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Nursing Excellence

The Online Newsletter for Children's Nurses
e-Edition, Issue 5 

Beverly Hayden Pugh
Magnet LogoNursing Rights and Responsibilities

By Beverly Hayden-Pugh, MOB, BSN, RN, NE-BC
Vice President & Chief Nursing Officer

As a part of our commitment to professional nursing practice, we look externally to compare and contrast the practice of nursing at Children’s Hospital Central California. Two years ago I favorably compared our practice with the American Nurses Association’s Bill of Rights for the Registered Nurse. In celebration of National Nurse’s Week 2010, it is time to once again review our progress. As I reflected on the outcomes and accomplishments of this past year, the presence of professional nursing practice is strongly evident.

The Bill of Rights for Registered Nurses supports our practice in conjunction with the Nurse Practice Act. Here are the rights along with a few thoughts as to how these were demonstrated in your work environment this past year:

Nurses have the right to practice in a manner that fulfills their obligations to society and to those who receive nursing care.

Nurses at Children’s Hospital have demonstrated recognized excellence in the provision of patient care. In October 2008 we achieved, for the second time, the Magnet Recognition® Award for Excellence in Nursing Services by the American Nurses Credentialing Center; the NICU was recognized by Advance for Nurses, Best Nursing Team for 2009; and in early 2010 the PICU was recognized with the Beacon Award for Critical Care Excellence®.

Several nurses were recognized for their contributions to nursing including: Kimberly Sutters, PhD, CNS and Diana Johnson, RN, CPHQ who were honored by the Food and Drug Administration Center for Devices and Radiological Health Med Sun Patient Safety Staff for their efforts with a product manufacturer to improve the safety of PICC lines; Kamela Loo, MSN, RN, RC, FNP-C, NNP-BC was awarded the Fresno’s First Five “Hand-on Hero’s” award; and Stacie Venkatesan, MSN, RNC- NIC, and Jennifer Norgaard, MSN, RNC-NIC, were recognized as Nurse of the Year in Advanced Practice and Education respectively by the Central Valley Coalition of Nursing Organizations (CVCNO).

Nurses have the right to practice in environments that allow them to act in accordance with professional standards and legally authorized scopes of practice (Nurse Practice Act).

In 2009, nurses throughout Children’s Hospital demonstrated their level of knowledge and expertise through maintaining and/or achieving national certification. Last year 39 percent of eligible nurses for fiscal year 2009 were nationally certified, a 9 percent increase from 2008!

Nurses have the right to a work environment that supports and facilitates ethical practice, in accordance with the Code of Ethics for Nurses and its interpretive statements.

One provision of the Code of Ethics for Nurses is “The nurse’s primary commitment is to the patient, whether an individual, family, group or community.”¹ This includes collaboration. During our Magnet Re-designation site visit, the appraiser identified, as an exemplar, nurses ability to work collaboratively with members of the interdisciplinary team resulting in improved patient care. Your commitment to the patient and family is further evident in innovative practice solutions such as the efforts developed by an interdisciplinary team in the Pediatric Dialysis Clinic. Marion Marin, BSN, RN, and her colleagues implemented a teen support group to reduce the adverse impact on teen health due to non-adherence to the medical regimen. In addition, nurses are supported in applying ethical principles through the Palliative Care Program, Ethics Consultation Team and Caregiver Case Review.

Nurses have the right to freely and openly advocate for themselves and their patients without fear of retribution.

Advocacy is accountability for all nurses which ensure quality care for our patients. Advocacy is demonstrated through: excellent patient care, participation in professional organizations to promote the professional practice of nursing, and collaboration and outreach education which result in enhanced quality of care for the patients we serve. Efforts this past year included leadership in numerous professional organizations such as the Emergency Nurses Association, Central San Joaquin Valley Nursing Leadership Coalition, Central San Joaquin Valley Chapter of Association of Operating Room Nurses, Local Chapter of the National Society of Pediatric Nurses and Central California Association of Neonatal Nurses, to name a few. Advocacy occurred through participation in collaboratives to enhance quality of care through development of standards and research such as the CPQCC Breastmilk Nutrition Quality Improvement Collaborative, Child Health Corporation of America (CHCA) multi-center research study - Pediatric Inpatient Falls, NICU CLABSI Collaborative. Nurses provided numerous outreach education events to community and healthcare organizations across the region including the Injury Prevention Program, child abuse advocacy, and pediatric and neonatal outreach education.

Nurses have the right to fair compensation for their work, consistent with their knowledge, experience and professional responsibilities.

The Clinical Advancement Program (CAP) continues to support and recognize individually driven professional development. This past year RNs continued to demonstrate a commitment to the profession resulting in: RN I - 14.8 percent, RN II - 38.2 percent, RN III - 30.5 percent and RN IV - 16.5 percent. CAP recognized nurses’ involvement in performance improvement, evidence-based practice, community service, exemplar clinical practice, national certification and continuous learning.

Nurses have the right to a work environment that is safe for themselves and their patients.

Nurses throughout the organization have collaborated and led efforts in enhancing patient safety including improving the effectiveness among caregivers, improving medication safety, reducing the risk of healthcare associated infection, reducing the risk of patient harm resulting from falls and encouraged patient/family active involvement in care. I know that through these efforts, more children have had “harm-free” experiences than they would have had even one year ago.

Nurses have the right to negotiate the conditions of their employment, either as individuals or collectively, in all practice settings.

Participatory governance is a core value which empowers nurses to make decisions about their practice. Nurses providing direct patient care routinely join together with nursing leaders to govern the practice of nursing. Collaboration is further evident through nursing participation on multiple interdisciplinary and medical staff committees. Nurses throughout the organization participate in the Nursing Governance Structure comprised of nursing committees governing the practice of nursing and interdisciplinary committees contributing to the provision of quality patient care. In 2009, a team of nurses, in collaboration with interdisciplinary colleagues, designed and transitioned our patient care health information management system from Meditech Magic to Meditech Client Server.

As we celebrate Nurse’s Week, we remember our rights but more importantly our responsibility to our children, their families and the community we serve. Your dedication and commitment is present reflecting the essence of nursing.



¹ American Nurses Association (ANA), Code of Ethics for Nurses with Interpretive Statements. 2001



In This Issue


Nursing Rights and Responsibilities

Nurse of the Year 2010

PICU Beacon Award

Critical Care Transport Excellence

A Culture of Inquiry

Nursing Governance Outcomes

Parents As Partners In Care

Professional Development

Contributions to Practice

Contributions to New Knowledge - Nursing Research

Leadership In Professional Nursing Organizations

Patient Satisfaction Comments