Volume 14, Issue 3, November 2003   
The ONS Nurse Practitioner SIG Newsletter is underwritten through a grant from Amgen, Inc.
     
Coordinator's Corner
Nurse Practitioner SIG Introduces New Web Page Administrator


Diane Cope, PhD, ARNP-BC, AOCN®
Fort Myers, FL
ecope@attglobal.net


Hello to all! I hope you had an enjoyable, fun, relaxing summer. I almost cannot believe that summer is over; it seems like only yesterday that we were watching fireworks on the Fourth of July. I am always saddened at the end of summer. This seems rather crazy because I live in Florida and the weather is always hot; however, I enjoy the lazy days when baseball is in season and our roadways are quieter without snowbirds.

The information in this newsletter has, on the other hand, created excitement and anticipation regarding all of the ONS activities that are in progress or will be occurring within the next few months. I hope that you will critically review the article “Legislation Update: Congress to Act on Medicare Drug Pricing,” by Janet VanCleave, MSN, ACNP-CS, AOCN®, and Ilisa M. Halpern, MPP. In the day-to-day world of patient care and clinical practice, we may easily forget about billing and costs. Proposed changes in Medicare drug pricing will have a direct impact on our practices, and we should become proactive. I encourage you to keep abreast of legislative events regarding these proposed changes and actively write your congressional representatives to inform them that this would compromise quality cancer care.


 
 

Special Interest Group Newsletter  November 2003
 
   


Coordinator's Corner
Nurse Practitioner SIG Introduces New Web Page Administrator


Diane Cope, PhD, ARNP-BC, AOCN®
Fort Myers, FL
ecope@attglobal.net


Hello to all! I hope you had an enjoyable, fun, relaxing summer. I almost cannot believe that summer is over; it seems like only yesterday that we were watching fireworks on the Fourth of July. I am always saddened at the end of summer. This seems rather crazy because I live in Florida and the weather is always hot; however, I enjoy the lazy days when baseball is in season and our roadways are quieter without snowbirds.

The information in this newsletter has, on the other hand, created excitement and anticipation regarding all of the ONS activities that are in progress or will be occurring within the next few months. I hope that you will critically review the article “Legislation Update: Congress to Act on Medicare Drug Pricing,” by Janet VanCleave, MSN, ACNP-CS, AOCN®, and Ilisa M. Halpern, MPP. In the day-to-day world of patient care and clinical practice, we may easily forget about billing and costs. Proposed changes in Medicare drug pricing will have a direct impact on our practices, and we should become proactive. I encourage you to keep abreast of legislative events regarding these proposed changes and actively write your congressional representatives to inform them that this would compromise quality cancer care.

The ONS Nurse Practitioner (NP) SIG Web page has a new Web page administrator. Bridget Cahill, RN, MS, APN, CNP, a member of the NP SIG, will assume this responsibility. Bridget is a nurse practitioner in gastrointestinal oncology at the Northwestern Medical Faculty Foundation in Chicago, IL. She is active in the Illinois Society for Advanced Practice Nurses, loves to ride motorcycles (be careful Bridget), and previously worked at the Cook County Boot Camp—a prison. Bridget is responsible for updating the NP SIG Web page. If you have any questions or things that you would like to have added or deleted, please contact Bridget at bcahill@nmff.org. Thank you, Bridget, for volunteering to perform this important work. I also would like to thank Marybeth Singer, MSN, ANP, for her previous work that actually created the NP SIG Web page.

Finally, please consider a topic submission for an NP SIG-sponsored session for the 2004 Institutes of Learning (IOL). The 2004 IOL Topic Submission Form can be found at www.ons.org under the conference section. Please complete and fax the form to me at 239-437-5788 by December 1, 2003.
 
