Focus This Issue

November 2012 Volume 21 • Number 4 Nevada RNFORMATION THE OFFICIAL PUBLICATION OF THE NEVADA NURSES ASSOCIATION www.nvnurses.org

Free to All Registered Nurses, Licensed Practical Nurses, & Nursing Students in Nevada: Quarterly Circulation 30,000

NEVADA NURSE CARRIES OLYMPIC TORCH Dr. Debra Toney, Las Vegas NNA member, was chosen to carry the Olympic torch!

NNA LAUNCHES HEALTHY NURSE INITIATIVE The goal is to empower and motivate Nevada nurses to give priority to their own personal health, safety, and wellness.

Nurses Campaign Activity Night Page 6 Focus this issue: The 2012 NNA Legislative Candidate Presort Standard US Postage PAID Questionnaire is presented, along Permit #14 Princeton, MN current resident or 55371 with articles about nurses becoming involved in the political process. Page 2 • nevada RNformation November, December 2012, January 2013 NNA Mission Statement Editorial Board The Nevada Nurses Association promotes professional nursing practice through continuing education, community service, nursing leadership, and Editor: Margaret Curley, RN, BSN [email protected] legislative activities to advocate for improved health and high quality health care for citizens of Nevada. John Buehler Garcia, RN, BSN Kaylene Opperman, BA, BSN, CLNC Eliza J. Fountain, RN, BSN Betty Razor, RN, BSN, CWOCN NNA State Board of Directors Wallace J. Henkelman, Ed.D, MSN, RN Denise Rowe, MSN, RN, FNP-C Mary Baker Mackenzie, MSN, RN Kathy Ryan, MSN, RN-BC Janice Muhammad RN, CNM, MS [email protected] . . . . . President John Malek, PhD, MSN, FNP-C Debra Toney, PhD, RN Scott Lamprecht, DNP, MSN, RN [email protected] . . . . President-Elect Janice Muhammad, RN, CNM, MS Christy Apple Johnson Denise Ogletree-McGuinn, RN, MS, MEd, APN, PNP student member [email protected] ...... Vice-President Are you interested in submitting an article for publication Nicola Aaker, MSN, MPH, RN, CNOR, PHCNS-BC [email protected]. . .Secretary in RNFormation? Please send it in a Word document to us Pam Johnson, RN, BSN [email protected]...... Treasurer at [email protected]. Our Editorial Board will review Kathy Ryan, MSN, RN [email protected]...... Director at Large the article and notify you whether it has been accepted for Mary Brann, DNP, MSN, RN [email protected] . . . .Director at Large publication. Articles for our next edition are due by September 1, Susan Growe, MSN/Ed, RN, OCN, [email protected]. . . . . Director at Large 2012. Sandy Olguin, MS, RN [email protected]...... President, District 1 If you wish to contact the author of an article published in Elizabeth Fildes, EdD, RN, CNE, CARN-AP RNFormation, please email us and we will be happy to forward [email protected]...... President, District 3 your comments. Betty Razor [email protected]...... Legislative Co-Chair

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For advertising rates and information, please contact Arthur L. CONTINUE Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216, Cedar Falls, Iowa 50613, (800) 626-4081, sales@aldpub. com. NNA and the Arthur L. Davis Publishing Agency, Inc. THE CARE reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement. DISCHARGED ISN’T THE Acceptance of advertising does not imply endorsement or approval by the Nevada Nurses Association of products advertised, the advertisers, or the claims made. Rejection LAST WORD. RECOVERY IS. of an advertisement does not imply a product offered for Kindred understands that when a patient is discharged from a advertising is without merit, or that the manufacturer lacks traditional hospital they often need post-acute care to recover integrity, or that this association disapproves of the product or completely. Every day we help guide patients to the proper care its use. NNA and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from setting in order to improve the quality and cost of patient care, purchase or use of an advertiser’s product. Articles appearing and reduce re-hospitalization. in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of NNA or those of the national or local associations.

A TRADITION OF QUALITY

Northern Nevada Medical Center is a progressive acute care hospital that offers high quality medical care to residents of Sparks, Reno and the surrounding areas of Nevada and California. The hospital’s tradition of providing quality healthcare in a comfortable, accessible environment means peace of mind for the thousands of patients it serves each year. Current Opportunities Per Diem Float Pool RN - **Pay is $44.00 per hour** At least 1 year critical care or ED experience required FT Emergency Dept RN At least one year ED experience required FT Geropsychiatric Dept RN In the Las Vegas area Kindred offers services in: At least one year psych experience required FT O.R. RN 3 Long-Term Acute Care Hospitals • 1 Subacute Unit At least one year OR experience required 1 Outpatient Wound Center • 2 Transitional Care and FT PACU RN Rehabilitation Centers • Homecare and Hospice At least one year PACU experience required Central Admissions: 702.784.4333 Owned by Universal Health Services, Inc., one of the leading health Dedicated to Hope, Healing and Recovery care management companies in the country. We offer a generous www.continuethecare.com compensation package including excellent benefits and also sign-on bonuses for hard to fill positions. To apply visit our website at: www.nnmc.com or call Human Resources at 775.356.4085 for further information November, December 2012, January 2013 Nevada RNformation • Page 3 In this issue focus 5 NNA Legislative Committee in Action 7 6 Nurses CAN 10 NNA 2012 Candidate Questionnaire 14 Check It Out: Make Your Voice and Your Vote Count 14 What is Oral Chemo Parity? 16 Promoting Healthcare

articles 7 Healthy Nevada Nurses Initiative 7 PTSD Apps Now Available 16 We Need a National Nurse for Public Health 17 Saint Mary’s Mission Outreach & HAWC Community Health Centers Partner 18 Prevention Important in Fight Against Fetal Alcohol Spectrum Disorders

professional practice 7 15 Baby Boomers and Hepatitis C 15 Registered Nurses as Care Coordinators

student corner 19 Healthy Nurses, Healthy Nation 19 Transitioning from Student to RN….and Back Again

10 regular features 4 Message from President Janice Muhammad 8 District 1 President’s Report 8 District 3 President’s Report 9 Letter to the Editor

NNA Member, Debra Toney, Carries Olympic Torch 6

Las Vegas nurse, Debra Toney, was honored for her achievements and lifetime of service to the people of Nevada and was given the opportunity to carry the Olympic Torch. She shares her experience with us. Page 4 • nevada RNformation November, December 2012, January 2013

Message from the President

Janice L. Muhammad, BSN, MS, RNC, CNM President, Nevada Nurses Association Dear Members and Colleagues, growth and financial success. In the most genuine way, I am honored to have served with you to Grant funding and revenue advance the profession of nursing. I have been fortunate to have served generating sources are key to with some amazing individuals in our state association. In this last message, sustaining needed programs. I humbly pass the baton and reflect on my last year in office. The Continuing Education As NNA President, developing relationships, increasing membership and and Professional Practice sustaining excellence in nursing, were central to my platform. As a presence, Committee is evolving as the NNA continues to build beneficial relationships with key stakeholders one of the key providers of throughout the state and its districts. Tracking data has shown dues paying continuing education. Web membership increase. Many refuse to settle for complacency, and seek platform updates will allow for ways to improve safety and quality in nursing practice and find inspiration a more agile offering of web- that fuels their passion for excellence. NNA involvement allows nurses based learning for the state opportunity to share their frustrations and dreams and realize what they required Bioterrorism training would like to achieve professionally. as well as other courses. There The times have been challenging, yet still hold promise. Transformation is excitement in the growing and ideas have emerged resulting in the necessity to change. The ANA interest to reactivate District House of Delegates was retired in June 2012, therefore the scope and role 4 which lies geographically in of a new governance model is coming forth. The Executive Board and Board the northeast region of the state. District 1 due north, and District 3 in of Directors have worked to provide leadership through strategic planning. the South each have dynamos as leaders working to bring value to their These dedicated officers and directors consistently consider ways to sustain constituents. The District’s programming, activities, and endeavors such as NNA’s future and relevancy. As change agents, the Board of Directors have the Initiative for the Future of Nursing and E-Mentoring project support the been committed to strive to increase what Member’s expect for value in profession in significant ways. return for their membership. Over the last two years, NNA has had several accomplishments. Autonomous practice is still an aim, yet gains towards the goal were Nonetheless, there is much more to achieve. I am optimistic that our state realized through collaborative efforts. The requirement for national association’s future is bright. The NNA is on the move! Yet the market certification as a validation of knowledge and expertise in advance practice penetration for NNA is improving at nearly 3 percent. Similar to other specialty areas was signed into law during the 2011 legislative session. The national organizations, NNA membership represents a small fraction of the statue will aid to ensure high quality care for Nevadans. The loss of a special over 27,000 Nevada RNs. Regardless of specialty, NNA is the only statewide practice group sprang forth a budding new APRN-centric organization. The professional nursing organization. We still need more of you to become Nevada Advanced Practice Nurse Association (NAPNA) will hone in on the affiliates of NNA and ANA. If not already a member, please consider joining needs of nurse practitioners. The Legislative Committee revamp after the us. For less than $22 bucks a month, you can have the rights and privileges end of the Nevada 76th Legislative session will continue to build capacity. of two world-class professional associations! NNA is using the momentum created by the societal and political A special thanks to the ingenuity and tireless efforts of the influences on health care delivery at the local, regional and national levels to Communications Director, Margaret Curley, RN. Your support has been ensure nursing interest is represented. We anticipate positive results from invaluable. Also, a heartfelt “Thank you” to the Executive Board: Vice- the 2012 elections and upcoming the 2013 legislative session. It is the will of president Dr. Denise Olgetree McGuinn, APRN, Treasurer Pamela Johnson, the membership that the BOD study the evolving work and endorsements of RN, Secretary Nicki Aaker, RN, and President-elect Dr. Scott Lamprecht, the National Nurse Initiative. NNA has taken the lead to help crucial dialogue APRN; the Board of Directors: Kathy Ryan, RN, Dr. Mary Brann, RN, Susan that focuses on work environments free of inappropriate and disruptive Growe, RN, Legislative Co-Chair Betty Razor, RN, President District 1 behavior such as bullying, lateral and vertical violence. Sandy Olguin, RN and President District 3 Dr. Elizabeth Fildes, RN. You all Required action restructured business strategies to ensure organizational have been astonishing! Words can’t express how grateful I am to have been so fortunate to meet and work with such awesome individuals. Your commitment and dedication is truly commendable. Congratulations Mr. President-elect! Best wishes for a remarkable term in office. Thanks for the many emails and calls received in support and solidarity. My only regret is not getting a chance to meet more of you and personally shake your hand and say—“Thank you!” I appreciate all you do for self-care, self-development and the care you give to others in this noble nursing profession.

If you would like to contact NNA or President Muhammad, please call 775-747-2333 or email [email protected].

