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OFFICIAL NEWSLETTER
MedSurg
MedSurg
Matters
Volume 16 - Number 2
March/April 2007
Dee A. Jones, BSN, RN
Pulmonary hypertension (PH) is a mysterious condition for patients and the medicalsurgical nurse. Year after year, patients experience the progressive effects of PH due
to undiagnosed or misdiagnosed illness. This article will discuss care of the patient
with PH and decrease the ambiguity of signs and symptoms in patients with PH.
P
Pulmonary hypertension (PH) is quite difficult to diagnose. The onset of PH often begins
with shortness of breath and fatigue, which is indicative of many other conditions (Steinbis,
2006). The medical-surgical nurse must be knowledgeable in many aspects of nursing care.
It has been said that the medical-surgical nurse is “Jack of all trades and master of none.”
I disagree. The medical-surgical nurse must be “master of creativity” and is a specialist in
this area of nursing. Care for the patient with PH requires both critical and creative thinking skills.
Pathophysiology
Pathophysiology becomes important to the nurse. “PH is diagnosed when the systolic pressure in the pulmonary artery exceeds 30mm Hg” (Sommers, Johnson, & Beery, 2007, p. 796).
The vessels in the pulmonary system become resistant, thus the vessel intima becomes fibrotic
and thickens. This leads to chronic “hypoxemia which produces hypertrophy of the medial muscle layer in the smaller branches of the pulmonary artery...As this condition progresses, cardiac
output falls and may cause shock” (Sommers et al., 2007, p. 797).
Two types of PH exist; primary PH and secondary PH. Primary PH is idiopathic or has an
unknown cause, but it can be hereditary. “In secondary PH, underlying conditions may cause
hypoxia, which causes vasoconstriction in the pulmonary vascular bed; blood flow is then
diverted to areas of adequate ventilation to allow for oxygenation” (Steinbis, 2006, p. 8). This
disease is quite debilitating as it progresses and can be fatal.
Assessment
Patient history is vital in nursing care no matter what the diagnosis. Genetics, past illnesses,
allergies, and medication history are bits of information that assist in caring for the patient. This
author notes that more awareness of PH is needed, even though PH has come to the forefront since
the removal of diet drugs like fenfluramine and dexfluramine from the market. It is documented that
“use of these drugs contributed to the development of PH in numerous people” (Steinbis, 2006, p.
8).
Cardiac evaluation becomes vital in the patient with PH. Upon auscultation, not only will
this patient have signs of right-sided ventricular failure, but left-sided ventricular failure may coexist as well (see Table 1 on page 12).
continued on page 12
FEATURES
NEWS
A Patient’s Perspective
On Pulmonary Hypertension . . . . . . . . . . . . . . . . .3
Drugs Being Studied to
Treat Pulmonary Hypertension . . . . . . . . . . . . . . . .4
Five Million Lives:
The Campaign for Patient Safety . . . . . . . . . . . . . .8
President’s Message . . . . . . . . . . . . . . . . . . . . . . .2
Diana Anderson
Named New Editor for MedSurg Matters . . . . . . .6
News from Committees . . . . . . . . . . . . . . . . . . .10
Chapter News . . . . . . . . . . . . . . . . . . . . . . . . .14
Kathleen A. Reeves
OFFICIAL NEWSLETTER
Volume 16 - Number 2
March/April 2007
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Indexing
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MedSurg Matters is indexed in the Cumulative
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© Copyright 2007 by AMSN. All rights
reserved. Reproduction in whole or part, electronic or mechanical without written permission
of the publisher is prohibited. The opinions
expressed in MedSurg Matters are those of the
contributors, authors and/or advertisers, and
do not necessarily reflect the views of AMSN,
MedSurg Matters, or its editorial staff.
Publication Management by
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President’s
MESSAGE
Quality Patient Care:
Why We Became Nurses
Most of you are probably aware that March 4-10,
2007, was Patient Safety Awareness Week. Posters and
special reminders were evident in the hospitals I frequent
as a clinical nurse specialist and as a faculty member. I
would like to share with you that at times, I see so many
signs and posters that I do not always take the time to read
the information thoroughly – that is until my son was hospitalized during that week.
Florence Nightingale stated long ago, “It may
seem a strange principle to enunciate as the very first
requirement in a hospital that it should do the sick no harm.” This statement continues to be relevant today. According to estimates from the Institute of
Healthcare Improvement (IHI), 40,000 instances of medical harm occur each
day in the United States. IHI’s definition of medical harm is “unintended physical injury resulting from or contributed to by medical care (including the
absence of indicated medical treatment) that requires additional monitoring,
treatment, or hospitalization, or that results in death. Such injury is considered
harm whether or not it is considered preventable, resulted from a medical error,
or occurred within a hospital.”
Did my son experience a medical error during his hospitalization? The honest answer to that question is – not to our knowledge. Were there some near
misses? Definitely. Fortunately, the overall nursing care resulted in positive outcomes for my son.
My sincere appreciation goes to the nurses who recognized the antibiotic
originally ordered for my son should not be administered to someone with a
penicillin sensitivity. Thankfully, the ordered medication was never administered
to my son. My son has known since he was a little boy that his extreme allergy
to penicillin could be life threatening, and thus, he clearly described this allergy
to the physician and nurses. Many organizations, including The Joint
Commission, recommend that patients be actively involved in their care as a
strategy to improve patient safety. Despite my son’s active participation in his
healthcare, the physician still ordered the incorrect medication.
Medications were administered throughout my son’s hospitalization.
Information was posted about patient safety measures throughout the hospital.
Maybe I noticed the posters since I had never been in that hospital before or
because of the irony of the content. Regardless, despite the focus on patient
safety, my son’s armband was not examined, the medication administration
record was not brought into the room, nor was there any request for my son to
state his name (actually, there was no greeting of any kind, rather a statement
that an intravenous medication was being hung). The Joint Commission’s safety
goal of using at least two patient identifiers when providing care was not met.
One of the basic rights (right patient) of medication administration was not folcontinued on page 6
LaVerne Cash
I
have struggled with my weight all my life. As a young
person, if I maintained some control over my eating and
exercised, keeping weight off wasn’t much of a problem. But as I reached my 30s, I found weight control
becoming increasingly more difficult. My main issue
was a constant overwhelming urge to eat similar to an addict
in withdrawal. Therefore, when the directors of a weight
maintenance program I was enrolled in approached me
about taking phen-fen as a means to control my appetite, I
desperately agreed despite the fact it seemed too good to be
true. As it turned out, it was. I experienced side effects from
the beginning, and 10 years later, I was diagnosed with pulmonary hypertension (PH) as a direct result of having taken
phen-fen.
I took the drugs for two separate intervals of 2 to 4
weeks each. Within days after beginning the medication
both times, I became weak, lightheaded, and short of breath
after walking short distances or climbing stairs. I reported my
symptoms to the center prescribing the drugs. The directors
swore my symptoms could not be a result of the drugs. A couple weeks after I started taking the drugs the second time, I
passed out after walking a short distance between two buildings. On my doctor’s advice, I stopped taking the drugs.
Immediately the symptoms disappeared.
