APNA Florida Chapter Newsletter Volume 13, Issue 1 March 2013

Transcription

1 APNA Florida Chapter Newsletter Volume 13, Issue 1 March 2013 President-Elect s Message Wow, our state conference was certainly a wonderful experience. The speakers were absolutely wonderful. Not only did the speaker share valuable information, they also challenged us with new ideas and to think outside the box. Seeing the DNP students and FAU campus was also a nice plus. I especially appreciated the members who offered suggestions and feedback to the organization during our general meeting after the conference. One suggestion was to look at ways to improve communication on a regular basis with the membership. One of our members is looking at using her capstone project at doing just that and several ideas are also in the works. If you would like to get involved, we will be stating the process of selecting a ballot for our board of directors for If anyone would like to get involved in a leadership position, please do not hesitate to contact me at: pbrown2550@aol.com. IN THIS ISSUE: President-Elect s Message p. 1 Board Meeting Minutes p. 2 FL Chapter Meeting minutes p. 3 Legislative Updates p. 6 Workplace Violence p. 8 Conference Wrap-Up p. 9 Board Member Info p. 12 Board Members Speak Out p. 13 More Legislation p. 16 1

2 APNA - Florida Chapter, Board Meeting January 8, 2013 Conference Call Present: Valerie Kolbert, Janet King, John Repique, Pat Brown, Judy Flanagan, & Darlene Conde- Nadeau. TOPIC DISCUSSION ACTION Call to Order By President elect Pat 8:30 PM. Noted. Welcome and Introductions Pat welcomed all to the meeting (call). Noted State Conference Our APNA- Florida Chapter Conference will be John Repique & others as noted held February 23 at FAU. The title is: Advancing the Future of Psychiatric Nursing. The Brochures will go out tomorrow and Board members will help disperse them (IE. Darlene to VA facilities, etc). Time was spent reviewing the anticipated income versus the expenses. Pat will ask Forest Pharmaceuticals to provide lunch and do a presentation. Judy will contact other companies regarding sponsorship. John, Donna and Pat will ask their respective companies for additional assistance and we anticipate 30 paying attendees. Expenses will include honorariums and food. Newsletter Congratulations Val on the last Newsletter. All Board members Articles for the next Newsletter are due by February 15 th. Assignments: Darlene president s report, George legislative issues, John conference, Pat clinical article, Donna who s new?, each board member to send in info regarding how they got into Psych nursing and possibly an article on CPT codes. Fall conference It was suggested that a conference be held in the Postponed until next meeting fall in central Florida. This discussion was tabled in the interest of time. New members/non- renewals Reported by Donna: Donna September 0 new, 6 nonrenewal October 12 new, 1 renewal, 5 nonrenewal November 5 new, 0 nonrenewal All new members get a letter from Darlene. Donna asks that we get addresses from anyone we know who joins, as APNA no longer provides this. At the State conference, we will have information on how and why to join APNA. Media Assistant 3 individuals expressed an interest in assisting Val with the Newsletter and writing articles for Postpone further discussion until the fall. the Member Bridge. When Val asked them to write an essay, 2 dropped out. The last one, who was very interested, has temporarily moved out of state to care for her ailing mother. Phone call meetings The Chapter phone call meeting scheduled for January 26, 2013 at 9 AM has been cancelled. This idea will be discussed further at our next Board meeting. It was determined that 1 or 2 topics should be presented which are of interest to our membership. This might stimulate more members to participate. Darlene Conde- Nadeau 2

