Official Newsletter of New Hampshire Nurses Association Quarterly publication direct mailed to approximately 21,000 Registered Nurses, LPNs, and LNAs in New Hampshire.
www.NHNurses.org
March 2019 | Vol. 43 No. 2
Please be sure to notify us with address changes/corrections. We have a very large list NHNA Elections to keep updated. If the nurse listed no longer lives at this address–please notify us to discontinue delivery. Thank You! The Annual New Hampshire Nurses Association Election Board Member at Large was conducted by electronic ballot on October 17, Carmen Petrin, MS, FPC-BC 2018. Election results were announced at the Annual Petrin has been an active Please call (603) 225-3783 or email Meeting on November, 2018. The following nurses board member with NHNA to [email protected] with have volunteered to support the mission of the New for many years, serving two Nursing News in the subject line. Hampshire Nurses Association on the Board of Directors terms as a Director at Large; and Commissions. and as acting Secretary when that position was President Elect vacant. She has become Issue Highlights Janice Deziel, MSN, RN the Board resident expert Deziel has served in a on Bylaws and provides variety of Nursing Leadership invaluable contributions in Critical Issue: Nursing Assistants – roles for over 14 years and drafting Bylaws changes and Licensed or Certified...... 2 currently is the Executive working with the American Update: LPN Membership in NHNA...... 6 Director at Catholic Medical Nurses Associations (ANA) Legislative Update...... 7 Center. Throughout her Committee on Bylaws to ensure NHNA’s alignment with career, she has developed ANA Bylaws. Nurse Practioner in OZ...... 9-10 strong relationships, building 2018 NHNA Conference...... 14 skills across all professional Commission on Government Affairs (CGA). Caring for the Caregiver - Resource for Nurses . . . 18 spectrums. Her particular The CGA focuses on legislative and regulatory affairs strengths include high related to nursing practice and health care; it is emotional intelligence, strong NHNA’s most visible work group. The Commission on communication skills both Government Affairs added three high caliber nursing written and verbal, forward thinking, and a profound advocates to its team. belief in the power of nursing. Deziel will serve on the NHNA Board for four years, first as President Elect, Shauna D’Alleva, MSN, followed by two years as President and a final year as MBA, RN is the Nurse Immediate Past President. Manager of Medical Specialty Care at the Manchester VA Secretary Medical Center. D’Alleva Pamela Kallmerten, DNP, RN, CNL noted “as a Federal Elected to a second term as employee, I have a unique Secretary for the Board of perspective of how legislation Directors. Kallmerten has affects nursing practice. served diligently for the past As a Registered Nurse in a two years, and as a Clinical nursing leadership position, I Associate Professor of Nursing continue to work as needed at the University of New in the clinical arena, therefore Hampshire offers insightful maintaining an acute sense of how legislation affects perspectives to Board nursing practice at the bedside.” discussions. Kallmerten, in her intent to serve wrote, Christina Lopez, RN, is the Director of Nursing / “Nurses have a duty to serve Resident Care Director at Ledgewood Bay in Milford. “As our patients, their families, I have become a more ‘seasoned’ nurse over the years I our communities and our profession. My knowledge and have become a self-proclaimed advocate for my fellow experience as a nurse, nurse practitioner, nurse educator nurses. I have built relationships with state surveyors and SAVE THE DATE and nurse leader will enhance my contributions to become more involved in being part of the changing NHNA.” regulations that affect both my residents and staff,” Innovation and Quality Lopez stated in her intent to serve application. Improvement Conference May 2 Carla Smith, MSN, RN, NCSN, GCPH, is a member of the National Nurses Week nursing faculty at Saint May 6-May 12 Presort Standard Joseph’s School of US Postage Nursing in Nashua. Red Sox Appreciation Night PAID Smith has experience May 15 Permit #14 in nursing advocacy Princeton, MN having served as current resident or 55371 the Advocacy Second Annual Excellence in Chair for the New Nursing Awards Banquet Hampshire School May 23 Nurses Association. Smith wrote “I am very passionate about legislation for quality healthcare Spotlight on Nursing NHNA Election continued on page 5 June 13 Page 2 • New Hampshire Nursing News March, April, May 2019 Guidelines for Submissions to NH Nursing News
NH Nursing News (NHNN) is the official publication to [email protected] with NN New Hampshire of the NH Nurses’ Association (NHNA), published Submission in the subject line. quarterly – and available in PDF format at our website: NURSING NEWS www.nhnurses.org. Views expressed are solely Publication Selection and those of the guest authors or persons quoted and do Rights: not necessarily reflect NHNA views or those of the Articles will be selected for publisher, Arthur L. Davis Publishing Agency, Inc. publication based on the Vol. 43 No. 2 NHNA welcomes submission of nursing and health topic of interest, adherence Official publication of the New Hampshire Nurses’ related news items, original articles, research abstracts, to publication deadlines, Association (NHNA), a constituent member of the and other pertinent contributions. We encourage short quality of writing and peer American Nurses Association. Published quarterly summaries and brief abstracts as well as lengthier review. *When there is every December, March, June, and September. Library reports and original works. An “article for reprint” may space for one article and two subscription rate is $24. ISSN 0029-6538 be considered if accompanied by written permission of equal interest are under review, from the author or publisher. Authors do not need to be preference will be given to NHNA members. Editorial Offices NHNA members.* NHNA reserves the right to edit articles to meet style New Hampshire Nurses Association, 25 Hall St., Unit and space limitations. Publication and reprint rights 1E, Concord, NH 03301. Ph (877) 810-5972, E-mail Manuscript Format and Submission: are also reserved by NHNA. Feel free to call us any [email protected] Articles should be submitted as double spaced WORD additional questions at 877-810-5972. documents (.doc format vs. .docx, please) in 12 pt. font Editor: Susan Fetzer, RN, PhD without embedded photos. Photos should be attached Advertising: separately in JPG format and include captions. Product, program, promotional or service announcements are usually considered advertisements NHNA Staff Submissions should include the article’s title plus vs. news. To place an ad, contact: Arthur L. Davis Joan Widmer, Nurse Executive Director author’s name, credentials, organization / employer Publishing Agency, Inc. Email [email protected] or Paula MacKinnon RN, Executive Assistant/ represented, and contact information. Authors should call 800-626-4081. Ad sales fund publication and Communications Specialist state any potential conflict of interest and identify any mailing of NH Nursing News and are not paid to Beth Dow RN, Event Coordinator applicable commercial affiliation. Email as attachments NHNA. NURSING NEWS is indexed in the Cumulative Nursing Index to Nursing and Allied Health Literature (CINAHL) and International Nursing Index.
Critical Issue: Nursing Assistants – For advertising rates and information, please contact Arthur L. Davis Publishing Agency, Inc., Licensed or Certified? 517 Washington Street, PO Box 216, Cedar Falls, Iowa 50613, (800) 626-4081, [email protected]. In the fall of 2018, the New Hampshire Nurses to conduct a survey of LNAs regarding this question. NHNA and the Arthur L. Davis Publishing Agency, Association (NHNA) was invited to attend a meeting Between November 29, 2018 and December 9, Inc. reserve the right to reject any advertisement. of key stakeholders to learn about proposed legislation 2018, NHNA emailed a survey link to 4,259 LNAs. Responsibility for errors in advertising is limited to to remove the licensure requirement for nursing The survey link provided a brief overview of the corrections in the next issue or refund of price of assistants in New Hampshire. Nursing assistants were current licensure process and the proposed legislative advertisement. certified prior to 2001, with licensure by the Board of change. The survey asked if the respondent was in Nursing required for the past 18 years. Responding support of this change, opposed to this change or to concerns regarding nursing workforce shortages had no opinion on this change. It also provided the Acceptance of advertising does not imply raised by constituents and working in concert with respondents with a 50 character free-text response endorsement or approval by the New Hampshire the New Hampshire Board of Nursing, Senator Jay box to elaborate on their opinion. Nurses Association of products advertised, the Kahn (D-Keene) and Chair of the Senate Education advertisers, or the claims made. Rejection of an and Workforce Development Committee, drafted Over the next two weeks, NHNA advertisement does not imply a product offered for legislation to remove the licensing requirement for received 228 responses (5.4%). The advertising is without merit, or that the manufacturer nursing assistants and revert back to certification. majority of respondents (57.5%) lacks integrity, or that this association disapproves Senator Kahn called a meeting of stakeholders, opposed this proposed change, of the product or its use. NHNA and the Arthur L. including representatives for the New Hampshire 21.5% supported the change Davis Publishing Agency, Inc. shall not be held liable Hospital Association, the New Hampshire Health and 21.1% expressed no opinion for any consequences resulting from purchase or use Care Association, the New Hampshire Home Care on the proposed change. What was of an advertiser’s product. Articles appearing in this Association, the New Hampshire Department of most enlightening, however, were publication express the opinions of the authors; they Health & Human Services, the Board of Nursing and the comments submitted by the do not necessarily reflect views of the staff, board, NHNA. respondents. The overwhelming or membership of NHNA or those of the national or theme for the comments submitted local associations. The goal of this legislation was to accelerate the was the perceived loss of process for credentialing nursing assistants in the state professionalism the proposed change thereby helping to fill the many open positions for generated. The theme was not only nursing assistants. The proposed legislation kept the prevalent among the opposed respondents, but was existing educational requirements of 40 hours didactic also apparent among the respondents that supported VISION STATEMENT learning and 60 hours of clinical learning. In addition, the change and/or had no opinion on the change. the certification exam would remain the same and the • “We deserve to stand with our heads held high… Empower New Hampshire nurses as leaders in post certification continuing education requirements we are proud to be LNAs.” advancing the profession of nursing and the health of of 24 hours every two years. The primary change • “It [licensed nursing assistant] is a more respectful New Hampshire. would be removing the second criminal background title and a deserved title.” check performed at the time of licensure with the • “Being licensed added a measure of dignity to the required $47.00 fee and eliminate the licensing fee of job.” $35.00 for the first two years, and the $25.00 annual • “Please don’t back pedal to a certification.” MISSION STATEMENT renewal fee. On February 6, 2019, Senator Kahn introduced NHNA, as a constituent member of the American Nurses During the meeting, stakeholders asked many Senate Bill 273 before a public hearing held by the Association, exists to promote the practice, development questions regarding how the proposed change Senate Committee on Executive Departments & and well being of NH nurses through education, would impact nursing assistant scope of practice, Administration (ED&A). Both he and Board of Nursing empowerment and healthcare advocacy. oversight, and the disciplinary process, and many Executive Director Denise Nies spoke to the benefits Adopted 10-20-2010. other questions. The Board of Nursing indicated that of this proposed legislation in streamlining the entry they would continue to provide oversight for nursing process into the profession for nursing assistants, assistants, provide guidance on scope of practice, the reduced costs to becoming a nursing assistant handle the disciplinary process, and manage the and the hope this would help alleviate some of unintended consequences if the bill was passed as National Biannual Nursing Assistant Registry. The the current workforce shortages. A representative introduced. Most expressed the preference that this bill Board of Nursing also reported that New Hampshire is of the Monadnock Heath Care Workforce Group be amended to a study committee; preferably one that one of only six states that currently requires licensure testified in support of this bill, stating it was needed would include LNA’s in the discussion process, would of nursing assistants; the remaining 44 rely on the to alleviate the acute workforce shortages they examine potential unintended consequences of the bill, national standard for certification. were experiencing in the western part of the state. and would attempt to address these issues in the final Other key stakeholders (New Hampshire Hospital legislation. During the course of this meeting, however, it Association, New Hampshire Home Care Association, became apparent that no one had examined what Dartmouth-Hitchcock, New Hampshire Health Care Ed Note: On March 6, the Senate Executive New Hampshire Licensed Nursing Assistants (LNA) Association, and NHNA) also testified at this public Departments & Administration Committee passed an thought about this proposed change. NHNA thought hearing; most stating concern that LNA’s did not amendment to SB 273, creating a study committee. it was important to hear from the LNAs and decided support this change and that there could be adverse March, April, May 2019 New Hampshire Nursing News • Page 3 PRESIDENT’S MESSAGE
14,000 reasons to celebrate! of the population of registered nurses in NH belong to the Membership Business Meeting. The NHNA Board of That’s the number of registered only nursing organization that represents the interests of all Directors wants the members to consider some important nurses in New Hampshire. nurse. As the largest group of health care professionals in changes to the By Laws that include electronic voting and Each year I look forward to the county and likely the state, and rated with the highest allowing LPN’s to join a NHNA as part of a three-year ANA’s announcement for honesty and ethical standards, what do we want to impact pilot program. We invite volunteers to join a task force their clever key message for with this leverage? That is a challenging question. dedicated to developing a plan for convening membership National Nurses Week coming to encourage dialog and discussion on these topics. If these May 6-12, 2019. This year the With so many areas for nurses to focus on and get involved topics are important to you, please join the task force. The tag line is ‘4 million reasons in from climate change and environmental issues, to NHNA board members hope and intend for your voice to celebrate’, the number of bullying and incivility among nurses, the nursing shortage to be represented by the strategic plan of NHNA and registered nurses across the and the countless specialty areas of nursing, there are in the way we implement that plan through our events nation. Imagine the positive many opportunities to pick your passion. Add to that the and advocacy work. If it isn’t, then we want to hear and impact of so many educated global, national, regional and local boards, commissions, learn from you. There is a saying, “diversity is our greatest Carlene Ferrier health professionals on the committees and ways to serve, and it is no wonder we strength.” And by the way, thank you for being nurse and well-being of this country. ANA extrapolates on the sheer have such a small membership. Although we add about have a great Nurses’ Week! numbers: “In fact, about one in every 100 Americans 30 new members per month, we also lose nearly that is a registered nurse.” In New Hampshire one out of many each month, making gains over time ever so slight. Carlene every 95 residents are nurses. As of January 2019, NHNA Even more challenging than membership is trying to attract membership is at 1,212 nurses. That is, approximately 8% enough attendees to constitute a quorum at the Annual
FROM THE ED’S DESK
