AACNs Vision: AACN is dedicated to creating a healthcare system driven by the needs of patients and families

where acute and critical care nurses make their optimal contribution.
Newsletter of the Sacramento Area Chapter
American Association of Critical Care Nurses
JulySeptember 2014
40th Anniversary Celebration
October 2
nd

Dinner at the Hilton Arden
Members Only, Pre-registration required

Fall Dinner Meeting
November 6
th

Acute Coronary Syndromes Update
Dr. Jonathan Hemphill,
Roseville Cardiology
Members Only; Pre-registration required
Sponsored by Inventive Health
partnering with Astra Zeneca

Upcoming Educational Events
2
2014-15 Chapter
Planning Team
President:
Trish Pifer
President-Elect:
Laura Tobin
Secretary:
Barbara Weiss
Treasurer:
Marcus Mimnaugh
Treasurer Elect:
Brittney Caldera
Membership Coordinator:
Patty J asper
Education Committee:
Trish Pifer, Barbara Weiss,
and Sharon Millan
Webmaster:
Barbara Weiss
Publications Coordinator:
Brenda McCulloch
Marketing Coordinator:
Laura Tobin
Hospitality Coordinators:
J odi Coltes and Ree Ben
Community Services Coordinator:
Ree Ben
Members at Large:
Nancy Key, Ken Wilson, Deb
bie Lopez, Bobbie Thompson,
Holly Watkins, and Charlene
Weiss-Wenzl
Future NTIs
2015 San Diego May 1621
2016 New Orleans May 1419
2017 Houston May 2025
National AACN
membership is re-
quired for SAC-AACN
membership. For
information, please
call 1-800-899-2226 or
From Our President
Trish Pifer RN MSN CCRN
Hello Sacramento Area AACN Chapter Members!
J uly officially started our new chapter year and my tenure
to Stand-Tall as your President. I am excited about the up-
coming year and the educational events our board has
planned!
My name is Trish Pifer, and I currently work at Sutter Roseville
Medical Center. My role is Clinical Nurse Specialist for Critical
Care. I Stepped-Forward and joined the Sacramento Area AACN
14 years ago from the urging of my colleague Ramona Blakely.
I asked her, "Why should I join SAC AACN with all my other
commitments?" She replied, "You get so much more than you ever
expect being involved in an AACN chapter!" She was absolutely
correct. I have learned so much professionally and personally. The
board has mentored many of our leaders and me in developing ex-
ceptional seminars, public speaking, promoting current clinical evi-
dence-based practice, and much more. I personally enjoy meeting
other nurses in our community, networking, and comparing current
practice. AACN has become my beacon for how to be a profes-
sional nurse and leader within our community. I would like to ac-
knowledge the other board members for their hard work and dedica-
tion to the Sacramento Area AACN chapter. Through a collabora-
tive framework we have been able to provide excellent educational
events year after year to the critical care community of the greater
Sacramento region. As our board often says It takes a village
I would like to take a moment to recognize Patty Jasper-Garrity
our past President. Patty did a fabulous job being our fearless leader
and Dared To be in the role for two full years! Our chapter ran
smoothly and productively providing our board with outstanding
leadership to provide excellent current critical and acute care educa-
tion. Under her leadership we collaborated with many community
(Continued on page 3)
Current Members
180 Members
38% certified
Treasurers Report
Checking: $19,927.86
Savings: $11,101,96


