2021 general assembly handbook

2021 ENA General Assembly

2021 General Assembly

Handbook

Table of Contents

General Assembly Business Agenda ............................................................................................................ 2

General Assembly Officials .......................................................................................................................... 4

Proposed General Assembly Standing Rules of Procedure .......................................................................... 5

Bylaws and Resolution Proposals

Proposed Bylaws Amendment Proposals

GA21-01: Term Limits for Board Members .......................................................................................... 8

GA21-02: Institute a Minimum Ter for Filled Vacancies .................................................................... 10

GA21-03: Proposal to Restructure the Nominations and Elections Committee ................................... 13

Proposed Resolutions

GA21-04: Federal Nurse Practice Act and Licensing in the United States of America ....................... 43

GA21-05: CATN (Course in Advanced Trauma Nursing) in the Classroom ...................................... 51

GA21-06: Emergency Clinical Nurse Specialist National Certification .............................................. 55

GA21-07: Triage Challenges in Emergency Nursing and Conducting Research ................................. 59

GA21-08: Training of the Emergency Care Assistive Personnel in the Emergency Department ........ 64

GA21-09: Increasing Community Resources ....................................................................................... 66

GA21-10: Identify and Support Ways That Decrease Emergency Department Nurses Taking Work-

Related Stress Home ............................................................................................................................ 71

Appendices

Appendix A – ENA General Assembly Reference Guide .......................................................................... 78

Appendix B – ENA Strategic Plan .............................................................................................................. 80

Appendix C – ENA and Affiliate Audited Consolidated Financial Statements 2020 ................................ 84

Appendix D – 2021 ENA Committee Roster ............................................................................................ 125


2021 General Assembly Business Agenda

6:00-10:00 am Pacific Time

7:00-11:00 am Mountain Time

8:00 am-12:00 pm Central Time

9:00 am-1:00 pm Eastern Time

TUESDAY, SEPTEMBER 21

8:00-8:15 am ................................................. General Assembly

Call to Order

Credentials Report

Adoption of General Assembly Standing Rules of Procedure

Adoption of Business Agenda

8:15-8:30 am ................................................. President Address & State of the Association

8:30-9:15 am ................................................. Open Reference Hearings

GA21-01: Proposals to Amend Bylaws: Minimum Term for Filled

Vacancies GA21-02: Proposals to Amend Bylaws: Term Limits

GA21-03: Proposals to Amend Bylaws: Structure of the

Nominations and Elections Committee

GA21-04: Federal Nurse Practice Act and Licensing in the United

States of America

GA21-05: CATN (Course in Advanced Trauma Nursing) in the

Classroom 9:15-9:45 am ................................................. BREAK

9:45-11:30 am ............................................... Open Reference Hearings

GA21-06: Emergency Clinical Nurse Specialist National

Certification

GA21-07: Triage Challenges in Emergency Nursing and

Conducting Research

GA21-08: Training of the Emergency Care Assistive Personnel in

the Emergency Department

GA21-09: Increasing Community Resources

GA21-10: Identify and Support Ways that Decrease Emergency Department Nurses taking work-related stress home

12:00 pm ....................................................... Adjournment

WEDNESDAY, SEPTEMBER 22

8:00-8:15 am ................................................. General Assembly

Call to Order

Credentials Report

Adoption of Business and Consent Agendas

8:15-9:15 am ................................................. Consideration of Proposed Bylaws Amendment Proposals and

Resolutions (Debate and Vote)

GA21-01: Proposals to Amend Bylaws: Minimum Term for Filled

Vacancies GA21-02: Proposals to Amend Bylaws: Term Limits

GA21-03: Proposals to Amend Bylaws: Structure of the

Nominations and Elections Committee

GA21-04: Federal Nurse Practice Act and Licensing in the United

States of America

GA21-05: CATN (Course in Advanced Trauma Nursing) in the

Classroom 9:15-9:45 am ................................................. BREAK

Sarah.McNulty

Typewritten Text

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2021 General Assembly Business Agenda

6:00-10:00 am Pacific Time

7:00-11:00 am Mountain Time

8:00 am-12:00 pm Central Time

9:00 am-1:00 pm Eastern Time

9:45 am-12:00 pm ......................................... Consideration of Proposed Bylaws Amendment Proposals and

Resolutions (Debate and Vote)

GA21-06: Emergency Clinical Nurse Specialist National

Certification

GA21-07: Triage Challenges in Emergency Nursing and

Conducting Research

GA21-08: Training of the Emergency Care Assistive Personnel in

the Emergency Department

GA21-09: Increasing Community Resources

GA21-10: Identify and Support Ways that Decrease Emergency Department Nurses taking work-related stress home

12:00 pm ....................................................... General Assembly Adjournment

Sarah.McNulty

Typewritten Text

Sarah.McNulty

Typewritten Text

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Officials

General Assembly Chair/President Ron Kraus, MSN, RN, EMT, CEN, ACNS-BC, TCRN

Indiana

Credentials Chairperson/Immediate Mike Hastings, MSN, RN, CEN

Past President Washington

President-Elect Jennifer Schmitz, MSN, EMT-P, CEN, CPEN, CNML, FNP-C,

NE-BC

Maine

Secretary/Treasurer Terry M. Foster, MSN, RN, CEN, CPEN, CCRN, TCRN, FAEN

Kentucky

Directors Dustin Bass, MHA, BSN, RN, CEN, NE-BC

North Carolina

Joop Breuer, RN, CEN, CCRN, FAEN

Netherlands

Kristen Cline, BSN, RN, CEN, CPEN, CFRN, CTRN, TCRN

California

Chris Dellinger, MBA, BSN, RN, FAEN

West Virginia

Steven Jewell, BSN, RN, CEN, CPEN

Texas

Ryan Oglesby, PhD, MHA, RN, CEN, CFRN, NEA-BC

Florida

Cheryl Randolph, MSN, RN, CEN, CPEN, CCRN, FNP-BC,

TCRN, FAEN

California

Emerging Professional Amie Porcelli, BSN, RN, CEN, TCRN

Pennsylvania

Chief Executive Officer Nancy MacRae, MS

Illinois

Parliamentarian Michael Taliercio

Legal Counsel Kimberly Pendo

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ENA General Assembly Standing Rules of Procedure

Page 1 of 3

Standing Rules of Procedure of the


Given the transition to a fully virtual format from a traditional in-person General Assembly, the ENA Board of Directors, upon the advice of ENA’s Legal Counsel and Parliamentarian, recommend the following Standing Rules governing the virtual 2021 General Assembly for adoption:

GENERAL

1. The 2021 General Assembly will be conducted using the LUMI platform. Delegates will credential, vote, and join the speaking que using the LUMI platform. Individual connectivity issues will not be a valid basis for any Point of Order or a challenge to any votes.

2. Delegates may not share or “transfer” their LUMI login information if they are unable to attend the General Assembly proceedings.

3. The General Assembly order of business will be limited to a president address/state of the association, discussion, and debate/vote of proposals.

4. Delegates and alternates must attend all General Assembly meetings and complete the post General

Assembly evaluation in order to receive a certificate of service.

RESOLUTIONS

5. Resolutions may be authored and submitted by the ENA Board of Directors, ENA committees,

the Journal of Emergency Nursing Editorial Board, a state council or chapter, or by a voting ENA

member, as outlined in the ENA General Assembly Standing Rules of Procedure.

6. The submission deadline for resolutions was May 24, 2021. Resolutions received after the deadline will not be considered.

COMPOSITION

7. State council delegates will be apportioned based on the ratio of members in the state or territory

to the total ENA membership as of May 14 in accordance with the ENA bylaws. International

delegates will be allocated in accordance with the ENA bylaws. ENA headquarters will send

necessary information for designating delegates, alternate delegates and state captains to state

councils.

8. Each state council must formally register delegates and alternate delegates in the state council’s

online management area with ENA headquarters no later than June 25, 2021.

9. The state captain must be selected as soon as possible but no later than 75 days prior to the

General Assembly.

10. The ENA Immediate Past President will oversee the credentials process.

11. A member registered as an alternate delegate may be transferred to delegate status, provided

that no state delegation exceeds the maximum number of delegates allotted. All delegate

changes must be submitted to ENA headquarters via e-mail to [email protected] by 12:00


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pm Central time on September 16, 2021. No changes will be accepted following this deadline.

REFERENCE HEARINGS

12. The author (or their designee) of a resolution or bylaw amendment proposal has the right to

speak first with respect to their resolution/proposal at the Reference Hearing for up to one (1)

minute; such time will not be counted in the total time for discussion. The total discussion time

allotted for each resolution or bylaw amendment proposal is ten (10) minutes. If there are

speakers in the queue when the discussion time expires, the chair will take a vote on whether to

extend discussion for an additional five minutes.

13. Amendments to resolutions or bylaw amendment proposals may only be submitted by the

Resolutions Committee. Amendments to resolution or bylaw amendment proposals from the

delegation will not be permitted.

14. Following the Reference Hearings, the Resolutions Committee will meet to determine

amendments to resolutions or bylaw amendment proposals and will determine the resolutions

or proposed bylaws amendments to be placed on a consent agenda (if any).

15. The Resolutions Committee will make any amendments to resolutions or bylaw amendment

proposals available to the delegates as soon as possible following the reference hearings and

completion of its work.

DEBATE & VOTING

16. The Resolutions Committee will determine the order in which the General Assembly will

consider, debate and vote on resolutions and bylaw amendment proposals.

17. After being recognized, delegates and ENA past presidents must give their name and affiliation

before beginning to speak.

18. A delegate may request that an individual without speaking rights be allowed to speak. A majority

vote is required to grant the request.

19. The total debate time allotted for each resolution or bylaw amendment proposal is ten (10)

minutes. If there are speakers in the queue when the debate time expires, the chair will take a

vote on whether to extend debate for an additional five minutes.

20. The author (or their designee) of a resolution or bylaw amendment proposal has the right to speak

first with respect to their resolution/proposal for up to one minute; such time will not be counted

in the total time for debate.

21. No delegate may speak more than once on the same resolution or bylaw amendment proposal,

nor longer than one (1) minute.

22. Debate shall alternate “pro” and “con,” to the extent possible. The Chair has the discretion to

manage the queue to ensure fairness in the best interests of the assembly.

23. No motions will be permitted from the floor.


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ADMINISTRATIVE

24. The Resolutions Committee is authorized to correct article and section designations, punctuation

and references in the Bylaws, Election Rules, and General Assembly Standing Rules of

Procedure as may be necessary to reflect the intent of the General Assembly.

25. Following the conclusion of the General Assembly, the draft General Assembly minutes will be

sent electronically to all state captains and the ENA Board of Directors for a 10-day review and

comment period. The minutes shall be subsequently approved by the Resolutions Committee.

26. The status of resolutions and bylaw amendments adopted by the General Assembly will be made

available to the ENA membership through ENA publications.

Proposal to Amend Bylaws


Proposal Number: GA21-01 1 2 Title: Term Limits for Board Members 3 4 Article and Section: Article VI Board of Directors, Section 4. Term of Office 5 6 Current bylaws language: 7 8 Section 4. Term of Office 9 Directors (with the exception of the immediate past president) shall serve for a three-year term of office, or until 10 such time as their successors are duly elected, qualified and take office. In order to provide for staggered terms, 11 at least two and no more than three directors shall be elected each year. The term of office shall commence on 12 January 1 each year following the election and terminate on December 31. 13 14 Proposed changes: 15 16 Section 4. Term of Office / Term Limits 17

A. Directors (with the exception of the immediate past president) shall serve for a three-year term of office, or 18 until such time as their successors are duly elected, qualified and take office. In order to provide for 19 staggered terms, at least two and no more than three directors shall be elected each year. The term of office 20 shall commence on January 1 each year following the election and terminate on December 31. 21

B. The Immediate Past President shall serve a one-year term in office, or until such time as their successor takes 22 office. 23

C. No director may serve on the Board of Directors for more than six (6) years, not including any time served to 24 fill a vacancy. 25

D. Notwithstanding anything set forth herein to the contrary (i) a director elected to serve as an officer may 26 remain on the Board until the conclusion of their term in such office and may complete their rotation through 27 the offices (i.e., President-Elect to President to Immediate Past President) despite the fact that such person 28 may have served on the Board for the maximum number of years; and (ii) a director completing their sixth 29 year as a director is eligible to run for an officer position. 30

31 Bylaws language if adopted: 32 33 Section 4. Term of Office / Term Limits 34

A. Directors shall serve for a three-year term of office, or until such time as their successors are duly 35 elected, qualified and take office. In order to provide for staggered terms, at least two and no more than 36 three directors shall be elected each year. The term of office shall commence on January 1 each year 37 following the election and terminate on December 31. 38

B. The Immediate Past President shall serve a one-year term in office, or until such time as their successor 39 takes office. 40

C. No director may serve on the Board of Directors for more than six (6) years, not including any time 41 served to fill a vacancy. 42

D. Notwithstanding anything set forth herein to the contrary (i) a director elected to serve as an officer may 43 remain on the Board until the conclusion of their term in such office and may complete their rotation 44 through the offices (i.e., President-Elect to President to Immediate Past President) despite the fact that 45 such person may have served on the Board for the maximum number of years; and (ii) a director 46 completing their sixth year as a director is eligible to run for an officer position. 47

48

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Rationale: 49 It is considered a best governance practice to institute term limits for Board service. Term limits encourage 50 increased opportunity for diversity and inclusion in leadership, allowing for new ideas and new perspectives on 51 the board and within decision-making. With staggered terms and term limits it enables the board to ensure a 52 balance of continuity, while avoiding stagnation that may occur with long terms of service. According to 53 Leading with Intent: 2017 Index of Nonprofit Board Practices, 72 percent of nonprofit boards have term limits. 54 55 Author(s): 56 2021 ENA Board of Directors 57 58 Supporter(s): 59 Arizona ENA State Council 60 Jean Proehl, ENA #10523 61 Jamla Rizek, ENA # 743653 62 Alicyn Gary, ENA #1652520 63 Agnes Kelly, ENA #47179 64 Kelly Hooper, ENA #1306954 65 Gretchen Mayer, ENA #22518 66 Philip Lerner, ENA #657795 67 Mark Goldstein, ENA #331450 68 Todd Haines, ENA #774122 69 Benny Marett, ENA #17179 70 Mel Wilson, ENA #23035 71 Patti Kunz Howard, ENA #25128 72 AnnMarie Papa, ENA #65692 73 JoAnn Lazarus, ENA #37139 74 Victoria Bradley, ENA #12893 75 Matt Powers, ENA #212707 76 Denise Bayer, ENA #48866 77 Diane Gurney, ENA #16982 78 Anne Manton, ENA #5079 79 Adam Johnston, ENA #1050433 80

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Proposal Number: GA21-02 82 83 Title: Institute a Minimum Term for Filled Vacancies 84 85 Article and Section: Article VI Board of Directors, Section 7. Vacancy 86 87 Current bylaws language: 88 89 Section 7. Vacancy 90 A vacancy that occurs in the position of director shall be filled in the following manner: 91 A. If the vacancy occurs between January 1 and before the completion of the current year’s election the vacancy 92

shall be filled by the person receiving the next highest number of votes in the previous year’s election with 93 the term ending December 31. 94

B. If the vacancy occurs after the current year’s election and there is more than six months left in the unexpired 95 term, the vacancy shall be filled by the person receiving the next highest number of votes in the current 96 year’s election with the term ending December 31 of the following year. 97

C. If all such persons decline to serve, if there were no additional candidates for that office during the most 98 recently concluded election, or if the vacancy occurs with fewer than six months left in the unexpired term, 99 the vacancy shall not be filled. 100

101 Proposed changes: 102 103 Section 7. Vacancy 104 A vacancyVacancies that occursoccur in the position of director shall be filled in the following manner: 105

A. Vacancies with twelve (12) or less months remaining in the unexpired portion of the term will not be filled. 106 B. A. If there is more than twelve (12) months remaining in the unexpired portion of the term and the vacancy 107

occurs between: 108

(i) after January 1 and beforeprior to the completion of the current year’s election the vacancy shall 109 be filled by the person receiving the next highest number of votes in the previous year’s election with the 110 term ending December 31. 111

B. If the vacancy occurs after the current year’s election and there is more than six months left in the unexpired 112 term, the vacancy shall be filled by the person receivingthat received the next highest number of votes 113 in(after the currentelected directors) in the previous year’s election with the term ending December 31 of the 114 following year.; 115

(ii) after the current year’s election, the vacancy shall be filled by the person that received the 116 next highest number of votes (after the elected directors) in the current year’s election; or 117

C. If 118 (iii) due to the election of such director as an officer, the vacancy will be filled in the current 119

year’s election for the unexpired balance of the term they were originally elected to fill by the person that 120 received the next highest number of votes (after the elected directors) in the current year’s election. 121

122

C. In the event (i) all such persons decline to serve, ifor (ii) there were no additional candidates for that 123 office during the most recently concluded election, or if the vacancy occurs with fewer than six months 124 left in the unexpired term, the vacancy shall not be filled. 125

126

D. Directors elected to fill a vacancy shall hold office for the balance of the term they are filling or until 127 such time as their successor is duly elected, qualified and takes office. 128

129

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Bylaws language if adopted: 130 131 Section 7. Vacancy 132 Vacancies that occur in the position of director shall be filled in the following manner: 133

A. Vacancies with twelve (12) or less months remaining in the unexpired portion of the term will not be filled. 134 B. If there is more than twelve (12) months remaining in the unexpired portion of the term and the vacancy 135

occurs: 136 (i) after January 1 and prior to the completion of the current year’s election, the vacancy shall be 137

filled by the person that received the next highest number of votes (after the elected directors) in the 138 previous year’s election; 139

(ii) after the current year’s election, the vacancy shall be filled by the person that received the next 140 highest number of votes (after the elected directors) in the current year’s election; or 141

(iii) due to the election of such director as an officer, the vacancy will be filled in the current 142 year’s election for the unexpired balance of the term they were originally elected to fill by the person that 143 received the next highest number of votes (after the elected directors) in the current year’s election. 144

145

C. In the event (i) all such persons decline to serve, or (ii) there were no additional candidates for that office 146 during the most recently concluded election the vacancy shall not be filled. 147

148

D. Directors elected to fill a vacancy shall hold office for the balance of the term they are filling or until such 149 time as their successor is duly elected, qualified and takes office. 150

151 Rationale: 152 ENA invests heavily in the onboarding of new board members to ensure strength of leadership and cohesive 153 team dynamics for optimal board performance. It typically takes at least one full year for a new Board member to 154 develop full competency in their role. Accordingly, a one-year term does not provide the new director with the 155 time necessary to achieve their full potential nor ENA the ability to maximize the resources invested. By filling 156 only those vacancies with more than 12 months remaining in the unexpired portion of the term being filled, such 157 newly appointed board member is afforded the best chance to succeed while maximizing ENA’s valuable 158 resources and the efficiency and functionality of the Board. 159 160 Author(s): 161 2021 ENA Board of Directors 162 163 Supporter(s): 164 Arizona ENA State Council 165 Jean Proehl, ENA #10523 166 Jamla Rizek, ENA # 743653 167 Alicyn Gary, ENA #1652520 168 Agnes Kelly, ENA #47179 169 Kelly Hooper, ENA #1306954 170 Gretchen Mayer, ENA #22518 171 Philip Lerner, ENA #657795 172 Mark Goldstein, ENA #331450 173 Todd Haines, ENA #774122 174 Benny Marett, ENA #17179 175 Mel Wilson, ENA #23035 176 Patti Kunz Howard, ENA #25128 177

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AnnMarie Papa, ENA #65692 178 JoAnn Lazarus, ENA #37139 179 Victoria Bradley, ENA #12893 180 Matt Powers, ENA #212707 181 Denise Bayer, ENA #48866 182 Diane Gurney, ENA #16982 183 Anne Manton, ENA #5079 184 Adam Johnston, ENA #1050433 185

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Proposal Number: GA21-03 187 188 Title: Proposal to Restructure the Nominations and Elections Committee 189 190 Article and Section: Article IX Committees, Section 2, B. Other Standing Committees, Nominations and 191

Elections Committee 192 193 Current bylaws language: 194 195 Nominations and Elections Committee. 196 1. Composition 197 a. The Nominations and Elections Committee shall consist of seven Voting Members elected to serve 198

on the Nominations and Elections Committee in the ENA national election: one member from each 199 of six regions who has not previously served on the Board of Directors, and one member who has 200 served on the Board of Directors. Nominations and Elections Committee members may only 201 represent the region in which they hold a voting membership. 202

b. The six regions shall be established by Nominations and Elections Committee policy. Each region 203 shall be composed of states with geographic proximity and relatively equal membership distribution. 204

c. A Nominations and Elections Committee chairperson shall be elected each year by the incoming 205 Nominations and Elections Committee. 206

2. Qualifications 207 a. Candidates must be a Voting Member in good standing and must have been a Voting Member during 208

each of the previous five years immediately prior to submitting their candidate application. 209 b. Candidates shall have served in an elected or committee position on the local, state or national level 210

within the previous five years. 211 c. Candidates must also have attended at least one ENA General Assembly within the previous three 212

years. 213 d. Members of the Nominations and Elections Committee may not run for or serve in any ENA board 214

position during their tenure on the Nominations and Elections Committee, and may not serve more 215 than two consecutive elected terms on the Nominations and Elections Committee. 216

3. Elections 217 a. Elections for the Nominations and Elections Committee shall be held annually. Members shall serve 218

for a three-year terms with terms beginning January 1 and ending on December 31, or until such 219 time as their successors are duly elected, qualified and take office. Voting Members shall be elected 220 to serve on the Nominations and Elections Committee each year. 221

b. All Voting Members shall have the opportunity to elect Nominations and Elections Committee 222 members by ballot from all regions. Candidates receiving the highest number of votes shall be 223 declared elected. In the event of a tie vote for a position on the committee, lots shall be drawn. 224

4. Overview 225 a. The Nominations and Elections Committee has general oversight of the national election. The 226

Committee shall solicit and mentor potential candidates and review national candidate applications. 227 b. The Nominations and Elections Committee will provide periodic updates to the Board of Directors 228

regarding the progress of their charges. 229 c. The Nominations and Elections Committee shall present a qualified slate of candidates to the Board 230

of Directors for its review and discussion prior to presenting the slate to the membership. Following 231 such review and discussion, the Nominations and Elections Committee shall present the slate to the 232 membership through publication in such ENA publications as determined by the Board of Directors 233 or its designee(s). 234

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5. Vacancies 235 a. A vacancy in the chairperson position shall be filled by a majority vote of the Nominations and 236

Elections Committee. 237 b. A vacancy of a committee member shall be filled by the candidate who received the next highest 238

number of votes from that region or as the past board member in the most recently completed 239 election. 240

c. In the event of a committee member vacancy from an uncontested election, a qualified candidate 241 must be nominated and elected by the state council presidents of the region affected by the vacancy 242 according to the Nominations and Elections Committee election process, meeting the same 243 requirements set forth in the bylaws as any potential candidate. 244

d. The committee position may remain vacant as approved by the Nominations and Elections 245 Committee if less than six months remain of the unexpired term. 246

247 Proposed changes: 248 249 Nominations and Elections Committee. 250 1. Composition 251 a. The Nominations and Elections Committee shall consist of the Immediate Past President and seven 252

Voting Members electedappointed to serve on the Nominations and Elections Committee in the 253 ENA national election: one member from each of six regions who has not previously served onby 254 the Board of Directors, and one member who has served on the Board of Directors. Nominations and 255 Elections Committee members may only represent the region in which they hold a voting 256 membership. 257

258 b. The six regions shall be established by Nominations and Elections Committee policy. Each region 259

shall be composed of states with geographic proximity and relatively equal membership distribution. 260 c. A Nominations and Elections Committee chairperson shall be elected each year by The Immediate 261

Past President shall serve as the chair of the incoming Nominations and Elections Committee. 262 2. Qualifications 263 a. CandidatesMembers of the Nominations and Elections Committee must be a Voting 264

MemberMembers in good standing and must have been a Voting Member during each of the 265 previous five years immediately prior to submitting their candidate application. 266

b. CandidatesMembers of the Nominations and Elections Committee shall have served in an elected or 267 committee position on the local, state or national level within the previous five years. 268

c. CandidatesMembers of the Nominations and Elections Committee must also have attended at least 269 one ENA General Assembly within the previous three years. 270

d. Members of the Nominations and Elections Committee may not run for or serve in any ENA board 271 position during their tenure on the Nominations and Elections Committee, (with the exception of the 272 Immediate Past President) and may not serve more than two consecutive elected terms on the 273 Nominations and Elections Committee. 274

3. Elections 275 3. Term 276 a. Elections forAppointed members of the Nominations and Elections Committee shall be held 277

annually. Members shall serve for a three-year terms with terms beginning January 1 and ending on 278 December 31, or until such time as their successors are duly elected, qualifiedappointed and take 279 office. Voting MembersThe Immediate Past President shall be elected to serve on the Nominations 280 and Elections Committee each yeara one-year term, or until such time as their successor takes office. 281

282

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b. All Voting Members shall have the opportunity to electIn order to provide for staggered terms, at 283 least two and no more than three members of the Nominations and Elections Committee members by 284 ballot from all regions. Candidates receiving the highest number of votes shall be declared elected. 285 In the event of a tie vote for a position on the committee, lots shall be drawn.shall be appointed each 286 year. 287

4. Overview 288 a. The Nominations and Elections Committee has general oversight of the national election’s key 289

purpose is candidate recruitment, selection and development. The Nominations and Elections 290 Committee shall solicit and mentor potential candidates and review national candidate applications 291 in accordance with procedures adopted by the Board of Directors. 292

293 b. The Nominations and Elections Committee is responsible for vetting candidates based on 294

competencies, key criteria and a formal interview process in accordance with procedures adopted by 295 the Board of Directors. 296

c. The Nominations and Elections Committee will provide periodic updates to the Board of Directors 297 regarding the progress of their charges. 298

cd. The Nominations and Elections Committee shall present a qualified slate of candidates to the Board 299 of Directors for its review and discussionapproval prior to presenting the slate to the membership. 300 Following such review and discussionapproval, the Nominations and Elections Committee shall 301 present the slate to the membership through publication in such ENA publications as determined by 302 the Board of Directors or its designee(s). 303

5. Vacancies 304 a. A vacancy in the chairperson position shall be filled by a majority vote of the Nominations and 305

Elections CommitteeBoard of Directors. 306 b. A vacancy of a committee member shall be filled by the candidate who received the next highest 307

number of votes from that region or as the past board member in the most recently completed 308 election. 309

c. In the event of a committee member vacancy from an uncontested election, a qualified candidate 310 must be nominated and elected by the state council presidents of the region affected by the vacancy 311 according to the Nominations and Elections Committee election process, meeting the same 312 requirements set forth in the bylaws as any potential candidate. 313

d. TheBoard of Directors, provided, however, a committee position may, in the discretion of the Board 314 of Directors, remain vacant as approved by the Nominations and Elections Committee if less than six 315 months remain of the unexpired term. 316

317 318 319 Bylaws language if adopted: 320 321 Nominations and Elections Committee. 322 1. Composition 323 a. The Nominations and Elections Committee shall consist of the Immediate Past President and seven 324

Voting Members appointed to serve on the Nominations and Elections Committee by the Board of 325 Directors. 326

b. The Immediate Past President shall serve as the chair of the Nominations and Elections Committee. 327 2. Qualifications 328 a. Members of the Nominations and Elections Committee must be Voting Members in good standing 329

and must have been a Voting Member during each of the previous five years immediately prior to 330

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submitting their application. 331 b. Members of the Nominations and Elections Committee shall have served in an elected or committee 332

position on the local, state or national level within the previous five years. 333 c. Members of the Nominations and Elections Committee must also have attended at least one ENA 334

General Assembly within the previous three years. 335 d. Members of the Nominations and Elections Committee may not run for or serve in any ENA board 336

position during their tenure on the Nominations and Elections Committee (with the exception of the 337 Immediate Past President) and may not serve more than two consecutive terms on the Nominations 338 and Elections Committee. 339

3. Term 340 a. Appointed members of the Nominations and Elections Committee shall serve three-year terms with 341

terms beginning January 1 and ending on December 31, or until such time as their successors are 342 appointed and take office. The Immediate Past President shall serve a one-year term, or until such 343 time as their successor takes office. 344

b. In order to provide for staggered terms, at least two and no more than three members of the 345 Nominations and Elections Committee shall be appointed each year. 346

4. Overview 347 a. The Nominations and Elections Committee’s key purpose is candidate recruitment, selection and 348

development. The Nominations and Elections Committee shall solicit and mentor potential 349 candidates and review national candidate applications in accordance with procedures adopted by the 350 Board of Directors. 351

b. The Nominations and Elections Committee is responsible for vetting candidates based on 352 competencies, key criteria and a formal interview process in accordance with procedures adopted by 353 the Board of Directors. 354

c. The Nominations and Elections Committee will provide periodic updates to the Board of Directors 355 regarding the progress of their charges. 356

d. The Nominations and Elections Committee shall present a qualified slate of candidates to the Board 357 of Directors for its review and approval prior to presenting the slate to the membership. Following 358 such review and approval, the Nominations and Elections Committee shall present the slate to the 359 membership through publication in such ENA publications as determined by the Board of Directors 360 or its designee(s). 361

5. Vacancies 362 a. A vacancy in the chairperson position shall be filled by the Board of Directors. 363 b. A vacancy of a committee member shall be filled by the Board of Directors, provided, however, a 364

committee position may, in the discretion of the Board of Directors, remain vacant if less than six 365 months remain of the unexpired term. 366

Rationale: 367 Appointment of the members of the Nominations and Election Committee by the ENA Board of Directors works 368 to (i) ensure a diverse group of the most qualified members are selected to serve; and (ii) remedies the conflict-369 of-interest issues inherent in the current structure. Currently, the Nominations and Election Committee faces the 370 recurrent problem of committee members forced to recuse themselves from the work of the committee due to the 371 conflict of interest created by their service on the committee in the year(s) they are up for reelection to the 372 committee. It is difficult for the committee to do its work and perform its functions when 2 to 3 committee 373 members cannot participate due to a conflict of interest, leaving the committee without the important perspective 374 and contributions of such committee members. The proposed appointment process would reduce the conflict of 375 interest inherent with the committee managing its own election. 376 377 By having the Immediate Past President chair the committee, the committee will gain valuable insight into the 378

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workings of the Board and the experience and qualifications that make successful ENA directors. Best practice 379 indicates the importance of a dedicated group to ensure the development and availability of future leaders for the 380 sustained success of an organization. The proposed amendment clearly defines that the focus of the Nominations 381 and Elections Committee is on candidate recruitment, selection and development, which are the keys to ensuring 382 ENA’s continued success. It is important that the role of the committee is to develop, solicit and ensure the best 383 candidates are selected in order to meet the future needs of the organization. With the adoption of the proposed 384 amendments, candidate vetting will be done based on competencies, key criteria, and a formal interview process 385 in accordance with procedures adopted by the Board. The Nominations and Elections Committee will have the 386 authority to formally vet candidates in order to present a slate of qualified candidates to the ENA Board of 387 Directors for its review and approval. 388 389 Author(s): 390 2021 ENA Board of Directors 391 392 Supporter(s): 393 Jamla Rizek, ENA # 743653 394 Alicyn Gary, ENA #1652520 395 Agnes Kelly, ENA #47179 396 Kelly Hooper, ENA #1306954 397 Gretchen Mayer, ENA #22518 398 Philip Lerner, ENA #657795 399 Mark Goldstein, ENA #331450 400 Todd Haines, ENA #774122 401 Patti Kunz Howard, ENA #25128 402 AnnMarie Papa, ENA #65692 403 JoAnn Lazarus, ENA #37139 404 Denise Bayer, ENA #48866 405 Adam Johnston, ENA #1050433 406

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9/26/2018 Emergency Nurses Association Page 1 of 14

BYLAWS 1 EMERGENCY NURSES ASSOCIATION 2

3 4

ARTICLE I 5 NAME 6

The name of this organization shall be the Emergency Nurses Association (ENA), a not-for-7 profit corporation incorporated in the State of Illinois. ENA shall have and continuously maintain 8 in the State of Illinois a registered office and a registered agent whose office is identical with 9 such registered office, and may have such other offices within or outside of the State of Illinois 10 as the Board of Directors may determine. 11

12 ARTICLE II 13 OBJECT 14

Section 1. Purpose 15 The purposes for which the corporation is organized are educational, within the meaning of 16 Section 501(c)(3) of the Internal Revenue Code of 1986, as amended (“IRC”), including but not 17 limited to the advancement of emergency nursing through education and public awareness. 18 19 Section 2. Rules 20 The following rules shall conclusively bind ENA and all persons acting for or on behalf of it: 21 A. No part of the net earnings of ENA shall inure to the benefit of, or be distributed to, its 22

directors, officers, committee members or other private persons, except that ENA shall be 23 authorized and empowered to pay reasonable compensation for services rendered and to 24 make payments and distributions in furtherance of the purposes set forth above. 25

B. No substantial part of the activities of ENA shall be the carrying on of propaganda, or 26 otherwise attempting to influence legislation, and ENA shall not participate in, or intervene in 27 (including the publishing or distribution of statements) any political campaign on behalf or in 28 opposition to any candidate for public office. Notwithstanding any provision of these Bylaws, 29 ENA shall not carry on any activity not permitted to be carried on by: 30 i. a corporation exempt from federal income tax under Section 501(c)(3) of the IRC (or the 31

corresponding provision of any future United States Internal Revenue Law); or 32 ii. a corporation, contributions to which are deductible under Section 170(c)(2) of the IRC 33

(or the corresponding provision of any future United States Internal Revenue Law). 34 35

Section 3. Official Publication 36 The official publication shall be the Journal of Emergency Nursing (JEN), which shall reflect the 37 purpose, mission objectives and positions of ENA. 38 39

ARTICLE III 40 MEMBERS 41

Section 1. Responsibilities of Membership 42 Each member has the responsibility to support the purpose, mission, vision, values and 43 objectives of ENA. 44 45 Section 2. Classifications and Criteria. Membership may be granted to any individual who (i) 46 abides by these bylaws, the ENA Code of Ethics, and such other policies, rules and regulations 47 as ENA may adopt; and (ii) meets the criteria for membership set forth in one of the following 48 categories: 49 A. Voting Members – voting members shall be classified as national, international, senior and 50

military (“Voting Members”). Voting Members shall have the right to vote, hold elected office, 51 serve on the Board of Directors, serve on committees, and attend ENA’s meetings and 52 social functions. 53

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1. National membership may be granted to any individual who is a professional registered 54 nurse licensed in the United States or its territories. 55

2. International membership may be granted to any individual who is a professional 56 registered nurse licensed (or the equivalent thereto) outside of the United States or its 57 territories. 58

3. Senior membership may be granted to a professional registered nurse who is age 65 or 59 older and licensed in the United States or its territories. 60

4. Military membership may be granted to a professional registered nurse licensed in the 61 United States or its territories who is currently serving or has been honorably discharged 62 or retired from the United States Armed Forces including Army, Navy, Marine Corps, Air 63 Force, Coast Guard, and Reserve Components. 64

B. Nonvoting Members – nonvoting members shall be classified as affiliate, student and 65 honorary (“Nonvoting Members”). Nonvoting Members shall be entitled to serve on ENA 66 committees and attend ENA member meetings and social functions. 67

1. Affiliate membership may be granted to any individual who shares interest in and 68 supports the purpose, mission and objectives of ENA but does not otherwise meet the 69 criteria for voting membership in ENA. 70

2. Student membership may be granted to any individual enrolled in a primary nursing 71 education program leading to eligibility for licensure as a professional registered nurse. 72

3. Honorary membership may be awarded to an individual meeting such criteria as shall be 73 determined by the president and the Board of Directors. 74

75 Section 3. Dues and Finance 76 A. The initial and annual dues for all ENA members and the time for paying such dues, and 77

other assessments, if any, shall be determined by the Board of Directors. Under special 78 circumstances, the Board of Directors, or its designee(s), may waive the annual dues and/or 79 assessments for any member or category of members. 80

B. The membership of any member who is in default of payment of dues or assessments for 81 more than three (3) months, or otherwise becomes ineligible for membership, shall be 82 terminated automatically, according to such rules or procedures as the Board of Directors or 83 its designee(s) shall establish, unless such termination is delayed by the Board of Directors 84 or its designee(s). 85

C. Members who have resigned or been terminated for non-payment of dues may only be 86 reinstated (i) if no more than three (3) months has elapsed since the date of termination; (ii) 87 upon payment of delinquent dues; and (iii) in accordance with such rules as may from time 88 to time be established by the Board of Directors. Former members not meeting the 89 requirements for reinstatement must reapply for membership. 90

D. Each state council and chapter shall receive an annual allocation for each dues paying 91 member within the state or chapter. 92

E. A surcharge may be added to the dues in some states by the state’s request. 93 94 Section 4. Disciplinary Action 95

A. Grounds for Discipline. ENA may discipline a member for any of the following reasons: 96 i. Failure to comply with these Bylaws, the ENA Code of Ethics, or any of ENA’s rules or 97

regulations; 98 ii. Conviction of a felony or a crime related to, or arising out of, the practice of nursing or 99

involving moral turpitude; 100

iii. Suspension, revocation, or forfeiture by any state, province, or country of the member’s 101 right to practice as a nurse; or 102

iv. Immoral, dishonorable, or unprofessional conduct considered prejudicial to the best 103 interests of, or inconsistent with, the purposes of ENA. 104

B. Procedures. Discipline may include, but not be limited to, censure, suspension, 105 probation, and expulsion. Disciplinary action may be taken provided that a statement of 106 the charges shall have been sent by certified mail to the last recorded address of the 107

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member at least fifteen (15) days before final action is to be taken. This statement shall 108 be accompanied by a notice of the time and place of the meeting at which the charges 109 shall be considered, and the member shall have the opportunity to appear in person 110 and/or to be represented by counsel and to present any defense to such charges before 111 action is taken by ENA. Such disciplinary actions shall be conducted in accordance with 112 such additional procedures as may be established by the Board of Directors. 113

114 ARTICLE IV 115 OFFICERS 116

Section 1. Officers 117 A. There shall be three officers: President, President-Elect, and Secretary/treasurer. The term 118

of office shall commence January 1 each year and terminate on December 31, or until such 119 time as their successors are duly elected, qualified and take office. The President-Elect shall 120 succeed to the office of president at the conclusion of the term. Officers shall exercise the 121 duties and responsibilities required of a member of the Board of Directors and such 122 additional duties and responsibilities set forth below. 123

B. President. The President shall be ENA’s principal elected officer and shall, in general, 124 supervise ENA’s business affairs, subject to the direction and control of the Board of 125 Directors, by communicating with the Chief Staff Officer as necessary regarding ENA’s 126 business. The President shall be a member, without vote, of all councils and committees 127 with the exception of the Nominations and Elections Committee and except as otherwise 128 provided by these bylaws. The President shall (i) serve as the Chair of the Finance 129 Committee; (ii) serve as ENA’s official representative and spokesperson, except as 130 otherwise provided by the Board of Directors; (iii) appoint representatives to ENA’s affiliated 131 organizations and other positions as necessary; (iv) fill, subject to the approval of the Board 132 of Directors, vacancies on ENA’s committees; and (v) in general, perform all duties 133 customarily incident to the office of President and such other duties as may be prescribed by 134 the Board of Directors. The President shall succeed to the office of immediate past president 135 upon expiration of the President’s term of office. 136

C. President-Elect. The President-Elect shall assist the President and shall substitute for the 137 President when required. The President-Elect shall appoint chairs and members of 138 committees, and a Board of Directors liaison to each committee for the year following his/her 139 term in office as President-Elect subject to Board approval and shall in general, perform all 140 duties customarily incident to the office of President-Elect and such other duties as may be 141 prescribed by the Board of Directors. The President-Elect shall succeed to the office of 142 President upon expiration of the President’s term of office, or in the event of the death, 143 resignation, removal, or incapacity of the President. 144

D. Secretary/Treasurer. The Secretary/Treasurer shall be the principal financial officer and 145 secretary of ENA and shall perform all duties traditionally incident to the offices of Secretary 146 and Treasurer and such other duties as may be assigned by the President or the Board of 147 Directors. The duties of the Secretary/Treasurer may be assigned by the Board of Directors 148 in whole or in part to the Chief Staff Officer, or his or her designee(s). 149

150 Section 2. Officer Qualifications 151 A. Each officer must be a Voting Member and must have been a Voting Member during each of 152

the previous five years immediately prior to submitting a candidate application. 153 B. Each candidate for President-Elect and Secretary/Treasurer must currently serve as a voting 154

member of the Board of Directors. 155 C. Each candidate must submit to, and pass as acceptable, a limited background check. 156 157 Section 3. Election 158 A. In the event of a tie vote for the positions of President-Elect and Secretary/Treasurer, there 159

shall be a second balloting of ENA membership. 160

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B. All directors who are elected as officers shall have their unexpired terms of office filled by 161 the candidates who receive the next highest number of votes; the candidate receiving the 162 highest number of votes shall receive the position with the longest term. 163

C. A candidate for an officer position who is not elected shall continue to serve the remaining 164 unexpired years of the original term as a director. 165

166 Section 4. Vacancies 167 A. If the office of President becomes vacant, the President-Elect shall succeed to the office of 168

President for the unexpired term and shall subsequently serve the one-year term of office of 169 President to which elected. In such case, the immediate past president may remain as 170 immediate past president for a second year or the office may remain vacant for that year. 171

B. A vacancy in the office of President-Elect may be filled by a current member of the Board of 172 Directors, or remain vacant as approved by a majority vote of the Board of Directors. If the 173 vacancy is filled, the President-Elect shall not automatically assume the office of president 174 for the subsequent term. 175

C. In the event that the office of President and President-Elect are vacated during the same 176 year, the Board of Directors shall appoint an acting president to serve until the next 177 scheduled election, at which time an election will be held for both President and President-178 Elect. 179

D. A vacancy in the office of Secretary/Treasurer may be filled by a current member of the 180 Board of Directors or remain vacant as approved by a majority vote by the entire Board of 181 Directors. 182

183 ARTICLE V 184 MEETINGS 185

Section 1. General Assembly 186 A. The General Assembly shall be composed of delegates from states territories, federal 187

districts, and international delegates representing the international members. 188 B. All Delegates, Alternates, International Delegates, and the International Alternate must be 189

Voting Members of ENA in good standing. ENA’s officers and directors may not serve as 190 Delegates, Alternates, International Delegates or the International Alternate. 191

C. The General Assembly shall be composed of 700 delegates apportioned as follows: 192 1. Neither the state nor international membership shall be allocated fewer than two 193

delegates, one of whom shall serve as captain. 194 2. In addition to the voting delegates, there shall be one nonvoting alternate delegate. 195 3. The remaining delegates will be allocated to the: 196 a. states based on the percentage the state’s membership is to the national 197

membership, as determined annually as outlined in procedures; and 198 b. international membership based on the percentage the international membership is to 199

the national membership, as determined annually as outlined in procedures. 200 D. International delegates will be selected by a point system developed by the board of 201

directors; the system will be administered and overseen by the ENA national office. The 202 members receiving the highest number of points will be selected. 203

