From the President, Karen Ward This past weekend was a busy one. It was Memorial Day weekend and also was the high school graduation ceremony for my husband's youngest daughter. Both occasions brought to mind some thoughts I found pertinent to this column. One of the student speakers at the graduation commented on the fact that she wanted to bring to her audience some brand new thoughts. Thoughts special to her fellow students and to the times. She did not want her speech to be "just another graduation speech." When she said this, I thought, "yes, that is how I feel about this column each time I sit down to write it!" The younger speaker went on to say that she had trouble with the assignment she had given herself. She shared that she finally realized that there was a reason for her difficulty. What became obvious was that every graduate, no matter what the year, has so much in common. Each young person embarking on the road after high school has hopes and dreams that set the course of the journey to be taken. Although specific plans vary greatly, everyone sitting in a graduate's chair is full of expectancy and this has been true for every graduate throughout history. With this common theme, feelings at the time of graduation are not unique to one time or place. "No wonder," she explained, "that my speech will not be all that different from those of previous years." Sitting there in the audience, knowing I had a deadline for this piece, a light bulb went off! I, too, had been trying to come up with something new and different to say this time. I did not want to keep sending the same message… or did I? After hearing the astute young woman, I thought that the reason so many of these "word from the President" columns sound alike is similar to the one she discovered. Where else but in the newsletter does the President get to let every member know how important involvement in this association is? Not everyone attends the meetings, or the research days, or the induction ceremony. The newsletter reaches every member of Xi Alpha and it's my chance to encourage active participation. Which brings me to Memorial Day… Memorial Day is our time to honor those brave men and women who lost their lives for something they believed in. I am sure their beliefs varied, but their commitment was strong enough to take them away from family and friends. Through their efforts, we enjoy the kind of life we have today. As nurses we can be especially proud and grateful for those in the medical corps. I guess you probably know where I am going with this one!!! Yes, a word on commitment…As we are inducted into Sigma Theta Tau International, we make a promise to uphold the high standards set forth by the organization. Part of those standards involve active participation…Need I say more?! See you at our next meeting!

35th Biennial Convention to Convene The 35th Biennial Convention will convene in San Diego, California on November 6 through 10, 1999. The theme "Avenues to the Future" will be designed to appeal to a diverse range of nursing roles, such as, leadership, clinical practice, complementary care, and information technology. Come and network with nurse leaders as a delegate, participant, or a volunteer. For more information, call STTI toll free 1-888-634-7575.

Challenge for Region Chapter by Jeanne Widener, Region 3 Committee Member for Awards Congratulations to all the recipients of awards at the region 3 Conference. The chapters represented can be proud of their accomplishments. The winners become nominees for International awards at the Biennial Convention in November. Chapters can still apply for any of the awards at the International level, even if no application was submitted at the Regional level. I hope several chapters are waiting to apply for the Chapter Heritage Award at the International level, since we had no entries at the Region 3 Conference. A huge THANK YOU goes to all the judges from across the Region. We had all states and many different chapters represented on the judging committees. I was glad to meet many of you in Austin. Thank you also to contact persons from each chapter that returned the survey I sent out in December. I would not have been able to compile the Region 3 Chapter Awards Resource Booklet without your assistance. Development of chapter awards is an important step in growth for each chapter. I will collect updates for the booklet when any chapter sends me additional information. The Booklet was available at the Regional Conference in Austin in February. Think about developing some new awards for the chapter this year. In Region 3, we currently have 60 chapters and few of those chapters have ever received the Key Award. Some chapters have tried, but never completed and sent in the final application. I would like to suggest your chapter use the Key Award application form as a guide throughout the remainder of the year. The Key Award application has been updated by the Regional Coordinators Committee to reflect the current vision of Sigma Theta Tau International. By using the application in planning and carrying out activities of the chapter, each committee of the chapter is reminded of the activities to include enhancing the chapter's function. I can hear you ask why busy chapter members should be looking at an application that is not due for months. By starting now, the application form can be completed a little at a time as the activities occur. If you have one person responsible for collecting the sections as activities are completed, the application will be ready to send in before the deadline passes. Completing sections of the applications over time also saves trying to remember all those details that no one wrote down. Key Award applications are also available from the national office. I am here to assist chapters in developing chapter awards or completing requirements for International Awards, including Key Awards. Contact Jeanne Widener, 2100 Belltree Drive, Reynoldsburg, Ohio 43068 or e-mail widenerjeanne@netscape.net or call 1-614-860-9523. I look forward to continued work with the Region 3 chapters throughout the remainder of this biennium.

