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The PulseTHE OFFICIAL

PUBLICATION

OF THE MONTANA

NURSES’ ASSOCIATION

I N S I D E

Cast Your Vote—MNA Candidate

ProfilesPage 4 & 5

Meth—The Kiss ofDeath Page 6

Convention Highlights Page 9-12

VOL. 43 NO. 4

OCTOBER-DECEMBER 2006

Presort StandardUS Postage

PAIDPermit #14

Princeton, MN55371

Linda Henderson, RN

I have recently made time to follow atelevision series of four shows on PBScalled “Remaking American Medicine.”Allof the episodes have been interestingfrom the stories of patients and providersto challenges within the health care sys-tem, and methods being implemented toimprove quality and safety. I would like tohighlight two issues that struck me,one ofmisinformation and one of a new namefor an old nursing career path.

In the second episode of this series, itdetailed one elderly woman’s experienceof being admitted to the hospital for rectal bleeding.Her treatmentat home had included routine use of narcotic medication for painrelated to a decubitus ulcer. Upon admission to the hospital, herphysician prescribed ongoing narcotic pain medication butbecause the facility still used handwritten orders rather than acomputerized system, the order was incorrectly transcribed. Theresult was the medication being identified as a PRN medicationrather than being administered routinely. Subsequently, despite fre-quent complaints of discomfort from the client along withincreased anxiety, etc., the client never received any pain medica-tion over the weekend of her hospital stay. The physician notedthis problem upon her return to the hospital to make rounds onMonday and realized that the patient was experiencing narcoticwithdrawal. Unfortunately, the message the physician gave to theinterviewer was that the patient was addicted to her pain medica-tion, rather than stating that she had developed physical tolerancedue to her regular use of the medication over the past months andthe lack of use over the weekend hospital stay.

The physician’s misinformation raises a significant concern forall health care providers who strive to educate the public aboutproper pain management and use of narcotics. Many patients havefears of addiction that prevent them from taking pain medicationin an effective manner. When physicians and other health careproviders, including nurses, perpetuate this myth to the public itmakes it even more difficult to overcome. Physical tolerance canand does occur with long-term use of narcotics. It is not the sameas addiction which is a compulsive use of a substance known bythe user to be physically, psychologically, and socially harmful andused despite that to achieve a euphoric feeling.

Fortunately, the Montana Pain and Symptom Management TaskForce, created by Senate Joint Resolution 28 during the 2005 Leg-islative session, is working hard to dispel this and other pain man-agement myths in Montana.The task force has adopted a standardof care for pain and symptom management and is enlisting variousorganizations to adopt, support and educate their members aboutthe standard. The Montana Nurses’ Association has endorsed this

President’s Message

Thoughts on theValue of ConventionEve Franklin, Executive Director

In the midst of all the change anduncertainty that exists in our world, onceagain we gather together for our annualconvention as a strong professionalgroup. The challenges continue to comeat us, and they seem to become morecomplex as the health care industry triesto cut costs making an end run aroundthose who know best how to run costefficient patient oriented systems, profes-sional nurses.

This past year, membership was con-fronted with significant assaults on nurs-ing practice and quality patient care: There was an unsuccessfulchallenge to Certified Registered Nurse Anesthetists (CRNA’s) abil-ity to function legitimately in their independent scope of practice;we legislatively defeated the expansion of EMT practice to includecare provision in an in-patient setting; the Board of Medical Exam-iners continues to write inadequate rules for the Medical AssistantBill of 2003 thereby compromising patient safety by underminingthe value of bedside nursing care; most recently, the Gold StreetClinic in Butte run by two seasoned Nurse Practitioners is experi-encing an ugly challenge to their ability to care for their patientsthrough the actions of a biased radiologist and a compliant hospi-tal board who has sought to bar them from ordering appropriatediagnostic tests.While these events may not on at first blush seemconnected, there is a shared theme that drives them. The crudetruth is that what drives these actions are a pursuit of money andpower. The patient is getting lost in the equation.We have all beeninvolved in a long battle to put the patient first, to focus on devel-oping health care systems that were patient oriented.We are nowexperiencing an erosion of the inroads we had made over the lastdecades . . . sorrowfully, often the excuse of a nursing shortage isused to justify changes that would be detrimental to patient care.But the real culprit . . . and we all know it . . . is that those who con-trol the health care industry see nursing’s attempts to improve thequality of patient care as draining what they see as THEIR portionof the health care dollar.

The value of belonging to a professional organization has manylevels.We meet a variety of needs through our association as nurs-es.We fulfill our needs to “belong,” to affiliate with others, we meetour educational needs, but make no mistake, the need to bandtogether for action on the regulatory and legislative front is moreimportant than ever.

The stamina of our Association is being tested again as externalforces eat away at the core of nursing.Talk to your colleagues aboutthe importance of membership. It isn’t just a club.When they ask,“Why do you belong? What good does it do?”Answer the following:

I want to work in an environment where my nursing expertisehas value, where the system values human needs, where it is safeto take my own family member for care.

When I see our convention hall filled with caring, expert, altru-istic nurses, I know we have no choice but to persevere.

Executive Director

Linda Henderson

Eve Franklin

(continued on page 2)

Mandatory Continuing EducationDo we need it?Survey page 15

Mandatory CE Q&A throughout issue

PUBLISHER INFORMATION & AD RATES

WRITER’S GUIDELINES:

MNA

MISSION STATEMENT

WHO WE ARE

CONTACTING MNA

TThhee PPuullsseeOfficial Publication of the Montana Nurses’

Association

Montana Nurses’Association104 Broadway, Suite G2

Helena, MT 59601 Phone (406) 442-6710

Fax (406) 442-1841 Email: [email protected]

Website: www.mtnurses.orgOffice Hours: 8:30 a.m.-4:30 p.m.

Monday through Friday

The Montana Nurses’Association is a professional association forregistered nurses, including advanced practice registered nurses,students and retired nurses in Montana. MNA provides collective

bargaining services, continuing education, and professional networking opportunities. MNA advocates on behalf of nursesbefore the Montana legislature, the Montana Board of Nursing,

and other public policy bodies.

The Montana Nurses’Association promotes professional nursing practice, standards and education; represents

professional nurses; and provides nursing leadership in promoting high quality health care.

Board Executive Committee:President Linda Henderson, RNPresident-Elect Tina Hedin, RNSecretary/Treasurer Lori Chovanak, BSN, RNC

Board of Directors:Brenda Donaldson, RN Mary Claire McGuire, FNPMaxine Ferguson, RN Barb Prescott, RNC, FNP, NDPauline Flotkoetter, RN Mae Rittal, RNAmy Hauschild, RN Rebecca Schneider, APRN

Editor: Eve FranklinAssistant Editor: Jolene Devine

Editorial Board:Lynn Hebert RN, Chair—Sun RiverMary Pappas,APRN—HavreBarbara Prescott,APRN—BozemanMae Rittal, RN—SidneyRachel Rockafellow, RN—Bozeman

MNA Staff:Eve Franklin, Executive DirectorPat Wise, Labor Relations DirectorRaymond Berg, Labor Relations SpecialistJan Kiely, Chief Operating OfficerJolene Devine, Project ManagerMarcy McLean, Grant Administrator

Questions about your nursing license? Contact the MontanaBoard of Nursing at: www.nurse.mt.gov

Any author is welcome to submit an article relatedto nursing or Montana nurses in The Pulse. Pleasecontact the Assistant Editor at [email protected].

Circulation 17,000 to every Registered Nurse,Licensed Practical Nurse & Nursing Student in Mon-tana. The Pulse is published 4 times annually by theArthur L. Davis Agency for the Montana Nurses’Asso-ciation, 104 Broadway, Suite G-2, Helena, MT 59601.

Acceptance of advertising does not imply endorse-ment or approval by the Montana Nurses’Associationof products advertised, the advertisers, or the claimsmade. Rejection of an advertisement does not imply aproduct offered for advertising is without merit, orthat the manufacturer lacks integrity, or that this asso-ciation disapproves of the product or its use. MNAand Arthur L. Davis Publishing Agency shall not beheld liable for any consequences resulting from pur-chase or use of an advertiser’s product. Articlesappearing in this publication express the opinions ofthe authors.They do not necessarily reflect views ofthe staff, board or membership of MNA or those ofthe national or local associations.

Advertising Rates: Contact Arthur L. Davis Agency,517 Washington St., P.O. Box 216, Cedar Falls, IA50613, 800-626-4081. MNA and the Arthur L. DavisAgency reserve the right to reject any advertisement.Responsibility for errors in advertising is limited tocorrections in the next issue or refund of price ofadvertisement.

Material is copyrighted 2005 by the Montana Nurses’Association and may not be reprinted without writ-ten permission from MNA.

—Montana Nurses’ Association Pulse—October, November, December 2006

standard of care. In addition, the task force has held anumber of educational sessions with the public and iscontinuing to gather information from the public abouttheir experience with pain management. Informationfrom the surveys will be compiled with a report back tothe Legislature. Future educational programs for boththe public and health care providers to improve painand symptom management in our state may result fromthis data. If you get the chance, participate in this datagathering effort and encourage your friends and neigh-bors to contribute as well.

