PENS Reporter - Summer 2016 by KellenComm

VOL 28/NO 1

A bi-annual publication of the Pediatric Endocrinology

President’s

Nursing Society

H In This Issue: 1 President’s Report 3 PENS Honors Prestigious Award Winners 4 Meet Your PENS Board Members 4 We Are PENS and We Are Noteworthy! 5 Highlights from PENS 2016 National Conference 8 Have you joined the PENS E-Community? 9 Committee Reports 10 PENS Conference Reimbursement Scholarships Entries 13 Intro to Bylaws Changes

Report

ello PENS Members

What a conference!! I know by now some of the dust has settled but I hope the knowledge gained from those few days spent together seeps deep into our minds and patient care practices. Again, I want to thank the committees, the speakers, our pharmaceutical partners, the PENS Board members and the PENS staff for contributing to the success of this conference. It takes an awesome team to accomplish this monumental task, and I hope you all agree that the hard work paid off. Not only did we work hard, but we played just as hard. The nighttime activities offered plenty of time to enjoy each other’s company, network and just have fun. As we enter our 30th year of PENS, I would like you all to consider what you can do to help this wonderful organization continue to work its magic. You all have something to contribute so please consider stepping out of your comfort zone just a little. There is plenty of support to mentor you into any role you would consider so I challenge you to take that 1st step! Planning for our 2017 conference is already begun, so please send any ideas, thoughts for topics and speakers, or anything else you think of that may assist us in the conference planning. Also in the works is the planning of the 2017 International Nursing Summit in September in conjunction with the 2017 PES conference. We are very excited about this full day nursing symposium and are also very proud of our collaboration of PENS, our allied international nurse groups, ENSA, CEPN/ICEP, ESPEN, and PES. I want to thank Nicole Kirouac, PENS immediate past president, for steering this important event. Stay tuned for more information in the months to come. I would like to call your attention to educational opportunities available to you as mentioned in the June Insider. One is through Med Learning Group for nursing and Med Learning Group for physicians. This free activity carries 1.0 NAPNAP CE contact hours as well as 1.0 Cat 1 AMA credits for physicians. It is currently on the NAPNAP website as well as on www.medlearninggroup.com. The title is: Short Stature Assessment in Children: A Fundamental Step toward Early continued on page 2

P.O. Box 14516 Lenexa, KS 66285-4516  913.222.8657  877.936.7367  FAX: 913.222.8606  PENS@KELLENCOMPANY.COM

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“President’s Report” continued from page 2 Diagnosis of Growth Failure and a Comprehensive Approach to Growth Disorders I truly am blessed to have been part of this profession for so many years, and I thank all for you for not only giving to your patients and families, but giving to PENS as well. Sincerely, 2016-2017 President Maryann Johnson, BSN, RN, M.Ed.

Maryann Johnson PENS President

President-Elect Cheryl Switzer, MSN, RN, CPNP, CDE Treasurer Linda Burkett, MSN, RN, CDE Secretary Tamara Nenadovich, RN Director Maureen Dever, MSN, CPNP- BC Director Cathy Flynn, RN, MSN, CPNP, CDE Director Kevin Lewis, DNP, APRN, PPCNP-BC, CDE Immediate Past President Nicole Kirouac, RN, BN Executive Director JerrieLynn Kind jlkind@kellencompany.com

The PENS Reporter is published twice a year by the Pediatric Endocrinology Nursing Society (PENS). Views expressed herein do not necessarily reflect the opinion of PENS. Copyright © 2016 Pediatric Endocrinology Nursing Society Editor Tammy Nenadovich, RN PENS Executive Office P.O. Box 14516 Lenexa, KS 66285-4516 Direct: 913.222.8657 Toll-Free: 877.936.7367 Fax: 913.222.8606 Website: www.PENS.org COPY SUBMISSIONS Please submit all future articles or items by e-mail to Tammy Nenadovich at nenadot@gmail.com. Subject: PENS Reporter Item

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PENS Honors Prestigious Award Winners

ENS is pleased to announce the following recipients of its annual awards. Thank you to all who have nominated a colleague! Excellence in Advanced Practice Award – this award honors a PENS nurse with a graduate degree in nursing, evidence of expert clinical skills in pediatric endocrinology nursing and demonstrates leadership in activities such as innovative clinical care, education, research, publication, presentations, mentoring and child advocacy. Our recipient has made a significant contribution to PENS, we literally would not be where we are today without her!

