the Official Magazine of the Emergency Nurses Association

connection

March 2013 Volume 37, Issue 3

All Together,

PULL!

Every Bit of Muscle Matters

As We Take Bold New Steps
Through Advocacy
Pages 14-20

INSIDE

FEATURES

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

22

No Career Wasted:
A Nurses Path Back
After Substance Abuse

32

Member Finds Paradise

Needs Good Teachers

The responsive
hospital delivers
exceptional CPR
And they choose Physio-Control
to help make it happen.
From guidelines compliance to efficiency, todays responsive
hospital faces a growing range of challenges. But every
day, in every department, prompt, effective CPR is always
in demand. Evidence-based and built on ve decades of
innovation, the CPR Solution from Physio-Control can help
your hospital respond better to patientsand the need
for constant performance improvement.

uninterrupted hands-free compressions

featuring comprehensive CPR analytics

with capnography and CPR Metronome

Get ready for a more responsive approach to CPR.

physio-control.com/CPR
2013 Physio-Control, Inc. Redmond, WA

Dates to Remember
March 11, 2013

LETTER FROM THE PRESIDENT |

Deadline for proposed bylaws and

resolutions for 2013 General
Assembly at Annual Conference in
Nashville, Tenn.

With Mentoring,
We Make Magic

March 25, 2013

Deadline for faculty course proposals

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

ENA Exclusive Content

PAGE 5
Judith C. Kelleher, 1923-2013
PAGE 6
Board Writes:
In-Flight Medical Emergencies
PAGE 8
ENAs Resource Pathway
to Safe Practice, Safe Care
PAGES 14-20
Advocacy Section
14 Ohio Efforts Pay Off
With New Law Against
Assaulting Health Care Workers
16 E NA Hosts Its First Emergency
Nursing Advocacy Intensive
18 Weve Come a Long Way, Baby
Or Have We?
20 New ENA Advocacy Department
PAGE 22
No Career Wasted:
A Members Path Back
From Workplace Substance Abuse
PAGE 30
The AEN EMINENCE Program
PAGE 32
ENA Member Finds Paradise
Needs Good Teachers

Monthly Features
PAGE 4
Members in Motion
PAGE 10
ENA Foundation
PAGE 11
NEW! Ask ENA
PAGE 12
Pediatric Update
PAGE 21
Ready or Not?
PAGE 26
CourseBytes

JoAnn Lazarus, MSN, RN, CEN

In Greek mythology, Mentor was the

trusted guardian Odysseus appointed
to watch over his son Telemachus
when Odysseus left for the Trojan
War. Mentor played a pivotal role in
the development of Telemachus,
providing encouragement and
practical plans for Telemachus to
deal with his personal dilemmas.
Because of this story, the term
mentor has taken on the meaning
of someone who imparts wisdom to
and shares knowledge with a less
experienced colleague.
Most of us can think of a more
experienced person in our lives who
has provided information, given
advice, presented us with a
challenge, initiated a friendship or
simply expressed an interest in our
personal development. Very often
our first mentor was a parent or
another relative who taught and
demonstrated some essential
knowledge or understanding.
Now, a mentor is someone who can
help you move to the next level in your
career or view new possibilities, open doors
for you by introducing you to new people,
act as a sounding board and share the good
and bad of their past experiences to
potentially keep you from making the same
mistakes.

Choose Wisely
What do you look for in a mentor? A
mentor is usually someone you admire and
whose footsteps you might like to follow. A
good mentor possesses all or most of the
following qualities: willingness to share
skills, knowledge and expertise; a positive

attitude and respect as a positive role

model; and a personal interest in the
mentoring relationship. In addition, a good
mentor exhibits enthusiasm for your
interests, values ongoing learning and
growth; provides guidance and constructive
feedback; is respected by colleagues; has
ongoing personal and professional goals;
values the opinions of others and motivates
others by setting a good example. It is
crucial that a good mentor must also have
the desire and time to take on a mentee.
In my own career, I can think of one
person who was important in my decision
to become an emergency department
director. She encouraged me to return to

Continued on page 28

Official Magazine of the Emergency Nurses Association

Make time in March to slide up to

your computer and take ENAs latest
free continuing education course.
GU: Its More Than Just P, by
Michael D. Gooch, MSN, RN, CEN,
CFRN, ACNP-BC, FNP-BC, EMT-P, is
an e-learning program worth 1
contact hour. It reviews the anatomy
and physiology of the genitourinary
tract, the clinical manifestations
associated with common GU
disorders and patient management.
To take this and other courses in the
CE catalog:
G
 o to www.ena.org/freeCE,
where youll log in as an ENA
member (or create a new
account).
A
 dd desired courses to your
cart and check out (courses
are completely free for
members only).
P
 roceed to your Personal
Learning Page to start or
complete any course for which
you have registered or to print a
certificate when youre done.
T
 o return to your Personal
Learning Page at a later time,
go to www.ena.org and find
Go to Personal Learning
Page under the Courses &
Education tab.
If you have questions about any
free e-learning course or the
checkout process, e-mail
elearning@ena.org.

ENA Connection is published 11

times per year from January to
December by:
The Emergency Nurses Association
915 Lee Street
Des Plaines, IL 60016-6569
and is distributed to members of the
association as a direct benefit of
membership. Copyright 2013 by the
Emergency Nurses Association.
Printed in the U.S.A.
Periodicals postage paid at the
Des Plaines, IL, Post Office and
additional mailing offices.

Fellowship Adds Fuel

to Illinois Nursing
Leaders Research
Steve Stapleton, PhD, RN, CEN, the
immediate past president of the Illinois
ENA State Council and an assistant
professor at Illinois State
Universitys Mennonite
College of Nursing, has
received a Nurse
Educator Fellowship
from the Illinois Board of
Education.
The award is aimed at retaining top
nursing faculty at Illinois nursing
colleges and universities. It includes a
$10,000 grant for continuing research.
Stapletons research centers on
managing pain for emergency
department patients, particularly after
discharge, with the goals of better
practice, better outcomes and fewer
readmissions. Self-described as a strong
proponent of lifelong learning, he
previously has received research grants
from the ENA Foundation and the
National Institutes of Health. His findings
have been published in the Journal of
Emergency Nursing, the Journal of
Clinical Nursing and the Journal of Pain
and Symptom Management.
Hes been at Mennonite in a tenure
track since 2010.
It is through my own academic

POSTMASTER:
Send address changes to
ENA Connection
915 Lee Street
Des Plaines, IL 60016-6569
ISSN: 1534-2565
Fax: 847-460-4002
Website: www.ena.org
E-mail: connection@ena.org

Member Services:
800-900-9659
Non-member subscriptions are available for $50 (USA) and $60 (foreign).

WHATS NEW WITH YOU?

E-mail connection@ena.org to
tell us about your recent successes or
to celebrate those of a member
colleague. Include names, credentials
and, if applicable, photos of the
nurse(s) being recognized.
achievement, Stapleton wrote in his
fellowship application, that I will
accomplish my objectives while
inspiring others to seek rewarding
professional and/or academic careers.
THREE ENA MEMBERS AT THE
University of Texas Medical Branch in
Galveston were among 11 co-authors of
an article on UTMBs revised annual
evaluation process.
Valerie Brumfield, MSN, RN, CCRN, a
clinical nurse specialist in the emergency
department; Leanne Ledoux, BSN, RN,
CEN, SANE, the assistant nurse manager
in the ED; and Ruth A. Sathre, MSN, RN,
CEN, a former ED staff nurse whos now
in the Doctor of Nursing Practice
program at Walden University, helped to
develop Enhancing RN Professional
Engagement and Contribution: An
Innovative Competency and Clinical
Advancement Program, which was
published in June 2012 in Nurse Leader.
The article describes the revision
process, which involved a new system
for bedside staff evaluations across
diverse settings and specialties.

Editor in Chief:
Amy Carpenter Aquino
Assistant Editor:
Josh Gaby
Writer:
Kendra Y. Mims
Editorial Assistant:
Renee Herrmann
BOARD OF DIRECTORS
Officers:
President: JoAnn Lazarus, MSN,
RN, CEN
President-elect: Deena Brecher,
MSN, RN, APRN, ACNS-BC,
CEN, CPEN

Secretary/Treasurer: Matthew F.
Powers, MS, BSN, RN, MICP, CEN
Immediate Past President: Gail
Lenehan, EdD, MSN, RN, FAEN,
FAAN
Directors:
Kathleen E. Carlson, MSN, RN, CEN,
FAEN
Ellen (Ellie) H. Encapera, RN, CEN
Marylou Killian, DNP, RN, FNP-BC,
CEN
Michael D. Moon, MSN, RN, CNS-CC,
CEN, FAEN
Sally K. Snow, BSN, RN, CPEN, FAEN
Joan Somes, PhD, MSN, RN, CEN,
CPEN, FAEN
Karen K. Wiley, MSN, RN, CEN
Executive Director: Susan M.
Hohenhaus, LPD, RN, CEN, FAEN

ENA Co-Founder

Judith C. Kelleher
MSN, RN, FAEN

1923-2013

Her Dream Lives On

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

ometimes, it only takes a

handful of people with
courage to step out on faith
and create a change those
who dare to dream big for what
they believe in ... those who
spark a revolution to improve
the lives of others.
For ENA it took two, and one
of them was Judith Kelleher.
Judy has touched the lives of
many, and she has left an
imprint on our organization and
in our hearts. There are no
adequate words to express how grateful we are
for the contributions she has made to our
profession.
She joined forces with Anita Dorr, RN, FAEN,
and they formed the national Emergency
Department Nurses Association in December
1970. After Anitas passing in 1972, Judy carried
on their shared vision. She was undaunted by
obstacles and determined that emergency nursing
would be recognized as a specialty.
She famously said, I think the thing that
typifies ENA in those early years is that we began
to speak out and speak up for emergency
nursing, for emergency nursing education, for
emergency nursing recognition.
Judy led the organization to national
prominence and recognition as the only

association dedicated to the

advancement of the specialty
through education and
advocacy. One of her dreams
was realized in 2012 when the
American Nurses Association
recognized emergency nursing as
a specialty.
More than 40 years have
passed since its creation, and
every single member of ENA is
still impacted today by Judys
accomplishments. As an
organization, we are truly blessed
to have been founded by a true leader and
trendsetter whose dream raised the standards of
how we practice. As individuals, we are inspired
by her dream to make a difference in the lives of
patients and emergency nurses everywhere.
It is a blessing that Judy was able to see the
difference she made in our organization from
the 40,000 emergency nurses who have united to
become a voice in our profession to the
thousands of patients who are receiving better
treatments in emergency departments around the
country because of her passion to improve
emergency care for everyone.
As one ENA member wrote on our Facebook
page this week, Rest in peace, Judith. Your
work here may be done, but your legacy will live
on for generations.

