is a really great opportunity to impact health care on a large scale,’’ he said. ‘‘What better way to do that than with those who are our front-line entryway to health care for a lot of people — through our emergency nurses?’’

Challenge Ends May 31 The ENA Foundation’s 2014 State Fundraising Challenge, ‘‘Building a Strong Foundation,’’ which kicked off Feb. 1, will conclude May 31 with a goal of raising a combined $125,000. Every dollar of State Fundraising Challenge donations will be used to fund 2015 ENA Foundation scholarship and research grants advancing emergency nursing education and research. Help your state stack up by donating at the ENA Foundation website, www.enafoundation.org. (Be sure to designate your gift for the State Fundraising Challenge.) You can check on your state’s progress at any time using the totals board. Please remember: While it’s a competition, it’s really about 50 states working together to lift the profession of emergency nursing.

ENA Foundation State Fundraising Challenge Building a Strong Foundation February 1 – May 31

How will your state stack up?

þ þ þ

Largest percentage increase per capita Largest number of individual donations per state Can your state raise more than $5000?

One Month to Go! 2014 State Fundraising Challenge visit www.enafoundation.org

ENA Foundation State Challenge_Connection_half_05 2014.indd 1

Official Magazine of the Emergency Nurses Association

3/25/14 3:55 PM

State and Chapter Leaders Conference

REACHING WITHIN, THEN REACHING OUT Emergency Nursing Leaders Get a Course in Connecting With Legislators, Members By Kendra Y. Mims, ENA Connection

NA state council and chapter leaders had the opportunity to attend informative educational sessions and network with their colleagues at the 2014 State and Chapter Leaders Conference on March 6 in Phoenix, ahead of Leadership Conference 2014. Richard Mereu, ENA chief government relations officer, Ken Steinhardt, ENA government relations director, and Susan Rajkovich, ENA marketing director, presented sessions on advocacy topics. During the ‘‘Advocacy Strategy’’ session, Steinhardt talked about the importance of building relationships with lawmakers. He reminded attendees that advocacy isn’t just about informing lawmakers

on the issues — it’s also about establishing credibility with them and building a relationship. ‘‘Advocacy is any source of effort you give to influence public policy — it’s about achieving specific outcomes, whether it’s to enact a new law or stopping legislation that will affect you,’’ Steinhardt said. ‘‘You are advocating to change something that affects your lives on a daily basis. You don’t want policies dictated to you — you want to get your voice heard and be able to shape policy. We wouldn’t have laws that it is a felony to assault an emergency nurse without your efforts.’’ Rajkovich discussed the importance of working with the media during an advocacy campaign to deliver a message. She reminded attendees that the key to effective media strategy is to involve the media in the process from the beginning. ‘‘Working with the media can be highly effective in advocacy, especially

when working with a larger audience,’’ she said. ‘‘Media is an integral part to your advocacy campaign. You want to make sure you know your media. Know who the health care reporters are in your state. Meet them early on in the process. Build a rapport with them so that we can get you a lot of media coverage further down the line. The media would love to talk to you. They want to know with the issues are.’’ Rajkovich also encouraged the use of social media, such as establishing campaigns on Twitter and YouTube to reach out to the public or using the power of social media during a hearing (i.e., creating a hashtag). Attendees interacted, shared ideas and asked questions as they walked through a hypothetical scenario that involved tactics to change workplace violence and raising assault of an emergency nurse from a misdemeanor to a felony. Steinhardt encouraged attendees to use EN411 (located at www.ena.org),

May 2014

which contains an advocacy toolkit and other pertinent information, such as how to write letters to legislators. He also shared tips on meeting with elected officials. ‘‘In your first meeting, you also have to build your case: Why is this important? How can this help emergency nurses?’’ he said. ‘‘Share ENA research on workplace violence. Whenever you can give actual facts and hard data, it helps. It makes people comfortable with moving forward. ENA is the one group that leads when it comes to research on WPV.’’

• Facebook: ‘‘It is great for branding, is highly visible and integrates with nearly everything,’’ Barbee said. ‘‘There are a lot of ways to deliver information.’’

Member Engagement

• Twitter: ‘‘It’s great for events and up-to-the-second news. It works really well when you’re doing an event or a live educational session because of the hashtag. If you want to categorize your event, use the hashtag. You will get results based on that hashtag.’’

State council and chapter leaders learned how to engage members from a multigenerational aspect, use different social media outlets to reach new members and use career wellness to motivate members in the ‘‘Member Engagement’’ session of the conference. Maureen Howard, ENA’s director of Member and Course Services, addressed the challenges and needs of baby boomers, Generation X and Generation Y and how recognizing the differences among the three groups can help when recruiting new members and retaining current ones. ‘‘Baby boomers like to lead and leave a legacy,’’ Howard pointed out. ‘‘They like to talk and explain everything thoroughly. Generation X wants to further their careers and communicate through e-mail, and Generation Y is looking to learn from others. They like to [communicate] through Facebook and Twitter.’’ Howard described the challenges each generation faces: Baby boomers face job dislocation, health care costs and retirement fund shrinkage. Generation X, a sandwich generation, is dealing with debt. Generation Y is also dealing with debt as well as unemployment. ‘‘We need to understand the challenges others are facing so that we can understand them and reach out to

• Google Plus: “The more posts or YouTube videos you make, the more you increase your visibility. It’s a great tool to reach beyond your core membership.’’ • LinkedIn: ‘‘I think it’s the best choice for professional outreach. It’s fully engaged in overall career advancement.’’

them,’’ Howard said. ‘‘We want to target solutions to these challenges so they can see the value of joining.” When it comes to recruiting new ENA members, Howard said baby boomers are very loyal and will join more easily than Generations X and Y. ‘‘We need to build a relationship with Generations X and Y before they sign up,’’ she said. ‘‘As they gain that trust in us, they’ll move forward with us.’’ Thomas Barbee, ENA’s digital marketing manager, discussed social media outreach and how to use it to keep members engaged. Attendees learned about the differences between Facebook, Google Plus, Twitter, LinkedIn and e-mail services and what each social media service has to offer.

Official Magazine of the Emergency Nurses Association

Several attendees shared how their chapters are using social media to engage members and keep them informed. Bridget Walsh, ENA’s chief talent officer, discussed career wellness and how ENA is looking at the career needs of different generations to help them with their professional development, whether the member is an emerging professional, emerging leader, seasoned professional or a retiree. ‘‘It’s important to keep all these generations engaged and use what these generations bring to your workplace and membership,’’ Walsh said. She encouraged attendees to share ENA’s career wellness resources with their members. ‘‘It’s about taking an active focus on your career so that you can prepare for the unexpected,’’ she said. ‘‘We want people to think about what they want to do each year. It’s about taking an annual career checkup. Encourage your members to look at what they’ve accomplished, what they want to accomplish and how ENA can help them.’’

