Vol. xxxV No. 3 september 2014 ACCESS

in this issue: • NEW DEADLINE FOR ANNUAL LICENSURE RENEWAL 2015-16 • ELECTRONIC DEVICES IN THE WORKPLACE • SELF-EMPLOYED? CONTRIBUTE TO ACCESS! p. 6 • ARNNL AWARDS FOR EXCELLENCE IN NURSING AND Contest Inside! HONORARY MEMBERSHIP … & MORE! Attention, Nursing Students: Contents

ARNNL COUNCIL Message from the President...... 3 Regina Coady President 2014-16 Julie Nicholas President-Elect 2014-16 From the Executive Director’s Desk...... 4 Patricia Rodgers Eastern Region 2014-17 ARNNL Council Matters...... 5 Sandra Evans Central Region 2012-15 Lacey Sparkes Western Region 2014-17 New Deadline for Annual Licensure 2015-16...... 6 Beverly Pittman Labrador/Grenfell Region 2012-15 Committed to Competence...... 7 Dena King Advanced Practice 2013-16 Lisa Jesso Practice 2013-16 The First 30 Years...... 8 Madonna Manuel Education/Research 2012-15 Q&A: You Asked...... 10 Elaine Warren Administration 2012-15 Carmel Doyle Public Representative 2011-14 Regulatory Notes...... 11 Ray Frew Public Representative 2011-14 Irene Baird Public Representative 2011-14 Nurses of Note ...... 12 Walter Arnold Public Representative 2011-14 Continuing Competency from Classroom to Lynn Power Executive Director Clinical Practice...... 14 Representatives from nursing student societies (observers) Advanced Practice View ...... 15 ARNNL STAFF Lynn Power Executive Director 753-6173 Goings On/Conferences and Workshops ...... 16 [email protected] Trust News...... 18 Michelle Osmond Director of Regulatory Services 753-6181 [email protected] Volunteer Spotlight ...... 19 Lana Littlejohn Director of Corporate Services 753-6197 [email protected] Clinical Corner ...... 20 Jennifer Barry Communications Officer 753-6198 [email protected] Congratulations, Nursing Graduates ...... 21

Siobhainn Lewis Nursing Consultant 753-0124 Policy & Practice [email protected]

Pamela King-Jesso Nursing Consultant 753-6193 Policy & Practice [email protected] On the cover (left to right): Standing - Sandra Moss, Maxine Power- Murrin, Sarah-Lynn Morgan, Madonna Manuel. Sitting - Patricia Grainger, Beverley McIsaac Nursing Consultant-Regulatory 753-6174 Regina Coady (ARNNL President), Louise Price. Services & Advanced Practice [email protected]

Bradley Walsh Regulatory Officer 757-3233 [email protected] Editor Jennifer Barry Creative Design Brenda Andrews, Image 4 Rolanda Lavallee Regulatory Officer 753-6019 Contributing Editor Danielle Devereaux [email protected]

Julie Wells Research & Policy Officer 753-6182 and ARNNL Trust Coordinator [email protected] Advertise in the next issue of ACCESS Contact Jennifer Barry at Christine Fitzgerald Administrative Assistant 753-6183 [email protected] or call 709-753-6198 Executive Director & Council [email protected] 55 Military Road, St. John’s, NL A1C 2C5 Jeanette Gosse Administrative Assistant 753-6060 Ph: 709-753-6040 Fax: 709-753-4940 Toll Free: 1-800-563-3200 Director of Regulatory Services [email protected] email: [email protected] www.arnnl.ca Jennifer Rideout Administrative Assistant 753-6075 Policy & Practice [email protected] ACCESS is the official publication of the Association of Registered Nurses of and Labrador. Renee Reardon Administrative Assistant 753-6088 ACCESS is published three times a year in January, May and (on leave) Advanced Practice [email protected] September. Subscriptions are available to non-members for Jennifer Lynch Administrative Assistant 753-6040 $25 per year. Registration [email protected] ©Association of Registered Nurses of Newfoundland and Labrador (ARNNL). All rights reserved. For editorial matters, please contact the editor. The views and Carolyn Rose Administrative Assistant 753-6041 opinions expressed in the articles and advertisements are those of the authors or Registration [email protected] advertisers and do not necessarily represent the policies of ARNNL.

2

ACCESS Vol. xxxV No. 3 September 2014 Message from the President

It was an absolute privilege to assume the role of ARNNL President in Gander during the June Annual Business Meeting. We received a warm reception by registered nurses in Central Newfoundland and were pleased to have representation from all regions of the province. Additionally, a large turnout at the Awards for Excellence in Nursing and the open linkage session at the ARNNL Presidents Reception were great opportunities to connect with RNs and the public. It was also a celebration of the 60th anniversary of ARNNL and self-regulation of registered nurses in our province.

I wish to acknowledge the passion and dedication demonstrated by my predecessor, ARNNL Past-President, Cathy Stratton throughout her term. I am humbled to be taking my place in the company of Cathy and all of the other visionary nursing leaders who have served before me. Beginning my two-year term on the 60th anniversary of ARNNL allowed me to look back over all that we have achieved and similarly to look ahead at all that is possible in our future. It was a good time to read once again the document prepared for the ARNNL 50th Anniversary in 2004 on the history of our organization. I invite you to read this document at www.arnnl.ca and reconnect with the great legacy of the achievements of ARNNL. In this edition of ACCESS (see p. 8) and in the January 2015 edition, we will give you a glimpse back over the 60 years of ARNNL and self regulation of registered nurses in this province.

Celebrating ARNNL’s 60 years is important. Self-regulation is a privilege entrusted to ARNNL by Government through our Act and Regulations. We are accountable to the public to ensure registered nurses are safe, competent practitioners, well prepared to meet standards of practice and our code of ethics. This accountability is the primary driver of the work of your elected Council as well as the staff of ARNNL.

In my term as President, I will focus on building active engagement with registered nurses, the public and our partners. I will focus on further strengthening our identity and visibility in the public and ensuring our voice is strong in the realm of healthy public policy, quality professional practice environments and advancing the professionalism of the registered nurse. To this end there are many initiatives and much work underway. I invite registered nurses to also increase engagement in our profession. Get involved at the employer, community, regional and provincial/national/international levels. In just the first few weeks in my role, I have met exemplary RNs in this province making a difference every day. These RNs demonstrate leadership and professionalism in everyday practice.

I especially put a challenge out to ARNNL members in this 60th anniversary year to become involved in the work of ARNNL. Visit www.arnnl.ca and review the many published standards, position statements and documents, attend continuing education teleconferences, become a workplace representative, volunteer for committee involvement, provide feedback on draft publications still under development, submit an item for ACCESS or ARNNL UPDATE, get in contact with an ARNNL Council member to discuss issues or attend the Annual Meeting in 2015. Find your voice in a way that works best for you.

Regina Coady, RN, MN [email protected]

3 From the Executive Director’s Desk

I spent almost nine years working with the nurses of Vietnam. During this experience I learned a lot about nursing practice in Newfoundland and Labrador.

I went to Vietnam to help nurses there establish the necessary regulatory processes to enable them to confidently say that all the nurses in Vietnam provide safe, competent and ethical care. My first observation? This statement, which garnered such respect from Vietnamese nurses for the related rules and policies, left me impressed. They were working on their first code of ethics and identifying standards for practice. Their pride was contagious and evident in their commitment to memorize the standards and values that meant so much to them. At that time they didn’t have a licensure system. By comparison, this year ARNNL is celebrating 60 years of licensure. I witnessed the nurses of Vietnam working diligently to understand and promote the value of a national or at least a state- based approved educational program. In 2015, our BN Collaborative Program will undergo its third review in collaboration with the Canadian Association of Schools of Nursing. And the list of differences goes on.

Why am I musing about another country and ARNNL’s past achievements? To help you appreciate what I learned through that relationship – having a body like ARNNL makes a meaningful difference to nursing practice. When I first met them the Vietnamese nurses had little control over their scope of practice, limited engagement with nursing schools, no means of addressing public complaints about care and extremely limited access to evidenced-based materials or professional development.

I encourage you to learn about all that your Council and the over 300 volunteers on ARNNL committees do for you and the practice of nursing with the same eagerness and appreciation as our Vietnamese counterparts. If ARNNL (through your engagement) did not set the “rules,” some other body would. This past year ARNNL conducted the first formal CCP audit (see p. 7); we reported on 25 allegations of conduct deserving of a sanction; we made changes to our bylaws to reflect requirements in theRN Act which stipulate that you can’t use the title “RN” unless you have a practicing license; and, in the coming licensure year, we are introducing a new deadline date for annual licensure renewal (see p. 6). We also celebrated over 100 RNs’ achievements in ACCESS, published over 20 documents to help guide your practice (e.g., Social Media Position Statement) and met with over 1,000 RNs in their workplaces.

