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the Official Magazine of the Emergency Nurses Association

connection
March 2013 Volume 37, Issue 3

All Together,
PULL!
Every Bit of Muscle Matters
As We Take Bold New Steps
Through Advocacy
Pages 14-20

5  ENA Co-Founder
 Judith
Judith C. Kelleher,
 1923-2013

22 No Career Wasted:
A Nurse’s Path Back
After Substance Abuse
INSIDE 32 Member Finds Paradise
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Dates to Remember
LETTER FROM THE PRESIDENT | JoAnn Lazarus, MSN, RN, CEN
March 11, 2013
Deadline for proposed bylaws and
resolutions for 2013 General

With Mentoring,
Assembly at Annual Conference in
Nashville, Tenn.

March 25, 2013


Deadline for faculty course proposals

We Make Magic
for Leadership Conference 2014 in
Phoenix (March 5-9, 2014).

ENA Exclusive Content


PAGE 5 In Greek mythology, Mentor was the
Judith C. Kelleher, 1923-2013 trusted guardian Odysseus appointed
to watch over his son Telemachus
PAGE 6
when Odysseus left for the Trojan
Board Writes:
In-Flight Medical Emergencies War. Mentor played a pivotal role in
the development of Telemachus,
PAGE 8
providing encouragement and
ENA’s Resource Pathway
to Safe Practice, Safe Care practical plans for Telemachus to
deal with his personal dilemmas.
PAGES 14 - 20
Because of this story, the term
Advocacy Section
‘‘mentor’’ has taken on the meaning
14 Ohio Efforts Pay Off of someone who imparts wisdom to
With New Law Against
Assaulting Health Care Workers and shares knowledge with a less
experienced colleague.
16 E NA Hosts Its First Emergency
Nursing Advocacy Intensive Most of us can think of a more
experienced person in our lives who
18 We’ve Come a Long Way, Baby
— Or Have We? has provided information, given
20 New ENA Advocacy Department advice, presented us with a
challenge, initiated a friendship or
PAGE 22 simply expressed an interest in our
No Career Wasted: personal development. Very often
A Member’s Path Back
From Workplace Substance Abuse our first mentor was a parent or
another relative who taught and
PAGE 30
demonstrated some essential
The AEN EMINENCE Program attitude and respect as a positive role
knowledge or understanding.
PAGE 32 model; and a personal interest in the
Now, a mentor is someone who can
ENA Member Finds Paradise mentoring relationship. In addition, a good
Needs Good Teachers help you move to the next level in your
mentor exhibits enthusiasm for your
career or view new possibilities, open doors
interests, values ongoing learning and
for you by introducing you to new people,
Monthly Features growth; provides guidance and constructive
act as a sounding board and share the good
feedback; is respected by colleagues; has
and bad of their past experiences to
PAGE 4 ongoing personal and professional goals;
Members in Motion potentially keep you from making the same values the opinions of others and motivates
mistakes. others by setting a good example. It is
PAGE 10
ENA Foundation crucial that a good mentor must also have
Choose Wisely the desire and time to take on a mentee.
PAGE 11 What do you look for in a mentor? A In my own career, I can think of one
NEW! Ask ENA mentor is usually someone you admire and person who was important in my decision
PAGE 12 whose footsteps you might like to follow. A to become an emergency department
Pediatric Update good mentor possesses all or most of the director. She encouraged me to return to
following qualities: willingness to share
PAGE 21
skills, knowledge and expertise; a positive Continued on page 28
Ready or Not?

PAGE 26
CourseBytes Official Magazine of the Emergency Nurses Association 3
Fellowship Adds Fuel WHAT’S NEW WITH YOU?
Make time in March to slide up to
to Illinois Nursing E-mail connection@ena.org to
tell us about your recent successes or
your computer and take ENA’s latest
free continuing education course.
Leader’s Research to celebrate those of a member
colleague. Include names, credentials
‘‘GU: It’s More Than Just P,’’ by
Steve Stapleton, PhD, RN, CEN, the and, if applicable, photos of the
Michael D. Gooch, MSN, RN, CEN,
CFRN, ACNP-BC, FNP-BC, EMT-P, is immediate past president of the Illinois nurse(s) being recognized.
an e-learning program worth 1 ENA State Council and an assistant
contact hour. It reviews the anatomy professor at Illinois State achievement,” Stapleton wrote in his
and physiology of the genitourinary University’s Mennonite fellowship application, ‘‘that I will
tract, the clinical manifestations
College of Nursing, has accomplish my objectives while
associated with common GU
disorders and patient management. received a Nurse inspiring others to seek rewarding
Educator Fellowship professional and/or academic careers.’’
To take this and other courses in the
CE catalog:
from the Illinois Board of
Education. THREE ENA MEMBERS AT THE
 o to www.ena.org/freeCE,
•G
The award is aimed at retaining top University of Texas Medical Branch in
where you’ll log in as an ENA
member (or create a new nursing faculty at Illinois nursing Galveston were among 11 co-authors of
account). colleges and universities. It includes a an article on UTMB’s revised annual
•A
 dd desired courses to your $10,000 grant for continuing research. evaluation process.
cart and ‘‘check out’’ (courses Stapleton’s research centers on Valerie Brumfield, MSN, RN, CCRN, a
are completely free for managing pain for emergency clinical nurse specialist in the emergency
members only). department patients, particularly after department; Leanne Ledoux, BSN, RN,
•P
 roceed to your Personal discharge, with the goals of better CEN, SANE, the assistant nurse manager
Learning Page to start or practice, better outcomes and fewer in the ED; and Ruth A. Sathre, MSN, RN,
complete any course for which readmissions. Self-described as a ‘‘strong CEN, a former ED staff nurse who’s now
you have registered or to print a
proponent of lifelong learning,’’ he in the Doctor of Nursing Practice
certificate when you’re done.
previously has received research grants program at Walden University, helped to
•T
 o return to your Personal
from the ENA Foundation and the develop ‘‘Enhancing RN Professional
Learning Page at a later time,
go to www.ena.org and find National Institutes of Health. His findings Engagement and Contribution: An
‘‘Go to Personal Learning have been published in the Journal of Innovative Competency and Clinical
Page’’ under the Courses & Emergency Nursing, the Journal of Advancement Program,’’ which was
Education tab. Clinical Nursing and the Journal of Pain published in June 2012 in Nurse Leader.
If you have questions about any and Symptom Management. The article describes the revision
free e-learning course or the He’s been at Mennonite in a tenure process, which involved a new system
checkout process, e-mail track since 2010. for bedside staff evaluations across
elearning@ena.org.
‘‘It is through my own academic diverse settings and specialties.

ENA Connection is published 11 POSTMASTER: Editor in Chief: Secretary/Treasurer: Matthew F.


times per year from January to ­Send address changes to Amy Carpenter Aquino Powers, MS, BSN, RN, MICP, CEN
December by: ENA Connection Assistant Editor: Immediate Past President: Gail
The Emergency Nurses Association 915 Lee Street Josh Gaby Lenehan, EdD, MSN, RN, FAEN,
915 Lee Street Des Plaines, IL 60016-6569 FAAN
Writer:
Des Plaines, IL 60016-6569 ISSN: 1534-2565 Kendra Y. Mims Directors:
and is distributed to members of the Fax: 847-460-4002 Kathleen E. Carlson, MSN, RN, CEN,
Editorial Assistant:
association as a direct benefit of Website: www.ena.org Renee Herrmann FAEN
membership. Copyright© 2013 by the E-mail: connection@ena.org Ellen (Ellie) H. Encapera, RN, CEN
Emergency Nurses Association. BOARD OF DIRECTORS
Marylou Killian, DNP, RN, FNP-BC,
Printed in the U.S.A. Officers:
Member Services: President: JoAnn Lazarus, MSN,
CEN
Periodicals postage paid at the Michael D. Moon, MSN, RN, CNS-CC,
Des Plaines, IL, Post Office and 800-900-9659 RN, CEN
CEN, FAEN
President-elect: Deena Brecher,
additional mailing offices. MSN, RN, APRN, ACNS-BC, Sally K. Snow, BSN, RN, CPEN, FAEN
Non-member subscriptions are avail- CEN, CPEN Joan Somes, PhD, MSN, RN, CEN,
able for $50 (USA) and $60 (foreign). CPEN, FAEN
Karen K. Wiley, MSN, RN, CEN
Executive Director: Susan M.
Hohenhaus, LPD, RN, CEN, FAEN
ENA Co-Founder
Judith C. Kelleher
MSN, RN, FAEN
1923-2013

Her Dream Lives On


Below is an excerpt of the eulogy that Deena Brecher, MSN, RN, APRN, ACNS-BC, CEN, CPEN,
2013 ENA president-elect, delivered at services for Judith C. Kelleher on Feb. 1.

S
ometimes, it only takes a association dedicated to the
handful of people with advancement of the specialty
courage to step out on faith through education and
and create a change … those advocacy. One of her dreams
who dare to dream big for what was realized in 2012 when the
they believe in . . . those who American Nurses Association
spark a revolution to improve recognized emergency nursing as
the lives of others. a specialty.
For ENA it took two, and one More than 40 years have
of them was Judith Kelleher. passed since its creation, and
Judy has touched the lives of every single member of ENA is
many, and she has left an still impacted today by Judy’s
imprint on our organization and accomplishments. As an
in our hearts. There are no organization, we are truly blessed
adequate words to express how grateful we are to have been founded by a true leader and
for the contributions she has made to our trendsetter whose dream raised the standards of
profession. how we practice. As individuals, we are inspired
She joined forces with Anita Dorr, RN, FAEN, by her dream to make a difference in the lives of
and they formed the national Emergency patients and emergency nurses everywhere.
Department Nurses Association in December It is a blessing that Judy was able to see the
1970. After Anita’s passing in 1972, Judy carried difference she made in our organization … from
on their shared vision. She was undaunted by the 40,000 emergency nurses who have united to
obstacles and determined that emergency nursing become a voice in our profession to the
would be recognized as a specialty. thousands of patients who are receiving better
She famously said, ‘‘I think the thing that treatments in emergency departments around the
typifies ENA in those early years is that we began country because of her passion to improve
to speak out and speak up for emergency emergency care for everyone.
nursing, for emergency nursing education, for As one ENA member wrote on our Facebook
emergency nursing recognition.’’ page this week, ‘‘Rest in peace, Judith. Your
Judy led the organization to national work here may be done, but your legacy will live
prominence and recognition as the only on for generations.’’

Look for an expanded tribute to the career and impact of Judith C. Kelleher in the May issue of ENA Connection.

