September 2010 Access

VOL XXXII NO 3 SEPTEMBER 2010 ACCESS

in THIS ISSUE: Online Registration is coming in 2011 • Innovations • CCP Update • Nurses of Note: Primary Health Care Practitioners . . . & more! Council ARNNL STAFF

Bev White, President Executive Director Pegi Earle 753-6173 Cathy Stratton, President Elect [email protected] Patricia Rodgers, Eastern Region Director of Regulatory Michelle Osmond 753-6181 Sandra Evans, Central Region Services [email protected] Anne Doyle, Western Region Director of Policy Lynn Power 753-6193 Beverly Pittman, Labrador/Grenfell Region & Practice [email protected] Cathy Alyward, Advanced Practice Director of Communications Janice Lockyer 753-6198 Evelyn Peyton Murphy, Practice [email protected] Madonna Manuel, Education/Research Cathy Burke, Administration Director of Corporate Services Elizabeth Dewling 753-6197 [email protected] Bea Courtney, Public Representative Ray Frew, Public Representative Nursing Consultant – Siobhainn Lewis 753-0124 Policy & Practice [email protected] 2 Public Reps to be appointed Pegi Earle, Executive Director Nursing Consultant – Beverley McIsaac 753-6174 Regulatory Services & [email protected] Advanced Practice

Project Consultant JoAnna Bennett (part-time) 753-6019 QPPE [email protected]

Research Analyst & Julie Wells 753-6182 ARNNL Trust [email protected]

Administrative Assistant to Christine Fitzgerald 753-6183 contents Executive Director & Council [email protected] Administrative Assistant to Jeanette Gosse 753-6060 Consultants & Workplace [email protected] Representative Program 1 | Message from the President Administrative Assistant to Jennifer Rideout 753-6075 Consultants, ACCESS & QPPE [email protected] 2 | Welcome All Internationally Educated Nurses to Newfoundland and Labrador ED Administrative Assistant to Colleen Jones 753-6041 Consultants & Professional [email protected] 3 | Taking a Closer Look at the Glass Conduct Review Administrative Assistant to Renee Reardon 753-6040 4 | Membership Survey Consultants, Data Processor [email protected] &Registration 6 | Online Registration: Coming 2011

7 | Clinical Corner ACCESS is the official publication of the Association of Registered Nurses of 8 | Continuing Competency Program: Registered Nurses Newfoundland and Labrador. Embrace Lifelong Learning ACCESS is published three times a year in January, May and September. Subscriptions are available for $25.00 per year. 10 | Innovations ON THE COVER: 2010 Awards for Excellence in Nursing Recipients Judith Wells, RN, BN, MN 11 | Rise and Shine Sleepyhead! - Award for Excellence in Nursing Research, Dr. Sandra MacDonald, RN, BN, MN, PhD - Award for Excellence in Nursing Education, Joan Bursey, RN, BN, MHS - Award for Excellence in Nursing Administration and Meiko Walsh, RN, BN - ARNNL Elizabeth Summers Novice Nurse Award. 12 | Branching Out: The Nurse Practitioner Role in Mental Health and Addictions

13 | Nurses of Note Editor | Janice Lockyer, Director of Communications

18 | Student’s Call to Action Advertise in the next issue of ACCESS 19 | 2010 BN Graduates Contact Janice Lockyer, Director of Communications, ARNNL [email protected] 753-6198 22 | ARNNL Trust: Call for Applications 55 Military Road St. John’s, NL A1C 2C5 Ph: (709) 753-6040 Fax: (709) 753-4940 Toll Free: 1-800-563-3200 email: [email protected] www.arnnl.ca

©Association of Registered Nurses of Newfoundland and Labrador (ARNNL). All rights reserved. For editorial matters, please contact the editor. The views and opinions expressed in the articles and advertisements are those of the authors or advertisers and do not necessarily represent the policies of ARNNL.

Access VOL xxXII NO 3 september 2010 fromMessage the President

It is with great pride that I begin my role as ARNNL President for the next two years. I thank you all for the privilege to act in this leadership role for the nursing profession in Newfoundland and Labrador. Over the last several years there have been great changes to the health care system and this change will continue as we strive to reorient the health care system to improve care and services to the province.

Leadership in nursing is about moving forward together to make a difference and we need to be vibrant, creative and innovative as we strive to make a difference in these difficult times. We are all leaders. Some of us are quiet leaders who affect the lives of those we interact with Iin ways that we don’t even realize; others are leaders in a more traditional role by virtue of occupying a leadership position. While the role of ARNNL President is a formal leadership position, the direction of this leadership will be guided by all of you, the ARNNL membership, as you share your input and participate in activities to move the mandate of the association forward to achieve excellence in nursing, public protection, quality healthcare and healthy public policy.

Some of the things that I would like to do while in this position include: • A review of the ARNNL ENDS to condense them in number so that we can focus on what is most important to us and what we have most control over; • Ensure that we protect the things that we are passionate about, such as self-regulation, a publicly funded health care system and nursing’s contribution to health care; • Find more ways to engage young nurses in association activities; and • Implement a written President’s report for the ongoing orientation of the President-Elect.

I recently had the honor of sitting near the Canadian Nurses Association (CNA) board table for orientation to that part of my role. It was very exciting to hear nurse leaders from across the country provide input into the direction of the CNA and nursing in the future. Topics discussed included chronic disease prevention and management, the determinants of health, primary health care, scope of practice, pandemics, skill mix, maternal/child health and healthy aging to name a few. As I sat there, I couldn’t help but think about how I might come to contribute to these conversations, as they include the very topics I have spent my career working on and speaking passionately about. It was at that point that I realized how much I am going to enjoy this volunteer role over the next 2 years and that I plan to seize every opportunity that comes with it. That piece of the orientation provided me with a glimpse of the affect that individual representatives from each province can have on nursing in this country. I know that we will only get out of it what we put into it, which I plan to maximize to the best of my ability.

I am honored and thankful for the opportunity to take on this leadership role, and I feel excited and passionate about what lies ahead. I would like to thank outgoing president Jim Feltham for his role modeling as I held the president-elect position, and I would like to welcome all new Council members and our new president-elect, Cathy Stratton, who I look forward to working with. I thank you for this opportunity and I look forward to leading the nursing profession with you for the next 2 years.

1 All Internati Margaret (Pegi) Earle, RN,on MSalclNy Edu Executive Director cated r Welcome Nurses to Newfoundland and Labrado

nternational recruitment is one of many provincial through a review of documents, but since April 2010 a initiatives directed at increasing the supply of local professional practice reference has been required. RNs to help alleviate our chronic nursing shortage. Although The reference evaluates the ability of IENs to meet entry- the number of ARNNL practising members has reached an level nursing competencies while practising on an interim all time high of 6100, regional health authorities (RHAs) license. ARNNL also strengthened its English language test continueI to report difficulty filling nursing positions, while requirements and lead the development of on-line learning members report chronic understaffing requiring them to modules, such as the Communications in Nursing module, regularly work overtime. The province’s RHAs have begun as research shows that language and communication are to hire internationally educated nurses (IENs) to help address one of the greatest challenges for IEN integration. Once the shortage. While ARNNL is concerned the forgoing assessments are in place, about the impact RN out-migration may be Professionally we the IEN is recommended to write the having on health care in source countries, Canadian Registered Nurse Examination we are pleased to welcome RNs from have the collective and on successful completion, registration around the world to our province and have responsibility to is granted with a full ARNNL practising been working with the Department of share knowledge with, license. The entire registration and Health and Community Services through learn from, mentor licensure process takes a minimum of Provincial Chief Nurse Anita Ludlow and 7 to 11 months. ARNNL’s registration other stakeholders, to establish the supports and befriend IENs so process helps ensure that internationally needed to help IENs successfully register they can reach their educated nurses have all the necessary and integrate into our provincial nursing full potential and skills to succeed in our province’s practice workforce. environments. make their own unique Research shows that from the moment contributions to our ARNNL registration and licensure is an IEN makes the decision to come only the first step of an IEN’s successful to Canada, establishing professional profession and health integration into the workforce. Studies registration and integrating into both a care system. show that a collaborative and respectful new employment position and a new working milieu with supportive colleagues community can be daunting. All RNs is an important element of IEN integration. have a role to play in helping to make this transition less That is why ARNNL supported the Department of Health daunting, so that IENs will be able to successfully build their and Community Services’ development of an Orientation new careers and lives here. ARNNL’s primary role is one of Framework for IENs and related learning resources for both public safety; we assess qualifications and register only those IENs and health providers working with IENs1. It is your role applicants who meet provincial standards. As a colleague, as RN colleague to mentor and support the IEN’s orientation your role is to actively support the IEN’s transition to to the workplace and the practice of nursing in NL; no Canadian nursing and integration into your workplace. one else can do so. Professionally we have the collective ARNNL has put considerable effort into implementing responsibility to share knowledge with, learn from, mentor best practices to improve the process for determining and befriend IENs so they can reach their full potential and the eligibility of IENs applying for registration. The make their own unique contributions to our profession and requirements and process for registration/licensure have been health care system. Internationally educated nurses are a clarified and made widely accessible to IENs by providing welcome addition to our professional ranks. the application package online. ARNNL’s primary focus is the assessment of education and practice background to 1 See details on www.practicenl.ca/nursing/nursing_portal_ establish evidence of competence to practice equivalent welcome.asp [International Educated Nurses] and www.arnnl.ca to the competencies required of RNs in Newfoundland and Labrador. This was traditionally determined solely References available on request

