WEST VIRGINIA NURSE

“Nurses working together for a healthy West Virginia”

The official publication of the West Virginia Nurses Association Quarterly publication distributed to approximately 19,600 RNs & LPNs in West Virginia.

July, August, September 2021 Volume 22 • No. 3

Inside: PRESIDENT’S MESSAGE

Dear WV Nursing Colleagues, at the beginning, true leaders are not afraid to fail. We President’s Message...... 1, 6 learn from our failures. Executive Director’s Message...... 2 As I’m writing my presidential If being a legislative leader in your district is address, it is the Memorial Day something you would be interested in, contact the Editor’s Column...... 3 Holiday weekend. I have deep central office. There can be more than one legislative Helping Breastfeeding Parents gratitude as I reflect on the leader in each district and we are happy to include you Navigate the COVID-19 Vaccine ultimate sacrifices of veterans as a legislative leader and help you succeed. with Podcasting ...... 4-5 who died protecting and During the legislative session we worked to find defending our country. financial assistance for nurses who exhausted PTO 2021 WVN Deadlines ...... 6 Memorial Day is also the early in the pandemic due to furlough, illness, or Informed Consent ...... 7 official kickoff to summer, family emergencies. After those funds were gone, they attending parades, and Joyce Wilson became sick with COVID or were quarantined because of WVNA 2021 Fall Elections: planting our gardens. My exposure and were off without pay. Some still have not Meet the Candidates ...... 8 flowers and vegetables are now in the ground and one been able to return to work and are relying on things like of my favorite sayings is “She who plants a seed in the GoFundMe accounts to make ends meet. These nurses On the Front Lines with ground and waits has hope.” I look forward to fresh were not eligible for worker’s compensation unless they West Virginia School Nurses ...... 9 vegetables every year and I know that a successful could prove they contracted COVID at work, and they The states and the public are garden takes hope and a lot of work. Gardening has were not eligible for unemployment because they were grateful for WVNA and all nurses. . . 10 also taught me from my failures. My greatest lesson not available for work. is learning to not be afraid of failure. I love being in my We started the process of looking for help for our Nightingale Tribute ...... 11 garden because it slows me down and I have time to colleagues by going to Governor Justice to ask for CARES Conferences & Meetings...... 11 think. What I’ve been thinking about mostly for the past Act money: that is, the Coronavirus Aid, Relief, and year or so is leadership. What makes a good leader? A Economic Security Act of 2020. Gov. Justice was not able Summary of the 2021 West good nurse leader? to assist, expressing that CARES money was mandated Virginia Legislative Session...... 12 In my reading and listening to lectures of leaders, for other WV projects. The Governor’s office suggested what I have learned is that a leader must be trusted and to us that we ask the BON to help by setting up a grant Membership Update...... 12 must be their authentic self. It is the job of the leader using the surplus of money in their account that comes Future of Nursing WV Update . . . . . 13 to create a culture of safety so that others can speak on from nursing licensure fees. Historically, a large amount issues of conflict. Good leaders know that conflict does of Board of Nursing funds has been “swept” into general ANA General Assembly: not have to bring defensiveness. If there is a culture of revenue. Preview from the Voting Delegate. . . 13 safety, voicing conflict can bring dialogue and conflict We continue to meet with the Board of Nursing on Pediatric ICU Stay Can Be Scary, resolution. this issue. During the 2021 legislative session, we had Lonely Experience – For Parents. . . 14 Nurses are natural leaders; building a culture of our bill introduced in the House of Delegates. It passed safety so that a patient and their family trusts us is the the House Finance Committee and passed “on the floor” An Ethic of Justice Viewed through foundation of the nurse-patient relationship. Listening is (that is, passed the whole House) with 97 delegates the Lens of an Ethic of Care. . . . . 15 natural to us nurses. In listening to our patients, we learn voting for it. Unfortunately, the bill died in the Senate what is conflicting them. Then we do the second thing Finance Committee. We will continue to work on passing that comes naturally to us: patient education. legislation to help nurses in need. We continue to have Nurses as leaders also know that everyone’s life meetings with the legislative committee of the BON to experience and perspective is different. We care for our reconcile the surplus of monies in their account. patients with respect to their perspective as well as our During the month of May, we celebrated National own. Fine line leadership skills. Nurses Month with Zoom and Facebook Live events Being a member of the WVNA requires a different every Tuesday night, featuring guest speakers and sort of nursing leadership skills. We are building trusting drawings for prizes. It truly was a great event for the relationships with legislators, and we respect that WVNA. Here’s a summary:

Presort Standard their perspectives are different from ours. We US Postage look for common ground, for a positive place to Week 1: Self Care PAID work from. Ian Avis, BSN, RN WVUSNA President, presented the Permit #14 Nurses listen to each other. Legislative leaders WVUSNA Resolution, “In Support of Meeting Nurses’ Princeton, MN current resident or 55371 play an essential role at this grassroots level. Self-Care Needs to Improve Patient Outcomes”; They bring information to the association about Lori McComas Chaffins, BSN, RN, spoke on the WV RN concerns of nurses working in each district of the Board’s Nurse Health Program; state, such as concerns around issues that hinder Aila Accad, MSN, RN, with Aila Speaks, led us in a West Virginia citizens having access to care. They self-care Emotional Freedom Technique (EFT) tapping also bring ideas for new legislation that could exercise. enhance nursing in West Virginia. Not all our President’s Message continued on page 6 legislation is successful the first time, but as I said Page 2 West Virginia Nurse July, August, September 2021 Executive Director’s Message

Julie A. Huron At this point in my work with nurses, I can easily see who WVNA Executive Director will be on a national platform in the future, and I want to help to connect you. If you are reading this and you are saying West Virginia Nurse As I am writing this, I have “YES, this is me…Contact me! Connecting nurses makes my Official Publication of the been preparing for ANA’s 2021 soul shine and inspires my spirit.” West Virginia Nurses Association Virtual Hill Day tomorrow. This Respectfully, I am pleased to say that the millennials are P.O. Box 1946 | Charleston, WV 25327 is when nurses from across the here and they are quickly making an impact on our state Phone: 866.986.8773 or 866.WVNURSE country meet with our U.S. nurses’ association. They are vocal, they are responding to Email: [email protected] senators and congressional our calls for action, they are connecting, have suggestions representatives to share and they work quick. We put together a PRIDE month in Webpage: www.wvnurses.org ANA bills. We ask for the two calls and a flurry of email and text messages. The WVNA legislators’ support and for Celebrates PRIDE month CE lineup has been fabulous and Published quarterly every January, April, July and October for the West our representatives to sign on the response of WV nurses has been positive and engaging. Virginia Nurses Association, a constituent member of the American as a co-sponsor. It’s effective Because of our engaged membership committee and Nurses Association. to establish a rapport with our Julie A. Huron our newly formed DEI committee our last two events The opinions contained herein are those of the individual authors and do representatives, and it helps us have included Facebook Live events, great prizes, new not necessarily reflect the views of the Association. to keep in communications with them throughout the creative ways to engage with WV nurses. This is not me, it’s WV Nurse reserves the right to edit all materials to its style and space year. We interchange these experiences when we meet a coordinated effort with nurses that want to be a part of requirements and to clarify presentations. with our West Virginia senators and delegates and share something great! I am grateful for the energy that flows from nursing stories and the experiences that our patients everyone! The saying, “your vibe attracts your tribe” is real. WVNA Mission Statement have. This fall we will hold a virtual nursing conference on The mission of the WVNA is to support WV nurses and to work for a healthier West Virginia. Every season of the year we have a different focus. October 21. It will be like our March Virtual Policy Summit and During the first quarter of the year, we are heavily will include a day of education, nursing awards, scholarships WVNA Executive Board focused on West Virginia’s legislative session, policy, for nursing students, a poster presentation, sponsorship President: Joyce Wilson [email protected] and bills that affect nurses and the health of West opportunities, and exhibitors. Our WVNA membership President-Elect: Teresa Hovatter [email protected] Virginians. That first quarter also brings our WVNA Vice President: Lori McComas Chaffins [email protected] assembly with election results will either be on the same day Treasurer: Roger Carpenter [email protected] Policy Day event, calls for nominations to open WVNA or a day prior or later. Please watch for our emails and our Secretary: Jon H. Casto [email protected] board positions, and calls for applicants to the WV news and announcements regarding the event details. Immediate Past President: Toni DiChiacchio [email protected] Board of Examiners for Registered Professional Nurses If you are not a WVNA member yet, I hope you realize that District Leader Representative: (WV RN Board). This year we added town hall events we need your voice. We are nothing without West Virginia Crystal Chapman [email protected] with several guest speakers. In May for National Nurses nurses. Numerous organizations reach out asking WVNA Early Career Nurse: Luke Velickoff [email protected] Month, we had a full month of Facebook Live Tuesday to support or sign on to their legislative issues. We examine Committee Chairs night events with weekly themes, multiple guest everything that we add our WVNA name to and often refer Bylaws / Policy and Procedures Chair: speakers, prizes, and opportunities to connect. We do back to our WVNA Health Policy and Legislative Statement to Luke Velickoff [email protected] all of this with a staff of one (me!). But that is not a true ensure that we are following our guidelines. APRN Congress Chair: Jodi Biller [email protected] representation of how the work gets done. I love to help nurses connect. Please reach out to me or Health Policy & Legislative Co-Chairs: WVNA is run by volunteer board members, any of our WVNA board members or committee members Teresa Hovatter [email protected] committee chairs, and committee members. My role is Jodi Biller [email protected] and we will connect you to a committee that is right for you. PAC Chair: Jon H. Casto [email protected] to connect the dots and make things happen. It is way Living through the COVID-19 pandemic and all that nurses Immediate Past PAC Chair: Joyce Wilson [email protected] more than that, but we truly have a huge impact with have gone through, we know more than ever that we are all in Membership Chair: Anitra Ellis [email protected] a staff of one. That is because we have a resourceful this together, and our sense of community is stronger! Getting Nominations and Awards Chair: board and talented committee members. WVNA is involved with an organization that you truly connect with can Toni DiChiacchio [email protected] nothing without nurses who care about advancing forever change your life. If you have a special talent, and want Nursing Workforce Initiative: their profession. They inspire me to figure out how to to do a little more with us, please let us know. I truly believe Heather Glasko-Tully [email protected] ANA Membership Assembly Delegate: do things I have never done before. That is one of the that if you want to get something done, you get a busy person. Moira Tannenbaum [email protected] reasons that I get so excited to meet nursing students So, busy nurses, we need you and want to get to know you. Ad Hoc Diversity, Equity, and Inclusion (DEI) Committee Chair: and the SNA leaders across the state. I want to know you Luke Velickoff [email protected] and your fellow students; I want to know your coworkers Warmest heartfelt regards, and who the movers and shakers are on your unit or in WVNA Staff Julie Absher Huron, Executive Director, [email protected] your clinic or wherever you practice. I want WVNA to be where nurses come to get to know each other and do WV Nurse Staff more great things! Moira Tannenbaum, Editor, [email protected] West Virginia Nurse Copy Submission Guidelines All WVNA members are encouraged to submit material for publication that is of interest to nurses. The material will be reviewed and may be edited for publication. There is no payment for articles RN-to-BSN Program published in the West Virginia Nurse. Article submission is accepted in Microsoft Word or similar format. ENTIRELY ONLINE Copy submission via email: Please attach a Microsoft Word (or similar) file to email. We ask that you not paste the text of the article into email. 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Please do not convert the file to a PDF. When sending pictures, please PROGRAM HIGHLIGHTS: provide a description identifying the people in the pictures and note who the photographer was, if relevant. • Most affordable RN-BSN in West Virginia Approximately 1,600 words equal a full page in the paper. This does • Work while completing your degree not account for headlines, photos, special graphics, pull quotes, etc.