Excellence in Clinical Practice Award – this award honors a PENS nurse with outstanding professional performance involved in the direct care of children with endocrine disorders and who demonstrates expertise as expressed through direct care, team building, child advocacy activities and mentoring of other professionals in the care of children and families affected by endocrine disorders. Congratulations to Shalyn McDaniel, RN!

Congratulations to Kathy Clark, RN, MSN, PNP-BC!

Shaylyn is a pediatric endocrine staff nurse at the Children’s hospital of Pittsburgh of UPMC in Pittsburgh, Pennsylvania.

Kathy is an advanced practice nurse at CS Mott Children’s Hospital, University of Michigan Health System in Ann Arbor, Michigan and is PENS’ founding president. Research Poster Awards – underwritten by our friends at The Human Growth Foundation Nursing Research Poster Award – Third Place Mary Zwisler, BSN, RN-BC and Sally Armstrong, RN Akron Children’s Hospital Hemolyzed Specimens: A Clinical Challenge in Endocrine Stimulation Testing

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Nursing Research Poster Award – Second Place Kris Welsh, MSN, RN, CPNP Nemours/A.I. duPont Hospital for Children Demystifying Maturity Onset Diabetes of the Young (MODY) Nursing Research Poster Award – First Place Rebecca Crespi, MSN, CPNP, CDE, Kristina Derrick, MD, Msc, Jaclyn Pappas, RN, Gia Puopolo, RN, Catherine Greaves, RN, CDE, Rubina Heptulla, MD

Children’s Hospital at Montefiore Emergency Medical Identification in Adolescent Diabetes Patients: Prevalence and Response to Educational Interventions Novice Poster Award Jennifer Abernathy, BSN and Ioanna Athanassaki, MD Texas Children’s Hospital Nurse-Monitored Calcium Protocol Halts Hypocalcemia in Total and Completion Thyroidectomy Patients

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Meet Your PENS Board Members 2016-2017 President Maryann Johnson, BSN, RN Hasbro Children’s Hospital Term ends 2017

Director Maureen Dever, MSN, CPNP- BC St. Christopher’s Hosp. for Children Term ends 2018

President–Elect Cheryl Switzer, MSN, RN, CPNP, CDE Cleveland Clinic Children’s Term ends 2017

Director Cathy Flynn, RN, MSN, CPNP, CDE St Rose Pediatric Endocrinology Term ends 2018

Treasurer Linda Burkett, MSN, RN, CDE Medtronic Term ends 2017

Director Kevin Lewis, DNP, APRN, PPCNP-BC WV Univ. Physicians of Charleston Term ends 2017

Secretary Tamara Nenadovich, RN Genentech Term ends 2018

We Are PENS and We Are Noteworthy! SO STAND UP AND BE RECOGNIZED AND SHARE YOUR NEWS! WE ARE BRINGING BACK AN OLD COLUMN CALLED “MEMBERS IN THE NEWS” Have you recently changed positions or received a promotion? Have you recently received an award related to your professional responsibilities or an academic honor? Have you recently been published? Have you recently made a presentation at a professional conference or a meeting? Are you serving in an elected or an appointed position in a professional or governmental organization? Have you recently traveled to another country to teach or learn more about our specialty? IF YOU CAN ANSWER “YES” TO ANY OF THESE QUESTIONS ... PLEASE TELL US ABOUT IT! SEND YOUR NEWS FOR THE NEXT NEWSLETTER TO nenadot@gmail.com BY Oct. 31, 2016.