Access VOL xxXII NO 3 september 2010 Taking a Closer All Internationally E ducated N rador Look at the Glass urses to Newfoundland and Lab By Lynn Power, RN, MN, Director of Policy & Practice

This article reflects commentary made Second, John challenged us to conceptualize the people we are employed to serve not as clients, but as citizens, “people with during a public lecture given by John the vision and the power to create their own way.” The Greek McKnight, Co-Director of the Asset-Based root of the word client actually means one who is controlled. To truly let go of a paternalistic view takes courage. This point was Community Development Institute and illustrated by another speaker who told the startling story of a diabetes centre that employs a clinical psychologist whose sole Professor of Human Development and role is to assist the people who come to the clinic as they decide Social Policy at Northwestern University, what, if any, of the suggested best-practices they plan to follow. In this clinic the term non-compliant was taboo. As nurses we Illinois. The lecture, which took place can only assist people, through information and support, to determine what concerns them, how they want to address their in May 2010, was co-sponsored by ARNNL, concerns, and how they will organize themselves and others to Eastern Health and the Division of implement solutions. And finally, John suggested we must implement this new Community Health and Humanities, Faculty approach within in a primary health care framework. He argued of Medicine, Memorial University of that we must become more attentive to the social determinants of health, identifying four primary factors: personal behavior, Newfoundland. social relationships, physical environment and income. He contends that only people working together in communities can influence these factors. “No matter how hard they try, our Do nurses approach health care as pessimists? Do we see the very best institutions cannot do many of the things that only glass as half empty? Your immediate reaction is likely a strong we [citizens] can do. As communities we are the people who NO. John McKnight’s recent lecture in St. John’s challenged can change these things. Medical systems and doctors cannot… this answer. He contends that we organize health care services Medical services count for less than 10% of what will allow us around needs assessments which, in essence, translate into gaps to be healthy.” With this argument he distinguishes between or deficiencies, i.e., half empty. care and service. Service is the goods and products provided McKnight asks us to consider whether health care providers through institutions, such as hospitals. Care, on the other hand, inadvertently maintain a paternalistic attitude. Think about it: as cannot be produced and is the domain of the people. Thus health nurses we know best-practices, we have the evidence. Very often care in its purest form is obtainable within social circles or our health promotion or prevention initiatives are framed around communities, not institutions. “In the symbolic example of the how we can convince others to change – to stop smoking, lose glass filled to the middle with liquid, the system sees the empty weight, etc. Interestingly, we also know, through best-practice half while the community sees the full half. The system needs a evidence on adult learning that top down or directive approaches client. The community needs a citizen.” rarely work. So what do we need to do differently? John McKnight’s take home message is that nurses cannot First, John encouraged us to flip our approach and work really fill anyone’s glass. Research and best-practice evidence with the individual or community to identify their assets and cannot be relied on as the only catalyst for change. Our role is to strengths. To illustrate this approach, he described a person empower and support people to self-define health and engage in who has a heart ailment and carpentry skills. As nurses, we are health-seeking behaviors. We need to accept that the opportunity trained to focus on the bad heart. However, a nurse attentive to to make significant and sustainable progress in health care lies assets also explores the carpentry skills, framing the benefits within communities, not institutions. Although this approach of a healthy lifestyle in the context of how the carpenter can requires patience and open-mindedness, when a healthy choice maintain his or her role in society. is implemented it will have occurred from the ground up and thus will be sustainable.

For information on John McKnight go to www.abcdinstitute.org 3 M e m b e r s h i p Survey By Julie Wells, B.Sc., MSc. ARNNL Research Analyst

As part of our ongoing Figure 1. Percentage of Members who Agree/Strongly Agree with Adjectives about the Association efforts to improve service and Good Source of Information 88 88 demonstrate accountability, Approachable 87 85 Supportive 82 ARNNL commissioned a survey to 81 Trying Hard 81 investigate members’ satisfaction 81 Well Run and Managed 77 with the quality of the services 80 Too Much Red Tape 40 46 and programs that we provide. Difficult to Make Contact 14 20 Only There for St. John's 12 As a follow-up to a similar study 12 conducted in 2005, this survey 020406080 100 Percent allows us to monitor member 2005 2010 opinions and attitudes.

random sample of 500 practicing Figure 2. Member Satisfaction with the Registration Process members was obtained from the 100 ARNNL registration database and A 90 a total of 403 telephone interviews were 80 completed between March 10th and 20th, 70 2010. Analysis shows that the 2010 survey 61 60 demographics are consistent with the 50 demographic make-up of the 2005 survey. Percent 40 31 Member Views of ARNNL 30 20 Results of the current survey indicate that 10 6 members are generally very pleased with 2 0 ARNNL. For example, at least 8-in-10 Very Satisfied Satisfied Not Very Satisfied Not At All Satisfied members agree/strongly agree that ARNNL is well run and managed, supportive, trying hard, approachable, and a good source of information (Figure 1). Figure 3. Percentage of Members Who Were Satisfied/Very Satisfied with Their For the most part, the results of the Contact with ARNNL in the Past Year

2010 survey are on par with the 2005 97 98 98 98 100 94 93 95 survey. There was a slight increase in the 90 91 89 percentage of members who agreed that 90 80 there is too much red tape (46% vs. 40%) 70 and that it is difficult to make contact 60 with the Association (20% vs. 14%). It is 50 possible that the timing of the 2010 survey Percent 40 influenced these results. The 2005 survey 30 was conducted in May whereas the 2010 20 survey was conducted in March during the 10 peak registration renewal period. 0 Phone E-Mail Website In Person Mail 2005 2010 4

Access VOL xxXII NO 3 september 2010 Most members (92%) indicated that Results of the 2010 and the percentage that prefer email they were satisfied with the annual current survey communication increased from 31% to registration process, with 61% reporting indicate that members 48%. that they were very satisfied (Figure are generally very When asked about the level of 2). The 32 members who were not pleased with ARNNL. satisfaction with their last contact with satisfied with the process listed too much For example, at least ARNNL, over 90% of members reported red tape/hassle, turn-around time too 8-in-10 members agree/ being satisfied (Figure 3). The percentage slow, too expensive, employer issues of members who were very satisfied with strongly agree and GST among the reasons for their their contact through the website dropped that ARNNL is well dissatisfaction. from 80% in 2005 to 62% in 2010. This Another indicator that members are run and managed, may be related to a potential learning pleased with ARNNL is the level of supportive, trying curve as members became familiar with interest in participating in ARNNL hard, approachable, the redesigned ARNNL website which was activities and events. For example, and a good source of launched in January 2010. nearly three quarters (72%) indicated information. Information Resources & Services they intend to attend an ARNNL education session. Member intention Most members were aware ARNNL’s to vote in a council election (78%), become a committee programs/services (Table 1) and have used our information member (45%) or a workplace representative (35%) resources (Table 2). Use of Access Magazine, Update increased in 2010. newsletter and consultation services were on par with those seen in 2005. However, use of the ARNNL website increased Contact with ARNNL significantly to 69% (compared to 41% in 2005). Of those Approximately 3-in-10 members surveyed reported that members who have used ARNNL’s information resources they had contacted ARNNL in the past year; the majority and services, the majority reported that improvements were contacted ARNNL by phone (30%). Compared to 2005, not needed. there was an increase in electronic contact (i.e., website Next Steps and email) and a decrease in both in-person and mail contact. Results also indicated a significant change in The results of the survey were very positive. We will preference for the way that we communicate with members use the results to inform our plans as we continue to strive as the percentage of members who most prefer to receive towards providing better and more effective services and information by mail dropped from 63% in 2005 to 40% in resources to our members. The survey will be repeated every 3 years to monitor your opinions of our efforts.

