2017 General Assembly Handbook

Transcription

1 Page General Assembly Handbook Table of Contents General Assembly Schedule... 2 General Assembly Business Agenda... 3 General Assembly Officials... 4 Proposed General Assembly Standing Rules of Procedure... 5 Bylaws and Resolution Proposals Proposed Bylaws Amendment Proposal GA17 01: Proposed Amended and Restated Bylaws... 9 Proposed Resolutions GA17 02: A National Standard for Child Passenger Restraint GA17 03: Public Access to Bleeding Control Kits GA17 04: Against Human Trafficking GA17 05: Establishing a Standard for Emergency Department Preparedness to Care for Children GA17 06: Develop an Emergency Department Geriatric Readiness Survey and Toolkit GA17 07: Freestanding Emergency Centers GA17 08: ENA s Position on Firearm Safety and Legislation GA17 09: Safety When Removing Patients from Private Vehicles Parliamentary Motions Guide Appendices Appendix A ENA Bylaws Appendix B ENA General Assembly Reference Guide Appendix C ENA Strategic Plan Appendix D ENA and Affiliate Audited Consolidated Financial Statements Appendix E 2017 ENA Committee Roster Appendix F Onsite Registration and Keypad Instructions Appendix G Delegate s Resource Appendix H Glossary of Terms NOTE: Additional delegate materials (e.g., late resolution submission, etc.) are available via the General Assembly Delegate area of the ENA website 2017 ENA General Assembly Marriott St. Louis Grand Majestic Ballroom A D 8/29/17

2 Page General Assembly Schedule TUESDAY, SEPTEMBER 12 6:45 7:30 am... General Assembly Delegates Continental Breakfast 6:45 7:30 am... Keypad Registration 7:45 8:15 am... General Assembly Open Ceremonies Call to Order and Introductions Credentials Report Adoption of General Assembly Standing Rules of Procedure Adoption of Business Agenda 8:15 8:20 am... President Address 8:20 8:25 am... President elect Address 8:25 8:30 am... Treasurer Report 8:30 8:35 am... Executive Director Report 8:35 8:40 am... ENA Foundation Chairperson Report 8:40 9:25 am... Open Reference Hearings 9:25 9:45 am... BREAK 9:45 11:45 am... Open Reference Hearings 11:45 am... Adjournment Times scheduled with authors directly... Authors Sessions WEDNESDAY, SEPTEMBER 13 6:45 7:30 am... General Assembly Delegates Continental Breakfast 6:45 7:30 am... Keypad Registration 7:45 8:00 am... General Assembly Call to Order Credentials Report Adoption of Business and Consent Agendas 8:00 9:30 am... Consideration of Amended and Restated Bylaws and Resolutions (Debate and Vote) 9:30 10:00 am... BREAK 10:00 11:30 am... Consideration of Amended and Restated Bylaws and Resolutions (Debate and Vote) 11:30 am 1:30 pm... LUNCH BREAK (on own) 1:30 3:00 pm... Consideration of Amended and Restated Bylaws and Resolutions (Debate and Vote) 3:00 3:30 pm... BREAK 3:30 3:40 pm... Memorial Presentation 3:40 5:00 pm... Open discussion (time permitting) 5:00 pm... General Assembly Adjournment 2017 ENA General Assembly Marriott St. Louis Grand Majestic Ballroom A D Updated 8/29/17

3 Page General Assembly Business Agenda TUESDAY, SEPTEMBER 12, General Assembly a. Opening Ceremonies b. Call to Order / Credentials Report c. Adoption of General Assembly Standing Rules of Procedure d. Adoption of Business Agenda e. President Address f. President elect Address g. Treasurer Report h. Executive Director Report i. ENA Foundation Chairperson Report 2. Open Reference Hearings a. Proposed amended and restated ENA Bylaws b. Resolutions c. Late Resolution WEDNESDAY, SEPTEMBER 13, General Assembly a. Call to Order / Credentials Report 2. Adoption of Business and Consent Agendas 3. Consideration of Amended and Restated Bylaws and Resolutions (Debate and Vote) 4. Open Discussion (Time Permitting) 2017 ENA General Assembly Marriott St. Louis Grand Majestic Ballroom A D Updated 8/29/17

4 Page General Assembly Officials General Assembly Chair Karen K. Wiley, MSN, RN, CEN President Parliamentarian Jim Slaughter, JD, CPP T, PRP Credentials Chairperson Kathleen E. Carlson, MSN, RN, CEN, FAEN Immediate Past President ENA Board of Directors President Karen K. Wiley, MSN, RN, CEN Nebraska President elect Jeff Solheim, MSN, RN, CEN, TCRN, CFRN, FAEN Oregon Secretary/Treasurer Sally K. Snow, BSN, RN, CPEN, FAEN Texas Directors Maureen Curtis Cooper, BSN, RN, CEN, CPEN, FAEN Massachusetts Ellen Ellie H. Encapera, RN, CEN South Carolina Mike Hastings, MSN, RN, CEN Washington Ron Kraus, MSN, RN, CEN, ACNS BC Indiana Patricia Kunz Howard, PhD, RN, CEN, CPEN, TCRN, NE BC, FAEN, FAAN Kentucky Karla Nygren, BSN, RN, CEN, CFRN, CPEN, TCRN, CCRN, CPN South Dakota Jean A. Proehl, MN, RN, CEN, CPEN, TCRN, FAEN, FAAN New Hampshire Executive Director Nancy MacRae, MS Illinois 2017 ENA General Assembly Marriott St. Louis Grand Majestic Ballroom A D 7/13/17

5 Page 5 Standing Rules of Procedure of the 2017 ENA General Assembly Proposed July The General Assembly Standing Rules of Procedure may be suspended by a majority vote, or amended or rescinded by a two thirds vote. If notice of the proposed action was given in the call for the meeting, they may be amended or rescinded by a majority vote. 2. Delegates and alternate delegates shall wear name badges designating their delegate status. RESOLUTIONS 3. Resolutions may be submitted by any voting member. 4. Resolutions received after the published deadline may be considered, provided all criteria is met. Resolutions received after the published deadline shall require a non debatable two thirds vote to consider and a majority vote to adopt. a. Late Resolutions Resolutions that are submitted after the published deadline, but at least 30 days prior to the General Assembly meeting being called to order. Late resolution submissions must include written explanation. Late resolutions are issues that requires timeliness or has urgency to the matter. Notice of such resolutions shall be made available to all delegates. b. Emergency Resolutions Resolutions that are submitted after the published deadline, but less than 30 days prior to the General Assembly meeting, or after the meeting has been called to order. Emergency resolutions are actual emergent issues which were not previously known to the Assembly and which must be handled promptly. Notice of such resolutions shall be made available to all delegates. ENA General Assembly Standing Rules of Procedure Proposed_ Page 1 of 4

6 Page 6 COMPOSITION 5. State council delegates shall be apportioned based on the ratio of members in the state or territory to the total ENA membership as of May 15, in accordance with the ENA bylaws. International delegates shall be allocated in accordance with the ENA bylaws. ENA headquarters will send necessary information for designating delegates, alternate delegates and state captains to state councils. 6. Each state council must formally register delegates and alternate delegates in the state council s online management area with the ENA headquarters at least 75 days prior to the General Assembly. 7. The state captain shall be selected as soon as possible, but no later than 75 days prior to the General Assembly. 8. The ENA Immediate Past President presents the credentials report. 9. An electronic voting device(s) will be assigned to each delegate. Delegates are responsible for checking out their own device(s) and may not give their device(s) to another delegate to cast their vote. 10. A member registered as an alternate delegate may be transferred to delegate status, provided, that no state delegation exceeds the number of delegates registered. The state captain shall sign authorizations to change delegates status. A delegate who turns over his or her duties to an alternate delegate must report to the keypad desk with the alternate to exchange keypads. If the delegate wishes to resume his or her duties, the keypads must be exchanged in the same way. 11. Delegates, alternates and ENA past presidents attending General Assembly meetings must complete the post General Assembly evaluation, in order, to receive a certificate of service. REFERENCE HEARINGS (DAY 1) 12. Open reference hearing discussions will be held on all submitted bylaws amendment proposals and resolutions received in accordance to the Standing Rules of Procedure. ENA members will also be provided an opportunity to provide feedback during the open reference hearing discussions. ENA General Assembly Standing Rules of Procedure Proposed_ Page 2 of 4

7 Page The author or designee shall be given the right to speak first for up to two minutes; such time shall not be counted in the total time for discussion. 14. Within the time allocated per proposal, each individual may speak for up to one minute when recognized. 15. Following the open reference hearing discussions, the Resolutions Committee will deliberate on the dialogue held and determine proposals to be placed on a consent agenda. 16. Following the open reference hearing discussions, the Resolutions Committee will prepare recommendations to the General Assembly for each proposal to adopt, not adopt, or to offer an amendment to the proposal for consideration. 17. Amendments to bylaws amendment proposals or resolutions must be submitted in accordance with the deadline set by the chair of the General Assembly. Amendments not submitted by the deadline shall require a non debatable two thirds vote to consider and a two thirds vote to adopt. 18. The Resolutions Committee shall determine the order of consideration of action items (except subsidiary amendments) that have been submitted for the second day of General Assembly. Delegates may change this order by a two thirds vote. 19. Amendments to proposals shall be made available to the delegates as soon as possible after the Resolutions Committee has finalized proposal recommendations and potential amendments. DEBATE AND VOTE (DAY 2) 20. After being recognized, delegates and ENA past presidents shall give their name and affiliation before beginning to speak. 21. An individual without speaking rights shall not be granted the floor unless permission is given by a majority vote. 22. The author or designee shall be given the right to speak first for up to two minutes; such time shall not be counted in the total time for debate. 23. Within the allotted debate time, a delegate or ENA past president may speak for up to two minutes when recognized to speak on a main motion and up to one minute when recognized to speak on any other debatable motion. ENA General Assembly Standing Rules of Procedure Proposed_ Page 3 of 4

8 Page Debate will alternate pro and con, as much as possible, and each delegate shall be allowed only one turn to speak in each queue. If an amendment or other debatable motion is made that takes priority over the pending question, the existing queue will be saved and a new queue will be opened. Once that priority motion is completed, the previous queue will be re opened and debate will resume on the pending question. 25. The total debate time allotted for each bylaws amendment proposal and resolution shall be 10 minutes. If there are speakers in the queue when the debate time expires, the chair shall take a vote on whether to extend debate for an additional five minutes. ENA General Assembly Standing Rules of Procedure Proposed_ Page 4 of 4

9 Page 9 Proposal to Amend Bylaws Proposal Number: GA17 01 Title: Proposed Amended and Restated ENA Bylaws Article and Section: Full Bylaws Revision Current bylaws language: See attached current ENA Bylaws. Proposed changes: See attached proposed amended and restated ENA Bylaws. Bylaws language if adopted: N/A Rationale: A Task Force was appointed in 2016 to review the ENA Bylaws and identify potential revisions to ensure the bylaws are in compliance with the Illinois Not for Profit Act, and incorporate clarity of key governance principles. Key substantive revisions were made in the following areas: The General Assembly authority and responsibility was enhanced to provide clarity on what the principle body is responsible for, including communication of member needs and providing input to the ENA Board of Directors on issues relating to the practice of emergency nursing. Therefore, the General Assembly composition was also enhanced to clarify the Board s role that they may attend and speak at all meetings of the General Assembly, but may not vote. Term limits for the at large directors have been incorporated to enrich member involvement opportunities to serve in a leadership position, attain new innovative ideas and to allow members the opportunity to advance their own leadership skills. The voting member qualification for the Board officer, at large director and Nominations and Elections Committee was revised to a minimum of five consecutive years immediately preceding the submission of a candidate application. An additional Article was created to provide clarification regarding dues and assessments. An additional article was added to distinguish the responsibilities and authority of the executive director. The executive director also serves as an ex officio nonvoting member of the ENA Board of Directors to ensure essential and invaluable input is provided in the Board s deliberations to make informed decisions for the association. Language was enhanced to provide clarity regarding the establishment of State Councils and Chapters. The Bylaws amendment process was modified to ensure the ENA Board of Directors have adequate time for review and approval of each bylaws amendment proposal prior to consideration by the General Assembly for vote General Assembly

10 Page 10 Proposal to Amend Bylaws Author(s): Bruce A. Olson, MSN, BSN, BA, RN, CEN, PHN Kathleen E. Carlson, MSN, RN, CEN, FAEN Louise Hummel, MSN, RN, CNS, CEN, TCRN, FAEN Julie Miller, BSN, RN, CEN Matthew F. Powers, MS, BSN, RN, MICP, CEN Joan Somes, PhD, MSN, RN, CEN, CPEN, FAEN Tiffiny Strever, BSN, RN, CEN, TCRN, FAEN Karen K. Wiley, MSN, RN, CEN 2017 General Assembly

11 Page BYLAWS EMERGENCY NURSES ASSOCIATION ARTICLE I NAME The name of this organization shall be the Emergency Nurses Association (ENA), a not-forprofit corporation incorporated in the State of Illinois. ARTICLE II OBJECT Section 1. Purpose The purposes for which the corporation is organized are educational, within the meaning of Section 501(c)(3) of the Internal Revenue Code of 1986, as amended, including but not limited to the advancement of emergency nursing through education and public awareness. Section 2. Mission The mission of the ENA is to advocate for patient safety and excellence in emergency nursing practice. Section 3. Objectives ENA exists to: A. Promote the specialty of emergency nursing. B. Promote the interests of ENA s members and to improve the professional environment of the emergency nurse through education and public awareness. C. Promote ethical principles as defined in the ENA Code of Ethics for Emergency Nurses and the American Nurses Association Code of Ethics. D. Collaborate actively with other health related organizations to improve emergency care. E. Be the primary resource for emergency nursing leadership, education, and research. F. Define standards that serve as a basis for emergency nursing practice. G. Develop, disseminate and evaluate emergency nursing education and research. H. Encourage interaction and mentorship among emergency nurses. I. Identify and disseminate information on key trends affecting and pertinent to emergency nursing. J. Serve as an advocate for the public regarding emergency care. Section 4. Official Publication The official publication shall be the Journal of Emergency Nursing (JEN), which shall reflect the purpose, mission objectives and positions of ENA. ARTICLE III MEMBERS Section 1. Membership Applications Membership applications must be submitted to the headquarters office with any required fees. Upon acceptance, a membership card is sent and the state council is notified. Section 2. Responsibilities of Membership Each member has the responsibility to support the purpose, mission, objectives, and positions of ENA. Section 3. Classifications A. Voting Members voting members shall be classified as national, international, senior and military. Voting members shall have the right to vote, hold elected office, serve on the board of directors, serve on committees, and attend ENA s meetings and social functions.

12 Page National membership may be granted to any individual who is a professional registered nurse licensed in the United States or its territories, hereinafter defined as Guam, American Samoa, Puerto Rico, U.S. Virgin Islands and the Northern Mariana Islands. 2. International membership may be granted to any individual who is a professional registered nurse licensed (or the equivalent thereto) outside of the United States or its territories. 3. Senior membership may be granted to a professional registered nurse who is age 65 or older and licensed in the United States or its territories. 4. Military membership may be granted to a professional registered nurse licensed in the United States or its territories who is currently serving or has been honorably discharged or retired from the United States Armed Forces including Army, Navy, Marine Corps, Air Force, Coast Guard, and Reserve Components. B. Nonvoting members nonvoting members shall be classified as affiliate, student and honorary. Nonvoting members shall be entitled to serve on ENA committees and attend ENA member meetings and social functions. 1. Affiliate membership may be granted to any individual residing in the United States or its territories who shares interest in and supports the purpose, mission and objectives of ENA but does not otherwise meet the criteria for voting membership in ENA. 2. Student membership may be granted to any individual enrolled in a primary nursing education program in the United States or its territories leading to eligibility for licensure as a professional registered nurse. 3. Honorary membership may be awarded to an individual meeting such criteria as shall be determined by the president and the board of directors. Section 4. Dues and Finance A. Members dues shall be currently maintained or termination of membership shall result. B. Membership dues of ENA members shall be determined by the board of directors, except that there shall be no dues for honorary membership, and senior membership member fees will not be more than that of the affiliate membership. At the start of the term, the president shall be granted a dues waiver for life, provided that he or she maintains eligibility as a voting member. C. The fiscal year shall be January 1 through December 31. D. Each state council and chapter shall receive an annual allocation for each dues paying member within the state or chapter. E. A surcharge may be added to the dues in some states by the state s request. Section 5. Suspension and Termination of Membership A. ENA members may have their membership suspended or terminated by a two-thirds vote of the board of directors for failure to adhere to the ENA bylaws or for cause. B. Such action shall not be taken until a member is advised of specific charges and given the opportunity to respond. ARTICLE IV OFFICERS Section 1. Officers A. There shall be three officers: president, president-elect, and secretary/treasurer. The term of office shall commence January 1 each year and terminate on December 31, except that the president-elect shall succeed to the office of president at the conclusion of the term. Officers shall exercise the duties and responsibilities required of a member of the board of directors. B. The president shall: 1. Serve as the official ENA representative and spokesperson, unless such duty is delegated; 2. Serve as an ex-officio member of all committees except the Nominations and Elections Committee; 3. Serve as chair of the Finance Committee;

13 Page Appoint representatives to affiliate organizations and other positions as necessary during the term of office; and 5. Fill, with the approval of the board, vacancies on committees that occur during the term of office. C. The president-elect shall appoint chairs and members of committees and a board liaison to each committee for the following calendar year. Section 2. Eligibility Requirements A. Each officer must be a voting member and must have been a voting member during each of the previous five years immediately prior to submitting a candidate application. B. Each candidate for president-elect and secretary/treasurer must currently serve as a voting member of the board of directors. C. Each candidate must submit to, and pass as acceptable, a limited background check verifying personal identity, professional licensure, highest academic level and an investigation for criminal activity. Section 3. Election A. In the event of a tie vote for the position of president-elect, there shall be a second balloting of ENA membership. B. In the event of a tie vote for the position of secretary/treasurer, lots shall be drawn. C. A candidate for an officer position who is not elected shall continue to serve the remaining unexpired years of the original term as a director. D. All directors who are elected as officers shall have their unexpired terms of office filled by the candidates who receive the next highest number of votes; the candidate receiving the highest number of votes shall receive the position with the longest term. Section 4. Vacancies A. If the office of president becomes vacant, the president-elect shall succeed to the office of president for the unexpired term and shall subsequently serve the one-year term of office of president to which elected. In such case, the immediate past president may remain as immediate past president for a second year or the office may remain vacant for that year. B. A vacancy in the office of president-elect may be filled by a current member of the board of directors, or remain vacant as approved by a majority vote of the board of directors. If the vacancy is filled, the president-elect shall not automatically assume the office of president for the subsequent term. C. In the event that the office of president and president-elect are vacated during the same year, the board of directors shall appoint an acting president to serve until the next scheduled election, at which time an election will be held for both president and presidentelect. D. A vacancy in the office of secretary/treasurer may be filled by a current member of the board of directors or remain vacant as approved by a majority vote by the entire board of directors. ARTICLE V MEETINGS Section 1. General Assembly A. The General Assembly shall be composed of delegates from all states and international delegates representing the international members. B. The number of voting state delegates allocated for General Assembly shall be 700, apportioned as follows: 1. No state shall be allocated fewer than two delegates, one of whom shall serve as state captain. 2. In addition to the voting delegates, there shall be one nonvoting alternate delegate. 3. The remaining delegates will be allocated to the states based on the percentage the delegation is to the national membership, determined annually as outlined in procedures.

14 Page C. The number of voting international delegates allocated for General Assembly shall be in addition to the 700 voting state delegates. 1. There shall be no more than five international voting delegates. 2. In addition to the voting delegates there shall be one nonvoting alternate delegate. 3. International delegates will be selected by a point system developed by the board of directors; the system will be administered and overseen by the ENA component relations department. The members receiving the highest number of points will be selected. D. In addition to the state delegate and international allocation, ENA past presidents may speak and vote at General Assembly. Section 2. Authority The General Assembly shall provide direction and stewardship for the organization, and shall develop and adopt policies and positions affecting the emergency nursing profession in furtherance of ENA s purposes. The General Assembly shall also approve, revise, or amend these bylaws, and receive reports of the board of directors, committees and other volunteer groups, the findings of the annual audit, and transact such other business as may come before the meeting. Section 3. Quorum A quorum for all meetings is a majority of the total voting delegates who have completed credentialing procedures. Section 4. Annual Meeting and Special Meetings A. The regular business meeting of the delegates shall be held annually and designated as the General Assembly. A formal notice of the meeting shall be published in ENA publications 60 days prior to the meeting. B. Other meetings of delegates shall be summoned by a two-thirds vote of the board of directors as circumstances warrant and shall be designated as special meetings of the General Assembly. Delegates shall be given at least thirty days advance notice of any special meeting of the General Assembly. Notice for special meetings shall state the general nature of the subject or subjects to be considered. ARTICLE VI BOARD OF DIRECTORS Section 1. Composition The board of directors shall be composed of the following: three officers, seven directors, the immediate past president serving as an ex-officio member for one year, and the executive director serving as a non-voting advisory member. No member may run for more than one nationally elected position at a time. No member may hold more than one nationally elected position at a time. Section 2. Authority The board of directors shall be the ENA official governing body responsible for the management of the affairs of ENA. To that end, it shall also: Perform all duties entrusted to officers and directors of a corporation; Debate and determine ENA policy; Oversee ENA s business and financial affairs; Provide strategic direction for ENA; and Provide leadership for all of the component divisions of ENA. Section 3. Eligibility Requirements A. Directors must be a voting member and must have been a voting member during each of the previous five years immediately prior to submitting a candidate application.

15 Page B. Candidates must have attended at least one ENA General Assembly within the previous three years in an approved verifiable capacity as outlined in the election rules. C. Each candidate must submit to, and pass as acceptable, a limited background check verifying personal identity, professional licensure, highest academic level and an investigation for criminal activity. D. Candidates shall have served in an elected or committee position on the local, state or national level within the previous five years. Section 4. Term of Office Directors shall serve for a three-year term of office on a rotating basis. The term of office shall commence on January 1 each year following the election and terminate on December 31. Section 5. Elections Elections shall be held annually. All voting members shall have the opportunity to elect officers and directors by ballot. Balloting may be by electronic means. Candidates receiving the highest number of votes for each position shall be declared elected. In the event of a tie for the director positions, lots shall be drawn. Section 6. Meetings A. Regular meetings of the board shall be held at least quarterly as determined by the board. At least ten days notice shall be given to all members of the board. B. Special meetings shall be held as called by the president or any three members of the board. At least three days notice shall be given to all members of the board. C. Meetings may be held in person or by electronic means, provided that all participants can hear and speak to one another at the same time. D. A majority of the voting members of the board of directors shall constitute a quorum for all meetings. All decisions of the board of directors require an affirmative vote of a majority of the board of directors. Section 7. Vacancy A vacancy that occurs in the position of director shall be filled in the following manner: A. If the vacancy occurs between January 1 and before the completion of the current year s election the vacancy shall be filled by the person receiving the next highest number of votes in the previous year s election with the term ending December 31. B. If the vacancy occurs after the current year s election and there is more than six months left in the unexpired term, the vacancy shall be filled by the person receiving the next highest number of votes in the current year s election with the term ending December 31 of the following year. C. If all such persons decline to serve, if there were no additional candidates for that office during the most recently concluded election, or if the vacancy occurs with fewer than six months left in the unexpired term, the vacancy shall not be filled. Section 8. Removal Any member of the board of directors may be removed in accordance with the provisions of law and the Illinois Not For Profit Act of 1986, as amended, by the persons entitled to elect such director, whenever, in their judgment, the best interests of ENA would be served by such removal. Section 9. Executive Committee A. The Executive Committee shall be composed of the president, the president-elect, and the secretary/treasurer as voting members, and the executive director as a nonvoting ex-officio member. The Executive Committee shall exercise all responsibilities specified in the bylaws and assigned by the board of directors. B. The Executive Committee shall assist the board in managing ENA on issues that are time sensitive between official board meetings and, in those urgent instances, will have and may

16 Page exercise all of the powers of the board in the oversight of the management of the business and affairs of ENA. C. The Executive Committee assists the president in setting priorities for the board and the executive director. Actions of the Executive Committee will be communicated to the board of directors. D. The Executive Committee may provide counsel to the executive director. E. The Executive Committee shall lead the board of directors in strategic initiatives. Section 10. Indemnification ENA shall indemnify, as set forth below, and to the fullest extent to which it is empowered to do so by the Illinois Nonprofit Corporation Act or any other applicable laws as may from time to time be in effect, any person who, by reason of being or having been a director, officer, employee, or agent of ENA, or who is or was serving at the request of ENA as a director, officer, employee, or agent of another corporation, partnership, joint venture, trust, or other enterprise, and who was or is a party or is threatened to be made a party to any threatened, pending, or completed action, suit, or proceeding. ARTICLE VII CONSTITUENT DIVISIONS Section 1. Levels of Organization A. ENA shall have two levels of organization, with an optional third level: National Level State Level Local Level, optional B. All levels of ENA are integral components of ENA. State councils are separately incorporated in each state in accord with bylaws and procedures. The local level within each state, where it exists, is an integral component of the state council and exists under the state council corporate status, in accord with bylaws and procedures. Section 2. Activities A. National level activities shall encompass activities of the General Assembly, special meetings of delegates, and the board of directors. B. The state level of ENA shall encompass all activities of state councils. 1. Charter Each state council shall be chartered by ENA in accord with procedures and shall actively support the philosophy and objectives of ENA. 2. Objectives Each state council shall function within the framework of ENA to coordinate and to implement ENA activities within the state. 3. Composition In states where chapters exist, state councils will be composed of representatives from each chapter within the state in accord with bylaws and procedures. If there are no chapters, state councils will be composed of members-atlarge. In the event that there is no state council, a member of the board of directors shall coordinate ENA activities within that state in accord with procedures. 4. Responsibility Each state council is an integral component of ENA and shall act in accord with bylaws and procedures. Each state council has the responsibility to monitor and to address professional issues related to emergency care. Each state council shall serve as a resource for emergency nursing within the state. 5. General Assembly delegation Each state council shall coordinate the individual state delegation to the ENA General Assembly in accord with procedures. 6. Funding Each state council shall receive an annual allocation for each individual member within the state in accord with procedures. 7. Suspension or Revocation of Charter The charter for a state council may be suspended or revoked by the board of directors in accord with procedures. C. The third level, if it exists, shall encompass all activities of chapters. Chapters, where they exist, are integral components of states and ENA and shall act in accord with bylaws and procedures.

17 Page Purpose Each chapter shall be chartered by the board of directors in accord with procedures and shall actively support the purpose and objectives of ENA. 2. Objectives Each chapter shall function within the framework of ENA to coordinate and to implement ENA activities at the chapter level. 3. Composition Chapter membership shall be obtained, in those states where chapters exist, when an individual joins ENA in accord with procedures. 4. Responsibility Each chapter has the responsibility to provide representation for active participation at the respective state level in accord with procedures. 5. Funding Each chapter shall receive an annual allocation for each chapter member in accord with procedures. 6. Suspension or Revocation of Charter The charter for a chapter may be suspended or revoked in accord with procedures. ARTICLE VIII COMMITTEES Section 1. Committees ENA shall have committees appointed by the board of directors in sufficient numbers necessary to address mission objectives, and positions of ENA. The president or an appointed board liaison, as well as the executive director, shall serve as non-voting members of all committees, except the Nominations and Elections Committee. Section 2. Standing Committees A. Finance Committee. 1. The Finance Committee shall be composed of the president, the president-elect, the secretary/treasurer and the immediate past president. The executive director shall serve as a nonvoting ex-officio member. 2. The Finance Committee shall: a. Oversee the financial planning and management of ENA by ensuring that all fiscal aspects are in order; b. Oversee the independence of ENA s audit functions and its compliance with legal and ethical standards; c. Oversee investment of funds; and d. Make fiscal recommendations to the board. B. Resolutions Committee. 1. The Resolutions Committee shall be composed of six members serving three-year terms, two appointed each year by the ENA president-elect and ratified by the board of directors. The committee chairperson shall be appointed by the president-elect and ratified by the board of directors from among the continuing members on the committee. The terms shall be staggered and shall commence at the adjournment of the General Assembly meeting following appointment. 2. The Resolutions Committee shall solicit, review, and present resolutions and proposed bylaws amendments to the General Assembly. C. Nominations and Elections Committee. 1. Composition a. The Nominations and Elections Committee shall consist of seven voting members elected in the ENA national election: one member from each of six regions who has not previously served on the board of directors, and one member who has served on the board of directors. Nominations and Elections Committee members may only represent the region in which they hold a voting membership. b. The six regions shall be established by Nominations and Elections Committee policy. Each region shall be composed of states with geographic proximity and relatively equal membership distribution. c. A Nominations and Elections Committee chairperson shall be elected each year by

18 Page the incoming Nominations and Elections Committee. The chairperson must have served as a member of the committee the previous year. Eligibility a. Candidates must be a voting member and must have been a voting member during each of the previous five years immediately prior to submitting their candidate application. b. Candidates shall have served in an elected or committee position on the local, state or national level within the previous five years. c. Candidates must also have attended at least one General Assembly within the previous three years in an approved verifiable capacity as outlined in the election rules. d. Each candidate shall submit to, and pass as acceptable, a limited background check verifying personal identity, professional licensure, highest academic level and an investigation for criminal activity. e. Members of the Nominations and Elections Committee may not run for or serve in any ENA board position during tenure on the Nominations and Elections Committee, and may not serve more than two consecutive elected terms. Elections a. Elections for the Nominations and Elections Committee shall be held annually. Members shall serve for two-year terms on a rotating basis with terms ending at the first meeting of the Nominations and Elections Committee following the annual General Assembly meeting. b. All voting members shall have the opportunity to elect Nominations and Elections Committee members by ballot from all regions. Candidates receiving the highest number of votes shall be declared elected. In the event of a tie vote for a position on the committee, lots shall be drawn. Responsibilities a. The Nominations and Elections Committee shall be responsible for developing election rules to facilitate elections and shall have general oversight over the election process. b. The Nominations and Elections Committee shall issue a call for candidates at the beginning of the election cycle. The Nominations and Elections Committee shall review, ratify and present a qualified slate of candidates for each position in the election of officers, directors and the Nominations and Elections Committee according to the election rules. The slate of candidates shall be presented to the membership through ENA publications. All national candidates shall be considered potential candidates until they have been ratified by the Nominations and Elections Committee. c. If no applications are received for open board or Nominations and Elections Committee positions, the Nominations and Elections Committee may solicit additional applications as outlined in operational procedures. d. Changes to the election rules must occur prior to the start of the election cycle. e. The Nominations and Elections Committee shall submit proposed amendments to the election rules to the board of directors, who shall review them for compatibility with ENA s purpose, mission, values, objectives, federal and state laws and fiscal viability. Following review and comment by the board of directors in accordance with these criteria, the Nominations and Elections Committee will submit proposed amendments to the Resolutions Committee by the amendment deadline date. f. Notice of amendments to the election rules shall be sent with the notice of the meeting. The General Assembly may amend the election rules within the scope of notice by majority vote. If notice has not been given as required by this section, the General Assembly may amend the election rules by a three-fourths vote. Vacancies a. A vacancy in the chairperson position shall be filled by a majority vote of the Nominations and Elections Committee.

19 Page b. A vacancy of a committee member shall be filled by the candidate who received the next highest number of votes from that region or as the past board member in the most recently completed election. c. In the event of a committee member vacancy from an uncontested election, a qualified candidate must be nominated and elected by the state council presidents of the region affected by the vacancy according to the Nominations and Elections Committee election process, meeting the same requirements set forth in the bylaws as any potential candidate. d. The committee position may remain vacant as approved by the Nominations and Elections Committee if less than six months remain of the unexpired term. ARTICLE IX DISSOLUTION In the event of dissolution of ENA, the net assets of the corporation shall be applied and all liabilities and obligations shall be paid, satisfied, and discharged, or adequate provision shall be made thereof. After payment of all liabilities and obligations, all remaining assets shall be distributed to an organization or organizations organized and operated exclusively for charitable, educational, scholastic or scientific purposes as shall at the time qualify as tax exempt under Sections 501(c)(3) of the Internal Revenue Code of 1986, as amended, or any subsequent law of the United States of America. ARTICLE X LIMITATIONS Section 1. Corporate Powers ENA shall possess all powers which a corporation organized under the General Not For Profit Corporation Act of 1986 of the State of Illinois, as the same from time to time may be amended, shall possess, including all powers which are not in conflict with the purposes for which ENA is organized. In any event, ENA shall not engage in any activity which would disqualify it from being exempt from taxation under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended, or any subsequent law of the United States of America. Section 2. Net Earnings No part of the net earnings of ENA shall inure to the benefit of any private individual. Further, no part of the income of ENA shall be distributed to its members, directors, or officers, provided however, that the payment of reasonable compensation for services rendered shall not be deemed a distribution of income. Section 3. Corporate Assets Anything herein contained to the contrary notwithstanding, no assets of ENA shall be donated, distributed, applied to, paid over or otherwise used or employed in any manner which would disqualify ENA from being exempt from taxation under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended, or any subsequent law of the United States of America. Section 4. Political Campaigns ENA shall not participate in or intervene in any political campaign on behalf of any candidate for public office, including the publication or distribution of statements. ARTICLE XI PARLIAMENTARY AUTHORITY The rules contained in the 11th edition of Robert s Rules of Order Newly Revised shall govern ENA in all cases to which they are applicable and in which they are not inconsistent with these bylaws and any special rules of order ENA may adopt.

20 Page ARTICLE XII AMENDMENT Section 1. Proposals Amendments to the bylaws may be proposed by the board of directors, state councils or under the signature of five voting members. Section 2. Submission Deadline Amendments must be submitted to ENA national office at least 90 days prior to the General Assembly. Section 3. Notice The board of directors shall review proposed bylaws amendments and resolutions for compatibility with ENA s purpose, mission, values, objectives, federal and state laws and fiscal viability, and provide recommendations to the General Assembly. Amendments will be submitted to the membership at least 60 days prior to the General Assembly. Publication of the amendments in an ENA publication shall constitute notice of any amendments of these bylaws to be considered for approval. Section 4. Vote In order to be approved, any amendment must be approved by a two-thirds vote of the delegates present and voting. The Emergency Nurses Association (ENA) Bylaws as appears above reflect amendments approved at the annual ENA General Assembly meetings since 2000: Chicago, IL, 2000; Orlando, FL, 2001; New Orleans, LA, 2002; San Diego, CA, 2004; San Antonio, TX, 2006; Salt Lake City, UT, 2007; Minneapolis, MN, 2008; Baltimore, MD, 2009; San Antonio, TX, 2010; Tampa, FL, 2011; San Diego, CA, 2012; Nashville, TN, 2013; and Indianapolis, IN, 2014.

