Quarterly circulation approximately 22,000 to all RNs, LPNs, and Student Nurses in Maine. Maine Lupins Photo courtesy of Juliana J. L’Heureux

Journal Highlights

SPRING 2014 President’s Message Save the Date!!! September 27, 2014 It’s a Birthday Party and You’re Invited!!! Page 3 Let’s Celebrate! by Irene Eaton Our compliments and profound gratitude to Ann Napier and her team, inclusive of Donna Policastro, Executive Sing, skip, stretch out your Director for this superb program and celebration! See the arms and twirl! We made Website for details and registration. Please register early! it through that challenging Recent reports from the American Nurses Association winter and chilly start to indicate that at least 50% of the new members joining spring. Enjoy the summer are at or under 35 years of age! Awesome! We need you, skies and gentle evenings. your energy, your vision, your in-this-age communication Grab each moment as a gift. savvy! Join us in leadership as we develop and expand While you experience the ANA’s programs in Maine. Membership dues are only spring into summer, also take $13/month. Join now at http://www.anamaine.org/ Attend a few moments to check our our Annual Meeting, Conference and Birthday Party Susan Henderson and Margaret Hourigan new ANA-Maine website and September 27th. Contact us at [email protected] to Irene Eaton Joint Resolution Recognizing the browse through the important become a part of the action. Centennial of Maine Nursing events of September 26 and 27, 2014 planned at two Moreover, our ANA-Maine historic centennial Joint Page 4 locations, thanks to interactive technology support! Ann Resolution passed in the Maine Legislature! Napier, Chairperson of the planning committee, provided Led by Representative Erik Jorgensen of Portland a vision for expanding the meeting state wide. Thanks and Representative Anne Graham of North Yarmouth, to her diligent work with the Program Committee’s who is our nurse legislator, the Joint Resolution passed support, they created a Birthday Party and program with overwhelming bi-partisan support. In the preamble, celebrating a 100 year partnership with ANA, along with the resolution reads, “Be it RESOLVED: That We, an early celebration of the Maine State Board of Nursing’s the Members of the One Hundred and Twenty-sixth Centennial, next year! legislature now assembled in the Second Regular Session, Begin the event at a Friday evening, September 26 on behalf of the people we represent, that this opportunity membership-only reception in Portland for the newly to recognize the 100th Anniversary of nursing practice elected ANA-President; concurrently, members from and education in the State of Maine; and be it further the north-central region are invited to a reception for RESOLVED: That a suitable copy of this resolution, duly Past President Mary Foley. Yes, the birthday celebration, authenticated by the Secretary of State, be transmitted to conference, luncheon with awards and annual meeting ANA-MAINE. Thank you, Juliana L’Heureux, chair of will be at two sites with link by teleconference. We’re the ANA-Maine legislative committee, for bringing this to State Senator “walking our talk” in efforts to shorten travel distance fruition! Kudos for picking up the ball and running with it! Emily Cain for Congress and facilitate member participation. The keynote speaker Researching our ANA-Maine centennial and the launch at the Portland site with the featured speaker at the of the Maine State Board of Nursing, an initiative that was Page 15 UMO site will be concurrent sessions; each site will also feature local speakers. This is only the tip of the iceberg. President’s Message continued on page 14

Presort Standard Index US Postage PAID A Nurse Comments on Nursing...... 2 Nurses’ Work: Keeping Patients Safe Permit #14 Princeton, MN Editor’s Opinion...... 3 Parts I and II ...... 10 current resident or 55371 Save the Date! ...... 3 Burnout and the Registered Nurse: The Joint Resolution Recognizing the Centennial Implications of Leadership Style...... 12 of Maine Nursing...... 4 Nursing Summit...... 13 Nurses in the News...... 6-7 Membership Application...... 14 A Vision Becomes a Reality...... 7 Poetry Corner...... 15 CE Calendar...... 8 State Senator Emily Cain for Congress ...... 15 Page 2 ANA Maine Journal May, June, July 2014 A Nurse Comments on Nursing

by Annelle Beall, MSN, RN, CNN, NE-BC care unit. In addition to necessary plasma exchanges, as often as twice a day, I received red cell transfusions, chemotherapy As a master’s-prepared, with rituximab and high-dose intravenous steroids. As if the certified nurse executive, I am other effects of the TTP were not enough, I had a lacunar stroke Volume 10 • Number 2 familiar with nearly all aspects while hospitalized. (Cognitive deficits and complications are Published by the of acute care. Nevertheless, not uncommon with TTP.) Truly remarkable were the many American Nurses Association-Maine I lacked experience from the encounters with nurses along every step of this journey to a constituent member association of the perspective of an acutely ill recovery. American Nurses Association E-mail: [email protected] patient until a recent 23-day An initial assessment of my illness in the emergency Web Site: www.anamaine.org hospitalization in Portland. department was professional, and the nurse not only cared for This experience proved to me me but for my spouse as well. He also was sensitive to the fact P.O.Box 1205, Windham, ME 04062 that competent, compassionate that as a hospital employee, I was concerned that I might receive nursing care is being practiced special treatment when admitted (something I discouraged). Annelle Beall ANA-MAINE BOARD OF DIRECTORS routinely in Maine hospitals. There is little I remember about the next 24 hours, but I Irene J. Eaton, MSN, RN, CS In early January, transient eschemic (TIA) symptoms took remember a nurse talking with me about how my blood pressure President, Kennebunk me to the emergency department. It was discovered that I had medication would need to be changed while hospitalized and [email protected] thrombotic thrombocytopenia purpura (TTP). why. Patricia Boston, MSN, RN, RRT I found it difficult to keep track of time. From my admission Upon my transfer to the academic medical center, the nurse First Vice President, Biddeford to the community hospital to the first several days at the large introduced himself and provided a clear and simple explanation Juliana L’Heureux, BS, RN, MHSA academic medical center, much of the time is accessible to me of what would happen next. This was helpful as my cognition Second Vice President, Topsham as only brief moments, seemingly as in a dream, or that time is was less than adequate. He also let me know that my spouse was Rebecca Quirk, MSN, RN IV, CNL, CPON, CPSTI totally lost. I became unresponsive early in my hospitalization on the way up, which was a huge concern to me at the time. Treasurer, Scarborough at the medical center and required several days in the critical There was a night nurse in critical care that I remember very Annelle Beall, MSN, RN, CNN, NE-BC well, however. She did something that was truly remarkable. Secretary, Scarborough My spouse had gone home that night. It was early the following Jill Bixby, APRN, MS, CHPN morning, and I wanted to speak with my spouse. The nurse Director, Oakland dialed the number and gave me the phone. Having me alert Patricia Boston and asking for a specific cola beverage was one of the most Director meaningful things that could have happened for my spouse. Joyce Cotton, DNP, APRN-BC The relief of my being responsive was monumental. It is very Director, Kennebunk likely that the nurse had no idea how important that was to the two of us during this terrifying time. It is also likely that she April Giard, PMH-NP Director, Orland does this kind of thing every day. We particularly connected with one of the floor nurses when Rosemary Johnson, PhD, APRN-BC Director, South Portland I was transferred out of critical care. She explained the therapies I would be receiving from a nursing perspective, and never Catherine Lorello-Snow, PMHRN-BC assumed that she shouldn’t explain. Furthermore, she made it Director, Portland clear that our participation was crucial to the treatment plan. My opinion mattered. Even if I was not assigned as her patient, she Contents of this newsletter are the opinion of the author alone and do not reflect the official position of ANA- followed my progress when she was on duty. MAINE unless specifically indicated. We always invite When I had the stroke, in a matter of seconds, it seemed, leaders of specialty organizations to contribute. multiple individuals came into the room. I remember seeing ANA-MAINE EDITORIAL COMMITTEE the words “nurse practitioner” on neurology’s nametag. I was Juliana L’Heureux, BS, RN, MHSA (Editor) unable to voice anything but the word “stroke,” but I was trying Rosemary Henry, MS, RN Millicent G. Higgins, EdD, RN to tell my spouse that this was the “stroke team.” Oddly, I did Sue McLeod, BSN, RN, BC not feel scared because the Nurse Practitioner was so competent. Terri Matthew, RN, BSN Other nurses during my hospital stay understood how I Paul Parker, BSN, RN wanted to receive my medications was important. One nurse Jenny Radsma, PhD, RN Nancy Tarr, MSN, ANP, FNP reassured me that he would interrupt me only if it were required We welcome submissions, but we reserve the right to reject by regulation, because he knew I had experienced little sleep the submission of any article. Send to [email protected]. CE previous night. He emphasized that sleep was essential to my calendar listings are without charge. recovery; therefore, all care would be concentrated around any necessary interruption. Attribution: We do not knowingly plagiarize. We encourage our authors to fact check their material but we do not assume During plasma exchanges, the nurses made sure I was responsibility for factual content of ads or articles. comfortable and taught me about the process whenever I was awake enough to receive information. Never did I feel I was For advertising rates and information, please contact Arthur L. Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216, a burden (although there were times when I likely was an Interprofessional Graduate Certificate Program in Gerontology Cedar Falls, Iowa 50613, (800) 626-4081, [email protected]. ANA- unplanned addition to their schedules). Maine and the Arthur L. Davis Publishing Agency, Inc. reserve The Interprofessional Graduate Certificate Program in Gerontology is Advocacy, education, clinical competency, and compassion the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of designed to strengthen the knowledge, skills, and abilities of health — these are all expectations of us as nurses. care and human service professionals who provide care to older adults price of advertisement. Published quarterly every February, May, in a variety of settings. How rewarding it is to see, even if it was from the other side August and November. of the delivery model. This 12-credit certificate program, consisting of five (5) courses, is offered online. Annelle Beall, MSN, RN, CNN, NE-BC, is Nurse Manager Acceptance of advertising does not imply endorsement or GRN 500: Opportunities and Challenges of Aging (3 cr.). Fall semester approval by ANA-Maine of products advertised, the advertisers, of 2B Inpatient Surgical, CCU and Dialysis, at Mercy Hospital. or the claims made. Rejection of an advertisement does not GRN 501: Life Transitions and Health in Aging (3 cr.). Spring semester She also serves as Secretary of ANA-MAINE. She is the imply a product offered for advertising is without merit, or GRN 502: Interventions for Care of Older Adults in Diverse Settings (3 cr.). Summer 2014 Secretary of the Board of ANA-Maine. that the manufacturer lacks integrity, or that this association disapproves of the product or its use. ANA-Maine and the Arthur GRN 503: Health Policy Issues of an Aging Population (2 cr.). Fall semester L. Davis Publishing Agency, Inc. shall not be held liable for any Integrative Seminar in Gerontology (1 cr.). Course in development; first offering consequences resulting from purchase or use of an advertiser’s planned in Spring 2015. product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, For more information, please go to: http://umaineonline.umaine.edu/ and board, or membership of ANA-Maine or those of the national or http://umaine.edu/gerontology/ local associations. www.anamaine.org The University of Maine is an equal opportunity/affirmative action institution. Postal Address corrections: This list of addressees is obtained from the Maine State Board of Nursing (MSBON) each issue. To keep your address current for these mailings, simply notify the MSBON of any needed changes in your postal mailing address. Published by: Arthur L. Davis Permission must be obtained from ANA Maine to replicate or Publishing Agency, Inc. reproduce any content from ANA Maine Journal. May, June, July 2014 ANA Maine Journal Page 3 Editor’s Opinion Creating Tomorrow’s

Nursing History SAVE THE DATE!!! by Juliana L’Heureux IT’S A BIRTHDAY PARTY AND YOU ARE INVITED!!!