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Highlights from PENS 2016 National Conference

ear Members,

The Rocky Mountains provided a beautiful backdrop for a wonderful PENS National Conference in Denver, CO. This year we were fortunate to have an outstanding pre-conference program, HANDS (Helping Administer to the Needs of the Student with Diabetes in Schools) in collaboration with our colleagues from the National Association of School Nurses. We appreciate the generous grant support from our sponsors: Lilly, Medtronic, and NovoNordisk, in order to provide this unique educational offering and the opportunity to network with our school nurse colleagues. Based on the positive feedback, we followed the design of last year’s program with a keynote address each morning, which were a thoughtprovoking way to start each day. We would like to thank all of our invited speakers, member and guest presenters, and member poster authors who did a fantastic job sharing their educational expertise and talents with us. I think the educational offerings provided all attendees with new ideas and approaches that we can implement in our clinical practice. Attendees also enjoyed a variety of evening events that provided great opportunities to network, catch up with old friends, and meet new colleagues. It has been my privilege and honor to serve as the Chair of the Conference Planning Committee (CPC). I am very grateful for the opportunity to

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work with the CPC team, who worked tirelessly to organize such a terrific conference. Each member brought her own talents and skills to contribute to our goal of offering an unforgettable educational offering.

about updates or new products and services related to patient care and education. Special thanks to these sponsoring companies: Abbvie, EMD Serono, Ferring, Genentech, Lilly, NovoNordisk, Pfizer and Sandoz.

I would like to take this opportunity to acknowledge my wonderful team of CPC members and staff who worked so diligently on the Conference program and the logistics of organizing:

Please remember to go online and complete your evaluations in order to receive CNE credit and also to share your feedback about the conference. We value the input from our members as we plan next year’s conference.

 Rebecca Crispi  Tammy Nenadovich  Cathy Metzinger  Board Liaison: Maryann Johnson  PENS Education Program Coordinator: Dede Gish-Panjada  Caitlin Arnold, Meetings Manager  Melinda O’Brien, Education Assistant  JerrieLynn Kind, Executive Director Also, I would like to express my gratitude to my PENS’ friends and colleagues for the kindness and support that I received during a family emergency. I feel fortunate to be part of such a wonderful, caring group and I appreciate your good wishes. I would also like to take this opportunity to thank all of our sponsors and exhibitors. Your support and contribution is key to the success of our conference! Our members enjoyed the opportunity to meet with you, get hands-on experience with products, and learn

I look forward to serving a second year as the Chair of the CPC for next year’s conference. The CPC held an open meeting during the Committee Session at the conference to invite anyone who is interested in volunteering for the committee to learn more about it and submit an application if interested. We were pleased at the response of those who attended the meeting and expressed interest in volunteering; the selection of committee members will be completed soon. Please mark your calendars to attend next year’s conference to be held in Minneapolis, Minnesota, April 26- 29, 2017, as we celebrate the 30th conference of PENS! Best wishes for an enjoyable summer. Take care, Meg Keil

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Captured Memories from PENS 2016 National Conference Lots of fun, friends and education were found at the 2016 PENS Conference in Denver! We hope you took some snapshots of your memories while attending!

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Have you joined the PENS E-Community? Why wait? Start now! Communication between PENS members just got easier! 

We are excited to offer our members information about our E-Community forums which are located in the Member Services section of our website. We have two forums open for members like you to interact with one another!

Current forum topics include: General Peds Endo and Diabetes.

How do I sign up (subscribe)? Simply sign in to the Members Only section with your ID number and password. If you need your ID number, check your Insider email or contact us at PENS@kellencompany. com. If you have not personalized your password, your password is “PENS12.” If you have forgotten your password, use the links on that page to reset it. Once you are logged in, click on the “Communities” link on the upper right of the page. Once there, you can view the Rules and Regulations document in the Announcements section as well as peruse the different forum titles. To join a forum, simply click “subscribe” on the desired forum.

How does it work? Once subscribed, you will be able to interact with other PENS members by posting questions/comments pertaining to the specific topics. An email alert will be delivered to you when there is activity in the forum to which you have subscribed. To remove yourself from a specific forum, simply click “unsubscribe.”

Posting Tips 

Lengthy Messages If you plan to post a lengthy message, it would be wise to write it out in a Word document first, then copy and paste the text to the Forum when you are ready to post it. If you are interrupted or otherwise delayed while composing a post (20-30 minutes), it is possible that the system will “time out” which will cause you to receive an error when attempting to post your message. The post may then be lost and need to be re-composed.

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Editing Messages Please be sure to proof messages prior to posting (clicking the save button at the bottom of the screen). While the Forums provide the ability to go back and “edit” your post, please be aware that every edit that is made will be re-posted to all committee members resulting in multiple alerts going out.

