"super union" not so super!

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Volume 6 • No. 2 April 2010

Med-Force Flight NursingPage 3

Telemedicine: Nursing’sFuture is Now

Pages 6-8

An Official Publication of the Illinois Nurses Association The Voice of Illinois Nursing for more than 100 Years

Quarterly circulation approximately 187,000 to all RNs, LPNs, and Student Nurses in Illinois.

“Super Union” not so SUPER!Since 1901, the Illinois Nurses Association has been the

voice of nursing in Illinois. We represent all nurses regardless of specialty or educational preparation. We have the ear of the Legislature in Springfield and we speak as one united profession. The Association works hard to protect the rights of nurses through education, advocacy and political action. Our advocacy is not limited to only a subsection of nursing. We work on behalf of all nurses regardless of membership status by monitoring all legislation that impacts the profession and health care in general. We are the Illinois NURSES Association and the only organization that has the history and longevity that makes us the “GO TO” resource when nursing issues need to be addressed.

Since the beginning of December INA has been under attack. Your elected leadership has repeatedly asked those who stood in favor of the formation of a so called “SUPER UNION” to lay out guidelines so that INA’s autonomy would be protected. We even asked for mediation but were denied.

No one organization can make all of its members happy at the same time. We welcome the input of our members and are transparent in all that we do. That is both the blessing and the curse of democracy. However, what has been happening lately is not simply members seeking to voice their concerns. An outside force has been feeding this frenzy. The Illinois Nurses Association looks to serve the entire profession, to bring unity to the nurses of Illinois and to have a strong presence that speaks together. Because together we will always be stronger. So as you continue to be exposed and bombarded with messages from NNU (CNA/NNOC) please ask yourself why? What do they have to gain by dividing the nurses of Illinois and the members of the INA.

Why would an organization claiming to have the best interest of the staff nurse and the profession at heart spend so much time and effort dividing the very group they claim to support? How does that help the staff nurse who is working short staffed or working in a hostile or unsafe environment?

They claim to be about nurses and moving the issues of staff nurses forward unless you disagree with or stand against their unilateral actions or decisions, then watch out. Because they attack, tell lies, exaggerate, and plant seeds of doubt in members’ minds.

So if you are asking yourself how did they get access to our members let me explain. Some of these people claiming to want to help the members are individuals who have come to INA’s aid in the past. Some have worked closely with the very members they now seek to discredit.

So if by “SUPER” you mean Subversive, Unethical, Power hungry, Ego-centric and Retaliatory then I guess you have gotten what you asked for.

However, the INA leadership will continue to strive for a super union. But our “SUPER” union will be one with Standards, Unity, Professionalism, Ethics and Respect for all members.

My Involvement In The Crisis Between INA/UAN and NNOC/NNUJudy Hopkins, RN

Colleagues, it is vital to understand how INA and the other coalition of states in the UAN came to be involved in a lawsuit against CNA/NNOC/NNU.

In 2007, the National Labor Assembly of the United American Nurses directed its Executive Board to explore affiliation with other national unions; always with the idea of keeping the identity of the UAN intact.

In early 2009, our E&GW Commission and UAN NLA Delegates were informed that although talks were in progress, the actuality of this ‘superunion’ was about three years away.

By March 2009, our E&GW Commission and UAN NLA Delegates were informed that the formation of this “superunion,” the affiliation of UAN and NNOC, would happen in December 2009.

In May 2009, Sandra Robinson, Elwood Thompson and Susan Swart traveled to DC to a meeting of the National Labor Cabinet. There again Sandra as well as other state leaders asked about the new urgency in the formation of this new union. They expressed their concerns regarding the “provisional” agreement and the unanswered questions from the members.

In mid year, we obtained copies of the newly named

National Nurses United (NNU) Constitution and the affiliation agreement. On inspecting the document, it was readily apparent that there was no place for representation or democracy in the new organization. It would be overseen by Roseann DeMoro of California and California would have the lions’ share of members on the Executive Council. Walt Frederickson, not surprisingly, had the next highest office, again by appointment not a vote, and Minnesota had the next highest number of representatives to that council. Michigan and Massachusetts both had equal representation with the remaining “small states” sharing one representative. Where was the voice of Illinois nurses in this new national nurses union? Muffled.

Our E&GW Commission asked to meet with the Executive Board of the UAN to discuss the continued haste and our concerns regarding the documents we had received. We met in Chicago on September 2, 2009. UAN President, Ann Converso, UAN Executive Director Walt Frederickson, UAN Treasurer Jean Ross, UAN Director Kathleen Gettys (by phone) and UAN Director Carolyn Hietamaki (by phone) were present. Representing INA were: INA Executive Director Susan Y. Swart, RN; INA President Pam Robbins, RN; E&GW Program Director Elwood R. Thompson, Chair of the E&GW Commission Sandra D. Robinson, RN; and me as an E&GW Commissioner. It was obvious from the

behavior of Frederickson and Ross that things at UAN were greatly changed. President Converso had been forbidden to speak her opinion. Ross spoke at length and in platitudes about the need for “getting rid of state boundaries,” for being “one national union.” The arrogance of Frederickson was grating. During the meeting the E&GW Commissioners asked for a revision of the obvious disparity in representation of the executive committee. When we asked for some democracy in the new organization, we were told that “it was done: it could not be changed” because this was the document that California had just approved and Massachusetts had noticed the document to its members.

On September 20, 2009, the National Labor

Cabinet met and was essentially told their concerns had been heard but ignored as it was “too late” to change the language now.

Our E&GW Commission again sought a second meeting with the UAN Executive Board on October 6, 2009. Sandra Fischer, RN and Linda Briggs, RN, joined us as UAN NLA Delegates. We again laid out our concerns as asked for the UAN Executive Council to seek clarification regarding Illinois’ unique position as the only state with two existing affiliates within its borders.

To our reasoning, since we saw nothing of the representation, democracy or methods for redress of the UAN in the new document, it was a dissolution of the UAN, not an affiliation. The UAN as we knew it would be gone with the Special National Labor Assembly (NLA) in November 2009.

We could not affect the vote at the Special NLA because Minnesota and Michigan had a majority of delegates. The only route left to us was to stop a quorum. A majority of member states was needed to conduct any business legally at the NLA. We, the E&GW Commission of the INA, organized a boycott by eleven member states of the UAN. When the final strategy was discussed on a conference call, it was decided that we needed an E&GW member who was NOT a delegate to the NLA, preferably an E&GW Commissioner, who was up to speed with the happenings related to UAN/NNOC/MA/MI/MN. That was me, Judy Hopkins.

I attended the Special NLA in Orlando, Florida in early November 2009, as a member of the UAN from Illinois. As of the opening ceremony, we knew that the coalition of small states had succeeded in defeating the constitutional requirement for a quorum. Accordingly, both President Ann Converso and Vice President Craft, handed over the gavel, refusing to chair an illegal meeting. Jean Ross went on to chair the meeting, leading by “acclamation.” The Parliamentarian stated on the record on more than one occasion, that any business conducted at this meeting would

My Involvement in the Crisis continued on page 4

April 2010 The Illinois Nurse

Through the INA: What Processes Nurses Can Use to Advance and

Promote Their Nursing Profession in Illinois!

Pam Robbins BSN, RNPresident, Illinois Nurses Association

Let’s begin with the largest union of registered professional nurses, the Illinois Nurses Association. Nurses identify problems through investigation, developing remedies based on nursing research as well as other resources and implement solutions through established union processes of Grievance, Nursing Practice Committees and Labor/Management meetings. Union nurses through contract negotiations and grievance resolution fashion binding improvements for their individual workplaces. Many nurses are unaware of the language within their existing contract and are sometimes apathetic to using the process of the union to resolve nursing issues and workplace deficiencies. The contract’s tools should be used by the collective members to improve their work environments. Thank you to all the INA labor leaders and members who fight for the rights of patients and nurses daily through the union process. Your vigilant efforts as nursing leaders improve nurses’ work environments and “define nursing practice” every minute of every day as they deliver care to their patients. The works of INA collective bargaining units have directly and indirectly affected the state with regards to improving nursing workplace environment practices, compensation and benefits. INA union contract language can also be found as stems for state nursing legislation promoting professional nursing for all Illinois nurses.

The other equally important group in any union is the rank and file collective members. The complement of leaders at the table and collective must work together to achieve advancements for nurses. Union nurses should contribute in developing contract language and their elected union nurse negotiators are the spokespersons for the collective and are to be reliable resources communicating often with members. Failing to stay informed on negotiations, casting a vote based on incomplete information or failing to vote does not promote the best interests of the collective in any contract. No one else knows your work environment, the politics, and

President Pamela Robbins, BSN, RN: [email protected] First Vice President Mildred Taylor, BSN, RN: [email protected] Vice President Roosevelt Gallion, M.Ed, BSN, RN: [email protected] Queen Gallien-Patterson, RN: [email protected] Sharon Zandell, RN: [email protected]

Board of Directors: Cheryl Anema: [email protected] Mary Bortolotti, RN: [email protected] Pam Brown: [email protected] Dan Fraczkowski: [email protected] Paula Kagan: [email protected] Karen Kelly, EdD, RN, CNE-BC: [email protected] Pamela J. Para RN, MPH, CPHRM, ARM, FASHRM: [email protected] Ruby P. Reese RN PhD Bonnie Salvetti: [email protected] Gloria Simon: [email protected] Krystal Spivey: [email protected] Joe Williams: [email protected] Terri L. Williams RN: [email protected]