E. In addition to the delegate and international allocation, ENA past presidents who are Voting 204 Members of ENA in good standing may attend, speak and vote at General Assembly 205 (except as otherwise set forth below). 206

F. Members of the Board of Directors, including Past Presidents serving on the Board, may 207 attend and speak at all meetings of the General Assembly but may not vote. 208

209 Section 2. Authority 210 The General Assembly is responsible for communicating member needs, providing feedback, 211 and input on issues relating to the practice of emergency nursing to the Board of Directors. The 212 General Assembly shall also approve, revise, or amend these bylaws in accordance with Article 213 XIV, and receive reports of the Board of Directors, committees and other volunteer groups, 214

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receive reports of the findings of the annual financial audit, and transact such other appropriate 215 business as may properly come before the meeting. 216 217 Section 3. Quorum 218 The presence of a majority of the total voting delegates who have completed credentialing 219 procedures shall constitute a quorum for the transaction of business at any duly called session 220 of the General Assembly. 221 222 Section 4. Annual Meeting and Special Meetings of the Voting Members 223 A. The annual meeting of ENA’s Voting Members (“Annual Meeting”) will be held in 224 conjunction with the General Assembly. 225 B. Special meetings of ENA’s Voting Members may be called (i) at the request of the 226 President or any five (5) members of the Board of Directors; (ii) at the written request 227 of two- thirds (2/3) of ENA’s Voting Members; or (iii) by resolution of the ENA board of 228 directors. 229 C. Notice of any annual or special meeting of the Voting Members shall state the time, date, 230 place, and purpose of the meeting, and shall be delivered not more than sixty (60) and not 231 less than thirty (30) days prior to the date of such meeting, unless otherwise required by 232 applicable law. 233 D. The lesser of (i) ten percent (10%) of ENA’s eligible Voting Members; or (ii) one 234 hundred (100) eligible voting members shall constitute a quorum for the transaction of 235 business at any duly called meeting of the Voting Members, provided that if less than a 236 quorum is present, a majority of the Voting Members present may adjourn the meeting to 237 another time without further notice. 238 E. The act of a majority or more of the Voting Members present (in person or by proxy) at a 239 duly called meeting at which a quorum is present shall be the act of the Voting Members, 240 unless the act of a greater number is required by law, the Articles of Incorporation, or these 241 bylaws. 242 F. Mail/Electronic Voting. Voting by mail or electronic means shall be permitted to the full 243 extent permitted by the Illinois General Not For Profit Corporation Act of 1986, as 244 amended (the “Act”), for any item of business properly coming before the Voting 245 Members. A mail or electronic vote of the Voting Members may be called by the Board of 246 Directors. 247 248

ARTICLE VI 249 BOARD OF DIRECTORS 250

Section 1. Composition 251 The Board of Directors shall be composed of the following: three officers, seven directors, the 252 immediate past president serving as an ex-officio member for one year, and the Chief Staff 253 Officer serving as a non-voting ex officio member. No member may run for more than one 254 nationally elected position at a time. No member may hold more than one nationally elected 255 position at a time. 256 257 Section 2. Authority 258 The Board of Directors is ENA’s official governing body and is responsible for the management 259 of ENA’s affairs and shall have supervision, control and direction of ENA. To that end, it shall: 260

• Perform all duties entrusted to officers and directors of a corporation; 261

• Debate and determine ENA policy; 262

• Oversee ENA’s business and financial affairs; 263

• Determine ENA’s policies in accordance with these bylaws; 264

• Have discretion in the disbursement of ENA’s funds; 265

• Adopt such rules and regulations for the conduct of its business as it shall deem 266 advisable; 267

• Appoint such agents as it may consider necessary; 268

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• Provide direction to and control over all ENA’s committees, unless specifically provided 269 otherwise in these bylaws; 270

• Provide strategic direction for ENA; and 271

• Provide leadership for all of the component divisions of ENA. 272 273

Section 3. Qualifications 274 A. Directors must be a Voting Member in good standing and must have been a Voting Member 275

in good standing during each of the previous five years immediately prior to submitting a 276 candidate application. 277

B. Candidates must have attended at least one ENA General Assembly within the previous 278 three years. 279

C. Each candidate must submit to, and pass as acceptable, a limited background check. 280 D. Candidates shall have served in an elected or committee position on the local, state or 281

national level within the previous five years. 282 283 Section 4. Term of Office / Term Limits 284

A. Directors (with the exception of the immediate past president) shall serve for a three-year 285 term of office, or until such time as their successors are duly elected, qualified and take 286 office. In order to provide for staggered terms, at least two and no more than three directors 287 shall be elected each year. The term of office shall commence on January 1 each year 288 following the election and terminate on December 31. 289

B. The Immediate Past President shall serve a one-year term in office, or until such time as 290 their successor takes office. 291

C. No director may serve on the Board of Directors for more than six (6) years, not including 292 any time served to fill a vacancy. 293

D. Notwithstanding anything set forth herein to the contrary (i) a director elected to serve as an 294 officer may remain on the Board until the conclusion of their term in such office and may 295 complete their rotation through the offices (i.e., President-Elect to President to Immediate 296 Past President) despite the fact that such person may have served on the Board for the 297 maximum number of years; and (ii) a director completing their sixth year as a director is 298 eligible to run for an officer position. 299 300

Section 5. Elections 301 Elections shall be held annually. All Voting Members shall have the opportunity to elect officers 302 and directors by ballot. Balloting may be by electronic means. Candidates receiving the highest 303 number of votes for each position shall be declared elected. In the event of a tie for the director 304 positions, lots shall be drawn. 305 306 Section 6. Meetings of the Board of Directors 307 A. Regular meetings of the board shall be held at least quarterly as determined by the board. 308

At least ten days’ notice shall be given to all members of the board. 309 B. Special meetings shall be held as called by the President or any three members of the 310

board. At least three days’ notice shall be given to all members of the board. 311 C. Meetings may be held in person or by electronic means, provided that all participants can 312

hear and speak to one another at the same time. 313 D. A majority of the voting members of the Board of Directors shall constitute a quorum for all 314

meetings. All decisions of the Board of Directors require an affirmative vote of a majority of 315 the Board of Directors present and voting at a meeting at which a quorum is present. 316

E. Voting members of Board of Directors (including the President) have the right and 317 responsibility to actively participate in board meetings by making motions, speaking in 318 debate and voting (unless precluded by a conflict of interest, as determined in accordance 319 with ENA’s conflict of interest policy). 320

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F. Any action requiring a vote of the Board of Directors may be taken without a meeting if a 321 written consent, setting forth the action taken, is approved by all of the members of the 322 Board of Directors entitled to vote with respect to the subject matter thereof. 323

324 Section 7. Vacancy 325 A vacancyVacancies that occursoccur in the position of director shall be filled in the following 326

manner: 327 A. Vacancies with twelve (12) or less months remaining in the unexpired portion of the term will 328

not be filled. 329 B. A. If there is more than twelve (12) months remaining in the unexpired portion of the term 330

and the vacancy occurs between: 331 (i) after January 1 and beforeprior to the completion of the current year’s election 332

the vacancy shall be filled by the person receiving the next highest number of votes in the 333 previous year’s election with the term ending December 31. 334

B. If the vacancy occurs after the current year’s election and there is more than six months left 335 in the unexpired term, the vacancy shall be filled by the person receivingthat received the 336 next highest number of votes in(after the currentelected directors) in the previous year’s 337 election with the term ending December 31 of the following year.; 338

(ii) after the current year’s election, the vacancy shall be filled by the person that 339 received the next highest number of votes ( the elected directors) in the current year’s 340 election; or 341

C. If 342

(iii) due to the election of such director as an officer, the vacancy will be filled in 343 the current year’s election for the unexpired balance of the term they were originally 344 elected to fill by the person that received the next highest number of votes (after the 345 elected directors) in the current year’s election. 346

347 C. In the event (i) all such persons decline to serve, ifor (ii) there were no additional 348

candidates for that office during the most recently concluded election, or if the vacancy 349 occurs with fewer than six months left in the unexpired term, the vacancy shall not be 350 filled. 351

352 D. Directors elected to fill a vacancy shall hold office for the balance of the term they are 353

filling or until such time as their successor is duly elected, qualified and takes office. 354 355 Section 8. Resignation and Removal 356 Any director may resign at any time by giving written notice to the President. Any member of the 357 Board of Directors may be removed in accordance with the provisions of law and the Illinois 358 General Not For Profit Corporation Act of 1986, as amended, by the persons entitled to elect 359 such director, whenever, in their judgment, the best interests of ENA would be served by such 360 removal. 361 362 Section 9. Indemnification 363 ENA shall indemnify, as set forth below, and to the fullest extent to which it is empowered to do 364 so by the Illinois General Not For Profit Corporation Act of 1986, as amended, or any other 365 applicable laws as may from time to time be in effect, any person who, by reason of being or 366 having been a director, officer, employee, or agent of ENA, or who is or was serving at the 367 request of ENA as a director, officer, employee, or agent of another corporation, partnership, 368 joint venture, trust, or other enterprise, and who was or is a party or is threatened to be made a 369 party to any threatened, pending, or completed action, suit, or proceeding. 370 371

ARTICLE VII 372 CHIEF STAFF OFFICER 373

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The administrative and day-to-day operation of ENA shall be the responsibility of a salaried staff 374 head or firm employed or appointed by, and responsible to, the Board of Directors. The salaried 375 staff head or, in the case of a firm, chief staff officer retained by the firm shall have such title as 376 shall be determined by the Board of Directors and shall be referred to in these bylaws as the 377 “Chief Staff Officer”. The Chief Staff Officer shall have the authority to execute contracts on 378 behalf of ENA and as approved by the Board of Directors. The Chief Staff Officer may carry out 379 such other duties as may be specified by the Board of Directors. The Chief Staff Officer (or firm, 380 as applicable) shall employ and may terminate the employment of staff necessary to carry out 381 the work of ENA. The Chief Staff Officer shall serve as a non-voting ex officio member of the 382 Board of Directors. 383

384 ARTICLE VIII 385

CONSTITUENT DIVISIONS 386 Section 1. State Councils 387 Voting Members of ENA who are licensed or reside within a particular state, commonwealth, 388 federal district, territory or possession of the United States (the “territory”) may be organized as 389 a constituent of ENA (each of which is referred to as a “State Council”). The Board of Directors 390 may authorize the establishment of State Councils which shall: 391

i. be organized and operated in accordance with these Bylaws, and such additional rules, 392 regulations and policies as may be adopted by the Board of Directors from time to time; 393

ii. fulfill criteria for affiliation as may be established by the Board of Directors from time to 394 time; 395

iii. enter into charter agreements with ENA, as determined by ENA; 396 iv. be issued a charter by ENA; and 397 v. organize and conduct their activities in such a manner as to establish its fundamental 398

alignment and functional compatibility with ENA. 399 400 A State Council’s general purposes and objectives shall be complementary and consistent, on a 401 local basis within its territory, with those of ENA and the State Council will advance the general 402 and specific purposes of ENA within its territory. All members of a State Council must be 403 members of ENA in good standing. 404

Section 2. Application for Recognition as a State Council 405 The Board of Directors, or its designee(s) shall adopt an application form and procedures to 406 facilitate the consideration of applicants seeking to be organized as a State Council. All 407 applicants must complete the application form and submit the application, along with the 408 designated fee, if any, to ENA’s administrative office. The Board of Directors or its designee(s), 409 shall review the application of all applicants and determine, based on the criteria set forth in 410 these bylaws and such other guidelines as the Board of Directors may prescribe, if applicants 411 meet the qualifications necessary for recognition as a State Council. 412 A. Charters for the operation of State Councils may be revoked by the Board of Directors 413

according to due process procedures established by the Board of Directors. Upon 414 revocation of a State Council’s charter, the State Council immediately shall remit all of its 415 funds (after satisfying any existing debts or obligations) and records to ENA national office. 416

B. No State Council or other entity shall use ENA’s name or trademarks in any manner 417 whatsoever unless duly authorized to do so by ENA pursuant to the terms of a written 418 agreement or policy. 419

C. ENA shall fund chartered State Councils pursuant to a formula determined by the Board of 420 Directors based on the State Council’s membership. 421

D. Each State Council shall be incorporated as a not-for-profit corporation, have a Board of 422 Directors, officers and bylaws in such form as shall be approved by the Board of Directors or 423 its designee(s). State Councils must maintain voting membership categories and criteria that 424 are identical to ENA’s. Any changes to a State Council’s bylaws require the prior written 425 approval of the Board of Directors, or its designees(s). 426

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E. Each State Council may hold such meetings as it deems appropriate. 427 F. Members may belong to only one State Council. 428 G. A member of a State Council may transfer to another State Council by written request to 429

ENA. 430

Section 3. Local Chapters 431 Voting members of the same State Council that are licensed or reside within the same local 432 geographical territory may be organized as a local chapter by the State Council and each such 433 local chapter will be an integral part of such State Council (i.e., it shall operate and function as a 434 committee or special interest group of the State Council) (each of which is referred to as a 435 “Local Chapter”). The name, boundaries, eligibility requirements for Local Chapters, and policies 436 and procedures governing their operations, shall be determined by the State Council, subject to 437 the prior written approval of the Board of Directors, and such rules and policies as may be 438 adopted by the Board of Directors from time to time. A State Council is responsible for 439 overseeing and managing the activities of its Local Chapters and shall have the right to disband 440 or dissolve any Local Chapter it creates, with appropriate due cause. 441 442

ARTICLE IX 443 COMMITTEES 444

Section 1. Committees 445 ENA shall have committees appointed by the Board of Directors in sufficient numbers necessary 446 to address mission objectives, and positions of ENA. The President or an appointed board 447 liaison, as well as the Chief Staff Officer, shall serve as non-voting members of all committees, 448 except the Nominations and Elections Committee or as otherwise set forth below. 449 450 Section 2. Standing Committees 451

A. Executive Committee. 452 i. The Executive Committee shall consist of the President, President-Elect, and the 453

Secretary/Treasurer. The Chief Staff Officer shall be invited to attend and participate in 454 all meetings, without vote, of the Executive Committee, except those held in executive 455 session. The President shall serve as the chair of the Executive Committee. 456

ii. The Executive Committee shall have the authority to perform the business and functions 457 of the Board of Directors in between meetings of the Board of Directors, except as 458 otherwise set forth in these bylaws or Illinois General Not for Profit Corporation Act of 459 1986, as amended, reporting to the Board of Directors any action taken; but the 460 delegation of authority to the Executive Committee shall not operate to relieve the Board 461 of Directors or any individual officer or member of the Board of Directors of any 462 responsibility imposed by law. 463

iii. The Executive Committee shall meet in person or by conference call upon the request of 464 the chair or a majority of the Executive Committee. Each member shall have one (1) 465 vote. Two (2) members of the Executive Committee shall constitute a quorum for the 466 transaction of business at any duly called meeting of the Executive Committee; provided 467 when less than a quorum is present at said meeting, a majority of the members present 468 may adjourn the meeting without further notice. The act of a majority of the members 469 present at a duly called meeting at which a quorum is present shall be the act of the 470 Executive Committee. 471

iv. Any action requiring a vote of the Executive Committee may be taken without a meeting 472 if consent, setting forth the action taken, is approved by all the members of the Executive 473 Committee entitled to vote with respect to the subject matter thereof. 474

B. Other Standing Committees. 475 The Board of Directors may establish other standing committees to support ENA’s purposes. 476 Such committees shall include, at a minimum, a Finance Committee, Resolutions 477 Committee, and Nominations and Elections Committee. If a standing committee has the 478

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authority of the Board of Directors, a majority of its members must be comprised of 479 Directors. Except otherwise set forth in these bylaws: the action establishing a standing 480 committee shall set forth the committee’s purpose, authority and required qualifications for 481 membership on the committee; 482 i. the Board of Directors, or its designee(s), shall determine the composition of ENA’s 483

standing committee; 484 ii. at all meetings of any standing committee, a majority of the members thereof shall 485

constitute a quorum for the transaction of business; 486 iii. a majority vote by committee members present and voting at a meeting at which a 487

quorum is present shall be required for any action; 488 iv. vacancies in the membership of a standing committee shall be filled by appointments 489

made in the same manner as the original appointments to that committee; 490

v. the Board of Directors or its designee(s) shall develop and approve policies and 491 procedures for the operation of all standing committees. All such policies shall be subject 492 to the approval of the Board of Directors; and 493

vi. all standing committees shall report to the Board of Directors. 494 495

Finance Committee. 496 1. The Finance Committee shall be composed of the President, the President-Elect, the 497

Secretary/Treasurer and the immediate past president. The Chief Staff Officer shall 498 serve as a nonvoting ex-officio member. 499

2. The Finance Committee shall: 500 a. Oversee the financial planning and management of ENA by ensuring that all fiscal 501

aspects are in order; 502 b. Oversee the independence of ENA’s audit functions and its compliance with legal 503

and ethical standards; 504 c. Oversee investment of funds; and 505 d. Make fiscal recommendations to the Board of Directors. 506 507 Resolutions Committee. 508

1. The Resolutions Committee shall be composed of six members serving three-year 509 terms, two appointed each year by the ENA President-Elect and ratified by the Board of 510 Directors. The committee chairperson shall be appointed by the President-Elect and 511 ratified by the Board of Directors from among the continuing members on the 512 committee. The terms shall be staggered and shall commence at the adjournment of 513 the General Assembly meeting following appointment. 514

2. The Resolutions Committee shall solicit, review, and present resolutions and proposed 515 bylaws amendments to the General Assembly. 516

517 Nominations and Elections Committee. 518 1. Composition 519 a. The Nominations and Elections Committee shall consist of the Immediate Past 520

President and seven Voting Members electedappointed to serve on the Nominations 521 and Elections Committee in the ENA national election: one member from each of six 522 regions who has not previously served onby the Board of Directors, and one member 523 who has served on the Board of Directors. Nominations and Elections Committee 524 members may only represent the region in which they hold a voting membership. 525

526 b. The six regions shall be established by Nominations and Elections Committee policy. 527

Each region shall be composed of states with geographic proximity and relatively 528 equal membership distribution. 529

c. A Nominations and Elections Committee chairperson shall be elected each year by 530 The Immediate Past President shall serve as the chair of the incoming Nominations 531 and Elections Committee. 532

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2. Qualifications 533 a. CandidatesMembers of the Nominations and Elections Committee must be a Voting 534

MemberMembers in good standing and must have been a Voting Member during 535 each of the previous five years immediately prior to submitting their candidate 536 application. 537

b. CandidatesMembers of the Nominations and Elections Committee shall have served 538 in an elected or committee position on the local, state or national level within the 539 previous five years. 540

c. CandidatesMembers of the Nominations and Elections Committee must also have 541 attended at least one ENA General Assembly within the previous three years. 542

d. Members of the Nominations and Elections Committee may not run for or serve in 543 any ENA board position during their tenure on the Nominations and Elections 544 Committee, (with the exception of the Immediate Past President) and may not serve 545 more than two consecutive elected terms on the Nominations and Elections 546 Committee. 547

3. Elections 548 3. Term 549 a. Elections forAppointed members of the Nominations and Elections Committee shall 550

be held annually. Members shall serve for a three-year terms with terms beginning 551 January 1 and ending on December 31, or until such time as their successors are 552 duly elected, qualifiedappointed and take office. Voting MembersThe Immediate Past 553 President shall be elected to serve on the Nominations and Elections Committee 554 each yeara one-year term, or until such time as their successor takes office. 555

556 b. All Voting Members shall have the opportunity to electIn order to provide for 557

staggered terms, at least two and no more than three members of the Nominations 558 and Elections Committee members by ballot from all regions. Candidates receiving 559 the highest number of votes shall be declared elected. In the event of a tie vote for a 560 position on the committee, lots shall be drawn.shall be appointed each year. 561

4. Overview 562 a. The Nominations and Elections Committee has general oversight of the national 563

election’s key purpose is candidate recruitment, selection and development. The 564 Nominations and Elections Committee shall solicit and mentor potential candidates 565 and review national candidate applications in accordance with procedures adopted 566 by the Board of Directors. 567

568 b. The Nominations and Elections Committee is responsible for vetting candidates 569

based on competencies, key criteria and a formal interview process in accordance 570 with procedures adopted by the Board of Directors. 571

c. The Nominations and Elections Committee will provide periodic updates to the Board 572 of Directors regarding the progress of their charges. 573

cd. The Nominations and Elections Committee shall present a qualified slate of 574 candidates to the Board of Directors for its review and discussionapproval prior to 575 presenting the slate to the membership. Following such review and 576 discussionapproval, the Nominations and Elections Committee shall present the 577 slate to the membership through publication in such ENA publications as determined 578 by the Board of Directors or its designee(s). 579

5. Vacancies 580 a. A vacancy in the chairperson position shall be filled by a majority vote of the 581

Nominations and Elections CommitteeBoard of Directors. 582 b. A vacancy of a committee member shall be filled by the candidate who received the 583

next highest number of votes from that region or as the past board member in the 584 most recently completed election. 585

c. In the event of a committee member vacancy from an uncontested election, a 586 qualified candidate must be nominated and elected by the state council presidents of 587

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the region affected by the vacancy according to the Nominations and Elections 588 Committee election process, meeting the same requirements set forth in the bylaws 589 as any potential candidate. 590

d. TheBoard of Directors, provided, however, a committee position may, in the 591 discretion of the Board of Directors, remain vacant as approved by the Nominations 592 and Elections Committee if less than six months remain of the unexpired term. 593

594 ARTICLE X 595

DISSOLUTION 596 In the event of dissolution of ENA, the net assets of the corporation shall be applied and all 597 liabilities and obligations shall be paid, satisfied, and discharged, or adequate provision shall be 598 made thereof. After payment of all liabilities and obligations, all remaining assets shall be 599 distributed to an organization or organizations organized and operated exclusively for charitable, 600 educational, scholastic or scientific purposes as shall at the time qualify as tax exempt under 601 Sections 501(c)(3) of the Internal Revenue Code of 1986, as amended (or the corresponding 602 provision of any future United States Internal Revenue Law). 603 604

ARTICLE XI 605 FINANCE 606

Section 1. Contracts 607 The Board of Directors may authorize any officer or officers, agent or agents of ENA, in addition 608 to the officers so authorized by these bylaws, to enter into any contract or execute and deliver 609 any instrument in the name of and on behalf of ENA, and such authority may be general or 610 confined to specific instances. 611 612 Section 2. Payment of Indebtedness 613 All checks, drafts or other orders for the payment of money, notes or other evidences of 614 indebtedness issued in the name of ENA shall be signed by such officer or officers, agent or 615 agents of ENA and in such manner as shall from time to time be determined by resolution of the 616 Board of Directors. In the absence of such determination by the Board of Directors, such 617 instruments shall be signed by the Secretary/Treasurer and countersigned by the President. 618 619 Section 3. Deposits 620 All of ENA’s funds shall be deposited to the credit of ENA in such banks, trust companies, or 621 other depositaries as the Board of Directors may select. 622 623 Section 4. Bonding 624 The Board of Directors shall provide for the bonding of such officers and employees of ENA as it 625 may from time to time determine. 626 627 Section 5. Gifts 628 The Board of Directors may accept on behalf of ENA any contribution, gift, bequest or devise for 629 ENA’s general purposes or for any special purpose. 630 631 Section 6. Books and Records 632 ENA shall keep correct and complete books and records of account and shall also keep minutes 633 of the proceedings of the Board of Directors. The books and accounts of ENA shall be audited 634 annually by accountants selected by the Board of Directors. 635 636 Section 7. Fiscal Year 637 ENA’s fiscal year shall be determined by the Board of Directors. 638 639

640 ARTICLE XII 641

WAIVER OF NOTICE AND ELECTRONIC COMMUNICATION 642

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643 Section 1. Waiver of Notice 644 Whenever any notice is required to be given under applicable law, the Articles of Incorporation 645 or these bylaws, waiver thereof in writing signed by the person or persons entitled to such 646 notice, whether before or after the time stated therein, shall be deemed equivalent to the giving 647 of such notice. 648 649 Section 2. Electronic Communication 650 Unless otherwise prohibited by law, (i) any action to be taken or notice delivered under these 651 bylaws may be taken or transmitted by e-mail or other electronic means; and (ii) any action or 652 approval required to be written or in writing may be transmitted or received by e-mail or other 653 electronic means. 654 655

ARTICLE XIII 656 PARLIAMENTARY AUTHORITY 657

The rules contained in the current edition of Robert’s Rules of Order Newly Revised shall 658 govern ENA in all cases to which they are applicable and in which they are not inconsistent with 659 these bylaws and any special rules of order ENA may adopt. 660

661 ARTICLE XIV 662 AMENDMENT 663

Section 1. Proposals 664 Amendments to the bylaws may be proposed by the Board of Directors, state councils or under 665 the signature of ten Voting Members in good standing. Amendments proposed by a State 666 Council or under the signature of ten Voting Members in good standing are subject to the prior 667 review and approval the Board of Directors to assure that proposed amendments (i) are 668 consistent with ENA’s purposes, mission, values and objectives: (ii) have no adverse financial 669 impact on ENA; (ii) do not create inconsistencies or conflicts with other provisions of the bylaws; 670 and (iv) do not conflict with the requirements of ENA’s Articles of Incorporation or federal or 671 state law. Proposed amendments approved or introduced by the Board of Directors (collectively, 672 “Approved Proposals”) will be presented to the General Assembly in accordance with the 673 provisions set forth below in this article XIV. 674 675 Section 2. Submission Deadline 676 Proposed amendments must be submitted to ENA national office at least 120 days prior to the 677 General Assembly. 678 679 Section 3. Notice 680 Notice of all Approved Proposals will be submitted to the membership at least 60 days prior to 681 the General Assembly. Publication of the Approved Proposals in an ENA publication to on the 682 ENA website shall constitute adequate notice. 683 684 Section 4. Vote 685 In order to be adopted , Approved Proposals must be approved by a two-thirds vote of the 686 delegates present and voting at a meeting of the General Assembly. 687 688

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BYLAWS 1 EMERGENCY NURSES ASSOCIATION 2

3 4

ARTICLE I 5 NAME 6

The name of this organization shall be the Emergency Nurses Association (ENA), a not-for-7 profit corporation incorporated in the State of Illinois. ENA shall have and continuously maintain 8 in the State of Illinois a registered office and a registered agent whose office is identical with 9 such registered office, and may have such other offices within or outside of the State of Illinois 10 as the Board of Directors may determine. 11

12 ARTICLE II 13 OBJECT 14

Section 1. Purpose 15 The purposes for which the corporation is organized are educational, within the meaning of 16 Section 501(c)(3) of the Internal Revenue Code of 1986, as amended (“IRC”), including but not 17 limited to the advancement of emergency nursing through education and public awareness. 18 19 Section 2. Rules 20 The following rules shall conclusively bind ENA and all persons acting for or on behalf of it: 21 A. No part of the net earnings of ENA shall inure to the benefit of, or be distributed to, its 22

directors, officers, committee members or other private persons, except that ENA shall be 23 authorized and empowered to pay reasonable compensation for services rendered and to 24 make payments and distributions in furtherance of the purposes set forth above. 25

B. No substantial part of the activities of ENA shall be the carrying on of propaganda, or 26 otherwise attempting to influence legislation, and ENA shall not participate in, or intervene in 27 (including the publishing or distribution of statements) any political campaign on behalf or in 28 opposition to any candidate for public office. Notwithstanding any provision of these Bylaws, 29 ENA shall not carry on any activity not permitted to be carried on by: 30 i. a corporation exempt from federal income tax under Section 501(c)(3) of the IRC (or the 31

corresponding provision of any future United States Internal Revenue Law); or 32 ii. a corporation, contributions to which are deductible under Section 170(c)(2) of the IRC 33

(or the corresponding provision of any future United States Internal Revenue Law). 34 35

Section 3. Official Publication 36 The official publication shall be the Journal of Emergency Nursing (JEN), which shall reflect the 37 purpose, mission objectives and positions of ENA. 38 39

ARTICLE III 40 MEMBERS 41

Section 1. Responsibilities of Membership 42 Each member has the responsibility to support the purpose, mission, vision, values and 43 objectives of ENA. 44 45 Section 2. Classifications and Criteria. Membership may be granted to any individual who (i) 46 abides by these bylaws, the ENA Code of Ethics, and such other policies, rules and regulations 47 as ENA may adopt; and (ii) meets the criteria for membership set forth in one of the following 48 categories: 49 A. Voting Members – voting members shall be classified as national, international, senior and 50

military (“Voting Members”). Voting Members shall have the right to vote, hold elected office, 51 serve on the Board of Directors, serve on committees, and attend ENA’s meetings and 52 social functions. 53

1. National membership may be granted to any individual who is a professional registered 54 nurse licensed in the United States or its territories. 55

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2. International membership may be granted to any individual who is a professional 56 registered nurse licensed (or the equivalent thereto) outside of the United States or its 57 territories. 58

3. Senior membership may be granted to a professional registered nurse who is age 65 or 59 older and licensed in the United States or its territories. 60

4. Military membership may be granted to a professional registered nurse licensed in the 61 United States or its territories who is currently serving or has been honorably discharged 62 or retired from the United States Armed Forces including Army, Navy, Marine Corps, Air 63 Force, Coast Guard, and Reserve Components. 64

B. Nonvoting Members – nonvoting members shall be classified as affiliate, student and 65 honorary (“Nonvoting Members”). Nonvoting Members shall be entitled to serve on ENA 66 committees and attend ENA member meetings and social functions. 67

1. Affiliate membership may be granted to any individual who shares interest in and 68 supports the purpose, mission and objectives of ENA but does not otherwise meet the 69 criteria for voting membership in ENA. 70

2. Student membership may be granted to any individual enrolled in a primary nursing 71 education program leading to eligibility for licensure as a professional registered nurse. 72

3. Honorary membership may be awarded to an individual meeting such criteria as shall be 73 determined by the president and the Board of Directors. 74

75 Section 3. Dues and Finance 76 A. The initial and annual dues for all ENA members and the time for paying such dues, and 77

other assessments, if any, shall be determined by the Board of Directors. Under special 78 circumstances, the Board of Directors, or its designee(s), may waive the annual dues and/or 79 assessments for any member or category of members. 80

B. The membership of any member who is in default of payment of dues or assessments for 81 more than three (3) months, or otherwise becomes ineligible for membership, shall be 82 terminated automatically, according to such rules or procedures as the Board of Directors or 83 its designee(s) shall establish, unless such termination is delayed by the Board of Directors 84 or its designee(s). 85

C. Members who have resigned or been terminated for non-payment of dues may only be 86 reinstated (i) if no more than three (3) months has elapsed since the date of termination; (ii) 87 upon payment of delinquent dues; and (iii) in accordance with such rules as may from time 88 to time be established by the Board of Directors. Former members not meeting the 89 requirements for reinstatement must reapply for membership. 90

D. Each state council and chapter shall receive an annual allocation for each dues paying 91 member within the state or chapter. 92

E. A surcharge may be added to the dues in some states by the state’s request. 93 94 Section 4. Disciplinary Action 95

A. Grounds for Discipline. ENA may discipline a member for any of the following reasons: 96 i. Failure to comply with these Bylaws, the ENA Code of Ethics, or any of ENA’s rules or 97

regulations; 98 ii. Conviction of a felony or a crime related to, or arising out of, the practice of nursing or 99

involving moral turpitude; 100 iii. Suspension, revocation, or forfeiture by any state, province, or country of the member’s 101

right to practice as a nurse; or 102 iv. Immoral, dishonorable, or unprofessional conduct considered prejudicial to the best 103

interests of, or inconsistent with, the purposes of ENA. 104 B. Procedures. Discipline may include, but not be limited to, censure, suspension, 105

probation, and expulsion. Disciplinary action may be taken provided that a statement of 106 the charges shall have been sent by certified mail to the last recorded address of the 107 member at least fifteen (15) days before final action is to be taken. This statement shall 108 be accompanied by a notice of the time and place of the meeting at which the charges 109 shall be considered, and the member shall have the opportunity to appear in person 110

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and/or to be represented by counsel and to present any defense to such charges before 111 action is taken by ENA. Such disciplinary actions shall be conducted in accordance with 112 such additional procedures as may be established by the Board of Directors. 113

114 ARTICLE IV 115 OFFICERS 116

Section 1. Officers 117 A. There shall be three officers: President, President-Elect, and Secretary/treasurer. The term 118

of office shall commence January 1 each year and terminate on December 31, or until such 119 time as their successors are duly elected, qualified and take office. The President-Elect shall 120 succeed to the office of president at the conclusion of the term. Officers shall exercise the 121 duties and responsibilities required of a member of the Board of Directors and such 122 additional duties and responsibilities set forth below. 123

B. President. The President shall be ENA’s principal elected officer and shall, in general, 124 supervise ENA’s business affairs, subject to the direction and control of the Board of 125 Directors, by communicating with the Chief Staff Officer as necessary regarding ENA’s 126 business. The President shall be a member, without vote, of all councils and committees 127 with the exception of the Nominations and Elections Committee and except as otherwise 128 provided by these bylaws. The President shall (i) serve as the Chair of the Finance 129 Committee; (ii) serve as ENA’s official representative and spokesperson, except as 130 otherwise provided by the Board of Directors; (iii) appoint representatives to ENA’s affiliated 131 organizations and other positions as necessary; (iv) fill, subject to the approval of the Board 132 of Directors, vacancies on ENA’s committees; and (v) in general, perform all duties 133 customarily incident to the office of President and such other duties as may be prescribed by 134 the Board of Directors. The President shall succeed to the office of immediate past president 135 upon expiration of the President’s term of office. 136

C. President-Elect. The President-Elect shall assist the President and shall substitute for the 137 President when required. The President-Elect shall appoint chairs and members of 138 committees, and a Board of Directors liaison to each committee for the year following his/her 139 term in office as President-Elect subject to Board approval and shall in general, perform all 140 duties customarily incident to the office of President-Elect and such other duties as may be 141 prescribed by the Board of Directors. The President-Elect shall succeed to the office of 142 President upon expiration of the President’s term of office, or in the event of the death, 143 resignation, removal, or incapacity of the President. 144

D. Secretary/Treasurer. The Secretary/Treasurer shall be the principal financial officer and 145 secretary of ENA and shall perform all duties traditionally incident to the offices of Secretary 146 and Treasurer and such other duties as may be assigned by the President or the Board of 147 Directors. The duties of the Secretary/Treasurer may be assigned by the Board of Directors 148 in whole or in part to the Chief Staff Officer, or his or her designee(s). 149

150 Section 2. Officer Qualifications 151 A. Each officer must be a Voting Member and must have been a Voting Member during each of 152

the previous five years immediately prior to submitting a candidate application. 153 B. Each candidate for President-Elect and Secretary/Treasurer must currently serve as a voting 154

member of the Board of Directors. 155 C. Each candidate must submit to, and pass as acceptable, a limited background check. 156 157 Section 3. Election 158 A. In the event of a tie vote for the positions of President-Elect and Secretary/Treasurer, there 159

shall be a second balloting of ENA membership. 160 B. All directors who are elected as officers shall have their unexpired terms of office filled by 161

the candidates who receive the next highest number of votes; the candidate receiving the 162 highest number of votes shall receive the position with the longest term. 163

C. A candidate for an officer position who is not elected shall continue to serve the remaining 164 unexpired years of the original term as a director. 165

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166 Section 4. Vacancies 167 A. If the office of President becomes vacant, the President-Elect shall succeed to the office of 168

President for the unexpired term and shall subsequently serve the one-year term of office of 169 President to which elected. In such case, the immediate past president may remain as 170 immediate past president for a second year or the office may remain vacant for that year. 171

B. A vacancy in the office of President-Elect may be filled by a current member of the Board of 172 Directors, or remain vacant as approved by a majority vote of the Board of Directors. If the 173 vacancy is filled, the President-Elect shall not automatically assume the office of president 174 for the subsequent term. 175

C. In the event that the office of President and President-Elect are vacated during the same 176 year, the Board of Directors shall appoint an acting president to serve until the next 177 scheduled election, at which time an election will be held for both President and President-178 Elect. 179

D. A vacancy in the office of Secretary/Treasurer may be filled by a current member of the 180 Board of Directors or remain vacant as approved by a majority vote by the entire Board of 181 Directors. 182

183 ARTICLE V 184 MEETINGS 185

Section 1. General Assembly 186 A. The General Assembly shall be composed of delegates from states territories, federal 187

districts, and international delegates representing the international members. 188 B. All Delegates, Alternates, International Delegates, and the International Alternate must be 189

Voting Members of ENA in good standing. ENA’s officers and directors may not serve as 190 Delegates, Alternates, International Delegates or the International Alternate. 191

C. The General Assembly shall be composed of 700 delegates apportioned as follows: 192 1. Neither the state nor international membership shall be allocated fewer than two 193

delegates, one of whom shall serve as captain. 194 2. In addition to the voting delegates, there shall be one nonvoting alternate delegate. 195 3. The remaining delegates will be allocated to the: 196 a. states based on the percentage the state’s membership is to the national 197

membership, as determined annually as outlined in procedures; and 198 b. international membership based on the percentage the international membership is to 199

the national membership, as determined annually as outlined in procedures. 200 D. International delegates will be selected by a point system developed by the board of 201

directors; the system will be administered and overseen by the ENA national office. The 202 members receiving the highest number of points will be selected. 203

E. In addition to the delegate and international allocation, ENA past presidents who are Voting 204 Members of ENA in good standing may attend, speak and vote at General Assembly 205 (except as otherwise set forth below). 206

F. Members of the Board of Directors, including Past Presidents serving on the Board, may 207 attend and speak at all meetings of the General Assembly but may not vote. 208

209 Section 2. Authority 210 The General Assembly is responsible for communicating member needs, providing feedback, 211 and input on issues relating to the practice of emergency nursing to the Board of Directors. The 212 General Assembly shall also approve, revise, or amend these bylaws in accordance with Article 213 XIV, and receive reports of the Board of Directors, committees and other volunteer groups, 214 receive reports of the findings of the annual financial audit, and transact such other appropriate 215 business as may properly come before the meeting. 216 217 Section 3. Quorum 218 The presence of a majority of the total voting delegates who have completed credentialing 219 procedures shall constitute a quorum for the transaction of business at any duly called session 220

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of the General Assembly. 221 222 Section 4. Annual Meeting and Special Meetings of the Voting Members 223 A. The annual meeting of ENA’s Voting Members (“Annual Meeting”) will be held in 224 conjunction with the General Assembly. 225 B. Special meetings of ENA’s Voting Members may be called (i) at the request of the 226 President or any five (5) members of the Board of Directors; (ii) at the written request 227 of two- thirds (2/3) of ENA’s Voting Members; or (iii) by resolution of the ENA board of 228 directors. 229 C. Notice of any annual or special meeting of the Voting Members shall state the time, date, 230 place, and purpose of the meeting, and shall be delivered not more than sixty (60) and not 231 less than thirty (30) days prior to the date of such meeting, unless otherwise required by 232 applicable law. 233 D. The lesser of (i) ten percent (10%) of ENA’s eligible Voting Members; or (ii) one 234 hundred (100) eligible voting members shall constitute a quorum for the transaction of 235 business at any duly called meeting of the Voting Members, provided that if less than a 236 quorum is present, a majority of the Voting Members present may adjourn the meeting to 237 another time without further notice. 238 E. The act of a majority or more of the Voting Members present (in person or by proxy) at a 239 duly called meeting at which a quorum is present shall be the act of the Voting Members, 240 unless the act of a greater number is required by law, the Articles of Incorporation, or these 241 bylaws. 242 F. Mail/Electronic Voting. Voting by mail or electronic means shall be permitted to the full 243 extent permitted by the Illinois General Not For Profit Corporation Act of 1986, as 244 amended (the “Act”), for any item of business properly coming before the Voting 245 Members. A mail or electronic vote of the Voting Members may be called by the Board of 246 Directors. 247 248

ARTICLE VI 249 BOARD OF DIRECTORS 250

Section 1. Composition 251 The Board of Directors shall be composed of the following: three officers, seven directors, the 252 immediate past president serving as an ex-officio member for one year, and the Chief Staff 253 Officer serving as a non-voting ex officio member. No member may run for more than one 254 nationally elected position at a time. No member may hold more than one nationally elected 255 position at a time. 256 257 Section 2. Authority 258 The Board of Directors is ENA’s official governing body and is responsible for the management 259 of ENA’s affairs and shall have supervision, control and direction of ENA. To that end, it shall: 260

• Perform all duties entrusted to officers and directors of a corporation; 261 • Debate and determine ENA policy; 262 • Oversee ENA’s business and financial affairs; 263 • Determine ENA’s policies in accordance with these bylaws; 264 • Have discretion in the disbursement of ENA’s funds; 265 • Adopt such rules and regulations for the conduct of its business as it shall deem 266

advisable; 267 • Appoint such agents as it may consider necessary; 268 • Provide direction to and control over all ENA’s committees, unless specifically provided 269

otherwise in these bylaws; 270 • Provide strategic direction for ENA; and 271 • Provide leadership for all of the component divisions of ENA. 272 273

Section 3. Qualifications 274

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A. Directors must be a Voting Member in good standing and must have been a Voting Member 275 in good standing during each of the previous five years immediately prior to submitting a 276 candidate application. 277

B. Candidates must have attended at least one ENA General Assembly within the previous 278 three years. 279

C. Each candidate must submit to, and pass as acceptable, a limited background check. 280 D. Candidates shall have served in an elected or committee position on the local, state or 281

national level within the previous five years. 282 283 Section 4. Term of Office / Term Limits 284 A. Directors shall serve for a three-year term of office, or until such time as their successors are 285

duly elected, qualified and take office. In order to provide for staggered terms, at least two 286 and no more than three directors shall be elected each year. The term of office shall 287 commence on January 1 each year following the election and terminate on December 31. 288

B. The Immediate Past President shall serve a one-year term in office, or until such time as 289 their successor takes office. 290

C. No director may serve on the Board of Directors for more than six (6) years, not including 291 any time served to fill a vacancy. 292

D. Notwithstanding anything set forth herein to the contrary (i) a director elected to serve as an 293 officer may remain on the Board until the conclusion of their term in such office and may 294 complete their rotation through the offices (i.e., President-Elect to President to Immediate 295 Past President) despite the fact that such person may have served on the Board for the 296 maximum number of years; and (ii) a director completing their sixth year as a director is 297 eligible to run for an officer position. 298 299

Section 5. Elections 300 Elections shall be held annually. All Voting Members shall have the opportunity to elect officers 301 and directors by ballot. Balloting may be by electronic means. Candidates receiving the highest 302 number of votes for each position shall be declared elected. In the event of a tie for the director 303 positions, lots shall be drawn. 304 305 Section 6. Meetings of the Board of Directors 306 A. Regular meetings of the board shall be held at least quarterly as determined by the board. 307