Official Magazine of the Emergency Nurses Association 5


BOARD WRITES | Matthew F. Powers, MS, BSN, RN, MICP, CEN, ENA Secretary/Treasurer

In-Flight Medical
Emergencies
Ding! ‘‘If there is doctor, nurse, with these factors come the signs and
paramedic or anyone with medical symptoms of nausea, vomiting,
training on board who can assist with headache, abdominal pain, dizziness,
a medical emergency, please ring your hypotension and syncope. Although
flight attendant call bell.’’ other medical conditions, such as
When emergency nurses hear this myocardial infarction or stroke, can
request, some may hope someone else occur at any time, most in-flight
will ring in; however, there is no medical emergencies are related to the carry additional equipment, including
guarantee of a physician being on environment and stress of travel. obstetrical kits and anti-nausea and
board, which occurs between 40 and What do you do? First, make over-the-counter pain medications.
90 percent of the time. yourself known to the flight attendant. A question of liability often arises.
Commercial aircraft emergencies Once you have been escorted to the Congress passed the 1988 Aviation
occur daily in the United States, in patient and have made your initial Medical Assistance Act, which allows
roughly 1 in 39,600 passengers. It is assessment and general impression, medical professionals to operate under
difficult to clarify the actual number of ask if the patient can be moved to a their scope of practice as long as the
medical emergencies due to a lack of more quiet and confidential area, such professional is practicing in good faith.
mandated reporting. as the bulkhead or rear of the cabin. If According to the Act, ‘‘An individual
Emergency nurses who hear the this is not an option, ask the flight shall not be liable for damages in any
call to assist may be the most prepared attendant to try to reseat passengers or action brought in by Federal or State
based on our knowledge and skill. In allow your patient to walk the aisles so court arising out of acts or omissions
my experiences assisting patients you can best complete a confidential of the individual in providing or
requiring in-flight medical intervention, assessment. Based on the medical attempting to provide assistance in the
I have found that the term ‘‘doctor’’ complaint and condition, your patient case of an in-flight medical emergency
can be applied to an array of positions, may need to lie as flat as possible unless the individual, while rendering
including emergency physician, across three seats. Do not be afraid to such assistance, is guilty of gross
Doctorate in Public Health Quality, ask for comfort packages that include negligence or willful misconduct.’’
podiatrist, pediatrician, dentist and a pillow and blanket. While rendering medical care, you
chiropractor. Ascertaining a doctor’s Today’s airlines in the U.S. are should never feel alone. Flight
specialty will better prepare a team to equipped with an automatic external attendants are trained in first aid and
care for an in-flight patient. Incorporate defibrillator and robust medical kit, CPR/AED and welcome any assistance.
the flight attendants into your care, as thought they are kept under lock and Ground medical control is available
they have the direct link to the captain, key. Basic equipment, such as a blood through the captain as a joint decision
who is the ultimate decision-maker pressure cuff, stethoscope and oxygen, is made whether to continue to the
and has contact with ground medical is readily available. Additional final destination or divert. Many times,
control. equipment and advanced cardiac with comforting medical and nursing
Medical emergencies that occur equipment, not limited to IV solutions care, patients make it to their
during flight are often related to travel and medications, are available for use destination to awaiting EMS personnel.
or stress. Hypoxia, barometric pressure with consultation through ground Next time you answer the ding
changes, temperature changes, medical control. Under Federal asking for assistance, your flight crew
dehydration, noise, vibration and Aviation Regulations, Appendix A to will be quite appreciative, and you
fatigue are environmental conditions Part 121, airlines must display the may even receive a token of gratitude
causing physiological stress. Along required equipment. Many airlines for your willingness to help.

6 March 2013
ENA Foundation 2013 State Challenge
Emergency T O ut forNursing
S HOU y Nursing
e r g e nEducation
c
E m c a t io n
E du

The Goal is Simple


Help emergency nurses get the education they need.
Shout out for the future of your profession by
making a donation to the ENA Foundation.

Your donation will help your state council’s


chances towards the following awards.

Challenge Awards
Largest percentage increase per capita:
1st Place - $250 ENA Marketplace gift certificate
2nd Place - $100 ENA Marketplace gift certificate
Largest number of individual donations per state:
1st Place - $250 ENA Marketplace gift certificate
2nd Place - $100 ENA Marketplace gift certificate

Donate Now
Visit www.ENAFoundation.org for more detailed information
on the State Challenge campaign and for updates on
where your state stands in the challenge race.

2013_ENAF_StateChallengeAd_fullpg.indd 1 1/30/13 1:32 PM


ENA’s Resource Pathway
to Safe Practice, Safe Care
By Dale Wallerich, MBA, BSN, RN, CEN, Senior Associate,
ENA Institute for Quality, Safety and Injury Prevention

ENA’s Strategic Plan for 2012-2014 includes four priority


areas that benefit the stretcherside nurse and contribute
to providing safe practice, safe care. Those priorities are
1) advancing emergency care at home and abroad; 2)
advocating for a culture of safe practice and safe care; 3)
championing for a culture of inquiry, learning and
collaboration within our profession; and 4) expanding
and fortifying ENA’s membership. One integrating
concept that encompasses these four philosophies is the
sharing of pertinent information on patient care, patient
and staff safety and a means to further the specialty of
emergency nursing.

Access to Education
To strengthen the nurse’s ability to provide safe practice,
safe care, ENA provides education in both formal and
informal ways, has developed a scope and standards for
the emergency nurse and offers a wealth of information
through products available at the ENA Marketplace
(admin.ena.org/store). ENA provides educational
programs to support and strengthen the excellent care An attendee taps into one of the educational opportunities that
delivered by emergency nurses. Courses, seminars and have come to define ENA’s annual Leadership Conference.
conferences are based on knowledge from experts in
the field and designed to help you achieve your Member Resources
professional development goals. The Journal of Emergency Nursing, the official journal of
ENA’s Center for e-Learning provides on-demand online ENA, reaches the greatest number of emergency nurses,
courses through its learning management system. Each emergency/trauma departments and ED managers of any
month, a new online course is launched and is free to all journal. The journal covers practice and professional issues,
members as a value-added benefit and for continuing based on current evidence, that challenge emergency nurses
education credits. every day and features original research and updates from
ENA’s Annual Conference is the largest educational the field. ENA’s news magazine, ENA Connection, is
gathering for emergency health care professionals. It is a published 11 times annually and provides current
comprehensive learning experience designed to enhance the information on association activities and emergency nursing
knowledge and skill level of emergency nurses, nurse issues.
managers, ED directors, clinical educators and more. ENA’s Emergency Nursing Scope and Standards of Practice is a
Leadership Conference is the premier educational gathering landmark publication that describes the competent level of
for emergency health care leaders, which offers an behavior expected for nurses practicing in the specialty of
unparalleled learning experience, networking opportunities emergency nursing. The book provides a guide for the
and exposure to the most cutting-edge tools and products in practitioner to understand the knowledge, skills, attitudes
emergency care services. and judgment that are required for practicing safely in the

8 March 2013
emergency setting. This book is available at the ENA the other on health literacy, are currently available at
Marketplace (admin.ena.org/store) along with a full www.ena.org/IQSIP/Practice/Pages/, along with other
selection of resources covering a wide range of the topics in informational tools available for download.
the practice of emergency nursing.
ENA continues to share pertinent information through its POSITION STATEMENTS
position statements, which ENA defines as an assertion of www.ena.org/about/position
the beliefs held, encouraged and supported by ENA.
Position statements provide concise information and material EMERGENCY NURSING RESOURCES
for understanding and analysis of the problem. Joint and www.ena.org/IENR/ENR
consensus position statements are an assertion of the beliefs
held, encouraged and supported by ENA developed in OTHER USEFUL LINKS
collaboration with external professional organizations with
www.ena.org/COURSESANDEDUCATION
mutual interest in providing safe practice, safe care. All
position statements are written in accordance with the www.ena.org/publications/jen
bylaws, strategic plan and code of ethics of the organization www.ena.org/publications/connection
and are officially endorsed by ENA as authorized by the ENA
admin.ena.org/store
Board of Directors.
Emergency nursing resources are evidence-based
Reference
documents that facilitate the application of current evidence
Emergency Nurses Association. (2012). ENA strategic plan
into everyday emergency nursing practice. ENRs are created
2012 - 2014 and beyond. Retrieved from www.ena.org/
following a rigorous process included in ENA’s Guidelines
about/Documents/ENAStrategicPlan2012-2014.pdf
for the Development of Evidence-Based Emergency Nursing
Resources. ENA believes that ENRs have a positive impact on Contributing: Kathy Szumanski, MSN, RN, NE-BC; Jessica
patient care and emergency nursing practice by bridging the Gacki-Smith, MPH; Altair Delao, MPH; Maureen Howard
gap between practice and currently available evidence. and Bree Sutherland.

New Tools
ENA Practice References are a new resource from ENA. They
are succinct practice statements that are based on current
A NATIONAL CONFERENCE FOR EMERGENCY DEPARTMENT
scientific evidence available at the time the documents are

EMERGENCY
NURSES, PHYSICIANS AND PHYSICIAN ASSISTANTS
developed. They are related to a clearly identified
circumstance and provide best practice information. They

CARE SUMMIT
are not meant to be a substitute for a nurse’s best judgment
in a given situation of care.
The concept of the practice reference came out of the
need to respond to member requests for a quick resource
that can assist in applying appropriate or available evidence
in a given clinical situation. It is anticipated that many of the
practice reference topics will come from ENA listserv
discussions and direct e-mail inquiries.
Two of the several EPRs drafted by the ENA Clinical
Practice Committee in 2012 were reviewed and approved by
the ENA Board of Directors. These first two practice
references focus on hemolysis and right-sided/posterior
EARN UP TO 17.5 CE HOURS
ECGs and are available at www.ena.org/IQSIP/Practice/
Pages. SNOWMASS, CO
Topic Briefs are informative documents that provide July 21-24, 2013
detailed, accurate and current information on a given subject
of importance to safe practice, safe care. The subjects
Register online at
selected for topic briefs come from inquiries from members
www.ContemporaryForums.com
or as a result of committee work on a particular subject.
Or By Calling 800-377-7707
Two Topic Briefs, one on health information technology and

