Advanced Registered Nurse Practitioner Care
Internet Edition, August, 1996, Volume 7, Number 8
Copyright 1996, Nurse Practitioner Support Services
Official Newsletter of ARNPs United

Table of Contents

Let The Challenge Begin

by Ted Ritter

It is with no little trepidation that I begin my tenure as President of ARNPs United. I can only hope to follow in the footsteps of Bob Smithing and Suzan Watanabe. Saying thanks doesn't seem enough. I plan to avail myself of their expertise regularly.

I pledge to make myself available and to keep an open mind. I am going to need all of your help to keep us a viable organization. This organization needs all of us to become involved. We can no longer depend on just a few members to do all of the work and to come up with all of the ideas and solutions. If you feel it is important to be represented by ARNPs United then you must become involved.

This year will be a year of consolidation and hopefully of growth. For those of you who are not members joining is imperative. I hope to see ALL of you at the annual meeting.

ARNPs United Annual Meeting

Thursday, October 24, 1996
at 6:20 pm
at the Washington State Trade and Convention Center in Downtown Seattle. It is being held during the Pacific Northwest Primary Care Conference.

Legislative Update

by Tracy Lin, ARNP and Gail Toraason McGaffick, JD

We hope you're all enjoying the summer. The purpose of our article this month is to provide some information about the 1996 elections and encourage you to be an active participant in the democractic process.

The November elections are very important to the State of Washington. All seats of the House of Representatives and one-half of the Senate seats are up for election. Currently, Democrats have the majority in the State Senate 25-24, while Republicans have the majority in the State House 62-36. Of the 25 Senate seats up for elections,16 are held by Democrats and 9 by Republicans.

In addition, there are several statewide offices on the ballot to include the Governor, Lieutenant Governor, and incumbant Insurance Commissioner Deborah Senn. Added to this state mix is the election at the national level of the President, all seats in the House, and some Senate seats. Neither Senator Gorton's or Murray's seats are up for election this year.

At the state level, in particular, the persons who are elected to the Legislature and to certain statewide offices such as Governor and Insurance Commissioner will help shape Washington's public policy directions for the next two to four years. As a result, it is very important for ARNPs to be informed and involved about these upcoming elections. The best way for you to do that is to attend local candidate forums, read your local newspapers, and do whatever you need to be sure you're making an informed decision when you vote in November. And if for some reason you're not registered to vote, it's very easy. You simply call your county voter registration office, usually the Auditor, and ask for a mail-in voter registration card.

FYI, in Washington state the filing period for candidates is July 22 through 26. The primary election is held on September 17, with the general election on November 5.

When we are informed, we elect persons that are truly representative.

Nurse Practitioner Evaluation Instrument

by Susan Caverly

The Dartmouth Nurse Practitioner Evaluation Instrument (DNPEI) is a tool designed primarily for the neonatal nurse practitioner, but may provide a model for other specialties of nurse practitioners who are interested in developing an evaluation instrument. It is described in the August issue of Neonatal Network. The article addresses the theoretical framework and the process of implementing the tool in a practice setting using a peer review model. The instrument itself is copyrighted, but the author Madge Buus-Frank requests an “intellectual payment” of feedback rather than a monetary payment for its use.

ANA Elects New President

by Susan Caverly

Beverly L. Malone, RN, PhD, FAAN has been elected the new president of the American Nurses Association. She has long been active in the ANA and other nursing organizations. She will be taking a leave of absence from her position as Dean of the A & T University School of Nursing.

Nurse practitioners in this country owe a debt of gratitude to the past president Virginia Trotter Betts for her outstanding leadership throughout her term of office. This position is perhaps the most visible and powerful of any nursing leadership offices in the country. It is also one that requires a tremendous dedication, competency, and stamina. We are indeed lucky that individuals of the caliber of these two women have chosen to serve the nursing community.

