The AMSN HUB now has a place for med-surg nursing advocates! Established in July, the AMSN “Med-Surg Nurse Advocacy” community includes updates on policy agenda priorities of AMSN – and your engagement and participation! Every AMSN member is enrolled in the Med-Surg Nurse Advocacy HUB community. To learn more and participate, connect with https://community.amsn.org. Med-surg nursing priority legislation is on the move in Washington! An AMSN-backed bill reauthorizing Title 8 nurse workforce development programs (HR 728) cleared the House Energy and Commerce Committee July 17 by voice vote. Its next step is a vote on the floor of the U.S. House of Representatives. AMSN makes it easy to contact your member of Congress and say “Vote YES on HR 728!” Click this link to get started: https://docs.google.com/document/d/1exr1Me48UjtfS0qF7u_IfqQZayJ2efXaJVkUYiddIdk/edit Besides committee action, nurse workforce legislation is drawing more cosponsorship support on Capitol Hill. HR 728 now has 121 bipartisan cosponsors – nearly a quarter of the 435-member U.S. House of Representatives. Its Senate counterpart, S 1399, has its original bipartisan cosponsors, Sens. Jeff Merkley (D-OR) and Richard Burr (R-NC) and none additional as the committee to which it has been referred has been working on legislation to help control cost growth in health care. The National Academy of Medicine “Future of Nursing: 2020-2030” project is hosting two more town meetings this summer, one that occurred today in Philadelphia, and then in Seattle August 7. AMSN is planning to be there and to speak out on behalf of med-surg nurses and their patients! Follow developments on AMSN’s Facebook, Instagram and Twitter pages. If you would like to attend yourself in-person or online, click this link for Seattle: www.nationalacademies.org/hmd/Activities/Workforce/futureofnursing2030/2019-AUG-07.aspx Recognition in legislation of the 120,000 women who served in the World War II era Cadet Nurse Corps has been supported by AMSN. On July 12 that support took one step closer to reality: the U.S. House of Representatives passed the 2020 National Defense Authorization Act (HR 2500) with a key Cadet Nurse Corps recognition provision added as an amendment by Rep. Cherie Bustos (D-IL). Read more about it from the Nursing Community Coalition here: https://docs.wixstatic.com/ugd/148923_0a504421c6ee4ee983867c65d9a73630.pdf
A Reflection of Nursing Around the World by Robin Hertel, EdS, MSN, RN, CMSRN - President, AMSN I recently attended the International Council of Nurses Congress Conference, held in Singapore this month. It was a gathering of more than 5,000 nurses from over 120 countries. Discussions and poster presentations over four days involved many of the issues nurses face on a daily basis, including safe staffing, workplace safety, quality, and the healthcare model. The central theme of the conference centered on moving beyond the focus on disease to one that is more focused on maintaining health. A key role for nurses in primary health care involves assisting patients to remain in the home as long as possible according to Elizabeth Iro, the Chief Nurse of the World Health Organization. This requires medical-surgical nurses to expand their areas of expertise to include disease prevention and the health of the community; of taking stock of where we are individually as nurses both professionally and personally; identifying our knowledge gaps and then taking action to address them. Investing resources in the power of nursing leadership was another focus. Even though nursing makes up 70% of the healthcare workforce, only 25% of leadership roles in healthcare are held by nurses. Yet nurses are the experts in the care needs of our patients, of the quality and safety gaps that exist in the practice environment and in staffing needs. Nurses have the power to hold the politicians and the health care system accountable for investing in the leadership potential of nurses if we collectively voice our concerns and support this with data and potential solutions. As a part of the health care team, nurses and administrative staff can work collaboratively to address the issues nurses face daily such as safe staffing and protection of the nurses and support staff from acts of violence. Having a seat at the table and actively engaging in discussions and policy development allows nurses the opportunity to change the health of our communities, our nation, and our world. Having a seat at the table is vital if the nursing profession is ever to realize a positive and collaborative health care environment in which we practice to the full extent of our licensure and do so safely. These are big issues and ones that AMSN is helping the medical-surgical nurse to address. The major focuses of AMSN’s strategic plan include providing tools to nurses to develop and maintain a healthy and safe practice environment, assisting in the professional development of medical-surgical nurses by providing education in the areas where knowledge gaps may exist and promoting the status and profile of nursing through certification as well as legislative advocacy. Nurses, both individually and collaboratively as a profession, can truly have a positive impact because we are experts at delivering patient-centered care while maintaining quality. We have opportunities to become more involved in the areas of policy development and turning these policies into practice while keeping patient safety at the forefront. Next year has been designated the Year of the Nurse. What will you do to move your practice and the profession forward?