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Special Interest Group Newsletter  November 2003
 
   


Legislative Update
Congress to Act on Medicare Drug Pricing


Janet VanCleave, MSN, ACNP-CS, AOCN®
New York, NY
janethvc@earthlink.net

Ilisa M. Halpern, MPP
ONS Health Policy Associate
halpern.ilisa@arentfox.com


Currently, Congress is poised to enact dramatic changes to the way the Medicare program reimburses for outpatient chemotherapy drugs administered in physician office settings, which will impact approximately 80% of cancer care delivered in the United States. In July 2003, the Senate and House of Representatives each passed bills to extend prescription drug coverage to Medicare beneficiaries. Although different in many aspects, in addition to providing new prescription drug coverage, each measure contained provisions that would decrease Medicare reimbursement for oncology drugs provided in physicians’ offices without an adequate increase in reimbursement for physicians’ office expenses, including oncology nursing services. Although the specifics of the cancer care cuts in the House and Senate bills differ, each would result in a reduction of approximately $16 billion from the cancer care system over the next 10 years. And, without waiting for Congress to act, the Bush Administration—through the Centers for Medicare and Medicaid Services (CMS), which oversees implementation of the Medicare program—in August proposed new payment rules that reduce payment for oncology and other drugs now covered by Medicare.

Because of a flawed policy created by Congress, the Medicare program and Medicare beneficiaries currently overpay for cancer-related care. However, this overpayment provides a much-needed cross-subsidy to compensate for oncology nursing and other cancer care and supportive services for which Medicare currently either underpays or fails to cover at all. ONS maintains that the current Medicare payment system is flawed and must be modified, but changes must come in the form of balanced reform—reducing drug overpayments while providing adequate increases in practice expense payments on the other side of the cancer care equation. In response to the cut of $16 billion from the cancer care system, ONS President Judy Lundgren, RN, MSN, AOCN®, issued a press statement voicing serious concern that the cuts would decrease access to quality cancer care for the nation’s seniors. Patient advocate groups and other cancer community stakeholders, such as the American Society of Clinical Oncology, US Oncology, and the Association of Community Cancer Centers, share ONS’s concern that these payment changes will adversely impact access to cancer care.

Medicare Reimbursement for Chemotherapy Drugs and Administration
Medicare pays for drugs by a method that leads to substantially higher payments than the actual cost of the therapies. Medicare’s payments for covered drugs are based on their average wholesale price (AWP). The manufacturers of the drug determine the AWP using their own criteria and can set the AWP at any level, without regard to the actual price paid by the purchasers. The AWP is not determined by any law or regulation and does not reflect the discounts that most other purchasers of drugs obtain from sellers. The makers of the drugs provide information to organizations that calculate AWPs and publish them in a drug pricing book known as the Red Book. Medicare’s administrative agents (private insurance carriers) pay claims for covered drugs on the basis of 95% of the published AWPs, whereas doctors generally pay 66%–87% of the AWP. Congress and the Bush Administration assert that their frustration stems from the fact that the government is paying more than the acquisition costs for many drugs and that because Medicare beneficiaries pay 20% of the bill, they are paying more out of pocket for their cancer care than is appropriate or necessary.

By reducing reimbursement for chemotherapy, policymakers hope to bring Medicare payment and beneficiary copayments more in line with actual costs. They see such a change as reasonable and good policy. ONS agrees that the government and Medicare beneficiaries should not make payments more than a drug's cost; however, ONS maintains that the government should not underpay for services, either. To that end, ONS advocates that reductions in drug reimbursement be enacted only with simultaneous increases in payments for oncology nursing services and other unpaid or underpaid expenses associated with delivering chemotherapy (e.g., IV tubing, needles) that currently are reimbursed inadequately.

Proposed Policy Changes
The policy approach included in the Senate-passed Medicare bill uses the current payment methodology but slashes drug payments to 85% of AWP. The bill, in essence, remains silent on practice expense payments by directing CMS to revise these payments for oncology. The imposition of this cut in the Senate bill without a clear and specific correction to practice expenses concerns ONS because practices may not receive the resources necessary to continue to provide quality cancer care. Moreover, the cancer community has been working with members of Congress and their staff to develop a revised payment system for oncology nursing practice expense and maintains that Congress—not CMS—should be the entity to make the necessary adjustments.

