NYS Nurse Practitioner Association Presents 2019 Awards

NYS Nurse Practitioner Association Presents 2019 Awards

The Nurse Practitioner Association New York State (NPA), the only statewide professional association of nurse practitioners, has named Janice Ceccucci, DNP, FNP-BC, Nurse Practitioner of the Year, and Daniel Babcock, MS, FNP-C, NP Student of the Year. The awards were presented at The NPA 35th Annual Conference, held in Verona, NY, and were attended by nearly 500 NPs and NP students from across the state. 

Stephen Ferrara, DNP, FNP, FAANP, Associate Dean of Clinical Affairs at Columbia University School of Nursing and Executive Director of the Nurse Practitioner Association New York State, said, “As health care professionals committed to excellence in patient care, nurse practitioners are redefining their role. We’re extremely pleased to recognize Janice Ceccucci and Dan Babcock for their dedication and service.”

Forensic NP and Professor at SUNY Polytechnic Institute Is NP of the Year

Janice Cerrucci, DNP, FNP-BC

Janice Ceccucci is an outstanding Nurse Practitioner and SANE (Sexual Assault Nurse Examiner). Ceccucci began her career working with sexual assault victims in the Emergency Department. Recognizing that there were gaps in services, particularly for child sex abuse victims, she decided to pursue forensic nursing. She is committed to ensuring services for child sex abuse and physical abuse patients are widely available.  

“Janice takes nursing to the next level,” says colleague (and nominator) Elizabeth Spooner Dunn. “Her passion for the profession, dedication to her patients and commitment to excellence make her not just a trusted colleague but an example and mentor to all.”

Ceccucci has also received the Joan Unger Memorial Award given by the New York State Coalition Against Sexual Assault for demonstrating excellence and innovation in services offered to the community in sexual assault. She has also been published by the Journal of Forensic Nursing and is co-founder of Forensic Nurse Practitioners of Schenectady.

On Call, Inside and Out of the Hospital

Outside the confines of Saratoga Hospital, Ceccucci is on call at home 36 hours a month to provide teleconsulting services to hospitals in remote areas that lack access to sexual assault nurse examiners (SANEs). In addition, she conducts sexual assault exams for pediatric patients at child advocacy centers—a service that Ceccucci and a colleague introduced in 2011 to better serve sexually abused children.

A leader in promoting the profession to the next generation, Ceccucci is an assistant professor at SUNY Polytechnic Institute. She is also the co-director and developer of Saratoga Hospital’s Advanced Practice Provider Fellowship Program, which mentors new nurse practitioners and physician assistants, also known as advanced practice providers. And, in case that was not enough to take on, Ceccucci is an assistant professor of nursing for SUNY Polytechnic in Utica and helped pilot a hybrid program that delivers live streaming and on-campus classes.

“I wouldn’t want to do anything else.”

Ceccucci received her master’s degree as a Family Nurse Practitioner from SUNY Poly in 2009, and was awarded her doctorate in Nursing Practice from State University of New York Upstate Medical University in Syracuse in 2016.   

“I’m proud to be the recipient of the NP of the Year. There are so many wonderful opportunities in nursing. For newer NPs, I would advise they take advantage of every opportunity that presents itself. I love being an NP. I wouldn’t want to do anything else,” Ceccucci said.

For further information on Janice Ceccucci, visit here.

NP Student of the Year Dan Babcock

Dan Babcock, Nurse Practitioner 2019 Student of the Year
Dan Babcock, MS, FNPC

Dan Babcock is an Air Force veteran and a former professional fire officer and paramedic who is currently a full-time Graduate Family Nurse Practitioner Student in the Decker School of Nursing at Binghamton University. He holds a BS in Nursing from Empire State College and as a Registered Nurse has worked in the emergency department and diagnostic imaging. After retiring as a lieutenant from the City of Binghamton’s Fire Department with 20 years of service, he decided to become a nurse practitioner. As Babcock grew up in rural Delaware County, New York, he has a particular interest in improving the health of the poor, rural and vulnerable populations that influenced his early life. 

