Inside this issue: New Features New Members/Toll Free Phone Number
2 3
AMTA Annual Research
4
Hospice Documentation
5
President to attend NOA Leadership Academy and AMTA Conference
6
Dr. Bonnie Mackey Manual
6
Andy Bernay-Roman Publishes New Book
6
NANMT Board Members Judy Dean, President jldrnc@comcast.net Andy Bernay-Roman, Treasurer & Founding Member andy@deepfeeling.com Cheryl Chapman, Director touch2rn@aol.com
Shawn Hicks, Exec Dir shicks@longmgt.com
Volume 11, Issue 3 2012 Headquarters PO Box 232 West Milton, OH 45383 855-366-2668 937-698-4128 Fax: 937-698-6153 info@nanmt.org
A New Director has joined the Board: A New Director has joined the Board: Cheryl Chapman, RN, HN-BC, LMT, NCTMB, a well known Continuing Educator in Nursing and Massage Therapy for more than 25 years has joined NANMT’s Board. Cheryl brings an overwhelming amount of expertise to the Board – having received several awards from National AMTA, being the
President of the NJ AMTA Chapter. Author of many articles related to Breast Massage, the Cancer patient as well as clinical & Nursing Management experience in both acute and extended care facilities. The Board is excited that Cheryl will help lead NANMT in its many endeavors.
Allegra Allegra has added 4 new CE courses which include “Holistic and Integrative Health: A Introduction; Walk Away Your Stress ; Meditation and Religious Traditions; and Pediatric Abusive Head Trauma aka Shaken Baby Syndrome.
thanks to those members who accessed these courses: End of Life Issues: Death, Dying & Grief; Hospice and Palliative
Several individuals have accessed Allegra and as an affiliate NANMT receives a commission for those CE Programs. So
Care; Spiritual Care of the Dying; Nutrition: An Integrative Approach and Natural Sweeteners: Health options for your
Sweet Tooth. Let NANMT know what you think of the quality of these courses. Remember, taking any courses from our Partner, Allegra Learning Systems gives you credit toward both Massage Therapy and Nursing CE for the same course. In addition, NANMT receives a commission on those completed courses.
Personal Website NANMT announces another FREE service for its Active & Senior Category members…… your own website within NANMT’s website. NANMT will design, host and maintain your webpage for you. This FREE web page will display your professional profile, your writ-
ten info about your services and will be linked NANMT’s Community Accessed Referral Directory and allows potential clients read about your services. Interested? Send NANMT an e -mail with the following info: your name, contact phone
Number, a JPG head shot of yourself no larger than 5 MB, your specialties and services, your rates, availability, any links to your other websites and how long been in practice. Also include professional accomplishments you wish to share.
More Changes Coming The Board is diligently working to make the process of making the initial and renewal process more consumer friendly. You will be notified as these changes are permanently in place before the January renewal date.
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NANMT NEWS
Standards of Care for the Nurse Massage Therapists
This page introduces a few new features of the NANMT Newsletter
Along with the revision of the Documentation Manual for the Nurse Massage Therapist, The Board determined that the current Standards of Practice (SOP’s) for our members also needed to be updated. Rather
than have just a few individuals review the relevancy of the Standards, the SOP’s have been placed on NANMT’s Website for Active and Senior members input. You will receive
a special code in a separate email to access the SOP’s. Take advantage of this opportunity to make a difference in a major document.
Frequently Asked Questions This is a new feature of the Newsletter. Have a question, submit it for a possible answer from a fellow member. Maybe you have information that many members may be interested in. Submit it to NANMT for publication in the next newsletter. Maybe NANMT should develop a Blog….something to think about in the future. Question # 1 If the State in which I practice Nursing acknowledges within the Nurse Practice Act or Scope of Practice that Massage is component of my Nursing Care, why must I also have a license to provide Massage Therapy to clients? Answer: This comment has come up often in conversation. Often there may be an overlap between the Practice of Nursing and that of Massage. All States regulate Nursing and therefore we nurses must be registered in the State in which we practice. Therefore, no one can call themselves a nurse or rep-
resent themselves as having our body of knowledge. That would be operating outside the regulation of the LAW. States which have Licensure, Certification, or Registration for Massage Therapy also have in their State Statutes an identified Scope of Practice for those who provide Massage Therapy. If a Nurse performs Massage Therapy for compensation, advertises as being a Massage Therapist, or whose Practice is primarily Massage the Nurse must have a dual Licensure in that State. If however massage is conducted as an element of practice within a broader documented nursing care plan this may be within the licensed nurses’ Scope of Practice. Question # 2 How will my NCB credential and recertification /with the NCBTMB be affected by NCB’s Board new changes regarding 750 hours of Education?