21 Page AMENDED AND RESTATED BYLAWS EMERGENCY NURSES ASSOCIATION 3 ARTICLE I 4 NAME AND PURPOSES Section 1. Name and Location. A. The name of the corporation shall be the Emergency Nurses Association ( ENA ), an Illinois not-for-profit corporation. B. ENA shall have and continuously maintain in the State of Illinois a registered office and a registered agent whose office is identical with such registered office, and may have such other offices within or outside of the State of Illinois as the ENA Board of Directors may determine Section 3. Rules. The following rules shall conclusively bind ENA and all persons acting for or on behalf of it: A. No part of the net earnings of ENA shall inure to the benefit of, or be distributed to, its directors, officers, committee members or other private persons, except that ENA shall be authorized and empowered to pay reasonable compensation for services rendered and to make payments and distributions in furtherance of the purposes set forth above. B. No substantial part of the activities of ENA shall be the carrying on of propaganda, or otherwise attempting to influence legislation, and ENA shall not participate in, or intervene in (including the publishing or distribution of statements) any political campaign on behalf or in opposition to any candidate for public office. Notwithstanding any provision of these Bylaws, ENA shall not carry on any activity not permitted to be carried on by: i. a corporation exempt from federal income tax under Section 501(c)(3) of the IRC (or the corresponding provision of any future United States Internal Revenue Law); or ii. a corporation, contributions to which are deductible under Section 170(c)(2) of the IRC (or the corresponding provision of any future United States Internal Revenue Law). 34 MEMBERSHIP Section 2. Purposes. As set forth in ENA s Articles of Incorporation, ENA s purposes are educational, within the meaning of Section 501(c)(3) of the Internal Revenue Code of 1986, as amended ( IRC ), including, but not limited to the advancement of emergency nursing through education and public awareness. ARTICLE II Section 1. Application. The ENA Board of Directors, or its designees(s), shall adopt an application form and procedures to facilitate the consideration of applicants for membership in ENA. All applicants shall complete and submit the application, along with the designated fee, if any, to ENA s administrative office. All such qualified applicants shall become members upon notice from ENA. ENA shall notify the appropriate state council upon acceptance of new members Section 2. Classifications and Criteria. Membership may be granted to any individual who: A. Abides by these Bylaws, the ENA Code of Ethics, and such other policies, rules and regulations as ENA may adopt; and Emergency Nurses Association Draft 06/08/17 1

22 Page B. Meets criteria for one of the following categories: i. Voting Members a. National Members. National membership may be granted to any individual who is a professional registered nurse licensed to practice in the United States or its territories. For purposes of these Bylaws, territories shall mean Guam, American Samoa, Puerto Rico, U.S. Virgin Islands and the Northern Mariana Islands. b. International Members. International membership may be granted to any individual who is a professional registered nurse licensed (or the equivalent thereto) to practice outside of the United States or its territories. c. Senior Members. Senior membership may be granted to a professional registered nurse aged 65 or older and licensed to practice in the United States or its territories. d. Military Members. Military membership may be granted to a professional registered nurse licensed to practice in the United States or its territories who is currently serving in, or has been honorably discharged or retired from, the United States Armed Forces including the Army, Navy, Marine Corps, Air Force, Coast Guard, and Reserve Components. ii. Nonvoting Members a. Affiliate Members. Affiliate membership may be granted to any individual residing in the United States or its territories who shares interest in and supports the purpose, mission and objectives of ENA but does not otherwise meet the criteria for voting membership in ENA. b. Student Members. Student membership may be granted to any individual enrolled in a primary nursing education program in the United States or its territories leading to eligibility for licensure as a professional registered nurse. c. Honorary Members. Honorary membership may be awarded to an individual meeting such criteria as shall be determined by the President and the ENA Board of Directors. Section 3. Rights and Duties. A. Voting and non-voting members shall be eligible to attend ENA s member meetings and social functions and serve on ENA committees. B. Only voting members may vote for the election of ENA s officers, directors and members of the Nominations and Elections Committee. Voting members shall have one (1) vote in all elections. C. Only voting members may serve on the ENA Board of Directors and in the General Assembly. D. Members shall not have the right to vote on the amendment of ENA s Articles of Incorporation or the merger or dissolution of ENA. Section 4. Benefits. Benefits associated with the various membership categories shall be determined by the ENA Board of Directors or its designee(s) from time to time. Section 5. Disciplinary Action. A. Grounds for Discipline. ENA may discipline a member for any of the following reasons: i. Failure to comply with these Bylaws, the ENA Code of Ethics, or any of ENA s rules or regulations; ii. Conviction of a felony or a crime related to, or arising out of, the practice of nursing or involving moral turpitude; iii. Suspension, revocation, or forfeiture by any state, province, or country of the member s right to practice as a nurse; or Emergency Nurses Association Draft 06/08/17 2

23 Page iv. Immoral, dishonorable, or unprofessional conduct considered prejudicial to the best interests of, or inconsistent with, the purposes of ENA. B. Procedures. Discipline may include, but not be limited to, censure, suspension, probation, and expulsion. Disciplinary action may be taken provided that a statement of the charges shall have been sent by certified mail to the last recorded address of the member at least fifteen (15) days before final action is to be taken. This statement shall be accompanied by a notice of the time and place of the meeting at which the charges shall be considered, and the member shall have the opportunity to appear in person and/or to be represented by counsel and to present any defense to such charges before action is taken by ENA. Such disciplinary actions shall be conducted in accordance with such additional procedures as may be established by the ENA Board of Directors. 109 DUES AND ASSESSMENTS Section 1. Payment of Dues. The initial and annual dues for all ENA members and the time for paying such dues, and other assessments, if any, shall be determined by the ENA Board of Directors. Under special circumstances, the ENA Board of Directors, or its designee(s), may waive the annual dues and/or assessments for any member or category of members Section 2. Non-Payment of Dues. The membership of any member who is in default of payment of dues or assessments for more than three (3) months, or otherwise becomes ineligible for membership, shall be terminated automatically, according to such rules or procedures as the ENA Board of Directors or its designee(s) shall establish, unless such termination is delayed by the ENA Board of Directors or its designee(s) Section 3. Reinstatement. Members who have resigned or been terminated for nonpayment of dues may only be reinstated (i) if no more than three (3) months has elapsed since the date of termination; (ii) upon payment of delinquent dues; and (iii) in accordance with such rules as may from time to time be established by the Board of Directors. Former members not meeting the requirements for reinstatement must reapply for membership. ARTICLE III ARTICLE IV 127 MEMBERSHIP MEETINGS Section 1. Annual Meeting. The annual meeting of ENA s voting members ( Annual Meeting ) will be held in conjunction with the General Assembly Section 2. Special Meetings. Special meetings of ENA s voting members may be called (i) at the request of the President or any five (5) members of the ENA Board of Directors; (ii) at the written request of two-thirds (2/3) of ENA s voting members; or (iii) by resolution of the ENA Board of Directors Section 3. Notice. Notice of any annual or special meeting of the voting members shall state the time, date, place, and purpose of the meeting, and shall be delivered not more than sixty (60) and not less than thirty (30) days prior to the date of such meeting, unless otherwise required by applicable law. 138 Emergency Nurses Association Draft 06/08/17 3

24 Page Section 4. Quorum. The lesser of (i) ten percent (10%) of ENA s eligible voting members; or (ii) one hundred (100) eligible voting members shall constitute a quorum for the transaction of business at any duly called meeting of the voting members, provided that if less than a quorum is present, a majority of the voting members present may adjourn the meeting to another time without further notice Section 5. Manner of Acting. The act of a majority or more of the voting members present (in person or by proxy) at a duly called meeting at which a quorum is present shall be the act of the members, unless the act of a greater number is required by law, the Articles of Incorporation, or these Bylaws Section 6. Mail/Electronic Voting. Voting by mail or electronic means shall be permitted to the full extent permitted by the Illinois General Not For Profit Corporation Act of 1986, as amended (the Act ), for any item of business properly coming before the voting members. A mail or electronic vote of the voting members may be called by the ENA Board of Directors. 154 ENA BOARD OF DIRECTORS ARTICLE V Section 1. Authority and Responsibility. ENA s affairs shall be managed by the ENA Board of Directors, which shall have supervision, control, and direction of ENA, shall determine its policies or changes therein within the limits of these Bylaws, shall actively promote its purposes, and shall have discretion in the disbursement of its funds. The ENA Board of Directors may adopt such rules and regulations for the conduct of its business as shall be deemed advisable and may, in the execution of the powers granted, appoint such agents as it may consider necessary. All of ENA s committees report to and are subject to the direction and control of the ENA Board of Directors, unless specifically provided otherwise in these Bylaws Section 2. Composition. The ENA Board of Directors shall consist of twelve (12) members (collectively, the Directors ) as follows: the President, President-Elect, Secretary/Treasurer, Immediate Past President; and seven (7) at-large members elected by the voting members (the At-Large Directors ). ENA s Executive Director shall serve as an ex officio nonvoting member of the Board Section 3. Qualifications. Only voting members with the following qualifications may serve as At-Large Directors: A. Must have been a voting member for a minimum of five (5) consecutive years immediately preceding the submission of a candidate application; B. Must agree to abide by such rules and policies governing the election process as may be adopted by the ENA Board of Directors from time to time (collectively, Election Rules ); C. Must have attended at least one ENA General Assembly within the three (3) years immediately preceding their election (as outlined in the Election Rules); and D. Must have served in an elected or committee position on the local, state or national level within the five (5) years immediately preceding their election. Section 4. Terms. A. At-Large Directors shall serve a three (3) year term in office, or until such time as their successors are duly elected, qualified, and take office. B. In order to provide for staggered terms, at least two (2) At-Large Directors shall be elected each year. Emergency Nurses Association Draft 06/08/17 4

25 Page C. The term of all At-Large Directors shall begin on January 1 of the year following the year in which they are elected and shall run until the close of the third calendar year (e.g., December 31) following their election or until such time as their successors are duly elected, qualified, and assume their position. D. At-Large Directors may not serve more than two (2) consecutive three-year terms in office. E. At-Large Directors completing two (2) consecutive full terms in office shall not be eligible for re-election to the ENA Board of Directors until at least one (1) year has elapsed since the completion of their last term in office. F. At-Large Directors serving more than half of a full term shall be deemed to have served a full term in office for purposes of term limits. G. No one may serve as an At-Large Director for more than an aggregate life-time total of nine (9) years. H. Notwithstanding anything set forth in these Bylaws to the contrary, the President, PresidentElect, Secretary/Treasurer and Immediate Past President shall remain on the ENA Board of Directors for the duration of their term in office Section 6. Regular Meetings. The ENA Board of Directors shall have a minimum of four (4) regular meetings each calendar year at such times and places determined by the ENA Board of Directors. Notice of meetings shall specify the location, date and time of the meeting and shall be delivered at least 30 days prior to the date of such meeting Section 7. Special Meetings. Special meetings of the ENA Board of Directors may be called by, or at the request of, ENA s President or upon a written request to ENA s President by four (4) members of the ENA Board of Directors. Attendance of a Director at any meeting shall constitute a waiver of notice of such meeting except where a Director attends a meeting for the express purpose of objecting to the transaction of any business because the meeting was not lawfully called and convened Section 8. Meeting by Conference Call. Any action to be taken at a meeting of the ENA Board of Directors, or any committee thereof, may be taken through the use of a conference telephone or other communications equipment by means of which all persons participating in the meeting can communicate with each other. Participation in such a meeting shall constitute presence in person at the meeting of the persons so participating. Notwithstanding anything set forth to the contrary in these Bylaws, any meeting to be held by conference call (whether regular or special) may be held upon a minimum of twenty-four (24) hours prior notice Section 9. Quorum. A majority of the voting members of the ENA Board of Directors shall constitute a quorum for the transaction of business at any duly called meeting of the ENA Board of Directors; provided that when less than a quorum is present at said meeting, a majority of the voting members of the ENA Board of Directors present may adjourn the meeting to another time without further notice. Section 5. Elections. A. The At-Large Directors shall be elected by the voting members annually. Elections shall be held pursuant to the Election Rules and shall be conducted by mail ballot or electronic means. B. Candidates receiving the highest number of votes for each position shall be declared elected. C. In the event of a tie between candidates for At-Large Director positions, lots shall be drawn. 230 Emergency Nurses Association Draft 06/08/17 5

26 Page Section 10. Manner of Acting. The act of a majority of the voting members of the ENA Board of Directors present at a duly called meeting at which a quorum is present shall be the act of the ENA Board of Directors, unless the act of a greater number is required by law, the Articles of Incorporation, or these Bylaws Section 11. Action Without a Meeting. Any action requiring a vote of the ENA Board of Directors may be taken without a meeting if a written consent, setting forth the action taken, is approved by all of the members of the ENA Board of Directors entitled to vote with respect to the subject matter thereof Section 12. Resignation and Removal. Any At-Large Director may resign at any time by giving written notice to the President. In addition, any member of the ENA Board of Directors may be removed in accordance with the Act by the persons entitled to elect such Director, whenever, in their judgment, the best interests of ENA would be served by such removal Section 13. Vacancies. Vacancies in any Director position shall be filled as follows: A. If the vacancy occurs between January 1 and before the completion of the current year s election, the vacancy shall be filled by the person receiving the next highest number of votes in the previous year s election. A Director appointed pursuant to this Section shall hold their position for the remainder of the original term for which he or she was appointed to fill. B. If the vacancy occurs after the current year s election and there is more than six months left in the unexpired term, the vacancy shall be filled by the person receiving the next highest number of votes in the current year s election with the term ending December 31 of the following year. C. If all such persons decline to serve, or there were no additional candidates for that office during the most recently concluded election, or if the vacancy occurs with fewer than six months left in the unexpired term, the vacancy shall be filled by vote of the members at the next regularly scheduled election. A Director appointed pursuant to this Section shall hold their position for the remainder of the original term for which he or she was elected to fill. 259 OFFICERS Section 1. Officers. ENA s officers shall be a President, President-Elect, Secretary/Treasurer and Immediate Past President (collectively, officers ). No two (2) offices may be held simultaneously by the same person. A. President. The President shall be ENA s principal elected officer and shall, in general, supervise ENA s business affairs, subject to the direction and control of the ENA Board of Directors, by communicating with the Executive Director as necessary regarding ENA s business. The President shall be a member, without vote, of all councils and committees with the exception of the Nominations and Elections Committee and except as otherwise provided by these Bylaws. The President shall (i) serve as the Chair of the Finance Committee; (ii) serve as ENA s official representative and spokesperson, except as otherwise provided by the ENA Board of Directors; (iii) appoint representatives to ENA s affiliated organizations and other positions as necessary; (iv) fill, subject to the approval of the ENA Board of Directors, vacancies on ENA s committees; and (v) in general, perform all duties customarily incident to the office of President and such other duties as may be prescribed by the ENA Board of Directors. The President shall succeed to the office of Immediate Past President upon expiration of the President s term of office. ARTICLE VI Emergency Nurses Association Draft 06/08/17 6

27 Page B. President-Elect. The President-Elect shall assist the President and shall substitute for the President when required. The President-Elect shall be a member, without vote, of all committees, except the Nominations and Elections Committee and except as otherwise provided by these Bylaws. The President-Elect shall appoint chairs and members of committees, and an ENA Board of Directors liaison to each committee for the year following his/her term in office as President-Elect and shall in general, perform all duties customarily incident to the office of President-Elect and such other duties as may be prescribed by the ENA Board of Directors. The President-Elect shall succeed to the office of President upon expiration of the President s term of office, or in the event of the death, resignation, removal, or incapacity of the President. C. Secretary/Treasurer. The Secretary/Treasurer shall be the principal financial officer of the Association and shall have charge of and be responsible for the maintenance of adequate books of account for ENA; shall have charge and custody of all of ENA s funds and securities, and be responsible therefore, and for the receipt and disbursement thereof; shall deposit all ENA s funds and securities in such banks, trust companies or other depositories as shall be selected in accordance with the provisions of these Bylaws; shall perform the duties normally expected of the secretary of an Illinois not-for-profit corporation, including seeing that all notices are duly given in accordance with applicable law, the Articles of Incorporation, and these Bylaws; being custodian of the corporate records; keeping minutes of the meetings of the ENA Board of Directors; keeping a record of the mailing address of each ENA member; and performing such other duties as may be assigned by the President or the ENA Board of Directors. The duties of the Secretary/Treasurer may be assigned by the ENA Board of Directors in whole or in part to the Executive Director, or his or her designee(s). D. Immediate Past President. The Immediate Past President shall have such duties as may be assigned by the President or the ENA Board of Directors Section 3. Term. Officers shall serve a one (1) year term in office, or until such time as their successors are duly elected, qualified, and take office and may not serve more than one consecutive term in the same office. The term of all officers shall begin on January 1 of the year following the year in which they are elected and shall end on December 31 (or until such time as successors are duly elected, qualified, and assume their position). Officers serving more than half of a full term shall be deemed to have served a full term in office. Unsuccessful candidates for officer positions shall remain on the ENA Board of Directors for the remainder of their term as an At-Large Director Section 4. Elections. A. The officers shall be elected by the voting members annually. Elections shall be held pursuant to the Election Rules and shall be conducted by mail ballot or electronic means. Section 2. Officer Qualifications. Only voting members with the following qualifications may serve as an ENA officer: A. Must have been a voting member for a minimum of five (5) consecutive years immediately preceding the submission of a candidate application; B. Candidates for President-Elect and Secretary/Treasurer must currently be serving as a member of the ENA Board of Directors; C. ENA Past Presidents may not run for the office of President-Elect or Secretary/Treasurer; D. Must have attended at least one ENA General Assembly within the three (3) years immediately preceding the elections in an approved and verifiable capacity; and E. Must agree to abide by the Election Rules. Emergency Nurses Association Draft 06/08/17 7

28 Page B. Candidates receiving the highest number of votes for each position shall be declared elected. C. In the event of a tie between candidates for the President-Elect and Secretary/Treasurer positions, lots shall be drawn. D. The vacancies on the ENA Board of Directors created by the election of At-Large Directors to officer positions shall be filled by the candidates for At-Large Director who received the next highest number of votes and such individuals shall hold such positions for the remainder of the unexpired term. The candidates who received the highest number of votes shall fill the term with the longest time remaining in such term Section 5. Resignation and Removal of Officers. Any officer may resign at any time by giving written notice to the President or other officer. In addition, any officer may be removed by a majority vote of the persons entitled to elect such officer, whenever, in their judgment, the best interests of ENA would be served by such removal. Such removal shall be without prejudice to the contract rights, if any, of the person so removed. Election of an officer or agent shall not of itself create any contract rights Section 6. Officer Vacancies. In the event of the death, resignation, removal or inability of the President to serve, the President-Elect shall (i) assume and fulfill the duties of the President; (ii) complete the balance of the President s term; and (iii) serve the next succeeding one-year term as President as originally elected to serve. In the event the President-Elect assumes the position of President, the President-Elect position shall remain vacant until the next election A vacancy in the office of President-Elect or Secretary/Treasurer may be filled by the ENA Board of Directors from amongst the members of the ENA Board of Directors. An officer appointed pursuant to this section shall hold such office for the remainder of the term, at which time he/she returns to their original elected term of office In the event that the office of President and President-Elect are vacated during the same year, the ENA Board of Directors shall appoint an acting President from amongst the members of the ENA Board of Directors to serve until the next scheduled election, at which time an election will be held for both President and President-Elect. 356 GENERAL ASSEMBLY Section 1. Authority and Responsibility. In addition to such other duties set forth in these Bylaws, the General Assembly shall be the principle body responsible for: A. Developing policies and positions and providing direction for matters relating to emergency nursing; B. Communicating member needs to the ENA Board of Directors. C. Providing input to the ENA Board of Directors on (i) issues relating to the practice of emergency nursing; and (ii) position statements relating to the practice of emergency nursing; D. Approving, revising, or amending the Bylaws in accordance with Article XIV; E. Voting on all matters properly brought before the General Assembly; F. Receiving reports of the findings of ENA s annual financial audit; G. Receiving reports of the ENA Board of Directors, committees and other volunteer groups; and H. Adopting procedures governing the operation of the General Assembly, subject to the prior approval of the ENA Board of Directors ( General Assembly Standing Rules of Procedure ). ARTICLE VII Emergency Nurses Association Draft 06/08/17 8

29 Page Section 2. Composition. The General Assembly shall consist of no more than seven hundred and five (705) voting Delegates and International Delegates elected or appointed as follows: A. Each State Council shall have the right to appoint (i) two (2) voting Delegates (each a Delegate ), one of whom shall serve as state captain; and (ii) one (1) nonvoting Alternate Delegate ( Alternate ) to the General Assembly. The remaining Delegates will be allocated amongst the State Councils based on the percentage the delegation is to the national membership. B. The International members shall have up to five (5) voting Delegates ( International Delegates ) selected from amongst the International members as well as one (1) nonvoting Delegate ( International Alternate ). The International Delegates and International Alternate will be selected by a point system developed by the ENA Board of Directors. C. ENA Past Presidents who are voting members of ENA in good standing may attend, speak and vote at meetings of the General Assembly. D. The members of the ENA Board of Directors, including ENA Past Presidents serving on the Board, may attend and speak at all meetings of the General Assembly, but may not vote Section 3. Annual Session. The General Assembly shall hold a regular annual session in conjunction with ENA s Annual Meeting Section 4. Qualifications for Delegates and Alternate Delegates. All Delegates, Alternates, International Delegates, and the International Alternate must be voting members of ENA in good standing. ENA s officers and directors may not serve as Delegates, Alternates, International Delegates or the International Alternate Section 5. Appointment of Delegates and Alternate Delegates. The names of all Delegates, Alternates, International Delegates and the International Alternate must be submitted in accordance with the General Assembly Standing Rules of Procedure Section 6. Special Sessions. Special sessions of the General Assembly may be called by a two-thirds (2/3) vote of the ENA Board of Directors stating the place, time, and purpose for which such session is requested, provided, however, such request must be made at least sixty (60) days prior to the date specified in the request for such special session. Business conducted at any special session shall be limited to the specific purpose stated in the request for such session, and any such additional business as approved by the ENA Board of Directors Section 7. Notice. Notice of any annual or special session of the General Assembly shall state the time, date, place and purpose of the session and shall be published either in print or on ENA s Website at least forty-five (45) days prior to the date of the session, unless otherwise required by the procedures established by the General Assembly Section 8. Quorum. The presence of a majority of the total number of voting Delegates and International Delegates who have completed credentialing procedures, as established by the General Assembly, shall constitute a quorum for the transaction of business at any duly called session of the General Assembly; provided that when less than a quorum is present at said session, a majority of the Delegates and International Delegates present may adjourn the session to another time without further notice. 413 Emergency Nurses Association Draft 06/08/17 9

30 Page Section 9. Manner of Acting. The act of a majority of Delegates and International Delegates present at a duly called session at which a quorum is present shall be the act of the General Assembly, unless the act of a greater number is required by these Bylaws or procedures adopted by the General Assembly and approved by the ENA Board of Directors Section 10. Attendance/Exercise of Voting Rights. Delegates, Alternates, International Delegates and the International Alternate shall have the right to attend all sessions of the General Assembly. Only Delegates, International Delegates and ENA Past Presidents (with the exception of those currently serving on the Board) shall have the right to vote. Alternates and the International Alternate shall have no right to vote, provided, however, in the event a Delegate/International Delegate is absent at any session of the General Assembly, his or her designated Alternate shall have the right to vote in place of the Delegate/International Delegate provided the steps necessary to change their status from Alternate to Delegate have been followed in accordance with the procedures established by the General Assembly Section 11. Resignation and Removal of Delegates and Alternate Delegates. Any Delegate, Alternate, International Delegate or International Alternate may resign at any time by giving written notice to ENA. In addition, any Delegate or Alternate may be removed by the State Council entitled to appoint such Delegate, whenever, in its judgment, the best interests of the Association would be served by such removal. International Delegates or the International Alternate may be removed by the ENA Board of Directors, whenever, in its judgement, the best interests of the Association would be served by such removal Section 12. Vacancies. In the event of the death, resignation, removal, or incapacity of a Delegate or Alternate, the State Council represented by said Delegate or Alternate shall name a qualified member to replace said Delegate or Alternate. In the event of the death, resignation, removal, or incapacity of an International Delegate or International Alternate, the ENA Board of Directors shall name a qualified member to replace said International Delegate or International Alternate. 442 EXECUTIVE DIRECTOR The administrative and day-to-day operation of ENA shall be the responsibility of a salaried staff head or firm employed or appointed by, and responsible to, the ENA Board of Directors. The salaried staff head or, in the case of a firm, chief staff officer retained by the firm shall have the title of Executive Director. The Executive Director shall have the authority to execute contracts on behalf of ENA and as approved by the ENA Board of Directors. The Executive Director may carry out such other duties as may be specified by the ENA Board of Directors. The salaried staff head or firm shall employ and may terminate the employment of staff necessary to carry out the work of ENA. The Executive Director shall serve as an ex officio nonvoting member of the ENA Board of Directors. 454 COMMITTEES Section 1. Standing Committees. A. Executive Committee. i. Composition. The Executive Committee shall consist of the President, President-Elect, and the Secretary/Treasurer. The Executive Director shall be invited to attend and ARTICLE VIII ARTICLE IX Emergency Nurses Association Draft 06/08/17 10

31 Page participate in all meetings, without vote, of the Executive Committee, except those held in executive session. The President shall serve as the chair of the Executive Committee. ii. Authority. The Executive Committee shall have the authority to perform the business and functions of the ENA Board of Directors in between meetings of the ENA Board of Directors, except as otherwise set forth in these Bylaws or the Act, reporting to the ENA Board of Directors any action taken; but the delegation of authority to the Executive Committee shall not operate to relieve the ENA Board of Directors or any individual officer or member of the ENA Board of Directors of any responsibility imposed by law. iii. Meetings and Voting. The Executive Committee shall meet in person or by conference call upon the request of the chair or a majority of the Executive Committee. Each member shall have one (1) vote. Two (2) members of the Executive Committee shall constitute a quorum for the transaction of business at any duly called meeting of the Executive Committee; provided when less than a quorum is present at said meeting, a majority of the members present may adjourn the meeting without further notice. The act of a majority of the members present at a duly called meeting at which a quorum is present shall be the act of the Executive Committee. iv. Action by Written Consent. Any action requiring a vote of the Executive Committee may be taken without a meeting if consent, setting forth the action taken, is approved by all the members of the Executive Committee entitled to vote with respect to the subject matter thereof B. Nominations and Election Committee. i. Composition. a. The Nominations and Elections Committee shall consist of seven (7) voting members elected by the voting members as follows: one (1) member from each of six (6) regions who has not previously served on the ENA Board of Directors, and one (1) member who has served on the ENA Board of Directors within the previous 5 years. b. The six (6) regions shall be approved by the ENA Board of Directors. Each region shall be composed of states with geographic proximity and relatively equal membership distribution. ii. Qualifications. Only voting members with the following qualifications may serve on the Nominations and Elections Committee: a. Must have been a voting member for a minimum of five (5) consecutive years immediately preceding the submission of a candidate application. b. Must have served in an elected or committee position on the local, state or national level within the previous five (5) years. c. Must have attended at least one (1) General Assembly within the previous three (3) years. d. Members of the Nominations and Elections Committee may not run for or serve in any ENA Board position during their tenure on the Nominations and Elections Committee, and may not serve on the committee for more than two (2) consecutive elected terms. e. Must agree to abide by the Election Rules. iii. Elections. a. Elections for the Nominations and Elections Committee shall be held annually. Members of the committee shall serve a two-year term on a rotating basis with terms beginning January 1 and shall end on December 31. b. All voting members shall have the opportunity to elect Nominations and Elections Committee members by ballot from all regions. Candidates receiving the highest number of votes shall be declared elected. In the event of a tie vote for a position on the committee, lots shall be drawn. Emergency Nurses Association Draft 06/08/17 11

32 Page iv. Overview. a. The Nominations and Elections Committee has general oversight of the national election. The Committee shall solicit and mentor potential candidates and review national candidate applications. The Nominations and Elections Committee shall present its ratified slate of candidates to the membership through ENA publications. b. The Nominations and Elections Committee will provide updates to the ENA Board of Directors regarding the progress of their charges. C. Other Standing Committees. The ENA Board of Directors may establish other standing committees to support ENA s purposes. Such committees shall include, at a minimum, a Finance Committee and Resolutions Committee. The action establishing standing committees shall set forth the committee s purpose, authority and required qualifications for membership on the committee. i. Composition. The ENA Board of Directors, or its designee(s), shall determine the composition of ENA s standing committees. If a standing committee has the authority of the ENA Board of Directors, a majority of members must be comprised of Directors. ii. Quorum and Manner of Acting. At all meetings of any standing committee, a majority of the members thereof shall constitute a quorum for the transaction of business unless otherwise set forth herein. A majority vote by committee members present and voting at a meeting at which a quorum is present shall be required for any action. iii. Committee Vacancies. Except as otherwise provided herein, vacancies in the membership of a standing committee shall be filled by appointments made in the same manner as the original appointments to that committee. iv. Policies and Procedures. The ENA Board of Directors or its designee(s) shall develop and approve policies and procedures for the operation of all standing committees. All such policies shall be subject to the approval of the ENA Board of Directors. All standing committees shall report to the ENA Board of Directors. Section 2. Advisory/Ad Hoc Committees and Work Teams. The ENA Board of Directors may appoint such advisory or ad hoc committees or work teams as are necessary or appropriate in the exercise of their authority and responsibility as set forth in these Bylaws. The action establishing such a committee or work team shall set forth the committee s or work team s purpose, composition and term. A. Quorum and Manner of Acting. At all meetings of any advisory or ad hoc committee or work team, a majority of the members thereof shall constitute a quorum for the transaction of business. A majority vote by committee or work team members present and voting at a meeting at which a quorum is present shall be required for any action. B. Committee/Work Team Vacancies. Except as otherwise provided herein, vacancies in the membership of a committee or work team shall be filled by appointments made in the same manner as the original appointments to that committee/work team. C. Policies and Procedures. The ENA Board of Directors or its designees shall develop and approve policies and procedures for the operation of all committees and work teams. All committees and work teams shall report to the entity creating the committee/work team. ARTICLE X 554 CONSTITUENTS: STATE COUNCILS/LOCAL CHAPTERS Section 1. State Councils. Voting members of ENA who are licensed or reside within a particular state, commonwealth, federal district, territory or possession of the United States (the territory ) may be organized as a constituent of ENA (each of which is referred to as a State Emergency Nurses Association Draft 06/08/17 12

33 Page Council ). The ENA Board of Directors may authorize the establishment of State Councils which shall: i. be organized and operated in accordance with these Bylaws, and such additional rules, regulations and policies as may be adopted by the ENA Board of Directors from time to time; ii. fulfill criteria for affiliation as may be established by the ENA Board of Directors from time to time; iii. enter into charter agreements with ENA, as determined by ENA; iv. be issued a charter by ENA; and v. organize and conduct their activities in such a manner as to establish its fundamental alignment and functional compatibility with ENA Section 2. Application for Recognition as a State Council. The ENA Board of Directors, or its designee(s), shall adopt an application form and procedures to facilitate the consideration of applicants seeking to be organized as a State Council. All applicants must complete the application form and submit the application, along with the designated fee, if any, to ENA s administrative office. The ENA Board of Directors, or its designee(s), shall review the application of all applicants and determine, based on the criteria set forth in these Bylaws and such other guidelines as the ENA Board of Directors may prescribe, if applicants meet the qualifications necessary for recognition as a State Council. A. Revocation. Charters for the operation of State Councils may be revoked by the ENA Board of Directors according to due process procedures established by the ENA Board of Directors. Upon revocation of a State Council s charter, the State Council immediately shall remit all of its funds (after satisfying any existing debts or obligations) and records to ENA headquarters. B. Name. No State Council or other entity shall use ENA s name or trademarks in any manner whatsoever unless duly authorized to do so by ENA pursuant to the terms of a written agreement or policy. C. Funding. ENA shall fund chartered State Councils pursuant to a formula determined by the ENA Board of Directors based on the State Council s membership. D. Organization. Each State Council shall be incorporated as a not-for-profit corporation, have a Board of Directors, officers and bylaws in such form as shall be approved by the ENA Board of Directors. State Councils must maintain voting membership categories and criteria that are identical to ENA s. Any changes to a State Council s bylaws require the prior written approval of the ENA Board of Directors, or its designee(s). E. Meetings. Each State Council may hold such meetings as it deems appropriate. F. Choice of State Council. Members may belong to only one State Council, and may join the State Council of their choice based on where they reside, practice or hold a license. G. Transfers. A member of a State Council may transfer to another State Council by written request to ENA Section 3. Local Chapters. Voting members of the same State Council that are licensed or reside within the same local geographical territory may be organized as a local chapter by the State Council and each such local chapter will be an integral part of such State Council (i.e., it shall operate and function as a committee or special interest group of the State Council) (each of which is referred to as a Local Chapter ). The name, boundaries, eligibility requirements for A State Council s general purposes and objectives shall be complementary and consistent, on a local basis within its territory, with those of ENA and the State Council will advance the general and specific purposes of ENA within its territory. All members of a State Council must be members of ENA. Emergency Nurses Association Draft 06/08/17 13

34 Page Local Chapters, and policies and procedures governing their operations, shall be determined by the State Council, subject to the prior written approval of the ENA Board of Directors, and such rules and policies as may be adopted by the ENA Board of Directors from time to time. A State Council is responsible for overseeing and managing the activities of its Local Chapters and shall have the right to disband or dissolve any Local Chapter it creates, with appropriate due process. 614 INDEMNIFICATION ENA shall indemnify all past and present officers, directors, employees, and committee, council, and task force members, and all other ENA volunteers to the full extent permitted by the Act, and shall be entitled to purchase insurance for such indemnification to the full extent of the law as determined by the ENA Board of Directors. 621 FINANCE ARTICLE XI ARTICLE XII Section 1. Contracts. The ENA Board of Directors may authorize any officer or officers, agent or agents of ENA, in addition to the officers so authorized by these Bylaws, to enter into any contract or execute and deliver any instrument in the name of and on behalf of ENA, and such authority may be general or confined to specific instances Section 2. Payment of Indebtedness. All checks, drafts or other orders for the payment of money, notes or other evidences of indebtedness issued in the name of ENA shall be signed by such officer or officers, agent or agents of ENA and in such manner as shall from time to time be determined by resolution of the ENA Board of Directors. In the absence of such determination by the ENA Board of Directors, such instruments shall be signed by the Secretary/Treasurer and countersigned by the President Section 3. Deposits. All of ENA s funds shall be deposited to the credit of ENA in such banks, trust companies, or other depositaries as the ENA Board of Directors may select Section 4. Bonding. The ENA Board of Directors shall provide for the bonding of such officers and employees of ENA as it may from time to time determine Section 5. Gifts. The ENA Board of Directors may accept on behalf of ENA any contribution, gift, bequest or devise for ENA s general purposes or for any special purpose Section 6. Books and Records. ENA shall keep correct and complete books and records of account and shall also keep minutes of the proceedings of the ENA Board of Directors. The books and accounts of ENA shall be audited annually by accountants selected by the ENA Board of Directors Section 7. Fiscal Year. ENA s fiscal year shall be determined from time to time by the ENA Board of Directors. Emergency Nurses Association Draft 06/08/17 14