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Responding to Messages When you receive the notification email that a posting has been created, you must be logged in to the community to reply. If you are continuously logged in, you can click the link in the email and your response will be posted. However, if you are not logged in, your response will not post. It is best to come to the community and sign in to respond effectively.

As nurses, we know we get a lot of great information from one another. This tool will allow you to ask questions and get answers directly from your peers! We hope that you enjoy the community and get the most out of this member benefit. If you have questions or problems, please do not hesitate to contact us.

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COMMITTEE REPORTS Education

Nominating

Committee The Education Committee is ready to go as we embark as a “renewed committee” with fresh faces and new directions. We have many first-time members to the Committee who are anxious to get started on providing the PENS Community with an innovative approach. We will begin to maintain and update the entire website with more up to date information. We will continue to collaborate with our other committees and offer support to them as needed with regards to education. Our mission is to provide resources for our members for their professional development as well as education for families and patients. The Education Committee will continue to work on the patient education handouts, as many have been completed by the previous committee and are available on the website. As noted at the Conference in Denver in May there are only a few handouts to finish and that project will then be complete. We will be looking at placing these handouts into a rotation to be reviewed in cycles in the future. PENS Education Committee members have worked very hard for years to create these documents for our members for use in practice to educate patients and families. Our mantra will be…. Let’s Educate and Promote Our Knowledge as Peds Endo Nurses... Respectively Submitted by, Lisa M. Davis MSN, APRN, CPNP

Committee Attention all members! If you or someone you know is interested in running for a position within PENS for 2017 please do not hesitate to contact us anytime. Nominations will be accepted for the positions of Treasurer, Director and Nominating Committee. Reminder to all members: Please do tell all new nurses about PENS, share the link to our website and talk about membership benefits too. Thank you from your Nominations/Membership committee.

International Pediatric Endocrine Nursing Events Save the Dates! 

ESPE 2016, September 10-12, 2016 in Paris, France

Join us for the 2nd Annual International Nurses Networking Event September 11th, 2016 at 1800 hrs. RSVP to nkirouac@hsc.mb.ca  1st ever: International Pediatric Endocrine Nursing Summit, September 13, 2017 in Washington, DC PENS is collaborating with the Canadian Pediatric Endocrine Nurses Group (CPEN), Endocrine Nurses Society of Australia (ENSA), and the European Society of Pediatric Endocrinology Nurses (ESPEN) to put together this Summit for all Pediatric Endocrine Nurses. Consider putting together a poster for the summit as well as attending the 10th International meeting of Pediatric Endocrinology September 14-17th at the same location. www.internationalmeeting2017.org for details on the larger meeting. More information on the Nursing Summit poster submissions to follow in coming months! Nicole Kirouac RN BN, nkirouac@hsc.mb.ca

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“Committee Reports” continued from page 9

Research

Committee We had a wonderful R-E-S-E-A-R-C-H presence at PENS Denver 2016! Informal reports conclude that this year’s Poster Session was outstanding. Thank you to all who submitted abstracts and created posters; they truly foster discussion amongst us about pediatric endocrine practice and research. A great big thank you to three outstanding speakers at our General Research Session for sharing their research projects with us. Jan Foote presented “Development and Psychometric Testing of the Neonatal Growth Measurement Survey,” Erika McCann presented “Screening for Retinopathy in Children and Adolescents with Diabetes Mellitus,” and Joanne Moser presented “Development of a Pediatric

Screening Tool for Diabetic Peripheral Neuropathy. All of us are inspired to hear about research efforts by our members and look forward to hearing updates on these projects. Please find this year’s abstracts published in the May/June issue of the Journal of Pediatric Nursing. We had an invigorating concurrent session on research and evidence based practice- we were so immersed in discussion that the moderator was forced to close down the room for us to stop! For anyone interested in details about evidence based practice, check out the PENS column by Carol Howe and Sharron Close, also in the May/June JPN issue. Research is exciting at PENS!

a new grant opportunity to our membership. Recently approved by the PENS Board of Directors, we are inviting applications for a 2-year Multi-Center Grant that will facilitate collaboration among investigators and institutions. The Multi-Center Grant offers support of $90,000 ($45,000 per year) to investigative teams from 3 or more institutions. This grant is the largest ever offered by PENS. Details for this as well as two other grants, the Research and the EBP grant, can be found on the PENS website. Contact Sharron Close for more information. Carol Howe, PhD, RN, CDE

Speaking of exciting, we announced

PENS Conference Reimbursement Scholarships Entries Each year, PENS allocates funds to assist selected members with conference fees. Applying for the scholarship is easy and it could be worth up to $1000 in conference scholarship funds to help with your expenses to the conference. The below entries are from our winning recipients of the scholarship in the clinical exemplar category. 2017’s scholarship cycle will begin early next year – be on the lookout any apply!

