January/February 2022 INSider

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Celebrate IV Nurse Day!

One Nurse Shares Her Career Change

A Patient’s Son Reflects on Infusion Nurses


Several INS Members Share Their Stories VOLUME 5



J u n e

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Journal of

Infusion Nursing

Editor: Mary Alexander, MA, RN, CRNI "', CAE, FAAN

Are you currently working on evidence-based research that would benefit other infusion nurse professionals? The Journal of Infusion Nursing (JIN) editors want to hear from you! JIN is seeking original manuscripts that present new research, clinical reviews, case studies, and professional development information relevant to the practice of infusion therapy. Topics may include but are not limited to: • Best practices for vascular access device selection and placement • Biologic and biosimilar therapies • Antibiotic infusions, side effects, and anaphylaxis protocols ■ Evidence-based interventions when caring for oncology or infusion therapy patients ■ Infusion therapy in the home care setting ■ Implanted ports Articles undergo a process of double-blind peer review. Final selections represent the broad scope of the infusion specialty and draw on the expertise of all health care providers who participate in the delivery of infusion therapy. Submit your manuscript at https://www.editorialmanager.com/jin/Default.aspx




• Wolters Kluwer 9·1<346




Joan Couden, BSN, RN, CRNI®





Nancy Bowles, MHA, RN, OCN®, CRNI®, NEA-BE, CPC-A Angela Skelton, BSN, RN, CRNI®

INSider encourages the submission of articles, press releases, and other materials for editorial consideration, which are subject to editing and/or


condensation. Such submissions do

John S. Garrett, MD, FACEP

not guarantee publication. If you are


Mary Alexander, MA, RN, CRNI®, CAE, FAAN

interested in contributing to INSider, please contact the INS Publications Department. Photos become the property of INSider; return requests must be in writing. INSider is an official bimonthly publication of the Infusion Nurses Society.


FUSION NURSES SOCIETY Chief Executive Officer: Mary Alexander, MA, RN, CRNI®, CAE, FAAN Executive Vice President: Chris Hunt Director of Operations and Member Services: Maria Connors, CAE Clinical Education & Publications Manager: Dawn Berndt, DNP, RN, CRNI® Marketing Manager: Whitney Wilkins Hall Managing Editor: Leslie Nikou Editorial Production Coordinator: Rachel King


Director of Clinical Education: Marlene Steinheiser, PhD, RN, CRNI® Senior Member Services & Conference Coordinator: Jill Cavanaugh Meetings Manager: Meghan Trupiano, CMP Certification Manager: Adrienne Segundo, IOM Certification Administrator: Bill Taylor

©2022 Infusion Nurses Society, Inc. All rights reserved. For information contact: INS Publications Department One Edgewater Drive, Suite 209

Senior Certification & Member Services Associate: Maureen Fertitta

Norwood, MA 02062

Member Services Associate: Susan Richberg

(781) 440-9408

Bookkeeper: Cheryl Sylvia


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In this Issue President’s Message: Celebrate National IV Nurse Day by Susan H. Weaver, PhD, RN, CRNI®, NEA-BC

A Cast of Characters: Infusion Nurses and My Family by Alex Berge, MFA

Rising Star Award Winner Jenny L’Heureux

From the Emergency Department to My Dream Job by Tammy Whitney, RN, CRNI®, VA-BC

CRNI® Connection: Concentrate on Certification and Recertification

Welcome New Board Members Pamela McIntyre, MSN, RN, CRNI®, Ig-CN and Inez Nichols, DNP, RN, CRNI®, VA-BC

Member Spotlight: Our members share their experiences with the infusion community

Meet the New NCOE Members Ashley Smith, RN, MSN, CRNI®, Lisa Tarango, BSN, RN, CRNI®, Tatiana Zhdanova, PhD, MSN, RN, CRNI®

Virtual Symposium: Infusion Therapy Related Complications

Welcome New INS Members: Domestic and International

INSide Scoop: A closer look at what’s going on within INS

P R E S I D E N T ’ S


Celebrate National IV Nurse Day Strong Initiatives Strong Nurses Strong Standards

Susan H. Weaver PhD, RN, CRNI®, NEA-BC

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As we begin 2022, I hope you will join me and consider taking some time for self-care. The Future of Nursing 2020-2030 report asserts the importance of nurses’ health and well-being and the impact their well-being has on the patient care they provide. The American Nurses Association (ANA) Healthy Nurse Healthy NationTM has helped me focus on what I could do for self-care, such as: • Stop and breathe. Sit, close your eyes, take some deep breaths. Become calm and distance from the stressful situation. • Take the stairs. • Eat more berries, the power food. • Be thankful. • Quiet your mind and be mindful. It is the simplest form of meditation. Be mindful drinking your hot beverage: What temperature is the glass/cup/container you’re holding? • Find joy! Look for the “good stuff,” and write down three good things every day. Start by doing this for one week. • Join the ANA Healthy Nurse Healthy NationTM

Let’s also celebrate! National IV Nurse Day is every January 25, a day to recognize you and all infusion nurses. In 1980, the US House of Representatives designated January 25 as a day each year to honor and recognize the accomplishments of the nation’s infusion nurses—as well as a day to honor and recognize the National Intravenous Therapy Association, now known as Infusion Nurses Society (INS). Then Massachusetts congressman Ed Markey called the specialty “a vital branch of our nation’s nursing profession.” The INS theme for this year, “Strong I(nitiatives), N(urses), S(tandards),” honors the characteristics that nurses exemplify. In this issue of the INSider, we recognize and celebrate the important work of infusion nurses, particularly in the testimonial from a son whose mother worked closely with infusion nurses and in several members sharing their own stories. We also recognize the importance of the 2021 Infusion Therapy Standards of Practice (the Standards) in infusion nurses’ practice. The Standards, which are based on the most current evidence available, will now be released every three years. So, as infusion nurses let’s celebrate National IV Nurse Day and use this day as an opportunity to educate and remind all nurses about the Standards.

