nursing matters february 2015

February 2015 � Volume 26, Number 2

Nursingmatterswww.nursingmattersonline.com

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By Kathleen Corbett FreimuthA researcher came to the Com-

munity Advisors on Research Design and Strategy – CARDS – seeking answers. How could her questionnaire tool provoke an authentic response from research participants? The advisors, seeing the research tool for the fi rst time, offered their unbiased perspective.

“I am troubled by the question, ‘Are you often displeased about trivial things?’ It’s judgmental,” one advisor said. “If I am dis-pleased, it’s not trivial to me. I could have a valid reason for being displeased. ‘What bothers or upsets you?’ might be a less-judgmental question.”

The origin of such pointed discussions began fi ve years ago when researchers at the University of Wisconsin–Madison School of Nursing sought a way to effec-tively engage people in research, especially those from under-repre-sented communities. They created CARDS, a unique advisory group with a non-research perspective.

The advisors constitute a core service of the Wisconsin Network for Research Support, a commu-nity-engagement center based at the School of Nursing. In 2010, Barbara Bowers, PhD, RN, FAAN, and associate dean for academic programs, received funding from the National Institute for Nursing Research and the National Center for Advancing Translational Sci-ences to develop a program to integrate community input with academic research.

“We wanted to link researchers with community members who

could bring the perspective of non-researchers into the world of academia,” said Gay Thomas, MS, director of community engage-ment for the Wisconsin Network for Research Support. “The goal of CARDS is to help researchers cre-ate materials that are more acces-sible, understandable and engaging for the general public.”

In developing the group, Thomas and colleague Betty Kaiser, PhD, RN, and director of community training for the network, partnered with Madison’s Goodman Commu-nity Center and the Lussier Com-munity Education Center. Together, they established two groups of advisors, whose members come from diverse racial, socioeconomic and educational backgrounds.

“These were the voices we wanted to hear on our advisory boards,” Thomas said. ”They rep-resent the breadth and diversity of people who use community cen-

ter services – parenting and child programs, senior-meal programs, women’s support groups and the food pantry. ”

At a 90-minute meeting with the guest researcher, facilitated by Thomas and Kaiser, the advi-sors receive a brief overview and are told the aim of the project or research. The advisors then review research-study plans and materials, and identify language or format-ting that might pose concerns for potential study participants. In the post-meeting phase, Kaiser and Thomas provide a detailed follow-up report to the researcher that includes a complete revision of the researcher’s document refl ecting suggestions from the advisors. The advisors are paid for each monthly meeting they attend.

In preparing the advisors for their advisory role, Thomas and Kai-ser emphasize the importance of

Playing a Strong Hand:CARDS engages community

Betty Kaiser (second from right) discusses research materials with Rasaki Em-manuel (second from left) and other CARDS advisors from the Goodman Com-munity Center. TODD BROWN/UWSMPH MEDIA SOLUTIONS

continued on page 4

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February • 2015 Nursingmatterswww.nursingmattersonline.com

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EDITORIAL BOARDVivien DeBack, RN, Ph.D., EmeritusNurse ConsultantEmpowering Change, Greenfield, WIBonnie Allbaugh, RN, MSNMadison, WICathy Andrews, Ph.D., RNAssociate Professor (Retired)Edgewood College, Madison, WI

Kristin Baird, RN, BSN, MSHPresidentBaird Consulting, Inc., Fort Atkinson, WIJoyce Berning, BSNMineral Point, WIMary Greeneway, BSN, RN-BCClinical Education CoordinatorAurora Medical Center, Manitowoc CountyMary LaBelle, RNStaff NurseFroedtert Memorial Lutheran HospitalMilwaukee, WICynthia WheelerRetired NURSINGmatters Advertising Executive, Madison, WI Deanna Blanchard, MSNNursing Education Specialist at UW HealthOregon, WIClaire Meisenheimer, RN, Ph.D.Professor, UW-Oshkosh College of NursingOshkosh, WISteve Ohly, ANPCommunity Health Program ManagerSt. Lukes Madison Street Outreach ClinicMilwaukee, WIJoyce Smith, RN, CFNPFamily Nurse PractitionerMarshfield Clinic, Riverview CenterEau Claire, WIKaren Witt, RN, MSNAssociate ProfessorUW-Eau Claire School of Nursing, Eau Claire, WI

© 2015 Capital Newspapers

Nursingmatters

EDITORIALNMBy Kaye Lillesand, MSN

When searching for one of Signe Cooper’s “Refl ec-tions” articles I came across an editorial I wrote about the mis-sion and purpose of NURSING-

matters. That was 20 years ago. I thought it might be interesting to refl ect on how we have done. We welcome your comments.

