2018 AWHONN Convention Program Committee Application

2018 AWHONN Convention Program Committee Application

Instructions: Deadline – August 9, 2016

Application Forms:

-Application Form

-Signed copy - of the Conflict of Interest Form

-Signed copy - Principles for Ethical Governance Document

-Applicant’s current CV or Resume

Application Packet should be sent by e-mail to Donna Ruth at

For questions call Donna Ruth at 615 646 1328

Demographic Information

Name of Applicant:AWHONN Membership Number:

Credentials:(highest degree earned, licensure, national certifications)

Preferred address, please indicate if this is a home or work address:

Home phone:Work phone:Cell phone:

E-mail Address:

Work title/Current role:

Name of Employer:

Optional – AWHONN encourages and promotes diversity with the organization and profession. Please assist us in this endeavor by indicating the ethnic group with which you most closely identify. ______

Additional Information

1. Which of the following conventions have you attended? Check all that apply

_____ 2012 Washington DC_____ 2013 Nashville

_____ 2014 Orlando _____ 2015 Long Beach

_____ 2016 Grapevine (Texas) Others (please list years)

List any other non-AWHONN conventions/educational conferences you attend on a routine basis:

1. What is your primary work focus and expertise? Check all that apply

_____Antepartum_____Administrative

_____Postpartum _____Academic/School of Nursing

_____Mother/Baby_____Informatics

_____Labor and Delivery _____High Risk Obstetrics

_____Women’s Health/GYN_____Newborn

_____NICU_____Ambulatory Care

_____Lactation consultant_____Other (please list)

1. Please identify any other AWHONN volunteer activities you have participated in.

Check all that apply.

_____Section/Chapter leader_____Emerging Leader program

_____FHM instructor_____Science team member

_____Editorial Board for Journal_____Public Policy Committee

_____Board of Directors_____Reviewer for Journal

_____Research Advisory Panel _____Other Advisory Panel

_____Other

1. Focusing on the educational program, what is done well at the AWHONN convention?

1. What opportunities do we have to improve the educational component of the convention?

1. Why do you want to serve on the AWHONN convention committee?

______

AWHONN - POLICIES ON AVOIDANCE OF CONFLICT OF INTEREST, LOYALTY AND

CONFIDENTIALITY AND COPYRIGHT ASSIGNMENT

Conflict of Interest

AWHONN recognizes that talented and energetic people often are called upon by various organizations to perform many roles. Thus, actual or potential conflicts of interest often arise, without fault of the person. However, both individuals and organizations have obligations to address these conflicts of interest in a forthright and proper manner.

A potential or actual conflict of interest exists if an AWHONN officer, or director; advisory panel, committee or task force member; section or chapter leader; employee or other appointee ("AWHONN Personnel") might reasonably lack objectivity in their decision making or performance for AWHONN, because of any personal, professional, financial or other interest or relationship they have. A non-exhaustivelist of the kind of situations which can give rise to conflicts of interest include situations in which:

1. AWHONN Personnel serve as officers or board members for other professional associations those policies or goals may diverge from those of AWHONN.

2. AWHONN Personnel are offered personal business opportunities which might otherwise be opportunities of AWHONN, or are asked to make decisions forAWHONN on business opportunities that might otherwise become their own personal opportunities (such as contracting to prepare a book or monograph).

3. AWHONN Personnel are involved in businesses that compete with AWHONN.

4. AWHONN Personnel desire to contract to provide goods or services to AWHONN.

5. AWHONN Personnel are asked to make decisions for AWHONN with respect to dealings with persons with whom they have substantial personal, professional,financial or other relationships.

Total avoidance of any potential conflict of interest, however remote or tenuous, is not a realistic goal. However, it is the responsibility of all persons in their AWHONN roles: (1) to disclose and raise for consideration any significant potential or actual conflict of interest, (2) to avoid any significant actual conflict of interest, and (3) to abide by decisions that are made by the designated AWHONN authorities (Chief Executive Officer or Board of Directors) concerning such matters.