State and Chapter Leaders Conference

Kathleen A. Hanson, RN, CEN (far left) discusses the power of passion for ENA while sharing the stage with fellow “ENA View” panelists (from left) Kara L. Davis, BSN, RN, and Louise Hummel, MSN, RN, CEN, CNS, FAEN, and 2014 ENA President Deena Brecher, MSN, RN, APN, ACNS-BC, CEN, CPEN.

‘ENA View’ From Three Different Angles By Kendra Y. Mims, ENA Connection

ttendees learned from three leaders with different backgrounds March 6 during ‘‘The ENA View,’’ a panel session hosted by 2014 ENA President Deena Brecher, MSN, RN, APN, ACNS-BC, CEN, CPEN. Brecher was joined by Kara L. Davis, BSN, RN, California ENA State Council government affairs chairperson, Kathleen A. Hanson, RN, CEN, Arkansas ENA State Council secretary and Louise Hummel, MSN, RN, CEN, CNS, FAEN, ENA Nominations Committee chairperson.

Hummel’s view Hummel discussed ways to increase member involvement for elections and shared findings from a survey the Nominations Committee sent to state council presidents and presidents-elect. ‘‘The purpose of this was to help the Nominations Committee identify best practices and opportunities related to the election process, not only at the state level but also at the

national level,’’ Hummel said. She discussed best practices identified, including offering a mentor opportunity/program for those interested in candidacy, incentive programs for voting and alternative methods for voting participation.

Davis’ view Davis talked about ways to engage in legislative advocacy and encouraged the audience to use ENA’s website to obtain advocacy resources and to join ENA’s ‘‘EN411’’ legislative network. ‘‘We need you to be plugged into this and when we send out the alerts,’’ Davis said. “We’re asking for your response, whether it’s a phone call or writing a letter to the legislator to support our position. We want you to be engaged. We provide templates so you don’t have to recreate the wheel.’’ Davis also discussed the importance of networking, sharing business cards and asking questions. ‘‘It’s OK to ask how to get involved and why you should,’’ she said. ‘‘I’m here to be a resource and share any

information that I have. ENA is here to share resources with you, and so are our government advocacy people.’’

Hanson’s view Hanson encouraged attendees to be deliberate in how they gain membership and to be an inspiration. She urged showing passion for ENA. ‘‘Why did you join ENA? What was in it for you?’’ she said. ‘‘It’s an investment in your career. Knowing the goals of that future member and sharing how ENA can help them reach their goal is incredibly effective.’’ Hanson reminded attendees that they are the voice and face of ENA: ‘‘As members of ENA, we all know the benefits of membership and we’re familiar of the difficult yet rewarding work that we do at ENA. We need to create opportunities of success for these new and non-members. ENA gives us the knowledge to continue to grow in our nursing career. It is the fuel for our fire. We all know what ENA can do for us. Now we just need to share it with other people.’’

May 2014

State and Chapter Leaders Conference

SIX WORK THE IGNITE SHIFT E NA leaders watched their colleagues deliver fast-paced presentations on the subject of change during Ignite Sessions at this year’s State and Chapter Leaders Networking Reception. Six participants were given five minutes each to address the crowd using 20 PowerPoint slides that automatically advanced every 15 seconds. These were the six participants who were up for the challenge: • Kathleen Hanson, RN, CEN, Arkansas, shared her nursing journey, including challenges and changes she overcame. • Tiffiny Strever, BSN, RN, CEN, Arizona, discussed leadership qualities that can guide a team to make a change.

• Nicholas Chmielewski, MSN, RN, CEN, CNML, NE-BC, Ohio, talked about the importance of feedback and how change requires feedback.

• Ron Kraus, MSN, RN, CEN, Indiana, talked about the eight steps of change and how change is the future. • Cam Brandt, MS, RN, CEN, Texas, focused her discussion on change and finding her purpose as an ENA member. • Terry Foster, MSN, RN, CEN, FAEN, Kentucky, talked about the changes in nursing over the years and how the only constant in the emergency department is change. The audience was encouraged to

Cam Brandt, MS, RN, CEN, presents her Ignite Session before a crowd of fellow state and chapter leaders. place money in a hat after each speaker presented, with the donation applied to that speaker’s state for the ENA Foundation State Fundraising Challenge. The six Ignite Sessions raised a total of $551 in support of the ENA Foundation. Kendra Y. Mims

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Official Magazine of the Emergency Nurses Association

® PROTECTING PEOPLE AT WORK

Night at the Movies

PEOPLE WATCHING

For ‘Waiting Room’ Director, Human Element Was Critical By Kendra Y. Mims, ENA Connection

he first time Thelma Kuska, BSN, RN, CEN, FAEN, watched ‘‘The Waiting Room,’’ she found herself focused on how the emergency personnel were portrayed. She saw kind, professional and caring ED staff who treated the patient population they served with compassion. When Kuska watched the documentary for the second time at the ENA Foundation event in Phoenix, she saw it in a different light. ‘‘I was more aware of the bigger picture,’’ she said. ‘‘I still saw how compassionate the staff was, but I am in their shoes now more than ever. I could feel their frustration that they are unable to provide their patients with immediate follow-up care. I feel the triage nurse’s feelings when she talked to the young man and admonished him for being disrespectful. ‘‘I saw our life in the ED, on another day, with the same kinds of patients. I saw that we all share the

same experiences whether we are on the West Coast, East Coast or the Midwest. The movie is thoughtprovoking, especially with what we are facing right now with the health care issues.’’ More than 300 people attended the ENA Foundation Night at the Movies event March 6 to watch a private screening of ‘‘The Waiting Room,’’ a compelling inside look at a public hospital’s ED waiting room in Oakland, Calif. Attendees also participated in an exclusive Q&A segment with the film’s director, Peter Nicks, who chatted with ENA Connection about what moved him to create the film and what he wanted emergency nurses to take away. Nicks’ inspiration for the film developed in the late ’90s, he said. When his wife landed her first job as a hospital speech pathologist, Nicks had an intimate perspective on patient stories and discovered the profound relationship between the patients and the hospital caregivers.