35 Page ARTICLE XIII 647 WAIVER OF NOTICE AND ELECTRONIC COMMUNICATION Section 1. Waiver of Notice. Whenever any notice is required to be given under applicable law, the Articles of Incorporation or these Bylaws, waiver thereof in writing signed by the person or persons entitled to such notice, whether before or after the time stated therein, shall be deemed equivalent to the giving of such notice Section 2. Electronic Communication. Unless otherwise prohibited by law, (i) any action to be taken or notice delivered under these Bylaws may be taken or transmitted by or other electronic means; and (ii) any action or approval required to be written or in writing may be transmitted or received by or other electronic means. 658 AMENDMENTS Section 1. Proposed Amendments. Amendments to the Bylaws may be proposed by the ENA Board of Directors, a State Council or no less than ten (10) voting members in good standing. Proposed amendments submitted by a State Council or by no less than ten (10) voting members are subject to the prior review and approval of the ENA Board of Directors to assure that proposed amendments (i) are consistent with ENA s purpose, mission, values, and objectives; (ii) have no adverse financial impact on ENA; (iii) don t create inconsistencies or conflicts with other provisions of the Bylaws; and (iv) don t conflict with the requirements of ENA s Articles of Incorporation or federal or state law. Proposed amendments approved by the ENA Board of Directors ( Approved Proposals ) will be presented to the General Assembly in accordance with the provisions set forth below in this Article XIV Section 2. Deadline. Proposed amendments to the Bylaws must be submitted to the ENA Board of Directors for its review and approval at least 120 days prior to the next meeting of the General Assembly in order to be considered at such meeting of the General Assembly Section 3. Notice. Notice of all Approved Proposals will be provided to the membership at least forty-five (45) days prior to the General Assembly. Such notice may be provided by (i) publishing such Approved Proposals in any of ENA s general membership publications (including, without limitation, its print or online journals or newsletters); or (ii) posting such Approved Proposals on the official ENA website Section 4. Vote. In order to be adopted, Approved Proposals must be approved by a twothirds (2/3) vote of the delegates present and voting at the General Assembly ARTICLE XIV ARTICLE XV DISSOLUTION In the event of ENA s dissolution, the ENA Board of Directors, after paying or making provision for the payment of all the liabilities of ENA, shall distribute its remaining assets to an organization(s) exempt under Section 501(c)(3) of the Internal Revenue Code of 1986 (or the corresponding provision of any future United States Internal Revenue Law) whose purpose includes the furtherance or support of the profession of emergency nursing, and in accordance with Illinois law, as the ENA Board of Directors shall determine. Any such assets not so disposed of shall be disposed of by the court of general jurisdiction of the county in which the Emergency Nurses Association Draft 06/08/17 15

36 Page principal office of ENA is then located, exclusively for such purposes in such manner, or to such organization or organizations that are organized and operated exclusively for such purposes, as said court shall determine. Emergency Nurses Association Draft 06/08/17 16

37 Page 37 GA17-02 Resolution TITLE: A National Standard for Child Passenger Restraint Whereas, Motor vehicle crashes remain the leading cause of death for children in the United States, with 602 children under the age of 13 killed in motor vehicle crashes and over 120,000 injured in 2014;1 Whereas, More than 130,000 children aged 12 and under are treated annually in emergency rooms in the United States for injuries related to motor vehicle crashes, with many sustaining debilitating injuries with long lasting sequelae;2 Whereas, Child restraints (correctly installed and used) can reduce deaths among infants by approximately 70% and small children by 54% 80%;2 Whereas, Booster seats reduce the risk of serious injury for children aged four to eight years by 45% compared to seat belts alone, and seat belt use reduces the risk of serious injury and death for older children by almost half;3 Whereas, Even though the number of children killed in motor vehicle crashes in the United States declined between 2002 and 2011, an additional 800 would have been saved if all children aged four and under had been in car seats;4 Whereas, Since 2002, most states have increased the required age for child safety seat/booster seat use, but there are significant differences between individual states. It is unrealistic to think families on a cross country road trip would be aware of the different laws in each state. More importantly, the laws of physics and crash dynamics are the same in all states;5 Whereas, Evidence based recommendations include the use of belt positioning booster seats for most children through eight years of age, yet only two states (Tennessee and Wyoming) have laws requiring child safety seats/booster seats for children through age eight;4 Whereas, Only four states (CA, NJ, PA, OK) require children younger than two years to be in a rear facing child seat, and two states lack booster seat laws altogether (FL, SD);5 and Whereas, Primary seatbelt laws allow law enforcement to stop a vehicle and issue citations whenever an unbelted or unsecured driver or passenger is observed,5 secondary seat belt laws require a separate primary violation to occur before the vehicle can be stopped. Resolved, That ENA, in conjunction with other stakeholders, explore a consensus statement advocating for one set of national guidelines or standards relating to child safety restraints that align with evidence based best practice; and Resolved, That ENA advocate for child safety restraint laws in states that do not have current primary child passenger restraint laws General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

38 Page 38 GA17-02 Resolution Resolution Background Information: For current highway safety laws by state, please refer to the following link: content/uploads/2016/01/2016 Roadmap Report FINAL.pdf. Motor vehicle crashes are a leading cause of death for American children aged five to 14. Every day in 2013, an average of three children under age 14 was killed and 471 injured in motor vehicle crashes in the U.S.6 The best way to protect children aged 12 and under from risks posed by air bags is to place them in the back seat, restrained by a child safety seat, booster seat or safety belt, as appropriate.6 For older children, seat belt use reduces the risk of serious injury and death by about half.3 In 2012, there were 298 passenger vehicle occupant fatalities among children aged four or younger, and of those, where restraint use is known, 31% were totally unrestrained. In the same year, the lives of more than 280 children four and under were saved by child passenger restraints.7 To date, 48 states and the District of Columbia (DC) have enacted primary enforcement booster seat laws. However, only 31 of those states and DC have laws that provide protection for children aged four to at least seven, as recommended by advocates including the National Traffic Safety Board (NTSB) and the National Highway and Traffic Safety Administration (NHTSA).6 Per NHTSA, properly used child safety seats reduce fatal injuries in passenger cars by 71% for infants and 54% for toddlers. Using a booster seat with a seat belt instead of a seat belt alone reduces a child s risk of injury in a crash by 59% according to Partners for Child Passenger Safety, a project of Children s Hospital of Philadelphia and State Farm Insurance.6 While NHTSA is responsible for approving the standards for manufacturing child passenger restraints, state laws govern how child passenger restraints are enforced. Infants and children in all vehicles should be covered by enforceable safety belt laws or child safety seat laws.8 However, differences in the wording of the various state laws result in many children being left unprotected. In Nebraska and Ohio, some children are left at risk because of a secondary enforcement law. In Nebraska, the primary law is applicable to children that must ride in a child safety seat; however, for children allowed to be placed in a seat belt, enforcement is a secondary law. In Ohio, children from four to 14 are protected by secondary enforcement only.9 Amended legislation has closed gaps, but the law completely neglects some groups of children including: 15 year old rear seat passengers in Arkansas, Alabama and Ohio; children aged seven and older riding in the rear seat in Mississippi; and children aged nine or older under 4 feet 9 inches travelling in the rear seat in Oklahoma.9,10 In the other 45 states and the District of Columbia, children under the age of 16 are protected by either primary or secondary laws.10 Wyoming uses only age in regulation of child passenger safety (IIHS, 2017). Of note, crash data from 2015 show Wyoming was the state with the highest motor vehicle crash mortality rate for all ages at 24.7 per 100, General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

39 Page 39 GA17-02 Resolution According to the IIHS, expanded child restraint laws covering children through age seven are associated with: a 5% reduction in all injuries; a 17% reduction in incapacitating or fatal injuries; a 300% increase in the use of appropriate child restraints; and a 6% increase in the number of booster seat aged children seated in the rear of the vehicle where they are better protected.12 The Child Passenger Restraint Systems Act of Washington State (later known as The Anton Skeen Act) was passed in 2000 to address child passenger safety and was soon echoed by other states.13 Anton's Law was a federal law passed December of 2002 calling for strengthened child passenger safety protections in motor vehicles. It also required the development of a crash dummy the size of a 10 year old child to be used in testing of child restraints in motor vehicles, as well as the installation of lap and shoulder belt assemblies for each designated seating position in motor vehicles.14 We know that boosters should be used by children until aged 8 10 and that appropriate fit in adult lap and shoulder belts is what determines safety, not the state legislature. The laws of physics say most children need a booster to make lap and shoulder belts fit properly. Traffic safety groups agree that a strong child passenger safety law should: Cover all children up to age 16 in all seating positions Be primary enforcement Require all children to be in age and size appropriate restraint systems (infant, child safety seat, booster seat) Require children younger than 13 to be properly secured in rear seats (provided the vehicle has them) unless all available rear seats are in use by children younger than 13 Apply to all vehicles equipped with seat belts; no vehicles (such as pickup trucks, taxis, or rental cars) should be exempt Make the driver responsible for restraint use by children under 16, regardless of the relationship to the child Allow passengers to ride only in seating areas equipped with seat belts and prohibit passengers in the cargo areas of pickup trucks Assure children with special needs use proper restraints Contain no exemptions, such as: allowing children to be unsecured if all seat belts are in use; attending to the personal needs of the child; medical waivers; out of state vehicles; and/or drivers who are not the vehicle owner or who are not related to the child.5 Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: The ENA vision statement includes being a leading influential voice on emergency health care policy and regulatory issues and collaborating with other healthcare partners to promote injury prevention and patient and community safety General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

40 Page 40 GA17-02 Resolution The mission of ENA is to advocate for patient safety and excellence in emergency nursing practice. The purpose of this resolution is to advocate for and support across the board standards and guidelines for car safety seat laws for children in the US.16 Financial Considerations/Operational Impact: A stakeholder meeting would need to be held at an approximate cost of $2,500 $8,000. ENA Government Relations time and resources would be required to effectively advocate, in conjunction with ENA state council leaders, that child restraint laws be primary seat belt laws in all states. This would be an approximate cost of $4,975. Professional References: 1. Centers for Disease Control and Prevention. (2016). Child passenger safety. Retrieved from 2. Emergency Nurses Association. (2016). Child vehicle restraint systems (safety seats): When to reuse and when to dispose. Retrieved from research/practice/documents/childsafetyseat.pdf 3. Sauber Schatz, E. K., West, B. A., & Bergen, G. (2014). Vital signs: Restraint use and motor vehicle occupant death rates among children aged 0 12 years United States, Morbidity and Mortality Weekly Report, 63(5), Centers for Disease Control and Prevention. (2014). Child passenger safety infographics. Retrieved from 5. Governors Highway Safety Association. (2016). Child passenger safety. Retrieved from laws/issues/child%20passenger%20safety 6. Advocates for Highway and Auto Safety. (2017). Child passenger safety. Retrieved from PASSENGER SAFETY/ 7. U.S. Department of Transportation, National Highway Traffic Safety Administration. (2014). Traffic safety facts Retrieved from omkht4raroqfggqmai&url=https%3a%2f%2fcrashstats.nhtsa.dot.gov%2fapi%2fpublic%2fpublication% 2F812261&usg=AFQjCNHi_TOLUKj0ZCGFgtTrt 4YYP9_Wg&cad=rja 8. American Automobile Association. (2014). Car seat guide. Retrieved from seat guide/ 9. Insurance Institute for Highway Safety. (2017). Safety belts. Retrieved from General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

41 Page 41 GA17-02 Resolution Advocates for Highway and Auto Safety. (2016). Missing: Have you seen these highway safety laws? Retrieved from content/uploads/2016/01/2016 Roadmap Report FINAL.pdf 11. Insurance Institute for Highway Safety. (2016). General statistics. Retrieved from statistics/fatalityfacts/overview of fatality facts 12. Colella, J. (2011). CR laws increase use, decrease injuries: New study analyzes pre and post booster seat law crash data in five states. Safe Ride News, 29(6). Retrieved from The Anton Skeen Act. Wa. RCW (2000) (enacted). Retrieved from Anton s Law, H.R. Res , 107th Cong., 116 Cong. Rec (2002) (enacted). Retrieved from 107publ318.pdf 15. Emergency Nurses Association. (2015). ENA has 2020 vision: Emergency Nurses Association five year strategic plan Retrieved from Emergency Nurses Association. (2014). Bylaws: Emergency Nurses Association. Retrieved from Author(s): Amy Boren, MS, BSN, RN, CEN, CPEN Eric Christensen BSN, RN, CEN, CPEN Rose Johnson RN, FAEN Deborah Skeen, BSN, RN, CEN, CPEN Deb Spann RN BC, CEN Supporter(s): Colorado ENA State Council, Sharon Schultz, president Louisiana ENA State Council, Donelle Brasseal, president 2017 General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

42 Page 42 GA17-03 Resolution TITLE: Public Access to Bleeding Control Kits Whereas, Uncontrolled external bleeding is a major cause of preventable death in traumatic injury (Bulger et al, 2014); Whereas, Bystander control of bleeding can significantly influence survival of someone with traumatic injury (American College of Surgeons, 2015); Whereas, Control of hemorrhage is easily and rapidly accomplished with minimal resources (U.S. Department of Homeland Security, 2016); Whereas, Bystander education is a Department of Homeland Security national priority (Department of Homeland Security, n.d.); Whereas, Death from hemorrhage is preventable with appropriate preparation and education (Levy & Jacobs, 2016); Whereas, Bleeding control kits should be provided for public access in all areas where lifesaving equipment is currently located, such as where automated defibrillators are housed (Jacobs & Joint Committee, 2015); Whereas, Our nation s threat from intentional mass casualty events is high; therefore, there are potential opportunities in the prehospital sector for bystander interventions to control external hemorrhage (Jacobs & Joint Committee, 2015); Whereas, A person involved in a traumatic event can exsanguinate in 5 minutes or less; it is essential to have the right equipment easily accessible to help prevent the loss of life (Taillac, 2014); Whereas, Ready access to tourniquets and other hemorrhage control materials, in addition to education would provide the public with a means of assisting in a case of uncontrolled bleeding (Levy & Jacobs, 2016); Whereas, Focusing on the management of uncontrolled bleeding provides an opportunity to impart knowledge from military medicine to our citizens, enabling them to perform simple but important actions that can significantly increase a trauma victim s chance of survival (Jacobs & Joint Committee, 2015); and Whereas, Immediate responders trained in hemorrhage control will not remain bystanders, while waiting for emergency medical services to arrive at the scene of a traumatic injury. Actions taken by those responders can prevent death by exsanguination (Levy, 2016). Resolved, That ENA issue a position statement or topic brief in support of public access to bleeding control kits and bystander education; 2017 General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

43 Page 43 GA17-03 Resolution Resolved, That ENA continue to promote awareness of this need and the benefit of provision; and Resolved, That ENA advocate for public access to the education and equipment necessary for hemorrhage control, and endorse bystanders acting as immediate responders General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

44 Page 44 GA17-03 Resolution Resolution Background Information: Death will result from uncontrolled hemorrhage if response is delayed. Uncontrolled bleeding is recognized as the prime cause of avoidable death in victims that experience penetrating traumatic injury (U.S. Department of Homeland Security, 2015b). Bystander education in control of external bleeding is a goal of many respected organizations, such as the American College of Surgeons Committee on Trauma, the Department of Defense, and the Department of Homeland (Department of Homeland Security, n.d.). Educational courses are available from these entities at low or no cost and are easily disseminated; however, support is needed for this education as well as pathways for the provision of bleeding control kits in public access areas. Advocates for the wider application of bleeding control measures encourage inclusion of the public in strategic planning, referring to the success of life saving measures following the Boston bombing event. Preplanning meant trained bystanders with bleeding control supplies were strategically placed all along the route. Review of this type of mass casualty event supports this strategy based on evidence that early hemorrhage control improves survival rates (Jacobs, 2013). Any person can be trained to respond in a bleeding emergency. Supplies for bleeding control kits should be purchased from a reputable company and can be costly. Collaboration between agencies and entities can streamline the process of procurement and placement, ensuring that public access to hemorrhage materials and education in bystander hemorrhage control is fully integrated into the emergency response plans for a community. Presidential Policy Directive 8 (U.S. Department of Homeland Security, 2015a) supports efforts towards a sharing of responsibility between all levels of governing bodies, public and private business, and the community. The value of including individual citizens in preparedness must not be overlooked; rather, the import of this component must be acknowledged and given greater prominence (Jacobs, 2013). Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: The ENA vision statement highlights the organization s commitment to partner in efforts promoting community safety. This resolution supports research, development, and promulgation of education programs and provides resources from ENA to actively engage citizens. ENA s visibility is increased by a focus on an evidence based response to community safety concerns. Finally, it will continue the promotion of ENA as a primary provider of leadership, education, and research in matters of public health and safety. Financial Considerations/Operational Impact: ENA previously attended a White House event on this topic in April, 2015 and information was disseminated in ENA publications. A link to the campaign is also available on the ENA website. Development of a position statement or topic brief would range from $4000 $13,500. ENA Government Relations time and resources would be required to effectively advocate at the federal level in favor of public access to education and the availability of necessary equipment for hemorrhage control and to endorse bystanders to act as immediate responders. This would be an approximate cost of $4, General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

45 Page 45 GA17-03 Resolution Professional References: American College of Surgeons. (2015). ACS partners with NAEMT for a civilian training course on hemorrhage control techniques. Retrieved from releases/2015/naemt0715 Bulger, E. M., Snyder, D., Schoelles, K., Gotschall, C., Dawson, D., Lang, E.,... McSwain, N. (2014). An evidence based prehospital guideline for external hemorrhage control: American College of Surgeons Committee on Trauma. Prehospital Emergency Care, 18(2), doi: / Department of Homeland Security. (n.d.). Become empowered: Learn how to stop the bleed. Retrieved from learn how stop bleed Jacobs, L. M., & Joint Committee to Create a National Policy to Enhance Survivability from Intentional Mass Casualty and Active Shooter Events. (2015). The Hartford Consensus III: Implementation of bleeding control. Bulletin of the American College of Surgeons, 100(7), Retrieved from hartford consensus iii implementation of bleeding control Jacobs, L. M., McSwain, N., Rotondo, M., Wade, D. S., Fabbri, W. P., Eastman, A.,... Joint Committee to Create a National Policy to Enhance Survivability from Mass Casualty Shooting Events. (2013). Improving survival from active shooter events: The Hartford Consensus. Journal of Trauma and Acute Care Surgery, 74(6), doi: /ta.0b013e318296b237 Kue, R. C., Temin, E. S., Weiner, S. G., Gates, J., Coleman, M. H., Fisher, J., & Dyer, S. (2015). Tourniquet use in a civilian emergency medical service: A descriptive analysis of the Boston EMS experience. Prehospital Emergency Care, 19(3), doi: / Levy, M. J. (2016). Public access bleeding control: Enhancing local resilience. Prehospital and Disaster Medicine, 31(3), doi: /s x Taillac, P. P. (2014, September). Stop the bleeding: New external hemorrhage control evidence based guideline. Journal of Emergency Medical Services, Suppl Retrieved from external hemorrhage control evidence.html U.S. Department of Homeland Security. (2015a). Presidential policy directive / PPD 8: National preparedness. Retrieved from policy directive 8 national preparedness U.S. Department of Homeland Security. (2015b). The first responder guidance for improving survivability in improvised explosive device and/or active shooter incidents. Retrieved from shooter guidance first responders U.S. Department of Homeland Security. (2016). Stop the bleed. Retrieved from General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

46 Page 46 GA17-03 Resolution Levy, M. J., & Jacobs, L. M. (2016, December). A call to action to develop programs for bystanders to control severe bleeding. JAMA Surgery, 151(12), Author(s): Deborah Spann, ADN, RN, CEN, RN BC Michael Gary, ADN, RN Donelle Brasseal, MSN, RN Supporter(s): Roy Barker Leslie Batson Karen Caruso Susan Cash Jan Corcoran Taylor Hinson Courtney Marbley Dawn McKeown Pam Pourciau Evelyn Prejean Karen Silady Anna K. Vaughn Arkansas ENA State Council, Dana Bell, president Colorado ENA State Council, Sharon Schultz, president Kentucky ENA State Council, Anna Cecil, president Louisiana ENA State Council, Donelle Brasseal, president Missouri ENA State Council, Sharon Trumbly, president New Jersey ENA State Council, Dawn Specht, president Oregon ENA State Council, Pam Bessler, president Rhode Island ENA State Council, Michelle Bargteil, president 2017 General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

47 Page 47 GA17-04 Resolution TITLE: Against Human Trafficking Whereas, Human trafficking is often referred to as modern day slavery and involves the use of force, fraud, or coercion to obtain some type of labor or commercial sex act. Human trafficking is the largest and fastest growing multi billion dollar criminal enterprise and the second largest criminal industry in the world, after drug trafficking. Human trafficking is problematic in all 50 states and the District of Columbia affecting every race and ethnicity; Whereas, The average age of entry of victims into the commercial sex industry is years old and as young as 7 years old, both male and female. Human trafficking victims of any age are often beaten, threatened, tortured, starved, drugged, and manipulated into cooperating; Whereas, The US state department estimates over 77 thousand identified victims worldwide in while the National Human Trafficking Hotline reports a 2016 conservative estimate of over 7,500 identified victims in America2, presenting a challenge to emergency care delivery; Whereas, The Code of Ethics for Nurses identifies not only the provision to promote, advocate, and protect the rights, health, and safety of patients, but also to advance the profession through professional standard development3; and Whereas, Emergency nurses are among the few professionals most likely to interact with these victims while they are still being controlled/held by their traffickers. ENA s existing position statement on human trafficking states emergency nurses play a vital role in recognizing and responding to the needs of victims and are proactive in educating staff vulnerabilities for victimization and signs of victimization.4 Resolved, That ENA revise the existing position statement on Human Trafficking Patient Awareness in the Emergency Setting to support efforts to prevent and eliminate human trafficking exploitation and to update resource hyperlinks; Resolved, That ENA collaborate with stakeholder organizations in the development and dissemination of resources enhancing the recognition and overall safety of victims of human trafficking; Resolved, That ENA provide resources to inform and educate members in the recognition of psychosocial and physical characteristics of human trafficking victims including provision of educational resources to counteract victims stigmatization and criminalization; and Resolved, That ENA include evidence based resources related to identification, safe intervention, and education of victims about rights and opportunities while complying with state laws regarding mandatory reporting of underage victims into the next revision of ENA educational resources, such as ENPC, TNCC, ENA Online Orientation, or Emergency Nursing Core Curriculum General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

48 Page 48 GA17-04 Resolution Resolution Background Information: In September 2014, H.R. 5411, titled Trafficking Awareness Training for Health Care Act of 2014, was introduced to the 113th US Congress.5 This legislation highlights and brings to the forefront the imminent need for the training and education in human trafficking that is currently lacking for healthcare professionals.5 Of the more than 11,800 endangered runaways reported to the National Center for Missing and Exploited Children in 2016, one in six were likely victims of child sex trafficking.6 While the majority of victims of human trafficking are found within the sex industry, they are also found in sweatshops, agricultural industries, and domestic servitude.7 10 The victims often require treatment for sexually transmitted infections, are likely to have higher rates of pregnancy, and are at risk for various other physical and mental health conditions.7,10,11 12 Approximately 54.7% of trafficking survivors present with posttraumatic stress symptomatology, and of those, 41.5% report having attempted suicide at least once.13 The 3P paradigm prosecution, protection, and prevention continues to serve as the fundamental framework used around the world to combat human trafficking. In addition, a fourth P partnership serves as a complementary means to achieve progress across and ensure enlistment from within all segments of society in the fight against modern slavery.14 CdeBaca & Sigmon recommend healthcare professionals receive training with focus on recognizing trafficking signs, interviewing techniques, and recommended responses when a victim is identified.15 The authors further state human trafficking can be positively impacted by early identification which helps restore physical and mental health of the victim. Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: ENA Bylaws, Mission, Vision, and Strategic Initiatives are centered in Safe Practice and Safe Care. Additionally, a 2015 ENA Position Statement acknowledging that emergency nursing plays a vital role in responding to the needs of human trafficking victims ensuring their safety, reducing further harm, educating staff, and collaborating with other disciplines in the safe practice and safe care of human trafficking victims. Despite how new the position statement is, many links in the Resources section of the statement are already inactive, a testament to how rapidly information is changing as new evidence is being discovered. While other elements of ENA s Strategic Plan may apply, this resolution primarily addresses knowledge, through encouragement of translation of evidence into nursing practice, and addresses quality and safety through expanding advocacy to include global recognition of ENA as the authoritative voice for safe practice, safe care in emergency nursing.16 ENA has an opportunity to truly be the global emergency nursing resource and advocate for Safe Practice of emergency nurses recognizing and providing Safe Care for this growing vulnerable, and often unrecognized population General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

49 Page 49 GA17-04 Resolution Financial Considerations/Operational Impact: The overall cost is approximately $18,000 including revision of the existing position statement and collaboration with stakeholder organizations which may include development of infographics, a topic brief or an elearning program. Professional References: 1. US Department of State (2016, June). Trafficking in Persons Report. Retrieved from 2. National Human Trafficking Hotline. (2016). Hotline Statistics. Retrieved from 3. Lachman, V. D., Swanson, E. O., & Winland Brown, J. (2015). The new Code of Ethics for Nurses With Interpretive Statements (2015): practical clinical application, part II. MedSurg Nursing, 24(5), Emergency Nursing Association. (2015). Position Statement: Human Trafficking Patient Awareness in the Emergency Setting. Retrieved from research/practice/position/pages/humantrafficking.aspx 5. Chon, K. (2014). Trafficking Awareness Training for Health Care Act, a bill to provide training for health providers who care for human trafficking victims. Retrieved from the U.S. Department of Health and Human Services website: 6. National Center for Missing and Exploited Children, 7. Ahn, R., Alpert, E. J., Purcell, G., Konstantopoulos, W. M., McGahan, A., Cafferty, E., Burke, T. F. (2013). Human trafficking: Review of educational resources for health professionals. American Journal of Preventive Medicine, 44(3), doi: /j.amepre Chisolm Straker, M., Richardson, L. D., & Cossio, T. (2012). Combating slavery in the 21st century: The role of emergency medicine. Journal of Health Care for the Poor and Underserved, 23(3), doi: /hpu Mulvihill, N. (2014). Human trafficking: look around it s in our own backyard. Health Progress, 95(2), Richards, T. A. (2014). Health implications of human trafficking. Nursing for Women s Health, 18(2), doi: / X. 11. Peters, K. (2013). The growing business of human trafficking and the power of emergency nurses to stop it. Journal of Emergency Nursing, 39(3), doi: /j.jen General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

50 Page 50 GA17-04 Resolution Clawson, H. J., Dutch, N., Solomon, A., & Goldblatt Grace, L. (2010). Human trafficking into and within the United States: A review of the literature. Retrieved from the U.S. Department of Health and Human Services website: Lederer, L. J., & Wetzel, C. A. (2014). The health consequences of sex trafficking and their implications for identifying victims in healthcare facilities. The Annals of Health Law, 23(1), US Department of State (2016, June). 3Ps: Prosecution, Protection, and Prevention Retrieved from CdeBaca, L. & Sigmon, J.N. (2014) Combating trafficking in persons: a call to action for global health professionals. Global Health: Science and Practice 2(3): D Retrieved from Emergency Nurses Association. (2015). ENA HAS 2020 VISION Emergency Nurses Association Five Year Strategic Plan Retrieved from Author(s): Cheryl MacDonald Sweet, BS, RN, CEN, CPEN Tami Wheeldon, BSN, RN, CEN Carla Brim, MN, RN, ARNP, CNS, CEN, PHCNS BC, FAEN Andi Foley, DNP, RN, CEN, AACNS AG Kathy Robinson, BS, RN, FAEN Supporter(s): Katie Bush, MSN, RN, CEN, SANE A Diane Gurney, MS, RN, CEN, FAEN Adam Weeks, MSN, RN, ARNP, CEN, CCRN, FNP BC, SANE A Pennsylvania ENA State Council, CherylAnn MacDonald Sweet, president Washington ENA State Council, Andi Foley, president 2017 General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

51 Page 51 GA17-05 Resolution TITLE: Establishing a Standard for Emergency Department Preparedness to Care for Children Whereas, A national assessment of pediatric readiness in the nations emergency departments in 2003 was not comprehensive and demonstrated relatively poor pediatric readiness with a reported weighted pediatric readiness score of 55;1 Whereas, Day to day emergency department readiness to care for children effects disaster planning and response and patient safety; Whereas, ENA co authored the joint policy statement Guidelines for Care of Children in Emergency Departments (guidelines) with the American Academy of Pediatrics (AAP) and the American College of Emergency Physicians (ACEP) and is currently engaged in the revision of the joint statement; Whereas, The National Pediatric Readiness Project (NPRP) based on the 2009 guidelines provided ED leaders with a weighted readiness score and gap analysis to identify opportunities for improvement. 84% of over 5000 hospitals competed the assessment; Whereas, The NPRP demonstrated 87% of children seen in emergency departments nationwide are seen in general ED s in community hospitals, not in specialty children s hospitals, and 27% of all annual ED visits are pediatric related accounting for 31 million children and adolescents with different clinical presentations and needs than adults;9 Whereas, ENA played a key role in encouraging hospital ED nurse leaders to participate in the NPRP assessment through the efforts of its national and state pediatric committees; Whereas, ENA is a partner in the EMS for Children Innovation and Improvement Center Facility Recognition QI Collaborative which includes 14 states; Whereas, The evidence demonstrates in states with pediatric facility recognition programs, pediatric readiness scores are higher;3 Whereas, The AAP and ACEP demonstrated in 2005, the presence of a champion improves emergency department readiness to care of children;1 and Whereas, The 2006 Institute of Medicine, emergency care for children: growing pains identified gaps in care for pediatric patients in the nations ED s and recommended that hospital ED s should have 2 pediatric emergency care coordinators, one a physician. Resolved, That ENA write a position statement recognizing the most current AAP/ACEP/ENA joint policy statement Guidelines for Care of Children in the Emergency Department as the ED preparedness standard of care for hospitals and free standing emergency departments; 2017 General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

52 Page 52 GA17-05 Resolution Resolved, That ENA develop a position statement that every ED designate a nurse Pediatric Emergency Care Coordinator (PECC) or incorporate the job duties of the PECC into an existing job description in all emergency departments that care for children; Resolved, That ENA disseminate the work of the EMS for Children Innovation and Improvement Center (EIIC) to support pediatric readiness and to improve pediatric care quality; and Resolved, that ENA disseminate resources developed by EIIC's Facility Recognition QI Collaborative as a basis for expanding these programs across the country General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

53 Page 53 GA17-05 Resolution Resolution Background Information: An EMS for Children grant in 2003 funded an AAP/ACEP project to disseminate a toolkit developed to assist hospital ED s to improve their hospital readiness score to care for children. An important outcome of the project demonstrated the presence of a pediatric champion in the emergency department was the single most important factor influencing the ED s readiness to care for children. (Gausche Hill/Lewis). In 2006, the IOM report on the future of emergency care in the US healthcare systems pointed out that an increase in ED volumes and a decrease in the number of ED s led to crowding, boarding of patients awaiting inpatient bed availability and frequent diversion of ambulances which effects access to emergency care especially for children8. The IOM report emergency care for children growing pains called the state of pediatric emergency care in the US uneven with some hospitals well prepared but many others challenged by the lack of resources or personnel to care for children. The report also recommended that hospitals should appoint two pediatric emergency care coordinators one a physician to provide leadership for the organization.9 As ENA members, we know that the responsibility for emergency department preparedness in terms of staff competency, policy and procedure development, equipment and supply procurement quality improvement, disaster planning and staff education lies firmly under the auspices and in the job description of the emergency nurse leader. Identifying a pediatric champion in each and every ED in the country will meet the intent of the IOM recommendation for one of two pediatric emergency care coordinators. This responsibility may demonstrate the need for a full time FTE depending on the ED s pediatric patient volume. The role may mean additional job duties in an existing job description where pediatric patient volumes are lower. The Joint Policy Statement: Guidelines for care of Children in the Emergency Department published in 2009 was co authored by the AAP, ACEP and ENA. An accompanying four page checklist was developed to simplify the process of assessing the ED for pediatric readiness. Because pediatric readiness still needed significant improvement, a coalition of stakeholders was convened in 2011 to develop a comprehensive assessment that would provide an opportunity for ED leaders to look at their ED s based on the Guidelines Checklist. The checklist was developed and cobranded by the AAP/ACEP/ENA and the EMS for Children program. The checklist was incorporated into the 4th edition of ENA s Emergency Nursing Pediatric Course. A pilot assessment was conducted in the state of California with 90% of hospitals participating. 93% of the assessments were competed by nurse leaders. California has had a voluntary facility recognition program in place at the county level throughout the state for many years. Emergency Departments approved for Pediatrics (EDAP) has been the model pediatric facility recognition program for the nation. Illinois, Arizona, Tennessee, Montana and other states have implemented facility recognition programs. Pediatric Readiness scores in California hospitals with EDAP programs were found to be higher than those in non EDAP hospitals. (Remick) The 2013 National Pediatric Readiness Project, (NPRP) rolled out nationwide, was a public health initiative developed to promote pediatric readiness in the U.S. and eight U.S. territories. The 55 question, web based assessment, which measured compliance with the guidelines, was sent to 5,017 ED s. More than 4,100 (83%) ED leaders responded to the assessment. The overall weighted pediatric readiness score was 68.9 on a 100 point scale, up from 55 in General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