• 24/7 access to courses Submit material to: • Small class sizes and individual feedback West Virginia Nurse PO Box 1946, Charleston, WV 25327 Email: [email protected] For more information or questions: For advertising rates and information, please contact Arthur L. Davis Publishing Agency, Inc., PO Box 216, Cedar Falls, Iowa 50613, (800) 626-4081, sales@aldpub. Please email [email protected]. com. WVNA and the Arthur L. Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to correction in the next issue or refund of price of advertisement.

Acceptance of advertising does not imply endorsement or approval by the West Virginia Nurses Association of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered ENROLL TODAY! for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. WVNA and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of WVNA or those of the national or local associations. July, August, September 2021 West Virginia Nurse Page 3 Editor’s Column

Moira Tannenbaum, MSN, APRN, CNM workflow was severely affected. Patient safety was at risk: for hours giving serial numbers. She was on hold, off Editor, West Virginia Nurse clinic staff could not access patient information in a timely hold, on hold again, all the while reminding IT that she is manner. You can imagine the dangers of staff seeing a physician. In other situations, she had been known to As a real-live nurse who is also a newspaper editor patients but not seeing all the necessary information about raise her voice and say, “You have to do this because I am for nurses, I process the stories I hear from other nurses the patients. a doctor, and my patient needs it.” The problem got fixed! through my lens of what things mean for the larger Several of the staff members had reached out to the Clinic staff could see the charts again at the speed they picture of nursing and health care. Here’s one of the information technology (IT) department at the national were used to, at least most of the time. latest from my personal grapevine. headquarters, saying “Hey, it’s taking us forever to see The staff calls the physician “Dr. Jelly” – I hear it’s … A medical director who works with two nurse our patients now. The PDF files won’t load. You have to a long story – and they are very grateful. Many staff practitioners, a medical assistant, and some LPNs and RNs do something,” but these pleas did not land on receptive said they had never seen a physician tackle a problem in a clinic setting – part of a national franchise – learned (or comprehending?) ears. The regional nurse manager like this one; they said it seemed like the kind of of the staff’s concern that the electronic health record seemed not to “get” the situation either. The medical thing nurses are expected to deal with while doing a (EHR) the clinic uses had lost a lot of functionality when director – who was relatively new to the clinic – talked hundred other things. And at a time when nurses have the compatible browser was updated but the EHR wasn’t. with the clinic staff to get the full picture, and then went been working so hard to cope with the pandemic, This meant that reviewing a patient’s chart suddenly took into action. She talked with IT and explained why this was it was a gift. My thought about this story is that the about six times longer than it previously had. Clinic staff dangerous for patient care. She found out what information medical director realized she could use her “physician now had to open each page of a patient’s chart individually, the IT department needed to solve the problem, gathered privilege” and get the message across in such a way save it as a PDF, and then view each page individually – the information – writing down the serial numbers and that administration had to listen. How can we all do while entering a password for each separate action. Clinic model numbers – got on the phone with IT, and sat there more of this together? Page 4 West Virginia Nurse July, August, September 2021 Helping Breastfeeding Parents Navigate the COVID-19 Vaccine with Podcasting

Heather ONeal, MSN, APRN, CNM, IBCLC For example, in one progressing slower than the rollout in the U.S., and many of our podcast episodes patients currently face waiting lists. It all started with a question from December 2020, Earlier in the pandemic, the CDC was not from a patient – or rather “The ‘Rona Vaccine recommending the COVID-19 vaccine for pregnant dozens of patients: “Should and Breastfeeding: people. The CDC now says: I get the COVID vaccine while What We Know Today” “Pregnant people are more likely to get severely I’m pregnant/trying to get (ONeal & Farrell, 2020), ill with COVID-19 compared with non-pregnant pregnant/breastfeeding?” we discussed that at people. If you are pregnant, you can receive a As one of the Milk Minute that time, national and COVID-19 vaccine. Getting a COVID-19 vaccine Podcast co-hosts, my top priority international health during pregnancy can protect you from severe is to provide our lactating organizations were only illness from COVID-19. If you have questions about listeners with honest, witty, recommending that getting vaccinated, a conversation with your evidence-based information pregnant or lactating healthcare provider might help, but is not required to empower positive decisions Heather ONeal individuals who were at for vaccination” (CDC, 2021c). for their health and wellbeing. high risk for COVID-19 consider getting the vaccine – after My co-host Maureen Farrell, a student midwife and certified consulting their health care providers. In fact, the National Recent studies of the COVID-19 vaccines indicate high lactation counselor (CLC), and I are passionate about Health Service (NHS) and the Royal College of Obstetricians levels of efficacy in preventing the virus and preventing making sure all breastfeeding/chestfeeding parents have and Gynaecologists (both in Britain) were recommending hospitalization or death due to COVID-19 and related the knowledge and skills to confidently feed their babies. against pregnant and breastfeeding parents receiving the complications (Yale Medicine, 2021). Side effects for all Naturally, as a plethora of vaccines are rolling out and vaccine, due to a lack of data from safety trials. But just four populations have proven to be relatively mild (even if they receiving emergency approval across the globe, parents months (four years in pandemic time?) later, that decision don’t always feel that way for the individual experiencing want to know: is this safe for me and my children? And health was reversed and we at Milk Minute released an updated them), with serious side effects (allergic reactions such as care providers like you want to confidently counsel their podcast with new information: any eligible individual is anaphylaxis or blood clotting) occurring extremely rarely. patients: receiving this vaccine is a decision you should feel encouraged to take the vaccine in consultation with their More than 230 million doses of approved COVID-19 good about for your families. health care provider (ONeal & Farrell, 2021). vaccines were administered in the U.S. between December As a certified nurse-midwife (CNM) and an International The NHS explicitly states on their website that 14, 2020 and April 26, 2021 (CDC, 2021b). As of June 7, 2021, Board Certified Lactation Consultant® (IBCLC®), I have been pregnant people should be offered the vaccine and 123,165 pregnant people self-identified as having received carefully monitoring recommendations from the Centers for should take either the Moderna or the Pfizer-BioNTech the vaccine during their pregnancy through a voluntary Disease Control and Prevention (CDC), as well as from other vaccine, in accordance with the available safety data vaccine safety tracking survey (CDC, 2021a). With the national and international maternal health organizations. from studies with pregnant recipients. NHS notes overwhelming majority of recipients reporting mild or no Guidance is changing rapidly and we expect it will continue that pregnant people who took the first dose of the side effects under the most rigorous safety monitoring to evolve as additional longer-term studies, and studies with AstraZeneca vaccine and experienced no problems with program ever instituted in our country’s history, there is a new populations, are conducted. It’s important to note here it may receive the second dose of that same vaccine. solid body of evidence to support the widespread use of that changing guidance is not our enemy, or an indication of Additionally, the NHS notes that breastfeeding parents these vaccines. While those in the U.S. and the rest of the safety concerns; in fact, it’s just the opposite. The more data may take the vaccine and that there is no evidence world collectively have been desperate for an end to this come in, are analyzed, and reanalyzed, the more assurance that the vaccines have any negative effect on fertility pandemic, we at the Milk Minute Podcast do not believe we can have for ourselves and our patients. (NHS, 2021). The United Kingdom’s vaccine rollout is anyone involved in vaccine development or public health would accept a rushed or unsafe immunization process that could risk public trust in the health care system precisely when we need it most. In this country, vaccine sites have established mandatory safety monitoring for all recipients, including with nurses and first responders trained to identify, treat, and transfer patients with allergic reactions quickly to hospital care. Furthermore, pharmaceutical companies, health departments, and research institutions have undertaken extensive studies to broaden our knowledge and confidence in the vaccines’ ongoing efficacy and safety. Even the CDC has instituted a new data collection program on vaccine safety and side effects, called v-safe (CDC, 2021d). Anyone who receives a vaccine is encouraged to enroll and enrolling is quick and easy, including from a smartphone. For those who received the vaccine during the periconception period (within 30 days of the last menstrual period) or during pregnancy, they should indicate so on their v-safe reporting; this will enable their registration on the V-Safe COVID-19 Vaccine Pregnancy Registry, if eligible. Participation in the v-safe pregnancy registry is voluntary, and participants can opt out at any time; as of June 7, 2021, over 5,100 people have already enrolled (CDC, 2021a). Their data will be critically important in continued research on vaccine safety for pregnant people as we all work to end the pandemic. On a positive note, there also appear to be early data indicating that parents who receive the vaccine while pregnant (especially during the third trimester) or breastfeeding can pass antibodies to their babies (CDC, 2021c). At this stage in the research, the strength and longevity of these antibodies’ protection for baby is not yet known, but it is giving many families hope since the vaccine is not yet approved for infants or for children below age twelve. The New York Times (Murphy, 2021) reported that some recently vaccinated parents who had already weaned their baby from breastfeeding/chestfeeding are attempting relactation. (Relactation is the process of bringing back a milk supply after a breastfeeding parent has weaned their infant or infants.) Yet others who are still nursing and recently vaccinated are sharing their breastmilk with infants of friends and family. Given how quickly vaccines were developed and received emergency approval, many people – including many parents – have concerns and feel hesitant to take the vaccine. As midwives and mothers, we podcasters at the Milk Minute understand. Bodily autonomy and respect are central to our practice as health care providers (and podcasters). We believe unconditionally in free choice and educated, empowered decision- July, August, September 2021 West Virginia Nurse Page 5 making. It is our duty to listen with open hearts to References National Health Service. (updated 2021, June 10). our listeners’ concerns, to sit with them in moments Centers for Disease Control and Prevention (CDC). (2021a, Coronavirus (COVID-19) vaccines. https://www.nhs. of uncertainty, and to provide them with the best updated June 7). V-safe COVID-19 vaccine pregnancy uk/conditions/coronavirus-covid-19/coronavirus- registry. https://www.cdc.gov/coronavirus/2019-ncov/ vaccination/coronavirus-vaccine/ information possible when making critical decisions vaccines/safety/vsafepregnancyregistry.html for themselves, their families, and their communities. ONeal, H., and Farrell, M. (2020, December 16). The ‘rona CDC. (2021b, updated June 8). Safety of COVID-19 vaccines. vaccine & breastfeeding: A look at what we know Make no mistake, the intersections of maternal health https://www.cdc.gov/coronavirus/2019-ncov/ today (episode 35) [audio podcast episode]. In Milk and ending this pandemic are fraught spaces with high vaccines/safety/safety-of-vaccines.html Minute Podcast. Breastfeeding for Busy Moms. https:// stakes. Maureen and I understand the trepidation, fear, CDC. (2021c, updated June 9). Information about COVID-19 breastfeedingforbusymoms.com/podcast/covid- and even anger at having to make what feel like (and vaccines for people who are pregnant or breastfeeding. vaccine-and-breastfeeding/ sometimes were) life or death decisions every day for https://www.cdc.gov/coronavirus/2019-ncov/ ONeal, H., and Farrell, M. (2021, April 2). Updates on the vaccines/recommendations/pregnancy.html COVID-19 vaccines for pregnant and/or lactating more than a year. We are tired too. CDC. (2021d, updated June 12). V-safe after vaccination Many of our listeners have spoken eloquently about people (episode 51) [audio podcast episode]. In Milk health checker. https://www.cdc.gov/ Minute Podcast. Breastfeeding for Busy Moms. https:// their decisions to take the vaccine or to wait for more coronavirus/2019-ncov/vaccines/safety/vsafe.html breastfeedingforbusymoms.com/podcast/covid-19- data. We affirm their right to bodily autonomy and stand Murphy, H. (2021, April 8; updated April 14). Vaccinated vaccine-for-pregnant-and-or-lactating-people/ with them to provide support and information when mothers are trying to give babies antibodies via Yale Medicine. (updated 2021, June 2). Comparing the needed. breast milk. The New York Times. https://www. COVID-19 vaccines: How are they different? https:// nytimes.com/2021/04/08/health/covid-vaccine- www.yalemedicine.org/news/covid-19-vaccine- breast-milk.html?referringSource=articleShare comparison

