1. Cupec, Pamela Ann MS, RN, ONC, CRRN, ACM
  2. President of NAON 2013-2014

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As I write this, the leaves are beginning to change colors, homecoming parade floats are being put away, and plans are being made for Halloween parties as well as Orthopedic Nursing Day. As you read this, the days are becoming shorter, crisp fall air with the herald of winter to come. We pause and reflect on where we have been in the past, where we need to move to in the future. With the end of the year upon us, we evaluate goals met, adjust plans, and mark off completed projects. We think about the wish list of items to complete in the year ahead. The deck may need to be painted, a son is getting married, or we finally return to school to complete an advanced degree.

Pamela Ann Cupec, MS... - Click to enlarge in new windowPamela Ann Cupec, MS, RN, ONC, CRRN, ACM President of NAON 2013-2014

So too is NAON, reflecting on the past year, and what to move forward for the next year. In July, the finance council met to review all the budget requests from the various committees as well as the forecast from the prior year, and whittled down the requests to a working budget. In the following months, the board worked to adjust the budget and, in September, met to approve the budget for the calendar year 2014. This provides the financial framework and structure of our organization for the next year, and from which we monitor the revenue and expenses of NAON. It is with this scrutiny that we can accomplish the goals that we set for ourselves and continue our healthy progress and growth.


The National Association of Orthopedic Nurses strives to align itself with changes in the healthcare industry and embraces the available tools to accomplish our goals. The way in which we practice and meet the growing needs of the consumer is evolving and we as an organization must keep pace. What good is a sound budget if there is not a plan or process that reflects the needs of the members and one that is responsive to the changes in our workplace and adapts to the new norms?


At this writing, we are at the cusp of changes in healthcare in part due to the Affordable Care Act, as well as changes in the CMS (Centers for Medicare & Medicaid Services) guidelines. Access to healthcare coverage has broadened and patients are now able to see their primary care physicians when they had not in the past due to lack of insurance. There is an increase in physician extenders, as well as nurse practitioners who bring healthcare in areas where there was none. Patients are also getting procedures done that were either postponed or cancelled because of limited or absent insurance plans. They no longer have to decide between groceries or seeing a specialist. Newly diagnosed conditions no longer turn into chronic health problem due to lack of early intervention and appropriate treatment plan.


What does this mean for the orthopaedic nurse? Many of the patients we see are in need of teaching in a quick and concise manner, undergoing major procedures such as total shoulder replacements but are ready for discharge the following day. Not only do we incorporate our patient education much earlier in the stay, but to be aware that our patients may not fully comprehend our instructions because they may still be using a patient-controlled analgesic pump or having a difficult go with postoperative nausea. The patients may also be off the unit for therapy sessions and be tired when they return, and not receptive to discharge teaching.


Although highly recommended, many patients cannot attend the total joint patient education session prior to surgery due to distance or limitations by transportation. More and more facilities are carving out observation units, to quickly assess, diagnose, and rule out conditions in a rapid pace. Many patients are alarmed at bills that they receive, thinking that they were admitted as inpatient status, only to find out that they were in an observation status and, thus, responsible for the copay for the stay and diagnostics procedures performed.


We have been witness to the change in the practice of healthcare, from reduced lengths of stay, to changes in inpatient criteria, and more procedures done in an outpatient setting. Care is being delivered in a variety of settings, with the focus away from the traditional hospital route. We no longer rely on volumes of reference materials, but what can be obtained electronically, shared digitally, and easily transferable. Our patients are quite savvy in accessing educational materials, doing their own research, and do not hesitate to participate in their plan of care.


Because of these changes, and certainly more to come, we must be responsive and reflective in our own practices and guiding principles. NAON as a leader in orthopaedic nursing must design programs and products to meet the needs of our members and to keep up with the current trends to make these initiatives in line with the market. We must be responsive to the requests and demands of our membership and look to our mission, values, and goals to guide us. These items are within our strategic plan.


In September, the Executive Board was given the opportunity to work on our strategic plan for the next 3 years, from 2014 to 2017, setting the tone of the future of NAON. This living document sets down the foundation of where we want to go in the next 3 years and, during that time period, will be assessed and updated regularly. This is a process to determine whether goals set up in the past are still attainable and still meet the mission of the organization. It is not intended to cover all things possible, but to choose a few main goals and areas of focus, and work on those to completion. As in nursing practice, these items are measurable and achievable.


For the strategic planning session, NAON reached out to individuals representing different facets of orthopaedics and orthopaedic nursing, including the NAON Foundation, Orthopaedic Certification Board, Orthopaedic Nursing Journal, NAON Educational Committee, and two nursing students, including a student starting a second career as a nurse. This was to reflect who we are, and in collaboration with our orthopaedic colleagues, how we see NAON in the next few years.


Over the course of the strategic planning day, the participants worked in groups to identify the strengths of NAON, the possible opportunities for NAON, and where we would like to position ourselves. Within the strategic planning process, three areas of focus were identified that fit within the mission of NAON. The areas identified were in research, technology, and membership. Breaking into smaller working groups, the participants created a working list of goals and strategies. From that point, the strategic plan will be brought forth to the members of the planning group to review and tweak and then the final plan to the Executive Board for approval. Once approved, the new strategic plan will be shared with the membership of NAON.


What does this mean for the members of NAON? It means that there is a flow to the development of the strategies that will shape the forward progress and plans of the organization moving toward 2017. This streamlines the process so that there will be goals met, projects completed, and growing of the organization. As we close the end of this year, we look to the next with fresh purpose and renewed passion for the exciting years ahead, charged with promise and energized for the challenges.


Ever Growing. Ever Strong. Ever Green.