Table 1. Table 2. Member Awareness of ARNNL Programs and Services Member Usage of ARNNL Information and Resources

Program/Service Awareness (%) Information/Resource Usage (%) Provide guidelines for practice 95 Access Magazine 94 Continuing Education 95 Update Newsletter 88 Liability Protection 95 ARNNL Website 69 Bursaries and Scholarships 93 Standards & Position Statements 72 Awards of Excellence 91 Consultation Services 35 Continuing Competency Program 90 Education Sessions 57 Professional Conduct Review Process 84 Annual Report 61 Quality Professional Practice 66 NurseOne Portal from CNA 56 Environment Program Note: percentage using the resource is calculated using only Workplace Representative Program 63 those who indicate they were aware of the resource.

Thank you to those members who took the time to participate in the survey. We value your feedback. For complete survey results, please visit the Publications section of our website (www.arnnl.ca.)

5 Online Registration Coming in 2011

Beginning in 2011, members will have the option of renewing their license online at www.arnnl.ca. Renewing online is fast, easy and convenient and represents another step forward in member services for ARNNL. When you renew online, you can complete your renewal quickly, save the cost of a stamp, pay online, receive instant notification that your application has been received and also get the chance to win a prize in ARNNL’s Online Renewal Contest.

Easy to Use! Maintaining Service to You! ARNNL has designed a user-friendly program that will guide ARNNL understands that change can take time. This is why, you through the renewal process quickly and easily. The process during the introductory phase of online registration renewal, also includes help screens designed to answer questions as they ARNNL will continue to provide the annual licensure/ arise during the process. The program will ensure that you fill membership renewal application by mail to all members. In out your application completely and accurately. The program fact, this year, your login and password will be printed on your will tell you if you’ve made a mistake or have missed informa- renewal application. We are certain, however, that following tion, and will provide opportunities to make corrections through- a short adjustment period, a few trials of the system, you out the process. will want to take advantage of the ease and speed of online renewal. ARNNL will continue to evaluate the use of the paper Convenient, Fast & Secure! application process as online renewal is phased in. As with all member interactions, ARNNL’s number one priority Keeping You Informed is keeping your information safe and secure. The online renewal In the coming months, ARNNL will provide you with more system will use industry-standard encryption technology to information about online registration renewal and how to make sure all information provided, including credit card prepare for it via our website. numbers used for payment, are safe.

Payroll Deduction Process! Members who are enrolled in an employer’s payroll deduction program will also be able to renew online. Simply complete your renewal application online and select payroll deduction on the ‘How to Pay’ menu. You will then be able to download a printable form titled “Notice to Employer”. This form will state that you have completed your licensure renewal application online at ARNNL. You will submit the downloaded form to your employer. As in previous years the employer will forward the funds for your licensure fee directly to ARNNL. ARNNL will process your renewal application only when the online renewal application has been completed and the licensure fee has been received from your employer.

Access VOL xxXii NO 3 september 2010 Know Thyself! Self awareness is necessary for a therapeutic Clinical relationship to develop. You must understand your own values, beliefs, thoughts and feelings, along with your strengths and limitations, and be aware of how they can affect the nurse-client relationship. Corner Self awareness enhances objectivity and creates a nonjudgmental attitude – a necessary component for safe and ethical care.

By Florence Budden, BN, RN, CPMHN(C), Faculty, Centre for Nursing Studies A little bit of Sugar makes the medicine go down... Administration of sucrose, in a water solution to a concentration of 20%- 50% has been studied as a method of non pharmacological pain management for Attention Deficit Hyperactivity Disorder and infants less than 4 months of age and now may be Pesticide Exposure: Be Careful effective for up to one year of age. It has been used Past research has shown that exposure to high levels for: venous access; intramuscular and subcutaneous of organophosphates, found in pesticides, has been injections; dressing and tape removal; lumbar associated with neurodevelopmental abnormalities; punctures; suturing and urinary catheterization. If the such as behaviour problems and lower IQ / cognitive infant uses one, a pacifier can be used in conjunction function. Recently, a group of researchers explored with the sucrose to enhance analgesic affect. Cochrane the relationship between what would be considered a Review (2001); Dunbar, et.al., (2006). “common level ” of exposure, through a representative sample of the general population of children age 8 to By Traci Foss-Jeans, RN, BN, Facilitator/Educator Model of 15, and ADHD. The findings showed that there were Nursing Clinical Practice, CNRHC, Central Health. children in the ‘common’ group with higher urinary levels of organophosphate metabolites and these kids were much more likely to meet the criteria for ADHD.

Up your Nose with a Rubber Hose! By Dr. Ian Simpson, GP, Western Region. Referenced from If you notice a child with distinctive bad breath - article posted in on line journal Pediatrics, retrieved May 17, check their nose. You may find something STORED 2010, www.pediatrics.org up there. Paper does not hurt so the child does not complain of pain or discomfort.

By Judy Joy-Mercer, RN, NP Needle or Pill? It is now well established that treatment with oral B12 supplementation is just as effective as IM in most cases of deficiency, regardless of the cause. Despite Calcium Administration Woes this, many practitioners are still unaware or reluctant Administering calcium supplements to seniors with to start or switch patients to pills. At our clinic, we dementia and/or swallowing difficulties can be a huge have switched over 60 patients in the last year and all nursing challenge. Calcium tablets are big, hard to have maintained normal B12 levels and in most cases crush, foam when mixed in apple juice and can upset the levels actually increased. Switching patients to oral the GI system. We are exploring a supplementation supplementation can significantly decrease nursing time program whereby a calcium powder is mixed in as well as other cost savings to the health care system. pudding to help alleviate administration problems. www.bcguidelines.ca/gpac/guideline_b12.html

By NPs within Long Term Care, St. John’s, Eastern Health By Tony Richards, RN, BN, BSc, Nurse Practitioner, New World Island Clinic, Central Health

Editor’s Note: Clinical Corner is designed for nurses to share information that they have found in their experience to be practical, safe, and effective. ARNNL requires that the information provided reflect good nursing judgment. We do not confirm the validity of the submitter’s tip in the literature. ARNNL does not endorse any products identified in the submissions to this column. 7 Continuing Competency Program: Registered Nurses Embrace Lifelong Learning by Beverley McIsaac, RN, NP, MN (ANP), Nursing Consultant - Regulatory Services/Advanced Practice

I have always felt proud to be a Registered Nurse RNNL’s vision, “Excellence in Nursing,” speaks (RN) and had a deep desire to make a difference in my to RNs having the knowledge, skill and judgment chosen career. I am currently implementing ARNNL’s A to ensure effective nursing outcomes. That is what Continuing Competency Program (CCP) and have been the public expects of us as RNs. The public depends on RNs to keep them safe, provide quality health care and have a conducting education sessions throughout the voice on public policy; this is an enormous responsibility. To province for the past year and, as those of you who ensure that RNs are able to fulfill this commitment, ARNNL have already attended a CCP education session will has implemented the Continuing Competency Program. know, I strongly believe that this new program is of How do we attain and maintain knowledge, skill and great benefit and value to nurses and the public. As judgment throughout our careers, as practice settings change I write this article, RNs from across the province and client care becomes more complex? As the health care are attending CCP education sessions in large system changes, we must continue to develop and enhance knowledge. ARNNL believes RNs are participating in numbers and embracing the CCP beyond expectations. lifelong learning, engaging in reflective practice, identifying It is clear that RNs in this province want to make learning goals and evaluating their nursing practice on a difference and provide the best possible care an ongoing basis. Though ARNNL is formalizing these to clients, families and the community. Making a processes through the CCP, we know that RNs have already difference begins with knowledge. been engaging in continuing competency practices. By providing the CCP toolkit, ARNNL is ensuring that you are

