The Washington Nurse

Don’t let them silence us Winter 2018 Volume 47, No. 4 A publication of the Washington State Nurses Association

S urprise billing survey

Opioid f act sheets

Wh y RNs are suing the EPA DON’T LET THEM

Volume 47, No. 4 SILENCE US

Winter 2018 WSNA UNION 6 Leadership CNE Summits credits Each event

Jan. 27 Pacific Lutheran University, Tacoma In 2018, WSNA’s annual union leadership conference will be broken out into several March 18 and 19 regional one-day events that we’ll be Campbells Resort, Chelan bringing to a city near you. April 14 Join us for a day of personal and professional development Red Lion Riverside, Spokane and come away with the tools needed to make a difference. May 19 We’ll be asking you to use your own personal experiences and Teamsters 58, Vancouver values to understand how workplace violence, staffing and the attack on workers’ rights will impact you both personally and June 2 professionally. Good Shepherd Center, Seattle Hear from RNs around the state and country speak about the June 10 and 11 potential impact of the three topic areas, network with other Campbells Resort, Chelan RNs working in your community and begin making a difference. Sept. 8 Join us for a fun and interactive opportunity with the best and Red Lion (Columbia Center), Kennewick brightest minds in nursing to make plans for our future and take Sept. 30 and Oct. 1 your career to the next level. Campbells Resort, Chelan ■ Visit www.wsna.org/leadership for more details and to register. Nov. 3 Skagit Casino, Mt. Vernon SAVE THE DATE!

LEAD THE WAY in WASHINGTON Healthcare STATE NURSES Designed by nurses with CONVENTION current practice needs in mind, Western’s RN- to-BSN Program ■ Top-tier healthcare & retirement benefi ts prepares you for the future ■ because a healthy team equals great patient care Sarah Bear of healthcare. ■ Competitive compensation EdD, MSN, RN, CNE Program Director ■ Full time and part time shifts MAY 1–3, 2019 ■ Relocation reimbursement considered Tulalip, Washington wwu.edu/bsn Active Minds Changing Lives AA/EO

Are You a Seasoned Labor & Delivery RN?

Picture Yourself at Valley’s Birth Center! Every year nearly 4,000 babies in South King County get their start at Valley. Our Birth Center offers state-of-the-art care, soothing surroundings and a compassionate, family-centered experience. Level III NICU nurses are a tightly coordinated team working alongside highly respected, neonatal specialists from Seattle Children’s and UW Medicine. Apply online at valleymed.org/careers Top-tier benefi ts • Competitive compensation • Full & part time shifts • Relocation reimbursement considered EXCLUSIVE SAVINGS ON DENTAL CARE FROM

Bright Now! Dental and WSNA are pleased to be partnering together to provide WSNA members and their families with exclusive savings for dental care. This is not an insurance plan, and participation is voluntary. You save and it works whether you have dental benefits or not!

BRIGHT NOW! DENTAL FEE COMPARISON | EXCLUSIVE WSNA PRICING | CASH BASIS

UNION MEMBERS YOUR POTENTIAL COST YOUR COST AT A BRIGHT SAVINGS AT A BRIGHT PROCEDURE NOW! DENTAL OFFICE* AT ANOTHER PROVIDER* NOW! DENTAL OFFICE* BEFORE DENTAL BENEFITS ARE APPLIED BEFORE DENTAL BENEFITS ARE APPLIED BEFORE DENTAL BENEFITS ARE APPLIED

Initial Oral Exam & Digital X-rays $288 $29 $259

Teeth Cleaning In absence of periodontal disease $132 $68 $64

Filling (2-surface Composite Resin-back tooth) $296 $145 $151 Root Canal (Molar 3-canals) $1,540 $740 $800 By General Dentist. If Specialist is necessary fees will vary.

Crown (Porcelain Fused to High Noble Metal) $1,420 $755 $665

Denture (Complete Lower) $1,680 $905 $775

*Source: 2014 Fair Health Data. Other exclusions may include and are not limited to implants, implant crowns, crowns with gold, specialty services and crowns/onlays/inlays that are all porcelain.

Bellevue-Crossroads Issaquah Maple Valley Puyallup Tukwila 15600 NE 8th St., #A1 775 NW Gilman Blvd., Ste. D 24040 SE Kent Kangley Rd., Ste. E200 10228 156th East St., Ste. 101 16400 Southcenter Pkwy., Ste. 103 Jennifer (Jungjin) Park Chu, DDS; Ahyoung Amber Kim, DDS; Chad Carver, DDS; Anit Mathew, DDS; Jimin Park, DMD; Richard Guzha, DDS; Hardeep Dhaliwal, DDS; Theressa Mah, DDS; David To, DDS; Shelby Beattie, DDS; Ted Hughes, DDS Lisa Uglialoro, DDS, MS; Randy Ball, DDS; Kwan Lee, DDS; Shelby Beattie, DDS; Monika Mahajan, DDS; Sean Monaghan, DDS; Vahid Ted Hughes, DDS; Vahid Atabakhsh, DDS; 425.372.0036 Ted Hughes, DDS Ted Hughes, DDS; Vanila Choudhry, DDS Atabakhsh, DDS; Yumi Abei, DDS Lisa Uglialoro, DDS, MS 425.507.1000 425.578.9152 253.840.0540 206.575.0400 Bellevue-Factoria 3820 124th Ave. SE Kent Northgate Silverdale Vancouver-Fisher’s Landing Chad Carver, DDS; Muzaffer Cakir, DDS; 25610 104th Ave. SE 401 NE Northgate Way, #570 10404 Silverdale Way NW, #E109 3250 SE 164th Ave., Ste. 102 Randy Ball, DDS Chong Lee, DDS; Hardeep Dhaliwal, DDS; Baljinder Kaur, DDS; Hardeep Dhaliwal, DDS; Michael Mitchell, DDS; Brandon Johnson, DDS; Hard- Austin Phoenix, DDS; Peter Vu, DDS James Liu, DDS; Lisa Uglialoro, DDS, MS; Randy Ball, DDS; Shelby Beattie, DDS; eep Dhaliwal, DDS; Kenny Tran, DDS; Rpyal Aaby, DDS 425.201.1700 Randy Ball, DDS; Yumi Abei, DDS Vanila Choudhry, DDS; Lisa Uglialoro, DDS, MS 360.891.1999 360.536.9033 Bellingham 253.850.9777 206.336.2100 Vancouver-Salmon Creek Spokane 4291 Meridian St., Ste. 101 Lake Stevens Olympia-Black Lake 21010 NE 129th St., Ste. 101 Harbinder Bal, DDS; Justin Pagan, DDS; 7407 N Division St., Ste. K Austin Phoenix, DDS; Jordan Anderson, DDS; Randy Ball, DDS; Sumedha Sharma, DDS; 709 State Route 9 NE 1530 Black Lake Blvd. SW, Ste. A103 Naim Abualshar, DDS; Ted Hughes, DDS; Jan Kooning, DMD; Jeffrey Pearson, DMD; Ted Hughes, DDS Samiramis Sando, DDS; Harbinder Bal, DDS; Trisha Le, DDS; Brandon Johnson, DDS; William Barton, DDS Shelley Aronson, DDS Jinsam Kwon, DDS; Sean Monaghan, DDS; Jung Ho Lee, DDS 360.715.8400 Ted Hughes, DDS; Trina Bruchal, DDS 509.464.2001 360.574.4574 360.338.7152 Bonney Lake 425.249.4129 Tacoma Woodinville 9503 192nd Ave. East Lakewood Olympia-Martin Way 4545 South Union Ave., Ste. 100 17740 Garden Way NE 4210 Martin Way East, Ste. 101 Jung Kim, DDS; Chad Carver, DDS; 10321 Gravelly Lake Drive SW Thien Nguyen, DDS; Hardeep Dhaliwal, DDS; Jean Chen, DDS; Randy Ball, DDS; Christen Kartaltepe, DDS; Lisa Uglialoro, DDS, MS; Sean Chang, DDS; Hardeep Dhaliwal, DDS; Rena Jhuty, DMD; Vahid Atabakhsh, DDS; Richard Franklin, DDS; Ted Hughes, DDS Ted Hughes, DDS: Vahid Atabakhsh, DDS Ashifa Nurani, DDS; Brandon Johnson, DDS; Jung Ho Lee, DDS; Praveena Velupula, DDS; Justin Robison, DMD; Ted Hughes, DDS Vahid Atabakhsh, DDS 253.475.7500 425.492.2000 253.299.3033 253.292.4041 360.455.9544 Federal Way Lynnwood 1507 S. 348th St., Ste. K2-102 18910 28th Ave. W, Ste. 202 Venkata Naveen Cherukuri, DDS; Christopher Park, DDS; Ted Hughes, DDS; Vahid Suk Hong, DDS; Harbinder Bal, DDS; Hardeep Atabakhsh, DDS Dhaliwal, DDS; Justin Pagan, DDS; Randy Ball, DDS; Uparika Sharma, DDS 253.835.3377 425.775.5557 Follow us Have questions? Contact your Union Account Representative,

Carrie Magnuson | [email protected] | 253.405.4547 TORRES STOCKSY/VICTOR — COVER AND PAGE THIS PHOTOS:

Nurani, Mitchell, Kim P.C.; Ashifa Nurani, DDS; Ahyoang Amber Kim, DDS; Michael Mitchell, DDS, Pearson, P.C. Jeffrey Pearson, DMD. ©2016 Smile Brands Inc. All rights reserved.

WSNA_1-sided_v2_r3_9_16.indd 1 9/22/16 3:56 PM CONTENTS

DON’T LET THEM SILENCE US PAGE 9

WINTER 2018

In focus ...... 3 Nursing practice Union Upcoming events ...... 4 Joelle Fathi joins WSNA as Director of Powering up at WSNA’s News briefs ...... 4 Nursing Practice and Health Policy ..... 23 Union Leadership Conference ...... 33 Help us paint an accurate picture of Congratulations, 2017 Leadership Cover story Washington’s nursing workforce ...... 24 Award winners! ...... 36 Protecting our freedom Being part of the solution: Mission accomplished! to join together ...... 9 Preventing opioid overdose NFN celebrates its history deaths in Washington ...... 27 and plans for the future ...... 38 When we fight together, we win! ...... 10 Opioid patient fact sheets The union difference...... 12 available in 22 languages ...... 28 Will you stand with me? ...... 15 More... Why are nurses suing the EPA? ...... 29 2017 March of Dimes Legislative affairs WSNA’s position on mandatory Nurse of the Year Awards ...... 40 influenza vaccinations and WSNA’s priorities for the strategies to address influenze ...... 30 Welcome new WSNA staff ...... 41 2018 legislative session ...... 17 Continuing education calendar ...... 31 How much did you pay Advocacy on the go!...... 18 in dues in 2017? ...... 41 Introducing Nurses’ Voices in Politics . 19 District news (KCNA, IENA and PCNA)...... 42 Surprise billing and health care costs . 20 Make a difference: 2017 elections shift power in Olympia . 21 Donate to WSNF to support student scholarships ...... 43 New members list ...... 43 In memoriam ...... 44 PHOTOS: THIS PAGE AND COVER — STOCKSY/VICTOR TORRES STOCKSY/VICTOR — COVER AND PAGE THIS PHOTOS:

wsna.org The Washington Nurse WINTER 2018 1 WSNA Board of Directors and Staff

President Chair, Cabinet on Economic and General Welfare Jan Bussert, BSN, RN – Vashon Island Julia Barcott, RN – Yakima Vice President Chair, Professional Nursing and Health Care Council VOLUME 47, ISSUE 4 WINTER 2018 Renata Bowlden, BSN, RN, C-EFM – University Place Pamela Pasquale, MN, RN, BC, CNE – Wenatchee ‘The Washington Nurse’ (ISSN# 0734-5666) Secretary / Treasurer Chair, Legislative and Health Policy Council newsmagazine is published quarterly by the Vee Sutherlin, MSN, RN, MEd – Nine Mile Falls Lynnette Vehrs, MN, RN – Spokane Washington State Nurses Association. It is distributed as a benefit of membership to Directors-at-Large all WSNA members. A member subscription Susan Glass, MS, BSN, RN – Spokane rate of $10 per year is included in WSNA Jordan Pai Palimar, BSN, RN – Seattle membership dues. The institutional subscription Evelyn Street, RN, CNOR – Olympia rate is $30 per year (Canada/Mexico: US$36 Ann Whitley, BSN, RN, CCRN – Yakima per year; foreign: US$49 per year). Rosa Young, MSN, RN, MPA – Seattle The information in this magazine is for the benefit of WSNA members. WSNA is a multipurpose, multifaceted organization. ‘The Washington Nurse’ provides a forum for members of all specialties and interests to express their Executive Director opinions. Opinions expressed in the magazine Sally Watkins, PhD, RN are the responsibility of the authors and do not Executive Assistant to the Executive Director necessarily reflect the opinions of the officers Bethany Desimone or membership of WSNA, unless so stated. Copyright 2018, WSNA. No part of this publication Senior Director of Labor Director of Finance may be reproduced without permission. Christine Watts, MN, RN Mary Reed ADVERTISING Director of Labor Accounting Specialist Margaret Conley, ARNP Hue Tran Information on advertising rates may be obtained Director of Organizing Director of Nursing Practice and Health Policy from the WSNA website or by contacting Tara Goode, BA, BSN, RN Joelle Fathi, DNP, RN, ARNP Martin Hsiung at 206-575-7979. Advertising deadlines are: March 1, June 1, Sept. 1 and Administrative Assistant, E&GW Director of Public Affairs Dec. 1. Advertising is accepted on a first-come, Jeanna Te Jennifer Muhm first-served basis for preferred positions, Nurse Representatives Political Action Specialist depending on space availability. WSNA Deborah Bessmer, BSN, RN Nathasja Skorupa reserves the right to reject advertising. Paid Jayson Dick, BSN, RN advertisements in ‘The Washington Nurse’ do Senior Director of Strategic Initiatives not necessarily reflect the endorsement of Travis Elmore, BSN, RN, RN-BC Anne Tan Piazza the WSNA members, staff or organization. Sara Frey, JD, BSN, RN Barbara Friesen, BSN, RN Communications and Digital Media Coordinator CONTRIBUTOR GUIDELINES Carmen Garrison, BSN, RN Christine Nguyen Mara Kieval, BSN, RN Communications Director Pat McClure, RN Ruth Schubert WSNA welcomes the submission of manuscripts and artwork. Please contact Ruth Schubert by Sue O’Donnell, MSN, RN, CMN, WHNP-BC Senior Web and Design Specialist email at [email protected] with submissions, Michele Rose, BSN, RN Ben Tilden article ideas or further questions. It is not the Hanna Welander, BSN, RN policy of WSNA to pay for articles or artwork. Terri Williams, MS, RN Director of Membership and Digital Transformation Josh Brown Ed Zercher, BSN, RN ARTICLE SUBMISSION DEADLINES Nurse Representative and Organizer Membership Services Program Manager Mary Peterson Jaclyn Perkins, BSN, RN Spring ...... Feb. 15 Nurse Organizers Membership Payments Program Manager Summer...... May 15 Tara Barnes, RN Patrick McGraw Fall ...... Aug. 15 Sydne James, BSN, RN Membership Associates Winter...... Nov. 15 Judy Marken, BSN, RN Jamie Adams Will Nesper, RN Becky Anderson DESIGNED, EDITED & PRINTED IN WASHINGTON STATE General / Corporate Counsel Kelly King Timothy Sears Shastie Steinshouer Executive Editor ...... Sally Watkins Editor ...... Ruth Schubert General Counsel Receptionist Designer ...... Ben Tilden Michael Sanderson Irene Mueller Lane Toensmeier Office Manager / Systems Administrator Legal Assistant Martin Hsiung Maria Pettit Washington State Nurses Association 575 Andover Park W., Suite 101, Seattle, WA 98188 206-575-7979 • 206-575-1908 fax [email protected] • wsna.org PHOTO: MERYL SCHENKER MERYL PHOTO:

2 The Washington Nurse WINTER 2018 wsna.org LETTER FROM THE PRESIDENT In Focus

IN FOCUS

What is Janus? In this issue of The Washington Nurse, you’ll read a lot about a case called Janus v. AFSME, which the U.S. Supreme Court has agreed to hear. A decision is expected by Spring 2018. If successful, the Janus decision could significantly weaken our freedom to stand together and negotiate a fair return on our work and safe conditions for our patients. Janus is a part of a national strategy by wealthy corporations to take away our freedom to join together and fight for things like safe staffing, protections from workplace vio- lence and so much more.

Why is this important for all of us? Strong work by unions results in a strong employee voice in the workplace. Com- petitive wages, access to affordable health care and security in retirement are some of the benefits that our collective voice can bring to us through negotiat- ing together. This is also how we have been successful in advocating for a safer practice environment where staffing, rest breaks, safe lifting requirements and protection from mandatory overtime are secured. Members have many stories that reinforce the notion that collective action and a strong WSNA member voice in the workplace is essential to secure a safe environment for patients and nurses. I know, because I have witnessed your work and heard your stories.

What do you need to do? First, know the facts. This issue of The Washington Nurse has the details you need to better understand this coordinated attack on workers and how it benefits the CEOs of hospitals and large corporations. Be alert to unsolicited information from outside groups who claim to be on your side — are they really pushing to weaken your voice and take away all the gains we have made together? WSNA has been working hard to educate and engage our members. Our membership is growing, and we have made some incredible gains in recent con- tract negotiations. Our ability to advocate for our patients and ourselves will be compromised by this case. It’s time for all of us to step up and engage. What can you do, in partnership with WSNA, in your Local Unit, in the legislature and in your communities across the state to ensure that we as nurses continue to stand together and push hospitals to put patients before profits?

Jan Bussert, BSN, RN WSNA President PHOTO: MERYL SCHENKER MERYL PHOTO:

wsna.org The Washington Nurse WINTER 2018 3 UPCOMING EVENTS NEWS BRIEFS

FEBRUARY 2018 For the most current nursing 3 WSNA Professional Nursing & Health Care Council meeting – WSNA office news and information, visit wsna.org/news. 5 WSLC Washington State NEWS BRIEFS Labor Summit – Seattle

20 WSNA Dues Structure Task Force meeting – WSNA office

19 Presidents’ Day – WSNA office closed

23 WSNA Finance Committee meeting – WSNA office

23 WSNA Executive Committee meeting – WSNA office

MARCH

3 Nursing Students of Washington State (NSWS) meeting – WSNA office 12 WSNA Dues Structure Task Force IDENTITY meeting – WSNA office

14 WSNA Occupational and Environmental Health and Safety Committee meeting – WSNA office

16 Washington State Nurses Foundation (WSNF) meeting – WSNA office THEFT 18–19 WSNA Leadership Summit – Chelan

21–23 2018 ANA Quality and Innovation Conference – Orlando, FL

22–23 WSNA Board of Directors meeting – WSNA office 22 WSNA Hall of Fame Gala – Seattle PREVENTION

APRIL

11 District Nurses Associations meeting (CRC) – WSNA office

13 WSNA E&GW Cabinet meeting – WSNA office

26–27 Council on Nursing Education in Washington State (CNEWS) CMS to start mailing meeting – Spokane new Medicare cards in April 13 WSNA Local Unit Council meeting – Seattle The Centers for Medicare & Medicaid Services (CMS) is preparing

14 WSNA Leadership Summit – Spokane to remove Social Security numbers from all Medicare cards in an effort to prevent fraud and combat identify theft for the 57.7 million

MAY Americans on Medicare. The new cards will use a unique, randomly- assigned number called a Medicare Beneficiary Identifier (MBI), to 6–12 National Nurses Week replace the Social Security-based Health Insurance Claim Number

19 WSNA Leadership Summit (HICN) currently used on the Medicare card. CMS will begin mailing – Vancouver, WA new cards in April 2018 and will meet the congressional deadline for replacing all Medicare cards by April 2019. Providers and beneficiaries will both be able to use secure look-up tools that will support quick access to MBIs when they need them. There will also be a 21-month transition period where providers will be able FOR MORE INFORMATION AND A to use either the MBI or the HICN, further easing the transition. COMPLETE AND UP-TO-DATE LISTING OF CMS has a website dedicated to the Social Security Removal Initiative (SSNRI) where providers can EVENTS, VISIT WSNA.ORG/CALENDAR. find the latest information and sign-up for newsletters. CMS is also planning regular calls as a way to share updates and answer provider questions before and after new cards are mailed beginning in April 2018. For more information, please visit www.cms.gov/Medicare/New-Medicare-Card. PHOTO: SHUTTERSTOCK / FREEDOM STUDIO FREEDOM / SHUTTERSTOCK PHOTO: COUNTY KING COURTESY AND TILDEN BEN PHOTOS:

4 The Washington Nurse WINTER 2018 wsna.org NEWS BRIEFS

Hall-of-Famer Patty Hayes, MN, RN, named Most Influential Seattleite Congratulations to our very own Hall of Fame member, Patty Hayes, MN, RN for her recognition as one of Seattle Magazine’s Most Influential Seattleites of 2017. As Seattle Magazine said: “She doesn’t ride a white horse or wear a badge, but Patty Hayes, R.N., M.N., is the closest thing King WSNA Hall of Famer Muriel Grace Softli County has to a sheriff for health, trying to protect more than 2 million county residents.” recognized by UW School of Nursing Patty, who served as WSNA’s Executive Director Decorated military veteran and WSNA Hall of Famer Muriel Grace Softli, MPA, MEd, BSN, RN received the from 1989–1992, has been the director of Public University of Washington School of Nursing Community Health Nurse Track Preceptor of the Year Award at Health – Seattle and King County since 2015. She the Washington State Advanced Practice Nursing Conference on Oct. 27, 2017. As a preceptor, Muriel gives and her team work to track and protect residents UW School of Nursing students important hands-on patient care experience. from dangers ranging from bad meals to reportable Muriel served in the Air Force Medical Corps from 1970 to 1996 and was the longest assigned flight nurse illnesses. In the face of a shrinking budget due in large and first African American nurse to be assigned to McChord Air Force unit 40th AES. Outside of the military, part to the state’s diminished support for essential Muriel served as a Seattle Public School nurse for 42 years. She retired seven years ago but came out of public health services, Patty leads the charge against retirement to care for students as the school nurse at First Place School, a private nonprofit school for children public health threats like food-borne illnesses and experiencing trauma or homelessness, where she began precepting Community Health nursing students. As communicable diseases like tuberculosis, mumps, a school nurse, Muriel and her UW students managed medications, dealt with students’ mental health needs, Ebola and Zika. provided annual preventative care exams, participated in Student Intervention Team meetings and more. “Hayes is a beacon of calm in this turbulence, WSNA would like to thank Muriel for her commitment and leadership in health care, education and nursing juggling each outbreak and preserving services for as well as congratulate her well-deserved award and recognition! the neediest,” Seattle Magazine said.

