- Email: [email protected]
Iris Frank, administrator, pioneers innovative specialty hospital
ris Frank, RN, MSN, CEN, is k n o w n to m a n y E N A members as a committed nursing leader who has b e e n a s i g n i f i c a n t c o n t r i b u t o r to e m e r g e n c y n u r s i n g for m a n y years. Her m o s t r e c e n t c a r e e r m o v e h a s t a k e n h e r from t h e c h a l l e n g e of e m e r g e n c y n u r s i n g m a n a g e m e n t to a n e n v i r o n m e n t w h e r e no other n u r s e m a n a g e r h a s b e e n . She r e c e n t l y a s s u m e d t h e p o s i t i o n of t h e t o p a d m i n i s t r a t o r of a n i n n o v a t i v e 30b e d h e a l t h c a r e center, S u t t e r M a t e r n i t y a n d S u r g e r y C e n t e r of S a n t a Cruz (Figure 1). F r o m a field of 234 entries, S u t t e r M a t e r n i t y a n d S u r g e r y C e n t e r w a s o n e of s e v e n r e c i p i e n t s of t h e C i t a t i o n A w a r d in t h e 1996 Modern Healthcare A n n u a l D e s i g n A w a r d s Program. R e c o g n i z i n g u n i q u e a r c h i t e c t u r a l h e a l t h c a r e d e s i g n c o n c e p t s , w i n n e r s are d e t e r m i n e d b y a jury s e l e c t e d jointly b y Modern Healthcare a n d t h e A m e r i c a n I n s t i t u t e of A r c h i t e c t s C o m m i t t e e on Health. T h e not-for-profit hospital, t h e first of its k i n d in t h e country, o p e n e d in M a r c h of this y e a r a n d prov i d e s low-risk o b s t e t r i c a n d s u r g i c a l s e r v i c e s in a four-star h o t e l e n v i r o n m e n t . Yet, t h e c o s t of s e r v i c e s in t h i s b e a u t i f u l facility, offering a m u l t i t u d e of p a t i e n t a m e n i t i e s , is no m o r e e x p e n s i v e t h a n a "reg ~ ular" h o s p i t a l b e c a u s e of its n a r r o w s e r v i c e lines. This is v e r y i m p o r t a n t in California's largely c a p i t a t e d h e a l t h c a r e e n v i r o n m e n t . Iris a c c e p t e d h e r posit i o n in J u l y 1995. W i t h i n 8 m o n t h s a n d a n u n b e l i e v a b l y h e r c u l e a n effort, Iris g o t a h o s p i t a l r e a d y to open. In t h a t t i m e s h e a c h i e v e d t h e following: (1) c o n c e i v e d a n d g a i n e d a p p r o v a l for a d m i n i s t r a t i v e s t r u c t u r e , (2) h i r e d t h e a d m i n i s t r a t i v e t e a m , (3) o r d e r e d all n e c e s s a r y e q u i p m e n t a n d supplies, a n d (4) w r o t e all t h e p o l i c i e s a n d p r o c e d u r e s a n d prep a r e d t h e h o s p i t a l for l i c e n s i n g . T h e l i c e n s e w a s g r a n t e d for M a r c h 8, 1996, a n d t h e h o s p i t a l o p e n e d
I
Marlene Jezierski is quality facilitator, Patient Data Quality Department, and Violence Education Coordinator, Mercy/Unity Hospital, Coon Rapids, Minnesota. Reprints not available from author. J Emerg Nurs 1996;22:626-8. Copyright 9 1996 by the Emergency Nurses Association. 0099-1767/96 $5.00 + 0
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w i t h a b a n g . A t 4:27 AM on April 8, 2 hours a n d 33 m i n u t e s before t h e p l a n n e d official 7 AM o p e n i n g of p e r i n a t a I services, t h e first b a b y w a s born at Sutter. Iris, an e m e r g e n c y n u r s e for 18 years, b e g a n her n u r s i n g c a r e e r in 1970 after h a v i n g t w o sons. Her c a r e e r goals w e r e to find a job t h a t w a s r e w a r d i n g , portable, a n d o n e s h e could w o r k p a r t - t i m e . After fini s h i n g a s e r i e s of d e g r e e s ( a s s o c i a t e , bachelor's, a n d
