montana nurses association (mna) is the recognized leader ... · february, march, april 2020...
TRANSCRIPT
MNA is comprised of registered nurses including advanced practice registered nurses. MNA is a non-profit, member driven organization that has been in existence for over 112 years. MNA is the preeminent voice of the professional nurse in Montana at the local, state, and national level. MNA represents and advocates for nurses in relation to nurse competency, scope of practice, patient safety, workplace violence, professional development/continuing education, safe staffing, and improved healthcare delivery and access, just to name a few. MNA staff and member leaders do all this through the professional association with governing councils and committees. All registered and advance practice registered nurses can (and should) belong to MNA as it is first and foremost the professional association for these nurses, moreover, MNA also enjoys an additional recognition of advocacy through collective bargaining (if applicable to your situation). It is a professional commitment to our nursing profession as policy, practice, and work environments are ever changing. Legislation and other advocacy situations are currently supported by those registered nurse members paying membership dues who have committed to their state professional association. It is ok to pay dues and allow others to advocate for you. With your MNA membership (which includes an ANA membership), it allows MNA to grow infrastructure and resources to invest in appropriate personnel (professional development, labor, lobbyists, legal)
for all nurses in Montana. MNA additionally invests resources back into the nurse members, financing their attendance to local, state, and national conferences. One of our most beloved nurses, Mary Munger,
THE OFFICIAL PUBLICATION OF THE MONTANA NURSES ASSOCIATION FOUNDATION Quarterly publication direct mailed to approximately 19,000 RNs and LPNs in Montana.
February 2020 • Vol. 57 • No. 1
www.mtnurses.org
Like us on Facebook Follow us on Twitter
Executive Director Report
Vicky Byrd, MSN, RN, Chief
Executive Officer
Statewide Nursing NewsPage 8
current resident or
Non-Profit Org.U.S. Postage Paid
Princeton, MNPermit No. 14
Elevating Care for our Veterans through High-Quality
Professional DevelopmentPage 6
Montana Nurses Association (MNA) is the recognized leader and advocate for the
professional nurse in Montana. RN, shared with me prior to her passing this past 2019 year, reaffirming: It is one thing to have been educated and licensed as an R.N., another to be employed as an R.N., but the mark of a real professional is a love for and interest in, what is happening to that profession, and a commitment to help it. Without taking this third step, without identification as a member of the professional nursing organization, many nurses are merely draining the good from the profession without adding their share to keep it strong and dynamic. (Munger, M. (n.d.). Membership: A professional commitment. Letter.)
MNA is committed to the nurses and nursing profession in Montana and will always need the nurses’ commitment to keep it strong and dynamic, furthermore, to make decisions that will safeguard the future of the nursing profession. Activism isn’t for everyone but as nursing professionals we must invest in our professional organization to ensure the infrastructure remains intact to carry our voices in all things that touch patients and nurses.
Here is a review of our governing councils and I hope to see more nurses involved at all levels.
Governing Councils of Montana Nurses Association
Council on Practice & Government Affairs:• Is a powerful and influential voice in local,
state, and national government.• Legislative lobbying on issues that impact
the nursing profession and healthcare in Montana.
o Practice and public safety issues o Workplace violence o Access to care o Monitor and maintain full practice/
prescriptive authority for APRNs o Financing of health care
Executive Director Report continued on page 2
Page 2 Montana Nurses Association Pulse February, March, April 2020
CONTACT MNAF & MNAMontana Nurses Association Foundation
and Montana Nurses Association20 Old Montana State Highway, Clancy, MT 59634• Phone (406) 442-6710 • Fax (406) 442-1841
• Email: [email protected] • Website: www.mtnurses.orgOffice Hours: 7:30 a.m.-4:00 p.m. Monday through Friday
VOICE OF NURSES IN MONTANAMNA is a non-profit, membership organization that advocates for nurse competency, scope of practice, patient safety, continuing
education, and improved healthcare delivery and access. MNA members serve on the following Councils and
other committees to achieve our mission:• Council on Practice & Government Affairs (CPGA)• Council on Economic & General Welfare (E&GW)• Council on Professional Development (CPD)• Council on Advanced Practice (CAP)
MISSION STATEMENT – MNAFPreserve the history of nursing in Montana and contribute, support and
empower the professional nurse in Montana.
MISSION STATEMENT – MNAThe Montana Nurses Association promotes professional nursing practice, standards and education; represents professional nurses; and provides
nursing leadership in promoting high quality health care.
PROFESSIONAL DEVELOPMENTMontana Nurses Association is accredited as an approver of continuing
nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
Montana Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s
Commission on Accreditation.
MNAF & MNAStaff:Vicky Byrd, MSN, RN, Chief Executive OfficerPam Dickerson, PhD, RN, NPD-BC, FAAN, Director of Professional DevelopmentCaroline Baughman, BS, Professional Development AssociateRobin Haux, BS, Labor Program DirectorAmy Hauschild, BSN, RN, Labor RepresentativeLeslie Shepherd, BSN, RN, Labor RepresentativeJill Hindoien, BS, Chief Financial OfficerJennifer Hamilton, Administrative Assistant
Board of DirectorsExecutive Committee:Board of Directors President Lorri Bennett, RNBoard of Directors Vice President Terry Dutro, MSN, APRN, AGPCNP-BCBoard of Directors Secretary Chelsee Baker, BSN, RN Board of Directors Treasurer Audrey Dee, RNBoard of Directors Member at Large Anna Ammons, BSN, RN, PCCNBoard of Directors CPGA Bobbie Cross, BSN, RNBoard of Directors PD Cheryl Richards, Ed.D, RN-BCBoard of Directors CAP Lori Chovanak, DNP, RN, APRN-BCBoard of Directors EGW Brandi Breth, BSN, RN-BC
Council on Practice & Government Affairs (CPGA)Gwyn Palchak, BSN, RN-BC, ACM Lisa Ash, RN, CNORSally Sluder, DNP, APRN, AGACNP-BC Jennifer Miller, RNLoni Conley, BSN, RN
Council on Professional Development (PD)Sandy Sacry, MSN, RN Megan Hamilton, MSN, RN, CFRN, NRP Gwyn Palchak, BSN, RN-BC, ACM Debby Lee, BSN, RN-BC, CCRP Emily Michalski-Weber, PMHNP-BC Abbie Colussi, RN Brenda Donaldson, BA, RN, CAPA Kim Reynen, BSN, RN Janet Smith, MN, MSHS, RN
Council on Advanced Practice (CAP)Chairperson-CAP Deborah Kern, MSN, FNPChairperson Elect-CAP Keven Comer, MN, FNP-BCSecretary-CAP Nanci Taylor, APRNMember at Large-CAP Terry Dutro, MSN, APRN, AGPCNP-BCMember at Large-CAP Emily Michalski-Weber, MSN, RN-BC
Council on Economic & General Welfare (EGW)Delayne Stahl, RN, OCN Lorie Van Donsel BSN, RN, PCCNCharlie Julia Buffo, RN Adrianne Harrison, RN
Questions about your nursing license?Contact Montana Board of Nursing at: www.nurse.mt.gov
If you wish to no longer receive The Pulse please contact Monique:
If your address has changed please contact Montana Board of Nursing
at: www.nurse.mt.gov
PUBLISHER INFORMATION & AD RATESCirculation 19,000. Provided to every registered nurse, licensed practical nurse, nursing student and nurse-related employer in Montana. The Pulse is published quarterly each February, May,
August and November by Arthur L. Davis Publishing Agency, Inc. for Montana Nurses Association, 20 Old Montana State Highway,
Montana City, MT 59634, a constituent member of the American Nurses Association.
For advertising rates and information, please contact Arthur L. Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216, Cedar Falls, Iowa 50613, (800) 626-4081, sales@aldpub.
com. MNA and the Arthur L. Davis Publishing Agency, Inc. 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.
Acceptance of advertising does not imply endorsement or approval by the Montana Nurses Association of products
advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. MNA and
the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of MNA or
those of the national or local associations.
WRITER’S GUIDELINES:MNA welcomes the submission of articles and editorials related
to nursing or about Montana nurses for publication in The PULSE. Please limit word size between 500-1000 words and provide
resources and references. MNA has the Right to accept, edit or reject proposed material. Please send articles
PULSE SUBMISSIONS
We are gathering articles that are relevant and appealing to YOU as a nurse. What
is happening in your world today? Is there information we can provide that would be
helpful to you? The Pulse is YOUR publication, and we want to present you with content that
pertains to your interests.
Please submit your ideas and suggestions to Jennifer.
Enjoy a user friendly layout and access to more information, including membership material, labor resources, Independent Study Library,
a new Career Center for Job Seekers & Employers, and more downloadable information.
Please visit MNA’s constantly updated website!
www.mtnurses.org
o Nursing control of nursing practice o Occupational safety and environmental
Health o Economic and General Welfare issues
• Advocates for nurses and nurse issues to the Montana Board of Nursing.
• Promotes participation of nurses in making of health care policy.
• Addresses ethical concerns of nurses• Encourages and promotes excellence in
nursing.• Holds a seat on the MNA Board of Directors
Council on Advanced Practice• Advocates legislatively for maintenance and
improvement of APRNs full practice and prescriptive authority.
• Represents and promotes advanced practice nursing within the organization and in Montana.
• Collaborates with the Council on Practice and Government Affairs to promote, advocate and protect the practice of APRNs.
• Holds a seat on the MNA Board of Directors
Council on Economic and General Welfare:• Negotiates contracts for over 30 hospitals
and health care institutions across Montana.• Ensures that contracts are enforced through
grievance and arbitration procedures.• Provides nurses with a voice in the decision
making within their work environments.• Protects employment rights of nurses.• Works with all councils of MNA to promote
high standard of nursing care in Montana.• Holds a seat on the MNA Board of Directors
Council on Professional Development• Collaborates with the MNA Director of
Professional Development to ensure quality in all continuing education/professional development functions.
