1. Walsh, Mary BS, CRNI

Article Content

Good morning and thank you. It is truly an honor and a pleasure to be standing here as the new INS President. This organization has helped to guide my career and has aided in my professional growth over the years, and now I hope to give back to INS-and to all of you-by serving in this capacity. Like you, I share a commitment to the specialty of infusion nursing. In preparation for my installation, I thought about the central tenants of that commitment, and in doing so formed a theme that will serve as the framework for my Presidential term. CARE: Collaborate, Advocate, Research, Educate sums up the areas of infusion nursing on which I plan to focus in the coming year. I would like to elaborate on each of these areas and map out for you some of my goals as President.

FIGURE. Mary Walsh, ... - Click to enlarge in new windowFIGURE.


Collaboration, the first part of my theme, is a term we hear often in the workplace. We want to be "team players," and we want the same from our colleagues. But the notion of working cooperatively sometimes does not stand up to the rigors of everyday practice. Perhaps this is because we have thought of collaboration in a reactive sense. Instead of collaborating on a plan of care, we call in reinforcements when something goes wrong. I would like to enter a new stance on collaboration, one that is proactive and emphasizes teamwork in devising patient plans of care so as to avoid medication errors, complications, or stress for both the patient and nurse, and improve outcomes.


As specialists, we are confident and proficient in initiating and maintaining vascular access devices. As nurses whose specialty overlaps with that of other clinicians, we are in a unique position to take the lead and foster collaboration. Nurses who work in homecare collaborate on patient plans of care on a regular basis in order to maintain consistency, even when more than one nurse or practitioners from different disciplines may be visiting the home. In the outpatient setting, oncology and infusion nurses often collaborate to facilitate the transition from hospital to ambulatory care. Consider the setting in which you work. How can you foster collaboration with other departments or with administrators to improve procedural regimens and, ultimately, patient care?



Nurses have long been the greatest advocates for their patients. And over the last two decades, we have found an even greater voice and begun to advocate for ourselves. But there is another kind of advocacy that I would like to introduce as a pillar of my Presidential term, and that is public policy advocacy. The impact of your involvement in public policy cannot be underestimated, and indeed, it is a crucial part of our lives as citizens, as caregivers, and as professionals. Advocacy is an important professional and personal skill. Without it, the Nurse Reinvestment Act would not have passed. Without it, the Home Infusion Act would not have been introduced.


I had the great pleasure of participating in the Nurse in Washington Internship in the fall of 2002 while serving as Director at Large for INS. The experience was eye opening: After 3 days of educational presentations, several of my nursing colleagues and I had the opportunity to meet with Representative William Delahunt of Massachusetts to discuss the Home Infusion Therapy Act, which at that time was making its way through the House of Representatives. This piece of legislation set new standards and redefined reimbursement for infusion medications delivered in the home setting. Unfortunately, the bill died in committee, but the introduction of this piece of legislation did much to raise awareness of reimbursement issues related to homecare. After the internship ended, I continued to act as a resource for Congressman Delahunt's office in their efforts to revive the issue.


While this experience afforded me the chance to meet and talk with Washington insiders, I took away from it one important lesson-that infusion nurses can influence the laws that shape the future of healthcare. We are living and working in a time when old methods of healthcare delivery are failing, costs are rising, and nurses are retiring from the profession faster than new nurses are entering. Each day, nurses are faced with tough choices, from the judicious use of infusion supplies and equipment to budgeting our time so as to give each patient the best care possible. For a long time, we have accepted these conditions as part of our profession. But we should be moving toward a higher level of inquiry when we talk about solving staffing issues, reimbursement, and risk management. There are larger issues that shape the environment in which we work, and we have the power to influence them.


It is my hope that each of us will begin to think about our role in shaping health policy. INS has added a free downloadable Guide to Public Policy to its Web site, which outlines the function of the infusion nurse in the health policy arena and offers tips on writing or e-mailing local policymakers to advocate for greater parity in reimbursement and other issues affecting our patients. I hope that INS members will take this opportunity to learn about the policy process and make their voices heard.



As part of the commitment to infusion nursing, I intend to make research and professional publication a priority during my term. INS is known as the leader in infusion research, and we set the standard by sharing the most current research through our publications. The Infusion Nursing Standards of Practice, Policies and Procedures for Infusion Nursing, and the Journal of Infusion Nursing have established benchmarks in infusion care. Solid research is the foundation that makes these publications so successful. And while the Standards and Policies and Procedures draw on many sources, the vast majority of that research came from infusion nurses just like you. I want to urge each of you to consider what knowledge you can share through professional publication. Perhaps your organization has instituted a novel approach to patient care or staffing issues, or has reduced its infection rates. Tell us how. Share the things that you are passionate about. Share the information through an article in the Journal or our member newsletter, Newsline. Publication is a type of collaboration, and when we collaborate, patient care improves, working conditions improve, and we grow personally and professionally.


In today's healthcare system, there is more and more focus on evidence-based practice, and the nursing field is no exception. Research gives us the ability not only to recommend new practices, but to show through quantifiable evidence that they work. Many of us who started nursing 20 years ago never thought that we would be doing research. Many of us do not feel equipped to do so. But this is where collaboration again becomes important. Talk with your colleagues and administrators about forming a research team and offer whatever skills you have. You will have an effect on infusion practices and procedures, broaden your professional scope, and improve care for your patients through research.



The final element of my theme, "Educate," has always been part of INS' mission, and I intend to carry on that tradition in my Presidential term. While INS, as an organization, is concerned with the education of its members, I would like to consider the education we offer to each other as colleagues and the education we give our patients.


I have already touched on the value of sharing your knowledge through publication, and this is indeed an important way to help educate your colleagues about your specialty. But let's consider the role we play as mentors. Many of us work with less experienced infusion nurses or nurse generalists who perform some infusion tasks. With consistency in infusion procedures such a priority, how many of us have taken the time to educate those around us when we see errors occur? Think about your early days as an infusion nurse. Did you have a mentor who patiently showed you proper procedure? Many of us did, and now it is our turn to take on the role of the mentor.


As a nurse with a long career in home infusion, patient education is a major component of my practice. Helping our patients to take part in their therapy is one of the best ways to ensure positive outcomes. For some of our patients, understanding the complex world of infusion therapy is scary, confusing, and overwhelming, especially for those faced with a major illness. But patients do want to participate in their care and thus retain a sense of control over their situation. Our patients deserve to know the right and wrong way to care for a catheter. They have the right to know if they are receiving proper care. As more and more healthcare is delivered outside the hospital setting, patient education needs will continue to expand, and infusion nurses are in a unique position to anticipate and meet those needs.


Each of us shares a sense of personal commitment to not only our patients and ourselves, but also to our specialty. We all have a great desire to make a difference and be the best nurses we can. We also face great challenges as our decades-old healthcare system takes on a new shape. I would like to remind each of you that it is sometimes the little things you do that make the biggest difference-a letter to your local Congressman, a few extra minutes to educate a colleague, or a few hours a week spent working on a research committee. Your participation is important, no matter how small the amount of time, no matter what your level of expertise. Let us remember that every journey begins with a single step.


I hope that you have enjoyed this meeting as much as I have. I am honored to lead this organization, and I look forward to serving you over the next year.