Over 30 Years of Trusted & Compassionate Care in Southern Nevada

Registration is free, fast, confidential To view our current employment and easy! You will receive an e-mail when a opportunities and to apply online, new job posting matches your please visit our website: www.nah.org job search. November, December 2012, January 2013 Nevada RNformation • Page 5 NNA Legislative Committee In Action What you need to know about the NNA & The Legislative Committee

will lobby on the phone, in the halls and offices • NNA represents all nurses in Nevada: members of the legislature, and during meetings with and non-members pertinent legislators. Committee members and the • NNA never endorses a candidate for office lobbyist will follow the bills through the legislative • NNA is a non-union body and does not engage process. They will attend and provide testimony in collective bargaining. at committee hearings as needed, contacting • NNA is the respected authority on legislative legislators to obtain support on NNA’s position issues that affect nursing, our profession, public on the “Bill” and often put out a call for nurses health, and patient care. to attend a specific committee hearing. A huge • NNA pays and utilizes the enormous efforts presence at a committee hearing often turns the of our lobbyist (year round) to guide us and tide in our favor. provide direction and strategies in our legislative The following are some of the steps that the efforts committee pursues and their explanations: The Legislative Committee is a group of Factors associated with successful dedicated nurses devoting a great deal of time legislation for the benefit of nursing and quality health care. Health related issues are a major priority The committee meets by teleconference once a for NNA and significant resources and time are are outcomes of interim committee sessions. All month between sessions and in the legislative year expended to launch legislative efforts. Some key BDRs are placed on the Nevada Legislative web (odd year) starts meeting weekly in mid-January factors are: site with very brief general comments and name through the end of the legislative session in May. • Choosing the right issue to move of the sponsor. The Lobbyist and committee The month of July starts the barrage of Bill Draft legislatively. Not all problems need legislative members must “wade” through the thousands that Requests (BDR). Our lobbyist and each committee or regulators fixes. Some with financial will be introduced and identify those that have an member spend hours researching those that may implications may have to be pushed on the impact on our practice. Thus begins the process affect our practice or health care. back burner for future considerations; some are of weeding through those BDRs that we watch, The BDRs (Bill Draft Requests) are usually early better addressed in other ways. research, or just monitor. Many require contacting on in the “idea” phase of the legislative process. • Crisis. Successful legislation efforts are the “sponsor” for additional information to get a Sponsors (legislators or legislative committee) sometimes linked to crisis. better feel for what the potential bill will be about. either are recycling old bills that didn’t pass last • Patience. Many of these issues have been Once a BDR gets a bill number, it is in official session, have new ideas based on issues that have introduced and reintroduced. arisen since last session, or are requesting bills at legislative language and active lobbying will (Continued on page 6) others’ requests. Some of the Bill Draft Requests take place. The NNA’s Legislative Committee

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Job Number FINAL CHeCKLIst Job Name INItIALs INItIALs Date 9-27-2012 Printed At 100% Agency RK Accreditation Time 2:30 PM Round 2 Legal Line

Job info sCHev Element 1/2P4C Pages 1 pg Folded Size INDI Code Live 10.25 in x 7.5 in VDP Tri m N/A NRw URL Bleed N/A Notes Chamberlain URL Approvals Pub Info APPRoveD APPRoveD DeNIeD DAte INItIALs w/ CHANGes Pub: Nevada RNformation Chamberlain Address Stephanie Gallo Issue: November, 2012 Contact: Anissa stender Chamberlain Phone PRINT [email protected] Inventory Code Title: Location: Production Code Prod Co:

OOH 3-Year BsN Copy Post Date: Quantity: other: 3005 Highland Parkway | Downers Grove, IL 60515 | P: 630.512.8914 | F: 630.512.8888 Page 6 • nevada RNformation November, December 2012, January 2013 Nevada Nurses Association Member nurses CAN Carries the Olympic Torch

Debra Toney, PhD, MS, BSN, FAAN

Have you Nurses Campaign ever done something that changes your life? Have you Activity Night met people that will always inspire you to do more? October 17, 2012 These are just a few of the On October 17th, the Nevada Nurses Gubernatorial race or a state or local race; just be many feelings Association and the American Nurses Association sure to identify yourself as a nurse and be part of I have after urge all nurses to volunteer on a political campaign the action! participating of their choice. Pick any candidate you like: The upcoming elections are important and as an Olympic Democrat, Republican, Independent or other. He nurses need to be visible and form working Torchbearer!! or she can be running in a Congressional race, a relationships with elected officials to educate They are certainly great feelings to have and I them about the critical issues facing nurses and have certainly been on cloud nine since returning our patients today. The first step to forging these home. relationships is participating on a campaign. Volunteering on a campaign provides access to The opportunity to participate in this the candidate and allows you to begin building international event which celebrates the the relationships necessary to advance some accomplishments of some amazing people is of nursing’s core issues such as; Safe Patient a proud and humbling moment. However, it Handling, Safe Staffing, ensuring APRNs have is a moment that could happen to anyone. access to their full scope of practice and securing Torchbearers are regular people like me. “I’m access to safe quality health care for all. a mother and grandmother. I go to work every And when it’s all said and done, share day and then I come home and take care of my your experience with ANA! family.” Visit http://www.rnaction.org/site/ I have a deep commitment to service and I PageServer?pagename=nstat_take_action_ am heavily involved in my community, something nurses_can_pledge2012 to share your photos, your all Torchbearers have in common. To be chosen stories and your feedback. to participate in a once in a life time event which is celebrated all over the world tells me that NNA Legislative Committee In Action someone is always watching. (Continued from page 5) While flying home, I had plenty of time to pinch myself to wake up but I was awake. Did this really • A strong coalition within nursing. Those lines and gain bi-partisan support are more just happen to me? Yes it did. Spending time with bills that have favorable legal and regulatory likely to move forward. some inspiring individuals and hearing their stories environments tend to have a formal coalition. • Personal Connections with personal of giving has given me the drive to do more. • A strong coalition beyond nursing. Support experiences with the issue. Some legislators from other healthcare providers, consumer will have already had personal experience that I was one of 22 individuals selected by the groups, and business sends a message that helps them understand the importance of the Coca-Cola Company for this honor, and one of the your issue is “bigger than just nursing”. issue. 8,000 Torchbearers who helped the flame make its • Shared Strategy. A strong coalition does not • Know who NNA key champions are. way across the country to London for the opening guarantee a shared strategy, but it is a step ceremony on July 27, 2012. The legislative committee invites all NNA toward developing one. There is often a lot of members to join us in this important legislative The Flame is delivered to the host country, “homework” to be done to achieve this step, process even if you are not on the committee. where it is transferred from one Torchbearer to and it is time-consuming. Do contact your legislator(s) and provide your another, spreading the message of peace, unity, • A savvy lobbyist committed to the issue. expertise as a health care constituent. Remember and friendship. It ends its journey as the last A good lobbyist will know if an issue should be that legislators are part-time legislators and Torchbearer lights the cauldron at the Olympic addressed legislatively and identify the best most have no health care background with few if Games Opening Ceremony in the Olympic Stadium, sponsors. NNA has a year around lobbyist: any resources in our field. You can provide that marking the official start of the Games. part-time between sessions and full-time during expertise for them. Take the first step and write or session. I have been asked many questions regarding call them now. • Choosing the right sponsor who will this experience. It was awesome! Each of us You can make a difference. Call if you have champion the bill. A successful effort requires carried the Torch for 300 meters, about the length questions/concerns a key legislator in a strong position. of three football fields. I did not expect to run the Beatrice “Betty” Razor • Sponsors from both parties and houses. relay but the excitement and cheers of the crowd Northern Legislative Interium Co-Chair Particularly in times of strong partisan divide, put my adrenaline into overdrive, and, yes, I ran. 775 841 2208 issues that can be shown to cut across party When I arrived in Las Vegas, I was met by my Mary Brann Southern Legislative Co-Chair biggest fans, my two grandsons Russell, five, and Miles, two, who held up signs that said welcome home granny Olympic Torchbearer. I plan to make sure that they grow up understanding the importance of living a positive lifestyle and giving Registered Nurses back to their community. MGGH is located in the small friendly, affordable This is a moment I will cherish forever and community of Hawthorne and we are a well-staffed rural Nevada Hospital and LTC Facility, something I want to share with my community, emphasizing quality care! Walk-In M-F especially young people, to help them understand Great Benefits Call Today! 8:00 am-6:00 pm Livescan that community service is something we must all Current NV license or ability to obtain one preferred. Saturdays Fingerprinting, 11:00 am-3:00 pm Electronic Submission, be involved in, no matter how big or small. Giving Fax Resumes to 775-945-0732 800 N. Rainbow Blvd., Suite 175 FBI Cards, RN Board Nevada, back to something bigger than ourselves leaves us ATTN: Mt. Grant General Hospital HR Dept Las Vegas, NV 89107 Out of State, Health Care and or Email Resumes to [email protected] 702-485-5256 many more. Free Employer with a great feeling of satisfaction. It is possible or call collect 775-945-2461 for more info. http://www.bdfingerprinting.com Accounts and Child ID Kits that you may be the next Olympic Torchbearer! November, December 2012, January 2013 Nevada RNformation • Page 7 healthy nevada nurses Healthy Nevada Nurses Initiative Elizabeth Fildes, Ed.D, R.N., CNE, CARN-AP Margaret Curley, R.N., B.S.N.

Nurses who are truly healthy – physically, schedules and endless outside responsibilities, The Initiative begins with the following mentally, emotionally, spiritually, and professionally don’t engage in healthy exercise. Many abuse objectives: – can transform their environments, ranging from tobacco, alcohol and other drugs. It is high time dysfunctional workplaces to the troubled health for the beliefs we profess – about health, safety, • Conduct a statewide Health Risk Assessment care system of our country. preventing injury and illness, alleviating suffering based on the holistic healing model Being a nurse means accepting a mission to – to manifest in a proper regard for our own lives, • Create a mechanism for groups of nurses to advocate for a health care system that responds our own health, our own fitness to live and to support each other in meeting their holistic to the needs of all. Being a nurse means accepting serve. health goals the responsibility to promote, optimize and Armed with the belief in nurses’ transformative • Provide 50 weeks of educational webinars/ protect patients’ health and safety. Being a nurse power, determined that it should produce action teleconferences that will serve as a focal means keeping a promise to prevent illness and exemplary results in our own lives; the point for face to face or virtual group and injury and to alleviate suffering. In fulfilling Nevada Nurses Association is taking the challenge meetings these commitments, we become agents of love, of helping Nevada nurses become healthier. • Develop self-monitoring tools to help compassion, justice and equality in our society. On October 5th, we launched the Healthy participants track their progress with tips on Underlying this fulfillment is our need – our duty Nevada Nurses Initiative at the Nevada how to overcome challenging barriers – to be healthy ourselves – physically, mentally, Nurses Association State Conference! Our goal • Support nurses’ efforts with trained nurse- emotionally, spiritually, and professionally. is to empower and motivate Nevada nurses to coaches via a nurse-managed Chronic We know all this. Yet, despite our acknowledged give priority to their own personal health, safety, Diseases Prevention Helpline commitments and despite our knowledge of the and wellness. In doing so, we live our lives to • Evaluate initiative outcomes 12 months after impact of chronic diseases on patients and their the fullest – physically, emotionally, mentally, launch based on the number of small groups loved ones, we often neglect our own health. It spiritually, and professionally – we achieve the formed and on participant self-reports is apparent that many of us desperately need greatest possible combination of our own personal the same support and interventions we have strength and the resourcefulness of others in With all that, we’re also issuing a challenge always given unhesitatingly to our patients. Many addressing our patients’ interests. We also capture to all nurses: Suggest activities! Send your of us are stressed at work and at home. Many the moral high ground of exemplifying what we suggestions to Elizabeth at Elizabeth.Fildes@tun. are morbidly obese and, despite punishing work ask of others. touro.edu or Margaret at [email protected]. PTSD Apps Now Available

The Nevada Nurses Association is proud to join the American Nurses Association in JOINING FORCES for Veterans, Military Service Members, and their families. The American Nurses Association (ANA) and the experts in the Department of Veterans Affairs (VA) have committed to “touch every nurse” in the country to raise awareness of post traumatic stress disorder and traumatic brain injury in returning combat veterans.