David Reyes elected President of WSPHA Jean Pfeifer elected to Congratulations to WSNA member David Reyes, DNP, MPH, RN, PHNA-BC, who was North Valley Hospital Board elected President of the Washington State Public Health Association Oct. 17, 2017. Congratulations to David Reyes is an assistant professor in the Nursing & Healthcare Leadership Jean Pfeifer, a retired Program at the University of Washington Tacoma. Before entering academia, RN and former WSNA David spent 17 years as a supervisor and administrator at Public Health – Seattle & Board member, for her King County. As a Health Services Administrator in the Community Health Services election to the Board Division, David managed health services delivery at various public health centers, of Commissioners for North Valley and participated in PHSKC’s diversity, social justice and health equity initiatives. Hospital in Tonasket. Before retirement, David received the Marguerite Cobb Public Health/Community Health Nurse Jean was a nurse at Seattle Children’s Award at the Washington State Nurses Convention in May 2017. In 2016, he was Hospital for 37 years, where she served appointed by the University of Washington’s President to the new Population as the WSNA Local Unit Chair for many Health Executive Council, which addresses eliminating disease as well as the years. North Valley is a critical access intersecting and overlapping factors that influence health. hospital.

SAVE THESE DATES! WSNA Hall of Fame Gala March 22, 2018 / 2019 Convention May 1–3, 2019 PHOTO: SHUTTERSTOCK / FREEDOM STUDIO FREEDOM / SHUTTERSTOCK PHOTO: COUNTY KING COURTESY AND TILDEN BEN PHOTOS:

wsna.org The Washington Nurse WINTER 2018 5 NEWS BRIEFS NEWS BRIEFS Health Care Authority limits quantity of opioids In the spirit of preventing misuse and addiction to opioids and taking control of the opioid crisis, Washington state Medicaid health plan, Apple Health, has set limits in the quantity of opioids that may be prescribed. With the exception of cancer treatment, palliative care, hospice, end-of-life care and established chronic (ongoing) opioid therapy, the policy sets the following limits: • For people ages 20 or younger: 18 tablets or capsules (about a three-day supply) • For people ages 21 or older: 42 tablets or capsules (about a seven-day supply) For further details on this clinical policy, visit www.hca.wa.gov/billers-providers/ programs-and-services/opioids.

WSNA membership cards go digital For many years, WSNA has printed and mailed a new membership card to every member once a year. With the changing times, we’re going digital to save administrative time and the cost of producing physical cards. Starting this year, we’ll be providing your membership numbers for WSNA, ANA and AFT (for union members) to you by the following methods: • An annual email • The Washington Nurse magazine (WSNA membership number only – you’ll find 1 it on the line above your name in the address block on the back cover) • The ‘My WSNA’ website (my.wsna.org) Additionally, you can always contact us by phone to obtain your membership numbers at 206-575-7979 (local) or 800-231-8482 (toll-free).

2

Shown above, WSNA members Frankie Manning (1) and Pamela Pasquale (2). Seattle/King County Clinic serves 4,300 A big thank you to the WSNA members and other providers and volunteers who helped make the annual Seattle/King County Clinic a success. The four-day event, held Oct. 26–29 at KeyArena at Seattle Center served over 4,300 patients and provided more than $3.7 million in health care services. PHOTOS THIS PAGE: AUSTON JAMES AUSTON PAGE: THIS PHOTOS

6 The Washington Nurse WINTER 2018 wsna.org NEWS BRIEFS PAID ADVERTISEMENT

EMPLOYMENT OPPORTUNITIES

Director of Nursing Saint Martin’s University invites applications and nominations for a collaborative, dynamic nurse educator to lead an innovative CCNE accredited RN-to-BSN program grounded in the AACN Essentials of Baccalaureate Nursing Members of the Health Coalition for Children and Youth, Education and informed by the IOM Report on the Future which includes WSNA, celebrated their work to pass the of Nursing. The University plans to submit an application for Cover All Kids law, creating Apple Health for Kids. approval to develop a pre-licensure baccalaureate program, development of which will become responsibility of the Edna Cortez speaks up for kids at director. This is a full-time, 12-month renewable position Apple Health for Kids celebration Faculty rank will depend on qualifications. Applicants should submit a cover letter, resume, and the names and contact Edna Cortez, RN, the WSNA Local Unit Chair information of three references to Ms. Tiffany McDuffy, for Seattle Children’s Hospital, joined a Executive Assistant to the Dean, at [email protected] panel of providers, clients and enrollment (electronic submission required). Nominations/referrals workers at the 10th Anniversary Celebration are welcomed and encouraged. Inquiries may be directed to of Apple Health for Kids, the state’s health Dr. Jeff Crane, Dean of the College of Arts and Sciences, at care program for children. [email protected] or 360-438-4564. The event, held at New Holly Gathering Hall on Nov. 3, 2017, brought together child health advocates, health care providers, Assistant Professor – Nursing navigators, legislators, families and This is a unique opportunity to contribute to the development, community leaders to celebrate the ten- implementation and evaluation of an RN-to-BSN curriculum. year anniversary of the passage of the Cover Unique aspects of the program include an elective course All Kids law in 2007, a landmark step toward in traditional Chinese medicine and evidence-based the goal of providing health coverage for all practice, and options for study abroad. This is a full-time, of Washington’s children through Apple Health for Kids. 9-month, tenure-track faculty position with the possibility Edna spoke movingly about the importance of health coverage for the children of summer teaching. The desired start date for the position and families she sees at Seattle Children’s. is August 2018, with adjunct appointment prior to that date “It is amazing to see parents that are so concerned about insurance when possible. Please send letter of interest, current c.v., copies of I usually tell parents let’s not worry about that right now, let’s focus on your graduate transcript(s), and 3 letters of recommendation, all kiddo,” Edna said. “I do not want parents to in pdf format, to [email protected], c/o Tiffany McDuffy, worry about how insurance is going to cover Executive Assistant to the Dean, College of Arts and Sciences, them… I’m grateful for what this program has Saint Martin’s University, 5000 Abbey Way SE, Lacey, WA to offer.” 98503 (tel. 360-438-4564). Review of applications will In 2007, 80,100 Washington children were begin in November, 2017 and continue until the position is uninsured, but our state has made remarkable filled. Questions and inquiries may be directed to Dr. Diane progress since that time, with fewer than three Hamilton, Interim Director, Nursing Program, at dhamilton@ percent of Washington’s kids now uninsured. stmartin.edu. Apple Health for Kids is a solution unique to — Washington state, using the federal programs Medicaid and Children’s Health All University employees are expected to support the Catholic, Insurance Program (CHIP) to finance care for children in families with incomes Benedictine liberal arts mission of the university. Candidates must below 300% of the federal poverty level under one umbrella program. Thanks have valid documentation permitting them to work in the US from to these programs working together, the number of kids in Washington without the date on which the appointment at Saint Martin’s takes effect. The position is subject to final budgetary approval. Saint Martin’s health insurance is the lowest in history. University is dedicated to the goal of building a culturally diverse As this issue of The Washington Nurse went to press, Congress had not and pluralistic faculty and staff committed to teaching and working yet passed reauthorization of the CHIP program, which is essential to keeping in a multicultural environment and strongly encourages applications children on Apple Health for Kids covered. from women, minorities, individuals with disabilities, and covered veterans. PHOTOS THIS PAGE: AUSTON JAMES AUSTON PAGE: THIS PHOTOS

wsna.org The Washington Nurse WINTER 2018 7 COVER STORY

8 The Washington Nurse WINTER 2018 wsna.org COVER STORY

hen we stand together as union nurses, we have the power to win a fair return on our work and conditions that allow us to provide better care PROTECTING to our patients. Over the years, we have joined together to successfully fight for better pay and working OUR Wconditions. And, we have fought back against things like unsafe staffing schemes, intermittent rest breaks and man- datory overtime that put profits before patients and make it harder for us to give our patients the care they deserve. FREEDOM As active members of WSNA, we have the power in num- bers to advocate for our patients and what we need to care for them in a healthy and safe way, pushing hospitals to TO JOIN address safe staffing, workplace violence, safe lifting and other workplace issues. But real freedom is about more than making a living and doing our jobs well; it’s also about having time to take a TOGETHER loved one to the doctor or nurse practitioner, attend a parent- teacher conference and retire in dignity. We need the power We can protect our rights in numbers of unions to protect things our families need like health benefits and paid time off to care for our loved ones. and our power by continuing Wealthy special interests and corporate lobbyists are to stand together as chipping away at all we have gained. Over the past several active WSNA members. years, corporate special interests have launched unprec- edented attacks against the freedom of working people to form strong unions, most recently urging the U.S. Supreme Court to take up a case called Janus v. AFSCME that takes aim at the ability of working people to join together and speak up for themselves, their families and their communi- ties. They want to take away our ability to collect dues at public facilities and weaken our union, opening the way for hospital CEOs to increase patient loads, lower wages and reduce benefits. They want to silence us. A decision from the Supreme Court is expected this spring. At issue is whether public-sector workers­—including nurses at public hospitals, health departments and veterans’ homes—should be allowed to quit paying their fair share for the work we do to negotiate and enforce good contracts, while continuing to benefit from union representation. If that happens, expect outside groups to come into your work- places or even to your front doors offering to teach you how to drop out. They want to weaken us so they can take away better working conditions, pay and benefits for which we have worked so hard. They want to take away your ability to effectively advocate for your patients and our profession. We can protect our rights and our power by continuing to stand together as active WSNA members. Working people like nurses deserve the same freedom hospital and corpo- rate CEOs have­—the freedom to negotiate a fair return on our work so we can provide for our families and have better working conditions that allow us to give patients our best. PHOTO: STOCKSY / VICTOR TORRES VICTOR / STOCKSY PHOTO:

wsna.org The Washington Nurse WINTER 2018 9 COVER STORY WHEN WE FIGHT TOGETHER WE WIN! What you need to know about Janus v. AFSCME. By Christine Watts, MN, RN Senior Director of Labor, WSNA

10 The Washington Nurse WINTER 2018 wsna.org COVER STORY

This gives employees the option of becoming full union members or skipping membership and becoming fair-share payers, who pay a reduced fee to support their union’s efforts on their behalf. If the U.S. Supreme Court decides against working people, and public-sector nurses start dropping their membership, our power to negotiate fair contracts for our work would be significantly dimin- WE ARE ALL WSNA. Together, we have grown our membership by leaps ished. If that isn’t bad enough, we will face a coordinated, sophisti- and bounds, achieved major victories to help protect our patients and cated campaign by anti-union groups and foundations to persuade our professional lives and negotiated precedent-setting agreements, our members to drop their membership. They know that when we all while fighting off efforts to strip away pay, benefits and the dignity don’t speak with a strong, unified voice, management wins and our of the nursing profession. We have not won them all, but consider patients lose. the following recent achievements: • New contract language to attack chronic understaffing, Organized attack by wealthy corporations including specific nurse-to-patient ratios written into These anti-worker attacks are coming from individuals and groups our contract at MultiCare Tacoma General Hospital; such as the Walton family (of Wal-Mart fame), the Koch brothers, Wall • A new staffing law passed by the legislature in Street, banks, huge multi-national corporations and corporate-funded 2017 that empowers nurses to protect patients political think tanks. These groups work with state politicians behind through stronger staffing committees; closed doors to try to rewrite state laws that govern your rights. This • Supreme Court victories to force employers is the wealthiest one percent, and they are the ones who benefit when to give meal and rest breaks; they take away our freedom to join together and negotiate. Make no mistake. These groups are very upfront about their goal— • Wages that support freedom for families to prosper; and to weaken and destroy public employee unions. As one fundraising • Multimillion dollar settlements with new break-relief nurses. letter to wealthy donors puts it: And consider just a few examples of the takeaways threatened by management that we defeated together: • Forced house-wide floating; “To the horror and dismay of • Cutting or eliminating rest between shifts; government unions across • Mandatory on-call/standby in all units; the country, the Supreme • Even deeper cuts in medical insurance, Court is taking up Janus PTO and retirement; and v. AFSCME this term. As a • Pay-for-performance schemes tying nurses’ result, we may well be on wages to factors beyond their control. the verge of an historic victory over government We have won at the negotiating table, in unions — and now is the court and the legislature because we stood time to put ourselves into together in unity. When we as WSNA position to make the most of members exercise our freedom to join this incredible opportunity.” together and speak with a single powerful We have won at voice, we can stand up to management’s the negotiating combined financial power. table, in court and Corporate lobbyists and wealthy the legislature They are engaged in this massive fundraising effort so they can CEOs have been mounting attacks on because we peddle falsehoods, and will even go so far as to send paid, scripted stood together in our freedom to speak with that one voice. unity. When we as lobbyists to show up at members’ homes and harass them into resign- One of the greatest threats is a case now WSNA members ing union membership. Why go to the trouble, you may ask? Because pending before the United States Supreme exercise our your collective voice is in their way. Court, Janus v. AFSCME, in which the new freedom to join Big corporations, politicians and wealthy interests have rigged conservative Court appears poised to together and our economy against working people for decades. They have robbed overturn its own longstanding precedent speak with a Americans of the freedom to earn a decent living, have work-life bal- and take away the freedom of public sec- single powerful ance, take a loved one to the doctor or serve the public well without tor nurses to build their powerful, unified voice, we can fear of losing their job. In our hospitals and clinics, wealthy CEOs voice. stand up to press management to cut staff, often leaving nurses without rest or At risk is the freedom of public sector management’s meal breaks and with more patients than they can safely care for. union employees and their employers to combined Nurses are forced to float to units in which they lack the necessary financial power. agree to fair-share union dues agreements.

wsna.org The Washington Nurse WINTER 2018 11 COVER STORY

Ask any union skill and training. Many nurses now work in constant negotiator. The moral distress. Your collective voice is what keeps THE UNION DIFFERENCE single most these issues in check. Members of labor unions earn more and have important factor better benefits than non-members. in negotiating Our power in numbers to fight back fair collective bargaining Unions are the most effective way for workers to come agreements is together and counter the influence big money and WAGES the level of union big corporations have on our democracy. By form- ing strong unions, workers are able to negotiate a fair Union members earn 25% more membership. than non-union workers. return on their hard work and benefits that support their families, as well as provisions to protect patients Median weekly earnings for full-time and salaried workers, 2015–16 and their own health. This isn’t just talk. According to the Bureau of Labor Statistics, workers who belong Union members ($1,004) to a union typically earn higher pay than non-union workers doing the same kind of job. Non-union ($802) And we use our collective voice to advocate for policies that benefit all working people—like increases HEALTH CARE to the minimum wage, affordable health care and great public schools for students—and to elect politicians Union members pay less in health insurance premiums than non-union workers. who will stand up for working people, not the wealthy and corporate interests. Unions are critically important to fix a rigged economy that disproportionately Share of premiums paid by employer, March 2017 hurts workers across the country, and particularly workers of color. Across the Employer-paid portion of health insurance benefits country, more than half of black workers and nearly 60 percent of Latino workers Individual Union members: 87% are paid less than $15 per hour. If corporations and politicians eliminate our free- coverage Non-union: 79% dom to come together in union, they will continue to drive down wages, kill jobs, Family Union members: 80% defund public hospitals, silence working people at the ballot box and dismantle coverage Non-union: 65% the fundamental values of freedom and opportunity we hold dear as Americans. We can’t let that happen.

RETIREMENT What is the Janus case? The United States Supreme Court has agreed to hear a case regarding the con- Union members are 28% more likely to have stitutionality of public sector unions’ right to collect fair share or agency fees retirement benefits than non-union workers. from non-members in a case known as Janus v. AFSCME Council 31. The issue Percentage of workers with access in Janus is whether the First Amendment gives the freedom to a public employer to retirement benefits, March 2017 to reach an agreement with a labor union that all employees of the bargaining unit who choose not to become members of the union will be required, instead Union members Non-union of paying dues, to pay a reduced “fair share” fee to help cover the union’s costs 94+6 94% 66+34 66% of negotiating contracts and grievance administration that the union is required to provide to those non-members. Outlawing “fair share” agreements would overturn 40 years of legal precedent. The Janus case originated with a federal court lawsuit, filed by billionaire PAID LEAVE Bruce Rauner, Governor of Illinois, in February of 2015. Governor Rauner sum- marily signed an order that stopped the collection of fair-share fees from non- Union members are 18% more likely to have paid sick leave than non-union workers. union state employees represented by over 25 different unions, in an attempt to weaken the ability of state employees to join together and negotiate. The union Percentage of workers with paid sick leave, March 2017 defendants and the state attorney general moved to dismiss the case. That’s when state employee Mark Janus, with legal assistance from national anti-union Union members Non-union 87% 60% groups filed a motion to intervene on the side of the Governor. The district court 87+13 60+40 subsequently dismissed the Governor from the case, but Janus pursued his claims before the district court and court of appeals, losing at every level. Source: U.S. Bureau of Labor Statistics Now that the case is before the U.S. Supreme Court, huge corporate inter- ests and the wealthy are funding a host of briefs to the Court arguing to weaken the ability of working people to negotiate a fair return on our work. The case is expected to be decided sometime between the end of March and June of 2018.

12 The Washington Nurse WINTER 2018 wsna.org COVER STORY

What happens if the Supreme Court rules against working people? The first impact of a loss in Janus is that it will become illegal for 3 THINGS YOU unions like WSNA to deduct fair-share fees from public sector non- members. While this is a blow, the much bigger question is up to CAN DO NOW all of us, the members of WSNA. If we maintain our memberships A decision in the Janus v. and persuade future nurses to join, we will keep growing stronger AFSCME case is expected from together. But if a substantial number of current members drop out, the U.S. Supreme Court this the impact on your standard of living, freedom to live a balanced life spring. Here are three things you and ability to advocate for and protect yourselves and your patients can do now to be prepared. may be profound. Ask any union negotiator. The single most important factor in negotiating fair collective bargaining agreements is the level of union membership. If management is not convinced that nurses 1 are united to support their negotiating committee, not only will fair wage increases disappear, but management will try to force nurses Understand the issues into giving up the keys to their independence and professionalism. Understand the rationale In hospitals with strong union membership, we have time and time behind this movement to again beat back painful takeaways and dangerous proposals that silence you. The articles in this would endanger the care our nurses provide. issue of The Washington Nurse are a great place to start. What are the implications for each of you? Consider both your home life and professional life. Real free- dom is about more than making a living—it’s about having the time and ability to spend time with family and friends or care 2 for loved ones. Many employers are proposing new restrictions on the use of earned benefits and are trying to take away your Talk about it freedom to use your time off as you need. A decision by one nurse The same is true with scheduling. How would your freedom to withdraw from union to schedule your life be impacted if the employer could tack membership undermines us all. on additional shifts over your FTE without your permission, Let your colleagues know you’re or even change your shifts and hours weekly or daily? And, standing with your union to protect your patients. How would your perhaps most importantly, what if your wages stagnate or even freedom to schedule fall? Over time, your family’s freedom to prosper will dimin- your life be impacted ish. In 2017, 94 percent of union employees in the U.S. had if the employer could access to health care benefits, compared to only 67 percent of tack on additional non-union workers. Union workers also pay less out-of-pocket 3 shifts over your for their insurance than non-unionized workers do. What if Just say no FTE without your hospital CEOs were to erode your medical benefits packages permission, or at will, imposing plans with thousands of dollars of copays and If the U.S. Supreme Court even change your deductibles at ever higher premiums? decides against working people, we can expect outside shifts and hours Also consider your professional life. From the point of view weekly or daily? organizations to pressure of many CEOs, a nurse is a nurse is a nurse. Some hospitals nurses to drop their union are trying even now to take away your freedom to do work in membership. Resist attempts your own specialty by forcing you to float all over the hospital. to take away our freedom to They want to take away rest between shifts for nurses who are join together to make change happen. already working far past a 12-hour shift. And what about your professional duty to care for your patients? Many hospitals are already stripping critical support staff, laying off nurses and denying time for breaks. We as WSNA members are pushing back against these practices, but we can only do that if we stand together in unity. Ask yourself if you are happy with trends like these continuing at your hospital and imagine it becoming intolerably worse.

wsna.org The Washington Nurse WINTER 2018 13 COVER STORY

Finally consider your profession. Your Being part of a union, I have a voice to make changes dues money supports advocacy efforts to and the ability to stand up without fear of retaliation. protect your professional standards in state I have the opportunity to improve conditions for nurses and law and regulatory agencies, and it allows their patients. I have a collective voice to make changes in for full participation in the American Nurses legislation, nursing practice and health and safety. As an Association and its critical advocacy role for active, involved and empowered member, I have contributed nurses. Your dues also support WSNA in its to victories on rest breaks, with a $5 million settlement for role of interpreting the complexities of the nurses, and I helped win a grievance that allows all members Nurse Practice Act and assuring the qual- to opt out of solicitation calls at home from the staffing office. ity of nursing education. We represent your After my mom got cancer and my children graduated from workplace and practice interests with the college, it was possible for me to become a nurse. I decided Nursing Care Quality Assurance Commis- John Gustafson, RN, CMSRN to do all I could for the rest of my life to lean in and to give sion and other state agencies, and we also St. Joseph Medical back to patients and families. My union helps me do that. Center, Tacoma provide input on proposals that affect your workplace safety and your practice.