Director Peter Nicks He became purely interested in telling a human story, he said, and he wanted to use the film to reframe the discussion about health care in a more human context. ‘‘It has become so politicized that we all kind of lost perspective on what is really at stake and what the story is really about, which is all of us, whether we have insurance or not,’’ he said. ‘‘One of the things we noticed early on in the filming that inspired us — and what we wanted to have the film reflect — was the remarkable empathy of the caregivers in this institution that’s underfunded, where people are working on a shoestring trying to solve really complex problems without the resources that they need, and doing so with a compassion and empathetic hand that we found quite surprising and remarkable.’’ Nicks said the triage nurse in the

Nicks fields emergercy nurses’ questions with Seleem Choudhury, MSN, MBA, RN, CEN, the 2014 ENA Foundation chairperson.

May 2014

film, C.J., symbolizes the type of caregiver patients want and the kind a lot of people aspire to be. There’s a lot of conversation in public hospitals about customer service, the relationship between the caregiver and the patient and human connection, he said. He wants the film to remind audiences about the power of that human connection, the listening ear and the ability to look at somebody as a human being, whether he or she is homeless or the mayor of Oakland. ‘‘Treating everyone the same is something that everyone deserves and is something that I think our health care system as a whole needs to aspire to more,’’ he said. Nicks said he was honored that the film was selected to be screened for the ENA Foundation event. ‘‘That’s why we made the film, to start these conversations and to get people engaged,’’ he said. ‘‘Most of the places we’ve screened have been

general audiences. Those audiences responded to it really powerfully, but when we show it to caregivers, it’s even more special because they work really hard every day in the trenches. You don’t often get that perspective on the work they do and being reminded why it matters.’’ Seleem Choudhury, MSN, MBA, RN, CEN, the 2014 ENA Foundation chairperson, described the film as powerful and empathetic. ‘‘It overturned the rock that politicians have ignored,’’ Choudhury said. ‘‘It showed raw emotion and

allowed us to get inside the patient, family and clinician, thus reaffirming what we as nurses and doctors have been saying for so long, that emergency departments around the country are propping up a broken system.’’ Nicks said ‘‘The Waiting Room’’ is a reminder of why caregivers do the work they do, though it’s not easy. ‘‘I think for us, it’s always great to celebrate that and show people that,’’ he said. ‘‘It’s not that it’s a celebratory film overall. There are a lot of problems in our system. One of the things that we say is that our system may be broken, but the people are not. I think particularly the people, the caregivers on the frontlines of our health care system, are going to lead the way in showing what’s possible as we go through these massive changes in our health care system. If our film can play one small role in that, then we’re proud of that.’’

Click. Shop. Done. • Leadership books, study guides and reference books • ENA merchandise – apparel, pins and more • Member discounts

Order online 24/7 at www.ena.org/shop ENA Marketplace Ad_Connection_half_05 2014.indd 1

Official Magazine of the Emergency Nurses Association

3/26/14 10:10 AM

Opening Session

ENA 2014 President Deena Brecher urged Leadership Conference attendees to use the media and look out for each other.

‘Making Safety Our No. 1 Priority’ President Intensifies Focus on Workplace Violence, Errors

eena Brecher, MSN, RN, APN, ACNS-BC, CEN, CPEN, ENA 2014 president, kicked off the Opening Session of Leadership Conference 2014 on March 7 by addressing workplace violence and its impact on emergency nurses. Brecher said two stories she heard from attendees made her realize there’s still a lot of work to be done to advocate for safe practice, safe care. One story involved a young nurse chased down by a patient after work and shot in the head. ‘‘The issue of workplace violence impacts all of us in this room, whether we’ve been a victim, a witness or we’ve lost a team member and friend,’’ Brecher said. ‘‘As we continue to research the extent of the problem, identify causes and potential effective interventions, we need to continue to share our stories

and bring attention to the issue.’’ Brecher encouraged attendees to use the media to raise awareness. She showed a clip from a TV news report that aired in Washington, D.C., and northern Virginia in which she was interviewed about caregivers becoming targets of violence from patients and visitors. ‘‘This is not part of being an emergency nurse — this is unacceptable behavior,’’ Brecher told the reporter in the video. The report also used ENA’s research, quoting statistics about workplace violence incidents in the ED. The second story Brecher shared was about an emergency nurse who recently took her own life after she made a medication error. Fourhundred thousand patients die every year as a result of errors in hospitals, Brecher said. She reminded attendees to advocate for a safe culture. ‘‘Sometimes we forget these errors have a huge impact on our colleagues, our friends and families as well,’’ she

said. ‘‘We need to learn to watch each other’s back in the ED to decrease the likelihood of making a mistake. We need to speak up when we see a mistake that’s about to happen. Most importantly, we need to support each other when we find ourselves at the sharp end of an error.’’ Brecher read a letter that ENA received from U.S. Rep. Renee Ellmers (R-N.C.), a registered nurse for more than 21 years, expressing her excitement about ENA’s work. Ellmers asked emergency nurses to speak up and get involved to advance commonsense policies and protect health care for future generations. ‘‘I believe her letter highlights the very important role emergency nurses play in advocating for safe practice and safe care,’’ Brecher said. ‘‘Safe practice starts with each of us taking ownership for our unsafe behaviors at bedside and making safety our No. 1 priority. Let’s honor these nurses by changing our practice.’’ Kendra Y. Mims

May 2014

ENA Foundation in the Business of Building Futures

Executive Director: Members’ Needs Are Our Mission

NA Executive Director Susan M. Hohenhaus, LPD, RN, CEN, FAEN, shared highlights, updates and coming attractions as she gave attendees an inside look at what was happening at ENA headquarters. Hohenhaus said monthly staff meetings at the ENA national office always begin with a focus and reminder of ENA’s mission, which is to advocate for patient safety and excellence in the emergency nursing practice. ‘‘We do that in a lot of ways, but the first one is in finding the ways to best support our members and to grow the membership,’’ she said. ‘‘We also know that those 40,000 members [40,327 from the January report] represent 180,000 emergency nurses in the U.S. alone. We also remember that we have international colleagues who belong to our organization and rely on the standards that ENA sets, so we have a lot of responsibility in our headquarters office.’’ Hohenhaus shared statistics from ENA’s major courses. In 2013, 15,526 students took the Emergency Nurse Pediatric Course, demonstrating its significant growth over the last four years. Trauma Nursing Core Course broke the 50,000 mark with 50,553 students in 2013. Hohenhaus also highlighted the significant accomplishment of the Geriatric Emergency Nursing Education online course, fully owned and deployed by ENA, and talked about ENA’s research initiatives, including two important bodies of work ENA has produced in the last year. One, an article in