Created by VA’s National Center for PTSD and be used by a patient who is receiving Prolonged people following disaster. Learn from the PFA ANA collaborators, PTSD mobile apps are for Exposure (PE) Therapy for PTSD: PE Coach. This online manual and training, and then this app can everyone, including those who are caring for app can assist you when using Prolonged Exposure assist you in the field. (Coming in the next few people with PTSD. Apps include the award winning (PE) Therapy for PTSD. It allows patients to keep weeks!) PTSD Coach mobile app and the first PTSD track of homework and record their narrative. These free PTSD apps are available for Android treatment companion app. These free PTSD apps are available for Android and Apple mobile devices, including tablets. Treatment companion apps are to be used by and Apple mobile devices, including tablets. What other apps would help you with PTSD a patient who is in PTSD treatment together with Provider Apps (use to make your job easier) care? More apps are coming soon, but if you have their care provider. The apps are to assist with Disaster Response - PFA Mobile: PFA stands for ideas email [email protected]. PTSD treatment. The first app of this kind is to Psychological First Aid, an intervention to help

If you would like to know more about becoming a foster or adoptive parent, please contact us for more Get paid to save lives! information: Nevada Donor Network is looking for 775-337-4510, or by email Adoption_Recruitment@ qualified people interested in saving washoecounty.us lives through organ and tissue donation. Isaac, 9 Some of our needs are Family Services Coordinators (bilingual–Spanish), Manager Washoe County Department of Family Services, Per Diem and full time of Social Services Procurement Technicians. Visit www.nvdonor.org www.haveaheartnv.org for a complete list of openings. Page 8 • nevada RNformation November, December 2012, January 2013 inside nna NNA District 1 Report NNA District 3 Sandy Olguin, MS, RN Report Wallace J. Henkelman, EdD, MSN, RN, Are you excited and Their Day, Be There, and Choose Your Attitude. happy to go to work? Have fun at work, be kind to others, be present District 3 Board of Directors Do you smile, laugh and with people, and choose your attitude! I know For Elizabeth Fildes, EdD, RN, CNE, have fun while working? from experience that this is no easy feat! I would CARN-AP, District 3 President Are you truly present and say that it’s like pulling teeth, however that pales focused on the situation in comparison to creating a healthy workplace. at hand when working? If you currently do not work in a healthy work Have you started your environment, take a look at yourself, be a District 3 of the morning drive to work with worries and stress thermostat and work with your team to develop a Nevada Nurses and put it all aside with a change of attitude shared vision, collaborate on a plan, carry out your Association is taking the after starting your shift? If you answered no to plan, and celebrate along the way, especially when leadership in helping any of the previous questions, you may want to your goal is sustainable. Nevada nurses become assess what you’re doing and what your work Throughout my nursing experience I’ve healthier. This October environment looks like. What can you do about encountered disruptive behavior, horizontal/lateral 5th, we are launching your work environment? During one of my training violence, and bullying and look back and wish I the Healthy Nevada seminars, I was encouraged to be a thermostat had reported it, stopped it, and made it into a big Nurses Initiative rather than a thermometer. The thermostat deal because it is a big deal. The person causing at the Nevada Nurses (feelings and attitudes) controls the temperature so much distress and stress stayed in their position Association State Conference! Our goal is to (behaviors) in the environment; the thermometer and I distanced myself, reported the disruptive empower and motivate Nevada nurses to give measures (mirrors) the temperature. When you behavior which was condoned, and then left the priority to their own personal health, safety, and are influenced by what people say and how they organization all together. No one needs to go wellness. The Initiative begins with the following behave, you are acting like a thermometer. It is a through that without some type of support. NNA objectives: challenge to be in a negative environment where has developed a workgroup addressing disruptive • Conduct a statewide Health Risk Assessment nothing works, there are not enough supplies, behavior and is seeking a solution to help eliminate based on the holistic healing model staff, or engagement and people are upset and/ these unacceptable behaviors. If you’re interested • Create a mechanism for groups of nurses to or resentful. You may consider packing up and in participating in working toward a solution, support each other in meeting their holistic running for the hills! An alternative is to be the please contact Margaret Curley directly. health goals thermostat and not let the temperature—of The 2012 NNA state convention, Healthy Nurses • Provide 50 weeks of educational webinars/ negative thoughts, attitudes, and behaviors and Healthy Workplaces, is on October 5th and teleconferences that will serve as a focal influence you and potentially your amazing day or 6th is at the Grand Sierra Resort in Reno, Nevada. point for face to face or virtual group night. Your attendance is requested! There will be a huge meetings You may wonder what the secret is to creating party within the GSR for the First Friday along with • Develop self-monitoring tools to help an incredibly-satisfying work environment and NNA’s Mix & Mingle, Meet & Greet and Networking participants track their progress with tips on memorable customer experiences. According to with health care providers, people who support how to overcome challenging barriers Seattle’s world-famous Pike Place Fish Market, nurses, candidates, and legislators on Friday, • Support nurses’ efforts with trained nurse- their secret lies within The Four Steps of the FISH! October 5th. Friday’s event is only $20! Please coaches via a nurse-managed Chronic Philosophy. These Four Steps include Play, Make contact Margaret Curley, Communications Director Diseases Prevention Helpline of NNA for more information. • Evaluate initiative outcomes 12 months after launch based on the number of small groups formed and on participant self-reports (Continued on page 9)

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For over 55 years, the School of Nursing has been recognized as the largest Nursing program in Idaho promoting excellence in teaching, research, and service.   A variety of courses and program options are available to fit your needs:  We invite you to contact us  to determine if Boise State’s • A student-friendly RN-BS program taught School of Nursing is the right  entirely online for nurses who want to complete fit for you.  their BS degree in nursing.  Becky White, Student Recruiter  208-426-4632 • Unique Masters program taught entirely online.  [email protected] Focused on nursing care of populations. Nurses  manage and coordinate; yet few programs  prepared us to look at aggregates of populations to make data based decisions. November, December 2012, January 2013 Nevada RNformation • Page 9 Letter to the Editor

It’s Friday, late morning, and I’m being given pill. I took another ACETOMENOPHEN. Again, just discharge instructions following abdominal surgery one. I took it easy, learned to splint – tighten my two-days before: “...And here’s 30-VICODIN for diaphragm – before sniffing, interrupt sneezes, pain.” My husband shot out of used the incentive spirometer – so I didn’t have to NNA District 3 Report his chair, “She’s an alcoholic, cough – and I didn’t lift heavy objects. All because (Continued from page 8) you can’t give her 30 of those I go to 12-Step meetings as if my life depended on things!” them. “It’s not addictive when it’s I’ve heard too many people I know and love, With all that, we are also issuing a challenge taken for pain,” he was assured. change their sobriety date after a prescription for to all nurses: Suggest activities! Send your While that may be true pain meds for a legitimate reason. Getting through suggestions to [email protected] or for nonalcoholics, it certainly surgery and recovery – sober – requires only a [email protected] isn’t true for us. The textbook for Alcoholics fitness of the spiritual condition. District 3 has been active in pursuing the Anonymous describes this phenomenon in such This is how it worked for me. Hospital goals of the Initiative for the Future of nursing wonderful language, which I am unable to quote registration the day before my kidney was to over the past year. To facilitate some of the verbatim, but will paraphrase loosely as, “I am be removed, was a few blocks from the surgery recommendations of the Initiatives involving the not an addict. I only take pills I need to take... site, and 2-doors up from Central Office. The day advancement of nursing education, District #3 has however, if I have the pill on hand, the symptom after the operation, the Sunshine Committee sent established a scholarship fund named after Dr. for that pill will always develop.” 2-representatives to my room for a brief meeting. Rosemary Witt PhD, RN, CNE, “The Rosemary Witt From my hospital bed, I can tell they aren’t Better magic than Santa could bring, don’t you Educational Scholarship,” to help nursing students going to let me out unless I take some, so I think? working on the achievement of their BSNs and agreed to five. Once the pharmacy made that It’s been just over a week. No more District 3 members pursuing higher nursing change I was on my way home. “You have ACETOMENOPHEN. Still have 5-VICODIN. This is degrees. The district has also initiated a dialogue unlimited refills on this,” Santa explained standing primarily related to the miracle of modern surgery, with University Health Systems to encourage by his magical sleigh. I know they mean well...but and has nothing to do with me being stoic. I have ADN nurses in their residency programs to take I hear, “Take those pills. You will need them.” 3-puncture wounds and a 4 inch incision just advantage of RN to BSN opportunities. District 3 The only otc pain reliever “safe” for someone above my pubic bone. I had massive amounts of received a grant to sponsor a Women’s Conference with only one kidney, is ACETOMENOPHEN. I pain meds IV until moments before discharge. I which was broadcast at 12 sites for nurses and remember hearing a pharmacology instructor was “dancing” (or what I call dancing) to live music nursing students. saying - “There’s no active pain relieving ingredient at the 4th of July party the very next week. My On May 12, 2012 District #3 held its second in ACETOMENOPHEN. It is probably prescribed stomach is still tender to touch, and is happier if annual Initiative on the Future of Nursing in for its placebo effect.” I don’t know if that’s what my pants are unbuttoned, otherwise, there is no Nevada Professional Progression awards dinner was really said or if it’s just what I remembered, pain to medicate, and I’m still sober. Thank you and dance. Awards were presented to Southern but after a 6-hour drive home, pain or no pain, 12-Steps & thank you God. Nevada nurses who achieved an advanced degree I’ll see if the placebo effect works. I took one or national certification within the past year. The ACETOMENOPHEN 500mg. I didn’t take two, in awards were presented for five doctorates, eight case I “needed” the VICODIN later—to avoid the MSNs, one CNE certification, and five BSN to RN accidental overdose of ACETOMENOPHEN – and Simplify your nursing research... degrees. Proceeds were dedicated to Future of the slow death of liver failure. (Obviously planning with access to over Nursing Action Coalition. to need it.) 10 years of nursing A series of programs is in progress to encourage The next morning, before getting out of bed publications at your the financial health of nurses in District 3. – which might REALLY hurt – I asked The-keeper- fingertips. Presentations already completed have included of-the-pills for ¼ of a VICODIN. He scampered “Taking Care of Your Financial Health: Strategic off to fulfill my wishes, only to return – alarmed Approaches Made Easy for Nurses” by Russ and empty handed several minutes later. “I can’t nursingALD.com Bateman, “Co-dependency, Helping Healing find them. I’m so sorry.” Reassessment time. On a Simply click on the Newsletter tab on the far right and enter your search term. without Hurting” by Joan McCraw, RN, APN, and scale of one to ten, I can feel my abdominal cavity “Social Security Basics” by Rita Meier from the – a novelty, rather than pain – unless I sniff – but Social Security Administration. that excruciating pain lasts just a bit longer than New Grads District #3, in conjunction with the Healthy a sniff, gone before I can even think of needing a JOIN OUR TEAM! Please Apply! Nurses Initiative, has planned a Russia/Scandinavia Cruise for August 12, 2013 as a fundraising Home Health Services of Nevada event for the NNA District 3 Scholarship Fund. has PT and FT openings in Rural Nevada, A conference will be provided on the cruise on giving you the opportunity to use your critical the topic of ”Holistic Health Strategies for Health thinking and assessment skills. We utilize Care Professionals” providing the opportunity for computer charting and in home telemonitoring. 20 FREE continuing education credits. All NNA Sign On Incentives Available members are invited to participate. For more information please go to the NNA website. www.careprohha.com Contact Leah Doke at [email protected] for openings in your area. Employment Opportunities www.homehealthservicesnv.com RNs & LPNs EOE Join a Home Health Company with a NURSING JOIN OUR TEAM! high opportunity for growth. INSTRUCTORS William Bee Ririe Hospital Dedicated. Passionate. Team Oriented. ITT TECHNICAL INSTITUTE in Henderson, one of the nation’s leading providers located in Ely, NV Spanish speaking nurses are of technical post-secondary education has immediate openings for NURSING A friendly rural community in INSTRUCTORS in the Breckinridge School of Nursing. We are seeking qualified RNs for moutainous Eastern Nevada encouraged to apply. both classroom and clinical with experience in teaching. Nursing Instructors are responsible for providing quality instruction to students by Clinical Informatics Coordinator, ensuring student satisfaction through the classroom, Nursing Skills Lab, or clinical Full-Time RN & Full-Time OR RN experience environment according to the program objectives. preferred; sign on/relocation bonus available; Minimum of three years practice as a Registered Nurse and clinical expertise relevant to generous benefits; State retirement (PERS); the teaching area required. A Master’s degree in Nursing and current active Registered very competitive salaries. Nurses license in applicable state or eligibility for licensure required. WBRH is an EOE employer. For consideration please apply online at www.itt-tech.edu. Contact: ITT TECHNICAL Vicki Pearce, [email protected] INSTITUTE Interested Applicants contact: 168 N. Gibson Road, 775-289-3467 Ext. 299 Henderson, NV www.wbrhely.org [email protected] Equal Opportunity Employer M/F/H/V Page 10 • nevada RNformation November, December 2012, January 2013 nna candidate questionnaire