3 We would like to schedule regular calls with members the suggestion was made to have one early in February following the Board conference call (meeting). Members will receive an blast advising them that the January 26 th conference call has been cancelled and that another will be scheduled in the future. Next meeting Telephone conference on February 5, 2013 at 8:30 PM. The meeting was adjourned at 9:30 PM. Respectfully submitted, Judy Flanagan, Secretary Informational APNA Florida Chapter Meeting February 23, 2012 Held at our State conference in Boca Raton at FAU Present: Patricia Brown (President Elect), Sandra Cadena, Elizabeth MacDermott (MAL), Deborah Renner, Patricia Tyra, Paulette Perlowin, Ruth Milstein, Vanessa Long, Valerie Kolbert (Media), Donna Linette (MAL), Linda Casabe, Marcia Greene, Diane Esposito, Barbara Kovac, Elizabeth Maree, Laurie Zeitlin, Carole Kain, Nancy Newbury, Linda Mays, John Repique (MAL), Monica Scaccianoce, John Lowe, Judith Flanagan (Secretary). Welcome & Introductions Pat Brown, President Elect, Informational opened the meeting at 3:55 PM. The Board members and the membership introduced themselves. Minutes reviewed Judy read the minutes from Previously accepted. the Chapter meeting held at the National Conference in Pittsburgh Treasurer s Report Checking - $4, Saving - $ George Smith, Treasurer Review of status of Goals for Amount before conference MALs are contacting new and non- renewed members. National is behind in sending out this information. Most non- renewals are due to finances. The State Conference will be held at FAU in March. The date was changed and the conference was today an excellent one! The Board was looking for someone to help with the dissemination of Donna Linette has assumed this responsibility John Repique & Donna Linette Valerie Kolbert 3

4 TRAP program 2014 Conference Central Florida Nominations Open discussion information via the Newsletter and Member Bridge. This person would receive a scholarship to the National Conference. We were unable to find anyone a few expressed interest, but when a 1 page essay was required, no one responded. We ll try again next year. Suggestions or volunteers to speak at future conferences? Have an increased focus on legislation for our specialty it was suggested that on a more consistent basis, we need to be aware of what is going on and pending issues. The Baker Act may be merged with the Marchman Act? We need current information. Explore ways to increase involvement of general membership. This program links new ARNPs who are coming into Florida with someone already practicing. It is available and has had at least 2 participants. Suggestions include: revisiting of CPT codes, new DSM, ICD- 10, Healthcare reform, Medicaid expansion, someone from APNA National?, Legislative issues. This year the following offices will be available: President Elect, Secretary and 3 Members- at- large. THANKS to John and Donna for presenting an excellent conference. More information on a Contact a Board member Carole Kain provided some information Utilize Member Bridge and conference calls John Repique Central Florida MALs Contact a Board member if interested. Informational 4

5 The meeting was adjourned at 4:40 PM. Respectfully submitted, Judith Flanagan, Secretary monthly basis re Legislative issues. Need someone to coordinate the Chapter conference calls and have specific topics for discussion. There were a few suggestions on how to communicate. 5

6 LEGISLATIVE UPDATES FROM THE FNA: DOCTOR TITLE BILL OPPOSED BY STATE S LARGEST NURSING ORGANIZATION Legislation is sophomoric, distracts from key health care decisions at Capitol TALLAHASSEE (Fla) The state s largest organization representing registered nurses today condemned legislation that forces nurses with doctorate degrees to explain to patients and the public that they are not medical doctors or face felony charges. SB 612 would require nurses who have attained their doctoral degrees and use the title of Doctor to state, in advertising or rendering care, that they are not medical doctors or osteopathic physicians. Offenders could face criminal charges of a third-degree felony, which is the same punishment for certain burglaries, neglect of an elderly or disabled adult, and animal cruelty resulting in death. At best, this bill is sophomoric and serves to distract legislators from important discussions about the future of Florida s health care, said Dr. Mavra Kear, Ph.D., ARNP, President of the Florida Nurses Association, who is neither a medical doctor nor an osteopathic physician. The legislation comes as lawmakers wrestle with statewide implementation of the Patient Protection and Affordable Care Act, the expansion of Medicaid to more Floridians and the development of online insurance marketplaces all of which will drive up the demand for primary care services. There is a demonstrated physician shortage in Florida, and nurse practitioners have the education and experience to step in and help their physician partners provide basic health care services, said FNA Executive Director, Willa Fuller, RN, who is seeking her doctorate but is neither a medical doctor nor an osteopathic physician. Instead, certain physicians choose to focus their energy on a problem that simply doesn t exist. State law already makes it a crime for individuals who lead the public to believe that one is a medical doctor or engaged in the licensed practice of medicine without holding a valid, active license. The penalty for this offense, however, is only a first-degree misdemeanor. All health care practitioners face disciplinary hearings from their professional board at the Department of Health if they fail to identify themselves to the patient -- orally or in writing, such as a name badge -- by the type of license the practitioner has. SB 612 is sponsored by Sen. Bill Galvano (R-Bradenton). The House version is expected to be filed by Rep. Heather Fitzenhagen (R-Fort Myers). SEE UPDATE NEXT PAGE!!! 6