Answer The call to NCBTMB HQ resulted in two responses: A) The customer service rep relayed that the 750 hours of Education would include the hours of the basic Massage Therapy Program plus all the CE hours submitted with the original Certification to make up the total of 750 hours required. B) It was also highly commended that the Certificant personally call NCB, have them access your records to determine the amount of CE hours you already have at (800) 2960664 Mon-Fri 9-5pm Chicago Central Time. So it would appears that those certified by any process - Porfolio or NCB exam, have the required 750 hours plus a national background check will not have their current re-certification process impacted. Please access www.ncbtmb.org and choose new credential program.
Book Reviewers/ Call for Newsletter Authors Have a story to tell? Maybe an approach you have found helpful with your clients? Or an area of expertise you wish to share. Check the Guidelines for Newsletter Article on NANMT’s site at www.nanmt org. Have experience as (or wish to
be) a Book Reviewer? If so, let NANMT know. NANMT has contacted various Publishers and Publications for their Specific Guidelines to review Books. NANMT intends to be the first contact- by Publishers - as having the Expertise on reviewing articles or texts on incorporation / adaptation of CAM methods into the Prac-
tice of Nursing , Health care, Wellness or Preventative health oriented measures. We have the expertise – it’s time to let others hear our voice. If you wish to become a Book reviewer….NANMT has generic guidelines. Just call the 800 number and access Judy Dean’s voicemail.
Volume 11, Issue 1
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UPDATE: Dual Insurance Survey Thanks to all of you who responded to our most recent survey regarding Dual Insurance. Over 25% response which is absolutely great. Former members also replied giving suggestions for improvement. Last week a call from the
potential Insurance Broker brought negative news. They felt that our members were so varied in their Nursing Practice area they would not be able to write so many individual policies. In the discussion, it was determined that the Broker felt that each nurse
whether in OB, Surgery, Home Care, Med-Surg, ICU required separate policies. Not sure about that assumption. It appears as though NANMT is at a standstill regarding this. As more information comes in, you will be notified.
NANMT’S New Toll Free Number NANMT recently changed it’s 800 number to (855) 366-2668. The usual monthly fees associated with an 800 number is offered Free through Grassroots, an organi-
zation committed to helping small non-profits to essential FREE services as they initially start or expand. MARK the number for future reference.
Welcome to All Members NANMT is only as strong as it’s membership and our membership is growing and each individual or institution which renewed as a member of the various Categories -- The Board is grateful for your support. NEW MEMBERS
NEW MEMBERS
If you want to contact one of these new members, please visit the member public referral section or the member section. If you would like a listing mailed to you for those members in your state, just let us know call 1.800.262.4017 or email info@nanmt.org.
new members
ACTIVE Members SUPPORTING Member Zorina Baich-Cone, RN LMT LMP Bend, OR Gillian Lewis RN Temple, AZ Roberta Cirocco ARNP LMT Jacksonville, FL Della DeVenturi, RN LMT MMP Pulask,i TN STUDENT Members Leonardo Feraer-Oporto, MS RPN CMBST CMT Melissa Chretien, LMT NCTMB Bath, ME Staten Island, NY Deborah Dye, RN Brook, IN Sheila Fontana, RN LMT Glenwood Landing, NY Sherry Friedman, LPN LMBT Asheville, NC Marissa Fratoni, RN LMT Leominster, MA Robert Jones, CMT Webberville, MN Susan Holtzman, LPN LMT West Palm Beach, FL Eulonda Martin, RN BSN Forest Hill, LA Candace Jerry, RN LMT Hamburg, AR Janice VonHeim, LPN LMT Blair, NE Elizabeth Kadar, RN LMT Pittsfield, MA Melissa L Wustner, CAN LMT NCTMB Bozeman, MT Debra Kietzma,n RN NCTMB Richland, WA Veda Elaine Lewis, RN NCTMB MT Marksville, LA Pending New Members Rosemary McCormick, RN LMT CLT New Hart- Lisa Stair, LPN LMT Marion, IN ford, NY Kali Young, RN Asbury, NJ Cindy McMullen, RN LMT Colorado Springs, CO Lisa Romano, RN LMT Clearwater, FL Jane Mergle, RN LMT NCTMB Loveland, CO Peter Monzon, RN Trinidad, CO Gretchen Murphy, RN NCTMB LMT Racine, WI RETURNING MEMBERS Margie W Quillen, RN MT Little Elm, TX Carole M Burkhart, RN LMT CHTP/I Sarasota, FL Anthony Suarez, LPN MT Miami, FL Judith Dean, RN NCTMB DSc CHt LaPorte, IN Dorothy Torsey, LPN LMT Scituate, MA Vicki L Grabicki RN LMP Bellingham, WA Patricia S Wolfe, RN NCTMB LMT Malden, MA Linda LePelley, RN LMTI LMT Henderson, TX Katharine F Vallario, RN NCTMB CMT
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NANMT NEWS
Documentation in Hospice: What Do Employers Expect? Hospice organizations that hire or contract massage therapists expect professionalism. They expect sound documentation skills. Although there isn't a lot of consistency in how documentation is carried out, what IS consistent is the requirement to do it, and do it well.