NURSINGmatters 1995 – What’s it all about? To help our readers and authors understand the direction NURSINGmatters is taking I’d like to use this editorial to share with readers the mission, visions and objectives our Editorial Board has developed for 1995.

Mission: NURSINGmatters is a communication tool. Its mission is to help create a dynamic, self-driv-en future for nurses and the profes-sion of nursing in Wisconsin.

Vision: The profession of nurs-ing is an essential part of a healthy society. To be a dynamic force it must grow continually. Nurses are professional experts and, as such, they have a responsibility to defi ne the future of the profession that will be benefi cial to society. We believe there are several essential elements in molding the future of nursing: knowledge, the ability to make connections, a sense of value and vision. Therefore, the 1995

objectives to accomplish this will include articles focusing on these areas.

Knowledge: Knowledge renders nurses powerful. NURSINGmatters will provide articles that increase nurses’ knowledge through:• Helping nurses understand the

business of healthcare,• Acknowledging the resources

inherent in nurses and the profes-sion,

• Keeping nurses aware of what is going on in the state at the leg-islative level, the corporate level and the practice level, and

• Keeping nurses appraised of pertinent actions at the national level.Connections: The ability to

make connections leads to creative problem-solving. NURSING-matters will provide articles that demonstrate the necessity and signifi cance of making connections through:• Internal connections – relation-

ships to one another,• External connections to consum-

ers and other professions,• Political connections – relation-

ships between policy and prac-tice, and

• The past – relationships between history and the future.Value: A sense of how valuable

the profession is to society spurs us to action. NURSINGmatters will provide articles that:• Demonstrate respect and support

for one another, and• Demonstrate respect for the pro-

fession and its role in society.Vision: “Where there is no vi-

sion, the people perish” – Proverbs 29:18. Where there is vision, the profession fl ourishes. NURSING-matters will provide articles that:• Refl ect leadership and positive

direction for the profession,• Identify creative or risk-taking

ideas for reform, and • Identify ideas for making a vision

become a reality.We will still be calling our

readers for articles and we always welcome suggestions for particular topics and/or authors. In addition, we are designing new features to help us articulate our professional expertise – just exactly what we do and why – to the public.

Our goal is when a reader fi n-ishes an issue the reader will have gleaned a new bit of information or a new bit of motivation to help take action. The ultimate goal is for each issue of NURSINGmatters is to help nurses create a dynamic fu-ture for themselves and the profes-sion. When nursing moves forward, society benefi ts.

Kaye Lillesand

Looking back to look forward

Feb 5: Strengths-Based Care Management for Geriatric Mental Health CareUW- Madison Continuing StudiesMadison608-262-2451 or continuingstudies.wisc.edu/certifi cates/ mental health-older-adult.html

Feb 19: Behavioral and-Psychological Symptoms of DememtiaUW- Madison Continuing StudiesMadison608-262-2451 or continuingstudies.wisc.edu/certifi cates/ mental health-older-adult.html

Mar 3: WNA Day at the Capi-tolWisconsin Nurses AssociationMadison800-362-3959 or [email protected]

EDUCATION MATTERS

February 2015 Calendar

February • 2015www.nursingmattersonline.com

By Karin KrauseIt has been a

while since I have told people what’s going on at Hope & A Future. We are living inter-generationally in

our Adult Family Home now. Our live-in staff now includes a single mom and her daughters, myself, my husband and one of our adult daughters. Ages range from 6 to 90 years of age in this home. We are strengthening the generations by bringing them together.

