Las Vegas • September 6-8, 2012Conference sessions focus on:• Managing the Business• Managing People• Managing Yourself   ...
Conference InvitationThe American Association of Critical-Care Nurses and Contemporary Forums proudly present the second a...
Who Should Attend?                                           AccreditationAny nurse in a management role in an acute or in...
Conference ScheduleThursday, September 6                                                            Friday, September 7   ...
Saturday, September 8                                                                   RAVE REVIEWS                      ...
Registration Information	 Registrations must include full tuition payment to be accepted. Registrations faxed without pay...
Hotel Accommodations                                                   Travel Discounts	 The conference will be held at t...
Please Post Prominently or Forward to a Colleague if Unable to Attend                                                     ...
Upcoming SlideShare
Loading in …5
×

AACN Nurse Manager Priorities

851 views

Published on

  • Be the first to comment

  • Be the first to like this

AACN Nurse Manager Priorities

  1. 1. Las Vegas • September 6-8, 2012Conference sessions focus on:• Managing the Business• Managing People• Managing Yourself REGISTER In collaboration with: EARLY & SAVE! Earn up to 18 hourswww.ContemporaryForums.com
  2. 2. Conference InvitationThe American Association of Critical-Care Nurses and Contemporary Forums proudly present the second annual AACNNurse Manager Priorities, a dynamic program featuring forward-thinking leaders in nursing management.Learning content focuses on a nurse manager’s three critical responsibilities—managing the business, managingpeople and managing yourself. We used last year’s participant feedback to create an even more dynamic program thataccommodates individualized learning plans for a wide range of nurse manager roles and experience.Make the most of this opportunity for learning and leadership growth by filling out the AACN Nurse Manager Skills Inventorybefore the conference. It’s posted at www.aacn.org/managerskillsinventory. Bring it with you as a guide to select yourlearning opportunities.Program Highlights Skills Inventory: Interactive presentations and discussions align with the AACN Nurse Manager Skills inventory and the AACN-AONE Essentials of Nurse Manager Orientation e-Learning course categories — Managing the Business, Managing the People, Managing Yourself. Patient Satisfaction: In-depth discussion of strategies to improve patient satisfaction to impact healthcare funding and improve your hospital’s financial health. Communication: Widening the range of your communication styles will expand your influence and improve collaboration with your team and fellow leaders. Managing Up: Do you get stuck when you try to introduce new programs or processes to senior managers? Experienced nurse leaders will help you learn how to “manage up.” Meaningful Recognition: Achieve shared outcomes with your team when you effectively use meaningful recognition and acknowledgement. 18 Concurrent Sessions: This year’s hot topics include: Culture change, the “right” way to evaluate performance, orientees’ adaptation and readiness to fly solo, strategic management and planning, and recognizing staff growth and team achievements with meaningful award and reward programs.First timer? Came last year? We look forward to welcoming you to Las Vegas. Mark your calendar now and invite yourcolleagues to join you.Program PlanningMary Bylone, MSN, RN, CNMLKathryn Clayton, MSN, MBA, ALNC Contemporary Forums Program ManagerRamón Lavandero, MA, MSN, RN, FAAN AACN, Director of Communications and Strategic AlliancesLaura Rednour AACN, Conference Business ManagerDenise C. Thornby, MS, RN, NEA-BCConference ObjectivesAt the conclusion of this conference, nurse managers will be able to: Discuss the impact of global healthcare and nursing issues on their organization. Utilize the Nurse Manager Skills Inventory tool to define personal education needs and facilitate management career planning. Explain budgeting terminology, components, concepts and processes. Identify strategies to improve nurse recruitment and retention and to maximize performance. Engage staff through collaboration, teamwork, mentoring and effective change management. Discuss quality management relevant to patient and workplace safety.AACN Nurse Manager Priorities is an official brand of the American Association of Critical-Care Nurses. Used with permission.2 Visit us at www.ContemporaryForums.com to register today • Follow us on Facebook and Twitter (#Priorities12)