Heather ONeal (L) and Maureen Farrell

“I think a lot of our listeners can relate to my experience with the COVID vaccine. When I was pregnant, it was scary to face down the decision to receive a vaccine that was completely untested in pregnant people, or risk getting a new disease with a chance of serious symptoms. I had already decided to get it if offered while lactating, but unexpectedly found availability much sooner. It’s difficult to make these decisions without solid data. After consulting with colleagues and putting some time into exploring my own feelings, I decided to get my vaccines while pregnant. And ultimately I think pregnant and lactating people need to make their own best choices here while we await real safety information.” – Maureen Farrell, CLC (co-host of the Milk Minute Podcast)

“It makes me so happy that I got vaccinated. When the vaccine started rolling out to health care workers like myself, I asked for advice and got lots and lots of bad backlash. I cried and was so stressed. I made the choice of getting vaccinated based on the AWHONN recommendation AND [this] podcast! So thankful for the admin of this group. So happy I didn’t listen to negative comments, and listened to the professionals and studies. Thank you.” – Sonia Ramirez, RN

“As a breastfeeding x-ray tech in southern WV, I was very hesitant to take the vaccine. I did a lot of research, but I kept coming up empty handed. Nobody wanted to give us definite answers, and I spent many nights researching while nursing my baby. I even talked to our physicians at my place of work, two pharmacists, and every coworker who was or could be in my position. I was leaning towards taking the vaccine but listening to the Milk Minute Podcast made me feel confident that I wouldn’t do any harm to my little one. These two ladies are awesome and to be honest, I might still be on the fence about it if it wasn’t for them. The unknown is very scary, and I would have to say I think it is just a personal decision that everyone has to make.” – Jamie Green, R.T.

At Milk Minute Podcast, we work hard to provide trustworthy, evidence-based advice for prospective and lactating parents. Together we will see the end of this pandemic, and we all have a role to play in the relay to the finish. For more information, listen to the Milk Minute Podcast on any podcast platform (Apple, Spotify, Google, Stitcher, iHeart Radio, Pandora), join our Facebook Support Group, and browse our website. Page 6 West Virginia Nurse July, August, September 2021

President’s Message continued from page 1

Week 3: Inclusive Health Care 2021 West Virginia Week 2: Recognition Speaker: Natasha Stone, BA, WGS, transgender Joanne Watson, MSN, RN, from WVU School of Nursing, visibility organizer, Fairness West Virginia. Nurse Deadlines shared her work with COVID vaccination in WV; Pamela Alderman, EdD, MSN, RN, president and professor Week 4: Hormone Therapy and Neurotransmitters WV Nurse is a quarterly newspaper. of nursing at Southern West Virginia Community and Speaker: John Prentice, M.A.; therapist, Harmony The due dates for the rest of 2021 are: . Technical College, shared the story of her career in nursing. House; graduate assistant, Marshall University.

• October 2021 issue: material due to WV Nurse Week 3: Professional Development Week 5: LGBTQIA Veterans’ Mental Health by August 23, 2021 Tena Brown, a motivational speaker and Speaker: Lt. Col. (ret.) USAF, Sandra (Sam) Cotton, • January 2022 issue: approximate due date empathy educator, spoke on empathy; we shared DNP, APRN, ANP-BC around Thanksgiving, 2021 the free CE offered by ANA; here’s the link: https:// anayearofthenurse.org/nurses-month-2021-week-3/ The association has never been stronger, our For submission information, committees are meeting often and doing great work, see p. 2 of this issue, or the info on WVNA’s website, Week 4: Community Engagement the executive board is solid, and our membership is West Virginia Nurse Copy Submission Guidelines. WVNA Membership Committee Chair, Anitra Ellis, growing. We were creative and imaginative during DNP, APRN, FNP-C, along with Kristen Dial, MHA, BSN, the pandemic and kept the association’s work on task. RN, with Coalfield Development and Wild Wonderful & Some of our new tools will continue even after the Healthy Logan County; and Angie Settle, DNP, CEO of WV pandemic. Health Right, spoke on their community engagement/ Looking forward, we will be having a summer volunteer activities. retreat; whether it will be in person or virtual is to be determined. We will hold elections in October for Recently, WVNA’s early career board member, Luke Secretary and Treasurer. Velickoff, came to the Board with a suggestion of forming a Diversity, Equity, and Inclusion (DEI) committee … while Stay calm, stay tuned, and continue on, simultaneously the ANA was asking its constituent state nurses associations (CSNAs) what we were doing around Joyce Wilson, RN DEI development. I appointed Luke to be our ad hoc DEI WVNA President Committee chair, and the first thing that happened next was that right away, he led us in developing our Pride *** Month education series, offering five free CE events in June 2021. As I write this, we have launched the series and Editor’s Note: had a very successful first presentation. Two recent articles from West Virginia Nurse will help readers who want to learn more about some of the Week 1: Destigmatization of Blood Donation Guidelines information in this article. Speaker: Luke Velickoff, BSN, RN. WVU Medicine. First, for background on the issue of “budget sweeps” by the West Virginia Board of Examiners for Week 2: Why Test for HIV? HIV Prevention and the Law Registered Nurses (WV RN Board), please see the article Speaker: Jeanette Southerly, BSN, RN, regional by Toni DiChiacchio, DNP, in the January 2020 issue of director of the West Virginia regional partner of the West Virginia Nurse, entitled “Transparency Tools: Are MidAtlantic AIDS Education and Training Center. Nurse Licensure Fees Being Used as Additional Taxes on Nurses?” Second, the June 2021 Pride Month presentation, “Destigmatization of Blood Donation Guidelines,” by West Virginia Perinatal Retina Consultants, a specialty practice in Luke Velickoff expanded on the article “An Examination Partnership Summit Charleston, is seeking applicants for a full- of Stigmatizing Guidelines Regarding Blood Donation” time Registered Nurse to join our team. published in the April 2021 issue of West Virginia Nurse, authored by Luke along with Sara Vincelli, BSN, RN. Patient care and team work are a top priority. October 14-15, 2021 You can link to either article through WVNA’s We are looking for candidates with leadership website: West Virginia Nurses Association; scroll down Stonewall Resort, Roanoke, WV qualities and supervisory experience. on the left till you see the tab “The West Virginia Nurse Travel to satellite offices is required. & Nursing Publications.” You can also access either article through the website of our publisher, Arthur To apply, send resume to: L. Davis: go to Nursing ALD, click the image of West PO Box 3970, Charleston WV 25339 Virginia in the U.S. map, and click “Read West Virginia www.wvperinatal.org or email to: [email protected] Nurse Archives.” July, August, September 2021 West Virginia Nurse Page 7 Informed Consent

