ANPD Annual Business Report

Earlier this month we held our Annual Business Meeting, a live webinar that we host each year to provide our members with an overview of the past year, the current state of the association, and a strategic view of where ANPD is heading. Read on for highlights from ANPD's 2016 Annual Business Meeting.

Membership

ANPD recently exceeded 4,000 members for the first time in the history of our association! We attribute this milestone in membership to our member benefits, which include:

• 10 free webinars from ANPD and Lippincott Solutions
• 12 issues of TrendLines, ANPD's electronic newsletter
• In-person and online networking opportunities
• Subscription to six online issues of Journal for Nurses in Professional Development (JNPD)

Publications

ANPD released two new books this year. Click the titles below for more information or to purchase our newest publications:

• Nursing Professional Development: Scope & Standards of Practice, 3rd Edition, co-edited by Drs. Mary Harper and Patsy Maloney
• Leadership in Nursing Professional Development: An Organizational and System Focus, co-edited by Charlene Smith and Dr. Mary Harper

Products

We further developed the programs in our Professional Development Center over the past year. Click the title of each program below, or our online store, for more information and to enroll:

• The Frontline Nurse Leader Development Program
• Preceptor Program Administration: NPD Considerations
• NPD Certification Preparation Practice Exams
• Online NPD Certification Preparation Course
• 2016 Convention Recordings
• Rapid Cycle Improvement in Healthcare Course

2017 Annual Convention

Save the date for our 2017 Annual Convention, taking place in New Orleans, LA on July 18 - 21, 2017. Remember to tag your convention-related social media posts with our hashtag, #ANPDAspire2017, and follow ANPD on social media! (Twitter, LinkedIn, Facebook, Instagram)

"T" is for Technology!

Sharon Gunn, DNP, RN, ACNS-BC, CCRN-K is a Clinical Nurse Specialist in Learning Innovation at Baylor Scott & White Health's Center for Clinical and Patient Learning in Dallas, TX.

Five years ago I started working in a department of learning innovation with a focus on using technology.  I was quite excited about this, as I was “stuck” in the PowerPoint rut, spending a lot of time doing face to face teaching on the unit, and trying to fit in case studies with busy clinicians’ schedules. I also, admittedly, get excited about gadgets, software programs, and thinking outside the box. I think technology is great, but it can be overwhelming, and expensive! Technology is constantly changing, making it difficult to “buy-in” to one product or approach only to realize next year you need an update! The beauty of technology is that if used appropriately, it certainly can and does facilitate learning. It also provides a means to reach a larger audience when human resources are limited. 

So where do you begin? Whether you have no budget, or unlimited funds (right!), there are plenty of resources available at your fingertips. When I was initially searching for some useful tools to use, I started with a Google search and found some great websites offering links to free stuff! Much of this is “borrowed” from K-12 educators, who are further along than we are regarding use of technology. 

http://www.freetech4teachers.com/

http://tech4teacher.weebly.com/

https://elearningindustry.com/321-free-tools-for-teachers-free-educational-technology

Look through the lists of resources on these sites, and if something grabs your interest, explore it and try it out! What you use will depend on your role, the learners, and workplace needs. Technology that I have used is quite varied, so I will give some examples to help illustrate what you can use, and how you can use it. 

Video:

An oldie, but a goodie, if used correctly. Almost everyone has a smartphone, and the video quality in most smartphones is more than adequate to use for learning purposes. Videos can be used to show how to use new equipment, procedures, or act out a case study. You may upload to a social media site if allowed by your institution, or your website. 

Instead of going out and creating a movie, flip the classroom! Have the learners create a video to show and discuss in class. Keep it short! Ideally, no longer than 2-3 minutes. TIP: Film in landscape rather than portrait mode for optimal presentation with widescreen monitors.

Social Media and Internet Resources:

If appropriate, use what is available to you! Create private Facebook pages; use Twitter, YouTube, Vimeo, or any other sites you can think of. Keep in mind that sensitive information is best kept for other venues. As an example, create a private Facebook page with fictitious characters and have the learners friend request the site. Post fictitious case studies, encouraging clinical discourse. 

If your institution allows access to Google Docs, this is a wonderful free resource that allows storing of information, collaborative presentations and documents, and other learning tools. It is great for group work, group presentations, and group concept map creation. 