“It’s an honor to be awarded NP Student of the Year. I chose to become a nurse practitioner because I love being challenged and love the relationships I form with my patients. Aside from the need for primary care providers, I chose family practice to give me a solid foundation for medical mission work. My wife and I do mission work in Guatemala several times a year, and I would like to do medical missions as a nurse practitioner,” Babcock said.

Nurse Practitioner Association New York State

Nurse Practitioners (NPs) are registered nurses who have completed advanced education, at a Master‘s or Doctorate level, plus additional clinical preparation. These professionals are authorized to independently diagnose illness and physical conditions, perform therapeutic and corrective measures, order tests, prescribe medications, devices and immunizing agents, and refer patients to other health care providers.

The Nurse Practitioner Association New York State (The NPA), the only statewide professional association of nurse practitioners, promotes high standards of healthcare delivery through the empowerment of nurse practitioners and the profession throughout New York State. For more information, visit: www.TheNPA.org.

From Forensics to Advocacy: What it’s Like to be a SANE (Sexual Assault Nurse Examiner)

From Forensics to Advocacy: What it’s Like to be a SANE (Sexual Assault Nurse Examiner)

When people experience sexual assault, they may sustain more than just physical injuries; trauma also affects short- and long-term mental health. The medical treatment needed may require a provider to examine parts of the body that were recently violated, which can cause more distress. When reporting an assault, survivors often lack the information they need about how to proceed.

Sexual assault nurse examiners (SANEs) are trained to help survivors across this spectrum of patient care. From providing evidence-based treatment to performing assessments to collect forensic evidence that can be used in a criminal trial, these nurses play a critical role in supporting survivors at the beginning of their recovery process.

What Is the Role of a Sexual Assault Nurse Examiner?

When a sexual assault survivor comes to a SANE-certified hospital or community health center, a sexual assault nurse examiner is the first point of care, according to Kim Day, forensic nursing director for the International Association of Forensic Nurses (IAFN). SANEs ask the patient if they would like a forensic exam, which can be completed even if the patient decides to not report their assault to law enforcement.

“Just going through the process with someone and providing holistic patient-centered care for that patient during a traumatic time in their life can really impact the way they leave the hospital,” Day said.

Forensic exams are meant to document trauma from the assault and collect evidence that could be used in a criminal trial. This includes taking a medical history; documenting scratches, bruises, abrasions, and other injuries on a body map diagram; taking photos of injuries; collecting DNA swabs to be processed; and observing the patient’s behavior. In cases where toxicology information is relevant, SANEs will also perform those tests on a patient.

In addition to performing a forensic exam, the main duty of a SANE is to provide holistic nursing care for the patient. Survivors of assault may need access to testing for pregnancy, as well as prophylactic antibiotics to prevent the contraction of diseases. Depending on the patient’s needs, SANEs also provide referrals to see other specialists, such as a licensed professional counselor, who can help them in their recovery process.

The SANE in Court: It’s Not Like “Law and Order”

Beyond working in the clinical setting, SANEs are qualified to testify in court if a patient’s case goes to trial. The specialized training SANEs receive prepares them to effectively answer questions regarding evidence discovered during a forensic exam. However, while SANEs can play a critical role in the trial process, the legal aspect of the job is not the main focus, Day said.

“If the nurse goes into this work thinking that they’re going to get the bad guy and put him behind bars, they will fail at this… because that is not what we do,” she said. “The work we do is nursing. We take care of the patients.”

This is a key factor to consider when choosing to become a SANE. Nearly 80 percent of sexual assaults are not reported to law enforcement, according to a Justice Department analysis of violent crime in 2016 (PDF, 669 KB). While performing a forensic exam and being prepared to provide evidence in court is a requirement of the job, the emotional and medical needs of a patient come first.

SANEs are trained to work within a multidisciplinary team, also known as a Sexual Assault Response Team (SART), which includes survivor advocates, members of law enforcement, and mental health providers. Together, these professionals coordinate the response to survivors of sexual assault.

