2011 President’s Report

Introduction

It is a privilege to serve as president of APNA and to present my report which covers the period from October 1, 2010 through September 30, 2011. I am pleased to report that APNA has continued to enjoy positive results in membership growth and retention over the past year. The Secretary’s report provides details on our membership status, which is at an all-time high with more than 7,500 active members. Likewise, our fiscal house is in order and once again our results from operations show a positive bottom line. Our most recent audit is discussed in more detail in the Treasurer’s Report.  Our bottom line from operations at 12-31-10 was plus $223,602. The results for our current year are also expected to produce a positive bottom line.

As we conclude this membership year we are also completing a three-year strategic planning cycle. Between now and February 2012 we will be seeking member input to inform this process.  In this next phase we will continue to strive toward our overall goal of being the “indispensible resource for psychiatric nursing”. We have achieved great progress towards realizing all four strategic goals of the current strategic plan:

  1. APNA will be the indispensible resource for member networking and professional development.
  2. APNA will be financially secure and stable.
  3. APNA will be the leader in creating strategic alliances with key stakeholders.
  4. APNA will be recognized as the expert voice for psychiatric-mental health nursing.

Discussion

In this report I will provide a brief summary of our status with regards to each of the four strategic goals listed above.

APNA will be the indispensible resource for member networking and professional development.

In terms of the first goal, our members’ participation in our networking site Member Bridge has created a nation-wide network that links all of us together in a manner unlike anything we have ever had before. Whether a member is fresh to the discipline or is one who has enjoyed a successful career, the system gives all an equal voice. It is gratifying to see inquiries posted to which other members weigh in and offer perspectives that often lead to continued dialogue.  The conversations regarding staffing offer an example of this valued exchange. These discussions on Member Bridge served as the catalyst to charge the Administrative Council, along with strong input and collaboration from the RN-PMH Council, to draft a position statement on staffing which was adopted by the Board of Directors. The full position paper is expected to appear in JAPNA in early 2012. The position statement can be found on the APNA website at http://www.apna.org/i4a/pages/index.cfm?pageid=4662.

Our member networking and professional development is further enhanced though the APNA councils, task forces and institutes. This activity report provides details on the goals and achievements of these committees but the aspect that is most remarkable is the number of APNA members who are actively engaged in APNA programs and initiatives. More than 1600 members are participating in APNA committees. This is tangible evidence of our single most important asset - our members. Our structure of councils, task forces, institutes and committees is the vehicle which enables APNA to assert that we are not a “professional organization” but an “organization of professionals”.

Education continues to be the central focus for APNA. During the past year APNA delivered 172 hours of educational offerings either in person or online. These activities were attended by 4,627 participants. Our conference in Anaheim will mark our 25th anniversary and will be the largest gathering ever of psychiatric mental health nurses in the US. At the time of this writing, more than 1130 participants have registered. The conference will offer up to 28 contact hours as well as an additional 14 hours available through the certification prep course which will be offered before the pre-conference program. There will be more than 100 presentations from the 300 plus abstracts submitted. This year the 165 posters presented at the meeting will be made available after the conference in an Online Poster Gallery. The number and quality of submissions are rising each year. We are grateful to our Scholarly Review Committee, chaired by Nancy Hanrahan, which does an outstanding job of reviewing the abstracts and selecting which sessions will be presented at the conference. Many of these presentations will be available online in our APNA eLearning Center after the conference. While attendees are able to earn up to 28 contact hours from the more than 70 hours available at the conference, much of the 70 hours will be available online afterwards.

The 9th Annual Clinical Psychopharmacology Institute was well attended and we are grateful to this year’s chair Georgia Stevens. Attendees’ evaluations show that out of the highest possible score of 6 for meeting the course objectives, the CPI program scored 5.6, or 93%. The CPI has become a major part of the APNA overall educational program. The program provided up to 24.25 contact hours and these courses are also all available online.