The other issue raised by the “Remaking AmericanMedicine” series involved use of registered nurses in acare management role in the public setting (i.e. publichealth nurses).The most recent episode discussed onecommunity’s recognition that patients with multiplechronic conditions were not being well managed acrossproviders. In an attempt to provide coordination of careamong providers for patients with these complex healthcare needs, the community decided to hire “care spe-cialists” (registered nurses) to work with the clientsacross their various providers to coordinate their care aswell as do home visits for monitoring and educationalpurposes.The program managers note that these nurseshave saved the community millions of dollars throughavoidance of medication errors and unstable conditionsthat would have resulted in emergency room visits andhospitalizations.

In many communities public health nurses havemoved away from secondary prevention of providingcare to adults and seniors with chronic conditions dueto the advent of Medicare home health services. Thefocus for public health nurses has primarily turned tohigh-risk maternal child clients. Unfortunately, Medicareand Medicaid both limit how long home health pro-grams can follow clients based upon the client’s condi-tion. Wouldn’t it be interesting to see what changescould be made in the health care system if we onceagain committed our tax dollars to having public healthnurses become the care managers needed for these indi-viduals with chronic conditions? Public health nurseswould resume secondary prevention care by followingthese clients on a long term basis to provide neededmonitoring and ongoing education that supports theclient’s ability to manage and coordinate care for theirmultiple conditions.

When the system begins to recognize that nursescan, and do make a difference, perhaps we, the taxpay-ers,will demand that there is more autonomy and acces-sibility to their services. One community is already find-ing out how valuable they can be.

President’s Message(continued from page 1)

Newly elected district representatives for theCouncil on Advanced Practice are from left toright Kerry Nickou, East Glacier Park, Co-Repre-sentative for District 6, Keven Comer, Bozeman-District 3, Joan VanDuynhoven, Condon-District 4,Karrin Sax, Florence-District 1, Paul Coats, White-fish-Chair, Pat Carrick, Dillon-Secretary/Treasurer& District 2 representative, MaryClair McGuire,Havre-Board Liaison to the Council on AdvancedPractice, Laureli Scribner, Billings-District 5,Charlene Pontoriero, Fairview-District 8 and Bev-erly Mayberry, Kalispell-District 7. Not picturedare Barb Prescott, Bozeman-District 3 representa-tive and President Elect and Elaine Becker, GreatFalls-Co-Representative for District 6.

Thank you Marcy . . . wewill miss you!

Last October, MNA receiveda yearlong Susan B. HarwoodOccupational Safety andHealth Administration (OSHA)grant to research and developtraining materials focusing onthe issue of Workplace Vio-lence in Rural Healthcare set-tings.We had the good fortuneto be able to hire MarcyMcLean to assist with the man-agement of various aspects ofthe grant. Marcy brought awealth of experience and a breadth of knowledge toMNA that has proved invaluable not only to the admin-istration of the grant, but also to the organization as awhole. She has been a delight to work with and a realtrooper. Marcy will be leaving MNA in November. Wethank her for her dedication and hard work over the lastyear and wish her well in all future adventures.

Advanced Practice Nursing

Marcy McLean

October, November, December 2006 —Montana Nurses’ Association Pulse—

Raymond Berg, Labor Relations Specialist

Goblins, ghosts and Hal-loween spirits, give way to thespirits and tradition of huntingfollowed by the spirit of thanksfound in the celebrations ofThanksgiving which meldsinto the spirit of Christmas,Hanukah and the New Year.One could find a spirit forevery month and holiday.Thereis community spirit, schoolspirit, state spirit, national andthe list goes on when you fillevents with passion you will find a spirit.

Nurses by nature and character offer the nursing pro-fession a kind of spirit. Nurses are passionate about giv-ing care to patients. Hence the spirit of nursing exists inevery nurse.As nurses gather in their unit, in a meetingor in the facility of their employment they provide a col-lective spirit.

I would like to focus on the collective spirit of nurs-ing. It seems to me that nursing requires a little bit ofHalloween spirit to help offset the sadness encounteredin nursing. When a nurse assists a family in death or apatient’s severe disability as a result of an accident thereis a sadness that non-nurses don’t have to think about.Collectively nurses have to have an ability to pull pranks

Labor Relations

Spirits of Nursingon one another and learn to laugh in the aftermath oftragedy or nursing by profession would be a very shortcareer for most people.

The spirit of nurses in collective bargaining offersmany nurses the opportunity to be grateful. Often con-versation is heard by nurses handling the job of contractnegotiations the thankfulness expressed by other nurs-es for their efforts on their behalf. Feeling thankful fornurse colleagues provides a sense of gratefulness to bea part of the collective spirit.

Recently observing a senior nurse say she was will-ing to help another brand new nurse study and preparefor her boards on a second try revealed another exam-ple of the spirit of nursing.The positive spirit of nursingis one that helps, restores, educates and defends thepractice of the profession.

Evaluate your spirit. Is it negative, jealous, vindictive,abrasive and caustic? If it is, change it or get out of nurs-ing. Be positive. Work collectively to make the profes-sion better. Educate yourself and assist your colleaguesas well.Advocate for your patients. Laugh, learn to leanon one another, ask for help when you need it.As nurs-es your spirit is so important. My challenge to you as anurse is to share your spirit with others. Nursing needsa positive spirit all the way from your unit to the nation-al level. If you need help with your spirit as a nurse, jointhe Montana Nurses’ Association where many positivespirits of nursing can be found within the organization.Collective spirit provides a collective voice.

Raymond Berg

Remember the Nurse Practice ActTina Hedin, RN, CEN

As nurses we often getcaught up in the care and com-passion of treating people. Weare a nurse no matter what rolewe are in, mother, friend, child,spouse, or nurse. We are oftencalled on for advice even if wearen’t literally wearing ournursing cape and cap.We oftendo things for our family or co-workers to make their life “bet-ter” without thinking “Am Iworking outside of my scope of practice?”

It happens behind closed doors, we start the IV on aco-worker because they’re dehydrated for whatever rea-son. We go to the medication dispensing systembecause someone has a headache and needs an OTCanalgesic.We work in specialty areas that may allow usaccess to ultrasounds, x-rays, sample medications, youname it.The action, whatever it is, is done out of com-passion and the desire to make things better and it isworking outside of your scope of practice.

If you are working in the clinical setting, if you aredoing things that you wouldn’t have access to if youwere Joe Public then you are working as a nurse andmust follow the nurse practice act.You are required tohave a physician’s order to perform any procedure orgive any medication. You are not covered by standingorders if the person you are treating is not registered asa patient.The consequences of such actions can be dire.Minimally, you will face a disciplinary action.An actionthat is very difficult to grieve. Equally important is thefact that those who know about the act may berequired to submit the act to the Board of Nursing.

So, if a co-worker is dehydrated encourage them togo to the Emergency Department or SDC. If a co-work-er has a headache, have a staff bottle of Tylenol or sendthem to the pharmacy. If you or a family member needsan x-ray,CT scan,ultrasound,get registered and do it theright way. If a co-worker or family member needs the flushot or tetanus shot make an appointment withemployee health and get it. Do not risk your livelihoodor license by trying to help out others outside of yourscope of practice. You will help more by maintainingyour nursing career!

Tina Hedin

Are We Ready for Mandatory Continuing Education?Edited by Lynn Hebert, RN

This article in its entirety was published in the April, May, June 2006, issue of the Pulse. It was written byMae Rittal, RN, from Sidney and Maxine Ferguson, RN, from Helena. Both of these members are on the MNABoard of Directors. Because of the subject’s importance and a related survey, the article is being repeated. Inthis issue you will see the article interspersed among other articles. Each section will address one particularquestion from the original article.

Please take the time to respond to the survey.This survey is for all RNs. It is not limited to MNA members.The survey is presented in this issue of the Pulse and it is available on the MNA website, www.mtnurses.org.You may clip, complete and mail; or print, complete and mail.The mailing address is Montana Nurses Asso-ciation, 104 Broadway Ste G2, Helena, MT 59601.Or you may copy into an e-mail to [email protected], com-plete and send.

1. Is a mandatory continuing education requirement needed in Montana?Many nurses already attend continuing education (CE) classes at their place of work, at MNA convention, atother conferences and workshops. Because many of Montana’s nurses are certified in their practice area bya national certifying body, such as American Nurses Credentialing Center (ANCC), they already are takingcontinuing education courses. Some could argue that nurses are already participating in continuing educa-tion. Others say that a mandatory requirement for CE is necessary to ensure that nurses who might not oth-erwise participate in CE are required to. Many other professions require continuing education for licensureor certification. Professional nursing is one of the few professions that does not require continuing educa-tion for relicensure or certification.

Montana Nurses’ Association members will receive aballot in the mail. Please exercise your member rightsby voting.

CANDIDATES LISTED IN THE ORDER, AS THEYWILL APPEAR ON THE BALLOT.

