"Super Union" not so SUPER!


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"Super Union" not so SUPER!

  1. 1. An Official Publication of the Illinois Nurses Association The Voice of Illinois Nursing for more than 100 Years Volume 6 • No. 2 Quarterly circulation approximately 187,000 to all RNs, LPNs, and Student Nurses in Illinois. April 2010 Telemedicine: Nursing’s Med-Force Flight Nursing Future is Now Page 3 Pages 6-8 “Super Union” not so SUPER! Since 1901, the Illinois Nurses Association has been the No one organization can make all of its members happy at They claim to be about nurses and moving the issues voice of nursing in Illinois. We represent all nurses regardless the same time. We welcome the input of our members and are of staff nurses forward unless you disagree with or stand of specialty or educational preparation. We have the ear of transparent in all that we do. That is both the blessing and the against their unilateral actions or decisions, then watch the Legislature in Springfield and we speak as one united curse of democracy. However, what has been happening lately out. Because they attack, tell lies, exaggerate, and plant profession. The Association works hard to protect the rights is not simply members seeking to voice their concerns. An seeds of doubt in members’ minds. of nurses through education, advocacy and political action. outside force has been feeding this frenzy. The Illinois Nurses So if you are asking yourself how did they get access Our advocacy is not limited to only a subsection of nursing. Association looks to serve the entire profession, to bring unity to our members let me explain. Some of these people We work on behalf of all nurses regardless of membership to the nurses of Illinois and to have a strong presence that claiming to want to help the members are individuals who status by monitoring all legislation that impacts the profession speaks together. Because together we will always be stronger. have come to INA’s aid in the past. Some have worked and health care in general. We are the Illinois NURSES So as you continue to be exposed and bombarded with closely with the very members they now seek to discredit. Association and the only organization that has the history and messages from NNU (CNA/NNOC) please ask yourself why? longevity that makes us the “GO TO” resource when nursing What do they have to gain by dividing the nurses of Illinois So if by “SUPER” you mean Subversive, Unethical, issues need to be addressed. and the members of the INA. Power hungry, Ego-centric and Retaliatory then I guess Since the beginning of December INA has been under Why would an organization claiming to have the best you have gotten what you asked for. attack. Your elected leadership has repeatedly asked those interest of the staff nurse and the profession at heart spend so However, the INA leadership will continue to strive for who stood in favor of the formation of a so called “SUPER much time and effort dividing the very group they claim to a super union. But our “SUPER” union will be one with UNION” to lay out guidelines so that INA’s autonomy would support? How does that help the staff nurse who is working Standards, Unity, Professionalism, Ethics and Respect for be protected. We even asked for mediation but were denied. short staffed or working in a hostile or unsafe environment? all members. My Involvement In The Crisis Between INA/UAN and NNOC/NNU Judy Hopkins, RN National Nurses United (NNU) Constitution and the Cabinet met and was essentially told their concerns had affiliation agreement. On inspecting the document, it was been heard but ignored as it was “too late” to change the Colleagues, it is vital to understand how INA and the readily apparent that there was no place for representation language now. other coalition of states in the UAN came to be involved in a or democracy in the new organization. It would be overseen Our E&GW Commission again sought a second meeting lawsuit against CNA/NNOC/NNU. by Roseann DeMoro of California and California would with the UAN Executive Board on October 6, 2009. Sandra In 2007, the National Labor Assembly of the United have the lions’ share of members on the Executive Council. Fischer, RN and Linda Briggs, RN, joined us as UAN NLA American Nurses directed its Executive Board to explore Walt Frederickson, not surprisingly, had the next highest Delegates. We again laid out our concerns as asked for the affiliation with other national unions; always with the idea office, again by appointment not a vote, and Minnesota had UAN Executive Council to seek clarification regarding of keeping the identity of the UAN intact. the next highest number of representatives to that council. Illinois’ unique position as the only state with two existing In early 2009, our E&GW Commission and UAN Michigan and Massachusetts both had equal representation affiliates within its borders. NLA Delegates were informed that although talks were in with the remaining “small states” sharing one representative. To our reasoning, since we saw nothing of the progress, the actuality of this ‘superunion’ was about three Where was the voice of Illinois nurses in this new national representation, democracy or methods for redress of the years away. nurses union? Muffled. UAN in the new document, it was a dissolution of the By March 2009, our E&GW Commission and UAN Our E&GW Commission asked to meet with the UAN, not an affiliation. The UAN as we knew it would be NLA Delegates were informed that the formation of this Executive Board of the UAN to discuss the continued haste gone with the Special National Labor Assembly (NLA) in “superunion,” the affiliation of UAN and NNOC, would and our concerns regarding the documents we had received. November 2009. happen in December 2009. We met in Chicago on September 2, 2009. UAN President, We could not affect the vote at the Special NLA because In May 2009, Sandra Robinson, Elwood Thompson and Ann Converso, UAN Executive Director Walt Frederickson, Minnesota and Michigan had a majority of delegates. The Susan Swart traveled to DC to a meeting of the National UAN Treasurer Jean Ross, UAN Director Kathleen Gettys only route left to us was to stop a quorum. A majority of Labor Cabinet. There again Sandra as well as other state (by phone) and UAN Director Carolyn Hietamaki (by member states was needed to conduct any business legally leaders asked about the new urgency in the formation of phone) were present. Representing INA were: INA Executive at the NLA. We, the E&GW Commission of the INA, this new union. They expressed their concerns regarding the Director Susan Y. Swart, RN; INA President Pam Robbins, organized a boycott by eleven member states of the UAN. “provisional” agreement and the unanswered questions from RN; E&GW Program Director Elwood R. Thompson, Chair When the final strategy was discussed on a conference call, the members. of the E&GW Commission Sandra D. Robinson, RN; and it was decided that we needed an E&GW member who In mid year, we obtained copies of the newly named me as an E&GW Commissioner. It was obvious from the was NOT a delegate to the NLA, preferably an E&GW behavior of Frederickson and Ross that things at Commissioner, who was up to speed with the happenings Presort Standard UAN were greatly changed. President Converso had related to UAN/NNOC/MA/MI/MN. That was me, Judy US Postage been forbidden to speak her opinion. Ross spoke at Hopkins. PAID length and in platitudes about the need for “getting I attended the Special NLA in Orlando, Florida in early Permit #14 Princeton, MN rid of state boundaries,” for being “one national November 2009, as a member of the UAN from Illinois. current resident or 55371 union.” The arrogance of Frederickson was grating. As of the opening ceremony, we knew that the coalition of During the meeting the E&GW Commissioners small states had succeeded in defeating the constitutional asked for a revision of the obvious disparity in requirement for a quorum. Accordingly, both President representation of the executive committee. When we Ann Converso and Vice President Craft, handed over the asked for some democracy in the new organization, gavel, refusing to chair an illegal meeting. Jean Ross went we were told that “it was done: it could not be on to chair the meeting, leading by “acclamation.” The changed” because this was the document that Parliamentarian stated on the record on more than one California had just approved and Massachusetts had occasion, that any business conducted at this meeting would noticed the document to its members. On September 20, 2009, the National Labor My Involvement in the Crisis continued on page 4
