NEWS FROM AORN CENTRAL OKLAHOMA

 

EDITOR: JANISE NEPVEUX               MARCH 2000

THE MARCH MEETING TO BE HELD AT INTEGRIS BAPTIST MEDICAL CENTER

BUILDING D, LEVEL C, ROOMS F AND G

<(This website contains a map to the meeting place)<

FEATURES click to tab down

MEMBERS TO LAPSE & NEW MEMBERS

MEMBERLINE NEWS

FACT OR FICTION ? - NURSING SHORTAGE

CONGRESS 2000

HEALTH - ESSENTIAL TREMOR

LEGISLATIVE - California law requires staffing ratios

SURFING NEWS - PREVENT SPAM

OFFICERS AND BOARD MEMBERS NEEDED!!!

If interested please contact Jane Pickelsimer 773-4951.

Offices to be filled:

President Elect

Vice President

Secretary

Two Board of Director Seats

Two Nominating Committee Seats

 

DEADLINE TO ENTER MARCH 30

Remember you earn points toward delegate selection as you participate as officers and board members!!!!

FACT OR FICTION ?

Nursing shortage plagues global health care

You’re in the hospital and push the bedside call button for help. No one comes.

Possible? Such a scenario may be the greatest fear health care consumers have about the nursing shortage. As a global shortage builds, a recent Harris Poll indicated more than half of Americans believe the quality of health care is affected “a great deal” by a shortage of nurses.

Where is the future of health care going, and how can practicing nurses survive the nursing shortage?

A panel at the Sigma Theta Tau convention in November participated in a “town meeting” to discuss the nursing shortage. The panel was moderated by Barbara Bronson Gray, RN, MN, editor, Web RN, a new Internet venture by Healtheon/Web MD. NurseWeek/HealthWeek sponsored the event.

“It may sound strange to think of it in this way, but nurses are actually in a great position during nursing shortages. It’s a time when nursing is suddenly understood as really important,” says Gray. “Wages go up, the breath of opportunities improves, conditions improve. Nurses need to prepare to take their careers further during a shortage.”

Despite 2.5 million registered nurses in the United States, a shortage exists among nurses with needed specialties, skills and experience. As a result, hospital recruitment efforts to reverse the shortage include large sign-on bonuses, salary increases and tuition reimbursement plans. Some even offer lawn services and maids in order to attract new nurses.

Incentives cannot erase the issues facing nursing, including an aging workforce, lack of ethnic and racial minorities and a decrease in baccalaureate prepared nurses, says Marilyn Chow, RN, DNSc, FAAN, vice president, patient care services, Summit Medical Center, Oakland, Calif.

“There are two issues facing us now—-how do we recruit nurses and how do we ensure a long term nursing supply?” says Chow. “A lot of what we’re faced with now didn’t happen overnight. We need to address some of the long term concerns of the nursing shortage.”

Driving the increased demand for specialized nurses are several factors—-shrinking health care dollars, an aging population that needs increased health care, new employment opportunities outside the hospital and dramatically increased nursing workloads that have left many nurses overworked. These same factors have discouraged young people from entering the profession.

“It’s the first time when the best and the brightest men and women are not considering nursing.” Gray says. “I have a car pool of 13-year-olds and there isn’t one of them who even knows anyone who wants to be a nurse. If nursing doesn’t solve this entry into practice issue, the best and the brightest don’t see it as good enough. They are looking for a good career for a baccalaureate degree.”

Gray sees the shortage affecting educators not only in the recruitment of students, but potentially in the restructuring of nursing education. Gray recommends a four-year broad education program including clinical with a fifth year as a paid internship. She also advocates for a universal entry into practice for nursing. Currently nurses have academic preparation ranging from associate, baccalaureate, master’s or PhD degrees.

A national proposal is in the works with a goal of two-thirds of registered nurses to hold a baccalaureate degree by 2010. California has a similar state initiative sponsored by the Association of California Nurse Leaders.

