University of Mary Washington

University of Mary Washington School of Nursing Policy and Information Handbook

I. Introduction

II. Mission

III. Philosophy

IV. Objectives

V. Curriculum

VI. Faculty

VII. References I. Introduction

The University of Mary Washington (UMW), a public liberal arts college, is located in Fredericksburg, Virginia approximately halfway between Washington, DC and Richmond, Virginia. It offers a variety of undergraduate, graduate and professional studies, but currently has no nursing program. There are many reasons this city and university would benefit from the addition of a Bachelor of Science in Nursing program (BSN), the main one being that it would be the only BSN School between Richmond and DC. Other supports for starting a nursing program here include: accessibility to higher education is part of Virginia’s strategic education plan and Baccalaureate education should be the standard for entry into professional nursing practice per the American Nurses Association (1965). We would like to recommend a nursing curriculum plan that we have developed with the University of Mary Washington in mind. There are many student-friendly aspects of UMW, such as access to public transportation, campus escort services, club vans, “bicycle friendly” campus, and accessibility to the school by Amtrak, Greyhound, the Virginia Railway Express and the school is only five miles off interstate 95, making driving convenient. The historic city of Fredericksburg provides a good mix of culture and recreation for students. Students will “learn from full time faculty, 90% of whom have earned a doctorate or other terminal degree in their field” (“About UMW,” n.d.). “There are more than 100 student clubs and organizations oriented around academic themes, the arts, sports and recreation, student government, cultural diversity, and other interests” (“About UMW,” n.d.). The prime location of UMW alone offers many exciting external classroom and clinical opportunities. The biggest potential support of the school, Mary Washington Hospital, already provides student health services to the university. This hospital is the 3rd busiest hospital in VA and besides the obvious clinical placement it would offer, could also serve as a source to fill faculty positions. Additionally within the Medicorp Health System is Stafford Hospital Center, the Region’s First-Free-Standing Emergency Department, Snowden at Fredericksburg (behavioral health), and Next Care Urgent Care in three locations. Additionally there are other local facilities that could offer invaluable clinical learning experiences: Potomac Hospital, HealthSouth Rehabilitation Hospital, six nursing homes, as well as a HCA Virginia hospital due to open in June 2010, Spotsylvania Regional Medical Center. This HCA hospital will create 400 jobs with a $26 million payroll (“Opening,” n.d.; Medicorp Health System, n.d.). There is also a proposal being considered for a new $11 million cancer center at Mary Washington Hospital (Hall, 2009). This shows that in Fredericksburg there is active interest in growth of their health care systems. A strong BSN program could attract students to Fredericksburg and having local employment could possibly keep graduates interested in staying in or near the city, which would keep money in the community. Population statistics of Fredericksburg supports higher education. 17.35% of residents have a 4-year college degree, versus 15.16% nationally. 12.21% of residents have graduate degrees vs. 7.16% nationally. Education is one of Fredericksburg’s leading industries. RN jobs are listed in the top five popular jobs in Fredericksburg (College Navigator, n.d.). Review of Fredericksburg local newspaper the Free Lance Star, shows an article archived from 7/8/2007 entitled “Hospitals: when we build them, will nurses come?” which details the plans that two hospitals, Spotsylvania Medical Center and Stafford Hospital Center (opened in 2009) have for recruiting nurses. These plans include scholarships for nursing students, relocation grants, improved benefits and compensations, and job transfers between existing facilities. On 11/7/2008, an article titled “Battling the nursing shortage” talks of the success of nursing graduates from Germanna’s Community College in Orange County. And on 4/1/2009 an article “Nursing program maxed out” discusses the nursing shortage and that many people are switching into nursing programs as a second career for job security. However, the article further points out that there are not enough spots in Germanna’s Community College for the number of students seeking enrollment. These are just a few examples of articles, but the fact that the newspaper is consistently covering the nursing shortage and benefits of recruiting nurses could be very beneficial to our plans to start a new BSN program at the University of Mary Washington. The City Council consists of a seven member legislative body, which includes a Mayor and six Council members, which are elected to four year staggered terms. The City Council has a focus of fostering economic and industrial development. It is interesting to note that Dr. Thomas Tomzak, the current Mayor of Fredericksburg (at-large,) left his private practice and job at Mary Washington Hospital to work for the Rappahannock Area Health District. He works for the Health Department treating poor and uninsured patients, as well as supervising nurse practitioners within the Department. He currently is the Physician Supervisor for five Maternity Clinics and is active in teen pregnancy prevention and Women’s health issues. There are also two council members Dr. Tomzak is serving with that could potentially help our endeavors to begin a new BSN program. Mary Katherine Greenlaw (at-large,) is the former chair of Medicorp Health System and she is currently the vice chair of Mary Washington Hospital Foundation. Another council member, Matthew Kelly, graduated from the University of Mary Washington and his wife is currently serving as an adjunct professor. These personal connections to the University of Mary Washington and Hospital from these key political forces could be detrimental in whether or not the plan to start a BSN program at the University of Mary Washington would be supported or not (“Physician-mayor”, n.d.; Fredericksburg City Council, n.d.). Listed in the Fredericksburg City Council Goals and Initiatives for 2009-2010 (written January 13, 2009) under Goal 3 is “Economic Vitality”. The City Council clarifies that this goal is to “Increase the prosperity of citizens and businesses and ensure adequate City revenues by (1) establishing Fredericksburg as a preeminent national tourism destination and (2) pursuing economic development and redevelopment opportunities that lead to high quality, sustainable employment.” It further shows that Initiative 3A’s Action Plan is to “assist the University of Mary Washington Foundation and other developers with submitting mixed use development applications that complement city development goals as expressed in the Jump Start 2010 Plan and the 2007 Comprehensive Plan.” This documentation of support for both development of the University and economic growth also appears hopeful for the City Council’s support of a BSN program at the University of Mary Washington (Goals and Initiatives, 2009). These are just some of the reasons that both Fredericksburg and the University of Mary Washington would benefit from the addition of a Baccalaureate nursing program. Read on to see our comprehensive curriculum plan.II. Mission The School of Nursing at the University of Mary Washington is a premiere public institution of higher education committed to cultivating an environment of academic distinction through research, freedom of inquiry, personal responsibility and intellectual integrity. We believe the nursing profession fosters lifelong learning through service to our patient population and larger community. III. Philosophy