District Presidents 1 Roosevelt Gallion: [email protected] 2 Mary Bortolotti: [email protected] 3 Sharon Peterson: [email protected] 5 Royanne Shultz: [email protected] 8 Ann O’Sullivan: [email protected] 9 Terri Williams: [email protected] 10 Jane Bruker: [email protected] 13 Janet Lynch: [email protected] 14 Martha McDonald: [email protected] 15 Eunice Mumm: [email protected] 17 Ann Smith: [email protected] 18 Acting President Alma Labunski: [email protected] 20 Cheryl Anema: [email protected] 21 Sandra Webb Booker: [email protected]

E & GW Commission Sandra D. Robinson, Chair: [email protected] Linda Briggs: [email protected] Nicola Carter: [email protected] Sandy Fischer: [email protected] LaGretta Green: [email protected] Judith K. Hopkins: [email protected] Thomas Magana: [email protected]

Virginia Rockett: [email protected] Christine H. Szkarlat: [email protected]

Local Unit Chairpersons/Co-Chairs City of Chicago: Timothy Hudson RC-23 State of Illinois: Lee Goehl Co-Chair Bill Schubert St. Joseph: Marlene Murphy and Chris Daly Union Health Services: Sophie Heldak University of Chicago: Karen Keller and Tom Magana University of Illinois: Marcia Hymon (D20), Leo Sherman VA Hines: Gail Robinson Christine Szkarlat (D9) VA North Chicago: Thelma Fuentes VA Westside: Murrie Davis (D01)

IllInoIs nurses AssocIAtIonPresident’s Message

Pam Robbins

the circumstances of your institution better than you. Stay informed to the process and tenure of your union negotiations, it is your responsibility. Ask questions! Vote responsibly! Previous contracts negotiated by local bargaining unit leadership supported by the rank and file are the building blocks of future contracts. No negotiations are conducted in a vacuum. It is a blend of union nurse leadership and the collective working together to embrace their roles in achieving a fair contract resolution despite distracting and divisive strategies from inside and/or outside of the collective.

For those who are saying to yourself “well I am not a union member and I see no benefit to joining this organization,” know that the union is but one process to advocacy for nurses, the profession and patient safety. INA provides resource and professional nurse networking as the largest and longest standing group of Illinois nurses. INA collaborates with other healthcare stakeholders including the two other state nursing professional organizations, the Illinois Association of Nurse Anesthetists and the Illinois Society of Advanced Practice Nurses. Our three organizations have worked well together improving Illinois nursing regulation including the Nurse Practice Act. Who better to speak for Illinois nurses than the organizations that represent Illinois nurses! INA members benefit from connections with the national American Nurses Association (ANA), and other state affiliate nursing organizations. Recognize you, the nurse, are key to activating any process!

Nurses in Illinois, organized or not, move their agendas of advancing the profession and patient safety forward through legislative process with the INA! I believe in appreciating every nurse’s individualized educational level, special skills and abilities but I also celebrate our similarities and embrace the collective mindset to achieve advancements for all nurses and their work environments via legislation. INA, the state’s professional organization for over 100 years, includes programs such as Government Relations which move INA members’ legislative agenda forward in Springfield. INA fashions nursing legislation and uses grassroots lobbying of nurses to educate themselves, the public, and legislators. The objective is for the General Assembly to successfully pass nursing and patient safety strategies into law. Such INA efforts include Staffing by Acuity (PA 095-0401), No Mandatory Overtime (PA 094-0349) in the private sector and the Ambulatory Surgical Treatment Center Act amendment that requires only an RN is qualified to be the Circulator in the Operating Room (PA 094-0915). INA legislation is member driven and addresses the issues of Illinois nurses. INA is continually vigilant, with our full time lobbyist in Springfield, as a watchdog whenever regulations concerning professional nursing practice issues arise. INA’s Commission on Workforce Advocacy educates nurses on strategies to deal with issues found in every work environment. Another INA committee, the Congress on Health Policy and Practice engages in evaluating the relevant scientific social and educational development and changes in health needs and practices with reference to their implications for nursing in all of its functional roles, clinical specialties and settings. Thank you to all the INA members and our collaborators who work on behalf of advancing the profession in Illinois and as state and national leaders promoting nursing for Illinois!

INA continues to be the choice for all registered nurses in Illinois. INA is not pigeonholed into serving only specific kinds of workplace issues, union or non-union, but rather identifies the needs of nurses wherever they practice. The nursing profession collectively needs all

of us to advance the profession utilizing our individual nursing talents. It is up to you to engage in collective power whether or not you are in a bargaining unit, presenting a new policy or practice in your individual work environment or participating in a statewide legislation grassroots campaign—all efforts should go to promoting safer healthcare delivery systems. Realize every positive action promotes nursing for every one of us. Being a member of the Illinois Nurses Association affords educational opportunities (CE’s are now required for licensure renewal) and as your knowledge grows this can be cultivated in your own work environment via policy and practice improvements! You are the key! INA will continue to represent our members and promote the practice as the largest registered nursing organization in Illinois as a democratic member-driven organization.Consider joining the INA, and through proven processes, move your agenda for nursing forward!

The Illinois Nurse April 2010

Illinois Nurses Association/Illinois Nurses Foundation

105 W. Adams, Suite 2101 911 S. Second Street Chicago, IL 60603 Springfield, IL 62704 312/419-2900 217/523-0783 Fax: 312/419-2920 Fax: 217/523-0838

www.illinoisnurses.com

Executive Director: Susan Swart, MS, RN: Ext. 229, [email protected] Financial Officer: Rick Roche: Ext. 230, [email protected] Director, EGW: Elwood R. Thompson: Ext. 228, [email protected] Executive Director: Sharon Canariato, MSN, MBA, RN, Ext. 235 [email protected] of Marketing and Member Services: Deb Weiderman, MS, RN, Ext. 232 [email protected] Director, Continuing Education: Kemi Ani, Ext. 240 [email protected]&GW Staff Attorney: Alice Johnson, Ext. 239, [email protected]&GW Staff Specialists: Rick Lezu, 217-523-0783 [email protected] Ray Scavone, Ext. 245, [email protected] Pam Brunton, Ext. 224 [email protected] Abass Wane, Ext. 249 [email protected]&GW Coordinator: Rhonda Perkins, Ext. 223 [email protected], Springfield Staci Moore, 217-523-0783 [email protected] Accountant: Toni Fox, Ext. 243 [email protected] Assistant: Brenda Richardson, Ext. 248 [email protected] Melinda Sweeney, Ext. 222 [email protected]

Editorial Committee Theresa Adelman, RN Cheryl Anema, PhD, RN Margaret Kraft, RN, PhD Alma Labunski, EdD, MS, RN, Chair Linda Olson, PhD, RN Lisa Anderson Shaw DPH, MA, MSN Mary Shoemaker, PhD, BS, MS, RN

The Illinois Nurse is published quarterly (4 issues yearly) by the Illinois Nurses Association, 105 W. Adams, Suite 2101, Chicago, IL 60603.

For advertising rates and information, please contact Arthur L. Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216, Cedar Falls, Iowa 50613, (800) 626-4081, [email protected]. INA and the Arthur L. Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement.

Acceptance of advertising does not imply endorsement or approval by the Illinois Nurses Association of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. INA and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of INA or those of the national or local associations.

IllInoIs nurses AssocIAtIon Med-Force Flight Nursingby Bonnie Guerra, RN, CFRN

Flight nursing requires solid experience, education, and skill. Flight programs require nurses have a minimum of 3-5 years of emergency or critical care experience. In addition to the educational preparation for professional nursing, the Med-Force flight nurses are required to maintain numerous advanced certifications. These advanced certifications are Advanced Cardiac Life Support, Basic Cardiac Life Support, Pediatric Advanced Life Support, Neonatal Resuscitation Program, Trauma Nursing Core Course, and Prehospital Trauma Life Support. Additional educational opportunities are gained at conferences, classes, and courses. Flight nurses are trained to independently perform advanced critical care procedures such as intraosseous needle placement, Rapid Sequence Intubation (RSI), needle chest thoracentesis, airway management, and cricothyrotomy. Members of the Med-Force flight crew also provide Landing Zone and safety training to local services. This preparation is necessary for the level of responsibility and autonomy inherent to this specialized role.

An important role of the flight nurse is to implement orders from medical control and execute set protocols for care. Even within this structure, the work of the flight

nurse is autonomous. The flight nurse is responsible for decisions about medications, treatments, and specialized nursing care rendered for a variety of clients in a wide array of situations. The flight nurse is challenged to prepare for the unpredictable. While in these situations, the focus is to make decisions that affect the best possible outcome and improve the patient’s condition.

One day we were called to an industrial accident for a seriously burned worker. We were on the scene within minutes. I will never forget the look of fear in his eyes and obvious pain he was experiencing. We gave reassurance, and began the work of stabilization. My partner and I exchanged looks and knew what needed to be done. An intravenous line (IV) was established and RSI performed to protect the patient’s jeopardized airway. We then loaded the patient into the helicopter for transport to a Level I trauma center with a burn center. In route, the patient was placed on the aircraft ventilator, a second IV started, pain medication

given, and sedation maintained. Parkland formula was calculated and fluid resuscitation initiated. We arrived at the trauma center within the “golden hour” (the time after a severe injury where prompt medical intervention can save lives). It was rewarding to know that we were meeting our goals of improving patient comfort, condition, and outcome using our experience, knowledge, and skills.


need to be ratified by the next NLA in March 2010. Having removed everyone except delegates and UAN members, the mood of the group in the hall was mob-like. They dismissed the UAN constitution in the morning when a quorum was required but clung to it in the afternoon when they wanted to impeach Ann Converso, Joan Craft and Kathleen Gettys.