Fundraising Activity The Finance Committee has undertaken many successful fundraising activities this year under the guidance of Patsy Forrest, chair. If you missed the opportunity, Pat O'Leary reports items are still available for purchase with the Sigma Theta Tau crest. Don't you want everyone to know that you support your local chapter? Or maybe it would be just the right recognition for a professional relationship! For more information, call O'Leary at 898-2437. Acrylic Mug $15 Ceramic Mug $13 Apricot Marble Paperweight $13 Lunch Sack $13 Business Cards/Note Holder $6 Post-It Notes $1.50 Pen Refills $1

Surf the Net Looking for information about our chapter? Misplaced your newsletter? "Don't worry; Be happy." Now you can find it on our Xi Alpha Chapter Web Home Web page. The address is www.mtsu.edu/~xialpha . Check it out.

April Induction Highlights A large crowd of family and friends were present as twenty-five new inductees were welcomed into the Xi Alpha Chapter of Sigma Theta Tau International. Suzanne Prevost, featured speaker, was also welcomed as a transfer member. An orientation, held in January, provided candidates with information regarding the opportunities of membership in Sigma Theta Tau. New inductees were treated to a reception at the MTSU Foundation House on Tuesday, April 13, 1999. Each new inductee was assigned a mentor to guide their professional growth in the chapter. Many inductees had the opportunity to meet and chat with their mentors that evening. On Sunday, April 18, 1999, the induction ceremony took place in the State Farm Auditorium of the MTSU Business and Aerospace Building. Dr. Suzanne Prevost, Chairholder, National HealthCare Chair of Excellence in Nursing was the featured speaker. Her words underscored the honor of the inductees' accomplishments, the obligation of commitment to the organization, and the opportunity challenging the new members. The new members were inducted by President of the Xi Alpha Chapter, Karen Ward, and subsequently pinned by their mentors. Jenny Sauls received the Patsy Forrest Academic Scholarship (see related story on page 4). Barbara Draude and Frances Carson were recognized for their diligent work as outgoing officers. New officers, Kim Vernier, Vice-President and Mary Jane Lavender, Counselor, were installed for the 1999-2001. 1999 Sigma Theta Tau Xi Alpha Chapter Inductees Jessica Cootes, Shuhanna Carter, James Byrge, Emily Barger, Barbara Austin; Jessi Murray, Teresa Mathis, Christian Ketel, Amy Hudson, Shanna Head, Emily Graham, Mary Dobbs; Susan Sanders, Tom Rone, Martina Harris, Michele Gebely, Carol Burnett, Amanda Whitlock, Angela White, Sarah Nelson; Mary Jane Young, Greta Whiteside, Auna Waller, Laura Savage, Lisa Breece

Research Corner By Mary Jane Lavender, Ramona McManus, Pat O’Leary, Sue Rucker, Serene Sandlin, Susan Seager Clinical decision-making by the registered nurse (RN) about patient care has been an issue since the days of Florence Nightingale. .Employers of twenty-first century nurses will seek those persons who demonstrate excellence in clinical decision-making. A major issue in nursing involves multiple levels of educational preparation including diploma, associate, and baccalaureate education. Six nurses conducted a study comparing clinical decision-making skills among diploma, ADN, and BSN Degree prepared nurses. Forty-three nurses from a medical center located in the Southeastern United States participated in the study. The instrument, Clinical Decision-Making in Nursing Scale was used in the survey. Interviews were conducted to ascertain how the nurses made decisions. This research indicates that the study of clinical decision-making behavior is vital for understanding how decisions are reached in the clinical area. The understanding of internal and external forces that influence clinical decision-making cannot be minimized. The findings reveal no significant difference in the self-perceived clinical decision-making skills of diploma, ADN, and BSN nurses. Experienced nurses make decisions based on the whole picture of the patient by evaluating the situation and setting priorities; less experienced nurses made decisions in steps, using the nursing process. Nurses from all three groups made decisions based primarily on patient needs and lastly on administrative duties. The nurses relied most on peers to assist in making clinical decisions, then physicians, and other professional personnel. All the nurses thought through the clinical problems and attempted to have two or three alternatives for decisions, if they had time. Most of the nurses felt comfortable with the type of decisions they have to make. If they were uncomfortable with any decisions, it was because of lack of knowledge. The nurses felt comfortable with resources available. All nurses weighed the value of new information but considered the source before applying it. BSN nurses tended to use books as a resource for information, while diploma nurses relied on past information. Implications from this study impact educators and nursing administration. Educators need to teach novice nursing students the application of clinical decision-making skills through additional clinical experience, emphasis on evaluation in a systematic manner, and clinical preceptor programs. Nursing Service Departments need to identify and use experienced nurses that make excellent clinical decisions as role models for less experienced nurses and nursing students. Nursing Service administrators need to prepare new graduates in acquiring the necessary decision-making skills required in managerial positions.