In particular, as we begin this new year, I believe “scrub the hub” or disinfecting access ports before connecting tubing or a syringe is one practice that needs more attention. When I began my nursing career, we did not have needleless connectors. We used needles when connecting tubing or a syringe for administration of medications. I think because we used needles we would always “scrub the hub.” Now, I notice many nurses are not routinely scrubbing the hub. For instance, when my father was in the hospital, I unfortunately rarely saw a nurse “scrub the hub.” Do nurses believe disinfection is not necessary with needleless connectors? The Standards explain that needleless connectors eliminate the use of needles and thus reduce needlestick injuries. However, needleless connectors do not eliminate the need for disinfection. The practice recommendation in the Standards states, “Disinfect the connection surface and sides of the needleless connector attached to any VAD to reduce the introduction of intraluminal microbes.” As infusion nurses, we know to “scrub the hub” for 5 to 15 seconds with isopropyl alcohol and allow to dry for 5 seconds or with alcohol-based chlorohexidine gluconate and allow to dry for 20 seconds. Although, as in many areas in nursing, more research is needed on subsequent entrees when administering IV medication and flushing, we always disinfect before the initial entry into the needleless connector, and the Standards does recommend disinfection between each entry, such as when flushing before and after a medication. As stated in systematic review on disinfection of needleless connector hubs in Nurse Research and Practice, “Just one omission of scrubbing the hub prior to access permits bacterial entry, attachment, and biofilm formation that allow the bacteria to strengthen prior to release into the bloodstream.” Consider using National IV Nurse Day as an opportunity not only to celebrate, but to remind nurses at your organization the importance of “scrub the hub” prior to every access. Cheers to a Happy New Year and Happy IV Nurse Day!

References NASEM (National Academies of Sciences, Engineering, and Medicine). The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press; 2021. https://doi.org/10.17226/25982. Gorski LA, Hadaway L, Hagle ME, Broadhurst D, Clare S, Kleidon T, Meyer BM, Nickel B, Rowley S, Sharpe E, Alexander M. Infusion therapy standards of practice. J Infus Nurs. 2021;44 (suppl 1):S1-S224. Moureau NL, Flynn J. Disinfection of needleless connector hubs: clinical evidence eystematic review. Nurs. Res. Pract. 2015;20(4):1-20. doi:10.1155/2015/796762.

January/February 2022




A Cast of Characters: Infusion Nurses and My Family by Alex Berge

At some point right after my mother’s death, I found her oncologist’s home address and spent considerable time lying awake in 4 a.m. fogs writing every word of a letter I knew I’d never send. Then, during the planning session for her celebration of life, I couldn’t resist asking the funeral home director what the toughest part of mortuary sciences school was, if he recommended it, and if he thought he’d need volunteer help for the rest of the month. I put his business card in my wallet where it still resides today without ever again seeing sunlight. Regardless of the outcome, or lack thereof, this is the part of grief that made tactical and functional sense. Maybe a way to combat the ethereal crush of the grief itself. Before she reached the funeral home, my mother was in the care of a single, fearless oncologist and a battery of infusion nurses, all members of a fleet of clinicians, many of whom became something of legend in my parents’ house over the 10-year span of the illness. That is how it felt whether on the phone from my apartment in Chicago or in person, sitting at the kitchen table, trying to not mention the disease itself. When it couldn’t be avoided, “How’s the cancer?” was usually how I phrased it, a weak attempt at keeping it light, not giving it too much power over the time we had left.



I didn’t feel the intricacies she must have been feeling about her situation at first. Of course, I knew she didn’t want to be going through this, to be obligated to a 30minute car ride all to sit and feel the cool rush of the dose chemotherapy (some 10,000 varieties, it seems), but she always found some joy in telling me about her last treatment or about when she had to go back (“Not for another month!” sometimes), relaying details about these nurses’ lives—about one’s daughter who was thinking about studying creative writing in college or another’s son who was considering moving to Chicago for law school. She recognized that the infusion nursing staff members were taking orders from the oncologist, but also were her last line of defense. More than anything, I think she admired and appreciated the prevailing attitude of these nurses toward her and the other patients, and many of those other patients’ spouses and friends and children. This is why I think about the nursing staff members so much still: they did their jobs with such grace and expertise, but with each patient’s dignity at the core. From my mother’s perspective, this was unwavering. I didn’t go often. But I did go once about four years ago and was fortunate enough to meet a few of my mother’s favorite infusion nurses (of about 10) at the facility where

she’d received her diagnosis and began treatment. I was trying to be back in my hometown more, to see her as much as I could. That day, she drove, which seemed somehow wrong, but it wasn’t something I chose to argue about with her. After the treatment, we were going to the mall, trying our best to beat the side effects before they came on; if they would come on, she never knew. We waited a few minutes before three nurses came in. I learned quickly one was working the floor while the other two were getting ready to start their shifts. Because I had only heard about these nurses from my mother and father, it took me a beat too long to comprehend her relationship with them, something I’d taken for granted all those years. As my mother looked at photos on one of their phones, the other soon-to-be-on-duty nurse told me, “Your mother is so thoughtful. Did she tell you she bought us berets? We wore them, too. All across Paris. We just love her.” She put her hand on my shoulder and I looked at my mother, who was starting that day’s therapy, laughing deeply at the photos. After, in the car on our way to the mall, I asked my mother why she did that for them. I agreed it was thoughtful, but it seemed sort of extreme, maybe too familiar. “But, doesn’t it seem, even to you, a tad overboard?” I asked. She was driving, pushing it faster and faster. She must have sensed the light ahead wasn’t going to stay green for long. “Nah,” was all she said, dismissively. Then after she switched lanes, we got caught by the nasty red light. In the silence she went on, “It’s been, what, six, seven years?” I nodded, flinching at the memory of the day she told me the news, a reflex I carry with me still. “I’ve been giving most of them cards for their birthdays and gifts for Christmas. The ones I’m close with, at least. It’s the least I can do. I like doing it.” Green light. I again agreed at the kindness of the gesture, and was ready to drop it, when she went on, eyes on the road. She said, “You know, it’s because they never make me feel sick, even though I am. We all know it. They could treat me like I’m dying, but don’t.” Her tone changed at this thought. “I may be sick, but I’m not a sick person. I have no room for pity. They understand the difference.” Later, within the next few years, she and I would talk more about the illness itself and the implications it would (and did) finally bring, but in the car that day I learned that my mother saw, and understood, what was coming her way. She felt it and harbored it and protected the rest of us from it the best she could. She never tried dodging it or trading away her soul for different results. Outside of my immediate family, the characters from my mother’s story