The New Hampshire Fostering Nurse Innovation: NHNA has teamed as our Event Coordinator. Beth is a certified infusion Nurses Association’s with Saint Anselm College to host the Innovation nurse with IV Solutions and Primary HealthCare at (NHNA) mission is to and Quality Improvement Conference on Home. Her position with NHNA is part-time and provide professional May 2, 2019. Bonnie Clipper, American Nurses she comes to NHNA with considerable experience development, foster Association’s Director of Innovation and Nursing in planning social as well as nurse education events, nurse innovation and to Practice is scheduled as the keynote speaker. Other as the past Program Director for the New England promote health advocacy. speakers include Kate Collopy, Director of Nursing Chapter of the Infusion Nurses Society. Beth wrote In November 2018, for Education, Research & Innovation at Wentworth- in her application letter, “Organizing and producing the first time since I Douglass Hospital and Fiona Wilson, from UNH exciting and educational nursing events is a passion joined the organization, Center for Social Innovation & Enterprise. A call of mine and the potential to expand to areas outside NHNA hosted a day- for abstracts was issued in January and we plan to of infusion is very intriguing.” NHNA is pleased to long nursing conference. have the authors of four or five of these abstracts have Beth as part of the team and we hope you will present their quality improvement projects at this welcome her to the organization. 120 nurses attended the Joan Widmer day-long event, which event. A special thanks goes to our planning team: featured speakers on innovation, work-life balance, Kelly Grady (Wentworth-Douglass Hospital), Pam Beth is busy planning a series of micro-events for advocacy, evidence-based practice, leadership and DiNapoli (CMC and UNH) and Amy Guthrie (St. nurses to gather, network and just have a fun night resilience (see related article in this issue). Anselm College). out. We will start in the Manchester area and then expand across the state. These events will be for In January 2019, NHNA hosted the annual Fostering Nurse Recognition: Consider joining both members and non-members. Keep an eye Legislative Town Hall Forum (see related article NHNA at the Second Annual Excellence in Nursing on the Upcoming Events section of the NHNA in this issue). The members of the Commission Awards banquet. This event, sponsored by New website for an event in your area. We hope you on Government Affairs presented nine bills with Hampshire Magazine, is scheduled for May 23, will consider joining one of these fun events…we potential impact on nurses, nursing practice 2019 at the Radisson Hotel in Manchester. This year might even slip in a small amount of educational and health care. Eight different locations around over 140 nominations were submitted for nurses content and award a contact hour for your time. the state hosted the Webinar on a large screen in 13 award categories. A team of 41 nurses, most Stay tuned… for nurses of all practice areas to gather and members of the Excellence in Nursing Task Force, participate. Student nurses also participated from reviewed and scored these nominations, with Joan their colleges. As it was a very snowy night, many each nomination being reviewed by three nurses also participated from the comfort of their own using a specialty specific rubric developed by the home. Be sure to check out the 2019 Legislative Excellence in Nursing Task Force. More information Activity page on the NHNA website for information about the event and a link to the registration regarding the bills presented. site can be found on the NHNA website, under Upcoming Events. Help us celebrate the winners of NHNA will continue to work toward meeting its the 2019 Excellent in Nursing Awards! mission throughout the year with many different offerings. Get out your calendar and start thinking More Fun Events to Come! With the growth ahead to the events that you would like to attend. in the number of annual events, as well as the There truly is something here for everyone! membership growth, the Board of Directors decided it was time to grow our operations team as well. For Student Nurses: The Graduating Student We are thrilled to announce the hire of Elizabeth Conference & Career Fair, scheduled for March (Beth) Dow, MSN, RN, CRNI, IGCN, WCC, VA-BC, 29, 2019 at Manchester Community College, is an annual event where NHNA invites graduating 100 Saint Anselm Drive student nurses to attend a day-long program Manchester, NH 03102 providing information to help with the transition from student to nursing practice. NHNA wishes (603) 641-7086 to thank Manchester Community College, and www.anselm.edu/cne Charlene Wolfe-Stepro, Nursing Department Chair, Maplewood Nursing Home in beautiful Westmoreland, NH is for their support of this important event. currently hiring for LPNs and RNs on our 3-11 and 11-7 shifts. We have full time and per diem positions available as Promoting Camaraderie: NHNA has also reserved well as weekend Baylor. Committed to Promoting Excellence in the Practice of Nursing a block of tickets for Red Sox Nurses Night on May Maplewood offers a competitive wage as well as a generous 15, 2019 in the left field grandstand #29. Last year, benefit package including Medical/Dental insurance, Vacation, New Hampshire VA nurse, Jeffrey Ballard, threw out Holiday & Sick time, NH Retirement, Short Term Disability the first pitch; maybe this year a New Hampshire and tuition reimbursement. Online programs now available. nurse will be selected again to throw out the first pitch or the sing the national anthem. Ticket sales Let us show you what working in a close on March 31st, so get your ticket soon to join family environment means. us for this fun night out. Go Sox!!! Give us a call at 399-7317 or e-mail [email protected] Page 4 • New Hampshire Nursing News March, April, May 2019 EVIDENCE BASED PRACTICE Effectiveness of Motivational Interviewing for Smoking Cessation in Unmotivated Patients Compared to Other Nursing Interventions
Michael L. Newell SN A study of this type of interaction is important to nursing (MI), health education (HE), and brief advice (BA) in a because nurses must educate patients on how to lower 2:2:1 ratio. The results, since there was missing data, used Smoking is a risk factor for a multitude of illnesses their modifiable risk factors for diseases and disorders two methods to account for this data: worst case scenario and diseases, including cancers, type 2 diabetes which includes encouraging people who smoke to quit (WCS), the data was evaluated with the missing data as mellitus, rheumatoid arthritis, respiratory diseases, and smoking. An examination of randomized clinical trials of participants who did not make quit attempts, or maximum cardiovascular diseases. In the United States, smoking is motivational interviewing in comparison with other types likelihood (ML) which evaluated the data as missing the leading cause of preventable deaths, and quitting can of smoking cessation interventions that nurses utilize was at random. The results found that at the three month lengthen one’s life by years (CDC, 2018). However, in conducted to answer the PICO question “Is motivational assessment of abstinence, MI and HE had a greater percent the United States alone, there are over 37.8 million adults interviewing more effective for smoking cessation chance of abstinence than BA, with a WCS of 5% and 8% over the age of 18 who smoke, according to the Centers in unmotivated patients compared to other nursing versus 0% with a p<0.05. By the six month assessment, HE for Disease Control and Prevention (CDC) study in 2016. interventions?” had a greater percent chance of abstinence than BA with a Although this number is down from the 20.9% in 2005, it WCS of 15% versus 4% with a p=0.016 and MI WCS 15% is still 15.5% of the population (CDC, 2018). Along with the To locate clinical trials, CINAHL and PubMed were versus 6% with a p=0.037 (Catley et al., 2015). Strengths health risks of smoking, smoking has nicotine which is an searched using key words including “motivational of this study were that both the HE and BA interventions addictive substance that leads to the increased difficulty interviewing,” “smoking cessation,” “brief intervention,” were scripted, and all the MI interviews were done by to quit. Nicotine works by releasing neurotransmitters, “health education,” and “not ready.” Limits used were all three counselors which eliminated the difference of primarily dopamine, into the brain which stimulate the English and United States. Inclusion criteria were clinical interviewers since these were not scripted. Additionally, reward centers of the brain (Dani, Jenson, Broussard, & trials that compared motivational interviewing to brief this study used the same amount of time and “intensity” De Biasi, 2011). To enact change, one must be motivated intervention, health education, or both with patients who for HE and MI to eliminate these biases between these two to do so. This is especially necessary when quitting an were smokers and were unmotivated or not ready to types of interventions. This study also used biochemical addiction. However, there are “motivational conflicts,” quit. Studies that were excluded were ones that included verification of saliva cotinine at both the three- and six- which can be divided into the stages of precontemplation, other substance use addictions such as alcohol since month assessments to have numerical confirmation contemplation, preparation, action, and maintenance. the question was focused on smoking, studies that used of abstinence. Cotinine testing is used for biochemical Despite the addictiveness of nicotine, for some people, participants who were planning on quitting since the verification because it is both found in tobacco and is one there is a difficulty of motivation to quit (U.S. Department question focused on patients who were not ready to quit, of the nicotine metabolites. Some limitations included, a of Health and Human Services, 2012). and studies that included pharmacological interventions predominant population of lower-SES African Americans as this question focused on nursing interventions. At the represented, likely differences in quality and intensity Motivational interviewing (MI) is seen as a style of end, there were three clinical trials that fit these criteria and for both HE and MI then regular practice, and this study interacting with clients, as opposed to a technique, and limitations. had some missing data with 94.1% completing the three has been most specifically used for patients who have month assessment and 89.4% completing the six month an ambivalence to substance use cessation. This method Critical Appraisal of the Evidence assessment. uses five principles to encourage a change in behavior. In a randomized clinical trial done during 2010-2011, These principles are, “express empathy through reflective Catley et al., (2015) recruited 255 smokers who smoked In a randomized controlled trial done by Davis et al., listening, develop discrepancy between clients' goals or at least one cigarette per day by using advertisements (2011), 230 people who smoked at least a pack a day and values and their current behavior, avoid argument and placed in a Midwestern city. They used participants reported pre-contemplative to contemplative for current direct confrontation, adjust to client resistance rather who reported a low desire to quit by indicating that they quit plans were recruited through advertisements from a than opposing it directly, and support self-efficacy and were a six or lower on a “How motivated are you to quit community. Participants were randomly assigned to either optimism” (U.S. Department of Health and Human smoking?” scale with zero being not at all motivated to 10 brief motivational interviewing or prescriptive counseling. Services, 2012, p. 41). The goal is to assist the client to as extremely motivated. The participants were randomly The results of this study found that there was no statistically discover their own motivation to make a positive change. assigned to one of three groups: motivational interviewing significant outcome measure for either group with p>0.05 in all outcome measures, intention to quit or reduce, verbal report to quit or reduce, or biologically verified quit or reduction (using urine cotinine levels). Strengths of this study were that both interventions were done for the same length of time, 15-minutes or otherwise “designed to simulate the real pressures faced by health care professionals” (Davis et al., 2011). Additionally, this study included three methods of data collection, 13 indicators of intentions to quit, verbal self-reporting, and biochemical verification, which all assessed reductions as well as quits. Limitations were that the analysis could include only 218 participants, not 100% of participants were available for the one month (71%) or six month (56%) assessments, and they assumed them all to have “not to have changed.”
In a randomized controlled trial done by Klemperer et al., (2016) 560 participants were recruited between 2013-2014 using the Nielsen panel, a national panel in which people can participate in surveys and receive redeemable points. The study compared the interventions of telephone brief motivational, reduction, and usual care in smokers over the age of 18 who smoked at least 10 cigarettes a day. It was concluded that there was no significant difference between all three interventions in making a quit attempt (QA) that lasted at least 24 hours. The strengths of this study were that it was a national study, that both the brief motivational and reduction interventions had a specific time frame, there were parameters or topics to discuss, and each consisted of three phone calls in which most participants partook in all of them (Klemperer et al., 2016). One limitation of this study was that while it was conducted over the phone, participants were recruited using email which limited the participants. There was also missing data of 31% for the follow up survey of QA in the first six months, and 37% of abstinence in the first six months, and 51% of the participants did not answer the 12-month follow up survey. While a sensitivity analysis was conducted to establish the significance of the missing March, April, May 2019 New Hampshire Nursing News • Page 5 data, the fact that there was in one case over half missing Recommendations interviewing is not more effective for smoking cessation data, it should be recognized. Additionally, there was no In 1991 Miller and Rollnick published the book in unmotivated patients compared to other nursing biochemical verification of quit attempts or abstinence. Motivational Interviewing: Preparing People to Change interventions, more research must be done to determine Addictive Behavior. Since then motivational interviewing which interventions are the most effective and for which Evidence Synthesis became seen as the “gold standard” (HealthSciences populations. After reviewing the methods and results of three Institute, 2018) to assist addicted ambivalent patients randomized controlled trials on the effectiveness of through the core belief that it “activates the capability References motivational interviewing compared to other nursing for beneficial change that everyone possesses” (U.S. Catley, D., Goggin, K., Jo Harris, K., Richter, K. P., Williams, interventions, there is no significant evidence that Department of Health and Human Services, 2012, p. K., Patten, C., & Resnicow, K. (2016). A Randomized Trial motivational interviewing is better than health education, 39). Yet, the appraised articles have not found significant of Motivational Interviewing: Cessation Induction Among brief advice, prescriptive counseling, reduction, and usual evidence that motivational interviewing increases quit Smokers With Low Desire to Quit. A Randomized Trial of Motivational Interviewing: Cessation Induction Among care interventions in leading to more quit attempts with attempts compared to other nursing interventions. Smokers With Low Desire to Quit, 50(5), 573-583. doi:https:// smokers who are not ready to quit. In the first study Catley doi.org/10.1016/j.amepre.2015.10.013 et al., (2015), found that health education by the six-month However, while the studies did not find that motivational Centers for Disease Control and Prevention. (2017, May 15). follow-up had a statistically significant greater percent interviewing increased quit attempts for smokers who Health Effects of Cigarette Smoking. Retrieved from https:// chance of abstinence than motivational interviewing. were not ready to quit, the studies did uncover some www.cdc.gov/tobacco/data_statistics/fact_sheets/health_ The second and third studies found that there was no other reasons why motivational interviewing may be effects/effects_cig_smoking/index.htm statistically significant outcome for any of the comparison an important intervention. The randomized controlled Centers for Disease Control and Prevention. (2018, September groups including motivational interviewing (Davis et al., trial done by Davis et al., (2011) found a trend in missing 24). Current Cigarette Smoking Among Adults in the United 2011; Klemperer et al., 2016). data, that people who were given prescriptive counseling States. Retrieved from https://www.cdc.gov/tobacco/data_ were less likely to participate in the follow-up which statistics/fact_sheets/adult_data/cig_smoking/index.htm The major strengths between all three studies was that may indicate that motivational interviewing could retain Dani, J. A., Jenson, D., Broussard, J. I., & Biasi, M. D. (2011, April 20). Neurophysiology of Nicotine Addiction. Retrieved from when they compared motivational interviewing to other patient relationships with healthcare providers, leading to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312002/ nursing interventions, they used comparable session opportunities for future interventions. Catley et al., (2015) Davis, M. F., Shapiro, D., Windsor, R., Whalen, P., Rhode, R., lengths to eliminate the often overlooked variables of concluded that even though motivational interviewing did Miller, H. S., & Sechrest, L. (2011). Motivational interviewing motivational interviewing including either more sessions, not result in more smoking cessation in their trial it may versus prescriptive advice for smokers who are not ready longer sessions, or both, than comparison interventions. be because the method of motivational interviewing done to quit. Patient Education and Counseling, 83(1), 129-133. Additionally, each of these studies included a follow- during the trial was different than that during education. doi:https://doi.org/10.1016/j.amepre.2015.10.013 up at six-months. The limitations that all three of the HealthSciences Institute. (2017, January 02). Developing A studies encountered were that there was missing data, Nurses are expected to provide patient education which Motivational Interviewing (MI) and collectively there were slight variations in what includes education on reducing risk factors for diseases Trainer In Your Organization. Retrieved from https:// each study considered to be a quit attempt; Catley et al., and illnesses. Since smoking is a risk factor for a multitude healthsciences.org/Case-Study-Developing-A-Motivational- Interviewing-Trainer-Organization (2015) considered an abstinence to be a measured saliva of illnesses and diseases, nurses are expected to utilize Klemperer, E. M., Hughes, J. R., Solomon, L. J., Callas, P. W., cotinine of 15ng/mL or less, Davis et al., (2011) considered interventions that will encourage patients to quit smoking. & Fingar, J. R. (2017). Motivational, reduction and usual an abstinence to be urine cotinine of 100mm or less, Before initiating smoking cessation interventions, nurses care interventions for smokers who are not ready to quit: and Klemperer et al., (2016) did not biochemically verify should be aware that the background of the patient has A randomized controlled trial. Society for the Study of abstinence as this study was done online and over the the potential to affect the type of intervention that will be Addiction: Addiction, 112(1), 146-155. doi:https://doi. phone. effective. Motivational interviewing may have less of an org /10.1111/add.13594 effect on lower-SES status African Americans than health U.S. Department of Health and Human Services, Substance Despite the limitations, the appraisal of all three studies education (Catley et al., 2015). Nurses must also be aware Abuse and Mental Health Services Administration. (2012). it is concluded that motivational interviewing does not that the type and quality of the chosen intervention has the Enhancing Motivation for Change in Substance Abuse Treatment significantly increase quit attempts when used with potential to strengthen or limit nurse-patient relationships, (Treatment Improvement Protocol No.35). Retrieved from https://www.ncbi.nlm.nih.gov/books/ smokers who were not ready to quit. Additional research pushing patients away or opening more opportunities for NBK64967/pdf/Bookshelf_NBK64967.pdf must be done to find the most effective intervention for further interventions (Davis et al., 2011). Finally, though the smoking cessation in unmotivated patients. short answer to the PICO question is “no,” motivational Michael Newell is a junior undergraduate nursing student at the University of New Hampshire.
