Vol. xxxiii No. 3 september 2012 ACCESS
in this issue: • PRIVACY AND CONFIDENTIALITY • PAPERLESS REGISTRATION RENEWAL • AWARDS FOR EXCELLENCE IN NURSING RECIPIENTS • WELCOME, NURSING GRADUATES! … & MORE! Contents
Message from the President...... 3 From the Executive Director’s Desk...... 4 ARNNL COUNCIL Regulatory Notes...... 5 Cathy Stratton President 2012-14 Registration Renewal 2013-14...... 6 Regina Coady President-Elect 2012-14 Q&A: You Asked...... 7 Colleen Kieley Eastern Region 2011-14 Sandra Evans Central Region 2012-15 Nurses of Note...... 8 Jennifer Joy Western Region 2011-14 The Greatest Story Ever Told...... 10 Beverly Pittman Labrador/Grenfell Region 2012-15 Cathy Alyward Advanced Practice 2009-13 Trust News...... 11 Evelyn Peyton Murphy Practice 2009-13 Campaign Says “It’s About Time”...... 12 Madonna Manuel Education/Research 2012-15 Elaine Warren Administration 2012-15 Advanced Practice View...... 13 Dr. Carmel Doyle Public Representative 2011-14 Goings On/Conferences and Workshops...... 14 Ray Frew Public Representative 2011-14 Irene Baird Public Representative 2011-14 ARNNL Council Matters...... 16 Walter Arnold Public Representative 2011-14 Discipline Decisions...... 17 Pegi Earle Executive Director Representatives from nursing student societies (observers) Volunteer Spotlight: ARNNL’s Workplace Representatives...... 18 ARNNL STAFF Meet Your ARNNL Staff...... 19 Margaret (Pegi) Earle Executive Director 753-6173 Clinical Corner...... 20 [email protected] Michelle Osmond Director of Regulatory Services 753-6181 Welcome, Nursing Graduates...... 23 [email protected] Lynn Power Director of Policy & Practice 753-6193 ON THE COVER (left to right): Dr. Deborah [email protected] Jennifer O’Neill Communications Officer 753-6198 Gregory, Patricia Rodgers, Beverly White (ARNNL [email protected] Past-President), and Linda Norman-Robbins at Elizabeth Dewling Director of Corporate Services 753-6197 ARNNL’s 20th Annual Awards for Excellence in [email protected] Nursing in June. Siobhainn Lewis Nursing Consultant—Policy & 753-0124 Practice [email protected] Editor Jennifer O’Neill Beverley McIsaac Nursing Consultant— 753-6174 Creative Design Brenda Andrews, Image 4 Regulatory Services & [email protected] Contributing Editor Danielle Devereaux Advanced Practice Administration Colleen Jones Bradley Walsh Regulatory Officer 757-3233 [email protected] JoAnna Bennett Project Consultant (QPPE) 753-6019 Advertise in the next issue of ACCESS [email protected] Contact Jennifer O’Neill at Julie Wells Research Analyst & ARNNL 753-6182 [email protected] or call 709-753-6198 Trust Coordinator [email protected] Christine Fitzgerald Administrative Assistant— 753-6183 55 Military Road, St. John’s, NL A1C 2C5 Ph: 709-753-6040 Fax: 709-753-4940 Toll Free: 1-800-563-3200 Executive Director & Council [email protected] email: [email protected] www.arnnl.ca Jeanette Gosse Administrative Assistant— 753-6060 ACCESS is the official publication of the Association of Director of Regulatory Services [email protected] Registered Nurses of Newfoundland and Labrador. Jennifer Rideout Administrative Assistant— 753-6075 ACCESS is published three times a year in January, May and Policy & Practice [email protected] September. Subscriptions are available to non-members for Colleen Jones Administrative Assistant— 753-6041 $25 per year.
Nursing Consultants [email protected] ©Association of Registered Nurses of Newfoundland and Labrador (ARNNL). All Renee Reardon Administrative Assistant— 753-6040 rights reserved. For editorial matters, please contact the editor. The views and opinions expressed in the articles and advertisements are those of the authors or Registration [email protected] advertisers and do not necessairly represent the policies of ARNNL.
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ACCESS Vol. xxxiii No. 3 september 2012 Message from the President
I feel truly honoured and privileged that you have entrusted me with the role of President of ARNNL. The privilege to act in this provincial leadership role comes at a critical time within our profession. I, and your Council, will endeavour to influence our preferred future and engage in dialogue with registered nurses (RNs). We are committed to exploring innovative and creative ways to achieve our Ends (goals) and policy direction for the nursing profession and the health care system.
Council continues to ensure advancement of the Ends of the association, as well as setting its policy direction. Four of the most recent policy directions related to the Ends are:
1. Accountability for Self-Regulation – the signing of the contract for the new national licensure exam has occurred and the exam will commence in 2015. 2. Professionalism – setting policy direction to elevate professionalism within our profession and highlight our role as registered nurses. 3. Quality Professional Practice Environments – this is a critical time in the nursing profession; major health care system transformation is unfolding to make way for more affordable, efficient, effective, and sustainable ways to meet the health care needs of the public. RNs make an incredible contribution to the health care system of Newfoundland and Labrador. 4. Healthy Public Policy – the theme at the Canadian Nurses Association (CNA) Biennial Convention in June was “Nurses: Movers and Shapers.” During the event, the National Expert Commission’s report, A nursing call to action: The health of our nation, the future of our health system, was released. I urge each of you to visit www.cna-aiic.ca/ expertcommission/ to read the report, which captures our profession’s determination and capacity to create real and positive change. ARNNL will work with CNA to ensure RNs are a leader in health care transformation as envisioned by the National Expert Commission.
I would like to thank outgoing President, Beverly White, for her commitment to nursing and ARNNL. Bev has been part of Council for 10 years and her dedication to the nursing profession is commendable. Her valuable knowledge and expertise, related to many facets of the profession, will be greatly missed, yet we celebrate all that she has accomplished. Welcome back to re-elected Councillors, and welcome to new Council members – congratulations! I would also like to make an honourable mention of our invaluable Public Representatives. Your diverse perspectives and dedication are essential to the functioning of ARNNL.
ARNNL Council and Staff are a hardworking, enthusiastic team and it is with a heavy heart that we must say farewell to ARNNL’s Executive Director, Pegi Earle, as she embraces retirement (see p. 14). One of my first priorities as President is ensuring that we identify an individual who has the ability to carry out the duties of the Executive Director with the same integrity, passion, and expertise that Pegi has brought to the position.
Again, thank you for this opportunity to serve as your President. I look forward to meeting many of you over the next two years. Together, we will tackle the issues that matter most to our profession, and work to advance the health of the people of Newfoundland and Labrador.
Cathy Stratton, RN, MN [email protected]
3 From the Executive Director’s Desk
Elevating Professionalism
Of late issues have been raised and trends are emerging related to the ‘professionalism’ of professionals, including registered nurses (RNs). On a fairly regular basis, concerns are raised about some RNs’ nursing identity, decorum, demeanor, and engagement in the workplace – concerns that most members would view as issues with professionalism. ARNNL’s 2012 survey of 400 members of the public found that of the RNs with whom participants had contact in the past year, 34 per cent did not introduce themselves by name and 51 per cent did not introduce themselves as RNs. So it is not surprising that an increasing number of members, and the public, are telling us, “Nursing needs to get back to the basics of what it means to be a professional!”
ARNNL is listening and taking action. In the past year, ARNNL held a Think Tank on Professionalism in Nursing with key stakeholders, and Focus Groups on Professionalism in Nursing with Workplace Representatives and clinical RN managers, which validated concerns with professionalism in nursing practice. We subsequently commissioned A Report on Professionalism in Nursing to identify issues and initiatives related to professionalism across the country and in the literature. A Working Group on Professionalism is now established, and is co-chaired by Lynnette McCarthy Woodrow, ARNNL Workplace Representative and Coordinator Surgical Services, Eastern Health, and Siobhainn Lewis, an ARNNL Nursing Consultant. The working group has been tasked to develop a strategy to promote professionalism and the values and behaviours that are core to being a RN, and to do so in an innovative and meaningful manner. ARNNL’s strategy will complement the Newfoundland and Labrador Nurses’ Union’s Clarity Project, as it will promote professionalism, and therefore, clarify what is meant when you say, “I am a registered nurse.”
Professionalism is all about the attitudes, values, and behaviours that reflect a profession’s primary accountability to the people it serves, which for nursing means putting the client first and working with others to provide safe, competent, and ethical care. While ARNNL is responsible for setting professional standards, as a self-regulated profession, RNs are accountable for managing their own professionalism. As professional RNs we are accountable for: upholding our standards for nursing practice and the values of our code of ethics, insightful practice and developing our knowledge and competence, choosing a positive attitude and demonstrating a spirit of collaboration, and caring for ourselves and projecting a professional image (Girard, Linton & Besner, 2005).