This past July, ARNNL took a very public stance and participated in a locally-produced documentary called Sister Morphine. This film portrays the impact drug addiction had upon the career of a former nurse. Although this nurse was not a member of ARNNL, the producers were local and thus sought from us an understanding of why regulatory bodies publish discipline decisions, a role which may be perceived as tough, but one that plays a critical role in public protection. A role that is still on Vietnam’s to-do list.

Working with the Vietnamese leadership team and their charge of almost 40,000 nurses taught me that what we take for granted in NL reflects a lot of hard work, thoughtfulness and a focus on quality nursing services for the public from all nurses of this province. In legislative jargon, it is called self- regulation. A privilege that ARNNL, with you and on upon your behalf, has held for 60 years. Read our annual report at www.arnnl.ca to learn more. You are the “self” in self-regulation. Take up your President’s challenge and join our team.

Lynn Power, RN, MN [email protected]

4 ARNNL Council Matters

COUNCIL BESTOWS ARNNL PRESIDENTS RECEPTION IN GANDER 50th HONORARY ARNNL MEMBERSHIP On June 7, Council presented Honorary Membership to Sandra Moss, a retired nurse from Western Health. Established in 1954, Honorary Membership is awarded to individuals who have helped advance the nursing profession and/or the Association. Sandra graduated from the Salvation Army Grace General Hospital in 1973 On June 4, ARNNL Council joined RNs and members of the public and took her first role as a registered at the Gander Community Centre in the Sports Hall of Fame for the nurse at Channel Hospital in Channel- ARNNL Presidents Reception. The event provided ARNNL Council Port aux Basques. She graduated with an opportunity to hear valuable input from RNs, community from Dalhousie University in 1976 with a Diploma in Public Health leaders and members of the public about where the nursing profession should be directing its attention in the future. Nursing, and in 2001 she received a Bachelor of Nursing degree from Memorial University of Newfoundland. Throughout her career Sandra has held various clinical and administrative roles within the community ARNNL WELCOMES NEW setting. She retired in 2013 as Regional Director of Community Support COUNCIL MEMBERS with Western Regional Integrated Health Board. Sandra was integral in Following ARNNL Council setting up prenatal classes in Port aux Basques, and introduced a formal Elections this past spring, referral system to ensure all newborns were referred to a community three new members were health nurse for follow-up. She also played a lead role in developing elected. As reported in home care nursing services in Southwest Newfoundland, which also the May 2014 issue of incorporated palliative and end-of-life care. Locally and provincially she ACCESS, Julie Nicholas played a key role in expanding end-of-life care, home care and seniors’ (ARNNL’s President-Elect services. Sandra was also the founding member of the Channel Chapter 2014-16) and Lacey Sparkes of ARNNL, served as an ARNNL Workplace Representative and ARNNL (Western Region Councillor Council member from 1996 to 2000. Patricia Rodgers 2014-17) were elected by COUNCIL MEMBERS acclamation. Official results for the Eastern Region Councillor election were revealed at ARNNL’s 60th RECOGNIZED Annual Business Meeting in June. Patricia Rodgers, ARNNL wishes to thank Cathy Clinical Educator (Critical Care) with Eastern Health, Stratton (ARNNL President is Council’s new Eastern Region Councillor (2014-17). from 2012-14) and Anne Doyle Welcome, everyone! (Western Region Councillor from 2012-14) for their dedication and commitment to the work of Council. Cathy and MEMORIAL DAY PARADE HONOURS Anne attended their last Council VETERANS AND THE ROLE OF RNs meeting in June. ARNNL President Regina Coady laid a wreath on Cathy Stratton and Anne Doyle behalf of ARNNL at the Memorial Day parade on July 1 in downtown St. John’s. In 2004, on the occasion of the 50th Anniversary of ARNNL, Attend an ARNNL Council meeting! the anniversary planning committee started the The next in-house Council meeting takes place on practice of ARNNL’s participation in the July 1 Oct. 23-24 at ARNNL House in St. John’s. ceremony at the provincial war memorial, as well as the Veterans Parade and wreath laying. Since Contact Christine Fitzgerald, Executive Assistant, at then, both retired and practicing RNs, dressed in (709) 753-6183 or [email protected] for details. traditional nursing attire, take part in the annual ceremony. All are welcome next July. *More details about the business of ARNNL’s Council are available in UPDATE, ARNNL’s e-newsletter. Email [email protected] to subscribe today! 5 New Deadline for Annual Licensure Renewal 2015-16 Anniversary By: Rolanda Lavallee, RN, MN, Regulatory Officer

Contest for Practicing licenses must be renewed by March 1, 2015

Nursing Students A new deadline for annual licensure Three prizes of $200 each renewal applications comes into effect to be awarded for the winning entry for the 2015-16 licensure year. In June, from each of the three BN Collaborative Council approved revisions to the By- program school of nursing sites in NL Laws. The revisions require all members seeking to renew practicing licenses to MARCH 2015 Deadline: Oct. 24, 2014 SAT THUR FRI submit licensure renewal applications TUE WED SUN MON 7 Help the Association of Registered Nurses 4 5 6 by March 1, however, the licensure 1 2 3 of Newfoundland and Labrador imagine the 12 13 14 expiry date will remain unchanged at 9 10 11 future of practice for registered nurses. Send a 8 21 March 31. During this transition year, 18 19 20 message to your future self! 15 16 17 applications submitted after March 1 27 28 24 25 26 will not be subject to late application 22 23 It’s 2074. You recall your nursing school days 30 31 and even remember when, back in 2014, ARNNL fees, however, late fees will apply as of 29 celebrated its 60th Anniversary. Where has the April 1. time gone? Why is the new March 1 deadline Tell us in 400 words or less: required? • What does 2074 nursing practice look like? The RN Act (2008) and the RN • Where does nursing practice take place in dates over the past five years, this is 2074? Regulations (2013) have established a consistent trend. Submission of a • What is the most important ‘tool’ being criteria and requirements for licensure/ licensure renewal application after used in 2074 nursing practice? membership renewal. To meet the March 1 increases the probability a • What is the biggest positive change in requirements, a member may require member may not be licensed as of April nursing practice since 2014? documentation from a third party 1, if outstanding documentation or (example, verification from another clarification of information is required Be creative! regulatory body or practice hours Entries will be judged on: to meet licensure requirements. from an employer) or direct follow-up • Innovation by ARNNL staff to clarify information • Forward-thinking How will the new deadline provided. A March 1 deadline provides • Focus on the public interest affect the Continuing • Reflection of ethical and professional 30 days in advance of the license expiry nursing values date to review and complete the Competence Program • Consideration of advancements in application process. The new deadline requirements? education and technology supports ARNNL’s public protection Members who submit licensure mandate by reducing potential health renewal applications prior to, or on Deadline for submission: service delivery impacts which may March 1 with outstanding Continuing Friday, Oct. 24, 2014. occur if a member is prevented from Competence Program requirements Forward entries to: [email protected]. working on April 1 as he/she does not will have until March 31 to submit Three prizes of $200 each will be awarded as meet licensure renewal requirements. updated information before a follows: One for the winning entry in each of In 2014, approximately 3,000 members conditional license is issued. the three BN Collaborative program school of submitted their licensure renewal If you have questions or require nursing sites. All students currently enrolled applications after March 1; 1,800 of further information, please contact in any year of the BN Collaborative program these were submitted after March 15; Regulatory Services at (709) 753-6040 may enter. 220 were submitted on March 31. Based or 1-800-563-3200 (toll free), or email Winning entries will be featured at on a review of application submission [email protected]. www.arnnl.ca, and winners will be announced in the January 2015 edition of ACCESS magazine. For information and questions, please contact Siobhainn Lewis at [email protected] or 709-753-0124.