NHNA Election continued from page 1 Cuchetti sees her role on the CNP as a way to serve her her the opportunity to work with “practicing RNs fellow nursing colleagues and future nurses. across the state from all backgrounds and age groups as services and support for the nursing profession. they achieve their educational goals for both BSN and I actively advocated with the New Hampshire Joan Loftus, DNP, RN, is MSN degrees,” providing her with insights relative to School Nurses Association… and prepared and Dean of the School of Nursing their needs and goals. submitted comprehensive research findings to the NH and Health Professions, at Commissioner of Education substantiating the need to Colby-Sawyer College. Loftus Commission on Continuing Education (CNE) maintain a position for a School Nurse Consultant within noted in her intent to serve, The CNE commission participates in the Northeast the NH Department of Education.” “I am certainly invested in Multistate Division (NEMSD) Education Unit. The nursing practice as it relates American Nurses Credentialing Center’s Commission Commission on Nursing Practice (CNP) to nursing students, their on Accreditation accredits the NEMSD Education Unit The CNP is responsible for advancing the profession education, their clinical as an Approver and Provider of continuing nursing of nursing through activities that identify and evaluate experience, and certainly education. trends, developments and issues that impact on nursing. practicing nurses. I would The CNP does this work by developing programs of like to be more involved in Tasha Humphreys, MS, FNP- activity for education and delivery of nursing practice, program development for BC, is a Nurse Practitioner at as well as, drafting position and policy papers. The our NH nurses that can augment their current or past the Health Resource Center commission looks forward to working with four newly education which in the end improves the quality of care in the area of addiction elected members. we give to our patients.” medicine. Humphreys will participate with a group Samantha Bernstein, BSN, Teresa Knight, MSN, of nurse peer reviewers RN, IBCLC, is a nurse on the MEd, RN, is the Director to evaluate and approve obstetrics unit at Monadnock of Nursing Programs for continuing education Community Hospital. She Granite State College. Knight programs across the five recently served on NHNA’s wrote, “I am interested in states served by the NEMSD. Excellence in Nursing Task serving on this commission Humphreys noted in her Force, Maternal-Child Care as I genuinely believe that intent to serve application, “I team. Bernstein noted, “I nursing and nurses must want to give back to my community and state because would like to serve because have a strong voice in health I have been blessed with support from so many…I am issues around nursing practice care within the State of NH.” a lifelong learner who strives to exemplify the range are of interest to me, such as Knight notes that her work at of personal, academic, professional and financial what level of education nurses Granite State College affords possibilities available to adults who persevere and should have, mandatory overtime, and staffing levels.” overcome adversity.” Catherine Cuchetti, MSN, RN, CNE, is a clinical nurse in the Cardiovascular Surgical 2019 NHNA Board of Directors Unit at Catholic Medical Center and PhD student at President ...... Carlene Ferrier RN, MPH Boston College. She has also President-Elect...... Janice Deziel, MSN, RN been a nursing educator for Secretary...... Pamela Kallmerten DNP, RN, CNL 10 years. Cuchetti states, “I Treasurer...... Barbarajo (BJ) Bockenhauer, MSN, APRN, PMHCNS-BC believe that my experiences Director at Large...... Carmen Petrin, MS, APRN and interest in workforce Director at Large...... Catherine McNamara, BSN, MM, RN development and practice Director at Large Recent Graduate...... Samantha Warren, RN issues make me sensitive to and appreciative of the needs of practicing nurses.” Page 6 • New Hampshire Nursing News March, April, May 2019 Update: LPN Membership in NHNA
The New Hampshire Nurses Association (NHNA) proceeding with such a significant change based on decided to defer a decision on any bylaws change until a conducted a survey of New Hampshire Licensed the decision with such low voter turnout. After future meeting could be called with the requisite quorum Practical Nurses (LPN) in July, 2018, seeking to discussion, however, the Board decided to and time for discussion. determine if they had an interest in joining NHNA. As proceed, announcing the LPN three previously reported, 80% of the respondents indicated year membership pilot program at NHNA bylaws, however, do not permit changes to the that they would consider joining NHNA. In November, the Annual Meeting & Conference, bylaws outside of the Annual Business Meeting, which 2018, an informal, electronic, non-binding survey was concluding that since this is limited to the fall of each year. Consequently, bylaws conducted of NHNA members to see if they would was only a pilot program, changes and the decision to implement a LPN three year support offering membership to LPNs. Here again, a it could be re-evaluated membership pilot program will be deferred until NHNA’s majority of the respondents, 73%, indicated support for after a one or two 2019 Annual Business Meeting in the fall. offering membership to LPNs. years, prior to any permanent change in In anticipation of its fall Annual Business Meeting Based on the results of these surveys, the Board of the membership structure. and the corresponding discussion of bylaw revisions, Directors of NHNA sought the guidance and advice of NHNA is convening a Bylaws Task Force to discuss the the American Nurses Association’s (ANA) Committee The announcement of this program, however, was changes proposed in 2018, along with other concerns. on Bylaws for drafting changes to the NHNA bylaws forestalled. A long-term and valued NHNA member For example, ANA is currently considering moving to to allow for LPN membership. The result of this approached President Carlene Ferrier and expressed electronic voting for bylaws changes, rather than at the collaborative effort was the decision to propose a three- concern about proceeding with the announcement of Membership Assembly, and perhaps NHNA should year membership pilot program offering membership to this three year membership pilot program based on the consider a similar move. The Bylaws Task Force will LPNs. The proposed bylaw changes to permit a three results of electronic voting. She felt that a membership convene between March and June of 2019 and much of year membership pilot program were incorporated in the discussion was critical in any change in the bylaws, the work will be virtual, via email and conference call. NHNA fall election ballot, sent electronically, via email, especially in membership status, a discussion that was The ideal applicant will have prior experience serving to the NHNA membership. not available during the electronic vote. In addition, on the NHNA Board of Directors or experience working the number of members in attendance at the Annual with bylaws in this or similar organization. If you are Despite several email reminders and social media Meeting & Nursing Conference indicated that a quorum interested in serving on this Task Force please submit posts, less than 10% of NHNA current members voted. was not present, nor was there adequate time available an Intent-to-Serve form found on the NHNA website on Prior to the November 14, 2018 Annual Meeting, the in the day’s program to allow for a robust discussion of the NHNA & You page. This opportunity is available to NHNA Board of Directors expressed concern about the proposed changes. Therefore, the Board of Directors NHNA members only. Please enter Bylaws Task Force in the first box on the form.
By the Numbers Legislative Advocacy Council Uses American Association of Nurse Practitioners Grassroots Expertise (AANP) announced the new national nurse practitioner (NP) count as well as findings from its 2018 National Nurse Practitioner Sample Survey. In the fall of 2018 the Commission on Government Currently 19 nurses are members across each of the As of January, a record number of more than Affairs (CGA) discussed ways to potentiate their New four teams and responsible for reviewing proposed 270,000 NPs are licensed to practice in the U.S., Hampshire legislative advocacy, a key strategic goal of legislation. The LAC suggests which bills the CGA should which represents an 8.9% increase from March the 2017-2020 NHNA Strategic Plan. The Legislative present at the Legislative Town Hall Forum or follow 2018. Findings from the AANP survey indicate Advocacy Council (LAC) was devised to “Create through the legislative session. Each team prepared the that, on average, clinically practicing NPs are 49 opportunities for nurses to actively engage in legislative summaries presented at the Legislative Town Hall Forum years of age, female, and practice in non-urban advocacy.” held on January 29, 2019. Team members provide areas. Most have graduate degrees (95.2%) with oral and written testimony at public hearings on the 17.8% indicating a doctoral degree as their highest The LAC is comprised of four teams of nurse advocates bills of interest. The members of these teams spend level of education. AACN has reported that more with each team headed by an active participant as a time speaking with legislators or writing editorials to than 26,000 new NPs completed their academic member of the CGA or a representative of one of the support or oppose legislation of interest, and engage in programs in 2017, a significant jump from the participating specialty organizations. Each team focuses other advocacy efforts relative to the bills the CGA is 23,698 graduates in 2016. on a particular legislative area: following. The CGA has developed an Advocacy Tool Kit • Nursing Practice & Licensure Issues, Linda Compton to be a resource to the team members, which is posted RN, Team Leader on the New Hampshire Nurses Association’s website. • Material & Child Health Issues, Sara Kellogg Meade The teams work closely with the members of the CGA. RN, Team Leader NHNA members interested in a Legislative Advocacy • Public Health Issues, Carla Smith RN, Team Leader Team should contact Pam Dinapoli, Chair CGA at the • Behavior & Mental Health Issues, Cynthia Cohen NHNA website. RN, Team Leader 35 Tilton Road • Tilton, NH 03276 Mark Mallahan www.belknapsubaru.com General Sales Manager [email protected] (603) 729-1300 (800) 358-4029 Fax (603) 729-1301
State of New Hampshire Job Posting Department of Health and Human Services Concord, NH Public Health Nurse Coordinator #30546 Salary Range: $46,761.00-$55,555.50 USD SCOPE OF WORK: Provides care coordination, case management and healthy homes services for lead poisoned children and adults. Responsible for technical assistance to the public, professional and contracted communities to prevent childhood lead poisoning and LN S! other environmental, health issues for the Healthy Homes and Environment Section. G A’s W IFT MINIMUM QUALIFICATIONS: EN ANT LL SH D! u Bachelor's degree in nursing or an allied health field ERO ED A FERE US SIGN VES OF from an accredited college or university. -ON BONUS INCENTI u Four years' of experience as a RN in a community health agency. u License/Certification: Current license as an RN by the New Hampshire Full & part-time positions available. Great starting Board of Nursing Education and Nurse Registration. u Certification as a Healthy Homes Specialist is recommended. pay with raise in 90 days! Excellent benefit package u Training in communication, conflict management, work-life balance, for those who qualify including health, dental, life, time management and Lean is preferred. For further information please contact: Beverly Drouin, Administrator II, 401k with employer match, disability, prepaid legal, [email protected], 603-271-8128 shift differentials, generous PTO plan and more! The State of New Hampshire provides comprehensive benefits as part of a total Must have valid NH LNA license. compensation package. visit: http://das.nh.gov/hr/documents/BenefitBrochure.pdf Apply electronically through: http://das.nh.gov/jobsearch/employment.aspx Send application to: New Hampshire Dept. of Health and Human Services, 129 Pleasant Street, Please apply online at Concord, NH 03301. Please reference the position number #30546 Public Health Nurse Coordinator. In order to receive credit for postsecondary education, a copy of official transcripts with a seal and/or www.websteratrye.com signature MUST be included with the application. Forward to the Human Resources Office with the recruiting agency. Position will remain open until a qualified candidate is found. EOE. March, April, May 2019 New Hampshire Nursing News • Page 7 LEGISLATIVE UPDATE Legislative Town Hall Forum
Despite the snow fall, the New Hampshire Nurses Nine 2019 Legislative Bills Requiring Nursing Advocacy of licensed in their title as a loss of professionalism. Association’s (NHNA) annual Legislative Town Hall NHNA opposes the current language of this bill, but Forum was held on January 29, 2019. Over 320 nurses CACR1: Relating to the Alcohol Fund, was presented will support if amended to reflect the formation of a and nursing students from around the state registered for by Cynthia Cohen RN. This constitutional amendment study committee. this event hosted by the Commission on Government concurrent resolution provides that a portion (5%) of the Affairs (CGA). The event was held via teleconference Liquor Commission Revenue shall be used for alcohol SB 308: An act relative to the health care workforce and to nurses and nursing students gathered at eight and drug abuse prevention, treatment and recovery making an appropriation therefor, was presented by Pam locations, including Dartmouth-Hitchcock in Lebanon, services. Historically, the legislature has failed to allocate DiNapoli RN. To best tackle the health care workforce LRGHealthcare in Laconia, Granite State College in the full 5%; this constitutional amendment will ensure challenges in 2019, this legislative package that Concord, Catholic Medical Center in Manchester, the full 5% is funded. NHNA supports CACR1. combines key policy and budget topics in a single bill Portsmouth Regional Hospital in Portsmouth, Cheshire to be considered as one proposal. There are eight major Medical Center in Keene, Exeter Hospital in Exeter and HB 237: An act establishing the New Hampshire rare provisions to this bill which touch on health care pipeline Rivier University in Nashua. Participants also tuned in disease advisory council, was presented by Kimberly investments, advanced training programs, investment from home via a teleconference platform. Pang RN. This bill will improve state policy for the in the state loan repayment program, investment rare disorders community by giving patients and in Medicaid providers, administrative relief, spend other members of this community a stronger voice down provisions, background checks and telehealth. in government. The Rare Diseases Advisory Council The NHNA joins New Futures and other health care will coordinate with other state rare diseases advisory associations in support of this bill. bodies, review any data on rare diseases in the state and raise public awareness regarding rare diseases in New Hampshire. NHNA supports HB 237. New Hampshire Nurses Association extends an HB 275: An act relative to school nurse certification, appreciation for the Legislative Town Hall Forum was presented by Nancy Wells RN. HB 275 seeks our host site coordinators. to remove the N.H. Department of Education certification requirements for school nurses. Currently • Dartmouth-Hitchcock, Lebanon – Cheryl RSA 200:29 requires a school nurse to be certified by Abbott the Department of Education. A similar measure was • LRGHealthcare, Laconia – Kaitlyn Liset defeated in 2018. NHNA opposes HB 275. • Catholic Medical Center, Manchester – Karen Perry SB 137: An act relative to the certification of school • Cheshire Medical Center, Keene – Paula Robert Dunn, Esquire, of Devine, Millimet, and NHNA’s nurses, presented by Nancy Wells RN. SB 137 seeks Hudon & Gail Laraba lobbyist, presented the State of State. Pam DiNapoli, to clarify RSA 200:29 requiring a school nurse to hold • Exeter Hospital, Exeter – Liz McFadden Chair of the CGA, provided introductory remarks about certification as a school nurse by the Department of • Portsmouth Reg. Hospital, Portsmouth – how and why nurses need to become involved in the Education. SB 137 includes a “grandfather” clause Joanne Shomphe & Julie Giltson advocacy process. She also discussed the legislative omitted in the final legislation passed in 2016 and further • Rivier University, Nashua – Judi O’Hara process and demonstrated some of the tools on the clarifies the timeline and pathways for a school nurse • Nashua Community College – Carole Boutin NHNA website designed to aid nurse advocates (found to meet the requirements for Department of Education under the Advocacy tab on the NHNA website, www. certification. NHNA supports SB 137. A special thank you to the IT Sponsor, Granite nhnurses.nursingnetwork.com). State College and Edward Connor, for providing HB 511: An act relative to vaping, was presented the technology need to host this event. To help members of the CGA and the Legislative by Carla Smith RN. This bill aims to add new Advocacy Council address any potential questions language to Chapter 126K Youth Access to and from the audience, a panel of legislative experts was Use of Tobacco Products to include “E-liquid” and also on hand. In addition to Robert Dunn and Pam “Tetrahydrocannabinol or THC vaporizer" in addition DiNapoli, this panel also include Representative Polly to cigarettes, tobacco products, E-cigarettes, and liquid Campion (Grafton, D12), Kitty Kidder, Vice Chair of nicotine. The bill expands current law preventing the New Hampshire Board of Nursing, and Carlene children under the age of 18 from purchasing or Ferrier, NHNA President. Rep. Campion, as Vice Chair possessing E-Liquids or THC vaporizers in addition to of the House Health, Human Services and Elder Affairs cigarettes, tobacco products, E-cigarettes, and liquid Committee, provided the audience with keen insights nicotine. NHNA supports HB 511. on many of the bills presented. Kidder provided the audience with insights relative to the role of the NH HB 555: An act relative to shaken baby syndrome, was Board of Nursing and the legislative process. presented by Sara Kellogg Meade RN. This bill requires hospitals to provide new parents with information on Nine bills culled from the legislative docket by members shaken baby syndrome. The bill also requires day care of CGA and the newly created Legislative Advocacy providers to participate in training for Shaken Baby councils, thought to have the most significant impact Syndrome as part of licensure process. Some of the on nurses, nursing practice and health care were then language and provisions of HB 555 need clarification. presented for discussion. It was noted that CGA and NHNA supports the intent of HB 555, but notes certain Legislative Advisory Council positions were guided by problems with the bill’s introductory language. the strategic intentions of NHNA. We consider opposing viewpoints and encourage members to advocate for and HB 719: An act establishing the position of school Pam DiNapoli, Program Moderator speaking against positions adopted by the CGA. nurse coordinator in the department of education and to audience gathered at Granite State College, making an appropriation therefor, was presented by Concord, and via teleconference. Seated in After the nine key bills were reviewed Pam DiNapoli Nancy Wells RN. SB 719 seeks to establish the position front of her are members of the Legislative presented a list of bills on the Commissions’ radar; bills of School Nurse Coordinator in the N.H. Department Panel: Rep Polly Campion, Robert Dunn, Kitty not formally presented at the Legislative Town Hall of Education and appropriate funding for such. School Kidder and Carlene Ferrier (left to right). Forum but which the CGA would continue to follow and nurses throughout the state relied on the expertise of the report on throughout the legislative session. An open Department of Education’s School Nurse Coordinator call for any legislation of interest to the membership but until 2010 when funding was withdrawn. NHNA not presented at the forum was made. One member supports HB 719. requested advocacy relative HB 621 (An act establishing a commission on aging) and the bill was added to the SB 273: An act relative to the regulation of nursing Robert Dunn Esq, CGA list. assistants by the board of nursing, was presented by NHNA’s lobbyist for Joan Widmer RN. This bill proposes changing nursing over 15 years will Each bill and bills on the CGA radar has been posted to assistants to being certified, no longer licensed. The be busy at the state the NHNA website, located under the 2019 Legislative goal of this legislation is to expedite the transition to house keeping CGA Activity tab. Information on these bills is updated weekly practice for nursing assistants after the certification exam members informed throughout the legislative session. A list of upcoming is passed and reduce the cost associated with licensure. of bill changes and hearings on bills of interest provide date, time and A survey of nursing assistants conducted by NHNA, hearings. location. CGA meets at the NHNA office on the fourth however, indicated that licensed nursing assistants did Tuesday of the month. Members are encouraged to not support this legislation (60% opposed, 20% support, submit agenda items relative to legislative advocacy 20% had no opinion). Survey respondents saw the loss through the Contact Us option on the NHNA website. Page 8 • New Hampshire Nursing News March, April, May 2019 2018 NHNA Awards