  2. 2. Page 2 April 2010 The Illinois Nurse President’s Message IllInoIs nurses AssocIAtIon President Pamela Robbins, BSN, RN: pamrobbins@urbancom.net First Vice President Through the INA: What Processes the circumstances of your institution better than you. Mildred Taylor, BSN, RN: m.taylor.rn@comcast.net Second Vice President Stay informed to the process and tenure of your union Nurses Can Use to Advance and negotiations, it is your responsibility. Ask questions! Roosevelt Gallion, M.Ed, BSN, RN: RG2194@aol.com Secretary Promote Their Nursing Profession Vote responsibly! Previous contracts negotiated by local Queen Gallien-Patterson, RN: qpatterson@aol.com bargaining unit leadership supported by the rank and file Treasurer in Illinois! are the building blocks of future contracts. No negotiations Sharon Zandell, RN: sharon.zandel@med.va.gov are conducted in a vacuum. It is a blend of union nurse Pam Robbins BSN, RN Board of Directors: leadership and the collective working together to embrace Cheryl Anema: tccnurse@aol.com President, Illinois Nurses Association their roles in achieving a fair contract resolution despite Mary Bortolotti, RN: mandkbort@aol.com distracting and divisive strategies from inside and/or Pam Brown: pbrown@brcn.edu Let’s begin with the largest outside of the collective. Dan Fraczkowski: dfraczkowski@yahoo.com union of registered professional Paula Kagan: pkagan@depaul.edu For those who are saying to yourself “well I am not Karen Kelly, EdD, RN, CNE-BC: kkellys@aol.com nurses, the Illinois Nurses a union member and I see no benefit to joining this Pamela J. Para RN, MPH, CPHRM, ARM, FASHRM: Association. Nurses identify organization,” know that the union is but one process to pjpara2001@yahoo.com problems through investigation, advocacy for nurses, the profession and patient safety. INA Ruby P. Reese RN PhD developing remedies based provides resource and professional nurse networking as the Bonnie Salvetti: bonnie.salvetti@sih.net on nursing research as well as Gloria Simon: galyaodi@yahoo.com largest and longest standing group of Illinois nurses. INA Krystal Spivey: kspiveyrn@aol.com other resources and implement collaborates with other healthcare stakeholders including Joe Williams: sangamojoe@aol.com solutions through established the two other state nursing professional organizations, Terri L. Williams RN: sewpro9370@aol.com union processes of Grievance, the Illinois Association of Nurse Anesthetists and the Nursing Practice Committees District Presidents Illinois Society of Advanced Practice Nurses. Our three 1 Roosevelt Gallion: RG2194@aol.com and Labor/Management meetings. organizations have worked well together improving 2 Mary Bortolotti: mandkbort@aol.com Union nurses through contract Illinois nursing regulation including the Nurse Practice 3 Sharon Peterson: speterson@crusaderclinic.org negotiations and grievance Pam Robbins Act. Who better to speak for Illinois nurses than the 5 Royanne Shultz: royanneschultz@hotmail.com resolution fashion binding organizations that represent Illinois nurses! INA members 8 Ann O’Sullivan: aosullivan@blessinghospital.com improvements for their individual 9 Terri Williams: sewpro9370@aol.com benefit from connections with the national American 10 Jane Bruker: jkbru@aol.com workplaces. Many nurses are unaware of the language Nurses Association (ANA), and other state affiliate 13 Janet Lynch: lynch.janet08@gmail.com within their existing contract and are sometimes apathetic nursing organizations. Recognize you, the nurse, are key 14 Martha McDonald: Martha.mcdonald@sih.net to using the process of the union to resolve nursing issues to activating any process! 15 Eunice Mumm: emumm@webtv.net and workplace deficiencies. The contract’s tools should 17 Ann Smith: nevann@comcast.net Nurses in Illinois, organized or not, move their agendas 18 Acting President Alma Labunski: ajlabu@aol.com be used by the collective members to improve their work of advancing the profession and patient safety forward 20 Cheryl Anema: tccnurse@aol.com environments. Thank you to all the INA labor leaders and through legislative process with the INA! I believe in 21 Sandra Webb Booker: stethes@yahoo.com members who fight for the rights of patients and nurses appreciating every nurse’s individualized educational daily through the union process. Your vigilant efforts as level, special skills and abilities but I also celebrate E & GW Commission nursing leaders improve nurses’ work environments and Sandra D. Robinson, Chair: nursemoney06@yahoo.com our similarities and embrace the collective mindset Linda Briggs: lindasbriggs@yahoo.com “define nursing practice” every minute of every day as they to achieve advancements for all nurses and their work Nicola Carter: colakola@hotmail.com deliver care to their patients. The works of INA collective environments via legislation. INA, the state’s professional Sandy Fischer: fish23w@yahoo.com bargaining units have directly and indirectly affected organization for over 100 years, includes programs such LaGretta Green: ltg1106@aol.com the state with regards to improving nursing workplace Judith K. Hopkins: Sicu40@aol.com as Government Relations which move INA members’ Thomas Magana: ndirish01@sbcglobal.net environment practices, compensation and benefits. INA legislative agenda forward in Springfield. INA fashions Virginia Rockett: momynator@yahoo.com union contract language can also be found as stems for nursing legislation and uses grassroots lobbying of nurses Christine H. Szkarlat: Christine.Szkarlat@va.gov state nursing legislation promoting professional nursing for to educate themselves, the public, and legislators. The all Illinois nurses. objective is for the General Assembly to successfully Local Unit Chairpersons/Co-Chairs The other equally important group in any union is City of Chicago: Timothy Hudson pass nursing and patient safety strategies into law. Such RC-23 State of Illinois: Lee Goehl the rank and file collective members. The complement INA efforts include Staffing by Acuity (PA 095-0401), Co-Chair Bill Schubert of leaders at the table and collective must work together No Mandatory Overtime (PA 094-0349) in the private St. Joseph: Marlene Murphy and Chris Daly to achieve advancements for nurses. Union nurses sector and the Ambulatory Surgical Treatment Center Union Health Services: Sophie Heldak should contribute in developing contract language University of Chicago: Karen Keller and Tom Magana Act amendment that requires only an RN is qualified to University of Illinois: Marcia Hymon (D20), Leo Sherman and their elected