MAMAssachusettsssachusetts RReporteport onon NNursingursing MARN is the Massachusetts Affi liate to the American Nurses Association

Vol. 6 No. 3 The Offi cial Publication of the Massachusetts Association of Registered Nurses, Inc. September 2008 PO Box 285 • Milton, MA 02186 • 617-990-2856 • [email protected] Quarterly Circulation 110,000

MARN Members Honor Your Colleagues Attend the ANA House of Living Legends & MARN Awards Delegates Meeting Open to all nurses Page 4 Page 15

2008 Fall Conference 2008 Fall Convention Clinical Simulation: The Clinical Simulation Future of nursing Practice The Future of nursing Practice and Education! and Education! Friday, October 17, 2008 Within the health care community, there is a heightened awareness to promote 7:30 am - 8:30 am patient safety by improving the clinician’s Continental Breakfast, Exhibits, Posters and registration ability to perform higher-level functions Clinical Simulation: such as critical thinking, communication, 8:30 am - 9:30 am The Future of nursing and teamwork. Clinical simulation, a Keynote strategy to teach, train and evaluate Healthcare Simulation: Practice and Education! clinicians, utilizes devices and equipment A Surprising View Friday, October 17, 2008 that mimic specific clinical scenarios. It is Daniel raemer, PhD applicable across a wide range of settings 7:30 am - 3:30 pm 9:30 am - 10:00 am including hospitals, community agencies Break, Exhibits, and Posters and nursing education programs and varied situations including ACLS training, 10:00 am - 11:00 am low frequency/high risk situations, and Breakout Session 1 orientation. A, B, C This conference will address 11:15 am - 12:15 pm the methodologies, utilization and Breakout Session 2 implementation of clinical simulation and A, B, D its impact on patient safety and quality health care. National and local experts 12:15 pm - 1:15 pm will awaken your interest, challenge your Exhibits, Posters and Buffet Lunch curiosity and expand your knowledge. 1:15 pm - 2:15 pm Keynote Speaker There will be opportunities to meet with Breakout Session 3 a wide variety of exhibitors and poster E, F, G Daniel raemer, PhD presenters and experience the latest state- research and Development Director of-the-art simulation equipment. 2:30 pm - 3:30 pm Plenary: Center for Medical Simulation Join us. Simulation in Nursing: The Past, Present, and Frontier Lombardo’s Janis Childs, rn, PhD 6 Billings Street Call for Posters randolph, MA 02368 All conference participants are Presort Standard US Postage welcome to contribute posters. PAID Posters will be displayed near the Permit #14 MArn is a Constituent Member Princeton, MN exhibitors so that all who attend will 55371 Association of the American nurses have an opportunity to see them. Association Go to www.MArnonline.org and AnCC Approved Contact Hours Pending fill out the poster submission form by September 12, 2008. Guidelines www.MARNonline.org for poster submission will also be available on line. Page 2—MAssachusetts Report on Nursing—September 2008

Breakout Sessions PO Box 285 Registration Information Milton, MA 02186 A. Think Big, Start Small: Integrating Simulation 617- 9 9 0 -2856 throughout the Curriculum Mail check or credit card information and [email protected] Judith Healey Walsh, MS, RN registration form to: B. Simulation Educators: Step by Step Strategies MARN, PO Box 285, Milton, MA 02186. for Successful Development Clare Lamontagne, MS, RN, CNE Registrations MUST BE postmarked no later C. Quality and Safety Education for Nurses than October 4, 2008. (QSEN): Integration into Simulation Carol Durham, MSN, RN, EdD(c) MARN, RISNA, and other ANA Members D. Pretending Never Felt So Real: Simulation and ❑ $90 Pediatric Staff Development Lindsay Gainer, RN, MSN, CPON and Non-Members Marcie Brostoff, RN, MSN ❑ $130 PO Box 285 E. Don’t Make Your Manikin a DNR: Strategies Milton, MA 02186 to Overcome Barriers to Implementation MASNA and Full-Time Students 617-990-2856 Stephen Donahue, BS, RRT ❑ $75 [email protected] F. Geriatric Simulation: Moving Education to (Sorry, fees are NON-REFUNDABLE.) Board of Directors Practice Carol Durham, MSN, RN, EdD(c) Select your Breakout Session preferences below. President G. Debriefing: A Reflective Process to Enhance June “Toni” Abraham, MS, APRN-C Clinical Practice Breakout Session 1 ~ Check ONE Jeanne McHale, MSN, RN and ❑ A ❑ B ❑ C Vice President Beth Nagle, MSN, RN Cidalia J. Vital, RN, MS, CNL Breakout Session 2 ~ Check ONE Secretary ❑ A ❑ B ❑ D Clinical Simulation Faculty Lindsay Gainer, RN, MSN, CPON Breakout Session 3 ~ Check ONE Treasurer Marcie Brostoff, RN, MSN ❑ E ❑ F ❑ G Trish Bowe, RN, MS Director of Staff Development, Directors Children’s Hospital, Boston Name: ______Susan Conrad, RN, PhD Barbra Gray, RN, BSN Janis Childs, RN, PhD Address: ______Anne Manton, PhD, APRN, RN, FAAN Associate Professor and Director, Kathryn McNamara, RN, BSN Learning Resource and Simulation Center, ______Theresa Spinelli, RN, ANP University of Southern Maine, College of City State Zip Yolanda Starling, BS, RN Nursing and Health Professions Email:______—Committee Chairs— Awards Stephen Donahue, BS, RRT Maura Fitzgerald, MS, RN Director, Simulation Center, Hartford Hospital Phone: (____)______Continuing Education Carol Durham, MSN, RN, EdD(c) Charge the following amount $ ______Sandra Reissour, BS, RN Clinical Associate Professor, Jeannie Gibbs, MSN, RN To my: ❑ MasterCard ❑ Visa Director of Clinical Education and Resource Health Policy Center University of North Carolina at Chapel Card Number: Angela Nannini, PhD, FNP, RN Hill Membership Committee Lindsay Gainer, RN, MSN, CPON Cidalia J. Vital, RN, MS, CNL Exp. Date: ______(MM/YYYY) Nurse Manager, Mentoring Task Force Children’s Hospital, Boston Cynthia Ann LaSala, MS, RN Signature Required:______Judith Healey Walsh, MS, RN Bylaws Director, Center for Clinical Education and Cammie Townsend MS/MBA Research, College of Nursing and Health Nominations & Elections Science, University of Massachusetts, Boston Lombardo’s 6 Billings Street Karen Manning, MSN, RN, CRRN, CNA Clare Lamontagne, MS, RN, CNE Randolph, MA 02368 Spring Convention Planning Professor of Nursing, School of Nursing, 1-800-986-5030 Peggie Griffin Bretz, MSN, RN Springfield Technical Community College Directions Newsletter Editor Myra F. Cacace, MS, APRN, BC-ADM, CDE Jeanne McHale, MSN, RN Located at the intersection of Route 128/93 and Clinical Nurse Specialist, Route 28 in Randolph, MA. MARN Staff Massachusetts General Hospital From Boston: Take South East Expressway/93 Executive Director South, at Braintree split - stay on 93 South (128 Mary Manning, MSN, RN Beth Nagle, MSN, RN North) to Exit 5A* Clinical Nurse Specialist, From Cape Cod: Take Route 3 North, to Route Administrative Assistant Heather Plumb Massachusetts General Hospital 93 South (128 North), to exit 5A* From Rhode Island: Take 95 North or Route 24 Acceptance of advertising does not imply endorsement or Daniel Raemer, PhD North, to 93 North (128 South), to Exit 5A* approval by the Massachusetts Association of Registered Nurses, *Take a right at the first set of lights on to Inc. of products advertised, the advertisers, or the claims made. Associate Professor of Anesthesia, Harvard Rejection of an advertisement does not imply a product offered Medical School, Bionegineer, Department of Scanlon Drive. Lombardo’s will be on the right, for advertising is without merit, or that the manufacturer lacks Anesthesia and Critical Care, Massachusetts next door to the Holiday Inn. integrity, or that this association disapproves of the product or its use. MARN and the Arthur L. Davis Publishing Agency, Inc. shall General Hospital, Research and Development not be held liable for any consequences resulting from purchase Director, Center for Medical Simulation or use of an advertiser’s product.

Exhibitor and Sponsor Opportunities Policy for Accepting Announcements for the Newsletter MARN encourages organizations and educational institutions to Available at the Simulation Conference submit announcements about continuing education opportunities and upcoming events that are of interest to nurses. Visit: www.MARNonline.org Please note: The announcement can not exceed 75 words. Fees must be included with submissions. The Fee Schedule is as follows: MARN Approved Providers/Sponsors—$25 Non MARN Approved Providers/Sponsors—$50 Payment can be mailed to MARN, PO Box 285, Milton, MA 02186. Please include a copy of the announcement and contact information (name, address, telephone, Email) with the check. Please email copy to www.MARNonline.org. For more information, contact [email protected].

Advertising Rates: Contact—Arthur L. Davis Publishing Agency, Inc., 517 Washington St., P.O. Box 216, Cedar Falls, IA 50613, 800-626-4081. The Massachusetts Association of Registered Nurses and the Arthur L. Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement. September 2008—MAssachusetts Report on Nursing— Page 3 President’s Message

Toni Abraham MSn, APrn-C launched by the ANA to help fight for safe staffing legislation. For more information on ANA’s safe Since becoming MARN staffing campaign and to send a letter in support president I had the privilege of safe staffing legislation to your Member of of being part of the Congress, please visit www.safestaffingsaveslives. Massachusetts delegation org. to the ANA biennial House Closer to home, the compromise to MA Safe of Delegates (HOD) which Staffing Bill No. 2805, was passed from the State took place in Washington Senate to the House in mid-July by a vote of 23- DC from June 24 through 13. We thank the Senators who supported the 27. Attending this gathering compromise on patient safety. For up to date was a great experience. I information, please visit our web site at http:// met so many outstanding www.MARNonline.org. Make calls to your local and knowledgeable Toni Abraham Senator and House Representative to do your part nurses. Other MARN ANA in making Massachusetts a safe place for patients Delegates who joined me included Judy Sweeney, and nurses in the hospital setting. Myra Cacace, Anne Manton, Jeanne Gibbs, Gayle Peterson and Mary Manning. Many amendment proposals caused lively discussion throughout the week as more than 600 members struggled to come to consensus on the important issues about the future agenda and direction of the ANA. As a novice participant, I marveled at the enthusiasm and commitment I witnessed in the few days I was there. Much to our pleasure, an amendment passed that allows for a ‘recent graduate’ (someone who Now that summer has ended I wish you all a has graduated within five years of taking office) to happy and productive autumn. Remember, the run for an ANA Director position. This new policy MARN Board of Directors meets every month will go into effect at the close of the 2010 House of and we are working hard to represent all nurses Delegates meeting. toward reaching our common goals. Please feel One of the truly wonderful experiences I had free to contact us at [email protected] or visit while in Washington was to get off the Metro at Special guest addresses the crowd. Urges support our website at www.MARNonline.org. DuPont Circle and see a beautiful poster calling for the Democratic candidate for President. attention to ANA’s Safe Staffing Campaign. Safe Staffing Saves Lives is a national campaign Page 4—MAssachusetts Report on Nursing—September 2008 MARN Members Attend the ANA House of Delegates Washington Metropolitan Area Transit Authority Posts ANA Ad: Safe Meeting in Washington, D.C. June 2008 Staffing Highlights The Critical Role by Jeanne Gibbs MSn, rn, Delegate Nurses Play In Patient Safety And

The Massachusetts Association of Registered Quality of Care Nurses was well represented this year at the ANA by Mary Stewart, Senior Public relations House of Delegates (HOD) meeting. In addition to Specialist, Communications Department the elected delegates, many other members were American nurses Association (AnA) present filling important non-delegate roles. Barbara Blakeney, MS, rn, immediate past President of the ANA, was in attendance. She was Staffing ratios should be required by always available to lend her support and share legislation but the number itself must be her history, wisdom and experience with us. The set at the unit level with Registered Nurse MARN delegation is proud that Barbara is from input, rather than by the terms of the Massachusetts as she exemplifies leadership, legislation. courage and a strong commitment to our profession. Her love for nursing shines through in all her endeavors. Her presence brings a calmness During the American Nurses Association (ANA) and comfort to those around her. 2008 Biennial House of Delegates meeting in Mary Manning, MSn, rn, Executive Director, of the “Living Legend Award” given by MARN in Washington, DC, the week of June 23, 2008, ANA had a non-voting seat at the Massachusetts table 2007 for her lifelong dedication to diversity. placed the advertisement below at the Dupont with the MARN delegation. Mary brought years Karen Manning, MSn, rn, Crrn, CnA, a Circle metro station to bring attention to ANA’s of experience attending past House of Delegates member of the MARN nominating committee, Safe Staffing Campaign. meetings and a wealth of knowledge on the process was present in her position as the current national Safe Staffing Saves Lives is a national with her. She prepared the delegates over several President of the Association of Rehabilitation campaign launched by the ANA to help fight for months before the actual HOD meetings to insure Nurses. safe staffing legislation. We need your help to that we were ready to go full steam ahead once in Cidalia Vital, rn, MSn, CnL, Vice-President make it a reality. The American Nurses Association session. She was always readily able to assist us of MARN, was present in the capacity of an ANA (ANA) believes staffing ratios need to be required and encouraged our growth in this important role Credentialing Committee member. Approximately by legislation but the number itself must be set at as a delegate. 600 elected delegates were present at this House the unit level with RN input, rather than by the Karen Daley, rn, MS, MPH, PhD(c), was present of Delegates. Only duly elected, credentialed terms of the legislation. as a candidate for the ANA Board of Directors. delegates are allowed on the floor of the house Different approaches to assure sufficient nurse The entire delegation was excited to be involved to vote. The Credentialing Committee is charged staffing have been proposed. in her campaign. Indeed, Karen not only won the with insuring through a thorough document • Nurse staffing plans: with input from election but “topped the ticket”. It was a pleasure review that each delegate is properly credentialed. practicing nurses, to assure safe nurse levels to campaign for her. Most delegates were already The badges worn by each delegate throughout the are based on patient need and other criteria. familiar with her and admired her for her strong HOD meetings allows them entry to the house • Fixed mandated ratios: a number set by commitment to the safety of all nurses particularly with voting privileges. This is an important and legislation or regulation. in the area of needle stick injury prevention. interesting role! • Combination of nurse staffing plans and Many had heard her speak in their home state on Maryjoan Ladden, PhD, rn, FAAn is a legislated nurse to patient ratio: Enhancing this issue and were aware that she contributed MARN member and Peer Reviewer on the MARN these approaches can include a provision for to the successful legislation signed into law in Accredited Approver Unit. She is currently making staffing information available to the her presence by President Clinton. We all wish the Chief Programs Officer at the ANA and public. her well in her new role and know that she will was present throughout the House of Delegates ANA's proposal is not a "one size fits all" continue to represent the members of MARN meetings. approach to staffing. Instead, it tailors nurse and all nurses around the country with zeal and Cynthia LaSala, MSn, rn, member of the staffing to the specific needs of each unit, based devotion. MARN Mentoring Task force, Lindsay Gainer, rn, on factors including patient acuity, the experience rachel Spector, rn, PhD, CTn, MARN MSn, CPOn, MARN Secretary, and Trish Bowe, of the nursing staff, the skill mix of the staff, member, was the recipient of one of the thirteen rn, MS, MARN Treasurer attended the ANA available technology, and the support services awards presented this year by the ANA. The Center for Nursing “Lead Conference” which was available to the nurses. Most importantly, this Massachusetts Delegation was present to see her held during the House of Delegates. approach treats nurses as professionals and receive the “Honorary Human Rights Award.” It was an exciting time at the House of Delegates empowers them at last to have a decision-making This award was created in 1985 and is awarded and one that I was honored to attend as one MARN role in the care they provide. by the ANA Board of Directors to a person who member in the presence of so many members who Show your political muscle! ANA needs YOU exemplifies the essence of nursing’s philosophy give so much of their time and selves to work for to ask your members of Congress to support the about humanity. Ms Spector was also the recipient the nurses of Massachusetts. Registered Nurse Safe Staffing Act of 2007 (S.73/ H.R. 4138). Tell them to co-sponsor this crucial piece of legislation TODAY! For more information on ANA’s safe staffing campaign and to send a letter in support of safe staffing legislation to your Member of Congress, please visit www.safestaffingsaveslives.org. September 2008—MAssachusetts Report on Nursing— Page 5 Editorial

