innovation and new nursing cognitive capabilities...volume 5 number 4 september 2019 the official...

current resident or

Non-Profit Org.U.S. Postage Paid

Princeton, MNPermit No. 14

Membership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

WNA Welcome: Welcome New WNA Members! . . . . . . . . . . . . 3 Wisconsin Nursing Trivia . . . . . . . . . . . . . . . . . . . 4

Wisconsin Nurses Association Updates: WNA Working for You - Summer 2019 . . . . . . . 6 WNA Board of Directors Meeting Highlights . 7 WNA Ready to Run? . . . . . . . . . . . . . . . . . . . . . . . 8

Upcoming Conferences . . . . . . . . . . . . . . . . . . . .12

Grant Updates . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Legislative Updates . . . . . . . . . . . . . . . . . . . . . . . . .13ANA Updates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14Mutual Interest Groups (MIGs) Updates: Environmental Health . . . . . . . . . . . . . . . . . . . . .14 Wisconsin Faith Community Nurse Coalition .15Wisconsin Center for Nursing . . . . . . . . . . . . . . .16WNA Nurse Practitioner Forum . . . . . . . . . . . . .18Workforce Advisory Council . . . . . . . . . . . . . . . .19

VOLUME 5 NUMBER 4SEPTEMBER 2019

The Official Publication of the Nurses Foundation of Wisconsin, in cooperation withthe Wisconsin Nurses Association. Delivered to you courtesy of the WNA membership.

NEWSLETTERALONG NURSE

COLLEAGUETO

A

PASS THIS

GAIN AMEMBER!

MEMBERSHIP APPLICATION ON PAGE 2

By Linda Gobis

Nursing innovation is one of the current hot topics on the national level, including several ANA webinars and conferences . This is the second article in my series on nursing innovation to give Wisconsin nurses a glimpse of the concepts, discussion and debate nationwide .

Joseph Aoun, in his book about artificial intelligence (AI) and its impact on professional practices, identifies new literacies and cognitive capabilities that will be necessary for health care and other professionals in the future . (Aoun, 2017, p . xix) My first article discussed new literacies nurses will need to know moving forward, including data, technological and “human” literacies . This article will focus on new cognitive capabilities, including systems thinking, entrepreneurship, cultural agility and critical thinking . (Aoun, 2017, p . xix)

Cognitive CapabilitiesAoun believes the first cognitive capability

needed in higher education and professional thinking is systems thinking . (Aoun, 2017, pp . 64-66) The health care industry has made some movement away from the silo model toward systems thinking in recent years . For example, risk management historically used the individual penal approach to medical errors . Over time, it became obvious that analyzing systems and processes, gaps in procedural steps and points of repeated errors were necessary to address the root causes of near misses and adverse events . Multi-disciplinary teams, inter-professional education and patient centered team based care were other systems based initiatives . Although computers and technology can be programmed to perform linear analysis of data across silos, they cannot be programmed to make creative leaps in systems thinking like humans . (Aoun, 2017, p . 65)

Aoun advocates for expanded global systems thinking that reaches outside the health care industry . For example, contaminated water is not only a public health problem, but should also include civic infrastructure, taxation and social justice issues . (Aoun, 2017, p . 66) In other words, looking at the issue from a global engineering, economic, legal and health sciences perspective . (Aoun, 2017, p . 65) Pandemics are also not solely a medical issue, but should include a marketing approach to community outreach campaigns . (Aoun, 2017, p . 66)

Aoun’s second cognitive capability is cultural agility . (Aoun, 2017, pp . 70-73) Increased global commerce not only involves global “systems,” but also learning how to operate in different cultures . In nursing terms, cultural competence . Nurses will not only have to provide culturally competent care to individual patients and families, but also patient populations across regions in national health care systems emerging nationwide . National nursing standards have been developing for nursing skills, tasks and interventions . These standards will not only need to be effective across traditional cultural differences, such as race, religion, and gender, but also regional differences (e .g . midwest, east

coast, west coast, deep south) . (Aoun, 2017, p . 71) Health care systems are also starting to develop internationally which will add to the complexity and chances for misunderstanding . Computers and other technology cannot account for unspoken meanings of words (e .g . facial expressions, vocal intonations, body language) and cultural assumptions like humans can . (Aoun, 2017, p . 72)

The third cognitive capability identified by Aoun is critical thinking . (Aoun, 2017, pp . 62-64) This has been a basic competency in baccalaureate nursing programs for quite awhile . However, Aoun believes “critical thinking on steroids” is needed . (Aoun, 2017, p . 63) Computers are good at decision-making trees with yes/no answers and data analysis . Nurses will, therefore, have to utilize the data analysis provided to examine nursing issues contextually . In addition, just because things worked a certain way in the past, does not necessarily mean they will work the same way in the future . (Aoun, 2017, p . 64) Health care is constantly changing so both context and questioning prior assumptions will be increasingly important . For example, new patient care guidelines, technology, cultural factors, and/or individual

Innovation and New Nursing Cognitive Capabilities

WNA Welcome

Innovation and New Nursing...continued on page 5

The Wisconsin Nurse September 2019

WISCONSIN NURSES ASSOCIATION2019 BOARD OF DIRECTORS

Linda Gobis, PresidentElizabeth Markham, Vice President

Pam Sanberg, Treasurer Megan LeClair-Netzel, SecretaryWendy Crary, Director-at-LargeJulie Olson, Director-at-Large

Laura Tidwell, Director-at-LargeAdey Tewolde, Staff Nurse Representative

Lisa Pisney, APRN Representative

WISCONSIN NURSES ASSOCIATION STAFFGina Dennik-Champion, Executive Director

Megan Leadholm, Associate Director Allison Champion, Membership and

Communications DirectorTeresa Prattke, Education Program Coordinator

NURSES FOUNDATION OF WISCONSINBOARD OF DIRECTORS

SueAnne TeStrake, PresidentPamela Macari Sanberg, Treasurer

Jana Esden, Secretary Alex Hetzer, Director-at-LargeGina Fellenz, Director-at-Large

Isabelle Garibaldi, Director-at-LargeJill Berg, Director-at-Large

Laurie Radojevich, Director-at-LargeLindsey Lucero, Director-at-LargeRorey Pritchard, Director-at-Large

Cathy Berry, WNA Board Representative

THE WISCONSIN NURSE EDITORIAL STAFFSueAnne TeStrake, Executive Editor

Gina Dennik-Champion, Deputy Executive EditorAllison Champion, Managing Editor

CONTACT INFORMATIONWisconsin Nurses Association/

Nurses Foundation of Wisconsin2820 Walton Commons, Suite 136

Madison, WI 53718 info@wisconsinnurses .org

www .wisconsinnurses .org – @wisconsinnurses

American Nurses Association 8515 Georgia Avenue, Suite 400 Silver Spring, MD 20910-3492

memberinfo@ana .org – www .nursingworld .org

The Wisconsin Nurse is published quarterly every March, June, September, and December by the Arthur L . Davis Publishing Agency, Inc . Subscriber rates are available, 608-221-0383 .

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, sales@aldpub .com .

NFW 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 Nurses Foundation of Wisconsin of the products advertised, the advertisers or the claims made . Rejection of an advertisement does not imply that 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 . NFW and the Arthur L . Davis Publishing Agency, Inc . shall not be held liable for any consequences resulting from purchase or use of advertisers’ products . Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of WNA, or those of the American Nurses Association .

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MEMBER OF WNA.

VISIT WWW.JOINANA.ORG OR COMPLETE THIS APPLICATION.

THEWISCONSINNURSE

MARLENE S GARVIS, MSN, JDAttorney at LawLicensed to practice in the state and federal courts of Minnesota, Iowa, and [email protected]: (612) 462-9119Fax: (952) 516-5798Web: www.marlenegarvis.com