union nurse negotiators are the be the Circulator in the Operating Room (PA 094-0915). VA Hines: Gail Robinson spokespersons for the collective and are to be reliable INA legislation is member driven and addresses the issues Christine Szkarlat (D9) resources communicating often with members. Failing of Illinois nurses. INA is continually vigilant, with our VA North Chicago: Thelma Fuentes to stay informed on negotiations, casting a vote based on full time lobbyist in Springfield, as a watchdog whenever VA Westside: Murrie Davis (D01) incomplete information or failing to vote does not promote regulations concerning professional nursing practice issues the best interests of the collective in any contract. No arise. INA’s Commission on Workforce Advocacy educates one else knows your work environment, the politics, and nurses on strategies to deal with issues found in every work environment. Another INA committee, the Congress on Health Policy and Practice engages in evaluating the relevant scientific social and educational development of us to advance the profession utilizing our individual and changes in health needs and practices with reference nursing talents. It is up to you to engage in collective to their implications for nursing in all of its functional power whether or not you are in a bargaining unit, roles, clinical specialties and settings. Thank you to all the presenting a new policy or practice in your individual INA members and our collaborators who work on behalf work environment or participating in a statewide of advancing the profession in Illinois and as state and legislation grassroots campaign—all efforts should go national leaders promoting nursing for Illinois! to promoting safer healthcare delivery systems. Realize INA continues to be the choice for all registered nurses every positive action promotes nursing for every one of in Illinois. INA is not pigeonholed into serving only us. Being a member of the Illinois Nurses Association specific kinds of workplace issues, union or non-union, affords educational opportunities (CE’s are now required but rather identifies the needs of nurses wherever they for licensure renewal) and as your knowledge grows this practice. The nursing profession collectively needs all can be cultivated in your own work environment via policy and practice improvements! You are the key! INA will continue to represent our members and promote the practice as the largest registered nursing organization in Illinois as a democratic member-driven organization. Consider joining the INA, and through proven processes, move your agenda for nursing forward!
  3. 3. The Illinois Nurse April 2010 Page 3 IllInoIs nurses AssocIAtIon Med-Force Flight Nursing Illinois Nurses Association/ by Bonnie Guerra, RN, CFRN nurse is autonomous. The flight nurse is responsible for Illinois Nurses Foundation decisions about medications, treatments, and specialized Flight nursing requires solid experience, education, nursing care rendered for a variety of clients in a wide 105 W. Adams, Suite 2101 911 S. Second Street and skill. Flight programs require nurses have a array of situations. The flight nurse is challenged to Chicago, IL 60603 Springfield, IL 62704 minimum of 3-5 years of emergency or critical care prepare for the unpredictable. While in these situations, 312/419-2900 217/523-0783 Fax: 312/419-2920 Fax: 217/523-0838 experience. In addition to the educational preparation the focus is to make decisions that affect the best possible www.illinoisnurses.com for professional nursing, the Med-Force flight nurses are outcome and improve the patient’s condition. required to maintain numerous advanced certifications. One day we were called to an industrial accident for a Executive Director: These advanced certifications are seriously burned worker. We were Susan Swart, MS, RN: Ext. 229, sswart@illinoisnurses.com Chief Financial Officer: Advanced Cardiac Life Support, on the scene within minutes. I will Rick Roche: Ext. 230, rroche@illinoisnurses.com Basic Cardiac Life Support, never forget the look of fear in Program Director, EGW: Pediatric Advanced Life Support, his eyes and obvious pain he was Elwood R. Thompson: Ext. 228, ethompson@illinoisnurses.com Neonatal Resuscitation Program, experiencing. We gave reassurance, Deputy Executive Director: Trauma Nursing Core Course, and and began the work of stabilization. Sharon Canariato, MSN, MBA, RN, Ext. 235 scanariato@illinoisnurses.com Prehospital Trauma Life Support. My partner and I exchanged looks Director of Marketing and Member Services: Additional educational opportunities and knew what needed to be done. Deb Weiderman, MS, RN, Ext. 232 are gained at conferences, classes, An intravenous line (IV) was dweiderman@illinoisnurses.com and courses. Flight nurses are trained established and RSI performed to Associate Director, Continuing Education: Kemi Ani, Ext. 240 kani@illinoisnurses.com to independently perform advanced protect the patient’s jeopardized E&GW Staff Attorney: critical care procedures such as airway. We then loaded the patient Alice Johnson, Ext. 239, ajohnson@illinoisnurses.com intraosseous needle placement, into the helicopter for transport to E&GW Staff Specialists: Rapid Sequence Intubation (RSI), a Level I trauma center with a burn Rick Lezu, 217-523-0783 rlezu@illinoisnurses.com needle chest thoracentesis, airway center. In route, the patient was Ray Scavone, Ext. 245, rscavone@illinoisnurses.com Pam Brunton, Ext. 224 pbrunton@illinoisnurses.com management, and cricothyrotomy. placed on the aircraft ventilator, a Abass Wane, Ext. 249 awane@illinoisnurses.com Members of the Med-Force flight second IV started, pain medication E&GW Coordinator: crew also provide Landing Zone and safety training to given, and sedation maintained. Parkland formula was Rhonda Perkins, Ext. 223 rperkins@illinoisnurses.com local services. This preparation is necessary for the level calculated and fluid resuscitation initiated. We arrived at Coordinator, Springfield Staci Moore, 217-523-0783 staci@illinoisnurses.com of responsibility and autonomy inherent to this specialized the trauma center within the “golden hour” (the time after Staff Accountant: role. a severe injury where prompt medical intervention can Toni Fox, Ext. 243 tfox@illinoisnurses.com An important role of the flight nurse is to implement save lives). It was rewarding to know that we were meeting Administrative Assistant: orders from medical control and execute set protocols for our goals of improving patient comfort, condition, and Brenda Richardson, Ext. 248 brichardson@illinoisnurses.com care. Even within this structure, the work of the flight outcome using our experience, knowledge, and skills. Melinda Sweeney, Ext. 222 msweeney@illinoisnurses.com Editorial Committee Theresa Adelman, RN Cheryl Anema, PhD, RN Margaret Kraft, RN, PhD Alma Labunski, EdD, MS, RN, Chair Linda Olson, PhD, RN Lisa Anderson Shaw DPH, MA, MSN Mary Shoemaker, PhD, BS, MS, RN The Illinois Nurse is published quarterly (4 issues yearly) by the Illinois Nurses Association, 105 W. Adams, Suite 2101, Chicago, IL 60603. For advertising rates and information, please contact Arthur L. Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216, Cedar Falls, Iowa 50613, (800) 626-4081, sales@aldpub.com. INA and the Arthur L. Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement. Acceptance of advertising does not imply endorsement or approval by the Illinois Nurses Association of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. INA and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of INA or those of the national or local associations.