The recipients of New Hampshire Nurses Association’s Annual Nursing Awards were design and development of standardized protocols, development of pre and post- announced at the Annual Meeting and Nursing Conference held on November 14, operative management plans, and she has also helped develop the Xiaflex program 2018 at the Dion Center on the Rivier University campus. Lyndsay Goss, Vice Chair for the management of Dupuytren’s contractures. Jennifer is also the lead preceptor of the Commission on Nursing Practice presented two awards for new nursing and clinical support staff which includes Athletic Trainers and the Rising Star and the Champion of Nursing Award. With Medical Assistants. Although not a job requirement, she volunteered to serve on the at advent of the Excellence in Nursing Awards, NHNA Ambulatory Onboarding Task Force, which has significantly improved the overall reconfigured the awards program and create the Rising functioning of the unit. Star Award to recognize a nurse who has been in the field less than five (5) years and has contributed to the The Division Director of her unit, Lance G. Warhold, MD, sums up Jennifer’s profession and demonstrated significant potential as a contributions: “Jenn demonstrates professionalism on a daily leader and nursing advocate – a rising star in the field. basis in her interactions with peers, physician providers, secretarial staff, and our patients. She is commonly in Fourteen promising nurses were nominated for the Rising Star Award. Each member phone contact with my patients to answer questions, of the Commission on Nursing Practice (CNP) uses a rubric to evaluate each nominee. to do follow-ups and address problems that my pre- Then the team comes together to review the final compiled results and select the top op and post-op patients may have while providing candidate. The quality of the nominees was considerable among those nominated them with the sense of comfort, caring and security making selection difficult. Two recipients garnered the 2018 Rising Star Award. Jennifer which helps them know that they are receiving the Gilmore and Jenifer Alden. best possible care. She is also the face of my practice in many ways as my patients know her by name and Jennifer Gilmore RN graduated with a BSN in nursing from Endicott College in May commonly reach out to her when needed.” Jennifer was nominated for of 2017, and is currently enrolled in the Masters’ Degree in Nursing Education at this award by Connie McCoy. Endicott. In her first year of nursing on the Hematology, Oncology and Bone Marrow Transplant unit at Dartmouth-Hitchcock, she has already earned her chemotherapy The Champion of Nursing Award honors an employer, institution or individual who and biotherapy certifications well ahead of the unit guidelines. Jennifer’s motivation has had a positive impact on the profession of nursing by demonstrating characteristics and drive to develop her expertise and skills in her field has made her co-workers and or practices that support individual nurses or the nursing profession. The recipient of supervisors take notice. the 2018 Champion of Nursing Award, Dawn Gosselin, BSN, RN, CWS, was unable to attend this event. Joan Widmer, NHNA Nurse Executive Director, presented her with Julia Sweet, BSN, RN, OCN, Clinical Nurse Educator cites the fact that although the award on December 10, 2018 at Wentworth-Douglass Hospital. Jennifer has just finished the nurse residency program she is already serving as a preceptor. “Being a successful preceptor requires flexibility, communication, Gosselin practices at the Wound Healing & Hyperbaric Medicine Clinic at leadership and teamwork. This role is usually given to the most clinically competent Wentworth-Douglass Hospital. She was nominated by Heather Sevigny, FNP-C, who staff nurses who are dedicated to the team and excel in their specialty. From the first has first-hand knowledge of why Dawn deserves the Champion of Nursing Award. day we met her, Jenny caught our attention because of her knowledge, ambition and Sevigny noted “Her documentation is thorough and concise but not at the expense big picture thinking. She is well respected by every member of our team and shows of patient care. It is only after her patients are cared for will you find her sitting at the potential to be a leader now and in the future,” remarked Sweet. computer frantically typing to capture the encounter. Dawn is an educator and leader amongst her peers. We often precept students in their last year of nursing school and Jennifer has participated for several years in the Prouty, a two-day athletic event new hires within our clinic and Dawn takes the lead to guide them in their endeavor.” that raises funds to benefit Dartmouth-Hitchcock Norris Cotton Cancer Center Sevigny continues “She spends the time necessary to not only explain the task, but (NCCC). She also participates at the Relay for Life at Endicott College, has worked to explain the purpose of what we do, and how to best explain the process to the as a substitute school nurse and volunteered at after school programs. Jennifer was patient. She educates new nurses to see the patient as a whole and to address their nominated for this award by Brendan Hickey. needs. In fact, we have offered positions to several of the nurses that Dawn mentored, as they demonstrate superior skills and abilities due to her tutelage.” Dawn Gosselin Jennifer Alden, RN was the second recipient of the 2018 Rising Star Award. Upon was described as taking pride in all aspects of her work and the willingness to do graduation in February of 2017, Jennifer joined the Ambulatory Orthopaedic whatever it takes to ensure patient needs are not just being met, “but are met at a Surgery and Sports Medicine Clinic at Dartmouth-Hitchcock. She works in the standard above all others.” fast paced Upper Extremity Subspecialty Unit. On her own time, she became certified in Anticoagulation Therapy Management. Her leadership has helped The New Hampshire Nursing News and all of New Hampshire’s nurses offers improve clinic efficiency and safety. She has taken the initiative to help with the congratulations to the recipients of the 2018 NHNA Nursing Awards!!
A GREENER New Hampshire Nursing News?
Every day the news abounds with stories about the problem of global warming. One of the topics proposed for discussion during the Policy Forum at the American Lyndsay Goss, Vice Chair Commission on Gilmore and Alden posing Nurses Association’s Membership Nursing Practice announcing the winners with DH Nursing Leaders Joni Assembly in 2018 was the health impacts of NHNA’s Rising Star Award Pictured Spring and Michelle Buck of global warming. Global warming has left to right (Goss, Joan Widmer, Jennifer Pictured left to right (Gilmore, become one of the key policy issues of the Gilmore and Jennifer Alden) Spring, Alden and Buck) 21st Century.
In seeking ways to ‘go green’ NHNA has discussed the paper distribution with the New Hampshire Nursing News publisher the Arthur L. Davis Company (ALD). One consideration is to transition to an electronic distribution of NHNN to non- members. Members would continue to receive mailed paper copies. Trees and the energy used to produce the paper on which NHNN is printed would be saved as well as gas used in the physical distribution of the paper. The NHNA Board of Directors agreed to test market this approach. Starting with the July 2019 issue, a sample of non-members from the NHNA distribution list will be sent an electronic version of the New Hampshire Nursing News instead of the paper version.
If you receive an electronic version of the July Issue of NHNN, please share your thoughts on this delivery method. Were you able to access the electronic version, did you have any difficulty with access? Did you like reading the issue in an electronic format? Send your feedback to [email protected] and put E-NHNN in the subject line. NHNA will also monitor email open and click through rates to see if this version of the journal is actively read by the electronic recipients. Joan Widmer (left) presenting Champion of Nursing Award to Dawn Gosselin (center) with her nominator, Heather Sevigny (right) March, April, May 2019 New Hampshire Nursing News • Page 9
Nurse Practitioner in OZ: The Struggle to Stay Patient-Focused within a Digital Storm
It’s 5 o’clock in New Hampshire. I look out my window I step into my office; Do you ever feel like me? Do you ever feel like at work and am not deterred despite the Nor’ Easter looming in the storm picks up. you are travelling down a yellow brick road being the sky like a midwestern tornado. Instinctively, I know The wind blows full shuffled along by little men and women wearing colorful the sun will never shine today. The swirling turbulence force into my face suits and marvel at the acrobatics these munchkins above tree line is exquisite and resembles somewhere when my nurse greets perform for you all day? For the record, I described over the rainbow in Kansas rather than my yard. I am me smiling and says, them this way only to play a part in my metaphor. Let’s quickly reminded of that Kansas farm girl and how “Your rooms are be honest; they are probably our most important co- excited she was to venture out that morning before racked up, your student workers and control our daily destiny. They embody the storm in the 1939 film, The Wizard of Oz. I may is in your office, and creativity as they maneuver us through the yellow brick be eager to get going to my office, but I can’t quite morning huddle is curves of the day. Along this arduous journey they say I’m thrilled about wrestling that computer at work in 10 minutes.“ It’s constantly guide and motivate us to continue skipping again, with all its angry red alerts in my face. Still, I am like being hit on the along as they pass us off to our patients. Our reminded of Dorothy’s determination as I put on a blue forehead by a loose patients then further inspire us to continue and white dress and with renewed optimism vow to board in the wind and by their intelligence, courage, and loyalty prevent the outside storm from seeping into my head so my head spins as I as they escort us through OZ and back early in the morning. quickly get caught up home each day. We could not in the tornado. Whoops, I meant Nor’ Easter. I instantly survive a minute without our trusty After a refreshing 12 hours at home, this is the day I am think of my dog back home, “Ollie, we’re not in Kansas companions! When did all this chaos going to attack and clear away those shiny little silicon anymore.” start anyway? It was not always this circuits! If I just stay ahead of the provider performance way at work. I’m even calling it work requirements, I can outmaneuver the computer storm My schedule is full by 10 o’clock but so far, I’m keeping now – never did that before. and prevent the metrics from leaking out into the nooks up with the electronic dots on my computer screen that and crannies of my daily schedule like glitter. Glitter is so signify completed triage calls, drug refills, staff messages, Since 2002 I have been using the hard to clean up after a spill. I love my practice and am order cosigns, and completed charts. I forgot to finish electronic medical record (EMR) truly looking forward to seeing three-year-old Jimmy’s those darn billing corrections and close the uncompleted in a very meaningful way to chubby face at 8:10, and Lucy’s pout as she spouts the charts from yesterday, but if I keep this pace I’ll be able improve my patient care. Yes numerous reasons I shouldn’t give her shots at 8:30. I to get them done by mid-day. A random thought pops – it’s a complicated component of especially can’t wait to see Owen because he still had in my head; “Oh no! Did I review all my labs from last modern care delivery but it lets me get accurate patient difficulty breathing when his mom called me at 2 AM night?” I find a computer nearby to check and quickly data quickly and guides me to higher levels of care by this morning. Yes. I am tired. Despite this fatigue I look relax. My educated guess was right. Sophie is on the completing tasks like a video game. At some point in the forward to seeing my patients, as well as the brewing correct antibiotic – whew! I send off a message to triage past five years, however, I lost control of the preferences sky outside while driving. It’s going to be an awesome to call and make sure she’s okay, refresh my screen, and goals in my computer game. Someone or something day! and clear out all the exclamation points near my 34 behind the curtain changed the program. Ah Ha! I know unopened messages and smirk. Despite the odds, I’m this sneaky wizard. This master game maker of Oz. His Instead of strapping Toto into a bike basket like Dorothy, winning. I’m taking the lead in the digital daily game I name is the Affordable Care Act of 2010(ACA) and the I scratch my dog Oliver goodbye and lug my briefcase call “Top Gun Provider Dashboard.” Today is going to be hot air balloon that brought him here was the HITECH into a SUV and cruise down Route 101 West through a good day. act of 2009! the storm. I momentarily daydream as I execute three deep breathing exercises guided by my smart watch, The calmness I felt only hours ago while driving The Health Information Technology for Economic and while listening to soft guitar music. They say this calms becomes a distant memory and by 11 o’clock, I Clinical Health (HITECH) Act of the American Recovery my amygdala, so I do it... a lot. While attempting a completely forget the tranquility from this morning and Reinvestment Act was intended to promote the calming posture my hazy memory of yesterday reminds before the storm. I think of somewhere over the rainbow use of the EMR to be used in a meaningful way. By me that when leaving last night, I forgot to close two and strongly believe, there’s no place like home. I using computers to support provider clinical decision patient charts, answer four billing corrections, and continue this mantra throughout the day – another tactic making and monitor uniform and individualized complete three pended triage calls. I made a mental they say calms my amygdala. Only two hours later, metric standards, it was believed that safety, quality note to do this before I see Jimmy. The fleeting thought however, my alter ego emerges, the Wicked Witch of and coordination of health care would improve. I do of Jimmy diverts my tactical planning. Although I lose the East! (Of course, I know it’s “West” but I live on the not believe anyone could have ever predicted that focus, it makes me feel a quick moment of real joy. He’s Seacoast – work with me here). I look at the computer organizations would create dashboards with user scores so stinkin’ cute. The Nor’ Easter lets up a little, today is and hear myself thinking through gritted teeth, “I’ll get and errors or that this would be only a click away to going to be a great day! you my pretty… and your little mouse too!” Page 10 • New Hampshire Nursing News March, April, May 2019 motivate professionals on to the next level. The hot air above in the mythical land of Oz. Although it feels real-it don't love are all those circuits, guidelines, and screens balloon got loose, and a millennial caught it. isn’t. Real is the patient in Room 8 who needs you and that need to be clicked away to get to our patients. the assistant who scrambles to get that nebulizer going Only when clicked away and cleared can we see that If you are like me, you probably flip flop between a before “he” stops breathing in Room 10. The recent beautiful face. AAAhhh, there you are! This is why we love and hate relationship with the EMR. The Affordable 2019 report by the Massachusetts Medical Society this travel to OZ each day! The rush from this reflection Care Act along with the Medicare Access and CHIP past January makes reference to provider burnout as the refreshes us but is transient and then is repeated over 25 Reauthorization Act of 2015 (MACRA) are all changing new crisis in health care suggesting that this problem is times before we get to travel home. Home. There’s no our compensation in healthcare from fee-for service to linked, in-part, to the “growth in poorly designed digital place like home. value-based reimbursement. Our value is measured by health records and quality metrics, “ that require more well documented provider performance metrics and time on computer tasks that “don’t directly benefit Reference: patient quality measures that we click into the data patients. Jha AK, Iliff AR, Chaoui AA, Defossez S, Bombaugh MC, stream. Many Affordable Care Organizations (ACO) Miller YA. (2019). A crisis in health care: a call to action even grade us on how well we perform these tasks by a Clearly the computer lets us do great things and on physician burnout Massachusetts Medical Society, provider dashboard! This screen vaguely resembles the allows us to help a larger volume of patients in more Massachusetts Health and Hospital Association, Harvard T.H. Chan School of Public Health, and Harvard Global lights and levers on a pinball machine. How incredible meaningful and accurate ways, but I agree with Health Institute. Waltham, MA. does this sound! Sounds great maybe for the future the growing number of experts that this informatic providers who were born with a clicker in their hand but perfectionism is a major player in the growing epidemic Christina Ferreri DNP APRN FNP is a nurse practitioner many of us have a slower learning curve; and right now of provider burnout. Despite being haggard at the end with a primary care pediatric practice at the Elliot we are doing both. We are still counting our widgets of each day in the storm though, I bet you are just like Pediatric Network in Manchester and is the adjunct with Revenue Value Units (RVU’s). Our productivity me and still start the day with energy and optimism. We pediatric faculty for the FNP Program at the University continues to be extremely important given we remain truly can’t wait to see that teenager in Room 8 at noon of New Hampshire. She is also the President of New predominantly reimbursed using the fee-for service who just started counseling and Zoloft and we just know Hampshire Nurse Practitioner Association. model. This double dipping creates the storm I described she’s going to smile during our visit this time! What we
New Hampshire Programs Offering post-BSN Graduate Education
Instate Progam Delivery Credits Program Focus Duration Cost per Accreditation Offered Method Required Credit
Colby Sawyer MSN CNL Hybrid 37 28 months 600.00 CCNE
Franklin Pierce MSN Education or Hybrid 36 na 400.00 ACEN Leadership Track
Granite State MSN Online/Hybrid 30 na 538.00 In process
Rivier MSN FNP 43 2 years 605.00/didactic CCNE Leadership Online/Hybrid 36 course Nursing Education Online 36 1,015.00/clinical Psych NP Online 43 course Health Online/Hybrid 36 Management Online Systems Post-MSN Variable Certificate FNP, Psych NP, Online Nursing Education
Southern New MSN CNL Online 39 na 627.0 0 CCNE Hampshire Nurse Educator Patient Safety and Quality
University of New MSN CNL Hybrid 34 2 years 770.00 CCNE Hampshire Evidenced Based 30 Nursing 45 FNP Post-MSN Certificate FNP Online Variable Psych NP
Notes: Information from Websites; Hybrid = online and campus course; CNL = Clinical Nurse Leader; CCNE = Commission on Collegiate Nursing Education; ACEN = Accreditation Commission for Education in Nursing
We are currently seeking FULL TIME PSYCHIATRIC NURSE PRACTITIONER If you like making a difference in your community and are passionate about working in a nonprofit WOUND TREATMENT ASSOCIATE LNAs & RNs organization Seacoast Mental Health Center is an excellent choice! A Nationally recognized wound care program offered by The mission of Seacoast Mental Health Center is to provide a broad, comprehensive array of high quality, effective and accessible mental health services to residents of the eastern half of Hanover Terrace Health & Rehabilitation Center is Rockingham County. the only free standing Skilled Nursing Facility in the Seacoast Mental Health Center is located in the beautiful Seacoast City of Portsmouth & Exeter, New Hampshire. The Center has been in existence since 1963 and is dedicated to providing evaluation and Upper Valley. treatment services to children, adolescents, adults and families that reside in our catchment area. Providing care for those in need with OVERVIEW Seacoast Mental Health Center, Inc. is seeking a Full Time Psychiatric Nurse Practitioner to evaluate, Respect, Dignity and Kindness prescribe, and follow outpatient clients in a collegial atmosphere. Experience and New Hampshire license Please call us to learn more at 603-643-2854 or required. Competitive salary and excellent benefits package. Application and overview from to apply email Patty Dyke, Human Resources To Apply please visit this link below: https:// recruit.hirebridge.com/v3/application/applink. Manager, [email protected] aspx?cid=7906&jid=441196 Drug free/EOE HEALEWOUNDCARE.COM March, April, May 2019 New Hampshire Nursing News • Page 11
98 St. Anselm sophomore nursing students received the traditional blessing of the hands on January 25, 2019. The class of 2021 gathered in the Abbey Master of Science in Nursing Church for the blessing before they began their first clinical placements. Kylie MacDonald, a senior Colby-Sawyer’s nursing student and president of the Student Nurses’ (MSN) program has been granted initial Association, addressed the student nurses. five year accreditation by the Commission on Collegiate Nursing Education (CCNE). CCNE ensures the quality and integrity of academic nursing programs through its robust accreditation process, serving the public interest by assessing and identifying programs that engage in effective educational practices.
