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December 2010 FNPN New Bullets

Posted over 9 years ago by Regina Pommer

Season’s Greetings!

The Staff and Board of Directors at the Florida Nurse Practitioner Network would like to thank all our members for you support and dedication. As we move into 2011, we look forward to a New Year of collaboration, and success for our industry. During this magical season, FNPN would like you to take the time to spend time with family, friends, and colleagues. Enjoy the good conversations, warm smiles and the simple joy that comes from feeling at peace. Rejuvenate yourself as you prepare for the next wave of our journey, one that will challenge your stamina, restraint and convictions. Remember, it is seasons like this that give us the reason to look at life with a new eye.

While each year brings its own unique challenges, the message we continue to send remains clear. Advocacy and Dedication are constantly being witnessed by the public and our peers. Apathy and negativity are toxic and bring no positive outcomes or gains for our profession or patients. Together, our goals of reaching for the right balance in practice, prescribing and empanelling are slowly creeping forward. Now, more than ever, you must renew your commitment and take up the fight once again. Again, Happy Holidays and we hope you enjoy the final newsletter of “2010”.



  • Kudos Corner
  • Message from the FNPN Board of Directors
  • FNPN Annual Elections
  • Legislative Update!
  • Membership Update
  • Job Announcement
  • From Your AANP Representative
  • FNPN PAC Update
  • Around the State and Around the Nation
  • News You Can Use


Quote of the Month:

Have a heart that never hardens, a temper that never tires, a touch that never hurts. ~Charles Dickens


Kudos Corner

The Nurse Practitioner Council of Palm Beach County would like to announce that Bonnie K. Marting was presented the Nurse Practitioner of the Year 2010 Award. Thank you Bonnie, for your dedication and ongoing efforts for Nurse Practitioners and Advance Practice Nurses locally and throughout Florida. As part of Bonnie’s unyielding efforts, her inspiration was the basis for the development of the Coalition for Advanced Practice Nursing, bringing together major Advanced Nursing organizations to work in collaboration for our profession. Additionally, she has been a steadfast member in both local and state organizations and met with legislators regularly to advocate for our cause. Congratulations again on a well deserved reward!


Message from the FNPN Board of Directors

As the upcoming year brings time for renewal, we hope you will consider your pledge to not only the FNPN, but your local organizations as well. This commitment needed is not only financial, but of a promise to remain engaged, whether by keeping abreast with the changes on the legislative front, or finding opportunities for education in your own back yard and around the state and nation. We ask all members to consider ‘bringing a friend’ to the registration table and helping to build our organizations to where they should be. With the numbers of Advanced Practice Nurses nearing 15,000 in Florida, we should have a strength that can overcome any push from our medical community. We MUST stand up and learn to feel empowered to push back, but do so with professionalism, wisdom and conviction. We hope you will let us nurture that side of you if you need it and engage those around you to do the same. Please be sure to contact us should you have questions about legislation, membership, education and more. Our Executive Assistant, Regina, is always available either by phone, computer and even skype!


FNPN Shining Star

We would like to recognize Jo Ann Fisher for her role as an NP advocate. Mrs. Fisher became a health care provider, with Osler Geriatrics, in Melbourne, Florida, on January 3, 2000. Prior to becoming a nurse practitioner, she was employed for 18 years as a staff nurse, department educator and finally supervisor in the Emergency Department at Holmes Regional Medical Center, Melbourne, Florida. She currently provides care for long term care residents in Assisted Living Facilities and became the clinical coordinator for the practice in August, 2005. Jo Ann was selected to participate in the American Medical Directors Association’s Clinical Practice Guideline (CPG) committee for Transitions in Care, in September 2008. In 2009 Jo Ann organized a Task Force Meeting in Brevard County, which included over 100 attendees from across the long term care continuum and continues to try to improve transitions of care in Brevard County. Most recently, JoAnn has been an incredible advocate of our advanced practice goals to maximize our ability to practice at the education and preparation provided in our degrees.

Mrs. Fisher received her bachelor’s of science degree from the University of Central Florida, and her master’s in nursing from the University of Florida. She is ANCC board certified as a Family Nurse Practitioner.