What can I personally do if Janus My union membership means the power to negotiate is decided against us? a fair return on my work and conditions that allow me Engage to give the best care to the mothers and babies I work with as a public health nurse. Remain a member and persuade others that standing together is not only the right choice, But the power we have working together goes beyond it’s the smart choice. contract negotiations. When King County proposed closing four public health clinics during the 2014 budget crisis, I Get involved joined together with other public health members and WSNA Get involved in negotiations and talk to your staff to organize rallies, gather petition signatures, reach out negotiators. Help educate your fellow nurses, to civic leaders and put pressure on the King County Council. especially those just entering the profession, Joining together in union, we were able to save all four clinics. about the collective bargaining agreement. That’s power, and that’s why it’s important to me to remain an Christina Enriquez, BSN, RN active member of WSNA. Public Health – Seattle Serve & King County Become a local committee member and learn how to bring those around you together.

I am grateful for my union membership in WSNA. Whatever happens, know that WSNA has I have worked as a nurse for nearly 10 years, all of them at Seattle Children’s. faced and overcome even greater challenges Being a part of a union means being part of a greater in the past. Standing together we can and will group with strength to stand together for what is right and fight. Standing together we will win. ■ what is fair. It is tremendously comforting to know that, so long as I have done the right thing, I will have the support of a strong union to stand by me, to have my back. I have seen this not only in my personal experiences but also those of my colleagues. It also has meant a lot to me to know that the union Lindsey Kirsch, BSN, RN will make policies happen which will make my working life Seattle Children’s Hospital as well as personal life better. In my discussions with RNs who have worked at non-union hospitals, I also realize the huge gains and perks that we have as RNs in my hospital. This includes everything from time off between shifts, pay schedules, certification pay and other areas, to name a few. In this time of unfair labor practices and litigious society, I know that I have an extremely strong and respected union working behind the scenes to allow me to do what I do best and love, be a nurse. PHOTOS: BEN TILDEN AND COURTESY LINDSAY KIRSCH LINDSAY COURTESY AND TILDEN BEN PHOTOS: TILDEN BEN PHOTO:

14 The Washington Nurse WINTER 2018 wsna.org COVER STORY WILL YOU STAND WITH ME? by Tara Goode, BA, BSN, RN Director of Organizing, WSNA

Like you, I’m a registered nurse, and I need to warn you that there is a war being waged on our ability to advocate for our profession and our patients. It’s not about party politics. It’s about power and our need to assert our collective voice to influence the care our patients receive. This attack did not originally target nurses, but instead, public union workers. Regardless, it’s going to impact our practice. It’s an This attack did not effort that has been in process for decades and is now gaining steam due to the current politi- originally target cal climate at the federal level. A decision is coming from the U.S. Supreme Court early this nurses, but instead, year that could allow public union nurses to withdraw their union membership, but would public union workers. still most likely obligate the union to continue to represent those nurses. Regardless, it’s As educated professionals, how do you think that would work? Where will the resources going to impact to represent you come from if not from dues money? What will diminished membership do our practice. to your collective power? Who’s going to gain from this decision? Better yet, who’s waging this attack on our profession and in turn our patients? Two names come to mind, the Walton family (Walmart) and the Koch brothers (billionaire industrialists). These are people who can afford private care at any cost and enjoy almost limitless power. They have no conscience when it comes to the practical impact of this effort on nursing or health care. They are solely concerned with two things: money and power. You have the power to make a difference. You have the freedom to choose to stand strong with RNs around the country. I challenge all RNs to do the following to ensure our voice remains strong: The call to 1. Just say no. If someone asks you to drop your membership in your union, just say action is now. no. It only serves to weaken your union and vastly diminish your ability to work on Here’s what we solutions to problems like safe staffing, workplace violence and nurse and patient need to do to safety. Every nurse matters, and we stand strong when we stand together. ensure our voice 2. Be unafraid to discuss this issue with your colleagues. I’m calling on you all to have remains strong. hard conversations and hold each other accountable for your decisions. If a nurse withdraws their membership, it’s a clear message to everyone that they are actively working against building union power. Expecting others to do the work needing to be done isn’t professional, and it’s not who we are as nurses. We’re better than that. 3. Stay informed. Seek out information. Look at the data. Understand the rationale. Re-evaluate your position and reaffirm your commitment to stand united with your colleagues. When nurses stand together, amazing things can happen. The call to action is now. Refuse to be swayed by slick sales tactics, repetitive untruths and party politics. Rely on your critical thinking abilities as a highly educated person and see through the smoke. You want freedom? You have it. You have the freedom to choose to work in a union facility or not. You want a choice? You have it. You have the choice to stand strong together or let outside, moneyed interests interfere with your ability to provide the best care possible to your patients. You want power? You have it. Nurses standing together can move mountains! Imagine what we could accomplish if we refuse to allow politicians and business people to play at being nurses and doctors. You want control? You have it. You control the trajectory of the labor movement. I am honored to be in the company of such intelligent and professional health care practi- tioners. Nurses are the heart and soul of not only the health care industry in this country, but of each and every community in which we live and work. It’s time to come together and stand strong against a very real and imminent threat to all we hold dear. Will you stand with me? ■ PHOTOS: BEN TILDEN AND COURTESY LINDSAY KIRSCH LINDSAY COURTESY AND TILDEN BEN PHOTOS: TILDEN BEN PHOTO:

wsna.org The Washington Nurse WINTER 2018 15 Because you should be more worried about what’s inside your books than how to pay for them...

The Washington State Nurses Foundation annually awards scholarships to qualified students preparing for a career as a registered nurse in Washington state. The minimum amount of each scholarship is $1,000.

APPLICATION DEADLINE & SCHOLARSHIP AWARD Materials must be postmarked by Feb. 9, 2018, and scholarship award announcements will be made by April 15, 2018.

TO APPLY You can find an application form in downloadable PDF format at www.wsna.org/wsnf.

Undergraduate student applicants must be enrolled in an approved program leading to an associate or baccalaureate nursing degree, and must have completed at least 12 nursing credits (credits from LPN programs do not apply toward the 12 completed credits). Graduate student applicants must be admitted to an approved graduate nursing program to be eligible to apply for a scholarship. Applicants must be either a resident of Washington state or enrolled in an approved RN program in Washington state. LEGISLATIVE AFFAIRS Also in this section Advocacy on the go! ------18 Introducing Nurses’ Voices in Politics - - - 19 Surprise billing and health care costs - - - 20 2017 elections shift power in Olympia - - 21

WSNA’s priorities for the 2018 legislative session The 2018 legislative session is underway. During this short, 60-day session, WSNA is focused on nurse education funding, public health funding, securing uninterrupted meal and rest breaks, ending surprise medical billing, addressing the opioid epidemic and expanding access to mental health services.

Budget priorities:

PUBLIC HEALTH is essential!

Nursing education funding Foundational public To provide scholarship and loan repayment funding that has a significant impact for nurses, allowing them financial health services stability while working with underserved communities. To protect the health and safety of our communities by ensuring that standards for chronic and communicable disease prevention are met across the state. Provider shortages affect everyone. When there are not enough health care providers, health access is limited, costs go up and wait times increase. Despite a projected nursing shortage in Washington state, access to Washington’s population has grown by more than one million residents since scholarship and loan repayment programs has not increased. Such programs 2000. In that same time, when adjusted for inflation and population growth, help rural and underserved communities by incentivizing providers to locate public health funding has decreased by 40 percent. there—and these programs help provide financial stability for nurses. In the 2017 state legislative session, the legislature provided a new, one-time $12 million investment in core public health services. This seed money is essential Washington State Opportunity Scholarship program to support Foundational Public Health Services, especially as it struggles to address the spiking rates of communicable disease across our state. House Bill 2143 would expand the existing Opportunity Scholarship program While this new investment is helpful, it is a drop in the bucket toward to include students in eligible advanced degree health profession programs. adequately funding Washington’s public health system to ensure it can track, Like the existing Health Profession Loan Repayment program, awards from the respond to and prevent disease outbreaks. WSNA joins coalition partners in Opportunity Scholarship program would require a service obligation in a rural continuing to highlight the dire need for new, sustainable public health funding or underserved community. in 2018 and beyond. The existing Opportunity Scholarship program is a public-private partnership, so private health care entities would need to contribute funding to help pay for these scholarships.

Health Profession Loan Repayment Program Washington’s Health Profession Loan Repayment program is a crucial resource for providers who have incurred significant student loan debt, and who want to provide care in rural and underserved communities. Sixty awards are currently funded. We are seeking to increase the funding, and awards, available to nurses.

wsna.org The Washington Nurse WINTER 2018 17 LEGISLATIVE AFFAIRS 2018 Legislative Priorities

Policy priorities:

Meal and rest breaks bill Surprise medical billing To protect patients by ensuring nurses receive To safeguard patients and their families against surprise uninterrupted meal and rest breaks, so that they medical bills when treated by an out-of-network provider at an can provide the highest quality patient care. in-network facility under emergency or surgical circumstances.

House Bill 1715 requires nurses be provided with uninterrupted meal and rest House Bill 2114 was introduced in the 2017 session and seeks to address surprise breaks, which are needed so that nurses can provide the highest quality patient medical billing, which happens when a patient is treated at a health care facility care. Nurses intercept 86 percent of medication errors before there is harm to that is in their health plan’s network, but may unexpectedly receive services or patients, and we always find time to provide care and comfort that leave an see certain providers that are out of their health plan’s network—resulting in a impression on patients and their families. That’s why, year after year, nurses are surprise medical bill for the out-of-network rate. These unexpected charges can voted the most trusted profession. Yet, nurses often work 10, 12 or more hours in amount to hundreds or thousands of dollars. a row—sometimes without time to take a break. Ensuring uninterrupted breaks This bill would ensure that patients pay in-network rates at in-network allows us as nurses to refocus and recharge. Breaks can literally be a lifesaver. facilities, even when being treated by an out-of-network provider in an Emergency Additionally, House Bill 1715 closes the mandatory overtime loophole by Department or surgical facility. clarifying that employers may not use prescheduled on-call time to fill chronic Surprise medical billing is not only an issue for patients, but also for nurses. or foreseeable vacancies due to staff shortages. Right now, many nurses are In 2017, WSNA surveyed our members on their experiences with surprise billing being called back for mandatory overtime after they’ve already worked a 10- or and medical debt. About a third of nurses who responded to the survey had 12-hour shift. This isn’t safe—for nurses or patients. We know that nurses who experienced a surprise medical bill, ranging from $100 to tens of thousands work shifts of 12.5 hours or longer are three times more likely to miss things— of dollars. This legislation will pull patients—and nurses—out of the middle of putting patients at risk. billing disputes. Thirteen other states restrict surprise balanced billing—and it’s time Washington did, too.

Advocacy on the go! Nurses are some of the best patient and legislative advocates! You are also extremely busy. That’s why, this session, we are offering some tips to help you advocate on the go.

Advocate through WSNA Legislative Add the Washington State Legislative Follow WSNA on Twitter – Action Alerts – find these alerts in your Hotline to your contacts – enter Washington’s you’ll find us @mywsna. email inbox; our click-to-act system allows legislative hotline into your mobile phone to you to store your information so that you make it easy to take action on the go: 1-800- Want more info on a particular bill? only need to click three buttons to email 562-6000. They’ll connect you directly to Check WSNA’s Legislative Priorities page your lawmakers on nursing priorities. your legislator’s office. If you would prefer to at www.wsna.org/legislative-affairs/ leave a voicemail, call after hours and make legislative-priorities-for-2018. Or search Learn your Legislative District sure to identify yourself as a constituent. for bills on the Legislature’s website – enter your home address at at http://app.leg.wa.gov/billinfo http://app.leg.wa.gov/DistrictFinder “Like” and “Follow” WSNA’s Facebook page – to find your district. we’ll include critical action alerts there as well.

18 The Washington Nurse WINTER 2018 wsna.org LEGISLATIVE AFFAIRS 2018 Legislative Priorities

Opioids / secure Access to mental medicine return health services To address the opioid epidemic and to ensure patients have a safe, (Volk decision) secure way to dispose of unwanted and unused medications. To ensure new foreseeability standards do not result in practice changes that limit access to mental health care.

During the 2017 session, the legislature passed House Bill 1427 which addressed preventive measures aimed at curbing the opioid epidemic, such as: A year ago, the Washington State Supreme Court issued a 6-3 decision in Volk v. • Requiring rulemaking to establish requirements for prescribing opioid drugs. DeMeerleer that changed the standard for “duty to warn” previously established • Sharing of the state’s Prescription Monitoring Program data with provider in Washington state and nationally. The Court held that, in the outpatient context, groups and health care facilities for quality improvement processes. the duty of health care providers to warn potential victims of violence extends to all individuals who may “foreseeably” be endangered by a patient who has • Making it easier for opioid treatment programs to be established in made a threat, even if no specific target was identified. This leaves providers communities. with unprecedented responsibility to interpret who to warn. In 2018, WSNA will support bills to further prevent, and provide treatment for, Senate Bill 5800 would return to the standard established before the Volk opioid addiction in our communities. decision: to require that a mental health professional providing mental health Additionally, WSNA will continue to support House Bill 1047 which establishes services to a patient has a duty to warn about a patient’s violent behavior only if a statewide secure medicine return program (sometimes referred to as drug the patient has made an actual threat of physical violence against an identifiable take-back). House Bill 1047 would: victim. This bill would ensure that mental health professionals do not change their • Expand secure medicine disposal options to reduce risks of medicine practice, resulting in either a chilling effect on the willingness to treat severely poisonings, misuse and overdoses, and prevent waste medicines from mentally ill patients or an increase in involuntary treatment commitments. contributing to environmental pollution. Following the 2017 legislative session, the University of Washington School of • Improve convenience for residents by providing secure drop boxes in Law conducted a study to analyze how the Volk decision was affecting providers pharmacies and hospitals, as now allowed under the DEA Rule for take-back and patient care. In 2018, WSNA will work to educate lawmakers about the results of controlled substances. of that study and continue to advocate for legislation that would return to the • Ensure financial sustainability through a system the pharmaceutical industry previous duty to warn standard. ■ funds and coordinates, relieving burdens on law enforcement, local agencies and taxpayers. • Grandfather in county programs created via local Board of Health action in King, Pierce, Snohomish and Kitsap counties—giving them 18 months to merge their local programs into the statewide program once it is implemented.

Introducing Nurses’ Voices in Politics WSNA needs you! In 2018, WSNA is launching a new political leadership program called Nurses’ Voices in Politics (NVP)—and we’re looking for WSNA nurses who would like to be trained to help build our grassroots political power.

NVP is designed to ensure that we have the nurse power to: The WSNA-PAC Board of Trustees is leading the effort to recruit nurses • Hold legislators accountable (win elections) to participate in the NVP program­—and you may be receiving a call from one of them soon! • Apply timely and voluminous pressure on This exciting program has the ingredients to be a fun and effective legislators (pass pro-nurse laws) way to build our power; all it takes is your support by joining today. • Develop nurse leaders (help nurses win elections) If you’d like to learn more please contact Nathasja Skorupa, WSNA’s Political Action Specialist, at [email protected] or 206-491-4647.

wsna.org The Washington Nurse WINTER 2018 19 LEGISLATIVE AFFAIRS Surprise Billing Survey Results Surprise billing and health care costs Most of us try to contain our health care expenses by ensuring we are seen by providers inside our health insurance company’s network. But this can become challenging in some health care situations. For example, a patient in the emergency room may need surgery and despite being in an in-network facility, that patient may see an anesthesiologist who is out of their insurance network— leading to a surprise bill for that provider’s services. Surprise medical bills can affect anyone—even those working in health care, like nurses. In 2017, WSNA surveyed 850 of its members on their experiences with medical bills and surprise billing.

We asked nurses about their personal experience with trouble paying for medical bills. 1 in 3 said they had experienced trouble paying for medical bills in the last 12 months. Of those… 70+30 90+10 34+66 70% had medical bills 90% had trouble One in three had trouble for a one-time or short- paying for co-pays, paying for an out-of- term medical expense deductible, coinsurance network doctor or facility that insurance didn’t fully cover

We asked nurses about the consequences to their health due to high medical cost.

Substituting self- Necessary medical treatment for treatment Recommended tests and treatments professional care :9<<: :< << 9<<:< Half of nurses surveyed Half of nurses surveyed deferred a medical relied on home therapies Seven out of ten put off test or treatment that or over-the-counter or postponed necessary was recommended drugs instead of seeing medical treatment a health professional

20 The Washington Nurse WINTER 2018 wsna.org LEGISLATIVE AFFAIRS Elections Shift Power

Victory! 2017 elections shift power in Olympia 100% of WSNA-PAC cross the country in November, power dynamics shifted in towns, cities and states. endorsed candidates Here in Washington, the balance of power in Olympia was up for grabs with two special won their elections election Senate races. With Manka Dhingra’s victory in Washington’s 45th legislative A district, Democrats regained control of the state Senate for the first time in six years. National exit polls indicate the issues that propelled voter turnout were the federal attacks on health care and horrifying incidents of gun violence. Women, people of color and millen- nial voters turned out in droves nationwide. The Washington State Nurses Association Political Action Committee (WSNA-PAC) is Phil Fortunato (R) charged with making bipartisan endorsements, as well as financial contributions, to candidates Legislative District 31 in statewide and state legislative races. Endorsements are based on candidate questionnaires, State Senator candidate interviews and incumbents’ voting records on WSNA priority issues.

Nurses stand with Nurses stand with Rebecca Saldaña. Phil Fortunato.

