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NoNoNoNoNovvvvvember 24, 2009 Vember 24, 2009 Vember 24, 2009 Vember 24, 2009 Vember 24, 2009 Vol. 10 Issue 46 ol. 10 Issue 46 ol. 10 Issue 46 ol. 10 Issue 46 ol. 10 Issue 46 Information for Denver’s Nursing & Health Care Professionals www.denvernursingstar.com Locally Published, Owned and Operated Each Week by Metro Publishing LLC

1

Recruiter Showcase

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L a u g h i n gwithElizabeth

by Elizabeth Bussey Sowdal

I Am TrulyThankful

Presorted StandardU.S. PostagePAID

Permit #1Oklahoma City, Ok 731

Denver’s Nursing StarP.O. BOX 239MUSTANG, OK 73064

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have much to be thankful for. For which to be thankful(that’s for you Mom!). I always do, and I know it andbelieve it, even on the days when I practically have to

chant it as I rush from one boring, meaningless chore to anotheror those times when life has given me a little bit of a bent nose,or on those rare and horrible gray, winter days when I almostthink I will never see green grass again.

I am blessed and more than blessed and I take it as aresponsibility to be grateful, to attempt to tally those blessingsand appreciate them and to know that things could very easilybe different.

But this year , thisThanksgiving, things seem alittle different for me thanthey have before. My life haschanged and, because of that,my outlook has changed.

As nurses we often seemto make it almost a point ofpride that we have hectic,busy, stressful careers. Welearned the attitude when wewere new nurses and we pass

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Making a Difference: Navynurse enjoys career challenges

by Mike LeeStaff Writer

Some nurses complainabout 12-hour shifts and after

getting off just look for a nicecomfortable place to hide. But12 hours into his day, TravisGuilfoyle is just getting started.

Twenty-four hour shiftscan often be the norm for theNavy nurse, who is stationedin Kandahar, Afghanistan.

Patricia L. Peterson is acaregiver by nature. And in

by Joelle MoranStaff Writer

her new role as executived i rec to r o f the RockyMountain Children’s HealthFoundation (RMCHF), she gets

to continue helping children and their caregiverswho are in need.

Peterson, who had previous careers as aregistered nurse and medical malpractice attorney,finds health care foundation work an excellent wayto combine her skills and give back to thecommunity.

“It’s in my heart as a nurse, and I understandthe law side of it, so it’s wonderful to give backand help,” Peterson said.

The RMCHF was established by HealthOnethis year as a nonprofit charitable foundation toaddress the unmet needs of pediatric patients andtheir families at any health care facilities in a six-state region, covering Colorado, Nebraska,Wyoming, Kansas, New Mexico and Montana.

RMCHF directorenjoys giving back

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Elizabeth

Elizabeth Bussey Sowdal is an RN andfreelance writer who lives and works inOklahoma City.

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NavyPage 2 November 24, 2009 Denver’s Nursing Star

it along to the new nurses we meet.But just over two years ago I

changed jobs. Well. No. I’m still a nurse.I changed venues (that makes it seemsway more glamorous! Venues! Ha!). Itook a deep breath, filled out anapplication after 15 years at one hospital,and was fortunate to be hired.

Oh my goodness it was a hardtransition for me. I thought I’d madean awful mistake. I thought I wouldnever learn the new computer stuff, ormake friends, or learn the differencebetween a MAZE procedure and cornchowder. But I stuck with it andsuddenly it is two years later.

I know my employment history isnot very interesting reading. But thechange in jobs changed my life. I amno longer walking the razor’s edge ofhysteria because I have enough workfor two twelve hour shifts to cram intoone shift. Because the place I now workhas a culture of "yes," everything isbetter, faster, easier, more organized.

What I mean by a culture of "yes"is that at this job the first answer outof anybody’s mouth is "yes" even ifthere is a qualifier later on. I rememberliterally begging the kitchen to send apatient a sandwich at the old job.Begging. Please. On dry bread, whatever,just a little sandwich. At this job theanswer is more like, "wheat, white, ryeor sourdough?"

When I see someone in the morningand say, "Hi! How are you?" the answeris always, always, always somethingpositive. We have a sign at theemployees’ entrance that says, "Enterwith a happy heart."

Our COO tells us that everyonehas problems, everyone has bad days,but that while we are at work we leaveour troubles behind and give all ourattention and focus to our patients and

their families (did you get that part,"and their families"?)

Which is just what we all, as nurses,want to do. It’s funny, but it seemsthat being given permission to do thatmakes a difference.

So, my point is not that I am nowworking at an amazing hospital. Well,I am, but that’s not my main point.

My main point is that because myprofessional life does not leave meexhausted, embittered, heartbroken, andcynical, my entire outlook has changed.

You’ve probably heard the old songby J. Howard Entwisle (note to self:add Goggle to things I am thankfulfor), "Keep on the sunny side, Alwayson the sunny side."

Well friends, I am here to tell youthat it is much, much easier to keep onthe sunny side when those around youare on the sunny side too.

And it is easier to find peoplewalking on the sunny side when theyhave access to all they need, in everyaspect, to do their jobs properly andwell; supplies, knowledge, support andtime.

I’m used to the computer now. I’vemade lots of new friends. I know whata MAZE procedure is now and knowthat there are absolutely no eggsinvolved in it at anytime. And I knowsome other things too.

I know that removing myself froman unhappy work environment was oneof the most important and meaningfulthings I have ever done in my life.

That the peace I have found, thefulfillment, the pride I take in myprofession, those positive feelings havehad positive affects on all the rest ofmy life as well.

I tell you this because I know thatsome of you, many of you feel as I felt– worn down, martyred, used up andunhappy.

And there is no reason for puttingup with that. There are lots of jobs inhealthcare and lots of nice places towork if you’ll throw back yourshoulders, tell yourself you can do itand then just go.

Mohandas Ghandi said, "Nobody canhurt me without my permission." I say,deny permission! Give yourselfpermission to make yourself happier.And see if those around you aren’thappier as a consequence.

"It will help us everyday, It willbrighten all the way, If we keep on thesunny side of life."

ARE YOUREADING THIS?

So are more than 80,000Healthcare

Professionals throughout theDenver Metro area !

Call 720-283-2209TODAY!!

As part of the Role 3 trauma team,Guilfoyle is part of a multi-national groupof nurses, doctors, medics/corpsmenstationed in Kandahar, Afghanistan. Everyday he comes in contact with peoplefrom England, Australia, Holland, NewZealand, Canada and other countries.

During a free moment, Guilfoyle tooka break to tell Denver’s Nursing Star whatNavy nursing is all about. Sept. 11 helpedsteer Guilfoyle to what he’s doing now.Guilfoyle was born in Topeka, Kansas in1979 and would make stops in Wichita,Kansas, as well as Sedalia, Seneca, andNeosho, Mo. while growing up

“That’s when I really startedentertaining the idea of joining themilitary,” said Guilfoyle, whose cousin isa Marine. ”Though at that time I didn’tknow which branch I was interested in.”

After graduating from Pittsburg StateUniversity in Pittsburg, Kan., Guilfoyletook a job in Tulsa at St. Francis Hospitalin the Cardiac ICU. He had almostforgotten about joining the military untilhe started working with a nurse techwho was a corpsman with the Seabeesin the Navy.

Conversations in the hallways furtherstoked Guilfoyle’s appetite for the military,especially the Navy. His stint as a travelnurse brought him into further contactwith friends who had been or werecurrently in the armed services.

“The biggest reason I chose the Navyover the other branches is because theNavy provides medical care to theMarines,” Guilfoyle said. “Anywhere thereis a Marine base there is usually a Navalhospital or at least a clinic.”

His time working as a travel nursehelped him realize that he also enjoyedmoving around. Never one to live inone place very long, Guilfoyle loved theidea of the Navy and the fact there wouldmost always be a beach wherever hewent.

“Don’t get me wrong, I loved workingin the ICU as a civilian,” he says. “I’vetaken care of some very sick people inmy short time as a nurse. Some you’renot sure if they’ll make it out of thehospital, and when they do it just makesyou feel good. When they come back tosay, ‘Thank You,’ that’s what makes itall worthwhile.

“I knew I was making a differencein those people’s lives and working inthe ICU, I loved a challenge. After talkingto my cousin who was a Marine, andtwo friends who are also Marines, …Ireally wanted to give back to them, maybenot so much them per say, but thosewho risk their lives for you and me.”

Looking back, Guilfoyle realizes it

wasn’t too much of a stretch that heended up in the healthcare field.

“It seems as though most of myfamily, at least my dad’s side, are in themedical field,” Guilfoyle said. “My dadis a nurse anesthetist at the local hospitalin Ft. Scott, Kan. My mom is currently apediatric home health nurse, who hasmore than 20 years as a surgical nurseand has also worked as a floor RN. Hehas everal aunts and an uncle who arenurses, as well as cousins who arecurrently in nursing. I also have a littlesister who is a massage therapist.”

But even surrounded by all thatmedicine, Guilfoyle still thought his futurewas elsewhere growing up.

