Maine ENA Newsletter Archive

President's Corner

Barry Worthing, RN

Maine Medical Center

It is long awaited, yet slow arriving. As winter relinquishes its grip on us we can begin to see and feel the impending arrival of spring. We look forward to this and other upcoming events with a sense of renewal. One of those anticipated events is the annual New England Regional Symposium. This year it is being hosted by our colleagues in Plymouth, Massachusetts. The program looks great. Another opportunity is our own spring education day May 11 at Stephens Memorial Hospital in Norway. It is rejuvenating after the long cold winter to get out, see old friends and make new ones. Acquiring new knowledge or reinforcing old is just as rewarding. It helps us see our jobs in a new light and prepares us for the upcoming busy summer season. I hope you can take advantage of at least one of these opportunities for yourself and your patients.

Barry Worthing, RN
President, Maine ENA

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MENA Membership

Maine ENA would like to welcome the following new members:

• Regina Blauvelt
• Heather Close
• Paige Dunn
• Georgia Golder
• Trina Littlefield
• Michelle Markie

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ENPC

2007 Courses

• May 10 & 11
• July 9 & 10
• October 4 & 5

Central Maine Medical Center, Lewiston

ENPC Instructor Course

• June 7

Central Maine Medical Center. Lewiston

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TNCC

2007 Courses

• June 6 & 13
• September 11& 18
• November 6 & 13

ENPC Instructor Course

date to be announced

Notice

Free manuals while funds are available for all ENPC and TNCC courses scheduled in 2007!

Course coordinatators must contact either Carmen Hetherington or Geneva Sides.

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Delegate Point Criteria for National Meeting

Dear Delegate Candidates:

This year the General Assembly will be held September 26 & 27, 2007 in Salt Lake City, Utah. The Maine General Assembly Committee, assisted by the Board of Directors, will select delegates according to the point system based on your ENA involvement for the calendar year January 2006 through December 2006.

Points are earned as follows:

Members active at the National level may double the points for items 3, 4, & 5.

Points will be assigned by the General Assembly Committee/MENA Board for community service, nursing recognition, activities that promote Emergency Nursing, and ENA special projects. As this information may be useful to break a tie, please include any activities that reflect your professional involvement.

Please submit your completed application, postmarked by May 23, 2007. Delegates will be notified by mail following the June 1st Board meeting.

Click here for a printable application for members who wish to be considered as a delegate to the 2007 ENA Annual Meeting.

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St. Andrews Nursing Article

Steven F. Juchnik, RN ,BSN

Emergency Department Manager
St. Andrews Hospital and Healthcare Center
Boothbay Harbor, Maine

Recently the ED staff at St. Andrews participated in numerous training modules designed to enhance their nursing skills. This included a Regional Disaster Drill on October 14, 2006. In this training scenario, the capabilities and capacity of the Emergency Department was tested beyond their normal scope of service. Thirty six simulated patients involved in a school bus accident as a result of a high speed police chase involving chemicals of unknown origin and subsequent trauma patients were sent to five area hospitals. St. Andrews staff received a total of 10 of these “patients” including four major multiple trauma victims of which two were contaminated with chemicals and had to be decontaminated prior to receiving treatment.

The other patients were either admitted or treated and released. The entire exercise showed how St. Andrews Hospital and Healthcare Center\'s Emergency Department is very unique in that it is the only Emergency Department accessible by land, sea and air, north of North Carolina. Given its unique accessibility, the nurses at St. Andrews must be trained to treat almost any type of injury or illness quickly and then transfer them to the appropriate facility for definitive treatment. In many instances, this may mean having a patient arrive by Coast Guard boat at the Emergency Department Dock, treat their injuries in the ED and then transfer them by Lifeflight helicopter to the nearest trauma center. St. Andrews is the only facility in close proximity which can serve the islands of Midcoast Region in the summer.

The Emergency Department team was effective in their interactions with local police, fire, and EMS departments in coordinating all the necessary elements needed for a mass casualty incident of this magnitude.

St. Andrews nursing and medical staffs were able to quickly triage, treat and transport the two major trauma victims by Lifeflight to a tertiary care center. St. Andrews Emergency Department Team was able to enhance their triage, mass casualty, decontaminated, treatment, and transport skills.

Prior to the Midcoast Regional Exercise, St. Andrews Emergency Team was able to experience and practice trauma and medical skills using Lifeflight of Maine’s Human Patient Simulator. Over the course of two days, the staff was able to test their skills and learn new techniques and applications in management of critically ill medical and trauma patients. Participants were given multiple scenarios prepared by specialized Lifeflight instructors and see how their interventions could result on a lifelike human patient.

“Stan”, as he is called, talks, breathes, bleeds, and responds physiologically just as a real patient would. Emergency physicians and nurses had the opportunity to enhance their team building skills in the management of critically ill patients and then critique their performance.

Through community involvement, continuing education, and adaptability, the Emergency Department Team at St. Andrews has established its niche in health care in the Midcoast region. Our emergency services support the Boothbay Harbor Region of approximately 7,068 local residents. During the summer months, the population swells to nearly 50,000 as families and tourists from around the world flock to this scenic resort region. Last year, we aided over 5,113 patients with emergency care. Our services are always available when you need us 24 hours a day, 365 days a year.

