- Email: [email protected]
International Family-planning Training for Nurse Practitioners
thoughts and opinions International Family-planning Training for Nurse Practitioners GILBERTE A. VANSINTEJAN, RN, MPH, EDD, AND PETER J. PURDY, MPH Since the mid-l970s, the Margaret Sanger Center of Planned Parenthood of New York City has prepared nurses and nurse midwives from less developed countries to be family-planning nurse practitioners. These nurse practitioners then provide services to patients, train other staff , and manage integrated family-planning clinics. More than 120 nurses and nurse midwives have arrived in groups of 10 at the Sanger Center, with 72 attending since 1981. Each course lasts 10 weeks. The core curriculum provides trainees with skills in women’s health care including contraception, in training and advocacy, and in management of clinics. Whether, in the current period of scarce resources, cross-cultural training programs of this type remain a worthwhile investment, and if so, which of their components are most important to this success, is assessed.
In the mid-l970s, a dozen publicly funded international family-planning training programs flourished throughout the United States, three of them in New York City. By the end of the decade, as a result of reassessment and reallocation of international educational monies, most of the programs had closed. One of the few that remains operational is the Margaret Sanger Center of Planned Parenthood of New York City. Today, as it has since 1974,the center provides one or two 10-week courses a year, each accomodating 10 nurses and nurse midwives. The program is supported by tuition fees. Individual agencies or their employees apply for admission, and a mix
Accepted: June 1985.
492
of international funding agencies provides scholarships. In a time of scarce international assistance resources, assessing and reassessing the worth of this kind of investment of family-planning training-to participants, to their sponsoring agencies, and to their countries-are essential. In what ways d o benefits manifest themselves? Which components within the training process and curriculum can ensure the greatest return on the investment? To obtain answers to these questions, the Margaret Sanger Center carried out a number of onsite follow-up visits to program graduates in addition to sending all graduates follow-up questionnaires to determine the extent and type of family-planning-related activities in’which they were engaged.
IMPACT OF TRAINING Short-term training in the United States confers prestige on those who graduate as nurse practitioners. This prestige has been a key factor enabling practitioners to make changes in the systems to which they have returned, whether they work for service providers, educational institutions, or ministries of health. As service providers (which most were when they left to attend the training), all graduates are now able to use new practical skills, particularly in physical assessment, gynecologic examination, and contraceptive prescription and management. Respondents reported that after their training and subsequent return to their coun-
November/December 1986 JOG”
tries, family-planning services in their agencies had been expanded and served more people. Training at the Sanger Center also specifically prepared participants to exercise the critical multiplier effect they were expected to have in their workplaces. Alumnae reported training their co-workers in clinical and community settings, teaching students in medical and nursing schools, and participating in workshops sponsored in their countries by various international agencies. In Uganda, a country where family-planning work is beginning to gain new momentum after 10 years of political instability, seven Sanger graduates have integrated family planning into the schools of nursing and midwifery. In other countries that have sent contingents of nurses to be trained, the multiplier effect has been particularly significant. Over the past 10 years, no fewer than 70 participants have come from schools of nursing and midwifery in the Sudan, Nigeria, Sierra Leone, Uganda, and Jordan. Six of those who returned to the University of Benin Nigerian Teaching Hospital initiated an informal family-planning training program within the obstetric/gynecologic department. Initially, this program was only for nurses associated with the university hospital. Today, with family planning openly and officially an integral part of maternal and child health care in Nigeria, the program has become a state training resource for field staff. Ultimately, the biggest impact of the Sanger Center’s family-planning nurse-practitioner program may be in the area of advocacy. In many countries in Africa, family planning is still a new service for women and a new function for nurses and midwives. A strong push was needed to overcome both political and professional resistance, and a number of Sanger graduates provided the pressure.