September 2019 The Wisconsin Nurse

Welcome New WNA Members! 5/16/19 – 8/13/19

Tammi Albrecht

Danielle Alonso

Amenah Al-Sarraj

Samantha Alvarez

Jodie Ausloos

Amanda Bacher

Amy Barry

Kara Beattie

Susan Berg

Cheryl Berg

Toni Boegel

Jill Bohn-Wolfe

Jesse Borowski

Susan Boyle

Angela Breaden

Alyssa Bredeson

Lisbeth Buchholz

Renee Bukovich

Lisa Bullis

Jennifer Burns

Angeline Cain

Jennifer Charles

Holly Christensen

Rita Cordova

Darae Coughlin

Rebecca Cronk

Samantha Debroux

Elisa Demet

Lea Devore

Lisa Doughty

Emily Downey

Jennifer Drayton

Kathryn Dykes

Carol Endries

Colleen Engler

Allison Erzberger

Deborah Ferguson

Andrea Fetherston

Kia Filla

Kimberly Franklin

Roshonda Frazier

Fay Fritsch

Thea Fronk

Faleasha Gallagher

Melanie Gentry

Sarah Gerard

Katie Gilbert

Alanna Gumise

Mary Hadle

Sarah Hartlaub

Crystal Hartman

Jeanne Hiatt

Jamie Hines

Latanya Holloway

Elizabeth Horwath

Courtney Hoster

Courtney Hunt

Kim Irish

Sheryl Jacobson

Alexandra Janota Gaines

Shalon Jarozewski

Kim Johnson

Sarah Johnson

Kim Johnson

Sherry Johnson

Tammy Jones

Tracy Jones

Ruby Juarez-Briski

Sara Kaluza

Rebecca Keith

Ellen Kenny

Melaku Kibebew

Michele Klister

Wendy Koenig

Kelly Konesko

Wendy Kons

Mary Kopp

Samantha Krieger

Amy Kuecherer

Laurie Kunkel-Jordan

Tracy Kussmaul

Kelly Laishes

Ashley Langenecker

Alison Layhew

Flower Lewis

Ann Mary Ligman-Schliem

BreEllen Loughlin

Katrina Lovick

Randi Mann

Tara Marek

Kristine Marklein

Denise McMahan

Jesslyn McMahon

Leesa McShane

Kristine Metz

Lori Mickelson

Lucy Mkandawire-Valhmu

Traci Moe

Courtney Moskal

Cortney Muns

Rosanne Norwood

Jessica Nowak

Sally Nuetzel

Basil Nwachukwu

Shaa O’Donnell

Tanya Olin

Jennifer Olson

Julia Ostrander

Julie Patrick

Gwen Pennington

Gina Perez

Sara Peters

Allison Philipps

Ali Phipps

Angie Polensky

Amanda Ponsler

Audrey Rabas

Kimberly Radtke

Shauna Radunzel

Ariana Ramirez

Margaret Reilly

Mary Reszczynski

Melissa Reuter

Hallie Richards

Julienne Rock

Suzanne Rogan

Tracy Rogers

Taylor Rotherham-Decremer

Beth Rozak

Nicole Saleske

Leomarys Santaella

Amanda Schacht

Diane Schadewald

Kristi Schneider

Kelsey Schumacher

Christy Schwartz

Amy Sekel

Laurel Sickinger

Diane Skewes

Jennifer Stanisch

Andrea Stein

Paula Stelsel

Hailey Stenberg

Quinette Tanner

Nicole Uelmen

Amanda Van Voorhis

Brian VanDenLangenberg

Jennifer Welsch

Kathy Williams

Alexandra Wilson

Jennifer Windpassinger

Kathryn Wingate

Sabrynna Young

Kandice Young

Melinda Young

Kate Young

Angela Zenke

Kimberly Ziolkowski

Tracy Zvenyach

WNA Welcome

http://mtmary.edu/rntobsn

http://www.ccneaccreditation.org


WNA Welcome

Compiled byLaurie K Glass and Signe Skott Cooper

In celebration of WNA’s 110th anniversary, try your hand at Trivia! (37 questions .)

What year was the first Wisconsin Nursing Practice Act passed?

What two Wisconsin nurses served as ANA presidents?

What Wisconsin Civil War volunteer nurse is portrayed in a painting in the State Capitol?

Where was the first Visiting Nurse Association in Wisconsin?

When was the Milwaukee Visiting Nurse Association established?

Who was the first director of the Milwaukee Visiting Nurse Association?

Who was the first county nurse in Wisconsin, and in what county?

What was the leading cause of death in 1900 - in Wisconsin and in the nation?

What Milwaukee company was the first one to employ an industrial nurse?

What was the first hospital in the state and where was it located?

Who is considered the "mother”of public health nursing in Wisconsin?

The wife of what governor of Wisconsin was a registered nurse?

Name an early African- American nurse in Wisconsin .

The "iron lung" was used to care for some patients with what disease?

One of the earliest native American nurses in the country was from Wisconsin . Who was she?

Where was the first practical nurse program in Wisconsin located?

Where was the first ADN program in the State?

Four Wisconsin nurses have been elected to the ANA Nursing Hall of Fame . Who are they?

Where is the headquarters of the Wisconsin Nurses Association located?

Until the 1930s, most graduate nurses were employed in what type of nursing?

Wisconsin was the first state in the country to pass a workers compensation law . True or false?

Who was the only Wisconsin nurse who died as a result of enemy action in World War II?

The name of what Wisconsin nurse appears on the wall of the Vietnam memorial in Washington, D .C . ?

Name 2 nurses that served in the Wisconsin Legislature .

What 2 Wisconsin Nurses have served as Chiefs of the US Army Nurse Corps?

Wisconsin Nursing History TriviaFrom 1949 to 1967 there was a Wisconsin State Department of Nurses responsible for the registration of nurses . Who was its only Director?

Wisconsin nurse registrations are numbered chronologically, beginning with no . 1 . Who was the #1 in Wisconsin and why was she so designated?

Who was the first Dean of the Marquette College of Nursing?

Who was the first director of the school at nursing at UWM?

The first airline stewardesses were nurses; the idea was from a nurse who later worked at Milwaukee County . Who was she?

Who were the 3 WNA members who started WINPAC?

Who was the longest serving WNA Executive Director?

Between 1909 and 2009, which city most frequently hosted the annual convention?

How many ANA conventions have been held in Milwaukee

Who was the first Wisconsin nurse to be inducted into the American Academy of Nursing (AAN)?

There are about 2500 members of the American Academy of Nursing, how many are Wisconsin nurses?

Which Wisconsin nurses have been named “Living Legends” by the Academy (AAN)?

Answers on page 15


WNA Welcome

Laurie K. Glass, RN, PhD, FAAN, UW-Milwaukee College of Nursing, Center for Nursing History

Many of you will remember Signe Skott

Cooper, the nurse historian who wrote more than 138 Nursing Matters articles (1993-2003) about Wisconsin nurses . Selected examples of these biographical articles were reprinted in Nursing Matters between 2013 and 2016 .

After her death in 2013, I received Signe’s original files, which included a box of about 200 black and white photographs . I organized and alphabetized the papers and photographs and an inventory list was made of the printed article so they could be retrieved by date of publication or by name .

Seeking a home for these significant records, I was pleased to discover the Wisconsin Women Making History Project (WWMH)*, of which the Wisconsin Historical Society is a partner . The goal of the project is to collect resources from all over the state to highlight the achievements of Wisconsin women in history . Could there be a more perfect home for the biographical research that Signe did on Wisconsin Nurses? The WWMH Project was more than willing to accept the records and photos . In August 2016, they were delivered to the UW Memorial Library, where the project is housed . Signe Cooper’s work will be preserved and be available to a wide audience of students and others interested in Wisconsin women and Wisconsin history .

I also sent Signe’s vita and explained how Signe herself was a Wisconsin woman making history . She was an Army nurse in the China-India-Burma theater in WWII, and a pioneer in distance education for nurses . She wanted nurses’ stories to be preserved for history, hence her biographical research . She also wanted nurses to be honored . We discovered in her papers how much time she spent finding sponsors for women (mostly Wisconsin women) to be included in the Women in the Military Service of America museum in Washington, DC . She even sent people the information needed to fill out the application .

*www .womeninwisconsin .org

Cooper’s Nursing Matters files donated to Wisconsin Women

Making History Project

Laurie K. Glass

Signe Skott Cooper

visceral responses will need to be considered in the analysis and judgments regarding effective nursing interventions and solutions . At this time, contextual analysis can only be done by humans, not computers, hence increasing in-depth and expanded critical thinking will be needed by nurses in the future .

The last cognitive capability is nursing entrepreneurship . (Aoun, 2017, pp . 66-70) This has been the biggest hot topic recently . Aoun describes two dimensions to this type of entrepreneurship—traditional startup and evolution . (Aoun, 2017, pp . 68-69) Traditional startup not only involves nurses starting their own businesses or practices, but also developing new nursing roles and/or ventures . (Aoun, 2017, p . 67) Historically, nurses have embraced changes, such as nurse-led clinics, multi-disciplinary education and a variety of new nursing doctoral programs . Evolution entrepreneurship, on the other hand, is more reformative . (Aoun, 2017, p . 67) For example, nurses could utilize an Uber-like model to work independently . (Clipper, 2018, June 23) Let’s say a nurse with home care experience would like to offer nursing services such as dressing changes . Nurses could utilize an online platform to establish a personal profile of experience, training and credentials . By registering with a online company, they could establish a “menu” of available nursing tasks or services . The fee for dressing changes could be posted, along with dates and times for patients to select appointments for their dressing changes . Payment could be made at the time of service . This model would give nurses more flexibility in choosing when they want to work and what they want to do . (Clipper, 2018, June 23) Nurse entrepreneurs could also utilize these innovative ideas to impact broader social injustices, such as access to quality patient care . (Aoun, 2017, p . 67)

Fundamental Shift in Higher EducationAoun suggests the best way to support innovation is by teaching it in

baccalaureate programs . (Aoun, 2017, p . 68) National nursing discussions have suggested establishing innovation competencies for student nurses at the time of graduation . (Clipper, 2018, June 23) The third and last in my series of articles will discuss the fundamental shift in nursing higher education and continued education to support this goal .

ReferencesAoun, J . E . (2017) . Robot proof: Higher education in the age of artificial intelligence.

Cambridge, MA: The MIT Press .Clipper, B . (2018, June 23) . Emerging Innovations. Presentation at the meeting of the

American Nurses Association, Washington, DC .Davidson, S ., Weberg, D ., Porter-O”Grady, T ., Malloch, K . (2016) . Leadership for

evidence-based innovation in nursing and health professions. Burlington, MA: Jones Bartlett Learning .

Fowler, M . (2015) . Guide to the code of ethics for nurses with interpretive statements. Silver Spring, MD: Nursingbooks .org .