At least ten days’ notice shall be given to all members of the board. 308 B. Special meetings shall be held as called by the President or any three members of the 309

board. At least three days’ notice shall be given to all members of the board. 310 C. Meetings may be held in person or by electronic means, provided that all participants can 311

hear and speak to one another at the same time. 312 D. A majority of the voting members of the Board of Directors shall constitute a quorum for all 313

meetings. All decisions of the Board of Directors require an affirmative vote of a majority of 314 the Board of Directors present and voting at a meeting at which a quorum is present. 315

E. Voting members of Board of Directors (including the President) have the right and 316 responsibility to actively participate in board meetings by making motions, speaking in 317 debate and voting (unless precluded by a conflict of interest, as determined in accordance 318 with ENA’s conflict of interest policy). 319

F. Any action requiring a vote of the Board of Directors may be taken without a meeting if a 320 written consent, setting forth the action taken, is approved by all of the members of the 321 Board of Directors entitled to vote with respect to the subject matter thereof. 322

323 Section 7. Vacancy 324 Vacancies that occur in the position of director shall be filled in the following manner: 325 A. Vacancies with twelve (12) or less months remaining in the unexpired portion of the term will 326

not be filled. 327 B. If there is more than twelve (12) months remaining in the unexpired portion of the term and 328

the vacancy occurs: 329

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(i) after January 1 and prior to the completion of the current year’s election, the 330 vacancy shall be filled by the person that received the next highest number of votes (after 331 the elected directors) in the previous year’s election; 332

(ii) after the current year’s election, the vacancy shall be filled by the person that 333 received the next highest number of votes (after the elected directors) in the current year’s 334 election; or 335

(iii) due to the election of such director as an officer, the vacancy will be filled in 336 the current year’s election for the unexpired balance of the term they were originally 337 elected to fill by the person that received the next highest number of votes (after the 338 elected directors) in the current year’s election. 339

340 C. In the event (i) all such persons decline to serve, or (ii) there were no additional 341

candidates for that office during the most recently concluded election the vacancy shall 342 not be filled. 343

344 D. Directors elected to fill a vacancy shall hold office for the balance of the term they are 345

filling or until such time as their successor is duly elected, qualified and takes office. 346 347 Section 8. Resignation and Removal 348 Any director may resign at any time by giving written notice to the President. Any member of the 349 Board of Directors may be removed in accordance with the provisions of law and the Illinois 350 General Not For Profit Corporation Act of 1986, as amended, by the persons entitled to elect 351 such director, whenever, in their judgment, the best interests of ENA would be served by such 352 removal. 353 354 Section 9. Indemnification 355 ENA shall indemnify, as set forth below, and to the fullest extent to which it is empowered to do 356 so by the Illinois General Not For Profit Corporation Act of 1986, as amended, or any other 357 applicable laws as may from time to time be in effect, any person who, by reason of being or 358 having been a director, officer, employee, or agent of ENA, or who is or was serving at the 359 request of ENA as a director, officer, employee, or agent of another corporation, partnership, 360 joint venture, trust, or other enterprise, and who was or is a party or is threatened to be made a 361 party to any threatened, pending, or completed action, suit, or proceeding. 362 363

ARTICLE VII 364 CHIEF STAFF OFFICER 365

The administrative and day-to-day operation of ENA shall be the responsibility of a salaried staff 366 head or firm employed or appointed by, and responsible to, the Board of Directors. The salaried 367 staff head or, in the case of a firm, chief staff officer retained by the firm shall have such title as 368 shall be determined by the Board of Directors and shall be referred to in these bylaws as the 369 “Chief Staff Officer”. The Chief Staff Officer shall have the authority to execute contracts on 370 behalf of ENA and as approved by the Board of Directors. The Chief Staff Officer may carry out 371 such other duties as may be specified by the Board of Directors. The Chief Staff Officer (or firm, 372 as applicable) shall employ and may terminate the employment of staff necessary to carry out 373 the work of ENA. The Chief Staff Officer shall serve as a non-voting ex officio member of the 374 Board of Directors. 375

376 ARTICLE VIII 377

CONSTITUENT DIVISIONS 378 Section 1. State Councils 379 Voting Members of ENA who are licensed or reside within a particular state, commonwealth, 380 federal district, territory or possession of the United States (the “territory”) may be organized as 381 a constituent of ENA (each of which is referred to as a “State Council”). The Board of Directors 382 may authorize the establishment of State Councils which shall: 383

i. be organized and operated in accordance with these Bylaws, and such additional rules, 384

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regulations and policies as may be adopted by the Board of Directors from time to time; 385 ii. fulfill criteria for affiliation as may be established by the Board of Directors from time to 386

time; 387 iii. enter into charter agreements with ENA, as determined by ENA; 388 iv. be issued a charter by ENA; and 389 v. organize and conduct their activities in such a manner as to establish its fundamental 390

alignment and functional compatibility with ENA. 391 392 A State Council’s general purposes and objectives shall be complementary and consistent, on a 393 local basis within its territory, with those of ENA and the State Council will advance the general 394 and specific purposes of ENA within its territory. All members of a State Council must be 395 members of ENA in good standing. 396

Section 2. Application for Recognition as a State Council 397 The Board of Directors, or its designee(s) shall adopt an application form and procedures to 398 facilitate the consideration of applicants seeking to be organized as a State Council. All 399 applicants must complete the application form and submit the application, along with the 400 designated fee, if any, to ENA’s administrative office. The Board of Directors or its designee(s), 401 shall review the application of all applicants and determine, based on the criteria set forth in 402 these bylaws and such other guidelines as the Board of Directors may prescribe, if applicants 403 meet the qualifications necessary for recognition as a State Council. 404 A. Charters for the operation of State Councils may be revoked by the Board of Directors 405

according to due process procedures established by the Board of Directors. Upon 406 revocation of a State Council’s charter, the State Council immediately shall remit all of its 407 funds (after satisfying any existing debts or obligations) and records to ENA national office. 408

B. No State Council or other entity shall use ENA’s name or trademarks in any manner 409 whatsoever unless duly authorized to do so by ENA pursuant to the terms of a written 410 agreement or policy. 411

C. ENA shall fund chartered State Councils pursuant to a formula determined by the Board of 412 Directors based on the State Council’s membership. 413

D. Each State Council shall be incorporated as a not-for-profit corporation, have a Board of 414 Directors, officers and bylaws in such form as shall be approved by the Board of Directors or 415 its designee(s). State Councils must maintain voting membership categories and criteria that 416 are identical to ENA’s. Any changes to a State Council’s bylaws require the prior written 417 approval of the Board of Directors, or its designees(s). 418

E. Each State Council may hold such meetings as it deems appropriate. 419 F. Members may belong to only one State Council. 420 G. A member of a State Council may transfer to another State Council by written request to 421

ENA. 422

Section 3. Local Chapters 423 Voting members of the same State Council that are licensed or reside within the same local 424 geographical territory may be organized as a local chapter by the State Council and each such 425 local chapter will be an integral part of such State Council (i.e., it shall operate and function as a 426 committee or special interest group of the State Council) (each of which is referred to as a 427 “Local Chapter”). The name, boundaries, eligibility requirements for Local Chapters, and policies 428 and procedures governing their operations, shall be determined by the State Council, subject to 429 the prior written approval of the Board of Directors, and such rules and policies as may be 430 adopted by the Board of Directors from time to time. A State Council is responsible for 431 overseeing and managing the activities of its Local Chapters and shall have the right to disband 432 or dissolve any Local Chapter it creates, with appropriate due cause. 433 434

ARTICLE IX 435 COMMITTEES 436

Section 1. Committees 437

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ENA shall have committees appointed by the Board of Directors in sufficient numbers necessary 438 to address mission objectives, and positions of ENA. The President or an appointed board 439 liaison, as well as the Chief Staff Officer, shall serve as non-voting members of all committees, 440 except the Nominations and Elections Committee or as otherwise set forth below. 441 442 Section 2. Standing Committees 443 A. Executive Committee. 444

i. The Executive Committee shall consist of the President, President-Elect, and the 445 Secretary/Treasurer. The Chief Staff Officer shall be invited to attend and participate in 446 all meetings, without vote, of the Executive Committee, except those held in executive 447 session. The President shall serve as the chair of the Executive Committee. 448

ii. The Executive Committee shall have the authority to perform the business and functions 449 of the Board of Directors in between meetings of the Board of Directors, except as 450 otherwise set forth in these bylaws or Illinois General Not for Profit Corporation Act of 451 1986, as amended, reporting to the Board of Directors any action taken; but the 452 delegation of authority to the Executive Committee shall not operate to relieve the Board 453 of Directors or any individual officer or member of the Board of Directors of any 454 responsibility imposed by law. 455

iii. The Executive Committee shall meet in person or by conference call upon the request of 456 the chair or a majority of the Executive Committee. Each member shall have one (1) 457 vote. Two (2) members of the Executive Committee shall constitute a quorum for the 458 transaction of business at any duly called meeting of the Executive Committee; provided 459 when less than a quorum is present at said meeting, a majority of the members present 460 may adjourn the meeting without further notice. The act of a majority of the members 461 present at a duly called meeting at which a quorum is present shall be the act of the 462 Executive Committee. 463

iv. Any action requiring a vote of the Executive Committee may be taken without a meeting 464 if consent, setting forth the action taken, is approved by all the members of the Executive 465 Committee entitled to vote with respect to the subject matter thereof. 466

B. Other Standing Committees. 467 The Board of Directors may establish other standing committees to support ENA’s purposes. 468 Such committees shall include, at a minimum, a Finance Committee, Resolutions 469 Committee, and Nominations and Elections Committee. If a standing committee has the 470 authority of the Board of Directors, a majority of its members must be comprised of 471 Directors. Except otherwise set forth in these bylaws: the action establishing a standing 472 committee shall set forth the committee’s purpose, authority and required qualifications for 473 membership on the committee; 474 i. the Board of Directors, or its designee(s), shall determine the composition of ENA’s 475

standing committee; 476 ii. at all meetings of any standing committee, a majority of the members thereof shall 477

constitute a quorum for the transaction of business; 478 iii. a majority vote by committee members present and voting at a meeting at which a 479

quorum is present shall be required for any action; 480 iv. vacancies in the membership of a standing committee shall be filled by appointments 481

made in the same manner as the original appointments to that committee; 482 v. the Board of Directors or its designee(s) shall develop and approve policies and 483

procedures for the operation of all standing committees. All such policies shall be subject 484 to the approval of the Board of Directors; and 485

vi. all standing committees shall report to the Board of Directors. 486 487

Finance Committee. 488 1. The Finance Committee shall be composed of the President, the President-Elect, the 489

Secretary/Treasurer and the immediate past president. The Chief Staff Officer shall 490 serve as a nonvoting ex-officio member. 491

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2. The Finance Committee shall: 492 a. Oversee the financial planning and management of ENA by ensuring that all fiscal 493

aspects are in order; 494 b. Oversee the independence of ENA’s audit functions and its compliance with legal 495

and ethical standards; 496 c. Oversee investment of funds; and 497 d. Make fiscal recommendations to the Board of Directors. 498 499 Resolutions Committee. 500

1. The Resolutions Committee shall be composed of six members serving three-year 501 terms, two appointed each year by the ENA President-Elect and ratified by the Board of 502 Directors. The committee chairperson shall be appointed by the President-Elect and 503 ratified by the Board of Directors from among the continuing members on the 504 committee. The terms shall be staggered and shall commence at the adjournment of 505 the General Assembly meeting following appointment. 506

2. The Resolutions Committee shall solicit, review, and present resolutions and proposed 507 bylaws amendments to the General Assembly. 508

509 Nominations and Elections Committee. 510 1. Composition 511 a. The Nominations and Elections Committee shall consist of the Immediate Past 512

President and seven Voting Members appointed to serve on the Nominations and 513 Elections Committee by the Board of Directors. 514

b. The Immediate Past President shall serve as the chair of the Nominations and 515 Elections Committee. 516

2. Qualifications 517 a. Members of the Nominations and Elections Committee must be Voting Members in 518

good standing and must have been a Voting Member during each of the previous 519 five years immediately prior to submitting their application. 520

b. Members of the Nominations and Elections Committee shall have served in an 521 elected or committee position on the local, state or national level within the previous 522 five years. 523

c. Members of the Nominations and Elections Committee must also have attended at 524 least one ENA General Assembly within the previous three years. 525

d. Members of the Nominations and Elections Committee may not run for or serve in 526 any ENA board position during their tenure on the Nominations and Elections 527 Committee (with the exception of the Immediate Past President) and may not serve 528 more than two consecutive terms on the Nominations and Elections Committee. 529

3. Term 530 a. Appointed members of the Nominations and Elections Committee shall serve three-531

year terms with terms beginning January 1 and ending on December 31, or until 532 such time as their successors are appointed and take office. The Immediate Past 533 President shall serve a one-year term, or until such time as their successor takes 534 office. 535

b. In order to provide for staggered terms, at least two and no more than three 536 members of the Nominations and Elections Committee shall be appointed each year. 537

4. Overview 538 a. The Nominations and Elections Committee’s key purpose is candidate recruitment, 539

selection and development. The Nominations and Elections Committee shall solicit 540 and mentor potential candidates and review national candidate applications in 541 accordance with procedures adopted by the Board of Directors. 542

b. The Nominations and Elections Committee is responsible for vetting candidates 543 based on competencies, key criteria and a formal interview process in accordance 544 with procedures adopted by the Board of Directors. 545

c. The Nominations and Elections Committee will provide periodic updates to the Board 546

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of Directors regarding the progress of their charges. 547 d. The Nominations and Elections Committee shall present a qualified slate of 548

candidates to the Board of Directors for its review and approval prior to presenting 549 the slate to the membership. Following such review and approval, the Nominations 550 and Elections Committee shall present the slate to the membership through 551 publication in such ENA publications as determined by the Board of Directors or its 552 designee(s). 553

5. Vacancies 554 a. A vacancy in the chairperson position shall be filled by the Board of Directors. 555 b. A vacancy of a committee member shall be filled by the Board of Directors, provided, 556

however, a committee position may, in the discretion of the Board of Directors, 557 remain vacant if less than six months remain of the unexpired term. 558

559 ARTICLE X 560

DISSOLUTION 561 In the event of dissolution of ENA, the net assets of the corporation shall be applied and all 562 liabilities and obligations shall be paid, satisfied, and discharged, or adequate provision shall be 563 made thereof. After payment of all liabilities and obligations, all remaining assets shall be 564 distributed to an organization or organizations organized and operated exclusively for charitable, 565 educational, scholastic or scientific purposes as shall at the time qualify as tax exempt under 566 Sections 501(c)(3) of the Internal Revenue Code of 1986, as amended (or the corresponding 567 provision of any future United States Internal Revenue Law). 568 569

ARTICLE XI 570 FINANCE 571

Section 1. Contracts 572 The Board of Directors may authorize any officer or officers, agent or agents of ENA, in addition 573 to the officers so authorized by these bylaws, to enter into any contract or execute and deliver 574 any instrument in the name of and on behalf of ENA, and such authority may be general or 575 confined to specific instances. 576 577 Section 2. Payment of Indebtedness 578 All checks, drafts or other orders for the payment of money, notes or other evidences of 579 indebtedness issued in the name of ENA shall be signed by such officer or officers, agent or 580 agents of ENA and in such manner as shall from time to time be determined by resolution of the 581 Board of Directors. In the absence of such determination by the Board of Directors, such 582 instruments shall be signed by the Secretary/Treasurer and countersigned by the President. 583 584 Section 3. Deposits 585 All of ENA’s funds shall be deposited to the credit of ENA in such banks, trust companies, or 586 other depositaries as the Board of Directors may select. 587 588 Section 4. Bonding 589 The Board of Directors shall provide for the bonding of such officers and employees of ENA as it 590 may from time to time determine. 591 592 Section 5. Gifts 593 The Board of Directors may accept on behalf of ENA any contribution, gift, bequest or devise for 594 ENA’s general purposes or for any special purpose. 595 596 Section 6. Books and Records 597 ENA shall keep correct and complete books and records of account and shall also keep minutes 598 of the proceedings of the Board of Directors. The books and accounts of ENA shall be audited 599 annually by accountants selected by the Board of Directors. 600 601

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Section 7. Fiscal Year 602 ENA’s fiscal year shall be determined by the Board of Directors. 603 604

605 ARTICLE XII 606

WAIVER OF NOTICE AND ELECTRONIC COMMUNICATION 607 608

Section 1. Waiver of Notice 609 Whenever any notice is required to be given under applicable law, the Articles of Incorporation 610 or these bylaws, waiver thereof in writing signed by the person or persons entitled to such 611 notice, whether before or after the time stated therein, shall be deemed equivalent to the giving 612 of such notice. 613 614 Section 2. Electronic Communication 615 Unless otherwise prohibited by law, (i) any action to be taken or notice delivered under these 616 bylaws may be taken or transmitted by e-mail or other electronic means; and (ii) any action or 617 approval required to be written or in writing may be transmitted or received by e-mail or other 618 electronic means. 619 620

ARTICLE XIII 621 PARLIAMENTARY AUTHORITY 622

The rules contained in the current edition of Robert’s Rules of Order Newly Revised shall 623 govern ENA in all cases to which they are applicable and in which they are not inconsistent with 624 these bylaws and any special rules of order ENA may adopt. 625

626 ARTICLE XIV 627 AMENDMENT 628

Section 1. Proposals 629 Amendments to the bylaws may be proposed by the Board of Directors, state councils or under 630 the signature of ten Voting Members in good standing. Amendments proposed by a State 631 Council or under the signature of ten Voting Members in good standing are subject to the prior 632 review and approval the Board of Directors to assure that proposed amendments (i) are 633 consistent with ENA’s purposes, mission, values and objectives: (ii) have no adverse financial 634 impact on ENA; (ii) do not create inconsistencies or conflicts with other provisions of the bylaws; 635 and (iv) do not conflict with the requirements of ENA’s Articles of Incorporation or federal or 636 state law. Proposed amendments approved or introduced by the Board of Directors (collectively, 637 “Approved Proposals”) will be presented to the General Assembly in accordance with the 638 provisions set forth below in this article XIV. 639 640 Section 2. Submission Deadline 641 Proposed amendments must be submitted to ENA national office at least 120 days prior to the 642 General Assembly. 643 644 Section 3. Notice 645 Notice of all Approved Proposals will be submitted to the membership at least 60 days prior to 646 the General Assembly. Publication of the Approved Proposals in an ENA publication to on the 647 ENA website shall constitute adequate notice. 648 649 Section 4. Vote 650 In order to be adopted , Approved Proposals must be approved by a two-thirds vote of the 651 delegates present and voting at a meeting of the General Assembly. 652 653

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Resolution GA21-04


TITLE: Federal Nurse Practice Act and Licensing in the United States of America 1

Whereas, the COVID-19 pandemic and other large scale disasters with variability in geographic 2 emergency patient volume surges require emergency nursing response across state lines and mutual aid from 3 emergency nurses who are not licensed to practice in the region of need (Aguilera et al., 2020; Bell, 2020; 4 Cuadros et al., 2021); 5 6 Whereas, variations in nurse practice acts and state regulatory interpretations prohibit best-evidence 7 emergency nursing practice in some states (Ballard et al., 2016; Castner & Boris, 2020; Castner et al., 2013); 8 9 Whereas, rapid advances in teletriage and emergency telenursing render many physical state geographic 10 boundaries meaningless to potential pragmatic access to high quality telehealth care (Brown, 2021; Carlberg et 11 al., 2020; Doraiswamy et al., 2020; National Council of State Boards of Nursing, 2021; Rambur et al., 2019); 12 13 Whereas, interstate nursing licensure compacts exist in piecemeal fashion and are not utilized in a 14 systematic regional or multi-regional manner across the country (DePasquale & Stange, 2016; Rambur et al., 15 2019); 16 17 Whereas, travel and agency nursing across states and territories are routinely utilized for emergency 18 nursing workforce vacancy and staffing (Gottleib & Zenilman, 2020); 19 20 Whereas, the post-COVID-19 pandemic recovery period is projected to worsen emergency staffing 21 shortages and create timely urgency and priority for emergency nursing workforce staffing (National Council of 22 State Boards of Nursing, 2021); and 23 24 Whereas, inconsistencies in nurse practice act regulation, prohibitions, and interstate compact 25 participation limit patient access to best-evidence physical and telehealth nursing care in both non-disaster and 26 disaster conditions (DePasquale & Stange, 2016; Rambur et al., 2019). 27 28 Resolved, ENA will explore, with stakeholders (e.g. American Nurses Association, Nursing 29 Organizations Alliance, National Council State Board of Nursing) to determine their stance on federal nursing 30 licensure; and 31 32

Resolved, ENA will continue support furthering of state licensure compacts. 33 34 Resolution Background Information 35 In the United States and U.S. territories, the practice of nursing is defined and regulated by state nurse practice 36 acts. These nurse practice acts with regulatory rules and interpretive statements are designed to codify and 37 specify the legal limits of safe and competent nursing practice. These laws were enacted at the state level 38 beginning in the early 1900’s with substantial variations in expertise, board of nursing composition, amendment 39 processes, and prohibitions. Thus, the practice of nursing evolves at different rates in different states and 40 territories with variations that create a barrier for best-evidence emergency nursing practice. For example, nurse-41 initiated protocols (also referred to as triage protocols, standing orders, complaint-specific protocols, advanced 42 triage orders, medical directives, and standing triage protocols) enhance the capability to provide timely and life-43 saving care in the emergency department setting (Castner & Boris, 2020; Douma et al., 2016). However, use of 44 these protocols have been prohibited in the regulatory language of several states, placing emergency nurses in the 45 morally untenable position of providing lifesaving care they are competent to provide or withholding or delaying 46 the care to comply with outmoded state prohibitions on practice (Castner & Boris, 2020; Castner et al., 2013). 47 Emergency nurses are not able to practice to the full extent of their training and education consistently across the 48 United States and territories. 49

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Resolution GA21-04


50 A nursing scope of practice decision tree (Figure 1) was developed by the American Association of Colleges of 51 Nursing (AACN), the American Nurses Association (ANA), the American Organization for Nursing Leadership 52 (AONL), and the National League for Nursing (NLN) with the National Council of State Boards of Nursing 53 (NCSBN) (Ballard et al., 2016). This framework was designed to guide nurses, health care facilities, and boards 54 of nursing in ascertaining whether a particular activity fell within the individual nurse’s scope of practice. As 55 seen in Figure 1, state nurse practice level prohibitions are the foremost and initial constraint placed on 56 determining whether an activity is within a nurse’s scope of practice. Many progressive states have few or no 57 prespecified prohibitions on nursing practice. Instead, they acknowledge that nursing practice and competencies 58 may evolve faster than legal and regulatory activities could or should attempt to match as advanced nurse 59 training, competencies, and ongoing public need for nursing skills or professional care progress (Castner et al., 60 2013). This leaves those states with detailed descriptions of the demarcations of nursing practice or prohibitive 61 language to advance slowly through legal and political processes, rather than at the pace of scientific evidence 62 and nurse competency attainment. These variations and inconsistencies place quality care and patient safety at 63 risk where prohibitions limit nursing practice evolution at the pace of best-evidence intervention that are 64 poignantly relevant to the emergency nursing specialty. Specialties, such as the emergency nursing specialty, add 65 to the scope and standards of the basic registered nursing practice delineated by each state and territory, but there 66 few valid or evidence-based reasons for variations in base nurse practice prohibitions by state (Emergency 67 Nurses Association [ENA], 2017). Rather, reasons for variations appear outmoded and largely political, instead 68 of being based on sound scientific evidence that informs emergency nursing practice advancements. Thus, the 69 highly political nature of state licensing and scope of practice may be a patient safety issue in its own right, 70 limiting quality emergency care and telenursing along state lines. 71 72 The COVID-19 pandemic and other large-scale, multi-state disasters demonstrate a clear public health need for a 73 rapidly mobile emergency nursing workforce across state and territory lines with geographic variation in the 74 surge demands for emergency nursing skill (Aguilera et al., 2020; Bell, 2020; Cuadros et al., 2021; Veenema, 75 2019). While state executive branches and administrators may waive liability and licensing requirements in a 76 state of emergency or disaster, inconsistent nurse scope of practice in each individual nurse’s home state creates 77 an initial barrier to forming novel teams under disaster conditions and providing consistent levels of care. 78 Further, infection control practices during the COVID-19 pandemic resulted in a rapid deregulation, 79 reimbursement, and advanced demand for teletriage and emergency telehealth (Brown, 2021; Carlberg et al., 80 2020; Doraiswamy et al., 2020; National Council of State Boards of Nursing, 2021; Rambur et al., 2019). With 81 the ability to provide nursing care by telehealth in physically distant locations, the geographic boundary divisions 82 created by state-level nurse practice acts become largely meaningless to potential pragmatic access to high-83 quality telehealth care. Thus, the surge capacity of the emergency nursing workforce is limited by the 84 experiential constraints imposed when the nurse originates from a state with prohibitive language on best-85 evidence care, the potential delay in obtaining a license in a new geographic state or territory to provide mutual 86 aid, and the capability to provide telehealth to patients outside of the nurse’s state of origin. Not only do these 87 constraints limit disaster surge response, but they also limit the ability to meaningfully respond to non-disaster 88 demand and emergency nursing workforce vacancy and job turnover (Castner et al., in press; Gottleib & 89 Zenilman, 2020; National Council of State Boards of Nursing, 2021). 90

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Resolution GA21-04


91 Figure 1 Nursing scope of practice decision tree 92 Source: National Council of State Boards of Nursing. (n.d.). Scope of practice decision-making framework. 93 https://www.ncsbn.org/decision-making-framework.htm 94 95

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https://www.ncsbn.org/decision-making-framework.htm

Resolution GA21-04


The emergency nursing specialty experiences among the highest rates of hospital job vacancy and turnover, 96 compared to other nursing specialties (Castner et al., in press; Gottleib & Zenilman, 2020). Travel and agency 97 nurses, often across state lines, have long been an essential strategy and workforce component to mitigate 98 emergency nursing staffing shortages and provide safe patient care (Gottleib & Zenilman, 2020). Providing 99 nursing care in different states on short-term contract can be delayed or even infeasible when states do not 100 participate in interstate compacts or the state licensing procedure is costly, prohibitive, or inefficient. Further, the 101 same emergency nurse with the same practice experience and training in one state may be prohibited from 102 practicing to the full extent of their training, experience, and education in other states with prohibitive language 103 (Ballard et al., 2016). Thus, state variations in nursing practice are exceptionally salient not only to the practice 104 of emergency nursing but in meeting sufficient workforce staffing requirements as well. 105 106 Interstate licensing compacts are agreements initiated among a group of states or territories that enable a nurse 107 with a license in one state to practice nursing in the compact states without obtaining a new, state-specific 108 license. Interstate compacts are not comprehensive as they are limited to political agreements among states. In 109 addition, a nurse must still abide by the nurse practice act and scope of practice in the state in which they are 110 delivering patient care. These compacts have been implemented in a piecemeal fashion, often without 111 consideration for the broad reach and access amenable to telehealth and have not been implemented in a 112 systematically regional or multi-regional manner across the country (DePasquale & Stange, 2016; Rambur et al., 113 2019). Until a federal level nurse practice act and licensing governing board is achieved, interstate compacts and 114 enhanced nurse licensure compacts provide an incremental solution to enabling nursing practice across state 115 lines. Evidence on telenursing and current compacts provides implications for the need to expand compacts 116 consistently to whole regions of the country, if not to all states and territories systematically (DePasquale & 117 Stange, 2016; Rambur et al., 2019). Federal systems of nursing practice are not new. Exemplars of well-118 coordinated federal systems for consistent nursing practice across states can be found in United States Military 119 Treatment Facilities, Veteran’s Affairs Hospitals, and among networks of the Indian Health Service. 120 There are valid reasons for variations in nurse scope of practice to meet the unique demands of care in health 121 care provider shortage areas (HCPAs); low-income, socio-economic deprivation areas; rural and critical access 122 hospital service regions; and tribal systems. However, these variations are not bound by state and U.S. territory 123 geography. Prohibitive language in state level nurse practice acts and regulatory statements do little to meet the 124 demands of these areas where nurse training and experience may need to expand the individual practicing nurse’s 125 scope, rather than restrict or constrain practice. Therefore, this resolution proposes that ENA seeks to initiate 126 collaboration with three other key national nursing organizations in order to address the need for a federal 127 nursing licensing board and nurse practice act while furthering multi-state/territory licensure compacts. 128 129 Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: 130 This resolution builds upon ENA’s mission to advance excellence in emergency nursing by removing state 131 prohibitions and regulatory barriers to nurses in the specialty being able to practice to the full extent of their 132 education and training. This resolution builds on the current ENA strategic plan and practice environment goal 133 that emergency nurses will work in an ideal practice environment to provide the highest quality of emergency 134 care in the safest way by collaborating to reduce state-to-state variations that may limit the use of nurse-initiated 135 protocols and other best-evidence emergency nursing interventions. This resolution is also aligned with the ENA 136 clinical practice guideline of Crowding, Boarding, and Patient Throughput (ENA, 2018). 137 138 Financial Consideration/Operations Impact: 139 The scope of work outlined in the resolved clauses has a fiscal impact between $10,000-$25,000. Upon 140

final outcomes of General Assembly, initiatives will be evaluated for resource planning in alignment 141

with ENA’s strategic plan and operational goals. 142

143 144

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Resolution GA21-04


Professional References 145 Aguilera, R., Hansen, K., Gershunov, A., Ilango, S. D., Sheridan, P., & Benmarhnia, T. (2020). Respiratory 146

hospitalizations and wildfire smoke: A spatiotemporal analysis of an extreme firestorm in San Diego County, 147 California. Environmental Epidemiology, 4(5), e114. https://doi.org/10.1097/ee9.0000000000000114 148

Ballard, K., Haagenson, D., Christiansen, L., Damgaard, G., Halstead, J. A., Jason, R. R., Joyner, J. C., 149 O’Sullivan, A. M., Silvestre, J., & Cahill, M. (2016). Scope of nursing practice decision-making framework. 150 Journal of Nursing Regulation, 7(3), 19–21. https://doi.org/10.1016/S2155-8256(16)32316-X 151

Bell, S. A. (2020). Practice informs research and research informs practice: The making of a disaster nurse 152 scientist. Journal of Emergency Nursing, 46(5), 553–556. https://doi.org/10.1016/j.jen.2020.06.009 153

Brown, H. L. (2021). Emergency care EMTALA alterations during the COVID-19 pandemic in the United 154 States. Journal of Emergency Nursing, 47(2), 321–325. https://doi.org/10.1016/j.jen.2020.11.009 155

Carlberg, D. J., Bhat, R., Patterson, W. O., Zaatari, S., Chandra, V., Kolkin, A., Ratwani, R. M., Wilson, M. D., 156 Ladkany, D., Adams, K. T., Jackson, M., Lysen-Hendershot, K., & Booker, E. A. (2020). Preliminary 157 assessment of a telehealth approach to evaluating, treating, and discharging low-acuity patients with suspected 158 COVID-19. Journal of Emergency Medicine, 59(6), 957–963. https://doi.org/10.1016/j.jemermed.2020.08.007 159

Castner, J., Bell, S. A., Castner, M., & Couig, M. P. (2021). National Estimates of the Reserve Capacity of 160 Registered Nurses Not Currently Employed in Nursing and Emergency Nursing Job Mobility in the United 161 States. Annals of Emergency Medicine, S0196-0644(21)00195-5. Advance online publication. 162 https://doi.org/10.1016/j.annemergmed.2021.03.006 163

Castner, J., & Boris, L. (2020). State laws and regulations addressing nurse-initiated protocols and use of nurse-164 initiated protocols in emergency departments: A cross-sectional survey study. Policy, Politics, & Nursing 165 Practice, 21(4), 233–243. https://doi.org/10.1177/1527154420954457 166

Castner, J., Grinslade, S., Guay, J., Hettinger, A. Z., Seo, J. Y., & Boris, L. (2013). Registered nurse scope of 167 practice and ED complaint-specific protocols. Journal of Emergency Nursing, 39(5), 467–473.e3. 168 https://doi.org/10.1016/j.jen.2013.02.009 169

Cuadros, D. F., Branscum, A. J., Mukandavire, Z., Miller, F. D., & MacKinnon, N. (2021). Dynamics of the 170 COVID-19 epidemic in urban and rural areas in the United States. Annals of Epidemiology, 59, 16–20. 171 https://doi.org/10.1016/j.annepidem.2021.04.007 172

DePasquale, C., & Stange, K. (2016). Labor supply effects of occupational regulation: Evidence from the nurse 173 licensure compact [Working paper 22344]. National Bureau of Economic Research. 174 https://doi.org/10.3386/w22344 175

Doraiswamy, S., Abraham, A., Mamtani, R., & Cheema, S. (2020). Use of telehealth during the COVID-19 176 pandemic: Scoping review. Journal of Medical Internet Research, 22(12), Article e24087. 177 https://doi.org/10.2196/24087 178

Douma, M. J., Drake, C. A., O’Dochartaigh, D., & Smith, K. E. (2016). A pragmatic randomized evaluation of a 179 nurse-initiated protocol to improve timeliness of care in an urban emergency department. Annals of 180 Emergency Medicine, 68(5), 546–552. https://doi.org/10.1016/j.annemergmed.2016.06.019 181

Emergency Nurses Association. (2017). Emergency nursing: Scope and standards of practice (2nd ed.). 182 Emergency Nurses Association. (2018). Crowding, boarding, and patient throughput. Journal of Emergency 183

Nursing, 44(2), 176–183. https://doi.org/http://doi.org/10.1016/j.jen.2018.10.011 184 Gottleib, J., & Zenilman, A. (2020). When nurses travel: Labor supply elasticity during COVID-19 surges 185

[Working paper No. 2020-166]. Becker Friedman Institute for Economics at the University of Chicago. 186 https://bfi.uchicago.edu/working-paper/2020166/ 187

National Council of State Boards of Nursing. (2021). NCSBN’s Environmental Scan COVID-19 and its impact 188 on nursing and regulation. Journal of Nursing Regulation, 11(4), S1–S36. https://doi.org/10.1016/s2155-189 8256(21)00002-8 190

Rambur, B., Palumbo, M. V., & Nurkanovic, M. (2019). Prevalence of telehealth in nursing: Implications for 191 regulation and education in the era of value-based care. Policy, Politics, & Nursing Practice, 20(2), 64–73. 192 https://doi.org/10.1177/1527154419836752 193

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https://doi.org/10.1097/ee9.0000000000000114

https://doi.org/10.1016/S2155-8256(16)32316-X

https://doi.org/10.1016/j.jen.2020.06.009


https://doi.org/10.1016/j.jemermed.2020.08.007

https://doi.org/10.1016/j.annemergmed.2021.03.006

https://doi.org/10.1177/1527154420954457


https://doi.org/10.1016/j.annepidem.2021.04.007

https://doi.org/10.3386/w22344

https://doi.org/10.2196/24087


https://doi.org/http:/doi.org/10.1016/j.jen.2018.10.011

https://bfi.uchicago.edu/working-paper/2020166/

https://doi.org/10.1016/s2155-8256(21)00002-8

https://doi.org/10.1016/s2155-8256(21)00002-8

https://doi.org/10.1177/1527154419836752

Resolution GA21-04


Veenema, T. G. (Ed.). (2019). Disaster nursing and emergency preparedness for chemical, biological, and 194 radiological terrorism, and other hazards (4th ed.). Springer Publishing Company. 195

196 Author(s): 197 New York State Emergency Nurses Association 198 199 Jessica Castner, PhD, RN-BC, FAEN, FAAN 200 ENA Member # 503401 201 716-417-7360 202 [email protected] 203 204 Jamla Rizek, MBA, MSN, RN, CEN, CPEN, NHDP-BC, NRP 205 ENA Member # 743653 206 315-491-7020 207 [email protected] 208 209 Supporter(s): 210 Karen Wiley, ENA #82169 211 Virginia Hebda, ENA #39963 212 Ann Yankay, ENA #87019 213 Donna Sowles, ENA #540247 214 Phyllis Parker, ENA #38420 215 Melaney Gordon, ENA #550730 216 Dawn MacMullen, ENA #587622 217 Joe Malenda, ENA #550860 218 Vepuka Kauari, ENA #205009 219 Mary Ellen “Mel” Wilson, ENA #23035 220 Sue Chalupa Breese, ENA #376547 221 Mary M. DaSilva, ENA #430121 222 Sandra Tetler, ENA #390415 223 Mickey Forness, ENA #7263 224 Eileen Breckenridge, ENA #103398 225 Mary Ann Teeter, ENA #12331 226 Marge Letitia, ENA #19020 227 Meredith Addison, ENA #22994 228 Brendan Kyek, ENA #1583277 229 Dr. Debbie Arbique, ENA #67876 230 Claudia E Garner, ENA #70500 231 Maureen O'Reily Creegan, ENA #6633 232 Eva Santiago, ENA #226511 233 Agnes Kelly, ENA #47179 234 Haylie Jo Wheeler, ENA #1458005 235 Al McLean, ENA #974739 236 Julie Miller, ENA #56917 237 Teri Riddle, ENA #798421 238 Karen Battaglia, ENA #106487 239 Nancy Moffett, ENA #1750438 240 Doris Price, ENA #1162283 241 Chris Gisness, ENA #17848 242

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mailto:[email protected]


Resolution GA21-04


Cheryl Ann MacDonald-Sweet, ENA #226547 243 Barbara Gibson, ENA #847705 244 Patricia Sica, ENA #68490 245 Kathleen Albert, ENA #107165 246 Carol Ceruzzi, ENA #62402 247 Christopher Benson, ENA #1091534 248 Georgette Salera, ENA #971900 249 Patricia Jess, ENA #38165 250 Tamira Balay, ENA #112048 251 Tiffany Johnson, ENA #868923 252 Kevin Moulin, ENA #817223 253 Lisa Dukes, ENA #682786 254 Mary Harwood, ENA #730848 255 William Schueler, ENA #477499 256 Aimee Lane, ENA #1866824 257 Brenda Snyder, ENA #1289595 258 Nancy Distelcamp, ENA #84415 259 Krista Anderson, ENA #1904806 260 Jennifer Hanish, ENA #725679 261 Taryn Amberson, ENA #884845 262 Annelise Johnson, ENA #788937 263 Dana Martini, ENA #721418 264 Derek Grassley, ENA #818914 265 Jean Proehl, ENA #10523 266 Harriet S. Hawkins, ENA #57250 267 Fred Neis, ENA #109820 268 Mariann F. Cosby, ENA #25957 269 Helen Passafiume Sandkuhl, ENA #6082 270 Sally K. Snow, ENA #9905 271 Ellen E. Ruja, ENA #3425 272 Mary Alice Vanhoy, ENA #51004 273 Dan Nadworny, ENA #561074 274 Louise Hummel, ENA #80504 275 Patricia Kunz Howard, ENA #25128 276 Thelma Kuska, ENA #29189 277 Cindy Hearrell, #58519 278 Nancy Mannion, ENA #22694 279 Jeff Solheim, ENA #101942 280 Carla Brim, ENA #464456 281 Patricia Clutter, ENA #5926 282 Rita Anderson, ENA#56587 283 Valerie Aarne Grossman, ENA #76446 284 Cheryl Randolph, ENA #74060 285 Vicki C. Patrick, ENA #9821 286 Chris Gisness, ENA #17848 287 JoAnn Lazarus, ENA #37139 288 Diana Meyer, ENA #54415 289 Meredith Addison, ENA #22994 290 Maryanne Portoro, ENA #20625 291

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Resolution GA21-04


Kelli Jones, ENA #912672 292

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Resolution GA21-05


TITLE: CATN (Course in Advanced Trauma Nursing) in the Classroom 1 2 Whereas, the Trauma Nursing Core Course (TNCC) was first released for students in 1986 and it is an 3 enduring opportunity which meets the basic education mandates for many Emergency Departments. 4 5 Whereas, experienced ED nurses who have taken TNCC multiple times do not have another ENA option 6 to meet their verification requirements. 7 8 Whereas, in many states TNCC is listed as meeting the requirements for Trauma Center designation. 9 Other courses such as the Advanced Trauma Care for Nurses (ATCN) course is listed as equivalent and is a 10 direct competitor for ENA. 11 12 Whereas, CATN was released in 1996, (updated in 2003 and placed in a strictly online format in 2011) 13 and is currently only utilized as a continuing education course. 14 15 Whereas, with the release of CATN II, the ENA found that members indicated “interest in the expansion 16 of knowledge related to the pathophysiologic processes in patients with acute injuries” and “inclusion of the 17 methodology necessary for complex decision making” (Sheehy, 2003) 18 19 Whereas, National ENA is in the beginning stages of updating CATN, and this update does not currently 20 include options for in person learning or the option of a verification. 21 22 Whereas, if adopted, this resolution is in direct alignment with ENA’s 2020-2025 vision and strategic 23 goals. 24 25 Resolved, that the ENA explore restoring CATN as an interactive learning opportunity; and 26 27 Resolved, that the ENA explore developing CATN as a verification course. 28 29 Resolution Background Information: 30 Currently, the standard trauma education of many emergency nurses includes TNCC. This course was first 31

released in 1986 and is now in its 8th edition. It is a gold standard for emergency nursing education. However, 32

many of our seasoned nurses have now had this 4-year verification many times. Our current TNCC 8th ed. 33

Manual states “The curriculum is designed for new trauma nurse learners to acquire essential knowledge and 34

skills. Post-course mentoring and support are essential to further develop and master trauma nursing expertise” 35

(Bratcher, 2020) 36

37

The Course in Advanced Trauma Nursing (CATN) was released in 1996 as an additional ENA offering. 38

However, this course was, and is still currently provided as continuing education only and does not include a 39

renewable verification. According to ENA’s own website, “CATN is an advanced course that goes beyond the 40

primary survey to focus on critical thinking and clinical decision-making to enhance trauma care. It includes 41

tools to anticipate complications early in the trauma continuum, resulting in better patient outcomes.” (ENA, 42

2021) 43

44

In its first two editions, CATN was initially a classroom-based course which included teaching in the flipped 45

classroom style. In 2011, it was updated to an online only format. In a meeting with National ENA, we were 46

unable to ascertain the current number of students taking either course. In addition, we hoped to compare data 47

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Resolution GA21-05


from current students taking the online version with the number of students that participated in the classroom 48

version. This data was not available. 49

50

Within our limited research capabilities, we attempted to review nationwide Trauma Center designation criteria. 51

Of those that we located, twenty (20) included TNCC as one of the courses which met the education criteria. In 52

eleven (11) states however, ATCN was listed as equivalent. Many states had other courses and continuing 53

education requirements. As many nurses take TNCC, they do not have any other ENA opportunity to meet their 54

educational requirements other than repeating the same course. 55

56

Currently, ENA is looking at the process of updating the current CATN course. However, in this discussion, the 57

option of a renewing verification is not part of the discussion. 58

59

It is understood that the cost of developing and maintaining a new verification course may be significant. 60

This is why the resolved clauses were created as an exploration of the concept. 61

62

Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: 63 64 This resolution, if adopted, appears to be in direct alignment with the vision, education goals, objectives and 65 strategies of the ENA. For review, the following excerpts, are directly from the National ENA’s 2020-2025 66 vision and strategic goals. 67 68 VISION: Be the premier organization for the emergency nursing community worldwide 69