November/December 1986 JOG”
Sanger graduates have become
strong advocates for the expanded role of nurse practitioners in the provision of family-planning services. In addition, the nurses’ exposure to women in professional roles in the United States has induced a new level of awareness in the nurses about the rights of women in their own countries, particularly the right t o have children who are planned and wanted. In the Sudan, the first six nurses who returned confronted considerabie resistance from physicians when they sought permission to perform speculum examinations and insert intrauterine devices. But a year later, joined by six more Sanger-trained colleagues, the group was able to wield a negotiating force, strong enough to win approval from the Ministry of Health. In Sierra Leone, a Sanger graduate who was a senior clinical nurse working in the country’s largest maternity hospital helped gain Ministry of Health approval for the initiation of family-planning services in an outpatient clinic. The nurse practitioner’s training had included developing strategies for gaining official approval in a complex political environment. Her per-sistence in achieving her goal represented a major breakthrough for moving contraceptive care into the governmental infrastructure of her country. This nurse’s exposure during training to the problem of adolescent pregnancy in the United States was a key factor in her later identifying and acting on the same problem in Sierra Leone. What emerges from these responses is that international training provided a milieu for gaining long-distance objectivity, seeing old problems in new ways, and feeling free to explore solutions and create strategies for achieving program goals. Sanger graduates also appear to be led by new energy, feeling that when they use
their new skills, they are contributing to the future. COMPONENTS FOR
A SUCCESSFUL TRAINING OUTCOME
In analysis of the components of success in this US.-based program, three elements seem to be particularly important: the selection process, the flexibility of the curriculum, and the follow-up. The Selection Process
When governments or private health-care agencies decide to introduce family planning or improve the quality of contraceptive care in their agencies, they usually select individuals on the basis of demonstrated competence or leadership. The Sanger Center has sought to ensure appropriate choices by requesting letters from senior officials endorsing candidates and committing themselves to using the graduates’ expanded skills, particularly in family planning. In addition, international financial sponsoring agencies have played a useful role in selecting prospective candidates by discussing the objectives of the training with the candidates’ superiors. From the outset, the Sanger Center has concentrated on working with relatively few countries to develop a critical mass of nurse practitioners in those countries. Two to three trainees from the same nation can provide mutual support during the training program in New York as well as on their return. These teams have, in turn, expanded themselves and set broader objectives. They have been sharp-eyed recruiters from their own ranks for subsequent courses, and they have been active in persuading their colleagues of the importance of family-planning programs in their own countries.
493
The Cumculum A critical dimension of the Sanger curriculum has been its flexibility and dynamism over the years. Through a needs assessment given at the initiation of each course, through trainees’ evaluation of the teachers during the course, and through the trainees’ evaluation of the program at the end of the 10 weeks, both trainees and trainers have input into the curriculum. Flexibility is further enhanced by individually tailoring a portion of the curriculum to the specific needs of each participant. A central core of knowledge is basic forall; beyond that, each person moves on to acquire at least beginning expertise in an area of special interest and need. Currently, the curriculum includes training of trainers, management, familyplanning services to patients, and major health-care issues within a cross-cultural context. These issues are discussed openly, without social or cultural censorship; among them are human sexuality, abortion, adolescent pregnancy, sex education, concepts of health politics, family-planning advocacy, and marketing of services. Over the 10 weeks of training, trainees appear to modify their attitudes concerning these issues. Their final course evaluation shows greater openness and understanding, and a willingness to set aside some of their traditional values. These aspects of the curriculum may be the most challenging and un conventional. A highly significant aspect of the training program over the past four years has been the assignment of individual projects, which are work plans to be implemented on return home. These projects have been consistently the most difficult but ultimately the most rewarding assignments for all trainees. For many, this project is their first experience in specifically defining a
494