that she made a BIG difference in my life. Her eyes The MAssachusetts report on nursing continues Preserve Your Roots became a bit teary, she kissed me on both cheeks and to feature articles and short stories written by nurses said “thank you.” who work with the homeless population in our by Myra F. Cacace, MS, GnP-BC Also at the House of Delegates I ran into one of my Commonwealth. Be sure to read about the experiences nursing professors from 32 years ago in New York. of nursing students as they face their apprehensions I was sitting in my friend’s garden last weekend She said she was really surprised to see me (I was and learn to revise their opinions about caring for marveling at the lushness and variety of her plants. In 19 years old and really nervous and clumsy in those homeless patients on page 12. Again I want to thank telling me what is involved in having such a beautiful days). I was able to thank her for scaring me stiff the staff and students from Boston Healthcare for garden to enjoy, she remarked that most of the work and for being one of the roots of my nursing career. the Homeless for submitting the articles and stories is done in the Spring and in the Fall. Starting in Hopefully this clumsy novice has learned a thing or you will read in this edition. I believe that this is a September she will dig up most of her plants and two in the last 30 years… crucial subject that deserves our attention. I hope you split them, being sure to keep the roots intact, and On a more personal note I say farewell to my agree and will consider sending in your thoughts and replant the parts in new places. Glad that it is not good friend and mentor, Bonnie L. Sharp who stories about your personal/professional experiences my job to split the plants I began to think about the will be moved to Culpepper, Virginia at the end of with this subject. I want to hear from you about other importance of preserving our roots in order to have a August. All the nurses in Massachusetts who have organizations in Massachusetts that are helping to firm ground from which to travel and to ensure our had the opportunity to work with and learn from make a difference. growth throughout our lives. Bonnie surely know that even in her retirement, One last note: Congratulations to Karen Daley This summer has been fraught with such rooting Massachusetts’ loss is Virginia’s gain. Bonnie is one who is a newly elected director at large on the board experiences. In June I said goodbye to one of my of the strongest roots I have to nursing and in life and of directors at ANA. I had so much fun helping closest friends as he lost his blessedly short battle I know we’ll continue to be friends and see each other with her campaign and distributing the “Daley with cancer. At age 59, a husband and father of two as much as ever in the coming years. Dose” to delegates who visited her booth during the daughters (and one of the best people I know) showed Speaking of knowing about our roots make sure campaign period. Massachusetts should be proud of us all the importance of having deep roots in his you read Clio’s corner by Mary Ellen Doona on page our reputation among the other constituent members faith in God. He and his wife (another of the best 10. I am thrilled that she brings our nursing history in the ANA. We continue to make a difference in the people I know) were so brave and often spent time alive in such a meaningful way. local as well as the national arena. encouraging and supporting us through his ordeal. So far I have received only positive comments I invite you to voice your opinion about this or In June I had the opportunity to attend the about the new style for the newsletter. Remember, any articles that peak your interest! Contact me at ANA House of Delegates. One of my many great I want to feature YOUR pictures in future editions! [email protected] or contact MARN at experiences was having the opportunity to tell Just pick up your digital camera and snap a few [email protected] or send mail to PO Box 285, another nurse about how she is one of the anchoring pictures from your worksite or your neighborhoods Milton, MA 02186. Please remember that it is our roots in my life. Here’s the story: I attended a nurse or your travels around this great commonwealth. The stated policy that we welcome all opinions. The practitioner conference in 1999 where the keynote newsletter team will even publically acknowledge Newsletter Committee wants to let the voices of every address was given by the ANA President, Beverly the picture as yours! With your help I am hoping to nurse in the Commonwealth be heard. However we Malone. She was the first person to clearly explain provide snapshots of a variety of settings that show do require that letters to the editor be signed in full the importance of belonging to your professional where nurses work and play! Send your pictures to in order for them to be included in the newsletter. We organization, especially ANA. I actually joined ANA [email protected] (deadlines to submit look forward to hearing from you! that day and I told Dr. Malone that because of her, I pictures: 9/1, 11/1, 2/1 & 5/1). was now a delegate and active member of MARN and MARN to Launch a Mentoring Program for Novice Nurses

by Cynthia Ann LaSala, MS, rn and professional development can be nurtured be hired to provide project management and serve as Chair, Mentoring Advisory Committee among MARN members. Such investments will not the resource person for both the mentor and mentees. only benefit individual nurses, but also contribute I would like to recognize and express my In the spring of 2007, following an 18-month to the creation of a stronger, more committed nurse gratitude to the following members of the Task Force period of information gathering by the Membership workforce. who remained committed to this work and were Committee, MARN held its annual spring Following its inaugural meeting in May 2007, the responsible for its success: Mary Manning, Executive convention entitled: Mentoring Matters: The Nursing Mentoring Task Force formulated vision and mission Director, Karen Daley, Barbara Blakeney, Patricia Journey which included a panel on mentoring. statements to serve as a framework for developing a Ruggles, Linda Moniz, Vanessa Russo, Diane Gillis, The program received extremely positive feedback proposal for an Association mentoring program: and Anne Manton. from participants. Following the convention, the Vision Statement The newly-formed Mentoring Advisory Committee Membership Committee developed a proposal which To promote knowledge, sharing of expertise, and held its first meeting on July 18th. The Committee is they presented to the Board who unanimously career development for both mentors and mentees comprised of representatives from MARN and other endorsed the establishment of a task force to assist to advance professional nursing and the work of the nurse and healthcare related organizations including in the development of an Association mentoring Association. the Massachusetts Organization of Nurse Executives, program. The Membership Committee believed that Rhode Island State Nurses Association, Massachusetts such a program would provide a strong foundation for Mission Statement Extended Care Federation, Massachusetts Hospital future development and implementation of successful To develop and implement an Association Association, Massachusetts Association of Colleges mentoring programs for recent nurse graduates Mentoring Program that will facilitate mentor/mentee of Nursing, Institute of Nursing Healthcare at local and national levels and promote career partnerships to encourage professional development Leadership, and Staff Development Association. The development through professional organizational and networking among the membership. Committee will meet on a regularly-scheduled basis involvement. The Task Force submitted a proposal to the to assist in program development, oversight and Evidence exists to indicate that mentoring Center for American Nurses (CAN) in January 2008 evaluation. Program outcomes will be featured in the programs benefit not only the workplace for program funding and was overjoyed to learn MARNNewsletter and posted on the MARN website. environment, but also the mentor, the mentee, and in April that MARN was awarded the CAN 2008 MARN is thrilled about this initiative to support the nursing profession by positively impacting a Growth, Innovation and Advocacy (GIA) Grantee and promote professional nursing. Stay tuned for new nurse’s role transition and reducing attrition Award to support development and implementation additional details! rates by reducing stress and increasing nurse of “Mentoring Matters: A Pilot Program for Novice satisfaction (Bally, 2007; Greene and Peutzer, 2002; Nurses.” Project goals are to develop a pilot references Hurst & Koplin-Baucum, 2003; Lloyd & Bristol, 2006; mentoring program that will: (1) promote career Bally, J. (2007). The role of nursing leadership in creating Thomka, 2001; Tourigny & Pulich, 2005). In one study development, advocate professional partnerships, a mentoring culture in acute care environments. Nursing by Greene and Peutzer (2002), attrition was reduced Economics, 25(3), 143-149. and provide educational opportunities for sharing Greene, M. & Peutzer, M. (2002). The value of mentoring: from 21 nurses during an 18 month period to five of knowledge and expertise; (2) facilitate self-esteem, A strategic approach to retention and recruitment. Journal of nurses in the same period after the inception of a confidence, self-enrichment, and continued personal Nursing Care Quality, 17(1), 67-74. mentoring program (Greene & Peuter, 2002). Research and professional growth to promote positive work Grindel, C. (2004). Mentorship: A key to retention and also validates the benefits to an organization in environments; and (3) assist nurses who are new to recruitment. MedSurg Nursing, 13(1), 36-37. providing a mentoring program (Bally, 2007; Greene the profession to develop strategies to reduce work- Hurst, S. & Koplin-Baucum, S. (2003). Role acquisition, & Puetzer, 2002; Grindel, 2004; Hurst & Koplin- related stress through mentoring relationships. The socialization and retention: Unique aspects of a mentoring program. Journal of Nursing Staff Development, 19(4), 176-180. Baucum, 2003; Tourigny & Pulich, 2005). A formal pilot program will pair novice nurses within their Lloyd, S. & Bristol, S. (2006). Modeling mentorship and mentoring program can be instrumental not only first 18 months of practice with experienced nurses collaboration for BSN and MSN students in a community in setting clearer role expectations for professional who will serve as their mentors. Both mentees and clinical practicum. Journal of Nursing Education 45(4), 129- nursing practice, but also in facilitating acculturation mentors would be required to commit to a 12 month 132. for both novice and more experienced professional mentoring relationship. A 12 month timeframe Thomka, L. (2001). Graduate nurses’ experiences of nurses (Bally, 2007; Tourigny & Pulich, 2005). will afford the dyads opportunity to establish a interactions with professional nursing staff during transition to the professional role. The Journal of Continuing Education MARN believes that healthy beginnings are relationship that will enable the mentoring process. in Nursing, 32(1), 15-19. crucial for new members of the profession. We Guidelines will be developed both for the selection Tourigny, L. & Pulich, M. (2005). A critical examination also believe that we have an obligation to provide of mentors and mentees as well as the mentoring of formal and informal mentoring among nurses. The Health opportunities through which strong nursing values program requirements. A Mentoring Coordinator will Care Manager, 24(1), 68-76. Page 6—MAssachusetts Report on Nursing—September 2008 Introducing New MARN Board of Directors Secretary Grandfathers Lindsay L. Gainer, RN, MSN, CPON has served Barbara A. Blakeney will not give up. He is called the liberal lion of the as a MARN Board Member since the fall of 2007. Senate and he has clearly, over a 40 plus year career Lindsay comes to us from the North Carolina I once had the opportunity to tell him that my earned the title. Nurses Association were she served as a Regional grandfather thought his grandfather had been Orrin Hatch, the conservative Senator from Utah Director on their Board of Directors from 2005- a decent man “of the people.” My grandfather who has become a good friend, has said he ran for 2007. She strongly believes in the collective voice believed that of his grandfather because on many the US Senate to take on the Ted Kennedy’s and that state nursing organizations and the American occasions my grandfather, the Boston cop, escorted found himself working with him. Senator Hatch has Nurses Association provide to our profession. She his grandfather, the Boston Mayor, on his rounds written a song about his friend that was played at enjoys serving on the Board of Directors of MARN of wakes, rallies and other events so essential for a the Democratic Convention in August 2008. Imagine and giving back to the nursing profession. politician early in the last century. It wasn’t that the that, a conservative Republican penned a song Mayor attended all these functions so much that honoring his liberal friend and it will be played at a Directors impressed my grandfather, as it was that he took the Democratic convention. Senator Kennedy once said Susan L. Conrad, RN, PhD has been a nurse time at each stop to shake the hands of the workmen of his friend Senator Hatch, “When we co-sponsor a educator for 35 years. She is dedicated to helping on their way home, still in their work clothes, often bill people just assume that one of us hasn’t read it.” nurses advance their professional development. covered in dust and dirt. They’d doff their caps and It’s a testament to both that good people can reach “Professional organizations, such as MARN, offer try to wipe their hands on their pants before shaking beyond bare knuckle politics and create change. a safe and nurturing environment for growth the Mayor’s hand. Hard working men surprised Ted Kennedy is a master at building bridges. He is and self-fulfillment. As a member of the Board of and pleased that the Mayor would stop the embodiment of the saying “Politics Directors, I hope to help shape nursing’s future and talk with them. I told him that my is the art of the possible.” If this is the and the leaders of tomorrow.” grandfather thought that any politician case then Ted Kennedy is a true artist Barbra J. Gray, RN, BSN believes that nursing is who would do that was a good man “of who, through his skill and commitment a field that affects all realms of spiritual, physical the people.” has made many things possible. Were and mental life. As a new graduate Board member, His face broke into a wonderful broad I to chronicle his accomplishments I she was exposed to the background of health care smile and he took me aside and treated me to several would need this entire issue to do so. No one works in which nursing plays a significant role. “This stories about his grandfather. He described how as a harder in the Senate than Ted Kennedy. has enlightened me on how nurses can make a boy it was his job to ride off on his bicycle each day to In all the times I’ve met him and spent a bit of time difference.” She believes that it is part of the role get all the Boston papers and in those days the papers with him, I’ve never actually thanked him for all he of a nurse to become involved in professional were “two a days” so his trip was both morning and has done and all he has tried to do. I should. In this organizations that empower nurses to advocate for evening. He told me how his grandfather loved to day and age we are quick to voice our displeasure our profession. travel about the city and meet people, how he never and slow to share our praise. Anne P. Manton, PhD, APRN, FAAN, FAEN seemed to tire of the stories of the city and how Senator Kennedy, thank you for all you have thinks that the myriad of issues that confront sometimes his grandfather would take him along. He accomplished and all you continue to do. Thank today’s health care in general, and nursing in was animated and a good story teller, but his assistant you for going to the Senate in the middle of your particular, are complex. “Nursing’s voice must was becoming anxious because he was now late for treatment to cast the deciding vote on an important be heard and nursing’s influence felt as plans are his next event. He seemed not to notice and as we health care bill. Thank you for your support of nurses developed to address these issues.” Anne became shared stories about our grandfathers I appreciated and quality, affordable accessible health care for all. a part of the Board of Directors of MARN because more than ever the commitment, passion and tenacity Thank you for fighting for quality education. Thank it is the best way for nurses to have a voice in of the man who has been my United State Senator the you for supporting increases in the minimum wage. shaping the future of the nursing profession. She majority of my life. Thank you for making peace a priority. I’m proud you believes that it is important to continue to increase Ted Kennedy is in the fight of his life—for his life are my representative in the United States Senate. the membership of MARN as we endeavor to fulfill and if we know anything about our Senior Senator Somehow I can’t help thinking your grandfather is this role. “I believe that because of my years of it is that he will give it his all and through it all he proud as well. experience in leadership roles in ANA and other will continue to fight for those interests that he has May you continue to represent Massachusetts in nursing associations, I will be able to contribute held near and dear his entire career. Ted Kennedy, the United State Senate for many years more with the uniquely to MARN’s ability to positively influence like his grandfather “Honey Fitz” Fitzgerald, has same skill, humor and resourcefulness you always nursing’s future.” a special place in his heart for working men and have. women. He has spent his career trying, through Nominating Committee legislation and public policy, to make sure working Patricia A. Edwards, EdD, RN, CNAA believes people get a fair shake. It’s been Ted Kennedy who that active involvement in your professional has pushed, sometimes for years at a time to improve organization is a responsibility of every nurse the minimum wage, to enhance Head Start, and early and she wants to serve MARN as a member of the childhood education. It’s been Ted Kennedy who has Consider Me nominating committee. worked for decades to improve access to health care. Nursing simply cannot have a better friend. Time I am frail after time he has taken on the hard issues. He simply I am an orchid I am a buffalo I have a hump I am sacred to God