Nila Cardozo, BSN, RN My clinical exemplar is about a patient that received a growth hormone stimulation test (GHST) during my orientation, as I shadowed to learn the process. I was introduced to endocrinology stimulation tests and familiarized with the provocative agents that are used for the GHST at the facility where I am employed, when I realized that clonidine, arginine and glucagon can have

dreadful side effects on the patients. Any miscalculation can lead to death. I remembered feeling scared and uncertainty of what to expect when I actually had to do the test myself. As I continued with my training I realized that although clonidine is easy to administer, it is readily available, more economical, and the side effects were drastically horrific just as I had read about it. The second GHST that I shadowed was for a two year old. The patient arrived for the test with her mother at the clinic at 0800, fasting since 0300 and received glucagon and clonidine based on current weight. Half an hour into the test blood pressure dropped to 70’s/40’s, then 60’s/40’s, my preceptor said to start trendelenburg position while she reached out to the endocrinologist on-call for disposition. The patient began to have a sedated look, pale with a glazed gaze, still responsive to mother’s voice and touch but almost lifeless. My heart was racing, but Continued on page 11

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felt as if it had stopped beating at the same time. I was tried to stay calm to keep the mother calm and not create a panic. I thought to myself if I had seen this on the floor, I would have called for a code blue already. I felt that the two to three minutes my preceptor was out of the room was an eternity. I was ready to push the code blue button, when my preceptor came in with a verbal order from the endocrinologist to do a normal saline bolus 10ml/ kg. The patient received a total of four boluses, blood pressure stayed in the 70’s/40’s but the patient was more responsive, her color was beginning to come back and gaze was interactive with mother’s gaze. The endocrinologist came to see the patient and say that it was the side effect from the clonidine that it will be wearing off soon and vital signs will be normalizing soon, but to continue with maintenance infusion of normal saline. The GHST was completed successfully with continuous diligent monitoring and vitals went back to normal, cheeks were pink again and slowly began to take oral fluids. Patient was discharged around 1500 with baseline vitals, responsive, playful and verbal. I remember thinking that I would not want to do an infusion of medications and tests that would get a patient to that state. I began to think why was this medication even an option of a provocative agent at all if other agents are available that do not have horrific side effects. When arginine and glucagon were used, side effects were mostly nausea and vomiting with minimal to no drop in blood pressure. I was so shocked by what happened to the two year old that I began to proactively advocate for the patients, repeatedly requested for the GHST protocol and order set to be changed and updated. After one year of working with endocrinologist and interim-chief medical director, the order set and protocol for GHST was updated to reflect safer practice with specific guidelines on how to proceed when side effects and hypoglycemia are present. The new protocol was a great success of which I am greatly proud. The updated process keeps patients safe and provides nurses guidelines on what to do until an endocrinologist can provide a disposition. It also provides limits of acceptable blood pressure based on age and sugar levels for the test to guide appropriate interventions. No patient should go through those horrendous side effects if there are other safe options available. If I were a parent I would want the safest way possible to get the test done and sometimes as outpatient clinicians we forget that the most economical options are not the safest options. When it comes to pediatric patients, even though medication calculations are based on weight, some patients are just very sensitive to medications.

Attending conferences such as the PENS National Conference, is a way to keep up to date on current practices within endocrinology and provide safe care. I look forward to attending the conference since it will be my first and I am eager to learn how other medical establishments practice.