7 Legislative update: Strength In Numbers (from FNPN) The amended version of the Dr. Title bill (SB 612) passed Thursday 3/7 out of the first Senate committee. The amended version is a far better bill than originally put forth by Senator Galvano and we can thank Senator Denise Grimsley, from Sebring, for her proactive effort. The amendment takes away the 3rd degree felony charge and does not require NP's to say who we are not. House Bill 699 that passed into law in 2006 requires health care providers to identify themselves to avoid confusion on the part of the patient as to who is rendering care. This is now in statute Basically this keeps things status quo. The combined efforts within the nurse practitioner community made this possible. Thanks to all, FNPN, FNA, FACN, FLANP and a special thanks to many of you who gave testimony to the news media throughout Florida, sent s and letters to your Senator, and made countless phone calls. Your efforts are being noticed in Tallahassee. House Bill 805 (House version of the Dr. Title bill) will be heard by the Health Quality Subcommittee very soon and we need to inform the members of this committee that we adamantly oppose this bill as well. Please contact the below members to voice your concern. Please go to itteeid=2716 to access this committee. Just double click the name and under their picture is the link to them directly. Thank you, Deb Friedrich, DNP, ARNP, FNP-BC FNPN Legislative VP AANP Discusses Future of Nursing Report with MedPAC Staff AANP President-Elect Kenneth Miller, PhD, RN, CFNP, FAAN, will join representatives of other nurse practitioner organizations Tuesday in meeting with the professional staff of the Medicare Payment Advisory Commission (MedPAC) to discuss the recommendations of the Institute of Medicine s 2010 report, The Future of Nursing: Leading Change, Advancing Health. The Commission, which advises Congress on a wide range of Medicare coverage and payment policies, is expected to discuss the IOM report at its upcoming April meeting and could make its own recommendations to Congress on addressing legislative and regulatory barriers to nursing practice. 7

8 The Effects of Workplace Violence on Hospital Based Psychiatric Staff Monica Scaccianoce, ARNP, DNP Workplace violence is a world-wide health problem. Researchers in the United States reported that 75%-100% of nursing staff on acute psychiatric units have been assaulted at least once during their careers. A descriptive study utilizing two valid and reliable tools was completed in May of this year by this writer. This study measured the amount of distress experienced by staff by utilizing the Impact of Event Scale (Horowitz, 1979). Staff members emotional, bio-physiological and social responses were also measured by M. Lanza s Assault Response Questionnaire (1988). A literature review was conducted to determine evidence based clinical interventions for staff victims. Data collection was limited to ninety days. Nine surveys were returned. Due to the small sample size one cannot generalize the findings. However a Pearson product moment coefficient was conducted between the subscales of the tools and strong positive correlations were detected. Results of the study were that forty four percent of participants reported moderate distress or severe distress. Six participants were found to have a medium to high chance of developing a stress related disorder. Additionally, the findings included a strong positive correlation (r =.0867, n = 9, p =.002) between the level of intrusion and emotional symptoms (such as depression, anxiety, guilt etc). Bio-physiological symptoms (body soreness, headaches, startle reactions etc.) were strongly correlated (r = 9.13, n = 9, p =.001) with both intrusion and avoidance. Both intrusion (r =.772, n = 9, p =.001) and avoidance (r =.719, n = 9, p =.029) were strongly correlated with social symptoms such as fear of returning to work and changes in relationships with significant others and coworkers. Implications of the study are that staff may experience intrusive thoughts, avoidant behaviors and disruption of social relationships post assault. These reactions may cause changes in their job performance and may progress to the development of PTSD. Several interventions might mitigate the effects of the assault. These interventions include: provision of support post incident; use of Psychological First Aid (Ruzek et. al., 2007); referral to EAP and ongoing screening for the presence of PTSD. Psychiatric nurses need to continue to conduct research in this area and need to advocate for the care of their peers who are victims of workplace violence. Psychiatric nurses need to have the strength and courage to care for the caregivers. mscaccianoce@jhsmiami.org please feel free to contact me for further information on this topic 8