While I furiously took notes at each meeting of the Special NLA, behind the scenes, INA leadership was conferring with the leadership of the coalition states strategizing. Accordingly, it was decided to firstly pursue an injunction, along with a temporary restraining order, to stop the founding convention of the NNU in December 2009. At this point, the constitution had been written, top officers assigned and VPs had been elected. All this had occurred but had not been legitimized at a legal NLA. The temporary restraining order was denied because CNA was able to convince the judge that what had happened was an AFFILIATION and not a DISSOLUTION. However, our legal request for an injunction was not dismissed. The latest motions filed in court by CNA replacing the UAN attorneys with CNA attorneys state that it is a DISSOLUTION!

It has been our contention since the beginning that this was not an affiliation of two equal bodies into one “superunion” but rather a hostile takeover of our UAN by NNOC, aided by principals from Minnesota and Michigan. Our UAN constitution had language related to dissolution in which all its assets were to be returned to the members. Is it not clear why NNOC did NOT want this viewed as a dissolution? NNOC/CAN covets our AFL/CIO seat, our national professional reputation, our members and our money.

It is imperative for the future of not only our E&GW program but ALL of INA that we fight this illegal dissolution of our UAN with every tool at our disposal and every ounce of our perseverance. We need to stand united and fight the menace to professional nursing in Illinois that is NNOC.

You may have received confusing messages from members questioning the replies from Susan Swart and Elwood Thompson to questions sent concerning this situation. I believe that the messages from these members are misconstruing the answers provided by INA staff members:

The information requested in the letter dated January 11, 2010 is available to you as an INA member. As has been the INA policy, it is available at the INA office. There have been attempts by people from California and Texas to infiltrate our teleconferences: to put this info on the Internet or blast it out as unsafe. Period. As to the votes of the E&GW Commission, votes are not recorded individually but rather pass/fail. This is not a new procedure with “this new INA.”

One comment implied that INA staff members or elected leaders were taking advantage of member dues dollars. What lifestyle are “they enjoying” that INA members are supporting? This remark is baseless and a slur on the integrity of the Association.

This lawsuit (to follow the language of the UAN constitution for votes, dissolution et cetera) is being financed—as was re-iterated ad infinitum on the last E&GW conference call—not only by a line item on the INA budget, but also by a consortium of the “smaller states.” The elected officers of the E&GW Commission were involved in the subsequent decisions related to the UAN. E&GW Commissioners and elected UAN delegates were invited to the two meetings involving members of the Executive Board of the UAN prior to the NLA in November, 2009. As I mentioned earlier in this report, it became clear at the second meeting that their (Frederickson and Ross) decisions had already been finalized regarding UAN, and that according to the constitution of the new NNU, INA had no voice and no recourse for disagreements. California controlled the new organization and since we are the only state in the UAN with firsthand experience with CNA, we knew we had to act decisively. The only legitimate avenue open to us to stop the dissolution of the UAN. Though logistically daunting, this was accomplished.

Personally, I believe that the lawsuit needs to go forward as the NNU has no place for any voice other than California, Michigan and Minnesota. If you look at the NNU constitution, you will see that.

As for the University of Chicago Medical Center, one of the members questioning the INA response message says “no one should be forced to accept a contract that ends up with them making less than they do now.” I agree. My understanding is that this contract calls for raises in each of the three years as well as a bonus in year three for the nurses at the top of the scale, with no take backs by management.

I hope this helps clarify our situation.I remain in solidarity.

My Involvement in the Crisis continued from page 1

Practice CornerIllinois Nurses Association Embraces

Social Mediaby Sharon Canariato

In an effort to bring Illinois nurses together, INA has recently created group profiles on the social networking venues of Facebook, LinkedIn and Nurses Lounge! With the development of online networks, the ability to network professionally and to stay connected has become easier than ever. Joining one or all of INA’s groups will help nurses keep current on news, information and events, while expanding opportunities to create new connections.

According to Wikipedia, a social network service focuses on building and reflecting social relations among people who share similar interests and/or activities. Essentially a social network grows by connecting people to others while developing a social bond. Recent studies have stated that the 35 to 54 year old age group is the fastest growing segment of social networking users.

Facebook was started in 2004 by four Harvard University students and has grown to 400 million subscribers. You can use your homepage to tell people about your work, school or recreational activities. You can upload pictures and videos and your friends can leave public or private messages. LinkedIn is the premier business-only social networking site. It allows people

to link to others in the professional community. This site is helpful to network professionally, search for job opportunities, and research companies. LinkedIn has 60 million subscribers. Nurses Lounge is a relatively new networking site. Unlike larger social networking sites, Nurses Lounge is a professional site where nurses can network in a professional environment and maintain privacy. 45% of the members have advance degrees or are nurse executives.

While social networking is obviously popular, what would be the benefit to join INA’s online group? Social networking allows nurses to interact in “real time.” Newsworthy information can be disseminated quickly through these websites. The need for communication in health care and among nurses has never been greater. Information would essentially be at your fingertips by joining our group. The group sites or fan pages are the place to go to stay informed by reading posts, communicating on issues and collaborating on projects. Visiting these sites will also keep you up to date on upcoming events that are important to the association. While INA’s pages are new, there is a strong impetus to enhance these pages. With the addition of Deb “the intern” Weiderman to our staff, these pages will flourish under her watch. Our goal is to provide current and relevant information in a timely manner to the nurses of Illinois.

I believe social networking will have a great impact on society, why not use it to benefit professional nurses?

Look for us in Facebook Groups at Facebook.com and to join our Nurses Lounge go to: http://community.nurseslounge.com/join/illinoisnurse

Sharon Canariato


On February 11, 2010 it took the jury less than an hour to return a not guilty verdict for Anne Mitchell, RN, defendant in the criminal trial that has come to be known as the “Winkler County nurses” trial. Mitchell faced a third-degree felony charge in Texas of “misuse of official information,” for reporting a physician to the Texas Medical Board for what she believed was unsafe patient care. Mitchell is a member of the Texas Nurses Association (TNA) and the American Nurses Association (ANA).

“We are very pleased about the not guilty verdict and that justice prevailed for Anne Mitchell,” stated Susy Sportsman, PhD, RN, president of TNA. “If anything was to be gained from the absurdity of this criminal trial, it is the reaffirmation that a nurse’s duty to advocate for the health and safety of patients supersedes all else.”

As the nations’ largest nursing association, ANA joined forces with TNA, one of its constituent member associations, in July of 2009 to strongly criticize and raise the alarm about the criminal charges and the fact that the results from this case could have a lasting and negative impact on future nurse whistle blowers. “ANA is relieved and satisfied that Anne Mitchell (RN) was vindicated and found not guilty on these outrageous criminal charges—today’s verdict is a resounding win on behalf of patient safety in the U.S. Nurses play a critical, duty-bound role in acting as patient safety watch guards in our nation’s health care system. The message the jury sent is clear: the freedom for nurses to report a physician’s unsafe medical practices is non-negotiable,” said ANA President Rebecca M. Patton, RN, MSN, CNOR. “However, ANA remains shocked and deeply disappointed that this sort

PNAI, Inc. Celebrates 53rd Anniversary with Inauguration

and Dinner Ballby Gloria O. Simon, RN, BSN, MEd

The Philippine Nurses Association, Inc. ( PNAI, Inc.) celebrated its 53rd anniversary with inauguration and dinner ball that was held January 22, 2010 at the Mirage, Four points Sheraton Hotel, Schiller Park, Illinois.

The Nomination and Election Committee, consisting of past presidents, Chaired by Gloria O. Simon, Co-chaired by Dionisia Battung and Thelma Fuentes, introduced the newly elected officers and members of the Board of Directors of 2009-2011. The induction and affirmation was performed by vice consul Bernardo of the Philippine Consulate.

In the 1950s foreign nurses came to the United States in the Exchange Nurse program. In 1957 Filipino nurses in Chicago formed the Filipino Nurses Association of Chicago (FNAC) and elected Adela Campos as its first president. Due to the transient nature of the Exchange Nurse Program, there were few years when there was activity. Fortunately Tam Kennedy revived it as the Filipino Nightingales of Chicago but later renamed it as the Filipino Nurses Association of Chicago. In 1966, when Emma Nemivant became president she renamed it Philippine Nurses Association of Chicago and maintained a chapter with the mother association, the Philippine Nurses Association, Manila, Philippines. On August 7, 1993 during Dionia Battung’s administration, the name was changed to the Philippine Nurses Association of Illinois to convey statewide inclusion, not just those nurses in the metropolitan Chicago area. It also obtained its incorporation and continues to the present as the Philippine Nurses Association of Illinois, Inc. the official nursing professional association representing the Filipino nurses in the state of Illinois. In 1977, the association became independent from the mother association, Philippine Nurses Association of the Philippines.

Gloria Simon

Not Guilty—Texas Jury AcquitsWinkler County Nurse

of blatant retaliation was allowed to take place and reach the trial stage—a different outcome could have endangered patient safety across the U.S., having a potential chilling effect that would make nurses think twice before reporting shoddy medical practice. Nurse whistle blowers should never be fired and criminally charged for reporting questionable medical care.”

“I was just doing my job,” relayed a jubilant Anne Mitchell, in a phone conversation with TNA immediately following the not guilty verdict, “but no one should have to go through this,” she said. “I would say to every nurse, if you witness bad care, you have a duty to your patient to report it, no matter the personal ramifications. This whole ordeal was really about patient care.”

Over $45,000 has been donated so far by individuals and organizations across the country to the TNA Legal Defense Fund as a way to support the defense of Anne Mitchell and former co-defendant Vicki Galle. “We didn’t have any support—emotional or financial—until TNA and ANA stepped in,” said Vicki Galle, RN, who also attended the trial in Andrews even though the prosecution had dismissed her indictment on February 1 as a co-defendant. “We could never have gotten through this without nursing’s support.”

The Illinois Nurse Practice Act states that nurses must report unsafe, unethical, or illegal health care practice or conditions to appropriate authorities (Section 1300.42, #10) and cannot be retaliated against (Section 50-50, #17).