Rivier University nursing and Public Health students, faculty, and staff, along with representatives from local civic and community leaders, participated in a Community Action Poverty Simulation aimed The New Hampshire Board of Nursing approved 153 at increasing awareness of poverty issues. applications for New Hampshire nursing faculty from The simulation helped students understand December 2017 to December 2018. the day-to-day complexities and frustrations of living in poverty. Participants in the three- hour exercise experienced a month in poverty by facing a variety of challenging, yet typical circumstances. Students assumed the roles of family members; different family groups On November 1, Keene State was notified its included grandparents raising grandchildren, nursing program has been fully accredited for the working parents, single parent households, next 10 years by the Commission on Collegiate elderly adults, and young adults caring for Nursing Education, the program remains on underage siblings. The activities were funded approved on probation by the Board of Nursing. by the Community Action Poverty Simulation (CAPS) is a component of the $2.04 million Nursing Education Grant awarded to Rivier University in 2018 by the Health Resources and Services Administration
ED Note: News from nursing schools, faculty, students or alumni are welcome. Please direct submissions to [email protected] with NHNN in the subject line. Page 12 • New Hampshire Nursing News March, April, May 2019 IN MY OPINION The Problem is the Problem Though living in different centuries management guru Background checks are required for nearly every profession that works with the public, Peter Drucker and physicist Albert Einstein had much in from school aides to pharmacy technicians and even massage therapists. How does common – their approach to problems. Druker knew that the Board of Nursing justify protecting the public on one hand and then advocating the up to 90% of the time, the frequent cause of failure was removal of background validation of these direct care providers on the other hand? Over that businesses were working to solve the wrong problem. 20 LNA’s came before the Board of Nursing in 2019 for licensure violations; the number In discussing the problem of atomic weapons in the 1940’s of individuals not able to be licensed because of a background check can’t even be Einstein remarked “We can’t solve problems using the estimated. Of interest though the Governor’s 2016 Commission report noted the delay same thinking we used when we created them.” in background checks due to state resources, there was no recommendation by the Commission to remove the requirement. Is eliminating background checks the solution to The problem of the shortage of nursing assistants in New the problem? Hampshire exemplifies trying to solve the wrong problem. The right question has not been asked. Yet, in SB 273, Health care employers are required or strongly recommended to verify a recent Senator Kahn (D-Keene) sponsored a bill this legislative background check on all employees. Removal of the background check for LNAs would session to change the title of licensed nursing assistant not likely spare them from the requirement. And, even worse, may make them reportable to certified nursing assistant. Such a change, and the Susan Fetzer to the Board of Nursing. Is this the solution to the problem? ramifications, reverses a decision made by the legislature in 2001; at that time the name was changed from certified to licensed. But the problem When giving a patient a new drug, we look for potential interactions; when creating a then was not the problem now, which brings up the issue – what problem does this solution it is important to identify any potential consequences. Board of Nursing Executive legislation attempt to solve? Director Nies noted in her letter to Licensed Nursing Assistants that there would be a savings of $62.00, yet the Board of Nursing would still maintain According to Senator Kahn there is a shortage of Licensed oversight of the registry. It is estimated that there would be a Nursing Assistants in New Hampshire to meet workforce net loss to Board of Nursing revenues of a quarter of a million needs. In the western part of the state, Kahn’s constituents The manager who comes dollars a year. The loss would be made up by increasing report a 45% vacancy rate. Nationwide the turnover of nursing up with the right solution to RN license fees as acknowledged in the bill. It amounts to assistants has been reported as 27.3% per year and growing. ‘robbing Peter to pay Paul.’ Increasing fees without increasing Governor Hassan’s Commission on the health care workforce the wrong problem is more services to RNs is nothing more than a tax on nurses. Nurses studied the problem and reported in December 2016 that dangerous that the manager in New Hampshire are already taxed for the investigation and there was a serious and growing problem in the supply of adjudication of compact nurses who are disciplined in New health care providers including registered nurses. While the who comes up with the Hampshire but pay no license fee to New Hampshire. Removing problem is clear, Kahn’s solution in SB 273 solves the wrong wrong solution to the right LNA fees will add another tax! Is this the solution to the problem. problem. – Peter Drucker. problem? According to the sponsors SB 273 removes the “barriers” to Senator Kahn notes that 44 “other states” do not license nursing becoming a nursing assistant. Those barriers were defined assistants but maintain their names on a registry. The Board of as money for licensing fees and money and time for a state Nursing in many “other states” are funded out of the general background check. But yet these barriers have never been established as the problem fund, not by nursing licenses. “Other states” also refer to LNAs as ‘unlicensed caregivers.’ causing the nursing assistant shortage. This solution solves the wrong problem! Even the The shame of this proposed solution was the lack of consideration for the voice of LNA’s Governor’s Commission did not find a financial barrier to wanna-be nursing assistants. themselves. The adjective “license” is perceived by most consumers and LNAs as holding a higher standard than the adjective “certified.” LNAs replying to the NHNA survey According to one source the validated their concern and discouragement regarding this perceived demotion. Will the average salary for a nursing devaluation of the title act to decrease the interest in this field? Is this the solution to the assistant is $15.56 per hour in problem? New Hampshire, which is 22% We can’t solve problems above the national average. Yet using the same thinking we The adage “You can’t solve the right problem until you are asking the right question” the salary in the Keene area applies to the disaster that will be created by SB 273. In my opinion the Board of Nursing, averages over $4.00 or 25% used when we created them. in supporting this legislation, lost sight of their mission to protect the public welfare. less an hour. Is there a local – Albert Einstein Fortunately, an amendment to add a study committee to study this ‘problem’ has been problem? The fees removed by accepted and a report due November, 2019. The current solution to the wrong problem SB 273 amount to four to five will be detrimental to all involved. What is right is not always popular, and what is popular hours of LNA employment, less is not always right. than the employment hours required by an RN to obtain licensure in New Hampshire. Is eliminating licensing fees the solution to the problem? Nurses Continue 17 Year Reign
Since 1976 the Gallup organization has surveyed a sample of random people in the US by phone and asked “please tell me how you would rate the honesty and ethical standards of people in these different fields.” Nurses have been included in the list since 1999 and have outpaced all others, with the exception of 2001. In 2001 nurses did not top the list – firefighters were included for the first and only time and scored the highest after the 9/11 terrorist attacks. The survey is conducted in November and results released in December, for an astounding 17th consecutive year nursing was at the top of the list, scored as ‘high’ or ‘very high’ by 84% of those phoned. The next most trusted groups after nurses were medical doctors, scoring 67%.
We want to know how you celebrated Nurses Week 2019! Did your employer have special activities? Did you exchange cards with your co-workers? Did you get taken out to dinner? Did you get thanked?
Please share your photos and stories with New Hampshire Nurses for our next issue – Celebrating all that is Nursing!
The deadline for the next issue of the New Hampshire Nursing News is June 1, 2019. Send your submissions to [email protected] with Nurses Week in the title. March, April, May 2019 New Hampshire Nursing News • Page 13 WELCOME NEW and RETURNING NHNA MEMBERS!
NHNA welcomes these new and returning members. Thank you!!! NHNA welcomes these new and returning members. Thank you!!! What do these 89 nurses and over 1,100 NHNA members know that you don’t? If you are not a member ask your neighbor on this list why they joined! Go to nhnurses.org where joining is easy and one of the best professional values for your money! We want to see your name here in the next issue of the NH Nursing NEWS!
Amherst Dover Lebanon New London Stratham Victoria Ann Baldasarre Rachel Sharon Eichenbaum Karen Clements Jillian Irene Paradis Megan Hall Ann Lak Deborah Fabry Sarah Wood Bedford Cherilynn Marshall Naomi Suellen Pratt Newmarket Stacy Lynn Jones Durham Pamela Jean Rice Laurie Murray Swanzey Eileen Keefe Anja Reed Lee Erin Cox Kerry Rosenthal Kristin March Newtown Bennington Barbara Ann Brotz Thorton Kelly Pelletier Enfield Manchester Adrienne Campbell Tristan Walsh Lynda Aramento Nottingham Walpole Cynthia Czarnecki Bow Raelene V. Shippee-Rice Catherine Taylor Ingram Tabitha Dowd Aimee Cancro Goffstown Michael David West Melanie Kapelson Stephanie Carlson Marnie Berdeen Warner Amy Leigh Labarre Kym Banh Allison Ohlman Palm Coast Hampton Bristol Kenneth Williams Suzette Manaker-Moody Teresa Broyer Melissa R Smith Caley Zajac Weare Nicole Mello Whitney Pambroke Ben Fernandes Samantha Ann Kazakis Brookline Meredith Diana Lynn Dion Hillsborough Jessica Fauteux Melissa Deleon Christy Ann Jensik Lisa Marie Shutt Sharon Gamache Jaculyn Kelly Winden Webster
Valerie Rude Katharine Lacourse Merrimack Chesterfield Joyce Anne Allen Peterborough Holderness Traci Fairbanks Donna Dailey Christine Aini Howe Windham Kelley Zogopoulos Karleny Foley Mary Heinzl Chichester Judith Landry Plainfield Jennifer Pedley Max Cowart Hooksett Melissa Underhill Kathleen Grennen Middleton Woodsville Annaka Kirsten Stables Concord Shirley Ann Mahoney Plaistow Dorothy Long Tonya Binder Jean Flora Hailson Hudson Kimberly Pang Milford Heather Grondin Bethany Cogley Rindge Natalie Lopez Derry Angela Gray Aletha Potter Mary Maureen Raposa Crystal Geoffroy Jillian Ostberg Nashua Kensington Colleen Mary Flaherty Rochester Valerie Greene Dorchester Nicole Gordon Jennifer Cormier Patricia Fanale Laconia Hannah Glover New Boston Sanborton Nancy Dirubbo Marissa Charest Kaela Hobby-Reichstein Jennifer Lynn Freo Alicia Schumacher
Easterseals NH Provides a lifespan of services to Board of Nursing Defense people with disabilities or special needs. PLEASE JOIN OUR TEAM! Complaints • Investigations • Hearings LNAs within Senior Services –Per diem or part-time Experienced Representation RN, LPN or Nurse Practitioner in Substance for RN, LPN, LNA, APRN Abuse Services – per diem part-time and full-time We offer a comprehensive benefits package and competitive pay Attorney Neil B. Nicholson For more information or to apply, please visit: Email: [email protected] eastersealsnh.org Phone: (603) 856-8441 Contact: Alyssa McMurchy, PHR, SHRM-CP Website: www.mcnich.com [email protected] Page 14 • New Hampshire Nursing News March, April, May 2019 2018 NHNA Conference: Inspiring and Worthwhile
“Very worthwhile.” “Great program and speakers,” the nurses present to innovate, to not “be afraid” to RN, Dean of Nursing at Rivier University; Mercedes “Very inspiring” were just a few of the comments take risks. Fleming, MSN, RN-BC, NE-BC, Manager of Nursing about the New Hampshire Nurses Association’s Systems & Support at Catholic Medical Center; (NHNA) Annual Meeting and Nursing Conference Evidence Based Practice: Donna Proulx, PhD(c), Natalie Gosselin, MS, RN, CPHQ, CSSGB, Director, held on November 14, 2018. 120 nurses from RN, CCRN-CSC, Director of Graduate Nursing Center for Quality & Safety at Southern New across the state gathered at the recently refurbished Education at Rivier University, spoke on the Hampshire Medical Center; Jennifer Thompson, MS. Dion Center at Rivier University in Nashua. Sister practical application of evidence-based practice. APRN, Executive Director of the New Hampshire Buley, President of Rivier University, was on hand She shared strategies on how direct care nurses Nurse Practitioner Association and Joni Spring, MS, early to welcome attendees. Conference organizer, can stay abreast of best practices in nursing care RN, CENP, DNP-C, Director of Outpatient Nursing Joan Widmer, Nurse Executive Director of NHNA, and shared information about available resources. & Clinic Operations at Dartmouth-Hitchcock. opened the day followed by presentations of nurse She described 13 evidence-based practice Carlene Ferrier, President of NHNA, asked the leaders practicing in the state of New Hampshire. competencies for practicing professional RNs such panelists about their path to their current leadership as “question clinical practices for the purpose of roles, the role of mentors in their careers, and the Innovations in Nursing: Wendy L. Wright, APRN, improving the quality of care” and “collect practice challenges they faced along the way. FAANP of Wright & Associates Family Healthcare data (individual patient data, QI data) systematically defined innovation and described the current as internal evidence for clinical decision making in Work – Life Balance: Sue Nordemo RN, CH, owner drivers for innovation in healthcare. She shared how the care of individuals, groups, or populations.” of Monarch Health Coaching, member of the nurses have been at the forefront of innovation in Nursing Leadership Panel: Six New Hampshire Holistic Nurses Association and Reiki Master, shared healthcare; seeking improved ways to care for their nurses shared their personal stories of growth ways to cope with the challenges life can throw patients. “Many of the women that work alongside within their leadership careers and included Martha your way and strategies to maintain the work-life me in the clinics innovate every single day…I bet Leighton, MS, RN and Chief Nursing Officer at balance. She encouraged the audience to participate you do as well,” remarked Wright. She encouraged Elliot Health Systems; Paula Williams, EdD. CAGS, in a 90-day challenge to not complain, not criticize and not condemn.