Access to Facebook, etc blocked? Maybe your institution would allow access to Edmodo. It is very similar to Facebook, plus allows you to upload and store documents, post blogs, separate learners into groups, and more. 

https://www.edmodo.com/

Audience response systems:

Got zero budget? No problem! There are several simple and free resources that incorporate use of mobile devices to allow learners to interact with you in a didactic situation. Examples include Kahoot, Socrative, and Infuse Learning. Believe it or not, this was one of the most popular tools I used in didactic situations. Some (like Kahoot) offer a competitive approach, awarding points to learners for correct responses. 

http://www.freetech4teachers.com/2014/03/seven-good-student-response-systems.html#.WAj2TpMrLUI

Whiteboards:

This is a great collaborative tool for brainstorming or gathering input from a variety of people who may be on different schedules! Participants can add to, or edit documents in real time together, or when their schedule allows. There are many available; personally I have used both Google Docs, and Realtime Board.

http://www.freetech4teachers.com/2014/01/seven-free-online-whiteboard-tools-for.html#.WAj3QpMrLUI

Augmented Reality:

Have you heard of the Pokémon Go game that has been so popular lately? That game uses augmented reality. Augmented reality allows the learner to interact with the environment in new ways. I suggest you learn more about what the possibilities are online, as there is not enough space to explain it here. Basically you can augment learning using a free app. For example, you create a newsletter with the image of staff nurses on the page. A special code is embedded onto the image so that when the app is opened the user can see a “secret” video you created augmenting what is provided in the newsletter. A free resource one of our educators uses in practice is called Aurasma. 

    

https://www.aurasma.com/ 

Screencasting Software:

Just like it sounds, this software records your computer screen.  There are a multitude of options available out there, and depending on what you want to use it for you could spend from $0 to $$$. This is a useful piece of software if you want to show a learner how to access resources on your intranet, or how to document something in the EHR. Free versions: For Windows, Microsoft Expression Encoder and Mac, Apple QuickTime Player. Paid examples include: Snagit, Screencast-O-Matic. 

https://andrewdouch.wordpress.com/2014/02/13/the-best-screencasting-software-for-teachers/

eLearning Software:

I am including a short blurb here because I am seeing more and more eLearning being developed by clinicians, for clinicians. Perhaps the two most commonly utilized software programs related to eLearning are Adobe Captivate, and Articulate Storyline. Both programs can be a bit pricey and require either a web platform or LMS to house the files. What I want to emphasize here is that eLearning should not be narrated PowerPoints! These software programs have plenty of bells and whistles to allow for interactivity, and self-directed learning. I have used eLearning to develop unfolding case studies to validate clinician competency and facilitate learning. There may be other programs out there, but these are the two I am familiar with:

http://www.adobe.com/products/captivate.html

https://www.articulate.com/

Note: At this time Articulate is only available for Windows, so if you use a Mac you will need to have Windows installed to be able to download and use the program. 

Virtual Reality:

I think we will see more and more of this type of learning moving forward.  Some institutions are already exploring the possibilities.  With more complex types of technology, we will likely have to work in teams with programmers, graphic artists, and animators. Have fun considering the possibilities!

https://www.oculus.com/

I hope you have found some of the information here useful. I did not mention simulation, as many of you are likely familiar with this approach. The sky is the limit when thinking about technology. I suggest you try things out, talk to your peers, and get feedback from your learners! Remember, just as you must credit sources you use in written papers and presentations, you must also obtain permissions and give credit for use of digital sources!  

Celebrating NPD Week 2016

ANPD celebrated NPD Week on September 18 – 24, 2016. Each year we devote an entire week toward celebrating our members' achievements and shining a spotlight on nursing professional development. This year during NPD Week we held a decoration contest for our members, offered a free webinar, "Wisdom, Passion, and Transformational Leadership," and sold NPD Week merchandise in our online store. Browse through the photos below, posted by your peers on social media, to see how some of your fellow NPD practitioners celebrated (and make sure to check out the winner of the decoration contest!). Next year NPD Week will take place from September 24 – 30, 2017. 

Adventist Health celebrated NPD Week with a workshop for staff from several of their hospitals. 

NPD Week decorations at Florida Hospital

NPD Practitioners from McGuire VA celebrate NPD Week

Cone Health celebrated with cupcakes, complete with the NPD Week logo!

