Volume XXV111 Number 1 January 2007

IN THIS ISSUE...

VON Nurses Helping the Public Stay on Their Feet

Province Introduces New Telecare Service

New School Food Guidelines Sweeping the Nation

Tattoos for You?

Trust Awards $55,000 ARNNL www.arnnl.nf.ca Staff Executive Director Jeanette Andrews 753-6173 [email protected] Director of Regulatory Heather Hawkins 753-6181 Services [email protected] Nursing Consultant - Pegi Earle 753-6198 Health Policy & [email protected] - Council Communications Pat Pilgrim, President 2006-2008 Nursing Consultant - Colleen Kelly 753-0124 Jim Feltham, President-Elect 2006-2008 Education [email protected] Ann Shears, Public Representative 2004-2006 Nursing Consultant - Betty Lundrigan 753-6174 Ray Frew, Public Representative 2004-2006 Advanced Practice & [email protected] Kathy Watkins, St. John's Region 2006-2009 Administration Kathy Elson, Region 2005-2008 Nursing Consultant - Lynn Power 753-6193 Janice Young, Western Region 2006-2009 Practice [email protected] Bev White, Central Region 2005-2008 Project Consultant JoAnna Bennett 753-6019 Ann Marie Slaney, Eastern Region 2004-2007 QPPE (part-time) [email protected] Cindy Parrill, Northern Region 2004-2007 Accountant & Office Elizabeth Dewling 753-6197 Peggy O'Brien-Connors, Advanced Practice 2006-2009 Manager [email protected] Kathy Fitzgerald, Practice 2006-2009 Margo Cashin, Practice 2006-2007 Secretary to Executive Christine Fitzgerald 753-6183 Director and Council [email protected] Catherine Stratton, Nursing Education/Research 2004-2007 Louanne Kinsella, Administration 2004-2007 Secretary to Consultants Jeanette Gosse 753-6060 Jeanette Andrews, Executive Director (non-voting) & Workplace Representative [email protected] Program Secretary to Consultants, Patricia McCarthy 753-6088 ACCESS, & ARNNL Trust [email protected] Contents Secretary to Consultants Colleen Jones 753-6041 [email protected] President’s Message 1 Secretary & Data Renee Butler 753-6040 Message from the Executive Director 2 Processor, Registration [email protected] ARNNL’s New Honourary Members 3 Research Assistant Julie Wells 753-6182 [email protected] Community Advisory Committees 4 Advance Nursing Practice: News & Views 5 ACCESS is the official publication of the Association of Registered VON Nurses Helping the Public Stay on Their Feet 6 Nurses of and Labrador. Clinical Corner 7 ACCESS is published three times a year in January, May & September. ARNNL Education and Research Trust 8 Subscriptions are available for $25.00 per year. ARNNL’s Leadership Project: An Update 9 Leadership in Professional Practice 10 Editor New School Food Guidelines Sweeping the Nation 11 Pegi Earle Creative Design Canadian Nurses Portal: NurseOne 12 Arlene Mercer, Freelance Designer Province Introduces New Telecare Service 13 Advertising Sales Tattoos for You? 14 Wanda Cuff Young Inc. Nurses of Note 15 842 Conception Bay Highway Goings On 16 CBS, NL A1X 7T4 Phone: 834-7977 Fax: 834-4650 [email protected] New Registrants Fall 2006 18 Administration Patricia McCarthy, ARNNL On The Cover: Mr. Frank Fitzpatrick attending a regular footcare 55 Military Road St. John’s, NL A1C 2C5 appointment with VON Nurse Melanie Russell, RN, BN. Phone: (709) 753-6040 Fax: (709) 753-4940 Toll Free: 1-800-563-3200 E-mail: [email protected] www.arnnl.nf.ca PRESIDENT’S MESSAGE

In October I was honored and privileged to assume the role At the provincial level, your as President of the Association of Registered Nurses of Council will continue to pursue, refine Newfoundland and Labrador (ARNNL). The ARNNL is the voice and strengthen the strategic direction for registered nurses in this province and through its affiliation of the ARNNL. Our focus will be on with the Canadian Nurses Association (CNA), the voice of nurses achieving the vision: Healthy People in Iin the country. Newfoundland and Labrador through As your President, I represent you on the CNA Board of our mission focusing on excellence in Directors. My first CNA meeting was quite an experience. As I nursing, public protection, quality sat at the board table at "50 The Driveway", I was impressed by health care and healthy public policy. the work of nurses across this country; their leadership and Much of the work and deliberation of vision! The volume and depth of preparatory reading material Council, on your behalf, focuses on the Pat Pilgrim, and the scope, diversity and complexity of issues discussed were many current issues related to the RN, BN, MEd, MBA challenging. I will ensure our representatives' tradition of regulation of the profession, competency positive, effective contribution at the national level will standards, quality of work-life and advocating for healthy public continue. policy. Registered nurses remain the largest group of healthcare Health Human Resources (HHR) Planning is vital. The quality workers. Nurses will continue to be at the forefront of the of healthcare has been demonstrated to be highly correlated changes needed to effectively evolve nursing and healthcare to with the effective supply of registered nurses. ARNNL represents the 21st Century. CNA's "Toward 2020: Visions for Nursing" nursing in provincial and federal HHR initiatives which will (June, 2006) lays the groundwork for dialogue about nursing's continue to be a major focus as we move forward. part in planning for health care in the 21st Century and the role We are facing many challenges related to leadership issues nurses will play. It challenges all stakeholders to work in nursing. Nurses are concerned about lack of leadership and collaboratively to address the changes needed in education and mentorship. Nurse managers are concerned about scope of job design, and in moving the health system from an illness and responsibility and workload. ARNNL is developing a Leadership treatment model to one that focuses on "health" at the Strategy to inform and guide nurses, nurse managers and other community level. CNA advocates for Governments to invest in stakeholders on evidence based strategies to address identified improving the healthcare system by investing its leadership and issues. resources in three areas: Nurses have the competence and the credibility to positively 1. Appropriate investment in information and impact health care and client outcomes. In our province we need communication technology, as there is growing evidence to vigilantly advocate for further investment and developments that such investments improve patient safety. in Primary Health Care Renewal, the Provincial Mental Health 2. Pan Canadian Health Human Resources Planning involving Strategy and the Provincial Wellness Strategy. All of these interdisciplinary collaboration in education and practice initiatives are sound, relevant strategic directions that will as well as maximizing scopes of practice of various improve the health and wellbeing of the people of this province. disciplines. ARNNL had a reflective Annual Business Meeting (ABM) in 3. Reducing disparities and enhancing the employability of October. Dr. Marlene Smadu, President of CNA, challenged us on Canadians by addressing literacy as a determinant of "futurism" and the need for us to envision and shape the future health as well as a focusing on other determinants, such of nursing and health care. We were once more re-energized as as poverty. we networked and reflected upon our many accomplishments and initiatives and especially, the value and strength of our (L-R): Marlene Smadu, CNA President; Pat Pilgrim, ARNNL President profession. As we heard the testimonials of the three recipients and Sandra MacDonald, ARNNL Past President at of the Awards for Excellence, we were once more assured about Annual Meeting in October 2006. the real, positive and superb contribution of individual nurses in ‘making a difference’ in their care, workplace, community and profession. I look forward to working with your Council, ARNNL staff and with you as we continue the nursing journey and, together, we move our profession responsively, relevantly and effectively into the 21st Century.