6

ACCESS Vol. xxxV No. 3 September 2014 Congratulations! RNs in NL are Committed to Competence Continuing Competence Program (CCP) Audit Results 2013-14 Licensure Year By: Staff Advisory Committee on Continuing Competence1

Overview of CCP Audit Process Overall Audit Results – Great Learnings from CCP Audit/Tips for • In April 2014, 50 practicing members News! helping you complete your 2014-15 (45 RNs and 5 NPs) were randomly • 100% of audited members submitted CCP CCP selected to participate in the audit material for the audit process. (Forty- Following a review of the CCP forms and were requested to submit their eight of the 50 CCP documents were submitted during the audit, the Professional Development Learning initially reviewed by the committee; committee identified the following tips to Plan, Professional Development two practicing members were granted assist you in completing your CCP: Evaluation Form and evidence for additional time for submission due to • For the 2014-15 licensure year, RNs are verification of formal hours (e.g., extenuating circumstances and their required to assess their practice utilizing CCP tracking forms, certificates, documents were submitted at a later the 2013 Standards of Practice for 2 etc.). date and reviewed). Registered Nurses and NPs are required • Audited members were employed • 92% of audited members met initial audit to utilize the 2013 Standards for Nurse in acute care, community, long term requirements. Practitioner Practice in Newfoundland care, education, administration • Only 8% of audited members required and Labrador when completing their and independent practice from all follow-up by the ARNNL Nursing CCP forms (see ARNNL website for regions of the province. Consultant to obtain clarification on the revised CCP forms). • In May, the CCP Audit Committee information that was submitted and/or • If you are selected for audit for the met to review the submitted for educational purposes. 2014-15 licensure year, ensure your documents, which were de- • Overall the CCP Audit Committee learning activities (conferences, identified. was impressed with the caliber of educational events, etc.) fall within the submissions. licensure year, April 1, 2014-March 31, 2015. • Ensure your learning goals have an action verb and indicate WHAT you are going to learn (e.g., “to increase my knowledge of palliative care nursing, including dealing with family members”). • Ensure that you include the number of hours for each learning activity that you completed (e.g., “my seminar was 2 hours in length”). • Review your target dates to ensure they include a month/year that falls within the ARNNL licensure year. • Review your CCP forms to ensure all sections are completed accurately. • Review the CCP tutorial and archived CCP teleconference on the ARNNL website. This will assist you in completing the CCP requirements CCP Audit Committee Members (left to right: Marcy Greene-Feder, Rhonda McDonald, Joanne Baird, Dorothy accurately. Bragg and Patricia Grainger) Plans for next year’s audit are underway. Next year the number of RNs and NPs

1(Joanne Baird, Dorothy Bragg, Cathy Burke, Patricia Grainger, Marcy Greene-Feder, Fatima Hewitt, Lisa Hoddinott, Heather Hunt-Smith, chosen for the audit will increase and we Pamela King-Jesso, Rhonda McDonald, Beverley McIsaac, Brad Walsh and Anne Rowsell) will be looking for volunteers for the Audit 2 Audit participants were selected using a stratified random sampling process. Committee. Stay tuned! 7 The Association of Registered Nurses of Newfoundland and Labrador (ARNNL) celebrates 60 years of history in 2014. While the Registered Nurses Act became effective in January 1954, nurses across Newfoundland and Labrador were affiliated for many years as the Newfoundland Graduate Nurses Association. Founded in 1913, they promoted the interests of graduate nurses in the colony through the advancement of nursing and professional nursing standards.

In this issue of ACCESS, we look back at the first 30 years. Look for a retrospective of nursing’s achievements from 1984-2014 in the January 2015 issue. The First 30 Years …

January 1, 1954 June 1954 RN Act came into force. Newfoundland was received into A declaration proclaimed “The ARNN is responsible for the Canadian Nurses Association. the Registration of Nurses which was previously under the - 673 practicing members jurisdiction of the Department of Health, and conducts the - 114 non-practicing members. affairs of nursing as laid down in the Newfoundland Nurses Act.”

1984 1979 The Health A resolution Act was passed; was passed ARNN lobbied at the Annual vigorously for this General new Act. Meeting to - 4,602 practicing consider placing members basic nursing - 540 non- education at practicing BN level; ARNN members. 1982 1981 celebrates 25 Canadian Nurses Association ARNN office moves to years. Board of Directors passed 55 Military Road in St. a motion for Bachelor of John’s. Nursing by the year 2000 as a point of entry to practice.

8 1956 1962 1964 1966 Standard Curriculum for The International Newfoundland hosted the Canadian A two-year School of Nursing Schools of Nursing was Code of Nursing Nurses Association Biennial. This Curriculum was approved for developed. Ethics was adopted. was recorded to be the first National Corner Brook. Conference to be held in the province. - 1,233 practicing members - 353 non-practicing members.

1978 1975 ARNN hired a Newfoundland nursing practice Nurses Union advisor to (NNU) was develop the formed. Prior to standards of this date ARNN practice. was involved in negotiating nurses’ wages. 1974 1969 - 2,589 practicing members Medical-Nursing - 442 non-practicing members. procedures booklet was published and distributed.

9 Q & A: You Asked By: Siobhainn Lewis, RN, MN, ARNNL Nursing Consultant – Policy and Practice

I’ve just learned there are two new ARNNL documents: one on professionalism Q: and one on the therapeutic nurse-client relationship. Does that mean there are new expectations for me?

No. Registered nurses have long held accountability for what they do and how they do it; in essence, My Practice – My Responsibility. Registered nurses The expectations related to professional behaviours, as well as the have long held RNs responsibility to initiate, maintain and conclude the therapeutic accountability for A: nurse-client relationship are not new, but they are being articulated in two new documents. The new documents – Professionalism and what they do and the Registered Nurse and The Therapeutic Nurse-Client Relationship how they do it; in – are referred to as Interpretive Documents, meaning they help essence, My Practice you interpret expectations indicated in the ARNNL Standards of Practice for Registered Nurses and the ARNNL Standards for Nurse – My Responsibility. Practitioner Practice in Newfoundland and Labrador.

Professionalism for the RN includes behaviours, qualities, values and attitudes that demonstrate to your client that you are accountable, visible, knowledgeable and ethical. Members of the public expect that RNs will invoke the elements of professionalism when providing nursing service, when collaborating with them, colleagues and other members of the health care team, and when advocating for healthy public policies. The Professionalism and the Registered Nurse document describes the expectations of the RN in upholding these elements of professionalism.

RNs are professionals who focus on the needs of their clients and in so doing form therapeutic relationships that are for the benefit of the client. RNs utilize relevant theories and interpersonal skills to achieve client health care needs. It is you, the RN, who sets and maintains the professional boundaries of the therapeutic relationship. As the professional you understand and utilize the therapeutic nurse-client relationship as the fundamental means of providing safe, competent, compassionate and ethical nursing care. The Therapeutic Nurse-Client Relationship document articulates several key concepts of the therapeutic relationship and, through use of practice examples, identifies how these concepts are applied in nursing practice.

So take the time to review these two new documents and reflect on your practice. How do you invoke the elements of professionalism? How do you manage the therapeutic nurse-client relationship? Is the therapeutic nurse-client relationship on your CCP radar for this year? It is your obligation as a registered nurse to know and uphold the expectations for your practice.

These new documents, as well as all documents to support your practice, are available at www.arnnl.ca. To receive copies of the poster series featuring the elements of professionalism, please email Jennifer Rideout at [email protected].

Q & A: YOU ASKED reflects member questions frequently asked about general topics. Members can access confidential practice consultation with ARNNL Nursing Staff. Visitwww.arnnl.ca under “Contact Us” for ways to get in touch.