  3. 3. Who Should Attend? AccreditationAny nurse in a management role in an acute or intensive A Certificate of Attendance will be available online aftercare patient setting: you complete the course requirements, enabling you to register your credit with the appropriate licensing boards or Nurse Managers/Assistants associations. To apply for credit not listed below, use the Clinical Coordinators procedure established by the specific organization. Clinical Directors Nurses and Nurse Practitioners Supervisors/Assistants Main Conference: 17 ANCC/ 20.4 CA BRN contact hours Charge Nurses Roundtable Luncheon with the Faculty: 1 ANCC/ 1.2 CA BRN contact hour. Educators/Instructors Contemporary Forums is accredited as a provider of… And staff nurses who plan to move into a nurse continuing nursing education by the American Nursesmanager role. Credentialing Center’s Commission on Accreditation. Contemporary Forums is approved by the California Board of Registered Nursing, Provider #04516. (CA BRN contact hour = 50 minutes)Conference FacultyDiane G. Aho, MA, RN, CCRN Daleen Aragon Penoyer, PhD, RN, CCRP, FCCMClinical Director Director, Center for Nursing ResearchCVICU/MICU-Cardiac Telemetry Orlando HealthSt. Joseph’s Hospital – HealthEast Orlando, FloridaSt. Paul, Minnesota Lisa Pettrey, MS, RN, NEA-BCMary Bylone, MSN, RN, CNML Leadership ConsultantVice President, Patient Care Services and Columbus, Ohio Chief Nursing Officer Dale M. Pfrimmer, MS, RNThe William W. Backus Hospital Nurse AdministratorNorwich, Connecticut Mayo Clinic College of MedicineGladys M. Campbell, MSN, RN, FAAN Rochester, MinnesotaCNE, Washington State Hospital Association Lindsy Schmitz, BSN, RNCEO Northwest Organization of Nurse Executives Clinical Nurse IIIPortland, Oregon Neurology, Neurosurgery and Stroke UnitJohn F. Dixon, PhD(c), MSN, RN, NE-BC University of Michigan HospitalsVice President for Medical, Cardiovascular, and Ann Arbor, Michigan Cardiopulmonary Services Scott C. Thigpen, DNP, RN, CCRN, CENDirector for The Center for Nursing Education & Research Associate Professor of NursingBaylor University Medical Center South Georgia CollegeDallas, Texas Douglas, GeorgiaDebra Honey, MHA, RN, CPHQ, FACHE, CENP Denise C. Thornby, MS, RN, NEA-BCPresident Nursing Leadership ConsultantHoney Consulting, Inc. Virginia Commonwealth University Health SystemChattanooga, Tennessee Richmond, VirginiaCindy Lefton, PhD, RNTeam Leader, The DAISY Award Impact Research ProjectVice President, Organizational Consulting Psychological Associates Maximize yourSt. Louis, Missouri conference experience!Cinda Liok, BSN, RN Before the conference, fill out the AACN NurseNurse Manager Manager Skills Inventory posted at:Neuro Intensive Care Unit www.aacn.org/managerskillsinventoryUniversity of Michigan Hospitals Select concurrent sessions for the categories that willAnn Arbor, Michigan best support your personal learning plan:Isabella McCool, DNP, RN, NE-BC • Managing the BusinessNurse Manager, Trauma ICU • Managing the PeoplePediatric Trauma, and Cardiovascular Thoracic Surgical ICUDeaconess Hospital • Managing YourselfEvansville, Indiana Contemporary Forums and AACN – Leaders in Quality Continuing Education for High Acuity and Critical Care 3
  4. 4. Conference ScheduleThursday, September 6 Friday, September 7 7:00 a.m. Conference Registration 8:00 a.m. Nurse Managers Have Maslow Needs Too!8:00 State of the Union: Where Is the Talent? Mary Bylone, MSN, RN, CNML Debra Honey, MHA, RN, CPHQ, FACHE, CENP 8:45 Appreciative Inquiry:8:45 Nurse Manager Role Mastery Skills of Positive Leadership Pettrey, MS, RN, NEA-BC Lisa Diane G. Aho, MA, RN, CCRN 9:30 Refreshment Break 9:30 Refreshment Break 9:45 Nurse Manager Essentials: 9:45 Change and Turbulence: Funding of Healthcare Today Moving from Survivor to Thriver Debra Honey, MHA, RN, CPHQ, FACHE, CENP Denise C. Thornby, MS, RN, NEA-BC10:30 Enhancing the Patient Experience: 10:30 Recipes for Cooking Up a Healthy What Are Organizations Doing to Work Environment Strengthen Patient Satisfaction? John F. Dixon, PhD(c), MSN, RN, NE-BC Gladys M. Campbell, MSN, RN, FAAN 11:15 Questions & Discussion11:15 Questions and Discussion Faculty Panel Faculty Panel 11:45 Lunch on Your Own11:45 ROUNDTABLE LUNCHEON WITH THE FACULTY Join your colleagues and faculty members for lunch and 1:15 p.m. CONCURRENT