Official Magazine of the Emergency Nurses Association 9


ENA FOUNDATION | Julie Jones, BSN, RN, CEN, 2013 ENA Foundation Chairperson

The Many Ways


We Can Do More
Hello, fellow ENA members. I am Julie Jones from South the hat at each state meeting. Second, they purchase jewelry
Carolina, and it gives me great pleasure to introduce myself from the ENA Foundation Jewelry Auction at the Annual
as your 2013 ENA Foundation chairperson. Conference. At each state meeting, members can buy tickets
Many years ago, as a member of the South Carolina state for chances to win the jewelry. Most recently, Kansas
council, I knew I wanted to make a difference in emergency honored one of its members, Darlene Whitlock, MSN, MA,
nursing. My colleagues and I realized we had the RN, APRN, ACNP, EMT-B, CEN, CPEN, by naming a
opportunity to give back and do more for others by giving scholarship after her. Members wanted to do something
to the ENA Foundation through the State special to recognize her efforts in Kansas
Challenge. After the loss of a colleague, regarding the trauma system, as well as
Antoinette Ruff-Johnson, BSN, RN, CEN, her years of dedication and service to the
we all wanted to do something in her Kansas ENA Board of Directors. State
honor. Raising money to name a state Council and chapter contributions made
council scholarship after her was the this possible.
perfect idea. We asked how much we Seleem Choudhury, MSN, RN, CEN,
needed to raise through the State the ENA Foundation chairperson-elect,
Challenge to name a scholarship, and Mike Hastings, MS, RN, CEN (left) and shared how the Colorado ENA State
Seleem Choudhury, MSN, RN, CEN, of the
sticker shock hit when we learned the Council (membership: 860) conducted its
Kansas and Colorado state councils.
amount was $5,000. How was our successful fundraising effort the last few
little state with 500 members going to come up with that years. In 2010, Colorado ENA began its journey to becoming
much? We continued passing the hat for the State Challenge more involved in the ENA Foundation. Before then, the
but knew that would not be enough. One chapter donated council had not contributed; when Choudhury became
10 percent of the proceeds from its oyster roast. We began council president, he made it a priority.
e-mailing members in South Carolina, telling the story of Colorado ENA started with simply making an ENA
what and why we were doing this. I expanded my e-mail Foundation donation a line item in its budget and its
requests to friends and family, who gladly contributed. Our strategic plan. It noticed a corresponding increase in
state council also informed Ruff-Johnson’s family of our individual donations. Colorado did some unique fundraising
intentions, as well as her former emergency department, to as well. It purchased 20 CEN review manuals, sold them at a
encourage donations in her honor. discounted rate and gave 100 percent of the proceeds to the
We succeeded and named our first scholarship in 2011. ENA Foundation. At its state conference, it asked for ENA
I am happy to say that we were able to sustain the how Foundation donations at its state booth.
and why of gaining donations and named the Antoinette At the end of 2011, Choudhury went to the board with the
Ruff-Johnson Memorial Scholarship in 2012. I share this story idea of increasing the donation for 2012 to $5,000 to name a
to show that even a smaller state can make a great scholarship. This will be given out in 2013 in remembrance
contribution and honor someone who has touched its of the victims of the Aurora movie theater shooting.
members’ lives. Every state has a story. Now is the time to tell your story
South Carolina is not the only small state to have made and connect it to your purpose by giving to the ENA
this commitment. Mike Hastings, MS, RN, CEN, of the Kansas Foundation. Let’s support our profession and each other.
ENA State Council (membership: 393) shared KENA’s story Reach out to other state chapters to brainstorm fundraising
with me. ideas. I can’t wait to hear about some of your ideas as we
‘‘We join the Foundation’s focus to expand the strive to make the 2013 ENA Foundation State Challenge the
knowledge of emergency nurses by offering education, most successful ever. For more information on the State
scholarships and funding research opportunities,’’ he said. Challenge and how you can contribute to the ENA
KENA members do this in several ways. First, they pass Foundation, please visit www.enafoundation.org.

10 March 2013
Q: I am an ED nurse finishing up expert witness, nurse death investigator
In response to member requests
my bachelor’s degree in nursing, and community education.
for more interactive opportunities,
and I plan on pursuing a master’s If you decide to stay within the
ENA Connection is proud to debut
degree. I have heard about forensic hospital setting, you may share your
its newest feature, Ask ENA.
nursing, and it has intrigued me. Is it expertise with your peers to help them
Members are encouraged to submit
a female specialty due to the high provide not only quality care but expert
questions about the organization
percentage of female sexual assaults? documentation for the patient who has
and emergency nursing in general.
Would a male have the same been injured, assaulted or abused.
Questions should be no longer
opportunities afforded to him? There are numerous master’s degree
than 200 words. For verification
– Jared from Boston programs across the country, with
purposes, you must include your full
several on the East Coast that specialize
name, address and e-mail address.
A: Jared, thank you for reaching out in forensic nursing. I would encourage
(We will accommodate requests to
to ENA. The term ‘‘forensic nurse’’ is you to contact the International
not print full names.)
relatively new — the field has only been Association of Forensic Nurses at iafn.
Questions will be referred to the
around for approximately 20 years. org to find out more about the specialty
appropriate ENA staff or department.
Because forensic nursing encompasses a and to seek their assistance in finding
Submission of a question does not
wide variety of issues, gender really an advanced program that meets your
guarantee publication. Submissions
does not matter. needs.
may be edited for clarity or
A forensic nurse is a nurse with I hope I have answered your
shortened for space.
specialized training in forensic evidence questions. Please feel free to contact me
E-mail questions to
collection, criminal procedures, legal at dwallerich@ena.org.
connection@ena.org, fax to
testimony expertise and much more as
847-460-4005 or mail to ENA — Dale Wallerich, MBA, BSN,
the job description continues to expand.
Connection, 915 Lee St., Des Plaines, RN, CEN, Senior Associate,
Other career branches for this job ENA Institute for Quality, Safety
IL 60016.
outside of the hospital include medical and Injury Prevention

Take charge of
Your Nursing Career
Are You Looking for a New Job Opportunity?
Job seekers can post their resume, search for jobs and most importantly create
an online profile for employers to find. You can maintain total privacy about
your job search by selecting to keep your resume and profile confidential in our
database.
To create an online profile, go to www.ena.org and go to the Career Center to log-on
and get started today. Be sure to come back frequently to keep your profile current!

Your path to lifelong career success.


PEDIATRIC UPDATE

Fewer Tears and Fears

Reducing Needless Pain


in Pediatric Minor Procedures
By Denise R. Ramponi, DNP, NP-C, CEN, FAEN, Assistant Professor, Robert Morris University, and Nurse Practitioner,
Heritage Valley Sewickley Emergency Department, Pittsburgh ♦ Edited by Elizabeth Stone Griffin, BS, RN, CPEN

Fact: Children get hurt and often require minor procedures


performed in the emergency setting.

Fact: Simple strategies can eliminate or drastically reduce


pain in pediatric minor procedures.

Pediatric pain is often under-recognized and undertreated


in the emergency setting. One study examining more than
1,000 pediatric patients undergoing minor procedures found
that almost none of the children received any pain
management strategies.1 Children can have long-lasting
negative psychological effects from a painful procedure.
Infant males who were circumcised shortly after birth
without pain control demonstrated higher levels of pain
when receiving their infant immunizations.2 Using simple
strategies can reduce pain and fear while increasing child
and parent satisfaction.
Evidence confirms that parents should be permitted to stay
with their children when undergoing minor procedures.3
Parental presence is helpful for children, yet it is not
consistently implemented. Parents should be provided
instructions on how to help maintain a calm and positive
atmosphere along with suggestions for distraction
techniques.
The position of the child can make a significant difference
in the child’s stress during the procedure. Comforting
positions, such as the child sitting in the parent’s lap or sitting Figure 1: Mother holding child in the “chest-to-chest” position.
in the “chest-to-chest” position with the parent (see Figure 1),
provide positive support as opposed to having the child lie very still and take some deep breaths like Mommy.’’
supine, which often results in panic and struggling. Distraction can direct the child’s attention away from the
Words can either comfort the child or invoke fear. pain related to the procedure. Distracters such as books,
Warning a child about anticipated pain often results in greater toys, music, video games, singing and deep breathing should
pain and anxiety in the child. Reassuring comments, such as be developmentally appropriate and able to capture the
‘‘You can do this’’ or ‘‘Don’t worry’’ can increase distress in child’s interest. The I-Spy book series is an excellent
children and should be avoided. Avoid telling the child what distracter for children. Talking and touch have been found to
you do not want the child to do: ‘‘Don’t move,’’ which can be the most helpful distracters.
also evoke fear in the child. Instead, tell the child what you The application of pressure (rubbing near the site or
want him or her to do: ‘‘I want you to try to hold your arm vibration in close proximity to the location where the

12 March 2013
procedure is being painful procedures.
performed) can also be The sucrose causes the
an effective method to release of endogenous
reduce pain. This endorphins and thus
method demonstrates reduces the pain.
use of the Gate Theory, Infants provided
similar to the method sucrose were found to
used by dentists who cry less and returned to
jiggle the lip before their baseline condition
giving intraoral quicker after
injections. procedures. Pacifiers
There are a number alone can also be
of non-invasive agents effective for analgesia.
that can be used to There are a number
reduce pain in the of other pain-reducing
emergency setting. strategies that are
Some can be applied beyond the scope of
immediately prior to this article. The methods
procedures, and others discussed can take a
must be applied 20 to minimal amount of time
30 minutes in advance and can significantly
of a procedure to reduce pain effectively
engage maximum in the pediatric patient.
benefit. Topical Figure 2: Skin blanched after 20 minutes of LET application.
vapocoolant spray is
an anesthetic skin refrigerant that instantly reduces pain for References
needlesticks and other skin punctures. It can be applied to 1. MacLean, S., Obispo, J., & Young, K.D. (2007.) The gap
minor open wounds or intact skin (such as abscesses). It is between pediatric emergency department procedural pain
sprayed for 4 to 10 seconds or until the skin is blanched, management treatments available and actual practice.
with a resultant 60 seconds of transient anesthesia to Pediatric Emergency Care, 23(2): 87-93.
perform the procedure. Liposomal lidocaine
2. Taddio, A., Katz, J., Ilersich, A. L., & Koren, G. (1997.)
(4 percent) cream can be applied to intact skin to reduce
Effect of neonatal circumcision on pain response during
pain from venipunctures. It can be placed over two areas
subsequent routing vaccination. The Lancet, 349(9052),
where the vein is most prominent, often the antecubital area
599-603.
and dorsum of the hand, for approximately 20 to 30 minutes
before IV starts. Two areas are typically used in case the first 3.Broome, M. (2000.) Helping parents support their child in
IV attempt is unsuccessful. pain. Pediatric Nursing, 26(3), 315-317.
For open wounds, mixtures of lidocaine, epinephrine and
tetracaine can be applied to lacerations in the triage area.
LET is applied to a cotton ball or other nonabsorbent
dressing and taped in place. As an alternative to using tape BLOG
ON
over the dressing, the parent can wear a glove and apply
pressure to the dressing over the wound for approximately
20 to 30 minutes before laceration cleansing and repair. The
skin will become blanched from the epinephrine in the LET
(see Figure 2).
Other considerations include application of viscous Head to enajoann.wordpress.com or
lidocaine jelly to the urethra for approximately 10 minutes the ENA website, www.ena.org, to read the
before urethral catheterization attempts in infants. Infants latest posts from 2013 ENA President JoAnn Lazarus,
can be provided sucrose solution by dipping a pacifier in the MSN, RN, CEN, in her new ENA President’s Blog.
sucrose and giving it to the infant before, during and after