  4. 4. Page 4 April 2010 The Illinois Nurse My Involvement in the Crisis continued from page 1 Practice Corner need to be ratified by the next NLA in March 2010. Having removed everyone except delegates and UAN members, the mood of the group in the hall was mob-like. They dismissed the UAN constitution in the morning when a quorum was Illinois Nurses Association Embraces required but clung to it in the afternoon when they wanted to impeach Ann Converso, Joan Craft and Kathleen Gettys. While I furiously took notes at each meeting of the Social Media Special NLA, behind the scenes, INA leadership was conferring with the leadership of the coalition states strategizing. Accordingly, it was decided to firstly pursue by Sharon Canariato to link to others in the professional community. This site is helpful to network professionally, search for job an injunction, along with a temporary restraining order, opportunities, and research companies. LinkedIn has 60 to stop the founding convention of the NNU in December In an effort to bring Illinois million subscribers. Nurses Lounge is a relatively new 2009. At this point, the constitution had been written, top nurses together, INA has networking site. Unlike larger social networking sites, officers assigned and VPs had been elected. All this had recently created group profiles Nurses Lounge is a professional site where nurses can occurred but had not been legitimized at a legal NLA. The on the social networking temporary restraining order was denied because CNA was venues of Facebook, LinkedIn network in a professional environment and maintain able to convince the judge that what had happened was an and Nurses Lounge! With privacy. 45% of the members have advance degrees or are nurse executives. AFFILIATION and not a DISSOLUTION. However, our the development of online While social networking is obviously popular, what legal request for an injunction was not dismissed. The latest networks, the ability to would be the benefit to join INA’s online group? Social motions filed in court by CNA replacing the UAN attorneys network professionally and to networking allows nurses to interact in “real time.” with CNA attorneys state that it is a DISSOLUTION! stay connected has become Newsworthy information can be disseminated quickly It has been our contention since the beginning that easier than ever. Joining one through these websites. The need for communication this was not an affiliation of two equal bodies into one or all of INA’s groups will help in health care and among nurses has never been greater. “superunion” but rather a hostile takeover of our UAN by nurses keep current on news, Information would essentially be at your fingertips NNOC, aided by principals from Minnesota and Michigan. information and events, while Sharon Canariato by joining our group. The group sites or fan pages Our UAN constitution had language related to dissolution expanding opportunities to are the place to go to stay informed by reading posts, in which all its assets were to be returned to the members. create new connections. communicating on issues and collaborating on projects. Is it not clear why NNOC did NOT want this viewed as a According to Wikipedia, a social network service Visiting these sites will also keep you up to date on dissolution? NNOC/CAN covets our AFL/CIO seat, our focuses on building and reflecting social relations among upcoming events that are important to the association. national professional reputation, our members and our people who share similar interests and/or activities. While INA’s pages are new, there is a strong impetus to money. Essentially a social network grows by connecting people to enhance these pages. With the addition of Deb “the intern” It is imperative for the future of not only our E&GW others while developing a social bond. Recent studies have Weiderman to our staff, these pages will flourish under program but ALL of INA that we fight this illegal stated that the 35 to 54 year old age group is the fastest her watch. Our goal is to provide current and relevant dissolution of our UAN with every tool at our disposal and growing segment of social networking users. information in a timely manner to the nurses of Illinois. every ounce of our perseverance. We need to stand united Facebook was started in 2004 by four Harvard I believe social networking will have a great impact on and fight the menace to professional nursing in Illinois that University students and has grown to 400 million society, why not use it to benefit professional nurses? is NNOC. subscribers. You can use your homepage to tell people Look for us in Facebook Groups at Facebook.com You may have received confusing messages from about your work, school or recreational activities. You and to join our Nurses Lounge go to: http://community. members questioning the replies from Susan Swart and can upload pictures and videos and your friends can nurseslounge.com/join/illinoisnurse Elwood Thompson to questions sent concerning this leave public or private messages. LinkedIn is the premier situation. I believe that the messages from these members business-only social networking site. It allows people are misconstruing the answers provided by INA staff members: The information requested in the letter dated January 11, 2010 is available to you as an INA member. As has been the INA policy, it is available at the INA office. There have been attempts by people from California and Texas to infiltrate our teleconferences: to put this info on the Internet or blast it out as unsafe. Period. As to the votes of the E&GW Commission, votes are not recorded individually but rather pass/fail. This is not a new procedure with “this new INA.” One comment implied that INA staff members or elected leaders were taking advantage of member dues dollars. What lifestyle are “they enjoying” that INA members are supporting? This remark is baseless and a slur on the integrity of the Association. This lawsuit (to follow the language of the UAN constitution for votes, dissolution et cetera) is being financed—as was re-iterated ad infinitum on the last E&GW conference call—not only by a line item on the INA budget, but also by a consortium of the “smaller states.” The elected officers of the E&GW Commission were involved in the subsequent decisions related to the UAN. E&GW Commissioners and elected UAN delegates were invited to the two meetings involving members of the Executive Board of the UAN prior to the NLA in November, 2009. As I mentioned earlier in this report, it became clear at the second meeting that their (Frederickson and Ross) decisions had already been finalized regarding UAN, and that according to the constitution of the new NNU, INA had no voice and no recourse for disagreements. California controlled the new organization and since we are the only state in the UAN with firsthand experience with CNA, we knew we had to act decisively. The only legitimate avenue open to us to stop the dissolution of the UAN. Though logistically daunting, this was accomplished. Personally, I believe that the lawsuit needs to go forward as the NNU has no place for any voice other than California, Michigan and Minnesota. If you look at the NNU constitution, you will see that. As for the University of Chicago Medical Center, one of the members questioning the INA response message says “no one should be forced to accept a contract that ends up with them making less than they do now.” I agree. My understanding is that this contract calls for raises in each of the three years as well as a bonus in year three for the nurses at the top of the scale, with no take backs by management. I hope this helps clarify our situation. I remain in solidarity.