In May, AMSN and MSNCB CEO Terri Hinkley, EdD, MBA, BScN, RN received her Doctorate in Human and Organizational Learning from George Washington University. The Human & Organizational Learning curriculum focuses on organizational issues such as strategic change, transformational leadership, individual and group learning processes, organizational development, and global and international issues. The degree helped Hinkley to develop a more critical lens with which to see the nursing community and its issues and challenges. “What interested me about the program at George Washington University was that it was structured with four main pillars: leadership, learning, culture, and change. You can take those constructs and apply them to whatever challenge you are facing in business or professional life,” she says. “For me, as a non-profit executive in the healthcare industry, with a true passion for nursing, I could marry my experience and commitment to the profession with the executive leadership principals, to better explore the future of nursing.” Hinkley completed the three-year doctoral program with a dissertation that focused on a critical issue that she feels is extremely important to nurses: second victim syndrome. She used a structural equation model to measure causal relationships between psychological capital, social capital, and second victim syndrome. In other words, she was interested in understanding how an individual’s overall life outlook and social support systems combine to impact the severity of second victim syndrome experienced by a registered nurse. Second victim syndrome occurs when a care provider experiences an unanticipated adverse patient event and becomes victimized in the sense that the provider is traumatized by the event. The provider can feel personally responsible for the patient outcome. Many nurses feel as though they have failed the patient, second guessing their clinical skills and competence. If left unchecked, it can leave the professional depressed, feeling alone and desperate. Sadly, second victim syndrome has led to death by suicide for some nurses. “I am interested in the impact of negative affective states for nurses: burnout, compassion fatigue, moral distress and second victim syndrome. I am drawn to them, because I really want to change the experience for our nurses moving forward. I don’t want them to have such negative experiences that they drop-out, disconnect from their jobs and their patients, or turn to alcohol and drugs,” says Hinkley. “I welcome anything that brings to light the factors that contribute to these conditions, because it means we can better help to minimize them.” Hinkley’s research found that no matter how much hope, optimism, self-efficacy or resilience you generally had, how severely – and if – you suffered from second victim syndrome depended on how people treated you, and whether people affirmed your competency as a nurse or blamed and shamed you. “That treatment from the nurse’s social support system was clearly the important variable in my study. You need support from your unit or team, your institution, and the industry / profession to recover from an episode of second victim syndrome. All three levels of support are important to preventing such negative effects,” she says. Hinkley says that her doctoral degree will benefit AMSN, MSNCB, and AJJ (AMSN and MSNCB’s association management agency) more broadly, because she can see things even more clearly from the nursing perspective. She can offer more ways to help nurses navigate a rapidly changing work environment, as her doctorate research prepares her to better help the AMSN and MSNCB boards and staff to think differently about what programs and services are offered to nurses by the associations. “I wanted to focus on the environmental factors and strategic foresight. It allowed me to look at nursing through a lens of culture and change. Skillsets and experiences and backgrounds have changed from what they were for nurses decades ago. So we need to ask: How do we address that and meet new needs of the future workforce? “We now have a five generational workforce for the first time ever: traditional, baby boomer, Gen X, Millennial, and Gen Z. That landscape alone causes disruption of support and increases misunderstandings – because each generation is so markedly different,” she says. “The Gen Zs are digital natives; they have never grown up without a smartphone. Their expectations and experiences are unique to traditionalists and baby boomers, who sometimes never fully embrace technology. Gen X-ers live-to-work, while Gen Zs want to work-to-live – that’s a very different paradigm. It means we need to think about work differently to meet both organizational and nurse needs.” To effect change, Hinkley believes that everyone involved in the nursing community can do more to support nurses and give them the tools they need so that they can support each other. With those resources, nurses can thrive. “I can’t express how eye-opening the doctorate program was for me. I am fulfilled knowing I will be able to apply what I have learned. I am able to look at nursing through a very special lens to study the issues affecting nurses. I know that AMSN and MSNCB will be able to meet the needs of our nurses even better as a result.”