70 • Emergency nurses practicing worldwide have the appropriate evidence-based resources needed to 71 provide the best care possible 72 • Emergency nurses globally have access to high quality education and resources to provide 73 excellent care 74 • Emergency nurses provide care using their full scope of practice 75 • Every emergency nurse receives the highest level of specialized training and education offered. 76

77 EDUCATION GOAL: Emergency nurses have the highest quality educational resources to provide the highest 78 level of care. 79 80 Objectives: 81 1. Expand research to increase the generation of new knowledge in emergency nursing 82 2. Expand the translation of best evidence into emergency nursing practice 83 3. Increase development and delivery of educational content for emergency nurses worldwide. 84 85 Strategies: 86 2. Identify and prioritize emergency nursing education gaps 87 3. Expand ENA core educational offerings for all levels of emergency nurses 88 4. Create new educational offerings that cover the breadth and depth of emergency nursing 89 90 Financial Consideration/Operations Impact: 91 The scope of work outlined in the resolved clauses has a fiscal impact between $10,000-$25,000. Upon final 92 outcomes of General Assembly, initiatives will be evaluated for resource planning in alignment with ENA’s 93 strategic plan and operational goals. 94

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Resolution GA21-05


Professional References: 95 Sheehy, S. e. (2003). Course in Advanced Trauma Nursing-II. (S. Sheehy, Ed.) Debuque, IA: Kendall / Hunt. 96 Bratcher, C., & all, e. (2020). Trauma Nursing Core Course (8 ed.). (J. Balnsfield, Ed.) Burlington, MA: Jones 97

and Bartlett Learning. 98 Emergency Nurses Association, (2021, 5 3). Course in Advanced Trauma Nursing (CATN), 2nd Edition. 99

Retrieved May 3, 2021, from ENA.org: https://www.ena.org/shop/catalog/education/online-100 learning/course-in-advanced-trauma-nursing-(catn)/c-23/c-100/p-198 101

102 Author(s): 103 Eric Christensen BSN, RN, CEN, CPEN, FAEN 104 ENA Member #425963 105 303-947-6186 106 [email protected] 107 108 Christopher Fangmeier, MBA, BSN, RN, CEN, TCRN 109 ENA Member #715591 110 303-359-2228 111 [email protected] 112 113 Casey Zeigler RN, CFRN 114 ENA Member #123260 115 303-525-7362 116 [email protected] 117 118 Amy Boren MS, RN, CEN, CPEN, TCRN 119 ENA Member #766789 120 970-405-8356 121 [email protected] 122 123 Mike Archuleta MSN, RN, CCRN 124 ENA Member # 366155 125 [email protected] 126 127 Supporter(s): 128 Colorado ENA State Council 129 Wyoming ENA State Council 130 Maureen O'Reilly Creegan, ENA #6633 131 Wesley Davis, ENA #477669 132 Andi Foley, ENA #112569 133 Cathy C Fox, ENA #40470 134 Laura E. Gallagher, ENA #489038 135 Marcia K. Harmon, ENA #408734 136 Louise Hummel, ENA #80504 137 Julie Miller, ENA #56917 138 Tim Murphy, ENA #30447 139 Jean Proehl, ENA #10523 140 Ellen Ruja, ENA #3425 141 Joan Somes, ENA #5802 142

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https://www.ena.org/shop/catalog/education/online-learning/course-in-advanced-trauma-nursing-(catn)/c-23/c-100/p-198

https://www.ena.org/shop/catalog/education/online-learning/course-in-advanced-trauma-nursing-(catn)/c-23/c-100/p-198






Resolution GA21-05


Tiffiny Strever, ENA #101152 143 Mary Alice Vanoy, ENA #51004 144

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Resolution GA21-06


TITLE: Emergency Clinical Nurse Specialist National Certification 1

2

Whereas, specialty certification distinguishes nursing expertise both clinically and professionally (Board 3

of Certification for Emergency Nurses [BCEN], 2017; Stucky & Wymer, 2020); 4

5

Whereas, advance practice registered nurses (APRN) practice in the emergency care setting in two 6

different roles: the nurse practitioner (NP) and clinical nurse specialist (CNS) (Emergency Nurses Association, 7

[ENA], 2019a); 8

9

Whereas, APRN licensure requires an advanced nursing degree, clinical hours, and national certification 10

in the specialty. Historically, acceptable specialty professional credentialing mechanisms include examination or 11

portfolio (Institute of Medicine, 2011, Appendix D; Nursing License Map. 2021); 12

13

Whereas, NPs can achieve initial national certification of ENP-C through the American Academy of 14

Nurse Practitioners (AANP) Certification Board or recertify through the American Nurses Credentialing Center 15

(ANCC) as ENP-BC (RegisteredNursing.org), a national certification option for emergency CNSs does not exist. 16

This creates inequity and may prevent CNSs from practicing to the full extent and authority of their degree 17

within the emergency care setting (ENA, 2019a; Evans et al., 2018); and 18

19

Whereas, the American Nurses Association (ANA) has established that specialty professional 20

organizations are accountable for establishing the education, skills, and competencies required for entry into 21

specialty practice (2017). In 2011, ANA recognized ENA as the specialty professional organization for 22

emergency nursing (ANA, 2011). 23

24

Resolved, that ENA establish the education, skills, and competency requirements for nurses to be 25

credentialed as a CNS in the emergency setting; 26

27

Resolved, that ENA advocate for a national certification designation for emergency CNSs; 28

29

Resolved, that ENA explore strategic partnerships to enable equitable access to national certification for 30

emergency CNSs; and 31

32

Resolved, that ENA explore the development of a national certification mechanism for emergency CNSs. 33

34

Resolution Background Information: 35

As an ANA recognized specialty organization, ENA holds the authority and has the accountability to establish 36

the education, skills, and competencies for nursing practice within the emergency setting (ANA, 2017). ENA has 37

long supported professional certification, including publication of an established Emergency Nursing 38

Certification position statement, and developed strategic partnerships with the BCEN to support professional 39

certification for emergency nurses (2018). Further, ENA has long supported the advancement of the APRN 40

through the Institute for Emergency Nurse Advanced Practice advisory council, published an Advanced Practice 41

Registered Nurses in the Emergency Care Setting position statement (2019a), and has conducted research to 42

establish NP and CNS core competencies (ENA, 2011, 2019b). 43

44

The CNS competencies help inform education requirements; however, academic institutions need to determine 45

education requirements that result in the competency. 46

47

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Resolution GA21-06


There is strong evidence that APRNs are effective clinicians who provide safe, cost-effective care (ANA, 2014). 48

Several bodies support full practice authority and the removal of barriers to nursing practice, including the 49

National Academy of Medicine (formerly the Institute of Medicine [IOM]), the National Governors Association 50

(NGA), the Federal Trade Commission (FTC), the Bipartisan Policy Center, and the Veteran’s Health 51

Administration (VHA) (ANA, 2016). The CNS scope of practice and licensure varies depending upon regulation. 52

At this time, CNSs can now practice independently in 28 states and prescribe independently in 19 states 53

(National Association of Clinical Nurse Specialists [NACNS], 2019a). 54

55

The American Academy of Emergency Nurse Practitioners (AAENP) developed a strategic partnership to 56

advance the emergency nurse practitioner (ENP) specialty, thereby paving the way for professional certification 57

mechanisms (Evans et al., 2018). In doing so, the AAENP set forth a practical framework that could guide the 58

development of professional certification mechanisms (Evans et al., 2018) for emergency CNSs to permit 59

licensure and practice to full ability in the emergency setting. 60

61

NACNS is the professional organization for CNSs. To that end, NACNS has established foundational 62

educational and core competencies for entry into practice as a generalist CNS (2019b). However, emergency-63

specific requirements remain with the ENA to establish. Similar to the AAENP example, it would be beneficial 64

to establish a partnership and collaboration with NACNS to refine the national verification mechanism for 65

emergency CNSs. 66

67

Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: 68

The mission of ENA is to “advance excellence in emergency nursing.” The vision is to “be the premier 69

organization of emergency nursing community worldwide,” with one of the descriptors being to have 70

“emergency nurses provide care using their full scope of practice.” One of the objectives of the community goal 71

of the strategic plan is to “increase collaboration and partnerships that advance emergency nursing.” The 72

establishment of a professional certification mechanism for emergency CNSs is in alignment with these goals. 73

74

Financial Consideration/Operations Impact: 75

The scope of work outlined in the resolved clauses has a fiscal impact of greater than $25,000. Upon final 76

outcomes of General Assembly, initiatives will be evaluated for resource planning in alignment with ENA’s 77

strategic plan and operational goals. 78

79

Professional References: 80

American Academy of Nursing. (2014). American Academy of Nursing: Improving health and health care 81

systems with advanced practice registered nurse practice in acute and critical care settings. Nursing Outlook, 82

62(5), 366–370. https://doi.org/10.1016/j.outlook.2014.07.003 83

American Nurses Association. (2011). Press release ANA recognizes emergency nursing specialty [Press 84

release]. https://www.nurse.com/blog/2011/08/23/ana-recognizes-emergency-nursing-as-specialty-2/ 85

American Nurses Association. (2016). Advanced practice registered nurses (APRN) [Policy statement]. 86

https://www.nursingworld.org/practice-policy/aprn/> 87

American Nurses Association. (2017). American Nurses Association recognition of a nursing specialty, approval 88

of a specialty nursing scope of practice statement, acknowledgement of specialty standards of practice, and 89

affirmation of focused practice competencies. https://www.nursingworld.org/~4989de/globalassets/ 90

practiceandpolicy/scope-of-practice/3sc-booklet-final-2017-08-17.pdf 91

Board of Certification for Emergency Nurses. (2017, September 18). Emergency nursing expertise and career 92

success linked to CEN certification in large-scale study [Press release]. https://bcen.org/news-releases/ 93

emergency-nursing-expertise-and-career-success-linked-to-cen-certification-in-large-scale-study/. 94

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https://www.nurse.com/blog/2011/08/23/ana-recognizes-emergency-nursing-as-specialty-2/

https://www.nursingworld.org/practice-policy/aprn/

https://www.nursingworld.org/~4989de/globalassets/%0bpracticeandpolicy/scope-of-practice/3sc-booklet-final-2017-08-17.pdf

https://www.nursingworld.org/~4989de/globalassets/%0bpracticeandpolicy/scope-of-practice/3sc-booklet-final-2017-08-17.pdf

https://bcen.org/news-releases/%0bemergency-nursing-expertise-and-career-success-linked-to-cen-certification-in-large-scale-study/

https://bcen.org/news-releases/%0bemergency-nursing-expertise-and-career-success-linked-to-cen-certification-in-large-scale-study/

Resolution GA21-06


Emergency Nurses Association. (2011). Competencies for clinical nurse specialists in emergency care [White 95

paper]. https://www.ena.org/docs/default-source/resource-library/practice-resources/other/competencies-for-96

clinical-nurse-specialists-in-emergency-care 97

Emergency Nurses Association. (2018).:Emergency nursing certification [Position statement]. 98

https://www.ena.org/docs/default-source/resource-library/practice-resources/position-statements/ 99

encertification.pdf?sfvrsn=b3563eb6_14 100

Emergency Nurses Association. (2019a). Advanced practice registered nurses in the emergency care setting 101

[Position statement]. https://www.ena.org/docs/default-source/resource-library/practice-resources/position-102

statements/advpracticeernursing.pdf?sfvrsn=e4186f66_26 103

Emergency Nurses Association. (2019b). Emergency nurse practitioner competencies [White paper]. 104

https://www.ena.org/docs/default-source/resource-library/practice-resources/other/practitioner-competencies 105

Evans, D. D., Hoyt, K. S., Wilbeck, J., Schumann, L., Ramirez, E., Tyler, D., & Agan, D. (2018). Embracing the 106

future for emergency nurse practitioners and specialty practice: Implications for research, clinical practice, 107

education and health policy. Journal of the American Association of Nurse Practitioners 30(10), 586–591. 108

https:/doi.org/10.1097/JXX.0000000000000123 109

Institute of Medicine (2011). The future of nursing: Leading change, advancing health. The National Academies 110

Press. https://www.nap.edu/read/12956/chapter/16#326 111

National Association of Clinical Nurse Specialists. (2019a). CNS scope of practice and prescriptive authority as 112

of 07.31.2020 [Policy statement]. https://nacns.org/wp-content/uploads/2020/08/PractPrescAuthority7.31. 113

2020.pdf 114

National Association of Clinical Nurse Specialists. (2019b). Statement on clinical nurse specialist practice and 115

education (3rd ed.). https://nacns.org/professional-resources/practice-and-cns-role/cns-competencies/ 116

Nursing License Map. (2021). Advanced practice registered nurse (APRN) career guide. 117

https://nursinglicensemap.com/advanced-practice-nursing/#:~:text=APRN%20Certification,for%20different 118

%20areas%20of%20specialty 119

Registered Nursing.Org. (2021). Emergency nurse practitioner certification. https://www.registerednursing.org/ 120

certification/emergency-nurse-practitioner/ 121

Stucky, C., & Wymer, J. (2020). Progressing toward specialty certification as the National Standard for Nursing. 122

Nursing Forum, 55(3). 531–534. https://doi.org/10.1111/nuf.12459 123

124

Author(s): 125

Carla Brim, MN, ARNP-CNS, PHCNS-BC, CEN, FAEN 126

ENA Member #464456 127

360-957-1067 128

[email protected]. 129

130

Jeannie Burnie, MS, APRN, AGCNS-BC, CEN, FAEN, FCNS 131


513-560-3342 133

[email protected] 134

135

Supporter(s): 136 Ivy Thoman, ENA #451660 137 Jean A. Proehl, ENA #10523 138 Garrett Chan, ENA # 102476 139 Denise Campbell, ENA #411591 140

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https://www.ena.org/docs/default-source/resource-library/practice-resources/other/competencies-for-clinical-nurse-specialists-in-emergency-care

https://www.ena.org/docs/default-source/resource-library/practice-resources/other/competencies-for-clinical-nurse-specialists-in-emergency-care

https://www.ena.org/docs/default-source/resource-library/practice-resources/position-statements/%0bencertification.pdf?sfvrsn=b3563eb6_14

https://www.ena.org/docs/default-source/resource-library/practice-resources/position-statements/%0bencertification.pdf?sfvrsn=b3563eb6_14

https://www.ena.org/docs/default-source/resource-library/practice-resources/position-statements/advpracticeernursing.pdf?sfvrsn=e4186f66_26

https://www.ena.org/docs/default-source/resource-library/practice-resources/position-statements/advpracticeernursing.pdf?sfvrsn=e4186f66_26

https://www.ena.org/docs/default-source/resource-library/practice-resources/other/practitioner-competencies

https://doi.org/10.1097/JXX.0000000000000123

https://www.nap.edu/read/12956/chapter/16%23326

https://nacns.org/wp-content/uploads/2020/08/PractPrescAuthority7.31.%0b2020.pdf

https://nacns.org/wp-content/uploads/2020/08/PractPrescAuthority7.31.%0b2020.pdf

https://nacns.org/professional-resources/practice-and-cns-role/cns-competencies/

https://nursinglicensemap.com/advanced-practice-nursing/#:~:text=APRN%20Certification,for%20different�%20areas%20of%20specialty

https://nursinglicensemap.com/advanced-practice-nursing/#:~:text=APRN%20Certification,for%20different�%20areas%20of%20specialty

https://www.registerednursing.org/%0bcertification/emergency-nurse-practitioner/

https://www.registerednursing.org/%0bcertification/emergency-nurse-practitioner/



Resolution GA21-06


Margaret J. Carman, ENA #202145 141 Nancy Denke, ENA #4207 142 Jacob A. Miller, ENA #579634 143 David T. House, ENA #468829 144 Scott E. Stover, ENA #71244 145 Chris Gisness, ENA #17848 146 Nycole Oliver, ENA #532022 147 Andi Foley, ENA #112569 148 Darleen Williams, ENA #29604 149 Karen Reilly Follin, ENA #79424 150 Diana Neubecker, ENA #185475 151 Andie Slivinski, ENA #660747 152 Cindy Reazin, ENA # 97857 153 William Fiebig, ENA #49953 154 Shelly Sherman, ENA #1284432 155 Sarah Taylor, ENA #512752 156 Maureen O’Reilly Creegan, ENA #6633 157 Renee Semonin Holleran, ENA #7937 158 Gabriel Campos, ENA #226571 159 Kelly Ashcraft, ENA #902201 160 Monique Jesionowski, ENA #872976 161 Judy Stevenson, ENA #303716 162 Valerie Aarne Grossman, ENA #76446 163 Linda Laskowski Jones, ENA #42215 164 Louise Hummel, ENA #80504 165 Mary Ellen “Mel” Wilson, ENA #23035 166 Glenine Collins, ENA #576700 167 Shawn Zembles, ENA #83483 168 Lisa Gilmore, ENA #123141 169 Roger Keddington, ENA #37690 170 Nancy Manion, ENA #22694 171 Harriet S. Hawkins, ENA #57250 172 Jessica Trivett, ENA #86800 173 Mariann Crosby, ENA #25957 174 Pat Clutter, ENA #5926 175 Diana Meyer, ENA #54415 176 JoAnn Lazarus, ENA #37139 177 Pamela Fox, ENA #4724 178 Jessica Castner, ENA #503401 179 William Schueler, ENA #477499 180 Benjamin Marett, ENA # 17179 181 Patricia Howard, ENA #25128 182 Thelma Kuska, ENA #29189 183 Ann Marie Papa, ENA #65692 184 Mary Jagim, ENA #33628 185 Paula Funderburke, ENA #72833 186 Maureen Curtis Cooper, ENA #28560 187

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Resolution GA21-07


Title: Triage Challenges in Emergency Nursing and Conducting Research 1

2

Whereas, triage decision-making is a critical element in emergency nursing. Triage is the initial 3

assessment and “eyes” laid on the patient and then “sorting” them and directing them to the appropriate level of 4

care; 5

Whereas, triage defines the trajectory of care, and incorrect decisions have been known to cause 6

significant delays and unseen decompensation. A triage RN is tasked with the important decision of assessing 7

how ill this person presenting may be. A challenge to accurate recognition is the placement of inexperienced, 8

new RNs in triage because of resource challenges with retaining quality, educated ED nurses (Ivanov et al., 9

2021; Wolf et al., 2018); 10

11

Whereas, even with the most seasoned RN’s there are minimal guidelines to support competency 12

development and accuracy; 13

14

Whereas, that ENA study and support the environment in which nurses function in the triage role as well 15

as study the effect of the environment on decisions made. 16

17

Whereas, that ENA conduct ongoing research to determine “competency” in the triage role and on the 18

minimum education, experience, and training required for competency in the triage role. 19

20

Whereas, racial, age, disability and gender bias can impede accuracy in triage decision-making by 21

causing nurses to ignore critical cues. Another challenge to the RN in triage is “triage fatigue” (Wolf et al., 22

2018), which can negatively affect decision-making. 23

There are currently many opportunities underway through ENA to study and investigate triage. The 24

following are a sample of some of this pending research: 25

26

• ENA has a program of research based on the 2020 ENA Delphi study. There is a decision fatigue study 27

that is currently IRB approved and about to go into data collection. 28

• Triage education for OB triage and the impact it has on correctly assessing acuity is IRB approved and 29

ready to enter intervention and data collection. 30

• Evaluation of a triage tiered system, which includes what screenings need to be done at triage and their 31

impact on acuity and maintaining safe patient care. 32

• There are other projects related to triage including the geriatric frailty screen. 33

34

Resolved, that ENA distribute a report on the state of the research on triage yearly. This would need to 35

include the year’s research plan, the studies in progress, and their stages of development. 36

37


ENA has a position statement posted titled Triage Qualifications and Competency” (ENA, 2018). This states that 39

nurses complete a “comprehensive, evidence-based triage education course and a clinical orientation with an 40

experience preceptor.” (ENA, 2018, p. 1). Ongoing competency and validation with chart audits are part of this, 41

but, in reality, inexperienced nurses are still placed in triage due to decreased allocation of nursing resources. In 42

2018 ENA purchased the Emergency Severity Index (ESI) course from. This course is a first step in ENA’s 43

ownership of education for triage, but it offers education on ESI and not triage decisions, critical thinking 44

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Resolution GA21-07


activities, and challenges. Triage acuity is not consistent since many will triage to the department or the provider 45

on duty, leading to poor decisions and undertriage of potential high-risk presentations (Sanders & Devon, 2016; 46

Arslanian-Engoren & Scott, 2016). 47

48

Special populations also pose an increased risk for undertriage. Contributing factors include minimal didactic 49

and clinical time in geriatric, pediatric, obstetric, and behavioral health courses in both pre-licensure and 50

continuing education. Other challenges to quick, accurate decision-making include a lack of educational focus on 51

patients who are autistic, have developmental delays, and those with “social issues” such as substance use 52

disorders and homelessness. This list is not inclusive by any means (Tam et al., 2018). The same authors cited 53

also looked at multiple retrospective studies and determined that experience of the nurse does not necessarily 54

correlate with accuracy in assigning correct ESI decisions. Ivanov et al. (2021) and Wolf et al. (2018) report that 55

the experience of the nurse does not necessarily correlate with accuracy in assigning correct ESI decisions. Their 56

research did find an increase in accuracy by nurses taking a triage refresher course and was also duplicated in a 57

study by Brosinski et al. (2017). Experienced nurses, despite years of clinical experience, may still be 58

functioning at the level of a novice RN (Wolf et al., 2018). Women who present with chest pain are often 59

incorrectly evaluated and triaged (Saban et al.,2019). Numerous studies demonstrate delays in women receiving 60

initial ECG testing, resulting in delays for interventional cardiac therapy (Arslanian-Engoren and Scott ,2016) In 61

this same study the study participants perceived barriers to prompt recognition and treatment of their conditions 62

that included time delays at entry, communication issues, and biases based on age and gender. 63

64

Racial biases in triage are well-documented; Hinson (2018) reports that high-risk presentations often went 65

unrecognized across their general population, while Schrader and Lewis (2013), Puumala et al. (2016), and Zook 66

et al. (2016), all noted undertriage in minority populations of all ages. Grossman et al. (2014) found significant 67

under triage in geriatric populations. Saban et al. (2019) report being female or having Arab ethnicity contributed 68

to a rating of ESI 3 when presenting with chest pain. 69

70

African American patients are more likely to be assigned lower triage acuity scores (TAS) by nurses than 71

Caucasian patients and are given lower TAS scores than Caucasian patients when they visit EDs during the same 72

time periods. In comparison to Caucasian patients, African American patients are 7% less likely to be assigned 73

an appropriate triage score, 10% less likely to be admitted to the hospital, and are 1.26 times more likely to die in 74

the ED or in hospital (Schrader &Lewis, 2013). 75

76

Bias has also been shown to play a role in pain management. Women are less likely to be perceived as needing 77

pain management for an injury than male patients, even after expressing the same level of pain and 78

demonstrating limited range of motion (Samulowitz et al.,2018). Adequate pain assessment needs to be assessed 79

as part of the triage process and, as per the ESI algorithm, pain can change the triage acuity score (ENA, 2018). 80

Samulowitz et al., 2018 discusses that females are more likely than men to be given a recommendation for 81

psychotherapy than pain management, in part because female patients are perceived as being more “emotional.” 82

Myths around the pain tolerance and decreased sensitivity of African Americans lead to disparities in pain 83

management: African-American patients are 14 percent less likely to receive opioid analgesics for traumatic or 84

surgical pain and 34 percent less likely to receive them for chronic pain (Dickason et al, 2015). Cultural 85

competency is embedded in current nursing education and pain is discussed as being an expression and can be a 86

function of “culture,” leaving many nurses with residual stereotypes that can delay appropriate pain identification 87

and management. 88

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Resolution GA21-07


Undertriage of trauma patients may result in unnecessary morbidity and mortality for these patients who do not 89

receive timely delivery of care. This challenges RN’s who need to balance this against excessive overtriage, 90

which results in overutilization of resources. This was demonstrated in a trauma triage study done at Vanderbilt 91

University but can hold true for triage of all patients (Stonko et al., 2018). 92

93

In a retrospective study, nurses were noted to have a triage accuracy of 59.8% (Ivanov et al., 2021). This agrees 94

and aligns with similar research studies. A program, “KATE,” using machine learning and natural language 95

processing in assessing ESI acuity had a higher accuracy for common high risk presentations using examples 96

from the ESI v. implementation handbook (Ivanov et al., 2021). KATE’s accuracy at two sites was 80% versus 97

41.3% for the emergency nurses. KATE or any program using machine earning (ML) could prove to be a useful 98

tool to assist nurses improve accuracy of triage but all would agree the clinical assessment, sometimes the 99

inherent “gut feeling” and experience of a skilled nurse can never be undermined or replaced with technological 100

tools. 101

102


The mission statement of the ENA is to advance excellence in emergency nursing through education, 104

networking, and advocacy and to embrace inclusion and diversity. 105

106

ENA has a current position statement outlining recommendations for assigning nurses to triage (ENA, 2018). It 107

states, “accurate triage decisions are important for successful emergency department (ED) 108

operations and optimal patient outcomes. (p. 1). It goes on to state competency is an ongoing validation process, 109

including ongoing chart review and clinician observation. Competency assessment is deemed to be left up to 110

individual institutions, and research demonstrates that there is limited data on qualifying or quantifying how this 111

can be carried out. 112

113

To mitigate the challenges of individual inexperience and chaotic environmental conditions and provide safe and 114

effective care for our patients, it is critical that the ENA develop standards for competency and provide the 115

education that brings nurses to a safe level of practice and to assure optimal patient outcomes for the public who 116

are entrusted to our care every day. 117

118


The scope of work outlined in the resolved clauses has a fiscal impact of greater than $25,000. Upon final 120



123


Arslanian-Engoren, C., and Scott, L. (2016). Women’s perceptions of biases and barriers in their myocardial 125

triage experience. Heart and Lung, 45(3), 166–172. https://doi.org/10.1016/j.hrtlng.2016.02.010 126

Brosinski, C., Riddell, A., Valdez, S. (2017). Improving triage accuracy: A staff development approach. Clinical 127

Nurse Specialist, 31(3). 145–148.http://doi.org/10.1097/NUR.0000000000000291 128

Dickason, R., Chauhan, V., Mor, A., Ibler, E., Kuehnle S., Mahoney, D., Ambrecht, E., & Dalawchi, P. (2015). 129

Racial differences in opiate administration for pain relief at an academic emergency department. Western 130

Journal of Emergency Medicine, 16(3), 372–380. https://doi.org/10.5811/westjem.2015.3.23893 131

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https://doi.org/10.1016/j.hrtlng.2016.02.01

http://doi.org/10.1097/NUR.0000000000000291

https://doi.org/10.5811/westjem.2015.3.23893

Resolution GA21-07


Emergency Nurses Association. (2018). Triage qualifications and competency [Position statement]. 132

https://www.ena.org/docs/default-source/resource-library/practice-resources/position-133

statements/triagequalificationscompetency 134

Grossman, F. F., Zumbrunn, T., Ciprian, S., Stephan, F-P., Natascha, W., Bingisser, R., & Nickel, C. H. (2014). 135

Undertriage in older emergency department patients—tilting against windmills? PLoS ONE, 9(8). Article 136

e106203. https://doi.org/10.1371/journal.pone.0106203 137

Hinson, J. S., Martinez, D. A., Cabral, S., George, K., Whalen, M., Hansati, B., & Levin, S. (2018). Triage 138

performance in emergency medicine: A systematic review. Annals of Emergency Medicine, 74(1), 140–152. 139

https://doi.org/10.1016/j.annemergmed.2018.09.22 140

Ivanov. O., Wolf, L., Brecher, D., Lewis, E., Masek, K., Montgomery, K., Andrieiev, Y., McLaughlin, M., Liu, 141

S., Dunne, R., Klauer, K., & Reilly, C. (2021). Improving ED emergency severity index acuity assignment 142

using machine learning and clinical language natural processing. Journal of Emergency Nursing, 47(2), 266–143

278e7. https://doi.org/10.1016/j.jen.2020.11.001 144

Puumala, S. E., Burgess, K. M., Kharbanda, A. B/, Zook, H. G., Castille, D. M., Pickner, W. J., & Payne, N. R. 145

(2016). The role of bias by emergency department providers in care for American Indian children. Medical 146

Care, 54(6). 562–569. https://doi.org/10.1097/MLR.0000000000000533 147

Saban, M., Zaretsky, L., Patito, H., Salama, R., & Darawsha, A. (2019). Round-off decision-making: Why do 148

triage nurses assign STEMI patients with an average priority? International Emergency Nursing, 43, 34-39. 149

https://doi.org/10.1016/j.ienj.2018.07.001 150

Samulowitz,A., Gremyr,I.,Erikkson,E., Hensing,G.(2018). “Bravemen” and “emotional women”: A theory-151

guided literature review on gender bias in healthcare and gender norms towards patients with chronic pain. 152

Pain Research Management. http://doi.10.1155/2018/6358624. 153

Sanders, S. F., & Devon, H. A. (2016). Accuracy in ED triage for symptoms of acute myocardial infarction. 154

Journal of Emergency Nursing, 42(4), 331–337. https://doi.org/10.1016/j.jen.2015.12.011 155

Schrader, C. D., & Lewis, L. M. (2013). Racial disparity in emergency department triage. Journal of Emergency 156

Medicine, 44(2), 511–518. https://doi.org/10.1016/j.jemermed.2012.05.010 157

Stonko, D. P., O’Neill, D. C., Dennis, B. M., Smith, M., Gray, J., & Guillamondegui, O. D. (2018.) Trauma 158

quality improvement: Reducing triage errors by automating the level assignment process. Journal of Surgical 159

Education, 75(6), 1551–1557. https://doi.org/10.1016/j.jsurg.2018.03.014 160

Tam, H. L., Chung, S. F., & Lou, C. K. (2018). A review of triage accuracy and future direction. BMC 161

Emergency Medicine, 18(1), Article 58. https://doi.org/10.1186/s12873-018-0215-0 162

Wolf, L. A., Delao, A. M., Perhats, C., Moon, M. D., Evanovich Zavotsky, K. (2018). Triaging the emergency 163

department, not the patient: United States emergency nurses’ experience of the triage process. The Journal of 164

Emergency Nursing, 44(3), 258–266. https://doi.org/10.1016/j.jen.2017.06.010 165

Zook, H. G., Kharbanda, A., Flood, A. B., Harmon, B., Puumala, S. E., Payne, N. R. (2016). Racial differences 166

in pediatric emergency triage scores. The Journal of Emergency Medicine, 50(5), 730–727. 167

https://doi.org/10.1016/j.jemermed.2015.02.056 168

169

Author(s): 170

Mary R. Harwood, MSN, RN, CEN 171

ENA Member # 730848. 172

(631) 942-5411 173


175

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https://www.ena.org/practice-research/Practice/%20Position/Pages/TriageQualifications.aspx

https://doi.org/10.1371/journal.pone.0106203



https://doi.org/10.1097/MLR.0000000000000533

https://doi.org/10.1016/j.ienj.2018.07.001



https://doi.org/10.1016/j.jsurg.2018.03.014

https://doi.org/10.1186/s12873-018-0215-0




Resolution GA21-07


Supporter(s): 176

Phyllis Parker, ENA #38420 177

Michelle Castiglione, ENA #928982 178

Marine Grennen, ENA #514034 179

Lisa Gaeta, ENA #891451 180

Mary DaSilva, ENA #430121 181

Erin Zazzera, ENA #464020 182

Deb Hellerman, ENA #780925 183

Rachael Mercorella, ENA #1933747 184

Stacy Hartcorn, ENA #1002398 185

MaryAnn Portoro, ENA #20625 186

MaryLou Killian, ENA #23501 187

Maureen M. Chernosky, ENA #110817 188

Nicoll Byrne, ENA #1715532 189

Brian Collins, ENA #987451 190

Christina Urbanick, ENA #1933765 191

Thomas Matthews, ENA #1933773 192

Nicole Petion, ENA #1610843 193

Julie Cohen, ENA #479951 194

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Resolution GA21-08


TITLE: Training of the Emergency Care Assistive Personnel in the Emergency Department 1 2 Whereas, the role of ancillary team members or Emergency Care Assistive Personnel (ECAP) in the 3 emergency department (ED) can vel called many interchangeable terms such as: Emergency Technician (ET), 4 Emergency Department Technician (EDT), Critical Care Technician (CCT), Clinical Assistant (CA), Emergency 5 Services Technician (EST), Patient Care Technician (PCT), etc., 6

7 Whereas, these ECAP’s hired to work in the ED may be high school graduates who have practiced as; 8 emergency medical technicians (EMT), phlebotomists, medical assistant’s (MA), corpsman, paramedics, nursing 9 students, or patient care assistants (PCA), 10 11 Whereas, the role of the ECAP is integral to the safe practice of emergency nursing, and 12 13

Whereas, individuals practicing in the role of an ECAP should have a standardized approach to the 14 required training to be competent in assisting the registered nurse (RN) in delivering emergency care. 15 16

Resolved, That the ENA will update or revise the existing Emergency Care Technician Curriculum 17 published in 2003 to guide the orientation and training for the ECAP. 18 19 Resolution Background Information: 20 In 2003, the ENA published the Emergency Care Technician Curriculum. The curricula served as a guide for 21 training of the entry-level emergency care provider. The text reviews various topics ranging from communication 22 and vital sign acquisition to delegation, body mechanics, and phlebotomy. This text that served as a valuable 23 resource to the emergency care team, has not been revised since 2003. 24 25 An expert panel convened by the National Council of the State Board of Nursing developed guidelines to 26 facilitate delegation in practice. This panel recognized that it is imperative that Registered Nurses (RN) clearly 27 understand the individual state practice acts regarding delegation. Throughout the guideline, the panel’s position 28 remains consistent that ECAP’s must have knowledge and competence of the delegated item. Successful 29 delegation is a result of clear communication, collaboration, and role clarity. 30 31 Further literature review revealed no additional evidence to guide ED nursing practice on orienting and educating 32 ECAP’s. 33 34 According to the ENA position statement regarding Staffing and Productivity in the ED, quality care is linked to 35 the appropriate staffing skill mix, including licensed and unlicensed care providers. Additionally, having the 36 proper staffing mix to include the ECAP can promote improved patient outcomes, along with patient safety, 37 nursing safety, nurse retention, and job satisfaction. 38 39

Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: 40 The ENA mission is to advance excellence in emergency nursing. Collaboration with healthcare partners is vital 41 to this aim. Furthermore, a team-based approach is critical to meeting high standards of care. The 2020-2025 42 strategic plan exemplifies these values. In order to deliver a collaborative team ensuring life-long learning and 43 delivery of excellent patient care, the education of ECAP’s must be a priority for the ENA. A standardized 44 approach to the education of ECAP’s may also add another avenue to enhance recruitment and retention of future 45 ED nurses. The revision of an orientation curriculum for ED ECAP’s will offer an additional opportunity to 46 increase ENA presence in every ED. 47 48

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Resolution GA21-08



The scope of work outlined in the resolved clauses has a fiscal impact of greater than $25,000. Upon 50

final outcomes of General Assembly, initiatives will be evaluated for resource planning in alignment 51

with ENA’s strategic plan and operational goals. 52 53 Professional References: 54 Baird, B. L., Berg, J., Cadwell, V., Ewald, P. J., Jackson-Bruce, C., Koran, Z., Niersbach, C., Scott, A., 55

& Santini, M. B. (2003). Emergency Nurses Association Emergency Care Technician Curriculum (1st ed.). 56 Jones & Bartlett Publishers. 57

Emergency Nurses Association (2021). Five year strategic plan. https://www.ena.org/about 58 Emergency Nurses Association (2021). Position statements. https://www.ena.org/practice-resources/resource- 59 library/position-statements 60 National Council of State Boards of Nursing. (2016). National guidelines for nursing delegation. Journal of 61 Nursing Regulation, 7(1), 5-14. https://doi.org/10.1016/S2155-8256(16)31035-3 62 63 Author(s): 64 Kathryn Gleason, MSN, RN, CEN 65 ENA Member #786912 66 513-509-6761 67 [email protected] 68 69 Jeannie Burnie, MS, APN, AGCNS-BC, CEN, FAEN, FCNS 70 ENA Member #183908 71 513-560-3342 72 [email protected] 73 74 Supporter(s): 75 Kristie Gallagher, ENA #442533 76 Andi Foley, ENA #112569 77 Bill Light, ENA #484897 78 Carla Brim, ENA #464456 79 Jeffrey A. Jones-Ritzler, ENA #430346 80 Nick Chmielewski, ENA #516473 81 Nancy Doolittle, ENA #775250 82 Ivy Thoman, ENA #451660 83 Megan Ellis, ENA #1525703 84 Rebecca Lemaster, ENA #1933388 85 Kim Schmeusser, ENA #329229 86 Aminda Seymour, ENA #173462 87 Maria L Ashdown, ENA #589643 88 Julie Shaw, ENA #49939 89

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https://www.ena.org/about

https://www.ena.org/practice-resources/resource-

https://doi.org/10.1016/S2155-8256(16)31035-3



GA21-09 Resolution


TITLE: Increasing Community Resources 1

2

Whereas, the Emergency Nurse Association (ENA) is comprised of a unique and diverse group of nurses 3

that serve the community in a variety of ways (McKee et al., 2018); 4

5

Whereas, ENA seeks different perspectives and experiences within emergency nursing and strategic 6

partnerships for practice improvement and inclusion (ENA, 2019a); 7

8

Whereas, advancements in emergency nursing and improvement in the lives of patients throughout the 9

world are impacted by the spirit of philanthropy (ENA, n.d.); 10

11

Whereas, community engagement requires not only education but strategic advocacy through 12

partnerships with stakeholders (ENA, 2019a); and 13

14

Whereas, community is one of the core goals of the ENA strategic plan, and ENA is indispensable to the 15

global community (ENA, 2019a). 16

17

Resolved, that ENA develop resources to help state councils and chapters engage members for 18

community outreach. 19

20


The landmark Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health 22

(2011) recognized the impact nurses have on improving the health of everyone in America. Nurses represent the 23

largest segment of the healthcare workforce, are considered the most trustworthy of all professions, and play a 24

huge role on the frontlines of care in our schools, hospitals, community health centers, long-term care facilities, 25

and other places (IOM, 2011). Nurses working in the community have long understood that to be effective in 26

contributing to improvements in the entire community’s health, they must assume the role of social change agent 27

(IOM, 2011). 28

29

In May 2021, the National Academy of Medicine Committee on the Future of Nursing 2020-2030 in 30

collaboration with the Robert Wood Johnson Foundation released “The Future of Nursing: 2020-2030”, 31

exploring how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, 32

utilizing technology, and maintaining patient and family-focused care into 2030. Specific focus areas include: the 33

role of nurses in improving the health of individuals, families, and communities by addressing social 34

determinants of health and providing effective, efficient, equitable, and accessible care for all across the care 35

continuum, as well identifying the system facilitators and barriers to achieving this goal, the role of the nursing 36

profession in assuring that the voice of individuals, families and communities are incorporated into design and 37

operations of clinical and community health systems, and the ability of nurses to serve as change agents in 38

creating systems that bridge the delivery of health care and social needs care in the community. In developing its 39

recommendations for the future decade of nursing in the United States, the committee drew from domestic and 40

global examples of evidence-based models of care that address social determinants of health and help build and 41

sustain a Culture of Health. 42

43

Nursing volunteers are needed in local and global communities for long-term, as well as short-term, services 44

(Dalmida et al., 2016). Increased globalization has made access to care increasingly difficult for the global 45

community, making the need for nurse volunteers of great importance (Dalmida et al., 2016). A lack of 46

understanding of a complex, contemporary society could have detrimental effects on social behaviors (Haupt et 47

al., 2018). Understanding these concerns and providing two-way connections can reduce negative impacts of 48

threats and emergencies, including public health emergencies, long-term health trends, and climate-related 49

impacts. Emergency nurses can reduce negative community impacts through education, connection, 50

communication, and community leadership. 51

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GA21-09 Resolution


52

To address this, ENA is in a unique position to connect emergency nurses with other nurses, as well as the 53

community, to promote education and well-being. Many ENA members already participate in events including 54

local, state, national, and international ENA events; non-ENA events such as CCRN or ANA conferences; 55

community events including staffing homeless shelters, safety education, and public health or safety at various 56

sporting events. While all of these activities are on-going, members may have difficulty finding these events as 57

they are frequently on third-party platforms, within private groups, or difficult to find on various web platforms. 58

Establishing a consolidated location where nursing and non-nursing volunteer events may be posted or shared 59

within the ENA community would increase connection through ease of locating activities, ideas for other forms 60

of engagement and service, public health involvement to positively impact the communities we serve, and 61

enhanced connection within the nursing community to promote our own community’s well-being, growth, and 62

development. Ideally, this would be hosted within ENA Connect as an interactive map with views of nursing and 63

non-nursing events as well as local, state, national, and international opportunities. 64

65

An example of how nurses can increase their impact can be seen through the Nurses on Boards Coalition 66

(NOBC), created in 2014, with a specific strategy of increasing the number of nurses serving in decision-making 67

positions in communities around the country. The coalition’s guiding principle is that building healthier 68

communities in America requires the involvement of more nurses on corporate, health-related, and other boards, 69

panels, and commissions (NOBC, 2021). Communities will benefit from the unique perspective of nurses to 70

achieve the goals of improved health. 71

72

Community engagement and service can take place in a variety of settings and to a diverse group of people, 73

including the vulnerable populations we serve. The needs of the community vary across the country and the 74

world. Nurses can work together to meet these needs and collaborate to provide care to the community (Dalmida 75

et al., 2016). Creating the community connection through service face-to-face, or even online, establishes a 76

strong base of collaboration and connection (Centers for Disease Control and Prevention [CDC], 2017). Social 77

media can be used to directly reach community members but also cross-promote activities (CDC, 2017). 78

Recognizing the emergency nursing community and encouraging it to establish connections and a relationship 79

with the community it serves has been encouraged intermittently, but with the last strategic plan update the 80

community focus shifted back to emergency nursing itself. Emergency nurses can make a cultural impact with 81

community engagement, which promotes community health and positive engagement. 82

83

Many emergency nurses are already involved in their community. Why not capitalize on this involvement of 84

what emergency nurses are doing in their geographic area and provide a platform to connect others with these 85

opportunities? Teen driver safety, child passenger safety, Stop the Bleed, CPR instructions to middle school and 86

high school students, volunteering at medical clinics, and volunteering at homeless shelters are some examples of 87

community engagement activities that emergency nurses can undertake. Community engagement also means 88

working collaboratively with and through groups of people with special interests and similar situations to 89

address. 90

91

Community engagement and cultural impact are mentioned in many ENA toolkits, position statements, and 92

documents. Ongoing community connection was highlighted in the Disaster Emergency Essentials Toolkit 93

(ENA, 2019b). Understanding cultural diversity and its importance for all levels of nursing practice was a main 94

point in the Cultural Diversity and Gender Inclusivity in the Emergency Care Setting position statement (ENA, 95