Access VOL xxXII NO 3 september 2010 able to document the activities you are participating in. Registered Nurses are reading the Code of Ethics for Research has shown that nurses who feel prepared and Registered Nurses, ensuring that they understand the values competent in their nursing practice are more likely to be and ethical responsibilities that guide nurses in decision- satisfied with their work and less likely to experience making. RNs have identified the need for continuous learning burnout. Research also relates positive patient outcomes to and knowledge, as the complexity of client care increases. the degree of nursing knowledge. Nurses who participate in RNs are actively embracing the CCP, which has encouraged ongoing education feel more able to influence the health care and facilitated dialogue between nurses, managers and system and are therefore more likely to remain within it. employers. Nurses are attending education sessions, challenging the system and requesting ongoing professional To date, ARNNL staff have delivered approximately 130 development. education sessions to over 2,500 RNs and we have been impressed and moved by the high degree of dedication and The value of the Continuing Competency Program goes engagement of nurses, who clearly wish to ensure that they beyond assuring the public that we are accountable and maintain competence throughout their careers. We have transparent to the people we serve, it also validates the vital heard many stories, for example nurses organizing socials work we do as registered nurses. Reflecting on and recording with co-workers and colleagues during national nursing the knowledge, skills and judgment required for practice are week to review nursing standards and to further develop their powerful reminders of our responsibilities as members of the knowledge on reflective practice. health care team. FAQs

What if I fail to meet the CCP I am planning to retire next year. Where can I get the Continuing requirements? Am I required to complete the Competence Program (CCP) If you indicate on your ARNNL CCP? documents? Will they be registration renewal form that you Yes! If you are planning to keep a mailed? have not met the CCP requirements, practicing license, you must meet Documents for the Continuing a member of ARNNL’s nursing the CCP requirements. Competence Program are available staff will contact you. If necessary, online at the ARNNL website, www. you may be granted a three- Why are there additional arnnl.ca.To access the documents, month period to complete the click the Continuing Competence requirements for nurse CCP process. If you do not meet tab on the menu bar and then the CCP requirements at the end practitioners (NPs)? the CCP Toolkit. You will find a of this period, you will be issued RNs who wish to practice as list of documents, which may be a non-practicing license. Your NPs must meet additional CCP downloaded to print and fill out in employer(s) will be notified of requirements due to the legislated hardcopy or downloaded and filled your non-practicing status. The advanced scope of practice, out electronically, in which case you process for reinstating your license competencies and standards will need to save the documents to is currently being developed and for nurse practitioners. NPs are your computer. You must click on a may require that you participate in required to complete the RN document to download it. additional educational requirements Self Assessment and the NP Self You may also request a hardcopy for reinstatement. Assessment, develop a learning plan of the toolkit from ARNNL by and implement the learning plan calling 1-800-563-3200 or email based on the standards for nursing [email protected] and we practice for RNs and the standards will ensure that you receive the for nursing practice for NPs. NPs documents by mail. are therefore required to complete two sets of documents.

9 By Siobhainn Lewis, RN, MN ARNNL Nursing Consultant – Policy and Practice

“Creativity is thinking up new things. Innovation is doing new things.” Theodore Levitt

hen thinking of innovations we As Florence Nightingale City recently benefited from a long often think of new inventions ago discussion between a Mental W or perhaps a totally new shared her innovations Health Case Manager and an RCMP way of doing something familiar. with the world, so we must officer on Newfoundland’s northern Innovations are not just about having peninsula who thought it was a good good ideas; they are about bringing a share our innovations idea to educate police officers about good idea to life. with each other. Through mental illness. This creative idea Plato called necessity “the mother became an innovation when it resulted of invention.”Innovative practice sharing and learning we in the establishment of Mental Health Police Liaison Committees in several often starts with an identified need for can reach far and wide change, or the recognition of a future communities across the province. At need; perhaps it is fueled by frustration and impact the direction the in-patient mental health unit at with the status quo or in response Central Health data is being gathered to a crisis. Some say innovations of nursing practice. through an electronic Minimum Data are prodded by a results-oriented Set (MDS) system. Although MDS is inclination to do the right thing. The keeping for sickness and mortality not new, its application in mental health need for innovative solutions has statistics. In Newfoundland and care is, and allows for benchmarking never been greater in our health care Labrador, many innovative practices from the Canadian Institute for Health environments. Innovation can apply to come to life in response to identified Information (CIHI) for national “a tool, technologies, processes, as well needs. Reflecting on Mental Health comparisons and a more comprehensive as how nurses act”. Innovations occur Services, for example, it was a need and efficient continuum of care. in the form of technology all the time, to provide the most accessible and Fostering a sense of discovery and like a smaller cell phone or a laptop that effective mental health and addictions learning is critical if innovative ideas fits in your purse, still, it’s not simply services for at-risk clients that resulted are to take root and grow. Operational new things that make for innovation, in the Mental Health Mobile Crisis pressures in a risk-averse environment but what we do with these new things Response Service being established can quell innovations. However, a that really counts. in St. John’s. This innovative unit, desire to make things better and safer As nurses, we are results-oriented which operates evenings, when calls for a climate that is supportive of and always work to prevent problems. the majority of emergency calls and receptive to the innovative process. Every day nurses respond to crisis are received, is designed to result As Florence Nightingale shared her in one form or another. So it would in a more rapid stabilization of the innovations with the world, so we must reason that innovation is inherent in individual requiring care, reduced share our innovations with each other. nursing practice. Florence Nightingale inpatient admissions to hospital, and Through sharing and learning we can was innovative in the 1850’s when decreased police involvement in reach far and wide and impact the she introduced systematic record- mental health emergencies. Labrador direction of nursing practice.

References available on request

Access VOL xxXII NO 3 september 2010 Rise & Shine, Sleepyhead! By Dr. Stan Kutcher, Martha Carmichael and David Venn Excerpted from Moods Magazine – Moods on Campus

very day teens stumble out of bed and trek bleary- try to catch up on lost sleep on weekends. Teenagers do not eyed to school. Typically their mornings are filled sleep late on weekends because they are lazy or antisocial, with frustrated parents, a quick breakfast with little but because they are sleep deprived. orE no nutrition, and a few unsatisfying in-class naps. Sleep deprivation in adolescents can negatively affect Sleep deprivation is a major problem for many adolescents, the control of behavior, emotion and attention, and is a and can affect school performance as well as how they significant impediment to learning, attainment of social develop cognitively and emotionally. Understanding how competence and quality of life. Not getting enough sleep the brain develops during the adolescent years allows us to can also affect a teenager’s performance in school and other answer questions such as: Why do teens find it difficult to go activities that require concentration and focus. Because to sleep at a decent hour and painful to wake up early? Are school schedules are not based on the sleep/wake patterns they just rebelling against social norms? of teenagers, many students in early morning classes report Although our understanding of the brain is incomplete, we Sleep deprivation have learned a great deal about how the brain develops over being less alert, more weary, the teenage years. Our brains are about 90 to 95% of their and having to expend greater in adolescents can maximum size by the time we are six years old. However, effort to pay attention. Reaction massive changes continue to occur over the next 15 to 20 times and performance of negatively affect the adolescents are much better years, as connections within the brain are strengthened and control of behavior, refined, and the networks that control those things that make in the afternoon than in the us human beings are remodelled and shaped. morning. With all this sleep deprivation no wonder teens emotion and attention, A number of new behaviours emerge during the adolescent are late for class, sleepy at and is a significant years that can be explained as a result of brain changes. school, reluctant to be involved Although these new behaviours can be frustrating, they in extracurricular activities and impediment to are completely normal in the context of teenage brain cranky. development. One of the most significant changes is sleep learning, attainment pattern alterations. Sleep patterns change during adolescence Decreasing the amount of because the brain’s circadian system changes. This occurs stimulating activities late at of social competence as a result of a complex dynamic interaction between night (TV, phone, internet) is genetically determined brain development and the impact of one way to recover lost sleep and quality of life. the environment. During the teen years the usual childhood hours. Unfortunately, many of pattern of get-up-early and go-to-bed early changes. This the social developments that might help correct the problem natural change in circadian rhythm is accentuated by the of adolescent sleep deprivation involve big social policy teenager’s environment. Teens are often awash in bright changes. These include restructuring school curriculums and lights late at night, electronic and social stimulation, and policy, such as starting and ending school later and, creating weekend gatherings that keep them active into the wee hours. a broader awareness of the sleep deprivation problem among These factors all converge to set a new go-to-sleep-late and parents and teachers. Changing teen culture to include wake-up-late cycle. awareness of the health needs of proper sleep is also likely to be an uphill battle. However, teenagers are still forced to wake up early on school days thus, their total sleep time is shorter on school Changes in the brain during adolescence are just as days than on weekends. Teens need about 9 to 9.5 hours of important as bodily changes. Teens need their sleep, not only sleep every night, more than pre-teens need. But because they because it is part of their biological makeup, but because it don’t get anywhere near this amount during the week, many benefits their social and academic performance, as well as their mental health.