I think about most are those nurses who treated her as if she might outrun the monster, and every time she saw them, she knew she never had to look over her shoulder. The confidence my mother gained from these nurses was unparalleled and the love she gave back was all to say, Thank you for allowing me this. Thank you for letting me back. Just recently, I brought these nurses up to my father, who was more often than not sitting by my mother’s side as she received her infusions. Even over the phone, I could sense something tight in his chest loosen. He recalled their names quickly, with fondness. He told me in no uncertain terms that many of the nurses were family. Not in a way that evokes a treacly, melodramatic emotion, but one of tactical and functional sense. For nearly ten years, my parents saw these nurses more than they saw me. There was a partnership built on getting from one day to the new next. In December 2019, my mother died. She was out of treatment options. She took the bullet for me, my sister, and my father. In the receiving line at the funeral home, I stood between my wife and my sister and smiled as people told me how much they loved my mother. My sister was radiant and gracious to all of our old teachers and long-lost school friends. My wife met each new person with her standard warmness. And I was simply just doing my best. About an hour in, I was greeted by those three nurses I had met years before. We shook hands. They never once quit smiling, and it was genuine. We didn’t talk for long but the impression they left was deeper. There wasn’t any outward sadness coming off them. Maybe they didn’t show their sadness because they knew that, along with my mother, they did the work to extend her life as long as they could. I was endeared by how they were celebrating my mother at my mother’s celebration of life. When they got to my father in the line, I kept watching them, how intently they looked at him, unblinking and earnest. I couldn’t hear what they were talking about but it was clear that somewhere deep inside each was the most powerful sense of understanding.

Born and raised in a Cleveland suburb, Alex Berge earned his MFA in fiction from West Virginia University in 2011. He currently lives with his wife in Chicago, where he’s a member of Poems While You Wait, a non-profit writing collective. He is the former associate editor for CRAFT Literary and his fiction can be found in Witness.

January/February 2022


View these webinars and more on-demand: www.learningcenter.ins1.org/webinars Being Provaccine in a World of Vaccine Hesitancy

The Impact of Syringe Safety During the COVID-19 Pandemic

Phlebitis: Straight from the Standards

Listen to these podcasts and more on-demand: www.learningcenter.ins1.org/podcasts Tissue Adhesive: A New Approach to Vascular Access Device Securement



Infection Prevention and Control in the Home Care Setting

Moral Distress: What You Can Do


Jenny L’Heureux

Jenny L’Heureux currently works at Fairview Home Infusion (FHI) in Minneapolis, Minnesota, where she is a clinical nurse supervisor. FHI has been an infusion provider for over 30 years, and offers care for adults and children in 12 states. Jenny joined FHI as a home infusion nurse in 2019, teaching patients and caregivers how to administer medications, and providing RN administered medications in homes and infusion suites. She is now responsible for onboarding new hires and, in collaboration with nursing leaders, clinically supporting 80 FHI field nurses. Jenny has worked in a variety of health care settings. She spent more than six years at home care agencies, and has experience in hospitals, transitional care units, assisted living buildings, and schools. Jenny received her RN degree from Excelsior College in New York in 2015, and is currently in school for her BSN at Grand Canyon University. She and her husband have two adult sons and live in the Twin Cities area.

January/February 2022


From the Emergency Department to My Dream Job by Tammy Whitney, BSN, RN, CRNI®, VA-BC

I remember the day as if it were yesterday. I was in my 19th

passing of her plans to build a vascular access team,

year as an emergency room charge nurse, and had settled

I told her to look me up if she ever got the administrative

into the idea that I would retire there. I had an enormous

go-ahead. I figured that was the end of that conversation.

amount of skill, theory, and leadership qualities that I constantly utilized. But one day, a lady I didn’t know walked in with an idea to start a vascular access team in our more than 600-bed hospital. At the time, Lisa was the manager of the outpatient infusion center. I had already been trained in ultrasound IV placement, which I was utilizing in the emergency department, and when Lisa mentioned in



A year passed. In early 2015, I received an email for an opportunity to help pioneer a team that would perhaps change the future of vascular access in our facility. I was nervous about moving from an expert trauma emergency department nurse to a novice vascular access nurse, but I believe that change is inherently good and productive, so I made the move.

In March of 2016 I placed the first bedside PICC line in our

infusate has allowed an opportunity to do the right thing:

facility. I was so proud and excited, and looked forward to

to knowledgeably provide the patients with the most

the opportunities my new skills would provide for patients.

appropriate line the first time.

