Posts Tagged ‘AACN’

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The Nuts and Bolts of Fluid Therapy in Critically Ill Patients

May 1, 2013

By Maureen Shawn Kennedy, AJN editor-in-chief

Back in the day when I was a bedside nurse, hemodynamic monitoring was just coming into play, and then only in coronary care. In the ER, we relied on a combination of vital signs (pulse and BP), urine output, and central venous pressure (CVP) to guide fluid administration. Later, patients in need of close monitoring received arterial lines to monitor pulmonary arterial pressures; monitors and stopcocks were everywhere (and soon after, infections, but that’s another story . . . ).

But things are changing again, and the trend is toward less-invasive monitoring. In our May issue, we’re pleased to bring you a comprehensive CE article (worth 2.6 contact hours), “Using Functional Hemodynamic Indicators to Guide Fluid Therapy.” The author is Elizabeth Bridges, PhD, RN, CCNS, an associate professor in biobehavioral nursing and health systems at the University of Washington School of Nursing and a clinical nurse researcher at the University of Washington Medical Center in Seattle. Many critical care nurses will know her from her “standing room only” research sessions at the American Association of Critical Care Nurses National Teaching Institute (this year it will be in Boston, May 20–23), in my view one of the best annual national nursing meetings.

Here’s the article abstract:

Hemodynamic monitoring has traditionally relied on such static pressure measurements as pulmonary artery occlusion pressure and central venous pressure to guide fluid therapy. Over the past 15 years, however, there’s been a shift toward less invasive or noninvasive monitoring methods, which use “functional” hemodynamic indicators that reflect ventilator-induced changes in preload and thereby more accurately predict fluid responsiveness. The author reviews the physiologic principles underlying functional hemodynamic indicators, describes how the indicators are calculated, and discusses when and how to use them to guide fluid resuscitation in critically ill patients.


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Critical Care 2012: An Educational Extravaganza

May 29, 2012

By Maureen Shawn Kennedy, AJN editor-in-chief

So, for the 12th or 13th time (I’ve lost count), I attended the National Teaching Institute of the American Association of Critical-Care Nurses (the “other” AACN organization, not to be confused with the American Association of Colleges of Nursing) in Orlando last week. And as usual it was impressive—approximately 6,000 attendees, and rows and rows of exhibitors. There were two helicopters, a bus, and an ambulance in the exhibit hall, as well as two-story booths and classrooms. While there were some recruiters looking for staff, they were overshadowed by monitoring companies, bed and equipment manufacturers, and pharmaceutical companies.

Some highlights:

Left to right: Outgoing AACN president Mary Stahl and incoming president for 2013, Kathryn Roberts.

Kudos to the AACN for its creativity in making general sessions lively and interesting. This year, the organization held open auditions for a member to assist as “MC” for the general sessions (or “super sessions”). It was a tie, and attendees were treated to two of their own in action, hamming it up and enjoying the spotlight.

The TED-talk presentation style used by both AACN president  Mary Stahl and president-elect Kathryn Roberts was refreshing—and unique for nursing meetings.

I interviewed both presidents—click the link to listen to the podcast (it may take a minute to load). The 2013 president, Kathryn Roberts, MSN, RN, CNS, CCRN, CCNS, is a clinical nurse specialist in the pediatric ICU at The Children’s Hospital of Philadelphia; she chose “dare to” as her theme for the year.

My favorite session, hands down, was Elizabeth Bridges’ “Critical Care Studies You Should Know About,” in which she pulled apart recent research and evaluated it in the context of other studies. She is the only person I know who can have 500+ people laughing and learning statistical analysis. (After hearing her speak last year, I approached her to do a column for AJN. Her column, Critical Analysis: Critical Care, debuted earlier this year with “Central Venous Pressure Monitoring: What’s the Evidence?”free until June 12. And she’s working on two more.)

The engaging super session featuring Robyn Benincasa—a firefighter, world class adventure racer (think Survivor and The Amazing Race combined), and motivational speaker—illustrated what one could achieve with team support, leadership, and perseverance. (Of course, being in superb shape for firefighting, endurance biking, and mountain climbing doesn’t hurt either.)

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Vampire Nurses, PhDs, Your Best Moment as a Nurse: Today’s Notes from the Nursosphere

March 30, 2011

Here are some recent posts of interest we noticed on the nursing blogs. Many of these blogs can actually be found on our blogroll, so we hope you’re exploring what’s there from time to time, even if we know the list isn’t exhaustive and is probably missing some other excellent (and at least somewhat frequently updated) blogs.