Nurses stand with ______Nurses stand with Manka Dhingra. ______Patty Kuderer and ______Vandana Slatter. ______Elect leaders who stand with nurses and patients. ______

______Vote for Rebecca Saldaña. ______Rebecca Saldana (D) ______Elect leaders who stand with nurses and patients. ______Vote for Phil Fortunato. ______Legislative District 37 ______The leading voice and advocate for nurses in Washington state. ______Elect leaders who stand with nurses and patients. ______Vote for Manka Dhingra. Elect leaders who stand with nurses and patients. The leading voice and advocate for nurses in Washington state. State Senator ______Vote for Patty Kuderer and Vandana Slatter. ______

______The leading voice and advocate for nurses in Washington state. ______The leading voice and advocate for nurses in Washington state. ______

100% of the WSNA-PAC endorsed candidates won their elections this year. We are so proud of the strong showing by WSNA-PAC endorsed candidates this year—and Manka Dhingra (D) of the nurses who helped get out the vote to ensure their victories. WSNA-PAC get out the vote (GOTV) efforts included the “communication sandwich” Legislative District 45 State Senator in the 45th legislative district, where the race was anticipated to be close and where WSNA nurses voting patterns reflect that of the district—swing voters. In other districts, WSNA-PAC mailed post cards that featured nurses standing with our endorsed candidates. In all GOTV efforts, WSNA-PAC focused on high quality interactions, making live phone calls and sending hand-written post cards rather than robo calls and pre-printed messages, as many other campaigns use. Over 900 nurses received personalized messages from other nurses. Social media was utilized with timely and effective Facebook posts. Patty Kuderer (D) Additionally, this year WSNA ran a phone bank in the 45th district during which nurses Legislative District 48 called all the WSNA nurses who live in that district. Calls were also made the night before State Senator general elections. ■

Vandana Slatter (D) Legislative District 48 State Representative Pos. 1

wsna.org The Washington Nurse WINTER 2018 21 Washington State Nurses Association

HONORING OUR 2018 INDUCTEES

Debbie Brinker, MSN, RN, CNS David Campbell, JD Hilke Faber, MN, BSN, RN, FAAN Judy Huntington, MN, RN Karen Matsuda, MNA, BSN, RN Barbara Van Droof, ARNP-BC March 22, 2018, 5:30–8:30 p.m. Salty’s on Alki 1936 Harbor Avenue SW, Seattle, WA 98126

Register at wsna.org/hof2018. PHOTO: JANET KLINGER PHOTOGRAPHY KLINGER JANET PHOTO: NURSING PRACTICE Also in this section Help us paint an accurate picture of Washington’s nursing workforce - - - - - 24 Preventing opioid overdose deaths - - - 27 Opiod patient fact sheets ------28 Why are nurses suing the EPA? - - - - - 29

“We have entered As nurses, on the front “lines of clinical care, a particularly we often carry the answers and the skills to address challenges in a pragmatic and complex era of patient-centered approach. health care, and I have committed much of my clinical practice currently the to identifying clinical problems or needs, and need for nursing designing and developing evidence-based clinical at the forefront programs from the ground up to address these problems. This work has given me the opportunity has never been to drive initiatives and build nationally recognized greater.” programs that are clinically based, federally regulated and systemwide, at a high level. This rounded and fulfilling nursing career has led me to the next steps of my professional continuum with a sincere interest and desire to offer a robust, impactful and meaningful contribution to nurses on a broader level. Joelle Fathi joins WSNA as Director of We have entered a particularly complex era of health care, and currently the need for nursing Nursing Practice and Health Policy at the forefront has never been greater. The issues are complex, multifaceted and involve In October 2017, Joelle Fathi, DNP, RN, ARNP, began a new position as Director of Nursing a multitude of stakeholders, including nurses, Practice and Health Policy here at WSNA. health care systems, payers (insurers) for health WSNA is fortunate to have a nurse of Fathi’s caliber and experience to lead the associa- care services, patients as consumers of health tion forward in our nursing practice and health policy work. Her demonstrated excellence care, nursing education systems and traditional or in clinical practice, nursing leadership and education, and health care policy advocacy are nontraditional collective bargaining units. These an incredible asset for nurses in Washington state and beyond. entities are interdependent but sometimes reside Joelle comes to us from the Seattle area where she most recently worked as Program on opposite ends of the care continuum, hold Director and Lead Nurse Practitioner for the Swedish Cancer Institute with Swedish Medi- alternative priorities and are not always actively cal Center. In her 15 years at Swedish, Fathi served on the Medical Executive Committee, engaged. It is not possible to remedy these Credentials Committee and the Continuing Medical Education Committee. She has driven challenges without all stakeholders collaboratively working together with a shared vision, priorities initiatives and built nationally recognized programs that are clinically based, federally regu- and conscious effort. lated and systemwide. As the unifying voice and advocating Joelle is currently on working committees such as the Washington State Telehealth Col- organization for nurses, patients and the entire laborative, American Cancer Society’s National Steering Committee for the Lung Cancer community, the WSNA is the undisputed entity to Round Table and the American Thoracic Society. Her experience includes advocacy and lead Washington’s nursing community through work in policy via various action networks, including providing testimony to the Legislature. a myriad of challenging issues and limitless In nursing education, Joelle has worked as Lecturer and currently serves as Clinical Assis- opportunities. I look forward to participating in tant Professor in the School of Nursing at the University of Washington. In 2004, she was that work and the opportunity to join with nurses nominated as “Exceptional Preceptor of the Year.” Joelle has also been faculty for physician around the state to advance the profession, leadership programs discussing and educating physicians on effective models of collabora- advocate for patients and ensure that high quality tive practice with nurses and advanced practice providers. health care is accessible to all. Joelle’s rich background in clinical research has resulted in multiple publications, includ- – Joelle Fathi, DNP, RN, ARNP ing a recent article in OJIN entitled “Nurses Advancing Telehealth Services in the Era of Healthcare Reform.” We are delighted to have Joelle on the WSNA team. ■

PHOTO: JANET KLINGER PHOTOGRAPHY KLINGER JANET PHOTO: ” wsna.org The Washington Nurse WINTER 2018 23 NURSING PRACTICE Workforce Surveys

WORKFORCE DEMOGRAPHICS

Help us paint an accurate picture of Washington’s nursing workforce

By Paula R. Meyer MSN, RN, FRE Executive Director, Nursing Care Quality Assurance Commission and Sofia Aragon JD, MN, BSN, RN Executive Director, Washington Center for Nursing

Statewide surveys will look at current trends and future nursing workforce needs

urses in Washington state will be asked to complete one or more What information is needed and why? surveys in 2018. The Nursing Care Quality Assurance Commis- Across the country, state nursing workforce centers and state boards sion, the state regulatory board, will be requiring for licensure of nursing collaborate to collect and analyze data about the nurs- N a statewide demographic nursing survey. Some nurses will also ing workforce. The reports that are generated inform policy makers, receive a separate survey from the Washington Center for Nursing, the nursing education programs and employers of nurses about the char- state nursing workforce center and University of Washington Center acteristics of the state’s nursing workforce, including education and for Health Workforce Studies. While they will have similar questions, skills obtained, where nurses choose to practice, practice specialty each survey will serve a different purpose, and data from both will be and other data for workforce planning and development. In addition, crucial to identifying state and national trends and informing nursing information about the nurse workforce benefits nurses directly by workforce development efforts. informing them about professional opportunities and challenges. Like By filling out both surveys, you will help inform policy recommen- all credible research surveys, the upcoming surveys from WCN-UW dations on how to expand and improve nursing education programs CHWS and NCQAC will carefully protect individual nurses’ informa- and strengthen the nursing workforce to better serve our changing tion and use approved procedures to ensure personal information is communities. not disclosed and all data are kept confidential. (Read more about ILLUSTRATION: AMIAK ILLUSTRATION:

24 The Washington Nurse WINTER 2018 wsna.org NURSING PRACTICE Workforce Surveys

the processes in the FAQ section.) The reports will not focus on any individuals, but rather, will paint a broader Frequently asked questions picture of Washington’s nursing workforce.

What data is already being collected? How are these surveys conducted? Since 2006, the WCN in collaboration with UW CHWS The WCN is contracting with the UW CHWS to conduct the Registered Nurse has published Nurse Data Snapshots, an analysis and Workforce Survey in early 2018. A sample of nurses will be asked to participate report on Washington’s nurse supply, distribution and by mail or email, and this survey will be identified as being from the WCN and demographic characteristics—based on the limited data the UW CHWS, with the Social and Economic Sciences Research Center (SESRC) available from nurse licenses (birthdate, gender and at Washington State University carrying out the data collection. Only a portion address) maintained by NCQAC. of licensed registered nurses in Washington will be asked to complete the Established in 2003 by the leaders of the Washing- Registered Nurse Workforce survey. Separately, beginning Jan. 1, 2018 NCQAC is requiring nurses to complete a demographic survey electronically through ton state nursing community, including the state nurses Nursys e-Notify. (Nurses can currently volunteer to complete the survey.) association, collective bargaining, four-year and com- munity college nursing education programs, and nurse How frequently will a registered nurse have to complete these surveys? executives to address the nursing shortage, WCN serves The WCN and UW CHWS Registered Nurse Workforce Survey will be completed as the statewide nursing resource center. WCN is largely early in 2018. The NCQAC survey (using Nursys) will require data submission funded by a $5 surcharge on LPN and RN licenses. annually upon licensure renewal. After the initial Nursys data submission, nurses will be asked to update changes for any of the questions asked. Why do we need to track the changing nursing trends? Health care delivery in Washington is changing rapidly. How is my personal information protected? The landmark publication “The Future of Nursing,” pub- Data and information security is important to everyone. There are primarily three lished in 2010 by the Institute of Medicine, set goals about organizations working collaboratively to ensure the appropriate security controls the nursing workforce to meet the health care challenges are in place to protect nurses’ demographic data: The ethics boards overseeing of our diverse communities: WCN and UW, the Washington State Department of Health and the National Council of State Boards of Nursing. • Nurses should practice to the full extent The WCN and UW CHWS Registered Nurse Workforce Survey has been of their education and training. reviewed by Washington’s human subjects review board, like any other research • Nurses should achieve higher levels study. WSU’s human subjects review board reviews SESRC’s survey operations of education and training through an involvement. The identities of individual nurses will be kept confidential, no improved education system that promotes personal identifiers will be disclosed and all information will be reported in seamless academic progression. aggregate form, consistent with all state and federal regulations. The DOH, working with Washington State Office of Cyber Security, works • Nurses should be full partners, with physicians to detect, block and respond to cyber-attacks on state networks every day. and other health care professionals, in This work includes prevention and mitigation of threats before they can cause redesigning care in the United States. significant damage. Cyber threats will continue to evolve, and so must our • Effective workforce planning and policy- defenses against them. DOH and security partners protect the information making require better data collection and assets entrusted to them and are also prepared to respond in the event an improved information infrastructure. something unexpected occurs. The NCSBN Information Security Management Program is aligned with the As a leader in nursing, Washington state was well posi- Security and Privacy Controls for Federal Information Systems and Organizations. tioned in 2010 to act on these goals. However, due to NCSBN uses the National Institute of Standards and Technologies 800-53, the lack of data on the nursing workforce, there is little moderate-impact security controls framework for its information security information on to what extent our state has advanced to protect the confidentiality, integrity and availability of information that is these goals. processed, stored and transmitted by NCSBN’s information systems. Please visit The upcoming surveys will give us a clearer view of the NIST website for additional information on the NIST 800-53 framework. NCSBN has corporate security policies, procedures and contractual security the workforce, how nurses are prepared to meet health requirements that promote the protection of intellectual property, employee care demands and what support is needed. and customer personal information, proper data security and data handling The Nursing Commission Demographic Survey procedures, and data transmissions. NCSBN also performs assessments, audits, penetration tests and vulnerability scans to help assure NIST 800-53, moderate- Beginning on Jan. 1, 2018, all nurses in Washington state impact security control compliance. will be required to fill out the Nursing Commission’s demographic survey questions online at the time they renew their licenses. ILLUSTRATION: AMIAK ILLUSTRATION:

wsna.org The Washington Nurse WINTER 2018 25 NURSING PRACTICE Workforce Surveys

The WCN UW CHWS Registered Nurse Workforce Survey More about Nursys Some nurses will be invited to participate in an additional sample survey conducted by the WCN and the UW CHWS in early 2018, either by mail or email. This survey will gather more information The National Council of State Boards of Nursing (NCSBN) is a national, not-for-profit, organization comprised of boards of about where nurses work, their practice specialty, whether they are nursing from 50 states and the District of Columbia; Washington working part time or full time, whether they have plans to advance state’s Board of Nursing (the Nursing Care Quality Assurance their education, career satisfaction, the provision of culturally com- Commission – NCQAC) is an active member of the NCSBN. The petent care and other factors. The findings from this survey will also NCSBN and NCQAC exist to protect the public’s health and welfare be available by the end of 2018. by assuring that safe and competent nursing care is provided by licensed nurses. As the comprehensive source of nursing licensure Nurses may also be invited to participate in one or more national surveys. statistics for the U.S. and in order to track nursing as a workforce, Since 2013, the National Forum of Nursing Workforce Centers and the NCSBN is partnering with their member state Boards of Nursing, National Council of State Boards of Nursing collaborated every odd including Washington state, to collect demographic data that year on a nationwide nursing workforce survey to learn about the nurs- pertains to licensed registered nurses. Beginning Jan. 1, 2018, ing supply. This survey was open until Nov. 30, 2017. Results from the NCQAC is requiring all nurses enroll with Nursys at the time of 2015 survey can be viewed at https://www.ncsbn.org/workforce.htm. application for a new nursing license or licensure renewal. The Heath Resource Services Administration within the U.S. Health and Human Services administration will also be conducting a Nursys fulfills the following purposes: survey of registered in nurses across the U.S. beginning March of 2018. 1. Allows you or an employer to verify the status (active/ inactive) of your nursing license(s), the status of your What are the differences between state and practice privileges and the status of any disciplinary national nursing workforce surveys? action by a participating board of nursing. • National surveys compile data from small samples of nurses 2. Provides an e-notification when you are due to in each individual state. Sample sizes for a given state renew any nursing licenses you hold and provides may not be sufficiently large to provide results that can a central place to review your license(s). accurately represent the nurse workforce of that state. 3. Collects demographic data via Nursys for the purposes • The national surveys provide “big picture” context but do of national and state workforce tracking. not seek to explain regional or local workforce trends. They The NCSBN is a strong resource for nurses. For more can contribute to informing national workforce efforts, information about Nursys and other topics you may visit: such as providing support for federal funding initiatives. https://www.ncsbn.org/nursys.htm. Informing state policy requires analysis appropriate to the data collection provided by the state in conjunction The demographic/national workforce tracking data with the state’s socioeconomic and political trends. that you will be asked at the time of enrollment is: • Additional state-level data collection from a large number of • gender, race/ethnicity nurses remains important to provide information about the • primary zip code nurse workforce statewide and for areas within the state. • membership status of a collective bargaining unit Funding for nurse workforce data collection and analysis comes from • language(s) spoken fluently different sources and is available at different times, so having suf- • nursing degree at time of initial licensure ficient high quality data for national, state and sub-state workforce • nursing school attended and year of graduation information may mean nurses are asked to respond to multiple sur- • all nursing-related degrees and credentials veys with similar questions. • which country originally licensed in It is key for nurses to participate in each nursing workforce sur- • year of initial nursing license vey they may receive from the Nursing Commission, WCN, NCSBN and HRSA. • active status as an Advanced Practice Nurse Nurses’ full participation of in these surveys is vital to inform the • which states licensed as an APN policy makers, educators and others who influence nursing workforce • employment status as a nurse development efforts. Information from these surveys can bolster • typical hours worked support to expand and improve nursing education programs and prevent nursing shortages that threaten the health of Washington communities. ■ Find more information about Nursys and how to access it at the Nursing Commission website: www.doh.wa.gov/ LicensesPermitsandCertificates/NursingCommission. View nursing workforce snapshots and other WCN nursing data at www.wcnursing.org/data-resources. PHOTO: IRYNA IMAGO IRYNA PHOTO:

26 The Washington Nurse WINTER 2018 wsna.org NURSING PRACTICE Opioid Overdose Prevention

Being part of the solution: Preventing opioid overdose deaths in Washington

Nancy Lawton, MN, ARNP, FNP President, ARNPs United of Washington State

wo people die of an opioid overdose nearly every day in Wash- Be aware of the new Health Care Authority guidelines ington state. Though heroin and synthetic fentanyl overdoses http://wsna.to/HCA-OpioidGuidelines have increased in number, deaths due to opiates prescribed HCA restricts opioid prescribing to 18 tablets, a 3-day supply, for patients 20 by providers remain the leading cause of unintentional over- and under and 42 tablets, a 7-day supply, for patients over 20. dose deaths. While the number of prescriptions for narcotics Provide naloxone, a short-term antidote for opioid overdose, to all Tis decreasing in Washington, the number of deaths is not. patients receiving opioid prescriptions and to family members who Nurses have a role to play in reducing opioid deaths in Washington. express concerns about relatives with substance use disorders. Here are some things you can do. Be sure they know how and when to use naloxone. All Safeway and Albertsons Enroll in and use the Prescription Monitoring Program (PMP) pharmacies in Washington now have naloxone available directly from pharmacists. http://www.wapmp.org/practitioner/pharmacist Pharmacies stock Narcan Nasal Spray, and patients can acquire it after a 15-20 minute pharmacy consultation. A prescription permits insurance coverage. At As of July 2017, 33 percent of ARNPs were enrolled, leading physicians increased risk of overdose are persons who have had a period of in percentage enrolled, but behind Physician’s Assistants and abstinence; someone leaving a rehabilitation or detox facility, Osteopathic Physicians. When seeing patients in clinical jail, prison or after a hospitalization. That person’s tolerance practice, check the PMP before any and every prescription will have decreased and if they resume opioid intake at the for a controlled substance is written. If done every time level they did before the period of abstinence they are at for every patient, we are not targeting any individual. increased risk for overdose. Nurses can be enrolled as delegates to simplify the process in clinic. Support efforts for public and private insurers to cover the costs of substance use disorder treatment. Become waivered with the DEA to prescribe buprenorphine. Medicare pays for some services and not others. http://wsna.to/AANP-OpioidCE Similarly, Apple Health programs are inconsistent on what treatments for what diagnoses are covered, exposing One year after waivers became available, 137 Washington patients to prohibitive costs. state ARNPs are now registered with the Drug Enforcement Agency as buprenorphine prescribers. Becoming waivered Psychiatric ARNPs have a special role to play in requires 24 hours of continuing education provided free through providing Cognitive Behavioral Therapy or Dialectic the American Association of Nurse Practitioners and the American Society of Behavioral Therapy as a means of addressing chronic pain. Addiction Medicine. The training is free, but your time is not. Request additional The Washington State Department of Labor & Industries now pays ARNPs 100 time from your employer to complete the one-time training. Use a low threshold percent of allowable charges for providing therapy to injured workers and for patients to access buprenorphine. Even if a patient continues using other assisting in their return to work. drugs or alcohol, buprenorphine aids the patient in continued positive behavior change. Assist patients to find a source for substance use disorder treatment Learn the location of your nearest needle exchange program. with “no wrong door,” including primary care, behavioral health or chemical You can find it on the NASEN directory (https://nasen.org/directory/wa). Provide dependency treatment. Be aware of housing and social services that can support the information to patients. a patient’s efforts to become opioid free. Keep local and state legislators informed and ask for their support. Prevent opioid dependence to begin with by careful opiate prescribing. Tell you lawmakers about effective, evidence-based substance use disorder Exposure to a first dose of opioids increases the risk of recurrent use. Recognize treatment options, and ask them to support and fund these services in our that acute pain can be quickly addressed with non-opiate options. Chronic non- communities. cancer pain requires a multimodality approach to learn means of functioning and Participate in the University of Washington Telepain conferences. adapting using nonpharmacologic methods to maintain a higher quality of life. http://depts.washington.edu/anesth/care/pain/telepain Follow the recommendations of the Agency Medical Submit information on a patient problem and experts will provide feedback and Director’s Guidelines for safe prescribing. suggestions for care. Observe and earn continuing education credits. http://wsna.to/AMD-OpioidGuidelines If you are a prescriber, refer to the guidelines. If you support prescribers, make sure they are aware of and follow these guidelines. The guidelines answer questions regarding challenging situations, including how to address the acute pain needs of a chronic pain sufferer. Support alternatives to opioid prescribing for chronic pain management including non-opiate medications, exercise, yoga, counseling and complementary medicine. PHOTO: IRYNA IMAGO IRYNA PHOTO:

wsna.org The Washington Nurse WINTER 2018 27 NURSING PRACTICE Opioids Fact Sheets

GUIDELINES FOR PRESCRIBING OPIOIDS

Opioids patient FOR ACUTE PAIN

fact sheet available The goal of these guidelines is to encourage the Washington state medical community to more safely prescribe opioids and to prevent the unintended or inappropriate long-term use of prescription opioid medications. The guidelines are not intended for patients who are in active cancer treatment, palliative care or end-of-life care. In addition, some modifications to the guidelines may be appropriate for patients following major surgery. in 22 languages The following guidelines are based on guidelines from the Centers for Disease Control and Prevention and the Washington State Agency Medical Directors Group, available at: www.cdc.gov/drugoverdose/pdf/guidelines_at-a-glance-a.pdf and www.agencymeddirectors.wa.gov/Files/2015AMDGOpioidGuideline.pdf. The Washington Health Alliance and Bree Collaborative 1 Do not prescribe opioids as first-line treatment for acute pain. teamed up to produce two info sheets on Opioids, Opioids (including prescription opioid pain relievers and heroin) killed more than 28,000 people in 2014, more one for providers, the other directed at patients. than any year on record. At least half of all opioid overdose deaths involve a prescription opioid. 2 Use evidence-informed pain care and opioid prescribing. “Guidelines for Prescribing Opioids for Acute Pain,” for BEFORE PRESCRIBING: providers, and “Opioid Medication & Pain: What You  Talk to patients about a treatment plan. Discuss realistic goals for pain and function—help them to understand that pain is a normal part of life and healing. Make sure they know the significant risks Need to Know,” for patients, include helpful graphics, associated with opioid use.  Unless contraindicated, ensure non-opioid alternatives are considered prior to use of opioid key facts and information. medications, such as:  NSAIDS and acetaminophen, tricyclic antidepressants (TCAs), serotonin-norepinephrine reuptake These info sheets in English are posted on the WSNA inhibitors (SNRIs), anti-convulsants, heat/cold, exercise, massage therapy and cognitive behavioral therapy. Opioids web page, wsna.org/nursing-practice/opioids.  Actively use the Washington State Prescription Monitoring Program (PMP) to review the patient’s history of controlled substance prescriptions. Use the data to determine whether the patient is receiving opioid dosages or dangerous combinations that put them at high risk for overdose. Find out more here: www.doh.wa.gov/ForPublicHealthandHealthcareProviders/HealthcareProfessionsandFacilities/Prescriptio Public Health – Seattle & King County translated the nMonitoringProgramPMP.

IF YOU PRESCRIBE: patient sheet into 21 additional languages. To download,  Start low and go slow. Prescribe the lowest effective dosage for the shortest duration.

go to wsna.to/OpioidInfographic, scroll down and click on  Use immediate-release opioids.  For acute pain prescribe no more than a 7-day supply of opioid medication for adults or a 3-day supply the “Resources” tab. (or 10 pills maximum) for youth 20 years and younger.  Avoid co-prescribing opioids, benzodiazepines (such as Xanax or Valium) and muscle relaxants (such as Soma or Flexeril) concurrently whenever possible.  Avoid > 90 mg Morphine Equivalent Dose (MED)/day; refer to a pain specialist if more is being considered.  Use a lower maximum dose threshold of 90 MED/day for chronic conditions.