Marlene Reed, RN require more than a minimum role for nurses in obtaining informed consent. In discussion with As nurses, we have all heard scenarios of patients patients, nurses can help patients identify being inadequately informed of the risks, complications, questions they still have about a procedure or benefits of medical procedures. We may even have that they want to ask the health care our own personal experiences as a patient where we felt provider performing it – before they consent only partially informed. Nurses can play a vital role in the to it. In doing so, nurses can contribute informed consent process to prevent such instances. A to patient-centered quality of the informed nurse’s primary commitment is to the patient and includes consent process beyond obtaining the signature. acting to minimize unwanted medical treatment (ANA, As there is variation in informed consent processes, 2015). it is imperative that nurses utilize their skills to Informed consent is defined as agreement or identify any barriers, gaps, or red flags in obtaining true permission accompanied by full notice about the care, informed consent. treatment, or service that is the subject of the consent. A Marlene Reed patient must be educated regarding the nature, risks, and References alternatives of a medical procedure or treatment. (The Joint Commission, 2016). American Nurses Association (ANA). (2015). Code of ethics for nurses with interpretive Although general standards for obtaining informed consent do exist, there are statements. Silver Spring, MD: Author. https://www.nursingworld.org/practice-policy/ nursing-excellence/ethics/code-of-ethics-for-nurses/coe-view-only/ no universal consent forms mandated for medical facilities in the United States. Centers for Medicare & Medicaid Services (CMS). (2008, October 17). CMS Manual System. Pub. Therefore, there are wide variations allowable for obtaining informed consent such 100-07: State Operations Provider Certification. Regulations and Interpretive Guidelines as in process, timing, and presentation. for Hospitals - Condition of Participation: Medical Record Services. Sections 482.13(b), According to 2008 guidelines by the Centers for Medicare & Medicaid Services 482.24(b), 482.51(b)(2). U.S. Department of Health & Human Services. https://www.cms. (CMS), the following components are required for informed consent documents: gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R37SOMA.pdf 1. Name of the hospital where the procedure or other type of medical treatment Spatz, E. S., Bao, H., Herrin, J., Desai, V., Ramanan, S., Lines, L., Dendy, R., Bernheim, S. M., Krumholz, H. Mm, Lin, Z., & Suter, L.G. (2020). Quality of informed consent documents is to take place; among US. hospitals: A cross-sectional study. BMJ Open, 10(5), e033299. doi: 10.1136/ 2. Name of the specific procedure, or other type of medical treatment for which bmjopen-2019-033299 consent is being given; The Joint Commission, Division of Health Care Improvement. (2016). Informed consent: 3. Name of the responsible practitioner who is performing the procedure or More than getting a signature. QuickSafety: An Advisory on safety and quality issues, administering the medical treatment; 21. https://www.jointcommission.org/-/media/deprecated-unorganized/imported- 4. Statement that the procedure or treatment, including the anticipated benefits, assets/tjc/system-folders/joint-commission-online/quick_safety_issue_twenty-one_ material risks, and alternative therapies, was explained to the patient or the february_2016pdf.pdf?db=web&hash=5944307ED39088503A008A70D2C768Aone_ february_2016pdf.pdf?db=web&hash=5944307ED39088503A008A70D2C768AA patient’s legal representative; 5. Signature of the patient, or the patient’s legal representative; and 6. Date and time the informed consent form is signed by the patient or the patient’s legal representative. HAPPY NURSES Because informed consent is a standard of quality rather than quantity, identifying strategies to improve informed consent measures can be challenging. WEEK! In an observational study of 25 hospitals across the United States, informed consent documents were assessed of adult patients undergoing elective procedures. An eight-item instrument was utilized and scored on a scale of 0-20, with 20 WE’RE HIRING representing the highest quality. Of 2480 informed consent documents from these hospitals, mean hospital scores ranged from 0.6 to 10.8 (out of 20). Only two If your passion is caring for people – then we want you! hospitals had > 50% of their documents score above a 10-point threshold. Only 30% of documents contained language describing the procedure, and only 11% of documents mentioned how the procedure would be performed. Just 2% reported CURRENTLY HIRING FOR: any quantitative risks, and just 5% included statements of the benefits of the Registered Nurses – Charleston Licensed Practical Nurse – Charleston procedure. Specific alternative options to the procedure were included on 17% of the documents. Registered Nurses – Huntington Licensed Practical Nurse – Huntington The study concluded that all hospitals performed poorly on a measure of informed consent quality (Spatz et al., 2020). This study assessed only the documentation component of informed consent; therefore, the results do not Apply Online: sufficiently address the complete informed consent process. However, the results can provide nurses with a starting point for improved performance. www.prestera.org/careers Patients have the right to receive accurate, complete, and understandable information. One key role for nurses is to be sure patients comprehend information about the procedure. Nurses can be very helpful by explaining the who, what, where, when, why, and how of a procedure to patients and their families in layperson’s terms. The patient may then accept, decline (refuse), or discontinue treatment without deceit, duress, or coercion (ANA, 2015). Patient advocacy efforts Page 8 West Virginia Nurse July, August, September 2021 WVNA 2021 Fall Elections: Meet the Candidates

