FEATURES

A Patient’s Perspective On Pulmonary Hypertension . . . . . . . . . . . . . . . . .3Drugs Being Studied to Treat Pulmonary Hypertension . . . . . . . . . . . . . . . .4Five Million Lives: The Campaign for Patient Safety . . . . . . . . . . . . . .8

NEWS

President’s Message . . . . . . . . . . . . . . . . . . . . . . .2Diana Anderson Named New Editor for MedSurg Matters . . . . . . .6News from Committees . . . . . . . . . . . . . . . . . . .10Chapter News . . . . . . . . . . . . . . . . . . . . . . . . .14

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OFFICIAL NEWSLETTER

Volume 16 - Number 2March/April 2007

Dee A. Jones, BSN, RN

PPulmonary hypertension (PH) is a mysterious condition for patients and the medical-surgical nurse. Year after year, patients experience the progressive effects of PH dueto undiagnosed or misdiagnosed illness. This article will discuss care of the patientwith PH and decrease the ambiguity of signs and symptoms in patients with PH.

Pulmonary hypertension (PH) is quite difficult to diagnose. The onset of PH often beginswith shortness of breath and fatigue, which is indicative of many other conditions (Steinbis,2006). The medical-surgical nurse must be knowledgeable in many aspects of nursing care.It has been said that the medical-surgical nurse is “Jack of all trades and master of none.”I disagree. The medical-surgical nurse must be “master of creativity” and is a specialist inthis area of nursing. Care for the patient with PH requires both critical and creative think-ing skills.

PathophysiologyPathophysiology becomes important to the nurse. “PH is diagnosed when the systolic pres-

sure in the pulmonary artery exceeds 30mm Hg” (Sommers, Johnson, & Beery, 2007, p. 796).The vessels in the pulmonary system become resistant, thus the vessel intima becomes fibroticand thickens. This leads to chronic “hypoxemia which produces hypertrophy of the medial mus-cle layer in the smaller branches of the pulmonary artery...As this condition progresses, cardiacoutput falls and may cause shock” (Sommers et al., 2007, p. 797).

Two types of PH exist; primary PH and secondary PH. Primary PH is idiopathic or has anunknown cause, but it can be hereditary. “In secondary PH, underlying conditions may causehypoxia, which causes vasoconstriction in the pulmonary vascular bed; blood flow is thendiverted to areas of adequate ventilation to allow for oxygenation” (Steinbis, 2006, p. 8). Thisdisease is quite debilitating as it progresses and can be fatal.

AssessmentPatient history is vital in nursing care no matter what the diagnosis. Genetics, past illnesses,

allergies, and medication history are bits of information that assist in caring for the patient. Thisauthor notes that more awareness of PH is needed, even though PH has come to the forefront sincethe removal of diet drugs like fenfluramine and dexfluramine from the market. It is documented that“use of these drugs contributed to the development of PH in numerous people” (Steinbis, 2006, p.8).

Cardiac evaluation becomes vital in the patient with PH. Upon auscultation, not only willthis patient have signs of right-sided ventricular failure, but left-sided ventricular failure may co-exist as well (see Table 1 on page 12).

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Reader ServicesMedSurg MattersAcademy of Medical-Surgical NursesEast Holly Avenue Box 56Pitman, NJ 08071-0056(856) 256-2300 • (866) 877-AMSN (2676)Fax (856) 589-7463E-mail: amsn@ajj.comWeb site: www.medsurgnurse.org

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Editorial ContentAMSN encourages the submission of news itemsand photos of interest to AMSN members. Byvirtue of your submission, you agree to the usageand editing of your submission for possible pub-lication in AMSN's newsletter, Web site, andother promotional and educational materials.To send comments, questions, or article sug-gestions, or if you would like to write for us,contact Editor Diana Anderson, BSN, RN,CMSRN, at danderson@nrmc.org

AMSN Publications and ProductsTo order, call 866-877-AMSN (2676), or visitour Web site: www.medsurgnurse.org.

ReprintsFor permission to reprint an article, call 866-877-AMSN (2676).

IndexingMedSurg Matters is indexed in the CumulativeIndex to Nursing and Allied Health Literature(CINAHL). © Copyright 2007 by AMSN. All rightsreserved. Reproduction in whole or part, elec-tronic or mechanical without written permissionof the publisher is prohibited. The opinionsexpressed in MedSurg Matters are those of thecontributors, authors and/or advertisers, anddo not necessarily reflect the views of AMSN,MedSurg Matters, or its editorial staff.

Publication Management byAnthony J. Jannetti, Inc.

Kathleen A. Reeves

Most of you are probably aware that March 4-10,2007, was Patient Safety Awareness Week. Posters and

special reminders were evident in the hospitals I frequentas a clinical nurse specialist and as a faculty member. Iwould like to share with you that at times, I see so manysigns and posters that I do not always take the time to readthe information thoroughly – that is until my son was hos-pitalized during that week.

Florence Nightingale stated long ago, “It mayseem a strange principle to enunciate as the very first

requirement in a hospital that it should do the sick no harm.” This state-ment continues to be relevant today. According to estimates from the Institute ofHealthcare Improvement (IHI), 40,000 instances of medical harm occur eachday in the United States. IHI’s definition of medical harm is “unintended physi-cal injury resulting from or contributed to by medical care (including theabsence of indicated medical treatment) that requires additional monitoring,treatment, or hospitalization, or that results in death. Such injury is consideredharm whether or not it is considered preventable, resulted from a medical error,or occurred within a hospital.”

Did my son experience a medical error during his hospitalization? The hon-est answer to that question is – not to our knowledge. Were there some nearmisses? Definitely. Fortunately, the overall nursing care resulted in positive out-comes for my son.

My sincere appreciation goes to the nurses who recognized the antibioticoriginally ordered for my son should not be administered to someone with apenicillin sensitivity. Thankfully, the ordered medication was never administeredto my son. My son has known since he was a little boy that his extreme allergyto penicillin could be life threatening, and thus, he clearly described this allergyto the physician and nurses. Many organizations, including The JointCommission, recommend that patients be actively involved in their care as astrategy to improve patient safety. Despite my son’s active participation in hishealthcare, the physician still ordered the incorrect medication.

Medications were administered throughout my son’s hospitalization.Information was posted about patient safety measures throughout the hospital.Maybe I noticed the posters since I had never been in that hospital before orbecause of the irony of the content. Regardless, despite the focus on patientsafety, my son’s armband was not examined, the medication administrationrecord was not brought into the room, nor was there any request for my son tostate his name (actually, there was no greeting of any kind, rather a statementthat an intravenous medication was being hung). The Joint Commission’s safetygoal of using at least two patient identifiers when providing care was not met.One of the basic rights (right patient) of medication administration was not fol-

President’sMESSAGEOFFICIAL NEWSLETTER

Volume 16 - Number 2March/April 2007

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Quality Patient Care: Why We Became Nurses

Ihave struggled with my weight all my life. As a youngperson, if I maintained some control over my eating andexercised, keeping weight off wasn’t much of a prob-lem. But as I reached my 30s, I found weight controlbecoming increasingly more difficult. My main issue

was a constant overwhelming urge to eat similar to an addictin withdrawal. Therefore, when the directors of a weightmaintenance program I was enrolled in approached meabout taking phen-fen as a means to control my appetite, Idesperately agreed despite the fact it seemed too good to betrue. As it turned out, it was. I experienced side effects fromthe beginning, and 10 years later, I was diagnosed with pul-monary hypertension (PH) as a direct result of having takenphen-fen.

