AMSN & MSNCB CEO Terri Hinkley Earns Doctorate, Gains Invaluable Lens to View the Future of Nursing

  • Posted on: 27 June 2019
  • By: AMSN

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.”

CEO's Corner: Happy Pride Month!

  • Posted on: 20 June 2019
  • By: AMSN
Terri Hinkley, AMSN CEO

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

AMSN Legislative Brief June 2019

  • Posted on: 17 June 2019
  • By: AMSN

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:

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.

Robin's Nest - AMSN President's Message, June 2019

  • Posted on: 17 June 2019
  • By: AMSN
Robin Hertel, AMSN Board President

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:

More Helpful Information / Links:
Gay and Lesbian Medical Association: Health professionals Advancing LGBT Equality.
Lavender Health.
National Coalition for LGBT Health.
National LGBT Cancer Network.
Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE).

Robin’s Nest

  • Posted on: 6 May 2019
  • By: AMSN

A Sense of Community

by Robin Hertel, EdS, MSN, RN, CMSRN
President, AMSN

It’s been a tough couple of months for nursing. In February, a nurse at Vanderbilt was arrested and charged with reckless homicide after a medication error resulted in the death of a patient. Just last month, nurses were in an uproar over Washington Senator Maureen Walsh’s uninformed comments about what nurses do. Incidents like these, and those that happen on a daily basis can bring nurses closer together to offer support and build a sense of community.

Nurses spend a lot of time together in the practice setting; sometimes more time than we spend with our outside friends or members of our family. Incidents such as those that made the news recently provide an opportunity for nurse leaders such as yourself to build and strengthen the sense of camaraderie and teamwork among all the members of the nursing team.
Building a sense of community needn’t (and shouldn’t) wait for a negative or traumatic incident to draw nurses together. Beginning now, you can take steps to form a tight community of support that will increase resilience and decrease the risk of burnout for all the members of the team.

Begin by discussing your shared values – What brought you into nursing? What does excellence in patient centered care look like? What is your ultimate goal in the delivery of nursing care? By discussing these questions and identifying areas of similarity you can begin to build a community with a sense of purpose and a set of values that everyone is working towards.
Also, pay attention to those areas that are different – recognizing that each of us brings different life experiences and talents to the table. Capitalizing on these differences to make a stronger and broader sense of community is a way to promote the synergy of the group.

I was working on a fairly good-sized med-surg unit when I started my nursing career. The nurses had a wide variety of backgrounds and educational levels. Our colleagues - patient care technicians, physical therapists, nursing students and support staff would often visit for short periods throughout the day and we found that despite the varied job responsibilities, educational level, and cultural background, we had a lot in common. It was only after a tragedy that shook us all to the core however, that brought us together into a tightly knit group.

My mentor, and one of my favorite nurses, was killed tragically in an accident with a semi-truck one Saturday morning. Needless to say, I was devastated. Yet our little community pulled together even tighter and supported one another; calling each other to check on how we were doing, discussing the impact one person’s life had on so many, picking up shifts for those who needed some time to grieve. We all wanted to attend the funeral of course and pay our last respects to our colleague and friend. The nursing students and their instructors along with nurses from other units all volunteered to cover our unit so we could attend the funeral together!

Following this, we took some time to tell our stories about our colleague – but it didn’t stop there. We created opportunities to share our own stories in daily huddles. We had created an environment of safety, trust, and collegiality that lasted for quite some time. Everyone has gone their own separate ways of course; pursuing new avenues of practice or retiring. Yet I remember those days of having a little community as one of my favorite things of nursing.

AMSN Commitment to Clinician Well-Being and Healthy Practice Environment

  • Posted on: 5 March 2019
  • By: AMSN

The Academy of Medical-Surgical Nurses (AMSN) is strategically committed to healthy practice environments for medical-surgical nurses. AMSN’s first strategic goal is to support medical-surgical nurses in navigating the changing environment and enhancing their physical, psychological and emotional well-being. AMSN is focused on education, research, strategic partnerships and advocacy to achieve this important goal.