January’s Journal of Emergency Nursing related to stories of workplace violence, is entitled ‘‘Nothing Changes, No One Cares: Understanding the Experience of Emergency Nurses Physically or Verbally Assaulted While Providing Care.’’ A second article, submitted to JEN and based on a national survey of emergency nurses, is entitled ‘‘Identifying Challenges and Facilitators in the Management of Behavioral Health Patients in the Emergency Department: A National Study.’’ Some coming attractions include a JEN reader survey, which will be followed by an ENA member needs assessment and a survey to address the needs of Academy of Emergency Nursing fellows. ‘‘We really do want your feedback on the next things we need to begin developing, particularly as we go into our new 2015 Strategic Plan,’’ Hohenhaus said. ‘‘Once the strategic plan is in draft form, it will be published for public comment for you to respond to. ‘‘We thank you very much and we want you to remember that if there’s anything we can do for you, please let us know. And thank you for what you do every day.’’ Kendra Y. Mims

eleem Choudhury, MSN, MBA, RN, CEN, 2014 ENA Foundation chairperson, talked about the mission of the ENA Foundation — providing educational scholarships and research grants in the discipline of emergency nursing — and how donations made to the foundation can benefit ENA members. Professional development scholarships allow members to attend conferences, academic scholarships let them advance their careers through education, and research grants advance emergency nursing. ‘‘Thanks to generous donations received in 2013 from ENA members, friends of emergency nursing and our corporate partners, we are pleased to offer you and all ENA members over $235,000 in scholarships and research grant opportunities this year,” Choudhury said. His construction helmet symbolized the theme of the ENA Seleem Foundation’s 2014 State Choudhury Fundraising Challenge, ‘‘Building a Strong Foundation.’’ He encouraged attendees to help their states by donating to the campaign, with every penny directly supporting scholarships and research grants in 2015. Choudhury presented Julie Jones, BS, RN, CEN, the 2013 ENA Foundation chairperson, with an award and expressed gratitude for her mentorship, volunteerism and commitment to the foundation. ‘‘Most of all, I want to thank you … the ENA member,’’ Choudhury said. ‘‘You, your ENA friends and our corporate partners are the reason behind our success and our ability to support education, professional development of emergency nurses and the implementation of evidence-based research. This is your foundation, and we are here for you.’’ Kendra Y. Mims

Official Magazine of the Emergency Nurses Association

Opening Session

Lose Your Illusions Getting Ahead of Adverse Events Means Changing Your Mind-Set By Kendra Y. Mims, ENA Connection

pening Session keynote speaker Gloria Donnelly, PhD, RN, FAAN, FCCP, spoke to conference attendees about the everyday illusions that lead to adverse events in health care and strategies that can help to ensure patient safety. Donnelly said she became interested in error 30 years ago and has been reading about and studying error her entire career. She shared an encounter she had with a student while working in staff development at a psychiatric hospital in Philadelphia in the late 1970s. The student was there for practice experience and was terrified because she had given an aspirin to the wrong patient. Donnelly expressed her gratitude to the student for admitting her error and keeping her integrity. She had the student fill out an incident report and encouraged her to look at the incident as a learning experience. When the incident report from the student’s instructor came across Donnelly’s desk two days later, she then understood why the student had been so worried. ‘‘I’ve never forgotten seeing that report because the emphasis was not on patient safety,’’ she said. ‘‘That was not No 1. The emphasis was on punishing the student and not using it as a learning opportunity.’’ She challenged attendees to examine the ways in which they process information and respond to

Gloria Donnelly, PhD, RN, FAAN, FCCP, shares her message about error in the ED. people in their environment who create illusions that lead to error. Illusions that emergency nurses face on a regular basis include the illusions of attention, memory, confidence, knowledge and cause. ‘‘Adverse events in health care are an extremely serious issue,’’ she said. ‘‘And yet they continue. Why is that? How do we reframe adverse events? None of us want to make a mistake, but we’re human, and whenever humans are involved, error will occur.’’ Medication errors are very high on the list of adverse events, Donnelly said. She reported findings from a 2010 U.S. Department of Health and Human Services study on adverse events that included findings that hospitals did not generate incident reports for 93 percent of adverse events. One of the biggest findings is a lack of high-quality studies of adverse events in emergency departments. This could be a focus of your organization, she suggested. Donnelly encouraged attendees to ask if there is a database on adverse events in their ED. ‘‘I think looking for patterns in your own data will reveal very interesting things and some measures that you can put in place to prevent

errors in your own situation,’’ she said. ‘‘We have limits to what we can process, and failure can only be prevented when it’s acknowledged and studied.’’ She reminded the audience that no system can reduce error completely. ‘‘You’re in an ED. You might not have the luxury of failure, but you need to measure that and experiment with safety issues,’’ she said. ‘‘We get into the policing aspect of things in nursing. It’s also about power. We always have to keep in mind that whatever system we put in place is there to reduce error and increase the safety of patients. It’s not about power over other staff.’’ Studying failure and learning from it is key. ‘‘What I’m encouraging you to do is to embrace wrongness because you learn by making mistakes, even small ones that are not considered adverse events,’’ Donnelly said. ‘‘It’s a vital part of how we learn and change. Error helps us to revise the understanding of ourselves and our environments. ‘‘Remember, we’re human. But in the end, we will only improve and we will only create safer environments for our patients when we learn from failure.’’

May 2014

Injury Prevention

Stories Worth Sharing in Every State I

n the middle of the Exhibit Hall at Leadership Conference 2014 was a large, colorful map of the United States that measured 7 by 9½ feet. The states were left empty to allow attendees to write in injury prevention programs and interventions achieved in their states. Conference attendees were up to the task, listing injury prevention programs in 24 of the states. Alaska boasted boating, biking and car seat initiatives while Arkansas had life jacket and ATV safety events held at ballparks. Minnesota had an extensive list, including thumb rings to warn about texting and driving, programs for bicycle helmet and personal flotation device safety and the “Towards Zero Death” traffic program. The map revealed more than just names of programs. It served as a reminder of the importance of injury prevention activities. Kentucky features “Charlie’s Challenge,” a community safety day held at Frankfort Regional Medical Center Attendees take turns on the in response to the death distracted-driving simulator of 6-year-old Charlie provided by the ENA Illinois Semones, who was State Council. struck and killed by a car while riding his bicycle in 2012. The event exemplifies the shared sense of purpose when the community and health care join forces to promote injury prevention. One nurse can make a difference. Next to the map was a driving simulator, donated for the conference by Thelma Kuska, BSN, RN, CEN, FAEN and the ENA Illinois State Council. Kuska visits Illinois high schools with the simulator on a mission to promote injury prevention. By teaching about the dangers of drinking and texting while driving, she is working to save the lives of teenagers across the state. We would like to know what you are doing for injury prevention in your state. Even more, we would like to know the story behind your efforts. Is it in response to a local tragedy or a trend of injuries that has become prevalent in your community? How did you gather the support and go forward with an initiative? Let