The issues related to professionalism that emerged in The Report on Professionalism in Nursing are in relation to: (1) social media, whereby breaches in clients’ rights to privacy and confidentiality, and boundary violations in therapeutic relationships, are not congruent with ethical values; (2) professional comportment, whereby physical appearance and conduct are not congruent with professional norms (Roach & Maykut, 2010); and (3) practice environments, whereby colleagues are not supported to ‘be the best registered nurse one can be,’ as evidenced by incivility and bullying, with minimal supports and structures to promote nursing excellence. These are the issues ARNNL’s Working Group on Professionalism will be addressing over the coming months. Stay tuned for an opportunity to participate in this important work and to contribute to ‘elevating professionalism’ in your workplace, as we all strive to be the best RNs we can be!
On a personal note … It is hard to believe that I am at the point in my life where I am retiring from a career that I have thoroughly enjoyed. Being a registered nurse is who I am, and having the opportunity to participate in the development of our profession through ARNNL has been a truly rewarding experience. In December I will leave ARNNL with a strong vision of its future, with members who are committed to that vision, and leaders and staff who are very capable of realizing that vision. As the ‘self’ in self regulation, I couldn’t have done this work without the support of you, ARNNL’s members – the registered nurses and nurse practitioners of Newfoundland and Labrador. Thank you for the privilege of working with you to advance the standards for nursing and health care in our province. I leave ARNNL knowing it is in a good place and in good hands. Au revoir!
References available on request.
Margaret (Pegi) Earle, RN, MScN [email protected] Regulatory Notes Privacy and Confidentiality: Can We Talk About It?
By: Michelle Osmond, RN, MS(N), Director of Regulatory Services
Registered nurses (RNs) have an ethical inappropriate purpose, using a As self-regulated professionals, it is the and professional responsibility to personal electronic device; responsibility of each RN to adhere to maintain the confidentiality and privacy • communication of patient information and apply the profession’s Standards of client health information. The Code to other health care staff without and Code. If you haven’t recently of Ethics (CNA, 2008) and the Standards client consent. reviewed the Standards, visit http:// for Nursing Practice (ARNNL, 2007) www.arnnl.ca/documents/pages/ guide and set out the accountabilities The complainants who filed allegations Standards_for_Nursing_Practice_ of RNs in this regard. The protection with ARNNL included both employers April_07.pdf, and pay particular of a client’s rights to privacy and and members of the public. Employer attention to Standards 1 and 4. confidentiality is nothing new; it is basic monitoring procedures, including audits to the establishment and maintenance of the electronic client record and staff The Canadian Nurses Association has a of the nurse-client relationship. access history, can identify unauthorized learning module on the Code available Provincial law also supports and further access of client records. The Standards online at no cost. Module six, Value E – extends the accountabilities of RNs, and and Code of Ethics inform the public Maintaining Privacy and Confidentiality, other individuals working in the health of what to expect from RNs, and the is an excellent resource for guiding care sector, with respect to privacy and PHIA details their rights to privacy and practice and understanding the confidentiality. The Personal Health confidentiality of health information. The expectations related to client privacy Information Act (PHIA) sets out the legal PHIA includes provisions that address and confidentiality. This module may requirement for all persons working in disclosure of privacy breaches to clients, be accessed at http://cna-aiic.dualcode. the health care sector, including RNs, and also the process for filing complaints com/. to uphold and protect a client’s right and reporting to the Office of the Privacy to privacy and confidentiality ACCESS( , Commissioner. The increased profile of All employers have reviewed and January 2011). PHIA establishes the rules privacy and confidentiality has not only revised policies related to this area since for the collection, use, and disclosure heightened the awareness of employers, the PHIA came into force. If you have of personal health information. The who under the PHIA are custodians of not recently viewed your employer’s Act came into force in April 2011 and health information, but also the public. policy, it is time. compliance is mandatory. For purposes of professional conduct The Government of Newfoundland Given that the protection of client review or the disciplinary process, the and Labrador has numerous resources, privacy and confidentiality is Registered Nurses Act (2008) defines available via its website, to help the fundamental to the profession, a conduct deserving of sanction. Conduct public and others better understand recent increase in the number of that is not consistent with the ethical the PHIA. One resource includes an complaints alleging RNs have breached and professional expectations set out online learning module available at client privacy or confidentiality is a in the Standards or the Code, such as http://www.health.gov.nl.ca/health/ concern. Since February 2012, five breaching a client’s or patient’s privacy PHIA/#online. This module is available at allegations related to issues of privacy or confidentiality, can constitute an no cost. or confidentiality have been filed with allegation of professional misconduct the Director of Professional Conduct and acting in breach of the code of If you have further questions, contact Review. The allegations raised issues ethics. Upon report to the Association, ARNNL. To access the Standards and with the conduct of RNs, including: a process will commence to resolve Code, or to learn more on this topic, visit • unauthorized access to client the allegation, any strategies or www.arnnl.ca. record(s), including accessing interventions proposed as part of a client information unrelated to any resolution must serve the interest of professional or job requirement of the public. Failure to maintain privacy the registered nurse (including RN(s) or confidentiality may negatively impact accessing their own health record and a client, and can also undermine trust that of a family member(s)); in registered nurses, and ultimately • transfer of patient information, damage the public’s perception of the without consent and for an profession.
5 Registration Renewal 2013-14: What You Need to Know By: Bradley Walsh, RN, BN, MN, CPON, Regulatory Officer
ARNNL is pleased to be implementing the ‘Member Self-Service’ tab on the Will I still receive a paper license card in paperless registration renewal for the ARNNL homepage. Members can access the mail? 2013-14 licensure renewal period. All the member self-service site 24/7 to ARNNL members will be required to update their email address and contact Beginning in the 2013-14 licensure renew their annual practicing license information. To log in you will require year, ARNNL will no longer issue paper or non-practicing membership online. your ARNNL registration number and license/membership cards to members. No paper renewal forms will be mailed password. If you do not know your Many other nursing jurisdictions across to members. The online registration password, click on the ‘Forgot your Canada no longer issue paper license renewal system will open on Jan. 16, Password’ link and follow the steps. cards. This decision was based on 2013. Members will receive an email Your password will be sent to you reports from nursing regulatory bodies notification when the online renewal electronically in two to three business across Canada and the United States of system is open. It is essential that all days. individuals misrepresenting themselves members have a current email address as registered nurses. Members and on file with ARNNL. All important I am enrolled in my employer’s payroll employers can verify the status of a information regarding registration deduction program. What do I need to license or membership through the renewal will be sent electronically. do? ‘RN Member Search’ or ‘NP Member Search’ feature available at www.arnnl. Member Online Registration Checklist ARNNL has made changes to the payroll ca. Members will receive an electronic deduction process for 2013-14. These receipt confirming payment that may be Do I need to have my email address on changes will improve the program for used for income tax purposes. file with ARNNL? members, employers, and ARNNL. Members will no longer be required to What if I am registered in another Members must have a valid email submit paper forms or a copy of their province or state? address on file with ARNNL to renew confirmation email to their employer. their practicing license and/or non- The employer will forward to ARNNL If you are registered/licensed in another practicing membership. If you do not the names and fees (RN: $480 and NP: jurisdiction, you will be required to have an email address, you will be $536.50) of those members for whom provide a verification of registration to required to create an email account. they have deducted the full licensure fee ARNNL. The verification of registration For additional information on creating before the online registration system must be sent directly to ARNNL an email address, members can access opens on Jan. 16, 2013. If ARNNL has from the relevant nursing regulatory the ‘Online Registration Renewal FAQs’ received your licensure fee from your authority and received at ARNNL House at www.arnnl.ca. To update your email employer, you will be notified that your prior to March 31, 2013. Your license address with ARNNL, members can fee has been paid when you log on to will not be processed and issued until visit the online registration renewal the online registration renewal system a current verification is received. It is website at http://ereg.arnnl.ca or to renew your 2013-14 license. If not, you your responsibility to ensure a current will be required to pay online. verification is on file.
Online Registration Renewal Benefits to You • Your personal and financial information is secure and protected using encryption technology. • You will receive confirmation of receipt of your renewal application as soon as it is submitted. • You can renew online 24 hours a day when registration renewal begins on Jan. 16, 2013. • You have a variety of payment options available – Visa, MasterCard, Interac, or payroll deduction through your employer. • If you’re returning from leave (e.g. maternity/parental, sick) and hold a non-practicing membership, you will be able to update your license to practicing status. • If you need assistance, you can chat online in real-time with ARNNL staff during business hours.
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ACCESS Vol.Vol. xxxiii No.No. 3 se septemberptember 2012 Q & A: You Asked By: Lynn Power, RN, MN, Director of Policy and Practice Q: Someone told me that RNs cannot distribute drug samples. Can RNs give out drug samples? No, RNs are not authorized to distribute medication samples to clients. There are a number of factors supporting this answer. A: Firstly, it is prohibited in legislation. In the Federal Food and Drugs Act, RNs are not identified as one of the occupations authorized to distribute samples.