Telemedicine: Nursing’s Future is Nowby Pamela J. Para

RN, MPH, CPHRM, ARM, FASHRM

CE OFFERING1.0 CONTACT HOURS---------------------------This offering expires in 2 years:February, 2012----------------------------------The goal of this continuing education offering is to provide information on Telemedicine and its implications to nursing practice.

The objectives of this article are:1. Define telemedicine2. Describe aspects of nursing involvement in

telemedicine3. Analyze telemedicine as a strategy/tool for

healthcare reform

In an age of technology and change, telemedicine presents a clear illustration of the benefits of combining new technological features with quality and business concepts, towards the advancement of healthcare delivery. A recently released report shows that technologically advanced hospitals, for example, have greater potential to improve processes and outcomes in patient care, reduce medical errors, increase productivity, and compete for market share against other hospitals. Telehealth technology has reduced hospitalizations and states’ Medicaid costs.1 There is no time like the present to incorporate telemedicine into discussions addressing the national focus on taming health care costs and improving the quality of care.

Telemedicine has been defined as the use of telecommunication technologies such as the Internet and videoconferencing to bridge geographic gaps and improve health care delivery2, or “the direct provision of clinical care via telecommunications—diagnosing, treating or following up with a patient at a distance.”3 It might be as simple as two health professionals discussing a case over the telephone, or as sophisticated as using satellite technology to broadcast a consultation between two facilities in two countries using videoconferencing equipment. The American Medical Association (AMA)’s Council on Medical Education and Medical Services defines telemedicine as “the provision of health care consultation and education using telecommunications networks to communicate information, and also as medical practice across distance via telecommunications and interactive video technology. The Institute of Medicine (IOM)’s Committee on Telemedicine defines telemedicine

as “the use of electronic information and communications technologies to provide and support health care when distance separates the participants.”4 The Department of Health and Human Services (DHHS) defines telemedicine as “the use of telecommunications technology for medical, diagnostic, monitoring, and therapeutic purposes when distance and/or time separates the participants.”5 The Centers for Medicare & Medicaid Services (CMS) defines telemedicine as “the use of medical information exchanged from one site to another via electronic communications to improve a patient’s health.” The Joint Commission uses the American Telemedicine Association (ATA)’s definition of telemedicine as “the use of medical information exchanged from one site to another via electronic communication for the health and education of the patient or health care provider and for the purpose of improving patient care, treatment, and services.”6

Telehealth is the term of preference by the American Nurses Association (ANA) for being more inclusive than one predicated on solely a medical model. The ANA strongly believes that the strength and promise of telehealth lie in providing increased access to health care services by augmenting existing services, not in replacing them. Telehealth is an umbrella term to describe all variations of health care using telecommunications.7 While telemedicine and telehealth are terms used interchangeably in legal and regulatory discussions, depending on the context, they always refer to the practice of using electronic technology to provide patient care over distance.

Telemedicine is a factor in diverse health care environments. In acute care settings, telemedicine is being adapted for use in surgery, trauma and critical care, telementoring and teaching, and in developing multimedia learning modules and Internet applications for international teaching.8 Telehomecare is the use of advanced telecommunication technologies and monitoring devices to enable audio and video interaction of patients at home with nurses and other care providers at the medical site, and the collection and monitoring of physiological data assessed at the patient’s home with portable devices.9 By 2015, the home is expected to be the hub of care.10 Home-based equipment will connect a patient at home to the doctor, who can monitor vital signs and other health care metrics. A baseline analysis by the Health Resources and Services Administration (HRSA)’s Office of Advancement of Telehealth of nineteen rural telemedicine grantees showed that many would have no access to adult psychiatric services, pediatric psychiatric services, dermatologist services, neurological services, specialized wound care consultations, and genetic counseling if telemedicine services had not been provided by the grantees. The Department of Veteran Affairs has engaged in telehealth in thirty-two different clinical areas, with main emphases on home telehealth, teledermatology, telemental health,

telepathology, telerehabilitation, teleretinal imaging, and telesurgery.11 Leading clinical applications in Indian health include teleradiology, teleretinal screening, teledermatology, telemental health, and telecardiology.12

According to the Online Journal of Issues in Nursing, the three areas of greatest interest to nurses with regard to telemedicine include:

1) Telephone practice/telephone triage/call center nursing;

2) Care using two-way interactive video (especially home care); and

3) Care using high tech equipment (primarily in military settings).13

A Kaiser Permanente study of telehealth nursing showed cost savings, positive health outcomes, and unexpectedly high patient satisfaction, especially in the elderly community, resulting from the use of telehealth care.

The concept of telemedicine was recorded as far back as 1924, when radio news foretold interactive video conferencing. Television was invented in 1927. Teleradiology was created in the 1950s, and two-way interactive television was available for neurological exams. There was satellite transmission of surgery to replace an aortic valve between Texas and Switzerland in 1965. Voice radio transmission of EKG information occurred between the fire department and the hospital in 1967. A hospital television cable transmitted information to nurse practitioners providing primary care at a distant clinic in 1972. In the 1990s, there were advances such as fiber optics, satellite communication, and compressed video, which minimized the technological and financial barriers that impeded the growth of telemedicine in the 1980s. Recent legislative efforts have included House Ways and Means Committee approval of several telehealth-related provisions as part of broader national health care legislation (i.e., carrying credentials across state lines, Medicare coverage of telehealth services for stand-alone dialysis centers). Telemedicine has been highlighted as a tool for homeland security, as well as healthcare reform through effective health information technology systems to improve care and lower costs. Today, robots make rounds, monitor intensive care units, respond to emergency calls, courier supplies and equipment, dispense medications, perform less invasive procedures, and serve as simulators for healthcare education. Live broadcasts of surgical procedures are conducted through video teleconferencing. Picture-archiving communications systems (PACS) provide real-time images through CT, MRI, ultrasound, angiography, nuclear medicine, and cardiology.14 The eICU® is a remote, centralized, intensivist-led care team that uses enabling technology to continuously monitor, assess, and intervene on patients in support of on-site

Continuing Education Offering

Telemedicine continued on page 7


caregivers.15 Exer-games, such as the Wii Fit, engage consumer involvement in transforming the health care system by improving health outcomes.

Telemedicine safety and standards have taken on greater importance in recent years. The nursing profession has risen to meet this need. Nursing practice standards related to telemedicine include:

• The American Academy of Ambulatory Care Nursing (AAACN)

Telehealth Nursing Practice and Administration Standards

Telephone Nursing Practice Core Course Manual (2001)

• The American Nurses Association Core Principles on Telehealth (1999) Competencies for Telehealth Technologies in

Nursing (1999) Developing Telehealth Protocols: A Blueprint

for Success (2001).These standards are particularly useful for nurses

entering telehealth practice, since they reflect extensive analysis of the role of nurses in this emerging area of practice. Nurses with expertise in this area of practice have identified the appropriate competencies for utilizing telepractice to augment patient care and enhance patient outcomes.

Other telemedicine standards and guidelines of significance include:

• American Telemedicine Association (ATA) Home Telehealth Clinical Guidelines Telehealth Practice Recommendations for

Diabetic Retinopathy Practice Guidelines for Teledermatology Core Standards for Telemedicine Operations Clinical Guidelines for Telepathology

• American Psychological Association (APA) Clinical Telepsychology Guidelines and

Statement on Services by Telephone• American Dermatology Association

Clinical Protocols for Teledermatology• Society of American Gastrointestinal and Endoscopic

Surgeons Guidelines for the Surgical Practice of

Telemedicine• American College of Radiology

Standards for Teleradiology Digital Imaging and Communication in

Medicine Standards• American Medical Association

Guidelines for Physician-Patient Online Communications

• Food and Drug Administration Guidances Related to Telemedicine

• American Heart Association and American Stroke Association

Collaborated on scientific statement offering evidence-based recommendations for using telemedicine in stroke care and allowing remote neurologists to examine stroke patients using telemedicine tools such as videoconferencing.16

Since states have the authority to regulate activities and license health professionals at the state level, the different licensure requirements must be untangled in order for telemedicine to expand services and improve access to care (which is ultimately up to Congress). For nurses, the National Council of State Boards of Nursing (NCSBN) model of nurse licensure allows a nurse to have one license (in the nurse’s state of residency) and to practice in other states (both physically and electronically), subject to each state’s practice law and regulation. To achieve mutual recognition, each state must enact legislation authorizing the Nurse Licensure Compact; adopting administrative rules and regulations for implementation of the Compact; designating a Nurse Licensure Compact Administrator to coordinate implementation of the Compact; and including Registered Nurses and Licensed Practical or Licensed Vocational Nurses. In 2002, the NCSBN Delegate Assembly approved the adoption of model language for a licensure compact for Advanced Practice Registered Nurses (APRNs). Only those states that have adopted the Registered Nurse (RN) and Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) Nurse Licensure Compact may implement a Compact for APRNs, which offers states the mechanism for mutually recognizing APRN licenses/authority to practice. The final rule is still being written for the APRN Compact, and no date has been set for implementation yet. Compact endorsements in support of the Nurse Licensure Compact include state nursing associations, the American

Organization of Nurse Executives (AONE), state hospital associations, American Association of Occupational Health Nurses (AAOHN), the U.S. Department of Commerce, The Center for Telemedicine Law, The Telehealth Leadership Council, and the Citizens Advocacy Center (CAC). To date, twenty-three states have enacted the Compact (Illinois has not).