This family of friends recently lived through the death of one of our members. I am sharing part of the story around this woman’s life and death. Our residents publish a monthly gazette; this is a slightly abridged story from the gazette:

We met Nadine when she was all dressed up in fancy Christmas clothes, with beauty-shop hair, make-up and jewelry. Her daughter and son-in-law had brought her to a Hope & A Future potluck and music party. She was all smiles and loved the music. Nadine seemed to love meeting new people, which she could do often because she had absolutely no short-term memo-ry. She could meet us over and over again. And, in time, we became housemates at Hope & A Future. Every day for more than a year, Nadine would wake up early. She would often pack a bag or start moving her belongings toward the door in preparation to go home. She was often worried her family didn’t know where she was. Because of her strong faith, we could interest her in a devotion or hymn, which would temporarily help her feel at home. From there she would read and reread the newspaper, and drink coffee until there was kitchen work for her to do. She enjoyed setting beautiful tables, peeling vegetables and stirring soups. When the work was done, though, she would begin trying to find a ride home and would ask for information on how to go home, over and over. We would show her room to her. She would exclaim

in surprise at having one in this location. Sometimes this settled her for a few minutes and other times she concluded we had kidnapped her and her things. When we would explain that her children had helped move her here she would say, “Oh… my children did. What are their names?” When we would tell her, Nadine often squinted at us and said, “You are good, you are really good. I don’t know what is going on here but I need to get home.”

After her new room was built on the main floor, she could walk to it on her own to look at her pictures and sit on her couch by the sunny window. Somehow during this time her new home began to be famil-iar. But as time went on the de-mentia and cancer progressed. She eventually lost the ability to set the table and to say beautiful prayers of thankfulness and worship before our meals. Some days forming an understandable word was impos-sible. It was hard for her to accept help; she wanted to be the helper.

If she became disheartened or up-set, her Bible was always comfort-ing to her. Many times we thought of the verse “seek the Lord early while He can be found.” Nadine had come to know the Lord early, when she could easily learn new things. When her short-term mem-ory no longer functioned, the Word dwelt in her long-term memory and remained a rich blessing to her. Her long-term memory was filled with the Word and worship. This was her ever-present help.

In time she became increasingly weak; Agrace Hospice came to help. We worked to keep her com-fortable and safe – by this time she knew she was in a safe home.

Then a miracle began. The weak-er her body became, the stronger her mind and spirit became.

One day while being helped to bed she looked up at a caregiver, smiled and said, “You know, Jesus is coming soon, and he’s very play-ful!”

The words were perfectly clear! If we reminded her of this later, she always remembered it. She would

Nadine takes her exit

Karin Krause sits with Nadine. When Nadine’s body left the building, family, friends and the dog walked out behind her singing a hymn accompanied by violin. She was driven off into a beautiful sunset. Amazing.

continued on page5

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respectful, constructive feedback to the researcher. Two two-hour train-ing sessions include case studies, dramatizations and role-playing, worksheets and exercises, and self-assessments. Concrete skill-building in several major areas includes recognizing common research terms and communicating effectively.

“A skill-building component deconstructs language barriers – terminology such as IRB and protocols – in order to establish a common language,” Thomas said. “We also work closely with guest researchers to help them use plain, straightforward language – no scientific jargon – in their materi-als and during advisor meetings. It levels the playing field.”

Above all, Kaiser and Thomas said they want to ensure an envi-ronment of mutual respect – the foundation of a strong community-academic partnership.

“During the training sessions, we

ask the CARDS a pivotal ques-tion,” Kaiser said. “‘How would you like people to give you feed-back on something important to you?’ Their approach prompts discussion and builds a foundation of respect for guest researchers and the opinions shared by everyone at a CARDS meeting.”

The advisor service centers on the belief that the most effective outcomes result from deep and respectful personal engagement. Accordingly, before the group’s meeting with the researcher, Thom-as and Kaiser share with advisors what they’ve learned from the researcher about his or her inspira-tion for the research.

Connecting in a personal, re-spectful way is key, advisor Rasaki Emmanuel said.

“Someone with a great mind is trying to better society,” Emmanuel said. “They value my opinion. I can sit down with the researcher and discuss how to better explain their work to people in my situation. The researchers’ personal stories inspire me to help them.”