Others view health care as having a professional

“We have a shortage of leaders and of leadership,” says Heather Clarke, RN, PhD, director of policy and communications, Registered Nurses Association of British Columbia. “There are cuts in top positions, and there are non-nurses assuming these roles.”

As technology progresses, there could eventually be a nursing surplus, according to Luther Christman, RN, PhD, FAAN, dean emeritus, Rush College of Nursing. With clinical nurses spending up to 70 percent of their shifts with non-clinical duties, he says if other staff assumed these duties, nurses could return to patient caregiving.

Areas outside of the U.S. face similar problems. In Vancouver there are reports of hospital units with up to a 25 percent staffing shortage, while other units are reducing the number of beds for patients. In the United Kingdom, there is a shortage of funding for nursing, says Dame June Clark, DBE, PhD, RHV,FRCN, professor of community nursing at University of Wales, Swansea, United Kingdom. She was a convention keynote speaker.

“Where there appears to be a shortage of nurses it’s actually a shortage of money to keep nursing posts open,” Clark says. “In England the government is using some very short term and counterproductive ways to address it.”

Increasing skills and capabilities may be the best way to ride out the shortage. By preparing for the future now, nurses can help ensure they will always have a place in health care.

“In the future we need people who can do more. With genetic counseling and Internet diagnosis, if nursing doesn’t gear up for that we will have a shortage of knowledge,” says Gray. “That’s the hidden shortage, the shortage of incredibly experienced and knowledgeable people who are comfortable with technology and treating patients all over the world.”

For more information, visit Sigma Theta Tau’s Web site at nursingsociety.org/media and select “Facts on the Nursing Shortage,” a paper with recommended solutions.

DELEGATE MEETING

APRIL 18, 2000

6:30pm

INTERGRIS BAPTIST MEDICAL CENTER

SURFING NEWS

NOT SO LOVELY SPAM

HOW TO PREVENT BEING SPAMMED

 

Unfortunately, the only real way to prevent all spam from reaching you is to not have an e-mail account. Because that isn’t practical, a few suggestions follow:

Take an active role in turning spammers away from your e-mail address. If everyone who ever gets spam makes it clear that it is wholly unwelcome,it eventually will go the way of 8-track tapes.

It is possible to set up mail-filtering rules that will automatically screen out spam that comes from the same source. An even neater trick is to have your e-mailer send out an automated reply to the spammer that lets them know the message was never seen by a human and the entire transaction was handled by your computer. A couple of the anti-spam sites listed at the end of this article carry instructions on how to set this up.

Register with the Network Abuse Clearinghouse (Abuse.Net) and report spam when it happens.

Contact the Coalition Against Unsolicited E-mail (CAUCE) www.cauce.org/ and your Congressional representatives and urge them to support legislation that cuts back on spammers’ rights in favor of consumers.

There are many anti-spam sites on the Internet, some with much more detailed background and instructions on how to fight spam. The following URLs are of interest:

“Death to Spam” www.mindworkshop.com/alchemy/nospam.html features several politely nasty ways to deal with spam, including setting up filters and automated replies.

“F.R.E.E. Great American Pink-Out ybecker.net/pink/, which has links to Congressional representatives’ e-mail addresses and an excellent “newbie primer” at www.ao.net/waytosuccess/newbie.html

Coalition Against Unsolicited E-mail (CAUCE), www.cauce.org/index.html, a 12,000-member volunteer organization, features analysis of pending legislation.

“Fight Spam on the Internet” spam.abuse.net features a tutorial on how to complain to ISPs about spam, a blacklist of Internet advertisers, and practical tools on how to fight spam.

HEALTH

ESSENTIAL TREMOR VS. PARKINSON’S DISEASE

The presence of tremors does not necessarily indicate the presence of Parkinson’s Disease. According to the International Tremor Foundation, while there are about 500,000 people with Parkinson’s in the United States, there are 3-4 million people who suffer from essential tremor. The chart below compares the two conditions.