By: Antoinette Falker, DNP, RN, GCNS-BC, CMSRN, CBN Dictionary.com defines pursuit as: the act of pursuing; an effort to secure or attain a goal; a quest; and any occupation, pastime, or the like in which a person is engaged regularly or customarily. They define excellence as the fact or state of excelling. The pursuit of excellence in nursing is indeed a quest that is accomplished by thoughtfully looking at ones environment and then strategically thinking about how to make a positive difference. If you are in a nursing department with high nursing turnover, making a difference might entail starting a Welcome Committee and developing an orientation tool for new staff. You may also want to consider starting an Engagement Committee to plan activities to enhance staff satisfaction and staff morale. If you work in a nursing department in which most of your new hires are graduate nurses, you may want to start a preceptor committee to better understand the needs of your preceptors and to develop an orientation tool specifically tailored to the needs of new nurses. If you can never find items in your supply rooms, consider starting a team comprised of nurses who like to organize. Empower them as front-end users to redo the supply area in a more user friendly manner. Now, I am not saying to remodel the supply room, rather I am saying to thoughtfully look at where items are stored in your supply room and then rearrange it to fit the work of your nursing division. If your nursing division is lucky enough to have an established nursing staff, consider setting a goal to increase the number of medical-surgical nurses who are certified medical-surgical registered nurses (CMSRN®). Recently, I had the opportunity to present a hospital in Illinois with the The AMSN PRISM Award®. While there, I was informed that a staggering 77% of the nurses on the unit receiving the AMSN PRISM Award were certified! How did that happen? The nurses and their leadership team decided to pursue excellence in medical-surgical nursing through specialty nursing certification. They found nurses to champion specialty nursing certification. You may want to consider becoming a nursing champion and finding other nursing champions. Consider starting a study group, and raise awareness of the opportunities provided by your facility for specialty nursing certification. Take the time to thoughtfully look at your environment, look at the opportunities for growth, and then begin your pursuit of excellence.
Sen. Roy Blunt Chairman Subcommittee on Labor, HHS and Education Senate Appropriations Committee U.S. Capitol Room S-128 Washington, DC 20510 Sen. Patty Murray Ranking Member Subcommittee on Labor, HHS and Education Senate Appropriations Committee U.S. Capitol Room S-128 Washington, DC 20510 Rep. Nita Lowey Chairwoman Subcommittee on Labor, HHS and Education House Appropriations Committee 2358-B Rayburn Building Washington, DC 20515 Rep. Tom Cole Ranking Member Subcommittee on Labor, HHS and Education House Appropriations Committee 2358-B Rayburn Building Washington, DC 20515 Dear Chairs and Ranking Members, On behalf of the 14,000 members of the Academy of Medical-Surgical Nurses (AMSN), as the organization’s President I write to submit this letter as testimony for the record to the House and Senate Appropriations Subcommittee on Labor, HHS and Education, regarding FY 2020 appropriations for Title 8 nurse workforce development programs, the National Institute of Nursing Research, and the Agency for Healthcare Research and Quality, all of which are priorities for members of our organization. AMSN is the only national specialty nursing organization dedicated to developing medical-surgical nurses personally and professionally. You know our members well as the type of nurse who would provide care for a person in the hospital. Our practice is the largest specialty in nursing, consisting of an estimated 650,000 professionals, and is the foundation of all hospital and community nursing practice. Our national agenda includes promoting evidence-based safe staffing models, addressing social determinants of health and the links between hospital care and postoperative health, promoting professional respect and safety in nursing and health care professions, and advancing nurses into leadership roles in health, community and public service. We simply request that Congress, in making appropriations decisions, listen to nurses. Med-surg nurses work on the front lines of care delivery every day. America’s 4 million nurses represent the largest workforce in our nation’s health care sector. We know what is best for our patients. We know what makes for effective, efficient, compassionate care. We live it every day, and we bring this experience to our agenda for advocacy. AMSN Requests for FY 2020 Labor, HHS and Education Appropriations AMSN requests the Congress provide the following appropriations within the Labor, HHS and Education Appropriations bills for FY 2020: U.S. Department of Health and Human Services, Health Resources and Services Administration, Title 8 Nursing Workforce Development … $266,000,000 U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Nursing Research … $173,000,000 U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality … $460,000,000. Title 8 Nursing Workforce Development AMSN requests Congress provide $266,000,000 in appropriations for nurse workforce development programs under Title 