If any AWHONN personnel believe that a conflict of interest may arise or exist with respect to themselves or another person, at the earliest possible date they should disclose the relevant facts of the situation to (a) the chief executive officer in the case of an employee, (b) the President, in the case of an officer or director (and the Chief Executive Officer in the case of the President), or (c) the President, in the case of committee members, section or chapter personnel.

The matter shall be resolved by the Chief Executive Officer or the Board (by majority vote) as the case may be.

If an appropriate set of conditions for accommodating the potentially conflicting activity cannot be agreed upon, the AWHONN personnel will be asked to refrain from the activity. Refusal or failure to abide by a decision regarding a significant conflict of interest may result in sanctions to an employee (consistent with AWHONN's employment policies), or to other AWHONN personnel (consistent with AWHONN's Bylaws).

Any time a advisory panel, committee or task force member, Board member, or officer of AWHONN becomes aware of a possible conflict of interest relating to a matter raised for discussion at a meeting, she or he should promptly disclose the potential conflict on the record and abstain from all discussions and votes on the matter(s) in question. Conflicts concerning section or chapter personnel should be resolved by analogous procedures.

An appropriate level of confidentiality shall be accorded to information developed in the course of review of potential conflicts of interest, and disclosures of such confidential information should only be made to the extent needed to resolve the matter or properly to conduct Association business.

Loyalty and Confidentiality

Consistent with law and recognized practice of non-profit organizations, AWHONN employees or persons who serve on AWHONN’s Board, advisory panels, committees, task forces or in leadership roles are obligated to respect their duties of loyalty and confidentiality. In the course of their work, they may become aware of confidential or proprietary information of AWHONN. This may relate to matters such as, but not limited to, AWHONN finances, legal matters, businesses, programs or plans, publications, employee matters, relations with other organizations, membership lists or sponsor lists. Persons may use such information only in order to perform their AWHONN roles. They may not, during or after performing their roles within AWHONN, use that information for their own advantage, or disclose it to others without clear (usually written) authorization of AWHONN. In addition, unless there is a written agreement to the contrary, all reports or material written for AWHONN remain its property.

Assignment of Copyright

I understand that in the course of my work as an AWHONN officer, director, advisory panel, committee or task force member, section, or chapter leader, employee or other appointed or elected position, documents may be produced by me (or a group of which I am a member) in the course of the appointment and that these documents in draft and final form are works for hire, or are otherwise the property of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). Further, in consideration of my being an elected or appointed member as noted above, I hereby assign to AWHONN the ownership of copyright in such works, whether published or unpublished. I further agree upon request to execute such specific assignments or instruments and take any action necessary to enable AWHONN to secure its copyright.

Conflict of Interest Disclosure (Refer to the Policy of Avoidance to Conflict of Interest)

I am associated with the Association of Women's Health, Obstetric and Neonatal Nurses in the following capacity. (List all current AWHONN positions, including allied organizations you serve on or act as a member or representative of AWHONN).

______

I am associated with the following organizations related to nursing or the health care of women and newborns as a member of the board of directors, committee, advisory panel or editorial board. (List name of organization, position you hold and term):

______

To my knowledge, my employer or other organizations with which I am involved have no significant dealings with AWHONN and are not significant competition of AWHONN, except as noted below:

______

To the best of my knowledge, neither I nor any member of my immediate family has a significant financial, personal, professional or other interest or relationship that conflicts with or might reasonably appear to conflict with my AWHONN activities, except as follows:

______

The preceding information is accurate. If new circumstances arise that reasonably might be viewed as creating a significant conflict, I will act in accordance with AWHONN’s Conflict of Interest Policy.

______

Signature Date

______

Please print or type full name Position title

AWHONN PRINCIPLES FOR ETHICAL GOVERNANCE

Framework

AWHONN is a nonprofit charitable/educational organization dedicated to promoting excellence in nursing practice, education and research in the areas of women’s health, obstetric and neonatal health. As an organization, AWHONN is committed to maintaining a governance structure and process that is open, fair, honest, respectful, responsible, and accountable. AWHONN’s governance process must comply with applicable law, AWHONN’s Articles of Incorporation and Bylaws, and policies adopted by the Board of Directors.