What Is a Sexual Assault Response Team?

SANEs and other trained health care providers: When an individual decides they would like to have a sexual assault forensic exam (SAFE), health care providers like Nurse Practitioners (NPs) or SANEs address the initial physical and psychological needs the patient might have as a result of their assault.

Survivor advocates: Individuals who need access to information and emotional support can work with an advocate to navigate their path to recovery. A survivor may reach out to an advocate via a crisis center, or one may be brought in to support someone who has decided to seek treatment at a hospital or report their assault to the police.

Law enforcement: In cases where an individual decides to report their assault, police officers and detectives are responsible for taking statements, coordinating with the hospital to receive the results of the forensic exam, and investigating the alleged assault.

Prosecutors: In cases where the survivor has chosen to report their assault and enough evidence is present, prosecutors are tasked with making the decision on whether to bring the case to court.

Therapists and counselors: In the aftermath of an assault, whether a case goes to trial or not, survivors need additional support to continue their recovery process. Mental health professionals trained in working with sexual assault survivors may provide care at any step in the recovery process, from coping with the immediate aftermath of an attack to navigating long-lasting trauma.

Why Is Access to SANE Care Important?

According to the Centers For Disease Control and Prevention (CDC), one in three women and one in four men have experienced sexual violence involving physical contact during their lifetimes. The effects of experiencing an assault can be both physical and psychological, necessitating specialized care that embodies the concept of cura personalis, or care for the entire person. This holistic attention to the entire individual is the expertise of clinicians like nurses.

SANE education programs are designed to train nurses to address survivors’ specific needs. After completion of this training, SANEs become uniquely qualified to treat this vulnerable patient group. This means that they can provide trauma-informed care to minimize the harm of invasive exams that may trigger a patient. In doing so, they can also equip their patients with forensic evidence that can be used if they decide to report their assault.

Not all hospitals have SANE programs. IAFN’s database of registered SANE programs   indicates that there are currently 962 in the United States. As a result, patients are sometimes required to travel long distances to access SANE care, according to a 2016 report on the availability of forensic examiners (PDF, 191 KB).   This means that the facilities with SANE expertise must be ready to do what they can to help every patient who walks in the door.

Trauma-Informed Care and Practicing Consent

One of the key challenges of completing a sexual assault forensic exam (SAFE) is examining a patient’s physical injuries without retraumatizing them. To help survivors feel comfortable, SANEs ask for consent during each step of the way while providing information on why they are doing each test.

“Consent is not just a piece of paper with a signature on it,” Day said. “It’s a process throughout the exam.”

In practice, the process of asking for consent may resemble the following:

  1. The SANE will inform the patient what body part they will examine and ask permission to do so.
    “I’m going to examine your neck now to see if there are any injuries. Do I have your permission to do so?”
  2. If the patient grants this permission and the SANE notices something that may require a sample collection, the nurse will again ask for permission to collect a specimen and explain why collecting that evidence is appropriate.
    “I notice a scratch that wasn’t mentioned when I documented your health history. There may be DNA or other materials near this wound, so I would like to swab it. Is that OK with you?”

In any instance where the patient does not want a test performed, the SANE is directed to honor the patient’s request. This integration of consent throughout the exam is meant to give the patient a sense of control, a feeling that may have been lost during their assault.

What Are the Requirements to Become a SANE?

Because SANEs work with a patient population that requires specialized care, nurses are required to meet certain expectations in order to take on this role. While some nurses go through training at the local level or through smaller programs, IAFN offers the most recognized certification for SANEs. Nurses can become certified as a SANE-A to care for adults and adolescents or a SANE-P to work in pediatrics. Some nurses elect to pursue both certifications so they can provide care to patients across all age groups.

Steps to SANE Certification
  • Education: To become a certified SANE, a nurse must have the minimum of a registered nursing (RN) license.
  • Experience: Prior to starting the certification process, a nurse must have at least two years of clinical experience working as an RN or at a higher level, such as an NP.
  • Training: As part of the certification process, nurses are expected to complete 300 hours of SANE clinical skills training.
  • Testing: The final requirement to become a certified SANE is to pass a certification examination. IAFN holds exams two times a year.