“It’s all about perspective,” said Karen Conner, another advisor. “The (program) allows me, in a small way, an opportunity to ‘pay it forward’ – to do something that could make a difference for some-one in the future.”

This past year, 30 researchers from various disciplines – includ-ing nursing, surgery and family medicine – participated in the

service. “It’s a powerful dynamic when

you have a variety of people with experiences and perspectives both within and outside the world of academia sharing with one anoth-er,” Kaiser said.

Contact Gay Thomas at [email protected] or Betty Kaiser at [email protected] for more information.

CARDScontinued from page 1

Gay Thomas (second from left) discusses research materials with CARDS advi-sors from the Lussier Education Center.

TODD BROWN/UWSMPH MEDIA SOLUTIONS

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smile and say, “That’s right!” Nadine gradually became more

tired and began spending more time in bed. One time she woke up when I, Karin, came in to check on her.

She looked at me and the equip-ment we now had in her room and asked, “Am I alright?”

I answered, “Your time to go to heaven with Jesus is very near.”

She closed her eyes and smiled slightly and said, “Yes; yes it is.”

A few weeks later she woke up looking distressed. Another care-giver asked if she was okay and she said, “I am fear.” They spent some time looking at her devotion until Nadine looked more settled. Later she napped and woke up with a big smile on her face. She looked at this same caregiver and said, “I am peace now and they are very kind.” We imagined angels min-istering to her in her sleep. This happened about three weeks before Nadine died. After making that statement of peace, she never again

experienced the nearly daily anxiety she lived with in the absence of a short-term memory. We wondered if her dementia had left or if her spirit took over as her body dimin-ished. It doesn’t matter; her peace was divine.

In the weeks that followed, she slept more and more. We watched her carefully for signs of discom-fort and two of us went in regularly to reposition and care for her. Once settled she would sometimes wake up to say something very specific to caregivers, or give a hug and a smile. When her daughter’s family would sing hymns at her bedside, she would sometimes join in sing-ing or mouthing the words or smile with her eyes closed. Sometimes she waved at the ceiling and said “hi” to something or someone we could not see.

Another time she said, “I have a Major on the hill, and he is beckon-ing me. Come on, come on, it is time to come home!” Yet another time she said, “Soon I will go to that great mercy, that great, great mercy.”

As Nadine became weaker, her daughter spent many nights sleep-ing in her mother’s room. One night we were helping Nadine when sud-denly Nadine looked at her daugh-ter and said, “I bless you, I bless you, I bless you!” We had tears of thankfulness for that moment. Nadine later looked at me and said, “She is some of my best work.” I agreed.

The day she died, Nadine made a rather sudden exit. The Hospice nurse was with her while we ate lunch. Suddenly she came out and said “it will be soon.” She had Na-dine’s son on the phone and as he said, “I love you Mom, good-bye,” Nadine breathed one of her last few breaths. Her daughter came into the room and wrapped her arms around her and cried and told her she would miss her and that she loved her. Nadine breathed a few more breaths as her daughter cried.

Suddenly her daughter stood back and said, “What am I crying about? You are with Jesus now, you lucky duck!”

A tear ran down Nadine’s nose

as a smile crossed her face and she breathed her last. Her daughter “preached herself happy,” remind-ing us all that the Bible tells us to die is gain.

There were tears and smiles. What a beautiful exit, Nadine! We are all changed.

I will add that Nadine’s daughter is a caregiver. She has told us many times that although her mother had faith, she believes the peace she found at the end of her life was in part because of the loving environ-ment and people caring for her. A home shared by children and live-in staff provides an environment that exceeds anything I have experi-enced in my 35 years as a Geriatric Nurse in institutional settings.

A new resident recently said, “People keep asking me what makes this place different and I finally told them. At meals, the director and all the staff sit down to eat at the same table and that is very different.”

A life shared is very different than shift work and break rooms.