10

ACCESS Vol. xxxV No. 3 September 2014 Regulatory Notes Electronic Devices in the Workplace: Considerations for Registered Nurses By: Michelle Osmond, RN, MS(N), Director of Regulatory Services and Professional Conduct Review

Look anywhere these days and you act on de-identified client information, with a device that has appropriate will see people using cell phones, such as a redacted lab result. Positive security features, such as encryption iPhones/smart phones or tablet devices. client identification is fundamental technology. With a large portion of the general to safe care and includes ensuring public owning a mobile device it is any results reviewed are for the right Client care is the first priority for not unexpected that these devices client. To date ARNNL has received one registered nurses. Personal use of are finding their way into workplaces, complaint related to the communication mobile devices while working may including nursing practice environments. of client information via a personal lead to concerns that the registered Mobile technology can link health mobile device. nurse is not available to attend to client professionals with an abundance of care. Furthermore, client safety may resources, such as drug references, best The ease of use and speed of mobile be placed at risk if a registered nurse practice guidelines and other clinical technology may make by-passing is distracted by his/her mobile device information. Given that this technology established work processes seem while providing client care. ARNNL will continue to expand, it is important harmless, however, unauthorized use of has received one complaint regarding for registered nurses to consider a personal device in the workplace may a registered nurse’s practice in which appropriate use of technology in the increase your exposure to allegations the use of a personal cell phone during workplace. of professional misconduct and you patient care was reported. Depending may be subject to employer discipline. on your practice role, accessing an Employers may have policies that state Clients have a right to privacy and “app” or other mobile functions may where and for what purposes mobile confidentiality; the means by which their be a legitimate request to assist in devices can be used in the workplace. personal health information is collected, client care, however, in settings where Registered nurses need to be aware stored and communicated must follow employer policy limits the use of mobile that clinical use of a mobile device for appropriate policy and procedures. devices, registered nurses may need to client related care requires employer initiate discussions to influence policy authorization. Although the varied “Bring your own device” (BYOD) is change. functions of a mobile device may seem a growing trend in many workplaces to be useful tools for client care, such as and some employer policies may allow If you are unfamiliar with your taking a photo of a wound to monitor the use of a personal device for work employer’s policy on mobile technology, healing or forwarding INR or other purposes. Through employer protocols review the policy and ask questions if results to a physician/nurse practitioner and organizational infrastructure, clarification is needed. Some workplaces to inform treatment, using a mobile work processes are defined, and added may not yet have developed policy device in the workplace without functionality such as encryption ensures in this area; registered nurses may authorization, in particular a personally confidential information is protected. bring the issue forward and offer to owed mobile device, is inappropriate Without this protection any information participate in a process to develop a and can result in a breach of client communicated or stored on the devices, policy. Resources that you can access confidentiality. Redacting or removing a including emails, voicemails, videos, text on this topic are the Canadian Nurses client’s identifying information may not messages or pictures may be exposed Protective Society InfoLaw: Mobile be sufficient to protect confidentiality. to unauthorized access if the device is Devices in the Workplace available at If the receiving device does not lost, stolen or lent to another individual www.cnps.ca, and ARNNL’s Social Media have adequate security features the (e.g., co-worker, friend or spouse). Position Statement (2013). information may be seen or heard by Employers who require an employee unauthorized persons. Furthermore, a to use a mobile device for work related physician or nurse practitioner cannot purposes should provide the employee References available upon request.

11 Nurses of Note By: Jennifer Barry, BA, Communications Officer

ARNNL’s Awards for Excellence in Nursing were presented to five RNs at a luncheon ceremony on June 5. ARNNL congratulates this year’s recipients and all nominees (see insert), and is inspired by their leadership and commitment. For more information, visit www.arnnl.ca.

Sarah-Lynn Morgan, RN Staff Nurse, Corner Brook Long Term Care Home, Western Health Elizabeth Summers Novice Nurse Award In 2013, Sarah-Lynn Morgan graduated from Western Regional School of Nursing with a Bachelor of Nursing degree and began her practice at Western Health in the Corner Brook Long Term Care Home as a staff nurse. Sarah-Lynn’s colleagues describe her as enthusiastic, professional and positive. Long term care is a complex environment, yet Sarah-Lynn handles its challenges with poise, knowledge and a calm approach. Sarah-Lynn has embraced leadership in her new role and recently became a volunteer with the ARNNL Workplace Representative Program (see p. 19). She is eager to learn and share her knowledge with colleagues to influence quality of care and a professional environment.

Louise Price, RN Public Health Nurse, Harbour Breton, Central Health Award for Excellence in Nursing – Practice Louise Price is a Public Health Nurse, a role that she has fulfilled since graduating from Memorial University with a Bachelor of Nursing degree in 1984. In her practice, Louise has embraced creative and innovative approaches in implementing public health nursing practices. Louise recognizes the need to use multiple methods in order to be effective with health promotion messaging. For example, in working to educate students about the hazards of energy drinks, she videotaped a presentation on the issue and had it broadcast during a local bingo game, reaching parents who buy the groceries. As a result of Louise’s efforts, Harbour Breton is also home to an “Intergenerational Café” which brings together seniors and youth to learn from each other.

Maxine Power-Murrin, RN Professional Practice Consultant, Eastern Health Award for Excellence in Nursing – Administration Maxine Power-Murrin consistently applies a professional practice lens to ensure quality programs and services are maintained and supported. Maxine has always taken on leadership roles, both formal and informal throughout her 31-year nursing career, initially as a staff nurse and more recently, as a Professional Practice Consultant for Nursing with Eastern Health. She works diligently with nursing and non-nursing groups to ensure that organizational policies are based on best practices. Maxine led the Nursing Professional Practice group at Eastern Health in conducting site observational audits across the region related to peripheral IV catheters, and subsequently developed an action plan and presentation to Eastern Health Senior Executives. Maxine was nominated for a Canadian Vascular Access Association Award of Excellence for her leadership in this initiative.

12

ACCESS Vol. xxxV No. 3 September 2014 Madonna Manuel, RN Educator, Western Regional School of Nursing, Western Health Award for Excellence in Nursing – Education Madonna Manuel has been a registered nurse for 27 years. Since 1989, she has centered her career on the application of teaching and learning. She has been an active member of Western Regional School of Nursing’s (WRSON) strategic planning initiatives, regularly attends Western Health’s medical rounds and is currently a member of ARNNL Council. Madonna is the primary leader of WRSON’s curriculum related to integration of Interprofessional Health Education and has contributed to curricula changes to the BN Collaborative Program on multiple levels. She is particularly dedicated to educating students about nursing issues, the Canadian health care system, health promotion across the lifespan and the complex care of clients in institutional and community settings.

Patricia Grainger, RN Educator, Centre for Nursing Studies, Eastern Health Award for Excellence in Nursing – Research A nursing school faculty member since 1987, Patricia Grainger also holds the position of Coordinator of the Research Office at the Centre for Nursing Studies in St. John’s. In addition to her own practice and research interests, Patricia has been teaching nursing research to undergraduate students for 15 years. Patricia encourages partnerships between nursing education and practice, and co-chairs Eastern Health’s Nursing Education and Research Council. One of the many research projects in which she has been involved is a study regarding the safety of early ambulation of patients following left heart catheterization. Evidence that resulted from this study has influenced a change in practice. Patricia is Vice-Chair of the non-clinical trials committee of the Provincial Health Research Ethics Board.

Future editions of ACCESS magazine For the will have a Self-Employed member SELF section. If you are self-employed and would like to contribute to this section please contact Pam King- EMPLOYED Jesso at [email protected].

• You are required to inform ARNNL of all your employers, including self-employment, and of any change in employer (within 30 days). To update your member profile, go tohttps:// ereg.arnnl.ca. • It is important to stay connected. From time to time ARNNL practice consultants may email information to self-employed RNs. Get on that list! Complete the online Self-Employed RN Form available on the self-employed RN practice webpage at www.arnnl.ca. • Considering self-employment? See the ARNNL website or contact a Nursing Practice Consultant for information and resources to support your practice.

13 Continuing Competency from Classroom to Clinical Practice By: Ashley Sutton

Nurse Practice (2013-18) and Standards of Practice for Registered Nurses (2013) to develop a personal learning plan for implementation in our final clinical course called Consolidated Practicum. In the plan, we set our goals to assist us in meeting the following standards: (1) Responsibility and Accountability, (2) Knowledge Based Practice, (3) Client Centered Practice and (4) Public Trust. At the end of the semester, we evaluate whether or not we have met the goals identified in our learning plan. This is completed through a face-to- face meeting with faculty to discuss knowledge and expertise obtained throughout our clinical experiences. We provide faculty with clinical examples to indicate how we have met the goals identified in our plan. Working through this process as students gives us the skills and abilities to complete the continuing competency requirements As fourth year nursing students at leaders introduce us to the ARNNL set out by ARNNL for registered Western Regional School of Nursing, we Continuing Competency Program nurses. This experience increases our see ourselves as “experts” in the role of required for annual registration. confidence as novice practitioners student; however, as graduate nurses A component of registration is and helps decrease anxieties related we again become “novice” in our new maintaining educational competence to continuing competence for nursing positions as staff nurses. Our employers through formal and self-directed registration. The whole process assist us with the transition from novice learning. During the seminars our peers becomes a normal part of our nursing to expert by providing orientation introduce us to the ARNNL website and practice without the added stress of a and mentorship programs, but who the Continuing Competence tool box. steep learning curve post-graduation! prepares us for the actual nursing This is where everything needed to registration requirements? Our nursing complete the Continuing Competency Ashley Sutton graduated from the BN education program plays a pivotal role Program is housed. As part of our (Collaborative) Program at the Western in this preparation process. clinical requirements we complete Regional School of Nursing in May 2014. the RN Self-Assessment and rank our The importance of continuing competencies from a novice to expert competence and lifelong learning is level. This is a beneficial, reflective Acknowledgements: The author would linked with entry-level competencies, exercise which assists us as students to like to acknowledge and thank Madonna the Code of Ethics and the Standards identify our personal strengths as well Manuel, RN, MN, Nurse Educator/Clinical of Nursing Practice throughout our as the areas we would like to further Placement Coordinator, Western Regional program. This knowledge is acquired develop. School of Nursing, for her tremendous through student-led seminars in a fourth support in the development of this year nursing course called “Issues in We also use ARNNL’s Competencies in manuscript. Nursing and Health Care.” The seminar the Context of Entry-Level Registered

14

ACCESS Vol. xxxV No. 3 September 2014 Advanced Practice View By: Beverley McIsaac, RN, NP, MN (ANP), Nursing Consultant – Regulatory Services/Advanced Practice

Knowing your Standards: Should a nurse practitioner treat family, close friends or oneself?