• Contributes to establishing and measuring goals and outcome measures for the Accredited Provider and Accredited Approver Units.
• Participates in development, implementation, and evaluation of policies, procedures, and guidelines of the continuing education/professional development program in adherence to accreditation criteria.
• Advocates for the value of quality continuing education/professional development through communication with members, nonmembers and other stakeholders.
• Considers the impact of national and state initiatives on continuous professional development in making recommendations regarding MNA’s role in providing and approving continuing nursing education.
• Makes recommendations to the Board of Directors regarding structural capacity to carry out provider and approver functions, including human, material, and financial resources.
• Holds a seat on the MNA Board of Directors
Executive Director Report continued from page 1
Nursing Faculty Position Available
Full-time, benefits eligible position starting soon Bachelor’s degree, RN license, and two years of experience required
summers and holidays off
Online Application: https://jobs.gfcmsu.edu Disabled/AA/EEO/Vet Preference Employer
February, March, April 2020 Montana Nurses Association Pulse Page 3
Labor Reports and NewsSAVE the DATE for Our NEW Nurse Advocacy Retreat!
Robin Haux, BSLabor Program
Director
Mark your calendars and save the date to attend our new Nurse Advocacy Retreat (formally the Labor Retreat) May 3rd, 4th and 5th, 2020 at Chico Hot Springs (make your room reservations soon as rooms fill up fast)!! Registration will include all contact hours and meals (lodging on your own). SCHOLARSHIPS WILL BE AVAILABLE so stay tuned for more information!!
The definition of advocacy is the act of speaking on the
behalf of or in support of another person. In nursing, advocacy stems from a philosophy in which nursing practice is the support of an individual to promote their own well-being, their fellow nurses, and their patients. Your advocacy for each other is how you impact change in your facilities. Through collective bargaining and your Union’s, you all have the ability to advocate for each other through ways that are protected by your contracts and the law.
This year’s Nurse Advocacy Retreat will include presentations about effective strategies and tools available to you through your contracts, education on how to engage new employees, how to more successfully advocate for nurses and patients by using tools and rights you have through your Union, and to
improve our nurses’ abilities at the bargaining table using contract campaign strategies. We will share success stories!
The event is designed for all ranges of knowledge and skill in the collective bargaining arena. First time attendees are warmly welcomed and encouraged to come to Chico and learn how to advocate by using your contract and your Union.
This event is a true retreat and wonderful networking experience in a welcoming, and casual atmosphere. We are excited to invite you all to our “re-branded” Nurse Advocacy Retreat (per our membership’s recommendation)! Come learn, network, and please bring a friend!
UNION OFFICERSSounds a touch
intimidating, like a band of tough thugs laying down the law. Or perhaps a group of knowledgeable contract experts who have been-there-done-it ALL. Not true.
In the early months of 2020, at least four of my Locals will be working on nominating and/or electing new Union officers. Within each of these newly elected group of leaders, I always expect a few new faces. Nurses who are new to the union scene make some of the best, most engaged officers and I always appreciate excited new faces.
There are many ways to organize Union leaders and many different positions that can be utilized. Many Unions recognize the typical President and Vice president roles. While others find co-presidents to be more effective. Both options function well. Whether your Union has co-presidents or the more standard President and VP, the roles typically share the same duties (ideally equally). Duties include presiding over Local meetings and being a voting member of the Local. Some Locals have their presidents attend and facilitate Professional Conference Committee/Labor Management Committee and participate on the negotiating team.
A union Secretary is another common leadership role. The duties of each secretary vary from Local to Local, but typically include maintaining an updated list of members. This task may seem
Leslie Shepherd, BSN, RN, Labor Representative
daunting, especially for our locals with 400+ members. Do not fear, we at MNA are excellent at helping you maintain these lists. In most of our contracts, there is language that requires your employer to provide us at MNA with regularly updated lists of members. Secretary duties also include taking minutes or notes at Local meetings as well as distributing those to the members.
Union Treasurer is another position that most Locals elect a member into. This officer is responsible for maintaining the Local budget and funds. Each union determines its budget and spending of any money differently. In MNA, each Local has its own bank account and Local funds. The Treasurer keeps track of any spending from the Local’s account. Local taxes are also filed each year and MNA is happy to assist the Local officers in this task.
One of my favorite officer positions that is relatively new is a media or communications officer. This individual works with the secretary to ensure the Local has an up to date membership list and that all members are communicated to. Whether it’s via email, mailboxes, bulletin boards, or social media; the media officer assists with ensuring the flow of communication to your members is kept up to date.
Every Local functions differently and has the ability to determine the officer needs through their bylaws. Locals can have each of the positions listed above or any combination of roles. Each position can be adapted to the role each elected member is able to take on. Each new team of officers elected will function differently than the last, but it is imperative that each group functions as a team. However you share the roles, know that leading your Union is
important work and has the potential to benefit each of your members. MNA is always here to assist in training new officers in their role and duties, while encouraging each team of officers to be the leaders of their Local.
New Licensed Graduates Welcome!Competitive Salary and Pay Based on Experience.
To learn more, please contact:Cyndy McClimate - Medical Recruiter
615.263.3148
Apply online at jobs.corecivic.com
CoreCivic is a Drug Free Workplace & EOE - M/F/Vets/Disabled.
Announcing Career OpportunitiesYou’ve Been Waiting For!
Crossroads Correctional FacilityShelby, Montana
Now Hiring:LPNs Full Time and PRN
RNs (PRN)
Page 4 Montana Nurses Association Pulse February, March, April 2020
Labor Reports and NewsKnow Your Rights! But What Are They?
All Montana Nurses Association union nurses have rights! You have Representation Rights under the Supreme Court’s Weingarten decision, but what are they? Always remember to ASK for a Union Rep, Local Rep, Resolutions Officer, OR any coworker to accompany you to a meeting with management! You have the right to a second set of eyes and ears!
Know your Weingarten Rights! Before discussing your Weingarten Rights, you must understand what an “investigatory interview” is. An investigatory interview is when you are questioned by your manager or director about any issue that you are, or may have been, involved with that could possibly lead to disciplinary action. This can include tardiness, overtime, patient complaints, peer complaints, etc. You should ask at the beginning of the meeting, “Is this a meeting that can lead to disciplinary action?” If they answer “Yes” then you have the right to ask for representation. If they say “No” and indicate that you don’t need anyone, listen carefully to what is being discussed. If it starts to feel like it could lead to discipline, you have the right to invoke your Weingarten rights.
Know the Rules! Under Weingarten Rights and when an investigatory interview occurs, the following rules apply:
1. The employee must make a clear request for union representation before or during the interview. The employee cannot be punished for making this request. (Note: Do not ask the employer, “do I need union representation?” It is up to you to make the statement that you want union representation.) Remember, management is not an appropriate representative, so if they offer you the nursing supervisor or someone else to sit with you, that is not adequate. You either need a local unit leader, a steward or
grievance officer, or any other member to act as your representative and you have the right to a reasonable amount of time to obtain representation.
2. After the employee makes the request, your employer must choose among three options. The employer must either:
1. Grant the request and postpone any further questioning until an union representative arrives and has a chance to consult privately with the employee; or
2. Deny the request and end the interview immediately; or
3. Give the employee a choice of: 1) having the interview without representation, or 2) ending the interview.
*If your employer denies your request for union representation and continues to ask you questions, this is considered an unfair labor practice under the law. If this occurs, you have the right to refuse to answer and you cannot be disciplined for a refusal to answer questions without union representation. Remember to say “I will listen, but I will not provide any comment until I can get union representation.”*
Why do you need representation? While your representative cannot disrupt the interview, your employer must allow them to speak and provide assistance. Additionally, your representative should take detailed notes of what all present parties say at the meeting. These notes
Robin Haux, BSLabor Program
Director
Weingarten RightsIf this discussion could in any way lead to my being
disciplined or terminated, or affect my personal working conditions, I respectfully request that my Union/Unit Representative or Nurse Advocate be
present at this meeting.
Until my representative arrives, I choose not to participate in this discussion
When Your Employer Notifies You of a Meeting...*Immediately ask your Supervisor/Manager/Director:
• “What is the purpose of the meeting?”• “Is the meeting investigatory?”• “Will I be asked questions which may possibly lead to discipline?”• “Will I be asked questions which require me to defend my conduct?”
If the meeting is investigatory or answers may lead to discipline:
_ #1 – Respectfully inform your employer you are invoking your Weingarten Rights & will need to have your Union/Unit Representative or Nurse Advocate present during questioning. _ #2 – Quickly arrange for your Union/Unit Representative or Nurses Advocate to attend the meeting.
and second set of eyes and ears can prevent later disputes about what was said at the meeting.
Your MNA Labor Representatives can provide you and your local with Weingarten cards and flyers with easy to access information on your rights!
Montana State University-Northern has Assistant Professor Nursing –tenure track positions open
PLEASE JOIN
OUR TEAM!
Teach in both the ASN (on-campus) and RN to BSN (online) nursing programs; faculty positions are on-campus in Havre, MT.
The ASN program requires teaching didactic lectures, laboratory skills, and clinical courses for the advanced medical surgical specialty areas, maternal, pediatric, and or mental health nursing.
The position will teach approximately 24 semester credit hours of classes per year.
For an application and position description, please visit:https://www.msun.edu/hr/employment.aspx
For information, please contact MSUN HR Director Suzanne Hunger at [email protected]
February, March, April 2020 Montana Nurses Association Pulse Page 5
The Makeup of MNAMNA consists of over 2,200 Registered
Nurses and Advanced Practice Registered Nurses across the state of Montana. The state is divided into eight Districts based upon location. Each District Nurses Association (DNA) is made up of collective bargaining members (local unit members) and non-collective bargaining members.