  5. 5. The Illinois Nurse April 2010 Page 5 Not Guilty—Texas Jury Acquits Winkler County Nurse On February 11, 2010 it took the jury less than an hour to of blatant retaliation was allowed to take place and reach return a not guilty verdict for Anne Mitchell, RN, defendant the trial stage—a different outcome could have endangered in the criminal trial that has come to be known as the patient safety across the U.S., having a potential chilling effect “Winkler County nurses” trial. Mitchell faced a third-degree that would make nurses think twice before reporting shoddy felony charge in Texas of “misuse of official information,” for medical practice. Nurse whistle blowers should never be fired reporting a physician to the Texas Medical Board for what she and criminally charged for reporting questionable medical believed was unsafe patient care. Mitchell is a member of the care.” Texas Nurses Association (TNA) and the American Nurses “I was just doing my job,” relayed a jubilant Anne Mitchell, Association (ANA). in a phone conversation with TNA immediately following “We are very pleased about the not guilty verdict and that the not guilty verdict, “but no one should have to go through justice prevailed for Anne Mitchell,” stated Susy Sportsman, this,” she said. “I would say to every nurse, if you witness bad PhD, RN, president of TNA. “If anything was to be gained care, you have a duty to your patient to report it, no matter the Gloria Simon from the absurdity of this criminal trial, it is the reaffirmation personal ramifications. This whole ordeal was really about that a nurse’s duty to advocate for the health and safety of patient care.” patients supersedes all else.” Over $45,000 has been donated so far by individuals and PNAI, Inc. Celebrates 53rd As the nations’ largest nursing association, ANA joined organizations across the country to the TNA Legal Defense Anniversary with Inauguration forces with TNA, one of its constituent member associations, in July of 2009 to strongly criticize and raise the alarm Fund as a way to support the defense of Anne Mitchell and former co-defendant Vicki Galle. “We didn’t have any and Dinner Ball about the criminal charges and the fact that the results from support—emotional or financial—until TNA and ANA this case could have a lasting and negative impact on future stepped in,” said Vicki Galle, RN, who also attended the trial by Gloria O. Simon, RN, BSN, MEd nurse whistle blowers. “ANA is relieved and satisfied that in Andrews even though the prosecution had dismissed her Anne Mitchell (RN) was vindicated and found not guilty indictment on February 1 as a co-defendant. “We could never The Philippine Nurses Association, Inc. ( PNAI, Inc.) on these outrageous criminal charges—today’s verdict is a have gotten through this without nursing’s support.” celebrated its 53rd anniversary with inauguration and resounding win on behalf of patient safety in the U.S. Nurses The Illinois Nurse Practice Act states that nurses must dinner ball that was held January 22, 2010 at the Mirage, play a critical, duty-bound role in acting as patient safety watch report unsafe, unethical, or illegal health care practice or Four points Sheraton Hotel, Schiller Park, Illinois. guards in our nation’s health care system. The message the conditions to appropriate authorities (Section 1300.42, #10) The Nomination and Election Committee, consisting of jury sent is clear: the freedom for nurses to report a physician’s and cannot be retaliated against (Section 50-50, #17). past presidents, Chaired by Gloria O. Simon, Co-chaired unsafe medical practices is non-negotiable,” said ANA by Dionisia Battung and Thelma Fuentes, introduced President Rebecca M. Patton, RN, MSN, CNOR. “However, the newly elected officers and members of the Board of ANA remains shocked and deeply disappointed that this sort Directors of 2009-2011. The induction and affirmation was performed by vice consul Bernardo of the Philippine Consulate. In the 1950s foreign nurses came to the United States in the Exchange Nurse program. In 1957 Filipino nurses in Chicago formed the Filipino Nurses Association of Chicago (FNAC) and elected Adela Campos as its first president. Due to the transient nature of the Exchange Nurse Program, there were few years when there was activity. Fortunately Tam Kennedy revived it as the Filipino Nightingales of Chicago but later renamed it as the Filipino Nurses Association of Chicago. In 1966, when Emma Nemivant became president she renamed it Philippine Nurses Association of Chicago and maintained a chapter with the mother association, the Philippine Nurses Association, Manila, Philippines. On August 7, 1993 during Dionia Battung’s administration, the name was changed to the Philippine Nurses Association of Illinois to convey statewide inclusion, not just those nurses in the metropolitan Chicago area. It also obtained its incorporation and continues to the present as the Philippine Nurses Association of Illinois, Inc. the official nursing professional association representing the Filipino nurses in the state of Illinois. In 1977, the association became independent from the mother association, Philippine Nurses Association of the Philippines.
  6. 6. Page 6 April 2010 The Illinois Nurse Continuing Education Offering Telemedicine: Nursing’s Future is Now by Pamela J. Para as “the use of electronic information and communications telepathology, telerehabilitation, teleretinal imaging, RN, MPH, CPHRM, ARM, FASHRM technologies to provide and support health care when and telesurgery.11 Leading clinical applications in Indian distance separates the participants.”4 The Department of health include teleradiology, teleretinal screening, Health and Human Services (DHHS) defines telemedicine teledermatology, telemental health, and telecardiology.12 CE OFFERING as “the use of telecommunications technology for medical, According to the Online Journal of Issues in Nursing, 1.0 CONTACT HOURS diagnostic, monitoring, and therapeutic purposes when the three areas of greatest interest to nurses with regard to --------------------------- distance and/or time separates the participants.”5 The telemedicine include: This offering expires in 2 years: Centers for Medicare & Medicaid Services (CMS) defines 1) Telephone practice/telephone triage/call center February, 2012 telemedicine as “the use of medical information exchanged nursing; ---------------------------------- from one site to another via electronic communications to 2) Care using two-way interactive video (especially The goal of this continuing education offering is improve a patient’s health.” The Joint Commission uses the home care); and to provide information on Telemedicine and its American Telemedicine Association (ATA)’s definition of 3) Care using high tech equipment (primarily in implications to nursing practice. telemedicine as “the use of medical information exchanged military settings).13 from one site to another via electronic communication A Kaiser Permanente study of telehealth nursing The objectives of this article are: for the health and education of the patient or health care showed cost savings, positive health outcomes, and 1. Define telemedicine provider and for the purpose of improving patient care, unexpectedly high patient satisfaction, especially in the 2. Describe aspects of nursing involvement in treatment, and services.”6 elderly community, resulting from the use of telehealth telemedicine Telehealth is the term of preference by the American care. 3. Analyze telemedicine as a strategy/tool for Nurses Association (ANA) for being more inclusive than The concept of telemedicine was recorded as far healthcare reform one predicated on solely a medical model. The ANA back as 1924, when radio news foretold interactive strongly believes that the strength and promise of telehealth video conferencing. Television was invented in 