Essential tremor                                       Parkinson’s disease

Tremor with movement or action	Tremor experienced at rest
Head tremors common	Face or lips may be involved   rather than entire head
Handwriting may be large and scrawled	Handwriting becomes progres- sively smaller and shakier
Tremor relieved by alcohol	Tremor unaffected by alcohol
No noted sense of rigidity	Rigidity
No noted balance problem	Balance difficulties
Speed of tremor is relatively fast	Tremor tends to be slower
Family history often present	Familial involvement much less frequent

It is important to note that there is always exceptions, so be sure to consult your doctor if you experience any of these symptoms.

Medications can help to relieve essential tremor. Physicians usually prescribe one of two drugs—-the beta blocker propanolol (Inderal) or the antiseizure medication primidone (Mysoline). Some people take one of the medications every day, while others choose to take drugs only on special occasions, such as when going out to dinner. Each reduces the severity of tremors in more than 60% of those who try them. If neither of these drugs work, physicians sometimes prescribe tranquilizers or other antiseizure medications. In very severe cases, a device that delivers mild electrical stimulation to block the signals that cause tremor may be surgically implanted in the brain.

There is some disagreement among doctors about whether to recommend therapeutic use of alcohol because of the potential for abuse. But most agree that, for people with no history of alcoholism or liver or kidney problems, a drink before dinner may not only be helpful but also just what the doctor ordered.

(source Harvard Women’s Healthwatch)

Central Oklahoma AORN

“New Trends in

Cardiovascular Surgery”

 

presented by

David Vanhooser, MD

March 21, 2000

7:00 PM

Integris Baptist Hospital

Bldg. D, Rms. F & G

CONGRESS 2000

AORN Tour Program March 31 - April 8, 2000

AORN’s tour program has been organized by Destination Management, Inc, New Orleans. For more information about Destination Management, check out their website at www.bigeasy.com.

Tour 1: City Tour offered Friday, March 31 (9:00am-12:00pm)

Tour 2: Cemeteries, Churches, and Chapels offered Friday, March 31 (9:30am-12:30pm)

Tour 3: Half-Day Laura Plantation Tour with Lunch offered Friday, March 31 (1:15pm-4:45pm)

Tour 4: Garden District Homes with Private Mansions offered Friday, March 32 (2:00pm-5:00pm) & Friday, April 7 (11:00am-2:00pm)

Tour 5: Nottoway Plantation with Dinner offered Friday, March 31 (5:30pm-10:30pm)

Tour 6: French Quarter Walking Tour with Gallier House offered Saturday, April 1 (9:00am-12:00pm)

Tour 7: Honey Island Swamp Tour offered Saturday, April 1 (10:00am-2:00pm) & Friday, April 7 (1:00pm-5:00pm)

Tour 8: Cajun Cooking with Alzina Toups offered Saturday, April 1 (9:30am-4:30pm)

Tour 9: Cooking with Spice offered Saturday, April 1 (1:00pm-4:00pm)

Tour 10: Crescent City Round-A-Bout offered Saturday, April 1 (1:00pm-4:30pm)

Tour 11: Cajun Fais Do Do offered Saturday, April 1 (4:30pm-8:30pm)

Tour 12: Dinner Jazz Cruise offered Saturday, April 1 (7:00pm-10:00pm)

Tour 13: Jazz Tour & Brunch at the Court of Two Sisters offered Friday, April 7 (10:30am-2:00pm)

Tour 14: City Tour & Longue Vue House & Gardens offered Friday, April 7 (1:00pm-5:00pm)

Tour 15: Mardi Gras Madness offered Friday, April 7 (2:00pm-5:00pm)

Tour 16: Voodoo, The Mystique of New Orleans offered Saturday, April 8 (9:00am-1:00pm)

Tour 17: New Orleans School of Cooking offered Saturday, April 8 (9:45M-1:15pm)

Tour 18: Half-Day Oak Alley Plantation offered Saturday, April 8 (1:30pm-5:00pm)

Tour 19: Haunted History Tour offered Saturday, April 8 (8:00pm-11:00pm)

MAKE TIME TO ATTEND

“SNAKE BITES”

presented by

KEN HIEKE, MD

Integris Baptist Medical Center

APRIL 18, 2000

CNOR APPLICATION

About the exam

CBPN has contracted with Professional Examination Service (PES) to develop and score the CNOR exam, and with Sylvan Prometric, a computer-based testing organization, to administer the CNOR exam at more than 200 Sylvan Testing Centers. Candidates may take the exam year round, Monday through Saturday (holidays excluded).

