The Washington Nurse
The opioid epidemic Fall 2017 Volume 47, No 3 A publication of the Washington State Nurses Association
Spe aking out for DACA
HOW NURSES ARE ADDRESSING
2 017 legislator voting record the opioid epidemic Volume 47, No 3
Fall 2017 MSN Specializations NOW AVAILABLE IN WASHINGTON
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LEARN MORE ABOUT WALDEN UNIVERSITY: WaldenU.edu/WSNA • 855-628-1499
*This offer is only valid for members of Washington State Nurses Association. This offer is not a guarantee that all candidates eligible for the offer will be granted acceptance or admission into Walden. All prospective students will be subject to the same standard admission and registration process when applying to Walden. The tuition benefit offered to students under this offer is a 10% tuition reduction. The tuition benefit is applicable to tuition only and does not apply toward books, materials, and other supplies or fees needed for a course. This reduction will remain in effect for the duration of the student’s continuous enrollment at Walden. All candidates who are current Walden students are eligible for the tuition benefit; however, no tuition reduction will be made retroactively. The tuition benefit cannot be used by a student in combination with any other tuition-reduction benefit. The tuition benefit and grants are not applicable for students enrolled in the Family Nurse Practitioner specialization in the Master of Science in Nursing (MSN) program. Walden may change the tuition benefit offered hereunder at any time, but such change will not affect the tuition benefit for students who are currently enrolled at Walden and using the existing tuition benefit. All tuition reductions, grants, or scholarships are subject to specific eligibility requirements. Contact a Walden University enrollment advisor for details. Because you should be more worried about what’s inside your books than how to pay for them...
The Washington State Nurses Foundation annually awards scholarships to qualified students preparing for a career as a registered nurse in Washington state. The minimum amount of each scholarship is $1,000.
APPLICATION DEADLINE & SCHOLARSHIP AWARD Materials must be postmarked by February 9, 2018, and scholarship award announcements will be made by April 15, 2018.
TO APPLY You can find an application form in downloadable PDF format at www.wsna.org/wsnf.
Undergraduate student applicants must be enrolled in an approved program leading to an associate or baccalaureate nursing degree, and must have completed at least 12 nursing credits (credits from LPN programs do not apply toward the 12 completed credits). Graduate student applicants must be admitted to an approved graduate nursing program to be eligible to apply for a scholarship. Applicants must be either a resident of Washington state or enrolled in an approved RN program in Washington state. Amplifying
When nurses speak with one voice, policy-makers listen. Join us in speaking upour together. Let’s build onvoices our 2017 wins. CNE Advocacy Camp and Legislative Reception available Step up. Speak Out. Lead. Jan. 11, 2018 2 to 5 p.m. Advocacy Camp 5:30 to 7 p.m. Legislative Reception The Heritage Room, Olympia
Interested in learning more about the legislative process? WSNA’s legislative priorities? How you can make a difference? Join us for a fun and engaging three-hour session that will leave you ready to step up, speak out, and be a legislative lead at Nurse Legislative Day. Practice your new skills while networking with lawmakers at WSNA’s annual Legislative Reception.
Refreshments and heavy hors d’oeuvres will be served. Receive complimentary admission to Nurse Legislative Day ($60 value) by attending Advocacy Camp. This event is capped at 150 participants, so register early.
CNE Nurse Legislative Day available Step up. Speak Out. Influence. Jan. 22, 2018 8 to 5 p.m. Washington Center for the Performing Arts, Olympia
Join hundreds of nurses and students from all across Washington state at your annual lobby day in Olympia. The governor is invited as our keynote speaker again this year, and we look forward to honoring a bipartisan group of legislators as 2017 COVER — STOCKSY/DAVID SMART STOCKSY/DAVID — COVER Nursing Champions. Morning sessions are followed by lunch (provided) and afternoon meetings with legislators on the hill. Help influence the state of nursing, health care, and patient safety!
This event is $60 for pre-registered WSNA members or free for Advocacy Camp participants.
register at wsna.org The leading voice and advocate for nurses in Washington state CO. & SIEDENTOP URS STOCKSY/ — PAGE THIS PHOTOS: CONTENTS
HOW NURSES ARE ADDRESSING the opioid epidemic Pages 16 to 26
FALL 2017
Up Front Nursing commission Labor Relations update on opioids ...... 21 In focus ...... 3 Washington State Labor Council Health and Safety Survey results ...... 27 Upcoming events ...... 4 Convention: WSNA resolution on Caring together: Nurses partnering rest breaks and mandatory overtime WSNA officers elected and with the community ...... 30 approved ...... 39 appointed for 2017-2019 ...... 4 UW Bothell students explore Recently settled contracts ...... 40 News briefs ...... 6 workplace violence ...... 31 WSNA video about nurse floating Features Nurse leaders launch initiative to solve gets the message out ...... 41 state nursing education challenges .... 32 Photos: Judy Huntington The art of listening retirement party ...... 10 Launch of National Education to engage and empower ...... 42
COVER — STOCKSY/DAVID SMART STOCKSY/DAVID — COVER Progression in Nursing Collaborative .. 32
Opinion: Speak up! ...... 12 Q&A: Getting to know Sally Watkins .... 13 Legislative Affairs Member News ANA Lobby Day WSNA member Jessica Esparza District news ...... 42 and Membership Assembly ...... 14 speaks out for DACA ...... 33 Call for nominations The opioid epidemic ...... 16 2017 WSNA-PAC endorsed candidates. 34 for 2018 Hall of Fame ...... 44 St. Clare emergency department 2017 legislator voting record ...... 36 In memoriam ...... 47 responds to the opioid crisis ...... 18 Why nurses are contributing New members list ...... 48 Preventing opioid abuse ...... 19 to WSNA-PAC ...... 38 2018 WSNA membership dues ...... 50 PHOTOS: THIS PAGE — STOCKSY/ URS SIEDENTOP & CO. & SIEDENTOP URS STOCKSY/ — PAGE THIS PHOTOS:
wsna.org The Washington Nurse FALL 2017 1 WSNA Board of Directors and Staff
President Chair, Cabinet on Economic and General Welfare Jan Bussert, BSN, RN – Vashon Island Julia Barcott, RN – Yakima Vice President Chair, Professional Nursing and Health Care Council VOLUME 47, ISSUE32 FALL 2017 Renata Bowlden, BSN, RN, C-EFM – University Place Pamela Pasquale, MN, RN, BC, CNE – Wenatchee ‘The Washington Nurse’ (ISSN# 0734-5666) Secretary / Treasurer Chair, Legislative & Health Policy Council newsmagazine is published quarterly by the Vee Sutherlin, MSN, RN, MEd – Nine Mile Falls Lynnette Vehrs, MN, RN – Spokane Washington State Nurses Association. It is distributed as a benefit of membership to Directors-at-Large all WSNA members. A member subscription Susan Glass, MS, BSN, RN – Spokane rate of $10 per year is included in WSNA Christina Bradley, BSN, RN – Tacoma membership dues. The institutional subscription Evelyn Street, RN, CNOR – Olympia rate is $30 per year (Canada/Mexico: US$36 Ann Whitley, BSN, RN, CCRN – Yakima per year; foreign: US$49 per year). Rosa Young, MSN, RN, MPA – Seattle The information in this magazine is for the benefit of WSNA members. WSNA is a multipurpose, multifaceted organization. ‘The Washington Nurse’ provides a forum for members of all specialties and interests to express their Executive Director opinions. Opinions expressed in the magazine Sally Watkins, PhD, RN are the responsibility of the authors and do not necessarily reflect the opinions of the officers Senior Director of Labor Special Projects Manager or membership of WSNA, unless so stated. Copyright 2017, WSNA. No part of this publication Christine Watts, MN, RN Darlene Delgado, RN may be reproduced without permission. Assistant Director of Labor Executive Assistant to the Executive Director Margaret Conley, ARNP Bethany Desimone ADVERTISING Nurse Representatives Director of Finance Deborah Bessmer, BSN, RN Mary Reed Information on advertising rates may be obtained Jayson Dick, BSN, RN from the WSNA website or by contacting Administrative Assistant, Programs and Operations Martin Hsiung at 206-575-7979. Advertising Travis Elmore, BSN, RN, RN-BC Hue Tran Sara Frey, JD, BSN, RN deadlines are: March 1, June 1, Sept. 1 and Dec. 1. Advertising is accepted on a first-come, Barbara Friesen, BSN, RN Senior Director of Strategic Initiatives first-served basis for preferred positions, Carmen Garrison, BSN, RN Anne Tan Piazza depending on space availability. WSNA Mara Kieval, BSN, RN Director of Public Affairs reserves the right to reject advertising. Paid Pat McClure, RN Jennifer Muhm advertisements in ‘The Washington Nurse’ do Sue O’Donnell, MSN, RN, CMN, WHNP-BC Political Action Specialist not necessarily reflect the endorsement of Michele Rose, BSN, RN the WSNA members, staff or organization. Nathasja Skorupa Hanna Welander, BSN, RN Terri Williams, MS, RN Communications Director CONTRIBUTOR GUIDELINES Ed Zercher, BSN, RN Ruth Schubert Assistant Director of Organizing Senior Web and Design Specialist WSNA welcomes the submission of manuscripts Tara Goode, BA, BSN, RN Ben Tilden and artwork. Please contact Ruth Schubert by email at [email protected] with submissions, Membership Coordinator Nurse Representative and Organizer article ideas or further questions. It is not the Jaclyn Perkins, BSN, RN Mary Peterson policy of WSNA to pay for articles or artwork. Nurse Organizers Membership Associates Tara Barnes, RN Jamie Adams ARTICLE SUBMISSION DEADLINES Sydne James, BSN, RN, CHPN Becky Anderson Judy Marken, BSN, RN Kelly King Spring ...... Feb. 15 Will Nesper, RN Patrick McGraw Summer...... May 15 Shastie Steinshouer Fall ...... Aug. 15 General / Corporate Counsel Winter...... Nov. 15 Timothy Sears Receptionist Irene Mueller General Counsel DESIGNED, EDITED & PRINTED IN WASHINGTON STATE Michael Sanderson Assistant Executive Director, Nursing Practice, Education and Research Lane Toensmeier Heather Stephen-Selby, MSN, ARNP-BC Executive Editor ...... Sally Watkins Legal Assistant Editor ...... Ruth Schubert Office Manager / Systems Administrator Maria Pettit Designer ...... Ben Tilden Martin Hsiung Administrative Assistant, E&GW Jeanna Te
Washington State Nurses Association 575 Andover Park W., Suite 101, Seattle, WA 98188 206-575-7979 • 206-575-1908 fax [email protected] • wsna.org PHOTO: MERYL SCHENKER MERYL PHOTO:
2 The Washington Nurse FALL 2017 wsna.org LETTER FROM THE PRESIDENT In Focus
A LOOK AHEAD
Your new WSNA Board of Direc- Convention resolutions tors met in August. We have new We have incorporated the membership feedback that and continuing work underway occurred during the roundtable discussions and the con- that will help to move WSNA vention resolutions that were adopted by the General forward in achieving the impor- Assembly into our organizational priority work plan. As tant goals driven by our strate- a reminder, these are the resolutions that were adopted: gic plan. Most notable are the 1. Supporting ANA’s Principles for Health System priorities of continuing to grow Transformation. This will be a key document our membership, strengthen our as we engage in discussions around health care member engagement, and address the health and safety reform with policy makers and partners. issues of patients and nurses that continue to increase 2. Controlling Rising Costs and Assuring in all settings where nursing practice occurs. Affordability of Prescription Drugs Here are the highlights: 3. Ending Healthcare Billing Practices District nurses associations that Contribute to Medical Debt Many of our districts are looking for ways to engage 4. Reaffirming Opposition to “Right to members in their work, and we are looking for new ways Work” Proposals and Legislation to make this happen. In the northern part of our state, Implementation of new and enhanced Districts 1, 16 and 9 have met together and have a desire Safe Nurse Staffing Legislation to form a region, share resources and take a more pro- There is a need to reconnect with our members who sit active approach to engage their members in legislative on the Safe Staffing Committees at their facilities. We and health policy initiatives. When this pilot project is will work with these nurses across the state to make sure completed, we will begin working with other regions in they understand the implications of the new law and the state where there has been an interest expressed to bring them the information and tools they will need to do the same. actively engage in the process, monitor the progress and Organizational affiliates appropriately report concerns to the committee and to We have bylaw language that allows for specialty nurses the Department of Health as needed. associations to affiliate with WSNA for the purpose of As we move into the legislative session, I urge you to adding their voice to our practice discussions and deci- respond to action alerts that come to you from WSNA via sions. They would have a voting seat on our Professional email. You will want to attend the Legislative Advocacy Nursing and Health Care Council and bring their unique Camp scheduled for Jan. 11, 2018, and Nurse Legisla- perspective and greater diversity of opinion to that table. tive Day Jan. 22, 2018. Your active participation is vital We have a framework and policy to guide us as we begin for telling your story and moving legislators and policy discussions with a few interested organizations. We will makers to action. keep you updated as that work continues.
Occupational and Environmental Health and Safety Committee Jan Bussert, BSN, RN This committee was reactivated and will hold its first WSNA President meeting in mid-October. Karen Bowman and Anne Buck, both experts in this field, have been appointed co-chairs. Workplace violence and nurse and patient safety in all practice settings will be an important focus for this committee. PHOTO: MERYL SCHENKER MERYL PHOTO:
wsna.org The Washington Nurse FALL 2017 3 Upcoming Events Elections and Appointments
OCTOBER
6 WSNA Finance Committee meeting – WSNA office
6 WSNA Executive Board Committee meeting – WSNA office
19 A-CNE meeting – WSNA office
20 A-CNE meeting – Kidney Center
23 District Nurses Associations meeting (CRC) – WSNA office
25-27 National Federation of Nurses Summit meeting – Seattle
27-28 Collective Bargaining Conference: A Look Inside the AFT Bargaining Playbook – Chicago
NOVEMBER
8 Occupational Environmental Health and Safety Committee meeting – WSNA office The 2017-2019 Board of Directors (from left to right): Rosa Young, Renata Bowlden, 9-11 AFT State Federation Presidents Verlee Sutherlin, Evelyn Street, Janice Bussert, Lynnette Vehrs, Sue Glass, Conference – Chicago Pamela Pasquale, Ann Whitley, Julia Barcott and Christina Bradley
11 Veterans Day holiday – WSNA office closed
14-17 AFT Nursing and Health Professionals WSNA officers who have been Organizing Conference – Las Vegas
21 Legislative and Health Policy Council elected or appointed for the meeting – WSNA office 2017-2019 biennium 23-24 Thanksgiving Day holiday – WSNA office closed
28-Dec. 1 ANA Leadership Summit – Washington, D.C. Board of Directors Cabinet on Economic and Janice E. Bussert (president) General Welfare DECEMBER Renata L. Bowlden (vice president) Julia Barcott (chair)
8 WSNA Board of Directors Verlee M. Sutherlin (secretary/treasurer) Clarise Mahler (vice chair) meeting – WSNA office Julia R. Barcott (chair, Cabinet on Economic Martha Goodall (secretary/treasurer) 25-30 Winter holidays – WSNA office closed and General Welfare) Francesca Castillo (at large) Lynnette K. Vehrs (chair, Legislative and Gary Cook (at large) JANUARY 2018 Health Care Council) Edna Cortez (at large) 1 New Year’s Day holiday – WSNA office closed Pamela Pasquale (chair, Professional John Gustafson (at large) Nursing and Health Care Council) 11 WSNA Advocacy Camp - Olympia Douglas Harper (at large) Sue Glass (at large) Francisco Mendez (at large) 18 Martin Luther King holiday – WSNA office closed Christina B. Bradley (at large, staff nurse) Janet Stewart (at large) 20 Nursing Students of Washington Evelyn L. Street (at large) meeting – WSNA office Ann M. Whitley (at large) Dues Structure Task Force 21 WSNA-PAC Board and Legislative and Health Policy Council meetings – Olympia Rosa D. Young (at large, staff nurse) Judy Huntington (appointed) Verlee M. Sutherlin (appointed) 22 WSNA Nurse Legislative Day – Olympia Bylaws and Resolutions Committee Gemma Aranda (appointed) Anita Stull (appointed) FEBRUARY 2018 Susan M. Jacobson (appointed) Sally Herman (appointed) Joanna Boatman (appointed) 23 WSNA Finance Committee meeting – WSNA office Joanna Boatman (appointed) Darlene Delgado (appointed) Darlene Delgado (appointed) 23 WSNA Executive Committee meeting – WSNA office Mike Krashin (appointed) E&GW Nomination and Sue Glass (appointed) Search Committee Anjanette Bryant
FOR MORE INFORMATION AND A Tim Davis COMPLETE AND UP-TO-DATE LISTING OF EVENTS, VISIT WSNA.ORG/CALENDAR. PHOTO: MERYL SCHENKER MERYL PHOTO:
4 The Washington Nurse FALL 2017 wsna.org Elections and Appointments
Legislative and Health Care Council Washington State Nurses Foundation ANA Membership Assembly Lynnette K. Vehrs (chair) (WSNF) Board of Trustees Representatives and Alternate Erin M. Allison (at large) Tim Davis (appointed) Representatives 2017-2019 Susan E. Jacobson (at large) Renata Bowlden (appointed) Janice E. Bussert (representative) Justin S. Gill (at large) Christina Bradley (appointed) Martha M. Goodall (representative) Susan Dunn (appointed) Ann Whitley (appointed) Jennifer A. Graves (representative) Lynn Nelson (appointed) Rosa Young (appointed) Christina B. Bradley (representative) Jeremy King (appointed) Sue Glass (appointed) Judith Huntington (representative) Frankie Manning (appointed) Renata L. Bowlden (representative) Occupational and Environmental Evelyn Street (appointed) Timothy R. Davis (representative) Health and Safety Committee Sarah A. Herman (representative) Annie Bruck (co chair, appointed) WSNA Nomination and Judi M. Lyons (representative) Karen Bowman (co chair, appointed) Search Committee Amy Boultinghouse (representative) Edna Cortez (appointed) Betty J. Blondin Charles C. Cumiskey (representative) Ed Dolle (appointed) Frankie T. Manning Darlene Delgado (representative) Erin Allison (appointed) Peggy J. Slider (chair) Anita A. Stull (representative) Sally Budack (appointed) Judith Turner Rosa D. Young (representative) Butch de Castro (appointed) Debbie Brinker (appointed) Justin S. Gill (alternate) Judy Huntington (appointed) Jordan E. Pai Palimar (alternate) Political Action Committee Suzanna Avery (alternate) (WSNA-PAC) Board of Trustees AFT 2018 Convention Julia R. Barcott (alternate) Ingrid Anderson (appointed) Martha M. Goodall (delegate) Ann M. Whitley (alternate) Sarah Darveau Foster (appointed) Francesca C. Castillo (delegate) Susan E. Jacobson (alternate) Amy Boultinghouse (appointed) Julia R. Barcott (delegate) Sarah A. Darveau-Foster (alternate) Travis Yirak (appointed) Judi M. Lyons (delegate) Suzanne Baek (alternate) John Gustafson (appointed) Susan E. Jacobson (delegate) Jennifer Fallon (alternate) Lois Schipper (appointed) Edna P. Cortez (delegate) Muriel Softli (alternate) Chris Birchem (appointed) Christina B. Bradley (delegate) Judi Lyons (appointed) Amy Boultinghouse (delegate) National Federation of Hilke Faber (appointed) Renata L. Bowlden (delegate) Nurses (NFN) Directors Dawn Morrell (appointed) Anita A. Stull (delegate) Renata L. Bowlden (director, 2018-2021) Clarise L. Mahler (delegate) Judi M. Lyons (director, 2017-2019) Professional Nursing and Allison Beaman (delegate) Health Care Council 2018 National Federation of Nurses Jennifer Fallon (delegate) Pamela Pasquale (chair) (NFN) National Labor Assembly Tiffany Guyette (delegate) Rachel C. Wang Martinez (adminstration) Francesca C. Castillo (delegate) Suzanne Baek (delegate) Louanne E. Hausmann (at large) Christina B. Bradley (delegate) Mara Kieval (delegate) Lori A. Bailey (education) Martha M. Goodall (delegate) Jordan E. Pai Palimar (delegate) Bobbi S. Woodward (practice) Julia R. Barcott (delegate) Sarah A. Darveau-Foster (delegate) Anne M. Hirsch (research) Sarah A. Darveau-Foster (delegate) Dianne “Didi” Gray (delegate) Muriel Softli (ethics and human rights) Edna P. Cortez (delegate) John Gustafson (delegate) Sarah Darveau Foster (appointed) Douglas J. Harper (alternate) Christopher N. Johnston (alternate) Richard Ramsey (appointed) Jordan E. Pai Palimar (alternate) Jordan Pai Palimar (appointed) Chuck Cumiskey (appointed) PHOTO: MERYL SCHENKER MERYL PHOTO:
wsna.org The Washington Nurse FALL 2017 5 PAID ADVERTISEMENTS NEWS BRIEFS
EARN YOUR For the most current nursing news and information, visit DNP NEWS BRIEFS wsna.org/update.
Have a BSN or MSN? Seattle Pacific University’s DNP program can help further your career as a family or adult/gerontology nurse practitioner. • Classes one day per week • Full-time/part-time options • Face-to-face instruction We focus on robust academics and relationship-centered learning to prepare you for advanced practice nursing. Apply today! Visit spu.edu/dnp or call 206-281-2888. ‘Defining Hope’ screenings coming to Washington Nov. 1 WSNA is partnering with the American Nurses Association and WSNA Districts to bring the new film “Defining Hope” to Washington state. Produced by the same team that created the photography book and documentary film “The American Nurse Project,” “Defining Hope” will be released in theaters on Nov. 1, with one-night-only screenings across the country to celebrate National Hospice and Palliative Care Month. “Defining Hope” is a story about people weighing what matters most at the fragile junctures in life, and the nurses who guide them. It follows eight patients with life-threatening illness as they make choices about how they want to live, how much medical technology they can accept, what they hope for and how that LEAD THE WAY hope evolves when life is threatened. It is optimistic and helps us define what “quality of life” really means in Healthcare for ourselves and our loved ones. Contact hours will be available and we are working on panel discussions to follow the film screening in some locations. Look for details about screenings in Spokane, Seattle, Tacoma and Vancouver at wsna.org.