Jo Ann is a member of GAPNA and President FL-GAPNA, a member of Florida Nurse Practitioner Network and Space Coast Clinicians. She is a member of the Florida Medical Directors Association (FMDA) and serves on the board as a liason for FL-GAPNA. Jo Ann is also a member of AMDA. Jo Ann is a member of the Partners in Quality and Ethics committees for Holmes Regional Medical Center, Melbourne, Florida. Recently, as a result of her commitment, JoAnn was instrumental in enlisting support from the Florida Medical Directors Association in offering a letter of support to the advanced practice goals! Congratulations JoAnn!

Mrs. Fisher is on the speaker bureaus for Forest Pharmaceuticals, Eisai Inc., Novartis Pharmaceuticals and GSK.

**Do you know a shining star? If so, please submit their name, description of the excellent advocacy they demonstrate as an Advanced Practice Nurse along with a photo to today!


Message from the FNPN Board of Directors

To date, the Coalition has raised more than $30,000 of our $100,000 goal! FNPN in collaboration with coalition for advance practice nursing has had a great start to the campaign. It is critical for us to continue to raise more than $100,000 though the coalition efforts. This successful campaign will ensure an effective public relations effort in moving Advance Practice Nursing to the next level. The need to raise public awareness and stimulate effective access to healthcare can be achieved though this unity. Please read on as the campaign continues.

Please take a moment today to pledge your commitment of being an active supporter of this campaign and start nurturing those around you to help carry us to victory!! Your donation can make that happen! If every one of the more than 14,000 Advanced Practice Nurses were to donate at least $10 (or more), we would quickly surpass our goal. The campaign will not limit supporters from donating more than $10. In addition, supporters can encourage their colleague, friends and family to donate as well. Imagine the possibilities! Please visit our website today at and make that pledge today!


FNPN Annual Elections

It is time once again to cast your vote in the election process for the Florida Nurse Practitioner Network. This year, the positions of President, Vice President for Education and Treasurer are ready to be voted on. Voting is restricted to one vote per member. Members must be current in their 2010 membership dues which will be reviewed by the election committee to ensure validity of all votes received.

Our current election committee, chaired by Gail Fox from West Palm Beach is currently available to answer any questions about the candidates nominated this year. Despite our current nominees being uncontested, write in candidates are always welcome. Please visit the following link to cast your vote ( . We hope you will take a moment to cast your vote in the 2011 cycle. Elections will commence beginning December 7, 2010 and run through midnight January 7th, 2011. Legislative Updates:


Home Health Action Alert

Action Alert! Now is the time for you to encourage your Senators and Representatives in Congress to seek passage of SB 2814 and HR 4993 The Home Health Care Planning Improvement Acts of 2009 and 2010. Please call or email your Senators and Representative in Congress to ask them to encourage passage of these bills. We were successful in reaching our goal for obtaining cosponsors to these bills last summer, and now we need to push for passage of this legislation.

The bills introduced by Senator Collins in the Senate and Representative Schwartz in the House authorize nurse practitioners to order home health services for Medicare patients ensuring that appropriate home health care services are provided without unnecessary delays and additional costs for care. Currently nurse practitioners are not able to order home health care services despite the fact that that they are eligible Medicare providers.

Let your legislators know that nurse practitioners have a long history of providing high quality, cost effective care to patients of all ages. We are particularly prepared to manage the problems of patients with chronic diseases and the elderly and should be able to certify Medicare patients for home care services. Thank them for their assistance in passage of this legislation.

The easiest and most effective ways to reach your member of Congress are to call his/her Washington DC office, or send an email through the AANP Advocacy Center on the AANP by clicking on the Ordering Home Health bar and following the instructions for sending the attached letter on the screen. You may also send or adapt the letter below to your Senators and Representative.

If you have questions, contact our Office of Health Policy at 202-966-6414. Thanks for getting involved.


Job Announcements!

There have been many new job postings around the state on our web site at for those of you that may have an interest. On our new website, the most recent postings are on the front page. A new feature will allow postings to be visible for 90 days. Please feel free to pass this along to your colleagues who may be interested in it as well, or who may have an interest in finding out more about our network. For those of you that have found jobs on our website, please be sure to let us know!