Iris m a y b e o n e of t h e only c h i e f e x e c u t i v e officers in t h e c o u n t r y w h o s i m p l y calls h e r s e l f "an administrator," rather t h a n t h e m o r e p r e s t i g i o u s title of CEO. She b r i n g s a m a g i c a l b l e n d of Texas charm, pragmatism, sensitivity, a n d h u m o r to her p r o f e s s i o n . m a s t e r ' s ) a n d w o r k i n g in o r t h o p e d i c s , oncology, a n d critical care, s h e d i s c o v e r e d a n d fell in love w i t h e m e r g e n c y nursing. It w a s t h e r e s h e r e m a i n e d for m o s t of h e r career. D u r i n g t h a t t i m e , s h e w a s m a n a g e r of t h r e e California e m e r g e n c y d e p a r t m e n t s . T h e k n o w l e d g e a n d skills s h e d e v e l o p e d in t h e m a n a g e r role p r e p a r e d h e r for t h e c h a l l e n g e of d i r e c t i n g a n d p i l o t i n g t h e S u t t e r project. Iris' e m e r g e n c y n u r s i n g c r e d i t s are many. Her first e n c o u n t e r w i t h t h e Journal of E m e r g e n c y Nursing w a s w h e n s h e w r o t e a n article p u b l i s h e d in 1979: "Avulsed Scalp Replantation. 'd She t h e n w r o t e a m o v i n g letter a b o u t a p o l i c e officer, well k n o w n to the emergency department, who was a trauma p a t i e n t w h o died. T h e letter w a s so well w r i t t e n t h a t s h e w a s a s k e d to r e v i e w articles a n d w r i t e more. She
Jezierski/JOURNAL OF EMERGENCY NURSING
Figure 1 Iris Frank, RN, MSN, CEN, poses in front of the Sutter Maternity and Surgery Center.
Figure 2 Iris Frank (left) was the medical director for the Monterey, California, visit of Pope John Paul II in 1987.
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w a s a s k e d to join t h e journal editorial b o a r d in J a n u a r y 1984, a n d quickly b e c a m e one of its m o s t valued m e m bers. She b e c a m e a s s i s t a n t a n d t h e n a s s o c i a t e editor, a n d s e r v e d as s e c t i o n editor of t h e "Profiles" a n d " M a n a g e r s A s k a n d Answer" columns. T h e list d o e s little justice to t h e level a n d quality of Iris' work. Gall Lenehan, journal editor, m o r e a c c u r a t e l y d e s c r i b e s t h e level of her contributions. "Iris h a s b e e n a bulwark to t h e journal for m a n y years. Her k n o w l e d g e is reliable, varied, a n d broad. W h e n w e n e e d a g u e s t editor, Iris volunteers. W h e n w e n e e d an article on a certain topic, it's Iris w h o k n o w s s o m e o n e w h o c a n write on it. W h e n w e n e e d a topic, Iris c o m e s u p w i t h an idea. W h e n w e n e e d a cover, Iris g e t s t h e original art work. W h e n a n e w i d e a is s u g g e s t e d , Iris often does t h e writing herself. She has w o r k e d tirelessly a n d selflessly a n d m a k e s it look easy. She frequently volunteers to t a k e on n e w responsibilities. Iris c o n c e i v e d t h e i d e a of the ' M a n a g e r s Ask a n d A n s w e r ' column, t h e n she e d i t e d it." Her c o n t r i b u t i o n s to t h e journal reflect t h e s c o p e of h e r e x p e r i e n c e a n d c o n t a c t s . O n e of t h e m a n y fine art c o v e r s to Iris' c r e d i t is Van G o g h ' s "Irises," her favorite. She h a s often l e c t u r e d on t h e art of w r i t i n g for p u b l i c a t i o n a n d is a c o n v i n c i n g a d v o c a t e for a s p i r i n g n u r s e writers. Iris feels e s p e c i a l l y PrOud of t h e s e x u a l a s s a u l t n u r s e t e a m w o r k s h e s p e a r h e a d e d in S a n t a Cruz, In t h e early 1980s s h e w o r k e dI l o n g a n d h a r d w i t h t h e d i s t r i c t attorney, c h i e f of police, a n d t h e C o m m i t t e e to P r e v e n t Violence A g a i n S t W o m e n , a local political a c t i o n g r o u p , to e s t a b l i s h SART (sexual a s s a u l t r e s p o n s e team), a p r o g r a m Ito s u p p