Secondly, it may not be best practice. There are rules, at the provincial level, in pharmacy regulations, and within Health Canada, that are not easily accommodated in many practice settings (such as an office). Ensuring that all samples are labelled properly is one such rule. Further, how is the distribution recorded? A comprehensive record of all medications has been shown in patient safety studies to be best practice in limiting medication errors (Institute for Safe Medication Practices (ISMP) - www.ismp.org) and reducing the risk of adverse events. The ISMP also raises concerns about the expiry date on sample medications, and the accuracy and comprehensiveness of client instructions and precautions. Do you have a policy on how you handle all these factors? Are written instructions provided to the client?
Thirdly, it may not be safe. Health Canada – Canada Vigilance Program expressed concerns about the ability to inform clients who had been given sample medications if there was a product recall. The Industry Guide for Good Manufacturing Practices speaks to the need to track the distribution of all medications in order to ensure that any lot or batch of the drug can be recalled. In addition, Health Canada cites storage requirements as a consideration. In accordance with their Guidelines for Temperature Control of Drug Products during Storage and Transportation, anyone distributing a drug product is accountable to follow all relevant storage requirements as determined by the manufacturer. Do you know the requirements? Is it possible to meet them in your work setting?
There are many factors to justify why RNs should not distribute sample medications to clients. The most obvious though, is that it is against the law.
Q&A: YOU ASKED reflects member questions frequently asked about general topics. Members can access confidential practice consultation with ARNNL Nursing Staff. Visit www.arnnl.ca under “Contact Us” for ways to get in touch.
PUT YOUR BEST FOOT FORWARD! All registered nurses engaged in foot care are encouraged to attend a special ARNNL Teleconference on Nov. 1, 2-3:30 p.m. To register, contact [email protected].
CALL FOR NOMINATIONS ARNNL is seeking nominations for the Governor General of Canada: Queen Elizabeth II Diamond Jubilee Medal. The nominee must be an ARNNL member who has made a significant contribution to the nursing profession. Deadline is Sept. 21. For more information about the award, and to access the nomination form, visit www.arnnl.ca.
7 Nurses of Note By: Jennifer O’Neill, BA, Communications Officer
ARNNL’s Awards for Excellence in Nursing Nursing Access Program for residents of Norman-Robbins often says, were presented at a luncheon ceremony coastal and rural Labrador. She has also “everything is possible if there is on June 6 to commemorate the 20th been integral in creating the new two- evidence to support it.” She possesses Anniversary of the Awards program. year fast track option, and is a notable the fortitude to go up against the odds, Since the provincial awards program voice for the transition and integration and is a forward-thinking administrator was established in 1992, 51 RNs have of WRSON into the Grenfell Campus of with vision. been honoured with this prestigious Memorial University. recognition. ARNNL congratulates this year’s recipients, and is inspired by their Dedicated to improving student life, Patricia Rodgers, Clinical Educator, dedication and commitment. For more Norman-Robbins’ colleagues say that General Hospital, Eastern Health information, visit www.arnnl.ca. she has brought the school into the 21st Award for Excellence in Nursing – century with technology: smart boards, Education simulation mannequins, digital signage, Linda Norman-Robbins, Director, teleconferencing equipment, and social Patricia Rodgers has been an integral Western Regional School of Nursing, media. Yet she remains protective of the member of the interdisciplinary team Western Health Award for Excellence in image of nurses. It was under Linda’s in the three critical care units at the Nursing – Administration administration that student uniforms General Hospital, Eastern Health for were re-introduced. over 30 years. She has been described Since 1987, Linda Norman-Robbins as a treasure chest of knowledge, a has been the Director of Western Norman-Robbins is credited with motivator, an innovative educator, an Regional School of Nursing (WRSON). advancing the research agenda at advocate for patient safety, and a policy Her name has been synonymous WRSON by establishing a Research guru. with many milestones for the school, Office, obtaining funding and grants, including: preparing the school to offer supporting faculty to attend renowned Rodgers is passionate about continuous the Baccalaureate degree program, research institutes, and embracing learning, and that enthusiasm is obtaining access to Master of Nursing innovative models whereby faculty contagious. Her colleagues say she is education on the West Coast, and balance teaching, research and scholarly inspired by research and welcomes developing and implementing the first activities, and committee work. new ideas. On a daily basis, she is said to stroll into the intensive care unit with a research article, a new policy, or information on an emerging trend in health care. Her teaching style and her genuine demeanor are said to leave a wonderful first impression of the General Hospital’s critical care units.
Rodgers is described as a true all-around advocate for the patient. Her colleagues say she instills in them the importance of addressing the emotional needs of the patient and family. She advocates for safe workplaces, as well as funding for continuing education.
Rodgers has served on ARNNL Council three times, is a member of the Canadian and the American Associations for Critical Care Nursing, and has held certification with the Canadian Nurses Association for most of her career.
Left to right: Patricia Rodgers, Dr. Deborah Gregory, Linda Norman-Robbins, Beverly White (ARNNL Past-President).
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ACCESS Vol. xxxiii No. 3 september 2012 Nurses of Note continued ...
Dr. Deborah Gregory, Health Policy topic as the principle investigator Analyst and Clinical Assistant Professor, examining the longitudinal trends. Eastern Health and Memorial University, Faculty of Medicine Dr. Gregory’s colleagues say that she Award for Excellence in Nursing – is an excellent mentor for nurses and Research others who are pursuing programs or research. She is never too busy to assist Dr. Deborah Gregory’s outstanding others in their pursuit of knowledge and passion for research, coupled with her professional development. ability to get “evidence into practice,” has helped improve the quality of health Dr. Gregory has helped raise the bar and care in the province. She has conducted bring to light the significant contribution extensive research in such areas as: registered nurses and nursing can make nursing work life, hemodialysis, clinical to quality client, system, and nursing Nicole Woodman, ARNNL Awards Committee Chair genetics, adverse health events, patient outcomes through research. safety, and adult obesity.
Her work, along with other research team members, has culminated into 24 reports, 54 academic and stakeholder presentations, 16 abstracts, and 15 article submissions to refereed journals.
In 1995, Dr. Gregory was a member of the research team which undertook a groundbreaking ARNNL-commissioned study to validate a scale to monitor registered nurses’ perceptions of the health care reform process. This scale has been used repeatedly since then and she remains committed to this research
If you would like to nominate a RN or NP you know for Nurse of Note, please email [email protected] 9 The Greatest Story Ever Told . . . By: Lynn Power, RN, MN, Director of Policy and Practice
Standards do not refer to just one document. To help Once upon a time, when ARNNL’s nursing standards were create the full story, it is important to understand how conceived … various standards fit into the plot. The ARNNLStandards for Nursing Practice form the basis for the entire storyline. What? Standards? Not much of a story there, you may say! These standards describe the expectations for all RNs in Although they can appear somewhat dry on paper, standards all domains and settings. Although too many to name in are actually dynamic statements describing who registered this article, characters include: accountability, scope of nurses (RNs) are as professionals. Before you run off and say, practice, continuing competency, advocacy, and leadership. “Boring,” remember that standards tell our colleagues, our As you know, every story needs a setting. Many groups clients, and the public what we do. They describe not only have developed or adopted standards to describe their our fundamental legal responsibilities, but also identify our unique area of practice in areas such as community leadership roles and ethical and societal obligations. Suzanne health, critical care, emergency, and gerontology. RNs Gordon, keynote speaker for the ARNNL and Newfoundland are expected to know and apply all relevant specialty and Labrador Nurses’ Union’s Nursing Innovations standards. Further, there are some ARNNL standards Conference, challenged registered nurses to illustrate the that are part of the setting in almost all stories, such as expertise we add and the critical roles we enact in health care, medication administration and documentation. Stories by telling our story. Standards are the plot of our story. also need a script. Agency standards or best practices, often articulated as employer policies, along with unit level standards or procedures, form the script. They articulate how you perform or carry out a responsibility. And finally, the story needs a climax – the pivotal point of the story. In standards language, this would be the care plan or client specific expectations; the assessments, interventions, and evaluations carried out at the point of care.
Standards make a noble story indeed. To ensure that standards stand the test of time, they are updated approximately every five years. The currentStandards for Nursing Practice (2007) are being revised, so it is time for all RNs in our province to take part in writing our story. I am excited to report that a working group, consisting of my counterparts in other Canadian nursing jurisdictions, has helped us get a good start on creating the 2013 version. The introduction has been drafted, but remember, it is our story. We need the RNs of Newfoundland and Labrador to tell us: What are you responsible and accountable for? How do you maintain and enhance your knowledge and competency? How does your practice keep the public interest in focus and uphold the public’s trust in the profession?
This fall there will be several ways for you to participate in telling our story. The draft Standards for Nursing Practice will be posted on our website, a survey will be sent out via email, ARNNL committees will add the topic to their agendas, and you are all invited to participate in the scheduled focus groups, either in person or via teleconference. The story of RN practice must be told.
The End ... or is it the Beginning? Help us continue to shape the RN practice story in the coming months.