A nursing history group meets regularly at the Maine State WHAT: “CELEBRATING 100 YEARS OF NURSES LEADING THE WAY IN Board of Nursing in Augusta for the purpose of putting together MAINE” a retrospective Centennial of professional nursing in Maine. In ANA-Maine Conference, Birthday Party and Annual Meeting documenting and writing about the past, these historians are also creating a baseline for the future. WHEN: SATURDAY, SEPTEMBER 27TH, 8:00 AM-4:30 PM In 1914, the American Nurses Association incorporated in LOCATION: Attend at either of two sites—at University of New Maine, where the leaders launched the legislation in 1915 to England in Portland or at University of Maine in Orono. Watch the create the Maine State Board of Nursing. This was the beginning ANA-ME web site for more details. of “registered nurses” in Maine. Over the past 100 years, many historic nursing heroes have spoken to those of us who are PROGRAM: Watch for more details. documenting their interesting stories. Listening to nurses who are Juliana L’Heureux teaching us about the past reminds us about how nurses today are For 100 years, Maine nurses have been leaders in health care and patient creating our generation’s history. What will nurse historians report care, providing skills, knowledge, leadership, inspiration and innovation when the Bicentennial history of Maine nursing is being assembled? to Maine residents and patients. In honor of our past leaders and to learn from our current leaders and colleagues, ANA-Maine is sponsoring a Notably, the legislative Joint Resolution to celebrate the Centennial of Maine Nursing will be conference for all Maine nurses. So that we may more fully appreciate our included in future annals. (A copy of this resolution is included in this newspaper) Appreciation past, take pride in our present, and be inspired for our future: will be extended to Maine State Rep. Erik Jorgensen of Portland and Rep. Anne Graham of • Presenters will focus on Leadership, New Ideas and Initiatives, and North Yarmouth, a nurse practitioner, who both led the legislative initiative recognizing the first Interdisciplinary Collaboration. 100 years of Maine’s registered nurses. We want nurses from all over the state to be able to attend Moving forward, history will recognize 2014 as the year when Ann Sossong, PhD, RN, presentations by nationally- known nurses, Maine nurses, and nursing received recognition as the first professor of nursing at the University of Maine in Orono. She is students who represent our future, so: also the Maine nursing leader who is coordinating the Centennial committee. • The conference will be held at two sites simultaneously—at the Most important, future historians will applaud Maine’s nurses for continuing to provide expert University of New England-Portland campus, and at the University of quality care to our patients, while the challenges of transitioning from traditional hospitals to high Maine-Orono campus. • Sites will be connected by interactive video conferencing. technology are changing the way health care is managed. • Live speakers will be at both locations. Morning Keynote speaker, On September 27, 2014, the Centennial ANA-MAINE annual meeting being planned at at UNE, will be the incoming ANA President. Afternoon Featured two locations at University of New England in Biddeford Pool and at the University of Maine Speaker, at UMO, will be past-ANA President Mary Foley. in Orono, will launch nursing’s future with a celebratory theme titled “Innovation, Integration, • CNEs will be available at both sites. Influence.” Leadership from Anne Napier will certainly be applauded when future nurse • At the provided luncheon, Annual Awards will be presented to outstanding Maine nurse leaders. historians reflect on the accomplishments of today’s professional leaders. Included in the • AND….we will have a birthday cake to help us celebrate. futuristic planning is the use of interactive technology (ITV) allowing for statewide participation. Certainly, today’s nursing leaders will be celebrated by future generations. We want those who So save the date: Saturday, September 27, and share in the journey as write our bicentennial stories to recognize how nursing’s success was built upon the dedication nurses continue to lead the way in Maine for the next 100 years. and caring of extraordinary and inspirational leaders of the past and the present, who were challenged to earn the public’s trust. To that end, all nurses are cordially invited to celebrate at our Centennial birthday party. To our compassionate, dedicated nurses Happy Nurses Week! Be sure to clip the “save the date” announcement published in this newsletter and make a point of participating and becoming a part of nursing history! The Nursing Centennial Committee members are: Ann Sossong PhD. RN, Susan Henderson, Full-Time Night ER RN MSN RN, Juliana L’Heureux, BS RN MHSA, Myra Broadway, JD MS RN, Elizabeth Clark Visit our website at www.cadean.org for all nursing opportunities! PhD RN, Valerie Hart EdD APRN PMHCMS-BC, Martha Eastman PhD MS BS and Marla Tracy L. Bonney-Corson, MSN, Director of Nursing • Charles A. Dean Memorial Hospital and Nursing Home Davis, MSN RN. P.O. Box 1129, Greenville, ME 04443 • 207-695-5265

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An affiliate of MID COAST HEALTH SERVICES AN EQUAL OPPORTUNITY EMPLOYER Page 4 ANA Maine Journal May, June, July 2014

State of Maine In the Year of Our Lord Twenty Fourteen JOINT RESOLUTION RECOGNIZING THE CENTENNIAL OF MAINE NURSING

Representative Anne Graham and Erik Jorgensen Susan Henderson and Margaret Hourigan with the WHEREAS, Maine nurses provide professional and high-quality health Nursing Centennial Exhibit at the 13th Annual Maine care for people in all parts of the State when and where it is needed, including Nursing Summit held on March 19, 2014, at the in urban, rural, island and wilderness settings; and Augusta Civic Center WHEREAS, Maine nurses provide their services in hospitals, in Picture Credit: Juliana L’Heureux hospice, public health and emergency settings, in homes, ‘in educational, governmental, industrial and private facilities, in long-term care, mental health, surgical care and obstetrical services settings, in physicians’ practices and in community health centers; and House of Representatives WHEREAS, quality health care provided by Maine nurses has long been Read and Adopted supported by the American Nurses Association of Maine, or ANA-Maine, March 4, 2014 which before 2001 was known as the Maine State Nurses Association; and Sent for Concurrence WHEREAS, ANA-Maine has been a constituent of the American Nurses Ordered Sent Forthwith Association since 1914, and nursing practice in Maine has been registered by the State Board of Nursing since 1915; and WHEREAS, it is the mission of the State Board of Nursing to protect the Millicent M. MacFarland public health and welfare in the area of nursing practice, and it is the mission Clerk of the House of ANA-Maine to work for the improvement of health standards and the availability of health care services for all Maine people; and In Senate Chamber WHEREAS, it is also the mission of ANA-Maine to foster high Read and Adopted standards for nursing and to promote the professional development of nurses; March 5, 2014 and In Concurrence WHEREAS, ANA-Maine advocates for nurses and promotes the recruitment and retention of nurses in Maine; and WHEREAS, nursing education has grown and expanded to meet the needs of a changing health care system to include certified registered nurse Darek M. Grant anesthetists, certified nurse midwives, nurse practitioners and clinical nurse Secretary of the Senate specialists; now, therefore, be it RESOLVED: That We, the Members of the One Hundred and Twenty- sixth Legislature now assembled in the Second Regular Session, on behalf H.P.1288 of the people we represent, take this opportunity to recognize the 100th ATTEST: Anniversary of nursing practice and education in the State of Maine; and be it further RESOLVED: That a suitable copy of this resolution, duly authenticated Mark W. Eves by the Secretary of State, be transmitted to, ANA-Maine. Speaker ofthe House of Representatives

ATTEST:

Justin L. Alfond President of the Senate May, June, July 2014 ANA Maine Journal Page 5