The policy approach in the House-passed Medicare legislation would allow the competitive market to determine the appropriate price through a new process known as “mandatory vendor imposition” (MVI), which requires a third-party pharmacy chosen by the government to deliver prescribed drugs, eliminating physicians and nurses from the acquisition and preparation of chemotherapy. Although physicians who choose not to participate in the MVI system are provided an option to continue to purchase chemotherapy directly, they will be reimbursed the average sales price (ASP) plus 12%, but only for two years. After the first two years, the reimbursement rate drops to only the ASP amount. Because ASP is based inherently on an average, it follows that some practices will purchase chemotherapy above ASP and some will purchase drugs below ASP. Those who purchase drugs above ASP will lose money on every such purchase, which serves as an intentional incentive to force physicians to participate in the MVI system. For more information about this proposal and ONS’s concerns, please view the letter ONS sent to the House Republican leadership at www.ons.org/LAC/lac82.pdf.

Oncology Nursing Society Position
ONS long has recommended changes in the Medicare method of reimbursement for chemotherapy drugs, chemotherapy administration, and associated supportive care. ONS maintains that the cuts in the House and Senate Medicare bills threaten access to quality cancer care and urges Congres to enact balanced reform. ONS maintains its commitment to working with the cancer community, members of Congress, and other stakeholders to enact legislation that ensures adequate and appropriate payment for chemotherapy drugs, oncology nursing practice expense, supportive care, and other related services.

Further Information
In summary, Medicare reimbursement for drugs used in office practice and physician office expenses is a complex issue but one that will significantly impact nursing practice. The different policy proposals and legislation are changing constantly. Nurses must keep current on events and voice their concerns to their elected officials. For more information, visit the ONS Legislative Action Center at www.onslac.org.

Bibliography
Iglehart, J.K. (2003). Medicare and drug pricing. New England Journal of Medicine, 348, 1590–1597.

Pear, R. (2003, August 6). Cancer drugs face funds cut in a Bush plan. New York Times, p. 1.

Online Resources From the ONS Legislative Action Center
ONS AWP and Oncology Nursing Practice Expense Issue Brief—Background document on Medicare payment policy for chemotherapy provided in physician office settings and information regarding the ONS advocacy position on the issue

ONS correspondence to House Chairs Bill Thomas (Ways and Means), Billy Tauzin (Energy and Commerce), Nancy Johnson (Health Subcommittee Ways and Means), Mike Bilirakis (Health Subcommittee Energy and Commerce), and Jim Greenwood (Investigations and Oversight Subcommittee Energy and Commerce)

Press statement by ONS President Judy Lundgren, RN, MSN, AOCN®, about the House and Senate Medicare measures: “ONS Calls on Congress to Preserve Quality Cancer Care

ONS Correspondence to Representatives Charlie Norwood (R-Georgia) and Lois Capps (D-California) in support of the Quality Cancer Care Preservation Act (HR 1622)

ONS and Association of Oncology Social Work correspondence to Representatives Charlie Norwood (R-Georgia) and Lois Capps (D-California) on the role of nonphysicians in the provision of quality cancer care

ONS General Principles and Policies Regarding Medicare Reimbursement for Oncology Nursing Practice Expenses

Reimbursement vs. Reality: A Discussion Paper on Medicare Payments for Cancer Treatment


 
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Special Interest Group Newsletter  November 2003
 
   


ONCC Completes Advanced Practice Nurse Role Delineation Study

Cynthia Miller Murphy, RN, MSN, CAE
Pittsburgh, PA
cyndi@ons.org


The Oncology Nursing Certification Corporation (ONCC) has completed the third role delineation study (RDS) of advanced oncology nursing practice. An RDS provides an important link between the actual practice of a discipline and what is included on a certification or licensing examination. An RDS is one of the primary building blocks of content validity for a certification examination. ONCC policy states that RDSs will be conducted at least every five years for each certification program. However, because of the evolution of advanced nursing practice in oncology, three RDSs have been conducted for the AOCN® certification program over the eight years since its inception.