Earlier this year we introduced the APNA eLearning Center. This new system encompasses a variety of features that provide members with affordable and accessible educational content, some of which is from the Annual Conference and CPI as noted above. The site is located at http://elearning.apna.org/

Our work to bring greater awareness and use of recovery principles is being carried out through our Recovery to Practice efforts which are funded from a subcontract through SAMHSA.  Mary Ann Boyd and Georgia Stevens continue to serve as primary consultants to the project. Since our last meeting, Mary Moller, Jeanne Clement and Kris McLoughlin have co-chaired the project curriculum committee. The curriculum will be pilot tested over the next year. Building on the success of the Recovery to Practice Project, APNA has created a new Recovery Council co-chaired by Mary Jensen and Nancy Dillon.

A cornerstone of our specialty is our scope of practice. “The Scope and Standards of Practice for Psychiatric-Mental Health Nurses” was last published in 2007 APNA has joined with ISPN and ANA to review and update the document. Kris McLoughlin from APNA and Catherine Kane from ISPN are co-chairing this effort that will produce the next edition. The integration of recovery principles, language from the APRN Consensus Model and emerging models of integrated health care will be part of the revision process. Our specialty continues to grow and evolve. The environment in which we practice and function is fluid. It is imperative that our scope and standards of practice be an accurate reflection of our professional accountabilities, responsibilities and functions.

The growth of our specialty depends on many variables, but having a cadre of interested nurses to choose psychiatric nursing as an educational path is a fundamental need. I am pleased that APNA was again successful in its application to Ortho-McNiel Janssen to fund the APNA Janssen Student Scholarship program. Merrie Kaas of Minnesota is the program’s faculty advisor and is actively engaged with our 15 undergraduate and 15 graduate scholars who were chosen by our Awards and Recognition Committee, chaired by Niki Gjere, from more than 200 applicants. 

The APNA website continues to improve each year. Content is updated on an ongoing basis and staff’s work with volunteers from our committees keeps the information fresh. The site undergoes continuous refinements.  Traffic to our site increases each year. During the past membership year we experienced a 24% increase in visits. Please see the full Website Report in Appendix C to get a more extensive appreciation of the activity.

In the same vein, please see Appendix D for the Communications Report. Our communications efforts serve to not only support our networking with each other but also help us extend our reach to other stakeholders to build our image as PMHNs. The combination of our efforts on the web via social media and press releases are enabling us to touch a broader audience. For example, our press release on the APNA Janssen Student Scholarship Program produced over 123,000 online impressions. The more people see the term “psychiatric-mental health nurse” the more people will become aware of our existence.  Acknowledgement starts with awareness.

APNA will be financially secure and stable.

The Treasurer’s Report provides details on our financial performance during the last fiscal year as well as summary of our performance over the past several years. We are grateful to our Treasurer, Rick Pessagno, who along with the full Board of Directors exercises fiduciary oversight of APNA’s assets. The highlight of the report is that our results from operations, that is activity other than investments, produced a positive bottom line of $223,602. That result along with investment gains of $75,216 net APNA a total gain in net assets of $298,818. The APNA balance sheet shows the ratio of current assets to current liabilities as 12.92. This is a measure of solvency and means that APNA has $12.92 for each one dollar that it owes.

APNA will be the leader in creating strategic alliances with key stakeholders.

The number of alliances that APNA maintains has continued to grow. Through our Board, committee structure and staff we are continuing to reach out to other organizations with whom we have common interests to provide our input and perspective on issues of importance. For instance we maintain our Organizational Affiliate Status with the American Nurses Association. One of the important activities that arises from our ANA affiliation is our participation in the AMA RVS Update Committee (RUC). The RVS is the relative value system used by Medicare to set the Medicare reimbursement fee schedule. The codes are updated every five years and this year the RUC is visiting the psychotherapy codes. Sandra Cadena from Florida is the APNA representative and her alternate is Deborah Johnson of North Dakota. It is very important that there be a psychiatric-mental health nurse on the committee and Sandra and Deborah provide that presence.