We developed a team that struggled to gain respect and understanding for a while, but as time progressed we were able to develop relationships with providers and staff. We began to make a difference at the bedside 24/7. I have now placed over 1,100 bedside PICC lines and an innumerable number of ultrasound-guided peripheral lines. Although I am proud of this endeavor, my story was not over. I had already obtained my certification in vascular access when I took a trip with Lisa to an Infusion Nurses Society Conference in May 2019 in Baltimore, Maryland. The conference changed my life, opening my eyes to my future. Each and every lecture sucked me in, and I realized I could make a difference in the lives of oncology and infusion patients. I was certain that I could use my skills and

knowledge to provide significant value in the care of

I am a strong believer in a patient being their best advocate. When I’m doing my ultrasound evaluation of a patient’s arms prior to therapy, I teach them along the way. My patient will understand the importance of vessel compressibility and vessel size prior to the start of treatment. They will know if the medicine they will be receiving is an irritant or vesicant and how it may or may not affect the inner lining of the vessel wall. Together, we will all make a plan. My job as a vascular access specialist in an outpatient setting known to have patients with challenging vasculature is essential. We completed a plan to place peripherally inserted central lines (PICC), and on November 2, 2021, I was proud to place the first PICC in our outpatient infusion center! We are making changes; we are accommodating

I had already obtained my certification in vascular access when I took a trip with Lisa to an Infusion Nurses Society Conference in May 2019 in Baltimore, Maryland. The conference changed my life, opening my eyes to my future. clients that suffer with poor vasculature as well as with infusions that can be harmful to veins from the inside out. I surprised Lisa in December 2019 by obtaining my CRNI. I was on a mission to follow my heart, to make a difference in the lives of oncology patients.

the needs of our clientele and their veins. I feel fortunate to be making a difference in the lives of patients that already have so much to deal with on a daily basis. Patients have told me horror stories of being stuck 7 or 9 times to get labs or an IV started on each and every visit. These same patients have thanked me, with tears in their eyes, for relieving their

A new cancer institute opened at our facility, and

fear of needle sticks and lab draws. The value of my

unfortunately, Lisa, our leader, left the vascular access

expertise is immeasurable. The combination of my CRNI

team. However, she had a vision and a plan to incorporate

and VA-BC certifications has led me to a place I love, a place

a vascular access specialist to her care team, and chose

where change, innovation, collaboration and growth lead to

me to fill that position. I felt lucky and appreciative that we

better patient outcomes and happier veins.

could move forward with both of our dreams. The ability to utilize ultrasound-guided placement of peripheral IVs has made a difference in the care of our oncology patients. Utilizing the theory of “no blind sticks” provides better patient outcomes and higher patient satisfaction. Vessel preservation is of the utmost importance for those patients receiving irritant and vesicant infusions. We now have the luxury of evaluating patients’ vasculature prior to the beginning of planned chemotherapy sessions and providing recommendations for appropriate line placement. Collaborating with providers in regard to vessel measurements, intended therapy plan, and intended

My name is Tammy Whitney. I recently celebrated my 30th wedding anniversary and married off my two amazing daughters. I have been a nurse for over 31 years, the better part spent as a trauma nurse in an emergency room setting, but the last 8 years I have found a new passion for infusion nursing and vascular access. I was born in Charlotte, North Carolina, in the same hospital that I have had the privilege of working at for almost the entirety of my career. My nursing mantra has always been, “just do the right thing every time.” Following this allows me to lay my head down at night knowing that I am an advocate for the care of the clients I encounter each and every day.

January/February 2022


We hope you were able to spend time with family and friends and have downtime over the holidays.

Now, it’s time to concentrate on CRNI® certification and recertification. For those looking to obtain certification, are you registered for the March 2022 exam? Click on the exam register link on the www.ins1.org website. There, you’ll find the important deadlines and application fee information plus the register button at the bottom of the page. Let’s check our toolbox for what you might need to get ready for the exam. Start with the great resources on the study information link on the website. Here you’ll find the CRNI® handbook, CRNI® reference material, and the approved reference list. You’ll also find the very important CRNI® exam checklist. Another great item is the CRNI® Academy. CRNI® Academy combines information from four CRNI® study resources (Core Curriculum for Infusion Nursing, Infusion Therapy Standards of Practice, Infusion Nursing: An Evidence-Based Approach, and Policies and Procedures for Infusion Therapy) into one comprehensive, online study tool. It includes sample exam questions, hundreds of flashcards, a personalized study plan, and intelligent gamification tools to help you prepare for the CRNI® exam.

For those recertifying, March will be here soon. If you have enough recertification units (RUs) to recertify, it’s a 2-step process: 1. Access your profile via the INS website. 2. Apply. From your profile page, click the Certification–Certification Management tab to access your CRNI® Certification Profile. At the bottom of the page, select Click to Register to recertify by CEU.

For those who still need RUs to recertify, click the recertification link on the website. From there you’ll see the recertification requirements and recertification options. At the bottom of the page is the financial planning for CRNI® recertification. This document outlines a detailed 3-year plan to help you on your journey once you’ve obtained your CRNI®. If you’ve just obtained your CRNI®, this outline will assist you in your planning. Three years go by quickly and we’re all busy. We don’t want the work you put in to go to the wayside. Not finding what you’re looking for? As always, click the Need Help icon on the lower righthand corner of the website. Staff is here Monday through Friday 8 a.m. to 5 p.m. EST. If it’s afterhours or on a holiday, still leave a message, and we’ll get back to you. Good luck, and have an amazing 2022!





Inez H. Nichols, DNP, FNP-BC, CRNI®, VA-BC, will serve as President Elect from 2022 to 2023. Pamela McIntyre, MSN, RN, CRNI®, Ig-CN, will serve as Director-at-Large from 2022 to 2024.

Inez H. Nichols

is a nurse practitioner currently licensed in Florida and Georgia. Career roles have integrated acute care, primary care, and occupational health care, as well as incorporated patient education, nursing education, and outcomes of monitoring related to infusion therapy. Nichols attended the University of North Florida and completed the Doctor of Nursing Practice (DNP) in 2017. Professional contributions include active work within professional nursing organizations, particularly the Infusion Nurses Society, where she has been a member for over 20 years and served in various roles, including a chapter liaison (Southeast), in chapter leadership, a Vesicant Task Force member, an INCC examination council member and secretary, and as the 2018-2020 INS secretary/treasurer. She has served as a Journal of Infusion Nursing review editor beginning in 2003 and has published widely within this specialty field.

