As I embark on my second term as President of the Ventura County Chapter

of AACN, I would like to take a moment to thank everyone for all of their support

and dedication. Without all of you it would have been impossible for this chapter to

Step Forward and make an impact in Ventura County. AACN’s immediate past pres-

ident, Vicki Good, challenged all of us to Step Forward and recognize that one step

made at one decisive movement can change the lives of many. That theme continues

to reign, and is now strengthened by the current motto given to us by our new

AACN president, Terri Kiss, who asks us all to Focus the Flame. During this time of widespread changes in health care, it is important to re-

member that nursing will be one of the constants that patients will look to for com-

fort. However, as the care-delivery setting continues its changing course, with in-

creased needs for more complex and specialized nursing staff, and new requirements

for nurses to have higher levels of education, we can anticipate that these demands

will bring increased stress and anxiety levels to all parties involved. For us to be able

to Focus the Flame, it is necessary to understand that in order to progress to a

more desirable and rewarding place, we will most likely find ourselves in unfamiliar or

uncomfortable situations… and this can create stress. Stressors may cause us to lash

out at, or be less tolerant of, the people closest to us (such as friends, family and

coworkers). At NTI, Tuesday’s Keynote Speaker Christine Cashen gave some sug-

gestions on how to handle this type of reaction to stress. She stated when we catch

ourselves taking this road, it is necessary to PAUSE and be clear what our intention

is. If something needs to be said then we should “Mean what we say. Say what we

mean. But, don’t say it mean.” Then… refocus. During your pause, reconnect on

what it will take to make you your best self. Vicki Good put it well as she gave everyone in attendance a compass to find

their north star. She said “Take a step. A single step. It can be small or large. When

you step forward, you lead.” Once you’ve taken that step, obstacles will get in your

way to get you off course. For most of us the problem is not that we don’t know

what to do but, instead, is mostly sticking to the task at hand long enough to get it

done. Our new theme, Focus the Flame, asks us to stop putting things off. Now is

the time for your courageous move to the next level. Decide to make the changes in

your life. It might look hard, or uncomfortable, or scary! Remember, you have the

courage, and you can do anything you set your mind to do. According to the NTI

keynote speaker on Wednesday, Dr. Brene Brown, “You can choose courage or you

can choose comfort, but you can't choose both. Courage is uncom-

fortable.” Over the next year, we (as individuals, as a chapter, and as

local facilities) will be challenged and may need to take a moment to

Pause, Identify Your Passion, Step Forward, and work to Remain

Courageous when it is uncomfortable. As we do all of these things,

we must Focus the Flame, and Live Your Commitment! VE

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The President’s Message

Nanette Logan, RN, MSNc, CCRN E

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Why did you become a nurse?

In high school I found that I really liked biology. During my time as a nurse’s aide I saw what nurses do and

thought that being a nurse would be something that could be interesting and rewarding. And it is, most days!

What about your job makes you feel happy?

Meeting all kinds of interesting people and seeing all the different ways that people can cope with difficult situa-

tions, and learning new things. I also enjoy working as a team to make sure we do what's best for our patients.

What are the challenges you encounter, and how do you overcome them?

I think challenges are what keep us fresh and interested in life. The challenges that come with being a nurse are

part of what keeps it interesting for me. No two days are alike. Not to say I enjoy all the challenges, because

many are difficult and frustrating. Nursing has seen many changes through the years that we must adapt to and

have little ability to impact. But there are still many things that we can still impact and have influence over.

What is the most amazing thing you have experienced as a critical care nurse?

A woman of about 80, who had experienced a full arrest at Wal-Mart with bystander CPR, proceeded to code

another 2 times in the emergency room. When she arrived to me in the unit, and was given a very poor progno-

sis, the family decided not to resuscitate again. The decision was to let her pass peacefully in view of the possi-

ble overwhelming brain injury she had probably suffered. Fortunately, she woke up and recovered and I got a

chance to meet her a couple months later. She was back to her driving and doing all the things she used to

do. That speaks to me that there is a God that has ultimate control. As medical professionals, we like to think

we know what’s going to happen and often we are right. But, when families cling to hope that seems unreason-

able, sometimes it’s OK to have some hope. Sometimes miracles happen.

What has your journey as a nurse been like?

I became a nurse at age 20, when the board exam was paper and pencil. A year later, I became a critical care

nurse. It's been a long journey! Overall it is a very fulfilling job to help someone get well, or to help families

cope with difficult situations.

At the end of a busy grueling day, how do you find balance in your life?