Toni DiChiacchio, DNP, APRN, FNP-BC, FAANP BioScrip’s 2019 Star Performer award for the Central Region to pursue her passion for helping parents breastfeed/ WVNA Nominations and Elections Chair as well as a BioScrip Hero award. chestfeed in a more inclusive and accessible way. On a more personal level, Jon is the Secretary for the Beyond breastfeeding, Heather also endeavors to help The WVNA elections will take WVNA and a Board of Trustees member with the WVN-PAC. new parents deal with major challenges, such as mental place electronically starting at He is married to his best friend Krista (also an RN) and is the health and body positivity in the postpartum period. 5 p.m. on Friday, October 1, 2021, father of four: a boy and three girls. He and his family enjoy Heather tackles these challenges through her business and voting will close on Friday, outdoor activities and all the beauty West Virginia has to entitled Breastfeeding for Busy Moms, where she October 15, 2021, at 5 p.m. The offer. teaches online breastfeeding classes, counsels through candidates have furnished virtual consults, and is the co-host of an evidence- biographical information for the Candidate for Vice President based media platform called the Milk Minute Podcast. 2021 ballot for board service. Lori McComas Chaffins, BSN, RN She serves the WV Affiliate of the American College of A link will be sent to all active Lori McComas Chaffins, a Nurse-Midwives (ACNM) as secretary, the West Virginia WVNA members (which will West Virginia native, was born in Nurses Association (WVNA) as a member of the HP&L include your username and Huntington and raised in Lincoln Committee and is also a member of ILCA (International voting ID) by 5 p.m. on Friday, Toni DiChiacchio County. Lori graduated from Marshall Lactation Consultant Association). October 1, 2021. You must be University in 1995 with a Bachelor of a current member to vote. You can join WVNA by clicking Science in Nursing and began her Candidate for Secretary here! You can add/update your email address at ana.org career as an emergency department Marlene Harrah Reed, RN (click “Membership” and then click “Join ANA”). Please nurse, where she truly fell in love Marlene Reed is a lifelong resident contact Julie at [email protected] for assistance. with the nursing profession. Lori attended the ANA Political of Kanawha County, W.Va. She has Election announcements will be made at the WVNA Advocacy Institute in 2011, became a registered lobbyist, been a registered nurse for sixteen Virtual Membership Assembly October 21, 2021, and and helped to pass the legislation in 2012 that brought years. Reed began her career in thereafter by email announcement to all members. about the nurse health program for registered nurses in WV. health care in 2001 as a medical The order of candidates presented: candidates are listed Chaffins served as Executive Director for WVNA from transcriptionist after she graduated in alphabetical order by last name within each category (for 2015 until 2017 and was then hired as the nurse health from West Virginia Junior College this election, that is Vice President and Secretary). Note that coordinator for the WV RN Board in October 2017. with a degree in medical assisting. all candidates are WVNA and ANA members. Lori is the mother of four and grandmother of two. She quickly decided to further her career and She makes God her priority and believes that everything subsequently obtained her nursing degree from the Candidates for Vice President: else falls into place. She is a lover of Israel, attended the University of Charleston in 2005. Marlene has worked in the two candidates for one position International School of Holocaust Studies in Jerusalem, areas of long-term care, trauma, dermatology, and utilization Israel, and educates the public on the Holocaust here at management. She has been employed with KEPRO since Candidate for Vice President home. Lori strives to do her best daily, she loves her job, and 2015 as a utilization management nurse, assisting West Jon H. Casto, RN, CRNI loves educating the nearly 34,000 registered nurses in WV. Virginia residents in obtaining medically necessary services. Jon H. Casto is a registered She currently serves as the Vice President of WVNA. Her advocacy interests include safe nurse to patient ratios, nurse and holds a CRNI® (Certified nurse retention in West Virginia, and patient informed Registered Nurse Infusion®) specialty Candidates for Secretary: consent. certification. He is employed with three candidates for one position Marlene serves as an assistant den leader for Cub Option Care Health Infusion Services Scouts. She is actively involved in church ministry and is as the regional nurse manager at their Candidate for Secretary an elementary Sunday school teacher. In her free time, she Charleston and Fairmont, W.Va., and Heather ONeal, MSN, APRN, CNM, enjoys roller skating and spending time with her husband Pittsburgh, Penna., locations. IBCLC (she/her/hers) and two children. Jon began his career in 1998 as a paramedic/firefighter Heather ONeal is a certified nurse- with the Charleston Fire Department, where he learned to midwife (CNM) and an International Candidate for Secretary start IVs in a moving ambulance. After obtaining his critical Board Certified Lactation Consultant® Sara Vincelli, BSN, RN (she/her/hers) care transport certification from Marshall University, he went (IBCLC®) in the wild and wonderful Sara Vincelli is a registered on to work as a flight medic with HealthNet Aeromedical state of West Virginia. ONeal is a nurse with the MidAtlantic AIDS Services, where his love of overcoming difficult IV access 2018 graduate of Frontier Nursing Education and Training Center situations continued to evolve. University’s nurse-midwifery program (MAAETC) in Morgantown. In After graduating from nursing school, Jon worked and a 2014 graduate of West Virginia University School of addition to her role as an HIV/AIDS as a staff nurse at St. Mary’s ER in Huntington. Not long Nursing (WVUSON). She worked as an RN at WVU’s Ruby clinical nurse educator, she serves after beginning his tenure at BioScrip Infusion Services, Memorial Hospital from 2015 to 2019 on the maternal infant her community in a rural, free, and he became enthralled with home infusion. He is trained care center and then later, in WVU Medicine Children’s charitable clinic, offering COVID-19 on PICC and midline insertion; his passion is navigating hospital resource pool. testing, vaccinations, and health education. Born and vascular access solutions. Within the organization, he is ONeal is a nurse entrepreneur in addition to being clinical raised in Charleston, South Carolina, she graduated also a member of BioScrip’s corporate RN advisory group nursing faculty at the WVUSON. Heather recently sold her from the University of South Carolina with her Bachelor and strategic operations team. Most recently, Jon received home birth practice, Wise Women Health Care, and decided of Science in Nursing. From hospital candy striper, to certified nursing assistant in the neurosurgery intensive care unit, to providing sexual health education in villages in Kenya, Sara optimizes each moment to make others feel comfortable and valued. For over three years, Sara provided care as a bedside nurse in a cardiothoracic surgical intermediate care unit in Asheville, North Carolina, and then in the cardiovascular intensive care unit (CVICU) in Morgantown with WVU Medicine. The entirety of her professional nursing career has consisted of providing care to the incredibly inspiring and resilient folks of Appalachia. Sara aims to advocate for the destigmatization of health issues, such as infectious diseases like HIV and viral hepatitis; substance use disorder; and other mental health diagnoses. Currently, Sara is enrolled in Regis University’s family nurse practitioner program, which focuses on rural and underserved communities. She values inclusive and equitable care, LGBTQIA+ rights, cultural humility, Available positions: health literacy, and preventative health care. Sara We currently have 24 full time, became involved with the WVNA in March 2021 and has contributed to the Bylaws / Policy and Procedures 3 part time and 6 per diem nursing Committee and the ad hoc Diversity, Equity, and Inclusion positions available. (DEI) Committee, as well as facilitated the partnership with the WVNA and MAAETC to enhance WVNA’s Pride We offer competitive pay and benefits educational series in June 2021. She feels deeply that nurses are to care for the whole person. As such, nurses including medical, dental, vision, PTO, are uniquely positioned to do what they do best – 401k, tuition reimbursement and more! advocate. Nurses have the capacity to passionately push to further the profession, in addition to supporting policy to enhance the overall wellness of patients, community, Contact Human Resources at and state. She feels incredibly humbled by the possibility of becoming a board member of the WVNA, which (330) 386-2022 advances the well-being of this state. July, August, September 2021 West Virginia Nurse Page 9 On the Front Lines with West Virginia School Nurses

Samantha Knapp, BSN, RN, NSNA President, West Virginia Association of School Nurses (WVASN)

West Virginia’s school nurses have been on the front lines of the COVID-19 pandemic in the school communities of our state and are welcoming the summer break that lies ahead. The skills and knowledge of this group of health professionals have been utilized during the pandemic to help ensure a safe learning environment for the students as well as a safe work environment for the staff within our West Virginia state school systems. School nurses have assisted at their county level with vaccination clinics for employees, students, and family members while continuing their regular job responsibilities. Additionally, school nurses will be providing care during summer programs that are being offered for students in almost every county in our state. A lot remains unknown about the fall; however, planning has begun for the 2021-2022 school year. Preschool and kindergarten registrations, reminders sent to parents/guardians of immunization requirements, and end of year surveys are just some of the final tasks that West Virginia’s school nurses have been doing recently to close out the 2020-2021 school year. The dedication and hard work of school nurses have not gone unnoticed. Governor Jim Justice signed a proclamation to recognize West Virginia school nurses on May 12, 2021. To all the school nurses in West Virginia, have a great summer!

***

Editor’s note: For more information on school nurses, visit National Association of School Nurses West Virginia Association of School Nurses WVASN Facebook Page

Beckley, Princeton, Charleston, Huntington, Chapmanville, Summersville and Parkersburg

http://careers.kindredathome.com Page 10 West Virginia Nurse July, August, September 2021 The States and the Public are Grateful for WVNA and All Nurses

Julie A. Huron WVNA Executive Director

As hard as we have all been working during the COVID-19 pandemic – adjusting to the new normal and hopefully adjusting back, amid the loss of friends and family – it feels like an unexpected blessing to get thanks from so many people and groups on behalf of nurses. Most recently, WOWK- Channel 13 and West Virginia Water issued a proclamation of thanks to WVNA. West Virginia Governor Jim Justice issued a proclamation to honoring West Virginia nurses for National Nurses Month. These awards honor nurses for continued work on the frontlines – giving vaccines, caring for patients, educating the public and legislators, and all the myriad other things nurses do. Michaela Smith, RN, joined me for a “photo Julie A. Huron op” with the Channel 13 award. As governments realized how much they needed nurses in remote locations to give vaccines, they stepped up their efforts to provide transportation, meals, even lodging for the vaccine teams. That’s WV Nurse editor Moira Tannenbaum, RN, on the left front crowded into a single-engine plane with other nurses, flying to South Bass Island in Lake Erie to vaccinate island residents.

Julie A. Huron (L) and Michaela Smith with award

Nurses flying to South Bass Island Approaching South Bass Island, Lake Erie July, August, September 2021 West Virginia Nurse Page 11

Nightingale Conferences & Meetings Tribute As we are going to press, in-person conferences are making a comeback. Conferences listed here are still “on” as of press time, whether virtual, hybrid, in-person, or to be determined. For any conference you’re interested in attending, WVNA recommends checking for updates on their website and subscribing to email alerts. In the past year, some of our West Virginia nurse colleagues have left this earthly life. Here is the list of July 21-23, 2021 (Wednesday-Friday) October 7-10, 2021 (Thursday-Sunday) nurses whose names West Virginia Nurses Association Sigma: Global Nursing Excellence American Association of Birth Centers (AABC) is aware of. We honor our fellow nurses who left us in 32nd International Global Nursing Research Conference Annual Birth Institute the year 2020, and who left so far in 2021. There may be > 600 nurse researchers, students, and clinicians focused San Diego, Ca. and virtual names you are aware of who are not listed here. If you on evidence-based research AABC 2021 Birth Institute know of other West Virginia nurses who have passed, Virtual please let us know at [email protected]. Sigma Nursing October 9-13, 2021 (Saturday-Wednesday) Association of Women’s Health, Obstetric, and Neonatal Doris Abram July 22-24, 2021 (Thursday-Saturday) Nurses Mary Bennett Philadelphia Trans Wellness Conference (AWHONN) National Conference Virtual & FREE Kissimmee, Fla. and virtual Marie Pasken Day Philly 2021 Trans Health Conf. (PTWC) AWHONN 2021 Convention Judy DeAngelis Chelsea Gibbs July 29-30, 2021 (Friday-Saturday) October 13-16, 2021 (Wednesday-Saturday) Norma Llewellyn National Student Nurses’ Association American Psychiatric Nurses Association Conference James Lovelace Annual Leadership University Summer Summit “Psychiatric-Mental Health Nurses: NSNA Summer Leadership Conference Revolutionizing Access to Person-Centered Care” Mary Meadows* TBD: virtual, in-person, or hybrid Rita Mercer August 3-8, 2021 (Tuesday-Sunday) APNA Annual Conference 2021 Peggy Miller National Black Nurses Association (NBNA) Sheila Nelson* 48th Annual Conference and Institute October 22, 2021 Virtual Appalachian Breastfeeding Network Mildred Noll NBNA 2021 Conference 4th Annual Conference Peggy Osborne Canceled due to lack of good internet access in much of Jeanette Parker* August 30-September 2, 2021 (Monday-Thursday) Appalachia Beth Reed International Lactation Consultant Association (ILCA) The group hopes to resume conferences in 2022 Julie Rice Riffe Annual Conference ABN 2021 Conference Houston, Texas and virtual Mary Ann Wildern Siebieda ILCA 2021 Conference October 27-30, 2021 (Wednesday-Saturday) Mylissa Smith* DONA International Summit: Shaunie Lou Sullivan* September 11-15, 2021 (Saturday-Wednesday) world’s first and largest doula organization Marguerite (Marge) Terrill World Congress of Intensive & Critical Care (WCICC) Calgary, Alberta, Canada Lois Ann White Canadian Association of Critical Care Nurses DONA Summit 2021 and Canadian Critical Care Society Kimberly Yow Virtual November 16-19, 2021 (Tuesday-Friday) World Congress of Intensive & Critical Care 2021 National Association of Hispanic Nurses (NAHN) Five of these West Virginia nurses died from COVID-19. 46th Annual Conference Their names are indicated by an asterisk. All these nurses September 30-October 3, 2021 (Thursday-Sunday) Puerto Rico: Sheraton Puerto Rico Hotel and Casino changed lives. Some lived into old age; others did not. For 30th Annual Medical-Surgical Nursing Convention NAHN 2021 Conference their lives and their work, we and all West Virginians are Academy of Medical-Surgical Nurses grateful. West Virginia Nurses Association sends heartfelt Orlando, Fla., and virtual condolences to their families and loved ones. We will read Med-Surg Nursing Convention their names aloud, along with the Nightingale Tribute, at Calling all CRNAs! our Membership Assembly in October 2021. Save the Date! WVANA Fall Meeting October 8-10, 2021 The Resort at Glade Springs