Thank you to ENA members from the following states for sharing your injury-prevention initiatives: Alabama Alaska Arizona Arkansas California Colorado Florida Illinois

Indiana Kentucky Maryland Minnesota Montana Nebraska Oklahoma Oregon

South Carolina Tennessee Texas Virginia Washington West Virginia Wisconsin Wyoming

us know at IQSIP@ena.org. The 2014 Wellness and Injury Prevention Observances Calendar provides a comprehensive listing on a variety of national topics throughout the year. This injury prevention tool can be found on the ENA website (www.ena.org) under Practice & Research/Practice/Safety/Injury Prevention. For information on initiatives in your state, contact your IQSIP State Leader, listed on the ENA website through this fast track: Membership/State Councils & Chapters/State Council Committee Chairpersons/ENA IQSIP State Chairs. The impact we make as emergency nurses is real. Each program written on the map at Leadership Conference can make a difference. What program will you add to the map? Briana Quinn, MPH, BSN, RN

Thank you to the following organizations for their generous support. STRATEGIC SPONSORS

The ENA Strategic Sponsorship Program is designed to create partnerships with leading organizations whose objectives include supporting the emergency nursing profession.

Sponsorship Ad_Connection_quarter_05 2014.indd Official Magazine of the Emergency Nurses Association

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Educational Sessions

How to Get Four Generations Working With One Purpose A

ttendees of this Jam Session on March 8 learned that when it comes to communication within the emergency department workforce, one size doesn’t fit all generations. Rose Sherman, EdD, RN, NEA-BC, FAAN, discussed the values, beliefs and attitudes of the four generations in the nursing workforce today and the important leadership strategies for working with a multigenerational workforce. She reported that veterans (born 1920-1945) make up 5 percent of the nursing workforce, baby boomers (1946-1960) make up 35 percent, Generation X (1961-1980) 40 percent and Generation Y (1981-2000) 20 percent. But Generation Y will be 50 percent of the nursing workforce by 2020, Sherman said. ‘‘That’s the group I think you need to pay attention to,’’ she told attendees. ‘‘What happens with that group in terms of employment is going to have a much bigger impact on the health care delivery system.’’ Sherman noted that one interest ing characteristic about Generation Y is its unique perspective about accommodation in the workplace. ‘‘This is the piece organizations and leaders are struggling with,’’ she said. ‘‘Some say it’s a feeling of entitlement. It’s more of how we raised Generation Y. We were very

accommodating. And now it’s not surprising that Generation Y is expecting the same of their employers. Fifty percent of your workforce by 2020 will be Generation Y, so this accommodation is going to have to become a part of your leadership strategy.’’ In terms of career expectations, Sherman said many from Generations X and Y have never worked a 12-hour shift, and they want a life outside of work. However, she doesn’t think Generations X and Y are wrong about the work/life balance. We all can take a lesson from this, she said. ‘‘You can see where this clash comes in when you have Generation X and Y wanting this work/life balance, and then you have the baby boomer group, myself included, who are really devoted and anchored to their work in a way that no other generation has been,’’ she said. ‘‘One thing that I worry about as a nurse leader is that a lot of nurses in leadership today, particularly in senior leadership roles, are baby boomers, and we have created roles that may be impossible for our younger nurses to step up to and be successful.’’ Sherman suggested three leadership strategies for nursing leaders to adopt: completing a generational profile to get to know

Rose Sherman, EdD, RN, NEA-BC, FAAN, breaks down the generations. staff, teaching staff about generational theory and capitalizing on the strengths of each generation. ‘‘Realize that we want to build synergy,’’ she said as she pointed out the strengths of each generation. ‘‘The veterans have a rich understanding of the history of nursing. They also know how to give care without technology. The baby boomers like working on teams and are good mentors. Generation X is creative and great at executing projects, and Generation Y is optimistic, enthusiastic, great with technology and civic-minded.’’ Sherman reminded attendees to understand each other without stereotyping based on a generational group. It’s all about finding common ground, she said. ‘‘That’s what it’s really all about across generations,’’ she said. ‘‘There are things that we all can agree on about patient outcomes, and that’s really where your focus has to be.’’ Kendra Y. Mims

Behavioral Health Patients in the ED: A Wakeup Call for All

he director of the ENA Institute for Emergency Nursing Research, Lisa Wolf, PhD, RN, CEN, FAEN, talked about the current state of emergency care for behavioral health patients and shared findings from ENA’s national study ‘‘Identifying Challenges and Facilitators in the Management of Behavioral Health Patients in the Emergency Department.’’ The findings from this study have been submitted to the Journal of Emergency Nursing and are expected to be published in 2014. ‘‘Essentially there is no information on behavioral health patients in this country; therefore, we could not make any policy pushes,’’ Wolf said. ‘‘Now ENA is the owner of this information and can help people drive policy. Data on this population is not vigorously collected in a standardized way, so that tells us this is a population that no one wants to know anything about.’’ Some of the information unknown for this population included the average length of stay in the

Lisa Wolf, PhD, RN, CEN, FAEN, shined new light on an overlooked issue. emergency department, models of care and emergency nurses’ knowledge and attitudes toward the patients. Two focus groups were used to develop the study, as well as an online survey created for ENA members. More than 1,200 members answered the survey. Wolf shared the following findings: • More than 40 percent of nurses working in EDs have had no education in behavioral health beyond nursing school.

Official Magazine of the Emergency Nurses Association

• About 36 percent of participants reported that their department had dedicated behavioral health staff. • A little more than half of respondents reported that there was no dedicated behavioral health treatment area in their ED. • Twenty-four percent reported they had no standard protocol for managing the care of behavioral health patients. • The average length of stay for behavioral health patients was 18 hours in the ED. (Length of stay ranged from two to 224 hours.) • Nurses who reported an increased level of confidence in caring for behavioral health patients were associated significantly with a shorter length of stay. ‘‘Because we have so much geographic and educational diversity in both the survey data and the focus group, we can make a statement about the state of emergency care for behavioral health patients in a way that you can bring to a legislator and policy-making group,’’ Wolf said. Kendra Y. Mims

Research and Evidence-Based Practice

PRESENTING THE POSTER WINNERS By Kendra Y. Mims, ENA Connection

he Institute for Emergency Nursing Research presented the research and evidence-based practice poster awards on March 7 at Leadership Conference 2014. Recipients were chosen from nine research topic submissions and 29 evidence-based practice topic submissions.