o r t s e x u a l a s s a u l t victims. A p r o f e s s i o n a l w h o ia l w a y s m a i n t a i n s a w a r e n e s s of n a t i o n a l t r e n d s , ir~s k n e w of a s u c c e s s f u l n u r s e e x a m i n e r p r o g r a m in T e x a s t h r o u g h her journal c o n t a c t s . "If t h e y c a n do it i~ Texas, w h y c a n ' t w e do it here?" s h e t h o u g h t . On Ithe o c c a s i o n of t h e prog r a m ' s t e n t h anniversary, ~Iris w a s affirmed in her efforts b y t h e d i s t r i c t a t t o r n e y w h e n h e p u b l i c l y c o m m e n d e d h e r for her efforts i h this area. A h i g h l i g h t in Iris' c a r e e r w a s t h e m a s s i v e organ i z a t i o n a l effort s h e c o o r d i n a t e d for e m e r g e n c y serv i c e s u p p o r t for P o p e J o h n Paul II's visit to Monterey, California in 1987 (Figure 2). She w a s r e s p o n s i b l e for conceiving, i m p l e m e n t i n g , a n d d i r e c t i n g t h e emerg e n c y care s y s t e m for t h e 85,000 people w h o a t t e n d e d . W h e n Iris a s s u m e d her first ED m a n a g e m e n t position, t h e r e w e r e t h o s e w h o a s k e d w h y s h e t h o u g h t s h e could m a n a g e a n e m e r g e n c y d e p a r t m e n t w i t h o u t ED e x p e r i e n c e . Iris p r o v e d h o w well s h e could m a n a g e , a n d in t h e end, "wrote t h e book" on ED m a n a g e m e n t , a c o m p r e h e n s i v e , w e l l - t h o u g h t out, tightly w r i t t e n t e x t entitled Managing E m e r g e n c y Nursing Services. 2 Iris F r a n k is a skilled a d m i n i s t r a t o r , s u c c e s s f u l risk taker, a n d s t r o n g leader. She h a s never a v o i d e d 625
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taking risks if s h e b e l i e v e d b e t t e r care w a s an outcome. One i n d i c a t i o n of t h e loyalty of those w h o work for her w a s t h e fact t h a t t h r e e n u r s e s in leadership positions c a m e to work for her at Sutter. Iris is t h e kind of leader w h o is a c u t e l y a w a r e of t h e d o w n s i d e of a stressful care delivery e n v i r o n m e n t a n d will consistently b e an advocate for n u r s i n g a n d p a t i e n t care values. "When you have just h a d your last portable t h e r m o m e t e r stolen from t r i a g e a n d y o u ' r e t h e triage nurse, it is difficult to focus on cost c o n t a i n m e n t issues," s h e exclaims. A n o t h e r s t r o n g i n d i c a t o r of Iris' c o m m i t m e n t , value, a n d abilities so i m p o r t a n t to t h e journal is r e f l e c t e d in a vote of c o n f i d e n c e from L e n e h a n : "When I n e e d s o m e o n e to r e v i e w a n editorial I h a v e written, Iris is one of t h e f e w i n d i v i d u a l s I rely on. She is a n e d i t o r ' s editor." Iris m a y b e one of t h e only c h i e f e x e c u t i v e officers in t h e c o u n t r y w h o s i m p l y calls herself "an a d m i n i s t r a t o r , " r a t h e r t h a n t h e m o r e p r e s tigious title of CEO. She b r i n g s a m a g i c a l b l e n d of Texas c h a r m , p r a g m a t i s m , sensitivity, a n d h u m o r to her profession. She is a s t e r l i n g e x a m p l e of a n u r s i n g l e a d e r w h o is able to c o m p r e h e n d b i g - p i c t u r e i s s u e s , r e t a i n e t h i c s , a n d m a i n t a i n a firm g r a s p on t h e v a l u e s of q u a l i t y c a r e a n d p r o f e s s i o n a l p r a c t i c e . Iris s u m m e d up h o w s h e feels a b o u t e m e r g e n c y n u r s i n g in t h e c o n c l u s i o n of her book: In 1941, four days after Pearl Harbor, a y o u n g American serving as a pilot in the Royal AI? Force was killed in action "somewhere in England." John Gillespie Magee, Jr., left