Have you ever wished… by wuxiangyu

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									                                                                                                                                               Have you ever




                                                                                                                  www.angelnames.org
                                                                                                                  Saratoga Springs, NY 12866
                                                                                                                  PO Box 423
                                                                   June 4, 2011                                                                wished…
                                                                NYSNA Headquarters
                                                                  11 Cornell Road                                                                 You knew what to say at the most
Empty Arms,
                                                                    Latham, NY
Sh atter ed Dr eams
                                                                                                                                                   difficult times?
Registration deadline: Wednesday, June 1, 2011
REGISTRATION OPTIONS
                                                                                                                                                  You had the tools to provide inten-
      Follow the link at www.angelnames.org to register online                                                                                    tional, compassionate care?
      Complete the registration form below and return it to ANA, PO Box
       423, Saratoga Springs, NY 12866
      Email your completed registration info./form to mgmosca@msn.com
                                                                                                                                                  You could truly make a difference?
      Call ANA at 518-654-2411 and leave your registration info.


    NYSNA Member ID#: ____________________________
                                                                                                                                               Empty Arms,
    Name:_________________________________________                                                                                             Shattered Dreams
    Home Address:__________________________________
    _______________________________________________
    City/State/Zip:___________________________________
    Home Phone:_(___)______________________________
    Cell Phone:_(___)________________________________
    Business Phone:_(___)____________________________
    E-mail address:__________________________________
    Facility:_________________________________________


    Registration Fee: $79*
    *Includes breakfast, lunch & refreshments
                                                                                                                                                    Caring for Fami lies During
                                                                                                                                                      and After Perinatal Lo ss
    Payment Method
    Check payable to ANA                                                                                                                      Fe atu rin g    in te rn ati on all y   acclaimed
    Visa American Express                                MasterCard                  Discover
                                                                                                                                               speaker and author S h e r o k e e Il se !
    Card Number:_________________________________________
    Expiration Date:____________________ *CVV#:_____________
                                                                                                                                                               June 4, 2011
    Name (print):___________________________________________
                                                                                                                                                   5          NYSNA Headquarters
    Signature:____________________________________________
    Date:________________________________________________
                                                                                                                                                CH’s            11 Cornell Road
    *CVV is the three-digit number (following the full credit card number) printed on the signature area on the
                                                                                                                                                                  Latham, NY
    back of VISA, MasterCard and Discover credit cards; it is a four-digit number printed on the FRONT of
    American Express credit cards (above the card number on the left or right).

    Please detach and return to Angel Names Association, PO Box 423, Saratoga Springs, NY 12866.
                                                                                                                                                        Registration—8:30 to 9:00 a.m.
                                                                                                                                                       Workshop—9:00 a.m. to 3:00 p.m.
                             Empty Arms, Shattered Dreams—Caring for Families During and After Perinatal Loss
    ABOUT THE PROGRAM                                                                                                                                             R E GI S T R A T I O N IN F OR M A T I O N
                                                                                  T O PIC S T O BE CO VERE D
WHO S HO UL D A T T END                                                           The anguish of loss                                                             When:         June 4, 2011 (Saturday)
This full-day program is designed for healthcare professionals,                         The role of love, hope and preparation on the human condition of grief
                                                                                                                                                                                                                                      5
                                                                                                                                                                  Where:        NYSNA Headquarters
including nurses; midwives; obstetricians and gynecologists and their
staff; emergency room, labor and delivery, and pediatric staff; EMT’s,
                                                                                        Parents’ feelings and needs
                                                                                                                                                                                11 Cornell Rd.                                     CH’s
and all who provide services to expectant and birthing families.
                                                                                  Compassionate caregiving
                                                                                        Your role in caring for and about others                                               Latham, NY
PU RPO SE                                                                               Attitude as the key to healthy, compassionate care
                                                                                                                                                                  Time:         8:30 to 9:00 a.m. Registration with light breakfast
The program is designed to improve the confidence and tools that                        Basis for relating to families
                                                                                                                                                                                9:00 a.m. to 3:00 p.m. Program*
health care providers need as they seek to give compassionate,                          Protectionism
intentional care for families experiencing miscarriage, stillbirth, neo-          Ways to take care of oneself
                                                                                                                                                                                *Lunch and refreshments included
natal, and early infant death. Identification of patients’ needs and
desires and positive, effective communication will be key focus areas.                  Body, emotions, spiritually                                              Fees:         $79 in advance, $89 at the door
                                                                                  Intentional preparation
                                                                                        Trained and ready                                                        Registration
PRO GRA M O BJE CT IV ES                                                                Patient-based Care with Intention vs. Medical-based Standard of Care     Deadline: Wednesday, June 1, 2011
Upon completion of the program, participants will be able to:
 Describe the grief process of pregnancy and perinatal loss, and                       Communication, compassion & consistency
    the parents’ needs and wants.                                                       Resources, referrals & follow-up                                         Due to insurance issues, children are not allowed on the premises during the
 Identify what compassionate caregiving is.                                      Ways to slow the process                                                        workshop.