“To be honest I never was interestedin the medical field until I came homeduring a break, either Thanksgiving orChristmas, while I was in college in NorthDakota, he said. “I was set on being anelementary education teacher. When Iwent home over the break I was talkingwith my dad and he asked if I would beinterested in going to watch a surgery.Since I had never seen anything likethat, I thought sure why not. I remembersitting next to my dad while headministered the anesthesia and watchedthe doctor while he was removing agallbladder and explained what he wasdoing and why he was removing it.

“I remember just being in awe ofwhat I was seeing. Then three days laterwhen I returned to North Dakota, I wentin to talk with my academic adviser andtold her I was switching majors and goingto move back to Kansas to go to nursingschool. I remember the look on her face,because I had a semester or two left andI’d graduate with my education degree.

Guilfoyle’s nursing career has beenon the fast track in the Navy. FromOfficer Development School in Newport,R.I. he was stationed at Naval HospitalCamp Lejeune in Jacksonville, N.C. Justa few months into his Navy career hefound himself asked to deploy toKandahar, Afghanistan for his currentassignment.

“This is not typical, at least fornurses,” Guilfoyle said, both humbled andhonored. With already five yearsexperience in cardio, medical and surgicalICU he was deemed combat zone ready.

“I think I did things a littlebackwards,” he said. “I went from nursingschool straight into the civilian settingthen to the Navy, whereas most nurses Ihave talked to in the Navy went straightto the Navy after nursing school. I thinkthe Navy prepares you to take onleadership responsibilities quicker thanin the civilian world.”

Guilfoyle calls his current assignmentthe highlight of his nursing career.

Denver’s Nursing Star November 24, 2009 Page 3

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Director

“We are not raising money forbricks and mortar,” Peterson said. “Weare solely raising money to assist needyfamilies whose children are receivingmedical treatment.”

The foundation will not pay formedical bills, but can help familiescover other costly expenses such astravel and hotel needs, or helping aparent who can’t work while theirchild is hospitalized or undergoingtreatment, pay the mortgage or putfood on the table.

“It’s an open box for what theirneeds are,” Peterson said.

The foundation is in the startupphase, Peterson said, writing policiesand procedures , get t ing grantguidelines and developing a board.

Once those policies are in place,fund-raising for specific areas willbegin to build on RMCHF’s $1 millionbase. Requests for grants will beaccepted beginning in late 2010.

Mimi Roberson, president and CEOof Presbyterian/St. Luke’s MedicalCenter and Rocky Mountain Hospitalfor Children (RMHC), said there aremany unmet needs for children andthe i r ca reg iver s tha t ex i s t ingorganizations in the region don’t serve.

“Our hospitals also have had manygrateful patients ask for ways theycan help other patients and familiesundergoing similar experiences,”Roberson said. “Pat will be workingwith all HealthOne hospitals todetermine the best way for thefoundation to support patients andtheir medical caregivers. She isincredibly passionate and motivatedto help patients and families.”

RMHC at Presbyterian/St. Luke’sis HealthOne’s anchor pediatric facilityfor specialized services, including high-risk obstetrics and neonatology.

Another goal of the foundation isto assist nurses, physicians and othermedical staff in education to helpimprove pediatric medical care. Thatcould come in the form of educationalpamphlets and clinics.

As an example, Peterson said agroup of emergency room physiciansmay put together a concussion clinicfor parents and athletic coaches aboutthe dangers of concussions.

But more than anything, Petersonsaid her goal for the foundation is toease the stress on families who havean ill or injured child.

“My goal is to be a resource forthe community where any pediatricpatients or their families in need knowto come to us as a resource for help,as well as alleviate the fears, concernsand overwhelming trouble that familieshave when a child is in trouble,”

Peterson said.Peterson herself realized her desire

to be a nurse during childhood whenshe took care of her diabet icgrandmother who lived with herfamily.

“I was taught to give insulin shots.I was the responsible caregiver child,and I learned by taking care of her athome,” Peterson said. “It was justsomething in my heart. I’m a caregiverby nature.”

She earned her BSN in 1979 fromTowson State University in Baltimore,Md. After graduating from nursingschool, Peterson moved to Californiaand worked as a critical care nurse atStanford University Hospital.

After about three years, Petersonmoved back to Baltimore and waslooking for an area of nursing topursue. While she pondered her futurein nursing, a physician fr iendconvinced her to take a job at MedicalMutual Liability Insurance Society ofMaryland, where she worked in theclaims division.

It helped her make a decision. Thecompany paid for her to go to lawschool and pursue her second career.

Peterson earned her Juris Doctoratein 1989 from the University ofBaltimore. Following that, she spentthe next near 18 years as a medicalmalpractice attorney defending doctors,nurses and hospitals.

Be fore tak ing the he lm ofHealthOne’s new foundation, Petersonworked at Memorial Health System inColorado Springs for nearly 10 years.She was in-house counsel for Memorialand later became president and CEOof the Memorial Health SystemFoundation.

Peterson said her success at takingover Memorial’s foundation andmaking it successful made her an idealcandidate for setting up the newRMCHF.

“When they were looking forsomeone to start a new (foundation),it was very exciting for me,” Petersonsaid. “But being able to start it upand have some vision and focus, Ithought it was time to come help thiscommunity of families and children.”

So far, Peterson said she’s seen agenerous and caring communityembrace the new foundation andforesees a bright future.

“After being a trial attorney, it’sincredible to be on the side of peoplethat are positive and helpful and notbe in an adversarial role,” she said.

For donations to meet these futurerequests, contact Peterson, 303-839-6829or e-mail Pat.Peterson@RMChildren.org

For in fo rmat ion , v i s i t thefoundat ion ’ s Web s i t e a twww.RMChildren.org

The American Organization of Nurse Executives (AONE) and TheLeadership Studio have collaborated to create a new web-based ExecutiveCoaching Resource Center (ECRC) for nurse leaders. The AONE ECRC isnow available as a members-only benefit on the AONE Web site(www.aone.org).

This coaching initiative - designed specifically for AONE members -includes the development of documents and other resources to assist nurseleaders who want to learn about and access executive coaching services.

The objectives of the AONE ECRC are to raise awareness and to informAONE members about executive coaching and the value of this service toone’s career. One study conducted by Manchester, Inc., showed employeeswho experienced executive coaching realized improvements in productivity,quality, organizational strength, customer service and shareholder value. Inaddition, organizations who offered executive coaching to their employeesreceived fewer customer complaints and were more likely to retain executives.The study also showed that professionals who work with executive coachesreceive a return on investment six times greater than the expense of thecoaching.

The American Organization of Nurse Executives is the national professionalorganization for nurses who design, facilitate and manage care. With morethan 6,500 members, AONE is the leading voice of nursing leadership inhealth care. Since 1967, the organization has provided leadership, professionaldevelopment, advocacy and research to advance nursing practice and patientcare, promote nursing leadership excellence and shape public policy forhealth care. AONE is a subsidiary of the American Hospital Association.

AONE launches coachingcenter for nurse leaders

ARE YOU READING THIS?So are more than80,000 Healthcare

Professionals throughout theDenver Metro area !

Call 720-283-2209 TODAY!!

Aroundthe State

Page 4 November 24, 2009 Denver’s Nursing Star

Three of the largest Front Rangehealth care organizations are taking anunprecedented leap forward in healthcare reform by improving care for morethan a million Coloradans with aninterconnected electronic patient recordexchange system.

The Children’s Hospital, KaiserPermanente Colorado and ExemplaHealthcare are now live with an electronichealth record (EHR) “health informationexchange” system. It allows patients toshow up at any one of the organizations’hospitals and clinics and have theirrecords instantly available to doctors withthe click of a button.

Being able to see and share thisinformation enhances the quality andcontinuity of care for patients, as doctorsshare vital patient medical informationthrough secure, encrypted Internetconnections. As a result, healthinformation exchanges such as this onewill allow doctors to more efficiently andaccurately diagnose patients andrecommend treatments.

“We no longer have to listen to voice-mail messages or try to decipher unclearfaxes,” said David Kaplan, MD, chiefmedical information officer for TheChildren’s Hospital. “Doctors now haveinstant access to a patient’s up-to-datehealth records, which saves time andreduces errors.”

The partnership is a pioneeringexample of three independent health careorganizations sharing patient healthrecords electronically, and is a concreteexample of how health care reform istaking place in Colorado . All recordsare up-to-date and changes are logged

in real time, helping the quality of patientcare, no matter where and by whomthey are seen. Less than two percent ofhealth care facilities nationally are usingfully electronic health records, and onlya handful are exchanging healthinformation in this integrated manner —highlighting the uniqueness of therelationship between the three providers.

“The Obama administration has made

it very clear that improving the nation’shealth care system hinges partly onmodernizing our industry with electronichealth records, and then encouragingthese systems to become more connected,”said Robert Miller, MD, of KaiserPermanente.