BOARD OF DIRECTORS –SECRETARY/TREASURER

Lori Chovanak, Helena—Inretrospect, I feel I have learned anenormous amount regarding MNAfinancials over the last two years.I have decided to run for a secondterm so that I may utilize theknowledge I’ve obtained to beeffective in continuing the finan-cial work of the organization.Thank you for allowing me to serve you and I hope tocontinue my service.

BOARD OF DIRECTORS –MEMBER AT LARGE

Pauline Flotkoetter, MilesCity—Accept responsibility for allconditions and policies attachedto the organization. Support theExecutive Director, ensure effec-tive organization planning, ensureadequate resources are available,and manage these resources effec-tively. I feel that I will be able todo these things, because of my past experience as aboard member.

Enhance the organizations image and recruit newmembers.


Kim Powell, Missoula—Ibelieve I can work effectively onthe Board of Directors. I have beenin leadership positions in manynot-for-profit organizations, haveexperience in real estate manage-ment and use Quickbooks com-fortably.

I believe the financial integrity and security of MNA isvital to its success and will work with the Board of Direc-tors to ensure financial viability of the organization.


Mae Rittal, Sidney—Todaythere are attacks from many direc-tions being made upon our nurs-ing profession, whether it is thereplacement of professional nurs-es with unlicensed workers orattempts to curtail the scope ofpractice of nurses. I believe weneed to actively guard our profes-sion, our scope of practice and, first and foremost, ourpatients and the quality of care they receive.

I would like to help in this effort by representingnortheastern Montana nurses on the MNA Board ofDirectors.

BOARD OF DIRECTORS –COUNCIL ON PRACTICE ANDGOVERNMENT AFFAIRS

Barbara Prescott, Bozeman—It is my belief that nursing is theone profession that can bring allof the elements of healthcaretogether to provide patients withoptimal care.As a member of theMNA Board of Directors, I willwork to secure an equal place fornurses in the healthcare arena. With the MNA, I willwork to create a dialog that promotes nurses as part-ners in healthcare with medicine and other health careprofessionals.

COUNCIL ON CONTINUINGEDUCATION – APPROVERUNIT

Bonnie Hash, Bozeman—Over the years since I became alicensed registered nurse in Mon-tana there have been manychanges in nursing care beinggiven to patients in hospitals, doc-tor’s offices, public health offices,etc. I’ve always felt that to be an effective nurse I mustdo continuing education keep current.You (and I) maybe surprised at what we learn.


Mary Pappas, Havre—As anursing educator, I believe thatquality patient care requires aquality education. I endeavor toparticipate in developing continu-ing education offerings that willmeet the needs of nurses in Mon-tana.


Molly Protheroe, Helena—Ibelieve in nursing as a force forgood in the community as well asfor each individual served. Ibelieve in one efficacy of empow-ered consumers. I believe in hav-ing practiced as a professionalmember of nurses associations for44 years. I am older, wiser and still learning.

COUNCIL ON CONTINUINGEDUCATION – PROVIDERUNIT

Brenda Donaldson, Helena—Ibelieve that education is empow-erment. As a member of theprovider unit to the Council onContinuing Education I will workwholeheartedly to further thestated goal of advancing the beliefthat quality nursing care isenhanced by quality continuing education for nurses.


Deborah Lee, Denton—As arural staff registered nurse, I canappreciate the need and value ofquality continuing education. Iwill strive to assist MNA inadvancing quality continuing edu-cation programs across the state.


Margaret “Maggie” Shulund,Stevensville—I am a relativelynew nurse who is enthusiastic,energetic and willing to worktoward improving the work envi-ronment, education and on what-ever conditions need improve-ment. I am willing to be a strongadvocate for the Montana Nurses’Association.


Pam Windmueller, GreatFalls—I believe education is vitalto the advancement and mainte-nance of the profession of nurs-ing. I will participate actively inMNA and other nursing activitiesto facilitate maximum educatoravailability for all nurses.

COUNCIL ON PRACTICE &GOVERNMENT AFFAIRS

Lynn Hebert, Sun River—Iwould like to serve on the Coun-cil on Practice and GovernmentAffairs. I have experience in bothfacets of the council and feel theydirectly impact professionalism innursing. There are many practiceissues on the table at this time,some of which may be decided inthe legislature. Members of this council are among the


Continuing EducationCandidate Profiles

(continued on page 5)

October, November, December 2006—Montana Nurses’ Association Pulse—

first to hear about and give input on the issues. Being amember of this council also gives me an avenue throughwhich I can better promote professional nursing prac-tice, standards and education; represent professionalnurses; and provide nursing leadership in promotinghigh quality health care.


Edi Martin, Missoula—I havebeen a registered nurse for 30years and have spent those yearsas a staff nurse and/or chargenurse. I feel that my years ofexperience as a bedside caregiver,my involvement in MNA and myactive participation in varioushospital committees, including the development ofnursing shared governance reflects my commitment todoing all I can to create a work environment that willallow nurses to provide the excellent patient care theydesire. I feel that my commitment to nurses and myyears of practical experience will enable me to be avaluable member on these councils.


Shelly Meyer, Missoula—I willadvocate through the work of thiscouncil for public policy and leg-islation to improve access to carefor the uninsured and under-served people in our state. Pro-tecting the economic welfare ofnurses through addressing theirworkplace environment including appropriate staffingand both patients and nurse safety can improve thequality of our nursing practice, which is also a majorgoal of this council.


Rebecca Sturdevant, Kalispell—Political and regulatory processesstrongly influence our profession-al nursing practice. Our voicemust be heard to maintain andimprove nursing in our state.Nurses have a responsibility tosupport and promote legislationand government regulations to improve access to healthcare and quality of nursing services. I will raise my voiceon behalf of Montana nurses.Thank you.

ECONOMIC & GENERAL WEL-FARE EXECUTIVE COMMITTEE

Vicky Rae Byrd, Helena—Ibring 18 years of staff nurse expe-rience (all in collective bargain-ing) to the table. I would like tostep up my participation in col-lective bargaining activities toempower fellow staff nursesregarding patient safety and work-ing conditions.


Edith Martin, Missoula—Ihave many years nursing experi-ence and would like to share myexperience with those nurses

CONGRATULATIONS NURSE LEGISLATIVE LEADERS ON YOUR

RECENT RE-ELECTIONwithin MNA. It is critically important that nurses havefair competitive wage/benefit packages available tothem as well as having a safe working environment.These things help nurses provide the excellent qualitypatient care they desire.


Sue Noem, Helena—I wouldconsider it a privilege to serve asa member of the Economic andGeneral Welfare Executive Com-mittee. I believe in the collectivebargaining system and would liketo further my involvement andeducation by fulfilling the require-ments of this position while supporting nurses in thework place.Thank you.

NOMINATIONS COMMITTEELynnora Jetter, Bozeman—I

have been a registered nurse and amember of Montana Nurses’Asso-ciation for over 24 years. I want toreach out for members that havenot been otherwise involved atthe state level of MNA. Member-ship in this association is vital tocontinued growth and the direc-tion of nursing in Montana.

NOMINATIONS COMMITTEEEdi Martin, Missoula—I have

been a registered nurse for 30years and have spent those yearsas a staff nurse and/or chargenurse. I feel that my years of expe-rience as a bedside caregiver, myinvolvement in MNA and myactive participation in varioushospital committees, includingthe development of nursingshared governance reflects my commitment to doing allI can to create a work environment that will allow nurs-es to provide the excellent patient care they desire. Ifeel that my commitment to nurses and my years ofpractical experience will enable me to be a valuablemember on these councils.

NOMINATIONS COMMITTEELauren McGrane, Helena—I

have been an active member ofMNA since my graduation 14years ago. I have also served onvarious committees and positionsfor the local, district and state lev-els. I would love to give sometime this year and serve on thenomination committee.

Candidate Profiles

Arlene Becker, RNRepresentative HD 52

Eve Franklin, RNRepresentative HD 24

Edith Clark, RNRepresentative HD 28

Teresa Henry, RNRepresentative HD 96

Carolyn Squires, LPNSenator SD 48

Cindy Hiner, RNRepresentative HD 85


Susan Porrovecchio, BSN, RN, CARN

It was a pleasure this pastMay to attend a Montana StateUniversity forum on metham-phetamine, sponsored by theMSU Wheeler Foundation. Par-ticipants had the opportunity toreview successes and dialogueon the direction of futureefforts. Tom Siebel, the manbehind the very successful“Meth In Montana” media pro-ject, was present as a featuredspeaker and gave a press con-ference prior to the forum. His statistics speak on theirown as to how the campaign has captured the minds ofMontana’s youth and the community. Local communitymembers were present to share their personal stories ofsuccess and struggle in dealing with this addiction. Imag-ine my surprise, not long after the conference, to read ina local Flathead newspaper an article reporting thenational perception to be,“Meth, It Is Not a Big Problem”!

The consensus of those present indicates that whilemuch awareness and education has occurred, our Mon-tana communities are in desperate need of affordablelong-term treatment options and resources. There wasmuch interest and support for the two new treatment cen-ters underway in Eastern Montana, a women’s program inBoulder and one for men in Lewistown.

