SpecialPointsofInterest

Page2:CAMSNConference2018PosterPage3:CNACertificationProgramfeaturingCAMSNMemberLauraVogelsangPages4-5:EducationCorner(LiverDysfunction:PictureThis)providedbyBrendaLane,RN,BScN,DipAdEd,MN,CMSN(C)andPresidentofCAMSNPage6:ContinuousLearningOpportunities:CaseStudies&Coursesfeaturingthethirdoffourarticlesonthe5mostcommonallegationsassociatedwithnursingnegligencelawsuits,providedbyChrisRokoshofConnectMedicalLegalExpertsPage7:FurthercontinuouslearningopportunitiesPage8:WaystobecomemoreinvolvedwithCAMSN

CAMSNNewsletterThe official newsletter for the Canadian

Association of Medical & Surgical Nurses February 2018

Individually,weareonedrip.Together,weareanocean.

-RyunosukeSatoro

OurVisionTobethevoiceofmedicalandsurgicalnursesinCanadaOurMissionMedicalandsurgicalnursesprovidenursingcaretoadultsexperiencingcomplexvariationsinhealth.Theyutilizediverseclinicalknowledgeandskillstocareformultipleacutelyilladultsandtheirfamilies.Theyareleadersatorganizing,prioritizingandcoordinatingcareaswellasworkingwithinterdisciplinaryteams.Thepracticeofmedical-surgicalnursingrequiresapplicationofevidence-basedknowledgeandbestpracticestandardstoprovidequality,safeandethicalcaretoclientsacrossthecontinuumofcare.TheCAMSNnurseadvocates,supportsandpromotestheintegralroleofmedicalandsurgicalnursestothehealthcaresystem.

CAMSNisanassociatememberoftheCanadianNurses’Association

(CNA)

EXECUTIVECONTACTINFORMATION:

PRESIDENTBrendaLane,RN,MN,DipAdEd,CMSN(C)brenda.lane@viu.caPASTPRESIDENTRobbynPeckford,RN,CNErobbyn.peckford@albertahealthservices.caSECRETARYCrystalCôté,RN,BN,CMSN(C),MSc(Admin)crystal.cote@mail.mcgill.caTREASURERCarolAnnConnors,RN,CNEcconnors@stfx.caCOMMUNICATIONSEstherRees,RN,BScN,CMSN(C)esther.rees@usask.ca2018CONFERENCECOORDINATORLauraNeal,RN,BN,MN,CMSN(C),CDlaura.neal@forces.gc.ca

Haveyoueverthoughtaboutjoiningourteam?ContactEstherRees,

CommunicationsExecutive,ifyouareinterestedinlearninghowyoucan

becomeinvolved.

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2018 CONFERENCEMedical-Surgical Nursing:It's Getting Complicated

tta a Con e ence and ent Cent e tta a nta io

June 7th & 8th, 2018 0730–1630 hrs

2-day: $250 + GST

1-day: $150 + GST

Students: $120 + GST (proof of student status)

To register online, visit: https://ccdeconference.usask.ca/index.aspx?cid=347

Numerous oral presenters, posters and topics including, but not limited to: Crack me up! Puzzling out Pelvic FracturesPsychedelic! - Review of Psychiatric Medications on the Med-Surg Floor

th t A look at cardiac issues including ECG reviewBest Practice for Surgical Incisions: Unraveling the Mystery of ProductsIn a Haze Medical Marijuana OverviewSeptic Shock & Antibiotic ReviewMedical Assistance in Dying

t How to Avoid Becoming a Legal Case Study

REGISTRATION COST (includes break ast, lunch, coffee and snacks):

Rooms have been reserved for registrants at the Hampton Inn (100 Coventry Road, Ottawa, ON). Rooms will be held until May 6th – to book yours, call 1-866-238-4218 and tell them you are with CAMSN. Rates are $135/night for single and $145/night for double.

This event is brought to you by the Canadian Association of Medical and Surgical Nurses (CAMSN). www.medsurgnurse.ca

SharetheCAMSNConferencePosterwithyourfriends&colleagues!https://medsurgnurse.files.wordpress.com/2018/02/camsn-conference-poster-2018.pdf

CAMSNConference2018

SpringRegistration&applicationwindowtoRenewbyContinuousLearningis

OPEN!!!