Standard 7: Therapeutic Management – The Nurse Practitioner (NP) manages and monitors the care of the client by providing safe, effective and current therapies, within the NP’s stream of practice, scope of practice and competence.

7.11 Does not prescribe drugs or other therapies for family members, close friends, or oneself when another nurse practitioner or physician is available.

At some point in their careers, most Interpersonal relationships are disclose information that the client does NPs may be faced with having to decide inherent in interactions among not want the nurse practitioner, their whether to treat a family member, a individuals and may be personal or friend or family member, to know. friend or even themselves. Each of these professional (CRNBC, 2013). The nurse- There are times when an NP may be situations raises clinical and professional client relationship is a professional required to treat a client with whom concerns that require deliberation. relationship established to meet the they have a personal relationship or is These situations can present an even health care needs of the client and a family member. These situations are greater challenge for an NP if he/ is fundamental in providing safe, viewed as exceptions that can occur she is the only provider immediately competent and ethical nursing care for minor health conditions or when available in a community. What are (ARNNL, 2014). The nurse practitioner’s there is a need for emergency care and the professional boundaries when it ability to establish and maintain that no other provider is readily available. comes to self-treating or treating family professional relationship with clients Under these circumstances, the nurse members or close friends? is an essential component of providing practitioner must transfer care to safe, competent and ethical care. When another qualified health professional Sometimes it can be difficult to evaluate a nurse practitioner knows a client, (nurse practitioner or physician) as soon whether there is a close personal through a personal relationship or as a as possible and practical. The decision to relationship with an individual. When family member, it is difficult to maintain treat or to refer the patient to another this occurs, the nurse practitioner may the objectivity necessary to enable provider should be documented. consider the impact that knowing the the nurse practitioner to enter into In no circumstances should a nurse individual personally could have on the a professional relationship with that practitioner self treat. care he/she provides. The NP may want client. to consider the following questions: Sometimes it can be difficult to evaluate • Could the relationship impact acting in The practice of nursing is based on a whether there is a personal relationship this individual’s best interests? nurse-client relationship and requires with a client and given the complexity of • Would the relationship with this acting in the best interest of clients a dual relationship of NP-family member person make it difficult to ask (CNA, 2008). When the client is a or NP-friend, nurse practitioners are certain questions, maintain patient family member or a close friend, it may advised to weigh all possible options confidentiality or make a mandatory be difficult for a nurse practitioner and seek guidance from their employer, report? to obtain a detailed history, conduct colleagues or ARNNL, before assuming • Would it be difficult to allow this sensitive examinations, convey a care for such clients. person to make a personal health care diagnosis or provide treatment options. decision that does not adhere to the Furthermore, the client may provide References available upon request. health care advice provided? an inadequate history or they may not

15 Goings On

MUN BOARD OF REGENTS MEMBER Left to right, back: Memorial Chancellor Susan Dyer-Knight; CELEBRATES BN GRADUATION IN board members Mary Cormier, CORNER BROOK Susan Murray, George Tucker, Pegi Earle, Sheila Ashton, Pat Coish- Memorial University Board of Regents Snow, and Dr. Mary Bluechardt, member Edmund Walsh recently graduated vice-president (Grenfell Campus). with a bachelor of nursing from Grenfell Left to right, front: Iris Petten, Campus, Memorial University, in partnership board chair, Edmund Walsh, Eleanor Swanson, vice-chair, and with Western Regional School of Nursing. To Dr. Gary Kachanoski, president celebrate, members of the board and other and vice-chancellor, Memorial VIPs who attended the ceremony took a University. Photo credit: Lori Lee moment to pose with Walsh. Hollett, Grenfell Campus. BOOK HIGHLIGHTS NEED FOR HOME CARE AND ARNNL LAUNCHES 60TH ANNIVERSARY COMMUNITY SUPPORTS DURING NATIONAL NURSING WEEK In her latest book, Bringing it Home – A Nurse RNs participated in events in shopping malls in St. Discovers Health Care Beyond the Hospital, ICU nurse John’s, Gander and Corner Brook on May 14 to mark Tilda Shalof leaves the hospital behind to accompany the 60th anniversary of the self-regulatory role of the nurses who work in homes, from mansions to RNs in the province. The Newfoundland Registered the streets, all across the country. Working with Nurses Act came into force in 1954 and granted the Victorian Order of Nurses, a Canadian not- registered nurses in the province the privilege and for-profit organization that provides home and responsibility of regulating nursing in the interest community care, Tilda meets a wide variety of of public protection. The original Act remained nursing professionals who offer untraditional care, relatively unchanged until 2008 when a new NL sometimes in unlikely settings. This book not only RN Act was passed in the House of Assembly. The describes a personal journey, but it also brings to light new health care number of registered nurses rose from 600 in 1954 issues. North America is on the cusp of change as the needs of our aging to over 6,000 in 2014. Do you have any ideas to help population put pressure on our health care system; more people need us celebrate? Email [email protected]. care in their homes and community supports to stay well. A portion of the proceeds from this book benefit The Victorian Order of Nurses. Visit www.mcclelland.com to order your copy.

*HOT OFF THE PRESS NEW ARNNL DOCUMENTS AT www.arnnl.ca Professionalism and the Registered Nurse (2014) Interpretive Document facilitates understanding and application of the practice standards in relation to professionalism, and the interrelated elements of Accountable, Knowledgeable, Visible and Ethical nursing practice are further outlined. Left to right: Regina Coady, ARNNL President; Steve Pike, MUNSON The Therapeutic Nurse-Client Relationship: Expectations for Registered student; RNs Colleen O’Brien and Rosaria Fewer; and CarolAnn Mason, ARNNL Workplace Representative Nurses (2014) Interpretive Document is a motivational read which outlines clinical practice examples that draw attention to both the key concepts and phases of the therapeutic nurse-client relationship.

INTERESTED IN HOLISTIC NURSING? Are you a registered nurse interested in alternative therapies, complementary therapies, energy healing and other holistic nursing approaches? Dana Ryan, the Newfoundland and Labrador Representative for the Canadian Holistic Nurses Association (CHNA) is applying for ARNNL Special Interest Group status and would like to hear from you! Contact [email protected]. Visit www.chna.ca or Dena King, ARNNL Councillor (Advanced Practice) www.facebook.com/CHNA.ca for more information about the CHNA. and Niki Keats, ARNNL Workplace Representative

16

ACCESS Vol. xxxV No. 3 September 2014 Goings On

RN RECEIVES GRANT FOR MUNSON REUNION 2014 HEALTHY AGING RESEARCH Memorial University School of Nursing (MUNSON) is bringing together graduates PROJECT from the classes of 2004, 1999, 1994, 1989, 1984, 1979 and 1974, from their MN A registered nurse working at the program (years 84-92), and from their outpost nursing program as part of Reunion Centre for Nursing Studies in St. 2014 this fall. It’s all happening Oct. 23-28 as part of MUNdays, which is Memorial John’s has received a project grant University’s flagship spirit event. The MUNSON events begin at the school on the as part of the Department of Health evening of Friday, Oct. 24. Class-specific events follow the next day, Oct. 25. Class and Community Services’ Healthy reps are: Nicole Pittman (2004); Renee Crossman and Alison Maddigan-Cox (1999); Aging Research Program. These Glenys Moran (1989); Sandy LeFort (MN 84-92) and outpost nursing program; grants enable a team of local and Patricia Grainger and Janet Templeton (1984); and Sharon Smith (1979). If you’d like national or international researchers to know more, contact Communications Coordinator Marcia Porter at mlporter@ to be assembled to conduct research mun.ca, or check out the Reunion 2014 website at www.mun.ca/mundays/alumni/. on a topic related to a priority theme. Sue Ann Mandville-Anstey received NATIONAL NURSING WEEK RECOGNIZED IN MAY $10,050 for her research, “What is it Like for Aging Nurses to Live and Work with Cardiovascular Disease in the Province of Newfoundland and Labrador: A Phenomenological Study.” Five projects that focus on healthy aging received $58,030 through the Program. Since 2008, the Healthy Aging Research Program has provided over $963,000 in funding for 36 researchers. Congratulations, Sue Ann!