As a nursing faculty we will foster and appreciate our students' basic quest for knowledge and reward their curiosity with a stimulating curriculum that will enhance both their creativity and critical thinking skills.

Faculty believe that cultural diversity and varied life experiences between both students and faculty members enriches the learning environment. Faculty believe that a diverse student body and nursing workforce offer patients a holistic care experience.

Metaparadigm Nursing: Nursing is a dynamic multidimensional profession that utilizes critical thinking and evidence-based practice to improve the quality of life or provide dignity in death to an individual, thereby positively affecting the individual’s family, group, and community. “Nursing seeks to sustain and preserve caring, wholeness, and humanity, across worlds and time” (Watson, 2002). Nursing utilizes the nursing process to evaluate the effectiveness of interventions. Person: Individuals are unique beings with emotional, physical, intellectual, social and spiritual needs. Individuals have the right to be treated with care and justice regardless of culture, ethnicity, socioeconomic status or race. An individual will strive to meet an optimal state of health according to Maslow’s Hierarchy of needs with optimization as self-actualization. Health: Health is the optimal state of wellness a person can achieve by participating in activities that promote quality of life. Equal access to health care is a right of all individuals. Environment (community): Community is composed of individuals, families, and groups of people who have similar or diverse backgrounds. Each member of the community adds value to the community. Communities should maintain member safety, socialization, education and freedom of religion and expression. IV. Objectives

General Purpose Statement To educate and prepare a diverse student population who upon graduation will be prepared for successful completion of standardized testing necessary for licensure, be prepared to practice holistic nursing in entry level positions in a variety of healthcare settings, and commit to lifelong learning necessary in an ever changing professional environment.

End of Program Objectives The graduate from University of Mary Washington School of Nursing will: 1) Assess the client’s physiological, psychological, sociocultural and spiritual needs 2) Form a caring partnership with the client to establish a goal and implement a plan to meet the client’s physiological, psychological, sociocultural and spiritual needs 3) Demonstrate a holistic approach in caring for clients; recognizing that family, significant others and spirituality impact health care needs 4) Will deliver nursing care in an ethical, legal, nonjudgmental, and nondiscriminatory fashion 5) Demonstrate critical thinking skills 6) Utilize evidence-based practice for decision-making 7) Demonstrate behaviors that promote patient safety 8) Foster an environment that promotes client self esteem and maintains dignity and comfort 9) Be able to utilize therapeutic communication skills in the delivery of care 10)Utilize resources to educate clients on illness prevention and health promotion 11)Recognize that he or she is a member of a healthcare team, respecting other health delivery disciplines 12)Establish professional goals and be committed to life long learning

