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October
2004—Issue 3
Editor House of Delegates Officers Claude
Dockter, RRT/Speaker-elect Denise
Johnson, RRT/Secretary Tony
Rodela, RRT/Treasurer LaDawn
L. Reynolds/Past Speaker |
In This Issue... | |
Editor’s
Notes
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Pat Munzer |
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Pat Munzer, MS, RRT To date I have spent a total of 8 years in the House of Delegates either as a delegate representing the state of Kansas or as a House Officer. These years have been and will continue to be some of my best memories. I have two more years to serve and look forward to that. To those of you running for a HOD Office I wish you the best. In reviewing the goals you submitted (enclosed in this issue of the Record and will also be with your agenda book reports) I realize what a wealth of talent we have in the House. One of the saddest things about elections is that someone has to lose. For those of you who get elected—congratulations; for those of you who don’t—please continue your involvement in our profession. The AARC is the successful organization it is today because of the involvement of dedicated individuals like you and our membership. As my term as Chair of the HOD Publication Committee draws to a close I want to thank my committee for their diligent and dedicated work. So thank you Michael Bates (MA), William Bitzel (GA), Fred Hill (AL), Joe Horn (TX), Ray Sibberson (OH), and advisor Michael Jackson (MA). Take care and I look forward to visiting with you all in New Orleans. [Top] |
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AARC, State Affiliates and Profession Moving Forward Tom Striplin, MEd, RRT As we approach New Orleans and the 50th celebration of our international congress, I believe the profession is moving in a forward direction with the cooperative help of the AARC and state affiliates. The recent U.S. Senate sponsorship of the home health care recognition bill demonstrates the positive relationship that occurs when state affiliates work with the AARC to achieve common goals. Our profession has been and will continue to be challenged on many health care fronts. Now is the time for us to place the needs of our patients first and work as a cohesive group to advance the practice of respiratory care. The House of Delegates conducted focus group meetings this past summer in Vail. The results from those groups were compiled and distributed to the HOD members for comments. As speaker, one change that I plan to implement at the fall meeting is presentation of verbal reports for those committees that have a recommendation only. Another implementation change is that I have been working with the executive office staff to create a web cast for orientation of new delegates. The orientation web cast will reduce duplication and streamline the orientation process. The web cast is scheduled to be aired in early November and will be archived as well. In an effort to streamline communication, the HOD list serve, the presidents/presidents-elect list serve and HOD/Presidents list serve have all been combined into one list. The combined list should promote better communication between the HOD, AARC and its affiliate representatives. It also reduces the number of “lists” that a representative has to check. Our membership has exceeded the 35,000 mark and that means that revenue sharing for our affiliates will remain at the current level of funding. A number of states have still not signed the “contract” by their own choosing. Those states that have agreed to “partner” with the AARC by signing the contract will most likely benefit from added incentives above and beyond revenue sharing. In an effort to respond to questions by some delegates regarding the status and history of resolutions generated by the House of Delegates and the process and or actions/inactions by the Board of Directors /Executive Office, I have compiled the last 3 years of resolutions into a summary report that will be part of my speaker presentation in New Orleans. I will be proposing to the body that this resolutions tracking summary report be a “rolling report” and will be updated yearly and maintained as part of the past speakers report. It is my hope that the results from this tracking report will put aside any contentions that the Board of Directors, the Executive Office, or the HOD itself is neglecting proposed requests generated from resolutions. I would like to thank the entire House of Delegates for giving me the opportunity to serve in this leadership role. As I approach my final meeting as speaker, I am confidant that our profession will continue to prosper and that our affiliations will increase in strength and numbers. The dedicated professionals in the House of Delegates and our leadership at the board and executive level have truly made the difference for our patients and practitioners. [Top] |
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Denise Johnson RRT, BS When we were in Vail in June, December seemed so far away, but here we are well into October and autumn is in full swing in the Midwest. Our attention is turning now to the 50th year of the AARC Educational Program. Many preparations are progressing for the House of Delegates meeting including an active Resolutions listserv and committee review of the submissions. As you have heard, this year we will be working on many of the recommendations that were discussed during the focus groups in Vail. These included several ways to streamline the House meetings, making certain our time together is well spent. One very important change Speaker Tom Striplin is working on is to hold new delegate orientation via web cast. This will allow us to more efficiently use time in New Orleans to conduct all of the business in front of us during our two-day meeting. I recently had the honor of having dinner with a few of my Minnesota colleagues including Dr. Fred Helmholz. I am sure many of you know Fred. You may have seen him as a judge at the AARC sputum bowl finals each year. He also helps us out at the Minnesota competition. This event is near and dear to his heart. He has been a remarkable pioneer and supporter of the