Siebel spoke to the national attention these projectsare receiving at the moment, and introduced the nextphase of his efforts—the Montana Meth Project’s “Paintthe State”contest.By now you have certainly encounteredevidence of the efforts of our youth to drive home the“Not Even Once”message.As far as is known,nothing likethis has ever been tried before. Artwork was judged foreffectiveness and creative impact. Each county winnerreceived $3,000, plus a chance to compete for thestatewide $10,000 first-place prize determined by notedartist Russell Chatham.Winners were honored in Helenaat a State Capitol award ceremony.

All who attended the forum were given a METH INMONTANA toolkit, courtesy of the Montana Departmentof Justice,MSU Extension Services,and Montana Office ofPublic Instruction.This valuable resource includes book-lets, posters, DVD/CDs, videos, focus cards, bookmarksand much more. The toolkit is available at your locallibrary.

For more information contact: MSU Extension Service,Mike Vogle, 109 Taylor Hall, Bozeman, MT 59717 or call406-994-3451.

Susan Porrovecchio is a staff RN at the Treasure StateCorrectional Training Center in Deer Lodge, an alter-native sentencing program for convicted male felons.She is currently serving on the MNA Council on Con-tinuing Education, Approver Unit.

Not Even Once

Don’t forget to renew your nursing license bycontacting

Montana State Board of Nursingat 406-841-2300 or visit their

Website atwww.nurse.mt.gov

“Meth—the Kiss of Death” mounted on a schoolbus was Garfield County’s entry into the MethProject. In addition to the big sign, each schoolbus window and the windshield included methmessages and graphics. Almost anywhere youdrive in Montana you can see similar signs paint-ed on everything from buildings to hay bales.

Susan Porrovecchio

Barb Prescott, DNP, FNP, RNC

Over the past century life expectancy of Americans haslengthened dramatically.This phenomenon is due in part tothe use of antibiotics as an intervention for the many dis-eases that devastated the population in the past. Polio, smallpox, diphtheria, and many other deadly diseases have beeneradicated. In the process, Americans have become depen-dent on medications to cure and save hours of suffering.However, as a consequence, we now turn to antibiotics forcommon disease conditions that our immune systems canhandle without antibiotics.

The Centers for Disease Control and Prevention (CDC) esti-mate that Americans are receiving more than one hundred mil-lion antibiotic prescriptions each year.We are now finding that inappropriate antibioticuse is leading to resistant organisms.Often,antibiotic prescriptions are received for viralconditions and broad spectrum antibiotics are being used where narrow-spectrumantibiotic therapy would be just as effective. Many times, it is the patient expectation ofreceiving antibiotic therapy that actually leads to receiving the prescription rather thanprescribing for a diagnosis of a condition that requires antibiotics. Healthcare providersare constantly under time constraints and because of patient expectations prescribingan antibiotic seems preferable to taking the time to explain why it is not necessary.

However, antibiotic resistance does not have to be inevitable. By reducing the inci-dence of unneeded antibiotic therapy, the incidence ofantibiotic resistant organisms can be reduced.The areaof highest patient expectation for antibiotics is acuterespiratory infection. Since healthcare providers strivefor patient satisfaction, this is the area where they feelpressured to prescribe antibiotics. If the diagnosis isviral, the provider needs to have a contingency plan forexplaining the treatment regimen without the use ofantibiotics. Patients need to be educated about the dif-ferences between viral and bacterial infections. However, even bacterial infectionscan be treated with boosting the immune system and the body’s response to infec-tion. Providers can target symptoms with antipyretics, decongestants, antihistamines,and antitussives. In addition, practical nursing care such as steaming, increasing clearliquids, low residue diet, sufficient sleep, and good hand-washing can be the mosteffective treatment in overcoming an upper respiratory infection. Educating patientsabout appropriate indications for antibiotic therapy, providing strategies to supportthe body in fighting infection, and educating about the signs and symptoms of infec-tion that require antibiotics can help maintain patient satisfaction without increasingthe use of antibiotics.

For more information regarding antibiotic use: http://www.aware.md

Antibiotic Use and Misuse

Barb Prescott

“ Patient educationimportant in reducing inappropriate useof antibiotics.”

Reverend Steve Rice

The young offender sat nervously, head down, sur-rounded by the adult mentors about to enter his life.Each mentor explained what he or she offered and whathe or she expected in return from the youth. In a matterof days the adolescent would be leaving one of Mon-tana’s two correctional facilities for juvenile offenders.Upon release, the youth would be supported by a teamof mentors committed to helping him move forwardinto productive adulthood as a member of a Montanacommunity.

One of the mentors identified by the youth as impor-tant to success was a parish nurse. Participating in thevoluntary religious programming at Pine Hills Youth Cor-rectional Facility, the youth began to ask serious ques-tions about meaning and purpose in life. Sustaining ini-tial advances made while in custody is important in thepost-correctional environment.While in the correction-al facility the youth’s care, including healthcare needs,were directed by corrections professionals. Uponrelease from custody increasing areas of life would beturned over for the youth to manage. Soon the youthwould be responsible for his own faith developmentand healthcare choices.

Navigating the healthcare system is a daunting chal-lenge for seasoned adults. Lacking knowledge and expe-rience with healthcare for a newly minted adult leads tomisuse of emergency room care and deferred care.Implications of lifestyle choices are not always wellunderstood. Delayed intervention contributes toincreased cost and morbidity. Accomplishments made

through programming while in custody can quickly belost if not adequately supported in the post-correctionalsetting.

Fortunately for the young man described above, oneof his mentors was a parish nurse. The nurse listenedpatiently as discussion progressed around the confer-ence table.Then from her unique perspective as a faith-based healthcare professional, Liz Campo, R.N., askedthe youth a single question that brought his headupright and caused everyone turn toward the nurse inquiet amazement. The nurse’s holistic perspective pro-vided a valuable insight to the mentoring team’s per-spective.

Parish nurses are making a difference in the lives ofMontana’s youthful offenders. Important introductions,education, and advocacy into local healthcare and faithcommunities are being accomplished under parishnurse guidance. Establishing a primary healthcareprovider relationship and connection to credible mem-bers of the youth’s own faith traditions are best carriedout through skills and abilities unique to parish nurseministry.

Individual parish nurses or parish nurse programsinterested in learning how to become reentry nursementors for young offenders can contact Steve at [email protected] or by phone at 951-6463.

The Rev. Steve Rice received MNA’s “Friend of Nurs-ing” award at their 94th annual conference inBillings. He is the religious director at Pine Hills YouthCorrectional Facility in Miles City and member of thehealth ministry team at First Lutheran Church.


Parish Nurses Mentor Youthful OffendersAre We Ready for MandatoryContinuing Education?

2. What is MNA’s position?MNA believes that the primary responsibilityfor education rests with the individual nurse,but that mechanisms need to be in place to sup-port this belief. The Board of Directors hasagreed that we need to look seriously at imple-menting a requirement for mandatory continu-ing education in Montana. Actions of the 2004and 2005 MNA House of Delegates have sup-ported moving forward with a mandatory edu-cation requirement. It will take a lot of work toput a requirement in place for a certain numberof continuing education credits or contacthours to renew one’s license.

MNA currently has several approaches in placethat support continuing education:

• MNA is accredited by the ANA Council onAccreditation as an approver of continuing edu-cation for nurses in Montana. In 1981, the Mon-tana Nurses’ Association was approved by theAmerican Nurses’ Association CredentialingCenter (now ANCC) to approve and providecontinuing education for nurses. The approverfunction continues to be accredited.A decisionwas made to go through another state for theprovider functions.

• MNA now contracts with the Ohio Nurses’Asso-ciation for the provider functions. Clearly, con-tinuing education is a longstanding priority ofMNA.

• The structure of the Association includes aCouncil on Continuing Education (along withCouncils on Economic and General Welfare,Practice and Government Affairs, and AdvancedPractice). As with each of the other councils,there is a Board of Directors representative forcontinuing education.

• Through a grant from the U.S. Department ofLabor, MNA is preparing online continuing edu-cation related to workplace violence.

• At this fall’s MNA convention in Billings,over 30workshops and plenary sessions will be offeredon a variety of topics.All will award continuingeducation contact hours.

• MNA recruited a registered nurse whose prima-ry responsibility is continuing education.

• MNA’s labor department actively supports con-tinuing education through language in collec-tive bargaining agreements with major employ-ers of nurses throughout Montana.

—Montana Nurses’ Association Pulse—October, November, December 2006CNS, can complete an individualized plan of study thatbuilds on their existing competencies and course workto prepare them for cer-tification and advancedpractice registerednurse (APRN) licensure.

Beginning in fall2007, pending Board ofRegent approval andfederal funding, the Col-lege of Nursing will offer a new track. The ClinicalNurse Leader (CNL) option will provide graduate edu-cation for baccalaureate prepared licensed registerednurses in clinical leadership for setting specific practiceat the point of care throughout the healthcare deliverysystem.The CNL roles include risk anticipation, risk pro-files, tailored interventions, client and community advo-cacy, educator, information manager, systems analyst,and team manager. CNL graduates have advanced nurs-ing knowledge but do not meet the criteria foradvanced practice nursing. The program of study ismuch shorter than either the FNP or CNS options andcan be completed via distance delivery in three semes-ters.