SESSIONS #4 interactive discussions on hot topics in nursing leadership. Each table will feature a faculty member who will facilitate #41 Family Presence: Why Does It Matter? discussion on the nurse manager’s three critical responsibilities – managing the business, managing people and managing (Repeat Session; same content as #11) yourself. Bring interesting scenarios to discuss that you’ve Denise C. Thornby, MS, RN, NEA-BC experienced and come prepared to be part of a dynamic, problem-solving activity. (Attendance is optional and requires #42 America’s Got Talent: Recruiting a reservation. Cost of the luncheon is $45 and 1 hour of CE credit will be awarded. Register early since space is limited.) and Hiring the Right Professionals Scott C. Thigpen, DNP, RN, CCRN, CEN 1:15 p.m. CONCURRENT SESSIONS #1 #43 Strategic Management and Planning #11 Family Presence: Why Does It Matter? Isabella McCool, DNP, RN, NE-BC (Repeat session: same content as #41) Denise C. Thornby, MS, RN, NEA-BC 2:15 Session Change #12 Changing a Unit’s Culture: 2:30 CONCURRENT SESSIONS #5 Confessions of a Bully #51 Managing Up Cinda Liok, BSN, RN Diane G. Aho, MA, RN, CCRN Lindsy Schmitz, BSN, RN #13 Meeting Management: #52 Career Planning: Options and Skills of Meeting Facilitation Considerations for Managers Lisa Pettrey, MS, RN, NEA-BC Daleen Aragon Penoyer, PhD, RN, CCRP, FCCM 2:15 Session Change #53 Award Programs: A Tool for Excellence Dale M. Pfrimmer, MS, RN 2:30 CONCURRENT SESSIONS #2 3:30 Refreshment Break #21 Performance Evaluations: Doing It Right Gladys M. Campbell, MSN, RN, FAAN 3:45 CONCURRENT SESSIONS #6 #22 Recognizing and Preventing Drug #61 Meaningful Recognition Has Power: Diversion in the ICU Together. Stronger. Bolder. Dale M. Pfrimmer, MS, RN Cindy Lefton, PhD, RN #23 Speaking Up Without It Being a #62 Unit-Based Research: It’s Possible! Career Terminating Event Daleen Aragon Penoyer, PhD, RN, CCRP, FCCM Isabella McCool, DNP, RN, NE-BC #63 Losing It 3:30 Refreshment Break Denise C. Thornby, MS, RN, NEA-BC 3:45 CONCURRENT SESSIONS #3 Lisa Pettrey, MS, RN, NEA-BC #31 Validating Competency: It’s Time to Retire 4:45 Adjourn Traditional Annual Skills Day Check-Offs John F. Dixon, PhD(c), MSN, RN, NE-BC #32 Merging Cultures in Today’s Workplace Diane G. Aho, MA, RN, CCRN #33 Investing in Your Unit’s Future: How to Decide If an Orientee Has Failed Cinda Liok, BSN, RN 4:45 Adjourn4 Visit us at www.ContemporaryForums.com to register today • Follow us on Facebook and Twitter (#Priorities12)
  5. 5. Saturday, September 8 RAVE REVIEWS “I have attended other nursing management8:00 a.m. Skilled Communication conferences for years and was tired of the same Cindy Lefton, PhD, RN information year after year. AACN Nurse Manager Priorities provided information that can easily be8:45 Effectively Leading Teams adapted for daily use in my position as a Nurse Cindy Lefton, PhD, RN Director. Great Conference!” 9:30 Refreshment Break Sandra Gonzales, BSN, RN, BC, CNML • Lubbock, Texas9:45 Managing the 20% “I attended the conference but my entire unit will gain Mary Bylone, MSN, RN, CNML from the knowledge I attained and the networking relationships that I made! Looking forward to next10:30 Supporting Staff from Both Ends year. I enjoyed the conference.“ of the Career Continuum Peggy Woolf, RN • Portland, Oregon Scott C. Thigpen, DNP, RN, CCRN, CEN “Excellent conference and well rounded educational11:15 Questions and Discussion topics to help me improve my day to day operations Faculty Panel as a nurse and a leader. Although I am not a11:45 Conference Summary and Evaluation manager, I believe it is essential for bedside nurses to grow and develop managerial and leadership skills12:15 p.m. Adjourn to collaborate effectively and improve the health of their work settings.” All Sessions are Synergy CERP Category C Angela Benefield BSN, RN, CCRN, CSC, CMC Temecula, California “I felt the conference was very well done. It wasViva Las Vegas! enlightening to see so many states represented from across the country and that we all are faced with the same problems. Tools were provided to help NurseI t’s impossible to resist the excitement of the neon lights, the shrieks of delight from jackpot winners, and the glitzand glamour of the hotels on the strip. A Disneyland for Managers evaluate and engage their staff to be focused on outcomes and quality care”. Gary Hamilton, BSN, RN, NM • Lubbock, Texasadults? You bet … and Las Vegas is so much more! Dineat restaurants inspired by the world’s