Sponsored By: Rep. Dennis L. Keschl of Belgrade Sen. James A. Boyle of Cumberland Rep. Erik C. Jorgensen of Portland Rep. L. Gary Knight of Livermore Falls Sen. David C. Bums of Washington Rep. Victoria P. Kornfield of Bangor Sen. Emily Ann Cain of Penobscot Cosponsored By: Rep. Chuck Kruger of Thomaston Sen. John J. Cleveland of Androscoggin President Justin L. Alfond of Cumberland Rep. Walter A. Kumiega III of Deer Isle Sen. Ronald F. Collins of York Rep. Henry John Bear Rep. Karen Kusiak of Fairfield Sen. Margaret M. Craven of Androscoggin of the Houlton Band of Maliseet Indians Rep. Michel A. Lajoie of Lewiston Sen. David E. Dutremble of York Rep. Paulette G. Beaudoin of Biddeford Rep. Thomas R W. Longstaff of Waterville Sen. Patrick S.A. Flood of Kennebec Rep. Roberta B. Beavers of South Berwick Rep. W. Bruce MacDonald of Boothbay Sen. Stanley J. Gerzofsky of Cumberland Rep. Seth A. Berry of Bowdoinham Rep. Joyce A. Maker of Calais Sen. Geoffrey M. Gratwick of Penobscot Rep. Russell 1. Black of Wilton Rep. Richard S. Malaby of Hancock Sen. James M. Hamper of Oxford Rep. Andrea M. Boland of Sanford Rep. Donald G. Marean of Hollis Sen. Anne M. Haskell of Cumberland Rep. Sheryl J. Briggs of Mexico Rep. Timothy r.Marks of Pittston Sen. Dawn Hill of York Rep. Joseph E. Brooks of Winterport Rep. Andrew T. Mason of Topsham Sen. Troy D. Jackson of Aroostook Rep. James 1. Campbell, Sr. of Newfield Rep. Anne-Marie Mastraccio of Sanford Sen. Christopher K. Johnson of Lincoln Rep. Katherine W. Cassidy of Lubec Rep. Paul D. McGowan of York Sen. Roger J. Katz of Kennebec Rep. Kathleen D. Chase of Wells Rep. Kimberly J. Monaghan-Derrig Sen. Colleen M. Lachowicz of Kennebec Rep. Justin Mark Chenette of Saco of Cape Elizabeth Sen. Brian D. Langley of Hancock Rep. Benjamin M. Chipman of Portland Rep. Matthew W. Moonen of Portland Sen. Garrett Paul Mason of Androscoggin Rep. Tyler Clark of Easton Rep. Stephen W. Moriarty of Cumberland Sen. Edward J. Mazurek of Knox Rep. Janice E. Cooper of Yarmouth Rep. Catherine M. Nadeau of Wins] ow Sen. Rebecca J. Millett of Cumberland Rep. Dale J. Crafts of Lisbon Rep. Mary P. Nelson of FaLmouth Sen. John L. Patrick of Oxford Rep. Matthea Elisabeth Larsen Daughtry of Rep. William F. Noon of Sanford Sen. Gary E. Plummer of Cumberland Brunswick Rep. Ann E. Peoples of Westbrook Sen. Thomas B. Saviello of Franklin Rep.MichaelGilbertDevinofNewcastle Rep. Matthew J. Peterson of Rumford Sen. Roger L. Sherman of Aroostook Rep. James F. Dill of Old Town Rep. Joshua R. Plante of Berwick Sen. Michael D. Thibodeau of Waldo Rep. Mark N. Dion of Portland Rep. Jane P. Pringle of Windham Sen. Douglas A. Thomas of Somerset Rep. Ann E. Dorney of Norridgewock Rep. Helen Rankin of Hiram Sen. John L. Tuttle, Jr. of York Rep. Jeffrey Evangelos of Friendship Rep. Megan M. Rochelo of Biddeford Sen. Linda M. Valentino of York Speaker Mark W. Eves of North Berwick Rep. Margaret Rotundo of Lewiston Sen. Eloise A. Vitelli of Sagadahoc Rep. Richard R. Farnsworth of Portland Rep. Diane Russell of Portland Sen. Rodney L. Whittemore of Somerset Rep. Joyce A. Fitzpatrick of Houlton Rep. Deane Rykerson of Kittery Sen. Richard G. Woodbury of Cumberland Rep. Lori Fowle of Vassalboro Rep. Linda F. Sanborn of Gorham Sen. Edward M. Youngblood of Penobscot Rep. Kenneth Wade Fredette of Newport Rep. Deborah J. Sanderson of Chelsea Rep. Aaron M. Frey of Bangor Rep. Robert J. Saucier of Presque Isle In Testimony Whereof, I have caused the Rep. Drew M. Gattine of Westbrook Rep. John C. Schneck of Bangor seal of the State to be hereunto affixed, Rep. Sara Gideon of Freeport Rep. Stanley Byron Short, Jr. of Pittsfield GIVEN under my hand at Augusta, this fifth Rep. Paul E. Gilbert of Jay Rep. Heather W. Sirocki of Scarborough day of March in the year twenty fourteen. Rep. Adam A. Goode of Bangor Rep. Madonna M. Soctomah Rep. Anne P. Graham of North Yarmouth of the Passamaquoddy Tribe Rep. Gay M. Grant of Gardiner Rep. Peter C. Stuckey of Portland Rep. Scott M. Hamann of South Portland Rep. Charles Kenneth Theriault of Matthew Dunlap Rep. Denise Patricia Harlow of Portland Madawaska Secretary of State Rep. Lance Evans Harvell of Farmington Rep. Ryan D. Tipping-Spitz of Orono Rep. Craig V. Hickman of Winthrop Rep. Sharon Anglin Treat of Hallowell Rep. Barry J.. Hobbins of Saco Rep. Beth P. Turner of Burlington Rep. Brian L. Hubbell of Bar Harbor Rep. Arthur C. Verow of Brewer Rep. Windol C. Weaver of York Rep. Joan W. Welsh of Rockport Rep. R. Wayne Werts of Auburn Rep. Alexander Reginald Willette of Mapleton

Registered Nurse Skilled Unit The members of OMNE extend a heartfelt At CORRECT CARE SOLUTIONS our care providers spend their days doing what they’re best at, serving patients . With less administrative work to do, thank you to all nurses who just celebrated you can focus on why you got into the healthcare industry… . Nurses Week. Must have acute or Med/Surg experience, able to perform caring for patients . Your Strength, Commitment, and Compassion in a team environment in a 40 bed skilled unit . We have opportunities now available in Maine . Make a difference! Comprehensive benefit package includes 90% employer Sites include: Auburn, Charleston, Machiasport, paid premium health insurance . Employer paid: dental South Portland, Warren, Windham, and Wiscasset . insurance, group life insurance, short-term and long-term Opportunities include: disability insurance . Additional benefits include 403(b) Nurse Practitioner, LPN, and RN . retirement savings plan and earned time plan . If you are looking for an exciting opportunity please join a team that Apply to: Jonathan Dahms, HR Generalist, [email protected] supports you professionally and personally. We invite you to take a To learn more about 1133 Washington Ave ,. Portland, ME 04103 look at our career opportunities and the benefits of working at CCS. Visit our website: Please apply online at www.correctcaresolutions.com /careers OMNE membership, please visit or fax to: 615-324-5774. www.omne.org http://www.sjr-me.com We are proud to be an EOE . Page 6 ANA Maine Journal May, June, July 2014 Nurses in the News

Special Thanks to our very Dedicated Nurses for the Excellent Care You Provide to Our Residents Each and Every Day! Nursing Leader Colleen Hilton RN Full Time Licensed Nurse positions in our 63 bed Skilled Nursing facility. This is a great opportunity to earn a competitive wage and Mayor of Westbrook Maine make a difference for our residents as you work with an effective and committed team of healthcare professionals . by Juliana L’Heureux from the Muskie Institute of USM. She is a graduate of the 2008 class of Health Leadership Development, a New Graduates encouraged to apply for our new Preceptor Nursing is ranked by the partnership between the Daniel Hanley Center for Health program which includes tuition reimbursement . public as the most trusted Leadership and the Institute for Civic Leadership. Also hiring per diem RNs, LPNs, CNAs & CNA-Ms profession. For Colleen Hilton In 2011, Hilton was recognized a one of five Maine of Westbrook, this trust Women to Watch by Mainbiz Magazine. More than Please send resumes to: transcended into community 85 Maine business leaders from across the state were 335 Stillwater Ave, Bangor, ME 04401 leadership. In addition nominated for this honor, and she was selected to Or call (207) 947-1111 to being the CEO of the represent the dual role of healthcare provider and the [email protected] • Stillwater-healthcare.com VNA and Hospice of South Mayor of Westbrook. Portland, she is the mayor of As a passionate advocate for home health and hospice, the city of Westbrook, which she has served on the Home Care Alliance of Maine is also her hometown. Board of Directors in several capacities. She’s a member Colleen Hilton Mayor Colleen Noyes of the Organization of Maine Nurse Executives (OMNE) Hilton grew up in Westbrook. She comes from a large and ANA-Maine, and she serves in several healthcare family. The daughter of Malcolm and Mary Jane Noyes, professional advisory roles. She also served on the board Hilton has two brothers and four sisters, several nieces of directors for a local nursing home. Hilton continues to and nephews and great-nieces and nephews. She has been serve as the vice chair of the Cumberland District Public married for 31 years to William Hilton and together they Health Council, advocating for public health along with 30 have three children — William N., Emily and John, all other member organizations. graduates of Maine colleges. This year, they welcomed In her local community, Hilton has served as a member their first grandchild, Colleen Mary. of the Westbrook School Committee for 10 years and as When asked about her public service commitments, its chair. She was a 2007 recipient of the Department of Hilton acknowledges her parents’ great influence, Education Commissioner’s Recognition award for her instilling the values of public service that place the work in Truancy, Dropout and Alternative Education. needs of others before self and make a difference in the She continues to stay involved with advocacy for children community. Her father, Malcolm, was a city councilor and education and currently serves as a member of the when they were called aldermen. He also served on Westbrook Children’s Cabinet, a joint effort with United the Westbrook Housing Authority Commission for 20 Way of Greater Portland and area business and civic years. Her siblings serve on other boards and committees leaders to further enhance programs to ensure children are in Westbrook. Hilton says her family taught her the successful in our community and schools. importance of helping others. “My family has always had In 2009, Hilton was first elected mayor of Westbrook a rich tradition of commitment to the city of Westbrook,” and is currently serving her third term. She is the first she says. female elected to this office in the city’s history. She As the CEO of the busy VNA and Hospice, she also enjoys hearing from nurses who might be considering a serves as the Vice President for Home Health and Hospice role in public policy leadership. Feel free to call her at 591- for Mercy Health System of Maine. 8110 or email her at [email protected]. Hilton completed her Bachelor of Science in Nursing at Check the website http://www.vnahomehealth.org/ for the University of Southern Maine. She holds a Certificate more information. of Graduate Studies in Health Policy and Management

The extraordinary dedication of our nurses is evident from day 1. With so many outstanding professionals working together, it’s no wonder our nursing staff is one of the country’s best. Because at our core, excellence in patient care is what matters most. It’s why for the past eight years, the Maine Medical Center nursing staff has held Magnet status, the nations’ highest mark for quality patient care.

www.mmc.org May, June, July 2014 ANA Maine Journal Page 7 A Vision Becomes a Reality: Nurses in the News Recollections in Honor of Sister M. Consuela White Donna DeBlois Appointed by Susan Henderson, MSN, RN