1927. lie in providing increased access to health care services Teleradiology was created in the 1950s, and two-way In an age of technology and change, telemedicine by augmenting existing services, not in replacing them. interactive television was available for neurological exams. presents a clear illustration of the benefits of combining Telehealth is an umbrella term to describe all variations of There was satellite transmission of surgery to replace new technological features with quality and business health care using telecommunications.7 While telemedicine an aortic valve between Texas and Switzerland in 1965. concepts, towards the advancement of healthcare delivery. and telehealth are terms used interchangeably in legal and Voice radio transmission of EKG information occurred A recently released report shows that technologically regulatory discussions, depending on the context, they between the fire department and the hospital in 1967. A advanced hospitals, for example, have greater potential to always refer to the practice of using electronic technology hospital television cable transmitted information to nurse improve processes and outcomes in patient care, reduce to provide patient care over distance. practitioners providing primary care at a distant clinic medical errors, increase productivity, and compete for Telemedicine is a factor in diverse health care in 1972. In the 1990s, there were advances such as fiber market share against other hospitals. Telehealth technology environments. In acute care settings, telemedicine is optics, satellite communication, and compressed video, has reduced hospitalizations and states’ Medicaid being adapted for use in surgery, trauma and critical care, which minimized the technological and financial barriers costs.1 There is no time like the present to incorporate telementoring and teaching, and in developing multimedia that impeded the growth of telemedicine in the 1980s. telemedicine into discussions addressing the national focus learning modules and Internet applications for international Recent legislative efforts have included House Ways on taming health care costs and improving the quality of teaching.8 Telehomecare is the use of advanced and Means Committee approval of several telehealth- care. telecommunication technologies and monitoring devices to related provisions as part of broader national health care Telemedicine has been defined as the use of enable audio and video interaction of patients at home with legislation (i.e., carrying credentials across state lines, telecommunication technologies such as the Internet nurses and other care providers at the medical site, and the Medicare coverage of telehealth services for stand-alone and videoconferencing to bridge geographic gaps and collection and monitoring of physiological data assessed dialysis centers). Telemedicine has been highlighted as a improve health care delivery2, or “the direct provision at the patient’s home with portable devices.9 By 2015, the tool for homeland security, as well as healthcare reform of clinical care via telecommunications—diagnosing, home is expected to be the hub of care.10 Home-based through effective health information technology systems to treating or following up with a patient at a distance.”3 It equipment will connect a patient at home to the doctor, improve care and lower costs. Today, robots make rounds, might be as simple as two health professionals discussing who can monitor vital signs and other health care metrics. monitor intensive care units, respond to emergency calls, a case over the telephone, or as sophisticated as using A baseline analysis by the Health Resources and Services courier supplies and equipment, dispense medications, satellite technology to broadcast a consultation between Administration (HRSA)’s Office of Advancement of perform less invasive procedures, and serve as simulators two facilities in two countries using videoconferencing Telehealth of nineteen rural telemedicine grantees showed for healthcare education. Live broadcasts of surgical equipment. The American Medical Association (AMA)’s that many would have no access to adult psychiatric procedures are conducted through video teleconferencing. Council on Medical Education and Medical Services services, pediatric psychiatric services, dermatologist Picture-archiving communications systems (PACS) defines telemedicine as “the provision of health care services, neurological services, specialized wound care provide real-time images through CT, MRI, ultrasound, consultation and education using telecommunications consultations, and genetic counseling if telemedicine angiography, nuclear medicine, and cardiology.14 The networks to communicate information, and also as medical services had not been provided by the grantees. The eICU® is a remote, centralized, intensivist-led care team practice across distance via telecommunications and Department of Veteran Affairs has engaged in telehealth that uses enabling technology to continuously monitor, interactive video technology. The Institute of Medicine in thirty-two different clinical areas, with main emphases assess, and intervene on patients in support of on-site (IOM)’s Committee on Telemedicine defines telemedicine on home telehealth, teledermatology, telemental health, Telemedicine continued on page 7
  7. 7. The Illinois Nurse April 2010 Page 7 Continuing Education Offering Telemedicine continued from page 6 Organization of Nurse Executives (AONE), state hospital supplemented with two-way interactive video encounters associations, American Association of Occupational Health with patients. Nurses are involved in distance surgery and caregivers. Exer-games, such as the Wii Fit, engage 15 Nurses (AAOHN), the U.S. Department of Commerce, The virtual diagnostics. Nurses also lead and participate in consumer involvement in transforming the health care Center for Telemedicine Law, The Telehealth Leadership discussions and decision-making about well-established system by improving health outcomes. Council, and the Citizens Advocacy Center (CAC). To date, safeguards and monitoring mechanisms for telemedicine Telemedicine safety and standards have taken on greater twenty-three states have enacted the Compact (Illinois has technology. importance in recent years. The nursing profession has not). The time to redesign and improve health care delivery risen to meet this need. Nursing practice standards related The regulatory influence on telemedicine serves has arrived. Technology can be used as a tool that will to telemedicine include: multiple purposes in facilitating this unique area of allow patients and nurses more choices. Collaboration • The American Academy of Ambulatory Care practice. Agencies and accrediting organizations with an and coordination with regulatory and accrediting bodies Nursing (AAACN)  Telehealth Nursing Practice and Administration interest in telemedicine include, but are not limited to: 1) is essential. Nurses can upgrade skills and competencies, The Centers for Medicare & Medicaid Services (CMS); 2) thereby presenting employment options beyond traditional Standards  Telephone Nursing Practice Core Course The Food and Drug Administration (FDA); 3) The Joint roles. Training programs in nursing and medical Commission; 4) The Agency for Healthcare Research schools need to prepare a “new” workforce. The ANA Manual (2001) and Quality (AHRQ); and 5) The Department of Health is committed to the use of telemedicine/telehealth in a • The American Nurses Association  Core Principles on Telehealth (1999) and Human Services (DHHS). CMS considers Medicare manner that enhances access to quality, affordable health  Competencies for Telehealth Technologies in beneficiaries eligible for telehealth services if they are care services. This is nursing’s window of opportunity presented from an originating site that is located