Certain recent laws and standards relating to governance of publicly held for-profit companies (such as the SarbanesOxley Act) for the most part do not apply to non-profit organizations such as AWHONN. Nevertheless, they reflect public expectations that all large organizations will seek to implement more careful and accountable governance processes. In this context, AWHONN has undertaken to confirm certain commitments through these Principles for Ethical Governance. It should be emphasized that these Principles are designed to confirm the values that underlie AWHONN’s governance processes. They are not intended to replace or preempt the more specific allocations of roles and obligations that are described in AWHONN’s Bylaws, in Board policies, in charges to various committees, or in other AWHONN governance documents.

It is intended that these Principles govern all persons who agree to participate in AWHONN's governance, including: Board members, committee or task force members, persons elected to AWHONN positions, persons who hold positions in the governance of AWHONN Sections, and AWHONN staff. (People in these roles are referred to as “Officials.”) AWHONN employees, of course, have an overriding obligation to comply with established reporting relationships and employee policies as well.

Principles

1. Duty of Care. The overarching obligation of all AWHONN Officials is to exercise an appropriate level of care and effort in fulfilling the roles they have agreed to assume. This obligation includes the duties to: prepare for meetings by reviewing materials; be informed on issues within the areas for which the Official has responsibility; to ask questions and respectfully challenge unclear or problematic information; and to use sound judgment in decision-making. The Duty of Care also requires that Officials attend scheduled meetings on a reasonably reliable basis, in accordance with AWHONN rules. Ultimately, it is the responsibility of the Board of Directors to exercise active oversight of AWHONN finances, programs and activities. In addition, AWHONN Officials should strive to help protect and advance its interests. Thus, an Official who learns of situations or practices that are contrary to the interests of AWHONN, or women’s and infants’ health, should bring them to the attention of the AWHONN Board.
2. Duty of Loyalty. People who are accomplished enough to be elected or appointed to leadership positions in a national organization such as AWHONN often have other positions, roles, and affiliations. However, both as a legal matter and as a matter of good governance, it is their obligation when they are performing a role within AWHONN, to place its interests above any other interest they may have. They must abide by AWHONN’s “Policy on Avoidance of Conflicts of Interest, Loyalty, and Confidentiality,” which provides more specific guidance. But in general, Officials must: (a)disclose to the relevant body (Board, Committee or staff supervisor) any significant, actual or potential, personal or professional, role or interest that might reasonably be viewed by others as compromising the proper and objective performance of their AWHONN role; and (b)withdraw from participating in any decision or matter in which they have such a conflict unless their participation is consented to by the appropriate AWHONN Official or body. In addition, Officials may never take advantage (on behalf of themselves or others) of an opportunity that originated with AWHONN and from which AWHONN itself could otherwise benefit. In common sense language: an Official should place the interests and welfare of AWHONN first when he/she is wearing the AWHONN “hat.”
3. Confidentiality. In the course of performing roles for AWHONN, Officials often receive confidential information about AWHONN (such as business or publishing plans) or about individuals (such as staff). They must not disclose such information except if it is necessary to perform their AWHONN role or if they have been properly authorized to do so.
4. Respect for Governance Roles. A national organization such as AWHONN can only function because of the selfless devotion of many people to serving in a variety of governance roles. The allocation of responsibilities among the Board, Committees, Sections and staff is described in AWHONN’s Bylaws and policies. Officials should respect and adhere to these defined roles. For example, the fundamental roles of the Board are to establish broad goals and policies, approve budgets, and exercise oversight. The fundamental roles of staff are to implement policies and programs, manage day-to-day activities, and to keep the Board informed of important information. Neither Board members nor staff should seek to assume the roles of others.