Do you know an employer who might find the FNPN Job posting a worthwhile site? If so, please be sure to tell them about the website and the fact that on average 20 or more jobs are posted each month. The traffic to our website is incredible and we have more and more folks seeking employment through this site than ever before. Let them know you saw it on the FNPN Website!


Membership Update

Armando Riera-Membership Chair

Renewal Reminder

Membership in FNPN runs on an annual basis Jan-Dec.

Please renew your membership today.

Membership in FNPN can be as a group or individual member.

Individual members belong and receive many benefits as part of their membership-frequent communication during the legislative session (or special sessions), a paid lobbyist based in Tallahassee, access to posted job opportunities, access to posted upcoming conferences and many more benefits. If you belong to your local NP group you are not an FNPN member until you join FNPN individually, group and individual membership are two separate levels of membership. I encourage you to visit our newly redesigned web page today and while you're there you can renew online.

Group Presidents please renew today and continue to be an integral part of our growing organization. We value our group members as this creates a vital network of NP groups throughout the state. These groups help disseminate information about trends, issues and changes impacting NP's at the state and national level. As a group member we will also assist with conference planning and obtaining approval for CEU's if offered. We will also assist with promoting your conferences and activities and can provide assistance or link you with support in web design.

Just a reminder, students and retired ARNPs have special rate dues, and we encourage you and your peers to join!


From your AANP Representative

Doreen Cassarino MSN, ARNP, FNP-BC, BC-ADM

AANP President featured on Modern Healthcare Webcast

A Webcast titled "New Rounds for Nurses?" featuring AANP President Penny Kaye Jensen and AAFP President Roland Goertz aired on Wednesday. The Webcast looked at the practical implications of expanded roles and responsibilities proposed for advanced practice nurses and reviewed recommendations from the Institute of Medicine and the Robert Wood Johnson Foundation. Click on the following to view the archived webcast as well as the power point presentation Click Here



Marifrances Gullo - PAC Chair

The purpose of the FNPN~PAC is to promote the ARNP profession through advancing the outcome of political issues or legislation. This is accomplished by contributing to the support of worthy candidates for State or Local offices who we believe have demonstrated their support of the principles to which this professional organization is dedicated. To further their purpose the PAC is empowered to solicit and accept these voluntary personal contributions (up to $500 per year per person). These contributions are used to attempt to influence the selection, nomination, or election of any individual to any State or Local office. Your decision to make a PAC contribution will help to continue our efforts wherever possible. Contributions can be made @ via Pay Pal…or your check payable to FNPN-PAC sent to 4637 Golden Apples Tr. Port Orange, FL 32129. Let’s make things happen together! Thank you for your support!!


Around the State and Around the Nation

CONGRATULATIONS to Cathy Giessel - new Alaska State Senator!!!

Cathy Giessel, former AANP state rep for Alaska and Fellow of AANP won a hard fought campaign for the Alaska State Senate. She won a 3 way primary with nearly 50% of the vote against two well funded opponents. She then won a 3 way general by nearly 10%-again, against two very well funded opponents. She had a grass roots campaign- and worked for a year- visiting over 8,000 homes in a very large district that is rural and urban. Thank you to all who supported Cathy in this very challenging endeavor. Congratulations to an NP who has demonstrated how we can participate- and win- in the political arena.

December MQA - Click Here


News You Can Use

The Florida NP Network has taken the next step to keep our members informed. Keep abreast of changes in your practice around the state and around the nation. You can join us today on Facebook under Florida Nurse Practitioner and Twitter under FloridaNP. We hope to hear from you.

Click below to listen to a NPR talk show about the role of Advanced Practice Nurses on "Talk of the Nation."

The show aired Tuesday.

The RWJF Initiative on the Future of Nursing Launches New Website to Help Advance the Recommendations in IOM Report

Website will feature ways to get involved, educational resources, research and data.

As part of the Initiative on the Future of Nursing, the Robert Wood Johnson Foundation has launched a new website to include:

  • details on the Institute of Medicine recommendations from the Future of Nursing report and the research and data behind them

  • ideas, action steps and resources for how organizations can become involved

  • toolkits and template materials for those working on the ground to advance the recommendations in their communities.