Pamela McIntyre is the vice president of clinical

services at Paragon Healthcare, where she is responsible for clinical integrity, serves as the senior manager integrating business development with clinical staff and operations, and oversees home health and infusion nursing divisions. She graduated with her ADN in 1984 and holds a MS in nursing leadership and administration from Capella University. Pamela is a member of IgNS, NHIA, and Sigma Theta Tau, and was chairperson for the American Cancer Society Relay for Life for 3 years. McIntyre has been a member of INS since 2016, obtained her CRNI® certification in 2018, and is a reviewer for the Journal of Infusion Nursing.

January/February 2022


INS Member


INS is honored to share our members’ stories with the infusion nursing community. Each nursing journey is unique and we can learn so much from each other. We will continue to share stories from our members who care for patients in a variety of care settings. We are proud of you all and commend you for your hard work, passion, and dedication to patient care.

Christina Klein MSN, RN, CRNI , OCN ®

What led you into the nursing profession? I had an aunt who was diagnosed with leukemia. I remember the way she spoke about the nurses that cared for her. I thought, I want someone to talk about me like that someday. These nurses really made a difference for my aunt. What made you decide to specialize in infusion therapy? I became the go-to person for DIVA patients so I was viewed as a valuable asset on my unit. I wanted to take it to the next level and be considered an “official” infusion therapy specialist. How has INS Membership benefited you in your journey? It has fashioned me with opportunities to meet infusion muses all over the globe, become part of the INCC council, present at conferences, and develop as a professional. Has there been a mentor, colleague, or INS member who has helped along the way? Yes. A fellow CRNI® encouraged and supported me with certification and another recognized my skills and contribution to infusion therapy. Both mentors assisted me in my professional development. Do you have stories from your practice that you would like to share with the infusion community? I have stories about nursing students and how I started introducing infusion therapy practice and standards with year one (NUR101) students.

Gurpreet Bajwa RN, BSN, MSN, FNP What led you into the nursing profession? My husband encouraged and inspired me to go back to school be a nurse. I was very nervous going back to school due to the language barrier. I could read and write but not speak much English. I always had some feeling inside me that I could do more, and I am very grateful that my husband encouraged me to go back to school. What made you decide to specialize in infusion therapy? I worked in dermatology for 3 years as an LPN and RN and saw many IV treatments that inspired me to specialize in infusion. After that, I worked at a home health care agency for 18 months, where I got minimal exposure to IV antibiotics and TPN. After that, I moved on to pharmacy and at the same time started my own business, Healing Home Health Care. I experienced how IVIG and several other infusions can improve patient health faster than other oral treatment. I am happy when I see the patient has big smile on their face. How has INS Membership benefited you in your journey? All the new research and information helps me to do better on daily basis. Has there been a mentor, colleague, or other INS member who has helped along the way? No, I just read the updated information. Do you have stories from your practice that you would like to share with the infusion community? I have lot to say and write about, to share with others and to inspire them.



Nicola Sampson CRNI , BSN ®

What led you into the nursing profession? I have always wanted to help people and make a difference. What made you decide to specialize in infusion therapy? After over a decade of inpatient acute care, I wanted to do something different. I ended up in ambulatory care where infusion therapy was a part of the job. I actually did not like it at first, but then the position for infusions only came up. I was on the fence about taking the job until my teenage daughter said to me, “You have to apply for that job. You know you will end up loving it.” So I applied, I got it, and I do love it. How has INS Membership benefited you in your journey? The membership helped me locate study materials for the CRNI® certification test. It also keeps me current on the advances in infusion nursing—even though a lot of it does not apply what my job entails and where I work. Has there been a mentor, colleague, or INS member who has helped along the way? Not another INS member. Just the support of my colleagues, my kids, and my managers. Do you have stories from your practice that you would like to share with the infusion community? In our line of work, we see so many acutely and chronically ill patients. With the recent losses I have endured in my job, I think every day about what I say to my patients. You just never know if it’s the last time you will be speaking to that patient, and I don’t ever want to regret the last thing I said. I have many stories about my experiences in this job that I can share. Out of the respect and privacy of my patients, I will not share any specifics at this time.

Michelle Hutchinson BSN, RN, VA-BC What led you into the nursing profession? My father suffered from major stroke event when I was a junior in high school. The stroke left him in hemiparesis and dysphasia that made it hard to communicate with him. My mom took care of him for 10 years. He was in the hospital for several months. During that time, I met wonderful nurses who wore white uniforms like angels. They were so kind to my father and my family, especially to my mom. I was touched by them and decided to go to nursing school, and I became a registered nurse. I have never regretted being a nurse in 30 years of nursing. I always feel blessed to be a nurse so I can take care of patients who need help. What made you decide to specialize in infusion therapy? I was really good at IV starts. I believe God has given everyone at least one talent. For me it was IV start skills, including PICC placement. How has INS Membership benefited you in your journey? I was an INS member a while back and found good books and journals. They give me great references on a daily basis. Has there been a mentor, colleague, or INS member who has helped along the way? I had a coworker who retired few years ago who was an INS member and CRNI®. She introduced me of CRNI® exam. Do you have stories from your practice that you would like to share with the infusion community? I studied for CRNI® exam, but unfortunately, I could not take it. And yet, the time I put in studying wasn’t a waste. It gave me so much knowledge of advance-based-practice and troubleshooting skills. After that, I always tried to provide colleagues and other nurses with suggestions based on INS standards and practice. I also strongly believe that IV nurses/vascular access nurses need to have up-to-date knowledge and to provide the best patient care with recommended technology. I was diagnosed with breast cancer in 2020, and underwent chemo and surgery, then radiation therapy. I have been in a cancer remission for almost 3 months now. I have returned to my position as VAT since the last week in September, but only for 4 hours a day. During chemo, I had an implanted port. I met few nurses following the standard practice when they accessed my port and infused chemo. I also saw nurses who did not follow it. I realized then that it was a lot harder to speak up to correct their wrong practices than I thought. I always teach patients to tell nurses if they don’t scrub the hub for a minimum of 15 seconds or if they find something not right. We need to remember knowledge is power and to provide the best and safest patient care as a specialist. Thank you for the opportunity to share my experience with INS. January/February 2022