This is the break down for each MNA District:
District 1: Mineral County, Missoula County and Ravalli County
Local units in District 1 –Local #15 – Community Medical CenterLocal #17 – Providence St. Patrick HospitalLocal #18 – Providence St. Patrick Coagulation ClinicLocal #32 – Partners in Home CareLocal #33 – Fresenius Kidney Care – MissoulaLocal #35 – Marcus Daly Memorial Hospital
District 2: Beaverhead County, Deer Lodge County, Granite County, Powell County and Silver Bow County
Local units in District 2 – Local #1 – Community Hospital of AnacondaLocal #3 – Rocky Mountain Clinic Local #5 – Saint James HealthcareLocal #7 – Montana State HospitalLocal #36 – Montana Chemical Dependency CenterLocal #37 – Butte Silver Bow Health Department
District 3: Gallatin County, Madison County, Park County and Sweet Grass County
Local units in District 3 – Local #4 – Bozeman HealthLocal #6 – Fresenius Kidney Care – Bozeman
District 4: Broadwater County, Jefferson County, Lewis & Clark County and Meagher County
Local units in District 4 – Local #8 – Montana DPHHSLocal #13 – St Peters Hospital
District 5: Big Horn County, Carbon County, Carter County, Custer County, Fallon County, Golden Valley County, Musselshell County, Powder River County, Rosebud County, Stillwater County, Treasure County, Wheatland County and Yellowstone County
Local units in District 5 –Local #2 – Billings ClinicLocal #38 – Rosebud Health Care CenterLocal #44 – Holy Rosary Healthcare
District 6: Blaine County, Cascade County, Chouteau County, Fergus County, Glacier County, Hill County, Judith Basin County, Liberty County, Pondera County, Teton County and Toole County
Local units in District 6 – Local #11 – Cascade City – County Health DepartmentLocal #12 – Northern Montana Health CareLocal #14 – Montana Mental Health Nursing Care CenterLocal #25 – Northern Rockies Medical Center
District 7: Flathead County, Lake County, Lincoln County and Sanders County
Local units in District 7 – Local #22 – Cabinet Peaks Medical CenterLocal #27 – Montana Veterans HomeLocal #34 – Clark Fork Valley Hospital
District 8: Daniels County, Dawson County, Garfield County, McCone County, Petroleum County, Phillips County, Prairie County, Richland County, Roosevelt County, Sheridan County, Valley County, and Wibaux County
Local units in District 8 – Local #21 – Glendive Medical CenterLocal #39 – Sidney Health Center
If you have any questions regarding your District, please contact Jennifer at [email protected].
New Member Benefit: MNA now offers certification through ANCC’s Success Pays® Program
> Reduced fee for MNA Members to obtain initial certification or recertify
> No cost if you don’t pass the exam; you can also take the exam a second time at no cost
> Pay only when you pass!> Identify your specialty practice area
How Success Pays® Works> Visit nursingworld.org/our-certifications/ to:
• Make sure you’re eligible to sit for the exam• Look at the test blueprint and test preparation materials• Make the decision to move forward
> Visit www.mtnurses.org and click on Success Pays® option to the left and sign up for the program!> MNA will contact you regarding how to get the benefit.
Jennifer HamiltonAdministrative
Assistant
CONGRATULATIONS TO THE FOLLOWING NURSES WHO HAVE TAKEN ADVANTAGE OF THE SUCCESS PAYS OFFERING BY ANCC TO MNA MEMBERS!
1. Juanita Wade RN-BC; certified in Medical-Surgical Nursing
2. Angela Gottwig RN-BC; certified in Cardiac/Vascular Nursing
3. Riley Braun RN-BC; certified in Medical-Surgical Nursing
4. Anastasia Ryan RN-BC; certified in Medical-Surgical Nursing
5. Jamie Benes RN-BC; certified in Medical-Surgical Nursing
6. Sue Edelbach RN-BC; certified in Medical-Surgical Nursing
7. Nichole Schmidt RN-BC; certified in Medical-Surgical Nursing
Page 6 Montana Nurses Association Pulse February, March, April 2020
Professional Development Department
Professional “Well-Being” and BurnoutHow would you rate your
own professional “well-being?” Have you stopped to reflect on your own work and what it means to you today? Is your perception of your value to your patients and your organization the same as it was a year ago? Five years ago? When you started in the profession? How do you feel when you get ready for work each day? Excited, enthusiastic, and energized, or drained, discouraged, and disillusioned?
Over the past 20 years, the National Academies of Sciences, Engineering, and Medicine have published several reports related to reducing errors and improving the practice of healthcare providers. Fundamental to both of those goals is creating and maintaining professional well-being. If we don’t take care of ourselves, we can’t effectively care for others. This perspective is also reinforced by the Institute for Healthcare Improvement, which advocates for actions to achieve the quadruple aim – improving quality of care, improving the patient experience, reducing medical care costs, and improving the experience of healthcare providers.
The National Academies of Sciences, Engineering, and Medicine has just released (December, 2019) its latest report, “Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being.” This report identifies burnout as consisting of emotional exhaustion, cynicism, and a low sense of accomplishment at work. Do these symptoms resonate with you? What do you do to combat these feelings – or avoid them, if you haven’t been affected? It is estimated that 35-54% of physicians and nurses in the United States have some or all of these symptoms, which often impact their ability to practice safely and/or have negative impacts on their health and personal lives.
While there is no “magic bullet” to prevent burnout or make it go away, addressing the problem is critical to clinicians, patients, and healthcare organizations. The NASEM report has a number of recommendations to address the problem of burnout. These include:
1. Making systemic changes, such as work-flow processes and appropriate use of technology, as well as looking at the culture of the organization and support for staff. Providing meaning in work, encouraging teamwork and interprofessional collaboration, and engaging all staff in participatory decision making help to create a culture of caring and support.
2. Professional development opportunities are key to helping staff learn and grow. These activities need to be meaningful and purposeful and designed to address gaps to strengthen practice. Creating and sustaining positive learning environments, both physical and virtual, encourage purposeful, ongoing development and foster a sense of pride and self-worth. Additionally, educational activities need to address the problem of burnout head-on, providing real-life expectations so students are prepared for the challenges of clinical practice, developing strategies for building resilience, and creating an environment in which all staff are encouraged and supported in seeking assistance in dealing with symptoms of burnout.
3. Reducing administrative burdens and unnecessary processes that are time-consuming and frustrating yet provide little benefit or return on investment. To some extent, these changes can be managed within an organization, but governmental, regulatory and accrediting agencies play significant roles in making these changes. Have you thought about how you might use your voice and your experience to suggest changes? Have you considered applying to be a member of the board of nursing or a member of a unit council in your organization? At both state and local levels, there are opportunities for engagement
– and people who work in regulatory and administrative roles often don’t know what those burdens are unless we share our experiences and recommendations.
4. Technology can be a burden, or it can be used to increase efficiency and productivity. Appropriate use of technology is key to reducing burnout. Granted, there is a learning curve with any new technology, and change is hard. However, a proactive approach to integrating helpful technology can have significant positive effects in both workflow and morale.
5. Support must be provided to clinicians to help them get the support and resources they need to deal with work in a very high-stress environment. Do you have an employee assistance program or access to counseling services in your place of employment? Do you feel supported and encouraged to use these services, or is it seen as a sign of weakness if you or a colleague identify the need for help?
6. Additional evidence is needed to show the effectiveness of these various points of intervention in preventing and dealing with burnout. While there is clear data to show that burnout is a problem and that it has negative impacts on providers, patients, and organizations, there is much less evidence of the value of various interventions. How can we leverage our knowledge of evidence-based practice to develop and implement effective methods to help colleagues? How can we collect and share evidence demonstrating our successes?
The bottom line – today’s healthcare environment is stressful in many ways. Failure to address burnout will have increasingly disastrous impacts on providers, patients, and organizations. All of us have responsibility to contribute to improving our practice environment, supporting colleagues, creating positive learning environments, and advocating for a culture of caring and support for providers as well as for patients. What can you do? What will you do?
Elevating Care for Our Veterans Through High-Quality Professional Development
Amanda Garey, MSN, BSN
On November 7, 2019, the Montana Nurses Association (MNA) hosted the fourth annual Seamless Care for Our Veterans conference in collaboration with Veterans Affairs (VA) Health Care, Montana Geriatric Education Center, and Montana Primary Care Association. The conference was presented in Helena, Montana and included broadcast participants from Lewistown, Missoula, and Miles City.
The overall goal of the conference was to acquire knowledge and skills of assessment to identify risks and illnesses common to the military veteran and their families, know how to access programs available for Veterans and their families and initiate and provide quality care to this unique patient population. Attendees enjoyed topics of the patient aligned care team model, medication assisted treatment, brain injury, sleep disorders, chronic pain, opioid use disorder and Post-Traumatic Stress Disorder (PTSD).
Before the conference, an expectation survey was sent out to those that were registered for the conference. Recurring themes of expectations included resources, communication techniques, mental health, pain management, access to treatment and healthcare coverage. Baby Boomers, born 1946-1964 were the majority of respondents on the pre-conference expectation survey.
Forty-five attendees were present, 26 live and 19 broadcast at four remote sites. Attendees included interprofessional teams with representation from pharmacy, nursing, social work, counseling services, and healthcare students. During the conference, attendees were actively engaged asking questions and reflecting on their own experiences of caring for veterans. Learners at remote sites used the chat window in go-to-meeting to facilitate engagement and discussion.
After the conference, four phone interviews were conducted finding themes of a positive learning experience, high impact information, and pain
Pam A. Dickerson, PhD, RN, NPD-BC, FAAN Director of Professional
Development
management resolution. One nurse practitioner stated, the “conference was delightful and worth my time.” Another stated, the “broadcast was great and I enjoyed learning multiple perspectives of different disciplines.” A student shared that the conference was “valuable, influenced a culture of trust within a team and motivated her to seek understanding and bridge gaps in veterans care.”