Nurses interested in learning more about the FNP,CNS, Post-Master’s Certificate, teaching electives, or thenew CNL option are encouraged to visit the College ofNursing website at http://www.montana.edu/nursing/academic/mn.htm or contact Ms. Lynn Taylor, the gradu-ate program Administrative Assistant at [email protected] or (406) 994-3500.Preliminary applications foradmission to the College of Nursing graduate programsare due January 15, 2007 and final applications are dueFebruary 15, 2007.

delivery with up to four tele-conference or interactive videosessions each semester. Thesesynchronous class meetingsprovide students with theopportunity to meet togetheron the closest nursing campusand access the class from theCollege’s teleconference orinteractive video systems.Alter-natively, students like BrendaKoessl who lives in Glasgow,Montana, or Carrie Deshelmswho resides in Albin, Wyoming, can choose to connectto the classes from their home or office phone.

The College also experienced a larger than usualenrollment in the teaching elective offered in the sum-mer of 2006.This 3-credit course, taught completely on-line, focuses on knowledge assessment and evaluation. Itis one of three courses designed for nurses interested inteaching. Students enrolled in the additional teachingelectives receive instruction in course design and deliv-ery, development of learning activities, and clinicalsupervision as well as a supervised practicum in class-room and clinical teaching.

It is expected that enrollments will continue to growas more nurses enroll in one of the four Post-Master’sCertificate options. Nurses with graduate degrees innursing who desire to become an FNP or Adult Health

Charlene Winters, DNSc, APRN, BC, CNS, CNS Pro-gram Coordinator

Deanna Babb, MN, FNP, FNP Program Coordinator

With 20 new students, theentering class of 2006 will gointo the record books as thelargest graduate class to enterMontana State University(MSU) College of Nursing inrecent years.The Family NursePractitioner (FNP) and AdultHealth Clinical Nurse Specialist(CNS) options now have acombined enrollment of 34students. Of these students, 24are full time while 10 plan to complete their program ofstudy on a part-time basis.

The increase in enrollment may be a result of the newdistance delivery methods implemented in the graduateprogram in 2005 to better meet the needs of practicingnurses and nurses residing in geographically isolatedareas. Graduate courses are primarily delivered over theInternet. Students access their courses from their homeor office computers using WebCT, the software used byMSU for all of its on-line classes. Students obtain clinicalexperiences in areas close to their home communities.

Faculty have the option to supplement on-line course

MSU Enrolls Largest Class of Graduate Nursing Studentsin More Than a Decade!

Deanna Babb

Charlene Winters

“ . . . new distance delivery methodsmeet needs . . . ”

Are We Ready for Mandatory Continuing Education?

3. What is currently required for Montana nurses and others?The only statutory (Montana law or rule) requirement for continuing education for nurses in Montanaaffects advanced practice registered nurses (APRN), who are required to have 20 hours of CE annually; 25hours annually if they hold prescriptive privileges. Many other Montana health providers and professionalswith whom nurses might work are required to have continuing education ranging from less than 10 hoursper year to over 30 hours per year, either through

A. a statutory requirement.A statutory requirement is in place for:Direct entry midwife Radiology TechnologistNaturopathic physician Respiratory Care PractitionerChiropractor Sanitarian Clinical Lab Scientist/Specialist Clinical Professional CounselorDentist Clinical Social Worker Occupational Therapist Audiologist/Audiologist Aide Physical Therapist Speech/Language Pathologist/AideClinical Psychologist Teacher

Or B. a national certifying body requirement.These include:

• Emergency Medical Technicians• Nutritionists/Registered Dietitians• Medical Doctors and Osteopaths• Registered Nurses who are certified by a national certifying body, such as ANCC. Other registered nurses

have no continuing education requirements.


MNA Convention 2006 EXHIBITORSAARP of Montana

Attentive Healthcare

Benefis Healthcare

Billings Clinic

Bozeman Deaconess Hospital

College Network

Dakota Med Temps

Genentech/Novartis

Gideons

GlaxoSmithKline

Great Falls Clinic

Infant Adoption Awareness

Lippincott Williams & Wilkins

Merck

Miles Community College

Montana Center on Disabilities

MNA Convention 2006 SponsorsThe Montana Nurses’Association expresses a sincere thank you to the following

organizations for their generous support of this convention.

Arthur L. Davis PublishingAllegiance Health Benefits

Allegra Print & ImagingBank of America

Benefis HealthcareBillings Clinic

Blue Cross Blue Shield of MontanaGonzaga University School of Nursing

HIV/STD Section of DPHHSInsights & Solutions

Junkermier, Clark, Campanella, Stevens, P.C.Montana Primary Care Association

MSU FoundationMSU-Bozeman College of Nursing

New West Health ServicesSt. Patrick Hospital & Health Sciences Center

Anderson Zurmuehlen & Co.Northern Montana Hospital

Salish Kootenai College Department of NursingValley Bank of Helena

Glendive Medical CenterMontana Area Health Education Center

UM Missoula College of TechnologyFinstad’s Carpet One

Carroll College Department of Nursing

Convention Highlights

Montana Medicaid Nurse First

Montana Mental Health Association

Mosby Publishing

MSU College of Nursing

Novartis

Pfizer

Prentice Hall

Prioricare Staffing Solutions

Rimrock Foundation

St.Alphonsus Regional Medical

St. James Healthcare

St. Lukes Health System

Social Security Disability Determination

Susan Komen Breast Foundation

U.S.Army Healthcare



MNA AWARD WINNERS E&GW Achievement Award . . . . . . . . . . . . . . . . . . . Vicky Rae Byrd, HelenaFriend of Nursing Award . . . . . . . . . . . . . Reverend Steven Rice, Miles CityAPRN of the Year Award . . . . . . . . . . . . . . . . . . . . Deanna Babb, Great Falls

Congratulations Awards Recipients

Brenda Donaldson presents Vicky Rae Byrd(right) with the 2006 Economic and GeneralWelfare Achievement Award.

Reverend Steven Rice from Miles City accepts the2006 Friend of Nursing Award.

MNA Executive Director Eve Franklin presentsthe Advanced Practice Registered Nurse of theYear Award to Deanna Babb, MSN, APRN, FNPfrom Great Falls.

Convention Suggestion Box

SamplerListed below are a few of the

suggestions received from convention attendees.

*Numerous respondents approve ofhaving convention in Helena everyyear with rotation of host district.

*Consider not having CEs same timeas the House of Delegates.

*Convention is great and excellentplace for nurses to network.

*Limit prearranged meals, maybe dinner always on your own.

*Give away free convention as a door prize.

*Make email main form of communication to members.

2006 Convention FactsNumber of Registrants: 124

Students: 28Retired RNs: 9

Number of Expert Speakers: 31

67 participants completed general evaluation formswith 97% positively responding that the conference

supported professional growth.

Cost of Food:Coffee & Tea for three days: $718.00

Break snacks and beverages: $2,312.31Awards Luncheon for 95: $1,556.81Breakfast Buffet for 97: $1,087.04

Opening night reception: $1,267.70



Keynote speaker Margaret Fitzgerald (left) and MNA PresidentLinda Henderson.

Mayor Ron Tussing welcomes nurses to Billings during open-ing ceremonies of the House of Delegates.

Exhibit Hall is a buzz as attendees talk with exhibitors abouttheir products, services, etc.

Past Presidents Teresa Henry, Kate Steenbergand John Honsky (left to right) continue toshow strong support of the MNA mission asconvention attendees.



Plenary speaker Sharon Howard talks aboutWorkplace Violence.

“Move over Julia Roberts . . .”Mary Munger speaks to thecrowd after her documentarypremier on October 12 at convention.

Montana Student Nurses Associa-tion President Chad Cline relaxesafter speaking to the House of Dele-gates during opening ceremonies.Chad entertained the delegates witha few humorous nursing anecdotesfrom personal experiences.

Numerous raffle and door prizes weregiven away during convention. KateSteenberg is shown overjoyed withhaving won the coveted tool box raffle.

Billings Deaconess Hospital (now Billings Clinic) local unit lead-ers for first contract under the new collective bargaining lawpose with Mary. Shown seated is Beverly Johnson, standingfrom left to right are Virginia Kimberly, Mary Munger, RuthHovis and Margaret Dorsey.


graduate student each year during the college’s Recog-nition Ceremony at the completion of the program.Finally, Hudson Trust scholarships are available to assistwith the expenses of graduate nursing students who arepresenting their research at a regional or national con-ference.

Additional funding for graduate school is availablefrom a variety of sources. One may review the manyopportunities available by referring to the College ofNursing website at: http://www.montana.edu/nurs-ing/student/scholarships.htm and clicking on the link atthe bottom of the page for more information about grad-uate scholarships. Should you have questions or needadditional information about the MSU graduate nursingprogram options or how to fund your education, pleasecontact Lynn Taylor at: [email protected] or (406) 994-3500.

