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 email@example.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 firstname.lastname@example.org. 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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