I took the drugs for two separate intervals of 2 to 4weeks each. Within days after beginning the medicationboth times, I became weak, lightheaded, and short of breathafter walking short distances or climbing stairs. I reported mysymptoms to the center prescribing the drugs. The directorsswore my symptoms could not be a result of the drugs. A cou-ple weeks after I started taking the drugs the second time, Ipassed out after walking a short distance between two build-ings. On my doctor’s advice, I stopped taking the drugs.Immediately the symptoms disappeared.

From that time (early 1994) until late 1995, I noticedthat even though I wasn’t taking the drugs, I had moreheadaches than normal. I didn’t have a history of migraines,but I had begun having exercise-induced migraine-likeheadaches and body aches. None of my doctors couldexplain why. In December 1995, I came down with a severecase of the flu. Normally I bounce back very quickly after anillness, but this time I didn’t. During the time I was sick, I expe-rienced chest pain and ended up having a battery of tests forheart disease, all of which came back normal. I ran a low-grade fever off and on for a couple weeks and was on antibi-otics for 2 months. The fever finally went away, but thefatigue and headaches didn’t.

A couple months before my illness, I had completed agrueling year of comprehensive written and oral exams formy PhD. It was generally believed that between the flu and

the stress of the preceding year, I was run down and thatwith time and rest, I would get better.

After several months of little, if any, improvement, mydoctor performed a number of additional tests, all of whichcame back normal. Finally, she told me I had chronic fatiguesyndrome (CFS). Early in 1997, my doctor told me of a studyfrom Johns Hopkins linking CFS with neurally mediatedhypotension (NMH) and sent me to Hopkins for a tilt tabletest.

In April 1997, I tested positive for NMH, which I wouldlater discover is consistent with PH. A person with NMH hasexcessive dilation of the blood vessels in the legs. As a resultof the dilation, when the person stands, blood pools in thefeet rather than being pumped throughout the body, which inturn lowers the individual’s blood pressure. The doctor testingme observed that although my blood pressure dropped dur-ing the test, my heart rate rose, indicating my heart was try-ing to compensate for the drop in blood pressure by workingharder to pump blood throughout my body. This was unusualfor an NMH patient; normally an NMH patient’s heart ratewould fall. I began treatment for NMH, but it didn’t seem tohelp.

Around this time, results of studies linking phen-fen to PHwere being released to the public. At this point, I becameconcerned that maybe my symptoms were not NMH or CFS,but instead were related to my prior use of phen-fen. My pri-mary care physician sent me for an echocardiogram. Theechocardiogram showed some minor valve leakages butnothing else, so the cardiologist decided I did not have PH.Two years earlier, the echocardiogram showed a healthyheart, with no leakage or any other issue, major or minor. Inretrospect, the signs of PH were there, but the cardiologistwas not well versed enough in PH to recognize it.

I couldn’t shake the feeling that something else wasgoing on. I had read a book written by a doctor inAnnapolis, MD, about CFS and the successes he had treat-ing it. This doctor had CFS himself. His experience hadenough similarities to my own that I gave my primary carephysician a copy of his book and asked her opinion. Shesaid she had done all she could for me and gave me a refer-ral to this doctor in December 1997.

LaVerne Cash

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The difference in the two echocardiograms concernedme, so I asked the CFS specialist about them. I was told thattechnology had improved since the first echocardiogram andthat what I was seeing was an improvement in imagingcapability from 1995 to 1997. Later it would be discoveredthat this was not the case, but that PH was already present,and the second echocardiogram showed the progression ofthe disease during the two years.

Although the onset of the worst of my symptoms did fitthe pattern for CFS, there were some that did not. The vaguefeelings of lightheadedness and dizziness that worsenedwith heavy exertion did not fit. I was convinced there wasmore than CFS wrong with me, and it was phen-fen related.I repeated my history of phen-fen use to every doctor I saw.Each one told me I had not been on phen-fen long enoughfor it to be a contributing factor. Although the prevalent viewis that a person needs to have taken phen-fen for at leastthree months for associated problems to develop, one pul-monologist treating me for PH says he has seen peopledevelop PH after as few as three weeks of use.

My condition seemed to improve with treatment for CFS,but not as much as I had expected; something was still beingmissed. The fact that a year and a half later I felt much bet-ter, in my mind, was an indication that I did have some ele-ments of CFS; however, the symptoms I had prior to 1995(headaches, lightheadedness, and body aches) were stillthere, and if anything, were getting worse. I believed thatthese persistent symptoms were consistent with NMH, whichis a frequently occurring component of CFS. When I com-plained that NMH symptoms were still giving me problems,the CFS specialist recommended ephedrine. Ephedrine is avasoconstrictor as well as bronchodilator. For a while, itmade me feel a lot better. I attributed this to the bron-chodilator properties of the drug. The vasoconstrictor prop-erties would have further tightened already constricted arter-ies, eventually making the condition worse, not better.Indeed, over the course of time, my condition did get worse.By the time I stopped taking ephedrine in 2002, I couldn’t tellmuch difference in how I felt on or off the drug.

By late 2004, I couldn’t walk across a parking lot with-out getting winded and having to stop for breath. Going upa flight of stairs would almost make me pass out. At thispoint, I knew I could not live with this anymore.

In 1995, when I first became ill, my blood pressure aver-aged 100/70. Slowly over the years my blood pressure hadbeen creeping up. When it reached a level of 120/80(which is considered good), my doctors claimed the increasein blood pressure was the result of the medication correctingmy NMH. I didn’t buy it. If the medication was correcting myNMH, why didn’t I feel better rather than worse?

As my blood pressure crept up, so did my weightbecause I couldn’t exercise to keep it down. By late 2004,my weight had gone up to 230 pounds, the highest it hadbeen since high school, and my blood pressure hadincreased to a point that even the doctors were becomingconcerned. I decided it was time to take off some of the

weight I had gained, hoping that would improve my health.I started a weight-loss program at the local hospital. Thisdecision probably saved my life.

December 31 2004, New Year’s Eve: I went to theweight-loss center for my entrance exam. My blood pressurewas 160/100! The attendants suggested I see my doctor ifit continued to be that high. As I thought about it on the wayhome, I knew I needed attention, and I needed it now! Myregular doctor’s office was closed for the holiday, so I wentto Patient First. After a long wait, I was finally able to see adoctor. He hooked me up to an EKG and found somethinghe didn’t like. In no time I was on oxygen, had an IV in myarm, and was taken in an ambulance to the hospital.

I was in the hospital for two days undergoing the usualbattery of tests for heart patients. This time, the echocardio-gram revealed the problem. My right ventricle had enlargedto almost twice its normal size, indicating pulmonary hyper-tension.

The next month was among the scariest in my life.Everything I had been told or read about PH was not good.Test after test came back negative. Again, nobody could finda reason for PH. My thoughts were along the lines of, “Yeah,yeah, here we go again.” For 10 years, there was neveranything found to be wrong, and yet I seemed to get sickerand sicker. It was very frustrating and very depressing.