The most recent study was initiated in August 2002. A survey instrument describing the roles and responsibilities of advanced practice nurses in oncology, as well as the knowledge required to carry out those roles and responsibilities competently, was developed with the input of an expert panel of 10 oncology clinical nurse specialists and 10 oncology nurse practitioners. In addition, nine currently certified AOCN®s provided input into the development of the instrument through telephone interviews and 20 AOCN®s pilot tested the instrument.

In January 2003, the survey was posted on a Web site and more than 4,000 master’s-prepared ONS members and AOCN®s were sent e-mails or letters inviting them to access and complete the survey. The technology used for the survey permitted nurses to complete it in more than one sitting, if necessary. The survey was somewhat lengthy, and the final response rate was 565 (approximately 14%). Analysis of the characteristics of the respondents determined that they were representative of the total sample and, therefore, the responses were reliable.

An important aspect of this study was the analysis of the data by subgroups based on the roles of clinical nurse specialist and nurse practitioner. A second panel of 17 experts met in May 2003 to review the results and make recommendations for future certification test content. The ONCC Board of Directors and a special task force are in the process of examining the data and recommendations to determine whether separate examinations should be developed for the two groups. Preliminary review of the data reveals that, although the tasks and responsibilities carried out by oncology clinical nurse specialists and oncology nurse practitioners are somewhat different, the knowledge required for each role is quite similar. Decisions about the future of the AOCN® examination will be announced during the next year, with implementation of the changes in 2005.

 
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Special Interest Group Newsletter  November 2003
 
   


Clinical Spotlight
Transplant Nurse Impressed With New Bone Marrow Biopsy Needle


Priscilla Kelly, RN, MSN
New York, NY

I have been practicing in hematology, oncology, and transplant nursing for the past 15 years. While studying for my clinical nurse specialist degree, I had the opportunity to learn how to perform bone marrow biopsy and aspirate procedures. Currently, I am working in a private practice and have been involved in the trial of a new bone marrow biopsy needle. To date, I have performed more than 120 biopsies using an eight-gauge Goldenberg Snaircoil™ (Novamed, Bologna, Italy) bone marrow biopsy needle with an average specimen length of 2 cm. I am quite impressed with this instrument and would like to share my experiences.

Patients undergoing this procedure for the first time fear the unknown and expect it to be painful. Patients who already have undergone the procedure with other needles expect the worst. Also true is that the previous experience of the operator influences the performance of the procedure. We, the operators, come to the setting with concerns about capturing an adequate specimen for diagnosis and about patients’ level of comfort during the procedure. The design of the instrument is such that the snaircoil device grabs and holds the specimen at the needle tip once the operator activates it. No needle manipulation is necessary to loosen and capture the specimen. This manipulation is very uncomfortable for patients. The needle has 1 cm markings on it, which allow for a more accurate measure of penetration. To take full advantage of the needle, patients should be prone. When locating the biopsy site, the columnar region of the posterior iliac crest is crucial for obtaining a lengthy specimen. With the Goldenberg Snaircoil needle, a difficult procedure is made much more comfortable for patients and operators. Despite the gauge of the needle I have been using, patients report very little discomfort, and I know from experience that handling the needle is comfortable for operators.

Please call me at 212-689-7032 if you have any procedural questions or would like any information about the needle.

 
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Special Interest Group Newsletter  November 2003
 
   


Bortezomib Approved for Relapsed and Refractory Multiple Myeloma

Diane Cope, PhD, ARNP-BC, AOCN®
Fort Myers, FL
ecope@attglobal.net


Multiple myeloma is the second most common hematologic malignancy and occurs predominantly in individuals 65–70 years of age. In 2003, an estimated 14,600 new cases of multiple myeloma will be diagnosed with an estimated 10,900 deaths (Jemal et al., 2003).