Information for Further Reading

Citation for this content: [email protected], the online MSN program from the School of Nursing & Health Studies

Palliative Care Nursing: Inner Strength and Moral Distress

Palliative Care Nursing: Inner Strength and Moral Distress

Alexander Wolf, author of the study Palliative Care and Moral Distress.
Alexander Wolf, DNP, RN, APRN, author of Palliative Care and Moral Distress, a study of moral distress among critical care nurses.

Palliative care nursing mainly revolves around enhancing the quality of life of seriously ill patients and their families during life-sustaining treatment and at the end of life. Whether or not they have been trained in palliative care, critical care nurses frequently have patients who are in need of such care. How prepared do they feel?

Or, what happens when critical care nurses encounter a lack of palliative care for their patients, or find themselves in circumstances that run counter to their precepts of care-taking? Alexander Wolf, DNP, RN, APRN has published a paper on nursing, palliative care, and the impact of “moral distress” on critical care nurses. DailyNurse conducted an interview with Dr. Wolf to discuss his paper and its findings.

DailyNurse: What are some examples of palliative care nursing practices a critical care nurse might perform?

Alexander Wolf: Critical care nurses are regularly tasked with assessing and managing the distressing physical, psychological, and spiritual symptoms of critical illness.  Those of us who are palliative care specialists can benefit from critical care nurses’ insight into patient/family dynamics, psychosocial situation, and cultural background. 

In addition, these nurses frequently have a difficult job of bearing witness to suffering, providing a therapeutic presence in difficult circumstances, and employing two-way communication skills to help determine the treatment goals of the patient and family.  These nurses must also be adept in ethical and legal aspects of care, for instance. They also need to be able to help interpret patients’ advance directives and to advocate for the wishes that patients have outlined, when appropriate. 

Critical care nurses are also instrumental in providing expert, compassionate end-of-life care in the intensive care unit, which may involve the careful withdrawal of life-sustaining treatments such as dialysis and mechanical ventilation.  This often requires thoughtful preparation and culturally sensitive communication with patients and family members, and skilled symptom management throughout the dying process.

DN: What is the phenomenon of “moral distress” that affects many palliative care providers?

AW: Nurses and other providers frequently report episodes of moral distress, in which an individual identifies the morally correct action to take, but feels unable to take it due to some type of constraint.  Helplessness or frustration are just a few of the many emotions that an individual might feel as a result — others might include outrage or guilt, among others. 

“Critical care nurses tend to experience frequent and intense moral distress in situations pertaining to the end of life, such as providing treatment perceived as inappropriate or futile, prolongation of life or death and lying to or withholding information from patients or family members.”

Alexander Wolf, Palliative Care and Moral Distress, Critical Care Nurse, Vol. 39.5, October 2019

Previous studies have also indicated that these feelings don’t seem to entirely go away either.  “Moral residue” often remains, and repeated episodes of moral distress often remind an individual of the previous episodes, causing their distress to intensify.  As a result, an individual may try to protect themselves by avoiding or withdrawing emotionally from ethically challenging situations, or by quitting their job. 

DN: Is palliative care training appropriate only for certain providers?

AW: Palliative care has evolved so much in recent years — it is no longer solely a subspecialty — now it is an important skill set for all healthcare providers, including nurses and physicians.

In addition, there is a continued shortage of specialists relative to the number of patients with palliative care needs. This really underscores the importance of nurses and other healthcare providers to be proficient to provide basic palliative care.  In 2014, the National Academies of Medicine recommended taking measures to improve the palliative care knowledge base of all clinicians. 

Numerous medical professional societies recommend timely access to palliative care, including for patients in the intensive care unit, but the lack of provider training remains a significant barrier.  Our study indicates that many critical care nurses have not had much palliative care education, so we still have to work hard to better prepare nurses to meet patients’ care needs.

DN: Ideally, what changes would you like to see result from your study?