Hanson Robotics Limited . (2017) . Sophia reawakens: Episodes 1 & 2 . Retrieved from https://www .youtube .com/watch?v=LguXfHKsa0c

Hanson Robotics Limited . (2018, August 3) . Sophia AI robot wants to help humans in health care . Retrieved from https://www .youtube .com/watch?v=4virn9wzSUM

Weberg, D ., Clipper, B . (2018, May 9) . Emerging technology and its impact on nursing practice. [Webinar] . Retrieved from: https://www .nursingworld .org/continuing-education/webinars/2019-national-nurses-week-webinar-free-webinar/

Innovation and New Nursing...continued from page 1


Wisconsin Nurses Association Updates

WNA provides political advocacy, professional development and strategies that support nursing practice, competence, and personal health .

Nurse Workforce Health, Rights, & Safety

Activity

APRN Modernization Act

Legislation has been introduced . 2019 Senate Bill 249 and 2019 Assembly Bill 267 provide for separate licensure for Advanced Practice Nurses based on education, certification and school accreditation criteria . Public hearings are to occur Aug or Sept

APRNs

Workplace Violence Legislation

Legislation has been introduced . 2019 Senate Bill 163 and 2019 Assembly Bill 175 provide for a Level H felony to individuals who cause battery to a nurse . Public Hearing are to occur September .

RNs

Healthy Nurses for Wisconsin MIG

WNA’s Healthy Nurses is a Mutual Interest Group (MIG) is interested in supporting nurse health . Join WNA’s Healthy Nurses for Wisconsin Mutual Interest Group

RNs

Preserving the Nurse Workforce Survey

WNA supported the efforts of WHA in pushing back a proposed amendment that would have changed the RN & LPN workforce surveys to voluntary . WNA has convened a workgroup to work on strategies to prevent this happening in 2019 Legislative session .

All

APRN Roundtable

WNA is inviting APRN related groups or individuals to join the APRN Roundtable . Invitations were sent out to Schools of Nursing, health systems, nursing associations and the individual APRN .

APRNs

Supporting Resiliency

WNA is working on the development of a debriefing toolkit to support nurses involved in traumatic workplace events .

Continued Competence & Conferences

WNA 2019 – 2020 Educational Offerings

APRN Northwoods Conference Sept . 27, 2019 . Wausau

Nurses Day at the Capitol March 4, 2020 Madison

Healthy Nurse Conference March 28, 2020, Elkhart Lake

APRN Clinical and Pharm Conference, April 24, 2020 Madison

Appropriate Nurse Staffing & Nurse Shortage

Topic Activity

Healthcare Workforce Planning

The Wisconsin Council on Medical Education and Workforce (WCMEW), of which WNA is a member, focuses on healthcare workforce data and health care delivery design models .

RNs

RN Workforce Report

The Wisconsin Center for Nursing’s has released the 2018 RN Workforce Report . Go to: https://wicenterfornursing .org/

All

Patient-Centered Team-Based Care

WNA developed a conceptual model that describes the benefits of using team based care for the care of populations with chronic disease can be found on WNA’s website .

RNs

Future Nursing Leader Award

WNA’s awarded five Future Nurse Leader Awards for the Spring 2019 semester .

RNs

Nurse Faculty Shortage

WNA and ANEW is looking at options for developing legislation to secure allocation of $10 million to financially support nurses interested in becoming nurse educators .

RNs

Patient Safety/Advocacy

Topic

Team-Based Care & Hyperlipidemia

WNA’s Clinical Expert Hyperlipidemia Panel is completing recommendations for health care organizations and teams that support decreasing the incidence of hyperlipidemia in WI .

RNs

Opioid Epidemic

WNA’s Opioid Task Force will be working on education guidelines for RNs and nursing students in relation to identifying nurses’ role in addressing Wisconsin’s Opioid Epidemic .

RNs

Mandatory CE for nurses

WNA is working on a legislative strategy that calls for mandatory CE for nurses as part of relicensure .

RNs

Reducing hyperlipidemia

WNA is developing learning tools and an awareness campaign to prevent, treat and reduce hyperlipidemia .

All

Healthy Hearts Initiative

WNA is working with others to provide an on-line platform that will connect health professionals to identify strategies to improving cardiovascular disease in WI .

All

YOU WERE REPRESENTED

Program Activity WHERE Date

Policy Update to ANEW on Nurse Faculty Loan Forgiveness in the state budget

Conf . Call 3/6

Policy Attended Board of Nursing Meeting DSPS 3/14

Policy Member update on WNA Legislative Priorities for 2019-2020

Webinar 3/20

Policy Meeting with Attorney General Josh Kaul State Capitol

3/21

Workforce WNA Healthy Nurse Conference WI Dells 3/23

Workforce WCMEW Data Collaborative Meeting DWD 3/25

Practice WNA Tri-Council Meeting Conf Call 3/25

Workforce WCMEW Advisory Council Meeting WHA Madison

3/27

Policy Meeting with Rep . Macco regarding continuation of Nurse Workforce Survey

State Capitol

3/27

Leadership WNA Finance Committee /WNA Board of Directors Meetings

Conf Call 3/27&29

Members ANA Midwest States Regional Meeting Conf Call 4/2

Education WNA APRN Pharmacology Conference Madison 4/11-13

Grant Grant Partners Meeting WI Dells 4/17

Policy Meeting with Deputy Secretary of DHS & Medicaid Director

DHS 5/6

Policy Meeting with WI AARP CEO and GOVA staff (discussion on legislation)

AARP 5/8

Policy Board of Nursing Meeting DSPS 5/9

Education Guest lecturer on Nurse Delegation to UW-Oshkosh Nursing Students

Oshkosh 5/10

Education Guest lecturer on influencing policy to UW-Eau Claire Nursing Students

Eau Claire 5/13

WNA Working for You – Summer 2019

http://marianuniversity.edu/munurse



The WNA Board of Directors met at the WNA Office on Friday July 12, 2019 . Here are the highlights:

Present: President, Linda Gobis; Vice President, Beth Markham; Secretary, Megan LeClair-Netzel; Treasurer, Pam Macari Sanberg; Director-at-Large, Laura Tidwell; Director-at Large, Julie Olson; APRN Representative, Lisa Pisney; Staff Nurse Representative, Adey Tewolde . Excused: Director-at-Large, Wendy Crary . WNA Staff: Executive Director, Gina Dennik-Champion; Associate Director, Megan Leadholm and Director of Member Services, Allison Champion . Guest: Tracy Gast, Accountant from Kollath CPA, Guest: Emily Wood, UW-Oshkosh BSN Completion Student .

1 . Approved minutes of Friday, March 29, 2019 Board of Directors Meeting and June 17, 2019 WNA Executive Committee Meeting .

2 . Accepted reports submitted by WNA President, Treasurer, Vice President and Executive Director .

3 . Received report from Allison Champion, WNA Member Services Director and Andrea Barber, WNA Social Media Consultant, on membership increase trends and social media analytics .

4 . Pam Macari Sanberg, WNA Treasurer and Julie Olson, WNA Board of Director will finalize the implementation strategy launching WNA’s Organizational Affiliate Membership structure .

5 . The WNA Finance and Executive Committees will review and analyze the financial benefits for adopting the ANA/WNA dues value-pricing category . Recommendations for adoption and proposed changes to WNA Bylaw Committee will be presented to the WNA Board at the October meeting for a decision .

6 . WNA Board to participate in a 2019 fall, Dane Council Habitat for Humanity build in partnership with the Wisconsin Medical Society and Wisconsin Pharmacy Society .

7 . WNA Board to evaluate WNA’s current position statement on Human Trafficking . Julie Olson and Laura Tidwell will review and submit revision recommendations for the October Board meeting .

8 . Next meeting October 24, 2019 9:00 am – 3:00 pm at the WNA Office .

9 . Meeting adjourned at 3:00 pm

WNA Board of Directors Meeting Highlights

Policy Meeting with Sen . Kooyenga on Workplace Violence Legislation

State Capitol

5/14

Policy Meeting with Rep . Kerkman on Workplace Violence and APRN Legislation

State Capitol

5/14

Leadership Meeting with Dane County Habitat for Humanity on Building Project

Madison 5/14

Leadership Presentation of WNA Future Nurse Leader Award

Eau Claire 5/25

Leadership Prep for ANA Membership Assembly Meeting with WNA Representatives

WNA 5/28

Workforce WNA Workforce Advocacy Council Meeting

WNA 5/30

Leadership WNA Executive Committee Meeting Call 6/3

Grant Cholesterol Expert Panel Meeting WNA 6/5

Grant Models of Team-Based Care Webinar 6/6

Leadership ANA Policy and Practice meeting Call 6/12

Grant Team Based Care Development Model with Mercy Health Systems

Janesville 6/13

Workforce WNA Workforce Advocacy Council Meeting

Call 6/25

Grant Contracted Partner Meeting Madison 6/26

Workforce WNA NP MIG Meeting WNA 6/29

Policy WNA Public Policy Council Meeting Call 7/1

Leadership WNA Opioid Task Force Meeting Call 7/8

Policy Presentation to Board of Nursing on APRN Legislation

DSPS 7/11

Education Public Policy Council Planning Subcommittee on Pre-Nurses Day Webinar

Call 7/11

Leadership WNA Board of Directors Meeting WNA 7/12

Education 2020 WNA Nurses Day at the Capitol Planning Committee Meeting

Call 7/15

Policy APRN Coalition Meeting Call 7/23

Policy WNA NP Forum Board Meeting Call 7/28

Policy APRN Modernization Act Legislative Update

Webinar 7/30

Education 2020 Healthy Nurse Planning Committee Meeting

Call 8/5

Policy WNA Public Policy Council Meeting Call 8/5

Policy APRN Coalition Meeting Call 8/11

For more information go to www.wisconsinnurses.org or [email protected]

Preparation is underway for the 2020 WNA Annual Meeting and the Leadership Summit which will be held on Friday January 17, 2020 in the Madison area from 12:00 Noon – 1:00 pm . Members are invited to join virtually or in person . This meeting will coincide with WNA’s Leadership Summit . The Leadership Summit will bring together the outgoing and the incoming leadership for the purposes of knowledge transfer and a smooth transition .