It’s good to know that Will, the nurse/comic artist who shares his drawings at Drawing on Experience, has started posting again more regularly. One of his most recent efforts depicts a night shift nurse as a kind of vampire. It’s funny and, in a way, insightful. We give just a thumbnail version of it below on the right, in the interests of preserving the artist’s copyright; to see it enlarged, click the image and visit the version posted on his site, where you can also find a bunch more drawings, many about his life as a relatively new nurse. 

The INQRI Blog (that INQRI stands for Interdisciplinary Nursing Quality Research Initiative, a real mouthful) has a new post about an increase in enrollment in nursing doctorate programs. Here’s an excerpt:

According to new data released recently by the American Association of Colleges of Nursing (AACN), enrollment in doctoral nursing programs increased significantly in 2010. The AACN believes that this shows a strong interest in both research-focused and practice-focused doctorates.

The post also connects this enrollment trend with some recommendations from the IOM Future of Nursing Report, which we’ve written about more than once on this blog in recent months. But no more policy today! Whatever your degree, if you’re a nurse, you probably wonder from time to time why you do such a challenging job. An evocative post at Those Emergency Blues recounts an after-dinner conversation between two friends about just this. One of them asks the other, “What’s your best moment in nursing?” The author struggles to find an answer. Here’s part of what she says:

I stopped and thought. I could see my reflection in the dining room mirror, dimly, and even I could see bone-tired in my face. But I thought about codes and trauma. I thought about why I was once made Employee of the Month. I thought of smaller moments of giving care— warm blankets, a back rub, a cup of ice chips, repositioning. I thought about missed findings. I thought about the time a patient an ambulance gurney went VSA while I was triaging her, and walked out of hospital ten days later. I thought about innumerable STEMIs caught and thrombolysed (and later sent for rescue cathetherization) within minutes of arrival. I thought about the times when I pushed for some extra intervention which made a real difference in the patient’s life.

It’s engaging, but it’s probably not the most important part of her answer, which you’ll have to read the entire post to learn. Anyway, maybe we’ll steal the question and ask it here, since we’d really like to know what our readers think (as the chill air hangs on at the end of March and energy levels waver). So what’s your best moment as a nurse?—JM, senior editor/blog editor

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What Lies Ahead? AACN Presidents Weigh In on Health Care Reform, Rapid Response Teams, and More

May 24, 2010

By Shawn Kennedy, AJN interim editor-in-chief

Kristine Peterson & Beth Hammer, incoming and outgoing AACN presidents

On my last day at the American Association of Critical-Care Nurses’ annual meeting last week in Washington, DC, I had a chance to speak with both Beth Hammer, whose term as president ended with the meeting, and Kristine Peterson, the new president. Our conversation ranged from how they felt about being president of such a large nursing organization to their views on health care reform and how rapid response teams are affecting the work environment of critical care nurses. You can hear the conversation free on AJN’s Web site: go to the Podcasts tab and click on Conversations. Or just click here (the download may take a minute or two).

And don’t miss my first post from the exhibit hall floor at the meeting (the National Teaching Institute & Critical Care Exposition, or “the NTI”)  and my second post on a conversation with a critical care nurse about a bad staffing practice, which seems to have hit a nerve!

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Thousands of Critical Care Nurses, a Helicopter, and More! AACN’s National Teaching Institute & Critical Care Exposition

May 19, 2010

By Shawn Kennedy, AJN interim editor-in-chief

 

NTI exhibit hall crowds.

I’m writing to you this morning from Washington, DC, where I’m attending the American Association of Critical-Care Nurses (AACN) 2010 National Teaching Institute & Critical Care Exposition (known simply as “the NTI”). I’m probably miscounting, but I think this might be my 15th visit to the NTI. I first attended when I was an ED staff nurse at Bellevue Hospital in New York City. I marveled at the hundreds of nurses who attended from all across the country. It was energizing and inspiring and overwhelming, and I learned a lot.

Now, it’s not just hundreds but thousands of nurses who attend the NTI, and they come not only from states across this country but also from around the globe. It’s still energizing, and there’s no doubt I can still learn a lot. Throngs of nurses have crowded the sessions, so much so that it’s hard to remember there’s a nursing shortage; but critical care nurses are still much in demand, and representatives from many hospitals—as well as from all branches of the military—are manning recruitment booths. The exhibit hall is still overwhelming: this year there are more than 500 exhibitors and the exhibits include a Life Flight helicopter, a couple of full-size buses equipped as classrooms or EDs, and a fully-equipped military emergency treatment tent.

I’ve attended some very good sessions and a couple of clunkers—a better ratio than I’ve found at most conferences. Now I’m off to interview the incoming and outgoing presidents of the AACN—look for that post, with a link to a podcast of the interview, in the next few days. I’ve got to get inside that helicopter . . .

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