problem, setting program objectives, and developing strategies to achieve them. A Nigerian nurse developed a program to reach and recruit sexually active adolescents in an environment that sought to deny it had a problem of teen pregnancy. A Thai nurse gained clearer understanding of management skills as she examined various options for redeploying staff and defining roles for nurses working on a mobile sterilization team. Each trainee works on her project with a Sanger Center staff member. Approximately 60% of the training program is clinical and didactic training in women’s healthcare and contraceptive technology. Training methodologies, management, issues, and individual projects make up the remaining 40%. Clearly, from the graduates’ responses, international nurse practitioner trainees must be prepared to fulfill a variety of roles. Many have been promoted from service providers to clinic or program managers. Management functions have in turn led to involvement in continuing education and in-service training. FOIIOW-UP Any short-term international training should include follow-up and evaluation, not only to reassess and improve the curriculum but to provide support to alumnae. The Sanger Center, over the past 10 years, has followed up in two ways: on-site contacts and mailed questionnaires. The former has had a strong beneficial impact. Having an official from an international training institution visit graduates in their work setting is a statement of the importance placed on their learning experience. During the 1970s, the Sanger Center was able to provide at least one onrsite follow-up visit to almost 60% of its graduates. Most of
these visits occurred between 12 and 18 months after the nurses had returned home. The visits often proved useful in solving on-site problems. In two cases in which the problem was obtaining supplies and equipment, the visiting Sanger administrator was able to help by linking the nurse practitioner and her institution with a local institution able to respond or an international group willing to assist the program. Persuading physicians to permit nurses to deliver contraceptive care was a primary problem. This was particularly true in the Sudan, where repeated follow-up visits and lengthy discussions with the Ministry of Health chief obstetrician were necessary before he finally yielded. Similar discussion, held in the context of seeking to maximize a mutual training investment, proved effective in persuading government officials in Sierra Leone to extend family-planning services to outpatient clinics in government hospitals. In Bendel State in Nigeria, follow-up discussions won permission for nurses to implement an in-service training program. For the graduates, on-site visits have often been useful opportunities to examine possible solutions to operational problems. Sanger Center representatives have met with a trainee alone to discuss her current professional role and have then met with her immediate supervisor. This approach has reinforced the problem-solving training at the center. Since 1980, budget constraints have precluded on-site follow-up visits. Mailed questionnaires and correspondence with graduates have replaced them. These exchanges continue to support and encourage the graduates in their work as family-planning practitioners. Brief reports have kept them up-to-date about new technology. Most graduates keep in touch to
November/December 1986 JOCNN
report their work and their fights
springboard for strengthening in-
for contraceptive choice.
dividuals who are suited by tem-
CONCLUSION Although funding remains limited and does not permit extensive collection and analysis of data, an assessment of the impact of shortterm international family-planning training, on site and through the mail, suggests that program graduates are making unique contributions. The magnitude of the need to train Third-World nursing and auxiliary personnel in family planning makes the generation of increased in-country and regional training capability imperative, and the Sanger Center supports this. Nevertheless, international training on a selected basis remains a worthwhile way to enhance and build leadership in education and advocacy in the reproductive health field. The family-planning nurse-practitioner program has become a CALL ON US..
ning training program for nursemidwives and related personnel. Report to A.I.D. for the period January 1976 to June 1978. Vansintejan C. Family planning/MCH training of foreign nurse-midwives and related personnel in the United States, Teachers College Dissertation, Columbia University, 1979. Vansintejan G, Wolf N. Final reports of international family planning training, the Sanger Center. Unpublished documents, 1981 to 1984.
Address for correspondence: G. Vansintejan, 54 Morningside Drive, Apt. 61, New York,NY 10025.
SUGGESTED READING Gorosh V, Gorosh M. Continuing education in an international context an evaluation tool for education leaders. Paper presented at the American Public Health Association Annual Meeting, Anaheim, California, November 1984. Helbig D, Pendleton E, Kohl S. The global influence of Downstate’s nurse-midwifery family planning training program. Unpublished paper, 1977.