greatest collection “Nurses are often selected to be managers basedof chefs–Wolfgang Puck, Emeril Lagasse, Bobby Flay on excellence in clinical skill and leadershipand Thomas Keller, just to name a few. Treat yourself to potential, but they may not have a full toolbox fora world-class show, including a choice of five Cirque du being successful nurse managers. This conferenceSoleil productions, Disney’s The Lion King, the Blue gave me the skills and tools that I will need to be aMan Group, Phantom-The Las Vegas Spectacular and successful leader and manager in my organization.”Jersey Boys. Make sure to also consider the variety of Cory McCann, BA, RN, CCRN • Salt Lake City, Utahwell-known headliners from the worlds of music, comedyand magic performing during your stay.Don’t miss the CityCenter complex located in the heartof The Strip, a blend of sleek architecture and public and even the Eiffel Tower, the Paris Las Vegas has allminiparks, with walkways and art throughout. You’ll find the passion, excitement and ambiance of Europe’s mostluxury hotels, a casino and Crystals, a three-story retail romantic city. Enjoy the charming atmosphere of thecenter whose shape resembles the multi-faceted surface European village and mall, the lively casino, the duelingof a quartz crystal. pianos at Napoleon’s, and coming the spring of 2012 Chef Gordon Ramsay will open his first Las Vegas restaurant,There’s never a dull moment in Las Vegas. Watch the Gordon Ramsay Steak! And right outside the doors, seevolcano erupt at the Mirage, don’t miss the rousing pirate all “the Strip” has to offer.battle at Treasure Island, marvel at the dancing watersdisplay at the Bellagio Take a romantic gondola ride World-class dining, internationally-known boutiques,through the canals of the Venetian. For a break from award-winning golf courses, savvy nightclubs andThe Strip, take a day trip to Hoover Dam where you’ll be European-style spas are calling you to this glittering city,impressed with the power of the mighty Colorado River. known as “Vegas!” Join your colleagues for “AACN Nurse Manager Priorities” and enjoy all of the fun in the city thatExperience all your fantasies of Paris right in the heart never sleeps. For more information, call the Las Vegasof Las Vegas! From guest rooms with a European flair to Convention and Visitors Authority at (702) 892-7575 or gogreat entertainment, fine French cuisine, sidewalk cafes online to www.visitlasvegas.com. Contemporary Forums and AACN – Leaders in Quality Continuing Education for High Acuity and Critical Care 5
  6. 6. Registration Information Registrations must include full tuition payment to be accepted. Registrations faxed without payment will not be processed. Conference communications are sent via email. When registering please provide attendee’s best email address as some emails are filtered and blocked. Since conference registration and hotel rooms are limited, early registration is advised. Out of consideration to registrants, children of any age and spouses may not attend the sessions. Tuition (U.S. Funds) AACN Member AACN Non-Member Early Registration Fee* (On/Before July 26) $515 $545 Regular Registration Fee $565 $595 (After July 26)* Postmarked or phone/fax/online registration and fees received on/before July 26.Your tuition includes refreshment breaks, Certificate of Attendance, and Online CE Library access to presentation handouts before andafter the conference. See page 7 for Library details. Group Discounts (Mail, fax or call in together. Online registration is not available.) Tuition discounts are given to groups of 3 or more registering for the complete Main Conference. $25 per person discount for 3 or 4 in a group $45 per person discount for 5 or more in a group Method of Tuition Payment Make payment by check (payable to Contemporary Forums and enclose with Registration Form), Visa, MasterCard, Discover, American Express or Purchase Order. A $30 fee is charged for any returned check. Personal checks are NOT accepted at the conference. Purchase Orders must be received with registration by the conference date and include the P.O. number, invoice address, tuition, approval signature, contact name, email address and phone number. Register Online, or by Phone, Fax or Mail (Payment is required to register.) Register only ONCE, online at www.ContemporaryForums.com, by mail, fax (800) 329-9923 or call (800) 377-7707, Monday-Friday, 8 a.m. - 5 p.m. (Pacific Time). Before calling, complete all registration information. Tax