In addition, as an ANA Organizational Affiliate, APNA has a representative on the ANA Congress on Nursing Practice and Economics (CNPE). Mary Moller is our voice at this table. Her understanding of PMHN coupled with her recently completed tenure on the APNA Board provide her with an excellent fund of knowledge from which to share the perspectives of psychiatric nurses. One of the functions of the CPNE is the approval of nursing specialty scopes and standards of practice.

I was privileged to represent APNA along with fellow Board member, Gail Stern, at the national summit meeting of the National Association of Clinical Nurse Specialists (NACNS). At this meeting we affirmed our support for PMH-CNS and explained the rationale for the future educational platform being PMH-NP across the life span.

As the APRN Consensus Model is adopted by state boards of nursing it is important that we maintain a close working relationship with the National Council of State Boards of Nursing. To maintain continuity in our representation, we have appointed Mary Johnson of Illinois. The NCSBN is located in Chicago, enabling Mary to attend meetings and discuss issues related to PMHN with NCSBN leadership.

Each year the Joint Commission holds a meeting with stakeholders to gain input on its standards. APNA sends a member of the Board to represent our view and provide input from PMHN. This year Gail Stern of Pennsylvania was our representative. Prior to attending the meeting, Gail solicited input from members via Member Bridge.

This year the National Organization of Nurse Practitioner Faculty (NONPF) extended an invitation to APNA to participate in two multispecialty panels. Susie Adams of Tennessee is the APNA representative working to validate the Core Competencies developed by NONPF for all NPs. Mary Weber of Colorado is the APNA representative on the group charged with the development of population based competencies.

APNA continues to participate in the LACE Network of organizations that have an interest in the implementation of the APRN Consensus Model. Patricia Cunningham of Tennessee and Barbara Drew of Ohio monitor the activity and regularly attend the virtual meetings conducted by the LACE Network.

When the American Medical Association was forming a work group to study major depressive disorders, they contacted APNA and wrote: “Given the American Psychiatric Nurses Association's long history of work in depression and other psychiatric disorders, we thought it important that a representative from the APNA be included on the Work Group, if APNA agrees.  In particular, we would welcome someone with expertise in Major Depressive Disorder or other depression spectrum disorders.” APNA was pleased that Roberta Waite of Pennsylvania was able to participate and provide a voice for PMHN in this work group.

We place high value on our excellent working relationship with the International Society of Psychiatric Nurses. The presidents of both organizations talk on a regular basis. To show our support, APNA appointed Beth Phoenix of California to attend and participate in the ISPN Annual Conference.

The Nursing Organization Alliance is comprised of nurse specialty organizations. The meeting provides an opportunity for elected leadership and senior staff to interact and build relationships. Regular attendance at this meeting helps to maintain the relationships we have with virtually every major nursing organization in the country. APNA President-Elect Marlene Nadler-Moodie has been invited to address the participants and discuss the success APNA has enjoyed in membership growth.

APNA was a sponsor of the SAMHSA Voice Awards and Suzane Wilbur of California represented PMHN at the meeting.

With the changes in health care reform, APNA participates in the College of Behavioral Health Leadership. In addition, we maintain our memberships in the Nursing Community and Mental Health Liaison Group. The positions of these organizations are reviewed by the Institute of Mental Health Advocacy that is co-chaired by Christine Tebaldi of Massachusetts and Margaret Halter of Ohio.  The institute provides commentary and recommendations on these positions to the APNA BOD.

APNA participates as a community partner in the outreach efforts of the VA Office of Mental Health Services as it strives to better serve the mental health needs of military veterans and their families. APNA supports these efforts by promoting awareness and access to resources through the APNA website. This year APNA was also invited to participate as a community partner in a meeting with the VA and Defense Centers of Excellence joint efforts to further expand military mental health services in the community. We look forward to continuing our relationship with the VA and to supporting the efforts to improve mental health services for individuals who defend our country. These meetings are attended by APNA member and staff Patricia Black of Virginia.

APNA once again participated in the National Alliance on Mental Illness’s annual conference. Mary Moller of Connecticut conducted an “Ask a Nurse” session to provide attendees with valuable information and to also raise awareness of PMHN. Special thanks to APNA Chicago members, Tony Amberg and Vincent Donlon, who spent many hours at a literature display table helping to make PMHN presence known.