After the conference, a post activity evaluation was sent out to all attendees. Overall, sessions scored high, contributing to learners’ perceptions that their practice would be positively impacted as they provide care for veterans in various practice settings. Formative evaluation showed that learners were actively engaged throughout the day. Attendees reflected on their own practice and were able to verbalize or write expectations about use of content in their practice settings.
A post-activity debriefing was held with all members of the planning committee, including all joint providers. All community partners involved have continued interest in contributing to next year’s conference and agreed that
1. the location is ideal, and 2. the remote broadcasting worked well.
The Seamless Care for Our Veterans conference has shown a positive influence on the interprofessional learning experience and is elevating the quality of care for veterans in the Montana community.
Central Montana Medical Center408 Wendell Ave. Lewistown, MT 59457
406.535.6213 (fax) 406.535.4698www.cmmc.health
Occupational Health Nurse PractitionerFull-time position
Apply on-line:
cmmc.health
CMMC is Hiring!
February, March, April 2020 Montana Nurses Association Pulse Page 7
Excerpts from ANA
Excerpted FromA practical approach to disclosing conscientious objectionBy Robert Anderson, DNP, APRN, CNP, and Joan Henriksen, PhD, RN
Professional consequences of conscientious objection
What risks do you take when you make a claim of consci entious objection (CO)? It depends.
In the push and pull between protecting clinicians' reli gious or moral views and protecting patients' access to healthcare and information, the terrain frequently shifts. Specific protections around abortion-related exemptions have existed since the early 1970s. Additional legal protec tions vary broadly both at the federal and state levels, and how they're interpreted and enforced frequently depends on the political landscape.
Conscience laws As recently as early 2018, the Centers for Medicare and Medicaid Services,
as part of the Department of Health and Human Services, introduced new rules to make it easi er for states to enforce conscience laws.* These laws are meant to protect individuals and organizations from being compelled to participate in activities that violate their con science. A new Conscience and Religious Freedom Division was formed within the Office for Civil Rights.
Mitigating risk The news occasionally features individual court cases relat ed to CO.
Assessing whether the cases constitute prece dent that might be relevant to specific situations is diffi cult. Remember that choices and behaviors have risks and that multiple factors influence what consequences you might experience when making a CO claim. Consult with your direct supervisor and the human resources depart ment to understand organizational policies and proce dures for making CO claims.
*Statutes frequently are based on the Coats-Snowe (1996, 42 U.S. Code § 238n), Weldon (2009, Consolidated Appropriations Act, PL 111-117, 123 Stat 3034), and Church (1973, 42 U.S. Code§ 300a-7) amendments.
Source: United States Department of Health and Human Services. HHS announces new Con-
science and Religious Freedom Division [press release].January 18, 2018. hhs.gov/about/news/2018/01/18/hhs-ocr-announces-new-conscience-and-religious-freedom-division.html
American Nurse Today; December 2019, Volume 14, Number 12; Pages 22-24
Excerpted FromAntibiotic Stewardship By Norman Wright, MS, BS, RN
Antibiotic stewardship recommendations
Your understanding of antibiotics, antibiotic resistance, and microbiology results can help ensure appropriate antibiotic use. Follow these recommendations from the American Nurses Association and Centers for Disease Con trol and Prevention. • Use proper technique to obtain appropriate cultures be fore
antibiotics are started.• Consult microbiology results to help guide antibiotic se lection and
termination when appropriate.• Encourage starting antibiotics as soon as signs of likely bacterial
infection are identified.• Advocate for good antibiotic practices in quality im provement efforts.• Initiate and participate in discussions about antibiotic use (for
example, evaluate each patient’s clinical status and readiness for change from I.V. to oral therapy, when possible).
• Take detailed allergy histories, especially for penicillin allergy. Educate patients and families about the impor tance of these histories.
American Nurse Today; November 2019, Volume 14, Number 11; Pages 46-47
Antibiotic resistance is a growing global threat that goes beyond methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci, and other familiar multidrug-resistant (MDR) pathogens. In fact, MDR organisms (those resistant to three classes of antibiotics) are now overshadowed by carbapenemresistant Enterobacteriaceae, which can be pan-drug resistant – resistant to all classes of antibiotics.
As a nurse, your antibiotic stewardship responsibility should be based on doing no harm, which can be accomplished with basic infection prevention practices and taking specific steps to ensure appropriate antibiotic use.
Page 8 Montana Nurses Association Pulse February, March, April 2020
Statewide Nursing News
RECAP OF PART I THEORETICAL LEADERSHIP PRINCIPLES & DEFINITIONS:
1. Definition of a Theory: A set of principles providing a basis for nurse administrator behaviors.
2. Leadership Theory: A body of administrative p r i n c i p l e s / t h e o r i e s related to leadership behaviors.
3. Positive Psychology Theory: A reinforcement of positive behaviors with the intention of encouraging future positive behaviors. (A component of Operant Conditioning)
4. Situational and Contingency Theories: The “IT ALL DEPENDS” theories. These theories support the nurse administrator’s job subjective decision(s) related to the nurse leader’s ability to perform nursing tasks and people relationships. It, also, encompasses the nurse administrator’s decision/choice to perform a “leader” or a “manager” role in selected situations. (Remember: Management is telling/informing nurse leaders what to do or what is expected – e.g. job description. Leadership is involving nurse leaders or selected others in decision-making and/or related nursing activities.
5. Nurse Administrator: Usually known as a Director of Nursing (DON).
6. Nurse Leader: Usually known as a Registered Nurse.
7. Job Description: A formal written and signed accounting of a nurse leader’s minimal responsibilities and/or behaviors for which he/she is held accountable in order to maintain a specific job assignment.
8. Bloom’s Taxonomy: A list of verb choices to be used to write each job expectation as stated in a formal job description. There are three domains – cognitive, psychomotor, and affective (feelings and attitude.) Usually, minimal expectation verbs are used for job descriptions; whereas, moderate to maximum expectation verbs are used for academic course syllabi. Minimal and maximum verb choices are available on-line.
GREAT MAN THEORY/CHARISMATIC THEORY (Thomas Carlyle, historian, writer and Herbert Spencer, sociologist, philosopher, and political theorist – 1800s)BELIEF: A LEADER IS BORN AND NOT MADE!
Theories, in general, have their origin as an outcome of historical observation. This theory
originated and has been observed since the 19th century. Some men/women over several centuries have found their place in history as “GREAT.” Some examples are Abraham Lincoln, Mahatma Gandhi and Alexander the Great. Clara Barton (founder of the Red Cross) and Florence Nightingale (founder of modern nursing) are examples of nursing in-born greatness. These people produced divine inspiration (probably forever) that has influenced social conditions in a positive manner.
Today, some facilities/organizations have historical pictures of “great” employees on their wall for the purpose of inspiration to other employees. There are people that will forever be known as charismatic that meet the definition of greatness. Your recognition as a nurse administrator of obvious in-born nurse leader potential for greatness or recognition of charismatic leadership behavior(s) is a validation of the Great Man Theory.
TRAIT THEORY (Dr. Gordon Allport, psychologist – 1900s)BELIEF: A LEADER IS BORN AND NOT MADE!
This theory says that people really are who they consistently represent themselves to be! For example, when a person is kind – they are (for the most part) usually kind. When a person is mean – they are (for the most part) usually mean. There is a pervasive pattern of behavior/trait (good or bad) that is consistent and usually stable in their relationships with others. A nurse leader with personal positive traits will usually show adaptability to a situation, cooperativeness, decisiveness, self-confidence, and an ability to tolerate stress.
Task traits versus relationship traits could be applied to the Trait Theory. For example: If you believe in the Trait Theory, then you understand that naturally in-born high performing relationship-oriented nurse leaders often have relationship traits to care for sensitive or grieving patients and families. They, also, often are liked by others and more likely to encourage positive work responses in other nurse leaders and supportive staff. Conversely, in-born high performing task-oriented nurse leaders are often known for systematic organizing, performing intricate processes and finite details, and often will stay on task to get a job done in a given amount of time.
Keep in mind that teaching high task behaviors to nurse leaders with high relationship behaviors is considered, usually, to be easier than trying to teach nurse leaders with high task performance behaviors. To find a nurse with high in-born
relationship abilities and high task abilities is an exceptional finding – but, not impossible!
Think about the times you, as a nursing administrator, are (or will be) expected to watch the nurse leaders to determine a specific tendency toward high tasks or high relationships as a personal trait! If you cannot or have not done that – now is past time to learn those skills! Choosing a nurse leader to do a specific job according to obvious traits is a skill! Your choice of a certain nurse leader to do
a specific job related to tasks or relationships is according to a theory that says IT ALL DEPENDS – and it often depends on personal traits! (Remember Situation and Contingency Theories?)
Be smart in your employment choices according to obvious traits! You never want another person to say as an outcome of a nursing administrator’s inappropriate job placement of a nurse leader resulting in a negative patient or family situation that they (and not you) were aware of the negative traits that caused a problem.
BEHAVIORAL THEORY (J.B. Watson, psychologist and B.F. Skinner, psychologist – 1900s)BELIEF: A LEADER IS MADE AND NOT BORN!
Historically, this theory followed the Trait Theory. It described a nurse leader in terms of behaviors instead of existing personal traits. Everyone has an opportunity to be a great leader is the message – you just have to learn how to do it! It, also, involves a form of psychotherapy to modify disagreeable job-related behavior. Consequently, the nurse leader ultimately performs leadership by improving his/her personal mental well-being and job-related skills. The therapy is most useful as an adjunct to improving or positively modifying nurse behaviors.
