february 2012 volume 21 • number 1 nevada ... · and a new credential, secret to becoming a...

current resident or

Presort StandardUS Postage

PAIDPermit #14

Princeton, MN55371

Nevada RNFORMATIONTHE OFFICIAL PUBLICATION OF THE NEVADA NURSES ASSOCIATION

Free to All Registered Nurses, Licensed Practical Nurses, & Nursing Students in Nevada: Quarterly Circulation 30,000

Ph

oto

cou

rtes

y of

th

e O

klah

oma

Nu

rses

Ass

ocia

tion

Focus this issue:The INITIATIve ON The FuTure OF NursINg

Nursing continues to change.What will it mean for Nevada nurses?

February 2012 www.nvnurses.org Volume 21 • Number 1

MeeT NevADA’s Nurses:

KIT LANDIs & sheLBY huNT Nurse herOes OF ThereNO AIr rACe DIsAsTerreALITY CheCK

Is The NursINg shOrTAge A MYTh? Where Are The JOBs FOr NeW grADuATes?

Mark Your Calendars!

Nurses NIghT AT The reNO BIghOrNs MArCh 17

IFNN PrOFessIONAL PrOgressION DINNer/DANCe MAY 12

NNA sTATe CONveNTIONgrAND sIerrA resOrT reNO OCTOBer 5-6

hOW DO We

ChANge The

IMAge OF

NursINg?

• nevada Rnformation February, March, April 2012

Published by:Arthur L. Davis Publishing Agency, Inc.

www.nvnurses.org

NNA Mission statementThe Nevada Nurses Association promotes professional nursing practice through continuing education, community service, nursing leadership, and legislative activities to advocate for improved health and high quality health care for citizens of Nevada.

NNA state Board of DirectorsJanice Muhammad RN, CNM, MS [email protected] . . . . . . . . PresidentScott Lamprecht, DNP, MSN, RN [email protected] . . . . . . . President-ElectDenise Ogletree-McGuinn, RN, MS, MEd, APN, PNP [email protected] . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Vice-PresidentNicola Aaker, MSN, MPH, RN, CNOR, PHCNS-BC [email protected] . . . . SecretaryPam Johnson, RN, BSN [email protected] . . . . . . . . . . . . . . . . . . . TreasurerKathy Ryan, MSN, RN [email protected] . . . . . . . . . . . . . Director at LargeMary Brann, DNP, MSN, RN [email protected] . . . . . . Director at LargeSusan Growe, MSN/Ed, RN, OCN, [email protected] . . . . . . . . . Director at Large Sandy Olguin, MS, RN [email protected] . . . . . . . . . . . President, District 1Elizabeth Fildes, EdD, RN, CNE, CARN-AP [email protected] . . . . . . . . . . . . . . . . . . . President, District 3 Tomas Walker, RN, MSN, APN, CDE [email protected] . . . . . . . . . . . . . . . . . . . . APN Co-Chair, Southern NevadaJackie Alexander, DNP, APRN, FNP-BC, AE-C [email protected] . . . . . . . . . . APN Co-Chair, Northern NevadaDoreen Begley, RN [email protected] . . . . . . . . . . . . . . . . . Legislative Co-Chair

editorial Board

Editor: Margaret Curley, RN, BSN [email protected]

John Buehler Garcia, RN, BSN Janice Muhammad, RN, CNM, MSEliza J. Fountain, RN, BSN Betty Razor, RN, BSN, CWOCNWallace J. Henkelman, Ed.D, MSN, RN Denise Rowe, MSN, RN, FNP-CMary Baker Mackenzie, MSN, RN Kathy Ryan, MSN, RNJohn Malek, PhD, MSN, FNP-C Debra Toney, PhD, RN

Are you interested in submitting an article for publication in RNFormation? Please send it in a Word document to us at [email protected]. Our Editorial Board will review the article and notify you whether it has been accepted for publication. Articles for our next edition are due by March 1, 2012.

If you wish to contact the author of an article published in RNFormation, please email us and we will be happy to forward your comments.

For advertising rates and information, please contact Arthur L. Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216, Cedar Falls, Iowa 50613, (800) 626-4081, [email protected]. NNA and the Arthur L. Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement.

Acceptance of advertising does not imply endorsement or approval by the Nevada Nurses Association of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. NNA and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of NNA or those of the national or local associations.

Become Your Own Boss and LOVE Your NEW Nursing Career

www.nursingsuccesssystem.comFor my FREE Special Nursing Report visit me online

New Career for Nurses, 3-Day Certification Course,

Receive continuing education creditand a new credential,

Secret to Becoming a 6-Figure Nurse Revealed Here

“America’s Favorite Nursing Educator”Tracy McClelland Enterprise, Inc Nursing Success System

1214 North Peterson Ave Suite PDouglas, GA 31533

[email protected]

Did you know...

Bryan Land Agency, LLC2300 W. Sahara Ave., Suite 800

Las Vegas, NV

www.bryanlandagency.com

• A woman is more likely to both be a caregiver for a loved-one and also require a caregiver in her lifetime?

• More than 70% of nursing home residents are women? • 71% of American workers would find it difficult to meet their

financial obligations if their next paycheck was delayed for even one week?

• Most people who have had a disability for three months or more did not think it would happen to them?

• Your benefits from your job might not be “portable”, meaning you don’t keep them if you leave your employer?

Let us help you review your Long-Term Care, Disability and Life insurance policies to ensure you have the

protection you deserve.

For a complimentary, no obligation guide to these

benefits, please email [email protected]

or call 702-856-4530

Law Offices of Tracy L. Singh, LLC

Now offering online scheduling! For direct access to our calendar, find us at www.schedulicity.com.

Phone: (702) 444-5520 • Fax: (702) 444-5521Mailing Address: 8635 W. Sahara Ave #437 • Las Vegas, Nevada 89117

Email: [email protected] • Website: www.tlsinghlaw.com

•Disciplinary Actions•Self Reports/Complaints•Applications/Renewals•Settlement Negotiations•Hearings/Appeals•Databank Disputes•Probation Support•Unprofessional Conduct

•DUI/Criminal Convictions•Chemical Dependency/ Diversion•Fraud/Falsification of Records•Abuse/Neglect of a Patient•Standards of Practice•& More

Stress Reduction is our Business

Licensure Defense for all Nevada Healthcare Providers

Tracy L. Singh, RN, JD

Registered NursesMGGH is located in the small friendly, affordable

community of Hawthorne and we are a well-staffed rural Nevada Hospital and LTC Facility,

emphasizing quality care!

Great Benefits Call Today!Current NV license or ability to obtain one preferred.

Fax Resumes to 775-945-0732 ATTN: Mt. Grant General Hospital HR Dept

or Email Resumes to [email protected] call collect 775-945-2461 for more info.

Join the Nevada Nurses Association today!

Application on page 22 or join online at

www.nvnurses.org

February, March, April 2012 Nevada RNformation •

MEET NEVADA’S NURSESWhen an airplane crashed into the spectator seating at the Reno Air Races on Friday, September 16, 2011, the expertise and professionalism of many Reno nurses saved lives. In this issue, we present the stories of two outstanding Nevada nurse heroes, Kit Landis and Shelby Hunt.

7

In this issue focus12 Initiative on the Future of Nursing

aprn practice

19 Regulatory Changes Propel Advanced Practice Nurses in Nevada Toward Nationally Standardized Practice

articles5 Clark County Alzheimer’s Action Network

5 Challenge to Homeopathy

8 Nevada’s Safe Staffing Law

8 Justice Is Served

9 Avoid Malpractice and Protect Your License: Impaired Practice

16 Student Corner: Bullying

16 Saint Mary’s Receives Federal Funding for Transition to Practice Program

17 Employment for New Graduate RNs: Is the nursing shortage a myth?

18 Palliative Care Nursing

18 Olive Oil and Strokes

18 New Treatment for Head Lice

regular features4 Message from President Janice Muhammad

6 District 1 President’s Report

6 Inside NNA

20 Editorial

21 Check It Out!

social media discussion21 How Can We Improve the Image of Nursing?

17

9

6


Dear Colleagues,It is in the midst of the Holiday Season that this message has been penned;

however by the time you read this, the New Year will be well underway. The NNA had an active past year and looks forward to increasing capacity to accomplish even more in 2012. The Board and Districts are gearing up to provide programs for nursing in a wide variety of interest and substance. Your suggestions are needed and welcomed.

Substantive issues the NNA will continue to highlight include, but are not limited to: the ongoing work of the Legislative Subcommittee; education and awareness of the statewide School Nursing ratios, challenges to provide care under less than favorable conditions, and the resultant impact on school age children; commissioning a task force to address Peer Abuse and Horizontal Violence in the workplace, the Nurse Mentoring Pilot Grant activities, Safe Workplace Practices; and Healthy Lifestyles for Nurses.

There will be continued focus and work on the Future of Nursing Initiatives. The NNA collaborates with the Nevada Alliance for Nursing Excellence (NANE), the Nevada Health Care Sector Council and other organizations to fulfill many of the elements and recommendation of this key proposal to advance the nursing profession. The NNA supports Nevada’s selection as a Regional Action Coalition (RAC) in leading change and advancing health in our state. Stay abreast of updates and planned events.

Nurses should and must work at the full scope of their education and training. The literature references the significant role of the Advance Practice Registered Nurses (APRNs) in improving access to high quality, patient centered, cost-effective care. With over 800 APRNs in Nevada, nearly 267,000 APRNs, and over 3 million registered nurses in the United States, this represents an influential force in the healthcare system. National and state efforts have been underway to eliminate barriers to practice and care by seeking to standardize APRN state-regulated scope of practice, recognized roles, and titles, criteria for entry into advanced practice, and certification examinations accepted for entry-level competence assessment by means of general agreement adopted by every state.

In Nevada, the legislative gains in the last session recognized the importance of national certification outlined in the APRN Consensus model. These gains are a part of the ground work and momentum to be carried throughout this year and into the 2013 state legislative efforts. Imperative due diligence by APRN’s must include strategies to educate the consumer, employers and other stakeholders

Janice Muhammad, RN, CNM, MSPresident, Nevada Nurses Association

to ensure clear understanding about the APRN role, competency, and regulatory provisions to protect the public.

Other key legislative issues relevant to nursing and the public include: provider acknowledgement of safe injection practices, patient safety checklist reflecting staff action and patient outcomes, online public notification of hospital sentinel event reports; required transparency in health care facility report of the top 50 readmission diagnoses; patient notification of hospital acquired illness; bill passage permitting licensure for Medication Aides-Certified (MAC’s); creation of the Silver State Health Insurance Exchange under the Affordable Healthcare Act of 2010 and statewide health insurance information exchange—electronic records for Nevada’s patients.

Also of significance to bear in mind and observe will be the resultant effects that term limit changes and redistricting have on the Legislature and Nevada’s constituents.

Be on the lookout for details about the 2012 NNA Biennial State Convention to be held in Reno, Nevada October 5-6, on our website at www.nvnurses.org.

The NNA is your nursing organization. Just do it! Let 2012 be the year you make NNA membership a priority. The satisfaction experienced by contributing time, talents and ideas to your profession is invaluable. Join NNA on our website at www.nvnurses.org. Feel free to contact me with your ideas, solutions and concerns at [email protected] or write to P.O. Box 34660, Reno, NV 89533.

Have a prosperous and productive New Year!

Message from the President

Copper/Chocolate

Brass/Black

Gold/Black

Black/Black

3MTM Littmann® Special Edition StethoscopesFor those who have earned the rightto wear the best.You didn’t choose the easiest career–you chose one of themost important. And by working hard every step of the way,you’ve made a difference.

It’s time to mark your achievement–with a 3MTM

Littmann®

Special Edition Stethoscope.

EVERYTHING MEDICAL( 7 0 2 ) 3 6 6 - 1111

1811 W. Charleston Blvd.Las Vegas, NV 89102

6960 W. Warm Springs Rd.Las Vegas, NV 89113

10% OFF ALLSTETHOSCOPESPLUS FREE I.D. TAG

(USE PROMO CODE “NNA” FOR DISCOUNT)

Follow VA Careers

VAcareers.va.gov Apply Today:

I’m inventing new modelsof Veteran’s health care.

I’m not just a nurse.

Chris, VA Nurse


Nevada Legislative NewsThe Nevada Nurses Association Legislative

Committee is pleased to welcome new committee co-chairs, Doreen Begley in northern Nevada and Belen Gabato in southern Nevada. We look forward to working together to advance professional nursing with their leadership.

All active NNA members are invited to participate on this committee. If you are interested, please contact [email protected] and you will be sent an information/application to be officially added to the membership list.

Nurse’s Day at the Legislature has been scheduled for February 27, 2013. Janet Haebler, MSN, RN, the American Nurses Association Associate Director of State Government Affairs, has agreed to be a speaker. Mark your calendars and plan to register early for this popular event.

NNA is beginning to organize for the next Legislative Session. Although 2012 is an “off” year

for a formal legislative session, there is still much to be done.

The committee has been discussing potential topics for legislative action. Topics include the APRN Consensus Model, evaluating the effectiveness of our current staffing legislation, horizontal violence, education issues, and school nurse concerns. The APN SPG is actively looking at the APN issues, and a new group has been formed, AHAT (APRN Healthcare Access Team). There is great interest in this topic.

As NNA sets legislative priorities, we need to hear from you about issues that are of concern. If there are regulations interfering with how you provide care, environmental issues that may be harmful to your patients, or problems in the workplace that you believe may need legislative action, please contact us at [email protected].

Nevada & National NewsNearly 40 Individuals Form Clark County Alzheimer’s ActionNetwork to Make Alzheimer’s Disease a Community Priority

Committee dedicated to transforming life for those with Alzheimer’s disease

Melissa Biernacinski

The impact of Alzheimer’s disease on Clark County is great and growing at an unprecedented rate. Every 69 seconds, someone develops Alzheimer’s disease in the United States. In Nevada, a popular retirement destination, it is expected that by 2025, there will be twice the number of people with Alzheimer’s disease as there were in 2000.