UW School of Nursing Dean Emerita Nancy Woods named Living Legend UW School of Nursing Dean Emerita Nancy Fugate Woods, PhD, RN, FAAN, was inducted as a Living Legend of the American Academy of Nursing at the Academy’s Transforming Health, Driving Policy conference, held Oct. 5-7 in Washington, D.C. Nancy retired from the UW School of Nursing in June 2017 after a career that spanned almost 50 years. She most recently served as the interim associate dean for diversity, equity and inclusion and professor in the Department of Biobehavioral Nursing and Health Informatics. Nancy was named Dean of the School of Nursing in 1998 and presided over ten years of the school’s number one ranking in U.S. News & World Report magazine. She also presided over the launch of the Doctor of Nursing Practice degree, the first program of its kind on the West Coast. She is one of the United States’ most distinguished scholars of women’s health and a pioneer of research wwu.edu/bsn on the menstrual cycle.
Active Minds Changing Lives AA/EO
6 The Washington Nurse FALL 2017 wsna.org NEWS BRIEFS
Washington nurses become Academy Fellows Three Washington nurses were inducted as Fellows in the American Academy of Nursing. They were honored, as part of the 173-member 2017 class of Fellows, at the Academy’s annual policy conference, Oct. 5-7, in Washington, D.C. Washington inductees are: Deborah Anne Burton, PhD, MN, BSN, RN, Vice President and Chief Nursing Officer at Providence St. Joseph Health Deborah Burton works in strategic partnership Updated POLST released with local chief nursing officers and chief medical officers to assure the highest quality of care. Before The Physician Orders for Life-Sustaining Treatment Top of page 2 (Previously titled joining Providence, Dr. Burton founded one of the (POLST) form has been revised, based on months “Other Contact Information”) nation’s first state-based nursing workforce centers, of discussion. The POLST is the medical order form • Title changed to: “Patient and Additional the Oregon Center for Nursing, to focus on serious that allows any individual with a serious illness or Contact Information (if any)” nursing workforce challenges. She is a member of frailty to summarize their wishes regarding life- • Added Patient Name, DOB, Phone to page 2 WSNA. sustaining treatment. You can download the new form at http://wsna.to/POLST_2017 • Removed “Name of Health Care Kathleen Shannon Dorcy, PhD, RN, Director, Professional Preparing Form” Among the updates: Clinical Nursing Research, Education and Section D Practice, at Seattle Cancer Care Alliance, Form header Fred Hutchinson Cancer Research Center • Revised and reworded the “Antibiotics” • Added the letters “(POLST)” following the title Kathleen Dorcy has worked in clinical research section to reflect feedback we have to implement the best and newest treatments to • Revised the sentence: “The POLST form received. The options are now: is always voluntary” to say “Completing patients in the Pacific Northwest. She has presented • “Use antibiotics for prolongation of life.” a POLST form is always voluntary.” at more than 80 international, national and local • “Do not use antibiotics except when conferences on topics including clinical trial • Deleted the gender section needed for symptom management.” enrollment, the assessment of care and the role of • Added the word “(optional)” to the oncology nurse. She is a member of WSNA. the “Last 4 #SSN” section Directions for Health Care Professionals Janet R. Katz, PhD, RN, Professor, Washington Section A • Revised the bullet that previously stated: “The State University College of Nursing POLST must be completed by a health care Janet Katz’s work is focused on increasing the • Reworded and reformatted this section to provider based on the patient’s preferences number of Native American and Hispanic students support consistency throughout the form and medical condition” so that it now says: in the health sciences as well as working to decrease Section B “Treatment choices documented on this form substance abuse and suicide rates among Spokane • Reversed the order of requested interventions should be the result of shared decision-making Tribe members. She has been a WSNA member for such that they are now (top to bottom): by an individual or their surrogate and medical more than two decades, including serving on the Full Treatment, Selective Treatment, and provider based on the person’s preferences and Professional Nursing Health Care Council from June Comfort-focused Treatment. The primary medical condition.” 1999 to June 2001. goal of each treatment is now listed. The Washington State Medical Association has a new Fellow selection criteria include evidence of • The previous “Limited Additional Interventions” website, called Honoring Choices Pacific Northwest significant contributions to nursing and health care, section is now titled “Selective Treatment.” (honoringchoicespnw.org) that includes a multitude and sponsorship by two current Academy fellows. of resources for physicians, nurses, social workers, • In the “Comfort-focused Treatment” Applicants are reviewed by a panel comprised of chaplains and other health care professionals in section, revised the EMS line to elected and appointed Fellows, and selection is Washington state. insert the word “consider.” based, in part, on the extent the nominee’s nursing Find the American Nurses Association’s position career has influenced health policies and the health paper “Nurses’ Roles and Responsibilities in and well-being of all. Providing Care and Support at the End of Life” at wsna.to/ANAEndOfLife
SAVE THESE DATES! 2018 Nurse Legislative Day Jan. 22, 2018 / Hall of Fame March 22, 2018 / 2019 Convention May 1-3, 2019
wsna.org The Washington Nurse FALL 2017 7 NEWS BRIEFS NEWS BRIEFS New legal services big, small or somewhere in between, you’ll have access to legal advice and services and identity theft when you need them. protection benefit for WSNA members Why should you protect your identity? Identity theft affects millions of Americans WSNA is pleased to offer legal and identity each year. Victims of identity theft can theft protection at a reduced rate through face issues such as lost job opportunities, LegalShield, which has been providing legal problems with securing a loan or harassment services for more than 40 years. LegalShield from debt collectors. You can get the experts offers affordable legal and identity theft on your side with an identity theft protection protection. LegalShield gives you the power plan. Services include access to your credit to access legal and identity theft advice and report (or consumer credit disclosure), services when you need them, all for one low consultations, expert restoration and more. monthly fee. For special WSNA pricing, plan information and Why would you need a legal plan? enrollment guidelines, please call Maureen A legal service plan can help with all sorts Kures at 425-765-0661 or Larry Fickel at 360- of planned and unplanned legal issues. As 981-2446 or visit www.WSNApartner.com. a LegalShield member, you can rest assured that whether you’re facing a legal issue that’s
Butch de Castro ANA joins National Academy of Medicine Anne Hirsch appointed named UW School of call to explore and address burnout UW School of Nursing’s Nursing associate The U.S. health care system is rapidly changing in associate dean for dean for diversity, academic affairs equity and inclusion an effort to deliver better care, improve health and lower costs. While many of these changes positively Anne Hirsch, PhD, ARNP, Congratulations to longtime impact the health of the country, they also add a lot FAANP, has joined the WSNA member Butch de of pressure on health care professionals. Excessive University of Washington Castro, PhD, MSN/MPH, RN, workloads and inefficiencies in documentation are School of Nursing as FAAN, who is joining the University of Washington commonplace, leading to high levels of burnout in associate dean for academic affairs. She is also School of Nursing as associate dean for diversity, clinicians, including nurses. In fact, 35 percent of an associate professor in the Psychosocial and equity and inclusion. Butch is a scholar with expertise hospital nurses experience high levels of emotional Community Health Nursing department. in public health nursing and occupational and exhaustion. Anne, who serves on WSNA’s Professional Nursing environmental health. Research shows that burnout leads to increased and Health Care Council, had been associate dean He spent the last four years as a member of the medical errors, decreased patient satisfaction, for graduate nursing education and the N. Jean faculty with the UW Bothell School of Nursing & greater turnover and reduction in work effort, and Bushman Endowed Chair in the College of Nursing Health Studies. Before that, he was faculty at the higher health care costs. at Seattle University, where she established a UW Seattle School of Nursing. He has experience The American Nurses Association, represented Doctor of Nursing Practice program. Before joining in occupational health policy from governmental by President Pamela F. Cipriano, PhD, RN, NEA-BC, Seattle University, she was the associate dean at and labor perspectives having worked with FOSHA’s FAAN, is among 20 professional and educational Washington State University, where she established Office of Occupational Health Nursing and the organizations committed to the National Academy PhD and DNP programs. Other leadership roles have American Nurses Association. of Medicine’s initiative to address burnout. included chairing a design team to develop a master Butch’s research focuses on occupational health A new National Academy of Medicine discussion plan for nursing in Washington state and serving, disparities, with an emphasis on how employment, paper identifies high-priority research principles to by appointment of Governor Jay Inslee, on the working conditions, and work organization contribute further understanding of the factors and implications committee to establish core performance measures to chronic stress and risk for occupational-related of clinician burnout and ways to best support health for health care. injury and illness. Much of his research has focused care workers. Anne has written numerous federal grants on disparities among immigrant and minority Read: “Burnout Among Health Care Professionals: to ensure historically underrepresented ethnic populations. A Call to Explore and Address This Underrecognized minority and rural-dwelling students can become Threat to Safe, High-Quality Care” from the National advanced practice nurses. Clinically, she provides Academy of Medicine at wsna.to/NAMburnout. care to homeless families and teens as a family nurse practitioner. She is a Fellow in the Academy of Nurse Practitioners and in the American Academy of Nursing. PHOTOS: ABOVE — SHUTTERSTOCK. BELOW — BEN TILDEN TILDEN BEN — BELOW SHUTTERSTOCK. — ABOVE PHOTOS: AP VIA PORTER KARRA OF CITY LAKE DEPARTMENT/COURTESY POLICE SALT PHOTO:
8 The Washington Nurse FALL 2017 wsna.org NEWS BRIEFS WSNA speaks out against arrest of Utah nurse Wubbels The nursing community was shocked and outraged over the video released Aug. 31 of a nurse on the Utah University Hospital burn ward being handcuffed and arrested for protecting her patient. Nurse Alex Wubbels refused to draw blood from an unconscious patient because the police officer didn’t have a warrant or the patient’s consent. The incident occurred July 26 at University Hospital in Salt Lake City, Utah, but the video footage from a police body camera was only released Aug. 31 by Wubbels and her attorney. The video of nurse Wubbels being handcuffed and dragged from her responsibilities on the burn unit spread rapidly through the news media and social media and sparked outrage from nurses across the country. On Sept. 1, ANA released a statement calling for the Salt Lake City Police Department to conduct In this July 26, 2017, frame grab from video taken from a police body a full investigation, make amends to the nurse and take action to prevent future camera and provided by attorney Karra Porter, nurse Alex Wubbels is abuses. “It is outrageous and unacceptable that a nurse should be treated in this arrested by a Salt Lake City police officer at University Hospital in Salt Lake City. Authorities say the police officer, whose rough arrest of Wubbels way for following her professional duty to advocate on behalf of the patient as has drawn widespread condemnation, put her in handcuffs even after well as following the policies of her employer and the law,” said ANA President investigators told him not to worry about getting a blood sample. Pam Cipriano, Ph.D, RN, NEA-BC, FAAN. WSNA released a statement that same day, standing up for nurse Wubbels and all nurses who fulfill their obligation to protect the rights of their patients. The officer was placed on administrative leave by the Salt Lake Police WSNA’s statement reached nearly 80,000 people on Facebook, was shared more Department, pending an internal investigation and another probe by the city’s than 2,000 times and generated nearly 50 comments. civilian review board. Then, Salt Lake County’s Unified Police Department opened The incident quickly resulted in apologies from Salt Lake City’s mayor and a criminal investigation at the request of the Salt Lake County district attorney, police chief. The University of Utah Hospital issued new policies stating that police who asked for help from the FBI. officers cannot interact with nurses or other frontline staff and are not allowed This story is still unfolding, but much of the attention and action that followed to enter certain areas of the hospital, such as the emergency department, burn this incident is thanks to the nurses and nursing organizations across the country ward or other patient areas. who spoke up for nurse Wubbels, patient rights and the profession of nursing.
WSNA statement on arrest of Utah nurse Published Sept. 1, 2017
The Washington State Nurses Association joins unconscious patient who had been injured in a Nursing’s Code of Ethics says, “the nurse the American Nurses Association, the Utah collision and was a patient on the burn unit. promotes, advocates for, and protects the Nurses Association and registered nurses “Patients have rights, and nurses have a rights, health, and safety of the patient.” across the country in expressing outrage over legal and moral obligation to protect those Watkins added: “It is completely the treatment of a registered nurse in Utah rights,” said WSNA Executive Director Sally outrageous that a registered nurse, following who was handcuffed and arrested by a police Watkins, Ph.D., RN. “In order to obtain a hospital policy and the law, should be treated officer for following her hospital’s policy and blood draw from a patient, law enforcement in this manner by law enforcement. As the law. needs patient consent or a court order. The nurses, we protect and care for our patients. WSNA also fully supports ANA’s call for the police officer who arrested nurse Wubbels Sometimes that includes defending their Salt Lake City Police Department to conduct a for refusing to take the blood draw from an rights. We fully support nurse Wubbels and full investigation, make amends to the nurse unconscious patient had neither a warrant would fight for any nurse in Washington state and take action to prevent future abuses. nor the patient’s consent. Nurse Wubbels did who was mistreated simply for doing their job The incident occurred July 26 at University exactly the right thing. In addition, pulling of protecting and advocating for their patient.” Hospital in Salt Lake City, Utah, and video a nurse away from her duty in this manner footage of the incident was recently released. endangers all of the patients under her care.” Registered nurse Alex Wubbels was arrested after refusing to draw blood from an PHOTOS: ABOVE — SHUTTERSTOCK. BELOW — BEN TILDEN TILDEN BEN — BELOW SHUTTERSTOCK. — ABOVE PHOTOS: AP VIA PORTER KARRA OF CITY LAKE DEPARTMENT/COURTESY POLICE SALT PHOTO:
wsna.org The Washington Nurse FALL 2017 9 Celebrating a career JUDY HUNTINGTON RETIREMENT PARTY AUG. 4, SEATTLE
Below: Judy Huntington and her family
WSNA Hall of Fame member WSNA Hall of Fame members Bonnie Sandahl-Todd Shirley Gilford and Verna Hill
Susan E. Jacobson, Sally Past president and CEO of the Hermann and Barbara E. Frye Washington State Hospital Association Leo Greenawalt and Judy Huntington
Judy Huntington, Sue Loper Powers, Eunice Cole, and Beverly Smith (seated) PHOTOS: BEN TILDEN BEN PHOTOS:
10 The Washington Nurse FALL 2017 wsna.org Left: Gingy Harshey-Meade (Indiana State Nurses Association), Kelly Trautner (AFT), Susan King (Oregon Nurses Association), Judy Huntington and Vicky Byrd (Montana Nurses Association)
Below: Pamela Newsom, Mike Krashin, Sally Watkins and Sally Baque
Left: Sue Loper-Powers, Katherine Bradley, Jackie Humes-Fear and Lynn Kemper
Below: Mary Dean
Above: Donna Poole, WSNA Hall of Fame member Frank Maziarski and Patty Hayes
Below: Past (and present) WSNA presidents Jan Bussert, Judi Lyons, Donna Poole, Louise Kaplan, Kim Armstrong, Sue Loper-Powers, Eunice Cole, Joanna Boatman, Judy Huntington and Susan E. Jacobson
WSNA Hall of Fame member Mary Lee Bell, Judy Huntington, and Hall of Fame member Muriel Softli
Past WSNA staff members — Brissy Combs and Lillie Cridland — who were inspired to pursue a new career in nursing PHOTOS: BEN TILDEN BEN PHOTOS:
wsna.org The Washington Nurse FALL 2017 11 OPINION Speak up!
OPINION Speak up! The practice you save may be your own
By Pamela Pasquale, MN, RN, BC, CNE Chair, WSNA Professional Nursing & Health Care Council
RCW 18.79.030 (1) It is unlawful for a person to practice A subsequent discussion with the clinic manager was informative, or to offer to practice as a registered nurse in this state as that person was not a licensed nurse and seemed to indicate that unless that person has been licensed under this chapter. an MA working in a clinic had special skills beyond their certification A person who holds a license to practice as a registered and was qualified to perform these types of tasks. nurse in this state may use the titles “registered nurse” and This last decade, WSNA has worked with the Nursing Commis- “nurse” and the abbreviation “R.N.” No other person may assume those titles or use the abbreviation or any other sion and the legislature to try and define the MA scope of practice. words, letters, signs, or figures to indicate that the person However, the lack of consistency and vague language makes it almost using them is a registered nurse. a “whack-a-mole” situation trying to define limits on MAs within the health care system allowing for these kinds of patient experiences. y husband and I are blessed with general It is alarming that the professional nurse role in patient care is being good health, thankfully. But recent inci- diluted with unlicensed personnel with hospital and clinic consolida- dents in our single-network system here tion and corporate mergers. M in Wenatchee have alarmed me. And it’s We all need to be vigilant about maintain- not confined to Wenatchee, but becoming more ing the role of the professional nurse, the most common in health networks across the U.S. trusted profession by the public in the U.S. for Last fall, my husband complained of not feel- Ask the over 15 years in a row. That trust shouldn’t be ing well. While checking his BP with my stetho- person to diluted by those who have not worked to earn scope and cuff, I detected an irregular heartbeat. identify that title. Nor should the education and experi- Where did that come from? Subsequent evalua- ence of millions of professional nurses be co- tion by our local cardiologist revealed A-Fib, and themselves opted by systems and regulatory processes. he was put on the appropriate anti arrhythmic. It and insist As RNs, we all need to help educate friends, didn’t produce the result the M.D. wanted and on speaking family and even ourselves in holding medical he was switched to a different anti arrhythmic. with the systems accountable for receiving the appropri- The second caused my husband side effects, and ate care so our reputation and standing as the a call was placed to the cardio clinic nurse to evaluate the symptoms nurse. most trusted profession will continue to mean and ask what he should do. Late in the day, my husband received a call something. It is imperative that all of us teach our from the clinic where he was read the chart notes from the cardiolo- family members to ask if the person on the phone gist. I called the next day to find out more information from the RN, at the M.D. office or clinic is a professional, licensed nurse. Medical only to find out that it was an MA who called with the medication management of common health issues happens in the community, update from the physician. Being aware of MA scope of practice, I not in hospitals. Questions about managing care need to be answered followed up to discuss the inappropriate communication with the by the nurse specialists working in these outpatient settings. ASK the “incident management” staff (who is not a nurse) to ask why the RN person to identify themselves and insist on speaking with the nurse. ■ was not returning calls to clarify medications, especially with a new cardiac patient. My husband also has a history of skin cancer and had noted two new areas with the common appearance of CA that had come on rapidly. We were scheduled to leave on a vacation in a week and called to see if he could be seen ASAP. The scheduler took the information and said, “I’ll give it to the nurse.” He was seen within an hour and we were relieved it was negative. I stopped the next day to thank the nurse for getting him scheduled so soon and the “nurse” was, again, an MA. Immediately, a call was placed to the “incident management” stating that evaluating symptoms to triage available M.D. appoint- ments was not in the MA scope of practice. They were also reminded that only LPNs and RNs who have completed the required accredited education, passed the national exam, and were held an active license could be called a “nurse.” PHOTO: MERYL SCHENKER MERYL PHOTO: SCHENKER MERYL PHOTO:
12 The Washington Nurse FALL 2017 wsna.org FEATURES Getting to know Sally Watkins
Getting to know your new executive director
In the months since Sally Watkins, PhD, RN, took over as WSNA’s executive director, you have had some great opportunities to get to know her and her priorities for WSNA. Sally presented at the Washington State Nurses Convention in May about the big-picture challenges facing nursing in Washington state and the summer issue of The Washington Nurse, shared with you the six strategic areas WSNA is focusing on: Health access, safe staffing, nursing practice and patient safety, occupational and environmental health, membership growth and engagement and association vitality. We wanted you to get to know Sally better as a person and as a nurse, so we asked her some questions about how she got into the profession and where her nursing career has taken her. Name Sally Watkins
Hometown Born in Roswell, New Mexico; Q: How long have you been a nurse and to make a difference beyond my individual patient primarily grew up in Dallas, Texas; has lived how did you begin your nursing career? assignments for a shift. I had a mentor once who, when asked which graduate program I should focus in Gig Harbor, WA, since 2000. I have been in the nursing profession for over 40 on, told me at that time we had hundreds of strong Education PhD from the Union Institute years. To some extent my nursing career began when clinically based nurses but were lacking in strong and University in Cincinnati, Ohio, in I was in junior high and volunteered at a hospital nurse leaders. She encouraged me to pursue a organizational behavior with a focus in in Dallas, Texas. I was given assignments not only degree in nursing administration. women and leadership; MS from University to deliver mail and flowers, but also to work in At the same time, I began to take on various of Utah School of Nursing; BSN from central supply folding drapes and gowns for the leadership positions with more and more University of Texas System School of operating room. I learned a great deal, including responsibilities. My expertise grew beyond having Nursing, Houston Campus. how hospitals worked from the view of the “mini-city” supervision for obstetrical and women’s services to in the basement! include pediatrics, inpatient psychiatry, perioperative One thing most people don’t know After my sophomore year in college I decided services, imaging and other areas. I enjoyed having about me I have five grandkids with whom to “test” myself to make sure nursing was what I “a seat at the table” where strategic decisions were I love to spend time and who, fortunately, really wanted to do as career. I volunteered for a being made and have continually wanted to have a live close by. summer at a mission hospital in Haiti, outside of Port- voice speaking for patients and their families as well One thing I want to learn I grew up playing au-Prince. As a student nurse, I was permitted to as those providing direct patient care. I was invited classical piano and played better in high provide direct care to patients of all ages, circulate to share those experiences as a guest speaker in school than I do now. I want to “relearn” my during surgery, administer medications, change many programs, then eventually was asked to help favorite music. dressings, etc. I worked with a very diverse team teach several different courses in leadership and and experienced delivering health care in a very health policy. underserved environment. When I returned from Haiti I knew nursing was for me. Q: Why did you decide to take the I completed my BSN at the University of Texas position of executive director for WSNA? System School of Nursing, Houston, and thought I wanted to become a nurse midwife. I looked at Having formerly worked at WSNA for a little over six Q: What advice would you give those different graduate programs and found the University years, I felt I knew what WSNA represented and was entering the nursing profession today? of Utah. The university required you work for at familiar with the work of the association at both a Find the area where you have passion and continue to least a year prior to starting graduate school, so state and national level. I felt that every experience I develop expertise in that area. Look for opportunities I started working as a new graduate in a high-risk have had as a nurse helped to prepare me for this role. for further growth and seek good mentors along obstetrical unit. I enjoyed this high-risk population I have worked in hospitals, health systems, academia, the way. Be willing to try new things. Nursing is a and eventually became a transport team member. We as a Pro Tem for the Nursing Care Quality Assurance profession where you should never be bored – there did both air and ground transport of pregnant women Commission, and I have been involved with other are MANY areas where nurses can practice, use their to the university from across seven states. That was professional organizations, including ANA, as either skills and always feel challenged. It is indeed a career where I really developed solid clinical expertise. a board member or advisor. Also, I wanted to return to the association now in for a lifetime. Q: How did you get involved in the my career to continue to build on the legacy that Judy various nursing leadership roles Huntington left and take WSNA “to the next level.” By you have had, including being that I mean ensure we are advancing our practice as a nurse executive and adjunct needed for the delivery of health care in the future. faculty in various universities? We need to continually assess the environments where care is being provided and make sure we are As a staff nurse I think I was always asking the “why” addressing today’s challenges, opportunities and questions and frequently ended up being the one to potential threats to delivering quality patient care. re-write a policy or procedure, revise job descriptions, develop a clinical ladder program for staff and get other assignments outside of bedside care. I wanted PHOTO: MERYL SCHENKER MERYL PHOTO: SCHENKER MERYL PHOTO:
wsna.org The Washington Nurse FALL 2017 13 ANA Lobby Day and Membership Assembly
ANA Lobby Day and Membership Assembly undreds of nurses from around the nation, including 10 from • Anita Stull, RN the Washington State Nurses Association, gathered in Wash- • Rosa Young, MPA, MSN, RN ington, D.C., June 8-10 for the American Nurses Association Lobby Day and Membership Assembly. Over the three days, ANA Lobby Day WSNA attendees visited the offices of our elected representa- tives to advocate for nursing issues, engaged in discussions Nearly 430 nurses participated in ANA’s Lobby Day, meeting with Habout advocacy and fostering member engagement, and elected lawmakers and their staff to discuss several major nursing issues, with ANA leaders. a major focus on protecting all patients’ access to affordable, quality The ANA Membership Assembly is the governing and official health care. Nurses also had the opportunity to speak with federal voting body of the American Nurses Association (ANA). It identifies lawmakers and their staff about other key ANA-supported measures, and discusses issues of concern to members and provides direction including safe staffing, Title VIII workforce development funding to the ANA Board of Directors. The ANA Membership Assembly is and APRNs having the ability to order home health care services. comprised of ANA members who are representatives from ANA’s WSNA members met with a number of our elected representa- constituent member organizations (C/SNAs), Individual Member tives and their staff, including Sen. Maria Cantwell and Rep. Cathy Division (IMD), affiliated organizations, or members of the ANA McMorris Rodgers, during their day on the Hill. Board of Directors. Specifically, two representatives elected from each C/SNA and the IMD; one representative from each of ANA’s ANA Membership Assembly Organizational Affiliates; and the ANA Board of Directors. This year’s Membership Assembly voted to return to the House of Nearly 300 representatives and observers attended the ANA Mem- Delegates model, which increases the number of voting representa- bership Assembly. tives according to the ANA apportionment policy. ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, WSNA elected voting representatives were WSNA President Jan- spoke of the association sharing ANA’s Principles for Health System ice Bussert, BSN, RN, and Kathy Ormsby, MSN, ARNP, FNP. Outgoing Transformation with President-elect Trump in December 2016 that, WSNA Executive Director Judy Huntington, MN, RN, and incoming in part, calls for access to affordable health insurance plans offering Executive Director Sally Watkins, PhD, MS, RN, also attended, along a minimum standard of benefits. with the following WSNA member alternate delegates/observers: Assembly representatives formally went on the record as firmly • Julia Barcott, RN opposing the American Health Care Act passed by the U.S. House of • Travis Elmore, BSN, RN Representatives May 4, 2017. They directed the ANA board to con- • Jennifer Graves, MS, RN tinue to aggressively oppose the AHCA as passed, propose provisions • Muriel Softli, MPA, MEd, BSN, RN
14 The Washington Nurse FALL 2017 wsna.org ANA MEMBERSHIP ASSEMBLY A delegate’s perspective based on ANA’s Principles for Health System Transfor- A delegate’s perspective on the mation and provide timely reports to the C/SNAs and ANA Membership Assembly the IMD. By Kathy Ormsby, ARNP Representatives also approved recommendations that were developed following two separate, but related, dialogue forums held the previous day. One focused on The 2017 ANA Membership Assembly took place in Wash- preparing nurses to be effective advocates in an uncer- ington, D.C., June 9-10 and consisted of approximately tain health care environment and another on fostering 300 attendees from ANA’s constituent state nurses asso- member engagement in association policy development. ciations (C-SNAs), individual member divisions and spe- Those recommendations call on ANA to: cialty nursing organizational affiliates, along with observ- • Highlight and promote the use of ers. The key focus this year was nursing advocacy and policy and advocacy resources. member engagement. It was an Member participants had the opportunity to share • Emphasize policy development and awesome their ideas on fostering member engagement and to help advocacy as central to the role of all RNs. and direct policy that represents the unique challenges in the • Advance mechanisms to heighten the professional work environment for nurses – especially empowering involvement of individual RN members in the today as we face potential drastic changes to our cur- experience. generation of policy and advocacy topics. rent health care system. ANA stood firm in opposition In another action, eligible voting representatives to the American Health Care Act due to the millions of adopted several bylaws, including one that expands the people who would be left without health insurance. The total number of voting seats to the Assembly to allow Membership Assembly reaffirmed ANA’s Principles for for more member engagement. Another bylaw change Health System Transformation, which includes essential standards for health allows C/SNAs to include non-RNs, such as LPNs and care services for all people. These are the same standards endorsed by WSNA. respiratory therapists, in their membership – with no ANA As nurses, we had the opportunity to take our message to our nation’s capital. membership status. We visited our senators and congresspeople and educated them on nursing issues, including protection of APRN full scope of practice for our veterans, Title VIII ANA Membership Assembly Elections Workforce Reauthorization and ANA’s Principles for Health System Transforma- tion. We had the opportunity to discuss important issues such as safe staffing. I was Eligible Assembly voting representatives elected four able to personally impart this information to U.S. Rep. Cathy McMorris-Rogers members to the nine-member board of directors. Ernest and Sen. Maria Cantwell, which is a very awesome and empowering experience. James Grant, PhD, RN, FAAN, of the North Carolina As a long-standing WSNA member of 30 years and your elected voting mem- Nurses Association, has been re-elected as vice presi- ber, I found this experience to be both energizing and unifying for all facets of dent. The newly elected board members are: Treasurer professional nursing practice. It was a wonderful opportunity to meet profes- Jennifer Mensik, PhD, RN, NEA-BC, FAAN, Arizona sional nurses from across the U.S. and vote on important bylaws that impact the Nurses Association; Director-at-Large MaryLee Paki- policies and direction of ANA. To that end, one important decision was for the eser, MSN, RN, FNP-BC, ANA-Michigan; and Director- return to the House of Delegate model (instead of the Membership Assembly at-Large, Recent Graduate Amanda Buechel, BSN, RN, model), which expands the total number of voting seats by basing the number ANA-Illinois. Terms of service begin Jan. 1, 2018. on state membership. This model affords more member engagement and was a The following ANA board members continue their critical bylaw change for WSNA, which values member voice and engagement. terms: President Pamela F. Cipriano, PhD, RN, NEA-BC, Another change was to allow non-RNs such as LPNs and respiratory therapists, FAAN, Virginia Nurses Association; Secretary Patricia who are already members of some C-SNAs, to be included in ANA membership. Travis, PhD, RN, CCRP, Maryland Nurses Association; Lastly, we elected new members to our ANA board (vice president, treasurer and Faith Marie Jones, MSN, RN, NEA-BC, Wyoming Nurses director-at-large) who we as a group felt would best meet the needs of Washington Association; and Director-at-Large, Staff Nurse Gayle M. state and professional nurses nationally. Peterson, RN-BC, ANA-Massachusetts; and Director- I would highly recommend to you as RNs and APRNs/ARNPs that you give at-Large Tonisha J. Melvin, MS, CRRN, NP-C, Georgia high consideration to becoming involved in your state and national nursing Nurses Association. associations. Put your name on the ballot and run for a seat on the WSNA Board, Elected to serve on the Nominations and Elections Cabinet or a member seat for the House of Delegates. This is truly an opportunity Committee were: Thomas Stenvig, PhD, MPH, RN, NEA- of a lifetime. ■ BC, FAAN, South Dakota Nurses Association, who is chair-elect; Anthony King, BSN, RN, CPN, ANA-New York; Terry Throckmorton, PhD, RN, Texas Nurses Asso- ciation; and Elizabeth Welch-Carre, MS, APRN, NNP-BC, Colorado Nurses Association. ■
wsna.org The Washington Nurse FALL 2017 15 16 The Washington Nurse
FALL 2017 wsna.org THE OPIOID EPIDEMIC
PHOTO: SHUTTERSTOCK PHOTO: SHUTTERSTOCK á á The following offer articles different perspectives onthe roleofnursesinaddressing the opioidepidemic. Youcanfindmore departments, professionaldepartments, groups andcommunityorganizations are working togethertoimplementtheprioritygoals,strategies comprehensive strategy toreducegovernment associatedwithopioids.State morbidityandmortality localhealth agencies, allowing nurse practitioners, for thefirst time, toprescribe buprenorphine, amedicationusedtoreduce theriskofoverdoses and intheplan. and actionscontained Nurses ANA hasworked toadvance nursing’s role infightingtheopioidcrisis.Incollaboration withtheWhiteHouse, ANAhasjoined provision oftheComprehensive Addiction andRecovery Act of2016 expands tomedication-assisted access treatment by use andoverdose prevention oftheWashington insupport Interagency State OpioidWorking Plan.Thisplanisthestate’s Nurses Associationhave bothtaken efforts. these actiontosupport Federal, and localgovernments state are responding totheopioidepidemicwithinitiatives aimedatpreventing opioidabuse, WSNA isamongthestakeholders thathave inourstate expressed interest aparticular inandcommitment toaddressing opioid treat opioidaddiction. forces with40 otherorganizations inapledge totrain more than540,000 opioidprescribers over thenext two years. Akey information ontheWSNA website atwww.wsna.org/nursing-practice/opioids. identifying effectiveidentifying treatments andpreventing deathsfrom overdoses. The Nurses AssociationandtheAmerican Washington State of the opioid epidemic in our communities, hospitals andclinics.In2014 hospitals of theopioidepidemicinourcommunities, alone, there were 1.27 overdoses are now theleadingcauseofdeathfor Americansundertheageof50. We seetheeffects epidemic The numberofoverdose deathsinvolving opioidshasmore thanquadrupledsince1999, anddrug And, 718 Washingtonians diedfrom opioidoverdose in2015 —more thanfrom caraccidents. million emergency room visitsandin-patientstays related toopioidsnationwide. the opioid ANA support forANA support national efforts addressing addressing WSNA andtheWashington State Interagency OpioidWorking Plan á á á View ANA’s IssueBrief ontheopioidepidemicat Read ANA’s positiononnursing’s role inaddressing theepidemicat á View Washington’s planatwww.stopoverdose.org/stateresponseplan.pdf http://wsna.to/2gy8fFl THE OPIOID EPIDEMIC http://wsna.to/2gx6Wqv . wsna.org
The Washington Nurse
FALL 2017 17 18 T Banta-Green and Williams (2016), however,Banta-Green (2016), andWilliams identified that heroin- The Washington Nurse Governor Jay Inslee wrote anexecutive order outliningastatewide OPIOID EPIDEMIC Control andPrevention released newguidelines for thetreatment of ing optionsfor, andaccess to, treatment thedisease. of its related deaths onpreventing include mustalso focus aconcerted indicates such anapproach removing apatient’s harm, actuallycauses ington state (DOH, 2017). Thefollowing year, theCenters for Disease tion monitoring adecrease program inprescription-related in2012, threatening andurgent illnesses primary care needs unmet bythe opiate of the number prescriptions was Infact, research notenough. related incidents have increased inallthree areas proportionately. respected; theyfeel treated aswell poorly asjudged. Thisleaves the legal access to asubstance onwhich physically theydepend and large ED, patients daily. Clare treating TheEDatserves 120-150 St. as we work with patients- daily disor who are with opioid use living and for some weand for are some theironlycontact withmedical care. Histori daily resourceas a crucial for the many patients with life- we see and leaves avulnerable population inourcommunities withdeadly among health care professionals leaves patients feeling theyare not police arrests, treatment-seeking have andmortality achieved. been overburdened system. Many our patients of live with untreated OUD, overdose, increasing access to overdose reversal agents, andexpand Since implementation thedrug. thestatewideforms of of prescrip patientsemotionally. turnto illicit propermedical Without support, other, acknowledging that onsimply reducing ourprevious focus Thetwo parallel documents opiate each plan response (Inslee, 2016). asachronicof illness. of us who us workof inhealth care have firsthand, experienced thisissue phy. individuals, inothersettings stigmatized frequently These or professional feeling helpless. Thislack coordinated of care continues patient who came treatment to seek feeling angryandthehealth care professionals and patients, feeling with both helpless. Opioid use chronic however, issue; Clare, at St. we believe in another philoso cally, EDs have viewed asthearena notbeen to treat orresolve this chronic Washington pain (Dowell, Haegerich 2016). state and Chou, causes and evidence-based treatments OUD. of This educational gap sidered asmall, community hospital; however, we have grown into a consequences. By Wolkin, Elizabeth MSN,RN RN,CEN,andJéaux Rinehart, BSN, der (OUD). interactions these Often, are frustrating for healthcare disorder is often misunderstood as a social ormoral insteaddisorder misunderstood issue isoften asasocial St. Clare emergency department responds totheopioidcrisis The emergency department at St. ClareThe emergency Hospital at St. was once department con An appropriate disorder andeffective and use to opioid response In 2015, there were 718 opioid overdose there relatedIn 2015, were 718 deaths in Wash- Consequently, health care professionals are nottrained onthe Every day, dangerous themediareports trends inoverdose- he opioid crisis iswell and widespread publicized nationally. related deaths (Katz, 2017). It isestimated that more than18,000 accidental death intheUnited States (Paparella, Many 2014). deaths in 2014 weredeaths to opioid overdoses, due in 2014 a leading of cause
St. Clare emergency department
FALL 2017 wsna.org - - - - - (ACEP) and the Washington State law RCW 69.50.315 recommend We are committed to withopioiduse reducing theharmassociated Paparella, ATale S.(2016). ofWaste andLoss: Lessons Learned. Journal ofEmergency Nursing, Opioid-related inWashington Deaths State, 2006–2016 (No. (2017). Washington DOH346-083). Katz, J. (2017, Are inAmerica June5).DrugDeaths Rising Faster ThanEver. TheNew York Times. Inslee, J. Executive (2016). Order 16-09 (State ofWashington, Office oftheGovenor). Retrieved from Dowell D, CDCGuideline for HaegerichTM,ChouR. Prescribing Opioidsfor Chronic Pain —United PhDMPHMSW,Bandta-Green, C., &Williams, J., PhD. Overview (2016). ofopioidtrends inPierce CollegeofEmergencyAmerican Physicians, Board ofDirectors. Naloxone (2015, October). homes and communities for immediate to response life-threatening injector orintranasal kits,similar oranepinephrine pen to aninsulin that anyone at risk having of orwitnessing anopioid overdose be their lives saving. are■ worth their patients, and to demonstrate to our patients that we believe andeducational materialstions for use andover onsafer opioiduse to develop aprotocol a“naloxone to dispense kit” to at-risk patients need understanding and relief their symptoms, of which we can they arrive because painmanagement, torefused ourdepartment upon discharge.upon Thiskitwould include themedication, simple instruc secondary to treatment, incarcerationuse Such orhospitalization. auto injector system. TheAmerican College Emergency of Physicians or suspected overdoses.or suspected Naloxone iseasyandcomes to inauto- use options for medical andnaloxone treatment, such asbuprenorphine one education session with a trained our health of care member team. our patientsheroin; who have use significant of opioids daily doses for ahealth care practitioner’s care, in used butitcan andshouldbe anexcesspatient opioids. hasused It of doesnotreplace theneed provide. Ourpatients needkindness, paincontrol understanding, and patients, as well as their friends and family, receiving should be this prescribed; orrecently abstinence of underwent orreduced aperiod given naloxone andtrained it(ACEP, to use Thistranslates 2015). to cists, physicians andadministrative leadership have meeting been sublingual film. drug free charge. of dose prevention. givendose one-to- following Thiskitwillbe anin-person, deaths. It means also providing thestaffwithhelptools to truly disorder inourcommunity. Thismeans reducing overdose-related 42(4), 352-354. doi:http://dx.doi.org/10.1016/j.jen.2016.03.025 SummaryOpioidOverdoseData.pdf ofHealth.doi:doh.wa.gov/Portals/1/Documents/Pubs/346-083-State Department opioid-epidemic-drug-overdose-deaths-are-rising-faster-than-ever.html Retrieved 2017, August 12, from https://www.nytimes.com/interactive/2017/06/05/upshot/ governor.wa.gov/sites/default/files/exe_order/eo_16-09.pdf mmwr.rr6501e1 2016.States, MMWRRecomm Rep 2016;65(No. RR-1):1–49. DOI:http://dx.doi.org/10.15585/ County. Alcohol andDrugAbuseInstitute, University ofWashington. Clinical---Practice-Management/Naloxone-Prescriptions-by-Emergency-Physicians/ Prescriptions by Emergency Physicians. Retrieved 2017, August 12, from https://www.acep.org/ Naloxone isanopioidreversal agent when a that used can be St. Clare HospitalSt. isworking toward thisgoal. Nurses, pharma - - -
PHOTO: SHUTTERSTOCK/MARAZE PHOTO: SHUTTERSTOCK/MARAZE Assess thepatient carefully Assess Pain medication matched be should to patient’s theindividual witha needs. Thisbegins Referral to Treatment (SBIRT) from the Substance andMental Abuse Health Admin Services the role ofthenurse Opioids have unintentional injurydeath aleading of become cause inWashington, even One model for Brief follow-up possible substance Intervention of is Screening, abuse and with theappropriate provider. wide, theCenters forControl Disease andPrevention (CDC) that overdose reports deaths hygiene. If patients are already managed being for chronic the nurse should consult pain, istration. SBIRT for isamethod ensuring that with disorderssubstance people and those use in the Journal the American of Medical byBaker (JAMA) Association and colleagues notes that there issignificant variabilityof opioids prescribed.Themost intheamountcommonly more thanmotor vehicle accidents orfirearm fatalities, according state to 2016 data. Nation rates between 1999 and 2014 highest among people age 25 to 54, according torates highestage totheCDC. amongpeople 54, 25 and2014 between 1999 monitoring patients. of role deaths, inreducingthese aswell asaddiction problems, through and theirassessments related to prescription opioids have quadrupled since 1999.Nurses can play animportant at risk for developing disorders these receive thehelp theyneed. substanceor disordersabout ahistory of use inthepatient andthepatient’s a prescription opioid andstrike withprescription awide adultpopulation, opioidoverdose Nurses Service OrganizationNurses Service or potential addiction, and refer addiction, or potential chronic pain patients to a pain management center or spe on Drug Abuse (NIDA) Ifasubstance disorder thenurse issuspected, Quick use Screen. or were dependent onprescription opioids. At least allopioidoverdose halfof deaths involve intheUnited almost2millionpeople States abused prescription these opioids.one of In2014, protect themselves from possible legal actionstemming from opioids. possible substance abuse, such asadvanced traumatic periodontitis, oral lesions andpoor indicatingperhaps that more healthcare providers are aware becoming the addiction issue. of family. Ifopioids areconsidered, being thepatient’s assess psychiatric status. Preventiveof Medicine adecrease intherate reported prescribing of opioids (-5.7 percent), consider referral for patients who opioids seek beyond when theyare likely needed. to be Be sure to thereferralcialist. document inthepatient’s health record. Nurses should also so theyreceiveso thecare theyneed. should remain while nonjudgmental referring patients evaluation for further and treatment, Preventing opioidabuse: By David Griffiths dispensed opioid was hydrocodone (78 percent), followed percent). opioidwas hydrocodone byoxycodonedispensed (15.4 (78 detailed medical history, currently including a list of prescribed and past medications. Ask Screen andrefer patients The depth and breadth prescription of opioid is far-reaching. abuse published study A 2016 A physical completed, exam be also should keeping inmindsigns andsymptoms of At thesame time, it’s for nurses well to be aware important steps theycan of take to help Every day, more than1,000 are people treated in emergency for misusing departments Nurses can also help detect patients with substance with the National misuse Institute Nurses needto closely controlled monitor of patient use drugs to avoid overdependence But there may acourse correction be underway. intheAmerican Journal study A2015 wsna.org OPIOID EPIDEMIC
The Washington Nurse
Preventing abuse
FALL 2017 - - - 19 OPIOIDS Preventing abuse
Apply evidence-based pain management Resources To provide optimal patient care, as well as to protect themselves from legal action, nurses should practice Governor Jay Inslee. Opioid evidence-based pain management. That includes considering non-steroidal anti-inflammatory drugs Epidemic Policy Brief, 2016. (NSAIDs), such as ibuprofen, as first-line pain medication. governor.wa.gov/sites/ NSAIDs have been shown to be at least as effective (if not more so) than opioids for managing pain, default/files/exe_order/ particularly in combination with acetaminophen. Before patients begin taking NSAIDs, verify that they OpioidEpidemic.pdf. are not taking other anticoagulants, including aspirin, and check for hepatic or renal impairment. Baker JA, Avorn J, Levin Nurses should complete continuing education courses in pain management and document they did R, Bateman BT. Opioid so, which can provide evidence of their knowledge in event of legal action. prescribing after surgical extraction of teeth Educate patients in Medicaid patients, 2000-2010. JAMA. Nurses have an opportunity to educate patients about the role of pain medication in their care. This 2016;315(15)1653-1654. education should include pain medication options and the reasons why non-opioids are preferred. Verbal and written instructions after the procedure need to contain name of drug, dosage, adverse Centers for Disease Control and Prevention. Prescription effects, how long the drug should be taken and how to store it. Results from a 2016 survey published opioid overdose data. 2016. in JAMA Internal Medicine found that more than half (61 percent) of those no longer taking opioid www.cdc.gov/drugoverdose/ medication keep it for future use, so patients need to be told to dispose of unused drugs and how to do data/overdose.html. so. Patients can search for places that collect controlled substance drugs through the Drug Enforcement Administration at www.deadiversion.usdoj.gov. Kennedy-Hendricks A, The same survey found that about 20 percent shared the opioid with another person, so education Gielen A, McDonald E, et al. Medication sharing, storage, material should mention not to do this. Nurses should also discuss the perils of driving or undertaking and disposal practices for complex tasks while taking an opioid. Document in the patient’s health record that this information was opioid medications among provided and the patient acknowledged receipt and understanding. An office visit can also provide the US adults. JAMA Int Med. opportunity for nurses to address opioid abuse on a larger scale. June 13, 2016. Below are some considerations for the use of pain medication in patients: MCauley JL, Leite RS, Melvin • Use non-steroidal anti-inflammatory drugs (NSAIDs) as the first option. Consider a selective CL, Fillingim RB, Brady NSAID to avoid increased risk of bleeding. Know that using acetaminophen in combination with KT. Opioid prescribing NSAID may have a synergistic effect in pain relief. (Do not exceed 3,000 mg/day in adults.) practices and risk mitigation • Provide patient education strategy implementation: identification of potential • Document patient communications, education and referrals in the health record targets for provider-level Nurses who assess and monitor patients for treatment of pain are encouraged to be mindful of and have intervention. Substance respect for their inherent abuse potential. Doing so helps protect patients from harm and nurses from Abuse. 2016;37(1):9-14. potential liability. ■ Levy B, et al. “Trends in opioid analgesic – prescribing rates by specialty, ABOUT THE AUTHOR U.S., 2007-2012.” Am J Prev David Griffiths is senior vice president of program management for Nurses Service Organization (NSO), where he Med 2015; 49(3): 409-413. develops strategy and oversees execution of all new business acquisition and customer retention for the group’s allied Substance Abuse and healthcare professional liability insurance programs. With more than 15 years of experience in the risk management Mental Health Services industry, he leads a team covering account management, marketing and risk management services. Administration. Screening, This risk management information was provided by Nurses Service Organization (NSO), the nation’s largest provider brief intervention, and of nurses’ professional liability insurance coverage for over 650,000 nurses since 1976. INS endorses the individual referral to treatment (SBIRT). professional liability insurance policy administered through NSO and underwritten by American Casualty Company of 2016. www.samhsa.gov/sbirt. Reading, Pennsylvania, a CNA company. Reproduction without permission of the publisher is prohibited. For questions, Thorson D, Biewen P. Bonte B, send an e-mail to [email protected] or call 1-800-247-1500. More at www.nso.com. et al. Acute pain assessment This article is provided for general informational purposes only and is not intended to provide individualized and opioid prescribing business, risk management or legal advice. It is not intended to be a substitute for any professional standards, protocol. Institute for Clinical guidelines or workplace policies related to the subject matter. Systems Improvement. 2014. www.cdc.gov/mmwr/ volumes/65/rr/rr6501e1.htm.