9 APNA Florida Chapter Conference a Success Coordinated by R. John Repique and Donna Linette, the APNA Florida State Chapter Spring Conference held at the Christine E. Lynn College of Nursing at Florida Atlantic University in Boca Raton on Saturday, February 23 was a big success by all accounts. With the theme Advancing the Future of Psychiatric-Mental Health Nursing, the conference covered a variety of topics and the 80 or so attendees earned 5.0 contact hours. Patricia Liehr RN, Ph.D. presented Stories from Pearl Harbor and Hiroshima: Implications for Surviving Wartime Trauma, followed by The Role of Cultural Buffers as Moderators of Health Outcomes by Karethy Edwards DrPH, APRN, FNP-BC and The Impact of Historical Trauma on the Substance Abuse of Native Americans by John Lowe RN, PhD, FAAN. Lunch was sponsored by Forest Pharmaceuticals and allowed for networking as it was on site. After lunch Ruth Milstein DNP, PMHNP-BC, LMHC presented Integrating Mental Healthcare & Primary Care: An EBP Quality Improvement Systems Change Project and then attendees could choose between Promoting Recovery With Trauma-Informed Practice by Diane Esposito MSN, ARNP, PMHCNS-BC, PhD(c) or 2013 CPT Code Changes: Billing and Documentation Update by Sandra Cadena PhD, APRN, PMHCNS-BC, CNE. An APNA Florida Chapter Meeting followed the conference. Everyone agreed that FAU was a wonderful setting for the conference and tours of the school and historical library were offered as well. Thanks to everyone who made the conference such a success. 9

10 APNA Florida Chapter State Conference 2/23/

11 Advertise in the APNA Florida Newsletter Active APNA members get a 50% discount on ads! Business card $ page $ page $100 Full page $ Contact Media Coordinator Valerie Kolbert ARNP Phone Fax The Experts Speak Presented by the Florida Psychiatric Society is a free series of educational podcasts on mental and public health. These podcasts, heard worldwide, are fabulous and a great way to keep abreast of new developments in psychiatry. Go to or scan the QR code Want to get published? Seeking Articles describing innovative practices by our members. Do you have any tricks of the trade you d like to share with your peers? Please submit to newsletter editor at ARNP11@aol.com Don t complain that there are no networking opportunities! Go to Member Bridge at APNA.org and get connected NOW! 11

12 President President-Elect Media Coordinator Secretary Darlene Conde-Nadeau Patricia Brown Valerie Kolbert Judy Flanagan ARNP MSN, ARNP PhD, ARNP MS, ARNP-BC Treasurer Member-at-Large Member-at-Large Member-at-Large George Byron Smith Nel Thomas MA, MSN, Janet King MA, RN- R. John Repique DNP, ARNP-BC, GNP RN C MS, RN, NEA-BC GBS25@case.edu Nel.Thomas@fhchs.edu Janet.king@adu.edu rjrrepique@aol.com , EXT Member-at-Large Member-at-Large Donna Linette Elizabeth MS, RN, NEA-BC MacDermott dlinette@geocarellc.com MSN, ARNP APNA Florida Board Members 12