Use of the Behavioral Theory in an extensive manner is probably more expensive, time-taking, and a risky approach than to have a nurse leader that has at least some in-born job-related traits for a nurse leader assignment. Sometimes this associated on-the-job-behavioral training results in questionable success. Psychology reminds us that people will eventually continue to do what has historically worked for them. Therefore, to learn and change behaviors for a long period of time is a challenge.
This is not to imply a nurse leader cannot learn to become an effective nurse leader in some cases. This does imply, however, that during the process of learning and practicing how to be a successful and effective nurse leader in his/her new role assignment, errors in judgement might result in staff confusion, disorientation, and process repetitive changes that cause more time than desired and functionally effective.
If you choose this theory as a nurse administrator and as the primary basis out of choice or need, please be gentle with a nurse leader seeking to learn intricate details of their job assignment related to their job description. This approach takes time and patience to often learn the hard-way! Always adjust job descriptions (minimum expectations) that thoroughly and completely represent new changes in their new nurse leader assignment.
Ineffective and inaccurate nurse leader decisions during the learning process can leave lasting harmful effects and consequences – meaning help and persistent monitoring are necessary by the nurse administrator! Determining a nurse leader to undergo the teaching process related to Behavioral Theory will, also, require a consideration of personal traits to produce job description success.
Carolyn TaylorEd.D, MN, RN
THEORIES: THE BASIS FOR LEADERSHIP DECISIONS (PART II)A NURSE ADMINISTRATOR’S GUIDE TO SUCCESS!
Join us in Great Falls!REGISTER TODAY
Improving the way clinicians diagnose, treat, manage, and educate their patients.
Clinical STD UpdateApril 2, 2020 Great Falls, MT
CNE/CME Available
For more information:206-685-9850 • uwptc.org • [email protected]
We are looking for
passionate and
caring nurses to
join our team.
RN – Inpatient NursingFull Time or Part Time
Competitive salary, great benefit package, student loan repayment and relocation expenses available.
Please contact the HR department at (406) 228.3662 for more information.
http://www.fmdh.org FMDH is an Equal Opportunity/Affirmative Action Employer
February, March, April 2020 Montana Nurses Association Pulse Page 9
Montana Nurses Association Approved Providers
Acute Care EducationVancouver, WA
Mat-Su Regional Medical Center Palmer, AK
Alaska Native Tribal Health Consortium Anchorage, AK
Montana Geriatric Education Center of UMMissoula, MT With Distinction
Alaska Nurses AssociationAnchorage, AK
Montana Health NetworkMiles City, MT
Alaska Regional HospitalAnchorage, AK
Montana VA Health Care SystemHelena, MT With Distinction
Alzheimer’s Resource of AlaskaAnchorage, AK
Mountain Pacific Quality HealthHelena, MT
Bartlett Regional HospitalJuneau, AK With Distinction
North Valley Hospital Whitefish, MT With Distinction
Benefis Healthcare SystemsGreat Falls, MT
Pacific Lutheran UniversityTacoma, WA
Billings ClinicBillings, MT
Planned Parenthood of the Great Northwest and the Hawaiian IslandsSeattle, WA
Boise State School of NursingBoise, ID
Providence Alaska Learning Institute Anchorage, AK
Bozeman HealthBozeman, MT
Providence HealthcareSpokane, WA
Cardea ServicesSeattle, WA
Providence St. Patrick HospitalMissoula, MT With Distinction
Caring for Hawai’i NeonatesHonolulu, HI
South Dakota Nurses Association Pierre, SD
Central Peninsula General Hospital Soldatna, AK With Distinction
South Peninsula Hospital Homer, AK With Distinction
Community Medical Center Missoula, MT
St. Alphonsus Health SystemBoise, ID
Confluence Health East Wenatchee, WA
St. Luke’s Health System Boise, ID
Evergreen HealthKirkland, WA
St. Peter’s Health Helena, MT
Foundation Health PartnersFairbanks, AK
St. Vincent Healthcare Billings, MT
Kadlec Regional Medical CenterRichland, WA
UF Health Shands Hospital Gainesville, FL
Kalispell Regional Healthcare System Kalispell, MT With Distinction
Wisconsin Nurses Association Madison, WI With Distinction
Kootenai HealthCoeur d’Alene, ID With Distinction
MNA thanks all of the Approved Provider Units we work with for their commitment to advancing and promoting quality nursing practice through continuing nursing education.
Know this – in the long-run, every nurse administrator has the potential of making judgement errors regarding potential and successful nurse leaders. Oh well – Just be contrite enough to realize your nurse administrator job assignment errors. Move forward, then, and make adjustments and new more accurate decisions, accordingly.
FYI: Each domain job description behavior starts with a verb. The three domains are cognitive, psychomotor, and affective (feelings and attitude). The accurate verb (minimal expectation) per each behavior in each domain can be selected by accessing a list of possible verbs available on a “Bloom’s Taxonomy” website.
OPERANT CONDITIONING (B.F. Skinner, Psychologist—1900s)Operant Conditioning (Instrumental Conditioning) is a learning process
through which the strength of a behavior is modified and reinforced through reward or punishment. Nursing administrators, also, should know that employees/people, by their very human nature, most often and ultimately do what works for them and that an employee’s past behavior will usually predict future behaviors. Being employed should mean an employee is expected to behave in a manner that works to meet the philosophy, goals, and objectives of the facility/organization. A nursing administrator’s role is to constantly monitor performance of job description expectations in order to reinforce positive behavior and correct immediately negative behaviors.
Chastising needs to be in private and immediate post observation or reporting – the sooner the better. Culminate the chastising with an example of positive behavior that would be acceptable. It is often too late for productive positive change if this confrontation waits until the next job description evaluation or sometime in the future when it is considered to be convenient. Just imagine the reinforcement of negative behavior repetitive opportunities
that would reinforce the negative behavior(s) or add collateral additional misbehavior due to a prolonged time before counseling from a nursing administrator! Such statements of required improved behavior change(s) followed by a positive expectation to counteract the negative behavior should be incorporated into the nurse’s job description and signed or initialed by the confronted nurse leader.
As an effective nurse administrator, always have the ability to state to a nurse leader the consequences of not stopping the identified negative behavior(s). On the gentler side, be objective, try to see things through the nurse leader’s eyes and, then, help this nurse leader to move on to more positive behaviors that will support better outcomes. This balancing act of fairness, firmness, and objectivity is the way of a true leader – isn’t it?! Yes, you have a tough job – but you, as a nurse administrator were identified to (hopefully) have the intellect and theoretical knowledge to do this!!
UNIVERSAL POWER OF THE NUMBER THREE (3) THEORY The following three (3) nursing administrator leadership expectations are
supported by the Universal Power of the Number Three (3) Theory. Consider the number of three (3) in our lives! Some are related to math, science, religion, biblical stories, poems, stories, philosophy, astronomy, art and the very make-up of our genes – e.g. The trilogy, triangle, Three Little Pigs, Three Musketeers, waltz, three wisemen with their three gifts, Orion’s Belt, past-present-future, the “third eye,” and yesterday-today-tomorrow (and that is certainly not all!) Therefore, nursing administrators, also, have three expected powers when performing administrative behaviors.
(1) RESPOND TO NEGATIVE & POSITIVE BEHAVIORS (2) PROVIDE IMPROVEMENT INFORMATION (3) SUPPORT POSITIVE CHANGE
Public Health Agencies respond to New Coronavirus
Public health agencies at all levels are responding to a new coronavirus originally identified in Wuhan, a city of 11 million in the Hubei province of China. Since the detection of the virus, currently known as 2019 nCoV, the illness has spread quickly in China resulting in over 20,000 cases and over 400 deaths reported in China as of 2/4/2020. While nearly 30 countries have reported at least one case, including 11 in the United States with direct and indirect links to Wuhan, China appears to be the only area with sustained transmission of the virus at this time.
The virus is closely related to other coronaviruses that have caused past outbreaks, including Severe Acute Respiratory Syndrome (SARS) in 2003 and Middle Eastern Respiratory Syndrome (MERS) in 2012. At this time, not enough information is available to determine whether the new virus will become well-established and result in broader world-wide spread. However, such spread is considered likely and public health agencies are responding aggressively to slow spread as we try to learn more about the virus.
Recently, the US government enacted quarantine measures targeting returning travelers from mainland China, particularly with an emphasis on those returning from Hubei province. At this time, travelers from the province will undergo a strict 14-day quarantine to monitor for any signs of illness. Travelers from mainland China, but who were not in Hubei province, will have a less strict self-quarantine monitored by local public health officials.
The Montana Department of Public Health and Human Services (DPHHS) is working closely with local public health agencies to prepare for monitoring of travelers and the potential for cases. Currently, only the US CDC can perform testing for this specific virus and only after consultation with local and state public health officials. Public health authorities are stressing the following:
• Stay informed by visiting our web site which includes recent Health Alert Network messages, information on any Montana cases or Patients Under Investigation (PUI) as well as relevant links to important guidelines from the CDC. The site can be reached at: https://dphhs.mt.gov/publichealth/cdepi/diseases/coronavirusmt
• Ensure your facility has contact information, including after hours contact numbers, for your local public health department. Prompt reporting of any concerns will help with rapid assessment of any patients of concern.
• Review CDC guidance on precautions to take in your settings to prevent this and other respiratory conditions from spreading. Specific guidance on clinical care and infection control practices can be found at: https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html
• Be aware that currently only travelers that have been within mainland China within 14 days of symptom onset or who have been a contact to a known case are patients needing further investigation and reporting to public health authorities. Travel to other international destinations or being in an airport are not considered risks at this time. The CDC and DPHHS web sites will be updated frequently as information changes.
Please contact your local public health department to address any questions or concerns regarding this issue.