For those of you whose eyes cross at the mention of progress notes, I want to offer a simple guide that is relevant to hospice.
I once spoke with a hospice director who told me, "We use to have a massage therapist but it didn't work out." When I asked her what went wrong, she said one reason was that, "her documentation was poor quality." The take-away message here is: Sharpen your documentation skills and accept that it is an important part of the job if you want to work in any aspect of our health care system. Why Document? The main reason you became a massage therapist most likely wasn't because you were excited about doing paperwork or writing progress notes. Ask any nurse or physical therapist or physician and they will tell you it isn't their favorite thing, either. I've found if I re-frame my ideas about documentation, then an attitude adjustment is quick to follow. What follows are good reasons to pay close attention to your documentation skills. Credibility: How you represent your work in progress notes reflects your degree of professionalism in the eyes of employers and coworkers. Efficacy: Progress notes provide a means to track effectiveness of techniques or approaches in attaining desired goals.
Functional Outcomes: Your notes tell a story, over time, about the difference massage makes in your client's activities of daily living. Improved relationship with colleagues: When your documentation provides valuable information for coworkers, your work is taken more seriously and you demonstrate that you are a team player.
Legal record: Documentation is your legal record of the services you provided. Marketable skills: When applying for a position in hospice, highlight experience you have with healthcare documentation. Don't just take my word for it. I did an online search for massage therapy jobs in hospice and in almost all notices job requirements referred to documentation skills. It's also worth noting that the number of job notices online is growing. Here are a few examples taken from postings that mention expectations with regards to documentation:
Document patient treat-
ments, needs and progress with accuracy and clarity. Reviews patient's chart and all medical history prior to initiating treatments. Documents all patient visits according to charting policies and procedures. Submits periodic reports to treatment team or physician to provide clinical data for evaluation. Maintain accurate and timely progress notes in the activities section of the medical chart. Basic computer skills to include Outlook, Microsoft Office and Windows. Keeping SOAP Notes Simple For those of you whose eyes cross at the mention of progress notes, I want to offer a simple guide that is relevant to hospice. Since many use SOAP notes, it's likely you will be required to use this format. Think of a SOAP note as a picture of the session, showing the reader what you observed of your client; what you did, how your client responded and what you plan to do for future sessions. S = Subjective information. In this section, record verbal comments your client makes about any of these things: their reason for and desired outcome of the session; a description of symptoms; the effect of symptoms on activities of daily living; and pain levels or other discomfort. It's common for the hospice care team to determine levels of pain using a pain scale the Wong-Baker
Volume 11, Issue 1
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Documentation in Hospice: What Do Employers Expect?—cont’d (Continued from page 4)
Faces and Ruler Pain Rating Scale. You should also record any other relevant comments by the patient or family caregivers. There are times when a client, due to an advanced condition, is unable to provide such information, in which case it might be reported to you by a nurse, physician or other team member. In this case, you would state that the client is unable to verbalize the information but it was reported by (name and title of informant). O= Objective observations. This section includes both observations of the client and what you did during the session. Describe just the facts about your observations — only what you can see, hear, touch or smell. Observations might include, but are not limited to special communication needs; breathing patterns; movement; muscle texture; functional mobility; body posture or position; skin condition; facial expression; sign of stress or agitation; interpersonal interaction; alertness; observation of confusion or memory loss; and non-verbal signs of pain. The record of what you did should include information about site restrictions, precautions taken, the length of the session, bed or wheelchair positioning adaptations performed, massage or bodywork techniques that were utilized and which area of the body was addressed. Descriptive language of the techniques used could include: focused touch, gentle compression, petrissage/kneading, effleurage/stroking, gentle stretching, holding, shared breathing, gentle rocking, mois-
