Vital Signs. News for Emergency Nurses President s Message. Ginny Orcutt. April/May 2016

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1 News for Emergency Nurses 2016 ENPC 3 Government Affairs President s Message Ginny Orcutt The beginning of the year has really taken off. Our first mee ng was held in January at Honor Health Deer Valley and was well a ended. Many new faces were seen networking and sharing ideas, along with a group of nursing students ge ng a feel for our state council and na onal organiza on. SPECIAL THANKS to Shannon Dunn for making the venue arrangements. TNCC 7 February your State Leaders ventured to the outskirts of Las Vegas for a 2-day orienta- on and networking session with State leaders from around the country. Forty-eight states, including Alaska, sent state council and chapter volunteer leaders to discuss best prac ce for membership, marke ng, financial strategies, and succession planning. Lisa Destrampe-McCarthy, (president elect); Lori Vandersloot (secretary/treasurer), and I a ended sessions on ENA branding strategies, Government Affairs updates, and other concurrent educa onal sessions. The most poignant impression taken to heart by all of us relates to involvement, The organiza on is only as strong as the members who become involved. This is a valid no on at the state council, Northern and Southern special interest groups (SIG) and na onal level. Succession planning was discussed in detail and in our state council this is a very important and relevant topic AZENA Officers Ginny Orcutt President President-Elect Lisa Destrampe- McCarthy Lori Vandersloot Secretary/Treasurer Rita Anderson Past President In the coming years , the state council there will be openings for new volunteer leaders to Chair various commi ees including Educa on, Pediatrics, and Membership. Interest has been sparked, discussions and communica ons are in exploratory/ forma ve stages, and for that I am grateful. If something sparks your interest, please reach out and contact me directly. A special thanks to Banner University Center of Tucson for hos ng the April 1 mee ng with an Educa onal session and light meal. Please check out AZENA.org for future mee ngs. April 22 nd is the annual Hot Topics conference to be held at Desert Willow conference center. I hope that you can join us for a day of great speakers, educa on, vendors, raffle prizes and a 50/50 raffle. Cont. page 7

2 Page 2 Everyone here has the sense that right now is one of those moments when we are influencing the future. Steve Jobs Membership Barbara Bray: bbray1245@gmail.com & Wendy Cartier: lbjcartier@comcast.net Super Tuesday... another sea saw of the poli cal world. This Presiden al race is a great illustrator of the importance of making your voice heard. It is a reflec on of our profession and the impact ones membership can make. You cannot afford to sit back and say you are too busy to belong, that membership is too costly, or you are happy with the way things are. Hospital corpora ons are merging and changing the norm we once knew. This can bring about a great deal of posi ve change, but it also can remove the community you know. ENA is on the cu ng edge of our profession and needs con nual input to keep it in touch with its members. Bring a friend and join us at our next membership mee ng. Enjoy a free CEU and learn more about your professional organiza- on, ENA. This is just one of the countless opportuni es AZENA offers. AZENA Hot Topics is in Phoenix April 22. Earn 7.5 CEU s, enjoy great lectures, meet others and be very well fed. We hope to see you soon. Nominate the 2016 Nurse of the Year Keeping green, the nomina on form is filled out and submi ed via , with the subject 2016 Nurse of the Year, to prac ce@azena.org. There is a template to follow below. I encourage you to print this template and post it where others can see. this template to others so that they can start thinking about a nurse they may want to nominate. Nominate someone today! The nomina on period for 2016 is open now and runs through October 15th. The award will be presented at our November 4th mee ng. Informa on to include in the nomina on: Nominee s name: Phone: address: Title: Employer: Your name: Phone: What is your affilia on with the nominee? Why does this nurse deserve to be recognized as an Arizona Emergency Nurse of the Year? (Please refrain from using the nominee s name, gender, or organiza on in the narra ve. completed nomina on to prac ce@azena.org using 2016 Nurse of the Year as the subject.)