54 Page 54 GA17-05 Resolution In April 2015, a group of stakeholders was convened in Washington, DC, to begin to plan for next steps in pediatric readiness. As one of three main partners, AAP/ACEP and ENA, we conducted focus groups to build on the idea of state champion teams to move pediatric readiness forward at the state level. The ENA Board agreed to fund a pilot meeting to bring the EMS for Children state managers and a representative of ENA from each of the five pilot states to Des Plaines to develop a plan for building state champion teams. AAP and ACEP funded their national representatives to the meeting which was held in Nov The goal of the project was to identify ENA, AAP and ACEP champions in those states to help move pediatric readiness ahead. In 2016, ENA joined the EMS for Children Innovation and Improvement Center (EIIC) in partnership with the AAP, ACEP and National Association of EMS Physicians. ENA s primary involvement to date has been as a partner in the EIIC Facility Recognition QI Collaborative. 14 states including all of the initial state champion pilot states were originally invited to participate in the collaborative. The EIIC, using quality improvement science, has worked with the state teams to identify opportunities for moving facility recognition ahead in their states. Quality Improvement Coaches are assigned to each state to help facilitate their progress. The collaborative is funded through Dec. of The full support of ENA for the role of the pediatric emergency care coordinator at the department level would help nurse leaders justify the role and in turn improve their ability to comply with the Guidelines and attain a higher pediatric readiness score. Studies to show that improved readiness improves patient outcomes are underway and preliminary results are promising. Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: The mission of the Emergency Nurses Association (ENA) is to advocate for patient safety and excellence in emergency nursing practice. Financial Considerations/Operational Impact: In 2016, ENA became a partner in the Emergency Medical Services for Children (EMSC) Innovation and Improvement Center (EIIC). In addition, in April 2016, HRSA and the EMSC (EIIC) partnered to support a pediatric medical facility recognition quality improvement collaborative. ENA is participating as a stakeholder organization in this initiative. The collaborative efforts of these partnerships support the resolved clauses; therefore, having no additional financial impact. Professional References: 1. Gausche Hill, M., Schmitz, C., & Lewis, R.J. (2009) Pediatric preparedness of United States emergency departments: A 2003 survey. Pediatrics, 120(6), CHECKLIST: Guidelines for Care of Children in the Emergency Department, Produced by the AAP, ACEP, ENA, the EMSC National Resource Center and Children s National Medical Center.Sep 21, General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

55 Page 55 GA17-05 Resolution A National Assessment of Pediatric Readiness of Emergency Departments, Marianne Gausche Hill, MD; Michael Ely, MHRM: Patricia Schmuhl, BA; Russell Telford, MA; Katherine E. Remick, MD; Elizabeth A. Edgerman, MD, MHP; Lenora M. Olson, PhD, MA. Apr 13, Next Steps to Improve Pediatric Readiness, Sally K. Snow, BSN, RN, CPEN, FAEN, ENA Connection March/April, Pediatric Readiness and Facility Verification. Katherine Remick, MD; Amy H. Kaji, MD, PhD; Lenora Olson, PhD, MA; Michael Ely, MHRM; Patricia Schmuhl, BA; Nancy McGarth, RN, MN; Elizabeth Edgerton, MD, PhD; Marianna Gausche Hill, MD. Annals of Emergency Medicine, Volume NO: Emergency Medical Services for Children and the Institute of Medicine Revisited, Joseph L. Wright, MD, MPH; Apr 3, Talking Points National Assessment of Pediatric Readiness of Emergency Departments. Marianne Gausche Hill, MD, et al 8. EMS for Children Program: History, Lifespan and Success Celebrating the 30th year. Joseph L Wright, MD, MPH, Marianne Gausche Hill, MD Schenk, Ellen et al. Annals of Emergency Medicine, Volume 65, Issue 6, (June 2015) 10. Institute of Medicine, Committee of the Future of Emergency Care in the US Health System. Hospital Based Emergency Care at the Breaking Point. Washington DC: National Academy Press; Institute of Medicine. Committee of the Future of Emergency Care in the US Health System. Emergency Care for Children: Growing Pains. Washington, DC: National Academy Press; 2006 Author: Barry F Hudson, RN, BSN, CPEN 2017 General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

56 Page 56 GA17-06 Resolution TITLE: Develop an Emergency Department Geriatric Readiness Survey and Toolkit Whereas, In the US, the geriatric population is the fastest growing sector of the population by a factor of 3;1,2 Whereas, Emergency department visits by geriatric patients will increase from the current 16% of the total to 24% by 2020;3 Whereas, Over 57% of elderly patients were categorized by triage as high priority compared with 35% of younger patients;3 Whereas, The geriatric population represents 43% of emergency department admissions and has longer lengths of stay;4 Whereas, The current emergency management model may not be adequate for geriatric care; 5 and Whereas, Older adults have multiple co morbidities, multiple medications, and complex physiologic changes that defines this population as a special needs group requiring specific considerations.7 Resolved, That ENA develop a national survey to assess the readiness of emergency departments to care for the geriatric patient; Resolved, That ENA develop a Geriatric Readiness Toolkit based on the Geriatric Emergency Department Guidelines; Resolved, That ENA provide ED leaders with a weighted readiness score and gap analysis to identify opportunities for improvement; and Resolved, That ENA develop a strategic plan for a voluntary recognition program for emergency facilities prepared for geriatric care General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

57 Page 57 GA17-06 Resolution Resolution Background Information: Emergency departments around the United States have to deal with increasing numbers of patients. Although there are regional variations, all are experiencing increasing numbers of geriatric patients in recent years.8 Geriatrics (those over 65) are increasing both in number and as percentage of the US population and will amount to an estimated 89 million or one in every 5 Americans by Current emergency departments may not have adequate management models for the complex considerations of the geriatric patient.5,6 Some have even suggested that the geriatric population should not seek care in the emergency departments.6 Despite this, geriatric patients will continue to show up in increasing numbers. The number of Americans over 65 [is] projected to be 89 million by and visits will be one fourth (25%) of all ED visits. In 2010 this population was almost 35 million, by 2020 it is projected to be greater than 54 million.11 In 2013, a Geriatric Emergency Department Task Force was organized by ENA, American College of Emergency Physicians, Society for Academic Medicine and The American Geriatrics Society and published the Geriatric Emergency Department Guidelines.4 This is a useful tool with which emergency departments can assess their readiness to properly care for the geriatric patient. The guideline could be the basis for a standard of geriatric care for emergency departments. Each department could determine its own inadequacies and identify the improvements needed. Once guidelines are met, individual departments could volunteer to be recognized as prepared for the care of geriatric patients. This resolution proposes that ENA, in collaboration with other organizations, develop a geriatric care preparedness toolkit for emergency department leaders to determine a weighted readiness score for their facilities and perform a gap analysis to identify areas for improvement. Departments that go through the process could be recognized on a volunteer basis. Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: The mission of the Emergency Nurses Association (ENA) is to advocate for patient safety and excellence in emergency nursing practice. Financial Considerations/Operational Impact: ENA is in the first year of a two year foundational phase grant, Developing a Geriatric Emergency Department Collaborative, a proposal from the American Geriatrics Society (AGS), to Improve Emergency Department Care of Older Adults, funded in part by the John Hartford Foundation. This has been designed to be a planning grant that will engage a small group of healthcare systems to explore feasibility and to engage in the development of a foundation for the long term goals of improving geriatric emergency care. Several outcomes have been identified, including once aimed at building evidence that the Geriatric ED guideline based care improves patient outcomes and is cost effective. Through collaborators such as ENA, the grant will lay the groundwork for a Geriatric Emergency Care Alliance. Staff time for development of a survey and staff analysis is the approximate cost of $4,000. Total estimated costs of this initiative are $22,020. Project duration is estimated at 2 years General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

58 Page 58 GA17-06 Resolution Professional References: 1. Ortman, J. M., Velkoff, V. A., & Hogan, H. (2014). An aging nation: The older population in the United States. Retrieved from the United States Census Bureau website: pdf 2. U.S. Census Bureau. (n.d.) Census data. Retrieved from 3. Fayyaz, J., Khursheed, M., Umer Mir, M., & Khan, U. (2013). Pattern of emergency department visits by elderly patients: Study from a tertiary care hospital, Karachi. BMC Geriatrics, 13, 83. doi: / American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, Society for Academic Emergency Medicine, Geriatric Emergency Department Guidelines Task Force. (2014). Geriatric emergency department guidelines. Annals of Emergency Medicine, 63(5), e7 e25. doi: /j.annemergmed Boltz, M., Parke, B, Shuluk, J., Capezuti, E., & Galvin, J. E. (2013). Care of the older adult in the emergency department: Nurses views of the pressing issues. The Gerontologist, 55(3), doi: /geront/gnt Chen, P. W. (2014, March 13). Emergency rooms are no place for the elderly. The New York Times. Retrieved from rooms are no place for the elderly/?_php=true&_type=blogs&ref=health&_r=0 7. Wilber, S. T. (2012). Geriatric Emergency Medicine. Retrieved from the American Geriatrics Society website: 8. Samaras, N., Chevalley, T., Samaras, D., & Gold, G. (2010). Older patients in the emergency department: A review, Annals of Emergency Medicine, 56(3), doi: /j.annemergmed 9. Wood, D. (2013, February). Geriatric EDs: The next trend in emergency medicine? AMN Healthcare News. Retrieved from healthcare news/geriatric eds next trend emergency medicine/ 10. Savenije, David, Muchmore, Shannon (2017, Healthcare DIVE) Growth in the number of geriatric Eds expected pcmaricon. (2017 Geriatric Emergencies power point: Author(s): Barry F. Hudson, RN, BSN, CPEN Valerie C. Brumfield, MSN, RN, CNS, CCRN, CEN 2017 General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

59 Page 59 GA17-07 Resolution TITLE: Freestanding Emergency Centers (FSEC) Whereas, In 2016 there were 387 hospital based freestanding emergency centers (FSEC) and 172 independent for profit FSECs within the U.S.;1 Whereas, The number of FSECs increased by 76% between the years of 2008 and 2015;1 Whereas, FSECs exist to provide premium emergency care to patient communities and are an integral part of our emergency healthcare delivery systems;2 Whereas, FSECs offer a new concept of emergency care and provide a niche emergency care service; Whereas, Variations in resources, staffing, and professional certifications in FSECs may lead to an increased risk of negative patient outcomes;3,4,5 Whereas, Many patients are confused about the role of FSECs versus urgent care centers; Whereas, Emergency medical systems, governmental agencies, and other professional organizations are determining how to most effectively utilize the FSECs;6 and Whereas, Violence within the emergency department continues to increase7, and the safety of medical personnel and our patients in FSECs is of utmost importance. Resolved, That the Emergency Nurses Association (ENA) collaborate with stakeholders to support minimum standards of patient care for FSEC; Resolved, That the ENA promote and disseminate literature describing the differences between emergency departments, FSECs and urgent care centers; and Resolved, That the ENA encourage FSECs to adapt and follow the ENA and American Organization of Nurse Executives (AONE) Guiding Principles Mitigating Violence in the Workplace General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

60 Page 60 GA17-07 Resolution Resolution Background Information: The Texas State Council of the Emergency Nurses Association has recently created a Freestanding Emergency Department Taskforce to address nursing concerns within the rapidly growing FSEC business. The FSECs business model has proven to be a successful venture for offering premium care to our emergency patients. These centers are migrating to other areas of the country, and will be a valuable component of our emergency care system. The Texas Council taskforce has acknowledged the need for emergency nursing involvement on a national level. We respectfully submit our resolution to the ENA general assembly for consideration. Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: The mission of the ENA is to advocate for patient safety and excellence in emergency nursing practice. 8 The FSEC care model is a new development in emergency medicine. It is important that the ENA advocate for patients as this new concept evolves into a viable segment of the nursing profession, in line with what has already been done by other segments of emergency care, such as EMS, RACs, governmental agencies. It is time for ENA involvement. Financial Considerations/Operational Impact: The ENA Nursing Institutes recognizes a gap around the issues associated with the freestanding emergency centers. To address this issue and support members employed in such settings, it is recommended that a committee or work team be created to assess the current state, create a plan for deliverables relevant to this setting of care, and engage with other stakeholders on this issue. Creation of a work plan could result in meaningful contributions to patient care, patient education and the nursing work environment. A stakeholder meeting would be held at an approximate cost of $2,000. An onsite committee meeting would be held at an approximate cost of $8,200. Total estimated costs of this initiative are $27,680. Professional References: 1. Freestanding EDs Growing in Popularity. (2017). Healthcare Risk Management, 39(1), Andrews, M. (2008). A wait at the ER measured in minutes, not hours. A new type of freestanding emergency room promises good medicine plus customer service. U.S. News & World Report, 145(7), Freestanding EDs Can Have Special Compliance, Liability Concerns. (2017). Healthcare Risk Management, 39(1), Gutierrez, C., Lindor, R. A., Baker, O., Cutler, D., & Schuur, J. D. (2016). State Regulation Of Freestanding Emergency Departments Varies Widely, Affecting Location, Growth, And Services Provided. Health Affairs, 35(10), doi: /hlthaff Freestanding ERs present unique safety concerns. (2016). Briefings on Hospital Safety, 24(3), 1 4, Retrieved from the HCPro Hospital Safety Center website: 2017 General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

61 Page 61 GA17-07 Resolution Lawner, B. J., Hirshon, J. M., Comer, A. C., Nable, J. V., Kelly, J., Alcorta, R. L., &... Browne, B. J. (2016). The impact of a freestanding ED on a regional emergency medical services system. American Journal Of Emergency Medicine, 34(8), doi: /j.ajem AONE and ENA. (2014). AONE guiding principles mitigating violence in the workplace. Retrieved from workplace violence.pdf 8. Emergency Nurses Association. (2016). ENA's mission, values and vision statements. Retrieved from Author: Daniel R. DiDonato, BSN, RN, CEN Supporter(s): Texas State Council, Resolutions Committee 2017 General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

62 Page 62 GA17-08 Resolution TITLE: ENA s Position on Firearm Safety and Legislation Whereas, The Code of Ethics for Nurses calls on nurses to act to change those aspects of social structures that detract from health and well being;1 Whereas, Emergency nurses witness firsthand the devastating consequences of firearm injuries for victims and their families, and bear a responsibility to participate in efforts to mitigate these preventable tragedies; Whereas, The mission of ENA includes prevention of injury and promotion of wellness and safety as essential components of emergency nursing practice and emergency care; Whereas, Each day on average, 88 Americans are killed and 202 are injured in firearms related incidents;2,3 Whereas, The U.S. firearm morbidity and mortality rate is up to twenty times higher than in 23 other high income countries analyzed collectively.4 Whereas, Firearm related trauma is the third ranked cause of accidental death by traumatic injury in the U.S., with traumatic injury as the fourth leading cause of death overall;5 Whereas, Suicide attempts by firearm are up to 95% fatal, and firearms are used in almost 50% of all suicide attempts, resulting in more than 22,000 deaths annually; for comparison, suicide attempts by overdose have a fatality rate of approximately 1.5%;3,5,31 Whereas, The financial consequences of firearms related death and injury impose an enormous financial burden on society, costing $174 billion annually;6 Whereas, Universal background checks are the only legislative measure found to reduce morbidity and mortality by firearms, and such measures are supported by a majority of Americans;22, 23 Whereas, Research into firearm morbidity and mortality is currently restricted by the federal government; Whereas, General Assembly Resolution states: That ENA encourages further research relating to educational interventions for firearm safety; and Whereas, Owing to the overwhelming risks and harm to the population associated with firearms, and the scale, complexity, and geographic variability of the problem, the issue is a public health crisis that requires a comprehensive, multifaceted approach General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

63 Page 63 GA17-08 Resolution Resolved, That ENA encourage the identification, development, and dissemination of educational resources that promote the safe storage of firearms, and advocate for training in safe handling practices and competent usage for all firearm owners; Resolved, That ENA encourage the utilization of screening tools to assist in the identification of individuals at high risk for death or injury from firearms; Resolved, That ENA urge the lifting of the restrictions and limitations on research into firearm related morbidity and mortality by the Centers for Disease Control and Prevention and the Department of Health and Human Services, and that funding be allocated for this research; Resolved, That ENA advocate for extension of the National Violent Death Reporting System, a database maintained by the Centers for Disease Control and Prevention, to include all U.S. states and territories; Resolved, That ENA support technology to make firearms safer, as well as promote the distribution of existing safety devices to firearm owners; and Resolved, That ENA support the requirement for universal background checks on all firearm purchases, including sales at gun shows and private sales between individuals General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

64 Page 64 GA17-08 Resolution Resolution Background Information: As the premier international professional organization dedicated to emergency nursing, ENA advocates for patient safety and helps guide emergency healthcare policy. Further, emergency nurses serve on the frontline of our nation s healthcare system and experience first hand the impact of firearm injuries on patients and healthcare providers. It is therefore appropriate that ENA members review, debate, and vote on the important public policy issue of firearm injury prevention. In 2014, 33,599 people died and 81,043 were injured by firearms in the U.S.5,8 The firearm homicide rate in the U.S. is 20 times higher than the combined rates of other countries that are comparable to the U.S. in wealth and population, and the firearm suicide rate is 5.8 times higher.3,4,9 The U.S. currently experiences a lower life expectancy than other comparable nations, and death by firearm accounts for as much as 21% of that difference.10 Firearm morbidity and mortality affect children disproportionately: more than 35,000 children under the age of 19 have died as a result of a firearm injury since In 2014 alone, 13,576 children under the age of 18 were treated for a non fatal firearm related injury.8 With the current flaws in the National Violent Death Reporting System, as many as 39% of unintentional firearm deaths may be misclassified, resulting in significant underestimation of the firearm mortality rate in children.11 Suicide is the third leading cause of death in young adults aged 10 24, and firearms are used in 95% of suicides in this age group.12,13 Seventy five percent of adolescents gain access to a firearm owned by a parent or friend to attempt or complete suicide.14 One study examining handgun purchases by adults found the primary cause of mortality in this group in the year following the purchase was suicide, and in the week after the handgun purchase their suicide rate was 57 times higher than that of the general population.15 Higher levels of gun ownership are also associated with higher rates of suicide in males.16 Conversely, reduction in firearm ownership is independently associated with a significant reduction in the overall suicide rate.17,18 As mental healthcare disparities have been identified as a priority issue for ENA, we should take note that over 63% of firearm deaths are suicides, accounting for 50% of all suicides.5 Also of note, 90% of people who unsuccessfully attempt suicide by other means do not go on to complete a successful attempt, challenging the notion that without access to firearms, suicidal individuals will simply find other means. Limiting the access of those with suicidal intent to lethal means such as firearms can therefore help ensure more individuals survive their suicide attempts and go on to be successfully treated for their suicidal ideation.18 There is promising research indicating a possible pharmacological therapy that could reverse acute suicidal ideation, making it more important than ever to limit access to lethal means for these individuals.32 Other measures have been taken to limit lethality, including adding fences around bridges and overpasses and changing chemical formulation of pesticides. Similar measures are appropriate to limit the lethality of firearms to suicidal patients as well. Limiting access to handguns, especially by children, has been shown to significantly decrease accidental death, injury, or suicide by firearm.20,21 A recent study found that states with legislation requiring universal background checks and identification requirements for all firearm and ammunition purchases experience lower firearm associated morbidity and mortality.22 (Currently, as many as 40% of firearms are purchased through private sales without background check.22) Investigators calculated that these measures have the potential to reduce firearm morbidity and mortality by as much as 90% if implemented at the federal level. A Gallup poll from General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

65 Page 65 GA17-08 Resolution found that 86% of Americans favor measures that would close the gun show loophole. 23 Programs that provide education regarding safe storage and distribute trigger locks to firearm owners have been found to significantly increase the incidence of safe storage practices, which in turn decreases mortality.24 Participation in these evidence based interventions represents an area where the ENA could make a significant impact on the incidence of firearm related death and injuries. Having a firearm in the home is significantly and independently associated with an increased risk of death for all occupants; one study found for every firearm death associated with self defense or protection, there were 1.3 accidental deaths, 4.5 criminal homicides, and 37 suicides.17,25 A person is more likely to be killed by an intimate partner or family member than a stranger, and the presence of a firearm in a domestic violence situation significantly increases the risk of homicide, endangering not only intended victims, but other family members, bystanders and coworkers.26,27 These data show that our current practices regarding firearms in the U.S. do not make us objectively safer. Patient screening is an important health promotion activity that has been effective in reducing morbidity and mortality for other public health issues (smoking, car seat use/seat belt use, helmets).28 Sixty four percent of individuals who received verbal firearm storage safety counseling from their healthcare providers improved their gun safety practices; 12% of those individuals completely removed the firearm from their home.19 This counseling includes screening to determine if at risk individuals reside in the home (children, elders with dementia, alcohol or substance abusers, depressed or suicidal individuals, etc.) and provides information regarding safe storage practices (installing trigger locking mechanisms, storing firearms in a locked case, storing ammunition in a separate locked case, storing each in separate rooms). These measures are known to mitigate death and disability by firearms, and nurses are uniquely positioned to carry out these screening activities and should do so without impediment.20,24,29 Research into the epidemic of firearm related morbidity and mortality is severely limited by an amendment made to a CDC appropriations bill from 1996 that forbids the CDC to conduct any research directed to advocate or promote gun control. This restriction also applies to the National Institutes of Health and the Department of Health and Human Services. The annual budget for firearm injury research is $2.6 million, a fraction of the amount budgeted for other health issues.7 Firearm related injuries account for almost 750,000 years of life lost annually; diabetes, accounts for 218,000 years lost, yet receives $1.1 billion dollars in annual research funding.7 The cost of firearm morbidity and mortality is a significant financial burden on society, costing $174 billion annually.6 These costs include lost work, medical and mental healthcare, emergency transport, criminal justice activities, insurance claims processing, employer costs, and decreased quality of life, making firearm injuries one of the most costly public health concerns of our time.6 The absence of solid and robust firearm injury data severely limits the ability to mitigate the death and disability that occurs. As a result of the epidemic of traumatic injury and death from firearms in the United States, numerous national healthcare organizations have taken the public position that firearm injuries are a public health crisis. For example, since the beginning of 2015, the American Nurses Association, American Medical Association, American College of Emergency Physicians, and the American Academy of Pediatrics have issued statements on firearms. Other public health concerns, such as tobacco use, motor vehicle accidents, and unintentional poisonings are addressed in a systematic manner. This includes public safety educational campaigns, research 2017 General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

66 Page 66 GA17-08 Resolution into safety features and design, legislation to enforce safety regulations, and federal regulation and enforcement of safety and design standards. Firearm morbidity and mortality can and should be addressed in the same scientific manner. Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: The mission of ENA is to advocate for patient safety and excellence in emergency nursing practice. This Resolution serves ENA s mission by calling for educational resources that promote the safe use and storage of firearms, encouraging best practices to mitigate the impact of firearm related injuries on the public at large, and supporting legislation that aims to curtail firearm related injuries and deaths. This resolution is also concerned with evidence based and common sense interventions that are proven to mitigate death and disability from firearm related injuries. ENA strongly values the inclusion and contributions of nursing in collaboration with healthcare partners to explore solutions to the challenges of emergency care delivery. Our colleagues in other sectors of healthcare have taken decisive positions on this topic and it is time for emergency nurses to help shoulder the responsibility for mitigating these preventable injuries and deaths. This Resolution is consistent with ENA s Five Year Strategic Plan ,30 which calls on ENA to provide leadership to its members on all legislative issues impacting the emergency healthcare industry. It also states that ENA should Increase visibility and participation in legislative and regulatory advocacy to promote patient and community safety and excellence in emergency nursing practice. Financial Considerations/Operational Impact: The first step is to identify and disseminate currently available, evidenced based resources. Should gaps be found in available resources, a committee could be appointed to develop original materials. The IENR is currently conducting the first phase of a study entitled, Emergency Nurses Perception of Risk for Firearm Injury and its Effect on Assessment Practices. The purpose of this study is to explore emergency nurses perception of patient risk for firearm injury, and in what ways that perception affects their process of patient screening, assessment, education, and discharge. The study includes mixed methods, consisting of a survey and subsequent focus groups. Following completion of the study, determination will be made regarding subsequent outcomes. ENA Government Relations time and resources would be required to effectively advocate for the extension of the National Violent Death Reporting System and expanded background checks on all firearm purchases. The total estimated project costs are $13,500. Professional References: 1. American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. 2. Centers for Disease Control and Prevention. (2013). Nonfatal injury reports, Retrieved from General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

67 Page 67 GA17-08 Resolution Centers for Disease Control and Prevention. (2016). Injury prevention & control: Data & statistics (WISQARSTM): Fatal injury data. Retrieved from 4. Richardson, E. G, & Hemenway, D. (2011). Homicide, suicide, and unintentional firearm mortality: Comparing the United States with other high income countries, The Journal of Trauma, 70(1), doi: /ta.0b013e3181dbaddf 5. Kochanek, K. D., Murphy, S. L., Xu, J., & Tejada Vera, B. (2016). Deaths: Final Data for National Vital Statistics Reports, 65(4) Retrieved from the Centers for Disease Control and Prevention website: 6. Miller, T. R. (2012). The cost of firearm violence. Retrieved from Children's Safety Network website: firearm violence 7. Nance, M. L., Krummel, T. M., & Oldham, K. T. (2013). Firearm injuries and children: A policy statement of the American Pediatric Surgical Association. Journal of the American College of Surgeons, 217(5), doi: /j.jamcollsurg Centers for Disease Control and Prevention. (2017). Injury prevention & control: Data & statistics (WISQARSTM). Retrieved from 9. Hoyert, D. L., & Xu, J. (2012). Deaths: Preliminary data for National Vital Statistics Reports, 61(6), Retrieved from Fenelon, A., Chen, L. H., & Baker, S. P. (2016). Major causes of injury death and the life expectancy gap between the United States and other high income countries. Journal of the American Medical Association, 315(6), doi: /jama Barber, C., & Hemenway, D. (2011). Too many or too few unintentional firearm deaths in official U.S. mortality data? Accident Analysis & Prevention, 43(3), doi: /j.aap Shenassa, E., Catlin, S., & Buka, S. (2003). Lethality of firearms relative to other suicide methods: A population based study. Journal of Epidemiology & Community Health, 57(2), doi: /jech Lubell, K. M., Swahn, M. H., Crosby, A. E., & Kegler, S. R. (2004). Methods of suicide among persons aged years United States, Morbidity and Mortality Monthly report, 53(22), Retrieved from the Centers for Disease Control and Prevention website: Johnson, R. M., Barber, C., Azreal, D., Clark, D. E., & Hemenway, D. (2010). Who are the owners of firearms used in adolescent suicides? Suicide and Life Threatening Behavior, 40(6), doi: /suli General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

68 Page 68 GA17-08 Resolution Wintermute, G. J., Parham, C. A., Beaumont, J. J., Wright, M., & Drake, C. (1999). Mortality among recent purchasers of handguns. New England Journal of Medicine, 341(21), doi: /nejm Siegel, M., & Rothman, E. F. (2016). Firearm ownership and suicide rates among US men and women, American Journal of Public Health, 106(7), doi: /ajph Cummings, P., & Koepsell, T. D. (1998). Does owning a firearm increase or decrease the risk of death? Journal of the American Medical Association, 280(5), Miller, M., Azrael, D., Hepburn, L., Hemenway, D., & Lippmann, S. J. (2006). The association between changes in household firearm ownership and rates of suicide in the United States, Injury Prevention, 12(3), doi: /ip Albright, T. L., & Burge, S. K. (2003). Improving firearm storage habits: Impact of brief office counseling by family physicians. Journal of the American Board of Family Practice, 16(1), Hepburn, L., Azrael, D., Miller, M., & Hemenway, D. (2006). The effect of child access prevention laws on unintentional child firearm fatalities, The Journal of Trauma Injury, Infection and Critical Care, 61(2), doi: /01.ta fc 21. Miller, M., Azrael, D., & Barber, C. (2011). Suicide mortality in the United States: The importance of attending to method in understanding population level disparities in the burden of suicide. Annual Review of Public Health, 33(1), doi: /annurev publhealth Kalesan, B., Mobily, M. E., Keiser, O., Fagan, J. A., & Galea, S. (2016). Firearm legislation and firearm mortality in the USA: A cross sectional, state level study. The Lancet, 387(10030), doi: /s (15) Newport, F. (2015). American public opinion and guns. Retrieved from the Gallup website: matters/187511/american public opinion guns.aspx?g_source=gun%20control&g_medium=search&g_campaign=tiles 24. Rowhani Rahbar, A., Simonetti, J. A., & Rivara, F. P. (2016). Effectiveness of interventions to promote safe firearm storage. Epidemiologic Reviews, 38(1), doi: /epirev/mxv Kellermann, A. L., & Reay, D. T. (1986). Protection or peril? An analysis of firearm related deaths in the home. New England Journal of Medicine, 314(24), doi: /nejm Campbell, J. C., Webster, D., Koziol McLain, J., Block, C., Campbell, D., Curry, M. A.,... Laughon, K. (2003). Risk factors for femicide in abusive relationships: Results from a multisite case control study. American Journal of Public Health, 93(7), doi: /ajph General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

69 Page 69 GA17-08 Resolution Cooper, A., & Smith, E. L. (2011). Homicide trends in the United States, : Annual rates for 2009 and Retrieved from the U.S. Department of Justice Bureau of Justice Statistics website: Jamal, A., Dube, S. R., Malarcher, A. M., Shaw, L., & Engstrom, M. C. (2012). Tobacco use screening and counseling during physician office visits among adults National Ambulatory Medical Care Survey and National Health Interview Survey, United States, Morbidity and Mortality Weekly Report, 61(02), Retrieved from Grossman, D. C., Mueller, B. A., Riedy, C., Dowd, M. D., Villaveces, A., Prodzinski, J.,... Harruff, R. (2005). Gun storage practices and risk of youth suicide and unintentional firearm injuries. Journal of the American Medical Association, 293(6), doi: /jama Emergency Nurses Association. (2015). ENA has 2020 vision: Emergency Nurses Association five year strategic plan Retrieved from Spicer, R.S. and Miller, T.R. (2000) Suicide acts in 8 states: incidence and case fatality rates by demographics and method. American Journal of Public Health. 90(12);1885.) 32. Lee, J., Narang, P., Enja, M., & Lippmann, S. (2015). Use of Ketamine in Acute Cases of Suicidality. Innovations in Clinical Neuroscience, 12(1 2), Author(s): Kristen M. Cline, BSN, RN, CEN, CPEN, SANE A, TCRN, CFRN Kirk Bobst, MSN, RN, CEN, CPEN, TCRN Joop Breuer, RN, CEN, FAEN Curtis Olson, BSN, BA, RN, EMT P, CEN William Schueler, MSN, RN, CEN, WVTS Supporter(s): Brenda Braun, MSN, RN, CEN, CPEN, FAEN Nancy Bonalumi, DNP, RN, CEN, FAEN Audrey Elizabeth Cloughessy, AM, RN, MHM Diane Gurney, MS, RN, CEN, FAEN Harriet Hawkins, RN, CPEN, CCRN, CPN, FAEN Jim Hoelz, MS, MBA, RN, CEN, FAEN Mary Jagim, MSN, RN, CEN, FAEN Linell Jones, BSN, RN, CEN, CPEN JoAnn Lazarus, MS, RN, CEN Anne P. Manton, PhD, RN, PMHNP BC, FAEN, FAAN Margaret (Peggy) McMahon, MN, RN, APN, CEN, NP C, FAEN Justin Milici, MSN, RN, CEN, CPEN, TCRN, CCRN, FAEN Elizabeth A. Mizerek, MSN, RN, CEN, CPEN, FN CSA 2017 General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

70 Page 70 GA17-08 Resolution AnnMarie Papa, DNP, RN, CEN, NE BC, FAAN, FAEN Matthew F. Powers, MS, BSN, RN, MICP, CEN Cheryl Randolph, MSN, RN, FNP, CEN, CPEN, CCRN, TCRN, FAEN Kathy Robinson, RN, FAEN Carole Rush, MEd, RN, CEN, ENC(C), FAEN Martha Saroop, MS, RN, CEN, NE BC Renee Simonin Holleran, PhD, FNP BC, CEN, FAEN Susan Sheehy, PhD, RN, FAEN, FAAN Rebecca Steinmann, MS, RN, APN, CEN, CPEN, TCRN, CCNS, CCRN, FAEN Tiffiny Strever, BSN, RN, CEN, TCRN, FAEN Anna Maria Valdez, PhD, RN, CEN, CFRN, CNE, FAEN Mary Ellen Wilson, MS, RN, CEN, COHN S, FNP C, FAEN Oregon ENA State Council, President, Pam Bessler Illinois ENA State Council, President, Nicholas Nelson 2017 General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

71 Page 71 GA17-09 Resolution TITLE: Safety When Removing Patients from Private Vehicles Whereas, Direct patient caregivers are known to have the highest risk of workplace injuries, the most common being musculoskeletal and needlestick injuries;1 Whereas, The Emergency Nurses Association (ENA) recognizes workplace safety as a priority as evidenced by the Workplace Injury Prevention (WPIP) Toolkit; 2 Whereas, Utilization of the ENA WPIP Toolkit problem identification process reveals that emergency department (ED) nurses are at increased risk of needlestick and musculoskeletal injuries. There is no mention of the specific problem of removing victims of opioid abuse when they present to the ED in private vehicles; Whereas, The inherent risks to ED staff members who assist in the removal of unconscious individuals from private vehicles are not mentioned in the ENA WPIP Toolkit; Whereas, ED nurses are not educated in the safe removal of patients from private vehicles; and Whereas, ENA has no position statement, guideline, or any educational reference to prepare ED nurses to safely handle the influx of opioid overdose patients presenting to EDs as a consequence of the current national heroin epidemic. Resolved, That ENA support initiation of a standard process to assist ED nurses in safely removing patients from private vehicles; Resolved, That ENA support research on the standard of care for removing patients presenting to EDs in private vehicles, and on the injuries to staff associated with this practice; and Resolved, That ENA identify and disseminate education highlighting standard methods to ensure safety when removing patients from private vehicles General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

72 Page 72 GA17-09 Resolution Resolution Background Information: At the request of an ED staff nurse, a literature search was undertaken to discover evidence based guidance on the safe removal of unconscious patients from privately owned vehicles. An extensive search of emergency medical services and law enforcement literature revealed no articles discussing evidence based practices ensuring scene safety, proper body mechanics, or needlestick protection when removing unconscious patients from vehicles. The Centers for Disease Control (CDC) estimates 385,000 sharp related injuries occur annually to healthcare workers in hospitals.3 There is no mention as to how many of these injuries occur when attempting to remove unconscious opioid overdose victims from vehicles even though the heroin epidemic has meant that ED staff nurses are being asked to do this on a daily basis. The CDC reports a near quadrupling of heroin overdose deaths from Heroin use has increased among men and women across all age groups, and has doubled in the year age group among all income levels. According to Hedegaard, Warner, and Minino (2017), the age adjusted rate of drug overdose deaths in 2015 (16.3/100,000) was 2.5 times what it was in 1999 (6.1/ 100,000). In that period, the death rate has risen among all age groups, with the largest growth being a five fold increase for adults aged (from 4.2 to 21.8 per 100,000). While all races have seen higher death rates from overdoses, the increases have not been uniform: 43% for Hispanics, 63% for non Hispanic blacks, and 240% for non Hispanic whites. In 2015, 21 states saw overdose death rates statistically significantly higher than the national average, with Ohio having one of the highest age adjusted rates at 29.9/100,000.5 These numbers highlight the increasing risk to ED staff nurses of potential back and needlestick injuries when providing patient care in this high risk area. Although the ENA WPIP Toolkit cites a variety of statistics from The Joint Commission (whose focus is primarily on patient safety) and the National Institute for Occupational Safety and Health (NIOSH) (whose focus is on methods to prevent worker injury and illness, with discussion on needlesticks and sharp injuries), no data were found regarding methods for ED staff nurses to safely remove patients from privately owned vehicles.2 Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: ENA s mission is to promote excellence in emergency nursing practice and advocate for a culture of inquiry that carries out rigorous research and incorporates its findings into nursing practice when the evidence is compelling.6 ENA bylaws reflect that the organization serves to define the standards that form the basis of emergency nursing practice.7 The ENA strategic plan empowers emergency nurses to actively engage in safe practice with educational offerings that are supported by new knowledge.8 Financial Considerations/Operational Impact: Revision of ENA s Workplace Injury Prevention Toolkit to address this topic would require staff time in the areas of injury prevention and information technology, and could likely be accomplished with 8 10 hours of work, estimating costs under $500. Other resolved clauses would likely involve collaboration with other stakeholders, such as our EMS colleagues General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

73 Page 73 GA17-09 Resolution For example, researching best practices and standards of care around vehicle extrication of unconscious patients could be explored with other stakeholders. The ideal format for sharing and disseminating this information could be recommended by these stakeholders in collaboration with our Emergency Medical Services Advisory Council. Identification of resources could also be a collaborative effort of the EMS AC with other stakeholders. This collaborative work could be conducted via phone and webinar and likely would not incur additional costs outside of current operations. Collection of data around injuries associated with this practice could be implemented, although it would be challenging to conduct an actual research study on this topic. A survey using self reported data could be implemented to gauge the scope of the problem. Costs associated with a research proposal are approximately $5,000 to $6,000 for development of the research proposal and survey, and $2,500 for IRB review. Additional costs for E Communications and IT would also be incurred. A focus group could also be held at annual conference, soliciting participation from those who have experienced such an injury, and is also part of current operations. Professional References: 1. Centers for Disease Control and Prevention, National institute for Occupational Safety and Health. (2013). Stop sticks campaign. Retrieved from 2. Emergency Nurses Association. (2014). Emergency department workplace injury prevention toolkit. Retrieved from research/practice/toolkits/edwip/documents/edwiptoolkit.pdf 3. Centers for Disease Control and Prevention, National institute for Occupational Safety and Health. (2015). Today s heroin epidemic. Retrieved from 4. Centers for Disease Control. Increases in drug and opioid overdose deaths United States, Retrieved from 5. Hedegaard, H., Warner, M., & Minino, A. M Drug overdose deaths in the United States, NCHS Data Brief, Retrieved from the Centers for Disease Control and Prevention website: 6. Emergency Nurses Association. (2015). About ENA. Retrieved from 7. Emergency Nurses Association. (2014). Bylaws: Emergency Nurses Association. Retrieved from 8. Emergency Nurses Association. (2015). ENA has 20/20 vision: Emergency Nurses Association five year strategic plan Retrieved from General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

74 Page 74 GA17-09 Resolution Additional References: Gasaway, R. (2017). Every EMS call starts with scene safety. Retrieved from the Situational Awareness Matters!TM website: ems call %20starts with scene safety/richgasaway Kirkwood, S. (2013). Scene safe mantra provides EMS danger. Journal of Emergency Medical Services, 38(6). Retrieved from 38/issue 6/administration and leadership/scene safe mantra provides ems danger.html Author(s): Jeannie Burnie, MS, APRN, CEN, AGCNS BC, FAEN Maria Newsad, BSN, RN, NE BC Christine Hassert, RN, CEN Ohio ENA State Council, Kristan Napier, president 2017 General Assembly This resolution was reviewed and meets the criteria for being compatible with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility.