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MENA Annual Awards

Maine ENA would like to acknowledge those Maine Nurses who have contributed in a special way to Emergency Nursing in the state of Maine, the United States, Maine ENA or National ENA.

President’s Award

For outstanding contribution to the Maine Emergency Nurses Association and / or the National Emergency Nurses Association.

Emergency Nursing Educator Award

For significant contribution(s) to education and / or training that enhances the ability of emergency care providers to serve their customers.

Emergency Nursing Provider Award

For exemplary contribution(s) to and / or manifestation of the art and science of nursing in the provision of emergency nursing care.

Emergency Nursing Leadership Award

For meritorious service above expectations in such activities as planning, development or management of systems, processes or departments that yield enhanced environments for the provision of emergency care.

Special Merit Citation

For exemplary long-term service, special advocacy of or contribution to emergency care and / or innovations that improve emergency nursing in the State of Maine.

Note: Award nominee’s do not necessarily have to be employed in an emergency department but must be involved with emergency nursing and / or EMS. Award nominee’s need not be ENA / MENA members.

Only those categories for which you wish to nominate an individual need accompanying comments. It is not necessary to name a nominee in each category to submit a nomination.

To submit a nomination:

• Identify the appropriate category
• Submit a written explanation for your submission
• Include your name, address, and how we can get in touch with you

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Board Member Profile

My name is Tammy Lachance and I am the Nursing Practice Chairperson for the Maine Emergency Nurses Association. I have been a member of ENA since I became a nurse in 1995. I previously served a two-year term as Board Member-At-Large (2004-2006), and have continued my involvement in Maine ENA by filling the vacant position of Nursing Practice Chair in 2006.

I was born and raised in Lewiston, Maine and attended nursing school at USM. I started my nursing career as a new grad in the Emergency Department at Rumford Hospital, and also did some ED agency work. I have been employed at Central Maine Medical Center for the past ten years, where I first worked as an ED staff nurse for three years. For the past seven years, I have been the Trauma Program Manager at CMMC. I love my job because it allows me to stay involved in Emergency Nursing and focus on trauma, which is my passion. I am active in the trauma community and am currently serving a two-year term as the Chair of the State Trauma Advisory Committee. I also enjoy teaching and am an instructor for TNCC, ENPC, and PALS.

As for my personal life, I live in Minot with my wonderful husband, Steve. We’ve been married for eleven years and have two adorable children, Trevor is 8 and Megan is 2 1⁄2. My favorite activity is watching my son play sports, especially hockey. I also enjoy skiing and boating. In my spare time (ha!ha!), I’m slowly working on my Master’s degree and hope to be a nurse practitioner someday.

If you have any ideas or suggestions for nursing practice surveys or collaborative projects, please send them my way!

Thank you,
Tammy Lachance, RN, BSN, CEN

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MENA Committee Chair Openings

If you are interested in becoming more active in Maine Emergency Nurses Association, now is a great time. There are a few new openings for Committee chairpersons.

General Assembly

You would be responsible for reviewing the delegate applications, adding the totals, and announcing who the MENA Delegates to the General Assembly will be for that year.

Education

You would be responsible for coordinating three meeting and education days per year. You would assist the host hospitals with finding speakers, filling out the CECH forms and applications, announcing speakers, and developing a brochure, etc.

Newsletter

You would be responsible for editing four newsletters per year and sending them out to the Maine ENA membership.

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CEN Review Quesstions

From CEN Review Manual, 3rd Edition

A female patient who is 13 weeks pregnant by ultrasound presents to the ED with the complaint of vomiting for several days. She states that she vomits everything she tries to eat or drink. She states that she feels very weak and dizzy. VS are BP 88/52, HR 120, RR 32, and T 37.7. Her urine has 3 + ketones and is negative for protein and leukocytes.

1. The highest priority nursing diagnosis for this patient is:
   1. Alteration in comfort related to weakness
   2. Fluid volume deficit related to persistent N/V
   3. Anxiety related to diagnosis
   4. Alteration in safety related to dizziness
2. You suspect that the patient is experiencing which of the following:
   1. Viral gastroenteritis
   3. Hyperemesis gravidarum
   5. Pregnancy induced hypertension
   7. Pelvic Inflammatory Disease (PID)
3. The most important intervention for this patients is:
   1. Initiate an IV line and rapidly infuse D5W solution
   2. Initiate an IV line and rapidly infuse 0.9% NS
   3. Initiate an IV line and rapidly administer 2 units of O-negative blood
   4. There is no indication that fluid resuscitation should be started at this time

A 32 year old female is pregnant and in her 34th week of gestation. She presents to the ED complaining of swelling in her lower extremities. She states that she has been having more headaches than usual. She denies visual disturbances. VS are BP 192/110, HR 100, RR 28, and T 37.4. You note that the patient has 3+ pitting edema to bilateral lower extremities and 3+ protein in her urine.