8 of the Public Health Service Act for FY 2020. We urge Congress once again to not accept the Administration’s proposal to severely reduce this program, and to support the joint recommendations of the Nursing Community Coalition, which we share. Administered by the Health Resources and Services Administration, Title 8 Nursing Workforce Development programs are instrumental in bolstering and sustaining the nation’s nursing pipeline. Title 8 programs address all aspects of the nursing workforce demand, including education, practice, recruitment, and retention. Furthermore, these programs increase access to care in communities that need it most; those in rural and underserved areas. It is also critically important that these nursing workforce programs continue to have individual line items, which include: Advanced Nursing Education (Sec. 811), which includes the Advanced Education Nursing Traineeships and Nurse Anesthetist Traineeships Nursing Workforce Diversity (Sec. 821) Nurse Education, Practice, Quality, and Retention (Sec. 831) NURSE Corps Loan Repayment and Scholarship Programs (Sec. 846) Nurse Faculty Loan Program (Sec. 846A) Comprehensive Geriatric Education (Sec. 865) Our members have ranked nursing workforce development among their highest priorities in policy. In a survey of AMSN members taken August 2019, they stated that they prioritize: Health care workforce development Advocacy for nurses entering the academic workforce and valuing what nurse educators do and provide Nurse staffing - including conversations that innovate care delivery Addressing gaps in education that contribute to provider burnout and lack of quality care. Title 8 programs effectively address these priorities. They must be sufficiently funded. America’s population is growing, aging, becoming increasingly diverse, and requiring more health care year by year. Its investment in the future nursing workforce through Title 8 appropriations delivers important value by helping to ensure a supply of highly educated and well-prepared caregivers, supporting the development of nursing faculty and needed educational infrastructure, and expanding incentives for nurses to choose public health careers. National Institute of Nursing Research (NINR) AMSN requests Congress provide $173,000,000 in appropriations for the National Institute of Nursing Research (NINR) within the National Institutes of Health for FY 2020. We associate ourselves with the recommendations of the Nursing Community Coalition for NINR funding. As one of the 27 Institutes and Centers at the National Institutes of Health, NINR’s research projects funded through this Institute are aimed at reducing burdensome chronic illness, improving end of life care, and promoting patient-centered care across the life continuum. From disease prevention and global health, to precision medicine and genomic studies, NINR is at the forefront of nursing science and research. Agency for Healthcare Research and Quality (AHRQ) AMSN requests Congress provide $460,000,000 in appropriations for the Agency for Healthcare Research and Quality (AHRQ) FY 2020. We ask that Congress one again not adopt the Administration’s request to transfer AHRQ to the National Institutes of Health, rename it the National Institute for Research on Safety and Quality, and reduce its funding by $112.5 million. We associate ourselves with the recommendations of the Friends of AHRQ funding request. Health services research of the type supported by AHRQ and its budget holds promise for improving health care, improving health, and promoting the cost-efficiency of our nearly $4 trillion U.S. health care sector. AHRQ-funded research identifies waste in health care so that stakeholders in the system can learn and change for the better. AHRQ initiatives have helped to reduce the incidence of hospital-acquired conditions and are well-situated to help the country and the health care industry respond effectively to the growing number of patients with multiple chronic conditions. Thank you for your attention to these requests. We stand ready to provide the Subcommittees any additional information you may require on these subjects. Sincerely, Robin Hertel, EdS, MSN, RN, CMSRN President
Happy Pride Month! AMSN continues to work tirelessly to bring value to our members and customers. As you’ve likely seen, we’ve rolled out podcasts, videos and new webinars. We’re building new online learning courses in behavioral health for medical-surgical nurses, significantly increased our advocacy and legislative activities and continue to explore ways we can support you as you navigate the increasingly complex and rapidly-changing work environment. Doing so requires significant strategic thinking and foresight. What will nursing look like in 2 years? In 5 years? What will med-surg nurses need to help them in the workplace? How will the nursing students in school today be prepared for the changing practice environment? There aren’t answers to these questions, at least not yet, but it doesn’t mean they aren’t critical to consider. Now I don’t know anyone with a crystal ball, so we’re left to try and understand today’s work environment and how external factors are likely to affect it. In the world of strategic thinking and foresight, these factors are called ‘signals’. We, at AMSN, are continuously scanning the external environment for such signals to understand how they will impact you and your