FANNP

1 September 2012, Vol. 23, No. 3. FANNP HIGHLIGHTED: NEONATAL NURSE-PRACTITIONER-PERFORMED. CIRCUMCISIONS. NEWS PLUS: POCKET NOTEBOOK LEGISLATIVE UPDATE EDUCATIONAL. OFFERINGS BRING IT ON LETTER FROM THE PRESIDENT NEW. BRAG BOARD. The Publication of the Florida Association of Neonatal Nurse Practitioners Neonatal Nurse Practitioner-Performed Circumcisions Legislative Leigh Ann Cates MSN, RN, NNP-BC, RRT-NPS. Update NNP -Texas Children's Hospital - Houston, TX. Assistant Professor - University of Texas Medical Branch - Galveston, TX. Diana Morgan-Fuchs, ARNP, NNP- Circumcision is a practice that Gomco clamp, and practice-specific BCS dates back to Biblical times. It involves steps to obtaining privileges for the removal of the foreskin that covers circumcision. The American Academy of the glans penis. Circumcisions are In order to obtain consent for Nurse Practitioners' 27th National typically performed in the hospital infant circumcision, the Nurse Conference was held June 20th by a Physician, Nurse Practitioner, or Practitioner must understand the through 24th in Orlando, Florida.

2 The Mohel that has been granted hospital indications, contraindications, conference provided an opportunity privileges. There are a number of complications, and need for emergent for Nurse Practitioners to attend different instruments used to perform intervention. Currently, the primary their regional meeting and obtain circumcision, including Gomco, indication for circumcision is parental region-specific updates from their Plastibell, and Mogen clamp devices. request. Thus, when obtaining representatives. Region 11 includes the Reportedly, in practices across the state consent, it is common to review states of Alabama, Florida, Georgia, of Texas, Nurse Practitioners are being with the parents that circumcision Mississippi and the Caribbean required to perform circumcisions is not medically necessary, and is Territory. The meeting began with a more frequently than in years past. request-driven (Lannon, Bailey, &. general message regarding the growth This change in practice raises a number Fleischman, 1999, p.)

3 686). Other of the American Academy of Nurse of questions, including standard rare indications include phimosis, Practitioners organization (AANP). training with regard to learning the paraphimosis, or balanitis (Angel, As of April 2012, the AANP has skill of circumcision, appropriate Maddox, & Rosenkrantz, 2011, reached its highest number of members preceptor identification and the p. 3). Some suggested benefits of at 3,800. A few goals discussed number of circumcisions required circumcision include a primary were continuing to build AANP. and qualifications for credentialing. reduction in urinary tract infections membership enrollment and striving This article will discuss the process of (Wiswell & Hachey, 1993, p. 4), for Nurse Practitioners to have plenary obtaining consent for circumcision, management of sexually transmitted authority in Region 11 by 2020. as well as establish standard disease (Weiss, Quigley, & Hayes, The ultimate goal is to promote an contraindications, complications, and 2000, p.

4 2361)(Bailey, Neema, awareness of the AANP to other Nurse adverse outcomes requiring emergent & Othieno, 1999, p. 294), and a Practitioners in an effort to build intervention. Additionally, this possible decrease in penile cancer support and cohesiveness regarding the article will include a description of (Schoen, 2006, p. 385). organization's legislative endeavors. performing a circumcision utilizing a CIRCUMCISIONS continues on page 4. LEGISLATIVE continues on page 6. 2. Letter from the President I hope your Summer has been filled with fun, relaxation, vacations and spending time with family and friends. It's time once again for back-to-school activities, tailgating, football and Fall festivities. It's my favorite time of year because our 23rd FANNP Symposium is just a few short weeks away! Our registration numbers are growing daily, but we still have room for more attendees. So, if you haven't registered yet, now is the time! You can register easily and quickly using our website at org.

5 Remember to encourage all of your NNP students, new graduates and fellow colleagues to attend. The opportunities for learning and networking are immense! Whether you are seeking employment, looking to hire new or experienced NNPs, hoping to establish professional friendships, or simply eager to refresh or obtain new knowledge, this is the conference for it all not to mention the beach, sunshine, and incredible sunsets! In your conference activity planning, be sure to register for the FANNP Brunch on Thursday. In addition to the phenomenal food, the Brunch facilitates an opportunity for our members to assemble and share valuable input regarding how to strengthen the mission and goals of our organization. Also, you do not want to miss the 80's-themed beach party! It's the time to just have some plain ole fun! Whatever your conference activity choices, we promise a memorable time. A day without laughter is a day wasted (Charlie Chaplin). See you in October! Terri Marin, PhD, NNP-BC.