On May 13, 2003, bortezomib (Velcade™, Millennium Pharmaceuticals, Cambridge, MA) received accelerated approval by the U.S. Food and Drug Administration (FDA) for the treatment of patients with multiple myeloma who have received at least two prior therapies and demonstrated disease progression after the last therapy. Velcade is the first drug in a new class of medicines called proteasome inhibitors. Proteasome is an enzyme complex that is present in all cells and plays a critical role in the regulation of cell growth and survival by degrading proteins involved in the cell cycle, angiogenesis, cell adhesion, cytokine production, and apoptosis. The proteasome is part of a recently discovered pathway called the ubiquitin-proteasome pathway that is common to many cancers and promotes uncontrolled cell proliferation. In cancer cells, ubiquitination proliferates and makes more protein recognizable by the proteasome. This produces increased cell cycle regulatory proteins that result in cell cycle dysregulation and uncontrolled mitosis. Proteasomes enhance transcription factors such as nuclear factor κB (NF-κB) that release prosurvival proteins. Prosurvival proteins protect a cancer cell from apoptosis and promote angiogenesis and cell adhesion. Velcade acts to block NF-κB. In the case of myeloma, Velcade inhibits myeloma cell growth and angiogenesis, blocks the production of adhesion molecules that facilitate binding of myeloma cells to bone marrow cells, and induces myeloma cell death.

Velcade’s FDA approval was based on a multicenter, phase II SUMMIT trial involving 202 patients with myeloma who had progressive disease despite receiving an average of six lines of therapy (Richardson et al., 2002). Velcade was administered via IV (1.3 mg/m2) twice a week for two weeks followed by a 10-day rest period. The mean number of cycles administered was six. Findings indicated a 35% overall response rate, with 59% of the patients experiencing a response or stable disease. Median duration of response was 12 months. The median overall survival was 16.4 months. The most commonly reported side effects were nausea (69%), diarrhea (49%), fatigue (49%), thrombocytopenia (44%), constipation (43%), vomiting (36%), peripheral neuropathy (35%), anorexia (34%), fever (34%), and anemia (31%).

To prepare Velcade for administration, each 3.5 mg vial should be reconstituted with 3.5 ml of normal saline. Reconstituted Velcade should be administered within eight hours of preparation, and reconstituted Velcade in a syringe should be administered within three hours or less. Velcade (1.3 mg/m2) is given as a three- to five-second IV push followed by a standard saline flush. Each dose is given twice weekly for two weeks (days 1, 4, 8, and 11) followed by a 10-day rest period.

Velcade currently is under investigation in phase I and II studies for other cancers, including prostate, colorectal, lung, lymphoma, and leukemia. A phase III trial comparing Velcade and dexamethasone in patients with relapsed and refractory myeloma also is being investigated.

References
Jemal, A., Murray, T., Samuels, A., Ghafoor, A., Ward, E., & Thun, M.J. (2003). Cancer statistics, 2003. CA: A Cancer Journal for Clinicians, 53, 5–26.

Richardson, P., Barlogie, B., Berenson, J., Traynor, A., Singhal, S., Jagannath, S., et al. (2002). Phase II multicenter study of the proteasome inhibitor bortezomib (VELCADE, formerly PS-342) in multiple myeloma patients with relapsed/refractory disease [Abstract 385]. In Proceedings of the 44th Annual Meeting of the American Society of Hematology (p. 104a). Washington, DC: American Society of Hematology.


 
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Special Interest Group Newsletter  November 2003
 
   


Help Us Celebrate National Family Caregivers Month


Family caregivers play a vital but often unrecognized role in caring for chronically ill, disabled, or aged loved ones. That’s why we encourage all Nurse Practitioner SIG members to help us celebrate National Family Caregivers (NFC) Month in November 2003.

The goal of NFC Month is to build caregiver self-esteem, expand caregiver self-awareness, and teach caregivers to become their own advocates. NFC Month is sponsored by the National Family Caregivers Association (NFCA), the nation’s leading family caregiver constituency organization. NFC Month offers nurses an opportunity to provide activities in support of family caregivers. NFCA has educational and promotional materials available and encourages all participating organizations to collect family caregiver stories. For information about NFC Month, contact NFCA at 800-896-3650 or visit www.nfcacares.org.
 