Gretchen McNeely, DNSc, RN, Associate Dean andAssociate Professor MSU-Bozeman College ofNursing

When asked why they haven’t pursued graduate nurs-ing education, many qualifiedstudents indicate that they don’tbelieve they can afford to goback to school. However, it maybe easier to finance graduatenursing education than onemight think. There are manyopportunities to consider as onecontemplates earning a master’sdegree in nursing at MontanaState University (MSU).

It is well-known that there isa nursing shortage in this country.There is also a shortageof qualified nursing faculty. The federal government hasprovided some funds to address both of these issues. Ifbaccalaureate prepared nurses are interested in pursuinga master’s degree in order to teach in a nursing program,there are federal funds available to help those students.Schools that offer the master’s degree in nursing apply forthese dollars which may then be loaned to their studentswho are enrolled in their programs that prepare nursesfor teaching roles.

MSU has applied for and received Nurse Faculty LoanProgram (NFLP) funding for several years. Studentsenrolled in any of the master’s options in the College ofNursing who also enroll in 3 elective teaching courses areeligible to apply for those loan dollars. If, after graduation,those individuals teach in any nursing program in thecountry for at least 3 years, up to 85% of the loan can beforgiven.

Another federally funded program that is available tograduate nursing students is the National Health ServiceCorp (NHSC). Family Nurse Practitioner (FNP) studentswith a desire to work with underserved populations canapply for scholarships and loan repayment through theNHSC. This scholarship program covers the costs oftuition, educational expenses, and a monthly stipend inexchange for providing primary care to an underservedcommunity full-time for 1 year for each full or partial yearof scholarship support, with a 2-year minimum commit-ment. The NHSC Loan Repayment Program (LRP) willpay up to $50,000 for two years of service, based on theparticipant’s outstanding balance of qualifying education-al loans. If the total amount of the participant’s qualifyingeducational loans is less than $50,000, the NHSC LRP willpay the remaining balance of the total qualifying educa-tional loans for two years of service.Additional informa-tion can be found at the NHSC websitehttp://nhsc.bhpr.hrsa.gov/.

MSU also has graduate teaching assistant (GTA) posi-tions for eligible graduate students who are interested inteaching and want to obtain practical experience whilecompleting their graduate program.These positions pro-vide tuition waivers as well as a monthly paycheck for 10hours of work per week during the academic year.

In addition,the College of Nursing at MSU applies eachyear for federal nurse traineeship funding which is divid-ed among all of the eligible full-time graduate nursing stu-dents. These Advanced Nursing Education Traineeships(AENT) funds are distributed as grants that do not requirere-payment.Eligible students must be interested in work-ing in medically underserved areas or health profes-sional shortage areas following graduation. Many loca-tions in Montana are designated as underserved andshortage areas.

Montana State University provides Presidential Schol-arships each year to entering graduate students; typical-ly, one of these is offered to an entering graduate nurs-ing student. The Collegeof Nursing is now ableto offer a similar scholar-ship to an entering grad-uate nursing studenteach year. Onceenrolled, graduate nurs-ing students are also eligible to apply or be nominatedfor other scholarships including the Jurkovich-Wilson,Margaret Voynovich, and Gladys Nye Stevenson gradu-ate scholarships.Through the generosity of the Hudsonfamily, additional scholarships are available to graduatenursing students who apply for financial assistancewhen completing their research for the thesis or pro-fessional project requirement. A Hudson Trust scholar-ship is also given to recognize the most outstanding

Are We Ready for MandatoryContinuing Education?

4. What is required for nurses in otherstates?

• Of the 52 states and constituencies, 25 requirecontinuing education for licensure renewal forRNs.

• The average requirement is about 24 contacthours every two years.

• Nearly half of the states have approval mecha-nisms in place (ANCC or other) to approveand/or provide continuing education for RNs,which seems to demonstrate that CE is a priori-ty for those states.

Financing Graduate Nursing Education at MSU: Let me count the ways!

Gretchen McNeely

“ . . . shortage ofqualified nursingfaculty . . . ”


NURSESby John C. Ulberg

Nurses come in all sizes andshapesWith hair from blonde to gray,They always seem to have amissionAnd from it they do not stray.

Whether patting down a baby at night Or holding an elder’s hand,A nurse is great comfort to our ailing folkSpread all across this great land.

They have the knowledge, they have the skillYou can trust them to do things right,No matter what time of dayOr how late into the night.

A nurse works closely with doctorsTo carry out their order with care,Though sometimes coordinating gets complicatedIt’s the nurse who usually clears the air.

A nurse must study the changes in medicine And stay up with trends and innovation,More than one has had to sacrifice personal timeAnd give up that family vacation

And when their shift is doneAnd they go home at the end of the day,You can be sure that these nurses worked hardAnd earned every cent of their pay.

Lest you feel this is a hollow tributeI hope you never find yourself under a hurting curse,But if you do, just know that a special person will showup there,Gently take your hand in theirs and say,“It’s OK, I’m a nurse.”

John Ulberg is a cowboy poet from Montana whowrote this poem for nurses in Missoula who cared forhim after an injury he incurred.

Published with permission from John Ulberg

Are We Ready for Mandatory Continuing Education?5. Where does my employer stand in regard to continuing education?Many hospitals, some smaller rural facilities, provide funds for nurses to continue their education. Hospitals

may pay registration fees,expenses,and permit attendance at continuing education without loss of pay.Some con-tinuing education may be mandatory, such as ACLS,and in some facilities CE hours in addition to mandatory hoursare paid, generally with a limit on the number of CE hours per year.

Hospitals and other agencies approved by the Montana Nurses’Association to be providers of continuing edu-cation (Approved Providers) offer many hours of continuing education that award contact hours.These approvedproviders include

• Benefis Health Care, Great Falls • Bozeman Deaconess Hospital, Bozeman • Billings Clinic, Billings • Kalispell Regional Hospital, Kalispell• Missoula Community Medical Center, Missoula• St. Patrick Hospital & Health Science Center, Missoula • St. Peter’s Hospital, Helena • St.Vincent Hospital, Billings, and the • Montana Geriatric Education Center, Missoula MNA represents nurses in most major hospitals as well as other healthcare facilities across the state. Language

in collective bargaining agreements that support continuing education generally is similar to the following, withspecifics added for each institution:

1) Compensation for mandatory in-service is at the nurse’s regular rate of pay unless the Hospital requiresattendance at a time that results in overtime.

2) Nurses may be required to provide an in-service to their colleagues on what they had learned after com-pleting a course.

3) Employees required by the hospital to attend educational seminars or meetings shall be reimbursed.4) Educational leave required by the Hospital shall be without loss of pay to the employee.5) In-service education programs will be provided on a continuing basis for all nursing personnel. It is the

responsibility of all nursing employees to attend mandatory in-service programs.6) Upon completion of the probationary period, each registered nurse shall be eligible for a minimum num-

ber of hours [varies as much as 5 to 20] of education per year with pay.7) Education shall include mandatory in-service, non-mandatory in-service, and seminars authorized by the

Nursing Director.8) Leave to attend professional education meetings may be granted without loss of pay.9) Expense allowances may also be granted at the discretion of the manager.

Shirley Cudney, RN

New funding from theNational Institutes ofHealth/National Institute ofNursing Research will make itpossible to continue theWomen to Women Project(WTW) at Montana State Uni-versity College of Nursing forfour more years. Under thedirection of Dr. Clarann Wein-ert, the WTW computer out-reach project has been provid-ing social support and health education to rural isolatedwomen for the past 10 years. From its inception, theoverall goal of WTW has been to help these women tomore successfully adapt to their chronic illnessesalthough their access to health information and servicesis limited.

WTW has moved through two phases in which it hasextended its reach from Montana to surrounding states,enriched its interdisciplinary research team, and devel-oped health teaching units that harness the World WideWeb The women participants embraced and actively

Shirley Cudney

MSU College of Nursing Women to Women ProjectReceives Continued Funding from NIH/NINR

participated in the WTW virtual support groups andonline health education activities. Results show thattheir social support, self-efficacy, self-esteem, and abilityto manage stress was increased while their depression,and loneliness werereduced—all indicat-ing successful psy-chosocial adaptationto chronic illness.

Because the pastresearch design andintervention was labor intensive, costly, and complex,there is reason to believe, through experience and sup-port from the literature, that a more streamlined inter-vention of shorter duration could be just as effective inenhancing psychosocial adaptation.The overall goal ofPhase Three is to test the impact of a computer-basedintervention on psychosocial adaptation, chronic illnessself-management, and quality of life among rural womenwith chronic illness. The unique contributions of thisphase will be to reduce the complexity of the researchdesign and intervention and further develop and refinea model of psychosocial adaptation to chronic illness, aswell as to move the intervention strategy closer toimplementation in clinical nursing practice. For furtherinformation on the project visit www.montana.edu/cweinert or contact the research office at 1 888375 1317.

“ . . . help ruralwomen to adapt tochronic illness . . . ”

Join MNAToday!


Zeta Upsilon Chapter ResearchFunding Opportunity

Clarann Weinert, SC, PhD, RN, FAAN, Zeta UpsilonResearch Taskforce Chair

The Zeta Upsilon Chapter Research Taskforceannounces a funding opportunity for Sigma Theta TauHonor Society members to support a research projector scholarly activity. This year we are pleased toannounce that the chapter has $2,625 to be awarded toone or more investigators.