AW: There are many changes we would love to see, but here are a select few.

Bedside nurses — particularly those who have had palliative care education — need to be empowered as leaders for integrating palliative care in their practice environment. They would be in an ideal position to educate their peers and interprofessional team members.  We need to better recognize nursing excellence.  Physician and nurse leaders need to collaborate to ensure that bedside nurses have a voice when they feel their patients’ needs are not being met.

The critical care nurses in our study seemed to highly value palliative care, but few felt highly competent, and even fewer reported having any recent education in palliative care.  Many nursing programs have done a great job in recent years to include palliative care in school curricula and in student clinical experiences, but it cannot just be “squeezed in”.  There is clearly still a lot we need to do to integrate palliative care as a key competency area for nurses across specialties, particularly in critical care.

“Nearly half of respondents [in this study] rated themselves as not competent or somewhat competent in knowledge of advance directives, living wills, and do-not-resuscitate order policies. Previous studies have illuminated knowledge gaps among acute and critical care nurses in this domain…. Given the legal and ethical implications, this knowledge gap should be a key focus of palliative care education initiatives…”

Wolf, Palliative Care and Moral Distress, Critical Care Nurse, Vol. 39.5, October 2019

Additionally, the nurses in our study placed a high value on interprofessional collaboration.  In continuing education for nurses it would be wise to be inclusive of other healthcare professionals. This could help foster increased recognition of patients’ palliative care needs by all team members.

For more information on Critical Care Nurse and the AACN, visit http://ccn.aacnjournals.org/.

Thanks are extended to Alexander Wolf, DNP, RN, APRN, Nurse Practitioner, Palliative Care, at TriHealth

Working as a Nurse Psychotherapist

Working as a Nurse Psychotherapist

Pursuing jobs in the field of psychotherapy isn’t just for doctors; nurses can do it too. Benjamin Evans, DD, DNP, RN, APN, past president of the New Jersey State Nurses Association, has his own practice as a nurse psychotherapist in addition to consulting. He made the change in the 1980’s after he had completed his nurse practitioner training. Based on his work with people living with chronic and catastrophic illnesses, he decided to earn a master’s degree in counseling because it would be a good fit.

Evans talked with us about what a nurse psychotherapist does and what nurses who are thinking of entering this area of the field should keep in mind.

What exactly does a nurse psychotherapist do?

A nurse psychotherapist does the same work as any other educated psychotherapist — using psychological and counseling methods to assist in behavior and mental health changes. Usually the state board of nursing incorporates some form of health counseling within the definition of nursing practice. Psychotherapy can be done with individuals, families, and groups.

What should nurses keep in mind if they are thinking of becoming a nurse psychotherapist?

Nurses need to understand their reasons for wanting to become psychotherapists. Psychotherapy is not about “fixing” others who have similar issues to the therapist.

It is not solely health counseling for issues like nutrition, stress, or weight control.  It is not nurse coaching. Psychotherapy is undergirded with theoretical frameworks that are used by the psychotherapist to help in the change.

Nurses who wish to become psychotherapists will be integrating nursing theories with theoretical frameworks from psychology, psychiatry, social work, and other disciplines.

Psychotherapy education is usually done at the graduate level. For this reason, the nurse wishing to do psychotherapy needs to determine if she or he will pursue psychotherapy education through a graduate nursing program like a psychiatric mental health nurse practitioner/clinical nurse specialist role or through another discipline like psychology, educational counseling, or social work.

What kind of certification or other education would they need?

Certification can be obtained by credentialing organizations like the American Nurses Credentialing Center or through various certifying bodies outside of nursing. Some types of psychotherapy have non-degree supplemental experiential training and then “certify” the practitioner in a particular modality — for example, training in cognitive behavioral therapy.

What else should they do?

A nurse wishing to become a psychotherapist should meet with and shadow a nurse psychotherapist to really learn all that the specialty initials. She or he should become familiar with modalities of psychotherapy and vet programs for training. 

What are the greatest challenges to being a nurse psychotherapist?