3
Trish Pifer, RN MSN, CCRN is the current Sacramento Area Chapter President. She works at Sutter Roseville Medical
Center as a Critical Care Clinical Nurse Specialist.
outreach programs such as Sacramento Food Bank and Family Services, Mustard Seed
School which provided education to homeless children, WIND Youth Services Sacramento
County's only program serving homeless youth, and Sutter Stroke Camp a retreat for stroke
survivors and their caregivers.
It is amazing to realize Sacramento AACN has been a successful chapter for over 40 years!
During these years our chapter has Focused the Flame with exceptional education and Dared To
Step Forward with the ever-evolving changes in healthcareTogether, Bolder, Stronger! Addition-
ally our chapter members have included a rich mix of nurses who are outstanding clinicians, leaders
in our community, educators at our local nursing programs and hospitals, Clinical Nurse Special-
ists, Nurse Practitioners, speakers at National Teaching Institute, and government employees. Think
about how many nurses we have connected with throughout the years and how many patients bene-
fited from current nursing education provided. Today Sacramento AACN is as Together, Bolder,
Stronger as ever, and we are prepared to Step Forward and tackle future critical and acute health-
care transformation.
This year our chapter is Focusing the Flame and planning many amazing educational events:
October 2
nd
SAC AACN 40
th
Chapter Anniversary Celebration pre-registration is needed.
Please join us for food, fun, and memories. This event will be at the Hilton Sacramento Hilton
West.
November 6
th
Acute Coronary Syndromes Update pre-registration is needed. Dr. J onathan
Hemphill is our featured speaker. J oin us at Ruth's Chris Steak House - Roseville Galleria.
February 2015 Spring Seminar Current Issues in Critical and Acute Care, additional infor-
mation will be coming as we plan this event.
For more information about our events please check us out on our webpage at www.aacn.org,
Facebook under sacaacn, or Twitter. Our chapter appreciates and welcomes your involvement,
please feel free to contact us if you have questions or suggestions.

Trish
(Continued from page 2)

4
5 Days at Memorial by Shari Fink
Several members of SAC-AACN meet monthly to discuss a book weve read, eat some deli-
cious food, drink some fine wine, and enjoy each others company. Sometimes, the book has a
nursing and/or medical theme, sometimes not. Last month we discussed 5 Days at Memorial, a
stark and compelling evidence-based portrayal of one New Orleans hospital during the disastrous
Hurricane Katrina and the subsequent failure of the levee systems. Do you know how your hospital
would react and response in a devastating disaster? Do you know how you would react? While some
of the stories and scenarios are painful, we recommend all nurses read this book.
As the floodwaters rose after Hurricane Katrina, patients, staff, and families who sheltered in New
Orleans Memorial Hospital faced a crisis far worse than the storm itself. Without power, an evacuation
plan, or strong leadership, caregiving became chaotic, and exhausted doctors and nurses found it difficult
to make even the simplest decisions. And, when it came to making the hardest decisions, some of them
seem to have failed. A number of the patients deemed least likely to survive were injected with lethal
combinations of drugseven as the evacuation finally began in earnest. Fink, a Pulitzer Prize winner for
her reporting on Memorial in the New York Times Magazine, offers a stunning re-creation of the storm,
its aftermath, and the investigation that followed (one doctor and two nurses were charged with second-
degree murder but acquitted by a grand jury). She evenhandedly compels readers to consider larger
questions, not just of ethics but race, resources, history, and what constitutes the greater good, while
humanizing the countless smaller tragedies that make up the whole. And, crucially, she provides context,
relating how other hospitals fared in similar situations. Both a breathtaking read and an essential book for
understanding how people behave in times of crisis. Review written by From Keir Graff on Booklist.
Our group has been meeting now for a couple of years and we are ALWAYS happy to have new people
join us. Our next book is Virtues of Oxygen by Susan Schoenberger. For more details, contact
Brenda McCulloch at 916-719-0649 or mccullb@sutterhealth.org

Good to Know.
CCRN-K a certification program for nursing professionals who in their practice apply
knowledge in a way that influences patients, nurses and/or organizations to have a positive
impact on acutely and/or critically ill adult, pediatric or neonatal patients, but do not work ex-
clusively or primarily at the bedside has now launched. CCRN-K may be obtained through an
initial exam or as a renewal option for CCRN and CCRN-E certificants. Email your questions
about eligibility to certification@aacn.org.

On Aug. 20, The J oint Commission, Oakbrook Terrace, Illinois, released the Sentinel Event Alert
Managing Risk During Transition to New ISO Tubing Connector Standards. New Interna-
tional Organization for Standardization (ISO) tubing connector standards are being developed for
manufacturers, to avoid patient injury and death from misconnections. The alert contains an in-
fographic with reminders and tips for managing risk during the transition.