“As a pediatrician, I’ve seen thebenefits of health-IT exchange first-hand.With quicker access to more information,I can now diagnose, treat and care for

the children in my practice with even greater confidence and improved results.”The three providers are in the process of an extended pilot program to test the

system, and officially went online with the CareEverywhere electronic health carerecord software system this summer. The foundational systems making this exchangepossible are commonly referred to as EHRs or electronic medical records (EMRs),and can hold a wide variety of information including immunization records, bloodtype, lab results, X-rays, allergies, medical histories, current and past medicationsand dosages. While investing in the switch from paper to electronic records costsmillions of dollars, the result leads to more efficient, cost effective health care withimproved safety, quality and communication.

Dr. Kaplan of Children’s Hospital adds that throughout the process, providershave kept a clear focus that while EHR is an important tool, it will never replacethe doctor-patient relationship. A doctor will always make the diagnosis and prescribetreatment, not a computer. Having EHR available to health care providers will onlycomplement that relationship.

“Traditionally, getting medical records from other organizations has been timeconsuming and inconvenient to the degree that clinicians areoften forced to make decisions without complete information,”said Joe Heaton, vice president and chief medical informationofficer at Exempla Healthcare. “The systems we have put in placenow allow for faster and more efficient access to clinicalinformation, which ensures that our patients have uninterruptedcontinuity of care between the doctor’s office and the hospital.”

Health Information Exchange at a glance����� Enhances quality and safety by reducing the chance for

medical errors that occur when information is written downinaccurately or illegibly, or is not available to care providers in atimely manner.����� Promotes efficiencies as physicians can quickly access

patient care documents electronically right in the exam room,rather than ordering a repeat of that test or exam that may havebeen done recently at a partner facility.����� Supports clinical decision-making by providing clinicians

prompt access to comprehensive, “continuity of care” patient andclinical information when needed.

The Children’s Hospital has defined and delivered pediatrichealthcare excellence for more than 100 years. Founded in 1908, The Children’sHospital is a leading pediatric network entirely devoted to the health and wellbeingof children. Continually recognized as one of the nation’s outstanding hospitals byU.S. News & World Report, The Children’s Hospital is known both for its nationallyand internationally recognized medical, research and education programs as well asthe full spectrum of everyday care for kids throughout Colorado and surroundingstates. With more than 1,000 healthcare professionals representing the full spectrumof pediatric specialties, The Children’s Hospital network of care includes its maincampus, sixteen Children’s Care Centers and more than 400 outreach clinics.

Kaiser Permanente Colorado is the state’s largest nonprofit health plan, proudlyworking to improve the lives and health of Denver , Boulder , and SouthernColorado area residents for 40 years. Kaiser Permanente Colorado providescomprehensive health care services to over 480,000 members through 20 medicaloffices and a network of affiliated hospitals and physicians. The health plan wasrecently named “Highest in Member Satisfaction” among Commercial Health Plansby J.D. Power and Associates for the second year in a row. Kaiser Permanente wasalso named the top-ranked commercial health plan and Medicare plan in Coloradoby US News & World Report/NCQA. In 2008, Kaiser Permanente proudly directedmore than $75 million to community benefit programs to improve the health of allColoradans. For more Kaiser Permanente news, visit kp.org/newscenter or followsus on twitter @kpcolorado.

Exempla Healthcare, formed in 1998, serves metropolitan Denver through itsthree hospitals – Exempla Good Samaritan Medical Center, Exempla LutheranMedical Center , Exempla Saint Joseph Hospital – and the Exempla PhysicianNetwork of primary care, occupational medicine and specialty physicians. Exempla’smission is to foster healing and health for the people and communities it serves.http://www.exempla.org

Denver hospitals linkelectronic patient records

Denver’s Nursing Star November 24, 2009 Page 5

The U.S. Food and Drug Administration announced that it has approved afifth vaccine for protection against the 2009 H1N1 influenza virus.

The vaccine is manufactured by ID Biomedical Corp. of Quebec, Canada,owned by GlaxoSmithKline PLC.

As with the four previous H1N1 influenza vaccines licensed by the FDA onSept.15, 2009, ID Biomedical Corporation will manufacture its H1N1 vaccineusing the established, licensed egg-based manufacturing process used forproducing seasonal flu vaccine.

Potential side effects of this H1N1 vaccine are expected to be similar tothose of the seasonal and H1N1 flu vaccines.

The most common side effect is soreness at the injection site. Others mayinclude mild fever, body aches and fatigue for a few days after the inoculation.

As with any medical product, unexpected or rare serious adverse eventsmay occur.

The FDA is collaborating with other government agencies to enhanceadverse event safety monitoring during and after the H1N1 2009 vaccinationprogram.

ID Biomedical’s H1N1 monovalent vaccine will be produced in multi-dosevials, in a formulation that contains thimerosal.

As with any medical product, unexpected or rare serious adverse eventsmay occur. FDA is collaborating with the U.S. Department of Health andHuman Services, including the Centers for Disease Control and Prevention,and other government agencies to enhance the capacity for adverse eventsafety monitoring during and after the 2009 H1N1 vaccination program. Formore information, visit www.fda.gov.

FDA Approves AdditionalVaccine for H1N1 Virus

Photo bPhoto bPhoto bPhoto bPhoto by Ky Ky Ky Ky Kellie Bonthrellie Bonthrellie Bonthrellie Bonthrellie Bonthrononononon

Health in Home LPN Donna JHealth in Home LPN Donna JHealth in Home LPN Donna JHealth in Home LPN Donna JHealth in Home LPN Donna Johnston vohnston vohnston vohnston vohnston values the one-on-alues the one-on-alues the one-on-alues the one-on-alues the one-on-one aspect ofone aspect ofone aspect ofone aspect ofone aspect of home health car home health car home health car home health car home health care and the oppore and the oppore and the oppore and the oppore and the oppor tunity totunity totunity totunity totunity todirdirdirdirdirectlectlectlectlectly toucy toucy toucy toucy touch pah pah pah pah patients’tients’tients’tients’tients’ li li li li livvvvveseseseses.....

Health in Home LPN DonnaJohnston likes going to work everyday knowing that she’s directlytouching her patients’ lives, makinga difference. It’s this one-on-one aspectof home health care that Johnsonvalues.

“You have the opportunity tomake an impact on somebody’s lifeeveryday,” Johnson said.

“You get to build those personalrelationships and realize that whatyou have to offer makes a difference.”

Unlike other health care settings,home hea l th ca r e invo lve senvironmental, holistic care, whichcan create an entire set of additionalchallenges for nurses and presentopportunities to be creative, Johnstonsaid.

“We have to address not just theillness, but the entire situation of theclient,” she said.

Health in Home provides healthcare services to elderly and disabledclients, many that require long-term

by Joelle MoranStaff Writer

care due to a health decline or illnessthat will affect them for their entirelives.

Because Johnston works inpatients’ homes, she can’t rely on theluxuries of technology and high-techequipment to diagnose patients ormake them comfortable.

This is where the creativity andability to improvise come into play.

“You have to make do with whatyou can find,” Johnston said.

For example, if a patient’s bedneeds to be elevated, Johnston woulddevise a way to prop it up, whereasin a hospital it just requires the pushof a button.

Or, if Johnston has a diabeticclient that needs to eat healthy on afixed budget, she’ll work with himto brainstorm what will fit into hisbudget and get as close to the perfectfoods as possible.

Although this improvising can bechallenging, Johnston jokes that theweather and traffic are the mostcommon headaches of being a homehealth nurse.

Johnston said she always wantedto be a nurse, but life happens and

her marriage and familytook precedence over hercareer.

After having a varietyof administrative jobs - manyhealth care-related such asin insurance and doctors’offices - she realized shewanted more out of life.

“The universe was tellingme it was time to go tonursing school,” she said.

Johnston earned her LPNin 2006 from the DenverSchool of Nursing and juststarted the LPN to RNprogram there as well. She’son track to complete her RNin December 2010.

After earning her LPN,she worked at a nursinghome for eight months andrealized that the stress ofhaving to care for too manypatients was not the type ofnursing she wanted to do.

So, she went to work in homecare for Above and Beyond, a homehealth agency that is no longer inexistence.

While there, she worked in thefield and had the opportunity to learnquality assurance and worked her wayto administrator of that agency.

Johnston joined Health in Homein 2008 and says she has “found ahome for myself in home care.” Shealso splits her time between the field- visiting about 20 clients a week -and in the office, doing administrativequality assurance work.

She says she enjoys the challengesof home care, and it’s what keepsher going, knowing that every dayis different.

“No day is exactly the same. Eventhough you have the same patients,new things come up, you learnsomething new or new ways of doingthings,” she said.

The goal of home health care isto keep patients in their ownsurroundings, which Johnston says is

doable the majority of the time.“When they’ve lost a lot, keeping

them in their home and giving themthat sense that they’re in control oftheir home is huge to our clients,”she said.

“I value the relationships I’m ableto build with the patients and theirfamilies, assisting them with gettingou t in the commun i ty andmaintaining their independence aslong as they can and knowing that Ihave a vital role in that.”