Congratulations to Aultman Hospital for winning the NPD Week decoration contest!

ANPD Annual Awards

Tina Spagnola, MSN, RN-BC, NE-BC, is the Director of Clinical Education & Research at Johns Hopkins All Children's Hospital.

The ANPD awards are presented each year at ANPD's Annual Convention. The awards ceremony is a wonderful time to recognize the wonderful work that is done by NPD Practitioners.  These awards celebrate the Nursing Professional Development (NPD) Practitioners that have demonstrated excellence in the practice of Nursing Professional Development. There are eight awards and each award aligns with the new Scope and Standards. The updated award categories will be based on the roles of the NPD Practitioner. The roles are: Learning Facilitator, Change Agent, Mentor, Leader, Champion for Scientific Inquiry, Advocate for NPD Specialty, and Partner for Practice Transition. Belinda E. Puetz Award criteria will remain the same.

The Recognition Committee encourages you to think of your coworkers, peers, affiliates and ANPD members who portray the excellence that should be recognized. Self submissions are highly encouraged. Don't shy away from nominating yourself. There are many departments of one NPD Practitioner, each providing wonderful programs, so take the time to self-submit and recognize yourself.

NPD Week provided us with the opportunity to celebrate our profession and practice. Let’s take the opportunity to extend that into the ANPD awards and think about potential nominees, including yourself.

Dispatch from Yangon: Promoting nursing care in Southern Myanmar

Marilyn Moonan, MSN, RN, CPN, is a clinical nurse educator for surgical programs and a global health nursing fellow in the Global Health Program at Boston Children’s Hospital. She has traveled to to Myanmar and Ghan, but she has also traveled extensively with Operation Smile over the past fifteen years to Asia, Africa, and South America.

As I walked into the inpatient pediatric oncology waiting area at Yangon Children’s Hospital—a relatively modern, well-equipped hospital in Yangon, Myanmar—a beautiful young woman approached me. She was holding her son, a 15-month-old boy who had Down syndrome. In English, she repeatedly sobbed, “Please help me.”

An interpreter explained that she and her husband were farmers from rural northern Myanmar (more than 700 miles from Yangon, an urban area of more than 5,000,000 people) and that recently their son had not wanted to breast feed, had been sleeping a lot and had developed lumps in his neck. They had previously traveled to Thailand, where their son was diagnosed with acute lymphoblastic leukemia (ALL). The parents had sold their farm to travel to Yangon so their son could receive chemotherapy.

I smiled and put my arm around her but could not think of what to say that would give her comfort. It was my first day at Yangon Children’s and my first experience in my yearlong global health nursing fellowship with Boston Children’s Hospital’s Global Health Program. With this single chance meeting in the waiting area, it took all of 15 minutes for me to begin to understand the challenges that families and medical staff in Myanmar face in providing quality, consistent health care.

The challenges of care

Normally, I’m a clinical nurse educator for Boston Children’s surgical programs. But in June 2015, a colleague and I traveled 28 hours on three flights for a unique opportunity: to be catalysts for positive change in the nursing care provided to families and children in a region of the world where so many factors complicate that being achieved with any regularity. 

There are many distinct health care system challenges in Myanmar. The nation allocates only 2 percent of its GDP to health care, the lowest amount in all of Southeast Asia. Nursing is task-oriented, and nurses are only paid approximately $100 per month. Nurses are not specifically trained for pediatric oncology and rotate throughout the hospital every six months. One nurse and one resident are together responsible for a ward of as many as 50 pediatric oncology patients at night. 

Despite these challenges, the nurses we worked with were extremely caring and clinically competent. They were thirsting for knowledge and enjoyed learning about any topic that we presented.

A map of Myanmar. Yangon is on the southern coast. (United Nations/Wikimedia Commons)

This visit to Yangon lasted just over a week. I checked in on mom and baby each day that I was in the hospital. The baby had responded well to the treatments. I found out that the mom had taken on the role of comforting other mothers with children on the unit, often carrying their babies through the unit while hers slept, so they would have some relief.

I saw her one more time when it was time for me to fly home. We exchanged smiles, hugs and well wishes, but there was finality in our goodbyes. I knew there was little if any chance that our paths would ever cross again. There was no way that we could stay in touch; she did not have access to or the Internet in her remote village.