Official Magazine of the Emergency Nurses Association 13


ADVOCACY

Ohio Efforts Pay Off With New Law


Against Assaulting Health Care Workers
By Nicholas Chmielewski, MSN, RN, CEN, NE-BC, Ohio ENA State Council Government Affairs Liaison
On Dec. 20, Ohio Gov. John Ohio Senate. Oelslager
Kasich signed Amended recognized Ohio ENA
Substitute House Bill 62 into during a Nov. 27 debate on
law. Taking effect March 22, the HB62 on the Senate floor by
Health Care Worker’s Protection saying, ‘‘In particular, I
Act will increase the penalty for would like to thank and
assault against nurses and other recognize the Ohio
health care professionals. Emergency Nurses
Sponsored by state Rep. Anne Association. The statistics,
Gonzales (R-Westerville), HB62 research and national
is a much-needed first step expertise they brought to
toward reducing the incidence the table on this issue was
of violence in Ohio’s hospitals. incredible.’’
Key elements of the new law In addition to strong
are illustrated in the table below. Pictured at the signing of HB62 with Ohio Gov. John Kasich work by Ohio ENA, the
‘‘Nurses and other hospital (seated) are (from left) state Rep. Anne Gonzales; Ohio ENA
State Council Immediate Past President Beverly Clensey, MS, actions of our individual
health care workers now have RN, CCRN, CEN; Ohio ENA Government Affairs Liaison members largely contributed
the opportunity and safeguard to Nicholas Chmielewski, MSN, RN, CEN, NE-BC; state Sen. Scott to HB62’s passage. The
keep the work environment a Oelslager; and ONA President Paula K. Anderson, RNC.
table on the next page lists
safer and more secure place to the individual members
support also were received from the
deliver care,’’ said Beverly Clensey, MS, who provided HB62 proponent
Ohio Hospital Association, American
RN, CCRN, CEN, immediate past testimony. In particular, Central Ohio
College of Emergency Physicians, Ohio
president of the Ohio ENA State Council. emergency nurse Libby Robb, RN,
State Medical Association and the Ohio
The passage of HB62 is the
chapter of the American Psychiatric testified before the Senate Judiciary’s
culmination of several years of work by
hearing on companion legislation
the Ohio Emergency Nurses Association Nurses Association.
(SB111) to share her tearful experience
and the Ohio Nurses Association. Our State Sen. Scott Oelslager, then-chair
of being assaulted by a patient. With the
grassroots passion for the topic and of the Senate Health Committee and
help of Ohio ENA member Gordon
expertise on the phenomena, combined sponsor of companion legislation Senate
Gillespie, PhD, RN, CEN, CPEN, FAEN,
with the political power of ONA, proved Bill 111, was instrumental in the bill’s
we brought national expert Donna
a most successful coalition. Letters of successful 18-month journey through the
Gates, EdD, MSPH, MSN, FAAN, to
testify before the Senate Judiciary’s
Key Elements of HB62 hearing on HB62. Also, an article by
ENA past president Diane Gurney, MS,
• Directs the Ohio Department of Health to create standardized signage in the
RN, CEN, FAEN, in the April 2011 issue
shape of a stop sign. The signage will state that abuse or assault of hospital
of ENA Connection was a catalyst to
staff will not be tolerated and could result in a felony conviction. Authorizes
introduce language in the bill permitting
hospitals to post the signage in public areas.
standardized hospital signage on the
• If the hospital offers de-escalation training to its staff, HB62:
issue.
° Authorizes a $5,000 fine for assault against healthcare professionals, health
care workers and security officers of a hospital for a first-time offense. ‘‘All emergency nurses are indebted
to the Ohio Emergency Nurses
° Increases the penalty for assault to a fifth-degree felony when the offender
has previously been convicted of an assault against a health care worker. Association, the Ohio Nurses
Association, Rep. Gonzalez and Sen.

14 March 2013
Oelslager for all their work on • Individuals with mental
this legislation,’’ said Gail Emergency Nurses Contributing at HB62 Hearings impairments.
Lenehan, EdD, MSN, RN, FAEN, • The degree of penalty that
FAAN, immediate past president House Criminal Justice, April 2011 should be applied to offenders.
of ENA. ‘‘The legislation will help Dan Abbey ♦ Tammy Brassler ♦ • Hospitals’ responsibility to
to protect the nurses of Ohio, but Nancie Bechtel ♦ Nick Chmielewski ♦ provide de-escalation training.
also provides inspiration for Ivy Cook ♦ Meghan Long ♦ • The need for signage to
similar legislation in other states Nicole McGarity promote awareness and
as well. Importantly, it sends a discussion on the issue.
message that will hopefully be
Senate Judiciary, November 2011 • The cost of implementation.
heard beyond the boundaries of Nick Chmielewski ♦ Beverly Clensey ♦ We were extremely grateful for
Ohio — that violence against Megan Long ♦ Nicole McGarity the expertise, support and
nurses and other health care guidance of ENA’s national office
workers will not be tolerated, during its journey to becoming law. staff during the last several years.
that it is no more acceptable than Key discussions included: This support was highlighted when
violence against police or firefighters.’’ • The philosophy of ‘‘protected classes.” Lenehan joined us at the Ohio State
It took the introduction of many • Explaining the need for this Capitol to celebrate HB62’s signing.
bills over several sessions to realize the legislation and helping legislators One important lesson learned is that
passage of HB62. In the 128th Ohio understand the prevalence of this successful legislative policy requires
General Assembly, state Rep. Denise violence. collaboration and compromise. Most
Driehaus introduced HB450 to restart • Explaining that this bill is not about important, however, is persistence. It
the conversation. Similar legislation ‘‘locking up’’ an elderly patient with was the unrelenting persistence of our
was introduced in that session by Rep. Alzheimer’s or a patient waking up members — through letter-writing and
Stephen Slesnick and then by from anesthesia in a combative state. phone calls — that resulted in HB62
Oelslaeger. In the 129th Assembly, • The scope of who should receive receiving a crucial floor vote in the
Slesnick and Driehaus re-introduced protection. Senate. To each of our members across
legislation. There were several • Individuals under the influence of the state who contributed, I say thank
discussions and changes to HB62 drugs or alcohol. you and congratulations!

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ADVOCACY

ENA Hosts Its First


Emergency Nursing
Advocacy Intensive
By Kendra Y. Mims, ENA Connection
More than 90 ENA state council leaders representing more
than 30 states attended ENA’s first Emergency Nursing
Advocacy Intensive in Chicago on Jan. 10-12. Sponsored by
Vidacare, this unique event provided attendees with an
exciting opportunity to learn more about advocating for the
emergency nursing profession to make a difference for their
patients and colleagues.
The three-day event kicked off with a welcoming
reception at ENA national headquarters, where attendees
were able to reconnect and network with their peers. 2013
ENA President JoAnn Lazarus, MSN, RN, CEN, opened the
second day with a presentation on ENA’s priorities and its
2013-2014 Public Policy. She explained that the ENA Board
of Directors determined that the new ENA Public Policy JoAnn Lazarus, MSN, RN, CEN, the 2013 ENA president,
shares her concept of ‘‘advocatism’’ during remarks on the
would be more nurse-focused.
second day of the Emergency Nursing Advocacy Intensive.
‘‘This is an organization about you and advocating for all
of you,’’ Lazarus said. ‘‘We know that safe practice advocates advocate for ENA in all places, both on and off the clock,
for safe care. By taking care of all of you, you’ll be able to with those professionally in your field and those who are
take care of your patients.’’ curious about it,’’ Schwartz said.
Lazarus discussed the meaning of her newly coined term Schwartz urged the audience members to attend
‘‘advocatism’’ and the importance of image, from appearance conferences and networking sessions to connect with and
to communication. build bridges for others. She said networking is the best way
‘‘To me, advocatism is what we do for our patients and to effectively communicate the message of ENA.
for the profession of nursing. Advocatism is really at the ‘‘ENA really provides an incredible bridge for you,’’ she
heart and soul of what we do as emergency nurses,’’ she said. ‘‘ENA has the tools, resources, research and incredible
said. ‘‘As ENA, we are held in high esteem because of the staff within ENA for you to go to and get that information to
image we have with the public and because of the help build that bridge for your hospital, a colleague or in
perception of what we do for others. Advocacy is not just your community. They are there for you, so use that bridge
about influencing public policy. From a nursing image when you lobby for that safer work environment. . . . You
perspective, it’s our responsibility that the public sees us in are so used to advocating for your patients all day every day,
the best light.’’ but you also have to advocate for yourselves. As you
Attendees learned about the importance of networking advocate for yourselves, you advocate for every one of your
from keynote speaker Laura Schwartz during her ‘‘Eat, Drink patients at the same time.’’
and Empower’’ presentation. As the former White House ‘‘The power of ENA and you the member is amazing,’’
director of events for the Clinton administration, Schwartz Schwartz continued. ‘‘When you’ve got a critical patient that
shared effective techniques for networking, communication you’re administering to, when you’re in the meeting with the
and mentoring. CFO talking about purchasing safer equipment, or when
‘‘No matter where we are . . . we have opportunity you’re out in the community to meet with legislators, you’re
everywhere we look to be ourselves and empower others not in that room with the patient or on Capitol Hill alone.
through our own background and stories, as well as to You are in there with the other 39,999 members of ENA.

16 March 2013
Top photo: Jeff Strickler, MA, RN,
CEN, CFRN (foreground), and
other emergency nurses from
around the country take in the
messages of the advocacy
intensive. Below, left: Michelle
Fox, BSN, RN, senior director of
clinical affairs for Vidacare,
shares industry perspective on the
importance of advocacy. At right
are Gordon Wheeler, associate
executive director of public
affairs for ACEP, and Adrianne
Drollette, senior political action
specialist for the American Nurses
Association. Below: Lazarus with
keynote speaker Laura Schwartz
(center) and ENA Executive
Director Susan Hohenhaus, LPD,
RN, CEN, FAEN.