When all the testing was done, I was told I had primarypulmonary hypertension. I was sent to Johns Hopkins for aright heart catheterization. Prior to the catheterization. I metwith Dr. Reda Girgis of the Pulmonary Hypertension pro-gram. He talked to me about PH, explained the various treat-ment options, told me what to expect during the procedure,and answered my questions. During our conversation, heexplained to me that one of the things that would be doneduring the catheterization would be to have me breathe nitricoxide. He told me the nitric oxide probably wouldn’t haveany effect; the reason they had me do it was that in 10% ofthe population of PH sufferers, the increase in blood pressurein the lungs is the result of spasms causing the blood vesselsto constrict. In those cases, exposure to nitric oxide opens thevessels and the blood pressure temporarily goes down. Thatwas a best-case scenario, but it rarely happened.

A week later, following my catheterization, Dr. Girgisdiscussed the results. He said “Remember that lucky 10% Italked to you about last week? You are in it!” There had beena significant reduction in the blood pressure in my lungsupon exposure to nitric oxide. Dr. Girgis put me on gradu-ally increasing amounts of calcium channel blockers. He alsoindicated that if the calcium channel blocker brought theblood pressure down enough, the damage to my heart mightpartially reverse.

Within a few days of starting treatment, I was able toeasily walk up stairs again. At my second catheterization,the blood pressure in my lungs had gone down from 50 to33. Dr. Girgis said that normally he would be pleased withthat decrease, but in my case, he thought he could get thepressure down even more and increased my medication.

866-877-2676 Nurses Nurturing Nurses®

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For two months after my hospitalization, I was onextended medical leave from work. My supervisors were try-ing to talk me into going out on disability. Fortunately, withina month of starting treatment, I was able to go back to work.As of this writing, I continue to do well with calcium channelblockers. An echocardiogram taken in April of 2006revealed partial healing of my heart. There was normal func-tion of the left heart, and the enlargement of the right ventri-cle was significantly reduced. A repeat right heart catheteri-zation in November 2006 showed that the blood pressure inmy lungs was only mildly elevated. I now walk one to twomiles most days of the week. I walk up two flights of stairs tomy office every day, participate in aerobics class once aweek, work a full time job, and am active in my church.

LaVerne Cash is an Operations Research Analyst for the U.S.Army Evaluation Center.

Editor’s Note: This article is a companion piece to "PulmonaryHypertension Requires Creative Nurses," by Dee A. Jones, BSN,RN (beginning on page 1 of this issue), and focuses on a patient'sordeal with pulmonary hypertension.

Attend the 2006 AMSNAnnual ConventionYear Round

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Drugs Being Studied to TreatPulmonary Hypertension

There are a number of drugs being investigated to treatpulmonary hypertension. Some are approved for other con-ditions; some are still in the investigation phase.

Bereprost® is a prostaglandin analog and worksdirectly on the pulmonary circulation, acting as a vasodila-tor. While this drug is not yet FDA-approved for pulmonaryhypertension, it is showing significant promise in clinicaltrials. So far, the major reactions to this drug includeheadache and facial flushing, both of which were dosage-related.

Epoprostenol (Flolan®) is a prostaglandin that acts asa vasodilator and platelet aggregation inhibitor.Epoprostenol has been approved for treatment of pul-monary hypertension since 2005 and has been shown toimprove symptoms and increase survivability.Epoprostenol must be kept refrigerated. “If usingepoprostenol at ambient temperatures above 25 degrees C(77 degrees F), a cold pouch or other insulation device mustbe used” (Clinical Pharmacology, 2007). Epoprostenolshould be administered via a central catheter due to its shorthalf life of approximately six minutes (ClinicalPharmacology, 2007).

Another prostaglandin used for pulmonary hyperten-sion is iloprost (Ilomedin®, Ventavis™). Iloprost isinhaled. Advantages of inhaled prostaglandins over intra-venous include increased patient compliance and less sys-temic absorption.

Treprostenil (Remodulin®; Uniprost™, and UT-15) is a form of epoprostenol that does not require refriger-ation and can be administered via subcutaneous infusion.

Sildenafil (Revatio™; Viagra®) is a phosphodi-esterase inhibitor that has been found to be very useful forthe treatment of pulmonary hypertension. By relaxing pul-monary vascular smooth muscles, this drug acts as avasodilator, improves mean pulmonary artery pressures,and improves cardiac function. It should not be used con-currently with nitrates. “According to Pfizer Inc., clinicaltrials have demonstrated that sildenafil (Revatio™) 20 mgtaken three times daily was effective for the treatment ofPAH in comparison to placebo. The most common sideeffects reported with therapy were headache, stomachupset, flushing, nosebleeds, and insomnia” (McAuley,2005).

ReferencesClinical Pharmacology. (2007). Epoprostenol. Retrieved March 3,

2007, from http://www.clinicalpharmacology-ip.com/McAuley, D.F. (2005). The current role of sildenafil citrate in the

treatment of pulmonary arterial hypertension. Retrieved March3, 2007, from http://www.globalrph.com/sildenafil.htm

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lowed. Even though a medication error did not occur dur-ing the time I was present, I feel that the current medica-tion administration process will surely result in errors.

My son was alert and oriented, and he questionedeach medication prior to administration. Consider thosevulnerable patients who cannot actively participate intheir care – those who are cognitively impaired, thosewho are unable to communicate, and those without fam-ily advocates.

Nurses across the country share with me that theystrive to provide excellent care but feel stressed when theymust accomplish so much for multiple acutely ill patients. Ibelieve nurses save lives, improve outcomes, strive to pro-vide the best care possible, and sometimes must do sowith limited resources and time. I also believe that someof the simple measures that improve patient safety do notrequire a large amount of resources or time. Examiningan armband, asking a patient to state his or her name,and checking a medication administration record requirevery little time but can make a dramatic impact on patientoutcomes. Simply saying, “Good morning,” takes very lit-tle time but is meaningful to the patient and family.

I am appreciative that my son’s outcome was positive.I will use this experience to reinforce what I teach my stu-dents as well as how I approach patients – the patients inour care are someone’s spouse, parent, child, sibling,loved one, and/or friend. Provide patients the nursingcare you would want your loved ones to receive. Aren’tpatients, after all, the reason we are nurses?

Kathleen A. Reeves, MSN, CNS, CMSRNAMSN President

President’s Messagecontinued from page 2

Diana Anderson Named NewEditor for MedSurg Matters

The AMSN Board of Directors ishappy to announce that DianaAnderson, BSN, RN, CMSRN, hasaccepted the role of Editor forMedSurg Matters. Diana accepted theposition in late December, and herresponsibilities as Editor began onJanuary 1, 2007.

Diana brings a wealth of experi-ence to this position, having begun her career in nursing in1986. Currently the Clinical Educator for the Medical-Surgical Unit at Navapache Regional Medical Center inShow Low, AZ, she has held the position of Director at vari-ous institutions, including Dalworth Nursing andRehabilitation Center, Arlington, TX; Vencor Hospital,Arlington, TX; and The Carrolton, Fayetteville, NC. She wasa Nursing Supervisor and Skilled Nursing Unit Manager atStokes-Reynolds Memorial Hospital in Danbury, NC, and aStaff Nurse in the Neurosurgery Unit at North CarolinaBaptist Hospital, Winston-Salem, NC. At present, Diana isworking on her Masters in Nursing Education through theUniversity of Phoenix.

In addition, Diana has served active duty in the UnitedStates Army from 1975-1979. She has also served with theNorth Carolina State Guard as Chief Nurse from 1989-1995 and in the Texas State Guard from 1995-1999, whereshe achieved the rank of Major.