Applications are to include a cover letter with name,address, telephone number, and e-mail address, careerplans/goals, how the project contributes to your careergoals, and a succinct plan for how this seed funding willlead to the acquisition of larger grant funding.Applicantsmust also submit a two page prospectus or research nar-rative that includes the purpose of the project, the pro-posed method and analysis plan, description of the pro-posed sample and recruitment strategies, a copy of anyinstrument(s) if applicable, a budget with justificationfor each line item, and the time line (not to exceed oneyear) for conducting the project.The two page limit forthe prospectus does not include the instrument(s),budget,or budget justification. Investigators will be noti-fied by December 15, 2006 regarding the funding deci-sion.The grant funding period is from January 1,2007 toDecember 31, 2007.

Recipient(s) must be present at the Spring Induction(March 31, 2007 in Helena) to be recognized and hon-ored for their success in acquiring Zeta Upsilon Chapterfunding and to give a brief presentation of their projectand the progress to date.They are expected to make aformal presentation on the findings from their fundedstudy to members of Zeta Upsilon Chapter within twoyears of receiving the award.

Please submit applications by 12 noon November20, 2006 (Mountain Time) to:

By mail—Clarann Weinert, SC, PhD, RN, FAAN, ZetaUpsilon Research Taskforce Chair, Montana State Univer-sity, College of Nursing, Bozeman, MT 59717

By email—In RTF (Rich Text Format only) to [email protected]

By fax—Clarann Weinert, SC, PhD, RN, FAAN (406 -994 6020)

Investigators who are interested in submitting anapplication are required to work with a mentor from theResearch Taskforce in the preparation of the proposal.Please contact Clarann Weinert ([email protected]), or another member of the Research Taskforce forassistance: Sandy Kuntz ([email protected]); DenaSutermaster ([email protected]); Karen [email protected]; Linda Sobeck ([email protected]); Christina Sieloff ([email protected]);or Barbara Jacobson ([email protected]).

SURVEY:Mandatory Continuing Education for Registered Nurses

RN License #________________________________

YES NO

� � 1. Do you believe registered nurses should have an annual continuing education requirementfor maintenance of licensure?

� � 2. Do you believe continuing education is a personal choice for you as a professional andshould not be mandated?

� � 3. How many hours of CE have you obtained in the last year?

� � 4. Does your employer require certain continuing education classes?

� � 5. Does your employer offer tuition assistance for CE classes?

� � 6. Are you allowed paid time off for continuing education classes?

� � 7. Are you certified by the ANCC or another organization in a specialty area of nursing thatrequires mandatory CE to maintain the certification?

� � 8. Do you believe you should receive competency credit for annual hours worked in your clinical setting?

� � 9. What methods do you utilize to obtain CE credits?_____ Employer sponsored workshops_____ Nursing Journals (Periodicals) with CE tests_____ Internet CE courses_____ Correspondence Courses with assigned syllabus/testing_____ Mandated testing to maintain Nursing Specialty Certifications_____ Employer mandated classes necessary for your nursing specialty

(ie.-CPR,ACLS, PALS, ENPC,TNCC etc)_____ State Nursing Conventions and/or Nursing Specialty Conventions

Independent workshops available to you within your medical field

� � 10. Would you support development of Rules at the State Board of Nursing to begin mandatorycontinuing education for registered nurses in this State?

Are We Ready for Mandatory Continuing Education?6. Why is continuing education important? What are arguments for and against mandatory CE?Many people, including some nurses, assume that once a nurse has finished her education and become regis-

tered, then that’s it, she/he doesn’t have to bother with any more learning, he/she just gets on with looking afterpatients.Nothing could be further from the truth.The table below highlights only a few of the arguments on eachside.

PROS• Continuing education can assist in retaining and

recruiting nurses in a health care facility.A num-ber of studies have identified staff developmentas a significant factor in nurse job satisfactionand retention.

• Many educational opportunities are availablethrough professional publications and on theInternet at very reasonable prices and can beused at home when time is available.

• In one study, 47 percent of respondents hadsome concern that their basic education did notprepare them well.

We’d like to hear from you! One of the arguments against mandatory continuing education is that there are notstudies to show that continuing education makes a difference in patient outcomes. What is your experience?Write us with any thoughts you have about how CE helped improve a patient’s outcome or helped you be a bet-ter nurse.

Also, let us know of your problems in obtaining relevant CE, your concerns about mandatory CE, or otherthoughts about continuing education in general.

Write to CONTINUING EDUCATION, MNA, 104 Broadway, Suite G2, Helena, MT 59601 or email Maxine Fer-guson at [email protected] or Mae Rittal at [email protected].

CONS• Montana is largely rural and this causes RNs to

travel great distances for educational opportuni-ties and require greater amounts of time awayfrom home and workplace.

• Rural areas experiencing nursing shortageswhich make it difficult to get time off from workto attend educational offerings.

• Small hospitals aren’t financially able to offereducational opportunities.

• RNs working full time and raising families don’thave time to go to educational opportunities.

• Some nurses feel CE doesn’t make any differ-ence in patient care.


Rachel Rockafellow, MSN, RN, CWOCN

The book, Freakonomics, ARogue Economist Exploresthe Hidden Side of Every-thing, by Steven D. Levitt andStephen J. Dubner was inter-esting summer reading. Levittis an economist who likes tolook past conventional wis-dom for the cause of commonphenomenon using mathemat-ical formulas to arrive at thetruth behind events. He cov-ered a variety of topics in his book; however, the onethat stuck with me the most was his study of why crimedecreased in the mid-1990’s. After looking at what thecommon sense theories were saying, he ran the num-bers.What he found was quite shocking. He correlatedthe decrease in crime figures to the passage of abortionrights in the 1970’s. It seems that children born to moth-ers who don’t want them (for whatever reason) aremore likely to become criminals. Fascinating stuff.

Whatever position one takes on the abortion issue,one is unlikely to change the stance of someone on theother side. As a woman coming of age in the 1970’swhen Roe vs.Wade was passed (and before the age of

AIDS), I remember the stories from the women olderthan I.As a married woman, my mother had to go out ofstate to get access to birth control. She told me the storyof a woman she knew in the 1960’s who called her forhelp. When my mother arrived at her apartment, shefound a trail of blood from the bathroom to the bed-room and a friend in trouble. It turned out the womanhad given herself an abortion and could not seek med-ical care because what she had done was illegal. Mymother was scared.They used sheets to finally stop thebleeding.Her friend was lucky and survived (and recent-ly had her 83rd birthday).

I have two friends who have had abortions in theirpast who were relieved to be able to have access to safeand legal abortion services when they needed them.Another friend gave her child up for adoption when shewas 16 and is now going to meet her son, Nicholas, forthe first time at the age of 26.These women were theones to make the decision about what was best forthem, their future, and what was going on in their lives.

Another woman I know deeply regrets the abortionshe had as a young woman. While she now votes tomake abortion illegal, it is interesting that she presentlyhas a very nice life with four healthy, beautiful childrenbecause she did not become sterile or die of sepsisbecause she had access to a safe and legal procedure ata time in her life when she felt that was her best choice.Who knows what her life would be like now if the cir-cumstances were different.

The American Nurses Association (ANA) has a posi-tion statement on “Reproductive Health” (available at:http://www.nursingworld.org/readroom/position/social/screpr.htm). Basically it states “. . . abortion is largely asymptom of social failure.”Their concern is that withoutlegal access to abortion services “. . . many womenwould inevitably rely on illegal procedures performedin clandestine systems, resulting in a return to high mor-tality and morbidity.” Making abortion illegal does notstop abortions.

The position statement goes on to say, “Just as theclient has rights, the nurse also has rights, including theright to refuse to participate in a particular case on eth-ical grounds. However, if the nurse becomes involved insuch a case and the client’s life is in jeopardy, the nurseis obligated to provide for the client’s safety, to avoidabandonment, and to withdraw only when assured thatalternative sources of nursing care are available to theclient.”We still have responsibilities to one another,evenwhen we disagree.

There are at least three nurse practitioners and onephysician’s assistant in town I know of that would notprescribe the “morning after pill” if a client requested it.There are alternatives available for the client. If these

Reproductive Rights Then and Now health care professionals are in a rural area where thereare no other options, how should the situation be han-dled? Tough call. When their personal values interferewith providing clients with legal options they are seek-ing, who is right?

Levitt, the author, found that children born to moth-ers who cannot care for them have a very tough lifeindeed.When unwanted pregnancies were terminated,crime in the United States declined when the childrenwho would have resulted from these unplanned preg-nancies would have reached adolescence. No one pre-dicted that as an outcome in the 1970’s.Today who isbetter able to answer the question of whether a womanshould have a baby or not than the woman herself?While we won’t settle the issue here, the Federal DrugAdministration’s recent ruling making the morning-afterpill available over the counter will put part of that deci-sion back in the hands of the women most affected bythe decision. Since the morning-after pill prevents preg-nancy (not terminate one), it obviates the need for anabortion.