You are never alone.’’ relations officer, discussed the current situation in
Susan Hohenhaus, LPD, RN, CEN, FAEN, ENA’s executive Washington, D.C., to raise awareness on becoming effective
director, led an informative session on public relations and government relation advocates. (Learn more about Richard
media training. Attendees learned how to effectively work with Mereu and his extensive legislative background on page 20.)
the media and connect with their communities. Hohenhaus Mereu’s session was followed by the expert panel on
discussed two types of media relations (proactive and reactive); advocacy, which included the following guest speakers:
how to deal with print reporters and broadcast reporters based ACEP Advocacy: Gordon Wheeler, ACEP associate
on their differences; knowing the rules of engagement when executive director, public affairs
working with journalists; and how to conduct a successful
 urses CAN 2012: Adrianne Drollette, American Nurses
N
interview by knowing who you are, what ENA represents and
Association, senior political action specialist
the definition of an emergency nurse. Attendees learned the
 tate and Federal Regulatory Agencies Weighing in on
S
advantages of using the media to advocate.
Health Care Scope of Practice: Anna Polyak, JD, RN,
‘‘Nursing is incredibly well-positioned in today’s health
American Association of Nurse Anesthetists, senior director
care environment,’’ Hohenhaus said. ‘‘In order to take care
 tate Council/Chapter/State Legislative Coordinator
S
of your patients, you have to make sure that you’re in a safe
Structure: Amy L. Hader, JD, Association of
place, that your scope and practice are protected and you’re
periOperative Registered Nurses, director, legal and
able to leverage federal and state funding to actually drive
government affairs
health care policy. You’re at the beginning of a revolution
that I feel is exciting.’’ Vidacare Corporation — Representation of the
Richard Mereu, JD, MBA, ENA’s new chief government Industry Perspective: Michelle Fox, BSN, RN,
 Vidacare senior director clinical affairs

Continued on next page

Official Magazine of the Emergency Nurses Association 17


ADVOCACY
ENA Advocacy
Intensive
Continued from page 17
We’ve Come a Long Way,
Attendees were able
to share important Baby … Or Have We?
issues affecting their
profession and By Mary Menafra, MSN, RN, CEN
emergency departments
I was fresh off the charges after being assaulted in the ED.
during the interactive
plane from Chicago, One answer especially disturbed me.
‘‘What’s Happening in
where I spent a This particular nurse was punched in the
Your State?’’ session.
spirit-lifting face by a patient. She subsequently went
The event ended with
weekend with my to the magistrate to press charges and was
informative sessions led
ENA peers at the denied her request because, she was told,
by guest speakers
Advocacy Intensive. Energized and ready ‘‘this was part of her job.’’ Reading this
Hershaw Davis, Jr.,
to get to work with my Virginia colleagues article and reflecting back on my own
MSN, RN, the ENA
to enable us all to have safe practice and experiences and testimony, I now see why
Government Affairs
provide safe care, I was handed a copy of this abuse is often seen as just part of the
Committee chairperson;
a 1961 newspaper article titled ‘‘Night in job. Well, it’s not.
Rita Anderson, RN, CEN,
Emergency Rooms: Hospital Nerve Centers Reading this piece led me to ask, ‘‘What
FAEN, ENA Government
Stay Alert.”1 has changed?’’ The answer is not much. In
Affairs Committee; Lisa
The article included photographs of 1961, patients lay on gurneys in hallways
Wolf, PhD, RN, CEN,
patients lining the hallway head to feet waiting for treatment; violence was a big
FAEN, ENA Institute for
while they waited for an intern to evaluate part of the reason for visits; and abuse of
Emergency Nursing
them further; police, nurses and doctors staff was a regular occurrence. The real
Research director;
huddled around a receiving desk, sifting changes are that patient volume has more
Elisabeth Weber, MA,
through patient information following an than tripled, technology allows staff to treat
RN, CEN, ENA
accident. Details of the latest and greatest more complex diseases and emergency
Government Affairs
technology, the electrocardiogram, which nurses and physicians stand united in their
Committee; Kathleen
‘‘produces a photographic record of the pursuit of safe work environments while
Conboy, BS, RN, CEN,
heart’s actions,’’ was highlighted for readers. they lobby together, all with the thought of
ENA Government Affairs
My attention was drawn to a section being able to better serve those in need.
Committee; and Deena
that outlined the violence that provides the During her opening lecture at the
Brecher, MSN, RN,
emergency room with much of our Advocacy Intensive, 2013 ENA President
APRN, ACNS-BC, CEN,
business and another section that read, JoAnn Lazarus explained advocatism as the
CPEN, 2013 ENA
‘‘These are the emergency rooms. These actions around advocating for others. I
president-elect.
are the places where lives are saved, submit to you that we all need to take this
Attendees left the
people helped, doctors and staff abused.’’ to heart and practice advocatism for each
intensive empowered
That sentence really hit home. As a other every day. Don’t let another nurse in
with knowledge and
member of the Virginia ENA State Council 40-plus years read an article that highlights
strategies to advocate
and the Virginia Nurses Association, I the waiting and the violence toward ED
for their patients and
testified before five committees during the staff. We need to change what future
themselves.
2011 Virginia General Assembly, where HB emergency nurses read. Let them see what
‘‘We have to help the
1690, a bill that provides some guaranteed you and I did to foster a safe environment
patient’s voice be
ramification to abusing or hitting any for them and the patients who need our
heard,’’ Lazarus said.
emergency department worker, was services each and every day.
‘‘We need to be the
voice of nursing and eventually passed into law. While preparing Reference
inform legislatures. I to testify on one of the later hearings, I Lindsay, G. (1961, July 23). Night in
look to all of us to be asked Virginia emergency nurses to share emergency rooms: Hospital nerve centers
able to change the their stories as to why they did not press stay alert. Richmond Times Dispatch.
world.’’

18 March 2013
Establish Yourself as a Leader
Join the faculty for ENA Leadership Conference 2014, Phoenix, March 5-9

Grow your career when you


become part of ENA Leadership
Conference Faculty. Share your
leadership knowledge, experience
and skills to help grow the
profession of emergency nursing.

Do you have specific knowledge


in a particular area of emergency
nursing, management or policy?

CALL FOR FACULTY


Has a particular experience given
you new insights into a current

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issue or trend and led to new best practices?

Do you have experience dealing with leadership challenges and issues?

Share your insights related to current


issues, trends, and best practices as a faculty
Submission
member at ENA Leadership Conference Deadline is
2014, March 5-9 in Phoenix, Arizona March 25, 2013
Topic areas:
• Management • Research • Community relationship building
• Operations • Education • Customer satisfaction
• Government affairs • Advance practice • Personal and professional development
• Technology • Orientation
• Team building • Retention

Find full information and course proposal guidelines


at www.ena.org and click on Leadership Conference
2014 Call for Course Proposals in the Calls and
Opportunities Section. We look forward to hearing
your cutting-edge course ideas.
ADVOCACY

ENA Shaping New Advocacy Department


By Kendra Y. Mims, ENA Connection
ENA is shaping its new advocacy
department with the hiring of its first
chief government relations officer.
Richard Mereu, JD, MBA, who
began his new position with ENA on
Dec. 24, has worked in Washington,
D.C, for more than 20 years and brings
an extensive legislative background
and congressional experience to ENA.
Susan Hohenhaus, LPD, RN, CEN,
FAEN, ENA’s executive director,
describes the new position as
instrumental in overseeing federal and
state advocacy efforts and government
relations related to emergency nursing.
‘‘This is the perfect time for ENA to
make advocacy for the profession of Richard Mereu, JD, MBA, the new ENA chief government relations officer, uses Skype
emergency nursing a priority,’’ to confer with staff at ENA headquarters from his office in Washington, D.C.
Hohenhaus said, ‘‘and Mr. Mereu is the
perfect professional to begin this of trying to get the initiatives that ENA developing an authoritative voice on
journey with us.’’ cares about passed through Congress.’’ Capitol Hill to meet the needs of
Mereu has a JD from Albany Law ENA’s mission to advocate for patients and emergency nurses.
School and an MBA from The Wharton patient safety and excellence in JoAnn Lazarus, MSN, RN, CEN, the
School. He has worked on a variety of emergency nursing practice is one of 2013 ENA president, said, ‘‘I look
health care issues as chief of staff to the factors that attracted Mereu to the forward to working with and learning
Rep. Elton Gallegly (R-Calif.) and staff position. Based in ENA’s Washington, more from Mr. Mereu about legislative
director for two subcommittees of the D.C. office, he looks forward to and regulatory issues and expanding
House Foreign Affairs Committee, as working on ENA’s top priorities, ENA’s influence.’’
well as serving as a professional staff including workplace violence in the Mereu said his position will allow
member on the House Judiciary emergency care setting, which he him to delve much deeper into health
Committee. He believes his vast describes as one of the most ‘‘important care issues.
background is essential to helping ENA issues affecting the functioning of ‘‘I’m extremely excited, especially
shape the new Advocacy Department. emergency departments.’’ now that health care reform is passed
‘‘Throughout my career I’ve had a lot ‘‘The primary goal is to establish a and it was upheld by the Supreme
of roles and worked on many issues, very visible presence for ENA on Court last year,’’ he said. ‘‘That will
everything from health care and budget Capitol Hill, to advocate for our create opportunities for ENA. Also,
issues to criminal law matters and priorities in Congress and in front of everybody recognizes that the role of
immigration,’’ he said. ‘‘We were able to the whole federal government and to emergency nurses is so important to
pass several bills that dealt with those move forward on legislation to the our overall health care system, so I’m
issues and fund programs in those areas. benefit of our members,’’ he said. starting at a very good time in terms of
‘‘I think my background is Mereu had the opportunity to being able to get in at the ground floor
important because the issues that ENA connect with members at ENA’s as these changes are being implemented
is facing now are so diverse. I know Emergency Nursing Advocacy at the federal level. I can really
the legislative process very well from Intensive in January when he influence some of the direction that our
having worked in Congress for all of presented a session on building health care system is going to go in on
those years. That’s important in terms relationships with legislators and behalf of ENA.’’

