The Society of Trauma Nurses (STN) is a nonprofit organization, established more than 25 years ago, governed by its members for the pursuit of common objectives. Those objectives are defined in STN's mission and summarized in the vision, "To be the premier global nursing organization across the trauma continuum" (STN, n.d.). These are the fundamental principles on which the strategic plan is built. The strategic plan was developed with member input and has five overarching goals: advocacy, knowledge sharing, leadership, quality, and alliance building. Within each of these pillars are the subgoals from which the implementation of the plan is constructed. The primary budget objective is to achieve the goals within the strategic plan for the benefit of the Society and its members.
There are four phases of a budget cycle: preparation, approval, execution, and evaluation (Lander, 2019). STN's board members have a fiduciary duty that is both ethical and legal to use their best judgment concerning oversight of STN's resources. First and foremost, the Board acts with the needs of the members in mind (Kagan, 2020). The process for preparing the annual budget involves analyzing past financial performance, along with the best current information, and any new resource inputs necessary to achieve strategic plan objectives, in a way that is useful to predict future financial outcomes. Targeted forecasting by project, during preparation, along with a check and balance process that invites committee input, ensures that STN makes every effort to provide members with what they want and need to provide the highest level of trauma care, without risking organizational sustainability (McMahon, 2017).
Execution of the budget to facilitate the delivery of planned programming and member-driven initiatives is not a race but a journey. It involves prioritizing the Board's strategic plan to ensure alignment with available resources, monitoring progress and outcomes at regular intervals, and taking corrective action or making budget adjustments as needed to advance initiatives in a fiscally responsible manner.
STN's overall financial position and budget comparisons are evaluated on monthly, quarterly, and annual bases, which are accomplished by a collaborative effort involving many levels of oversight for accuracy and transparency. A detailed monthly review of financial reports, receipts, and budget reconciliation is conducted by STN's treasurer and STN staff, along with the Board of Directors. The Finance Committee, which includes two STN volunteer non-board members, meets quarterly to consider midterm financial issues. This committee examines the composition of STN's investment portfolio and ongoing recommendations for the most judicious use of assets and net income to help advance STN's long term goals.
STN also contracts with an outside accounting firm to perform a financial audit in odd years and financial review in even years. This firm prepares STN's 990 reports, which are submitted to the Internal Revenue Service annually. The audited or reviewed financial reports, along with the 990 filings are reviewed by STN's Finance Committee and Board of Directors before dissemination. STN members may review STN's 990 reports and STN's audited financial statements upon request. The Finance Committee and the Board welcome comments and questions.
Some things are hard to predict. Pandemics, for example. The global impact of COVID-19 has caused tremendous economic hardship and uncertainty for STN and its members beyond the unprecedented health, safety, and psychological concerns. For STN, the cancellation of TraumaCon had a significant impact on programming and the annual budget. TraumaCon, STN's annual conference, is its flagship event-a place where members from around the globe convene to attend presentations and view posters on a variety of trauma topics; visit exhibitors specializing in devices, materials, or software to improve trauma care; and socialize and network with colleagues from across the country and internationally. The cancellation was necessary but completely unforeseen. Fortunately, pivoting and adapting to change to serve an immediate need are what trauma nurses do, and so does their organization! Whether hosting town hall meetings to provide a format to share experiences and network during uncertain times; to providing virtual courses that comply with a policy of social distancing; to taking a hard look at our organization and realizing we need do more around equity and inclusion to fulfill our mission; STN strives to meet member needs, while thinking outside the box and adjusting to the environment.
STN's fiscal year budget, which starts July 1st, is typically formulated to breakeven or net a modest income. In 2019-2020, however, the Board planned for STN to endure a significant deficit to make necessary investments in programming and services to meet the objectives for the organization and its members as outlined in the strategic plan. These budgeted losses, coupled with the unplanned financial impact from the coronavirus pandemic, will likely result in the most significant single-year loss for STN in the past decade. Fortunately, consistent, responsible stewardship and organizational successes have situated STN in good financial position to weather this storm. Even with the sustained losses, STN has enough cash on hand to cover nearly 1 year of expenses.
Evaluation of the past year and the current environment and climate of uncertainty have clouded the financial picture, making budget preparation for 2020-2021 difficult. Nonetheless, STN recognizes that the time-proven processes to align member needs with available resources, even in the context of today's environment, present the most effective path to financial agility and security, even during tough times.
STN remains true to its mission, vision, and its members. STN's Board of Directors is equally committed to responsible financial stewardship and risk management that will enable it to continue to meet the needs of its members and achieve its vision to be the premier trauma nursing organization across the continuum.
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