From Washington, D.C. to Melbourne, Australia

From Washington, D.C., for ENA’s “Day on the Hill” to Melbourne, Australia, for the International Council of Nurses conference, this has been an amazing week! I have just arrived in Australia after 21 hours of flying, so I will make this blog short.

Seventy-seven emergency nurses converged on Congress to express our views on funding for Title XIII, Poison Control Centers and the Safe Staffing Act that was just introduced by U.S. Rep. Lois Capps (D-Calif.). We were a force to be reckoned with! As you know, emergency nurses can be very persuasive.

Beginning this Sunday, 2013 President-elect Deena Brecher and I will have the opportunity to meet and listen to nurses from all around the world who will be attending ICN. I will give you details on that experience next week. For now, I am trying to get used to the time change and the fact that I have lost a day.

Have a wonderful week!

JoAnn

Preparing for ENA’s Day on the Hill

As emergency nurses we never use the “Q” word, however, I must say this week has been relatively quiet for me. Other than the state presidents’ call and a few other calls, I have had the opportunity to focus on my day job as a consultant.

Next week will be anything but quiet. We start off the week with the board meeting and ENA’s Day on the Hill in Washington, D.C. From there, Deena Brecher and I will fly to Melbourne, Australia, for the International Congress on Nursing Quadrennial Congress. This should be a wonderful experience. Stay tuned.

Earlier this week I received information about a bill that North Carolina’s House of Representatives is trying to pass. House Bill 693 would require notarized written approval from a parent before a doctor or other provider could diagnose, treat or even counsel anyone under age 18 for mental health or substance abuse. Parental approval would also be required for contraception, pregnancy care and testing for sexually transmitted diseases.

I would be interested to hear your thoughts on this proposal. Click here to read an article about HB 693.

Have a great weekend!
JoAnn

Emergency nurses and physicians: The two must be one

This week, I attended the Emergency Department Practice Management Association conference in Las Vegas and spoke at Michigan ENA’s Annual Spring Conference in Mount Pleasant, Mich. The two conferences could not have been more different. EDPMA’s conference was focused on the impact of health care changes such as the Affordable Care Act and on physician practice and reimbursement, while Michigan’s conference focus was on nursing practice and patient care. Don’t get me wrong – they were both very good conferences. They just reminded me of how very siloed our two professions still are. 

What I see in my trips across the country, in my role as consultant, is a lack of true collaboration between medicine and nursing. It always seems we are pointing fingers at each other. “If only the nurses were properly staffed.” “If only the physicians wouldn’t order so many tests.” I believe the first place to begin this collaboration is with department leadership: the ED medical and nursing directors. These two individuals must have a shared vision for the department and the ability to articulate this vision. Once these two are on the same page, it becomes easier to tackle issues in the department together and to focus on the needs of the patients. I realize this won’t solve all the problems in health care; however, it will create a better environment for nursing, medicine and our patients.

What about where you work? Do your medical and nursing leaders work as a team with only one side, or are they on opposing teams?

Have a great weekend! I am headed to sunny Florida for a couple of days of sun and spa.

JoAnn

The Support You Need, Professionally and Personally

This week I am at the ENA headquarters for a meeting with the ED Operations Committee. What a wonderful group of leaders! This group is working on a “survival guide” for new managers. I sure wish I had this back in my early days as a nurse manager and I am sure that the staff I worked with would feel the same way. I did a lot of practicing on them!

When I leave Chicago today, I head to Las Vegas for the Emergency Department Physician Management Association conference. On Tuesday, I will be at the Michigan ENA Annual Spring Conference. Fortunately, my husband is with me for a portion of this trip. This helps keep me centered and reminds that I am more than the ENA President this year, that I have a life outside of ENA. I am also a wife, mother, grandmother and employee.

The events of last week brought home to me the importance of family, our work families and our personal families. When was the last time you said thank you to the people who support you most? If you are like I am, you may take them for granted, thinking they will always be there. Don’t wait until tomorrow. Let them know now how much you appreciate them.

Have a safe and wonderful weekend.

JoAnn

Random Acts of Kindness Hold Us Together

This has been a week of crisis. The bombs in Boston were closely followed by the explosion in West, Texas. Though they are different events, they are also very similar, marked by death, injuries and heroes.

As emergency nurses, we like to think we are prepared for anything. We never know the real answer to that until the test comes, as it did this week. We all wish we could be there to support our peers in this time of crisis. Some nurses did the next-best thing. They sent pizzas and prayers! I received e-mails from a few of the ED directors in Boston who said that they feel very supported by all of you and proud to be emergency nurses.

I don’t want to forget the other emergency health care workers and firefighters who responded to the scenes. We all belong to a community that thinks nothing of itself when it comes to taking care of others.

We can support one another, even when it is not in response to a crisis. Show your appreciation by performing a random act of kindness for our fellow emergency health care workers and first responders. Not everyone can send pizzas or flowers to Boston, but what about a letter and a batch of cookies to your local EMS professionals? Give blood. Volunteer at local races in honor of your Boston and West colleagues.

In times of crisis, we all come together like a family. Like a family, we share the pain of those who are on the front lines. We pray for them and call them heroes. To the emergency nurses and other emergency health care workers and firefighters of Boston and West, thank you for all you do every day, but especially for the care you gave this week. We salute you!

JoAnn

Barcelona, Spain – what a wonderful place for a conference!

Rosa Sánchez Díaz (left), president of the Sociedad Española de Enfermería de Urgencias y Emergencias, with ENA 2013 President JoAnn Lazarus, MSN, RN, CEN.