2018). Most published material focuses on specific populations, but care for the populations starts before the 96

bedside in the community. 97

98


This resolution aligns with ENA’s values and beliefs around the spirit of philanthropy. Philanthropy extends 100

beyond financial donations and involves charity in the form of actions that can impact the greater community 101

health (Grabor & Saylor, 2018). 102

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GA21-09 Resolution


103

Community is one of the core goals for the 2020–2025 Strategic Plan. The focus of “community” must extend 104

past the community of emergency nurses to the community that we care for. Engaging with each other and the 105

community we care for before they reach the stretcher increases the positive impact that emergency nurses can 106

have on the community and health overall. 107

108


The scope of work outlined in the resolved clauses has a fiscal impact between $10,000-$25,000. Upon final 110



113


Centers for Disease Control and Prevention. (2018). Crisis + emergency risk communication: Community 115

engagement. https://emergency.cdc.gov/cerc/ppt/CERC_CommunityEngagement.pdf 116

Dalmida, S. G., Amerson, R., Foster, J., McWhinney-Dehaney, L., Magowe, M., & Nicholas, P. (2016). 117

Volunteer service and service learning: Opportunities, partnerships, and united nations millennium 118

development goals. Journal of Nursing Scholarship, 48(5), 517–526. https://doi.org/10.1111/jnu.12226 119

Emergency Nurses Association. (n.d.). About ENA. https://www.ena.org/about 120

Emergency Nurses Association. (2018). Cultural diversity and gender inclusivity in the emergency care setting 121

[Position statement]. https://www.ena.org/docs/default-source/resource-library/practice-resources/position-122

statements/culturaldiversity.pdf?sfvrsn=e85dc130_24 123

Emergency Nurses Association. (2019a). 2020–-2025 Emergency Nurses Association strategic plan. 124

https://www.ena.org/docs/default-source/default-document-library/enastrategicplan.pdf?sfvrsn=5c367de2_2 125

Emergency Nurses Association. (2019b). Disaster emergency essentials toolkit. https://www.ena.org/docs/ 126

default-source/resource-library/practice-resources/toolkits/disaster-emergency-127

essentials.pdf?sfvrsn=285c37fb_6 128

Grabor, J., & Saylor, J. (2016). Influence through philanthropy: Engaging members and serving the local and 129

global community [Presentation]. Sigma Repository. http://hdl.handle.net/10755/620369 130

Haupt, B., & Connolly Knox, C. (2018). Measuring cultural competence in emergency management and 131

homeland security higher education programs. Journal of Public Affairs Education, 24(4), 538–556. 132

https://doi.org/10.1080/15236803.2018.1455124 133

Institute of Medicine (2011). The Future of Nursing: Leading Change, Advancing Health. The National 134

Academies Press. https://doi.org/10.17226/12956 135

McKee, A. T., Bramer, A., Lu, C., & Wood, A. (2018). 2018 Member needs assessment key findings and 136

recommendations. McKinley Advisors. 137

National Academies of Sciences, Engineering, and Medicine. 2021. The Future of Nursing 2020-2030: 138

Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press. 139

https://www.nationalacademies.org/our-work/the-future-of-nursing-2020-2030#communications-toolkit 140

Nurses on Boards Coalition. (2021). About. https://www.nursesonboardscoalition.org/about/ 141

142

Authors: 143

Shannen Kane, BSN, RN, CEN 144

ENA Member #1567064 145

919-500-2940 146


148

Lauren Plaine, MPS, RN, CEN 149


757-717-4720 151


153

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https://emergency.cdc.gov/cerc/ppt/CERC_CommunityEngagement.pdf

https://doi.org/10.1111/jnu.12226

https://www.ena.org/about

https://www.ena.org/docs/default-source/resource-library/practice-resources/position-statements/culturaldiversity.pdf?sfvrsn=e85dc130_24

https://www.ena.org/docs/default-source/resource-library/practice-resources/position-statements/culturaldiversity.pdf?sfvrsn=e85dc130_24

https://www.ena.org/docs/default-source/default-document-library/enastrategicplan.pdf?sfvrsn=5c367de2_2

https://www.ena.org/docs/default-source/resource-library/practice-resources/toolkits/disaster-emergency-essentials.pdf?sfvrsn=285c37fb_6



http://hdl.handle.net/10755/620369

https://doi.org/10.1080/15236803.2018.1455124

https://www.nationalacademies.org/our-work/the-future-of-nursing-2020-2030#communications-toolkit

https://www.nursesonboardscoalition.org/about/



GA21-09 Resolution


Nancy Mannion, DNP, RN, CEN, FAEN 154


717-413-8363 156


158

Thelma Kuska, BSN, RN, CEN, FAEN 159


708-257-4283 161


163

Supporters: 164

Florida Emergency Nurses Association, Penny Blake, MSNc, CCRN, CEN, ENA #425261, President 165

Susan Sheehy, ENA #11136 166

Merri Addison, ENA #22994 167

Jeffrey Murphy, ENA #454325 168

Maureen Lugod, ENA #826084 169

Chris Guisness, ENA #17848 170

Tibor Bajor, ENA #80582 171

Allison Helkmerichs, ENA #394200 172

Jean Proehl, ENA #10523 173

Karen Battaglia, ENA #106487 174

Marites Gonzaga-Reardon, ENA #111906 175

Kathryn Bowen, ENA #193553 176

Shawna Brantley, ENA #665612 177

Kelly Monestero, ENA #89756 178

Carol Tulley, ENA #473766 179

Vicki Bacidore, ENA #180955 180

Karla Nygren, ENA #492909 181

Mary Alice Vanhoy, ENA #51004 182

Benjamin Marett, ENA #17179 183

Susie Martenson, ENA #34201 184

Penelope Blake, ENA #425261 185

Carla Brim, ENA #464456 186

Sally Snow, ENA #9905 187

Jim Hoelz, ENA #32651 188

Juanita Vondenberg, ENA #928212 189

Julie Miller, ENA #56917 190

Patricia Kunz Howard, ENA #25128 191

Andi Foley, ENA #112569 192

CherylAnn McDonald Sweet, ENA #226547 193

Valerie Brumfield, ENA #433778 194

Ellen Ruja, ENA #3425 195

Mary Ellen "Mel" Wilson, ENA #23035 196

Lynn Visser, ENA #84104 197

Carole Rush, ENA #65519 198

Pat Clutter, ENA #5926 199

Mariann F. Cosby, ENA #25957 200

Pamela Fox, ENA #4724 201

Jessica Castner, ENA #503401 202

William Schueler, ENA #477499 203

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GA21-09 Resolution


Harriet S. Hawkins, ENA #57250 204

Cheryl Randolph, ENA #74060 205

Vicki C. Patrick, ENA #09821 206

Denise Bayer, ENA #48866 207

Sherine Villegas, ENA #1689309 208

Linda Larson, ENA #1951 209

Donna Mason, ENA #775275 210

Meridith Addison, ENA #22994 211

Cindy Hearrell, ENA #58519 212

JoAnn Lazarus, ENA #37139 213

Shawntay Harris, ENA #849084 214

Kyle Smith, ENA #1405392 215

Megan Parks, ENA #900270 216

Laura McDavid, ENA #1701865 217

Virginia Orcutt, ENA #381081 218

Christopher Barnes, ENA #759889 219

Abigail Coles, ENA #1468401 220

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Resolution GA21-10


TITLE: Identify and Support Ways that Decrease Emergency Department Nurses taking Work-Related 1 Stress Home 2 3 Whereas, emergency nurses work in stress-filled environments that can cause moral distress, burnout, 4 and a state of physical and mental exhaustion; ( Alomari et al., 2021; Cocker & Joss, 2016; Dekeseredy et 5 al.,2019; Duffy et al., 2015; Gomez-Urquiza, 2017; Machado, 2018; Morrison & Joy, 2016; Rozo et al., 2017; 6 Trudgill et al., 2020; Wolf et al., 2016; Wolf et al., 2020); 7 8 Whereas, emergency nurses provide care to traumatized victims which can cause secondary traumatic 9 stress/compassion fatigue; (Administration for Children & Families, n.d.; Figley 1995; ENA 2020; The National 10 Child Traumatic Stress Network, 2015; Wolf et al., 2016; Wolf et al., 2020) 11 12 Whereas, emergency nurses frequently suffer physical and/or emotional trauma due to work-place 13 violence which can cause post traumatic stress; (Emergency Nurses Association [ENA], 2019, Trudgill et al., 14 2020; Wolf, 2014) 15 16 Whereas, being exposed to, and experiencing, physical and verbal violence; dealing with inadequate 17 staffing, lack of support, and a sense of inability to provide safe and effective care can lead to behaviors 18 associated with primary/post and secondary traumatic stress/compassion fatigue; (Administration for Children & 19 Families, n.d.; Duffy et al., 2014; ENA, 2020; Figley, 1995; Freeman, 2021, Relias Media, n.d.; The National 20 Child Traumatic Stress Network, 2015; Rozo et al., 2017; Trudgill et al., 2020; Wolf et al., 2014; Wolf et al., 21 2016; Wolf et al., 2020) 22 23 Whereas, emergency nurses’ family members, friends, and significant others state that they can often 24 identify the type of day the nurse experienced based on behaviors exhibited by the nurse when they arrive home 25 from work; (Alhani & Mahmoodi-Shan, 2018;, Dekeseredy et al., 2019; J. Somes, personal communication, 26 March 4, 2020; J. Somes, personal communication, February 3, 2021) 27 28 Whereas, “connecting with family and friends to talk about work-related stress” is often recommended as 29 a method of coping with stress and promote well-being; (Allen & Palk, 2018; ENA, 2015; ENA; 2020; Health 30 Care Toolbox, n.d.; Marsac & Ragsdale, 2020; Tubbert, 2016); and 31 32 Whereas, emergency nurses’ family members, friends, and significant others have shared that there are 33 times when the emergency nurse talks about/shares the events of a work-related, stress-filled day, that it has lead 34 to stress within the family; (Dekeseredy et al., 2019; Morrison & Joy, 2016; Wolf et al,. 2016; Wolf et al., 2020). 35 36

Resolved, ENA will further investigate the causes and impacts of emergency nurses’ unmitigated work-37

related stress which can lead to secondary traumatic stress (compassion fatigue) and post traumatic stress; and 38

39

Resolved, ENA will identify and support interventions that mitigate risk of, and increase ED nurses’ 40

ability to cope with, secondary traumatic stress (compassion fatigue) and primary/post traumatic stress to help 41

prevent them from taking work-related stress home. 42

Resolution Background Information: 43 During an ENA Chapter meeting in early 2020 (pre-COVID), a discussion about the increased stress on the job, 44 worsening work place violence, feelings of burnout, and the number of people leaving the ED had one nurse 45 saying “My kids have told me they can tell by the way I get out of the car what kind of day I’d had and if they 46 should stay clear!” Others noted they had family members who would react to attempts to talk about their 47

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Resolution GA21-10


workday by avoiding them, or leaving the room! One even shared that family pet avoided her! This generated 48 the question “What are we bringing home to our families?!” (Remember this meeting was pre-COVID and the 49 concern was not related to infection!) (J. Somes, personal communication, March 4, 2020; J. Somes, personal 50 communication, February 2, 2021) 51 52 An open discussion ensued with nurses listing workplace violence, lateral violence, inadequate staffing, lack of 53 management support, working without breaks, unsafe patient care situations, a concern from the nurses (from 54 various health care systems) that workplace support systems were not “trustful”, or “user friendly”, and the 55 inability to provide quality care as major causes of their distress. They felt this distress was being brought home 56 and inflicted on their families. Chapter leaders were asked to take action. Even though the Chapter was already 57 holding peer to peer meetings to provide a venue for nurses to talk about their distress, they offered two seminars 58 addressing work-related stress and ways to build resilience. The arrival of the COVID-19 situation required the 59 seminars (converted to webinars) to be expanded to include COVID-related stress and be presented virtually. 60 COVID-related stress became a focus, but the pandemic has only aggravated the non-COVID- related stress that 61 had prompted the original discussion. Members continued to ask about the risk to family members and non-62 nursing friends becoming stressed as the result of being exposed to the stress the ED nurses were feeling and 63 bringing home. (J. Somes, personal communication, March 4, 2020; J. Somes, personal communication, 64 February 2, 2021) 65 66

One Problem – Two areas of Concern 67 Charles Figley is recognized as an expert in stress disorders and frequently cited. In his chapter on Compassion 68 Fatigue as a Secondary Traumatic Stress Disorder: An Overview (Figley 1995), he defines compassion fatigue 69 and secondary traumatic stress as: “the stress deriving from helping others who are suffering or who have been 70 traumatized” (Figley, 1995, p. 7). He states the terms Compassion Fatigue (CF), Secondary Traumatic Stress 71 (STS), and Secondary Traumatic Stress Disorder (STSD) can be used interchangeably, as the symptoms are the 72 same (Figley, 1995, p. 15). He points out that the Diagnostic and Statistical Manual of Mental Disorders (DSM 73 5) codes related to victims of physical or psychological trauma state that the “trauma can be the result of 1.) 74 caring for someone who has suffered trauma, 2.) witnessing trauma inflicted on someone, 3.) hearing about the 75 trauma suffered by another, or the 4.) result of trauma being inflicted on the person.” (APA, 1994, p.424, as 76 cited in Figley 1995, p. 4). Thus, he feels that nurses suffering from Post Traumatic Stress Disorder (PTSD) will 77 have behaviors similar to a nurse with CF and STS, as all three disorders have the same symptoms- it is the 78 source of the trauma (stress) that is being inflicted in a different manner (vicariously versus directed at/on the 79 nurse) (Figley 1995, p. 5). He felt the terms PTSD, CF, and SDS can be used interchangeably and that PTSD 80 should also be interpreted as Primary Traumatic Stress Disorder as every stress reaction is post by definition”. 81 (p.5 & 9) He also found that nurses favored being labeled as having “compassion fatigue” rather than being 82 labeled as having “secondary traumatic stress or a traumatic stress disorder”; as compassion fatigue had less of a 83 negative connotation (Figley, 1995, p. 15). 84 85 The Nurses’ Stress 86 The stressors identified by Chapter member members during the meetings were similar to findings reported in 87 literature. Multiple studies have shown emergency nurses work in stress-filled environments that caused moral 88 distress, physical and mental exhaustion, burnout, physical and emotional trauma, secondary traumatic stress 89 (compassion fatigue), and post traumatic stress (Allen & Park, 2018; Alomari et al.,2021; Cocker & Joss, 2016; 90 Dekeseredy et al., 2019; Duffy et al., 2015; ENA, 2015; ENA, 2020; Gomez-Urquiza, 2017; Hui et al., 2019; 91 Machado, 2018; Morrison & Joy, 2016; Rozo et al., 2017; Trudgill et al., 2020; Tubbert, 2016; Wolf et al., 2014; 92 Wolf et al., 2016; Wolf et al., 2020). ENA’s Campaign on “No silence on ED Violence” highlights an additional 93 work-related stressor for the ED nurse – workplace violence. (ENA website, n.d.) ED nurses are not only at risk 94 of suffering secondary traumatic stress (STS) while providing patient care; but over 70% of nurses state they 95

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Resolution GA21-10


have personally suffered physical injuries and even more reported suffering verbal violence, putting them at risk 96 of post-traumatic stress disorder (PTSD), which some also refer to as primary traumatic stress. (ENA, 2019; 97 Wolf et al., 2020) A third common stressor for ED nurses is “double duty care-giving”, when the nurse is 98 expected provide patient care at the job and when home has to provide care for older family members, or family 99 members who are ill (Dekeseredy et al., 2019; Gomez-Urquiza, 2019; Machado, 2018). Trudgill and Wolf have 100 labeled the stress of the ED nurse as “Post Traumatic Stress Disorder” (PTSD) when collectively describing the 101 various types of stressors encountered by ED personnel; from inadequate staffing, over-crowding, and providing 102 care for victims of gun violence, car crashes, witnessing human suffering to having to deal with workplace 103 violence (Trudgill et al., 2020; Wolf et al., 2020).Trudgill found that one in four emergency nurses met the 104 criteria for PTSD, but also noted a concern that her study’s findings likely were “underestimates of the truth” as 105 she found many ED personnel “chose not to participate for fear of their manager learning of their struggles” and 106 that information “consequently damaging their careers”. (Trudgill et al., 2020) The concern related to 107 management’s methods of dealing with work-place stress was also identified during ENA Chapter meetings as 108 well as been raised by emergency physicians (Freeman, 2021). The Chapter nurses identified they did not find 109 the workplace “support systems” as being “trustful”, or “user-friendly” and was one of the reasons the Chapter’s 110 Peer to Peer group had been started. (J. Somes, personal communication, October, 2019). Wolf addressed work-111 place violence in “Nothing Changes, Nobody Cares: Understanding the Experience of Emergency Nurses 112 Physically or Verbally Assaulted while Providing Care” when she wrote that a “culture of acceptance around 113 workplace violence” persists and noted a lack of administrative support and judicial recourse leading to nurses 114 working under these conditions (Wolf et al., 2014) Is it any wonder that Emergency Nurses are bringing their 115 work-related stress home? 116 117 The Family being exposed to the nurses’ stress 118 Being “connected” and talking about work-related feelings with family members and friends are commonly 119 suggested approaches for creating resiliency and providing support for the emergency nurse (Administration for 120 Children & Families, n.d.; Allen & Palk, 2018; American Psychological Association [APA], 2012; APA, 2018; 121 ENA, 2015; ENA, 2020; Health Care Toolbox, n.d.; Marsac & Ragsdale, 2020; Tubbert, 2016). Yet, when one 122 considers the definition of compassion fatigue (CF) and secondary traumatic stress (STS), one must wonder if 123 this “connecting” to share feelings about work-related stress and the work-day’s events could lead to stress in the 124 nurses’ family members and non- nursing friends. No studies were found that looked specifically at the question 125 - are family members developing secondary traumatic stress (compassion fatigue) as the result of the nurse 126 bringing their unmitigated stress home? Figley in his chapter on Compassion Fatigue as a Secondary Traumatic 127 Stress Disorder: an Overview did note that “traumatized people complained that family and friends discouraged 128 them from talking about their traumatic experiences after a few weeks because it is so distressing to the 129 supporters. “ (Figley, 1995, p. 6) Figley also noted that an “emotional arousal appears to be associated with an 130 empathic and sympathetic reaction” and “simply being a member of a family and caring deeply about its 131 members makes us emotionally vulnerable to the catastrophes which impact them (the person). Families become 132 “victims” because of their emotional connection with the victimized family member.” (Figley, 1983, p. 12 as 133 cited in Figley, 1995, p.5). When emergency nurses bring their work-related stressors home and try to debrief by 134 talking about work with their family, or friends, they will most likely cause the family and friends to worry. The 135 worry can be about the psychological trauma being incurred by the emergency nurse, or concerns of the nurse 136 being victimized as the result of physical violence, staffing issues, perceived lack of support, and concerns of not 137 being an effective and safe care-giver (Alomari et al., 2021; Cocker & Joss, 2016; Dekeseredy, 2019; Gomez-138 Urquiza, 2017; Machado, 2018; Morrison & Joy, 2016; Trudgill et al., 2020; Wolf et al., 2016; Wolf et al., 139 2017). Figley notes that “learning about unexpected or violent death, serious harm, or threat of death or injury 140 experienced by a family member or other close associates” can lead to traumatization without actually being 141 harmed, especially if they have an empathetic nature or concerned/care about the person (APA, 1994, p. 424 as 142 cited in Figley 1995, p. 4). Concerns about family members were highlighted by Figley when he noted: “nearly 143

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Resolution GA21-10


all the attention has been directed to people in harm’s way, and little to those who care for and worry about 144 them.” (Figley, 1995, p. 6). One wonders about the impact of emergency nurses sharing their feelings of stress, 145 or the family simply being aware of what has happened at work, on the nurse’s family. Studies note relationships 146 between family members and friends of the nurses have suffered due to the nurse’s work-related stress (Alhani & 147 Mahmoodi-Shan, 2018; Dekeseredy et al., 2019; Gomez-Urquiza, 2019; Machado, 2018). Behaviors ranging 148 from lashing out at family and friends to nurses isolating themselves from family, destroying relationships, and 149 taking their lives have been described even before COVID added to the stress (Administrations for Children & 150 Families, n.d.; Alhani & Mahmoodi-Shan, 2018; Dekeseredy et al., 2019; Duffy et al., 2015; ENA, 2015; ENA 151 2020; Figley, 1995; Machado, 2018; Marsac & Ragsdale, 2020; The National Child Traumatic Stress Network, 152 2015; Wolf et al., 2016; Wolf et al., 2020). Some nurses isolate themselves from the family in order to protect 153 them, leading to additional stress as the result of this withdrawal. (Figley 1995, p. 5) Figley notes this could 154 happen and it does appear that family members could be at risk of suffering secondary trauma (compassion 155 fatigue) as the result of the nurse bringing work-related stress home (Figley 1995, p. 9). During COVID-19 156 emergency nurses shared stories of how they would strip in their garage and shower prior to entering the home in 157 order to prevent exposing family members to the infection. Yet, how many ED nurses are “exposing” their 158 family to the stress of their work via their words and/or behaviors as they interacted with their family and 159 friends? 160 161

The request 162 An initial suggestion to ask ENA to investigate if the emergency nurses’ families were developing Secondary 163 Traumatic Stress and “fix” the family was altered to a more attainable request to investigate and support ways to 164 “fix” the emergency nurse. There are many studies that address ED nurse’s stress and methods to cope ranging 165 from building one’s own resiliency to seeking professional help (Administration for Children & Families, n.d.; 166 Allen & Palk, 2018; Alomari et al., 2021; American Psychological Association [APA], 2012; APA, 2018; 167 Cocker & Joss, 2016; Dekeseredy et al., 2019; Duffy et al., 2015; ENA, 2015; ENA, 2020; Gomez-Urquiza, 168 2017; Health Care Toolbox, n.d.; Hui et al., 2019; Machado, 2018; Marsac & Ragsdale, 2020; Morrison & Joy, 169 2016; Trudgill et al., 2020; Tubbert, 2016; Wolf et al., 2016; Wolf et al., 2020). ENA’s Topic Briefs on 170 Compassion Fatigue and The Well Nurse discuss stressors impacting emergency nurses, but also note that more 171 research needs to be done. (ENA, 2015; ENA, 2020) The Compassion Fatigue Topic Brief more focused on 172 stress during a disaster and related to double duty care-giving, but only minimally mentions the day to day stress 173 related to staffing issues, holding patients, lack of equipment, lack of support, and the moral distress when unable 174 to provide quality care (ENA 2015). It also did not address risk of harm due to work place violence that nurses 175 describe and studies show is occurring. (American College of Emergency Physicians [ACEP], 2018; ENA, 2019; 176 Wolf et al., 2014; Wolf et al., 2020). Methods a nurse can use to increase their own wellness and compassion 177 satisfaction were outlined in both Topic Briefs, but these methods notably often took initiative and energy on the 178 part of the nurse who has been described as “physically and mentally exhausted” (Duffy et al., 2014; ENA, 2015; 179 ENA, 2020; Wolf et al., 2016; Wolf et al., 2020). Several studies did made recommendations for support 180 provided by “enlightened” management. These recommendations included seminars and workshops on ways to 181 mitigate stress, secondary traumatic stress, and post traumatic stress provided by the work site, and included 182 work-sponsored counseling services, or peers working to create a safety net for the nurse ( Administration for 183 Children & Families, n.d.; Allen & Palk, 2018; APA, 2012; APA, 2018; Bride et al., 2004; ENA2015; ENA, 184 2020; Health Care Toolbox, n.d.; Hui et al., 2019; Marsac & Ragsdale, 2020; the National Child Traumatic 185 Stress Network, 2015; Tubbert, 2016; Wolf et al., 2020). However, other studies found ED personnel did not 186 always trust management when it came to reporting stress. They reported nothing seemed to take place to correct 187 the situation, and there seemed to be a stigma when admitting one needed help with stress. (ACEP, n.p.; 188 Freeman, 2021; Wolf et al., 2014) 189 190 It could be that family members are not at risk of developing secondary traumatic stress or compassion fatigue 191

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Resolution GA21-10


because the nurses are protecting their family members from the stress they are experiencing, or are taking 192 advantage of work-sponsored coping mechanisms in order to not take their work related stress home or inflict it 193 on their families and friends (Administration for Children & Families, n.d.; Allen & Palk, 2018; APA, 2012; 194 APA, 2018; Bride et al., 2004; ENA, 2015; ENA; 2020; Health Care Toolbox, n.d.; Hui et al., 2019; Marsac & 195 Ragsdale, 2020; The National Child Traumatic Stress Network, 2015; Tubbert, 2016, Wolf et al., 2020). 196 However, if this is not the case, it would seem reasonable to ensure that methods of helping the emergency nurse 197 cope with their primary/post (PTSD) and Secondary Traumatic Stress (compassion fatigue) are effective and 198 easily available, so the emergency nurse is not taking that stress home to families and friends. It would also 199 seem logical, if the nurses are not taking their stress home, there would be a trickledown effect of a decreased 200 risk of family exposure to stress and the development of Secondary Traumatic Stress or Compassion Fatigue. 201 To that end, we request ENA identify and support ways to decrease emergency nurses taking their work related 202 stress home. 203 204

Relationship to ENA Bylaws, Mission, Vision, and Strategic Initiatives: 205 Emergency Nurses work in a stress-filled environment that places the nurse at risk of Secondary Traumatic 206 Stress, as well as Post traumatic Stress due to work place violence (Administration for Children & Families, n.d.; 207 Alomari et al., 2021; Cocker & Joss, 2016; Dekeseredy et al., 2019; Duffy et al., 2015; ENA, 2020; Figley, 1995; 208 Gomez0Urquiza, 2017; Machado, 2018; Morrison & Joy, 2016; Rozo et al., 2017; The National Child Traumatic 209 Stress Network, 2015; Trudgill et al., 2020; Wolf et al., 2016; Wolf et al., 2020). This stress, if taken home 210 affects family life; as well as the nurses’ wellness and ability to provide quality care, and potentially retention 211 (ENA, 2015; ENA, 2019; ENA, 2020; Figley, 1995). By identifying and supporting actions that can decrease the 212 nurses’ risk of stress and be able to manage stressors that remain, the effects of work-related stress on the nurse, 213 as well as the family can be diminished. 214 215 Financial Consideration/Operations Impact: 216 The scope of work outlined in the resolved clauses has a fiscal impact of greater than $25,000. Upon final 217 outcomes of General Assembly, initiatives will be evaluated for resource planning in alignment with ENA’s 218 strategic plan and operational goals. 219 220 Professional References: 221 Administration for Children & Families. (n.d.) Secondary traumatic stress. U.S. Department of Health & 222

Human Service. https://www.acf.hhs.gov/trauma-toolkit/secondary-traumatic-stress 223 Alhani, F., Mahmoodi-Shan, G.R. (2018). Work-family conflict as a stressor in the lifestyle of nurses: A content 224

analysis. Journal of Nursing and Midwifery Sciences. 5(3) 79-88. 225 http://dx.doi.org/10.4103/JNMS.JNMS_26_18 226

Allen, R. & Palk, G. (2018) Development of Recommendations and Guidelines for Strengthening Resilience in 227 Emergency Department Nurses. Traumatology. 24(2), 148–156. http://dx.doi.org/10.1037/trm000014 228

Alomari, A.H., A., Collison, J., Hunt, L.,& Wilson, N.J. (2021). Stressors for emergency department nurses: 229 Insights from a cross-sectional survey. Journal of Clinical Nursing. 30:7-8 975-985 230 https://doi.org/10.1111/jocn.15641 231

American College of Emergency Physicians (ACEP). (2018) Violence in emergency departments is increasing, 232 harming patients, new research finds 233 Violence in Emergency Departments Is Increasing, Harming Patients, New Research Finds 234 (emergencyphysicians.org) 235

American College of Emergency Physicians (ACEP). (2020) Poll: Workplace stigma, fear of professional 236 consequences prevent emergency physicians from seeking mental health care. 237 https://www.emergencyphysicians.org/article/mental-health/poll-workplace-stigma-fear-of-professional-238 consequences-prevent-emergency-physicians-from-seeking-mental-health-care 239

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https://www.acf.hhs.gov/trauma-toolkit/secondary-traumatic-stress

http://dx.doi.org/10.4103/JNMS.JNMS_26_18

http://dx.doi.org/10.1037/trm000014

https://doi.org/10.1111/jocn.15641

https://www.emergencyphysicians.org/press-releases/2018/10-2-2018-violence-in-emergency-departments-is--increasing-harming-patients-new-research-finds

https://www.emergencyphysicians.org/press-releases/2018/10-2-2018-violence-in-emergency-departments-is--increasing-harming-patients-new-research-finds

https://www.emergencyphysicians.org/article/mental-health/poll-workplace-stigma-fear-of-professional-consequences-prevent-emergency-physicians-from-seeking-mental-health-care

https://www.emergencyphysicians.org/article/mental-health/poll-workplace-stigma-fear-of-professional-consequences-prevent-emergency-physicians-from-seeking-mental-health-care

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American Psychological Association (APA). (2012). Building your resilience. 240 https://www.apa.org/topics/resilience 241

American Psychological Association (APA). (2018, October 14). Coping with stress at work. 242 https://www.apa.org/topics/healthy-workplaces/work-stress 243

Bride, B., Robinson, M., Yegidis, B., Figley, C.R. ( 2004).Development and validation of the Secondary 244 Traumatic Stress Scale. Research on Social Work Practice. 14(1): 27-33. 245 http://doi.org/10.1177/1049731503254106 246

Cocker, F., Joss, N. (2016). Compassion Fatigue among Healthcare, Emergency and Community Service 247 Workers: A systematic Review. International Journal of Environmental research and Public Health. 248 13(6). Article 618. https://doi.org/10.3390/ijerph13060618 249

Dekeseredy, P., Kurtz Landy, C., & Sedney, C., (2019) An Exploration of Work Related Stressors Experienced 250 by Rural Emergency. Online Journal of Rural Nursing and Health Care. 19(2). 251 http://doi.org/10.14574/ojrnhc.v19i1.550 252

Duffy, E., Avalos, G., Dowling, M. (2015) Secondary Traumatic Stress among Emergency nurses: A Cross-253 sectional Study. International Emergency Nursing. 23(2):53-8. https://doi.org/10.1016/j.ienj.2014.05.001 254

Emergency Nurses Association. (2015) ENA The well nurse [Topic Brief]. https://www.ena.org/docs/default-255 source/resource-library/practice-resources/topic-briefs/the-well-nurse.pdf?sfvrn=40cb75a3_6 the-well-256 nurse.pdf (ena.org) 257

Emergency Nurses Association. (n.d.) Workplace violence – practice issues No silence on violence 258 campaign. https://www.ena.org/practice-resources/workplace-violence 259

Emergency Nurses Association. (2019). ENA Position statement on Violence and its impact on emergency 260 nurses. https://www.ena.org/docs/default-source/resource-library/practice-resources/postion-261 statements/violenceintheemergencycaresetting.pdf?sfvrsn=49343551_12 262 violenceintheemergencycaresetting.pdf (ena.org) violence-and-its-impact-on-the-en-final-board-draft.pdf 263 (wordpress.com) 264

Emergency Nurses Association. (2020). Compassion fatigue. [Topic Brief] https://www.ena.org/docs/default-265 source/resource-library/practice-resources/topic-briefs/compassion-fatigue.pdf?sfvrsn=40cb75a_6 266 compassion-fatigue.pdf (ena.org) 267

Figley, C. (1995). Compassion fatigue as secondary traumatic stress disorder: An overview. In C. R. Figley 268 (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the 269 traumatized (pp. 1–20). Rutledge, Taylor, and Francis Group. 270

Freeman, G. (2021) Help physicians, nurses overcome fear of seeking assistance for stress relief. Relias Media 271 www.reliasmedia.com/articles/147695-help-physicians-nurses-overcome-fear-of-seeking-assistance-for-272 stress-relief 273

Gomez-Urquiza, J.L., De la Fuente-Solana, E.I., Albendin-Garcia, L., Vargas-Pecino, C., Ortega-Compos, E.M., 274 Canada-De la Fuenta, G.. (2017) Prevalence of Burnout Syndrome in Emergency Nurses: A Meta-analysis. 275 Critical Care Nurse. 37(5), e1-e9. https://doi.org/10.4037/ccn2017508 276

Health Care Toolbox. (n.d) Center for Pediatric Traumatic Stress. Self Care Tips to Prevent Secondary Stress. 277 Center for Pediatric Traumatic Stress https://healthcaretoolbox.org/selfcare-tips-prevent-secondary-stress 278

Hui, X., Kynoch, K., Tuckett, A., Eley, R., & Newcombe, P. (2019). Effectiveness of interventions to reduce 279 occupational stress among emergency department staff: a systematic review protocol. JBI Database System 280 Rev Implement Reports. 17(4) 513-519. https://doi.org/10.11124/jbisrir-d-19-00252 281

Machado, M., (2018). Secondary traumatic stress among emergency department nurses.) [Master’s Thesis, 282 Rhode Island College] James P. Adams Library Digital Commons. https://doi.org/10.28971/532018MM74 283

Marsac, M.L., & Ragsdale, L. B. (2020, May 21). Tips for recognizing, managing secondary traumatic stress in 284 yourself. AAP News. https://www.aappublications.org/news/2020/05/21/wellness052120 285

Morrison, L. E., & Joy, J. P. (2016) Secondary traumatic stress in the emergency department. Journal of 286 Advanced Nursing 72(11):2894-2906. https://doi.org/10.1111/jan.13030 287

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https://www.apa.org/topics/resilience

https://www.apa.org/topics/healthy-workplaces/work-stress

http://doi.org/10.1177/1049731503254106

https://doi.org/10.3390/ijerph13060618

http://doi.org/10.14574/ojrnhc.v19i1.550

https://doi.org/10.1016/j.ienj.2014.05.001

https://www.ena.org/docs/default-source/resource-library/practice-resources/topic-briefs/the-well-nurse.pdf?sfvrn=40cb75a3_6

https://www.ena.org/docs/default-source/resource-library/practice-resources/topic-briefs/the-well-nurse.pdf?sfvrn=40cb75a3_6

https://www.ena.org/docs/default-source/resource-library/practice-resources/topic-briefs/the-well-nurse.pdf?sfvrsn=a2c01cf1_8

https://www.ena.org/docs/default-source/resource-library/practice-resources/topic-briefs/the-well-nurse.pdf?sfvrsn=a2c01cf1_8

https://www.ena.org/practice-resources/workplace-violence

https://www.ena.org/docs/default-source/resource-library/practice-resources/postion-statements/violenceintheemergencycaresetting.pdf?sfvrsn=49343551_12

https://www.ena.org/docs/default-source/resource-library/practice-resources/postion-statements/violenceintheemergencycaresetting.pdf?sfvrsn=49343551_12

https://www.ena.org/docs/default-source/resource-library/practice-resources/position-statements/violenceintheemergencycaresetting.pdf?sfvrsn=49343551_12

https://stopedviolence.files.wordpress.com/2019/11/violence-and-its-impact-on-the-en-final-board-draft.pdf

https://stopedviolence.files.wordpress.com/2019/11/violence-and-its-impact-on-the-en-final-board-draft.pdf

https://www.ena.org/docs/default-source/resource-library/practice-resources/topic-briefs/compassion-fatigue.pdf?sfvrsn=40cb75a_6

https://www.ena.org/docs/default-source/resource-library/practice-resources/topic-briefs/compassion-fatigue.pdf?sfvrsn=40cb75a_6

https://www.ena.org/docs/default-source/resource-library/practice-resources/topic-briefs/compassion-fatigue.pdf?sfvrsn=40cb75a3_6

http://www.reliasmedia.com/articles/147695-help-physicians-nurses-overcome-fear-of-seeking-assistance-for-stress-relief

http://www.reliasmedia.com/articles/147695-help-physicians-nurses-overcome-fear-of-seeking-assistance-for-stress-relief

https://doi.org/10.4037/ccn2017508

https://healthcaretoolbox.org/selfcare-tips-prevent-secondary-stress

https://doi.org/10.11124/jbisrir-d-19-00252

https://doi.org/10.28971/532018MM74

https://www.aappublications.org/news/2020/05/21/wellness052120

https://doi.org/10.1111/jan.13030

Resolution GA21-10


The National Child Traumatic Stress Network. (2015) Secondary traumatic stress a fact: sheet for organizations 288 employing community violence workers. https://www.nctsn.org/resources/secondary-traumatic-stress-fact-289 sheet-organizations-employing-community-violence-workers 290

Rozo, J.A., Olson, D., Thu, H., & Stutzman, S. (2017) Situational factors associated with burnout among 291 emergency department nurses. Workplace Health & Safety. https://doi.org/10.1177%2F2165079917705669 292

Trudgill, D., Gorey, K., & Donnelly, E. (2020) Prevalent posttraumatic stress disorder among emergency 293 department personnel: Rapid system review. Humanities & Social Sciences Communications. 7, Article 89 294 . https://doi.org/10.1057/s41599-020-00584-x 295

Tubbert, S. J. (2016). . Resiliency in Emergency Nurses. Journal of Emergency Nursing. 42(1), 47-52. 296 https://doi.org/10.1016/j.jen.2015.05.016 297

Wolf, L. A., Delao, A. M., & Perhats, C. (2014) Nothing changes, nobody cares: Understanding the experience 298 of emergency nurses physically or verbally assaulted while providing care. Journal of Emergency Nursing. 299 40 (4) 305-310. https://doi.org/10.1016/j.jen.2013.11.006 300

Wolf, L. A., Delao, A. M., Perhats, C., Clark, P. R., Edwards, C., & Frankenberger, W. D. (2020) Traumatic 301 stress in emergency nurses: Does your work environment feel like a war zone? International Journal of 302 Emergency Nursing. 52, Article 100895 https://doi.org/10.1016/j.ienj.2020.100895 303

Wolf, L. A., Perhats, C., Delao, A. M., Clark, P. R., & Moon, M. D. (2017) On the threshold of safety: A 304 qualitative exploration of nurses’ perceptions to factors involved in safe staffing levels in emergency 305 departments. Journal of Emergency Nursing. 43(2),150-157. https://doi.org/10.1016/j.jen.2016.09.003 306

Wolf, L. A.., Perhats, C., Delao, A. M., Moon, M. D., Clark, P.R.,& Zavotsky, K. E. (2016). “It’s a Burden you 307 Carry”, Describing moral distress in emergency nursing. Journal of Emergency Nursing. 42 (1) 37-46. 308 https://doi.org/10.1016/j.jen.2015.08.008 309

310

Author(s): 311 Joan Somes PhD, RN-BC, CEN, CPEN, FAEN, NRP 312 ENA Member #5802 313 952 432 0815 home 952 426 2060 cell 314 [email protected] 315 316 Supporter(s): 317 Minnesota Emergency Nurses Association State Council 318 David Cheesebrow, ENA #66524 319 Jane Smalley, ENA #57413 320 Rebecca Englund, ENA #656678 321 Dede Koenekamp, ENA #79183 322

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https://www.nctsn.org/resources/secondary-traumatic-stress-fact-sheet-organizations-employing-community-violence-workers

https://www.nctsn.org/resources/secondary-traumatic-stress-fact-sheet-organizations-employing-community-violence-workers

https://doi.org/10.1177%2F2165079917705669

https://doi.org/10.1057/s41599-020-00584-x



https://doi.org/10.1016/j.ienj.2020.100895





Appendix A

ENA General Assembly

Reference Guide

DELEGATION

1. Each state council shall determine its own method for delegate selection by using a point system,

election or lottery.

2. Each state council is encouraged to take the following eligibility criteria into consideration in choosing

its delegates:

• Attendance at 50 percent of all scheduled meetings of the state council or local component since the

previous General Assembly.

• Service in an elected or appointed position at the local, state or national level during the prior three

years; or

• Participation in at least one of the following activities related to emergency nursing since the

previous General Assembly:

o Lecturer (other than that which is required in a professional nursing role)

o Projects, such as public education, legislative involvement and chapter fundraising

o Research in emergency nursing

o Publishing on topics related to emergency care

o Certification through the Board of Certification for Emergency Nursing (BCEN)

3. At least 30 days prior to the General Assembly, the ENA national office will send confirmation of

delegate status to each delegate and alternate delegate. All proposed bylaws amendments, resolutions,

rules and procedures will be made available on the ENA website.

4. Delegates and alternate delegates shall attend all business sessions of the General Assembly.

RESOLUTIONS

5. Resolutions must be submitted by the published deadline, to be considered during General Assembly.

6. Resolutions received at ENA headquarters will be forwarded to the Resolutions Committee, legal

counsel, parliamentarian and ENA Board of Directors for review for compatibility with ENA’s purpose,

mission, values, objectives, bylaws and standing rules, federal and state laws and financial feasibility.

7. Resolutions that do not comply shall be returned to the authors with explanation.

8. Proposed resolutions submitted will be reviewed by the ENA Board of Directors for possible

implementation prior to General Assembly.

9. The Resolutions Committee shall work with authors to combine proposed resolutions that have the same

or similar subject matter.

10. Resolutions brought before the General Assembly shall include the exact text of the proposal along with

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Appendix A

the financial considerations and operational implications. They may also include comments from the

Resolutions Committee and the ENA Board of Directors.

BYLAWS AMENDMENT PROPOSALS

11. Bylaws amendment proposals received at ENA headquarters will be forwarded to the Resolutions

Committee, legal counsel, parliamentarian and ENA Board of Directors for review for compatibility with

ENA’s purpose, mission, values, objectives, bylaws and standing rules, federal and state laws and

financial feasibility.

12. Bylaws amendment proposals that do not comply shall be returned to the authors with explanation.

13. The Resolutions Committee shall work with authors to combine proposed bylaws amendments that have

the same or similar subject matter.

14. Proposals to amend the ENA Bylaws shall include the exact text of the proposal. They may also include

comments from the Resolutions Committee and ENA Board of Directors.

MISCELLANEOUS

15. The Resolutions Committee shall be authorized to correct article and section designations, punctuation

and references in the Bylaws, Election Rules, and General Assembly Standing Rules of Procedure as

may be necessary to reflect the intent of the General Assembly.

16. The draft General Assembly minutes shall be sent electronically to all state captains and the ENA Board

of Directors for a 10-day review and comment period. The minutes shall be subsequently approved by

the Resolutions Committee.

17. The status of resolutions adopted by the General Assembly will be made available to the ENA

membership.

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2020–2025 Emergency Nurses Association Strategic Plan

MISSION STATEMENT:To advance excellence in emergency nursing

CORE VALUES:IntegrityEvidenced by openness and honesty in decisions, communications and actions

Diversity & InclusionEvidenced by an organization that creates a culture and climate of mutual respect, inclusivity, and equity

CollaborationEvidenced by a professional community characterized by mutual respect, service to the benefit of others, and appreciation of our members’ contributions

ExcellenceEvidenced by a culture of inquiry dedicated to innovation, compassion, and global commitment to best practice

CredoDerived from the vision of our co-founders Judith Kelleher and Anita Dorr, our priorities are guided by these values and beliefs:

• Inclusion and the contributions of nursing, in collaboration with healthcare partners worldwide, help explore innovative solutions to the challenges of emergency care delivery.