6 President, FANNP . THE FLORIDA ASSOCIATION OF. NEONATAL NURSE PRACTITIONERS. BOARD OF DIRECTORS NEWSLETTER EDITOR. Terri Marin, Peachtree city , GA. Tiffany Gwartney President . Leslie Parker, Gainesville, FL. President Elect MEMBERS AT LARGE. Ruth Bartelson, Winter Park, FL Ashley Darcy Past President Jacqui Hoffman Kim Irvine, Land O'Lakes, FL. Mary Kraus Secretary Having a good time at FANNP 's annual Sheryl Montrowl, Gainsville, FL Diane McNerney Join us this year at the 23rd National Neonatal Nurse Treasurer Practitioners Symposium: Clinical Update and Review October 16-20, at the Sheraton Sand Key Resort, 1-800-74- FANNP Clearwater Beach, Florida Box 14572, St. Petersburg, FL 33733-4572. 3. EDUCATIONAL. OFFERINGS. FANNP Brag Board Care of the Surgical Neonate: Where the Journey Begins October 4-5, 2012. Inn at the League FANNP is very fortunate to be On August 11, 2012, Patrice Rogers, Philadelphia, PA. associated with and supported by a MSN, NNP, graduated from the multitude of talented and professional University of Florida's School of 2012 Annual Vermont Oxford Practitioners who continually grow Nursing with her MSN degree.

7 She Meeting & 13th Quality and develop themselves. The purpose is currently studying for the NCC. Conference of the Brag Board is to call attention exam. Patrice hopes to find a position October 13-14 2012. to achievements such as acceptance in the Central Florida area and is Sheraton Chicago Hotel & Towers by a professional organization for looking forward to utilizing her many Chicago, IL. poster presentations, completing years of dedicated nursing experience an MSN, DNP or PhD program, in beginning her career as an NNP. FANNP 's 23rd National passing the NCC exam, acceptance In honor of the 40th anniversary Neonatal Nurse Practitioners to be published in a professional Symposium: Clinical Update publication, or even survival of of the opening of the University of and Review one's dissertation defense. The Tennessee, Knoxville's College of October 16-20, 2012. FANNP would like to recognize the Nursing, Dr. Terri Marin, PhD, Sheraton Sand Key Resort following individuals for their recent NNP-BC was selected as a recipient Clearwater Beach, Florida accomplishments: of the Fabulous 40 Nursing Alumni Award'.

8 The award identifies forty Contemporary Forums'. On May 3, 2012, Melissa Lopez, outstanding alumni who were The Fetus & The Newborn MSN, NNP-BC graduated from the nominated and selected because October 28-31, 2012. University of Missouri in Kansas city of how they make a difference in Hyatt Regency San Francisco San Francisco, CA. and successfully passed her NCC the lives of individual patients, board certification exam on July 19, organizations, and/or the community. 2012. She has recently accepted a The awardees will be recognized Contemporary Forums'. position at All Children's Hospital, at the 4th Annual NightinGala Developmental Interventions located in St. Petersburg, FL. Melissa for EXCELLENCE in nursing in Neonatal Care attended the FANNP conference and healthcare, LEADERSHIP in November 7-10, 2012. in 2011, and found it to be a great advancing the nursing profession Orlando, Florida preparation resource for her board and INNOVATION in professional exam. nursing. Hot Topics in Neonatology December 3-4, 2012.

9 On May 4, 2012, Jillian Congratulations and strong work Omni Shoreham Hotel Aschenbrenner, MSN, NNP-BC to all of our June graduates, Jillian Washington, DC. graduated from the University of Aschenbrenner, NNP, Melissa Lopez, Florida and successfully passed her NNP, Patrice Rogers, NNP and Dr. NCC board certification exam on Terri Marin, NNP for their exciting NEO-The Conference for Neonatology July 5, 2012. She also has recently accomplishments! Do YOU have an Continuous Quality Improvement accepted a position at All Children's exciting professional accomplishment February 21- 24, 2012. Hospital's NICU. Jillian attended you would like to share with us? If so, Hilton Bonnet Creek the 2011 FANNP conference with please email Orlando, Florida Melissa Lopez in preparation for com with submissions. her board examination. Jillian is excited about her new position and Thank you! developing her skill set as a new NNP. 4. CIRCUMCISIONS. Continued from page 1. In addition, the Nurse Practitioner the penis and a safety pin or hemostat is performance of circumcisions.

10 Currently, must ensure that the patient has no utilized to secure the foreskin to the bell. the Medical Director has been required contraindications to circumcision. The base of the Gomco is then attached to appear before the credentialing These include prematurity, concealed to the bell, and securely tightened. Finally, board to address the necessity, level or buried penis, webbed penis, chordee, a scalpel is used to excise the foreskin of training, and Physician support for hypospadias, epispadias, micropenis, or distal to the Gomco clamp. Once this Practitioner-performed circumcisions. The ambiguous genitalia (Angel et al., 2011, is complete, the Gomco device can be credentialing board must then confer and p. 3). Although bleeding diatheses are not removed, and a dollop of petroleum jelly agree to extend privileges; they remain in absolute contraindications, they should or bacteriostatic ointment can be applied deliberation at this time. be discouraged. The most common to the glans of the penis.