Page 10 Montana Nurses Association Pulse February, March, April 2020
Amanda May Wacker Happel, MN, BSN, RN-BC, CNL
The need for an effective transition to practice program, such as nurse residency programs (NRPs), has been documented for over 80 years (Townsend, 1931 as cited in Spector et al., 2015). Anderson, Hair, and Todero (2012) stress how new graduate registered nurses (RNs) face high patient acuity and complex situations, and nursing shortages, high turnover, burnout, excessive overtime demands, reduced new RN orientations (Joint Commission on Accreditation of Healthcare Organization, 2002; Jones & Gates, 2007 as cited by Anderson et al., 2012). Not only does this turnover negatively affect morale and job satisfaction, it’s also expensive with the estimated cost to replace these nurses ranging from $49,000 to $92,000 per nurse (Kram & Wilson, 2016). NRPs have been recommended to combat turnover and provide support during the transition into professional practice (Benner, Sutphen, Leonard, & Day, 2010; IOM 2011; The Joint Commission, 2002 as cited by Spector et al., 2015; Cochran, 2017). However, despite these recommendations, there continues to be a lack of comprehensive, evidence-based NRPs offered by employers (Spector, et al., 2015). An integrative review of literature was completed in November, 2019 to explore the best practice components of NRPs.
Using the framework of Whittemore & Knafl (2005) to guide the process, this integrative review was performed by mining relevant literature from predetermined databases and all reference lists of the selected literature between June 2018 and August 2018. Search results identified a total of 1148 potentially relevant articles. In the initial review of inclusion criteria three articles were eliminated because they were not available in English, 218 articles were excluded as they had not been conducted within the United States, and 339 duplicates were removed. Additionally, 594 publications were eliminated as they were found not to be relevant to the purpose of this review. Some repeating reasons for article exclusion included: pertaining to nurse practitioner graduates, relating to student nurse externships, addressing LPN programs instead of RN programs, not focusing on acute care settings, and a generalization of NPRs without discussing components. This left 26 prospective articles, which were then further evaluated. Seventeen additional studies were eliminated for 1) duplication of another study, 2) for not discussing specific components of NRPs, but instead NRPs in general,
or 3) for focusing on a single teaching method/item and not discussing the NRP as a whole. This left a total of nine articles, whose references were mined for additional articles. A further four articles were found to fit inclusion criteria, bringing the total number of articles meeting inclusion criteria to 13.
After reviewing how different factors affect the transition of new graduates, it was concluded that an NRP based on a national model, such as the American Association of Colleges of Nursing (AANC)/ University HealthSystem Consortium (UHC) National Post-Baccalaureate Graduate Nurse Residency Program (Krugman et al., 2006) or the National Council of State Boards of Nursing’s (NCSBN) Transition to Practice model program (Spector et al., 2015), or developed internally in congruence with national models would provide best chance for a successful transition for new graduates. This model would include an adaptive, evidence-based curriculum that is customized to the patient populations and unit specifics, a program length of at least 12 months, and training and careful selection of preceptors and mentors. Additionally, it is recommended to that NRP staff have an awareness of differences in new graduate ADN and BSN preparedness and skill sets and adapt the NRP as needed to accommodate both cohorts.
REFERENCESAmerican Academy of Nursing Community. (2011). One
year post-baccalaureate nurse residency. Retrieved from http://www.aannet.org/initiatives/edge-runners/profiles/edge-runners--one-year-post-baccalaureate-nurse-residency.
American Academy of Nursing Community. (2013). Competencies and curricular expectations for clinical nurse leader education and practice. Retrieved from https://www.aacnnursing.org/Portals/42/AcademicNurs i ng /Cur r i cu lumGu ide l i nes /CNL-Competencies-October-2013.pdf
Anderson, G., Hair, C., & Todero, C. (2012). Nurse residency programs: An evidence based review of theory, process, and outcomes. Journal of Professional Nursing, 28(4), 203-212. doi:10.1016/j.profnurs.2011.11.020.
Beecroft, P. C., Kunzman, L. A., Taylor, S., Devenis, E., & Guzek, F. (2004). Bridging the gap between school and workplace: Developing a new graduate nurse curriculum. Journal of Nursing Administration, 34 (7/8), 338-45.
Benner, P. (2001). From Novice to Expert: Excellence and Power in Clinical Nursing Practice, Commemorative Ed. Prentice Hall Health, Upper Saddle River, NJ.
Buerhaus, P. (2017, February 3). MSU professor and colleagues publish regional nursing workforce supply projections In MSU News Service by Cantrell, A. Retrieved February, 21, 2018 from http://www.montana.edu/news/16701.
Cambridge Dictionary. (n.d.). Definition of "salience" – English Dictionary. Retrieved February 23, 2018, from https://dictionary.cambridge.org/us/dictionary/english/salience.
Cline, D., Frentz, K. L., Fellman, B., Summers, B., & Brassil, K. (2017). Longitudinal outcomes of an institutionally developed nurse residency program. JONA: The Journal of Nursing Administration, 47(7/8), 384-390. doi:10.1097/nna.0000000000000500.
Cochran, C. (2017). Effectiveness and best practice of nurse residency programs: A literature review. MEDSURG Nursing, 26(1), 53-63.
Crawford, C. (2014). Integrative review process. Retrieved January 21, 2018, from http://www.academyebp.org/education/integrative-review-process.
Delack, S., Martin, J., McCarthy, A. M., & Sperhac, A. M. (2015). Nurse residency programs and the transition to child health nursing practice. JONA: The Journal of Nursing Administration, 45(6), 345-350.
Harrison, D., & Ledbetter, C. (2014). Nurse residency programs. Journal for Nurses in Professional Development, 30(2), 76-82. doi:10.1097/nnd.0000000000000001.
Hansen, J. (2015). Results from the National Council of State Boards of Nursing’s transition to practice study, part 2. Journal for Nurses in Professional Development, 31(4), 240-241. doi:10.1097/nnd.0000000000000189
Health Resources and Services Administration (HRSA) (2017, July, 21). Supply and demand projections of the nursing workforce: 2017-2030. Retrieved December 1, 2017 from http://bhw.hrsa.gov/health-workforce-analysis/research/projections
Keller, J. L., Meekins, K., & Summers, B. L. (2006). Pearls and pitfalls of a new graduate academic residency program. JONA: The Journal of Nursing Administration, 36(12), 589-598. doi:10.1097/00005110-200612000-00010.
Kramer, S. L., & Wilson, J. (2016). Nurse residency program attracts and retains novice nurses. Nursing2016, 46(2), 15-16. doi:10.1097/01.nurse.0000476245.39588.ff.
Kramer, M., Maguire, P., Halfer, D., Budin, W. C., Hall, D. S., Goodloe, L., . . . Lemke, J. (2012). The organizational transformative power of nurse residency programs. Nursing Administration Quarterly, 36(2), 155-168. doi:10.1097/naq.0b013e318249fdaa.
Krugman, M., Bretschneider, J., Horn, P. B., Krsek, C. A., Moutafis, R. A., & Smith, M. O. (2006). The national post-baccalaureate graduate nurse residency program. Journal for Nurses in Staff Development (JNSD), 22(4), 196-205. doi:10.1097/00124645-200607000-00008.
Letourneau, R. M., & Fater, K. H. (2015). Nurse Residency Programs: An integrative review of the literature. Nursing Education Perspectives, 36(2), 96-101. doi:10.5480/13-1229.
Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidenced-based practice in nursing & healthcare: A guide to best practice. 3rd ed., Philadelphia, PA: Wolters Kluwer.
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice. Philadelphia, PA: Wolters Kluwer.
Poynton, M. R., Madden, C., Bowers, R., & Keefe, M. (2007). Nurse residency program implementation: The Utah experience. Journal of Healthcare Management, 52(6), 385-397.
Reinsvold, S. (2008). Nursing Residency: Reversing the cycle of new graduate RN turnover. Nurse Leader, 6(6), 46-49. doi:10.1016/j.mnl.2007.11.002.
Sandau, K. E., & Halm, M. A. (2010). Preceptor-based orientation programs: effective for nurses and organizations? American Journal of Critical Care, 19(2), 184-188. doi:10.4037/ajcc2010436
Smith, J. B., Rubinson, D., Echtenkamp, D., Brostoff, M., & McCarthy, A. M. (2016). Exploring the structure and content of hospital-based pediatric nurse residency programs. Journal of Pediatric Nursing, 31(2), 187-195. doi:10.1016/j.pedn.2015.10.010.
Spector, N., Blegen, M. A., Silvestre, J., Barnsteiner, J., Lynn, M. R., Ulrich, B., . . . Alexander, M. (2015). Transition to Practice Study in Hospital Settings. Journal of Nursing Regulation,5(4), 24-38. doi:10.1016/s2155-8256(15)30031-4
Spector, N., & Echternacht, M. (2010). A regulatory model for transitioning newly licensed nurses to practice. Journal of Nursing Regulation, 1(2), 18-25. doi:10.1016/s2155-8256(15)30346-x
Strauss, M. B. (2009). Easing the transition: A successful new graduate program. The Journal of Continuing Education in Nursing, 40(5), 216-220. doi:10.3928/00220124-20090422-06.
Welding, N. (2011). Creating a nursing residency: decrease turnover and increased clinical competence. MedSurg Nursing, 20(1), 37-40.
Whittemore, R. & Knafl, K. (2005). The integrative review: updated methodology. Journal of Advanced Nursing, 52(5), 546-553.
Best Practice Components for Nursing New Graduate Residency Programs: an Integrative Review of the Literature.
Professional Travelers Inc.
If interested, please email resume to [email protected] or call the
Staffing Director at 1-406-203-6008.
Professional Travelers Inc. is a Western Montana based healthcare traveling agency that employs CNAs, LPNs, and RNs. We are the highest paying traveling company in the area!