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

Official Magazine of the Emergency Nurses Association

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

In-Flight Medical
Emergencies
Ding! If there is doctor, nurse,
paramedic or anyone with medical
training on board who can assist with
a medical emergency, please ring your
flight attendant call bell.
When emergency nurses hear this
request, some may hope someone else
will ring in; however, there is no
guarantee of a physician being on
board, which occurs between 40 and
90 percent of the time.
Commercial aircraft emergencies
occur daily in the United States, in
roughly 1 in 39,600 passengers. It is
difficult to clarify the actual number of
medical emergencies due to a lack of
mandated reporting.
Emergency nurses who hear the
call to assist may be the most prepared
based on our knowledge and skill. In
my experiences assisting patients
requiring in-flight medical intervention,
I have found that the term doctor
can be applied to an array of positions,
including emergency physician,
Doctorate in Public Health Quality,
podiatrist, pediatrician, dentist and
chiropractor. Ascertaining a doctors
specialty will better prepare a team to
care for an in-flight patient. Incorporate
the flight attendants into your care, as
they have the direct link to the captain,
who is the ultimate decision-maker
and has contact with ground medical
control.
Medical emergencies that occur
during flight are often related to travel
or stress. Hypoxia, barometric pressure
changes, temperature changes,
dehydration, noise, vibration and
fatigue are environmental conditions
causing physiological stress. Along

with these factors come the signs and

symptoms of nausea, vomiting,
headache, abdominal pain, dizziness,
hypotension and syncope. Although
other medical conditions, such as
myocardial infarction or stroke, can
occur at any time, most in-flight
medical emergencies are related to the
environment and stress of travel.
What do you do? First, make
yourself known to the flight attendant.
Once you have been escorted to the
patient and have made your initial
assessment and general impression,
ask if the patient can be moved to a
more quiet and confidential area, such
as the bulkhead or rear of the cabin. If
this is not an option, ask the flight
attendant to try to reseat passengers or
allow your patient to walk the aisles so
you can best complete a confidential
assessment. Based on the medical
complaint and condition, your patient
may need to lie as flat as possible
across three seats. Do not be afraid to
ask for comfort packages that include
a pillow and blanket.
Todays airlines in the U.S. are
equipped with an automatic external
defibrillator and robust medical kit,
thought they are kept under lock and
key. Basic equipment, such as a blood
pressure cuff, stethoscope and oxygen,
is readily available. Additional
equipment and advanced cardiac
equipment, not limited to IV solutions
and medications, are available for use
with consultation through ground
medical control. Under Federal
Aviation Regulations, Appendix A to
Part 121, airlines must display the
required equipment. Many airlines

carry additional equipment, including

obstetrical kits and anti-nausea and
over-the-counter pain medications.
A question of liability often arises.
Congress passed the 1988 Aviation
Medical Assistance Act, which allows
medical professionals to operate under
their scope of practice as long as the
professional is practicing in good faith.
According to the Act, An individual
shall not be liable for damages in any
action brought in by Federal or State
court arising out of acts or omissions
of the individual in providing or
attempting to provide assistance in the
case of an in-flight medical emergency
unless the individual, while rendering
such assistance, is guilty of gross
negligence or willful misconduct.
While rendering medical care, you
should never feel alone. Flight
attendants are trained in first aid and
CPR/AED and welcome any assistance.
Ground medical control is available
through the captain as a joint decision
is made whether to continue to the
final destination or divert. Many times,
with comforting medical and nursing
care, patients make it to their
destination to awaiting EMS personnel.
Next time you answer the ding
asking for assistance, your flight crew
will be quite appreciative, and you
may even receive a token of gratitude
for your willingness to help.

March 2013

t io
a
c
u
d
E

The Goal is Simple

Help emergency nurses get the education they need.
Shout out for the future of your profession by
making a donation to the ENA Foundation.
Your donation will help your state councils
chances towards the following awards.

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

Largest number of individual donations per state:

1st Place - $250 ENA Marketplace gift certificate
2nd Place - $100 ENA Marketplace gift certificate

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

2013_ENAF_StateChallengeAd_fullpg.indd 1

ENA Foundation 2013 State Challenge

t forNursing
u
O
Emergency
T
S HOU y Nursing
c
nEducation
e
g
r
e
m
n

1/30/13 1:32 PM

ENAs Resource Pathway

to Safe Practice, Safe Care
By Dale Wallerich, MBA, BSN, RN, CEN, Senior Associate,
ENA Institute for Quality, Safety and Injury Prevention
ENAs Strategic Plan for 2012-2014 includes four priority
areas that benefit the stretcherside nurse and contribute
to providing safe practice, safe care. Those priorities are
1) advancing emergency care at home and abroad; 2)
advocating for a culture of safe practice and safe care; 3)
championing for a culture of inquiry, learning and
collaboration within our profession; and 4) expanding
and fortifying ENAs membership. One integrating
concept that encompasses these four philosophies is the
sharing of pertinent information on patient care, patient
and staff safety and a means to further the specialty of
emergency nursing.

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

March 2013

emergency setting. This book is available at the ENA

Marketplace (admin.ena.org/store) along with a full
selection of resources covering a wide range of the topics in
the practice of emergency nursing.
ENA continues to share pertinent information through its
position statements, which ENA defines as an assertion of
the beliefs held, encouraged and supported by ENA.
Position statements provide concise information and material
for understanding and analysis of the problem. Joint and
consensus position statements are an assertion of the beliefs
held, encouraged and supported by ENA developed in
collaboration with external professional organizations with
mutual interest in providing safe practice, safe care. All
position statements are written in accordance with the
bylaws, strategic plan and code of ethics of the organization
and are officially endorsed by ENA as authorized by the ENA
Board of Directors.
Emergency nursing resources are evidence-based
documents that facilitate the application of current evidence
into everyday emergency nursing practice. ENRs are created
following a rigorous process included in ENAs Guidelines
for the Development of Evidence-Based Emergency Nursing
Resources. ENA believes that ENRs have a positive impact on
patient care and emergency nursing practice by bridging the
gap between practice and currently available evidence.

the other on health literacy, are currently available at

www.ena.org/IQSIP/Practice/Pages/, along with other
informational tools available for download.

POSITION STATEMENTS
www.ena.org/about/position

EMERGENCY NURSING RESOURCES

www.ena.org/IENR/ENR

OTHER USEFUL LINKS

www.ena.org/COURSESANDEDUCATION
www.ena.org/publications/jen
www.ena.org/publications/connection
admin.ena.org/store
Reference
Emergency Nurses Association. (2012). ENA strategic plan
2012 - 2014 and beyond. Retrieved from www.ena.org/
about/Documents/ENAStrategicPlan2012-2014.pdf
Contributing: Kathy Szumanski, MSN, RN, NE-BC; Jessica
Gacki-Smith, MPH; Altair Delao, MPH; Maureen Howard
and Bree Sutherland.

New Tools
ENA Practice References are a new resource from ENA. They
are succinct practice statements that are based on current
scientific evidence available at the time the documents are
developed. They are related to a clearly identified
circumstance and provide best practice information. They
are not meant to be a substitute for a nurses best judgment
in a given situation of care.
The concept of the practice reference came out of the
need to respond to member requests for a quick resource
that can assist in applying appropriate or available evidence
in a given clinical situation. It is anticipated that many of the
practice reference topics will come from ENA listserv
discussions and direct e-mail inquiries.
Two of the several EPRs drafted by the ENA Clinical
Practice Committee in 2012 were reviewed and approved by
the ENA Board of Directors. These first two practice
references focus on hemolysis and right-sided/posterior
ECGs and are available at www.ena.org/IQSIP/Practice/
Pages.
Topic Briefs are informative documents that provide
detailed, accurate and current information on a given subject
of importance to safe practice, safe care. The subjects
selected for topic briefs come from inquiries from members
or as a result of committee work on a particular subject.
Two Topic Briefs, one on health information technology and

A NATIONAL CONFERENCE FOR EMERGENCY DEPARTMENT

NURSES, PHYSICIANS AND PHYSICIAN ASSISTANTS

EMERGENCY
CARE SUMMIT
EARN UP TO 17.5 CE HOURS

SNOWMASS, CO
July 21-24, 2013

Register online at
www.ContemporaryForums.com
Or By Calling 800-377-7707

Official Magazine of the Emergency Nurses Association

ENA FOUNDATION |

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

The Many Ways

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

10

March 2013

In response to member requests

for more interactive opportunities,
ENA Connection is proud to debut
its newest feature, Ask ENA.
Members are encouraged to submit
questions about the organization
and emergency nursing in general.
Questions should be no longer
than 200 words. For verification
purposes, you must include your full
name, address and e-mail address.
(We will accommodate requests to
not print full names.)
Questions will be referred to the
appropriate ENA staff or department.
Submission of a question does not
guarantee publication. Submissions
may be edited for clarity or
shortened for space.
E-mail questions to
connection@ena.org, fax to
847-460-4005 or mail to ENA
Connection, 915 Lee St., Des Plaines,
IL 60016.

