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1st PNASA International Conference 2023

Date:    March 25, 2023 

Time:    8:00 AM - 3:00 PM (CST)  |  10:00 PM - 5:00 AM (PH Time)

Venue:  University of the Incarnate Word (UIW) Accelerated BSN Learning Center

              7330 San Pedro Ave, San Antonio, TX 78216, USA


              Hybrid via Zoom webinar (Only available for outside San Antonio Attendees)


       "The Nurse and Beyond: Setting a Stage for Opportunities to Align, Respond, and Belong" 

Topics and Speakers

At the Forefront of Policy and Legislative Arena: Nurses Influencing Healthcare

Andrew Smith, MA

Executive Director, Government Relations and Public Policy, University Health

Nurses and the nursing profession have been clouded with apathy and fragmentation. Nurses have somewhat been reluctant to get involved outside the four corners of the patient’s room. Nurses’ preoccupation in taking care of their patients blinded their perspectives in understanding pressing issues beyond patient care. Very recently issues such as short staffing, workplace violence, and moral injury have been in the table of discussions. The demands of the ever changing landscape of healthcare and changing needs of the patients have somehow directly and indirectly affected the profession. 

Nurses are tagged as the biggest arm in healthcare. Nurses should be able to use its power in number and influence to effect change. To be effective in this aspect, nurses should be able to develop a sense of awareness in legislation and the political arena as a whole.

Prior to joining the University Health System, Smith served as Director of Intergovernmental Relations for the City of San Antonio, from 2006-2009, and was the Federal and State Legislative Officer for the San Antonio Water System from 2000-2006.  Smith also served as a legislative aide to two Texas state representatives from 1997-2000.  

Smith, a native of Macon, Georgia, has an undergraduate degree from the University of Maryland University College, in Government and Politics, and an M.A. in Public Administration from Bowie State University (Md.).  Smith is a former United States Army field artilleryman who severed in Desert Storm with the 4th Battalion 82nd Field Artillery as a forward observer.  

Smith and his wife, Carmen, have three children:  Greer (25) a LT. Junior Grade in the U.S. Coast Guard, Hunter (22) an infantryman in the Texas Army National Guard and Miles (21) a Jr. at Texas A&M University majoring in Engineering and a jet engine mechanic in the Texas Air National Guard.  The Smith family enjoys travelling, camping, backpacking, hunting, and fishing.  They are members of San Pedro Presbyterian Church.  

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Andrew Smith has been the Director of Government Relations and Public Policy for the University Health System since February 2009.  In this position Smith is responsible for the development, implementation and coordination of an effective program of federal, state and local government relations and advocacy for the System.  Smith serves as a liaison among other medical, hospital managed care organizations and community service organizations in legislative policy and community health related issues and programs. Smith has developed strong relationships with federal, state and local governing bodies to advance the mission, vision and values of the organization. Smith collects, analyzes and develops data and other information pertinent to health care public policy and advocacy issues and shares this information with stakeholders at all levels.

Value-informed Nursing Practice: Role of Nurses in Value-Based Care

Golda Manalili, DNP, MSN, RN, RN-BC

Executive Director, 12MSU/MSE & 9 Medicine Units, University Health

Value-based care is a framework in healthcare delivery that creates and places more value to patients. Value in the context of healthcare is measured in patient’s health outcomes. Although value-based care has been conflated with quality improvement, patient satisfaction, and cost reduction, it is distinct but related to these concepts. Nurses as an important stakeholder in the framework, it is important to understand nurses significant role in the myriad of individuals and disciplines. 


Golda Manalili has 18-years of experience in nursing practice, academia, and nursing management. She holds a board certification in Medical-Surgical nursing. She is the immediate past president of the Philippine Nurses Association of San Antonio, Inc. (PNASA), and an active member of various nursing and community organizations. She is a recipient of multiple leadership, clinical and community service awards. Currently she serves as chair of the nomination committee of PNASA, and the communication and social media committee of the South-Central Texas Organization for Nursing Leadership (SCTONL). She was recently elected as the Chief Executive Officer of the Academy of Medical Surgical Nursing- San Antonio Chapter (AMSN). She completed her Master of Science degree in Nursing from Norwich University, and her Doctor of Nursing Practice degree from Grand Canyon University.

She has mentored young nurse leaders and served as a preceptor to a number of BSN and MSN students. Her units achieved the prestigious Beacon Award from the American Association of Critical Nursing and the Premier Recognition In the Specialty of Medical-Surgical (PRISM) Nursing award from the Academy of Medical Surgical Nursing (AMSN) which truly shows her support and advocacy for excellence in nursing practice.

Advancing Cultural Competency in LGBTQ Equity

Peter A. Guarnero, RN, Ph.D, MSc Clinical Research 

Associate Professor of Clinical Nursing

Director of Nursing, Pride Community Clinic, UT Health San Antonio

Nurses are faced everyday with cross-cultural broad range of clientele in terms of race, socio-economic status, religious affiliation, sexual orientation, and gender identity both in the hospital and in the community. The lesbian, gay, bisexual, transgender, and queer (LGBTQ) community has had challenging prejudices, and perceived biases affecting the quality and efficient access to healthcare. Raising awareness in the plight and healthcare needs of this group of clientele is key to creating a healthcare environment that is inclusive, just, equitable, compassionate, caring, and safe. 