Midterm Objectives At the beginning of the junior year, the student will be able to: 1) Recognize and respect individual’s religious, cultural, and ethnic differences 2) Recognize that nursing is a caring art that looks at individuals holistically 3) Recognize that nursing care is delivered in a nonjudgmental manner to all who seek care or education regarding health issues 4) Recognize that nursing involves life long learning and continued education 5) Recognize the need to deliver nursing care based on research and obtained evidence 6) Recognize the professional responsibility for the advancement of the nursing profession 7) Have developed basic therapeutic communication skills 8) Is progressing in critical thinking skills 9) Accept responsibility as an active participant in their education V. Curriculum

Freshman year, fall semester Credits Biol 125 – Phage Hunters I with laboratory 4 Chem 111 – General Chemistry with laboratory 4 Engl 202D – Writing about medicine (WI) 3 FSEM 100 – First year seminar 3 Math 110 – Finite math with applications 3 17 Freshman year, spring semester Biol 126 – Phage Hunters II with laboratory 4 Comm 209 – Argumentation (SI) 3 Engl 205 – Art of literature (WI) 3 Math 200 – Introduction to statistics 3 Psyc 100 – General psychology 3 16 Sophomore year, fall semester Biol 384 – Human Anatomy 4 Language elective* 3 Nurs 201 - Concepts in nursing 3 Nurs 222 - Nursing research (WI) 3 Psyc 332 – Developmental psychology: 3 adolescent and adult 16 Sophomore year, spring semester Biol 385 – Human Physiology 4 Language elective* 3 Nurs 235 - Wellness and Prevention Nursing 3 Nurs 245 - Technologies of Nursing Practice with 4 (1 clinical credit = 30 hours) clinical Nurs 261 - Health Assessment 3 (1 laboratory credit = 15 hours) 17 Junior year, fall semester Comm 360 - Group Mentoring (SI) 1 Language elective/General elective* (3) Nurs 300 - Pharmacology 4 Nurs 320 - Ethical and Legal Issues in Nursing 3 (WI) Nurs 325 - Medical-Surgical Nursing with clinical 5 (2 clinical credits = 60 hours) 16 (13) Junior year, spring semester Biol 204 - Nutrition 3 Comm 365 - Group Mentoring (SI) 1 Language elective/General elective* (3) Nurs 335- Medical-Surgical Nursing with clinical 5 (2 clinical credits = 60 hours) Nurs 340 - Maternal Child Nursing with clinical 5 (2 clinical credits = 60 hours) 17 (14) Junior year, summer semester Experiential Learning – Community Service 40 hours – general education requirement Senior year, fall semester Comm 400 - Group Mentoring (SI) 1 Human Experience & Society elective 3 Nurs 380 - Psychiatric/Mental Health Nursing 4 (2 clinical credits = 60 hours) with clinical Nurs 410 - Acute Care Nursing with clinical 4 (2 clinical credits = 60 hours) Nurs 486 - Leadership and Management in 4 (2 clinical credits = 60 hours) Nursing with clinical 16 Senior year, spring semester Comm 410 - Group Mentoring (SI) 1 Global Inquiry Elective 3 Nurs 415 - Community Health Nursing with 4 (1 laboratory credit = 15 hours; 1 clinical credit laboratory and clinical = 30 hours) Nurs 490 - Senior Preceptorship - clinical 4 (4 clinical credits = 120 hours) Nurs 499 -Transition to Professional 1 13 Total Credits: 128 (122) Nursing Credits: 59 Clinical Hours: 540 Campus Laboratory Hours: 30 1 credit = 30 clinical hours; 1 credit = 15 campus laboratory hours

*See faculty advisor to determine if four years of language are required. (SI) – speaking intensive class, 2 courses required for general education (WI) – writing intensive class, 4 courses required for general education

Prior to beginning junior level nursing courses students must complete: Bio 125, 126, 384, 385 Biology (Microbiology), Anatomy, Physiology Chem 111 Chemistry Math 200 Statistics Psych 332 Developmental Psychology Comm 209 Argumentation

