Maine ENA Newsletter Archive

President's Corner

Sandie Weagle, RN, CEN

Waldo County Hospital, Belfast

The primary goal of Maine ENA is education. There are, of course, other objectives to which our professional organization aspires, but the education of our colleagues, our patients, and the general public is our primary goal.

Maine ENA believes it is imperative that emergency nurses continue their education throughout their careers. Courses sponsored by our national organization are a great foundation on which to build. The Emergency Nurse Pediatric Course (ENPC) and the Trauma Nurse Core Course (TNCC) provide skills and standards for caring for our children and for our trauma patients, and should be attended by all emergency nurses.

In these times of fiscal constraint, money for education is not as readily available as we would like, and, so, the burden of paying for courses often falls on the individual nurse. Maine ENA has set a goal of reducing the costs of these courses, to make them more accessible to more nurses. Maine ENA is paying for the manuals, at a cost of $40 each, thereby reducing the tuition by $40 per class. In an attempt at further cost containment, Maine ENA had submitted to the national office, a resolution calling for an accounting of the costs of producing these courses, as well as seeking a way to make them more affordable.

The national ENA office has rejected our resolution on the basis that it is operational, and not specific to nursing practice. While we disagree, and feel it is directly related to competence to practice, we are willing to compromise, and work with the association.

A task force is being established to look at the TNCC and ENPC courses to review the following:

• Current open pricing model
• Additional administrative procedures established by states
• Interstate issues
• Purpose of assessments and how they are used in practice
• Understanding of roles of trauma and pediatric chairs
• Role of International Faculty in the national/state/local relationship

Wendy Nivison, RN, BSN, CEN will be Maine ENA\'s representative to this task force. Wendy has taken these courses, but is not an instructor. Any information, ideas, or concerns that TNCC and ENPC instructors have, should be communicated to Wendy.

The more data she has, the better she can represent us and be instrumental in addressing the charges of the group. We look forward to being involved on the national level, and making a difference in our organization.

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Pediatric Committee Report

September 10, 2004

1. ENPC Updates

   To date, three ENPC updates have taken place with 16 of 17 instructors being re-verified. The last instructor update is taking place on September 28 in Lewiston.

   The updates took place in the northern, central and southern part of the state to assure all would be able to attend an update.

   A special thanks to my friend and colleague, Karen Taylor for assisting with these updates. Maine ENA has graciously paid for the manuals (provide and instructor supplements) for all of these instructors. Maine ENA has also paid for all provider manuals for all courses over the past year.

2. ENPC classes

   I will be holding a course on September 16 and 17 in Lewiston which is currently full. I also have a class on November 15 & 16 which has a few openings left.

   A course is scheduled for October 5 & 6 in the northern part of the state; Lisa Mooers is the contact person and can be reached at lhm425@hotmail.com

   Karen Taylor will be holding a course on October 12 & 19 at the Doubletree in Portland and she can be reached at Taylokd@mmc.org

   Paula Luhrs will be holding a course on October 21 and 22 at Maine Coast in Ellsworth and she can be reached at Sprcva@midmaine.com

   And a course is scheduled for November 15 & 22 at SMMC and Mike Mirisola can be reached at Michael.Mirisola@verizon.net

   Thank you to all instructors for volunteering your time to bring this course to our colleagues in the state.

3. ENPC instructor Course

   I will be holding an instructor course sometime in the spring and will be notifying those potential candidates when the date is set.

Respectively submitted,

Carmen Hetherington, RN, BSN, CEN
Chair, Pediatric Committee

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ENPC Courses

• October 5 & 6: Northern Maine area

• October 21 & 22 Maine Coast, Ellsworth

• Nov. 15 & 16 at Central Maine Medical Center. Lewiston

• November 15 & 22 at SMCC

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Maine ENA Election Results 2004

President-Elect: Barry Worthing

Secretary Treasurer: Andrea Haskell-Varnum

Board Member: Wendy Nivison

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General Assembly Committee

Annual Meeting Report
September 3, 2004

The point criteria for delegate application was reviewed and revised by the MENA Board at the spring meeting of the Board. A letter including a “call for delegates” and the criteria were sent to the members in May. Applications were reviewed and presented to the MENA Board at the June 11, 2004 meeting.