BECOME A NURSING Left to right: St. Clare’s Day Surgery RNs Sheila Dominaux, Kathy Scott, Carmel Pittman, Ann Osmond, Patricia Rideout and Reshelda White GRAD STUDENT Flexibility and opportunity set CONFERENCES AND WORKSHOPS Memorial’s graduate programs apart! The Master in Nursing program is Canadian Society of Gastroenterology Newfoundland & Labrador Nurse offered via distance learning and offers Nurses & Associates Practitioner Association a Practicum and Nurse Practitioner “Brave the Current” Conference 2014 “Wave of Change – Oceans of Opportunity options. The new PhD in Nursing began Oct. 2-4, 2014 in Advancing Health” Conference 2014 in 2013 and is a full-time, onsite program. Scotiabank Convention Centre, Oct. 10-11, 2014 To learn more check out www.mun.ca/ Niagara Falls, ON Centre for Nursing Studies, St. John’s nursing/grad/. www.csgna.com www.nlnpa.ca

“Kids Rock” Janeway Emergency Newfoundland and Labrador Nurses’ Pediatric Conference & Webinar Union 40th Biennial Convention Oct. 3-5, 2014 Nov. 4-7, 2014 Bruneau Centre for Research and Sheraton Hotel Newfoundland, St. John’s Innovation (MUN Campus), St. John’s www.nlnu.ca www.kidsrocknl.ca Psychiatric/Mental Health Nurses Special Eastern Health Wound & Skin Care Interest Group of Newfoundland and Symposium “Back to Basics” Labrador Oct. 9-10, 2014 Annual Education Day St. John’s Long-Term Care Facility Dec. 8, 2014 [email protected] www.psignal.comlu.com Masters grads Kate Narduzzi and Carla Kennedy

17 Trust News

By: Julie Wells, BSc, MSc, Research & Policy Officer and Trust Coordinator

CALL FOR APPLICATIONS Trust Elects New Applications are now being accepted for awards in the following categories: Board of Directors Members of the Trust elected a new Board of Directors Continuing Education Awards at the annual meeting on June 3. Congratulations to Bursaries for Conferences & Post Basic Courses (up to $1,000) the members of the 2014-15 Board: NL Gerontological Nurses Association Bursary ($500) Nursing Leadership Awards ($500-$3,000) Penny Grant, President Peter & Elizabeth Yetman Oncology Nursing Bursary (up to $1,000) Janet Templeton, President-Elect Violet Ruelokke Primary Health Care Award (up to $1,000) Sara Smith, Eastern Urban Regional Director Starlene Lundrigan, Eastern Rural Regional Director Bachelor of Nursing Scholarships ($1,000 each) Beverley Reid, Central Regional Director BN Years 2, 3, 4 Anna Marie Alteen, Western Regional Director BN Fast Track Year 2 Brenda Eddison, Northern Regional Director Flo Hillyard Memorial Scholarship Paulette Roberts, Labrador Regional Director General Hospital School of Nursing Alumni Association Scholarship Joan Whelan, Director-at-Large Anita Ludlow, Director-at-Large Post Basic Bachelor of Nursing Scholarships ($750 - $1,500) Lynn Power, Secretary-Treasurer (non-voting) BN Post RN Scholarship Julie Wells, Coordinator (non-voting) St. Clare’s Alumni Association Scholarship ARNNL Bay St. George Chapter Scholarship The Board extends thanks to out-going members Sharon Smith (President) and Beverly Simms (Northern Available to RNs from the Bay St. George area Regional Director). It is through the willingness of members to dedicate their time and expertise that the Graduate Scholarships ($1,000- $2,000) Trust is able to achieve its goals. NL Nurses Respiratory Society Legacy Scholarship Masters or PhD Scholarships (Nursing & Non-Nursing) ARNNL 50th Anniversary Scholarship ARNNL Education Marcella Linehan Scholarship & Research Trust RN Re-Entry Scholarship ($500) th Nursing Research Awards (up to $2,500 each) 25 Anniversary Scholarship Criteria and application forms are available at: www.arnnl.ca/trust The Trust is delighted to announce that Kathleen Stevens has been selected as the first recipient of the ARNNL Education & Research Deadline for applications is Oct. 15. Trust 25th Anniversary Scholarship.

Late or incomplete applications The scholarship, valued at $4,500, is awarded will not be considered. to a registered nurse from Newfoundland and Labrador who is enrolled in a doctoral program and has demonstrated academic excellence during undergraduate and graduate studies, along with leadership in the nursing profession and/or community service.

Congratulations, Kathleen!

For more information about the scholarship, please visit the Canadian Nurses Foundation website (www.cnf-ficc.ca).

18

ACCESS Vol. xxxV No. 3 September 2014 Volunteer Spotlight: The ‘Self’ in Self-Regulation ARNNL’s Workplace Representatives

Workplace Representatives (WPRs) volunteer to represent ARNNL by supporting professional nursing practice and communicating information in their workplaces. WPRs complete an orientation and a workshop on Leadership in Professional Practice to prepare for the role. Ongoing support and development is provided through regular meetings and education sessions. Our WPRs are introduced in ACCESS so you can get to know these important volunteers.

Sarah-Lynn Morgan RN, BN Sarah-Lynn Morgan has been employed at the Corner Brook Long Term Care home for the past year as a staff nurse. Sarah-Lynn assumed this role as a novice nurse upon graduation with a Bachelor of Nursing degree from Western Regional School of Nursing in 2013. In the long term care setting Sarah-Lynn coordinates care for 63 residents. “Good assessment skills are important,” she says, “as elderly clients often have multiple co-morbidities.” Palliation and providing support and comfort to residents and families is an important part of the role of the RN in long term care, as is support and direction to other members of the health care team. “Although long term care was not initially my first choice, it has provided me with many opportunities for personal, educational and career advancements. I enjoy the independence in clinical decision-making.” Sarah-Lynn enjoys working with residents with dementia and with families transitioning to long term care. She is excited to be a workplace representative for her professional association. Sarah-Lynn and her husband are expecting twins in October. Sarah-Lynn Morgan was the 2014 ARNNL recipient of the Elizabeth Summers Novice Nurse Award. See page 12 for details.

Stephanie Matthews RN, BN, CCHN(C) Stephanie Matthews graduated from the Salvation Army Grace General Hospital in 1993 and subsequently completed a Bachelor of Nursing degree from MUN in 1996. In 2010 she attained CNA certification in Community Health. Stephanie has worked as a public health nurse for 10 years, currently working out of the Charles R. Bell Building, with Eastern Health in St. John’s. In her office area there are 10 public health nurses and 12 home and community care RNs, and she welcomes the opportunity to provide a link with the professional association. Stephanie admits that the enjoyment she receives in her work comes from being able to make a difference in the lives of the children and families for whom she provides care. With three children (ages 12, 14, 16) Stephanie is also busy with school and volunteer activities, such as safe grad committees and the Church soup kitchen.

Watch for the call for nominations Regional Councillors: early next year! ARNNL • Central Council • Labrador/Grenfell Elections Domain Councillors: • Education/Research 2015 • Administration

19 Clinical Corner

Colonoscopy Oh, Baby Preparation The Baby-Friendly Council of Newfoundland and Labrador (NL) is the provincial Many people have said the committee providing leadership for the implementation of the Baby-Friendly preparation for their colonoscopy Initiative in NL. The Baby-Friendly NL website and social media assets (Facebook, is more uncomfortable than the Twitter and YouTube channel) support NL families during pregnancy and in the first procedure itself. To reduce cramping years after birth. The website is directed at pregnant women, breastfeeding families and decrease discomfort during and health professionals. The goal of the online community is to support parents the prep, keep hydrated with warm in choosing and continuing to breastfeed, and in providing access to local supports liquids instead of cold. Including warm and parent and professional resources. The Baby-Friendly NL Facebook page has clear broths and herbal teas, but no over 1,500 members, provides daily updates and connects women to provincial and milk, to the liquid diet preceding a regional supports. Check out the online resources at www.babyfriendlynl.ca. colonoscopy, may relax the colon and provide much needed nutritional hydration.