20 March 2013
READY OR NOT? | Knox Andress, BA, RN, AD, FAEN

Hang Together or Separately


In an act of defiance and revolution, conference was held Nov. 26-27, 2012, in Arlington, Va., with
representatives of the 13 American a mission of providing coalition-building strategies and best
colonies broke from the British practices. Organized and hosted by the Northern Virginia
Empire, signing the Declaration of Hospital Alliance, Seattle King County Healthcare Coalition,
Independence on July 4, 1776. and MESH, Inc. of Indianapolis, the conference was an
Benjamin Franklin’s warning to his colleagues at that signing, opportunity for stakeholders from around the country to
“We must hang together, gentlemen ... else, we shall most share best practices and lessons learned from building and
assuredly hang separately,” highlighted the importance of sustaining health care coalitions focused on health care
unity and coalition in the face of overwhelming odds. preparedness. Attendees came from Guam and most U.S.
Coalitions were crucial for nation-building then and to health states and included hospital emergency preparedness and
care emergency preparedness today. Hospital Preparedness Program grant leadership from local,
state and federal levels.
Future Needs
Joint Commission emergency management standards and the
lessons of Hurricanes Katrina and Sandy and the Joplin, Mo.
tornado remind us that hospitals and their emergency
departments must ultimately plan for overwhelming threat
scenarios requiring them to stand alone or evacuate. The
recent threat of a highly infectious H5N1 pandemic, with its
projected 50 percent mortality rate, would overwhelm most
U.S. hospital intensive care units.
Pandemics have occurred four times during the last 100 Attendees included the following ENA members: Elisabeth
years. Concerns for certain and future natural, technological Weber, MA, RN, CEN, of Chicago; Doris Neumeyer, BSN, RN,
or terrorism catastrophes are ever present. Emergency of Washington, Mich.; Lori Upton, MS, BSN, RN, of Houston;
department and hospital capacity and capability must be and Knox Andress, BA, RN, AD, FAEN, of Shreveport, La.
maximized and coordinated with community health care
Upton presented “How Coalitions Can Support Recovery
resources.
Operations” while Andress shared “How Coalitions Can
Nationally, hospitals have been building their surge
Develop Evacuation Plans for Hospitals and Nursing Homes.”
capacity and capability by organizing and reaching out to
Dr. Nicole Lurie, assistant secretary for Preparedness and
community health care response partners, forming emergency
Response, U.S. Department of Health and Human Services,
response alliances, networks and coalitions. Since 2001,
welcomed attendees to a wide range of intriguing health care
emergency preparedness, surge capacity and resilience in
preparedness coalition-building topics and panel discussions,
U.S. hospitals and health care systems have been facilitated
including the following:
and supplemented by the mechanisms and associated
funding of the U.S. Department of Health and Human • Building and Sustaining Coalitions
Services, Office of the Assistant Secretary for Preparedness • Crisis Standards of Care
and Response Hospital Preparedness Program. • How Coalitions Support Response
How are health care preparedness coalitions organized,
• How Coalitions Can Develop Information Sharing Systems
funded and sustained over time? What benefits are there to
and Plans
being a member of a health care preparedness coalition?
What are best practice examples of existing coalitions? When • How Coalitions Can Develop Evacuation Plans for Hospitals
have health care preparedness coalitions lessened or and Nursing Homes
mitigated emergency department impacts during disasters? To • Engaging Coalition Partners and Participants
answer these questions, enter the 2012 National Healthcare • How Coalitions Can Develop Behavioral Health Operations
Preparedness Coalition conference. Plans/Triage

A Successful Conference • How Coalitions Can Support Recovery Operations


The inaugural National Healthcare Preparedness Coalition • ASPR Grant Metrics and Reporting Discussion

Official Magazine of the Emergency Nurses Association 21


M
other Nature’s gift to computers,’’ he says, ‘‘so you could still Marshall, a guy who could walk in and
Mobile, Ala., on go next door and get a job and they right away be pegged for bigger things
Christmas Day was a didn’t know that you were in trouble in nursing, had become a surprise
large EF2 tornado other places.’’ tornado under their noses.
dropping in on the He’d lost a job in an emergency ‘‘It was a nasty, nasty scene,’’ he
downtown. The Mobile Infirmary department the previous year and spent says. ‘‘That’s when I hit my bottom and
Medical Center took a hit: some broken six weeks in rehab after introducing I realized, ‘You’re gonna die if you
windows, uprooted trees and methamphetamines into a buffet of don’t stop.’ ”
overturned cars. Next door at the drugs that already included marijuana,
♦ ♦ ♦ ♦ ♦
University of South Alabama Children’s booze and pills. Now he was working
and Women’s Hospital, where ENA in a different hospital’s intensive care Feb. 25, 2012, New Orleans. It wasn’t
member John Marshall, BSN, RN, is the unit, training to become a supervisor, the first time Marshall had heard Allison
3-to-11 supervisor, the tornado did which meant he’d been given a key to Bolin dig into this topic. Here at ENA’s
minimal damage as it rolled past. the pharmacy — and its narcotics. To Leadership Conference, he sat in again
No serious injuries were reported in beat the regular drug screens, he knew as Bolin, BSN, RN, CEN, CPEN, laid out
the community. the exact day each month that he the warning signs of employee
‘‘That’s the first time I ever met a needed to stop shooting dope, stop substance abuse and drug diversion in
tornado face-to-face,’’ Marshall says in smoking pot, stop popping pills. But his hospitals. Emergency nurses can be
his easy drawl. ‘‘It had my attention.’’ fix still had to come from somewhere. particularly susceptible, Bolin cautioned,
But as storms go for Marshall, this So he found himself breaking into the because of their special risk factors: high
was nothing. The biggest and scariest operating room. job stress, access to medications, a
he’d faced came more than a generation Nitrous oxide. It wouldn’t show up tendency to feel invulnerable.
earlier, some 350 miles away in his on the screens. He took care to mix in At the end of her presentation, Bolin
hometown of Macon, Ga. enough oxygen. invited questions at an open
In April 1985, Marshall, then 34 and ‘‘Eventually,’’ he says, ‘‘they found me microphone. Marshall stood. He had not
married with a young son, already had unconscious in the operating room and I a question but a story — his. He’d been
been fired from three area hospitals as couldn’t let go of the hose. And that’s there. He’d been the nurse Bolin was
rampant substance abuse ripped a hole the night I got in trouble that last time. urging others to identify, to report, to
in his life and nursing career. I’d been on the nitrous about six hours.’’ help, to save. He’d become a new breed
‘‘This was before the days of Colleagues were in disbelief. John of nurse: one who’d widened his scope

22 March 2013
from helping patients to also helping
other health care workers escape the
nightmare he’d known first-hand.
The room applauded.
John Marshall hasn’t had a fix in 27
years, but he’s made a life of fixing. As
facilitator of the Mobile Professional
Group, with which he’s been involved
since 1987, he sits in every other week
with anywhere from six to 26 health
care professionals whose encounters
with drugs and alcohol have led them
into his circle. The group is run like a
12-step program, the same way Marshall
got clean. Meeting topics rotate. New
members are worked in as they come.
It’s a casual, safe, free place where
people who handle narcotics as part of
John Marshall in 1974 at the start of a career that fell into chaos a decade later.
their jobs can find the peer support to
keep themselves straight. referred to him by the Alabama board. too smart, that I should be well by
It’s also non-punitive — a way for Others were invited by active members now,’’ Marshall says. ‘‘And that’s just the
nurses to manage their recoveries or pointed there by treatment centers. nature of the disease of addiction — it’s
without being put on probation by the Most who attend are nurses; he a liar. It’ll lie to you. So after you’re not
Alabama Board of Nursing. currently has two from EDs. Doctors being monitored and you don’t have to
‘‘Most states have some kind of have their own group for recovery — go after a while, if you happen to be
nondisciplinary program now,” says the International Doctors of Alcoholics one of those people that hadn’t crossed
Marshall, who didn’t have that option in Anonymous — but two or three docs the wall, you kind of phase out.’’
1985 and spent the next several years His mission is to see that as many as
still come to Marshall’s meetings. He
on probation in Georgia and Alabama.
has nurse anesthetists, a pharmacist. possible don’t. He stresses a spiritual
‘‘Usually it’s required that the person
He’s had surgeons, even veterinarians. philosophy of finding a ‘‘higher power’’
call [the board] and report themselves:
Some are there to satisfy the — a touchstone bigger than the drugs or
‘I’ve got a problem, I need some help.’
nondisciplinary requirement after one alcohol. For some, that’s religion. For
If people wait until an employer calls
failed drug screening. Their problem is some, it’s a symbol — a tree, for
and says, ‘We’ve got somebody with a
that they used casually, not abusively, instance, or perhaps the group itself. A
problem,’ a lot of times they end up on
and got caught. Some, like Marshall, are few in the group, long after rescuing
probation.’’
there because they became true their careers in health care, continue to
No one wants that. Probation opens
chemical addicts, no longer wanting the attend meetings 10 or 15 years later.
the door to legal consequences for
diversion or writing self-prescriptions. It fix but physically needing it; they Some have lived out their natural lives
offers no anonymity. In Alabama, ‘‘crossed the wall,’’ as he puts it. That’s as members.
Marshall says, it means ‘‘their license is the other end of the spectrum. ‘‘With addiction,’’ Marshall says,
stamped with ‘probation.’ It goes out in There’s a large middle area — nurses ‘‘they say once a cucumber’s a pickle,
the state newsletter who’s in trouble who aren’t chemically dependent but it’s always a pickle — it’s never a
with drugs, where in the nondisciplinary who face the grim risks of denial, relapse cucumber again.’’
program, none of that’s done.’’ and career derailment.
♦ ♦ ♦ ♦ ♦
Some in Marshall’s group, after ‘‘We have a disease that tells us we
reaching their crisis points, were don’t have it, that we’re OK, that we’re By early 1985, John Marshall knew he
was a pickle, or what he’d later call
“I got to a point where it didn’t work anymore. one. More aptly, he says, he was ‘‘a
nurse manager’s nightmare.’’ Three
I couldn’t do enough dope to feel good. I could do enough years earlier, his first shot of Demerol
to pass out and get sick, but I couldn’t stop.” Continued on next page