     Identify ways to take care of oneself.                                            Help at the time of shock and disbelief                                  * All attendees must have photo ID to enter the building.

     Describe Intentional Preparation.                                                 Preparation, birth plan/care plan

     Define ways to slow the loss process and the importance of a                      Staff/parent advocate contact                                             Space in this program is limited. Registrations will be accepted
                                                                                                                                                                   on a first-come, first-served basis. A $50 administrative fee will
      birth plan.                                                                       The “goodbye” planning                                                    be deducted for cancellations received one week before the
     Identify tests that occur during the autopsy.                               Identify tests that occur during autopsy                                         event. NYSNA reserves the right to cancel this program if a
     Define some of the practical concerns that may arise.                             Options                                                                   sufficient number of participants are not registered, in which
                                                                                                                                                                   case the entire registration fee will be refunded.
                                                                                        Permission & Informed consent
5.0 contact hours will be awarded for this program. In order to receive con-            Discussing with parents
tact hours, participants are required to attend the entire session and complete
                                                                                        Autopsy results                                                          Register using one of the following methods:
an evaluation.
                                                                                  Practical concerns                                                                     Online: Go to www.angelnames.org, click on the link
T HE S PEA K ER                                                                         Options pros/cons                                                                for the Empty Arms, Shattered Dreams CE Program.
S H E R O K E E I L S E is an author and international speaker on pregnan-              Importance of memories
                   cy loss and infant death, and the mother of three children                                                                                            By Email: Email completed registration form, or a
                   who died during pregnancy. She has presented thou-                                                                                                     message that includes the information requested on
                   sands of workshops in the US, Canada, Australia, NZ,                                                                                                   the form, to mgmosca@msn.com.
                   UK, and Japan. She is a guest lecturer at Vanderbilt,
                   Yale, William Beaumont, and the University of MN, and a                                                                                               By Phone: Call the ANA home office at 518-654-2411
                   visiting instructor at Georgetown University. Sherokee is          The New York State Nurses Association is accredited as a provider of                and leave a message with the information requested
                   the co-founder of the former Pregnancy and Infant Loss                                                                                                 on the registration form.
                                                                                      continuing nursing education by the American Nurses Credentialing
                   Center, and President of Wintergreen Press and Babies
                                                                                      Center’s Commission on Accreditation.
Remembered. She has served on the Board of the International Stillbirth                                                                                                  By Mail: Mail completed registration form and pay-
Alliance, and is a Board member of the National Health Federation. She is                                                                                                 ment to ANA, PO Box 423, Saratoga Springs, NY
the author of several publications and is best known for her book “Empty
Arms: Coping with Miscarriage, Stillbirth and Infant Death”. She has been a
                                                                                                                                                                          12866.
                                                                                                             Declaration of Vested Interest: None
guest on Oprah, Donohue, Home Show, and other national, regional, and
local programs. Sherokee attained a BA degree in psychology and sociolo-
                                                                                      NYSNA and ANA wish to disclose that no commercial support was received.
gy as well as a teaching certificate from Hamline University.

								
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