Q: I am an ED nurse finishing up
my bachelors degree in nursing,
and I plan on pursuing a masters
degree. I have heard about forensic
nursing, and it has intrigued me. Is it
a female specialty due to the high
percentage of female sexual assaults?
Would a male have the same
opportunities afforded to him?
Jared from Boston
A: Jared, thank you for reaching out
to ENA. The term forensic nurse is
relatively new the field has only been
around for approximately 20 years.
Because forensic nursing encompasses a
wide variety of issues, gender really
does not matter.
A forensic nurse is a nurse with
specialized training in forensic evidence
collection, criminal procedures, legal
testimony expertise and much more as
the job description continues to expand.
Other career branches for this job
outside of the hospital include medical

expert witness, nurse death investigator

and community education.
If you decide to stay within the
hospital setting, you may share your
expertise with your peers to help them
provide not only quality care but expert
documentation for the patient who has
been injured, assaulted or abused.
There are numerous masters degree
programs across the country, with
several on the East Coast that specialize
in forensic nursing. I would encourage
you to contact the International
Association of Forensic Nurses at iafn.
org to find out more about the specialty
and to seek their assistance in finding
an advanced program that meets your
needs.
I hope I have answered your
questions. Please feel free to contact me
at dwallerich@ena.org.
Dale Wallerich, MBA, BSN,
RN, CEN, Senior Associate,
ENA Institute for Quality, Safety
and Injury Prevention

Take charge of

Your Nursing Career

Are You Looking for a New Job Opportunity?

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

Your path to lifelong career success.

PEDIATRIC UPDATE
Fewer Tears and Fears

Reducing Needless Pain

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

Fact: Children get hurt and often require minor procedures

performed in the emergency setting.

Fact: Simple strategies can eliminate or drastically reduce

pain in pediatric minor procedures.
Pediatric pain is often under-recognized and undertreated
in the emergency setting. One study examining more than
1,000 pediatric patients undergoing minor procedures found
that almost none of the children received any pain
management strategies.1 Children can have long-lasting
negative psychological effects from a painful procedure.
Infant males who were circumcised shortly after birth
without pain control demonstrated higher levels of pain
when receiving their infant immunizations.2 Using simple
strategies can reduce pain and fear while increasing child
and parent satisfaction.
Evidence confirms that parents should be permitted to stay
with their children when undergoing minor procedures.3
Parental presence is helpful for children, yet it is not
consistently implemented. Parents should be provided
instructions on how to help maintain a calm and positive
atmosphere along with suggestions for distraction
techniques.
The position of the child can make a significant difference
in the childs stress during the procedure. Comforting
positions, such as the child sitting in the parents lap or sitting
in the chest-to-chest position with the parent (see Figure 1),
provide positive support as opposed to having the child lie
supine, which often results in panic and struggling.
Words can either comfort the child or invoke fear.
Warning a child about anticipated pain often results in greater
pain and anxiety in the child. Reassuring comments, such as
You can do this or Dont worry can increase distress in
children and should be avoided. Avoid telling the child what
you do not want the child to do: Dont move, which can
also evoke fear in the child. Instead, tell the child what you
want him or her to do: I want you to try to hold your arm

12

Figure 1: Mother holding child in the chest-to-chest position.

very still and take some deep breaths like Mommy.
Distraction can direct the childs attention away from the
pain related to the procedure. Distracters such as books,
toys, music, video games, singing and deep breathing should
be developmentally appropriate and able to capture the
childs interest. The I-Spy book series is an excellent
distracter for children. Talking and touch have been found to
be the most helpful distracters.
The application of pressure (rubbing near the site or
vibration in close proximity to the location where the

March 2013

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

BLOG
ON

Official Magazine of the Emergency Nurses Association

13

ADVOCACY

Ohio Efforts Pay Off With New Law

Against Assaulting Health Care Workers
By Nicholas Chmielewski, MSN, RN, CEN, NE-BC, Ohio ENA State Council Government Affairs Liaison
Ohio Senate. Oelslager
On Dec. 20, Ohio Gov. John
Kasich signed Amended
recognized Ohio ENA
Substitute House Bill 62 into
during a Nov. 27 debate on
law. Taking effect March 22, the
HB62 on the Senate floor by
Health Care Workers Protection
saying, In particular, I
Act will increase the penalty for
would like to thank and
assault against nurses and other
recognize the Ohio
health care professionals.
Emergency Nurses
Sponsored by state Rep. Anne
Association. The statistics,
Gonzales (R-Westerville), HB62
research and national
is a much-needed first step
expertise they brought to
toward reducing the incidence
the table on this issue was
of violence in Ohios hospitals.
incredible.
Key elements of the new law
In addition to strong
are illustrated in the table below. Pictured at the signing of HB62 with Ohio Gov. John Kasich
work by Ohio ENA, the
(seated) are (from left) state Rep. Anne Gonzales; Ohio ENA
Nurses and other hospital
actions of our individual
State Council Immediate Past President Beverly Clensey, MS,
health care workers now have
members largely contributed
RN, CCRN, CEN; Ohio ENA Government Affairs Liaison
the opportunity and safeguard to Nicholas Chmielewski, MSN, RN, CEN, NE-BC; state Sen. Scott
to HB62s passage. The
Oelslager; and ONA President Paula K. Anderson, RNC.
keep the work environment a
table on the next page lists
safer and more secure place to
the individual members
support also were received from the
deliver care, said Beverly Clensey, MS,
who
provided
HB62 proponent
Ohio Hospital Association, American
RN, CCRN, CEN, immediate past
testimony. In particular, Central Ohio
College of Emergency Physicians, Ohio
president of the Ohio ENA State Council.
emergency nurse Libby Robb, RN,
State Medical Association and the Ohio
The passage of HB62 is the
testified before the Senate Judiciarys
chapter of the American Psychiatric
culmination of several years of work by
hearing on companion legislation
Nurses Association.
the Ohio Emergency Nurses Association
(SB111) to share her tearful experience
State Sen. Scott Oelslager, then-chair
and the Ohio Nurses Association. Our
of being assaulted by a patient. With the
of the Senate Health Committee and
grassroots passion for the topic and
help of Ohio ENA member Gordon
sponsor of companion legislation Senate
expertise on the phenomena, combined
Gillespie, PhD, RN, CEN, CPEN, FAEN,
Bill 111, was instrumental in the bills
with the political power of ONA, proved
we brought national expert Donna
successful 18-month journey through the
a most successful coalition. Letters of
Gates, EdD, MSPH, MSN, FAAN, to
testify before the Senate Judiciarys
hearing on HB62. Also, an article by
Key Elements of HB62
ENA past president Diane Gurney, MS,
Directs the Ohio Department of Health to create standardized signage in the
RN, CEN, FAEN, in the April 2011 issue
shape of a stop sign. The signage will state that abuse or assault of hospital
of ENA Connection was a catalyst to
staff will not be tolerated and could result in a felony conviction. Authorizes
introduce language in the bill permitting
hospitals to post the signage in public areas.
standardized hospital signage on the
If the hospital offers de-escalation training to its staff, HB62:
issue.
Authorizes a $5,000 fine for assault against healthcare professionals, health
All emergency nurses are indebted
care workers and security officers of a hospital for a first-time offense.
to
the
Ohio Emergency Nurses
Increases the penalty for assault to a fifth-degree felony when the offender
Association, the Ohio Nurses
has previously been convicted of an assault against a health care worker.
Association, Rep. Gonzalez and Sen.

14

March 2013

Oelslager for all their work on

Emergency Nurses Contributing at HB62 Hearings
this legislation, said Gail
Lenehan, EdD, MSN, RN, FAEN,
House Criminal Justice, April 2011
FAAN, immediate past president
of ENA. The legislation will help
Dan Abbey Tammy Brassler
Nancie Bechtel Nick Chmielewski
to protect the nurses of Ohio, but
Ivy Cook Meghan Long
also provides inspiration for
Nicole McGarity
similar legislation in other states
as well. Importantly, it sends a
Senate Judiciary, November 2011
message that will hopefully be
Nick Chmielewski Beverly Clensey
heard beyond the boundaries of
Megan Long Nicole McGarity
Ohio that violence against
nurses and other health care
workers will not be tolerated,
during its journey to becoming law.
that it is no more acceptable than
Key discussions included:
violence against police or firefighters.
The philosophy of protected classes.
It took the introduction of many
Explaining the need for this
bills over several sessions to realize the
legislation and helping legislators
passage of HB62. In the 128th Ohio
understand the prevalence of this
General Assembly, state Rep. Denise
violence.
Driehaus introduced HB450 to restart
Explaining that this bill is not about
the conversation. Similar legislation
locking up an elderly patient with
was introduced in that session by Rep.
Alzheimers or a patient waking up
Stephen Slesnick and then by
from anesthesia in a combative state.
Oelslaeger. In the 129th Assembly,
The scope of who should receive
protection.
Slesnick and Driehaus re-introduced
Individuals under the influence of
legislation. There were several
drugs or alcohol.
discussions and changes to HB62

le
b
a
il ok
a
v
a ebo
w
No s an
a

Individuals with mental

impairments.
The degree of penalty that
should be applied to offenders.
Hospitals responsibility to
provide de-escalation training.
The need for signage to
promote awareness and
discussion on the issue.
The cost of implementation.
We were extremely grateful for
the expertise, support and
guidance of ENAs national office
staff during the last several years.
This support was highlighted when
Lenehan joined us at the Ohio State
Capitol to celebrate HB62s signing.
One important lesson learned is that
successful legislative policy requires
collaboration and compromise. Most
important, however, is persistence. It
was the unrelenting persistence of our
members through letter-writing and
phone calls that resulted in HB62
receiving a crucial floor vote in the
Senate. To each of our members across
the state who contributed, I say thank
you and congratulations!