The exam consists of 200 multiple-choice questions. Candidates will be given four hours to complete the exam, and individual scores are based on the number of correct answers. The computerized format of the exam does not require previous computer experience. A pre-examination tutorial provides instructions on how to take the exam on the computer. It will also provide examples of how to select answers as well as how to mark questions you may want to return to and review before completing the exam. Time spent on the pre-examination tutorial is not part of the four-hour testing period. Because both PES and Sylvan independently score and verify CBPN test results for accuracy, hand scoring of the exam is not available.

Application Fees

AORN Member $250

Non-AORN Member $350

Late Fees

Applications received after the deadline date will be processed only if accompanied with the $75 late fee.

Transfer Fees

Transfer from one test period to the next test period is permitted one time only with a $50 transfer fee. 

Transfer requests must be in writing and must reach CBPN no later than 30 days prior to your scheduled exam. Payment of the $50 transfer fee must accompany the request.

Forfeiture of Fees

Failure to schedule and take the exam during the testing period you have chosen will result in forfeiture of all fees submitted. The entire application fee will be forfeited if:

The candidate fails to cancel an appointment with Sylvan within the required time.

The candidate fails to appear as scheduled to take the exam.

The candidate arrives at Sylvan for the exam without proper identification and current, valid RN license.

The candidate fails to achieve a passing score on the exam.

In all of these circumstances, the applicant must complete the entire application process (including payment of the application fee) in order to take the exam at a future date.

Refunds and Cancellations

Refunds are made at the discretion of CBPN, and the $100 application fee constitutes a nonrefundable processing charge. To receive a partial refund, you must do both of the following:

Send a written request to CBPN to withdraw application prior to 30 days before the exam window you have chosen.

Cancel your exam by calling Sylvan at least 48 hours in advance of your scheduled appointment time.

WELCOME NEW, RENEWED, &

REJOINED MEMBERS

Traci Frey                 Angela Gann

Kathy Lockhart                Barbara Hunter

Gwendolyn Allen                Suzann Charbeneau

Sherry Mills                         Cheryl Omundson

Cynthia Palmer                Dana Taylor

EDUCATION CALENDAR

 

February 2000

PO 101 Course Facilitator Seminar - Denver, CO -2/28/00

March 2000

Prep for CNOR Cert Exam - Chicago, IL- 3/4/00

April 2000

PO 101 Course Facilitator Seminar - New Orleans, LA - 4/1/00

Nurses in Business, Industry and Consulting Conference 2000 - New Orleans, LA - 4/1/00

47th Annual AORN Congress - New Orleans, LA - 4/1/00

2000 AORN Pre-Congress - New Orleans, LA - 4/1/00

Preparing for the CNOR Certification Exam - Jacksonville, FL - 4/28/00

May 2000

Prep for CNOR Cert Exam - Denver, CO - 5/19/00

PO 101 Course Facilitator Seminar - Denver, CO - 5/22/00

June 2000

PO 101 Course Facilitator Seminar - Denver, CO - 6/12/00

RNFA Forum - Denver, CO - 6/22/00

MEMBERLINE NEWS

 

GOVERNMENT AFFAIRS UPDATE

RNFA Reimbursement Legislation

Congratulations AORN! Due to strong grassroots efforts in Georgia, Congressman Mac Collins (R-GA) has agreed to sponsor the CRNFA Medicare reimbursement bill in Congress. The final touches are being put on the draft and should be “dropped” (introduced) within two weeks. He is preparing to have several press events in Georgia to commemorate the occasion, kicking it off with a press conference to coincide with a February 24, reception in Atlanta, hosted by AORN members.

Please contact your Congressional delegation and ask them to cosponsor this legislation. The more sponsors we have, the stronger the bill is and the more likely AORN achieves its goal. You don’t need a bill number to put in your request.