Forces of nature

Several months after I returned home, I began hearing about devastating flooding in northern and other areas of Myanmar. Nurses that we had met in Yangon shared horrifying photographs—a dead infant floating in a flooded village; a toddler chest deep in mud, holding a dead, mud-covered snake. More than 100 people died, and thousands were displaced as mudslides wiped away their homes. Water sources were contaminated, power sources were cut, and roads and bridges were washed out.

I thought about that beautiful family and wondered if they had escaped the fury of Mother Nature. I also worried about the storms’ effects on the oncology patients I’d met. How do they maintain their fluids when their water was contaminated? How do they avoid infection? How can they possibly even think about making it to a follow-up appointment? The overall rate of oncology treatment abandonment in Myanmar is thought to be about 25 percent. I am sure that this year’s extreme flooding only exacerbated the problem.

In the past year, we have In the past year, we have been able to teach 15 nurses “Helping Babies Breathe”, 20 Nursing students & nurses about the child with respiratory dysfunction, the child with GI dysfunction, pediatric health assessment, pediatric growth & development, infection control, IV infiltration & phlebitis. We taught 68 nurses about error prevention training, pressure ulcers, recognition & management of shock.  Finally, 26 nurses, a pediatric Surgeon, and nephrologist were taught about the child with renal dysfunction & transplant. Teaching methods consisted of simulation, just in time teaching, bedside rounding, and formal lectures. We have continued teaching thorough web conferencing, email and social media. It has been thrilling to see the nurses teaching this content to other nurses throughout the hospital and community. As we continue our work in Myanmar, we hope to continue building strong partnerships with inter-professional teams at Yangon Children’s, working for sustainable change and knowledge transfer.

Importance of Certification

Debbie Buchwach, MSN, RN-BC is the Director of Professional Practice for Ambulatory Nursing & Optimization for Kaiser Permanente in the Northwest Region.

Nursing Professional Development week is September 18-24. This is a great time to pause and reflect on the importance of NPD certification.

We began our nursing careers with the desire to provide the best care for our patients/clients. We participated in in-services, attended conferences, read specialty-care journals, and collaborated with other colleagues to increase our knowledge, skills, and abilities. Once we transitioned from novice to expert in our field, many of us sought certification. It was a way to recognize our depth of knowledge and commitment to our chosen specialty practice. I often wonder why some of us don’t follow this same path when we enter into the specialty practice of Nursing Professional Development.

I was acutely aware that I had entered a different nursing specialty when I was asked to implement a new interprofessional care plan. What I didn’t know as I planned my “training” was that I needed to understand change, leadership, and learning theory. Looking back, I didn’t provide the best learning experience for the learners. I was fortunate that my organization sent me to my first ANPD Conference just a few months later. I was exposed to best practices in our field, networked with fellow NPD Practitioners, and found out about the Journal for Nurses in Professional Development. I left with a commitment to increasing my knowledge, skills, and abilities in order to provide the best NPD leadership to my organization.

A year later, I attended my first ANPD certification preparation class. My learning objective was to gain a better understanding of what I needed to know to be an effective NPD Practitioner. What I left with was a passion for our specialty. I actively sought out best practices through reading the journal and other professional resources, networking with NPD colleagues, and attending the ANPD convention every year. As I incorporated my learning into my practice, I became more valuable to my organization. I was better able to provide the leadership required to help the organization meet its strategic goals.

Four years into my NPD career, I decided to seek certification. I wanted to validate the specialized knowledge, skills, and abilities I had developed. I attended another ANPD certification preparation class to prepare for the exam. This time, I validated what I had learned and identified a few opportunities for additional preparation. A few months later, I took and passed my board exam. I’m now entering my second recertification cycle.

Why is certification important? Certification is one of the measurements used to validate professional growth and competence in a specialty field. Because we are role models for lifelong learning, I believe it is important that NPD Practitioners are certified. NPD certification increases our credibility with staff, interprofessional colleagues, and organizational leaders. The journey to NPD certification, which begins with professional development, ultimately leads to evidence-based programs that change nursing practice which improve patient outcomes. Certified NPD Practitioners provide leadership that is critical in meeting the challenges of our current healthcare systems.

What are your thoughts on the importance of NPD certification for NPD Practitioners?