Nursing courses must be taken in sequential order and are only offered once a year. Short Syllabi BIOL 125, 126 (Phage Hunters I, II) – This research course sequence is designed for freshman using a “learning by doing” approach to introductory biology. It is a hands-on, discovery type of course with an emphasis on critical thinking and communication skills. Themes covered will be similar to Biological Concepts 121, 122 with an emphasis on microbiology, molecular biology, genomics, and bioinformatics. Students will isolate and characterize unique viruses and prepare data for presentation. Laboratory. Biol 204 (Nutrition) – Prerequisites: Biology 121 or Biology 126. A survey of current information related to human nutritional needs in health and disease, demographic factors, food additives and special diets. Biol 384 (Human Anatomy) – Prerequisites: Biology 121, 122 or Biology 125, 126. The structure of the human body at the cell, tissue, organ, and system levels of organization. Laboratory. Biol 385 (Human Physiology) – Prerequisites: Biology 211 and 301 or 384. A systematic study of the physiology of the nervous system, circulation, respiration, digestion, kidney function, muscle function, integument system, homeostasis, hormonal control, and reproduction in the human body. Laboratory. Chem 111 (General Chemistry with laboratory I) – Introduction to the fundamental principles of chemistry and the more important elements and their compounds. Laboratory. The entry-level course for additional work in chemistry and biology. Comm 209 (Argumentation) – Study of the use of reasoning in persuasive communication with emphasis on the construction, evaluation, presentation, refutation, and defense of oral arguments. Comm 360, 365, 400, 410 (Group mentoring) - Provides a relaxed learning environment in which students will become more comfortable embracing their role as an emerging caring professional nurse. In accordance with Jean Watson’s Theory of Human Caring, promotion and acceptance of the expression of positive and negative feelings will occur. Students will determine their course objectives and meet weekly in groups of 8-10 with one faculty member facilitating the class. Active participation is required. Must begin with 360 and complete four-class sequence in four subsequent semesters. Engl 202D (Writing about medicine) – Writing seminar allows students to hone their writing skills while focusing on writing in a particular context of interest to them. Topics may vary by section. Engl 205 (Art of literature) – An introductory course emphasizing the development of the genres of poetry, prose fiction, non-fiction, and drama. Using a historical perspective, students study the role of the reader, the surrounding culture, and the language of the text. The course offers student the tools of critical analysis and encourages the pleasures of close reading and exchange of ideas. Experiential Learning (Department of Biology) - The department has established another mechanism by which biology majors may satisfy this general education requirement (besides the options listed under the “Experiential Learning” requirement course list found on page 55). The Biology Service Learning option requires students to apply knowledge and skills acquired in their formal courses and to reflect upon how such application has augmented their education. Students will complete a Community Outreach and Resources (COAR) Service-Learning contract in which they will 1) identify the agencies for which they will conduct their service, 2) indicate the biology faculty members who will evaluate the academic component of their activities, and 3) describe the duties that they will carry out for these agencies. Students must complete 40 hours of service within 12 months of submitting their COAR contracts. Students completing their community service during their last semester must complete all requirements by March 1 (November 1 for those finishing in December). Contact the biology department chair for additional details. (The nursing program is housed in the Department of Biological Sciences as such students may complete the Biology Service Learning option to complete the general education requirement for experiential learning.) FSEM 100 (First-year seminar)– The first-year seminar introduces students to the pursuit of intellectual inquiry. Students will study a non-traditional topic in a nontraditional way while exploring the concept of a liberal arts education. Specific topics will vary from course to course. Math 110 (Finite math with applications)– Includes topics such as sets, logic, probability, statistics, and counting. Other topics are at the discretion of the instructor. Designed for the non-major. Math 200 (Introduction to statistics) – First course in statistical methods. Includes descriptive and inferential techniques and probability, with examples from diverse fields. Topics vary with instructor and may also include sampling methods, regression analysis, and computer applications. Nurs 201 (Concepts in Nursing) – Must be accepted into nursing program: Foundational course for all nursing courses. Focuses on nursing as a profession and a discipline. History and trends in nursing and health care to be discussed. Introduction to regulations and sections of the Code of Virginia and ANA Standards and Scope of Nursing Practice. Exploration of the Theory of Human Caring and respect for cultural differences, values, preferences and expressed needs. Nurs 222 (Nursing Research) – Must be accepted