1 ACCESS MESSAGE FROM THE EXECUTIVE DIRECTOR ARNNL Responds to or a little more than one month's operating expenses. This does not allow much room for ongoing budget Fee Increase Decision over runs. Nurses have told ARNNL through Jeanette Andrews, RN, MN surveys and other means that they have concerns about their workload and their ability to provide safe client care. A majority of nurses feel there is limited support to initiate positive change in As many of you are aware by now, Council's resolution to increase fees by $39 (over their workplaces. Nurses in long term a two year period) was not accepted by the 137 RNs who attended the ARNNL annual care have consistently stated that the business meeting held in St. John's in October 2006. (Note: the original resolution to structures are not in place to enable increase fees by $50 was amended because a proposed CNA fee increase was not accepted by them to work to their full scope of CNA voting delegates in June 2006.) ARNNL has responded to this decision by practice. It was for these reasons that implementing various strategies to generate alternate revenue and decrease the Quality Professional Practice expenditures. Environment Program was developed. In the area of revenue generation, fees for the Annual General Meeting to be held It has been clearly shown that the in St. John's in October 2007 will increase from $175 to $200 for early bird registration program can and does bring about and from $235 to $250 for late registration. positive change in the workplace. A portion of the proposed fee increase was specifically earmarked to support the Nurses have also told ARNNL that they Quality Professional Practice Environment Program. The decision has been made to support the development of a continue the program in the next budget year (2007-08) provided sufficient funding continuing competency program for can be obtained from sources external to ARNNL. ARNNL staff are working diligently registered nurses and that they want with several stakeholders to identify and apply for interim funding sources to keep the ARNNL to be more involved in advocacy program going. for primary health care and other In the area of expenditures, the decision was made to avoid eliminating, as much as components of healthy public policy. In possible, any of ARNNL's current programming but rather to proceed slowly or reduce order to continue to move forward in the level of activity in order to stay within the available budget. This will affect these areas additional financial development of ARNNL's continuing competency program, Council visits to regions resources are required. throughout the province, ARNNL's health policy work, National Nursing Week, the Council will meet face-to-face on Quality Professional Practice Environment Program, and the Workplace Representative st nd February 1 and 2 and at that time Program. Ordinarily ARNNL would have conducted a survey of public views on various will be asked to consider whether to aspects of nursing and the nursing profession in 2007-08 but this survey will be once again seek member support for a delayed. Decisions have been made to reduce or eliminate ARNNL activity in a several fee increase at the Annual General areas deemed not essential to ARNNL's mandate (e.g. approval of post-basic courses, Meeting in October 2007 so that ARNNL annual donation to the Canadian Nurses Foundation, Resource Manual, a reduced can move forward in the areas that number of Tuesday afternoon teleconferences, and non-renewal of subscriptions). nurses have identified as priority. It has now been more than five years since ARNNL has had a fee increase. During Clearly, it is not possible to maintain that time staff salaries have increased in line with government-approved increases for existing programming and introduce the GS and Hay Classifications and annual CNA fee increases have been implemented. new areas of activity in the face of a Inflationary increases have occurred in other areas. Over this five year period, through shrinking budget. ARNNL is working careful financial management, ARNNL has been able to maintain and even enhance hard to address the priorities identified services in areas such as supports to nursing practice, the regulation of nurse by nurses and now requires the support practitioners, and advocacy for healthy public policy. of nurses to continue this work. Even with the revenue generating and cost saving measures described above it is possible that ARNNL may run budget deficits in the current and the coming year. At “Knowing is not enough, we must apply. this time ARNNL has savings of approximately $200,000. On an annual operating Willing is not enough, we must do.” budget of approximately $1.6 million these savings represent about 12% of the budget Johann Wolfgang von Goethe

ACCESS 2 January 2007 ARNNL’s New Honourary Members

Since 1954, ARNNL has bestowed Honourary Memberships on 46 individuals who have made an outstanding contribution to the nursing profession through distinguished service to the people of the province and the development of the profession itself. At this year's annual meeting, honourary memberships were bestowed on two Registered Nurses: Patricia Careen from SPlacentia and Pearl Herbert from St. John's. Pat Careen, RN practiced in Placentia Health Care Center and the remote communities of Placentia Bay where she became affectionately known as "Nurse Careen" to all, as she touched the lives of most families in her thirty years of nursing in the region. A 1974 graduate of MUN's Family Practice Program, she was a leader in the development of the nurse practitioner role in the province. She gained a reputation as a consummate professional who was much admired and respected by nursing and medical students and professional colleagues through her career. Since (L/R): Pat Careen & Pearl Herbert 'retirement' Pat has embraced nursing on the coast of Labrador where with characteristic vigor she still practices regularly in community health centers from Mary's Harbour to Cartwright. A colleague noted, "She will never stop being a nurse!" Pearl Herbert, RN was an Associate Professor at Memorial University School of Nursing where she coordinated the Outpost Nursing and Nurse Midwifery Program. While Pearl retired from her position in 1996, she continued and continues to volunteer actively as a member of ARNNL's Nomination Committee, the Breastfeeding Health Coalition, Editor of the Atlantic Region Canadian Association of Schools of Nursing and the Association of Midwives of NL newsletters, and as an active member of the NL Public Health Association. However, it is her leadership and dedication to improving the health of childbearing women and children in our province, which "really" led to this nomination. Her curriculum vita lists many provincial, Atlantic region and national committees working on women's health issues. She is recognized as "the" resource person, historian and archivist about matters related to childbearing and maternal- perinatal care in the province. Moreover, throughout her career she advocated tenaciously for improved health services; especially, on matters related to women's health and midwifery. In 2003, the Atlantic Centre of Excellence for Women's Health recognized Pearl with its Leadership Award.

XXVIII (1) 3 ACCESS Community Advisory Committees "Input by the people, for the people served"

Public participation is a fundamental principle of primary health care (PHC). In PHC, individuals and communities are not merely consulted on their health services but they have a role in making decisions about the services: It is a 'partnership of equals' for the promotion of health. ARNNL interviewed Gerry Poirier and Dave Regular, co- chairs of the Central Health's -New World Island Community Advisory Committee (CAC), to see how this PHC principal was being put into action.

ARNNL: What is the Community Advisory Committee (CACs) structure in Central Health? Gerry Poirier and Dave Regular Mr. Regular: Existing CACs in Twillingate-New World Island and are con- tinuing. New CACs are now being rolled out in the NewWesValley and Springdale areas. CACs will be established in other areas in the region in the future. Our CAC is composed of 15 representatives of groups such as, the RCMP, clergy, rural secretariat, community ARNNL: What will PHC mean to your councils, school councils and administrators, and youth and senior's groups. community?