Deductibility Expenses of training, tuition, travel, lodging and meals to maintain or improve professional skills may be TAX DEDUCTIBLE. Consult your tax advisor. Partial Attendance (Online registration is not available.) Call Contemporary Forums for tuition and CE credit for individual days. Group discounts do not apply. Registrations may not be shared. Cancellations Cancellations may be made by phone or in writing. Cancellations received on/before July 26 receive a full tuition refund. Cancellations received after July 26 are assessed a $20 processing fee. No refunds for cancellations received after the conference begins or for “no shows.” If this meeting is cancelled for any reason, including labor strikes or acts of God, liability is limited to a full refund of registration fees. Program Changes Contemporary Forums reserves the right to make necessary changes in speakers, topics or schedule. The most current program can be found on our website. Questions? Contact Contemporary Forums at (800) 377-7707, Monday - Friday, 8 a.m. - 5 p.m. (Pacific Time) or email info@cforums.com. If you require special arrangements at this conference, call (800) 377-7707, at least 30 days prior to the conference. EASY WAYS TO REGISTE R Online (Credit card only) Fax (Credit card or Phone (Credit card only) Mail - Attn: Registrar Visit us at Purchase Order) Monday - Friday Contemporary Forumswww.ContemporaryForums.com (800) 329-9923 (800) 377-7707 6377 Clark Avenue, Ste. 200 24 hours a day 8am - 5pm, Pacific Time Dublin, CA 94568 6 Visit us at www.ContemporaryForums.com to register today • Follow us on Facebook and Twitter (#Priorities12)
  7. 7. Hotel Accommodations Travel Discounts The conference will be held at the Paris Las Vegas, Contemporary Forums has a special discount 3655 Las Vegas Blvd. South, Las Vegas, NV 89109. A agreement with United Airlines unavailable limited block of rooms is being held for you and your to the general public. To obtain these special guests at special group rates which will be in effect, based conference fares call the Special Meeting on room availability, from September 4 to September 9 Desk at (800) 521-4041, Account Code 510CW. Ticketing for those wishing to extend their stay to enjoy area and payment can be done directly by you or through your activities or qualify for discount airfares. travel agent. To ensure the best flights and times, since seats are limited, make your reservations early. Fares are Rates: $139 single/double guaranteed at the time of the ticket purchase. Rates are per room and subject to prevailing state and local taxes. To obtain the special group rates, make your reservation Hertz is the official car rental agency early and before the “hotel room block release date” for the conference. Special rates which is August 13. Rooms may sell out before this date will be in effect throughout the conference as well as one so be sure to make your reservation now. After the week before and after. For special rates, call HERTZ at release date, rooms and group rates may no longer be (800) 654-2240 and refer to Contemporary Forums plus the available so call the hotel regarding availability. conference discount code CV#03000259. To reserve your room online, please visit our website at CONTEMPORARY FORUMS www.ContemporaryForums.com for details. 2012 CONFERENCE CALENDAR For room reservations, call (877) 603-4389 and inform (Partial listing) them that you are attending the Contemporary Forums’ conference on AACN Nurse Manager Priorities. Pediatric Nursing: Care of the Hospitalized Child Request a confirmation number and written confirmation Boston, MA • May 2-5 of your reservation. Reservations must include a first Neonatal Pharmacology Washington, DC • June 7-9 night’s deposit. Perinatal Dilemmas Contact the hotel regarding cancellation policy. For Jackson Hole, WY • July 15-18 arrivals after 3 p.m., call the hotel on the day of travel to Pharmacology for Advanced Practice Clinicians reconfirm reservations. San Francisco, CA • September 10-16 Washington, DC • October 8-14 For additional hotel information, call the Paris Las Vegas Las Vegas, NV • November 5-11 at (800) 722-5597. AACN Progressive Care Pathways Las Vegas, NV • October 14-17 Case Management Along the Continuum Boston, MA • October 14-17 Online CE Library The Fetus & Newborn: State-of-the-Art Care San Francisco, CA • October 28-31 Developmental Interventions in Neonatal Care Earn CE Credit Online Orlando, FL • November 7-10 Contemporary Forums Online