Since Diana’s membership with AMSN in 2004, shehas been very active in the organization. She has beenChapter President of Chapter #411, a member and eventualchairperson of the Chapter Development Committee, a mem-ber of the AMSN Convention Program Planning Committee,a speaker for the AMSN Annual Convention, has authoredarticles for MedSurg Matters, and has attained certificationin medical-surgical nursing through the MSNCB. Outside ofAMSN, Diana has been active within her institution by serv-ing as editor for the unit’s bi-weekly newsletter.

Diana is happy to hear from all members of AMSN.Whether you wish to write a feature article or a brief storyabout why nursing is important to you, she wants to know!

In addition, the AMSN Board of Directors and the staffat Anthony J. Jannetti, Inc. thank Marlene Roman for herloyal dedication as former Editor of MedSurg Matters. AsMarlene takes on additional responsibilities in her role asPresident for MSNCB, we will look to her for leadership andinnovative ideas that she has continually brought to AMSNand MSNCB.

Again, we extend our congratulations to Diana and lookforward to her role as Editor of MedSurg Matters!

MedSurg Matters welcomes news from AMSN mem-bers. If you have a news item or article that you wouldlike published, send it along with your name, address,phone number, and other comments/suggestions to:Carol Ford, Managing Editor; East Holly Avenue/Box56, Pitman, NJ 08071-0056 Fax: 856-589-7463, Email:fordc@ajj.com

Send us Your News

IssueJuly/August 2007Sept/Oct 2007Nov/Dec 2007

DeadlineMay 15, 2007July 15, 2007

September 15, 2007

The official online job bank of the Academy of Medical-SurgicalNurses, the AMSN Career Center, offers the most targetedresource available for medical-surgical nurse professionals.Whether you’re looking for the perfect opportunity or the perfect candidate to fill an open position in your facility,

your perfect match is just a click away.

Visit www.MEDSURGNURSE.org and click on Careers or contact the Customer Care Center at 888-884-8242

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New AMSN Chapters Formed

Midwest Chapter #316Congratulations to the Midwest Chapter

#316, which earned its charter in February2007. Based in Quincy, IL, the chapter hasappointed the following officers:President: Karen Koenig, BSN, RN,

CMSRNPresident-elect: Angela S. Loos, BSN,

CMSRNSecretary: Jonita Brunier, RNTreasurer: Jolinn Huebotter, BSN, RN

The Midwest Chapter plans to meet on thefirst Tuesday of every other month. Goals ofthe chapter will be to provide outstanding careto medical-surgical patients in the communityand to improve the image of the professionalmedical-surgical nurse. Chapter objectives areto enhance the professional growth of chaptermembers and the medical-surgical nurses inthe tri-state area, and to facilitate communica-tion and collaboration among medical-surgi-cal nurses in the Midwest Medical-SurgicalNurses Association area.

Midlands Chapter #228Congratulations to the Midlands Chapter

#228, which was granted its charter inFebruary 2007. Officers for the MidlandsChapter include:President: A. Darlene Hudson, RN,

CMSRNPresident-elect: Lisa R. Page, RN,

CMSRNSecretary: Anneda Wallace, MS, RNTreasurer: Ronella F. Eaddy, RN

Based in Columbia, SC, the chapter hasestablished the following goals: • To provide a network opportunity for

adult health and medical-surgical nursesin the South Carolina Midlands region.

• To increase membership in the nationaland local chapter.

• To promote the professional image ofadult health and medical-surgical nursingwithin the medical community.There is a one-time membership fee of

$10, and the chapter will meet every othermonth. Upcoming meetings will feature top-ics on orthopedic injuries and treatmentmodalities, prevention of DVT, and commu-nity-acquired MRSA.

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Mary had just arrived on the Med-Surg Unit fol-lowing surgery for a ruptured appendix. Shewas in severe pain, rating her pain at a 9 ona scale of 0 to 10. Her receiving nurse on theMed-Surg Unit checked Mary’s admissionorders and saw that Mary could have 6 mg

of morphine sulfate IV. After checking Mary’s identificationband and allergies, the nurse administered the 6 mg. of mor-phine. The nurse then went to answer another patient’s call.Nine minutes later, when the nurse re-entered Mary’s room,she found Mary unresponsive with a respiratory rate of 6.

Timothy was admitted to a Med-Surg Unit from a long-term care facility for treatment of an infected pressure ulcer.The admitting physician wrote in his admission orders tocontinue all medications from the long-term care facility. Thenurse used the medication sheet provided by the facility towrite the medication orders. Two days later, Timothy was notdoing well, exhibiting severe hypotension and cardiac dys-rhythmias. A nurse reviewing Timothy’s chart discoveredthat the original medication list provided by the long-termcare facility was actually for a different patient, and Timothyhad been receiving 17 medications for conditions that hedid not have. These medications included cardiac medica-tions, blood thinners, and anti-hypertensives. Timothy recov-ered, but his stay was extended by 8 days due to this med-ication error.

Florinda was admitted to a Med-Surg Unit for treatmentof a central venous catheter (CVC) infection. The CVC hadbeen placed as an outpatient procedure 4 days prior forchemotherapy administration. Florinda presents today withfever, redness and drainage at the insertion site, and gen-eralized malaise.

What do these patients have in common? Each of thesepatients experienced medical harm. Harm is defined by theInstitute for Healthcare Improvement (IHI) as, “Unintendedphysical injury resulting from or contributed to by medicalcare (including the absence of indicated medical treatment),that requires additional monitoring, treatment, or hospital-ization, or that results in death. Such injury is consideredharm whether or not it is considered preventable, resultedfrom a medical error, or occurred within a hospital” (n.d.).“IHI estimates that 15 million incidents of medical harmoccur in U.S. hospitals each year. This estimate of overallnational harm is based on IHI’s extensive experience instudying injury rates in hospitals, which reveals thatbetween 40 and 50 incidents of harm occur for every 100hospital admissions” (Patient Safety & Quality Healthcare,

2007, p. 6). Because it is estimated that approximately40,000 medical errors occur each day in the United States,the IHI is spearheading the 5 Million Lives Campaign.

The 5 Million Lives Campaign is intended to protect thelives of 5 million patients over the next two years from med-ical harm. There are 12 areas identified where additionalinterventions could decrease harm. The first 6 areas arefrom the 100,000 Lives Campaign, and the second 6 areadditional areas that have been identified as areas that areprone to medical harm. The resulting 12 areas include:

• Develop Rapid Response Teams. Don’t wait for acode to happen; early intervention saves lives!

• Provide evidence-based care for myocardial infarc-tions to prevent cardiac deaths.

• Develop systems for reconciliation of medications.• Prevent infections at surgical sites by the appropriate

use of pre- and peri-operative antibiotics.• Prevent development of central line infections using

evidence-based procedures.• Prevent ventilator-associated pneumonia.• The Surgical Care Improvement Project

(www.medqic.org/scip) was developed to reducesurgical complications.

• Develop evidence-based measures to prevent pres-sure ulcers.

• Develop programs to prevent medication errors relat-ing to high-alert medications. The Campaign focusesspecifically on reducing errors related to anti-coagu-lants, narcotics, insulin, and sedatives.

• Use evidence-based practices to reduce Methicillin-Resistant Staphylococcus Aureus (MRSA) infection.