• Compassion is an essential element of the emergency nursing profession.

• We should embrace inclusion, diversity and mutual respect in all interactions and initiatives to promote the essential value of different perspectives and experiences within emergency nursing.

• A team-based delivery of resources meet the highest quality standards of excellence for patients and emergency nurses.

• Emergency care evolves through lifelong learning and a culture of inquiry for the discovery and integration of evidence-based research into emergency nursing practice.

• Our Code of Ethics establishes and encourages adherence to principles of honesty and integrity.

• The spirit of philanthropy allows the advancement of the profession of emergency nursing and improves the lives of patients throughout the world.

• We place the highest value on our members for their contributions to the care of patients and their families, the emergency nursing profession, and our organization.

Appendix B Back to Top

Vivid Description of an Envisioned FutureVISIONBe the premier organization for the emergency nursing community worldwide

VIVID DESCRIPTION

Emergency Nurses

• Emergency nurses practicing worldwide have the

appropriate evidence-based resources needed to

provide the best care possible

• Emergency nurses globally have access to

high quality education and resources to provide

excellent care

• Emergency nurses are working in an ideal practice

environment

• Emergency nurses provide care using their full scope

of practice

• Every emergency nurse receives the highest level

of specialized training and education offered

ENA as an organization

• ENA is recognized as the preeminent worldwide

resource in emergency nursing

• ENA is indispensable to the global community

• All emergency nurses are members of the ENA

community

• ENA is the primary source of evidence-based

emergency nursing resources and standards of care

Patients

• All patients (children, adults, seniors) receive high

quality, specialized emergency care in all settings

• Lower morbidity and mortality is demonstrated

for emergency patients as a result of leading-edge

emergency nursing education and training provided

by ENA

• Patients receive expedited ED visits with streamlined

admission to needed inpatient beds

The Public

• Legislators appreciate and advocate for the

knowledge and depth of care provided in the ED

• Emergency nurses provide a key voice in public

health epidemics

• Communities are educated on injury prevention

to avoid preventable visits to the ED


Goals, Objectives & StrategiesPRACTICE ENVIRONMENT GOAL:

EMERGENCY NURSES WILL WORK IN AN IDEAL PRACTICE ENVIRONMENT TO PROVIDE THE HIGHEST QUALITY OF EMERGENCY CARE IN THE SAFEST WAY.

Objectives:1. Improve quality and safety in emergency nursing

practice

2. Prevent violence in the ED

3. Establish and disseminate standards for emergency nursing practice

4. Improve recruitment and retention of emergency nurses

Strategies:1. Develop and compile comprehensive institutional

safety assessment and quality measures for emergency nursing

2. Lead efforts to develop and disseminate data and resources to address workplace violence

3. Establish and disseminate standards for emergency nurses to provide care using their full scope of practice

4. Identify and disseminate best practices for emergency nursing staffing

5. Generate and promote new knowledge in emergency nurse wellness

6. Advocate for emergency departments to have the necessary resources and supplies for the highest quality, safe practice and safe care

EDUCATION GOAL: EMERGENCY NURSES HAVE THE HIGHEST QUALITY EDUCATIONAL RESOURCES TO PROVIDE THE HIGHEST LEVEL OF CARE.

Objectives:1. Expand research to increase the generation of new

knowledge in emergency nursing

2. Expand the translation of best evidence into emergency nursing practice

3. Increase development and delivery of educational content for emergency nurses worldwide.

Strategies:1. Identify research opportunities to meet the future

needs of emergency nurses

2. Identify and prioritize emergency nursing education gaps

3. Expand ENA core educational offerings for all levels of emergency nurses

4. Create new educational offerings that cover the breadth and depth of emergency nursing

5. Create the framework for the gold standard for emergency nursing orientation

6. Influence academia to include emergency nursing content

7. Ensure relevance of instructional design and delivery for all learners to match how and where they learn


930 E. Woodfield RoadSchaumburg, Illinois 60173

847.460.4000ena.org

COMMUNITY GOAL:ENA IS THE AUTHORITY AND PREMIER ORGANIZATION FOR EMERGENCY NURSING WORLDWIDE.

Objectives:1. Increase membership

2. Increase collaboration and partnerships that advance emergency nursing

3. Increase ENA presence in every ED

4. Expand the impact of the ENA Foundation

5. Expand the voice of the emergency nurse in healthcare policy and public health

Strategies:1. Evaluate membership categories

2. Strengthen member value proposition

3. Define strategic approach to partnerships and organizations that advance emergency nursing

4. Increase ENA brand and product awareness in EDs

5. Implement education and advocacy strategies for injury prevention and public health issues

6. Develop partnerships and a framework for emergency nurses to respond to disasters

CULTURE GOAL:ENA’S CULTURE IS DYNAMIC, ENSURING RELEVANCE IN A CHANGING ENVIRONMENT TO ADVANCE THE MISSION.

Objectives:1. Utilize best-in-class technology to support

the development and delivery of leading-edge education, research and practice resources and member engagement

2. Employ best practices in governance and leadership

3. Nurture and grow an organizational culture and talent consistent with ENA’s values

4. Manage expenses and resource utilization consistent with ENA’s goals and objectives

Strategies:1. Implement new and emerging technologies to

enhance the user experience

2. Identify and implement best practices in governance

3. Strengthen support of State Councils and Chapters to provide best practices in strategic decision making and leadership

4. Implement a comprehensive staff development program

5. Implement actions that advance diversity and inclusivity


PKF Mueller | www.pkfmueller.com | +1 847 888 8600

EMERGENCY NURSES ASSOCIATION AND AFFILIATE

AUDITED CONSOLIDATED FINANCIAL STATEMENTS

YEARS ENDED DECEMBER 31, 2020 AND 2019

LOCAL KNOWLEDGE, GLOBAL EXPERTISE

Assu

ranc

e Appendix C Back to Top

CONTENTS PAGE Consolidated Financial Statements Independent Auditor’s Report ..................................................................................................... 1-2 Consolidated Statements of Financial Position ........................................................................... 3 Consolidated Statements of Activities and Changes in Net Assets ............................................. 4 Consolidated Statements of Functional Expenses....................................................................... 5-6 Consolidated Statements of Cash Flows ..................................................................................... 7

Notes to Consolidated Financial Statements ............................................................................... 8-27 Supplementary Information Independent Auditor’s Report on Supplementary Information .................................................. 28 Emergency Nurses Association Statements of Financial Position ................................................................................................. 29 Statements of Activities and Changes in Net Assets ................................................................... 30 Statements of Functional Expenses ............................................................................................. 31-32 Statements of Cash Flows ............................................................................................................ 33 ENA Foundation Statements of Financial Position ................................................................................................. 34 Statements of Activities and Changes in Net Assets ................................................................... 35

Statements of Functional Expenses ............................................................................................. 36-37 Statements of Cash Flows ............................................................................................................ 38

Appendix C Back to Top

Certified Public Accountants ■ Business & Financial Advisors Offices in Elgin, Chicago, Orland Park, Sarasota & Philadelphia

PKF Mueller is a member firm of the PKF International Limited family of legally independent firms and does not accept any responsibility or liability for the actions or inactions of any individual member or correspondent firm or firms.

1707 N. Randall Road, Suite 200 ■ Elgin, Illinois ■ 60123 Ph: 847.888.8600 ■ Fax: 847.888.0635 ■ www.pkfmueller.com

INDEPENDENT AUDITOR’S REPORT

To the Finance Committee of Emergency Nurses Association and Board of Trustees of ENA Foundation

Report on the Consolidated Financial Statements

We have audited the accompanying consolidated financial statements of Emergency Nurses Association and Affiliate, which comprise the consolidated statements of financial position as of December 31, 2020 and 2019 and the related consolidated statements of activities and changes in nets assets, functional expenses and cash flows for the years then ended and the related notes to the consolidated financialstatements (collectively, financial statements).

Management’s Responsibility for the Financial Statements

Management is responsible for the preparation and fair presentation of these financial statements inaccordance with accounting principles generally accepted in the United States of America; this includes the design, implementation and maintenance of internal control relevant to the preparation and fairpresentation of financial statements that are free from material misstatement, whether due to fraud or error.

Auditor’s Responsibility

Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audits to obtain reasonable assuranceabout whether the financial statements are free of material misstatement.

An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the financial statements. The procedures selected depend on the auditor’s judgment, including the assessment of the risks of material misstatement of the financial statements, whether due to fraud orerror. In making those risk assessments, the auditor considers internal control relevant to the entity’s preparation and fair presentation of the financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entity’s internal control. Accordingly, we express no such opinion. An audit alsoincludes evaluating the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by management, as well as evaluating the overall presentation of the financial statements.

We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion.

-1-


Opinion

In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Emergency Nurses Association and Affiliate as of December 31, 2020 and 2019, and the changes in their net assets and their cash flows for the years then ended in accordance with accounting principles generally accepted in the United States of America.

Elgin, Illinois July 16, 2021

-2-


2020 2019Current assets:

Cash and cash equivalents $ 1,560,378 1,741,436 Accounts receivable, net of allowance for doubtful accounts of

$152,575 and $197,000 for 2020 and 2019, respectively 1,644,616 1,707,684 Grants receivable 16,909 16,723 Other receivables 74,053 47,188 Current portion of mortgage receivable 60,251 - Inventory 34,986 50,552 Prepaid expenses and other current assets 957,577 943,648

Total current assets 4,348,770 4,507,231

Property and equipment, net 11,885,260 12,266,872

Property held for sale - 2,450,000

Mortgage receivable, net of current portion 1,813,749 -

Investments 20,827,589 19,826,403

Total assets $ 38,875,368 39,050,506

Current liabilities:Accounts payable $ 321,627 773,746 Wages and benefits payable 554,371 944,905 Accrued expenses 465,904 612,605 Credits on customer accounts 76,741 230,910 Assessments payable 822,900 1,330,139 Line of credit 1,099,209 1,099,209 Current portion of deferred revenue 2,676,587 2,579,300 Current portion of bond payable 337,586 337,313

Total current liabilities 6,354,925 7,908,127

Long-term liabilities:Interest rate swap agreement 1,209,973 712,437 Deferred revenue, net of current portion 1,284,361 1,182,892 Bond payable, net of current portion 8,872,932 9,210,518

Total long-term liabilities 11,367,266 11,105,847

Total liabilities 17,722,191 19,013,974

Net assets:Without donor restrictions:

Undesignated 17,033,882 16,292,887 Board-designated 2,444,174 2,427,354

Total without donor restrictions 19,478,056 18,720,241

With donor restrictions 1,675,121 1,316,291

Total net assets 21,153,177 20,036,532

Total liabilities and net assets $ 38,875,368 39,050,506

The accompanying notes are an integral part of the consolidated financial statements.-3-

LIABILITIES AND NET ASSETS

EMERGENCY NURSES ASSOCIATION AND AFFILIATECONSOLIDATED STATEMENTS OF FINANCIAL POSITION

DECEMBER 31, 2020 AND 2019

ASSETS


WITHOUT DONOR WITH DONOR WITHOUT DONOR WITH DONORRESTRICTIONS RESTRICTIONS TOTAL RESTRICTIONS RESTRICTIONS TOTAL

Support and revenue:Courses $ 12,137,728 - 12,137,728 14,897,385 - 14,897,385 Membership dues 4,583,459 - 4,583,459 4,258,905 - 4,258,905 Conferences 867,804 - 867,804 3,333,411 - 3,333,411 Publications 584,984 - 584,984 760,483 - 760,483 Marketplace 506,938 - 506,938 586,580 - 586,580 Sponsorships 278,250 - 278,250 499,010 - 499,010 Royalties 155,369 - 155,369 515,554 - 515,554 Other 256,654 - 256,654 480,881 - 480,881 Grants 181,735 - 181,735 80,988 - 80,988 Paycheck Protection Program grant revenue 1,938,315 - 1,938,315 - - - Mailing lists 3,960 - 3,960 19,781 - 19,781 Contributions 193,892 450,342 644,234 128,764 421,128 549,892 Donated services 75,000 - 75,000 95,000 - 95,000 Special event revenue, net of direct expenses - - - 52,389 - 52,389 Net assets released from restrictions 261,351 (261,351) - 340,158 (340,158) -

Total support and revenue 22,025,439 188,991 22,214,430 26,049,289 80,970 26,130,259

Expenses:Programs, grants and scholarships 14,299,399 - 14,299,399 17,871,999 - 17,871,999 Management and general 7,095,121 - 7,095,121 8,111,964 - 8,111,964 Fundraising and development 462,763 - 462,763 453,258 - 453,258

Total expenses 21,857,283 - 21,857,283 26,437,221 - 26,437,221

Increase (decrease) in net assets - before other income 168,156 188,991 357,147 (387,932) 80,970 (306,962)

Other income (expense):Interest expense (378,564) - (378,564) (403,661) - (403,661) Investment income, net 1,915,759 169,839 2,085,598 3,124,439 203,474 3,327,913 Loss on interest rate swap agreement (497,536) - (497,536) (427,846) - (427,846) Loss on disposal of property held for sale (450,000) - (450,000) - - -

Total other income 589,659 169,839 759,498 2,292,932 203,474 2,496,406

Change in net assets 757,815 358,830 1,116,645 1,905,000 284,444 2,189,444

Net assets, beginning of year 18,720,241 1,316,291 20,036,532 16,815,241 1,031,847 17,847,088

Net assets, end of year $ 19,478,056 1,675,121 21,153,177 18,720,241 1,316,291 20,036,532

-4-

CONSOLIDATED STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETSEMERGENCY NURSES ASSOCIATION AND AFFILIATE

The accompanying notes are an integral part of the consolidated financial statements.

20192020



PROGRAMS, GRANTS MANAGEMENT FUNDRAISINGAND SCHOLARSHIPS AND GENERAL AND DEVELOPMENT TOTAL

Payroll expenses:Salaries and wages $ 5,416,146 3,189,000 - 8,605,146 Employee benefits 743,590 433,757 - 1,177,347 Payroll taxes 401,152 218,721 - 619,873

6,560,888 3,841,478 - 10,402,366

Operating expenses:Bank charges and credit card processing fees - 361,651 909 362,560 Advertising and promotion 106,572 251 2,389 109,212 Discount on sales 142,192 - - 142,192 Bad debt expense 35,160 - - 35,160 Computer 223,389 780,161 - 1,003,550 Conferences 627,462 91,741 850 720,053 Cost of goods sold 1,343,693 - - 1,343,693 Depreciation and amortization 359,425 117,967 11,722 489,114 Fulfillment and warehousing services 210,333 - - 210,333 Grants and scholarships 330,408 2,640 381,562 714,610 Insurance 57,912 46,494 - 104,406 Miscellaneous 31,958 69,565 - 101,523 Postage, freight and shipping 238,061 9,630 87 247,778 Printing 242,936 12,344 251 255,531 Professional services 965,007 845,119 30,448 1,840,574 Provision for UBIT 1,316 - - 1,316 Public relations 9,211 156 - 9,367 Recruitment fees - 38,017 - 38,017 Stipends 101,969 137,000 - 238,969 Supplies and equipment 35,965 101,422 553 137,940 Temporary workers 35,010 86,949 - 121,959 Training 31,649 120,736 - 152,385 Travel 127,094 102,215 1,780 231,089

5,256,722 2,924,058 430,551 8,611,331

Occupancy expenses:Building maintenance 114,796 71,991 7,783 194,570 Depreciation 135,870 85,207 9,212 230,289 Insurance 12,537 7,862 850 21,249 Real estate taxes 155,014 97,212 10,509 262,735 Rent 45,514 31,629 - 77,143 Telephone 2,622 1,645 178 4,445 Utilities 54,278 34,039 3,680 91,997

520,631 329,585 32,212 882,428

Assessment expenses:State/chapter membership dues 543,738 - - 543,738 ENPC/TNCC 1,417,420 - - 1,417,420

1,961,158 - - 1,961,158

$ 14,299,399 7,095,121 462,763 21,857,283

EMERGENCY NURSES ASSOCIATION AND AFFILIATECONSOLIDATED STATEMENT OF FUNCTIONAL EXPENSES

YEAR ENDED DECEMBER 31, 2020

-5-




Payroll expenses:Salaries and wages $ 5,425,344 3,598,339 - 9,023,683 Employee benefits 1,130,052 722,663 - 1,852,715 Payroll taxes 404,695 245,559 - 650,254

6,960,091 4,566,561 - 11,526,652

Operating expenses:Bank charges and credit card processing fees - 427,023 276 427,299 Advertising and promotion 156,716 - - 156,716 Discount on sales 174,041 - - 174,041 Bad debt expense 39,553 - - 39,553 Computer 159,406 672,581 - 831,987 Conferences 2,205,102 270,099 11,154 2,486,355 Cost of goods sold 1,830,712 - - 1,830,712 Depreciation and amortization 311,679 130,190 12,038 453,907 Fulfillment and warehousing services 271,831 - - 271,831 Grants and scholarships 489,341 - 382,019 871,360 Insurance 55,441 51,066 - 106,507 Miscellaneous 113,767 82,135 - 195,902 Postage, freight and shipping 276,250 3,890 404 280,544 Printing 309,658 11,728 6,400 327,786 Professional services 634,521 575,624 - 1,210,145 Provision for UBIT 51,852 - - 51,852 Public relations 26,455 450 - 26,905 Recruitment fees 1,125 68,819 - 69,944 Stipends 143,690 142,000 - 285,690 Supplies and equipment 58,797 109,706 1,007 169,510 Temporary workers 211,305 39,632 - 250,937 Training 38,026 222,051 - 260,077 Travel 566,415 315,733 1,026 883,174

8,125,683 3,122,727 414,324 11,662,734


587,497 422,676 38,934 1,049,107


2,198,728 - - 2,198,728

$ 17,871,999 8,111,964 453,258 26,437,221

EMERGENCY NURSES ASSOCIATION AND AFFILIATECONSOLIDATED STATEMENT OF FUNCTIONAL EXPENSES



-6-


2020 2019Cash provided by (applied to) operating activities:

Change in net assets $ 1,116,645 2,189,444 Adjustments to reconcile change in net assets to

net cash applied to operating activities:Depreciation and amortization of property and equipment 711,884 669,061 Amortization of debt issuance costs 7,519 7,792 Loss on interest rate swap agreement 497,536 427,846 Loss on disposal of property held for sale 450,000 - Bad debt (recovery) expense (44,425) 33,466 Realized and unrealized gain on investments (1,633,845) (2,737,409) Contributions restricted for investment in endowments (63,104) (106,009) Decrease (increase) in assets:

Accounts receivable, net of change in allowance for doubtful accounts 107,493 187,485 Grants receivable (186) (16,723) Other receivables (26,865) (108) Inventory 15,566 64,275 Prepaid expenses and other current assets (13,929) (280,183)

Increase (decrease) in liabilities:Accounts payable (452,119) (15,666) Wages and benefits payable (390,534) 120,438 Accrued expenses (146,701) (90,198) Credits on customer accounts (154,169) (399,374) Assessments payable (507,239) (286,401) Deferred revenue 198,756 23,000

Total cash applied to operating activities (327,717) (209,264)

Cash provided by (applied to) investing activities:Purchases of property and equipment (330,272) (574,043) Payments received on mortgage receivable 126,000 - Purchase of investments (3,506,307) (2,740,647) Proceeds from sale and maturities of investments 4,138,966 4,476,502

Total cash provided by investing activities 428,387 1,161,812

Cash provided by (applied to) financing activities:Collections of contributions restricted for investment in endowments 63,104 106,009 Payments on line of credit - (8,382) Payments on bonds payable (344,832) (344,832)

Total cash applied to financing activities (281,728) (247,205)

Net increase (decrease) in cash and cash equivalents (181,058) 705,343

Cash and cash equivalents, beginning of year 1,741,436 1,036,093

Cash and cash equivalents, end of year $ 1,560,378 1,741,436

Noncash investing transaction:Mortgage receivable from sale of property held for sale $ 2,000,000 -

Other cash flow information:Interest paid $ 378,564 403,661

Income taxes paid $ 5,849 53,000

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EMERGENCY NURSES ASSOCIATION AND AFFILIATE


CONSOLIDATED STATEMENTS OF CASH FLOWSYEARS ENDED DECEMBER 31, 2020 AND 2019


EMERGENCY NURSES ASSOCIATION AND AFFILIATE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 1 - NATURE OF OPERATIONS Emergency Nurses Association and Affiliate (Organization) consists of Emergency Nurses Association (ENA) and ENA Foundation (ENAF). ENA is a not-for-profit, professional association whose mission is to advocate for patient safety and excellence in emergency nursing practice. ENA, whose national headquarters is located in Schaumburg, Illinois, was founded in 1970. Paid membership is approximately 43,500. ENAF was established in 1991 to operate exclusively for charitable, educational and scientific purposes relating to emergency nursing. ENAF activities benefit emergency nurses, patients and the public through provision of undergraduate, advance practice, doctoral and continuing education scholarships and research grants. NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES Basis of Presentation The consolidated financial statements have been prepared on the accrual basis of accounting in accordance with accounting principles applicable to not-for-profit organizations and in accordance with accounting principles generally accepted in the United States of America. Principles of Consolidation The accompanying consolidated financial statements (collectively, financial statements) include the accounts of ENA and ENAF. The sole voting member of ENAF is ENA. Since ENA has control of the ENAF Board, accounting principles generally accepted in the United States of America require that the financial position and activities of both organizations be consolidated. All significant interorganizational transactions and balances have been eliminated in consolidation. Cash and Cash Equivalents For purposes of the statements of cash flows, the Organization considers all highly liquid instruments with an original maturity of three months or less to be cash equivalents. Accounts Receivable Accounts receivable consists of amounts due from Trauma Nursing Core Courses (TNCC), Emergency Nursing Pediatric Courses (ENPC), the sale of advertising space in various ENA publications and royalty arrangements with vendors for ENA educational offerings. Management reviews the aging of the course receivables to determine the level of allowance for doubtful accounts to establish against the course receivables. As of December 31, 2020 and 2019, no allowance was deemed necessary for non-course receivables.

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Inventory Inventory is stated at the lower of cost or net realizable value, determined by the first-in, first-out (FIFO) method. As of December 31, 2020 and 2019, there was no allowance for obsolete or excess inventory recorded. Property and Equipment Property and equipment is stated at cost and is depreciated and amortized over the estimated useful lives of the related assets using the straight-line method. Purchases greater than $2,500 are capitalized to property and equipment. Costs of repairs and maintenance are charged to expense as incurred. Property Held for Sale Property held for sale is recorded at the lower of cost or estimated fair value. During the year ended December 31, 2019 it was determined that the property held for sale was not impaired. On August 21, 2020, the property held for sale sold for $2,000,000 resulting in a loss on sale of $450,000 for the year ended December 31, 2020. Investments Long-term and short-term investments in marketable securities with readily determinable fair values are presented in the financial statements at fair value. Short-term investments are those with a maturity of greater than three months but no more than one year. Long-term investments with a maturity of greater than one year are mutual funds or equity securities. The fair values of investments are based on quoted market prices, when available, for those investments. Both realized and unrealized gains and losses are reported as investment income in the consolidated statement of activities and changes in net assets. The Organization's investments are exposed to various risks, such as interest rate, credit and overall market volatility. Due to these risk factors, it is reasonably possible that changes in the values of investments will occur in near term that will materially affect the amounts reported in the consolidated statements of activities and changes in net assets. Credits on Customer Accounts Credits on customer accounts represent overpayments on accounts of ENA course directors relating to course fees. These overpayments are not automatically refunded, but instead are held on the account until the course director provides instruction as to the disposition of the credit. The credits are typically applied to future courses. Assessments Payable Assessments payable are amounts due to ENA State Councils and Chapters for their share of paid memberships and course fees. Assessments are calculated and paid quarterly.

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Interest Rate Swap Agreements Interest rate swap agreements are reflected at fair value in the Organization’s consolidated statements of financial position and the related portions of the debt being hedged are reflected at an amount equal to its carrying value. Under accounting principles generally accepted in the United States of America, not-for-profit entities may elect to use a simplified hedge accounting approach to account for interest rate swap agreements that are entered into for the purpose of economically converting a variable-rate borrowing into a fixed-rate borrowing. Under this approach, the statement of activity charge for interest expense is similar to the amount that would result if the Organization had directly entered into a fixed-rate borrowing instead of a variable-rate borrowing and a receive-variable, pay-fixed interest rate swap. The Organization elected to use the simplified accounting approach. Net Assets Net assets, revenues, gains and losses are classified based on the existence or absence of donor or grantor imposed restrictions. Accordingly, net assets and changes therein are classified and reported as follows: Net Assets Without Donor Restrictions – Net assets available for use in general operations and not subject to donor-imposed restrictions. Currently the ENA Board of Directors (ENA Board) has designated funds for ENAF endowments as well as to fund projects that fall within the criteria of the ENA spending policy. The ENAF Board has also designated funds for the ENAF endowments. Net Assets With Donor Restrictions – Net assets subject to donor-imposed restrictions. Some donor-imposed restrictions are temporary in nature, such as those that will be met by the passage of time or other events specified by the donor. Other donor-imposed restrictions are perpetual in nature, where the donor stipulates that resources be maintained in perpetuity. Donor-imposed restrictions are released when a restriction expires, that is, when the stipulated time has elapsed, when the stipulated purpose for which the resource was restricted has been fulfilled, or both. Concentration of Credit Risk The Organization maintains its cash in bank deposits which, at times, may exceed federally insured limits. The Organization’s uninsured cash balance was $836,511 and $1,156,576 at December 31, 2020 and 2019, respectively. The Organization believes it is not exposed to any significant credit risk on cash. The Organization maintains its investments in broker accounts which, at times, may exceed federally insured limits. As of December 31, 2020 and 2019, the Organization’s uninsured investment balance was $19,844,076 and $18,926,091, respectively. The Organization believes it is not exposed to any significant credit risk on cash or investments.

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Revenue from Contracts with Customers The Organization derives a significant portion of its revenue from revenue sources that involve contracts with customers. Those sources include courses, membership dues, conferences, publications, marketplace, sponsorships, royalties and other revenue. Revenues are recognized when control of these goods or services are transferred to its customers, in an amount that reflects the consideration the Organization expects to be entitled to in exchange for those goods or services. The Organization does not have any significant financing components as all payments are received within a year of the services being provided. Costs incurred to obtain a contract will be expensed as incurred when the amortization period is less than a year. All contracts contain specified pricing for each performance obligation thus allocation of the transaction price is not necessary. Disaggregation of Revenue from Contracts with Customers The following table disaggregates the Organization’s revenue based on the timing of satisfaction of performance obligations for the years ended December 31: 2020 2019 Performance obligations satisfied at a point in time $ 14,153,707 20,119,009 Performance obligations satisfied over time $ 5,217,479 5,213,200 Revenues from performance obligations satisfied at a point in time consist of revenues from courses, conferences, publication advertising revenue, marketplace, event sponsorships and other revenues. Revenues from performance obligations satisfied over time consist of membership dues, publication editorial support and profit sharing, corporate engagement council sponsorships and royalties. Performance Obligations For performance obligations related to courses, control transfers to the customer at a point in time. Courses occur on specified dates and course fee revenue is recorded when the course is held. Revenue from the sale of manuals is recognized upon shipment to the customer. For performance obligations related to membership dues, control transfers to the customer over time. The Organization offers membership categories of one year, three years, five years and lifetime. Revenue is recorded in equal installments as control is passed to the customer over the term of the membership. The Organization has determined that the average career span of an emergency professional is thirteen years and recognizes lifetime memberships over a thirteen-year period. For performance obligations related to conferences, control transfers to the customer at a point in time. Conferences occur at specified dates and revenue is recorded at the time the conference is held.

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Revenue from Contracts with Customers, Continued Performance Obligations, Continued For performance obligations related to publication advertising revenue, control transfers at a point in time. Revenue is recorded at the time the advertisement is printed or advertising service is performed. For performance obligations related to publication editorial support and profit sharing, control transfers to the customer over time in equal installments as control is passed to the publisher over the term of the agreement. For performance obligations related to marketplace, control transfers to the customer at a point in time. Revenue from marketplace is recognized upon shipment of goods to customers. For performance obligations related to event sponsorships, control transfers to the customer at a point in time. Events occur at specified dates and revenue is recorded at the time the event is held. For performance obligations related to corporate engagement council sponsorships, control transfers to the customer over time. All obligations associated with corporate engagement council sponsorships are satisfied in the year in which the contract was obtained. For performance obligations related to royalty revenue, control transfers to the customer over time. The Organization recognizes royalty revenue using the output method based on terms agreed upon in contracts established with customers. The Organization receives a percentage of gross income in exchange for a customer’s usage of the Organization’s name and logo. The Organization also receives commissions based on net revenue generated for promotion of a job board on the Organization’s website. For performance obligations related to other revenues, control transfers to the customer at a point in time. For the year ended December 31, 2019, a significant portion of the other revenues related to postponing the close date of the property held for sale. Conference fees received in advance are deferred until the conference takes place. Course fees received in advance are deferred until the course takes place. Membership dues received in advance are deferred until the period to which the dues relate. The deferred amounts as of December 31, 2020 and 2019 are included in deferred revenue on the consolidated statements of financial position. Contributions The Organization recognizes contributions when cash, securities or other assets, an unconditional promise to give, or a notification of a beneficial interest is received. Conditional promises to give, that is, those with a measurable performance or other barrier, and a right of return, are not recognized until the conditions on which they depend have been substantially met. Contributions received are recorded as without donor restrictions or with donor restrictions, depending on the existence and/or nature of any donor restrictions. Contributions not collected at the end of the year are disclosed as pledges receivable and are recorded at their estimated fair values. They are subsequently valued at the present value of future cash flows. All contributions are expected to be collected in one year or less.

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Contributions, Continued All donor-restricted support is reported as an increase in net assets with donor restrictions, depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or a purpose restriction is accomplished), net assets with donor restrictions are reclassified to net assets without donor restriction and reported in the consolidated statements of activities and changes in net assets as net assets released from restrictions. Accounting Estimates The preparation of financial statements in accordance with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenue and expenses during the reporting period. Actual results could differ from those estimates. Income Taxes ENA and ENAF are exempt from federal and state income taxes under Internal Revenue Code Section 501(c)(3). ENA pays unrelated business income tax on advertising revenues derived from various ENA publications, as well as sponsorship revenues that provide marketing opportunities for the sponsor. Unrelated business income tax (UBIT) for the years ended December 31, 2020 and 2019 amounted to $1,316 and $51,852, respectively. Provision for UBIT expense is included in programs, grants and scholarship expense on the consolidated statements of functional expenses. Management has concluded that as of December 31, 2020 and 2019, there were no uncertain positions taken or expected to be taken that would require recognition of a liability or disclosure in the consolidated financial statements. The Organization would account for any potential interest or penalties related to possible future liabilities for unrecognized income tax benefits as income tax expense. The Organization is no longer subject to examination by federal, state or local tax authorities for periods before 2017. Functional Expenses The costs of program and supporting service activities have been summarized on a functional basis in the consolidated statements of activities and changes in net assets. The consolidated statements of functional expenses present the natural classification detail of expenses by function. Accordingly, certain costs have been allocated among the programs and supporting services benefited. The financial statements report certain categories of expenses that are attributable to more than one program or supporting function. Therefore, expenses require allocation on a reasonable basis that is consistently applied. The Organization utilizes a direct coding methodology for a majority of their expenses, however, expenses classified as occupancy expenses on the consolidated statements of functional expenses are allocated on the basis of estimates of time and effort.

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Changes In Accounting Principles – Fair Value Measurement In August 2018, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement, which modifies certain disclosure requirements for reporting fair value measurements. The Organization adopted ASU No. 2018-13 as of January 1, 2020. The adoption did not have a material impact on the Organization’s disclosures related to the fair value measurements. New Accounting Standard – Leases In February 2016, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) No. 2016-02, Leases (Topic 842). The FASB also subsequently issued additional ASUs, which amend and clarify Topic 842. The most significant change in the new leasing guidance is the requirement to recognize right-to-use assets and lease liabilities for operating leases on the statement of financial position. The ASUs are effective for fiscal years beginning after December 15, 2021. Early adoption is permitted. The Organization is currently evaluating the methods of adoption allowed and the effect that adoption is expected to have on its financial position, results of operations and cash flows and related disclosures. Management Evaluation of Going Concern In accordance with accounting principles generally accepted in the United States of America, management performed an evaluation to determine if adverse conditions or events, considered in the aggregate, raise substantial doubt about the Organization’s ability to continue as a going concern for the one-year period from the date the financial statements were available to be issued. Management’s evaluation did not identify any conditions or events raising substantial doubt about the Organization’s ability to continue as a going concern for the period from July 16, 2021 to July 16, 2022. Subsequent Events Subsequent events have been evaluated through July 16, 2021, the date that the financial statements were available for issue. In February 2021, the Organization received a second Paycheck Protection Program loan in the amount of $1,938,315. See Note 16. In March 2021, the Organization received notice that the Small Business Administration authorized full forgiveness of the first Paycheck Protection Program loan, which legally released to Organization from the loan obligation. See Note 16.

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 3 - LIQUIDITY AND AVAILABILITY The following tables reflects the Organization’s financial assets as of December 31, 2020 and 2019, reduced by amounts not available for general expenditure within one year. Financial assets are considered unavailable when illiquid or not convertible to cash within one year, because donors have imposed restrictions on the use of the funds, or because the governing board has set aside the funds for a specific operational contingency reserve. Liquidity and Availability as of December 31, 2020 Less: Funds Financial Assets Funds Not Restricted by Available for Total Per Convertible to Less: Funds Board for an General Statement of Cash Within One Restricted by Operating Expenditures Financial Position Year Donors Reserve Within One Year

Cash and cash equivalents $ 1,560,378 - ( 218,259) - 1,342,119 Accounts receivable, net 1,644,616 - - - 1,664,616 Grants receivable 16,909 - - - 16,909 Other receivables 74,053 - - - 74,053 Investments 20,827,589 - ( 1,456,862) ( 2,444,174) 16,926,553 Total financial assets $ 24,123,545 - ( 1,675,121) ( 2,444,174) 20,004,250 Liquidity and Availability as of December 31, 2019 Less: Funds Financial Assets Funds Not Restricted by Available for Total Per Convertible to Less: Funds Board for an General Statement of Cash Within One Restricted by Operating Expenditures Financial Position Year Donors Reserve Within One Year

Cash and cash equivalents $ 1,741,436 - ( 46,751) - 1,694,685 Accounts receivable, net 1,707,684 - - - 1,707,684 Grants receivable 16,723 - - - 16,723 Other receivables 47,188 - - - 47,188 Investments 19,826,403 - ( 1,269,540) ( 2,427,354) 16,129,509 Total financial assets $ 23,339,434 - ( 1,316,291) ( 2,427,354) 19,595,789 The Organization’s endowment funds consist of donor-restricted endowments. Income from donor-restricted endowments is restricted for specific purposes. As of December 31, 2020 and 2019, donor-restricted endowment funds were not available for general expenditure. The Organization’s board-designated endowment of $1,835,515 and $1,925,444 as of December 31, 2020 and 2019, respectively, is subject to an annual spending rate of 5% as described in Note 12. Although the Organization does not intend to spend from this board-designated endowment (other than amounts appropriated for general expenditure as part of the ENAF Board’s annual budget approval and appropriation), these amounts could be made available if necessary. During 2020, the ENAF Board designated funds for utilizing reserves to support COVID-19 relief. At December 31, 2020, there was a balance of $106,749 with this designation. Although the Organization intends to spend these funds in support of COVID-19 relief, these amounts could be made available if necessary.

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 3 - LIQUIDITY AND AVAILABILITY, CONTINUED Additionally, the ENA Board has designated funds within the parameters of the ENA spending policy for utilizing reserves on identified projects. At December 31, 2020 and 2019 there was a balance of $501,910 with this designation. Although the Organization intends to spend these funds in accordance with the ENA spending policy referred to above, these amounts could be made available if necessary. As part of the Organization’s liquidity management plan, cash in excess of current needs for expenses are invested in mutual funds. Investments are released to cover operating expenses as needed upon management approval. Additionally, the Organization maintains a line of credit that if deemed necessary can be drawn upon to cover operating expenses (Note 7). NOTE 4 - PROPERTY AND EQUIPMENT The useful lives for purposes of computing depreciation and amortization are as follows: Buildings 40 years Building improvements 30 - 40 years Equipment 5 years Program development 3 - 7 years Furniture and fixtures 15 years Computer software 3 - 7 years Property and equipment is summarized as follows as of December 31, 2020 and 2019: 2020 2019 Land $ 1,492,112 1,492,112 Buildings 2,948,699 2,948,699 Building improvements 5,969,138 5,969,138 Equipment 262,170 262,170 Program development 913,206 815,584 Furniture and fixtures 1,297,835 1,286,753 Computer software 5,032,211 4,810,643 17,915,371 17,585,099 Less accumulated depreciation and amortization ( 6,030,111) ( 5,318,227) $ 11,885,260 12,266,872 Depreciation expense of property and equipment charged to operations was $525,363 and $525,913 for the years ended December 31, 2020 and 2019, respectively. In addition, the Organization amortized development costs (included in programs, grants and scholarship expenses) for the years ended December 31, 2020 and 2019 in the amounts of $186,521 and $143,148, respectively.

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 5 - MORTGAGE RECEIVABLE On August 21, 2020, the Organization entered into a real estate sale agreement with a third party. The Organization agreed to provide financing for a portion of the purchase price of the property sold, which amounted to $1,900,000. The mortgage receivable is stated at unpaid principal balance, less an allowance for loan losses. As of December 31, 2020, an allowance was not deemed necessary. Certain insurance coverage is required and the policies must name the Organization as additional insured. Interest on the note is compounded annually and accrues at a rate of 4.00% annually from September 1, 2021 through August 31, 2023 and at a rate of 5.00% annually from August 31, 2023 through the maturity date. Interest on the loan is recognized over the term of the loan and is calculated using the interest method on principal amounts outstanding. No interest was received for the year ended December 31, 2020. The Organization’s practice is to charge off any loan or a portion of a loan when the loan is determined by management to be uncollectible due to the third party’s failure to meet repayment terms, or for other reasons. NOTE 6 - FAIR VALUE MEASUREMENTS Accounting standards generally accepted in the United States of America establish a framework for measuring fair value. That framework provides a fair value hierarchy that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1 measurements) and the lowest priority to unobservable inputs (Level 3 measurements). The three levels of the fair value hierarchy are described below: Level 1 Inputs to the valuation methodology are unadjusted quoted prices for identical

assets or liabilities in active markets that management has the ability to access at the measurement date.

Level 2 Inputs other than quoted prices included within Level 1 that are observable for

the asset or liability, either directly or indirectly such as: • Quoted prices for similar assets or liabilities in active markets;

• Quoted prices for identical or similar assets or liabilities in inactive markets; • Inputs other than quoted prices that are observable for the asset or liability;

• Inputs that are derived principally from or corroborated by observable market data by correlation or other means.

If the asset or liability has a specified (contractual) term, the Level 2 input must be observable for substantially the full term of the asset or liability.

Level 3 Inputs to the valuation methodology are unobservable and significant to the fair

value measurement.

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NOTE 6 - FAIR VALUE MEASUREMENTS, CONTINUED The asset’s or liability’s fair value measurement level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. Valuation techniques used need to maximize the use of observable inputs and minimize the use of unobservable inputs. Following is a description of the valuation methodologies used for assets and liabilities measured at fair value. There have been no changes in the methodologies used at December 31, 2020 and 2019. Mutual funds: Valued at the closing price as reported by the fund. Mutual funds held by the Organization are open-end mutual funds that are registered with the U.S. Securities and Exchange Commission. These funds are required to publish their daily net asset value (NAV) and to transact at that price. Interest rate swap: Valued using both observable and unobservable inputs when available and can generally be corroborated by market data. The methods described above may produce a fair value calculation that may not be indicative of net realizable value or reflective of future fair values. Furthermore, while the Organization believes its valuation methods are appropriate and consistent with other market participants, the use of different methodologies or assumptions to determine the fair value of certain financial instruments could result in a different fair value measurement at the reporting date. Assets and liabilities reported at fair value consisted of the following at December 31: Fair Value at December 31, 2020 Level 1 Level 2 Level 3 Total Assets: Mutual funds: Fixed income: Broad domestic $ 4,559,119 - - 4,559,119 High yield bonds 5,684,903 - - 5,684,903 Short-term bonds 37,323 - - 37,323 Equity: Domestic large cap 5,445,110 - - 5,445,110 Domestic small/mid cap 1,040,214 - - 1,040,214 International equity 1,981,176 - - 1,981,176 Emerging markets 2,079,744 - - 2,079,744 $ 20,827,589 - - 20,827,589 Liability - Interest rate swap $ - 1,209,973 - 1,209,973

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NOTE 6 - FAIR VALUE MEASUREMENTS, CONTINUED Fair Value at December 31, 2019 Level 1 Level 2 Level 3 Total Assets: Mutual funds: Fixed income: Broad domestic $ 4,492,275 - - 4,492,275 High yield bonds 5,099,422 - - 5,099,422 Short-term bonds 220,060 - - 220,060 Equity: Domestic large cap 5,181,790 - - 5,181,790 Domestic small/mid cap 1,001,768 - - 1,001,768 International equity 1,859,880 - - 1,859,880 Emerging markets 1,971,208 - - 1,971,208 $ 19,826,403 - - 19,826,403 Liability - Interest rate swap $ - 712,437 - 712,437 For the years ended December 31, 2020 and 2019, there were no significant transfers in or out of Level 3. NOTE 7 - LINE OF CREDIT The Organization has a $2,500,000 unsecured line of credit. This line expires on December 21, 2021 and bears interest at 1.5% plus 30 day LIBOR (2.50% at December 31, 2020). The outstanding balance on the line of credit was $1,099,209 at December 31, 2020 and 2019, respectively. Restrictive covenants imposed under the line of credit require the Organization to maintain an unrestricted cash and investment to total fund debt of not less than 1.25 (ENA only). As of December 31, 2020 and 2019, this covenant was met. NOTE 8 - BOND PAYABLE On December 21, 2017, a Series 2017 Industrial Revenue Bond (Bond) was issued by the City of Watseka. The aggregate principal amount of the Bond is $10,000,000 and the proceeds of the Bond were used to finance the purchase of the land and building in Schaumburg, IL. The maturity date of the Bond is December 21, 2047. The Bond bears interest at variable rates throughout the life of the bond. As of December 31, 2020, the interest rate on the Bond is 1.19%. The Bond requires monthly payments of $28,736.