Wendy Wright speaking on Donna Proulx speaking on Nurses speaking with Sue Nordemo speaking on Innovation in Nursing Evidence-based Practice at exhibitors Work-Life Balance the Bedside
Carlene Ferrier asking questions of the Leadership Panel (seated L to R: Martha Leighton-Elliot Health Systems, Mercedes Fleming-CMC, Natalie Gosselin-SNHMC, Joni Spring-DHMC, Paula Williams-Rivier, and Jennifer Thompson-NHNPA)
Nurses networking lunch March, April, May 2019 New Hampshire Nursing News • Page 15
Advocacy: Carlene Ferrier, MPN, RN and and comedy), moving on to explore personal stress Representative Polly Campion (Grafton, 12), MS, reduction and resilience strategies: movement, RN, spoke on nursing advocacy. For the past 15 mental enema, music, relaxation techniques and Lyndsay Goss, MSN, RN, and Chair of the years, the Gallop poll has named nursing as the reframing thought. Commission on Nursing Practice presented the most trusted profession. With four million nurses 2018 NHNA Nursing Awards during the Annual in the United States, nursing has the opportunity to Nurses on Boards Initiative: Carol Long MS, RN, Meeting and Conference. be a significant voice to improve healthcare in this CENP, NEA-BC, CNML, the Director of In-Patient country. Ferrier spoke to the advocacy work being Care Services at Elliot Health Systems, spoke on the The Rising Star Award done by the American Nurses Association and work of the New Hampshire Action Coalition on the was presented to NHNA. Campion, an ad hoc member of NHNA’s Nurses on Boards initiative. The Nurses on Boards Jennifer Gilmore BSN, Commission on Government Affairs, spoke on the Coalition (NOBC) began in 2014 with the expressed RN and Jennifer Alden, work she does through her participation on the goal of getting 10,000 nurses placed on boards by RN, both of Dartmouth- House Health, Human Services and Elderly Affairs the year 2020. By the end of October 2018, the Hitchcock. Committee. NOBC reported 5,327 nurses reporting seats on boards, with 525 in the most recent 90-day period. The Champion of Resilience: Amy Guthrie, MSN, RN, Director of In July 2018, New Hampshire noted 17 nurses on Nursing Award was Continuing Nursing Education at Saint Anselm, boards, nine nurses serving and wanting to serve on presented to Dawn spoke on traits that all nurses need to be successful an additional board and 29 nurses looking to serve Gosselin, BSN, RN, in a high stress profession. She began by identifying on a board. The New Hampshire goal for 2020 is 48 CWS, of Wentworth- five stress hardy personality traits (control, nurses. Douglass Hospital. challenge, commitment, compartmentalization
Annual Meeting Annual Meeting GOLD SPONSORS SILVER SPONSORS Page 16 • New Hampshire Nursing News March, April, May 2019 NCLEX Reconsidered Focus on Hematology
Ed Note: Where it has been a year or years since you took the NCLEX (AKA Renee Plodzik, RN, MSN, nursing profession with excellence, caring, compassion, “Boards”), how well ARNP was recently selected human dignity, and patient advocacy,” says CMC VP would you do now? for the 2019 New Hampshire of Nursing and Chief Nursing Officer Jennifer Cassin, Union Leader’s annual 40 MS, RN, CNS, CENP. “I am in awe of the standards 1. A client with a new Under 40 awards. Since they strive for with each and every patient. It’s always a diagnosis of pernicious 2002 the awards have pleasure to hear from patients and their families about anemia asks the nurse, how honored more than 680 their experience on this unit.” he caught the disease. What is outstanding Granite Staters the nurse’s best response? making a difference in their communities and professions. a. Your stem cells were Plodzik is a primary care affected by a chemical nurse practitioner for Concord that you ate, drank or Hospital Internal Medicine in Concord, N.H., who has were exposed to founded multiple programs dedicated to helping cancer b. A diet low in iron can patients and survivors lead healthy lives. She graduated result in this diagnosis for from Saint Anselm with her bachelor’s in nursing and some individuals earned her master’s in nursing from Boston College. c. Unfortunately, smoking As a wife, mom of three young children, two-time at least two PPD, can cause cancer survivor, and a nurse practitioner in a variety of blood cells to be irritated and destroyed clinic settings, Plodzik says she juggles her family life, d. Your stomach lining has been affected by profession and volunteer work for one good reason— bacteria and you are unable to absorb vitamins to provide patients with the same support and kindness Members of the Silver Beacon CMU at Catholic needed for your blood cells she received throughout her battle with cancer. Three Medical Center years ago, Plodzik started Fit4acause, a donation-only 2. What information should be included in pre- fitness program that benefits patients with cancer. In The Intensive Care Unit (ICU) at Exeter Hospital has procedure teaching for a patient who will undergo the summer of 2018, she organized the first annual received its third Silver Beacon Award. “Receiving a a diagnostic bone marrow biopsy? (Select all that Fit4acause Triple Challenge, a five-mile bike, 5K and third silver Beacon Award is a great honor for the entire apply) five-circuit boot camp, which raised close to $10,000 staff in Exeter Hospital’s ICU,” said Susan Burns-Tisdale, to benefit cancer survivors. More recently, she started Senior Vice President of Clinical Operations and Chief a. Explain the procedure to the patient and her the Cancer Survivorship Clinic at the Payson Center at Nurse Executive at Exeter Hospital. “We hold three spouse Concord Hospital, which focuses on helping survivors Beacon Awards concurrently - in addition to this one, b. Encourage questions before the patient signs the live healthily after cancer treatment. our Family Center recently was recognized with a silver informed consent Beacon Award and our Progressive Care Unit (PCU) c. Explain that the site will be anesthetized before AACN Beacon Awarded previously received a gold Beacon Award and currently the procedure The American Association of Critical Care Nurses’ holds a silver Beacon Award. d. Expect a pressure dressing over the insertion site (AACN) Beacon Award for Excellence recognizes unit for 15 minutes caregivers who successfully improve patient outcomes e. Midazolam will be administered prior to and align practices with AACN’s six Healthy Work transport to Xray for the test Environment Standards. Those standards are skilled communication, effective decision making, appropriate 3. The healthy parents of a male child with a history staffing, meaningful recognition, and authentic of sickle cell disease brings their two other leadership. Units that receive this national recognition biological children, one boy and one girl, in for serve as role models to others on their journey to genetic testing. What is the likelihood that the excellent patient and family care,” explains AACN siblings are carriers of the sickle cell gene? President Clareen Wiencek, RN, PhD, ACNP, ACHPN. The Cardiac Medical Unit (CMU) at Catholic Medical a. Boy has a 50% chance; Girl has a 25% chance Center (CMC), has received the silver-level Beacon b. Boy has 100% chance; Girl has a 50% chance Award for Excellence from the American Association c. Boy has a 50% chance; Girl has a 100% chance of Critical-Care Nurses (AACN). The CMU is a 27- d. Both have a 50% chance bed unit for patients with cardiac conditions including Members of the Silver Beacon ICU at Exeter heart failure, arrhythmias, and stroke. The unit has 105 Hospital 4. A patient’s admitting CBC reveals a “shift to the staff and the added support of environmental services, left.” Based on this data What signs and symptoms dietary, case management and social work, and physical should the nurse plan to monitor closely? and occupational therapy. “We couldn’t do what we do Christopher Laurent, RN without them,” says CMU Director Eileen Grunwald, MSN, ARNP was named, with a. pallor, purpura, and cool extremities MS, RN, NEA-BC. “The team on the CMU embraces the a team of three Primary Care providers, as the Best Medical b. hypoxemia and tachypnea Providers Coos County in the c. hyperthermia and fluid volume deficit Come join a thriving private practice in Caledonian Record’s Best of d. hypertension and tachycardia downtown Manchester, NH. the North Country magazine Novus Vita Counseling, Pllc, reader survey. Laurent holds a 5. The nurse reviews lab values for a patient with established in 2013, continues to grow. BSN from East Tennessee State newly diagnosed multiple myeloma. What We are in need of behavioral University, a Master’s from abnormalities should be expected? (Select all that APRNs who are licensed in the the University of Alabama at apply) state of NH, are enthusiastic and Birmingham and received a interested in a private practice atmosphere that offers scheduling post master’s certificate from the University of California a. Hypokalemia autonomy, as well as outstanding San Diego in 1996 as a Family Nurse Practitioner. b. Hypercalcemia facilities and a supportive and He served in the US Navy for over 25 years. Laurent collaborative environment. practices for Weeks Medical Center at the Whitefield c. Leukocytosis If this sounds of interest to you, please give us a call at Physicians’ Office. d. Elevated INR 603-232-6987 or email Ellen at [email protected] e. Anemia Answers on page 19
CALLING ALL MAKE A DIFFERENCE AT CAMP STARFISH! We are SEEKING NPs, RNs, LPNs AND HEALTH ASSISTANTS ready to RNs & LPNs! take on the excitement of living and working in our camp Healthy House (no 'infirmaries' here!). Room & board, competitive salary, Looking for a change? How about sharing your paid time off, transportation, laundry, and plenty of opportunity to knowledge and skill by teaching LNA classes! make a difference are all part of the deal. Our UNIQUE 1-To-1 RATIO WANT TO MAKE A DIFFERENCE IN OF STAFF-TO-CAMPERS ensures that our campers with emotional, THE LIVES OF SENIORS? We are currently hiring Nurses to teach per diem, who meet the following criteria: social, behavioral and learning challenges find SUCCESS AT CAMP! • Min . 2 years experience in long term care • Strong ability to multi-task Join a team who shares your values, commitment to quality care and GREAT SUMMER OPPORTUNITY! compassion for your residents • Positive and enthusiastic attitude! • Team player Camp tuition discounts and barters are available for employees. For more information and to apply text HEALTH to 603-483-3372 • Desire to help others learn and grow Recent Graduates encouraged to apply. You can learn more about us and what we offer, or apply online at EMAIL: [email protected] WWW.GOLDENVIEW.ORG online at www.LNAHealthCareers.com/Careers PHONE: 978-637-2617 NATIONAL NURSES WEEK Interested candidates should submit a resume Camp lll-starfish WWW.CAMPSTARFISH.ORG Thank you for your vast contributions and positive impact in the lives of patients to [email protected] or fax 603-647-2175. WHY STARFISH? SEE 197+ REASONS: WWW.TINYURL.COM/STARFISHREVIEWS March, April, May 2019 New Hampshire Nursing News • Page 17 SPOTLIGHT ON A SPECIALTY New Hampshire School Nurses’ Association
Kathy Barth RN NHSNA advocates for school nurse members by For more information on the role of the 21st century providing regular continuing education programs. We School Nurse, visit the NASN website at 21st Century offer fall and spring meetings, as well as a program School Nurse. https://www.nasn.org/nasn/nasn- called Essentials, which is an overall training for resources/professional-topics/framework. If you are school nurses in New Hampshire. Essentials includes a school nurse and would like more information presentations on practice areas including health about the organization, please visit our website at screenings, delegation, emergency medications, nhschoolnurses.org, or email us at nhschoolnurses@ scope of practice of the school nurse, understanding gmail.com Medicaid, and topics of importance to school nurse practice. NHSNA also participates in the planning of Kathy Barth, BSN, RN, NCSN is currently the the New England School Nurse conference which is President of the New Hampshire School Nurses held every May. Association.
This year, Elliot Hospital donated a Stop the Bleed kit to NHSNA. Through our Essentials program, we trained a number of school nurses to be trainers of SPEND THE SUMMER ON LAKE WINNIPESAUKEE Stop the Bleed. With the kit, NHSNA members can The New Hampshire School Nurses’ Association now have what they need to provide training at their (NHSNA) is 300 members strong! We are proud local schools. of the school nurses who work hard every day to support the health and wellness of New Hampshire’s NHSNA communicates regularly with our children. Through their informed care, and thoughtful members with the Webmaster providing regular support of the school community, students with communications to all school nurses across the LOOKING FOR FUN RNs, LPNs, Nurse Practitioners acute and chronic health needs can be in school state on practice issues and through forums where wanting to spend the summer in New Hampshire. every day. NHSNA nurses work with teachers and members can collaborate on school nurse issues. Travel | Room & Board |NH licenses paid | Competitive Salary administration to provide accommodations for Included on the website is a monthly President’s Send resume to [email protected] students if needed and to educate the community on letter; we share information on Facebook and Twitter. Check us out at www.robindel.com the health needs of students. They quietly provide for basic food, clothing, and hygiene for families in need, and they work hard with families experiencing a crisis to connect them with a provider who can assess and provide treatment; and following a crisis, collaborate with the provider to assure school attendance for that child. AVAILABLE NOW! New Hampshire LPN IV Therapy Course BOARD OF NURSING APPROVED
Hybrid IV therapy course 28 Hour online didactic 4 Hour hands-on skills lab $325
REGISTER AT https://www. NHSNA is a state affiliate of The National pedagogyeducation.com/ Association of School Nurses (NASN). We have a Main-Campus/Class-Catalog/ working relationship with several organizations who Infusion/Class.aspx?Class=355 support the work of the school nurses and the health of our students, such as the Children’s Behavioral Facilities interested in hosting skills lab contact: A priority for NHSNA this year is to advocate for a Health Collaborative, The Asthma Collaborative, [email protected] permanent position of School Nurse Coordinator to be DHHS Oral Health Program, Convenient MD, DHHS housed at the Department of Education. This position Lead Poisoning Prevention Program. has been vacant off and on for several years. To that end, NHSNA identified a house legislator to sponsor HB 719, which funds and mandates the position. The School Nurse Coordinator would provide leadership, policy and guidelines, resources, and continuing education, as well as promote collaboration between school nurses and other organizations across the state which includes superintendents, principals, DHHS, and more. A public hearing was held on January 30, 2019, with members of NHSNA attending. The New Hampshire Nurses Association also signed – in in support of this bill.