MO HB 1133 and SB 574

There are two RNFA reimbursement bills in the Missouri State Legislature right now. The two versions are the same but introduced by each house. House version 1133 has been passed out of the House Insurance Committee Executive Hearing, with minor language changes. The Senate version SB 574 has been scheduled for hearing and should pass with the minor changes as well.

KY H.B. 281

This bill was heard in the house and has been passed favorably to the Senate. It is scheduled for a hearing in the Senate Committee on Health and Welfare. This bill is flying through with tremendous success.

IA SB 397 was carried over but has not been scheduled for hearing.

GA H.B. 744 and SB 58 have been carried over from last year but has not been scheduled for a hearing. These two bills will hopefully be scheduled for a hearing some time soon.

MA S.B. 514 this bill was sent to the senate committee on ways and means but has not been scheduled for hearing as to date. This was carried over from last year and we hope it will come out favorable.

Surgical Technologists and Unlicensed Assistive Personnel Legislation - Surgical technologists and Surgical First Assistants are seeking to become licensed in IL.

IL HB 2996 Creates the Surgical Assistant Practice Act. Regulates surgical assistants through licensing requirements. Amends the Regulatory Sunset Act to repeal the new Act on January 1, 2011. Amends the Perfusionist Licensing Act. Retitles the Board of Perfusion as the Board of Perfusion and Surgical Assisting. Adds a member to the Board who is actively licensed as a surgical assistant. This bill has been referred to the House Rules Committee.

In Washington State, we are still awaiting the outcome of the Department of Health rule making process for the registration of surgical technologists.

Dorothy Paulk State Legislative Coordinator gives a legislative update during the 1999 OSCPN Annual meeting. Thank you Dorothy for keeping each of us up to date with the current legislation in Oklahoma, and with the NEWEST LEGISLATIVE ALERT FROM AORN!

MEMBERS WHO WILL LAPSE

MARCH 31, 2000

Roberta Billy	Rhonda Bridge	Teresa Bradshaw
Jerry Bunch	Kristine Cronquist	Jerianne Davis
Elizabeth Fisher	Brenda Ferguson-Argo	Roberta Graham
Debra Fogle	Julie Harger	Mary Hurt
Michele Jamison	Marva Jennings	Nancy Kennedy
Linda Mariman	Patricia Mayo	Joyce Pantry
Lou Patterson	M Rooks	Linda Routledge
Manda Ruffin	Barbara Schneider	Donna Stanford
Barbara Westerman	Lana Yurdakul

 You can renew your membership or join AORN online using E-Shop@AORN:        current members watch for your access code on your membership renewal notice.

You can also call National AORN at (1-800-755-2676 to renew your membership.)

MISSING RN

LICENSE NUMBER

National AORN requests that the following nurses please call (800) 755 -2676 and report their license number to complete your file.

DEBORAH MILLER & TONYA BOYANTON

Thank you for taking care of this request!

LAW AB 394

California has become the first state to require hospitals to meet fixed minimum nurse-to-patient ratios on all patient care units.

California Governor Gray Davis signed the state legislation (AB 394) into law Oct. 10, and in so doing, has placed a national spot light on an important nursing issue — staffing.

The staffing requirements are expected to be implemented by Jan. 1, 2002, following the development of specific regulations by the California Department of Health Services.

“This is a signal that nurses’ and health care consumers’ concerns over nurse staffing have reached critical mass, “ ANA President Beverly L. Malone, PhD, RN, FAAN.

The issue of appropriate hospital staffing has definitely resonated beyond California’s borders.

“AB 394 has drawn nation attention to the impact of hospitals’ financial pressures on the providers closest to the patients — nurses,” said Marian Lowe, ANA\California executive director, who’s been flooded with calls form nurses, regulators and patient advocate from across the country following the governor’s action. “Crafting these (RN staffing) regulations will provide a forum for nurses to showcase their vital contribution to patient care to both consumers and the decision-makers at the local, state and national level.”