3 Page 3 Taking care of children has nothing to do with politics. I think perhaps with time, instead of there being a politicization of humanitarian aid, there will be a humanization of politics. Audrey Hepburn Practice Lisa Destrampe McCarthy The ENA leadership conference in Las Vegas was an excellent event that really put into focus the benefits of being a part of a professional organiza on. What we do at the local/state level enhances the work of the ENA at the na onal and interna onal levels; most importantly, posi vely impac ng the lives and roles of emergency nurses and the pa ents cared for ul mately leading to safe prac ce, safe care. It is important to recognize those around us who are going above and beyond as an outstanding emergency nurse. The AZ ENA Nurse of the Year award is tradi onally presented at the final membership mee ng of the year. In 2015, zero nomina ons were received. This was ini ally very disappoin ng, but it stands as a testament that people live busy lives and it can be difficult to make the me to do extra, non-mandatory work. It also means that there is an opportunity to enhance communica on and perhaps alter the process. It is not too early to nominate an excep onal nurse TODAY for the 2016 AZ ENA Nurse of the Year award. Opposite of this ar cle is the demographics and further descrip on to submi ng the applica on. The nominee must be an emergency nurse in the state of Arizona who goes above and beyond their basic job expecta ons. Perhaps they are making contribu ons to the profession through sharing their knowledge and exper se within the community or region. Are they a CEN, CNS, Educator, Faculty Instructor, Course Instructor, etc. that is ac vely enhancing the knowledge base of many? Do they volunteer in the community-boy Scout/Girl Scout Leader or other youth group volunteer, do they speak to classrooms of students, are they involved in mission trips, are they mentors? These are only a few of the possibili es that could be used as evidence within the narra ve to nominate a nurse as a Nurse of the Year. The narra ve should include examples of how this nurse goes above and beyond to posi vely impact and advance the prac ce of emergency nursing. Ginny Orcutt, Rita Anderson and Diana Ringer visit Arizona s Capitol

4 Page 4 Emergency Nurse Pediatrics Course Fewer than 5% of pediatric emergency room visits are true medical or surgical emergencies. ENPC was developed to educate nurses on caring for children both acute and non-acute. The course is designed to develop and reinforce critical thinking. This is an excellent course for all nurses caring for the pediatric population in the acute setting. Scheduled Date Location Registration Deadline May 21 & 22, 2016 Honor Health Sco sdale Shea April 15, 2016 June 18 & 19, 2016 Phoenix Children s Medical Center May 13, 2016 September 3 & 4, 2016 Tucson Medical Center July 29, 2016 September 10 & 11, 2016 Safford August 5, 2016 September 17 & 18, 2016 Phoenix Children s Medical Center August 12, 2016 October 15 & 16, 2016 Phoenix Children s Medical Center September 9, 2016 November 5 & 6, 2016 Honor Health Sco sdale Shea September 30, 2016 Cancellation Policy: Registration may be cancelled up to 30 days prior to the course date for a partial refund, less $50 for the course materials; If between days of the course date, $120 will be retained to cover course materials and application process. If cancellation is requested within 14 days of the course, fees are not refundable. Changing course date after application requires a $40 fee regardless of dates. Course Fees: $300 Non ENA member $240 ENA Member ENPC Registration Please Print Clearly NO PHONE REGISTRATIONS WILL BE ACCEPTED Name ENA Member # RN LPN Address City State Zip Code Phone ( ) Hospital or facility where employed Enclosed is: $ Non ENA member $ ENA Member FOR COURSE: Send Registration & Payment to: AZ ENA ENPC 5505 E McLellan Rd Unit 78 Mesa, AZ Course information: Janet Tully enpcaz@outlook.com In accordance with the American with Disabilities Act (ADA), please advise the AZ ENA Peds Chair, Janet Tully if you require special accommodations due to a disability so appropriate personnel and accommodations may be accomplished within the limits of the course.