Consider me Consider me Please consider me

I don’t hear well I have no teeth I can’t see now Yet I am here Please consider me

When I struggle to look into your eyes I know Whether you are really here, or not…

Please touch me with tenderness Please handle with care

I am old I used to be you You will be me

We are here together Years tell us the truth… Always

I am frail I am an orchid I am a buffalo

I am more human than I’ve ever been Diane Findlen Garrow September 2008—MAssachusetts Report on Nursing— Page 7 Expansion of Mandated Mental Health Benefits Signed by Governor Patrick, August 5, 2008

mental health professionals including psychiatric clinical nurse specialist members of NURS, updates the current list of nine biologically-based conditions covered by the 2000 law, to include coverage of these three additional conditions. Furthermore, the bill expands mental health coverage for children diagnosed with autism. This represents a significant expansion of mandated mental health benefits in the Commonwealth since the MHPL was enacted. "As a psychiatric nurse clinical specialist, I am pleased that Mental Health Parity, which was first adopted in the year 2000, mandating insurance coverage of Governor signing Secretarys Ledholm & Bigby biological psychiatric disorders same as physical illnesses, will now also include Eating Disorders, individuals of all ages, enabling them to live, work and participate in their communities.3 “This by Craven & Ober Policy Strategists, LLC Post Traumatic Stress Disorder, Substance Abuse and Autism. It is vital that anyone historic legislation is both health care expansion and civil rights legislation. It expands treatment The Massachusetts House of Representatives experiencing a mental health illness have access to treatment without having to worry about their for mentally ill and addicted individuals and ends on June 30th overwhelmingly passed the Mental discrimination against the people who suffer from Health Parity House Bill 4423. The Bill was insurance coverage," said Representative Kay Khan (D-Newton). Representative Mary Grant these diseases,” noted Chairwoman Balser. introduced by the House Chair of the Joint Craven & Ober Policy Strategists, LLC is a full Mental Health and Substance Abuse Committee, (D-Beverly), also a psychiatric clinical nurse specialist serving in the Massachusetts House service Massachusetts-based government relations Representative Ruth Balser (D-Newton) and firm dedicated to credible, assertive advocacy it builds on the first Massachusetts Mental of Representatives noted, “We continue to move 1 closer and closer to understanding through our and to the dissemination of reliable public policy Health Parity Law which gave full coverage to information. “biologically-based” mental disorders, such as payments and our policies that mental health is an neurodegenerative disorders. The Massachusetts references State Senate before the end of the formal session 1. Chapter 80 of the Acts of 2000. on July 24th, voted to pass the measure as Senate 2. Health Law Advocates Testimony before Joint Bill 2840 and sent it to the Governor’s desk. Having Committee on Mental Health and Substance Abuse the Governor sign the bill into law August 5th, this Regarding Mental Health Parity Law, April 3, 2006 new law will take effect July 1, 2009. accessed August 4, 2008 at http://www.hla-inc.org/ In 2000, the Legislature passed, “An Act Relative public/mental.health.par.4.3testimony.pdf to Mental Health Benefits,” now referred to as the 3. Massachusetts Department of Mental vision and Mental Health Parity Law (MHPL). The original mission statement accessed August 4, 2008 at http:// www.mass.gov/?pageID=eohhs2agencylanding&L=4&L0 MHPL designates the following mental disorders as =Home&L1=Government&L2=Departments+and+Divisi biologically based: schizophrenia, schizoaffective ons&L3=Department+of+Mental+Health&sid=Eeohhs2 disorder, major depressive disorder, bipolar disorder, paranoia and other psychotic disorders, obsessive-compulsive disorder, panic disorder, Commissioner and Chair delirium and dementia and affective disorders. It requires private insurers, Blue Cross/Blue integral part of the overall health and functioning Shield and HMOs to cover treatment of mental of every citizen. Expanding what is covered helps health conditions on a non-discriminatory basis, us move forward.” compared to coverage for “physical illnesses.” The In addition, the new law provides a significant law also applies to health plans offered to state regulatory change. The Commissioner of Mental employees and retirees of the Group Insurance Health will now have unilateral authority to Committee. The law does not apply to so-called require unlimited coverage for any additional “self insured” plans governed by federal ERISA disorder contained in the DSM. Under law. Governor Patrick’s Administration, the current Since 2000, a number of issues have arisen. The Commissioner of Mental Health is Barbara Department of Mental Health was authorized by Leadholm, a psychiatric clinical nurse specialist the Legislature, in consultation with the Division herself. This is a meaningful policy difference representative Balser speaking of Insurance, to add to the list of “biologically- given the Massachusetts Department of Mental based” illnesses that are covered services, but Health’s (DMH) vision, as the State Mental unfortunately, prior Administrations have Health Authority, to promote mental health been unwilling to do so. Health Law Advocates through early intervention, treatment, education, together with a number of organizations and policy and regulation so that all residents of the advocates, mindful of this provision, petitioned Commonwealth may live full and productive the Commissioner of Mental Health back in 2004, lives. DMH assures and provides access to services specifically requesting that eating disorders be and supports to meet the mental health needs of added to the list of biologically based illnesses.2 The petition was unfortunately dismissed, leaving the question of whether eating disorder treatment was a service covered by Massachusetts carriers. The original MHPL left out coverage for eating disorders, post-traumatic stress disorder (specifically mentioning rape) and substance abuse. This new law, passed with the advocacy of Page 8—MAssachusetts Report on Nursing—September 2008 NEWS FROM THE NURSING ARCHIVES Mary Ellen Doona rn EdD Posterity is left to speculate. It is not unreasonable Saturnia into a hospital ship and commissioned her to assume that being awarded the Frances Slanger the U.S.S. Francis Slanger. rita Flynn nursing Scholarship Medal for excellence in surgical nursing as she As precious as the Slanger Medal was, it was only at northeastern University graduated from the BCHSON (7 September 1956) with the passing of years that Flynn came to a full might have been when Flynn began to realize that the understanding of its true worth. With her best friend The late M. Rita Flynn (9 April 1935-4 January past touches the present. and sister, Ann Marie McDonald (BCHSON 1945), 2005) epitomized many nurses of her era. After The award came as a “complete surprise,” Flynn Flynn attended the NAA annual meeting in the earning a nursing diploma from the Boston City recalled many years later, adding “I slightly remember Spring of 2004 where they listened to Bob Welch the Hospital School of Nursing (1956), she practiced the Director of Nurses, Ms. Margaret B. Welch, author of American Nightingale: The Story of Frances nursing at the Boston City and the Peter Bent Brigham mentioning Frances Slanger.” Flynn treasured the Slanger, Forgotten Heroine of Normandy (Simon and Hospitals while continuing her education first at gold medal and learned once she became a graduate Schuster). Flynn pointed out to the Slanger family Boston College where she earned a baccalaureate nurse in the operating room that the supervisor, head the Medal that rested in the exhibit next to Slanger’s degree (1962) and then at Northeastern University nurse and surgeons had recommended her for the Purple Heart and a copy of 7 November 1944 Stars where she earned a masters degree (1966). These award. These senior professionals touched the future and Stripes. Slanger came alive as Flynn chatted with clinical and academic credentials, made Flynn part as they validated the worth of the young nurse. her family. of the profession’s post war transformation and Slanger who was just four foot ten inches tall had Five decades after receiving the Slanger Medal, subsequent movement of its education from hospitals also graduated from the BCHSON (1937). A few years Northeastern University’s Nurses Alumni Association to college campuses. She accepted a position with the later on D Day (6 June 1944) she was hanging on to the has created the Rita Flynn Nursing Scholarship nursing school at Northeastern University where she straps of a taller soldier so she would not be washed to be given to a nursing student in clinical or directed its cooperative program. beneath the waves as she landed with the U. S. Army cooperative experience. Jane Franks and her husband As Flynn matured in her profession, she realized in Normandy. For the next four months Slanger and Peter donated the lead gift. Nancy Hoffart, Lynn that where nursing had been was as important as her fellow nurses in the 45th Field Hospital cared for Babbington, both current faculty members, and Elaine the urgent now of practice. That heightened sense wounded soldiers. One evening after duty Slanger Capozzoli, a retired faculty member and Flynn’s of nursing’s history prompted Flynn’s joining the wrote a letter to the GIs telling them: “We want [the colleague added to this gift, as did, alumni: Marie Nursing Archives Associates soon after it was soldiers] to know how much we think of them” and DeSisto and her husband Thomas of Massachusetts, established in 1970. As crowded as her organizational mused with her unseen audience how their lives Mary Margaret Baker of Hawaii, Kathy Davidson, commitments to her alumnae associations, were like the fire that warmed her as she was writing Ginny Murphy; and, other Northeastern University professional associations and nursing’s honor society the letter. Even “if there is a spark of life in a fire,” staff: Cindy Zilch and Nan Wetherhorn. Grateful for already were, the NAA had priority for the rest of her she said, “it can be nursed back to life.” So, too, can the NEU experience and guided by then Dean Nancy career and life. Once she became a director of the a human being be nursed back to life. “It is slow, it is Hoffart the NEU Alumni Association encouraged the NAA Board and later its vice-president, Flynn was gradual,” she wrote, “but nurses do it all the time in gifts from many other alumni to recognize Flynn’s able to shape policy even as she focused on making these field hospitals.” guidance of nursing students in their cooperative nursing’s historical record readily available. She That evening, 21 October 1944, she mailed her program. took on the arduous task of revising the NAA’s by- letter to the GI newspaper, Stars and Stripes. A few Each time the Rita Flynn Nursing Scholarship is laws, which made it contemporaneous with changes hours later German artillery strafed the camp striking awarded, the past will touch the present. Recipients happening in the profession. Similarly, she served as many nurses. All recovered except for Slanger who will not have known the tall, slim, blonde nurse with an unofficial parliamentarian ensuring that meetings died within hours of being wounded. Unaware of the warm smile that lit up her brown eyes but at the did not stray from the task at hand. Effectively, what had happened, Stars and Stripes published ceremony they will learn of her dedication to their Flynn said by her behavior that nursing’s history was Slanger’s letter in its 7 November 1944 issue. Soldiers predecessors and their co-operative experiences. serious business. were always expressing their gratitude for the nurses’ The awardees will be furthering Flynn’s own The time has long since passed when Flynn herself care and compassion. That gratitude only increased commitment to nursing as they use the scholarship might have answered the obvious question: How did once they learned of Slanger’s death. Before long the to advance their own learning. And each time that nursing’s history become of such importance to her? military responded, refitted the Italian luxury liner happens the present will honor the past. September 2008—MAssachusetts Report on Nursing— Page 9 Advanced Practice News