For more about the Washington Health Alliance: For more about the Bree Collaborative: www.WashingtonHealthAlliance.org www.BreeCollaborative.org

Opioids Facts & Figures

THE OPIOID EPIDEMIC

Opioid Medication & Pain: Drug overdose is the leading cause of accidental In 2015 alone, 718 people in Washington died from overdoses death in the US and in Washington state, and involving opioids. What You Need to Know opioid addiction is driving the epidemic. Washington State Department of Health American Society of Addiction Medicine If you’ve had an injury, surgery or major dental work, you are likely to have pain. Pain is a normal part of life and healing. Talk Commonly prescribed opioids: with your doctor about how you can get the most effective pain relief with the least risk. Codeine Dilaudid NON-OPIOID PAIN TREATMENTS HAVE FEWER RISKS More than 3 out of 5 drug overdose Nationally, 4 in 5 new heroin In Washington, 57% of people Fentanyl deaths involve an opioid. users started out misusing currently using heroin were dependent For pain that will likely be gone in a week or two, it is always best to start with non- prescription painkillers. on prescription opioids before they Hydrocodone (Vicodin) Centers for Disease Control and Prevention opioid pain treatments. Opioids may help control pain at first, but they are usually not began using heroin. American Society of Addiction Medicine necessary. Consider other options that may work just as well but have far fewer risks. Hydromorphone UW Alcohol and Drug Abuse Institute • Over-the-counter pain relievers Methadone • Physical therapy Meperidine TEENS AND OPIOIDS • Exercise • Professional help coping with the emotional effects of pain Morphine MS Contin OPIOIDS ARE STRONG PRESCRIPTION MEDICATIONS 1 in 5 teens experiment with prescription drugs. Oxymorphone (Opana) Opioids can be the right choice for treating severe pain, such as from cancer or Centers for Disease Control and Prevention Oxycodone (OxyContin) immediately after major surgery. However, medications such as Vicodin, Percocet and OxyContin are very powerful and can be deadly. Even if you take them as directed, Percocet ALL opioids have serious side effects such as addiction and overdose. These are only some Nearly half of young people who More than 4 in 10 teens who misused 95% of parents believe their child has OPIOIDS ARE CHEMICAL COUSINS OF HEROIN AND ARE of the prescription opioids. If you get a inject heroin started off abusing or abused a prescription drug took it never taken a prescription drug for a HIGHLY ADDICTIVE prescription for pain, prescription drugs. from their parent’s medicine cabinet. reason other than its intended use. ask your doctor if it is You can build up a tolerance to opioids over time, so you need to take more and more National Institute on Drug Abuse Partnership for Drug-Free Kids Partnership for Drug-Free Kids an opioid. to get the same relief. The higher the dose, the more dangerous opioids are. You can even become addicted after a short time.

If you are prescribed an opioid for short-term pain: KEEPING KIDS & TEENS SAFE Sometimes kids and teens are prescribed opioids when they shouldn’t be. Or they may be given a prescription for more pills than they need. Teens may also experiment with drugs they find in your medicine cabinet. Follow these 3 simple guidelines whenever possible:

The prescription should Take the lowest dose Always talk with the doctor Dispose of opioid DON’T FILL a prescription SECURELY STORE opioids SAFELY DISPOSE* of extra only be for a three- possible for the shortest about managing your medicines as soon as 1 for more than a 3-day supply 2 away from kids and teens. 3 opioids when you are done. to seven-day supply (often period of time. pain better without taking you stop using them.* (maximum 10 pills) for anyone Don’t keep them around. this is as few as 10 pills). perscription opiods. 20 years old or younger.

*King County has dozens of pharmacies that can dispose of your unused medications for free. Find the one closest to you at: www.takebackyourmeds.org. *King County has dozens of pharmacies that can dispose of your unused medications for free. Find the one closest to you at: www.takebackyourmeds.org.

www.WashingtonHealthAlliance.org www.BreeCollaborative.org www.WashingtonHealthAlliance.org www.BreeCollaborative.org PHOTO: ROB CRANDALL / SHUTTERSTOCK.COM / CRANDALL ROB PHOTO:

28 The Washington Nurse WINTER 2018 wsna.org NURSING PRACTICE EPA Lawsuit

Why are nurses suing the EPA? By Barbara Sattler, DrPH, MPH, RN, FAAN

ow is it that our shampoo can contain car- tion Agency, rather than requiring manufacturers cinogens and our floor cleaner reproductive to prove that a chemical or product is safe before Under current law toxicants? letting us use the product in our homes, schools FStates cannot pass For over a decade, nurses have been or workplaces. In every instance in which the EPA safety laws that are more working with a wide range of partners, tried to prove that a chemical was dangerous, the restrictive than federal law once a chemical is including other health professionals, industry prevailed in keeping it on the market. The under review by the EPA. Henvironmentalists and health-affected groups, to EPA could not even ban asbestos—a known carcino- update the nation’s chemical safety policy. Written gen with unquestionable evidence of harm. FThe EPA is required to review only 10 to in 1976, the Toxic Substance Control Act was an In 2016, after making significant compromises, 20 chemicals per year, ineffectual safeguard for people and the environ- the Republican Congress passed and President while over 80,000 ment from exposures to toxic chemicals in our air, Obama signed a new chemical safety law. The big- chemicals are currently water, food and products. It did not require com- gest compromise made was inclusion of a provision in the marketplace. panies to do any sort of pre-market testing of their that precludes states from passing chemical safety FThe EPA is not required products for toxicity or potential harm. laws that are stricter than the new federal law once to consider the complete Worse, it established that any chemicals that a chemical is under review by the EPA. Historically, scope of ways a chemical were already in the marketplace (some 80,000 we have looked to progressive states to pass legisla- is being used, allowing them to underestimate chemicals) were “generally regarded as safe” tion on health and safety before federal laws have health risks. without any evidence about their safety or harm made their way through Congress and to the Presi- to confirm this assumption. This was a way to dent. Now, states are barred from further protecting “grandfather” a host of toxic chemicals and thus their citizens from toxic chemicals, even if their protect them from new requirements for safety test- citizens overwhelmingly want the added protection. ing. The burden of proof regarding toxicity was Another problem with the 2016 chemical safety placed on the public and the Environmental Protec- law is the timeline for review of potentially, and PHOTO: ROB CRANDALL / SHUTTERSTOCK.COM / CRANDALL ROB PHOTO:

wsna.org The Washington Nurse WINTER 2018 29

WSNA's position on mandatory influenza vaccinations and often known, toxic chemicals. In the first year, only 10 new chemicals are required to be reviewed. By 2019, only 20 chemicals need to be under review at any given strategies to address influenza time. The Registry for Toxic Effects of Chemicals includes over 150,000 chemi- The following position statement was cals for which there is some toxicological evidence; over 80,000 chemicals are adopted by the WSNA Board of Directors in the marketplace. Think about how many years it will take to get through that Dec. 4, 2009 and reviewed Oct. 20, 2017. list at a pace of 10 to 20 chemicals per year. Consider, too, how many years and The Washington State Nurses Association (WSNA) is decades we will continue to see preventable health effects from toxic chemicals committed to advocating for the health of nurses, patients that have not yet been reviewed. and the communities they serve. Because of this commitment, As a nurse whose mantra is “evidence-based practice,” I find it difficult to help WSNA strongly recommends that all nurses and other health individuals and communities navigate the purchasing decisions required to live, care providers be vaccinated against all influenza viruses. work, learn and play in a healthy environment because of the lack of information WSNA strongly supports and urges voluntary efforts that aim about so many of the chemicals that make up our everyday products. Because we for 100 percent vaccination rates, including annual education and implementation of comprehensive influenza vaccination don’t require complete labeling for the vast majority of products, we can’t even programs for all health care providers. do our own independent literature searches regarding the ingredients. WSNA supports enforcement of existing Federal and State When nurses started working on revamping the old chemical law, we had regulations to ensure that all employers meet the Centers for three elements that our coalition members agreed on: 1) We need basic health Disease Control (CDC) and Occupational Health and Safety and safety information on all chemicals in the marketplace, 2) We must be able Administration (OSHA) requirements for influenza prevention. to protect the most vulnerable of our population, including the fetus, infants WSNA believes a hospital-by-hospital approach to and children, from the effects of toxic chemicals, and 3) The EPA must have the mandatory vaccinations is poor public policy. It lacks power to ban chemicals that create the greatest risk of harm. consistency and adequate protection for patients and In June 2017, the EPA issued new guidance documents, as required by law, health care workers. WSNA believes that any vaccination spelling out how they are going to review chemicals under the new law. These policy is only one component of a comprehensive influenza guidelines, issued under an anti-regulation administration, allow the EPA to prevention policy and should only be enacted as a result of federal or public health regulation. WSNA believes that any pick and choose which uses they will consider when determining if the chemical such regulation must include the following core components: poses an unreasonable health risk. Consider the case of lead. Lead can be found as a contaminant in air, water, food, toys and even in lipstick. If the EPA elects • Employers must ensure that appropriate protection and safety measures are in place to look at only one or two of these sources, they could underestimate the health to provide a safe workplace environment risks, allowing a toxic chemical to be used in products that would otherwise be for nurses and health care workers. deemed unsafe. • Employers must ensure that influenza vaccines are These new guidelines were the last straw; nurses joined other organizations available and offered to every health care worker in suing the EPA for placing the public at an unreasonable health risk. annually at convenient times and locations. “The new guidelines fly in the face of our attempts to protect the public’s • The policy must cover all health care settings and health,” said Katie Huffling, Executive Director of the Alliance of Nurses for health care workers. This includes all settings such Healthy Environments. as hospitals, long-term care facilities, adult boarding Three separate suits were filed in District Courts around the country. It is homes, outpatient clinics, etc. Health care workers anticipated that the judges in the courts will consolidate the cases into one. must include those licensed and unlicensed who With so many policy changes occurring­—in health care, the environment and work in close proximity to patients, (e.g. nurses, other important areas—it is sometimes difficult to keep up. We invite you to stay emergency responders, physicians, housekeeping informed, join our calls, get involved and join a growing number of nurses who personnel, health care secretarial staff, etc). are concerned about potentially toxic chemicals in our everyday lives. • If a declination form is required for vaccination, the Follow the court case and get information about chemical safety and chemical nurse must be able to sign the form confidentially; policy at www.saferchemicalshealthyfamilies.org. that is, the nurse must not be required to divulge Join our free monthly national calls with other nurses who are concerned about personal health information or declare the reason(s) chemicals and public health policy. Get the details at the Alliance of Nurses for for refusal of a vaccine. The employer must not Healthy Environments website, https://envirn.org/policy-advocacy. ■ discriminate against or discipline a nurse for opting out. • The employer must not discriminate against or discipline nurses for the appropriate use of sick time. Barbara Sattler, DrPH, MPH, RN, FAAN, Professor, University of San Francisco School of Nursing and Health • The employer must comply with CDC and Professions ([email protected]) and Board Member OSHA Guidelines must be used for prevention, of the Alliance of Nurses for Healthy Environments protection and safety of nurses and patients. (https://www.enviRN.org)

WSNA is a member of the Safer Chemicals, Healthy Families coalition.

30 The Washington Nurse WINTER 2018 wsna.org NURSING PRACTICE Continuing Education

CONTINUING EDUCATION CALENDAR

FEBRUARY 2018 MAY 2018 2018 UNION LEADERSHIP EVENTS Nursing Grand Rounds (NGR), Live and Video Nursing Grand Rounds (NGR), Live and Video Teleconference Series Teleconference Series WSNA UNION Feb. 1, 2018, noon–1 p.m. May 3, 2018, noon–1 p.m. Leadership Seattle, WA Seattle, WA Summits Wound Management Education Progr a.m. Winter/ Fifth Annual, Nursing Research Symposium Spring 2018 May 11, 2018, 8 a.m.–4:30 p.m. We’re making changes at WSNA to better meet your Feb. 7, 2018 – April 12, 2018 Seattle, WA needs! In 2018, our annual leadership conference will Midwifery Update 2018 Suicide Prevention Course be broken into several regional one-day conferences Feb. 7, 2018, 8 a.m.–4:50 p.m. May 23, 2018, 8 a.m.–3:30 p.m. that we’ll be bringing to a city near you. Shoreline, WA Seattle, WA Announcing our 2018 Leadership Summit educational TrachSafe Emergency Airway Management offerings (CNE content will be the same at each): Course JUNE 2018 Feb. 7, 2018, 3:45 p.m.–9 p.m. Seattle, WA Nursing Grand Rounds (NGR), Live and Video Jan. 27 Teleconference Series Pacific Lutheran University, Tacoma A UWCNE Progr a.m.: Cardiovascular Care Update June 7, 2018, noon–1 p.m. Feb. 15, 2018, 8 a.m. – Feb. 16, 2018, 4:45 Seattle, WA March 18 and 19 p.m. Campbells Resort, Chelan Shoreline, WA TrachSafe Emergency Airway Management Course April 14 June 20, 2018, 3:45 p.m.–9 p.m. MARCH 2018 Seattle, WA Red Lion Riverside, Spokane A UWCNE Progr a.m.: Diabetes Update May 19 March 1, 2018, 8 a.m.–4:50 p.m. MAY 2019 Shoreline, WA Teamsters 58, Vancouver Washington State Nurses Convention Nursing Grand Rounds (NGR), Live and Video May 1–3, 2019 June 2 Teleconference Series Tulalip, WA Good Shepherd Center, Seattle March 1, 2018, noon–1 p.m. Seattle, WA June 10 and 11 A UWCNE Progr a.m.: Suicide Prevention Training Campbells Resort, Chelan March 6, 2018, 8 a.m.–4 p.m. Shoreline, WA Sept. 8 Suicide Prevention Course Red Lion (Columbia Center), Kennewick March 16, 2018, 8 a.m.–3:30 p.m. Seattle, WA Sept. 30 and Oct. 1 Campbells Resort, Chelan Pediatric End-of-Life Conference – Save the Date March 20, 2018, 8 a.m.–4:45 p.m. Nov. 3 Seattle, WA Skagit Casino, Mt. Vernon

APRIL 2018 Join us for a day of personal and professional Nursing Grand Rounds (NGR), Live and Video development and come away with the tools needed Teleconference Series to make a difference. We’ll be asking you to use your April 5, 2018, noon–1 p.m. own personal experiences and values to understand Seattle, WA how workplace violence, staffing and the attack on A UWCNE Progr a.m.: a.m.bulatory Care Nursing workers’ rights will impact you both personally and Conference professionally. April 18, 2018, 8 a.m. – April 19, 2018, 4:05 p.m. Hear RNs from around the state and country speak Lynnwood, WA about the potential impact of the three topic areas, 39th Annual Duncan Seminar: Spina Bifida: network with other RNs working in your community Promoting Wellness and Preventing Pitfalls and begin making a difference. April 20, 2018, 8 a.m.–4:30 p.m. Seattle, WA Join us for a fun and interactive opportunity with the best and brightest minds in nursing to make plans for our future and take your career to the next level.

For the the most up to date information on these and other events, Visit www.wsna.org/leadership for including how to register, visit www.wsna.org/calendar. more details and to register.

wsna.org The Washington Nurse WINTER 2018 31 The store is now open.

Get your WSNA-branded Lands’ End gear at wsna.org/landsend. UNION Also in this section 2017 Union Leadership Conference - - - 34 Congratulations 2017 Leadership Award winners ------36 Mission accomplished! NFN celebrates its history and plans for the future - - - - 38

Powering up at WSNA’s Union Leadership Conference WSNA’s Union Leadership Conference was held in Chelan Sept. 24–26, 2017. About 120 WSNA union leaders from around the state gathered at Campbell’s Resort to share ideas, listen to speakers and participate in workshops aimed at supporting their WSNA work. There was also time for celebration and fun as WSNA’s Cabinet on Economic & General Welfare presented the 2017 Leadership Awards at the banquet.

Sally Watkins, PhD, RN, Executive Laura Ewan, JD, Senior Associate at Schwerin Director of WSNA Campbell Barnard Iglitzin & Lavitt and Tim Sally welcomed attendees with a nod to Sears, JD, WSNA General/Corporate Counsel the association’s history and look to the In “Unionism 2017 and Beyond,” Laura future. Since 1908, registered nurses of and Tim provided an overview of what we Washington state have played a pivotal role can potentially expected at both the state as the leading voice, authority and advocate and federal level when it comes to worker for the nursing profession. Sally’s question protections and collective bargaining to the group was a challenge: “Where do we rights. Member engagement will be key go now?” Every nurse in Washington state as we stand together to protect our rights must think about, and challenge themselves and our power as registered nurses. to overcome, obstacles in an ever-changing and tumultuous time in our history.

Jennifer Mensik, PhD, MBA, RN, NEA-BC, FAAN Evan Sutton, Assistant to the President The author of “Lead, Drive, and Thrive in for Communications, AFT the System” delivered the keynote address In his presentation, “Power Up: Social on the theme for Leadership this year, Media for Mobilization,” Evan discussed “Surviving and Thriving.” Jennifer shared the key elements of a good story and her personal journey of becoming a health how we can use social media to amplify care leader and provided the audience our message and get people to act. tools to identify and develop not only their survival skills but mechanisms to thrive. h To watch Evan’s presentation and earn 1.0 online CEs, go to cne.wsna.org h To watch Jennifer’s presentations and earn 2.0 online CEs, go to cne.wsna.org

Christine Watts, MN, RN, WSNA Senior Director of Labor and Anne Tan Piazza, MBA, WSNA Senior Director of Strategic Initiatives This presentation, “How to Make the New Staffing Law Work for Us,” explained key components of the 2017 law, which focuses on greater transparency of staffing plans, increased accountability in adoption of staffing plans and strengthening staffing committees. They also provided an overview of WSNA wins on staffing in both bargaining and legal actions including negotiation of staffing ratios into collective bargaining contract (Tacoma General) and $5 million win on back rest break pay (St. Joseph Tacoma). Look for education and training sessions around the state in 2018 to support nurses in the implementation of this new law.

h To watch an abbreviated version of this presentation and earn 0.5 online CEs, go to cne.wsna.org

wsna.org The Washington Nurse WINTER 2018 33 Kittitas Valley Hospital local unit officers Cody Staub, Jeanette Simonton, Jennifer Crane, Natalie Seubert and Andria Graham.

Cathy Sanders, Tom Booze and Cathy Powers accept an “outstanding negotiating team” award on behalf of the Northwest Hospital local unit negotiating team.

Tesfaye Geda, Kami Prentice and Travis Elmore. DiDi Gray (winner of the “membership” award) with fellow Southwest Washington Medical Center nurses Jonathan Chase, Summer Chase and Erin Winston in back, and Rae Lynn Crocker and Nicole Schriock in front.

Julie Strate and Sharon Sim Rozee.

Beverly Hilliard, Jeanne Avey and Evelyn Schill.

Michelle Burton, winner of the “rising star” award, and Karen Winchell PHOTOS: CARMEN GARRISON AND JENNIFER MUHM JENNIFER AND GARRISON CARMEN PHOTOS:

34 The Washington Nurse WINTER 2018 wsna.org 2017 Union Leadership Conference

Sept. 24-26, 2017 Campbell’s Resort, Chelan

Nurses from across the state convened at WSNA’s annual labor traning event in Chelan to get an update on the national and state labor scenes, learn how to be more effective leaders in the workplace, celebrate successes and strategize for the coming year.

Members of the WSNA Cabinet on Economic and General Welfare Martha Goodall, Julia Barcott, Gary Cook, Fran Castillo, John Gustafson, Janet Stewart and Clarise Mahler with Edna Cortez (winner of the “outstanding local unit chair” award for her work leading the WSNA local unit at Seattle Children’s Hospital).

Leadership Conference auction raises money for scholarships Auction bidders donated $2,000 for scholarships at our Union Leadership Conference in Chelan. A special thank you to the local bargaining units that provided baskets for the auction: • Seattle Children’s Hospital • St. Joseph Medical Center, Tacoma • Skagit Regional Health

WSNA President Jan Bussert (second from left) with University of Washington Medical Center nurses Susan Griffith, Teresa Wren, Jill Cook and Jordan Pai Palimar. Emergency department nurses at UWMC won the 2017 “adversity” award. PHOTOS: CARMEN GARRISON AND JENNIFER MUHM JENNIFER AND GARRISON CARMEN PHOTOS:

wsna.org The Washington Nurse WINTER 2018 35 UNION NEWS Leadership Awards

Congratulations, 2017 Leadership Award winners!