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ACCESS Vol. xxxiii No. 3 september 2012 Trust News
CALL FOR APPLICATIONS Trust Elects New Board of Directors Applications are now being accepted for awards in the following categories:
The Trust elected a new Board of Continuing Education Awards Directors at its annual meeting on June • Health Educators Bursary (up to $750) NEW 6, 2012. Congratulations to the members • Nancy Llewellyn RN Pediatric Nursing Bursary ($500) of the 2012-13 Board: • Nursing Leadership Awards ($500-$3,000) • Kay Daley Scholarship for Nursing Leadership (up to $1,000) • Sharon Smith, President • Peter & Elizabeth Yetman Oncology Nursing Bursary (up to $1,000) • Penny Grant, President-Elect • Violet D. Ruelokke Primary Health Care Award (up to $1,000) • Janet Templeton, Eastern Urban • Bursaries for Conferences & Post Basic Courses (up to $1,000 each) Director
• Starlene Lundrigan, Eastern Rural Bachelor of Nursing Scholarships ($1,000 each) Director • BN Years 2, 3, 4 • Beverley Reid, Central Regional • BN Fast Track Year 2 Director • Flo Hillyard Memorial Scholarship • Anna Marie Alteen, Western Regional • General Hospital School of Nursing Alumni Association Scholarship Director
• Eleanor Fowler, Labrador Regional BN (Post RN) Scholarships ($750 - $1,500) Director • BN Post RN • Dianne Hart, Director-at-Large • St. Clare’s Alumni Association Scholarship • Cindy Parrill, Director-at-Large
• Pegi Earle, Secretary-Treasurer ARNNL Bay St. George Chapter Scholarship • Julie Wells, Coordinator (non-voting) • Available to RNs from the Bay St. George area
The Board extends thanks to out-going Graduate Scholarships ($1,000 - $2,000) members Holly LeDrew (President), and • Master’s or PhD (Nursing & Non-Nursing) Glenda Roy (Central Regional Director). • ARNNL 50th Anniversary Scholarship • Marcella Linehan Scholarship
RN Re-Entry Scholarship ($500)
Nursing Research Awards (up to $2,500 each)
Criteria and application forms are available at: www.arnnl.ca/trust Deadline: Oct. 15, 2012 Late or incomplete applications will not be considered.
11 Campaign says “It’s about time” for more NPs By: Denise Rideout, Internal Communications Coordinator, Canadian Nurses Association
A Canadian Nurses Association Regional focus prompted other media outlets to provide (CNA) public awareness campaign CNA worked closely with ARNNL to coverage. in Newfoundland and Labrador this create a regional focus on the value spring helped spread the message that of NPs. The campaign reflected ARNNL also helped with creative increasing the number of existing nurse current realities, especially those that marketing when staff members practitioners (NPs) will improve access Newfoundland and Labrador’s health developed an NPNow.ca email signature to more health care options, enhance care system must face, such as meeting for outgoing email during the campaign, the care of the whole client, and reduce public health needs in light of an aging a tool CNA plans to use in its other wait times. population, and managing an ever- provincial NP initiatives later this year. growing number of chronic diseases. In addition, ARNNL tapped into the CNA launched the “Nurse Practitioners: power of its local resources, mainly It’s About Time!” initiative in October The campaign also combined street- through its NPs and provincial Workplace 2011 to help make people aware that level engagement with a province-wide Representatives — a network of RNs and NPs, with their additional education reach. There were radio ads and a new NPs — who helped make sure campaign and experience, are a solution to some feature CNA had not yet tried in other messages were heard at the local level of Canada’s most pressing health care jurisdictions – placing large, colourful through email, word of mouth, and system problems. CNA has brought the digital and standard billboard ads at distributing (close to 500) posters. program to various jurisdictions since four of the busiest thoroughfares in St. then; starting in March 2012, through a John’s. Local NPs were also interviewed Together, ARNNL and CNA used a variety partnership with ARNNL, it successfully on provincial TV and radio, and residents of tools to spread positive messages ran the NP campaign in Newfoundland were encouraged to write letters to their about the NP role. According to an and Labrador over a six-week period. provincial elected officials. evaluation conducted after the campaign When the campaign was launched, in St. John’s, those who had seen the ARNNL’s Executive Director, Pegi Regional interest campaign were significantly more likely Earle, spoke out on behalf of NPs, ARNNL provided CNA with some valuable to be aware of the range of health care noting that while the “government of advice to help spread the “It’s About needs that NPs can address. Newfoundland and Labrador continues Time!” message effectively across to invest in improving access to care, the province. Realizing the power of Promotion continues more dedicated funding is required provincial media to reach residents and Although the campaign officially ended for nurse practitioners.” “Further politicians, ARNNL recommended that in late April, efforts to promote the value investment in nurse practitioners,” she a letter about the value of NPs be sent and role of NPs have continued in the said, “will support improving access to to the editors of The Telegram and The province. An information luncheon at one health care services and reducing wait Western Star. This letter helped extend of the Rotary Club chapters in St. John’s times throughout the province.” the reach of the campaign’s message, and drew media coverage from VOCM Radio, which meant that people throughout Newfoundland and Labrador heard, once again, about the value of NPs.
ARNNL representatives also took the NP message to meetings with the Honourable Susan Sullivan, Minister of Health and Community Services; Dwight Ball, Leader of the Official Opposition; and Lorraine Michael, Leader of the New Democratic Party.
As a result of the campaign, CNA, ARNNL, and NPs are hopeful that the number of NPs in the province will rise, along with improved access to health care.
A billboard on Topsail Road in St. John’s during the campaign. Find more information about NPs at www.npnow.ca. 12
ACCESS Vol. xxxiii No. 3 september 2012 Advanced Practice View The Pain Nurses: Role of the Clinical Nurse Specialist in Acute Pain Management By: Natasha Fulford, BN, RN, MN and Pamela Goulding, RN, BN, MHS
Pain management is integral to care which can be a very challenging time for Ensuring that acute pain is managed of the surgical client. The subjective clients. The role of the CNS is to ensure properly during postoperative periods nature of pain can create complex safety, adequate pain relief, and optimal can increase patient satisfaction, and challenging issues for health care patient satisfaction postoperatively. The decrease the risk of chronic or long- staff. Pain is what the patient says it is, client population served by the CNS for term pain, and decrease length of stay. therefore, as health care providers, it Acute Pain Service are those who have All of the benefits to adequate pain is essential that we understand what been consulted through anesthesia and management can lead to decreased the patient is saying. Many health care have received a pain modality, an epidural, health care system burden, including providers under-medicate patients or patient controlled analgesia pump. hospital visits, admissions, and ultimately, because of lack of education or health care costs. The clinical nurse experience, or fear of over-medicating. As a clinician, the CNS provides in- specialists working within the Acute Unrelieved acute postoperative pain depth assessment of clients using Pain Service are here to provide in-depth results in avoidance of movement expert knowledge in the specialty of advice, promote a positive learning and ambulation on the part of the pain management, consults with many environment, provide support, and patient, which may delay recovery members of the health care team, ensure quality and safety outcomes time (Hutchinson, 2007). Patient and provides advice, skills, support regarding acute pain management for dissatisfaction and increased health care and knowledge to address challenges postoperative surgical clients. costs are associated with inadequate with acute pain management. The CNS pain management. educates staff, clients, and families on “Divimun est se dare dolorem” the latest evolving techniques in pain Translation: Nursing positions that focus on acute management and the best practice “Blessed are those who treat pain” pain management of postoperative guidelines for optimal outcomes and Galen of Pergamon (Physician, A.D. surgical clients are not a foreign improved satisfaction. 129-199) concept. Many institutions across the country engage clinical nurse specialists, About the Authors nurse practitioners, or nurse clinicians to ensure safe and adequate pain management, with the ultimate goal of increasing patient satisfaction and decreasing health care costs.
The clinical nurse specialist (CNS) position came to fruition for the Acute Pain Service at St. Clare’s Mercy Hospital in 2007 and at the General Hospital in 2011. A CNS identifies gaps in practice, conducts research to improve clinical Pamela Goulding, RN, BN, MHS, is the Natasha Fulford, BN, RN, MN, is practice, and promotes quality and clinical nurse specialist with the Acute a clinical nurse specialist with the safety of client care by ensuring that Pain Service at St. Clare’s Mercy Hospital. Acute Pain Service and is currently policy and procedures are current and Pamela holds a Master of Health Studies working at the General Hospital. developed following evidence-based degree from Athabasca University. She has Natasha holds a Master of Nursing guidelines. A CNS must hold a Master’s numerous years of experience in medical- degree from Athabasca University. or Doctoral degree in Nursing (ARNNL, surgical nursing, critical care nursing, She has experience in medical-surgical 2007 & CNA, 2008). and community health nursing. She is nursing and perioperative nursing. temporarily replacing Peggy Sheppard, BN, She is a member of The Canadian Pain The CNS works in conjunction with RN, MN, who is currently on leave. Peggy Society, The Canadian Association their colleagues in Acute Pain Service to was instrumental in initiating the clinical of Advanced Practice Nurses and an create a positive experience for surgical nurse specialist role for the Acute Pain acute pain management specialist clients in the post-operative phase, Service within Eastern Health. networking interest group.