EMERGENCY NURSING
Scope and Standards of Practice

ENA oers the most important book you will ever need to grow your practice...
Emergency Nursing: Scope and Standards of Practice.
This book will cover criteria-based job descriptions and performance
evaluations and so much more.
Departmental policies and procedures
Strategies for health promotion
Orientation and continuing education programs
Quality improvement programs and activities
Content expertise on the scope of emergency nursing practice
And American Nurses Association now recognized emergency nursing as a speciality

To learn more about the new Emergency Nursing: Scope and

Standards of Practice and to order visit www.ena.org/shop.

ADVOCACY

ENA Hosts Its First

Emergency Nursing
Advocacy Intensive
By Kendra Y. Mims, ENA Connection
More than 90 ENA state council leaders representing more
than 30 states attended ENAs first Emergency Nursing
Advocacy Intensive in Chicago on Jan. 10-12. Sponsored by
Vidacare, this unique event provided attendees with an
exciting opportunity to learn more about advocating for the
emergency nursing profession to make a difference for their
patients and colleagues.
The three-day event kicked off with a welcoming
reception at ENA national headquarters, where attendees
were able to reconnect and network with their peers. 2013
ENA President JoAnn Lazarus, MSN, RN, CEN, opened the
second day with a presentation on ENAs priorities and its
2013-2014 Public Policy. She explained that the ENA Board
of Directors determined that the new ENA Public Policy
would be more nurse-focused.
This is an organization about you and advocating for all
of you, Lazarus said. We know that safe practice advocates
for safe care. By taking care of all of you, youll be able to
take care of your patients.
Lazarus discussed the meaning of her newly coined term
advocatism and the importance of image, from appearance
to communication.
To me, advocatism is what we do for our patients and
for the profession of nursing. Advocatism is really at the
heart and soul of what we do as emergency nurses, she
said. As ENA, we are held in high esteem because of the
image we have with the public and because of the
perception of what we do for others. Advocacy is not just
about influencing public policy. From a nursing image
perspective, its our responsibility that the public sees us in
the best light.
Attendees learned about the importance of networking
from keynote speaker Laura Schwartz during her Eat, Drink
and Empower presentation. As the former White House
director of events for the Clinton administration, Schwartz
shared effective techniques for networking, communication
and mentoring.
No matter where we are ... we have opportunity
everywhere we look to be ourselves and empower others
through our own background and stories, as well as to

16

JoAnn Lazarus, MSN, RN, CEN, the 2013 ENA president,

shares her concept of advocatism during remarks on the
second day of the Emergency Nursing Advocacy Intensive.
advocate for ENA in all places, both on and off the clock,
with those professionally in your field and those who are
curious about it, Schwartz said.
Schwartz urged the audience members to attend
conferences and networking sessions to connect with and
build bridges for others. She said networking is the best way
to effectively communicate the message of ENA.
ENA really provides an incredible bridge for you, she
said. ENA has the tools, resources, research and incredible
staff within ENA for you to go to and get that information to
help build that bridge for your hospital, a colleague or in
your community. They are there for you, so use that bridge
when you lobby for that safer work environment. ... You
are so used to advocating for your patients all day every day,
but you also have to advocate for yourselves. As you
advocate for yourselves, you advocate for every one of your
patients at the same time.
The power of ENA and you the member is amazing,
Schwartz continued. When youve got a critical patient that
youre administering to, when youre in the meeting with the
CFO talking about purchasing safer equipment, or when
youre out in the community to meet with legislators, youre
not in that room with the patient or on Capitol Hill alone.
You are in there with the other 39,999 members of ENA.

March 2013

Top photo: Jeff Strickler, MA, RN,

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

You are never alone.

Susan Hohenhaus, LPD, RN, CEN, FAEN, ENAs executive
director, led an informative session on public relations and
media training. Attendees learned how to effectively work with
the media and connect with their communities. Hohenhaus
discussed two types of media relations (proactive and reactive);
how to deal with print reporters and broadcast reporters based
on their differences; knowing the rules of engagement when
working with journalists; and how to conduct a successful
interview by knowing who you are, what ENA represents and
the definition of an emergency nurse. Attendees learned the
advantages of using the media to advocate.
Nursing is incredibly well-positioned in todays health
care environment, Hohenhaus said. In order to take care
of your patients, you have to make sure that youre in a safe
place, that your scope and practice are protected and youre
able to leverage federal and state funding to actually drive
health care policy. Youre at the beginning of a revolution
that I feel is exciting.
Richard Mereu, JD, MBA, ENAs new chief government

relations officer, discussed the current situation in

Washington, D.C., to raise awareness on becoming effective
government relation advocates. (Learn more about Richard
Mereu and his extensive legislative background on page 20.)
Mereus session was followed by the expert panel on
advocacy, which included the following guest speakers:
ACEP Advocacy: Gordon Wheeler, ACEP associate
executive director, public affairs
 urses CAN 2012: Adrianne Drollette, American Nurses
N
Association, senior political action specialist
 tate and Federal Regulatory Agencies Weighing in on
S
Health Care Scope of Practice: Anna Polyak, JD, RN,
American Association of Nurse Anesthetists, senior director
 tate Council/Chapter/State Legislative Coordinator
S
Structure: Amy L. Hader, JD, Association of
periOperative Registered Nurses, director, legal and
government affairs
Vidacare Corporation Representation of the
Industry Perspective: Michelle Fox, BSN, RN,
Vidacare senior director clinical affairs

Continued on next page

Official Magazine of the Emergency Nurses Association

17

ADVOCACY
ENA Advocacy
Intensive
Continued from page 17
Attendees were able
to share important
issues affecting their
profession and
emergency departments
during the interactive
Whats Happening in
Your State? session.
The event ended with
informative sessions led
by guest speakers
Hershaw Davis, Jr.,
MSN, RN, the ENA
Government Affairs
Committee chairperson;
Rita Anderson, RN, CEN,
FAEN, ENA Government
Affairs Committee; Lisa
Wolf, PhD, RN, CEN,
FAEN, ENA Institute for
Emergency Nursing
Research director;
Elisabeth Weber, MA,
RN, CEN, ENA
Government Affairs
Committee; Kathleen
Conboy, BS, RN, CEN,
ENA Government Affairs
Committee; and Deena
Brecher, MSN, RN,
APRN, ACNS-BC, CEN,
CPEN, 2013 ENA
president-elect.
Attendees left the
intensive empowered
with knowledge and
strategies to advocate
for their patients and
themselves.
We have to help the
patients voice be
heard, Lazarus said.
We need to be the
voice of nursing and
inform legislatures. I
look to all of us to be
able to change the
world.

18

Weve Come a Long Way,

Baby Or Have We?
By Mary Menafra, MSN, RN, CEN
I was fresh off the
plane from Chicago,
where I spent a
spirit-lifting
weekend with my
ENA peers at the
Advocacy Intensive. Energized and ready
to get to work with my Virginia colleagues
to enable us all to have safe practice and
provide safe care, I was handed a copy of
a 1961 newspaper article titled Night in
Emergency Rooms: Hospital Nerve Centers
Stay Alert.1
The article included photographs of
patients lining the hallway head to feet
while they waited for an intern to evaluate
them further; police, nurses and doctors
huddled around a receiving desk, sifting
through patient information following an
accident. Details of the latest and greatest
technology, the electrocardiogram, which
produces a photographic record of the
hearts actions, was highlighted for readers.
My attention was drawn to a section
that outlined the violence that provides the
emergency room with much of our
business and another section that read,
These are the emergency rooms. These
are the places where lives are saved,
people helped, doctors and staff abused.
That sentence really hit home. As a
member of the Virginia ENA State Council
and the Virginia Nurses Association, I
testified before five committees during the
2011 Virginia General Assembly, where HB
1690, a bill that provides some guaranteed
ramification to abusing or hitting any
emergency department worker, was
eventually passed into law. While preparing
to testify on one of the later hearings, I
asked Virginia emergency nurses to share
their stories as to why they did not press

charges after being assaulted in the ED.

One answer especially disturbed me.
This particular nurse was punched in the
face by a patient. She subsequently went
to the magistrate to press charges and was
denied her request because, she was told,
this was part of her job. Reading this
article and reflecting back on my own
experiences and testimony, I now see why
this abuse is often seen as just part of the
job. Well, its not.
Reading this piece led me to ask, What
has changed? The answer is not much. In
1961, patients lay on gurneys in hallways
waiting for treatment; violence was a big
part of the reason for visits; and abuse of
staff was a regular occurrence. The real
changes are that patient volume has more
than tripled, technology allows staff to treat
more complex diseases and emergency
nurses and physicians stand united in their
pursuit of safe work environments while
they lobby together, all with the thought of
being able to better serve those in need.
During her opening lecture at the
Advocacy Intensive, 2013 ENA President
JoAnn Lazarus explained advocatism as the
actions around advocating for others. I
submit to you that we all need to take this
to heart and practice advocatism for each
other every day. Dont let another nurse in
40-plus years read an article that highlights
the waiting and the violence toward ED
staff. We need to change what future
emergency nurses read. Let them see what
you and I did to foster a safe environment
for them and the patients who need our
services each and every day.
Reference
Lindsay, G. (1961, July 23). Night in
emergency rooms: Hospital nerve centers
stay alert. Richmond Times Dispatch.