Dr. Guarnero was born and raised in San Antonio, TX. He places much value in education and life-long learning. In 1976 he received his Associate Degree in Nursing from San Antonio College. He received his Bachelor’s degree in Scholastic Philosophy from St. Mary’s Seminary College, Perryville, Missouri in 1981. Come 1986, he finished his Bachelors of Science in Nursing from Loyola University, Chicago. He received a Master of Nursing in Psychiatric Nursing from the University of California, Los Angeles in 1990 and received his PhD in Nursing Science from the University of California, San Francisco in 2000. Lastly, he received a Master of Science in Clinical Research from the Graduate School, University of New Mexico, Albuquerque, NM in 2012. 

Dr. Guarnero is a published author in various peer reviewed publications. His research works has focused on the influence of family and community on the social and sexual lives of Latino gay and bisexual men. 

He worked in a variety of staff nurse positions at Santa Rosa Hospital, San Antonio, Perryville County Hospital, Perryville Missouri; Rush Medical Center, Chicago, Illinois; Neuropsychiatric Institute, UCLA; St. John’s Hospital Santa Monica, California; and Langley Porter Psychiatric Hospital and Clinics (UCSF), San Francisco, California. 

He is currently employed at the School of Nursing, UT Health San Antonio. On September 1, 2022, he was promoted to Associate Professor of Clinical Nursing. In 2017 he was appointed Director of Nursing, Pride Community Clinic, the student-faculty collaborative teaching clinic, that provides primary care to gender and sexual minority clients. 

Prior to returning to San Antonio, Dr. Guarnero was an Assistant Professor at the University of New Mexico, College of Nursing, Albuquerque, NM. 

Protecting the Carer: Understanding Moral Injury in Nursing 

Travis Johnson-Esparza, mDiv, BCC 

Staff Chaplain, University Health

The nursing profession has been beset with a number of challenges like the COVID 19 pandemic, staffing shortage, challenging team dynamics, and value conflict that affect the core of the nurses as care givers. Provision of quality and safe care to our patients entail an intact and strong being. It is high time therefore to protect the nurses as the bearer of care. 

Moral injury is not a new concept, but has recently been placed in the pedestal of discussions because of the current situation nursing and healthcare is facing. 

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Chaplain Travis is a board certified chaplain (APC) who has worked on staff with Spiritual Care Services at University Hospital since 2019. His primary interests include research-based chaplaincy, bioethics, and the intersection of psychology and spirituality. Previously, he worked with congregations going through leadership transitions; and he holds a master’s degree in behavioral neuroscience. He is married with two children, and in his spare time, he enjoys distance running and playing guitar. 

Shock Board: Trends, Innovations, and Evolving Landscape of Cardiogenic Shock Care 


Cardiothoracic Surgery Nurse Practitioner, Abiomed Clinical Instructor

Cardiogenic shock is a life threatening emergency and is a common cause of mortality. Understanding the presenting signs and symptoms distinct from other disease processes which is usually under recognized is pertinent in preventing patient demise. The management remain to be challenging despite advancement in therapeutic options. This topic will discuss up-to-date evidence-based clinical management guidelines with focus on the SHOCK Board along with understanding the evolving landscape of cardiogenic shock.


Juyoung Song is a board certified Adult Gerontology Acute Care Nurse Practitioner working with Methodist Physicians | South Texas Cardiothoracic Surgeons and Abiomed in San Antonio.

She completed her Bachelor's degree in Chemistry with pre-medical studies at University of Texas San Antonio prior to attending Texas Culinary Academy for Patisserie and Baking. After several years working in various bakeries, Miss Song returned to the medical field by attending University of Texas Medical Branch for the Accelerated BSN program. She worked at Methodist Hospital as a surgical ICU nurse prior to attending University of Texas Health Science Center for her Master's in Nursing. Her strong cardiac background led her to work as a Per Diem Clinical Educator for Abiomed and as a Cardiothoracic Surgery Nurse Practitioner.

Miss Song practices in San Antonio primarily at Methodist facilities managing cardiothoracic surgical patients and mechanical circulatory support including Impella, ECMO, IABP, LVADs. 

Poster Presentation

Poster Presentation

Competency-Based e-Learning Module for Nurses in a Multi-Service-Line Surgical Unit

Exequiel Naculangan, Jr., DNP, MAN, RN, PCCN

Patient Care Coordinator, 10 Sky

Metabolic and Bariatric Coordinator

University Health

Implementation of Behavioral Emergency Response Team (BERT): Decrease On the Job Injuries by Promoting Safety: A Pilot Program Evaluation

Leticia Flores Canchola, RN, PhD-ED, PMHN-BC

Nurse Educator III

Center for Learning Excellence

University Health

Health Care Providers’ Experience of Caring for Patients in the Hospital Dying of COVID-19: A Case Study

Lisa A. Dodge, RN, MSN

Executive Director

Patient Placement, Utilization Management, and Clinical Documentation

University Health

Advocating for Environmental Health and Environmental Justice: Imperatives and Competencies for Nurse Leaders


Vice President and Associate Chief Nursing Officer, University Health

Fellow, Alliance of Nurses for Healthy Environments (ANHE)









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