I disconnect from work as best as possible and reconnect into my family. I go to the gym, play golf, read.

How has AACN played a role in your career?

I have been a member of AACN for most of my career. AACN is dedicated to providing critical care nurses

with strong evidence-based information about how we can better take care of our patients. I have used the local

chapter meetings and the annual NTI to further my knowledge. The local chapter meetings provide an oppor-

tunity to network with other nurses to find out what other hospitals are doing. And of course we always have

fabulous food and drink at our local VC-AACN educational events!

Karen Mason, RN - ICU/CCU

St. John’s Regional Medical Center - Oxnard

Page IN THE MIX

NURSING SPOTLIGHT

One of the courses I attended during NTI 2014 focused on evidenced-based documentation.

As we are all aware, evidenced-based practices are guiding our clinical methodology while directing the care of the patient, using proven guidelines to produce excellent and expected outcomes. When nurses get

“too busy” to chart, or when they summarize an entire day at the end of the shift, bad things can happen. Attorneys trained in medical malpractice look for ways to poke holes in nursing documentation or to place doubt in the minds of a

jury. Some of the major causes of healthcare professionals losing malpractice cases are related to not communicating in

the medical record by providing accurate, clear, and concise documentation.

A few of the takeaways that I felt would benefit EVERY nurse to improve their documentation skills are listed below:

EVIDENCED-BASED DOCUMENTATION 1. Tell a story. You will not remember the essence of the shift 7 years later unless you tell the story of your day as it

happens. 2. Real-time documentation. Chart as close as possible to the time the events are happening. When you delay

charting until the end of the shift, it is possible for questions to arise as to your certainty of the timeline of events.

Or, are you defensively charting? What is real time documentation? Documenting within an hour of procedures, medication administra-

tions, reassessments and issues such as complications or adverse effects. 3. No gaps in documentation. This would include incomplete I&Os, and missed vital signs or neuro checks. If not

documented, it is assumed that they did not occur; this could put your nursing credibility into question. 4. Do not use negative, subjective, or assumptive phrases. Examples include words such as ‘manipulative behav-

ior’, ‘uncooperative’, and ‘actively withdrawing from a substance’. It is best to describe the actual behavior that is be-

ing exhibited, instead of labeling or diagnosing the patient.

Complete your electronic/drop down charting of the head-to-toe assessment immediately after assessing the patient at

the start of the shift, then move to focused-based documentation. FOCUSED BASED DOCUMENTATION is when you document on the patient continually throughout the shift,

and includes the following data:

Patient’s strengths such as increased ambulation without assist or use of the I.S. with volumes.

Problems and needs

Concerns and behaviors

Therapies and responses to medications and procedures

Changes in condition with appropriate physician notification

All Significant events

Remember to use the 6 C’s of documentation:

1. Client’s words

2. Clarity

3. Completeness

4. Conciseness

5. Chronological order

6. Confidentiality

Nursing is one of the most respected professions; therefore, Credibility is everything!

Don’t try to cover up anything, and make sure to take full credit for all of the exceptional work you do every day.

Stand Tall at the Bedside, Not in the Courtroom Presented at NTI 2014

Course # C75M140 Report back by: Nanette Logan, RN, CCRN

Page 3 Volume 2, Issue 2

Nearly 10 years ago, I joined the Air Force because I wanted to be a

run-out-onto-the-battlefield, life-saving military medic. Of course, the mili-

tary’s needs come first and the Air Force placed me in an engineering posi-

tion. This allowed me to live in Germany for 2 years, the east coast for a

year and deploy to the Middle East for 6 months. It was a great experience,

but in 2010, when I had finished my Active Duty commitment, I moved back

to California to cross-train as a medic, just like I had originally planned. I

spent 4 months in medic school, and then 4 months at a hospital rotating

through ICU, med-surg, OB, pediatrics and ER. I was in complete awe of the

RNs. They were so knowledgeable and organized, and had such talent to

think critically and remain calm under pressure. I applied to CSU Channel

Islands, and began in the fall of 2011. I love that nursing embodies camaraderie and teamwork, similar to

the military. I love that in nursing, knowledge, experience and research is

power. That’s what I want to bring to nursing: the power to advocate for

my patients and always encourage best (evidenced based) practice. Cur-

rently, I work as a medic in the Air National Guard and as a part time care-

taker. I’m involved in the Ventura Medical Reserve Corps, the Red Cross, a

new member of the AACN, and VC-AACN. I’m thrilled to be so involved

because it makes me that much more excited that I have chosen such an

amazing and diverse career. I graduated in May 2014, and will soon enter

the world of professional nursing. I feel that both my military experience

and being active in professional organizations as a student have prepared

me to excel and succeed as a new-graduate RN.