Download a file with 12 individual slide presentations and one all-inclusive presentation that
provide background for the recommendations and suggestions in International Guidelines for
Management of Severe Sepsis and Septic Shock 2012, from the Surviving Sepsis Campaign.
Authors of the guidelines developed the free PowerPoint slide presentations, which can be used
for educational purposes to improve knowledge and team performance.

5
AACN Online CE Center

AACN Members
Every CE activity that you find here is FREE as a member. Explore over 300 CE offerings, and take note
of new online features such as your personal transcript record, and continuous access to all of your CE
certificates. And, of course, FREE, UNLIMITED CE is now a member benefit.
Nonmembers
To enjoy UNLIMITED FREE CE credits from over 300 CE offerings, join us now. If you would like to
see what we offer first, take the free trial and earn up to 4.5 contact hours.

Examples of timely topics that are available include:
Post-Intensive Care Syndrome: ICU Interventions Matter
Management of Acute Hyperglycemic Emergencies: Focus on Diabetic Ketoacidosis
Predictors of Agitation in Critically Ill Adults
Examining The Evidence To Guide Practice: Challenging Practice Habits
SAC-AACN PCCN/ CCRN Review
September 10th and 11th, 2014
Once again Carol Rauen provided an superb Progressive Care
Certification Nurse (PCCN) and Critical Care Nurse Certification
(CCRN) review for our chapter! Over 50 nurses attended this
great program. Here are some of the responses from the attendees:
Carol is a great speaker - knowledgeable, humorous, practi-
cal, informative, dynamic, enthusiastic.
Great syllabus! Learned a lot. Well planned program!

Did you know Carol Rauen also teaches preparatory CCRN and
PCCN reviews at NTI? She is also the monthly Critical Care
Nurse contributor for certification test prep of CCRN and
Cardiac Surgery Certification (CSC) questions.
Here is an example of a current sample questions with the correct answer and rationale:

Hemodialysis would be an appropriate treatment for an overdose of:
A. Acetaminophen
B. Tricyclic antidepressant
C. Aspirin
D. Cocaine
See correct answer and rationale on page 6

Sources
Alspach J . Core Curriculum for Critical Care Nursing. 6th ed. St Louis, MO: Elsevier Saunders;
2006:824.
Chulay M, Burns SM. AACN Essentials of Critical Care Nursing. 2nd ed. New York, NY: McGraw Hill;

6

Focus the Flame: AACN's 2014-2015 Theme
On J uly 1, President Teri Lynn Kiss launched Focus the Flame as AACNs theme for 2014
2015. Original art designed by Canadian artist Helen DSouza illustrates key elements of this
years theme.
A bright flame casts its warm glow, radiating the brilliance of excellence in every direction as it rises
from the blues and greens of a turbulent sea, revealing familiar shapes a ship, a labyrinth and what
could be large raindrops or perhaps tears surrounded by predictable patterns and lines amid the disar-
ray. The sea represents the healthcare environment.
Two hands become a flame that, in turn, assumes the shape of a human figure a nurse lifted by the up-
turned hands of the flames spark.
Caring hands support and celebrate the nurse, but neither
the hands nor the nurse are engulfed by the flame. In-
stead, the hands arise from the flame to summon and di-
rect its power toward the nurses heroic figure, which
holds a prize a single lick of flame incised with a heart
to represent the nurses focused passion.
F-I-R-E Fearlessness. Inquiry. Resilience. Engage-
ment. is an acronym reminding us that caring for our
internal flame and focusing it are not optional, Kiss ex-
plains. F-I-R-E places front of mind the qualities re-
quired to care for our flame so we can focus on achieving
our mission of driving excellence, because nothing less is
acceptable.
Later in the year, I hope members of our community of
exceptional nurses will nominate individual colleagues
and chapters for a Circle of Excellence Award, so we
may applaud how they successfully focused their flame,
Kiss says.



From Page 5 Correct Answer: C . Rationale: Aspirin overdose can cause
significant respiratory and metabolic dysfunction. In patients with high
blood levels (normal range, 310 mg/dL) exhibiting physical overdose
complications, hemodialysis is useful for fast removal of the compound.
Unfortunately acetaminophen, tricyclics, and cocaine are not dialyzable.
Other substances that can be removed with hemodialysis are methanol, eth-
ylene glycol, lithium, and dabigatran.