Rep. Callahan made these remarks on behalf of the Massachusetts League of Community Health A Victory for nurse practitioners: Centers, Inc.; 1 of whom shall be a representative of It is a beautiful day. The sun is shining and the the Massachusetts Medical Society; 1 of whom shall sky is blue. But today we have to reflect on important be a representative of the Massachusetts Center for Massachusetts Nurse legislation. I had to file an amendment to undo Nursing, Inc.; 1 of whom shall be a representative of language that was aimed at meeting the needs of the Massachusetts Nurses Association; 1 of whom Practitioners special interest groups rather than for health care shall be a representative of the Massachusetts consumers. Association of registered nurses; 1 of whom I'm very, very pleased that I was able to get the shall be a representative of the Massachusetts S 2660 Promoting Cost Containment, Transparency listening ear of the gentlewoman from Stow and the Hospital Association, Inc.; and 1 of whom shall be a and Efficiency in the Delivery of Quality Health Care Speaker of the House. Each of us has been elected to representative of Health Care For All, Inc. Members Passed by Representatives and Senators speak for those who cannot. We're not elected to do of the council shall be appointed for terms of 3 years the bidding of special interest groups. The Senate or until a successor is appointed.” Myra Cacace GnP-BC President knew better and the speaker knows better, nancy O'rourke, President MCnP and everybody knows that in this chamber we're Massachusetts Association of nurse Anesthetists fighting for families back home. House 5017, An Act relative to nurse Anesthetists July 31, 2008: Nurse Practitioners from around the I had a wonderful conversation with the gentleman (redrafted by Health Care Financing, formally H Commonwealth called and e-mailed their legislators from North Adams, about relaxing out on the grass in 1144 and H 4518, by rep. Khan and others) in record numbers to urge them to remove damaging the western part of the state. But we can't do that yet. language that had been inserted into the section of the It is really difficult to work on a bill and see it finally Legislative History: bill relating to consumer choice of nurse practitioners released but with new language that does not serve 7/24/08 engrossed in the House; 7/28/08 in Senate as primary care givers, prior to being released from the best interests of people who need primary care… Ethics and Rules the House Ways and Means Committee. language that could undo an entire industry. For Nurse Practitioners, their role and services People at home are waiting months to get an are a pivotal component of the bill. For the first time, appointment with their primary care providers who What the Bill Does: all health insurers will be required to recognize can't meet the current demand, never mind who must Gives nurse anesthetists the authority to NPs as primary care providers and list them in deal with the insurance access provision we passed. order tests and therapeutics and prescribe directories along side other primary care providers so Today, through a lot of hard work, I think we've been medications in accordance with regulations consumers may choose them to coordinate and direct able to come to a consensus. What this amendment promulgated jointly by the Board of nursing their care. This also makes NPs more transparent is going to do is going to fix some important things. and the Board of registration in Medicine after in the health care delivery system, making it easier It's going to provide transparency for consumers to consultation with the Board of registration in to measure and report the outcomes of the care they see a complete list of health care providers that are Pharmacy. deliver. Massachusetts now joins 24 other states that available to them and to pick a nurse practitioner to recognize the NP as a primary care provider in the help them to feel better. law! The other important item in this bill is the Nurse anesthetists are recognized in The bill's 62 sections have many other provisions restoration of loan forgiveness for both physicians Massachusetts, along with nurse practitioners, nurse notable for advancing NP practice and the NP role. Of and nurse practitioners. This is a comprehensive midwives, and psychiatric nurse clinical specialists, note the bill: amendment, but if we fail to pass it, we cannot claim as advanced practice nurses (APNs). Nurse to increase access to primary care. practitioners, nurse midwives, and psychiatric nurse • Focuses on "providers," not just physicians; Today I want to thank the people who signed onto clinical specialists currently have the authority to • Establishes a new Health Care Workforce the original amendment. I want to thank the speaker order tests, therapeutics and prescribe medications. Center with a particular emphasis on primary who listened to the wisdom of the people working in Nurse anesthetists are the only APN group care, including NPs. The Center will develop the field, the nurse practitioners. I want to say that authorized to practice by the Board of Registration in short and long term policies to address the original language in the Senate President’s bill Nursing that currently does not have this authority. workforce shortages; was the right language. • Creates a new loan forgiveness program for If we are not able to pass my amendment, we will rationale: doctors, NPs and nurses who commit to fail to do what is right by the people in favor of doing • Nurse anesthetists have a proven track record of practicing in certain specialties; what is right by the special interest groups. We can't delivering safe and cost-effective care. • Requires the recognition of NPs for consumer just take a bill that is lobbed over to us from the choice and increased access to primary care; Senate and not do due diligence…even if it is the end • Confusion over the ability of nurse anesthetists • Authorizes a MassHealth "Medical Home" of a beautiful day in the middle of July. to write prescriptions related to pre and post- Demonstration project to encourage primary Thank you very much. anesthesia care, has made it more difficult for care "providers" to adopt a coordinated, The amendment was adopted. Chorus of yeas nurse anesthetists to deliver quality care to patient-centered care model; came from members. BY A ROLL CALL VOTE OF patients in some settings. Nurse anesthetists • Establishes a Pharmacy Academic Detailing 152-0, THE BILL WAS ENGROSSED. This legislation need clear authority to order tests and Program to educate "providers" who prescribe, is on the heels of the state's passage of massive therapeutics and prescribe medications, just as on the use of therapeutic alternatives in lower reform just last session to insure every citizen of the their APN colleagues now have. cost brand names and generic drugs; Commonwealth. • The Board of Registration in Nursing • Creates an affordable housing model for requires that APNs are educated in advanced health care "professionals" committed to MARN to have a designated seat pharmacotherpeutics and work in collaboration providing care in underserved regions; on the Advisory Council. with a physician. Prescriptions written by • Establishes a Nursing and Allied Health The legislation also establishes a 16 member APNs must also include the name of the APNs Workforce Development Trust Fund to Healthcare Workforce Advisory Council. There is a supervising physician. increase the nursing workforce and creates designated seat on the Advisory Council for a MARN • Twenty-five states and the District of loan forgiveness/incentive programs for representative. Columbia authorize nurse anesthetists to write graduates who commit to serve as nursing As stated in the legislation: prescriptions. faculty for a specified number of years; “The council shall advise the center on the • Directs the MassHealth Payment Policy capacity of the healthcare workforce to provide Advisory board to study methods of timely, effective, culturally competent, quality Examples of how this bill will benefit the anesthesia improving reimbursement or bonuses for physician and nursing services The council shall patient by enabling timely and efficient anesthesia "providers" engaged in primary care. consist of 16 members who shall be appointed by care by nurse anesthetists: the governor: 1 of whom shall be a representative of the Massachusetts Extended Care Federation; 1 • Preoperative care: With this authority, the nurse Stacey Ober, of Craven & Ober Policy Strategists, of whom shall be a physician with a primary care anesthetist will be able to assess and evaluate LLC shared details of the vote in the State Senate: specialty designation who practices in a rural area; patients for anesthesia and surgery and order We won this battle and had our amendment 1 of whom shall be a physician with a primary care lab testing and medications before surgery. adopted! Ours was the very last amendment specialty who practices in an urban area; 1 of whom Examples of pre-op tests include cardiac negotiated to be adopted before the vote on shall be a physician with a medical subspecialty; consults, blood tests, pulmonary function tests the entire bill, due to some fine footwork and 1 of whom shall be an advanced practice nurse, (PFT), EKGs, neurological consults, X-Rays, etc. exceptional understanding of issues important authorized under section 80B of said chapter 112, Examples of pre-op medications include pain to nurse practitioners on the part of the sponsor who practices in a rural area; 1 of whom shall be an medications, antibiotics, anti-anxiety drugs and of the amendment, Rep. Jen Callahan. Two advanced practice nurse, authorized under section prophylactic medications for nausea. other amendments which had an impact on our said 80B of said chapter 112, who practices in an • Postoperative care: The CRNA will be able to amendment were also adopted—the loan forgiveness urban area; 1 of whom shall be a representative of the better manage patients in the recovery room; for section and a change in the text relating to physician Massachusetts Organization of Nurse Executives; 1 of example, she can order medications for pain, assistants. We will have to wait to see what the final whom shall be a representative of the Massachusetts nausea, and high and low blood pressure. product looks like after the House clerk pulls together Academy of Family Physicians; 1 of whom shall be a all the changes which occurred before the vote was representative of the Massachusetts Workforce Board For more information, contact Mary Ann Hart at taken. Association; 1 of whom shall be a representative of 617-797-8488 or [email protected]. Page 10—MAssachusetts Report on Nursing—September 2008 the first and second floors of the new hospital. The doctors taught the pupil nurses how patients should be nursed and had volunteer women teach cooking, sewing and housekeeping. When Wilhemina Worth, Clio’s Addie Kelton and Nettie Hathaway graduated, Mrs. Elizabeth Stone handed them their diplomas and her fellow lady business manager gave each a bouquet Corner of “choice” flowers (Newsclipping, May 18, 1887). Mary Ellen Doona Several years later when Mary Hackett, a graduate of the Long Island College Hospital Training School rn, EdD Historian came to Waltham to nurse her sister, Worcester persuaded her to join the School. Worcester’s concept of nursing was the neighbor nursing that he had witnessed and done as a child. When he was twelve years old he had nursed his Dr. Alfred Worcester and the friend during a bout of typhoid fever. Through the long night of watching the convalescent, Worcester Waltham Training School changed his feverish friend’s bedding, and then washed and dried the soiled linens. He had learned Waltham Training School for nurses Class of For Nurses from the example of his mother and father that 1889. Superintendent most likely is Mary Hackett. neighbors helped neighbors when they were sick. The Photo by Waltham Historical Society, Inc. Mary Ellen Doona rn EdD tasks were various. Some provided nursing services as night watchers allowing the worn out family to get The Trained Nurse as doctors focused on science. His solution was to some rest, while others did housework, farm chores make nursing medicine’s art. As was his wont, he did Movement was a decade or read to a blind person. The occasional neighbor old in 1885 when Alfred so without collaborating with nurses who were on stood out for natural skill in caring for the sick, said another path. They hoped that path led to nursing as Worcester, M.D. (1855-1951) Worcester, suggesting that in these “born nurses” an 1883 graduate of Harvard a distinct profession with its education separate from rested the seeds of the nursing profession (Worcester, a hospital’s labor needs. Their efforts came to naught Medical School and his A. 1949). partner Dr. Edward Cutler in 1903 when they were unable to persuade Simmons Worcester contended that it was “a mistaken College in Boston’s Fenway to create a program opened a hospital in Cutler’s idea” that hospital training such as that at the house on Waltham’s Main preliminary to clinical nursing. Massachusetts General Hospital or Boston City During this same time, as Harvard Medical School Street. The year before they Hospital was sufficient for neighbor nursing had joined with medical erected its magnificent buildings on Longwood (Worcester, A. 1926, 1027). He was keenly aware Avenue, Worcester turned to his alma mater to peers to found the Waltham Alfred Worcester that most graduate nurses practiced in people’s Fellows of the Massachusetts institutionalize his concept of nursing. It did no harm M.D. in red Cross homes. The problem with graduate nurses, said that Worcester held three Harvard degrees and was Medical Society. The uniform c. 1925. Worcester, was that people of little means, such as following gives an idea of the the son-in-law of former President Thomas Hill (1862- Photo by Waltham the immigrants and factory workers in industrialized state of medicine practiced 1868). President Charles Eliot (1869-1909) looked Historical Society, Inc. Waltham, could not afford to hire a nurse, and those at that point in Waltham. with favor on Worcester’s proposal for a nursing who could afford nursing services were unable to school at Harvard. The necessary large endowment Appendectomies and locate a nurse. The Boston Medical Library’s directory caesarian sections were radical procedures, surgeries was readily promised but the benefactor’s portfolio of nurses addressed the latter problem so successfully took a hit on the stock market. As Worcester put it, at home were a common practice, infectious diseases that doctors and patients found nurses easily and the were the leading cause of death, antibiotics were a “Obstacles…wrecked the enterprise before its start” fees that nurses paid dissolved the Library’s debt. (Worcester, 1949 [6]). Harvard’s interest in nursing century away and refusal to believe that bacteria By 1912 as part of their organizational efforts nurses caused disease was ordinary. changed during President A. Lawrence Lowell’s would develop their own Central Directory. (1909-1933) administration. The University declined It was in this climate that Worcester and his The nursing services that the WTSN provided the medical peers opened the Waltham Training School the honor of implementing the recommendations community differed from those of graduate nurses of the Rockefeller Foundation’s study of nursing for Nurses. The doctors lectured pupil nurses on and, as well, from those offered by the innovative the basic sciences each week, first in a hired parlor, [Goldmark Report, 1923]. Yale University accepted Boston Instructive Nursing Association that Phoebe and established its nursing school. then in a former grocery store on the corner of G. Adam and Abbie Howes founded in 1886. The Lyman and Main Streets and finally in rooms on Worcester had taken some comfort in Eliot’s BIDNA nurses went into homes to care for the sick promise: “Neither you nor the Waltham Training poor, most of whom were immigrants, and to instruct School for Nurses need have the least fear of their them in hygiene. Boston philanthropists who equated [Massachusetts State Nurses Association] hostility” sin with sickness, underwrote these services as part (Worcester, 1949, [6]). For their part, the nurses stayed of their mission to teach immigrants American ways, focused on education as the criterion for training and thereby, protect the city’s health and morality. schools. During the same ten years that the number of Worcester’s WTSN contrasted with its training schools increased from 35 to 432, nursing’s contemporaries at the MGH (1873), BCH (1878) and leaders created: a superintendents society (1893); Massachusetts Memorial Hospital (1883) and with the training school alumnae associations (c. 1893); a BIDNA. The WTSN was not associated with a general national nursing organization of the alumnae (1896); hospital nor with philanthropy. It was a free-standing and, the American Journal of Nursing (1900). Then, school where pupil nurses paid tuition, cared for along with other state associations throughout the patients in Waltham, Lincoln, Auburndale, Concord, United States, Massachusetts’ nurses began a drive to West Newton, Newtonville, Watertown and Belmont gain laws to regulate the practice of nursing. and collected fees for their services which were From 1903 to 1910 they sponsored House Bill turned over to the School. The WTSN’s uniqueness #564: An Act to Regulate the Practice of Professional would eventually become its downfall. Nursing of the Sick in the Massachusetts Legislature. In the meantime, the number of hospitals grew That bill sought an all nurse board of registration and training schools proliferated. Each promised and mandated graduation from a training school in a a nursing education but exacted the cheap labor general hospital. The severity of the opposition earned of their pupil nurses. Medicine staunched the for the Massachusetts’s bill the distinction of having proliferation of hospitals and Rockefeller millions been the most virulently resisted. The men nurses, subsidized the reformation of medical education. The most of whom had trained in specialty hospitals like hospital ward became the classroom where medical the McLean Hospital, were not eligible for registration students studied the cause of disease and learned to according to the bill’s criteria. Rightly, they feared make exact diagnoses. The pupil nurse became more that their earning power would suffer if registration essential as the hospital replaced the home as the site were passed. Many of them joined doctors and of care. The reformation of nursing education would hospital administrators against the nurses. A valiant have a prolonged and troubled journey. few did not and these are listed in 1910 among the Worcester feared for medicine’s art of practice first registered nurses in Massachusetts. The doctors supporting the nurses were vocal but their voices were too few. When a much watered down bill was passed, nurses had won the educational criterion but the governor appointed a doctor to head the Board of Registration in Nursing. Two years before his death at ninety-six Worcester summed up for the Harvard Medical Alumni Bulletin (1949) what registration of nurses meant: “All went well with us [WTSN] until the graduates of Hospital Schools obtained the political and legislative control of nursing. [The 1910 law] made the [WTSN] diploma worthless” (Worcester, 1949). In 1919, when Worcester was president of the Massachusetts Medical Society (1919-1921) the Massachusetts State Nurses (continued on page 11) September 2008—MAssachusetts Report on Nursing— Page 11 listened to the Dean of the Yale School of Nursing Clio’s Corner . . . (Memorial, 1930, 781-2). His wish for nursing’s (continued from page 10) connection with Harvard was history as his WTSN soon would be. Association’s secretary, Mary E. P. Davis, wrote him The WTSN closed in 1935 in its fiftieth year having that his training school graduates had lost their graduated seven hundred and seventy-six nurses. eligibility for membership in the MSNA because: The elegant u-shaped WTSN building that Robert pupil nurses were sent out to care for patients without E. Glancy of Watertown built in 1899 with its front being fully trained; the employment of pupil nurses parallel to the Charles River and its rear facing Christ was unfair to graduate nurses; and, earnings of the Church Episcopal at 760 Main Street was sold to the pupil nurses belonged to them and not the WTSN. Rhineheart Functional Handwriting System. Various That year after the nursing registration success, Waltham Training School for nurses as seen from owners succeeded Rhineheart through the years until 1911, Whitcomb and Barrows of Boston published the rear facing Main Street. the building came to rest most recently with Fred Linda Richards’ autobiography, Reminiscences of Photo by Waltham Historical Society, Inc. Kimberk. Architect Kimberk who is rehabilitating America’s First Trained Nurse. Worcester persuaded the building celebrates its small foot-print and its Richards to write the autobiography and called heard his grandmother’s eyewitness account of the wood, brick and stone structure. His commitment on a convalescent living with the Worcester’s to battle in Lexington between the Red Coats and the to Waltham’s history is evident in his designating edit the text. Two of Richards’ former associates, Minutemen. His patriotism was American born and rooms on the building’s first floor for exhibits of the Edward Cowles, M.D. with whom she developed the bred. Perhaps his antipathy to American nursing Waltham Historical Society, Incorporated. There, Co- training schools at the Boston City and the McLean rested in his memory of his parents and neighbor presidents Sheila FitzPatrick and Wayne McCarthy Hospitals, and John Berry M.D. with whom she had nursing that remained so precious he could not mount displays from the documents and artifacts created the training school in Kyoto, Japan testified tolerate any criticism of it. Here the evidence is silent. the Society has collected and preserved since 1913. in the introduction to Richards’s preeminence in the Nonetheless, history was important to Worcester. The Society’s efforts have made it possible to tell the Training School Movement. Most likely Worcester He was a charter member of the Waltham Historical story of Worcester’s contentious relationship with suggested the title but he added nothing to the Society, Incorporated. He valued the past and was Massachusetts’ nurses. introduction. This is a strange omission given their sensitive to how the future would look back on its long relationship having first met in 1883 when he past. In 1930 he created an historical moment that Works cited. Eaton, Louise. (31 August 1989). Correspondence with was a medical student and Richards was at the BCH. served him more than it did its subject. In the last Mary Ellen Doona. Stranger still was the absence in a book about the month of her life, Worcester had Linda Richards Newsclipping. (18 May 1887). Alfred Worcester Box, first trained nurse of any encomiums from nurses. transferred from the Frances Willard Homestead in Waltham Historical Society, Incorporated. Worcester later relished the praise nursing’s leaders Northborough, Massachusetts to the New England No author. (1930). The Memorial Service for Miss Linda gave the volume unaware of his part in its existence Hospital for Women and Children. Private nurses had Richards. American Journal of Nursing, 30: 781-782. (Worcester, 1949). Strangest of all, Richards never cared for Richards during the five years since she Worcester, A. (21 August 1919). Address: Fiftieth revealed the story behind her story. suffered a stroke 17 March 1925. Richards spent her Anniversary of the New England Hospital for Women If the nursing leaders claimed Richards as the last month on this earth in the hospital where she and Children. Alfred Worcester Box, Waltham Historical symbol of the trained nurse, Worcester claimed had earned nursing’s first diploma. Nursing students Society, Incorporated. her as America’s Florence Nightingale. Worcester of her alma mater relieved her private nurses and Worcester, A. (26 November 1926). Home Nursing. New England Journal of Medicine, 215: 1027-1029. was deferential to Florence Nightingale to the point shrouded her body when Richards died 16 April 1930 Worcester, A. (1949). The Shortage of Nurses: of obsequiousness. His arguments supporting the in her eighty-ninth year (Eaton, L. August 31, 1989). Reminiscences of Alfred Worcester ’83. Harvard Medical WTSN were buttressed with Nightingale’s positions Worcester had his symmetry but his sympathy for the Alumni Bulletin. Alfred Worcester Box, Waltham Historical to the disparagement of American nursing. Important frail old lady must be questioned. Society, Incorporated. what ifs occur at this point. What if Worcester had One month later, on the 16 May 1930 more chosen to forge relationships with Massachusetts’ than eight hundred registered nurses and nursing nursing leaders? And, what if the nursing leaders students gathered for the Massachusetts State Nurses were able to persuade Worcester that their concept Association’s memorial service at Boston’s Old South of nursing was a more valid response to American Church. Worcester, then Harvard’s second Henry needs than Nightingale’s? But he did not, nor did K. Oliver Professor of Hygiene (1925-1935) led the they, and the struggle continued. Worcester persisted eulogists with inflated claims that Richards and in his adulation of Nightingale and flaunted his Florence Nightingale knew each other well. The truth preference for British nursing. He hired her favorite was they had met once over lunch at Nightingale’s nurse, Angelique Pringle, for a two-year stint at the home in May 1877, a visit MGH’s Martin Brimmer WTSN. Then he was offended when Massachusetts’s had arranged in gratitude for Richards rescuing the nurses were “indifferent to Miss Pringle.” Nor could faltering Boston Training School in 1874. Waltham Training School for nurses with gazebo he win over Massachusetts’ nurses with his opinion Lucy Lincoln Drown, BCHSON (1884) who at front entrance parallel to the Charles river. that their mandating a nurse to teach nursing was a succeeded Richards as superintendent remembered Photo by Waltham Historical Society, Inc. “ridiculous requirement” (Worcester, 1949). He had Richards when she was full of hope, energy and started his WTSN without any nursing input and enthusiasm. Mary Riddle, BCHSON (1889), the first continued to dismiss the need. chair of the Board of Registration of Nursing spoke Worcester remained an Anglophile as far as of the light that Richards had cast on the care and nursing was concerned. At the same time, he was comfort of patients. Then, as the Memorial drew to a justifiably proud of being a Son of the American close Annie Goodrich trumpeted nursing education. Revolution. He vaunted the heritage of having It must have cost Worcester a twinge or two as he Page 12—MAssachusetts Report on Nursing—September 2008 Overcome Prejudice and Fear:

emergency shelter and not a mental health clinic, the Students Experience Attitude Adjustments nurses take whatever effective approach necessary to help their clients get their medical care. I think this is a wonderful way to take care of a person in need who The Value of Nursing Leadership in First Clinical Experience Changes would otherwise not have let anyone else treat him. the Setting of Caring for the Homeless Long-held Attitudes The staff at Pine Street Inn does such a great job working with substance abusers! They do not ‘talk by Theresa Lynch, about her experience at by Debbie Cullen down’ to them because of their habits. They reach out Barbara McInnis House to them and help them want to try to turn their lives Pine Street Inn was my first clinical experience as around. The clinic at Pine Street is one-of-a-kind There is much to be said of the perceived value of a student nurse. On May 19, 2008, we were given our and my attitude about life and nursing the homeless title. Our Northeastern University clinical instructor’s placements at orientation. When I first heard I was at has changed deeply and dramatically due to this dominion invited greater cooperation from the Pine Street, I was rather concerned. I live in South tremendous experience. medical team, specifically, providers of this respite Boston and drive by this area all the time. My friends hospital setting, than did the presence of individual and I use to joke about how nobody should ever walk nursing students. Thank goodness for that, for today down there at night. With this was my perspective, Student Nurse Learns Lessons Rebecca asked a nurse practitioner, Karen, to work I was horrified by the idea of facing Thursday… with one of us. When her willingness was apparent Thursday was the day I started clinical. As we were for the Future I seized the opportunity, introduced myself as a oriented to the shelter, and introduced to the nurses student and off we went for the morning. there, on that scary Thursday, I was surprised to find by Brianna Jakubik, nursing Student Ironically, I had not noticed this nurse practitioner my views beginning to change. Class of 2009 during the previous weeks of study. However, I There are so many programs provided at the must remark on the strengths of her clinical poise. homeless shelter to help the people who want to get As a student at the Massachusetts General Her clear maturity and youthful energy, a mirror off the streets. The staff works with homeless men Institute of Health Professions, I was fortunate reflection perhaps, made me smile and admire. and women to help them to find jobs and apartments. to be placed at The Pine Street Inn for my Bio- Assessment of each patient clearly incorporated the There are programs to provide necessary services to behavioral clinical experience. I was eager to emotional as directly as it did the physical. In my homeless people who also suffer from mental illness. learn but unsure of what to expect. The increasing experience, trust is found in the exchange of glances. There are post-detox programs to help the homeless number in the homeless population poses a Could a figure in authority maintain that confidence, population with substance abuse issues. The Pine challenge for nurses to meet each individual's moderate endearment and secure the reliance of a Street Inn is mostly an emergency shelter but offers healthcare needs. It quickly became very obvious client? Karen did just that. case managers for individuals who want to help to me that many factors affect access to healthcare Homelessness creates a vulnerable population themselves. within the homeless population, including lack of with countless needs who require care by skilled It used to frustrate me to walk down the streets and resources and unreasonable costs. nurses. The survival tactics developed by this see homeless people begging for money or swearing at The clinic at the Pine Street Inn provides population can include manipulation and reluctance you as you walked past them. I use to think to myself, healthcare to those in need. The nurses at Pine to lose what little control they feel they have. And “Why can’t they just get off the streets? Money is tight Street demonstrate a tremendous amount of yet, this vulnerability leads to paramount loneliness, for me and my family and we have a roof over our respect for the patient's individuality, and provide pain, and illness. Nursing goals of harm reduction, heads…why can’t they?” My experiences working education that focuses on prevention of illness, patient education, and effecting change, are steps with the people at Pine Street taught me that many such as the importance of a healthy diet, exercise, only achieved with trust. of these people have no choice. Some people are on and medication adherence. The nurses at Pine Karen beholds this tragedy with sincerity. the streets due to a mental illness, or are substance Street approach each patient as a individual with The observed evidence of practice included abusers and have lost their homes because they can sensitivity and competence, and provide the high encouragement, patient accountability, medicinal not keep their jobs and they can not cope with their quality care that every human being deserves. intervention and referrals and she gave each client lives. I never realized how much mental illness My experience as a nursing student in this her full attention. This nurse practitioner excelled in and substance abuse contributes to the problem of setting has been challenging yet rewarding. I have communication as a bilingual provider, expert care homelessness. I have a better understanding that encountered uncomfortable situations involving during assessment, collaborative care by confirming substance abuse is an illness and should be treated substance abuse and mental illness, and have and avoiding conflicting BMC dialysis and cardiac as such and that a person who is addicted needs learned to take risks when responding to meet the appointments, and effective time management as consistent help to overcome the illness. needs of each patient. I recognize that substance evidenced by prompt nursing notes. My favorite story from the clinic is about a patient abuse and mental illness creates uncertain and I gladly followed the footsteps (actually, she wore with a severe mental illness, who is being cared unstable circumstances for the people who are clogs) of this kind mentor, who provided the kind of for by a nurse, who is the only nurse the patient plagued with them. I also learned a bit about inspiration that every nursing student needs during would allow to care for him. This client believed myself, and learned so much about working in their clinical experiences. That day, Karen’s manor that his nurse was actually a lower ranking officer unpredictable environments. I know that the was inviting, tutorial, supportive and encouraging. I who worked with him in the CIA. He called her experience I had and helped prepare me for my had a fabulous experience. “McSergeant” (he was “McGeneral”) so she was future in healthcare. From my experience at Pine allowed to treat him. Since the Pine Street Inn is an Street, I am inclined to continue my work with an at-risk population, and pursue a career involving public service and serving those in need.