CE Library is your on-demand resource for quality accredited healthcare For complete conference information visit www.ContemporaryForums.com, continuing education. call toll-free at (800) 377-7707 or email:info@cforums.com. The Library contains over 1,300 topics featuring the most relevant and up-to-date education dedicated to a variety of clinical areas. AACN Programs in 2013 Online CE Library Group Access Programs: Hospitals and healthcare facilities can provide and A Slice of AACN NTI manage quality accredited continuing Las Vegas education to meet staff needs. To request National Teaching Institute & Critical Care Exposition® group access discount pricing and details, Boston visit onlineCElibrary.com AACN Nurse Manager Priorities or call (925) 361-4811. Las Vegas AACN Progressive Care Pathways Las Vegas onlineCElibrary.com For information visit www.aacn.org Email UpdatesIf you are not currently receiving Online CE Library or conference information and updates via email, please go towww.ContemporaryForums.com/en/Email/Updates/. You will then be notified of all conferences as soon as they areannounced as well as have access to special promotions. All email addresses are for Contemporary Forums use only. Contemporary Forums and AACN – Leaders in Quality Continuing Education for High Acuity and Critical Care 7
  8. 8. Please Post Prominently or Forward to a Colleague if Unable to Attend U.S. POSTAGE Contemporary PRSRT STDRegistration Form: AACN Nurse Manager Priorities Forums PAIDSend this form with full payment (U.S. Funds) to:Contemporary Forums, Attn: Registrar, 6377 Clark Avenue, Suite 200, Dublin, CA 94568Fax (800) 329-9923, Phone (800) 377-7707, or visit www.ContemporaryForums.comREGISTRATION INFORMATION (Please Print Clearly)*Name, License/Degrees, Place of Employment, City, State appear on your badge. Please share with your colleagues*First Name Social Security # (Last 4 Digits)*Last Name *License/Degrees*Place of Employment*City *State*Attendee’s E-mail For confirmation, receipt, access CEpresentation slides prior to conference, youraccess to your Certificate of Attendance and Online to Library. Please print clearly and providebest email address as some emails are filtered and blocked. 6377 Clark Avenue, Ste. 200 Contemporary Forums PDFHome AddressCity State Zip Dublin, CA 94568Daytime Phone(s) Code:CONCURRENT SESSIONS SELECTION (See pg. 4)List the number of your 1st and 2nd choices since sessions are limited in size.Assignments are made in the order received.Thursday, September 6 Friday, September 7 PAYMENT SUMMARY #087612Session #1 (1:15 p.m.) Session #4 (1:15 p.m.) _________1st, _________2nd choice __________1st, __________2nd choice Early Fee Postmark Deadline: July 26Session #2 (2:30 p.m.) Session #5 (2:30 p.m.) __________1st, _________2nd choice __________1st, __________2nd choice Conference Tuition $Session #3 (3:45 p.m.) Session #6 (3:45 p.m.) __________1st, _________2nd choice __________1st, __________2nd choice Group Discount (See page 6) -$ (Registration forms must be sent in together)AACN Members I am an AACN member and eligible for the AACN discounted tuition. Roundtable Luncheon with the Faculty + $ (Sept. 6 - $45)PROFESSIONAL PROFILEChoose ONE category in each section that best applies to you. If you have multipleroles, select the one that occupies the majority of your time. Use “Other” only if none TOTAL PAYMENT ENCLOSED $of the choices apply to you.1. POSITION/JOB FUNCTION 3. CLINICAL SETTING  Check/Money Order Payable to Contemporary Forums Charge Nurse  Cardiovascular Surgical ICU OFFICE USE ONLY: C_________ D _________ E _________ Clinical Coordinator  Combined ICU/CCU Clinical Director  Coronary Care Unit Educators/Instructor  Emergency Department Credit Card # Nurse Manager/Assistant  Intensive Care Unit Staff Nurse  Medical/Surgical ICU Supervisor/Assistant  Medical/Surgical Unit Exp. Date Other:_________________  Neuro/Neurosurgical ICU  Obstetrics/LDRP/Perinatal  Oncology Unit Print Cardholder’s Name2. YEARS IN MANAGEMENT POSITION  Outpatient/Ambulatory Care1  Pediatrics  Progressive Care Unit Billing Address 2-3 4-7  Recovery Room 8-10  Rehabilitation  Respiratory ICU City State Zip 11+  Step Down Unit  Trauma Unit  Other:_________________ Payer EmailWe collect this data in order to provide you with information about ContemporaryForums, conferences, and the Online CE Library. If you prefer not to receive further Payer Phone #information, please see our Privacy Statement at www.ContemporaryForums.com.

×