More info available at www.wvana.com

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Teresa Hovatter, RN MEMBERSHIP WVNA HP&L Committee Chair and WVNA President-Elect UPDATE The West Virginia Nurses Association advocates for the Julie Absher Huron, Executive Director nurses of West Virginia as well as for the health and well- being of West Virginians. During the COVID-19 pandemic, WELCOME to WVNA! It’s exciting to see the WVNA found itself as the connector of all nurses. Nurses momentum that is happening in WVNA in 2021, were reaching out to us to gain assistance for PPE, to share especially after our first Virtual Policy Summit their stories of lost wages, to find out what to do when they wrapped up in March. We had over 215 in became sick with COVID, and to connect. Nurses talk and attendance, our Facebook Live National Nurses WVNA listens. The policy positions that WVNA has taken Month activities were also a success, and our WVNA reflect the needs expressed by WV nurses, WVNA members, Celebrates PRIDE Month education series, offering and the nurses who participated in our surveys. We do five free CE hours in June, has engaged more nurses everything we can to help nurses. to our events and they seem to be getting to know WVNA convened several meetings leading up to the us via Facebook Live events. I love seeing nurses 2021 West Virginia Legislature’s Regular Session. Once the comment in the chat! legislative session started, our HP&L committee began The WVNA welcomed 43 new/reinstated weekly meetings again, as we followed the fast-moving WV members from April 1 through June 7, 2021. We legislative session. want to know what is important to you, the West Following is a recap of the final details of the 2021 WV Virginia nurse. WVNA is a group of professional Regular and Special legislative sessions. opposed to the bill. Those opposed have been working nurses that have slowly gotten involved with the to make the legislation safer for parents who are intimate association, first by logging in to our meetings HB 2672 – Relating to posting of safety information in partner violence survivors and to make it a better bill for and listening, then by deciding to get a little more hospitals. This bill was completed via the rules committee. breastfeeding families. involved, maybe by joining a committee or by Lead Sponsor: Delegate Heather Tully, RN (41st House Lead Sponsor: Del. Geoff Foster (15th House district). becoming a legislative leader. The next step I see district). Sponsor: Majority Leader Amy Summers, RN (49th Sponsors: Dels. Summers, Erikka Storch (3rd House dist.), nurses take is a run for office with WVNA. The WVNA House district). Chris Phillips (47th), Steele, Terri Sypolt (52nd), Jonathan is the voice for all West Virginia nurses, and we are The purpose of this bill is to require a hospital to post the Pinson (13th), Patrick McGeehan (1st), J. Jeffries, D. Jeffries, nothing without members. We invite you to get to contact information to the Office for Health Facility Licensure Ruth Rowan (57th). know us. Get involved, however it fits your schedule. and Certification (OFLAC) to inform the public how to file a This bill died in the Senate Judiciary Committee. Remember this, “Tuesday evenings at 7 p.m.: complaint. that’s the time for WV nurses.” Something is usually Completed via the Rules Committee. SB 277 – COVID-19 Jobs Protection Act Lead Sponsor: Sen. President Craig Blair (15th Senate happening on Tuesday nights. If you are unsure you can always email me; several nurses often text me. HB 2796 – Supplemental appropriations bill. This bill district). Email me at [email protected] or text me was planned to expire funds to the surplus balance of Sponsor: Sen. Stephen Baldwin (10th dist.). at (866) 986-8773. general revenue and to supplement and increase an item WVNA and AARP were vocal in encouraging the removal On Tuesday evenings we usually have town hall of appropriation in the aforesaid account for the designated of the immunity for willful misconduct and reckless or meetings, an education series, or committees are spending unit for expenditure during the fiscal year 2021. intentional infliction of harm. Added amendments to make meeting. We fit it in however we can – this is how The purpose of this bill was to provide relief for nurses the bill safer. we move nursing forward in West Virginia. I think it’s who become ill from COVID-19 while caring for patients, Completed legislation. Effective March 11, 2021. great to have a state full of nurses who network and using excess surplus funds paid from nursing licensure fees. truly know each other; they go on to become the Lead Sponsor: Majority Leader Amy Summers. SB 334 – Establishing license application process for nurses who network with nurses and policy leaders Sponsors: Dels. Tully, Householder (64th House district), needle exchange programs. across the country and even around the world. Vernon Criss (10th dist.), Charlie Reynolds (4th), Matthew Lead Sponsor: Sen. Eric Tarr (4th Senate district). WVNA advocates for you – the nurse – Rohrbach, MD (17th). Sponsor: Sen. Amy Grady (4th dist.). and for your patients. Please watch for our This bill died waiting to be placed on the Senate Finance Completed legislation. Effective March 4, 2021. news and announcements via email, or Committee agenda. HB 2344 – Modify statute related to licensed veterinary you can find information on our website at wvnurses.org/nursing-news. We invite you to attend HB 2707 – APRN: Relating to prescriptive authority for technicians, modifying the definition of “Registered our events, and please share your voice when advanced practice registered nurses; legislate executive Veterinary Technician” from “Technician” to “Nurse.” surveys or public comments are needed. orders of 2020. Lead Sponsor: Del. Jeffrey Pack (28th House district). We want you to succeed, to get involved, and to Lead Sponsor: Del. Tully. Sponsor: Majority Leader This bill died in the House Agriculture and Natural Resources get to know us! Summers. Committee. This bill died waiting to be placed on the House Health Committee agenda. HB 2869 – To remove any mandatory mask mandate in West Virginia. • Jonathan Adams • Deb Koester • Leanne Browning • Ann Langdon SB 714 (“PA Bill”) – Relating to physician assistant practice Lead Sponsor: Delegate Joe Jeffries (22nd House district). • Shawnta Boyer • Khristina Light act; was amended in House to include three days of Schedule Sponsors: Dels. Todd Longanacre (42nd House district), • Deborah Burch • Harley Manuel II medication for PAs and APRNs. The Senate accepted that Shannon Kimes (9th), Dianna Graves (38th), D. Rolland amendment and the bill passed. Jennings (53rd), Adam Burkhammer (46th), McGeehan, • Amy Calain • Alyssa McClain Lead Sponsor: Sen. Tom Takubo, DO (17th Senate district). Charles Horst (42nd), Carl Martin (45th), J. Pack, & Eric • Alexis Canterbury • Lindsey McClintic Completed legislation. Householder. • Raelyn Carr • Karri McCormick This bill died in the House Judiciary Committee. • Mary Curry • Stephen Metheny HB 2674 – CRNA: Relating to the administration of • Alexis Dale • Corey Moles anesthetics; legislative executive orders. This bill passed the SB 568 – Eliminate mask mandate; relating to emergency • Jessica Davis • Teresa Mullins House but then in Senate Health and Human Resources powers of Governor. • Stephanie Duling • Katherine Naylor Committee, it was completely changed from addressing Lead Sponsor: Sen. Michael Azinger (3rd Senate district). Sabrinia Fike • Kendra Peltier CRNA scope of practice, to putting in three days of Sponsor: Sen. Robert Karnes (11th). • Brooke Frost • Mary Rankin prescribing of Schedule II medications for APRNs. When it This bill died in the Senate Government Organization • Judy Harold • Melissa Renner was referred to Senate Rules Committee, it died there. Committee. • Wanda Haynes • Whitney Rose Lead Sponsor: Del. Tully. **** • Rebekah Hoh • James Runyon Died in the Senate Rules Committee. The WVN HP& L committee will have a legislative • Kati Holland • Frances Smaltz leader training on Tuesday, August 3, 2021 at 7 p.m. If this • Stacy Houchin • Heather Thumm HB 2368 – Mylissa Smith’s Law, creating patient visitation interests you, please reach out to Julie at the Central Office • Mary Jordan • Cindy Wandling privileges. at [email protected]. Our 2022 Health Policy & • Dystiny Kern • Rachel Ward Lead Sponsor: Del. Dean Jeffries (40th House district). Legislative (HP&L) Statement will be coming out for review • Cheryl Kirk • Cheryl Warner Sponsors: Dels. Summers, Tully, J. Pack, Rohrbach, Joe soon. It will be voted on at the 2021 WVNA Membership • Kasey Kirk • Karen Wigal Ellington, MD (27th district), Brandon Steele (29th), Paul Assembly, which is taking place at our fall conference on Espinosa (66th), Assistant Majority Whip Daniel Linville (16th), October 21, 2021. Gary Howell (56th), Larry Pack (35th). We are starting to work on our 2022 legislative agenda Completed legislation with amendments. Effective April 20, and look forward to hearing about what is important to West 2021. Virginia nurses.