(continued on page 13) September 2008—MAssachusetts Report on Nursing— Page 13 Learning to Care for Massachusetts Homeless

(continued from page 12) Alex by robbie Gamble 2/28/01 Not So Bad After All You were close hooked to the humming by Shauna Worrell-Waldron to your riding weight when you died O2 humidifier but all that wiry jockey muscle washcloth over your eyes had pulled up into your chest in another world. The homeless population is one that tends to be as you heaved and strained overlooked within our society. Society has placed for every breath you drew. I imagined it was the tack room the stigma that people who are homeless are violent, dark and pungent with leather, worthless and an unfair burden on society. We often I knew you almost two years, liniment, animal sweat. build a wall between the homeless and ourselves senior third-floor denizen You’d step outside to protect us from perceived danger, but mostly ever serene on morning rounds your racing silks brilliant so that we will not have to be bothered. Honestly, the days I had your team, flashing in the sun think about it: When you are walking in the city or rarely any complaints the gates would clang open riding the public transportation and you come face unfailingly polite and you’d burst away. to face with a person who is homeless (and possibly reminiscing about East End Toronto where you first worked the track The horse was a good one mentally ill), how fast do you hurry by and avoid where I got married. you’d simply lie any communication and or interaction with the low along his neck individual? At first you calmed me let him find his own As a nursing student at the Massachusetts General new-on-the-job provider path through Hospital Institute of Health Professions I had the as you would a skittish racehorse the fading pack opportunity to fulfill my Bio-behavioral clinical just holding me in your presence, surging with ease requirement at the Pine Street Inn located in Boston, and for two years I wrote round the clubhouse turn MA. To say the least, this has been an eye opening the same terse progress note: one length, three lengths ahead and educational experience. I had the chance to advanced emphysema/oxygen pulling away observe, listen and communicate to both men and dependent/no place to go. over the Woodbine grandstand beyond the roaring crowd women under the guidance of my clinical instructor You knew it was the end of the road up, up above the Leslie Spit Trish Bowe who is a Registered Nurse for the Boston patiently waiting out over Lake Ontario Health Care for the Homeless. I learned that many of for something to break. Toronto Islands fading the individuals who reside at Pine Street Inn have in the distance lost their homes, abuse substances and may have Late in the afternoons nothing but crisp, clean air undiagnosed mental illness. Many of the individuals I’d stick my head into Room 305 breathing free and easy have had a place to call home sometime in their lives you were always flat out breathing free and easy…. but unfortunately the choices they made or the paths on your bed by the window they crossed (hanging with the wrong crowd, abusing Robbie Gamble is an FNP who has worked at BHCHP for more than 7 years. He started as a part substances) left them with no money, no job, in and time new grad at the McInnis House. He has worked on the family team for several years. He & out of jail and unable to lead successful lives. his wife, Martha (also a nurse practitioner) are bilingual & sponsor a clinic in Central America. I was surprised to discover that some of the Robbie writes beautiful poetry. Alex was a track man (Trish knew him well) who died at individuals enjoy residing at Pine Street Inn because McInnis House. the residents have found a place where they have Robbie is an adjunct educator with the MGH IHP (Institute of Health Professions) been “treated the best in their lives.” For some Pine program, meeting with new nursing students to orient them about issues related to Street Inn is “home.” I agree that Pine Street Inn being homeless. indeed offers many services to these individuals and the staff there try their best to assist people to meet their needs as well as possible. Services like the Engage Program and the Working Women’s Program Milford Nurse Practitioner Collects at Pine Street Inn are two of the programs that are structured to help the residents at Pine Street Inn to Sox for the Homeless (at a Red Sox game) get back on the right track and back into society. I feel programs like these are vital to encourage these individuals to take back control of their lives. Health is a huge factor when dealing with the homeless/mentally ill. Due to lack of money, heavy substance abuse and poor routine healthcare visits these individuals are usually in poor physical health and are more prone to chronic health conditions. I met people who were suffering from foot ulcers, respiratory problems and hypertension. Access to the health clinics on site at Pine Street Inn helps these individuals to receive excellent care and treatment from the staff. There are major challenges when trying to provide quality care to a person who is sick, Photo taken by Joslyn Allen, Boston Health Care under the influence of substances and mentally ill at for the Homeless Program a health clinic. Kudos to the Pine Street Inn staff who handles these encounters professionally, caring for Boston Health Care for the Homeless Program and changing the lives of the people they treat! (BHCHP) nurse practitioner (and MARN President) I must admit that, at first, it was hard for me to Toni Abraham of Milford collects socks from a Red start a conversation with a clinic patient during my Sox fan. The nonprofit program which provides first few weeks at Pine Street Inn…I had my wall up. I health care to the homeless community in Boston was afraid of rejection. What if the individual did not collected 14,700 pairs of new white socks at this past want to speak to me or share his/her story with me? weekend’s Sox vs. Orioles games. BHCHP caregivers Could I really help them? But my fears were quickly distribute thousands of socks every year to their alleviated. As the semester progressed I began to homeless patients. knock down my wall and talk to the people. It has been a pleasure to lend an ear to the many individuals who I met at Pine Street Inn. The people I met have many of the same concerns as you and I. They are just not as lucky and just need caring guidance, support and someone to talk to in order to get back on their feet. First impressions and appearances are not what you might think after you take the time to start the conversation and really listen to what they are saying. You will do a complete 360 once you realize that people who are homeless are not as “crazy” or “violent” as we think they are! Page 14—MAssachusetts Report on Nursing—September 2008 Bulletin Board

Mark your Calendar Consulting registered nurse Participants Sought for new nursing Study Exploring the This program has sought approval by the Opportunities Experience of Sharps Injuries Massachusetts Association of registered nurses, an accredited approver of continuing nursing education Every year, it is estimated by the American nurses Credentialing Center’s that hundreds of thousands of Commission on Accreditation. US healthcare workers sustain Mentoring Program sharps injuries. Those injuries Sexual Health Matters Conference Coordinator Consultant account for up to 80 percent September 26, 2008, 8:00am-4:00pm of occupational blood-borne pathogen exposures, Harvard Medical School, Boston Part-time flexible 12 months including exposures to HIV, hepatitis B and hepatitis grant funded position C. Nurses report the majority of these work-related What is sexual health, and why is it important injuries. Despite clear indications that suggest they to you and those you serve? Responsible for implementing the new MARN contribute to nurses’ job stress and detract from Sexual Health is not only about behavior. Mentoring Program: nurses’ ability to care for patients, no prior research Join us to understand how cultural, social, “Mentoring Matters: A Pilot Program for Novice exists that provides an in-depth understanding biological and economic factors, and sexuality Nurses” of the experience of sharps injury, including its education, determine sexual health. (funded by the aftermath and meanings. Center for American Nurses.) Karen Daley, a PhD candidate in the nursing Workshops include Vulvar Pain, IUDs/Implants, program at Boston College, is conducting Oncology, Minors and more! Qualifications dissertation research designed to provide a better Learn more & register online: * Experience with mentoring and/or understanding of the impact and meanings www.shm.atlastravel.com staff development programs & project associated with the experience of sharps injuries. Approval for 21 Nursing Contact Hours management Registered nurse volunteers from Massachusetts, is pending. * Works independently. Rhode Island, New Hampshire and Maine are being * Outstanding communication skills sought as participants for this study. Nurses who * Effective time management skills have sustained their injury within the previous six Save the Date * Knowledgeable about health care practice months are eligible for participation, which involves one or more face-to-face interviews. environments MArn 2009 Spring Convention * RN preferred A clearer understanding of the impact and meanings of this experience will better inform will be April 3rd and 4th at the For further information: please contact Mary Dedham Hilton. Manning, MARN Executive Director at 617-990- the care provided to nurses and other healthcare 2856 or via email [email protected]. workers who sustain these injuries. For more information, please contact the Congratulations to Winchester Application deadline October 1, 2008. investigator, Karen Daley, rn at (617) 596-1381 or email: [email protected]. Medical Center, Winchester, MA Re-designation of Magnet Status Achieved!

MArn Continuing Education AnA nEWS Unit Director MArn Member Elected Part-time, flexible, independent AnCC Launches new Web Site to the AnA Board of consultant position Directors ANCC is proud to launch its new web site MARN member Karen Administratively responsible for the MARN www.nursecredentialing.org Daley was elected to the ANCC Accredited Approver Unit All sections of our website have been ANA Board of Directors. improved, but the most dramatic overhaul is Thank you to all MARN Qualifications: in the Certification section. Now nurses can members who supported * Experience with continuing nursing go to one page and find everything related to her campaign for education/staff development their specialty —site visitors no longer click to national office. * Strong leadership Skills one page for an application, another for the test Congratulations to Karen! * Outstanding communication skills content outline, and yet another for a review * Computer skills course. Everything is pulled together in one * Able to work independently easy location. * RN with a graduate degree (Baccalaureate or The ANCC site’s search feature is better than Graduate degree must be in nursing) ever! While the new web site is now live to the For further information: please contact Mary public, this is just the beginning. We continue Manning, MARN Executive Director at 617-990- editing the content, fine-tuning the navigation, 2856 or via email [email protected]. and working to make the site as strong as possible. Application deadline October 1, 2008. With the new web site, ANCC takes another step forward as the leader in nurse AnA Delegates Vote to have a “new Grad” credentialing. seat on the AnA Board of Directors If you have any suggestions or see something There is now a designated seat for new graduates that needs attention, please send an email to The MArn Approver Unit (within 5 years of graduation) to serve on the [email protected]. ANA Board of Directors. The only Professional Nursing Organization MARN was the first state organization to establish a ANCC Approver Unit in the Commonwealth designated voting seat for a new graduate. New graduates are appointed to the MARN Board. Program reviewers: available The new graduate seat on the ANA Board AnCC Wants YOU!!! to review your nursing education will be an elected position. programs any time. Models Wanted!!! For up to date information about how to become an approved provider (for a single Seeking Gero NPs or CNOs with activity or as an organization) please visit Nurse Executive Certification the MARN Website www.MARNonline.org rachel Spector receives If you are an ANCC-certified Gerontological Nurse American nurses Association’s Practitioner, or are a CNO (or director level) nurse holding the Nurse Executive or Nurse Executive, Honorary Human rights Award Advanced certification, this is your opportunity to fulfill that life-long fantasy to be a model! If you know The Honorary Human Rights Award, established someone who fits this description, please let them in 1985 by the Board of Directors of the American know about this opportunity. Nurses Association, is presented to a member in ANCC is seeking participants to feature in its ad recognition of an outstanding commitment to campaign of successful nurses, highlighting their human rights and exemplifying the essence of affiliation with ANCC. The ads are included in renowned healthcare publications, including weekly nursing’s philosophy about humanity. In 2007 and monthly periodicals. MARN selected Rachel as a Living Legend in Volunteers for this effort must be ANCC-certified Under Construction: Massachusetts Nursing for her lifelong dedication and cannot be currently involved with other ANCC to understanding the need to respect diversity in activities such as Content Expert Panels, Item Writer all the people we serve as nurses. Rachel received Panels or other leadership functions. Individuals New CE Units are being developed so there her award at a special ceremony during the annual interested in being considered may send a digital will not be one in this edition. Look for a House of Delegate convention in Washington DC on photo with an email, identifying name, certification, new Continuing Education Unit in the next June 26, 2008. certification #, employer, position and contact edition of the MAssachusetts report on Congratulations Rachel! information, addressed to the attention of Juanita Woods (301-628-5211) at [email protected] nursing. September 2008—MAssachusetts Report on Nursing—Page 15 For Members Only

OPPORTUNITY TO HONOR New Member Benefit-Research YOUR COLLEAGUES: Living Legends in Recruitment Notices MARN Awards Open to All Nurses Massachusetts Nursing Award Nominations Sought MARN members are eligible to submit You probably work with or know nurse nursing research recruitment notices via the colleagues whose commitment to nursing and to The prestigious Living Legends in email list and on the MARN website free of patient care is exemplary. Yet in the rush of today’s charge. For more information visit the MARN world, there is often little time to acknowledge Massachusetts Nursing Award recognizes website www.MARNonline.org—Join MARN— them and their professional contributions. MARN nurses who have made significant lifetime Member Benefits Awards provide you the opportunity to honor their contributions to the profession of nursing Center for American Nurses Launches remarkable, but often unrecognized practice. on a state (Massachusetts), national or Redesigned Website MARN Awards are not restricted to MARN international level. Living Legends in www.centerforamericannurses.org. members. Nominees must be member of MARN or Massachusetts Nursing Awards are Workforce advocacy tools and information nominated by a MARN member. These awards can presented each year at the MARN Awards you need right at your fingertips! be peer or self nominated. Dinner Ceremony. Candidates for this News…User friendly resources… position award should nominated by a colleague. statements…publications…continuing education Mary A. Manning Nurse Mentoring Award modules. Qualifications: National Job Network • exemplifies the ideal image of a mentor Qualifications: A Member Portal where you can update your • has a record of consistent outreach to nurses in • Is currently or has been a past member profile and customize your login practice or in the pursuit of advanced education of the Massachusetts Association of Instant access to popular articles and • has a record of achievement in offering guidance Registered Nurses (MARN) or member newsletters: Nursing that Works, WISERWoman to and fostering development among nursing of the Massachusetts Nurses Association (nurse investor education) and Focus on Health professionals over a number of years (MNA) when it served as the American Tools to develop a Healthy Workforce and • or contributed to support the development of Nurses Association (ANA) state affiliate create Healthy Work Environments to ensure mentoring programs within their organization, • Has made significant contributions to institution or practice community Optimal Patient Care. the profession of nursing on a state, The Center’s new online journal NURSES Excellence in Nursing Practice national or international level FIRST…the only online journal focused on Qualifications: workforce advocacy issues. • Has inspired other nurses by virtue of • Provides direct patient care. such contributions. • Provides holistic care to patients and their • Has exhibited creativity and innovation families. • Has blazed trails for future nurses • Advocates for patients. • Is a role model for peers. MEMBER BENEFITS • Demonstrates a passion for excellence in Nomination Process: nursing practice: ✓ Access the applications at the MARN Your guide to the benefits of ANA/MARN website: www.marnonline.org membership...It pays for itself Excellence in Nursing Education ✓ Complete the application and submit Qualifications: electronically or by mail by the • Dell Computers—MARN and ANA are pleased • Is a faculty member or a clinical educator. to announce a new member benefit. MARN • Uses innovative approaches to teaching based deadline of November 19, 2008. and ANA members can now receive 5%-10% off on the learning needs of the learner. ✓ If you have questions, need help? Call purchases of Dell Computers. To take advantage • Facilitates learning and professional MARN at 617-990-2856. of this valuable offer, or for more details, call development. 1-800-695-8133 or Visit Dell’s Web site at www. Dell.com Excellence in Nursing Research • Walt Disney World Swan and Dolphin Hotel Qualifications: • Professional Liability Insurance—a must have • Has published or presented research findings. Exhibitor and Sponsor Opportunities for every nurse, offered at a special member • Research has had (or has the potential to have) a Available at the price. positive impact on patient care. • Nurses Banking Center—free checking, online Simulation Conference bill paying and high yield savings all available The nomination process is easy: Visit: www.MARNonline.org to you 24/7 to fit any shift or schedule at an ✓ Access the applications at the MARN website: affordable price—Liability/Malpractice, Health www.marnonline.org Insurance, Dental and Vision. ✓ Complete the application and submit • CBCA Life and Health Insurance Plans— electronically or by mail by the deadline of Disability Income, Long Term Care, Medical November 19, 2008. Policy for Accepting Catastrophe, Medicare Supplement, Cancer ✓ If you have questions, need help? Call MARN at Announcements for the Newsletter: Insurance and Life Insurance Plans provided by 617-990-2856. CBCA Insurance Services. The Award recipients will be invited to the MARN encourages organizations of higher education to submit announcements about continuing education • Discounts on auto rental through Avis and MARN Awards Dinner Ceremony in April 3, 2009. Budget: opportunities and upcoming events that are of interest to nurses. Fees must be included with submissions. Call Avis 1-800-331-2212 and give ID# B865000 The Fee Schedule is as follows: Call Budget—1-800-527-0700 and give ID# Non-MARN Approved Providers/Sponsors—$50 X359100 MARN Approved Providers/Sponsors—$25 • Save on your hotel stays at Days Inn, Ramada Professional Scholarship Payment can be mailed to MARN, PO Box 285, Milton, Inn, Howard Johnson and more. Available to MARN Members MA 02186. Please include a copy of the announcement • Online discounts on all your floral needs and contact information (name, address, telephone, through KaBloom. Email) with the check. Please email copy to www. The Ruth Lang Fitzgerald Memorial Scholarship MARNonline.org. of up to $1000 is given to a member of the Massachusetts Association of Registered Nurses Announcements are limited Promote yourself: professional development tools to pursue an area of interest or special project to 75 words. and opportunities that will be beneficial to the member and/or the • Members save up to $140 on certification through ANCC. Association. The Scholarship may be used to attend an educational conference or some other educational • Online continuing education available at a activity. It may also be used for participation in a discount or free to members. humanitarian aid project. • Conferences and educational events at the MARN News is an up to date national and local level offered at a discount to information service about a variety members. Qualifications: • Must be a member of MARN for at least a year of issues important to nurses in • Member discounts on nursesbooks.org— ANA’s publications arm. (12 months). Massachusetts. You must be a MARN • Preference will be given to candidates who member to be included, so join today! • Find a new job on Nurse’s Career Center— have current or prior military service; work or developed in cooperation with Monster.com. MARN member: Have you gotten hope to work with a senior population; or who your MARN News message? If not, have an interest in legislative issues. then we don’t have your correct email • Must have been a recipient of a MARN Stay informed: publications that keep you current not address. If you want to begin receiving Award or Scholarship in a previous year. • Free subscription to The American Nurse—a $20 this important information, just send Value. an email to: [email protected] • Free online access to OJIN—the Online Journal Application Process of Issues in Nursing. ✓ Access the applications at the MARN website: with “ADD” and your name on the • Free subscription to the MAssachusetts Report www.marnonline.org/awards subject line. on Nursing—a $20 value ✓ Complete the application and submit We also welcome any pictures that • Free access to ANA’s Informative listserves electronically or postmarked by mail by show MARN members in action… including Capitol Update and Members Insider. October 30, 2008. at work or at play. Interested persons, ✓ • Access to the new Members Only web site of If you have questions, need help? Call MARN at please contact Myra Cacace at myra@ NursingWorld.org. 617-990-2856. net1plus.com. The selected member will be notified by • Free access to MARN’s Member-Only Listserve November 30, 2008. Page 16—MAssachusetts Report on Nursing—September 2008 In Memory of Ida Jean Orlando Pelletier Author, clinician, consultant, educator, friend, mentor, researcher, loving wife