CNA: $19 LPN: $29RN: $40
$.55 a mile for traveling expenses.
February, March, April 2020 Montana Nurses Association Pulse Page 11
APRN CornerHello APRNs, get your
calendar out, get the days off work and make sure you are signed up for the Annual MNA APRN Pharmacology Conference – February 28th and 29th in Helena at the Delta Colonial Hotel https://cnebymna.com/aprn/ Last year we had over 120 APRNs sign up and are looking forward to seeing you all. It is such a great time to reconnect and meet new APRNs. The conference will cover topics from coding a Transitional Care Visit, conducting difficult conversations with patients about opioid use, drug testing and "option tool box." Anxiety, depression, urologic, CHF, antithrombotic use in Atrial Fib, medications in lactating women, just to name a few. There will be vendors and a brief state and national legislative summary.
This is always a fun and exciting time – bring a friend and let's make this the best state conference yet. See you all soon. [email protected]
Keven ComerMN, APRN, FNP-BC
Everyone Deserves A Job They Love!!Let Us Help Today, Call 406.228.9541
Prairie Traveler’s Commitmentto our Staff
• Excellent Wages • Health Care Benefits• Travel Reimbursement • Annual Bonus• Paid Lodging • Zero Assignment• Flexible Work Schedules Cancellations• 24/7 Staff Support • Varied Work Settings
APPLY TODAY 406.228.9541Prairie Travelers Recruitment Department
130 3rd Street South, Suite 2 • Glasgow, MT 59230For an application or more information, visit
www.prairietravelers.com
Prairie Travelers is recruiting Traveling Healthcare Staff in Montana,
North & South Dakota • Registered Nurses (Hospital, ER, ICU, OB and LTC)• Licensed Practical Nurses• Certified Medication Aides• Certified Nurse Aides• Full-Time and Part-Time
Page 12 Montana Nurses Association Pulse February, March, April 2020
ANA SmartBrief
WHO declares coronavirus a global health emergencyCoronavirus death toll rises to 258 as US and others impose strict travel restrictions
News for the nursing profession
James Griffiths and Nicole Chavez, CNN
Updated 0051 GMT (0851 HKT) February 1, 2020
Hong Kong (CNN)The United States and other countries issued strict travel restrictions for foreign nationals who traveled to China as the number of deaths from the Wuhan coronavirus outbreak continued rising on Friday.
A day after the World Health Organization (WHO) declared the virus a global health emergency, Chinese authorities reported 45 deaths, all of them in Hubei, the province at the center of the outbreak of which Wuhan is the capital, bringing the total death toll across the country to 258.
As of Friday, there were more than 10,000 coronavirus cases confirmed in China, authorities said, an increase of over 2,000 from the previous day. That surpasses the 2003 severe acute respiratory syndrome (SARS) outbreak that began in southern China, which infected 8,098 people worldwide, killing 774.
More than 20 countries and territories outside of mainland China have confirmed cases of the virus — spanning Asia, Europe, North America and the Middle East – as the United Kingdom reported its first two cases on Friday.
On Friday, President Donald Trump signed a proclamation suspending the entry of foreign nationals who have traveled in China in the last two weeks and could pose a risk of spreading the virus, Health and Human Services Secretary Alex Azar said.
Foreign nationals who are the immediate family of US citizens or permanent residents are exempt. US citizens returning to the United States who have been in China’s Hubei province in the two weeks before their return will be subject to up to 14 days of mandatory quarantine, Azar said.
The decision by the WHO prompted governments to upgrade their own response to the virus, with the US State Department raising its travel advisory for China to it’s highest level: Do not travel.
The WHO defines a public health emergency of international concern as “an extraordinary event” that constitutes a “public health risk to other States through the international spread of disease,” and “to potentially require a coordinated international response.” Previous emergencies have included Ebola, Zika and H1N1.
Ghebreyesus, who met this week with Chinese President Xi Jinping, said the WHO “continues to have confidence in China’s capacity to control the outbreak.”
“We would have seen many more cases outside China by now — and probably deaths — if it were not for the government’s efforts,” he added.
Much of China goes back to work on Monday, after the Lunar New Year holiday was extended in an attempt to rein in the virus. The fear now — as tens of millions of people travel across the country and cities return to usual business — is that new self-sustaining epidemic spots will rear up.
Many schools and universities across the country will remain closed for much of next week.
Evacuation and spreadAs Wuhan and much of Hubei remains on
lockdown in a bid to contain the virus, many countries have begun extracting their citizens from the city.
A charter plane carrying more than 350 South Koreans landed at Gimpo International Airport near Seoul on Friday, following flights organized by the US and Japan to evacuate their citizens. Multiple other governments, including the UK, Australia, New Zealand and Canada are still arranging flights.
Meanwhile, more cases of the virus have been reported worldwide. Singapore confirmed three additional cases Thursday, bringing the total number of confirmed infections in the city to 13.
Health officials said all 13 cases are in a stable condition and “most are improving.” They also advised citizens to “defer all travel to Hubei Province and all non-essential travel to mainland China.”
The Singapore government said it will distribute four masks each to 1.3 million households in the city from Saturday. Other Asian territories, particularly Hong Kong, have struggled to maintain supply of masks, with many stores running out following an initial rush by residents to stock up.
More than 130 infections with the virus — but no deaths — have been reported outside mainland China.
The UK has confirmed its first two cases of Wuhan coronavirus in the northwest of England, according to a statement by Chris Whitty, the chief medical officer for England.
“We can confirm that two patients in England, who are members of the same family, have tested positive for coronavirus. The patients are receiving specialist NHS (National Health Service) care, and we are using tried and tested infection control procedures to prevent further spread of the virus,” he said.
“The NHS is extremely well-prepared and used to managing infections and we are already working rapidly to identify any contacts the patients had, to prevent further spread,” he added.
“We have been preparing for UK cases of novel coronavirus and we have robust infection control measures in place to respond immediately. We are continuing to work closely with the World Health Organization and the international community as the outbreak in China develops to ensure we are ready for all eventualities.”
Two of China’s neighbors have instituted emergency measures to try and stop the virus spreading there. Russia said it was closing its border in the Far East, and limiting rail services from all of China from January 31. Meanwhile, North Korea declared a state of emergency and said it was instituting a “hygienic and anti-epidemic” response.
Facing a long quarantineMuch of Hubei has been
under effective quarantine for weeks now, with almost every city facing travel restrictions in a province home to nearly 60 million people. Wuhan has been completely locked down, with residents cooped up in their homes and the streets abandoned.
Foreigners being airlifted out of the city are also facing up to two weeks of mandatory or voluntary quarantine once they land in their home countries.
However, this has sparked controversy in some countries, especially in Australia, where a plan to house evacuees in a former detention center for migrants on Christmas Island has generated no small amount of negative publicity.
Public broadcaster ABC spoke to some Australians in Wuhan who said they would rather remain in the city than face two weeks on what has been described by
some opposition lawmakers as a “leper camp,” even as Canberra defended its decision as the only place capable of quarantining hundreds of people.
At March Air Reserve Base in Southern California, where US evacuees were flown earlier this week, one man said he was willing to remain under quarantine “as long as I need.”
Jarred Evans said that the US Centers for Disease Control told evacuees that the initial 72-hour quarantine that was suggested “is really not enough time, but you know, they’re not obligated to keep us here.”
“You’re not obligated to leave (when the 72 hours are up), so they’re saying that the best thing for you, your people, your family and the community is to stay as long as possible,” Evans said.
After flying out of near-freezing temperatures in Wuhan, Evans said he and the other passengers were spending time outdoors enjoying the sunny, 22 degrees Celsius (72F) weather.
“We’re all still taking major precautions. So it’s not like we’re around here hugging each other and shaking hands and things like that,” Evans said. “We’re wearing our masks ... But honestly, you know, everyone is enjoying themselves because what we experienced, what we’ve seen, is very serious, you know, people are dying. So when you see that and think about things like that, try to take as much appreciation of what is in front of you.”
What happens next?Speaking on Friday, China’s Foreign Ministry said the
country had full “confidence and capability” in winning the fight against the virus.
“Since the outbreak of the novel coronavirus epidemic, the Chinese government has been taking the most comprehensive and rigorous prevention and control measures with a high sense of responsibility for people’s health,” said ministry spokeswoman Hua Chunying in a statement. “Many of these measures go well beyond the requirements of the International Health Regulations. We have full confidence and capability to win this fight against the epidemic.”
China has taken major measures to try and contain the epidemic, locking much of Hubei down, partially closing the border with Hong Kong and extending the Lunar New Year holiday, all of which could have a severe drain on the country’s economy, already vulnerable due to the US-China trade war.
With most people due to go back to work on Monday, it remains unclear whether more measures will be announced, and if not, how this will influence the spread of the virus.
Health experts previously estimated that the number of cases could be far higher than currently confirmed. Researchers at Imperial College London have estimated
that at least 4,000 people were infected in Wuhan by January 18, almost a week before the lockdown began. Their model suggests a low national figure of 20,000 infections by the end of the month, potentially as high as 100,000.
Researchers in Hong Kong estimate there could be 75,815 people in Wuhan infected with coronavirus as of January 25, according to a paper published Friday in The Lancet.
UPDATE: This story has been updated to reflect the number of confirmed cases of Wuhan
coronavirus outside mainland China.CNN’s David Culver, Yong Xiong, Natalie Thomas
and Steven Jiang in Beijing; and Helen Regan, Pauline Lockwood, Carly Walsh, Eric Cheung, Yuli Yang, Chermaine Lee, Alexandra Lin, Isaac Yee, Angus Watson and Sophie Jeong in Hong Kong contributed reporting. Angela Dewan and Gianluca Mezzofiore reported from London, while Livia Borghese reported from Rome.