From that time (early 1994) until late 1995, I noticed
that even though I wasn’t taking the drugs, I had more
headaches than normal. I didn’t have a history of migraines,
but I had begun having exercise-induced migraine-like
headaches and body aches. None of my doctors could
explain why. In December 1995, I came down with a severe
case of the flu. Normally I bounce back very quickly after an
illness, but this time I didn’t. During the time I was sick, I experienced chest pain and ended up having a battery of tests for
heart disease, all of which came back normal. I ran a lowgrade fever off and on for a couple weeks and was on antibiotics for 2 months. The fever finally went away, but the
fatigue and headaches didn’t.
A couple months before my illness, I had completed a
grueling year of comprehensive written and oral exams for
my PhD. It was generally believed that between the flu and
the stress of the preceding year, I was run down and that
with time and rest, I would get better.
After several months of little, if any, improvement, my
doctor performed a number of additional tests, all of which
came back normal. Finally, she told me I had chronic fatigue
syndrome (CFS). Early in 1997, my doctor told me of a study
from Johns Hopkins linking CFS with neurally mediated
hypotension (NMH) and sent me to Hopkins for a tilt table
test.
In April 1997, I tested positive for NMH, which I would
later discover is consistent with PH. A person with NMH has
excessive dilation of the blood vessels in the legs. As a result
of the dilation, when the person stands, blood pools in the
feet rather than being pumped throughout the body, which in
turn lowers the individual’s blood pressure. The doctor testing
me observed that although my blood pressure dropped during the test, my heart rate rose, indicating my heart was trying to compensate for the drop in blood pressure by working
harder to pump blood throughout my body. This was unusual
for an NMH patient; normally an NMH patient’s heart rate
would fall. I began treatment for NMH, but it didn’t seem to
help.
Around this time, results of studies linking phen-fen to PH
were being released to the public. At this point, I became
concerned that maybe my symptoms were not NMH or CFS,
but instead were related to my prior use of phen-fen. My primary care physician sent me for an echocardiogram. The
echocardiogram showed some minor valve leakages but
nothing else, so the cardiologist decided I did not have PH.
Two years earlier, the echocardiogram showed a healthy
heart, with no leakage or any other issue, major or minor. In
retrospect, the signs of PH were there, but the cardiologist
was not well versed enough in PH to recognize it.
I couldn’t shake the feeling that something else was
going on. I had read a book written by a doctor in
Annapolis, MD, about CFS and the successes he had treating it. This doctor had CFS himself. His experience had
enough similarities to my own that I gave my primary care
physician a copy of his book and asked her opinion. She
said she had done all she could for me and gave me a referral to this doctor in December 1997.
continued on page 4
3
MedSurg
MedSurg
Matters
Academy of Medical-Surgical Nurses
4
The difference in the two echocardiograms concerned
me, so I asked the CFS specialist about them. I was told that
technology had improved since the first echocardiogram and
that what I was seeing was an improvement in imaging
capability from 1995 to 1997. Later it would be discovered
that this was not the case, but that PH was already present,
and the second echocardiogram showed the progression of
the disease during the two years.
Although the onset of the worst of my symptoms did fit
the pattern for CFS, there were some that did not. The vague
feelings of lightheadedness and dizziness that worsened
with heavy exertion did not fit. I was convinced there was
more than CFS wrong with me, and it was phen-fen related.
I repeated my history of phen-fen use to every doctor I saw.
Each one told me I had not been on phen-fen long enough
for it to be a contributing factor. Although the prevalent view
is that a person needs to have taken phen-fen for at least
three months for associated problems to develop, one pulmonologist treating me for PH says he has seen people
develop PH after as few as three weeks of use.
My condition seemed to improve with treatment for CFS,
but not as much as I had expected; something was still being
missed. The fact that a year and a half later I felt much better, in my mind, was an indication that I did have some elements of CFS; however, the symptoms I had prior to 1995
(headaches, lightheadedness, and body aches) were still
there, and if anything, were getting worse. I believed that
these persistent symptoms were consistent with NMH, which
is a frequently occurring component of CFS. When I complained that NMH symptoms were still giving me problems,
the CFS specialist recommended ephedrine. Ephedrine is a
vasoconstrictor as well as bronchodilator. For a while, it
made me feel a lot better. I attributed this to the bronchodilator properties of the drug. The vasoconstrictor properties would have further tightened already constricted arteries, eventually making the condition worse, not better.
Indeed, over the course of time, my condition did get worse.
By the time I stopped taking ephedrine in 2002, I couldn’t tell
much difference in how I felt on or off the drug.
By late 2004, I couldn’t walk across a parking lot without getting winded and having to stop for breath. Going up
a flight of stairs would almost make me pass out. At this
point, I knew I could not live with this anymore.
In 1995, when I first became ill, my blood pressure averaged 100/70. Slowly over the years my blood pressure had
been creeping up. When it reached a level of 120/80
(which is considered good), my doctors claimed the increase
in blood pressure was the result of the medication correcting
my NMH. I didn’t buy it. If the medication was correcting my
NMH, why didn’t I feel better rather than worse?
As my blood pressure crept up, so did my weight
because I couldn’t exercise to keep it down. By late 2004,
my weight had gone up to 230 pounds, the highest it had
been since high school, and my blood pressure had
increased to a point that even the doctors were becoming
concerned. I decided it was time to take off some of the
www.medsurgnurse.org
weight I had gained, hoping that would improve my health.
I started a weight-loss program at the local hospital. This
decision probably saved my life.
December 31 2004, New Year’s Eve: I went to the
weight-loss center for my entrance exam. My blood pressure
was 160/100! The attendants suggested I see my doctor if
it continued to be that high. As I thought about it on the way
home, I knew I needed attention, and I needed it now! My
regular doctor’s office was closed for the holiday, so I went
to Patient First. After a long wait, I was finally able to see a
doctor. He hooked me up to an EKG and found something
he didn’t like. In no time I was on oxygen, had an IV in my
arm, and was taken in an ambulance to the hospital.
I was in the hospital for two days undergoing the usual
battery of tests for heart patients. This time, the echocardiogram revealed the problem. My right ventricle had enlarged
to almost twice its normal size, indicating pulmonary hypertension.
The next month was among the scariest in my life.
Everything I had been told or read about PH was not good.
Test after test came back negative. Again, nobody could find
a reason for PH. My thoughts were along the lines of, “Yeah,
yeah, here we go again.” For 10 years, there was never
anything found to be wrong, and yet I seemed to get sicker
and sicker. It was very frustrating and very depressing.
When all the testing was done, I was told I had primary
pulmonary hypertension. I was sent to Johns Hopkins for a
right heart catheterization. Prior to the catheterization. I met
with Dr. Reda Girgis of the Pulmonary Hypertension program. He talked to me about PH, explained the various treatment options, told me what to expect during the procedure,
and answered my questions. During our conversation, he
explained to me that one of the things that would be done
during the catheterization would be to have me breathe nitric
oxide. He told me the nitric oxide probably wouldn’t have
any effect; the reason they had me do it was that in 10% of
the population of PH sufferers, the increase in blood pressure
in the lungs is the result of spasms causing the blood vessels
to constrict. In those cases, exposure to nitric oxide opens the
vessels and the blood pressure temporarily goes down. That
was a best-case scenario, but it rarely happened.
A week later, following my catheterization, Dr. Girgis
discussed the results. He said “Remember that lucky 10% I
talked to you about last week? You are in it!” There had been
a significant reduction in the blood pressure in my lungs
upon exposure to nitric oxide. Dr. Girgis put me on gradually increasing amounts of calcium channel blockers. He also
indicated that if the calcium channel blocker brought the
blood pressure down enough, the damage to my heart might
partially reverse.