Respiratory Care profession over the past many decades and at the age of 93 years young is still teaching RT students at Mayo in Rochester, Minnesota. He has stayed active in the MSRC and the AARC and makes every attempt to get to the annual meetings of both organizations. We were fortunate to be a part of a memorable evening as Dr. Helmholz shared stories from the very early days of Inhalation Therapy. I will not soon forget my time with Fred and it reminded me of the many reasons I have stayed in this profession over the past thirty years. He truly is an inspiration to anyone who’s life he has touched. He has touched mine through the years but especially that evening and it renewed my sense of pride and commitment to this meaningful work as a Respiratory Therapist. Look for him; he is planning to be in New Orleans in December! Please contact me with any questions you might have about the upcoming House meeting. This will be my fourth House meeting as your Secretary. It has been an honor and I want to thank you for the opportunity to serve in this role. I am looking forward to seeing you all in December. [Top] |
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Tony Rodela MBA, RRT For those of you in the House who are new, I want to review the Budget process. The guiding philosophy in the preparation of the AARC budget is to balance a conservative projection of revenues and expenses. This enables the AARC to maximize the level of service to the membership and the profession while maintaining sufficient capital reserves to assure a sound financial future for the AARC. The first step in the process is to utilize the rates and volumes that are approved by the House and BOD. Primary revenue and expense budgets are developed. In order to maintain integrity, the revenue and expenses are developed independently, sharing only the approved rates and volumes. Because they are developed independently, and the preliminary expenses include new and expanded projects as directed by the AARC leadership, the revenues and expenses are not balanced after this first step. In other words, Expenses exceed Revenues. The next step is a detailed review of all departmental accounts. Priorities are established, rates and volumes are reviewed against the most recent trends and justifications for all expense items are reviewed again. Many cuts are made to projects, department and committee budgets to bring the budget into balance. The final step is to present the proposed budget to the BOD and the HOD for review and approval. Recognizing that most of you have not previously been involved in the development of the AARC budget, you may not be aware of the magnitude of chartered affiliate support provided in the budget. The following is an example of the major categories in which that support is provided. This information came from the 2004 budget.
With this budget, the AARC will continue to enhance its services to the membership and the profession, while maintaining financial security. As with any plan, there are challenges to overcome and goals to meet. And in this case, this is particularly true in terms of achieving our membership levels and beyond. With the goal of “weaning” ourselves from the dependency on investment income it is now more important than ever that our membership grow so that we can continue to meet our members increasing needs while remaining financially strong. [Top] |
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LaDawn L. Reynolds, BA, RRT One of the charges as Past Speaker is to submit an article to the Record summarizing the actions of the Board. As I started putting everything together I realized there was much more information I wanted to share than I anticipated. Rather than taking up space here to detail this info, I decided I would send out a report to the HOD similar to what I’ve done in the past. By the time you read this article, you should have received a copy of the report. If not, let me know and I’ll email you a copy. In addition, if you have any questions about the report or other Board activities, please feel free to contact me. [Top] |
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LaDawn L. Reynolds, BA, RRT Well, the ballots are out and the results won’t be announced until after this article is due, so I have no idea where my next adventure in this profession will take me. What I do know is that I’ll be supporting and working for the respiratory care profession in some kind of capacity, whether it’s at the national or state level. The professionalism and dedication displayed by the House of Delegates truly sets it apart and has made me very proud to be a part of it. I have made so many friends over the years and you all have become my second family. The passion for respiratory care and each other is truly infectious. Where else can you debate controversial bylaws changes during the day and joke around with “whipped cream” desserts at night. This group knows how to work and play which is important in the walk of life. I would like to thank numerous people who have supported
me along these past 10 years, but I’ve had so many mentors along the way that there
would be no way to name them all. Suffice to say that everyone that has
been a part of the AARC Board of Directors, Executive Office and House
of Delegates since 1993 (especially the past three years) has been a
big influence on my dedication to respiratory care and the AARC. I thought
I had been around a long time until I look back and see how many of you
are still here as well. Obviously the support of the Kentucky Society
for Respiratory Care Board and members has also meant a great deal. Without
them none of this would have been possible. |
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AARC House of Delegates Vail, CO Debbie Fox, MBA, RRT-NPS, Chair The results of the Effectiveness Survey conducted at the Vail HOD meeting are listed below. Delegates returned seventy-three surveys at the meeting. The average ranking for each statement and other comments received are listed below. If you have any questions, please contact me. Thank you to everyone who took the time to fill out and return the surveys. Special thanks to Maggie McMillin for tabulating the survey results.