References available upon request. 13 Goings On
ARNNL’s EXECUTIVE DIRECTOR SET TO RETIRE NURSING LEADER RECEIVES POSTHUMOUS Pegi Earle, ARNNL’s Executive Director, has announced HONOUR her intent to retire at the end of the year. Members were A pioneer for the nursing profession in Newfoundland notified at the Annual Business Meeting in June. Prior to and Labrador has been recognized in the Canadian Nurses assuming the Executive Director position in September Association (CNA) Memorial Book, and was honoured by 2007, Pegi worked with ARNNL for 20 years as Consultant CNA at its Biennial Convention and Awards Banquet in June. for Education and, most recently, Consultant for Health Jean Lewis started nursing in England in 1936, moving to Policy and Communications. Pegi has worked to advance St. John’s in 1945. Her calling was public health, where her standards of nursing education and practice on provincial, leadership brought significant improvements to the quality national, and international levels, and was integral in of care provided by “district” nurses working in cottage leading the progression of nursing education from diploma hospitals in 1,300 outport communities in the province. Lewis to baccalaureate for entry to nursing practice in the was also instrumental in advancing the profession, helping province. Pegi is known for her enthusiasm, dedication, to draft legislation for the formation of ARNN and becoming and passion for nursing – qualities that have guided her its third president. As a community leader, she volunteered as she has worked over the years with Councils, staff, and widely and received many accolades, including the National ARNNL members to advance nursing in the public’s interest. Red Cross Society’s Distinguished Service Award, the Queen’s She will be missed! Council struck a search committee and Silver Jubilee Medal, Honorary Memberships in ARNNL and actively recruited for a new Executive Director over the the Newfoundland Association of Health Services Executives, summer. Stay tuned for an official announcement in the and lifetime membership in the Canadian Public Health coming weeks. Association. Lewis was a pioneer and a steadfast leader who made a difference to public health nursing and health care in munson’s men Newfoundland and Labrador. Lewis passed away on Feb. 13, 2011. She was 91.
NURSING CHARITY BALL RAISES OVER $10,000 FOR PROVINCIAL GROUP In March, nursing students and members of the nursing community gathered for the 14th Annual Nursing Charity Ball in support of the Eating Disorder Foundation of Newfoundland and Labrador. Over $10,300 was raised for the Foundation. ARNNL congratulates everyone involved!
Three men of Memorial University of Newfoundland’s School of Nursing (MUNSON) Bachelor of Nursing (Collaborative) program pose with Dr. Robert Left to right: Chad Warford, Charity Ball Coordinator (Centre for Nursing Meadus, Associate Professor of Nursing, at the School’s Graduation and Awards Studies); Pegi Earle, Executive Director, ARNNL; Melissa Power (student, Centre ceremony in June. Pictured, left to right: Michael Dawe, Christopher Harty for Nursing Studies); Hilary Turner, Charity Ball Coordinator (MUN School of (recipient of the ARNNL Award for Leadership in Nursing, BN - Collaborative), Dr. Nursing); Anita Ludlow, Provincial Chief Nursing Officer; and Debbie Forward, Robert Meadus, and Ryan Parsons. President, Newfoundland and Labrador Nurses’ Union.
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ACCESS Vol. xxxiii No. 3 september 2012 Goings On
PAST ARNNL AWARD WINNER RECEIVES A FAMILY AFFAIR NATIONAL AWARD At Memorial University’s School of Nursing Crest Ceremony A past ARNNL Award for Excellence in Nursing recipient in April, it was evident that a passion for nursing runs deep and professor of nursing at Memorial University’s School of in some families. The annual ceremony welcomes first year Nursing has received a national students to the nursing profession. honour. Dr. Donna Moralejo received an Award of Merit from the Community and Hospital Infection Control Association of Canada (CHICA-Canada) for her work on training modules to help health care workers control infections. The e-learning modules, titled Infection Prevention and Control: The Left to right: Doug Trainor and Lori Trainor (Doug’s stepmother and graduate Team Approach, are designed of the General Hospital School of Nursing); Cynthia Higdon (graduate of MUN for health care workers and School of Nursing) and Leslie Higdon (Cynthia’s daughter); Helen Kerr; Patrick are offered through Georgian Edison and Elizabeth Edison (Patrick’s mother and graduate of the General College. Dr. Moralejo is also Hospital School of Nursing). director of education on the CHICA board of directors. This is NEW ARNNL-CANADIAN NURSES FOUNDATION her second Award of Merit from CHICA. The first was in 2006 DOCTORAL SCHOLARSHIP AVAILABLE IN 2013 for her work as part of an advisory group that developed The ARNNL Education & Research Trust is pleased to CHICA-Canada’s two-term course on infection prevention and announce that its 25th Anniversary Scholarship will be awarded control for novice infection control practitioners. by the Canadian Nurses Foundation for the first time in 2013. This important initiative will help our province address the NATIONAL NURSING WEEK RECOGNIZED IN MAY need for more doctoral-prepared nurses to teach in our educational programs and to conduct research that advances nursing knowledge. The scholarship, valued at $5,000, will be awarded to a registered nurse pursuing a doctoral degree who has demonstrated academic excellence during undergraduate and graduate studies, and leadership in the nursing profession and/or community service. The application form will be available on the Canadian Nurses Foundation website in December (www.cnf-fiic.ca). Further details will be posted on the Trust website (www.arnnl.ca/trust) as they become available. Stay tuned!
CONFERENCES AND WORKSHOPS Nurses who work at the Mission Store Building (Labrador-Grenfell Health) in St. Newfoundland & Labrador Nurse Practitioner Anthony. Association Conference Sept. 20-21, 2012 - Holiday Inn, St. John’s www.nlnpa.ca National Emergency Nurses Affiliation Provincial Conference Oct. 19-21, 2012 - The Glynmill Inn, Corner Brook www.nena.ca or [email protected] Western Regional School of Nursing Alumni and Friends Dinner Oct. 20, 2012 - Mamateek Inn, Corner Brook The registered nurses of Service Canada in St. John’s. www.swgc.mun.ca/nursing
15 ARNNL Council Matters
RN REGISTRATION LICENSURE EXAM TO CHANGE ARNNL WELCOMES NEW Council has agreed to enter into a contract with the National Council of State Boards COUNCIL MEMBERS of Nursing (NCSBN) to offer a new National Council Licensure Examination for Following ARNNL Council elections Registered Nurses (NCLEX-RN) in 2015. Council is confident the contract meets the this past spring, two new members requirements set out in ARNNL’s criteria for the examination and in the Request for were elected to Council. Official results Proposals. The development of plans for transitioning to the new exam is underway; were revealed at ARNNL’s 58th Annual the plans and other information will be available in the coming months. For answers Business Meeting in June. Regina Coady, to Frequently Asked Questions about the exam, visit www.arnnl.ca. Director of Occupational Health, Safety and Rehabilitation – Eastern Health, was ANNUAL REPORT RELEASED elected by acclamation as President- ARNNL’s 2011-12 Annual Report, Advancing Nursing Excellence. Raising the Professional Elect for 2012-14. In addition to being Bar, was released in June. In addition to highlighting Council’s policy direction and involved in the nursing profession at the other accomplishments of a governance nature during 2011-12, the report provides organizational, provincial, Atlantic, and details on the many important initiatives undertaken by staff and members to achieve national levels over a 30-year period, ARNNL’s legislative and policy mandate. Visit www.arnnl.ca to view the report. Coady has worked in direct practice, education, and administration, as well OUTGOING COUNCIL MEMBERS MEMORIAL DAY PARADE as in Government policy and planning RECOGNIZED FOR EXEMPLARY HONOURS VETERANS AND THE roles. Elaine Warren, Director, Surgery Program at Eastern Health, will fill the SERVICE ROLE OF REGISTERED NURSES ARNNL wishes to thank Beverly White Administration Councillor role from (Council President from 2010-12) and 2012-15. Warren, a registered nurse for Cathy Burke (Administration Councillor 30 years, is currently the Chair of the from 2007-12) for their dedication and provincial Wound and Skin Committee, commitment to the work of Council. is a former associate professor at Beverly and Cathy attended their last Memorial University, and has served as Council meeting in June. a member on a number of committees and working groups.
Beverly and Cathy
Regina Coady Elaine Warren
Attend an ARNNL Council meeting! The next in-house Council meeting takes place on Oct. 26-27 at ARNNL ARNNL President Cathy Stratton during the House in St. John’s. Contact Christine Memorial Day parade on July 1 in downtown St. Fitzgerald, Executive Assistant, at John’s. Both retired and practicing RNs, dressed in (709) 753-6183 or cfitzgerald@arnnl. Beverly and Pegi Earle, ARNNL’s traditional nursing attire, took part in the annual ca for details. Executive Director ceremony.
*More details about the business of ARNNL Council are available in UPDATE, ARNNL’s e-newsletter. Email [email protected] to subscribe today!