20 The Washington Nurse FALL 2017 wsna.org OPIOIDS Nursing commission update PAID ADVERTISEMENT Boise State University Nursing commission update on opioids CELEBRATES
By Paula Meyer, MSN, RN, FRE Executive Director, Nursing Care Quality Assurance Commission 1000 ONLINE RN-BS Graduates he Nursing Care Quality Assurance Commission’s House Bill 1427 passed the Legislature and was purpose is to protect and improve the health of signed by Governor Inslee May 16, 2017, becoming the people of Washington state. On any day, the effective July 23. The Nursing Commission will The FUTURE OF NURSING purpose may include making sure applicants participate with other health care professional boards 80% baccalaureate degrees for a license meet the requirements defined by and commissions in developing the implementation, by 2020 Tthe commission, investigating complaints against rules and actions. nurses or performing audits of nurses’ continuing As nurses, we assess and evaluate many competency documents. On other days, the people every day. As the largest single profession commission may determine the scope of practice in in healthcare, nurses play a key role in assessment Washington for nursing assistants, licensed practice of people in pain and decreasing unintentional nurses and advanced registered nurse practitioners. deaths related to opioids. Our assessments and The commission also adopts rules to further explain communication with other health care providers laws for nursing practice. is essential to recognizing when people are using In 2011, the Nursing Commission adopted rules opioids effectively AND how to intervene when for the treatment of chronic, non-cancer pain people are using opioids incorrectly. As nurses, here management in WAC 246-840-460 through WAC are two ways you can impact the opioid crisis: 246-840-493. The Nursing Commission, Medical • Medication reconciliation and safe Quality Assurance Commission, Dental Quality storage in homes. Whenever you are APPLY NOW Assurance Commission, Board of Osteopathic educating a patient on their use of pain Flexible and Affordable Medicine and Surgery, and Board of Podiatry adopted medications, stress safe storage to prevent BOISE STATE UNIVERSITY the same rules for these professions. The five boards children from accessing medications. and commissions worked together to determine • Supporting drug drop offs at pharmacies limits in prescribing pain medications, define pain Bachelor’sOnline Completion Completion Track for medication disposal. Simply flushing management specialists, and consulting. these in the toilet is no longer an acceptable The rules were effective in that they served as one method to rid the medication cabinet of Online Graduate Programs strategy to decrease unintentional poisoning and unused medications. Check with local deaths related to the use of opioids. Unfortunately, pharmacies to determine if they collect the crisis of people continuing to die from opioid use unused medications for safe disposal. This continues. Governor Jay Inslee issued an executive DNP can be a very valuable resource for patients. Post-Master’s order directing state government agencies in their Doctor of Nursing work to combat the opioid crisis. The Nursing The Department of Health published the Opioid- Practice Commission, with other health care regulatory related Deaths in Washington State 2006-2016 that agencies, is working together to identify strategies appears on pages 22 through 25. As you can see, to further decrease access to opioids and continue there is a growing problem in our state. The Nursing AGNP to treat people’s pain. Commission, with other boards, commissions Nurse Practitioner Master’s Degree On June 15, Governor Inslee held a second and the governor’s support, wants to address the Boise State University conference to announce his goals for Washington problem and see decreasing trends in the number State: of deaths in our state. 1. Prevent inappropriate opioid HEALTHCARE IMULATION prescriptions and use S 2. Treat people with opioid use disorder Graduate Certificate and connect them to support services, including housing hs.boisestate.edu/nursing 3. Save lives by intervening in overdoses 4. Use data to focus and improve our work Questions? Call (208) 426-1727
wsna.org The Washington Nurse FALL 2017 21 From the Washington State Department of Health: Opioid-related Deaths
Opioid-related Deaths in Washington State, 2006–2016
The Department of Health monitors opioid-related deaths by analyzing data from death certificates using two different methods. Details on these methods are in Appendix A. Differentiating between overdose deaths involving prescription opioids or heroin can be very challenging.
Opioid-related Overdose Deaths
Number of opioid-related overdose deaths by year, Washington State, 2006–2016^
METHOD 1* METHOD 2**
Number Number of Number Number of State Number of Number of Number Year prescription of prescription Population opioid- of heroin synthetic of heroin opioid opioid- opioid related overdose overdose overdose opioid related overdose deaths deaths deaths deaths overdose deaths deaths deaths
2006 6420263 678 565 53 51 584 464 120
2007 6525095 666 522 77 37 597 454 143
2008 6608240 709 577 73 54 658 512 146
2009 6672168 719 583 68 70 644 490 154
2010 6724544 649 532 67 66 570 420 150
2011 6767911 707 550 145 57 607 407 200
2012 6817763 713 518 186 61 619 388 231
2013 6882394 647 437 212 59 608 381 227
2014 6968173 695 425 301 66 612 319 293
2015 7061402 718 415 313 69 632 287 345
2016 7183713 694 435 287 87 N/A N/A N/A Preliminary ^ 2016 data are preliminary
22 The Washington Nurse SUMMER 2017 wsna.org From the Washington State Department of Health: Opioid-related Deaths
*Method 1 includes intentional, unintentional, and undetermined deaths. Deaths due to "morphine" with no other information are assumed to be prescription overdose death. Deaths involving both heroin and prescription opioids will appear twice, once in each column. It includes all Washington State residents regardless of where they died and non-residents who died within Washington State.
**Method 2 includes unintentional and undetermined deaths only. Deaths due to "morphine" with no other information are assumed to be heroin overdose deaths. It includes Washington residents who died in Washington. Washington residents who die outside of Washington are excluded.
Number and age-adjusted rate of opioid-related overdose deaths by county of residence, Washington State, 2012–2016, using Method 1
Number of Rate per 100,000 Number of Rate per 100,000 County County Deaths population Deaths population
Adams 2 ***Suppressed Lewis 34 9.1
Asotin 12 10.8 Lincoln 5 ***Suppressed
Benton 84 9.3 Mason 44 14.7
Chelan 31 8.6 Okanogan 13 7.3
Clallam 54 16.5 Pacific 8 ***Suppressed
Clark 199 8.8 Pend Oreille 6 ***Suppressed
Columbia 2 ***Suppressed Pierce 423 9.9
Cowlitz 71 13.6 San Juan 9 ***Suppressed
Douglas 20 10.5 Skagit 66 11.2
Ferry 5 ***Suppressed Skamania 2 ***Suppressed
Franklin 17 4.4 Snohomish 488 12.4
Garfield 0 0 Spokane 215 8.8
Grant 24 5.9 Stevens 15 7.8
Grays 42 12.3 106 7.7 Thurston Harbor
Island 38 10.9 Wahkiakum 0 0
Jefferson 15 10.3 Walla Walla 25 8.5
King 995 9 Whatcom 69 7
Kitsap 104 7.8 Whitman 13 8.1
Kittitas 17 9.1 Yakima 65 5.5
Klickitat 4 4.3 WA State 3,467 9.6
wsna.org The Washington Nurse SUMMER 2017 23 From the Washington State Department of Health: Opioid-related Deaths
***Suppressed due to small numbers
Number and rate of opioid-related overdose deaths by age group and type of opioid, Washington State, 2012–2016^, using Method 1
Age Number of Rate per Number of Rate per Number Rate per Number of Rate per Group opioid- 100,000 prescription 100,000 of heroin 100,000 synthetic 100,000 related population opioid population overdose population opioid population (yrs) deaths overdose deaths overdose deaths deaths
15-24 285 6.2 124 2.7 158 3.4 33 0.7
25-34 713 14.7 329 6.8 399 8.2 57 1.2
35-44 674 14.8 422 9.3 274 6 65 1.4
45-54 896 18.8 632 13.2 281 5.9 84 1.8
55-64 687 15.1 537 11.8 159 3.5 75 1.6
65+ 205 4.2 180 3.7 27 0.5 28 0.6
^ 2016 data are preliminary Summary: • In both methods, the total number of opioid overdose deaths has not changed substantially since 2008. And, the number of prescription opioid involved overdoses has declined, while heroin overdoses have increased.
• Method 1 likely underestimates heroin overdoses, and by a greater extent in earlier years. This underestimation makes the increase in the number of heroin overdose deaths appear more dramatic compared to Method 2.
• Method 1 results in a higher number of overdoses because it includes intentional overdoses, including suicides and homicides.
• The counties that have opioid overdose rates higher than the state rate are Clallam, Cowlitz and Snohomish.
• Persons who die from heroin overdoses tend to be younger than those who die from overdoses due to prescription opioids.
• The 2016 death data are still preliminary.
24 The Washington Nurse SUMMER 2017 wsna.org From the Washington State Department of Health: Opioid-related Deaths
Appendix A: Description of Methods
Method 1: This method is used by the Centers for Disease Control and Prevention. A death is considered to be opioid-related if the death certificate lists any of the following ICD-10 codes as an underlying cause of death:
• X40-X44: Accidental poisonings by drugs • X60-X64: Intentional self-poisoning by drugs • X85: Assault by drug poisoning • Y10-Y14: Drug poisoning of undetermined intent And, includes any of the following ICD-10 codes as a contributing cause-of-death:
• T40.0: Opium • T40.1: Heroin • T40.2: Natural and semisynthetic opioids • T40.3: Methadone • T40.4: Synthetic opioids, other than methadone • T40.6: Other and unspecified narcotics
Method 2: This method was developed by Department of Health with input from University of Washington and Department of Labor and Industries in 2006. This method is time intensive, so data are currently available through 2014. Deaths are selected for further review if they have any of the following ICD-10 codes as a contributing cause-of-death:
• T40.0: Opium • T40.1: Heroin • T40.2: Natural and semisynthetic opioids • T40.3: Methadone • T40.4: Synthetic opioids, other than methadone • T40.6: Other and unspecified narcotics • F11: Mental and behavioral disorders due to use of opioids
And, the manner of death is either natural, accident or undetermined and a term describing an overdose is written on the death certificate.
Deaths are classified as a prescription opioid if a prescription was listed on the death certificate, except if the drug was morphine or hydromorphone and it was not clear that these were prescriptions. This is because heroin metabolizes into these drugs, is what is detected by the toxicology testing, and therefore often written on the death certificate.
DOH 346-083 May 2017 For persons with disabilities, this document is available on request in other formats. To submit a request, please call 1-800-525-0127 (TDD/TTY 711).
wsna.org The Washington Nurse SUMMER 2017 25 WSNA_1-sided_v2_r3_9_16.indd 1 Nurani, Mitchell, KimP.C.; Ashifa Nurani, DDS; Ahyoang Amber Kim, DDS; Michael Mitchell, DDS, Pearson, P.C. Jeffrey Pearson, DMD. ©2016 Smile Brands Inc. All rights reserved. EXCLUSIVE SAVINGS ON DENTAL CARE FROM Bellevue-Crossroads Bellevue-Crossroads 253.835.3377 Atabakhsh, DDS Christopher Park, DDS; Ted Hughes, DDS; Vahid Venkata Naveen Cherukuri, DDS; 1507 S.348thSt., Ste. K2-102 Federal Way 253.299.3033 Ted Hughes, DDS: Vahid Atabakhsh, DDS Christen Kartaltepe, DDS; Lisa Uglialoro, DDS, MS; Jung Kim,DDS; Chad Carver, DDS; 9503 192ndAve. East Bonney Lake 360.715.8400 Ted Hughes, DDS Randy Ball, DDS; Sumedha Sharma, DDS; Harbinder Bal, DDS; JustinPagan, DDS; 4291 MeridianSt., Ste. 101 Bellingham 425.201.1700 Randy Ball, DDS Chad Carver, DDS; Muzaffer Cakir, DDS; 3820 124th Ave. SE Bellevue-Factoria 425.372.0036 Shelby Beattie, DDS; Ted Hughes, DDS Jennifer (Jungjin) Park Chu, DDS; 15600 NE8thSt., #A1 *Source: 2014 Fair exclusions may HealthData.Other include andare not limited toimplantcrowns, implants, crowns andcrowns/onlays/inlays services withgold,specialty thatare allporcelain. voluntary.not! or and Youbenefits dental savehave anditworks whetheryou members participation insuranceisand plan, anWSNA not is This care. provide dental for to savings exclusive with families their together partnering be to pleased are WSNA and Dental Now! Bright Carrie Magnuson |[email protected] |253.405.4547 BRIGHT NOW! DENTAL FEE COMPARISON Filling Composite (2-surface Resin-back tooth) Crown (Porcelain Fused to HighNobleMetal) Teeth Cleaning By GeneralDentist.IfSpecialist isnecessary fees willvary. Initial OralExam & DigitalX-rays Root Canal (Molar3-canals) Denture (Complete Lower) Contact your Union Account Representative, PROCEDURE
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BEFORE DENTAL BENEFITS ARE APPLIED YOUR AT COST ABRIGHT NOW! DENTAL OFFICE* 253.475.7500 Rena Jhuty, DMD;Vahid Atabakhsh, DDS; Thien Nguyen, DDS; Hardeep Dhaliwal, DDS; 4545 South Union Ave., Ste. 100 Tacoma 509.464.2001 DDS William Barton, Naim Abualshar, DDS; Ted Hughes, DDS; 7407 NDivisionSt., Ste. K Spokane 360.536.9033 eep Dhaliwal, DDS; Kenny Tran, DDS; Rpyal Aaby, DDS Michael Mitchell, DDS; Brandon Johnson, DDS; Hard Silverdale10404 Way NW, #E109 Silverdale 253.840.0540 Atabakhsh, DDS; Yumi Abei,DDS Monika Mahajan, DDS; Sean Monaghan,DDS; Vahid Richard Guzha, DDS; Hardeep Dhaliwal, DDS; 156thEast10228 St., Ste. 101 Puyallup $905 $740 $755 $145 $68 $29
- BEFORE DENTAL BENEFITS ARE APPLIED NOW! DENTAL OFFICE* SAVINGS AT A BRIGHT Tukwila 425.492.2000 Richard Franklin, DDS; Ted Hughes, DDS Jean Chen, DDS; Randy Ball, DDS; 17740 Garden Way NE Woodinville 360.574.4574 Shelley Aronson, DDS Jan Kooning, DMD;Jeffrey Pearson, DMD; Austin Phoenix, DDS; Jordan Anderson, DDS; St., NE129th Ste.21010 101 Creek Vancouver-Salmon 360.891.1999 Austin Phoenix, DDS; Peter Vu, DDS Ave.,3250 SE164th Ste. 102 Landing Vancouver-Fisher’s 206.575.0400 Lisa Uglialoro, DDS, MS Ted Hughes, DDS; Vahid Atabakhsh, DDS; Theressa Mah, DDS; DavidTo, DDS; 16400 Southcenter Pkwy., Ste. 103 | CASH BASIS UNION MEMBERS Follow us $800 $665 $259 $775 $151 $64
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PHOTOS AND ILLSUTRATIONS: SHUTTERSTOCK, THE NOUN PROJECT AND INFOBITS PHOTOS AND ILLSUTRATIONS: SHUTTERSTOCK, THE NOUN PROJECT AND INFOBITS Accident prevention The results arein. The results The sadtruthisthatnursestoday continuetoface violencefrom patients,injure themselves whensafe equipmentisnot lifting All nursesshouldwork inasafe andhealthy environment. Thissurvey isacriticalfirst stepinmakingyour workplace safer and WSNA launchedourHealth andSafety Survey inJuly and available, andriskexposure toharmfulchemicalsandblood-bornepathogens. healthier. WSNA willusethesurvey results to: more than 2,000 thestate RNsacross responded. How healthy andsafe areyou at work? • • •
exemplifies aculture Inform WSNA onwhere tofocus andprioritize ourefforts employerAssess complianceofhealthandsafety laws andregulations Gather baselineinformation onthehealthandsafety facing challenges ournurses corporate executive { 50% of safety from its My institution My institution (26% undecided) officers ~ 24% One inthree have nurses experienced injury or illness duringaworkplaceor illness accident A quarter of thosereportA quarter thatthehazard was not corrected toprevent future occurences Nearly halfofthoseinjured required responsibility toprovide My employer fulfilstheir a safe workplace for me { 44% medical treatment 9< (26% undecided) < ~ 30% wsna.org overall healthandsafety are not aware oftheir employer's accident prevention program I give my employer an 50% 33% 35% 15%
C A B More than The Washington Nurse HEALTH AND SAFETY grade of: 12% 4% D
F
Survey FALL 2017 27 HEALTH AND SAFETY Survey
Workplace violence
S M T W T F S 86% Nurses are reluctant to report violence have experienced from a patient or witnessed One in five report facing violence in the 23% fear retaliation workplace violence workplace 25% are unsure how to report at least once a week 50% believe reporting will not prevent future assaults
:9<< Nurses are even more reluctant to report <<<< violence, bullying or harrassment :9<< from a coworker 64% do not feel support from 56% have suffered :<:< management physical injury 66% fear retaliation More than 50% believe workplace violence 46% fear losing their job 76% have suffered is a serious problem psychological injury where they work
Personal protective equipment (PPE) :9<<:<:< <<<<:9<< 95+5 13% 95% are trained say their employer One in ten nurses report not in donning still uses latex having PPE readily available and doffing gloves
Respiratory protection 9 << 1 in 4 did not receive Two in three nurses said they have been fit testing to exposed to a respiratory hazard ensure proper fit for respirator Only 56% reported the incident 46% say they didn’t report due to being too busy 17% feared being blamed 44% reported no 15% didn’t want to be ridiculed by coworkers annual fit testing
28 The Washington Nurse FALL 2017 wsna.org HEALTH AND SAFETY Survey
Hazardous drug handling 60+40 76+24 98+2 1 in 3 Only 60% say 76% report they 98% feel nurses (both they have did not have an encouraged by male and female) received training opportunity to their employer to report they have in hazardous provide input file an incident or not been given drugs and on developing report exposure to safety education antineoplastics policies and hazardous drugs in working with safety procedures on hazardous hazardous drugs drugs relating to pregnancy
Safe patient handling More than When choosing not to use <9 safe lifting procedures or equipment, nurses <:9 give these reasons: One in five nurses say their Can't find extra help 62% employer does not provide ½ safe lifting equipment of respondents Takes too much time 57% have suffered an injury related to Equipment not on floor 44% Nearly 50% say lifting lifting a patient equipment is not Equipment is broken 19% easily accessible 46% did not report the injury Haven't been trained 53% said they didn't report on equipment 12% 20% say equipment is not for fear of being blamed in good working order
Bloodborne pathogens 38% 93+7 report having had a needle 93% participate stick injury or blood-borne One in three nurses say in annual blood- pathogen exposure not all their needles and borne pathogen 91% were treated in a respectful and syringes have safety guards training confidential manner 78% received counsel for HIV testing
wsna.org The Washington Nurse FALL 2017 29 30 A collaborative relationship between the nurse and agency an can be variety such to services asEnglish people language of educa learning, the communitytoimprove health The Washington Nurse workloads that anurse cancontribute potentially to asavolunteer. HEALTH AND SAFETY Washington. Sheis world ofICUnursing ing disparities. through a combination paid and volunteer of staff with varying expe housing assistance,tion, job training andnutrition services andfood that create conditions these can result innursing work that takes a models, even notdirectly those related to “health care,” couldhave rience levels. Each agency can have very diverse staffingneeds and mental health inacommunity. issues called issues, These social more “upstream” approach tosolutionsthat seeking mitigate ongo literature, findings, and then discoversummarizing the pertinent Coming together: Nurses partnering with with partnering together:Nurses Coming as liaisons between the agencyas liaisons and academia by reviewing the latest applications innonclinical settings inacommunity. Nurses can serve and play. politicalandeconomic agendas Recognizing thesocial, organization for practice best methods can improve systems these and effective way to determine needs that theagency may have. positivelyserve.populations affect they the Evidence-based practice and transition intothe Lauren Birkey just the University of to work upstream on By Lauren Birkey, MN,RN in community excited toleave the health nursing at master’s degree health promotion and community sphere completed her education. determinants health, are of conditions in which live, people work Assessing theprograms orwork processes offered by an agency or Nonprofit organizationsservice agencies offer awidesocial and
Community partnership FALL 2017 W based guidelinesbased aswell asresearch evi health, such as using cellphone applica homes? Nurses are capable delivering of improve local community services and inundated withever-increasing evidence- ing excellent care ways. in unique With through collaboration withvarious types toring andinformation sharing. tions ortext messaging for health moni tice inthenursing profession? that careof prac what definesscope the the world, butisthebreadth delivery of of technology, the nursing profession is advances and in science information of agenciesof to address andenviron social put into practice by various agencies to populations inthat community byprovid excellent care invarious settings around can positively impact a community and dence. Some of these advances these dence. of can be Some