Nurses Needed Visit nursingALD.com today! Unique multi-faceted organization needs your skills and talent to fill our NURSING positions! Come join our team of Search job listings compassionate professionals, where you will be a respected in all 50 states, and filter by location and credentials. member of our collaborative and integrated organization. We are currently seeking: For more information go to: Browse our online database Full Time www.goodwinch.org • OB Registered Nurse of articles and content. • Primary Care Nurse Email: Morgan Berryman • Substance Use Disorder HR Coordinator at and Recovery RN [email protected] Find events
Interested Candidates please apply at: for nursing professionals in your area. https://bit.ly/2TxIxQd Your always-on resource for nursing jobs, research, and events. Page 18 • New Hampshire Nursing News March, April, May 2019
From the Bookshelf
Lean In: Women, Work, and the Will to Lead By: Sheryl Sandberg with Nell Scovell, 2014, Albert Knof Books
She does talk about crying at work (which many of us Reviewed by Anita Pavlidis, RN, MSN To borrow from one of may have done at one time) and I was happy to see her Sandberg’s favorite quotations, dismantle the guilt-trip fallacy that is “women having “Done is better than perfect.” Last fall, I attended the NHNA Annual Meeting and it all.” Lean In is a call for leadership, an invitation to Schultz concludes “for all its Nursing Conference which included a day long program. participate in creating a society that values women, imperfections, Lean In has the The theme of the conference was “Nursing & Beyond” mothers, men, fathers, and in which women value and potential to be an important and featured several interesting speakers and topics. support each other and ourselves. The statistics, although book if a wider range of Among them was a panel of nurse leaders in the state an improvement on previous decades, are certainly women than those reflected who spoke on Leadership and Innovation. Included in not in women’s favor – of 197 heads of state, only 22 in its pages start hashing that discussion was a reference to the Sheryl Sandberg are women. Women hold just 20 percent of seats in out Sandberg’s best ideas in book Lean In; Women, Work and the Will to Lead. parliaments globally, and in the world of big business, a families across the country.” meager 18 of the Fortune 500 CEOs are women. The panel re-enforced the concept that many who have In Lean In, Sheryl Sandberg had long careers continue to be a lifelong learners. Not After reading the book, I found Sandberg far more – Facebook COO and one of only does it keep nurses proficient and skilled in the likeable than I expected and I appreciated her self- Fortune magazine’s Most Powerful Women in Business profession, but it can also make each of us stronger deprecating sense of humor, honesty about her – draws on her own experience of working in some of leaders. insecurities and enthusiasm for supporting other women. the world’s most successful businesses and looks at what It was an easy read, using approachable common speech women can do to help themselves, and make the small One of the drawbacks for me was that many leadership and simple, direct narrative. She does describe steps changes in their life that can effect change on a more books are written by business leaders as this one was, women can take to combine professional achievement universal scale. Reviewers on GoodReads offer a wide and is not nursing literature. None the less the discussion with personal fulfillment using resources available to range of opinions/reviews about the book (see Website piqued the interest of the nursing colleagues I was her and other women. Many of her examples apply to link below). sitting with and we decided a review of the book was all women in the workplace and their daily struggles; warranted. coming to work early, leaving late, constantly checking Sandberg makes some excellent points about women’s emails, being available to business colleagues, family, tendency to scale back their careers in anticipation of Lean In was published in 2013 to positive reviews but husbands, children, and friends. Certainly an interesting having a family. Alternatives discussed include societal many have been critical of the contradictions in the book regarding work life balance. book. Sandberg is the Harvard educated chief operating changes, re-balancing of marriage, and leaning in ahead of time so one has more leverage once children actually officer of Facebook, incredibly wealthy and committed I would recommend making time to read this book and arrive. She acknowledges that many women won’t to transforming the role of women in the workplace. as lifelong nurse learners, continue to appreciate a well gain extra leverage from “leaning in” (women in lower- Connie Schultz, a nationally syndicated columnist writing written book even if it isn’t nursing literature. for The Washington Post referenced a few noteworthy paid positions lack power to begin with). Society needs to change – and greater inclusion and advancement of examples of contradictions; stand up for yourself but https://www.washingtonpost.com women improves society. Sandberg also voices support don’t tick off the boss. Seek help from more experienced https://www.goodreads.com women but don’t ask for a mentor. Make your husband for those who choose to be stay-at-home moms, though there was a little nudge to all of them to “get out there” a real partner, but don’t tell him how to do it and Anita Pavlidis, RN MSN was the former Director of politically and otherwise. The issues she raises are appreciate whatever he does by himself regardless of Nursing at the NHTI, Concord’s Community College important. The inequality is far reaching as she raises how he does it. and Program Specialist at the New Hampshire Board of excellent points on this being an issue of equality for Nursing both sexes.
Caring for the Caregiver – Resource for Nurses
During disaster situations, nurses often find themselves • Stress relieving techniques • Effective coping strategies and relaxation techniques dealing with the challenges and potentially undesirable • Aspects of disaster work that produce stress for wellness outcomes of working in compromised environments. • Stress-prone and stress-resistant personality traits • How to recognize symptoms of PTSD in yourself or Often, the ability to provide care is affected by a lack • How to recognize acute or chronic stress others of staff and supplies or loss of utilities such as electricity • The role of self-esteem in promoting and resolving • Key indicators of compassion fatigue and water. In addition, as residents of the area, nurses stress • How to combat compassion fatigue are also affected by disasters and are equally concerned about the safety of their own families and homes.
Texas Nurses Association and Texas Organization of Nurse Executives, with support from the Johnson & Johnson Foundation, developed Care for the Caregiver to help nurses before, during and after disasters. With many cities still recovering from hurricanes, active fires and evacuations throughout the west coast, and harsh winter storms predicted, nurses need to be ready to face any disaster, both at home and at work.
Nurses are often compelled by their duty to care for others. In addition to mental and physical fatigue, nurses may experience moral distress related to ethical concerns arising from the conflicting values and obligations inherent in the disaster work environment. To best care for patients, nurses must care for themselves. Visit https://nhnurses.nursingnetwork.com/page/78391- caring-for-the-caregiver for more information and a link to watch videos, download resources, and get more information on preparedness, resiliency, self-care and more. Nurses can learn: • How to create a family disaster preparedness plan • Key items for a disaster kit at home, for work and while traveling • What to expect if working during a disaster • How to understand work policies and obligations March, April, May 2019 New Hampshire Nursing News • Page 19 Carmen Petrin in the News
What can one do in a 50- year career? If you're Carmen NURSES Petrin, APRN, MS, you can make a difference in many people's lives. Carmen is a ON THE MOVE nurse practitioner at CMC's New England Heart & Vascular Institute (NEHVI). She recently was recognized for 50 years of service to Thomas Mee, RN, BSN, MBA, was appointed as the new CMC. Last year, she was Chief Executive Officer of North Country Healthcare. honored with an Excellence North Country Healthcare is the parent organization of in Nursing award from New four Critical Access Hospitals and one home health agency Hampshire Magazine. in Northern New Hampshire. The member organizations include Androscoggin Valley Hospital in Berlin, Littleton "Realizing that my peers value Regional Healthcare in Littleton, Upper Connecticut my contributions to nursing Valley Hospital in Colebrook, Weeks Medical Center Carmen Petrin, APRN, MS and CMC means so much to me. I've in Lancaster, and North Country Home Health and President & CEO Dr. Joseph Pepe at the been so fortunate throughout Hospice Agency in Littleton. North Country Healthcare is 2018 CMC Employee Service Awards my life, supported by my comprised of 1,400 workforce members and is the largest family and colleagues, which employer in the North Country. Mee earned his Bachelor has allowed me to work hard doing what I love and achieve my goals," says Petrin. of Science in Nursing in 1985 from Madonna University in Livonia, Michigan, and his Master of Business Administration in Finance in 1990 Carmen began her nursing career at a time when the art and practice of nursing from Wayne State University in Detroit, Michigan. He has held the positions of looked very different from what it is today. Chief Operating Officer, Vice President of Operations, and Chief Nursing Officer at McLaren Health Care, mid-Michigan’s largest health care system. “We did not do office visits. Technology was less complicated. We hand-wrote orders and progress notes,” she remembers, “But NEHVI was always visionary and forward Kate Williams, BSN, RN, ACM, has been appointed to thinking, practicing state-of-the art cardiology.” the Dartmouth-Hitchcock Board of Governors. The Board of Governors is a multidisciplinary group of individuals She taught nursing students and continued to hone her own skills, becoming a critical from across the D-H system, who serve as the Medical nurse and an advanced cardiac life support (ACLS) instructor with the American Executive Committee focused on ensuring and enhancing Heart Association in 1982. the quality and safety of care, treatment, and services provided to patients in the inpatient and ambulatory When CMC began its cardiothoracic surgical program in 1986 – the predecessor to settings within Mary Hitchcock Memorial Hospital the New England Heart & Vascular Institute – Carmen was there. Always learning, (MHMH) and Dartmouth-Hitchcock Clinic (DHC). always growing, she became a nurse practitioner in 2005. Williams received her BSN from the University of Vermont School Of Nursing. She has practiced at UVM Medical As an APRN, Carmen is the primary cardiology provider for many patients at NEHVI. Center in Burlington, Vermont, Maine Medical Center in Even after 50 years, she thrives off of her work, telling New Hampshire Magazine, “I Portland, Maine, and has worked at Dartmouth-Hitchcock am inspired by patients and families who tell me that I made a difference and had a Medical Center for 27 years. Her experience includes Acute Inpatient Rehabilitation, positive impact on the quality of their lives.” Cardiology, Cardiovascular Surgery, Thoracic Surgery, and School Nursing. She is currently a case manager for the Emergency Department, and president of the Thank you, Carmen, for your dedication! MHMH Professional Nursing Organization.
To access electronic copies of New Hampshire Nursing News, please visit http://www.nursingald.com/publications Answers to NCLEX Reconsidered from page 16 1. d 2. b, c, d 3. d 4. c 5. b, e Page 20 • New Hampshire Nursing News March, April, May 2019 IN MEMORY OF OUR COLLEAGUES
The New Hampshire Nurses Association honors the CRVNA from the Concord Hospital School of Nursing. He was memory of and acknowledges the work of deceased Shirley Edna Hansen-Watson, 86, died proud to serve as a nurse at Concord Hospital in their nurses who have graduated from New Hampshire Cardiac Care Unit. nursing schools or who have actively practiced in New on November 23, 2018. A Concord Hampshire during their career. Sharing the names and native she obtained her nursing diploma information about these nurses is one way we honor from the Laconia School of Nursing and their contribution to the profession. Brief submissions are welcome. attended Simmons College. She practiced Concord Hospital Nurse for 30 years as a Nurse and Referral Helene B. (Boucher) Bourque, 80, died Coordinator for the Concord Visiting Nurses Association December 3, 2018. She was a 1958 Army Nurse Corps (VNA) retiring in 1988. graduate of the Mt. St. Marys Sacred Louise E. (Story) Nylund, 94, died Heart School of Nursing and practiced at November 6, 2018. A Hanover, NH native Concord Hospital and the Merrimack she obtained her nursing diploma in County Nursing Home. Vermont and during WWII, joined the Pioneer NP Army Nurse Corps. Her early Shirley Anne (Randall) Bayerle, 88, employment included private passed away November 26, 2018. She duty nursing at Mary obtained her nursing diploma in 1951 and St. Joes Nurse Hitchcock Memorial Hospital (DHMC). obtained nurse practitioner certification Janice Dorine (Etheridge) Conway, 75, in 1970. Shirley became the first Nurse died December 6, 2018. A New York Practitioner to work at Mary Hitchcock native she practiced as an RN at St. (DHMC). She earned a B.S. in Psychology Joseph Hospital for nearly 20 years. She St. Joes Nurse from Nathaniel Hawthorne College in 1983. Shirley Rita I. (Roy) Levesque, passed on also worked in animal rehabilitation, retired from Dartmouth-Hitchcock Medical Center where she lovingly cared for injured November 18, 2018 at the age of 81. She October 8, 1992. practiced nursing at St Joseph’s Hospital animals, from cats to raccoons, and Nashua NH for 15 years. Rita was Staff nursed them back to health. Nurse, quickly working her way to Head Nurse, then finally House Supervisor. In MHMH Grad 1978 she graduated from N.E. College with Geraldine Jones Hoyt, 93, passed away a BA in Psychology and Sociology and was an RN in November 26, 2018. She was a graduate Frisbie Nurse various Nursing homes as Charge Nurse, Supervisor, of Mary Hitchcock Memorial Hospital Paulette Theriault, 68, died December 7, 2018. She Assistant Director, and as a Consultant. She retired at age School of Nursing, Class of 1946. Soon practiced as an operating room nurse and nurse 71. after working at Mary Hitchcock, she was supervisor at Frisbee Memorial Hospital before moving given the position of Night Supervisor, on to Portsmouth Hospital. which she held until June 1955. She was also a part of the United Case Manager State Cadet Nurse Corp, during World War Betsy (Chase) Appleby passed away II. Gero Nurse November 23, 2018 at the age of 77. After Karen E. Johnson, 58, died December 8, obtaining her nursing diploma Betsy 2018. A Rochester native she practiced as practiced as a nurse in Keene and an RN at the Dover Rehabilitation and Manchester, NH and later as a case LPN to BSN Living Center, Webster at Rye and most manager for home health care. Dorothy Rogers Heald, 90, died recently, Cornerstone VNA. November 26, 2018. Dorothy received her LPN from Simmons College and went on to receive her RN from the University of New Hampshire. Dot practiced in both VA Nurse geriatrics and pediatric nursing for over Patricia (Pat) Bryan, 82, passed away on 25 years at the Elliot Hospital. November 23, 2018 in Texas. She graduated CMC Nurse from St. Joseph’s School of Nursing in Cynthia Mary (Castricone) Drake passed Nashua, NH and New Hampshire away in Florida on December 8, 2018. She graduated from Castle Junior College Technical Institute in Concord, NH. Pat was Keene Grad a retired RN Charge Nurse for the veterans in Windham, NH in 1978 with an Sharon Lyn Kelly, 75, passed away on November 27, Associates in Business Science, Notre Administration Hospital in Manchester NH. 2018. After graduating from Elliot Hospital School of She worked in the nursing home unit and spent her life Dame College in Manchester, NH in Nursing in Keene, NH, in 1964, Sharon moved to Boston 1994 with a Bachelor of Science in caring for disabled veterans. She was instrumental in starting to become an operating room nurse. She soon grew the hospice program at the Manchester VA. Business Administration, and Rivier University in passionate about the fight against cancer and was among Nashua, NH in 2018 with a Bachelor of Science in the first cancer nurse specialists. Nursing. She practiced as a nurse at Catholic Medical Center. NHH Grad Shirley Huston Hatton, 85, passed away November 28, 2018. She was a graduate of the NH Hospital School of 3rd Career RN Nursing in the 1950’s. Richard O. Blanchard II, 75, died December 19, 2018. A Concord native he entered the U.S. Navy and served aboard the aircraft carrier, USS Essex. After leaving the Huggins Nurse Navy, he resided in the Philadelphia area where he Jean M. (Sprague) Knisley Labrie, 90, graduated from Philadelphia College of Art and worked died November 30, 2018. She practiced as a photographer. Returning to Concord, he worked at Huggins Hospital and the Manchester both as a photographer and as a mental health worker at VNA. NH Hospital. After graduating from St. Joseph Hospital School of Nursing in 1988, he worked for several local facilities including St. Joseph Hospital, Hospice House and Merrimack County Nursing Home.