Ms. Poirier: I am the Board representative and Dave is the community representative and we Mr. Regular: I am excited about the are co-chairs of our CAC. The CACs are viewed as a public participation link to the Board of team approach; it improves access Trustees. to health care and our services are more continuous. Now we get to ARNNL: How is the CAC important to PHC for the provision of public input? see the right provider with better links to specialists and others team Ms. Poirier: The CAC gives the Board a place to go, to get the community's ideas and per- members. The recent provincial e- spectives. It is important to have this process; so, the community can liaise with the valuation showed that our area had people who make the decisions, Central Health's Board of Trustees. a high degree of information system capacity and that the sharing of Mr. Regular: The local issues that impact people's health are brought to the CAC and the health information through technol- CAC brings the people's issues to the Board. I think it is very important. ogy has helped the public see the ARNNL: What is your vision of health care? team approach to health care (e.g. An X-ray taken in Twillingate is read Mr. Regular: I see a renewed health care system which will improve access to primary on the spot by a radiologist in health care. A system that emphasizes health promotion, illness and injury prevention, and Gander). this is very key, a team-based, interdisciplinary approach to service provision. This system will achieve better health outcomes and it will be sustainable and cost effective. It sounds Ms. Poirier: I have to say the focus on like a 'tall order' but to quote the Bible, "Without a vision, the people perish." wellness rather than illness. People are starting to see the benefits of Ms. Poirier: I will add a couple of points. In the team approach we must use the appropri- lifestyle changes and our efforts are ate providers not just [Medical] Doctors. We have to change the mind set of 'seeing the helping to keep people well; so MD for everything.' Also in my vision, the system empowers people. People are allowed hopefully, we won't need the health to have control over their own heath. system until much later in our lives.

ARNNL: What are the challenges associated with involving the public and ensuring you are repre- Also when it is hard to recruit physi- senting your community? cians having a health team in place means there will be people to Ms. Poirier: One challenge is reaching marginalized groups, for example, isolated people, provide a quality health service. I people who can't read our newsletters, and people who don't understand the system. can still go see the Social Worker or Another is getting the views of a broad section of the population as with a shrinking the Nurse Practitioner, etc. volunteer pool (related to out-migration and an aging population), we have the same people 'at the table.' (Continued on page 5)

ACCESS 4 January 2007 by Betty Lundrigan, RN, MN, Nursing Consultant Advanced Practice and Administration

ARNNL Nurse Practitioner Standard's Working Group NP-PHC to Perform Driver Medical Examinations ARNNL has established a NP Standards Working Group. The Amendments to the Highway Traffic Act occurred at the working group will be: spring sitting of the legislature. These amendments allow NPs • reviewing and updating the current NP standards of PHC to perform driver medical examinations. NPs are practice, authorized to complete driver medicals for individuals whose • identifying areas of NP practice that require new medical conditions fall within the NP scope of practice. Dr. Roy standards development, and Lilly and Mrs. Jeannie Coombs, RN from Motor Registration • developing new standards and process expectations for Division will be providing an educational teleconference, NP prescriptive authority, diagnosis, consultation and January 18, 2007, 2 - 4 PM for NPs. Betty Lundrigan will send all collaboration, and ordering diagnostic tests in NPs a notice of this session and conference call access codes. accordance with the recommendations from the NP Mark your calendars now for this event. Regulations Review. NP Prescriptive Authority for Controlled Drugs The revised NP standards will identify the behaviors The Canadian Nurses Association continues to work on expected of NPs in the provision of safe, competent and ethical behalf of its member jurisdictions to resolve the issue of NP practice. (Note: For a summary of highlights from the NP authority to prescribe controlled drugs under the federal regulations review recommendations readers are referred to Controlled Drugs and Substances Act. There is agreement on ARNNL ACCESS, 27(1) September 2006.) most aspects of the policy framework Granting Authorities The first meeting of the working group was held on under the Controlled Drugs and Substances Act to Regulated October 4, 2006. There is wide representation on the working Health Professionals. Health anticipates the new group from the NP community, the College of Physicians and regulations to be published in the Canada Gazette, Part I, Surgeons of NL, the NL Pharmacy Board, employers and NP spring 2007. faculties. At the October meeting a number of sub-working groups were formed to start this work. The work on ARNNL Advanced Practice Position Statements requirements for collaboration and consultation, and The ARNNL Advanced Nursing Practice Advisory prescriptive authority will commence in early 2007. The Committee has revised the Nurse Practitioner and Clinical preparation of the NP standards is integral to the current Nurse Specialist position statements. The consultation with revisions to the Registered Nurses Act and the subsequent stakeholders occurred in November and the two revised changes to the regulations. Once they are drafted the documents are due to go to Council for Approval in February standards will be circulated widely for feedback. Stay tuned! 2007.

Community Advisory Committees (Continued) Mr. Regular: I think we have more stable health care in this region than we've ever had in our lives. I see a tremendous differ- ence.

Ms. Poirier: Yes, We've spent many Board meetings talking about how we were going to fill our staff positions. We used to be really concerned about our health services. These feelings have almost dissipated- it's amazing. Now we can focus on other things like health promotion. More people are involved now and working together for health. We do attribute it to PHC reform.

ARNNL: Central Health is definitely putting the theory of "input by the people, for the people served" into action. PHC is very well promoted and accepted by Central Health.

Ms. Poirier and Mr. Regular proudly explain: "Central Health does not see PHC as an add on service, rather it is the way the Board is going to do business!"

Dave Regular is a retired teacher, manager of his family construction business, an avid community volunteer and a member of health boards and groups since 1990. Gerry Poirier is a retired social work supervisor, an avid community volunteer and a member health boards and committees since 1986.