Within a few days of starting treatment, I was able to
easily walk up stairs again. At my second catheterization,
the blood pressure in my lungs had gone down from 50 to
33. Dr. Girgis said that normally he would be pleased with
that decrease, but in my case, he thought he could get the
pressure down even more and increased my medication.
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For two months after my hospitalization, I was on
extended medical leave from work. My supervisors were trying to talk me into going out on disability. Fortunately, within
a month of starting treatment, I was able to go back to work.
As of this writing, I continue to do well with calcium channel
blockers. An echocardiogram taken in April of 2006
revealed partial healing of my heart. There was normal function of the left heart, and the enlargement of the right ventricle was significantly reduced. A repeat right heart catheterization in November 2006 showed that the blood pressure in
my lungs was only mildly elevated. I now walk one to two
miles most days of the week. I walk up two flights of stairs to
my office every day, participate in aerobics class once a
week, work a full time job, and am active in my church.
LaVerne Cash is an Operations Research Analyst for the U.S.
Army Evaluation Center.
Editor’s Note: This article is a companion piece to "Pulmonary
Hypertension Requires Creative Nurses," by Dee A. Jones, BSN,
RN (beginning on page 1 of this issue), and focuses on a patient's
ordeal with pulmonary hypertension.
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Drugs Being Studied to Treat
Pulmonary Hypertension
There are a number of drugs being investigated to treat
pulmonary hypertension. Some are approved for other conditions; some are still in the investigation phase.
Bereprost® is a prostaglandin analog and works
directly on the pulmonary circulation, acting as a vasodilator. While this drug is not yet FDA-approved for pulmonary
hypertension, it is showing significant promise in clinical
trials. So far, the major reactions to this drug include
headache and facial flushing, both of which were dosagerelated.
Epoprostenol (Flolan®) is a prostaglandin that acts as
a vasodilator and platelet aggregation inhibitor.
Epoprostenol has been approved for treatment of pulmonary hypertension since 2005 and has been shown to
improve symptoms and increase survivability.
Epoprostenol must be kept refrigerated. “If using
epoprostenol at ambient temperatures above 25 degrees C
(77 degrees F), a cold pouch or other insulation device must
be used” (Clinical Pharmacology, 2007). Epoprostenol
should be administered via a central catheter due to its short
half life of approximately six minutes (Clinical
Pharmacology, 2007).
Another prostaglandin used for pulmonary hypertension is iloprost (Ilomedin®, Ventavis™). Iloprost is
inhaled. Advantages of inhaled prostaglandins over intravenous include increased patient compliance and less systemic absorption.
Treprostenil (Remodulin®; Uniprost™, and UT15) is a form of epoprostenol that does not require refrigeration and can be administered via subcutaneous infusion.
Sildenafil (Revatio™; Viagra®) is a phosphodiesterase inhibitor that has been found to be very useful for
the treatment of pulmonary hypertension. By relaxing pulmonary vascular smooth muscles, this drug acts as a
vasodilator, improves mean pulmonary artery pressures,
and improves cardiac function. It should not be used concurrently with nitrates. “According to Pfizer Inc., clinical
trials have demonstrated that sildenafil (Revatio™) 20 mg
taken three times daily was effective for the treatment of
PAH in comparison to placebo. The most common side
effects reported with therapy were headache, stomach
upset, flushing, nosebleeds, and insomnia” (McAuley,
2005).
References
Clinical Pharmacology. (2007). Epoprostenol. Retrieved March 3,
2007, from http://www.clinicalpharmacology-ip.com/
McAuley, D.F. (2005). The current role of sildenafil citrate in the
treatment of pulmonary arterial hypertension. Retrieved March
3, 2007, from http://www.globalrph.com/sildenafil.htm
5
Academy of Medical-Surgical Nurses
MedSurg
MedSurg
Matters
Diana Anderson Named New
Editor for MedSurg Matters
6
The AMSN Board of Directors is
happy to announce that Diana
Anderson, BSN, RN, CMSRN, has
accepted the role of Editor for
MedSurg Matters. Diana accepted the
position in late December, and her
responsibilities as Editor began on
January 1, 2007.
Diana brings a wealth of experience to this position, having begun her career in nursing in
1986. Currently the Clinical Educator for the MedicalSurgical Unit at Navapache Regional Medical Center in
Show Low, AZ, she has held the position of Director at various institutions, including Dalworth Nursing and
Rehabilitation Center, Arlington, TX; Vencor Hospital,
Arlington, TX; and The Carrolton, Fayetteville, NC. She was
a Nursing Supervisor and Skilled Nursing Unit Manager at
Stokes-Reynolds Memorial Hospital in Danbury, NC, and a
Staff Nurse in the Neurosurgery Unit at North Carolina
Baptist Hospital, Winston-Salem, NC. At present, Diana is
working on her Masters in Nursing Education through the
University of Phoenix.
In addition, Diana has served active duty in the United
States Army from 1975-1979. She has also served with the
North Carolina State Guard as Chief Nurse from 19891995 and in the Texas State Guard from 1995-1999, where
she achieved the rank of Major.
Since Diana’s membership with AMSN in 2004, she
has been very active in the organization. She has been
Chapter President of Chapter #411, a member and eventual
chairperson of the Chapter Development Committee, a member of the AMSN Convention Program Planning Committee,
a speaker for the AMSN Annual Convention, has authored
articles for MedSurg Matters, and has attained certification
in medical-surgical nursing through the MSNCB. Outside of
AMSN, Diana has been active within her institution by serving as editor for the unit’s bi-weekly newsletter.
Diana is happy to hear from all members of AMSN.
Whether you wish to write a feature article or a brief story
about why nursing is important to you, she wants to know!
In addition, the AMSN Board of Directors and the staff
at Anthony J. Jannetti, Inc. thank Marlene Roman for her
loyal dedication as former Editor of MedSurg Matters. As
Marlene takes on additional responsibilities in her role as
President for MSNCB, we will look to her for leadership and
innovative ideas that she has continually brought to AMSN
and MSNCB.
Again, we extend our congratulations to Diana and look
forward to her role as Editor of MedSurg Matters!
www.medsurgnurse.org
President’s Message
continued from page 2
lowed. Even though a medication error did not occur during the time I was present, I feel that the current medication administration process will surely result in errors.
My son was alert and oriented, and he questioned
each medication prior to administration. Consider those
vulnerable patients who cannot actively participate in
their care – those who are cognitively impaired, those
who are unable to communicate, and those without family advocates.
Nurses across the country share with me that they
strive to provide excellent care but feel stressed when they
must accomplish so much for multiple acutely ill patients. I
believe nurses save lives, improve outcomes, strive to provide the best care possible, and sometimes must do so
with limited resources and time. I also believe that some
of the simple measures that improve patient safety do not
require a large amount of resources or time. Examining
an armband, asking a patient to state his or her name,
and checking a medication administration record require
very little time but can make a dramatic impact on patient
outcomes. Simply saying, “Good morning,” takes very little time but is meaningful to the patient and family.
I am appreciative that my son’s outcome was positive.
I will use this experience to reinforce what I teach my students as well as how I approach patients – the patients in
our care are someone’s spouse, parent, child, sibling,
loved one, and/or friend. Provide patients the nursing
care you would want your loved ones to receive. Aren’t
patients, after all, the reason we are nurses?