• Decrease readmissions for congestive heart failurepatients using evidence-based care

• “Get Boards on Board.” Encourage hospital boardmembers to support the 5 Million Lives campaignand proactively work towards providing safe care inhospitals (IHI, n.d.).

The 5 Million Lives Campaign is built on the successesexperienced by the IHI’s 100,000 Lives Campaign. Over3,000 hospitals participated in the 100,000 Lives project,and an estimated 122,000 lives were saved over 18months as a direct result. Because of that overwhelming suc-cess, the 5 Million Lives Campaign hopes to involve evenmore hospitals in an effort to protect 5 million people fromexperiencing medical harm between December 2006 and

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December 2008. Many organizations are becoming activein this Campaign. The American Nurses Association isencouraging nurse leaders to get involved and offers addi-tional information for nursing activities on its Web site(http://nursingworld.org/patientsafety/).

There is no cost to hospitals wishing to participate in the5 Million Lives Campaign. Hospitals are requested, though,to select at least one intervention and provide feedback tothe IHI on progress made. The IHI provides many tools foruse in implementing the interventions on their Web page(http://www.ihi.org/IHI/Programs/Campaign/Campaign.htm?TabId=2).

The 5 Million Lives Campaign is all about patient safety.If Mary’s hospital was a participant in this campaign, per-haps nursing actions involving high-alert medications, suchas narcotics, would have had further emphasis placed onknowing potential side effects, cumulative actions, and inter-actions with other medications. Timothy would have bene-fited from a medication reconciliation system that validated

medications prior to admission and compared them tomedications ordered after admission. Florinda may haveavoided an inpatient admission and potential sepsis if evi-dence-based care measures were in place at the time shereceived her central line.

IHI’s motto for this campaign is:Some is not a number. Soon is not a time.The number is five million. The time to start is now.

Medical-surgical nurses are in the position to influencethe care received by their patients. Now is the time fornurses to become active and encourage hospitals andhealth care organizations to get involved in this project.Make a difference. The time to start is now. There are 5million patients waiting.

Diana Anderson, BSN, RN, CMSRNEditor, MedSurg Matters

ReferencesAmerican Nurses Association. (2007). Effecting positive change

in patient safety/advocacy. Retrieved March 5, 2007, fromhttp://nursingworld.org/patientsafety/

Institute for Healthcare Improvement. (n.d.). Protecting 5 million livesfrom harm. Retrieved March 5, 2007, fromhttp://www.ihi.org/IHI/Programs/Campaign/Campaign.htm

Patient Safety & Quality Healthcare. (2007). IHI launchesnational campaign to reduce medical harm. RetrievedMarch 5, 2007, from http://www.psqh.com/jan-feb07/5million.html

AMSN’s Management Company, Anthony J. Jannetti, Inc.,Receives Association Management Company Accreditation

Anthony J. Jannetti, Inc. (AJJ), AMSN’s management com-pany, has been recognized by the American Society ofAssociation Executives (ASAE) as an accredited associationmanagement company (AMC). This is the highest recognitionan AMC can receive.

AJJ (www.ajj.com) has managed AMSN for 16 years,providing full-service association management, public relationsand marketing, creative design and publishing, corporatesales, professional education, Web site and Internet, member-ship and database management, and conference managementservices. AJJ publishes AMSNs official journal, MEDSURGNursing: The Journal of Adult Health, and official newsletter,MedSurg Matters.

“This is such an honor for AJJ,“ said Anthony Jannetti, AJJpresident. “We will continue to meet and exceed the standardsendorsed by ASAE by providing outstanding management ser-vices to AMSN.”

ASAE’s AMC accreditation is a voluntary process that val-idates a company meets the standards set forth by ASAE’sAccreditation Commission. This program identifies quality

AMC services, assesses the procedures of individual AMCs,formally recognizes those AMCs that meet requirements setforth by the AMC Accreditation Commission, and improves thequality of services provided to the association community.

“AMC accreditation distinguishes AJJ’s leadership anddemonstrates our company has met industry-established stan-dards for top-quality management services. Over 500 AMCsexist, and only 66 companies, including AJJ, have achievedaccreditation,” said Cyndee Nowicki Hnatiuk, EdD, RN, CAE,AJJ vice president for organizational development andAMSN’s executive director.

The American Society of Association Executives(www.asaecenter.org) is an individual membership organiza-tion of more than 22,000 association executives and industrypartners representing nearly 11,000 organizations. Its mem-bers manage leading trade associations, individual member-ship societies, and voluntary organizations across the UnitedStates and in 50 countries around the globe, as well as pro-vide products and services to the association community.

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Chapter DevelopmentCommittee News

Communication plays such a large role in our profes-sion. We communicate with patients, families, peers, andproviders every day! Communication helps keep our patientsalive and well, and plays a huge role in our professionalnursing organization. Communication keeps our chaptersand our whole organization alive and thriving. I was think-ing the other day how communication is so important for ourchapters. This is the reason for this “Chapter DevelopmentTip.” I see the importance of communication affecting ourchapters in so many ways, but I am just going to limit my tipto communication within the chapters and focusing onrecruitment for your chapter

Take a minute to think about how you communicate withyour fellow chapter members. Do you network through e-mailbetween meetings? This is an excellent medium for commu-nication between the times you meet. It is also an excellentretention tool for your chapter. A few times a month, you arenetworking with a group of peers – asking questions, lettingothers know of accomplishments, or just sending remindersof upcoming meetings or educational events. I have set up aspecial group list in my e-mail for members of my chapter. Itis simple to send out a group e-mail to network with my peersbetween meetings. You can also add non-members to yourlist who attend your meetings. Use this as a recruitment toolto encourage non-members to join! Add them to your list sothey receive your emails (ask their permission first) and canlearn all that AMSN and your chapter have to offer.

The other important communication tip I want to pass onrelates to recruitment. I keep lines of communication openwith the local hospitals in my area. In order to revitalize ourchapter, I sent a letter to the Chief Nursing Officers and theMedical-Surgical Nurse Managers of many local hospitalseducating them about AMSN and our local chapter. I offeredmy time for staff meetings to talk about the organization andthe many benefits that come with membership. You will bepleasantly surprised at the responses you receive!

Now I want to hear from you! Please e-mail me withyour tips. Let me know what communication methods did anddid not work in your chapters. I will summarize the results inanother issue so we can learn from each other. You can e-mail me at mfrace@yahoo.com. Until next time, keep thoselines of communication open!

Mike Frace, MSN, RN, RRTChair, AMSN Chapter Development Committee

News fromCOMMITTEES

Clinical Practice Committee Update

The Clinical Practice Committee has a full agenda forthe coming year. The members are working with the 2007Convention Planning Committee to organize a breakout ses-sion at the 2007 Annual Convention in Las Vegas. TheAMSN Clinical Practice and Leadership awards are underrevision. The goal is to make the selection criteria more con-cise and facilitate the nomination process. Self-nominationwill be an option for 2007.

A module on evidence-based practice was developedlast year to supplement the work already in progress by theResearch Committee. The module will be linked to the AMSNWeb site after revisions have been made. Also on theagenda for the Clinical Practice Committee is the review ofposter abstracts for the convention and updating the AMSNScope and Standards. With the number of tasks to complete,the Clinical Practice Committee will be looking to expand itsmembership over the coming months with enthusiasticAMSN members! If you are interested in joining the CRC,complete the “Willingness to Serve” form online. Visitwww.medsurgnurse.org, click on “Committees,” and select“Willingness to Serve.” We welcome your talents!