Barcelona, Spain – what a wonderful place for a conference! I am here at the congress of the Sociedad Española de Enfermeria de Urgencias y Emergencias (SEEUE). I only understand un poco Spanish; however, the language of nursing is universal. The nurses are discussing topics such as domestic violence, helicopter transport, education of patients and families, triage and the future of emergency nursing. Later today, I will have the opportunity to sit on a panel to talk about quality and safety in our practice. Through discussions, I have found out that Spain and Mexico are very interested in bringing TNCC and ENPC to their countries.

The biggest difference I have noticed between us and them is age. The nurses here are all so young! I was told that retirement is mandatory at the age of 55. Can you imagine what our workforce would look like if we were all required to retire at 55? Talk about a shortage of nurses, since the average age of U.S. emergency nurses is about 48.

Everyone here is so gracious and warm, and the opportunity for networking is amazing. There are nurses here from Spain, Mexico, Brazil, Canada and the U.S. This is the beginning of a new international relationship. I will be sad to leave; however, I know I will see some of my new friends at the ENA Annual Conference and maybe in Mexico in October.

Adiós! Tener un gran fin de semana.

JoAnn

Purpose, Power and Passion

That is what the members at the National Student Nurses Association meeting in Charlotte, N.C., were told to never forget in their careers. I have just had the most awesome two days in my time as president. To be among these bright, articulate nursing students was so inspiring. They are our future, and I think we are in good hands.
I had the opportunity to do two presentations on emergency nursing during this conference. In both presentations, the room was packed – I am talking more than 300 students in each session. They all want or think they want to be emergency nurses. It was so inspiring to hear them talk about their excitement about starting their careers in nursing.
How many of us feel that way about our careers? When we think back to the days before we actually graduated from nursing school, what were our aspirations? Where did we think we would be when we grew up? How far away are we from those goals?
If you wonder what the next generation of nurses will look like, just go to NSNA.org and look at the resolutions these students are bringing to their House of Delegates. We need to support their energy and enthusiasm to make positive changes to health care. I suggest we all go “hug a student nurse today.”
Have a wonderful weekend,
JoAnn

ENA President JoAnn Lazarus, MSN, RN, CEN, met with students Taylor Harrison and Marlee Flynt following her presentation at the National Student Nurses Association conference April 4. Harrison and Flynt attend James Madison University in Harrisonburg, Va.

Prescription Restriction Posting Request in S.C. EDs: EMTALA Violation?

This week has been relatively quiet as ENA president. I spent the week out in California doing the work of my “day job.” In addition, I had the opportunity to put the finishing touches on my presentations for the National Student Nurses Association conference next week in Charlotte, N.C., and my presentation for the Spanish Society of Emergency Nursing conference in Barcelona, Spain, the following week. I am so excited about the opportunity to speak to student nurses and to meet emergency nurses in Spain!

I was made aware of a letter sent by the South Carolina Hospital Association to the regional CMS office in Atlanta to see if it would be okay to post signs in emergency departments in South Carolina that inform patients about restrictions on opioid prescribing practices in emergency departments. The response from CMS stated that “while they shared SCHA concerns and those of the provider community about the increasing prevalence of prescription drug abuse and its harmful effects; the intent of the EMTALA statute is to assure that all individuals who come to the emergency department for a medical condition receive an appropriate medical screening examination to determine whether or not an emergency medical condition exists.”

CMS’ concern is that “some patients with legitimate medical needs and legitimate need for pain control would be unduly coerced to leave the ED before receiving an appropriate medical screening exam.” So this regional CMS’ position is that posting of such a notice would be an EMTALA violation.

This proposal is specific to one state and set of circumstances, but it could have more far-reaching implications and consequences. I am curious what you think about South Carolina Hospital Association’s proposal and the response of CMS. 

I hope you have a great weekend. Happy Easter and Happy Passover!

JoAnn

Inspiration for Me and a Question for You

I started off this week at the ENA national office for a Resolutions Committee meeting. It is exciting to see such important recommendations and questions come to this committee for the General Assembly to decide.

Then I headed off to Denver, Colo. for the American Organization of Nurse Executives annual conference. I was thrilled to have the opportunity to hear a speech by Capt. Chesley Sullenberger, the captain who landed the US Airways jetliner in the Hudson River in 2009. What an unbelievable accomplishment! It was an enlightening presentation, especially when he spoke about the changes in aviation that have improved safety. He talked about the need to do the same in health care. Amen!

This week I received an e-mail regarding a Florida Legislature bill that proposes to make it a third-degree felony for a nurse with a doctoral degree to introduce himself or herself as “Dr. Smith,” without immediately qualifying that with a statement that he or she is not a medical doctor.

What do you think? Should nurses who have doctoral degrees not be able to use their title when introducing themselves to patient and families? Should ENA take a position on this? I would love to hear your thoughts.

JoAnn

Finally Going Home

Since leaving home three weeks ago, I have flown 11,450 miles. I am finally going home tomorrow. I get to sleep in my own bed! On Sunday I am off again.

This week I attended a “Great Ideas” conference in Colorado Springs and then spoke at the New Jersey ENA Emergency Care Conference in Atlantic City. What a wonderful group of people!

I had the opportunity to be the keynote speaker at the New Jersey ENA conference. I spoke on finding your passion, and I have a couple questions for all of you:

• Are you passionate about your career as an emergency nurse? If not, why not?
• What would you change if you could about your career?

I would love to hear from you.

JoAnn