by Patricia A. Tyra, Ed.D., PMHCnS- BC. In 1966 she was the first psychiatric nurse to Science of Home Infusions’.” obtain an Applied Research Grant from NIMH to According to Schmieding, using Orlando’s theory Ida Jean Orlando Pelletier, a first generation Italian conduct an evaluative study titled “Two Systems at Lincoln General Hospital, Lincoln, NE, and Boston American, was born in Jersey City, New Jersey, of Nursing in a Psychiatric Hospital.” The nurses City Hospital, Boston, MA, produced substantial August 12, 1926. She died Nov. 28, 2007, at age 81, at McLean Hospital, participated in the research, benefits—increasing effectiveness in meeting in Mt. Auburn Hospital, Cambridge, MA, following a providing extensive process recordings of their patient needs, improved decision-making skills, fall at home and a long battle with recurring cancer. patient interactions. This was the first time that the more effective resolution of staff and staff/physician Orlando earned her nursing diploma from Flower nursing process of caring for patients was actually conflicts and more positive nursing identity and Fifth Avenue Hospital School studied so scientifically. Orlando unity (Schmeiding/Orlando web site). of Nursing (1947), her Bachelor published the research results in Research using Orlando’s theory with patients of Science degree in public The Discipline and Teaching of with a bipolar disorder, at a Veterans Administration health from St. John’s University, Nursing Process (1972). (VA) ambulatory setting in Providence, RI, resulted Brooklyn (1952) and her Master Orlando also served as a in such positive outcomes (Shea, McBride, Gavin, of Arts degree in mental health Consultant to the Bedford & Bauer, 1997) that the research was expanded consultation from Teachers Veterans Administration to a multimillion dollar study at 12 sites in the College, Columbia University, Hospital; taught at Boston VA system (Schmeiding/Orlando website). While New York (1954). She worked University School of Nursing and teaching at the Somerville Hospital School of for several years in the greater was Project Consultant for the Nursing in Massachusetts during the 90’s, Matana New York City area and upon New England Board of Higher and Kasmanian called Orlando’s theory, with her completion of her Masters degree Education in Wellesley. As a permission, the “Discipline Response” and used she moved to Yale University in member of the American Nurses her communication tool and a video interview with 1954, where she was a Research Association in Massachusetts, she her to teach nursing students. These students found Associate and Principal Project served a term as Vice Chairman Orlando’s theory “phenomenally helpful by the Investigator of a NIMH grant of the Psychiatric Nursing end of their clinical rotations, in both their clinical titled “Integration of Mental Special Interest Group. Her experiences and personal lives. One year they invited Health Concepts in a Basic longest volunteer activities were her to be their Graduation speaker” (J. Matana, Nursing Curriculum.” From 1958- serving on the Board of Directors/ personal communication, January 27, 2008). During 1961 she was an Associate Professor and Director of Board of Overseers of Harvard Community Health the early years of this decade, as clinical specialists the Graduate Program in Mental Health Psychiatric Plan from 1972-1991 and as an elected Town Meeting at Shattuck Hospital, Matana and Kasmanian taught Nursing at Yale University. Member in Belmont from the 70’s to the 90’s. every nurse and mental health worker on all three Mimi Dye was a Yale nursing student in both Orlando’s Deliberative Nursing Process is shifts, Orlando’s communication theory. the basic nursing and then in the Master of Science now taught at many Massachusetts educational Currently Mimi Dye is writing a book in Nursing (psychiatric) program under Orlando’s institutions, and in other countries, Orlando’s “Assumptions can Mislead—Failures in Health direction. “Ida worked with the students in all the theory is also being taught although educators and Care and Elsewhere,” which is a tribute to Orlando different clinical areas to figure out her model of researchers may not be aware of their use of Orlando’s and Orlando was to have written the introduction. communication. She would say ‘never assume, when theory (Schmieding, 1986, p.13). At St. Francis Xavier “Understanding her model may be easy, but actual we do sometimes errors occur’. I was one of six nurses University, Nova Scotia, where Sister Loretta Gillis, consistent implementation is difficult.” (M. Dye, in the graduate program and I went back just to a former student of Orlando’s at Yale, incorporated personal communication, January 29, 2008) April study under her” (M. Dye, personal communication, Orlando’s theory into a nursing communication 2006, was Orlando’s last professional public January 29, 2008). skills course syllabus. (Schmeiding/Orlando web appearance when she was recognized as a “Nursing Orlando identified that the nurse’s distinct and site) Judy Matana reports that: “As a student nurse Living Legend” by the Massachusetts Association of unique role was to find out and meet the patient’s at Beth Israel Hospital in Boston in 1963, I was Registered Nurses (MARN) at their awards dinner immediate need for help, even if the help needed introduced to Ida’s theory through her textbook while in Bedford, MA. Mary Ellen Doona presented the might not be what the behavior suggested. The nurse on my psych rotation at the Bedford VA Hospital. I award stating that MARN “honors Ida Jean Orlando must be sensitive and perspective enough to help the continued to use her theory, teaching nursing students for asking penetrating questions about nursing’s patient determine what help is needed. Promoting at Metropolitan (Met) State Hospital, Waltham, MA fundamental identity and throwing light on its this nursing behavior was a startling deviation from in the late 80’s which is where I first met her.” (J. distinct function.” (M.E. Doona, 2006) Her husband, what nurses were historically doing (M.E. Doona, Matana, personal communication, January 27, 2008) Bob, and two long time colleagues, Patricia Tyra, 2006). Orlando published these conclusions as the When Met State Hospital closed Orlando moved to flying up from Florida, and Norma Jean Schmeiding, “deliberative nursing process” in The Dynamic Nurse Gaebler (Children’s) Unit. Then she retired in 1993, driving up from Rhode Island, were able to share the Patient Relationship in 1961. This classic “little” book but remained actively available as a consultant and evening celebration with her. has been translated in 12 languages identifying the mentor to former students and colleagues and any Anne G. Hargreaves, another Massachusetts “Nursing Process” as a general theoretical framework who sought her help. psychiatric nurse, who was also a 2006 Nursing for the nurse-patient relationship in any clinical Marie Kasmanian, working as a clinical nurse Living Legend, commented upon learning of setting. As an out of print it book it has been reissued specialist, was taught by Orlando at Met State Orlando’s death “She has left us with a wonderful by the National League for Nursing. Hospital in the mid 80’s. “I’m so grateful to have legacy. She will be missed, but hopefully more nurses Orlando married Robert Pelletier and moved from met her; she changed my career and how I felt about will embrace her theory.” (A.G. Hargreaves, personal Yale to Belmont, MA, in 1962 to work at McLean nursing. She lived the ‘discipline’.” (M. Kasmanian, communication, January 20, 2008) Hospital in Belmont, MA, as a Clinical Nursing personal communication, January 27, 2008). Orlando Consultant. Orlando helped hospital nursing was Darlyn Scott’s clinical nursing supervisor at references Met State and encouraged her to obtain certification. Doona, Mary Ellen. (June, 2006). Ida Jean Orlando-Pelletier staff, supervisors and instructors to learn to use (MARN Celebrates Nursing! Celebration of Nursing Excellence the “deliberative nursing process” to understand Scott recalls how Orlando “always wanted the and Nursing Living Legends). Massachusetts Report on Nursing, patients’ need for help by helping them to better nurse to be with/next to the patient, even when the 4(2) p.4. understand the specific meaning of their behavior patient was in 4 point restraints. On all the hospital Haggerty, L.A.(1985). A theoretical model for developing committees, she constantly advocated for nurses students’ communication skills. Journal of Nursing Education, in order as it relates to their distress and help them 24(7),296-298. to determine ways to relieve this distress (Orlando, doing nursing, not what others should be doing (but Haggerty, L.A. (1987). An analysis of senior nursing students’ 1961, pg 29). McLean School of Nursing instructors weren’t). She championed the nurse giving nursing immediate responses to distressed patients. Journal of Advanced went on to teach Orlando’s “deliberative nursing care. She advocated back then for pharmacists Nursing. 12, 451-461. process” to nursing students at Children’s Hospital, giving out medications, not nurses—nurses should be Orlando, I.J. (1961). The dynamic nurse-patient relationship, taking care of patients. Actually she was for holistic function, process and principles. New York: G.P. Putnam. Massachusetts General Hospital and Peter Bent Orlando, I.J. (1972). The discipline and teaching of nursing Brigham Hospital. nursing—looking at the patient as a whole person.” process: An evaluative study. New York: G.P. Putnam. (D. Scott, personal communication, January 28, 2008). Potter, M.L. & Bockenhauer, B.J. (2000). Implementing Recently, when Lynda Bayless and the nurses at Orlando’s nursing process theory: A pilot study. Journal of Kaiser Foundation Hospital, Santa Rosa, CA, wanted Psychosocial Nursing and Mental Health Services, 38(3), 14-21. Potter, M.L. & Tinker, S. (2000). Put power in nurses’ hands- to implement her theory system wide, Norma Jean Orlando’s nursing theory supports nurses-simply. Nursing Schmieding arranged for Lynda and a non-nursing Management, 7, 40-41. colleague to meet with Orlando in Massachusetts Schmieding, N.J. (1984). Putting Orlando’s theory into practice. to discuss the details. Lynda (L. Bayless, personal American Journal of Nursing, 84(6), 759-761. communication, February 9, 2008) reports that Schmieding, N.J. (1986). Orlando’s theory. In P. Winstead-Fry (Ed). Case studies in nursing theory (pp.1-36). New York: National “the whole afternoon was magical. It was such League for Nursing. a ‘leap of faith’ for Orlando to agree to meet with Shea, N.M., McBride, L., Gavin, C., & Bauer, M. (1997). The someone from 3,000 miles away whom she didn’t effects of ambulatory collaboration practice model on process know. We are now using Orlando’s communication and outcome of care for bipolar disorder. Journal of the American theory at the bedside with our pain scale to gage the Psychiatric Nurses Association. 3(2), 4-57. Web Site: URI.edu/nursing/schmieding/Orlando patient’s need for medication. In fact, every encounter, in practice or management, is more positive if we use Patricia A. Tyra, Ed.D., PMHCNS-BC., is Professor Orlando’s deliberative nursing process. It is crucial Emerita, University of Massachusetts-Lowell and to all our conversations. You could say we are all Emergency Clinician, Island Counseling Center, Martha’s becoming ‘Orlandonized’ in our communications to Vineyard Community Services. She resides in Edgartown, solve problems. Her theory is becoming a cornerstone Massachusetts. (This editor is proud to say that Dr. Tyra of nursing care at Kaiser. It is guiding ‘The State of the was one of her graduate nursing professors.) September 2008—MAssachusetts Report on Nursing—Page 17 Meg Styles Aims to Loan Budding Nurses the Money to Train in their Own Countries

