4.16.2009

NSNA Annual Convention 2009 - Day 3





I never, ever made it to the 9AM plenary sessions, and this year was no different. Hey, I'm sorry, I'm not getting up at 8AM, I'm just not. It looked interesting, though, The topic was "The Politics of Caring" and legislative issues surrounding the nursing profession. The session was moderated by Rebecca M. Patton, MSN, RN, CNOR, President, American Nurses Association. Speakers were Suzanne Begeny, MS, RN, Director of Government Affairs, Ammerican Association of Colleges of Nursing and Virginia Trotter Betts, MSN, JD, RN, FAAN, Commissioner of the Tennessee Dept. of Mental Health and Developmental Disabilities. The political stuff actually looks pretty interesting, and I intend to get in touch with my state or national ANA governmental relations committees once I get home. The idea of directly lobbying on capitol hill for health issues is appealing, but maybe I'll wait and take on a support role until I have beefier credentials.

My first stop today was the Expo, a combination job and school faire. I didn't find -any- schools that had a Clinical Nurse Leader MSN program, and few offered RN to MS, but I had some nice conversations and snagged some nifty hand-outs. The National League for Nursing booth was a worthwhile stop, the regional sales manager I met there knows my old Director of Nursing from back at school (who's since been elevated to a state-wide position), and we chatted about career opportunities and issues particular to CT (apparently the Northeast is -much- harder for new grads to find positions in hospitals than other areas of the country). She gave me her card and invited me to look her up when I got back once I had an idea which facility/school I wanted to get in to (if it's in CT, that is).

The booth for Baylor Health Care System caught my eye, since like many of us I work and enjoy Baylor shifts (work 12 hours on a weekend and get paid for 20). I asked if they invented the Baylor shifts and they DID! I told them I used to think it was "Bailer" shifts, as in, students work the shifts and then bail on the organization once they're out of school. hah. From what the RN from Baylor told me they're actually phasing out the practice because no one wants to work 7a-7p or 7p-7a on a weekend. It's different in nursing homes, we agreed.

One of the students had a neat demonstration display of an eye-tracking interface for people who are unable to speak or write, where they can use their eyes to select words or letters, using predictive text entry like cellphones. The rig cost 15,000USD even though it clearly consisted of about 300USD worth of hardware. I guess that's what happens when Medicare covers 80% of it. I didn't go through the entire calibration routine so I found the eye-tracking somewhat finicky, but the student presenting the unit assured me that with lengthier calibration the control is more exact. We talked about Neurofeedback for a while, I really think EEGs would be a more effective way to control the interface, and wouldn't even require you to have both eyes or a steady gaze.

The military was out in force, as usual, particularly the Army. I didn't get a chance to visit all of the booths, but tomorrow I'm going to hit up the US Public Health Service booth as well as the pain management nursing booth and a few others that looked interesting.

(Video of expo walkthrough pending)

Having been released from my obligations to sit through the house of delegates I actually got a chance to attend two whole focus groups! I avoided the Pharmacology Made Insanely Easy session, since I remembered from past years that it's just a sales pitch for their book. First I hit up "What Every Nursing Student Should Know-Malpractice Case Studies", presented by Kate Mager, Association Manager, Nurses Service Organization and Delores Hunsberger, BA, Healthcare Division of Affinity Insurance Services, Inc. I greatly enjoyed last years malpractice focus group presented by a woman from the National Council of State Boards of Nursing Education, and was skeptical about a presentation given by someone who's here to sell us malpractice insurance, but it was actually a pretty good presentation. We were shown some as-yet-unpublished statistical data the NSO has collected about nursing malpractice lawsuits and got some good advice on practices to adopt to protect our practice. The NCSBNE presentation last year had more interesting case studies, but this year we got more practical information about how to prevent malpractice suits and how to protect ourselves in case we are named in a suit.



Next I hurried over to the "Oncology Nursing: Real-time Personalized Medicine" session so I could grab a seat near the electrical outlet to charge up my devices. This session was presented by Amy Strauss Tranin, MS, ARNP, AOCN, Quality Outcomes Coordinator, The University of Kansas Hospital, Cancer Center, Kansas City KS. She was a great extemporaneous speaker, a quality I enjoy (since I have it myself and get bored/offended by people who read slides to me). She only briefly talked about DNA analysis of tumor cells to select effective chemotherapy agents, though, and spent the rest of the time talking about herself. She definitely inspired us towards membership in the Oncology Nurse's association, it looks like even though I'm not an oncology nurse, if I can prove that I see enough patients with cancer (and nursing homes are full of 'em) over a 1-year period I can actually become a certified oncology nurse through their organization (I'd have to take a test like you do with ENA or other professional organizations). She went on to become a Genetics councilor and has her own private practice! Although the talk was somewhat limited to self-exposition, it was an inspiring example of how a Nurse can become an expert at something and operate an independent practice.



I stopped by the first Resolutions hearing where they go over all the resolutions, but I remembered the first one is rather boring, they basically just go over them. Later on they debate them and that's where I always had the most fun. I'll have to refresh my memory on the times and circumstances a sustaining member can speak from the floor, they set a microphone up by the gallery, I just don't remember when I'm able to do that.

Flipping through the resolutions, I only see one I'd be compelled to argue against. It's right up front. "In support of Adolescent Pregnancy Prevention and Education". Well-intentioned, I'm sure, but there's a story about this I'll tell the house if I get the opportunity:
During my labor and delivery rotation, one of my last patient assignments was two rooms. A woman in her early/mid 20s diagnosed with incompetent cervix and Type I diabetes, confined to bed. Completely resistant to teaching and non-compliant with the hospital's suggestions. In the next room was a young hispanic woman in her mid teens, who had just given birth to twins. Some of my classmates made snide comments about the latter, but while tending to this woman and her twins, I got to meet three generations of mothers and fathers lending their support, and found through my assessment that the young mother was extremely knowledgeable and prepared intellectually, socially and emotionally for motherhood. It was the patient in the next room I was worried about.