Kathleen A. Reeves, MSN, CNS, CMSRN
AMSN President
Send us Your News
MedSurg Matters welcomes news from AMSN members. If you have a news item or article that you would
like published, send it along with your name, address,
phone number, and other comments/suggestions to:
Carol Ford, Managing Editor; East Holly Avenue/Box
56, Pitman, NJ 08071-0056 Fax: 856-589-7463, Email:
[email protected]
Issue
Deadline
July/August 2007
Sept/Oct 2007
Nov/Dec 2007
May 15, 2007
July 15, 2007
September 15, 2007
New AMSN
Chapters Formed
Midwest Chapter #316
Congratulations to the Midwest Chapter
#316, which earned its charter in February
2007. Based in Quincy, IL, the chapter has
appointed the following officers:
President: Karen Koenig, BSN, RN,
CMSRN
President-elect: Angela S. Loos, BSN,
CMSRN
Secretary: Jonita Brunier, RN
Treasurer: Jolinn Huebotter, BSN, RN
The Midwest Chapter plans to meet on the
first Tuesday of every other month. Goals of
the chapter will be to provide outstanding care
to medical-surgical patients in the community
and to improve the image of the professional
medical-surgical nurse. Chapter objectives are
to enhance the professional growth of chapter
members and the medical-surgical nurses in
the tri-state area, and to facilitate communication and collaboration among medical-surgical nurses in the Midwest Medical-Surgical
Nurses Association area.
Midlands Chapter #228
Congratulations to the Midlands Chapter
#228, which was granted its charter in
February 2007. Officers for the Midlands
Chapter include:
President: A. Darlene Hudson, RN,
CMSRN
President-elect: Lisa R. Page, RN,
CMSRN
Secretary: Anneda Wallace, MS, RN
Treasurer: Ronella F. Eaddy, RN
Based in Columbia, SC, the chapter has
established the following goals:
• To provide a network opportunity for
adult health and medical-surgical nurses
in the South Carolina Midlands region.
• To increase membership in the national
and local chapter.
• To promote the professional image of
adult health and medical-surgical nursing
within the medical community.
There is a one-time membership fee of
$10, and the chapter will meet every other
month. Upcoming meetings will feature topics on orthopedic injuries and treatment
modalities, prevention of DVT, and community-acquired MRSA.
Your next Career or the perfect
Medical-Surgical Nurse candidate
is just a click away!
The official online job bank of the Academy of Medical-Surgical
Nurses, the AMSN Career Center, offers the most targeted
resource available for medical-surgical nurse professionals.
Whether you’re looking for the perfect opportunity or the
perfect candidate to fill an open position in your facility,
your perfect match is just a click away.
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locations you select.
Visit www.MEDSURGNURSE.org and click on Careers
or contact the Customer Care Center at 888-884-8242
You may also send an e-mail to [email protected]
The AMSN Career Center
is a member of
ary had just arrived on the Med-Surg Unit following surgery for a ruptured appendix. She
was in severe pain, rating her pain at a 9 on
a scale of 0 to 10. Her receiving nurse on the
Med-Surg Unit checked Mary’s admission
orders and saw that Mary could have 6 mg
of morphine sulfate IV. After checking Mary’s identification
band and allergies, the nurse administered the 6 mg. of morphine. The nurse then went to answer another patient’s call.
Nine minutes later, when the nurse re-entered Mary’s room,
she found Mary unresponsive with a respiratory rate of 6.
Timothy was admitted to a Med-Surg Unit from a longterm care facility for treatment of an infected pressure ulcer.
The admitting physician wrote in his admission orders to
continue all medications from the long-term care facility. The
nurse used the medication sheet provided by the facility to
write the medication orders. Two days later, Timothy was not
doing well, exhibiting severe hypotension and cardiac dysrhythmias. A nurse reviewing Timothy’s chart discovered
that the original medication list provided by the long-term
care facility was actually for a different patient, and Timothy
had been receiving 17 medications for conditions that he
did not have. These medications included cardiac medications, blood thinners, and anti-hypertensives. Timothy recovered, but his stay was extended by 8 days due to this medication error.
Florinda was admitted to a Med-Surg Unit for treatment
of a central venous catheter (CVC) infection. The CVC had
been placed as an outpatient procedure 4 days prior for
chemotherapy administration. Florinda presents today with
fever, redness and drainage at the insertion site, and generalized malaise.
What do these patients have in common? Each of these
patients experienced medical harm. Harm is defined by the
Institute for Healthcare Improvement (IHI) as, “Unintended
physical injury resulting from or contributed to by medical
care (including the absence of indicated medical treatment),
that requires additional monitoring, treatment, or hospitalization, or that results in death. Such injury is considered
harm whether or not it is considered preventable, resulted
from a medical error, or occurred within a hospital” (n.d.).
“IHI estimates that 15 million incidents of medical harm
occur in U.S. hospitals each year. This estimate of overall
national harm is based on IHI’s extensive experience in
studying injury rates in hospitals, which reveals that
between 40 and 50 incidents of harm occur for every 100
hospital admissions” (Patient Safety & Quality Healthcare,
MedSurg
MedSurg
Matters
M
8
2007, p. 6). Because it is estimated that approximately
40,000 medical errors occur each day in the United States,
the IHI is spearheading the 5 Million Lives Campaign.
The 5 Million Lives Campaign is intended to protect the
lives of 5 million patients over the next two years from medical harm. There are 12 areas identified where additional
interventions could decrease harm. The first 6 areas are
from the 100,000 Lives Campaign, and the second 6 are
additional areas that have been identified as areas that are
prone to medical harm. The resulting 12 areas include:
• Develop Rapid Response Teams. Don’t wait for a
code to happen; early intervention saves lives!
• Provide evidence-based care for myocardial infarctions to prevent cardiac deaths.
• Develop systems for reconciliation of medications.
• Prevent infections at surgical sites by the appropriate
use of pre- and peri-operative antibiotics.
• Prevent development of central line infections using
evidence-based procedures.
• Prevent ventilator-associated pneumonia.
• The Surgical Care Improvement Project
(www.medqic.org/scip) was developed to reduce
surgical complications.
• Develop evidence-based measures to prevent pressure ulcers.
• Develop programs to prevent medication errors relating to high-alert medications. The Campaign focuses
specifically on reducing errors related to anti-coagulants, narcotics, insulin, and sedatives.
• Use evidence-based practices to reduce MethicillinResistant Staphylococcus Aureus (MRSA) infection.
• Decrease readmissions for congestive heart failure
patients using evidence-based care
• “Get Boards on Board.” Encourage hospital board
members to support the 5 Million Lives campaign
and proactively work towards providing safe care in
hospitals (IHI, n.d.).
The 5 Million Lives Campaign is built on the successes
experienced by the IHI’s 100,000 Lives Campaign. Over
3,000 hospitals participated in the 100,000 Lives project,
and an estimated 122,000 lives were saved over 18
months as a direct result. Because of that overwhelming success, the 5 Million Lives Campaign hopes to involve even
more hospitals in an effort to protect 5 million people from
experiencing medical harm between December 2006 and
medications prior to admission and compared them to
medications ordered after admission. Florinda may have
avoided an inpatient admission and potential sepsis if evidence-based care measures were in place at the time she
received her central line.