OUTSTANDING LOCAL UNIT CHAIRPERSON MEMBERSHIP AWARD Harry James, RN Christopher “CJ” Johnston, RN University of Washington Medical Center, Seattle MultiCare Tacoma General Hospital, Tacoma

Harry has been on the negotiation team for 20 years. As a bargaining unit leader, CJ is very active in many He is known for his ability to keep his team informed aspects of his local unit. He attends new hire orientation and for making the extra effort to communicate with the whenever possible and is constantly recruiting nurses as nurses in his facility. Harry is well respected by both peers local unit reps. CJ takes responsibility for many of the WSNA and management for his leadership skills and calm demeanor. He is bulletin boards, keeping them neat and up to date. He is noted especially for always steady in the face of adversity and acts as a true mentor to new members. his ability and initiative in utilizing social media to recruit and engage members. Harry is the first WSNA person to greet newly hired nurses at UWMC and During recent periods of turmoil at Tacoma General, CJ was a steady support for presents the best first impression of the positive influence the union has on his co-workers, offering kindness, caring and an objective attitude. everyday life at UWMC. He is helping the next generation learn to advocate for RNs. CJ is always willing to help in any way he can to strengthen the membership Harry gives selflessly of his time and talent to lead his local unit and is always visibility of WSNA, to help nurses understand how WSNA impacts them and to faithful to his leadership role. The person who nominated Harry called him a tell nurses how they can get more involved in WSNA. He serves on the Nurse real “unsung hero!” Conference Committee, as well as participating actively on the negotiation team for several contract cycles. OUTSTANDING LOCAL UNIT CHAIRPERSON Edna Cortez, RN Seattle Children’s Hospital, Seattle MEMBERSHIP AWARD Dianne “Didi” Gray, RN Edna is a longtime member and leader in her local PeaceHealth Southwest Medical Center, Vancouver bargaining unit. She tirelessly gives of her time to help other nurses in the facility. Her strong voice and commitment Didi is an exceptional person. She is a leader in her local to the nurses at Children’s has been unparalleled. unit as well as the greater Labor community in southwest To know Edna is to know a confident yet humble person. She is never too tired Washington, serving on various councils and boards while to listen to a nurse’s concerns or to represent them in speaking to management. working and parenting two young children. She is active in chairing or co-chairing numerous hospital committees and has Didi has been actively working to build the membership and engagement been a vital part of the negotiation team during the last several contract cycles. of nurses in her Local Unit for years. She regularly meets with groups of newly Edna is an excellent communicator, fielding calls and email from members, hired nurses as a representative of WSNA to explain the ways that their WSNA as well as using the Local Unit Facebook page to promote visibility and membership benefits all. communication among the nurses at Children’s. Edna’s natural ability to mentor, Didi is known to nurses throughout the hospital as a dedicated WSNA member, inspire and “never give up” are unsurpassed. willing to help in any way that she can to strengthen and support her unit.

RISING STAR OUTSTANDING LOCAL UNIT CHAIRPERSON Michelle Burton, RN Joan Guercia, MSN, BSN Public Health – Seattle & King County Kadlec Regional Medical Center, Richland Michelle is an emerging leader in her local unit and in Joan is not only a grievance officer, she is also a true leader WSNA. She has been active in her local unit for several and a team builder who has the strength and dedication to years, attending meetings and being vocal. serve as Local Unit Chair while an active grievance officer. In the past year, Michelle has demonstrated her commitment Joan knows how to make each member feel that she has his to her local unit and fellow nurses by supporting colleagues through a difficult or her back and that she is in the fight alongside them, defending each and grievance time, even though it meant more work for her. She is compassionate every one! toward her peers and their dedication to safe patient care. Michelle stepped She maintains a positive attitude in the face of negativity, is vigilant in pursuing forward as a witness in a grievance meeting that might have put her in a very facts instead of accepting fiction and encourages positive communication in difficult situation with her supervisor. her peers. Michelle is respected by her peers and continues to show excellent leadership, Joan is always available to nurses who have a grievance and is known to go communication and organizational skills. to administration whenever she feels there is a problem that needs her advocacy. During her many years in nursing, Joan has worked in many specialty areas and is admired for her compassion, professionalism and competence. Joan is very knowledgeable and is a great resource. She loves helping!

36 The Washington Nurse WINTER 2018 wsna.org UNION NEWS Leadership Awards

Each year, WSNA’s Cabinet on Economic & General Welfare recognizes outstanding leaders in Local Units across the state. These fearless nurses, nominated by their peers, received their awards at WSNA’s Leadership Conference in late September 2017. Congratulations to all of them for their dedication and outstanding work on behalf of WSNA members!

ADVERSITY AWARD OUTSTANDING NEGOTIATION TEAM Northwest Hospital Negotiating Team Tacoma General Hospital Negotiating Team Northwest Hospital, Seattle MultiCare Tacoma General Hospital, Tacoma

Pictured page 34. The Tacoma General team faced an uphill battle from the first day of negotiations. This team is tough! They stood together through challenging times. They worked Negotiating for over a year in adversarial conditions, they stuck together in an long and hard, at their own personal financial sacrifice. There were those in the exceptional way. bargaining unit who were quick to criticize them but did not want to work to They worked hard to provide timely and accurate communication to their make things better. bargaining unit. As WSNA pioneers in successfully using Facebook and social This team was steadfast, though the very people they were working to media to engage nurses and the community, they have shown the power of this represent were giving them verbal abuse in the background. Despite the type of publicity. Through various event—from hiring a food truck, to public hardships, they remained calm and professional. rallies, to pickets over the freeway which included an airplane towing a message Through it all, this brave and tremendously strong team continued to go to banner—they were powerful and tireless. Whenever opportunities presented the table to get the best contract possible for all members of the bargaining unit. themselves, they spoke passionately about the need for safe nursing staffing and were successful in garnering the next step forward in the push for fixed ADVERSITY AWARD ratio staffing in this state. Emergency Department Nurses Negotiations were very challenging, yet everyone remained cohesive University of Washington Medical Center, Seattle and determined, never swaying from their resolve to represent each nurse and each department to the best of their ability. This team’s professionalism, Pictured page 35. approachability and interactive stance are a shining example for us all. As you can imagine, the ED at UWMC is a fast-paced and often chaotic place in which to work. When you add in dealing with construction and the disruptions EMERITUS AWARD it causes, along with high acuity and high census, one can understand that it Terry Surratt, RN takes a special type of nurse to work there. The stresses of dealing with just one Formerly of MultiCare Tacoma General Hospital, shift in this area are truly exceptional; dealing with it week after week is daunting. Tacoma Through all the difficulties this year, this group of nurses has maintained their focus on their reason for being nurses. They always provide the best possible Terry worked at Tacoma General for many years before her care to each person who presents at their doors, regardless of gender, illness or recent retirement and has been a loyal and involved member economic status. All of these ER nurses proudly represent professional nursing of WSNA. As a respected and vocal leader, Terry led her unit to their patients and community. through their recent successful contract negotiations, changing strategies as necessary to bring about the best outcome for the nurses at her facility.

OUTSTANDING NEGOTIATION TEAM AWARD Terry’s contributions over the years have been many and are truly valued Northwest Hospital Negotiation Team by the nurses at Tacoma General, especially those who have followed in her Northwest Hospital, Seattle footsteps to become the current leaders and officers. She was so determined to make these negotiations successful that she resigned her seat on the Cabinet Pictured page 34. to focus her attention on her Local Unit. Terry is described by her nominator as There is strength and steel in each of these team members. They have faced a “true motivator and advocate extraordinaire!” open hostility from other nurses at their hospital and endured harsh criticism from peers who were not willing to volunteer to help to make things better. With professionalism and determination, they worked together to provide one-on-one coaching to others who had trouble understanding the negotiation process. This group had to overcome personal biases and conflicts to build a cohesive team and stand firm in the face of adversity. They were able to achieve unity and represent the best interests of the nursing staff, as well as the patients for whom they care, always keeping patient safety in the forefront of their concern. Each team member was so deeply committed to the long haul that they willingly sacrificed time and energy to stick with the protracted negotiations.

wsna.org The Washington Nurse WINTER 2018 37 UNION NEWS National Federation of Nurses

Mission accomplished! NFN celebrates its history and plans for the future

by Judith A. Huntington, MN, RN WSNA Executive Director Emerita

Brief history of the NFN As a result, in 2012, NFN appointed an NFN “Membership 2007 Following the disaffiliation from the United Committee” to begin exploration of an NFN affiliation with American Nurses (UAN) in December 2007, the state another national AFL-CIO labor union. After evaluating nurses associations of Montana, New York, Ohio, Oregon many different national unions, the membership committee and Washington formed a labor states coalition and began narrowed the field to three possible national unions: AFT, to work together to form a new national union of Nurses AFSCME and OPEIU. Labor Organizations (NLOs). The resulting new union was The NFN Board and the NLOs, after careful vetting and called the National Federation of Nurses (NFN). The Montana much deliberation and discussion, selected AFT as the Nurses Association joined NFN shortly thereafter. union of our choice and in 2012 an affiliation agreement From left: Edna Cortez, Fran Castillo, Over the next 12 months, the coalition worked together was negotiated. It was an exciting time and proved to be a Martha Goodall, Sally Watkins, Christine truly great decision! Watts, Jan Bussert, Judi Lyons, Renata at least monthly by conference calls and face-to-face Bowlden and Susan E. Jacobson meetings to develop a NFN Constitution and Bylaws based 2013–2017 In February and March of 2013, NFN and its on a set of “Core Covenants” dedicated to respect for each member NLOs successfully negotiated and signed a 5-year state association’s sovereignty and transparency and to affiliation agreement with AFT and, through the affiliation, On Oct. 25–26, 2017, build a strong collaboration to meet the needs of nurses regained its membership in the AFL-CIO. The affiliation with National Federation of Nurses everywhere. AFT became permanent in February 2017. (NFN) representatives from the 2008 When the National Federation of Nurses was member state nurses associations founded in 2008, the stated purposes of the NFN were Dissolution and a vote for change of Montana, Ohio, Oregon and to strengthen and assist member NLOs and to establish Now that the AFT affiliation is permanent and we have Washington met in Seattle for and implement an effective national labor agenda that regained membership within the AFL-CIO, the question a “NFN Celebration and Summit” supports and advances the economic and general welfare, arose whether we needed to continue the NFN in its present to celebrate the history and workplace conditions and practice of RNs through collective form, dissolve or reorganize into a different structure. accomplishments of the NFN bargaining and shared decision-making. Following a year of discussions, the NFN Executive Board and completion of the affiliation voted in Aug. 2017 to formally dissolve the NFN and begin with our new national union, the 2008–2011 These were the formative years for the NFN. a transition to a more voluntary, less formalized coalition American Federation of Teachers, Much time and effort was spent developing policies and structure to meet as needed. The action of the Executive AFT. The celebration also marked procedures, assisting each other in state organizing and Board was ratified by a vote of the elected labor leadership the dissolution of the formal defending against attacks from other unions—including of each of the four remaining NFN states on Sept. 27, 2017. structure of the NFN. The keynote the National Nurses United (NNU), working on a National Rationale for a less formalized structure and possible speaker for the event was Randi Labor Agenda, and preparing to apply for a national charter return to a coalition meeting format was supported because Weingarten, AFT President. with the AFL-CIO. It was also a period of great unrest in the New York State Nurses Association, which was undergoing the NFN leaders believe there is still value in the NLOs that WSNA was represented at the an internal raid. NYSNA ultimately was taken over by new represent primarily RNs and are a part of ANA in coming celebration and summit event radical leadership and disaffiliated from both ANA and NFN together for mutual support and collaboration on important by NFN Vice President Susan E. in 2012. nursing and labor issues, even as we participate actively Jacobson; NFN Executive Board in the AFT. They also believe there is value in continuing 2011–2013 One of the main objectives of NFN was to members Judi Lyons and Renata to build on those relationships and that it can be done as achieve a charter as a national union within the AFL-CIO. Bowlden; WSNA Cabinet Chair a coalition as opposed to a separate organization with a After our disaffiliation from the UAN, it was necessary to Julia Barcott,; WSNA President Jan formal structure. The coalition format may also open up wait three years to apply for a national Charter with the AFL- Bussert; WSNA Cabinet members possibilities for additional states to want to participate in CIO. The NNU strongly objected to and opposed any direct Edna Cortez, Fran Castillo and the coalition. affiliation or national charter for the NFN within the AFL-CIO. Martha Goodall; WSNA staff Sally For the past few years, NFN operated with minimal staff During 2011 there were many meetings with attorneys and Watkins, Christine Watts, Margaret and has been rebating back nearly all the NFN dues to the the AFL-CIO to see if we could find a path back to direct Conley and Tara Goode; and former NLOs for their use. WSNA has used the rebate to offset the affiliation with the AFL-CIO. The disaffiliation of NYSNA WSNA staff Judy Huntington and impact of the new AFT dues on our members. Additionally, from the NFN in 2012 further weakened our ability to gain Barbara Frye. NFN has provided additional support to the NLOs in the recognition, with the loss of half of the NFN membership form of organizing and special assistance grants. Because (approximately 35,000 RNs.) the NFN dues have been paid out of the total WSNA dues Ultimately, the AFL-CIO made it clear that from their collected from our members represented for collective perspective there would be no direct charter to NFN and bargaining, there will be no change to the current WSNA the only options open to us were either a reaffiliation with dues as a result of the recent structure change. ■ NNU or an affiliation with another AFL-CIO national union.

38 The Washington Nurse WINTER 2018 wsna.org Washington State Nurses Association 575 Andover Park West, Suite 101, Seattle WA 98188 www.wsna.org/hall-of-fame

The Washington State Nurses Association warmly invites you to join us for a gala dinner in honor of the 2018 inductees into our Hall of Fame:

Debbie Brinker, MSN, RN, CNS David Campbell, JD Hilke Faber, MN, BSN, RN, FAAN Judy Huntington, MN, RN Karen Matsuda, MNA, BSN, RN Barbara Van Droof, ARNP-BC March 22, 2018, 5:30 p.m. — 8:30 p.m.

Salty's on Alki 1936 Harbor Avenue SW, Seattle, WA 98126

$40 per guest Grilled salmon, Draper Valley Farms chicken breast or vegetable napoleon

Please return the registration form below to reserve your spot.

 Detach and return by mail to WSNA, 575 Andover Park West, Suite 101, Seattle WA 98188 or fax to 206-575-1908, or you may register online at wsna.org.

REGISTRATION FORM

2018 WSNA Hall ______guests x $40 per guest = $ ______total. of Fame Induction

Ceremony & Gala Guests Chicken Salmon Vegetarian  MasterCard / Visa  Check (written to WSNA) Dinner ______   ______Cardholder Name March 22, 2018 ______   ______Salty's on Alki Card Number ______   ______Exp Date ______   ______Billing Address ______   ______City ______   ______State Zip ______   ______Phone Number ______   RECOGNITION March of Dimes Awards

2017 March of Dimes Nurse of the Year Awards On Friday, Nov. 17, 2017, the March of Dimes – Washington Chapter Annual Nurse of the Year Awards were presented during a breakfast program at the Washington State Convention Center in Seattle. More than 300 nurses in 15 categories were nominated by their peers for their contributions to the nursing profession and to patient care.

We congratulate those recognized at the 2017 Nurse of the Year Awards (WSNA members highlighted).

ADVOCACY FOR DISTINGUISHED NURSING PATIENTS NURSE OF THE YEAR ADMINISTRATION RISING STAR FRONT LINE LEADER AND LEADERSHIP Mike Hastings Jennifer Graves Kara Yates Hunter Barrett Swedish Medical Center - Washington State Hospital Multicare - Mary Bridge Children’s Seattle Children’s Hospital Jeanell Rasmussen Edmonds Association Harrison Medical Center, a part of Hospital CHI Fransiscan Health HOSPICE, HOME HEALTH CLINICAL CARE EDUCATION SURGICAL/PROCEDURAL PALLIATIVE CARE Gail Van Alstyne Sheryl Greco PEDIATRIC Amber Weiseth James Johnson Seattle Children’s Hospital University of Washington Medical J. Mari Clarkmoore EvergreenHealth EvergreenHealth Hospice Center Seattle Children’s Hospital

COMMUNITY HEALTH WOMEN’S HEALTH LEGEND OF NURSING AND PUBLIC HEALTH EMERGENCY RESEARCH Rebekah Arends Patricia Groff Maggie Bissell Kristen McDonald ADVANCEMENT Providence Regional Medical Seattle Cancer Care Alliance Swedish Medical Center - Swedish Medical Center - Seth Eisenberg Center - Everett Edmonds Edmonds Seattle Cancer Care Alliance

We would also like to recognize the WSNA members who were nominated by their peers for an award.

Amanda Baker Daniel Henriquez Chad Markward Saaliha Nawaz Emma Corbilla Deaconess Medical Center Overlake Hospital Medical Center Seattle Children’s Hospital Seattle Children’s Hospital UW Medicine/Northwest Hospital & Medical Center Carolyn Jones Erin Zimmerman Danielle Roland Sarah Caufield Evergreen Home Health Overlake Hospital Medical Center Seattle Children’s Hospital Seattle Children’s Hospital Kailyn Skjonsby UW Medicine/Northwest Jesica Odongi Julia Hart Erika Miller Tawny Morris Hospital & Medical Center Evergreen Home Health Overlake Hospital Medical Center Seattle Children’s Hospital Seattle Children’s Hospital Merilee Fjelstul Teresa Arndt Maggie Kujath Jena Verbance Amanda Mackey UW Medicine/Northwest Evergreen Home Health Overlake Hospital Medical Center Seattle Children’s Hospital St. Clare Hospital Hospital & Medical Center

Terra Johnson Susan Stauffer Karly Regalia Eloisa Charles Madeline Dahl Evergreen Home Health Providence Sacred Heart Medical Seattle Children’s Hospital St. Clare Hospital UW Medicine/University of Center & Children’s Hospital Washington Medical Center Julia Perhurova Kathleen (Kate) Coffee Janette Reddekopp EvergreenHealth Alexis Weable Seattle Children’s Hospital St. Clare Hospital Molly MacGuffie Seattle Children’s Hospital UW Medicine/University of Leah Bray Maria Donavi Vinarao Clara Eickhoff Washington Medical Center EvergreenHealth Allison Agnew Seattle Children’s Hospital St. Joseph Medical Center Seattle Children’s Hospital Lansia Jipson Tara Connor Megan Jackson Julie Roberts Virginia Mason Medical Center EvergreenHealth Andrea Steinbach Seattle Children’s Hospital St. Joseph Medical Center Seattle Children’s Hospital Lillian (Elizabeth) Bowler Ann Marie Smith Megan Urquhart Kathleen Briggs Virginia Mason Medical Center EvergreenHealth Brianna Felix Seattle Children’s Hospital St. Joseph Medical Center Seattle Children’s Hospital Mashelle Fathiafshar Allyson Matsumoto Nancy Brajtbord Rebecca Weichers Virginia Mason Medical Center Multicare Good Brianna Williams Seattle Children’s Hospital St. Joseph Medical Center Samaritan Hospital Seattle Children’s Hospital Mina Wirth Rachel Richards Anna Garrett Virginia Mason Medical Center Julie Gehring Caitlin Shearer Seattle Children’s Hospital UW Medicine/Northwest Multicare Tacoma Seattle Children’s Hospital Hospital & Medical Center Pam Jewell Rachel Sayles General Hospital Virginia Mason Medical Center Caitlin Siegfried Seattle Children’s Hospital Catherine Lehtinen Alyssa Nguyen Seattle Children’s Hospital UW Medicine/Northwest Sharon Veith Remia Zhong Overlake Hospital Medical Center Hospital & Medical Center Virginia Mason Medical Center Carly Kuhlman Seattle Children’s Hospital Seattle Children’s Hospital

40 The Washington Nurse WINTER 2018 wsna.org WSNA Staff Membership News

How much did you Welcome new WSNA staff pay in dues in 2017?