The regulatory influence on telemedicine serves multiple purposes in facilitating this unique area of practice. Agencies and accrediting organizations with an interest in telemedicine include, but are not limited to: 1) The Centers for Medicare & Medicaid Services (CMS); 2) The Food and Drug Administration (FDA); 3) The Joint Commission; 4) The Agency for Healthcare Research and Quality (AHRQ); and 5) The Department of Health and Human Services (DHHS). CMS considers Medicare beneficiaries eligible for telehealth services if they are presented from an originating site that is located in a rural health professional shortage area or in a county outside of a Metropolitan Statistical Area. Entities participating in a federal telemedicine demonstration project approved by DHHS as of December 31, 2000 also qualify as originating sites regardless of geographic location. Real-time interactive audio and video are conditions of payment (rather than store-and-forward technology, which is only eligible in Alaska or Hawaii). The FDA plays a critical regulatory role in ensuring the safety and effectiveness of telemedicine medical devices and software, with the Center for Devices and Radiological Health (CDRH) acting as lead agency. The Joint Commission’s “New and Revised 2009 Accreditation Requirements” include the telemedicine standard focusing on credentialing and privileging processes for licensed independent practitioners who are responsible for the care, treatment, and services of the patient via telemedicine link at the originating site only. Telemedicine does not fulfill the in-person requirement for the evaluation by a licensed independent practitioner of the individual in restraint or seclusion.17 AHRQ releases evidence reports on what types of telemedicine services are more strongly supported by scientific evidence and for which settings. The overall focus of the DHHS is to expand access to quality health care through the use of telecommunications and information technologies.18

Since the advent of nursing care over distance, Boards of Nursing have been receiving calls about licensure, liability, and other legal issues, especially when the nurse and patient are in different states. Questions have arisen about whether nursing care provided electronically over distance actually constitutes the practice of nursing. The Boards of Nursing have determined that nursing practice occurs at the point that a nurse utilizes the knowledge, skill, judgment, and critical thinking that is inherent in nursing education and that is authorized through the nursing license.19

From a patient safety perspective, technical safeguards should include audit trails for accessed data, cryptography, token-based or biometric message authentication, personal identification, and user verification. Patient/caregiver responsibility for compliance with equipment and technology must be considered, with attention to verifying understanding of any instructions given. Staff training should include orientation and ongoing competencies regarding telemedicine technologies and applications particular to the staff members’ roles and responsibilities. Telemedicine providers must ensure that equipment is satisfactory and subject to routine inspection, preventive maintenance, and any necessary software upgrades. Maintenance and security of patient information must be preserved. All practitioners involved in cyber-partnerships must be credentialed through the same process as if they were practicing on-site, or in accordance with state laws and statutes. Informed consent should address the risks of the care to be administered and any risks presented because the care is being delivered via telemedicine.

Telemedicine can be utilized for multiple purposes. First of all, access to services is enhanced through connections to specialists, portability, virtuality and mobility. Through its efficiency, there is increasing potential to reduce health care costs for patients, providers, payers, and the health care system at large. Telemedicine can improve outcomes by engaging consumer involvement and deeper knowledge of healthy behavior. Finally, telemedicine can be a viable means of addressing increasing workforce shortages. Care can be improved with the appropriate use of technology, and it is technology that will likely give nurses more time to do “nursing.”

Through nursing’s partnership with telemedicine, there is opportunity for “restructuring” the American health care system together. Nursing call centers continue to proliferate and provide telephone triage, health information and referral services. Home care services are being

supplemented with two-way interactive video encounters with patients. Nurses are involved in distance surgery and virtual diagnostics. Nurses also lead and participate in discussions and decision-making about well-established safeguards and monitoring mechanisms for telemedicine technology.

The time to redesign and improve health care delivery has arrived. Technology can be used as a tool that will allow patients and nurses more choices. Collaboration and coordination with regulatory and accrediting bodies is essential. Nurses can upgrade skills and competencies, thereby presenting employment options beyond traditional roles. Training programs in nursing and medical schools need to prepare a “new” workforce. The ANA is committed to the use of telemedicine/telehealth in a manner that enhances access to quality, affordable health care services. This is nursing’s window of opportunity to work with others to enhance healthcare services, participate in information sharing, and improve how care is delivered.

Pamela J. Para is a Nurse Consultant in the Non-Long Term Care Certification & Enforcement Branch, Division of Survey & Certification, Chicago Regional Office, Centers for Medicare & Medicaid Services. The author acknowledges Jossey-Bass, A Wiley Imprint, for permission to use content written by this author for publication in the Risk Management Handbook for Health Care Organizations, Fifth and Sixth Editions. The views represented in this article do not represent the views of either the Centers for Medicare & Medicaid Services or the United States. The content of this article is the result of the author’s own research.

HOW TO EARNCONTINUING EDUCATION CREDIT

This course is 1.0 Contact Hours

1. Read the Continuing Education Article2. Take the test on the next page3. Complete the entire form

DEADLINEAnswer forms must be postmarked by

February 1, 2012

1. Mail or fax the completed answer form. Include processing fee as follows:

INA members – $7.50Non members – $15.00

Check or money order payable to INA orcredit card information only

MAIL: Illinois Nurses Association Attn: Sharon Canariato 105 W. Adams, Suite 2101 Chicago, IL 60603

FAX: Credit Card Payments Only 312-419-2920

ACHIEVEMENT• To earn 1.0 contact hours of continuing education,

you must achieve a score of 75%• If you do not pass the test, you may take it again

at no additional charge. • Certificates indicating successful completion of

this offering will be emailed to you

ACCREDITATIONIllinois Nurses Association is an approved provider of

continuing nursing education by the Georgia Nurses Association, an accredited

approver by the

American Nurses Credentialing Center’s Commission on Accreditation.

Continuing Education OfferingTelemedicine continued from page 6

Telemedicine continued on page 8


Continuing Education OfferingTest Questions

1) The terms “telemedicine” and “telehealth” can be used interchangeably (True/False).

2) The benefits of telemedicine include all except which one of the following: a. Improved outcomes b. Reducing medical error c. Protecting patients’ rights d. Increasing productivity.

3) Which regulatory entity is responsible for ensuring the safety and effectiveness of telemedicine medical devices and software?

a. The Centers for Medicare & Medicaid Services b. The Food and Drug Administration c. The Agency for Healthcare Research and Quality d. The Department of Health and Human Services.

4) Currently, professional licensure requirements are regulated by the federal government (True/False).

5) Which of the following are patient safety considerations for telemedicine implementation?

a. Staff training and competencies b. Patient/caregiver responsibility c. Equipment maintenance and upgrades d. All of the above.

6) Nurses can partner with telemedicine to “restructure” the health care system by doing all except which of the following?

a. Follow doctors’ orders b. Upgrade skills and competencies c. Collaborate with regulatory and accrediting bodies d. Participate in information sharing.

(Submit entire form below for contact hours)

ANSWER FORM CE #23: Telemedicine: Nursing’s Future is NowPlease circle the appropriate letter

1. True False 2. A B C D

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (Please PRINT clearly)

Name: _____________________________________________________________________________________________________________________________________

Address: ___________________________________________________________________________________________________________________________________

City _____________________________________________________________________: State: ________________ Zip: ___________________________________

Phone: ___________________________________________________________________ Email Address: _________________________________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Evaluation—CE 0210-23 Strongly Agree (5) Strongly Disagree (1)

Learner achievement of objectives:1. Define telemedicine 5 4 3 2 12. Describe aspects of nursing involvement in telemedicine 5 4 3 2 13. Analyze telemedicine as a strategy/tool for healthcare reform 5 4 3 2 1

How many minutes did it take you to read and complete this program? _________________________________________________________________________________

Suggestions for improvement? Future topics? _____________________________________________________________________________________________________

METHOD OF PAYMENT ❑ INA Member ($7.50) INA ID# _______________________________________❑ Non Member ($15.00)

❑ Money Order ❑ Check ❑ VISA ❑Master Card ❑ American Express (note: a fee of $25 will be assessed for any returned checks)

Card account number: ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ Credit card expiration date: ____ ____ / ____ ____

Signature __________________________________________________________________ Date _____________________________________________________

Mail all tests to: INA, Attn: Sharon Canariato, 105 W. Adams, Sute 2101, Chicago, IL 60603

ReferencesThe American Nurses Association. Accessed January 30, 2010 from http://www.nursingworld.orgThe National Council of State Boards of Nursing. AccessedJanuary 30, 2010 from http://www.ncsbn.orgPara, P. (2006). Evolving Risk in Telemedicine, Risk Management Handbook for Health Care Organizations (5th ed.).

Volume 3, San Francisco, California: Jossey Bass, A Wiley Imprint, 3, 369-399.

1 Ranney, D. (2009, August 3). Pilot project shows promise for cutting Medicaid costs. Kansas Health Institute News Service. Accessed January 30, 2010 from http://www.khi.org/news/2009/aug/03/pilot-project-shows-promise-cutting-medicaid-costs/

2 Demeris, G., Patrick, T. B., Mitchell, J. A., and Waldren, S. E. (2004, September). To Telemedically Err Is Human. Joint Commission Journal on Quality and Safety,30(9), 521-527.

3 Brown, N. (2002, May 3, PowerPoint presentation). “What is Telemedicine?”4 Institute of Medicine. (1996). Telemedicine: A Guide to Assessing Telecommunications in Health Care. Accessed

January 30, 2010 from www.nap.edu/readingroom/records/0309055318.html5 Clancy, C.M. “Telemedicine Activities at the Department of Health and Human Services: Before the Subcommittee on

Health Committee on Veterans Affairs, May 18, 2005. [www.ahrq.gov/news/test51805.htm]. Last visited January 30, 2010.

6 Joint Commission on Accreditation of Healthcare Organizations, Hospital Accreditation Standards: MS-39, 2005.7 Brown, op. cit.8 Bloch, C. “Teletrauma: From Myth to Reality.” Federal Telemedicine News, pp. 7-8, May 17, 2005.