Because of this, nearly 40 individuals representing numerous health care-related organizations, companies, and non-profits have partnered together to organize the Clark County Alzheimer’s Action Network to make Alzheimer’s disease a community priority. Their ultimate goal: to provide high quality care and services for those who need it most and to collaborate to promote a cure for this devastating disease.

The committee’s official launch took place Tuesday, Nov. 15, at the Cleveland Clinic Lou Ruvo Center for Brain Health. Dr. Jeffrey Cummings, one of the country’s leading Alzheimer’s experts, kicked off the project along with Clark County Commission Chair Susan Brager.

Alzheimer’s disease is the most common cause of dementia and accounts for 60-70 percent of all cases. Alzheimer’s disease and other dementias are progressive, degenerative illnesses that attack the brain. They affect people’s abilities, impacting on all aspects of their life and others in their lives, particularly those who care for them.

“Clark County, with leading health advocates, visionary public health officials and an engaged Alzheimer’s stakeholder community, has the opportunity to reduce the impact and improve the

quality of life for those affected by Alzheimer’s disease and all Clark County citizens,” Dr. Cummings said. “Attention to this rapidly growing problem needs to improve so that those affected do not suffer without help, or hope.”

The Clark County Alzheimer’s Action Network (CCAAN) is committed to making this change in order to transform the quality of life of people with Alzheimer’s disease and related dementias in the community. The organization is beginning to build a large group of supporters and will continue to engage more. Rather than duplicate existing efforts, the group is in the process of identifying resources that currently exist within the community.

To make Alzheimer’s disease a priority in the community, CCAAN plans to drive awareness of Alzheimer’s disease to increase community focus and actions, empower Alzheimer’s providers to recognize and deliver Alzheimer’s-centered continuum of care, and serve as a catalyst to create a robust, interconnected Alzheimer’s providers community, strengthening the health professional network to ensure Clark County residents impacted by Alzheimer’s disease receive best-in-class care, support, and access to research.

The committee is still open to new members who are involved in the health care industry. For more information on the Clark County Alzheimer’s Action Network, call 702-483-6026.

Challenge to HomeopathyWallace J. Henkelman, Ed.D, MSN, RN

Assistant professor, Touro University Nevada

Homeopathic drug sales have grown to be an $870 million annual industry in the United States. As a result of congressional action in 1938, introduced by Senator Royal Copeland, a homeopathic practitioner, the FDA regulates homeopathic drugs in several different ways from other drug products. Manufacturers of homeopathic drugs are deferred from submitting New Drug Applications (NDAs) to the FDA. Homeopathic drugs are exempt from Good Manufacturing Practice (GMP) requirements related to expiration dating and from finished product testing for identity and strength.

Since there is no valid scientific evidence that homeopathic “drugs” work (anecdotal evidence does not constitute scientific proof) these exceptions to FDA regulations are being challenged by two prominent scientific organizations, the Center for Inquiry and the Committee for Skeptical Inquiry. Manufacturers are being accused of false advertising and promoting the use of unproven treatments for medical conditions. The challenging parties want homeopathic substances to be subject to the same regulations as non-homeopathic substances.

ReferenceCenter for Inquiry. 2011, CFI and CSI petition FDA

to take action on homeopathic drugs. Retrieved from http://mail.aol.com/34078-111/aol-6/en-us/Printmessage.aspx

When You Give Food, You Give Hope

CALL 331-FOOD

www.fbnn.org

nursingALD.comAccess to over 10 years of nursing publications

at your fingertips.

Make your nursing research easy...


Inside NNANNA installed new officers at the Annual

Meeting of the Members on October 22, 2011. Elected at the state level were: Scott Lamprecht, state president-elect, Nicki Aaker, state secretary, and Susan Growe, Director, Jean Lyon, Denise Rowe, and Betty Razor, nominating committee. New District 1 Board members are: Sandy Olguin, President, Sarina Gould, secretary, Debi Ingraffia-Strong, treasurer, Jean Lyon, Emily Elliott, and Linda Saunders, Directors. The new President-Elect for District 3 is Patricia Roselle. Delegates to the ANA House of Delegates chosen to represent NNA are: Elizabeth Fildes, Julie Wagner, and Nicholas Green. Alternates are Jean Lyon and Pam Johnson. Congratulations!

NNA has been awarded a mentoring project grant from the American Nurses Association. We will be offering email mentoring services to new graduate nurses, nurses returning to school for a higher degree, and nurses seeking credentialing. This service will be available in any geographic area of Nevada. For more information on how to become or request a mentor, visit our website at www.nvnurses.org.

* * * * *NNA District 1 reportSandy Olguin, MSN, RN

Hello, all you wonderful people! I’m Sandy Olguin, excited and grateful to be the newly elected NNA District 1 President. One of my goals is to support the Initiative on the Future of Nursing by supporting policies that enhance nursing practice, educational events, networking opportunities, and nursing scholarships. With the talents and expertise of District 1 members, I’m confident that this goal will be achieved.

As a Nursing Instructor at Carrington College, I have the privilege to help persuade the future of nursing. It is rewarding and stimulating to be able to positively impact nursing education. One of my greatest moments in life, aside from giving birth to three beautiful children, was hearing the news that my daughter was accepted to nursing school.

The District 1 Dinner/Silent Auction/CEU Event was a huge success thanks to the hard work of Julie Wagner, Nick Green, & Linda Lesperence. We are grateful to our sponsors and donors: Charmaine Cruet, Nevada Center for Dermatology, Lin Zahrt, Deloris Middlebrook, Laura Hanson, Jean Lyon, Margaret Curley, Achieve Fitness, Betty Razor, Julie Wagner, Marla Johnson, Linda Saunders, Thomas Drakulich, Mary Mckenzie, Foundation for Wellness/Dr Michael Johnson, Darci Page at Sierra Plastic Surgery, TresImage Salon, John Ascuaga’s Nugget, and Edgewood Golf Course. Thanks to your generosity, we raised more than $1600 for northern Nevada nursing scholarships!

Based on feedback from NNA members, we have decided to move forward with Nursing Recognition at the Reno Bighorns on March 17, 2012. Purchase tickets from Reno Bighorn’s Pat Lahlum 775-853-8234 (credit card only) or the District 1 Board members. It should be a great event. We hope to see you there!

I would like to take this opportunity to introduce you to the District 1 officers:• SusanneByrne,VicePresident,currently

works in outpatient admissions at Northern Nevada Adult Mental Health Services.

• SarinaGouldjoinedNNAtwoyearsagoandhas recently been elected as Secretary. Her plan for this year is to become proficient in her role as secretary and assist with all District 1 functions.

• DebiIngraffi-StrongisaProfessorofNursingat Western Nevada College and serves as our Treasurer. Debi has been a long term member and instrumental in planning and organizing NNA events. She commits to continue her long time loyalty and dedication to enhancing nursing practice.

There are six NNA District 1 Directors:• EmileeElliotthasrecentlybeenelected

as Director at Large for District 1. Emilee currently works in the PACU at Sierra Surgery and Carson Tahoe as she pursues her MSN as a Family Nurse Practitioner. She has been a nurse for over 5 years, formerly was a medical Social Worker and joined NNA to make a difference in nursing and our community.

• Dr.JulieWagneriscurrentlyaClinicalNurseEducator for Saint Mary’s Regional Medical Center. Since 2006, her involvement in NNA has included Professional Education Chair (past), Professional Education Committee member & liaison (current) and Legislative Committee member. As a member of the board, she aspires to raise awareness of NNA and benefits of membership, increase membership, support educational events, and raise money for nursing scholarships.

• LoneWebbhasbeenanursesince1980andfor the last 23 years has been a Staff Nurse in Same Day Surgery at Renown Regional Medical Center. Lone, a member of NNA for 20 years, joined the board in 2010, to represent the nurse at the direct care level.

• LindaSaundersisaNursingInstructoratTruckee Meadows Community College and joined NNA to make a difference in the future of nursing.

• JeanLyon,ChiefNursingOfficerofSierraSurgery, exudes excellence in nursing leadership and is committed to enhancing the image of nursing in her role as Director and Nomination Committee chair.

• MarlaJohnson,continuinghersecondtermas Director, has been a member since 1985 and has served on the Legislative and Nominating committees. Marla shares, “Being a member gives me the opportunity to connect with other nurses and keep up with the changes in the profession.” She strives to learn as much as she can from those before her and those just beginning.

Heartfelt thanks go out to the NNA District 1

Board of Directors and volunteers who give their time, experience and expertise.

I am blessed to have the privilege and honor to serve as the NNA District 1 President. I am committed to serving the members of District 1 to the best of my ability. Thank you for giving me this opportunity; it allows me to make a difference.

save the Date!Nurse Appreciation Night

with the reno Bighorns – March 17th, 2012

Join the Nevada Nurses Association, Western Nevada College, Carrington College, and Truckee Meadows Community College, as the Reno Bighorns take on the NBA affiliate of the Golden State Warriors. Forty percent of all special ticket sales go back to the Nevada Nurses Association’s scholarship fund. Scholarships go to outstanding students in the nursing schools across Northern Nevada.

In addition, there will be special in game recognition of all nursing professionals and students in attendance. There will be a nursing relay competition at halftime, and each school will have the opportunity to have an informational concourse table during the game!

The Nevada Nurses Association and the Reno Bighorns have teamed up with Kohl’s and the Active 20-30 Club of Reno to fight childhood obesity and promote literacy in Northern Nevada schools.

Please detach form below and mail check orcard information made out to:

Nevada Nurses Association c/o sandy Olguin,PO Box 34660, reno, Nv, 89533

Or call 775.853.8234 to place ordersover the phone directly with the

reno Bighorns.

# of tickets _______ x $12.00 = _______ Total

Inquiries and questions can be directed to:Pat Lahlum / [email protected]

Name: _______________________________

school/employer Affiliation: ______________

Address: ______________________________

City, state, Zip: ________________________

Business Phone: _______________________

Cell Phone:____________________________

e-mail Address: ________________________

Payment Information

Circle one: Check / Credit Card

Check Number: _______________________________

Card Number: ________________________________

Exp Date: ____________ CVV Number: ___________

Cardholder Signature: __________________________

Circle One: VISA MC DISC AMEX


Meet Nevada’s Nurses: Kit Landis & Shelby HuntMary Mackenzie, RN, MS, MA

On Friday, September 16, 2011 a tragic accident occurred at the Reno Air Races. A plane crashed into the box seat area by the grandstand. The crash caused 11 deaths, including the pilot, and injured 70 people. Health care personnel present at the Reno Air Races rendered immediate care to victims after the plane crashed. The expert actions of these personnel present at the Reno Air Races and the prompt arrival of emergency workers to the scene helped mitigate the situation. All area hospitals played an important role in treating victims who were swiftly transported for hospital care. Professionals (security, police, REMSA staff, medics, firefighters, nurses, physicians), spectators, and community members are credited with significant, heroic actions. This article will focus two registered nurses who were working the day of the crash. Their stories are representative of the important contribution nurses made in responding to the disaster.

Kit Landis and Shelby Hunt were on duty at Saint Mary’s Regional Medical Center at the time of the plane crash. Kit Landis, RN, MS is Service Line Administrator, Surgical Services and was the “on call” administrator the day of the crash. Shelby Hunt, RN, MHA, CEN is the Administrative Director, Emergency Services and was on duty in the ER at the time of the accident.

After official notification of the disaster was received, Kit became the Incident Commander, functioning to oversee all hospital activities as well as coordinating with the community and monitoring the Operating Room. Shelby remained in the ER directing the Emergency Department activity and working closely with staff and patients. They both served to expedite appropriate care for the casualties and their families.

As Incident Commander, Kit called for “code—triage standby” and when the disaster was confirmed, designated “code—triage active.” Kit describes her role as communicating the situation and then organizing responses. The incident commander assigns staff to provide for operations, security and communication. For operations control, Kit assigned a nurse who managed and maintained information about available resources—staff and materials. Initially, Kit alerted key staff about the situation, requested on duty staff to remain, arranged for staff to report back to the hospital, and called in the “stand-by” teams for the OR. Many staff reported to the hospital upon hearing of the crash. Kit says the response was “amazing” with staff “stepping up to the plate” to deal with the crisis and provide trauma level care.

Within 30 minutes of notification, patients were at Saint Mary’s Emergency Department. The ER received 27 patients, 9 of which were sent to the Operating Room and 3 were directed to Urgent Cares. One victim admitted to the hospital died a few days after admission.

While functioning as the Incident Commander, Kit performed very differently from her usual “hands on” role with patients. She described it as providing “indirect care” to patients. She was located in a designated area away from direct patient care. Her main focus was on providing tools and resources for staff to accomplish their tasks. Maintaining communication was key. She conducted briefings at least every hour to receive

updates about changing needs and then made assignments of staff and resources accordingly. She reports that since the situation was changing so rapidly, continual adjustments were necessary requiring the ability to “change on a dime.” Kit attributes her ability to function efficiently without becoming “overwhelmed” was due largely to the tremendous support she received from administration and staff who were more than willing to take on necessary duties.

St Mary’s ER Administrative Director Shelby Hunt, RN, BSN, MHA has 17 years of experience working as an ER nurse, but had never experienced what she calls “a true life, actual” disaster. She credits disaster training for her capable management of the Emergency Department during the crisis. Shelby’s clear direction and decisive actions ensured that the victims were provided appropriate care and treatment in a timely, efficient manner.

Medical staff met victims at the ER doors and promptly directed them to appropriate care. Initially, operating room nurses were assigned to the ER to assist surgeons with reception and assessment of patients. When surgery was indicated, the OR nurses called from the ER and arranged set up preparation for patients requiring the Operating Room so patients could go directly from the ER to surgery. The OR’s medical director, Dr. Chris Eby, rallied available medical staff who were qualified to suture patients with lacerations. The “laceration teams” allowed ER doctors time to perform more complex procedures and freed time for surgeons to perform emergency operations. Shelby recalls hearing “Shelby, Shelby, Shelby” –how can I help; what can I do? At one point,

Shelby was so inundated with staff requests to help that she was unable to delegate new tasks needed due to the overwhelming response. She remembers feeling “like a deer in the headlights.” A staff member recognized this as distracting and directed excess staff to a room where they were readily available and could be called upon when needed. Several leaders emerged as they recognized a particular need and started working on it without specific direction. Shelby compared herself to an “orchestra conductor” with her staff all playing important roles.