There’s an opportunity CEO of Home Health to recognize the leadership of Sister M. Consuela by Juliana L’Heureux the interim CEO role at HHVN, she served as executive White and to participate in director of Kno-Wal-Lin Homecare and vice president of the Sister Consuela White Donna DeBlois, RN, Community Health for Pen Bay Healthcare in Rockland. Scholarship Fund. BSW, MBA, MSB, has Her professional leadership experience includes When Sister Consuela been appointed as President positions with Homecare and Hospice Alliance of retired as the founder of and CEO of HomeHealth Maine, OMNE Nursing Leaders of Maine and the the nursing program at Visiting Nurses in Saco ME. Board of the National Association for Homecare and Saint Joseph’s College, she DeBlois served as interim Hospice. Moreover, she served in leadership positions gave me, a nursing faculty President and CEO of the with healthcare industry associations both on a state Susan Henderson member, a box of pictures agency since October 2013. and national level. She earned both her MBA and MSB from a drawer in her office. Judith Stone, the chair of the degrees from Husson College in Bangor, her BSW from I put the box away and when she retired, gave it to her HomeHealth Visiting Nurses the University of Maine and her nursing degree from department chair, who had the pictures scanned into said the Board of Trustees Donna DeBlois CMMC School of Nursing. a PowerPoint presentation that was given to me at my search committee worked Contact DeBlois at the website http://www.homehealth. May 2011 retirement party at the college. with an independent firm to find a permanent candidate org/. Sadly, Sister Consuela died that May. for the position. “After an extensive search, the Board Over the summer, I thought a lot about Sister clearly expressed confidence and enthusiasm for Donna’s 5th Annual Patient Safety Academy Consuela and looking at the pictures. There were pictures leadership abilities, her engagement with staff, and the Friday, September 5, 2014 of the first capping and pinning. Fran Linehan, a nursing visionary path she has set forth for HomeHealth Visiting 9 am - 4 pm faculty member, who was hired before the first class University of Southern Maine, Nurses” she said. Portland Campus, Abrombson Center started its sophomore year, Barbara Malonson Daggett, DeBlois has more than 30 years of experience in the who graduated in the class of 1982, and Dr. Carol Seavor, All persons interested in or engaged in patient safety are home health field, mostly in Maine. Prior to accepting invited to attend the Patient Safety Academy . who replaced Sister Consuela as department chair, got ANA continuing nursing education credits will be together and realized that they wanted to do something provided for eligible participants . to remember Sister. We wanted to have something Registration is $50 (with a discounted rate of $25 for students) . published that would tell future nursing students and For more information, please visit: http://usm.maine.edu/muskie/psa faculty about the history of the nursing department and or contact: Judy Tupper, DHEd, CHES, CPPS, at [email protected] Sister Consuela. With editing by Charmaine Daniels and graphic design by Renee LeBrun, they wrote A Vision Becomes a Reality: No Campus Visits Recollections in Liberal Credit Transfers Honor of Sister M. Competitive Tuition Consuela White Classes That Fit Your Schedule (2012/2013. Barbara Malonson Daggett’82, Susan Henderson, Francis Linehan and Carol Seavor). Saint Joseph’s Director of Nursing College has published this story and a If you have an adventurous spirit and a copy will be given yearning to live the simple and good life, to individuals who come join us in paradise! donate $20 or more We are searching for a Director of Nursing who will embrace to the Sister Consuela our Mission to “provide personalized service to support the White scholarship health and well-being of all people through their journeys in life” fund at Saint Joseph’s College. It is hoped that you will AMHC provides competitive pay and a supportive team environment . according to our core values of Integrity, Respect, Compassion, order a copy and find this history meaningful and your Our mission is to provide comprehensive mental health, substance Stewardship and Excellence . abuse treatment services to Aroostook, Washington and Hancock Cordova Community Medical Center is a 23 bed Critical Access generous support will help to grow the scholarship fund County communities . for current and future nursing students at Saint Joseph’s. Hospital that includes a Family Practice Clinic, Emergency ❍ Psychiatric Nurse Practitioners Department, Inpatient, Long Term Care, and Swing Care/Rehab. To participate, please contact Heather Plati in the Office of Institutional Advancement at Saint Joseph’s by Recruitment is underway for Master Level Psychiatric Nurses who are The Medical Center is a warm, friendly and caring work independently licensed in the State of Maine . Primary responsibilities environment with a very capable and knowledgeable staff . We emailing [email protected] or call 207-893-7898. are to provide psychiatric assessments and medications management, have between 8-12 geriatric residents living in our Long Term as well as consultation to multidisciplinary care teams . Care facility; we all love and care for them as members of our family . We also serve a close-knit community of approximately This position requires a Masters Degree that represents study in 2100 people year round that can boom to around 5000 between advanced clinical practice in a selected area of psychiatric nursing, and May and September every year during the fishing season . passing of a national certification examination . This position requires the individual to be independently licensed as an Advanced Practice Cordova Community Medical Center (CCMC) may be the career Nurse by the Maine State at time of hire . AMHC is also NHSC approved opportunity you are looking for . In addition to accruing paid time employer . off, regular employees enjoy access to health insurance and life The Summer Camp, a nonprofit insurance . CCMC is a participant in the State of Alaska’s Public Salary commensurate with experience . Assistance also available for residential summer camp, Employees Retirement System (PERS) and we offer employees provides girls from low-income interview, relocation and licensure expense reimbursement . the option to voluntarily enroll in a 403b Tax Sheltered Annuity . families and foster homes with Please submit a letter of interest, resume to: Employees are eligible for membership with Denali Alaskan the opportunity to experience a Federal Credit Union and receive a discount in the cafeteria and sleep-away camp . Our summer Brittany Haines on annual passes for the Bidarki Recreation Center and Bob sessions for 2014 will be held at a private camp in Washington, Maine, Korn Swimming Pool . located 20 minutes from Augusta . We are an American Camp Association Human Resource Specialist accredited camp celebrating our 29th season this summer . We are seeking AMHC Please contact: to hire a nurse for the following dates: June 21st–June 30th and P O. . Box 1018, Caribou, Maine 04736 907-424-8000 August 4th–August 16th. Travel allowance provided . Email to: [email protected] Tim James, HR Coordinator If you are interested in MAKING A DIFFERENCE this summer, please www.amhc.org [email protected] • 907-424-8221 contact: Tracy St . Onge-May, 8 Church Street, Bridgton, ME 04009 (800) 979-9896 • thesummercamp org. • [email protected] AMHC is a non-profit organization and an Equal Opportunity Employer . www.cdvcmc.com Page 8 ANA Maine Journal May, June, July 2014

19 PESI/Portland. Autism and Other Although we attempt to be as accurate as possible, information concerning events is published as submitted. We do not Neurodevelopmental Disorders: Practical assume responsibility for errors. If you have questions about any event, please call the event planner directly. Strategies to Improve Processing. 8 a.m.- 4 p.m. Speaker: Patricia McGuire, MD FAAP. If you wish to post an event on this calendar, the next submission deadline is June 20, 2014, for the Summer 2014 Early Registration: $189.99, available until April 29. For issue. additional information, call 1-800-843-7763 or visit http:// Send items to [email protected]. Please use the format you see below: date, city, title, sponsor, fee and contact www.pesihealthcare.com. information. There is no charge to post an educational offering. 27 University of New England. Sigma Theta Tau Advertising: To place an ad or for information, contact [email protected]. Kappa Zeta 26th Annual Induction Ceremony. 2 p.m., ANA-MAINE is the ANCC-COA accredited Approver Unit for Maine. Not all courses listed here provide ANCC-COA Finley Recreation Center, Portland Campus. For more credit, but they are printed for your interest and convenience. For more CNE information, please go to www.anamaine.org. information, go to http://kappazeta.nursingsociety.org/ home. To obtain information on becoming an ANCC-COA CNE provider, please contact [email protected]. 28 PESI/Portland. The Orthopaedic Patient: USM/PCE indicates the class is offered through University of Southern Maine/Center for Professional and Continuing Musculoskeletal Concepts for Acute and Chronic Education. For course descriptions, visit http://usm.maine.edu/pdp/pdp-certificate-programs, http://www.usm.maine.edu/ Disorders. 8 a.m.-4 p.m. $189.99 single advanced muskie/continuing-education. (The previous website address no longer works) or call 207-780-5900 or 800-787-0468 for a registration or group rate; $199.99 single after May 8. For catalog. additional information, call 1-800-843-7763 or visit http:// Most classes are held at the new Abromson Community Education Center in Portland, conveniently located just off I-295. www.pesihealthcare.com. Free parking nearby. 30 PESI/Portland. Rehabilitation Strategies for CCSME indicates class is held by the Co-Occurring Collaborative Serving Maine. Cognitive-Communication Disorders. 8 a.m.-3:30 p.m. $189.99 single advanced registration or group rate; $199.99 For PESI HealthCare seminars in Maine, visit http://www.pesihealthcare.com. single after May 10. For additional information, call Visit the ANA-MAINE Calendar of Events at: http://www.anamaine.org/calendar.cfm for more information for additional 1-800-843-7763 or visit http://www.pesihealthcare.com. upcoming events. June 2014 Opening for CNE Program Reviewers 3 PESI/Bangor. Non-Medication Treatments for ADHD. 8 a.m.-4 p.m. $189.99 single advanced registration Are you passionate about nursing education? Do you RN to Bachelor of Science Degree. Blended online or group rate; $199.99 single after May 14. For additional have experience in adult learning and nursing education, and classroom program, University of Southern Maine, information, call 1-800-843-7763 or visit http://www. as well as a baccalaureate or graduate degree in nursing? College of Nursing and Health Professions. Contact Amy pesihealthcare.com. If so, ANA-MAINE has a spot just for you on its Gieseke, Program Coordinator for USM’s Online/Blended Continuing Nursing Education Committee! ANA-MAINE Programs, 207-780-5921 or [email protected]. 4 PESI/Portland. Breastfeeding Success: Supporting is an Accredited Approver of Nursing Continuing Nursing RN-BSN distance education for licensed RNs wishing the Journey. 8 a.m.-3:30 p.m. $189.99 single advanced Education by the American Nurses Credentialing Center’s to complete the BSN degree; exclusively online program of registration or group rate; $199.99 single after May 15. For Commission on Accreditation (ANCC-COA). Make use study. University of Maine at Fort Kent. Contact Professor additional information, call 1-800-843-7763 or visit http:// of this wonderful opportunity to facilitate the ongoing Diane Griffin, coordinator, 207-834-8622 or dgriffin@ www.pesihealthcare.com. education of your peers, and to become involved in your maine.edu. nursing organization. For more information, contact Dawn USM/ONLINE. Certificate Program in 4 PESI/Portland. Non-Medication Treatments for Wiers at 207-938-3826, or [email protected]. Gerontology (15 undergraduate credits). Students may ADHD. 8 a.m.-4 p.m. $189.99 single advanced registration complete the five courses in the program in one year or group rate; $199.99 single after May 15. For additional by taking one course in each 7-week session or they information, call 1-800-843-7763 or visit http://www. may proceed at their own pace. For more information, pesihealthcare.com. visit usm.maine.edu/online/online-certificate-program- Looking for cutting edge training in the gerontology or call 207-780-5900 or 1-800-787-0468. management of STDs and HIV? 8 USM/PCE/Portland. Patient Safety Course (100 contact hours/10.0 CEUs) Class meets online for 10 weeks, Visit www.RatellePTC.org to view the latest May 2014 June 8-August 16 with faculty member Judith Tupper. course offerings and register for a course $800. For more information, visit usm.maine.edu/pdp or call 207-780-5900 or 1-800-787-0468. that is convenient for you. Many courses 16 PESI/Portland. Treatment Resistant Anxiety, offer free CME/CEU credit. Worry & Panic: 60 Effective Strategies. 8 a.m.-4 p.m. 11 PESI/Portland. Preventing Post-Operative Speaker: Jennifer L. Abel, Ph.D. Early Registration: Complications Seminar. 8 a.m.-4 p.m. $189.99 single $189.99, available until April 26. For additional advanced registration or group rate; $199.99 single after information, call 1-800-843-7763 or visit http://www. May 22. For additional information, call 1-800-843-7763 pesihealthcare.com. or visit http://www.pesihealthcare.com