HB 2363 – “Best Interests of the Child Protection Act Committee is working and/or tracking. Updates are as of of 2021,” regarding shared child custody. Several nurses press time. You can click on the hyperlink for any bill in this were supportive of this bill, while several nurses were article to link to its status. July, August, September 2021 West Virginia Nurse Page 13 FUTURE OF NURSING WV UPDATE Future of Nursing WV Action Coalition Update

Aila Accad, MSN, RN / Executive Director, FONWV Nurse Business News • Practice Innovation is a hallmark of nursing practice. Whether o Modernizing Practice Laws Team The Future of Nursing West Virginia Action Coalition you have a new idea for how to improve patient care o Improving Retention & Quality through Transition to (FONWV) is an organization of nurses and nursing within your work setting, or an idea for a business that Practice (TTP) Models Team champions working together for a healthier WV improves access to care in the community, the FONWV o Nursing Workforce Retention & Recruitment Action Team through strengthening nursing practice, education, Nurse Entrepreneur Course can help you think through and leadership. Here is an update on our progress and your idea and bring it to daylight. See details of the • Education an invitation to join us toward enhancing the culture of course at FONWV Nurse Entrepreneur Course. The o Increase the Number of BSN Graduates Team health in West Virginia. FONWV website has a directory of many WV nurses in o Increase Number of Doctoral Prepared Nurses Team Since our last update to West Virginia Nurse, we business. Here’s the link: WV Nurses Business Directory. o Lifelong Learning Team have added content to our website. Please check out Congratulations to an alumna of FONWV’s Nurse o Nursing Workforce Pipeline, Pathways, and Faculty our Nursing Education Toolkit! It has information on Entrepreneur Course, Heather ONeal, MSN, APRN, CNM, Action teams everything from LPN programs in West Virginia to RN IBCLC, on the success of her podcast, Milk Minute (co- reentry programs in the Mountain State to posters about hosted with student midwife Maureen Ferrall), which • Leadership aspects of nursing. FONWV Nursing Education Toolkit. was nominated for the American College of Nurse- o Presence on Policy and Health Decision-Making The website features several other toolkits, too, including Midwives (ACNM) Media Award in 2021, and on the Boards Team one for faith community nurses. success of her business, Breastfeeding for Busy Moms. o Developing Nurse Leadership Team We held a very successful biennial Workforce Summit, Congratulations also to Crystal Lovett, RN, CLC, CLS, Nurse o Online Nurse Manager & Mentor Courses Team “Partnering for Better Solutions,” on April 20, 2021, by Entrepreneur Course grad and owner of Mocha Milk in the Zoom. Several of our Teams gave updates. We hope to Mountains, who was awarded the West Virginia WIC and • Operations Team be in person again for the next conference. Pacify Award Inaugural Diversity in Lactation Consulting • Strategic Advisors Team Scholarship. She will receive $1,000 to cover the cost of • Diversity, Equity, & Inclusion Team WVNA Representative to FONWV the International Board of Lactation Consultant Examiners • Recognition Gala and Awards Team A huge thanks to Cassy Taylor DNP, APRN, CRNA, for (IBLCE) exam required to become an International Board her years of excellent work as the representative from Certified Lactation Consultant (IBCLC). The scholarship is • Culture of Health Projects West Virginia Nurses Association (WVNA) to FONWV. designed to improve diversity among lactation consultants. o Faith Community Nursing Network Brenda Keefer, MSN, APRN, FNP-BC, will serve in this role Lovett is the first Diversity in Lactation Consulting scholarship o Health Ambassador RN for the next term, 2021-2023. winner in West Virginia. • Shared Data Group Upcoming Events Future of Nursing Teams o Build an Infrastructure for the Collection and Analysis Future of Nursing West Virginia will hold our Annual Future of Nursing WV has numerous teams, some of of Interprofessional Health Care Workforce Data Awards Gala on Saturday, September 25, 2021. This will which are grouped into constellations such as Practice feature our inaugural Nurse Excellence Awards. You and Leadership, working on nursing issues affecting West *** can read more on our website or by using this link: Virginia. If you are interested in working with a team, FONWV Award Criteria. We hope you’ll think of an contact Aila Accad at [email protected]. You Follow Our Social Media excellent nurse to nominate today! The deadline for can read more about each team at FON Teams. A sample Please like our page on Facebook: FONWV Facebook. nominations is August 1, 2021. of teams is listed below. We’re on Twitter, Instagram, and YouTube too.

ANA General Assembly: Preview from the Voting Delegate

In the fall 2020 election cycle, WVNA voters elected the meeting. In the COVID era, the Membership Assembly Moira Tannenbaum, RN Voting Delegate to ANA Membership Assembly, me to the position of ANA voting delegate for 2021-2022. is being held virtually and there were several “pre-event” 2021-2022 This means I attend the ANA General Assembly, represent meetings as well. For example, one of these showcased what WVNA’s interests, and vote as the representative on behalf ANA is doing to combat racism in nursing. of WVNA members. I have big shoes to fill, because the West For more information on the Membership Assembly, Virginia nurses who have gone before me in this role are a here’s a link to ANA’s information page on it: ANA dedicated and knowledgeable cadre. The WVNA delegate Membership Assembly. serves alongside the WVNA president in this role. In the October 2021 issue of West Virginia Nurse, you’ll find In the years of real, in-person ANA membership a complete report about WVNA and our participation in this assemblies, the WVNA voting delegate travels to attend year’s ANA General Assembly. Page 14 West Virginia Nurse July, August, September 2021 Pediatric ICU Stay Can Be Scary, Lonely Experience – For Parents

Wendi MacKay, WVU Director of Marketing and Communications, WVU School of Nursing

Reprinted with permission.

When children are admitted to a pediatric intensive care unit, they aren’t the only ones who can find the experience sad, scary and lonely. So can their parents. A new study led by Brad Phillips – a researcher with the West Virginia University School of Nursing – suggests that being young, being single, having a low income, and having limited post-secondary education may make parents more likely to feel lonely or perceive a lack of emotional support when their children are in the PICU. The findings appear in the International Journal of Nursing Sciences. “I worked as a PICU nurse for 10 years,” said Phillips, a doctoral student and clinical education assistant professor in the Department of Family/Community Health. “We ask parents, ‘Do you need anything?’ And that’s interpreted as, ‘Do you need a water or a coffee?’ If you don’t sit down and have a conversation with them, it’s hard to get to the root of what they really need.” Between January 2019 and January 2020, Phillips and his colleagues interviewed 80 parents of children admitted to a PICU. The researchers used questionnaires to measure the participants’ depression, anxiety, anger, fear, loneliness, and perceived emotional support. They also gathered demographic characteristics about the parents—such as their age, marital status, and education level—and information about the children’s medical conditions. Parents who had never been married—or who were separated, divorced, or widowed—reported more loneliness and poorer emotional support than those who were married or partnered. Similarly, parents who were 25 years old or younger reported higher loneliness and lower emotional support when compared to older participants. In addition, parents were more lonely and reported worse emotional support if they hadn’t completed college or if their household income was less than $40,000 for depression. But currently, health care workers are working to identify symptom a year. clusters that occur with situations or illnesses, hoping to enhance understanding “Sometimes things happen that are really bad, unexpected traumas, and and develop interventions that target the symptom cluster.” I think especially if you’re a low-resource parent—like a single, young parent With WVU’s new children’s hospital being constructed, there is an opportunity with not much money—you’re going to be at a high risk for having a lot of to ensure that newly identified needs of parents will be met. negative emotions around this event that has turned your life upside down,” said Phillips and Theeke have many ideas about what a targeted intervention might Laurie Theeke, a mentor for the study. Theeke is a professor and director of the look like. Ph.D. Program at the School of Nursing. Though currently a nurse practitioner in “First and foremost, we need to recognize that the current COVID-19 pandemic the Department of Family Medicine, she previously worked for several years in the has impacted the parent experience at hospitals, and the negative emotions PICU. identified in this study may actually be heightened for parents at the moment,” The researchers found that fear correlated with depression and anxiety. They Theeke said. also discovered that the lower emotional support for parents was linked to more Phillips notes that based on the study’s findings, it may be necessary to screen loneliness, anger and symptoms of depression. parents to identify who is at risk for this cluster of negative emotions when their “I think what was most interesting is that all of these emotions were connected children are admitted to the PICU. in some way, like a web,” Phillips said. “Maybe some fear leads to anxiety, and “We could create a questionnaire for nurses to administer to the parent, and some loneliness leads to depression. It’s this really complex, interrelated system of then subsequently flag these at-risk parents in the electronic medical record emotions that these parents are experiencing.” system,” he said. Nurses are particularly suited to meet the intricate emotional needs of pediatric Nurses could then incorporate these needs into care planning to enhance patients’ parents. In a 2020 Gallup poll, Americans ranked nurses the No. 1 most emotional support and link at-risk parents to additional services so that they get ethical and honest profession for the 19th year in a row. the emotional support they need. Nurses frequently answer parents’ questions, which can range from logistic to “It is important to truly assess who has the most needs,” Phillips said. “We know poignant: Where’s the restroom? Is there a vending machine around here? Is this from other research studies that some of these parents are having post-traumatic symptom normal? Will this test hurt my child? Is she going to be OK? stress at home when children are admitted to the PICU. One study even showed “Historically, medical teams have worked to treat individual symptoms,” Theeke that it was comparable to that of domestic violence or 9/11 victims.” said. “For example, we would give an inhaler for wheezing or an antidepressant Both Phillips and Theeke advocate for structural supports in hospitals and additional services. Phillips suggests that units “provide parents with a place to get away.” “That could be a parent lounge with televisions and lockers—a place they can go, take a shower and rest where they don’t have to sleep at the bedside,” Phillips said. Although the COVID-19 pandemic complicates communal meals now, slow cookers of soup and baskets of rolls could one day cover kitchen counters in PICU wards. Parents could access the kitchen, have a free, hot meal, and relax with their significant other. “They could also have a place where siblings can just go and play so that they SIGN ON BONUS know they’re being taken care of,” Phillips said. Minnie Hamilton Health System, located in Grantsville, WV, has Support groups for parents whose children are in — or who have been an exciting opportunity for a high-performance individual and is discharged from — the PICU could be another way make them feel supported. The currently seeking applicants for: meetings could take place in person or online. Theeke, a nationally known expert on loneliness, emphasizes the importance Full Time– Regular, 36+ hours per week, Registered Nurse of being present and listening in the moment. Support groups can offer this (RN) in the emergency room and med surge settings. experience. “Part of feeling supported is mutuality,” she said. “Knowing that you’re talking MHHS offers a competitive salary with shift differential, as well as tuition to someone who truly does understand helps you to establish that sense of assistance and an excellent benefit package including: health, dental, mutuality, which can lead to longer-term relationships even after a support vision, life insurance, 401k, paid time off. intervention is over. And, you know, I think there are parents who might want to For more information visit lead or participate in a group because there’s meaning in telling others what has https://www.mhhs.healthcare/career-opportunities.html happened to you. When you’ve had a traumatic experience, telling your story is therapeutic.”