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NOTE 8 - BOND PAYABLE, CONTINUED The Bond agreement requires the Organization to furnish audited financial statements 270 days after each year end. There were debt issuance costs of $123,194 related to the bond issuance. Amortization expense for the years ended December 31, 2020 and 2019 was $7,519 and $7,792, respectively. During 2018, the Organization entered into a $10,000,000 interest rate swap agreement with a bank to fix the rate on the variable rate bond and to manage the borrowing costs. The interest rate swap agreement has a termination date of December 10, 2027 and a fixed interest rate of 3.61%. The settlement value of the interest rate swap at December 31, 2020 and 2019 was a liability of $1,209,973 and $712,437, respectively. The settlement rate was estimated using a present value calculation of the swap's remaining estimated cash flows, not adjusted for any nonperformance risk. The Bond payable as of December 31, 2020 and 2019 consisted of the following: 2020 2019 DEBT ISSUE DEBT ISSUE PRINCIPAL COSTS NET PRINCIPAL COSTS NET

Bond $ 9,310,336 99,818 9,210,518 9,655,168 107,337 9,547,831 Current portion 344,832 7,246 337,586 344,832 7,519 337,313 $ 8,965,504 92,572 8,872,932 9,310,336 99,818 9,210,518 Principal payments due on Bond payable during each of the next five years are as follows: 2021 $ 344,832 2022 344,832 2023 344,832 2024 344,832 2025 344,832 Thereafter 7,586,176 $ 9,310,336

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NOTE 9 - OPERATING LEASES The Organization is obligated under certain operating leases, primarily for certain office space and office equipment which expire on various dates until 2025. Total rent expense under all operating leases amounted to $107,465 and $104,346 for the years ended December 31, 2020 and 2019, respectively. The aggregate future minimum lease commitment on these leases as of December 31, 2020 is as follows: 2021 $ 95,138 2022 78,537 2023 63,682 2024 65,343 2025 67,055 $ 369,755 NOTE 10 - RETIREMENT SAVINGS PLAN ENA has a 401(k) defined contribution retirement savings plan (Plan) available to substantially all of ENA’s employees. ENA matches up to 4% of each employee’s contribution to the Plan. The Plan also has a discretionary profit-sharing component. ENA’s discretionary profit-sharing contribution is determined annually based on the fiscal results of the organization with input from staff and the Board. In 2019, ENA’s profit-sharing contribution was 5% of each qualified employee’s salary. In 2020, there was no profit-sharing contribution. ENA’s contribution is funded on a current basis. Total contributions to the Plan in 2020 and 2019 were $256,285 and $679,760, respectively. NOTE 11 - COMMITMENTS AND CONTINGENCIES The Organization has entered into a number of contracts with various vendors for space, hotel accommodations and ancillary services for future meetings. Minimum estimated cancellation fees are as follows: 2021 $ 1,297,238 2022 127,992 2023 - 2024 2,040,450 $ 3,465,680 The $1,938,315 Paycheck Protection Program loan and its forgiveness are subject to examination under the terms of the agreement with the Small Business Administration for a period of six years from the date the loan is forgiven. The Organization is not currently under examination nor has the Organization been contacted.

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NOTE 12 - ENDOWMENTS The Organization's endowment includes three board-designated endowments established for the ENAF and fourteen donor-restricted endowment funds primarily for the general operating purposes of the Organization, as well as for specific programs and scholarships. Net assets associated with endowment funds are classified and reported based on the existence or absence of donor-imposed restrictions. Interpretation of Relevant Law The State of Illinois adopted the Uniform Prudent Management of Institutional Funds Act (UPMIFA) on June 30, 2009. The Organization has adopted a spending policy that requires the preservation of the fair value of the original gift as of the gift date of the donor-restricted endowment fund absent explicit donor stipulations to the contrary. As a result of this policy, the Organization retains in perpetuity (a) the original value of initial and subsequent gift amounts (including promises to give net of discount and allowance for doubtful accounts) donated to the endowment and (b) any accumulations to the endowment made in accordance with the direction of the applicable donor gift instrument at the time the accumulation is added. Donor-restricted amounts not retained in perpetuity are subject to appropriation for expenditure by the Organization in a manner consistent with the standard of prudence described by UPMIFA. The Organization considers the following factors in making a determination to appropriate or accumulate donor-restricted endowment funds:

• The duration and preservation of the fund • The purposes of the Organization and the donor-restricted endowment fund • General economic conditions • The possible effect of inflation and deflation • The expected total return from income and the appreciation of investments • Other resources of the Organization • The investment policies of the Organization

Strategies Employed for Achieving Objectives To satisfy its long-term rate of return objectives, the Organization relies on a total return strategy in which investment returns are achieved through both capital appreciation (realized and unrealized) and current yield (interest and dividends).

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 12 - ENDOWMENTS, CONTINUED Spending Policy and How the Investment Objectives Relate to Spending Policy The Organization has a policy of appropriating annually no more than 5% of the prior three-year average of the fair market value of the endowment, including any capital appreciation and/or current yield. In establishing this policy, the Organization considered the long-term expected return on its endowments. This is consistent with the Organization’s objective to maintain the fair value of the endowment assets held in perpetuity for a specified term as well as to provide additional real growth through new gifts and investment return. Donor-restricted endowments are spent in accordance with the donors’ requirements; distributions are made for purposes that conform to the donors’ stated intentions. Funds with Deficiencies From time to time, certain donor-restricted endowment funds may have fair values less than the amount required to be maintained by donors or by law (underwater endowments). There were no funds with deficiencies for the year ended December 31, 2020 and 2019. Endowment net asset composition by type of fund as of December 31, 2020: WITHOUT WITH DONOR DONOR RESTRICTIONS RESTRICTIONS TOTAL Board-designated endowment funds $ 1,835,515 - 1,835,515 Donor-restricted endowment funds Original donor-restricted gift amount and amounts required to be maintained in perpetuity by the donor - 1,003,528 1,003,528 Accumulated investment gains - 453,334 453,334 $ 1,835,515 1,456,862 3,292,377

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 12 - ENDOWMENTS, CONTINUED Changes in endowment net assets for the year ended December 31, 2020: WITHOUT WITH DONOR DONOR RESTRICTIONS RESTRICTIONS TOTAL Endowment net assets, January 1, 2020 $ 1,925,444 1,269,539 3,194,983 Investment return, net 194,071 168,219 362,290 Transfer of board-designated endowment funds to COVID-relief fund ( 200,000) - ( 200,000) Appropriation of endowment assets for expenditures ( 84,000) ( 44,000) ( 128,000) Contributions - 63,104 63,104 ( 89,929) 187,323 97,394 Endowment net assets, December 31, 2020 $ 1,835,515 1,456,862 3,292,377 Endowment net asset composition by type of fund as of December 31, 2019: WITHOUT WITH DONOR DONOR RESTRICTIONS RESTRICTIONS TOTAL Board-designated endowment funds $ 1,925,444 - 1,925,444 Donor-restricted endowment funds Original donor-restricted gift amount and amounts required to be maintained in perpetuity by the donor - 940,423 940,423 Accumulated investment gains - 329,116 329,116 $ 1,925,444 1,269,539 3,194,983

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 12 - ENDOWMENTS, CONTINUED Changes in endowment net assets for the year ended December 31, 2019: WITHOUT WITH DONOR DONOR RESTRICTIONS RESTRICTIONS TOTAL Endowment net assets, January 1, 2019 $ 1,658,894 1,000,906 2,659,800 Investment return, net 338,200 203,474 541,674 Appropriation of endowment assets for expenditures ( 71,650) ( 40,850) ( 112,500) Contributions - 106,009 106,009 266,550 268,633 535,183 Endowment net assets, December 31, 2019 $ 1,925,444 1,269,539 3,194,983 NOTE 13 - NET ASSETS WITH DONOR RESTRICTIONS Net assets with donor restrictions consist of the following: 2020 2019 Endowments: Karen O’Neil Endowed Scholarship Fund $ 120,921 109,337 New York State September 11 Endowment Fund 157,364 143,831 Judith C. Kelleher Memorial Endowment Fund 144,721 123,264 Anita Dorr Memorial Endowment Fund 2,309 1,932 Jeanette Ash Endowed Scholarship Fund 60,836 49,751 Richard Wynkoop Scholarship Fund 49,137 37,944 Elizabeth B. Moore Memorial Fund for Scholarships 141,359 129,771 Texas Endowed Scholarship Fund 129,261 106,308 Mildred Fincke Memorial Endowed Scholarship Fund 27,955 12,378 Joan Eberhardt Endowed Scholarship Fund 55,617 51,090 Peggy McCall Fund 28,258 25,000 Jeff Solheim International Endowment 15,000 - Gracen Brooke Oglesby Pediatric Fund 1,075 - Castner and Spencer Family Research Fund 4,696 - General Endowment Fund 518,353 478,933 1,456,862 1,269,539 Purpose restricted contributions 218,259 46,752 $ 1,675,121 1,316,291

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 14 - NET ASSETS RELEASED FROM DONOR RESTRICTIONS Net assets released from restrictions during the years ended December 31, 2020 and 2019, because donor restrictions were met by satisfying the stated purpose or time or other event are as follows: 2020 2019 Scholarships $ 182,525 340,158 COVID-19 relief 78,826 - $ 261,351 340,158 NOTE 15 - IMPACT OF COVID-19 In March 2020, the World Health Organization declared the outbreak of a novel coronavirus (COVID-19) as a pandemic, which continues to spread throughout the United States of America. Due to the impact of COVID-19 and the resulting decision to move to a virtual meeting in 2020, the Organization saw a temporary decrease in course fees, conferences, publications, and sponsorships. Management continues to actively monitor the global situation in order to mitigate any potential future impact on the Organization’s changes in net assets and financial performance. In 2021, previous revenue declines experienced in 2020 have since rebounded. NOTE 16 - PAYCHECK PROTECTION PROGRAM LOAN On April 5, 2020, the Organization received proceeds in the amount of $1,938,315 under the Paycheck Protection Program (PPP). Established as part of the Coronavirus Aid, Relief and Economic Security Act (CARES Act), the PPP provides for loans to qualifying businesses in amounts up to 2.5 times the business’s average monthly payroll expenses. PPP loans and accrued interest are forgivable after a “covered period” of 24 weeks as long as the borrower maintains its payroll levels and uses the loan proceeds for eligible purposes, including payroll, benefits, rent, and utilities. The forgiveness amount will be reduced if the borrower terminates employees or reduces salaries during the covered period. Any unforgiven portion of a PPP loan is payable over two or five years at an interest rate of 1%, with a deferral of payments for 10 months after the end of the covered period. Given Congress’ intent to have the proceeds of the PPP loans forgiven by meeting specific criteria, The Organization has elected to treat the PPP loan in accordance with the conditional government grants model in accordance with FASB ASC 958-605. The Organization initially recorded the loan as a refundable advance and subsequently recognized PPP grant revenue in accordance with the guidance for conditional government grants; that is, once the measurable performance or other barrier and right of return of the PPP loan no longer existed. The Organization has recognized $1,938,315 as Paycheck Protection Program grant revenue on the consolidated statements of activities for the year ended December 31, 2020. On March 4, 2021, the Organization received notice that the Small Business Administration authorized full forgiveness of the PPP loan, which legally released to Organization from the loan obligation.

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YEARS ENDED DECEMBER 31, 2020 AND 2019 NOTE 16 - PAYCHECK PROTECTION PROGRAM LOAN, CONTINUED Pursuant to the 2021 Consolidated Appropriations Act (CAA), the Organization applied for a second $1,938,315 PPP loan and received the funds on February 1, 2021. The loan is intended to be forgiven if the proceeds are used to cover eligible expenses enumerated in the CAA, including that at least 60% be used to cover eligible payroll expenses. In addition, the Organization must maintain employee and compensation levels. The loan carries an interest rate of 1% and has a maturity date of February 1, 2026. The Organization intends to comply with all requirements to qualify for loan forgiveness. NOTE 17 - RECLASSIFICATIONS Certain amounts in the 2019 financial statements have been reclassified to conform with the year 2020 presentation.

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S U P P L E M E N T A R Y I N F O R M A T I O N


Certified Public Accountants ■ Business & Financial Advisors Offices in Elgin, Chicago, Orland Park, Sarasota & Philadelphia

PKF Mueller is a member firm of the PKF International Limited family of legally independent firms and does not accept any responsibility or liability for the actions or inactions of any individual member or correspondent firm or firms.

1707 N. Randall Road, Suite 200 ■ Elgin, Illinois ■ 60123 Ph: 847.888.8600 ■ Fax: 847.888.0635 ■ www.pkfmueller.com

INDEPENDENT AUDITOR’S REPORT ON SUPPLEMENTARY INFORMATION

To the Finance Committee of Emergency Nurses Association and Board of Trustees of ENA Foundation

We have audited the consolidated financial statements of Emergency Nurses Association and Affiliate as of and for the years ended December 31, 2020 and 2019, and our report thereon, which expresses an unmodified opinion on those consolidated financial statements appears on pages 1 and 2. Our auditswere conducted for the purpose of forming an opinion on the consolidated financial statements as a whole. The supplementary information is presented for the purposes of additional analysis and is not arequired part of the consolidated financial statements. Such information is the responsibility ofmanagement and was derived from and relates directly to the underlying accounting and other records used to prepare the consolidated financial statements. The information has been subjected to the auditing procedures applied in the audits of the consolidated financial statements and certain additionalprocedures, including comparing and reconciling such information directly to the underlying accounting and other records used to prepare the consolidated financial statements or to the consolidated financial statements themselves, and other additional procedures in accordance with auditing standards generally accepted in the United States of America. In our opinion, the information is fairly stated in allmaterial respects in relation to the consolidated financial statements as a whole.

Elgin, Illinois July 16, 2021

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Cash and cash equivalents $ 1,229,456 1,449,630 Accounts receivable, net of allowance for doubtful accounts of $152,575 and $197,000 for 2020 and 2019, respectively 1,635,317 1,702,666 Grants receivable 16,909 16,723 Other receivables 74,053 47,188 Current portion of mortgage receivable 60,251 - Due from affiliate - ENA Foundation - 7,900 Inventory 34,986 50,552 Prepaid expenses and other current assets 957,577 943,648

Total current assets 4,008,549 4,218,307

Property and equipment, net 11,880,046 12,259,640

Property held for sale - 2,450,000

Mortgage receivable, net of current portion 1,813,749 -

Investments 16,911,006 16,215,232

Total assets $ 34,613,350 35,143,179

Current liabilities:Accounts payable $ 294,106 766,377 Wages and benefits payable 554,371 944,905 Accrued expenses 465,904 612,605 Credits on customer accounts 76,741 230,910 Due to affiliate - ENA Foundation 6,245 - Assessments payable 822,900 1,330,139 Line of credit 1,099,209 1,099,209 Current portion of deferred revenue 2,676,587 2,579,300 Current portion of bond payable 337,586 337,313

Total current liabilities 6,333,649 7,900,758

Long-term liabilities:Interest rate swap agreement 1,209,973 712,437 Deferred revenue, net of current portion 1,284,361 1,182,892 Bond payable, net of current portion 8,872,932 9,210,518

Total long-term liabilities 11,367,266 11,105,847

Total liabilities 17,700,915 19,006,605

Net assets:Without donor restrictions:

Undesignated 16,410,525 15,634,664 Board-designated 501,910 501,910



See Independent Auditor's Report on Supplementary Information.

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EMERGENCY NURSES ASSOCIATIONSTATEMENTS OF FINANCIAL POSITION


ASSETS



2020 2019Support and revenue:

Courses $ 12,137,728 14,897,385 Membership dues 4,583,459 4,258,905 Conferences 867,804 3,333,411 Publications 584,984 760,483 Marketplace 506,938 586,580 Sponsorships 278,250 499,010 Royalties 155,369 515,554 Other 256,654 480,881 Grants 181,735 80,988 Paycheck Protection Program grant revenue 1,938,315 - Mailing lists 3,960 19,781 Donated services 75,000 95,000

Total support and revenue 21,570,196 25,527,978

Expenses:Programs, grants and scholarships 13,640,569 17,410,480 Management and general 7,041,150 8,048,522 Fundraising and development 451,413 432,991

Total expenses 21,133,132 25,891,993

Increase (decrease) in net assets - before other income 437,064 (364,015)

Other income (expense):Interest expense (378,564) (403,661) Investment income, net 1,664,897 2,698,611 Loss on interest rate swap agreement (497,536) (427,846) Loss on disposal of property held for sale (450,000) -

Total other income 338,797 1,867,104

Change in net assets 775,861 1,503,089

Net assets without donor restrictions, beginning of year 16,136,574 14,633,485

Net assets without donor restrictions, end of year $ 16,912,435 16,136,574


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EMERGENCY NURSES ASSOCIATIONSTATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS




Payroll expenses:Salaries and wages $ 5,034,584 3,189,000 - 8,223,584 Employee benefits 743,590 433,757 - 1,177,347 Payroll taxes 401,152 218,721 - 619,873

6,179,326 3,841,478 - 10,020,804

Operating expenses:Advertising and promotion 106,572 251 969 107,792 Discount on sales 142,192 - - 142,192 Bad debt expense 35,160 - - 35,160 Bank charges and credit card processing fees - 361,651 - 361,651 Computer 223,389 774,501 - 997,890 Conferences 627,462 90,895 - 718,357 Cost of goods sold 1,343,693 - - 1,343,693 Depreciation and amortization 359,425 115,949 11,722 487,096 Fulfillment and warehousing services 210,333 - - 210,333 Grants and scholarships 54,500 2,640 381,562 438,702 Insurance 57,912 46,014 - 103,926 Miscellaneous 31,958 69,565 - 101,523 Postage, freight and shipping 237,948 9,120 - 247,068 Printing 242,936 11,919 - 254,855 Professional services 963,922 823,551 24,948 1,812,421 Provision for UBIT 1,316 - - 1,316 Public relations 9,211 156 - 9,367 Recruitment fees - 38,017 - 38,017 Stipends 101,969 137,000 - 238,969 Supplies and equipment 35,803 98,472 - 134,275 Temporary workers 35,010 84,951 - 119,961 Training 31,649 120,736 - 152,385 Travel 127,094 84,699 - 211,793

4,979,454 2,870,087 419,201 8,268,742


520,631 329,585 32,212 882,428


1,961,158 - - 1,961,158

$ 13,640,569 7,041,150 451,413 21,133,132


EMERGENCY NURSES ASSOCIATIONSTATEMENT OF FUNCTIONAL EXPENSES


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Payroll expenses:Salaries and wages $ 5,043,325 3,598,339 - 8,641,664 Employee benefits 1,130,052 722,663 - 1,852,715 Payroll taxes 404,695 245,559 - 650,254

6,578,072 4,566,561 - 11,144,633

Operating expenses:Advertising and promotion 156,716 - - 156,716 Discount on sales 174,041 - - 174,041 Bad debt expense 39,553 - - 39,553 Bank charges and credit card processing fees - 427,023 - 427,023 Computer 159,406 667,060 - 826,466 Conferences 2,205,102 269,045 - 2,474,147 Cost of goods sold 1,830,712 - - 1,830,712 Depreciation and amortization 311,679 128,172 12,038 451,889 Fulfillment and warehousing services 271,831 - - 271,831 Grants and scholarships 409,841 - 382,019 791,860 Insurance 55,441 50,586 - 106,027 Miscellaneous 113,767 81,973 - 195,740 Postage, freight and shipping 276,250 3,746 - 279,996 Printing 309,658 11,224 - 320,882 Professional services 634,521 549,854 - 1,184,375 Provision for UBIT 51,852 - - 51,852 Public relations 26,455 450 - 26,905 Recruitment fees 1,125 68,819 - 69,944 Stipends 143,690 142,000 - 285,690 Supplies and equipment 58,797 105,751 - 164,548 Temporary workers 211,305 38,034 - 249,339 Training 38,026 222,051 - 260,077 Travel 566,415 293,497 - 859,912

8,046,183 3,059,285 394,057 11,499,525


587,497 422,676 38,934 1,049,107


2,198,728 - - 2,198,728

$ 17,410,480 8,048,522 432,991 25,891,993


EMERGENCY NURSES ASSOCIATIONSTATEMENT OF FUNCTIONAL EXPENSES


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Change in net assets $ 775,861 1,503,089 Adjustments to reconcile change in net assets to

net cash applied to operating activities:Depreciation and amortization of property and equipment 709,866 667,043 Amortization of debt issuance costs 7,519 7,792 Loss on interest rate swap agreement 497,536 427,846 Loss on property held for sale 450,000 - Bad debt (recovery) expense (44,425) 33,466 Realized and unrealized gain on investments (1,295,465) (2,213,769) Decrease (increase) in assets:

Accounts receivable, net of change in allowance 111,774 192,253 Grants receivable (186) (16,723) Other receivables (26,865) (108) Due (to) from affiliate - ENA Foundation 14,145 (1,895) Inventory 15,566 64,275 Prepaid expenses and other assets (13,929) (280,183)

Increase (decrease) in liabilities:Accounts payable (472,271) (21,618) Wages and benefits payable (390,534) 120,438 Accrued expenses (146,701) (90,198) Credits on customer accounts (154,169) (399,374) Assessments payable (507,239) (286,401) Deferred revenue 198,756 23,000

Total cash applied to operating activities (270,761) (271,067)

Cash provided by (applied to) investing activities:Purchases of property and equipment (330,272) (574,043) Payments received on mortgage receivable 126,000 - Purchases of investments (3,113,487) (2,331,312) Proceeds from sale and maturities of investments 3,713,178 4,070,449

Total cash provided by investing activities 395,419 1,165,094

Cash applied to financing activities:Payments on line of credit - (8,382) Payments on bonds payable (344,832) (344,832)

Total cash applied to financing activities (344,832) (353,214)

Net increase (decrease) in cash and cash equivalents (220,174) 540,813

Cash and cash equivalents, beginning of year 1,449,630 908,817

Cash and cash equivalents, end of year $ 1,229,456 1,449,630

Noncash investing transaction:Mortgage receivable from sale of property held for sale $ 2,000,000 -

Other cash flow information:Interest paid $ 378,564 403,661

Income taxes paid $ 5,849 53,000


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EMERGENCY NURSES ASSOCIATIONSTATEMENTS OF CASH FLOWS




Cash and cash equivalents $ 330,922 291,806 Accounts receivable 9,299 5,018 Due from affiliate - ENA 6,245 -

Total current assets 346,466 296,824

Property and equipment, net 5,214 7,232

Investments 3,916,583 3,611,171

Total assets $ 4,268,263 3,915,227

Current liabilities:Accounts payable $ 27,521 7,369 Due to affiliate - ENA - 7,900

Total current liabilities 27,521 15,269

Net assets: Without donor restrictions:

Undesignated 623,357 658,223 Board-designated 1,942,264 1,925,444


With donor restrictions 1,675,121 1,316,291

Total net assets 4,240,742 3,899,958



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ENA FOUNDATIONSTATEMENTS OF FINANCIAL POSITION


ASSETS



WITHOUT DONOR WITH DONOR WITHOUT DONOR WITH DONORRESTRICTIONS RESTRICTIONS TOTAL RESTRICTIONS RESTRICTIONS TOTAL

Support and revenue:Support:

Contributions $ 575,454 450,342 1,025,796 510,783 421,128 931,911 Special events revenue, net of direct expenses - - - 52,389 - 52,389 Net assets released from restrictions 261,351 (261,351) - 340,158 (340,158) -

Total support and revenue 836,805 188,991 1,025,796 903,330 80,970 984,300

Expenses:Programs, grants and scholarships 769,588 - 769,588 575,648 - 575,648 Management and general 215,044 - 215,044 226,340 - 226,340 Fundraising and development 121,081 - 121,081 125,259 - 125,259

Total expenses 1,105,713 - 1,105,713 927,247 - 927,247

Increase (decrease) in net assets - before other income (268,908) 188,991 (79,917) (23,917) 80,970 57,053

Other income:Investment income, net 250,862 169,839 420,701 425,828 203,474 629,302

Change in net assets (18,046) 358,830 340,784 401,911 284,444 686,355

Net assets, beginning of year 2,583,667 1,316,291 3,899,958 2,181,756 1,031,847 3,213,603

Net assets, end of year $ 2,565,621 1,675,121 4,240,742 2,583,667 1,316,291 3,899,958


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STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETSENA FOUNDATION

20192020




Operating expenses:Advertising $ - - 1,420 1,420 Bank charges and credit card processing fees - - 909 909 Computer - 5,660 - 5,660 Conferences - 846 850 1,696 Depreciation - 2,018 - 2,018 Grants and scholarships 657,470 - - 657,470 Insurance - 480 - 480 Postage, freight and shipping 113 510 87 710 Printing - 425 251 676 Professional services 111,843 182,641 115,231 409,715 Supplies and equipment 162 2,950 553 3,665 Temporary workers - 1,998 - 1,998 Travel - 17,516 1,780 19,296

$ 769,588 215,044 121,081 1,105,713


STATEMENT OF FUNCTIONAL EXPENSESYEAR ENDED DECEMBER 31, 2020

ENA FOUNDATION

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Operating expenses:Bank charges and credit card processing fees $ - - 276 276 Computer - 5,521 - 5,521 Conferences - 1,054 11,154 12,208 Depreciation - 2,018 - 2,018 Grants and scholarships 461,519 - - 461,519 Insurance - 480 - 480 Miscellaneous - 162 - 162 Postage, freight and shipping - 144 404 548 Printing - 504 6,400 6,904 Professional services 114,129 188,668 104,992 407,789 Supplies and equipment - 3,955 1,007 4,962 Temporary workers - 1,598 - 1,598 Travel - 22,236 1,026 23,262

$ 575,648 226,340 125,259 927,247


ENA FOUNDATIONSTATEMENT OF FUNCTIONAL EXPENSES


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Change in net assets $ 340,784 686,355 Adjustments to reconcile change in net assets to

net cash provided by (applied to) operating activities:Depreciation of property and equipment 2,018 2,018 Realized and unrealized gain on investments (338,380) (523,640) Contributions restricted for investment in endowment (63,104) (106,009) Increase in assets:

Accounts receivable (4,281) (4,768) Increase (decrease) in liabilities:

Accounts payable 20,152 5,952 Due (to) from affiliate - ENA (14,145) 1,895

Total cash provided by (applied to) operating activities (56,956) 61,803

Cash provided by (applied to) investing activities:Purchases of investments (392,820) (409,335) Proceeds from sale and maturities of investments 425,788 406,053

Total cash provided by (applied to) investing activities 32,968 (3,282)

Cash provided by financing activities:Collections of contributions restricted

for investment in endowment 63,104 106,009

Net increase in cash and cash equivalents 39,116 164,530

Cash and cash equivalents, beginning of year 291,806 127,276

Cash and cash equivalents, end of year $ 330,922 291,806


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ENA FOUNDATIONSTATEMENTS OF CASH FLOWS



Emergency Nurses Association add date 1

2021 ENA VOLUNTEER GROUP ROSTER, CHARGES AND CRITERIA

Table of Contents 2021 GENERAL CRITERIA ..................................................................................................................................................... 2

ADVOCACY ADVISORY COUNCIL ..................................................................................................................................... 3

AWARDS COMMITTEE .......................................................................................................................................................... 3

CLINICAL PRACTICE GUIDELINES COMMITTEE ............................................................................................................ 4

COURSE ADMINISTRATION FACULTY ............................................................................................................................. 4

DIVERSITY, EQUITY AND INCLUSIVITY COMMITTEE .................................................................................................. 5

EMERGENCY DEPARTMENT OPERATIONS COMMITTEE ............................................................................................. 6

EMERGENCY MANAGEMENT AND PREPAREDNESS COMMITTEE ............................................................................ 6

EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL ............................................................................................ 7

EMERGENCY NURSING QUALITY MEASURES DEVELOPMENT WORK TEAM ........................................................ 7

EMERGENCY NURSING ADVANCED PRACTICE ADVISORY COUNCIL ..................................................................... 8

EMERGENCY NURSING CONFERENCE EDUCATION PLANNING COMMITTEE ....................................................... 8

EMERGENCY NURSING EDUCATION ADVISORY COUNCIL ........................................................................................ 9

EMERGENCY NURSING RESEARCH ADVISORY COUNCIL ........................................................................................ 10

EMERGING PROFESSIONAL ADVISORY COUNCIL ...................................................................................................... 10

EMERGING PROFESSIONAL LIAISON .............................................................................................................................. 11

ENPC REVIEW COMMITTEE .............................................................................................................................................. 11

GERIATRIC COMMITTEE .................................................................................................................................................... 12

INTERNATIONAL ADVISORY COUNCIL ......................................................................................................................... 12

LANTERN AWARD COMMITTEE....................................................................................................................................... 13

LANTERN AWARD REVIEWERS ....................................................................................................................................... 13

PEDIATRIC COMMITTEE .................................................................................................................................................... 14

PEER REVIEW EDUCATION COMMITTEE ....................................................................................................................... 15

POSITION STATEMENT COMMITTEE .............................................................................................................................. 15

QUALITY AND SAFETY ADVISORY COUNCIL .............................................................................................................. 16

RESOLUTIONS COMMITTEE .............................................................................................................................................. 17

TNCC REVIEW COMMITTEE .............................................................................................................................................. 17

TRAUMA COMMITTEE ........................................................................................................................................................ 18

APPENDIX A: ......................................................................................................................................................................... 19

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2021 GENERAL CRITERIA

General Criteria for all committees (unless specifically noted) is as follows: • Strong attention to detail and the ability to meet deadlines • Professional writing and editing skills

o Writing and/or editing samples may be required for consideration • Ability to provide expert and time-sensitive feedback on documents from external entities, as requested by the Association, on behalf of the President • Proficient in Microsoft Office Suite (Word, Excel, PowerPoint) • Ability to use ENA Connect for committee activity (online) • Timely response to email and phone calls • Ability to participate in meetings via online video conference, phone or in person

o Some committees require attendance at onsite meetings, requiring travel (expenses paid by ENA) o Review and agree to ENA’s travel policy and guidelines if applicable o Agree to participate in online video conferencing or conference calls and share documents via ENA Connect

• In general, committee meetings, video conferences and conference calls are scheduled during ENA business days of Monday through Friday, however these meetings may take place outside of the general timeframe as needed. • Be accountable to ENA’s committee code of conduct, communication standards.

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ADVOCACY ADVISORY COUNCIL

Name Position State Position Term Service Term 1. William Schueler,

MSN, RN, CEN,

FAEN

Chair OR 1/1/21 – 12/31/22 1/1/20 – 12/31/23

2. Amie Porcelli, RN,

CEN

Member PA 1/1/21 – 12/31/21 1/1/19 - 12/31/21

3. Danita Mullins, MSN, RN, CEN

Member AR 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Debby Rogers, MS, RN, FAEN

Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

5. Lauren Plaine, BSN, RN, CEN

Member VA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Mona Kelley, MSN, RN

Member TN 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Kristen Cline Staff Liaison: Rob Kramer 2021 Charges:

1. Review and identify public policy as it relates to advocacy in emergency nursing Generate ideas for program development and implementation related to government relations and advocacy. Assist in prioritizing advocacy efforts based on ENA’s organizational priorities

2. Provide assistance to ENA State Government Affairs Chairs for assigned states

2021 Specific Criteria:

• Must have extensive knowledge of public policy issues affecting emergency care and emergency nursing at

the state and federal levels

• Demonstrated advocacy involvement with ENA State Council/Chapter

• Ability to serve for a two-year term

• One onsite meeting at Day on the Hill required

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AWARDS COMMITTEE

Name Position State Position Term Service Term

1. Melanie Gibbons Hallman, DNP, RN, CRNP, CEN, ACNP-BC, ENP-C, FNP-BC, TCRN, FAEN

Chair AL 1/1/21 – 12/31/22 1/1/21 – 12/31/23

2. Kevin Jennings, BSN, BS, RN Member MO 1/1/21 – 12/31/21 1/1/19 - 12/31/21

3. Marcia Harmon, BSN, RN, CEN Member NE 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Vanessa Lozada, BSN, RN, SANE-A, SANE-P Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21

5. Regina Newby, BSN, RN, CEN Member OK 1/1/20 – 12/31/21 1/1/20 – 12/31/21

6. Tameka Poston-Myricks, MSN, BSN, RN, CEN Member AL 1/1/20 – 12/31/21 1/1/20 – 12/31/21

7. Anthony Thomsen, BSN, RN, CEN, NREMT-P, NRP Member IA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

8. Abigail White, MSN, BSN, RN, CEN, ACCNS-AG Member IL 1/1/20 – 12/31/21 1/1/20 – 12/31/21

9. Linda Arapian MSN, RN, EMT-B, CEN, CPEN, TCRN, FAEN

Member MD 1/1/21 – 12/31/22 1/1/21 – 12/31/22

10. Louise Hummel MSN, RN, CNS, CEN, TCRN, FAEN Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

11. Jennifer Williams-Cook, BSN, RN, CEN, CPEN, CFRN, NRP, TCRN

Member MS 1/1/21 – 12/31/22 1/1/21 – 12/31/22

12. Barbara Gibson, BSN, RN, CEN Member TN 1/1/21 – 12/31/22 1/1/21 – 12/31/22

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Board Liaison: Terry Foster Staff Liaison: Ellen Siciliano 2021 Charges: 1. Encourage award application submission 2. Review awards and their applicable criteria and provide recommendations for revisions 3. Review and score eligible candidate applications 2021 Specific Criteria:

• Must be able to participate in reviewer training and utilize the electronic award scoring tool

• Experience at a state or chapter level at ENA


• No onsite meeting required

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CLINICAL PRACTICE GUIDELINES COMMITTEE


1. Annie Horigan, PhD, RN Chair GA 1/1/21 – 12/31/21 1/1/18 – 12/31/22

2. Janet Kaiser, MSN, BSN, RN, CEN Member VA 1/1/18 – 12/31/21 1/1/18 – 12/31/21

3. Lisa Gilmore, DNP, MSN-ED, RN, APRN, FNP, CNS, EMT-P, CEN, CPEN, CFRN, ACCNS-AG, ACCNS-P, FNP-C, NREMT-P

Member MO 1/1/19 – 12/31/21 1/1/19 – 12/31/21

4. Kathy Van Dusen, MSN, RN, CEN, CPEN, NHDP-BC Member CA 1/1/19 – 12/31/21 1/1/19 – 12/31/21

5. Judith Bradford, DNS, MSN, RN, FAEN Member MS 1/1/21 – 12/31/21 1/1/21 – 12/31/21

6. Robin MacPherson-Dias, MS, BSN, RN, CEN, CPEN, CCRN, TCRN

Member CA 1/1/21 – 12/31/23 1/1/21 – 12/31/23

7. Andrea Perry, MSN, BSN RN, CEN, CPEN, CNL, MICN Member CA 1/1/21 – 12/31/23 1/1/21 – 12/31/23

8. Alison Camarda, MSN-ED, BSN, RN, CEN, CPEN, SANE Member VT 1/1/21 – 12/31/22 1/1/21 – 12/31/22

9. Andrea Slivinski, DNP, RN, CEN, CPEN, ACNS-BC Member NC 1/1/21 – 12/31/22 1/1/21 – 12/31/22

10. Andrew Slifko, DNP, MBA, RN, EMT-B, NEA-BC Member NJ 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Terry Foster Staff Liaison: Altair Delao 2021 Charges: 1. Develop evidence-based clinical practice guidelines 2. Recommend topic areas for future clinical practice guidelines development 3. Review and update existing clinical practice guidelines as appropriate 2021 Specific Criteria:

• Formal training in research and evidence-based practice translation required

• Must have current emergency department experience

• Must have capacity to review significant numbers of scientific articles and other literature, conduct literature searches and be able to critically analyze and discuss the results of the literature searches including a working knowledge of evidence ratings

• Must be able to write clearly, professionally, and within the time constraints of the CPG process o Scientific writing samples are required as part of submission process

• Doctoral degree preferred, master’s degree required

• Ability to serve for a three-year term

• Two onsite meetings required

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COURSE ADMINISTRATION FACULTY


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1. Amy Boren, MS, BSN, RN, CEN, CPEN, TCRN Chair CO 1/1/21 – 12/31/22 1/1/21 – 12/31/23

2. Kristine Powell, MSN, RN, CEN, NEA-BC, FAEN Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21

3. Jennifer Taylor, MSN, RN, EMT-B, CEN, TCRN Member TN 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Cathy Fox, RN, CEN, CPEN, TCRN, FAEN Member VA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

5. Sonya Drechsel, BSN, RN, CEN, TCRN Member MN 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Melanie Doster, MSN, BSN, RN, CEN Member NC 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Chris Dellinger Staff Liaison: Nicole Williams 2021 Charges: 1. Review course administrative procedures and provide recommendations on an ongoing basis 2. Recommend disciplinary action of Course Directors and Course Instructors as necessary 3. Provide recommendations for course implementation based on various course delivery models 4. Serve as ambassadors on ENA Connect sites for Course Directors and Instructors 2021 Specific Criteria:

• Must be TNCC and ENPC Faculty

• Experience in working with ENA educational programs


• Willingness to engage in online TNCC and ENPC communities consistently

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DIVERSITY, EQUITY AND INCLUSIVITY COMMITTEE


1. Anna Valdez, PhD, MSN, RN, CEN, CFRN, CNE, FAEN

Chair CA 1/1/21 – 12/31/21 1/1/21 – 12/31/22

2. Hershaw Davis, Jr., MSN, RN Member MD 1/1/21 – 12/31/22 1/1/21 – 12/31/22

3. Jennifer Bevacqua, RN, CPNP-AC, CPNP-PC Member OR 1/1/21 – 12/31/22 1/1/21 – 12/31/22

4. Tangela Faulk, RN Member NC 1/1/21 – 12/31/22 1/1/21 – 12/31/22

5. Jo Tabler, MSN, BSN, RN, CEN, CFRN, AGCNS-BC

Member IN 1/1/21 – 12/31/21 1/1/21 – 12/31/21

6. Carlton Purvis, BSN, RN Member TN 4/1/21 – 12/31/21 4/1/21 – 12/31/21

7. Kaleena Soorma, RN Member NY 1/1/21 – 12/31/21 1/1/21 – 12/31/21

Board Liaison: Ryan Oglesby Staff Liaison: Nicole Williams

Charges:

1. Assess the experiences of emergency nurses related to DEI within the emergency nursing community and ENA

2. Determine barriers and challenges to promoting DEI within the emergency nursing profession and ENA community

3. Implement strategies, with ENA Board approval, to improve DEI within the ENA community Specific Criteria:

• Must have current ENA membership

• Ability to serve for at least a 6-month term

• Must be comfortable with virtual engagement via online meetings, email and document sharing

• Experience working within, creating or the desire to impact the development of an environment that values and encourages diversity of thought, experience, demographic backgrounds and identifies

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EMERGENCY DEPARTMENT OPERATIONS COMMITTEE


1. Beth Estep, MSN, RN, CEN Chair OH 1/1/21 – 12/31/21 1/1/20 – 12/31/22

2. Rita Anderson, BSN, RN, CEN, FAEN Member AZ 1/1/21 – 12/31/21 1/1/19 – 12/31/21

3. Denise Bayer, MSN, RN, FAEN Member CA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Jonathan Green, DNP, RN, NP, CEN, CCRN, ENP-C, FNP-C

Member NJ 1/1/20 – 12/31/21 1/1/20 – 12/31/21

5. James Thomas, MSN, RN, CEN Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Susan Domagala, RN Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Chris Dellinger Staff Liaison: Cathy Olson 2021 Charges: 1. Provide subject matter expertise related to emergency department operations/management 2. Identify, recommend, and/or develop evidence-based best practices for emergency department leadership to

improve patient and staff safety in emergency care settings and provide evidence-based recommendation for creating a safe work environment

3. Review and provide feedback on educational content and other ENA initiatives as requested


• Must have a good understanding of systems, organization and management of operations in the delivery of emergency care

• Experience in a leadership role in an emergency care setting



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EMERGENCY MANAGEMENT AND PREPAREDNESS COMMITTEE


1. Angie Lee, MSN-ED, RN, CEN Chair NY 1/1/21 – 12/31/22 1/1/20 – 12/31/23

2. Brian Rogers, MSN, BSN, RN, CEN Member PA 1/1/21 – 12/31/21 1/1/19 – 12/31/21

3. April Burge, MSN, RN, EMT-B Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Paul Mikita, BSN, RN Member NJ 1/1/20 – 12/31/21 1/1/20 – 12/31/21

5. Grace Burgos, PhD, MSN, BSN, RN Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21

6. Wendy Wheeler, BSN, RN, EMT-B, CEN, CPEN Member CT 1/1/21 – 12/31/22 1/1/21 – 12/31/22

7. Taryn Amberson, MPH, BSN, RN, CEN Member HI 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Mike Hastings Staff Liaison: Monica Kolbuk 2021 Charges: 1. Provide subject matter expertise on emergency management and preparedness 2. Identify best practices for all patient populations related to emergency management preparedness 3. Identify, recommend and develop resources for emergency management and preparedness 2021 Specific Criteria:

• Must have knowledge and active involvement in emergency management, planning, application and evaluation



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EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL


1. Jeffrey Maler, BSN, RN, EMT-B, CEN, TCRN Chair TX 1/1/20 – 12/31/21 1/1/20 – 12/31/22

2. Gina Slobogin, DNP, MSN, BSN, AND, RN, APRN, FNP, EMT-B, EMT-P, APRN-BC, FNP-BC, NHDP-BC, NREMT-P, PHRN

Member PA 1/1/21 – 12/31/21 1/1/19 – 12/31/21

3. Justin Beal, RN, EMT-P, CEN, CPEN, CFRN, NREMT-P, PHRN, TCRN

Member WV 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Kay-Ella Bleecher, MSN, RN, APN, CRNP, CEN, FNP-C, NREMT-P, PHRN, FAEN

Member PA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

5. Deborah McCrea, EdD, MSN, RN, EMT-P, CEN, CFRN, FNP-BC

Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Andrew Bowman, MSN, BSN, RN, APRN, NP, ACNP, EMT-P, CEN, CPEN, CFRN, CTRN, ACNP-BC, ACNPC, CCRN, CCRN-CMC, CVRN, NREMT-P, NRP, TCRN

Member IN 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Mike Hastings

Staff Liaison: Stephanie Klavon

2021 Charges: 1. Provide subject matter expertise on emergency medical services as it relates to the emergency nurse 2. Review and recommend resources to promote collaboration between EMS providers and emergency nurses 3. Review EMS initiatives to improve population health and provide recommendations as relevant to emergency

nursing


• Must have current or recent experience as an EMS provider (basic, advanced, pre-hospital RN, flight nursing that does 911 response) or be in an EMS leadership or education position

• Ability to review and respond to assigned documents related to EMS and emergency nursing, sometimes on urgent timelines

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EMERGENCY NURSING QUALITY MEASURES DEVELOPMENT WORK TEAM


1. Kathy Baker, PhD, RN, NE-BC Chair VA 1/1/21 – 12/31/23 1/1/21 – 12/31/23

2. Elizabeth Tedesco, DNP, RN, CEN, PHRN Member PA 1/1/21 – 12/31/23 1/1/21 – 12/31/23

3. Kathleen Zavotsky, PhD, RN, CEN, ACNS-BC, CCRN, FAEN

Member NJ 1/1/21 – 12/31/23 1/1/21 – 12/31/23

4. Shenee Laurence, MPH, BSN, BS, RN Member CA 1/1/21 – 12/31/23 1/1/21 – 12/31/23

5. Shuba Samuel, PhD, MSN, BSN, RN, FNP, CEN, CNE, FNP-BC

Member MI 1/1/21 – 12/31/23 1/1/21 – 12/31/23

6. Anna May, MSN, MBA, BA, RN, CEN, CPEN Member NE 1/1/21 – 12/31/23 1/1/21 – 12/31/23

7. Elizabeth Brennan, EdD, MSN, Med, BS, ADN, RN, CEN Member PA 1/1/21 – 12/31/23 1/1/21 – 12/31/23

Board Liaison: Dustin Bass Staff Liaison: Catherine Olson, MSN, RN Research Lead: Lisa Wolf, PhD, RN, CEN, FAEN

2021 Charges: 1. Provide subject matter expertise on emergency nursing quality improvement 2. Research current evidence for best nursing practice to improve patient outcomes in the emergency department 3. Recommend pertinent, evidence-based emergency nursing quality measures to be developed

4. Develop introductory set of emergency nursing quality measures 5. Draft and refine process for testing of measures.

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• Must have knowledge and/or experience in emergency department quality improvement and benchmarking of data

• Must have strong understanding of nurse-sensitive quality indicators

• Master’s Degree strongly preferred.