Sam Whiting The Lightbulb: I realized that to fulfill my dream Sunday, June 15, 2008 of taking nursing scholarships global, I would have to go it alone. I recalled my mother's words that she Two years ago, Meg Styles quit commercial real would say to herself during her profession. 'I put estate to enter the nonprofit sector as a fundraiser. myself in a corner and I fight my way out.' I knew this Now Styles, who is 40 and lives in Danville, is raising to mean 'You do something because it is right and strategy is based on four important principles: funds for her own nonprofit organization to increase there's a great need and you're the one to do it.' That ❖ Nursing scholarships are granted to persons the worldwide supply of nurses. became the Gretta Foundation. most vulnerable and disadvantaged; "My mom, Dr. Margretta Styles, known as Gretta, This article appeared on page P—4 of the San ❖ Nursing education empowers persons was a global leader in nursing. She was dean of Francisco Chronicle. by providing the tools to enter into an nursing at UCSF from 1977 to 1987. Then she became indispensable and remunerative profession; president of the American Nurses Association ❖ A nurse’s contribution to humanity through a and later president of the International Council of career of care and cure is incalculable; Nurses, which is like the U.N. of nursing, in Geneva. ❖ By increasing the nursing workforce globally, She is known as an international leader in nursing there is greater hope to stem the relentless education, regulation and credentialing. She died in advance of diseases like HIV and improve 2005. “Imagine a world without persons who know what patient care worldwide. When my mother passed away, I made a life nurses know; who believe as nurses believe; who do As professor and dean of nursing colleges change. I ended a career, 13 years in commercial real what nurses do; who have the effect that nurses have throughout the US, and as a past president of estate, and went back to get my master's in public upon the health of individuals, families and nations; the American Nurses Association (ANA), the administration. I started to work for a nonprofit who enjoy the trust that nurses enjoy… Imagine a American Nurses Credentialing Center (ANCC) and focusing on HIV care and prevention in Malawi, sub- world without nurses.” the International Council of Nurses (ICN), Gretta Saharan Africa. One of their programs is in-country demonstrated a lifelong commitment to leadership nursing scholarships. This challenge was made in nursing. She defined nurse credentialing: critical I wanted this model to go global, and the only by the nurse scholar renowned work that recognizes and differentiates quality in way I could do that was to go it alone and start this globally as an international all aspects of nursing practice. She spearheaded foundation in her memory. The Gretta Foundation, leader in nursing education, ICN's definitive work on nursing regulation. Gretta’s (www.grettafoundation.org) provides in-country regulation and credentialing: most enduring legacy is her signature work in nursing education in disease-burdened nations. We're the late Dr. Margretta Madden credentialing and its contribution to better patient taking impoverished persons and providing them the Styles or “Gretta,” as she was outcomes globally. tools to enter into an indispensable career. Nursing is known to her fellow nurses. Nursing scholarship recipients will enter into the one career that will never go away. Globally, we For those living in nursing programs in their country’s system of are looking at a profoundly chronic shortage, and it's developing countries, education. Each scholarship will provide its recipient getting worse day by day. There are organizations conceiving a world without with an annual tuition, room and board, living where aspiring nurses from other countries are nurses takes no imagination allowance, books, school uniforms, shoes, and brought to developed countries like the United States at all. Today, many are in a clinical supplies, such as stethoscopes and blood to get an education. This is specifically in-country. death grip due to chronic shortages in the healthcare pressure readers. Once students have completed We're not taking persons out of their culture or their workforce. These shortages profoundly undermine their nursing programs and have passed the exit nation. We're going there. global efforts to improve maternal health, decrease exams administered by their nursing colleges, they The Gretta Foundation is taking persons who child mortality rates, and fight the devastating and are qualified to take their nation’s registered nursing would not have the opportunity and providing disproportional advance of diseases such as HIV. exam and become licensed to practice nursing. In them full scholarships—tuition, room and board, Nowhere are these conditions more evident than repayment for the scholarship, graduating scholars clinical supplies, uniforms and also a small living in Africa. According to the WHO World Health will serve in their country’s clinics and hospitals for allowance—to enter into their own country's Report 2006, Sub-Saharan Africa has 24% of the a predetermined period of time commensurate with nursing-school system. If they go to a government- global disease burden but only 3% of the health each year of academic assistance. sponsored college, then it's about $1,200 a year for a care workforce worldwide and 1% of the global With nursing school education being cost full scholarship. Worst case scenario we're looking health expenditure. Where the need is most dire, the prohibitive for many around the globe, The Gretta at maybe $3,300 a year. At the end, they will become healthcare resources are nearly nonexistent. Foundation will provide young people in disease- registered nurses. Their obligation is to work in a paid Exacerbating the healthcare crisis is a problematic burdened countries the opportunity to enter into this position in a hospital or clinic in their country one trend of the nursing “brain drain.” Due to higher pay noble profession. For a sum modest by most economic year for every year of scholarship assistance. and better workplace conditions, many skilled nurses standards, donations to this requisite work can have We're looking at Malawi, Tanzania, Uganda and are migrating from disease-burdened countries an exponential impact. Zambia. I've been to Malawi. I found incredibly to more industrialized countries in the north. As The Gretta Foundation is proud to contribute gracious people living in the most deplorable a result, the loss of this essential human capital to the noble aspirations of future nurses while situations. It's a long way from Danville and anything negatively affects healthcare availability and patient’s increasing healthcare capacity around the world. that's Danville. It's a long way from anything any of quality of care. Nurses are instruments of change who empower us would know. These conditions are crying for relief and The their communities by caring for the ill and provide We have no seed money yet. To get this far I Gretta Foundation is answering that cry. Gretta’s the only real hope for disease prevention and cure. A have been funding it personally. I have a board of daughter, Meg Styles, is proud to honor her mother’s nurse’s impact on the world is inestimable. directors, and we're looking for grants. Our goal is to memory through the creation of The Gretta To learn more about The Gretta Foundation and offer our first 75 scholarships in September, which Foundation. The Gretta Foundation is a 501 (c) (3) how you can support our mission, please contact: will cost $112,000. My goal is to see Gretta Scholars charitable corporation, whose mission is to provide Meg Styles, President and Founder all over the world. in-country nursing scholarships to disadvantaged [email protected] Recently, I had the opportunity to go to persons living in disease-burdened nations 101 California Street, Suite 2450 PMB 868 Washington, D.C., because my mother's birthday, while bolstering desperately depleted healthcare San Francisco, CA 94111 March 19, was declared Certified Nurses Day and workforces. 415-391-3139. was read into the Congressional record. I don't want The Gretta Foundation’s nursing scholarship to jinx us, but we've been asked to put together a very robust proposal to do work in countries in Africa. I don't miss commercial real estate, but having a business background is extremely valuable. I also think being a single mother for nearly my entire adult life makes me very tenacious." Page 18—MAssachusetts Report on Nursing—September 2008 A Great Day to Remember at MARN

by Kristy Dwyer mind such as “I am a student nurse. How would need to understand this when working with our professional nurses react to my presence at their co-workers from other generations. I am a junior at UMASS Boston’s College of conference? Would they be welcoming? And The highlight of my day and one of the most Nursing and Health Sciences. I am also a member finally, what will I really get out of this day?” touching moments for me was when one of the of a wonderful scholarship program called the Suffice it to say my concerns were silenced. I was speakers asked all of the nursing students to Nursing Scholars Program headed by Linda quickly introduced to my writing mentor Victoria stand, and the gathering of highly experienced Dumas, Ph.D., RN, ANP. This scholarship program Palmer-Erbs, Ph.D., APRN, BC who has been an nurses gave us a round of applause. I cannot tell is for students from diverse populations as well as invaluable resource for me as well as MARN’s you just how touched I was at that moment. I felt from under-represented populations. The program own newsletter editor, Myra Cacace, GNP/ADM- so welcomed it truly made my day! Additional provides financial support to students in the form BC, CDE. I never thought I would be so whole highlights included attending the Massachusetts of stipends and provision of laptop computers. But heartedly welcomed by nurses who are active in Student Nurse Association (MASNA) student the most important part of the Nursing Scholars a professional organization such as MARN, find forum. It was great to hear about the stories and Program is the mentoring by an ever present and a writing mentor and be encouraged to submit an experiences of the newly licensed registered amazing faculty giving all the academic support article to the MAssachusetts Report on Nursing by nurses. It was also nice to meet other student a student could ever desire. The Nursing Scholars Myra, the MARN newsletter editor! For me it is a nurses who are still in school and some of whom Program will also keep track of where my nursing big deal. are looking forward to their graduation and their career leads me in the future. All that being said… As my morning progressed I sat and listened to future as nurses. for me, the Nursing Scholarship Program means Trish Gibbons, RN, DNSc discuss the concept of In short, for me the MARN conference was a opportunity. leadership and the qualities of a great leader, as wonderful day because I had the chance to meet An integral part of the Nursing Scholars well as the concepts of service and excellence. I and create relationships with my student peers Program is to keep the students informed about was in awe. The next very informative lecture was as well as to meet some of the most inspirational educational opportunities and activities occurring given by Barbara B. Stabile, RN, MS on leading the nurses besides my nursing professors...nurses I can outside the classroom setting. This is how I came multigenerational team of nurses. This lecture was only aspire to be like one day. to be invited to attend my first conference offered very interesting to me as a student nurse because Kristy Dwyer lives in Marshfield, Massachusetts by the Massachusetts Association of Registered Ms. Stabile gave actual examples comparing the and is a student at the University of Massachusetts Nurses (MARN). When I first heard about the traits of nurses from post WWII, and Generation in Boston. Kristy is a member of the Nursing MARN conference I was excited about the prospect X, to Baby Boomers etc. Ms. Stabile made all who Scholars Program, a Member of the National of attending a conference with real nurses! were present realize that we need to pay attention Scholars Honor Society and is part of the UMASS Yet I was also nervous about actually going to to how the generation we are raised in, determines Boston Student Nurse Association. Hopefully she the conference. A couple of things crossed my how we respond to the work environment and we will be a regular contributor to the MAssachsuetts Report on Nursing!

An Invitation for MARN Members! Become an active member— Join a MARN Committee today!

Mary A. Manning, MN.RN Sandra MJ Reissour at [email protected] or 413- Executive Director 794-3402. Massachusetts Association of Registered Nurses MARN Fall Clinical Conference Planning PO Box 285 Committee: Plans and executes Annual Fall Milton, Ma 02186 Conference focused on topics of clinical relevance. 617-990-2856 Responsibilities include site selection, speaker selection, developing contact hour application, Are you a MARN member who is looking for a assisting with marketing and on-site registration. way to become more involved in the organization? Meets monthly by teleconference and/or email to Do you have a special talent or interest? Can you find plan. For more information, please contact MARN at the time to work on a one time only project? If you [email protected] or 617-990-2856. are looking for the chance to become more active in MARN Health Policy Committee: Reviews the organization, then we are looking for you! Listed proposed legislation and health policy issues below are the descriptions of the various active for recommendation to the Board of Directors. committees for the Massachusetts Association of Provides analysis to the Board and the membership Registered Nurses. for recommendations; will also be meeting with MARN Awards Committee: Develops criteria legislators. Meets monthly on the first Tuesday for and selects winners for three annual nursing evening of each month by teleconference (7- excellence awards, two scholarship awards and Living 8pm) and plans to meet quarterly in person. For Legend awards. Meets quarterly by teleconference and more information, please contact MARN: info@ email and once/year in person to prepare for Awards MARNonline.org Luncheon/Dinner. Members expected to attend MARN Membership Committee: Develops new Annual Meeting and Awards Luncheon/Dinner membership initiatives, reviews membership during the Spring Convention. For more information, statistics, and contacts new members to welcome please contact MARN at [email protected] or them to the Association. Presents to schools and 617-990-2856: Attention: Maura Fitzgerald, Chair. colleges of nursing, attends other professional MARN Bylaws Committee: Reviews MARN organizational programs and meetings to promote Bylaws annually to create and propose changes and MARN and the importance of professional additions as suggested by the membership and/or organizational membership. Meetings are monthly by Board of Directors and to maintain compliance with teleconference (5:30-6:30pm) and quarterly in person. ANA Bylaws. Meets in person as necessary (usually For more information, please contact chairperson, once per year) and by teleconference and email as Cidalia Vital at [email protected]. necessary to prepare for Annual Meeting. Members MARN Newsletter Committee: Meets exclusively expected to attend Annual Meeting held during by email to review articles for publication, develop Spring Convention. For more information, please story lines, and create a quarterly newsletter circulated contact Cammie Townsend at CTownsend@mghihp. to every RN licensed by the Commonwealth. ALL edu or 617-990-2856. MARN MEMBERS ARE INVITED TO SUBMIT MARN Continuing Education Committee: The ARTICLES OF INTEREST. For more information, Massachusetts Association of Registered Nurses, Inc. please contact Editor Myra Cacace at newsletter@ is accredited as an approver of continuing nursing MARNonline.org or 978-433-6155. education by the American Nurses Credentialing MARN Spring Convention Planning Committee: Center’s Commission on Accreditation. This Plans and executes Annual Spring Convention committee plans and executes an Annual Provider and Business Meeting. Responsibilities include Forum, writes quarterly newsletter articles, and site selection, speaker selection, business meeting functions as the MARN Approver Unit in reviewing execution, developing contact hour application, provider and activity applications for continuing assisting with marketing and on-site registration. education credit. Meets monthly in Milton, MA on the Meets monthly by teleconference and/or email to first Wednesday morning of each month (9am–12pm). plan. For more information, please contact MARN For more information, please contact Chairperson at [email protected] or 617-990-2856: Attention Peggie Griffin Bretz. September 2008—MAssachusetts Report on Nursing—Page 19 MARN Vision Statement VISION STATEMENT

MARN is committed to the advancement of nursing standards and practice, and to continuing professional development of registered nurses across the Commonwealth who share the belief that greater achievement occurs in an environment that embraces mutual respect of diverse perspectives, a spirit of collegiality, and the advocacy role of the nurse to individually and collectively shape quality health care.

This contemporary organization provides a virtual home for the nurturing and development of its membership. As a constituent member of ANA, the membership proactively responds to regional and national issues in ways that produce rippling outcomes in larger communities of professional nurses, health care decision makers, and citizens. Membership initiatives serve to strengthen enduring partnerships with other stakeholders in health care.

ANA Receives Award For Safe Patient Handling Education

SILVER SPRING, MD—The American Nurses Association is proud to be one of two recipients selected to receive the 2008 National Occupational Research Agenda (NORA) Partnering Award for the Safe Patient Handling and Movement Training Program for Schools of Nursing project. “Creating and maintaining a healthy work environment is a top concern of registered nurses and is vital to the recruitment and retention of nurses…ANA hopes that safe patient handling concepts will be taught in all schools of nursing and safe patient handling programs will be made available in the workplace so nurses can be free from the devastating impact of musculoskeletal disorder injuries due to manual patient handling,” said ANA President Rebecca M. Patton, MSN, RN, CNOR. ANA partnered with the National Institute of Occupational Safety and Health (NIOSH) and the Tampa Veterans Administration Patient Safety Center of Inquiry on this important project. The effort is designed to develop and evaluate a new evidence-based curriculum module for schools of nursing introducing safe patient handling and movement concepts into fundamentals of nursing. The use of assistive devices and equipment had been shown to protect nurses by reducing injuries due to manual patient handling while improving the quality of care. To learn more about ANA’s efforts to create a healthier work environment, and its Handle With Care campaign, please visit http://www.nursingworld.org/ MainMenuCategories/OccupationalandEnvironmental/ occupational health/handlewithcare.aspx.