Another rewarding aspect of homecare, Johnston said, is seeing patientsnot only when they are ill, but alsoas they adapt to their illness andheal.

And as home health nurses workautonomously, they serve as theinvaluable eyes and ears for doctors,often seeing what’s happening withpatients sooner than a doctor.

“It gives you a little more freedomas a nurse, more responsibility. Withthat you can really get to know yourpatient and experience one-on-onenursing,” she said.

Health in Home LPNenjoys touching lives

Want to reach more than80,000 readers?

Send us all your continuing education programsand we’ll publish themFREE OF CHARGE!

Email your continuing education information to usat: news@denvernursingstar.com or simply fax it to

720-283-2198!

Page 6 November 24, 2009 Denver’s Nursing Star

1 4 01 4 01 4 01 4 01 4 0 GENERAL NURSINGGENERAL NURSINGGENERAL NURSINGGENERAL NURSINGGENERAL NURSING1 4 01 4 01 4 01 4 01 4 0 GENERAL NURSINGGENERAL NURSINGGENERAL NURSINGGENERAL NURSINGGENERAL NURSING

Fort MorganColorado

Plains MedicalCenter Nurse

Manager -Psychiatric

Services - FT.Plans, implements, delivers

and evaluates overalldelivery of nursing care to

patients in the GeriatricBehavioral Health Unit.

Requires BSN, orcomparable degree/

experience required, and aminimum of 3-5 years of

progressively responsiblemanagement experience inpsychiatric health services,

preferably in patientservices, or related field;demonstrated leadership

expertise; knowledgeregarding psychiatric

nursing; current Colorado RNLicense, and BLS. MSNpreferred. To learn more

about our team, browse ourweb page or apply online

www.coloradoplainsmedicalcenter.com, call970-542-3331 or email

janet.brinkman@lpnt.net ormail to 1000 Lincoln St,CS4200, Ft. Morgan, CO

80701.

Full-timeLPN or RNto manageour WoundProgram

Sunny Vista Living Center islooking for a full-time LPN or

RN to manage our WoundProgram. Wound and LTC

experience a plus. Be a partof an exceptional Nurse

Management Team. Make adifference in a setting where

you are appreciated! Faxresume to: 719-471-4352 ore-mail: dns@sunnyvista.org.

EOE drugfree

NurseSupervisor

All About Staffing, Aurora,CO (Full time) Nursing

Supervisor opportunity : 8a-8p every other weekend.Candidate should have 2

years of experience in eachmodality of acute care, i.e..trauma, med surg, ed. Applyby phone at 1-866-967-5748.Please quote Job Code 8298Basalt,

ColoradoNurse or

Medical Asst.Highly organized, self

motivated, ambitious, drivento excel, team player and

focused on the overallsuccess of clinic. Ability to

connect with clients,establish friendly

relationships immediatelyand build and maintain trustwith customers. Fax coverletter and resume to 970-927-5245 or email them todoctor@premiercaremd.net

CHARGENURSE

Supervisionof Med/Surgnursing staff

all aspects of nursingprocess; assess plans,

implement & evaluate, anddocumentation of care. Fiveyears Med/Surg experience,

Graduation from anaccredited nursing program;

BSN degree preferred.Current Colorado RN

licensure; Certification: BLS,ACLS. E.O.E. Estes Park

Medical Center 555 ProspectAve. Estes Park, CO 80517970-577-4458 Fax resumes

to: 970-577-4307www.epmedcenter.comEPMC is a drug free

workplace and a drug screenis required.

Full timeAdult

PsychiatristAdult psychiatrist needed fora full time opportunity in anoutpatient facility located inColorado. M-F from 8am to

5pm. Utilize ElectronicHealth Record system?must

have reasonable typingskills (dictation also

available). On-call is notrequired. Initial evals are 1

hour, w/ follow-up appts.- 20minutes, transfer of

established clients - 40minutes. Work within a team

of approximately eightphysicians and five nursesin adult clinic. Clinic will be

closed Christmas week. If allpatients are follow ups, docwould see about 18 ppd.Thisfacilitly is located in a greatlocation for all that Colorado

has to offer. Beautifulscenery, numerous outdooractivities, great restaurants

and cultural events.LocumTenens.com will covermalpractice insurance, which

is occurrence, as well astravel and housing costs.For further details pleasecontact Ronda Price by

phone at 800-261-3422 or800-261-3422 x 1693. Faxyour CV to (678) 352-4393.

Ref # 366872

Nurse. PT &PRN Nurses

and MDSCoordinator(Registered

Nurse) neededat Grace Healthcare in GWS.

Please apply in person at2305 Blake Ave. Glenwood

Springs, CO 81601. Job ID#202471-4312530

READING THIS?Advertise here and you will

have the opportunity toplace your ad in the homesof more than 48,000 Nurses& healthcare professionalsin the Denver Metro area!

SERVICECOORDINATOR

IntakeHuman Services

Our dedicated team atDenver Options coordinatesthe resources, services and

supports for people withdevelopmental disabilities.

Join us as a: SERVICECOORDINATOR-Intake

Children's CaseManagement. The Service

Coordinator (SC) isresponsible for receivingreferrals and coordinatingintake activities for EarlyIntervention. The SC willcomplete State referral

forms & gather data neededfor Denver Options,

including information forplacement, community

coordination & funding. TheSC will be responsible for

assigning referrals toService Coordinators, in

collaboration w/EI ProgramManagers. The incumbent

will ensure that children whoare eligible for earlyintervention receive

appropriate documentationfor eligibility. The SC will

work with communitypartners to ensure

continuous performanceimprovement. Position

requires a Bachelor's degreein Human Services or related

field, 2 years casemanagement experi-enceworking with people with

developmental disabilitiesand their families, previousexp. in Early Intervention/

Part C, a valid driver'slicense & proof of insurance.

Our outstanding benefitsinclude medical, dental,

vision, life and disablity andretirement plan. Qualifiedapplicants should send

resume to: J Gordon. 9900E. Iliff Avenue. Denver, CO80231. Fax: (303)636-5613.

Email:jgordon@denveroptions.org.

www.denveroptions.org.EOE/M/F/D/V

Activity DirectorCastle Country AssistedLiving, Inc. is a non-profit

organization providingcompassionate care and

supportive communities forseniors. We accomplish thisin our three assisted livinghomes: Cantril House and

Valley House both in CastleRock, and Victorian House

in Parker. Our warm andinviting homes provide a

family-like community for ourresidents. CCAL is currentlylooking for a dynamic person

to join our team as anActivity Director for all three

of our communities. TheActivity Director creates

programs and encouragesparticipation in activities

which are age-appropriateand sensitive to the needs

of our residents. The ActivityDirector is to provide a

warm, friendly, andstimulating environment for

each resident. Activityexperience is a must. CCAL

requires a backgroundcheck and a drug and

alcohol screening. Pleasesend resume with salary

requirements tostacyrobak@castlecountryassistedliving.org or fill outan application at 221 Cantril

Street in Castle Rock.castlecountryassistedliving.org

1 4 01 4 01 4 01 4 01 4 0 GENERAL NURSINGGENERAL NURSINGGENERAL NURSINGGENERAL NURSINGGENERAL NURSING

LicensedPractical NurseJob #: LPN Yuma. Full-

time. Yuma Life CareCenter. SSC Yuma

Operating Company LLC.323 W 9Th Avenue.

Yuma, CO 80759. ComeJoin Our Team of Nursesat Yuma Life Care Center,a 58 bed Skilled NursingHome in Yuma, CO. Fulland part time openings.

Qualified candidates,please email resume toWendy Schultz, Region

Recruiter,WSSchultz@savasc.com.Phone 1-877-628-9172

1 6 11 6 11 6 11 6 11 6 1 LICENSEDLICENSEDLICENSEDLICENSEDLICENSEDPRACTICAL NURSEPRACTICAL NURSEPRACTICAL NURSEPRACTICAL NURSEPRACTICAL NURSE

1 7 01 7 01 7 01 7 01 7 0 N U R S EN U R S EN U R S EN U R S EN U R S EP R A C T I T I O N E RP R A C T I T I O N E RP R A C T I T I O N E RP R A C T I T I O N E RP R A C T I T I O N E R

Neonata NursePractitioner

NNPWe are now interviewing

for Neonatal NursePractitioners for a cutting

edge hospital inColorado. The facility is a

Magnet-designated,teaching hospital which

has been selected one ofthe nation's top ten

outstanding hospitals init's catagory by severalpublications. The team

consists of 22 attendingdoctors plus residents

and fellows, along with alarge NNP team. The

facility provides care at itsmain campus and

through a network thatincludes eleven Care

Centers and more than400 outreach clinics.

Located just 30 minutesfrom outdoor activities

such as kayaking, hiking,and skiing. But the snowstays in the mountain for

the skiers, and in thevalley, you’ll experience365 days of sunshine!