BEST RESEARCH POSTER Horizontal Hostility Among Emergency Nurses in a Level I Trauma Center Heather Liska, MPA, BSN, RN, CEN, St. Anthony Central Hospital, Kittredge, Colo. Heather Liska, MPA, BSN, RN, CEN ‘‘When I looked at horizontal hostility in the literature, a lot of work had been done on new grads and new student nurses,’’ Liska said. ‘‘Our department, on the other hand, is experienced nurses. We don’t have a new grad program; the majority has more than 10 years of experience.’’ Liska wanted to examine how the data applied to her ED. A quantitative design using validated survey questions was used to gather primary data; the sample included all emergency nurses in this ED. ‘‘I wanted to look at the mitigating factors and the contributing factors,’’ Liska said. ‘‘The prevalence was 100 percent of the participants surveyed had experienced horizontal hostility in the past 12 months, so it clearly

still applies to us experienced nurses, not just the newer ones.’’ Liska discovered the frequency was lower in comparison with the national data, which motivated her to look closely at the mitigating factors. The data showed that the level of support from the immediate supervisor, as well as the nurse’s self-esteem, played a crucial role in reducing the effects of horizontal hostility. ‘‘What we found is that our staff had a huge level of self-esteem to begin with,’’ she said. ‘‘They are very happy, very confident and sure of themselves. We have strong support from our immediate supervisor.’’ Liska also found that the relationship between the emergency

nurses and the physicians could use improvement, so her ED is looking at holding interdisciplinary celebrations instead of nurse-only celebrations. She said a lot of managers and directors in other departments want to apply this study to their departments. She hopes her poster will help people understand how prevalent horizontal hostility is in emergency nursing and its effects on emergency nurses, which can range from depression to nurses leaving their positions. “We can support each other vs. eating our young,’’ she said. ‘‘We can provide solid leadership that supports nurses in their growth, and we can also do our best to decrease

May 2014

violence in the workplace and take care of some of these contributing factors. We all want to come to work and feel good about what we do, feel good about each other and feel good about ourselves. ‘‘I think it starts with being aware that we can change our actions in how we’re presenting ourselves to each other and be more supportive of each other as a profession.’’

BEST EVIDENCE-BASED PRACTICE POSTER Mistaken Identity: Mislabeled Specimens in the Emergency Department Stacie Howard-Carpenter, MHA, MSN, RN, CEN, Stephanie Mallette, MSN, RN, CEN, and Jane Sewell, BSN, RN, CEN, Aultman Hospital, Canton, Ohio The purpose of the project was to improve patient safety by decreasing the number of mislabeled specimens in the emergency department. ‘‘In 2012, we had an issue with misidentified specimens — we had 41 in that year,’’ said HowardCarpenter, the on-site presenter. ‘‘In the fall of 2012, we put together a multidisciplinary team with all of the key players, which included employees from lab, blood bank, ED and the IT department. We sat down and took a look at the entire specimen, from the actual order by our physicians to actual delivery in the lab area. We analyzed it, identified some issues we were having and then we put some interventions in place.’’ During the analysis, HowardCarpenter and her team discovered

Stacie Howard-Carpenter, MHA, MSN, RN, CEN that the majority of mislabeled specimens were their blood bank specimens because they were hand-labeled. ‘‘One of the things we put in place was the expectation that if you are hand-writing a label, then you should have a second staff person take a look at that label before you submit it to the lab,’’ HowardCarpenter said. Since the implementation, misidentified blood bank specimens decreased from 22 to two from 2012 to 2013, she said. The number of mislabeled specimens overall decreased by 66 percent in 2013. Among other problems identified, the two-patient identifier procedure was not being consistently followed by staff, and the disciplinary process for errors was inconsistent. The interventions put in place included education on mislabeled specimens added to yearly skills sessions,

one-on-one education with employees for all variances related to mislabeled specimens and consistent follow-through with the disciplinary process. Howard-Carpenter hopes her poster helps others to understand the importance of having a multidisciplinary team when examining an issue and following through. ‘‘If you’re going to have expectations, make sure that you inspect it and follow up, and make sure that people are compliant with the interventions that you put in place,’’ she said. She said she’s ecstatic to be a poster winner. ‘‘I think it’s great for our organization,’’ she said. ‘‘It just shows what our organization values. We had support from the administrative level on down to make this happen. Our staff was also compliant, which resulted in our success.’’

Official Magazine of the Emergency Nurses Association

State Council Achievement Awards

Toasting a Terrific 20

wenty ENA state councils were recognized March 7 with ENA State Council Achievement Awards, which honor those that have met or exceeded the necessary requirements in their efforts to effectively network among members, promote professional development of members and conduct affairs in a sound business manner. Recipients are pictured with 2014 ENA President Deena Brecher, MSN, RN, APN, ACNS-BC, CEN, CPEN.

ARIZONA STATE COUNCIL Rita Anderson, BSN, RN, CEN, FAEN, President

CALIFORNIA STATE COUNCIL Carole Snyder, MSN, RN, President

CONNECTICUT STATE COUNCIL Colleen Desai, MSN, RN, CEN, President

FLORIDA STATE COUNCIL Leona Stout-Demps, MSN, RN, CEN, President

ILLINOIS STATE COUNCIL Vicki Bacidore, MSN, RN, APRN, CEN, ACNP-BC, President

INDIANA STATE COUNCIL Cheryl Riwitis, MSN, RN, FNP, EMT-P, CEN, CFRN, President

KENTUCKY STATE COUNCIL Anne Afton, BSN, RN, Immediate Past President

LOUISIANA STATE COUNCIL Pam Pourciau, MSN, RN, APRN, CEN, ANP-BC, RN-BC, Secretary

May 2014

MARYLAND STATE COUNCIL Caroline Doyle, BSN, RN, CEN, President

MASSACHUSETTS STATE COUNCIL Sheila Silva, DNP, RN, President

MINNESOTA STATE COUNCIL Bruce Olson, MSN, RN, CEN, President

MISSOURI STATE COUNCIL Jami Blackwell, BSN, RN, CEN, President

NEBRASKA STATE COUNCIL Suszanne Deyke, MSN, RN, CEN, President

NEW JERSEY STATE COUNCIL Elizabeth McFarland, RN, CEN, President

NORTH CAROLINA STATE COUNCIL Chris McGrath, RN, EMT-B, CFRN, President

OHIO STATE COUNCIL Marilyn Singleton, BSN, RN, President

SOUTH DAKOTA STATE COUNCIL Karla Nygren, BSN, RN, CEN, CPEN, CFRN, CCRN, President

TEXAS STATE COUNCIL Cam Brandt, MS, RN, CEN, CPEN, President

VIRGINIA STATE COUNCIL Christopher Parker, ADN, RN, CEN, CPEN, NREMT-P, Immediate Past President

WASHINGTON STATE COUNCIL Carla Brim, MN, RN, CEN, President

Official Magazine of the Emergency Nurses Association

General Session

Triumph in the Face of Violence Attendees learned March 8 about unique and challenging issues that can arise from violent crimes and how these tragedies affect the ED. Helen Kenny, BSN, RN, CEN; Mark Mayes, MHA, BSN, RN, CEN; Daniel J. Nadworny, BSN, RN and Michelle Ziemba, MSN, RN, spoke at this extended panel presentation moderated by Valerie Coleman Morris, a former CNN business anchor. They discussed lessons learned from the July 2012 movie theater shootings in Aurora, Colo., the Sandy Hook massacre of December 2012, the Tucson shootings of January 2011 and last April’s Boston Marathon bombings. They also illustrated best practices to show how strong teams can overcome stressful times and discussed ethical consideration when caring for suspects and victims in the same ED.