Becky Anderson Will Nesper By Patrick McGraw Membership associate Organizer WSNA Membership Payments Program Manager Becky Anderson is a native Will was born and raised in Cleveland, Ohio. He earned of Washington, born and a BA in psychology at Bowling Green State University in Would you like to know how raised in the Puget Sound Ohio. Will moved to Seattle with his girlfriend, now wife, and much you paid in dues to area. She has a long changed careers to nursing during the economic downturn. WSNA in 2017? background working with He worked as a hospice/palliative care nurse for patients The membership department can the Washington State with HIV, ALS and Huntington’s Disease at Bailey Boushay provide information to a member Water & Sewer Association, House in Seattle. Will is excited to continue his career where over the phone about the total where she assisted the helping nurses reach their potential and patient safety are amount of dues collected in the Membership Department paramount. current or previous year. We can also with multiple projects, Outside of work, Will is an avid outdoor recreationist, send a statement by mail or email meetings, conferences and workshops, along with including kayaking, snowboarding, cycling and backpacking. at the request of a member. Please maintaining the membership dues. Most recently, Becky The last three summers he backpacked with his family note that the Washington State comes to WSNA from the Alaska Fishing Industries, where around Mt. Rainier on the Wonderland Trail. Nurses Association (WSNA) does not she was a Human Resources Recruiter for five factory send information regarding the total trawlers. amount of dues payments received In her spare time, Becky enjoys spending time with her without a request from the member. family, grandchildren and friends. Dues payable to WSNA are not deductible as a charitable Tara Barnes contribution for federal income tax Organizer purposes. However, they may be deductible under other provisions of Tara is a Seattle native and child of an Irish immigrant. She the Internal Revenue Code. For more attended Seattle Central Community College and completed information, please consult your tax her BSN from Seattle University in 1994. Her work experience advisor. started in long-term care and pediatric home care. She spent The membership department 12 years at Evergreen Hospital in med/surg and critical care. may be reached by phone by While there, Tara was a local unit officer and served on the calling 206-575-7979, by fax at negotiation team three times. She received the honor of Christine Nguyen Communications and digital media coordinator 206-838-3099 or by email at WSNA grievance officer of the year. [email protected]. Thank you Tara worked at Swedish Edmonds for the past seven Christine is a recent graduate of the University of Washington, for your continued support of and years, where she served as SEIU1199NW delegate for her where she studied communications and history. During her participation in WSNA. department, as executive board member for the facility time at UW, she worked in various departments, including and member political organizer for all Swedish campuses. finance, marketing and communications. Prior to joining Tara’s passion for labor union work stems from her WSNA in October, Christine worked with a team within the Grandfather Eamon and Uncle Gerry, who sacrificed University of Washington’s human resources department, much in the shipyards of Ireland and America to elevate The Whole U, to promote wellness in the workplace for all conditions for workers and families. She enjoyed several staff, faculty, students and families of UW. quarters teaching Shoreline CC nursing students in the Christine finds joy in working in an environment where hospital setting 2011 to 2012. all are passionate and driven to strengthen the community and make a change. Bettering workplace environments and conditions is something she finds very important, and to be a part of an organization that focuses on influencing reform and development is something she is proud to say she is a part of. When she doesn’t have her nose in a book, she is on the mat, training in judo.

wsna.org The Washington Nurse WINTER 2018 41 Districts

DISTRICT 2 DISTRICT 4 DISTRICT 3 King County Nurses Association Inland Empire Nurses Association Pierce County Nurses Association

King County Nurses Association is offering several I have been extremely honored to be your IENA PCNA 5th Annual Bowling Tournament continuing nursing education events on a variety president. We have an active and productive district of current topics of interest to nurses. Unless in Eastern Washington. I want to share with you Saturday, Feb. 24, noon–2 p.m. otherwise noted, events are open to all nurses that every level of our organization I have served Pacific Lanes Bowling Alley and nursing students. Details and registration at has made me very proud to be a member of WSNA. 7015 S. “D” St. Tacoma, WA 98408 www.kcnurses.org, “Education and Events.” Nurses speaking with one voice and working together $25 registration fee can achieve a great deal! Let me address some of Join Pierce County Nurses Association for our 5th Seminar: Ethics Conversations what we have accomplished and opportunities in annual Bowling Tournament to raise money for and Health Equity the near future. nursing scholarships. Light lunch provided! Prizes Saturday, Feb. 10, 8:30 a.m –1 p.m. I attended a council meeting of the WSNA district awarded for most team spirit, lowest scoring team Good Shepherd Center, Wallingford (Seattle) presidents and executive directors a couple of and highest scoring team and individuals. This workshop will feature three interactive months ago. Our district 4 is dynamic! We, along sessions exploring ethics, upscaling social justice with our western Washington districts, are providing Teams of 4 — $100 practice for health equity and value-based care, scholarships to students, giving awards to our Teams of 6 — $150 and mindfulness. Speakers include: Anne Poppe, talented nurses and donating funds to nonprofit Individuals — $25 PhD, MN, BSN, BA, RN; Doris M. Boutain, PhD, RN, agencies that reflect our values. PHNA-BC; and Christine Prenovitz, MSW, E-RYT. All proceeds go to the PCNA Scholarship Fund! The Legislative Reception was Oct. 18 at The Each year, PCNA awards scholarships to PCNA District Meeting: Conversations with Spokane Club. It was well attended by nurses and members continuing their education, ADN and the New WSNA Executive Director candidates. We had three State Legislators and BSN students and graduating high school seniors Wednesday, Feb. 28, 5:30–7:30 p.m. three city council candidates. Jan Bussert, WSNA who are pursuing a career in nursing. This year, Good Shepherd Center, Wallingford (Seattle) President, and Nathasja Skorupa, Political Action PCNA is also offering a special scholarship for LPN- 1.5-hour Certificate of Completion Specialist, spoke about the need for nurses to to-RN students. All applications are available at Sally Watkins, PhD, RN, executive director of speak out. Nurses voiced thoughtful questions www.piercecountynurses.com and due by March Washington State Nurses Association, provides and concerns. We were able to question two of leadership in multiple areas, including legislation, 31, 2018. our representatives as to why they do not vote for health policy, nursing practice, advocacy and labor the nurses’ bills in Olympia. One of them willingly relations. Hear about current WSNA activities and To stay up to date on our PCNA responded. legislative updates for 2018, and ask any burning events and activities questions you may have. Register by Feb. 22. Education event will be March 10 at Red Lion River Like us on Facebook Inn. It will be a 2-hour CNE offering on the topic facebook.com/piercecountynurses Dinner Seminar: Health Care Ethics of “Healthy Nurse” by Teresa Bigand. This is in the Get on our email mailing list Discussion: Henrietta Lacks and Beyond morning and we will enjoy a hearty breakfast. This Email us at [email protected] Wednesday, March 28, 5:30–8 p.m. is a good time to network with other nurses and to be added to our distribution lists Good Shepherd Center, Wallingford (Seattle) catch up on the news. 2.0-hour Certificate of Completion Visit our website Join Bridget Carney, PhD, RN, health care ethicist, to IENA Board of Directors has some openings for www.piercecountynurses.com discuss the book “The Immortal Life of Henrietta members to join us in working to shape educational, Lacks” and bioethics issues related to the medical legislative and other funs events. Consider taking the use of patient tissue and genetic material. next step and serve IENA. Please call our office at Registration fee includes a copy of the book; (509) 328-8288 to let us know if you are interested! register by March 1 and KCNA will mail it to you. Final registration deadline March 19. — Lynnette, Vehrs, MN, RN, District President

HEADS UP: Annual Meeting and Spring Banquet Thursday, May 10, 5:30–9 p.m. Ballard Bay Club, Seattle This festive event, scheduled during National Nurses Week, includes annual nurse awards, nursing student scholarships, a lovely Northwest-cuisine dinner, and silent and live auctions to benefit the KCNA Scholarship program. Enjoy good food and beautiful views while supporting the future of the profession. Register before March 15 for early-bird savings: $40/KCNA member, $45/nonmember. Rates will increase by $20 after March 15. Final registration deadline April 30.

42 The Washington Nurse WINTER 2018 wsna.org New Members Washington State Nurses Foundation

DISTRICT 1 Elyse D. Dietz Whatcom County Emily A. Coleman Tess A. Golling Emma I. Collins Make a difference: Hannah P. Korsgaard Erica L. Kahl Lacey R. Ruby Erin N. Sheridan Donate to the WSNF to support Michael G. Collins Gabrielle M. Delos Reyes Waldo S. Hockman Genevieve C. Aguilar student scholarships Wendy R. Wescott Grace Ikeler Yelena I. Zalyashko Hana N. Powers Lora B. Kroon Hannah S. Shepard Aaron D. Lebovitz Heather Hwee Giving to the WSNF Addie C. Lepley Hermona K. Tekeste Crystal H. Neva Hopi D. Jayne ou can help make a difference in someone’s life by giving a gift to the Washington State Nurses Cynthia L. Thompson Hyemin Kim Foundation (WSNF). Your gift will support scholarships for students attending college, either to Isatou Canteh Danielle M. Telford become an RN or to advance their education with a BSN, Master’s or doctoral degree. We are all Denice M. Burns Jacqueline P. Agdeppa Heather R. Houston Jamie A. Kane aware that tuition costs have been climbing, especially in the past several years, much faster than Jackie A. Guthrie Jamie L. O’Connell Y inflation. Your gift will allow us to award scholarships to more students and to give larger scholarships, Jakob O. Frisch Janice M. Samonte Kelley A. Palmer-McGee Jean Pierre V. Neri all to very deserving students—future nurses and future nurse leaders. Kelsey L. Groenhout Jema R. Mateo And, your gift can serve in another way. A gift can be made to honor or remember a friend, family Jenna R. Byrd Kendra L. Fresh member, nurse colleague or mentor. The Foundation will send the honoree a letter notifying them that Laurel E. Rister Jennifer A. Wohlman Lisa M. Adams Jennifer L. Bracken you have honored them with your donation. (Note: Donation amounts are always confidential). If you Megan T. Copps Jennifer T. Bereta would like to target your donation to a specific fund, you can select from the following: Naomi L. Roberts Jessica D. Lebowitz Nichole M. Braun Jessica E. Geiger • Etta B. Cummings Emergency Assistance Fund Jessica E. Scott Olivia M. Risch • May S. Loomis Professional Development Fund Paula K. Risch Jessica L. Morr Rachael E. Geist Jessica Lee • Dolores Little Scholarship Fund Ji Hae Park Shannon L. Thompson • Nursing Mini Grant Fund Sherri L. Kohr Jillian M. Bendixen Victoria C. Truchan Jomay Ruiz • WSNF General Operations Fund Jordan D. Mudd Jordan E. Ferrell • Judy Huntington Scholarship Fund DISTRICT 2 Joy A. Irvin King County Julia A. Sehgal To make a secure online donation, go to wsna.org/WSNF. Renelle E. Fernandez Julie K. Smith Corey L. Lagadinos Justine N. Skillings Abigail J. Weaver Kailyn G. Skjonsby Adam D. Turner Kamalpreet K. Gill Receiving from the WSNF Adrian F. De Jesus Kara M. Baxter Ahnalee L. Herke Karri A. Allen If you are enrolled in a nursing program for a BSN or graduate degree, consider applying for a scholarship. Aileen C. Canaria Kate M. Pizzey Scholarship applications are due Feb. 12, 2018, to be awarded during the summer of 2018 for the 2018–19 Aileen G. Palawar Kathleen A. Balagtas Alexa R. Stampanoni Kathryn E. Curran academic year. Allison A. Sullivan Katie N. Alissa Another way that you can receive from the WSNF is through a Amanda A. Courtney Kelsey E. Rinaldi community service mini-grant. Receiving a mini-grant can Amanda L. Wagner Kelsey O. Niebergall Amanda R. Carpenter Kevin Constantinescu make a difference in YOUR community! We make grants to Amber R. Stehman Kira M. Bernard WSNA members who are doing various community service Amy K. Takeda Kristen E. Decker Andrea E. Rosso Kyanna B. Justice or educational projects. Grants of up to $500 are available to Andrew J. Innes Laura E. Hall help fund your project. Angela M. Lattanzio Laura E. Lenz If you are enrolled in an academic program, you can Anna L. Hoyer Lauren D. Sattely Anna R. Bryan Lauren M. Frishholz apply for a mini-grant from the WSNF to help pay for a Anthony C. Camcam Lecca J. Roberts project required for academic credit. Likewise, if you aren’t Arezu H. Piroozmandi Lenaya L. Leblanc in school but you are interested in doing a community service Ariana K. Bitting Linda S. Banks Ashley M. Burgett Lindsay M. Alvani project in a local neighborhood, then funding for these kinds Ashley N. Ruse Lindsey A. Strohsnitter of projects is also available through the WSNF. If you are Awet M. Berhe Madeline M. Haugen Bailey L. Godfrey Madison J. Hommes interested in a mini-grant, then apply for funding of your Bernadette T. Reyes Magdalyn H. Grumm-Albert project. Your project could be the next one that the Caitlin E. Morris Marisa E. Taylor Foundation supports. Applications for mini-grants are Casey C. Boothman Marlon D. Monillas Chenin S. Tofflemire Marvin M. Alvaro accepted year-round and will be reviewed by the Chloe L. Blair Mary C. Thompson Board of Trustees as they are received. There is Christopher P. Cox Mary R. Sichko no deadline for the mini-grant applications. Ciara K. Bartlett Matthew J. Jasinski Colleen S. Coyne Maya S. Avarzamani We look forward to hearing from YOU! Danielle R. Paschall Meagan A. Newman Danya K. Akram Meagan E. McKenzie Learn more about how to apply at Desiree L. Duarte Melanie L. Brown wsna.org/WSNF. Diana C. Moran Melanie M. Chun Dina L. Barnes Michele F. Dillman Eilidh S. Mote Michelle S. Greever Elizabeth A. Kleymann Min Park Elizabeth J. Shevins Mishel S. Andre Elizabeth Knope My-Tho T. Nguyen The mission of the WSNF, a 501(c)(3) charity, is to promote the advancement of educational and professional Elizabeth M. Gideon Nadine G. Bennett excellence within nursing, and the health and well being of the citizens of Washington state.

wsna.org The Washington Nurse WINTER 2018 43 In Memoriam New Members

Nathalie A. Audette Ashlyn N. Hicks Yvette Edwards Nicole L. Reynolds Aubrey R. Goldsmith Nicole M. Jowett Aziza S. Saliev Yvette Edwards, a dedicated local PX (Military Store) and then was a Department Olivia J. Fox Belen K. Port public health nurse, died on Sept. of Defense employee. Upon completion of the tour Paige K. McCulley Bereket W. Beyn 3, 2017. She spent the last 20 years in Germany, her husband re-enlisted and the family Patricia L. Smith Breanna M. Hagen Qi C. Huang Brianna N. Guerrero in service to King County, much relocated to Washington state. Rachel A. Handley Brooke A. Phagan of this time with the Child Care Yvette attended Pierce College, received her Rachel B. Cannon Brooke A. Wilson Health program. She touched degree and was accepted into the University of Rachel E. Bull Bryan J. Meadows Rachel L. Cortner Caitlin B. Young countless people in the community, serving the most Washington School of Nursing. Yvette graduated Rachel S. Watanabe Camila T. Pair vulnerable children and families with her kindness with honors while being parenting full time. As an Rachelle J. Robinson Carly M. Hubbard Rahma H. Arero Carolyn M. Fitzpatrick and passion. RN she worked for a Sea Mar clinic, serving Hispanic Rebecca M. Elmer Catherine D. Paul Yvette was born in Las Vegas, New Mexico, on Jan. and predominantly indigent patients. She also did Sabrina Marie H. Angle Chelsea J. Bergthaler 19, 1965, to Elias J. Monroe Jr. and Diane M. Monroe some volunteer work and assisted at El Centro Sally R. Farmer Christina A. Aga Samantha M. Marsack Christopher T. Parks (nee Geoffrion), one of seven children. As a child de la Raza, across the street from Sea Mar. Yvette Sara M. Neal Cindy B. Chung Yvette was described as somewhat of a tomboy and eventually moved on to enter Public Health Nursing Sarah N. Fein Corina Saldivar as a teen was an accomplished Baton Twirler and for King County, where she was known as not only Sarah R. Lehecka Corneliu Capusan Savannah Ojendyk-Banks Cristie L. Mellon marched in parades. She was also featured in a movie a public health nurse but also an excellent authority Selwyn O. Osial Daniel Peck as an extra. She was a phenomenal musician as a on Child Care Health and Facilities. She authored or Shandon M. Lystad Darlino A. Gatchalian Siobhan E. Brosnan Dawnita R. Munshaw clarinetist who was awarded All-State honors three co-authored numerous health policies for countless Sophia L. Overly Deborah G. Dial years in a row. She was a member of the University King County Child Health/Day Care Facilities. Her Susanna E. French Demetria S. Espinoza of New Mexico Marching Band. She also played the policies resulted in multiple changes in how infants Syla Shirlane B. Espiritu Diana L. Johnson Sylvia P. Nguyen Eliza A. Grey Piano and Pipe Organ at a Church that she attended and children are treated at numerous day care Taylor J. Sytsma Elizabet G. McMahon with her husband in Germany. facilities. She also assisted pregnant unwed and Teresa M. Kazakos Elizabeth H. Asmare Yvette was a student at the University of New indigent teens and women. In addition, she taught Terri N. Fredlaw Elizabeth W. Shannon Tiffany J. Liu Emily M. Biggs Mexico after receiving a Presidential scholarship first aid and CPR courses throughout King County. Ting Zu Juang Emma J. Cunningham in addition to several other academic and music Yvette was a member of two parishes, Holy Tyler A. Breier Erin E. Johnson Tyler J. Gilleland Farwa Fatima A. Sheriff scholarships. While attending UNM she met her Spirit in Kent and St. Anthony’s in Renton. Yvette Valeriya K. Artamonova Gabriela L. Toledano husband, Yusef, and then they had a child, Monique, will always be remembered as a loving daughter, Victoria I. Anderson Gwendolyn B. Portes born in Albuquerque, New Mexico. The family sister, wife and mother and is missed by all that Zane N. Lyons Haimanot Abate Zuhra Kazime Halie M. Boyce relocated to Georgia while Yusef enlisted and knew her. Services were held at St. Anthony’s Parish Charles A. Harding III Heather L. Jordan worked for the U.S. Army. Vanessa and Dominick were in Renton. After a slow, professional escort by the Dylan J. Robertson Heather M. Dixon born in Georgia, and then the family relocated to Seattle Police Department, Yvette was Interred in Elise C. Atkinson Heidi-Tanya L. Farrington Lindsey R. Whitehall Holly H. Clem Germany, where Yusef was stationed for a little over the columbarium at Tahoma National Cemetery. Wen Pei Y. Ridenour Hunter L. Bowlby three years. While in Germany, Yvette worked for the Kelsi R. Mullings Irit Gomelskiy Nino J. Signey Jacob J. Lakatua Bryn L. Brendamour Jacqueline A. Gage Emily S. Price Jacqueline S. O’Leary Sharon Marie Monaghan Jennifer L. Eckerman James M. Elliott Ross G. Beaulaurier Janni L. Trenary Raised in Dodge City, Kansas and an alumna of daughter, she adapted her signature dry wit for a Dana L. Beck Jasmine M. Mackey the University of Kansas, Sharon Monaghan came playfulness that earned her the role of Mackenzie’s Nora D. Kreiger Jean M. Piette to Seattle in 1981, which quickly became home. favorite playmate and instigator of mischief. A Genevieve B. Gonzales Jennifer L. Hutchings Jaleh A. Jaffari Jennifer M. Noar Graduating from the University of Washington in devoted wife and mother, Sharon was also a favorite Jamie E. McDonald Jeremy D. Stultz 1982 with her Masters in Nursing, Sharon worked aunt and source of endless laughter and love for Jillian E. Hipolito Jeremy M. Trout in the Harborview Burn Center ICU before opening children of all ages. Lourdes R. Mayeda Jessalyn S. Holdcroft Leslee A. Goetz Jill E. Stack the hospital’s Neurosurgery ICU in 1984 as the Alzheimer’s Disease crept into Sharon’s life just Lois A. Schipper Joan M. Cornel department’s Nurse Manager. For several decades, before her fiftieth birthday, corroding the brain of this Allison R. Covey John D. Patterson Anne C. Riski John M. Delgado she continued her career as a health care executive in fiercely intelligent, independent woman. Sharon tried Caron M. McMahon Joseph W. Glahn roles with NW Emergency Physicians, Virginia Mason in every way possible to hold on to those she loved Caterina M. Newren Justin K. Thomson and Children’s Hospital, while building a reputation and they to her. Over the years, Cathie, Mackenzie, Ingrid E. Fitzgerald Kalle N. Peterson Janina Damm Kara E. Coombs for exceptional leadership, mentorship and devotion family and friends have surrounded her with the love Karen Bidwell Kara R. Martin to her staff. and devotion she showed them throughout her life. Kristy A. Messerich Karen Lambka In 1982, Sharon met and fell in love with Cathie On Aug. 24, 2017 after a vigil that included a scotch Joanne L. Pinner Katherine A. Frenzel Aditi KC Katherine A. Reyna Cannon, whom she would marry in 1987 on the toast, tales of a wild youth and an open window, Alea-Kay Cepe Keaton L. Hambrecht backside of the Taj Mahal. Together they travelled Sharon’s spirit was finally set free. She believed she Alexander J. Shinosky Keillan L. Mennella Alexis M. Brown Kelley C. McLaughlin the world, built a village of friends and family and would return to us; we will watch for her. Alyssa J. Zeutschel Kellie A. Tanascu raised their daughter, Mackenzie Monaghan Cannon. Sharon is survived by her wife, Cathie; daughter, Amanda C. Ning Kelsey K. Duran She was a lifelong adventurer and always up for one Mackenzie; brothers, Shawn, Kevin, Patrick, Stacey Amanda E. Hue Kevin A. Letter Amanpreet K. Labaana Krista N. Johnson last sled ride, challenge or dare if you suggested it. and Tom; sister, Sheila (Seattle); a band of in-laws; Ambaye W. Gebru Kun Yang Whip smart with a wicked sense of humor, Sharon a plethora of loving nieces and nephews, and a Andrea-Rose Phan Landon K. Wadley was unflinchingly loyal and protective of those lucky multitude of friends. She joins her parents, Chuck Anna E. Ryden Lara L. Thoreson Anna Rediske Laura D. Stafford enough to be in her tribe. When she welcomed her and Madge, as well as her aunts in the next life. Arneel H. Jadraque Lewis A. Valladares