Jill Arzouman, MS, APRN, BC, CNS – SurgeryChair, AMSN Clinical Practice Committee

Legislative Policies & IssuesCommittee Update

The Legislative Policies & Issues (LP&I) Committee isresponsible for maintaining the legislative page of theAMSN Web site. This page contains information of interestabout legislative issues, including legislation and policiesapproved by AMSN, as well as other legislative informationpresented for your information, links to legislative informa-tion, and how to write to your legislator.

The LP&I Committee is excited to announce the additionof an interactive Web sticker to the Web site allowing you tosearch for the elected officials in your area or for informationabout specific legislation. We have also added referenceinformation, such as nursing-related Congressional commit-tees, and the Federal Budget and Appropriations Primer2007 prepared by the American Nephrology Nurses’Association (ANNA).

We are working on information about lobbying tech-niques and continue to monitor various Web sites for infor-mation about legislation of interest to med-surg nurses. Websites being monitored include ANA Federal Advocacy,League of Women Voters, National Council of State Boardsof Nursing, Centers for Medicare and Medicaid Services,NLN Public Policy Action Center, Capitol Update, andCongressional Quarterly.

Cindy Ward, MS, RNC, CMSRNChair, LP&I Committee

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Certified Medical-Surgical Registered Nurse (CMSRN)is the earned credential recognizing that the highest stan-dards of medical-surgical nursing practice have beenachieved. You can become certified by successfully com-pleting the MSNCB examination.

Exams are offered at the above locations. Additionalsites may be added for 10 or more candidates. Local sitesare subject to cancellation for insufficient registration.

For more information and submission deadlines,contact:

MSNCB CertificationEast Holly Avenue/Box 56 Pitman, NJ 08071-0056

Phone: 856-256-2323 • Fax: 856-589-7463E-mail: amsn@ajj.com Web site: www.medsurgnurse.org

Scottsdale, AZScottsdale, AZLos Angeles/Burbank, CASan Diego, CASan Francisco/Burlingame, CAWalnut Creek, CADenver, COHarford, CTNewark, DEOrlando, FLPompano Beach, FLSt. Augustine, FLAtlanta, GASavannah, GAHonolulu, HIChicago, ILFt. Wayne, INIndianapolis, INBaton Rouge, LABaltimore, MDBoston/Framingham, MALansing, MISt. Paul MNKansas City, MOSt. Louis/Chesterfield, MO

Charlotte, NCOmaha, NEFreehold, NJAlbuquerque, NMNew York, NYRochester, NYStony Brook NYCincinnati/Blue Ash, OHCleveland, OHPortland/Tualatin, ORPhiladelphia/Bensalem, PAPittsburgh, PAColumbia, SCMemphis, TNNashville, TNDallas, TXHouston, TXSan Antonio, TXAlexandria, VACharlottesville, VAVirginia Beach, VARichmond, VASeattle, WASpokane, WATacoma, WA* (*given on following Sunday)Milwaukee, WI

May 5, 2007 • October 13, 2007

EXAM DATES and LOCATIONS

Professional DevelopmentTask Force

The Professional Development Task Force is developinga program that will be comprised of four modules to bedeveloped from outlines. Team Building is the first of ourmodules and is currently under development. Several newcommittee members have joined us and are working with ourprevious members researching and writing the module.Other modules will be developed on Clinical Leadership,Communication, and Problem Solving/Critical Thinking. Thegoal of these modules is to provide greater leadership skillsand respect for the medical-surgical nurse at the bedside. Aswe develop the modules, we are also considering how topresent or offer the modules, what will be the final presenta-tion format, and how we will get that accomplished.

Nancy Janes, RN, BCClinical Educator, St. Francis Hospitals

The Public Relations Task ForceThe Public Relations Task Force was formed after a

brain-storming session during which the AMSN Board ofDirectors developed a new strategic plan. The goal of the PRTask Force is that the national and international health carecommunities will increasingly recognize AMSN as the expertin adult health. The first task was to develop an action planto meet our first objective “increase public awareness andthe image of AMSN.” During our first conference call, thetask force identified our external audience, which includedhospitals, directors of nurses, clinical nurse specialists, hos-pital educators, and case managers. This strategy was com-pleted in January 2006.

We then identified strategies for promoting AMSN toour key audiences. We developed a Hospital GroupMembership Program that is being piloted by the ClevelandClinic. The pilot has been in progress for one year, and theCleveland Clinic has renewed its commitment with AMSN.We are expanding this program to other interested groups.Please contact Sue Stott at the National Office or visit theAMSN Web site (click on “Membership” and select “GroupMembership” for program details). We worked on develop-ing a key message for AMSN, but we decided we alreadyhad one, and with the approval of the Board of Directors, wekept “Nurses Nurturing Nurses,” which is truly the essence ofwho we are. The task force also developed a new member-ship brochure that was available during last year’s annualconvention.

We have made significant strides over the past year,and we are committed to reaching AMSN goals for now andin the future!

Doris G. McQuilkin, MA, BSN, RNChair, Public Relations Task Force

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Blum, 2006, p. 29). The best time toarrange this type of follow-up would bebefore the patient is discharged home.Careful resource planning is very essen-tial for the nurse to ensure safe dis-charge for the patient.

SummaryPulmonary hypertension does not

have to be a medical mystery to themedical-surgical nurse. With the propereducation and keen assessment skills,the patient will have improved out-comes and better of quality of life.Creative specialists at the bedside givefirst-line care to those in the hospital.Medical-surgical nurses are the link thatcompletes a continuum of care.

Dee A. Jones, BSN, RN, is the CareCoordinator for Perry Point VA, MD, andthe Care Coordination Home TelehealthProgram; she is also the Medical-SurgicalVisiting Professor and Clinical Instructor atHarford Community College, Bel Air, MD.She may be reached at: P.O. Box 833,A.P.G., MD; 410-272-4740; e-maildenurs98@aol.com. Visit www.denurs98.zoomshare.com for more information.

ReferencesGottlieb, S., & Blum, K. (2006).

Coordinated care, telemonitoring,and the therapeutic relationship:Heart failure management in theUnited States. Disease Managementand Health Outcomes, 14(Suppl 1),29-31.

Sommers, M.S., Johnson, S.A., & Beery,T.A. (2007). Pulmonary hypertension.In Diseases and disorders: A nursingtherapeutics manual (3rd ed.) (pp.796-797). Philadelphia: F.A. DavisCompany.

Steinbis, S. (2006). What you shouldknow about pulmonary hypertension.The Nurse Practitioner, 29(4). 8-19.

Left Ventricular Failure Right Ventricular Failure

Systemic hypotension Jugular venous distension

Low urinary output Peripheral edema

“Click” at the left sternal border Hypertrophy of the right ventricle

Syncope Increased central venous pressure

Table 1.Left Ventricular Failure vs. Right Ventricular Failure

Hyperventilation and coughingleading to dyspnea, and decreasedbreath sounds indicate that the patientneeds immediate attention. It is alsoimportant to provide careful examina-tion of the skin and urinary system(Sommers et al., 2007). Patients withPH usually undergo heart catheteriza-tions to measure the pressure in thelungs. Assessment of pain, respiratoryfunction, and monitoring for signs ofbleeding are vital after this procedure.Sterility of the catheter insertion siteshould also be maintained (Sommers etal., 2007).