About the NNA Candidate Questionnaire Margaret Curley, RN, BSN

The Nevada Nurses Association has conducted I would, however, caution readers about making If you don’t see your candidates listed below, I a survey of the legislative candidates on issues of assumptions because a legislator is not listed strongly encourage you to call or email them and concern to NNA for years, but this is the first year below. There are a number of reasons why your discuss these or other issues of concern. we have done the survey electronically. We sent an legislative candidates may not have participated. If your candidates are listed below, please read invitation to all legislative candidates to participate, • This was our first electronic survey and, in their responses carefully, then call or email them and we appreciate those who did. I was spite of our best efforts, some may not have to thank them for their interest in working with particularly impressed by the serious consideration received the invitation. nurses on issues important for professional nursing many gave to the issues raised, following up on • Some called and explained that they don’t do and quality patient care in Nevada. recommended references and calling for additional written surveys, but would be glad to discuss Finally, thank you to fellow legislative committee information. They have provided thoughtful and these issues in person. members Wally Henkelman, Laurie McGinley, considered answers. Thank you to all of the • One answered all the questions, but Susan Growe, and Aleta Campbell for their help in candidates who took the time from the busy the survey tool recorded the identifying contacting legislative candidates. campaign schedule to complete the survey. information as “anonymous”!

NAME DISTRICT Would you support We know now that more Would you support Is there anything else you would like PARTY AFFILIATION legislation requiring Nevadans will be entering legislation that permits Nevada nurses to know about you? that, when an individual the healthcare arena through access within Nevada contracts with a health places other than emergency schools to undesignated plan to provide services, room visits. Do you believe epinephrine auto injection and chemotherapy primary care providers for students who suffer treatments are listed as a should be able to practice from severe allergic covered service, that IV to the full extent of their reaction? and oral chemotherapy scopes of practice in order be covered in the same that these Nevadans will be manner? (See page 14 for able to receive primary care? more information on oral chemoparity)

SENATE CANDIDATES Gregory Hughes 1 Undecided Yes Undecided I’m undecided about 2 out of the 3 IAP issues because I’m very wary about the word legislate. It is my belief that legislators should legislate less and stay out of our business. My father died from cancer and I believe IV chemo was the biggest contributing factor. And as far as epinephrine, I’m not against it as long as the parents pay for it.

Tick Segerblom 3 I need more information Yes I need more information My wife is a nurse. I support anything D we can do to give more authority to nurses and less to doctors.

Greg Brower 15 I need more information I need more information I need more information The above questions raise very R important and complicated health policy issues. I cannot answer any of questions with a simple “yes” or “no,” but I would be happy to meet with your association to discuss them in detail. Thank you. GB

Sheila Leslie 15 Yes Yes Yes I have always enjoyed working with NNA D on its legislative issues and look forward to doing so again. I would be happy to sponsor any of these bills. I greatly admire the work of the NNA and believe the bills we have worked on together, such as needlestick safety, unsafe assignments, and workers comp have had a significant impact in our state.

Harley Kulkin 19 Yes Yes Yes Health care in Nevada needs major D improvement. As a former employee of Carson Tahoe Hospital and the Veterans Hospital, Reno and my own personal experiences I know Nevada is way behind the Nation. Nevada does not provide cutting edge medicine in any field. Nevada needs to invest in itself in medicine and education.

ASSEMBLY CANDIDATES

John Hambrick 2 Yes Yes I need more information Will the Association ever allow R legislators to become auxiliary members? It could increase a sense of ownership.

Phyllis Moilenan 3 Yes Yes Yes R November, December 2012, January 2013 Nevada RNformation • Page 11

Peggy Pierce 3 Yes I need more information I need more information D

Jonathan Hansen 4 I need more information I need more information I need more information I would appreciate the opportunity to IAP discuss these issues after obtaining additional information. Obviously they are important to this group and I would make myself available if elected to discuss specific needs.

Bill Harrington 5 Yes Yes Yes Dr. Bill Harrington is a board certified R emergency physician working at Southern Hills and Boulder City Hospitals. His wife Diane is a registered nurse and they have been married for 30 years with six children. Bill previously served in the assembly. Bill works with nurses all day in the E.D. and honors their skill, dedication, and compassion.

Brent Leavitt 7 I need more information Yes Yes I am a major proponent of eating real R food and making available to everyone better healthcare. The problem isn’t just health insurance it’s the dependency people have upon the insurance to survive. Creating system of true insurance and educating people to make better decisions on their own is the key to success.

Andrew Martin 9 I need more information Yes Yes I am advocate for affordable healthcare D and affordable health insurance. I believe the nursing profession to be honorable and there should be truth in labeling as to not confuse the public and, at the same time, recognize the education and experience achieved at all levels of the nursing profession.

Maggie Carlton 14 I need more information Yes I am undecided I believe nurses have the most impact D on successful patients. As Primary care evolves, they will play a very important role.

Len Marciano 17 Yes Yes Yes I have spent 31 years in education R as both a teacher and administrator. During this time I have seen the fine work school nurses have done with both students and the community. I would like to see in Nevada nurses practicing to the full extent of their education and training, and, nurses as full partners with physicians and others in health care.

Steven Brooks 17 I support your issues wholeheartedly D

Richard Carrillo 18 Yes Yes Yes D

Cresent Hardy 19 I need more information I need more information I need more information R

Felipe Rodriguez 19 Yes Yes Yes Felipe is an enthusiastic team player D with a willingness to accept new responsibilities with a natural ability to communicate with people, a self starter who works well under pressure and a leader with strong decision making skills and a strong desire to succeed. He looks forward to working with your organization. Page 12 • nevada RNformation November, December 2012, January 2013 nna candidate questionnaire

Becky Harris 21 Yes Yes Yes I regularly see Nurse Practitioners when R I am sick or need a test performed. I appreciate the high level of care I receive and the ability to be seen more quickly.

My husband has been a dentist for over 15 years. Through his dental practice I have gained much insight into the various issues facing healthcare providers in Nevada.

Dr. Andy Eisen 21 Yes Yes Yes As a practicing physician in Nevada for D over 15 years, and a current collaborating physician for two of the best Pediatric Nurse Practitioners in the business, I know first-hand the important role nurses play in patient care. I’ve seen how hard nurses fight to care for and protect their patients, and many of the most important lessons I’ve learned as a physician have come from the nurses with whom I’ve been lucky enough to work.

While I could try to list what I think is important about the work that nurses do, the proof of the value I place on that work and the professionals who do it has to come from how I’ve shown that over the years. I’d ask that you reach out to nurses and APN’s alongside whom I’ve worked at UMC Pediatrics, the Helping Kids Clinic, the Bower School-Based Health Center, and elsewhere, and ask them what they think. Their honest appraisal is more important than anything I could write here.

Randy Spoor 22 Yes Yes Yes Visit my website – randyspoor.com to read D about me. While I read the background information supplied with these questions, I found them informative to where they simply backed up my position. We need legislators who put healthcare and education as their primary goals for improvement. I will meet regularly with nurses to insure your goals are met.

Rodney Petzak 26 Yes Yes I need more information Retired State Correctional officer, D Episcopal priest. Stands for tax reform to support the state educational system and improve the state infrastructure.

Teresa Benitez-Thompson 27 Yes I need more information Yes I am a Licensed Social Worker by D profession. I work for a private health care hospice. The Nursing professionals I work with are some of the kindest folks I have ever met. Maybe I got lucky? I enjoy being part of an interdisciplinary medical team that is patient focused.

Lucy Flores 28 Yes Yes I need more information That I appreciate their hard work D (because being a nurse is definitely hard work) and that I support policy ideas that will help ensure patient safety while ensuring nurse safety as well.

Bob Irwin 29 Yes Yes Yes With the upcoming changes in universal R health care, given the shortage of doctors, a great deal more patient care will be put on nurses. The availability of continued upgrades in training of nurses, nurse practitioners and P.A.s will become extremely important to the future of our medical services. November, December 2012, January 2013 Nevada RNformation • Page 13

Mike Sprinkle 30 Yes Yes Yes As a practicing paramedic for over D 20 years, I believe I have a unique understanding of health care (and especially emergency pre-hospital health care) here in Nevada. I have a lot of respect for Nurses and the job they do and have always felt like I had a strong working relationship with those I was fortunate enough to work with.

Dave Espinosa 31 I need more information Yes Yes Health care matters, and their related R costs, will be the central focal point of this coming legislative session. I look forward to our working and talking together to provide the highest quality care while managing costs and protecting patient choice. For Question 1, I would like to see a complete cost study first.

Skip Daly 31 I need more information I need more information I need more information Thank you for the opportunity to learn D more about these issues. At this time I don’t have enough information to answer yes or no. I look forward speaking to you soon about these and any other issues.

Tom Blanchard 35 Yes Yes Yes Having been a US Navy Corpsman and R FMF Field Medic stationed in Camp LeJune, as well as a Paramedic in Los Angeles County, Nevada Test Site and in Las Vegas. I am very sensitive to the Health Care Community as a whole. I have lived the extended hours and lack of appreciation felt by most every health care worker out there.

James Healey 35 Yes I need more information Yes Having 7 back surgeries has allowed me D to experience the amazing compassion and dedication of our Nurses in Nevada. I look forward to working with the NNA to better understand your issues and needs of the Legislature and work with you to continue to improve conditions for our nurses and patients.

Anthony Wernicke 36 Yes Yes Yes Being a CNA for years, I know how hard D nurses work and under paid. We need more nurses in the field, Nevada being dead last per nurse vs. patient ratio. As your Assemblyman, I will fight for Nursing and Patient rights....