75 PageMotions 75 Parliamentary Guide th Based on Robert's Rules of Order Newly Revised (11 Edition) The motions below are listed in order of precedence. Any motion can be introduced if it is higher on the chart than the pending motion. YOU WANT TO: Close meeting Take break Register complaint Make follow agenda Lay aside temporarily Close debate Limit or extend debate Postpone to a certain time Refer to committee Modify wording of motion 11 Kill main motion 10 Bring business before assembly (a main motion) YOU SAY: I move to adjourn I move to recess for I rise to a question of privilege I call for the orders of the day I move to lay the question on the table I move the previous question I move that debate be limited to... I move to postpone the motion to... I move to refer the motion to I move to amend the motion by... I move that the motion be postponed indefinitely I move that [or "to"]... INTERRUPT? 2ND? DEBATE? AMEND? VOTE? No No Yes Yes No No No Yes Majority Majority Yes No No No None Yes No No No None No Yes No No Majority No Yes No No 2/3 No Yes No Yes 2/3 No Yes Yes Yes Majority No Yes Yes Yes Majority No Yes Yes Yes Majority No Yes Yes No Majority No Yes Yes Yes Majority Jim Slaughter, Certified Professional Parliamentarian-Teacher & Professional Registered Parliamentarian (W) (F) P.O. Box 41027, Greensboro web site: Side 1

76 PageMotions 76 Parliamentary Guide th Based on Robert's Rules of Order Newly Revised (11 Edition) Incidental Motions - No order of precedence. Arise incidentally and decided immediately. YOU WANT TO: Enforce rules Submit matter to assembly 25 Suspend rules 26 Avoid main motion altogether Divide motion Demand rising vote Parliamentary law question 33 Request information 2ND? YOU SAY: INTERRUPT? DEBATE? AMEND? VOTE? Point of order I appeal from the decision of the chair I move to suspend the rules which I object to the consideration of the question I move to divide the question I call for a division Parliamentary inquiry Request for information Yes No No No None Yes Yes Varies No Majority No Yes No No 2/3 Yes No No No 2/3 No Yes Yes No No No Yes No Majority None Yes (if urgent) No No No None Yes (if urgent) No No No None Motions That Bring a Question Again Before the Assembly - no order of precedence. Introduce only when nothing else pending. 34 Take matter from table 35 Cancel or change previous action 37 Reconsider motion I move to take from the table I move to rescind/ amend something previously adopted... I move to reconsider the vote... No Yes No No Majority No Yes Yes Yes 2/3 or maj. w/ notice No Yes Varies No Majority Jim Slaughter, Certified Professional Parliamentarian-Teacher & Professional Registered Parliamentarian (W) (F) P.O. Box 41027, Greensboro web site: 9/2011 Side 2

77 Page 77 BYLAWS EMERGENCY NURSES ASSOCIATION Appendix A ARTICLE I NAME The name of this organization shall be the Emergency Nurses Association (ENA), a not-forprofit corporation incorporated in the State of Illinois. ARTICLE II OBJECT Section 1. Purpose The purposes for which the corporation is organized are educational, within the meaning of Section 501(c)(3) of the Internal Revenue Code of 1986, as amended, including but not limited to the advancement of emergency nursing through education and public awareness. Section 2. Mission The mission of the ENA is to advocate for patient safety and excellence in emergency nursing practice. Section 3. Objectives ENA exists to: A. Promote the specialty of emergency nursing. B. Promote the interests of ENA s members and to improve the professional environment of the emergency nurse through education and public awareness. C. Promote ethical principles as defined in the ENA Code of Ethics for Emergency Nurses and the American Nurses Association Code of Ethics. D. Collaborate actively with other health related organizations to improve emergency care. E. Be the primary resource for emergency nursing leadership, education, and research. F. Define standards that serve as a basis for emergency nursing practice. G. Develop, disseminate and evaluate emergency nursing education and research. H. Encourage interaction and mentorship among emergency nurses. I. Identify and disseminate information on key trends affecting and pertinent to emergency nursing. J. Serve as an advocate for the public regarding emergency care. Section 4. Official Publication The official publication shall be the Journal of Emergency Nursing (JEN), which shall reflect the purpose, mission objectives and positions of ENA. ARTICLE III MEMBERS Section 1. Membership Applications Membership applications must be submitted to the headquarters office with any required fees. Upon acceptance, a membership card is sent and the state council is notified. Section 2. Responsibilities of Membership Each member has the responsibility to support the purpose, mission, objectives, and positions of ENA. Section 3. Classifications A. Voting Members voting members shall be classified as national, international, senior and military. Voting members shall have the right to vote, hold elected office, serve on the board of directors, serve on committees, and attend ENA s meetings and social functions.

78 Page National membership may be granted to any individual who is a professional registered nurse licensed in the United States or its territories, hereinafter defined as Guam, American Samoa, Puerto Rico, U.S. Virgin Islands and the Northern Mariana Islands. 2. International membership may be granted to any individual who is a professional registered nurse licensed (or the equivalent thereto) outside of the United States or its territories. 3. Senior membership may be granted to a professional registered nurse who is age 65 or older and licensed in the United States or its territories. 4. Military membership may be granted to a professional registered nurse licensed in the United States or its territories who is currently serving or has been honorably discharged or retired from the United States Armed Forces including Army, Navy, Marine Corps, Air Force, Coast Guard, and Reserve Components. B. Nonvoting members nonvoting members shall be classified as affiliate, student and honorary. Nonvoting members shall be entitled to serve on ENA committees and attend ENA member meetings and social functions. 1. Affiliate membership may be granted to any individual residing in the United States or its territories who shares interest in and supports the purpose, mission and objectives of ENA but does not otherwise meet the criteria for voting membership in ENA. 2. Student membership may be granted to any individual enrolled in a primary nursing education program in the United States or its territories leading to eligibility for licensure as a professional registered nurse. 3. Honorary membership may be awarded to an individual meeting such criteria as shall be determined by the president and the board of directors. Section 4. Dues and Finance A. Members dues shall be currently maintained or termination of membership shall result. B. Membership dues of ENA members shall be determined by the board of directors, except that there shall be no dues for honorary membership, and senior membership member fees will not be more than that of the affiliate membership. At the start of the term, the president shall be granted a dues waiver for life, provided that he or she maintains eligibility as a voting member. C. The fiscal year shall be January 1 through December 31. D. Each state council and chapter shall receive an annual allocation for each dues paying member within the state or chapter. E. A surcharge may be added to the dues in some states by the state s request. Section 5. Suspension and Termination of Membership A. ENA members may have their membership suspended or terminated by a two-thirds vote of the board of directors for failure to adhere to the ENA bylaws or for cause. B. Such action shall not be taken until a member is advised of specific charges and given the opportunity to respond. ARTICLE IV OFFICERS Section 1. Officers A. There shall be three officers: president, president-elect, and secretary/treasurer. The term of office shall commence January 1 each year and terminate on December 31, except that the president-elect shall succeed to the office of president at the conclusion of the term. Officers shall exercise the duties and responsibilities required of a member of the board of directors. B. The president shall: 1. Serve as the official ENA representative and spokesperson, unless such duty is delegated; 2. Serve as an ex-officio member of all committees except the Nominations and Elections Committee; 3. Serve as chair of the Finance Committee;

79 Page Appoint representatives to affiliate organizations and other positions as necessary during the term of office; and 5. Fill, with the approval of the board, vacancies on committees that occur during the term of office. C. The president-elect shall appoint chairs and members of committees and a board liaison to each committee for the following calendar year. Section 2. Eligibility Requirements A. Each officer must be a voting member and must have been a voting member during each of the previous five years immediately prior to submitting a candidate application. B. Each candidate for president-elect and secretary/treasurer must currently serve as a voting member of the board of directors. C. Each candidate must submit to, and pass as acceptable, a limited background check verifying personal identity, professional licensure, highest academic level and an investigation for criminal activity. Section 3. Election A. In the event of a tie vote for the position of president-elect, there shall be a second balloting of ENA membership. B. In the event of a tie vote for the position of secretary/treasurer, lots shall be drawn. C. A candidate for an officer position who is not elected shall continue to serve the remaining unexpired years of the original term as a director. D. All directors who are elected as officers shall have their unexpired terms of office filled by the candidates who receive the next highest number of votes; the candidate receiving the highest number of votes shall receive the position with the longest term. Section 4. Vacancies A. If the office of president becomes vacant, the president-elect shall succeed to the office of president for the unexpired term and shall subsequently serve the one-year term of office of president to which elected. In such case, the immediate past president may remain as immediate past president for a second year or the office may remain vacant for that year. B. A vacancy in the office of president-elect may be filled by a current member of the board of directors, or remain vacant as approved by a majority vote of the board of directors. If the vacancy is filled, the president-elect shall not automatically assume the office of president for the subsequent term. C. In the event that the office of president and president-elect are vacated during the same year, the board of directors shall appoint an acting president to serve until the next scheduled election, at which time an election will be held for both president and presidentelect. D. A vacancy in the office of secretary/treasurer may be filled by a current member of the board of directors or remain vacant as approved by a majority vote by the entire board of directors. ARTICLE V MEETINGS Section 1. General Assembly A. The General Assembly shall be composed of delegates from all states and international delegates representing the international members. B. The number of voting state delegates allocated for General Assembly shall be 700, apportioned as follows: 1. No state shall be allocated fewer than two delegates, one of whom shall serve as state captain. 2. In addition to the voting delegates, there shall be one nonvoting alternate delegate. 3. The remaining delegates will be allocated to the states based on the percentage the delegation is to the national membership, determined annually as outlined in procedures.

80 Page C. The number of voting international delegates allocated for General Assembly shall be in addition to the 700 voting state delegates. 1. There shall be no more than five international voting delegates. 2. In addition to the voting delegates there shall be one nonvoting alternate delegate. 3. International delegates will be selected by a point system developed by the board of directors; the system will be administered and overseen by the ENA component relations department. The members receiving the highest number of points will be selected. D. In addition to the state delegate and international allocation, ENA past presidents may speak and vote at General Assembly. Section 2. Authority The General Assembly shall provide direction and stewardship for the organization, and shall develop and adopt policies and positions affecting the emergency nursing profession in furtherance of ENA s purposes. The General Assembly shall also approve, revise, or amend these bylaws, and receive reports of the board of directors, committees and other volunteer groups, the findings of the annual audit, and transact such other business as may come before the meeting. Section 3. Quorum A quorum for all meetings is a majority of the total voting delegates who have completed credentialing procedures. Section 4. Annual Meeting and Special Meetings A. The regular business meeting of the delegates shall be held annually and designated as the General Assembly. A formal notice of the meeting shall be published in ENA publications 60 days prior to the meeting. B. Other meetings of delegates shall be summoned by a two-thirds vote of the board of directors as circumstances warrant and shall be designated as special meetings of the General Assembly. Delegates shall be given at least thirty days advance notice of any special meeting of the General Assembly. Notice for special meetings shall state the general nature of the subject or subjects to be considered. ARTICLE VI BOARD OF DIRECTORS Section 1. Composition The board of directors shall be composed of the following: three officers, seven directors, the immediate past president serving as an ex-officio member for one year, and the executive director serving as a non-voting advisory member. No member may run for more than one nationally elected position at a time. No member may hold more than one nationally elected position at a time. Section 2. Authority The board of directors shall be the ENA official governing body responsible for the management of the affairs of ENA. To that end, it shall also: Perform all duties entrusted to officers and directors of a corporation; Debate and determine ENA policy; Oversee ENA s business and financial affairs; Provide strategic direction for ENA; and Provide leadership for all of the component divisions of ENA. Section 3. Eligibility Requirements A. Directors must be a voting member and must have been a voting member during each of the previous five years immediately prior to submitting a candidate application.

81 Page B. Candidates must have attended at least one ENA General Assembly within the previous three years in an approved verifiable capacity as outlined in the election rules. C. Each candidate must submit to, and pass as acceptable, a limited background check verifying personal identity, professional licensure, highest academic level and an investigation for criminal activity. D. Candidates shall have served in an elected or committee position on the local, state or national level within the previous five years. Section 4. Term of Office Directors shall serve for a three-year term of office on a rotating basis. The term of office shall commence on January 1 each year following the election and terminate on December 31. Section 5. Elections Elections shall be held annually. All voting members shall have the opportunity to elect officers and directors by ballot. Balloting may be by electronic means. Candidates receiving the highest number of votes for each position shall be declared elected. In the event of a tie for the director positions, lots shall be drawn. Section 6. Meetings A. Regular meetings of the board shall be held at least quarterly as determined by the board. At least ten days notice shall be given to all members of the board. B. Special meetings shall be held as called by the president or any three members of the board. At least three days notice shall be given to all members of the board. C. Meetings may be held in person or by electronic means, provided that all participants can hear and speak to one another at the same time. D. A majority of the voting members of the board of directors shall constitute a quorum for all meetings. All decisions of the board of directors require an affirmative vote of a majority of the board of directors. Section 7. Vacancy A vacancy that occurs in the position of director shall be filled in the following manner: A. If the vacancy occurs between January 1 and before the completion of the current year s election the vacancy shall be filled by the person receiving the next highest number of votes in the previous year s election with the term ending December 31. B. If the vacancy occurs after the current year s election and there is more than six months left in the unexpired term, the vacancy shall be filled by the person receiving the next highest number of votes in the current year s election with the term ending December 31 of the following year. C. If all such persons decline to serve, if there were no additional candidates for that office during the most recently concluded election, or if the vacancy occurs with fewer than six months left in the unexpired term, the vacancy shall not be filled. Section 8. Removal Any member of the board of directors may be removed in accordance with the provisions of law and the Illinois Not For Profit Act of 1986, as amended, by the persons entitled to elect such director, whenever, in their judgment, the best interests of ENA would be served by such removal. Section 9. Executive Committee A. The Executive Committee shall be composed of the president, the president-elect, and the secretary/treasurer as voting members, and the executive director as a nonvoting ex-officio member. The Executive Committee shall exercise all responsibilities specified in the bylaws and assigned by the board of directors. B. The Executive Committee shall assist the board in managing ENA on issues that are time sensitive between official board meetings and, in those urgent instances, will have and may

82 Page exercise all of the powers of the board in the oversight of the management of the business and affairs of ENA. C. The Executive Committee assists the president in setting priorities for the board and the executive director. Actions of the Executive Committee will be communicated to the board of directors. D. The Executive Committee may provide counsel to the executive director. E. The Executive Committee shall lead the board of directors in strategic initiatives. Section 10. Indemnification ENA shall indemnify, as set forth below, and to the fullest extent to which it is empowered to do so by the Illinois Nonprofit Corporation Act or any other applicable laws as may from time to time be in effect, any person who, by reason of being or having been a director, officer, employee, or agent of ENA, or who is or was serving at the request of ENA as a director, officer, employee, or agent of another corporation, partnership, joint venture, trust, or other enterprise, and who was or is a party or is threatened to be made a party to any threatened, pending, or completed action, suit, or proceeding. ARTICLE VII CONSTITUENT DIVISIONS Section 1. Levels of Organization A. ENA shall have two levels of organization, with an optional third level: National Level State Level Local Level, optional B. All levels of ENA are integral components of ENA. State councils are separately incorporated in each state in accord with bylaws and procedures. The local level within each state, where it exists, is an integral component of the state council and exists under the state council corporate status, in accord with bylaws and procedures. Section 2. Activities A. National level activities shall encompass activities of the General Assembly, special meetings of delegates, and the board of directors. B. The state level of ENA shall encompass all activities of state councils. 1. Charter Each state council shall be chartered by ENA in accord with procedures and shall actively support the philosophy and objectives of ENA. 2. Objectives Each state council shall function within the framework of ENA to coordinate and to implement ENA activities within the state. 3. Composition In states where chapters exist, state councils will be composed of representatives from each chapter within the state in accord with bylaws and procedures. If there are no chapters, state councils will be composed of members-atlarge. In the event that there is no state council, a member of the board of directors shall coordinate ENA activities within that state in accord with procedures. 4. Responsibility Each state council is an integral component of ENA and shall act in accord with bylaws and procedures. Each state council has the responsibility to monitor and to address professional issues related to emergency care. Each state council shall serve as a resource for emergency nursing within the state. 5. General Assembly delegation Each state council shall coordinate the individual state delegation to the ENA General Assembly in accord with procedures. 6. Funding Each state council shall receive an annual allocation for each individual member within the state in accord with procedures. 7. Suspension or Revocation of Charter The charter for a state council may be suspended or revoked by the board of directors in accord with procedures. C. The third level, if it exists, shall encompass all activities of chapters. Chapters, where they exist, are integral components of states and ENA and shall act in accord with bylaws and procedures.

83 Page Purpose Each chapter shall be chartered by the board of directors in accord with procedures and shall actively support the purpose and objectives of ENA. 2. Objectives Each chapter shall function within the framework of ENA to coordinate and to implement ENA activities at the chapter level. 3. Composition Chapter membership shall be obtained, in those states where chapters exist, when an individual joins ENA in accord with procedures. 4. Responsibility Each chapter has the responsibility to provide representation for active participation at the respective state level in accord with procedures. 5. Funding Each chapter shall receive an annual allocation for each chapter member in accord with procedures. 6. Suspension or Revocation of Charter The charter for a chapter may be suspended or revoked in accord with procedures. ARTICLE VIII COMMITTEES Section 1. Committees ENA shall have committees appointed by the board of directors in sufficient numbers necessary to address mission objectives, and positions of ENA. The president or an appointed board liaison, as well as the executive director, shall serve as non-voting members of all committees, except the Nominations and Elections Committee. Section 2. Standing Committees A. Finance Committee. 1. The Finance Committee shall be composed of the president, the president-elect, the secretary/treasurer and the immediate past president. The executive director shall serve as a nonvoting ex-officio member. 2. The Finance Committee shall: a. Oversee the financial planning and management of ENA by ensuring that all fiscal aspects are in order; b. Oversee the independence of ENA s audit functions and its compliance with legal and ethical standards; c. Oversee investment of funds; and d. Make fiscal recommendations to the board. B. Resolutions Committee. 1. The Resolutions Committee shall be composed of six members serving three-year terms, two appointed each year by the ENA president-elect and ratified by the board of directors. The committee chairperson shall be appointed by the president-elect and ratified by the board of directors from among the continuing members on the committee. The terms shall be staggered and shall commence at the adjournment of the General Assembly meeting following appointment. 2. The Resolutions Committee shall solicit, review, and present resolutions and proposed bylaws amendments to the General Assembly. C. Nominations and Elections Committee. 1. Composition a. The Nominations and Elections Committee shall consist of seven voting members elected in the ENA national election: one member from each of six regions who has not previously served on the board of directors, and one member who has served on the board of directors. Nominations and Elections Committee members may only represent the region in which they hold a voting membership. b. The six regions shall be established by Nominations and Elections Committee policy. Each region shall be composed of states with geographic proximity and relatively equal membership distribution. c. A Nominations and Elections Committee chairperson shall be elected each year by

84 Page the incoming Nominations and Elections Committee. The chairperson must have served as a member of the committee the previous year. Eligibility a. Candidates must be a voting member and must have been a voting member during each of the previous five years immediately prior to submitting their candidate application. b. Candidates shall have served in an elected or committee position on the local, state or national level within the previous five years. c. Candidates must also have attended at least one General Assembly within the previous three years in an approved verifiable capacity as outlined in the election rules. d. Each candidate shall submit to, and pass as acceptable, a limited background check verifying personal identity, professional licensure, highest academic level and an investigation for criminal activity. e. Members of the Nominations and Elections Committee may not run for or serve in any ENA board position during tenure on the Nominations and Elections Committee, and may not serve more than two consecutive elected terms. Elections a. Elections for the Nominations and Elections Committee shall be held annually. Members shall serve for two-year terms on a rotating basis with terms ending at the first meeting of the Nominations and Elections Committee following the annual General Assembly meeting. b. All voting members shall have the opportunity to elect Nominations and Elections Committee members by ballot from all regions. Candidates receiving the highest number of votes shall be declared elected. In the event of a tie vote for a position on the committee, lots shall be drawn. Responsibilities a. The Nominations and Elections Committee shall be responsible for developing election rules to facilitate elections and shall have general oversight over the election process. b. The Nominations and Elections Committee shall issue a call for candidates at the beginning of the election cycle. The Nominations and Elections Committee shall review, ratify and present a qualified slate of candidates for each position in the election of officers, directors and the Nominations and Elections Committee according to the election rules. The slate of candidates shall be presented to the membership through ENA publications. All national candidates shall be considered potential candidates until they have been ratified by the Nominations and Elections Committee. c. If no applications are received for open board or Nominations and Elections Committee positions, the Nominations and Elections Committee may solicit additional applications as outlined in operational procedures. d. Changes to the election rules must occur prior to the start of the election cycle. e. The Nominations and Elections Committee shall submit proposed amendments to the election rules to the board of directors, who shall review them for compatibility with ENA s purpose, mission, values, objectives, federal and state laws and fiscal viability. Following review and comment by the board of directors in accordance with these criteria, the Nominations and Elections Committee will submit proposed amendments to the Resolutions Committee by the amendment deadline date. f. Notice of amendments to the election rules shall be sent with the notice of the meeting. The General Assembly may amend the election rules within the scope of notice by majority vote. If notice has not been given as required by this section, the General Assembly may amend the election rules by a three-fourths vote. Vacancies a. A vacancy in the chairperson position shall be filled by a majority vote of the Nominations and Elections Committee.

85 Page b. A vacancy of a committee member shall be filled by the candidate who received the next highest number of votes from that region or as the past board member in the most recently completed election. c. In the event of a committee member vacancy from an uncontested election, a qualified candidate must be nominated and elected by the state council presidents of the region affected by the vacancy according to the Nominations and Elections Committee election process, meeting the same requirements set forth in the bylaws as any potential candidate. d. The committee position may remain vacant as approved by the Nominations and Elections Committee if less than six months remain of the unexpired term. ARTICLE IX DISSOLUTION In the event of dissolution of ENA, the net assets of the corporation shall be applied and all liabilities and obligations shall be paid, satisfied, and discharged, or adequate provision shall be made thereof. After payment of all liabilities and obligations, all remaining assets shall be distributed to an organization or organizations organized and operated exclusively for charitable, educational, scholastic or scientific purposes as shall at the time qualify as tax exempt under Sections 501(c)(3) of the Internal Revenue Code of 1986, as amended, or any subsequent law of the United States of America. ARTICLE X LIMITATIONS Section 1. Corporate Powers ENA shall possess all powers which a corporation organized under the General Not For Profit Corporation Act of 1986 of the State of Illinois, as the same from time to time may be amended, shall possess, including all powers which are not in conflict with the purposes for which ENA is organized. In any event, ENA shall not engage in any activity which would disqualify it from being exempt from taxation under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended, or any subsequent law of the United States of America. Section 2. Net Earnings No part of the net earnings of ENA shall inure to the benefit of any private individual. Further, no part of the income of ENA shall be distributed to its members, directors, or officers, provided however, that the payment of reasonable compensation for services rendered shall not be deemed a distribution of income. Section 3. Corporate Assets Anything herein contained to the contrary notwithstanding, no assets of ENA shall be donated, distributed, applied to, paid over or otherwise used or employed in any manner which would disqualify ENA from being exempt from taxation under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended, or any subsequent law of the United States of America. Section 4. Political Campaigns ENA shall not participate in or intervene in any political campaign on behalf of any candidate for public office, including the publication or distribution of statements. ARTICLE XI PARLIAMENTARY AUTHORITY The rules contained in the 11th edition of Robert s Rules of Order Newly Revised shall govern ENA in all cases to which they are applicable and in which they are not inconsistent with these bylaws and any special rules of order ENA may adopt.

86 Page ARTICLE XII AMENDMENT Section 1. Proposals Amendments to the bylaws may be proposed by the board of directors, state councils or under the signature of five voting members. Section 2. Submission Deadline Amendments must be submitted to ENA national office at least 90 days prior to the General Assembly. Section 3. Notice The board of directors shall review proposed bylaws amendments and resolutions for compatibility with ENA s purpose, mission, values, objectives, federal and state laws and fiscal viability, and provide recommendations to the General Assembly. Amendments will be submitted to the membership at least 60 days prior to the General Assembly. Publication of the amendments in an ENA publication shall constitute notice of any amendments of these bylaws to be considered for approval. Section 4. Vote In order to be approved, any amendment must be approved by a two-thirds vote of the delegates present and voting. The Emergency Nurses Association (ENA) Bylaws as appears above reflect amendments approved at the annual ENA General Assembly meetings since 2000: Chicago, IL, 2000; Orlando, FL, 2001; New Orleans, LA, 2002; San Diego, CA, 2004; San Antonio, TX, 2006; Salt Lake City, UT, 2007; Minneapolis, MN, 2008; Baltimore, MD, 2009; San Antonio, TX, 2010; Tampa, FL, 2011; San Diego, CA, 2012; Nashville, TN, 2013; and Indianapolis, IN, 2014.

87 Page 87 Appendix B ENA General Assembly Reference Guide DELEGATION 1. Each state council shall determine its own method for delegate selection by using a point system, election or lottery. 2. Each state council is encouraged to take the following eligibility criteria into consideration in choosing its delegates: Attendance at 50 percent of all scheduled meetings of the state council or local component since the previous General Assembly. Service in an elected or appointed position at the local, state or national level during the prior three years; or Participation in at least one of the following activities related to emergency nursing since the previous General Assembly: o Lecturer (other than that which is required in a professional nursing role) o Projects, such as public education, legislative involvement and chapter fundraising o Research in emergency nursing o Publishing on topics related to emergency care o Certification through the Board of Certification for Emergency Nursing (BCEN) 3. At least 30 days prior to the General Assembly, the ENA national office will forward confirmation letters to each delegate and alternate delegate. All proposed bylaws amendments, resolutions, rules and procedures will be made available on the ENA website. 4. Delegates and alternate delegates shall attend all business sessions of the General Assembly. 5. Business attire is appropriate during General Assembly meetings. RESOLUTIONS 6. Resolutions must be submitted by the published deadline, to be considered on the floor of the General Assembly. 7. Resolutions received at ENA headquarters will be forwarded to the Resolutions Committee, legal counsel, parliamentarian and ENA Board of Directors for review for compatibility with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws and financial feasibility. ENA General Assembly Reference Guide July 2017 Page 1 of 2

88 Page Resolutions that do not comply shall be returned to the authors with explanation. 9. Proposed resolutions submitted will be reviewed by the ENA Board of Directors for possible implementation prior to General Assembly. 10. The Resolutions Committee shall work with authors to combine proposed resolutions that have the same or similar subject matter. 11. Resolutions brought before the General Assembly shall include the exact text of the proposal along with the financial considerations and operational implications. They may also include comments from the Resolutions Committee and the ENA Board of Directors. BYLAWS AMENDMENT PROPOSALS 12. Bylaws amendment proposals received at ENA headquarters will be forwarded to the Resolutions Committee, legal counsel, parliamentarian and ENA Board of Directors for review for compatibility with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws and financial feasibility. 13. Bylaws amendment proposals that do not comply shall be returned to the authors with explanation. 14. The Resolutions Committee shall work with authors to combine proposed bylaws amendments that have the same or similar subject matter. 15. Proposals to amend the ENA Bylaws shall include the exact text of the proposal along with the financial considerations and operational implications. They may also include comments from the Resolutions Committee and ENA Board of Directors. MISCELLANEOUS 16. The Resolutions Committee shall be authorized to correct article and section designations, punctuation and references in the Bylaws, Election Rules, and General Assembly Standing Rules of Procedure as may be necessary to reflect the intent of the General Assembly. 17. The draft General Assembly minutes shall be sent electronically to all state captains and the ENA Board of Directors for a 10 day review and comment period. The minutes shall be subsequently approved by the Resolutions Committee. 18. The status of resolutions adopted by the General Assembly will be made available to the ENA membership. ENA General Assembly Reference Guide July 2017 Page 2 of 2

89 Page 89 Appendix C ENA HAS 2020 VISION Emergency Nurses Association Five Year Strategic Plan Community Vision Statement: ENA is recognized as the authority and premier community for emergency nursing as evidenced by the development and adoption of practice, research, and educational resources. Objectives: Build and promote tangible and intrinsic value for emergency nursing community Engage and support ENA state and chapter components Collaborate with international emergency nursing colleagues Develop and implement a student outreach plan that introduces students to the emergency nursing specialty Increase ENA membership to 60,000 through creating a compelling recruitment engagement and retention experience Engage and empower advanced practice emergency nurses by enhancing and supporting the Institute of Emergency Nursing Advanced Practice Engage and empower emergency nurses from varied practice settings by expanding ENA s practice, research, and education agenda through the work of the Institute for Quality, Safety and Injury Prevention (IQSIP), Institute for Emergency Nursing Research (IENR) and Institute for Emergency Nursing Education (IENE) Conduct research studies to influence the emergency nursing profession and health care industry Engage and empower emergency nurses from varied practice settings through Advocacy Governance & Leadership Vision Statement: ENA provides leadership in emergency healthcare through collaborative partnerships with association stakeholders, healthcare systems, government and regulatory agencies, corporations and patient advocacy groups. Objectives: 1. Provide leadership for strategic partnerships and collaborative relationships, both domestically and internationally as demonstrated by its research agenda and evidenced based tools and programs. 2. Lead the profession of emergency nursing beyond task-oriented care to knowledge-based safe practice and safe care 3. Create a consistent and recognizable brand across all ENA programs, products, and services 4. Empower ENA talent as an essential component of the ENA brand

90 Page 90 Knowledge Vision Statement: ENA is recognized as the premiere authority for emergency nursing education, research and practice resources as evidenced by the adoption of its education programs by emergency nurses and other healthcare professionals. Objectives: 1. Be innovative in ENA content development and subsequent production processes 2. Develop ENA educational programs and resources to actively engage nurses across emergency care settings as well as other healthcare professionals 3. Enhance quality of ENA products and programs through consistent and rigorous evaluation 4. Develop measurable outcomes associated with ENA branded content 5. Increased use of ENA branded programs by 50% 6. Support the generation of new knowledge in emergency nursing through original research, research funding, and collaboration with other partners 7. Encourage the translation of evidence into nursing practice Quality and Safety Vision Statement: ENA defines the gold standard for quality and safety in emergency nursing care. Objectives: 1. Establish and validate key metrics and procedures to improve quality and safety for emergency nursing care and injury prevention 2. Establish the Lantern Award as the exemplar for quality and safety of emergency nursing care 3. Expand advocacy to include global recognition of ENA as the authoritative voice for safe practice, safe care in emergency nursing

91 Page 91 Advocacy Vision Statement: ENA is a leading influential voice on emergency healthcare policy and regulatory issues as evidenced by its lead role in direct advocacy on Capitol Hill and with other government agencies. Objectives: 1. Provide leadership to ENA and its members on all legislative issues impacting the emergency healthcare industry 2. Expand legislative advocacy through increased presence in U.S. Congress 3. Provide opportunities for more direct member engagement in and knowledge of legislative advocacy 4. Increase visibility and participation in legislative and regulatory advocacy to promote patient and community safety and excellence in emergency nursing practice 5. Increase engagement with partners and coalitions to leverage ENA influence over the legislative process Infrastructure Vision Statement: Investing in people, technology, and facilities to advance ENA s mission. Objectives: 1. Invest in and implement a technology infrastructure capable of integrating systems that support timely, accurate, and relevant information, helping to reduce manual paperwork, eliminate duplication, and improve efficiency. 2. Embrace state-of-the-science technology to support leading-edge education, research, and practice resources 3. Manage expenses and utilization consistent with the objectives and goals 4. Invest in the development, assessment and recruitment of the appropriate talent to support our 2020 vision

