NURSES’ NOTESTHE OFFICIAL MEMBER NEWSLETTER OF THE AMERICAN ASSOCIATION OF MANAGED CARE NURSES

Volume Thirteen, Number Four

Insidepg 2..... President’s Message Cont.pg 2..... The Value of Mentoringpg 2..... New CMCNs!pg 3..... New Members!pg 4..... New Members Continuedpg 4..... Funny Nurses Advice!pg 4..... Nurse Leader of the Year!pg 5..... Legislative Article

The Best Example of Leadership is to Lead by Exampleby Michael Garrett, RN, MSN, CTT+

President’sMessage

With this message,I hope to concludemy business aspresident withmany thanks to allof those greatpeople in our orga-nization who havehelped and partici-pated along the way,recognize thegrowth that we haveaccomplished andlook towards the fu-

ture. It is difficult to believe, but my two yearterm is coming to a close. Though sometimescliché, it is all too true “time flies when you arehaving fun”. There are so many people that havemade my time as president a true pleasure, butlet me just highlight a few standouts.

First and foremost I must thank Katie Eadsfor her unwavering support and whose guid-ance led to an incredibly smooth term in of-fice. There are many pieces to the puzzle ofbeing president, but with your help I was ableto fit them together seamlessly. This certainlyassisted me through difficult decisions andtimes. Secondly, Dr Williams, I wish to thankyou for believing in me and showing your sup-port. Thirdly, I must mention Patti, my task-master, always making sure I was present forconference calls, taking great meeting min-utes and also being an ear to bend whenneeded. I would be remiss without mention-ing the Board of Directors. I am truly appre-ciative of the support you all gave me duringmy term, both members past and present. Iam certain that your hard work and dedica-tion will continue in the coming years. Lastly,I would not have been able to be as effectiveas president if the company I work for ECI andmy NY Team did not allow me the necessarytime to participate and hold this rank in sucha prestigious organization. It has truly beenmy privilege and honor to serve as your Presi-dent for the last two years. Your willingnessto speak up and stay active keeps us growing.

by Sheryl Riley, RN, OCN, CMCN

Whether you are called a Corporate Executive,a Hospital Administrator, a Case Manager, aUtilization Review Nurse Specialist, or anyother job title, it is imperative you have per-fected, at least to some degree, basic leader-ship skills. In the current business climate,almost every single position in the ManagedCare world incorporates the qualities of aleader into the job description.

Many feel that you must be a Manager or Su-pervisor or Executive of some type to be aLeader. Nothing could be further from the truth.Certainly not everyone can be the “boss,” andnot everyone has staff members reporting tothem. Nevertheless, even in what some mayfeel is the very lowest position, the character-istics of “leading” are so important. One ofthe best ways to exemplify good leadership isto live your values and principles each andevery day. Never back down on what you knowis honest and true. Treat others with respectand dignity, and give them credit for havingthe knowledge they have. Of course, theirthoughts and feelings about a particular sub-ject may not agree with yours, but respecttheir right to have those thoughts and feel-ings. And understand that it is all right to agreeto disagree.

Recognize and respect diversity. It is a won-derful thing that we are not all the same; whata boring world this would be if we were. In-stead, we come from different backgrounds,different cultures and different ways of livinglife. Leaders use these differences in thepeople they work with and to good advantagefor all. Leaders will understand that the diver-sity in all of us only helps to bring a freshnessand vitality to the workplace.

One of the most important qualities of beinga good leader is to not be afraid of gettingyour hands “dirty.” If you have employees work-ing under you, do not give them any task orjob that you would not do yourself. Of course,for those in management, delegation is im-portant, but many times we need to remem-ber our “roots” - we all started “at the bot-tom.” We have all “been there” at some pointin our careers, and we know what it is like to“work in the trenches.” We need to remember...continued on page 2

that those who may be new to the business orprofession, or new to our staff or work area,may not have the experience we have, andthey may need some help becoming ac-quainted with the normal processes andworkflows. New staff members are not mon-sters or burdens; a good leader will help themassimilate easily, whether they are your em-ployees or your co-workers. We all know changeis inevitable --- and lately we have all seen agreat deal of change, with most likely more tocome. The very nature of change means it willhave an impact --- sometimes good, some-times not so good. One of the things leaderswill do when change occurs is thoroughly ex-plain the change to those they manage or workwith. It is very disconcerting to introduce achange with no explanation or instruction.This type of action only serves to underminetrust, and loss of trust can be devastating toa team.