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Special Interest Group Newsletter  November 2003
 
   


Historically Black Colleges and Universities to Institute a Cancer Prevention and Early Detection Program for African Americans


Are you or one of your colleagues a nurse educator or clinical preceptor interested in improving cancer prevention and early detection in minority populations? If so, apply for an ONS program to help reduce cancer mortality among these populations.

Through a grant from the National Cancer Institute (R25 CA 09554), ONS is offering a Cancer Prevention and Early Detection Program for Historically Black Colleges and Universities and Minority Serving Institution (HBCU/MSI) Nurse Educators. Under the leadership of Sandra Millon Underwood, RN, PhD, FAAN, the program is designed to reduce health disparities and cancer mortality among medically underserved African Americans by integrating information about prevention and early detection into the educational curricula of HBCU/MSIs. The grant covers most travel, lodging, meals, and course expenses.

The program runs from Friday evening through Sunday afternoon and will be held February 6–8, 2004, in Miami, FL. (Application deadline is December 20, 2003.)
For more information or an application, visit the Education area of ONS Online at www.ons.org or contact the Education Cancer Care Issues Team toll free at 866-257-4ONS, ext. 6296 (eccit@ons.org).
 
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Special Interest Group Newsletter  November 2003
 
   


Special Deals on Certification Renewal and Continuing Education Credits


Save $75 on Certification Renewal
Renew your OCN®, AOCN®, or CPON® certification by using the Oncology Nursing Certification Points Renewal Option (ONC-PRO). ONC-PRO logs and instructions can be printed from ONCC Online at www.oncc.org or requested by contacting the Oncology Nursing Certification Corporation at 877-769-ONCC (toll free) or oncc@ons.org.

Get Certified for Free in 2004
If you’re planning to earn or renew oncology nursing certification in 2004, you could do it for free! The Oncology Nursing Certification Corporation (ONCC) will award up to 50 free registrations for a 2004 ONCC test or certification renewal through the Roberta Scofield Memorial Certification Awards. Application materials are available at www.oncc.org or by contacting ONCC at 877-769-ONCC (toll free) or oncc@ons.org.

Earn Continuing Education Credit Online
Do you need nursing continuing education to qualify for initial OCN® or CPON® certification or to renew your OCN®, AOCN®, or CPON® credential by the Oncology Nursing Certification Points Renewal Option? The Oncology Nursing Certification Corporation offers links to online continuing education opportunities at www.oncc.org. Some are even free!
 
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Special Interest Group Newsletter  November 2003
 
   


Unapproved Nurse Practitioner SIG 2003 Planning/Networking Meeting Minutes


Date: Thursday, May 1, 2003
Place: Colorado Convention Center, Denver, CO
Rooms: 201C–209C
Begin: 5:15 pm (MT)
Adjourn: 6:45 pm (MT)
Recorder: T. Armstrong
Attendees:
SIG members: L. Allen, B. Biedrzycki*, J. Blash*, B. Brien*, R. Brintnall*, D. Cope, M. Davies, V. Deleruyelle, C. Dolbey, S. Feehan, K. Fessele, L. Fow*, N. Gantz*, D. Hendrickson, K. Holly, C. Horrell, L. Karl, E. Keating*, M. King, P. Lipari*, M. Lynch, K. Martin, J. Meehan, T. Messer, K. Mullen*, B. O’Brien, P. Reed, J. Rosiak*, B. Ruzevick*, M. Schlatter, W.J. Smith*, J. VanCleave*, S. Vanleeuwen, W. Vogel*, M. Wiseman*, and K. Yennie*
* Interested in being in a work group
Non-SIG members: Deborah Heim, RN, MSN, CS, AOCN®, 5150 Harborage Dr., Fort Myers, FL 33908-4542; Arlene B. O’Rourke, 31 Longwood Dr., Portland, ME 04102-1523 (exp. 3/31/03); Linda A. Pfeifer, CRNP, RR 3, Box 2196, Greensburg, PA 15601-9803; Gabriele Snyder, RN, MSN, CS, ANP, AOCN®, 103 Deer Park Ln., Cary, NC 27511-9716; Karon M. Stone, APRN, BC, FNP, Coastal Hematology of Oncology, 500 Eisenhower Dr., Savannah, GA 31406; and Susan Wakeling, RN, MSN, AOCN®, 2085 Riverside Dr., Lakewood, OH 44107-5363