We would like to invite you to join us in working to fulfill the promise of nursing. Please share this message with a friend or colleague so she or he can sign up to get involved or stay connected with the implementation of the recommendations as we move toward improving the health and health care of all Americans.

Additionally, on November 30, RWJF will feature a live webcast of the National Summit on Advancing Health through Nursing in Washington, D.C. The webcast will feature presentations by Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of RWJF; Donna Shalala, Ph.D., and Linda Burnes Bolton, Dr.P.H., R.N., FAAN, chair and vice chair of the Committee on the RWJF Initiative on the Future of Nursing, at the IOM; and a keynote presentation by Donald Berwick MD, MPP, FRCP, administrator for the Centers for Medicare and Medicaid Services. The Summit panels and presentations will highlight the recommendations from The Future of Nursing: Leading Change, Advancing Health report and steps to help foster implementation.

The webcast will broadcast live via a link on RWJF Initiative on the Future of Nursing website dedicated to implementing the recommendations. You can register for the webcast in advance at


It’s time to collaborate—not compete—with NPs

Jeff Susman, MD


It is time—time to abandon our damagingly divisive, politically Pyrrhic, and ultimately unsustainable struggle with advanced practice nurses (APNs). I urge my fellow family physicians to accept—actually, to embrace—a full partnership with APNs.

Why do I call for such a fundamental change in policy? First, because it’s the reality.

In 16 states, nurse practitioners already practice independently. And in many more states, there is a clear indication that both the public and politicians favor further erosion of barriers to independent nursing practice. Indeed, such independence is outlined in “The Future of Nursing: Leading Change, Advancing Health,” published by the Institute of Medicine (IOM) in October 2010. Among the IOM’s conclusions:

  • Nurses should practice to the full extent of their education and training.

  • Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.

  • Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States.

Second, I believe our arguments against such a shift in policy don’t hold up. Despite the endless arguments about outcomes, training, and patient preferences, I honestly believe that most nursing professionals—just like most physicians—practice within the bounds of their experience and training.

Indeed, the arguments family physicians make against APNs sound suspiciously like specialists’ arguments against us. (Surely, the gastroenterologists assert, their greater experience and expertise should favor colonoscopy privileges only for physicians within their specialty, not for lowly primary care practitioners.) Rather than repeating the cycle of oppression that we in family medicine battle as the oppressed, let’s celebrate differences in practice, explore opportunities for collaboration, and develop diverse models of care. Third, I call for a fundamental shift in policy because I fear that, from a political perspective, we have much to lose by continuing to do battle on this front. Fighting fractures our support and reduces our effectiveness with our legislative, business, and consumer advocates.

Finally, I’m convinced that joining forces with APNs to develop innovative models of team care will lead to the best health outcomes. In a world of accountable health care organizations, health innovation zones, and medical “neighborhoods,” we gain far more from collaboration than from competition.

As we ring in the new year, let’s stop clinging to the past—and redirect our energies toward envisioning the future of health care.

THE JOURNAL OF FAMILY PRACTICE ©2010 Quadrant HealthCom Inc.


Enroll Today: NCQA’s Recognition Programs for NPs
  • Who? Did you know that nurse practitioners are eligible for NCQA’s recognition programs?

  • What? The National Committee for Quality Assurance is a private, 501(c)(3) not-for-profit organization dedicated to improving health care quality. Since its founding in 1990, NCQA has been a central figure in driving improvement throughout the health care system, helping to elevate the issue of health care quality to the top of the national agenda. The NCQA seal is a widely recognized symbol of quality.

  • When? NCQA's is now inviting NPs to their voluntary Recognition Programs to recognize high-performing clinicians & practices in key areas of clinical quality & care coordination. Consider this for your practice.

  • Why? Be recognized for your expertise! NPs are now eligible for Diabetes Recognition (DRP), Heart/Stroke Recognition (HSRP), Physician Practice Connections® Recognition (PPC), and Physician Practice Connections® - Patient Centered Medical Home™ Recognition (PPC-PCMH) programs. A practice that receives NCQA Recognition may list its NPs and PAs who meet individual standards in the NCQA Recognition Directory.