Sommers et al. (2007) maintainthat the assessment of a patient’s anxi-ety level is significant, as anxiety reduc-tion assists to preserve the patient’senergy. Support for the patient andfamily is needed throughout the hospi-tal stay. The nurse or clergy may pro-vide spiritual support during this time ofcrisis.

Collaborative CareCaring for the patient with PH will

take team effort; yet, the medical-surgi-cal nurse is at the bedside providingfirst-line care to the patient. Nurses arethe link between the patient and theinterdisciplinary team. Good communi-cation and documentation are highlybeneficial to the patient’s recovery. Themedical-surgical nurse uses great detailin documenting vital signs, cardiovas-cular and pulmonary physical assess-ment data, and responses to medica-tion, diet, fluids, oxygen administration,and any changes in the patient’s status(Sommers et al.,2007).

Management of the patient with PHincludes administration of medications,such as diuretics, anticoagulants,vasodilators, and sildenafil (Viagra®).Other medications, such as bron-chodilators, may be ordered as well.Therapy is aimed at maintaining asmuch cardiac function as possible(Sommers et al., 2007). The medical-surgical nurse needs to have knowledgeof these medications and their indica-tions (see Drugs Being Studied to TreatPulmonary Hypertension on page 5).

Pulmonary Hypertensioncontinued from page 1

Discharge planning begins the firstday of admission for this patient. Notonly is it necessary for the nurse to planfor the physical needs of the patient, butthe patient’s spiritual needs must also beaddressed, thus providing holistic care.Discharge planning will focus on educa-tion about anticoagulant therapy, signsand symptoms of bleeding, low-salt diet,weight control, and good hydration. Ahome assessment is warranted as well.The patient with PH may go home onoxygen therapy; thus, additional educa-tion is necessary for the patient and fam-ily concerning equipment usage andsafety (Sommers et al., 2007).Education should begin as early as pos-sible.

Resources for this patient includesupport groups, spiritual care, and pal-liative care if needed. Many patientswith PH are often diagnosed at a latestage in the disease, and treatmentoptions are limited to medication andlung transplantation. Exercise for thepatient with PH is still under investiga-tion. Rehabilitation is geared towardestablishment of the patient’s activitylevel (Steinbis, 2006).

The Future of PH ResearchMedication is the focus of research

for PH at present. Sildenafil is the firstoff-label medication to be used in somefacilities. Sildenafil causes selective pul-monary vasodilation and is very effec-tive in low doses. Inhaled nitric oxidedilates the pulmonary vasculature, but itis very expensive (Steinbis, 2006).

In a university study, data from a“telemonitoring programme confirmedthat the close follow-up of patients ledto improved quality of life” (Gottlieb &

The Conference for Clinical Excellence

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Northern Nevada Chapter #408regrouped in June 2006 after being dormant for a couple ofyears. Since then, we have raised more than $600 in salesof our polo shirts and fees we charge for monthly dinners.We have also brought in more members. Each month, wehave a dinner sponsored by a vendor and a presentation forwhich nurses can receive CNE credit. Either the vendor pre-sents or we find a speaker on a medical-surgical topic. Sometopics that have been presented include pressure ulcer pre-vention, kyphoplasty, PICC care and maintenance, andmethamphetamine abuse. Over the next 3 months, we havescheduled presentations on infected wounds, blood man-agement, and PET scans. We charge non-members $10 toattend, and members are always free. Since we regrouped,we have had an additional incentive – no local dues untilJune 2007. Nurses have found the dinners to be a greatplace to obtain information, receive CNE credit, and net-work with their peers. I have a member e-mail list and a non-member e-mail list. The members get the e-mails about thedinner about a week before the non-members to give themthe first chance to reserve a seat since it is on a first-come,first-serve basis.

When we register nurses, we also give them handoutson upcoming events and opportunities related to the nursingcommunity, such as walk-a-thons, other nursing organizationmeetings, and classes offering CNE credit. The nurses findthis useful, and they know they can only get the list at the din-ners. Right before dinner, we have a member meeting wherewe discuss volunteer opportunities, upcoming events, andwhat we plan to do with all that money! Right now, we aredeciding how much to give each officer to go to the con-vention, and the rest we are planning on starting scholar-ships for nursing students in our chapter’s name.

We also participate in volunteer events such as immuniza-tions clinics, walk-a-thons, and hold membership drives at thelocal hospitals and nursing schools, all while wearing our AMSNshirts. Another thing we discuss is how exciting convention is.

– Terry Ditton

San Diego Chapter #412 would like toannounce a first-of-a-kind event here in San Diego that tookplace on March 15, 2007. Three professional organizationspresented, “A Tale of Three Cultures.” This dinner conferencefeatured specialists in the industry that looked at patients asthey cross the specialties of orthopedics, med-surg, and oncol-ogy. This was a joint event that was sponsored by the SanDiego Chapter of AMSN, the Oncology Nursing Society, andthe National Association of Orthopaedic Nurses.

– Adrian Han Miu, MSN, Chapter President

South Central Indiana Chapter #312 iscurrently holding elections. Results were announced at theMarch 12th meeting, held at Kings Daughters Hospital inMadison, IN. Our January 8th meeting was held at ColumbusRegional Hospital, and Jo Tabler, RN, CEN, Flight Nurse with

Charlotte, NC, Chapter #225 is busy get-ting ready for our first CMSRN Review Course. We areputting the Review Course on ourselves using the officialReview Course material. We have instructors lined up tospeak on their areas of expertise. We also have drug repre-sentatives coming to serve us lunch and to talk about theirproducts. We see this not only as a big help for those we areencouraging to take the exam, but also as a fund raiser andrecruitment tool for our chapter.

The review course dates are April 21-22 at PresbyterianHospital in Charlotte, NC. We now have about 20 peopleregistered. If this goes well, we plan to do this every year.

– Jodi Taylor

Long Island Chapter #112 has been busythis year! We will be hosting our 2nd Annual EducationalDay on April 14, 2007, from 8:30 a.m. – 3:00 p.m. at theStony Brook University Medical Center Technology Park. Thisyear’s topic, “Evidence-Based Practice,” will include 5 CNEcredits. Speakers from several hospitals across Long Islandwill be making presentations on evidence-based practicesthat their hospitals have applied to clinical practice. The costis $30 for members, $40 for non-members, and $15 for stu-dents. At the Education Day, we will be raffling off the twomemberships we received at last year’s convention for receiv-ing the Educational Achievement Award.

Nursing students from Suffolk Community Collegeattended our September 2006 meeting.

We donated $200 to a local shelter at Christmas and willdonate $200 to another shelter this spring. Finally, we will behaving a Master of Nursing Education student present a lec-ture on Cerebrovascular Accidents at our March meeting.

– Karen Tronolone, RN, MPA, BC

Northern Arizona Chapter #411 is plan-ning a busy spring. With money raised during several fund-raisers this winter, the chapter plans to offer four membershipscholarships to local nursing students who are interested inbecoming med-surg specialists. A legislative meeting is beingset up in the spring to meet with our local StateRepresentative and other elected officials to discuss currentlegislation that affects nurses. The chapter has submitted twoposter abstracts for the AMSN Annual Convention that arebeing worked on by the whole chapter. At the March meet-ing, we assembled a slate to elect new officers. We are alsoplanning fund-raisers to send as many members to conven-tion as we can!

– Pam Prorok, BSN, RN, CMSRN

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PHI Flight Services, presented, “Cold Emergencies.” Jo did anexcellent job, and everyone in attendance verbalized that theylearned something new and useful.