Both Kit and Shelby credit disaster training drills for their outstanding management of the air crash crisis. Kit comments that she really “appreciated” practice drills, as they served to be excellent preparation. Hospital emergency management training employed various scenarios (dam broken, H1N1 outbreak, broken propeller, earthquake) for practicing disaster responses. Kit and Shelby participated in disaster exercises involving internal hospital actions as well as mass casualty exercises designed to replicate responses expected throughout the entire community. They described the disaster plan as working “well” and “efficiently” with only a few items identified as needing improvement. Shelby remarked that unlike disaster training drills,

Kit Landis, rN, Ms

shelby hunt, rN, MhA, CeN

(Continued on page 20)

Over 30 Years of Trusted& Compassionate Care in Southern Nevada

To view our current employment opportunities and to apply online,

please visit our website: www.nah.org

NOW HIRINGFlight Nurses

for our bases in Reno and

Las Vegas

Send resume attention: Donna MillerEmail: [email protected]

Fax: 702.740.5951 Office: 702.740.5952www.flyingicu.com

A division of Life Guard International, Inc.

Humboldt General Hospital

REGISTERED NURSESFull-time positions available for: Emergency Room, Labor and Delivery, Med/Surg, and ICU. Nevada license required. We offer competitive salary DOE; excellent benefits including Public Employees Retirement, group insurance benefits, accrued PTO & Sick Leave.

Contact HR Director

Humboldt General Hospital118 E. Haskell Street

Winnemucca, NV [email protected] (775) 623-5904

EOE EmployerNon-smoking facility, non-smoker preferred.

JOIN OUR TEAM!William Bee Ririe Hospital

located in Ely, NVA friendly rural community in moutainous Eastern Nevada

Full-Time RN & Full-Time OR RN experience preferred; sign on/relocation bonus available; generous benefits; State retirement (PERS);

very competitive salaries.WBRH is an EOE employer.

Contact:Vicki Pearce, [email protected]

775-289-3467 Ext. 299www.wbrhely.org


Nevada’s Safe Staffing LawDebra Scott, MSN, RN, FRE

AB 121 was passed by the Legislature during its 2009 Session. It relates to health care facilities and requires certain hospitals in larger counties (with a population of 100,000 or more which is currently Clark and Washoe Counties) to establish a staffing committee and to make a documented staff plan available to the Health Division of the Department of Health and Human Services on December 31st of each year.

The definitions below are included in the law:

“Health care facility” means:1. A hospital;2. An independent center for emergency

medical care;3. A psychiatric hospital; and4. A surgical center for ambulatory patients.“Nurse” means a person licensed pursuant to

chapter 632 of NRS to practice nursing, including, without limitation, a licensed practical nurse. The term does not include a certified nursing assistant.

“Unit” means a component within a health care facility for providing patient care.

Each hospital located in a county whose population is 100,000 or more and which is licensed to have more than 70 beds is required to establish a staffing committee to develop a documented staffing plan. The staffing committee shall meet at least quarterly and must consist of:

(a) Not less than one-half of the total members from the licensed nursing staff who are providing direct patient care at the hospital; and

(b) Not less than one-half of the total members

appointed by the administration of the hospital.

Each hospital is required to establish a staffing committee and must prepare a written report concerning the establishment of the staffing committee, the activities and progress of the staffing committee and a determination of the efficacy of the staffing committee. The hospital shall submit the report on or before December 31st of each year.

As a condition of licensing, a health care facility located in a county whose population is 100,000 or more and which is licensed to have more than 70 beds shall make available to the Health Division a documented staffing plan and a written certification that the documented staffing plan is adequate to meet the needs of the patients of the health care facility. The documented staffing plan must include, without limitation:

(a) A detailed written plan setting forth the number, skill mix and classification of licensed nurses required in each unit in the health care facility, which must take into account the experience of the clinical and nonclinical support staff with whom the nurses collaborate, supervise or otherwise delegate assignments;

(b) A description of the types of patients who are treated in each unit, including, without limitation, the type of care required by the patients;

(c) A description of the activities in each unit, including, without limitation, discharges, transfers and admissions;

(d) A description of the size and geography of each unit;

(e) A description of any specialized equipment and technology available for each unit; and

(f) Any foreseeable changes in the size or function of each unit.

A documented staffing plan must provide sufficient flexibility to allow for adjustments based upon changes in a unit of the health care facility.

If nurses are aware that their facility is not following the staffing plan, they may contact the Nevada Bureau of Health Care Quality and Compliance and lodge a formal complaint. The Bureau will accept anonymous complaints, and upon assessment of the complaint, may conduct further investigation.

Since this law applies to only 2 of Nevada’s 17 counties, we asked Diane Allen, RN, Bureau of Health Care Quality and Compliance about rural

Nevada.

“Thislawspecificallyaddressesnursestaffingin the urban areas; however, the bureau may

receivecomplaintsregardinglackofstaffingfromany nurse or other source (for example family member or patient) or anonymous. The lack of staffingshouldsupplyspecificpatientissuesorspecificlackofcarethatwasprovidedtosupport

the issue.”

An internet based complaint form is available that can be used to submit a complaint.

News from ANA

sILver sPrINg, MD – The American Nurses Association (ANA) is gratified that justice ultimately prevailed in the ‘Winkler County’ case involving two west Texas nurses who filed a complaint against physician Rolando Arafiles citing unsafe practices. On Monday, Nov. 7, Arafiles pled guilty and was sentenced to 60 days in jail and five years probation. In addition, he must pay a $5,000 fine and surrender his medical license. Earlier this year, the Winkler County sheriff, county attorney and hospital administrator received jail sentences for their roles in trying to silence two nurses who complained to the Texas Medical Board about Arafiles.

The criminal convictions of all those involved in prosecuting the nurses sends a powerful message: Those who retaliate against nurses who speak up in the interest of patients will be held accountable.

“In the end, the ‘Winkler County’ case is really about patient care. Every single nurse who witnesses unsafe care has a duty to patients to report it. The final outcome of this case is not only a victory for nursing—it’s a win for every patient in this country,” said ANA President Karen A. Daley, PhD, MPH, RN, FAAN. “ANA is the quintessential advocate for nurses across this

country, and we will never back down from taking a strong stand in defense of nurses doing their jobs. ANA will continue to fight relentlessly to protect nurses who speak up for their patients.”

The case in this small, rural county made national headlines in 2009 after Anne Mitchell, RN, and Vicki Galle, RN, two long-time registered nurses at Winkler County Memorial Hospital in Kermit, Texas, were charged with violating the law by sending an anonymous letter to the state medical board that expressed concern about Dr. Arafiles at the hospital. After receiving a complaint of harassment from the physician, the Winkler County Sheriff’s Department initiated an investigation that resulted in criminal charges against both nurses that carried potential penalties of ten years imprisonment and a maximum fine of $10,000. Mitchell and Galle, who had a combined 47 years of employment at the hospital, were also fired from their positions.

Charges of misuse of official information against Galle were dropped. Mitchell endured a four-day jury trial, and was found not guilty. The nurses filed a federal civil suit against their accusers alleging violation of civil rights, among other violations, and won a $750,000 settlement.

The Texas attorney general’s office ultimately indicted the hospital and government officials who originally accused the nurses of wrongdoing.

In July 2009, ANA joined with the Texas Nurses Association (TNA) to strongly criticize and raise alarm about the criminal charges leveled against the nurses, and the fact that the results from this case could have a potential chilling effect on future nurse whistle-blowers. Nurses play a critical, duty-bound role in acting as patient safety watch guards in our nation’s health care system.

“We didn’t have any support—emotional or financial—until TNA and ANA stepped in,” said Galle. “We could never have gotten through this without nursing’s support.”

Texas lawmakers passed a bill earlier this year that strengthened laws to protect nurses against retaliation when they advocate for the safety of patients. The law significantly increases financial penalties for retaliation (up to $25,000) and provides nurses with immunity from criminal prosecution.

NNA was instrumental in passing strengthened whistleblower protections for nurses in Nevada in 2009. Email us at [email protected] for details.

JUSTICE IS SERVED:TEXAS PHYSICIAN PLEADS GUILTY

ANA Gratified by Convictions in ‘Winkler County’ Nurses Whistleblower Case


Avoid Malpractice and Protect Your License: Impaired Practice

Tracy Singh, RN, JD

Impairment is a serious issue for nurses. Usually, the word impairment is used to describe those who are using illicit drugs or alcohol while working. As a result, there is an automatic assumption and stigma associated with any allegation of impairment. However, impairment is not limited to substance abuse and more than ever before, it is important for nurses to take better care of themselves so they can be adequately prepared to safely take care of others, avoid malpractice, and protect their licenses.

In recent years, there have been more lawsuits and board complaints filed against nurses. Fewer jobs are available in today’s economy and the old saying “nurses eat their young” is an unfortunate reality. Nurses have been quick to bully, ostracize and turn each other in under stressful conditions whereas in the past there may have been more of a familial or at least collegial environment. Some nurses report their work environment to be ever increasingly hostile.

Impairment is something that is often noticed or reported by fellow nurses when one is caught sleeping on the job, behaving erratically, or when one nurse suspects another of being impaired in some way. During the winter months and into the spring there is a higher prevalence of illness with a higher censes due to flu and other respiratory conditions. However, these conditions are not limited to our patients. Nurses are not immune to the flu or other illnesses and in general, nurses tend to take care of everyone else before themselves. It is important to remember that your health is important too. If you are not getting proper rest, fluids and nutrition, you could be compromising your health which ultimately could lead to working as an impaired nurse.

Nurses are also notorious for self-diagnoses and self-medicating; including giving each other medications or even IV fluids while at work. Doing so could lead to additional allegations of diversion of equipment or supplies for personal use, impairment at work, practicing beyond the scope and failure to follow policy. Furthermore, continuing to care for patients while you are ill could lead others to wonder if you are impaired at work, especially if a patient is harmed.

Another form of impairment is exhaustion. With economic stressors and financial constraints, many nurses continue to work more than one job; sometimes working up to or in excess of 80 hours per week. Every nurse has their own limitations and the capacity to work a certain amount of hours before they are compromised. As a nurse, it is your responsibility to know your own limits and to avoid working beyond them. Otherwise, you could be placing your patients at risk. Fatigue due to working too many hours or not sleeping enough could lead to allegations of impairment and disciplinary action may be taken against you by the nursing board.

Additional concerns involve certain medications that nurses are taking for pain, anxiety, depression, ADHD or other conditions. Seasonal changes could alter the effectiveness of medications due to changes in sleeping and eating habits. It is important to stay in tune with your own responses to your medications, to recognize when dosage modifications are necessary and to be aware of any side effects you may experience. Otherwise, such alterations could lead to being impaired at work and the fact that you have a prescription for your medication is not going to be enough to avoid disciplinary

action if something were to happen at work while impaired.

In sum, impairment could be any number of factors including fatigue, inability to focus, physical or other abnormal attributes causing changes or deficits to the nurse who is caring for patients. Nurses sometimes feel as though they have to be the hero and just push through no matter what is going on with them, but it is important to realize that your license comes first and patient safety should be your number one priority. If you are impaired for any reason such as a change in medication, illness or fatigue, get help! Call in sick, ask to go home or be relieved from your assignment in order to avoid

regrettable mistakes or lapses in judgment which you will not be able to take back. Likewise, it is just as important to realize that nurses are not always aware of the gradual changes that may be occurring, especially when they are ill. If you notice that a co-worker appears to be impaired, offer your assistance and see if that nurse may need help before something goes wrong. Take care of yourself first…your license depends on it!

The information presented in this article is the opinion of the author, not NNA, and is meant for general information only, not to be taken as legal advice. For questions or comments, you may contact the author at [email protected] or (702) 444-5520.

Nevada Substance Abuse Prevention and Treatment Agency (SAPTA)

The mission of SAPTA is to reduce the impact of substance abuse in Nevada.

SAPTA funds services with private non-profit treatment organizations, community level prevention organizations in all 17 Nevada counties, and governmental agencies statewide.

Treatment Services Offered• Detoxification • Residentialtreatmentservices• Outpatientcounseling • Opioidmaintenancetherapy• Comprehensivetreatmentpriorityadmissionorinterim services to pregnant women:

• Pregnantinjectiondrugusers• Pregnantsubstanceabusers

• Non-pregnantinjectiondrugusers

Prevention Services Provided• ProvideFederalandStatefundingtolocalandregionalcoalitions

who fund community level direct service providers to provide evidence-based programs, practices, and policies, on identified substance abuse and related factors in communities

• ProvideFederalandStatefundingtolocalandregionalcoalitionstoprovide environmental strategies to change community norms

• Providetrainingandtechnicalassistance

For questions or resources contact SAPTA at:Carson City: 775-684-4190 Las Vegas: 702-486-8250

Website: http://mhds.nv.gov(Scroll to the end to find the link to SAPTA)


Newly Elected NNA State Board MembersPresident-elect

Scott Lamprecht, DNP, MSN, RN, is owner of Complete Medical Consultants and an Associate Professor at Touro University Nevada. Scott completed his Doctorate in Nursing Practice (DNP) 2009 with a Practice Based Dissertation titled Sudden Cardiac Arrest Screening in Adolescent Athletes. Additionally he is an active member of both the Nevada State Emergency Cardiovascular Care Committee and Chairman of the American Heart Association’s Southern Nevada Area Regional Faculty Workgroup. Scott is also a Basic Life Support, Advanced Cardiac Life Support and Pediatric Advanced Life Support Instructor with a 25 year background in Critical Care

including ER/EMS, ICU/CCU, Trauma, and Open-Heart Surgery. He is also completing his clinical rotations for Family Nurse Practitioner. Scott began his research as a First Degree Black Belt and Martial Arts Instructor with the American Taekwondo Association.

Scott has been very active in both the Nevada Legislature and Washington DC as an advocate for the American Heart Association. He has testified several times on healthcare-related legislation and has met with Nevada and US Legislators to discuss health policy and National Institutes of Health (NIH) grant funding. As an RN and APN, Dr. Lamprecht is a supporter of professional nursing practice for all nurses in the state of Nevada.