As such, nursesAs such, valuable can be assets Outside theclinical nurses setting, wsna.org vaccines inaclinic, orprovid hat defines the nursing profes ing health care at schools or at operating rooms, delivery of sion? Bedside care, assisting in ------These questions helped mediscover helped questions self-reportedThese methods teachers workflow. I observed theagency’s teachers inthe classroomsetting, with evidence-based practice guidelines inourdaily work. These by focusing on social determinants health. onsocial of by focusing health, and providing high-quality education can impactthehealthhealth, andproviding high-quality helped maintainclarityhelped throughout theproject. ing community programs can indirectly affect individual outcomes improve outcomes. ing ways results tothese apply to anagency workflow orprocess to their methods of educationtheir methods delivery of usingtheresults that Ifound. the delivery education to of children at this agency. Using my nursing theliteratureto query andsynthesize solutionsthat couldhelp the to meadesire to determine iftheirearly childhoodeducation (ECE) nonclinical agency’s capacity best-practice by introducing guidelines required to synthesize formulate information, come hypotheses, mary of thefindingsmary of along with my recommendations to strengthen mizing thedevelopment therefugee of children theyserved andhow recently involved Ihave in. hadtheprivilege working of for andwith a social service agency service inWashingtona social state volunteer asastudent up withacohesive care plan,andthenimplement itinaccordance use intheclassroomuse that are best-practice-oriented. arubricusing derived practices, from best these andIdesigned a actly what information theywanted to know andwhat skills Icould agency. Ithuscollaborated withagency to personnel determineex and values that are unfamiliar to nonclinical organizations. Optimiz applicable to a community at large. Moreover, nurses can expand a adulthood. My agency service was work intendedadulthood. to withthissocial intellectualas anurse, curiosity Ipossessed andtheskills Iknew of eachof andhave individual positive effects that can extend into questionnaire for staffmembers to supplement my observations. theagency,offer andIidentified an acceptable timeline both for favorably itcompared to similar programs inthecounty. years.for some During my tenure, thisagency’s expressed personnel eral practices best for teaching to that applied thisagency’s couldbe agreeupon could Definingthespecificgoals that bothparties parties. collect data andto present itto theagencythat so theycouldmodify enhance theECEcommunity program the andpositively influence center could be considered a “high-quality” program, ifitwas opti center considered couldbe a“high-quality” skills that we nurses routinely at side the bed or clinic use office are skill set and assessment expertise, Iwas able toskill expertise, planto set andassessment thisproject, delivery education to of refugee children through this agency. An example of this type of community of workAn example is a project this type I was of After reviewing thedata, Isynthesized aplan andpresented asum- After athorough conducting literature review, Idiscovered sev While my knowledge early of childhood education was limited, Education is one component of the five social determinants the fivesocial of Education of is onecomponent Nurses arewe arebecause qualified in this especially capacity - - - -
PHOTO: RUTH SCHUBERT PHOTO: RUTH SCHUBERT with a nonprofit with anonprofit community organization by promoting the use of best practices best of by promoting can theuse determinants,by improving such social as by venturing outside thetraditional health hospital and clinical confident and be box importantly, enhance thelives andhealth their community andpositively affect the that the skills we have extended can be to tion inmy case. the skills andtools that nurses offer. Nurses refugee children’s access to quality educa not directly involved care” in“health projects, lives many of individuals inthat community of those served, those whichof is what the nursing profession is about. ■ profession isabout. community-oriented endeavors.community-oriented Working organizationscare Local arena. make could a greater impact in the community byutilizing can affect thehealthofa community, even if strengthen the agency’s capacity, butmore As nurses, we must thinkoutside the Nursesof members influential can be - - workplace violence The listofprojects studentshadtochoosefrom included: UW Bothell students explore students UW Bothell WSNA hadidentifiedasaneedfor itsmembers. WSNA would like studentsfor tothankthese theirstellarwork! Also, AnnieBruckandKaren Bowman Cypher, RN.“Itkindofopenedmy eyes.” who worked ontheproject. In August, WSNA hostedaposterpresentation onworkplace by violenceissues studentsintheUniversity agitated thatshewasn’tagitated gettingmedsasfrequently asshewanted, threw awheelchairatMeheret. seeing onthewebsite. for improving it.Thegroup didresearch andsentasurvey toothersgaugetheir intheirBSNcohort higherthanintheprivatetimes sector, and80 percent oftheincidentscomefrom patients. students onacommunityhealthproject thatexplored theissue, withstudentsselectingadeliverable that forward aswe convene theWSNA Occupational andEnvironmental Health andSafety Committee. research Thestudentsfound andstatistics. thattheincidenceofworkplace violencefor nurses isfour provided exemplary leadership asco-faculty for thisproject. We are excited thestudents’ tocarry work of Washington BothellSchoolofNursing BSNProgram. WSNA partnered withnursing faculty and understanding ofworkplace violenceandfindoutwhatkindsofinformation they were interested in • • • • • • •
“I didn’t really understand thefullscopeofworkplace violenceandhow prevalent itis,” saidKelly “I learnedhow hightheprevalence is–Iwas surprised,” saidMeheret Fessaha, RN,oneofthestudents blood testing whenexposureblood testing happensintheworkplace related issues Exploring toblood-bornepathogenexposure andsource and contentaddressing workplace violence Providing editstothe WSNA suggested onlinecourse design Developing resource materialregarding techniques de-escalation related toworkplace violenceinhealthcare Interviewing policeandsecurityofficersissues toidentify experienced Developing web andpalmcard content concerningwhistleblowing laws andresources neededupdates/revisionsIdentifying totheWSNA website concerningtheissueofworkplace violence Providing totheWSNA editsandupdates positionpaperonthetopicofworkplace suggested violence Another project looked atWSNA’s webpage onworkplace violenceandoffered recommendations She was surprisedeven thoughshehasexperienced workplace violencefirsthand. Onepatient, One project reviewed WSNA’s positionpaperonworkplace violence, withstudentslooking atcurrent HEALTH AND SAFETY wsna.org Students exploreStudents workplace violence
The Washington Nurse
FALL 2017 ■ 31 WASHINGTON CENTER FOR NURSING News
Launch of the National Nurse leaders launch initiative to solve Education Progression in state nursing education challenges Nursing Collaborative
From the Washington Center for Nursing From the Washington Center for Nursing
Several complex issues facing nursing are getting in the way of Washington state’s ability to produce a nursing The National Education Progression in Nursing workforce needed by our growing communities: a nursing faculty shortage, nursing education funding that Collaborative (NEPIN) has formally launched fails to keep pace, and a lack of quality practice experiences for all students. Coupled with that is a national to accelerate educational advancement for call to advance nursing education so that nurses have access to baccalaureate and graduate education. nurses across the United States. NEPIN’s diverse A group of Washington state nursing leaders has banded together to form a statewide initiative called stakeholders have joined to establish a national Action Now! to tackle these challenges and transform the state’s nursing education system. focus that will identify, support and scale up The Action Now! movement is spearheaded by the Washington Center for Nursing, the statewide central practices that advance BSN and higher nurse nursing resource center; the Washington State Nursing Care Quality Assurance Commission (NCQAC), the preparation in response to the urgency of this state’s nursing regulatory board; and the Council on Nursing Education in Washington State, the statewide initiative. organization of deans and directors of Washington nursing programs. The collaborative will work to ensure that Action Now! will work with key stakeholders to develop priorities, strategies and initiatives to: community colleges, universities and employers • Provide opportunities for nurses to advance their education work in full collaboration to educate current and future nurses to the baccalaureate and beyond. • Establish sustainable financing for nursing programs NEPIN is new, but the organization’s continued • Ensure quality practice experience for all nursing students work emanates from the APIN (Academic • Create a stronger and more diverse faculty and nursing leadership pool Progression in Nursing) initiative, a grant-funded effort of the Robert Wood Johnson Foundation Provide opportunities for nurses to advance their education (RWJF) that concluded in June. The Organization Health needs are changing. Nurses must be prepared to deliver increasingly complex care and have the skills for Associate Degree Nursing (OADN) Foundation to lead health care into the future. The 2010 Institute of Medicine’s Future of Nursing Report recommended will serve as the fiduciary and convener for the an increase to the percentage of nurses with a BSN or higher degree to 80 percent by 2020, as well as collaborative in partnership with the National increasing the number of graduate-prepared nurses. Research shows this helps to ensure our nation has Forum for State Nursing Workforce Centers. access to high-quality, patient-centered care and better prepares nurses for leadership positions in a rapidly “The percentage of the RN workforce with a changing health care system. The Washington Center for Nursing is in close partnership with the National BSN or higher degree increased from 49 percent in Forum of Nursing Workforce Centers and Organization for Associate Degree Nursing at the national level 2010 to 53.2 percent in 2015, yet in many regions, to accelerate these efforts. nurses and students still lack the progression options they seek,” said Sofia Aragon, JD, BSN, Establish sustainable financing for nursing programs RN, executive director of the Washington Center Funding levels across the state must keep up with the need to attract the best-qualified faculty. We need for Nursing and president-elect of the National to grow nursing schools to meet the demand so that more students can graduate and practice nursing in Forum of State Nursing Workforce Centers. different settings and roles. Those graduates become nurse educators, nurse practitioners, researchers “Further progress requires our deeper engagement and leaders in organizations. with nursing employers and even stronger collaboration between universities and community Ensure quality practice experiences for all nursing students colleges. Ultimately, improving pathways for Nurses provide care in a variety of settings. Currently, there is an alarming shortage of clinical placement education progression in the nursing workforce experiences and clinical faculty to teach nursing. More residency and preceptorship programs are needed will enhance both patient care and population for nursing students. health.” The NEPIN collaborative evolved from a series Create a stronger and more diverse faculty and nursing leadership pool of meetings which included the Organization A long-standing strategy to address health disparities is a nursing workforce that reflects the cultural for Associate Degree Nursing, HealthImpact, diversity of our state. We need more diversity in the ranks of nursing leadership, including nursing faculty, the Washington Center for Nursing, Western to better support all students. Governors University College of Health Professions, the University of Phoenix, University of Kansas In the coming year, the leaders of Action Now! will work with key stakeholders from nursing, health care, School of Nursing, the Center to Champion workforce development, policy and the business community to develop lasting solutions that will improve Nursing in America, and the University of California the health of all Washingtonians. at San Francisco Lee Center for Health Policy Studies. For more information and to get involved, contact Action Now! co-leads Sofia Aragon, Annette Flanders, and Mindy Schaffner by emailing [email protected] PHOTO: COURTESY JESSICA ESPARZA JESSICA COURTESY PHOTO:
32 The Washington Nurse FALL 2017 wsna.org LEGISLATIVE AFFAIRS Also in this section Endorsed candidates - - - - 34 2017 legislator voting record - 36 Why nurses are contributing to WSNA-PAC ------38
“The future is just uncertain. I’m hoping something better will come out of this.”
Jessica Esparza with her parents on the day of her graducation from Big Bend Community College in 2015. WSNA member Jessica Esparza speaks out for DACA Jessica Esparza says she’s here to stay. She wants to keep working as a registered nurse on the medical oncology unit at Central Washington Hospital in Wenatchee. She wants to continue helping patients get through chemo, speaking with vulnerable patients in their native language and advocating for the needs of her community. Without DACA, though, Jessica may not be able to continue doing the work she loves. Jessica is one of the nurses in Washington state who is undocumented and has a work permit only because of the Deferred Action for Childhood Arrivals (DACA) program. “If I don’t have a work permit, I can’t work as a nurse anymore,” Jessica said. It’s that simple. And that’s why Jessica is speaking out about her DACA status and her commitment to continue caring for her patients. The day President Trump said he was going to end DACA, Jessica wrote on Facebook that she would continue to be the best nurse she can, “Because my patients do not care what documentation I have as I hold their hand and cry with them after that terminal diagnosis. Because my patient’s family does not care what color my skin is as I give CPR to their loved one. Because my patients do not care about my accent as I educate them about their chronic condition. Because my patients do not care about where I am really from when I’m taking care of them.” Trump gave Congress six months to come up with a comprehensive immigration reform bill that includes addressing DACA, a program President Obama created through executive order to protect young people who were brought to the U.S. as children. Asked if she is afraid of being deported, Jessica said, “I hope it doesn’t happen. It would be kind of insane to deport someone who’s contributing to their community and is not a criminal.” Jessica came to the U.S. when she was 11 years old. Her mother decided the risk of crossing the border without documents was worth keeping the family together, so she followed Jessica’s father to Washington state, where he had been working seasonally as a farm laborer for many years. PHOTO: COURTESY JESSICA ESPARZA JESSICA COURTESY PHOTO:
wsna.org The Washington Nurse FALL 2017 33 LEGISLATIVE AFFAIRS PAC-endorsed candidates
Jessica attended Big Bend Community College in Moses Lake under Washington state’s Development, Relief and Education for Alien Minors (DREAM) Act, which pro- tects undocumented minors. She graduated in June 2015 and went to work at Central Washington Hospital with a work permit provided through the DACA program. Losing her ability to work as a nurse would be a loss not only to Jessica, but to her patients as well. Research shows that patients tend to receive better quality care when health professionals mirror the ethnic, racial and linguistic backgrounds of their patients. From left: Yun Yun Lu, SharonTrooseth, As one of only a few Spanish-speaking Phil Fortunato and nurses at Central Washington Hospital, Jes- Faith Hammel sica is often called on to talk with Spanish- speaking patients about such things as medi- cations and discharge instructions. 2017 WSNA-PAC endorsed candidates “That way the patients go home knowing The WSNA-PAC Board endorsed a number of candidates running in special elections for the what they’re supposed to do,” Jessica said. Washington State Legislature. Most of these candidates were appointed to the Legislature She was once asked by a doctor to speak and served in the 2017 session – with the exception of the 45th Legislative District, where with a patient about a cancer diagnosis. It was there is an open seat. WSNA-PAC’s endorsed candidates were evaluated based on a can- a sensitive conversation that the doctor didn’t didate questionnaire, an interview with members of the PAC Board and nurses, as well as want to have via a translator on Skype. Jessica incumbents’ 2017 legislative voting record. was able to talk to the patient in person, in Spanish and with sensitivity. Phil Fortunato for Senate The fate of DACA recipients is now in the 31st Legislative District AT A GLANCE hands of Congress. On Sept. 8, WSNA issued Phil Forunato was elected to the Washington State House of Party: Republican a statement that joins the American Nurses Representatives in 2016, and was appointed to the Washington Association in calling on Congress to work State Senate following Senator Pam Roach’s election to the Occupation: Small together to find a compassionate, bipartisan Pierce County Council. Senator Fortunato is a small-business business owner solution that respects the humanity of every owner of an erosion control and stormwater management 2017 WSNA Legislative individual affected by the president’s recent company, and he is a strong supporter of workers’ rights. During Voting Record: 100% decision to rescind the executive action for the 2017 legislative session, he achieved a 100 percent voting 2017 Primary Election: 58.35% those with DACA status. We support nurses record on WSNA legislative priorities – supporting safe nurse like Jessica who are contributing so much to staffing and opposing right-to-work legislation. In his candidate 0 votefortunato.org interview with WSNA, Senator Fortunato stated that he will be the health of patients in our state. a champion for uninterrupted rest and meal breaks for nurses. “The future is just uncertain,” Jessica said. “I’m hoping something better will come out of this.” ■ Rebecca Saldana for Senate 37th Legislative District AT A GLANCE Rebecca Saldana was appointed to the Washington State Senate áá Read the full statement from WSNA at Party: Democrat http://wsna.to/DACAstmt. when Pramila Jayapal was elected to Congress. Senator Saldana is the executive director of Puget Sound Sage, a community- Occupation: Executive Director based organization that advocates for racial and social equity, of Puget Sound Sage and she is a former union organizer. In the Senate, she serves on 2017 WSNA Legislative Voting the Commerce, Labor & Sports Committee (which held hearings Record: 80% (based on five bills) on safe nurse staffing and uninterrupted rest breaks legislation) and the Transportation Committee. During her first session 2017 Primary Election: 97.75% in the Legislature, Senator Saldana achieved an 80 percent 0 rebeccasaldana.com voting record on WSNA legislative priorities – supporting the vast majority of nursing issues. She holds a Bachelor of Arts in theology and humanities from Seattle University. PHOTOS: NATHASJA SKORUPA NATHASJA PHOTOS:
34 The Washington Nurse FALL 2017 wsna.org LEGISLATIVE AFFAIRS PAC-endorsed candidates
Manka Dhingra for Senate 45th Legislative District AT A GLANCE
Manka Dhingra is a senior deputy prosecutor with the King Party: Democrat County Prosecuting Attorney’s Office, where she supervises Occupation: Senior Deputy the Regional Mental Health Court, the Veterans Court, and the King County Prosecutor Community Assessment and Referral for Diversion program. 2017 Primary Election: 51.49% As a mental health and crisis intervention expert, Manka collaborates with and trains law enforcement on appropriate 0 electmanka.com response. She serves on the Board of NAMI (National Alliance on Mental Illness) Eastside. She graduated from the University of Washington School of Law and earned her Bachelor of Arts degree from the University of California at Berkeley. In her candidate interview, Manka discussed the importance of workers’ rights and clearly understood the challenges nurses face with staffing and intermittent rest breaks.
From left: Hilke Faber, Rebecca Saldana, Patty Kuderer for Senate JacquelineHermer and Jill Yang
48th Legislative District AT A GLANCE
Patty Kuderer was appointed to the Senate seat vacated Party: Democrat when Cyrus Habib was elected Lieutenant Governor in 2016, and she previously served in the Washington State House of Occupation: Attorney Representatives since 2015. Her more than 30-year legal career 2017 WSNA Legislative Voting has spanned public and private sector law, including helping Record: 80% (based on five bills) individuals in employment discrimination cases. Senator 2017 Primary Election: 61.35% Kuderer believes that health care is a right, and she serves as ranking minority member on the Senate Health Care Committee. 0 pattykuderer.nationbuilder.com During her first session in the Senate, Senator Kuderer achieved an 80% voting record on WSNA legislative priorities, voting in support of safe nurse staffing and the school nurse supervision bill. She earned her law degree from William Mitchell College of Law and her bachelor’s degree from the University of Minnesota. From left: Steph Weil, Manka Dhingra and Tara Barnes Vandana Slatter for House 48th Legislative District AT A GLANCE
Dr. Vandana Slatter was appointed to the Washington State Party: Democrat House of Representatives in 2017. In her first term, Rep. Slatter achieved a 100 percent voting record on WSNA legislative Occupation: Pharmacist priorities – and she signed on as a sponsor of the safe nurse 2017 WSNA Legislative staffing bill (HB 1714), the rest breaks bill (HB 1715) and the Voting Record: 100% school nurse supervision bill (HB 1432). She sits on the House 2017 Primary Election: 76.96% Health Care & Wellness Committee, as well as the Education Committee and Technology & Economic Development 0 vandanaslatter.com Committee. Rep. Slatter is a pharmacist, a former Bellevue City councilmember and a health care and biotech professional, and has served on the Overlake Hospital Board of Trustees. She earned a Doctor of Pharmacy and a Master of Public Administration degree, both from the University of Washington. From left: Steph Weil, Vandana Slatter, Patty Kuderer and Tara Barnes PHOTOS: NATHASJA SKORUPA NATHASJA PHOTOS:
wsna.org The Washington Nurse FALL 2017 35 LEGISLATIVE AFFAIRS Legislator voting record
2017 legislator voting record As part of its endorsement process, the WSNA-PAC Board reviews the voting records of candidates currently serving in the Legislature, or incumbents. The 2017 Legislator Voting Record was developed based on priority bills that WSNA supported during the 2017 state legislative session. Not all WSNA priority bills were voted on in both chambers, which is why the bills lists differ from Senate to House. As the voting records below indicate, most nursing issues have bipartisan support in Olympia.