Janice Plain, LPN, CRN Learning Patience and Compassion from Patients Burned out, that’s where I was in my nursing career. After twenty-six years, I had lost my passion for nursing. I had begun to search for a new career when Dr. Deeb reached out to me with a job offer in his pediatric endocrinology office in Tallahassee, Florida. As I began working with the children and their families my previous passion for nursing was restored and began to burn brighter than ever before. Parents and children alike are so grateful for the care we provide. I have grown over the past year as a result of these interactions. Diabetes is a large part of our practice and I came into this position understanding diabetes as a disease. What I did not comprehend in the beginning was how allencompassing diabetes is for the child and their family members. I recently heard a speaker say that being diagnosed with Type 1 Diabetes is like getting a new fulltime job with no pay, no vacation and no benefits. There is so much truth in his statement. I have two stories that I would like to share. The first involves a friend of mine with a newly diagnosed Type 1 Diabetes child that recently turned four years old. I knew about the child’s diagnosis and had sympathy for them but I fell into the same trap that others thoughtlessly do. “It’s just diabetes, they can treat him with insulin and he will be fine.” I had no idea that her world had been turned upside down until I became their nurse and she confided in me during an office visit. She expressed anger, anxiety, and frustration, mental and physical fatigue and last but not least fear. She doesn’t sleep for more than an hour at a time during the night because she worries he may be low, she checks him constantly. Her husband volunteers to take over night watch but she continues to do it herself because she can’t let go of the fear. I read her posts on Facebook and she is frustrated that her own friends and family do not understand the magnitude of Type 1 Diabetes. Anger is present, she was recently scorned by another mother at a restaurant when she checked her son’s blood sugar at the table. These are her words… “Fortunately my friends would never say any of this, but a few people who don’t know us well, have said them all at Continued on page 12

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“Scholarship Entries” continued from page 11 one time or another. Then there was the Mom who gave me a nasty look, with her lip curled up, in Chick-Fil-a one day when l checked Cody’s blood sugar, after I stared back and said “what? “ and gave her a look that said “say something and it will be you and me... Mostly me!” She kept her comments to herself and turned away!” It’s clear that she is still learning to cope with her son’s diagnosis, she will find a way to effectively deal with her emotions because she is a strong, smart and loving mother. Their story has made a permanent impression on me and has given me so much com passion for the children and their families. The second story that I would like to share with you involves a mother of a T1D child that taught me yet another lesson about compassion and understanding. Our office participates in the T1D registry and enrollment recently opened again for a limited amount of time. I was excited to introduce families to T1D and cheerfully approached a mother with a consent form ready to explain the registry. The mother snapped at me that she wanted no part in the registry. To be frank, she was absolutely rude. I walked away from the room somewhat irritated that she had spoken to me in such a manner. After all, it’s “just” a registry that collects data and would not require extra visits or work on their end. I went back to my desk believing she was a grouch. Several minutes later I went back into the room to retrieve his glucometer and the mother was sitting quietly with tears in her eyes. She apologized to me. Before I could assure her that no apology was needed she began to tell me her story. Her son was diagnosed with T1D as a toddler and she has managed it so well until recently. She checks blood sugars 6-8 times a day, he is on pump therapy and his A1C is always in range. Now he is thirteen and going through puberty. Puberty is hard enough on parents and kids alike but adding T1D to the mix is making things very complicated for her. Her words to me were “I am so sorry that I was rude to you but I can’t do one more thing right now, diabetes has taken over our lives.” She felt she was losing control. Now he is old enough to be an active participant in his own care but has decided he is “over” diabetes. Simply put, he is fed up! For the next 30 minutes she poured out her feelings to me. Once again I heard the same emotions. Fear, anger, frustration and fatigue. As I listened to her I felt so much compassion for them both. I believe the child was stunned to hear his mother talk like this to a stranger and I also believe it opened his eyes to the fact that she is just trying to keep him alive and allow him to live a long and healthy life without the

complications that can occur from not taking care of his diabetes. I left the room as Dr. Deeb came in to complete the visit. She found me on her way out and expressed her gratitude to me for listening to her when she needed to let her feelings out. I learned once again to never forget what the child and the family live with on a daily basis. These families have reminded me why I became a nurse all of those years ago.