The Annual Meeting items include any proposed Bylaw changes, Professional Policy Recommendations, informational reports and results of the WNA Elections .

Proposed changes to the WNA Bylaws must to be submitted to WNA’s Committee on Bylaws no later than September 1, 2019 .

Proposed Professional Policy Recommendations which will be in a Dialogue Forum format need to be submitted to WNA’s Professional Policy Committee before August 1, 2019 .

More information regarding the process for submitting proposed Bylaw and Dialogue Forum topics is available on WNA’s website or you can contact WNA at info@wisconsinnurses .org .

SAVE THE DATE WNA Annual Meeting and

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All positions are two-year terms .All nominees must be WNA/ANA

members in good standing .Positions begin on January 1, 2020 .

Please contact WNA Membership & Communications Director Allison Champion

with any questions about the available leadership opportunities . 608 .221 .0383 x . 201 or

Allison@wisconsinnurses .org

POSITIONS AVAILABLE

WNA Board of DirectorsPresidentTreasurer

APRN RepresentativeDirector-at-Large

WNA CouncilsWorkforce Advocacy Council (3)

Nursing Practice and Quality, Research, and Education Council (3)

Public Policy Council (3)

WNA CommitteesNominating Committee (3)

Other OpportunitiesWNA Representative to ANA Membership

Assembly


2019 WNA Election – Available PositionsABOUT THE WNA BOARD OF DIRECTORS

The Board of Directors is the governing body of the association that exercises corporate responsibility and the fiduciary duties of WNA . It is made up of four officers (President, Vice President, Secretary, and Treasurer) and five directors (Staff Nurse Representative, Advanced Practice Registered Nurse Representative, and three Directors-at-Large) . Currently, the WNA Board meets four times a year for an all-day meeting (9a-3p), typically on Fridays .

WNA BOARD OF DIRECTORS – PRESIDENTRole: The President provides leadership for the Wisconsin Nurses Association by directing ongoing activities of the Association in collaboration with the Board of Directors, and by planning future endeavors which will continue to meet the needs of the membership .

Qualifications: 1 . Active member of WNA .2 . Adherence to WNA’s purposes and goals and

is representative of the general attitude and values of the Association .

3 . Will complete full term of office .4 . Experience as a group leader with skills

in group process, problem solving, policy formation, conflict management and working with the media .

Responsible to: WNA membership primarily through its elected leadership .

Term of Office: Is elected by the membership by mail/electronic ballot for a two (2) year term as President .

Basic Function: The President serves as the chief elected officer of the Association, representing the entire membership . With the Executive Director, represents WNA as an official spokesperson .

Responsibilities: 1 . Serves as presiding officer at meetings of

the membership, Board of Directors and Executive Committee .

2 . Serves as ex-officio member of all committees with the exception of the Nominations Committee .

3 . Serves as one of the representative to the ANA Membership Assembly Meeting .

4 . Serves as a representative of WNA and to the ANA Leadership Council Meetings .

5 . Offers guidance and counsel to the Executive Director, delegating appropriate duties .

6 . Reports to the membership at the Annual Meeting and annually via the “President’s Message” in The Wisconsin Nurse .

7 . Reports verbally and/or in writing to the Board of Directors at all regular meetings and reports by memoranda as necessary between meetings .

8 . Prepares agendas for the Annual Meeting of the membership and Board of Directors, in collaboration with the Executive Director .

9 . Represent the Wisconsin Nurses Association as official spokesperson on matters of policy, as provided in the bylaws of the Association and within the confines of the policies established by the membership and Board of Directors . Uses discretionary power to assign responsibility for such representation as necessary .

10 . Represents and speaks for the profession with allied health organizations, other nursing groups, legislative and governmental bodies, and the public . It is within these arenas that the President carries out one of the more important functions of the office: the WNA President accepts the role of public relations ambassador for the nursing profession in Wisconsin .

11 . Offers guidance and consultation to elected and appointed officials of the Association, constituents, and membership as required .

12 . May bring to the attention of the Board of Directors expectations and recommendations for long-range planning, policy making, and setting priorities which would promote the purposes and goals of the Association; monitors goal attainment; orchestrates the review and updating of the Association goals and action plans at least biannually .

13 . Participates in the review of the Executive Director’s performance, conducted at least once per year .

14 . Promote the fiscal solvency of the WNA in collaboration with the Treasurer, Executive Director, Finance Committee, and accountant .

15 . Foster a positive relationship with WSNA through the WNA advisor to WSNA; be available for the WSNA spring convention .

16 . Solicits members of the Board for various liaison activities and other responsibilities .

17 . Call emergency meetings of the Executive Committee and/or Board of Directors .

18 . Be knowledgeable of the major current nursing and health care issues .

19 . Represent WNA at all official functions or designate a member of the Executive Committee or Board to carry out this duty .

20 . Conducts WNA orientation/advisory; fosters leadership development activities .

21 . Review and signs Statement of WNA Board Member Conflict of Interest annually

22 . Will work with Parliamentarian in preparation of meetings involving the full membership and in circumstances when consultation is required for Board meetings .

Responsibilities:1 . Regularly participate in one-hour call meeting

with Executive Director to receive updates and conducting any planning .

2 . Lead the regularly scheduled WNA Board of

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Director Meetings . Meetings are every three months and 6-7 hours in length . (Usually in-person at the WNA Office)

3 . Lead in-between meetings of the Board of Directors . Meetings may be 4 times a year 1-2 hours in length . (Conference Call)

4 . Lead WNA Executive Committee Meetings . Meetings may be four times per year 1-2 hours in length . (Conference Call)

5 . Participate as an Ex-Officio, in meetings of the Finance (every three months 1-2 hours), Personnel (2-3 hours twice a year), and Bylaws (Months of June – October, five one-hour meetings) Committees . (Conference Calls)

6 . Attend the WNA Fall Conference/Membership Assembly Meetings . Meetings are in person, for three days including a Friday and Saturday .

7 . Lead the Annual WNA Annual Business Meeting which is part of the Membership Assembly . Usually on a Saturday in October for 3 hours, in person .

8 . Chair the Wisconsin Nursing Coalition Meetings . Meeting are the fourth Thursday every other month from 9:00 am – 12:00 pm, in person, at the WNA Office .

ANA Meetings:1 . Attend in person, the annual ANA

Membership Assembly and other events/meetings that coincide with the meeting . Usually in June for 3-4 days, Washington, DC .

2 . Attend in person, the annual ANA Leadership Assembly meeting . Usually in the fall . 1-2 days .

3 . Participate in scheduled ANA Conference Calls that provides update of ANA activities . Occur quarterly, 1-1 ½ hours .

4 . Participate in scheduled calls with ANA President . 1-2 times per year, one hour in-length .

WNA BOARD OF DIRECTORS - TREASURERThey will: demonstrate adherence to WNA’s purposes and goals and is representative of the general attitude and values of the Association . Willing to complete full term of office, chair Finance Committee, and actively participate in Executive Committee, Board of Directors, and other meetings as requested . Have interest and commitment to learning WNA budget policies and procedures and other financial aspects of importance to the Association . Serves as an officer of the WNA Board of Directors .

Role: The Treasurer provides leadership for the Wisconsin Nurses Association as a member of the Board of Directors, specifically with regard to financial implications of endeavors designed to meet the needs of the members .

Qualifications: 1 . Active member of WNA .2 . Support of WNA’s purposes and goals as a

representative of the Association .3 . Willing to complete full term of office, chair

Finance Committee, and actively participate in Executive Committee, Board of Directors, district and structural unit liaison, and other meetings as requested .

4 . Interest and commitment to learning WNA budget policies and procedures and other financial aspects of importance to the Association .

Responsible To: WNA membership through the Board of Directors .

Term of Office: Elected by secret ballot of the entire membership to serve a for two (2) year term .

Basic Function: The Treasurer, in consultation with the President, Executive Director, WNA Finance Committee and contracted accounting firm, shall be responsible for monitoring the fiscal affairs of the Association . Treasurer shall provide reports and interpretation of the Association’s budget and financial condition to the Board of Directors and the membership .

Responsibilities1 . Serves as chairperson of the Finance

Committee . Prepares upcoming fiscal year operating budget, monitors and report on status of budget at every Board of Directors meeting, makes recommendations regarding resource investments and provides regular review of WNA policies and procedures that include a fiscal impact .

2 . Communicates regularly and works with the Executive Director in drafting the upcoming fiscal year operating budget to be presented to the Finance Committee .

3 . Remains a member on the Finance Committee for at least one year after their term of Treasurer has ended .

4 . Prepares for Board meetings by reading materials provided and requests additional information when indicated .

5 . Participates in Board deliberations and seeks additional information as needed .

6 . Review and signs Statement of WNA Board Member Conflict of Interest annually .

Time Commitment*1 . Attend all four meetings of the Board of

Directors, usually scheduled for a full day on a Friday .

2 . Chair Finance Committee, which meets every 1-2 months for a one hour conference call .

3 . Review and be knowledgeable of all board related materials prior to board meeting, usually requires one hour .