XXVIII (1) 5 ACCESS VON Nurses Helping the Public Stay on Their Feet Footcare is a matter of quality of life

by Darlene Billard- Croucher, RN, Executive Director & Shelia Dominaux, RN, Nurse Manager, Victorian Order of Nurses, St. John's, NL Branch

Did you know that the average based resources help nurses keep patients' mobile and person takes so many steps in a independent. lifetime that they could travel around VON also examined our practices related to infection the world twice? Each and every day, prevention and control. Health Canada and the Provincial feet carry our full weight. We often do not Infectious Disease Advisory Committee (PIDAC) have published think of them as part of our overall physical new guidelines on the disinfection and sterilization of health until a problem arises, but our feet play a vital role in equipment. Accordingly an autoclave system is to be used to our well being. Healthy feet keep us active and mobile. sterilize footcare instruments. Utilizing an autoclave helps The Victorian Order of Nurses (VON) recognizes the value of ensure that any heat-susceptible bacteria on instruments are quality footcare. Consequently in 2000, VON Canada initiated eliminated thus limiting the spread of infectious diseases Footcare Clinical Best Practice Teams linking experts across which could be potentially transmitted from client to client, the organization to promote evidence based practice and to service provider to client, or client to service provider. foster consistency across programs. Challenges associated with implementing these guidelines The Footcare Team comprised of VON nurses from across ...an autoclave system is to be used to sterilize the country turned to the literature to review our current footcare instruments. practices. The Registered Nurses Association of Ontario’s best practice guidelines were very helpful in leading this review. has included the cost, setting up autoclaves in convenient Consequently, VON implemented new guidelines for the locations for nurses to access, and providing access to an prevention and treatment of footcare complications for autoclave for nurses who work in remote rural locations. diabetics. We now use an evidence based assessment tool and VON branches have worked with hospitals and clinics to risk algorithm to assess clients' feet. We even have online make arrangements for appropriate use of and timely access access to resources, to make keeping on top of the evidence to autoclaves. Thus, the implementation of national easier. standards required a number of people to come together As VON nurses we provide foot care in clinics and in the and problem solve in order to meet the standards while home, depending on the clients' mobility status. Care includes respecting the challenges that community health nurses face clipping nails, treating corns, calluses, ingrown and thickened each day in clinics, community centers, client homes and nails, as well as preventative care and referral to other health schools. professionals. Our nurses have the knowledge and experience Each step of the way, the Footcare Best Practice Team was to deliver advanced footcare techniques such as: use of dermal used as the vehicle to look at VON standards, communicate drill in reduction of Rams Horn nails, prevention of ingrown the needs and issues of frontline nurses and help attain the nails, etc. Foot care may involve a one-time problem or resources to support excellence in clinical care. Building upon treatment for ongoing chronic disease (diabetes, heart this expertise VON is currently developing a training disease, circulation problems) making foot care an essential program for nurses who wish to educate others in footcare. part of everyday living. While nurses provide assessment, care This interactive training program will support high quality and advice to people of all ages, it is often the elderly and consistent footcare practices for all interested nurses. people with diabetes who have particular problems looking In 2005, nearly 30,000 people across Canada received after their feet. Therefore, all VON nurses in the province have foot care services through VON. VON's best practices in been trained in advanced footcare. footcare exemplifies how a national organization has All nurses need to be feet smart; for example, a minor foot successfully implemented clinically based proactive irritation for a client with circulation problems can become a guidelines in a key program that helps Canadians major complication if not addressed promptly. In addition, stay independent and on their feet. clients may have a loss of protective sensation and be unaware that there is a stone or foreign object in their foot or between their toes. Thus the use of a risk assessment tool and evidence

ACCESS 6 January 2007 Clinical Corner is an opportunity for nurses to share clinical tips about nursing care in relation to new procedures, drugs, equipment, or to share evidence discovered to support best practices and promote continuity of care. To contribute a tip, fill out the form on our website or contact Lynn Power at ARNNL House for assistance with writing your idea.

No More Tears Did you know that baby shampoo is gentle enough to wash eyes? We had a client who experienced chronic conjunctivitis due to eyelash problems. By washing her eyes daily with baby shampoo we were able to limit acute inflammation and greatly improve the quality of her life. Sharon Leonard, RN, BN, Community Health, Eastern Health

Freshly Cleaned not Freshly Squeezed Reminding clients to wash their hands before they check their blood glucose level using a glucose meter takes care of more than removing germs. False blood glucose levels can be recorded if a client has just eaten or peeled fruit with a high sugar content, as juice residue can remain on the hands if not washed. Juanita O'Leary, RN, Certified Diabetes Educator, Adult Diabetes Center, Eastern Health

A Great Web Resource for Thromboembolic Disease If you are caring for clients with or at risk for thromboembolic disease, check out this great web site - www.tigc.org. The site, from The Thrombosis Interest Group of Canada, is dedicated to furthering education and research in the prevention and treatment of thrombosis. With sections for both professionals and clients, it offers advice on such topics as anticoagulation, including oral Vitamin K Antagonists (i.e. Warfarin), Heparin, and Low Molecular Weight Heparin; DVT Treatment and Prophylaxis, including cancer and thrombosis; and others. It's a great resource! Charlene Downey, RN, MN, CON(C), Advanced Practice Nurse-Hematology, Eastern Health

Safety Tip Syringe Infusion Pumps- Delay in Detection of Downstream Occlusion Most syringe infusion pumps have a pressure sensor near the plunger which triggers an audible alarm when the line is occluded. A lag in detecting downstream occlusion could result in a delay in the administration of medications or an inadvertent bolus dose, if the occlusion is not carefully corrected. There have been reported cases of such delays linked to the use of large size syringes with low rate infusions and with certain lengths and types of tubing. Health Canada has issued several recommendations to help avoid this potential adverse event. To learn more visit Health Canada - Health Products and Food Branch web site …which is easily accessible through www.nurseone.ca.

Editor’s Note Clinical Corner is designed for nurses to share information that they have found in their experience to be practical, safe, and effective. ARNNL requires that the information provided reflect good nursing judgment. We do not confirm the validity of the submitter’s tip in the literature. ARNNL does not endorse any products identified in the submissions to this column.

XXVIII (1) 7 ACCESS education and ARNNL research trust Congratulations Award Recipients! Twenty years ago the ARNNL Education and Research Trust was This year, a total of 68 awards were presented: born! Its beginnings were small with 5 members and $5,000 to ƒ 33 bursaries for continuing education (conferences, award in scholarships. The Trust has come a long way since then. certification, and post-basic courses); In 2006, all 6300 members of the ARNNL are members of the Trust. ƒ 10 scholarships for Post RN BN study; Because of member support, the Trust was able this year to make ƒ 13 scholarships for Master and Doctoral study; available a total of $55,000 in scholarships, bursaries, and research ƒ 3 research grants; grants. Together with $3,000 from external sources (thanks to the ƒ 1 scholarship for RN Re-entry into nursing, and Canadian Cancer Society NL Division, NL Gerontological Nurses ƒ 8 scholarships for basic nursing study. Association, and St. Clare's Mercy Hospital Nursing School Alumni) The names of this year's recipients are found at the amount available in this year's competition totaled $58,000. www.arnnl.nf.caÆscholarships.

BN Post RN and Re-Entry Canadian Cancer Society Mona Fisher and Harry Lake recipients

Basic Nursing

Continuing Education

MN/PhD Study West Coast Recipients Pictures of awards ceremonies at Western Regional School of Nursing and ARNNL House in December 2006.