9 Demeris et al, op. cit.10 Calvan, B., “Kaiser, UCD labs seek innovations in patient care, costs.” The Sacramento Bee, July 28, 2009. [www.

sacbee.com/140/v-print/story/2060963.html]. Last visited January 30, 2010.11 VHA Telehealth. [www.va.gov/occ/Veteran/Telehealth.asp]. Last visited January 2005.12 Clancy, op. cit.13 Hutcherson, Carolyn M., “Legal Considerations For Nurses Practicing In A Telehealth Setting.” Online Journal of

Issues in Nursing, September 30, 2001. [http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume62001/No3Sept01/LegalConsiderations.aspx]. Last visited January 30, 2010.

14 “Newspapers Examine Emerging Telemedicine Technology.” Kaiser Daily Policy Report. July 6, 2005. [www.kaisernetwork.org/daily_reports/print_report.cfm?DR_ID=31215&dr_cat=3]. Last visited January 30, 2010.

15 Ries, M. et al. “eICU: Critical Care at Advocate in the 21st Century.” PowerPoint presentation, April 8, 2005.16 “American Heart Association Backs Telemedicine for Strokes.” iHealthBeat, California HealthCare Foundation, July 1,

2009. [http://www.ihealthbeat.org/Articles/2009/7/1/American-Heart-Association-Backs-Telemedicine-for-Strokes.aspx]. Last visited January 30, 2010.

17 The Joint Commission. Frequently Asked Questions, November 24, 2008. [http://www.jointcommission.org/AccreditationPrograms/BehavioralHealthCare/Standards/09_FAQs/default.htm]. Last visited January 30, 2010.

18 Clancy, C.M. “Telemedicine Activities at the Department of Health and Human Services: Before the Subcommittee on Health Committee on Veterans Affairs, May 18, 2005. [www.ahrq.gov/news/test51805.htm]. Last visited January 30, 2010.

19 Hutcherson, op. cit.

3. A B C D4. True False

5. A B C D6. A B C D


INA-PACIllinois Nurses Association Political

Action Committee

Nurses want to provide quality care for their patients.The Illinois Nurses’ Association Political Action Committee

(INA-PAC) makes sure Springfi eld gives them the resources to do that. The work of INA-PAC is supported through the generous contributions of its members. In the coming years, some of the most signifi cant nursing issues could be decided legislatively—making it crucial to maintain a powerful position among lawmakers in Springfi eld. Help PAC, help YOU!

So . . . . . . if you think nurses need more visibility . . . . . . . . if you think nurses united can speak more effectively in the

political arena . . . . . . . . if you think involvement in the political process is every

citizen’s responsibility

Become a INA-PAC contributor TODAY!

Make checks payable to INA-PAC.$_____________

Please indicate above your desired level of contribution

Date: ___________________

Name: ______________________________________________________

E-Mail: ______________________________________________________

Address: _____________________________________________________

City, State, Zip Code: __________________________________________

Preferred Phone Number: _______________________________________

Please mail completed form & check to: Illinois Nurses Association Atten: INA-PAC 105 W. Adams St., Suite 2101 Chicago, IL 60603

INA-PACIllinois Nurses Association Political

Action Committee

Nurses want to provide quality care for their patients.The Illinois Nurses’ Association Political Action Committee

(INA-PAC) makes sure Springfi eld gives them the resources to do that.

The work of INA-PAC is supported through the generous contributions of its members. In the coming years, some of the most signifi cant nursing issues could be decided legislatively—making it crucial to maintain a powerful position among lawmakers in Springfi eld. Help PAC, help YOU!

So . . . . . . if you think nurses need more visibility . . . . . . . . if you think nurses united can speak more effectively in the

political arena . . . . . . . . if you think involvement in the political process is every

citizen’s responsibility

Become a INA-PAC contributor TODAY!

Make checks payable to INA-PAC.$_____________

Please indicate above your desired level of contribution

Date: ___________________

Name: ______________________________________________________

E-Mail: ______________________________________________________

Address: _____________________________________________________

City, State, Zip Code: __________________________________________

Preferred Phone Number: _______________________________________

Please mail completed form & check to: Illinois Nurses Association Atten: INA-PAC 105 W. Adams St., Suite 2101 Chicago, IL 60603

INA Member Receives Award for Timely New Book

In the wake of the Haiti disaster it is comforting to know that there are new resources available pertaining to disaster preparedness. Deborah Adelman, INA member, won AJN’s 2009 Book of the Year Award for her textbook titled Disaster Nursing: A Handbook for Practice. The book covers practical as well as essential information regarding disaster preparedness, the role of the nurse as first responder and volunteer, and nurse response in the hospital and community. It also covers treatment of vulnerable populations, legal and ethical issues that may arise, and culturally appropriate care during a disaster. Nurses can use the reality-based scenarios to apply critical thinking and to add to their knowledge base.

If you wish to read the book: Adelman, D. S. and Legg, T. L. (2009). Disaster Nursing: A Handbook for Practice. Sudbury, MA, Jones and Bartlett Publishers.

If you wish to read the article: Book of the Year Awards 2009. (2010, January). American Journal of Nursing110(1), 80-86.

Deborah Adelman


The Evolution of LifeFlight—a Peoria, IL Critically Acute Transport Program

by Afife Halabi, RN, MSHA, MBA, Manager Life Flight, OSF Saint Francis Medical CenterWith Theresa A. Hoadley, PhD, RN, TNS,

Assistant Professor, OSF Saint Francis Medical Center College of Nursing

Life Flight is a hospital based, 24-hour helicopter air-medical transport system at OSF Saint Francis Medical Center in Peoria, Illinois. Since June 1984, the Sisters of the Third Order of St. Francis have led the way in air-medical transport helicopter service in Illinois. Working within a 150-mile radius of OSF Saint Francis Medical Center, Life Flight has transported more than 25,000 patients providing an efficient, immediate, air response system serving hospitals in the North Central Illinois region. Critically ill patients will have the opportunity to be connected with a comprehensive tertiary care facility which offers outstanding medical resources. These medical resources include, but are not limited to: cardiology and cardiovascular, general and plastic surgery, maternal-fetal medicine, neonatal network—level III, neurology and neurosurgery, ophthalmology, orthopedic surgery, radiology including MRI and CT, radiation oncology, regional hemodialysis center, rehabilitation services, surgery, and stroke network. The Children’s Hospital of Illinois at OSF Saint Francis Medical Center provides comprehensive trauma care and tertiary care for children.

Not only can we boast a perfect safety record, our average response time from activation of a transfer request to airborne is 8 minutes. More than 93% of all transports are interfacility transfers between medical facilities, with approximately 7% of the transports being accident scene response requests.

Life Flight is the busiest air medical program in the state of Illinois, averaging over 1400 air transports per year. We operate two state-of-the-art, single pilot, IFR (Instrument Flight Rules) rated, twin engine, model Bell 230 aircraft capable of transporting one patient and three crew members. Each aircraft is powered by two Allison C30 engines, which allow cruising speeds reaching 150 mph and a range of 300 miles without refueling. IFR refers to a set of rules governing the conduct of flight under weather conditions where navigation by Visual Flight Rules (VFR) is no longer reliable. These IFR equipped aircraft enable us to fly safely with the lowest weather minimums allowed by the Federal Aviation Administration. A state-of-the-art cockpit and a transport cabin equipped with a full line of medical equipment contribute to Life Flight’s ability to bring the latest technology to the critically ill or injured patient. On-site maintenance support is available for all major or minor maintenance requirements 24 hours a day.

The real strength of Life Flight, however, is in our teams! The transport team is composed of critical care registered nurses, paramedics, physicians, and respiratory therapists who provide the backbone of the team’s medical care. The primary crew configuration for most transports is comprised of two registered nurses or a registered nurse and paramedic team. As part of their formal training, Emergency Medicine resident physicians accompany the team, learning and experiencing first-hand the unique challenges of the pre-hospital and unstable air environment. Specialty teams for high risk maternal and neonatal transports are utilized and accompany the core Life Flight team on these types of transport requests. This configuration effectively initiates tertiary hospital care directly at the patient’s bedside, whether at the scene of an emergency or at a community hospital. The foundation of our service always has been, and will continue to be, providing excellence in patient care and supporting the Mission of OSF.

With more than 100 hours of continuing education courses and skills labs per crew member per year, our teams provide proficient clinical care to neonatal,

pediatric and adult patients during the transport phase of care. The medical crew receives extensive training in aeromedical patient transport, including specialized skills such as intubation and rapid sequence induction (RSI), surgical airway, needle thoracentesis, pericardiocentesis, intraosseous infusion, and transtrachial jet ventilation.

Many Life Flight medical crew members hold national certifications such as Certified Flight Registered Nurse, Certified Flight Paramedic, Critical Care Emergency Medical Transport Paramedic, and Certified Critical Care Nurse. In addition, the medical crew must maintain currency in the following certification courses: Prehospital Registered Nurse or Emergency Medical Technician—Paramedic; Trauma Nurse Specialist or Trauma Nurse Core Curriculum; Basic Trauma Life Support, Prehospital Trauma Life Support or International Trauma Life Support; Advanced Cardiac Life Support; Pediatric Advanced Life Support or Emergency Nurse Pediatric Core Curriculum; and Neonatal Resuscitation Provider.

The first transfer of a patient by helicopter in central Illinois occurred on January 10, 1967. This flight was also historic in that it was the first transfer of a prematurely delivered infant from one hospital to another by air in this state. The caregiver was one of the Sisters from the Third Order of St. Francis. The helicopter utilized was the Peoria Journal Star Newspaper aircraft, a Hughes 300, which provided two seats, one for the pilot and one for a passenger. The infant was transferred, rapidly and safely, in a small box held on the Sister’s lap. The Journal Star Helicopter continued to facilitate the transfers of premature infants utilizing the Hughes 300 into the early 1970’s. The Illinois Department of Transportation helicopter began assuming the transport role of the increasing transfer requests of the critically ill or injured with its Bell 206 Jet Ranger, then Bell 206 Long Ranger, in the 1970s.