March 2013

Establish Yourself as a Leader

Join the faculty for ENA Leadership Conference 2014, Phoenix, March 5-9
Grow your career when you
become part of ENA Leadership
Conference Faculty. Share your
leadership knowledge, experience
and skills to help grow the
profession of emergency nursing.
Do you have specific knowledge
in a particular area of emergency
nursing, management or policy?

CALL FOR FACULTY

FULL PAGE AD

Has a particular experience given

you new insights into a current
issue or trend and led to new best practices?

Do you have experience dealing with leadership challenges and issues?

Share your insights related to current

issues, trends, and best practices as a faculty
member at ENA Leadership Conference
2014, March 5-9 in Phoenix, Arizona

Submission
Deadline is

March 25, 2013

Topic areas:
Management
Operations
Government affairs
Technology
Team building

Research
Education
Advance practice
Orientation
Retention

Community relationship building

Customer satisfaction
Personal and professional development

Find full information and course proposal guidelines

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

ADVOCACY

ENA Shaping New Advocacy Department

By Kendra Y. Mims, ENA Connection
ENA is shaping its new advocacy
department with the hiring of its first
chief government relations officer.
Richard Mereu, JD, MBA, who
began his new position with ENA on
Dec. 24, has worked in Washington,
D.C, for more than 20 years and brings
an extensive legislative background
and congressional experience to ENA.
Susan Hohenhaus, LPD, RN, CEN,
FAEN, ENAs executive director,
describes the new position as
instrumental in overseeing federal and
state advocacy efforts and government
relations related to emergency nursing.
This is the perfect time for ENA to
make advocacy for the profession of
emergency nursing a priority,
Hohenhaus said, and Mr. Mereu is the
perfect professional to begin this
journey with us.
Mereu has a JD from Albany Law
School and an MBA from The Wharton
School. He has worked on a variety of
health care issues as chief of staff to
Rep. Elton Gallegly (R-Calif.) and staff
director for two subcommittees of the
House Foreign Affairs Committee, as
well as serving as a professional staff
member on the House Judiciary
Committee. He believes his vast
background is essential to helping ENA
shape the new Advocacy Department.
Throughout my career Ive had a lot
of roles and worked on many issues,
everything from health care and budget
issues to criminal law matters and
immigration, he said. We were able to
pass several bills that dealt with those
issues and fund programs in those areas.
I think my background is
important because the issues that ENA
is facing now are so diverse. I know
the legislative process very well from
having worked in Congress for all of
those years. Thats important in terms

20

Richard Mereu, JD, MBA, the new ENA chief government relations officer, uses Skype
to confer with staff at ENA headquarters from his office in Washington, D.C.
of trying to get the initiatives that ENA
cares about passed through Congress.
ENAs mission to advocate for
patient safety and excellence in
emergency nursing practice is one of
the factors that attracted Mereu to the
position. Based in ENAs Washington,
D.C. office, he looks forward to
working on ENAs top priorities,
including workplace violence in the
emergency care setting, which he
describes as one of the most important
issues affecting the functioning of
emergency departments.
The primary goal is to establish a
very visible presence for ENA on
Capitol Hill, to advocate for our
priorities in Congress and in front of
the whole federal government and to
move forward on legislation to the
benefit of our members, he said.
Mereu had the opportunity to
connect with members at ENAs
Emergency Nursing Advocacy
Intensive in January when he
presented a session on building
relationships with legislators and

developing an authoritative voice on

Capitol Hill to meet the needs of
patients and emergency nurses.
JoAnn Lazarus, MSN, RN, CEN, the
2013 ENA president, said, I look
forward to working with and learning
more from Mr. Mereu about legislative
and regulatory issues and expanding
ENAs influence.
Mereu said his position will allow
him to delve much deeper into health
care issues.
Im extremely excited, especially
now that health care reform is passed
and it was upheld by the Supreme
Court last year, he said. That will
create opportunities for ENA. Also,
everybody recognizes that the role of
emergency nurses is so important to
our overall health care system, so Im
starting at a very good time in terms of
being able to get in at the ground floor
as these changes are being implemented
at the federal level. I can really
influence some of the direction that our
health care system is going to go in on
behalf of ENA.

March 2013

READY OR NOT? |

Knox Andress, BA, RN, AD, FAEN

Hang Together or Separately

In an act of defiance and revolution,
representatives of the 13 American
colonies broke from the British
Empire, signing the Declaration of
Independence on July 4, 1776.
Benjamin Franklins warning to his colleagues at that signing,
We must hang together, gentlemen ... else, we shall most
assuredly hang separately, highlighted the importance of
unity and coalition in the face of overwhelming odds.
Coalitions were crucial for nation-building then and to health
care emergency preparedness today.

Future Needs
Joint Commission emergency management standards and the
lessons of Hurricanes Katrina and Sandy and the Joplin, Mo.
tornado remind us that hospitals and their emergency
departments must ultimately plan for overwhelming threat
scenarios requiring them to stand alone or evacuate. The
recent threat of a highly infectious H5N1 pandemic, with its
projected 50 percent mortality rate, would overwhelm most
U.S. hospital intensive care units.
Pandemics have occurred four times during the last 100
years. Concerns for certain and future natural, technological
or terrorism catastrophes are ever present. Emergency
department and hospital capacity and capability must be
maximized and coordinated with community health care
resources.
Nationally, hospitals have been building their surge
capacity and capability by organizing and reaching out to
community health care response partners, forming emergency
response alliances, networks and coalitions. Since 2001,
emergency preparedness, surge capacity and resilience in
U.S. hospitals and health care systems have been facilitated
and supplemented by the mechanisms and associated
funding of the U.S. Department of Health and Human
Services, Office of the Assistant Secretary for Preparedness
and Response Hospital Preparedness Program.
How are health care preparedness coalitions organized,
funded and sustained over time? What benefits are there to
being a member of a health care preparedness coalition?
What are best practice examples of existing coalitions? When
have health care preparedness coalitions lessened or
mitigated emergency department impacts during disasters? To
answer these questions, enter the 2012 National Healthcare
Preparedness Coalition conference.

conference was held Nov. 26-27, 2012, in Arlington, Va., with

a mission of providing coalition-building strategies and best
practices. Organized and hosted by the Northern Virginia
Hospital Alliance, Seattle King County Healthcare Coalition,
and MESH, Inc. of Indianapolis, the conference was an
opportunity for stakeholders from around the country to
share best practices and lessons learned from building and
sustaining health care coalitions focused on health care
preparedness. Attendees came from Guam and most U.S.
states and included hospital emergency preparedness and
Hospital Preparedness Program grant leadership from local,
state and federal levels.

Attendees included the following ENA members: Elisabeth

Weber, MA, RN, CEN, of Chicago; Doris Neumeyer, BSN, RN,
of Washington, Mich.; Lori Upton, MS, BSN, RN, of Houston;
and Knox Andress, BA, RN, AD, FAEN, of Shreveport, La.
Upton presented How Coalitions Can Support Recovery
Operations while Andress shared How Coalitions Can
Develop Evacuation Plans for Hospitals and Nursing Homes.
Dr. Nicole Lurie, assistant secretary for Preparedness and
Response, U.S. Department of Health and Human Services,
welcomed attendees to a wide range of intriguing health care
preparedness coalition-building topics and panel discussions,
including the following:
Building and Sustaining Coalitions
Crisis Standards of Care
How Coalitions Support Response
How Coalitions Can Develop Information Sharing Systems
and Plans
How Coalitions Can Develop Evacuation Plans for Hospitals
and Nursing Homes
Engaging Coalition Partners and Participants
How Coalitions Can Develop Behavioral Health Operations
Plans/Triage

A Successful Conference

How Coalitions Can Support Recovery Operations

The inaugural National Healthcare Preparedness Coalition

ASPR Grant Metrics and Reporting Discussion

Official Magazine of the Emergency Nurses Association

21

other Natures gift to

Mobile, Ala., on
Christmas Day was a
large EF2 tornado
dropping in on the
downtown. The Mobile Infirmary
Medical Center took a hit: some broken
windows, uprooted trees and
overturned cars. Next door at the
University of South Alabama Childrens
and Womens Hospital, where ENA
member John Marshall, BSN, RN, is the
3-to-11 supervisor, the tornado did
minimal damage as it rolled past.
No serious injuries were reported in
the community.
Thats the first time I ever met a
tornado face-to-face, Marshall says in
his easy drawl. It had my attention.
But as storms go for Marshall, this
was nothing. The biggest and scariest
hed faced came more than a generation
earlier, some 350 miles away in his
hometown of Macon, Ga.
In April 1985, Marshall, then 34 and
married with a young son, already had
been fired from three area hospitals as
rampant substance abuse ripped a hole
in his life and nursing career.
This was before the days of

22

computers, he says, so you could still

go next door and get a job and they
didnt know that you were in trouble
other places.
Hed lost a job in an emergency
department the previous year and spent
six weeks in rehab after introducing
methamphetamines into a buffet of
drugs that already included marijuana,
booze and pills. Now he was working
in a different hospitals intensive care
unit, training to become a supervisor,
which meant hed been given a key to
the pharmacy and its narcotics. To
beat the regular drug screens, he knew
the exact day each month that he
needed to stop shooting dope, stop
smoking pot, stop popping pills. But his
fix still had to come from somewhere.
So he found himself breaking into the
operating room.
Nitrous oxide. It wouldnt show up
on the screens. He took care to mix in
enough oxygen.
Eventually, he says, they found me
unconscious in the operating room and I
couldnt let go of the hose. And thats
the night I got in trouble that last time.
Id been on the nitrous about six hours.
Colleagues were in disbelief. John

Marshall, a guy who could walk in and

right away be pegged for bigger things
in nursing, had become a surprise
tornado under their noses.
It was a nasty, nasty scene, he
says. Thats when I hit my bottom and
I realized, Youre gonna die if you
dont stop.