Scott will assume the presidency of NNA in October, 2012.

secretaryI have served on NNA’s State Board as a Director-

at-Large since 2009. I was the 2010 Co-chair of the State Convention Committee. We had a successful 2010 State Convention in Las Vegas in October 2010. I am currently beginning to plan the 2012 State Convention in Reno, Nevada. I enjoyed serving Nevada nurses during my first term in the NNA and look forward to continuing to serve the nurses of Nevada in the Secretary position.

I work at Sierra Surgery Hospital as the Assistant Chief Nursing Officer/Clinical Nurse Specialist. My job responsibilities include—Quality Assurance; Infection Control; Employee Health; Magnet Project Director;

Chair of the Shared Governance Council; Contract Staff and Student Compliance; Membership on many committees and councils; Assist in providing leadership to nursing staff, maintaining compliance with State and Federal regulations, and maintaining adherence to nursing standards and Joint Commission standards.

My vision for the nursing profession is to:* have a safe environment in which to provide the best care to

patients,* have the ability to govern the way care is provided to patients,* have involvement in professional nursing organizations, and* have all nurses utilize evidence-based practices and nursing research

to enhance nursing practice.Nevada is facing and will face many nursing issues. Due to the economic

condition of the state, nurses may face substandard conditions as hospitals and companies struggle to survive. Our educational institutions are facing budget cuts which could affect nursing education, producing a possible threat of a nursing shortage in the future. Hospitals and clinics that provide care to people without health insurance, or inadequate health insurance, are being forced to close, resulting in limited access to healthcare for this population.

Another issue in Nevada is autonomous practice for Advance Practice Nurses. Nevada has many areas underserved by medical physicians. These areas would benefit from additional healthcare professionals who can provide quality healthcare to citizens within these areas. In Nevada, Advance Practice Nurses are required to have a collaborating physician in order to practice. Nurse Practitioners work within a nurse practitioner scope of practice, and consult with physicians and specialists. A formal collaboration agreement with a physician is unnecessary.

Director-At-LargeSusan Growe received her Master’s in Nursing and

Education from University of Phoenix. She originally got her nursing degree at CSN. Ms. Growe practiced in Pediatrics for a year and then oncology for 6 years before working at Nevada State College in which she teaches Foundations of Nursing and Pathophysiology for the past 5 years. She has an interest in med/surg and oncology, specifically Ovarian Cancer. She has been an active member for the Oncology Nursing Society, American Nurses Association, Nevada Nurses Association with the legislative committee and recently as a non-elective position for the nomination committee, and Sigma Theta Tau International Zeta

Kapa Chapter as the Chair for the Leadership Succession Committee. She has also been a member of the National Patient Advocate in which she went to Washington DC to advocate for patients as well as talk to local and state elective representatives many times. She is the Vice President of Communications for the Nevada Faculty Alliance for Nevada State College.

During her spare time, she likes to bird watch on hikes at many National and State Parks, volunteer at Leid Animal Shelter, and spend time with her husband and visit her 21 year old daughter. As Director, Susan will work to strengthen commitment to the ideals and purposes of the profession for the state of Nevada.

state Nominating CommitteeI began my nursing career following high school

graduation. I graduated from a diploma nursing school and following graduation I earned bachelors and masters degrees in health education. I later went on to earn a BSN, MSN, and PhD in nursing. I completed a post graduate family nurse practitioner program.

Clinically I have worked in critical care, staff development, home health, as a college professor, and nurse practitioner. For the past fifteen years, I have worked in nursing administration as a Chief Nursing Officer. I continue to conduct nursing research and publish.

I have always been interested in nursing policy and practice issues. I have studied the history of nursing and

the evolution of where nursing is today. I believe that with the emergence of health care reform, there are opportunities for nursing to play a pivotal role in molding the future of healthcare in the United States. I believe that the American Nurses Association will play an important role in the new model of care.

On the personal side, I am married to Bob Lyon. A California native, I have been a Nevada resident since 1992. I live on Mt. Rose with Bob, four Yorkshire Terriers, and one Maltese. My hobbies include playing banjo, reading, and quilting.

Denise Rowe received her Master in Nursing degree and training in family practice from the Vanderbilt University School of Nursing in Nashville Tennessee. Ms Rowe currently practices as a nurse practitioner providing primary care to veterans in Geriatrics and Extended Care in Las Vegas Nevada. She also provides care to families in the retail health setting at Take Care Health clinics in Walgreens drug stores in Las Vegas, Nevada.

Ms Rowe’s practice interests include hypertension, heart disease, diabetes, osteoporosis and prostate cancer. She is also dedicated to improving public health and reducing health disparities. She is an active member of the Southern Nevada Black Nurses Association men’s

health committee working to improve health outcomes through education of underserved and at risk male populations in the Las Vegas community.

Ms Rowe has published an article on Osteoporosis in men in the Federal Practitioner, the peer reviewed journal for the Department of Veterans Affairs, Department of Defense and Public Health Service. Ms Rowe is on the editorial board of Nevada RNFormation, the official publication of the Nevada Nurses Association and has written several articles for this publication.

scott LamprechtDNP, MsN, rN

Nicki AakerMsN, rN

susan growe MsN/ed, rN, OCN

Jean Lyon, PhD, FNP-BC, NeA-BC,

Chair

Denise rowe MsN, APN, FNP, BC



I moved to Carson City in 1999 from So. California where I’d started CWOCN programs at community hospitals, a research program at City of Hope, and my own private practice in 1993. When retiring to Nevada I restarted my private practice to provide services in the community. I currently act as a mentor to other WOC Nurses in the area and co-chair the support group. I’m also active in health ministry at church, and other community volunteer services, such as helping the community in a disaster as a CERT member. I have served in various positions in NNA at both the district and state levels. Serving as President of District One was an honor and a privilege; there

were many challenges, but what an incredible journey working with the dedicated nurses who contribute their time and talents to strengthen the status of NNA as a valued and viable force in nursing.

ANA house of DelegatesEach state or constituent member association (S/CMA) of the American

Nurses Association elects delegates to represent the S/CMA at the ANA House of Delegates, which meets every two years. These nurses who gather represent the governing body of the American Nurses Association. The decisions made by this group will impact nursing across America for the next two years and beyond.

These elected NNA delegates will represent the Nevada Nurses Association and all Nevada nurses at the 2012 American Nurses Association House of Delegates in Washington, DC.

Dr. Elizabeth Fildes is an Associate Professor at Touro University School of Nursing and an Assistant Professor at the University Of Nevada School Of Medicine, Department of Psychiatry. She teaches in the undergraduate and graduate programs at Touro University Nevada School of Nursing.

Dr. Fildes founded the Nevada Tobacco Users’ Helpline, the state of Nevada’s Quitline in 1997, where she continues to direct Helpline services. Her research activities focus on the use of distance counseling technology to increase treatment access for individuals with nicotine addiction and co-occurring disorders in frontier, rural and underserved communities. Since 1998, she has presented on the effectiveness of distance counseling technology in

local, regional, national and international conferences.Elizabeth Fildes received The Public Health Hero Award in 1999 for her

outstanding dedication to reducing tobacco use in Southern Nevada. She was appointed and commissioned by the Governor of the State of Nevada to serve as a member of the Healthy Nevada Task Force for eight years.

Dr. Fildes is a grant reviewer for the Health Resources and Services Administration under the U.S. Department of Health and Human Services. She was recently appointed to the Addictions Nursing Certification Board of the International Nurses Society on Addictions.

Dr. Fildes is currently looking for innovative ways to fund the treatment of nicotine dependence through public-private partnerships. She continues to be an advocate for all victims and survivors of nicotine addiction.

Dr. Fildes is the President of NNA District 3; she was recently honored as a 2011 Health Care Hero by the Nevada Business Magazine.

I am currently a NNA District 1 board member and serve as an education committee member. I am passionate regarding the collaboration of education and practice for the best patient outcomes; advancing all nursing degrees to BSN; and quality continuing education for nurses.

Besides being active in NNA, I serve on the Education Alliance Board of Washoe Co., NV as a member and liaison to Saint Mary’s Regional Medical Center and the Nevada Nursing Education and Practice Alliance member (NEPPA). I am a member of the Academy of Medical Surgical Nurses and Sigma Theta Tau International Honor Society.

I am presently the Interim Director of Education and medical-surgical advanced clinical educator for Saint Mary’s Regional Medical Center in Reno, NV. My main responsibilities include leadership and management of education team, assisting with Transition to Practice Grant for new graduate

nurses, assisting the hospital in meeting regulatory requirements (i.e. JC, CMS, and other regulatory agencies), developing and maintaining general and clinical orientation plans for new professional hires, providing continuing education and skills training for 500+ nurses and other allied health professionals, providing regulatory safety education for all staff, and serving as the liaison between health care college and hospital to bring students in for clinical experiences.

My areas of interest are medical-surgical nursing; gerontology; adult education principles; administration; grants; online learning; regulatory requirements for acute care hospitals; and developing nursing and allied health programs to include curriculum and accreditation.

As a nursing leader in the State of Nevada, I have a vested interest in a quality nursing workforce and healthy working environment for all health care professionals throughout Nevada. If elected, I can offer ANA/NNA a knowledgeable perspective of health care practice and current education needs of Nevada, as well as Nevada’s initiatives in striving for safer patient care. Additionally, I am able to speak regarding efforts to encourage nurses’ to advance their educational degree, increase their continuing education on current issues and trends, and how legislation affects health care and nursing.

I bring an enthusiastic voice knowledgeable in the needs of Nevada to enhance that health care experience that all people come into contact with. Acting as Assistant Professor at the University of Nevada Reno, I have been privileged to see the beginning of new nurses and the obstacles they may encounter as they begin their journey towards attainment of becoming Registered Nurses.

Nevada is last in the nation when it comes to health care and jobs, two things that should not be taken lightly. It with this attitude that I will represent the needs and necessities of Nevada at the House of Delegates.

Betty razor, rN, BsN, CWOCN

Newly Elected NNA State Board Members(Continued from page 10)

elizabeth eugenio-Fildes, edD, rN, MAC, CNe, CArN-AP

Julie WagnerPhD, rN

Nicholas green MsN, rN

certification


The Initiative on theThe Future of Nursing and the Role of Nevada Nurses

Debra A. Toney, PhD, RN, FAAN

A year has passed since The Institute of Medicine (IOM) first released The Future of Nursing: Leading Change, Advancing Health in October 2010 (IOM 2010). This landmark report serves as a blueprint for transforming the U.S. health care system by strengthening nursing

care and better preparing nurses to help lead health reform.

Health care today is more complex. Our population is aging and becoming more diverse. The demand for nursing care has increased and we do not have enough nurses in the pipeline to fill the void. Advances in healthcare and technology have contributed to the way we provide care to our patients. With the implementation of the Affordable Care Act, more than 40 million previously uninsured individuals will have access to healthcare. All of this is happening amidst a nursing shortage like never before. The nursing shortage threatens the safety and well being of the patients whom we are charged to care for in our health care system. It is estimated that 500,000 new nurses will be needed by 2025 (Buerhaus, 2008).

As members of the largest group of healthcare professionals in the health care workforce, nurses are integral to overcoming our health care challenges. Nurses spend more time with patients and understand care processes across the continuum of care. Nurses are on the front lines of health care delivery and will play a major role in overhauling our health care system. The trusted voice of nurses is what it will take to reform our health care system.

However, nurses continue to face barriers that prevent them from performing to the best of their abilities. In some States nurses are not able to work to the fullest extent of their education and training nor are they at the table when important decisions are made.

The Future of Nursing: Campaign for Action is a partnership between The Robert Wood Johnson Foundation and AARP. This campaign is about bringing together key stakeholders, nursing and non-nursing, from local, regional, and national levels to bring forth sustainable change to improve

the health of our nation. This will only occur if nurses are involved in bringing about this needed change.

The mission of the initiative is to ensure that all Americans have access to high quality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success. Central to this report are four key messages which serve as the building blocks for implementing health care change.

1. Nurses should practice to the full extent of their education and training.

2. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.

3. Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States.

4. Effective workforce planning and policy making requires better data collection and information infrastructure.

The Institute of Medicine Report identified specific recommendations that give guidance to implementing changes to transform the U.S. health care system as well as the profession of nursing. The report includes the following eight recommendations:

1. Remove scope of practice barriers.2. Expand opportunities for nurses to lead and

diffuse collaborative improvement efforts.3. Implement nurse residency programs.4. Increase the proportion of nurses with a

baccalaureate degree to 80% by 2020.5. Double the number of nurses with a

doctorate by 2020.6. Ensure that nurses engage in lifelong

learning.7. Prepare and enable nurses to lead change to

advance health.8. Build an infrastructure for the collection and

analysis on interprofessional health care workforce data.

To achieve these recommendations, Action Coalitions are being developed in all 50 states. The main objective of the Action Coalitions is to advance the IOM report recommendations. Currently 36 states have launched Action Coalitions. Action Coalitions are interested and committed stakeholders representing nursing and non-nursing organizations. Nevada is actively involved in becoming an Action Coalition and will submit an application as part of the Wave IV Action Coalition expansion in January 2012.

I first became involved in this initiative while serving as President of the National Black Nurses Association. Having the opportunity to provide testimony at one of the many forums was quite rewarding. This began my journey to learn as much about the campaign for action as possible and to ensure that members understood what it meant to their future. I now have another opportunity to share this information with nurse colleagues in my home State of Nevada.

The Health Care Sector Council and the Nevada Alliance for Nursing Excellence have joined together to put forth the application to the Robert Wood Johnson and AARP Foundations to establish an Action Coalition within the State of Nevada. They are bringing their experience and intellect together in an unprecedented collaboration towards one important goal, improving the health of Nevada.

The goal of the Action Coalition will be to facilitate the collaboration of professional nursing organizations within the State and business organizations on a shared vision and strategic plan to advance the recommendations of The Future of Nursing: Campaign for Action.