in a rural to work with others to enhance healthcare services, Nursing (1999)  Developing Telehealth Protocols: A Blueprint health professional shortage area or in a county outside participate in information sharing, and improve how care of a Metropolitan Statistical Area. Entities participating is delivered. for Success (2001). in a federal telemedicine demonstration project approved These standards are particularly useful for nurses by DHHS as of December 31, 2000 also qualify as Pamela J. Para is a Nurse Consultant in the Non- entering telehealth practice, since they reflect extensive originating sites regardless of geographic location. Real- Long Term Care Certification & Enforcement Branch, analysis of the role of nurses in this emerging area of time interactive audio and video are conditions of payment Division of Survey & Certification, Chicago Regional practice. Nurses with expertise in this area of practice (rather than store-and-forward technology, which is only Office, Centers for Medicare & Medicaid Services. The have identified the appropriate competencies for utilizing eligible in Alaska or Hawaii). The FDA plays a critical author acknowledges Jossey-Bass, A Wiley Imprint, telepractice to augment patient care and enhance patient regulatory role in ensuring the safety and effectiveness for permission to use content written by this author for outcomes. of telemedicine medical devices and software, with the publication in the Risk Management Handbook for Health Other telemedicine standards and guidelines of Center for Devices and Radiological Health (CDRH) Care Organizations, Fifth and Sixth Editions. The views significance include: acting as lead agency. The Joint Commission’s “New represented in this article do not represent the views of • American Telemedicine Association (ATA)  Home Telehealth Clinical Guidelines and Revised 2009 Accreditation Requirements” include either the Centers for Medicare & Medicaid Services or  Telehealth Practice Recommendations for the telemedicine standard focusing on credentialing and the United States. The content of this article is the result privileging processes for licensed independent practitioners of the author’s own research. Diabetic Retinopathy  Practice Guidelines for Teledermatology who are responsible for the care, treatment, and services of  Core Standards for Telemedicine Operations the patient via telemedicine link at the originating site only.  Clinical Guidelines for Telepathology Telemedicine does not fulfill the in-person requirement for the evaluation by a licensed independent practitioner of • American Psychological Association (APA) HOW TO EARN  Clinical Telepsychology Guidelines and the individual in restraint or seclusion.17 AHRQ releases evidence reports on what types of telemedicine services CONTINUING EDUCATION CREDIT Statement on Services by Telephone are more strongly supported by scientific evidence and • American Dermatology Association  Clinical Protocols for Teledermatology for which settings. The overall focus of the DHHS is to expand access to quality health care through the use of This course is 1.0 Contact Hours • Society of American Gastrointestinal and Endoscopic telecommunications and information technologies.18 Surgeons  Guidelines for the Surgical Practice of Since the advent of nursing care over distance, Boards of Nursing have been receiving calls about licensure, 1. Read the Continuing Education Article Telemedicine liability, and other legal issues, especially when the nurse 2. Take the test on the next page • American College of Radiology  Standards for Teleradiology and patient are in different states. Questions have arisen 3. Complete the entire form  Digital Imaging and Communication in about whether nursing care provided electronically over distance actually constitutes the practice of nursing. The Medicine Standards Boards of Nursing have determined that nursing practice DEADLINE • American Medical Association Answer forms must be postmarked by  Guidelines for Physician-Patient Online occurs at the point that a nurse utilizes the knowledge, skill, judgment, and critical thinking that is inherent February 1, 2012 Communications in nursing education and that is authorized through the • Food and Drug Administration  Guidances Related to Telemedicine nursing license.19 From a patient safety perspective, technical safeguards 1. Mail or fax the completed answer form. • American Heart Association and American Stroke should include audit trails for accessed data, cryptography, Include processing fee as follows: Association  Collaborated on scientific statement offering token-based or biometric message authentication, personal INA members – $7.50 identification, and user verification. Patient/caregiver Non members – $15.00 evidence-based recommendations for using responsibility for compliance with equipment and telemedicine in stroke care and allowing remote technology must be considered, with attention to verifying neurologists to examine stroke patients using understanding of any instructions given. Staff training Check or money order payable to INA or telemedicine tools such as videoconferencing.16 should include orientation and ongoing competencies credit card information only regarding telemedicine technologies and applications MAIL: Illinois Nurses Association Since states have the authority to regulate activities and particular to the staff members’ roles and responsibilities. Attn: Sharon Canariato license health professionals at the state level, the different Telemedicine providers must ensure that equipment is 105 W. Adams, Suite 2101 licensure requirements must be untangled in order for satisfactory and subject to routine inspection, preventive Chicago, IL 60603 telemedicine to expand services and improve access to maintenance, and any necessary software upgrades. care (which is ultimately up to Congress). For nurses, the Maintenance and security of patient information must be FAX: Credit Card Payments Only National Council of State Boards of Nursing (NCSBN) preserved. All practitioners involved in cyber-partnerships 312-419-2920 model of nurse licensure allows a nurse to have one must be credentialed through the same process as if they license (in the nurse’s state of residency) and to practice were practicing on-site, or in accordance with state laws in other states (both physically and electronically), subject and statutes. Informed consent should address the risks ACHIEVEMENT to each state’s practice law and regulation. To achieve of the care to be administered and any risks presented • To earn 1.0 contact hours of continuing education, mutual recognition, each state must enact legislation because the care is being delivered via telemedicine. you must achieve a score of 75% authorizing the Nurse Licensure Compact; adopting Telemedicine can be utilized for multiple purposes. First • If you do not pass the test, you may take it again administrative rules and regulations for implementation of all, access to services is enhanced through connections at no additional charge. of the Compact; designating a Nurse Licensure Compact to specialists, portability, virtuality and mobility. Through • Certificates indicating successful completion of Administrator to coordinate implementation of the its efficiency, there is increasing potential to reduce health this offering will be emailed to you Compact; and including Registered Nurses and Licensed care costs for patients, providers, payers, and the health Practical or Licensed Vocational Nurses. In 2002, the care system at large. Telemedicine can improve outcomes NCSBN Delegate Assembly approved the adoption of by engaging consumer involvement and deeper knowledge ACCREDITATION model language for a licensure compact for Advanced of healthy behavior. Finally, telemedicine can be a viable Illinois Nurses Association is an approved provider of