The AARC House of Delegates is an appropriate forum for comprehensive reporting of AARC activities. 3.68 47 (4) 20 (3) 1 (2) 0 (1) 1 N/A The leadership of the House of Delegates consistently attempts to promote involvement of the chartered affiliates. 3.49 39 (4) 28 (3) 2(2) 0 (1) Communication between the AARC HOD and BOD is generally effective and continues to improve. 2.98 10 (4) 45 (3) 11 (2) 0 (1) 2 N/A The resolution process is an effective means of promoting changes within the AARC. 3.01 21 (4) 31 (3) 10 (2) 5 (1) 3 N/A The “Open Microphone” session provides an effective means of introducing new ideas and fostering cohesiveness. 3.58 40 (4) 23 (3) 2 (2) 0 (1) 3 N/A The resolution process allows for timely input into
AARC strategic planning. The format of the AARC HOD provides good opportunities for both formal and informal networking. 3.44 35 (4) 28 (3) 5 (2) 0 (1) The HOD committee system promotes affiliate involvement in planning and impacting the direction of the HOD and the AARC. 3.26 23 (4) 42 (3) 5 (2) 0 (1) The HOD is an effective means of addressing key affiliate issues through existing AARC structure. 3.2 23 (4) 39 (3) 7 (2) 1 (1) Outliers on Numbering Additional Comments: - As this is my first meeting I am unable to evaluate if communication is improving. My responses are limited by attendance at this one meeting and possibly I would have a different outlook with more time and experience. - At times we spend too much time at the microphone talking about less important issues—some things are beat to death. - Need more informal network time. End formal session earlier to allow this informal network time to take place. - We spent too much time on issues that did not /do not move our profession in a forward manner. It is very frustrating. We spend too much time dwelling on PAST issues, so lets move on. I think the focus groups are a great way for use to communicate with each other. - Speed-up recognition of delegate from floor: Parliamentarian to have an electronic board or wall which posts state name in the order they have been recognized so they can get to the microphone faster and be waiting when their time to speak arrives. Also, more microphones should be available throughout the room. - Lots of time is wasted waiting for people to get to the microphones. Have people approach the microphone and wait for their turn. About 1-hour could be added to the meeting! - Suggest that delegates line up at the microphone with their placard to be recognized. This would save time rather than wait for each to approach the microphone. - Some have a tendency to monopolize the microphone. - Things are slowly improving. - AARC congress—needs new blood for speaker pool. - While the intent of the HOD is to address important issues, we seem to get off point too frequently. Perhaps we need to work on this process. - Too much rehashing of previous meeting i.e., HOD vs. BOD. Need to put a mechanism in place to limit these topics. LET IT GO! - Enjoyed focus groups. - ? explore the possibility of a having board lunches (as on 2nd day here) available or a sandwich buffet of some sort in an adjoining room to enable us to continue discussions, etc., and shorten the lunch break. - Communication in between the Past-Speaker and the HOD is excellent. The Past-Speaker CAN NOT be held accountable for AARC HOD discussion and info that occurred when she or he is not present at the AARC BOD at that time. - Let’s get on with some business significant to the profession and not operations of HOD. [Top] |
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Confessions of a Recovering Mushroom Steve Kessinger, CRT
It’s an old joke and a funny one. When I was a fledgling therapist this joke was a routine answer to how we were doing. Of course that was 26 years ago and the profession did not have the reputation we do today. In fact, we were better known for knowing where the party was after work, and for having wheelchair races and water fights with 50 cc syringes. And the truth is that we never really knew what was happening in the facility. Part of this was a problem with communication (an ongoing issue to this day) and part was our apathy to participate. Participation would have meant taking responsibility for our own careers. I confess that during those early years I was one of many who did not fully embrace the concept of respiratory care as a profession. We did not have any state licensure, or any other regulations. In fact in my state of Nevada, one could work as an RT without ever having any formal schooling. A friend of mine, who eventually went through school with me, actually started intubating patients after two weeks of on the job training. During our formal training he was startled by the potential consequences of his actions. He kept shaking his head and mumbling something like, “stupid, stupid, stupid!” I remember being proud of what I was doing but never really bought into the idea of belonging to a professional organization. Professional meant being proper and sounding intellectual. Professional meant paying annual dues that I would rather use on recreational outings. In 1985 (7 years into my career), I was cajoled into attending a state society meeting by my boss. She was a presence to be reckoned with. As I was a Lead Therapist at the time, I felt obligated not to place myself on the wrong side of her desk. (I was apathetic, not stupid!) The main