Maria Clarke BScN, CGN(C) Mabel Chaytor RN, CGN(C) St. Clare’s Hospital Endoscopy Unit Eastern Health, St. John’s

Stick With It! Inside enteral feeding tube packaging is a label sticker that provides information such as the manufacturer, the reference and lot number of the tube. Affixing the label sticker to the client’s health record is quick and easy and eliminates confusion regarding the tube type specifications. To provide optimal care for clients with enteral feeding tubes, it is imperative to have the date of the initial tube insertion and last replacement, current tube type, brand, French size, markings at skin level and follow-up arrangements clearly documented in the client’s record. How APPropriate! Valery Goulding RN, BN, GNC(C) Clinical Educator, Long Term Care, Have you been vaccinated against measles? When was your last tetanus shot? Eastern Health What vaccinations do you need to get for your trip? Thanks to the first national, bilingual smart phone app you’ll no longer be searching for these answers or your vaccination records. This free, secure app allows people to store, manage and easily Just Blowing Smoke? access their immunization information, as well as receive reminders about vaccine Are E-cigarettes legal? Why the big updates based on their provincial/territorial vaccine schedules. It is available for controversy? Are there health and safety iPhone and Android operating systems, including Android-enabled BlackBerry smart risks? Can E-cigarettes help smokers quit phones. Access the app at Immunize Canada, www.immunize.ca. smoking? To learn more about this issue, you can view information from the Canadian based Non-Smokers’ Rights Association at www.nsra-adnf.ca.

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

20

ACCESS Vol. xxxV No. 3 September 2014 Congratulations, Nursing Graduates OF THE BACHELOR OF NURSING (COLLABORATIVE) PROGRAM, May 2014

Abbott, Brittany Aspen Cove Hall, Nicole St. John’s Patey, Stephanie St. Lunaire-Griquet Adams, Rebecca St. John’s Hancock, Danielle Steady Brook Payne, Amanda St. Paul’s Allen, Erika Corner Brook Hann, Michael Payne, Veronica Cox’s Cove Alteen, Laura St. John’s Hann, Shaila Summerside Pellerin, Kristen Beaver Bank, NS Ayre, Karla Hawke’s Bay Hawco, Victoria Conception Harbour Pennell, Meghan Mount Pearl Baker, Heidi Hayes, Jessica Goulds Perry, Leah Conception Bay South Banman, Sherry Kingston, NS Hemeon, Adam Botwood Pierce, Allison Harbour Breton Bennett, Angus Josh Steady Brook Hillman, Sarah Gibsons, BC Power, Sheena St. John’s Benoit, Jenna Lower Cove Hiscock, Jennifer St. John’s Preston, Aimee Corner Brook Bonnell, Reuben Little Bay East Hogan, Alyssa Paradise Price, Catherine Fortune Bragg, Jenny St. John’s Holwell, Alison Conception Bay South Puddester, Claudia Bay Bulls Brown, Olivia Lethbridge Hopkins, Aimee Englee Puddester, Rebecca St. John’s Buckle, Dawn Corner Brook House, Karla Bellburns Pynn, Gina Moncton, NB Buffett, Nicole Fortune Hunt, Ashley Bell Island Reardon, Heather St. John’s Burry, Jennifer Portugal Cove-St. Philip’s Hunt, Jillian St. John’s Reddick, Amelia Halifax, NS Burry, Stacy Chapel Arm Hunt, Lindsay St. John’s Redmond, Luke Middle Cove Burt, Sarah Virgin Arm Hunt, Tara St. John’s Rice, Terri-Lynn Newville Butler, Amanda Mount Pearl Hurley, Chantal Millertown Rideout, Stephanie Conception Bay South Butt, Christina Paradise Hynes, Victoria Dunville Ring, Jessica Dartmouth, NS Button, Allison Clarenville Jackson, Robyn Whiteway Rose, Miranda St. Carol’s Byrde, Keshia Burin Jacobs, Megan Clarenville Rose, Sandralee St. John’s Byrne, Melissa York Harbour James, Toni Casey Rowe, Brittany Heart’s Content Canning, Heidi Conception Bay South John, Victoria Conne River Rowe, Jennifer St. John’s Carter, Amanda Mount Pearl Kelly, Lisa Mount Pearl Rowsell, Ashley Grand Falls-Windsor Chesher, Hillary Mississauga, ON Kelly, Melissa St. Alban’s Rowsell, Stephanie Norris Arm Clarke, Amanda Mount Pearl Kemp, Julia North Sydney, NS Seaward, Jamie Channel-Port aux Basques Clarke, Katie St. John’s Kennedy, Sherry Conception Bay South Sharpe, Jessica Upper Island Cove Coffin, Johanna Corner Brook Kennedy, Stephen Bishop’s Falls Shea, Sara St. John’s Colbourne, Jennifer St. John’s King, Kayla Portugal Cove-St. Philip’s Shepherd, Jennifer Corner Brook Coombs, Cinderella Forresters Point Kozhani, Elbonita Charlottetown, PEI Simmons, Brandon Random Island Cooper, Jacqueline Langdon, Katie Laurenceton Simms, Rebecca Mount Pearl Cormier, Julia Hanwell, NB Lavers, Kaylie Port Saunders Singleton, Teri-Lynn Coley’s Point Cranford, Jessica New Harbour Leamon, Jenna Rose Blanche Skinner, Samantha Harbour Breton Crowley, Kerry-Lynn Chapel’s Cove LeMessurier, Karen St. John’s Smith, Lindsey Amherst, NB Day, Jasmine New Harbour Linehan, Ashley Mount Carmel Spontaneo, Crystal Corner Brook Devereaux, Julie Logy Bay Lundrigan, Amy Mount Pearl Stout, Alana Edmonton, AB Devereaux, Paula Avondale Maddox, Rebecca Adam’s Cove Strugnell, Angelia Port Hope Simpson DeZeeuw, Bronwyn St. John’s Maloney, Meghan Conception Bay South Summers, Samantha Paradise Dodd, Evangeline St. John’s Marsden, Sarah Portugal Cove-St. Philip’s Sutton, Ashley Pasadena Doody, Rebecca Admiral’s Beach Matchim, Erin Eastport Tapp, Megan Port Aux Basques Doody, Shauna Admiral’s Beach McIsaac, Trudi Mount Pearl Taylor, Erika Corner Brook Doucet, Hilary Halifax, NS McLean, Ashley St. John’s Taylor, Hayley Forresters Point Doucette, Lance St. Georges McNeill, Nicole Richmond, PEI Taylor, Heather Goulds Doyle, Katelyn St. John’s McQuinn, Anna Halifax, NS Taylor, Jessica New Maryland, NB Dunn, Jacquelin Paradise Mercer, Candice Whitbourne Terry, Laura Middle Arm Dwyer, Jody Holyrood Meszaros, Kristie Thomas, Ashley Earle, Tiffany Carbonear Mifflin, Alison Torbay Thompson, Kelly Digby, NS Earles, Michael St. John’s Milner, Rebecca Grand Falls-Windsor Tohsam, Anne-Marie Fukwin Bamenda, Cameroon Eldridge, Cassie Minto, NB Moores, Jessica Toope, Nakita Mount Pearl Elliott, Nikita River of Ponds Morris, Michael Corner Brook Trickett, Brittany Carbonear Eveleigh, Heidi Conception Bay South Mouland, Jessica Labrador City Tucker, Robyn St. John’s Eveleigh, Victoria Beaumont Mulle, Krista Liverpool, NS Tulk, Mandy Stoneville Fagan, Sarah Conception Bay South Mullins, Gabrielle Ramea Udo, Diana Port Harcourt, Nigeria Fitzgerald, Nikita Open Hall Mulrooney, Sherri-Lynn Goulds Vokey, Laura St. John’s Fitzgerald, Rhonda Open Hall Murdoch, Ashley Deer Lake Wade, Renee Bishop’s Falls Fougere, Stephanie Northwest Arm, NS Murphy, Allison Mount Pearl Wallace, Susan New Glasgow, NS Francis, Tyler Deer Lake Murphy, Jeremy Corner Brook Walsh, Edmund Corner Brook Geehan, Julie Conception Bay South Norris, Courtney Newtown Warren, Katie Ramea Giffin, Samantha Fall River, NS Norris, John Newtown Warren, Keith Fortune Gifford, Jocelyn Coley’s Point North, Martha Halifax, NS Warren, Samantha Marystown Giles, Erin Stephenville Noseworthy, Holly Pouch Cove Watkins, Vanessa Twillingate Gillingham, Tiffany Appleton Nugent, Amanda Conception Bay South West, Samantha Logy Bay Goodyear, Cassandra Lumsden Oxford, Sara St. Alban’s Whiteway, Kelly Goulds Gould, Keirsten Bear Cove Park, Cecilia Frenchman’s Cove Wilson, Katlyn Kensington, PEI Greenham, Wendy Comfort Cove Park, Jennifer Corner Brook Wiseman, Amy (Evans) West Bank, BC Grenning, Malinda Torbay Parsons, Beth Corner Brook Woodman, Brittany New Harbour Guinchard, Crystal-Lynn Anchor Point Parsons, Natasha Flatrock Wright, Kimfa Holyrood Hackett, Krystal Benoit’s Cove Parsons, Vanessa Botwood Young, Tasha St. John’s Hall, Chris Corner Brook Patey, Nikita Main Brook Zhu, Xiaoqi Corner Brook 21 MEMBER REMINDER: live the life you Keep your information up-to-date! always wanted discover nursing opportunities in manitoba