SSgt Rachel Weinberg, New Nurse Graduate

California State University Channel Island

“I’m thrilled to be so

involved because it

makes me that much

more excited that I

have chosen such an

amazing and diverse

career.”

Page 4 IN THE MIX

NEW LOCATION FOR MONTHLY MEETINGS 2433 Ventura Blvd

Camarillo, CA 93010

Formerly the French Bull Dog

NEW GRADUATE SPOTLIGHT

2014 MEETING DATES

July 2 August 6

September 3 October 1

November 5 December 3

Report Back

2014 AAHPM & HPNA Annual Assembly

The Annual Assemble of the American Academy of Hospice & Palliative Medicine (AAHPM) and the

Hospice & Palliative Nurse Association (HPNA) took place this year in San Diego. I had the pleasure

of attending (for the first time) this conference. This 3-day conference is similar to AACN’s NTI, in

that it rotates around the U.S. and offers many learning opportunities to broaden one’s knowledge.

In comparison to Hospice Medicine, the specialty of Palliative Care Medi-

cine is fairly new and still being defined. Both specialties share the goal of

improving quality of life for patients and families facing serious or life-

threatening conditions. Whereas Hospice works primarily with individuals

with a life expectancy of less than 6 months, the Palliative Care Specialist

supports individuals through the continuum of their illness, from diagnosis

through curative treatments or at end of life.

Each day of the conference opened with a plenary session. The plenary

session that held the most meaning for me was “The Human Side of

Healthcare – Stories as Medicine, Medicine as Stories”. The speaker, Dr.

Loise Aronson, spoke on listening to the stories of our patients and our-

selves. If you have an opportunity to read her book “A History of Present

Illness”, it is well worth it.

A prime focus of this conference was communication, listening (actually

hearing what’s being said), and caring for oneself. Additionally, there were

many clinical based topics to choice from. One such session “Complications of Chronic Dialysis; Chal-

lenges & Opportunities for Palliative Care Providers” spoke to me personally. One of the patients

that our team at VCMC (Ventura County Medical Center) was supporting was dealing with the com-

plication Calciphylaxis. This session increased my knowledge on caring for the individual that deals

with these very serious complications.

The sessions on international hospice and palliative care were heartbreaking. Physicians from several

counties attended this conference through grant support. They spoke about the barriers and struggles

to providing appropriate/high quality care to their patients, especially at end of life. The dilemma with

many international providers that work in third-world countries is adequate pain management and ob-

taining opioids. A case from the country of Georgia was presented via video. Witnessing the pain of

this person was heart-wrenching. I left this session with sadness in my heart, as well as realizing how

lucky we are in the U.S. to have accessibility to various treatment options so that we can better sup-

port our patients in their health struggles.

This conference offered great knowledge and wonderful camaraderie for my personal and professional

growth in the field of Palliative Care Medicine.

Connie Fincher, RN, BSN, CE, CHPN

Ventura County Medical Center Palliative Care Nurse Coordinator

VC-AACN Treasurer

Page 5 Volume 2, Issue 2

NEW MEMBERS

CMH

Stephanie Duenez

VCMC

Gloria Lee

Marilyn Manley Shelley Tuttle

Los Robles Hospital and Medical Center

Cecilia Bradley Priscilla Eaton

Marilou McQueen Belinda Suitt

Leonor Stricker Peter Winch

St. John’s, Oxnard

Michelle Aguilar Christine Craver

Maria Theresa English Patrice Gubricky

Jasmin Klotz Jose Macarayo

Cathy Ramirez Erika Ramirez

Kerry Reed Freddielyn Referente

Theresa Smith Scott Varner

California State University, Channel Islands

Ashley Tegley Rachel Weinberg

Laura Wong

Ventura College

Margarita Caluya Janette Moreno

RECOGNITION CORNER NEW CCRNs

Joy Eugenio……. Los Robles Hospital

Freddielyn Referente …….. St. John’s Oxnard

Milagros Tabije-Ebuen……. St. John’s Pleasant Valley

NEW GRADUATES

Christine Gibson, ADN Ventura College

Jennifer Reuf, BSN California State University Channel Islands

Rachel Weinberg, BSN California State University Channel Islands

Laura Wong, BSN California State University Channel Islands

International Nursing & Study Abroad Reporting Back

by: Laura Wong & Rachel Weinberg

In the winter of 2014, CSUCI sent the first cohort of ten senior nursing students to Trinity Col-

lege, Dublin with the purpose to learn about healthcare in Ireland. Ireland’s rich history is evi-

dent in every social dynamic, including their healthcare system. The cohort spent two weeks

as study abroad nursing students, receiving lecture four days a week and attending two clinical

shifts at St. James’s Hospital. The curriculum included various topics in nursing such as men-

tal health, pediatrics, intellectual disability, end of life, midwifery, and women’s health issues.