4 . Prepares financial update for board meeting . Approximately two hours, working in collaboration with WNA Executive Director .

5 . Helps prepare yearly budget . Additional 1-2 hours/month during July, August, and September .

*This position requires a fair time commitment . If you have questions, please contact WNA Membership & Communications Director Allison Champion: 608 .221 .0383 x . 201 or Allison@wisconsinnurses .org

WNA BOARD OF DIRECTORS –

ADVANCED PRACTICE REGISTERED NURSE REPRESENTATIVE

Role: The individual Board Member serves as a director of the WNA Board of Directors and provides a perspective of the APRN . A member running for this position must be an Advanced Practice Registered Nurse .

Responsible To: WNA Board of Directors and membership .

Term of Office: Is elected by membership by secret ballot for a two (2) year term .

Responsibilities1 . Attends regularly scheduled Board of

Directors meetings and special meetings as called by the President .

2 . Serves as a member-at-large and performs the duties as outlined in the WNA Bylaws .




6 . Serves as WNA Board Liaison to WNA APRN Forum Board of Directors . Attends APRN Board of Directors meetings, approximately five per year, held on Saturdays at the WNA offices in Madison .

Time Commitment1 . Attend all four meetings of the Board of

Directors, usually scheduled for a full day on a Friday .

2 . Review and be knowledgeable of the Board of Directors agenda item materials, approximately one hour .

3 . Attends WNA APRN Forum Board of Directors meetings, approximately five per year, held on Saturdays at the WNA offices in Madison .

WNA BOARD OF DIRECTORS – DIRECTOR-AT-LARGE

Role: The individual Board Member serves as a director of the WNA Board of Directors .

Responsible To: WNA Board of Directors and membership .

Term of Office: Is elected by membership by secret ballot for a two (2) year term .

Responsibilities: 1 . Attends regularly scheduled Board of

Directors meetings and special meetings as called by the President .

2 . Serves as a member-at-large and performs the duties as outlined in the WNA Bylaws .


2019 WNA Election...continued on page 10

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Time Commitment1 . Attend all meetings of the Board of Directors,

usually scheduled for a full day on a Friday four times a year .

2 . Review and be knowledgeable of the Board of Directors agenda item materials, approximately one hour .

WNA COUNCILS

Wisconsin Nurses Association has three Councils, each consisting of 6-10 members, who are either elected by the membership or appointed by the WNA Board of Directors as needed . The Councils are: a . Workforce Advocacy, b . Nursing Practice and Quality, Research, and Education, and c . Public Policy .

The WNA Councils are the identified structural units of WNA . Their collective role is to advance WNA’s goals and strategic plan, which in turn support the professional image and practice of Wisconsin’s RNs .

WORKFORCE ADVOCACY COUNCILWNA’s Workforce Advocacy Council is

responsible for reviewing the activities, work products, tools, and services offered through WNA's Workforce Advocacy Program, which provides members with professional practice advocacy services, including supporting the nurse's professional integrity, rights and responsibilities, ethics, principles, advancement of practice standards, and personal well-being .

The Council collaborates with WNA’s other Councils, Mutual Interest Groups, and Task Forces as appropriate . The Council provides quarterly reports to WNA’s Board of Directors and an Annual Report to the membership .

You may be asked to help facilitate Rapid Response Conference Calls, which are opportunities for members to call in and give their feedback on important issues . It is expected

that you will prepare for and attend all meetings, which annually consist of one face-to-face meeting (approximately five hours in length), and monthly or bi-monthly conference calls (one hour) .

NURSING PRACTICE AND QUALITY, RESEARCH, AND EDUCATION COUNCIL

WNA’s Nursing Practice and Quality, Research, and Education Council identifies an agenda relating to nursing practice and quality, research, and education, based on WNA’s goals and strategic plan . The Council reviews and promotes opportunities for nursing practice and quality, which may include promoting best practices and reviewing important documents pertaining to Scope of Practice, Professional Standards, and ANA’s Code of Ethics . While doing so, the Council helps provide a forum for discussion on issues related to nursing practice . The Council encourages and facilitates research opportunities . The Council also helps guide WNA’s educational agenda, which includes informing nurses of educational issues and opportunities .


You may be asked to help facilitate Rapid Response Conference Calls, which are opportunities for members to call in and give their feedback on important issues . It is expected that you will prepare for and attend all meetings, which annually consist of one face-to-face meetings (approximately five hours in length), and monthly or bi-monthly conference calls (one hour) .

PUBLIC POLICY COUNCILWNA’s Public Policy Council monitors and

evaluates legislative and regulatory policies that can have an impact on nurses and health care and promotes nurse participation in the public policy process . The Council creates a Public Policy Agenda for the Association based on WNA’s goals and strategic plan . The Council develops a lobbying and education strategy, reviews proposed legislation and regulation to determine if WNA

should support or oppose, and provides updates to the membership on the status of legislation and regulations .


As a member of the Council, you should expect to review proposed legislation, make recommendations, and overall actively participate in the development and monitoring of WNA’s Public Policy Agenda . You should be willing to provide testimony on behalf of WNA as needed, as well as engage other WNA members if grassroots involvement is needed . You may be asked to help facilitate Rapid Response Conference Calls, which are opportunities for members to call in and give their feedback on important issues . It is expected that you will prepare for and attend all meetings, which annually consist of two face-to-face meetings (five hours, scheduled on a Saturday), and monthly or bi-monthly conference calls (one hour) .

WNA COMMITTEESThe Wisconsin Nurses Association has several

Committees, which are composed of members appointed by WNA’s Board of Directors . However, because WNA’s Nominating Committee helps prepare the ballot to elect WNA’s Board of Directors, the Bylaws specifically require that the Nominating Committee be elected by the membership to ensure transparency and autonomy .

NOMINATING COMMITTEEThe Nominating Committee provides nominees

for the WNA Board of Directors (Officers and Directors), Councils, and Committees, as well as candidates for WNA Representative to ANA Membership Assembly . Committee members take the time to learn the role of positions that need to be filled and help prepare leadership succession strategies . Committee members ensure appropriate diversity is represented throughout WNA’s structural units . They select candidates who are understanding and tolerant of the viewpoints of others and who are willing to interact openly and directly with other members and WNA staff .

The Nominating Committee meets via conference call, typically one hour in duration, from April to August . A standard election season will require three to four conference calls . Committee members also make personal contact with members to inquire about their interest in running for office . A Committee member typically calls six to ten members per election cycle .

WNA REPRESENTATIVE TO ANA MEMBERSHIP ASSEMBLY

The Membership Assembly is the governing and official voting body of the American Nurses Association (ANA) . It identifies and discusses issues of concern to members and provides direction to ANA’s Board of Directors .

WNA members send two representatives to the ANA Membership Assembly . One representative is the WNA President . The other is elected-at-large . Please note that this position is a two-year position, which means that the elected representative will make two trips to Washington DC to conduct business at Membership Assembly . Membership Assembly meetings are typically held in June or July . WNA will provide a stipend to the representative for each trip . If the elected representative is unable to attend, the next candidate with the highest vote totals will serve as the representative .


2019 WNA Election...continued from page 9

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This is the official notice to all WNA members to consider submitting a topic for WNA’s Annual Dialogue Forum, or proposed Bylaw changes and/or submitting your name to run for one of WNA’s elected leadership position .

WNA’s Dialogue Forum provides a formal process for members to respond to and improve a topic that has relevance to WNA members, the nursing profession and/or the public . Dialogue Forum topics can be submitted by one or a group of WNA members . The Dialogue Forum process consists of three different topics that are introduced and discussed . A summary of the discussions and any recommendations are recorded and reviewed by WNA’s Professional Policy Committee . The

2019 Official Call for Dialogue Forum Topics, Proposed Changes to WNA Bylaws and Nominations

Professional Policy Committee submits a report with recommendations for the WNA membership to approve during the WNA Annual Meeting . You can find the process on WNA’s website under “About WNA .”

WNA Bylaws serve as the most important legal document of the association . WNA’s Bylaws outline in writing the day-to-day rules and provide a comprehensive guide to keep things running smoothly . The WNA membership approves any changes to the Bylaws at the Annual Meeting . Any suggested or proposed changes are to be forwarded to the WNA Bylaw Committee .

It is not too soon to think about running for a WNA elected leadership position . The WNA

Nominations Committee wants you to know which leadership positions are up for election this year . Nominations for WNA’s Board of Directors positions are WNA President, Treasurer, two (2) Directors one of whom is an Advanced Practice Registered Nurse . There are three positions for each of WNA’s Structural Units, Public Policy Council, Tri-Council, and Workforce Advocacy Council . This is also the year to elect the WNA representatives and alternates to the ANA Membership Assembly . Lastly, three positions are open on the Nominations Committee . All of the position descriptions can be found on WNA’s website under the Membership Tab .

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Upcoming Conferences

Grant Updates

Register today for the 6th Annual Northwoods Clinical Practice Update! This intensive one-day conference reviews current and identified new

pharmacological and clinical approaches to management of common conditions in primary and acute care with the goal of safe prescribing practice and optimal therapeutic outcomes .

Topics include updates on the Opioid epidemic in Wisconsin, women's health, concussions and brain injuries, and more! Visit Wisconsinnurses .org for more information and a link to register!