13 BOARD MEMBERS SPEAK OUT Why I chose Psychiatric Nursing - Judy Flanagan I was in my final semester at the University of Michigan School of Nursing - the only rotation I had left was Psych. I was assigned to the Children's Psychiatric Hospital - they were ages 4 through 12. I had always planned to work in Pediatrics, but after completing my Psych rotation, I fell in love with the area and the children. Through the years (I graduated with my BSN in 1967), I have worked in other areas of nursing but always returned to Psych but in the end was spending more time with adults than children. In 1995 I graduated from USF with a Masters in nursing and completed the ARNP program. Since I have been working in outpatient Psych and even though I'm trying to retire, I can't quite leave so I'm working part-time and still love it! Why I chose Psychiatric Nursing Pat Brown Initially I thought nurses wore white uniforms, caps and played with technical items. I thought if I as going to be a real nurse I needed to be in an area that had those things. I started in surgery; then tried ICU, next a step down unit. All the time thinking I had just spent 4 years in school and was not particularly happy with my career decision. My husband reminded me how much I had enjoyed my psychiatric rotation in nursing school. I applied for a position on a psychiatric unit at JMH in Miami and fell in love with my career! Why I chose Psychiatric Nursing Valerie Kolbert My psych rotation in nursing school was at the Hospital of the University of Pennsylvania on 10 Gates and my assigned patient was a floridly manic second year family practice resident. It made working through that whole doctor-nurse relationship thing all the more interesting. When I graduated in 1977, I really liked psychiatry but I also really liked the surgical intensive care unit. What to do??? Why, make a list of what I liked best about both and compare them! It soon became apparent that what I liked best about the SICU was working with families in crisis, but if I worked in the ICU I d be too busy with the patient to do much 13

14 work with the family. If I went with psychiatry I could do psychiatric liaison nursing and work with the ICU families in that role. The rest is history. For 35 years I have embraced psychiatric nursing with a passion in many different settings. If you had told that shy little nursing student back in 1977 that she would one day have her own private practice I would have laughed and asked what you were smoking. Now I can t imagine it any other way. Janet L. King Member at Large I am currently pursuing a Ph. D. in Nursing Philosophy at Barry University. Working full time and attending school is a challenge. I miss having more free time to garden and visit with friends. My dissertation if all goes according to plan will concern nurses and how they can better serve patients with a history of childhood sexual abuse. Applying this knowledge will advance my skills in nursing instruction, help assist the nursing community with research and would allow me to be a positive beacon of light to others. I would be remiss if I did not mention now how I plan to accomplish this goal. It is through God and His Spirit, the experienced staff at Barry University, and course study that I hope to obtain this objective. As a Bachelor of Science nursing student at Villanova University, it was not until I was in my last semester that I was glad I had decided to be a nurse. The last semester was psychiatric nursing at a Pennsylvania State Hospital. Though it seemed oppressive to the patients, I found a cause and undying interest in the psychology of the mind. I believe health and psychology go hand in hand to produce an outcome in an individual. Science is now investigating the association between genetic disposition and environmental stressors. They are designating genes that are responsible for schizophrenia, impulsive disorders and obsessive symptoms. While I am not surprised with this discovery, because of my experience as an observer and clinician, I am obviously selecting to learn more to supplement my teaching practice as I also teach genetics in our BSN program at Adventist University of Health Sciences at Florida Hospital in Orlando. Academic Experience Psychiatric nursing has always intrigued me. It was the only text in nursing school I read from cover to cover with anticipation. My fellow students would dread clinical and fear the abnormal as much as I found it fascinating. Dispensing both inpatient and outpatient therapy gave me a broader view of treatment. Teaching is by far though my greatest experience of all. 14