In addition to learning nursing content within the discipline, we engaged in comparative analy-

sis of health trends in United States and Ireland, such as infant mortality and meeting the

needs of the older old population.

Ireland has a universal healthcare system in which all Ireland residents have access to

healthcare that is funded by taxes and

free at point of service. As students

entering the workforce during a time of

change within our own system, it was

an invaluable lesson to experience first

hand how this impacts the consumers

of care. Although it was found that

wait times in Ireland were excessive

compared to the US, Irish residents

expressed satisfaction with the care

they received.

Another key difference is that in Ire-

land, student nurses are forced to

choose a specialty from the start of

their student careers. The five options are: pediatric, midwifery, mental health, intellectual disa-

bility, or general nursing. (General nursing would be the equivalent to a BSN here in the US).

By focusing on a specific discipline, it was discovered that these nurses are highly prepared to

serve their specific population. However these specialized nurses may lack the knowledge

base to practice outside of their specialty, which may prevent patients from experiencing the

continuity of care that our patients do here.

All in all, the study abroad experience offered insights of healthcare

that could not have been taught in the classroom. The opportunity to view

health care from a different culture has broadened our perspective on how

deliver culturally competent care. By researching and immersing ourselves

in the history, people, and health care system of Ireland, we are better

equipped to meet the needs of our changing demographics in the US.

Vicki Good

Immediate Past President

NTI 2014 in Denver, CO

Terri Kiss

AACN President

Lecture and Luncheon at Gainey Winery, April 2014

VOLUNTEER !

We need your

help!

Operation “Disaster Preparedness 2014”

Relay for Life, Ventura County 2014

P.O. Box 5937 Oxnard, CA 93031

Visit our website

@

www.vc-aacn.org

or email us at

SAVE THE DATE Fall Symposium – 2014

Tuesday – September 23, 2014

Time – 8:00 am to 4:30 am

Place – undetermined

Keynote speaker:

Barbara A. McLean MN, RN, CCRN, CCNS-NP, FCCM Nurse Intensivist & Critical Care Specialist

Presenter at NTI 2014 in Denver, CO

Topic:

Hemodynamic Endpoints for the Critical Thinker & Ventilation Strategies

VENTURA

COUNTY

CHAPTER OF

AACN

"Live your Commitment"

HOSPITAL & STUDENT LIASIONS

Community Memorial Hospital Ann Marie Beppler, ICU

Los Robles Hospital Vanessa Buescher, ICU

Moorkpark College Position Open (student only)

St. John’s Pleasant Valley Milagros Tabije-Ebuen

St. John’s Oxnard Joni Kent, ICU

TOSH Evelyn Barber

VCMC Connie Fincher, Palliative Care Nurse Coordinator

U.C. Channel Islands Ashley Tegley

Ventura College Janette Moreno

PRESIDENT:

Nanette Logan, RN, MSNc, CCRN

TREASURER:

Connie Fincher, RN, BSN, CCRN

SECRETARY:

Wendy Lee, RN, MPH, CCRN

Rose Egertson, RN

BOARD MEMBERS:

Vanessa Buescher, RN, BSN, CCRN

Joni Kent, RN, MSN, CCRN

MEMBERSHIP FORM

To join Ventura County Chapter of AACN, you must be a national member of AACN.

National Membership: $78.00 / year or ($69.00 for groups of 5 or more)

Ventura Chapter Membership: $20.00 / year

Application Date: ____________ Total Submitted: ______________

Name: _________________________________________ National Number: ______________

Address: _____________________________________________________________________

Home Phone:_______________________ Cell Phone: _______________________________

Work Phone: ____________________________ CCRN: Y or N

E-mail: ____________________________

Mail completed application with check to the VC-AACN address listed above, complete online @

http://www.vc-aacn.org/membership.html or submit to your hospital or student liaison.

Additional questions call: Nanette Logan 805-358-4373