into nursing program: An introduction to evidence based practice. Examines the importance of nursing research and includes beginning skills of evaluating and applying evidence based research to nursing practice Nurs 235 (Wellness and Prevention Nursing) – Prerequisites: Fall Sophomore level nursing courses - Teaches a prevention based model of nursing that encourages critical thinking in relation to wellness needs for both general and specific populations, using evidenced based practice. Provides basis of knowledge for patient education in subsequent clinical courses. Nurs 245 (Technologies of Nursing Practice) - Prerequisites: Fall Sophomore level nursing courses - Examines the basics of the nursing process. Focuses on the application of core nursing principles and on the basic health and safety needs of patients. Clinical. Nurs 261 (Nursing Health Assessment) - Prerequisites: Fall Sophomore level nursing courses - Focuses on the skills required in obtaining a complete patient history as well performing a complete physical assessment of a patient. Examines assessment techniques for both the healthy adult patient as well as diverse populations. Laboratory. Nurs 300 (Pharmacology) – Prerequisites: Sophomore level nursing courses - Develop competency in identifying common drug classifications, interactions, side effects, contraindications, and usages of a variety of medications. This class will also focus on the proper administration techniques to ensure patient safety. A minimum grade is required in this course before students are permitted to distribute medications in the clinical setting. Nurs 320 (Ethical and Legal Issues in Nursing) – Prerequisites: Sophomore level nursing courses - Exploration of the ethical and legal issues surrounding aspects of nursing such as patient rights, documentation, delegation, variance reports, and end of life concerns. Professional responsibility and the legal ramifications will be discussed. Classroom content will be delivered in a round table format to encourage student participation in all discussions. Nurs 325, 335 (Medical-Surgical Nursing I, II) – Prerequisites: Sophomore level nursing courses - Focuses on pathophysiology review of each body system being studied and application of this information while caring for medical or surgical patients in an acute care clinical setting including care for patients affected by bioterrorism while maintaining patient safety. Content will be delivered with an increasing level of complexity to facilitate learning as well as ensuring that classroom content correlates with the clinical experience. Clinical. Nurs 340 (Maternal Child Nursing) - Prerequisites: Sophomore nursing courses and Fall Junior level courses - Explores care of the prenatal, pregnant, and postpartum woman as well as assessing for signs of domestic violence. Course includes caring for the pediatric patient and learning how to recognize and prevent child abuse. Nurs 380 (Psychiatric and Mental Health Nursing) - Prerequisites: Sophomore and Junior level courses - Focuses on pathophysiology and pharmacology associated with psychiatric and mental health conditions and the impact on the individual, family, and community. Identification and implementation of multidisciplinary approaches to psychiatric and mental health care management in a variety of settings. Clinical. Nurs 410 (Acute Care Nursing) - Prerequisite: Sophomore and Junior level courses - Focuses on pathophysiology and pharmacology associated with the care of the acutely ill adult in a variety of settings using a multidisciplinary approach. The nursing process is utilized to aid in critical thinking, documentation, psychomotor skills and time management. Clinical. Nurs 415 (Community Health Nursing) - Prerequisites: Sophomore, Junior and Fall Senior level courses - Focuses on culturally sensitive exploration and interpretation of systematic assessments and evaluation of interventions conducted with an emphasis placed on goals identified in Healthy People 2020. Geriatric population specific content included with special emphasis on recognition of patient abuse, neglect, and abandonment. Laboratory and Clinical. Nurs 486 (Leadership and Management in Nursing) - Prerequisites: Sophomore and Junior level courses - Focuses on exploring leadership styles and demonstration of learned techniques to facilitate care of individuals, families and the community in a variety of settings. Clinical. Nurs 490 (Senior Preceptorship) - Prerequisites: Sophomore, Junior and Fall Senior level courses - Provides expanded clinical experience to facilitate critical thinking, time management, and skill enhancement and value exploration. Clinical. Nurs 499 (Transition to Professional) - Prerequisites: Sophomore, Junior and Fall Senior level course - Examines the transition between student nurse and professional nurse through the exploring of change theories and techniques to acquire a professional role, including a portfolio. Psyc 100 (General Psychology) – Fundamental principles of human behavior; history of psychology; research methods; the nervous system; learning; memory; personality; psychological disorders; therapy; social behavior; careers in psychology. Psyc 332 (Developmental psychology: adolescent and adult) – Theories of, and research on, personality, social, physical, and intellectual characteristics from adolescence to young adulthood. VI. Faculty The faulty offer a rich blend of backgrounds and experiences in nursing, education, research and community service.