Nursing is hard work, and as a result, nurses suffer from significant stress and stress-related illnesses and are at greater risk of professional burnout (Bao & Taliaferro, 2015; Boamah & Laschinger, 2014; Brunetto, Rodwell, Shacklock, Farr-Wharton, & Demir, 2016; Manzano-Garcia & Ayala, 2017; Rahimnia, Karimi Mazidi, & Mohammadzadeh, 2013; Schaufeli, Leiter, & Maslach, 2009). In fact, the nursing profession is one of the professions with the highest level of burnout (Manomenidis et al., 2017; Manzano-Garcia & Ayala, 2017).

Burnout affects nurses’ physical health, memory, absenteeism and job satisfaction (Laschinger & Grau, 2012; Manomenidis et al., 2017; Sweet & Swayze, 2017) and costs institutions a significant amount of money in sick time and employee turnover, not to mention the financial and reputational costs associated with patient harm or medical errors (Laschinger & Grau, 2012). Furthermore, nurse burnout impacts their ability to provide safe patient care with optimal patient outcomes (Bao & Taliaferro, 2015; Laschinger & Grau, 2012; Manomenidis et al., 2017; Manzano-Garcia & Ayala, 2017; Sweet & Swayze, 2017). Therefore, the risks to the personal physical and mental health of the nursing workforce, patient well-being and institutional well-being because of burnout are significant.

AMSN Position Statement on Healthy Practice Environments

AMSN has drafted a position statement related to Healthy Practice Environments (HPEs). This position statement defines AMSN’s philosophy and stand on the obligations employers and nurses share in the well-being of medical-surgical nurses and can be found here.


AMSN provides education about well-being, self-care, resilience and the negative effects of burnout, lateral violence, nurse bullying, etc. at its annual convention. AMSN continues to build education and professional resources for medical-surgical nurses to increase knowledge and the necessary skills and tools to combat these negative effects.

AMSN is launching a bi-monthly podcast series, of which one regular topic will be self-care for the medical-surgical nurse. Through interviews with industry leaders and experts, AMSN will provide subscribers/listeners with practical tools and skills to combat negative states such as burnout, moral injury, second victim syndrome, etc.


AMSN is conducting a research study about medical-surgical nurses’ perceptions of their work environment, using the Practice Environment Scale. AMSN will disseminate the results and develop programs to address issues identified in the research results.


AMSN actively advocates on behalf of the over 600,000 medical-surgical nurses in the United States about issues such as staffing, nurse education, workforce issues, and practice issues. We strongly support safe and effective staffing assignments that provide optimal patient care while also minimizing the negative effects of ineffective staffing, such as unfinished nursing care, burnout, stress and turnover intentions. AMSNs position statement on staffing can be found here.

AMSN is committed to the well-being of the medical-surgical nurse and is happy to support the National Academy of Medicine Action Collaborative on Clinician Well-Being and Resilience. We have a strategic and long-term commitment to promoting healthy practice environments for medical-surgical nurses and would be pleased to share the action collaborative’s work with our community of medical surgical nurses.

The Academy of Medical-Surgical Nurses (AMSN; is a vibrant community of medical-surgical nurses that represents the largest group of nurses practicing in the acute care environment today. AMSN promotes excellence in medical-surgical nursing by providing education, professional resources, and networking opportunities to its over 12,000 members. AMSN partners with other health care organizations and industries to improve the country’s patient care.

Medical-surgical nurses apply high-level skills, as well as compassion and commitment, to care for patients in a broad range of settings, from hospitals to communities to battlefields. They care for patients who are being treated for cancer, heart disease, diabetes, and many other acute and chronic illnesses. Medical-surgical nurses are also influential advocates, leaders, educators, and researchers. Through multi-media platforms, AMSN helps give nurses a voice in making a positive impact on the health care industry. The organization also gives nurses the tools they need to apply evidence-based practice to achieve better patient outcomes.

Of the estimated 3.0 million practicing registered nurses in America, approximately 600,000 are medical-surgical specialists, making it the single largest nursing specialty in the country.