ACCESS 8 January 2007 Nurses continue to have their fingers on the pulse of Canadians

Health care and the environment remain the two most important issues facing Canadians, especially nurses, according to the findings of the Health Care in Canada Survey, the most comprehensive survey of Canadian public and health care providers opinions on Nursing leadership plays a critical health issues. role in the provision of quality "These findings are consistent with health care. Decreasing numbers CNA's futures work that shows that Canadians want to of nurse managers, lack of play a bigger role in their health, are concerned about the nurse's involvement in decision making, large spans of control impact of the environment on their health and embrace the for nurse managers, and gaps in clinical leadership were some idea of team-based models of care to improve access to of the concerns that led ARNNL to examine nursing leadership primary health care, "says Marlene Smadu, president of issues in more detail. Consequently ARNNL Council Canadian Nurses Association. established a number of goals on nursing leadership that are Nurses continue to have their fingers on the pulse of needed to insure excellence in nursing, public protection, Canadians likely because of the time they spend with quality health care and healthy public policy: patients navigating the health system. The responses of nurses correlate with those of the public more than any of • Knowledgeable, visionary nursing leaders. the other health professionals surveyed. • Practice environments support nursing leadership at all The 2006 survey finds widespread support for more levels. home and community care programs, equitable access to • The voice of nursing is heard within health care pharmaceuticals, ensuring the security of the Canadian organizations. vaccine supply, increased funding for research and a ban on • Adequate numbers of nurse leaders in management roles. schools selling junk food. • The role of the RN in clinical management positions is a CNA is a partner organization of the Health Care in desirable career option supported by: adequate Canada Survey which is available on www.hcic-sssc.ca preparation for the role, reasonable spans of control, and recognition for the workload and responsibility.

Over the last two years ARNNL has been working to achieve Discipline Decision these goals and address the issues of nursing leadership in This is to inform you of the action taken by the our province. Key informant interviews and focus groups Association of Registered Nurses of Newfoundland and were conducted with over 200 registered nurses in NL to Labrador (ARNNL) following a decision rendered by the identify leadership issues and explore views on potential Professional Conduct Review/Discipline Committee of the ARNNL. The decision resulted from a Hearing held actions that the profession can do to enhance leadership pursuant to Section 21 of the (Newfoundland) Registered capacity within the nursing community. To this end ARNNL is Nurses Act. developing a Leadership Strategy that builds on the results of Terrance Harvey ARNNL #14507 the focus groups and key informant interviews. The Strategy As a result of a hearing held on October 18, 2006, will identify directions and actions for ARNNL to support the Terrance Harvey was found to be in breach of Sections 21 expansion of nursing leadership capacity. RN's Views on (2)(a) dishonesty and (2)(c) a habit or illness making the Leadership: A Report of ARNNL's Leadership Focus Groups (2006) nurse unfit to care for the sick, and 21 (2) (d) conduct was released in early December and is available on that does not conform to the standards of the Discipline Decision www.arnnl.nf.ca. It is anticipated the Leadership Strategy will profession, of the Registered Nurses Act. be released in early 2007 for implementation over the next The Panel who oversaw the hearing ordered that the three years. registration of Terrance Harvey # 14507 be revoked effective immediately.

XXVIII (1) 9 ACCESS Leaders in Professional Practice ARNNL’s Workplace Representatives

Workplace Representatives (WPR) volunteer to represent WARNNL by supporting professional nursing practice and communicating information in their workplaces. Reps complete an orientation and a workshop on Leadership in Professional Practice to prepare for the role. Ongoing support and development is provided through regular meetings and education sessions, for example, this past fall Reps attended our annual meeting, The Leader in Me workshop, and a regular representative meeting. Our Reps are introduced in ACCESS, so you will get to know these important volunteers!

Cathy Cake is a Workplace Rep in the Dialysis Program, Eastern Health. She is the clinical educator Sharon McDonald is the Workplace Rep on for the dialysis units at the General Hospital, 4NB General Surgery Unit, General Hospital, Waterford Hospital, and the and Eastern Health. The unit has 42 beds for general satellite sites. Since graduation from the and plastic surgery. It also houses the only Burn General Hospital School of Nursing in 1985, Cathy Unit in the province. She is a graduated of the General Hospital completed a BN at MUN School of Nursing, MUN's Nursing School of Nursing and subsequently, completed courses in Leadership Program and in 2001; she earned CNA's Certification conversational French and Diabetic Education. Sharon gets in Nephrology Nursing. She is active in the Canadian Association involved- She was a shop steward for her NLNU branch until of Nephrology Nurses and Technicians and was a member of the 2000 and a member of the first ARNNL Quality Professional 2006 provincial conference planning committee. As the clinical Practice Environment pilot group. She is active in the Canadian educator she is responsible for the education needs of 60+ Association of Burn Nurses where she is serving as a Councilor. staff that provide dialysis for 150 patients. She enjoys being Provincially, she is the President of the Burn Nurses involved in education and research to support staff and improve Association. It is not surprising that Sharon notes, "The one patient care. Cathy "feels good about the difference we [dialysis thing that is near and dear to my heart is our Burn Unit. When team] make in our patients lives." providing burn care, you develop a close relationship with your patient. I really enjoy caring for my patients and making a Joan Goudie is the Workplace Rep with the difference in their lives." Government's Department of Health and Social Development. Joan is the public health and Dawn Walsh is the Workplace Rep at Bay St home care nurse for Postville, an aboriginal George Long Term Care Centre, Western Health community on the Labrador coast with a population in Stephenville Crossing. The Centre is a 112 of 250. She is one of two RNs in the community. Joan bed facility with a protective care unit and three graduated from Western Regional School of Nursing in 1997, chronic care units. There are 28 RNs and 65 LPNs on completed the VON Footcare Course and is completing a BN staff. Dawn, a LPN graduate of Nova Scotia Community College, from MUN. She works with a variety of public health programs practiced seven years and then "I finally followed my heart and in child health, school health and elder health, and provides went back to school to become a RN." In 2004, after leaving a home care. She is a member of the locally developed 'Inspiring job and her family, she graduated with an Honors' Nursing Young Women' program, whereby, women meet weekly with Diploma from St Lawrence College in Ontario. She has plans to girls aged 11-17 years to "inspire" them to make healthy pursue a BN and CNA's Certification in Gerontology Nursing. choices, plan their careers; and generally, to build self-esteem. Dawn "really and truly enjoys going to work each day…I enjoy Joan, an descendent, feels good about being able to work seeing my residents and I feel good about making a difference and help people of her own culture…"with the position I hold I in their lives. It makes me happy that I can bring a smile to can help create a healthier generation for my own people." their faces." For more information visit www.arnnl.nf.ca JAbout ARNNL J Workplace Program or call Pegi Earle.