profession in the future. To do so takes a lot of expertise and experience. We are not doing this alone. AMSN has an exceptional board made up of committed medical-surgical nurses from a variety of backgrounds and practice settings. We have hundreds of volunteers that have contributed their expertise and experience to the work we are doing. We can’t do it without them. You see, diversity improves the decision-making process. As one of my George Washington University doctoral professors noted in a publication on strategic thinking, “Diversity of age, gender, education, experience, organizational tenure, knowledge, and skills has been found to enhance work group creativity, judgmental quality and overall outcomes” (Goldman, 2012, p. 28). In fact, many scholars and experts in strategic thinking have identified the team involved in decision-making as one of the strongest indicators of success. It is not enough to have a smart ‘leader’ making the decisions for an organization. Teams, made up of diverse individuals willing to critically debate opportunities before reaching consensus on a decision, increase the success of an organization. Collectively we are better thinkers and make better decisions than we do individually. That’s because we bring a variety of perspectives, lived experiences and expertise together in committees, task forces, teams, and our boards of directors, which enable us to consider many alternatives that might not be apparent to one individual. The greater the heterogeneity of the team, the better. So, let us remember to value and embrace those that are ‘different’ than we are. Let us welcome them to the table and learn from them. Let us truly strive to ensure that we are representative of all people in the work we do. AMSN is committed to increasing the diversity and inclusion of its staff, board, volunteers and members. We have so much we can learn from all of you. As we celebrate Pride Month, let us celebrate all that diversity and inclusion can do to make us stronger and better…as nurses, as leaders, and as people. Goldman, E. (2012). Leadership practices that encourage strategic thinking. Journal of Strategy and Management, 5(1), 25-40. doi:10.1108/17554251211200437
The House of Representatives was expected the week of Mon., June 10, to vote on legislation that includes strong funding for key AMSN workforce development and research priorities. Along with the Nursing Community Coalition, AMSN and its members have been urging Congress to support these vital funding priorities. A key committee on May 8 cleared the FY 2020 Labor-HHS-Education Appropriations bill (HR 2740, H Rept 116-62) providing increases in Title 8 nurse workforce development and the National Institutes of Nursing Research. It also provided level funding for the Agency for Health Care Quality and Research (AHRQ), though overall AHRQ funding was cut from expiration of a key funding source authorized by the Affordable Care Act (ACA). But the House bill’s funding increases are at risk: its overall $11 billion increase in funding depends on bipartisan congressional leaders and the Administration agreeing to increase overall domestic spending for 2020 which they have not yet done. See AMSN’s written testimony to Congress HERE. New legislation has been introduced in the U.S. Senate that reauthorizes Title 8 nurse workforce development programs AMSN supports. AMSN is calling upon members to contact their members of the Senate to cosponsor the Title 8 Nursing Workforce Reauthorization Act (S 1399), introduced by Sens. Jeff Merkley (D-OR) and Richard Burr (R-NC). Support Your Workplace – Be Heard in Congress on Nurse Workforce Legislation here: https://docs.google.com/document/d/1exr1Me48UjtfS0qF7u_IfqQZayJ2efXaJVkUYiddIdk/edit More than a dozen major national nursing organizations joined AMSN in signing onto national-level regulatory comments May 31 in support of health information technology improvements. Led by AMSN, the letters supported making more patient health information available to health care professionals through trusted exchange networks. They also favored requiring hospitals to improve the effectiveness and reliability of electronic patient notifications. Read the letters to the Department of Health and Human Services, and the Office of the National Coordinator for Health Information Technology. State-based legislation opposed by AMSN has stopped progressing in the states of Illinois and Pennsylvania. A bill in Illinois inconsistent with AMSN policy on safe staffing for patient care, HB 2604, failed to be cleared by the Rules Committee before the legislature adjourned for the summer. AMSN advised the legislature that staffing should be based on “patient acuity, and the skill and capability of individual nurses in a unit… By contrast, HB 2604 sets fixed nurse-patient ratios in Illinois health care facilities; therefore, our organization is opposed to the legislation in its present form.” Likewise, a bill in Pennsylvania that risked complicating nurses’ CMSRN and CCCTM credentials, HB 811, has failed to progress in committee and is likely finished for the year. “We respect that the intent of HB 811 is to open employment and economic opportunity for persons who have criminal records and have paid their debts to society,” wrote AMSN President Hertel. “Our organizations are concerned that HB 811 as introduced includes several problematic and unclear provisions.