5 Page 5 HOT TOPICS in EMERGENCY NURSING CARE SAVE THE DATE April 22, 2016 Desert Willow Conference Center 4340 E. Cotton Center Blvd., Suite 100 Phoenix, AZ Registration and brochure available via : Registra on is open! Arizona Emergency Nurses Associa on (AZENA), a 501 C 3 nonprofit organiza on. In accordance with American Disabili es Act (ADA), please advise AZ ENA State Educa on Chair at: educa on@azena.org if you require special accommoda ons due to a disability so appropriate personnel and accommoda ons may be accomplished within the limits of the mee ng. This no ce is required at least 15 days prior to the mee ng. Registra on fee includes: Con nuing Educa on Contact Hours, Con nental Breakfast, Lunch and Con nuous Refreshment Breaks 3 Tracts: Elder/Pediatric, Trauma, Leadership/Clinical (Topics and Speakers subject to change) Topics to Include: Infant concussion, Pediatric Burn injury, Drug diversion, Human Trafficking, Emerging Trends STEMI, Stroke, Psych, Boarding, and More, Abdominal Trauma, Herbal Medica ons, Trauma Care and Pi alls, Flight Trauma Physiology, and more. Returning and new faculty: Terry Foster, Nancy Denke, Maureen Creegan, Rita Anderson and many more. Watch your mail for more!!!

6 America will never be destroyed from the outside. If we falter and lose our freedoms, it will be because we destroyed ourselves. Abraham Lincoln Important Links to check out: Ena.org Azena.org Azleg.gov Aznurse.org The liberties of a people never were, nor ever will be, secure, when the transactions of their rulers may be concealed from them. Patrick Henry, American colonial revolutionary Government Affairs Rita Anderson: andersonrnrita@aol.com. Much is happening on the legisla ve front over the past month. The Arizona legislature opened the 2016 session in January and is expected to complete the session in March. As I write this ar cle, there are almost 700 bills in the House and over 500 bills in the Senate for their considera on, in addi on to the main work of the legislature to pass a budget. AZENA is suppor ng H.B which will allow pharmacists to dispense naloxone without a prescrip on, but conform to protocols (educa on on contac ng EMS when the naloxone is administered, for example). The bill also permits health care providers to prescribe naloxone to families, community organiza ons and persons in posi ons to assist a person in need. This would allow the naloxone to be kept at schools. The bill received an almost unanimous House pass vote in February and was sent to the Senate. Just last week (March 7th) the bill passed out of the assigned Senate commi ees with a proper for considera on vote and was placed on the consent agenda. On February 25th, Ginny Orcu, AZENA President and I paid a visit to the AZ Legislature to discuss our organiza on s key issues. We were joined by AZENA member Diana Ringer as we met with Senator Judy Burges and staff for Senator Farley and Representa ves Livingston and Lovas. We also informed them of our support for H.B.2241, which would prohibit the use of handheld wireless communica on devices by drivers of public transporta on, taxis, livery transporta on, buses and other passenger transporta on, and S.B which would prohibit use of communica on devices for a driver under permit or during the first six months of receiving a license. On March 9th, I had the opportunity to meet with Congressman Trent Franks during his home district visit. I was able to thank him on behalf of emergency nurses for his support of EMSC (Emergency Medical Services for Children) and HR 2646, Helping Families in Mental Health Crisis Act. These two legisla ve issues are a focus of ENA s na onal agenda. Our state has developed a strong rela onship with the Congressman and his office in Washington D.C. and he has consistently voted in favor of the bills we support. In May, Ginny Orcu and I will be a ending the ENA Day on the Hill and will again meet with our senators and congressional representa ves to bring the message of emergency nurses to the Capitol. We are hoping that you will let us know if there is an issue that is your passion that we can discuss at the federal level.