Responsibilities: - Provideregional care with all

pediatric subspecialtiesrepresented including

cardiovascular andECMO - Manage pre-term

infants - No transportresponsibility - NNPs work

12 and 24 hour shifts -Provide a broad

background and supportfor their colleagues.

Requirements: - Master'sdegree - 3-5 years of

experience as NNP in alevel 2 or 3 NICU -

Prescriptive authority,DEA number - NCC

certification. Contact ustoday toll free at

(866) 952-9164 or bye-mail at

jobs@teamstaffrx.com.We look forward to

helping you take the nextstep in your career!

Visit The Webdenvernursingstar.com

Denver’s Nursing Star November 24, 2009 Page 7

2 0 42 0 42 0 42 0 42 0 4 REG ISTEREDREG ISTEREDREG ISTEREDREG ISTEREDREG ISTEREDN U R S EN U R S EN U R S EN U R S EN U R S E

2 0 42 0 42 0 42 0 42 0 4 REG ISTEREDREG ISTEREDREG ISTEREDREG ISTEREDREG ISTEREDN U R S EN U R S EN U R S EN U R S EN U R S E

2 0 42 0 42 0 42 0 42 0 4 REG ISTEREDREG ISTEREDREG ISTEREDREG ISTEREDREG ISTEREDN U R S EN U R S EN U R S EN U R S EN U R S E

2 0 42 0 42 0 42 0 42 0 4 REG ISTEREDREG ISTEREDREG ISTEREDREG ISTEREDREG ISTEREDN U R S EN U R S EN U R S EN U R S EN U R S E

NursePractitionerPlanned Parenthood of the

Rocky Mountains has a part-time, (Monday’s 7:30am-4pm) Nurse Practitioner

position available inColorado Springs, CO.

Duties of the NP includepatient exams, patient

assessment, lab work andpatient education.

Requirements of the NP,CNM, or PA who has

completed an NP, CNM, orPA educational program andis certified as an NP, CNM,

or PA by a nationalcertification organization andmet state requirements forlicensing or certification as

an NP, CNM, or PA; Or, if notcertified at time of

employment, must receivecertification within two yearsof date of hire, or Possess aMedicare number. Applicantsmust have previous clinicalexperience in reproductive

health care services.Spanish speakers a plus!Apply at www.pprm.org or

fax your resume to 303-861-0282. PPRM is an EqualOpportunity Employer andValues Diversity in People

and Ideas

1 7 01 7 01 7 01 7 01 7 0 N U R S EN U R S EN U R S EN U R S EN U R S EP R A C T I T I O N E RP R A C T I T I O N E RP R A C T I T I O N E RP R A C T I T I O N E RP R A C T I T I O N E R

Cath LabRegistered Nurse

Employer located in Denver,CO (Full time, Temporary)

Schedule: Varies. Cath LabRN * Must have current COLicense * 8 hr day shift plus

call (call includes everyother wknd Friday, Saturdayand Sunday) * Weekday calltwo to three times per week/

14 total call days in fourweek period * Must be veryexperienced * Must have

ACLS Tech Group Inc. 244W. Main. Spokane, WA

99201. Toll Free: 800-523-3968. Spokane: 509-688-3000. Fax: 888-771-5669

RegisteredNurse

MEDICALSURGICAL

Employer located in CO(Temporary) Come visit

downtown Denver CO for thesummer! Working with one ofour top client facilities...thehospital is seeking a Med-Surg RN w/ a minimum of 2yrs experience to help outon their day shift - 7a-7p.

CO license (2-3 wks) -COMPACT STATE. Please

contact Aureus at 1800 8565457 for more information.EOE / E-Verify / AAE. 800-856-0375. Please quote Job

Code 09-248514Registered Nurse

OBSTETRICSEmployer located in CO(Temporary) Two Mother/

Baby nurses needed in COto help out the hospital.Come visit Colorado andenjoy the outdoors and

shopping of the Denver area.Contact your Aureus

Account Manager at 800-856-5457. EOE / E-Verify /AAE. 800-856-0375. Pleasequote Job Code 09-248438

RegisteredNurse -OR-

PERIOPERATIVEEmployer located in CO(Temporary) Colorado

hospital is in need of an ORnurse to help out for an 8week assignment, on theday shift. If you like the

outdoor sports, along withthe beauty of the Rocky

mountains this is the placeto be! 1. BLS, ACLS 2. COor Compact License 3. 3

years minimum experience 4.Need to be proficient ingeneral, ortho (including

totals), OB, C-Sections, ENTand cataract procedures. 5.

Requires 1 shift call every 3-4 days, and every 3rd or 4th

weekend. Call AureusNursing 800-856-5457.

EOE / E-Verify / AAE. 800-856-0375. Please quote Job

Code 09-249168

RegisteredNurse

All About Staffing, LoneTree, CO (Travel) Unit: Peds.

This is a 13 week travelassignment. In this position,you will evaluate, plan, andadminister nursing care topatients. You will provide

prescribed medication andtreatment, help physicians

during exams and treatment,and monitor and record

patient condition, notifyingphysician when appropriate.You will also monitor patient

care provided by LPNs,CNAs, and others. Shift:

7:00 PM to 7:00 AM36 hourwork week. Minimum

Requirements: Completion ofnursing school and state

license.1 year recent acutecare experience. Apply byphone at 1-866-967-5748.

Please quote Job Code 7999

RegisteredNurse

Job #: Job-9460. PRN.Minnequa Medicenter, SSCPueblo Operating Company

LLC. 2701 CaliforniaPueblo, CO 81004. Sava

Senior Care’s affiliate longterm care facility,Minnequa

Medicenter- located inPueblo , CO has an opening

for Registered nurses,various shifts . Call to

inquire. For moreinformation, please contactWendy Schultz, RegionalNurse Recruiter, Email:

WSSchultz@savasc.com. Orphone me at 877-628-9172

Fax: 262-628-9185

CathlabRegistered

NurseLocation: Lafayette, CO.Length: 13 Weeks. Shift:

Days - 8 hr days. ScheduledWeekly Hours: 40. Cardiac

Cath Lab RN / Interventional/Procedural Cath Lab. Must

have 2yrs Cath Lab exp andprior travel preferred / ACLS,

BLS required / call will bediscussed during interview.Benefits: Generous Hourly

Pay. Housing: Private,Furnished, W&D, Utilities

paid OR receive a monthlysubsidy. Insurance: Medical,Dental, Life and Prof Liability

available 1st Day. Travel:Choose mileage, airfare, orallowance. 401k: Available

on day one! For moreinformation about this traveladventure add it to your cartby clicking the link above, or

contact us. Call 800-240-2526 or email

jobinfo@nurse.tv at TravelNurse across America and

reference job# 54189.

PICURegistered

NurseLocation: Aurora, CO.

Assignment Length: 13Weeks. Shift: All - 12 hr

shifts. Scheduled WeeklyHours: 36. PICU RN /

Minimum of 3 years of PICUexperience required and

preferred to be from largepediatric teaching facility.

Previous travel experiencealso preferred. Current

Healthcare Provider BasicLife Support card and

Pediatric Advanced LifeSupport cards required.

Benefits Generous HourlyPay. Housing: Private,

Furnished, W&D, Utilitiespaid OR receive a monthly

subsidy. Insurance: Medical,Dental, Life and Prof Liability

available 1st Day. Travel:Choose mileage, airfare, orallowance. 401k: Available

on day one! For moreinformation about this traveladventure add it to your cartby clicking the link above, or

contact us. Call 800-240-2526 or email

jobinfo@nurse.tv at TravelNurse across America and

reference job# 54207.

Registered Nurse - EREmployer located in CO

(Temporary) RN needed forER in Colorado city of

360,000. Fantastic views ofthe mountains. Abundant

outdoor activities. One yearexperience needed.

Combination of evenings andnights. Call 800-856-5457

EOE / E-Verify / AAE. 800-856-0375, Please quote Job

Code 09-248212

Full-timeRegistered Nurse

Job #: RN Yuma. Full-time.Yuma Life Care Center. SSCYuma Operating CompanyLLC. 323 W 9Th Avenue.Yuma, CO 80759. Come

Join Our Team of Nurses atYuma Life Care Center, a 58bed Skilled Nursing Home inYuma, CO. Full and part time

openings. Qualifiedcandidates, please email

resume to Wendy Schultz,Region Recruiter,

WSSchultz@savasc.com.Phone 1-877-628-9172

Registered NurseTELEMETRY

Employer located in CO(Temporary) Come visitbeautiful Denver for the

winter. One of our top clientfacilities is seeking 1

Telemetry RN to help themout for 13 wks, October

start date, BLS and ACLSrequired. Please call yourAureus Representative at

your earliest convenience at800.856.5457! 1. BLS,

ACLS. 2. CO or compactlicense(license takes 2-3wks). 3. 12 hr nights. 4. 2+

years experience is required.5. PBDS Test required. 5.

PBDS test is required EOE/ E-Verify / AAE. 800-856-0375. Please quote Job

Code 09-247900

OR Registered NurseEmployer located in Denver,

CO (Full time,Temporary)Schedule: 8/hr days. OR RN.Tech Group Inc. 244 W. Main.