ACCESS 10 January 2007 by Glendora Boland, Provincial Nutrition Consultant, Department of Health & Community Services

It's sweeping the nation; schools are jumping on board nutritious and 59% of to help make a difference in the health of our children. It schools did not have any makes sense. Research abounds telling us what we already specific food policies or guidelines. Clearly, something know; good nutrition helps children and teens grow, stay needed to be done. healthy, be active and learn better. To support this, in June In May 2005, the ARNNL united with other health 2006, provincial School Food Guidelines were released by professionals and released the discussion paper, "Healthy the Department of Health & Community Services and the Eating & Active Living : Taking Action to Address Obesity in Department of Education. Children & Youth". The report highlighted the need for The School Food Guidelines set a nutritional standard provincial school food policies and increased opportunities for all foods sold or served at schools in our province. These for physical education. Guidelines are based on "Canada's Food Guide to Healthy Fast forward to 2006 as rising obesity rates have rung Eating". Foods are divided into 'Serve Most' or 'Serve an alarm bell among health professionals and the public Moderately' categories. The guidelines also include a list of alike. The time has arrived to move together to make a foods that are not part of these categories and not difference. Teachers, administrators, students, school recommended to be served or sold in schools. councils, caterers, parents, other community partners and Many schools are already offering more healthy choices government need to make it easier for our children to make in the cafeteria and canteen, at meetings, sports and special healthy choices while at school. Our school communities events. School districts, school administrators, caterers and wanted change but asked for leadership from government. other community partners are working together to help The "Healthy Students, Healthy Schools" initiative is all support healthy living in our schools. about that. This initiative is a priority in Achieving Health & What got the ball rolling? In October of 2000, the Wellness: A Provincial Wellness Plan for Newfoundland and Coalition for School Nutrition completed a provincial Labrador. The initial actions on school health focus on wide survey of all K-12 schools to determine the kinds of school meals, cafeteria guidelines, recreation opportunities, foods sold and served in schools. The survey netted a 72% training for members of the school community, enhanced return rate and the evidence was clear; only 46% of the curriculum, student involvement and support for parents foods offered in school cafeterias were considered and educators.

If you are interested in learning more about your school community check out our website at www.livinghealthyschools.com

For more information about the Provincial Wellness plan and how it relates to your community visit www.gohealthy.ca

XXVIII (1) 11 ACCESS ACCESS 12 January 2007 Province Introduces New Telecare Service

The Government of Newfoundland and Labrador is committed to records. The Department of Health and providing quality, accessible primary health care services to all Community Services will be monitoring residents of the province. HealthLine on a monthly basis to ensure that Meeting this commitment, Health and Community Services provincial performance standards are being Minister Tom Osborne officially launched the province's new toll-free met. telephone service, HealthLine, on September 27, 2006. HealthLine is HealthLine's main office is located in St. now providing Newfoundlanders and Labradorians with access to Anthony. Two satellite sites are located in health advice and information, 24 hours a day, 7 days a week, Stephenville and . regardless of where they live. As part of the Primary Health Care Atlantic Primary health care is the first level of contact people have with the partnership, Newfoundland and Labrador has health and community services system, such as a family doctor, nurse an agreement with the Province of New practitioner, community health nurse, paramedic, or social worker. A Brunswick regarding the establishment of the new addition to the healthcare community, HealthLine benefits patients contact centre in this province. As part of this with non-emergent situations or minor symptoms regardless of where agreement, Clinidata, the largest telecare they live - ultimately improving access to health care services in rural service provider in Canada, will be managing and remote communities. HealthLine. Clinidata is among the top five HealthLine's specially trained registered nurses use computerized providers of telecare services in the world and standardized clinical guidelines to triage calls and rapidly identify ... the nurse collects pertinent information callers' needs. Through a telephone assessment that lasts an average of and assesses the caller's needs. 10 minutes, the nurse collects pertinent information and assesses the caller's needs. Based on the assessment, the registered nurse will currently provides services to populations in provide symptom-specific information, education, advice on self-care, New Brunswick, Ontario, the Northwest or help determine if the caller should make an appointment with a Territories, and the Canadian family physician, go to a clinic, contact a community service or go to a Armed Forces. hospital emergency room. The registered nurse may also direct the Over the last decade, Clinidata has caller to an automated library of recorded health information. All calls implemented many formal and centralized tele- are free of charge and an MCP card is not required. nursing services throughout the country. With HealthLine is not an emergency line. Individuals should always call Clinidata operating the HealthLine service in their local emergency number or 911, where available, in the case of Newfoundland and Labrador, nine of the 13 emergencies. HealthLine is also not meant to replace physicians; provinces and territories now have province- therefore, the service does not include writing prescriptions or wide telecare service available, and that number ordering medical tests. is sure to grow until all Canadians have access to In addition, HealthLine nurses do not make diagnoses. The health care 24 hours a day, 7 days a week. registered nurses follow computerized standardized guidelines and If you have a health-related issue or nursing practices of Newfoundland and Labrador. They provide question, call HealthLine at 1-888-709-2929. symptom advice and health information and guide the caller to the For more information about the HealthLine most appropriate action based on the description of the caller's service, visit www.yourhealthline.com or contact symptoms at the time of the call. Joy Stuckless, RN, BN, Project Manager In keeping with standard professional health care practices, all calls Selfcare/Telecare Project, DHCS, 709 729-4826, [email protected] or Marlene M. Penney, RN, and records are confidential. When a person calls, the nurse asks the CNCC(C), Director of Operations, NL Healthline, caller's name; however, this information is optional. A record is kept of Clinidata Corporation, every caller and is managed in the same manner as standard medical 709 454-4133, [email protected].

XXVIII (1) 13 ACCESS Tattoos: For You? By Kristine Feaver-Noseworthy RN, CPN(C), OT Bense Medical Aesthetics

of the orbital area. While the basis of these reactions is not clear, some suggest it is the result of an interaction with the metallic components of some pigments. Consequently, if an MRI is recom- mended for an individual possessing a tattoo or permanent A notable new fashion trend is the tattoo. One in makeup, they are advised to inform the technician or radiologist every seven people in North America has at least performing the test, so that appropriate precautions can be taken, one! In addition to regular tattoos, permanent make- Diagnostic imaging staff at the General Hospital, Eastern Health A require patients to complete a Magnetic Resonance Procedure up is also available. Screening form declaring they possess tattoos and/or permanent Procedure and Risks makeup. Tattooing involves the introduction of ink into Concerns associated with the introduction of epidural anesthetics the skin utilizing a needle which penetrates the through tattoos on the lower back have also been noted. The FDA has outer dermal layers up to 3,000 times per minute. indicated that there is no conclusive evidence of complications arising Tattoos are minimally invasive procedures but as a result of the introduction of an epidural needle or other anesthet- still have potential risks. ic injections through tattooed skin. However, some practitioners chose to avoid a tattoo where practical. Infection: Non-sterile equipment/needles can transmit infectious diseases. Exposure to Tattoo Removal Hepatitis B & C, HIV, tuberculosis and other my- While tattoos are meant to be permanent, with new laser tech- cobacterium bacilli, syphilis, malaria, and nologies their removal is now possible. leprosy can occur in addition to localized infec- tions. To mitigate the infection risk, use only The removal process involves the administration of intense pulses reputable tattoo artists. Health professionals of laser light which are absorbed by the tattoo pigment. This laser light handing patients with tattoos should also be vaporizes/fractures the tattoo inks provoking a response similar to a cautious to avoid accidental needle pricks. low grade inflammation which allows the body to process and remove small areas of altered pigment. Treatment times and intensities will Allergic Reactions: Reports of allergic reactions to vary from 15-45 minutes, and often six or more treatments are tattoo pigments have been rare, however the required. Patients have described the effect as similar to a short 'snap' U.S. Food and Drug Administration (FDA) has from a rubber band. received reports of adverse reactions associated with some ink shades. While results with this laser technology have been very positive, the great variability in the kinds, mixtures and quantities of ink used Granulomas: Nodules can form around the in tattoos, and in individual patient responses, means that results particles of tattoo pigment, simulating a foreign can vary. Newer tattoos with brighter inks usually need extra treat- body reaction. ments. Multi coloured professional tattoos especially on the lower Keloid formation: Persons who are prone to de- legs, tend to respond more slowly. veloping keloids (scars that grow beyond normal boundaries) also run this risk from tattoos. Conclusion Concerns have been raised over possible skin The wisest counsel a nurse can give a person considering a tattoo reactions to MRIs. Rare reports have been made of is to remember that they are meant to be permanent. Think not simply transient swelling/burning or redness in the of what is 'cool' today but how he or she will feel with the same tattoo affected areas, during or following an MRI. It has or makeup in old age. Stress the importance of obtaining tattoos at a also been suggested that tattoo pigments can clean and credible location and inform those who may have made a interfere with the quality of MRI images. These hasty decision that all is not lost, as tattoo removal is now available. For complications appear to occur primarily with more information contact Kristine Feaver-Noseworthy, Clinical Director, persons with permanent eyeliner undergoing MRIs Bense Medical Aesthetics, 722-4060 or www.bense.ca.