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ACCESS Vol. xxxiii No. 3 september 2012 Discipline Decisions Summary of Adjudication Tribunal Decisions Registered Nurses Act, 2008, Section 29(4)
FAYE WHeeler katherine richards Newfoundland and Labrador Registration #6894 Newfoundland and Labrador Registration #14077
In the matter of an Application made by the Association of In the matter of a Complaint against Katherine Richards (the Registered Nurses of Newfoundland and Labrador (ARNNL) “Respondent”), Registration # 14077, and a hearing of the and a Complaint against Faye Wheeler (the “Respondent”), Complaint pursuant to Section 25 of the Registered Nurses Act, Registration #6894, and a hearing of the Application and 2008 (the “Act”); an Adjudication Tribunal of the Association of Complaint pursuant to Sections 25 and 31 of the Registered Registered Nurses of Newfoundland and Labrador (ARNNL) in Nurses Act, 2008 (the “Act”); an Adjudication Tribunal of a Decision dated April 27, 2012 found the Respondent guilty of the ARNNL in a Decision dated March 8, 2012 found the conduct deserving of sanction pursuant to the Act, in particular, Respondent guilty of conduct deserving of sanction pursuant the following sections: to the Act, in particular, the following sections: 18(c)(i) professional misconduct and 18(c)(v) acting in breach 18(c)(iii) conduct unbecoming a Registered Nurse, in that of the Act and Code of Ethics, in that the Respondent left the Respondent failed to comply with a previous order of work without permission and failed to reassign her clients to an Adjudication Tribunal; and the care of another registered nurse; 18(c)(iii) conduct unbecoming a Registered Nurse, and 18 (c)(v) acting in breach of the code of ethics, in that the 18(c)(i) professional misconduct, in that the Respondent Respondent was dishonest in her dealings with both her lacked compassion and a caring approach in interactions employer and the ARNNL. with the family of a client assigned to her care;
The conduct deserving of sanction occurred during the period 18(c)(iii) conduct unbecoming a registered nurse, 18(c)(iv) of November 18, 2009; while the Respondent practiced in St. incapacity or unfitness to engage in the practice of nursing, Anthony, Newfoundland and Labrador, and May, July and and 18(c)(v) acting in breach of the Act and the Code of August 2010. The Complainant was Labrador-Grenfell Health Ethics, in that the Respondent repeatedly and continuously and the ARNNL. failed to report her absences from work in accordance with employer’s reporting protocols and expectations; and Pursuant to section 28(3) of the Act, the Adjudication Tribunal ordered the following: 18(c)(ii) professional incompetence, in that the Respondent 1. The Respondent’s license remain suspended until she failed to assess and attend to the physical needs of a client, completes conditions summarized as follows: failed to turn and re-position a client as required, failed (i) submits to the ARNNL negative random blood to provide incontinence care in a timely manner, failed to toxicology screens over four consecutive month period; document nursing interventions, failed to observe a client as (ii) successfully completes learning modules in professional required, and document the required surveillance. responsibilities, jurisprudence and ethics; and (iii) successfully completes a paper on the code of ethics The conduct deserving of sanction occurred from March 2007 and other subject matter specified in the order. to December 2009 while the Respondent practiced in St. John’s, Newfoundland and Labrador. The Complainant was Eastern 2. The Respondent shall, following the return of her nursing Health. license and her return to nursing practice, provide an The Adjudication Tribunal ordered suspension of the additional four negative blood toxicology screens over a Respondent’s license to practice nursing until such time as 12-month period. the Respondent can demonstrate to an Adjudication Tribunal that she can safely return to nursing practice. The Adjudication 3. The Respondent shall provide a copy of the Order of the Tribunal further identified conditions for the consideration of an Adjudication Tribunal to any future employer and shall Adjudication Tribunal hearing the Respondent’s application for further provide written confirmation from any future reinstatement of her nursing license. employer to the Director of Professional Conduct Review that she has complied with this provision of the Order. Pursuant to section 28(3) (e) of the Act, the Adjudication Tribunal ordered that the Respondent pay a contribution The Adjudication Tribunal ordered the Respondent towards the costs of the tribunal proceedings in the amount of responsible for the partial costs of the ARNNL in its $6,000, which amount is reflective of the partial costs associated investigation and the hearing of the Application and with the entire complaint and the complete lack of effort on the Complaint in the amount of $12,500. part of the Respondent to participate in the process.
17 Volunteer Spotlight: The ‘Self’ in Self-Regulation ARNNL’s Workplace Representatives
Workplace Representatives (WPRs) volunteer to represent ARNNL by supporting professional nursing practice, and communicating information in their workplaces. WPRs complete an orientation and a workshop on Leadership in Professional Practice to prepare for the role. Ongoing support and development is provided through regular meetings and education sessions. Our WPRs are introduced in ACCESS so you can get to know these important volunteers.
Benay Sinnicks, RN Benay Sinnicks graduated from Western Memorial School of Nursing in 2001. Shortly after graduation, she completed a Regional Nurse preparation program through Labrador-Grenfell Health and began work as a Regional Nurse in Forteau, and then Roddickton. One and a half years ago she started work as a Community Health Nurse with a geographical area covering Englee to Conche to Main Brook. Working in continuing care, Benay’s client population is mostly elderly and there are many assessments for home supports. “My elderly clients are the most appreciative patients. It is busy, but I love it,” she says. Benay became an ARNNL WPR just over a year ago. “I’ve always read the information that came from ARNNL, but I wanted to be more involved. Now, as a Workplace Rep, I have a better understanding of my professional association and how I am supported in my practice. I am able to help others also understand this now, too!” Benay and her husband, Troy, have two daughters, Lexie and Kate.
Deneka Pottle, RN Deneka Pottle graduated from Western Memorial School of Nursing in 1993. Following a short stint in Goose Bay, she moved to Gander and began working at James Paton Memorial Hospital in 1994. Through the subsequent years, Deneka worked in emergency and obstetrics, but moved to OR/PACU in 1999 where she has remained. She became an ARNNL WPR in 2010. Deneka actively participates in ARNNL education sessions and events, and is a member of ARNNL’s Professionalism Strategy working group. “Being a WPR allows me to be involved in my association and to stay on top of what is going on in nursing,” she says. “Also, I can be a resource person and an educator for others in my work area regarding ARNNL, and this is something that I truly enjoy.” In addition to her volunteer work with ARNNL, Deneka is active with her NLNU branch, serving as branch vice-president and shop steward. She is trained in and performs fit testing, has completed TNCC, a diabetic education course, and is a champion for ARNNL’s Continuing Competency Program. Deneka is nearing completion of her Bachelor’s Degree in Nursing, with three courses left to complete!
Peggy Allan, RN, BHScN Peggy graduated from St. Clare’s School of Nursing 34 years ago and went on to complete her Bachelor of Health Science in Nursing in 2003. She works in the Health Protection branch at Western Health, in Corner Brook, as a communicable disease control nurse. Her work involves surveillance of communicable diseases with responsibility primarily for the immunization program through the Western region of the province. “It is rewarding to see a decline in diseases as a result of the implementation of an immunization program. For example, one of the recent programs, pneumococcal vaccine, has resulted in a decline in bacterial pneumonia infections in children,” says Peggy. Some of her past volunteer activities were on school councils, as a swim meet official, and as a ski instructor. She currently volunteers for the local triathlon and duathlon in Corner Brook. She is also involved with the current accreditation process for Western Health. Peggy has enjoyed a very rewarding career in nursing, and is happy to participate in the ARNNL Workplace Representative program.
Sean Dillon, RN, BN, BBA Sean Dillon completed a Bachelor of Business Administration degree before entering the BN Fast-Track program at MUN, graduating in 2006. “Leaving business and completing a nursing degree was the best decision I ever made,” says Sean, who works as a staff RN in the Emergency Department, St. Clare’s Hospital. In addition to being an active participant in unit activities, and a member of the St. Clare’s Education Committee, he is a NLNU shop steward, branch treasurer, and a volunteer with Rovers Ground Search and Rescue. Sean has been an ARNNL WPR for the past two years. “I love being a registered nurse,” he says. “I love going to work each shift and am excited for all the opportunities that are available to me.” Sean is a member of the Canadian Society of Vascular Nurses, and a research coordinator for the Anaconda Graft Endovascular Aneurysm Repair (EVAR) Surgery. Running, skiing, and hiking round out his long list of activities.
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ACCESS Vol. xxxiii No. 3 september 2012 Meet Your ARNNL Staff
One of ARNNL’s key roles is to provide support to members to help improve and advance the quality of nursing services in our province. Our Policy and Practice staff serve that important function.
In this edition, we are pleased to introduce you to Lynn Power, Director, and Siobhainn Lewis, Consultant, with Policy and Practice.
The Policy and Practice team provides a variety of services, from individual confidential consultation to group sessions, to helping resolve professional practice challenges. They offer educational events, such as the Tuesday afternoon teleconferences, annual conferences, and specialized workshops. The Workplace Representative and the Quality Professional Practice Environment programs are managed within this portfolio. Lynn Power
Lynn and Siobhainn write the practice columns published in ACCESS, compile Clinical Corner tips, draft the content for the ‘You Asked’ column, and more. They chair or sit on numerous provincial advisory committees that help enhance connections between ARNNL and nursing practice and public policy matters. As well, they lead the development of position statements, guiding documents, and practice-related programs offered through ARNNL, and represent the registered nurses of this province on several local and national nursing-related committees.
