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Scope of practice and protocols sought for ED nurse practitioners
JOURNALOF EMERGENCY NURSING
e s ) . - - T a f f y Davis, RN, BSN, CEN, Franklin Memorial
Hospital, Emergency Department, 1 Hospital Drive, Farmington, ME 04938
First ENA Nurse Practice Networking Session
Dear Editor; T h e first E N A N u r s e P r a c t i c e N e t w o r k i n g Sess i o n w a s h e l d in S a n A n t o n i o on O c t o b e r 1, 1994. T w e n t y - t w o m e m b e r s r e p r e s e n t i n g 10 s t a t e s p a r t i c i p a t e d in t h e s e s s i o n . T h e r e w a s l i v e l y d i s c u s s i o n a b o u t t h e u s e of unlicensed assistive personnel. Comments ranged from c o n c e r n s a b o u t t h e p o s s i b l e i n c r e a s e in t h e p a r a m e d i c s c o p e of p r a c t i c e in F l o r i d a to u n e a s i n e s s a n d a n g e r a b o u t t h e l a c k of r e g i s t e r e d n u r s e s on t r a u m a r e s u s c i t a t i o n t e a m s in c e r t a i n h o s p i t a l s in Ohio and Georgia. W e a l s o t a l k e d a b o u t E N A ' s S c o p e of P r a c t i c e position statement and packet. The group discussed w a y s for t h i s i n f o r m a t i o n to r e a c h a l a r g e r p o r t i o n of the general membership. F i n a l l y , t h e n e e d for a n a v e n u e of c o m m u n i c a tion b e t w e e n s t a t e a n d n a t i o n a l P r a c t i c e C o m m i t t e e s w a s i d e n t i f i e d . O n e m e t h o d of c o m m u n i c a t i o n is a n a n n u a l n e t w o r k i n g s e s s i o n . A n o t h e r is t h e d e v e l o p m e n t of a r o s t e r of t h o s e p r e s e n t a t t h i s first n e t w o r k i n g s e s s i o n . T h e r o s t e r wiI1 s e r v e a s a r e s o u r c e for c o m m u n i c a t i o n b e t w e e n s e s s i o n m e m bers. T h e list i n c l u d e s N a t i o n a l N u r s e P r a c t i c e Committee members and several state Practice Committee chairpersons. These talented and exper i e n c e d n u r s e s c a n h e l p to a n s w e r q u e s t i o n s , a n d w e can keep each other informed about current practice issues. If y o u w o u l d b e i n t e r e s t e d in r e c e i v i n g a c o p y of t h e list or w o u l d like u s to a d d y o u r n a m e to t h e list, p l e a s e s e n d m e y o u r request.--Susan Kaplan,
RN, CEN, Chair, Massachusetts Nursing Practice Committee; member, ENA National Nursing Practice Committee, 9 Carlson Circle, Natick, MA 01760
Scope of practice and protocols sought for ED nurse practitioners
Dear Editor: I am a family nurse practitioner student worki n g on m y p r o j e c t to c o m p l e t e m y m a s t e r ' s d e g r e e . M y p r o j e c t i n v o l v e s w r i t i n g p r o t o c o l s for t h e n u r s e p r a c t i t i o n e r in t h e e m e r g e n c y d e p a r t m e n t . O u r curr e n t ED c e n s u s is m o r e t h a n 65,000 v i s i t s p e r year. Six m o n t h s a g o w e d e v e l o p e d a m i n o r c a r e t r a c k to
r e l i e v e t h e u r g e n t t r a c k in t h e d e p a r t m e n t . Our g o a l is to s e e 50% of t h e ED p a t i e n t s in t h e m i n o r c a r e track. I would appreciate correspondence and advice on d e f i n i n g t h e n u r s e p r a c t i t i o n e r ' s s c o p e of p r a c tice, d e v e l o p i n g p r o t o c o l s , a n d s o u r c e s of i n f o r m a tion u s e d a s a b a s i s . I h a v e w o r k e d a s a n e m e r g e n c y n u r s e for 23 y e a r s a n d b e l i e v e t h e r e is a n e e d a n d a p l a c e for p r a c t i t i o n e r s in t h e e m e r g e n c y s e t t i n g . -
Alice McCann, RN, BSN, CEN, 113 Brycewood Circle, Hattiesburg, MS 39402
More on reentering