ACCESS 14 January 2007 ARNNL Awards for Excellence were presented to three Registered Nurses at the fall annual meeting.

Recipients of our awards for excellence are M. Hackett A. Gaudine K. Fitzgerald nominated by colleagues and selected through a

rigorous peer review process. Since established in Marge brings to her teaching. Throughout her 28 year career 1992, twenty-five ARNNL members have received Marge has been committed to improving the quality of nursing education at the local, provincial, and national level. In the awards. The award is a white porcelain vase with a 1990s she, and five other faculty members from the hospital schools of nursing, successfully crafted the first "collaborative" figurative sculpture of ARNNL's logo. BN curriculum of its kind in the country. Since then she initiated other innovative program revisions in response to Kathy Fitzgerald- Excellence in Nursing Practice emerging trends in health care. It is not surprising that faculty Kathy Fitzgerald is the Patient Care Coordinator at the Dr. credit Marge's leadership as instrumental in achieving the gold Bliss Murphy Cancer Center, Cancer Care Program, Eastern standard/ 7 year accreditation for MUN's BN (Collaborative) Health. It is her commitment to patients and families, her and BN (Post RN) programs. Marge Hackett is an exemplary caring and compassion, her expertise as an oncology nurse educator, an innovative leader, and consummate professional and her contribution to the development of oncology who demonstrates excellence in nursing education. nursing practice that led to her nomination for this award. Dr. Alice Gaudine- Excellence in Nursing Research Kathy is described as "the epitome of professional nursing". She is a compassionate and committed oncology nurse who Dr. Gaudine's expertise in research and contribution to the continually goes above and beyond what is expected. Kathy development of future nurse researchers led to her nomination is a leader who works with colleagues and patients to create for this award. Alice is an Associate Professor at Memorial new and innovative approaches to care delivery at in the University School of Nursing where she recently completed a cancer program, for example, she was a major player in term as Associate Director of Graduate Programs and Research. creating the "Our Living Room" and the "Look Good, Feel She also holds a joint appointment with Memorial's Counseling Better" programs. Kathy can also be counted on to lead the Centre and an adjunct appointment with Dalhousie University advancement of nursing standards at the local, provincial School of Nursing. Her interests and areas of expertise include and national levels through her participation in the mental health nursing, ethics, leadership and management, and Oncology Professional Practice Committee, Canadian program development and evaluation. Dr. Gaudine has been Association of Nurses in Oncology and the National very successful in obtaining funding as a principal investigator Ovarian Cancer Association. Kathy Fitzgerald is an from two major research funding agencies that puts her in the exemplary practitioner, mentor, innovator, and builder who top ranks of researchers in Canada: the Social Sciences and demonstrates excellence in nursing practice. Humanities Research Council and the Canadian Institute of Marge Hackett- Excellence in Nursing Education Health Research. Alice takes every opportunity to mentor It is Marge Hackett's commitment to improving the the upcoming generation of graduate student nurses. She quality of nursing education and her dedication to her has supervised over 22 Master of Nursing students through students that led to her nomination for this award. Marge is their practica or theses. Alice has a very impressive record of an Associate Professor at Memorial University School of research dissemination. Her research has been quoted in Nursing (MUN) where she recently completed her second scholarly work and nursing textbooks. Dr. Alice Gaudine is a term as Associate Director of Undergraduate Nursing mentor for nurse researchers, an expert research methodologist Programs. Marge's contribution to nursing education is and a knowledge generator who demonstrates excellence in exemplary. Student evaluations note the high quality, com- nursing research. prehensive knowledge, thoughtful and reflective approach by Pegi Earle, RN, MScN

For more information on the process to nominate a colleague for an ARNNL Award for Excellence in Nursing visit www.arnnl.nf.ca

XXVIII (1) 15 ACCESS Goings On

Looking Beyond the Hurt: A (L-R): Susan Froude, Nursing Educator, Western Regional School of Nursing; Dr. Anne Kearney, Coordinator & Faculty, Office of Research, Centre for Nursing Studies; Dr. Nancy Edwards, Service Provider's Guide to CHSRF/CIHR Chair, Professor, School of Nursing and Director, Community Health Research Elder Abuse has been updated (May Unit - University of Ottawa; Trudy Read, Manager - Policy Integration, Western Health. 2006). Published by the Seniors

In the sweltering heat of +30ºC temperatures last summer, Resource Center of NL with the support three ARNNL members participated in a Research Internship of the RCMP, RNC and 13 professional at the University of Ottawa. As part of Dr. Nancy Edwards' organizations, this desk top reference Canadian Health Services Research Foundation (CHRSF) and helps service providers to identify and Canadian Institute of Health Research (CIHR) Chair, 25 support victims of elder abuse. It nurses from across Canada and two colleagues in Jamaica provides a concise overview of the became immersed in the research of Multiple Interventions for indicators of abuse, relevant legislation Community Health. During the three months, interns linked and regional resources for seniors. with interdisciplinary investigators and decision-makers, wrote Download a copy from manuscripts for peer review, joined research teams in Ottawa, www.seniorsresource.ca/beyond.htm or developed new research ideas, and learned many practical skills order a copy at [email protected] to build a research program. The interns acknowledge the ($10 + $3 shipping). support of their employers and Dr. Edwards for a valuable and exciting learning experience.