11 Branching Out

The Nurse Practitioner Role in Mental Health and Addictions BY Elisa Sinnicks–House, RN, NP

f course there have been some for me to address role challenges Ochallenges, and the learning and develop a network of support. When I graduated as a curve has been rather steep. While This speaks to who we are as reg- I work the majority of my time at istered nurses and nurse practitio- Nurse Practitioner (NP) in Humberwood, the provincial ad- ners, and our ability to adapt and diction center in Corner Brook, be resourceful. Becoming a valued 2002, I did not expect to I also work with the Regional member of an interdisciplinary Psychiatry Unit at Western Memo- team has really been a worthwhile one day find myself work- rial Regional Hospital. I act as a venture. I have learned from the resource for all Mental Health and expertise of many other profes- ing in the area of Mental Addictions in the Western Region. sionals, including social workers The role poses many challenges, and other health care providers, Health and Addictions. I but the appreciation I receive has and together we have integrated been outstanding. the NP role into the Mental Health knew this was an essen- One of the biggest challenges of and Addictions programs in the this new position was establishing Western Region. tial field within the health the NP role within a non-medical Addiction and mental health facility, which Humberwood is. issues are often not well under- care system of course, but While the facility was very accept- stood or accepted by society. I ing of my role and the need for have found a new understanding I didn’t think it was the advanced practice nursing skills, and appreciation for the clientele implementing medical/nursing I work with in this new NP role. place for me. So I must ad- models into an environment where The clients present an appreciation social work models prevailed was for life’s many advantages and mit, when I was offered the not without its hiccups. Addition- disadvantages. I am surrounded ally, because the role of NPs is not by people with enormous courage position of NP for Men- always fully known, even within and determination, people who the health care system, I was fre- struggle with addictions and mental Health and Addictions quently required to explain my tal health issues each day. role and scope of practice within When I became a nurse practi- with the Western Regional this new environment. Not having tioner 8 years ago, I knew I had a mentor, medical staff member, or found a career that I would love, Health Authority in August another NP onsite to consult with but I did not foresee that develop- and discuss cases was another big ing and implementing this role 2009, I wasn’t sure if I challenge. Taking the opportunity within the area of Mental Health to network with other NPs and and Addictions would provide should take it. After much addiction and mental health care me with so many wonderful op- providers in Newfoundland and portunities to make a difference. deliberation, I accepted Labrador and other Atlantic prov- For me, the clients I serve provide inces has been a great help. the satisfaction that I feel with my the position, and I’m very My background in rural nursing role. The future is bright for the helped me deal with the challenges NP role in Mental Health and Ad- happy that I did. of developing the new NP role, as dictions, and it is also bright for it provided the experience needed the clients we serve.

Access VOL xxXII NO 3 september 2010 Primary Health Care Nurse Practitioners: A Valuable Assetof to Psychiatric Practice NuBY Beverley MrcIsaac, RN, NP,es MN (ANP), Nursing Cons ultNoteant - Regulatory Services/Advanced Practice Geri Dalton RN NP, Bill Blackmore RN NP, and Sandra Murray BN NP, Eastern Health

Bill Blackmore, to a vulnerable population Geri Dalton and that would otherwise not Sandra Murray have access to health care graduated from the services. Having the time Centre for Nursing to spend with clients and Studies Nurse listening to their needs is Practitioner Primary fundamental to providing Health Care Program holistic health care. in 2000 and have each The three NPs each worked in a variety of identify the need to work roles and areas of practice as a team. As Sandra states, as registered nurses (RNs) and nurse practitioners (NPs) “If you are not a member of the team, it just won’t work.” since then. All three have spent most of their nursing Like most nurses, Geri, Bill and Sandra do not practice careers working with clients who need mental health care, in isolation; their nursing practice is a component of the and not one of them has ever considered working in any larger health care team and involves social workers, other other area of nursing. Sandra puts it this way, “This is a RNs, physicians, counselors and psychologists. Bill adds passion that we have and we believe that all people need that teamwork is important in all areas of nursing, yet no mental health care as much as they need physical care.” area requires a higher degree of support and collaboration When I met with these dedicated NPs, I quickly realized than mental health: “I can’t imagine working without the that all three have a high degree of enthusiasm and support of all disciplines and of course the client. It is so commitment for their role. In fact, these three individuals important to include the client.” The NPs identify their were the first NPs to work in mental health nursing in the practice as being holistic – providing physical, emotional, province. The NP role in mental health is still evolving, as psychological, spiritual and social care to their clients – it evolves opportunities to enhance patient care services and stress that assessing all aspects of health is critical to in community and hospital settings are being recognized. ensuring sound mental health. Geri is currently establishing a primary care clinic at the In mental health care, as in most nursing practice Hope Community Centre in St. John’s, a new program settings, there are many challenges to overcome, but for established in the downtown area, which allows clients these three NPs “the client always comes first.” Their with mental health issues to access a range of primary care common belief is that all clients, regardless of where they services. This is a new venture and a challenge that Geri live or work, are worthy of quality health care and this is is excited and very enthusiastic about. She describes her what makes Geri, Bill and Sandra nurses of note. new role as an opportunity to provide health care services

If you would like to nominate an RN you know for our Nurse of Note, please contact Janice Lockyer via e-mail at [email protected] 13 Goings on...G oings on...

Front (l-r) Jane Mulcahy, Glenda Pack. Back (l-r) Pam King-Jesso, Front (l-r) Elizabeth Downton, Charlotte Ryan. Back (l-r) Pam King- Rodolfo Pike, Mary Arnold, Ann Manning, Geraldine Mahoney, Jesso, Andrea Pretty, Tammy Chaytor, Roxanne Rodgers-Harding, Louise Jones. Louise Jones.

Eastern Health Honours Nurses for Exemplary Service Eastern Health kicked off National Nursing Week this year by hosting the First Annual Nursing Awards of Excellence Gala to recognize nursing excellence throughout the organization. Hosted by Eastern Health’s Regional Nursing Leadership Council and Professional Practice Nursing Team, the Nursing Awards of Excellence are an opportunity to recognize nurses who demonstrate exemplary service in using their knowledge and skills to benefit patients, clients and residents, colleagues and the whole organization. Recipients for the Inaugural Awards were:

Beginning Practitioner of the Year Nursing Practice of the Year Advanced Nursing Practice of the Year- Jane Mulcahy, Staff Nurse, Pediatric Tammy Chaytor, LPN, St. Luke’s Home Glenda Pack, Nurse Practitioner, Cardiac/ Intensive Care Unit, Children’s/Women’s Andrea Pretty, Staff Nurse, Surgery Critical Care Program Health Program Program Natasha Lowe, Staff Nurse, Surgery Nursing Leadership of the Year - Moira Nurse Preceptor of the Year Program O’Regan-Hogan, Clinical Nurse Specialist, Mary Arnold, LPN, Children’s/Women’s Roxanne Rogers Harding, Oncology Public HealthProgram Health Program Patient Care Coordinator, Cancer Care Program Nurse Manager of the Year - Geraldine Nurse Educator of the Year Charlotte Ryan, Staff Nurse, Pediatric Mahoney, Nurse Manager, St. Patrick’s Rodolofo Pike, Clinical Educator, Cardiac/ Intensive Care, Children’s/Women’s Health Mercy Home Critical Care Program Program Elizabeth Downton, Public Health Nurse, Nursing Director of the Year - Ann Public Health Program Manning, Director, Community Health and Nursing Services Conferences and Workshops Nursing Innovations – September 27 & 28, 2010 Mental Health: Our Common Denominator The ARNNL & NLNU biennial Innovations conference will be held September 27 & 28th, 2010 at Holiday Inn, St. John’s. Join health care colleagues from all practice areas as we explore innovations in mental health. For more information, including agenda and registration forms, go to the ARNNL website, www.arnnl.ca, news and events section. Go oings on... 14 ings on...G Access VOL xxXII NO 3 september 2010 oings on ARNNL Members Added to the CNA ARNNL Members Receive National First G ...G Memorial Book Nations and Inuit Health Branch Awards o . ARNNL is pleased to note that Phyllis Barrett and Catherine for Excellence i McGrath were added to the Canadian Nurses Association ngs on.. Congratulations are extended to June Fry and Tina Memorial Book at the CNA Biennial in June. The Memorial Buckle who received the 2010 National FNIHB Awards of Book describes the contributions of some of Canada’s Excellence. The Awards, which recognize the devotion honoured nurses, who, in service to their fellow Canadians, and commitment that nurses have demonstrated in First have elevated the nursing profession and health care in this Nations and Inuit communities across Canada, were country. To visit the Memorial Book online go to www.cna- presented on May 14, 2010 at a ceremony held in Ottawa. nurses.ca/CNA/resources/memorial/default_e.aspx. June, who works at the Health Canada, Labrador Health Secretariat received the Award of Excellence for a Health Canada Employed Community Health Nurse, while Tina, who works with the Nunatsiavut Government, received MUN School of Nursing the Award of Excellence for an Inuit Employed Community wants to get in touch with you! Health Nurse. Since 1965, the graduates of Memorial’s School of Nursing have been making a difference. The health of a community defines its success and Memorial’s nurses play a vital role. You are leaders, innovators, advocates and caregivers in Newfoundland and Labrador and around the world. No matter where you practice, you are always part of the Memorial community. As alumni, you have access to a truly global network, with alumni outreach that connects you to events, networking opportunities, professional development workshops and many other benefits. Visit munalum.ca and keep us up to date with your most recent email address and city of residence. We will make sure that you stay informed about the latest School of Nursing news, events and benefits! New Release! The Mustard Seed: The Story of ARNNL congratulates our 2010 Awards for St. Clare’s Mercy Hospital Excellence in Nursing Award Winners by Kathrine E. Bellamy, RSM Judith Wells, RN, BN, MN - Award for Excellence in Nursing Published by Flanker Press Research, Dr. Sandra MacDonald, RN, BN, MN, PhD - Award About the Book (from Flanker Press, for Excellence in Nursing Education, Joan Bursey, RN, BN, www.flankerpress.com): MHS - Award for Excellence in Nursing Administration and The Mustard Seed is a comprehensive Meiko Walsh, RN, BN - ARNNL Elizabeth Summers Novice history of the contribution the Sisters Nurse Award. For more information on the Awards for of Mercy made to health care in Excellence in Nursing visit www.arnnl.ca (Photo on Cover) Newfoundland and Labrador. With extensive research and a large collection of photographs, Sister Kathrine Bellamy tells the fascinating history of one of St. John’s landmarks and the people who built it from the ground up. Through their Midwifery Legislation now in place in NL work with dedicated professionals in the field of health care, Following the new Health Professions Act would any persons the Sisters of Mercy of Newfoundland brought the “mustard who have qualified as midwives in any country, and who may seed” that was planted in 1922 to full growth as one of the be interested in practicing midwifery in this province, please major health care institutions in the province today—St. contact Pearl Herbert at [email protected] for further Clare’s Mercy Hospital. information. A commitment is not required, only expression of interest as the specifics of practice are not yet known. Go oings on... ings on...G 15 Workplace Reps

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

Lynette McCarthy Ann Williams Woodrow As a Psychiatric Mental Health Nurse, Ann Lynette has been working for 11 years as a works in the Mental Health and Addictions staff nurse at the 5E Vascular and General Case Management Program of Eastern Surgery Unit at St. Clare’s. A graduate of the Health which provides case management MUN School of Nursing in 1999, Lynette is services to approximately 240 people. The currently pursuing her Masters of Nursing program supports clients with mental illness from Athabasca University in Alberta via to live active healthy lives in the community. distance. She says she loves being a nurse because it is Ann is very active in the nursing community and serves “dynamic and challenging and always exciting!” An active on many committees including the Mental Health and volunteer professionally and personally, Lynette works with Addictions Waitlist Management Committee, the Moving the Heart and Stroke Foundation and serves on the Regional Lives Forward Scholarship Fund Selection Committee and Occupational Health and Safety Committee, the Regional the Trauma Initiative Advisory Committee with Eastern Accreditation Team: Surgery Program and the Regional Health. Ann also works with the Canadian Registered Nurses Council for Education and Research to name a few. When Exam development, consulting and review committee she isn’t nursing, Lynette can be found spending time with and says she feels “privileged and honoured to have been her two children and her husband Adam. selected to participate, as a psychiatric mental health nurse, in the development of the Canadian Registered Nurse Exam (CRNE). With my employers invaluable support, I have been able to ensure that geographical and specialty representation Liam Squires is achieved and that psychiatric mental health nursing A recent nursing grad, Liam completed his remains an integral component of the CRNE.” BN program in 2008 and began working A graduate of the St. Clare’s School of Nursing, Ann says with VON in Corner Brook. In his role that being a nurse “is always interesting, challenging, with VON, Liam works within the greater stimulating, and most of all, rewarding” and she finds that it Corner Brook area and provides community is “the soft side of nursing … a kind word, gentle smile or services, such as pre-travel vaccines, foot simply acknowledging fellow human beings that is the most care and blood work, to people in the difficult to teach, but most appreciated by patients and their community. While his work is primarily with older clients, families.” Married for 25 years, Ann has 2 children and lives Liam says working with the VON has given him experience in the community of Bay Bulls. caring for all ages and has helped him learn to think on his feet. “Every day I learn something new and must adapt to health care issues as they arise,” said Liam. “For me this is what keeps nursing exciting.” Active in the community, Vicki Christopher Liam volunteers with the Massey Drive Volunteer Fire A Site Coordinator with the Labrador Department and the Candlelighters Association of Health Centre in Happy Valley-Goose Bay, Newfoundland and Labrador, a support organization that Vicki has been a nurse for four years. She works with children who have cancer. graduated with her BN from the Western Regional School of Nursing in 2006 and has been a Workplace Representative for a year. Married with two children, Vicki says she loves being a nurse because she can “make a difference in the lives of people in my community.”

Access VOL xxXII NO 3 september 2010 Summary of

Adjudication New Board of Directors The Trust elected a new Board of Directors at its annual meeting Tribunal Decision on June 18, 2010. Congratulations to the members of the 2010-2011 Board: Registered Nurses Act, 2008, Section 29(4) Holly LeDrew, President Sharon Smith, President-Elect Janet Templeton, Eastern Urban Director In the matter of a Complaint against Judith Suzette Porter, Eastern Rural Director Watton (the “Respondent”), and a hearing Glenda Roy, Central Regional Director of the Complaint pursuant to Section 25 of Cindy Parrill, Western Regional Director the Registered Nurses Act, 2008 (the “Act”), Eleanor Fowler, Labrador Regional Director Carole Dalton, Director at Large an Adjudication Tribunal of the Association Penny Grant, Director at Large of Registered Nurses of Newfoundland and Pegi Earle, Secretary-Treasurer (non-voting) Labrador (ARNNL), in a Decision dated April Julie Wells, Coordinator (non-voting) 16, 2010, found the Respondent guilty of conduct deserving of sanction, in particular, professional The Board extends thanks to out-going Directors Erin Tizzard, misconduct and professional incompetence, Eastern Urban and Daphne Andrews, Director at Large. pursuant to Section 18 (c) (i) and (ii) of the Act. The Adjudication Tribunal found the Respondent Spring Funding Competition Over $10,000 was awarded during the Spring 2010 funding failed to demonstrate accountability in her competition. Congratulations to recipients who received funds obligations as a Registered Nurse, failed to show to attend conferences and write the CNA certification exam! competency or critical thinking in medication Please see the website for a list of recipients. administration, and fell asleep while on duty. The conduct occurred during the period of July Thank you to Donors The Board of Directors extends heartfelt thanks to the Nurse 19, 2007 to July 9, 2008. The Adjudication Educators of Newfoundland and Labrador Special Interest Tribunal ordered that the Respondent shall not Group and the Eagle River/Naskaupi Chapter of ARNNL for their be eligible to have her license to practice nursing recent donations to the Trust. These donations will support RNs re-instated until she has successfully completed and student nurses who are working to further their education and knowledge of nursing science. This tangible support an Education Re-Entry to Practice Nursing will be greatly appreciated by each recipient along with the Program, a post RN, BN Health Assessment, considerable honour that recipients feel on being selected for a and Pathophysiology and Pharmacology courses scholarship or research grant. from an accredited Canadian School of Nursing or other post–secondary education institution. New National Scholarship Approved Members attending the Trust annual meeting unanimously Official course transcripts must be submitted approved a resolution to establish a perpetual scholarship to the ARNNL Director of Regulatory Services with the Canadian Nurses Foundation (CNF) as part of their before the Respondent’s license is considered for Nursing 4.0 fundraising campaign. A donation of $125,000 will reinstatement. The Adjudication Tribunal further be made over a four year period to establish the scholarship, which will be available to members pursuing a Doctoral degree. ordered that the Respondent pay a portion of the Members attending the annual meeting recognized this very costs incurred by ARNNL in the investigation important initiative will help our province address the need and hearing of the Complaint in the amount of for more doctoral prepared nurses to teach in our educational $12,500.00. programs and to conduct research that advances nursing knowledge. Information will be posted on the Trust website Michelle Osmond, RN MS(N), www.arnnl.ca/trust as it becomes available. Director of Professional Conduct Review