Nevada currently has many activities occurring that are called for in the IOM report including, extension of nurse residencies throughout the State, leadership training and legislative efforts to remove scope of practice barriers. One major pillar is to prepare and enable nurses to lead change, calling all nurses, nursing education and professional associations to prepare the nursing workforce to assume leadership positions across all levels. The goal of the Nevada working group is to bring all stakeholders under the umbrella of the Action Coalition, uniting to achieve common strategic goals as outlined by the Future of Nursing: Campaign for Action.

In order to ensure Action Coalitions are sustainable for the long- term, technical assistance is tailored to meet the specific needs of each Action Coalition and can include, for example, access to: grant writers; sustainability planning/facilitation; links to potential funders (including in-kind contributors); and collaboration and coordination with existing RWJF nursing grant programs (e.g. Partners Investing in Nursing’s Future).

An investment in the Future of Nursing Campaign will support the education and training of nurses of all levels, including advanced practice nurses, faculty and nurse scientists.

Nevada must be prepared to lead. What can you do to implement the recommendations? Begin by committing to read the report. Can you identify 2-4 specific activities over the next 2 years for engagement and implementation? What are your ideas for collaboration? We have many roles to fill, including creating partnerships in the State to implement the recommendations. The future of health care depends on all of us and Nevada nurses have an opportunity to be involved in transforming health care in our State and the country.

referencesInstitute of Medicine. (2010). A summary of the December

2009 forum on the future of nursing: Care in the community. Washington, DC: National Academies Press.

Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press.

The Future of Nursing: Leading Change, Advancing health, Institute of Medicine Website. www.iom.edu/reports. Published October 5, 2010/ Accessed November 20, 2011.

“The Future of the Nursing Workforce in the United States: Data, Trends and Implications.” Peter Buerhaus, RN, Ph.D., Douglas Staiger, Ph.D., and David Auerbach, Ph.D.: Boston, MA. Jones and Bartlett Publishers. (2008).

JOIN OUR TEAM!

EOE

New GradsPlease Apply!

Home Health Services of Nevada has PT and FT openings throughout Nevada, giving you the opportunity to use your critical thinking

and assessment skills. We utilize computer charting and in home telemonitoring.

Excellent Pay Rates & Benefits!

Contact Leah Doke at [email protected] for openings in your area.


Future of NursingNurses Should Practice to the Full Extent of Their Education and Training

Regulatory Barriers

Debra Scott, RN, MSN,

When taken on its face, it seems that there would be no argument against implementation of the first key message of the IOM’s Future of Nursing Initiative, that nurses should practice to the full extent of their education and training. In truth, barriers do exist which limit nurses’ scope of practice, impair transition from education to practice, decrease mobility, and undermine the financial rewards of professional practice.

The IOM Report speaks to all levels of nursing, from advanced practice registered nurses, to licensed professional nurses, to licensed practical nurses. Endogenous and exogenous barriers serve to limit the potential for nurses to be instrumental in leading innovative strategies to improve state, national, and international health care systems.

First, we as nurses limit our own potential as leaders in health care. Our education prepares us to identify a problem, in other words to make a nursing diagnosis, and then “fix” it. As long as the nursing profession sees itself as primarily in acute care settings, we limit our role in what healthcare is becoming—focused on delivery of healthcare in the community rather than in hospitals. Nursing attitudes must broaden to include utilization of community resources and collaboration among the health care team of providers that manage an individual’s overall health care plan.

We are seeing truly future minded nurses making strides in health care wellness and prevention, defining nursing’s role in health maintenance rather than limiting our role to disease or symptom management. We need to

reconceptualize nursing’s role by identifying health access gaps and bridging those gaps with what nurses have always been able to offer—a focus on patient centered health care.

Barriers must be identified, defined, analyzed, and removed.

Regulation may limit scope of practice for nurses. The diversity among states in regulating advanced practice registered nurses (APRNs) impedes mobility and leads to confusion in scope of practice. Issues arise from the diversity in the level of supervision/collaboration that is required for APRN practice. In addition, the authority to prescribe dangerous drugs, and to a greater degree, controlled substances varies among states—another barrier to consistent standards of practice.

Reimbursement discrepancies may render an APRN unable to receive financial compensation for healthcare services which are comparable to services offered by other compensated providers. Insurance companies must assess and revise

their outdated policies to allow reimbursement for services offered by the appropriate provider.

Interdisciplinary challenges to scope of practice, without an examination of the rigor of education nor the evaluation of competency, pose barriers to nurses’ professional practice.

The complexity of healthcare delivery environments have created a gap between education and practice which has resulted in barriers to professional development of the nursing workforce. Transition to practice opportunities provide a setting where new nurses can acquire the knowledge and skill to practice to the full extent of their education. Integration of experiential learning provides new nurses with the courage and skill to be instrumental in moving our profession forward.

Finally, and most importantly, we, as nurses, must be at the forefront of moving our profession toward overcoming the barriers to our practicing to the full extent of our education and training. Let’s use this groundbreaking report to do what we know must be done to transform the role of nursing to provide greater access and higher quality health care to the citizens we serve.

referencesInstitute of Medicine, The Future of Nursing, Leading

Change, Advancing Health, Washington, D.C.; The National Academies Press; 2011.

Spector, N. & Echternacht, M. (2010).A regulatory model for transitioning newly licensed nurses to practice. Journal of Nursing Regulation, 1(2), p18-25.

Nursing Leadership & Innovation in Nevada

The Nevada Tobacco Users’ HelplineElizabeth Fildes, EdD, RN, CNE, CARN-AP

As one of the Centers for Disease Control and Prevention (CDC) Best Practices for Comprehensive Tobacco Control Programs, telephone-based tobacco cessation counseling has been identified in research as an effective and evidence-based approach to tobacco cessation. Founded by a nurse in 1997, the Nevada Tobacco Users’ Helpline (Helpline) has been the State of Nevada’s free tobacco quitline that provides comprehensive, statewide nicotine dependence treatment for all forms of tobacco (smoked and smokeless), and education available to all Nevada residents 18 years and older. The program is medically driven, research & evidence-based, follows CDC’s Best Practices guidelines, follows Agency for Healthcare Research and Quality Guidelines (AHRQ), uses FDA approved medications in the Helpline Medication Assistance Program (MAP) and hires professional counselors for treatment delivery. Although quitline services vary across states, the Helpline offers a longer, more intensive proactive counseling protocol than any other state quitline, with many users receiving proactive counseling sessions for a year or more before discharge. Program evaluation results based on over 40,000 clients served, support meta-analytic reviews that have established that telephone counseling is an effective intervention for tobacco use cessation.

Nevada NPs Make a Difference in theHigh-risk Senior Citizen Population

With offices in Northwest and Southeast Las Vegas (LV), Caremore Nurse Practitioners (NPs) are part of an innovative system that began in the late 90’s and expanded to LV, in early 2010, from Southern California. Caremore’s program uses an innovative collaborative model where the local NPs at the Caremore Care Center clinic work with seniors who have the diagnoses of HTN, COPD, CHF, Tobacco Dependency, DM, CKD, Fall Risk, and Anticoagulation needs.

Currently staffed with two full time NPs, a part-time NP, and a locum tenum NP, the Medicare Advantage patients go to the clinic sometimes multiple times in a week. This innovative prevention model actually decreases cost by reducing patient hospitalizations.

A day in the life of a Caremore NP includes seeing a patient whose warfarin level is not in balance and prescribing dosages to stabilize the patient’s drug levels. The NP will see a new patient for an hour long appointment to welcome them into the program. Managing phone calls for patients whose home monitors link to the telephone and alert the NP if the patient’s blood pressure is increasing, or the congestive heart failure (CHF) patient’s weight on the Caremore provided scale has changed more than 3 pounds overnight is another NP responsibility. The NP may then see a COPD patient and make adjustments to their home medications based on the GOLD standard. Later in the day, the NP may help a patient stop smoking



Education: A Priceless CommodityJohn Malek, PhD, MSN, APN-C

The Initiative on theNNA District 3 Embraces IFN

Elizabeth Fildes, RN, EdD, CNE, CARN-AP

Nevada Nurses Association’s District 3 is using the Initiatives for the Future of Nursing Recommendations as the blue print for all its activities.

recommendation 1: remove scope-of-practice barriers.

Advanced practice registered nurses should be able to practice to the full extent of their education and training. District 3 nurses participated in the passage of SB 205 requiring national certification for advanced practice nurses. Martha Drohobyczer testified in support of the bill. Belen Gabato assumed the Legislative Chair position for Southern Nevada in August. She is organizing legislative committee in District 3.recommendation 2: expand opportunities for nurses to lead and diffuse collaborative improvement efforts.

Many District 3 nurses are leading efforts under this recommendation. Our Deans and Directors of Nursing Programs, Chief Nursing Officers, faculty, nurses in public health; hospital educators, charge nurses and many more continue

to initiate, lead and manage collaborative efforts in numerous practice environments to improve patient care. Many have received grants to support their endeavors. It is the intent of District 3 to recognize these nurses on the 2nd Annual Initiative for the Future of Nursing in Nevada Professional Progression (IFNNPP) Awards on May 12, 2012.recommendation 3: Implement nurse residency programs.

At the IFNNPP Awards District 3 honored graduates of the nurse residency program from St. Rose Dominican Hospital. We will continue to do this.recommendation 4: Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020.

NNA District 3 established a scholarship fund named after Dr. Rosemary Witt to help support students working on their baccalaureate degree.

NNA District 3 have started dialogue with University Health Systems regarding a joint information session for the ADNs in their Nurse Residency program to introduce them to the RN to BSN opportunities.recommendation 5: Double the number of nurses with a doctorate by 2020.

NNA District 3 established a scholarship fund named after Dr. Rosemary Witt to help support students working on their doctoral degree

At the IFNNPP Awards IFNN, District 3 honored nurses for graduating from their Doctoral programs

recommendation 6: ensure that nurses engage in lifelong learning.

District 3 successfully secured a grant to sponsor a Women’s Conference which was broadcasted in 12 sites attracting nurses and student nurses. In addition plans are underway to sponsor a “Financial Health for Nurses” continuing education program based on the request of nurses representing UMC, St. Rose and United Health Care Home Health Agency.recommendation 7: Prepare and enable nurses to lead change to advance health.

District 3 is planning a workshop on Nurse Entrepreneuring, coming in 2012.

NNA District 3 sees the numerous opportunities for nurses to work on promoting a safe, quality, patient-centered care that is accessible to all Nevadans. There is a lot to be done, we are busy and we are calling all nurses to join us. We must do it! Nevadan’s TRUST us to help create a system that we can trust to take care of us and the people we love.

references:Robert Wood Johnson Foundation IOM Recommendations

(2011) Retrieved on September 5, 2011 from http://www.thefutureofnursing.org/recommendation/detail/recommendation-8

Scholastic and technical aptitudes are mandatory to maintain the highest standards of our profession. It is our responsibility to adapt almost daily to increasing changes and healthcare standards. In addition to meeting educational requirements for licensure, many nurses have chosen to advance their degrees and credentials. When you decide to obtain national credentials or advance your degree status, there remains a certain amount of anxiety and ambiguity associated with this decision. Prior to making an informed decision one must examine the variables. These include cost, location, program, sacrifices, and goals. Whether your desire involves being a specialist or generalist, begin by establishing short and long term goals.

• Beexplicitinyourpurpose.Doingsowillenhance the accomplishment of your goals.

• Remainfocusedevenduringtimesofadversity.• Althoughattimesyoumaynotthinkso,

remember that who you are does make a difference! My choices have touched an entire generation of nursing professionals through my teaching and I know explicitly that my knowledge, skills, and abilities have improved the delivery of healthcare and have made a difference.

Perhaps the shortest distance between two points was not always a straight line, but the journey has been the greatest experience of my life. Today there seem to be as many types of nursing programs available as there are universities. This can make the decision to return to school more overwhelming, but there is hope. When I decided to return to school it was a painstaking task. The foremost question I needed to explore was my purpose for continuing professional education. How would my education contribute to the overall body of knowledge in nursing and what impact would this education have on my nursing practice? I consider myself “old school.” I graduated with an Associate Degree in Nursing at the age of 22 and at 35 was contemplating advancing my degree. A lot had changed during those years while I was working, and the choices seemed endless. During the 1980’s there was considerable discussion and controversy surrounding the status of RN education

and entry into practice. Employers were looking for BSN graduates for management and education positions. Associate degree RNs were referred to as “technical” nurses and opportunities were very few without advanced degree status. After a great deal of research and cost analysis I returned to school. First I worked on my BSN. Upon graduation, the university I was attending was ready to implement their first nurse practitioner program with a focus on family practice and I was asked to be a part of this monumental undertaking. Once again, this involved additional research, cost analysis, and personal goals. Rather than taking a break, I proceeded directly into a Master of Nursing program. Knowing myself that if I took a break, I might not return, I entered a doctorate program immediately after completion of my MSN. The more advanced the educational preparation, the greater the financial impact. Many times I wanted to opt out, but with support from my family and colleagues I continued on my journey. What I realized was that any goals we set come with sacrifice and a great deal of hard work.

Was it all worth it? I’m here to tell you, I have never had any regrets about returning to school. The doors of opportunity and growth for me opened wide and I walked through. I’m glad I completed this education at a time when I had the opportunity and the means to do so. There is no time like the present, so if you are thinking about it, you have taken the first step towards a much more rewarding career.

Visit us online anytime . . .

www.nvnurses.org


Future of NursingEBP Skills and Data-Driven Clinical Decision Making

Ludy Llasus, PhD, APN, NP-C

The 2010 report by the Robert Wood Johnson Foundation’s Initiative on the Future of Nursing in collaboration with the Institute of Medicine calls for nurses to practice to the full extent of their education and training. One recommendation from the report is to expand opportunities for nurses to lead and diffuse collaborative improvement efforts (Institute of Medicine of the National Academies, 2010, p. 2). Nurses should be able to lead and manage interdisciplinary collaborative efforts to conduct research, improve practice environments and health systems to improve health outcomes and reduce healthcare cost. To achieve such expectation, there is a need for a nursing workforce with high levels of proficiency in evidence-based practice skills for data-driven clinical decision making to improve health outcomes. This also includes decisions that can affect the working environment of the nurse that facilitates a culture of patient safety.