a legacy, a p o e m entitled "High Flight," which is probably the b e s t k n o w n p o e m of WWII. We e m e r g e n c y nurses have "done a hundred things m o s t people have not dreamed of, " j u s t as M a g e e did. Daily as w e use our hands and our heads and our hearts to care for the sick, the needy, the broken and the dying, w e too have "put out our hand, and touched the face of God." E m e r g e n c y n u r s i n g m a n a g e m e n t . It d r a i n s our energy, our e m o t i o n s , a n d our intellect, b u t it g i v e s us m u c h in r e t u r n - - a s e n s e of b e i n g n e e d e d . . . of b e l o n g i n g . . , of e x c i t e m e n t . . , of f u l f i l l m e n t . . , of k n o w i n g t h a t w e m a k e a difference, often b e t w e e n living a n d d y i n g , to h u n d r e d s of t h o u s a n d s w h o e a c h y e a r s e e k h e l p in t h e d e p a r t m e n t s w e m a n a g e . 2 References
1. Frank IC. Avulsed scalp replantation. J Emerg Nurs 1979;5(4):8-11. 2. Frank IC. Managing emergency services. Rockville (MD): Aspen, 1989. Contributions f o r this c o l u m n shouM be sent to
Marlene J e z i e r s k i , RN, BAN, 1140 128th Ave N.E., Blaine, M N 5 5 4 3 4 ; p h o n e (612) 780-6897.
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Marlene Jezierski is quality facilitator, Patient Data Quality Department, and Violence Education Coordinator, Mercy/Unity Hospital, Coon Rapids, Minnesota. Reprints not available from author. J Emerg Nurs 1996;22:626-8. Copyright 9 1996 by the Emergency Nurses Association. 0099-1767/96 $5.00 + 0
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w i t h a b a n g . A t 4:27 AM on April 8, 2 hours a n d 33 m i n u t e s before t h e p l a n n e d official 7 AM o p e n i n g of p e r i n a t a I services, t h e first b a b y w a s born at Sutter. Iris, an e m e r g e n c y n u r s e for 18 years, b e g a n her n u r s i n g c a r e e r in 1970 after h a v i n g t w o sons. Her c a r e e r goals w e r e to find a job t h a t w a s r e w a r d i n g , portable, a n d o n e s h e could w o r k p a r t - t i m e . After fini s h i n g a s e r i e s of d e g r e e s ( a s s o c i a t e , bachelor's, a n d
Iris m a y b e o n e of t h e only c h i e f e x e c u t i v e officers in t h e c o u n t r y w h o s i m p l y calls h e r s e l f "an administrator," rather t h a n t h e m o r e p r e s t i g i o u s title of CEO. She b r i n g s a m a g i c a l b l e n d of Texas charm, pragmatism, sensitivity, a n d h u m o r to her p r o f e s s i o n . m a s t e r ' s ) a n d w o r k i n g in o r t h o p e d i c s , oncology, a n d critical care, s h e d i s c o v e r e d a n d fell in love w i t h e m e r g e n c y nursing. It w a s t h e r e s h e r e m a i n e d for m o s t of h e r career. D u r i n g t h a t t i m e , s h e w a s m a n a g e r of t h r e e California e m e r g e n c y d e p a r t m e n t s . T h e k n o w l e d g e a n d skills s h e d e v e l o p e d in t h e m a n a g e r role p r e p a r e d h e r for t h e c h a l l e n g e of d i r e c t i n g a n d p i l o t i n g t h e S u t t e r project. Iris' e m e r g e n c y n u r s i n g c r e d i t s are many. Her first e n c o u n t e r w i t h t h e Journal of E m e r g e n c y Nursing w a s w h e n s h e w r o t e a n article p u b l i s h e d in 1979: "Avulsed Scalp Replantation. 'd She t h e n w r o t e a m o v i n g letter a b o u t a p o l i c e officer, well k n o w n to the emergency department, who was a trauma p a t i e n t w h o died. T h e letter w a s so well w r i t t e n t h a t s h e w a s a s k e d to r e v i e w articles a n d w r i t e more. She
Jezierski/JOURNAL OF EMERGENCY NURSING
Figure 1 Iris Frank, RN, MSN, CEN, poses in front of the Sutter Maternity and Surgery Center.