Closing Session

Performance Under Pressure Closing speaker Dan Diamond, MD, FAAFP, gave the audience practical strategies to deliver greater impact when they return to their emergency departments. He also discussed ways to deliver exceptional care during difficult times, how to overcome burnout and renew passion for your work and how to withstand and succeed under extreme pressure by learning from those who have ‘‘served in the trenches.’’

May 2014

A TIME TO EXPLORE More than 85 exhibitors of emergency nursing products and services met with Leadership Conference 2014 attendees at the Exhibit Hall, beginning with a reception March 6 that allowed dedicated time to walk the floor, grab a bite and enjoy music from a three-member mariachi band.

Official Magazine of the Emergency Nurses Association

UNTIL WE DANCE AGAIN ... Leadership Conference’s closing celebration on March 8 was a flurry of color and movement, thanks to the Living Traditions Dance Troupe, led by seven-time world champion hoop dancer Derrick Suwaima Davis (far right), and a Southwest fusion trio. Mark your calendar for the 2014 Annual Conference in Indianapolis!

LEADERSHIP CONFERENCE PHOTOS BY JULES CLIFFORD

2014 ANNUAL CONFERENCE

SAVE THE DATE INDIANAPOLIS, IN Indiana Convention Center

October 7-11, 2014

For the latest news about 2014 Annual Conference, please visit www.ena.org

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May 2014

BOARD WRITES |

Karen K. Wiley, MSN, RN, CEN

Our Strained Safety Net I

f emergency departments are the safety net in our country’s health care system, then emergency nurses and physicians are the threads that hold that safety net together, and never more so than for patients who require mental health care. Lack of access to care and financial resources is part of the problem, but there are other causes of increasing dependence on EDs — the decrease in social support systems and the exploding problem of addiction, for example. Families are in crisis when they find a suicide note left by their son or daughter. They call a mental health crisis line, if there is one, and are directed to the emergency department for a psychiatric evaluation. EDs are open 24 hours a day and are required to see everyone, regardless of an ability to pay. Even patients who seek readmission to a psychiatric hospital willing and able to take them are sent to an ED for ‘‘medical clearance,’’ only to find the bed is taken when their medical evaluation is completed. Pediatric inpatient psychiatric hospital beds are rarely available.

Our Changing World In 2008, Nebraska passed a safe-haven law for abandoned children, with no age limit. The law was in effect for only 10 weeks, but during that short period, 36 children ranging in age from 20 months to 17 years were left at local EDs, many because of mental health/behavioral issues. Six were from other states. Some parents gave up all rights to their child and walked away. Some of the children had no idea they were being left for good.1 They must have felt unimaginably alone. This response brought national attention to the desperation of parents and the lack of mental health resources for all patients, particularly children. ED staff is in the all-too-familiar position of assuming responsibility for patients with countless complex problems. My state’s response to this crisis was to create a family help line and develop a program to hire and train parents who had personal experience with the behavioral health system to be ‘‘navigators’’ for families. Case managers are now available to help parents of adopted children and guardians of former state wards to access the behavioral health system.2 Fast-forward to 2014. The hospital where I work has inpatient psychiatric care for patients age 4 to 100. We have specially trained psychiatric assessment nurses who handle

patient intake; after consultation with a psychiatrist, they determine placement and disposition. Even with these services, though, patients can wait days, sometimes weeks, for inpatient placement. With an annual census of 35,000 to 40,000 patients, we see 400 to 500 psychiatric patients per month, and the need for psychiatric services is growing. Recently, our ED reached a crisis mode when 19 of our 27 beds were filled with psychiatric patients waiting for an inpatient bed. No inpatient psychiatric beds were available within a 250-mile radius. We soon became a psychiatric unit, with little room for incoming medical patients. Door-to-bed times become blurred, and two- to three-hour waits extend to 16 or more hours. The biggest challenges with placement are for those patients who are suicidal or otherwise acutely in danger and have a diagnosis of autism, mental retardation and/or dementia. These patients do not meet inpatient criteria for many facilities. At times, other facilities send patients to the ED and refuse to take them back because they can’t ensure the safety of the patient or others at the facility. ENA has been actively advocating for more funding for mental health patients for many years and is part of the Substance Abuse and Mental Health Services Administration coalition of more than 60 organizations devoted to helping those with psychiatric illness and addictions. ENA has a network of state government affairs chairpersons across the country. At ENA’s government affairs office in Washington, D.C., Richard Mereu, ENA chief government relations officer, and Ken Steinhardt, ENA director of government relations, help with federal and state legislation and regulation. Mereu is responsible for federal issues; Steinhardt covers state issues. Our safety net is becoming more burdensome. The threads are stretched to the breaking point. The crisis is looming, and help beyond the ED is desperately needed. Emergency nurses are in a crucial position to let others know about the issues. References 1. Stoddard, M., & Moring, R. M. (January 15, 2014). Life of the safe haven kids. Omaha World-Herald, pp. B2, B4. 2. Stoddard, M. (January15, 2014). Families at crisis stage still struggle, advocates say. Omaha World-Herald, p. B4.