17 Students’ Call to Action By Jessica Drover, Krista Howell, Megan Hudson, Jessica Hunt & Katelyn Hynes

On January 12th, 2010 a 7.0 magnitude earthquake devastated the Caribbean country of Haiti. The eyes of the world were glued to television screens displaying horrific images of mass destruction. Influential speeches, classroom instruction and water cooler conversations revolved around these heartbreaking events and the misfortune of those individuals impacted. The topic arose on a daily basis in our nursing classes as students at MUN School of Nursing were deeply moved by the images and stories that emerged. Daily lunchtime conversations and heartfelt sorrow soon lead to discussions about how we could contribute to the relief efforts.

anting to help, we turned to the Canadian Nursing to various relief organizations, educating communities and Students’ Association (CNSA), the official voice building networks with other professional associations. W for nursing students across the country. The CNSA Through our efforts we gained tremendous knowledge website states: “Our goal is to increase the legal, ethical, related to the operation of our student association. We professional, and educational aspects which are an integral unexpectedly became aware of the array of opportunities we part of nursing. CNSA is actively dedicated to the positive have, as nursing students, to make a difference in the everyday promotion of nurses and the nursing profession as a whole.” lives of individuals and not just in an acute care setting, but After reviewing various position papers and resolutions on the from a global perspective as well. Through this experience CNSA website, we realized that there was no definition of the we have gained greater insight into the role of the nurse as an role of nursing students in global relief efforts. As a profession advocate for action and caring that extends beyond clients we that exemplifies caring and compassion, we believed that it was can physically care for from day to day. We have learned how important for the organization that represents Canadian nursing we can become involved in actions that impact the lives of students to take a stand in this direction. We took it upon individuals who may be thousands of miles away. ourselves, as third-year nursing students, to write and present a resolution on global relief efforts at the January 2010 CNSA Resolution approved in January 2010 by CSNA National National Conference in Quebec City. Assembly Presenting a resolution seemed to be a feasible avenue for Be it resolved that CNSA endorse, support and become us to demonstrate our support for the cause. We felt there was involved in global relief efforts and acknowledge the impact of little we could do as individuals, aside from participating in natural disasters on both national and international levels. fundraisers or donating money, and while these efforts do make Be it further resolved that CNSA promote and support a difference, we wanted to do more. We thought this would strategies that prevent the spread of disease through education be a great opportunity to educate our classmates and fellow about diseases and social behaviours associated with disasters nursing students nationwide, as well as others within this that may be exacerbated by deteriorated living conditions. profession, about the importance of action in times of crisis. Be it further resolved that CNSA advocate for global Our review of the CNSA perspectives and objectives equality and availability of essential resources such as clean presented a very strong basis for the development of the and safe water to all people by developing global partnerships resolutions we presented in our paper Global Relief Efforts in to gain insight and knowledge, as well as aid in relief efforts. Natural Disasters. The main point we wished to present was a These partnerships should include networks with other nursing call for the CNSA to become actively involved in advocating student associations, professional disciplines, governmental for and supporting students in their endeavors to participate and nongovernmental agencies at local, regional, national, and in global relief efforts. We also suggested ways in which the international levels. CNSA could achieve this objective, such as providing links

Access VOL xxXII NO 3 september 2010 BN (Collaborative) Program MAY 2010 Graduates A Welcome to New Members of the Profession!

