Sample Completed Fellow Application

APHON Fellow in Pediatric Hematology/Oncology Nursing Application

First Name: Last Name:

Franny APHON

E-mail:

frannymay@aphon.org

Section I Activities in Support of or Service to APHON 1. List your service as a member of the National Board of Directors. 4 points per term, if within 5 years; 3 points per term, if between 5-10 years ago; 2 points per term if more than 10 years prior maximum 15 points Position Years of Term

2. List any service as a Local Chapter President. 4 points per term, if within 5 years; 3 points per term, if between 5-10 years ago; 2 points per term if more than 10 years prior maximum 15 points Chapter Position Years of Term Central Illinois President 2018-2020 (2 terms)

3. List service as a member of an ONCC ® , CPON ® , CPHON ® , or BMTCN ® Exam Development Committee. 4 points per term, if within 5 years; 3 points per term, if between 5-10 years ago; 2 points per term if more than 10 years prior maximum 15 points ONCC Specific Exam Development Committee Years of Term CPHON test writing committee 2015-2019 (2 terms)

4. List service as APHON Committee Chair or task force chair for APHON National. (See a list of committees/task forces.) 4 points per term, if within 5 years; 3 points per term, if between 5-10 years ago; 2 points per term if more than 10 years prior maximum 15 points APHON Position Years of Term Conference Committee Chair 2018

5. List any service as a member of an APHON committee or task force. (See a list of committees/task forces). Not eligible to earn points as a chair/co-chair and member of a committee or task force in the same year. (Note: For APHON chapter membership, only service as an executive board member is eligible for this category.) Executive board members include president, VP, Sec, Treasurer 4 points per term, if within 5 years; 3 points per term, if between 5-10 years ago; 2 points per term if more than 10 years prior maximum 15 points APHON National Committee Position Years of Term Conference Committee 2017

APHON Local Chapter Committee Position

Years of Term 2016-2018

Central Illinois Treasurer

ONCC Committee Position

Years of Term

6. List participation as an invited faculty/presenter at an APHON educational offering (e.g., Annual Conference, APHON-sponsored Spring Conference, APHON sponsored webinars/e-Learning, APHON Certification Review Course for CPON or CPHON exams.) (Presentation of concurrent sessions is not eligible for points for this entry.) 4 points per year, if within 5 years; 3 points per year, if between 5-10 years ago; 2 points per year if more than 10 years prior maximum 15 points

Title

Meeting

Month/Year

7. List any service as an author of a book chapter or nursing education curriculum produced by APHON. Please see the list of eligible resources provided. 5 points per publication, points if within 5 years; 4 points per publication, if between 5-10 years ago; 3 points per publication if more than 10 years prior with a maximum of 15 Publication Specific Chapter

8. List any service as an editor or section editor of a book or nursing education curriculum produced by APHON. Please see the list of eligible resources provided. 5 points per publication, points if within 5 years; 4 points per publication, if between 5-10 years ago; 3 points per publication if more than 10 years prior with a maximum of 15 Publication Year Published

9. List any service as a reviewer for APHON for any of the following: • Manuscript review for the Journal of Pediatric Oncology Nursing (JOPHON) • Content review for any publication or presentation produced by APHON, including electronic media review. Note: If the review of content, abstracts, or manuscripts is your responsibility as a member of an APHON committee, you are not eligible to earn points for such committee work in this category as it is captured in your committee work. 2 points per instance maximum 8 points Type of Review Start/End Date JOPHON reviewed one article 2019 10. List if you have served as an editor or on an editorial board for the Journal of Pediatric Oncology Nursing (JOPHON) or APHON Counts. 4 points per term, if within 5 years; 3 points per term, if between 5-10 years ago; 2 points per term if more than 10 years prior maximum15 points for JOPHON 3 points per term, if within 5 years; 2 points per term, if between 5-10 years ago; 1 point per term if more than 10 years prior maximum 12 points for APHON Counts Publication and Role Start/End Date

11. List any service to APHON in a non-board role that furthered the mission of APHON (e.g., writing/reviewing position statements or educational products, including electronic products, for example, disease booklets). Please see eligible activities from the list provided. 3 points per activity, if within 5 years; 2 points per activity, if between 5-10 years ago; 1 point per activity if more than 10 years prior maximum 12 points Activity Start/End Date Author: Treatments of Hematopoietic Progenitor Stem Cell Transplantation 2016

12. List if you were a recipient of an award given by APHON or ONCC. Please see the list of eligible awards from the list provided.