Being a good leader does not mean you mustbecome “one of the guys” --- but it does meanyou must keep everything in perspective. Youmust remember and understand who yourstaff and co-workers are, and where they comefrom. You must realize they may have differ-ent ideas than you --- but that their ideas mayhave tremendous merit, and at least deserveto be heard. You must seek to gain and keepthe trust and respect of those around you byshowing you care, you respect them for theiruniqueness, and you appreciate their contri-bution. And it never hurts to remember whatTEAM means --- Together Everyone AchievesMore.

2

President’s Messagecontinued...continued from page 1This year was marked with incredible successof retaining membership as well as growingit. Total membership increased approximately38% over the course of 2008. Now that iswhat I call a great success. I believe thisgrowth is a direct result of hard work on thepart of the AAMCN staff and the membership.Getting the word out, talking it up and lettingpeople know we are the only association forManaged Care Nurses.

As many of you are aware, we just completedthe Fall Managed Care Forum, with a recordexhibit hall turnout. Even with the sloweconomy, we had increased attendance fromlast year. WOW!! We have begun to tally thereviews from the conference with an over-whelming response of excellent. People werepleased with the speaker selection, the topicscovered as well as the vendors. Apparently,our agenda, speakers and location really gavehealthcare professionals a reason to come tothe conference. In other good news this year,the four nurses who took the certificationexam this fall can proudly say they all passedand are now Certified Managed Care Nurses.

In its second year, the Managed Care Nurseof the Year award went to Jan Gilbert. We arepleased and proud to honor Jan with this award.Please keep those in mind who you think de-serve next year’s award.

I want to take this moment to congratulateand lend all of my support to our new Presi-dent LaNita Knoke. We are so proud andpleased that she will be taking over in January2009. LaNita is a long standing member ofAAMCN and has been a supporting memberof our team not only during my Presidencybut also for previous presidents. She has alsoserved and chaired for the Leadership Com-mittee, Conference and other important roleswithin AAMCN. I am certain she will continuethe legacy that I inherited from those beforeus and continue to help the organization growto further success in years to come.

I have been a member of AAMCN for the past12 years and I will continue to stay involvedin everyway I can. Again, it has been my dis-tinct honor and privilege to be your Presidentover the last 2 years. I will miss my role but Iwill continue to support, and help AAMCN growbecause I believe we are the only associationthat is the true voice of Managed Care Nurseseverywhere.

Remember we are only limited by our own shortsightedness,

Sheryl

Congratulations New CMCNs!

Nurse Leader of theYear Award!

The Leadership Institute of the American Association of Managed CareNurses (AAMCN) is pleased to announce the 2008 Managed Care NursingLeader of the Year, Janet (Jan) Gilbert, MSN, BSN, CMCN. Though she wasunable to attend the conference, Ms. Gilbert’s award was announced atthe Fall Managed Care Forum Pre-Conference on November 5, 2008 at theParis Hotel in Las Vegas, NV.

Congratulations Jan!

Julie Ann Brubeck, RN, CMCN

Anthem - Wellpoint

Victoria Lane Burk, RN, CMCN

Wellpoint

Tammy A. Davis, RN, CMCN

Anthem BCBS of MO

Debra Ellingson, RN, CMCN

Mary S. Gross, RN, CMCN

Anthem

Phyllis E. Guest, RN, BSN, CMCN

Anthem

Marissa A. Harper, RN, BSN, CMCN

United Health Group/AmeriChoice

Regina A. Johnson, RN, CMCN

Anthem

Cindy A. Jones, BSN, RN, CMCN

DMBA

Lynn E. Keough, LPN, CMCN

Humana

Anne Marie Leja, RN, CMCN

Humana

Mari E. Miceli, RN, CMCN

Wellpoint (Unicare State Indemnity Plan)

Susan H. Moore, RN, BS, CMCN

Anthem Blue Cross/Blue Shield

Janice W. Mosby, BSN, RN, CMCN

DMBA

Mary L. Plowman, RN, CMCN

HMC, Anthem Blue Cross Blue Shield

Amber L. Reeder, RN, BSN, CMCN

Anthem BC/BS/Wellpoint/HMC

Lana Kay Richmond, MSN, CMCN

WellPoint - HMC

Joanne Smith, RN, CMCN

Florida Memorial Health Network

Joyce E. Thiem, RN, CMCN

Texas Children's Health Plan

Janet Treadwell, RN, MSN, PhD, CMCN

Texas Children's Health Plan

Diane K. Woodington, LPN, CMCN

Humana

Stacey A. Zukowski, LPN, CMCN

Humana

Mary A. Bonton, RN, BSN, CMCN

Americhoice by United Healthcare

3

Welcome New Members!Jeanne Alexander, RN, BSN, CCMHighlands Wellmont Health Network