Bill Vote
1. HB 1714 Safe Nurse Staffing L Yes 2. HB 1715 Nurse Rest & Meal Breaks G No E Excused 3. HB 1346 School Nurse Supervision R Resigned 4. HB 1432 Foundational Public Health Services 5. HB 2114 Balanced Billing (Medical Debt) 6. HB 1427 Opioid Treatment Programs 7. SB 5975 Paid Family and Medical Leave 8. SB 5800 Mental Health Provider Duty to Warn (Volk Bill)
Senator District 1 3 6 7 8 Senator District 1 3 6 7 8
Angel, Jan (R) 26 G L L G L McCoy, John (D) 38 L L L L G Bailey, Barbara (R) 10 L L L G L Miloscia, Mark (R) 30 L L L L G Baumgartner, Michael (R) 6 L L L G L Mullet, Mark (D) 5 L L L L L Becker, Randi (R) 2 L L L L L Nelson, Sharon (D) 34 L L L L G Billig, Andy (D) 3 L L L L L O'Ban, Steve (R) 28 L L L L L Braun, John (R) 20 L L L L L Padden, Mike (R) 4 L L L G G Brown, Sharon (R) 8 G L L G L Palumbo, Guy (D) 1 L L L L L Carlyle, Reuven (D) 36 L L L L L Pearson, Kirk (R) 39 L L L G L Chase, Maralyn (D) 32 L L L L L Pedersen, Jamie (D) 43 L L L L G Cleveland, Annette (D) 49 L L L L G Ranker, Kevin (D) 40 L E L L L Conway, Steve (D) 29 L L L L G Rivers, Ann (R) 18 L L L L L Darneille, Jeannie (D) 27 L L G L L Rolfes, Christine (D) 23 L L L L L Ericksen, Doug (R) 42 L L L G L Rossi, Dino (R) 45 L L L G L Fain, Joe (R) 47 L L L L L Saldaña, Rebecca (D) 37 L L L L G Fortunato, Phil (R) 31 L L L L L Schoesler, Mark (R) 9 G L L L L Frockt, David (D) 46 L E G L G Sheldon, Tim (D) 35 L L L G L Hasegawa, Bob (D) 11 L L L L G Short, Shelly (R) 7 G L L G L Hawkins, Brad (R) 12 L L L G L Takko, Dean (D) 19 L L L L L Hobbs, Steve (D) 44 L L L L L Van De Wege, Kevin (D) 24 L L L L G Honeyford, Jim (R) 15 G L L G L Walsh, Maureen (R) 16 L L L L L Hunt, Sam (D) 22 L L L L G Warnick, Judy (R) 13 G L L L L Keiser, Karen (D) 33 L L G L G Wellman, Lisa (D) 41 L L L L G King, Curtis (R) 14 L L L L L Wilson, Lynda (R) 17 G L L L L Kuderer, Patty (D) 48 L L L L G Zeiger, Hans (R) 25 L L L L L Liias, Marko (D) 21 L L L L G
36 The Washington Nurse FALL 2017 wsna.org LEGISLATIVE AFFAIRS Legislator voting record
Representative District Pos. 1 2 3 4 5 6 7 Representative District Pos. 1 2 3 4 5 6 7
Appleton, Sherry (D) 23 1 L L L L L L L Macri, Nicole (D) 43 1 L L L L L L L Barkis, Andrew (R) 2 1 L G L L G L G Manweller, Matt (R) 13 2 L G L L G L L Bergquist, Steve (D) 11 2 L L L L L L L Maycumber, Jacquelin (R) 7 1 G G L L G G G Blake, Brian (D) 19 2 L L L L L L L McBride, Joan (D) 48 2 L L L L L L L Buys, Vincent (R) 42 2 L G L L G L G McCabe, Gina (R) 14 2 L L L L L L L Caldier, Michelle (R) 26 2 E G L G L L G McCaslin, Bob (R) 4 2 L G L G L G G Chandler, Bruce (R) 15 1 L G L G G E G McDonald, Joyce (R) 25 2 L G L G L L L Chapman, Mike (D) 24 1 L L L L L L L Morris, Jeff (D) 40 2 L L L L L L E Chopp, Frank (D) 43 2 L L L L L L L Muri, Dick (R) 28 1 L G L L L L L Clibborn, Judy (D) 41 2 L L L L L L L Nealey, Terry (R) 16 2 L G L L L L G Cody, Eileen (D) 34 1 L L L L L L L Orcutt, Ed (R) 20 2 L L L L L G G Condotta, Cary (R) 12 1 L G L L G G G Ormsby, Timm (D) 3 2 L L L L L L L DeBolt, Richard (R) 20 1 E L L L L L G Ortiz-Self, Lillian (D) 21 2 L L L L L L L Dent, Tom (R) 13 1 L G L L G L L Orwall, Tina (D) 33 1 L L L L L L L Doglio, Beth (D) 22 2 L L L L L L L Pellicciotti, Mike (D) 30 1 L L L L L L L Dolan, Laurie (D) 22 1 L L L L L L L Peterson, Strom (D) 21 1 L L L L L L L Dye, Mary (R) 9 1 L G L L L L G Pettigrew, Eric (D) 37 2 L L L L L L L Farrell, Jessyn (D) 46 2 L L L L L L R Pike, Liz (R) 18 2 L G L G L L G Fey, Jake (D) 27 2 L L L L L L L Pollet, Gerry (D) 46 1 L L L L L L L Fitzgibbon, Joe (D) 34 2 L L L L L L L Reeves, Kristine (D) 30 2 L L L L L L L Frame, Noel (D) 36 1 L L L L L L L Riccelli, Marcus (D) 3 1 L L L L L L L Goodman, Roger (D) 45 1 L L L L L L L Robinson, June (D) 38 1 L L L L L L L Graves, Paul (R) 5 2 L G L L L L L Rodne, Jay (R) 5 1 L G L L L G G Gregerson, Mia (D) 33 2 L L L L L L L Ryu, Cindy (D) 32 1 L L L L L L L Griffey, Dan (R) 35 1 L G L G L L G Santos, Sharon Tomiko (D) 37 1 L L L L L L L Haler, Larry (R) 8 2 L G L L G G L Sawyer, David (D) 29 1 L L L L L L L Hansen, Drew (D) 23 2 L L L L L L L Schmick, Joe (R) 9 2 L G L L L L G Hargrove, Mark (R) 47 1 L G L L L L G Sells, Mike (D) 38 2 L L L L L L L Harmsworth, Mark (R) 44 2 L G L L L L L Senn, Tana (D) 41 1 L L L L L L L Harris, Paul (R) 17 2 L G L L L L L Shea, Matt (R) 4 1 L G L G L G E Hayes, Dave (R) 10 2 L G L L L L E Slatter, Vandana (D) 48 1 L L L L L L L Holy, Jeff (R) 6 2 L L L L L L E Smith, Norma (R) 10 1 L E L L L G L Hudgins, Zack (D) 11 1 L L L L L L L Springer, Larry (D) 45 2 L L L L L L L Irwin, Morgan (R) 31 2 L G L L L G G Stambaugh, Melanie (R) 25 1 L G L G L L L Jenkin, Bill (R) 16 1 L G L L L L G Stanford, Derek (D) 1 1 L L L L L L L Jinkins, Laurie (D) 27 1 L L L L L L L Steele, Mike (R) 12 2 L G L L G L G Johnson, Norm (R) 14 1 L G L L L L G Stokesbary, Drew (R) 31 1 L G L L G G L Kagi, Ruth (D) 32 2 L L L L L L L Stonier, Monica Jurado (D) 49 2 L L L L L L L Kilduff, Christine (D) 28 2 L L L L L L L Sullivan, Pat (D) 47 2 L L L L L L L Kirby, Steve (D) 29 2 L L L L L L L Tarleton, Gael (D) 36 2 L L L L L L L Klippert, Brad (R) 8 1 L G L L G G G Taylor, David (R) 15 2 G G G G G G G Kloba, Shelley (D) 1 2 L L L L L L L Tharinger, Steve (D) 24 2 L L E L L L L Koster, John (R) 39 2 L G L L L L G Van Werven, Luanne (R) 42 1 L G L L G L L Kraft, Vicki (R) 17 1 L G L L L L G Vick, Brandon (R) 18 1 L G L G G L G Kretz, Joel (R) 7 2 L G L L G G G Volz, Mike (R) 6 1 L L E L L G G Kristiansen, Dan (R) 39 1 L G L L G L G Walsh, Jim (R) 19 1 L G L L L L G Lovick, John (D) 44 1 L L L L L L L Wilcox, J.T. (R) 2 2 L G L L G L L Lytton, Kristine (D) 40 1 L L L L L L L Wylie, Sharon (D) 49 1 L L L L L L L MacEwen, Drew (R) 35 2 L G L G L L L Young, Jesse (R) 26 1 L G L G L G G
wsna.org The Washington Nurse FALL 2017 37 LEGISLATIVE AFFAIRS WSNA-PAC Here’s why nurses are contributing to the WSNA-PAC — and why you should, too To contribute to the WSNA-PAC fund, please visit www.wsna.org/pac/donate where you can make a one-time donation or sign up for monthly contributions.
“I believe in supporting the “I challenge all Washington “I give to our WSNA-PAC “When I received the WSNA-PAC so that we can state nurses to provide because now is the time for us endorsement and contribution advocate for healthy work financial support to the to step up as nurses to protect from the WSNA-PAC, I was environment laws, safe PAC. Think about donating many of our patient safety absolutely thrilled. I knew staffing laws, and find those the equivalent of a cup of and workplace safety gains.” that my colleagues were candidates that are willing coffee a month, or making Kathleen Lange, RN behind me, and I was with to go to the state Legislature a PAC contribution equal them. We need to give to and advocate for us.” to one hour of your pay.” our WSNA-PAC. We must Clarise Mahler, RN Chris Birchem, RN have nurses, and people who support nurses, representing us in elected office.” Lynnette Vehrs, RN Former legislative candidate
PAC FACTS
What is WSNA-PAC? Where does WSNA-PAC Who serves on the WSNA- The Washington State Nurses Association Political money come from? PAC Board of Trustees? Action Committee (WSNA-PAC) was established All WSNA-PAC funds are currently raised Current board members are listed on the to contribute support for statewide and state independently from voluntary individual WSNA-PAC Board of Trustees webpage at legislative candidates who have demonstrated donations. No WSNA dues money is used to www.wsna.org/pac/trustees. their belief and commitment to the legislative and support candidates. regulatory agenda of the Washington State Nurses How do I get involved with Association. Who can contribute to the WSNA-PAC? the WSNA-PAC? Please contact Nathasja Skorupa, WSNA political How does WSNA-PAC WSNA members and non members can contribute action specialist, at 206-575-7979, ext. 3005, or decide who to endorse? to the WSNA-PAC. [email protected]. Endorsed candidates are strong on nursing and How do I contribute to patient safety issues, regardless of political How does WSNA-PAC decide which the WSNA-PAC? affiliation, and must complete a candidate candidates to contribute to? To contribute to the WSNA-PAC fund, please questionnaire and an interview. Incumbents’ The WSNA-PAC Board consists of 11 members visit www.wsna.org/pac/donate where you can voting records are considered, and the district’s whose role is to make endorsement and financial make a one-time donation or sign up for monthly past voting patterns are also taken into account. contribution decisions in statewide and state contributions. legislative elections. Please see p. 34 to learn more about WSNA-PAC’s endorsement process.
38 The Washington Nurse FALL 2017 wsna.org LABOR RELATIONS Also in this section Recently settled contracts ------40 Video gets the word out about floating - 41 Listening to engage and empower - - - 42
Washington State Labor Council Convention: WSNA resolution on rest breaks and mandatory overtime approved
WSNA sent 25 delegates to the Washington State Labor Council Convention, held in Vancouver July 18-20. They joined hundreds of delegates representing unions across the state. The theme of the convention was “Resist and Persist” and featured AFL-CIO Secretary-Treasurer Liz Shuler, Washington Governor Jay Inslee and Attorney General Bob Ferguson, among others. “Have we been here before? Has it ever been easy to be in the labor movement?” asked AFL-CIO Secretary-Treasurer Liz Shuler in her keynote address. “Now is the time to remember why we are in the labor movement for the first place. It‘s because we care about people. People we love. People we will never meet.” Convention delegates celebrated recent wins, such as passage of the paid family leave law in Olympia and last fall’s labor-led Initiative 1433 that is raising the state minimum wage to $13.50 and allowing all workers to earn paid sick leave. They also honored the work of people like Attorney General Bob Ferguson, who led Washington’s successful legal effort against the Trump administration’s Muslim travel ban, and Jorge Barón, executive director of the Northwest Immigrant Rights Project, for his extraordinary efforts to fight for the rights of immigrant workers and their families in Washington state. WSNA submitted a resolution on rest breaks and mandatory overtime that was approved by the Julia Barcott, chair of WSNA’s Cabinet on Economic and General Welfare delegates. St. Joe’s Tacoma nurse John Gustafson addressed the delegates in support of the WSNA- submitted resolution. (See below for the full text of this resolution.) Delegates also approved a Safe Patient Care resolution calling upon Congress and state legislatures to pass safe patient care legislation that would ensure proper nurse staffing that is fundamental to keeping patients safe from infections and other health hazards.
In Support of Rest Breaks and Closing the Mandatory Overtime Loophole for Registered Nurses and Healthcare Workers to Increase Patient Safety Resolution 17
WHEREAS, patients and their families expect to receive nurse or worker must return to the job before the break Now, therefore, be it exceptional medical care in Washington’s healthcare is finished; and RESOLVED, that the Washington State Labor Council, facilities and hospitals; and WHEREAS, a Washington state arbitrator recently stated AFL-CIO, and its affiliates will promote legislation that WHEREAS, medical errors are now the third leading that “the requirement of a nurse on break to be ‘on requires all healthcare workers to receive uninterrupted cause of death in the United States, just behind heart call’ diminishes the purpose of a break from work”; and meal and rest breaks; and be it further disease and cancer, according to a 2016 study by WHEREAS, other professions have recognized that RESOLVED, that the Washington State Labor Council, researchers at Johns Hopkins Medicine which estimates fatigue endangers public safety and have responded AFL-CIO, and its affiliates will promote legislation that that more than 250,000 patients are killed by medical by instituting strict limits on overtime and by mandating closes the mandatory overtime loophole by clarifying errors each year; and uninterrupted rest breaks; and that employers may not use prescheduled on-call WHEREAS, registered nurses intercept eighty-six WHEREAS, after working a ten or twelve-hour shift, time to fill chronic or foreseeable vacancies due to percent of medication errors before there is harm to many nurses and healthcare workers are called back staff shortages and that limits mandatory overtime patients; and for mandatory overtime as hospitals and health care in hospitals and healthcare facilities; and be it finally WHEREAS, often the staffing needs of a department facilities respond to chronic nursing shortages by RESOLVED, that the Washington State Labor Council, may also necessitate the need for more CNAs, technical activating on-call nurses; and AFL-CIO, and its affiliates will support Washington workers, or other healthcare professionals who provide WHEREAS, nurses and healthcare workers who work state nurses and healthcare workers and incorporate direct patient care; and shifts of twelve and a half hours or longer are three the issue of rest breaks into its 2018 state legislative WHEREAS, registered nurses and healthcare workers times more likely to miss things, putting patients at agenda. often work a ten or twelve hour shift without time to risk; and take rest or meal breaks, and when rest or meal breaks WHEREAS, these practices are not safe for nurses, do happen, they are often interrupted, meaning the healthcare workers, or their patients;
wsna.org The Washington Nurse FALL 2017 39 LABOR RELATIONS Contracts
Recently settled contracts
Wage Increases Other Compensation Changes Other Changes
Multicare ÎÎ New step 32 ÎÎ Preceptor pay to apply to all students Good ÎÎ Charge nurse premium increased to $2.50 per ÎÎ Nurses cannot be required to care for more Samaritan hour patients than the staffing matrices allow except in “emergent circumstances” Hospital 1st year 4% Puyallup ÎÎ Contract forbids management from making 2nd year 2% unilateral changes to each unit’s staffing ratios ÎÎ Increased PTO cash out option from 40 hours to 3rd year 2% 80 hours ÎÎ Stronger grievance rights language ÎÎ Improved access to new employees during orientation process
Overlake ÎÎ Increased charge nurse premium to $2.75 per ÎÎ Employer will hire 8 additional .9FTE RN’s into the Hospital hour day shift float pool primarily for break relief. Medical Center ÎÎ Increased charge nurse premium to $5 per hour ÎÎ Improved low census language Bellevue on night shift ÎÎ WSNA representative allowed to attend Safe 1st year 4% Staffing Committee meetings 2nd year 3% ÎÎ Just Cause provision extended to per diem nurses 3rd year 2.75% ÎÎ Educational leave extended to .9 FTE RN’s not just 1.0 FTE RN’s ÎÎ Limited successorship language ÎÎ Improved new employee orientation access language
Providence ÎÎ PM shift differential increased to $3 ÎÎ Nurses may be reimbursed up tp $500 per year Holy Family ÎÎ Noc shift differential increased to $4 for certification and other educational program Hospital ÎÎ Callback minimum pay increased to 3 hours at fees. 1st year 3.25% Spokane 1 1/2x. ÎÎ Enhanced language for mandatory in-services 2nd year 3% ÎÎ Preceptor pay increased to $1.50 per hour and rest between shifts calculation ÎÎ Enhanced language regarding the hospital’s 3rd year 3% responsibility to provide safe staffing ÎÎ Improved clinical grouping language ÎÎ Expanded bereavement leave provisions
Seattle/King ÎÎ ARNPs to receive 3% additional ÎÎ Unpaid religious holidays — employee may County Public effective Jan. 1, 2017 request up to 2 unpaid holidays for reasons of Health - Staff ÎÎ Ratification bonus of $650 per RN faith or conscience Nurses 1st year 2.25% ÎÎ Nurses working night shift in the jail are eligible ÎÎ Expanded alternative shift language in the jails for reimbursement for parking in Goat Hill Garage ÎÎ Aligned nurses King County family medical Seattle 2nd year 2.25% ÎÎ New certification premium pay provision leave language with that of other King County 3rd year 2.25% ÎÎ Daily overtime will be paid at the overtime rate if employees a nurse is mandated to work beyond their shift ÎÎ New paid parental Leave benefit ÎÎ Reduced grievance procedure from 4 steps to 3 ÎÎ Established a new committee on flexible staffing
Skagit Valley ÎÎ Established premium of $400 per exam for SANE ÎÎ Improved language for training and supervision Hospital RNs of resident nurses Mt. Vernon ÎÎ Employer may assign RN as surgical services ÎÎ Enhanced definition of preceptor 1st year 2% resource nurse and pay $1.50 per hour premium ÎÎ New language requiring conference committee 2nd year 2% to meet at least 4 times per year ÎÎ Several improvements to pay, training and scheduling for hospice nurses, including clarification of mileage language
Skyline ÎÎ Preceptor pay increased to $2 per hour ÎÎ Enhanced language: safety, breaks and PTO use Hospital 1st year 8% ÎÎ Evening shift differential increased to $2.25 per ÎÎ Full recognition of past experience, regardless of White Salmon hour hiring date 2nd year 3% ÎÎ Noc shift differential increased to $4.25 per hour ÎÎ Improved access for WSNA reps 3rd year 2% ÎÎ Certification, BSN and MSN premiums increased ÎÎ Increased holiday on-call pay
40 The Washington Nurse FALL 2017 wsna.org LABOR RELATIONS Floating video
WSNA video about nurse floating gets the message out This summer, WSNA noted a growing problem in contract negotiations around the state. Increasingly, hospitals were coming to the bargain- ing table with proposals to expand floating beyond nurses’ clinical areas. We all know that’s just not safe. In response, WSNA Nurse Organizer Sydne James created a video to illustrate just how ridiculous these proposals are by offering some extreme scenarios. The video reached 49,000 people on Facebook and was viewed nearly 17,000 times. Here’s what Sydne had to say about creating the video: “What I liked about making this video was how willing everyone was to help make it happen, and we had fun doing it. Although this video was light-hearted and farcical, it was about a really important issue and it resonated with nurses. Using short videos on social media can be a very impactful tool to get information to our members, to advance issues, to get support, etc. They are not difficult to make and they are really popular right now. Plus, it’s fun! I hope our members will bring ideas of videos they would like to see and we can help RNs make more such videos.”
áá Didn’t get to see the video? Find it on WSNA’s Facebook page at www.facebook.com/pg/myWSNA/videos.