15 The mentors I remember clearly are the following though I am sure there are many others that have influenced me through the ages. The army paid my college tuition so I owed them three and a half years. During that time, I encountered a consulting psychiatric nurse that videotaped me during patient groups. Spending time helping me study how I was coming across to patients. I became more acquainted with my body language and the messages I radiate. Three psychiatrists during the span of my inpatient experience took time to teach and answer questions. During my master s practicum, my clinical supervisor was available and very valuable as a mentor. We worked on my personal issues as well as fostering clients as they processed their personal issues. I have a total of 20 years in psychiatric nursing. I have been teaching full time for ten years at Adventist University of Health Sciences. Our program is progressive and is based on many learning theories. Most obviously, we use the adult learning theory which supports a student that is independent, self-directed and more motivated by internal drives as opposed to external drives. It is problem-based and evidence based learning with application of critical thinking at its core. Research Experience Being a head nurse at Walter Reed Medical Center at the later part of the Vietnam War, I was able to promote an idea. When I started working there all the patients were put together on the same bay (unit) no matter what their acuity. I came up with a plan to divide the bays into 3 different units: A, B, and C bays. C bay was a closed intensive unit with 10 beds. B bay was for those patients not requiring C bay but still needing redirection from time to time, allowing them to go to the mess with short supervised outings. A bay was completely open and allowed patients to go on pass and reconnect with current society. The army coronel allowed me the staffing I needed and any other items or support necessary. It was successful and reduced the days of psychosis on average for soldiers, increased safety on the bays and fostered successful re-socialization of soldiers as a whole. Alas when asked to write up the results for a professional journal, I declined. I was short and now I wish I did record the findings. I received an MA in Counseling from Webster University in I find attending the national APNA each year a highlight for learning the latest information and current trends in psychiatric nursing. In 2011, I became board certified by the ANCC in psychiatric and mental health nursing. I also enjoy being a member of the Florida Chapter of the APNA where we can attend local state conferences like the Spring Conference that was held on February 23 in Boca Raton, at Florida Atlantic University. 15

16 Another Legislative Update from FNPN: Physical Therapy Bill Moving in Committees SB 536 and HB 413 is being championed by FNPN and advocated heavily for by FNPN professional lobbyist is moving forward this week in committees. Senate Bill 536, Relating to Physical Therapy, by Senator Nancy Detert (R-Venice) was heard at the Health Policy Committee. The bill would allow Advanced Registered Nurse Practitioners (ARNPs) to authorize a physical therapist to implement a treatment plan for a patient. The bill passed unanimously and will now head to the Senate Banking and Insurance Committee, scheduled to meet Thursday, March 14th. The House companion, HB 413 by Representative Travis Hutson (R-Palm Coast), was approved in the House Health and Human Services Committee and is now ready to be heard by the full House! The Florida Nurses Association, Florida Association of Nurse Anesthetists, Florida Association of Nurse Practitioners and the Florida Nurse Practitioners Network want lawmakers to modernize 40- year-old nurse practitioner laws to reflect changes coming under the Affordable Care Act, which will bring thousands of people into commercial and Medicaid health care plans. "With a shortage of primary care physicians, nurse practitioners - with their experience and education - are ready and available to step in and provide patients with the basic health care services, without delay." said FNA President Mavra Kear on behalf of the four organizations. Specifically, the groups want lawmakers to update laws that prohibit advanced registered nurse practitioners (ARNPs) from prescribing certain medications and to modify policies including reimbursement practices that will encourage commercial and Medicaid health plans to make nurse practitioners available for the growing number of enrollees. The nurses are part of a growing chorus of other groups calling for changes in scope of practice laws: * The Associated Industries of Florida, in its 2013 legislative recommendations, makes the following statement: "Florida cannot simply hire hundreds of physicians overnight... there is a plethora of trained, professional health care providers who are currently prohibited from delivering basic care that could be used if some regulatory, licensing barriers were removed." Continued on page 17 16

17 * In a summary of its ARNP Scope of Practice Summit in Tallahassee, Florida TaxWatch President and CEO Dominic Calabro says that stakeholders are ready to discuss the issue and have productive negotiations based on evidencebased reports, and focus on doing what is best for Floridians. "Now is the time to put aside historical disagreements among interest groups, and work together toward a healthier, efficient, and cost-effective Florida,'' he states. * A National Governors Association report in December urged states to "consider changing scope of practice restrictions and assuring adequate reimbursement for their services as a way of encouraging and incentivizing greater (ARNP) involvement in the provision of primary health care." "As lawmakers address comprehensive changes under the Affordable Care Act, we look forward to assisting them with the primary care challenges faced by our state," said FNA Executive Director Willa Fuller. "It is vital that nurse practitioner laws are updated to reflect the role we play in this new age of health care." Thanks to the FNA for this update. 17