A New Advanced Practice Nursing Organization is Born

by Susan Caverly

The Association of Acute Care Nurse Practitioners (AACNP), the first national association for tertiary and acute care nurse practitioners has recently been formed. The first general meeting will be held at the Philadelphia Adams Mark Hotel on Tuesday September 10, 1996. Information can be obtained by E-mail at: ACNPassoc@aol.com or by US mail at the Association of Acute Care Nurse Practitioner, P.O Box 153, Wynnwood, Pennsylvania 19096. The president is listed as Paul P. Logan, MSN, CRNP, CS, CCRN.

Medical Outcomes Report Cards

by Susan Caverly

In a study published in the New England Journal of Medicine, Schneider & Epstein found that the reporting of outcomes has deleteriously affected the access to care that severely ill cardiac patients have. The cardiovascular physicians sampled indicated that the Consumer Guide to Coronary Artery Bypass Graft Surgery” published by the State of Pennsylvania, and which reports risk-adjusted rates of mortality from all coronary artery bypass surgeries performed in the preceding year has influenced availability of surgical procedures. Although the physicians have criticized the risk-adjustment method, they have been more reluctant to provide bypass surgery to patients who are poor surgical risks. The authors encourage that in the future performance report cards would have greater credibility and usefulness if they are developed from a collaboration with physicians.

This study raises a number of questions. There have been concerns that the use of report cards would increase liability for practitioners and create a sense of distrust among those who require health care. The manner in which the “grades” are made available to the public, and interpreted by an individual consumer is also potentially problematic. The problem is that those who seek health care do deserve to know the qualification and success rates of the potential providers, yet, often the information is terribly incomplete in the need to keep it simple and succinct.

Another concern is the focus on the physician as provider. While this might be anticipated for a study published in the New England Journal of Medicine, it does not negate the fact that nurse practitioners and alternative care providers may also need to engage in the report card process. When this occurs, do we need to assure that the elements reported are the same or do we need to promote some additional category to those that would encompass the medical provider? Nurse practitioners need to be thinking about these issues before we face them and certainly before the outcomes appear in the literature about Washington State.

Health Actions in the US House of Representatives

The US Representatives have been discussing the ethics of patenting medical procedures and whether or not the suspension of patents for one year will adversely affect research and development in the biotech industry. They have also been focusing on the revocation of the controversial gag clauses in contracts between practitioners and insurers which prevent the disclosure of information about treatment options outside those offered by the insurance plan. Initial compromise actions have been to decrease the list of practitioner activities that are prohibited, but to attempt to respond to concern that the ability to disclose insurance information may be used to essentially line the pocket of the practitioner by encouraging consumers to contract with insurers who reimburse for care at a higher rate. The discussion regarding issues such as these appear to be ongoing. It is of interest that there are congressmen who are identified as physicians and as dentists engaged in the debate, yet nurses or nurse practitioners are not mentioned. We might want to consider the necessity of improving nursing representation at both the state and federal level as health agendas remain issues for public debate and legislation.

Of Interest

Resources for NPs

by Susan Caverly

A number of interesting resources have surfaced on the web of late. For instance, it appears that Glaxo Wellcome, Inc. offers free videos for patient education regarding breast self examination, asthma management, and Alzheimer's disease. These are available by calling 800.824.2896.

An organization named “Gifts in Kind International” has a program for qualified organizations to receive donations for a service fee. The fees are reasonable (or so the editors have been informed) and the products useful. For instance it may be possible to obtain sock donations for homeless shelters. More information can be found on their web page at: http://www.giftsinkind.org.

For those interested in newly available positions for employment, but don't want to wait for the next issue of ARNP Care, or if you're looking for something across the country then check out employment opportunities for advanced practice nurses at http://www.nurse.net/jobs the positions are posted on the web site and are also available via E-mail.

Classified Ads

Rheumatology Nurse Practitioner

Pacific Northwest Practice Opportunity - Two rheumatologists and a PA in a private practice limited to rheumatology seek a Nurse Practitioner. In addition to rheumatic diagnosis and care, the NP's practice would include osteoporosis evaluation and treatment with DEXA bone densitometry monitoring. Attractive, competitive compensation, pension plan participation, and health care insurance included in an ideal practice environment. Contact George Krick, MD at 206.572.3520.

