NSNA Annual Convention 2009 - Day 5

Today was the last day of the convention proper, there were two more rounds of focus sessions and the closing meetings of the house of delegates. I had kind of been slacking on attending the house of delegates meetings, which I felt somewhat guilty about, but hey, I was here this year so I could go to the focus sessions and NOT get hung up in the house of delegates like I was the past two years.

Last night I got locked out of my hotel room because the magnetic ID badge from work that I keep in my wallet wiped out my room key. Whoops! A few trips down to the lobby later and I was in bed by about 4AM. As a result, I missed the 10AM house of delegates meeting that I promised Namrata (Delegate from NJ) that I would attend to help her defend her resolution on limiting noise levels in health care environments. I busted my butt trying to keep the resolution afloat last year, and I would have been crushed if it failed two years in a row. Thankfully it passed. The full text of all of the resolutions that passed can be found at NSNA's website (2009 resolutions aren't up yet at the time of this entry).

I slept through or skipped out on the majority of the resolution hearings but I did get an opportunity to speak from the floor, probably my favorite experience at any of these conventions. The resolution to support using federal stimulus monies to develop nursing residency programs was predictably fractious. What annoys me the most about this process and prompts me to speak is that the average person's ability to separate assertions from arguments is sadly underdeveloped. Even among nursing students, a pretty well-educated bunch, this is true. People spoke out against the resolution because of their political objections to the federal stimulus package in general. The resolution before the house clearly read that -if- the stimulus package passes, the NSNA should encourage it's constituents to lobby for some of that money to be used to develop Nurse Residency programs. Then the argument became "oh, well, that money should be used for cancer research", because people didn't understand that the monies were specifically allocated -already- for programs to alleviate the health care worker shortage. Nurse Residency programs have been soundly proven to improve retention statistics, which is an important facet of the health care worker shortage crisis.

I was nervous about addressing the house of delegates as an outsider for the first time, but my statements were met by deafening applause (much as they were when I was a delegate). I actually spoke -against- a motion to refer and delay the resolution to next year, which was defeated with 91% of the delegates responding Nay. The resolution itself was adopted with just over 80% of the delegates responding Yay.

Here's a dump of the results of the resolution hearings. I got percentages for most but not all of them, since I arrived late and had to rely on patient and understanding gallery members for notes:

In Support of Adolescent Pregnancy Prevention and Education - Adopted 95%
... Legistlation to Increase Penalties for Assault Against Health care Workers - Defeated 54%
... Advocating Nationwide Continuing Education Requirements for Nurses - Adopted 93%
... Evidence-Based Nursing Practice - Adopted 96%
... Increasing Environmental Health Advocacy and Education - Adopted 90%
... Adolescent Sun-Safety Awareness and Education - Adopted 92%
... Including Global Health in the Nursing Curriculum - Adopted 89%
... Liability Protection for Paid Health care Personnel During a Declared Disaster or State Emergency - Adopted 96%
... Increased Collaboration with Child Life Specialists - Adopted 89%
... Herpes Zoster Vaccination of Adults Over 60 Years of Age - Adopted 90%
... Vaginal Microbicide Development - Adopted
... Reduction of Unnecessary Noise in Health Care Facilities - Adopted
... Increasing Education, Awareness and Identification of Preventable Pressure Ulcers - Adopted
... Interdisciplinary Education - Adopted
... Increasing Awareness of the Therapeutic Value of Music Therapy - Adopted
... Increase Awareness and Evaluate Competency of Culturally and Linguistically Appropriate Care - Adopted
... Early Recognition and Intervention Programs in Healthcare Facilities to Prevent Respiratory and Cardiac Arrest - Adopted
... Workforce Data Collection - Adopted
... Prevention, Awareness, and Nationalized Regulatory Standards for MRSA - Adopted
... Awareness and Prevention of Elder Abuse - Adopted
... Electronic Health Records (EHR): Enhancing Patient Safety - Adopted 89%
(arguers against got confused because they were hung up on exactly which electronic record system should be used when the resolution was about supporting EHR implementation in general)
... Increasing Awareness of Mental Health Disparities in Youth - Adopted 97%
... Increasing Awareness for Standardized Patient Care Hand-Off - Adopted 96&
(arguers against got confused because they were hung up on exactly which method of hand-off should be utilized when the resolution was about the necessity for the adoption of standards)
... Utilizing Recent Federal Stimulus Monies Toward Nursing Residency Programs - Adopted around 80%
(arguers against got confused because they imagined themselves to be the US senate and motioned to refer until the NSNA could decide exactly how the money could be distributed, which isn't our role)

The usual frustrations with attending the house of delegates were all there. Delegates would argue passionately based on what they felt and not that they read and thought. Delegates would eagerly run through the gamut of logical fallacies to deride resolutions that didn't jive with their local politics. After the session a former Philosophy Major who now studies nursing thanked me for my statements, and we commiserated on the average person's inability to form a coherent argument.