turizing, abdominal massage, manual lymphatic drainage, energetic modality and caregiver instruction or support. A= Assessment. Record the immediate results of the session including observed client responses and changes. Examples of observable responses might include signs of decreased pain; positive verbal comments; decreased agitated behaviors; fell asleep; increase in social interaction; appears more engaged; decreased muscle tension; relaxation response; deeper breathing; appears more alert; change in facial expression; improved movement; postural change; skin changes; returned touch; and improved ability to perform an activity of daily living. P=Plan. This section includes information relevant to the treatment plan, including frequency of future sessions; additional client needs; treatment recommendations for future sessions and desired outcomes; client requests; and a need for caregiver instruction. On the Job I interviewed several massage therapists employed in hospice or long-term care about what documentation is required of them. As expected, it varies a great deal. Some organizations use electronic systems and more organizations are transitioning to electronic record keeping. Some organizations provide the therapist with documentation forms developed by the company. Other therapists must provide their own forms. Some use a structured SOAP note form with checklists, others write narrative notes or a combination of the two. Most organizations place the therapist's documentation in the medical record or
other patient chart. Valerie Stoughton Hartman is a Complementary Therapy Hospice and Palliative Care Nurse and Chairman of the National Hospice and Palliative Care Organization (NHPCO) Allied Therapy Section. She says that complementary therapies have taken a place in mainstream services provided by hospice programs in the United States. While many hospices appreciate and grow volunteer complementary therapy programs, others remain committed to hiring hospice prepared therapists. When it comes to documentation, the industry is in the midst of figuring out best practices. As it stands right now, documentation standards are dictated by each individual hospice program. Administrators make executive decisions in order to assure accurate documentation reflects the purposeful use of a modality. Hired therapists have a responsibility in the referral process, interdisciplinary team communication, evaluation, assessment and provision of service. Volunteer expectations are often much less demanding. The NHPCO is a resource for program development if a massage therapist volunteers or is hired to work with a hospice program that is a member of the organization. I agree with Valerie when she encourages massage therapists working in hospice to join the NCHPP Allied Therapy Section, which oversees allied therapy and complementary therapy use and integration in end of life care. We can all have a voice in establishing best practices in this rapidly growing field of massage.
Ann Catlin, LMT, OTR has more than 30 years experience with elders in facility care, persons with disabilities and the dying, using both her skills as a massage therapist and occupational therapist. She is the executive director of the Center for Compassionate Touch LLC, an organization that provides Compassionate Touch training for massage therapists and other health professionals and consulting services for eldercare and hospice organizations. Published in the Aug/2012 issue of Massage Today,
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NANMT NEWS
National Organizations Alliance – NOA National Organizations Alliance – NOANANMT is a member of the NOA, a coalition of more than 65 organizations united to create a strong voice for nurses as they focus on current and emerging nursing and health care related issues.
Judy Dean, President of NANMT, will attend NOA’s 8th Annual Leadership Academy on August 18 & 19 in Louisville, KY. The conference provides consistent effective volunteer governance leadership education for individuals
within the Alliance Organization. The conference will assist volunteer leaders on their journey of development and refinement of the knowledge and skills necessary to govern and lead their organizations effectively.
AMTA National Convention, Raleigh NC Oct. 4 - 6, 2012 Judy Dean, President of NANMT, will represent NANMT at the convention to connect with each of the exhibitors to market the advantages of advertising in the NANMT’s newsletter or on
the website. In addition, Judy will connect with many of her former colleagues of NCB to discuss the potential of developing a National Certification of the Nurse Massage Therapists. Hopefully her presence
at the Exhibit Hall will allow her to connect with many Nurse Massage Therapists attendees to share our goals with them.
Dr. Bonnie Mackey Documentation Manual The Documentation Manual for Nurse Massage Therapists authored by Dr. Bonnie Mackey in the 1990’s s being revised to
reflect the current and emerging trends within Nursing and Massage Therapy. When complete, the newly revamped
A New E-Book Andy Bernay Roman, the Treasurer for NANMT, has written an E Book entitle “Deep Feeling, Deep Healing, Mind- Body Wisdom for Bodyworkers.” It is available from Amazon via the Kindle Synopsis of the e-Book “Touch is emotional. Although bodyworkers primarily focus on the treatment of the soft tissue of the body, they are
in fact treating the whole person and often encounter an expression of emotion and/or memories triggered by touch. In this e-book, massage therapies and/or bodyworkers learn how psychoneuroimmunology (PNI) validates the mind/body link so they can better support clients and help them facilitate positive changes that last over time.