Spokane, WA 99201. TollFree: 800-523-3968.

Spokane: 509-688-3000.Fax: 888-771-5669

Registered Nurse -REHABILITATIONEmployer located in CO

(Temporary) Great hospitallocated in the ColoradoSprings/ Pueblo area.

Hospital is looking for RN'sto work 12 hour nights for a13 week contract. Plenty ofoutdoor activities during the

summer time! Please callAureus Nursing at 800-856-5457 for more details. EOE

/ E-Verify / AAE. Pleasequote Job Code 09-249060

PED RNEmployer located in Denver, CO(Full time,Temporary) Schedule:Day/Night Rotational. Travel PEDRN. Tech Group Inc. 244 W. Main.

Spokane, WA 99201. Toll Free:800-523-3968. Spokane: 509-688-

3000. Fax: 888-771-5669

Page 8 November 24, 2009 Denver’s Nursing Star

TTTTTherherherherhere are are are are are thre thre thre thre three nee nee nee nee nururururursing prsing prsing prsing prsing prooooogggggrrrrrams ofams ofams ofams ofams offffffererererered aed aed aed aed at Dent Dent Dent Dent Denvvvvver Scer Scer Scer Scer School ofhool ofhool ofhool ofhool ofNurNurNurNurNursing fsing fsing fsing fsing for nor nor nor nor nurururururses ofses ofses ofses ofses of v v v v varararararying educaying educaying educaying educaying educational letional letional letional letional levvvvvels:els:els:els:els: the the the the the ADN prADN prADN prADN prADN prooooogggggrrrrram,am,am,am,am,ADN to LPN prADN to LPN prADN to LPN prADN to LPN prADN to LPN prooooogggggrrrrram,am,am,am,am, and Upper Di and Upper Di and Upper Di and Upper Di and Upper Division Baccalaurvision Baccalaurvision Baccalaurvision Baccalaurvision Baccalaureaeaeaeaeate prte prte prte prte prooooogggggrrrrram.am.am.am.am.

by Joelle MoranStaff Writer

Students benefit at DenverSchool of Nursing

The Denver School of Nursing (DSN)is a private secondary educationinstitution established in 2003 and isowned by Education Affiliates.

The school’s sole focus is nursing,which is a great benefit for students,said Dr. Deb Swanson Banik, dean ofnursing for DSN.

DSN students are also at a greatadvantage because the school is privatelyowned, Banik said, which makes itcompetitive with salaries and allows fora low student-to-faculty ratio.

“We try to spend a lot of resourcesto help students succeed,” she said.

That extra help could be tutorialservices or extra time in the learninglab. But it also comes with DSN’s state-of-the-art technology. DSN has a skillslab, where students learn routine skillssuch as how to take blood pressureand do IVs. The lab also has pediatricand adult simulation models.

The college is also developing asimulation lab, in which students comein and take care of a model with thelatest technology.

The instructor will be able to setup different case scenarios under whichstudents provide care to high-techmodels and instructors can manipulatethe response to care, making it an

excellent educational tool, Banik said.“If students make mistakes, it’s a

safe environment,” she said of thesimulation lab. “There’s remediation andfeedback from the instructor on whatshould have been done.”

The simulation lab will be locatedin a building across from the school’slocation at the corner of 19th and Marketstreets in LoDo. The lab will be equippedwith cameras to tape lessons so studentscan be shown in debriefing where theydid well and where they could correcttheir decisions, Banik said.

There are three nursing programsoffered at DSN for nurses of varyingeducational levels. They include theADN program, ADN to LPN program,and Upper Division Baccalaureateprogram.

The ADN program prepares studentsto take the NCLEX-RN exam and usuallytakes two years to complete if generaleducation courses are included, and ashorter period of time if a student hassome of these general education classesalready completed.

The LPN to ADN program isdesigned for students who have hadone year of practical nursing educationand gives them advanced placement incompleting the associate RN program,which takes four quarters to complete.

The Upper Division BaccalaureateProgram is designed for students who

already have bachelor’sdegrees in other fieldsor two years of post-secondary generaleducat ion credi ts .Graduates of thisprogram earn a BSN,which takes sevenquarters to complete.Banik says this is oneof DSN’s most sought-after programs.

“With theeconomy, i t hasprovided career peoplewith the opportunityto experience not onlya new career , but theopportunities that areavailable to nurses,”Banik said. “Nursinghas just gotten into somany areas you canpretty much write your own ticket anymore.”

Whether setting up a practice as a nurse practitioner or having nursingexpertise in an area such as oncology, nutrition or forensics, the possibilities arewide open, Banik said. Forensic nursing has branched out in phenomenal ways,Banik said, and is used in crime scene investigation, rape investigations andelder abuse cases. Forensic nurses have also been used to analyze tissue samplesto identify victims of natural disasters such as Hurricane Katrina in New Orleansin 2005 and the 2004 tsunami in Southeast Asia.

“Nursing has just gotten into so many areas that if you don’t like one area,you can always move to something else,” Banik said.

DSN has about 500 students and admits students four times a year. There areabout 40 faculty and Banik said DSN is only hiring masters-prepared nurses.There is one clinical instructor for about every six students, which requires a lotof adjunct faculty, Banik said.

Banik said DSN is planning to start an online RN to BSN program, sostudents can come in with a ADN and finish the BSN program in a short periodof time. For information about DSN’s programs, application information and startdates, visit the school’s web site at www.denverschoolofnursing.org.

In the first conclusive study on thesubject, patients who get coronary bypasssurgery with the use of a heart lungbypass machine have better recoveriesthan patients who had the same procedurewithout the bypass machine.

That’s according to a major studyco-authored by Frederick L. Grover, MD,a cardiothoracic surgeon at the DenverVeterans Affairs Medical Center and chairof the department of surgery at Universityof Colorado Denver School of Medicine.The study was published recently in theNew England Journal of Medicine.

Physicians at 18 Veterans Affairsmedical centers, including the VA inDenver, found there was no differencein the early (30-day) combined outcomesof death and major complications. Butby one year, about 10 percent of the2,203 patients that had the off-pumpprocedure had died, had heart attacksor required repeat bypasses.

That is compared to 7.4 percent ofthose who underwent operations usingheart-lung machines. There was nodifference in survival between the studygroups up to 5 years after surgery.Researchers believed there would be fewercomplications for patients who had bypasssurgery without the heart lung machine.The findings were the opposite for themajority of the patients.

“We thought those patients wouldend up doing better neurologically. Orthey would get out of the hospital faster,but neither occurred,” said co-authorGrover, who is also one of the principalinvestigators nationally.

While most patients having coronarybypass surgery won’t have any specialbenefit from having off-pump surgery, asmall number of patients may benefitbecause of their particular conditions andcircumstances. The study represents across section of surgical expertise that is

probably more typical of national surgerythan some single center reports fromsurgeons who have made this a majorinterest and have dedicated their careerto it.

The study lasted for seven years andcost $12 million. It was sponsored by theCooperative Studies Program (CSP), adivision of the US Department of VeteransAffairs that specializes in comparativeeffectiveness research. This study involvedseveral cardiothoracic surgeons,cardiologists, and nurse date managersat each of the 18 VA Medical Centersthat participated, as well as the statisticalsupport from the Perry Point VACooperative Studies Center in Marylandand the National Study AdministrativeOffice here in Denver.

The University of Colorado DenverSchool of Medicine faculty work toadvance science and improve care as thephysicians, educators and scientists atUniversity of Colorado Hospital, TheChildren’s Hospital, Denver Health, National Jewish Health, and the Denver VeteransAffairs Medical Center. Degrees offered by the UC Denver School of Medicineinclude doctor of medicine, doctor of physical therapy, and masters of physicianassistant studies.

For additional news and information, please visit www.ucdenver.edu.

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Bypass machine leads tobetter patient recoveries

Denver’s Nursing Star November 24, 2009 Page 9

Nation

Breast cancer is a significant publichealth problem. Although all womenare at risk for developing breast cancer,the risk is greater in women as theygrow older, especially after the age of40, and in women with a hereditarypredisposition for developing breastcancer. Breast cancer treatment isusually less aggressive and bettertolerated when the disease is detectedearly.

Currently, the three primary toolsused for the early detection of breastcancer are breast self-examination(BSE), clinical breast examination (CBE)by a heal thcare provider , andmammography (Nat iona lComprehensive Cancer Network[NCCN], 2005).

Systematic monthly BSE has beenrecommended since 1933; however,more than 30 nonrandomized trialshave produced conflicting results aboutthe efficacy, sensitivity, and specificityof the practice (Austoker, 2003; Havey,Miller, Baines, & Corey, 1997).

The effectiveness of BSE is largelydependent on the skill of the womanpracticing BSE, and the consensus isthat BSE should be used in combinationwith other breast cancer screeningmodalities (NCCN, 2005).