Introduction  of members Members in attendance were introduced, including the Nurse Practitioner (NP) SIG leadership, as well as attendees who were not members.
Volunteer sign-up Sign-up sheet for members interested in volunteering for work groups and coordinator-elect
Update on evening symposium M. Lynch provided an update on the evening symposium about billing reimbursement
Update on 2001 and 2002 Advanced Practice Nurse Retreats M. Lynch provided an update on the 2001 retreat work groups. T. Armstrong provided an update on the 2002 retreat.
Work groups  
    Newsletter J. VanCleave provided an update on the newsletter, including deadlines and availability on the SIG's Web site.
    Mentorship C. Dolbey and M. Davies presented an overview of the program and reviewed current matches. They discussed the need to opt on Web site.
    Legislative W. Vogel discussed the start-up of legislative group to update part of Advanced Practice Nurse Virtual Community and asked for volunteers.
Think tank for advanced practice nurses T. Armstrong presented content of “Think Tank” for NP practice, which she attended and represented ONS.
Archives B. Biedrzycki presented archives information, including NP SIG poster.
Approval of 2002 minutes Minutes were approved by T. Armstrong and seconded by J. VanCleave.
NP job description Reviewed initial draft of job description in 1996. Revised in 1999. Plan to form a work group to review description.
Open discussion Issues discussed included funding and legislative concerns facing NPs in oncology practice.

 
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Special Interest Group Newsletter  November 2003
 
   


Nurse Practitioner SIG Officers

Coordinator
Diane Cope, PhD, ARNP-BC, AOCN®
605 Astarias Circle
Fort Myers, FL 33919-3247
239-437-3571 (H)
239-437-4444 (O)
ecope@attglobal.net

Ex Officio
Terri Armstrong, MS, APRN, BC
2908 Amherst St.
Houston, TX 77005-3018
713-665-0718 (H)
713-745-4621 (O)
carmstr270@aol.com

Editor
Janet VanCleave, MSN, ACNP-CS, AOCN®
11 E. 87th St., Apt. 8A
New York, NY 10128-0578
212-289-7849 (H)
917-738-5474 (O)
janethvc@earthlink.net

 

Coeditor
Christie Hancock, APN, MSN, RN, CS, OCN®
1207 E. Country Club Terr.
Jonesboro, AR 72401-4324
870-935-4546 (H)
870-972-4510 (O)
christiemh@sbcglobal.net

ONS Publishing Division Staff
Elisa Becze, BA
Copy Editor
412-859-6317
ebecze@ons.org

 

Know someone who would like to receive a print copy of this newsletter?
To print a copy of this newsletter from your home or office computer, click here or on the printer icon located on the SIG Newsletter front page. Print copies of each online SIG newsletter also are available through the ONS National Office. To have a copy mailed to you or another SIG member, contact Membership/Leadership Administrative Assistant Carol DeMarco at carol@ons.org or 866-257-4ONS, ext. 6230.

ONS Membership/Leadership Team Contact Information
Angie Stengel, BA, Director of Membership/Leadership
astengel@ons.org
412-859-6244

Diedrea White, BA, Manager of Member Relations and Diversity Initiatives
dwhite@ons.org
412-859-6256

Carol DeMarco, Membership/Leadership Administrative Assistant
carol@ons.org
412-859-6230

To view past newsletters click here .

The Oncology Nursing Society (ONS) does not assume responsibility for the opinions expressed and information provided by authors or by Special Interest Groups (SIGs). Acceptance of advertising or corporate support does not indicate or imply endorsement of the company or its products by ONS or the SIG. Web sites listed in the SIG newsletters are provided for information only. Hosts are responsible for their own content and availability.

Oncology Nursing Society
125 Enterprise Dr.
Pittsburgh, PA 15275-1214
866-257-4ONS
412-859-6100
ONS Online: www.ons.org

 
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