Feb. 25, 2012, New Orleans. It wasnt
the first time Marshall had heard Allison
Bolin dig into this topic. Here at ENAs
Leadership Conference, he sat in again
as Bolin, BSN, RN, CEN, CPEN, laid out
the warning signs of employee
substance abuse and drug diversion in
hospitals. Emergency nurses can be
particularly susceptible, Bolin cautioned,
because of their special risk factors: high
job stress, access to medications, a
tendency to feel invulnerable.
At the end of her presentation, Bolin
invited questions at an open
microphone. Marshall stood. He had not
a question but a story his. Hed been
there. Hed been the nurse Bolin was
urging others to identify, to report, to
help, to save. Hed become a new breed
of nurse: one whod widened his scope

March 2013

from helping patients to also helping

other health care workers escape the
nightmare hed known first-hand.
The room applauded.
John Marshall hasnt had a fix in 27
years, but hes made a life of fixing. As
facilitator of the Mobile Professional
Group, with which hes been involved
since 1987, he sits in every other week
with anywhere from six to 26 health
care professionals whose encounters
with drugs and alcohol have led them
into his circle. The group is run like a
12-step program, the same way Marshall
got clean. Meeting topics rotate. New
members are worked in as they come.
Its a casual, safe, free place where
people who handle narcotics as part of
their jobs can find the peer support to
keep themselves straight.
Its also non-punitive a way for
nurses to manage their recoveries
without being put on probation by the
Alabama Board of Nursing.
Most states have some kind of
nondisciplinary program now, says
Marshall, who didnt have that option in
1985 and spent the next several years
on probation in Georgia and Alabama.
Usually its required that the person
call [the board] and report themselves:
Ive got a problem, I need some help.
If people wait until an employer calls
and says, Weve got somebody with a
problem, a lot of times they end up on
probation.
No one wants that. Probation opens
the door to legal consequences for
diversion or writing self-prescriptions. It
offers no anonymity. In Alabama,
Marshall says, it means their license is
stamped with probation. It goes out in
the state newsletter whos in trouble
with drugs, where in the nondisciplinary
program, none of thats done.
Some in Marshalls group, after
reaching their crisis points, were

John Marshall in 1974 at the start of a career that fell into chaos a decade later.
referred to him by the Alabama board.
Others were invited by active members
or pointed there by treatment centers.
Most who attend are nurses; he
currently has two from EDs. Doctors
have their own group for recovery
the International Doctors of Alcoholics
Anonymous but two or three docs
still come to Marshalls meetings. He
has nurse anesthetists, a pharmacist.
Hes had surgeons, even veterinarians.
Some are there to satisfy the
nondisciplinary requirement after one
failed drug screening. Their problem is
that they used casually, not abusively,
and got caught. Some, like Marshall, are
there because they became true
chemical addicts, no longer wanting the
fix but physically needing it; they
crossed the wall, as he puts it. Thats
the other end of the spectrum.
Theres a large middle area nurses
who arent chemically dependent but
who face the grim risks of denial, relapse
and career derailment.
We have a disease that tells us we
dont have it, that were OK, that were

I got to a point where it didnt work anymore.

I couldnt do enough dope to feel good. I could do enough
to pass out and get sick, but I couldnt stop.
Official Magazine of the Emergency Nurses Association

too smart, that I should be well by

now, Marshall says. And thats just the
nature of the disease of addiction its
a liar. Itll lie to you. So after youre not
being monitored and you dont have to
go after a while, if you happen to be
one of those people that hadnt crossed
the wall, you kind of phase out.
His mission is to see that as many as
possible dont. He stresses a spiritual
philosophy of finding a higher power
a touchstone bigger than the drugs or
alcohol. For some, thats religion. For
some, its a symbol a tree, for
instance, or perhaps the group itself. A
few in the group, long after rescuing
their careers in health care, continue to
attend meetings 10 or 15 years later.
Some have lived out their natural lives
as members.
With addiction, Marshall says,
they say once a cucumbers a pickle,
its always a pickle its never a
cucumber again.

By early 1985, John Marshall knew he
was a pickle, or what hed later call
one. More aptly, he says, he was a
nurse managers nightmare. Three
years earlier, his first shot of Demerol

Continued on next page

23

had been 50 mg. Now 50 mg wouldnt

touch him.
I got to a point where it didnt work
anymore, he said. I couldnt do
enough dope to feel good. I could do
enough to pass out and get sick, but I
couldnt stop. I tried everything I could
do to stop, and I couldnt stop.
The manager that fired me in the
ED [in 1984] told me, You are not the
same person I hired. And I wasnt. You
know, the meth made me crazy. So then
I thought it was just the meth Its the
meth thats doing it. As long as I just
drink beer and smoke pot, Ill be OK.
By February, less than six months
after his dismissal from that ED and his
short rehab stint, he had relapsed,
driven into a frightening tailspin by the
access to narcotics at his new hospital,
where hed been hired as a relief
supervisor. He diverted more and more,
never denying patients their medications
but instead measuring out more so that
he could save scraps.
Eventually I knew I was gonna get
caught, he says. I knew that. It wasnt
a surprise.
The surprise, he says, came after his
final nosedive with the nitrous oxide,
when he returned to the treatment center
where hed completed his first rehab.
Get out, the addictionologist told
him. I cant help you.
Marshall, he said, had conned his
way through the program once already.
It got worse. The Georgia Board of
Nursing had been notified. The Drug
Enforcement Administration had been
notified. Marshall was looking at a
possible six to 10 years in jail.
And if youre here when I get out
of group, the addictionologist told him,
Im going to have you arrested for
trespassing.
Marshall slumped in a chair, stunned.
Bottom was even lower than he thought.
The only morsel he was offered was
a phone number for a treatment center
in Atlanta, the Ridgeview Institute,
which specialized in recovery for health
care professionals.

24

Marshall stands before the room to discuss his recovery and his work with the Mobile
Professional Group after a presentation by Allison Bolin, BSN, RN, CEN, CPEN
(right), during last years Leadership Conference in New Orleans.
So thats where his recovery began.
He checked into a three-month
program at Ridgeview.
He stayed for six.

The first year after rehab was the
hardest. Probation meant hospitals in
Atlanta didnt want to talk to him. A
doctor hed worked with during his
treatment offered him a job at a halfway
house for head-injury patients. That
gave him a foot back in the door as a
nurse, though the only nursing thing I
really did was give Dilantin for the
seizures, he says. The rest of it was
trying to manage a community of
head-injury patients, which is a different
world all in itself.
Still, a chance was a chance. And
others would follow.
Another of Marshalls former
counselors needed a nurse in recovery
to work in an alcohol-dependency
program at a Mobile hospital. That job
took him to Alabama resetting his
five-year probation in 1986. When
the hospital folded after a few months,
he decided to stay near the Gulf rather
than transfer north to Birmingham. But
finding work at another local hospital

proved tough.
They would look at my rsum and
go, Oh, you were critical care this is
good. Oh, you were a paramedic this
is good. Oh, youve got emergency
this is good, he says. But then
theyd hit that last page about the drug
treatment, and it was like the paper
caught fire in their hands or something.
Committed to his recovery, Marshall
fell in with the Mobile Professional
Group. He remarried.
One hospital, Knollwood Park in
Mobile, snapped the pattern of rejection
and decided to take a chance on him.
He was hired to work in the head-injury
unit. He was still there in 1991 when
his probation was lifted and he again
was licensed to handle narcotics.

Marshalls job history since the late
1980s is the sort of career climb others
expected for him before his collapse.
His employment at Knollwood Park
evolved from a happy break to a
17-year stay until the hospital was sold.
From the head-injury division, he moved
to the emergency department, where he
eventually rose to ED nurse manager in

March 2013

2000. He became house supervisor in

2003, then started with the Childrens
and Womens Hospital in 2007.
Never far away was the group.
Marshall had made contacts in his
treatment that afforded him clean slates.
His end of the bargain, he realized, was
to advocate for others in turn. A nurse
in recovery whose license has been
revoked might list him as a reference on
a job application. He has been to court
on another nurses behalf in a childcustody case.
The group helps me do that, he
says. We do things to help our
members get back on track in several
aspects of their life, not just in
employment. Somebody was there for
me when I was in trouble and needed
help, so now my job is when somebody
needs help, Im there for them.
In my groups and meetings that I
go to with 12-step, when somebody
asks you to do something, you say yes.
These people call me 24/7.
Sometimes he has dreams that hes
still using the ol drinkin and
druggin dreams, he calls them. Though
hes not in an emergency department
officially, he sees trauma. He sees
children going through chemotherapy.
Sometimes elements in his life dont feel
balanced. Steps feel out of sync. Thats
when he makes a few calls, too.
Recovering and fixing go both ways.
Im in recovery, but my disease is in
the parking lot doing pushups,
Marshall says. I still do those things
because if I dont do those things, Im
going to be acting like a pickle again,
and I dont know if I could live through
that. Twenty-eight years ago, Id have
just taken something to change the way
I feel and keep on going. And I dont
do that now.
And my life is so much better now,
truly a miracle. Staying high all the time
is a full-time job. When you wake up in
the morning and say, Oh, my God,
what have I got? Have I got enough?
Where am I getting more?, thats a
full-time job. Its so much easier now

Is Your Co-Worker in Trouble?