Nurse Practitioners in Rural Practices

The Washington Locum Tenens Program seeks NPs interested in rural practice opportunities. Professionals who are interested in helping their rural colleagues while supplementing their incomes. Professionals in transition or who are just out of school. People who are starting a family and want to practice part time. If you seeking short or long-term temporary work, the Locum Tenens Program can help support you in your search and placement. For more information or to apply, contact: Locum Tenens Program AHEC at WSU Spokane, 601 West First Avenue, Spokane, WA 99204-0399, phone: 509.358.7640.

Nurse Practitioner

Swedish Medical Center is seeking an exceptional individual to work in our TCU, on our Ballard Campus. This is a FT, day position. You must be licensed as an Advanced Registered Nurse Practitioner, hold prescriptive authority as an ARNP and credentials as an adult, family or geriatric nurse practitioner. This position requires 3+ years ARNP experience with adults and a Masters in Nursing degree is preferred. Swedish Medical Center offers a competitive compensation and benefits package. Please send resume with cover letter and/or application to: Swedish Medical Center, Human Resources, PO Box 14999, Seattle, WA 98114. EOE. Job Line: 206.386.2888.

Continuing Education

The Healing Power of Music - Practical Applications for Professionals

August 19, 1996. Location: Harmony Hill Wellness Learning Center, Union, WA. A workshop for health care professionals. Participants will explore a musical solution to healing with the body's own natural rhythms. CEUs available. Ms Hoffman's work may be previewed at Harmony Hill's Wellness Festival, August 17, 1996. For information, call Harmony Hill at 360.898.2363.

American Psychiatric Nurses Association 10th Anniversary Conference Celebration, “Waves of Change in Psychiatric Nursing.”

October 23-26, 1996. Location: La Jolla, CA at the Hyatt Regency Hotel. The conference will focus on changes in psychiatric nursing, health-care, and technology. Focus sessions will provide an in-depth discussion of each topic. “How-To” sessions will provide nurses with the skills they need most. The exhibit hall will contain displays from major pharmaceutical companies on the latest treatments. For more information, contact: APNA Conference Department at 202.857.1137.

Pacific Northwest Annual Conference for Primary Care Practitioners

October 24-26, 1996. Location: Washington State Convention and Trade Center, Seattle, WA. This conference offers practitioners an opportunity to validate and enhance clinical competencies, acquire new assessment and management skills, examine critical issues in health care at the state and national level for their impact on primary care practice, foster a strong coalition of primary care providers, and learn about new products, services, and pharmacotherapeutic agents. Sponsors include University of Washington Continuing Nursing Education, Planned Parenthood of Western Washington, ARNPs United - WSNA, Western Washington Area Health Education Center and the Washington Academy of Physician Assistants. Contact Continuing Nursing Education at the University of Washington, Box 357260, Seattle, WA 98195-7260 or phone 206.543.1047.

Assoc of Reproductive Health Professionals' Annual Reproductive Health `96

November 14-17, 1996. Location: Nashville, TN at the Stouffer Renaissance Hotel. This meeting will be held in conjunction with Planned Parenthood Federation of America and cosponsored by the National Association of Nurse Practitioners in Reproductive Health. Sessions focus on interaction of AIDS and other STDs, diagnostics and the consequences of STDs, contraception, cancer prevention and detection, pregnancy management and the latest in primary care therapies. The method will be lecture style. ARHP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians. The credit hours earned will be in Category One of the Physician's Recognition Award of the American Medical Association. All sessions are also approved by ACNM and CNM for accreditation.

3rd Biennial Clinical Women's Health in the Perimenopause `96

November 22-24, 1996. Location: Amelia Island, FL at the Ritz-Carlton. Sessions focus on contraception and cancer, practical guidelines for evaluation, diagnosis and treatment of disorders common to the midlife woman. Nationally respected speakers will discuss the latest research, future trends and public policy. The method will be lecture style. ARHP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians. The credit hours earned will be in Category One of the Physician's Recognition Award of the American Medical Association. All sessions are also approved by ACNM and CNM for accreditation.