Allen, Nicole North West River, NL George, Jennifer Deer Lake O’Reilly, Terri Grand Bank, NL Allingham, Christi Brig Bay, NL Giles, Penney North Harbour, NL Oake, Natalie Deer Lake, NL Alyward, Bernard Mount Pearl, NL Gill, Niki Fogo, NL Pardy, Leann Bonavista, NL Andrews, Holly Mount Pearl, NL Goobie, Tara hampton, NB Parker, Erin White Hills, NS Antle, Margot Paradise, NL Goodyear, Charlotte Lumsden, NL Parrill, Stephanie Sandy Cove, NL Antle, Robyn Botwood, NL Graves, Carmen Wolfville, NS Parsons, Melvina South Brook, NL Apesteguy, Melantha tatamagouche, NS Green, Callista Grand Falls-Windsor, NL Payne, Michelle Fogo, NL Ash, Kira hant’s Harbour, NL Griffiths, Stacey Mount Pearl, NL Penney, Katherine Corner Brook, NL Bagu, Lara Crowsnest Pass, AB Hakanjin, Arzana kosovo, Yugoslavia Perchard, Jennifer St. John’s, NL Baker, Shannon holyrood, NL Halfyard, Carolyn Conception Bay South, NL Peterson, Angela Burgeo, NL Barry, Bradley Grand Falls-Windsor, NL Hamlyn, Angela Port Saunders, NL Pike, Genista Red Bay, NL Beresford, Jasmin Paradise, NL Hart, Heather Fogo, NL Pollard, Alexa St. John’s, NL Blackmore, Teresa Grand Falls-Windsor, NL Hickey, Nikita Grand-le-Pierre, NL Power, Jamie Marystown, NL Bown, Carolyn Paradise, NL Hicks, Reneé heatherton, NL Preston, Ashley Corner Brook, NL Bradbury, Jessica Goulds, NL Hillier, Jaclyn Fortune, NL Randell, Kayla Bonavista, NL Bradbury, Kimberly torbay, NL Hiltz, Danitra Port aux Basques, NL Reid, Kersten upper Island Cove, NL Bragg, Amy Grand Falls-Windsor, NL Hiscock, Sara Grand Falls-Windsor, NL Reid, Krista Bishop’s Falls, NL Brennan, Sarah Shoal Harbour, NL Hodder, Pam St. John’s, NL Ricks, Samantha Goose Cove, NL Brown, Christine Mount Pearl, NL Holmes, Joshua Seldom, Fogo Island, NL Roil, Greg St. John’s, NL Bryan, Renelle Burnt Islands, NL Howse, Laura Conception Bay South, NL Rolls, Megan Bonavista, NL Budgell, Chrisoula St. Anthony, NL Humphries, Amy St. John’s, NL Rowsell, Wanda Lee Coley’s Point, NL Burke, Diane tilting, Fogo, NL Humphries, Kimberly Lumsden, NL Rumbolt, Samantha Norris Point, NL Bussey, Sarah St. Lunaire, NL Hunt, Nikita Wareham, NL Ryan, Melanie Ferryland, NL Byrne, Melissa Conche, NL Hynes, Laura Port au Port East, NL Ryder, Danielle St. John’s, NL Caines, Danielle Bartlett’s Harbour, NL Johnson, Vanessa St. John’s, NL Saindon, Jennifer Winnipeg, MB Canning, Charity Birchy Bay, NL Jones, Heather Mount Pearl, NL Sainsbury, Jennifer Wesleyville, NL Canning, Victoria New World Island, NL Kashila, Mathew Congo, Africa Saunders, Colin Bishop’s Falls, NL Cassell, Jonathan Roddickton, NL Kavanagh, Robin St. John’s, NL Shea, Megan Georgetown, NL Chambers, Kaitlan Blue Cove, NL Kearney, Trudy Croque, NL Slade, Janna Carbonear, NL Chaulk, Christine Mud Lake, NL Keats, Yvonne Petty Harbour, NL Smith, Jennie St. John’s, NL Chen, Xuting St. John’s, NL Kelly, Jennifer Grand Falls-Windsor, NL Smith, Shauna South Dildo, NL Chisholm, Jessica halifax, NS Kelly, Kayla Corner Brook, NL Snelgrove, Tessa Grates Cove, NL Clarke, Darren Marystown, NL Kelly, Melissa Freshwater, Placentia Bay, NL Spires, Amanda St. Andrews, NB Clarke, David Corner Brook, NL Kenny, Lindsay Cupids, NL Spurrell, Alana Clarenville, NL Clarke, Emily truro, NS Kingston, Georgia Cavendish, PEI Spurrell, Katheryn Mount Pearl, NL Clarke, Laura victoria, NL Lake, Erica La Scie. NL Stokes, Kristen Cape Freels, NL Clarke, Megan Burin, NL Lawless, Romina Corner Brook, NL Sullivan, Melanie Pouch Cove, NL Clarke, Nicole Burin, NL Lawrence, Catherine Bell Island, NL Swan, Kimberly L’Anse au Loup, NL Coffin, Rachel Joe Batt’s Arm, NL LeBlanc, Nicole Dartmouth, NS Sweetapple, Janet Corner Brook, NL Coleman, Nikita Isle aux Morts, NL Legge, Erica Corner Brook, NL Toope, Terri-Lee Pond Cove, NL Connors, Jeanette Pouch Cove, NL Lewis, Colleen Avondale, NL Torarak, Cheryl hopedale, NL Coombs, Laura Spaniards Bay, NL Loder, Colleen Badger, NL Traverse, Jennifer kingston, NL Coombs, Nicole upper Island Cove, NL Luther, Mandy Mount Pearl, NL Tremblett, Ambrose Bishop’s Falls, NL Cooney, Lori Conception Bay South, NL Mackey, Erin St. John’s, NL Van Staalduinen, Kaitlin Carlisle, ON Costello, Katherine Labrador City, NL Maloney, Krista Gander, NL Verge, Melissa Paradise, NL Cribb, Samantha hammonda Plains, NS Martin, Nicole hickman’s Harbour, NL Vokey, Kimberley Bay Bulls, NL Crotty, Melissa Paradise, NL Mavin, Shanda Fortune, NL Wakeham, Nicole Freshwater, NL Cull, Janine Carmanville, NL McCormack, Melanie Bishop’s Falls, NL Walsh, Alicia Bay-de-Verde, NL Dean, Rachelle Corner Brook, NL McFatridge, Malorie Stephenville Crossing, NL Walsh, Christa Marystown, NL Delahunty, Laura St. John’s, NL Meade, Jenna hermitage, NL Walsh, Natasha Southern Harbour, NL Dinn, Danielle Witless Bay, NL Mercer, Ashley Grand Falls-Windsor, NL Walsh, Stacey Calvert, NL Downing, Laura harbour Grace, NL Milley, Meaghan Labrador City, NL Warren, Genna Arnold’s Cove, NL Doyle, Ashley Conception Harbour, NL Mills, Mark Bishop’s Falls, NL Warren, Rebecca Chapel Arm, NL Drake, Julia Marystown, NL Milmine, Jennifer Shoal Harbour, NL Watkins, Candace Wesleyville, NL Eason, Stephanie Conception Bay South, NL Molloy, Maureen outer Cove, NL Watts, Catherine Gander, NL Elliott, Adam Botwood, NL Montague, Janice North West River, NL Way, Ashley ottawa, ON Fagan, Laura Conception Bay South, NL Mozwa, Aminata Saskatoon, SK Whelan, Desirée tilton, NL Farrell, Tracy Gander, NL Mulcahy, Katie Mount Pearl, NL White, Christopher Pasadena, NL Flemming, Gina Corner Brook, NL Mullins, Chantelle Corner Brook, NL Whyte, Krystle South East Bight, NL Flynn, Terri-Lynn Conche, NL Murphy, Alison Bay de Verde, NL Williams, Kristin happy Valley-Goose Bay, NL Foley, Robyn Bishop’s Falls, NL Murphy, Amanda Job’s Cove, NL Williams, Stephanie Dundas, ON Fontaine, Stephanie trepassey, NL Newbury, Jana Clarenville, NL Winsor, Jenene triton, NL Foulds, Jenna Saskatoon, SK Nolan, Kayla Frenchman’s Cove, NL Young, Tina Stephenville Crossing, NL Gale, Rebekah Cormack, NL Noseworthy, Courtney Corner Brook, NL Gardiner, Gillian Conche, NL O’Grady, Vanessa kingston, NL

19 Online Registration RENEWAL

Coming in 2011 Online registration renewal will be fast, easy and convenient! The process will be Safe, Supported and Secure! Your login and password will be sent to you on your annual licensure/membership renewal application – Remember to keep your password secure! You can complete the application and pay online using a credit card! You will be able to save and print your application! Watch www.arnnl.ca and your annual licensure/ membership renewal package for further details

Are you protected? Every nurse should have professional liability protection.

www.cnps.ca 1-800-267-3390 Log in to Members Only Username: ARNNL Password: assist

Canadian Nurses Protective Society

Access VOL xxXII NO 3 september 2010 GROUP HOME AND AUTO INSURANCE for members of the Canadian Nurses Association

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PROTECTION MADE EASY... GROUP RATES MADE EASIER! As a member of the Canadian Nurses Association, you can SAVE on your home and auto insurance through preferred group rates, while enjoying high-quality insurance products and outstanding service. As the leading provider of group home and auto ENJOY SAVINGS THROUGH insurance, we offer a wide range of innovative products, PREFERRED GROUP RATES so you are sure to get the coverage that is right for MelocheMonnex.com/cnanurses your particular needs…and the peace of mind that goes with it! 1 866 269 1371 Monday to Friday, 8 a.m. to 8 p.m. (ATLANTIC) Monday to Friday, 8:30 a.m. to 8:30 p.m. (NEWFOUNDLAND) Insurance program supported by

The TD Insurance Meloche Monnex home and auto insurance program is underwritten by SECURITY NATIONAL INSURANCE COMPANY and distributed by Meloche Monnex Insurance and Financial Services Inc. in Québec and by Meloche Monnex Financial Services Inc. in the rest of Canada. Due to provincial legislation, our auto insurance program is not offered in British Columbia, Manitoba or Saskatchewan. *No purchase required. Contest ends on January 16, 2010. Skill-testing question required. Odds of winning depend on number of entries received. Complete contest rules available at MelocheMonnex.com. Meloche Monnex® is a trade-mark of Meloche Monnex Inc. TD Insurance is a trade-mark of The Toronto-Dominion Bank, used under license.

Projet : Annonce MMI 2009 Province : .EWFOUNDLAND Épreuve # : 1 Client : Meloche Monnex Publication : !##%33 Date de tombée : 9/02/09 No de dossier : Format : 7.5 x 10 , -- ?--)X sCNANURSES?%. Couleur : BLK Graphiste : -ARIE *OSÏE0ROULX

(AMELIN-ARTINEAUs BOULDE-AISONNEUVE/"UREAUs-ONTRÏAL1UÏBEC (!#s4& ATTENTION : Merci de vériﬁ er attentivement cette épreuve aﬁ n d’éviter toute erreur. Online application forms are now available!

CALL FOR APPLICATIONS Applications are now being accepted for awards in the following categories:

Continuing Education Awards Florrie Penney RN Physical Rehabilitation Bursary ($500) Nancy Llewellyn RN Pediatric Nursing Bursary ($500) Nursing Leadership Awards ($500-$3000) Bursaries for Conferences & Post Basic Courses (up to $1000)

BN Scholarships ($1000 each) BN years 2, 3, 4 BN Fast Track Year 2 Flo Hillyard Memorial General Hospital School of Nursing Alumni Association Scholarship

BN (Post RN) Scholarships ($750 - $1500) BN Post RN St. Clare’s Alumni Association Scholarship

RN Re-Entry Scholarship ($500)

ARNNL Bay St. George Chapter Scholarship Available to RNs from the Bay St. George area

Graduate Scholarships ($1000- $2000) Masters or PhD (Nursing & Non-Nursing) ARNNL 50th Anniversary Scholarship Marcella Linehan Scholarship

Violet D. Ruelokke Primary Health Care Award (up to $1000)

Nursing Research Awards (up to $2500 each)

For more information or to apply online, visit: www.arnnl.ca Email: [email protected] Deadline for applications is October 15th Late or incomplete applications will not be considered.