Gilberte Vansintejan is a consultant in international health and education. Dr. Vansintejan is a member of NAACOG and the American Public Health Association. Peter Purdy is associate exeCutivedirector of Planned Parenthood of New York City. Mr. Purdy is a member of the American Public Health Association and the National Family Planning and Reproductive Health Association.
. NAACOG, THE SPECIALTY ORGANIZATION FOR OGN NURSING
Why call on NAACOG? Because whether or not you’re a member, we can handle your needs and concerns as a professional nurse in the obstetric. gynecologic, and neonatal (OGN) environment. NAACOG can do this because we Publish the bimonthly Journal of O b stetric, Gynecologic, and Neonatal Nursing so we keep you apprised of the latest research and practice developments in your specialty Publishthe monthly NAACOG Newsletter, which promotes
NAACOG services, benefits, and activities as well as covers current OGN topics Conduct quality continuing education courses to ensure quality care in today’s healthcare arena 0 Provide legislative representationon
November/December 1986 JOCNN
perament, organizational position, and commitment to assume positions of leadership in th e service, management, and educational arenas. The Margaret Sanger Center continues to work toward shortterm international professional training in family planning in the hope of providing a basis for some of the programs of all national and multinational organizations. The development of leadership, to which short-term training contributes, is a never-ending need.
Helbig D. The Downstate family plan-
issues such as Maternal-Infant Medicaid Amendments and the National Commissionon Infant Mortality Provide networking opportunities through chapters, sectbns, districts, and national activities Publish nursing standards, guidelines, practice resources, and a professional liability series Are the voice for OGN nursing, and as such, we are members of federations, councils, and task forces that address nursing and special OGN issues. In addition, special benefits afforded to NAACOG members include Reduced fees to members for continuing education offerings as well as for purchases of numerous publications
Use of a toll-free 800 number A resource center for women’s health and perinatalmaterialsas well as the availability of free Medline searches and research assistance @I Group rates on malpractice, life, and disability insurance. If you’re a member, take advantage of the many ways you benefit from your NAACOG membership. And tell your colleagues about the many benefits NAACOG offers. If you’re not a member, consider calling on us to serve your needs as an OGN nursing professional. Call the Membership Department at 1/ 800-533-8822today, or write for further information.
NAACOG The Organization for Obstetric, Gynecologic, and Neonatal Nurses, 600 Maryland Ave., SW, Suite 200E, Washington, DC 20024.
495
In the mid-l970s, a dozen publicly funded international family-planning training programs flourished throughout the United States, three of them in New York City. By the end of the decade, as a result of reassessment and reallocation of international educational monies, most of the programs had closed. One of the few that remains operational is the Margaret Sanger Center of Planned Parenthood of New York City. Today, as it has since 1974,the center provides one or two 10-week courses a year, each accomodating 10 nurses and nurse midwives. The program is supported by tuition fees. Individual agencies or their employees apply for admission, and a mix
Accepted: June 1985.
492
of international funding agencies provides scholarships. In a time of scarce international assistance resources, assessing and reassessing the worth of this kind of investment of family-planning training-to participants, to their sponsoring agencies, and to their countries-are essential. In what ways d o benefits manifest themselves? Which components within the training process and curriculum can ensure the greatest return on the investment? To obtain answers to these questions, the Margaret Sanger Center carried out a number of onsite follow-up visits to program graduates in addition to sending all graduates follow-up questionnaires to determine the extent and type of family-planning-related activities in’which they were engaged.