Recently settled contracts
Wage Increases Other Compensation Changes Other Changes
PeaceHealth ÎÎ On-call pay increased to $4.10 per hour ÎÎ Fair share membership- all newly hired RN’s will Southwest ÎÎ Evening shift differential increased to $5.70 per be requied to pay fair share fee’s Medical Center 1st year 4% hour ÎÎ Greatly improved break language Vancouver 2nd year 4.25% ÎÎ Preceptor pay increased for $2 per hour ÎÎ Enhanced staffing language ÎÎ Incentive Pay Pilot Program initiated ÎÎ Limited successorship language 3rd year 4.25% ÎÎ Improved parity language ÎÎ Improved grievance procedure ÎÎ Improved staffing committee language
University of 1st year 2% ÎÎ Stand-by premium increased to $4 per hour for ÎÎ Enhanced rest/meal break recording language Washington the first 49 hours and $6.25 per hour for 50 or ÎÎ Enhanced Clinical Float Pool language 2nd year 2% Medical Center more hours per pay period Seattle 3rd year 2%
Viriginia Mason ÎÎ 7 new steps added ÎÎ Enhanced rest/meal break recording language Medical Center 1st year 3% ÎÎ PM shift differential increased to $3 per hour ÎÎ Enhanced Clinical Float Pool language Seattle 2nd year 2.75% ÎÎ Noc shift differential increased to $5 per hour 3rd year 2.5% ÎÎ Week-end premium increases to $4.25 ÎÎ Certification pay increased to $1.60 per hour
Whatcom ÎÎ Clarification of county medical plan contributions County Health 1st year 2.25% ÎÎ Established a pilot program for 0.9 FTE schedule Department 2nd year 2.5% Bellingham
wsna.org The Washington Nurse FALL 2017 41 LABOR RELATIONS Organizing District News
DISTRICT 3 Pierce County Nurses Association
PCNA is proud to announce our next president is Tami Green! Many of you know her from her work in the Washington State Legislature. It is an honor to share this exciting news with everyone, and we hope many of you will come to The art of listening to our events and meet her. All members engage and empower are welcome at our monthly meetings, scheduled for the first Thursday of the By Tara Goode, BA, BSN, RN WSNA Assistant Director of Organizing month from 4:30 to 6 p.m. It is always sad to say farewell to board members who relinquish their Have you ever wondered why some people are better communicators than others? I have an seats. Thank you, Karen Tranholt and idea that I believe explains this phenomenon. Angele Bouche, for all your time and effort. Some people are listeners. Some people are talkers. Welcome to Rachel deSousa and Shannon Some people know how to balance both to achieve their desired outcome. Lynn. New people means new ideas and a chance to review our goals and plans. In the world of organizing, the latter is the most important. Knowing when to hold your input and comments and just hear someone out is a challenge. We’re nurses. We want to fix Defining Hope problems. When someone comes to us with an issue, we naturally and instinctively want We are working with WSNA to present the to make it better for them. There’s the rub. In organizing, the idea is not to solve a problem film “Defining Hope” Nov. 1, 2017. Along with for someone. The idea is to engage them in working to solve their own problems through the screening there will also be CE awarded for collective action. viewing this film. Please Like us on Facebook or The question then becomes, how do you have a conversation that empowers the nurse contact us via piercecountynurses.com for more to use their critical thinking skills and passion for the profession to come up with their own specific time and location. solution? It’s called an organizing conversation, and it’s pure magic when you use it well. PCNA 5th Annual Bowling Tournament What exactly is an organizing conversation? The first thing to understand is that it’s 80 percent listening, so you’re not actually doing a lot of back-and-forth conversing. Next, you Saturday, Feb. 24, noon – 2 p.m. Pacific Lanes Bowling Alley go into the conversation with a plan to get to a particular outcome: You want to engage the nurse in using the tools in their contract or shared governance process to map out their own $25 registration fee plan to achieve their goal. Register online at www.piercecountynurses.com There is no absolute right or wrong way to have these conversations. What you’re trying to Join us in raising money for nursing scholarships! do is find out what the issue is, determine how it got that way, identify what would be better, Registration fee includes two games of bowling, and figure out how to get there. It is also good to brace a nurse for potential push back from shoe rental and a light lunch. Trophies awarded leadership on their ideas so the nurse goes in with eyes wide open. for highest-scoring team and individuals as The final key element to an organizing conversation is to have an “ask.” An ask is con- well as Most Team Spirit. Grab your friends and firmation that a nurse will commit to working on the solution. Sometimes, it’s as simple as co-workers and form a team! All proceeds go to the PCNA Scholarship Fund. coming up with a plan or having another conversation with you so they continue to pursue their goal. Other times, your ask may be committing to talk to other people to recruit them To stay up to date on our PCNA to join in their efforts to make a change collectively. events and activities As any good organizer does, I have an ask for you. Two actually. Will you commit to talk- Like us on Facebook ing to your colleagues about your working conditions and issues impacting the profession? facebook.com/piercecountynurses/ Then ask yourself, “What am I prepared to do about it?” ■ Get on our email mailing list Email us at [email protected] to be added to our distribution lists Visit our website www.piercecountynurses.com
42 The Washington Nurse FALL 2017 wsna.org District News
DISTRICT 2 King County Nurses Association
This fall and into 2018, King County Dinner Seminar: Substance Use 2018 Nurses Association will offer a number Disorder – It Can Happen to You Dinner Seminar: Human Trafficking of continuing nursing education Wednesday, Dec. 6, 5:30 – 8 p.m. events on a variety of current topics Good Shepherd Center, Wallingford (Seattle) Thursday, Jan. 25, 5:30 – 8 p.m. Good Shepherd Center, Wallingford (Seattle) of interest to nurses. Unless otherwise This course is designed to address substance noted, events are open to all nurses use disorder within the general population and This session will raise awareness regarding the and nursing students. Details and among health care providers. Participants will prevalence, risk factors and health consequences of sex trafficking, with Kelly Martin-Vegue, RN, registration at www.kcnurses.org, learn the signs and symptoms, treatment options, MSW, The Center for Children & Youth Justice. “Education and Events.” legislative actions, and the role of nursing in addressing this national health care crisis. Speaker Washington state has implemented a trauma- informed response protocol; the speaker will 2017 Heather Stephen-Selby, BSN, MSN ARNP-BC, RN, is assistant executive director of nursing practice, discuss principles and identify resources. Register Dinner Seminar: Money Matters education and research at WSNA. Register by Jan. 22. by Dec. 4. Tuesday, Oct. 24, 6:30 – 8:30 p.m. Seminar: Ethics Conversations Ivar’s Salmon House, Seattle Washington State Nurses Association CNEPP (OH-231, & Health Equity 9/1/2018) is an approved provider of continuing nursing KCNA MEMBERS ONLY. This FREE, no-obligation education by the Ohio Nurses Association (OBN-001-91), an Saturday, Feb. 10, 8:30 a.m. – 1 p.m. workshop is designed to provide an overview of accredited approver by the American Nurses Credentialing Good Shepherd Center, Wallingford (Seattle) financial planning and investing. Speaker Adrian Center’s Commission on Accreditation. Hedwig is financial advisor at Salal Investment This workshop will feature three interactive Services. Join KCNA’s MentorLink sessions exploring ethics, upscaling social justice practice for health equity and value-based care, Register by Oct. 16. The KCNA MentorLink and mindfulness. Speakers include: Anne Poppe, program provides a way to PhD, MN, BSN, BA, RN; Doris M. Boutain, PhD, RN, Fall Nursing Summit: connect KCNA members with other members PHNA-BC; and Christine Prenovitz, MSW, E-RYT. Learning About (new nurses or nurses new to a position) and Homelessness nursing students to facilitate supportive mentor District Meeting: Conversations with Monday, Nov. 20, 5:30 – 8 p.m. relationships. This is the third year of the program, the New WSNA Executive Director Good Shepherd Center, open to any KCNA member. Mentors share Wednesday, Feb. 28, 5:30 – 7:30 p.m. Wallingford (Seattle) professional expertise, while students and new nurses learn how to find greater satisfaction in Good Shepherd Center, Wallingford (Seattle) 1.5-hour Certificate of Completion their professional pursuits. Each team sets its 1.5-hour Certificate of Completion The summit will include two parts: own schedule for meeting or chatting in sessions Sally Watkins, PhD, RN, executive director of • The Meaning of Home: Nursing’s Role in designed to be fun, flexible and inspirational. Washington State Nurses Association, provides Effectively Addressing Homelessness, with Minimum commitment is six months; most teams leadership in multiple areas, including legislation, Josephine Ensign, DrPH, RN, NP-C, author have contact every few weeks. health policy, nursing practice, advocacy and labor of “Catching Homelessness: A nurse’s To get involved: relations. Hear about current WSNA activities and story of falling through the safety net” 1. Complete the application at legislative updates for 2018, and ask any burning • Taking Action for the Homeless: help pack www.kcnurses.org/members/mentorlink questions you may have. Register by Feb. 22. 400 cold kits for distribution to vendors via and return by Monday, Nov. 6. There is Real Change. Real Change representatives, no cost to participate in this program. Dinner Seminar: Health Care Ethics including Vendor of the Year, will be on hand. Discussion: Henrietta Lacks and Beyond 2. Attend orientation on Wednesday, Nov. 29, Register by Nov. 13. 5:30-8 p.m. The event will include dinner. Wednesday, March 28, 5:30 – 8 p.m. Good Shepherd Center, Wallingford (Seattle) 2.0-hour Certificate of Completion Join Bridget Carney, PhD, RN, healthcare ethicist, to discuss the book “The Immortal Life of Henrietta Lacks” and bioethics issues related to the medical use of patient tissue and genetic material. Registration fee includes a copy of the book; register by March 1 and KCNA will mail it to you. Final registration deadline March 19.
wsna.org The Washington Nurse FALL 2017 43 HALL OF FAME Nominations for 2018
In 1996, the Washington State Nurses Association unveiled its Hall of Fame, recognizing the dedication and achievements of Washington state registered nurses who have made significant lifetime contributions to the nursing profession. Every two years we induct a new group of outstanding nurse leaders and practitioners into the Hall of Fame.
2016 2006 Kathryn E. Barnard, PhD, RN, FAAN Pat Greenstreet, BSN, JD, RN Marie Annette Brown, PhD, RN, ARNP, FNP-BC, FAAN Barbara Innes, EdD, RN Barbara Frye, BSN, RN Paul Kunkel, MS, RN Renee Hoeksel, PhD, RN Frank T. Maziarski, CRNA, BSN, MS, CLNC Vivian Lee, MPA, BSN, RN Lois Price-Spratlen, MN, PhD, RN, CNS, FAAN Bonnie Sandahl Todd, MN, ARNP Susan Wilburn, BSN, MPH, RN
2014 2004 Joan M. Caley, RN, MS, CNS, CNL, NEA, BC Marjorie Batey, PhD, RN, FAAN Col. Margarethe Cammermeyer, (Ret.) PhD, RN Bobbie Berkowitz, PhD RN, FAAN Thelma Cleveland, PhD, RN Janice Ellis, PhD, RN Maxine Davis Haynes, MN, RN Beverly M. Horn, PhD, RN, FAAN Janet Primomo, PhD, RN Erin King, RN, MN Rheba De Tornyay, EdD, RN, FAAN Jeanne Quint Benoliel, PhD, RN, FAAN
2012 2002 Helen Behan, MN, RN Eunice Cole, RN, BSN Helen Kuebel, MSN, RN Barbara Thoman Curtis, RN Frankie T. Manning, MSN, RN Rosa Franklin, RN Maureen B. Niland, PhD, MS, BSN, RN Patty Longstreet Hayes, RN Gretchen Schodde, MN, ARNP, FNP-BC Margarita Prentice, RN Beverly Smith Louise Shores, RN, EdD
2010 2000 Mary Bartholet, MS, RN Mary Lee Bell, MPA, BSN, RN-C Anna Mae Ericksen, RN Joanna Boatman, RN Verna Hill, MN, BSN, RN Shirley M Gilford, BSN, RN Louise Kaplan, PhD, MN, ARNP Muriel G Softli, MPA, MEd, BSN, RN Margaret M. Ouchi, MN, RN Frances Terry, MN, ARNP Thelma Pegues, MN, BSN Elizabeth R Thomas, BSN, ARNP
2008 1998 Anne Foy Baker, RN Marguerite Cobb, MN, RN Etta B. Cummings, RN Dolores “Deo” Little, MN, RN Sister John Gabriel, RN Mary Ann Thimmes, MN, RN Evelyn Hall, RN 1996 May S. Loomis, RN Betty Anderson, RN, BSN, M.Ed Anna R Moore, RN Betty Harrington, RN, BSN, M.Ed Lillian B Patterson, RN Janet Holloway, MA, RNC Elizabeth Sterling Soule, RN Katherine J Hoffman, RN, MN, PhD Minerva Blegen Sathe, RN Myrtle Warneke, RN
44 The Washington Nurse FALL 2017 wsna.org HALL OF FAME Nominations for 2018
Call for nominations for the 2018 Hall of Fame
Criteria Each nominee must have demonstrated excellence in the areas of patient care, leadership, education, public service, nurse advocacy, heroism, patient advocacy or clinical practice, and have achievements of value to nursing beyond the inductee’s lifetime. In addition, each inductee will have had a positive impact on the health and/or social history of Washington state through sustained, lifelong contributions. The nominee may be living or deceased. Nominations must be received by WSNA by Nov. 15, 2017, to be considered for the 2018 Award. Award winners will be notified in January 2018 and will be recognized by the Association, family, friends and nursing colleagues at the Hall of Fame Awards event to be held March 22, 2018, at Salty’s on Alki.
❚ Nominate either online at www.wsna.org/hall-of-fame or submit the paper application below.
Hall of Fame Nomination Form
Nominee
______First name Preferred if different Last name Credentials
______Street address
______City Zip code
______Home phone Work phone
______Fax number Email
Documentation oo On a separate sheet of paper identified as Criteria #1: Summarize this nominee’s WSNA membership background including membership dates, offices held and specific WSNA-related accomplishments. oo On a separate sheet of paper identified as Criteria #2: Describe how this nominee has demonstrated excellence in the areas of patient care, leadership, education, public service, nurse advocacy, heroism, patient advocacy or clinical practice. oo On a separate sheet of paper identified as Criteria #3: Describe how the achievements of this nominee will have enduring value to nursing beyond the inductee’s lifetime. oo On a separate sheet of paper identified as Criteria #4: Describe how this nominee has demonstrated excellence that affected the health and/or social history of Washington state through sustained, lifelong contributions. oo On a separate sheet of paper identified as Optional Criteria #5: Submit a history of the nominee’s professional achievements/peer recognition.
Nominee’s employment
______Current position or title
______Employer
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______City Zip code
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Submitting additional nursing employment background is encouraged to assist in publicizing this nominee, if chosen as an award recipient. Please attach on a separate piece of paper or submit CV.
wsna.org The Washington Nurse FALL 2017 45 HALL OF FAME Nominations for 2018
Relative
If the nominee is deceased, are there any known living relatives? ❑ o Yes o No
______Name of closest relative
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Nominator
______Person submitting nomination
______Nominator’s street address
______City Zip code
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______Fax number Email
______Relationship to nominee
Checklist oo The application form is complete on both the front and back oo The documentation to support award Criteria #1-4 and optional #5 are attached to the application in numerical order with a paper clip. oo A nominee photograph is included. Please do not write in ink on the back of the photograph or place a paper clip across the photo image, as both will cause damage to the photo.
46 The Washington Nurse FALL 2017 wsna.org In Memoriam
Betty M. Throughout her tenure as an educator at the their home in Edmonds, Washington. One of Verle’s ICNE, she provided leadership in sculpting the loves was fishing on their boat, the Halcyon. Anderson nursing program’s design, which for many years After the passing of John in 1996, Verle met Betty M. Anderson, was the only curriculum of its kind in the United Sidney Casey, who she married in a beautiful setting one of the founders of States. Subsequently, she felt the need to devise in Hawaii in January 2001. Verle continued to pursue the Washington State a program that would enable registered nurses her fishing ventures with Sid. Sid and Verle have University College of working in Walla Walla, the Tri-Cities, Yakima and spent many wonderful days traveling the world and Nursing and one of the Wenatchee to complete course and clinical work going on fishing ventures in B.C. Verle always said first inductees into the for their BSN. Eventually, under her leadership, the she was so very fortunate to have married two such Washington State Nurses Hall of Fame, died August Yakima program was expanded to also accept the wonderful husbands. Sid is a loving husband and has 13, 2017, at the age of 99. basic baccalaureate students. Betty’s futuristic always been by Verle’s side. Betty received her Bachelor of Science in nursing approach to nursing education and expertise in Verle is survived by her husband of 16 years, from the University of Washington and her masters’ working with colleagues and university officials Sidney Casey, step-sons John Beaunaux and his in education from Whitworth College. opened entirely new and innovative opportunities wife, Sandra, and James Beaunaux; along with five Betty was an innovative leader in nursing for the rural registered nurse to advance his or her grandchildren and six great-grandchildren. She is administration and education, where she devoted education. also survived by her sister-in-law, Hilde Bergman, 22 years of service in addition to her staff nursing. A Between her long tenure with St. Luke’s Memorial nephew and niece and their children, all of Canada. pillar of the nursing community, Betty was a driving Hospital as director of both nursing services and Verle is preceded in death by her parents, force in the development of a baccalaureate nursing nursing education, and with the ICNE as assistant husband John, daughter-in-law Arlene and brother program in Spokane. and associate dean, Betty served for two years Elmer. In the mid-1960s, there were no four-year nursing as director of nursing services and consultant to programs in Eastern Washington. Nurses in the Kootenai Memorial Hospital in Coeur d’Alene, Idaho, Patricia (Pat) Nasser Prinz region were educated in diploma programs offered where she established a women’s auxiliary and candy by area hospitals. Betty was among the visionary striper program. Pat was born July 18, 1941, in Huntington, West nurse leaders from Spokane who knew the bachelor’s For nearly five decades, Betty was an active Virginia, to parents Ruth Sammons Nasser of Louisa, degree would become increasingly important in the member of the Washington State Nurses Association, Kentucky, and Fred Nasser of Kfeir, Lebanon. Pat profession. contributing countless hours of work on numerous graduated from Huntington High School and Duke Betty was the director of nursing service and state-level commissions, boards and committees, and Stanford universities. She served as a teacher education at St. Luke’s Hospital in Spokane when which included the first WSNA Commission on and medical researcher of sleep and circadian she began discussions with others in the nursing Nursing Administration, the Committee on Public rhythms on the faculties of the Duke University profession about the need for additional nursing Relations and Membership and the Committee on Physiology Department and the University of instruction in the region. She went personally to Continuing Education. She served as treasurer of Washington Departments of Psychiatry and WSU with Betty Harrington to enlist the support of the Inland Empire Nurses Association, provided Biobehavioral Nursing. She served on numerous then-President Glenn Terrell for a baccalaureate leadership for two terms as president of the Spokane advisory committees for the National Institutes of nursing program that would allow associate degree League for Nursing and served as a member of the Health and as a Veterans’ Administration research and diploma-educated registered nurses to achieve Board of Directors of the Washington State League career scientist. a BSN degree. for Nursing Education. After retiring as a research professor emerita at They proposed an innovative solution: to Betty was the truest definition of “nurse leader” the UW, she worked with teens and adults affected create a consortium baccalaureate nursing (BSN) according to the people who worked with her – kind, by family patterns of addiction in Alateen and Alanon. program that would serve Eastern Washington, caring, strong and principled. Pat was a cancer survivor since 2006. She served in North Idaho and Western Montana. Betty and her four clinical trials of experimental cancer therapies and mentored other cancer survivors. Pat is survived colleague convinced Terrell to accept administrative Verle H. Beaunaux responsibility for this new program. by her beloved husband, Hugh MacMahon, M.D., Called the Intercollegiate Center for Nursing On April 3, 2017, Verle Halcyon Beaunaux passed her treasured daughter, Alyssa Prinz of Menlo Park, Education (ICNE), the consortium was the first of its away at Sunrise of Edmonds under hospice care. California, and by her sister, Yvonne Nasser Waters kind in the nation and included Eastern Washington Verle was born June 26, 1929, in New Denver, of St. Petersburg, Florida. Her brother, David Nasser State College (now Eastern Washington University), British Columbia, Canada, to Oscar and Elizabeth of St. Louis, Missouri, is deceased. Fort Wright College of the Holy Names, Washington Bergman. State University and Whitworth College (now She entered St. Joseph’s School of Nursing in Whitworth University). ICNE became a successful 1949 and later entered the Royal Columbia Hospital model for consortium colleges and universities School of Nursing, where she graduated in May 1952. nationwide. Verle moved to Seattle, Washington, and started The program opened in the summer of 1969 with her career at Children’s Hospital, where she worked an inaugural class of 37 BSN students. Attendance from 1952 until she retired in 1992. Verle was very grew quickly and by 1973 there were more than 200 dedicated to nursing and in her supervisory role junior-level nurses. always loved being hands-on with the babies. Betty once said, “We were all pioneers back then. Verle married John A. Beaunaux Jan. 21, 1954. And they’re still pioneering today.” John and Verle were married for 42 years and made