December 2008. Many organizations are becoming active
in this Campaign. The American Nurses Association is
encouraging nurse leaders to get involved and offers additional information for nursing activities on its Web site
(http://nursingworld.org/patientsafety/).
There is no cost to hospitals wishing to participate in the
5 Million Lives Campaign. Hospitals are requested, though,
to select at least one intervention and provide feedback to
the IHI on progress made. The IHI provides many tools for
use in implementing the interventions on their Web page
(http://www.ihi.org/IHI/Programs/Campaign/Campaign.
htm?TabId=2).
The 5 Million Lives Campaign is all about patient safety.
If Mary’s hospital was a participant in this campaign, perhaps nursing actions involving high-alert medications, such
as narcotics, would have had further emphasis placed on
knowing potential side effects, cumulative actions, and interactions with other medications. Timothy would have benefited from a medication reconciliation system that validated
IHI’s motto for this campaign is:
Some is not a number. Soon is not a time.
The number is five million. The time to start is now.
Medical-surgical nurses are in the position to influence
the care received by their patients. Now is the time for
nurses to become active and encourage hospitals and
health care organizations to get involved in this project.
Make a difference. The time to start is now. There are 5
million patients waiting.
Diana Anderson, BSN, RN, CMSRN
Editor, MedSurg Matters
References
American Nurses Association. (2007). Effecting positive change
in patient safety/advocacy. Retrieved March 5, 2007, from
http://nursingworld.org/patientsafety/
Institute for Healthcare Improvement. (n.d.). Protecting 5 million lives
from harm. Retrieved March 5, 2007, from
http://www.ihi.org/IHI/Programs/Campaign/Campaign.htm
Patient Safety & Quality Healthcare. (2007). IHI launches
national campaign to reduce medical harm. Retrieved
March 5, 2007, from http://www.psqh.com/janfeb07/5million.html
AMSN’s Management Company, Anthony J. Jannetti, Inc.,
Receives Association Management Company Accreditation
Anthony J. Jannetti, Inc. (AJJ), AMSN’s management company, has been recognized by the American Society of
Association Executives (ASAE) as an accredited association
management company (AMC). This is the highest recognition
an AMC can receive.
AJJ (www.ajj.com) has managed AMSN for 16 years,
providing full-service association management, public relations
and marketing, creative design and publishing, corporate
sales, professional education, Web site and Internet, membership and database management, and conference management
services. AJJ publishes AMSNs official journal, MEDSURG
Nursing: The Journal of Adult Health, and official newsletter,
MedSurg Matters.
“This is such an honor for AJJ,“ said Anthony Jannetti, AJJ
president. “We will continue to meet and exceed the standards
endorsed by ASAE by providing outstanding management services to AMSN.”
ASAE’s AMC accreditation is a voluntary process that validates a company meets the standards set forth by ASAE’s
Accreditation Commission. This program identifies quality
AMC services, assesses the procedures of individual AMCs,
formally recognizes those AMCs that meet requirements set
forth by the AMC Accreditation Commission, and improves the
quality of services provided to the association community.
“AMC accreditation distinguishes AJJ’s leadership and
demonstrates our company has met industry-established standards for top-quality management services. Over 500 AMCs
exist, and only 66 companies, including AJJ, have achieved
accreditation,” said Cyndee Nowicki Hnatiuk, EdD, RN, CAE,
AJJ vice president for organizational development and
AMSN’s executive director.
The American Society of Association Executives
(www.asaecenter.org) is an individual membership organization of more than 22,000 association executives and industry
partners representing nearly 11,000 organizations. Its members manage leading trade associations, individual membership societies, and voluntary organizations across the United
States and in 50 countries around the globe, as well as provide products and services to the association community.
9
Academy of Medical-Surgical Nurses
News from
COMMITTEES
Chapter Development
Committee News
MedSurg
MedSurg
Matters
C
10
Communication plays such a large role in our profession. We communicate with patients, families, peers, and
providers every day! Communication helps keep our patients
alive and well, and plays a huge role in our professional
nursing organization. Communication keeps our chapters
and our whole organization alive and thriving. I was thinking the other day how communication is so important for our
chapters. This is the reason for this “Chapter Development
Tip.” I see the importance of communication affecting our
chapters in so many ways, but I am just going to limit my tip
to communication within the chapters and focusing on
recruitment for your chapter
Take a minute to think about how you communicate with
your fellow chapter members. Do you network through e-mail
between meetings? This is an excellent medium for communication between the times you meet. It is also an excellent
retention tool for your chapter. A few times a month, you are
networking with a group of peers – asking questions, letting
others know of accomplishments, or just sending reminders
of upcoming meetings or educational events. I have set up a
special group list in my e-mail for members of my chapter. It
is simple to send out a group e-mail to network with my peers
between meetings. You can also add non-members to your
list who attend your meetings. Use this as a recruitment tool
to encourage non-members to join! Add them to your list so
they receive your emails (ask their permission first) and can
learn all that AMSN and your chapter have to offer.
The other important communication tip I want to pass on
relates to recruitment. I keep lines of communication open
with the local hospitals in my area. In order to revitalize our
chapter, I sent a letter to the Chief Nursing Officers and the
Medical-Surgical Nurse Managers of many local hospitals
educating them about AMSN and our local chapter. I offered
my time for staff meetings to talk about the organization and
the many benefits that come with membership. You will be
pleasantly surprised at the responses you receive!
Now I want to hear from you! Please e-mail me with
your tips. Let me know what communication methods did and
did not work in your chapters. I will summarize the results in
another issue so we can learn from each other. You can email me at [email protected]. Until next time, keep those
lines of communication open!
Mike Frace, MSN, RN, RRT
Chair, AMSN Chapter Development Committee
www.medsurgnurse.org
Clinical Practice
Committee Update
The Clinical Practice Committee has a full agenda for
the coming year. The members are working with the 2007
Convention Planning Committee to organize a breakout session at the 2007 Annual Convention in Las Vegas. The
AMSN Clinical Practice and Leadership awards are under
revision. The goal is to make the selection criteria more concise and facilitate the nomination process. Self-nomination
will be an option for 2007.
A module on evidence-based practice was developed
last year to supplement the work already in progress by the
Research Committee. The module will be linked to the AMSN
Web site after revisions have been made. Also on the
agenda for the Clinical Practice Committee is the review of
poster abstracts for the convention and updating the AMSN
Scope and Standards. With the number of tasks to complete,
the Clinical Practice Committee will be looking to expand its
membership over the coming months with enthusiastic
AMSN members! If you are interested in joining the CRC,
complete the “Willingness to Serve” form online. Visit
www.medsurgnurse.org, click on “Committees,” and select
“Willingness to Serve.” We welcome your talents!
Jill Arzouman, MS, APRN, BC, CNS – Surgery
Chair, AMSN Clinical Practice Committee
Legislative Policies & Issues
Committee Update
The Legislative Policies & Issues (LP&I) Committee is
responsible for maintaining the legislative page of the
AMSN Web site. This page contains information of interest
about legislative issues, including legislation and policies
approved by AMSN, as well as other legislative information
presented for your information, links to legislative information, and how to write to your legislator.