Figure 2 Iris Frank (left) was the medical director for the Monterey, California, visit of Pope John Paul II in 1987.
D e c e m b e r 1996 627
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w a s a s k e d to join t h e journal editorial b o a r d in J a n u a r y 1984, a n d quickly b e c a m e one of its m o s t valued m e m bers. She b e c a m e a s s i s t a n t a n d t h e n a s s o c i a t e editor, a n d s e r v e d as s e c t i o n editor of t h e "Profiles" a n d " M a n a g e r s A s k a n d Answer" columns. T h e list d o e s little justice to t h e level a n d quality of Iris' work. Gall Lenehan, journal editor, m o r e a c c u r a t e l y d e s c r i b e s t h e level of her contributions. "Iris h a s b e e n a bulwark to t h e journal for m a n y years. Her k n o w l e d g e is reliable, varied, a n d broad. W h e n w e n e e d a g u e s t editor, Iris volunteers. W h e n w e n e e d an article on a certain topic, it's Iris w h o k n o w s s o m e o n e w h o c a n write on it. W h e n w e n e e d a topic, Iris c o m e s u p w i t h an idea. W h e n w e n e e d a cover, Iris g e t s t h e original art work. W h e n a n e w i d e a is s u g g e s t e d , Iris often does t h e writing herself. She has w o r k e d tirelessly a n d selflessly a n d m a k e s it look easy. She frequently volunteers to t a k e on n e w responsibilities. Iris c o n c e i v e d t h e i d e a of the ' M a n a g e r s Ask a n d A n s w e r ' column, t h e n she e d i t e d it." Her c o n t r i b u t i o n s to t h e journal reflect t h e s c o p e of h e r e x p e r i e n c e a n d c o n t a c t s . O n e of t h e m a n y fine art c o v e r s to Iris' c r e d i t is Van G o g h ' s "Irises," her favorite. She h a s often l e c t u r e d on t h e art of w r i t i n g for p u b l i c a t i o n a n d is a c o n v i n c i n g a d v o c a t e for a s p i r i n g n u r s e writers. Iris feels e s p e c i a l l y PrOud of t h e s e x u a l a s s a u l t n u r s e t e a m w o r k s h e s p e a r h e a d e d in S a n t a Cruz, In t h e early 1980s s h e w o r k e dI l o n g a n d h a r d w i t h t h e d i s t r i c t attorney, c h i e f of police, a n d t h e C o m m i t t e e to P r e v e n t Violence A g a i n S t W o m e n , a local political a c t i o n g r o u p , to e s t a b l i s h SART (sexual a s s a u l t r e s p o n s e team), a p r o g r a m Ito s u p p o r t s e x u a l a s s a u l t victims. A p r o f e s s i o n a l w h o ia l w a y s m a i n t a i n s a w a r e n e s s of n a t i o n a l t r e n d s , ir~s k n e w of a s u c c e s s f u l n u r s e e x a m i n e r p r o g r a m in T e x a s t h r o u g h her journal c o n t a c t s . "If t h e y c a n do it i~ Texas, w h y c a n ' t w e do it here?" s h e t h o u g h t . On Ithe o c c a s i o n of t h e prog r a m ' s t e n t h anniversary, ~Iris w a s affirmed in her efforts b y t h e d i s t r i c t a t t o r n e y w h e n h e p u b l i c l y c o m m e n d e d h e r for her efforts i h this area. A h i g h l i g h t in Iris' c a r e e r w a s t h e m a s s i v e organ i z a t i o n a l effort s h e c o o r d i n a t e d for e m e r g e n c y serv i c e s u p p o r t for P o p e J o h n Paul II's visit to Monterey, California in 1987 (Figure 2). She w a s r e s p o n s i b l e for conceiving, i m p l e m e n t i n g , a n d d i r e c t i n g t h e emerg e n c y care s y s t e m for t h e 85,000 people w h o a t t e n d e d . W h e n Iris a s s u m e d her first ED m a n a g e m e n t position, t h e r e w e r e t h o s e w h o a s k e d w h y s h e t h o u g h t s h e could m a n a g e a n e m e r g e n c y d e p a r t m e n t w i t h o u t ED e x p e r i e n c e . Iris p r o v e d h o w well s h e could m a n a g e , a n d in t h e end, "wrote t h e book" on ED m a n a g e m e n t , a c o m p r e h e n s i v e , w e l l - t h o u g h t out, tightly w r i t t e n t e x t entitled Managing E m e r g e n c y Nursing Services. 2 Iris F r a n k is a skilled a d m i n i s t r a t o r , s u c c e s s f u l risk taker, a n d s t r o n g leader. She h a s never a v o i d e d 625