Lowe also hopes the new measure will help retain RNs in the profession.

“Too often we hear that nurses are leaving the hospital because they are frustrated by inadequate staffing and the mental and physical stress that accompanies this problem,” Lowe said. “Alleviating this stress and improving job satisfaction is an important benefit of adequate staffing. So we hope this legislation will accomplish all it set out to do.”

To that end, ANA\C plans to have an instrumental role in how the staffing measure is implemented in California hospitals.

Currently, ANA\C is collaborating with nurse executives in an initiative known as the California Nursing Outcomes Coalition (CalNOC), which collects nursing quality outcomes data from more than 50 hospitals in the state. Lowe said that the work of CalNOC will be key to structuring reforms that accurately reflect hospital staffing and quality care.

Although many ANA\C nurses support the new measure, they also have some concerns that they want addressed by state officials responsible for determining the staffing regulations.

Among them is the hope that any ratios established will be a floor, and not a ceiling on hospital staffing. Further, RNs want to ensure that nurses’ experience level and education are considered when establishing minimum ratios, in addition to patient acuity, Lowe said.

And yet another nursing concern involves the potential for unintended effects.

“If a hospital’s experience shows that established ratios are financially and practically untenable, there is nothing to prevent them from closing an entire unit,” Lowe pointed out. “This would work against nurses’ desire to secure patients’ access to health services.”

ANA has long shared similar concerns regarding staffing ratios.

In its 1999 Principles of Nurse Staffing, ANA called for staffing decisions to be made on the basis of three sets of principles: those related to patient care, staff-related issues and institution/organization concerns.

“What the Principles boils down to,” Malone said, “is what should be the obvious - staffing decisions should be based on real patients conditions and real provider competencies. However, there are certainly instances when staffing ratios can serve as a safety net to ensure safe, quality patient care.”

In 1999, 21 staffing-related bills (outside of long term care) have been proposed in 15 states, as of press time. New Mexico passed a $150,000 appropriation to finance a nursing workforce study, and New Hampshire approved a measure that would require hospitals to report on a number of variable, including RNs per beds.

Text of AB 394 and its amendments are available at:

www.leginfo.ca.gov.

ANA ‘s Principles of Nurse Staffing (Pub # 9902AB) is available at (800) 637-0323 and (800) 274-4ANA and ask for PNS-1.

www.nursebooks.org under “nursing administration

www.nursingworld.readroom.stffprnc.htm

 

Source of article The American Nurse Nov/Dec99

SAMPLE TALKING POINTS FOR YOU TO WORK FROM IN DRAFTING YOUR OWN

LETTERS TO YOUR TWO SENATORS AND YOUR

REPRESENTATIVE IN CONGRESS

 

Date

 

The Honorable John Doe

United States Congress

Washington, DC 20515 (for Members of the House of Representatives)

20510 (for Senators)

Re: Medicare Reimbursement For CRNFAs

Dear Representative Doe [ or Dear Senator for letters to Senators]:

First paragraph:

Introduce yourself as an operating room nurse and a constituent.

Explain that you are writing this letter to encourage the legislator to support Medicare Reimbursement for the surgical first assisting services of Certified Registered Nurse First Assistants (CRNFAs).

Define what a CRNFA is and explain that other non-physician provider with less operating room experience and education are being reimbursed for this service. [This can be found in the January & February issue of the Cutting Edge.]

Second paragraph:

Explain your role in the operating room including information on what makes your services unique and how these services, alone, affect patient care.

Provide information on positive outcomes of your work such as a personal experience in which you made a difference or objective information depicting positive results when CRNFAs are used (e.g., a survey showing increased patient satisfaction or decreased costs). [This can be found in the February issue of the Cutting Edge.]

Third paragraph:

Reiterate that you want the legislator to support Medicare reimbursement of CRNFAs.

Invite the legislator to the operating room to observe your work.

Fourth paragraph:

Provide information on how the legislator and the legislator’s staff may contact you.

Offer to be a resource on nursing issues.

Thank the legislator for her or his consideration.

Very truly yours,

Your Name