Goldie White Graduates as NP-PHC Since 'retiring' as Director of Nursing from Notre Dame Bay Memorial Hospital in Twillingate, ARNNL Past President Goldie White worked as a Regional Nurse and is currently practicing in on the Labrador coast. She decided she needed Nurse Practitioner (NP) preparation. After 15 months of enthusiastically studying five hours a day and working full time, Goldie graduated with 12 other RNs from the NP-Primary Health Care Program at the Center for Nursing Studies in November 2006. Goldie has three sons, all are Registered Nurses and all are married to RNs! Sons Fletcher and Tyler (in photo) are practicing in the Sarasota, Florida area and youngest son, Denver is in Whitby, Ontario. Goldie reports Labrador Grenfell Health and colleague Joy Barrett, RN were very supportive of her studies. Goldie, you are an inspiration to us all!

ACCESS 16 January 2007 Goings On

Cottage Hospitals: Celebrating 70 Years of Caring The Rooms and the Newfoundland & Labrador Health Archive & Museum launched the opening of a new exhibit at the Rooms entitled Cottage Hospitals: Celebrating 70 Years of Caring. From the cradle onwards, a unique system of nineteen cottage hospitals, six nursing stations and a clinic on a boat once provided quality medical care all over Newfoundland and Labrador. This exhibit takes you inside their walls to share the stories of the dedicated people who worked in these distinct hospitals. CNF SCHOLARS

Renee Fagan is enrolled in the BN (Fast Track) program at MUN School of Nursing and was (L-R): Kerri Piercey, Curator Health Archive and Museum; awarded a Canadian Nurses Foundation (CNF) Kay Daley, RN, Founding Chairperson; Erin Russell, Manager, BN Scholarship. Moira O'Regan-Hogan, Renee Fagan NL Health Archive and Museum. Community Health, Eastern Health received a CNF Certification Award for Community Health Nursing and Mercedes Sellars, Mental Health Crisis Centre, Eastern Health received a CNF Certification Award for Psychiatric/ Mercedes Sellars Mental Health Nursing. Congratulations!

Globalization Workshop

In October, ARNNL hosted a CNA workshop Globalization and its Impact on Nurses and Health Systems for RNs & The Centre for Nursing Studies is students interested in very pleased to announce they women's health and the recently received confirmation that advancement of international each of their Post Basic Programs for nursing and health issues. Registered Nurses (Gerontology, Critical Care and Perioperative Nursing) has been granted 9 transfer credits toward the Athabasca University Post-RN CANO National Conference, Bachelor of Nursing Program. September 14-17, 2007, Delta Hotel & When developing and delivering the CNS’ Post Basic Convention Centre, St. John's. For information contact programs, we assured nurses we would pursue Bernadine O'Leary, 777-7601. university credit recognition. Many RNs from our province enroll in the Athabasca Nursing Program and Discover the Road to Learning…on the Rock, could benefit from this articulation agreement. September 27-29, 2007, Delta Hotel & Convention Centre, St. John's, hosted by the Learning Disabilities If you have any questions please call Sharon Fitzgerald, Association of Newfoundland and Labrador. For Associate Director, Centre for Nursing Studies (777-8168) or information contact [email protected]. email ([email protected]). Visit www.arnnl.nf.ca for a list of other educational events.

17 ACCESS Congratulations New Registrants! Fall 2006 BN Fast Track Graduates MUN School of Nursing Amminson, Audrey Calgary, AB Barber, Deanne Corner Brook Beattie, Scott St. John's Bussey, Sheldon St. John's Candow, J A Stewart Grand Falls-Windsor Carey, Janine Ottawa, ON Chaffey, Karen Grand Falls-Windsor Coish, Michelle Paradise Coleman, Sandra Corner Brook Colson, Elizabeth Corner Brook Dillon, Sean St. John's Durdle, Susan Pasadena Evans, Robert Paradise Garcin, Shelley Pasadena Hart, Jennifer St. John's Hatcher, Candace Rose Blanche Higgins, Lorelei Humphries, Nancy Wesleyville McDonald, Stacy Park, Blaine Corner Brook Power, Krista St. John's Ryan, Jennifer Doyles Samson, Janelle D'Escousse, NS Sheppard, Joy Stag Harbour Sheppard, Vicki Lark Harbour Simms, Diana Hickman's Harbour Smith, Heather Gander Spracklin, Lori Corner Brook White-Gosse, Molly Corner Brook Wilson, Melissa St. John's Nurse Practitioner - Primary Health Care Graduates Centre for Nursing Studies Barbour, Lori Lumsden Beeso, Eileen (Kennedy) Bell Island Budden, Brian St. John's Budden, Michelle (Kelly) Placentia Button-Garland, Juanita Caplin Cove, Conception Bay Cahill, Denise Mount Pearl Cochrane, Bill Bonds Path, Placentia Dumaresque, Janet Lance-au-Clair O'Reilly, Sheila (Brennan) Placentia Samson Gagnon, Bonnie St. Peter's, NS White, Goldie (Bath) Makkovik Willcott, Valda St. Alban's

ACCESS 18 January 2007 ARNNL Education & Research Trust CONFERENCE Nominate A Colleague FUNDING Every year at our annual meeting ARNNL presents awards for excellence to Registered Nurses who demonstrate excellence in The Trust will be holding a second nursing practice, administration, education, &/or research. competition for conference funding in We know there are many RNs who demonstrate the spring 2007. Applications will be professional excellence on a daily basis and are very considered for conferences held between deserving of an ARNNL Award for Excellence in January 1, 2007and June 30, 2007. Nursing. However, in order for 'excellent' nurses to be The deadline for application is considered for this accolade they must be nominated. That's where you come in… April 15, 2007. Take this opportunity to nominate a colleague for an award for excellence in nursing practice, or education, Applications are available at or administration, or research… or nominate a www.arnnl.nf.ca colleague in each category! or contact Patricia McCarthy at Visit our web site to learn more about the criteria and ARNNL House nomination process. We want to be inundated with nominations by the May 30th deadline!

Award for Excellence nomination forms are available on www.arnnl.nf.ca=awards programs or contact Jeanette Gosse at ARNNL House.

XXVIII (1) 19 ACCESS ACCESS 20 January 2007 XXVIII (1) 21 ACCESS Renewal forms will be mailed by the end of January. Please contact ARNNL if you have not received your form by the middle of February. Nurses paying through payroll deductions must follow your employer’s instructions for submitting your application form. All forms and fees must be received together at ARNNL House on or before March 30, 2007 (as March 31 is Saturday). Failure to renew your license by the deadline will result in payment of a late fee, and possibly a penalty fee. Your employer may also impose a form of discipline/penalty. Nurses on a 12 month leave of absence may be eligible to obtain a non-practicing membership. Visit www.arnnl.nf.ca for more details on the renewal of your practicing license or to obtain a non-practicing membership. Information will be enclosed with the renewal form. RNs remember your license expires March 31, 2007!!!