Practice Registered Nurses (APRNs). Only those states means of addressing increasing workforce shortages. Care continuing nursing education that have adopted the Registered Nurse (RN) and Licensed can be improved with the appropriate use of technology, by the Georgia Nurses Association, an accredited Practical Nurse (LPN) or Licensed Vocational Nurse and it is technology that will likely give nurses more time approver by the (LVN) Nurse Licensure Compact may implement a to do “nursing.” Compact for APRNs, which offers states the mechanism Through nursing’s partnership with telemedicine, there American Nurses Credentialing Center’s Commission for mutually recognizing APRN licenses/authority to is opportunity for “restructuring” the American health on Accreditation. practice. The final rule is still being written for the APRN care system together. Nursing call centers continue to Compact, and no date has been set for implementation yet. proliferate and provide telephone triage, health information Compact endorsements in support of the Nurse Licensure and referral services. Home care services are being Compact include state nursing associations, the American Telemedicine continued on page 8
  8. 8. Page 8 April 2010 The Illinois Nurse Continuing Education Offering Test Questions 1) The terms “telemedicine” and “telehealth” can be used interchangeably 4) Currently, professional licensure requirements are regulated by the federal (True/False). government (True/False). 2) The benefits of telemedicine include all except which one of the following: 5) Which of the following are patient safety considerations for telemedicine a. Improved outcomes implementation? b. Reducing medical error a. Staff training and competencies c. Protecting patients’ rights b. Patient/caregiver responsibility d. Increasing productivity. c. Equipment maintenance and upgrades d. All of the above. 3) Which regulatory entity is responsible for ensuring the safety and effectiveness of telemedicine medical devices and software? 6) Nurses can partner with telemedicine to “restructure” the health care system by a. The Centers for Medicare & Medicaid Services doing all except which of the following? b. The Food and Drug Administration a. Follow doctors’ orders c. The Agency for Healthcare Research and Quality b. Upgrade skills and competencies d. The Department of Health and Human Services. c. Collaborate with regulatory and accrediting bodies d. Participate in information sharing. (Submit entire form below for contact hours) ANSWER FORM CE #23: Telemedicine: Nursing’s Future is Now Please circle the appropriate letter 3. A B C D 5. A B C D 1. True False 4. True False 6. A B C D 2. A B C D ---------------------------------------------------------------------------------------------------------------------- (Please PRINT clearly) Name: _____________________________________________________________________________________________________________________________________ Address: ___________________________________________________________________________________________________________________________________ City _____________________________________________________________________ : State: ________________ Zip: ___________________________________ Phone: ___________________________________________________________________ Email Address: _________________________________________________ ---------------------------------------------------------------------------------------------------------------------- Evaluation—CE 0210-23 Strongly Agree (5) Strongly Disagree (1) Learner achievement of objectives: 1. Define telemedicine 5 4 3 2 1 2. Describe aspects of nursing involvement in telemedicine 5 4 3 2 1 3. Analyze telemedicine as a strategy/tool for healthcare reform 5 4 3 2 1 How many minutes did it take you to read and complete this program? _________________________________________________________________________________ Suggestions for improvement? Future topics? _____________________________________________________________________________________________________ METHOD OF PAYMENT ❑ INA Member ($7.50) INA ID# _______________________________________ ❑ Non Member ($15.00) ❑ Money Order ❑ Check ❑ VISA ❑ Master Card ❑ American Express (note: a fee of $25 will be assessed for any returned checks) Card account number: ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ Credit card expiration date: ____ ____ / ____ ____ Signature __________________________________________________________________ Date _____________________________________________________ Mail all tests to: INA, Attn: Sharon Canariato, 105 W. Adams, Sute 2101, Chicago, IL 60603 References 9 Demeris et al, op. cit. The American Nurses Association. Accessed January 30, 2010 from http://www.nursingworld.org 10 Calvan, B., “Kaiser, UCD labs seek innovations in patient care, costs.” The Sacramento Bee, July 28, 2009. [www. The National Council of State Boards of Nursing. AccessedJanuary 30, 2010 from http://www.ncsbn.org sacbee.com/140/v-print/story/2060963.html]. Last visited January 30, 2010. Para, P. (2006). Evolving Risk in Telemedicine, Risk Management Handbook for Health Care Organizations (5th ed.). 11 VHA Telehealth. [www.va.gov/occ/Veteran/Telehealth.asp]. Last visited January 2005. Volume 3, San Francisco, California: Jossey Bass, A Wiley Imprint, 3, 369-399. 12 Clancy, op. cit. 13 Hutcherson, Carolyn M., “Legal Considerations For Nurses Practicing In A Telehealth Setting.” Online Journal of 1 Ranney, D. (2009, August 3). Pilot project shows promise for cutting Medicaid costs. Kansas Health Institute News Issues in Nursing, September 30, 2001. [http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ Service. Accessed January 30, 2010 from http://www.khi.org/news/2009/aug/03/pilot-project-shows-promise- ANAPeriodicals/OJIN/TableofContents/Volume62001/No3Sept01/LegalConsiderations.aspx]. Last visited January cutting-medicaid-costs/ 30, 2010. 2 Demeris, G., Patrick, T. B., Mitchell, J. A., and Waldren, S. E. (2004, September). To Telemedically Err Is Human. 14 “Newspapers Examine Emerging Telemedicine Technology.” Kaiser Daily Policy Report. July 6, 2005. [www. Joint Commission Journal on Quality and Safety,30(9), 521-527. kaisernetwork.org/daily_reports/print_report.cfm?DR_ID=31215&dr_cat=3]. Last visited January 30, 2010. 3 Brown, N. (2002, May 3, PowerPoint presentation). “What is Telemedicine?” 15 Ries, M. et al. “eICU: Critical Care at Advocate in the 21st Century.” PowerPoint presentation, April 8, 2005. 4 Institute of Medicine. (1996). Telemedicine: A Guide to Assessing Telecommunications in Health Care. Accessed 16 “American Heart Association Backs Telemedicine for Strokes.” iHealthBeat, California HealthCare Foundation, July 1, January 30, 2010 from www.nap.edu/readingroom/records/0309055318.html 2009. [http://www.ihealthbeat.org/Articles/2009/7/1/American-Heart-Association-Backs-Telemedicine-for-Strokes. 5 Clancy, C.M. “Telemedicine Activities at the Department of Health and Human Services: Before the Subcommittee on aspx]. Last visited January 30, 2010. Health Committee on Veterans Affairs, May 18, 2005. [www.ahrq.gov/news/test51805.htm]. Last visited January 17 The Joint Commission. Frequently Asked Questions, November 24, 2008. [http://www.jointcommission.org/ 30, 2010. AccreditationPrograms/BehavioralHealthCare/Standards/09_FAQs/default.htm]. Last visited January 30, 2010. 6 Joint Commission on Accreditation of Healthcare Organizations, Hospital Accreditation Standards: MS-39, 2005. 18 Clancy, C.M. “Telemedicine Activities at the Department of Health and Human Services: Before the Subcommittee on Health 7 Brown, op. cit. Committee on Veterans Affairs, May 18, 2005. [www.ahrq.gov/news/test51805.htm]. Last visited January 30, 2010. 8 Bloch, C. “Teletrauma: From Myth to Reality.” Federal Telemedicine News, pp. 7-8, May 17, 2005. 19 Hutcherson, op. cit.