By Pam Macari Sanberg, MS, RN, NEA-BC, NHA

WNA continues to partner with the Department of Health Services, Chronic Disease Prevention Unit, CDC Grant . We have advanced to year two of the second five-year cycle . The funding supports the implementation of evidence and practice-based interventions for reducing the prevalence of hypertension/hyperlipidemia in Wisconsin .

On June 5, 2019, WNA hosted a Hyperlipidemia Expert Clinical Panel Workgroup . Lynne Braun, APRN and a member of PCNA was a member of the committee that developed the new cholesterol guidelines and presented information to the panel .

The charge set forth to the panel for this grant cycle is to:

1 . Make recommendations to ultimately inform improvement in the quality and care outcomes for patients with elevated serum lipid levels in Wisconsin as an adjunct to the recommendations of the Hypertension Expert Clinical Panel in November 2017 . These recommendations will be developed into a guide that will be shared on the Mighty Networks social media platform for the Community of Practice and published to be widely disseminated in Wisconsin and beyond .

2 . Apply the team-based care model (publication 2016) to the disease process of elevated serum lipid levels .

3 . Propose recommendations that will foster durable linkages between health systems, health departments, and community agencies, now and into the future .

If you would like more information, WNA invites you to join the WI Heart Health Community of Practice . This media platform provides information related to Heart Health in WI and allows for clinicians to engage with each other through networking, webinars, and resources .


Legislative Updates

Below is a summary of the legislative proposals that WNA has taken a position

Legislation WNA Position Status

Assembly Bill 139 & Senate Bill 134 Relating to: reporting of naloxone administration by ambulance service providers .

Support – The collection of data related to the administration of naloxone is another important tool to addressing the opioid overdose crisis for Wisconsin .

No public hearings scheduled .

Assembly Bill 162 & Senate Bill 155 Relating to: participation in the Volunteer Health Care Provider program by agencies serving homeless individuals .

Support – Provides access to care for the homeless population . Which in can reduce emergency department and hospital readmissions

Public hearings 5/22/19 and 7/16/19 .

Assembly Bill 175 & Senate Bill 163 Relating to: causing bodily harm to harm to a nurse and providing a penalty .

Active Support – This bill provides the same penalty for battery i .e . Workplace Violence, to a nurse regardless of employment setting . The criminal penalty is a Level H felony subject to $10,000 fine and/or six years of incarceration .

Assembly Public Hearing scheduled for September 19 and Senate Public Hearing September 17 . Take action! Go to WNA’s website to learn more:http://bit .ly/2019WPV

Assembly Bill 178 & Senate Bill 166 Relating to: eligibility for physician, dentist, and health care provider educational loan assistance programs .

Active Support – Provides loan forgiveness to nurse midwives, nurse practitioners and mental health providers if he or she agrees to practice in a free or charitable clinic or a mental health shortage area for the required time .

Assembly Public Hearing 7/10/19 . Senate Public Hearing scheduled for 8/27/19

Assembly Bill 214 & Senate Bill 200 Relating to: storage and processing of sexual assault kits and requiring the exercise of rule-making .

Support – Future forensic evidence collected by Sexual Assault Nurse Examiners (SANE) has assurance that the evidence kit backlogs are addressed and instill a timely and patient centered process for the collection and processing of kits .


Assembly Bill 238 & Senate Bill 225 Relating to: diabetes care and prevention plan

Support – Approximately 356,000 adults and 6,500 children and adolescents in Wisconsin have been diagnosed with diabetes and is the 7th leading cause of death in Wisconsin, This bill requires the DHS, in consultation with the ETF, to develop and implement a plan to reduce the incidence of diabetes in WI, improve diabetes care, and control complications associated with diabetes .

Assembly Public Hearing 7/10/19 and Senate 8/6/19 .

Assembly Bill 248 & Senate Bill 262 Relating to: eliminating personal conviction exemption from immunizations .

Support – To protect the health of the public, all individuals should be immunized against vaccine-preventable diseases except for medical reasons .


Assembly Bill 267 & Senate Bill 249 Relating to: advanced practice registered nurses, extending the time limit for emergency rule procedures, providing an exemption from emergency rule procedures, and granting rule-making authority .

Active Support – This legally acknowledges Advanced Practice Registered Nursing (APRN) in state statute . An APRN license will be issued if the following criteria are met: graduate with a master’s degree or higher from an accredited nursing program and the individual has national board certification related to their role . This bill will provide increased access for patients and safety .

No public hearings scheduled . Go to WNA website to take action . http://bit .ly/APRNWI2019

Administrative Rule CR 19-087 Support – The proposed rule supports greater protection for the client receiving care from a Personal Care Worker . Expanding involvement of the RN to directly observe the abilities and competencies of the care delivered by PCW supports quality and safe care .

Department of Health Services public hearing 8/9/19 .

WNA Legislative Update

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Members attending the ANA Membership Assembly voted to approve a new dues pricing concept . Part of the decision was based on the positive results of ANA’s “Value Pricing Pilot” that began in 2013 with seven states followed by expansion in 2016 to 16 other states including WNA .

The WNA Finance Committee and WNA Board of Directors will be examining the benefits of offering another membership dues option . If the Board determines that a value pricing option looks like a viable solution to recruitment and retention of members they will forward proposed changes to the WNA Bylaw Committee . The Bylaw Committee will offer these recommendations for a vote of the membership at the January 17, 2020 Annual Membership Meeting .

For more information email Gina Dennik-Champion, Executive Director, gina@wisconsinsinurses .org

WNA Board to Examine Benefits

of New Dues Pricing Option

Adopted at June ANA Membership Assembly Meeting

ANA Updates

Kathryn Lammers PhD, PHN, RN

In this WNA newsletter I want to share some methods for nurses to join the fight for best practices in environmental health . Often sharing experiences encourages us to keep our focus on long term positive outcomes . Therefore, this newsletter article describes a unique national conference and the new fellowships . The future newsletter articles will describe real life experiences of nurses active in environmental health .

Opportunity Knocks . Do not let barriers get in the way!

The unique national conference was the Alliance of Nurses for Environmental Health (ANHE) “Calling All Nurses: Leading the Way to Healthy Environments” was an exciting exploration of nursing actions and advocacy . The conference included inspirational presentations, interactive discussions, and participatory action planning . The two-day event was held in Nashville May 6 and 7, 2019 as a pre-conference event before CleanMed . Next year the summit will be held in Orlando, Florida . Nurses can stay extra days to attend the CleanMed conference at reduced charge . CleanMed is the conference for Health Care without Harm .

After attending last year and this year, I am committed to going again . The roughly 60 participants are in very different projects from hospital waste, prenatal education, antibiotic stewardship, climate change to pollution prevention . The ANHE board offered many methods for attendees to feel welcomed and to learn about current issues .

Journey of a Nurse Environmentalist

MIG Updates

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One of the dynamic speakers was the former Administrator of Environmental Protection Agency Director Gina McCarthy, who continues to champion climate change issues .

Beverly Malone, president Of National League of Nursing and one of the 100 top health leaders in the country, was inspirational with her practical examples of informed power, charisma power, coercive power, and extended power .

At the meeting ANHE introduced first-of-its-kind fellowship program to train nurses to work with communities in tackling serious environmental health threats, including toxic chemical pollution, water contamination, climate disruption and related health impacts, and more . Funded by the Kresge Foundation, the program has a particular focus on environmental health equity and justice, specifically addressing the disproportionate impact of environmental exposures on vulnerable groups .

The program includes 30 ANHE fellows from across the United States, with three from every EPA region . The fellows hail from Wisconsin, Minnesota, and many other states .

In addition to geographical diversity, the fellows are diverse in terms of age, nursing specialty and expertise, educational attainment, race and ethnicity, gender, and more, reflecting the diverse nation and communities they serve .

Paired with expert environmental health nurse mentors, the fellows will conduct projects in their communities to address a community-identified environmental health need and build support for community-driven solutions . In addition, the fellows will work to educate health professionals and colleagues in their communities about environmental health in order to expand knowledge and engagement of health professionals on critical environmental health issues .

To learn more about the ANHE Environmental Health Nurse Fellowship and the program participants, visit https://envirn .org/anhe-fellowship/ . Follow ANHE on Facebook and Twitter @enviRN to view updates of the nurse fellows’ work throughout the program .

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Browse our online databaseof articles and content.

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MIG UpdatesWFCNC is a mutual interest group of the Wisconsin Nurses Association

Answers- 1911- Adda Eldredge, Barbara Nichols- Cordelia Harvey- Eau Claire- 1907- Maud Tompkins Davis- Elizabeth Leenhouts, Milwaukee County- Tuberculosis- Pfister and Vogel- St . John’s Infirmary, Jones Island (forerunner of

the Milwaukee St . Mary’s Hospital)- Cornelia Van Kooy- Carrie Lee Nelson, wife of Gaylord Nelson- Leola Franklin Fields- Poliomyelitis- Nancy Cornelius Skenadore- Kenosha Vocational School- Milwaukee Institute of Technology- Sr . Berenice Beck, Florence Blake, Helen Bunge

Julia Thompson (ANA’s first lobbyist)

- Madison- Private duty nursing- True- Ellen Ainsworth- Jerome Olmsted- Judy Robson, Beloit, 1987-2011, Walter Kunicki,

Milwaukee, 1981-1998

- Julia Flikke (1937-1943), Mary Phillips (1947- 1951)- Adele Stahl- Mary Hardaker - she was the president of

the first committee responsible for nurse registrations .