(4 points per award, maximum 12 points)

Award

Year 2019

Jean Ferguson Excellence in Patient Education

13. List if you were a recipient of a scholarship given by APHON or ONCC. Please see the list of eligible awards from the list provided. (2 points per scholarship, maximum 12 points) Award Year Cindy Stutzer Palliative Care Scholarship 2020

14. List research or clinical grants received given by APHON. (3 points per grant, maximum 9 points) Project Title Are gastrostomy tube feeds better tolerated than nasogastric tube feeds?

Period of Grant Award

2018-2020

Section II Certification, Presentations, Publications, and Research 15. List currently held ONCC Certification(s), including CPON ® , CPHON ® , or BMTCN ® . (3 points per certification, maximum 6 points)

Credential CHPON

Year Earned

2012 2015

BMTCN

16. List abstracts presented as posters/papers at an APHON Annual Conference. (1 point per presentation, maximum 6 points)

Title

Meeting

Month/Year September 2018

Engaging adolescents in HCT education

Savannah, GA

17. List preconference and concurrent sessions given at an APHON Annual Conference or other peer-reviewed forums. (1 point per presentation, maximum 6 points)

Presentation Title Safety and efficacy of chemotherapy administration Unconscious bias in caring for children with cancer Creating a nurse led BMT survivor clinic Neuro-Oncology tips for the non-neuro-oncology nurse Impact of integrating palliative care at diagnosis of high-risk solid tumors

Meeting

Month/Year September 2019

San Jose, CA

Savannah, GA

September 2018

Savannah, GA

September 2018

Portland, OR

September 2014

Portland, OR

September 2014

18. List presentations at an APHON Local Chapter Education Meeting or other local or regional peer-reviewed forums. Industry-sponsored presentations are excluded. (1 point per presentation, maximum of 8 points)

Presentation Title Integrating palliative care for common brain tumors Self-care for nurses-Why does it matter Should palliative care consults be “routine” with a Stem Cell Transplant?

Meeting

Month/Year February 2019

Central Illinois

Central Illinois

July 2017

Central Illinois

May 2015

New treatments for JMML Central Illinois

November 2015

19. List participation as invited faculty or presenter at educational forums relevant to the specialty of pediatric hematology/oncology nursing other than APHON Annual Conference or APHON Local Chapter Education Meeting (e.g., HPNA, ONS, NAPNAP, ANCC, COG, etc.). 3 points, if within 5 years; 2 points, if between 5-10 years ago; 1 point if more than 10 years prior maximum 12 points Presentation Title Meeting Month/Year 20. List research and clinical review articles relevant to the specialty of pediatric hematology/oncology nursing published in the Journal of Pediatric Oncology Nursing (JPON) or other peer-reviewed journals. List Articles in APA 7 th Edition Format FHPON, F., Echetenkamp, D., Wallace, N., Perko, K., Hooke, M.C. (2021). Are gastrostomy tube feeds better tolerated than nasogastric tube feeds? Journal of Pediatric Oncology Nursing: official journal of the Association of Pediatric Oncology Nurses , 39 (7), 465-468. https://doi.org/10.1177/12345678910. Super, S., FPHON, F., Nurse, N. (2019). Nursing burnout in pediatric hematology oncology nursing: it doesn’t have to end here. Journal of Nursing Self Love, 3 (3), 2-5. https://doi.org/10.3456/13578024680. FHPON, F., Professor, J., Chair, M. (2017). Going to nursing school and being a full time mother is impossible! Parenting in Crisis Times, 35 (4), 120-122. https://doi.org/10.7935/1147098736589009. 3 points, if within 5 years; 2 points, if between 5-10 years ago; 1 point if more than 10 years prior maximum 12 points 21. List any book chapters or nursing education curriculum that you authored that were not produced by APHON but are relevant to the specialty of pediatric hematology/oncology nursing. List Titles in APA 7 th Edition Format 3 points, if within 5 years; 2 points, if between 5-10 years ago; 1 point if more than 10 years prior maximum 12 points 22. List any instance of being an editor or author of a book nursing education curriculum not produced by APHON but relevant to the specialty of pediatric hematology/oncology nursing. List Titles in APA 7 th Edition Format 3 points, if within 5 years; 2 points, if between 5-10 years ago; 1 point if more than 10 years prior maximum 12 points