19 USM/PCE/Portland. Using Motivational 11 PESI/Portland. Cognitive Behavioral Therapy and Interviewing with Chronic Illness (12 contact hrs/1.2 Mindfulness. 8 a.m.-4 p.m. Speaker: Richard Sears, PsyD, CEUs). Class meets two days, May 19 & 20. Instructor-led MBA, ABPP. Early Registration: $189.99, available until training by Stephen Andrew. $295. For more information, May 22. For additional information, call 1-800-843-7763 visit usm.maine.edu/pdp or call 207-780-5900 or 1-800- Sylvie Ratelle STD/HIV or visit http://www.pesihealthcare.com. Prevention Training Center of New England 787-0468.

Cutting edge training since 1995 May, June, July 2014 ANA Maine Journal Page 9

16 PESI/Portland. Understanding the Needs of The Dying. 8 a.m.-4 p.m. $149.99 single advanced registration July 2014 August 2014 or group rate; $199.99 single after May 27. For additional information, call 1-800-843-7763 or visit http://www. 10 PESI/Bangor. Ethical Principles in the Practice of 21 Congrès mondial acadien 2014. Conference - The pesihealthcare.com. Maine Mental Health Professionals. 8:30 a.m.-4:30 p.m. Nursing Profession: History, Analysis of the Present and $199.99 single advanced registration until June 20. For Looking Towards Future Directions. August 21 and 22, 18 USM/PCE/Portland. Health Psychology Institute additional information, call 1-800-843-7763 or visit http:// 2014. www.cma2014.com. (15 contact hours/1.5 CEUs) Class is offered online or www.pesihealthcare.com. on-site, June 18-20 led by Psychology faculty member William Gayton. The cost depends on your registration 11 PESI/Portland. Ethical Principles in the Practice selection- $175- $475. For more information, visit usm. of Maine Mental Health Professionals. 8:30 a.m.-4:30 maine.edu/pdp or call 207-780-5900 or 1-800-787-0468. p.m. $199.99 single advanced registration until June 21. For additional information, call 1-800-843-7763 or visit 25 PESI/Portland. Using the DSM-5® for http://www.pesihealthcare.com. Revolutionizing Diagnosis & Treatment. 8:30 a.m.-4 p.m. Speaker: Martha Teater, MA, LMFT, LCAS, LPC. 16 USM/PCE/Portland. Childhood Psychopathology Nursing Faculty Position Early registration: $99.99, available until June 5. For Institute (15 contact hours/1.5 CEUs) Class is offered additional information, call 1-800-843-7763 or visit http:// online or on-site, July 16-18 led by Psychology faculty Full-time tenure track position available in the Department of Nursing www.pesihealthcare.com. member William Gayton. The cost depends on your for Fall 2014 . The successful candidate will be able to teach across registration selection- $175- $475. For more information, the undergraduate curriculum, and demonstrate recent teaching 27 PESI/Portland. Infectious Diseases: Reduce, and clinical experience . Areas of teaching expertise sought include visit usm.maine.edu/pdp or call 207-780-5900 or 1-800- maternal child health, evidence based practice, leadership, and/or Eliminate, Prevent. 8 a.m.-4 p.m. $189.99 single 787-0468. mental health nursing . Qualified candidates must possess an earned advanced registration or group rate; $199.99 single after doctorate or doctoral candidacy, have a research agenda, university June 6. For additional information, call 1-800-843-7763 or level teaching experience and eligibility for RN licensure in the state of 23 PESI/Portland. Survival Spanish for Healthcare Maine . Faculty rank and salary are commensurate with qualifications . visit http://www.pesihealthcare.com. Professionals. 8 a.m.-4 p.m. $189.99 single advanced registration or group rate; $199.99 single after July 3. For The Department of Nursing is located on two campuses in Portland and Biddeford, Maine . The primary location of this position is Portland . 30 USM/ONLINE. CON 390 Evaluation & additional information, call 1-800-843-7763 or visit http:// Assessment of the Older Adult (3 undergraduate credits). www.pesihealthcare.com. The University of New England offers a competitive salary . To apply Class runs June 30-August 15 with faculty member Susan please submit a letter of interest and CV to [email protected]. The number 620 must appear in the subject line of the email. Moore. For more information, visit usm.maine.edu/online/ 29 PESI/Portland. Respiratory Emergencies: Key online-certificate-program-gerontology or call 207-780- For information, contact Interventions in a Crisis Seminar. 8 a.m.-4 p.m. $189.99 Human Resources 5900 or 1-800-787-0468. single advanced registration or group rate; $199.99 single University of New England after July 9. For additional information, call 1-800-843- 716 Stevens Avenue Portland, ME 04103 30 USM/ONLINE. SWO 375 Gender and Aging (3 7763 or visit http://www.pesihealthcare.com. undergraduate credits). Class runs June 30-August 15 with Review of applications will begin immediately and search will remain faculty member Susan Fineran. For more information, open visit usm.maine.edu/online/online-certificate-program- gerontology or call 207-780-5900 or 1-800-787-0468. www.une.edu

Happy Nurses Week

In recognition of the heartfelt passion you display all year long, HomeHealth Visiting Nurses wishes you a Happy Nurses’ Week 2014!

For over a century, we have brought Care at a the best in home health to our Care patients and families in Southern higher level Maine . As the leading home health care agency in the region, we proudly deliver comprehensive care Our online with compassion, commitment and program provides: the highest standards of excellence . • A career-focused education Our services are available • Flexible courses designed for throughout York, Cumberland and working adults with busy schedules southern Oxford Counties . • Tuition rates on average 15–20% less than BEGIN major for-profit online universities RN Opportunities in most areas . • Supportive advisors who understand your needs TODAY Requires at least one year of hands-on nursing experience . • Rolling admissions and monthly start dates For employment opportunities, please visit BACHELOR’S AND MASTER’S IN NURSING www.homehealth.org Visit online.sjcme.edu/MEnurses or call 800-752-4723 for more information. EOE • Proud Member of the MaineHealth Family Page 10 ANA Maine Journal May, June, July 2014 Nurses’ Work: Keeping Patients Safe Parts I and II