Under the Registered Nurses Regulations (2013), all members are required to keep their You’ll earn a competitive salary and enjoy an incredibly affordable quality of life. Experience friendly information on file with ARNNL up-to-date. This includes: communities, a thriving arts and cultural scene plus access to beaches, lakes and parkland and enjoy • Change in name (copy of legal documentation required) a healthier balance between your work as a nurse and your personal life. • Mailing address Make your plans now and you may qualify to receive: • Email address • Employment information • Up to $5,000 in relocation assistance • $4,000 in conditional grant funding for new graduates who choose Changes must be reported to ARNNL within 30 days of the effective date of change. Members to work in a rural area can update this information at https://ereg.arnnl.ca/. • $2,000 in grant money if you choose to work in a personal care home For nurse practitioners employed with an employer other than a Regional Health Authority, • $2,000 in grant money if you choose to work in a position where declarations regarding the arrangement with a physician, including physician name and bilingualism/French language is a hiring requirement address, must be on file with ARNNL. Should any of the information with respect to this arrangement change, the NP must contact ARNNL immediately. • Continuing education funding

FALL/WINTER 2014-2015 WORKSHOPS COMING TO NEWFOUNDLAND AND LABRADOR

SUICIDE PREVENTION, INTERVENTION DEALING WITH DIFFICULT PEOPLE AND POSTVENTION STRATEGIES St. John’s: October 22, 2014 St. John’s: October 20-21, 2014 MANAGEMENT AND SUPERVISION DE-ESCALATING POTENTIALLY - The Crucial Skills VIOLENT SITUATIONS™ St. John’s: November 14, 2014 St. John’s: November 13, 2014 EMOTIONAL INTELLIGENCE ANXIETY - Practical Intervention Strategies TO REGISTER FOR A CTRI WORKSHOP: - Expanding Influence www.ctrinstitute.com St. John’s: December 9, 2014 [email protected] St. John’s: December 10, 2014 204.452.9199 UNDERSTANDING MENTAL ILLNESS COACHING STRATEGIES FOR LEADERS St. John’s: February 12, 2015 TO REGISTER FOR AN ACHIEVE WORKSHOP: - Conflict, Performance, Change www.achievecentre.com St. John’s: February 19, 2015 RESTORATIVE JUSTICE [email protected] - Guiding Principles for 204.452.0180 CONFLICT RESOLUTION SKILLS Communities and Organizations St. John’s: March 26, 2015 St. John’s: March 11, 2015 WEBINARS No matter where you live, you can easily access Live the life you always wanted, in Manitoba. MINDFULNESS COUNSELLING STRATEGIES many of workshops right from your desk. Our 60-70 Please visit our websites in minute webinars offer you the opportunity to hear, - Activating Compassion and Regulation view and engage with our September for information on more St. John’s: April 8-9, 2015 trainers. workshops coming to St. John’s. Please visit our websites for details. For more information, please visit our website at www.manitoba.ca/health/nurses www.ctrinstitute.com www.achievecentre.com In Winnipeg: 204-788-6668 Toll Free in Canada: 1-877-681-4983 22 Email us at: [email protected]

ACCESS Vol. xxxV No. 3 September 2014

7886-CSM-NRRF-ad [7 x 9.5 4Cp]-June2014-1.indd 1 6/25/14 10:38 AM live the life you always wanted discover nursing opportunities in manitoba

You’ll earn a competitive salary and enjoy an incredibly affordable quality of life. Experience friendly communities, a thriving arts and cultural scene plus access to beaches, lakes and parkland and enjoy a healthier balance between your work as a nurse and your personal life.

Make your plans now and you may qualify to receive: • Up to $5,000 in relocation assistance • $4,000 in conditional grant funding for new graduates who choose to work in a rural area • $2,000 in grant money if you choose to work in a personal care home • $2,000 in grant money if you choose to work in a position where bilingualism/French language is a hiring requirement • Continuing education funding

Live the life you always wanted, in Manitoba.

For more information, please visit our website at www.manitoba.ca/health/nurses In Winnipeg: 204-788-6668 Toll Free in Canada: 1-877-681-4983 Email us at: [email protected]

7886-CSM-NRRF-ad [7 x 9.5 4Cp]-June2014-1.indd 1 6/25/14 10:38 AM You’ve worked hard. Let TD Insurance recognize your efforts.

Professionals can save more. You could WIN At TD Insurance, we recognize all the time and effort you put into getting where $60,000 cash you are. That’s why, as a member of the Association of Registered Nurses of to build your Newfoundland and Labrador, you have access to our TD Insurance Meloche Monnex dream kitchen!* program which offers preferred group rates and various additional discounts. You’ll also benefit from our highly personalized service and great protection that suits your needs. Get a quote today and see how much you could save.

Request a quote today 1-866-269-1371 melochemonnex.com/arnnl

Insurance program supported by

HOME | AUTO | TRAVEL

The TD Insurance Meloche Monnex home and auto insurance program is underwritten by SECURITY NATIONAL INSURANCE COMPANY. The program is distributed by Meloche Monnex Insurance and Financial Services Inc. in Quebec and by Meloche Monnex Financial Services Inc. in the rest of Canada. For Quebec residents: We are located at 50 Place Crémazie, Montreal (Quebec) H2P 1B6. Due to provincial legislation, our auto insurance program is not offered in British Columbia, Manitoba or Saskatchewan. *No purchase is required. There is one (1) prize to be won. The winner may choose between an amount of $60,000 CAD to build a dream kitchen of his/her choosing or $60,000 CAD cash. The winner will be responsible for choosing a supplier and for coordinating all of the required work. The contest is organized by Security National Insurance Company and Primmum Insurance Company and is open to members, employees and other eligible persons who reside in Canada and belong to an employer, professional or alumni group which has entered into an agreement with the organizers and is entitled to receive group rates from the organizers. The contest ends on October 31, 2014. The draw will be held on November 21, 2014. A skill-testing question is required. Odds of winning depend on the number of eligible entries received. The complete contest rules are available at melochemonnex.com/contest. ® The TD logo and other trade-marks are the property of The Toronto-Dominion Bank.

12-MM9208-13_MMI.EN•arnnl (7.5x10)-B.indd 1 Projet : Annonce MMI 2013 Province : Newfoundland & Labrador Épreuve # : 2 13-11-25 12:08 PM Publication : Access Client : TD Assurance Date de tombée : 14/11/2013 Format : 7.5x10 Dossier # : 12-MM9208-13_MMI.EN•arnnl (7.5x10) Couleur : Quad Graphiste : Yannick Decosse

Hamelin-Martineau Inc. • 505, boul. de Maisonneuve O, Bureau 300 • Montréal (Québec) H3A 3C2 • T : 514 842-4416 C : [email protected] ATTENTION : MERCI DE VÉRIFIER ATTENTIVEMENT CETTE ÉPREUVE AFIN D’ÉVITER TOUTE ERREUR/PLEASE CHECK THIS PROOF FOR ERRORS