ENA conference faculty presenter
Allison Bolin, BSN, RN, CEN, CPEN,
a rapid-response nurse at Dominican
Hospital in Santa Cruz, Calif., offers
these red flags for substance abuse
or drug diversion in the ED:

Difficult life problems: Has

your co-worker had a recent back
injury? Is he or she going through a
divorce? These kinds of situations, in
combination with some of the signs
above, can point to a larger problem.

Behavioral extremes: Some

with substance-abuse issues become
sloppy and dont seem to care about
their work. Others, particularly those
diverting drugs, become hypervigilant,
paying extra attention to who is
receiving medications, offering to
medicate other nurses patients and
spending more time than normal in
the dispensing areas.

If youre worried that a colleague

is battling substance abuse, report
your suspicions to your supervisor (it
could save a life, Bolin stressed) and
let the department proceed according
to policy. If youre a supervisor, she
said, make sure you have the
documentation to support a
reasonable suspicion and involve the
human resources department before
confronting the employee.
Often the most respected nurses
are the ones most in trouble, Bolin
said. She herself has been in recovery
since 1990 and runs a support group
for nurses in two counties.
So many nurses dont even
recognize it could be a problem,
she said. Were not any less
immune because of our education.
In fact, were probably at greater
risk, especially in the emergency
department.
Josh Gaby

Personality changes: Substance

abusers tend to withdraw socially
and show increased irritability.
Absenteeism: Often seen in
employees with alcohol problems.
Coming in on days off or
frequently volunteering for extra
shifts: Often seen in drug diversion.
Fishy reports: Most hospitals
have anomalous usage reports that
identify whos dispensing which
drugs the most. Abnormally high
numbers can indicate diversion.

living life on lifes terms.

His grown son from his first
marriage has seen his perseverance,
has seen him guiding others through.
He has a daughter, 23, who grew up
a witness to his recovery.
Life is good. His mornings are
only about one vice now coffee.
He asked a counselor about that
once. Was it a problem?
As long as youre not shootin up
freeze-dried Folgers, he was told,
youll be fine.
Readers can contact John
Marshall at jtaddictions@aol.com.

Official Magazine of the Emergency Nurses Association

Workplace Violence
Prevention Online Courses
FREE
for ENA
Members

Now available free to ENA members are

three webinars that discuss violence in the
workplace and mitigation strategies.

Visit www.ena.org and sign up today.

Non-members can purchase these continuing
education courses by visiting ENAs LMS

Not a member? Join ENA today!

These webinars are brought to you by

In collaboration with

Thank you to our sponsor

Stay tuned for upcoming workplace violence educational opportunities.

25

COURSE BYTES
Updated Administrative Procedures

ENPC 4th Edition Information

The Administrative Procedures have

been updated with two items, effective
immediately:
1. TNCC Reverification courses can
continue to be held; however no
contact hours can be awarded for
attending the course.
2. Non-RN health care providers
who work in an emergency setting can
participate in the written and skill
station testing of both the ENPC and
TNCC Provider courses. The non-RN
health care worker who attends a
Provider course will receive a
certificate of attendance with the
appropriate number of contact hours,
but will not receive a verification card
or verification status.
Please refer to the Administrative
Procedures posted on the TNCC and
ENPC pages of www.ena.org for
further details.

ENPC course directors received an

e-mail in November 2012, providing
information regarding corrections
being made to the ENPC 4th Edition
Instructor Supplement and the course
slides. Corrected copies of the
instructor supplement will be provided
to all instructors who had previously
purchased it at no additional charge.
Shipments started in January. Those
instructors who had previously
purchased a downloadable instructor
supplement are being contacted to
advise them that they can now
download a corrected copy.
All course directors who had
previously requested and received the
4th edition CD-ROM will be
automatically sent a new copy as well.
The Course Directors Only section of
www.ena.org reflects the updated,
corrected information.
The new CD-ROM and Course
Directors Only web page will include
a practice test and answer key. This
will help the students prepare for the
provider course. Also included in the
instructor course folder are the scored
teaching scenarios related to the
examples played during the instructor
course from the course DVD.

ENPC Provider Manual Errata

All ENPC 4th Edition Provider
manuals that are shipped will have an
errata document included, until the
next reprint is needed. This errata
document can also be found at:
www.ena.org/coursesandeducation/
ENPC-TNCC/enpc
We anticipate reprinting the ENPC
4th Edition Provider manuals in the
spring. We appreciate everyones
assistance in identifying these changes.

ENPC 4th Edition Instructor Update

The deadline for completing the
ENPC 4th Edition Instructor Update is
Feb. 28. The update can be found on
your Personal Learning Page under the
Courses and Education tab at www.
ena.org. It is necessary to indicate that
you reviewed the video/modules
before you can access the 50-question
exam. This can be found under the
Assessment tab within each module.

26

TNCC Reverification Courses

TNCC course directors were notified via
e-mail in November 2012 that the ENA
Board of Directors met on Oct. 24,
2012, and decided that the 6th edition
TNCC Reverification courses can
continue to be held after Dec. 31, 2012.
As of Jan. 1, however, no contact hours
can be awarded for attending a TNCC
Reverification course. This decision was
made after receiving quite a bit of
feedback from course directors
indicating that the availability of the
one-day reverification course option,
even without the ability to award
contact hours, would provide a much
needed option for many institutions.

First Anniversary
ECourseOps is celebrating its one-year
anniversary as course directors
increasingly take advantage of its
capabilities. About 65 percent of the
course applications submitted to ENA
come through eCourseOps. We have
received a lot of very positive
feedback indicating that eCourseOps is
easy to use for adding a course,
ordering books and paying invoices. A
very popular feature is the copy
course icon that allows instructors to
create a new course by copying an
existing course while making
necessary small changes, such as new
course dates.
Log in to www.ena.org to access
eCourseOps via the Courses &
Education tabs dropdown menu.
There are frequently asked questions
and help documents on the landing
page. Course Operations is available
for assistance at 800-942-0011 or
courseops@ena.org. If you havent
yet used eCourseOps, give it a try. We
think youll like it.

Your Input is Welcome

CourseBytes is the official
communication to all TNCC and ENPC
directors and instructors. Topic ideas for
future issues and feedback are welcome
at CourseBytes@ena.org.

March 2013

Letter From the President

Continued from page 3

school to obtain my masters degree

and then encouraged me to apply for
her position when she left. But more
important than her words were her
actions. I witnessed her every day
modeling the behaviors of someone I
wanted to become: She was graceful
under pressure, politically savvy and
had the respect of the emergency
department staff. I am just sorry
that I never had the opportunity to
thank her.

Two-Way Street
What does it take to be a good
mentee? The mentee should drive the
relationship. As the mentee, you must
be comfortable in communicating
openly with your mentor. You must be
clear about what you expect to
accomplish by partnering with this
person. Be committed to the

Mentoring is a brain
to pick, an ear to listen
and a push in the
right direction.
John Crosby
mentoring relationship and dont forget
to acknowledge your mentor.
One of my goals as ENA president
is to provide more opportunities for
mentoring within our organization. We
already have one great mentoring
program in EMINENCE. The
EMINENCE program is designed to
pair ENA members with experienced
Academy of Emergency Nursing
fellows. AEN fellow mentors volunteer
their time and talents to work with
up-and-coming ENA members.
This provides a wonderful

opportunity to share knowledge and

experience with the next generation of
emergency nurse leaders.
The ENA Board of Directors has
implemented a new program to pair
an emerging leader with a board
mentor. The mentors will spend the
year helping their mentee develop
their leadership goals and determine
an action plan for national ENA
contributions.
I encourage all of you to
acknowledge your mentors, find a
mentor or become a mentor.
Resources
Loretto, P. (n.d.). Top 10 Qualities of a
Good Mentor. Retrieved from www.
interships.about.com
Roberts, A. (1999). Homers mentor:
Duties fulfilled or misconstrued.
Retrieved from www.peermentor.net.

ENA STATE CONNECTION

New Jersey ENA State Council
New Jersey ENA will hold the 35th
Annual Emergency Care Conference,
March 13 15. This is the third
largest emergency care conference
in the nation. For more information,
contact Cheryl Newmark, RN, NJ
ENA media relations, at cgnrn75@yahoo.com.
Share your state council and chapter news with emergency
nursing colleagues from around the world in State
Connection. Highlight council and chapter activities,
announcements and other initiatives by submitting a short
article to ENA Connection.
Suggested topics include:
Volunteer opportunities to solicit, encourage and welcome
members to get involved in your state or chapter
State council or chapter successes, achievements
or accomplishments
Membership drive campaigns and updates
Award announcements or call for awards

28

Innovated projects, ideas or best

practices
Articles should be under 400
words and will be edited for length
and clarity. High-resolution digital
photos or images that can be scanned
are welcome with your submission.
State Connection also offers an opportunity to announce
upcoming educational programs, state council or chapter
meetings or special events in the Meetings and Events
section. Include the following information with your
submission:
State/Chapter name
Event/Conference name
Date of the event
Time
Location
Presenter(s)
Website or contact information
To submit an article or event or for more information,
contact us at connection@ena.org.