The LP&I Committee is excited to announce the addition
of an interactive Web sticker to the Web site allowing you to
search for the elected officials in your area or for information
about specific legislation. We have also added reference
information, such as nursing-related Congressional committees, and the Federal Budget and Appropriations Primer
2007 prepared by the American Nephrology Nurses’
Association (ANNA).
We are working on information about lobbying techniques and continue to monitor various Web sites for information about legislation of interest to med-surg nurses. Web
sites being monitored include ANA Federal Advocacy,
League of Women Voters, National Council of State Boards
of Nursing, Centers for Medicare and Medicaid Services,
NLN Public Policy Action Center, Capitol Update, and
Congressional Quarterly.
Cindy Ward, MS, RNC, CMSRN
Chair, LP&I Committee
[email protected]
Nurses Nurturing Nurses®
Professional Development
Task Force
The Professional Development Task Force is developing
a program that will be comprised of four modules to be
developed from outlines. Team Building is the first of our
modules and is currently under development. Several new
committee members have joined us and are working with our
previous members researching and writing the module.
Other modules will be developed on Clinical Leadership,
Communication, and Problem Solving/Critical Thinking. The
goal of these modules is to provide greater leadership skills
and respect for the medical-surgical nurse at the bedside. As
we develop the modules, we are also considering how to
present or offer the modules, what will be the final presentation format, and how we will get that accomplished.
Nancy Janes, RN, BC
Clinical Educator, St. Francis Hospitals
The Public Relations Task Force
The Public Relations Task Force was formed after a
brain-storming session during which the AMSN Board of
Directors developed a new strategic plan. The goal of the PR
Task Force is that the national and international health care
communities will increasingly recognize AMSN as the expert
in adult health. The first task was to develop an action plan
to meet our first objective “increase public awareness and
the image of AMSN.” During our first conference call, the
task force identified our external audience, which included
hospitals, directors of nurses, clinical nurse specialists, hospital educators, and case managers. This strategy was completed in January 2006.
We then identified strategies for promoting AMSN to
our key audiences. We developed a Hospital Group
Membership Program that is being piloted by the Cleveland
Clinic. The pilot has been in progress for one year, and the
Cleveland Clinic has renewed its commitment with AMSN.
We are expanding this program to other interested groups.
Please contact Sue Stott at the National Office or visit the
AMSN Web site (click on “Membership” and select “Group
Membership” for program details). We worked on developing a key message for AMSN, but we decided we already
had one, and with the approval of the Board of Directors, we
kept “Nurses Nurturing Nurses,” which is truly the essence of
who we are. The task force also developed a new membership brochure that was available during last year’s annual
convention.
We have made significant strides over the past year,
and we are committed to reaching AMSN goals for now and
in the future!
Doris G. McQuilkin, MA, BSN, RN
Chair, Public Relations Task Force
EXAM DATES and LOCATIONS
May 5, 2007 • October 13, 2007
Scottsdale, AZ
Scottsdale, AZ
Los Angeles/Burbank, CA
San Diego, CA
San Francisco/
Burlingame, CA
Walnut Creek, CA
Denver, CO
Harford, CT
Newark, DE
Orlando, FL
Pompano Beach, FL
St. Augustine, FL
Atlanta, GA
Savannah, GA
Honolulu, HI
Chicago, IL
Ft. Wayne, IN
Indianapolis, IN
Baton Rouge, LA
Baltimore, MD
Boston/Framingham, MA
Lansing, MI
St. Paul MN
Kansas City, MO
St. Louis/
Chesterfield, MO
Charlotte, NC
Omaha, NE
Freehold, NJ
Albuquerque, NM
New York, NY
Rochester, NY
Stony Brook NY
Cincinnati/Blue Ash, OH
Cleveland, OH
Portland/Tualatin, OR
Philadelphia/Bensalem, PA
Pittsburgh, PA
Columbia, SC
Memphis, TN
Nashville, TN
Dallas, TX
Houston, TX
San Antonio, TX
Alexandria, VA
Charlottesville, VA
Virginia Beach, VA
Richmond, VA
Seattle, WA
Spokane, WA
Tacoma, WA*
(*given on following Sunday)
Milwaukee, WI
Certified Medical-Surgical Registered Nurse (CMSRN)
is the earned credential recognizing that the highest standards of medical-surgical nursing practice have been
achieved. You can become certified by successfully completing the MSNCB examination.
Exams are offered at the above locations. Additional
sites may be added for 10 or more candidates. Local sites
are subject to cancellation for insufficient registration.
For more information and submission deadlines,
contact:
MSNCB Certification
East Holly Avenue/Box 56 Pitman, NJ 08071-0056
Phone: 856-256-2323 • Fax: 856-589-7463
E-mail: [email protected] Web site: www.medsurgnurse.org
11
Academy of Medical-Surgical Nurses
www.medsurgnurse.org
Pulmonary Hypertension
continued from page 1
Hyperventilation and coughing
leading to dyspnea, and decreased
breath sounds indicate that the patient
needs immediate attention. It is also
important to provide careful examination of the skin and urinary system
(Sommers et al., 2007). Patients with
PH usually undergo heart catheterizations to measure the pressure in the
lungs. Assessment of pain, respiratory
function, and monitoring for signs of
bleeding are vital after this procedure.
Sterility of the catheter insertion site
should also be maintained (Sommers et
al., 2007).
Sommers et al. (2007) maintain
that the assessment of a patient’s anxiety level is significant, as anxiety reduction assists to preserve the patient’s
energy. Support for the patient and
family is needed throughout the hospital stay. The nurse or clergy may provide spiritual support during this time of
crisis.
MedSurg
MedSurg
Matters
Collaborative Care
12
Caring for the patient with PH will
take team effort; yet, the medical-surgical nurse is at the bedside providing
first-line care to the patient. Nurses are
the link between the patient and the
interdisciplinary team. Good communication and documentation are highly
beneficial to the patient’s recovery. The
medical-surgical nurse uses great detail
in documenting vital signs, cardiovascular and pulmonary physical assessment data, and responses to medication, diet, fluids, oxygen administration,
and any changes in the patient’s status
(Sommers et al.,2007).
Management of the patient with PH
includes administration of medications,
such as diuretics, anticoagulants,
vasodilators, and sildenafil (Viagra®).
Other medications, such as bronchodilators, may be ordered as well.
Therapy is aimed at maintaining as
much cardiac function as possible
(Sommers et al., 2007). The medicalsurgical nurse needs to have knowledge
of these medications and their indications (see Drugs Being Studied to Treat
Pulmonary Hypertension on page 5).
Table 1.
Left Ventricular Failure vs. Right Ventricular Failure
Left Ventricular Failure
Right Ventricular Failure
Systemic hypotension
Jugular venous distension
Low urinary output
Peripheral edema
“Click” at the left sternal border
Hypertrophy of the right ventricle
Syncope
Increased central venous pressure
Discharge planning begins the first
day of admission for this patient. Not
only is it necessary for the nurse to plan
for the physical needs of the patient, but
the patient’s spiritual needs must also be
addressed, thus providing holistic care.
Discharge planning will focus on education about anticoagulant therapy, signs
and symptoms of bleeding, low-salt diet,
weight control, and good hydration. A
home assessment is warranted as well.
The patient with PH may go home on
oxygen therapy; thus, additional education is necessary for the patient and family concerning equipment usage and
safety (Sommers et al., 2007).
Education should begin as early as possible.