92 Page 92 Appendix D MUELLEr & Co., LLP Assurance Certified Public Accountants ~ Business Advisors MUELLER Chicago & Elgin Phone Fax EMERGENCY NURSES ASSOCIATION AND AFFILIATE AUDITED CONSOLIDATED FINANCIAL STATEMENTS YEAR ENDED DECEMBER 31, 2016

93 Page 93 CONTENTS PAGE Consolidated Financial Statements Independent Auditors Report Consolidated Statements of Financial Position... 3 Consolidated Statements of Activities and Changes in Net Assets... 4 Consolidated Statements of Cash Flows... 5 Notes to Consolidated Financial Statements Supplementary Information Independent Auditors Report on Supplementary Information Emergency Nurses Association (ENA) Statements of Financial Position Statements of Activities and Changes in Net Assets Statements of Cash Flows ENA Foundation Statements of Financial Position Statements of Activities and Changes in Net Assets Statements of Cash Flows... 28

94 Page 94 INDEPENDENT AUDITORS REPORT Finance Committee Emergency Nurses Association ENA Foundation Board of Trustees Des Plaines, Illinois Report on the Consolidated Financial Statements We have audited the accompanying consolidated financial statements of Emergency Nurses Association and Affiliate, which comprise the consolidated statements of financial position as of December 31, 2016 and 2015 and the related consolidated statements of activities and changes in nets assets and cash flows for the years then ended and the related notes to the consolidated financial statements. Management s Responsibility for the Consolidated Financial Statements Management is responsible for the preparation and fair presentation of these consolidated financial statements in accordance with accounting principles generally accepted in the United States of America; this includes the design, implementation and maintenance of internal control relevant to the preparation and fair presentation of consolidated financial statements that are free from material misstatement, whether due to fraud or error. Auditors Responsibility Our responsibility is to express an opinion on these consolidated financial statements based on our audits. We conducted our audits in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement. An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the consolidated financial statements. The procedures selected depend on the auditors judgment, including the assessment of the risks of material misstatement of the consolidated financial statements, whether due to fraud or error. In making those risk assessments, the auditor considers internal control relevant to the entity s preparation and fair presentation of the consolidated financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entity s internal control. Accordingly, we express no such opinion. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. -1Certified Public Accountants Business Advisors Offices in Elgin and Chicago

95 Auditors Responsibility, Continued Page 95 We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion. Opinion In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the consolidated financial position of Emergency Nurses Association and Affiliate as of December 31, 2016 and 2015, and the consolidated changes in its net assets and their consolidated cash flows for the years then ended in conformity with accounting principles generally accepted in the United States of America. Elgin, Illinois July 14,

96 Page 96 EMERGENCY NURSES ASSOCIATION AND AFFILIATE CONSOLIDATED STATEMENTS OF FINANCIAL POSITION DECEMBER 31, 2016 AND 2015 ASSETS Current assets: Cash and cash equivalents Accounts receivable, net of allowance for doubtful accounts of $156,028 and $136,190 for 2016 and 2015, respectively Inventory Prepaid expenses and other current assets 2016 $ 684, ,661 1,510, , ,605 1,540, , ,638 2,522,583 2,689,278 3,469,691 3,689,128 20,614,054 18,735,785 $ 26,606,328 25,114,191 $ 216, , ,356 3,091, ,709 1,496, , , ,360 3,047, ,653 1,310,630 6,818,592 6,739, ,789 1,004,871 7,637,381 7,744,253 16,484,058 1,610,518 15,242,160 1,345,807 18,094,576 16,587, , , , ,102 18,968,947 17,369,938 26,606,328 25,114,191 Total current assets Property and equipment, net Investments Total assets 2015 LIABILITIES AND NET ASSETS Current liabilities: Accounts payable Wages and benefits payable Accrued expenses Deferred revenue Credits on customer accounts Assessments payable Total current liabilities Long-term liabilities Deferred revenue, net of current portion Total liabilities Net assets: Unrestricted: Undesignated Board designated Total unrestricted Temporarily restricted Permanently restricted Total net assets Total liabilities and net assets $ The accompanying notes are an integral part of the consolidated financial statements. -3-

97 Page 97 EMERGENCY NURSES ASSOCIATION AND AFFILIATE CONSOLIDATED STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS YEARS ENDED DECEMBER 31, 2016 AND Revenue, Gains and Other Support: Courses Membership dues Conferences Publications Marketplace Sponsorships Royalties Other Grants Mailing lists Contributions Donated services Special event revenue, net of direct expenses of $61,387 and $34,108 for 2016 and 2015, respectively Net assets released from restrictions $ Total revenue, gains and other support Expenses: Programs, grants and scholarships Support services, management and general Fundraising and development Total expenses Increase (decrease) in Net Assets - before other income Change in Net Assets Net assets, beginning of year Net assets, end of year UNRESTRICTED TEMPORARILY RESTRICTED PERMANENTLY RESTRICTED 11,557,442 3,934,513 2,959, , , , , ,613 15,650 29, , , ,558-44,208 - $ UNRESTRICTED TEMPORARILY RESTRICTED PERMANENTLY RESTRICTED 11,557,442 3,934,513 2,959, , , , , ,613 15,650 29, , ,600 10,735,438 3,677,681 2,787, , , , , ,079 65,562 23, , , , ,045-10,735,438 3,677,681 2,787, , , , , ,079 65,562 23, , ,000-98,996 - TOTAL (185,135) TOTAL 2, ,996 (244,996) - 2,081-98, ,135 21,016,238 (27,438) 44,208 21,033,008 19,927, ,045 20,089,113 13,673,390 5,712,183 1,268, ,673,390 5,712,183 1,268,614 13,287,656 5,504,987 1,096, ,287,656 5,504,987 1,096,343 20,654, ,654,187 19,888, ,888,986 44, ,821 38, , , ,051 Other income (expense): Investment income (loss) Gain (loss) on disposal of property and equipment 2015 (27,438) 1,168,569 (24,011) 75, ,244,199 (24,011) (333,239) 106 (15,812) - - (349,051) 106 1,144,558 75,630-1,220,188 (333,133) (15,812) - (348,945) 1,506,609 48,192 44,208 1,599,009 (294,770) (15,093) 161,045 (148,818) 16,587, , ,102 17,369,938 16,882, , ,057 17,518,756 18,094, , ,310 18,968,947 16,587, , ,102 17,369,938 The accompanying notes are an integral part of the consolidated financial statements. -4-

98 Page 98 EMERGENCY NURSES ASSOCIATION AND AFFILIATE CONSOLIDATED STATEMENTS OF CASH FLOWS YEARS ENDED DECEMBER 31, 2016 AND 2015 Cash provided by (applied to) operating activities: Change in net assets Adjustments to reconcile change in net assets to net cash provided by operating activities: Depreciation and amortization Net (gain) loss on disposal of property and equipment Bad debt expense Realized and unrealized (gain) loss on investment Contributions restricted for investment in endowment Decrease (increase) in assets: Accounts receivable, net of change in allowance for doubtful accounts Grants receivable Other receivables Inventory Prepaid expenses and other current assets Increase (decrease) in liabilities: Accounts payable Wages and benefits payable Accrued expenses Deferred revenue Credits on customer accounts Assessments payable 2016 $ 1,599,009 Cash provided by financing activities Collections of contributions restricted for investment in endowment 733,645 (106) 30, ,461 (161,045) 9,838 25,075 (66,967) (517,851) 22,334 7,222 74,652 69,968 (549,743) 233,478 30,996 (141,531) 134, ,872 36,324 (3,341) 32, ,391 95, ,794 Cash and cash equivalents, beginning of year 1,712,495 (287,818) (4,989,555) 3,865,899 (197,117) 200 (13,252,953) 6,579,457 (1,411,474) (6,870,413) 44,208 Net decrease in cash and cash equivalents (148,818) 483,244 24,011 19,838 (754,613) (44,208) 1,188,355 Cash provided by (applied to) investing activities: Purchases of property and equipment Proceeds from sale of property and equipment Purchase of investments Proceeds from sale and maturities of investments ,045 (178,911) (4,996,873) 863,661 5,860,534 Cash and cash equivalents, end of year $ 684, ,661 Other cash flow information Income taxes paid $ 67,168 75,739 The accompanying notes are an integral part of the consolidated financial statements. -5-

99 Page 99 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS NOTE 1 - NATURE OF OPERATIONS Emergency Nurses Association and Affiliate (Organization) consists of Emergency Nurses Association (ENA) and ENA Foundation (ENAF). ENA is a not-for-profit, professional association whose mission is to advocate for patient safety and excellence in emergency nursing practice. ENA, whose national headquarters is located in Des Plaines, Illinois, was founded in Paid membership is approximately 41,800. ENAF was established in 1991 to operate exclusively for charitable, educational and scientific purposes relating to emergency nursing. ENAF activities benefit emergency nurses, patients and the public through provision of undergraduate, advance practice, doctoral, and continuing education scholarships, and research grants. NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES Principles of Consolidation The accompanying consolidated financial statements include the accounts of ENA and ENAF. During 2016, management oversight of ENAF was the responsibility of the ENAF Management Board, subsequent to year-end this responsibility changed to the ENAF Board of Trustees. The sole voting member of ENAF is the ENA. Since ENA has control of the ENAF Management Board, accounting principles generally accepted in the United States of America require that the financial position and activities of both organizations be consolidated. All significant intercompany accounts and transactions have been eliminated in consolidation. Cash and Cash Equivalents For purposes of the statement of cash flows, the Organization considers all highly liquid instruments with an original maturity of three months or less to be cash equivalents. Accounts Receivable Accounts receivable consists of amounts due from Trauma Nursing Core Courses (TNCC), Emergency Nursing Pediatric Courses (ENPC), the sale of advertising space in various ENA publications and royalty arrangements with vendors for ENA educational offerings. Management reviews the aging of the course receivables to determine the level of allowance for doubtful accou nts to establish against the course receivables. -6-

100 Page 100 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Inventory Inventory is stated at the lower of cost or market, determined by the first-in, first-out (FIFO) method. As of December 31, 2016 and 2015, there is no allowance for obsolete and excess inventory necessary; therefore, no allowance was recorded. Investments Long-term and short-term investments in marketable securities with readily determinable fair values are presented in the consolidated financial statements at fair value. Shortterm investments are those with a maturity of greater than three months but no more than one year. Long-term investments with a maturity of greater than one year are mutual funds or equity securities. The fair values of investments are based on quoted market prices, when available, for those investments. Both realized and unrealized gains and losses are reported investment income i n the consolidated statement of activities and changes in net assets. The Organization's investments are exposed to various risks, such as interest rate, credit and overall market volatility. Due to these risk factors, it is reasonably possible that changes in the values of investments will occur in near term and will materially affect the amounts reported i n the consolidated financial statements and changes in net assets. Property and Equipment Property and equipment are stated at cost and depreciated over estimated useful lives using the straight-line method. Purchases greater than $2,500 are capitalized to property and equipment. Costs of repairs and maintenance are charged to expense as incurred. Credits on Customer Accounts Credits on customer accounts represent overpayments on accounts of ENA course directors relating to course fees. These overpayments are not automatically refunded, but instead are held on the account until the course director provides instruction as to the disposition of the credit. The credits are typically applied to future courses. Assessments Payable Assessments payable are amou nts due to ENA State Councils and Chapters for their share of paid memberships and course fees. Assessments are calculated and paid quarterly. Deferred Revenue Deferred revenue includes that portion of ENA membership dues that have not been earned as of the report date. ENA offers membership categories of one year, three years, five years and lifetime. -7-

101 Page 101 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Deferred Revenue, Continued Membership dues revenue is recognized on a prorated monthly basis over the term of the membership. The lifetime membership is recognized over a 13 year period. Deferred revenue also includes ENA conference fees collected in the year prior to the conference and ENA course fees collected in the year prior to the course. Course revenue is recognized in the period in which the course is given. Publication revenue is recognized in the period(s) published, and marketplace revenue is recognized when goods are shipped. Classification of Net Assets Net assets of the Organization are classified as unrestricted, temporarily restricted or permanently restricted depending on the presence and characteristics of donor-imposed restrictions limiting the Organization's ability to use or dispose of contributed assets or the economic benefits embodied in those assets. Donor-imposed restrictions that expire with the passage of time or can be removed by meeting certain requirements result in temporarily restricted net assets. Permanently restricted net assets result from donor-imposed restrictions that limit the use of net assets in perpetuity. Earnings, gains and losses on restricted net assets are classified as unrestricted unless specifically restricted by the donor or by applicable state law. Board Designated Net Assets Board designated net assets are unrestricted net assets designated by the ENA Board. These designations are based on Board actions, which can be altered or revoked at a future time by the Board. Currently the Board has designated funds for the ENAF endowments as well as to fund projects that fall within the criteria of the ENA spending policy. Concentration of Credit Risk The Organization maintains its cash in bank deposits which, at times, may exceed federally insured limits. The Organization believes it is not exposed to any significant credit risk on cash. As of December 31, 2016 and 2015, there are no amounts exceeding the federally insured limits. The Organization maintains its investments in broker accounts which, at times, may exceed federally insured limits. As of December 31, 2016 and 2015, the Organization s uninsured investment balance was $19,806,851 and $17,862,652, respectively. -8-

102 Page 102 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Contributions Contributions received are recorded as unrestricted, temporarily restricted or permanently restricted support, depending on the existence and/or nature of any donor restrictions. Contributions not collected at the end of the year are disclosed as pledges receivable and are recorded at their estimated fair values. They are subsequently valued at the present value of future cash flows. All contributions are expected to be collected in one year or less. All donor-restricted support is reported as an increase in temporarily or permanently restricted net assets, dependi ng on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or a purpose restriction is accomplished), temporarily restricted net assets are reclassified to unrestricted net assets and reported in the consolidated statement of activities and changes in net assets as net assets released from restrictions. Accounting Estimates The preparation of consolidated financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenue and expenses during the reporting period. Actual results could differ from those estimates. Income Taxes ENA and ENAF are exempt from federal and state income taxes under Internal Revenue Code Section 501(c)(3). ENA pays unrelated business income tax on advertising revenues derived from various ENA publications, as well as sponsorship revenues that provide marketing opportunities for the sponsor. Unrelated business income tax for the years ended December 31, 2016 and 2015 amounted to $97,357 and $95,106, respectively. Unrelated business income tax expense is included in programs, grants and scholarship expense on the consolidated statement of activities and changes in net assets. Management has concluded that as of December 31, 2016 and 2015, there were no uncertain positions taken or expected to be taken that would require recognition of a liability or disclosure in the consolidated financial statements. The Organization would account for any potential interest or penalties related to possible future liabilities for unrecognized income tax benefits as income tax expense. The Organization is no longer subject to examination by federal, state or local tax authorities for periods before

103 Page 103 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Income Taxes, Continued During 2014, the Organization was notified it is under an audit from the Illinois Department of Revenue. Management had estimated a liability of $15,000 and had included this amount as an accrued liability as of December 31, The audit was completed during 2015 and the total due was $23,989. The additional amount of $8,989 was expensed in the year ended December 31, Functional Expenses The costs of providing the program and support services have been reported on a functional basis in the consolidated statement of activities and changes in net assets. Indirect costs have been allocated between the various programs and support services based on estimates, as determined by management. Although the methods of allocation used are considered reasonable, other methods could be used that would produce a different amount. Adoption of Accounting Policy Going Concern Evaluation In August 2014, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) No , Presentation of Financial Statements Going Concern (Subtopic ). ASU No is effective for the Organization for annual periods ending after December 15, In the 2016 consolidated financial statements, the Organization adopted ASU No , which requires management to assess, for each interim and annual reporting period, whether adverse conditions or events, considered in the aggregate, raise substantial doubt about the Organization s ability to continue as a going concern for the one-year period from the date the consolidated financial statements are available to be issued. In addition, management is required to consider whether it is probable that their plans intended to mitigate any adverse conditions or events that they identify will be effectively implemented and whether it is probable that, if implemented, their plans will mitigate the identified conditions or events that raised substantial doubt. ASU No also prescribes the disclosures required to be made in periods when substantial doubt is raised and certain disclosures are required in such periods irrespective of whether it is probable that substantial doubt is alleviated by the effective implementation of management s plans. Management s assessment did not identify any conditions or events raising substantial doubt about the Organization s ability to continue as a going concern for the period from July 14, 2017 to July 14, New Accounting Standard Revenue from Contracts In May 2014, the FASB issued ASU No , Revenue from Contracts with Customers (Topic 606), which supersedes the revenue recognition requirements in Accounting Standards Codification 605, Revenue Recognition. ASU No provides for a single five-step model to be applied to all revenue contracts with customers. -10-

104 Page 104 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED New Accounting Standard Revenue from Contracts, Continued ASU No also requires additional financial statement disclosures about the nature, amount, timing and uncertainty of revenue and cash flows arising from customer contracts, including significant judgments and changes in judgments. ASU No is effective for annual reporting periods beginning after December 15, Early adoption is permitted for annual reporting periods beginning after December 15, The Organization is currently evaluating the methods of adoption allowed by ASU No and the effect that ASU No is expected to have on its financial position, results of operations and cash flows and related disclosures. New Accounting Standard Leases In February 2016, the FASB issued ASU No , Leases, which is intended to improve financial reporting about leasing transactions. ASU No requires that leased assets be recognized as assets on the balance sheet and the liabilities for the obligations under the lease also be recognized on the balance sheet. ASU No requires disclosures to help investors and other financial statement users better understand the amount, timing and uncertainty of cash flows arising from leases. The required disclosures include qualitative and quantitative requirements. ASU No is effective for fiscal years beginning after December 15, 2019 and interim periods within those fiscal years. Early adoption is permitted. ASU No must be adopted using a modified retrospective transition, and provides for certain practical expedients. Transition will require application of the new guidance at the beginning of the earliest comparative period presented. The Organization is currently evaluating the methods of adoption allowed by ASU No and the effect that ASU No is expected to have on its financial position, results of operations and cash flows and related disclosures. New Accounting Standard Presentation of Financial Statements In August 2016, the FASB issued ASU No , Presentation of Financial Statements of Not-for-Profit Entities (Topic 958). ASU No is intended to simplify how the Organization classifies its net assets, and also improve the information it presents in the consolidated financial statements and notes about liquidity, financial performance and cash flows. ASU No is effective for annual financial statements issued for fiscal years beginning after December 15, 2017, and for interim periods with fiscal years beginning after December 15, The Organization is currently evaluating the methods of adoption allowed by ASU No and the effect that ASU No is expected to have on its financial position, results of operations and cash flows and related disclosures. -11-

105 Page 105 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Subsequent Events Subsequent events have been evaluated through July 14, 2017, the date that the consolidated financial statements were available for issue. NOTE 3 - PROPERTY AND EQUIPMENT The useful lives for purposes of computing depreciation are as follows: Buildings Building improvements Equipment Program development Furniture and fixtures Computer software years years years years years years The cost of property and equipment is summarized as follows as of December 31, 2016 and 2015: 2016 Land Buildings Building improvements Equipment Program development Furniture and fixtures Computer software $ Less accumulated depreciation and amortization $ ( ,000 3,140, , , , ,578 4,058,948 9,371,094 5,901,403) ( 530,000 3,140, , , , ,748 4,202,589 9,886,617 6,197,489) 3,469,691 3,689,128 Depreciation expense of property and equipment charged to operations was $416,584 and $667,311 for the years ended December 31, 2016 and 2015, respectively. In addition, the Organization amortized development costs (included in programs, grants and scholarship expenses) for the years ended December 31, 2016 and 2015 in the amounts of $66,660 and $66,334, respectively. -12-

106 Page 106 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 4 - INVESTMENTS Investment income (loss) for 2016 and 2015 were as follows: 2016 Interest and dividends, net of expenses Unrealized and realized gains (losses) 2015 $ 489, ,613 ( 421, ,461) $ 1,244,199 ( 349,051) Investment fees for 2016 and 2015 were $25,000, and are included in investment income (loss) on the consolidated statements of activities and changes in net assets. NOTE 5 - FAIR VALUE MEASUREMENTS Accounting standards require certain assets be reported at fair value in the consolidated financial statements and provide a framework for establishing that fair value. The framework for determining fair value is based on a hierarchy that prioritizes the inputs and valuation techniques used to measure fair value. The following tables present information about the Organization's assets measured at fair value on a recurring basis at December 31, 2016 and 2015 and the valuation techniques used by the Organization to determine those fair values. Fair values determined by Level 1 inputs use quoted prices in active markets for identical assets that the Organization has the ability to access. Level 1 investments consist of mutual funds which are valued at the daily closing price as reported by the fund. Mutual funds held by the Organization are open-end mutual funds that are registered with the U.S. Securities and Exchange Commission. These funds are required to publish their daily NAV and to transact at that price. The mutual funds held by the Organization are deemed to be actively traded. Fair values determined by Level 2 inputs use other inputs that are observable, either directly or indirectly. These Level 2 inputs include quoted prices for similar assets in active markets and other inputs such as interest rates and yield curves that are observable at commonly quoted intervals. Level 3 inputs are unobservable inputs, including inputs that are available in situations where there is little, if any, market activity for the related asset. These Level 3 fair value measurements are based primarily on management's own estimates using pricing models, discounted cash flow methodologies, or similar techniques taking into account the characteristics of the asset. -13-

107 Page 107 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 5 - FAIR VALUE MEASUREMENTS, CONTINUED In instances whereby inputs used to measure fair value fall into different levels in the above fair value hierarchy, fair value measurements in their entirety are categorized based on the lowest level input that is significant to the valuation. The Organization's assessment of the significance of particular inputs to these fair value measurements requires judgment and considers factors specific to each asset. Investments reported at market value consist of the following at December 31, 2016: Assets at Fair Value at December 31, 2016 Level 1 Level 2 Level 3 Total Mutual funds: Fixed income: Broad domestic International bonds High yield bonds Short-term bonds $ 3,782, ,928 2,387,771 4,791, ,782, ,928 2,387,771 4,791,005 3,052,178 1,408,308 1,295, ,160 1,213, ,052,178 1,408,308 1,295, ,160 1,213,202 Real estate funds 738, ,555 Commodities 767, ,488 20,614, ,614,054 Equity: Domestic large cap Domestic small/mid cap International equity Market neutral Emerging markets $ -14-

108 Page 108 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 5 - FAIR VALUE MEASUREMENTS, CONTINUED Investments reported at market value consist of the following at December 31, 2015: Assets at Fair Value at December 31, 2015 Level 1 Level 2 Level 3 Total Mutual funds: Fixed income: Broad domestic International bonds High yield bonds Short-term bonds $ 3,224, ,157 1,797,913 5,276, ,224, ,157 1,797,913 5,276,350 2,595,082 1,206,325 1,093, ,120 1,091, ,595,082 1,206,325 1,093, ,120 1,091,951 Real estate funds 671, ,468 Commodities 622, ,752 18,735, ,735,785 Equity: Domestic large cap Domestic small/mid cap International equity Market neutral Emerging markets $ -15-

109 Page 109 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 6 - OPERATING LEASE The Organization is obligated under certain operating leases, primarily for certain office space and office equipment which expire on various dates until Total rent expense under all operating leases amounted to approximately $84,120 and $48,433 for the years ended December 31, 2016 and 2015, respectively. The aggregate future minimum lease commitment on these leases as of December 31, 2016 is as follows: $ 98,745 32,079 $ 130,824 NOTE 7 - RETIREMENT SAVINGS PLAN ENA has a 401(k) defined contribution retirement savings plan (Plan) available to substantially all of the Organization s employees. ENA matches up to 4% of each employee s contribution to the Plan. The Plan also has a profit-sharing component. ENA s profit-sharing contribution is set each year as part of the budget process. In 2016 and 2015, ENA s profit-sharing contribution was 5% of each qualified employee s salary. ENA s contribution is funded on a current basis. Total contributions to the Plan in 2016 and 2015 were $594,290 and $575,097, respectively. NOTE 8 - COMMITMENTS The Organization has entered into a number of contracts with various vendors for space, hotel accommodations and ancillary services for future meetings. Minimum estimated cancellation fees are as follows: $ 1,041, ,820 1,596,604 $ 2,875,558

110 Page 110 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 9 - ENDOWMENTS The Organization's endowment includes three board-designated endowments established for the ENAF and nine donor-restricted endowment funds primarily for the general operating purposes of the Organization, as well as for specific programs and scholarships. Net assets associated with endowment funds are classified and reported based on the existence or absence of donor-imposed restrictions. The Board of Trustees of the Organization has interpreted the Uniform Prudent Management of Institutional Funds Act (UPMIFA) as requiring the preservation of the fair value of the original gift as of the gift date of the donor-restricted endowment funds, absent explicit donor stipulations to the contrary. As a result of this interpretation, the Organization classifies as permanently restricted net assets (a) the original value of gifts donated to the permanent endowment, (b) the original value of subsequent gifts to the permanent endowment, and (c) accumulations to the permanent endowment made in accordance with the direction of the applicable donor gift instrument at the time the accumulation is added to the fund. The remaining portion of the donor-restricted endowment fund that is not classified in permanently restricted net assets is classified as temporarily restricted net assets until those amounts are appropriated for expenditure by the Organization in a manner consistent with the standard of prudence prescribed by UPMIFA. In accordance with UPMIFA, the Organization considers the following factors in making a determination to appropriate or accumulate donor-restricted endowment funds: 1) 2) 3) 4) 5) 6) 7) The duration and preservation of the fund The purpose of the Organization and the donor-restricted endowment fund General economic conditions The possible effect of inflation and deflation The expected total return from income and the appreciation of investments Other resources of the Organization The investment policies of the Organization -17-

111 Page 111 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 9 - ENDOWMENTS, CONTINUED Endowment net asset composition by type of fund as of December 31, Board designated funds endowment $ Donor-restricted funds endowment Total funds Unrestricted Temporarily Restricted 1,142, ,142, , , , , ,310 2,017,211 $ 1,142,840 Permanently Restricted Total Changes in endowment net assets for the fiscal year ended December 31, Unrestricted Temporarily Restricted 1,068, , ,102 1,850,469 31,537 24,537-56,074 66,086 51, ,179 Total investment income 97,623 75, ,253 Contributions 25,000-44,208 69, Endowment net assets, beginning of year Investment income: Interest and dividends Net appreciation (realized and unrealized) $ Obligation to replenish corpus Appropriation of endowment assets for expenditure Endowment net assets, end of year ( $ 719 ( 719) 49,000) ( 26,719) 1,142, ,061 Permanently Restricted - ( 721,310 Total 75,719) 2,017,211

112 Page 112 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 9 - ENDOWMENTS, CONTINUED Endowment net asset composition by type of fund as of December 31, Board designated funds endowment $ Donor-restricted funds endowment Total funds $ Unrestricted Temporarily Restricted Permanently Restricted 1,068, ,068, , , ,971 1,068, , ,102 1,850,469 Total Changes in endowment net assets for the fiscal year ended December 31, Endowment net assets, beginning of year Investment income: Interest and dividends Net depreciation (realized and unrealized) Unrestricted Temporarily Restricted 1,122, , ,057 1,758,204 31,427 19,885-51,312 ( 62,945) ( 35,697) - ( 98,642) ( 31,518) ( 15,812) - ( 47,330) $ Total investment loss Contributions 25, , , ( 719) 719 Appropriation of endowment assets for expenditure ( 46,600) - $ 1,068, Total - Obligation to replenish corpus Endowment net assets, end of year Permanently Restricted 104,869 - ( 677,102 46,600) 1,850,469

113 Page 113 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 9 - ENDOWMENTS, CONTINUED From time to time, the fair value of the assets associated with individual donor-restricted endowment funds may fall below the historic dollar value at date of gift. In accordance with professional accounting standards, deficiencies of this nature are reported in unrestricted net assets which was $719 at December 31, These deficiencies resulted from unfavorable market fluctuations. During 2016, market conditions were favorable allowing the $719 deficiency from 2015 to be restored. The Organization has adopted investment and spending policies for endowment assets that attempt to provide a predictable stream of funding to programs supported by its endowment while seeking to maintain the purchasing power of the endowment assets. Endowment assets include those assets of donor restricted funds that the Organization must hold in perpetuity or for a donor specified periods. The long-term investment objective for the endowment funds is to generate sufficient income to support its programs while preserving the related principal. To satisfy its long-term rate-of-return objectives, ENAF relies on a diversified asset allocation strategy that places a greater emphasis on equity-based investments to achieve its long-term return objectives within prudent risk constraints. ENAF's policy allows for the distribution of up to 5% of the endowment's fair value. NOTE 10 - RESTRICTION ON NET ASSETS Temporarily restricted net assets consist of the following: Purpose restrictions: Karen O Neil Endowed Scholarship Fund $ New York State September 11 Endowment Fund Judith C. Kelleher Memorial Endowment Fund Anita Dorr Memorial Endowment Fund Jeanette Ash Memorial Endowment Fund Richard Wynkoop Memorial Endowment Fund Elizabeth Moore Memorial Endowment Fund Texas Endowment Fund General Endowment Fund Total temporarily restricted net assets -20- $ ,660 13,268 23,654 21, , ,286 1,842 73,604 14,053 17,328 3,194 57, , ,869

114 Page 114 EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (CONTINUED) NOTE 10 - RESTRICTION ON NET ASSETS, CONTINUED Permanently restricted net assets consist of the following: 2016 Karen O Neil Endowed Scholarship Fund $ New York State September 11 Endowment Fund Judith C. Kelleher Memorial Endowment Fund Anita Dorr Memorial Endowment Fund Jeanette Ash Memorial Endowment Fund Richard Wynkoop Memorial Endowment Fund Elizabeth Moore Memorial Endowment Fund Texas Endowment Fund General Endowment Fund Total permanently restricted net assets $ ,439 65,769 90,104 65,045 1,102 29,365 6, ,000 25, ,308 88,109 64,203 1,000 15,955 4, , , , ,102 NOTE 11 - NET ASSETS RELEASED FROM RESTRICTIONS Net assets released from restrictions during the years ended December 31, 2016 and 2015, because donor restrictions were met by satisfying the stated purpose or time or other event are as follows: 2016 Scholarships Research Total net assets released from restrictions 2015 $ 236,996 8, ,135 3,000 $ 244, ,135 NOTE 12 - RECLASSIFICATIONS Certain amounts in the 2015 financial statements have been reclassified to conform with the year 2016 presentation. -21-

115 Page 115 SUPPLEMENTARY INFORMATION

116 Page 116 INDEPENDENT AUDITORS REPORT ON SUPPLEMENTARY INFORMATION Finance Committee Emergency Nurses Association ENA Foundation Board of Trustees Des Plaines, Illinois Our report on our audits of the consolidated financial statements of Emergency Nurses Association and Affiliate for the years ended December 31, 2016 and 2015 appears on pages 1 and 2. Those audits were made for the purpose of forming an opinion on such consolidated financial statements taken as a whole. The 2016 and 2015 information on pages 23 through 28 is presented for purposes of additional analysis and is not a required part of the consolidated financial statements. Such information is the responsibility of management and was derived from and related directly to the underlying accounting and other records used to prepare the consolidated financial statements. The information has been subjected to the auditing procedures applied in the audits of the consolidated financial statements and certain additional procedures, including comparing and reconciling such information directly to the underlying accounting and other records used to prepare the consolidated financial statements or to the consolidated financial statements themselves, and other additional procedures in accordance with auditing standards generally accepted in the United States of America. In our opinion, the information is fairly stated in all material respects in relation to the consolidated financial statements for the years ended December 31, 2016 and 2015 taken as a whole. Elgin, Illinois July 14, Certified Public Accountants Business Advisors Offices in Elgin and Chicago

117 Page 117 EMERGENCY NURSES ASSOCIATION STATEMENTS OF FINANCIAL POSITION DECEMBER 31, 2016 AND 2015 ASSETS Current assets: Cash and cash equivalents Receivables: Accounts receivable, net of allowance for doubtful accounts of $156,028 and $136,190 for 2016 and 2015, respectively Due from affiliate - ENA Foundation Inventory Prepaid expenses and other current assets , ,969 1,510, , ,605 1,540,317 2, , ,338 2,407,000 2,412,009 3,469,691 3,685,761 17,830,154 16,405,634 $ 23,706,845 22,503,404 $ 210, , ,356 7,320 3,091, ,559 1,496, , , ,321 3,047, ,156 1,310,630 6,819,099 6,729, ,789 1,004,871 7,637,888 7,734,564 15,601, ,678 14,492, ,590 16,068,957 14,768,840 23,706,845 22,503,404 $ Total current assets Property and equipment, net Investments Total assets LIABILITIES AND NET ASSETS Current liabilities: Accounts payable Wages and benefits payable Accrued expenses Due to affiliate - ENA Foundation Deferred revenue Credits on customer accounts Assessments payable Total current liabilities Long-term liabilities Deferred revenue, net of current portion Total liabilities Net assets: Unrestricted: Undesignated Board designated Total unrestricted Total liabilities and net assets $ See Independent Auditors' Report on Supplementary Information. -23-

118 Page 118 EMERGENCY NURSES ASSOCIATION STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS YEARS ENDED DECEMBER 31, 2016 AND Revenue, gains and other support: Courses Membership dues Conferences Publications Marketplace Sponsorships Royalties Other Grants Mailing lists Donated services $ Total revenue, gains and other support Expenses: Program services Support services, management and general Fundraising and development Total expenses Increase (decrease) in net assets - before other income Net assets, beginning of year $ See Independent Auditors' Report on Supplementary Information ,735,438 3,677,681 2,787, , , , , ,057 65,562 23, ,000 20,605,994 19,539,542 13,548,062 5,599,144 1,147,773 13,192,705 5,398, ,678 20,294,979 19,571,494 1,013,113 (24,011) Increase (decrease) in net assets Net assets, end of year 11,557,442 3,934,513 2,959, , , , , ,613 15,650 29, , ,015 Other income (expense): Investment income (loss) Gain (loss) on disposal of property and equipment 2015 (31,952) (284,121) ,102 (284,015) 1,300,117 (315,967) 14,768,840 15,084,807 16,068,957 14,768,840