Nadinecontinued from page 3

Be part of something REMARKABLE

UW Health. Remarkable Careers.HN-41748-15

UW Health at The American Center is a unique new health andwellness facility taking shape on the east side of beautifulMadison, Wisconsin. Opening in August 2015, the three-story,496,000-square foot structure will offer superb inpatient andoutpatient care in a welcoming, patient- and family-centeredenvironment.

To support this exciting growth, we are seeking skilled nurses forthe following areas/positions:• Emergency Department • Inpatient Med/Surg• Nurse Case Manager • Pre-/Post-PACU

Please contact Melissa Holman, senior nurse recruiter, [email protected] or 800-443-6164, or visituwhealth.org/careers under the UW Hospital and Clinics section.

To watch our progress, visit uwhealth.org/americancenter

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By Nicole Meighen, RN, MSN

As a new nurse begins to consider which specialty he or she would like to begin a career in, public health is normally

not considered. Why is this? When I first began my nursing career, I wanted to be “in the trenches” providing emergency care. I thought that fast-paced environment would be a place where I could help vulnerable patients through difficult times.

However, after about a year of working in the emergency room, I discovered something life-changing for me. I asked myself, “Why is this emergent patient care needed so often?” The answer is simple. Preventive education is not being stressed enough to patients, resulting in adverse events like strokes and heart attacks.

Because of this revelation, I sought a public-health posi-tion that would allow me to help patients prevent avoidable adverse events. After about a month of searching, I located an occupational-health position at Procter & Gamble. Upon walk-ing into the plant, I knew I would be a public-health nurse for life. The environment is welcoming and preventative education is highly valued; each and every day I have the honor of helping employees set and work toward accomplishing their personal health goals.

Currently, my passion is work-ing to create a holistic health-coaching program that helps employees learn how to improve their health by empowering them to be an active member in man-aging it.

In addition, I have developed numerous lesson plans that work to improve the knowledge of site

emergency responders. Dur-ing each lesson I begin with a knowledge check that tests the responders’ knowledge recall from the previous session. Next, I speak about common health conditions and how to appropri-ately respond to medical needs. After the content is given, I have members apply this learned knowledge. The responders do drills and practice the skills I teach them. Lastly, a post-knowl-edge check is given, promoting the internalization of important information.

What have I seen? Not only has emergency-response care vastly improved, employee overall health management has also improved. Because em-ployees are more aware of what causes adverse events, they coach peers about how to live healthier lives.

There are many other roles that occupational-health nurses ful-fill. For example, nurses play an active role in case management, ergonomics, health-surveillance programs, travel health, risk review, charity work and much more. To be an occupational-health nurse means to be a flex-ible and hardworking individual; no day is ever the same and this is why I love it. The employees always come first. I truly believe that if more healthcare profes-sionals would have the “ah-ha” moment that I had, we as a com-munity could prevent much of the devastation I witnessed as an emergency-room nurse.

To learn more about occupa-tional health nursing, attend the Midwest Regional Occupational Health Conference. It provides nurses with the opportunity to network with one another and to obtain continuous education credits. Visit www.wsaohn.com/conference-program for more information.

Take nursing into work

Correctional NursingWisconsin Department of Corrections

Passion, Commitment, Autonomy

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We believe that every individual person hasintrinsic value and the right to health care.As professional nurses our responsibility is tothe care, restoration health and treatment ofpatients. As nurses we deliver care within theframework of a security environment, andwithin the underpinnings of nursing practice.Consider the Wisconsin Department ofCorrections for your next career.

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Two Doctor of Nursing Practice in Leadership students have accept-ed new positions at University of Wisconsin Hospitals and Clinics’ new east-side hospital, UW Health at The American Center, scheduled to open in 2015.

Jessica Dern received her Master’s of Science degree in Nursing Admin-

istration from Edgewood Col-lege, and will be completing her Doctor of Nursing Prac-tice in Leader-ship in May 2015. Dern is currently a manager

on an inpatient cardiology floor at UWHC. She has been promoted to director of Professional Services for UW Health at The American Center, and will be responsible for oversee-ing Lab, Pharmacy, Radiology, Food Services, Nutrition and Echo Vascu-

lar Labs.Kari Fisher, an Advanced Prac-

tice Nurse and current manager at the William S. Middleton Veterans Administration Hospital, is also scheduled to finish her Doctor of Nursing Practice in Leadership from Edgewood College in May 2015. She has accepted a position as director of Perioperative and Emergency Room Services for UW Health at The American Center. She will oversee the operation of the operating room – pre-operative, clinic, post-anesthesia care unit, Surgical Professional Services and 14 operating rooms – as well as Emergency Room services.