Documentation Manual will be available to members.
NANMT Membership Application Contact/Name _____________________________________________ Email _________________________________ Business/Company/Institutional Name _________________________________________________________________ Mailing Address __________________________________________________________________________________ City
___________________________________________ State _____________ Zip ________________
Home Phone __________________________ Cell __________________________ Fax _________________________ Nurse/Massage Business Phone ______________________________ Website: _______________________________ ** Professional Designations (Include all that apply) ** RN **
LPN
LVN
___
LMT
MT
Student Nurse________________________________** Institution
CMT
NCTMB
__________________
Massage Student ________________________________
City State
Institution
City State
**RN/LPN Lic# _________________________ **Massage Lic#_____________________________ State
#
** NCTMB # ___________________
State
[] Not Required
#
Business Lic# ____________________________
[] Not Required
State/County/City
PLEASE SEND PROOF OF STATUS: Include photocopy of actual Nursing and Massage Therapy License issued by your STATE. For Student membership, submit photocopy of student status proof of enrollment.. MAIL or FAX TO: 937-698-6153 Attn: Membership EMAIL SCANS to: info@nanmt.org
Nurse Specialties __________________________________________________________________________________ Massage/Bodywork Modalities ________________________________________________________________________ I want my information to appear in the NANMT public online referral directory at www.nanmt.org
[] Yes [] No
(For Active and Senior Members with Nurse Massage Therapy Professional Designations currently offering services.)
How did you find NANMT?
Web
School
Book
Referral
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Other _______________
I testify that all this information is true and correct. I understand I am responsible for notifying NANMT if any changes in this information occur. NANMT's CODE of ETHICS: The National Association of Nurse Massage Therapist members uphold the highest standards in the professions of both Nursing and Massage Therapy. By signing below, you agree to abide by NANMT's By-laws, Code of Ethics and Standards of Care. To review these documents please access www.nanmt.org. Include photocopy of actual Nursing and Massage Therapy licensure to be included with membership payment.
____________________________________________________________ Signature
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Date
Please check the appropriate boxes:
boxes:
ACTIVE:(one vote) A licensed nurse who holds NCBMB certification or a state license to practice therapeutic massage/bodywork, or has completed a minimum of 500 hours verifiable instruction in massage and/or bodyworks. Please send proof of status by mail, fax or email. This is required to process Active Members. $100 yearly dues As an active member, I am interested in a leadership role within NANMT. STUDENT: (non-voting) One of the following applies: a licensed nurse enrolled in a massage therapy/bodywork program which will quality him/her to take a state massage licensing exam or the NCTMB exam; a nurse massage therapist enrolled in a graduate level nursing program; a practicing massage therapist enrolled in an accredited school of nursing . Please send proof of school enrollment by mail, fax or email. This is required to process Student Members. $55 yearly dues INSTITUTIONAL MEMBER: (non-voting) A university, college or school of nursing or massage therapy, corporation, or individual business supporting NANMT’s goals and mission. Benefits: discounted advertising and exhibit space at conferences. $300 yearly dues SUPPORTING MEMBER: (non-voting) An individual interested in supporting NANMT’s philosophy and goals. $75 yearly dues SENIOR MEMBER: (non-voting) An individual age 62 or over. $65 yearly dues [Type not mandatory – you may choose to be Active if qualified or Supporting.]
Please make payable to NANMT in US funds and return completed application and fee to: National Association of Nurse Massage Therapists (NANMT) PO Box 232, West Milton, OH 45383-0232. ** Required
NATIONAL ASSOCIATION OF NURSE MASSAGE THERAPISTS
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Headquarters PO Box 232 West Milton, OH 45383 855-877-0323 937-698-4128 Fax: 937-698-6153 info@nanmt.org
Hertz offers NANMT members special year-round discounts on daily, weekly, weekend, and monthly rentals for business or pleasure; traveling in the U.S. or worldwide. Call 800-6542210 or visit the Hertz website at www.hertz.com. Mention your NANMT code when making your reservation. You must present your Hertz Member Discount Card at the time of rental. It’s that easy! Members, Go to the Members Only page of NANMT.org for your NANMT Code.
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