7

In May, I had the privi-
lege to attend the Na-
tional Teaching Insti-
tute (NTI) in Denver. I
am thankful for the op-
portunity to be a part of
the Sacramento Chapter
of AACN and to have
attended such an excel-
lent national confer-
ence. I am a big advo-
cate for professional growth and leadership develop-
ment, and celebrating ways that nurses advance pa-
tient care and our healthcare system. I believe the
nursing profession plays a key role in producing
leaders to transform health care forward. The nation
is faced with a struggling economy, downsizing of
hospital organizations, a rise in the number of com-
plex patients, and a future shortage of bedside
nurses. There are many ways in which direct-patient
care nurses, clinical managers and directors, nurse
educators, and advanced practice nurses can exhibit
transformational leadership skills. Some of these
ways include, empowering colleagues to share their
strengths, organizing or presenting education to ad-
vance the knowledge of nurses, stepping forward
when patient safety is a concern, and through par-
ticipation in projects or writing an article that pro-
motes or reinforces a topic, or writing about re-
search or evidence-based practice and performance
improvement.
I always enjoy the NTI conference; in fact it is one
of my favorite nursing conferences. While at NTI I
attended a few different sessions that encourage
nurses to lead the way and share their knowledge
and professionalism with their work units, hospitals,
professional organizations, and the community.
One of the sessions that stood out to me was with
Dare Greatly to Step Forward and Focus the Flame
Laura L. Tobin, MSN, RN, CCNS, ACNS-BC, PCCN
presenter Ruth Kleinpell, PhD, RN, FAAN,
FCCN, regarding Publishing in Nursing. I
specifically went to this lecture because it is one
of my biggest challenges, which I face, outside of
public speaking. I yearn to accomplish publishing
articles and projects, yet I have often felt over-
whelmed by my fear of writing an article and having
it critiqued and/or declined. That is how I have
viewed writing, as more of a chore than a positive
challenge and accomplishment. Yet, I enjoy read-
ing professional nursing journals and participating in
projects focused on leadership or improving patient
or organizational outcomes. It is easy for me to be
concerned with time and the negative thought of, I
am not a strong writer or that I need to have every-
thing perfect so that I am viewed as intelligent and
hard working, and not as foolish for not being exact
in my work. Other nursing colleagues have voiced
this same concern to me; they sometimes question
their ability to write a professional article or if they
truly have the time, focus, and knowledge to write
publishable work. These same barriers to writing and
public speaking were also addressed in one of the
keynote sessions with national speaker, Brene
Brown, PhD, LMSW. She captivated the audience
with her research studying shame-and-vulnerability.
Brene recently published her book, Daring Greatly,
which was a top seller at the NTI bookstore. In her
discussion she focused on the fear of being vulner-
able and facing shame. Her keynote speech was well
received at NTI, and during this session she talked
about the ways at which vulnerability impacts lead-
ers and how it often feels and is viewed as discom-
fort. As a result of the prior, this limits some profes-
sionals from their ability to dare greatly. She talked
about how it is uncomfortable to stand up and talk to
a group of colleagues and she shared her own fears
with public speaking. She also shared how it is un-
(Continued on page 8)
8