7 Page 7 Trauma Committee Charlann Staab TNCC Please review the AZ ENA schedule of courses for 2016 on the website for dates and loca ons throughout the state. If you are interested in hos ng a course at your facility, it is not too late, please call Charlann or at c.staab@live.com ASAP the calendar for 2016 is posted on the AZENA website. If you are registering RNs on behalf of a Facility: the Reg on line hyperlink: online: AZENA_TNCC_classes which is also found on the website allows a facility representa ve to register and pay for a group of students or single students. Payment must be received for all courses prior to books being sent and prior to any course a endance. AZENA prepays courses and books. Pricing structure is based on pre-payment of courses by AZENA. If you are planning on becoming a new provider or re-verifica on as a provider this year, please be sure you sign up in a mely manner some addi onal points to know: Na onal requires that we send out your study materials 30 days in advance. There is an on-line component required to a end the course- content included in the on line por on is included in the wri en test. Courses fill 2-3 weeks PRIOR to the deadline, so if there is a loca on and date you are interested in, plan accordingly. Please be sure to read the refund policy. If you no show a course, you lose your registra on fee. Our courses are ra o limited. If you have sent in your registra on for a course and do not receive your study materials and course confirma on by 30 days out, please contact myself or the TNCC registrar listed on the applica on and website. Please read your study materials your success in this course is directly ed to your prepara on. The 7 th edi on is a fast moving review of materials provided. You are responsible for all content in the study materials. President s Message cont. pg 1 Now thru May 31 st please consider making a pledge of a monetary dona on to the ENA Founda on. The state fundraising challenge began during the State Leaders Conven on Rockin it Out for Scholarships has a na onal goal of $225,000. All monies donated fund the future of emergency nursing by contribu ng to scholarships for emergency nurses. Please consider dona ng today. You can pledge in one of three ways: Mail your check to the ENA Founda on, a n.: State Challenge; call ENA Founda- on at , or visit the giving page at h p:// on and click GIVE TODAY. Please designate the state of AZ when making your dona on. Our state would like to have a significant amount listed on the tally board and we need your help. It is my hope that everyone is reading the ENA STAT that comes by every week. A recent issue announced that there are more than 60 academic scholarships ready to be given away. The applica ons for these generous scholarships must be completed by Please go to the ena.org website and click on ENA Founda on for further informa on. We have many scholarship winners right here in our state. Please look at the site and get your applica on for learning submi ed. Furthering educa on and advancing the profession of nursing impacts the lives of both the scholarship winners and the pa ents they ul mately serve. If you have a ques on or sugges on, please contact me at or on my cell phone

8 Page 8 TRAUMA NURSING CORE COURSE INFORMATION Two Day Provider Course TNCC was developed and implemented to identify a standardized body of trauma nursing knowledge. The TNCC (Provider) course is a course designed to provide the emergency nurse with essential cognitive knowledge and psychomotor skills to care for the adult trauma patient. The certification is for 4 years. Completion comes with Contact Hours. Great for CEN renewal. Course Fees: 2-day provider course: Non ENA members $300. ENA member is $240, ENA number must be documented to receive discount. Includes study material: TNCC Provider Manual 7 h edition. IF YOU DO NOT RECEIVE YOUR COURSE MATERIALS 30 DAYS PRIOR TO THE COURSE, PLEASE CONTACT THE AZ ENA TRAUMA CHAIR, CHARLANN STAAB. YOU ARE NOT SCHEDULED FOR ANY COURSE UNTIL YOU RECEIVE A CONFIRMATION OR LETTER AND STUDY MATERIALS FROM RACHEL GARNER- PERKINS THE ARIZONA ENA TNCC REGISTRAR. Cancellation /reschedule Policy Registration may be cancelled up to 30 days prior to the course date for a partial refund, less $54 for the course materials. Changing course date after application requires a $40 fee regardless of date. AZENA HAS MOVED TO ONLINE REGISTRATION AND PAYMENT AS THE PREFERRED METHOD COURSE INFORMATION AND WEBLINK : online: Date Days of week Location Course type Deadline June 4 & 5 Sat/Sun June 11&12 Sat/Sun Summit Hospital in Show Low, Arizona Mt. Vista Medical Center Mesa Provider Provider May 1 May 6 July Sat/Sun Honor Health- Shea campus Brady Conf Center, Scottsdale Provider June 5 August Sat/Sun Mtn Vista Medical Center, Mesa. Provider July 1 Oct 8-9 Sat/Sun Mtn Vista Medical Center, Mesa. Provider August 25 Oct Sat/Sun Honor Health- Shea at Brady Conf Center Provider Sept 10 Dec Sat/Sun Mtn Vista Medical Center, Mesa Provider Oct 25