5. Avoiding Misuse of AWHONN Position. No Official should use his/her AWHONN position to obtain some improper advantage or pursue some private interest. (For example, it would be improper for an Official who had a dispute with a vendor to the hospital in which she was a Director of Nursing to try to cause AWHONN to refuse to deal with that vendor or to adopt a policy directed against its products.) However, accurately sharing with colleagues in AWHONN information learned in practice would be customary and not improper.
6. Clarifying When One Speaks for AWHONN. In a variety of contexts, persons may write letters, give presentations, or attend meetings in which their private job or accomplishments, and their AWHONN role, may both be apparent. Unfortunately under legal doctrines such as “apparent authority,” some parties may claim (fairly or not) that they understood the person to be speaking for AWHONN. Therefore, Officials should always take reasonable measures to make clear when they are speaking for themselves, and when they have been properly authorized to speak on behalf of AWHONN.
7. Finances. All officials must comply with AWHONN’s financial policies and limitations, as described in the Bylaws, budgets or other policies. But in general: (a)the Board has an obligation to see that AWHONN operates within its available or realistically-projected revenues; (b)Officials in charge of programs or activities should adhere to budgets (unless appropriate authority is obtained to depart from a previously approved budget); and (c)any official who has custody of AWHONN funds should take due care to protect such funds and to maintain proper records of revenues and expenses. As a matter of policy, AWHONN retains an independent accounting firm to prepare annually accurate, audited financial statements.
8. Financial Dealings with AWHONN. Officials should disclose any material financial interest they or immediate family members have (excluding holding of stock or other interests in public companies) in any entity (a)that does business with AWHONN, or is directly and materially affected by AWHONN, and (b)regarding which the Official is asked to participate in an AWHONN decision.
9. Meetings. AWHONN's Bylaws and policies include certain requirements for notices of meetings and the matters on the agenda; all Officials should comply with those policies. But at a minimum: (a) there should be a written agenda for each meeting; (b) the meeting should be confined to items on the Agenda, or new business duly raised and recorded in the minutes; (c)the minutes should reflect all important matters discussed or decisions made at a meeting; and (d)inappropriate matters (personal gossip, personnel matters, personal health issues) should not be discussed in AWHONN meetings.
10. Publications. AWHONN maintains detailed policies governing various kinds of publications. Officials should comply with those policies. But in general, Officials should strive to ensure that any AWHONN publications with which they are involved: (a) are researched and written in accordance with generally recognized professional standards; (b)are accurate and balanced; and (c)avoid libelous or inappropriate material.
11. Mutual Respect. AWHONN is a large and diverse organization. AWHONN’s members and Officials naturally disagree on many issues about which they may feel strongly. Nevertheless, all communications utilizing AWHONNsponsored media (such as meetings, web-based media and publications) should be professional and respectful in tone and content.
12. Public Policy and Governmental Representation. Because of the collective expertise and hard work of its members and staff, AWHONN has established credibility among governmental and other policymakers. This is a valuable asset to be protected, so that AWHONN can continue to advocate effectively for women’s and infants’ health in Congress, federal agencies, state governments, and elsewhere. In order to maintain AWHONN’s credibility, it is essential that Officials who are involved in governmental communications and representation (including but not limited to lobbying) on AWHONN’s behalf observe certain guidelines. Among these are the following:

(a)An Official should communicate with government personnel on behalf of AWHONN only when authorized by the appropriate AWHONN officer or body.

(b)All communications to governmental personnel should be respectful, professional and accurate.

(c)Policy recommendations that have obvious and essential legal premises or implications should be reviewed with counsel beforehand whenever feasible.

(d)While communicating with governmental personnel on behalf of AWHONN, Officials should confine themselves to expressing accurately AWHONN’s positions– and should not express their own personal views if they differ.

(e)If Officials are unexpectedly called upon (such as in a meeting or a hearing) to respond to inquiries from governmental personnel on issues outside those on which AWHONN has established policy, they should either decline or clearly state that they are expressing only their own personal views.