CNACertificationProgram

LearnmoreaboutbecomingCNACertifiedinMedical-

SurgicalNursing:

InitialCertification-Minimumof3,900hoursofexperienceasaRNinyourspecialtyareaoverthepast5years-WrittencertificationexamSeemore,includingtheapplicationprocessat:https://nurseone.ca/en/certification/get-certified

CertificationRenewal-Minimumof2,925hoursofexperienceasaRNinyourspecialtyareaduringyourcurrent5-yearcertificationterm-Demonstrateadvancedknowledgeofyourspecialtyareathrougheither:• ContinuousLearning–100hoursofcontinuouslearningactivitiesoveryour5-yearcertificationterm

• Re-writingthecertificationexam

See more at: https://nurseone.ca/en/certification/renewing-your-certification

“Obtainingmymedical-surgicalcertificationthroughtheCanadianNurses’Associationhasbeenoneofthebiggestmilestonesofmycareer.Thecredentialofbeingacertifiedmedical-surgicalnursehashelpedmetoestablishgreatertrustwithmypatientsandcolleagues.DoingCNAcertificationisajourneyinwhichyouendupfeelingvalidatedinyourknowledgeandmoreconfidentasapractitioner.Mymedical-surgicalcertificationhasbenefitedmeinmyrolesasastaffnurse,educator,andresearcher.Iamproudtonowbeofthefivemedical-surgicalcertificationnursementorsinCanadaandIhopetohelpothersbenefitfromcertificationaswell.”LauraVogelsang,RN,PhD(C),CMSN(C),CCNE(C)Don’tdoitalone.Contactoneofthefivemedical-surgicalcertificationnursementorsinCanadawhoareeagerlywaitingtosupportyouinthisjourney!Medical-SurgicalNurseMentorshaveaminimumofthreeyears’experienceandholdcurrentCNAcertificationinmedical-surgical

nursing.

https://www.cna-aiic.ca/en/certification/exam-preparation/mentorship-program

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CNACertificationDiscoveryWeek

January28th–February3rd

HaveyoueverthoughtaboutobtainingyourCNAcertificationinmedical-surgicalnursing?TheCNACertificationprogramofferstheonly

nationallyrecognizednursingspecialtycredential.Certifiednursesarecommittedtoanadvancedstandardofprofessionalcompetencedirectlycorrelatedwith

improvedpatientoutcomes.

EducationCorner

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LiverDysfunction:PictureThis

ByBrendaJ.Lane,RN,BScN,DipAdEd,MN,CMSN(C)

Mr.FailLivor,a48year-oldmale,isbeingadmittedtoyourunitwithcirrhosis.Youmentallyreviewthepotentialclinicalmanifestations,pathophysiology,andanticipatecollaborativeinterventions.PictureThis:Ascites–Peritonealfluidcollectioniscausedbyincreasedportalhypertensionandhypoalbuminemia.Duetoscarringintheliver,theportalveinpressureincreasesandthehydrostatic(“pushing”)pressureincreasesleadingtofluidshiftingintotheperitonealspace.Additionally,theliverdecreasesproductionofalbuminresultingindecreasedplasmacolloidoncoticpressure(PCOP).This“pulling”pressurehelpskeepfluidinthevascularspace(extracellularfluid);bringingfluidbackintothevascularbed.WhenthePCOPisdecreasedthehydrostatic(“pushing”)pressureisgreaterandfluidleavesthevascularbedintointerstitialspaces,liketheperitoneum.Youanticipateaparacentesistodrainofftheserousfluidtodeceaseabdominalgirthandfacilitateeaseofbreathing.AlbumininfusionsmaybeorderedtoincreasethePCOPasalbuminisalargeproteinmoleculeandwillfacilitatemovementofperitonealfluidbackintothevascularbed.Youanticipatethatthealbumininfusionswillbefollowedbyadiureticinordertopreventfluidoverload.Jaundice–Yellowingofthescleraandskinisacommonlyanticipatedclinicalmanifestation.Bilirubinconjugationisalteredandbilirubinentersintothebloodstreamandurine.Urinemayappeardarkbrownduetourobilinogen.Whenthehemoglobinbreaksdowntohemeandglobin,theliverconjugatesittoformbile.Whenthisprocessisalteredduetoliverdysfunctionthebilirubinisnot metabolizedproperlyandcolourstheskinandsclera.Also,asthereisdecreasedbileintheintestinaltract,clay-colouredstoolsmaybeanticipated.PortalHypertension–Thescarredliverincreasesthepressureintheportalveinandbloodisbackedup,mostcommonlyintothegastricandesophagealveins.Beta-blockersmaybeorderedtohelpdecreaseportalhypertension.Surgicalinterventionmayincludeplacementofashunt,whichallowsvenousbloodtobypasstheliver.Therearemanytypesofshunts.Forexample,theportalveinmaybesurgicallyattachedtotheinferiorvenacava(IVC)tobypasstheliversoblooddrainsdirectlyintotheIVCreturningtotheheart.OthertypesmayincludetherenalveinorsplenicveinsattachedtotheIVC.Surgicalintervention(TIPS-transjugularintrahepaticportosystemicshunt)isusedtobypasstheliverandreduceportalhypertension.Theinterventionalradiologistplacesastentconnectingtheportalveinandthehepaticveintocarrybloodfromtheliverbacktotheheart.Thisprocedurewillreduceportalhypertension,whichcontributestoesophagealvaricesandascites.