by Cheryl M. Roberts, BSN, MS, RN, CPHQ in performance, and improving the education of the way to that of a blame-free culture to encourage reporting healthcare workforce. of errors so the risk for making errors could be addressed. Editor’s note: This is a two-part article. Part I was Since that time, extensive work has been done in the The philosophy of the blame-free culture gave way to first published in the fall 2012. Now, the entire article is field of patient safety. Initially, few facilities were able that of an “accountable culture” and evolved into what is printed, with Part I and Part II appearing side-by-side. to consistently track their performance, but there were now referred to as a “just culture.” A just culture is one in no universal nomenclature and no agreement on what which systems that predispose to error are identified and In the 1990s, general satisfaction with and confidence could or should be measured. Over the course of a few remedied, which is distinct from errors of accountability in healthcare providers and institutions was relatively low years, organizations such as The Joint Commission (TJC) involving human error (e.g., “slips”) or risky behavior among the public. Stories abounded of substandard care, and large third-party payers such as the federal Center (taking shortcuts), or even reckless behavior (forgoing including medication overdoses, amputation of the wrong for Medicare and Medicaid Services (CMS) worked safety precautions), which is contrasted with a “no-blame” limb, missed cancer diagnoses, dead babies, botched with other groups such as the Leapfrog Group and the approach (Agency for Healthcare Research and Quality, transplants, and other serious adverse occurrences. National Quality Forum to standardize measurement n.d.). Wachter (2012) states that just culture contributes to Medical malpractice premiums skyrocketed. In 1996, concepts, quality and safety improvements, and reporting an “atmosphere of trust in which people are encouraged, the Committee on Quality of Healthcare in America was requirements. Public reporting of quality and satisfaction even rewarded, for providing essential safety-related formed by the National Academy of Sciences’ Institute data became the norm through TJC and CMS. In Maine, information.” But, a just culture is also one in which the of Medicine (IOM), and its members, forward thinkers a group of large, self-insured employers organized with providers are clear about “where the line must be drawn from health care, science, and business, were charged with a few interested healthcare partners to create the Maine between acceptable and unacceptable behavior.” identifying strategies to achieve substantial improvement Health Management Coalition (MHMC). The MHMC Healthcare administrators and providers of care now in the quality of health care delivered to Americans. utilized the already-reported CMS measures and the recognize that the most common contributor to error is In 1999, the committee Leapfrog Group’s survey information, created some the process or system that allowed the error to occur. released its initial report, measures of their own regarding medication safety and Generally speaking, the individuals involved are not published a year later as invited healthcare providers to join them in demonstrating unintelligent or bad or negligent, nor are they the actual the part of the Institute the provision of safe, quality care. The MHMC has cause of the error. Clarification of this premise in recent of Medicine’s Quality continued to be a leader in the state and nationally years encourages accountability such that individuals who Chasm series, entitled To regarding public reporting of comparable data. Some practice consistently risky behavior or consistently violate Err Is Human: Building organizations (like the state of Maine and University of policy or protocols, should indeed be held accountable for a Safer Health System. Maine system) use this information to rank hospitals and the behavior that puts others — patients and colleagues The report focused on the providers and offer incentives to those insured to seek care — in harm’s way. The method by which processes and fact that human beings are at those facilities or providers who are ranked the highest. systems are dissected to identify the flaws in a system and inherently error-prone, that Nationally, financial incentives have been successfully any other factors that influenced an error is known as a errors could be prevented used by CMS to focus attention on areas of concern such Root Cause Analysis. This analysis is carried out, usually by designing systems that as hospital readmissions, never events, care of patients over the course of several meetings, by having all parties To Err is Human make it easy to do the right with heart conditions, community-acquired pneumonia, associated with an occurrence discuss what happened and things and hard to do the and surgical infection, using evidence-based care to steer ask one simple question: Why? If a process is examined By the Institute of Medicine, National wrong things, and that we necessary changes. Nurses are at the forefront of many of prior to an error occurring, it is called a Failure Mode Academy of Sciences could no longer overlook these initiatives. Effects Analysis. This approach is preferable to waiting the issues of quality and Although many of the efforts are and have been driven until after an error or adverse event has occurred and is safety staring us in the face. The publication was not by attempts to address the high cost of health care, many widely practiced in organizations where “near-misses” are only a groundbreaking summary of mistakes that occur healthcare providers, especially nurses, are inherently regularly reported. A near-miss event is an error that is across the healthcare landscape and that had often been interested and invested in safe patient care. Whether this caught or stopped before it reaches the patient. accepted as “one of those things that happen.” It also means assuring that patients diagnosed with community- addressed needed changes in the systems and processes in acquired pneumonia receive their initial antibiotic within Part II health care and the strategies to facilitate these changes, six hours of diagnosis or making sure the right patient has Following are two scenarios involving patients and which if undertaken could prevent errors. The committee surgery on the correct body part, nurses play an important highly competent caregivers where serious or potentially concluded that between 44,000 and 98,000 Americans role in overseeing the collaborative care that is regularly serious adverse events occurred. These caregivers intended died every year from preventable medical errors and that provided. Nurses’ role as patient advocate guarantees them to provide (and thought they had provided) exceptional many more experienced, or barely escaped, non-fatal a place in the forefront of quality and safety improvement care to their patients. Nonetheless, their actions missed the errors and injuries. initiatives. In addition to these examples of collaborative mark for what is considered to be safe, competent practice, In 2001, a follow-up care, there are multiple areas of patient safety that any and consequently, the individuals involved were personally report was published by nurse can independently address, such as proper patient changed, as were the patients and their families, by the IOM, entitled Crossing identification, medication administration safety, prevention event. the Quality Chasm: A of serious injury from falls, prevention of healthcare- Scenario 1: In the late 1990s, the quality/infection New Health System for associated infections, and understandable patient control department of a small hospital worked the 21st Century. This education. collaboratively with surgeons, nurse anesthetists, the report acknowledged Let us briefly examine what is meant by medical pharmacist and surgical nurses to assure that patients that patient safety, while error and adverse event. There are two main distinctions. having surgery in which a prophylactic antibiotic was extremely important, First, because patients do regularly experience adverse indicated received the appropriate antibiotic in a timely provided only a piece of outcomes, distinguishing between those outcomes that fashion. The recommendation was that the antibiotic be the puzzle. This report occur as a result of medical care and those events that given within one hour prior to incision. Since this practice issued recommendations happen as a result of underlying medical conditions is often occurred two or more hours prior to the incision, for healthcare providers necessary. The first is considered a medical error or improvement was needed in the process. The system in and institutions to adopt Crossing the Quality patient harm. The Institute for Healthcare Improvement place was fairly complex, involving many people, each a new perspective about Chasm: A New Health (2006) defines medical error or harm as “unintended with different expectations and functions. The surgeon the purpose and aims of System for the 21st physical injury resulting from or contributed to by generally ordered the antibiotic “on call” to the OR, the the healthcare system. Century medical care (including the absence of indicated medical OR nurses went to the med-surg unit to get the patient, and Widespread system flaws By the Committee on treatment) that requires additional monitoring, treatment the nurses on the med-surg unit thought it was their job to were acknowledged Quality Healthcare in or hospitalization or that results in death.” The second give the antibiotic before the patient left the unit for the America that ultimately affected distinction, since patients may experience harm in the OR. After examining the process, the decision was made millions of Americans and their treatment, dignity, absence of error, patient safety literature separates into that it would be better if the antibiotic was given after the comfort, satisfaction and finances. The ideas were preventable and non-preventable adverse events. patient arrived in the OR area. This change had not been revolutionary, involving changes in the structure and Evolution in the area of patient safety has occurred completely adopted (some nurses found it hard to give up processes of healthcare delivery, including setting new since the time prior to 1998 when it was not uncommon their usual task), nor had the change been particularly well national priorities for improvement, creating better ways to see staff punished if they reported an error. When communicated (that it was not a choice) and the nurses to disseminate and encourage evidence-based practice, Betsy Lehman, a reporter for the Boston Globe, died at on the floor still considered it to be helpful to give the fostering use of information technology, implementing the Lahey Clinic as a result of a chemotherapy overdose antibiotic before the patient left the floor. payment policies that would reward improvements (Allen, 2004), the nurse and pharmacist lost their jobs and their professional licenses. This punitive philosophy gave Nurses’ Work continued on page 11 May, June, July 2014 ANA Maine Journal Page 11