4. Based on the preceding assessment, you suspect that the patient has:
   1. Pregnancy-induced hypertension
   2. Preeclampsia
   3. Eclampsia
   4. Normal findings of pregnancy
5. After the patient has been placed in a room for further evaluation, she begins to develop seizure activity. She is placed on her left side and on 100% non-rebreather mask. The seizures are eventually controlled after the administration of a loading dose of magnesium sulfate. A maintenance infusion is started. Which of the following would suggest that the patient is developing magnesium sulfate toxicity?
   1. RR 10
   2. BP 130/92
   3. HR 98
   4. Temp 36.3

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2007 Maine ENA Calendar

MENA Board Meetings

• June 1st - Carmen Hetherington\'s, Harpswell, Maine - 0900 to 1200
• October 12th - MaineGeneral Medical Center, Waterville - 0900 to 1200
• December 14th - Wendy Nivson\'s, Winslow, Maine - 0900 to 1200

MENA Meeting and Education Days

• May 11th - Stephen\'s Memorial Hospital, Norway, Maine
• September 7th - Hilton Garden Inn, Auburn

ENA Meetings

• April 25, 26, and 27 - NERS - Plymouth, Massachusetts
• September 25 & 26 - ENA General Assembly, Salt Lake City, Utah
• September 27, 28, 29 - ENA Scientific Assembly, Salt Lake City, Utah

Everyone is welcome!

Please feel free to contact any board member for directions.

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CEN Review Answers

1. B: The patient’s presentation indicates dehydration secondary to N/V.
2. B: Hyperemesis is a term used to describe intractable N/V during pregnancy.
3. B: Signs of hypovolemia and unstable VS are initially treated with an isotonic solution.
4. B: Preeclampsia is a multisystem disorder that is found only during pregnancy. It is associated with an elevated BP and proteinurea. It usually occurs after 20 weeks of gestation. PIH is a rise in BP without protein in the urine. Eclampsia is the condition in which seizure activity occurs in the presence of preeclampsia.
5. A: Patients who receive magnesium sulfate should be monitored closely for loss of deep tendon reflexes and respiratory depression.

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Emergency Departments Employment Opportunities

Maine General Medical Center, Waterville Campus

We are looking for nurses with a passion for Emergency Nursing!

We currently have several positions available to accommodate our newly renovated and expanding emergency department.

• Excellent Patient Satisfaction
• Collaborative Practice Between Nurses and Physicians
• New Behavioral Health Suite
• Future Electronic Record and State of The Art Equipment
• Competitive Salary and Benefits
• Great Opportunity for Personal and Professional Growth!
• State of Maine RN License Required
• ED Clinical Experience Preferred but We Are Willing to Train Exceptional Candidates

Call and Learn More About The Opportunities We Have To Offer!

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Maine ENA Survey Results

Survey on the use of local anesthetics for IV insertion in the ED

August / September 2006

Tammy Lachance, RN, BSN, CEN

• 37 surveys were sent by mail to ED Nurse Managers in August 2006
• The following question was asked:

  Do you currently use or have you tried any local anesthetic methods to decrease the pain of IV insertion in your ED? (YES or NO)

  If you answered “YES”, which drug(s) or method(s) are used and rate them according to (1) ease of use, (2) nursing satisfaction, and (3) effectiveness of preventing pain on a scale of 1 to 5 (low to high)

• 23 responses were received -- a return rate of 62.3%!!! THANK YOU!!!
  • 4 (17.4%) responded “NO”
  • 19 (82.6%) responded “YES”
• Those who responded “NO” cited staffing limitations and lack of nursing interest as reasons for not utilizing local anesthetics for IV insertion
• Those who responded “YES” critiqued the following medications:
  • EMLA Cream (N=15)
  • Lidocaine Injection (N=8)
  • Lido / Epi Iontophoresis (N=1)
  • LMX (4% Lido Cream) (N=2)
  • Paine Ease Spray (N=2)
• Overall, for all methods, the total score ranged from 12 to 15 (out of 15 total possible points), with individual categories ranging as follows:
  • Ease of use: 3 to 5
  • Nursing satisfaction: 1 to 5
  • Effectiveness: 2 to 5
• Hopefully we can all use this information to give the best possible care to our patients, either by supporting our current practice or by trying something new. Thank you for supporting nursing research.

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Maine ENA - Call for Nominations

President - Elect
(President-Elect, 2008 & 2009; President, 2010 & 2011)

Responsible for leading/governing MENA, acting as liaison with National ENA, attending yearly Leadership Conferences, and attending yearly National Conferences

Board Member at Large
(2008 & 2009)

Responsible for assisting President in governing MENA.

Responsibilities for both positions include:

• Attending 4 Board of Director meetings per year.
• Attending 3 MENA Educational meetings per year.

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Maine ENA Educational Scholarship

Maine ENA will be offering a yearly educational scholarship in the amount of $250.00 for certification or re-certification of CEN, ENPC, or TNCC or another ENA sponsored course on an annual basis to one individual. It will be awarded at the Annual Meeting in the late summer/fall. The actual check will only be paid to the course director or registration person.

Requirements:

• ENA Member
• Work in ED for at least the past year
• Submit letter of intent stating your reasons for asking for scholarship

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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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