Delegates are as follows: President, Sandi Weagle; and applicants, Donna Blaney-Brouse, Susan Dupler, Geneva Sides, Karen Taylor, Jane Whittaker, and alternate, Judi Carver.

Respectfully submitted,

Judy Carver
Chairperson
General Assembly Committee

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CEN Review Questions

From CEN Review by Renee Simonin Holleran

Triage Review

1. Which patient should be taken into the ED first?
   1. Patient with chest pain
   2. Child who is drooling
   3. Patient with a laceration
   4. Patient who is bleeding
2. Which of the following mnemonics may be used to determine and describe a patient’s level of consciousness?
   1. PQRST
   2. AVPU
   3. TIPPS
   4. AEIOU

An 18 year-old man comes to the triage area complaining of upper body weakness, as well as numbness and tingling in both hands. The patient states that he was involved in a fight the previous night and that his head was shoved between his legs. The patient is alert and oriented. Vital signs are B/P 110/70, P 64, R 18, and T 99 F. His pupils are equal and reactive. He is unable to keep his arms extended for longer than 5 seconds, and he cannot make a fist.

3. The Triage classification for this patient would be:
   1. Delayed Care
   2. Emergent
   3. Urgent
   4. Non-urgent
4. The initial care provided by the triage RN should include application of:
   1. Heat to the neck
   2. Ice to the neck
   3. A cervical collar
   4. Elastic bandage wraps to the hands
5. Of the following, which nursing diagnosis would be most appropriate for the care of this patient?
   1. Injury, high risk for, related to a spinal cord injury
   2. Fluid volume deficit, high risk for, related to a spinal cord injury
   3. Hyperthermia, related to a spinal cord injury
   4. Infection, high risk for, related to a spinal cord injury
6. Focused triage documentation for this patient should include documentation of:
   1. Adventitious breath sounds
   2. Peripheral and central pulses
   3. Paradoxical pulses
   4. Level of consciousness

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News from BCEN...CEN Renewal Options!!

Every year at the BCEN booth nurses approach the booth with some old understanding about CEN renewals. This year we are introducing new options for renewal to help make it easier for you. First and foremost, any RN can take the CEN exam. Some nurses still think you need a BSN……this is not the case. Secondly, once you take the written exam, you can renew by a couple of options. You do not have to sit for the written exam every four years!

Renewal options now include:

1. Renewal by CEU’s.
2. Renewal by Internet Based Testing (IBT)
3. Retake the written / computer exam.

If you choose to renew by CEU’s, BCEN is presently working on an on-line application and form that could be completed and submitted. The form would allow you to enter CEU courses, which you attended, and additionally we are looking at taking into consideration other educational projects that nurses participate in (i.e. Publications, Item Writing, Presentations/Lectures, Preceptorship, Academia).

The newest option for renewal is the IBT. The IBT is the option to renew by taking an open-book computer based test. BCEN has been working throughout the past year to re-evaluate the open-book exam. The open-book exam has now been completely reviewed, revised, and critiqued. With the IBT you will register on-line, log onto a secure website, have 30 days to complete the exam, and receive an immediate score report. You can go in and out of the website as many times as you like during your 30 day window.

Please visit the BCEN website for more information. If you have comments or suggestions we value your input.

Thank You,

Robin Gilbert, RN, BSN, CEN
BCEN Board Member

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Government Affairs Report

September 2004

LD1826 “An Act to Encourage the Proper Disposal of Expired Pharmaceuticals.”

This bill creates the Unused Pharmaceutical Disposal Program, administered by ME, DEA, to provide for the safe, effective and proper disposal of unused or expired prescription drugs. The program involves the use of repaid mailers to be made available and used by the public to mail drugs to a single collection location. The drugs received may be handled only by the agency and disposed of in a manner that ensures the safety of the public and the environment.

LD 1152 “ An Act to Authorize Collaborative Practice for Emergency Contraception”

This bill authorizes a pharmacist to initiate emergency contraception drug therapy in accordance with standardized protocols developed by the pharmacist and an authorized prescriber acting within his or her scope of practice. The pharmacist must have a standardized fact sheet developed by the Dept. of Professional and Financial Regulation, Maine Board of Pharmacy, in consultation with the DHS, American College of Obstetricians, and Gynecologists, the Maine Pharmacy Association. It also required the pharmacist to complete a specific training program.