Jim Wheeler 39 I am undecided Yes I need more information R

Pete Livermore 40 Yes Yes I am undecided I served in the 2011 legislature R committee of Health and Human Services.

Rich Dunn 40 Yes Yes I need more information I support affordable access to health D care, but do not believe this can be accomplished without demand-side insurance reform. I know how that can be done, and plan to pursue it.

Paul Aizley 41 I need more information I need more information I need more information I view each issue as being very important D and I need to hear the pros and cons. I will give full attention to these issues when they come forward as proposed legislation. Page 14 • nevada RNformation November, December 2012, January 2013 candidate questionnaire What is Oral Chemo Parity? Carla Brutico RN, OCN ONS State Health Policy Liaison – Nevada

Oral Chemo Parity is a term used to describe patient ambulatory infusion center, hooked up are given with IV chemotherapy. Approximately legislation that would eliminate the financial to an IV bag containing a chemotherapy agent one-quarter of all cancer drugs in development disparity faced when a cancer patient is prescribed specific to their tumor type. Now we have the are oral treatments (5). Understanding that oral an oral “chemo” drug versus a traditional availability of oral chemotherapy drugs – the first oncolytics carry a convenience factor with them intravenous (IV) chemo drug. The basic issue was FDA-approved in August of 2001 (2), with – the patient can take the medication at home or is this: IV chemo drug treatment is covered more being introduced each year since then. work - it is also important to understand that the by insurers under the patient’s major medical The reason behind this change in how cancer new oral oncolytics do not have an IV equivalent. benefit with an average co-payment ranging is treated is the explosion of cancer research So, patients do not have the choice of either/or. from fifteen to thirty-five dollars per visit. Oral which allows scientists and researchers to identify For many types of cancer the oral oncolytic is the “chemo” is prescribed by the physician, obtained “targets” inside the cancer cell itself. We now only choice for anti-cancer therapy. at a pharmacy, and is paid as part of the patient’s know that the intra-cellular domain of cancer cells Because of the cost issue we are seeing a pharmacy benefit with much higher co-payments acts as a “command center” of sorts with signaling disturbing trend: many patients on oral oncolytics and out-of-pocket costs. A twenty percent co-pay pathways that can literally “command” the body, are literally “abandoning” their treatment. A study on a $10,000 oral chemo prescription will require as one example, to send a new vascular supply to published in the Journal of Oncology Practice, the patient to come up with $2000 per month. feed the cancer cell, thus facilitating its continued “Patient and Plan Characteristics Affecting Many patients cannot afford the first prescription, growth (3). Abandonment of Oral Oncolytic Prescriptions” let alone the subsequent monthly refills. It is a sad There have been oral forms of chemotherapy concludes with this statement: commentary that almost 10% of patients choose and hormonal therapy used to treat cancer for “Abandonment of newly prescribed oral not to fill their first prescription for oral chemo several decades. Historically, they have been oncolytic therapy is not uncommon, because of the high cost-sharing (1). oral formulations of IV agents. Now, there is an and the likelihood increases for patients To understand why this situation has come increase in the development of oral oncolytics – enrolled in plans with pharmacy benefit about and what can be done as a solution, one the preferred term for these drugs – which act in designs that require high cost sharing. must understand how the two forms of cancer a different way to interfere with cancer cell growth Increased concurrent prescription treatment differ and why we will continue to see because they can go inside the cancer cell itself. activity was also associated with a higher an increase in the newer oral form of cancer They are small molecule inhibitors and agents abandonment rate. These factors should agents. targeted at receptors that regulate the growth and be taken into account when considering Cancer patients have traditionally been treated survival of cancer cells (4). likely adherence to cancer therapy” (6). with intravenous (IV) drugs for many years. Oral oncolytics are becoming the standard of Enter the Oral Chemo Parity legislation issue. Indeed, it is the way most of us think about cancer care for many types of cancer although there are The two forms of “chemotherapy” are paid for treatment: the patient in a hospital bed or out- combination treatments in which oral oncolytics dependant on the way they are dispensed. An information sheet for HR 2746, The Cancer Coverage Parity Act of 2011, states: “Insurance has not kept pace with innovation in medicine and the growing trend towards orally administered chemotherapy” (1). States which have passed their Check it Out! own Oral Chemo Parity Acts have done so with the intent that cancer patients have “fair and equal Make your Voice and your Vote Count access to oral therapies.” The bills require health plans to provide coverage “for orally administered anti-cancer medication at a cost no less favorable The Merriam-Webster Dictionary defines Kathleen Sanford highlights the history than the cost of an IV, port administered, or advocacy as the “act or process of advocating of nursing advocacy in her interesting article injected anti-cancer medication” (1). These bills or supporting a cause or proposal.” Additional “Overview and Summary: Nurse Advocates: Past, ensure that access to anti-cancer medications, descriptions run the gambit from communicating Present, and Future. Drawing from the research regardless of delivery method, is maintained and and recommending, to negotiating, to arguing of several authors, Sanford addresses Florence patient don’t have to forgo taking their medication and pleading. Clearly, advocacy is conscious and Nightingale and her consistent passion for change because of the expense (7). purposeful. As we approach state and national and equity in healthcare, the power of the trusted Efforts are underway to introduce Nevada’s Oral elections, it is essential that we understand and nursing profession in influencing policy and Chemo Parity legislation in the 2013 session. articulate exactly what we believe in, and advocate legislation, the value of presenting and maintaining for the changes we envision. a united front when advancing nursing agendas, References If advancing your concerns regarding the future the ways and means of building essential support, (1) www.myeloma.org Cancer Coverage Parity Act of health care in Nevada is a new frontier for you, and the pursuit of partnerships in achieving of 2011 – HR 2746 From Silence to Voice is a must read! Authors leadership and success. Authors’ original works are (2) FDA Approves Capecitabine, First Oral Bernice Buresh and Suzanne Gordon suggest additional resources. Chemotherapy for the Treatment of guidelines for effective communication, exercises Please visit Kathleen Sanford’s January 2012 Metastatic Colorectal Cancer (Aug 1, 2001) that take you from theory to practice to skill, and article in the Online Journal of Issues in Nursing http://www.cancernetwork.com/display/ tips for media presentations. at www.nursingworld.org/MainMenuCategories/ article/10165/78583 Please visit the From Silence to Voice website ANAMarketplace/ANAPeriodicals/OJIN (3) http://www.ons.org/ClinicalResources/ at http://silencetovoice.com/ OralTherapies/Toolkit Looking for information regarding the upcoming (4) 5 Critical questions in the science of VEGF and elections? “Vote Nevada” provides a “general The Online Advocacy Tool, developed by angiogenesis http://www.biooncology.com/ election roster of candidates for 2012 legislature,” the South Central Library System, introduces research-education/vegf/index.html “primary election results,” “election information readers to the advocacy process, and offers (5) Keeping Pace with Oral Chemotherapy http:// from the media,” and so much more! Please visit these keys for success: be persistent, polite, and accc-cancer.org/oncology_issues/articles/ this interesting webpage at http://leg.state.nv.us/ prepared; integrate advocacy into your personal mayjune09/MJ09-Barefoot.pdf Division/Research/VoteNV/index.cfm and professional culture; be thankful for the (6) http://myeloma.org/Advocacy/JOP-2011- In addition, the Legislative Committee of involvement of others and the progress you share; Streeter-46s-51s-1.pdf Patient and Plan the Nevada Nurses Association meets monthly and remain patient – success may take time. Their Characteristics Affecting Abandonment of to discuss relevant legislation and formulate plans action plan is an excellent guideline for beginners Oral Oncolytic Prescriptions – Streeter SB, for legislative priorities. If you would like to attend and experienced alike. Schwartzbery L, Husain N, and Hohnsrud M, these teleconference meetings and learn what the Please visit the Online Advocacy Tool website Journal of Oncology Practice, Vol 7, Issue 3S: Nevada Nurses Association is doing for you, or if at www.scls.info/pr/advocacy/plan.html 46s-51s, 2011. you simply want more information, please email (7) http://myeloma.org/Advocacy/Oral_Parity_ [email protected]. Coalition_Mission_Goals.pdf November, December 2012, January 2013 Nevada RNformation • Page 15 professional practice RNs as Care Baby Boomers and Hepatitis C Wallace J. Henkelman, EdD, MSN, RN, Coordinators Touro University Nevada Wallace J. Henkelman, EdD, MSN, RN Touro University Nevada According to a recent press release from the Baby Boomers do not realize that they are at risk Centers for Disease Control and Prevention (CDC, and, therefore, do not request the test. Testing In June of 2012, the American Nurses May 2012), one in 30 baby boomers (2 million and treatment could potentially save 120,000 lives. Association (ANA) released a position statement on persons) in the United States is infected with Since Baby Boomers are five times more likely care coordination defining it as a core professional the Hepatitis C virus and most of them are not to be infected than other adults, those of us in standard for registered nursing practice. The aware of the infection. Hepatitis C infections are the Baby Boomer generation, born from 1945 and reason for the development of this statement was usually asymptomatic, or nearly so, for years 1965, should probably request the test and nurses articulated as ANA’s commitment to improving or even decades before causing serious health in primary care practice should recommend it to health outcomes, improving quality of life, and problems. Long-term effects include cirrhosis and their patients in that age group. providing greater efficiency in the provision of liver cancer. Liver cancer, one of the long-term health care. The main provision in the position consequences, is currently the leading cause of Reference statement is that: liver transplants and the fastest-growing cause of Centers for Disease Control and Prevention. cancer deaths in the U.S. (2012, May). CDC announces first ever national Patient-centered care coordination is a core Since new therapies for Hepatitis C can cure hepatitis testing day and proposes that all professional standard and competency for all approximately 75% of the infections, the CDC is baby boomers be tested once for hepatitis C. registered nursing practice. Based on a partnership proposing that all Baby Boomers be tested for the Retrieved from http://www.cdc.gov/nchhstp/ guided by the healthcare consumer’s and family’s infection. Current guidelines provide for testing Newsroom/HepTestingRecsPressRelease2012. needs and preferences, the registered nurse is only for persons with known risk factors, but many html integral to patient care quality, satisfaction, and the effective and efficient use of health care resources. Registered nurses are qualified and educated for the role of care coordination, especially with high risk and vulnerable populations (ANA, 2012).