March 2013

New ENA monthly offering for

FREE Continuing Education with
contact hours for our members.
Available March 1
GU: Its More Than Just P, 1.0 contact hour
Michael D. Gooch, MSN, RN, CEN, CFRN, ACNP-BC, FNP-BC, EMT-P
Dont miss out on enhancing your education by
registering and completing the offering.
Go to www.ena.org/FreeCE for additional free
continuing education opportunities.

The Emergency Nurses Association is accredited as a provider of continuing nursing education by the American
Nurses Credentialing Centers Commission on Accreditation.

The AEN EMINENCE Program

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

Mentee

Mentor

Area of Interest

Meredith Addison, MSN, RN, CEN

Thelma Kuska, BSN, RN, CEN, FAEN

Trauma Systems

Kiefah Awadallah, MSN, BS, RN

Rebecca Steinmann, MS, RN, APN,

CEN, CPEN, FAEN

Program Development

Kimberly Brandenburg, BSN, RN, CEN

Patricia Kunz Howard, PhD, RN, CEN,

CPEN, NE-BC, FAEN

Injury Prevention (SBIRT)

Colleen Connors, MSN, RN, CEN

Anne Manton, PhD, APRN, FAEN,

FAAN

Program Development

Hershaw Davis Jr., BSN, RN

Susan Hohenhaus, LPD, RN, CEN,

FAEN

Professional Presentations

Siegfried Emme, MSN, RN, NP-C, CEN,

CCRN

Jean Proehl, MN, RN, CEN, CPEN,

FAEN

Program Development

Michael Franks, BSN, RN, CEN

 ordon Gillespie, PhD, RN,

G
PHCNS-BC, CEN, CPEN, FAEN

Writing for Publication

Marites Gonzaga-Reardon, MSN, RN,

APN, CEN, CCNS

Gail Lenehan, EdD, MSN, RN, FAEN,

FAAN

Writing for Publication

Jerry Jones, MBA, BSN, RN

Andrea Novak, PhD, RN-BC, FAEN

Educational Conference Planning

Jennifer Morris, RN, CPEN, CPN

Jeff Solheim, MSN, RN-BC, CEN,

CFRN, FAEN

Professional Presentations


Curtis Olson, BSN, BA, RN, EMT-P,
CEN

Laura Criddle, PhD, RN, CEN, CPEN,

FAEN

Writing for Publication

 harlann Staab, MSN, RN, CFRN,

C
CHC-C

Carole Rush, MEd, BSN, RN, CEN,

FAEN

Writing for Publication

Kathy Van Dusen, BSN, RN, CEN

Diana Meyer, DNP, MSN, RN, CEN,

CCRN, FAEN

Advanced Practice Role Development

Belinda Watkins, BSN, RN, CPEN

Harriet Hawkins, RN, CPEN, CCRN,

FAEN

Program Development



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

30

March 2013

nual
ion

g
y Nursin
e
mergenc

ual
er Man
Provid
n
io
it
Ed
Fourth

The Emergency Nurses Association is proud

to present the release of the 4th edition of
the Emergency Nursing Pediatric Course.
It has been revised and updated, evidencebased, and continues to incorporate various
teaching and learning styles.

A portion of the course will be presented in

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

Upon successful completion of ENPC, RN participants are

verified for four years, receive a verification card and earn
up to 16 contact hours.
This course brings the emergency nurse a resource for
treating the pediatric patients arriving to emergency
departments every day.
The Emergency
Nurses Association is
accredited as a provider
of continuing nursing
education by the American
Nurses Credentialing
Centers Commission on
Accreditation.

To verify why ENPC is right for you and to

view course schedules, please visit
www.ena.org/coursesandeducation

Vocation in Her Vacation

ENA Member Finds Paradise Needs Good Teachers

By Amy Carpenter Aquino, ENA Connection
Lee Singer, RN, CEN, is a woman of many talents. An
emergency nurse since 1987 and an EMT since 1978, she is a
member of her local disaster medical assistance team, an avid
surfer and a concert flutist. She is a provider for the Trauma
Nursing Core Course and an instructor for the Emergency
Nursing Pediatric Course and for a Rhode Island emergency
medical services training program. She has saved lives on
both coasts, from conducting air evacuations in California to
assisting an urban search and rescue team in Rhode Island,
performing assessments on people stranded in their homes
after Hurricane Sandy devastated Misquamicut last October.
In 2012, Singer extended her emergency care and training
reach to St. John in the U.S. Virgin Islands. During a
vacation, Singer and her boyfriend, who is also an EMT,
were on a St.John beach when they met a member of the
local rescue squad.
I asked her what kind of training she had, and she said
they were always looking for people to do training, said
Singer, an emergency department charge nurse at South

County Hospital in Wakefield, R.I.

Six months later, Singer returned to St. John for a week to
train rescue workers, including EMTs from the island and
from St. Thomas, as well as members of the National Parks
Department. Two-thirds of St. John is dedicated park space.
The rescue workers usual training consisted of videos from
their training officer, some outdated lectures and occasional
EMT training by instructors from the U.S.
Singer incorporated TNCC and ENPC information into her
training lectures, as well as an extensive review of anatomy
and physiology.
Im a firm believer that if you know what youre looking
at and what parts youre looking at, you can understand
whats going on in a trauma situation or a burn situation,
Singer said. We did a lot of the basic scene material. I used
the TNCC method for airway, breathing and circulation, and
I taught them the CIAMPEDS mnemonic we use in ENPC for
complaint, immunization and allergies, which they loved.
As a beach vacation destination, St. John sees its share of
drunk-driving traumas, water injuries and coral cuts, while
other islands also see surfing injuries. The local population

AC13
Offering educational and
networking opportunities
for professionals caring
for emergency patients.
For more information, visit
www.ena.org.

32

March 2013

ENA member Lee Singer, RN, CEN, with Bob Malacarne,

training officer for the St. John rescue corps, in St. John.
suffers from a very high incidence of asthma, as well as some
obesity and those comorbidities, such as diabetes and high
blood pressure, in addition to some alcoholism, Singer said.
In addition to addressing those emergencies, Singer said
she incorporated training with familiar prehospital elements,
such as the MIVT report (mechanism of injury, vital signs
and treatment) and the PQRST (provokes, quality, radiates,
severity and time) pain pathway assessment.
You need to dig below the surface, she said. This
person had a broken bone, but you need to dig underneath
this, so I would go into the structures and say, OK, this is
what happened, this person fell over the handlebars, and

you see a bruise on this side. What do you suspect? What do

you think is under there? And they start more critical
thinking, and when they really caught on it was wonderful.
Singers students benefitted so much that the training
officer asked her to return this April. Singer plans to bring
tons of new information that is going to blow their minds,
including pediatric standards and a toxicology lecture on
bath salts and some of the poisonous plants used by locals
in folk medicine treatments.
A win-win exchange is how Singer described her
Caribbean teaching experience. While her students gained
new knowledge and skills, Singer said she returned with
renewed energy to pursue her own education and
certifications.
Ive gotten better in my practice as a nurse also, she
said, by doing some of the research and putting it into
practice. Ive learned a lot of tricks of trade from the rescue
down there. For instance, they do what they call high-angle
rescues, because its all pretty mountainous, so I can take
some of that back for our EMTs.
Singer encouraged other ENA members to remain open to
new prospects, wherever they are.
If you have an opportunity, youd better take that
opportunity and do the best that you can with it, she said.
I would offer that not just to nurses but to anybody. Oh,
the places youll go, as Dr. Seuss wrote.

marketplace ExprEss
NEW! Comprehensive systematic review for Advanced Nursing practice
Cheryl Holly, EdD, R Susan Salmond, EdD, RN, FAAN,
Marie K.Saimbert. BPharm, MSN, MLIS, RN (Editor)
In an age of rapidly expanding knowledge, it is crucial for health professionals to stay abreast
of the most current evidence-based information when making clinical decisions. The text
sets forth a rigorous, step-by-step approach to the process of conducting a literature search,
including both quantitative and qualitative studies, as well as grey literature. It describes
how to extract and synthesize the most relevant data, how to integrate systematic reviews into
practice, and how to disseminate the results.

Take $10 off during the month of March!

retail (Non-Member) price:
ENA Member price:

360 pages
ISBN: 9780826117786
2011
Weight: 2 lb.

$70.00
$59.00

Visit www.ena.org/shop and mention this ad in the comment section of your

order or call 800-900-9659 today. Marketplace Hours M-F 9 a.m. 5 p.m. CT.

LC13_marketplace_halfpage.indd 1

Official Magazine of the Emergency Nurses Association

2/1/13 11:33 AM

33

Recruitment Ads

Recruitment Ads

be happy.
When youre on the right team, happiness ensues.
You know us as recognized ED leaders who guide hospitals toward real and
effective change. Now we would like to get to know you. Blue Jay Consulting is
looking for professionals with the leadership insight and clinical experience to
bring process improvements to our clients, and the passion and commitment to
enhance the overall quality of emergency care. If you consider yourself among
the best in your eld, youll nd yourself in good company at Blue Jay Consulting.
Join the strongest team in the industry and... be happy.

As a Blue Jay Consultant, I apply the skills

and experience I have gained in my nursing
career every day. Each assignment brings
new challenges and opportunities to make a
difference for ED staff and the patients they
care for. My work touches the lives of many
people. I love what I do and the colleagues
and clients I work with.
NANCY BONALUMI, RN, MS, CEN
Director
Blue Jay Consulting, LLC

www.bluejayconsulting.com
Contact Jim Hoelz or Mark Feinberg at 407-210-6570 to discuss how we can capitalize on
one anothers strengths.