Second Career RN Gero Nurse (Capt. USAF-Ret) Paul Hopwood, 84, Margaret B. (Hill) Tilton, 91, died died December 1, 2018. A Portsmouth December 17, 2018. As a graduate of the native, he was in the US Army Medical Laconia Hospital School of Nursing she Corps and attended the University of practiced as a registered nurse at the New Hampshire for a couple of years Merrimack County Nursing Home in until he found his calling with the US Air Boscawen, where she worked for over 20 Force. He served several deployments years, retiring in the 1990’s. She was during the Vietnam War as part of the flight previously employed at the Shepard Nursing Home in crew on B52s. After a few years of Franklin. retirement, Paul graduated in 1981 as an RN March, April, May 2019 New Hampshire Nursing News • Page 21
ED Nurse Rivier Grad Concord Hospital Grad Pauline M. Donnelly Marsh, 95, passed Patricia (Anderson) Cramer, 60, died Phyllis (Stockwell) Hamilton, 93, died away December 22, 2018. She obtained January 5, 2019. She earned her Associate January 31, 2019 in Montana. A graduate her nursing diploma from the Sacred of Science in Nursing from Rivier or the Concord Hospital School of Heart Hospital of Nursing in Manchester, University in Nashua, NH from which she Nursing she started her career at the NH in 1945. Pauline worked at the Exeter spent decades as an RN dedicated to Laconia NH Hospital and after 10 years Hospital for 20 years, first as an ER nurse caring for patients in nursing homes and began a 35 year career with the State of and then as the evening supervisor on the in private home settings throughout New NH as an RN at the Laconia State School. 3 to 11 shift. Hampshire and Vermont
Nashua Grad Nurse Centenarian OB Nurse Alice L. Johnson, 97, passed away February 1, 2019. She Myrtle I. (Jauron) Latvis, 103, a native of Ann Marie Greene, 71, died January 9, was a 1942 graduate of the Nashua Memorial Hospital Nashua, NH, passed away on December 2019. As a RN she was drawn to caring School of Nursing. 24, 2018. She graduated from the for expectant mothers, and began Memorial Hospital Nurses’ Training working as a childbirth educator and School as a Registered Nurse and Lamaze instructor in Manchester, NH. practiced at Memorial Hospital (SNHMC) NHTI Grad for several years until receiving an offer to Karen A. (Rosher) Valenti, 62, died join Dr. Frank F. Flagg at his practice in Nashua. Nursing February 3, 2019. She obtained her was her calling, and she served many families through associates nursing degree from the New the 23 years she worked with Dr. Flagg. Upon his Hampshire Technical Institute in Concord retirement, Myrtle spent many happy years as a private Student Nurse and practiced for most of her career at duty nurse caring for several elderly individuals in their Stanislao Franco Iebba, 39, died January the Mary Gale Home in Manchester homes. Even into her 90’s living at the Kirkwood Corners 10, 2019. He received a Master of caring for elderly women. Assisted Living, Myrtle helped other residents get to their Science in Psychology in California and a rooms or to the dining room, or volunteered to get Master’s of Science in Public Health in Boston. He was in the process of something for a resident who forgot an item when they PRH Nurse completing the Direct Entry Master’s went to a meal, or who needed an aide or a nurse. She Lorraine E. (Chabot) Gordon, 84, passed curriculum at the University of New even sat with a couple of residents who were dying, away February 4, 2019. A 1955 diploma Hampshire at the time of his death. holding a hand and softly soothing them, while family graduate she received a Bachelor of members took a break. Some of the staff even said to her Science from Franklin Pierce College in “we should put you on the payroll!” Sharing careers, the 1984. She practiced at the Portsmouth nurses also enjoyed conversing with her about the Regional Hospital and then at the Mark College Nurse changes in nursing through the years. H. Wentworth until 2002. She also Mary Agnes (Conlon) Hagstrom, passed worked part time as an on-call school nurse and a away January 11, 2019. She obtained a private duty nurse after retirement from the Hospital. nursing diploma in Massachusetts in 1951 Nurse Educator and a BA from New England College in Joyce Helene (Suchinski) Blood, 76, died 1977. She practiced at St. Ann December 26, 2018. Born in Illinois she Rehabilitation and Nursing Center, in the WDH Nurse received her nursing degree at the Oyster River School District, but she Virginia “Ginnie” M. (Grant) Stillwagon, University of Illinois at Chicago and her especially loved her work at the UNH Student Health 79, died February 4, 2019. She received PhD in Psychiatric Nursing at Boston Center. her LPN and then returned to school to College. Joyce was a psychiatric nurse obtain her RN degree in 1978. She practitioner at Concord Hospital for many practiced at Wentworth Douglass years and was committed to providing mental health Hospital until her retirement in 2001 care to those in need. Prior to working as a nurse UNH Grad practitioner at Concord Hospital, she worked in the Erica J. (Webber) O’Donnell, 36, passed nursing departments at Colby Sawyer College and the away January 14, 2019. She obtained a Contoocook Valley School District New Hampshire Technical Institute, including acting as BSN from the University of New SAU #1 - Peterborough, NH the NHTI Chairperson. Hampshire and an MBA in Health Care Administration from Walden University. She practiced at York Hospital for the last Apply to be a WDH Nurse eight years. Substitute RN Maureen (Gregoire) Wallace, 64, passed away on December 26, 2018 in Florida. ($180/day). She spent many years at Wentworth Douglass Hospital in many positions Medic to Nurse including medical, surgical and head Dean Edward Ward, 59, passed away Go to www.convalsd.net, click on nurse positions. She worked on the January 17, 2019. Born in Frankfurt “Careers” and complete an application. leadership team at York Hospital. Germany, he served in the US Army as a helicopter medic in the 68th medical detachment for over 10 years. He practiced as an RN Cadet Nurse Corps at Concord Hospital and St. Cynthia Fradd Blood, 94, died December Joseph’s Hospital. 27, 2018. A Manchester native she attended the University of New Hampshire for one year. Due to a shortage of nurses during WW II, Cynthia Gero Nurse felt called to nursing, and in 1943 joined Joan (Cacio) Nelson passed away January the U.S. Cadet Nurse Corps at the Peter Littleton Regional Healthcare, located in the White Mountains 20, 2019 at the age of 91. A New York of New Hampshire is a desired vacation setting which offers Bent Brigham Hospital School of Nursing in Boston. She diploma graduate she practice at The year round recreation including hiking, fishing, golfing, skiing, was awarded the John P. Reynolds Medal and graduated Edgewood Center in Portsmouth for 22 snowmobiling, has great schools, and is conveniently located as a registered nurse in 1946. She returned to years prior to her retirement. between Boston and Montreal. It’s a place to build a life and a Manchester and worked for the future for yourself and your family. Manchester VNA, then taught for two and a half years at the Elliot Hospital We have openings for School of Nursing. RNs & LNAs Occ Health Educator in Obstetrics, MedSurg, Eleanor Anne Warren Marchak, 93, Emergency Room, OR & ICU passed away January 24, 2019. She Concord Nurse obtained a nursing diploma from the New Also Seeking RNFA in the OR Mary H. (Howe) Moran, 80, died December 27, 2018. Hampshire State Hospital in Concord, A graduate of the Concord Hospital School of Nursing Littleton Regional Healthcare offers N.H. She practiced as a nurse, which she spent her nursing career at Concord Hospital and competitive compensation, a generous benefits package and including teaching, in various Hospitals in Havenwood Heritage Heights. ample opportunity for professional growth and development. Massachusetts and New Hampshire eventually obtaining a Master of Occupational Education Qualified candidates are invited to apply at our website www.lrhcares.org. from the University of New Hampshire. With that degree she went on to teach at the Regional #9 Vocational Center-Kingswood Regional High School in Wolfeboro, Littleton Regional Healthcare Human Resources Department N.H. 600 St. Johnsbury Road, Littleton, NH 03561 Phone: 800-464-7731 or 603-444-9331 • Fax: 603-444-9087 EOE Page 22 • New Hampshire Nursing News March, April, May 2019 MANAGEMENT HUMOR ME MINUTE Regularly exercising our sense of humor improves resiliency, positivity and balances Lolly Daska in her new book Leadership Gap: What anti-negativity. Laughter may not solve Gets Between You and Your Greatness examines problems but can change your chemistry ways to simplify leadership. She notes “leadership allowing you to face them anew. In this issue may be complex, but great leaders are almost always we present one-liners and the story of the great simplifiers.” Five ways to simplify are presented for duck hunters to bring a smile. Submissions are leadership consideration. welcome. 1. Don’t try to read minds. By learning how to ask questions and listen to • Three glove sizes: Small, large and empty the answers you can improve communication. Some of the biggest and box. most unnecessary complications come from a lack of communication and understanding. • Hand sanitizer: The best way to find cuts on your hands you didn’t know you had. 2. Keep your word. Complications occur when people fail to say what they mean • One of the benefits of eating healthier is that you never have to ask or mean what they say. Simplify by keeping your promises and remember that questions like, “Who ate my salad?” what is said matters because people are listening. • “A man speaks frantically into the phone, ‘My wife is pregnant, and her contractions are only two minutes apart!’ ‘Is this her first child?’ the 3. Life is too short to waste time being cranky. There will always be things that provider queries. ‘No, you idiot!’ the man shouts. ‘This is her husband!’” cannot be controlled, but every situation comes with a choice of how you will respond, be mindful of your attitude. You can be cranky or you can be • “The worst time to have a heart attack is during a game of charades.” confident. • The proper way to use a stress ball is to throw it at the last person to piss you off. 4. Don’t try to please everyone. Trying to make everyone happy is complicated • I used up all my sick days….so I called in dead. AND impossible. Simplify by doing what is right and treat people as you would like to be treated. • I always feel better when my doctor says something is normal for my age but then I think dying will also be normal for my age at some point. 5. Make time for what’s important. The state of being busy but unproductive is • Smoking will kill you... Bacon will kill you... But, smoking bacon will cure complicated. Simplify by considering what your priority is. Simplify the to-do list it. to make time for things that are truly important. • I don’t engage in mental combat with the unarmed. • If four out of five people SUFFER from diarrhea... does that mean that one enjoys it?
Board Vacancies The Board of Nursing currently reports three vacancies: Licensed Nursing Assistant (LNA) position with experience in Long Term Care (LTC); Registered Nurse (RN) with News administrative and clinical experience and a public member. In addition A group of physicians are duck hunting. The general surgeon spots a duck the terms of two members expire in flying from the marsh, aims his rifle, shoots the duck in one shot, and turns to 2019. the others and says “I just shot myself a duck.” The intern sees a duck, aims his rifle, leads the duck with his first shot, trails it with his next shot and hits with his third. He turns to the group and says, “It was too small for a condor, The Board of Nursing responses to questions presented to the Board by too big for a sparrow. I think that it was probably a duck.” The radiologist sees licensees. a duck, aims a shotgun, hits the duck, and turns to the group. He states “I just hit a flying animal. It may be a duck, pheasant, or quail. Possible flying squirrel. Q: Are nurses permitted to repeat the same educational offerings in the Cannot exclude a pterodactyl at this point. I think I should shoot it again, but same two year renewal period and receive credit from the board office with a scoped rifle next time.” The emergency physician spots a duck flying for attending the marsh and aims a huge, automatic combat shotgun, unloading two full A: Yes magazines into the air, as the other physicians take cover behind him. After the tremendous noise ceases, the intern uncovers his ears and shouts, “What the Q: Are courses such as glucometer training, use of IV pumps and back heck was that?” The emergency physicians turns around and says, “I have no training (mandatory training for organizations) counted toward courses idea, but I’m pretty sure that I hit it.” that “are designed to enhance nursing knowledge, judgment, and skills”? A: Yes
Q: Can an RN place an arterial line using ultrasound guidance? Making a difference A: Yes while earning a living! Q: Can an LNA replace a tracheostomy cap? A. Yes, in all settings, provided the RN or LPN has delegated this task WE’RE SEEKING RNs, LPNs, MNAs & LNAs appropriately. for Per Diem, PT and FT positions Join a dynamic, caring organization Ed Note: BON Practice Advisories are abstracted from meeting minutes. with professional growth RN Scope of Practice and Advisory list located at BON website is dated “RiverWoods truly cares about opportunities where you October 2015. can grow your career while their residents and employees making a difference in the and is a wonderful place to lives of our residents. As a work. As a newer employee, I can see why so many have such member of the RiverWoods 2018 Board Actions a long work history here and are healthcare team, you will During 2018, according to the BON website the Board reviewed the cases proud to say they’ll retire from of 83 licensees to remove, revoke or reinstate licenses by license category enjoy high staff to resident RiverWoods.” Cheryl, LNA ratios, job autonomy, tuition these actions included 41 RNs, nine APRNs, 10 LPNs, and 23 LNAs. In reimbursement and competitive pay in a addition, 12 licenses of compact RNs were denied practice in New beautiful work environment. Hampshire from states that included Maine, Texas, North Carolina, North Visit RiverWoodsRC.org/joinourteam Dakota, Tennessee, Virginia and Mississippi. Six additional ‘emergency’ to view our current openings or call meetings in 2018 were held by the BON for license disciplinary actions. 603.658.1541 to learn more. March, April, May 2019 New Hampshire Nursing News • Page 23 So What IS Climate Change?
Barbara Sattler, RN, DrPH, FAAN, is true for all species on earth. When human temperatures rise from 98.6 to 100.4 Professor, University of San Francisco, [email protected] and degrees it means the difference from feeling fine to having a fever and not feeling well. Cara Cook, MS, RN, AHN-BC, Climate Change Program Coordinator, When our temperatures get even higher we begin to see bodily system distress and Alliance of Nurses for Healthy Environments, [email protected] damage. What happens when the earth has a fever?
At a recent nursing meeting I attended I asked nurses to pair up and role play the As the earth warms, we are beginning to see shifts in climate which are resulting in following: “Your neighbor has just asked you – so what IS climate change?” Each nurse some areas seeing much more rain and others much less, some colder winters, some had to take a turn with a partner and answer that question, as though she/he were hotter summers. telling her neighbor the answer. After completing the role play, I asked how many of the nurses were able to answer that question with a high level of confidence and only As we encounter more extreme heat days and extended heat waves, we are going to about 10% raised their hands. When I ask how many could answer with reasonable see many more heat-related illnesses and even deaths in humans. People who work confidence only another 10% raised their hands. How about you, would you feel outside in agriculture, utilities, construction, gas/oil, and many other fields will be at confident answering the question? What everyone discovered from this activity higher risk for hyperthermia. And, of course, extreme storms and wildfires have been was how unprepared many nurses are to talk about what climate change is. While taking an enormous toll on human and ecological health. nurses are more familiar with what climate change seems to be causing, such as more extreme weather events, sea level rise, and extensive wildfires, a large portion are Changes to the earth’s climate can have irreversible effects on plants, including our unable to explain what climate change is in simple terms. agricultural food crops. Rising ocean temperatures is affecting plankton which is the foundation of the food chain for fish and sea mammals. An estimated billion people So here is a little are dependent on fish as their main source of protein. In addition to interrupting the primer: world’s food supply, there are many other health threats associated with the changes we are seeing. For an extensive list of how climate change affects human health, visit The earth’s https://bit.ly/2qNLNtW. temperature has historically been While there are some natural sources of greenhouse gases, the ones we have the most modulated by the capacity to reduce are those that are manmade. As individuals we can assess our sun’s rays beating household’s contribution to greenhouse gases by using a “carbon footprint calculator,” down, warming the such as this one from the U.S. Environmental Protection Agency: https://bit.ly/1XIc9pa. land and water, and As nurses, we can help promote climate healthy purchasing and practices in our then radiating heat health care facilities, K-12 schools, faith-based organizations, universities, and any back out beyond the other settings in which we have influence. earth’s atmosphere. This process has The new International Council of Nurses (which ANA is a member of) announced its kept the earth at a new position statement on climate change in September 2018 and calls on all nurses livable temperature to help address climate change (see: https://www.icn.ch/sites/default/files/inline-files/ for humans and other PS_E_Nurses_climate%20change_health.pdf) It calls for us to heed the scientific lifeforms to flourish. evidence which, in the case of climate change, is abundant.
However, we now have a “blanket” of gases that are surrounding the earth, gases We must be able to talk about this issue with a degree of confidence and we must created substantially by human activities such as transportation, energy production, engage both individually and as a profession to advocate for policies and practices that industry, cooking/heating, and agriculture. (See the image below) These gases will decrease greenhouse gas production from a wide range of its sources. The truth is are called greenhouse gases because they create the same warming effect as a climate change is a health issue and that’s what we nurses are all about. greenhouse and are slowly warming the earth – both the land and particularly the oceans. And in the process, they are changing our climate. Climate is distinguished For more resources on climate change and health, including nurse-focused guides and from weather in that weather is what occurs from day to day or week to week, but webinars, visit the Alliance of Nurses for Healthy Environments Climate and Health climate is what occurs over longer periods of time, month to month and year to year. Toolkit: climateandhealthtoolkit.org. To join our free monthly calls on Climate Change and Nursing please email the authors.
The process is a bit like what happens to your car when you leave it outside in the sun with the windows up. The sun’s rays heat the inside of the car and that heat cannot adequately escape, so the car heats up.
Just as there is a small range of body temperatures at which humans can be healthy, the same NursingALD.com NursingALD.com can point you right to that Free to Nurses perfect NURSING JOB!
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E-mailed Job Leads Quality Care Close to Home North Country Hospital is a 25 bed critical access private, nonprofit acute care community hospital with physician practices serving twenty communities in a two- county area in the rural Northeast Kingdom of Vermont. We are currently seeking applicants for the following positions: • Emergency Room- 3 Full Time & 1 Per Diem • ICU, RN- 1 Full Time • Nursing FLEX Pool, RN- 2 Full Time & 1 Part Time • Surgical Services, Operating Room, RN- 1 Full Time & 1 Per Diem • Primary Care Newport, RN Office Nurse- 1 Full Time & 1 Per Diem • New Graduate RN Positions - Full Time- 1 Operating Room, 1 Maternal Child Health, 1 Inpatient Medical Surgical Unit At North Country Hospital quality patient care is our greatest commitment, employees are our greatest asset, excellent patient experience is our greatest accomplishment, and the health of the community is our greatest responsibility. For additional information contact: Tabitha Cole, Human Resources (802) 334-3210, ext. 405 • E-Mail: [email protected] North Country Hospital, 189 Prouty Drive, Newport, VT 05855 www.northcountryhospital.org