What is care coordination? The National Quality Forum (NQF) defines it as “a function that helps ensure that the patient’s needs and preferences for health services and information sharing across people, functions, and sites are met over time.” Registered nurses have the proven ability to problem-solve and engage in health care activities at multiple levels and in diverse settings which makes them ideally suited for this role. The Institute of Medicine (IOM) has recommended that nurses become full partners with physicians and other health care professionals, which would Come Live the Alaskan Dream facilitate these activities. In the educational setting, the American Association of Colleges of Nursing (AACN) lists Join us at the newest medical center, in Alaska’s among its essential competencies “implementing holistic, patient-centered care across the fastest growing economy. We are highest ranked health/illness continuum, across the lifespan, and in and among all healthcare settings” and in patient satisfaction and core measure scores, in “communicating affectively with all members of the healthcare team.” Generalist baccalaureate nursing the most beautiful place on Earth! program are required to include these skills in their curricula. According to the ANA, “registered nurses and • FT Operating Room RN’s all health care professionals must be permitted to function to the greatest extent allowed by their • FT Labor and Delivery RN education, experience, and scope of practice” (ANA, 2012). Only then will patients and the • FT Physical Therapist community be able to experience quality health outcomes and the health care system experience • FT ED RN efficiency and effectiveness. • FT ICU RN Reference • FT Sterile Processing Tech American Nurses Association (2012, June 11). Care coordination and registered nurses’ essential role. ANA Congress on Nursing Practice and Economics. Retrieved from http://nursingworld. Competitive wages with exceptional benefits org/position/care-coordination package including Medical/Dental/Vision/ Life, 401k with Employer match, Paid Time Off, 32nd Annual High Sierra Critical Care Conference relocation and sign on bonus. Save the Date Silver Legacy March 4, 5, 6, Resort Casino 2013 20 contact hours of continuing education credit for nurses and Apply online at www.matsuregional.com respiratory care practitioners 20 Category 1 credits for physicians—3 ethics courses Regional and National Speakers Representing Premier Medical Centers or email [email protected] An important learning experience with the Thrill of Reno-Tahoe www.alahsccc.org Page 16 • nevada RNformation November, December 2012, January 2013 Promoting Healthcare John Malek, PhD, ARNP respective institutions? Foremost, we should all be a profession, it is our responsibility to support members of our national organization. Through community organizations and groups, educate Nursing as we know it has transcended beyond our contributions our voices and concerns will be the public, facilitate informed choice, and identify the traditional hospital setting. This is no surprise heard, and importantly, acted upon. According to conditions and circumstances that contribute to to many of us as employment and educational the ANA guide, collectively we have a responsibility illness, injury, and disease. We must participate opportunities have shown. As a result, efforts in to be knowledgeable about the health status of in institutional and legislative efforts to promote promoting healthcare have also transcended the the community and existing threats to health and health and meet national health objectives. We “traditional” patient and now include community, safety. must focus on what unites us. Human life is human national, and international healthcare issues. This election year, the next president, every life, and placing more value on one individual over These issues include world hunger, homelessness, House seat, and 33 Senate seats are up for grabs. another is an atrocity of enormous proportions. poverty, human rights, access to healthcare, With the upcoming election, the next president We should not be so concerned with the everyday cultural diversity, and distribution of resources. and Congress could make decisions about the political attacks but rather be more concerned Accordingly, our approach to care has also evolved future of Social Security and Medicare that will and informed on what our individual leaders to affirm human dignity and respect for cultural affect generations to come. It has always been will support and fight for. As communities we values and practices. While much of our care is my personal opinion that quantity for the sake should provide examples of our accomplishments, delivered to individuals, and despite the plethora of of meeting the bottom line does not correlate continuing to focus on the solutions rather than to nursing literature available, understanding of these to quality in the delivery of healthcare. The remain stagnant in the problems. Make your voice concepts is best explained within the American implementation of healthcare policies that diminish count, make your vote count, lend support and Nurses Association Guide to the Code of Ethics for the delivery of quality healthcare to all individuals know that in some small way you have contributed Nurses. According to the ANA guide, “the nurse is a viable argument for the promotion of health to promoting healthcare for all individuals and not collaborates with other health professionals and and ethical treatment of all. We are in the grips of just a select few. If we don’t do it, someone will do the public in promoting community, national, and many health epidemics locally and internationally. it for us! Who you are does make a difference and international efforts to meet health needs.” Our We are the greatest nation in the world, yet we should continue to fight for what is ethically guide does not state that our concerns should we allow individuals to sleep under bridges, die right and just for our communities, wherever they be limited solely to the organization for which without dignity, and many of our children do not may be. Let us continue to make each day count, we work or the community in which we live. So even have one substantial meal a day. Who will for ourselves, our nation, and our world. how do we affect change outside the walls of our be the voice for those too weak to speak? As

We Need A National Nurse for Public Health Pat Van Betten, RN

Nursing continues to be visibly and effectively This action by Congress would blend so And finally, let’s never forget the words of involved in President Obama’s efforts to improve beautifully into the leadership role that nursing Margretta Madden Styles: national health care, and the cornerstone/ holds with this administration, and works in perfect overarching issue driving much of health care harmony with all that nurses envision for a healthy I have encouraged nurses everywhere to reform is the need to contain costs. One way to do America. Think of a world in which nurses are a strong, this is to put more emphasis on prevention. Studies No other administration has made disease vital, and dynamic social force. show that the American public supports efforts for prevention and healthy lifestyles such a priority. Think of a world in which nursing is at the disease prevention and health promotion, and looks This is the perfect time to focus on public health forefront of health care. to nurses for leadership and resources to help with as an achievable national priority, and highlight Think of a world in which the word ‘nurse’ has a this. the significant roles nurses can play in health singular, positive meaning and the image of Many members of Congress are co-signers for promotion. nursing is sharp and distinct in the eyes of the HR 3679 The National Nurse Act of 2011, We have historical precedents for this position public. which will designate the Chief Nurse Officer of the being full time, very involved, and very visible. HR Think of a world in which nursing speaks with U.S. Public Health Service as the “National Nurse for 3679 restores to nursing the national prominence one voice. Public Health” to elevate the authority and visibility we have previously enjoyed. Think of a world in which nurses bring honor and of this existing position. This legislation supports When Lucille Petry Leone served as the first reward to themselves, to all women, to all further work needed to promote prevention, female Chief Nurse Officer and Assistant Surgeon people. improve outcomes, and guide national, state, and General she had high visibility. The position had Think of a world in which the words of Florence local efforts in addressing the nation’s health. the equivalent rank of rear admiral in the navy or Nightingale, ‘No system shall endure that The time is right for this. President Obama has brigadier general in the army, and she was pleased does not march’ resound through our daily shown that he values nurses by including us in the that her rank elevated the stature of nursing. In lives. planning of health care reform, and by appointing addition to serving as director of nursing education Think of a world in which the Director General nurses to strategic national positions. That is a for the USPHS, Leone was the technical expert of the World Health Organization is a nurse. tribute of nursing’s decades of political involvement on nursing for the World Health Organization. This, by the way, is my dream for nursing. at the national level as an informed and committed She was also the administrator for the Division of (1985). profession, always striving to improve society and Nurse Education of USPHS to oversee the Cadet assure more social justice. This kind of valuable Nurse Corps during WWII. In 1977 she wrote, “The Let us have someone, full time, to put a publicly consultation of nurses began long before Lillian horizon for nursing expands exhilaratingly. The recognized national face on nursing. Let us have Wald’s effective lobbying for the Children’s Bureau depth has not been sounded. So we explore depths someone, full time, to continue to advocate for and can be documented as part of every national and distances… The distant star is the health of all nursing involvement in health policy, someone to achievement related to health care reform. people.” provide leadership for nursing in a way that both Another example, Faye Glenn Abdullah, retired enhances the profession and strengthens nursing’s as Deputy Surgeon General for the USPHS with the involvement in health care issues. Let us have Alpine Hematology-Oncology rank of two star rear admiral. She left a legacy in someone, full time, whose examples of leadership We thank our Nurses for their dedicated service. nursing research, theory and education that helped and involvement emphasis the vital importance of define progressive, patient centered care, including nursing to the health of the public. Let us have this 236 West 6th St., Suite 400 Reno, Nevada 89503 the first federally tested coronary care unit. qualified professional to work in a complementary Office (775) 329-0873 Abdullah enhanced nursing school curricula and and very visible way with the Office of the Surgeon Fax (775) 329-1026 helped establish national health policy related to the General. Such effectiveness would be a very strong www.alpinedoctors.com AIDS epidemic as well as the needs of the elderly. natural recruitment tool as well. Steven A. Schiff, M.D. John A. Shields, M.D. She promoted advanced nursing practice, especially For more information on how you can get Sowjanya Reganti, M.D. Margaret Van Meter, M.D. in areas of school health, care of the elderly and involved to help move this legislation forward, visit Julie Simeoni, MN, APN veterans. http://nationalnurse.org. November, December 2012, January 2013 Nevada RNformation • Page 17 Saint Mary’s Mission Outreach and HAWC Community Health Centers Partner to Enhance Health Care Services and Programs in Northern Nevada

Saint Mary’s Mission Outreach and HAWC populations to receive medical treatment. Through goal by caring for many of our citizens with very (Health Access Washoe County) Community Health Saint Mary’s Dental Sealant Program and Mobile limited resources,” the honorable Bob Cashell, City Centers are proud to announce a new partnership Dental Clinic, thousands of children and adults of Reno Mayor. to enhance health care services in northern have enrolled in the programs and now receive “As a founding supporter of many of Saint Nevada. The two organizations merged to become, regular oral health education and services. Mary’s Mission Outreach programs as well as Community Health Alliance (CHA) effective July Additionally, Women, Infant Children (WIC) has HAWC Community Health Centers, the Nell 1, 2012. The merger will provide greater service rapidly grown into a respected community partner J. Redfield Foundation is excited to see this opportunities and enhance the organization’s who offers nutrition services for at-risk and low- innovative partnership. It is our belief that ability to provide healthcare for the community. income women and their young children. Immunize collaboration and cooperation can achieve greater “Our focus has been on providing health care Nevada successfully increases vaccination results than any one of us on our own. Working services that are affordable and accessible, and awareness statewide to parents and health care together, these organizations will continue to serve we are committed to maintaining these program providers through community outreach, education the health care needs of our region,” said Jerry services for the future of our community,” said and advocacy. Lastly, the Nevada Comprehensive Smith and Jeanne Jones, directors of the Nell J. Mike Johnson, vice president, Community Health Cancer Coalition worked collaboratively with local Redfield Foundation. and Mission Integration at Saint Mary’s. “We share cancer centers to develop strategies focusing on “A strong safety net of primary care is essential the same values and mission as HAWC and by decreasing cancer incidence and mortality rates. for this community and the combined forces of merging both organizations, we can collaborate to Each of the programs offered by Saint Mary’s have HAWC and Saint Mary’s mission programs will enhance the services our community receives.” made a positive impact in the community and ensure the most vulnerable in our community “The mission of the HAWC clinics and of Saint measurably improved the health of the region. can continue to receive the care they need,” said Mary’s Outreach programs are virtually the same— HAWC was founded in 1988 when John Scott, Thomas L. Schwenk, M.D., dean, University of to serve the underserved by providing high quality M.D. and the Washoe County Medical Society Nevada School of Medicine. affordable, comprehensive, primary health care sought a way to provide basic health care Saint Mary’s Mission Outreach and HAWC will to those in need. HAWC, its Board of Directors, resources to populations in need. In 1995, HAWC merge effective July 1, 2012. To learn more about management, providers and all our employees opened its first medical program and has since this partnership and the future direction of the welcome the challenge and opportunity to work expanded to offer low-cost family medicine, organization call Mike Johnson at 775-770-3951. To together and continue our now joint mission of pediatrics, internal medicine, chronic disease inquire about program services or appointments, health care service,” said Dan Ahearn, M.D., chief management, laboratory and x-ray services, call the numbers listed below: executive officer of HAWC Community Health women’s health care, dentistry, health care for Centers. the homeless, mental health services, and on-site HAWC, Wells Avenue – 775-329-6300 Since 1992, Saint Mary’s Mission Outreach has pharmacy services. Currently, HAWC operates HAWC, Virginia City – 775-284-3570 provided medical, dental, women’s health and medical facilities on Wells Avenue, in the Record Nell J. Redfield Health Center, Neil Road – preventive services to thousands of community Street complex and in Virginia City. Throughout 775-770-3780 members. The resources offered by Saint Mary’s the years, the organization has provided services Nell J. Redfield Health Center, Sun Valley – have helped educate the community about to thousands of individuals, children and adults in 775-674-5437 preventive health care and the importance northern Nevada as a Federally Qualified Health Women, Infant, Children (WIC) – 775-770-7500 of healthy living. In 2011, the Nell J. Redfield Center (FQHC). Mobile Dental Program – 775-770-7888 Health Centers served over 29,000 patients and “The health and well-being of all segments of Northern Nevada Dental Health Program – successfully implemented programs ranging our community is what will allow our region to 775-770-6609 from women’s health to pediatric asthma care prosper in the future. These two organizations Immunize Nevada – 775-770-6713 and chronic disease management. The Centers coming together will help achieve this important Comprehensive Cancer Planning – 775-770-6703 has become a vital resource for disadvantaged