Post Master's Family Nurse Practitioner Program

If you have a Master's Degree in Nursing and would like to become a Family Nurse Practitioner, our program is for you. At the Pacific Lutheran University Center for Continued Nursing Learning we offer courses scheduled to accommodate the working nurse. Our Post Master's Family Nurse Practitioner Program consists of 240 classroom hours and 630 clinical hours. For more information on this exciting and innovative program, contact us at 206.535.7683 or E-mail at: ccnl@plu.edu

Masters of Science in Nursing & Post-Masters NP Pathways in Family and Adult/Gerontology

Earn your Master of Science in Nursing degree at Seattle Pacific University in our evening and weekend program. The MSN Program is a full (one year) or part-time (two year) program meeting one night a week and three Saturdays per quarter. Flexible packaging of courses and individual tailoring of your MSN degree are only a few of the benefits of SPU's Master of Science in Nursing Program. We also have master-post masters NP Pathways in Family and Adult/Gerontology. For more information, visit our web site at: http://paul.spu.edu/, call 206.281.2888 or 800.899.1769, write 3307 Third Ave West, Seattle, WA 98119 or E-mail us at: msninfo@spu.edu

Basic Colposcopy Training, Advanced Colposcopy, Endometrial Biopsy, IUD Insertion Training, Vulvar and Vaginal Lesion ID Course, Gynecology Review and LEEP/Cryo Training Seminar.

CME Solutions, LLC has been approved as a provider by the Washington State Nurses Association. Contact hours are available for every course. Call Karen Taylor at 206.865.9005 for dates and location. Fax number is 206.865.0616.

Editorial Information
ARNP Care Office
212 Railroad Ave N, Kent, WA 98032
206.852.9042 Fax 206.480.0002
care@nurse.net

Editors:
Susan Caverly, MA, ARNP
Robert T. Smithing, MSN, ARNP
Madeline D. Wiley, MSN, ARNP 		Production Staff:
Melanie Finley, Kelly Libby, &
Pete Mullin
Contributing Editors:
Ted Ritter, MN, ARNP 		Publisher:
Nurse Practitioner Support Services

Ad Information

Copy deadline is the second Tuesday of the month prior to publication. Ads may be accepted later then this on a space available basis. Position Available Ads per insertion of less than 66 words are $45, of 66 to 130 words are $75. Continuing Education Announcements per offering for up to three (3) insertions of a BRIEF description are $35, sponsoring organizations of ARNPs United may publish CE announcements at no charge. New Product Announcements per product for one insertion of 130 words or less are $75. Ad Inserts are $480 for one issue. All ads are subject to space limitations and editing. Call for detailed rate information. Mail copy to ARNP Care, 212 Railroad Ave N, Kent, WA 98032. Phone 206.852.9042. Fax 206.480.0002. E-mail care@nurse.net

Please Join Us

You may believe that because this newsletter arrives every month you are a member of ARNPs United. That is wrong. Since 1989 ARNP Care has been sent to every ARNP in Washington regardless of membership status. This is in imminent danger of stopping due to a lack of funds. Remember the number of members is what makes an organization strong and credible with the legislature and others. So join us today. Individual memberships are $150 per year. Lifetime memberships are $1000. Student currently enrolled in a ARNP program may join for $50 per year. Make your check out to ARNPs United and mail it to: ARNPs United, 212 Railroad Ave N, Kent WA 98032.

Member Thank You!

Thank you for being one of the ARNPs in this state who have joined ARNPs United. Without your support it would not have been possible to have hired a lobbyist and had such a successful legislative session in 1995. It is also clear that without your support the organization would not have been capable of moving forward in developing a solid framework to build on the grassroots efforts of the ARNPs in this state. ARNPs who are not members of ARNPs United have received ARNP Care printed on lavender paper to let them know they are not members.

Nurse Practitioner Support Services
212 Railroad Ave N, Kent, WA 98032. Phone: 253.852.9042 Fax: 253.852.7725
npss@nurse.net
Copyright 1998 Nurse Practitioner Support Services