Dear Editor: T h e JOURNAL OF EMERGENCY NURSING r e c e n t l y p u b l i s h e d t w o a r t i c l e s t h a t f o c u s e d on m e n t o r s . T h i s o c c u r r e d j u s t a s I w a s g o i n g to s u b m i t m y o w n article! M y m e n t o r p r o v i d e d o r i e n t a t i o n for m e in t h e e m e r g e n c y d e p a r t m e n t 15 y e a r s ago. I still live b y t h e p e a r l s of w i s d o m s h e g a v e to m e . . . c a n n u l a t e w h a t y o u can; n e v e r l e t t h e m h u r t you; a s k if you do not k n o w ; a n d a l w a y s t r y to k e e p y o u r s e n s e of h u mor! As a colleague, my mentor would make sure I w a s c o m f o r t a b l e in crisis, m a y b e p o k e h e r h e a d i n t o a t r e a t m e n t r o o m to s e e if I n e e d e d help, a n d s o m e t i m e s s h e w o u l d c h e c k j u s t to b e s u r e I w a s s m i l i n g . A n d , if I w a s not, s h e w o u l d o c c a s i o n a l l y a c t o u t s o m e t h i n g h y s t e r i c a l l y i n s a n e (in a p r o f e s s i o n a l m a n n e r , of course)! I have often seen her share her knowledge not o n l y w i t h me, b u t w i t h o u r e n t i r e staff. S h e is a s o l i d peer professional, and has become an even better p e r s o n a l friend. M o s t r e c e n t l y , t h i s n u r s e h a s f i n a l l y become an acknowledged nursing leader: she serves on t h e E N A Board of Directors. T h r o u g h all t h e s e acc o m p l i s h m e n t s , t h e r e is a l w a y s a n u n d e r l y i n g t h e m e of e n e r g y a n d e f f e c t i v e n e s s t h a t is contagious. I c o m e from t h e s c h o o l of " e m u l a t e w h a t y o u a d m i r e , " so, it c o m e s a s no s u r p r i s e t h a t I r e c e n t l y h a v e b e e n a b l e to r e a l i z e s o m e i m p o r t a n t goals: a m o r e a c t i v e p a r t i c i p a t i o n in m y p r o f e s s i o n a l a s s o c i ation, f u r t h e r i n g of m y e d u c a t i o n , w r i t i n g for p u b l i cation, a n d t e a c h i n g . I a m s u r e I w o u l d n o t b e a s int e r e s t e d in t h e s e a s p i r a t i o n s if it w e r e n o t for m y p e r s o n a l m e n t o r a n d friend, k n o w n to m e as " D u b a . " T h i s l e t t e r is w r i t t e n n o t o n l y to e n c o u r a g e o t h e r ED n u r s e s to r e c o g n i z e a n d h o n o r t h e i r m e n tors, b u t a l s o to e n c o u r a g e e a c h o n e of u s to s t r i v e to b e a mentor!--Mik Staeck, RN, BSN CEN, North-
ern Nevada Medical Center, Sparks, Nevada
June 1995 197
e s ) . - - T a f f y Davis, RN, BSN, CEN, Franklin Memorial
Hospital, Emergency Department, 1 Hospital Drive, Farmington, ME 04938
First ENA Nurse Practice Networking Session
Dear Editor; T h e first E N A N u r s e P r a c t i c e N e t w o r k i n g Sess i o n w a s h e l d in S a n A n t o n i o on O c t o b e r 1, 1994. T w e n t y - t w o m e m b e r s r e p r e s e n t i n g 10 s t a t e s p a r t i c i p a t e d in t h e s e s s i o n . T h e r e w a s l i v e l y d i s c u s s i o n a b o u t t h e u s e of unlicensed assistive personnel. Comments ranged from c o n c e r n s a b o u t t h e p o s s i b l e i n c r e a s e in t h e p a r a m e d i c s c o p e of p r a c t i c e in F l o r i d a to u n e a s i n e s s a n d a n g e r a b o u t t h e l a c k of r e g i s t e r e d n u r s e s on t r a u m a r e s u s c i t a t i o n t e a m s in c e r t a i n h o s p i t a l s in Ohio and Georgia. W e a l s o t a l k e d a b o u t E N A ' s S c o p e of P r a c t i c e position statement and packet. The group discussed w a y s for t h i s i n f o r m a t i o n to r e a c h a l a r g e r p o r t i o n of the general membership. F i n a l l y , t h e n e e d for a n a v e n u e of c o m m u n i c a tion b e t w e e n s t a t e a n d n a t i o n a l P r a c t i c e C o m m i t t e e s w a s i d e n t i f i e d . O n e m e t h o d of c o m m u n i c a t i o n is a n a n n u a l n e t w o r k i n g s e s s i o n . A n o t h e r is t h e d e v e l o p m e n t of a r o s t e r of t h o s e p r e s e n t a t t h i s first n e t w o r k i n g s e s s i o n . T h e r o s t e r wiI1 s e r v e a s a r e s o u r c e for c o m m u n i c a t i o n b e t w e e n s e s s i o n m e m bers. T h e list i n c l u d e s N a t i o n a l N u r s e P r a c t i c e Committee members and several state Practice Committee chairpersons. These talented and exper i e n c e d n u r s e s c a n h e l p to a n s w e r q u e s t i o n s , a n d w e can keep each other informed about current practice issues. If y o u w o u l d b e i n t e r e s t e d in r e c e i v i n g a c o p y of t h e list or w o u l d like u s to a d d y o u r n a m e to t h e list, p l e a s e s e n d m e y o u r request.--Susan Kaplan,