Resources for this patient include
support groups, spiritual care, and palliative care if needed. Many patients
with PH are often diagnosed at a late
stage in the disease, and treatment
options are limited to medication and
lung transplantation. Exercise for the
patient with PH is still under investigation. Rehabilitation is geared toward
establishment of the patient’s activity
level (Steinbis, 2006).
The Future of PH Research
Medication is the focus of research
for PH at present. Sildenafil is the first
off-label medication to be used in some
facilities. Sildenafil causes selective pulmonary vasodilation and is very effective in low doses. Inhaled nitric oxide
dilates the pulmonary vasculature, but it
is very expensive (Steinbis, 2006).
In a university study, data from a
“telemonitoring programme confirmed
that the close follow-up of patients led
to improved quality of life” (Gottlieb &
Blum, 2006, p. 29). The best time to
arrange this type of follow-up would be
before the patient is discharged home.
Careful resource planning is very essential for the nurse to ensure safe discharge for the patient.
Summary
Pulmonary hypertension does not
have to be a medical mystery to the
medical-surgical nurse. With the proper
education and keen assessment skills,
the patient will have improved outcomes and better of quality of life.
Creative specialists at the bedside give
first-line care to those in the hospital.
Medical-surgical nurses are the link that
completes a continuum of care.
Dee A. Jones, BSN, RN, is the Care
Coordinator for Perry Point VA, MD, and
the Care Coordination Home Telehealth
Program; she is also the Medical-Surgical
Visiting Professor and Clinical Instructor at
Harford Community College, Bel Air, MD.
She may be reached at: P.O. Box 833,
A.P.G., MD; 410-272-4740; e-mail
[email protected]. Visit www.denurs98.
zoomshare.com for more information.
References
Gottlieb, S., & Blum, K. (2006).
Coordinated care, telemonitoring,
and the therapeutic relationship:
Heart failure management in the
United States. Disease Management
and Health Outcomes, 14(Suppl 1),
29-31.
Sommers, M.S., Johnson, S.A., & Beery,
T.A. (2007). Pulmonary hypertension.
In Diseases and disorders: A nursing
therapeutics manual (3rd ed.) (pp.
796-797). Philadelphia: F.A. Davis
Company.
Steinbis, S. (2006). What you should
know about pulmonary hypertension.
The Nurse Practitioner, 29(4). 8-19.
The Conference for Clinical Excellence
Academy of Medical-Surgical Nurses
CHAPTER
NEWS
Charlotte, NC, Chapter #225 is busy getting ready for our first CMSRN Review Course. We are
putting the Review Course on ourselves using the official
Review Course material. We have instructors lined up to
speak on their areas of expertise. We also have drug representatives coming to serve us lunch and to talk about their
products. We see this not only as a big help for those we are
encouraging to take the exam, but also as a fund raiser and
recruitment tool for our chapter.
The review course dates are April 21-22 at Presbyterian
Hospital in Charlotte, NC. We now have about 20 people
registered. If this goes well, we plan to do this every year.
– Jodi Taylor
Long Island Chapter #112 has been busy
MedSurg
MedSurg
Matters
this year! We will be hosting our 2nd Annual Educational
Day on April 14, 2007, from 8:30 a.m. – 3:00 p.m. at the
Stony Brook University Medical Center Technology Park. This
year’s topic, “Evidence-Based Practice,” will include 5 CNE
credits. Speakers from several hospitals across Long Island
will be making presentations on evidence-based practices
that their hospitals have applied to clinical practice. The cost
is $30 for members, $40 for non-members, and $15 for students. At the Education Day, we will be raffling off the two
memberships we received at last year’s convention for receiving the Educational Achievement Award.
Nursing students from Suffolk Community College
attended our September 2006 meeting.
We donated $200 to a local shelter at Christmas and will
donate $200 to another shelter this spring. Finally, we will be
having a Master of Nursing Education student present a lecture on Cerebrovascular Accidents at our March meeting.
– Karen Tronolone, RN, MPA, BC
14
Northern Arizona Chapter #411 is planning a busy spring. With money raised during several fundraisers this winter, the chapter plans to offer four membership
scholarships to local nursing students who are interested in
becoming med-surg specialists. A legislative meeting is being
set up in the spring to meet with our local State
Representative and other elected officials to discuss current
legislation that affects nurses. The chapter has submitted two
poster abstracts for the AMSN Annual Convention that are
being worked on by the whole chapter. At the March meeting, we assembled a slate to elect new officers. We are also
planning fund-raisers to send as many members to convention as we can!
– Pam Prorok, BSN, RN, CMSRN
www.medsurgnurse.org
Northern Nevada Chapter #408
regrouped in June 2006 after being dormant for a couple of
years. Since then, we have raised more than $600 in sales
of our polo shirts and fees we charge for monthly dinners.
We have also brought in more members. Each month, we
have a dinner sponsored by a vendor and a presentation for
which nurses can receive CNE credit. Either the vendor presents or we find a speaker on a medical-surgical topic. Some
topics that have been presented include pressure ulcer prevention, kyphoplasty, PICC care and maintenance, and
methamphetamine abuse. Over the next 3 months, we have
scheduled presentations on infected wounds, blood management, and PET scans. We charge non-members $10 to
attend, and members are always free. Since we regrouped,
we have had an additional incentive – no local dues until
June 2007. Nurses have found the dinners to be a great
place to obtain information, receive CNE credit, and network with their peers. I have a member e-mail list and a nonmember e-mail list. The members get the e-mails about the
dinner about a week before the non-members to give them
the first chance to reserve a seat since it is on a first-come,
first-serve basis.
When we register nurses, we also give them handouts
on upcoming events and opportunities related to the nursing
community, such as walk-a-thons, other nursing organization
meetings, and classes offering CNE credit. The nurses find
this useful, and they know they can only get the list at the dinners. Right before dinner, we have a member meeting where
we discuss volunteer opportunities, upcoming events, and
what we plan to do with all that money! Right now, we are
deciding how much to give each officer to go to the convention, and the rest we are planning on starting scholarships for nursing students in our chapter’s name.
We also participate in volunteer events such as immunizations clinics, walk-a-thons, and hold membership drives at the
local hospitals and nursing schools, all while wearing our AMSN
shirts. Another thing we discuss is how exciting convention is.
– Terry Ditton
San Diego Chapter #412
would like to
announce a first-of-a-kind event here in San Diego that took
place on March 15, 2007. Three professional organizations
presented, “A Tale of Three Cultures.” This dinner conference
featured specialists in the industry that looked at patients as
they cross the specialties of orthopedics, med-surg, and oncology. This was a joint event that was sponsored by the San
Diego Chapter of AMSN, the Oncology Nursing Society, and
the National Association of Orthopaedic Nurses.
– Adrian Han Miu, MSN, Chapter President
South Central Indiana Chapter #312 is
currently holding elections. Results were announced at the
March 12th meeting, held at Kings Daughters Hospital in
Madison, IN. Our January 8th meeting was held at Columbus
Regional Hospital, and Jo Tabler, RN, CEN, Flight Nurse with
[email protected]
PHI Flight Services, presented, “Cold Emergencies.” Jo did an
excellent job, and everyone in attendance verbalized that they
learned something new and useful.
Linda Zapp, RN, MSN, CNS, presented a program on
“Multi-generation Communication” at the March 12th meeting. We all work side-by-side with colleagues from other generations, and everyone thinks differently.