Ellen Aliberti, RNUnited Health Care - HPN

Adaline AllredKindred Healthcare

Karen Astley-Moore, RN, BSN, OCND K Pierce and Associates

Celeste Bahia, RNOperating Engineers Local 825

Mary Barone-Leitch, BSN, CPUM, CPUR, CCMShaller Anderson, an Aetna Company

Tonyce Bates, RNAmgen

Jhenessey BathanKindred Healthcare

Karen Beamer, RNHumana

Sharon Bennett, RN, URCMBethesda Memorial Hospital

Suzy Bick, RNAnthem/Wellpoint

Marilyn BlezaKindred Healthcare

Linda Bognolo, RN

Donna Booth-Dillon, RNSHPS, Inc.

Susan Breitenberg, BS, RN

Stacey BrocklehurstCapital BlueCross

Stephanie BrundageKindred Healthcare

LaThrease Bunton, RNAnthem/Wellpoint

Shannon Callahan-Mynatt, RNHMC Wellpoint

Margaret Elaine Cannon, RN

Susan Clubb, RNUniversal American Corp. Heritage HealthSystems

Karen Coomer, RN, BS, CMCNAnthem

Catherine Couch, RNAnthem/Wellpoint

Charlotte Craver, RNValue Options, Inc.

Gwendolyn Dale Mc Fate, RN, BSNUniversal American Corp. Heritage HealthSystems

Lisa DaveyHMC/Wellpoint

Jeffrey De Lay, RNGenesee County CMH

Lynn Deerman, MSNEnhanced Care Initiatives

Gwen Duffield, RN, CCMAetna

Maxine FfrenchGulfquest

Margaret FolseBCBS of Louisiana

Karen I. Foore, RN, BS, MA, CPHQ, CCM,CPUR, CPUMFallbrook Hospital

Vanessa Foote, RN, CCMHighlands Wellmont Health Network

Carol Frost, RNHMC Wellpoint

Sherry Galow, LVNTx. HealthSpring Insurance Co.

Kathleen Gilmore, RNAnthem

Tamara GrayKindred Healthcare

Robert Greenberg, RNKindred Healthcare

Tracey C. Gunderson, ADNCommunity Heatlh Plan of Washington

Beverly Hansen, RNEnhanced Care Initiatives of AL

Marsha Hass, RN, BSWestwind Options

Susanne HenryGulfquest

Judy A. Herbstreit, RNHumana Inc.

Delphine Hill, BSNBlue Cross Blue Shield of Georgia

Darlene Holzbach, RNHumana, Inc.

Linda Hopkins, RNHMC

Marjorie Horner, RNGreat-West Healthcare/Cigna

Ginny Hourigan, RNWellCare

Deborah JacobsGulfquest

Cindy Johnson, BSN, CCMMercy Health Plans

Kathleen Johnson, RNGEHA

Paulette Jones, RN

Ruth Devine, Assoc.

Shirlene Kassing, RN, BSNSt. Elizabeth Hospital

Maude King-Bruce, RN/AAS

Diane K'Meyer, RNSwedish Covenant Managed Care Alliance

Janet L. Koch, BSNHTP Wound Management

Leslie Lailer, BSNBoston Medical Center HealthNet Plan

Heidi Larson, RNUCare

Katherine Lassiter, RNC, CMCNHealthSpring, Inc.

Peggy Lee, RN, BSNUniversal American Corp. Heritage Hlth. Sys.

Jean Maitland, RNAnthem

Shirley Martinec, RNScottsdale Healthcare Shea

Lisa McCormick, RNAMERIGROUP Corporation

Kathy McCullarGulfquest

Debra Meloy, CMCNAetna

Maureen Menacher, RNGenzyme Corp.