Fineout-Overholt and Johnston (2007) defined data-driven decision making as the use of data from published research, unpublished research, outcomes management initiatives, quality initiatives, or implementation projects to drive health care decisions. Nurses need to have an understanding of basic outcomes and the role it plays in improving healthcare. Outcomes refer to a patient’s responses to treatment in a healthcare context (Doran & Sidani, 2007). Outcomes in healthcare are often tied to regulatory and reimbursement issues such as The Joint Commission and Centers for Medicare and Medicaid Services (CMS) where data are often collected at point of care by nurses (e.g. core measures). The data is then analyzed and decisions are made by administrators or quality group within the organization which may directly or indirectly affect nursing practice.

For nurses to effectively participate in the discussion table when decisions are made that may affect nursing practice, knowledge of outcomes data is critical for a meaningful input and participation in the decision making process. The nursing workforce should be well-versed in outcome measurements and basic outcome evaluation principles. Nurse sensitive outcomes (e.g., patient satisfaction with pain management and patient education, functional status, symptom control, pressure ulcers, falls, and intravenous infiltrations) are increasingly important for nursing to articulate the role nursing plays in improving quality in patient care. Information obtained from measurements of these nurse sensitive outcomes allows nurses to negotiate practice changes based on data.

Evidence-based practice (EBP) skills can provide the foundation for data-driven clinical decision making competency expected from the nursing workforce. Proficiency in database searching skills, direct access to evidence-based resources, implementation of evidence-based practice interventions, evaluation of effectiveness of implemented evidenced-based interventions, and evaluation of outcomes are EBP skills. Understanding of how to collect data, the ability to enter data into a database, and analyze data using simple statistics is important. Use of research knowledge feeds into decision-making and practice (Nutley, Walter, & Davies, 2003).

Fostering EBP skills that supports data-driven decision making should be a collaborative effort between nursing and organizational management with the goal of improving quality patient care. Demand for safety, quality, and effective health care calls for the engagement of nurses in EBP to improve patient outcomes. A nursing workforce that are consumers of research knowledge facilitates research knowledge translation into

practice which then will facilitate data-driven clinical decision making to improve health outcomes.

referencesDoran, D. M., & Sidani, S. (2007). Outcomes-

focused knowledge translation: A framework for knowledge translation and patient outcomes improvement. Worldviews on Evidence-Based Nursing, 1, 3-13. doi: 10.1111/j.1741-6787.2007.00073.x

Fineout-Overholt, E., & Johnston, L. (2007). Evaluation: An essential step to the EBP process.Worldviews on Evidence-Based Nursing, 1, 54-59. doi: 10.1111/j.1741-6787.2007.00081.x

Institute of Medicine of the National Academies (2010). The future of nursing: Leading change, advancing health. Report recommendations. Washington, DC: National Academies Press.

Nutley, S., Walter, I., & Davies, H. T. O., (2003). From knowing to doing: a framework for understanding the evidence-into-practice agenda. Evaluation, 9, 125-148.

NSC SChool of NurSiNg

The NSC School of Nursing is accredited by the Commission on Collegiate Nursing Education and approved by the Nevada State Board of Nursing.

Students are admitted to the School of Nursing in four tracks:

1. Regular2. Accelerated3. Part Time4. RN to BSN

The School of Nursing prepares BSN graduates, utilizing a caring-based philosophy. NSC is seeking full-time faculty with backgrounds in medical-surgical, pediatric, maternity, or community health nursing to teach theory classes and clinical/skills labs beginning Fall 2012.

full-time QualifiCatioNS

Required:• ActiveRNlicense• MSN• Effectiveoralandwritten communication skills

Preferred:• Ph.D.(requiredfortenure-track)• Teachingexperience• Simulationexperience

Part-time PoSitioNS

Part-time positions are also available for Spring 2012 and Fall 2012. Qualifications provided online.

overview

Nevada State College was

established in 2002 as Nevada’s

first and only mid-tier institution

in the Nevada System of Higher

Education. As the first four-

year comprehensive college

in the state, NSC is dedicated

to providing quality education,

social, cultural, economic and

civic advancement to the citizens

of Nevada.

NSC also addresses Nevada’s

need for increased access to

higher education. The College

places special emphasis on

meeting the state’s need for

effective, highly educated, skilled

teachers and nurses and offers

a wide range of baccalaureate

degree programs grounded in the

liberal arts and sciences.

NSC CamPuS

NSC’s main campus sits on a

509-acre site in Henderson,

Nevada, a city consistently

ranked as one of the best

places to live and located just

15 miles from the world-famous

Las Vegas Strip. NSC has a

satellite campus in the heart of

Henderson’s Downtown District

and off-site locations throughout

the state.

School of Nursing Tenure-Track & Lecturer Faculty PositionsAvailable Fall 2012

about NSC Nevada State College is a young, rapidly growing four-year college, with an enrollment of nearly 3000 students.Ourstudentslearnfromthebestteachers,using the latest technology, in a small personal environment.

The School of Nursing is seeking dedicated faculty to work in a highly collegial, interdisciplinary environment. Ourfacultyandstaffenjoytherareopportunitytoshape the college as it continues growing into a cornerstone of higher education in Southern Nevada.

At NSC, we are committed to achieving and maintaining a diverse workforce. This commitment is rooted in the belief that a diverse educational experiencebeginswiththepeoplewhoareprovidingand supporting that education. To us, diversity means valuing the spectrum of social, cultural, and intellectual identities among people and helping all achieve success.

An equal opportunity/affirmative action college committed to excellence through diversity

Apply for full-time and part-time positions now at nscjobs.com.

Simplify your nursing research...

nursingALD.comSimply click on the Newsletter tab on the

far right and enter your search term.

with access to over 10 years of nursing publications at your fingertips.


Student CornerBullying

Warda Ali, Nursing Student, Touro University Nevada

What is bullying? Bullying has different meanings for different people but what it ultimately means is use of superior strength or influence to intimidate (someone), typically to force him or her to do what is wanted. What is often not answered in articles is the origin of bullying in the nursing profession. I personally believe bullying starts in nursing school.

From the beginning of nursing school my classmates and I were informed that “nurses eat their young.” Bullying is not a tolerated behavior but that statement can intimidate students about what the clinical setting is going to be like.

I personally have witnessed bullying and experienced bullying in a clinical setting, where some nurses that go out of their way to let students know that “they can’t stand students” and they make sure that they give them the hardest time. I have seen the students come out crying because their clinical instructors or preceptors just screamed at them because of a mistake. The one thing that some working nurses or teachers fail to remember is that “they were once students.”

I have also witnessed students bullying

students, which is strange to me because one would think that the students would be protective of each other, but inside they sometimes try to “eat each other alive.” The nursing program is hard, but one would think that it would unite the class in general. When a student bullies another student it is usually done in a passive aggressive way, but it can go on for a long time. I have also witnessed teachers bullying teachers in front of students in some schools and teachers bullying students.

Nursing is about caring and being a team, so how we go from that to bullying I do not have a definite answer, but most of the time the people who bully do not realize that they are bullying. I personally think that there should be a class on bullying, where students can be taught how not to bully, how to prevent bullying from anybody, thus creating a positive domino effect, because once they become nurses they will spread that knowledge to the experienced nurses as well as the new nurses to come. By starting to train students on signs and prevention of bullying should stop bullying. I personally believe bullying

is a learned behavior and it has a vicious cycle that gets passed on from generation to generation and has to be stopped.

Bullying should not be tolerated, and if a nurse, teacher, or student is caught bullying they should be retrained in an anti-bullying class and placed on probation. If they do not adhere to rules then termination of the nurse or teacher and expulsion of the student should be considered. Nursing is all about caring and negative behaviors like bullying should not be tolerated. Anti-bullying should be reinforced in classes just like any other subject so that students can be educated about bullying, what it does to the victim, and how to prevent it. The society that we live in often seems to glorify negative behavior, and as nurses we should not tolerate such behaviors because our mission and our profession are about caring and compassion. We, as nursing students are in a powerful position and our position is to make a difference. When we see negative behavior we should not tolerate it, instead we should educate and guide our community in the right direction.

Saint Mary’s Receives Federal Funding for Transition to Practice Program Jami-Sue Coleman, RN, MSN, MBA

Opportunities to work in healthcare in northern Nevada are on the rise and the need for qualified nurses continues to be an economic driver for the region. Nevada has one of the lowest nurse-to-population ratios in the nation. In an effort to promote job growth and retention of qualified nurses, Saint Mary’s Regional Medical Center will begin a program for newly licensed registered nurses in 2012. The Transition to Practice Program was developed with a Health Resources & Services Administration (HRSA) funded grant that supports nursing education, practice and retention.

This program is modeled after the National Council of State Boards of Nursing Transition to Practice guidelines and will provide focused

education for the recent graduate in a supportive environment. Saint Mary’s has partnered with Truckee Meadows Community College to develop a curriculum for the 86 nurses the program anticipates it will recruit over next three years.

Additionally, the Transition to Practice Program was designed with the goals of the Bureau of Health Professionals and the Nevada Elders Count in mind. These goals include:

• Improveretentionratesofnewnursegraduatesanddecreasevacancyrates

• Increaseclinicalcompetency

• Reducestresslevels

• Increaseperceptionoforganizationalsupport

• Increasecriticalthinkingskillsandclinicaldecisionmaking

• Improvetimemanagementandabilitytoprioritizecare.

Transition programs that promote core competencies for new graduate nurses while providing ongoing support have been shown to improve a nurse’s transition into professional practice. During the year-long Transition to Practice Program, newly licensed nurse graduates will receive rigorous training and mentoring that better prepares them for their career as a clinical nurse.

“We are very excited to receive this grant and already know how impactful this will be for our community. Providing newly licensed nurse graduates with a transition program will greatly enhance their first year as practicing nurses,” said Jami-Sue Coleman, TPP program director. “The program encourages one-on-one mentoring and will assist new nurses with building greater knowledge in specialty areas. Our goal is to improve healthcare delivery by recruiting and maintaining qualified registered nurses.”

Eligible candidates for the program include recent graduates from an accredited nursing program with preference given to local schools including Carrington College, Orvis School of Nursing, Truckee Meadows Community College, and Western Nevada College. More information is available by visiting http://www.saintmarysreno.org.

1024 Central Park DriveSteamboat Springs, CO 80487

YVMC is a drug free workplace and applicants must pass a pre-employment drug screen.

Yampa Valley Medical Center is a community not-for-profit, regional hospital located in the ski town of Steamboat Springs, CO with 39 inpatient beds, a Level IV trauma center and a Level II Nursery.

Yampa Valley Medical Center offers avariety of career opportunities including:

• Clinical Nurse Educator

Check our website www.yvmc.org foradditional nursing opportunities.

We offer a comprehensive benefit package with RELOCATION ALLOWANCE and a healthy working environment. The entire family will enjoy our small-town lifestyle, world-class ski resort, recreational and cultural activities and

scenic splendor in the spectacular Rocky Mountains.

EOE

To apply call: 970-870-1118Fax: 970-871-2337

email: [email protected]


The Elephant in the Room: Employment for New Graduate RNsCarrie O’Reilly, PhD, MSN, RN

Assistant Professor and Undergraduate Programs Coordinator, Touro University Nevada

It is a rare thing to have someone speak, other than you, the exact words that are on your mind at a time when you truly want those words to be spoken aloud and for the record. While attending the most recent American Association of Colleges of Nursing (AACN) Baccalaureate Education Conference in St. Louis last month this happened to me.

A keynote speaker spoke about The Future of Nursing Report released by the Institute of Medicine (IOM) in October 2010. The main focus of the presentation was the need for nursing educators to help meet the IOM’s call to raise the number of baccalaureate prepared registered nurses (RN) from the current 60 percent to “80 percent of the nation’s RN workforce by 2020” (IOM, 2010, p. 173). The reason for this call was to ensure that the RN workforce possesses the educational capacity to provide “an expanded set of competencies, especially in the domains of community and public health, leadership, systems improvement, and change, research, and health policy” expected to be a part of the expanded role of RN’s in the changing health care landscape faced in the U.S. as health care reform and increasing demands progress (IOM, 2010, p. 173).

So, where was the elephant? The answer was another question. Where is the demand for new RNs? One attendee stood to ask how competency is maintained if there is a prolonged time between graduation from nursing school and employment. Another attendee from California stood to assert that the RN shortage was a myth as her program graduated ninety RNs in 2011 and of those only two had found jobs within the year. Her words were “I think we are missing the 900 pound elephant in the room. If there is a shortage, where are the jobs for these new graduates?” My thoughts exactly. It is difficult to see graduates struggle to find work as an RN in the current economic climate cognizant of the educational debt most incur while unable to see any clear indication of increasing opportunities in the RN workforce in Nevada.

So, is the “current” nursing shortage a myth?As hard as those words might be to hear,

they do seem to be correct. Dr. Peter Buerhaus, Director of the Center for Interdisciplinary Health Workforce Studies, Institute for Medicine and Public Health, Vanderbilt University, states “In the near-term (next couple of years) we can expect that, until there is a strong jobs recovery, most hospitals and other employers will continue to find that they can employ all the RNs they want at prevailing wages” (as cited by Tri-Council for Nursing, 2011, para. 21).

There is hope in the near-term for new graduates seeking positions if a few things occur as projected. A big IF…. First, if we see continued and more rapid economic recovery the near-term need for RNs is expected to rise sharply. The average age of the working RN population is rising. The current average age of RNs in the workforce is over 47 years (IOM, 2010). Currently, over 900,000 of the estimated 2.6 million working RNs are over the age of 50 (Buerhaus, 2011). It has been estimated that two-thirds of the recent growth in RN employment was supplied by RNs over the age of 50 who reentered the workforce as a result of family income difficulties resulting from the current economic recession (Buerhaus, Staiger, & Auerbach, 2009). “Because hospital employment of RNs over the age of 50 increased by more than 100,000 in 2007 and 2008, the exit could be swift and deep as many of these RNs seek to resume (or begin) their retirement once their spouses’ rejoin the labor market (Buerhaus, 2011).