9 TRAUMA NURSING CORE COURSE Page 9 TNCC was developed and implemented to identify a standardized body of trauma nursing knowledge. The TNCC (Provider) course is a course designed to provide the emergency nurse with essential cognitive knowledge and psychomotor skills to care for the adult trauma patient. Course Fees: $300 per 2 day course. ENA members receive a discount (ENA number must be documented to receive discount). Study materials are mailed out approximately 4-6 weeks prior to class. IF YOU DO NOT RECEIVE YOUR COURSE MATERIALS 30 DAYS PRIOR TO THE COURSE, PLEASE CONTACT THE AZ ENA TRAUMA CHAIR. YOU ARE NOT SCHEDULED FOR THIS COURSE UNTIL YOU HAVE CONFIRMATION LETTER AND STUDY MATERIALS. Cancellation/reschedule Policy Registration may be cancelled up to 30 days prior to the course date for a partial refund. Changing course date after application requires a $40 fee regardless of dates. PLEASE CHECK THE WEBSITE: FOR NEW CLASSES AND ON-LINE REGISTRATION Due to scheduling restrictions- phone registration is not allowed. To confirm space availability: rsgarner@aol.com (623) Rachel Perkins Garner Not interested in online registration? Payment sources are limited to personal check, corporate check or money order. In accordance with Americans with Disabilities Act (ADA), please advise the AZ State Trauma Chair, Charlann Staab (c.staab@live.com) if you require special accommodations due to a disability so appropriate personnel and accommodations may be accomplished within the limits of the course. This notice is required at least 15 days prior to any course. Course Fees: TNCC Verification: $300 Non ENA member $240 ENA Member* ENA Number must be included for the discount TNCC Registration Please Print Clearly NO PHONE REGISTRATIONS WILL BE ACCEPTED Name ENA Member # RN Other disciplines are Audit LPN Other Address City State Zip Code Phone ( ) COURSE DATE/LOCATION: Hospital or facility where employed Enclosed is: $ Non ENA member $240 ENA Member A confirmation or letter will be sent to the address you provide PRINT LEGIBLY. If your information is unreadable, your materials will not make it to you. You will then be responsible for the cost of a second mailing. Send Registration & Payment to: AZENA TNCC Rachel Perkins Garner 3820 N 153 rd Ave Goodyear, AZ 85395