IMPACT OF TRAINING Short-term training in the United States confers prestige on those who graduate as nurse practitioners. This prestige has been a key factor enabling practitioners to make changes in the systems to which they have returned, whether they work for service providers, educational institutions, or ministries of health. As service providers (which most were when they left to attend the training), all graduates are now able to use new practical skills, particularly in physical assessment, gynecologic examination, and contraceptive prescription and management. Respondents reported that after their training and subsequent return to their coun-
November/December 1986 JOG”
tries, family-planning services in their agencies had been expanded and served more people. Training at the Sanger Center also specifically prepared participants to exercise the critical multiplier effect they were expected to have in their workplaces. Alumnae reported training their co-workers in clinical and community settings, teaching students in medical and nursing schools, and participating in workshops sponsored in their countries by various international agencies. In Uganda, a country where family-planning work is beginning to gain new momentum after 10 years of political instability, seven Sanger graduates have integrated family planning into the schools of nursing and midwifery. In other countries that have sent contingents of nurses to be trained, the multiplier effect has been particularly significant. Over the past 10 years, no fewer than 70 participants have come from schools of nursing and midwifery in the Sudan, Nigeria, Sierra Leone, Uganda, and Jordan. Six of those who returned to the University of Benin Nigerian Teaching Hospital initiated an informal family-planning training program within the obstetric/gynecologic department. Initially, this program was only for nurses associated with the university hospital. Today, with family planning openly and officially an integral part of maternal and child health care in Nigeria, the program has become a state training resource for field staff. Ultimately, the biggest impact of the Sanger Center’s family-planning nurse-practitioner program may be in the area of advocacy. In many countries in Africa, family planning is still a new service for women and a new function for nurses and midwives. A strong push was needed to overcome both political and professional resistance, and a number of Sanger graduates provided the pressure.
November/December 1986 JOG”
Sanger graduates have become
strong advocates for the expanded role of nurse practitioners in the provision of family-planning services. In addition, the nurses’ exposure to women in professional roles in the United States has induced a new level of awareness in the nurses about the rights of women in their own countries, particularly the right t o have children who are planned and wanted. In the Sudan, the first six nurses who returned confronted considerabie resistance from physicians when they sought permission to perform speculum examinations and insert intrauterine devices. But a year later, joined by six more Sanger-trained colleagues, the group was able to wield a negotiating force, strong enough to win approval from the Ministry of Health. In Sierra Leone, a Sanger graduate who was a senior clinical nurse working in the country’s largest maternity hospital helped gain Ministry of Health approval for the initiation of family-planning services in an outpatient clinic. The nurse practitioner’s training had included developing strategies for gaining official approval in a complex political environment. Her per-sistence in achieving her goal represented a major breakthrough for moving contraceptive care into the governmental infrastructure of her country. This nurse’s exposure during training to the problem of adolescent pregnancy in the United States was a key factor in her later identifying and acting on the same problem in Sierra Leone. What emerges from these responses is that international training provided a milieu for gaining long-distance objectivity, seeing old problems in new ways, and feeling free to explore solutions and create strategies for achieving program goals. Sanger graduates also appear to be led by new energy, feeling that when they use
their new skills, they are contributing to the future. COMPONENTS FOR
A SUCCESSFUL TRAINING OUTCOME
In analysis of the components of success in this US.-based program, three elements seem to be particularly important: the selection process, the flexibility of the curriculum, and the follow-up. The Selection Process
When governments or private health-care agencies decide to introduce family planning or improve the quality of contraceptive care in their agencies, they usually select individuals on the basis of demonstrated competence or leadership. The Sanger Center has sought to ensure appropriate choices by requesting letters from senior officials endorsing candidates and committing themselves to using the graduates’ expanded skills, particularly in family planning. In addition, international financial sponsoring agencies have played a useful role in selecting prospective candidates by discussing the objectives of the training with the candidates’ superiors. From the outset, the Sanger Center has concentrated on working with relatively few countries to develop a critical mass of nurse practitioners in those countries. Two to three trainees from the same nation can provide mutual support during the training program in New York as well as on their return. These teams have, in turn, expanded themselves and set broader objectives. They have been sharp-eyed recruiters from their own ranks for subsequent courses, and they have been active in persuading their colleagues of the importance of family-planning programs in their own countries.