Nurses’ Work continued from page 10 to feel unwell again. The physician told her to give 3 ml a new communication policy of tolerance for of epinephrine. The nurse drew up the medication but questions from nursing staff and setting forth On one particular day, the OR called for the patient. was not quite sure about it for some reason she could not ways to assure staff that their questions had been The floor nurse had mixed the antibiotic but did not have pinpoint. Twice she asked the physician if the dosage was correctly heard. time to hang it; rather, she handed the bag to the one of 3 ml of epinephrine and she was told “yes”; in fact, the the nurses who had arrived from the OR to get the patient. physician quickly wrote it down as he was being distracted The circumstances of this occurrence were truthfully The OR nurse and floor nurse exchanged a few words by other things. The nurse tried to look up epinephrine disclosed to the family, to the hospital personnel, and then that were subsequently recognized as misunderstood. in the drug book and the page was missing. When asked, the greater community. In short, the family expressed their The patient went to the OR, had the scheduled surgical the nurse who had given the first dose, said only, “Gee, appreciation of the way the situation was handled and procedure, and returned to the floor with epidural that’s a hefty dose,” and continued to talk to Patient B. The communicated their forgiveness to the nurse and physician analgesia. Pain control was an issue for the patient over nurse went into the patient’s room and administered 3 ml involved. Other far-reaching changes that occurred the course of the day and before leaving for the day the of epinephrine, which as you have likely surmised by now, included: CRNA came up to re-evaluate the patient. She opened the was a dosage error — 10 times the usual dose. l Many hospitals across the country removed epidural analgesia box and found the bag with the patient’s Within an hour, Patient A had a cardiac arrest. When the multi-dose vials of epinephrine from their pre-op antibiotic infusing, not the fentanyl mixture she reviewing the patient’s chart, the physician recognized emergency departments and replaced them with had anticipated and thought she had used. Fortunately, the his error. In speaking with Poison Control personnel, Epi-pens, at a cost of $50 per pen compared to antibiotic, although administered intrathecally, caused no he learned there is no antidote for epinephrine. Autopsy pennies for the multi-dose vial. However, had these damage. This medication error was able to be classified as showed a heart with changes likely caused by epinephrine. injectables been available to the nurse in the ED, she not causing patient harm. The patient who died was my neighbor; his family, would have needed 10 epi-pens to administer the A review and investigation ensued that identified my friends who were closely associated with the hospital. dose she gave, a signal that would have forced her that the CRNA thought the prepared I.V. bag contained I was there with the physicians to talk to this family, to continued questioning of such a lethal dose. fentanyl and did not examine the bag or label, even explain what we thought might have happened and assure l The labeling of epinephrine and the similarity of though it did not fit easily into the box. The bag had been them we would know more after an autopsy. I have the appearance of vials with varying dosages was again assumed to contain fentanyl but was plainly labeled as family’s permission to share this fatal event with you so brought to the attention of the manufacturer. the antibiotic. The antibiotic in the OR was premixed in that others might be spared a similar event. Also, let l Mosby recognized the gravity of omitting the pharmacy and labeled with the same size and color me say that the nurses and physician were experienced anaphylaxis treatment from its materials. label used for any I.V. admixture. While she thought she and very competent; they were not prone to or expected identified the contents of the bag she had been handed, by any of their colleagues to make serious mistakes. HAZARDS They were personally and professionally devastated the CRNA had given it only a cursory glance and never Some holes due to considered that a mistake had been made. The nurse on by this occurrence. Although no formal disciplinary active failures the med-surg unit thought she was being helpful when in action occurred, this event was examined within our fact she complicated the new procedure. institution. Consequently, many multiple system issues that The areas identified as problematic were: contributed to this devastating error became revealed: l l Although the nurse was experienced in working Staff members who did not follow protocols for Other holes due to ¡ Administering a medication mixed by someone with epinephrine, she was accustomed to the dosage latent conditions else indicated during cardiac arrest, which is more dilute ¡ Identifying a medication prior to administration and used for a different purpose. Accident l Inconsistent practices regarding preoperative l No protocol existed that allowed the nurse to SUCCESSIVE LAYERS OF DEFENSES antibiotics administer medication for an allergic reaction l Process changes not communicated to all involved without an order. staff members as mandatory l Because the patient was medicated prior to being From these two incidents, you can better comprehend What changes do you think should have been made? seen by the physician, the physician never saw the Swiss Cheese Theory, described by Wachter (2012). Would you be more heavy-handed in the implementation Patient A in his initial condition. This theory developed by James Reason, a patient safety of a new procedure? In the real world of multiple l Having staff attend education sessions and to adhere expert, posits that the contributing factors to most errors departments caring for the same patient, how could this to department policies rather than their own posed a in complex organizations relate to the organization’s problem have been foreseen and prevented? challenge at times. incomplete layers of protection, which allow the errors to l The drug books in the ED had not been updated pass through on their way to causing terrible harm. Thus, The following changes were made in the process to because the intention was to shift to computerized you can see how during simple, everyday tasks we can be prevent recurrence: resources; education in this area had not been distracted, or give up questioning too easily, or side-step l The prophylactic, preoperative antibiotic was never completed by the ICU nurse by the time of the error. ingrained procedures. Instead, we all need to be vigilant again given on the med-surg unit prior to surgery l Orientation of nursing staff to the ED did not every day, all the time, to keep safe the people who trust unless specifically ordered as such. include anaphylaxis and treatment. Neither was a us and come to us for help. l The label used for epidural analgesia was changed checklist included in the Mosby nursing resource so it was different from that used for other manual used by the facility. Cheryl M. Roberts, BSN, MS, RN, CPHQ teaches medications. l The epinephrine came in multi-dose vials, a nursing at University of Maine of Fort Kent. She has 30 l The epidural analgesia box was double checked by decision made prior to this event as a way to keep years of experience in risk management and nursing a second nurse before it was closed and whenever costs down. administration. reporting off to another caregiver. l The nurse felt as though she had “pestered” others enough even though she remained uncomfortable References Scenario 2: The second case occurred in 2010. It was with the order. She did not believe she should Agency for Healthcare Research and Quality. (n.d.). Patient a late evening in early June. A husband and wife had continue to question the physician or the other nurse. safety network: Safety culture. Retrieved from: http://psnet. ahrq.gov/primer.aspx?primerID=5 been out to supper together and had consumed seafood, What do you think should have happened? Were Allen, S. (2004). With work Dana Farber learns from ’94 nothing unusual. The husband began feeling unwell and these individuals personally and solely responsible for mistakes. Boston Globe. Retrieved from: http://www.boston. this patient’s death? Should they have lost their jobs or was brought to the hospital. The nurse who triaged the com/news/local/articles/2004/11/30/with_work_dana_ licenses? What steps would you take to prevent this sort of patient (Patient A) determined he was having an allergic farber_learns_from_94_mistakes/?page=full reaction to the seafood he had eaten, which she termed error from happening to anyone else? What lessons do you Institute for Healthcare Improvement. (2006). IHI launches anaphylaxis. take from this occurrence? national campaign to reduce medical harm in U.S. Thinking a written protocol allowed for and covered hospitals, building on its landmark 100,000 lives campaign. her actions, the nurse administered 0.3 ml of 1:1000 Several changes were made as a result of this event, a Retrieved from http://www.ihi.org/about/news/Documents/ epinephrine subcutaneously. Patient A began to feel better. few of which included: IHIPressRelease_IHILaunchesCampaigntoReduceHarm_ A change of shift occurred, and the nurse who triaged the l The nurses were informed that in absence of a Dec06.pdf patient left to go home after giving report to the remaining protocol for allergic reaction, a physician was Institute of Medicine. (2000). To err is human: Building a safer nurse. The ED started to get busy and because the ICU required to evaluate the patient before medication health system. National Academies Press. Available fulltext online: http://www.nap.edu/catalog.php?record_id=9728 was closed, the ICU nurse was floated to the ED to help. was given. Institute of Medicine. (2001). Crossing the quality chasm: A new The nurse who gave the epinephrine at the time Patient l All nursing staff was educated and required to be health system for the 21st century. National Academies Press. proficient in using the computerized resources. A arrived found herself caring for a patient (Patient B) Available fulltext online: http://www.nap.edu/openbook. l Epi-pens were supplied for the ED and the multi- with psychiatric needs, a patient who was well known php?isbn=0309072808 in the ED and prone to violence. Patient B insisted only dose vials were removed from service. Wachter, B. (2012). On swiss-chees and patient safety. Wachter’s one particular nurse could come into his room. The ICU l Anaphylaxis and allergic reaction were added to the World. Retrieved from: http://community.the-hospitalist. nurse reassessed Patient A (with the allergic reaction) orientation checklist. org/2012/06/12/on-swiss-cheese-and-patient-safety/ and reported to the physician that Patient A was starting l Medical staff and the board of directors approved Page 12 ANA Maine Journal May, June, July 2014 Burnout and the Registered Nurse: The Implications of Leadership Style

by Denise Worcester, RN Many factors inherent within the daily demands of the enthusiasm (Whitehead et al., 2010). registered nurse contribute to workplace fatigue, stress, job Participative leadership, also known as democratic Burnout threatens the health dissatisfaction and subsequently burnout. Nursing leadership leadership, is another relationship-focused style (Whitehead of nurses and contributes to style is a factor affording a significant contribution to et al., 2010). This style is characterized by shared leadership workforce shortages (Edward the incidence of burnout among nurses in the workplace within a team setting and given guidance by a leader & Hercelinsky, 2007; Kravits, (Cummings et al., 2010; Kanste, 2008; Malloy & Penprase, (Whitehead et al., 2010). Important initiatives and decisions McAllister-Black, Grant & 2010). Whitehead, Weiss and Tappen (2010) identified are agreed upon within the team environment (Whitehead et Kirk, 2010). The registered leadership as a key source of job stress leading to burnout al., 2010). This style of leadership encourages motivation and nurse experiences one of through the way managers relate to and communicate with creativity (Whitehead et al., 2010). the highest prevalence rates their staffs. Therefore, nursing leadership has been tasked to of burnout and has been examine its role in bringing health and well-being back to the Leadership Style and Burnout: The Research one of the most studied nursing workforce through healthier work environments and Research has investigated the implication of leadership professions in this subject area improved job satisfaction (Cummings et al., 2010). style towards the significant workplace issue of burnout Denise Worcester (Leiter & Maslach, 2009). among registered nurses. A distinct relationship emerges, Therefore, it is fundamentally Leadership Styles revealing a correlation between leadership behaviors important to incorporate strategies that promote a healthy Definitions of leadership include common key elements: and burnout (Cummings et al., 2010; Kanste et al., 2007; work environment and professional satisfaction, thereby leadership is a process, leadership involves influence, Malloy & Penprase, 2010). Work environments with low diminishing the effects of work-related stressors leading to leadership occurs within a group setting and leadership levels of nurse burnout had managers who emphasized the burnout. Nursing leadership has an inherent responsibility involves pursuit of a shared goal (Cummings et al., 2010; relational aspects of work, such as individual well-being to create and maintain healthy work environments, with Whitehead et al., 2010). Successful leadership expands and job satisfaction (Kanste, 2008). Alternatively, a task- leadership style serving as a significant contributing upon these elements to include concepts such as effective focused leadership style, such as transactional or laissez-faire factor towards this endeavor (Malloy & Penprase, 2010). adaptation, skillful communication, and self-awareness leadership, resulted in heightened job dissatisfaction and This paper explores the impact of (a) burnout on nursing, (Whitehead et al., 2010). There are numerous leadership burnout (Cummings et al., 2010; Kanste et al., 2007; Malloy (b) distinguishes several styles of nursing leadership (c) styles prevalent in the workplace and often a combination of & Penprase, 2010). investigates the correlation between various leadership styles may be observed in practice to achieve organizational A 2008 study surveyed 627 nurses to investigate the styles and burnout within the research and (d) reflects upon goals (Cowden, Cummings & Profetto-McGrath, 2011). association between leadership behavior and burnout potential holistic leadership approaches to address the issue Regardless of the particular style, a shared commonality may (Kanste, 2008). Leadership behavior was measured utilizing among registered nurses in the workplace. be discerned within a task-focused or relationship-focused the Multifactor Leadership Questionnaire and burnout was framework (Cowden et al., 2011). measured with the Maslach Burnout Inventory-Human Workplace Issue: Burnout Services Survey (Kanste, 2008). The study substantiated Nursing’s future is challenged by the potential for burnout Task-Focused Leadership Style the premise that relationship-focused leadership behaviors, that often results from the intrinsic nature of the caring and Task-focused leadership focuses on completion of the such as those of transformational leadership, protected healing (Edward & Hercelinsky, 2007). The concept of necessary tasks within the expectations of the organizational individuals from burnout as defined by emotional exhaustion, burnout was introduced in the 1970s as a way to describe and unit workflow aimed at achieving certain goals (Cowden depersonalization and reduced personal accomplishment adverse reactions to work in human services (Kanste, et al., 2011). Task-focused leadership includes transactional (Kanste, 2008). 2008). Burnout is defined as a syndrome of emotional and laissez-faire styles (Cowden et al., 2011; Cummings Another study published in 2009 analyzed the data exhaustion, depersonalization and reduced personal et al., 2010). Transactional leadership is characterized by obtained from a questionnaire completed by 667 Canadian accomplishment that results from continual exposure to rewarding achievement and reprimanding mistakes (Malloy nurses (Leiter & Maslach, 2009). The goal was to investigate workplace stressors (Kanste, 2008; Leiter & Maslach, 2009). & Penprase, 2010). The reward/reprimand continuum is used the role of burnout in predicting the intention of nurses to Emotional exhaustion can occur from feeling overwhelmed in exchange for follower compliance (Malloy & Penprase, leave their positions (Leiter & Maslach, 2009). Burnout and emotionally overextended (Fearon & Nicol, 2011). 2010). Alternatively, laissez-faire leadership is a lack of was measured by the Maslach Burnout Inventory – General Depersonalization ensues when nurses lose interest in leadership involving passive management by exception Scale which included the three dimensions of burnout: their job and the quality of the care they deliver; it is often and avoidance of involvement (Malloy & Penprase, 2010; exhaustion, depersonalization/cynicism, and inefficacy or referred to as compassion fatigue in the medical community Whitehead et al., 2010). Laissez-faire leaders tend to react to reduced personal accomplishment (Leiter & Maslach, 2009). (Borysenko, 2011). Reduced personal accomplishment arises problems only when they become too serious to ignore, and The results of this study demonstrated that burnout was a from dissatisfaction with achievement and productivity at often avoid situations warranting decisive action (Cummings predictor of turnover intention among nurses surveyed (Leiter work, or simply feeling ineffective in providing the high level et al., 2010). & Maslach, 2009). The study also showed that the primary of quality desired in an optimal caring-healing environment reason for turnover was related to the extent to which the (Fearon & Nicol, 2011). Ultimately, burnout may simply Relationship-Focused Leadership Style nurses were involved with their work (Leiter & Maslach, evolve as a result of the imbalance between what nurses give Relationship-focused leadership focuses on people 2009). Essentially, the psychological withdrawal of cynicism, and receive in the workplace (Fearon & Nicol, 2011). and relationships, instead of tasks, to achieve shared a dimension of burnout, has a direct correlation with social Burnout is not only a debilitating condition that goals (Cummings et al., 2010). Relationship-focused withdrawal and nursing career choices that include leaving severely affects the health of nurses, but also contributes to leadership includes transformational and participative a position or even the profession in its entirety (Leiter & organizational concerns like decreased work performance styles. Transformational leaders motivate others to engage Maslach, 2009). This study reinforces the necessity for and productivity, increased errors, less than optimal patient in problem solving, shared decision making, and their own nursing leadership to create and maintain a healthy work outcomes, absenteeism and turnover (Leiter & Maslach, professional development through coaching, mentoring and environment incorporating optimal leadership style, such as 2009; Milliken, Clements & Tillman, 2007). The incidence simply being present (Bjarnason & LaSala, 2011). Ability to transformational leadership, that builds relationships, engages of burnout among nurses in the U.S. has reportedly been as build trust, inspirational motivation, demonstrated integrity, staff, and minimizes depersonalization or cynicism as it high as 54 percent with associated costs of an approximated intellectual stimulation, and individualized consideration are relates to burnout (Leiter & Maslach, 2009). $250 billion to $300 billion annually (Kravits et al., 2010; attributes of the transformational leaders (Kanste, Kyngas, Milliken et al., 2007). An estimated one in five nurses will & Nikkla, 2007; Malloy & Penprase, 2010). This style A Holistic Leadership Approach to Burnout Among actually leave his or her job due to job dissatisfaction and demonstrates an ability to communicate a vision in a way Registered Nurses burnout (Milliken et al., 2007). that is meaningful, exciting, and inspires commitment and The research recognizes the importance of relationship- focused behaviors, as an aspect of leadership style, to be protective measures against burnout within nursing (Kanste, 2008). As such, leadership programs must emphasize an www.maineahq.org integrated approach to teaching successful and inspirational leaders (Wright, 2012). The most important tool a leader carries in his or her repertoire is the tool of self-awareness Online Associates Degree The Mission of the Maine Association for Healthcare Quality is to improve the quality of healthcare by advancing the theory and (Wright, 2012). In fact, self-aware, contemplative leaders are Health Information Technology practice of quality management in healthcare organizations and to able to recognize the potential for burnout among their staffs support the professional growth, and subsequently take steps to prevent it (Sayre-Adams & Today’s fastest growing health career development, and education of Wright, 2012). healthcare quality management For more information call 1-888-879-8635 professionals . or visit us on the web: www.umfk.edu Find us on Burnout and the Registered Nurse continued on page 13 May, June, July 2014 ANA Maine Journal Page 13