For the first time, APNA was invited to participate in the National Task Force on the Criteria for Evaluation of Nurse Practitioners Programs. The invitation demonstrates that input into this process by psychiatric-mental health nurses is being sought and is valued. This involvement is particularly important as we work together to support a smooth transition into the implementation of PMHN LACE recommendations. We are pleased that Susie Adams of Tennessee is actively participating in this process.

APNA will be recognized as the expert voice for psychiatric-mental health nursing.

Much of the commentary above speaks to the recognition that APNA now enjoys as the expert voice of PMHN. So many activities are applicable to overlapping goals. Certainly our excellent working relationship with the ENA could be listed above but the collaboration in which we are currently involved is not only evidence of a strong alliance, it is a mutual recognition of areas of expertise in the handling of behavioral emergencies in the emergency department setting. APNA and ENA are co-presenting at each other’s conferences. APNA members Marlene Nadler-Moodie and Jolie Gordon-Browar of California are presenting for APNA along with faculty from ENA.  In addition ENA invited APNA to participate in a meeting on the Behavioral Health Assessment Standards in the emergency room. Christine Tebaldi of Massachusetts will provide APNA’s perspective.

Earlier this year the American Psychiatric Association reached out to APNA to review its newly revised “Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging”  The APA wrote, “Your organization is among a small group of reviewers selected by the ECT Task Force to provide expert review of this draft guideline.” We are grateful to Mary Rosedale of New York who lead the effort and produced a set of comments that provided excellent feedback reflecting the depth of understanding of the ECT modality within PMHN.

Efforts to provide an expert voice in PMHN are shown through APNA’s position papers and organizational responses. Last October (during the Annual Conference in Louisville) we released our position statement on Psychiatric Mental Health Advanced Practice Nurses.  Then in January and February of this year APNA made statements on both Electroconvulsive Therapy and LACE Recommendations. Following these efforts was the previously mentioned position statement on staffing, with the full paper being published in JAPNA’s January/February 2012 issue.  Positions such as these are taken with member initiative and input, as with the Organizational Responses we have submitted to CMS and NCQA this year.  Members have had a voice in PMHN directly and through APNA’s responses on the proposed rule on Conditions of Participation in Community Mental Health Centers, as well as the Inpatient Psychiatric Facility Quality reporting measures. 

There is one accomplishment from this past year that is of immense significance. Through the efforts of our Editor-in-Chief, Karen Stein of New York, and the Editorial Board, our journal, JAPNA, was accepted into MEDLINE for indexing. JAPNA is our chief vehicle to disseminate state of the science information on PMHN. Our recognition as an expert voice was limited while the journal was not indexed. This limitation has been lifted and our journal will now be searchable by a much wider audience.  In addition, Karen Stein and the Editorial Board have included an APNA Board of Directors Column in the journal to facilitate the communication of core strategic initiatives undertaken by APNA on behalf of our professional discipline and of our involvement in shaping the future of mental health care.

Summary

As you can see, APNA is an energized and robust organization. At the beginning of the year I felt the task of President would be daunting. My concerns were quickly dispelled. I found myself surrounded by a wonderful Board of Directors who is deeply committed to our profession and to APNA members. I thank each of them and extend my sincerest appreciation for that commitment. I have enjoyed their support throughout the year and I applaud them for all they do.  The chairs of our councils, task forces, institutes and committees are extremely capable, competent and always professional.  It is through their leadership that we are able to achieve our strategic goals.  I am in awe of all of you and offer my thanks for your outstanding contributions.

The part of serving as APNA President that I will always carry with me is the passion and engagement of our members. You willingly volunteer your time and expertise in order to position Psychiatric Mental Health Nurses to be present, connected and engaged with each other and with the population we strive to expertly serve.  A thank you is in order but it is not a sufficient expression of the deep gratitude and respect that I hold for all that you do. You are APNA!!!