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taking risks if s h e b e l i e v e d b e t t e r care w a s an outcome. One i n d i c a t i o n of t h e loyalty of those w h o work for her w a s t h e fact t h a t t h r e e n u r s e s in leadership positions c a m e to work for her at Sutter. Iris is t h e kind of leader w h o is a c u t e l y a w a r e of t h e d o w n s i d e of a stressful care delivery e n v i r o n m e n t a n d will consistently b e an advocate for n u r s i n g a n d p a t i e n t care values. "When you have just h a d your last portable t h e r m o m e t e r stolen from t r i a g e a n d y o u ' r e t h e triage nurse, it is difficult to focus on cost c o n t a i n m e n t issues," s h e exclaims. A n o t h e r s t r o n g i n d i c a t o r of Iris' c o m m i t m e n t , value, a n d abilities so i m p o r t a n t to t h e journal is r e f l e c t e d in a vote of c o n f i d e n c e from L e n e h a n : "When I n e e d s o m e o n e to r e v i e w a n editorial I h a v e written, Iris is one of t h e f e w i n d i v i d u a l s I rely on. She is a n e d i t o r ' s editor." Iris m a y b e one of t h e only c h i e f e x e c u t i v e officers in t h e c o u n t r y w h o s i m p l y calls herself "an a d m i n i s t r a t o r , " r a t h e r t h a n t h e m o r e p r e s tigious title of CEO. She b r i n g s a m a g i c a l b l e n d of Texas c h a r m , p r a g m a t i s m , sensitivity, a n d h u m o r to her profession. She is a s t e r l i n g e x a m p l e of a n u r s i n g l e a d e r w h o is able to c o m p r e h e n d b i g - p i c t u r e i s s u e s , r e t a i n e t h i c s , a n d m a i n t a i n a firm g r a s p on t h e v a l u e s of q u a l i t y c a r e a n d p r o f e s s i o n a l p r a c t i c e . Iris s u m m e d up h o w s h e feels a b o u t e m e r g e n c y n u r s i n g in t h e c o n c l u s i o n of her book: In 1941, four days after Pearl Harbor, a y o u n g American serving as a pilot in the Royal AI? Force was killed in action "somewhere in England." John Gillespie Magee, Jr., left a legacy, a p o e m entitled "High Flight," which is probably the b e s t k n o w n p o e m of WWII. We e m e r g e n c y nurses have "done a hundred things m o s t people have not dreamed of, " j u s t as M a g e e did. Daily as w e use our hands and our heads and our hearts to care for the sick, the needy, the broken and the dying, w e too have "put out our hand, and touched the face of God." E m e r g e n c y n u r s i n g m a n a g e m e n t . It d r a i n s our energy, our e m o t i o n s , a n d our intellect, b u t it g i v e s us m u c h in r e t u r n - - a s e n s e of b e i n g n e e d e d . . . of b e l o n g i n g . . , of e x c i t e m e n t . . , of f u l f i l l m e n t . . , of k n o w i n g t h a t w e m a k e a difference, often b e t w e e n living a n d d y i n g , to h u n d r e d s of t h o u s a n d s w h o e a c h y e a r s e e k h e l p in t h e d e p a r t m e n t s w e m a n a g e . 2 References
1. Frank IC. Avulsed scalp replantation. J Emerg Nurs 1979;5(4):8-11. 2. Frank IC. Managing emergency services. Rockville (MD): Aspen, 1989. Contributions f o r this c o l u m n shouM be sent to
Marlene J e z i e r s k i , RN, BAN, 1140 128th Ave N.E., Blaine, M N 5 5 4 3 4 ; p h o n e (612) 780-6897.