Bao, S., & Taliaferro, D. (2015). Compassion fatigue and psychological capital in nurses working in acute care settings. International Journal for Human Caring, 19(2), 35-40.
Boamah, S., & Laschinger, H. (2014). Engaging new nurses: The role of psychological capital and workplace empowerment. Journal of Research in Nursing, 20(4), 265-277. doi:10.1177/1744987114527302
Brunetto, Y., Rodwell, J., Shacklock, K., Farr-Wharton, R., & Demir, D. (2016). The impact of individual and organizational resources on nurse outcomes and intent to quit. Journal of Advanced Nursing, 72(12), 3093-3103. doi:10.1111/jan.13081
Laschinger, H. K., & Grau, A. L. (2012). The influence of personal dispositional factors and organizational resources on workplace violence, burnout, and health outcomes in new graduate nurses: A cross-sectional study. International Journal of Nursing Studies, 49(3), 282-291. doi:10.1016/j.ijnurstu.2011.09.004
Manomenidis, G., Kafkia, T., Minasidou, E., Tasoulis, C., Koutra, S., Kospantsidou, A., & Dimitriadou, A. (2017). Is self-esteem actually the protective factor of nursing burnout? International Journal of Caring Sciences, 10(3), 1348-1359.
Manzano-Garcia, G., & Ayala, J. C. (2017). Insufficiently studied factors related to burnout in nursing: Results from an e-Delphi study. PLoS One, 12(4), e0175352. doi:10.1371/journal.pone.0175352
Rahimnia, F., Karimi Mazidi, A., & Mohammadzadeh, Z. (2013). Emotional mediators of psychological capital on well-being: The role of stress, anxiety, and depression. Management Science Letters, 3(3), 913-926. doi:10.5267/j.msl.2013.01.029
Schaufeli, W. B., Leiter, M. P., & Maslach, C. (2009). Burnout: 35 years of research and practice. Career Development International, 14(3), 204-220. doi:10.1108/13620430910966406
Sweet, J., & Swayze, S. (2017). The multi-generational nursing workforce: Analysis of psychological capital by generation and shift. Journal of Organizational Psychology, 17(4), 19-28.

AMSN Launches The Med-Surg Moments Podcast!

  • Posted on: 4 March 2019
  • By: AMSN

Join Us in Our Pod Every Month

The Medsurg Moments:The AMSN Podcast is an engaging look at the lives of - and surrounding- medical-surgical nurses. We’ll have guests on from every corner of the industry, bringing you stories that are relatable and compelling on myriad topics.

Our goal is to bring you interesting perspectives and insight that will serve you at any step of your nursing career.

Listen to, subscribe and download your Med-Surg Moment podcasts at iTunes, Spotify, Google Play Music, and Stitcher. Visit our Med-Surg Moments Podcast site here:!

CEO’s Corner - Dawning of a New Day – AMSN’s New Logo and Branding

  • Posted on: 4 March 2019
  • By: AMSN

Terri Hinkely, MBA, BSN, RN, CCRC, AMSN CEO

As individuals in the nursing community, we are fundamentally wired to always be listening, always be considering the needs of those around us. We assess, we plan, we implement, and we evaluate. The nursing process is the cornerstone of nursing practice. At AMSN, we work hard – month in and month out – to embody the same process when we interact with our members. The things that matter to each and every one of you, also matter to us.

We are excited to say that we have listened to you and how you would like AMSN to continually communicate, engage and interact with you. We are thrilled to announce an official re-branding of AMSN – with new colors, new logo, brand-new website, blog and more - due to launch in May of this year! Of course, you already have seen that we have recently launched our podcast, “Med-Surg Moments: The AMSN Podcast” that is hosted by nurses, for nurses. You can subscribe to our podcast through iTunes, Spotify, Google Play Music, and Stitcher. You can also visit our podcast site at

You can look forward to a streamlined, user-friendly website for AMSN, where you can find everything from convention information, continuing education, social interaction, and more – quickly and seamlessly. You’ll see a modern look and feel and will have more opportunities to get the most out of your AMSN membership. As ever, we are always listening to you, and what you want out of your AMSN experience.

If you have any thoughts to share on things you’d like to see in the coming year, please let us know. We will continually strive to make AMSN your source for professional development, certification, scholarships, and advocacy.

You can depend on us, just as your patients and colleagues depend on you.