Official Magazine of the Emergency Nurses Association 23


had been 50 mg. Now 50 mg wouldn’t
touch him.
‘‘I got to a point where it didn’t work
anymore,’’ he said. ‘‘I couldn’t do
enough dope to feel good. I could do
enough to pass out and get sick, but I
couldn’t stop. I tried everything I could
do to stop, and I couldn’t stop.
‘‘The manager that fired me in the
ED [in 1984] told me, ‘You are not the
same person I hired.’ And I wasn’t. You
know, the meth made me crazy. So then
I thought it was just the meth — ‘It’s the
meth that’s doing it. As long as I just
drink beer and smoke pot, I’ll be OK.’ ’’
By February, less than six months
after his dismissal from that ED and his
short rehab stint, he had relapsed, Marshall stands before the room to discuss his recovery and his work with the Mobile
driven into a frightening tailspin by the Professional Group after a presentation by Allison Bolin, BSN, RN, CEN, CPEN
(right), during last year’s Leadership Conference in New Orleans.
access to narcotics at his new hospital,
where he’d been hired as a relief
So that’s where his recovery began. proved tough.
supervisor. He diverted more and more,
He checked into a three-month ‘‘They would look at my résumé and
never denying patients their medications
program at Ridgeview. go, ‘Oh, you were critical care — this is
but instead measuring out more so that
He stayed for six. good. Oh, you were a paramedic — this
he could ‘‘save scraps.’’
is good. Oh, you’ve got emergency
‘‘Eventually I knew I was gonna get ♦ ♦ ♦ ♦ ♦
— this is good,’ ’’ he says. ‘‘But then
caught,’’ he says. ‘‘I knew that. It wasn’t
The first year after rehab was the they’d hit that last page about the drug
a surprise.’’
The surprise, he says, came after his hardest. Probation meant hospitals in treatment, and it was like the paper
final nosedive with the nitrous oxide, Atlanta didn’t want to talk to him. A caught fire in their hands or something.’’
when he returned to the treatment center doctor he’d worked with during his Committed to his recovery, Marshall
where he’d completed his first rehab. treatment offered him a job at a halfway fell in with the Mobile Professional
‘‘Get out,’’ the addictionologist told house for head-injury patients. That Group. He remarried.
him. ‘‘I can’t help you.’’ gave him a foot back in the door as a One hospital, Knollwood Park in
Marshall, he said, had conned his nurse, though ‘‘the only nursing thing I Mobile, snapped the pattern of rejection
way through the program once already. really did was give Dilantin for the and decided to take a chance on him.
It got worse. The Georgia Board of seizures,’’ he says. ‘‘The rest of it was He was hired to work in the head-injury
Nursing had been notified. The Drug trying to manage a community of unit. He was still there in 1991 when
Enforcement Administration had been head-injury patients, which is a different his probation was lifted and he again
notified. Marshall was looking at a world all in itself.’’ was licensed to handle narcotics.
possible six to 10 years in jail. Still, a chance was a chance. And
‘‘And if you’re here when I get out others would follow. ♦ ♦ ♦ ♦ ♦
of group,’’ the addictionologist told him, Another of Marshall’s former
‘‘I’m going to have you arrested for counselors needed a nurse in recovery Marshall’s job history since the late
trespassing.’’ to work in an alcohol-dependency 1980s is the sort of career climb others
Marshall slumped in a chair, stunned. program at a Mobile hospital. That job expected for him before his collapse.
Bottom was even lower than he thought. took him to Alabama — resetting his His employment at Knollwood Park
The only morsel he was offered was five-year probation — in 1986. When evolved from a happy break to a
a phone number for a treatment center the hospital folded after a few months, 17-year stay until the hospital was sold.
in Atlanta, the Ridgeview Institute, he decided to stay near the Gulf rather From the head-injury division, he moved
which specialized in recovery for health than transfer north to Birmingham. But to the emergency department, where he
care professionals. finding work at another local hospital eventually rose to ED nurse manager in

24 March 2013
2000. He became house supervisor in
2003, then started with the Children’s
and Women’s Hospital in 2007. Is Your Co-Worker in Trouble?
Never far away was the group.
ENA conference faculty presenter Difficult life problems: Has
Marshall had made contacts in his
Allison Bolin, BSN, RN, CEN, CPEN, your co-worker had a recent back
treatment that afforded him clean slates.
a rapid-response nurse at Dominican injury? Is he or she going through a
His end of the bargain, he realized, was
Hospital in Santa Cruz, Calif., offers divorce? These kinds of situations, in
to advocate for others in turn. A nurse
these red flags for substance abuse combination with some of the signs
in recovery whose license has been
or drug diversion in the ED: above, can point to a larger problem.
revoked might list him as a reference on
a job application. He has been to court Behavioral extremes: Some If you’re worried that a colleague
on another nurse’s behalf in a child- with substance-abuse issues become is battling substance abuse, report
custody case. sloppy and don’t seem to care about your suspicions to your supervisor (it
‘‘The group helps me do that,’’ he their work. Others, particularly those could save a life, Bolin stressed) and
says. ‘‘We do things to help our diverting drugs, become hypervigilant, let the department proceed according
members get back on track in several paying extra attention to who is to policy. If you’re a supervisor, she
aspects of their life, not just in receiving medications, offering to said, make sure you have the
employment. Somebody was there for medicate other nurses’ patients and documentation to support a
me when I was in trouble and needed spending more time than normal in reasonable suspicion and involve the
help, so now my job is when somebody the dispensing areas. human resources department before
needs help, I’m there for them. Personality changes: Substance confronting the employee.
‘‘In my groups and meetings that I abusers tend to withdraw socially Often the most respected nurses
go to with 12-step, when somebody and show increased irritability. are the ones most in trouble, Bolin
asks you to do something, you say yes. said. She herself has been in recovery
Absenteeism: Often seen in
These people call me 24/7.’’ since 1990 and runs a support group
employees with alcohol problems.
Sometimes he has dreams that he’s for nurses in two counties.
still using — the ol’ ‘‘drinkin’ and Coming in on days off or ‘‘So many nurses don’t even
druggin’ dreams,’’ he calls them. Though frequently volunteering for extra recognize it could be a problem,’’
he’s not in an emergency department shifts: Often seen in drug diversion. she said. ‘‘We’re not any less
officially, he sees trauma. He sees Fishy reports: Most hospitals immune because of our education.
children going through chemotherapy. have anomalous usage reports that In fact, we’re probably at greater
Sometimes elements in his life don’t feel identify who’s dispensing which risk, especially in the emergency
balanced. Steps feel out of sync. That’s drugs the most. Abnormally high department.’’
when he makes a few calls, too. numbers can indicate diversion. Josh Gaby
Recovering and fixing go both ways.
‘‘I’m in recovery, but my disease is in
living life on life’s terms.’’
the parking lot doing pushups,’’
Marshall says. ‘‘I still do those things His grown son from his first
Workplace Violence
because if I don’t do those things, I’m marriage has seen his perseverance, Prevention Online Courses
going to be acting like a pickle again, has seen him guiding others through. FREE Now available free to ENA members are
for ENA three webinars that discuss violence in the
and I don’t know if I could live through He has a daughter, 23, who grew up Members workplace and mitigation strategies.
that. Twenty-eight years ago, I’d have a witness to his recovery.
just taken something to change the way Life is good. His mornings are
Visit www.ena.org and sign up today.
I feel and keep on going. And I don’t only about one vice now — coffee.
Non-members can purchase these continuing
do that now. He asked a counselor about that education courses by visiting ENA’s LMS
‘‘And my life is so much better now, once. Was it a problem? Not a member? Join ENA today!
truly a miracle. Staying high all the time ‘‘As long as you’re not shootin’ up
These webinars are brought to you by

is a full-time job. When you wake up in freeze-dried Folgers,’’ he was told, In collaboration with Thank you to our sponsor

the morning and say, ‘Oh, my God, ‘‘you’ll be fine.’’


what have I got? Have I got enough?
Where am I getting more?’, that’s a Readers can contact John
full-time job. It’s so much easier now Marshall at jtaddictions@aol.com. Stay tuned for upcoming workplace violence educational opportunities.

Official Magazine of the Emergency Nurses Association 25


COURSE BYTES

Updated Administrative Procedures ENPC 4th Edition Information


The Administrative Procedures have ENPC course directors received an
been updated with two items, effective e-mail in November 2012, providing
immediately: information regarding corrections
1. TNCC Reverification courses can being made to the ENPC 4th Edition
continue to be held; however no Instructor Supplement and the course
contact hours can be awarded for slides. Corrected copies of the
attending the course. instructor supplement will be provided
2. Non-RN health care providers to all instructors who had previously
who work in an emergency setting can purchased it at no additional charge.
participate in the written and skill Shipments started in January. Those
station testing of both the ENPC and instructors who had previously
purchased a downloadable instructor
TNCC Provider courses. The non-RN
supplement are being contacted to
health care worker who attends a
advise them that they can now
Provider course will receive a
certificate of attendance with the
download a corrected copy. First Anniversary
All course directors who had ECourseOps is celebrating its one-year
appropriate number of contact hours,
previously requested and received the anniversary as course directors
but will not receive a verification card
4th edition CD-ROM will be increasingly take advantage of its
or verification status.
automatically sent a new copy as well. capabilities. About 65 percent of the
Please refer to the Administrative
The Course Directors Only section of course applications submitted to ENA
Procedures posted on the TNCC and
www.ena.org reflects the updated, come through eCourseOps. We have
ENPC pages of www.ena.org for corrected information. received a lot of very positive
further details. The new CD-ROM and Course feedback indicating that eCourseOps is
Directors Only web page will include
ENPC Provider Manual Errata a practice test and answer key. This
easy to use for adding a course,
ordering books and paying invoices. A
All ENPC 4th Edition Provider will help the students prepare for the very popular feature is the “copy”
manuals that are shipped will have an provider course. Also included in the course icon that allows instructors to
errata document included, until the instructor course folder are the scored create a new course by copying an
next reprint is needed. This errata teaching scenarios related to the existing course while making
document can also be found at: examples played during the instructor
necessary small changes, such as new
www.ena.org/coursesandeducation/ course from the course DVD.
course dates.
ENPC-TNCC/enpc Log in to www.ena.org to access
We anticipate reprinting the ENPC TNCC Reverification Courses
eCourseOps via the Courses &
TNCC course directors were notified via
4th Edition Provider manuals in the Education tab’s dropdown menu.
e-mail in November 2012 that the ENA
spring. We appreciate everyone’s There are frequently asked questions
Board of Directors met on Oct. 24,
assistance in identifying these changes. and help documents on the landing
2012, and decided that the 6th edition
page. Course Operations is available
ENPC 4th Edition Instructor Update TNCC Reverification courses can
for assistance at 800-942-0011 or
continue to be held after Dec. 31, 2012.
The deadline for completing the As of Jan. 1, however, no contact hours courseops@ena.org. If you haven’t
ENPC 4th Edition Instructor Update is can be awarded for attending a TNCC yet used eCourseOps, give it a try. We
Feb. 28. The update can be found on Reverification course. This decision was think you’ll like it.
your Personal Learning Page under the made after receiving quite a bit of
Courses and Education tab at www. feedback from course directors Your Input is Welcome
ena.org. It is necessary to indicate that indicating that the availability of the CourseBytes is the official
you reviewed the video/modules one-day reverification course option, communication to all TNCC and ENPC
before you can access the 50-question even without the ability to award directors and instructors. Topic ideas for
exam. This can be found under the contact hours, would provide a much future issues and feedback are welcome
Assessment tab within each module. needed option for many institutions. at CourseBytes@ena.org.