Kiley Bailey, RN, BSN – Mrs. Bailey’s experience lies in Labor and Delivery. Mrs. Bailey has acted as a Perinatal Loss Bereavement Coordinator and Spanish interpreter. Mrs. Bailey is currently seeking a Nursing, Master of Science specializing in maternal health.

Kimberly Davis, RN, BSN – Mrs. Davis’s experience lies in medical-surgical nursing with an emphasis on orthopedics. Mrs. Davis has been involved in teaching pre-op total joint replacement classes and acted as a student preceptor and charge nurse. Mrs. Davis participated in a variety of hospital committees, including an ethics committee. Mrs. Davis’s teaching experience includes a variety of courses designed for Licensed Practical Nursing students. Mrs. Davis has utilized simulators in a laboratory setting and had clinical instructing experiences in Richmond, Virginia. Mrs. Davis is currently seeking a Nursing, Master of Science specializing in adult health.

Carrie Lewis, RN, BSN, CCRN – Mrs. Lewis’s experience lies in critical care medicine. Mrs. Lewis has participated in hospital committees to improve patient outcomes through unit research projects. Mrs. Lewis has precepted a variety of students in the Intensive Care Unit and has acted as a clinical and campus laboratory instructor. Mrs. Lewis is an active member of the Greater Fredericksburg Area Chapter of the American Association of Critical Care Nurses and a Make-A-Wish volunteer. Mrs. Lewis is currently seeking a Nursing, Master of Science specializing in adult health.

Christina Lichvar, RN, BSN – Ms. Lichvar’s experience lies in the acute pediatric care. Ms. Lichvar is interested in evidenced-based practice. Ms. Lichvar is currently seeking a Nursing, Master of Science specializing in pediatric health.

Charlette Ridout, RN, BSN – Mrs. Ridout’s experience lies in multiple nursing arenas including emergency room care. Mrs. Ridout has acted as a classroom instructor and a clinical instructor. Mrs. Ridout is currently seeking a Nursing, Master of Science specializing in adult health. ??? VI. References

About UMW Fast Facts. (n.d.). Retrieved September 31, 2009, from University of Mary Washington website: http://www.umw.edu/about/facts/default.php.

American Nurses’ Association (1965). A position paper. New York: American Nurses Association.

Andrusyszyn, M.A., Goldenberg, D., & Iwasiw, C.I. (2009). Curriculum development in nursing education. Second edition. Boston, MA: Jones and Bartlett.

Bolipata, K. (2008, November 11). Battling the nursing shortage. Free Lance-Star. Retrieved September 14, 2009, from http://www.fredericksburg.com/News/FLS/2008/112008/11072008/423485.

College Navigator. (n.d.). Retrieved October 1, 2009, from IES National Center for Education Statistics website: http://nces.ed.gov/COLLEGENAVIGATOR/? q=university+of+mary+washington&s=all&id=2 32681

Fredericksburg City Council. (n.d.). Retrieved September 14, 2009, from Fredericksburg, VA Government website: http://www.fredericksburgva.gov/Departments/CityCouncil/index.aspx.

Goals and Initiatives 2009-2010. (n.d.). Retrieved September 14, 2009, from Fredericksburg City Council website: http://www.fredericksburgva.gov/uploadedFiles/City_Council/GeneralContent/Goals_Initia tives09- 10.pdf.

Gould, P. (2009, April 1). Nursing program maxed out. Free Lance-Star. Retrieved September 14, 2009 from http://fredericksburg.com/News/FLS/2009/042009/04012009/450822

Hall, J. (2009, September 12). Health Care Competition Heats Up. Free Lance-Star. Retrieved September 12,2009, from http://www.fredericksburg.com/News/FLS/2009/092009/09122009/493283.

Hall, J. (2006, August 2). Physician-mayor Tomzak takes public-health post. Free Lance-Star. Retrieved September 12, 2009 from http://fredericksburg.com/News/FLS/2006/082006/08022006/210439/index_html?page=1

Hamilton, T. (2007, July 8). Hospitals: When we build them, will nurses come? Retrieved September 14, 2009, from The Free Lance Star website: http://www.fredericksburg.com/News/FLS/2007/072007/07082007/296274.

Keating, S.B. (2006). Curriculum development and evaluation in nursing. Philadelphia, PA: Lippincott & Wilkins.

Mary Washington Hospital (n.d.). Retrieved September 21, 2009, from Mary Washington Hospital website: http://www.medicorp.org/mwh/.

Mission Statement. (n.d.). Retrieved September 21, 2009, from University of Mary Washington website: http://www.umw.edu/bov/umw_mission_statement/default.php .

Opening of Spotsylvania Regional Medical Center. (n.d.). Retrieved September 14, 2009, from website: http://www.spotsrmc.com/.

Regulations Governing the Practice of Nursing: Virginia Board of Nursing. (2009). Richmond, VA: Commonwealth of Virginia.