The resolutions in general smacked of the submitters' desire to get a resolution published at any cost, even if the end-result was toothless and uncontroversial. I guess this is a good thing, since the goal is to get as many of the resolutions passed as possible, but the easy passage of most of them and the early dismissal of the hearings was...I dunno..slightly disappointing and kinda lazy-seeming. Having sat through most of this process three times I also thought it was interesting that the understanding and implementation of parliamentary procedure itself changed from year to year. I was, however, happy to see the resolution regarding increased penalties for assault against health care workers fail, as I thought it focused too much (all the way) on punishment and not enough on prevention.

Earlier on in the parliamentary process (I missed this..I was asleep..haha) A motion was filed to ban RN to BSN students from participating in the house of delegates. A couple of people mentioned this to me but thankfully it failed. The fact that it was even proposed kinda pisses me off, since I think that not only should RN to BSN students be active members, but RN to MSN and doctoral candidates as well. One of the major problems the SNA faces at the national, regional, state and school levels is the fast turn-over time. As a graduate of an associate's degree nursing program, I can tell ya by the time you get involved in the student nursing associations and figure out what you can do and where you can do it ... it's time to graduate. Apparently some of the professional organizations have this problem too, as people relocate and take on a different responsibility profile. If we're going to come at this problem from one end - involving pre-nursing students - it only makes sense to include the graduate nursing students as well. Why limit ourselves? Xenophobia is unseemly.

Today was the last day of focus groups. The first one I attended was "The Effect of a Holistic Nurse's Presence", presented by Vicky Slater, PhD, HN-BC, American Holistic Nurses Association (more alphabet for my alphabet soup! I think I'm up to four titles I want now). The American Holistic Nurses Association is based out of Flagstaff, AZ. It was a fantastic presentation, and the only truly interactive presentation I attended. I've always been a big fan of holism, when we were asked to verbally present an inventory of things we were good and not so good at towards the end of nursing school, providing holistic care to my patients was something I brought up as something I thought I did very well.

(She actually used a transparency projector, which she claimed she used to point out that holistic nurses CAN use technology, but failed to back up this point. That's ok. I Love her with all my Heart anyway)

The presentation gave me a lot of ideas on how I can continue to develop my intuition and create sacred space for my residents. The presentation also deepened my appreciation for the RN I've adopted as my mentor at my workplace. The importance of being present to yourself and limiting the influence of toxic emotions was already something I could intellectually grasp, but the cosmic coincidences at play in the actual presentation itself helped to strengthen that understanding and make it more accessible in the moment.

The next and last focus session of the convention was "So, You Want to be a Nurse? That Could End in a Disaster!". It was presented by Steven Busby, MSN, FNP-BC, Clinical Assistant Professor of Nursing/Coordinator of Nurse Practitioner Programs, PhD Candidate, Nursing with Homeland Security Specialty.

This was by far the most entertaining speaker of the bunch. He's a former paramedic who transitioned to nursing and went on to get his masters and board-certification as a family nurse practitioner. I didn't get a hand-out so I cant trace his entire illustrious career but he spoke at length about his copyright-pending theory of multiple-casualty incidents and his experiences responding to national emergencies. I had never heard of the strategic national stockpile before and it's a pretty interesting concept. Apparently there are multiple stockpiles of medicine, food, water, and medical equipment scattered throughout the country in secret locations, and a single drop-off of supplies from one of these locations can be delivered to anywhere in the country within 12 hours by 8 semi trucks. He shared with us pictures of his own training in disaster nursing, including an exercise where his team was doing so well the instructor came up to him (who was leading the team) and informed him that his oxygen had run out and was now unconscious, and the rest of his team had to rescue him and carry out the mission with the leader as a burden rather than an asset. Very inspiring! He also shared with us a very interesting program they've implemented in ... AZ I think ... Where they get all the statewide localities to donate their GIS data to multiply their situational awareness a thousandfold. As a computer geek myself it was a pretty interesting idea. Live video feeds of key infrastructure locations, google earth resolutions increased to one pixel = 6 inches, all the things you could possibly want to maximally prepare a region for disaster.

I was honored by a just less-than-a-minute blurb from Cheryl K. Schmidt, PhD, RN, CNE, ANEF, ANA-Appointed Consultant to the NSNA, I asked her to tell y'all why these conventions are important:

I also ambushed a random student and asked her to do the same:

Afterward, they played one of my favorite songs (and books) at the Irish Pub: The Ballad of Finnegan's Wake.

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