26 March 2013
Letter From the President Continued from page 3

school to obtain my master’s degree ‘‘Mentoring is a brain opportunity to share knowledge and
and then encouraged me to apply for experience with the next generation of
her position when she left. But more
to pick, an ear to listen emergency nurse leaders.
important than her words were her and a push in the The ENA Board of Directors has
actions. I witnessed her every day implemented a new program to pair
right direction.”
modeling the behaviors of someone I an emerging leader with a board
wanted to become: She was graceful John Crosby mentor. The mentors will spend the
under pressure, politically savvy and year helping their mentee develop
had the respect of the emergency mentoring relationship and don’t forget their leadership goals and determine
department staff. I am just sorry to acknowledge your mentor. an action plan for national ENA
that I never had the opportunity to One of my goals as ENA president contributions.
thank her. is to provide more opportunities for I encourage all of you to
mentoring within our organization. We acknowledge your mentors, find a
Two-Way Street already have one great mentoring mentor or become a mentor.
What does it take to be a good program in EMINENCE. The
Resources
mentee? The mentee should drive the EMINENCE program is designed to
Loretto, P. (n.d.). Top 10 Qualities of a
relationship. As the mentee, you must pair ENA members with experienced
Good Mentor. Retrieved from www.
be comfortable in communicating Academy of Emergency Nursing
interships.about.com
openly with your mentor. You must be fellows. AEN fellow mentors volunteer
clear about what you expect to their time and talents to work with Roberts, A. (1999). Homer’s mentor:
accomplish by partnering with this up-and-coming ENA members. Duties fulfilled or misconstrued.
person. Be committed to the This provides a wonderful Retrieved from www.peermentor.net.

ENA STATE CONNECTION


New Jersey ENA State Council • Innovated projects, ideas or best
New Jersey ENA will hold the 35th practices
Annual Emergency Care Conference, Articles should be under 400
March 13 – 15. This is the third words and will be edited for length
largest emergency care conference and clarity. High-resolution digital
in the nation. For more information, photos or images that can be scanned
contact Cheryl Newmark, RN, NJ are welcome with your submission.
ENA media relations, at cgnrn75@yahoo.com. State Connection also offers an opportunity to announce
upcoming educational programs, state council or chapter
Share your state council and chapter news with emergency meetings or special events in the “Meetings and Events”
nursing colleagues from around the world in State section. Include the following information with your
Connection. Highlight council and chapter activities, submission:
announcements and other initiatives by submitting a short • State/Chapter name
article to ENA Connection. • Event/Conference name
Suggested topics include: • Date of the event
• Volunteer opportunities to solicit, encourage and welcome • Time
members to get involved in your state or chapter • Location
• State council or chapter successes, achievements • Presenter(s)
or accomplishments • Website or contact information
• Membership drive campaigns and updates To submit an article or event or for more information,
• Award announcements or call for awards contact us at connection@ena.org.

28 March 2013
New ENA monthly offering for
FREE Continuing Education with
contact hours for our members.
• Available March 1
GU: It’s More Than Just P, 1.0 contact hour
Michael D. Gooch, MSN, RN, CEN, CFRN, ACNP-BC, FNP-BC, EMT-P

Don’t miss out on enhancing your education by


registering and completing the offering.
Go to www.ena.org/FreeCE for additional free
continuing education opportunities.

The Emergency Nurses Association is accredited as a provider of continuing nursing education by the American
Nurses Credentialing Center’s Commission on Accreditation.
The AEN EMINENCE Program
The Academy of Emergency Nursing is proud to report its fifth group of mentors
and mentees are currently working on projects for the 2012-2013 program. The
EMINENCE program is designed to pair ENA members with experienced Academy
fellows. AEN fellow mentors volunteer their time and talents to work with
up-and-coming ENA members. This provides a wonderful opportunity to share
knowledge and experience with the next generation of emergency nurse leaders.
Applicants submit project descriptions and are matched with fellows who have
expertise in the subject matter. Project topics include professional presentation,
writing for publication, research, educational conference planning and program
development. Upon acceptance into the program, mentees pay a $100
administrative fee.
The following mentee/mentor pairs are participating in the 2012-2013 program:

Mentee Mentor Area of Interest


Meredith Addison, MSN, RN, CEN Thelma Kuska, BSN, RN, CEN, FAEN Trauma Systems

Kiefah Awadallah, MSN, BS, RN Rebecca Steinmann, MS, RN, APN, Program Development
CEN, CPEN, FAEN

Kimberly Brandenburg, BSN, RN, CEN Patricia Kunz Howard, PhD, RN, CEN, Injury Prevention (SBIRT)
CPEN, NE-BC, FAEN

Colleen Connors, MSN, RN, CEN Anne Manton, PhD, APRN, FAEN, Program Development
FAAN

Hershaw Davis Jr., BSN, RN Susan Hohenhaus, LPD, RN, CEN, Professional Presentations
FAEN

Siegfried Emme, MSN, RN, NP-C, CEN, Jean Proehl, MN, RN, CEN, CPEN, Program Development
CCRN FAEN

Michael Franks, BSN, RN, CEN  ordon Gillespie, PhD, RN,


G Writing for Publication
PHCNS-BC, CEN, CPEN, FAEN

Marites Gonzaga-Reardon, MSN, RN, Gail Lenehan, EdD, MSN, RN, FAEN, Writing for Publication
APN, CEN, CCNS FAAN

Jerry Jones, MBA, BSN, RN Andrea Novak, PhD, RN-BC, FAEN Educational Conference Planning

Jennifer Morris, RN, CPEN, CPN Jeff Solheim, MSN, RN-BC, CEN, Professional Presentations
CFRN, FAEN

Curtis Olson, BSN, BA, RN, EMT-P, Laura Criddle, PhD, RN, CEN, CPEN, Writing for Publication
CEN FAEN

 harlann Staab, MSN, RN, CFRN,


C Carole Rush, MEd, BSN, RN, CEN, Writing for Publication
CHC-C FAEN

Kathy Van Dusen, BSN, RN, CEN Diana Meyer, DNP, MSN, RN, CEN, Advanced Practice Role Development
CCRN, FAEN

Belinda Watkins, BSN, RN, CPEN Harriet Hawkins, RN, CPEN, CCRN, Program Development
FAEN

If you would like to participate in the 2014-2015 EMINENCE program, watch for application information posted at
www.ena.org/about/academy/EMINENCE in mid-March 2013. Applications are due April 30.

30 March 2013
nual
ion
ual
Provid
er Man
Ed it io n The Emergency Nurses Association is proud
Fourth
to present the release of the 4th edition of
mergenc

the Emergency Nursing Pediatric Course.


It has been revised and updated, evidence-
based, and continues to incorporate various
y Nursin

teaching and learning styles.


• A portion of the course will be presented in
e
g

an online format through ENA’s Center for


e-Learning.
• Pediatric Clinical Considerations is now
case-based using group discussion.
• The adolescent patient is addressed with
a separate chapter and lecture.
• Triage is now Prioritization with a focus on the
process, rather than the place.

Upon successful completion of ENPC, RN participants are


verified for four years, receive a verification card and earn
up to 16 contact hours.

This course brings the emergency nurse a resource for


treating the pediatric patients arriving to emergency
departments every day.

To verify why ENPC is right for you and to


The Emergency
view course schedules, please visit
Nurses Association is
www.ena.org/coursesandeducation
accredited as a provider
of continuing nursing
education by the American
Nurses Credentialing
Center’s Commission on
Accreditation.
Vocation in Her Vacation

ENA Member Finds Paradise Needs Good Teachers


By Amy Carpenter Aquino, ENA Connection County Hospital in Wakefield, R.I.
Six months later, Singer returned to St. John for a week to
Lee Singer, RN, CEN, is a woman of many talents. An train rescue workers, including EMTs from the island and
emergency nurse since 1987 and an EMT since 1978, she is a from St. Thomas, as well as members of the National Parks
member of her local disaster medical assistance team, an avid Department. Two-thirds of St. John is dedicated park space.
surfer and a concert flutist. She is a provider for the Trauma The rescue workers’ usual training consisted of videos from
Nursing Core Course and an instructor for the Emergency their training officer, some outdated lectures and occasional
Nursing Pediatric Course and for a Rhode Island emergency EMT training by instructors from the U.S.
medical services training program. She has saved lives on Singer incorporated TNCC and ENPC information into her
both coasts, from conducting air evacuations in California to training lectures, as well as an extensive review of anatomy
assisting an urban search and rescue team in Rhode Island, and physiology.
performing assessments on people stranded in their homes ‘‘I’m a firm believer that if you know what you’re looking
after Hurricane Sandy devastated Misquamicut last October. at and what parts you’re looking at, you can understand
In 2012, Singer extended her emergency care and training what’s going on in a trauma situation or a burn situation,’’
reach to St. John in the U.S. Virgin Islands. During a Singer said. ‘‘We did a lot of the basic scene material. I used
vacation, Singer and her boyfriend, who is also an EMT, the TNCC method for airway, breathing and circulation, and
were on a St.  John beach when they met a member of the I taught them the CIAMPEDS mnemonic we use in ENPC for
local rescue squad. complaint, immunization and allergies, which they loved.’’
‘‘I asked her what kind of training she had, and she said As a beach vacation destination, St. John sees its share of
they were always looking for people to do training,’’ said drunk-driving traumas, water injuries and coral cuts, while
Singer, an emergency department charge nurse at South other islands also see surfing injuries. The local population

AC13

Offering educational and


networking opportunities
for professionals caring
for emergency patients.

For more information, visit


www.ena.org.
32 March 2013
you see a bruise on this side. What do you suspect? What do
you think is under there?’ And they start more critical
thinking, and when they really caught on it was wonderful.’’
Singer’s students benefitted so much that the training
officer asked her to return this April. Singer plans to bring
‘‘tons of new information that is going to blow their minds,’’
including pediatric standards and a toxicology lecture on
bath salts and some of the poisonous plants used by locals
in folk medicine treatments.
A ‘‘win-win’’ exchange is how Singer described her
Caribbean teaching experience. While her students gained
new knowledge and skills, Singer said she returned with
ENA member Lee Singer, RN, CEN, with Bob Malacarne,
renewed energy to pursue her own education and
training officer for the St. John rescue corps, in St. John.
certifications.
suffers from a very high incidence of asthma, as well as some ‘‘I’ve gotten better in my practice as a nurse also,’’ she
obesity and those comorbidities, such as diabetes and high said, ‘‘by doing some of the research and putting it into
blood pressure, in addition to some alcoholism, Singer said. practice. I’ve learned a lot of tricks of trade from the rescue
In addition to addressing those emergencies, Singer said down there. For instance, they do what they call high-angle
she incorporated training with familiar prehospital elements, rescues, because it’s all pretty mountainous, so I can take
such as the MIVT report (mechanism of injury, vital signs some of that back for our EMTs.’’
and treatment) and the PQRST (provokes, quality, radiates, Singer encouraged other ENA members to remain open to
severity and time) pain pathway assessment. new prospects, wherever they are.
‘‘You need to dig below the surface,’’ she said. ‘‘This ‘‘If you have an opportunity, you’d better take that
person had a broken bone, but you need to dig underneath opportunity and do the best that you can with it,’’ she said.
this, so I would go into the structures and say, ‘OK, this is ‘‘I would offer that not just to nurses but to anybody. ‘Oh,
what happened, this person fell over the handlebars, and the places you’ll go,’ as Dr. Seuss wrote.’’

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Official Magazine of the Emergency Nurses Association 33


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