Judith Lowitz, RN, CPN, LMT I have worked as a staff nurse in a variety of inpatient units for my entire nursing career spanning a couple of decades. Then, I found an opportunity to step out of my comfort zone in the hospital and venture into a completely different venue. For the past three summers, I volunteered at a camp for kids with type 1 diabetes. Since I am licensed as both a registered nurse who specializes in pediatric endocrinology and a massage therapist, I acted in both roles. I practiced one or both skills in any given situation depending on the needs of the camper, as assessed by myself and the medical staff. I found this both rewarding and gratifying. The routine in this camp included pre-meal and bedtime blood sugar checks. Then the kids received their insulin injection. Sometimes waiting their turn to receive the insulin was a source of frustration, and some kids got restless and impatient. I initiated giving massages to help distract them and provide them with individual attention. The resultant atmosphere was much calmer, and the kids became less tense and more attentive to instructions. The beauty of camp for kids with diabetes was that the kids met and befriended other kids with diabetes, which made them feel less isolated. Most significantly, they learned to incorporate sound diabetes management decisions into their daily lives. As a volunteer, I felt great helping to ensure that the kids learned that living with diabetes includes fun and the ability to reach almost any goal. In my dual role, I helped find “teachable” situations. For example, when I gave a massage, I taught about foot care and the care of any cuts or vulnerable areas of the body to getting hurt. While I gave a massage to one camper, I had a whole audience of other campers in the bunk who were listening (hopefully) as they waited their turn. A common occurrence with kids at camp is homesickness. I offered these kids massage, which Continued on page 12

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“Scholarship Entries” continued from page 11 they usually readily and happily accepted. Giving them individual attention provided a unique opportunity for them to share their thought, feelings, and concerns. I found that this gave them an increased sense of wellbeing and an increased ability to deal with inevitable stressors they may encounter. Of course, kids at camp sometimes got hurt while having fun. Another example where I utilized both professional skills was when a camper developed a couple of cuts and bruises from sliding down a sliding board. I thoroughly cleaned and dressed her cuts and assessed her for any injured areas. After I consulted with the medical staff,

I gave her a light massage which provided comfort and distraction. This gave her the ability to bounce back and again enjoy the activities. Initially, when I decided to volunteer at a camp for kids with a chronic condition, I felt anxious and uneasy. However, with the support of my colleagues who gave me positive reinforcement and made me feel like I was a significant part of the team, I was able to overcome my hesitancy. These experiences increased my confidence, provided professional development, and gave me a more comprehensive understanding of the kids that I care for in the hospital.

Intro to Bylaws Changes As you may remember, the membership recently voted on several bylaws changes for the Society. Here’s the scoop on what the changes were and what it means going forward: Increase of one director to balance our seven member board when President-Elect and/or Immediate Past President role is not present.

ARTICLE IV Board of Directors A. The organization shall be governed by the Board of Directors. The Board of Directors includes the President, Immediate Past President, President-Elect, Secretary, Treasurer, and three Directors. The President and President-elect are not to be employed by industry The Immediate Past President and President Elect will serve on alternate years. Immediate Past President would not hold a seat on the Board when a President-Elect is holding a current seat. Section 3. President-Elect The President-Elect shall 1) assist the President in the performance of the president’s duties as requested; 2) learn the duties of the President; 3) substitute for the President as requested; and 4) assume the office of President at the end of the President’s term. The President-Elect position may only be filled by a member who has served as a current or past PENS leadership role. Increasing the Presidential term to two years encourages uniformity for the organization. This allows the President time to foster relationships with staff, members, vendors and allied organizations, as well as additional time to develop and implement their goals and plans.

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B. Term of Office Section 1. The President shall serve a one-year term as PresidentElect, a two-year term as President, and a one-year term as Immediate Past President. The total commitment is four years. In order to maintain a seven member board we would add another director position which would be a two-year term. (Three directors in total with staggered terms.) Section 4. Terms of office shall be staggered. The Secretary, President-Elect and one Director shall be elected in even years, and the Treasurer and two Directors shall be elected in odd years. Once these changes came into effect with the approved vote, our president at that time, Maryann Johnson, agreed to lengthen her term and became our first president with a two-year term. Cheryl Switzer, president-elect, will remain in this position until the close of the conference in 2017 when she will become president for a two-year term. Your Executive Staff and Board of Directors believe these new and improved terms of office will greatly improve the communication within the group and maintain the consistency of running the organization on a day to day and strategic level. Thank you to all those who took part in our bylaws vote – the changes were made because you made a difference!

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Thank You For sharing feedback that helps shape our future together, for giving us opportunities to listen and learn from you, and for everything you do to support patients and caregivers every step of the way. Here’s to the journey ahead and moving forward together.

Every advocate needs an ally.

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