RN, CEN, Chair, Massachusetts Nursing Practice Committee; member, ENA National Nursing Practice Committee, 9 Carlson Circle, Natick, MA 01760
Scope of practice and protocols sought for ED nurse practitioners
Dear Editor: I am a family nurse practitioner student worki n g on m y p r o j e c t to c o m p l e t e m y m a s t e r ' s d e g r e e . M y p r o j e c t i n v o l v e s w r i t i n g p r o t o c o l s for t h e n u r s e p r a c t i t i o n e r in t h e e m e r g e n c y d e p a r t m e n t . O u r curr e n t ED c e n s u s is m o r e t h a n 65,000 v i s i t s p e r year. Six m o n t h s a g o w e d e v e l o p e d a m i n o r c a r e t r a c k to
r e l i e v e t h e u r g e n t t r a c k in t h e d e p a r t m e n t . Our g o a l is to s e e 50% of t h e ED p a t i e n t s in t h e m i n o r c a r e track. I would appreciate correspondence and advice on d e f i n i n g t h e n u r s e p r a c t i t i o n e r ' s s c o p e of p r a c tice, d e v e l o p i n g p r o t o c o l s , a n d s o u r c e s of i n f o r m a tion u s e d a s a b a s i s . I h a v e w o r k e d a s a n e m e r g e n c y n u r s e for 23 y e a r s a n d b e l i e v e t h e r e is a n e e d a n d a p l a c e for p r a c t i t i o n e r s in t h e e m e r g e n c y s e t t i n g . -
Alice McCann, RN, BSN, CEN, 113 Brycewood Circle, Hattiesburg, MS 39402
More on reentering
Dear Editor: T h e JOURNAL OF EMERGENCY NURSING r e c e n t l y p u b l i s h e d t w o a r t i c l e s t h a t f o c u s e d on m e n t o r s . T h i s o c c u r r e d j u s t a s I w a s g o i n g to s u b m i t m y o w n article! M y m e n t o r p r o v i d e d o r i e n t a t i o n for m e in t h e e m e r g e n c y d e p a r t m e n t 15 y e a r s ago. I still live b y t h e p e a r l s of w i s d o m s h e g a v e to m e . . . c a n n u l a t e w h a t y o u can; n e v e r l e t t h e m h u r t you; a s k if you do not k n o w ; a n d a l w a y s t r y to k e e p y o u r s e n s e of h u mor! As a colleague, my mentor would make sure I w a s c o m f o r t a b l e in crisis, m a y b e p o k e h e r h e a d i n t o a t r e a t m e n t r o o m to s e e if I n e e d e d help, a n d s o m e t i m e s s h e w o u l d c h e c k j u s t to b e s u r e I w a s s m i l i n g . A n d , if I w a s not, s h e w o u l d o c c a s i o n a l l y a c t o u t s o m e t h i n g h y s t e r i c a l l y i n s a n e (in a p r o f e s s i o n a l m a n n e r , of course)! I have often seen her share her knowledge not o n l y w i t h me, b u t w i t h o u r e n t i r e staff. S h e is a s o l i d peer professional, and has become an even better p e r s o n a l friend. M o s t r e c e n t l y , t h i s n u r s e h a s f i n a l l y become an acknowledged nursing leader: she serves on t h e E N A Board of Directors. T h r o u g h all t h e s e acc o m p l i s h m e n t s , t h e r e is a l w a y s a n u n d e r l y i n g t h e m e of e n e r g y a n d e f f e c t i v e n e s s t h a t is contagious. I c o m e from t h e s c h o o l of " e m u l a t e w h a t y o u a d m i r e , " so, it c o m e s a s no s u r p r i s e t h a t I r e c e n t l y h a v e b e e n a b l e to r e a l i z e s o m e i m p o r t a n t goals: a m o r e a c t i v e p a r t i c i p a t i o n in m y p r o f e s s i o n a l a s s o c i ation, f u r t h e r i n g of m y e d u c a t i o n , w r i t i n g for p u b l i cation, a n d t e a c h i n g . I a m s u r e I w o u l d n o t b e a s int e r e s t e d in t h e s e a s p i r a t i o n s if it w e r e n o t for m y p e r s o n a l m e n t o r a n d friend, k n o w n to m e as " D u b a . " T h i s l e t t e r is w r i t t e n n o t o n l y to e n c o u r a g e o t h e r ED n u r s e s to r e c o g n i z e a n d h o n o r t h e i r m e n tors, b u t a l s o to e n c o u r a g e e a c h o n e of u s to s t r i v e to b e a mentor!--Mik Staeck, RN, BSN CEN, North-
ern Nevada Medical Center, Sparks, Nevada
June 1995 197