UNIVERSITY OF NEVADA, RENO Orvis School of Nursing www.unr.edu/nursing

B.S. in Nursing RN to BSN M.S. in Nursing FNP Nurse Educator Clinical Nurse Leader DNP (Doctor of Nursing Practice) (A collaborative program with UNLV) University of Nevada, Reno Statewide • Worldwide Page 18 • nevada RNformation November, December 2012, January 2013 Prevention Plays Powerful Role in Fight Against Fetal Alcohol Spectrum Disorders John Packham, PhD Director of Health Policy Research at the University of Nevada School of Medicine and President Elect of the Nevada Public Health Association

Prenatal exposure to pregnant and there is no known safe time to drink Vegas are first screened for alcohol, tobacco and alcohol and other drugs alcohol during a pregnancy. Indeed, a baby’s drug use. Those women with a positive screen for is the leading cause of brain and central nervous system are developing alcohol or drugs then undergo a more thorough preventable birth defects throughout pregnancy and can be irreparably assessment for substance use through a follow and intellectual disabilities damaged at any time. up structured clinical interview conducted at the in Nevada. Children born same prenatal visit. The screening process utilized to women who use alcohol Preventable disorder by participating FASD clinic sites in Nevada also during pregnancy have an The good news is that the problems associated represents an opportunity to ensure that infants elevated risk for a number with prenatal alcohol exposure are 100 percent prenatally exposed to alcohol and illicit drugs of lifelong negative health preventable – if a woman doesn’t drink alcohol are identified and referred into early intervention and developmental outcomes. while she is pregnant, her child will not suffer from programs. Despite the documented dangers of prenatal an FASD. Among the nearly 11,000 pregnant women alcohol consumption, surveys consistently reveal Equally encouraging news is the recent success screened thus far, 23 percent were smoking that 1 in 10 pregnant women in the US report use of efforts in Nevada to reduce the number of cigarettes in early pregnancy, 28 percent were of alcohol and an estimated 2 percent of pregnant disorders resulting from prenatal alcohol use drinking alcohol, 4 percent were smoking women binge drink during the course of their through the identification and screening of those marijuana, and a little over 1 percent were pregnancy. These figures probably understate the women whose pregnancies are at risk from alcohol using other illicit drugs, such as cocaine and magnitude of the problem and are undoubtedly and other substance abuse. methamphetamine. higher in Nevada considering our state’s above- Over the past three years, the Nevada Overall, 38 percent the pregnant women had a average levels of adult alcohol consumption and Fetal Alcohol Spectrum Disorders Project, a positive screen for substance use – that is, they binge drinking, as well as unhealthy levels of collaborative prevention effort spearheaded by were using alcohol, tobacco and/or marijuana alcohol use among women of childbearing age. public and private agencies across Nevada and the during early pregnancy. From a polydrug use Fetal Alcohol Spectrum Disorders or FASD is Children’s Research Triangle based in Chicago, has perspective, nearly 2 in 5 pregnant women were an umbrella term used to describe adverse health screened over 10,000 women seeking pregnancy- using more than one substance, most often a effects that can occur in an individual whose related services at clinics in Reno, Carson City, combination of tobacco and alcohol. mother drank alcohol during pregnancy. These Winnemucca, and Las Vegas. include stunted or delayed growth, malformed In its brief existence, the project has High cost of FASD facial features and other physical abnormalities, demonstrated that a careful screening and brief While interventions and management are cognitive impairment and related disabilities, and intervention in the lives of pregnant women available for specific symptoms of FASD, the health a host of behavioral problems. The most serious using alcohol, tobacco, and illicit drugs can play effects of FASD are permanent and cost the nation disorder is fetal alcohol syndrome or FAS, which a powerful role in reducing the number of babies a staggering $4 to 6 billion annually – an FAS birth, is the leading known cause of mental retardation harmed by such exposures, not to mention for example, carries lifetime health costs that, on in the US, surpassing Down syndrome and spina reducing the costs associated with managing and average, exceed $1 million. bifida. treating related disorders down the road. The implications of increased screening on An estimated 40,000 babies nationwide are Dr. Ira Chasnoff of the Children’s Research health system costs in Nevada, not to mention born each year with some type of disorder linked Triange notes that “published studies have preventable suffering for children, parents and to prenatal alcohol use. Indeed, more children indicated that by screening and assessing women other care givers, are thus enormous. Statewide are affected by prenatal exposure to alcohol than in the prenatal period and providing an educational FASD Project Coordinator Shelly Young concludes juvenile diabetes and cancer combined. intervention, you can significantly reduce the “the value of this project extend far beyond human Much remains to be understood about fetal effects of the alcohol exposure and improve the and financial boundaries. With continued support alcohol spectrum disorders. Current research is long term health of the child.” and expansion we have an opportunity in Nevada nonetheless unequivocal on two points: there is All women seeking prenatal care in participating to save lives and to save money during these no known safe amount of alcohol to drink while clinical programs in northern Nevada and Las difficult economic times.”

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Black/Black EVERYTHING MEDICAL 1811 W. Charleston Blvd. 6960 W. Warm Springs Rd. Las Vegas, NV 89102 Las Vegas, NV 89113 (702) 366 -1111 November, December 2012, January 2013 Nevada RNformation • Page 19 student corner Healthy Nurses, Healthy Nation Khadeja Bilali, Nursing Student Touro University Nevada

A nurse’s job is without at least one half hour break? Nurses help be a change in nursing eating habits, because to assist patients in patients restore their health, but they should take our community needs them to be healthy. Poor restoring their health, under consideration that their body needs an eating habits may lead to more nursing shortages, but do nurses really adequate amount of nutrition and rest. because our body speaks when it’s not treated care about their Consuming junk food, such as cookies, chips, properly; even a robot would shut-down when own health? During and soda does not replace a good nutritious meal. over-used. In addition, stress associated with the my clinical training Nurses are patients’ educators, and they should work load and the constant work may lead to hours, I have seen that nurses have a lot on their set a good example; patients or patients’ family serious issues. For instance, it may lead nurses plates to meet their patients’ needs. For a day do observe, and in order for their advice to be to hate their job and have a negative energy and shift nurse, this is how their day starts. First they accepted when discussing healthy nutrition, their environment that would not only affect them and obtain change of shift report; second, introduce actions shouldn’t contradict their stated beliefs. their colleagues, but their patients as well, causing themselves to their patients; third, getting lab According to MyPyramid, nutritious snacks should medical errors, uncontrolled stress, tension, and so and med orders organized and prioritized; fourth, include fresh vegetables and fruits, vegetables and on. administer medications as scheduled. The check fruit juices, dried fruits, nuts and seeds, as well as Meal and rest breaks are mandated by federal list never ends until the pm nurse arrives , and the grain products. This is just for nutritional snacks; law, so this should be implemented in all hospitals cycle starts all over. what would be considered for a nutritious lunch? settings, regardless of the employee’s choice, even My question is, how could it be possible that The main question I have is what might be the if they are unpaid ones. Nurses should invest in our body functions by working 12 hours straight main cause for nurses skipping their lunch break? their health, because they certainly need it both Is it the shortage? I do believe that there must now and when they retire. Transitioning from Student to RN….and Back Again Christy Apple-Johnson, RN

This summer has been their family at the end of the day. employment. For example, the Nevada State Board a challenge for me— When I began nursing school, I pledged to be of Nursing will no longer notify those up for re- emotionally and mentally. a lifelong learner and to never accept not knowing licensure to reapply unless fingerprints are needed I graduated with my the answer to a question as the end point to any from what I recently learned. If there are changes associate’s degree, passed situation (I still spend hours buried in Tabers at to the practice laws within our state, we must take the NCLEX, and took on times). All of us took a similar pledge. It is our the time to educate ourselves of those changes my first job as a Registered ethical duty, despite how we are feeling on any and be up to date on our delivery. If there are Nurse in the field of particular day. I have been plagued with day-long potential changes in the near future to practice Emergency Nursing. I am morning sickness for weeks on end, but I must laws, we should examine them and advocate for continuously flashing back still assess the sights and smells that may send me the change that will benefit our patients the most. to the chapter in my trends running to the nearest trash can after I leave the All of these things require a balance of our time book about “role transition room. Just as it is my responsibility to be thorough and effort. They require the motivation to choose strain.” Reading about it and applying it are in my assessments, we all have a responsibility to learn and do what is best for the greater good worlds apart as you all already know. There is no to understand the health care atmosphere that rather than our own immediate selves and circle of textbook that ever quite prepares you for this. My surrounds us within and outside of our place of loved ones. This is why I became a nurse. This is school did an excellent job addressing this subject why I remain a student and always will. so I am fortunate enough to have an awareness that prepared me for this trial. Now that I am a RN, I can easily see why so Continuing Education for Healthcare Professionals! many nurses put off returning to school for their BSN (or leave the nursing profession altogether within the first year on that matter). I am just barely getting my bearings as a working nurse and now I am reorganizing my life once again to Providing statewide access to online be a student. Who wants or needs that added responsibility? The perspective I have developed health professional continuing to cope is this: I am a nurse and I will always be education and training courses that a student, whether I enroll or not. The day that I are convenient, affordable and geared quit learning is the day that I am no longer allowed just for you! to consider myself a nurse. This is my pledge to my patients and to my employer. Additional www.highsierraahec.org schooling is but an extension of what I do on the job each day. Rural Nevada needs highly educated and involved health care professionals to tackle the Find Yourself in Majestic Northwestern Montana... obstacles that lie right in front of us. Even if you choose not to continue your education, do ER Nurses—Make the move! you learn something new every day? Are you We have two openings available immediately for experienced aware of what is occurring in nursing legislature? Emergency Room RNs in our beautiful Western Montana Community. Do you understand the forecast of changes to Competitive Salary and Excellent Benefits including paid time off, your daily practice? I understand that it can medical/dental/vision, retirement and student loan repayment! feel overwhelming to bother with these things. Must have two years ER experience, have or obtain a Montana RN license, As a wife, mother, full-time employee, student, and current BLS and ACLS certification. and highly involved professional student nursing Interested applicants call Erin at 406-283-7168 organization board member, I am very empathetic For more information and to apply online, please visit to those that simply want to get a paycheck and www.sjlh.com Click on the careers tab! have enough time to sleep and spend time with EEOE Page 20 • nevada RNformation November, December 2012, January 2013 NAPNA CEU Event Nursing Associations in Nevada

The first NAPNA CEU event will occur on American Association of Kimberly (800) 899-2226 [email protected] October 20th, 2012 at the Grand Sierra Resort. Critical Care Nurses Acker-Fitzpatrick www.aacn.org & [email protected] Participants can earn up to 6 CEUs during the event for only $30. There will also be drawings American Association of Wren Ballard [email protected] for various items including wine baskets and Neuroscience Nurses- www.aann-nnc.org memberships to NAPNA and AANP. Northern Nevada Chapter