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June has had a long history of celebrations with weddings and graduations; of freedom with the celebration of Juneteenth; and of personal and social rights with the celebration of Pride month. Unfortunately, nursing hasn’t always celebrated the differences that make us stronger as a profession. We have, on occasion, denied our colleagues the freedom to be themselves in the practice setting and failed to acknowledge the personal and social rights of the members of our profession. I have a colleague who has told stories about increasing stress and anxiety after informing other members on the nursing team of his identification with the LGBTQIA community. Rather than a feeling inclusivity and freedom to be himself, my colleague described being subjected to a hostile and often homophobic environment, even to the point of being told by a nurse leader to “stop acting so gay." Nursing is supposed to be the essence of caring and yet more than 50% of persons identifying as being LGBTQ reported hearing jokes in the work setting about lesbian or gay individuals according to a study completed just last year (Fidas & Cooper, 2018). This essence of caring is such an important part of our profession that it is the first standard in the Nursing Code of Ethics which charges nurses to care for others, including their colleagues, with compassion and respect (American Nurses Association, 2015). Perhaps the issue is not so much that nurses wish to be exclusive to those who identify as part of the LGBTQIA community but instead an unawareness of the unique culture, language, and barriers that members of this community face. Here are a few things nurses can do to increase awareness and cultural competence: • Promote an inclusive practice environment. An inclusive practice environment decreases stress and burnout, while promoting feelings of safety and ultimately, improved patient outcomes. • Recognize the need for cultural competency training. Nurses can establish their own LGBTQIA clinical competence as well as spearhead the drive to increase cultural awareness of everyone in the organization. Multiple resources are available that use a variety of learning modalities including in-person training, webinars and learning modules (see insert). • Interprofessional collaboration. Nurses can lead committees made up of multidisciplinary healthcare team members in developing processes and nondiscriminatory position statements that create an environment of inclusivity. • Discuss barriers and needs. Nurses can engage in open and frank discussions with members of the LGBTQIA community regarding the use of preferred pronouns, medical and psychological issues faced. • Engage in advocacy. Nurses can work to promote and welcome the presence of the family of choice of a colleague who identifies as part of the LGBTQIA community as a part of company activities. My colleague eventually left nursing because of the increased stress and hostility of the workplace. It is heartbreaking, not just because of the loss of a member of our profession, but also because what he faced somehow diminished the light that was within him. He was never the same vibrant personality but instead became wary and withdrawn. As nurse leaders, each of us can work to transform the healthcare setting to one of inclusion, respect, caring and nondiscrimination. Are you willing to start the journey? The Med-Surg Moments: The AMSN Podcast Friday 21st edition discussed issues affecting the LGBTQ community and med-surg nursing professionals. Get the episode everywhere you get your podcasts, or visit here: www.medsurgmoments.org More Helpful Information / Links: Gay and Lesbian Medical Association: Health professionals Advancing LGBT Equality. http://www.glma.org Lavender Health. https://lavenderhealth.org National Coalition for LGBT Health. https://healthlgbt.org National LGBT Cancer Network. http://cancer-network.org Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE). www.sageusa.org
Community. Robin Hertel, AMSN President, spoke of community in her ‘Robin’s Nest’ message in this newsletter. Community likely means something slightly different to all of us, but one thing community will have in common for all of us is that it invokes a sense of belonging. Whether geographical, spiritual, familial or professional, community is where we find expertise, wisdom and support from people that we identify with. As we saw with Senator Walsh’s uncalled for comments, the nursing community immediately came together and rallied as one. Regardless of your practice setting, years of experience, educational preparation …We. Are. One. There is power in community. There is power that is so much greater than any one individual. Together we are more than the sum of our parts. There is a German term for this, it’s called ‘gestalt’. That’s why AMSN exists. Community. Gestalt. Being more than the sum of our parts. Connection is an integral part of AMSN…it’s in our tagline. Compassion. Commitment. Connection. We want you to connect with your peers and build a community. A community of medical-surgical nurses, proud and strong. AMSN’s online community, the Hub, provides you with a means to connect and build community with your peers. It’s where you can find answers, expertly moderated by AMSN’s Clinical Practice Committee, so that every answer is grounded in evidence-based practice. It’s where you can find advice, input, best practices, and even share a laugh or two. We encourage you to visit and engage with your community in the Hub. Over the next few months you’ll see exciting changes in the online community. We’ll be adding new communities, based on member needs. We’ll be improving the infrastructure to be more engaging. We hope these changes resonate with you because we want you to engage with your peers and colleagues. We want you to immerse yourself in your community. To belong. To contribute. To grow. Gestalt. Together, we are more than the sum of our parts.