While I am sure no one’s mind will be changed aboutanything by this article, I hope we develop the ability torespect one another for whatever choices we feel areright for our lives and ourselves and leave the judgmentof one’s actions to whichever higher power oneadheres. May you never have to make such difficultchoices.

Don’t forget to renew your nursing license bycontacting

Montana State Board of Nursingat 406-841-2300 or visit their

Website atwww.nurse.mt.gov

Continuing Education Calendar

Clinical Application of Ventilator WaveformsReference Number: 2005-37Date: 10/1/2005 - 9/30/2007Contact: Loralee Goehle, 925-788-9519 Location:Online - http://elearning.respironics.comContact Hours: 1 C.H.

NPPV: Across the Continuum of CareReference Number: 2005-38Date: 10/1/2005 - 9/30/2007Contact: Loralee Goehle, 925-788-9519Location:Online - http://elearning.respironics.comContact Hours: 1 C.H.

Respiratory Monitoring: Principles & Clinical Application of VCO2Reference Number: 2005-39Date: 10/1/2005 - 9/30/2007Contact: Loralee Goehle, 925-788-9519Location:Online - http://elearning.respironics.comContact Hours: 1 C.H.

Rachel Rockafellow


Silver Spring, MD—ANCC Online is now availablevia ANCC’s website at www.nursecredentialing.org. Inthis first phase, two new services will be availableonline: certification verification requests, and self-ser-vice updating (by certified nurses) of personal informa-tion.

One of the primary functions of certification is to val-idate nurses’ skills, knowledge and abilities. Employers,state boards of nursing, and other organizations, rou-tinely seek to verify that candidates for employment,licensure, etc. are indeed certified. The new ANCCOnline will simplifyand streamline theprocess for thesecertification stake-holders to verify thecertification statusof candidates andapplicants to theirorganizations. If youwant to verify the certification status of an ANCC-Certi-fied nurse you need their name and social security or

certification number,and you can request verification oftheir status directly from the ANCC website, with noneed to fax, phone or mail requests.The results will bemailed to you in 10-14 days.

The other new feature introduced in the ANCCOnline rollout allows ANCC-Certified nurses to updatetheir own personal information, including address,email, phone etc.This is considered a critical first stepin a broad strategic move by ANCC to electronic andonline platforms for service delivery. ANCC is increas-ingly moving to electronic communication and docu-ments, replacing mail and paper; to improve service andefficiency, reduce costs and environmental impacts.

ANCC is increasingly using email to solicit feedbackfrom its certified nurses on important certification andpractice issues; in the future ANCC will likely be usingemail as the sole source of contact for issuing renewalreminders, and will deliver catalogs and other docu-ments in electronic form. However, a major challenge inmaintaining effective communication is to maintain up-to-date addresses, particularly email information, on thecertified nurses. Nurses belong to one of the mostmobile of professions.

The American Nurses Credentialing Center Launches‘ANCC Online’, Introducing Online Verification-of-Certification Requests and Other Services

“ . . . the power andresponsibility forupdating that information is beingplaced with the individual nurse . . . ”

With ANCC Online, the power and responsibility forupdating that information is being placed with the indi-vidual nurse.ANCC is encouraging all its certified nurs-es to go to the ANCC Website at www.nursecredential-ing.org, and update their email address, mailing addressand phone number, and to do so anytime their informa-tion changes.

About ANCCANCC is the nation’s leading nursing credentialing

organization, offering general and advanced practicecertification in over 35 specialty areas. In addition,ANCC offers nursing continuing education contacthours and review course materials through its Insti-tute for Credentialing Innovation, accredits organiza-tions that offer and/or approve continuing educationcourses for registered nurses, and promotes excellencein nursing services through its Magnet RecognitionProgram®. ANCC certifications and designations arehighly regarded by federal, state and local agenciesand the for-profit and not-for-profit sectors across thenation and globally.Each ANCC program is offered onan international platform through the ANCC Creden-tialing International program. The American NursesCredentialing Center is a subsidiary of the AmericanNurses Association (ANA). Its web site can be found atwww.nursecredentialing.org.

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Montana Nurses’ Association

104 Broadway, Suite G2 • Helena, MT 59601 • 406/442-6710 • 406/442-1841 Fax

Membership Category (check one)

M Full Membership Dues� Employed - Full Time� Employed - Part Time

R Reduced Membership Dues� Not Employed� Full Time Student� New graduate from basic nursing

education program, within six months after graduation (first membership year only)

� 62 years of age or over and not earning more than Social Security allows

S Special Membership Dues� 62 years of age or over and not

employed� Totally disabled

Please Note:$5.42 of the CMA member dues is for sub-scription to The American Nurse. $16 is forsubscription to the American Journal ofNursing. Various amounts are for subscrip-tions to CMA/DNA newsletters. Please checkwith your CMA office for exact amount.

State nurses association dues are notdeductible as charitable contributions for taxpurposes, but may be deductible as a businessexpense. However, that percentage of duesused for lobbying by the CMA is notdeductible as a business expense. Pleasecheck with your CMA for the correct amount.

TO BE COMPLETED BY CMA:

__________ __________ ___________STATE DIST REG

Expiration Date ________ / ________Month Year

Choice of Payment (please check)� E-Pay (Monthly Electronic Payment)

This is to authorize monthly electronic pay-ments to American Nurses Association, Inc.(ANA). By signing on the line, I authorize myConstituent Member Association (CMA/ANA )to withdraw 1/12 of my annual dues and anyadditional service fees from my account.

� Checking: Please enclose a check for thefirst month’s payment; the account designated by the enclosed check will be drafted on or after the 15th of each month.

� Credit Card: Please complete the credit card information below and this credit cardwill be debited on or after the1st day of each month.

__________________________________________Monthly Electronic Deduction Authorization

Signature

� Full Annual Payment

Membership Investment _______ANA-PAC (Optional—$20.04suggested) _______Total Dues and Contributions _______

Online: www.NursingWorld.org (Credit CardOnly)

� Check (payable to ANA)

� Visa � MasterCard

� Automated Annual Credit Card Payment This is to authorize annual credit card pay-ments to American Nurses Association, Inc.(ANA). By signing on the line, I authorizeCMA/ANA to charge the credit card listed inthe credit card information section for theannual dues on the 1st day of the monthwhen the annual renewal is due.

__________________________________________Annual Credit Card Payment Authorization

Signature

� Payroll DeductionThis payment plan is available only wherethere is an agreement between your employ-er and the association to make such deduc-tion.

__________________________________________Signature for Payroll Deduction

Please mail your completed application withpayment to your STATE NURSES ASSOCIATIONor to:

Montana Nurses’ Association104 Broadway, Suite G2

Helena, MT 59601

* By signing the Monthly Electronic DeductionAuthorization, or the Automatic Annual Credit CardPayment Authorization, you are authorizing ANAto change the amount by giving the above-signedthirty (30) days written notice. Above signed maycancel this authorization upon receipt by ANA ofwritten notification of termination twenty (20) daysprior to deduction date designated above. Mem-bership will continue unless this notification isreceived. ANA will charge a $5 fee for any returneddrafts or chargebacks.

DATE ________________________________

__________________________________________________ ________________________________ ________________________Last Name/First Name/Middle Initial Home Phone Number Social Security Number

__________________________________________________ ________________________________ ________________________Credentials Work Phone Number Basic School of Nursing

__________________________________________________ ________________________________ ________________________Preferred Contact: Home _____ Work_____ Fax Number Graduation (Month/Year)

__________________________________________________ ________________________________ ________________________Home Address Date of Birth RN License Number/State

__________________________________________________ ____________________________________________________________Home Address E-mail

__________________________________________________ _____ UAN Member? _____ Not a Member of Collective Bargaining UnitCity/State/Zip

__________________________________________________ ____________________________________________________________Employer Name Member of Collective Bargaining Unit other than UAN? (Please specify)

________________________________________________________________________________________________________________________Employer Address

________________________________________________________________________________________________________________________Employer City/State/Zip Code

CREDIT CARD INFORMATION

__________________________________________Bank Card Number and Expiration Date

__________________________________________Authorization Signature

__________________________________________Printed Name

Amount: $__________________________________

Employer Code _________________________

Approved By _____________ Date _________

$ ____________________________________AMOUNT ENCLOSED CHECK #

Sponsor, if applicable ____________________

SNA membership # ______________________

M E M B E R S H I P A P P L I C A T I O N

DISTRICT CONTACTSDistrict 1Meetings every first Tuesday of

the month September throughApril at CMC–for more informa-tion contact:

Cindy BumgardnerHome—(406) 728-7954Work—(406) 728-4100Email: [email protected]

District 2Vacant

District 3Barb PrescottHome—(406) 585-1393Email: [email protected]

District 4Brenda DonaldsonHome—(406) 442-0681Email: [email protected]

District 5Tina HedinHome—(406) 656-9632Work—(406) 657-4150Email: [email protected]

District 6Pam WindmuellerHome—(406) 771-7453Work—(406) 455-5375Email: [email protected]

District 7Angela St. John(406) 892-1003

District 8Vacant

Cindy Bumgardner

Barb Prescott

Tina Hedin

Pam Windmueller

Brenda Donaldson

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