Due to increased need, in June 1984, Life Flight was officially formalized. With a total team comprised of three registered nurses working 24-hour shifts, they became the first dedicated transport nurses for Saint Francis Medical Center. A Bell 206 Long Ranger provided by the Illinois Department of Transportation was maintained off-site at the Peoria Journal Star Newspaper hangar initially, and then relocated to Byerly Aviation at the Greater Peoria Airport. This aircraft was a single engine, single pilot helicopter capable of transporting one patient and two attendants. Because this helicopter was not dedicated entirely to EMS missions, it wasn’t readily available when transfer requests were received.

Recognizing the importance of the transport of the critically injured patient during the first hour following injury, and with increasing numbers of transport requests, Saint Francis Medical Center leased its first fully dedicated helicopter in October 1986, again, a Bell 206 Long Ranger, leased from Omniflight Helicopters based in Janesville, Wisconsin. During this time period, multiple other flight programs were starting throughout the United States.

In October 1989, Life Flight upgraded to a twin-engine helicopter, a Sikorsky S-76, leased from Petroleum Helicopters, Inc. This aircraft was replaced in September 2002 when OSF Aviation, LLC was formed and purchased two Bell 230 aircraft. At that time OSF Healthcare System owned the aircraft, with CJ Systems Aviation Group of Pittsburg, PA, supplying EMS pilots and maintenance crew. Two additional Bell 230 aircraft were acquired in 2006 for future use within the OSF Healthcare System. The Bell 230 helicopter is capable of transporting one patient, three medical crew and one pilot. The aircraft is medically configured and equipped as an ALS (Advanced Life Support) air ambulance so that all aspects of aeromedical transport may be managed by the Life Flight team.

In October and November 2006, OSF Aviation, LLC became the aviation operator for the air medical services to OSF Healthcare System facilities – OSF Saint Francis Medical Center Life Flight and OSF Saint Anthony Medical Center, respectively. The company provides aircraft, pilots, mechanics, and maintenance and aviation management personnel to these air medical programs. In the summer of 2007 a new aeromedical operations center opened at Greater Peoria Regional Airport. The facility houses Life Flight and OSF Aviation operations personnel under one roof.

Life Flight is staffed with eight full time pilots and four mechanics, all OSF Aviation employees. The program currently operates two Bell Model 230 IFR capable aircraft, 24 hours a day. Typical crew configuration for all transport missions is one pilot and two to three medical crew members.

OSF Aviation pilots are required to possess a minimum of 2,000 hours of Pilot in Command time, with a Commercial Helicopter certificate and current instrument rating. All of the pilots at Life Flight hold an Air Transport Pilot (ATP) certificate. The mechanics receive mandatory annual maintenance training to maintain currency with aircraft and maintenance procedures. Aircraft are hangared on-site with capability to perform most major and minor maintenance requirements.

Radio and telephone communications are the framework that binds the components of an EMS system together. The communications system links one emergency health care provider with other members of the emergency

The Evolution of Life Flight continued on page 12


health care team 24 hours a day. The heart of any EMS system is the communications control center. At OSF Life Flight, this department is called Medical Communications, and it is staffed with flight communicator specialists whose minimal training begins at the EMT-basic level with many having obtained NAACS flight communicator certification, the industry standard for specialized training for helicopter emergency medical service dispatch. Their duties include gathering and disseminating pertinent patient and/or equipment needs information, activating transport teams, flight following, and communications with regional facilities and EMS agencies. Computers, sophisticated electronics including GPS satellite navigation tracking, telephones, computerized road and navigational maps, and computerized radio consoles surround the flight communicator specialist. All dispatch and flight following for OSF Life Flight is performed through Medical Communications. Medical Communications fields aeromedical traffic calls for aircraft inbound to OSF Saint Francis Medical Center helipads. Their job is a critical link in the communications between multiple and varied EMS units.

The Association of Air Medical Services (AAMS) estimates that there are nearly 400,000 rotor wing transports annually, with an additional 150,000 patients flown by fixed wing aircraft each year, in the United States only. Patients are flown by fixed wing for many different reasons, ranging from stable patients wishing to relocate closer to family for rehabilitative care to the critical patient requiring specialty services. The fixed wing environment differs from the rotor wing environment primarily in that fixed wing travels farther, faster and higher. The fixed wing is primarily a facility-to-facility transport, typically long distance in nature.

Helicopter emergency medical services are integral to the United States healthcare system for several reasons. The medical crews aboard air ambulances provide more than the advanced life support level medical skills and equipment found on ground ambulances. In addition, they bring the additional skills, equipment and supplies of a tertiary hospital, including more advanced drugs, and more sophisticated critical care medical skills whenever they respond to a community hospital, to the scene of an injury or accident, or to a pre-planned rendezvous point with a ground ambulance. This higher level of care is especially important in rural areas, which may have few advanced life support ground ambulances available.

Air medical transport is beneficial not only because it provides a higher level of medical care to the patient en-route, but also because it provides speedier response and travel times. When treating the critically ill or injured, it is always important to minimize the time spent delivering a patient to a physician’s direct care. Helicopters fly point-to-point, minimizing the distance traveled and avoiding the traffic delays experienced by ground ambulances.

Patients isolated from ground EMS or trauma centers by distance, lack of ambulance-passable roads or by terrain features such as mountains, canyons, forests, and bodies of water, benefit greatly from air medical service. Helicopter EMS is also a timesaving way to avoid urban and suburban traffic congestion.

The top three patient conditions most often associated with helicopter EMS are cardiac conditions (i.e. myocardial infarction), cerebrovascular accidents/strokes, and trauma. Other conditions that may warrant air medical transport include high risk obstetrics, neonatal care, pediatrics, complex surgical and medical conditions including aortic aneurysms, poisoning or overdose, organ transplantation (movement of patients and organs), and respiratory complications requiring ventilator support. At Life Flight, the top three reasons for patient transports are trauma, cardiac and neurological conditions.

Life Flight plays in integral role in the HEART 777 initiative at the OSF Saint Francis Heart Hospital and the BRAIN 333 initiative at the Illinois Neurological Institute at OSF Saint Francis Medical Center. The Heart 777 Program is a regional response team that quickly brings lifesaving treatment for heart attack victims and has saved lives of many individuals who do not live close to a large medical center. For patients coming from the region, the goal is 120 minutes or less to open the artery. Life Flight’s goal is for an 8 minute enroute time from when the transfer request is accepted, a 4-5 minute rendezvous time from when the aircraft shuts down until the medical crew arrives at the patients bedside, and a 10 minute ground time. The median times for a HEART 777 patient in FY 2009 were 138 minutes in the first quarter, 102 minutes in the second quarter, 127 minutes in the third quarter and 115 minutes in the fourth quarter. The BRAIN 333 program has contributed to over 175 patients transferred from 33 outlying hospitals, with 135 interventional treatments performed.

Safety is the highest priority for air medical crews. In recent years, special focus has been placed on advances in safety management systems, aviation technologies, and crew training. Numerous aviation technologies have been refined and incorporated into many air medical programs’ operations, including Life Flight. Among these technologies are night visions goggles (NVGs), radar altimeters, GPS navigation, satellite tracking, helicopter terrain alert warning systems (HTAWS), and traffic collision avoidance system (TCAS). The avionics equipment in our helicopters has been upgraded to include the above mentioned technologies. Night vision goggle training and education for the medical crew

and pilots has begun, with a mid-March implementation date.

Survival gear, which includes such products as fire retardant flight suits, helmets, eye protection, and satellite phones, also has become the standard for most air medical programs across the country. Life Flight’s core and ancillary medical crew follow this standard.

In addition, enhanced crew and safety management systems have become a part of the everyday operation of air medical systems. Often referred to as Air Medical Resource Management (AMRM), such systems greatly improve both safety and efficacy on air medical missions by enhancing the ability of aviation personnel, flight crew, ground-based communication staff, and management to interact proactively on a mission-to-mission basis. Yearly Air Medical Resource Management training is provided to the core Life Flight medical crew.

Safety management systems further help companies track incidents, identify issues, and solve problems before they happen. Some of the most important advances have been made in risk-management models. These management tools help pilots, crews, and managers determine what environmental conditions are acceptable and greatly enhance the management of risk across air medical systems. In collaboration with OSF Aviation, Life Flight has implemented various tools to identify potential issues. Crew briefing, performed at the beginning of each shift by the pilot, focuses on various topics including weather, aircraft status, emergency procedures/landings, warnings and cautions are reviewed. A flight risk assessment worksheet is also completed at the beginning of every shift by the pilot. This worksheet allows the pilot to determine the total risk assessment value and based on that value determine the risk assessment level—low, medium, or high. This assessment is reviewed with the medical crew and all three sign it.

OSF Life Flight is a member of the Illinois Association of Air and Critical Care Transport (IAACCT), an organization comprised of the state’s air medical programs. The purpose of the association is to promote and enhance safety, education and communication in critical care air and ground medical transport within the State of Illinois. Participation in this organization is voluntary. However, this collaboration of the air medical programs in Illinois has led to the development of common elements of operational, dispatch, and communication standards for the purpose of safe air medical operations.

Life Flight works diligently to provide excellent, quality care and service to our patients and our referral network. We go forward with support and renewed commitment to those communities where our presence can make a difference. Through our ongoing relationships with EMS providers, referring hospitals, nurses and physicians in our region, we hope to make a difference.

Afife Halabi, RN, MSHA, MBA has 19 years of nursing experience at OSF SFMC on a general surgical unit, emergency department, mom/baby, and with Life Flight.