True, there are risks associated with adolescent pregnancy, but there are also risks associated with introducing solid foods too young and some cultures do that as well. Who are we to say that the young hispanic woman shouldn't have had children? Maybe the presence of multiple generations of parents is an advantage, a source of strength. There's some research to support this but I can't point to it at the moment, that human civilization advanced rapidly once people lived long enough to be grandparents. The point is that I think the resolution shows a lack of cultural competence, one of the major nursing buzzwords lately.

Flipping through the rest, I silently cheered when I saw "In Support of the Reduction of Unecessary Noise in Health Care Facilities" (hopefully they'll correct the spelling in the next session). The resolution was introduced last year but failed because it contained too many specific solutions to the problem of noise in health care facilities, which is really a problem for biomedical engineers to figure out. This year's version of the resolution has a lot of the changes I suggested to Namrata Jani last year (who was the resolution's author, I think), unfortunately a poorly managed House of Delegates denied her constituency the opportunity to revisit the revised resolution (I was extremely disappointed with the lack of knowledge of parliamentary procedure last year compared to two years ago). Hopefully this year they'll get it passed.

Hardly any of the remainder of the resolutions look contentious, but you'd be surprised what people will fight over that looks like it should be a done deal. "In Support of Legislation to Increase Penalties for Assault Against Healthcare Workers" might draw a couple of criticisms for being too focused on punitive measures and not prevention. "In Support of Advocating Nationwide Continuing Education Requirements for Nurses" looks like it's going to trigger the whole "States rights" issue that people (including me) in the past have invoked to derail a resolution. Worst case though they'll strike one of the resolved clauses and simply resolve to encourage constituents to pursue continuing education whether it's required or not, leaving out supporting mandatory continuing ed.

"In Support of Evidence-Based Nursing Practice" looks like a no-brainer, an easy way to get a resolution passed and gain some kudos, same with "In Support of Increasing Environmental Health Advocacy and Education" (a popular issue lately), "....Adolescent Sun-Safety Awareness and Education", "...Liability Protection for Paid Healthcare Personnel During a Declared Disaster" (another hot-button issue lately..a gem from the res: 551 disasters have been declared between 1999 and 2008!), "...Increased Collaboration with Child Life Specialists", "...Herpes Zoster Vaccination of Adults over 60 years of age", "...Vaginal Microbicide Development", "...Increasing Education, Awareness and Identification of Preventable Pressure Ulcers", "...Interdisciplinary Education" (another hot-button issue and authored by Johns Hopkins, who usually sends along the heavy artillery when it comes to debating, I'm glad I've only entered debates on their side in the past!), "...Increasing Awareness of the Therapeutic Value of Music Therapy", "To Increase Awareness and Evaluate Competency of Culturally and Linguistically Appropriate Care" (a BIG BIG issue lately and contains a great RESOLVED statement: "...that the NSNA create awareness that failure to provide appropriate language services to patients is a direct violation of Federal mandates under CLAS and Joint Commission standards"), "...Early Recognition and Intervention Programs in Healthcare Facilities to Prevent Respiratory and Cardiac Arrest" (basically in support of hospitals having rapid response teams, something I couldn't imagine a hospital lacking), "...Workforce Data Collection", "...Prevention, Awareness, and Nationalized Regulatory Standards for MRSA", "...Awareness and Prevention of Elder Abuse", "...Electronic Health Records (EHR): Enhancing Patient Safety", "...Increasing Awareness of Mental Health Disparities in Youth"

... These all look like no-brainers, and a quick readthrough of the RESOLVED statements didn't reveal any glaring weaknesses to exploit logically. You never know, of course. Debate, especially in some of the less..shall we say...literate constituencies is not always constrained to logical arguments. Fortunately it looks like most of these sidestepped the mistake we made a couple years ago by using language that was too complex (we got it passed anyway but it took some fancy parliamentary maneuvering to get someone to change their vote and get it reconsidered).

A couple that stand out as resolutions that are potentially fractious are "...Utilizing Recent Federal Stimulus Monies Toward Nursing Residency Programs", "...Increasing Awareness for Standardized Patient Care Hand-Off", and "...Including Global Health in the Nursing Cirriculum" (they really need to spellcheck these).

The Federal Stimulus resolution, of course, is going to incite conflict along red and blue lines, and with the small sample size of our delegations, you don't want to underestimate the bible-belt voting block (they reared their ugly head in the DNR vs AND and providing condoms to prison inmates debates a couple years back..unsuccessfully thankfully). The Standardized Patient Care Hand-Off and Global Health in Nursing Curriculum resolutions are going to inspire some arguments about the WHEREAS statements...even though parliamentary procedure doesn't allow you to debate WHEREAS statements, people who don't know this try to do it anyway every year (3 years ago that was me, hehe).

Should be a pretty smooth set of resolutions hearings, with the occasional heated debate. I'll swing by to watch in between focus groups. Tomorrow I think I'll hit up "Managing Complex Medical Issues through the Application of Rehabilitation Nursing Principles" (since I work in a rehab/long-term care environment after all) and "Nursing Leadership for the New Millennium: Essential Attributes". Saturday has some of the toughest decisions for focus groups, but I'll get to those later.



I bought this hoodie last year, but didn't try it on first, and discovered that girls mean very different things by "Extra Large" than boys do. I had to give that one away, but this time I got an XXXL, which is only slightly too big for me (I like a spacious hood in my hoodie, though)

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