James Griffiths Nicole Chavez
Work continues on Wuhan Huoshenshan hospital on January 30, 2020 in Wuhan,
China. The 1,000-bed hospital is scheduled to open on February 5.
OverviewThe Centers for Disease Control and Prevention
(CDC) and the World Health Organization are working to contain a rapidly developing outbreak of a novel (new) coronavirus (2019-nCoV) identified in Wuhan, China. The first case in the United States was diagnosed on Jan. 21 in a man who had traveled from China. Japan, South Korea, Taiwan and Thailand have also reported cases. The virus is believed to have been transmitted from animals to humans, but person-to-person spread appears to be occurring. The CDC is working with the Department of Homeland Security to funnel all travelers from Wuhan to five airports (Atlanta, Chicago, Los Angeles, JFK in New York and San Francisco) for screening.
SymptomsThe coronavirus causes fever and lower respiratory illness — cough and difficulty
breathing, resulting in pneumonia. Preliminary information indicates that persons older than 60 and those with underlying illness are at higher risk of severe disease and death, but information is still lacking on the scope of the illness. While the disease appears to be very infectious, it does not appear to be as deadly as SARS and MERS, earlier corona-type viruses. The CDC has developed a diagnostic test that it will share with domestic and international partners. No vaccine or specific treatment is yet available; care is supportive.
For AFT Nurses and Health Professional members and employersCoronavirus: How to be prepared
Download this special bulletin for healthcare workers.The CDC recommends that healthcare providers screen patients for infection from the
coronavirus. If a patient has:1. Fever and symptoms of lower respiratory illness and history of travel from Wuhan;
or close contact with a person under investigation within 14 days;2. Fever or symptoms of lower respiratory illness and close contact with a person
with confirmed coronavirus illness within 14 days.3. Fever may not be present in some patients, such as the very young, elderly,
immunosuppressed, or those taking fever-reducing medication. Clinical judgment should be used to guide testing in these cases.
Providers should immediately notify hospital infection control and the local/state public health department. The CDC will help public health departments to safely collect, store and ship specimens. Currently, diagnostic testing can only be done at the CDC. Local labs should not attempt testing. View additional CDC guidance on collection and handling of specimens (link is external).
Protections for healthcare workersWe do not yet know exactly how the virus is transmitted, but the CDC recommends
infection control and personal protective equipment (PPE) for airborne, droplet and contact transmission—large and small infectious material can be inhaled or absorbed through mucous membranes.*
Patients with suspected coronavirus illness should immediately be given a surgical mask and placed in isolation, preferably in a negative pressure room.
Personnel working with patients with suspected or confirmed coronavirus illness should use standard precautions, contact precautions and airborne precautions — use of an N95 or stronger respirator, nitrile gloves, gown and facial shield to protect the eyes, nose and mouth from splashes. Handwashing protocols are critical to prevent the spread of infection.
Workers must be medically cleared to use a respirator and should receive refresher training on donning and doffing PPE. Those using filtering face piece respirators, such as disposable N95s or N100s should have been fit tested. The Occupational Safety and Health Administration rule on respirators gives you the right to demand training and fit testing.
Information for educatorsCoronavirus: How to be preparedA special bulletin for teachers and school staff.
Get information about what teachers, paraprofessionals, school nurses and custodians can do to safeguard against the virus, as well as what schools can do regarding ventilation and preventive schoolwide and districtwide policy.
Important practices include excluding children with fever and respiratory symptoms from school until symptoms are resolved; isolating sick children from the general school population when they do attend school; stepping up education and providing good reminders (posters, etc.) in classrooms and to parents on the current infection control policies; ensuring good hand hygiene (give students additional time and opportunities to wash their hands, instruct students to use soap and water); reminding students to avoid touching their faces with unwashed hands; and consider using disinfectant on high-use areas such as doorknobs. For complete information and details, see the full bulletin.
Help your students understand infectious disease and find tools to protect yourself and your community on AFT’s Share My Lesson online collection of lesson plans and resources (link is external). You’ll find everything from news program videos to research projects and analyses of past epidemics.
Information for travelersThe CDC is warning against all nonessential travel to China, and the U.S. State
Department has increased their advisory to Level 4 — no travel to China. People traveling outside of the United States should follow these recommendations:
• Avoid contact with sick people;• Avoid animals (alive or dead) and animal markets.• Avoid animal products, including uncooked meat.• Wash hands often with soap and water for at least 20 seconds. Use alcohol-
based sanitizer if soap and water are not available.
For people who have traveled to Wuhan and feel sick with fever, cough or difficulty breathing:
• Seek medical care right away, but call ahead to the doctor’s office or emergency room. They will need to make sure you are met and taken directly to a private room.
• Avoid contact with others.• Do not travel while sick.• Cover your mouth and nose with a tissue or your sleeve (not your hand) when
coughing and sneezing. Wash hands often with soap and water for at least 20 seconds. Use alcohol-based sanitizer if soap and water are not available.
AFT Nurses and Health Professionals will continue to monitor the outbreak and provide additional materials to help members protect themselves and their communities.
*Union leaders should make information requests on the employers’ infection control plan and occupational health preparedness plan. See our toolkit at aft.org/coronavirus for more information
https://www.aft.org/coronavirus?link_id=6&can_id=1eee0699c543b835aa997e3ea9b5633d&source=email-aft-daily-communicatorjanuary-30-2020&email_referrer=email_713597&email_subject=aft-daily-communicator-january-31-2020
Resources from American Federation of Teachers/ Nurse and Health Professionals
AFT Resources on the coronavirus
February, March, April 2020 Montana Nurses Association Pulse Page 13
Page 14 Montana Nurses Association Pulse February, March, April 2020
www.cnebymna.com
Be sure to check out our CNEbyMNA Website for
Continuing Education opportunities. Sign up
for upcoming events and online learning courses. It is constantly updated with
new Webinars and Courses for your continued learning!
*Montana Nurses Association is accredited
with distinction as a provider of continuing nursing education by the American Nurses Credentialing Center’s
Commission on Accreditation*
see more
see more
see more
see more
$15.00 $15.00
$15.00 $15.00
Performing a Quick and Helpful Physical Assessment
What is Your Learning Environment?
Transitions of Care:Interfacility Transfers
Quick Review of 12-lead ECG
Critical Thinking in Practice and PolicyIn October I attended the 107th Annual Montana
Nurses Association Convention in Helena. This was only my second year attending and voting as a Delegate. Last year I was introduced to the MNA convention process and served as a delegate for the first time. I loved meeting others in the nursing community, earning educational credits related to local and global nursing issues, and participating in the parliamentary procedures of being a delegate.
Since 2018 was a Legislative election year, MNA Convention arranged for a panel of speakers made up of Montanans running for local, state, and national office. I had never considered myself a very politically involved nurse, or citizen, but something caught fire in me that night as I realized if these citizens can speak to issues in government then so can I. In January 2019, I attended MNA legislative day in Helena where several nurses from across the state lunched with Senators and Representatives, we had a Q & A session with Governor Bullock and learned how bills become law. I was transformed in learning how a citizen led government works and has influence that trickles down to various aspects of my day-to-day tasks, employment laws, and access to resources.
You see, I have been in nursing administration before and I understand we must do so many tedious red-tape tasks as nurses. All the extra paperwork takes away from our time at the bedside. I know those tasks are dictated by practice, or law, and have come to fruition in practice because someone felt they were important. But who was that someone? Are nurses making these decisions about how healthcare is delivered at the bedside? Are nurses speaking to rural access healthcare issues at our state government level? Who gets to make the laws regarding violence prevention for healthcare workers?
Our MNA works in beautiful choreography with many boards, state department, hospitals, and associations to bring our issues up during legislative session and try to convince citizens, who don’t work in healthcare, why these topics are important. As one of the largest work forces in Montana, how much better would it be if we actually had nurses in our Montana Legislature?
My flame for politics is growing as I begin thinking how all these systems of professional associations, bureaucracy, private industry players and payers are intertwined. It reminds me very much of the body systems, we need all
Loni Conley, RNCandidate,
Montana State Legislature
organ systems in communication with one another and functioning at optimal level to survive and thrive. As nurses, we use our critical thinking skills to help understand how heart failure effects urine output and kidney health and vice versa. As nurses, we are always thinking of the potential unintended consequences of an action, such as medication side effects or post-surgical complications. We can apply these same critical thinking concepts to regulations, policy, and law. When new laws are written it’s difficult to know what the unintended consequences will be 10 years down the road. That is why I am so passionate about looking at every angle of an issue, hearing all sides, and running all algorithms for outcomes prior to making a decision. Isn’t that what we educate our patients to do with their health?
Today, I am asking you to let me be your critical thinking voice in the Montana House of Representatives.
February, March, April 2020 Montana Nurses Association Pulse Page 15
Has your contact information changed?
New name? New address?New phone number?New email address?
To update your contact information, please email or call Montana Nurses Association: [email protected] or 406-442-6710
SAVE THE DATE
*2020 APRN Pharmacology Conference*
Helena, MT – February 28th & 29th 2020
*Nurse Advocacy Retreat*
Chico, MT – May 3rd, 4th, & 5th 2020*MNA Convention*
Helena, MT – October 7th, 8th & 9th 2020*
*Seamless Health Care for Our Veterans*
Helena & Broadcast Sights – November 10th 2020
MEMBERSHIPMATTERS!
Montana Nurses Association would like to invite you to join us today!
BENEFITS INCLUDE:• EMPOWERING RNs TO USE THEIR VOICES
IN THE WORKPLACE• IMPROVING PATIENT CARE
• HAVING INPUT REGARDING WAGES & BENEFITS
• CONTINUING EDUCATION OPPORTUNITIES
• LEGISLATIVE REPRESENTATION
Call or email [email protected]
(406) 442-6710
Applications also available onour website.
mtnurses.org