INS is proud and honored to announce three new members to the National Council on Education (NCOE). NCOE works with the INS Education Department to develop programs which O








member serves a three-year term.


interest to infusion nurses. Each



issues, and subjects of general




current trends, most prevalent



address the latest methodology,


Ashley Smith, RN, MSN, CRNI® Ashley is a nurse, leader, and speaker who values dedication, service, and excellence. Her strong background in emergency medicine and home infusion and specialty pharmacy provide the combination needed to take home infusion nursing to the next level. Ashley is passionate about quality education and is inspired to mentor fellow nurses. Ashley became an RN in 2006 and continued on to earn her MSN in nursing education from the University of North Alabama. She holds a CRNI® certification and is a member of Infusion Nurses Society (INS), Sigma Theta Tau, and the American Nurses Association. When not at work, you may find Ashley in the garden, tackling a home improvement project, and loving on her family. Ashley and her family often volunteer with their church and other local organizations, sharing love and kindness when and where it is needed most.



Lisa Tarango, BSN, RN, CRNI® Lisa Tarango has been an RN for 29 years. She worked her way up the clinical ladder from aide to LVN to associate degree RN, and finally earned her bachelor’s in 2008 from Roberts Wesleyan College. She has held nursing roles in management, pediatrics, adult med-surg, critical care (NICU and ICU), home health, and ambulatory infusion. Lisa values education and continually strives to learn. One of her mottos is “One cannot be over educated or overdressed!” Her current role as a corporate clinical educator at Altus Biologics allows her to combine her passion for nursing with her passion for education. She was the recipient of Altus Biologics employee of the month in October 2020 and was the ACE award recipient for 2020, the company’s equivalent of employee of the year. As a way to further her education, she took the CRNI® exam and received her CRNI® credentials in October 2021. A native New Yorker, Lisa now resides near Cocoa Beach, Florida. When not working, you may find Lisa at home with her rescue, an English Bulldog named Mackie; cheering on her Buffalo Bills; or enjoying time with friends and family. She has two incredible daughters, but the role she cherishes most now is as a new grammy to her grandson, Luca.

Tatiana Zhdanova, PhD, MSN, RN, CRNI® Tatiana is an infusion nurse who values commitment, knowledge, and quality. Her strong scientific background as a chemistry PhD and in medical-surgical nursing allow her to serve communities with exceptional quality. She has worked for home infusion and specialty pharmacies for last 6 years. Tatiana is also a clinical educator and inspires nursing students and fellow nurses to excellence and commitment to the patient care. Tatiana completed her MSN in nursing administration at Aspen University at 2020. She became CRNI® at 2017, and she has been a reviewer for the Journal of Infusion Nursing since 2019. Tatiana strives to bring INS Standards to each nursing unit and to connect science and infusion in the field of nursing. Tatiana likes bead work and hiking, which she usually does during vacations and on weekends with her large family.

January/February 2022


Virtual Symposium: Infusion Therapy Related Complications This Infusion Nurses Society virtual symposium will address the following 5 challenging aspects involved in the delivery of infusion therapy. Managing Infusion Reactions

All infusion reactions involve the immune system; however, some (anaphylactic) are allergic in nature whereas others (anaphylactoid) are not true allergic reactions. Although reactions can be allergic or nonallergic, the clinical manifestations are the same and require prompt, accurate assessment and management to avoid severe adverse events, including fatality. Content in this session addresses the nurses' role in patient risk assessment, institution of prophylactic measures, administration monitoring, severity grading, management, and follow-up care.

Preserving Skin Integrity

For some patients, maintaining skin integrity is challenging. Many patients receiving infusion therapy have multiple comorbidities, including renal impairment, nutritional deficiencies, hematologic disorders, or cancer. These conditions can impair the skin surrounding the vascular access device (VAD) insertion site which is vulnerable to being injured or damaged during VAD insertion, care, and dressing changes. Medical adhesive-related skin injuries (MARSI) can occur when the superficial layers of the skin are removed by VAD dressing medical adhesives, causing skin trauma. MARSI impairs the patient’s skin integrity and increases the risk for infection. In this session, attendees will learn about selecting the appropriate VAD dressing for each patient, techniques for dressing application, and interventions to prevent MARSI.

Infiltration and Extravasation: Prevention, Assessment, and Interventions

The inadvertent administration of a solution, nonvesicant (infiltration) or vesicant (extravasation), into surrounding tissue can cause significant patient harm. Despite adherence to policies and procedures for vascular access device (VAD) insertion and care and management during infusion therapy, an infiltration or extravasation may occur. In this session, educational content addresses prevention, assessment, and interventions for infiltration and extravasation.

Implanted Port Complications and Management

Implanted vascular access ports are vascular access devices that are surgically placed in the body to facilitate long-term infusion therapy. Implanted ports differ in construct, size, and application and can be subject to technical difficulties which may lead to patient complications. In this session, learn more about implanted vascular access ports, use and management, complications—such as occlusions, malposition, infection, infiltration, and extravasation—and ways to intervene.