topic that night was the evolution of state licensure. As I sat in the back listening, I realized that the room was filled with people no longer willing to accept second-rate citizenship in the field of healthcare. The light was beginning to appear in the mushroom cave and I was feeling more and more like someone who had been missing a huge portion of his career. Then it happened! Before I knew what happened, a “friend” nominated me to work on a committee that would investigate licensure for Nevada. This “friend” along with two others also volunteered to participate. These guys were my mentors and my idols. They had tons of stories to tell about “things” they had done as RT’s. They were also very well educated. While I was resistant at first, I felt that with these guys at the helm I could provide some help in some form. The light in the cave was continuing to increase. What happened next was payback for years of apathy. My “mentors” each had to drop out of the committee due to various reasons. Having the most experience (a whopping 3 months worth) I was named chair. Some Karmic force had driven me to this point and I was not sure (and at the time not necessarily willing) to continue. But, while apathetic, I have always been up to a challenge and this was a doozy. Well, we achieved state licensure. Now as a profession, we have 48 states plus Puerto Rico and the District of Columbia that have some form of state regulation. I’m proud to be a part of the evolution from mushroom to professional. You are probably wondering why I’ve been telling this story. We have now risen to a height of professionalism not foreseen 26 years ago (let alone 50 years ago). We still have farther to go. There are thousands of therapists out there who continue to be apathetic and unwilling to participate. My point is this. If an old mushroom like me can be converted to an active professional, surely these current ’rooms can be cultivated into shining stars in our profession. Take the time to convince them of their obligation to the profession they chose. Being kept in the dark and fed BS is a “choice” now, not a requisite. [Top] |
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Fred Hill, MA, RRT Background: On Wednesday, September 15, 2004, hurricane forecasts projected that Hurricane Ivan, which had reached a classification of a Category 5 hurricane on September 13, was moving in a direction which might take the dangerous storm, then downgraded to Category 4 (~140 mph), into Mobile Bay and ultimately into Mobile AL, a relatively large metropolitan area slightly above sea level. The storm had dropped to Category 3 (~130 mph) when it reached land at Gulf Shores, AL, Thursday morning at 2 a.m.. Nick Dupree (a ventilator-dependent young man), his mother, his grandmother, and younger brother (also ventilator-dependent) elected to ride out the wrath of Hurricane Ivan in their home, as opposed to seeking shelter at a local hospital or any of a number of storm shelters set up in the Mobile area. The following account is an edited version of an email description of the adventures that befell Nick and his family related to this Hurricane. (You can find more information about Nick in the August 2004 issue of the AARC Times, page 52) To my many friends and acquaintances: I’ve survived Hurricane Ivan after a near direct-hit in Mobile. Hurricane Ivan imposed a great deal of hardship along the Gulf Coast, especially in Alabama and Florida. Wednesday, the power went down, fried my cable modem and my ventilator. We reverted to the back-up ventilator and my old dialup modem. Then we cranked up our generator. About 5 hours later, the generator sputtered and died. Ultimately, we went a full 4 days without power. But we were fortunate, no damage to our house, where we rode it out (we learned from previous hurricanes that going to a hospital where you can’t sleep or get additional supplies imposed greater hardships). Category 4 hurricanes don’t play around. We were lucky we live inland in the city of Mobile and behind the hill (Spring Hill) and we were protected from most of the damage. Ivan turned east at the last minute, which saved Mobile, Biloxi MS and New Orleans from most of the devastation, but Gulf Shores and Orange Beach on the eastern shore of Mobile Bay, where Ivan made landfall, got wiped out. Much of those coastal areas either simply do not exist anymore, or look like ground zero, with countless formerly towering condominiums torn in half, or nothing but chunks of rubble, shredded by the winds and storm surge. Thankfully most of the coastal people fled. Pensacola, FL got a major hit. The I-10 bridge to Pensacola is torn into two pieces, as is the Pensacola Bay bridge. We’re really lucky it turned east. Also, we’re fortunate this hurricane didn’t flood us significantly at all, nor did I hear a single thunderbolt (odd). Other hurricanes were far worse in terms of rainfall. Hurricane Danny (category 1) flooded us the worst because it lingered on Mobile Bay for a week, and sucked the water out of Mobile Bay (fish were flapping around without water it was one of the weirdest things I’ve ever seen) and slung the water on our house. Hurricane Georges which came into Mobile Bay (category 2–3) also flooded us. Ivan wasn’t a big rainmaker for us (it was, mercifully, pretty fast moving) but packed a hellacious punch wind-wise, reminded me of Hurricane Opal (category 2) but much