The 2016 NPD Scope and Standards: Began with Florence

Patsy Maloney, EdD, MSN, RN-BC, CEN, NEA-BC is a Senior Lecturer of Nursing and Healthcare Leadership at University of Washington Tacoma.

"Let us never consider ourselves finished nurses...we must be learning all our lives."

                                                                                                  -Florence Nightingale

There has been much excitement about the release of the 2016 Nursing Professional Development (NPD) Scope and Standards. The workgroup of NPD experts did a great job. The workgroup stood on the shoulders of the nursing and NPD leaders that went before us. This blog entry will briefly describe what a scope and standards document is, the history of our current scope and standards, a brief overview of the major changes in our current scope and standards, and a call to implement the standards by advancing the NPD specialty.

What is a Scope and Standards document? A nursing specialty scope of practice describes the specialty practice, its boundaries, and its practitioners (Anderson, 2011).  The American Nurses Association (ANA) (2015) publishes a Nursing Scope and Standards that applies to all nurses, including all specialty nurses. The scope is an overview of nursing and answers the who, what, when, where, how, and why questions of nursing practice. The standards of professional practice have two parts, a description of each standard followed by a list of competencies (Strong, 2016). The second edition of Nursing Scope and Standards (ANA, 2010) is available online. The third edition (2015) can be purchased online.

History of the NPD Scope and Standards. The history of our scope and standards begins with the history of our specialty. The roots of our specialty go back to the founder of modern nursing, Florence Nightingale. Ms. Nightingale’s belief that life-long learning was crucial influenced her opposition to registration (licensure) of nurses. She believed that if nurses were licensed after completing their training program, they would consider themselves “finished nurses” and would not continue learning (http://www.austincc.edu/adnlev1/rnsg1413online/mod_prof/history_notes.htm).
Pfefferkorn stated “The improvement of the nurse in service, in its broadest implications is as old as nursing…but the improvement of the graduate nurse for professional or cultural growth, is yet in its infancy”  (1928, p.700). So the improvement of nursing practice “in service” of the patient is as old as nursing, but including the professional development of the nurse beyond the immediacy of care of the patient was in its infancy in 1928 (88 years ago). The word in-service and in-service education took hold and articles about in-service education started to appear in the nursing literature. As more nurses moved from independent practice to hospital employees and the need for nurses increased, in-service education to orient and refresh nurses became even more important. By 1953 the in-service education role began to separate from that of nursing administrator, and divisions of in-service education were established within departments of nursing service (Abruzzese & Yoder-Wise, 1996).

Concurrent with the development of divisions of in-service education within hospitals, ANA started to develop the forerunners to scope and standards. These documents were called statements of functions. One of the earliest mentions of these was in the American Journal of Nursing in 1954. These statements of functions were developed by ANA committees. The 1954 statements included education, but not in-service education. By 1956 the statements of functions had evolved to statements of functions, standards, and qualifications for practice. Over the next few years American Journal of Nursing published these statements for a variety of nursing areas. They did not use the term specialties. Although in-service education was not included in the first statements of functions, standards, and qualifications, the specialty was included in The Yearbook of Modern Nursing 1956. It was not until 1966 that the Nursing Service Administrators section of ANA developed a “statement of functions and qualifications for in-service educators (Abruzzese & Yoder-Wise, 1996). This document was the precursor of our scope and standards.

By 1970 in-service education was subsumed under continuing education, which had come to include all education that took place outside degree granting nursing school programs. The Journal of Continuing Education published the ANA’s landmark statement on in-service education in 1970 and in 1972 published ANA’s landmark statement on continuing education. The Council on Continuing Education was organized with members from both in-service education and college continuing education programs in 1973. In 1974 ANA published the first standards for continuing education and in 1976 published guidelines, not standards for staff development. (Abruzzese & Yoder-Wise, 1996). With the publication of these guidelines the term in-service education was replaced with the term nursing staff development. Instead of referring to an area of practice, in-service education came to mean education and training delivered in the practice setting to facilitate an individual’s ability to function within a given agency (ANA, 2000). 

Finally, in 1990 ANA published Standards for Nursing Staff Development (ANA, 1990). This was followed in 1994 by Standards for Nursing Professional Development: Continuing Education and Staff Development. Nursing professional development had become the umbrella term to encompass both continuing education and staff development. Embracing this new term, the Scope and Standards of Practice for Nursing Professional Development was published by ANA in 2000. The 2010 Nursing Professional Development: Scope and Standards of Practice was published jointly by ANA and National Nursing Staff Development Organization (NNSDO) (ANA & NNSDO, 2010). Our scope and standards led the way for the re-naming and re-branding of our specialty from NNSDO to the Association for Nursing Professional Development (ANPD) in 2012.