Official Magazine of the Emergency Nurses Association

PERSPECTIVES |

Catherine Olson, MSN, RN, Director of the Institute for Quality, Safety and Injury Prevention

Be Alarmed About This Alarm Fatigue Becoming Real Threat to Patient Safety “Don’t cry wolf, shepherd boy, when there’s no wolf!”

he advice from this ancient fable can easily be applied to real-life scenarios in the emergency department. The persistent pings from various medical devices can make it difficult for patient care staff to distinguish critical alarms from the more common, artifact-induced false alarms, leading to a ‘‘cry wolf’’ effect. In addition, the chaotic, noisy environment of the ED contributes to distractions and staff indifference to the monotonous alarms. The high sensitivity of monitor alarms, coupled with narrow parameters for blood pressure, arrhythmias, oxygen saturation levels and other physiologic measurements, may cause false alarms and subsequently lead caregivers to silence, ignore or disable potentially critical warnings.1 Alarm fatigue, or the phenomenon of health care workers being desensitized to the endless drone of alarms and alerts, is a serious patient safety issue.2 The purpose of alarm systems on medical devices is to help keep patients safe, but if not properly managed, the result can be patient injury or even death. In 2010, the death of a 60-year-old patient in a Boston hospital intensive care unit was attributed to a delay in staff response to monitor alarms.1 This sentinel event brought the issue of alarm fatigue to the national forefront.1 In 2013, a Joint Commission sentinel event alert indicated there were 98 alarm-related cases between January 2009 and June 2012, of which

80 cases resulted in death.2 Most cases of alarm-related events reportedly occurred within hospitals’ critical areas — telemetry, intensive care, general medicine and the ED.2 The ECRI Institute, a nonprofit, evidence-based practice center, placed alarm hazards first on its 2013 and 2014 Top Ten Technology Hazards lists.3 The Joint Commission established a 2014 National Patient Safety Goal on alarm management for hospitals (and critical-access hospitals), which went into effect Jan. 1, 2014.4 Phase I began in January and requires hospitals to make alarm management a priority while determining the most important alarm signals to manage based on their internal situations.4 Phase II, to be effective January 2016, directs hospitals to establish policies and procedures and provide staff education for managing the alarms identified in Phase I.4 Most alarm hazards in the ED are attributed to the setting of wide alarm limits to reduce frequency of alarms, pausing or silencing ‘‘nuisance’’ alarms, turning alarm volume down too low, difficulty in hearing alarms due to proximity of the alarm source and use of hall beds with stand-alone monitors not connected to the central station.5 Alarm fatigue experienced by ED staff is most often prompted by excessive alarming from 1) monitor electro cardiogram electrodes becoming dislodged; 2) monitors not placed in standby mode when not in continuous use (e.g., transports to radiology); and 3) pulse oximetry sensors that cannot detect a signal.5 So, how can hospital ED staff

effectively address alarm hazards to ensure their patients’ safety? Unfortunately, there is no universal solution, as many organizational variables exist, including patient demographics, clinical needs, staffing, department culture and alarm system coverage.5 Evidence-based, interdisciplinary methods, such as a comprehensive unit-based safety program or the TeamSTEPPS approach, may be beneficial to address issues and develop policies and procedures.6 While formal quality improvement processes to tackle alarm management are being developed, here are some ways to start protecting patients in the ED 7: • Before application of electrodes, wash areas with soap and water and dry with washcloth or gauze. • Change electrodes if they lose stickiness. • Customize alarm limits, especially for heart rate and pulse oximetry. • Monitor only those patients with a clinical indication for monitoring.

• Use standby mode when patients are removed from a monitor temporarily. References 1. Cvach, M. (2012). Monitor alarm fatigue: An integrative review. Biomedical Instrumentation & Technology, July/August, 268-277. doi:10.2345/0899-8205-46.4.268 2. The Joint Commission. (2013). Medical device alarm safety in hospitals. Sentinel Event Alert, 50. Retrieved from http://www. jointcommission.org/assets/1/18/ SEA_50_alarms_4_5_13_FINAL1.pdf 3. ECRI Institute. (2013). ECRI Institute releases top 10 health technology hazards report for 2014. Retrieved from https://www.ecri.org/ Press/Pages/2014_Top_Ten_Hazards. aspx 4. The Joint Commission. (2013). The Joint Commission announces 2014

national patient safety goal. Joint Commission Perspectives, 33(7). Retrieved from http://www. jointcommission.org/assets/1/18/ JCP0713_Announce_New_NSPG.pdf 5. Pelczarski, K. (2013). Addressing alarm problems in the emergency department. Patient Safety & Quality Healthcare. Retrieved from http:// www.psqh.com/may-june-2013/1647addressing-alarm-problems-in-theemergency-department 6. Agency for Healthcare Research and Quality. (2013). Education and training for health professionals. Retrieved from http://www.ahrq.gov/ professionals/education/index.html 7. American Association of Critical Care Nurses. (2013). AACN practice alerts. Alarm Management. Retrieved from http://www.aacn.org/wd/ practice/content/practicealerts/ alarm-management-practice-alert. pcms?menu=practice

Tapestry Scholarship Continued from Page 25 for my compassion fatigue. I now have a resurgence of strength and hereby resolve to put forth more effort that my staff need from me. Thank you for this opportunity, and know that I bring more energy back to Minnesota with me. – Molly Bridget Delaney, PhD, MBA, RN, CEN, CPEN, Minnesota The six other 2014 Tapestry Scholarship recipients are as follows: • Erin Aston, BSN, RN, CPEN, North Carolina • Danielle Bonca, BSN, Nevada • Angela Hodge, MSN, RN, ACNS, CEN, CHEP, EMT-P, Ohio • Kelly Mills, BSN, RN, CEN, Indiana • Rebekah Schelhaas, RN, CEN, South Dakota • Jessica Trivett, MSN, RN, CEN, New Jersey.

Your Patient is Proof... You have what it takes. Validate your expertise. Get certified. Visit www.BCENcertifications.org for more information about becoming a: Certified Emergency Nurse (CEN®) Certified Flight Registered Nurse (CFRN®) Certified Pediatric Emergency Nurse (CPEN®) Certified Transport Registered Nurse (CTRN®)

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Average improvement in throughput for admitted and discharged patients

Average improvement in time from arrival to seeing a physician.

Typical improvement in patient satisfaction scores and likelihood to recommend

Improve emergency care, improve your career You know us as recognized ED leaders who guide hospitals toward real and effective change. Now we would like to get to know you. Blue Jay Consulting is looking for professionals with the leadership insight and clinical experience to bring process improvements to our clients, and the passion and commitment to enhance the overall quality of emergency care. If you consider yourself among the best in your field, you’ll find yourself in good company at Blue Jay Consulting. Join the strongest team in the industry and improve your career. Contact Jim Hoelz or Mark Feinberg at 407-210-6570 to discuss how we can capitalize on one another’s strengths.

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Average improvement in LWBS rates, resulting in an additional $1.6 million in collected revenue

“As a Blue Jay consultant, I bring my 30 years of emergency department leadership experience to each client. Every assignment brings a unique set of challenges, but the tools to solve them are similar. We can often shorten the improvement process from years to months and create an environment that is better for patients, families and staff. I leave each assignment with a good feeling that I have left it better than when I arrived. I love being a Blue Jay consultant.” —

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Senior Consultant Blue Jay Consulting, LLC