Submitted:

Pamela Poisson, RN, Chair, Government Affairs

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ENCARE

January-August 2004

We are all doing education daily in the work that we perform, let’s start taking credit for it. Any time that you educate the public on injury prevention, please notify me so I can send these numbers into National ENA, and Maine ENA will get credit for our hard work.

• Dare to Care: 1145 Students
• Child Passenger Safety Seat Checks: 36 with Safety Seats given away
• Bike Rodeo with Helmets fitted: 75
• Gun Locks given away: 375 – more have been given away but 0 numbers reported
• Domestic violence and sexual assault education: At least 2 presentations.

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ED Nurses Speak Out About ENCARE Program

These nurses have been very busy presenting to students at Noble High School, Thorton Academy, Sanford High School and Bonney Eagle High School. They are to be commended for their contributions for the community and for their representation of SMMC. For more information about the ENCARE program, visit www.ena.org/encare

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Injury Prevention in Action - Bike Rodeo

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MENA Annual Awards

Special Merit Citation

Betty Chesley for her many years of service to Maine ENA.

Leadership Award

Sandie Weagle, Waldo County Hospital, Belfast

Nurse Provider Award

Ann Bishop-Kodis, MMC, Portland and Laurel Deveau, Penobscot Valley Hospital in Lincoln.

MENA Scholarship 2004

Jennifer Bagley, St. Joseph’s Hospital, Bangor- $250

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CEN Review Answers

1. B

   Based on rapid patient assessment, the patient with airway difficulties should be taken in first. A child who is drooling may have epiglottitis and is at great risk of complete airway obstruction.

2. B

   A (alert) V (verbal) P (responds to painful stimuli) U (unresponsive) PQRST - pertains to patient history TIPPS and AEIOU - description of causes that may alter a patient’s LOC

3. B

   Based on rapid patient assessment using ABCDE, this patient would be Emergent. He has signs and symptoms of a neurological deficit that could have him at risk for additional complications related to injury of the cervical spine.

4. C

   One of the goals of triage is the initiation of therapeutic interventions. Because this patient may have suffered a spinal cord injury, the initial care should include immobilization of the cervical spine.

5. A

   The initial assessment indicates that the patient is in no acute distress, but, because of the mechanism of injury, he is at risk for additional injury.

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NERS 2005

NERS 2005 will be held May 16-18 at the Marriott Sable Oaks in South Portland, ME. The Planning Committee has been working for some time now, and plans are well under way. The Symposium is Co-Chaired by Susan Dupler and Karen Taylor with many MENA members contributing to the overall success of the conference.

Carmen Hetherington is chairing the Program Committee. She has most, if not all, speakers confirmed already. Polly Zimmerman, our National ENA Board Liaison will be the keynote speaker. Tess Gerritsen, MD, a nationally known author, will be speaking, as well as doing a book signing for her latest medical mystery thriller. The speakers will cover a broad range of topics certain to interest the beginner to novice ED RN’s. The cap-note will be done by Kathy Eliscu and will be sure to leave us exiting with a positive outlook.

Barry Worthing is chairing the Vendors Committee and, along with his assistants, has many ideas for vendor contributions as well as area attractions.

Jane Whittaker and her group are actively soliciting donations for the Hospitality Committee. Look for information on Maine Hospital Basket Raffles (always a big draw!). There will be many give-aways, but you must attend to be a winner.

NERS 2005 promises to be an excellent educational experience and a lot of fun. Make plans now to attend!

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Emergency Departments Employment Opportunities

Maine General Health

We are currently searching for experienced RNs to become part of the ED team at Maine General Medical Center in Augusta and Waterville.

• State of Maine RN license required
• 3 to 5 years of ED clinical experience required but willing to train exceptional candidate.

Call and learn more about the opportunities Maine General Health has to offer.

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Maine ENA Newsletter Info

Carol Minnis, RN, CEN
Maine General Medical Center, Waterville

Maine ENA and I would appreciate any input to our newsletter. This would include:

• Nursing Stories
• Clinical Narratives, “The Work of Nursing”
• What’s going on at your hospital?
• Awards
• Tips and Solutions

Advertisement rates

• 1/4 page :$15.00
• 1/2 page :$30.00
• full page :$60.00

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