- Sr . Berenice Beck- Frances H . Cunningham- Ellen Church (Marshall)- SueEllen Pinkerton, Laurie Glass, Sue Schuler- Edith Partridge, the 1st ED, 32 years, 1924-1956,

Gina Dennik-Champion, the 9th ED, 22 years to date, 1997-present

- Milwaukee, 54 of the 100 conventions- Just 1 in 1930 .- Rose Marie Chioni, was 1 of 36 in the charter

group, 1973 . She was a UW Madison faculty member at the time .

- 49- 2010 Norma Lang and Barbara Nichols, 2003

Signe S . Cooper, 1994 Harriet Werley .

WNA Past Presidents. From left to right; Row 1: Kathy Poi, Laurie K. Glass, Barbara Nichols,

Hildehard Siegal. Row 2: MaryJane Bloom, Bonnie Albaugh

Sister Berenice Beck

Julia Thompson

Walter Kunicki Judy Robson

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Updates from the Wisconsin Center for NursingThanks to all of those who

attended the 9th Annual Wisconsin Center for Nursing Conference on June 7! This year’s conference was held at Waukesha County Technical College in Pewaukee, WI . Over 120 registered and attended this one-day conference that focused on emerging roles, challenges, and barriers in the nursing profession . Please save the date for the 10th Annual Conference on June 5, 2020 in Waukesha!

Wisconsin Center for Nursing

By Barbara Nichols, PhD (hon) MS, RN, FAANExecutive Director, Wisconsin Center for Nursing

In June, WCN attended two national meetings dealing with Nursing Workforce issues: The National Workforce Forum and the ANA Membership Assembly .

National Forum of State Nursing Workforce CentersThe Annual Conference of National Forum of

State Nursing Workforce Centers was held June 12-14 at the Brown Palace Hotel, Denver, Colorado .

The conference addressed issues that will impact the role of nurses in the decade ahead . Topics discussed were: telehealth, aging and diverse populations, behavioral and primary healthcare, growing impact of the APRN role, building health communities and enhancing workforce diversity .

ANA 2019 Membership AssemblyOn June 20-22, WCN attended the ANA

2019 Membership Assembly . Compelling and critical issues discussed at the meeting focused on immunization regarding measles, human trafficking, and ethical issues regarding patient care and public health . Workforce issues were addressed by advocacy for building national support for funding workforce development programs and the efficacy of utilizing APRNs to advance home health care services .

The following members were elected to serve on the ANA 9-Member Board of Directors: Vice President Susan Swart, EdD, MS, RN, CAE, ANA-Illinois; Treasurer Jennifer Mensik, PhD, RN, NEA-BC, FAAN, Oregon Nurses Association; Directors at Large, James Watson, DNP, RN, NEA- BC, Texas Nurses Association; Marcus Henderson, BSN, RN, Pennsylvania State Nurses Association as the Recent Graduate Representative .

Continuing the Vision: Future of Nursing 2020-2030On March 20, 2019 The National Academy of

Medicine (NAM) launched a new study on the future of nursing . The goal of the new committee on the Future of Nursing 2020-2030 is to extend the original vision and chart a course for the nursing profession to help out nation create a culture of health, reduce health disparities, and improve the health and well being of the US population in the 21st century .

Nearly 10 years ago, NAM published the forward-thinking report: The Future of Nursing: Leading Change, Advancing Health which included recommendations to improve access to safe and high-quality patient care through nursing . The landmark report called for action to build the capacity of the Nursing Workforce by the following:

• Fostering interprofessional collaboration• Improving diversity by making it a workforce

priority• Increasing the population of nurses with a

baccalaureate degree by 2020• Doubling the number of nurses with a

doctoral degree by 2020• Utilization of advanced practice RNs (APRNs)

to the full extent of their education and training

• Ensuring that healthcare leadership positions are available to and filled by nurses

During 2020 the unprecedented progress made will be highlighted including recommendations leading to the context for the need of the second report .

2019 ConferenceMaking a Difference in Perinatal Mental Health

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Wisconsin Center for Nursing

The Wisconsin Center for Nursing 9th Annual Conference, PRIMARY CARE: EMERGING ROLES, CHALLENGES, AND BARRIERS explored how health care, business professionals, non-profits, and organizations can work together to effectively improve primary health care delivery . The conference focused on the role of primary health care as critical to improving the nation’s health .

Wisconsin Center for Nursing Conference on Primary Care a Huge Success!

The day-long event took place on June 7, 2019 at the Waukesha County Technical College in Pewaukee . The presentation topics and presenters were as follows:

Keynote Address: Emerging Roles in Care Coordination and Team-Based Care

- Suzan Ulrich, DrPH, MSN, MN, CNM, FACNM – Associate Professor, College of Nursing Resurrection University

Utilizing a Health Equity Assessment Tool to Assist in Primary Care Delivery

- G . Adriana Perez, PhD, ANP-BC, FAAN, FGSA – Assistant Professor and Senior Fellow Leonard Davis Institute of Health Economics, University of Pennsylvania School of Nursing

Workshop 1: Wisconsin Physician and Nurse Workforce

- George Quinn – Executive Director, Wisconsin Council on Medical Education and Workforce

- Susan Zahner, DrPH, RN, FAAN – Associate Dean for Faculty Affairs and Professor, UW–Madison

Workshop 2: Interprofessional Education: A Necessity for Team-Based Care

- Dr . Hossein Khalili, PhD, MScN, BScN – Director, University of Wisconsin Center for Interprofessional

Workshop 3: The Role of the RN: Approaches for Focusing on the Social Determinants of Population Health

- Mary Muse, MS, RN, CCHP-A, CCHP-RN – CNO/Director of Nursing, WI Department of Corrections

- Sandra Littlejohn, MA, BSN, RN – Executive Consultant, Gundersen Health Systems

- Pamela L . Guthman, DNP, RN-BC – Clinical Assistant Professor, UW–Eau Claire College of Nursing and Health Sciences; UW–Madison Rural Immersion Nursing Program

- Nuala A . Nowicki, RN – School District Nurse, RN Wellness Coach, First Aid/BLS/CPR & Stop the Bleed Instructor, Prevea Health

Workshop 4: Approaches for Retaining a Diverse Workforce

- Terrie Garcia, PhD, RN – Project BEYOND-2 Coordinator, Marquette University College of Nursing

- Heather Costley, MSN, RN – Nurse Administrator – Primary Care, Mayo Clinic Health System

- Sarah Brzozowski, MBA, BSN, RN, NEA-BC – PhD Student, University of Wisconsin–Madison

Thomas Veeser, RN, MS – CNO/Administrative

Director Quality, Holy Family Memorial provided a summary of the conference and thoughts for moving forward .

For more information regarding the conference you can mail the Wisconsin Center for Nursing at info@wisconsincenterfornursing .org

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By Sarah Endicott DNP

(Reprinted with permission from the School of Nursing, University of Wisconsin-Madison.)

Wisconsin residents are concerned about access

to high quality healthcare . This is especially true in rural areas like the community where I live and worked as a geriatric nurse practitioner . Waits for appointments and drives to clinics can be long . Coverage can be limited or non-existent, as can provider and patient awareness of available options and services .

While there is no single solution to the problem, there are answers . One is to allow advanced practice registered nurses to practice to the full extent of their education, training and experience .

Currently, Wisconsin state law limits APRNs to what the American Academy of Nurse Practitioners refers to as “reduced practice .” Practically speaking, this means that APRNs in Wisconsin practice with less freedom and more restrictions than comparably educated and licensed peers in some states, including bordering states Minnesota and Iowa . Reduced practice results in decreased access to quality healthcare, poorer health outcomes and the flight of providers .

Currently, advanced practice registered nurses in 22 states and two U .S . territories have full practice authority . An additional 11 states do not allow APRNs full practice authority but impose fewer restrictions than Wisconsin . The Academy of Medicine and the National Council of State Boards of Nursing recommend the full-practice model .

In Wisconsin, one restriction is that APRNs must have a documented collaborative practice agreement with a physician .

The APRNs carry the responsibility of securing the collaborative agreement .A legislated collaborative agreement is not the same as collaboration . All

health care professionals collaborate . It is an ethical imperative in practice, and nursing has long been a champion for collaboration and an innovator of team-based care . The required collaborative practice agreement is simply a restrictive document that burdens APRNs and restricts their ability to practice in underserved areas where they lack access to a physician to sign the agreement .

Under the current law, APRNs practice under their own licenses and assume full responsibility for patient care . The law does not require the physician to provide education or training to the APRN or to see any of the patients under the care of the APRN in collaboration or consultation . However, the physician is able, and likely will, take a percentage of the APRN’s billing as part of the agreement .

I collaborated with nurses, physicians, physical therapists, speech therapists, occupational therapists and dieticians every day of my practice . Each of us brings expertise, experience, and a unique view to patient problems . Together we provide excellent care . Yet APRNs are the only healthcare professionals legislated to collaborate . Required collaboration that subordinates one profession to another is not true collaboration and it is not the way I work with my colleagues from other disciplines . And if collaboration is legislated for nurses, it should be for all healthcare professionals .

Legislative collaborative agreements also create arbitrary barriers to care . In a brief released in October 2018, the Wisconsin Policy Forum reported that 20 of Wisconsin’s 72 counties do not have a practicing psychiatrist . Several other counties share a single psychiatrist . In order to practice in these under-served counties, psychiatric advanced practice nurses—who are educated, trained and licensed to provide psychiatric mental healthcare—would need to enter into a collaborative practice agreement with a physician who has less education and training in behavioral health . The other option is to enter a collaborative practice agreement with a physician who does not practice in that county and who does not know the population or the local behavioral health resources .