Sensitivity for CBE has beenreported to range from 40%–69%, andits specificity ranges from 88%–99%(Humphrey, Helfand, Chan, & Woolf,2002). Trials in which CBE is combinedwi th mammography havedemonstrated a mortality reduction of14%–29% (Humphrey et al.).

Like BSE, the sensitivity andusefulness of CBE is related, in part,to the skill of the healthcare providerperforming the examination. When CBEis performed prior to mammography,it may be useful in identifying anarea of suspicion that might not bereadily visible on mammography orprov ide guidance in se lec t ingadditional imaging techniques (Smith,2003).

The pr imary ev idence fo rsupporting mammography comes fromseven large randomized clinical trialsthat show a statistically significantmortality reduction from breast cancerin women aged 40–69 years who

underwent regular mammographyscreening (Smith et al., 2003).

Overall, the trials suggested a 24%mortality reduction associated withmammography use. The sensitivity forannual mammography ranges from71%–96%, with lower sensitivity seenin younger women who tend to havedense breasts, and specificity rangesfrom 94%–97% (Humphrey et al., 2002).

It Is the Position of ONS That����� Oncology nurses should review

the scientific basis for each breastscreening modality and interpret thedata for women. Educational materialsneed to be culturally competent andappropriate for the literacy andeducational level of each woman.����� Risk assessment is a component

of regular health care and integral tothe cancer screening process. Althoughgeneral guidelines exist for offeringcancer screening tests, they often mustbe modified based on the presence ofs ign i f i can t r i sk fac to r s .Recommendations for breast cancerscreening should be made only aftera woman’s risk is assessed andinterpreted.����� The benefits, risks, and potential

l im i ta t i ons o f BSE , CBE , andmammography need to be discussedwith each woman and tailored to herrisk factor assessment.����� Women at higher-than-average

risk for breast cancer should be referredto a healthcare provider with expertisein breast cancer risk assessment andcancer genetics for guidance about theappropriate age and frequency forscreening.����� Women should have access to

comprehensive breast cancer screening.����� Every woman, after having a

comprehensive breast cancer riskassessment, has the right to make aninformed decision about breast cancerscreening.����� Women should be instructed

on the strengths and limitations ofBSE and be allowed to make a choiceabout their BSE practice. All womenshould be offered the opportunity tolearn proper BSE technique beginningat age 20. Nurses should use instructionregarding BSE to heighten awarenessabout the early detection of breast

SystemaSystemaSystemaSystemaSystematic monthltic monthltic monthltic monthltic monthly BSE has been ry BSE has been ry BSE has been ry BSE has been ry BSE has been recommended since 1933;ecommended since 1933;ecommended since 1933;ecommended since 1933;ecommended since 1933; ho ho ho ho howwwwweeeeevvvvvererererer,,,,, mor mor mor mor more than 30e than 30e than 30e than 30e than 30nonrnonrnonrnonrnonrandomizandomizandomizandomizandomized trials haed trials haed trials haed trials haed trials havvvvve pre pre pre pre produced confoduced confoduced confoduced confoduced conflicting rlicting rlicting rlicting rlicting results aesults aesults aesults aesults about the efbout the efbout the efbout the efbout the efffffficacicacicacicacicacyyyyy,,,,, sensiti sensiti sensiti sensiti sensitivityvityvityvityvity,,,,, and specif and specif and specif and specif and specificityicityicityicityicityofofofofof the pr the pr the pr the pr the practiceacticeacticeacticeactice.....

cancer because i t provides anopportunity to further educate womenabout comprehensive early cancerdetection and prevention strategies.����� CBE should be performed by a

healthcare provider with training andexpertise on an annual basis to allwomen beginning at age 20.����� Women should begin regular,

annual mammography starting at age40. Mammography equipment shouldbe dedicated to breast examinationsand meet federa l , s t a t e , andprofessional standards for quality andsafety. Films should be interpreted byradiologists with expertise in reading

mammograms.����� Oncology nurses need to

support legislation that improves accessto breast cancer screening.����� Oncology nurses should obtain

ongoing continuing education toenhance knowledge and ski l ls ,implement risk assessment strategies,and identify factors that promote breastcancer screening.����� Oncology nurses need to

conduct and support further andongoing research on the preventionand early detection of breast cancer.For more in format ion , v i s i twww.ons.org

ONS releases breast cancerscreening statement

At its meeting on Nov. 18, the state Board of Health voted to postponeits rulemaking hearing scheduled for Dec. 16 concerning the proposed repealof the definition of “significant responsibility for managing the well-beingof a patient” (Regulation 2 A(iii), 5 CCR 1006-2).

The postponement comes following a Nov. 10 decision by Denver DistrictCourt Judge Larry Naves that voided the Board of Health’s Nov. 3 emergencyrulemaking. That rulemaking had eliminated language about the regulatorydefinition of “significant responsibility” as that term relates to primarycaregivers for medical marijuana patients.

As stewards of Colorado’s public health, the board recognizes and considersthe needs and health of all Colorado citizens in its actions and will continueto seek appropriate input in its public proceedings.

The board will explore its legal options before determining how toproceed. Please continue to check the Board of Health’s Web site, http://www.cdphe.state.co.us/op/bh/index.html , for information about reschedulingof the hearing.

Vote postpones rule onmedical marijuana registry

Continued Education

LPN IV Certification –Full Course – IndependentStudy

We are now offering aColorado Board of Nursingapproved, full 60-hour IVCertification for LPNs in anindependent study format! Thiscourse allows completion ofthe didactic content at yourown pace and on you owntime. After completion of theindependent study modulesand quizzes you will attend aone-day laboratory educationand practice seminar in SouthDenver. Once these twosections are successfullycompleted you will validatethe clinical skills in your ownfacility with a qualified RNpreceptor. Registration Fees:$510.00 Contact Hours: 60 Weare also offering a skillsvalidation for LPNs that arecurrently not employed or donot have a means to validatetheir IV skills. For additionalinformation contact CarolynnCassutt Consulting, Inc at(303) 680-2243 or visit ourweb site at:CassuttConsulting.com.

Pediatric Challenges:New Approaches toTreatment andPrevention

These evening CME activitiesare offered several times ayear for primary careproviders with a focus on newtherapies and preventionstrategies for common healthproblems in children andadolescents. Held in variousmetro area locations, theseevents begin with dinnerfollowed by a 60 minutepresentation and a panel Qand A session. (CMEcredit)For more information,please contact (720) 777-6160orwww.thechildrenshospital.org.

Open

Page 10 November 24, 2009 Denver’s Nursing Star

Gero 580-95The University of Louisiana atMonroe is offering a newonline graduate course thisspring for professionals whoprovide long-term and acutecare to persons sufferingconditions of dementia. Thelong-term care concentrationin the university’s gerontologygraduate program is the first inthe nation to be accredited.Gerontologists, nurses, counse-lors and other professionalcaregivers may benefit fromthe valuable informationprovided in the course, a classwhich will raise questionsabout many commonly heldassumptions about Alzheimer’sand related conditions.Thecourse considers theories thatneurodegenerative conditionsshould not claim the elderly,nor should they dominate themor degrade their humanity.Visit the ULM GOLD websiteat www.ulm.edu/onlinedegrees. For moreinformation about the course,contact Chris Johnson at (318)342-1465 or e-mailcjohnson@ulm.edu.

Check out our banner ads atwww.denversnursingstar.com!

For special banner ad rates, simplyemail your request to

advertising@denvernursingstar.com.

Trauma Nursing CoreCourse (TNCC)The Trauma Nursing CoreCurriculum (TNCC), a coursedesigned by the EmergencyNurses Association, teaches acore level knowledge andpsychomotor skills associatedwith the delivery of nursingcare to trauma and criticallyill patients. Upon successfulcompletion of the course,certification is awarded bythe Emergency NursesAssociation and is valid forfour years. Upon completionof this course, participantsshould be able to:Demonstrate knowledge ofpathophysiology as a focusfor the signs and symptoms ofinjury. Demonstrateappropriate psychomotorskills related to the care ofthe trauma patient includingairway management, spinalimmobilization, andresuscitation of the traumavictim. 19 CEU hours areawarded by the EmergencyNurses Association for coursecompletion, regardless ofperformance on the writtenexam and skills stations.Contact: Starlight Wagner at303-861-6336 orwagner.starlight@tchden.org.