The Evolution of Life Flight continued from page 11


Meet Three Student Nurse Association of Illinois (SNAI) Board Members

My name is Andrea Barrett-Hollander and I am proud to be serving as the 2009-2010 President for the Student Nurses Association of Illinois (SNAI). I am currently a senior at Northern Illinois University where I serve as the Treasurer for the school’s Student Nurses Organization. In addition to that, I am a 4.0 student and part of the NIU’s Honors Program. Outside of school I am happy to be a wife and mother of three beautiful children while working two part-time jobs as both a Nurse Intern at OSF St. Anthony Medical Center in Rockford, IL and a medical assistant for a pediatrician in Belvidere, IL. SNAI is an important aspect of my college career because, as an organization, we can initiate change that will improve policy and enhance the richness of the learning experience for the future leaders in nursing. As President of SNAI, I look forward to a year of promoting the interests of student nurses of this great state. Networking with nursing leaders, faculty, and other students from IL and around the country is something that I am anxiously anticipating. My goal is to make a difference in the lives of my fellow nursing students and to pave the way for success for not only current aspiring nurses but for those in the years to come.

Hello Illinois NSNA members! My name is Katie Nauman and I am the Director of Publications for the Student Nurses’ Association of Illinois (SNAI). Currently, I am a second semester senior nursing student at Methodist College of Nursing (MCON) in Peoria. In my school chapter, I am the Student Nurses’ Association Secretary/Treasurer as well as a student representative for the MCON Bylaw and Policy Committee. Also, I work as a Certified Nursing Assistant on the orthopedic floor at Methodist Medical Center. In my free time, I enjoy being thoroughly involved with my college. In addition to my involvement

at MCON and SNAI, I enjoy spending time with my family, friends, and two dachshunds. In my position, I am responsible for sending emails to all the SNA chapters throughout the state of Illinois as well as submitting articles to various publications. My goal for the 2009-2010 school year is to get as much student involvement at our Leadership Convention in March of 2010 as well as representation at the NSNA 58th Annual Convention at Disney’s Coronado Springs.

My name is Lindsey Herzog and I am the Student Nurses Association of Illinois (SNAI) Nominations and Elections Committee Chair (NEC Chair). This is a new position this year so I thought I would explain what this position means. It is my job to recruit you to run for office for the SNAI Board of Directors (BOD) for the 2010-2011 school year. I also have committee members that are going to help me in this process. Please contact me if you are interested in running for a SNAI BOD position for the 2010 to 2011 school year. Serving on the SNAI BOD is a great opportunity to develop your leadership skills as well as learn about serving on a professional organization board. Holding a position on the SNAI BOD takes time and energy, but it is rewarding. I have experience serving as the SNAI Director of Marketing 2007 to 2008 and the SNAI President 2008 to 2009. In addition to recruiting you to run for a SNAI BOD position, I am working with Director of Membership Sarah Brown so I am available to come to your school to talk about joining SNAI and the National Student Nurses Association. Please contact me, if you are interested in running for a SNAI BOD position or if you have any questions for me about the SNAI BOD. My email address is [email protected]. Thanks! Lindsey Herzog

Presentation of “My Hero, My Dad, The Nurse”

Jean Roberson, RN (right) presents “My Hero, My Dad the Nurse” to Vicky Trupiano, director of Fountaindale Public Library in Bolingbrook. Jean states: “The 950+ nurses of District 2 are very happy to donate this book to the Fountaindale Public Library, Bolingbrook. Hopefully it will inspire some future nurses to make this their career!”

Sauk Hosts 7th Annual Men in Nursing Dayby Janet Lynch, MS, RN, Dean of Health Professions

Sauk Valley Community College

The 2010 event was held on February 5th at Sauk Valley Community College in Dixon, IL. The day was developed in cooperation with KSB Hospital, CGH Medical Center, Whiteside Area Career Center and the college. Funding was provided through the Non-Traditional Occupations grant from the Illinois Community College Board, Illinois State Board of Education and the Carl D. Perkins Career and Technical Education Improvement Act of 2006.

Seventeen students from the area high schools attended the day. The students were exposed to the course work and the preparation it takes to have a smooth academic transition from high school to college. Whiteside Area Career Center, the region’s vocational center provided details of the options it offers for health career education. Career paths unique to each individual student from their high school to Sauk Valley College were provided. The activities then began.

IV’s were started. ECG’s were read. The cadaver was explored and victims were tagged in the disaster triage session. A body systems tour had the students matching multiple pieces of equipment with the system it would be used on or with. Accident scenes, vehicle extraction, treatment of traumatic injuries and patient follow up was also completed in the sessions for the day.

The day ended with 6 male nurses and 2 male nursing students telling the students why they chose to work in the field of nursing. The general message the students received was that the men appreciate a secure employability, flexibility in employment options and the ability to make a difference in people’s lives. This ability to make a difference is the true essence of nursing and is the reason behind nursing being such a desirable position.


The INA District 2 Scholarship Program

INA District 2 is pleased to announce their first scholarship program for qualified students who are members of INA District 2 or whose parent, grandparent, or spouse is a current member of INA District 2.

The objective is to help worthy nursing students to continue their education. INA District 2 reserves the right to alter or discontinue the Scholarship Program as circumstances warrant.

The Scholarship program consists of 2-one year awards with a $500 fixed allotment.

How and when to apply:1) Complete the attached application form and submit

the following additional data.A) An essay describing why you want to be a

nurse or why you want to advance your nursing education and how you will make a difference with a nursing education and this scholarship.

B) A letter of recommendation from only one (1) teacher, counselor, school administrator in the nursing program.

C) Letter of recommendation from the INA District 2 member whom you are related. Disregard if INA District 2 member is applying for the scholarship.

2) Send to:Mary BortolottiINA District 2 President105 Spinnacre PlacePoplar Grove, IL 61065Or email to:[email protected]

Completed application must be postmarked by April 15, 2010

Application ChecklistDeadline April 15, 2010

❑ Recommendation from teacher, counselor, school administrator concerning student’s present activities. No more than one typed page.

❑ Essay on why you want to be a nurse or why you want to advance your nursing education and how you will make a difference with a nursing education and this scholarship.

❑ Letter of recommendation from INA District 2 member and how you are related. Disregard if District 2 member is applying for the scholarship.

Application without the above information will be considered incomplete and will be rejected.

Admissions to Schools: Applicants for INA District 2 Nursing Scholarships must themselves apply to the nursing school of their choice and must be responsible for meeting all admission requirements.

Selection of WinnersSelection will be based on review of the essay and

recommendation letters.

If you are interested in applying for the INA District 2 Nursing Scholarship,

carefully examine all eligibility requirements and procedures

How Winners are ChosenThe INA District 2 Scholarship recipients will

be announced each May through the INA District 2 Newsletter and in Illinois Nurse. Scholarship awards become effective when the winners are officially enrolled in their school of choice.

Payment of AwardScholarship awards will be paid directly to the

recipients for appropriate use. Payments will be made in October after proof of registration.

Changes in ProgramThe INA District 2 Scholarship Committee reserves the

right to change, suspend or discontinue this scholarship program at its discretion. However, no general suspension or discontinuation will adversely affect any scholarship awards already in effect.

Other ScholarshipsINA District 2 Scholarships may be used in conjunction

with other scholarships. Therefore applicants are advised to apply for all available scholarships for which they are eligible.

Application for INA District 2 Nursing Scholarship

Type or print information except your signature in the spaces provided:

Name: ______________________________________

Email Address: _______________________________

Home Address: _______________________________

City, State, Zip: _______________________________

Date of Birth: _________________________________

School: ______________________________________

School Administrator: __________________________

Street: _______________________________________

City, State, Zip ________________________________

Graduation Date _______________________________

INA District 2 Member’s Name: __________________

Relationship to Applicant: _______________________

Applicant Signature: ___________________________

Mail application to:Mary BortolottiINA District 2 President105 Spinnacre PlacePoplar Grove, IL [email protected]

Illinois Center for Nursing presents Testimony at IOM Forum on the Future of Nursing: Community

Health, Public Health, Primary Care and Long-Term Care

The Institute of Medicine (IOM), in collaboration with the Robert Wood Johnson Foundation (RWJF) has established a major initiative on the future of nursing. The first 13 months of the two-year initiative involves information gathering and preparation of the consensus report. Three regional town hall meetings and workshops will provide input to the study committee.

A regional meeting was held December 3, 2009 in Pennsylvania. The topic: Community Health, Public Health, Primary and Long-Term Care. The Illinois Center for Nursing (ICN) presented written testimony regarding the home health and home/community based services sector in Illinois.

The fastest growing segment of the healthcare industry, according to the US Department of Labor, is service provided outside hospitals, clinics, and nursing homes. The AARP reports that home healthcare is at its highest demand, and trends suggest even greater demands in the future. Efforts are currently under way to address the needs within the home health workforce, and proactively improve job conditions while maintaining the highest care giving standards.

The Illinois Center for Nursing (ICN) is spearheading an initiative designed to improve the current situation in home healthcare, through a series of meetings, with multiple state agencies, unions, employers and advocacy groups. This initiative is focusing on defining the sector and workforce, developing effective models and strategies that improve job quality and building integrated and robust workforce strategies.

Innovative pilot programs have been developed by organizations like Provena Home Care, Addus HealthCare, Inc, Asi, Inc. Peer interviewing has allowed these programs to both recognize seasoned employees and to significantly decrease employee turnover. Greater involvement amongst all levels of licensed and unlicensed personnel in coordination of care meetings enhances patient care, caregiver communication, work recognition, and ultimately, workforce retention. This expanded involvement also addresses the critical need to generate better career opportunities for homecare workers.

New models and ideas will continue to be used to promote chronic care management that integrates health care clinical services with social services and support systems.

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