Burnout and the Registered Nurse continued from page 12 Emotional intelligence is likewise integral to the prevention of burnout (Fearon & Nicol, Nursing Summit 2011). Emotional intelligence refers to the ability to process, understand, and manage emotions with particular emphasis on relationships with others (Fearon & Nicol, 2011). As a leader, knowing how to handle a situation involves recognizing one’s own feelings along with understanding the deeper meaning behind those feelings (Fearon & Nicol, 2011). The use of reflective practices and a holistic approach assists in the development of self-awareness and emotional intelligence (Fearon & Nicol, 2011). Self-reflection is both a self-care and a therapeutic clinical practice that integrates the critical thinking abilities of the mind with the compassion of the heart (Dossey & Keegan, 2013). Emotional intelligence represents the relationship between emotion and reason, a meshing of the heart and the mind, to create a caring-healing work environment that reduces the potential for burnout (Akerjordet & Severinsson, 2010). Erie Chapman (2011) reflects on seven practices of high purpose leadership within the book, Radical Loving Care. These practices align with the holistic, relationship-focused behaviors of the successful nurse leader and include the practices of personal commitment, passion, the exploration of personal potential, presence, positive attitudes, persistence, and Student nurses from the University of Maine Augusta (UMA) attending the meditation (Chapman, 2011). These practices are achieved through adoption of a holistic Nursing Summit “Nurses Leading Change Through Innovation” on approach to leadership style involving self-reflection, self-awareness, meditation, and the March 19, 2014 at the Augusta Civic Center. From left: Sophie Starrett, development of emotional intelligence (Chapman, 2011; Dossey & Keegan, 2013; Wright, Allison Maxwell, Maria Goslin, Samantha Healey, Danica Simmons, Trisha 2012). Chapman speaks of success as being grounded in personal commitment to the Cote and Jenna Caswell; back row: Shirley Uges. highest possible purpose in our lives (Chapman, 2011). For leaders, this not only involves Picture Credit: Juliana L’Heureux a commitment to patient care and optimal patient outcomes, but also a commitment to staff satisfaction and well-being (Dossey & Keegan, 2013). Passion is a practice of loving the people with whom we work as well as loving the environment where we are engaged (Chapman, 2011). Presence requires that we work our way out of our personal needs so Fully accredited by the that we may hear and realize the needs of others (Chapman, 2011). Persistence speaks to Accreditation Commission for Education in Nursing the power that motivates us to persevere, even when we may momentarily lose sight of our purpose, and therefore requires reflection to remind us what is important (Chapman, 2011). The holistic practice of meditation is essential for self-healing (Chapman, 2011). Allowing time for contemplation and reflection through meditation practices may enhance healing, and prevent the risk of incurring new wounds or the inclination to unintentionally wound others University of Maine (Chapman, 2011). This speaks to the importance of self-reflective holistic leadership and at Augusta’s emotional intelligence as protective measures against workplace burnout (Dossey & Keegan, 2013; Kanste, 2008). Bachelor of Science Conclusion Burnout is a significant workplace issue affecting the health of nurses and contributes to a number of organizational issues with substantial financial repercussions. Leadership style Nursing Completion Degree has significant implications for this issue. Leadership development emphasizing relationship UMA’s RN-BSN program is designed to accommodate - focused behaviors is essential to the prevention of burnout among our nursing workforce. the schedule of working registered nurses who wish to Furthermore, holistic approaches incorporating self-reflective practices may assist in the earn a baccalaureate degree in nursing by offering development of emotional intelligence within the nursing leadership community. With online and hybrid courses. improved self-awareness, and balance between emotion and reason, nursing leaders will foster strong relationships with their nursing staffs. Moreover, leadership styles will promote healthier work environments, and improve job satisfaction and individual well-being. For more information: (207) 621-3465 Leadership may be instrumental in successfully minimizing the effects of burnout inherent in [email protected] the caring-healing practices of the nursing profession. www.uma.edu/rn-bsn.html Denise Worcester, RN, is a student at University of Maine at Augusta currently enrolled in the RN to BSN program. She is a nurse at Maine General Medical Center in Augusta.

School of Nurse Anesthesia n Milk is nutrient-rich, with nine essential nutrients. It is the #1 food source of three of the four nutrients the 2010 Dietary Guidelines for Americans (DGA) identify as falling short in the diets of both children and adults Master of Science – calcium, potassium and vitamin D . n Motivate parents to be role models. Parents are important in Nurse Anesthesia influences on children’s behavior, including eating right and being physically active . So encourage them to eat fruits and vegetables and drink milk . Their • 27-month program actions speak louder than words . – 8-month didactic phase comprised of science and anesthesia courses n The DGA recommends low-fat or fat-free milk and milk products daily

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President’s Message continued from page 1 launched by nursing leaders 100 years ago, has taken an extraordinary amount of diligence by a committee led by Ann Sossong, professor of nursing at the University of Maine in Orono. Among the projects the committee is engaged in includes meeting with nursing leaders to record their oral histories and having these interviews transcribed. Additionally, the committee accessed the nursing archives at the Maine State Board of Nursing (MSBON), at the University of Southern Maine (USM) and at the Boston University Gottlieb Archival Center and other locations to obtain as many written records about Maine’s nursing history as possible. A call was issued in this journal, and at meetings throughout Maine to ask nurses to submit their stories for the oral and written history collection. Participating in the nursing history project with Professor Sossong are nurses Susan Henderson, Myra Broadway, director of the Maine State Board of Nursing, Beth Clark, Juliana L’Heureux, Martha Eastman, Valerie Hart and Marla Davis. There are 25,000 Maine nurses who will join us for the Centennial celebrations and our September historic annual meeting. All of you are cordially invited to our celebrations!

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Safety & Health Council of Northern New England May, June, July 2014 ANA Maine Journal Page 15 Poetry Corner State Senator Emily Cain for US Congress 2nd District TAKE HEART A Conversation in Poetry The American Nurses Association Edited and introduced by Wesley McNair, political action committee (PAC) has Maine Poet Laureate endorsed Maine State Senator Emily Cain of Penobscot District 30. Senator A short lyric by the late Maine poet David Walker Cain is running for election to replace greets the arrival of a newborn with both praise and Congressman Mike Michaud who is now a candidate for governor. wisdom. Photo Credit: Juliana L’Heureux A Prayer, A Welcome by David Walker

Little wrinkle from my flesh, eyelid

curling down at my fool’s prattle; child

before whom I’m the more child—your future

older than my past… Forgive the father Looking for the perfect

I’ll be, become all career? I can never know;

teach me to hold Look no further than... you for a while, and then to let go. nursingALD.com Take Heart: A Conversation in Poetry is produced in collaboration with the Maine Writers & Publishers Alliance. Poem copyright © 2003 Wesley McNair. Reprinted from Find the perfect nursing the Maine Poets, Down East Books, 2003, by permission of Wesley McNair. Questions about submitting to Take Heart job for you! may be directed to Gibson Fay-LeBlanc, Special Consultant to the Maine Poet Laureate, at mainepoetlaureate@gmail. com or 207-228-8263. Take Heart: Poems from Maine, an anthology collecting the first two years of this column, is now available from Down East Books.

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