493
The Cumculum A critical dimension of the Sanger curriculum has been its flexibility and dynamism over the years. Through a needs assessment given at the initiation of each course, through trainees’ evaluation of the teachers during the course, and through the trainees’ evaluation of the program at the end of the 10 weeks, both trainees and trainers have input into the curriculum. Flexibility is further enhanced by individually tailoring a portion of the curriculum to the specific needs of each participant. A central core of knowledge is basic forall; beyond that, each person moves on to acquire at least beginning expertise in an area of special interest and need. Currently, the curriculum includes training of trainers, management, familyplanning services to patients, and major health-care issues within a cross-cultural context. These issues are discussed openly, without social or cultural censorship; among them are human sexuality, abortion, adolescent pregnancy, sex education, concepts of health politics, family-planning advocacy, and marketing of services. Over the 10 weeks of training, trainees appear to modify their attitudes concerning these issues. Their final course evaluation shows greater openness and understanding, and a willingness to set aside some of their traditional values. These aspects of the curriculum may be the most challenging and un conventional. A highly significant aspect of the training program over the past four years has been the assignment of individual projects, which are work plans to be implemented on return home. These projects have been consistently the most difficult but ultimately the most rewarding assignments for all trainees. For many, this project is their first experience in specifically defining a
494
problem, setting program objectives, and developing strategies to achieve them. A Nigerian nurse developed a program to reach and recruit sexually active adolescents in an environment that sought to deny it had a problem of teen pregnancy. A Thai nurse gained clearer understanding of management skills as she examined various options for redeploying staff and defining roles for nurses working on a mobile sterilization team. Each trainee works on her project with a Sanger Center staff member. Approximately 60% of the training program is clinical and didactic training in women’s healthcare and contraceptive technology. Training methodologies, management, issues, and individual projects make up the remaining 40%. Clearly, from the graduates’ responses, international nurse practitioner trainees must be prepared to fulfill a variety of roles. Many have been promoted from service providers to clinic or program managers. Management functions have in turn led to involvement in continuing education and in-service training. FOIIOW-UP Any short-term international training should include follow-up and evaluation, not only to reassess and improve the curriculum but to provide support to alumnae. The Sanger Center, over the past 10 years, has followed up in two ways: on-site contacts and mailed questionnaires. The former has had a strong beneficial impact. Having an official from an international training institution visit graduates in their work setting is a statement of the importance placed on their learning experience. During the 1970s, the Sanger Center was able to provide at least one onrsite follow-up visit to almost 60% of its graduates. Most of
these visits occurred between 12 and 18 months after the nurses had returned home. The visits often proved useful in solving on-site problems. In two cases in which the problem was obtaining supplies and equipment, the visiting Sanger administrator was able to help by linking the nurse practitioner and her institution with a local institution able to respond or an international group willing to assist the program. Persuading physicians to permit nurses to deliver contraceptive care was a primary problem. This was particularly true in the Sudan, where repeated follow-up visits and lengthy discussions with the Ministry of Health chief obstetrician were necessary before he finally yielded. Similar discussion, held in the context of seeking to maximize a mutual training investment, proved effective in persuading government officials in Sierra Leone to extend family-planning services to outpatient clinics in government hospitals. In Bendel State in Nigeria, follow-up discussions won permission for nurses to implement an in-service training program. For the graduates, on-site visits have often been useful opportunities to examine possible solutions to operational problems. Sanger Center representatives have met with a trainee alone to discuss her current professional role and have then met with her immediate supervisor. This approach has reinforced the problem-solving training at the center. Since 1980, budget constraints have precluded on-site follow-up visits. Mailed questionnaires and correspondence with graduates have replaced them. These exchanges continue to support and encourage the graduates in their work as family-planning practitioners. Brief reports have kept them up-to-date about new technology. Most graduates keep in touch to
November/December 1986 JOCNN
report their work and their fights
springboard for strengthening in-
for contraceptive choice.