comfortable to present an idea that may be unsuc-
cessful and how it is easy to avoid challenging
practice or the way something is done for fear of
being humiliated or viewed in a negative way. I
highly recommend reading her book: Daring
Greatly. This session inspired me to be courageous
and work on establishing my own professional
goals to face my fears of writing, and view it as an
opportunity to learn and grow, and to challenge
myself to dare greatly. I want to challenge all of
you to find a way to dare greatly in your work, to
believe in yourself, and to know that you, too, can
impact work colleagues, a professional organiza-
tion, patient care, and your community.
I appreciated the lecture by Ruth Kleinpell, PhD,
RN-CS, FAAN, FCCN regarding Publishing in
Nursing. I find writing a professional article or par-
ticipating in nursing research to be intimidating,
and I know other colleagues have voiced this con-
cern to me, as well. Ruth presented some great tips
for how to begin writing, ways to remain organized
and focused, tips for overcoming writers block,
and the key to successful work and publication.
Ruth also discussed the barriers to publishing in
professional journals. Some of the barriers include,
believing you are not qualified to write, the factor
of time or a busy schedule, and uncertainty of how
to organize and put into words a professional topic
or project. Ruth shared some great steps to in-
crease the success of having a journal accept your
writing for professional publication. There are also
three stages to writing
a professional paper,
planning your paper
and outline, writing,
and rewriting. It is
important to not feel
discouraged and to
expect that edits and
rewriting are a part of
accomplishing
professional publica-
tion
TIPS FROM RUTH M. KLEINPELL WHEN IT COMES
TO PUBLISHING IN A PROFESSIONAL JOURNAL:
Seek out a mentor or experienced author to help
guide you
Write a brief letter to an editor-in-chief regarding
a previous journal article
Pick a topic and J ournal
Formulate an outline or plan of action with a
timetable
Perform a literature search/review for references,
as well as examples of other journal articles cen-
tered on the patient population or the topic focus
Schedule short periods of time for writing in your
calendar (i.e., 1-2 hours daily 3-4 days-a-week)
Develop a query or summary of what you want to
write, and considering it as a correspondence to
describe your topic and potential work. The
query would be a way to communicate with jour-
nal editors, to determine if they are interested in
reviewing your article for future publication. It is
important to sell the topic by emphasizing how it
is valuable to the journal audience. Be certain to
focus on spelling and punctuation
Writing a queryalso helps adjust your writing
to the editors suggestions. Also, if there are
similar journal articles about your topicit is
important to share how your paper will be differ-
ent. If there is minimal literature supporting the
topicit is good to share this, as well
Use the publishers guidelines/follow the format
of the journal or suggested author format
Provide your educational background, work/
career summary or any specific roles, or projects,
or ties that show you have a background with this
topic
The editor typically responds in a month to work
that is mailed to them, but if you share questions
by e-mail you may receive a response sooner.
If they suggest changes or thoughts, emphasize
your appreciation and that you will include these
in your writing/manuscript
(Continued on page 9)
9
RUTH KLEINPELLS TIPS FOR HOW TO AVOID
WRITERS BLOCK:
Believe in yourself and your work
Reach out and seek editor feedback
Set a deadline
Ask other colleagues for assistance or reach out
to your director or organization for support
when possible
Begin today
Schedule short writing sessions
Avoid long working sessions (i.e., do not sched-
ule 8 hour days of writing)
Organize your writing into phases and focus on
one phase at a time
Do not allow yourself to get overwhelmed by
searching for literature
If you co-author a paper, be sure that it is well-
planned
Brainstorm ideas before writing
When ready to begin writing, start with any sec-
tion
Keep your writing private while you are writing
and do not share until you are done
Do not expect the first draft to be publishable
work
When the first draft is completed, have col-
leagues review your article/paper
Reward yourself throughout the planning,
writing, and rewriting process
Dare greatlytake the risk to share your
passion or a clinical pearl, or a project, or re-
search that may impact other nurses, healthcare
providers, patient outcomes or organizational or
community outcomes. One of the
challenging aspects of leadership roles is
to not only elude confidence in your work,
but to find ways to step forward and focus
the flame to promote excellence in your work,
and also to share that excellence with others.
It is not easy to write, let alone, strive to write
published work. It takes time, commitment, and
discipline. If you take it one step-at-a-time, it is
much easier to not feel overwhelmed; in fact it is
a way to also reflect on how to make your work
even better. I want to challenge all of you to con-
sider facing vulnerability with courage and tak-
ing a risk to either write a professional article,
join and participate in a unit or hospital council;
find a mentor who empowers and guides you in a
positive direction;
lead or assist a team
with a clinical pro-
ject; advance or
continue your edu-
cation; take a na-
tional certification
exam; present on a
topic or project at
your hospital or for
a professional or-
ganization, or at a
local, regional, or national conference. If you
take the first step, your courage will help you
grow and by daring greatly you can do wonderful
things that make an impact on the nursing profes-
sion and patient care!
Laura Tobin is SAC-AACNs Publicity Coordinator. She is a
Clinical Nurse Specialist at Sutter Roseville Medical Center.