Tadd Meyers

Clarice MooreBlue Cross Blue Shield of Georgia

Linda M. MooreKindred Healthcare

Carol Norton, RN, CCMHighlands Wellmont Health Network

Patricia Ochenski, RN, BSNWellpoint

Lisa Robin Osborne, RN, CCMHighlands Wellmont Health Network

Shawna Owen, RNAnthem/Wellpoint IN

Lynette Parker

Audrey PellicanoHealthfirst

Jason Petros

Daisie PriestKindred Healthcare

Janet ReinselJohns Hopkins HeathCare

Brenda Roberts, RNUniversal American Corp. Heritage HealthSystems

Amber Rogers, RNMonida Healthcare Network

Alla Rudnitsky, RN, MSN, CCMCenter for Elders Independence...continued on page 4

Nurses’ NotesNurses’ Notes is the official newsletter ofthe American Association of Managed CareNurses (AAMCN). For submissions, contactPatti Hulcher at phulcher@aamcn.org or804-747-9698.

Patti Hulcher, Editor in ChiefExecutive Coordinatorphulcher@aamcn.org

Katie EadsVice President, Educationkeads@aamcn.org

Ann PatrickConference Coordinatorapatrick@aamcn.org

Jeremy Williams, PublisherVice President, Member Servicesjwilliams@aamcn.org

Sloane ReedVice President, Sales and Marketingsreed@aamcn.org

AAMCN, 4435 Waterfront Drive, Suite 101,Glen Allen, VA 23060. This material maynot be reproduced without the express writ-ten permission of AAMCN.Funny Nurses Advice

Bebe Russo, RNVA Endoscopy Group

Marie Schaefer, RN, CCM

Felicia SessionGulfquest

Michelle Simmons, RNWellpoint

Dana Sparrow, RN, BSNUniversal American Corp. Heritage HealthSystems

Denise Speaks, RNManaged Health Care Associates, Ltd.

Cathy Sportsman, LPN

Lisa Stoudt, RNCIGNA Healthcare

Kyle Summers, RNBlue Cross Blue Shield of Illinois

Judy Testh, RNEmployers Insurance

Patricia Thein, RNAnthem

Linda Thurston, RNHealth Tradition Health Plan

New Members Continued!

The things I learned not to do as a new nurseon the nightshift:1. Never go into a patient’s room in thedark without a flashlight

a. You may fall over someone on the floor

b. Stepping on body fluids isn’t pleasant

c. Doing the slide in your new Nurse Mateshoes and wondering what the heck is thatstuff? Sticks like glue and won’t come offeven with industrial cleaner from house-keeping!

d. Always check under the patient’s bed younever know what you’ll find

i. Yes, a woman under the bed in the malepatient’s bed. He was worried about his per-formance after a laminectomy and wantedto give it a test drive. The patient didn’t carethat his roommate that could hear them.

e. Last rule on dark rooms—never ever leaninto a side rail of a confused patient in thedark

i. You may occur the wrath of the DarkBrown Stain gods on your uniform

by Jeanette Smith, RN, BS

Katharyn TrevinoKindred Healthcare

Pamela S. Tropiano, RN, BSN, MPACareSource

Jason Tunnell, RNAnthem/Wellpoint IN

Corinne Van Cleave, RNHealthSpring, Inc.

Amy Vincill, RN, CCMHighlands Wellmont Health Network

Deborah Waldie, RNGlaxo Smith Kline

Anne Ware, RN, MA, CPHQBCBS of TN

Denise West, RN, AS

Svon Woods, RNAnthem/Wellpoint IN

Karen Wooldridge, BSN, RNHumana

Sandra Lee YoungKindred Healthcare

Roberta (June) Young, RNUnited Health Care - HPN

ii. That nice little bag you taped on theside rail for tissues, the one that the pa-tient didn’t use - and now you know theydidn’t use it!!

2. Never try to jump over thewax on the floor to get intoa patient’s room

a. Results are exactly whatyou think and just try to finda pair of scrubs to wear fromOB or the Operating Room inthe middle of the night.

3. Never venture into the“code” room alone in the ED.

a. If you do hear the metaltables rattle and a moan -RUN!!

4. And finally, one importantlesson learned by a newnurse……. At 6 am, when youhave been crazy busy allnight, make sure you readwhat you are mixing for theearly morning enema. Youshould mix salt and bakingsoda, not salt and cornstarch. It is fine for gravy butnot for an enema. In caseyou are wondering, I didcatch it before I gave it!!!

4

Now that the presidential election is over, youmay be finding yourself excited or disap-pointed. Regardless of your state of emotionsat this time, we have a clear winner and thepeople of our country made the choice. It isnow time, no matter what side of the aisle youstand, to get involved.

Experts are speculating that in President-Elect Obama’s first 100 days in office, he willfocus on the economy, healthcare and energy.