wsna.org The Washington Nurse FALL 2017 47 New Members
DISTRICT 1 Grace A. Fisher Peter J. Pall Emma R. Curnan Martha C. Vivar Marissa L. Swegle Whatcom County Hosanna D. Frye Fereshteh Parsa Christen R. D’Arrigo Tezra A. Wakefield April K. Thomas Jennifer L. Aanes Yansheng Fu Catherine J. Pennie Lisa W. Daigler Katherine A. Walusiak Kimberly M. Thompson Heather O. Borland Marissa A. Garland Laura F. Peters Elizabeth L. Davidson Teresa L. Williams Gina R. Thompson Suzanne A. Bryan John Gentzel Katherine D. Pfund Patricia C. DeChesser Patrick M. Williams Gabriela J. Villarreal Josephine C. Carrillo Kathryn A. Geren Manh D. Pham Marissa R. DeVries Xing Wu Jordan E. Vuong Thomas M. Carson Emma D. Gilbert Jennifer L. Plapinger Mary Ann B. Edquid Judee L. Webb RubyAnn C. Godier Mikayla B. Polzin Taylor K. Eldore Barbara J. Weston Jennifer M. Donnelley DISTRICT 4 Melissa M. Godshalk Jason R. Pulido Danielle S. Epp Estee L. Wilson Brenda Goebel Spokane / Adams / Maya G. Golan Melissa E. Ramirez Chitoo G. Ezeokeke Kathryn J. Wilson Charity P. Jacobsen Lincoln / Pend Monica M. Gomez Caitlin H. Rasp Joseph F. Ferry Kathy A. Wold Karlee F. Keith Oreille Counties Leigh R. Raby Ashley R. Goodwin Patrick T. Resta Tracey A. Fleming Katharina R. Wysling Blake B. Albretsen Courtney A. Viladas Arrum-Alice Goodwin-Yoon Lacey A. Retzlaff Matthew A. Foxworthy Andre P. Guerin Rachel E. Reyes Debra L. Fredericks Melodee D. Anderson Shantel M. Wahl DISTRICT 5 Alyssa A. Hale Samantha L. Rezsnyak Julice N. Friddle Stacie R. Anderson Walla Walla / Rachel S. Hall Karin R. Riggs Gabriela Fuentes Tracy R. Astleford Columbia Counties DISTRICT 2 Brenda A. Hammond Brittany L. Rios Jonathan M. Goebel Jennifer L. Banks King County Emma K. Hancock Maura E. Robertson Andrew L. Gomen John J. Bauman Dana L. Bertran Helen M. Adamson Kathryn E. Hardy Melinda G. Roetcisoender Nona S. Govella Canela V. Beck Danny A. Busby Stephanie D. Adkins Christa S. Harrigill Rosa M. Rojas Ellisa D. Greer Tereza L. Brooks Holly N. Daggett Michael R. Agas Julia K. Hart Barbara A. Rukundo Cody J. Guenther Joel G. Cardenas Kalani K. Dodd Ahmed B. Ahmed Abigail A. Hassler Kaylie M. Saiki Charlene M. Hardges Erin A. Clark Jennifer A. Gillentine Angella L. Alania Taylor L. Hayden Emma M. Salud Sherie M. Hess Carissa D. Close Amy L. Martin Rebecca B. Alderson Amber S. Heberling Cathy H. Sanders Janelle M. Hrdlicka Laura M. Combs Elizabeth A. Swisher Taylor D. Alexander Lorraine M. Hodgins Katherine S. Sanford Deborah C. Hutchens Yelena N. Connely Madalyn N. Crosse Emily F. Anderson Kristen L. Hoeft Nicole B. Saunders Nancy E. Jackson DISTRICT 6 Jacqueline Cruz Hannah D. Anderson Jennifer M. Hogan Emily R. Saunders Melissa A. Johnson Yakima City / Nancy L. Dorman-Nowak Milissa S. Andrews Eunha Holdhus Corinda L. Savojni Therese R. Juntunen North Yakima Lucas M. Atencio Elizabeth B. Hubbard Lindsey L. Scheller Megan C. Karnath Dean L. Douglas Ty M. Fotheringill Ashley N. Atmospera Hannah M. Huebner Julie M. Schwartz Amanda A. Kelly Dena L. Dunken Amy S. Norton Jessica S. Baer Nicole R. Jackman Kelly A. Shantel Alicia B. Ketterer Arik W. Dunlow Carissa A. Timm Todd A. Bahl Kara L. Janssen Arjana Shehi Stephanie N. Kilpatrick Rebekah L. Evans Shauni M. Barrett Emily S. Jerdee Janessa R. Shepherd Bill A. Klinakis Rachel A. Fiddes Stacy L. Bays Rebekah B. Jurick Stephanie A. Sheridan Jon Kuelz Monica J. Fisher DISTRICT 7 Joan M. Beade Kate E. Kapner Haley R. Sheridan Heather J. Lang Jolynn Fout Chelan / Douglas Mark E. Beaumont Madeline M. Kasper Scott A. Simmons Lyne C. Liboiron-Bouie Kirsten A. Fulton / Grant Counties Lindsay K. Gale Brenda Bernal Dara Khamphounvong Nicole B. Simmons Dana J. Llanos Dalynn B. Bernethy Carly M. Garza Basudev Bhattarai Courtney A. Kirk Kathryn E. Sjolund Tasha A. Macomber Karla K. Bourgeois Emily K. Hanson Sara G. Birru Colleen E. Kocer Shendra M. Smith Pamela R. Mattson Alison L. Brigleb Christina L. Hebert Brittanie N. Bliss Kaman Kong Vanessa A. Sochulak Helene Matumona Brittany Casey Ann M. Hein Samantha Bostelman Lauren M. Konrad Nicole Z. Spaziano Sarah A. McEntee Oneida Duran Mollie A. Herr Thomas S. Bowman Melissa J. Krell Michelle M. Steiner Naomi M. McHolland Sandy K. Moser Susan R. Heuscher Allie E. Branham Lisa M. Kurobe Kirsten J. Strobel Jordyn K. Mertz Yanis D. Plakos Shanna M. Holt Melanie L. Brown Shari L. Landreville Kaitlin C. Swartz Gurpreet K. Minhas Michele L. Whittaker Matthew C. Howell Cheryl R. Bryant Tiffany Y. Le Anna M. Swinford Kevin L. Mitchell Genevieve S. Wilson Jessica L. Buehler Linda K. Lee Ryan M. Tom Lexie J. Modlin Anna E. Ibanez Romelie A. Bulosan Sarah M. Leong Hannah J. Velling Jane A. Montebell Mary E. Jaquish DISTRICT 8 Erica H. Buzbee Daniele Lin Sarah L. Weerheim Melisa M. Moran Danielle M. Johnson Mary Beatrice P. Cantillep Vicki C. Lomnicky Kristy H. Welles Brianne M. Mueller Anje P. Kaarlson-Montgomery Grays Harbor Sunnie Carmichael Mallory Loomis Mary S. Werner Dona Mukalel John Rachel A. Knoles Kala R. Winter Ashley A. Carter Derek M. Lopez Wendy R. Westcott Maren W. Munns Taylor O. Kuehn Margaret M. Lothian Claire E. Willard Karen L. Nichols Sydney M. Larios Morgan E. Cassidy DISTRICT 10 Carmila May D. Lucas Jamie K. Williams Lynn A. Noland Lauren B. Lind Beth A. Champion Wahkiakum / Rovelyn Trinidad D. Macalinao Jane M. Wong Nancy A. Olson Markie L. Lindquist Lisa A. Chapman Cowlitz Counties Deborah A. Charbonneau Julie R. Marre Charise A. Yarborough Natasha D. Omsberg Shawn A. Lockman Shi Shi Chen Betony L. Martin Lindsey L. Yeung Sharon A. Parsons Hisac Lucas Arika R. Davidson Yvonne Chen Jeananne P. Martin Jasmine A. Yousif Azra Polimac Raquel Maldonado Amanda K. Davis Julie E. Christopherson Adriane L. Martinez Tanya Zakrajsek Makensie J. Potter Tori B. Malek Katherine A. DeRosier Camille Clarke Anya L. McAllister Molly M. Zimmerman Gelineau M. Puna Melissa A. Markee Ellen M. Gray Holly H. Clem Jacqueline M. McCutcheon Christina E. Rager Monica L. Martin April A. Harper Jamie E. McDonald Kelly A. Ranes Kayla M. McBride Sarah J. Jordan Sandra K. Conner DISTRICT 3 Emily J. McNellan Jill M. Raschick Isabella K. Milburn Jennifer L. Sanford Jodi M. Cooley Pierce County Claudette Cooper Robert R. Menke Jéaux Rinehart Renee F. Mottoh Zachary D. Townley Claire E. Cooper Margaret K. Merz Erin K. Adamic Crystal L. Robertson Typhany R. Murbach Ricardo L. Alves Silva Damien P. Murdoch Carl E. Coyle Kasandra L. Michel Kayla A. Rosendale DISTRICT 11 Brittany J. Andrews Amanda R. Nelson Sarah M. Creighton Marijoie J. Miner Timothy R. Runez Clark / Skamania Anna Dominique B. Anglley Teresa M. Normandeau Alison S. Cutler Takara J. Mitsui Emilee C. Sanchez Counties Kolleen D. Daly Sara A. Moallin Vincent M. Antonini Lorenzo N. Sellers Ellen D. O’Reilly Jessi L. Atkins Tammy M. Davis Kelsey K. Moore Annie R. Augusto-Belocura Kristin A. Shaw Angel D. Perez Quevedo Randi R. Barrett Margaret S. Decuir Kelsey K. Mummert Stacy K. Avara Sherri L. Shepherd Katherine E. Pinnell Lisa M. Beggs Kelly A. DeGraffenried Peter M. Myers Samantha M. Avendano Esther S. Shin Mark B. Plummer Gloria L. Buesa Allison G. Denby Coco S. Nagle Alexandra L. Barber Robin J. Snider Robert J. Prado Danyelle K. Douglas Aileen B. Deoferio-Cabang Lyndsie R. Neely James G. Blackwell Krista A. Suchland Olivia J. Purcell Deltarose G. Ellison George L. Dickerson Joanna K. Nelson Leland T. Brechbiel Lauren S. Sung Brittany L. Ramirez Cara R. Fitzgerald Erin D. Dijulio Jennifer N. Nguyen Simone Brown Cherie Lynae C. Suski Wendy A. Roller Katelyn D. Glenn Lisa M. Dimech Marni Nicholson DeVi J. Burke Kimberly Sykes Miranda W. Sanders Alison L. Hale Casey R. Dooley Alison M. Nowaczyk Jessica C. Burkett Margarita C. Tabudlong Kimberly A. Schiene Nichole D. Herzman Kelley M. Downey Nafkot A. Nurga Kathryn A. Burnham Giselle Tayal Katherine R. Smasne Michaela J. Heth Delisha M. Dupee Caterina N. Nussio Sarah A. Cherwien Kim Thomas Jake N. Stickelmeyer Roger L. Heward Kimberly N. Easter Amy M. Orloff Peter M. Conrad Charlene D. Thompson Kaitlyn M. Storch Katrina R. Hunziker Elizabeth S. Emond Brian D. Ottesen Angela P. Cooper Jamie L. Tollefson Allesondra K. Straggi Chanel R. Jost Cynthia D. Fajmon Kali M. Owen Logan T. Cornyn Dacia R. Uecker Verlee M. Sutherlin
48 The Washington Nurse FALL 2017 wsna.org New Members Membership Information
Megan W. Larkin Jennifer S. Shelton Colette L. Raappana Jacqueline S. Simons If you are currently a member and have had a Carol Rumpel Tiffany A. Starkey change in your employment situation… Nicole E. Schriock Kevin J. Swackhamer Mary F. Thompson Kaitlan D. Whalen Please complete a Change of Information Form or email your changes to [email protected]. The Change Brenda A. Velazquez Lara DISTRICT 18 of Information Form is available on the WSNA website under “Membership,” or you can contact the WSNA DISTRICT 15 Kittitas County Membership Department at 800-231-8482 or 206-575-7979 to request one. Benton / Franklin Lacey M. Nicholson Counties Please note: It is the member’s responsibility to notify WSNA in writing of any changes in address, employer,
Semone S. Anderson DISTRICT 98 FTE status, layoff or leave of absence. Write to: Membership – Washington State Nurses Association, 575 Amanda R. Austin All Other Counties Andover Park West, Suite 101, Seattle, WA 98188. Michelle P. Barker Stephanie M. Gamboa Christopher B. Blake Gwendolyn A. Hull Sayra Y. Campbell Elizabeth R. Johnson Stephanie J. Cho Kerstin A. Lesniak NOTICE OF WASHINGTON STATE NURSES ASSOCIATION POLICY REGARDING Taylor G. Christensen Sommer Scheidegger NONMEMBERS EMPLOYED UNDER UNION SECURITY AGREEMENTS Dawn S. Clark Valerie J. Tebow Kyleaha Collis Federal and state labor laws recognize the right of unions in Washington to enter into collective bargaining Laura M. Thome Lily Ann R. Corleto Danika F. Wagenaar agreements with employers that require employees, as a condition of employment, either to join the union Tiffany N. Dawson (and thereby enjoy all of full rights and benefits of membership) or to pay fees to the union (and thereby McKenzie J. Finnicum satisfy a financial obligation to the union without enjoying the full rights and benefits of union membership). Julie A. Fletcher Regardless of the wording of the “union security” agreement, employees represented by the Washington Eric L. Foss State Nurses Association for purposes of collective bargaining and covered by a union security agreement Lucas J. Fraley are not required to become full members of WSNA, and are required only to choose either to be members Katherine L. Garza of WSNA or pay fees to it. Employees who choose to become members of the Washington State Nurses Charlene J. Garza Association pay WSNA dues and receive all of the rights and benefits of WSNA membership. Employees who Olga V. Golyshevsky Mercedez Gomez either decline to become members of WSNA or who resign from WSNA membership may meet their union Kalei D. Grayson security obligation by payment of “agency fees” for representation. Letha Iverson WSNA has negotiated union security agreements, which have been ratified by the democratic vote of Jeanette M. Johnson the affected employees and which require that all employees must either join the union or pay fees to the Rita I. Jones union, in order to ensure that each employee who is represented by WSNA pays a fair share of the cost of Miranda D. McCombs that representation. Such union security agreements strengthen WSNA’s ability to represent employees Shirlauna Miller effectively in collective bargaining, contract enforcement and grievance administration, while eliminating Angela L. Mohr “free riders” who enjoy the benefits of a WSNA contract and representation without contributing their fair Madison L. Morris share of the union’s expenses for negotiating, administering and enforcing the contract. Through the col- Anna M. Munoz lective bargaining process, nurses represented by WSNA achieve higher wages, better benefits, fairness in Christina A. Omta the disciplinary procedure, and enhanced respect for their skills and professionalism. These improvements, Shawna J. Orozco won through collective bargaining, enhance the terms and conditions of working life for all employees, and Rebecca M. Peterson allow them to better provide for themselves and their families. Angela M. Porter Only WSNA members enjoy all of the full rights of WSNA membership. Only WSNA members have the Jennille E. Prasad right to attend local unit meetings and speak out on any and all issues affecting their workplace, WSNA and Adrianna M. Renteria its members; the right to participate in the formulation of WSNA policies; the right to have input into WSNA Valerie J. Thelander bargaining goals and objectives, and to serve on WSNA negotiating committees; the right to nominate and Bobbie M. Thomasson vote for candidates for WSNA office, and to run as a candidate for WSNA office; the right to vote on contract Jasmin A. Viveros ratification and strike authorization; the right to participate in the WSNA general assembly; and the right to Megan A. Weeks participate in the American Nurses Association and the National Federation of Nurses. Agency fee payers are non-members of WSNA who are employed under a union security agreement and DISTRICT 16 fulfill their union security financial obligation to WSNA by payment of agency fees. Agency fee payers forfeit Skagit / Island / San valuable rights and benefits of WSNA membership. Agency fee payers give up their rights to have input Juan Counties into the affairs of WSNA, the organization that represents them in dealings with their employer concerning Lisa N. Anderson wages, hours of work, health and retirement benefits, disciplinary matters, and other terms and conditions Chantelle A. Beason of employment. Any WSNA member who chooses to become an agency fee payer (and thereby forfeit his or Sophia A. Bixler her WSNA membership rights) may resign at any time from WSNA by submitting a written notice of resigna- Linda M. Bollinger tion from WSNA membership, which becomes effective upon receipt by WSNA. All agency fee payers must Jessica M. Brown submit to WSNA an Agency Fee Payer Application Form, which is available upon request from WSNA. Agency Amber S. Bryson fee payers are required to pay fees equal to their share of WSNA costs germane to collective bargaining, Steven L. Caporgno contract administration and grievance adjustment. WSNA automatically reduces the fee charged to agency Amber L. Davis fee payers by the amount attributable to expenditures incurred for WSNA activities that are not related to its Rachel L. Duggan Amber V. Dykes responsibilities as representative for purposes of collective bargaining. In our most recent accounting year, Harmony C. Edwards 8.22% of WSNA’s total expenditures were spent on activities unrelated to collective bargaining representa- Jo Anna S. Gagliardi tion. Any non-member who is financially obligated to WSNA under a union security agreement may inspect Jennifer A. Gross the audit report of WSNA expenditures at a reasonable time and place upon written request to WSNA. Any Daniel T. Johnson non-member who disagrees with the amount of the agency fee may file a written challenge, which must Dallas Kathan state the basis for the challenge. For any member who resigns his or her membership, such challenge must Noley T. Khan be received by WSNA during the 30 day period after the postmark of his or her written notice of resignation Amanda L. Laird and change in status from full member to agency fee payer. For non-members, challenges must be received Kara A. Lynch by WSNA within the 30 day period from the postmark of WSNA’s annual written notice of the new calculation Julia F. Marsh of agency fees that take effect on January 1 of each year. Such challenges shall be decided by an impartial Monique M. McFarland arbitrator appointed by the American Arbitration Association pursuant to its Rules for Impartial Determina- Stephanie M. Means tion of Union Fees. Any challenge must be submitted to: WSNA, ATTN: Agency Fee Challenges, 575 Andover Lyka O. Mendoza Park West, Suite 101, Seattle WA 98188. Any other notice required under this policy must be submitted in Courtney B. Neveu writing to WSNA, ATTN: Membership, 575 Andover Park West, Suite 101, Seattle, WA 98188, and is effective Miranda A. Northrup upon receipt by WSNA. It is recommended that any notice required under this policy be sent by certified Kelly A. Rifenbury mail, but certified mail is not required for any such notice. Anna M. Rodriguez Robert D. Roth Lene N. Schille
wsna.org The Washington Nurse FALL 2017 49 MEMBERSHIP Dues
2018 WSNA membership dues The total annual amount of dues for WSNA mem- the ANA dues amount will remain the same and will contracts in effect on July 1 each year. The average bers includes the American Nurses Association (ANA), be in effect through December 31, 2019. 5th step monthly salary is then multiplied by a dues Washington State Nurses Association (WSNA), and For WSNA members not represented by WSNA adjustment factor of 1.00% and again by 12 to deter- the District Nurses Association (DNA), dues portions. for Collective Bargaining, there is no dues increase mine the amount for the annual WSNA portion of the This combined amount is based on the following in 2018. Members who work less than 80 hours per dues and is applied in January the following year. Information: 1) the District you are employed in, 2) month, are retired or not represented for collective Eight percent (8%) of the WSNA portion of the the total hours you are scheduled to work per month bargaining may also qualify for one of the reduced dues of WSNA collective bargaining members are (FTE), and 3) whether you are represented by WSNA dues categories. returned to the WSNA Cabinet on Economic and for collective bargaining or not. WSNA dues for mem- For members represented by WSNA for collec- General Welfare (4%) and to the member’s local unit bers are adjusted annually on January 1st each year tive-bargaining the amount of dues also includes per (4%) for their use. based on a formula approved by the membership in capita dues to National Federation of Nurses (NFN) The amount of the dues increase for 2018 for 1991 and revised in 2003. and the AFT/AFL-CIO. For 2018 the NFN dues remain the WSNA portion of the dues will be 4.24% which ANA dues are adjusted every three years based the same at $2.50 per month ($30.00 annually). The is $2.50 per month ($30.07 annually) for members on the Consumer Price Index (this increase is capped 2018 AFT dues for members represented by WSNA represented by WSNA for Collective Bargaining in at a maximum of 2%). This increase is applied to both for Collective Bargaining will be $8.07 per month our highest dues-paying category. collective-bargaining and non-collective bargaining ($96.86 annually). The updated WSNA dues rate schedule is effec- members. The last ANA dues increase was in Janu- For members represented for collective bargain- tive January 1, 2018. Please see the accompanying ary 2014 and the next increase was scheduled for ing by WSNA, the formula for the WSNA portion of Dues Rate chart for your specific dues rate for 2018. January 2017, however, by action of the 2016 ANA the dues is based on the statewide average of the Membership Assembly, “the dues escalator for 2014, 5th-step wage rate for RNs in WSNA-represented bar- 2015 and 2016 shall not be implemented,” therefore gaining units. This calculation is made from existing
WSNA Districts 1 Whatcom 4 Spokane / 6 Yakima City / 9 Snohomish 12 Clallam/ 15 Benton / 18 Kittitas County County Adams / Lincoln North Yakima County Jefferson Franklin 98 All others / Pend Oreille 2 King County 7 Chelan / 10 Wahkiakum 13 Thurston 16 Skagit / Island not listed / Stevens Douglas / Grant / Cowlitz County / San Juan 3 Pierce County 5 Walla Walla / 8 Grays Harbor 11 Clark / 14 Whitman 17 Kitsap County Columbia Skamania County
Dues Categories A B C D F R E In a WSNA- In a WSNA- In a WSNA- New Graduate Employed and New graduate 62 years of age and represented represented represented Nurse employed not covered by a nurse, employed not employed, or bargaining unit and bargaining unit bargaining unit and in a WSNA WSNA collective and not covered by totally disabled working an average and working an working an average represented bargaining a WSNA collective of 80 or more average of 40 of less than 40 bargaining unit contract, or bargaining contract hours per month hours or more hours per month (for the 1st year of unemployed (for first year of (0.5–1.0 FTE) and less than 80 (less than 0.24 FTE, membership only) membership only) hours per month or per diem) (0.25–0.49 FTE)
Dues Rates Effective Jan. 1, 2018 – Dec. 31, 2018. Subject to change with proper notice.
Category A Category B Categories C & D Category F Category R Category E
Annual Install* Monthly Annual Install* Monthly Annual Install* Monthly Annual Install* Monthly Annual Install* Monthly Annual Install* Monthly
1, 6, 8, 17, 18 $1,022.64 $342.21 $85.22 $798.72 $267.57 $66.56 $574.80 $192.93 $47.90 $413.04 $139.01 $34.42 $209.04 $71.01 $17.42 $204.48 $69.49 $17.04
2 $1,075.92 $359.97 $89.66 $838.56 $280.85 $69.88 $601.44 $201.81 $50.12 $439.68 $147.89 $36.64 $235.68 $79.89 $19.64 $217.92 $73.97 $18.16
3 $1,043.04 $349.01 $86.92 $814.08 $272.69 $67.84 $584.88 $196.29 $48.74 $423.25 $142.41 $35.27 $219.25 $74.41 $18.27 $209.63 $71.21 $17.47
4 $1,038.72 $347.57 $86.56 $810.72 $271.57 $67.56 $582.72 $195.57 $48.56 $421.00 $141.66 $35.08 $217.00 $73.66 $18.08 $208.50 $70.83 $17.38
5, 15 $1,017.60 $340.53 $84.80 $794.88 $266.29 $66.24 $572.16 $192.05 $47.68 $410.50 $138.16 $34.21 $206.50 $70.16 $17.21 $203.25 $69.08 $16.94
7 $1,023.12 $342.37 $85.26 $798.96 $267.65 $66.58 $575.04 $193.01 $47.92 $413.25 $139.08 $34.44 $209.25 $71.08 $17.44 $204.63 $69.54 $17.05
District 9, 12 $1,030.08 $344.69 $85.84 $804.24 $269.41 $67.02 $578.40 $194.13 $48.20 $416.75 $140.25 $34.73 $212.75 $72.25 $17.73 $206.38 $70.12 $17.20
10, 13 $1,020.24 $341.41 $85.02 $796.80 $266.93 $66.40 $573.60 $192.53 $47.80 $411.75 $138.58 $34.31 $207.75 $70.58 $17.31 $203.88 $69.29 $16.99
11 $1,032.72 $345.57 $86.06 $806.16 $270.05 $67.18 $579.84 $194.61 $48.32 $418.00 $140.66 $34.83 $214.00 $72.66 $17.83 $207.00 $70.33 $17.25
14, 98 $1,012.56 $338.85 $84.38 $791.28 $265.09 $65.94 $569.76 $191.25 $47.48 $408.00 $137.33 $34.00 $204.00 $69.33 $17.00 $202.00 $68.66 $16.83
16 $1,027.68 $343.89 $85.64 $802.32 $268.77 $66.86 $577.20 $193.73 $48.10 $415.50 $139.83 $34.63 $211.50 $71.83 $17.63 $205.75 $69.91 $17.15
* Installment amounts include $3.99 annual fee
50 The Washington Nurse FALL 2017 wsna.org Why I give...
“I believe in supporting the WSNA-PAC so that we can advocate for candidates who will go to Olympia and advocate for nurses and patients.” — Clarise Mahler, RN
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