119 Page 119 EMERGENCY NURSES ASSOCIATION STATEMENTS OF CASH FLOWS YEARS ENDED DECEMBER 31, 2016 AND 2015 Cash provided by (applied to) operating activities: Increase (decrease) in net assets Adjustments to reconcile change in net assets to net cash provided by operating activities: Depreciation and amortization Net (gain) loss on disposal of property and equipment Bad debt expense Realized and unrealized losses (gains) on investments Decrease (increase) in assets: Accounts receivable Grants receivable Other receivables Inventory Prepaid expenses, deposits and other assets Increase (decrease) in liabilities: Accounts payable Wages and benefits payable Accrued expenses Due (to) from affiliate - ENA Foundation Deferred revenue Credits on customer accounts Assessments payable 2016 $ 1,300,117 (315,967) 479,877 24,011 19,838 (597,081) 726,912 (106) 30, ,437 9,838 25,075 (70,267) (517,851) 22,334 7,222 74,287 73,268 (547,253) 233,478 31,035 10,043 (141,531) 134, ,872 34,039 (3,341) 32,364 (9,307) 397,741 94, ,794 1,097,455 Cash provided by (applied to) investing activities: Purchases of property and equipment Proceeds from sale of property and equipment Purchases of investments Proceeds from sale and maturities of investments ,566,191 (287,818) (4,643,386) 3,815,947 (197,117) 200 (11,913,875) 5,629,622 (1,115,257) (6,481,170) Net decrease in cash and cash equivalents (17,802) (4,914,979) Cash and cash equivalents, beginning of year 586,969 5,501,948 Cash and cash equivalents, end of year $ 569, ,969 Other cash flow information Income taxes paid $ 67,168 75,739 See Independent Auditors' Report on Supplementary Information. -25-

120 Page 120 ENA FOUNDATION STATEMENTS OF FINANCIAL POSITION DECEMBER 31, 2016 AND 2015 ASSETS 2016 Current assets: Cash and cash equivalents Due from affiliate - ENA Prepaid expenses and other current assets $ 115,583 7, ,692 3, , ,992-3,367 2,783,900 2,330,151 $ 2,906,803 2,613,510 $ 6, , , ,813 12, ,779 1,142, ,910 1,069,217 2,025,619 1,819, , , , ,102 2,899,990 2,601,098 2,906,803 2,613,510 Total current assets Property and equipment, net Investments Total assets 2015 LIABILITIES AND NET ASSETS Current liabilities: Accounts payable Accrued expenses Due to affiliate - ENA Credits on customer accounts Total current liabilities Net assets: Unrestricted: Undesignated Board designated Total unrestricted Temporarily restricted Permanently restricted Total net assets Total liabilities and net assets $ See Independent Auditors' Report on Supplementary Information. -26-

121 Page 121 ENA FOUNDATION STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS YEARS ENDED DECEMBER 31, 2016 AND Support, revenues and other additions: Support: Contributions Special events revenue - net of direct expenses of $61,387 and $34,108 for the years 2016 and 2015, respectively Other Net assets released from restriction UNRESTRICTED TEMPORARILY RESTRICTED PERMANENTLY RESTRICTED 458, ,558 44,208 2, ,996 (244,996) 706,018 (27,438) $ Total revenue, gains and other support Expenses: Programs, grants and scholarships General and administrative Fundraising and development Total expenses Increase in net assets - before investment income Investment income (loss) $ TEMPORARILY RESTRICTED PERMANENTLY RESTRICTED 720, , , , ,927-2,081-98, ,135 (185,135) - 98, , , , , ,945 TOTAL , , , , , , , , , , , , ,866 44,208 67,806 70, , ,079 (27,438) 155,456 75, ,086 (49,118) (15,812) - 206,492 48,192 44, ,892 21,197 (15,093) 161, ,149 1,819, , ,102 2,601,098 1,797, , ,057 2,433,949 2,025, , ,310 2,899,990 1,819, , ,102 2,601,098 Change in net assets Net assets, end of year UNRESTRICTED TOTAL 307, , ,841 51,036 Net assets, beginning of year 2015 See Independent Auditors' Report on Supplementary Information (64,930)

122 Page 122 ENA FOUNDATION STATEMENTS OF CASH FLOWS YEARS ENDED DECEMBER 31, 2016 AND 2015 Cash provided by (applied to) operating activities: Change in net assets Adjustments to reconcile change in net assets to net cash provided by operating activities: Depreciation Realized and unrealized (gain) loss on investments Contributions restricted for investment in endowment Decrease (increase) in assets: Due (to) from affiliate - ENA Prepaid expenses Inventory Increase (decrease) in liabilities: Accounts payable Accrued expenses Deferred revenue Credits on customer accounts 2016 $ 298, ,149 3,367 (157,532) (44,208) 6, ,024 (161,045) (10,043) 3,300-9,307 (3,300) 365 (2,490) (39) (347) 2, (2,350) 97 90,900 Cash provided by (applied to) investing activities: Purchases of investments Proceeds from sale and maturities of investments Cash provided by financing activities Collections of contributions restricted for investment in endowment (1,339,078) 949,835 (296,217) (389,243) (161,109) Cash and cash equivalents, beginning of year Cash and cash equivalents, end of year $ See Independent Auditors' Report on Supplementary Information ,304 (346,169) 49,952 44,208 Net decrease in cash and cash equivalents ,045 (81,894) 276, , , ,692

123 Page ENA COMMITTEE ROSTER, CHARGES AND CRITERIA Appendix E General Criteria for all committees (unless specifically noted) is as follows: Strong attention to detail and the ability to meet deadlines Professional writing and reviewing skills o Writing samples may be required for consideration Ability to provide expert and time-sensitive feedback on documents from external entities as requested by the Chief Nursing Officer, on behalf of the President Proficient in Microsoft Office Suite (Word, Excel, PowerPoint) Ability to use ENA Connect for committee activity (online) Timely response to and phone calls Ability to participate in meetings; some may be onsite requiring travel (expenses paid by ENA) Review and agree to ENA s travel policy and guidelines Ability to participate in several conference calls and share documents via WebEx Conferencing and ENA Connect In general, committee meetings, WebEx teleconferences and conference calls are scheduled during ENA business hours of Monday through Friday, 9:00 am 4:00 pm Central time *Emerging Professionals noted in red ADVOCACY ADVISORY COUNCIL NAME Rita Anderson, BSN RN CEN FAEN Chairperson (1/1/17 12/31/17) Virginia Orcutt, MSN BSN RN CEN Michelle Cockrell, MSN BSN RN Pat Clutter, MEd, RN, CEN, FAEN Tim Murphy, MSN, RN, CEN, ACNP-BC Mary LeBlond, MSN RN CEN SANE FAEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM Arizona Arizona Ohio Missouri New Jersey Texas 1/1/17 12/31/17 1/1/17 12/31/18 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/17 12/31/18 Rita Anderson Jeff Solheim Rob Kramer 2017 Charges: 1. Review and identify public policy as it relates to advocacy in emergency nursing. 2. Generate ideas for program development and implementation related to government relations and advocacy. 3. Assist in prioritizing advocacy efforts based on ENA s organizational priorities. Specific Criteria: Must have extensive knowledge of public policy issues affecting emergency care and emergency nursing at the state and federal levels Demonstrated advocacy involvement with ENA State Council/Chapter Ability to serve for a one-year term Emergency Nurses Association 7/10/2017 1

124 Page 124 AWARDS COMMITTEE NAME STATE Alex Sproul, RN Chairperson (1/1/17 12/31/17) William Light, BSN BS ADN RN CEN CPEN TCRN Suzanne Wurster, MSN BSN RN CEN Linda Arapian, MSN RN EMT-B CEN CPEN TCRN FAEN Kristen Connor, MS, BSN, RN, CEN, PHRN Sue Deyke, MSN RN CEN Tonya Barnard, BSN RN EMT-B CEN CPEN CFRN CTRN CCRN TCRN Rose Marie Nolazco, BSN RN Teresa Wenner, MSN BSN RN CEN CPEN Traci McGregor, BSN RN CEN Katie Johnson, MS RN CEN CCRN Patricia Nierstedt, MS, RN, CEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: TERM South Dakota Oregon Pennsylvania Maryland California Nebraska Louisiana Illinois West Virginia Missouri Washington New Jersey 1/1/17 12/31/17 1/1/17 12/31/18 1/1/17 12/31/18 1/1/17 12/31/18 1/1/16 12/31/17 1/1/17 12/31/17 1/1/17 12/31/18 1/1/17 12/31/17 1/1/17 12/31/17 1/1/17 12/31/17 1/1/17 12/31/17 1/1/17 12/31/17 Alex Sproul Karla Nygren Ellen Siciliano 2017 Charges: 1. Review and score eligible candidate applications 2. Review application criteria and provide recommendations for revisions 3. Encourage award application submission 4. Establish criteria for the State Achievement Innovation Award Specific Criteria: Must be able to participate in reviewer training and utilize the electronic award scoring tool Experience at a state or chapter level at ENA Ability to serve for a two-year term BYLAWS TASK FORCE NAME Bruce Olson, MSN BSN BA RN CEN PHN, Chairperson Matthew F. Powers, MS BSN RN MICP CEN Joan Somes, PhD MSN RN CEN CPEN FAEN Karen Wiley, MSN RN CEN Louise Hummel, MSN RN CNS CEN TCRN FAEN Julie Miller, BSN RN CEN Tiffiny Strever, BSN, RN, CEN FAEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM Minnesota California Minnesota Nebraska California Kansas Arizona 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 Bruce Olson Kathleen Carlson Renee Scaletta 2017 Charges: 1. To revise the current ENA Bylaws utilizing a draft set of Bylaws provided by ENA Legal Counsel 2. Work with the ENA state and chapter leaders and members for their input throughout the process Emergency Nurses Association 7/10/2017 2

125 Page 125 CERTIFIED EMERGENCY NURSING (CEN) REVIEW MANUAL WORK TEAM NAME Louise Hummel, MSN, RN, CNS, CEN, FAEN, Chairperson (1/1/16 12/31/17) Benjamin E. Marett, EdD, MSN, RN, CEN, CCRN, NE-BC, FAEN Dawn M. Specht, PhD, MSN, RN, CNS, CEN, CCNS, CCRN Jacqueline Stewart, DNP, MSN, RN, CEN, CCRN, FAEN Jennifer Anne Van Cura, DNP, MSN, MBA, RN, CEN Melissa L. Weir, MS, BSN, RN, CEN, CPEN, CNE 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM California 1/1/16 12/31/17 South Carolina New Jersey Pennsylvania Colorado Maryland 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 Louise Hummel Kathleen Carlson Nicole Williams 2017 Charges: 1. Develop the 5th edition of the CEN Review Manual to reflect the most current CEN practice analysis. 2. Seek experts in each content area for item writing. 3. Evaluate options for course delivery, including printed manual, online format and other options. Specific Criteria: Experience with item writing and test question development Must have CEN certification or previous CEN certification Ability to serve until work completed Emergency Nurses Association 7/10/2017 3

126 Page 126 CLINICAL PRACTICE GUIDELINES COMMITTEE NAME 1. Anna Maria Valdez, PhD, MSN, RN, CEN, CFRN, FAEN, Chairperson (1/1/17 12/31/18) 2. Judith Young Bradford, DNS MSN RN FAEN Chairperson-elect (1/1/17 12/31/18) Chairperson (1/1/19 12/31/20) 3. Mindi Lynne Johnson, DNP MSN BSN RN CPN 4. Andrea Slivinski, DNP, RN, CEN, ACNS-BC 5. Marylou Killian, DNP, MS, RN, CEN, FNP-BC, FAEN 6. Nancy Erin Reeve, MSN, BSN, RN, CEN 7. Annie Horigan, PhD, RN 8. Stephen Stapleton, PhD, MSN, MS, BSN, BS, RN, CEN, FAEN 9. Mary Alice Vanhoy, MSN, RN, CEN, CPEN, NREMT-P, FAEN 10. Mary Zaleski, MSN, RN, CEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM California 1/1/17 12/31/18 Mississippi 1/1/17 12/31/20 Michigan North Carolina New York Virginia Georgia Illinois Maryland Maryland 1/1/17 12/31/19 3/8/17 12/31/17 1/1/17 12/31/17 1/1/15 12/31/17 1/1/16 12/31/18 1/1/15 12/31/18 1/1/16 12/31/18 1/1/15 12/31/17 Anna Valdez Jean Proehl Lisa Wolf 2017 Charges: 1. Develop evidence-based clinical practice guidelines. 2. Recommend topic areas for future clinical practice guidelines development. 3. Review and update existing clinical practice guidelines as appropriate. Specific Criteria: Must have current emergency department experience Must have capacity to review significant numbers of scientific articles and other literature, conduct literature searches and be able to critically analyze and discuss the results of the literature searches including a working knowledge of evidence ratings Must be able to write clearly, professionally, and within the time constraints of the CPG process o Scientific writing sample required Formal training in research and evidence-based practice translation highly recommended Masters or doctoral degree required Ability to serve for a three-year term COURSE ADMINISTRATION FACULTY NAME Harriet Hawkins, RN, CPEN, CCRN, FAEN, Chairperson (1/1/17 12/31/17) Geraldine Muller, MSN RN CEN TCRN Paula Davis, MSN ARNP CEN CPEN CFRN FNP-BC Sandra Waak, RN, CEN Mindy Yorke, MSN, RN, ARNP, CEN, CPEN, FNP-BC 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM Illinois Michigan Florida Maryland Florida 1/1/17 12/31/18 1/1/17 12/31/18 1/1/17 12/31/18 1/1/16 12/31/17 1/1/16 12/31/17 Harriet Hawkins Patricia Kunz Howard Nicole Williams 2017 Charges: 1. Review course administrative procedures and provide recommendations as requested. 2. Provide recommendations for team members and team leaders for dissemination of TNCC and ENPC. 3. Recommend disciplinary action of Course Directors and Course Instructors as necessary. Specific Criteria: Must be TNCC and ENPC faculty Experience in working with ENA educational programs Ability to serve for a two-year term Emergency Nurses Association 7/10/2017 4

127 Page 127 EMERGENCY DEPARTMENT BEHAVIORAL HEALTH COMMITTEE NAME Tomi St. Mars, MSN, RN, CEN, FAEN, Chairperson (1/1/17 12/31/17) Kristi Creighton, ADN RN Michael Gary, RN Janet Curley, DNP RN CEN Kelly Jeanne Collins, BSN RN CEN SANE 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM Arizona Nebraska Louisiana New Jersey Maine 1/1/17-12/31/18 1/1/17-12/31/18 1/1/16 12/31/17 1/1/17-12/31/18 1/1/17 12/31/17 Tomi St. Mars Karla Nygren Cydne Perhats 2017 Charges: 1. Provide subject matter expertise on behavioral health issues to inform practice, education, research, and policy agendas for the organization. 2. Develop evidence-based resources to assist emergency nurses to care for behavioral health patients in the emergency setting Specific Criteria: Must have knowledge of behavioral health practice as it impacts emergency nursing Experience in development or implementation of behavioral health guidelines for care within community or institution Experience in the development of nursing education related to behavioral health issues preferred Writing sample required Ability to serve for a two-year term EMERGENCY DEPARTMENT OPERATIONS COMMITTEE NAME Pamela A. Assid, DNP, MSN, BSN, RN, CNS, CEN, CPEN, NEA-BC Chairperson (1/1/17 12/31/17) Lynn Marie Garreffi, MSN RN CNL RN-BC Jennifer Granata, MSN, BSN, RN, EMT-P, CEN, CPEN, FNP-BC India Owens, MSN RN CEN NE-BC FAEN Terry Stigdon, MSN, RN, CPEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM Colorado 1/1/17-12/31/18 Massachusetts Maine Indiana Indiana 1/1/17-12/31/18 1/1/16 12/31/17 1/1/17-12/31/18 1/1/16 12/31/17 Pamela Assid Mike Hastings Cathy Olson 2017 Charges: Identify and recommend innovative system-wide strategies to decrease ED boarding time. Provide subject matter expertise related to emergency department operations/management. Identify best practices for use of technology/informatics to improve patient safety in the emergency department Specific Criteria: Must have a good understanding of systems, organization and management of operations in the delivery of emergency care Experience in a leadership role in an emergency setting of care Ability to serve for a two-year term Emergency Nurses Association 7/10/2017 5

128 Page 128 EMERGENCY MANAGEMENT AND PREPAREDNESS COMMITTEE NAME Daniel Nadworny, MSN, BSN, RN Chairperson (1/1/17 12/31/17) Sue Ann Bell, PhD, RN, FNP-BC Angela Gentry, BSN RN Angela Hodge, DNP RN EMT-P CEN ACNS-BC SANE Donna Hovey, MPPM, BSN, RN, CEN, CCRN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM Massachusetts Michigan Texas Ohio Maine 1/1/17-12/31/18 1/1/16 12/31/17 1/1/17-12/31/18 1/1/17-12/31/18 1/1/17 12/31/17 Daniel Nadworny Mike Hastings Monica Kolbuk 2017 Charges: 1. Provide subject matter expertise on emergency management and preparedness. 2. Identify best practices for all patient populations related to emergency management preparedness. 3. Identify, recommend and develop resources for emergency management and preparedness to benefit emergency nursing. Specific Criteria: Must have knowledge and active involvement in emergency management, planning, application and evaluation Ability to serve for a two-year term EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL NAME Vicki Sweet, MSN, RN, CEN, FAEN, Chairperson (1/1/17 12/31/17) Kathy Robinson, RN, FAEN Brad Lieberman, JD BS EMT-B Antonio Garcia, MS, BSN, BS, RN, APRN, ACNP, EMT-P, CEN, CPEN, ACCNS-AG, ACNP-BC Fred Neis, MS, RN, CEN, FAEN, FACHE Stacia Smith, MSN BSN RN EMT-P CEN CCRN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM California Pennsylvania New York Texas 1/1/17-12/31/17 1/1/17-12/31/18 1/1/17-12/31/18 1/1/16 12/31/17 District of Columbia Missouri 1/1/17 12/31/17 1/1/17-12/31/18 Vicki Sweet Patricia Kunz Howard Monica Kolbuk 2017 Charges: 1. Provide subject matter expertise on emergency medical services as it relates to the ED nurse. 2. Review and recommend resources to promote collaboration between EMS providers and ED nurses. 3. Review EMS initiatives to improve population health and provide recommendations as relevant to emergency nursing. Specific Criteria: Must have current or recent experience as an EMS provider (basic, advanced, pre-hospital RN, flight nursing that does 911 response) or be in an EMS leadership or education position Ability to review and respond to assigned documents related to EMS and emergency nursing, sometimes on urgent timelines Ability to serve for a one-year term Emergency Nurses Association 7/10/2017 6

129 Page 129 EMERGENCY NURSING CONFERENCE EDUCATION PLANNING COMMITTEE NAME Jami Blackwell, BSN BS RN CEN, Chairperson (1/1/17 12/31/17) Kristen Cline, BSN RN CEN CPEN CFRN SANE-A TCRN Chairperson-elect (1/1/17 12/31/17) Cheryl Randolph, MSN RN FNP CEN CPEN CCRN FNP-BC TCRN FAEN Kifah Awadallah, DNP MSN BS RN Christine Russe, MSN RN CEN CPEN TCRN FAEN William Schueler, MSN RN CEN Trina Cole, MSN BSN RN SANE FACHE Charlene Draleau, MSN, RN, CPEN Karen Drum, BSN, RN, CEN Joan Eberhardt, MA, BSN, RN, CCRN, FAEN Sondra Heaston, MS, RN, APRN, CEN, CNE, NP-C Don Andrews, MS BSN RN CEN Kristine Powell, MSN, RN, CEN, NEA-BC, FAEN Kimberly Brandenburg, MSN BSN RN CEN CENP Jack Rodgers, BSN, RN, CEN, NREMT-P* Jessica Trivett, MSN, RN, CEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM Missouri South Dakota 1/1/17 12/31/17 1/1/17 12/31/19 California Ohio Texas Oregon Missouri Rhode Island North Carolina Missouri Utah Louisiana Texas Nebraska Georgia New Jersey 1/1/17 12/31/17 1/1/17 12/31/17 1/1/17 12/31/19 1/1/17 12/31/17 1/1/17 12/31/19 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/17 12/31/19 1/1/16 12/31/17 1/1/17 12/31/19 1/1/17 12/31/17 1/1/16 12/31/17 Jami Blackwell Karen Wiley Nicole Williams 2017 Charges: 1. Evaluate course applications and make course session recommendations, including keynote and other speakers 2. Act as Session Host and provide onsite support as needed. 3. Identify key learning outcomes and content for education relevant to emergency nursing clinical practice, trauma, pediatrics, geriatrics, professional development, evidence-based practice and research. 4. Create a plan to include content designed for advanced practice nurses, including pharmacology and relevant clinical and professional development issues based on member feedback and needs assessment. Specific Criteria: Attendance at an ENA Conference within the last three years Highly recommended that applicants have attended the Emergency Nursing 2017 to observe meeting processes and flow of events Must be available to attend the annual conference Willingness to work throughout annual conference as session monitors Highly recommended that applicants not participate as delegates or alternate delegates at the 2017 General Assembly due to scheduling issues Experience in program planning and/or nursing education Ability to collaborate with faculty on review and revision of submission in accordance with ANCC guidelines Knowledge of the American Nurses Credentialing Center (ANCC) Guidelines Required attendance at an onsite planning meeting at the ENA National Office in Des Plaines, IL TBD Ability to serve for a two-year term Emergency Nurses Association 7/10/2017 7

130 Page 130 EMERGENCY NURSING PEDIATRIC COURSE (ENPC) REVISION WORK TEAM NAME Deena Brecher, MSN RN CEN (Chairperson 6/6/16 12/31/17) Margaret Dymond, BSN RN Dawn McKeown, MSN RN CEN CPEN TCRN FAEN Jason Nagle, RN CEN CPEN CPN TCRN Terry Stigdon, MSN RN CPEN Tracy Swetokos, MSN RN CEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM Ohio Canada Louisiana Arizona Indiana Florida 6/6/16 12/31/17 6/6/16 12/31/17 6/6/16 12/31/17 6/6/16 12/31/17 6/6/16 12/31/17 6/6/16 12/31/17 Deena Brecher Maureen Curtis Cooper Nicole Williams 2017 Charges: 1. Provide subject matter expertise for the Emergency Nursing Pediatric Course (ENPC). 2. Conduct a systematic needs assessment for next revision, including review of course evaluations and post- course roll-out feedback, as well as interviews and surveys of key stakeholders. 3. Develop updated content in a variety of formats (manual, online, classroom) based on needs assessment and course review process in collaboration with instructional design team. 4. Revise, edit and provide quality control oversight for drafted course materials. Specific Criteria: Must have subject matter expertise in pediatrics It is desired that this work team represents diversity in experience, including pediatric nurses representing children s hospitals as well as nurses representing general hospitals providing emergency care to pediatric patients ENPC verification preferred Ability to serve for a one-year term EMERGENCY NURSES WELLNESS WORK TEAM NAME Jeanne Venella, DNP, MS, RN, CEN, CPEN Chairperson (1/1/17 12/31/17) Rebekah Dailey, BSN, RN, CEN AnnMarie Papa, DNP RN CEN NE-BC FAAN FAEN Shawn M. Moreau, BSN, RN, CEN Sarah Abel, MSN RN CEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM Pennsylvania 1/1/15 12/31/17 Kentucky Pennsylvania Louisiana Indiana 1/1/16 12/31/17 1/1/17 12/31/17 1/1/17 12/31/17 1/1/17 12/31/17 Jeanne Venella Karen Wiley Nicole Williams 2017 Charges: 1. Identify strategies including partnerships with other organizations to improve the work environment and retention of emergency nurses. 2. Develop or identify resources to create a healthy work environment for emergency nurses. 3. Explore the development of a Wellness Community within ENA CONNECT where members can share hospital initiatives, personal success, or best practices with debriefing after a difficult code or trauma, etc. Specific Criteria: Must have knowledge about the topic of how the work environment impacts emergency nurses Ability to serve a one-year term Emergency Nurses Association 7/10/2017 8

131 EMERGING PROFESSIONALS WORK TEAM NAME David Gueldner, ADN RN CEN Domingos Martins, Jr., MSN RN CEN Keven Sweeney, BSN RN CEN Breanne Ward, BSN RN CEN 2017 Chairperson: 2017 BOD Liaisons: 2017 Staff Liaison: Page 131 STATE TERM Missouri Connecticut Pennsylvania Texas 1/31/17 7/31/17 1/31/17 7/31/17 1/31/17 7/31/17 1/31/17 7/31/17 N/A Mike Hastings Karla Nygren Bridget Krause 2017 Charges: 1. Help identify the core needs and motivations of emerging professional members 2. Determine what benefits most appeal to this segment 3. Provide recommendations on the best channels to communicate with this membership group 4. Provide advice on how to engage emerging professionals in volunteering at the national, state and chapter levels 5. Help provide support and generate engagement in an online community for emerging professionals Specific Criteria: Must have five years or less experience in emergency nursing at time of appointment Serve the professional and collaborative needs of members new to emergency nursing Ability to serve a one-year term GERIATRIC WORK TEAM NAME Sheila Desilet, BS N RN CEN CCRN Chairperson (1/1/17 12/31/17) Sharon Coffey, DNP, FNP-C, ACNS-BC, CEN, CCRN, CHEP Denise Rhew, PhD MSN RN CEN Joan Michelle Moccia, DNP, MSN, RN, ANP-BC, CCRN Afton Stoneking, BSN, RN ACNP CEN AGACNP-BC 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM Idaho Alabama North Carolina Michigan Ohio 1/1/17 12/31/17 1/1/16 12/31/17 1/1/17 12/31/17 1/1/16 12/31/17 1/1/17 12/31/17 Sheila Desilet Ellen Encapera Nicole Williams 2017 Charges: 1. Provide subject matter expertise related to geriatric emergency care. 2. Identify and recommend resources to promote geriatric readiness in the emergency department. 3. Revise, edit and develop resources for geriatric emergency care as requested. Specific Criteria: Must have subject matter experience in Geriatrics (elderly) population and be willing to serve on collaborative projects Ability to serve for a one-year term Emergency Nurses Association 7/10/2017 9

132 Page 132 INSTITUTE FOR EMERGENCY NURSING ADVANCED PRACTICE (IENAP) ADVISORY COUNCIL NAME Carla Brim, MN, RN, CNS, CEN, PHCNS-BC Chairperson (1/1/17 12/31/17) Matthew Dunn, MSN, BSN, BS, RN, CRNP, ACNP-BC Margaret Carman, DNP MSN RN ACNP-BC ENP-BC FAEN Diane K. Fuller Switzer, DNP RN ARNP CEN CCRN ENP-BC FNP-BC FAEN Cindy Kumar, MSN, RN, ACNP-BC, FNP-BC Amy Rettig, MSN, MA, RN, NP, CNS, ACNS-BC, PMHNP-BC Karen Reilly Folin, MSN, RN, ACNP, CNS, CEN, ACNP-BC, CCNS, SANE Darleen Williams, MSN, RN, CNS, EMT-P, CEN, CCNS 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: TERM 3/2/15 12/31/18 Washington Minnesota North Carolina Washington Texas Ohio Virginia Florida 3/2/15 12/31/17 1/1/17 12/31/18 1/1/17 12/31/18 3/2/15 12/31/17 3/2/15 12/31/17 3/2/15 12/31/17 3/2/15 12/31/17 Carla Brim Jean Proehl Josie Howard-Ruben 2017 Charges: 1. Provide subject matter expertise for the Institute. 2. Advise the Institute Director in defining the current and long-term direction of the Institute for Emergency Nursing Advanced Practice. 3. Generate ideas for program development and implementation. 4. Assist in prioritizing the Institute s programs based upon the ENA Strategic Plan. 5. Review and provide feedback on educational content and other initiatives as requested. Specific Criteria: Must be a certified nurse practitioner or clinical nurse specialist (includes faculty) Must have knowledge about and experience in advanced practice in emergency or urgent care settings Evidence of scholarly activities such as developing evidence-based practice protocols, developing or conducting nursing education, implementing evidence into practice, evaluating outcomes (patient/population, nurse, or systems level), and/or publications is required Must have a minimum of a Master s Degree in Nursing (doctorate preferred) Ability to serve for a one-year term Emergency Nurses Association 7/10/

133 Page 133 INSTITUTE FOR EMERGENCY NURSING EDUCATION (IENE) ADVISORY COUNCIL NAME STATE Lisa Matamoros, DNP, RN, CEN, CPEN, RN-BC Chairperson (1/1/17 12/31/17) Carlana Coogle, RN Diane Gurney MS RN FAEN Julie Derringer, BSN, BA, RN, CEN Nicole Price, MSN RN ANP CNS CPEN Stacie Hunsaker, MSN RN CEN CPEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: TERM 1/1/17 12/31/17 Florida Idaho Massachusetts Kentucky Alaska Utah 1/1/17 12/31/18 3/8/17 12/31/17 1/1/16 12/31/17 1/1/17 12/31/18 1/1/17 12/31/18 Lisa Matamoros Ron Kraus Nicole Williams 2017 Charges: 1. Provide subject matter expertise for the Institute. 2. Advise the Institute Director in defining the current and long-term direction of the Institute for Emergency Nursing Education. 3. Generate ideas for program development and implementation. 4. Assist in prioritizing the Institute s programs based upon the ENA Strategic Plan. 5. Review and provide feedback on educational content as requested. Specific Criteria: Must have extensive knowledge about and experience in nursing education Knowledge of adult learning principles Experience with various educational delivery methods, including live, enduring, online, and/or distance learning Must have a minimum of a Bachelor of Science in Nursing Ability to serve for a one-year term INSTITUTE FOR EMERGENCY NURSING RESEARCH (IENR) ADVISORY COUNCIL NAME STATE Paul Clark, PhD, MA, RN Chairperson (1/1/17 12/31/17) Michael Moon, PhD MSN RN CEN CNS-CC FAEN Hershaw Davis, Jr., MSN, RN Nancy Knechel, PhD MSN BSN BS RN ACNP ACNP-BC APRN-BC Anita Smith, DNS, BSN, RN, ACNS-BC Kathleen Zavotsky, PhD, RN, CEN, ACNS-BC, CCRN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: TERM Kentucky Texas Maryland California California New Jersey 1/1/17 12/31/18 1/1/17 12/31/18 1/1/16 12/31/17 1/1/17 12/31/18 1/1/16 12/31/17 1/1/16 12/31/17 Paul Clark Ron Kraus Lisa Wolf 2017 Charges: 1. Provide subject matter expertise for the Institute. 2. Advise the Institute Director in defining the current and long-term direction of the Institute for Emergency Nursing Research. 3. Generate ideas for program development and implementation. 4. Assist in prioritizing the Institute s programs based upon the ENA Strategic Plan. 5. Collaborate with ENA Foundation to review research grant proposals. 6. Participate in developing research protocols, analyzing data and contributing to manuscripts 7 Participate in development and writing Understanding Research column for JEN Specific Criteria: Must have extensive knowledge about and experience in nursing research Evidence of scholarly activities such as developing proposals, conducting research, dissemination, and/or implementing findings into practice is required Interest in collaborative research with other members of the Advisory Council Must have a minimum of a doctorate, will consider those enrolled in PhD programs Ability to serve for a one-year term Emergency Nurses Association 7/10/

134 Page 134 INSTITUTE FOR QUALITY, SAFETY AND INJURY PREVENTION (IQSIP) ADVISORY COUNCIL NAME STATE 1. Courtney Edwards, MSN MPH BSN RN EMT-B CEN CCRN Chairperson Texas (1/1/17 12/31/17) 2. Kathryn Starr Rogers, MSN RN CEN CPEN CPHQ NEA-BC TCRN Oregon 3. Melinda Elayda, MPA BSN RN California 4. Eric Ringle, MS RN Pennsylvania 5. Danita Mullins, MSN, RN, CEN Arkansas 6. Amy Humker, MSN, RN Ohio 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: TERM 1/1/17 12/31/17 1/1/17 12/31/18 1/1/16 12/31/17 1/1/17 12/31/18 1/1/16 12/31/17 1/1/17 12/31/18 Courtney Edwards Ellen Encapera Cathy Olson 2017 Charges: 1. Provide subject matter expertise for the Institute. 2. Advise the Institute Director in defining the current and long-term direction of the Institute for Quality, Safety and Injury Prevention. 3. Generate ideas for program development and implementation. 4. Assist in prioritizing the Institute s programs based upon the ENA Strategic Plan. 5. Review and provide feedback on practice resources as requested. Specific Criteria: Must have knowledge about and experience in quality, safety, and/or injury prevention Previous experience in implementing quality, safety and/or injury prevention activities Ability to serve for a one-year term INTERNATIONAL ADVISORY COUNCIL NAME 1. Kim Gaarde, RN Chairperson (1/1/17 12/31/17) 2. Sharon Payne, MN, RN, NP Chairperson-elect (1/1/17 12/31/17) 3. Robert Gaygay, MS, BSN, RN 4. Luis Guzman, MSN BSN RN EMT-B 5. Milvia Navarro, MSN, RN 6. Vanessa Gorman, BS, RN, CEN 7. Sherry Uribe 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE Norway New Zealand USA (Oklahoma) Bermuda USA (California) Australia Canada TERM 1/1/17 12/31/17 1/1/16 12/31/18 1/1/17 12/31/18 1/1/17 12/31/18 1/1/17 12/31/18 1/1/16 12/31/17 1/1/17 12/31/17 Kim Gaarde Jeff Solheim Renee Scaletta 2017 Charges: 1. Advise ENA on relevant topics specific to international members. 2. Develop opportunities for international member expansion. 3. Evaluate current process for international delegate selection and provide recommendations. 4. Evaluate all ENA white papers, position statements and topic briefs for global perspective. Specific Criteria: Strong understanding of ENA Understanding of local and global nursing issues Ability to participate in meetings; which may be in the United States requiring travel Ability to participate in WebEx calls during ENA normal meeting hours of 9:00 am to 4:00 pm US Central Time Zone Ability to speak and write in English Ability to serve for a two-year term Emergency Nurses Association 7/10/