Delegation Attends Regional Conference Several members of the Xi Alpha Chapter attended the Regional 3 Conference, held in Austin, Texas earlier this year. Each member of the delegation actively participated in the conference. Linda Covington spoke on enhancing multicultural diversity; Susan McKinney discussed developing a strategic plan for chapters; Suzanne Prevost took an active role during the business meeting and explained how Judy Wakim forged a transcultural affiliation with Japan as partners in a comfort study; and Karen Ward, as chair of the Research Award Committee, presented the Regional Research Dissemination Award. Before closing the conference, Xi Alpha President, Ward and President-elect, Shayne Hitchcock, in addition to two Iota Chapter members, LeeAnn Busby and Sandra Walters, invited Region 3 members to Nashville, Tennessee for the next Regional conference in the year 2000. Tennessee chapters, Xi Alpha and Iota, will co-host the event.

VAMC Research Activities The department of Veterans Affairs has long been recognized as a good place to conduct nursing research. The Alvin C. York VA in Murfreesboro is no exception. Several very timely studies in which nurses are principal investigators or collaborators are addressing notable issues facing nursing and health care today. Nurses in VAMC's Mental Health program are currently conducting a funded study on the effects of telephone nursing support on schizophrenic patients. Patients receiving structured nursing telephone interventions are being compared to a control group receiving only routine phone calls (appointment reminders, etc.) on measures including quality of life, symptom intrusiveness, medication side effects and hospital recidivism. Across the VA campus, in the admission area, nurses have begun a creative study on the effects of self-care teaching on patient outcomes. This study is based upon the commonly held belief that systems such as the VA have traditionally encouraged medical dependence rather than individual self-care and self-determination. In this study, randomly selected patients who are new to the VA system are provided tools such as self-care manuals, telephone advice line information, and a baseline health risk appraisal to assist them to take charge of their own health care. They will be compared to control patients in terms of health status, health care system utilization, and patient satisfaction. Other studies in progress include measures of nurse satisfaction during times of rapid change (meaning now!), assessment of the preventative health needs of veteran patients, and several newly developing studies in the area of pain management. The VAMC welcomes nursing faculty or students who are interested in conducting research at its facility, or who would like to participate with VA nurse leaders in multi-site or collaborative studies. For more information, please contact Judith St. Onge, PhD, RN, Chief, Nursing Service or Kathy Burnham, MA, RN, Associate Chief Nursing Education at (615) 867-6118.

Sauls Awarded Scholarship The most recent recipient of the Patsy Forrest Academic Scholarship is Jenny Sauls. Sauls received recognition for her outstanding academic success at the April Induction Ceremony. Sauls, an educator in the School of Nursing at MTSU, is currently a doctoral candidate at the University of Alabama in Birmingham. The scholarship will be partial funding of her dissertation research entitled, "The Use of Ice for Pain Associated with Chest Tube Removal" now in progress at Vanderbilt University Medical Center. Citing the research priority of pain management by the National institutes of Health, Sauls wishes to test a research-based intervention that may make a difference in patient outcomes regarding pain management during and after chest tube removal. She believes it to be imperative that nurses challenge interventions utilized for so long because "that's the way we've always done it." The scholarship was initiated by the colleagues of Patsy Forrest in recognition of her loyalty, diligence, and respect for knowledge development in the profession of nursing. Sauls reflected on her positive influence, "I feel a great respect for Mrs. Forrest who molded me as a novice nursing student and mentored me as a novice faculty."

Have an Idea? Want to Volunteer? Complete the membership survey and return it to the chapter office by July 15, 1999.

Upcoming Events: Aug. 28, 1999 Breast Cancer Update, MTSU October 29, 1999 25th Annual Nursing Research Conference, Nashville, TN