• Experience in emergency nursing leadership or education preferred

• Knowledge and experience in nursing research preferred

• Knowledge and experience in nursing informatics or EHR data retrieval desired

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EMERGENCY NURSING ADVANCED PRACTICE ADVISORY COUNCIL


1. Nancy Denke, DNP, RN, ACNP, CEN, ACNP-BC, CCRN, FNP-BC, FAEN

Chair AZ 1/1/21 – 12/31/21 1/1/20 – 12/31/22

2. David House, DNP MSN BSN BS RN APRN CRNP FNP CNS CEN ENP-C FNP-BC

Member AL 1/1/21 – 12/31/21 1/1/19 - 12/31/21

3. Kimberly Brandenburg, CEN, CPEN, APRN-BC, FNP-C Member NE 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Tresa Zielinski, DNP, RN, APRN, CPNP-PC Member IL 1/1/20 – 12/31/21 1/1/20 – 12/31/21

5. Steve Branham, RN, ACNP-BC, CCRN, ENP-C, FNP-BC Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Scott Stover, DNP, MSN, MBA, APRN, CNS, CEN, ACNS-BC, CPHQ, NEA-BC

Member FL 1/1/21 – 12/31/22 1/1/21 – 12/31/22

7. Jacob Miller, MS, ACNP, FNP, CNS, CFRN, CCRN, NREMT-P

Member OH 1/1/21 – 12/31/22 1/1/21 – 12/31/22

8. William Fiebig, DNP, ARNP, CEN, AGACNP-BC, ENP-C, FNP-BC, FNP-C, NREMT-P

Member SC 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Jennifer Schmitz Staff Liaison: Margaret Carman 2021 Charges: 1. Provide subject matter expertise for advanced practice nursing issues 2. Generate ideas for advanced practice nursing program development and implementation in accordance with

ENA’s strategic plan 3. Review and provide feedback on educational content and other ENA initiatives as requested 4. Collaborate with conference education planning committee to enhance the APRN conference experience 2021 Specific Criteria:

• Must have experience in advanced practice in emergency or urgent care settings

• Evidence of scholarly activities such as developing evidence-based practice protocols, developing or conducting nursing education, implementing evidence into practice, evaluating outcomes (patient/population, nurse, or systems level), and/or publications is required

• Certified nurse practitioner or clinical nurse specialist preferred

• Doctorate of Nursing Practice or other appropriate advance degree required


• Onsite meeting required

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EMERGENCY NURSING CONFERENCE EDUCATION PLANNING COMMITTEE


1. Teresa Dodge, RN, BSN, CEN Co-Chair NY 1/1/21 – 12/31/21 1/1/21 – 12/31/21

2. Rachael Smith, MSN, RN, CEN, CCRN, TCRN Co-Chair CT 1/1/21 – 12/31/21 1/1/21 – 12/31/21

3. Melinda Elayda, MPA, BSN, RN Member CA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Heidi Gilbert, BSN, RN, CEN, SANE Member OK 1/1/20 – 12/31/21 1/1/20 – 12/31/21

5. Jill LeBeau, RN Member CO 1/1/20 – 12/31/21 1/1/20 – 12/31/21

6. Sarah Sargalski Munier, MSN, RN, CEN Member MD 1/1/20 – 12/31/21 1/1/20 – 12/31/21

7. Brett Pickens, DNP, MSN-ED, BSN, ADN, RN, CEN, CPEN, CNE

Member MS 1/1/20 – 12/31/21 1/1/20 – 12/31/21

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8. Bradley Rund, MSN, BSN, AS, RN, EMT-P, CEN, CPEN, CFRN, NREMT-P

Member IN 1/1/20 – 12/31/21 1/1/20 – 12/31/21

9. Brent Seus, RN Member MO 1/1/20 – 12/31/21 1/1/20 – 12/31/21

10. Kirk Tapia-Bobst, MSN, RN, CEN, CPEN, PHRN, TCRN Member IL 1/1/20 – 12/31/21 1/1/20 – 12/31/21

11. Marie Yabut, MN, RN, CEN Member WA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

12. Christopher John Fernandez, BSN, RN Member ON 1/1/21 – 12/31/22 1/1/21 – 12/31/22

13. Jamie Stephens-Davenport, MSN, RN, CEN, CPEN,

TCRN

Member KY 1/1/21 – 12/31/22 1/1/21 – 12/31/22

14. Jason Carter, MSN, BSN, AND, RN, EMT-P, CEN, CPEN, NREMT-P, TCRN

Member OK 1/1/21 – 12/31/22 1/1/21 – 12/31/22

15. Kifah Awadallah, DNP, MSN, BS, RN Member OH 1/1/21 – 12/31/22 1/1/21 – 12/31/22

16. Nycole Oliver, DNP, RN, APRN, CEN, ACNPC-AG, FNP-C, FAEN

Member AR 1/1/21 – 12/31/22 1/1/21 – 12/31/22

17. Chantel Knox, MSN, RN, CEN, TCRN Member MD 1/1/21 – 12/31/22 1/1/21 – 12/31/22

18. Traci Mcgregor, MBA, BSN, RN, CEN, NE-BC Member ID 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Ron Kraus Staff Liaison: Rashonda Legault 2021 Charges: 1. Identify key learning outcomes and content for education relevant to emergency nursing 2. Explore and implement innovative learning approaches to enhance the overall ENA conference experience

3. In collaboration with advanced practice advisory council and other organizations as appropriate, create a plan to

include content designed for advanced practice nurses, including pharmacology and relevant clinical and

professional development issues based on member feedback and needs assessment


• Highly recommended that applicants have attended the Emergency Nursing 2019 to observe meeting processes and flow of events

• Must be available to attend the annual Emergency Nursing conference o Willingness to work throughout annual conference as session monitors o Ability to walk long distances and participate in conference activities as scheduled o Suggest that applicants not participate as delegates or alternate delegates at the 2021 General

Assembly to avoid scheduling issues

• Experience in program planning and/or nursing education

• Knowledge of the American Nurses Credentialing Center (ANCC) Guidelines for continuing education

• Onsite meeting required at the ENA office

• Ability to adapt to quickly to new technology


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EMERGENCY NURSING EDUCATION ADVISORY COUNCIL


1. Wesley Davis, DNP, APRN, CEN, AGACNP-BC, ENP-C, FNP-C

Chair WY 1/1/20 – 12/31/21 1/1/19 – 12/31/22

2. Barbra Bachmeier, JD, MSN, APRN, NP-C, FAEN Member IN 1/1/20 – 12/31/21 1/1/20 – 12/31/21

3. Julie Slack, PhD, RN Member MI 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Meredith Holder, MSN-ED, RN, CEN, TCRN Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

5. Victor (Matt) Pearson, RN, CEN, CPEN, CCRN, TCRN Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Dana Kemery, EdD, MSN, RN, CEN, CPEN, CNE Member NJ 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Steven Jewell Staff Liaison: Nicole Williams 2021 Charges: 1. Provide subject matter expertise for educational products and other initiatives

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2. Generate ideas for educational products, program development and implementation 3. Assist in prioritizing the content development initiatives based upon the ENA Strategic Plan 4. Review and provide feedback on educational content as requested 2021 Specific Criteria:

• Must have extensive knowledge about and experience in nursing education

• Knowledge of adult learning principles

• Experience with various educational delivery methods, including live, enduring, online, and/or distance learning

• Must have a minimum of a Master’s degree in Nursing



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EMERGENCY NURSING RESEARCH ADVISORY COUNCIL


1. Paul Clark, PhD, MA, RN Chair IN 1/1/20 – 12/31/21 1/1/19 – 12/31/22

2. Courtney Edwards, DNP, MPH, RN, CEN, CCRN, TCRN Member TX 1/1/19 – 12/31/21 1/1/19 – 12/31/21

3. Kimberly Johnson, PhD, RN, CEN Member OH 1/1/19 – 12/31/21 1/1/19 – 12/31/21

4. Christian Burchill, PhD, RN, CEN Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

5. Michael Moon, PhD, MSN, RN, CNS-CC, CEN, FAEN Member VA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Michael Callihan, PhD, MSN, RN, EMT-P Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22

7. Stephanie Frisch, PhD, MSN, RN, EMT-B, CEN, CCRN, PHRN

Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

8. Tania Strout, PhD, MS, BSN, RN Member ME 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Ryan Oglesby Staff Liaison: Lisa Wolf 2021 Charges: 1. Provide subject matter expertise for the advisory council 2. Assist in development and implementation of 5-year research strategic plan 3. Assist in prioritizing the advisory council’s programs based upon the ENA Strategic Plan 4. Collaborate with ENA Foundation to review research grant proposals 5. Participate in developing research protocols, analyzing data and contributing to manuscripts 6. Participate in development and writing Understanding Research column for Journal of Emergency Nursing (JEN) 7. Participate in review of ENA Clinical Practice Guidelines

8. Participate in review of abstracts and posters to be presented at the annual conference. 2021 Specific Criteria:

• Writing sample may be required as part of submission

• Must have extensive knowledge about and experience in nursing research

• Evidence of scholarly activities such as developing proposals, conducting research, dissemination, and/or implementing findings into practice is required

• Interest in collaborative research with other members of the Advisory Council

• Must have a minimum of a doctorate, will consider those enrolled in PhD programs

• Ability to serve for a two- or three-year term in order to collaborate meaningfully on research projects

• Onsite meeting required

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EMERGING PROFESSIONAL ADVISORY COUNCIL


1. Mica David, BSN, RN Chair GA 1/1/21 – 12/31/21 1/1/20 – 12/31/22

2. Haley Brown, BSN, RN, EMT-B Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21

3. Norma Hernandez-Ramirez, MSN, RN Member CA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

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4. Alexus Moore, MSN-ED, RN Member VA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

5. Amie Porcelli, BSN, RN, CEN, TCRN Member PA 1/1/21 – 12/31/21 1/1/21 – 12/31/22

6. Robert Ramos, BSN, RN Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22

7. Oneka Hill, BSN, BS, RN Member MI 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Ryan Oglesby Staff Liaison: Matt Hessler 2021 Charges: 1. Help assess and engage the needs of emerging professional members 2. Evaluate whether any new benefits or resources are necessary to support the needs of emerging professionals 3. Advise ENA on the best channels to communicate with this membership group 4. Advise on opportunities for expanding engagement of emerging professionals 5. Serve as the planning team for the emerging professionals event held during annual conference


• Must have five years or less experience in emergency nursing at the time of appointment

• Must be comfortable with virtual engagement via online meetings, email, and document sharing

• Ability to serve a two-year term


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EMERGING PROFESSIONAL LIAISON


1. Amie Porcelli, BSN, RN, CEN, TCRN Member PA 1/1/21 – 12/31/21 1/1/21 – 12/31/21

Staff Liaison: Ashley Schuring 2021 Charges: 1. Provide the emerging professional perspective and key insights through active participation in all Board meetings 2. Serve as a non-voting liaison to the ENA Board of Directors for a one-year term 3. Participate in person at all Board meetings during the year and attend the State and Chapter Leaders Orientation

and Day on the Hill 4. Participate in Board projects and workgroups as assigned 5. Provide an update/seek commentary on issues facing emerging professionals during the ENA Update with the

Board of Directors at the annual conference 6. Simultaneously serve as a member of the Emerging Professional Advisory Council for one year and serve as Chair

the following year 7. Draft an end-of-year report on the experience as an Emerging Professional Liaison and support the transition of

the role to a new emerging leader 8. Other mentoring/shadowing opportunities may include: a one-on-one meeting with the ENA president and

shadowing a Board Liaison during a state visit and/or volunteer group call (with permission)


• Must have five years or less experience in emergency nursing at the time of appointment

• Be a current ENA member in good standing

• Previous experience in an ENA State Council/Chapter leadership position or ENA volunteer position is recommended

• Cannot be a sitting member of the ENA Board of Directors

• Must be able to commit to attending in-person meetings and various video conferences as needed

• Must be comfortable with virtual engagement via online meetings, email, and document sharing

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ENPC REVIEW COMMITTEE


1. Cam Brandt, MSN, RN, CEN, CPEN Chair TX 1/1/21 – 12/31/22 1/1/21 – 12/31/23

2. Patricia Kunz Howard, PhD, RN, CEN, CPEN, NE-BC, TCRN, FAEN, FAAN

Member KY 1/1/21 – 12/31/22 1/1/21 – 12/31/22

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3. Ashellee Street, BSN RN Member ND 1/1/21 – 12/31/22 1/1/21 – 12/31/22

4. Claudia Phillips, MSN-ED, RN, CEN, CPEN Member NM 1/1/21 – 12/31/21 1/1/21 – 12/31/21

5. Stefanie Miller, MSN, RN, CEN Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Justin Milici, MSN, RN, CEN, CPEN, CCRN, CPN, TCRN, FAEN

Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22

7. Elizabeth Bryant, MSN, RN, CEN, CPEN, NE-BC Member KY 1/1/21 – 12/31/21 1/1/21 – 12/31/21

8. Lisa Smotrich, RN, CCRN, RN-BC Member FL 1/1/21 – 12/31/21 1/1/21 – 12/31/21

Board Liaison: Terry Foster Staff Liaison: Katrina Ceci 2021 Charges: 1. Provide subject matter expertise for the Emergency Nursing Pediatric Course (ENPC) 5th ed 2. Serve are subject matter experts (SMEs) in the quarterly Agile Revision process 3. Provide content review of course material and recommendations for course content edits 2021 Specific Criteria:

• Must have subject matter expertise in pediatrics

• It is desired that this work team represents diversity in experience, including pediatric nurses representing children’s hospitals as well as nurses representing general hospitals providing emergency care to pediatric patients

• ENPC 5th ed Course Instructor or Course Director verification required

• Ability to serve for a 12-month term

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GERIATRIC COMMITTEE


1. Joan (Michelle) Moccia, DNP, MSN, RN, ANP-BC, CCRN Chair MI 1/1/21 – 12/31/22 1/1/21 – 12/31/23

2. Aaron Malsch, RN, MSN, GCNS-BC Member WI 1/1/21 – 12/31/21 1/1/19 - 12/31/21

3. Jaimie Ostrom, MSN, BSN, RN, CEN, CNL Member TX 2/1/21 – 12/31/21 2/1/21 – 12/31/21

4. Lisa Gaeta, MSN, BSN, RN, CEN Member NY 1/1/20 – 12/31/21 1/1/20 – 12/31/21

5. Suszanne Deyke, MSN, RN CEN Member NE 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Patricia Primmer, RN Member NJ 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Joop Breuer Staff Liaison: Katrina Ceci

2021 Charges: 1. Provide subject matter expertise related to geriatric emergency care 2. Identify and recommend resources to promote geriatric readiness in the emergency department 3. Revise, edit and develop resources for geriatric emergency care as requested 2021 Specific Criteria:

• Must have subject matter experience in Geriatrics (elderly) population and be willing to serve on collaborative projects

• Research and/or performance improvement background recommended

• Experience with development and evaluation of education for bedside emergency nurses preferred

• Ability to write clearly, professionally, and within established timelines

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INTERNATIONAL ADVISORY COUNCIL

Name Position Country Position Term Service Term

1. Dawn Peta, BSN, RN Chair Canada 1/1/21 – 12/31/21 1/1/19 – 12/31/22

2. Walter Sergio Lugari, BSN, RN, ATCN Member Germany 1/1/20 – 12/31/21 1/1/20 – 12/31/21

3. Marc Marquez, RN Member Australia 1/1/20 – 12/31/21 1/1/20 – 12/31/21

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4. Margaret Dymond, BSN, RN Member Canada 1/1/20 – 12/31/21 1/1/20 – 12/31/21

5. Adam Johnston, BA, RN, CEN Member ND 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Gunilla Lundgren, RN Member Sweden 1/1/21 – 12/31/22 1/1/21 – 12/31/22

7. Vanessa Gorman, MSN-ED, BS, RN, CCRN, FAEN Member Australia 1/1/21 – 12/31/21 1/1/21 – 12/31/21

Board Liaison: Joop Breuer Staff Liaison: Missy Norwick 2021 Charges: Charges to be developed upon 2021 committee formation and presented to the Board for ratification at a future date. 2021 Specific Criteria:

• Strong understanding of ENA

• Understanding of local and global nursing issues

• Ability to participate in virtual and in-person meetings in the United States. Onsite meeting at annual emergency nursing conference required


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LANTERN AWARD COMMITTEE


1. Tyler Babcock, MSN, MBA, BSN, RN, CEN Chair PA 1/1/21 – 12/31/21 1/1/20 – 12/31/22

2. Jennifer Van Cura, DNP, MSN, MPH, MBA, RN, CEN, CPEN, TCRN

Member CO 1/1/21 – 12/31/21 1/1/19 - 12/31/21

3. Ma Cecilia Reyes, BSN, RN Member NC 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Debra Rodriguez, MSN, BSN, RN, SANE Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21

5. Chris Rankin, DNP, MSN, BSN, RN, CEN Member OH 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Lucinda Clos, RN Member MI 1/1/21 – 12/31/22 1/1/21 – 12/31/22

7. Natalie Heywood, RN Member AZ 1/1/21 – 12/31/22 1/1/21 – 12/31/22

8. Will Stewart, MSN, RN, EMT-P, CEN, NE-BC Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22

9. Diane Heine, DNP, MSN, BSN, ADN, RN, CEN Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22

10. Theresa Diloy, MSN, BSN, RN, CEN, CPEN Member VA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Dustin Bass Staff Liaison: Ellen Siciliano 2021 Charges: 1. Review and recommend revisions for Lantern Award program materials as requested 2. Review and score eligible Lantern Award applications 3. Provide substantive and supported comments/feedback for Lantern application responses 2021 Specific Criteria:

• Must be able to participate in reviewer training and utilize the online reviewer tool to evaluate Lantern applications

• Deadlines and activity are heaviest between January-July; must have capacity to review a significant number

of applications within an eight-week period (April-May) and participate in video conference meetings during

June and/or July to create applicant feedback letters

• Excellent writing skills required in order to provide content for inclusion in applicant feedback letters.



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LANTERN AWARD REVIEWERS


1. Carol Fridal, MS, RN, EMT-B, CEN, CLNC Chair IA 1/1/21 – 12/31/22 1/1/21 – 12/31/23

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2. Christina Kelly, BSN, RN, CEN Member PA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

3. Kimberly Mueller, BSN, RN, CEN, CPEN Member IA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Mary Beth Tucker, RN, CEN, CCNS Member GA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

5. Marina Andrade, BSN, RN, CEN Member TX 1/1/20 – 12/31/21 1/1/20 – 12/31/21

6. Heidi Webber, RN Member MO 1/1/20 – 12/31/21 1/1/20 – 12/31/21

7. Mary Collins, RN Member OH 1/1/21 – 12/31/22 1/1/21 – 12/31/22

8. Deborah Schwytzer, DNP, RN, CEN, RN-BC Member OH 1/1/21 – 12/31/22 1/1/21 – 12/31/22

9. Hanna Gerke, RN, CEN Member NJ 1/1/21 – 12/31/22 1/1/21 – 12/31/22

10. Karla Nygren, MSN, MBA, BA, RN, CEN, CPEN, CFRN, CCRN, CPN, TCRN

Member SD 1/1/21 – 12/31/22 1/1/21 – 12/31/22

11. Kimberly Treaster, MSN, RN, CEN Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Dustin Bass Staff Liaison: Ellen Siciliano 2021 Charges: 4. Review and recommend revisions for Lantern Award program materials as requested 5. Review and score eligible Lantern Award applications 6. Provide substantive and supported comments/feedback for Lantern application responses 2021 Specific Criteria:

• Must be able to participate in reviewer training and utilize the online reviewer tool to evaluate Lantern applications

• Deadlines and activity are heaviest between January-July; must have capacity to review a significant number

of applications within an eight-week period (April-May) and participate in video conference meetings during

June and/or July to create applicant feedback letters

• Excellent writing skills required in order to provide content for inclusion in applicant feedback letters.



PEDIATRIC COMMITTEE


1. Gail Schoolden, DNP, RN, APRN, CNS, CPEN, ATCN Chair MD 1/1/21 – 12/31/21 1/1/20 – 12/31/22

2. Katherine Logee, MSN, RN, NP, CEN, CPEN, CFRN, CNE, FNP-BC, PNP-BC

Member CA 1/1/21 – 12/31/21 1/1/19 – 12/31/21

3. Karen Kaskie, BSN, RN, CEN, CPEN, CFRN Member SD 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Tristen Palumbo, MSN, MBA, BSN, RN, CPEN, CPN Member LA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

5. Caleb Jacobs, MSN, RN Member WA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Sara Daykin, DNP, RN, CPEN, TCRN Member NM 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Cheryl Randolph Staff Liaison: Cydne Perhats 2021 Charges: 1. Provide subject matter expertise related to pediatric emergency care 2. Identify, recommend and/or develop resources for care of the pediatric patient in emergency care settings 3. Review and provide feedback on educational content and other ENA initiatives as requested 2021 Specific Criteria:

• Must have subject matter experience in pediatrics

• Experienced nurses representing children’s hospitals as well as nurses representing general hospitals that provide emergency care to pediatric patients desired

• Current ENPC provider status


• No onsite meeting is required

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PEER REVIEW EDUCATION COMMITTEE


1. Charlene Draleau, MSN, RN, CPEN, CPN, RN-BC Member RI 1/1/20 – 12/31/21 1/1/20 – 12/31/21

2. Mariann Cosby, DNP, MSN, MPA, RN, CEN, CCM, LNC, NE-BC PHN

Member CA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

3. Candi Miller-Morris, MSN, RN, CNS, CEN, CCRN Member NM 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Shuba Samuel, PhD, MSN, BSN, RN, FNP, CEN, CNE, FNP-BC

Member MI 1/1/20 – 12/31/21 1/1/20 – 12/31/21

5. Melissa Scott, PhD, MSN, BSN, ADN, RN Member NC 1/1/20 – 12/31/21 1/1/20 – 12/31/21

6. Joan Somes, PhD, MSN, RN, CEN, CPEN, RN-BC, FAEN Member MN 1/1/20 – 12/31/21 1/1/20 – 12/31/21

7. Jonathan Willis, MSN, RN, CEN, CPEN, CCRN-K (Adult), TCRN

Member IN 1/1/20 – 12/31/21 1/1/20 – 12/31/21

8. Mary Zaleski, DNP, RN, CEN, RN-BC, FAEN Member MD 1/1/20 – 12/31/21 1/1/20 – 12/31/21

9. Crystal Miles-Threatt, MA, BSN, RN, CEN, CCRN-K (Adult), TCRN

Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

10. Genevieve Wessel, MSN, BS, RN, NP, CEN, AGACNP-BC, TCRN

Member IL 1/1/21 – 12/31/22 1/1/21 – 12/31/22

11. Janis Farnholtz Provinse, MS, BSN, RN, CNS, CEN, TCRN, FAEN

Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

12. Marie Garrison, MSN, RN, EMT-I, CEN Member OH 1/1/21 – 12/31/22 1/1/21 – 12/31/22

13. Nicole Price, MSN, ANP, CNS, CEN, CPEN, TCRN Member WA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

14. Sarah Rueda, RN Member MD 1/1/21 – 12/31/22 1/1/21 – 12/31/22

15. Sherine Villegas, RN Member NY 1/1/21 – 12/31/22 1/1/21 – 12/31/22

16. Caroline Meza, MSN, RN Member NJ 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: N/A Staff Liaison: Kim Cheramie 2021 Charges: 1. Serve as peer review members of the ENA’s accredited Approver Unit CNE applications

2. Participate as pilot study subjects for ENA's accredited Provider Unit’s newest products or activities

3. Serve as content reviewers for ENA's accredited Provider Unit ongoing CNE activities


• Experience with the American Nurses Credentialing Center’s criteria for continuing nursing education

• Ability to independently review, on average one to two continuing education applications and required forms submitted to ENA’s approval unit each month, occasionally requiring a quick turn-around. The number of submitted applications and required forms varies each quarter.

• Mentor new members through at least three CNE applications of varying complexity

• Ability to serve for a two-year term No onsite meeting is required

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POSITION STATEMENT COMMITTEE


1. Elizabeth Stone, MSN, RN, CPEN, FAEN Chair NC 1/1/20 – 12/31/21 1/1/20 – 12/31/22

2. Brenda Braun, MSN, BSN, RN, CEN, CPEN, FAEN Member NJ 1/1/20 – 12/31/22 1/1/20 – 12/31/22

3. Carla Brim, MN, RN, CNS, CEN, PHCNS-BC Member WA 1/1/19 – 12/31/21 1/1/19 – 12/31/21

4. Alison Day, PhD, MSN, BS, RN, FAEN Member UK 1/1/20 – 12/31/22 1/1/20 – 12/31/22

5. Ann Marie Papa, DNP, MSN, BSN, RN, CEN, NE-BC, FAEN, FAAN

Member PA 1/1/19 – 12/31/21 1/1/19 – 12/31/21

6. Kathryn Rogers, MSN, RN, CEN, CPEN, CPHQ, NEA-BC, TCRN

Member OR 1/1/19 – 12/31/21 1/1/19 – 12/31/21

7. Sharon Vanairsdale, DNP, MS, RN, APRN, NP, CNS, CEN, ACNS-BC, NP-C, FAEN, FAAN

Member GA 1/1/20 – 12/31/22 1/1/20 – 12/31/22

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8. Jennifer Williams, PhD, RN, ACNS-BC Member MO 9/23/19 – 12/31/21 9/23/19 – 12/31/21

9. Jean Proehl, MN, RN, CEN, CPEN, TCRN, FAEN, FAAN Member NH 1/1/21 – 12/31/22 1/1/21 – 12/31/22

10. Joanne Navarroli, MSN, BS, RN, CEN Member AZ 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Steven Jewell Staff Liaison: Monica Kolbuk 2021 Charges: 1. Recommend subject matter experts to collaborate with ENA committees and work teams in developing new

position statements 2. Review, revise, develop and/or recommend for archive, Position Statements for ENA Board approval 3. Collaborate with external organizations on Joint and Supported Position Statements at the direction of the ENA

Board of Directors 2021 Specific Criteria:

• Capacity to review significant number of scientific articles and other literature, conduct literature searches, and be able to critically analyze and discuss the results of the literature searches

• Ability to write clearly, professionally, and within the timelines established by the PSC process o Academic writing sample using APA format and editing sample will be required as part of submission

• Master’s degree required; Doctoral degree is preferred.

• Previous experience on the Clinical Practice Guidelines Committee, IENR Advisory Council or Journal of Emergency Nursing (JEN) Editorial Board is preferred

• Ability to participate in at least one video conference call each month

• Ability to serve for a three-year term

• No onsite meeting is required Back to Top

QUALITY AND SAFETY ADVISORY COUNCIL


1. Robert Kentner, MSN, RN, EMT-P, CEN, CPHQ, NREMT-P, TCRN

Chair NE 1/1/21 – 12/31/21 1/1/20 – 12/31/22

2. Elizabeth, EdD, MSN, Med, BS, ADN, RN, CEN Member PA 1/1/21 – 12/31/21 1/1/19 – 12/31/21

3. Leann Briggs, BSN, BA, RN Member KS 1/1/20 – 12/31/21 1/1/20 – 12/31/21

4. Vivianna Carter, BSN, RN, TCRN Member MO 1/1/21 – 12/31/22 1/1/21 – 12/31/22

5. Joshua Monsivais, BSN, RN, CEN Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Kayla Lott, MSN, RN, CRNP, CEN, FNP-C Member AL 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Mike Hastings Staff Liaison: Cathy Olson 2021 Charges: 1. Provide subject matter expertise on quality, safety and injury prevention relevant to emergency nursing practice 2. Generate ideas for program development and implementation for quality, safety and injury prevention in

accordance with the ENA Strategic Plan 3. Review and provide feedback on initiatives, practice resources or other documents as requested 2021 Specific Criteria:

• Must have knowledge about and experience in quality, safety, and/or injury prevention

• Previous experience in implementing quality, safety and/or injury prevention activities



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RESOLUTIONS COMMITTEE


1. Daniel Misa, MSN, RN, CEN, CPEN Chair NJ 1/1/21 – 12/31/21 1/1/19 – 12/31/22

2. India Owens, MSN, RN, CEN, NE-BC, FAEN Member IN 1/1/19 – 12/31/21 1/1/19 – 12/31/21

3. Christopher Parker, MSN, BSN, RN, CEN, CPEN, CFRN, CNL, NRP, TCRN

Member VA 1/1/20 – 12/31/22 1/1/20 – 12/31/22

4. Cody Staub, RN Member WA 1/1/20 – 12/31/22 1/1/20 – 12/31/22

5. Todd Haines, MSN, BSN, RN, EMT-I, CEN Member TN 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Gina Slobogin, DNP, MSN, BSN, AND, RN, APRN, FNP, EMT-B, EMT-P, CEN, APRN-BC, FNP-BC, NHDP-BC, NREMT-P, PHRN, TCRN

Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

Board Liaison: Jennifer Schmitz Staff Liaison: Ashley Schuring 2021 Charges: 1. Conduct annual call for resolutions and bylaws amendments 2. Provide assistance to resolution and bylaws authors submitting a proposal 3. Ensure submitted bylaw amendments and resolutions adhere to ENA guidelines and formatting requirements 4. Review and provide feedback regarding the resolutions and bylaws amendments guidelines and supporting

materials for submission of a proposal 5. Lead the reference committee hearings and assist with debate and vote during the onsite General Assembly

meeting 6. Deliberate and determine final recommendations and potential amendments for consideration during day two of

General Assembly 2021 Specific Criteria:

• Experience with the resolutions and bylaws process on the local, state, or organizational level

• Prior attendance at one ENA General Assembly as a delegate

• Working knowledge of Roberts Rules of Order

• Two onsite meetings required. One held at the ENAoffices and one held at the ENA annual emergency nursing conference

• Ability to serve for a three-year term Back to Top

TNCC REVIEW COMMITTEE


1. Sheila Silva, DNP, RN Chair MA 1/1/21 – 12/31/22 1/1/21 – 12/31/23

2. Jim Sullivan, MSN, RN, CEN Member TX 1/1/21 – 12/31/21 1/1/21 – 12/31/21

3. Julie Miller, BSN, RN, CEN Member KS 1/1/21 – 12/31/22 1/1/21 – 12/31/22

4. Melanie Crowley, MSN, RN, CEN, TCRN Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

5. Julie Tseh-Willcockson, RN Member CO 1/1/21 – 12/31/21 1/1/21 – 12/31/21

6. Rebecca VanStanton, MSN, RN, CEN, CPEN, TCRN Member MI 1/1/21 – 12/31/22 1/1/21 – 12/31/22

7. Judy Stevenson, DNP, MS, BSN, RN, APRN, CNS, CEN, CPEN, ACCNS-AG, CCRN, NHDP-BC, TCRN

Member OK 1/1/21 – 12/31/21 1/1/21 – 12/31/21

Board Liaison: Cheryl Randolph Staff Liaison: Katrina Ceci 2021 Charges: 1. Provide subject matter expertise for the Trauma Nurse Core Course 8th ed 2. Serve as subject matter experts (SMEs) in the quarterly Agile Revision process 3. Provide content review of course material and recommendations for course content edits 2021 Specific Criteria:

• Must have current emergency department experience, including care of the trauma patient

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• Must be a current TNCC course director

• Experience with development and evaluation of education for bedside emergency nurses preferred

• Ability to serve for a 12-month term Back to Top

TRAUMA COMMITTEE


1. Justin Winger, PhD, MA, BSN, BA, RN, PHN Chair CA 1/1/21 – 12/31/21 1/1/19 – 12/31/22

2. Justin Heinrich, MSN, RN Member PA 1/1/20 – 12/31/21 1/1/21 - 12/31/21

3. Casey Hill, MSN, RN, CEN, TCRN Member NH 1/1/20 – 12/31/21 1/1/21 - 12/31/21

4. Julie Tseh-Willcockson, RN Member CO 3/1/20 – 12/31/21 3/1/21 - 12/31/21

5. Sonny Ruff, DNP, MSN, BSN, ADN, RN, APRN, FNP, CEN, ENP-BC, FNP-C

Member MS 1/1/20 – 12/31/21 1/1/21 - 12/31/21

6. Olivia Smoak, BSN, RN, CEN Member FL 1/1/21 – 12/31/22 1/1/21 – 12/31/22

7. Vientiane Pajo, BSN, RN, CEN, TCRN Member FL 1/1/21 – 12/31/22 1/1/21 – 12/31/22

8. Eric Cohen, BSN, RN, CEN, TCRN Member NY 1/1/21 – 12/31/22 1/1/21 – 12/31/22

9. Tonya Barnard, BSN, RN, CEN Member LA 4/19/21 – 12/31/21 4/19/21 – 12/31/21

Board Liaison: Kristen Cline Staff Liaison: Monica Kolbuk 2021 Charges: 1. Collaborate on the ongoing updates and revisions of ENA’s trauma related courses 2. Provide subject matter expertise related to trauma emergency care. 3. Collaborate on the development of trauma and/or injury prevention resources 2021 Specific Criteria:

• Must have subject matter experience in trauma and be willing to serve in collaborative projects

• Must currently be providing emergency care to trauma patients

• TNCC Instructor status preferred, not required



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APPENDIX A:

FOR REFERENCE: ENA FOUNDATION VOLUNTEER GROUPS (ENA Foundation volunteer group participants selected by ENA Foundation Board)

ENA FOUNDATION FUNDRAISING COMMITTEE – ENA Foundation Committee


1. Melane Marsh, BSN, RN, CEN, SANE Chair NV 1/1/21 – 12/31/21 1/1/21 – 12/31/21

2. Regina Newby, BSN, RN, CEN Member OK 1/1/21 – 12/31/22 1/1/21 – 12/31/22

3. Erin Dees, MSN-ED, MSN-L, RN, CEN Member MS 1/1/21 – 12/31/22 1/1/21 – 12/31/22

4. Mickey Forness, BS, RN, CEN Member NY 1/1/21 – 12/31/22 1/1/21 – 12/31/22

5. CherylAnn MacDonald Sweet, BS, RN, CEN, CPEN Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Karla Nygren, MSN, MBA, BA,RN, CEN, CPEN, CFRN, CCRN, CPN, TCRN

Member SD 1/1/21 – 12/31/22 1/1/21 – 12/31/22

7. Barbara Gibson, BSN RN CEN Member TN 1/1/21 – 12/31/22 1/1/21 – 12/31/22

8. Melissa Easdon, MBA, BSN, RN, CEN, CPEN Member AR 1/1/20 – 12/31/21 1/1/20 – 12/31/21

9. Todd Haines, MSN, BSN, RN, EMT-I, CEN Member TN 1/1/20 – 12/31/21 1/1/20 – 12/31/21

10. Howard Miller, BSN, RN, NREMT-P, PHRN Member PA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

11. Jeff Solheim, MSN, RN, CEN, CFRN, TCRN, FAEN, FAAN Member OR 1/1/20 – 12/31/21 1/1/20 – 12/31/21

Board Liaisons: Michael Loughran and Jessica Mathieson Staff Liaison: Lise Jinno and Meghan Higham 2021 Charges:

1. Promote and strengthen the culture of philanthropy

2. Champion fundraising efforts with and for the ENA Foundation in your community and state

3. Provide advice and guidance to the Foundation Board of Trustees with respect to the mission, and strategic

outlook, of the Foundation as it relates to raising money to further the mission

4. Provide advice and guidance to state officers and fundraising chairs as it relates to raising money to further

the mission of ENA

5. Develop a network of resources


• Collaborate with the ENA Foundation and the ENA Foundation Board of Trustees to assist in local and state

fundraising and program initiatives

• Participate in the promotion of the State Challenge, ENA scholarships and research grants, and engage in

ENA fundraising activities

• Establish and maintain annual fundraising initiatives at the state level through collaboration with the State

Council officers and fundraising chairs and plan for adequate resources to maintain or expand fundraising

efforts

• Maintain communications about current and ongoing fundraising activities with ENA Foundation, ENA

Foundation Board of Trustees, and other ENA State Fundraising Chairs

• Network within the state and with other similar organizations on fundraising and development initiatives in

venues such as ENA annual, regional, and local conferences, meetings, coalitions, task forces and work

groups

• Participate in ENA Foundation fundraising events at ENA conferences, if attending


• Have fundraising experience and preferably responsibilities/roles within their local Council or Chapter

ENA FOUNDATION RESEARCH GRANT COMMITTEE – ENA Foundation Committee

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1. Nancy Mannion, DNP, MS, RN, CEN, FAEN Chair PA 1/1/19 – 12/31/21 1/1/19 – 12/31/21

2. Christine Russe, MSN, RN, CEN, CPEN, TCRN, FAEN

Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22

3. Gina Slobogin, DNP, RN, CEN Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

4. Sarah Abel, DNP, RN, CEN, FAEN Member IN 1/1/21 – 12/31/22 1/1/21 – 12/31/22

5. Andi Foley, DNP, RN, APRN, EMT-B, CEN, ACCNS-AG, TCRN, FAEN

Member ID 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Shawntay Harris, MSN, MHA, MBA, BSN, RN, CEN, CPEN, NE-BC, TCRN

Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22

7. Sharon Jones, EdD, MSN, RN, CEN Member NJ 1/1/20 – 12/31/21 1/1/20 – 12/31/21

Board Liaison: Nancy Mannion Staff Liaison: Lise Jinno and Meghan Higham 2021 Charges:

1. Review and score applications for ENA designated research grants and seed grants.

2. Provide guidance and strategic outlook for future research as it relates to engaging ENA membership on

available research and successful funding of research

3. Actively engage and champion ENA research and seed grant activity at organizational, state, local and

community levels.


• Participate in video conference calls for training and review of research grants

• Promote research grants to members at the state and local level

• Maintain communication with the ENA Foundation Board of Trustees member and ENA Foundation staff

regarding the grant review process

• Contact research grant recipients, providing constructive feedback to unsuccessful applicants regarding

application process

• Collaborate with other ENA entities to identify resources for seed grant awardees

• Network within the state and with other similar organizations on the promotion of research grants and

development initiatives in venues such as, ENA annual, regional and local conferences, meetings, coalitions,

task forces, and work groups.

• Have research experience



ENA FOUNDATION SCHOLARSHIP COMMITTEE – ENA Foundation Committee


1. Jim Hoelz, MS, MBA, RN, CEN, FAEN Chair PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

2. Chris Gisness, MSN, RN, APRN, FNP, CEN, FNP-C, TCRN, FAEN

Associate Chair

GA 1/1/19 – 12/31/21 1/1/20 – 12/31/21

3. Deborah McCrea, EdD, MSN, RN, EMT-P, CEN, CFRN, FNP-BC

Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22

4. Patrice Christensen, BSN, RN Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

5. Louise Hummel, MSN, RN, CNS, CEN, TCRN, FAEN Member CA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

6. Joyce Foresman-Capuzzi, MSN, RN, CNS, EMT-P, CEN, CPEN, CTRN, CCNS, CCRN, PHRN, SANE, FAEN

Member PA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

7. Vicki Patrick, MS, APRN, CEN, ACNP-BC, FAEN Member TX 1/1/21 – 12/31/22 1/1/21 – 12/31/22

8. Harriet Hawkins, RN, CPEN, CCRN, CPN, FAEN Member IL 1/1/21 – 12/31/22 1/1/21 – 12/31/22

9. Melanie Gibbons Hallman, DNP, RN, CRNP, CEN, ACNP-BC, ENP-C, FNP-BC, TCRN, FAEN

Member AL 1/1/21 – 12/31/22 1/1/21 – 12/31/22

10. Audrey Snyder, PhD, RN, ACNP, FNP, CEN, ACNP-BC, CCRN, FNP-BC, FAEN, FAAN, FAANP

Member NC 1/1/21 – 12/31/22 1/1/21 – 12/31/22

11. Amy Boren, MS, BSN, RN, CEN, CPEN, TCRN Member CO 1/1/21 – 12/31/22 1/1/21 – 12/31/22

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12. Laura Wilson, MSN-ED, RN, CEN Member NY 1/1/21 – 12/31/22 1/1/21 – 12/31/22

13. Alexus Moore, MSN-ED, RN Member VA 1/1/21 – 12/31/22 1/1/21 – 12/31/22

14. Roger Casey, MSN, RN, CEN, TCRN, FAEN Member WA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

15. Kelly Collins, BSN, RN, CEN, CPEN, SANE Member ME 1/1/20 – 12/31/21 1/1/20 – 12/31/21

16. Carol Fridal, MS, RN, EMT-B, CEN, CLNC Member IA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

17. Mary Harwood, MSN-ED, RN, CEN Member NY 1/1/20 – 12/31/21 1/1/20 – 12/31/21

18. Christina Kuehster, MS, RN Member CO 1/1/20 – 12/31/21 1/1/20 – 12/31/21

19. Thelma Kuska, BSN, RN, CEN, FAEN Member IL 1/1/20 – 12/31/21 1/1/20 – 12/31/21

20. Patricia Nierstedt, MS, RN, CEN, TCRN Member NJ 1/1/20 – 12/31/21 1/1/20 – 12/31/21

21. Hannah Thadeo, RN, CEN, CPEN, TCRN Member CA 1/1/20 – 12/31/21 1/1/20 – 12/31/21

Board Liaison: Jim Hoelz Staff Liaison: Lise Jinno and Meghan Higham

2021 Charges: 1. Review and score applications for ENA designated scholarships 2. Provide guidance and strategic outlook for future scholarships as it relates to Foundation direction

3. Champion ENA academic scholarship activity at the all levels of the organization.


• Participate in video conference calls for training and review of academic scholarships

• Maintain communication with the ENA Foundation Board of Trustees regarding the scholarship review

process

• Contact scholarship recipients

• Participate in the committee evaluation process and provide feedback on application and scoring rubric tools

• Network within the state and with other similar organizations on the promotion of academic scholarships and

development initiatives in venues such as, ENA annual, regional and local conferences, meetings, coalitions,

task forces, and work groups



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2021 general assembly handbook

Documents