The nursing and NPD leaders on whose work the 2016 NPD Scope and Standards of Practice is built are too numerous to name. But I think it is really important to acknowledge Ms. Barb Brunt, who served with the 1994, 2000, and the 2016 standards work groups. Her contributions to our current scope and standards are immeasurable. Another NPD giant is Dr. Dora Bradley, who led the work group for the 2010 NPD Scope and Standards of Practice. This work group created the NPD Practice Model as a systems model that maintained much of its relevance and only required the 2016 workgroup. The 2010 Scope and Standards was an outstanding foundational document for the 2016 scope and standards work group.

Overview of the revisions in the 2016 NPD Scope and Standards. The significant revisions in the NPD Scope and Standards of Practice (ANPD, 2016) include expanding the settings in which the NPD specialty is practiced beyond acute care and even including virtual environments, replacement of the intertwined elements with seven NPD roles, identification of general (NPD Generalist) and advanced levels (NPD Specialist) of NPD practice. NPD practitioner became the umbrella term that incorporates both the NPD generalist and the NPD specialist (Harper & Shinners, 2016). Two standards of performance (Collegiality and Advocacy) were removed and integrated throughout the other standards. Change Management and Mentorship/Advancing the Profession were added in response to the NPD Role Delineation Study (Warren & Harper, 2015).

Conclusion. The seeds of the 2016 NPD Scope and Standards of Practice were planted by Florence Nightingale when she emphasized the need for life-long learning.  These seeds started to take root when Blanche Pfefferkorn addressed the National League for Nursing Education’s convention and discussed the deliberate pursuit of professional growth post-graduation from nursing school (Pfefferkorn, 1928). After the publication of Pfefferkorn’s address articles on in-service education started to appear in the nursing literature. In the 1950’s in-service education divisions started to appear in hospitals and by the 1960’s the predecessor of the current scope and standards was developed. Our current 2016 Scope and Standards is the result of the work of well over 100 years of thought leaders. The last, but not least standard of performance, Standard 16: Mentoring and Advancing the Profession, calls us to advance our specialty. Our specialty is one of the oldest of nursing specialties. Be proud. Call your specialty by name, Nursing Professional Development. 

References

Abruzzese, R. S., & Yoder-Wise, P. S. (1996).  Staff development: Our visions.  In R. S. Abruzzese (Ed.).  Nursing staff development: Strategies for success (pp. 3-14). St. Louis, MO: Mosby Yearbook.

American Nurses Association. (2000). Scope and standards of practice for nursing professional development. Washington DC: Author.

American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring, MD: Author.

American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author.

American Nurses Association and National Nursing Staff Development Organization. (2010). Nursing professional development: Scope and standards of practice. Silver Spring, MD: ANA.

ANA Statements of functions. (1954). The American Journal of Nursing, 56(10), 1305-1309.

ANA Statements of functions, standards, and qualifications. (1956). The American Journal of Nursing, 56(8), 1027-1030.

Anderson, T. (2011). Nursing professional development: Scope and standards of practice (2010). Nebraska Nurse, 44(3), 8-9.

Harper, M. G.  & Maloney, P. (2016).  Nursing professional development:  Scope and standards of practice (3^rd ed.).  Chicago, IL:  ANPD.

Harper, M.G. & Shinners, J. (2016). Overview of nursing professional development. Journal for Nurses in Professional Development, 32(4), 228-229.

History Notes. (n.d.). Nursing as a profession. Retrieved from http://www.austincc.edu/adnlev1/rnsg1413online/mod_prof/history_notes.htm

Pfefferkorn, B. (1928). Improvement of the nurse in service: An historical review. The American Journal of Nursing, 28(7), 700-710.

Strong, M. (2016). Maintaining clinical competency is your responsibility. American Nurse Today, 11(7), 46-47.

Warren, J. I., & Harper, M. G. (2015, July). Nursing professional development role delineation study. Presentation at the annual meeting of the Association for Nursing Professional Development, Las Vegas, NV