worse. We’re very lucky, we had an oak tree uprooted in our yard and our driveway was somewhat unrecognizable from fallen limbs and leaves, but no damage to our house, which is as I expected. Also as expected, our big problem was the power outage. Scary! We had to run our ventilators from our van battery for 2 days (you can do this, a full tank of gas keeping the alternator charging that battery and you can run a ventilator non-stop as long as the car has gas). You can only imagine how terrifying it is scrambling to get power before your ventilator stops breathing. We’ve been through hell without dependable power. And all this time without my humidifier or oxygen was trying on the lungs, but I’m fine. Fortunately, we were saved by the generosity of this community. There was a huge outpouring of support on Friday, September 17. People remembered me from the crusade and all the advocacy work I’ve done, and after seeing on the local news how we were surviving from our van battery and running low on gasoline, people donated 4 generators, gasoline and some fans so I can live with no air conditioning in the 93 degree heat. This literally kept me breathing. I’m so extremely grateful for the support and kindness people can show, and it heartens me to see good works can pay off later. I’m so lucky and sooooo thankful. There was a short blurb in the Mobile Register (local newspaper) which said words to the effect “Nick gave to the community and now the community is giving in return.” I just wanted to drop you guys a note to let you know we’re surviving. Our power finally came back Sunday night. It was a long 4 days and now I am resting up and trying to recover mentally and physically from the ordeal. I hope to be back at full force soon. Best to you all, Nick Postscript: Hurricane Ivan made clear that the Gulf Coast lacked an organized plan for dealing with emergency services despite the fact that this area has been hit repeatedly by hurricanes over its entire history of human habitation. Baldwin County, on the east side of Mobile Bay, was hit hardest by Hurricane Ivan in the state of Alabama. Baldwin County provided no emergency shelters for residents during this recent crisis. Governor Riley had ordered an evacuation, but officials failed to recognize that evacuation along vehicle-clogged routes is not a reasonable option for the elderly, the infirm, and those with special needs, such as ventilator-dependent individuals. In Mobile County, on the west side of the bay, shelters were available primarily in various public schools. Many people with special needs, including ventilator-dependent people, sought shelter in these schools, but the people there were not trained to meet the needs of many of the people seeking shelter. Fortunately, things went reasonably well. In past situations, hospitals would allow ventilator-dependent patients to seek shelter and plug into their emergency power systems. The problems for the hospitals related to reimbursement. There was no medical reason for the ventilator-dependent patients to be there, so reimbursement was not possible. So, the patients needed to bring their own supplies and care providers. The hospitals were then little more than a special needs motel with dependable emergency power. Some hospitals stated in advance of Ivan’s arrival, that their doors would not automatically be open to such patients this time around. Clearly, we are a long way from weaving an appropriate safety net for patients with special needs. If Nick was not such a well-known figure in the Mobile community, I wonder if he would have attracted the news coverage during this period that led to him and his family getting the assistance they needed to survive. Obviously, hurricanes, earthquakes, volcanic eruptions, and other natural disasters impose danger, hardship, and suffering on many citizens, but if you are not an able-bodied individual, fleeing to safer ground may not even be a choice. [Top] |
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Nominees for HOD Officer Positions Norm Kerr—OR (Speaker-elect)
Fred Hill—AL (Speaker-elect)
Denise Johnson—MN (Speaker-elect)
Bill Lamb—MO (Speaker-elect) If granted the opportunity to lead the HOD, my goals as House Speaker Elect are to:
Debbie Fox—KS (Secretary)
Rhonda Windhorst—KY (Secretary)
Roy Wagner—TX (Secretary)
Laura Lucas—SC (Secretary)
Gordy Gunderson—SC (Treasurer)
Bob Milisch—WI (Treasurer) Make sure that all activities of my office are well communicated to the HOD. Steve Kessinger—NV (Treasurer)
Debbie Lierl—OH (Treasurer) To carry out charges as assigned by the Speaker, including; collaborating with the speaker-elect to prepare the HOD budget, participate in the AARC budget process by serving on the finance committee, report to the HOD all actions of the finance committee, serve on the delegates assistance committee, prepare the financial impact of resolution to be considered by the HOD as requested by the Resolution Committee. My personal goal would be to make sure that I do my part to keep communication between the HOD and the AARC Board of Directors open and honest. In order to do this, I will make sure that I understand the why’s and how’s of any proposed financial changes, so I am able to fully explain these proposals to the HOD. [Top] |
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(as of October 25, 2004)
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