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EsophagealVarices-Asthepressureincreasesintheportalvein,smallermorefragilevesselsdevelopandarepronetorupturecausinglife-threateninghemorrhage.Regularlyscheduledprophylacticbandingproceduresmaybeperformedtotieoffvaricessotheydonotrupture.Bleedingmaybecomplicatedduetodeficientclottingfactors.Bleeding–DecreasedVitaminKabsorptionleadstoriskofbleeding,bruising,andchallengingcontrolofhemorrhageifthevaricesrupture.AnticipateVitaminKadministration.Additionally,mostBvitaminsarediminishedthusfolicacid,thiamine,andmulti-vitaminsarealsoanticipatedorders.CoagulopathyduetoreducedhepaticsynthesisoffactorsII,V,VII,andIXmayoccur,thusmonitoringclottingtimeswillbeaconsideration.Observeforpetechiaeandpurpura.Furthermore,alow-gradeDIC(disseminatedintravascularcoagulation)maydevelop.

HepaticEncephalopathy-Mentalconfusionandinappropriatebehaviourisduetotheaccumulationofammonia.Sincethelivercannotconvertammoniatourea,theammoniabuildsupandcausescognitivedysfunction.Elevatedammonialevelsshouldbemonitored.Lactulosewillbeordered,butnotasalaxative!Instead,itisorderedtobindwiththeammoniainthegastrointestinaltractandcauseittoberemovedviadefecation.BUT,yes,therewillbeincreasedbowelmovements.Cognitivefunctionshouldbemonitoredforimprovement.Anticipatealowproteindiet,asammoniaisaby-productofproteinmetabolism.

CaputMedusae–Duetoportalhypertension,superficialabdominalvenousengorgementmayoccuraroundtheumbilicusappearingassnake-likemeshwork.Treatmentstodecreaseportalhypertensionandascitesmaybeconsidered.

SpiderAngiomas–Spider-likebluishdiscolouredveinsmayappearonthenose,face,neckandanteriorchest.Thesemaybeduetohormonalimbalanceswithincreasedestrogen.

Gynecomastia–Inmen,breastenlargementmayoccursecondarytoanimbalanceofhormones,astestosteronedecreasesandestrogenlevelselevate.Additionally,testicularatrophymayoccur.

ItisimportanttorecognizethatMr.Livorhasacomplicatedconditionwhichrequiressafetymeasuresandregularmonitoring.Youarenowreadyforyouradmission!

Author:BrendaJ.Lane,RN,BScN,DipAdEd,MN,CMSN(C),isaProfessorintheBachelorofScienceinNursingprogramatVancouverIslandUniversity,teachingpathophysiologycoursesandclinicalpractice.Sheisalegalnurseconsultantprovidingopiniononmedical-surgicalcases.

LiverDysfunction:PictureThis(Continued)

EducationCorner

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LegalIssuesinNursing;MedicationErrorsByChrisRokoshRN,LegalNurseConsultant,CEOandFounderofConnectMedicalLegalExpertsCAMSNispleasedtosharewithyouthethirdoffourarticlesonthe5mostcommonallegationsassociatedwithnursingnegligencelawsuits.“Haveyouevermadeamedicationerror?IknowIhave;andtodateIhavenevermetanursewhohasn’t.Sadly,theseerrorsoccurmuchtoofrequently.Infact,medicationerrorsconstitutethegreatestnumberofadverseeventsinhealthcare.Fortunately,manyoftheerrorsdonotresultinharm.Forinstance,anursemaygiveapatientTylenolwhenIbuprofenwasordered.Aslongasthepatientdoesn’tsuffersignificantinjuryorseriousadversereaction,thiswouldbeconsideredabreachinthestandardofcarebutwouldnotmakeforasuccessfullawsuit.“Ontheotherhand,ifanurseadministersamedicationthatresultsinseriousinjuryordeath,thepatientcansuethenurseandmayalsosuethedoctor,pharmacistandhospital.Multiplepartiescanbesuedwithmedicationerrorsbasedonthefactthattheremaybemanycontributingfactors,andmanyindividuals,whoplayapartintheordering,dispensing,administrationanddevelopingtheprocessesformedicationadministration…”Readmore,includingafictionalcasestudyinvolvingamedicationerrorwithanadverseoutcome,at:https://medsurgnurse.ca/legal-issues-in-nursing-medication-errors/

ContinuousLearningOpportunities:

CaseStudies&Courses

CE-4031PainManagementCourse–March26th-June15th,2018Nursingcareofclientsofteninvolvesmanagingpainalongsideotherhealthconsiderations,Thiscoursebeginswithanoverviewofconceptsrelatedtopainincludingcommonmisconceptions,epidemiology,andbasicneurophysiologyofpain.Youwilllearnhowtoworkcollaborativelytoaccuratelyassesspaininyourpatientsaswellasdifferentiateacuteandchronicpainmanagementtechniques.Non-pharmacologicalpainmanagementstrategiesarealsodiscussed.Painmanagementinpediatrics,olderadults,andIndigenouspopulationsisexamined.Opioidsafety,theuseofcannabis,andendoflifepainmanagementaresomeofthetopicsdiscussedinthiscourse.Youwillcompletethiscoursearmedwithknowledgeofeffectiveevidencebasedstrategiesformanagingpain.Prerequisite:LPN/RN.Youwillberequiredtoprovideyourlicensenumberatthetimeofregistration.

OnlineRegistration:http://saskpolytech.ca/programs-and-courses/part-time-studies/course/pain-management/CE-4031/(Deadline:March16th,2018)

Introducingthe“IntroductiontoLegalNurseConsulting”CoursebyConnectMedicalLegalExperts

April17th-20th,2018Calgary,AB

ALegalNurseConsultant(LNC)isalicensed,RegisteredNursewho

performsacriticalanalysisofclinicalandadministrativenursingpractice,healthcarefactsandissuesandtheiroutcomesforthelegalandhealthcare

professions.

Learnmoreat:https://www.connectmlx.com/connect-to-education/introduction-to-legal-

course-consulting

EducationCornerContinuousLearning

Opportunities

What’stheHarminHarmReduction?ACollectiveActionCommunity-BasedConference

March29th,201808:30-15:30

Chatham-Kent,ONhttps://www.eventbrite.ca/e/whats-the-harm-in-harm-

reduction-registration-42485590545?aff=es2

CanadianAssociationofNursesinHIV/AIDSCareApril5-7,2018Vancouver,BCwww.canac.org

TrendsinCareoftheElderlyFreeportPhysiciansEducationFundMay2nd,2018at08:30-15:25

Kitchener,ONhttps://www.eventbrite.ca/e/trends-in-care-of-the-

elderly-tickets-38450235690?aff=es2

“Theroadtosuccessisalwaysunderconstruction.”

-LilyTomlin

TheNurse,theChart,andtheLaw

Wednesday,March14,201812:00-1:00PMEDTCNPSWebinarwww.cnps.ca

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May3-6,2018Victoria,BCwww.caet.ca

CanadianOrthopaedicNursesAssociation

May27-30,2018Regina,SK

www.cona-nurse.org

WaystobecomemoreinvolvedwithCAMSN…

EducationCornerAnEducationCornerhasbeenaddedtotheCanadianAssociationofMedicalandSurgicalNurses’official

website,www.medsurgnurse.ca,aswellasthequarterlynewsletters.

CAMSN’sgoalistoprovideeducationalpiecesthatbestservetheinterestandlearningneedsofmedical-surgicalnursesacrossCanada.

v DoyouhaveanideaforourEducationCorner?Isthereamedical-surgicaltopicyouwouldliketoknowmoreabout?

v Areyouinvolvedinnursingeducation?Wouldyouliketocontributeaneducationalpiece?Haveyoudonearesearchstudyrelevanttomedical-surgicalnursing?

v AreyouwritingtheMedical-SurgicalCertificationExamandthere’sanareaofnursingincludedinthecompetenciesthatyou’dliketoknowmoreabout?Telluswhatitis!Wecancreateaneducationalpiecetosupportyouinyourexampreparation.

Visit:https://medsurgnurse.ca/education-corner/foraccesstoallofthepreviouspiecesincludedintheEducationalCorner.

FeatureMember

TheCanadianAssociationofMedicalandSurgicalNurseswouldliketofeature

innovativeCAMSNmemberswhoaremakingadifferenceinmedical-surgicalnursing.

IfyouwouldliketobefeaturedinaCAMSNnewsletterand/oronthewebsite,sendusyourworkinitiative(500-750words).

Ifyouwouldliketonominatesomeonetobefeatured,letusknowandwecancontactthem!

ContactUs!

Doyouhaveanideaforournewsletter?DoyouhaveaquestionforCAMSN,oran

upcomingworkshopyouwouldlikesharedwithfellowmembers?

Wewouldloveyourfeedbackandweencourageourmembersto

sharetheirexpertise!

PleasecontactEstherRees,ExternalCommunications

Coordinatoratesther.rees@usask.ca.

VisittheofficialCAMSNWebsite!

www.medsurgnurse.caJointheofficialFacebookgroup!

Search:CAMSN

NextNewsletter:- CAMSN2018ConferenceAgenda- EducationCorner- ConsiderjoiningtheCAMSNExecutiveTeam!

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