Lynn and Siobhainn have been with ARNNL for 12 and four years respectively, following several years in clinical practice, education, and management. They thoroughly enjoy all the challenges and rewards of their roles. They are pleased to introduce you to some of the work they do, and welcome your input as ARNNL moves forward to advance RN practice in Newfoundland and Siobhainn Lewis Labrador.
GHOSTS OF VIOLENCE
Internationally-acclaimed Atlantic Ballet Theatre of Canada brings Ghosts of Violence to Newfoundland and Labrador this fall – a riveting multimedia production that brings the issue of intimate partner violence to the stage. Strong theatrical values and emotional dance narrative tell the story of four women caught in the cycle of abuse. The Canadian Nurses Association is a proud partner of this important production that is touring across Canada. Tickets on sale at the Arts & Culture Centres.
Oct. 29: St. John’s Nov. 1: Gander Nov. 5: Grand Falls-Windsor Nov. 7: Corner Brook Nov. 9: Stephenville
19 Clinical Corner
A Spoonful of Sugar Helps the Self Injury Information Bedtime Routines: ZZZ’s to A’s Medicine Go Down Help an adolescent who self injures by Establishing a back-to-school bedtime When immunizing infants, encourage teaching about urges and waiting-out routine for children is important the parent to offer a sweet drink to baby urges. All urges, not just the urge to and encourages good sleep habits. – breast milk is best. Research shows it self injure, will pass if you wait it out. Suggestions include: having a winding- decreases the infant’s pain and allows Suggest they make a plan to distract down period; sticking to a bedtime and baby to remain calm and comfortable. themselves while waiting it out. alerting your child both half an hour When the parent holds the baby closely The more they wait it out, the more and 10 minutes before that time; and it can reduce trauma. Low lighting, the urges will decrease over time. encouraging older kids and teens to set where possible and safe, and soft music Encourage use of a “15 minute rule” and maintain a bedtime that allows for such as lullabies, help to make baby from when the urge arises to when it the full hours of sleep needed at their more comfortable and cooperative. is acted upon. Examples of distraction age. How much sleep is needed? With public health nurses doing multiple include: shaking a glitter bottle and School-age to preteen: 10 – 12 hours injections at each clinic visit, these little watching it settle; cracking a glow stick Teens: 8.5 – 9.5 hours tricks help soothe babies and also allow and waiting until it’s no longer glowing; the clinic to run more smoothly. exercise; playing with a pet; or doing Sleep deprivation adds up over time, so something self-soothing. Check out the an hour less per night is like a full night Ann-Marie Slaney, RN, BN, CCHN(C) Kids Help Phone website at http://www. without sleep by the end of the week. Community Health Nurse, St. Lawrence kidshelpphone.ca/Teens/InfoBooth/ Among other things, an insufficient Emotional-Health/Self-injury/In-the- amount of sleep can lead to: decreased Pesky Problem moment.aspx, for more information. attentiveness, decreased short-term Given the prevalence of infestations, the memory, inconsistent performance, and notoriety, and high anxiety levels that Tanya Purchase, RN, CPMHN(C) delayed response time. a diagnosis of head lice (pediculosis) in Out-Patient Psychiatry Clinic school children can generate in parents Janeway Hospital Sandra Carpenter, BN, RN, CCHN(C) and/or teachers, health care providers Parent & Child Health Coordinator need to ensure that head lice myths are Walk the Talk Central Health, Lewisporte dispelled and that accurate information Children and teens are often excited is provided. Anyone can get head lice. and/or distracted when walking or Puffers and Peanuts They are spread through head-to-head biking on the roadways, especially when Did you know that Atrovent contact with an infested person’s head they are going back to school. Did you (ipratropium) may be contraindicated or by contact with personal items (hats, know that the following three important in a patient with a peanut allergy? hair brushes, combs, or bedding). cognitive road skills are typically NOT Product information for Atrovent Children need to be reminded not to acquired until between nine and 11 years (ipratropium) Inhalation Aerosol states share these items. Head lice crawl. They of age? that it is contraindicated in patients do not jump or fly. How do I check? Use 1. Deciding on and using a safe crossing with hypersensitivity to soya lecithin good lighting and a fine toothed comb; route. or related products, such as soybean nits (eggs) are attached to the hair close 2. Realistically assessing a vehicle’s and peanut. Soya lecithin acts as a to the scalp; be sure to check near the speed. suspending agent and is added to the bottom of the neck and behind the ears; 3. Judging safe gaps in traffic. inhalation aerosol preparations of this unlike dandruff, they cannot be easily Children who have not yet reached this drug. Nurses should assess patients for flicked off. Keep yourself informed of age should be supervised by an older soy lecithin and peanut allergy prior to the best practices and recommended child or adult when walking or biking to administration. treatments. For more information, school. check out the Canadian Pediatric Society Roxanne Rodgers Harding, RN, CON(C) website: www.cps.ca. Jenesta Holloway, RN, BN, MHSM Patient Care Coordinator Dr. H. Bliss Murphy Cancer Centre Sandra Carpenter, BN, RN, CCHN(C) Regional Health Promotion Consultant Eastern Health Cancer Care Program Parent & Child Health Coordinator Central Health Central Health, Lewisporte Do you have a Clinical Corner Tip? Editor’s Note: Clinical Corner is designed for registered nurses to share information that they have Share your learnings! Contact Siobhainn Lewis at found in their experience to be practical, safe, and effective. ARNNL requires that the information provided reflects good nursing judgement. We do not confirm the validity of the submitter’s tip in the [email protected] to submit your tip, or for more information. literature. ARNNL does not endorse any products identified in the submissions to this column. 20
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Get an online quote at www.melochemonnex.com/arnnl or call 1-866-269-1371 Monday to Friday, 8.30 a.m. to 8.30 p.m. Saturday, 9.30 a.m. to 4.30 p.m.
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The TD Insurance Meloche Monnex home and auto insurance program is underwritten by SECURITY NATIONAL INSURANCE COMPANY. The program is distributed by Meloche Monnex Insurance and Financial Services Inc. in Quebec and by Meloche Monnex Financial Services Inc. in the rest of Canada. Due to provincial legislation, our auto insurance program is not offered in British Columbia, Manitoba or Saskatchewan. *No purchase required. Contest organized jointly with Primmum Insurance Company and open to members, employees and other eligible persons belonging to employer, professional and alumni groups which have an agreement with and are entitled to group rates from the organizers. Contest ends on January 31, 2013. 1 prize to be won. The winner may choose the prize between a Lexus RX 450h with all basic standard features including freight and pre-delivery inspection for a total value of $60,000 or $60,000 in Canadian funds. The winner will be responsible to pay for the sale taxes applicable to the vehicle. Skill-testing question required. Odds of winning depend on number of entries received. Complete contest rules available at www.melochemonnex.com/contest. ®/ The TD logo and other trade-marks are the property of The Toronto-Dominion Bank or a wholly-owned subsidiary, in Canada and/or other countries.
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13_MM8791-12_MMI.EN•arnnl (7.5x10).indd 1 12-02-08 11:53 AM
Projet : Annonce MMI 2012 Province : Newfoundland & Labrador Épreuve # : 1 Client : Meloche Monnex Publication : Access Date de tombée : 10/02/2012 Format : 7.5x10 No de dossier : 13_MM8791-12_MMI.EN•arnnl (7.5x10) Couleur : N&B Graphiste : Yannick Decosse
Hamelin Martineau • 505, boul. de Maisonneuve O. Bureau 300 • Montréal (Québec) H3A 3C2 • T : 514 842 4416 F : 514 844 9343 ATTENTION : Merci de vérifier attentivement cette épreuve afin d’éviter toute erreur. Facilitating Learning That Promotes Collaboration And Maximizes Productivity WORKSHOPS COMING TO NEWFOUNDLAND & LABRADOR
EMOTIONAL INTELLIGENCE - Value in the Workplace ASSERTIVE COMMUNICATION St. John’s: October 19, 2012 and June 14, 2013 St. John’s: April 12, 2013 LEADERSHIP & MANAGEMENT - The Essential Foundations MANAGING PERSONALITIES - Myers Briggs for Leaders St. John’s: November 15, 2012 and June 6, 2013 St. John’s: May 7, 2013 CONFLICT RESOLUTION SKILLS FOUNDATIONS FOR OUTSTANDING St. John’s: November 30, 2012 WORKPLACE PERFORMANCE MEDIATION - An Informal Process for Conflict Resolution St. John’s: May 8, 2013 St. John’s: December 13-14, 2012 DEALING WITH DIFFICULT PEOPLE St. John’s: March 8, 2013 Corner Brook: March 15, 2013 COACHING STRATEGIES FOR LEADERS - Conflict, Performance, Change St. John’s: March 22, 2013
TO REGISTER OR FOR MORE INFORMATION: www.achievecentre.com 204.452.0180 [email protected]
2012-2013 workshops coming to Newfoundland and Labrador
DE-ESCALATING POTENTIALLY VIOLENT SITUATIONS™ Helping Communities and Organizations St. John’s: November 6, 2012 and April 19, 2013 with Issues of Crisis and Trauma Corner Brook: November 9, 2012 CRISIS RESPONSE PLANNING St. John’s: November 14, 2012
TRAUMA - Strategies for Resolving the Impact of Post Traumatic Stress St. John’s: December 5-6, 2012
UNDERSTANDING MENTAL ILLNESS St. John’s: March 19, 2013
COUNSELLING SKILLS - An Introduction and Overview St. John’s: March 20-22, 2013
ANXIETY - Practical Intervention Strategies TO REGISTER OR FOR St. John’s: May 14, 2013 MORE INFORMATION: DEPRESSION - Practical Intervention Strategies St. John’s: May 15 2013
www.ctrinstitute.com CRITICAL INCIDENT GROUP DEBRIEFING 204.452.9199 St. John’s: June 5, 2013 [email protected] www.ctrinstitute.com
22
ACCESS Vol. xxxiii No. 3 september 2012 BN (Collaborative) Program May 2012 Graduates
Welcome to the nursing profession!