Specifically, as it relates to the economy, we’relikely to see legislation that supports reduc-ing taxes. Experts agree that he will likelyeliminate the small business capital gainstax, implement legislation that will promotejob growth and ensure that the financial creditcrisis has the necessary oversight.

In terms of healthcare, the Obama adminis-tration will reform Medicare, they will likelymove toward decreasing the reimbursement

Legislative Articleby Shelly Martin, BSN, MHSA, CPHQ, CMCN, CCM

to Medicare Advantage Plans. Legislative ex-perts have predicted that this decrease in fund-ing will likely be a gradual decrease, but none-the-less, a decrease for managed care organi-zations. Additionally, SCHIP (State Children’sHealth Insurance Program) will be reautho-rized (but with lower limits than initially pro-posed). Lastly, we could see legislation pro-motion health information technology.

Energy legislation will focus on reducing gasprices (or maintaining them since they havedropped significantly), promoting renewablesources of energy and curbing energy specu-lation. At this point, there are no details abouthow these things will be accomplished, justthat they are likely to be concentrated on inthe first 100 days of the Obama presidency.

This is the time to stand up and get involved.I believe that our legislators and President-Elect, once again, are focusing on issueswithin healthcare they know very little about.

Working for a large Medicare Advantage orga-nization, I continue to be disturbed that thegovernment is focusing on the one area whereoutcomes are significantly better than, prof-its are not astronomical and services are enor-mously improved over the product offered byour government.

Getting involved and making a differentmeans that you call, write and e-mail yourfederal representatives, Senators and Con-gressmen and women. Tell them you want toget involved, tell them your ideas and an-swers. Take a stand for what we know to bethe right answers within healthcare, from thepeople who understand how it works. Otherways you can get involved is by contactingyour organizations Governmental Relationsdepartment, join political action committees,talk to your colleagues. The time is now tomake a difference, if we don’t stand up to thechallenge and try to make a difference, the deci-sions and outcomes will be decided for us.

SPRING MANAGED CARE FORUMAPRIL 23-24, 2009

ATLANTA, GA

Visit www.aamcn.org to learn more about the Spring Forum and Register Today!For a limited time, use the discount code NN250 to save $250 off of your registra-tion fee. Please contact Patti Hulcher at phulcher@aamcn.org with any questions!

Mentors come in many forms; generally, wethink of business mentors but there are somany other forms both in your professionaland personal life. Remembering that your pro-fessional life is bigger then your day to dayjob, you need to look at your career as a whole,not just what you are paid to do everyday. Amentor may be your Grandmother whom youbelieve taught you everything about how tolive your life as easily as it could be, or thesupervisor who modeled the leadership skillsthat formed your career. You need both to besuccessful, however, generally we do not lookat them as the link to the whole.

Starting with the definition, a mentor is anindividual, generally older, more experienced,who guides another individual’s development.You would expect that this guidance not befor personal gain. The right mentor can be the

The Value of Mentoringby Lanita Knoke, RN, BS, CMCN

most valuable asset in your career; the wrongone can be devastating. A good mentorequates to a coach, always challenging you,inspiring you and demanding that you do yourvery best. They can improve your confidenceand lead to opportunities you had not previ-ously considered. They are familiar with arange of professional options and are able toput aside self-preoccupation to foster thegrowth of new professionals. I have been for-tunate in my life to have many mentors bothprofessionally and personally. There weretimes however, that I may not have used thatterminology when thinking of them, but inessence that is what they imparted to me. Ibelieve sometimes we learn more from thosewho are contrary to our leadership style.

One of the things I believe we do well as anAssociation is imparting the value of

mentoring. It is encouraged on the Board ofDirectors. This is accomplished by pairingnew board members with current or past mem-bers to gain knowledge and ability makingthem more successful members of the board.When I joined the Board, my mentor was Shellywho provided me the encouragement to movefurther within the board and accept the posi-tion of president elect. The president andpresident-elect further their board relationshipusing this same format, working together overthe course of the year. Mentoring in this fash-ion provides consistency so that the newPresident has working knowledge of theAssociation’s day to day operations. This hasbeen an invaluable year to me working withSheryl to gain this knowledge and understand-ing. With the support and wisdom that bothSheryl and Shelly have provided me, I hope toprove myself worthy. Thank you for this op-portunity to be President of this wonderfulassociation. Please do not hesitate to con-tact me for any assistance.

5