Our May meeting will be hosted by Schneck Medical
Center and will be held Monday, May 14, 2007, at 6:30
p.m. The program is to be announced. Our chapter voted to
promote nursing to elementary school students as part of the
Nursing 2000 campaign. If you would like to be involved in
this fun project, please contact Sharon Taylor at
[email protected]. The title of the program is, “Nursing is
Amazing,” and Nursing 2000 provides literature and videos
to assist us.
We would love for you to become involved in our chapter. Our local dues are $20.00 per year and can be mailed
to Cindy Clark, RN, at 11272 S. County Road 700 W,
Westport, IN 47283. Also, if you would notify the AMSN
National Office that you are a member of Chapter 312, it
would help us track our chapter membership. The contact at
AMSN is [email protected].
– Sharon Taylor
Southeastern Wisconsin Chapter #314
is only 8 months old, but we’ve accomplished a lot in a short
period of time. Our members have been very fortunate to
hear several speakers give outstanding presentations. Dr. Ian
Gilson presented, “Nursing Care of the AIDS Patient,” Dr.
Kathryn Schroeter presented “Dealing With Difficult People
in the Workplace,” Theresa Bronson, NP, presented
“Diabetes Management,” and Linda Botts and Laura Pippo
did a presentation about the Southeastern Wisconsin
Medical Reserve Corps, encouraging our membership to
consider joining and giving back to their community.
We have participated as a chapter to help support the
vulnerable populations in our community by collecting and
donating personal care items and winter coats, scarves, mittens, and hats to the Milwaukee Rescue Mission. On Nurses
Day, May 6th, we will be getting together as a chapter to
participate in this year’s MS Walk.
Four of our members attended the AMSN Convention in
Philadelphia this past year. Melissa Paulson-Conger, one of
our members, took the encouragement from Chapter leadership to enter the essay contest sponsored by the AMSN
Foundation for the Nurse in Washington Internship
Scholarship (NIWI) and won! She attended the meeting in
Washington, DC, in March and will present her experience
this summer. Two of our members attended the Nurses Day
at the Capitol on March 6, and they will also be giving presentations regarding their experiences.
This is just a little view of what we’ve been doing. We
are all very excited and proud to be Southeastern Wisconsin
Chapter #314 of the Academy of Medical-Surgical Nurses!
– Brenda Baranowski RN, CMSRN, CHPN
Nurses Nurturing Nurses®
Southern Nevada Chapter #413 meets
every second Wednesday of the month. Each month we
have an education program. February’s program topic was
“Confusion Assessment of the Older Adult,” presented by
Kevin Gulliver, MSN, RN, CEN, from UNLV’s School of
Nursing. Future monthly topics include a Wound Care
Update and “How to Be a Preceptor to a Student Nurse.”
– Jan Austin, MA, RN, CHCP
The Heart of America Chapter #313
is in the midst of planning our Spring Med-Surg Review
Course scheduled in March and April 2007. In February, we
had a CNE offering on Holistic Nursing. We are planning
our Community Service Activity with the Harvesters
Organization in Kansas City for later in the Spring. In
August, we will have our second CNE offering on Infectious
Disease Updates.
– Robyn McKearney, Chapter President
The Sunshine Region Chapter #203 has
many exciting things going on. For example, we are hosting
a Medical-Surgical Certification Review Course along with
the North Broward Medical Center on April 24th and 25th.
We do a continuous gently used clothing and new toiletries
drive for North East Focal Point in Fort Lauderdale, FL. In
March, we participated in a Health Fair for the United
Federation of Teachers – Retired Teachers Chapter in which
approximately 500 participants attended.
– Beth Cohen, Chapter President
West Virginia Chapter #113 members
collected over 100 cold weather clothing items, including
mittens, gloves, toboggans, scarves, and ear muffs of various
sizes as a community service project. Items were donated to
Scott’s Run Settlement House in Morgantown, WV. In
January, we designed and distributed our first bi-annual
newsletter to members. We are trying to get the word out
about our chapter and increase member participation.
2007 Chapter Goals are to:
• Enhance recognition of the WV Chapter through
advertisements.
• Recruit 6 to 10 new members in 2007 and broaden
recruitment to outside facilities.
• Planning of a 4 to 8-hour workshop focused on
advanced medical-surgical nursing.
• Facilitate communication and collaboration among
medical-surgical nurses in the WV area.
• Enhance the image of medical-surgical nursing as a
specialty.
• Become more politically active.
– Sharon Tylka
15
Volume 16 - Number 2 • March/April 2007
OFFICIAL NEWSLETTER
MedSurg
MedSurg
Matters
Presorted Standard
US POSTAGE
PAID
Bellmawr, NJ
PERMIT #58
East Holly Avenue Box 56, Pitman, NJ 08071-0056 • 866-877-AMSN (2676)
[email protected] • www.medsurgnurse.org
BOARD OF DIRECTORS
Kathleen A. Reeves, MSN, CNS, CMSRN
President
Cecelia Gatston Grindel, PhD, RN, CMSRN, FAAN
Immediate Past President
Kathleen A. Singleton, MSN, RN, CNS, CMSRN
Treasurer
Kathleen Lattavo, MSN, RN, CMSRN
Secretary
Edna Ennis, BSN, RN, CMSRN
Director
Sandra D. Fights, MS, RN, CMSRN
Director
Teresa Ann Snyder, BSN, RN
Director
Jo-Ann Wedemeyer, BSN, RN, CMSRN
Director
Med-Surg Matters is indexed in the Cumulative Index to Nursing & Allied Health Literature
AMSN Announces Opening Keynote
Speaker for Annual Convention
LeAnn Thieman, LPN, author of Chicken Soup for the
Nurse’s Soul, will present AMSN’s Keynote Address on
Thursday, October 25, from 5:15 p.m. – 6:30 p.m. Ms.
Thieman, who has spoken at previous AMSN annual conventions, will again share stories that will warm your soul and
enlighten your nursing spirit.
With a marked decrease of nurses entering the field, nurses
have been forced to cope with increasing work loads, inadequate staffing, and an overall lack of support for their profession. Ms. Thieman’s book has brought much needed recognition to the “nurse’s soul,” and she hopes to remind AMSN’s
Annual Convention attendees of why they chose nursing as their
profession and that they are health care’s link to compassionate
patient care.
mission:
The mission of the Academy of
Medical-Surgical Nurses is to
promote excellence in adult health.
© 2007 by Academy of Medical-Surgical Nurses
MEDSURG MATTERS
Diana Anderson, BSN, RN, CMSRN
Editor
Cynthia Nowicki Hnatiuk, EdD, RN, CAE
Executive Director
Suzanne Stott, BS
Association Services Manager
Carol Ford
Managing Editor
Robert Taylor
Graphic Designer
Robert McIlvaine
Circulation Manager
2007 AMSN Annual Convention
Planning Committee
Janet Burton – Chair
Gloria Hurst
Terry Ditton
Diana Anderson
Judy Dusek
The 2007 Annual Convention Planning Committee is
putting the finishing touches on the program. Watch for
more information about the convention program, sessions,
and speakers in upcoming editions of MedSurg Matters,
AMSN e-news, and the AMSN Web site (www.medsurgnurse.org).
vision:
The Academy of Medical-Surgical Nurses is
recognized as the world-wide leader for
medical-surgical nursing practice.
AJJ-0307-V-7M