dividuals who are suited by tem-
CONCLUSION Although funding remains limited and does not permit extensive collection and analysis of data, an assessment of the impact of shortterm international family-planning training, on site and through the mail, suggests that program graduates are making unique contributions. The magnitude of the need to train Third-World nursing and auxiliary personnel in family planning makes the generation of increased in-country and regional training capability imperative, and the Sanger Center supports this. Nevertheless, international training on a selected basis remains a worthwhile way to enhance and build leadership in education and advocacy in the reproductive health field. The family-planning nurse-practitioner program has become a CALL ON US..
ning training program for nursemidwives and related personnel. Report to A.I.D. for the period January 1976 to June 1978. Vansintejan C. Family planning/MCH training of foreign nurse-midwives and related personnel in the United States, Teachers College Dissertation, Columbia University, 1979. Vansintejan G, Wolf N. Final reports of international family planning training, the Sanger Center. Unpublished documents, 1981 to 1984.
Address for correspondence: G. Vansintejan, 54 Morningside Drive, Apt. 61, New York,NY 10025.
SUGGESTED READING Gorosh V, Gorosh M. Continuing education in an international context an evaluation tool for education leaders. Paper presented at the American Public Health Association Annual Meeting, Anaheim, California, November 1984. Helbig D, Pendleton E, Kohl S. The global influence of Downstate’s nurse-midwifery family planning training program. Unpublished paper, 1977.
Gilberte Vansintejan is a consultant in international health and education. Dr. Vansintejan is a member of NAACOG and the American Public Health Association. Peter Purdy is associate exeCutivedirector of Planned Parenthood of New York City. Mr. Purdy is a member of the American Public Health Association and the National Family Planning and Reproductive Health Association.
. NAACOG, THE SPECIALTY ORGANIZATION FOR OGN NURSING
Why call on NAACOG? Because whether or not you’re a member, we can handle your needs and concerns as a professional nurse in the obstetric. gynecologic, and neonatal (OGN) environment. NAACOG can do this because we Publish the bimonthly Journal of O b stetric, Gynecologic, and Neonatal Nursing so we keep you apprised of the latest research and practice developments in your specialty Publishthe monthly NAACOG Newsletter, which promotes
NAACOG services, benefits, and activities as well as covers current OGN topics Conduct quality continuing education courses to ensure quality care in today’s healthcare arena 0 Provide legislative representationon
November/December 1986 JOCNN
perament, organizational position, and commitment to assume positions of leadership in th e service, management, and educational arenas. The Margaret Sanger Center continues to work toward shortterm international professional training in family planning in the hope of providing a basis for some of the programs of all national and multinational organizations. The development of leadership, to which short-term training contributes, is a never-ending need.
Helbig D. The Downstate family plan-
issues such as Maternal-Infant Medicaid Amendments and the National Commissionon Infant Mortality Provide networking opportunities through chapters, sectbns, districts, and national activities Publish nursing standards, guidelines, practice resources, and a professional liability series Are the voice for OGN nursing, and as such, we are members of federations, councils, and task forces that address nursing and special OGN issues. In addition, special benefits afforded to NAACOG members include Reduced fees to members for continuing education offerings as well as for purchases of numerous publications
Use of a toll-free 800 number A resource center for women’s health and perinatalmaterialsas well as the availability of free Medline searches and research assistance @I Group rates on malpractice, life, and disability insurance. If you’re a member, take advantage of the many ways you benefit from your NAACOG membership. And tell your colleagues about the many benefits NAACOG offers. If you’re not a member, consider calling on us to serve your needs as an OGN nursing professional. Call the Membership Department at 1/ 800-533-8822today, or write for further information.
NAACOG The Organization for Obstetric, Gynecologic, and Neonatal Nurses, 600 Maryland Ave., SW, Suite 200E, Washington, DC 20024.
495