Challenges include training (time and cost), building a practice, obtaining referrals, and ongoing maintenance of competency. 

Additionally, reimbursement issues play into the challenges of practice as many insurers do not cover nurses for psychotherapy.

What are the greatest rewards?

There are many rewards to being a nurse psychotherapist, including watching as behavior changes and mental health improvements are accomplished by the patients. 

Is there anything else important for our nurse readers to know?

The practice of psychotherapy as a nurse is quite rewarding. The nurse who chooses to go into psychotherapy practice must want to help others to make behavioral or mental health changes. The nurse must have clear boundaries — being able to be empathic and not take on the issues of the client. Nurse psychotherapists must be mindful of self-care and to develop a sound network for referrals when the issues presented are outside of the psychotherapist’s area of expertise.

Children’s Hospital Colorado’s Neonatal Nurse Practitioner Fellowship Program Receives ANCC Accreditation

Children’s Hospital Colorado’s Neonatal Nurse Practitioner Fellowship Program Receives ANCC Accreditation

Children’s Hospital Colorado recently received Accreditation with Distinction from the American Nurses Credentialing Center (ANCC) for its Neonatal Nurse Practitioner (NNP) Fellowship Program, becoming the first ANCC Accredited NNP program in the country.

The ANCC Practice Transition Accreditation program is dedicated to validating hospital residency and fellowship programs that help transition registered nurses (RNs) and advanced practice registered nurses (APRNs) into new practice settings that meet rigorous, evidence-based standards for quality and excellence. APRNs in the NNP Fellowship program at Children’s Hospital Colorado are part of an elite program that promotes the acquisition of knowledge, skills, and professional behaviors necessary to deliver the safest and highest-quality care.

Pat Givens, Senior Vice President and Chief Nursing Executive for Children’s Colorado, tells eurekalert.org, “We are extremely proud that Children’s Hospital Colorado’s Neonatal Nurse Practitioner Fellowship is recognized by ANCC as one of the highest-quality transition programs in the country for NNPs. The accreditation provides the patients and families we serve across the state and region with the reassurance that our neonatal nurse practitioners are some of the most highly trained in the country.”

Children’s Hospital Colorado is one of the nation’s leading and most expansive pediatric healthcare systems with a mission to improve the health of children through patient care, education, research, and advocacy. To learn more about Children’s Hospital Colorado’s recent accreditation approval for its Neonatal Nurse Practitioner Fellowship program, visit here.

Loma Linda University School of Nursing Receives $2.6M Grant to Grow Advanced Practice Registered Nurse Program

Loma Linda University School of Nursing Receives $2.6M Grant to Grow Advanced Practice Registered Nurse Program

The Loma Linda University School of Nursing has been awarded a four-year, $2.6 million grant from the US Department of Health and Human Services (HHS) to help grow the number of advanced practice registered nurses (APRNs) in Southern California.

The grant is funded by the HHS’s Advanced Education Nursing Grant Program and will provide funding toward tuition assistance for qualifying students and enhanced training. The school recently received confirmation of the funding for year one of the 4-year grant.

Gloria Mattson Huerta, DNP, Nurse Practitioner program coordinator and assistant professor in the Loma Linda University School of Nursing, tells news.llu.edu, “This grant will allow us to update and enhance the training provided to students. This will include the development of standardized patient scenarios focusing on behavioral health issues, as well as managing the opioid crisis — both of which are significant issues in the Inland Empire as well as nationally.”

Pete Aguilar, representative for California’s 31st US Congressional District, has promoted adding HHS funding to provide high-quality affordable healthcare in the state’s medically-underserved communities. He believes that increasing the number of highly-qualified nurses in the region can help ensure better health outcomes for our communities. He tells news.llu.edu, “I’m proud to announce this funding, and I look forward to a continued partnership with Loma Linda University in order to increase access to quality health care throughout San Bernardino County.”

To learn more about the four-year, $2.6 million grant awarded to the Loma Linda University School of Nursing to help grow the number of advanced practice registered nurses in Southern California, visit here.


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