Competency Validation for Patient Safety

Competency is a required level of effective performance in the work environment defined by adherence to professional standards, including knowledge, skills, abilities, and judgment based on established science. Due to its invasive, high-risk nature, the clinician with responsibility for VAD insertion, safe delivery of infusion therapy, and VAD management must demonstrate competency with each of these skills as well as with the comprehensive role of infusion nursing. The length of clinical experience and passive recurrent performance are not surrogates for clinical knowledge and procedural competence for experienced clinicians. So how can initial and ongoing competency be validated? In this session, attendees will learn about managing competency assessment and validation in 2 phases: initial competency and ongoing competency.

At the completion of this symposium, attendees will earn 5 contact hours and 10 RUs. 19


Supported Through an Educational Grant by


Michele Africa Misbah Akbar Christopher Akers Marci Anderson Charles Anthony Zorymar Areford Alyssa Aust Shawn Bainbridge Sandra Balcer Heidi Balfany Rudolph Bauder Lisa Baxter Grace Becker John Rey Benedicto Patricia Blenet Karen Blewitt Selena Brown Nicole Burke Todne Burns CarolynBurr Maria Callaway Sarah Carsman Jaclyn Cartwright KatelynCiuffetelli Orrin Converse Melissa Corrao Chelsea Dalbey Quynh Dao Ryan Dennis Kristine Doria Gary Dormevil Lacey Douglas Christopher Duke Glenda Durrett



Joseph E. Elmer

Kasie Leonard

Gabriel Eigen

Joe Liedecke

Theresa Emmerling

Deb Lind

Doris Espinal

Billy Lindberg

Elaine Evangelista

Marika Loftman-Davis

Gary Evers

Lyudmyla Lukova

Kirsten Fell

Karen Lynn

Hannah Feller

Melissa Madrid

April Figueroa

Lisa Maffei

Carly Foley

Todo Maligad

Isaiah Frye

Rebecca Marcum

Kelly Gardner

Julie Matulewicz

Jessica Gavin

Nannette McDaniel

Kelly Gelfman-Watanabe

Melissa Mckissack

Paige Gilvin

Wanda McNeal

Jessica Goben

Kristy Mendoza

Jeanna Golob

Julia Merrill

Stacy Gray

Laura Messer

Amy Green

Shannon Micklos

Jennifer Green

Jeffrey Miller

Beth Hartman

Amanda Montgomery

Edith Hicks

Stephanie Moye

April Hunt

Rebecca Navel

Bethany Hunt

Claudia Nesler

Denise Jaffe

Darryl Nichols

Venus Jaschke

Loretta Nichols

Saloman Joseph

Teresa Nidey

Jennifer Maureen Kalugdan

Almond Nolan

Leigh Ann Kelly

Meagan Nunez

Victoria Kenyon

Ashley Odom

Deborah Kingsley

Ellen O’Donnell-Ali

Victoria Knox

Tracey Ogle

Jacques LeClaire

Harry Padilla

Jennifer Leddy

Mia Marie Anne Palencia

Paula Lee

Sarah Palya

Danielle Leigh

Kristin Parker


Sheba Thomas


Deborah Prado

Jinu Thomas

Rebecca Provencher

Leann Thoresen

Rebecca Bechet – United Arab Emirates

Trish Pruiksma

Kayla Thurman

Emmanuel Canillas – Canada

Elaine Punzalan

Amy Tucker

Jessica Rasmussen

Hanna Tweedy

Angela Ratzlaff

Jamin Tyson

Deoksik Choi – South Korea

Tonya Redman

Laura Use

Azlina Daud – Malaysia

Rebecca Reed

Brandon Valenzuela

Jolene Reese

Rayneisha Varner

Andrea Renaud

Lore Vega

Bobby Rice

Jean Verdecia

Yujoo Kang – South Korea

Dan Richmond

Hugues Villeneuve

Yujeong Ko – South Korea

Shannon Rives

Becky Wallace

Raheema Saleh

Jennifer Walsh

Seon Sayles

Laura Waltemath

Jaehyun Lee – United Arab Emirates

Jaclyn Schindler

Crystal Wang

Hyejin Park –South Korea

Charito Sendino

Crystal Ward

Lesley Sgro

Yocheved Weinreb

Leticia Shay

JD Weir

Patti Shay-Dagenais

Jennifer Welch

Hyoeun Song – South Korea

Ashley Simmons

Debbie Werneke

Diana Vucic – Australia

Tajinder Singh

Shelley West

Alfred Siringoringo

Holly Whitehead

Casey Skalka

Bernadette Wieboldt

Tanya Song

Sheri Wiggins

Omaris Soto Rosario

Eyvonne Willetts

Tamika Spratt

Marion Williamson

Crystal Stalnaker

Kristin Windschitl

Margaret Stanaway

Jennifer Winters

Valerie Stayton

Alysson Wittmeyer

Jake Stephens

Jennifer Wyatt

Angela Stong

Hui Xu

Katie Stroh

Paige Yang

Elizabeth Sztyber

Melissa Zankich

Brandon Tabilisma

Amy Zeis

Peter Chapman – Australia

Jonas Fast – Switzerland Ara Jo – South Korea

Yuna Lee – South Korea

Amanda Saba – Brazil Rae-Lyn Snyder – Canada

January/February 2022


INSide Scoop Our recurring feature, INSide Scoop, serves to keep you informed on things happening within INS as well as upcoming events, items of interest, new educational deliverables, certification news, and other current information. Here we communicate directly with our membership as well as with the larger infusion nursing community to keep you informed on topics—in real time.



While we’re still addressing issues related to the COVID-19 pandemic and concerns with in-person meetings, in-person meetings are also returning. In October, INCC chair Myra Swintz and CEO Mary Alexander attended the American Board of Nursing Specialties (ABNS) fall conference in Chicago, Illinois. INCC is 1 of over 30 ABNS member organizations that collectively represents approximately 930,000 certified registered nurses worldwide and is accredited by the American Board of Specialty Nursing Certification (ABSNC). Sessions of interest included vaccine hesitancy and the nurse’s role, feasibility of microcertifications, creating the future of the nursing workforce, improving diagnostic performance through teamwork, and designing a successful organizational DEI initiative.