Neonatal ResuscitationProgram (NRP) RenewalCourse The NRP Renewal Course, aprogram of the AmericanAcademy of Pediatrics and

December

12/10/09 PediatricTrauma Conference

This two-day conference willprovide education related tothe care of the pediatrictrauma patient. ContinuingEducation Credit: CME andCNE credit This conferencewill provide educationregarding state-of-the-art careof the pediatric traumapatient, including severaltopics on child physicalabuse. This program will beof interest to MDs, RNs,Nurse Practitioners, PhysicianAssistants, RespiratoryTherapists, EMS providersand aero medical personnel.Objectives Upon completionof this conference, partici-pants should be able to:Discuss best practice modelsfor injury prevention and theprinciples of air transport ofthe critically injured child.Recognize the signs andsymptoms and discuss themanagement and treatmentoptions for pediatric braininjury, maxillofacial trauma,urologic injury,thoracoabdominal injuries,shock, hand burns, andcompartment syndrome.Discuss the epidemiologic,clinical and laboratoryaspects of common metabolicdiseases that can mimicabusive head trauma. Reviewdocumentation needs in thesetting of non-accidentaltrauma. Identify strategies forsuccessful organ donation inchild abuse cases. LocationDetails: 2nd Floor Confer-ence Center The Children’sHospital 13123 E. 16thAvenue Aurora, CO 80045

12/01/09 & 12/02/09Pediat-ric Advanced Life Support(PALS) for Providers

The intended audience for thiscourse includes pediatricians,emergency and family practicephysicians, dentists, hospitalpharmacists, registered nurses,respiratory therapists, EMSpersonnel and other ALSproviders who care for pediat-ric patients. The PALS coursewill provide the participantwith: Information needed torecognize infants and childrenat risk for cardiopulmonaryarrest; Information and strate-gies needed to prevent cardiop-ulmonary arrest in infants andchildren; The cognitive andpsychomotor skills needed toresuscitate and stabilize infantsand children in respiratoryfailure, shock, or cardiopulmo-nary arrest. The Children’sHospital is accredited by theAccreditation Council forContinuing Medical Educationto provide continuing medicaleducation for physicians. TheChildren’s Hospital takesresponsibility for the content,quality and scientific integrityof this CME activity. TheChildren’s Hospital designatesthis educational activity for amaximum of 13 AMA PRACategory 1 Credit(s)TM.Physicians should only claimcredit commensurate with theextent of their participation inthe activity. Application forCME credit has been filed withthe American Academy ofFamily Physicians. Determi-nation of credit is pending.Registration fees will be fullyrefunded if cancellation isreceived within three weeks ofthe course. 50 percent will berefunded up to one week priorto the course, provided asubstitute can be found. Norefunds will be given after thattime or for non-attendance.Attendance at all lectures andstations is required. Certifica-tion will not be granted for latearrival, or significant absenceduring any part of the course.Location Details 2nd FloorConference Center TheChildren’s Hospital 13123 E.

16th AvenueAurora, CO 80045. For moreinformation, visitwww.thechildrenshospital.org.

the American HeartAssociation, is designed as aself-study for MDs, RNs,RTs, PAs and EMTs who wishto renew their training everytwo years as an NRP Providerand it is shorter than thestandard-length ProviderCourse. Upon successfulcompletion of the renewalcourse an NRP coursecompletion card will beissued. Contact: Susan Clarkeat 720-777-6875 or emailSusan atclarke.susan@tchden.org

LPN IV Certification -ChallengeThe LPN will submit aregistration form, along with

evidence of completion ofan IV program, or a ColoradoLPN license indicating the IVauthority, and signedagreement with payment.After receipt of above items,Carolynn Cassutt Consultingwill send the Central LineSelf-study and written tests.These can be emailed, mailed,or faxed. Please indicate yourpreference on the registrationform in the commentssection. The LPN will reviewthe course materials andcomplete the written tests.Once completed, the LPN willneed to attend one of our LPNIV Certification LaboratoryPractice days. These areoffered every month generallyon the 15th. For a completelisting of dates please visit ourweb site.www.cassuttconsulting.com

Denver’s Nursing Star November 24, 2009 Page 11

OPINION

Denver’s Nursing StarBoard of Commentary

Andrea Arnold, RN, BC Linda Mundorff(Rener), RN, MPH, MSN, NDc

Deresa Claybrook, MS, RHITLicia McCurdy, LPN

Angela Lash, RN, CM

Vickie Jenkins

Opinions expressed in columns and lettersto the editor are not necessarily theopinions of employees, ownership of thisnewspaper or the publishing company.

Virginia Gillispie, RN, ND

Vicki L. Mayfield, M.Ed., RN, LMFT

Sherry L. Ray, CPCC

Colleen FolschEileen Doherty

Elizabeth Sowdal, RN

Proposed Health Care ReformBills Contain LTC provisions

Legislative NewsCommentary by Eileen Doherty, M.S.

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A little talkedabout provisionin the healthcare debate isthe CLASS act,which is part ofboth the Senateand the Househea l th carereform bills.

C L A S S ,C o m m u n i t yL i v i n gA s s i s t a n c e

Services and Supports Act, is designedto provide more than 10 millionAmericans who need long term careservices and supports with financialsupport for activities of living.

The need for long term will onlycontinue to grow as the baby boomersreach retirement age and experiencemore disabling conditions. Individualswould qualify for CLASS servicessimilar to qualifications for long termcare insurance.

Individuals who are unable toperform two or more activities of dailyliving, e.g. eating, bathing, dressing,transferring, or who have a cognitivedisability that requires supervision orassistance to perform those activitiesas a result of traumatic brain injury,Alzheimer’s disease, multiple sclerosis,or mental retardation, would be eligibleif the condition is expected to lastmore than 90 days.

Although not expected to supplantlong term care insurance and/orMedicaid services for home care and/or nursing home care, this programwould not require underwriting andeveryone would be entitled to receivebenefits.

According to an analysis by theCongressional Budget Office anddiscussed by the Kaiser FamilyFoundation, the plan to finance thisprogram is through monthly premiumspaid by voluntary payroll deductions.

The plan is to have working adultsautomatically enrolled in the program,unless they choose to opt out. Ifemployers choose not to participate,individuals can still participate byenrolling and paying premiumsprivately. Anyone is eligible exceptpatients in hospitals, nursing homes,r ehab i l i t a t i on and Medica idbeneficiaries.

Although premiums will be placedin a “Life Independence Account” foreach eligible beneficiary and managedby the Department of Health andHuman Services as a new insuranceprogram, benefits are envisioned tobe paid out of a trust fund. Monthlypremiums would be determined by aformula to have the trust fund solventfor 75 years. Low income individualsand students would pay minimalamounts.

Individuals are expected to receiveapproximately a $50 per day cashbenefit based on disability. Given thatthe average cost of home care isbetween $20-$30 per hour and thatnursing home care costs approximately$200 per day, the benefit is notintended to cover the entire cost oflong term care, but rather to support

the costs currently covered by privatepay, Medicaid, and long term careinsurance.

Similar to Social Security, theindividual would be eligible forbenefits during their lifetime, includingto offset costs of nursing homeplacement. Individuals would beeligible to carry over benefits frommonth to month, but not from year toyear, out of their account.

The net effect of this proposalwould be to reduce the federal budgetdeficit by $74 billion during the period2010-2019, primarily with savings inMedicaid. These estimates are basedon a $123 per month premium foremployees and an average daily benefitof $75 for life, with an inflation factor.

Individuals would have to pay intothe program for five years before theywould be able to receive benefits, thuspayouts from the program would notbegin until after 2016.

This is a minimal benefit thatbegins to address the government’sresponsibility in meeting the long termcare needs of an aging population.

Coupled with the long term careinsurance partnership initiative andMedicaid reforms, this may provideanother financing alternative for thecommunity needs of an elderlypopulation that needs more assistanceto live independently.

Eileen Doherty, M.S. is the ExecutiveDirector of Senior Answers and Servicesand the Colorado Gerontological Society. Shehas more than 35 years of experience ingerontology in administration, research,training and education, and clinical practice.

Letters to the Editor

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E-mail: news@denvernursingstar.comFax: (720) 283-2198

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Unsigned letters will not be published. However, names may be withheldupon request. Denver’s Nursing Star reserves the right to edit submissionsfor clarity and length.

The American Nurses Association(ANA) joined other health care groupsto support the Physicians for SocialResponsibility’s (PSR) newly-releasedreport, “Coal’s Assault on HumanHealth.” Registered nurses see theeffects of coal-generated pollution onthe health of newborns who haveelevated mercury levels and on patientswith lung or cardiac disease.

The PSR report concludes that coalcontributes to four of the top fivecauses of mortality in the U.S. — heartdisease, cancer, stroke, and chroniclower respiratory diseases – and islinked to increased incidences of majordiseases. The report recommendsestablishing a national energy policythat puts greater emphasis on humanhealth and replaces dependence oncoal with clean, safe alternatives. Formore information, vis itwww.nursingworld.org.

ANA backs reportregarding coal’simpact on health

AT 10:26 A.M. SANDY HARDWICKBROUGHT HER 57-YEAR-OLD CARDIAC

PATIENT BACK TO LIFE.

WHAT DID YOUACCOMPLISH THIS MORNING?

If you’re not satisfied with your answer, maybe you should be looking fora more satisfying career. Nursing is rewarding in more ways than you

think. Starting salaries are high. There are more generous financial aidpackages to help you pay for school. And with over 600,000 openings inthe next decade, you’re virtually guaranteed a job when you graduate.So if you are looking for a second career where you can make a living

and make a difference, check out nursing.

IF CARING WERE ENOUGH, ANYONE COULD BE A NURSE.