Additionally, if the past trend of nurses over the age of 50 years moving away from health care delivery to either retirement or roles away from direct patient care continues, more direct care jobs will become available. One recurring reason cited by RNs for moving away from direct patient care has been dissatisfaction within the nursing workplace (Black, Spetz, & Harrington, 2008). The current “difficulties are further complicated by other changes in hospital care, such as new medical technologies and a declining average

length of stay, that have led to increases in the amount of care required by patients while they are in the hospital” and an increasing physical demand on RNs in direct patient care that adds to job dissatisfaction (Stanton, 2004).

Finally, if new graduate RNs re-think the “must haves” of their job searches; they should reevaluate their expectations in light of current workforce realities (Clavreul, 2011). Many of the graduates are frustrated because they are unable to land their “dream job” located in the “dream location” as opposed to any nursing job where the nursing demand and needy populations reside. The opportunities that once existed in specialty care for new graduates are not so plentiful now, but there are new opportunities in other aspects of health care delivery such as home health and long term care centers. “Employment in nursing care facilities is expected to grow because of increases in the number of older persons, many of whom require long-term care. Many elderly patients want to be treated at home or in residential care facilities, which will drive demand for RNs in those settings” (U.S. Bureau of Labor Statistics, 2009, p. 4). Further, home health care “is expected to increase in response to the growing number of older persons with functional disabilities, consumer preference for care in the home, and technological advances that make it possible to bring increasingly complex treatments into the home. The type of care demanded will require nurses who are able to perform complex procedures” (U.S. Bureau of Labor Statistics, p. 5).

There is an elephant out there. But, so are nursing jobs. There is something to be said for reality checks and a willingness to work as a needed direct care provider in the geographic area where the demand exists. The result will be a nursing workforce in the future with valuable experience and who prove that they do, indeed, possess those valuable competencies research suggests will be so necessary in tomorrow’s health care environment.

references available on request.

We specialize in transitional and long term care for brain injured and medically-complex patients in a 35-bed SNF. We offer a relaxed fun-working environment with excellent benefits including medical, dental, paid vacation and a 401(k) with matching contribution. Duties include but are not limited to:

• Assisting the Director of Nursing in planning, developing, organizing, implementing, evaluating and directing the day-to-day functions of the nursing services

• Participate in developing, maintaining, and updating our written policies and procedures that govern functions of the nursing department. Participate in the development, maintenance and implementation of the quality improvement program.

• Ensuring that reference material (Federal and State regulations, etc.) at the nurses station is current. Ensuring that the nursing policy and procedure manual is current at all times.

• Function as risk manager/quality improvement and infection control monitor for the facility.

• Report occupational exposures to blood, body fluids, infectious materials and hazardous chemicals in accordance with the facility’s policies and procedures.

If you are looking for a challenging yet rewarding career, please email resume [email protected] or

fax to 702.800.3060, Attn: Sheila.

CareMeridian is seeking an RN to be our

Assistant Director of Nursing/Case

Manager

www.careprohha.com

Employment Opportunities

RNs & LPNsJoin a Home Health Company with

a high opportunity for growth. Dedicated. Passionate.

Team Oriented.

Interested Applicants contact:[email protected]


with Caremore’s tobacco cessation program. Then the NP will manage risk factors for patients with chronic kidney disease. An important part of the NP’s job is to manage patients with diabetes, including assisting the patient with a glucose monitor that can be downloaded during clinic visits, and free lancets and monitoring strips, plus teaching how to use both long and short acting insulins and providing wound care.

In addition to all the care provided by the NPs the Caremore senior can go to the clinic to visit with the “extensivist,” a physician director that also visits the patient in the hospital, and sees the patient in the clinic after the hospitalization. There are also visits at the clinic with a pulmonologist, a podiatrist, and a psychiatrist, plus multiple disease focused nutrition classes led by a dietician, all centrally scheduled on the Caremore electronic health record (EHR).

To add to the value, the clinic includes a senior friendly gym called “Nifty after 50” that guides the patients in how to lose weight and increase strength and balance to help prevent falls; they can also see a physical therapist at the gym. The social aspects of the gym also help seniors who may have slight depression due to isolation or pain. An RN Case Manager, medical assistants, and a Licensed Clinical Social Worker round out the staff in the clinics.

Caremore also employs two additional NPs in its Touch program. NPs go out to assisted living facilities to help patients, providing quality healthcare with the convenience of not having to leave home. A few not so common perks the seniors receive are toenail trimming offered in the clinic and drivers to assist them with getting to appointments or picking up prescriptions. To learn more about Caremore please see their website at: http://www.caremore.com

Model described by Diane McGinnis, DNP, APN-FNP, NP-C, the AANP NV State Representative 2010-2012. To contact Diane, please email: [email protected]

Nevada NPs Make a Difference

(Continued from page 13)Professional Nursing Practice

Palliative Care NursingLeslie Hunter-Johnson, MSN, RN-BC, CCRN, CNRN, CHPN

Palliative Care Coordinator, Sunrise Hospital and Medical Center

Palliative care nursing is a new specialty that is directed at identifying and treating pain and other symptoms for patients in acute care settings who are experiencing life-threatening and/or chronic illnesses. The goal is to improve the quality of life while concurrently providing curative treatment. There have been misconceptions that palliative care equates to an anticipated death. The results of a public opinion survey conducted by the Center to Advance Palliative Care (CAPC), confirmed that physicians equated palliative care with hospice care and were reluctant to order referrals to those facilities offering palliative care services.

On September 1, 2011, The Joint Commission released certification standards on Advanced Certification for Palliative Care. This information should help promote consumer awareness of the availability of palliative care in acute care settings. The services are provided by specially trained teams that include physicians, nurses, and other

team members that work together toward the patient’s goals. Along with treatment of pain and symptom management, the patient is treated as a whole and not a defined disease process. This process has a positive impact on the patient and family and promotes stress reduction in an otherwise stressful situation.

As a palliative care nurse, I am very passionate about the patients and families to whom I provide care. The members of the team take the time to listen to those involved without constraints of limited time. We look at the patient and their symptoms as a whole forest, and not just a single tree. Recently, Nevada was upgraded from a “D” to a “B” on the provision of palliative care services due to the continuing efforts of palliative care providers.

For more information on palliative care or to view the Public Opinion Survey on Palliative Care, visit the Center to Advance Palliative Care website at www.capc.org

Research HighlightsWallace J. Henkelman, Ed.D, MSN, RN

Assistant Professor, Touro University Nevada

Olive Oil and Stroke Risk

A recent study conducted in three cities in France (Samieri et al., 2011) compared persons of ages 65 and older with no history of stroke looking at, among other things, dietary habits. Two specific items studied were self-reported intake of olive oil and plasma oleic acid levels (an indirect indicator of olive oil intake). There were 7,625 individuals in the first group and 1,245 in the second. After adjustment for demographic, other dietary variables, body mass index, and other risk factors for stroke, it was found that intensive users of olive oil had a 41% lower incidence of stroke than those who did not use olive oil. Intensive use was defined as using olive oil for both cooking and dressings. The participants with high oleic acid levels were 73% less likely to have strokes than those with lower oleic acid levels. Oleic acid can, however, be increased by dietary factors other than olive oil consumption.

Perhaps in discussing diet with our clients, we need to suggest the use of olive oil, particularly in clients with risk factors for stroke.

reference:Samieri, C., Feart, C., Proust-Lima, C., Peuchant, E.,

Tzourio, C., Stapf, C., Barberger-Gateau, P. (2011). Olive oil consumption, plasma oleic acid, and stroke incidence. Neurology 77(5), 418-425. doi: 10.1212/WNL.0b013e318220abeb

New Treatment for Head Lice

Head lice are a persistent problem, particularly in persons living in crowded situations such as classrooms. Traditional, nonpharmacological treatments such as applying petroleum jelly and combing are very time-consuming and tedious. Unfortunately, lice have also been developing resistance to commonly used pharmacological agents such as Nix (permethrin) making treatment more difficult.

The FDA recently approved a new treatment for head lice, spinosad (Natroba Topical Suspension) for use on children age four and older. It is more expensive, but clinical trials have shown it to more effective than Nix (86% vs. 44% louse-free after 14 days). It has been shown to be effective after just one treatment without the combing for nits. The nits appear to be unable to hatch after the treatment.

referencesBinns, C. (2011). No more nit-picking? New FDA approved

treatment promises easier way to defeat lice. TODAY Health@ TODAY.com.

U.S. Department of Health and Human Services. (2011). FDA approves head lice treatment for children and adults. Retrieved from http://www.fda.gov/NewsEvents/Newsroom?PressAnnouncements/ucm240302.htm

Come join us in our beautiful facilitylocated in Elko, Nevada. Wonderful people,

majestic mountains, clean air and greatopportunities await you in our growing

community.

SEEKING RNs:Cardiac Care Coordinator

ER DirectorOB Director

Positions in OB, ER, andMed/Surg/Peds

Competitive Benefits and Pay

Visit our website for detailsand to view all othercareer opportunities.

Apply online at www.nnrhospital.com2001 Errecart Blvd, Elko, NV 89801

EOE/AA

Find a nursing career where you can become a star!


APRN PracticeRegulatory Changes Propel Advanced Practice Nurses in

Nevada Toward Nationally Standardized PracticeSusan Watson, PhD, FNP-BC

Exciting and significant changes for Nevada Advanced Practice Nurses (APNs) are being proposed by the Nevada State Board of Nursing (NSBON). A workshop,

that should be attended by all APNs in Nevada, to review proposed changes to the regulations and laws related to nursing practice is on December 21, 2011, followed by a public hearing on January 10, 2011. These meetings are to discuss adoption and amendment of the changes that pertain to chapter 632 of the Nevada Administrative Code. The Board proposes adoption, amendment or repeal for 49 of the 197 regulations contained in chapter 632, which contains most of the relevant regulations governing the scope and practice of nursing in the state. Familiarity with the regulations is a requirement of licensure.

The Board of Registered Nursing is clearly adopting a proactive stance, moving the profession toward proposals identified in two landmark documents, “The Future of Nursing” report prepared by the Institute of Medicine (2011) and the Robert Wood Johnson Foundation, and the “Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education” (APRN Work Group & the National Council of State Boards of Nursing APRN Advisory Committee, 2008). Changing state regulations to reflect proposals by professional practice associations at the national level may ease the barriers and restrictions allowing advanced practice nurses to employ a full scope of practice within the rapidly changing healthcare environment.

As stated in the IOM report and supported by the recommendations within the consensus model, ‘Nurses have the opportunity to play a central role in transforming the health care system to create a more accessible, high-quality, and value-driven environment for patients. If the system is to capitalize on this opportunity, however, the constraints of outdated policies, regulations, and cultural barriers, including those related to scope of practice, will have to be lifted, most notably for advanced practice registered nurses.’ (IOM, 2011). The advance practice scope of services should be defined by patient care needs. (WHO, 2006).

APRN regulations noted within the consensus model include the essential elements of licensure, accreditation of nursing-related educational degrees and certification programs, formal recognition of certification that recognize the achievement of standards recognized by the profession and that the formal preparation of APRNs is at a graduate degree or post-graduate certification level.

The NSBON regulatory proposals reflect changes related to those elements. To bring Nevada closer to the consensus model, eleven of the regulatory changes are related to the name change from the current term of “advanced practitioner of nursing” (APN) to the nationally recognized title “advanced practice registered nurse“ (APRN). The definition proposed within the Nevada regulations is: ”Advanced practice registered nurse means a registered professional nurse who has specialized skill, knowledge and

experience obtained from an organized formal program of training, and who is authorized in special conditions (NAC 632.255 to 632.295) inclusive, to provide designated services in addition to those which a registered nurse is authorized to perform.” (NAC 632.020). The proposal includes language that recognizes the four recognized advanced practice registered nurse roles of certified registered nurse anesthetists, certified nurse midwives, clinical nurse specialists and certified nurse practitioners included in the definition of APRN within the consensus model (2006).

Scope of practice for Advanced Practice Registered Nurses (APRNs) is variable and changing nationally across states and territories. Within the consensus model, the scope of practice for Certified Registered Nurse Anesthetists is identified as: being prepared to provide a full-spectrum of anesthesia care and anesthesia related care to clients across the lifespan, in diverse inpatient and outpatient medical settings. Certified Nurse-Midwives (CNMs) provide a full range of primary health care services including gynecologic and obstetrical care, preconception care, family planning, childbirth, prenatal and postpartum care and care of the newborn across diverse inpatient and outpatient medical settings. Clinical Nurse Specialists (CNS) integrate care across the continuum through three spheres of influence: patient, nurse and system, and are responsible and accountable for diagnosis and treatment of health across a continuum from health to illness, disease management, health promotion, and prevention of illness and risk behaviors for individuals, families, groups and communities. Certified Nurse Practitioners (CNP) provides care along the wellness-illness continuum across settings. CNPs practice autonomously in diverse areas such as family practice, pediatrics, internal medicine and medical subspecialties such as geriatrics, behavioral health and women’s health care. Clinical CNP care includes health promotion, disease prevention, health education

and counseling as well as the diagnosis and management of acute and chronic diseases. CNPs are prepared to be primary care CNPs as well as acute care CNPs, having separate national consensus-based competencies and separate certification processes.

Advanced Practice Nurses in Nevada must be informed and involved in standardizing practice that will promote 21st century healthcare delivery in the state. Proposed changes can be viewed on the Nevada State Board of Nursing website at: http://nevadanursingboard.org/practice-and-discipline/notice-of-intent-to-act-upon-a-regulation/.

references:APRN Consensus Work Group and the National Council

of State Boards of Nursing APRN Advisory Committee. (2008). Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education. Retrieved 12/4/11 from: http://www.nonpf.com/associations/10789/files/APRNConsensusModelFinal09.pdf

Nevada State Board of Registered Nursing(2011) Notice of intent to act upon a regulation. Retrieved 12/4/2011 from: http://nevadanursingboard.org/practice-and-discipline/notice-of-intent-to-act-upon-a-regulation/.

Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine; Institute of Medicine [IOM]. ( 2011). The Future of Nursing: Leading Change, Advancing Health. The National Academies Press. Retrieved 12/4/2011 from: http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.