Mandatory Cognitive Assessments Set to Become Part of Annual Wellness Visits

Deborah Brauser

December 7, 2010 — The Alzheimer's Association is establishing a new workgroup of field experts to provide primary care physicians with guidance on cognitive assessments, which are due to become a mandatory part of annual wellness visits by Medicare patients starting January 2011.

Part of the Patient Protection and Affordable Care Act, these assessments are part of final regulations for implementing the new wellness visits, which were announced November 3 by the Centers for Medicare and Medicaid Services (CMS).

"We have maintained for quite some time that the key to early diagnosis for Alzheimer's disease is cognitive surveillance in a medical care system that has the capacity to move people into a more intensive evaluation of their cognitive problems as they begin to show difficulties with simple tasks," William H. Thies, PhD, chief medical and scientific officer for the national office of the Alzheimer's Association in Chicago, Illinois, told Medscape Medical News.

Dr. William H. Thies

"We look at the Medicare action really as confirmation that we're on the right track and that they saw the wisdom of our advice," added Dr. Thies. He noted that "this is an area that is often given short attention" in the absence of both adequate reimbursement and definitive medications that will stop the progression of Alzheimer's disease.

"Previous research has shown that you don't need either of those things to get benefit for the patient. And we think the new rules from Medicare will encourage people to look at how they're going to go about fulfilling this cognitive surveillance request."

Building Consensus

According to the Alzheimer's Association, the purpose of the workgroup is to build consensus around appropriate methods and processes that can be used in the primary care setting to detect possible cognitive impairment during the wellness visits.

If further assessment of cognition is indicated during the visit, the workgroup will also provide guidance for practitioners as to the follow-up process to determine a definitive diagnosis.

The group will also help determine approaches and conversation starters with patients about possible concerns or how to address patients who do not follow up. "By convening stakeholders, thought leaders, and experts in the Alzheimer's arena to collaborate on cross-cutting solutions, the Association believes the valuable insights these leading experts will provide will help reduce undiagnosed cognitive impairment," they write.

Simple Process Needed

Dr. Thies said that he predicts that the group, which will begin meeting in January, will immediately start on developing a "very simple, fairly wide-open" cognitive surveillance process.

"It may be something as simple as a 2- or 3-word recall, where you give a patient 3 words to remember at the start of their visit and then at the end you ask them to tell what those words are," he said.

"Obviously you can't do a cognitive diagnosis with that. But if you see people over a period of years and they do really well on that test and then all of a sudden they're not, then that's the signal to move to a more intense evaluation."

He noted that he thinks the new assessment system will be either a series of tests or some sort of criteria for tests that the clinician can select, plus suggestions for a follow-up system to put into place.

"Identifying that someone is beginning to have cognitive difficulties will be just the beginning. Ideally they would then go on to further evaluation that would either confirm or not confirm the diagnosis of dementia and be as specific as possible for Alzheimer's or not Alzheimer's. And then that diagnosis would be taken into consideration as the rest of the care of that patient is considered," said Dr. Thies.

After the workgroup comes to a consensus, Dr. Thies said that the fate of their decisions is open to a number of possibilities. "It could go as far as becoming official rules for CMS, if they so choose, or it may simply become advice for physicians who are trying to implement this type of yearly visit and the cognitive evaluation that’s part of it." Trying to build these kinds of systems as efficiently as we can and as early as we can is going to be really important if we're going to have any hope at all of managing this epidemic. It may take some time for the workgroup to reach process recommendations, yet January's mandatory implementation is right around the corner. In the interim, Dr. Thies recommends that for now clinicians can best prepare by doing an overall situation assessment.

Dr. Thies said he hopes the workgroup's recommendations lead to a definitive cognitive surveillance process being put into place for most patients older than 65 years. "Only about half of the 5.3 million Americans that have Alzheimer's today have a diagnosis. So trying to build these kinds of systems as efficiently as we can and as early as we can, is going to be really important if we're going to have any hope at all of managing this epidemic," he said.



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