135 Page 135 LANTERN AWARD COMMITTEE NAME 1. Ann Chopivsky, MSN, BSN, RN, CEN, Chairperson (1/1/17 12/31/17) 2. Tobin Miller, DNP, MSN-ED, RN, CEN, CFRN, CCRN 3. Marvella Cephas, MSN, RN, CEN 4. Daniel Budusan, MSN, BSN, ADN, RN, CEN 5. Ma Cecilia Reyes, BSN, RN 6. Colleen Claffey, MSN, RN, CEN 7. Jennifer Davis, MSN, MPH, RN, EMT-P, CEN, NE-BC 8. Will Stewart, MSN, RN, EMT-P, CEN, NE-BC 9. Marilyn Singleton, BSN, RN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE Virginia California New Jersey Georgia North Carolina Florida Ohio Texas Ohio TERM 1/1/17 12/31/17 1/1/17 12/31/17 1/1/17 12/31/18 1/1/15 12/31/17 1/1/17 12/31/18 1/1/17 12/31/17 1/1/17 12/31/18 1/1/16 12/31/18 1/1/15 12/31/17 Ann Chopivsky Maureen Curtis Cooper Ellen Siciliano 2017 Charges: 1. Review and recommend revisions for Lantern Award program materials as requested. 2. Review and score eligible Lantern Award applications. 3. Provide substantive and supported comments/feedback for Lantern application responses. Specific Criteria: Must be able to participate in reviewer training and utilize the online reviewer tool to evaluate Lantern applications Deadlines and activity are heaviest between January-July, including an on-site summer meeting Committee member will provide guidance and oversight for 2-3 Lantern Reviewers (not members of this Committee) Willingness to mentor Lantern Award reviewers if needed Must have capacity to review a significant number of applications within an eight-week period (April-May) Excellent writing skills required in order to provide content that is useful for inclusion in applicant feedback letters Ability to serve for a three-year term LANTERN AWARD REVIEWERS NAME Randi Alfonzo, BSN, RN Donna Emch, MA, BSN, RN, CCRN Danna Bell, RN CEN (replacing Jason D. Moretz) Marge Letitia, BSN, RN, EMT-P, CEN Deborah Schwytzer, DNP, RN, CEN, RN-BC Kimberly Probus, MSN, RN Montray Smith, RN Barbara Weintraub, MSN, MPH, BSN, BA, RN, CEN, CPEN, ACNP-BC, FAEN Teresa Wenner, MSN, BSN, RN, CEN, CPEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM Florida Michigan Arkansas Connecticut Ohio Kentucky Florida Illinois 1/1/15 12/31/17 1/1/15 12/31/17 1/1/17 12/31/17 1/1/15 12/31/17 1/1/17 12/31/17 1/1/15 12/31/17 1/1/15 12/31/17 1/1/15 12/31/17 West Virginia 1/1/15 12/31/17 N/A Maureen Curtis Cooper Ellen Siciliano 2017 Charges: 1. Review and score eligible Lantern Award applications. Specific Criteria: Must be able to participate in reviewer training and utilize the online reviewer tool to evaluate Lantern applications Must have capacity to review a significant number of applications within an eight-week period (April-May) Must be able to participate in reviewer discussions through and conference/webex calls Each reviewer will be overseen by a Lantern Award Committee member Reviewer focus is on scoring applications using the defined set of criteria in the scoring tool No participation in committee decisions or face-to-face meetings is involved Ability to participate in meetings; some may be onsite requiring travel (expenses paid by ENA) Ability to participate in several conference calls and share documents via WebEx Conferencing Ability to serve for a three-year term Emergency Nurses Association 7/10/

136 Page 136 PEDIATRIC COMMITTEE NAME 1. Joyce Foresman-Capuzzi, MSN RN CNS EMT-P CEN CPEN CTRN CCNS CCRN PHRN SANE FAEN Chairperson (1/1/17 12/31/17) 2. Cam Brandt, MS RN CEN CPEN 3. Rose Johnson, RN 4. Justin Milici, MSN RN CEN CPEN CFRN CCRN FAEN 5. Nicholas Nelson, MS, RN, CEN, CPEN, CTRN, CCRN, NRP, TCRN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE Pennsylvania TERM 1/1/17 12/31/17 Texas Louisiana Texas Illinois 1/1/17 12/31/18 1/1/16 12/31/17 1/1/17 12/31/18 1/1/17 12/31/18 Joyce Foresman-Capuzzi Kathleen Carlson Nicole Williams 2017 Charges: 1. Collaborate on the ongoing update and revision of the Emergency Nursing Pediatric Course. 2. Provide subject matter expertise related to pediatric emergency care. 3. Identify and recommend resources for the care of the pediatric patient in emergency care. Specific Criteria: Must have subject matter experience in pediatrics and be willing to serve as a liaison in collaborative projects Experienced nurses representing children s hospitals as well as nurses representing general hospitals providing emergency care to pediatric patients desired Current ENPC provider status Ability to serve for a two-year term PEER REVIEW EDUCATION COMMITTEE NAME 1. Sandra F. Fonkert, MSN RN CEN CPEN TCRN Chairperson (1/1/17 12/31/17) 2. Jose Alejandro, PhD, MSN, MBA, RN, RN-BC, FAAN, FACHE 3. Marylee Bressie, DNP, MSN, BSN, RN, APN, CEN, CCNS, CCRN 4. Lisa Eckenrode, DNP MSN MBA RN NRP TCRN 5. Janis M. Farnholtz-Provinse, MS, RN, CNS, CEN 6. Joan Somes, PhD MSN RN CEN CPEN FAEN 7. Marie Garrison, MSN RN EMT-I CEN 8. Matthew Howard, MSN, RN, CEN, CPEN, CPN 9. Susan Maycock, DNP, RN, ACNS-BC 10. Mary McAdams, BSN, RN, CEN, CPEN 11. Nancy McGowan, PhD, RN 12. Nicholas Harmon, BSN, RN 13. Kathleen Shubitowski, MSN, BA, RN, CEN 14. Kay Smith, BSN, RN, CEN 15. Kevin Stansbury, MBA, BS, RN 16. Geraldine Muller, MSN RN CEN TCRN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE Minnesota TERM 1/1/17 12/31/18 Florida Minnesota Pennsylvania California Minnesota Ohio Indiana Michigan Indiana Texas Tennessee Massachusetts Kentucky California Michigan 1/1/16 12/31/17 1/1/16 12/31/17 1/1/17 12/31/18 1/1/16 12/31/17 1/1/17 12/31/18 1/1/17 12/31/18 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/17 12/31/18 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/17 12/31/18 Sandra F. Fonkert N/A Josie Howard-Ruben 2017 Charges: 1. Serve as peer review panel members of the ENA education ANCC Approver Unit. 2. Participate as pilot study subjects for ENA's accredited Provider Unit Learning Management System. 3. Serve as content reviewers for ENA's accredited Provider Unit continuing nursing education products. Specific Criteria: Experience with the American Nurses Credentialing Center s criteria for continuing nursing education Ability to independently review continuing education documents submitted to ENA s approval unit each month, occasionally requiring a quick turn-around Ability to serve for a two-year term Emergency Nurses Association 7/10/

137 Page 137 POSITION STATEMENT COMMITTEE NAME 1. Justin Winger, PhD, MA, BSN Chairperson (1/1/17 12/31/17) E. Marie Wilson, MPA, RN Melanie A. Crowley, RN, MSN, CEN Molly Bridget Delaney PhD, RN, CEN Katherine Mallett, MSN, BSN, RN Elizabeth Stone, MSN, RN, CPEN Joop Breuer, RN, CEN, CCRN, FAEN Audrey (Liz) Cloughessy, MHA, RN, FAEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE California TERM 1/1/17 12/31/18 Connecticut California Minnesota Missouri North Carolina Netherlands Australia 1/1/17 12/31/17 8/11/15 12/31/17 1/1/17 12/31/17 1/1/17 12/31/18 3/4/16 12/31/17 1/1/17 12/31/18 1/1/17 12/31/18 Justin Winger Sally Snow Monica Kolbuk 2017 Charges: 1. Recommend subject matter experts to collaborate with ENA committees and work teams in developing new position statements. 2. Respond to General Assembly requests to develop new Position Statements. 3. Review, revise, develop and/or recommend for archive, Position Statements for ENA Board approval. 4. Collaborate interprofessionally with external organizations on Joint and Supported Position Statements at the direction of the ENA Board of Directors. Specific Criteria: Excellent writing and editing skills Ability to participate in monthly conference calls if needed Ability to serve for a two-year term TNCC REVISION WORK TEAM NAME 1. Joseph Blansfield, MS, NP, TCRN Chairperson (1/1/17 12/31/18) 2. Melanie Crowley, MSN, RN, CEN 3. Janis Farnholtz Provinse, MS, BSN, RN, CNS, CEN, TCRN 4. Margaret McNeill, PhD, MS, BS, RN, APRN, CNS, CCNS, CCRN, NE-BC, FAAN 5. Kellyn Pak, MSN, RN, CEN, MICN 6. Sheila Silva, DNP, RN 7. Angela Westergard, MSN, MBA, RN, CEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE Massachusetts California California Maryland TERM 4/1/17 12/31/18 4/1/17 12/31/18 4/1/17 12/31/18 4/1/17 12/31/18 California Massachusetts Arizona 4/1/17 12/31/18 4/1/17 12/31/18 4/1/17 12/31/18 Joseph Blansfield Ron Kraus Josie Howard-Ruben Nicole Williams 2017 Charges: 1. Provide subject matter expertise for the Trauma Nursing Core Course (TNCC) 2. Conduct a systematic needs assessment for next revision, including review of course evaluations and post-course roll-out feedback, as well as interviews and surveys of key stakeholders 3. Develop updated content in a variety of formats (manual, online, classroom) based on needs assessment and course review process in collaboration with IENE and the instructional design team 4. Revise, edit and ensure quality of course content Specific Criteria: Must have current emergency department experience, including care of the trauma patient Must be a current TNCC provider (instructor or course director status preferred) Must have previous educator experience Prefer some elearning design experience Must have previous writing and publication experience (published writing preferred) Must be able to write clearly, professionally, and within the time constraints of the publication process. Adherence to publication timelines is an essential component of this project Ability to read and synthesize nursing and scientific literature Ability to serve for the length of the project, which could range from at least 1 year to as long as 2 years Emergency Nurses Association 7/10/

138 Page 138 TRAUMA COMMITTEE NAME 8. Dawn McKeown Chairperson (1/1/17 12/31/17) 9. Roger Casey, MSN RN CEN TCRN FAEN 10. Sonny Ruff, DNP, MSN, BSN, AND, RN, FNP, CEN, FNP-C 11. Jade Falls, BSN RN CEN 12. Heidi Gilbert, BSN, RN, SANE 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE Louisiana Washington Mississippi Arizona Oklahoma TERM 1/1/17 12/31/17 1/1/17 12/31/18 1/1/16 12/31/17 1/1/17 12/31/18 1/1/17 12/31/18 Dawn McKeown Kathleen Carlson Monica Kolbuk 2017 Charges: 1. Collaborate on the ongoing update and revision of the Trauma Nursing Core Course. 2. Provide subject matter expertise related to trauma emergency care Specific Criteria: Must have subject matter experience in trauma and be willing to serve as a liaison in collaborative projects Must currently be providing emergency care to trauma patients Must have familiarity with TNCC Must have current TNCC provider status. Ability to serve for a two-year term UNIFORMED SERVICES WORK TEAM NAME 1. David McDonald, MSN, RN, APN, CEN, CCNS Chairperson (1/1/17 12/31/17) 2. Colyn Barry, BSN, RN, CEN 3. Dennis Castro, BSN, RN, MICN 4. Keely Chavez, BSN, RN, CEN 5. Benjamin Coe, MA, BSN, BS, RN, EMT-B, CEN, PCCN, TCRN, FF2 6. LaQuisha Jackson, BSN, AS, RN 7. Christopher Lane, BSN, RN, CEN 8. Katherine Mallett, MSN, BSN, RN 9. John Bergacs, BSN, RN, EMT-B, CEN 10. Tiffiny Strever, BSN, RN, CEN, FAEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE North Carolina TERM 1/1/16 12/31/17 Texas New Jersey New Mexico Missouri Ohio Texas Missouri Pennsylvania Arizona 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/16 12/31/17 1/1/17 12/31/18 1/1/16 12/31/17 1/1/16 12/31/17 1/1/17 12/31/18 1/1/16 12/31/17 David McDonald Mike Hastings Lindsay Paxton 2017 Charges (New charges drafted after committee selection meeting): 1. How to maximize involvement at the National level a. Governance representation b. Product Development c. Committee Involvement 2. Advise ENA on relevant topics specific to uniformed Services 3. Provide advice and support of the Uniformed Services online community as well as help to increase engagement in the community. Specific Criteria: Advise on the design and functions of a Military Section for ENA members Advise on the role of the Uniformed Services Special Interest Group Facilitator Serve the professional and collaborative needs of members serving in active, reserve, or retired U.S. military capacities Ability to serve for a one-year term Emergency Nurses Association 7/10/

139 Page 139 APPENDIX A: ENA STANDING COMMITTEES AND BOARDS ACADEMY OF EMERGENCY NURSING (AEN) BOARD ELECTED COMMITTEE NAME STATE TERM Gordon Gillespie, PhD, RN, CEN, FAEN Chairperson (1/1/17 12/31/17) Nancy Denke, DNP, ACNP, CEN, FAEN Chairperson-elect (1/1/17 12/31/17) Vicki Patrick, MS, RN, CEN, ACNP-BC, FAEN Member-at-Large Utah Arizona 1/1/15 12/31/17 1/1/17 12/31/18 Texas 1/1/17 12/31/18 Stephen Stapleton, PhD, MS, RN, CEN, FAEN, Member-at-Large Renee Semonin Holleran, PhD, APRN, FNP, CEN, CFRN, CTRN, CCRN, FAEN, Immediate Past Chairperson Illinois Pennsylvania 1/1/16 12/31/17 1/1/17 12/31/ Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: Gordon Gillespie Jean Proehl Bridget Krause 2017 Charges: 1. Serve as mentors on professional development for members and evaluate EMINENCE Mentoring program. 2. Support Academy policies, procedures and guidelines and recommend any changes to the ENA Board of Directors 3. Present eligible applicants annually to the ENA Board of Directors for ratification and induction into the Academy. 4. Facilitate the Annual Meeting of the Academy Fellows. 5. Provide subject matter expertise about the Academy to ENA in order to communicate to the members and public the value of the Academy and its member s accomplishments. 6. Explore and recommend ways to utilize Academy members as valuable resources for ENA to the ENA Board of Directors. 7. Incorporate a mentorship program into the EMINENCE program for emerging leaders. 8. Provide ways to promote the AEN as part of the ENA umbrella of nursing excellence. Emergency Nurses Association 7/10/

140 Page 140 ENA FOUNDATION BOARD OF TRUSTEES NAME 1. Chris Gisness, MSN, RN, APRN, FNP, CEN FAEN, Chairperson (1/1/17 12/31/17) 1. Steven J. Jewell, BSN, RN, CEN, CPEN, USN(ret), Chairperson-Elect (1/1/17 12/31/18) 2. Thelma Kuska, BSN, RN, CEN, FAEN, (Immediate Past Chairperson 1/1/17 12/31/17) 3. Bill Miller, BSN, RN, PHRN, NREMT-P, Member-At-Large 4. Mickey Forness, BS, RN, CEN, Member-At-Large 6. Anne May, BSN, RN, Member-At-Large 7. Carla Duryee, Corporate Member-At-Large 8. Michelle Fox, RN, BSN, Corporate Member-At-Large 9. Don Payerle, Corporate Member-At-Large 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE TERM Georgia 1/1/17 12/31/18 Texas 1/1/17 12/31/18 Illinois 1/1/17 12/31/17 Pennsylvania New York Maryland Kansas Texas Michigan 1/1/17 12/31/17 1/1/17 12/31/17 1/1/17 12/31/18 1/1/17 12/31/17 1/1/17 12/31/17 1/1/17 12/31/17 Chris Gisness Patricia Kunz Howard Lorelee Hood Responsibilities: 1. Promote the mission of the foundation a. Champion the value of education and research to potential applicants and donors. 2. Engage and participate in fundraising activities on behalf of the foundation a. Making a personal gift b. Cultivate prospective donors c. Solicit donations d. Provide stewardship to donors 3. Participate in the development of new strategic programs a. Academic scholarships b. Continuing education scholarships c. Research grants 4. Review and select scholarship and grant award recipients a. Academic scholarships b. Continuing education scholarships c. Research grants Expectations: 1. Participate in all board meetings and conference calls as required 2. Liaison to state councils for fundraising activities and providing information 3. Actively participate in all foundation outreach activities through participation and volunteer time. a. State Challenge b. Conference events and activities Emergency Nurses Association 7/10/

141 Page 141 JOURNAL OF EMERGENCY NURSING EDITORIAL BOARD NAME 1. Jessica Castner, PhD, RN, CEN, FAEN, Associate Editor 2. Cindy Lefton, PhD, RN, Associate Editor 3. Margaret M. McMahon, MN, RN, CEN, FAEN, Associate Editor 4. Kathy Oman, PhD, RN, FAEN, FAAN, Associate Editor 5. Linda Scheetz, EdD, RN, FAEN Associate Editor 6. Cheryl Wraa, MSN, RN, FAEN, Associate Editor 7. Sue Barnason, PhD RN CEN FAEN 8. Alison Day, PhD, MSN, MS, BS, RN 9. June Thompson, DrPH, RN, FAEN 10. Anna Maria Valdez, PhD, MSN, RN, CEN, CFRN, CNE, FAEN 2017 Chairperson: 2017 BOD Liaison: 2017 Staff Liaison: STATE New York Missouri New Jersey Colorado New York California Nebraska England Florida California TERM 1/1/17 12/31/18 1/1/17 12/31/18 1/1/17 12/31/18 1/1/17 12/31/18 1/1/17 12/31/18 1/1/17 12/31/18 1/1/17 12/31/18 1/1/17 12/31/18 1/1/16 12/31/17 1/1/16 12/31/17 N/A Sally Snow Josie Howard-Ruben 2017 Charges: 1. Assist the Journal of Emergency Nursing editor in addressing the development, direction, and policies of the Journal. 2. Participation in the Journal of Emergency Nursing as a consulting editor, contributing editor, reviewer and/or author. 3. Actively participate in the solicitation of authors and manuscripts for the Journal of Emergency Nursing. Specific Criteria: Previous publishing and demonstrated editing skill and experience required Must have ability to solicit, review and edit manuscripts as needed for the Journal of Emergency Nursing NOMINATIONS AND ELECTIONS COMMITTEE ELECTED COMMITTEE NAME Mary E. (Mel) Wilson, MS, RN, CEN, COHNS, FNP-C, FAEN, Past ENA Board Member, Chairperson (1/1/16 12/31/17) Kristen Connor, MS, BSN, RN, CEN, Region 1 Karen Silady, MN, RN, CEN, Region 2 Jeff Jarding, MSN, RN, CEN, Region 3 Kristie Gallagher, MSN, RN, CEN, NRP, Region 4 Daniel Misa, MSN, RN, CEN, CPEN, Region 5 Ryan Oglesby, PhD, MHA, RN, CEN, NEA-BC, Region Chairperson: 2017 Staff Liaison: STATE TERM Ohio 1/1/16 12/31/17 California Louisiana Iowa Ohio New Jersey Florida 1/1/17 12/31/18 1/1/16 12/31/17 1/1/17 12/31/18 1/1/16 12/31/17 1/1/17 12/31/18 1/1/16 12/31/17 Mary (Mel) Wilson Ashley Daly 2017 Charges: 1. Conduct an equitable national election according to established ENA bylaws, policies and procedures. 2. Assess, plan, implement and evaluate committee activities, progress and accomplishments throughout the year. 3. Review and provide feedback regarding the national candidate applications for content, ease of use and effectiveness, in accordance with established bylaws, policies and procedures. 4. Solicit potential candidates for the ENA Board of Directors and Nominations and Elections Committee. 5. Present a ratified slate of candidates to the ENA Board of Directors. 6. Provide a written and/or verbal progress report to the ENA Board of Directors at scheduled meetings as requested. 7. Report board competencies developed and competencies grid to the ENA Board of Directors. Emergency Nurses Association 7/10/

142 Page 142 RESOLUTIONS COMMITTEE NAME Eric Christensen, BSN, RN, CEN Chairperson (1/1/17 12/31/17) Julie Miller, BSN, RN, CEN Andorra Foley, DNP, RN, CEN, ACCNS-AG Louise Hummel, MSN, RN, CNS, CEN, TCRN, FAEN Joanne Navarroli, MSN, BS, RN, CEN Bruce A. Olson, MSN, BSN, BA, RN, CEN, PHN Chelsea Collins, BSN, BA, RN 2017 Chairperson: 2017 Board Liaison: 2017 Staff Liaison: STATE TERM Colorado Kansas Washington California Arizona Minnesota Colorado 1/1/16 12/31/18 1/1/17 12/31/17 1/1/17 12/31/17 1/1/17 12/31/17 1/1/17 12/31/18 1/1/16 12/31/18 1/1/17 12/31/18 Eric Christensen Jeff Solheim Renee Scaletta 2017 Charges: 1. Ensure appropriateness of bylaw amendments and resolutions related to emergency nursing practice. 2. Conduct annual call for resolutions and bylaws amendments. 3. Provide assistance to resolution and bylaws authors submitting a proposal. 4. Review and provide feedback regarding the resolutions and bylaws amendments guidelines and supporting materials for submission of a proposal. 5. Recommend basic competencies, training and testing materials to prepare delegates for participation at General Assembly. 6. Provide a written and/or verbal progress report to the ENA Board of Directors at scheduled meetings as requested. Specific Criteria: Experience with the resolutions and bylaws process on the local, state, or national level Prior attendance at one ENA General Assembly as a delegate Working knowledge of Roberts Rules of Order Attendance at two meetings, one held at ENA National Headquarters in Des Plaines, IL and one held at the ENA Annual Conference Emergency Nurses Association 7/10/

143 Page 143 Appendix F Onsite Registration and Keypad Instructions for Delegates, ENA Past Presidents and ENA Members Onsite Registration Onsite registration will be at America s Center Convention Complex in St. Louis on Monday, September 11 from 4:00-7:00 pm CDT and will open at 6:30 am CDT on Tuesday, September 12. A registration kiosk will also be available in the Majestic Ballroom Foyer at the Marriott St. Louis Grand: o Monday, September 11, 4:00-7:00 pm CDT o Tuesday, September 12, 6:30 am-6:00 pm CDT o Wednesday, September 13, 6:30 am-6:00 pm CDT You will receive your delegate badge and other Emergency Nursing 2017 material as applicable at the registration counter. If you do not register prior to attending General Assembly, you will not receive your keypads for speaking and voting. Keypad Distribution Keypad distribution will take place in the Majestic Ballroom Foyer at the Marriott St. Louis Grand: o Tuesday, September 12 from 6:45-7:30 am o Wednesday, September 13 from 6:45-7:30 am Each delegate and ENA past president will receive two keypads; one to seek recognition into the microphone queue to speak, and one to be used for the credentialing process and voting. Delegates must show their delegate badge at the keypad distribution counter to receive both keypads and their delegate ribbon. Both keypads are personally assigned to each delegate and the ENA past presidents. ENA members who are non-delegates, including alternate delegates, may request a microphone queuing keypad to seek recognition to speak during the Open Reference Hearing discussions on Day 1, and during the Open Discussion (time permitting) on Day 2. The individual s name, member number and address must be provided. All individuals are responsible for their assigned keypad(s) and should be returned for servicing at the end of each day. Change in Delegate and Alternate Delegate Status Onsite A delegate change form must be completed and signed by the state president or state captain and returned to the General Assembly information booth for changes in delegate and alternate delegate status. This change is for the registered alternate assuming the delegate position, or for a delegate replacement, due to the inability of the delegate to attend ENA General Assembly Marriott St. Louis Grand Majestic Ballroom A-D 8/25/17

144 Page 144 Onsite Registration and Keypad Instructions for Delegates, ENA Past Presidents and ENA Members Using the Wireless Keypads DAY 1 Roll Call of Delegates 1. Per the ENA Bylaws, a quorum is a majority of the total voting delegates who have completed credentialing procedures. 2. Voting delegates will be asked to take roll call by pressing 1 on the voting keypad. Press 1 for roll call Open Reference Hearing Discussions 3. Delegates, ENA past presidents, and ENA members (non-voting delegates) wishing to speak during the Open Reference Hearing discussions may seek recognition by pressing 1 on the microphone queuing keypad. To cancel your request to speak, press 3. (NOTE: Pro/con debate will not be utilized during the open reference hearings): Press 1 to speak to the proposal Press 3 to cancel your request 4. Microphones placed throughout the General Assembly floor will be designated per each state and ENA past presidents. ENA members (non-voting delegates) will be informed of the designated microphone to speak from ENA General Assembly Marriott St. Louis Grand Majestic Ballroom A-D 8/25/17

145 Page 145 Onsite Registration and Keypad Instructions for Delegates, ENA Past Presidents and ENA Members 5. When an individual seeks recognition to speak, their name and designated microphone number will be displayed on the screen in the order in which it was received. The highlighted individual displayed on the screen identifies the next individual to speak. 6. Participants wishing to make an interrupting motion must approach the designated Interrupting microphone located in the front of the meeting room. DAY 2 Debate and Vote 1. Only delegates and ENA past presidents will participate in the debate and vote. 2. Delegates and ENA past presidents wishing to speak during the debate and vote may seek recognition by pressing the appropriate button on the microphone queuing keypad: Press 1 to speak in favor of a motion (pro) Press 3 to cancel your request Press 2 to speak against a motion (con) 3. Microphones placed throughout the General Assembly floor will be designated per each state and the ENA presidents. 4. When an individual seeks recognition to speak, their name, microphone queue recognition symbol (pro or con), and designated microphone number will be displayed on the screen in which it was received. The highlighted individual displayed on the screen identifies the next individual to speak ENA General Assembly Marriott St. Louis Grand Majestic Ballroom A-D 8/25/17

146 Page 146 Onsite Registration and Keypad Instructions for Delegates, ENA Past Presidents and ENA Members 5. The chair will alternate pro and con debate, as much as possible, until debate is closed or the queue is empty. 6. When the time arrives for a vote, the voting keypad will be used. The chair will state please vote now. Delegates and ENA past presidents will press the appropriate button on the voting keypad: Press 1 to vote in favor of a motion (pro) Press 2 to vote against a motion (con) 7. Delegates will have 15 seconds in which to cast their votes. To change a vote during this time, press the appropriate button within the timeframe. The last button entered before the time limit will be captured. The display screen will show the word received to confirm the vote was recorded. 8. Participants wishing to make an interrupting motion must approach the designated Interrupting microphone located in the front of the meeting room ENA General Assembly Marriott St. Louis Grand Majestic Ballroom A-D 8/25/17

147 Page 147 Onsite Registration and Keypad Instructions for Delegates, ENA Past Presidents and ENA Members Open Discussion (as time permits) 9. Following the Debate and Vote, Alternate Delegates and ENA members (non-voting delegates), may visit the keypad distribution counter to request a microphone queuing keypad to seek recognition to speak during the Open Discussion. The individual s name, member number and address must be provided. All individuals are responsible for their assigned keypad(s) and should be returned for servicing at the end of each day. 10. Delegates, ENA past presidents, and ENA members (non-voting delegates) wishing to speak during the open discussion (as time permits) may seek recognition by pressing 1 on the microphone queuing keypad. To cancel your request to speak, press 3. (NOTE: Pro/con debate will not be utilized during the open discussion): Press 1 to speak to the discussion topic Press 3 to cancel your request 11. Microphones placed throughout the General Assembly floor will be designated per each state and ENA past presidents. ENA members (non-voting delegates) will be informed of the designated microphone to speak from. 12. When an individual seeks recognition to speak, their name and designated microphone number will be displayed on the screen in the order in which it was received. The highlighted individual displayed on the screen identifies the next individual to speak ENA General Assembly Marriott St. Louis Grand Majestic Ballroom A-D 8/25/17

148 Page 148 Appendix G ENA General Assembly Delegate s Resource ENA's Mission Statement The mission of the Emergency Nurses Association is to advocate for patient safety and excellence in emergency nursing practice. ENA's Values Statements ENA values the inclusion and contributions of nursing in collaboration with healthcare partners to explore solutions to the challenges of emergency care delivery. ENA values compassion as an essential element of the emergency nursing profession. ENA values and embraces inclusion and diversity in all interactions and initiatives. ENA values the team based delivery of resources that meet the highest quality standards of excellence for patients and emergency nurses. Inquiry ENA values lifelong learning and a culture of inquiry for the discovery, translation and integration of evidenced based research into emergency nursing practice. Integrity ENA values its code of ethics and adheres to the principles of honesty and integrity. Spirit of Giving Value Statement: ENA values the spirit of philanthropy which allows the advancement of the profession of emergency nursing and improving the lives of patients throughout the world. Membership Value Statement: ENA places the highest value on its members for their contributions to the care of patients and their families, the emergency nursing profession, and our organization. ENA's Vision Statement The Emergency Nurses Association is the global emergency nursing resource and advocate for safe practice and safe care. August

149 Page 149 ENA General Assembly Delegate s Resource Roles at General Assembly The Chair of General Assembly is the ENA President. The Chair presides over the meeting. The ENA Board of Directors is responsible for the management of the affairs of ENA and represents the interest of ENA members and the specialty of emergency nursing as a whole. The ENA Board of Directors attends General Assembly and assists with answering questions as needed during the proceedings. The Resolutions Committee assists in leading the reference hearings, debate and vote. The committee also assists authors with their proposals during the meeting and during the amendments session. The committee prepares the agenda for the debate and vote proceedings of General Assembly. Legal Counsel provides assistance to the Chair at General Assembly and attends the amendments session to ensure ENA s bylaws, policies and procedures are legally sound. The Parliamentarian provides procedural assistance to the Chair before and during General Assembly including consultation for revisions to bylaws amendment proposals. All bylaws amendments and resolutions are reviewed by legal counsel and the parliamentarian for compatibility with ENA s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws, and financial feasibility. General Assembly Delegates shall be apportioned based on the percentage the delegation is to the national membership as of May 15 in accordance with the ENA bylaws. International delegates shall be allocated in accordance with the ENA bylaws. ENA headquarters will send necessary information for designating delegates, alternate delegates and state captains to state councils. No state shall be allocated fewer than two delegates, one of whom shall serve as State Captain. State Captains shall be selected as soon as possible but no later than 75 days prior to the General Assembly. Each state council must register their state captain, delegates and alternate delegate in the ENA Online Management System at least 75 days prior to the General Assembly. Following this deadline, no additional General Assembly delegates may be registered. Only changes to the existing delegates registered in the Online Management System by the deadline may be made. August

150 Page 150 ENA General Assembly Delegate s Resource The state council presidents, presidents elect, delegate/general assembly chairpersons and state captains are the only officer positions that have access to register delegates. The state council president may follow the instructions below to ensure these positions are entered as officers: 1. Login to by entering your ENA member login and password. 2. At the top of the screen, select My Account and select My Profile. 3. On the right hand side of your Personal Information page, click on Volunteer and Leadership within the Account Links section. 4. Scroll down to the Council Chapter Management area and click on +Add Officer. 5. Search for the individual and click Search. 6. Select the individual you want to add as the State Captain or Delegate/General Assembly Chair. 7. Select the position and enter the start and end dates then click Save. 8. The added role will now show in the Council Chapter Management area. Preparation The Delegate Competency should be viewed by all delegates in preparation for General Assembly. The orientation training will provide in depth information relevant to the delegate s role. The link to the orientation training will be available on the General Assembly Delegates area of the ENA Website. The General Assembly Handbook and additional materials are available on the General Assembly Delegates area of the ENA Website. August

151 Page 151 Appendix H General Assembly Glossary of Terms Amendments: Amendments are proposals to change the words in a motion. They are voted on before the final vote is taken on the motion. Only one place in the motion can be amended at a time. Caucus: A caucus is a small meeting of delegates from a state or area in which they discuss agenda items and explore options. Debate: The author(s) has the right to speak first, after which discussion is alternated by pro/con as much as possible. Each delegate has the right to speak once to each debatable motion and if speaking a second time yields to anyone who hasn t yet spoken on that motion. To speak a third time, the General Assembly must grant permission by a two thirds vote. Interrupting Motions: Interrupting motions are given priority before other motions or speakers and include: Point of Order: to call attention to a breach of the General Assembly s rules EXAMPLE: The chair recognizes a non delegate to speak without permission of the delegates Question of Privilege: to seek remedy to issues of safety, health, or integrity of the General Assembly, or the protection of personal property EXAMPLE: There is too much noise and I can t hear what the speaker is saying. Appeal: to appeal the chair s ruling so the assembly decides the question EXAMPLE: If the chair has ruled a point of order not well taken, any member can approach a microphone and say I appeal from the decision of the chair. Parliamentary Inquiry: to seek procedural guidance EXAMPLE: Would an amendment be in order at this time? Call for the Orders of the Day: to follow the adopted agenda EXAMPLE: If a break was set for 10:00, at 10:00 any member can approach a microphone and say I call for the orders of the day. Late Resolutions: Resolutions received after the published deadline may be considered, provided all criteria is met. These resolutions shall require a non debatable two thirds vote to consider and a majority vote to adopt. Late Resolutions Resolutions that are submitted after the published deadline, but at least 30 days prior to the General Assembly meeting being called to order. Late resolution submissions must include written explanation. Late resolutions are issues that requires timeliness or has urgency to the matter. Notice of such resolutions shall be made available to all delegates. Emergency Resolutions Resolutions that are submitted after the published deadline, but less than 30 days prior to the General Assembly meeting, or after the meeting has been called to order. Emergency resolutions are actual emergent issues which were not previously known to the Assembly and which must be handled promptly. Notice of such resolutions shall be made available to all delegates. August

152 Page 152 Appendix H General Assembly Glossary of Terms Motion: A motion is a request for an action. It describes the decision that is being made. Only delegates can make or second motions. Open Reference Hearings: During the open reference hearings, authors are given time to speak first; time is then allocated for delegates to discuss and provide comments to each proposal. In addition, ENA members who are non delegates will also have the opportunity to participate in the open reference hearing discussions. Previous Question (Call the Question): Calling the question is often used for the motion titled Previous Question, which means to stop debate. The person making the motion must seek recognition in the usual way. Adoption of the motion requires a second and a two thirds vote. If two thirds of the General Assembly does not vote to close debate, debate continues. Proviso: A proviso specifies a later time at which a motion takes effect. Quorum: A quorum is the number of delegates necessary to conduct business. The General Assembly quorum is the majority of the total voting delegates who have completed credentialing procedures. Completed credentialing procedures means a delegate has checked in and received a badge. The total number of delegates who completed credentialing will be announced. When asked to do so, delegates will press the 1 on the voting keypad to establish the quorum. The presence of a quorum will be announced. Request for Information (not an interrupting motion): A Request for Information is a request relevant to the pending motion that is not related to parliamentarian procedure. EXAMPLE: If adopted, how much would this business item cost? Seek Recognition: Keypads are used to seek recognition to speak. Delegates and ENA past presidents will be provided a microphone queuing keypad to seek recognition to speak. ENA members who are non delegates, including alternate delegates, may request a microphone queuing keypad to seek recognition to speak during the Open Reference Hearing discussions on Day 1, and during the Open Discussion (time permitting) on Day 2. Guests do not have the right to speak, but can be granted permission by the General Assembly if the request is made by a delegate. A majority vote is required. Speaking Queue: The names of those in line to speak will be displayed on a screen. If a secondary motion is made, the queue will be saved and a new queue will be started. For example, if an amendment is made, the queue for the main motion will be saved and a new queue opened for the amendment. August

153 Page 153 Appendix H General Assembly Glossary of Terms Timing: Timekeeping will be utilized to monitor discussion and debate time limits. Voting: Voting is completed by delegates utilizing the voting keypad. The Chair starts the voting process by saying please vote now. Delegates vote yes by pressing the appropriate button. Delegates have 15 seconds to cast their votes. August