10 ED Angels of Palliative Care Page 10 John was a self-admi ed "frequent flyer to the ED. He was only 60-years-old, but was dealing with the co-morbidi es of hypertension, heart disease and renal failure. Consequently, he had been in the hospital more than he had been at home. While not being married, he was essen ally taking care of himself - poorly. He appeared to have a raging right leg celluli s and was certain to be admi ed to the hospital again. However, the ED doctor changed his thought process when John stated that he was receiving pallia ve care. Remarkably, pa ents receiving pallia ve care might have a new lease on life through being given the op on to be treated less aggressively. These pa ents know that they will die eventually, but not necessarily today. They prefer to be more involved in the decision-making from the beginning. The doctor simply treated the infec on and worried less about finding others abnormali es that could enlist hospitaliza on. In consulta on with his nephrologist, John was given a loading dose of Levaquin in the ED and receive the addi onal doses during his rou ne dialysis treatments. John appeared quite content with his free choice and outpa ent therapy. He had learned how to work the system to his advantage. Providing pa ents with the choice to have it their own way requires an openness and understanding of pallia on - the best interest of the pa ent commingled with peace of mind. Emergency nurses triage pa ents based on their acuity defined as the measurement of the intensity of nursing care required by the pa ent. As ED technicians and physicians rarely appreciate the amount of work entailed in managing pa ent care, nurses righ ully triage pa ents. Balancing pa ent care with the best interest of the pa ent is an intui ve ma er and requires a seasoned nurse one who has weathered the storm front of perilous situa ons repeatedly. Triaging pa ents, dis nguishing them, requires taking a step back before proceeding forward. The adage haste makes waste is fi ng for the decision-making process in no-win situa ons. Physicians are quick to write orders while nurses reserve the right to ques on their appropriateness from a logis cal and moral perspec ve. Beyond simply managing pa ent care, nurses balance the appropriateness of the treatment with the dignity of the pa ent. Through weighing these considera ons, a nurse might speak up and renego ate the care plan from a different perspec ve of manageability and pallia ve care. End-of-life care is not supposed to be burdensome. Clearly, if the workload becomes too much for the nurse, the pa- ent is suffering as well. Poin ng this out dis nguishes reality from fantasy and recognizes that those in the throes of dying need pallia ve care. Most people are afraid to men on anything about the prospects of death. Emergency nurses are not like most people, they simply say and do the unthinkable and unmen onable. Providing pallia ve care in the ED is o en above and beyond the call of duty, yet needs to rest capably and squarely upon ED nurses who have broad shoulders that bear angel s wings. ~Kevin Haselhorst, MD prac ces emergency medicine at Abrazo Health in Arizona and is author of Wishes To Die For and Sail the 7 C s of Graceful Departures. He is a keynote speaker and contribu ng writer for the Arizona Republic s Ask the Expert Column and posts blogs on Kevin MD, the Conversa on Project and wishestodiefor.com. Contact: DrH@kevinhaselhorst.com or wishestodiefor.com

11 SPRING INTO ACTION THROUGH INJURY PREVENTION EDUCATION Joanne E. Navarroli They say Spring is in the air but for Arizona emergency department nurses that just means an increase in accidents and injuries as the residents and visitors enjoy our great state. In fact, there are nearly 27 million emergency department visits each year a ributed to inten onal or uninten onal injuries (CDC, 2015). Visits range from simple sports or hiking incidents to scorpion and snake envenoma on to the more significant overdoses and crimes of violence. While a vast majority of these visits are from uninten onal causes they may have been prevented through educa on and outreach. For example, Southern AZ ENA SIG has held drama c prom safety demonstra ons depic ng the consequences associated with drinking and driving geared toward high school students a ending prom/gradua on events. Nursing, being the most respected profession (Gallup, 2015), has the unique opportunity to provide educa on on a number of topics to a wide ranging audience from kindergarten to seniors. Let s spring into ac on and educate our communi es. A number of resources are provided below; explore, become passionate, and educate. Happy Spring Emergency Nurses Associa on Injuries by Topic h ps:// ce-research/prac ce/safety/ Injury%20Preven on/pages/informa onal.aspx American Academy of Pediatrics h ps:// -safety- ps/pages/sports-injury-preven on-tip-sheet.aspx Centers for Disease Control (CDC) - General Injury Preven on h p:// Senior/Fall Preven on h p:// onalsafety/falls/adul alls.html Na onal Center for Healthy Housing h p:// on--and- Solu ons/injury-preven on-and-safety.aspx Occupa onal Safety/Health Administra on (OSHA) h ps:// Prom Night Safety h p:// Arizona Emergency Nurses Association AZENA is a non-profit organization. AZENA functions as a specialty nursing organization for professional nurses committed to the advancement of emergency nursing, including education, legislative concerns and injury prevention. AZENA state council represents Arizona emergency nurses for the Emergency Nurses Association. Upon joining the national association, a member obtains membership at the national level, as well as representation at the state level. Active members have the right to vote and hold office at all levels. Joining ENA means joining a international professional network of emergency nurses!