23. List any service as a content reviewer of publications not produced by APHON but related to the specialty of pediatric hematology/oncology nursing, including electronic media. List Titles in APA 7 th Edition Format (1 point per instance, maximum 4 points) 24. List if you have served as an editor or on an editorial board for peer-reviewed journals other than JOPHON , which are relevant to the specialty of pediatric

hematology/oncology nursing. (2 points per publication, maximum 8 points)

Publication

Role

Start/End Date

25. List research or clinical grants received relevant to the specialty of pediatric hematology/oncology nursing. (3 points per grant, maximum 9 points) Project Title Granting Agency Project Dates

Section III Service Through Teaching/Mentoring

26. List any service precepting interdisciplinary learners with direct supervision provided to a student enrolled in a formal accredited academic healthcare education program. The precepting should be in a one-on-one relationship with specific goals to learn information about the specialty of pediatric hematology/oncology care and the role of the disciplines involved. One-day shadowing experiences will not be accepted. A minimum of 25 hours is required. (3 points per preceptorship, maximum 12 points)

Student Academic Level School/Program

Dates

BSN student

U of Illinois U of Illinois

2018-2019

MS/PNP student (X2)

2020 and 2021

27. List participation in a formal structured educational presentation made to laypersons (e.g., lectures to civic groups, public service announcements, radio or TV appearances). The content of the presentation must be related to the field of

pediatric hematology/oncology care. (1 point per presentation, maximum 10 points) Topic

Organization

Month/Year

Supporting siblings of kids with cancer Community support for kids with cancer and their families

Illinois School District September 2018, 2019 and 2020 Kiwanis Club of Illinois March 2018

Self-care matters

Ronald McDonald House staff Candlelighters

June 2019, 2020

Parent support group February 2018 to present 28. List any teaching award or teaching honor for services relevant to the specialty of pediatric hematology/oncology nursing. 3 points, if within 5 years; 2 points, if between 5-10 years ago; 1 point if more than 10 years prior maximum 12 points Award/Honor Group Location Month/Year Pediatric educator of the year Chicago IL January 2018

Children’s Hospital of Illinois U of Illinois School of Nursing

Outstanding pediatric clinical preceptor

Chicago, IL

March 2020

Section IV Public Service

29. List any non-APHON state or national committee or task force relevant to the specialty of pediatric hematology/oncology nursing of which you are a member. (Examples: Legislative committee or task force for state/national membership organizations, e.g., COG, ANA, NAPNAP, AAHPM, CAPC, NHPCO, PQLC, SWPN, ION, NQF, NCP, etc.) (2 points per year of service, 10 maximum points) Organization City/State Term of Service

COG BMT Committee

USA

September 2018- present

NAPNAP National Education Committee

USA

2017-2020

30. List any professional honors or awards you have received relevant to the specialty of pediatric hematology/oncology nursing from sources other than APHON. (2 points per activity, maximum 6 points) Award/Honor Group Location Month/Year