Abbott, Miranda Musgrave Harbour Gebert, Mandy Hamburg, Germany Parrott, Colette St. John’s Alexander, Leanne Stephenville Crossing Genge, Santana Anchor Point Parsons, Elizabeth Gambo Alexander, Sheena St. John’s George, Jana Torbay Parsons, Julia Portugal Cove-St. Philip’s Allen, Jessica Corner Brook Gifford, Rochelle Coley’s Point Parsons, Megan Conception Bay South Anstey, Reegan Twillingate Gilbert, Tasha Hopeall Parsons, Patricia Bay Roberts Antle, Melissa Mount Pearl Goobie, Ashley St. John’s Parsons, Ryan New-Wes-Valley Arns, Amanda Paradise Gosse, Jessica Torbay Parsons, Stephen Channel-Port aux Basques Avery, Haley Halifax, NS Granter, Nicole Pool’s Island Patey, Ryan St. Lunaire Avery, Stephanie Hickman’s Harbour Greene, Natalie Tilting Paul, Michelle Gambo Ball, Bethany Deer Lake Greenham, Pamela Carmanville Payne, Candice Benoit’s Cove Barnable, Brittany Ferryland Griffin, Amanda Kippens Peach, Samantha Grand Bank Bartlett, Catherine Trinity, Trinity Bay Griffin, Darryl Dunville Pearce, Michelle Catalina Batten, Melissa Conception Bay South Griffiths, Vanessa Fox Harbour Peckford, Nicole Corner Brook Benoit, Heather Bell Island Guy, Samantha Musgrave Harbour Peckford, Robin Point of Bay Beresford, Nicole St. John’s Hann, Kayla Wesleyville Peddle, Jessica Mount Pearl Bishop, Jessica Upper Island Cove Harty, Christopher Duntara Perrier, Kayla Millertown Bixby, Tammy Deep Bay, Fogo Island Hatendi, Natasha Burgeo Perry, Ashley Laurenceton Blake, Krista Happy Valley-Goose Bay Hillier, Joanne St. Anthony Perry, Victoria Marystown Blake, Natalie Straitsview Hinks, Michael Corner Brook Phinney, Brooke Quispamsis, NB Blake, Nicole Happy Valley-Goose Bay Hounsell, Danica Marystown Piercey, Jill McCallum Blanchard, Robin Irishtown Howell, April Shearstown Pike, Jenelle Carbonear Bullen, Jennifer Lourdes Hughes, Andrea Happy Valley-Goose Bay Pittman Duah, Wendy St. John’s Bullis, Lindsey St. John’s Hull, Ashley Little Bay Islands Pittman, Jaclyn Dunville Bungay-Smith, Janine Clarenville Humby, Paula Paradise Pittman, Katie Jackson’s Arm Bursey, Sarah Deer Lake Hunter, Dana London, ON Power, Sherri Corner Brook Burt, Catherine Northern Arm Hussey, Meagan Pasadena Ralph, Diane Conception Bay South Burt, Matthew St. John’s Janes, Amanda St. John’s Regular, Kathi-Lee Baie Verte Burton, Matthew Springdale Janes, Kristen Lewisporte Regular, Renee Hampden Butt, Teri-Lynn Portugal Cove-St. Philip’s Johnson, Lori Catalina Reid, Jessica St. Stephen, NB Button, Jenissa Wareham Joseph, Shauna Stephenville Rickert, Jessica Conception Bay South Byrne, Ashlin Ferndale Kane, Aisha Corner Brook Roberts, Laura Corner Brook Caines, Chelsea Bartlett’s Harbour Kean, Stacey St. Anthony Roberts, Megan Lewisporte Callahan, Debra Corner Brook Kearsey, Melissa St. John’s Sajonas, Jennifer St. John’s Campbell, Natania Cook’s Harbour Keating, Shealie Mount Arlington Heights Sheppard, Christina Fogo Island Careen, Kayla Mount Pearl Keefe, Ashley Black Tickle Sheppard, Leigh-Ann Conception Bay South Chafe, Courtney Goulds Keeping, Jessica Laurenceton Simms, Sarah St. Patrick’s Clarke, Brittany North River Kehoe, Mitchell Lower Island Cove Skiffington, Melissa Upper Amherst Cove Cochrane, Loralie Placentia Kelly, Charlene Gambo Skinner, Chrissy Pasadena Colbert, Laura St. John’s Kelly, Erin Pouch Cove Slade, Sarah Salmon Cove Colbourne, Gina Carbonear Kenway, Jessica Winterland Small, Stefanie Baie Verte Coles, Shandie Savage Cove Kenway, Morgan Mount Pearl Sparkes, Lacey Rocky Harbour Collins, Richard Placentia King, Nicole Grand Falls-Windsor Spurrell, Kelly Mount Pearl Connors, Kristy Conception Harbour King, Rebekah Grand Falls-Windsor Spurrell, Shelley Grand Falls-Windsor Cooze, Chelsea Newtown Lambert, Jessica Harbour Breton Stack, Shauna Outer Cove Corbett, Lisa Marie Brent’s Cove Langdon, Brittany Grand Bank Steeves, Jana Riverview, NB Cormier, Tiffany Codroy Valley Langdon, Jessica Grand Bank Strange, Melanie St. John’s Crotty, Danielle Conception Bay South Lannon, Robyn Paradise Strickland, Kelly Mount Pearl Crummey, Robyn Carbonear LaValle, Kristen Stephenville Strickland, Sarah Paradise Cumben, Courtney Grand Bank LeDrew, Jessica Lewisporte Strong, Courtney Clarenville Dawe, Bethany Conception Bay South Legge, Jessica Deer Lake Strowbridge, Jessica Channel-Port aux Basques Dawe, Daisy Upper Island Cove Letemplier, Diana Joe Batt’s Arm Stuckey, Amanda Pike’s Arm Dawe, Heidi Stephenville Loveless, Julia Seal Cove Sturge, Sarah Mount Pearl Dawe, Michael St. John’s Macfadden, Jenine St. Bride’s Sullivan, Stephanie Paradise Decker, Megan Pasadena Major, Mila Reidville Thompson, Keshia Bishop’s Falls DeGruchy, Samantha Hillview Marchant, Danielle Berwick, NS Toulouse, Stephanie Goulds Devereaux, Sarah Port aux Basques Marshall, Evannah St. John’s Trimm, Gina Grand Bank Devine, Christina Halifax, NS Martin, Paula Winterton Trimm, Traci Forteau Duffney, Kerriann Benoit’s Cove McCarthy, Sarah Goose Bay Tucker, Amy St. John’s Dwyer, Jonathan Norris Arm McDonald, Kathryn Outer Cove Walsh, Eniko St. Lawrence Earle, Anna St. John’s McLevey, Teresa St. John’s Warren, Jennifer Mount Pearl Eveleigh-George, Victoria Badger Mooney, Eta St. Mary’s Weir, Philip Mount Pearl Fagner, Megan Paradise Murphy, Shannon Conception Bay South White, Allison Lewisporte Fancey, Jenelle S. Bishop’s Falls Musseau, Nicole St. John’s White, Brittany Torbay Farewell, Jillian Jean de Baie Nichols, Jerrica Deer Lake Wight, Erin Conception Bay South Fewer, Vanessa Happy Valley-Goose Bay Norman, Monica St. John’s Williams, Jennifer Grand Falls-Windsor Fitzpatrick, Erin Marystown O’Leary, Leanne Broad Cove Williams-Gibbons, Courtney Forrester’s Point Foley, Kimberly St. John’s Oake, Amanda Corner Brook Wrice, Robyn St. John’s Fowler, Sarah St. John’s Oates, Tracey Fermeuse Wright, Andrea Mount Pearl Gaslard, Cecilia Port au Choix Oliver, Danielle Gull Island Young, Kyrene Stephenville Osmond, Samantha Gambo
23 ARNNL’s Registration Renewal 2013-14 is going PAPERLESS!
WHAT’s new: get started: • 100% online renewal • Ensure your email address is on file with • Improved employer payroll deduction process ARNNL – contact ARNNL to register your • No paper license/membership cards email address and retrieve your password! • Edit your contact information online • Chat online in real-time with ARNNL staff during business hours
Look inside on page 6 for details!