44 The Washington Nurse WINTER 2018 wsna.org New Members

Lexis A. Gerhardt Angela L. Liang Jean-Esther A. Rossow Jennifer N. Lashua Rose M. Golder Tabitha J. Good DISTRICT 7 Lindsey J. Tripp Ashley A. Hanna Bernard R. Rimmele Jenny L. Lund Ryan T. Alexander Thomas E. Durham Chelan / Douglas Lydia L. Glynn Ashley C. Hasenauer- Heather A. Svitak Jensen P. Hartman Sadelle K. Shevlin-Bennett Veronica K. Franco / Grant Counties Ahlers Lydia N. Jones Victoria L. Funk Jesusa C. Franco Sara K. Sheets Whitney R. Ward Lenda P. Flores Ashley M. Harrison Lyn K. McSharry Mary B. Roller Jocelyn M. Rogers Sara N. Yazdi Mariah K. Arneson Amie D. Garcia Britney M. Dixon Mam Asta Jobe Corey J. Ramstein Johanna L. Rollins Sarah A. McEntee Keith J. Peterson Bailey S. Trainor Brittany E. Drye Margaret W. Njoroge Lydia A. Owusu- Johanna T. Allen Shane T. Harris Patricia C. Nichols Edward G. Long Cameron A. Warriner Acheampong Maria L. Etafo Johanna Z. Lench Sharon Perry Juanita R. Odiorne Emily A. Rowe Carly J. Mairose Aimee J. Watanabe Marify F. Lacdao John A. Husby Sheila D. Renton Jennifer D. Grace Jennifer L. Nice Caroline E. Lindsley Alesha L. Reed Marily B. Sta. Maria Joshua W. Judson Shira Rauh Cassandra R. Redden Justin Whitman Cassandra C. Opara Alexis R. Johnson Marina Y. Pomar Judilyn M. Caoagdan Stefania N. Olson Elizabeth A. McLaughlin Linnea R. Paull-Ferguson Charlotte L. Hindley Allison T. Sunderland Marjorie L. Hall Judith A. Menard Stella W. Mwaura Lindsey R. Schwaderer Lisa M. Miller Christina M. Backus Amanda D. Taylor Mary Catherine Kaitlyn J. Hodgson Susan M. Wilkinson Lisa J. Day Megan R. Thrift De Guzman Clare M. Hatton Amanda L. Hockmuth Kamille Anne G. De Leon Suzanne K. Scott Alicia Kreutzer Rionni M. Brown Alvarez Matida Conteh Clarissa S. Potts Anastasiya Khatskevich Katherine Mitchell Tami M. Munizza Ashlie V. Goulet Sara M. Bergenholtz Melinda E. Anderson Crystal J. Rances Andrew J. Villanueva Kathleen Ann A. Tara L. Patrick Britanie L. Speziale Stephenie S. Santa Cruz Melissa A. Barclay Deborah J. Stormer Angela S. Glover Mangiliman Tara S. Davis Charles M. Kato Tracy M. Stoddard Mi H. Kwon Diana V. Osterdyk Anna S. Faric Kathleen McClone Tempest R. Day Chelsy G. Goertler Yesenia Ochoa Valdovinos Michele E. Percosky Eden P. Campo Annabel E. Cantrell Katie J. Hudson Teressa J. Oberg Christopher M. Mulvihill Minyiwa C. Mulenda Elizabeth J. Cheatham Anne M. Landen Katie L. Belongia Tiffany G. Smith-Fromm Christopher S. Simmons Mona L. Johnson Ellen S. Andersen Annie Reyes Katsiaryna V. Shaliatun Tiffany L. Neil Dana M. O’Dea DISTRICT 8 Moroni B. Black Elliot S. Fletcher Ashlee Mae U. Gallardo Kaylee J. Budde Timothy A. Soliday Dawn R. Mortensen Grays Harbor Myung H. Moon Eunice W. Ngure Ashley A. Yotter Keila M. Tinsley Tracy H. Kuizon Geena D. Wright Lucero Y. Garcia Oropeza Nadine J. Agner Fatmata Thomas Ashley J. Lemay Kelsey M. Hamilton Trisha C. O’Hearne Gerald P. Ingram Morgan D. Watters Nastassia K. Shon Gena M. Houghton Ashley R. Bezera Kenna R. Gordon Valerie E. Nelson Grace K. Mason Julie A. Day Natalia J. Roscher Hadley E. Coon Azeb A. Meles Keri L. Buehring Vanessa B. Livingston Heather B. Mecham Libby X. Meador Nicole M. Rinehart Helena I. Williams Barbara L. Zambrana Kimberly A. Seames Victoria S. Hoy Holly A. Bjur Ashley L. Snodgrass Nikole J. Baird Ikrah S. Hussain Bradley V. Harmon Kimberly A. Weaver Whitney L. Couture Jacqueline L. Block Erin R. Carossino Phoebe Morgan Jaclyn D. Shunk Breanna M. Laughlin Kimberly L. Braxton Yelena L. Karnaukh Jahmie C. Montgomery Kenzie L. McFadden Rachel J. Rasmussen Jacy K. Jeffrey-Howe Brianna W. Kilgore Kirsi M. Vivolin Yelena V. Korshenyuk Josh M. Hix Lacey D. Dahlstrom Rachel N. Latendresse Jamal L. Bell Brittney A. Merrill Kristen K. Bicknell Kurt R. Leach Kandace J. Kannberg Laura J. Jordan Rachel R. Izzo Janelle M. Carolus Brittney M. Kelly-Stowe Kristen N. Tracht Kathryn A. Lewis Linda S. Davenport Raymond M. Omana Jee H. Kim Carolyn B. Nartnik Kristina L. Scott Kelleena K. Bonglamphone Micaela R. Golia DISTRICT 4 Rebecca A. Pringle Jeffrey W. Reidhead Carolyne C. Schmidt Kristina M. Clark Kelli S. O’Connor Monica A. Ayala Spokane / Adams / Rebecca J. Houle Jennifer E. Hotchkiss Cassaundra L. Randle Kyla A. George Kimberly A. Bauer Nicholas A. Neeley Lincoln / Pend Rebekah C. Carty Jennifer L. Langevin Catherine T. Salcedo Kylee R. Johnson Lily F. Daffer Nichole D. Franks Oreille Counties Rendell G. Ragutero Jessica L. Sherman Cecelia M. Williams Kylie A. Adams Linda C. Bertholf Rebecca M. Meyer Renee M. Bunda John W. Sasser Chondra C. Nelson Lelani F. Maandig Abel Saba Lisa R. Bumbeck Roxann E. Milbourn Renniefe V. Reyes Johnna L. Anderson Christina M. Funaro-Pagani Liana R. Delacorte Jessie R. Stensgar Matthew A. Cox Tonya G. Wakefield Riely K. Harris Jonna R. Koegelenberg Christopher C. McCall Lisa M. Goodman Diana F. Miller Megan E. Golden Rinah S. Raguine Joslyn A. Potter Cody S. Shedd Lyudmila V. Svistunova Aenoi Williamson Megan K. Potter DISTRICT 9 Robert S. Kasibante Julia C. Stecker Cora J. Weberg Mallory M. Hodges Alexa J. Broersma Megan M. Stewart Robyn L. Nazar Kaetlyn R. Hughes Crystal Danielle Marcelle Arce Allison N. Camarota Melanie R. Galloway Snohomish C. Almazan Roshan L. Bahmani Kalynn E. Gulin Maria Cristina C. Lynch Ashley N. Uhlenkott Michelle H. Thompson County Daniel A. Moffett Rossana C. Aquino Katerina Volosevych Maria E. Pratiwi Breanna E. Ervin Rebecca L. Boyd Melinda Furrer Danielle E. Lewicki Sandra S. Lee Kayla R. Akers Maria P. Salas Brian W. Meadows Ronda M. Cross Chanel N. Bordsen-Swartz Danielle N. Mahlum Sara M. Crawford Kelli M. Roulette Marian K. Bolton Carlene T. Myren Sandra L. Darnold David L. Alford Sarah M. Anundson Kendra S. Wilson Martha C. Vivar Carlin J. Williams Sara A. Anderson Deanna J. Mehlhoff DISTRICT 10 Shana C. Mejia Kori A. Majors Mary J. Kautz Chance W. Raver Sara L. Morasch Dionna G. Burgess Wahkiakum / Shelby R. Smiley Kristen C. Barrett Maureen E. Ahern Chandlar M. Knutzen Sarah E. Bailey Doreen Nyokabi Cowlitz Counties Stacy L. O’Shea Krystie A. Galapon Meghana V. Bachu Chelcie M. Melton Selina R. Byrum Dyan M. Lauer Anna C. Baker Stephen S. Connelly Kyle E. McIntyre Melissa Segura Christian M. Meyer Shane H. Ryan Elias H. Karter Hsin-Yi Sung Steven J. Vander Heide Laura K. Timbs Michael A. Cable Crystina M. Canfield Sherri J. Schweizer- Sue M. Baek Lindsay N. Hanks Eljahn L. Balon Michael J. Robinson Denise M. Dinsmoor Gordon Inna D. Gershun Susana E. Abad Ma Danica Joy F. Camacho Emily D. Spagnola Michelle C. Mills Dorothy D. Lewis Stacy N. Orta James A. Sully Taylor J. Martino Madison J. LeMaster Emily M. Packer Michelle D. Bruff Elizabeth M. Costin Stephanie J. Ray Robin M. McConnell Taylor L. Hayden Mallory L. Price Emma D. Salender Michelle L. Stark Emily L. Christie Stephanie R. Stout Shannah K. McIntosh Teresa Locke Carlson Margaret J. Rule Erin L. Blair Minh Thu Nguyen Eric D. Williams Steven L. Vanhille Tanya L. Aho Thomas E. Neufeld Mari R. Wagsholm Georgia C. Somarakis Misty M. Willmott Hattie J. Johnson Sydney C. Matsuda-Fong Amber R. Sanders Tiffany Chin Marlowe L. McMurtry Gisllene M. Shin Molly K. Thias Janet C. Noffsinger Colleen N. Roberts Tiyanna C. Rodgers Matthew G. Pesely Grace O. Weaver Myriah N. Perez Jenna M. Hulse Meagan K. Richards DISTRICT 5 Tram-Anh H. Thi Matthew N. Kinney Gregory L. Wolff Nancy R. Yoder Kara L. Helmstadter Rachael M. Durkee Walla Walla Un Sherpa Megan L. Reddaway Hayley J. Mazzeo Natalia Lozinscaia Karen K. Knapp Shawna L. Nooner / Columbia Vanessa R. Borja Melissa E. Jackson Heather Bugenig Nathan W. Buchanan Karly E. Reinders Sofie P. Shulda Counties Veronica L. Karrer Miri S. Choi Heather M. Brandon Neva Y. Blasdell Kristina M. Gianakos Taylor R. Wasmundt Vincent S. Witwer Monica J. Guerrero Helena A. Laubach Nicole A. Laughlin Laura A. Mellon Judith I. Fetroe Trevor M. Byman Zachary J. Carvalho Nathaniel J. Symonds Hoboung Song Nicole R. Egan Lauren A. Bricker Mary S. Jennings Jill A. Huhta Nicole L. Mack Ian C. Bergeron Nikki M. Gilman Lindsay R. Pond Mia F. Cambronero Peyton N. Schmidt-Teague Inna P. Gruy Olivia E. Tamburello Margaret E. Daniels Lisa A. Hubbard-Mancha DISTRICT 3 DISTRICT 11 Reginald C. Mamaril Inna Y. Deyneka Paul J. Fernandez Mary A. Delay Pierce County Ishwerjot Kaur Clark / Skamania Roxana K. Hawelmai Peter M. Conrad Maya S. Wagers DISTRICT 6 Counties Derese A. Bogale Samrawit S. Zeinu Ivan R. Gonzalez Regalado Pyung G. Mun Megan K. Jackson Yakima City / Alisha N. Plank Firen R. Towanda Sara J. Drebis Jacqueline P. Sweet Rachel A. Ballou-Church Melody A. Eddy North Yakima Caitlin N. Giorgini Jessica M. Cisneros Stephanie L. Frankson Jacquelyn M. Richardson Rachel E. Rytter Michael A. O’Sullivan Kimberly A. Shipley Elena M. Willis Jillian I. King Stephanie L. Martin James A. Perryman Raiza S. Villanueva Michael R. Cahn Brandon M. Fuellas Fiona P. Reardon Shannon M. O’Brien Stephanie N. Tang Janelle R. Deleon Rebecca E. McGraw Michelle N. Drietz Carissa A. Timm Kailee R. Tabaco Vanessa J. Rhodes Sunni M. Steffensen Jeanne M. Dorres Rebecca K. Navia Mollada S. Sweet Nicole C. Bannister Mallory E. Cox Abigail R. McInnis Tarekegn G. Ayansa Jenilee K. Thiederman Regan L. Horton Nicole A. Mowbray Matthew D. Millard Alyson A. Ringle Yelizaveta Bobrovnikov Jennifer L. Ashmore Reggielyn C. Tallud Rebecca L. Birnel McKenzie R. Patterson Andrea M. Clark Michelle L. Livingston Jennifer L. Lovik Rivalyn O. Duenas Riley C. Ball Meghan E. Luebbert Andrea N. Murphy Tiffany M. Westeren Jennifer M. Merrill Robert M. Bright Shawna R. Polione Michael P. Herrera Angela C. Dominguez Edgardo B. Herrera Jennifer M. Olson Ronald A. Fox Susan R. Heuscher

wsna.org The Washington Nurse WINTER 2018 45 New Members Membership Information

Noelle M. Adams Laekynn R. Culpepper DISTRICT 17 Cecille D. Miguel Laurie A. Boogerd Kitsap County If you are currently a member and have had Shing Yu M. Burkhart Lisa S. Roberts Phyllis J. Ray a change in your employment situation… Martha C. Rodriguez Margaret L. McKechnie Diane M. Littau Alicia N. Parks Miles G. Colburn Mary L. Robinson Please complete a Change of Information Form or email your changes to Amanda M. Jensen Monica Lemus Cisneros Michele L. Liedtke-McDonald Aymee Burch Sandra Cruz-Zamora [email protected]. The Change of Information Form is available on the Brianna M. Fanello Sarah J. Lindenmeier DISTRICT 18 WSNA website under “Membership,” or you can contact the WSNA Membership Callie J. Nelson Sarah N. Reyes Carleen M. DeBoer Stephen A. Wendt Kittitas County Department at 800-231-8482 or 206-575-7979 to request one. Carol L. Mazan Wendy M. Clyma Elizabeth A. Hosey Christine D. Bonesteele Jaime M. Eddy Please note: It is the member’s responsibility to notify WSNA in writing of any Christina J. MacGregor Elizabeth J. Baker DISTRICT 16 changes in address, employer, FTE status, layoff or leave of absence. Write to: Rosalynd E. Smith Eric W. Janku Skagit / Island / San Membership – Washington State Nurses Association, 575 Andover Park West, Erica L. Larson Juan Counties Heather E. Shay DISTRICT 98 Suite 101, Seattle, WA 98188. Alicia P. De Bont Igor V. Shapoval All other counties Janet E. Moskop Becca M. Ward Christine E. Rodriguez Samantha J. McCrumb Jennie L. Hunter Notice of Washington State Nurses Association policy regarding nonmembers Erika J. Rindal Cher E. Conner Jennifer M. Kitts employed under WSNA collective bargaining agreements Crystal L. Kosik Jessica N. Taylor Jessica K. De Vries Joelle Fathi Federal and state labor laws recognize the right of unions in Washington to enter into collective Jocelyn M. Stromstad Karen I. Skrinde Sharon Wallace bargaining agreements with employers that require employees, as a condition of employment, John T. Walstrom McKenzee L. Taber Amy J. Blair either to join the union (and thereby enjoy all of full rights and benefits of membership) or to pay Julia L. Boyce Patricia A. Hall Diane L. Cantu fees to the union (and thereby satisfy a financial obligation to the union without enjoying the Lissette V. Guevara Amanda L. Fisher Erin M. Hoagland full rights and benefits of union membership). Regardless of the wording of the “union security” Michelle P. Mai Anna D. Jordan Caroline R. Berry Jennifer M. Shertzer agreement, employees represented by the Washington State Nurses Association for purposes of Russ H. Campbell collective bargaining and covered by a union security agreement are not required to become full Dusta J. Wright Travis M. Albright Sean P. Fogarty members of WSNA, and are required only to choose either to be members of WSNA or pay fees Grace Caroline W. Kamano Teresa Hemminger to it. Employees who choose to become members of the Washington State Nurses Association Joline F. Levine Trisha A. Delgado pay WSNA dues and receive all of the rights and benefits of WSNA membership. Employees who Jonathan A. Burnworth either decline to become members of WSNA or who resign from WSNA membership may pay Julia V. Dudkina “agency fees” to cover their share of the cost of representation, and thereby satisfy any applicable DISTRICT 14 Loretta D. Bezold union security obligation. WSNA has negotiated union security agreements, which have been Whitman County Matthew R. Parmer ratified by the democratic vote of the affected employees and which require that all employees Natalie A. Walsborn Natasha L. Hight must either join the union or pay fees to the union, in order to ensure that each employee who Shileen K. Leinweber Riley E. Keown is represented by WSNA pays a fair share of the cost of that representation. Such union security Elizabeth A. Marek Viktoriya V. Hall agreements strengthen WSNA’s ability to represent employees effectively in collective bargaining, Melissa A. Brooks Rachel Parmer contract enforcement and grievance administration, while eliminating “free riders” who enjoy Allison E. Paul the benefits of a WSNA contract and representation without contributing their fair share of the Amanda M. Phillips DISTRICT 15 union’s expenses for negotiating, administering and enforcing the contract. Through the collective Ashley R. Heilig Benton / Franklin bargaining process, nurses represented by WSNA achieve higher wages, better benefits, fairness Barry R. Antler Counties in the disciplinary procedure, and enhanced respect for their skills and professionalism. These Beverly M. Hunt improvements, won through collective bargaining, enhance the terms and conditions of working Andie L. Clark Brynn K. Rilea life for all employees, and allow them to better provide for themselves and their families. Only Channel Manigo Cheryllynn Y. Milhomme WSNA members enjoy all of the full rights of WSNA membership. Only WSNA members have the Dara N. Jansons Chona M. Hapa right to attend local unit meetings and speak out on any and all issues affecting their workplace, Elizabeth C. O’Keeffe Colleen A. O’Leary WSNA and its members; the right to participate in the formulation of WSNA policies; the right Heather J. Soule Darci D. Rose to have input into WSNA bargaining goals and objectives, and to serve on WSNA negotiating Karen A. Stemwell Doreene M. Hulford committees; the right to nominate and vote for candidates for WSNA office, and to run as a Karen Romero Edward M. Love candidate for WSNA office; the right to vote on contract ratification and strike authorization; the Katherine A. Knutson Greg S. Seed right to participate in the WSNA general assembly; and the right to participate in the American Maria G. Mendoza Heidi C. Hauenstein Nurses Association and the American Federation of Teachers. Melissa Mackey Jessica J. Howard Agency fee payers are those who choose not to be full members of WSNA but who pay Nicole L. Hockett Jessica L. Shaffer their share of WSNA’s expenses for negotiating, administering and enforcing the contract with Robert G. Steltenpohl Johnna N. Vanderhoek their employer by payment of agency fees. They thereby fulfill any applicable union security Stacy L. Gray Joyce A. Peyton financial obligation to WSNA under the terms of any collective bargaining agreement between Summer R. Touchette Kelsey K. Clark their employer and WSNA. Agency fee payers forfeit valuable rights and benefits of WSNA Travis J. Schouviller Kristy N. Westphal membership. Agency fee payers give up their rights to have input into the affairs of WSNA, the Zachary T. Hontz Laura L. O’Neil organization that represents them in dealings with their employer concerning wages, hours of Alex M. Arnold Lauren C. Pena work, health and retirement benefits, disciplinary matters, and other terms and conditions of Robert M. Nagel Lauren E. Snow employment. Any WSNA member who chooses to become an agency fee payer (and thereby Christine D. Raines Lilia V. Varivoda forfeit his or her WSNA membership rights) may resign at any time from WSNA by submitting a Amanda C. Ramble Lisa M. Heisel written notice of resignation from WSNA membership, which becomes effective upon receipt by Angela D. Barclay Lysette D. Vazquez WSNA. Agency fee payers should submit to WSNA an Agency Fee Payer Application Form, which Angela F. Hocker Margarita Ilyin is available upon request from WSNA. Agency fee payers are required to pay fees equal to their Anna K. Chrisman Matthew R. Habenicht share of WSNA costs germane to collective bargaining, contract administration and grievance adjustment. WSNA automatically reduces the fee charged to agency fee payers by the amount Candace D. Yencopal Meghan A. Wagner attributable to expenditures incurred for WSNA activities that are not related to its responsibilities Chase D. Pelton Mike S. Leveque as representative for purposes of collective bargaining. In our most recent accounting year, Chavon C. Avis Olivia R. Erchinger 6.6% of WSNA’s total expenditures were spent on activities unrelated to collective bargaining Dorothy R. Zinn Samantha A. Rainey representation. Any non-member who is financially obligated to WSNA under a union security Emily M. Klug Shannon R. Lauder agreement may inspect the audit report of WSNA expenditures at a reasonable time and place Emily T. Salas Susan T. Gray upon written request to WSNA. Any non-member who disagrees with the amount of the agency fee Jaden L. Thurston Suzanne W. Balde Jamie L. Robbins may file a written challenge with WSNA, which must state the basis for the challenge. For members Tricia A. Ayotte who resign their membership during the calendar year, challenges must be made within 30 days Jessica K. Rost Trisha A. Loomis Jessika S. Watson of the postmark of the notice regarding their change in status from members to agency fee payers. Victoria C. Handel For non-members, challenges must be made during the 30 day period after the postmark of Juanita Castillo Jeniffer Tobon WSNA’s written notice of the new calculation for agency fees that take effect on Jan. 1 of each year. Katelyn L. Kinne Such challenges shall be decided by an impartial arbitrator appointed by the American Arbitration Kathryn M. Pfaff Association pursuant to its Rules for Impartial Determination of Union Fees. Any challenges must Kayla R. Brown be submitted to WSNA, ATTN: Agency Fee Challenges, 575 Andover Park West, Suite 101, Seattle, Kaylee J. Regier WA 98188. It is recommended that any challenges submitted be sent by certified mail, but certified Kerri L. Miller mail is not required.

46 The Washington Nurse WINTER 2018 wsna.org Why I give...

“I believe in supporting the WSNA-PAC so that we can advocate for candidates who will go to Olympia and advocate for nurses and patients.” — Clarise Mahler, RN

Learn more about WSNA-PAC and make your contribution at wsna.org/pac Washington State Nurses Association NON–PROFIT ORG. 575 Andover Park West, Suite 101 Seattle, WA 98188 U.S. POSTAGE PAID PERMIT No. 1282 SEATTLE, WA

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