Section V Statement of Contributions and Impact

This section provides you an opportunity to succinctly describe how your leadership and unique contributions have impacted the field of pediatric hematology/oncology nursing. Please be as specific as possible when providing data to support the impact of your work; remember that the events described in this section must align with your CV. (600- word max. I received my BSN in 2005 and spent three years in general pediatrics. I will always remember the first time I floated to the pediatric hematology/oncology unit. I was initially overwhelmed and by the end of my 12-hour shift, thought “this is where I belong”. I transferred to the Pediatric Hematology/Oncology Unit and have never looked back. My initial position was working on a general hematology/oncology unit. I had an amazing mentor, Susie Super, who encouraged me to become involved with APHON. I joined our local chapter in 2009 and remain an active member. I was elected treasurer and served for two years (2016-2018); and president of our Central Illinois Chapter from 2018-2020. I became involved in national APHON through my local chapter experience and have served as a committee member and chair of the Conference Committee. I look forward to continued involvement in national APHON. Again, thanks to my amazing mentorship, I took the CPHON exam in 2012 and BMTCN in 2015. I have maintained my certification since that time and have encouraged other staff nurses to become certified. One of my roles on our unit is the (unofficial) ambassador for certification. I am proud to have been an item writer for the CPHON exam for two terms from 2015 to 2019. Recognizing the importance of evidence-based education and my emerging clinical expertise, I focused on sharing my knowledge. I have presented at our local chapter meetings and at the APHON yearly conference. I received the Pediatric Educator of the Year Award from our Children’s Hospital in 2018. I have authored three articles for JOPHON. In addition to my passion for educating our colleagues, I have also had the opportunity to hone my skills in educating patients and families. In collaboration with three interprofessional colleagues, our new diagnosis notebook was updated and adapted for online use. I received the APHON Jean Ferguson Award in 2019 for this work.

Recognizing the important role mentorship has played in my career, I am

committed to paying it forward. I have mentored both BSN and MSN/PNP students from the U of Illinois and recently received the Outstanding Pediatric Clinical Preceptor from the University of Illinois. Acknowledging the nurse’s role in clinical research, I applied for and was awarded an APHON Evidence Based Practice grant in 2018 to assess adolescent preference for Nasogastric vs Gastrostomy tube feedings during cancer treatment. Finally, the importance of advocacy as a nurse has compelled me to bring the voice of our patients and colleagues to the community. To that end, I have presented to the Illinois School District and the Kiwanis Club. I have spoken on the importance of self-care to the Ronald McDonald House staff and help facilitate a Parent Support Group for Candlelighters.

Thank you for your consideration.

Section VI Statement of Future Engagement

Please describe how your significant contribution(s) supports the mission of APHON and how you will continue to uphold advancing pediatric hematology/oncology care if named an APHON Fellow. (300-word max)

I am passionate about the general pediatric hematology oncology nurse and building mentorship to sustain the profession by addressing educational needs and self-care. I have thoughtfully identified areas where I may serve the organization and advance pediatric hematology oncology nursing practice. I am passionate about education. I have contributed to several APHON publications and would be interested in continuing this work as well as developing patient and family education tools for home care. My EBP grant resulted in the creation of enteral feeding education tools and was accepted for publication in JOPHON. Many institutions have such handouts, as well as some information in the COG Handbook, and I envision these documents being evidence based APHON endorsed tools for families. This would provide standardized tools that can be customized for institutions. This work would specifically address comprehensive care, partnerships in care between the health care team and families, honoring child/family preferences in care, access to community resources, and providing the full range of services needed in home care by families. I have an established voice in my local area through several community-based organizations. I would like to become more involved at the national level by representing APHON, for example in ONCC, the Alliance for Childhood Cancer, or similar opportunities, to highlight the voice of the bedside clinician in optimizing care for children with cancer and blood disorders through certification and advocacy. One specific area of interest includes mentoring initiatives for pediatric hematology oncology nursing so that the nurses’ voice is heard, honored, and respected. I am also very interested in the Self Care Task Force and have applied to be a member. By recognizing and addressing the needs of staff nurses, as well as advanced practice nurses, APHON can mitigate burnout and compassion fatigue to allow for sustainability of the profession.

Total Point Self-Report Your Point Totals Below

Section

Total Points

42

Section I – Activities in Support of and/or Service to APHON

25

Section II – Certification, Presentations, Publications, Research

25

Section III – Service Through Teaching/Mentoring

10

Section IV – Public Service

Section V – Statement of Contributions and Impact Section VI – Statement of Future Engagement

Total Point Count _102

Application Attestation I certify that the information provided in this application accurately represents my professional status and experience. Furthermore, I recognize that any falsified information may lead to the revocation of my Fellow status. I also understand that the application fee is non-refundable, regardless of the outcome of the application process. I acknowledge that Fellow status is granted at the sole discretion of the Association of Pediatric Hematology/Oncology Nurses Board of Directors and includes many variables, including but not limited to the contents of this application. By typing my name below, I am electronically signing my application, and this will be considered the same as a written signature.

Frannie APHON

Date

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