Note: Brad Phillips will conduct a follow-up study with parent caregivers in the home to further understand what it is like to live through this experience. Parents caring for a child with an acquired disability living in West Virginia are welcome to reach out to see if they meet eligibility criteria. Parents interested in participating in the study can contact Phillips at [email protected].

Editor’s Note: Brad Phillips serves WVNA as a member of both the Nominations and Awards and the Events committees. West Virginia Nurse showcased his research in our January 2021 issue. July, August, September 2021 West Virginia Nurse Page 15 An Ethic of Justice Viewed through the Lens of an Ethic of Care: How Nurse Leaders May Combat Workplace Bullying

Gloria Matthews, DNP, RN, CNL, CDE Normative leadership models such as transformational, environment for the prevention of workplace bullying. The University of Oklahoma Medical Center servant and authentic leadership constructively address integration of the divergent ethical perspectives of an ethic Valerie Eschiti, PhD, RN, AHN-BC, CHTP, CTN-A the bullying by modeling an ethic of care perspective of care and an ethic of justice provides an environment of University of Oklahoma Health Sciences Center and seeking to facilitate followers’ self-actualization. The collegiality, transparency and support for improved patient- Fran & Earl Ziegler College of Nursing, assumption is that ethical leadership styles promote social related and nurse-related outcomes. Lawton Campus cohesion, professionalism, and empowerment (Webster, 2016). References Reprinted with permission from Balevre, S. M., Balevre, P. S., & Chesire, D. J. (2018). Nursing Oklahoma Nurse May 2021 issue Ethic of Justice professional development anti-bullying project. Journal for Nurses in Professional Development, 34(5), 277-282. https:// The ethic of justice is a moral approach that is The purpose of this paper is to present integration of doi.org/10.1097/NND.0000000000000470 characterized by justice, fairness, reciprocity and the Berry, P. A., Gillespie, G. L., Fisher, B. S., & Gormley, D. K. (2016). two ethical approaches to combatting workplace bullying protection of individual rights. Individuals demonstrate Recognizing, confronting, and eliminating workplace within a clinical setting from an advance nursing practice impartiality and the ability to reason abstractly through the bullying. Workplace Health & Safety, 64(7), 337-341. https:// leadership perspective. A description of ethic of care and application of formal, logical and impartial rules (Simola, doi.org/10.18291/njwls.v7i1.81398 ethic of justice is presented and critically appraised as it 2003). The ethic of justice aligns with the transactional Einarsen, K., Mykletun, R. J., Einarsen, S. V., Skogstad, A., & Salin, D. relates to managing workplace bullying. The importance leader who influences followers by control, reward and (2017). Ethical infrastructure and successful handling of workplace bullying. Nordic Journal of Working Life Studies, of the application of the ethic of justice through the lens corrective transactions (Groves & LaRocca, 2011). of the ethic of care will be elucidated. 7(1), 37–54. https://doi.org/10.18291/njwls.v7i1.81398 Structural empowerment is gained through Fink-Samnick, E. (2018). The new age of bullying and violence in establishment of an ethical infrastructure that reinforces health care: part 4: managing organizational cultures and Description and Application to Workplace Bullying ethical principles and behavioral expectations of members beyond. Professional Case Management, 23(6), 294–306. A failure of nursing leadership to address workplace of the organization (Einarsen, Mykletun, Einarsen, https://doi.org/10.1097/NCM.0000000000000324 bullying demonstrates a lack of compassion and Skogstad, & Salin, 2017). Aligned with the ethic of justice, Groves, K., & LaRocca, M. (2011). An empirical study of leader ethical values, transformational and transactional leadership, and organizational injustice. Bullying is the repeated and organizations establish standardized policies, procedures persistent, abusive mistreatment by one or more follower attitudes toward corporate social responsibility. and documents such as codes of ethics, procedures for Journal of Business Ethics, 103(4), 511–528. https://doi. perpetrators towards one or more victims that is marked handling complaints and zero tolerance policies (Einarsen org/10.1007/s10551-011-0877-y by threatening, humiliating or intimidating conduct, et al.). Hutchinson, M. (2009). Restorative approaches to workplace work interference, or verbal abuse (Fink-Samnick, 2018). Hutchinson (2009) posits that rather than focusing on bullying: Educating nurses towards shared responsibility. Bullying is a systemic problem and reflects behavior the individual, leaders should direct corrective measures Contemporary Nurse, 32(1–2), 147–155. https://doi. patterns and surreptitious characteristics of a culture towards the act of bullying itself and gain insight into org/10.5172/conu.32.1-2.147 Lachman, V. D. (2014). Ethical issues in the disruptive behaviors of of violence that contributes to various expressions and work group and organizational factors that enable the manifestations of violence within an organization (Smit incivility, bullying, and horizontal/lateral violence. Medsurg behavior. The focus is on reintegration and restoration Nursing, 23(1), 56-60. & Scherman, 2016). The Joint Commission (2008) notes of social relationships within the context of a supportive Parker, K. M., Harrington, A., Smith, C. M., Sellers, K. F., & Millenbach, that intimidating and disruptive behaviors contribute to group, such as a restorative circle, where the attention L. (2016). Creating a nurse-led culture to minimize medical errors, poor patient and staff satisfaction, staff is placed on repairing harm rather than on blame and horizontal violence in the acute care setting: A multi- turnover, and poor collaborative work environments. punishment. interventional approach. Journal for Nurses in Professional Development, 32(2), 56-63. https://doi.org/10.1097/ NND.0000000000000224 Ethic of Care Reflection on Integration of Ethical Approaches The ethic of care is a moral approach characterized Simola, S. (2003). Ethics of justice and care in corporate crisis It is important for leaders to integrate the two ethical management. Journal of Business Ethics, 46(4), 351-361. by contextual, holistic empathy and is based on caring perspectives by distributing justice within a caring https://doi.org/10.1023/A:1025607928196 and on strengthening and maintaining interpersonal framework (Sorbello, 2008). Organizations and leaders must Smit, B., & Scherman, V. (2016). A case for relational leadership and relationships. It emphasizes the importance of insight clarify and communicate that bullying is unacceptable. an ethics of care for counteracting bullying at schools. gained from being open and receptive to the realities If corrective actions fail, termination is an acceptable South African Journal of Education, 36(4), 1-9. http://www. sajournalofeducation.co.za/index.php/saje/article/ and needs of others (Simola, 2003). The ethic of care consequence to continued behavior. At times, leaders aligns with the authentic, servant and transformational view/1312/668 must implement corrective actions and uphold values and Sorbello, B. (2008). The nurse administrator as caring person: A leaders who put followers’ interests above their own policies set forth by the organization, but it is in the delivery synoptic analysis applying caring philosophy, Ray’s ethical and influence followers through building relationships, and intent that determines a caring leader. theory of existential authenticity, the ethic of justice, and the developing a collective vision, and attending to the needs ethic of care. International Journal of Human Caring, 12(1), 44- and growth of their followers (Groves & LaRocca, 2011). Conclusion 49. 10.20467/1091-5710.12.1.44 Most occurrences of bullying are learned behaviors Combating bullying requires a multidimensional The Joint Commission. (2008). Behaviors that undermine a culture of safety. (Sentinel Event Alert, Issue 40). http://www. directed by reactions to stress and organizational norms approach. By establishing a relationship-based ethics of and, therefore, can be unlearned (Berry, Gillespie, Fisher, & jointcommission.org/assets/1 /18/SEA_40.pdf care perspective, along with visible organizational-based Webster, M. (2016). Challenging workplace bullying: the role of Gormley, 2016). Leaders guided by an ethic of care model regulatory sanctions in communication and ethic of justice, social work leadership integrity. Ethics & Social Welfare, 10(4), take decisive action when confronted with behaviors organizations can create and sustain a respectful working 316–332. https://doi.org/10.1080/17496535.2016.1155633 that do not adhere to expected conduct. In combating workplace bullying, effective leaders are proficient in communication and competent in coaching, staff development, maintaining high standards of conduct, and fostering an environment of trust and mutual respect (Parker, Harrington, Smith, Sellers, & Millenbach, 2016). Bullying is an attempt to intimidate and gain power over someone else. Structural empowerment is an effective technique to mitigate the effects and incidents of bullying (Lachman, 2014). Effective nurse empowerment can be obtained through shared governance to minimize power imbalances and enhance shared responsibility and transparency in decision making (Berry et al.; Parker et al.). Skill development is an important weapon in the battle against bullying. Strategies such as cognitive rehearsal, Visit nursingALD.com today! skills-based training, and role-playing have been successful in raising staff awareness and combating bullying (Balevre, Search job listings Balevre, & Chesire, 2018; Parker et al., 2016). in all 50 states, and filter by location and credentials. Browse our online database of articles and content. Find events for nursing professionals in your area. Your always-on resource for nursing jobs, research, and events. Join us at ahn.org/careers.