Topics covered during the event are: Association of periOperative Ren Scott- (702) 383-7326 [email protected] • Diabetes Mellitus: Registered Nurses Feagle Las Vegas ~ Sleep Apnea ~ Breast Cancer Healing Touch Program, Terry Kunz (702) 493-0695 www.terrystouch.com ~ Screening for Cardiovascular Disease Las Vegas RN, LMT, HTCP [email protected] (includes hands on workshop) Hospice and Palliative Nicolina Miller [email protected] or Nmillerrn- • COPD: overview and treatment strategies Nursing Association in [email protected] Northern Nevada Registration is between 7am and 8am on Saturday, October 20th, 2012. For an event form, National Association of Maria Lipscomb (702) 239-9684 [email protected] contact [email protected]. Please feel free Hispanic Nurses to share this will all APNs, PAs and students. Nevada Nurses Association Margaret Curley (775) 747-2333 www.nvnurses.org & [email protected]

Nevada Organization of Susan Adamek (702) 995-0239 [email protected] Nurse Leaders High, but Normal, Blood Nevada State Association Jeanine Clancy www.nevadaschoolnurses.com or of School Nurses or [email protected] Glucose Levels and Debbie Pontius

Cognitive Impairment Philippine Nurses (702) 258-1224 PNANV.org Wallace J. Henkelman, EdD, MSN, RN Association of Nevada Touro University Nevada Preventive Cardiovascular Kim Newlin [email protected] Nurses Association pcna.net As part of a longitudinal study on aging done in Australia, fasting blood glucose levels were Society for Vascular Nursing Kathy Ware (916) 734-7701 [email protected] measured and correlated with the results of MRI (Sierra Chapter) or www.svnnet.org brain scans in cognitively healthy, nondiabetic (888) 536-4SVN individuals over a period of four years. The (4786) average age of the 250 participants was 62.5. After controlling for age, sex, body mass index, Southern Nevada Black Marcia Evans (702) 615-3575 www.snbna.net hypertension, alcohol use, and smoking, it was Nurses Association or noted that there was a significant correlation (702) 338-0524 between high blood glucose levels and atrophy of the hippocampal and amygdalar regions of Wound, Ostomy, Joyce Moss www.pcr.org the brain. This correlation was significant even Continence Nurses for blood glucose levels within the normal range, but near the high end of that range. The high end of the range, as defined by the World Health Organization, was designated as 110 mg/dl. for The hippocampus is associated with memory formation, primarily the conversion of short-term Search Balance to long-term memory and with spatial orientation. Incidentally, it is one of the first brain structures to be damaged by Alzheimer’s disease. The amygdala is also associated with memory and also with neurological arousal and emotional states. Damage to these areas could be associated with progressive cognitive impairment and dementia.

Perhaps nurses doing blood glucose screenings should be more concerned about detecting individuals with high normal blood glucose levels and counseling them on lifestyle changes that could bring their glucose levels down to safer levels. The American Diabetes Association is a Find your perfect valuable source of information on possible changes such as weight loss, exercise, and healthy dietary nursing career on habits. Such counseling could help prevent future cognitive decline in affected individuals. Cherbuin, N., Sachdev, P., & Anstey, K. J. (1012). nursingALD.com Higher normal fasting plasma glucose is Registration is free, fast, confidential and easy! You will receive an associated with hippocampal atrophy: the PATH e-mail when a new job posting matches your job search. Study. Neurology, 79(10), 1019-1026. November, December 2012, January 2013 Nevada RNformation • Page 21 Nurses At Renown Earn State’s Only Pathway To Excellence Honors

RENO, Nev. (Aug. 23, 2012) – Earlier this • A balanced lifestyle is encouraged the dedication and determination of our nurses month, Renown Regional Medical Center and • Collaborative interdisciplinary to keep patient care the priority in this ever Renown South Meadows Medical Center became relationships are valued and challenging and changing healthcare the first and only Pathway to Excellence® supported environment,” Lorraine Haines, MSN, hospitals in Nevada. Only 87 hospitals out of more • Nurse Managers are RN, said. than 5,000 nationally have earned the award. competent and accountable “I cannot over-emphasize the Additionally, only 23 states have such designated • A quality program and significance of the Pathway to hospitals, most of which being located on the east evidenced-based practices Excellence distinction for Renown coast. are utilized Regional and Renown South The Pathway to Excellence award honors a work Meadows Medical Center nurses, environment designed to improve overall nursing The Pathway to Excellence our patients, our community, and satisfaction and improve retention of quality award identifies the elements of our state,” said Jennifer Richards, nursing staff. Pathway to Excellence recognizes a work environments where nurses PhD, RN, “I am honored to be part number of elements of an ideal nursing practice flourish and as a result, where optimal of this truly remarkable achievement, environment. Among others, they include safety in patient care is delivered every day. which has put Nevada on the map in a very the work environment, systems to address patient “Receiving this honor is a great recognition of positive way.” care concerns and nurse recognition. “Your dedication and commitment to excellence truly let us stand out as leaders in healthcare,” Jeff Stout, MSN, RN, Chief Nursing Officer at Renown Regional, said in an initial announcement to nurses and employees throughout the Renown Health network. “We have joined an elite fraternity of chosen hospitals who demonstrate an ongoing commitment to going above and beyond and placing our patients and families at the center of all of our decisions. This is evidence of the amazing work you do every day. I am so proud to be part of Renown.” The honor, granted by the American Nurses Credentialing Center (ANCC), is based on the confirmed presence of characteristics known as “The Pathway to Excellence Criteria.” For an organization to earn the Pathway to Excellence distinction, it must successfully undergo a thorough review process that documents foundational quality initiatives in creating a positive work environment, as defined by nurses and supported by research. These initiatives must Visit our website for current nursing be present in the facility’s practices, policies and culture. Two separate 500+ page documents were opportunities submitted from the two hospitals. The written documentation included evidence to support how each hospital meet the 12 Pathway to Excellence www.carsontahoe.com Practice Standards: • Nurses control the practice of nursing • The work environment is safe and healthy Recruiter: 775.445.8678 • Systems are in place to address patient care and practice concerns Job hot line: 888.547.9357 • Orientation prepares new nurses • The Chief Nursing Officer is qualified and Carson City, Nevada participates in all levels • Professional development is provided and (Located in Northern Nevada, near Lake Tahoe and Reno) utilized • Competitive wages/salaries are in place • Nurses are recognized for achievements

Serving the needs of local professionals since 1997 Carson Tahoe Regional Medical Center Features: • JCAHO accredited • 144 beds (138 private rooms) • Comprehensive healthcare system

We are located at: • Growth opportunities 941 Jacks Valley Rd, Suite A, Carson City, NV 89705 (775) 783-9191 • Competitive salaries Scrubs • Fashion Whites • Shoes • Medical benefits Medical Accessories • Gifts Visit us online at: • Generous 401k www.uniformityusa.com • Vacation / Sick leave • Paid holidays • Education assistance EOE Page 22 • nevada RNformation November, December 2012, January 2013

REGISTERED NURSES Full-time positions available for: ICU, Emergency Room, Med/Surg, Labor & Delivery, and Surg Tech. Nevada license required. We offer competitive salary DOE; excellent benefits including Public Employees Retirement, group insurance benefits, accrued PTO & Sick Leave. Contact HR Director Humboldt General Hospital 118 E. Haskell Street, Winnemucca, NV 89445 [email protected] Fax (775) 623-5904 EOE Employer Non-smoking facility, non-smoker preferred.

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EACH CLASS IS PRESENTED AS A STAND ALONE MODULE & CAN BE TAKEN IN ANY ORDER OR LOCATION

$15,000 Sign on/Relo RN’s $7,500 for LPNs Family Members looking For gainful Employment? • North Dakota’s oil boom = jobs + $ $$!! Experienced RNs & LPNs • Only sharp new Grads needed for perm, LTC and clinic positions in not-for-profit facility in “Majestic” North Dakota Looking for • North Dakota known for its blue skies, friendly people, top ranked experienced public schools, low crime, and booming economy!! • Sign-on bonus paid your first RNs, LPNs paycheck. $5000 for RNs, $2500 for LPNs. Complete 1 year agreement and get option for 2nd year and the remainder of bonus money. and • Wholesome family location/Jobs galore! • Relo assist. Reimbursement up to RN Liaison $5,000 for RNs and $2500 for LPNs. • Free Retirement Pension, fully funded by employer, no employee contributions required = more $$ in your pocket. • Low cost health insurance premiums; coverage begins within 2 wks of start. FOR FREE INFORMATION CALL Please fax resume to 702-696-1003 or email Jim Cox Staffing Consultant to [email protected] 1-800-304-3095 ext 101 Email: [email protected] November, December 2012, January 2013 Nevada RNformation • Page 23

Nevada Substance Abuse Prevention and Treatment Agency (SAPTA) The mission of SAPTA is to reduce the impact of substance abuse in Nevada. SAPTA funds services with private non-profit treatment organizations, community level prevention organizations in all 17 Nevada counties, and governmental agencies statewide. Treatment Services Offered • Detoxification • Residential treatment services • Outpatient counseling • Opioid maintenance therapy • Comprehensive treatment priority admission or interim services to pregnant women: • Pregnant injection drug users • Pregnant substance abusers • Non-pregnant injection drug users Prevention Services Provided • Provide Federal and State funding to local and regional coalitions who fund community level direct service providers to provide evidence-based programs, practices, and policies, on identified substance abuse and related factors in communities • Provide Federal and State funding to local and regional coalitions to provide environmental strategies to change community norms • Provide training and technical assistance For questions or resources contact SAPTA at: Carson City: 775-684-4190 Las Vegas: 702-486-8250 Website: http://mhds.nv.gov (Scroll to the end to find the link to SAPTA)

Kaplan College Las Vegas–School of Nursing is accepting applications for Full-Time Instructors. Must have MSN and Clinical Experience. OB, Peds +/or Psych Speciality Preferred.

Please send resumes to DON Dr. Katherine Cylke: [email protected] Page 24 • nevada RNformation November, December 2012, January 2013

Paris Las Vegas HoteL | May 2-4 EArn 16 cE crEdits (Includes 3 Hours of Pharmacology) April 5, 2013 EArly BIrd rEgIStrAtIoN dEAdlINE PCNA MEMBEr – $249 | NoN-MEMBEr – $399 rEgistEr todAy At www.pcnA.nEt/symposiumnv

progrAm topics • New NHlBI guidelines for the Management of Patients at Increased risk for CVd • A Practical Approach to the Management of Hypertension: 2013 Update • Prescribing Exercise for Patients with Heart disease: Keeping it Safe • Sex Matters: Insights from WISE • time is Brain: optimal Care of the Stroke Patient in 2013 • Calculating the CVd risk Score: Which tool for Which Patient? • the role of Mobile technology in Improving Cardiovascular Health • Health Coaching: A Key role for Cardiovascular Nursing • Surgical Approaches to Weight loss: role in CVd risk reduction • Palliative Care for the CVd Patient: When the goal is Care-not Cure

PCNA Preventive Cardiovascular Nurses Association

PCNA’s 19th Annual Symposium is your source for cutting-edge information, best practices, and national guidelines in cardiovascular risk reduction and disease management.