There are better ways to meet the mental health needs of Wisconsin .Ultimately, legislated collaborative practice agreements prevent APRNs

from taking care of the patients who need them most . They do not improve care; they only limit access to it . We need to allow full practice authority for APRNs so that the people of Wisconsin can access the healthcare they need and deserve .

Representative Mike Rohrkaste

Tina Bettin DNP, MSN, RN, FNP-BC, APNP, FAANP, President of NP Forum

Annually, at the American Association of Nurse Practitioners (AANP) National Convention, there are award winners recognized from every state for activities that they are involved in, which support or move the NP profession forward . At this time, I would like to recognize the two awardees from Wisconsin . The awardees received their awards on Friday, June 21 in Indianapolis, Indiana .

The first award is for the State Award for Excellence . Established in 1991, the State Award for Excellence recognizes an NP in each state who demonstrates excellence in clinical practice . The awardee of the 2019 State Excellence Award was Rhonda Hoyer MSN, ANP-BC, APNP . Rhonda is employed at UW Health as the Director of Advanced Practice, while still working part-time in internal medicine . In her role of Director of Advanced Practice, she oversees nearly 500 APPs (nurse practitioners, certified nurse midwives and physician assistants) . Her role is to enhance, optimize and strengthen the roles and relationship of APPs with our patients, physician partners and the organization . Rhonda Hoyer says, “It is her personal goal to ensure that each APP has a satisfying work environment that is fulfilling, clinically challenging, and allows their skills to be fully optimized in meeting the needs of patients and health care teams .”

The second award is for the State Award for Advocacy . In 1993, the state award for advocate was added to recognize the efforts of an individual who had made a significant contribution toward increasing the awareness and recognition of NPs . The awardee of the 2019 State Advocate Award was Representative Mike Rohrkaste (R-Neenah) . Representative Rohrkaste has been instrumental in the APRN Modernization Legislation . He has been a sponsor of the legislation both times that it was introduced . Representative Rohrkaste was key in the initial assistance in drafting the legislation . When the first legislative Bill was pulled, he was adamant that he would bring the bill forward again .

I would like to thank each of these awardees for empowering the NP profession and helping to position NPs for the future .

In August/September of each year, the nomination period opens for the two awards . The awardees are selected by a selection committee based on criteria from AANP . The awards are given at the National Conference annually . To nominate someone, you must be a member of AANP . The nominee does not need to be a member of AANP . WNA is a member of AANP as a NP organization . With WNA being a member and you being a WNA member, you can receive a discount when you join AANP . In the future, the NP Forum website will have a listing of all the past awardees .

Rhonda Hoyer, MSN, ANP-BC, APNP

Sarah Endicott, DNP RN, GNP-BC is a Clinical Associate Professor at UW-

Madison and is a WNA member.

Wisconsin AANP Excellence Award Winners

Time for Full Practice Authority


By Adrianne Ewald-Peterson BSN, RN

Adrianne is a WNA Member and Chairperson of Wisconsin Nurses Association Workforce Advocacy Council . She has served on the Advocacy Council as Chair for several years, previously served on the Board of Directors and other committees and councils and has recently spoken at the Wisconsin Healthy Nurses Conference in regards to the topic of Stress . She has worked as a nurse in the critical care arena for over 10 years and is currently working with Humana Healthcare Services in Clinical Strategies as a Senior Process Development Professional .

Patient care is what nurses are gifted to do . Right? However, it is the moral obligation of self-care from within our nursing ethics that I would like to reflect on . As nurses, we have due diligence to tend to the patient . However, nursing ethics also calls for us to care for ourselves . How have so many of us failed to fulfill that promise?

The emotional investment and burden that the nurse is responsible for in patient care management is enormous . In addition to the demands of providing excellent patient care the nurse is professionally accountable for the needs of the patient’s family, meeting expectations of their co-workers and the healthcare team . Nurses are also expected to care for their own family, friends, social network, community and the wider world . All of theses relationships and obligations are equally important and the nurse’s thoughts can become overwhelming . Despite all of these multiple responsibilities, nurses must do all of these and still maintain self-care .

The topic of moral injury, a term utilized to describe post-traumatic stress disorder in the military community has recently been gaining popularity in the clinical arena replacing the description of “burnout” when speaking to the symptoms of professional and personal exhaustion . Moral injury is a particular type of trauma characterized by guilt, crisis and loss of trust following a perceived moral violation . Jinkerson, J . D . (2016) .

Moral injury has hit close to home for me as a nurse . Several years ago, I ultimately fell victim to this particular type of trauma, which was a gradual assault over the years on my integrity and profession due to the burden of clinical and personal burden . My secondary symptoms of emotional exhaustion were overwhelming and I can tell you for years that anxiety greeted me when I woke up, it accompanied me to the hospital, followed my through the ICU halls and it tucked me into bed at night . Sleep was scarce as I thought of all the medication lists, patient care duties, spreadsheets and scenarios replaying in my head . Particular traumatic events, deaths, suicides replayed in my head even in the daytime . Shame followed me from childhood and bubbled up often to remind me how guilty, unworthy and inadequate I was . It also questioned my mothering skills when I bathed, nursed and rocked my babies to sleep each night . Guilt hung on my shoulders if I said or did the wrong thing at the wrong time . Eventually, as years went by working and living life as a mother, wife and nurse there became this consistent loss of hope for positivity in it all . I loss the ability to identify my feelings and I felt I

loss control of my life . I wasn’t fully mindful of the events occurring in front of me . I was not mindful and in control like a textbook professional and adult should be . My emotional exhaustion was more than the feeling of “being tired .” It eventually became the crash, the textbook burnout . For years it was driven by adrenaline, which turned out to be physiologically damaging to my mind and body as a whole . Physical exhaustion followed closely behind the emotional exhaustion and exhibited itself as acute fatigue, shortness of breath, chest pain and migraines . The stress was real .

When all that stress was being lived day in and day out, the coping mechanisms that crept into my life were behaviors consistent with detachment and cynicism . It was emotionally easier to remove myself from the reality of life, go through the motions and float through it all above the clouds or behind the scenes . It was easier to laugh at everything or smile even though the scenario truly wasn’t funny or I wasn’t happy . Life was extremely rewarding at times and yet at other times it was devastating .

I felt I wasn’t legitimate, even though I was competent . I was going through the motions and not feeling acknowledged, even though I was . I was living each day as it was full throttle, not being fully mindful of the consequences . I didn’t feel adequate . I wasn’t enough . I believed that I didn’t have enough credentials behind my name even though I was quite a skilled and accomplished nurse . I just wasn’t enough . Never enough . . .Feelings of inadequacy at its finest . My pivotal event of being hospitalized and treated for an intractable migraine and a heart arrhythmia triggered the rise of the phoenix from the ashes .

It took a series of simple skills . Essentially, I built myself a resilience tool kit that helped me rise up to be mentally and physically healthy again . All by surrounding myself with family, friends, positive self-help influences, spiritual guides, healthy eating and exercising .

First of all I began practicing mindfulness as much as possible . Being mindful is as simple as just being still and letting things go, letting things be or just breathing . Taking the time for each moment to be what it is versus letting it fly past like a train . A crucial step was acknowledging the opportunities or areas that I needed to work on and truly face them head on . Those opportunities felt larger than life . Although once I stated them out loud and wrote them down, they didn’t feel trapped inside anymore . It was so much easier to let them go . I then found it easier to forgive those that hurt me and myself . Stones have been thrown and now it was time to put them down . Then, one of the most beneficial I feel, was when I started practicing intentional gratefulness . Practicing gratefulness is proven to produce happiness and physiologically it remaps your brain! No meds required! After that happiness started to emerge, it was easier to be deliberately kind to others and myself . I learned to effectively meditate, pray and journal . I felt I returned to the authentic me . Then, I began to live each day as the person I was

meant to be, not who someone else wanted me to be . I deliberately removed toxic people from my life and reestablished positive relationships . I cut negative influences from my life and replaced them with positive . I start eating healthier each day and started eating to live versus living to eat . Then I committed to exercising to live the way that makes me happy versus conforming to what others define as the standard . I look for passion and joy in all that I do . By doing this daily resilience building, I am developing myself to be a healthy, emotionally intelligent professional prepared to handle stress at any given time .

Nursing education in regards to patient care management was not taught and trained with a high consideration or emphasis to self-care . There was no re-enforcement of mindfulness when conducting clinical rounds, internships and bedside work when I went through those days of my profession . Retrospectively I see that I wasn’t prepared for what happened to me professionally or personally . Nobody is to blame for that either . However, going forward there is so much that the nursing community can do to support each other . Nursing education, professional organizations and clinical organizations must be eager to support the efforts of promoting self-care to building resiliency in our nurses alongside personal self-growth .

Citation:Jinkerson, J . D . (2016) . Defining and assessing moral

injury: A syndrome perspective . Traumatology, 22(2), 122-130 . Obtained from https://psycnet .apa .org/record/2016-22456-001 July 31, 2019 .

Additional Resources: A Nurse's Guide to Preventing Compassion Fatigue,

Moral Distress, and Burnout by Dr . Joyce Batcheller

https://www .nursingworld .org/practice-policy/work-environment/health-safety/combating-stress/

ht tps : / / w w w . ahna .org / Home / Resources / Stress -Management

Adrianne Ewald-Peterson BSN, RN

Workforce Advisory Council

Personal Reflection on Moral Injury

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