World Health Organization, (2006). WHO Health Promotion Glossary: new terms. HealthPRomotion International Advance Access. Oxford University Press: Author. Retrieved 12/4/2011 from: http://www.who.int/healthpromotion/about/HP%20Glossary%20in%20HPI.pdf

Dr. Watson graduated with a PhD in 2010 from the University of Miami. She has been a registered nurse for 34 years and is now working as an assistant professor of nursing at Roseman University of Health Sciences and as a Family Nurse Practitioner at Cornerstone Family Practice in Henderson, NV.

The “biggest and best” uniform store in Reno!!

Shop and redeem this $10 gift certificate on scrubs or shoes!

Lelia’s Scrubs

GIFT CERTIFICATE

Limit One Per Customer

8175 S. Virginia St., Suite 250, Reno, NV 89512775.825.2888 Open M-F 10am-7pm–Sat & Sun 10am-4pm

$10

$10

$10

$10FREE INFORMATION PACKAGECall or email Jim CoxSenior Consultant800-304-3095 ext 101 orEmail: [email protected]

®


notification regarding numbers and severity of victims to expect was not received; victims just arrived at the ER. Shelby reports this upset some staff, but she had a sense that the injured would just “show up.” Upon learning of the disaster, Saint Mary’s staff had started preparations for victims and were ready when they arrived at the emergency room doors. Staff triaged victims quickly and directed them to appropriate care.

Kit reflects that during the incident she was able to “disconnect” from emotions and functioned on “auto-pilot” to provide rationale direction. After the crisis, Kit felt called to “nurse her nurses” especially those less experienced with trauma situations. Shelby describes the need to be a “nurse for the nurses and doctors” affected by the tragic incident. Chaplains assisted at the scene of the disaster and later worked at the hospital with victims and families. In addition, chaplains were available to hospital staff. Kit requested that a local chaplain who is especially effective working with fire fighters speak with recovery room and OR staff. Primarily, staff wanted to discuss their feelings about the victims and their families and discuss visual impressions.

Continuing discussion about post incident reflection, Kit was impressed with the “collective community response” during the crisis and the ongoing support of the community after the disaster. She thinks the “coolest thing” was that everyone came together displaying “heart” and sharing a “sense of humanness.” Kit reports feeling “a sense of camaraderie with the community and her colleagues” including the physicians. Kit is proud of her staff’s response during the crisis and gives them recognition for exceeding expectations and successfully bridging boundaries. Shelby describes the community response as “phenomenal” and felt there were “no barriers” during the crisis due to the emergence of a “cohesive team approach.”

After experiencing a “true life” disaster, Shelby offers the following advice.

1. “Train like it’s real” during disaster exercises. Participate in the drill to become prepared in the event of a crisis and to learn the role(s) expected for your position.

Meet Nevada’s Nurses(Continued from page 7) 2. After the incident, talk about your emotions

and feelings; vent and relive your story as often as you feel necessary.

3. Get back to work as soon as possible, but not until you feel you are ready.

Kit concurs with Shelby’s advice for disaster preparation and offers additional comment for post incident management.

1. Staff may require support after the incident is concluded and the crisis is deemed “managed.”

2. Suggests peers and especially senior staff listen to disturbed staff allowing them time to talk through their “horrific” experience.

3. Listeners can remind those impacted of their vital role and that they were responsible for saving lives and alleviating suffering.

4. After talking about their experience and venting their emotions, most staff will be able to return to their jobs and find the return to work helpful. However, some staff may experience more difficulty including post traumatic stress disorder (PTSD) and require professional counseling. Staff should be encouraged to seek appropriate counseling when their distress persists.

The response from nurses throughout the Reno/Sparks area after the Air Race’s tragic accident was remarkable. The nurses who responded to the need are to be commended for their heroic, tireless efforts during the mass casualty crisis and for their continued support of victims, families and colleagues in the aftermath. Kit and Shelby are two examples of the many nurses who performed in an outstanding manner during the crisis. They, along with other nurses in the community, earned respect and recognition for their capable leadership and, like others, they continue to provide care, support and direction to colleagues and members of the community post crisis.

The editorial board invites Nevada nurses to submit contributions relating their experience about this disaster or any other mass casualty. Please include a description of your actions along with your thoughts, impressions and reflections. Of particular interest—advice for effective preparation and suggestions for improved management of the incident.

EditorialDear Colleagues,

Happy New Year to all of you. We hope you like the new format of RNFormation. We are looking at ways to make NNA’s publication more helpful to nurses. Plans are also underway to integrate our communications to better utilize our website, Facebook page, and Twitter.

We hope the changes make RNF and all of our other publications more user friendly for nurses. Please let us know how we are doing.

And just for fun, we will start hiding a picture of a syringe that looks like this:

somewhere in each issue of RNFormation. The first person who calls us at 775-747-2333 and identifies the correct location, will win a $25 Starbucks gift card.

Your emails, calls, and suggestions are always welcome. If you have a professional issue that you wish to bring forward, please contact us about submitting an article.

I look forward to meeting many of you in the coming year.

Warmest regards,Margaret Curley, RN, BSNEditor, RNFormation

WOCN ConferenceScheduled in Napa The Pacific Region of the Wound Ostomy

Continence Nurse Society will be holding their annual conference this year in Napa, California at the Embassy Suites on February 10th – 11th, 2012. The speakers will cover topics associated with wounds, ostomies and continence with vendors on Friday the 10th of February. The cost of the conference for PCR WOCN Member $170, non-PCR/WOCN Member $195, and student is $160. At the door it is $200.00. 7.5 CEU will be offered. To enroll or for more information you can go the PCR website at http://www.pcr.org/


Social media questionfor discussion

How Can We Improvethe Image of Nursing?

A new restaurant opened recently in Las Vegas which has a “medical” theme; customers are “patients,” orders are “prescriptions,” and waitresses are “nurses.” The Truth About Nursing Southern Nevada chapter held a demonstration to protest the use of the term “nurse” for food service personnel. This has sparked serious discussion among nursing colleagues about the most effective approach for nursing to take in addressing how nurses are represented and perceived by the public.

We all know that the use of the title “nurse” for anyone other than a licensed nurse is illegal, and

Check it Out!In the United States, one of our greatest

challenges is living healthy lives. By now, everyone knows the amazing benefits of physical activity, so why are we so reluctant to incorporate exercise into our daily routines? Perhaps we need a reminder of the benefits? The Mayo Clinic believes physical activity can influence and improve energy levels, mood, sleep, weight control, and prevent or alleviate the effects of illness and disease. Oh, and by the way, physical activity can be fun, especially when shared with family and friends, including our beloved animals!

If you’re just beginning, the Mayo Clinic suggests you may want to talk with your doctor, especially if you have chronic health or illness conditions. Guidelines and tools for beginners are grouped under the headings of aerobic exercise, stretching and flexibility, strength training, and sports nutrition. In addition, fact sheets, slide shows, and videos address an interesting and wide variety of topics such as heart rate (normal ranges and target exercise heart rates), boot camp and workplace options, and overcoming challenges and staying motivated. This is a great place to begin as a beginner! Please visit this Mayo Clinic page at www.mayoclinic.com/health/fitness/MY00396

If walking around the block is just not all it’s cracked up to be, how about something new and different?

Tai chi (also known as tai chi chuan) emphasizes the body mind connection through continuous flowing and graceful movement to enhance balance, coordination, flexibility, and breathing, and promote peace and reduce stress. There are more than 100 movements and positions designed to achieve these goals. Scientific evidence supports the value of tai chi, especially in the elderly, and those with bone, joint, or muscle concerns. Be sure to read the valuable advice under tips for getting started. Please visit this Mayo Clinic page at www.mayoclinic.com/health/tai-chi/SA00087

Yoga practice comes in all shapes and sizes. It began as the path to spiritual enlightenment, a life-changing experience that blends behavior, diet, and meditation for flexibility, strength, and physical-mental-emotional health. Today, documented health benefits include increased fitness and weight loss, management of chronic health conditions, and stress reduction. Yoga may not be suitable for everyone, so please review the guidelines for precautions and finding a yoga class. Please visit this Mayo Clinic page at www.mayoclinic.com/health/yoga/CM00004 and Yoga Journal at www.yogajournal.com/basics/165

Budokon is a living art blending physical and Zen practices. Physical practice explores range of motion and develops agility, balance, control, power, and speed through yogic and martial arts. Creator and founder Cameron Shayne provides inspiration and motivation, and nutritional guidelines to support the physical demands of his practice. Please visit Budokon International at www.budokon.com/index.php

When all is said and done, physical activity can be challenging, fun, healthful, and rewarding. No matter what you choose to do today, please plan on exercising more than just your fingers on the remote control—please get up out of that comfy chair and take your first step toward glowing and vibrant health—you’ll be glad you did!

there would be broad consensus to take action if a medical assistant or a CNA was represented as being a “nurse.” But what about a waitress dressed in a white uniform with a cap who calls herself “nurse?” Is this a threat to the image of nursing?

We received articles from two nurses with different perspectives on the approach needed to address image problems in nursing. Visit our website at www.nvnurses.org and click on the link to read both articles, then post your comments on the Nevada Nurses Association Facebook page. We look forward to hearing your views.

EOE

Visit our website for current nursing opportunities

www.carsontahoe.comRecruiter: 775.445.8678

Job hot line: 888.547.9357Carson City, Nevada

(Located in Northern Nevada, near Lake Tahoe and Reno)

Featuring: •JCAHOaccredited • 138 private rooms • Comprehensive healthcare system • Growth opportunities • Competitive salaries • Medical benefits • Generous 401k • Vacation / Sick leave • Paid holidays • Education assistance


What Has NNA Done for You Lately?

In the last quarter, as always, NNA has been working on behalf of all Nevada nurses. The past quarter’s activities include:

1. NNA convened a statewide committee in December at the request of the Legislative Committee to address the long-standing problem of horizontal violence (also called nurse-to-nurse bullying, peer abuse, lateral violence) in the workplace. The American Nurses Association considers bullying/horizontal violence a violation of nursing ethics and the Joint Commission issued a Sentinel Event Alert linking the “toxic atmosphere” created by disruptive behavior in health care facilities to preventable adverse patient outcomes. Interest in finding solutions to this problem is high, and a subcommittee will begin meeting to develop a plan of action which will be presented to the full committee in February.

2. NNA was awarded a grant by the American Nurses Association to start a statewide mentoring program. Mentoring will be provided by experienced nurses to new graduate nurses and nurses returning or considering returning to school for an advanced degree or certification. We realize the busy schedules that most nurses have, so this project will be web-based, with mentoring by email, and will take only about 15 minutes per week for mentors. Do you have 15 minutes a week to help a colleague? If so, please contact us at 775-747-2333.

3. NNA District 1 held a silent auction/CEU event which raised more than $1600 for nursing scholarships in northern Nevada.

4. A poll of NNA members indicated that nurses want more professional networking and CEU opportunities. NNA is developing social networking tools to assist in meeting these needs. Join the Nevada Nurses Association group on Facebook; follow up on Twitter at @NVNursesAssoc; connect to the Nevada Nurses Association group on LinkedIn for networking and professional discussions.

5. The NNA Legislative Committee has been meeting monthly to plan the 2013 Legislative Agenda. NNA also continues to employ a lobbyist to monitor legislative activities for impact on nursing.

www.unr.edu/nursing

B.S. in NursingRN to BSNM.S. in Nursing

FNPNurse EducatorClinical Nurse Leader

DNP (Doctor of Nursing Practice)

Orvis School of Nursing

University of Nevada, RenoStatewide • Worldwide

UnIVERSITY OF nEVADA, REnO


Ask a Nurse

1-800-HOMECARE (466-3227) Inside Nevada Only

(702) 791-3729

February 1, 2012

EXPERIENCED HOME CARE RNs ONLYRNs MUST have knowledge re: OASIS (Admissions, Resumptions, Recerts, D/Cs

Special Skills with any of the following is also a plus:

Port-a-Cath – PICC Lines – Peripheral Lines – Central Lines – IV Administration

TPN Administration – Chemo Therapy Certified

Dear RN,

Since 1994 the skilled nursing staff at Caring Nurses (CNI) has continued to deliver the highest standard of quality care to our local seniors in the Las Vegas area.

In 2009 and 2010 Caring Nurses was awarded by Home Care Elite, the distinction of being in the top 5% of all Home Health Care Providers nationwide, for outstanding clinical and functional outcomes’ performance.

Our continued growth in Las Vegas Nevada motivates us to seek qualified RNs who meet our high standards.

In return we offer:

An attractive per diem visit reimbursement

Profit-sharing plan

MATCHING 401K

ESOP program

At CNI we provide a team-oriented environment that gives you great support, flexibility and recognition. You will also find that our office and administrative staff are friendly, courteous and play a supportive role to all our field staff clinicians.

Applicants must be devoted and committed to providing quality nursing care while enjoying independence. We seek directed professionals who desire a rewarding career in home health.

CNI uses the latest technology that includes an internet based electronic documentation website.

Contact our office @ (702) 791-3729 for additional information or fax your resume to (702) 791-3859. The e-mail address is: [email protected]

CNI is looking foward to hearing from qualified applicants. Our number is easy to remember 1 (800) HOMECARE.

Sincerely,

Roger CorbinChief Operations Officer

2968 E. RUSSELL RD • LAS VEGAS, NEVADA 89120 • (702) 791-3729 • FAX (702) 791-3859


As a RN, you can advance your education onlineand work towards advancing your career.Online options include: RN to BSN Option,RN-BSN to MSN Option andMaster of Science in Nursing (MSN) Degree Program.

Chamberlain College of Nursing offers a proven model with advanced degree program options to take you to the next step. Keep moving forward.

Take the leap.Pursue those three big letters that come after your name.BSN and MSN

Now enrolling for spring, summer and fall semesters

©2012 Chamberlain College of Nursing, LLC. All rights reserved.

National Management Offi ces | 3005 Highland Parkway | Downers Grove, IL 60515 | 888.556.8CCN (8226)

Comprehensive consumer information is available at: chamberlain.edu/studentconsumerinfo

For more information, please visit chamberlain.edu or call 888.556.8CCN (8226)

february 2012 volume 21 • number 1 nevada ... · and a new credential, secret to becoming a...

Documents