In November, Mary Alexander was invited by the Institute of Safe Medication Practices (ISMP) to participate in a national summit, The Future of Perioperative Medication Safety: Charting Our Path Forward. The 2-day virtual meeting was attended by a multidisciplinary group of health care experts, frontline practitioners, professional association representatives, and medical product vendors. The goal was to develop a consensus document for publication that addressed the adoption and implementation of best practices for all perioperative settings to reduce and eliminate risk and support safe patient outcomes.

In November, INS president elect Max Holder and CEO Mary Alexander attended the 2021 Nursing Organizations Alliance (NOA) fall summit in Virginia Beach, Virginia. At the opening session, author and filmmaker Carolyn Jones focused on celebrating nurses and their work, especially during the pandemic. The audience was treated to several clips from her film In Case of Emergency. Sue Hassmiller, the senior advisor for nursing at the Robert Wood Johnson Foundation, highlighted areas within the report, The Future of Nursing: Charting a Path to Achieve Health Equity, that nursing organizations may adopt to create a shared agenda that addresses health equity. As a frequent attendee at many Nursing Alliance Leadership Academy (NALA) meetings, Alexander provided a testimonial at the business meeting on the value of NALA to volunteer leaders and the chief staff executives.

Congratulations to the newest addition to the INS/INCC management team! Whitney Wilkins Hall has been promoted from Marketing Project Manager to Marketing Manager. In her new role, she will work closely with managers of each department to create and execute business growth and development plans. Whitney started with INS just 1 year ago, but in a short amount of time has managed to excel in her project manager role and reports quantifiable increases correlating to marketing initiatives. Whitney brings her creative energy and enthusiasm to each task along with unparalleled organizational skills, ensuring that the vast amount of marketing responsibilities are executed efficiently. Whitney says she feels honored to be given the opportunity and looks forward to what INS can accomplish in 2022.

The day prior to the NOA fall summit, INS attended the American Nurses Association (ANA) organizational affiliates meeting. Chaired by ANA president Ernest Grant, the meeting covered topics on ANA initiatives on racism in nursing, nursing staff issues, and vaccine hesitancy.

Maria Connors, CAE, Director of Operations and Member Services, and Marlene Steinheiser, PhD, RN, CRNI, Director of Clinical Education, attended the 2021 MAGNET conference as exhibitors. They connected with clinicians working in acute care, outpatient infusion centers, home infusion, and academia. Many attendees were interested in



the Fundamentals of Infusion Therapy (FIT) program to aid in educating nursing students, new graduates, and nurses new to infusion therapy. Some attendees were interested in INS certification and continuing nursing education. Many who stopped by the INS booth were familiar with the INS Infusion Therapy Standards of Practice. It was exciting to hear that nurses knew that the INS Standards underpin their organizations’ policies. It was a great couple of days to connect with clinicians, nursing managers, industry partners, and even the pet therapy dogs!

Membership Services In the past fifteen years, the digital age has improved the global communication at INS. We now have members from over 33 countries, and you can connect with INS using our homepage chat feature to receive immediate customer service. INS has also taken a more targeted approach to hear what our members want—and it’s working! Our members can earn CEUs free by viewing live or archived webinars online through the INS LEARNING Center. We also offer virtual education, which allows you to partake in educational programs at a time that is convenient for you. The Journal of Infusion Nursing offers member access to current and archived issues. The Clinical Community Discussion Forum allows members to connect with other infusion nurses with their clinical questions. And as of this year, members receive free digital access to the Infusion Therapy Standards of Practice, an unparalleled offering. And don’t forget that membership also provides you with great pricing discounts off our products, education, and events. There’s never been a better time to join INS!


Marlene Steinheiser, PhD, RN, CRNI®, Director of Clinical Education, at the 2021 MAGNET Conference

Meetings Did you know that INS Annual Meetings now offer different opportunities to present in front of a large group of nurses to showcase the latest products and services in the infusion industry? New this year are Partner Presentations, where the sponsor provides a 1-hour educational session for up to 300 attendees (150 for each session). Sessions will repeat, which allows the presentation to occur for two different audiences. The sponsor will select the speaker and manage the content presented. These presentations will occur simultaneously with other sponsored sessions on Saturday, June 4 at 2:30 p.m. and again at 3:45 p.m. at INS 2022. Visit our website to learn more!

The Publications Department would like to welcome four initial members to the newly formed Journal of Infusing Nursing Editorial Review Board: Lynn G. Brown, MS, MA, BSN, RN, CRNI®, FACHE, Gail P. Dammert, MBA, MSN, RN, OCN, Angie Malone, DNP, APRN, ACNS-BC, OCN, AOCNS, NE-BC, and Theresa Wicklin Gillespie, PhD, MA, FAAN. We look forward to working with all four members in the years ahead. Congratulations to Marlene Steinheiser, PhD, RN, CRNI®, Director of Clinical Education and Dawn Berndt, DNP, RN, CRNI®, Clinical Education and Publications Manager, who worked with a group of researchers to publish “Effect of Infusion Therapy Interactive Modules on Nursing Students’ Knowledge and Self-Confidence” in Teaching and Learning in Nursing, the official journal of the Organization for Associate Degree in Nursing. Their results showed that the FIT program, an interactive e-learning program developed in accordance with the INS Standards, addressed the missing educational content in nursing school curriculum and significantly improved students’ knowledge and selfconfidence. To find out more about this article, the FIT program, and/or INS educational opportunities, email Marlene Steinheiser at marlene.steinheiser@ins1.org.

January/February 2022



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