Linda Zapp, RN, MSN, CNS, presented a program on“Multi-generation Communication” at the March 12th meet-ing. We all work side-by-side with colleagues from other gen-erations, and everyone thinks differently.

Our May meeting will be hosted by Schneck MedicalCenter and will be held Monday, May 14, 2007, at 6:30p.m. The program is to be announced. Our chapter voted topromote nursing to elementary school students as part of theNursing 2000 campaign. If you would like to be involved inthis fun project, please contact Sharon Taylor atstaylor1@crh.org. The title of the program is, “Nursing isAmazing,” and Nursing 2000 provides literature and videosto assist us.

We would love for you to become involved in our chap-ter. Our local dues are $20.00 per year and can be mailedto Cindy Clark, RN, at 11272 S. County Road 700 W,Westport, IN 47283. Also, if you would notify the AMSNNational Office that you are a member of Chapter 312, itwould help us track our chapter membership. The contact atAMSN is amsn@ajj.com.

– Sharon Taylor

Southeastern Wisconsin Chapter #314is only 8 months old, but we’ve accomplished a lot in a shortperiod of time. Our members have been very fortunate tohear several speakers give outstanding presentations. Dr. IanGilson presented, “Nursing Care of the AIDS Patient,” Dr.Kathryn Schroeter presented “Dealing With Difficult Peoplein the Workplace,” Theresa Bronson, NP, presented“Diabetes Management,” and Linda Botts and Laura Pippodid a presentation about the Southeastern WisconsinMedical Reserve Corps, encouraging our membership toconsider joining and giving back to their community.

We have participated as a chapter to help support thevulnerable populations in our community by collecting anddonating personal care items and winter coats, scarves, mit-tens, and hats to the Milwaukee Rescue Mission. On NursesDay, May 6th, we will be getting together as a chapter toparticipate in this year’s MS Walk.

Four of our members attended the AMSN Convention inPhiladelphia this past year. Melissa Paulson-Conger, one ofour members, took the encouragement from Chapter leader-ship to enter the essay contest sponsored by the AMSNFoundation for the Nurse in Washington InternshipScholarship (NIWI) and won! She attended the meeting inWashington, DC, in March and will present her experiencethis summer. Two of our members attended the Nurses Dayat the Capitol on March 6, and they will also be giving pre-sentations regarding their experiences.

This is just a little view of what we’ve been doing. Weare all very excited and proud to be Southeastern WisconsinChapter #314 of the Academy of Medical-Surgical Nurses!

– Brenda Baranowski RN, CMSRN, CHPN

Southern Nevada Chapter #413 meetsevery second Wednesday of the month. Each month wehave an education program. February’s program topic was“Confusion Assessment of the Older Adult,” presented byKevin Gulliver, MSN, RN, CEN, from UNLV’s School ofNursing. Future monthly topics include a Wound CareUpdate and “How to Be a Preceptor to a Student Nurse.”

– Jan Austin, MA, RN, CHCP

The Heart of America Chapter #313is in the midst of planning our Spring Med-Surg ReviewCourse scheduled in March and April 2007. In February, wehad a CNE offering on Holistic Nursing. We are planningour Community Service Activity with the HarvestersOrganization in Kansas City for later in the Spring. InAugust, we will have our second CNE offering on InfectiousDisease Updates.

– Robyn McKearney, Chapter President

The Sunshine Region Chapter #203 hasmany exciting things going on. For example, we are hostinga Medical-Surgical Certification Review Course along withthe North Broward Medical Center on April 24th and 25th.We do a continuous gently used clothing and new toiletriesdrive for North East Focal Point in Fort Lauderdale, FL. InMarch, we participated in a Health Fair for the UnitedFederation of Teachers – Retired Teachers Chapter in whichapproximately 500 participants attended.

– Beth Cohen, Chapter President

West Virginia Chapter #113 memberscollected over 100 cold weather clothing items, includingmittens, gloves, toboggans, scarves, and ear muffs of varioussizes as a community service project. Items were donated toScott’s Run Settlement House in Morgantown, WV. InJanuary, we designed and distributed our first bi-annualnewsletter to members. We are trying to get the word outabout our chapter and increase member participation.

2007 Chapter Goals are to:• Enhance recognition of the WV Chapter through

advertisements.• Recruit 6 to 10 new members in 2007 and broaden

recruitment to outside facilities.• Planning of a 4 to 8-hour workshop focused on

advanced medical-surgical nursing.• Facilitate communication and collaboration among

medical-surgical nurses in the WV area.• Enhance the image of medical-surgical nursing as a

specialty.• Become more politically active.

– Sharon Tylka

BOARD OF DIRECTORSKathleen A. Reeves, MSN, CNS, CMSRN

PresidentCecelia Gatston Grindel, PhD, RN, CMSRN, FAAN

Immediate Past PresidentKathleen A. Singleton, MSN, RN, CNS, CMSRN

TreasurerKathleen Lattavo, MSN, RN, CMSRN

SecretaryEdna Ennis, BSN, RN, CMSRN

DirectorSandra D. Fights, MS, RN, CMSRN

DirectorTeresa Ann Snyder, BSN, RN

DirectorJo-Ann Wedemeyer, BSN, RN, CMSRN

Director

MEDSURG MATTERSDiana Anderson, BSN, RN, CMSRN

EditorCynthia Nowicki Hnatiuk, EdD, RN, CAE

Executive DirectorSuzanne Stott, BS

Association Services ManagerCarol Ford

Managing EditorRobert Taylor

Graphic DesignerRobert McIlvaine

Circulation ManagerMed-Surg Matters is indexed in the Cumulative Index to Nursing & Allied Health Literature

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MedMedSurgSurgMedSurgMattersMattersMattersMatters

Volume 16 - Number 2 • March/April 2007

OFFICIAL NEWSLETTEROFFICIAL NEWSLETTER

AJJ-0307-V-7M

mission:The mission of the Academy ofMedical-Surgical Nurses is topromote excellence in adult health.

The Academy of Medical-Surgical Nurses isrecognized as the world-wide leader formedical-surgical nursing practice.vision:

© 2007 by Academy of Medical-Surgical Nurses

AMSN Announces Opening KeynoteSpeaker for Annual Convention

LeAnn Thieman, LPN, author of Chicken Soup for theNurse’s Soul, will present AMSN’s Keynote Address onThursday, October 25, from 5:15 p.m. – 6:30 p.m. Ms.Thieman, who has spoken at previous AMSN annual con-ventions, will again share stories that will warm your soul andenlighten your nursing spirit.

With a marked decrease of nurses entering the field, nurseshave been forced to cope with increasing work loads, inade-quate staffing, and an overall lack of support for their profes-sion. Ms. Thieman’s book has brought much needed recogni-tion to the “nurse’s soul,” and she hopes to remind AMSN’sAnnual Convention attendees of why they chose nursing as theirprofession and that they are health care’s link to compassionatepatient care.

2007 AMSN Annual Convention Planning CommitteeJanet Burton – Chair

Gloria HurstTerry Ditton

Diana AndersonJudy Dusek

The 2007 Annual Convention Planning Committee isputting the finishing touches on the program. Watch formore information about the convention program, sessions,and speakers in upcoming editions of MedSurg Matters,AMSN e-news, and the AMSN Web site (www.med-surgnurse.org).