They began their new roles in January.

“We are thrilled that both Jes and Kari have accepted these new posi-tions, and wish them the very best in opening a new hospital in 2015,” said Roberta Pawlak, associate dean for Graduate Nursing Pro-grams at Edgewood College.

CELEBRATIONSNM

Jessica Dern

Students accept hospital positions

“I’m not a threat”Kaci Hickox, the Ebola nurse who was forcibly held in an isolation tent in New Jersey for three days, says she will not obey instructions to remain at home for 21 days in Maine. The 33-year-old nurse for Doctors Without Borders was the first person pulled aside Jan. 23 at Newark Liberty International Airport under new state regulations, after her return from Sierra Leone where she was work-ing with Ebola patients. After her public outcry, in which she complained of “inhumane” treatment, Hickox was allowed Jan. 19 to leave New Jersey, travel-ing by private car to her home in Maine. Hickox, who shows no symptoms of the deadly virus, says she believes the quarantine policy is “not scientifically or constitutionally just.” PHOTO CREDIT: ASSOCIATED PRESS

Come seeWhat Is Possiblehere.

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Froedtert Health’s strong partnership with theMedical College of Wisconsin has benefitedpatients, health care professionals and the regionsince 1980. With three hospitals and more than30 primary and specialty care health centers andclinics, the Froedtert & the Medical Collegeof Wisconsin health network provides a workenvironment where medical and non-clinicalprofessionals can feel encouraged, respected,valued and highly regarded. We currentlyhave the following opportunities available:

Community Memorial HospitalMenomonee Falls, WisconsinICU – Registered NursesInternal Float – Registered NursesLabor & Delivery – Registered Nurses

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To learn more about the Froedtert & theMedical College health network and toapply, please visit froedtert.com/careers

We are proud to be an Equal Opportunity Employer. Asa federal contractor/subcontractor, we take affirmativeaction in employment based on race, sex, disability andstatus as a protected veteran. We welcome protectedveterans to share their priority consideration status withus at 414-777-1680. We maintain a drug-free workplaceand perform pre-employment substance abuse testing.

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Carrie Wartman, nominated by fellow public-health nurses Jean Tyn-dall and Sara Mack-iewicz, was given the Lillian Wald Award in 2014. The award recognizes new public-health nurses for their contribu-tions to public-health nursing practices within their agencies and/or communities. Wartman has worked for two years as a public-health nurse at Ashland County Health and Human Ser-vices Department. Since begin-ning her employment in public health, Wartman has brought a passion and momentum for posi-tive change. Her focus over the

past two years has been on mater-nal, infant and school-age health and wellness. One of the greatest achievements of Wartman’s career in public health so far has been her ability to connect with the various organizations and enti-ties that provide family support in northern Wisconsin. With her for-mer experience in city government – Wartman is a former city council member – she has an innate ability to work with others in a meaning-ful and productive way.

Erica Sherman, public-health nurse at Wood County Health Depart-ment, is the 2014 recipient of

the Florence Nightingale Award, which recognizes public-health nursing’s leadership in achiev-ing one or more objectives of Healthiest Wisconsin 2020 Health Priorities at either a community or systems level within the award-ee’s jurisdiction. Sherman was nominated by Leah Meidl, one of her peers. Sherman’s notable accomplishments include coordi-nating education and resources, promoting physical activity, estab-lishing sustainable gardens with child-care providers, developing a car-seat program in Wood County that has grown to six technicians, a car-seat recycle program, a car-seat diversion program for drivers cited for improper use of a car seat, and as the lead for a prena-tal-care coordination program. Sherman has seen growth of the programs when many agencies are seeing declines.

Peggy Stalheim, public-health nurse at Marathon County Health Depart-ment for the past 17 years, is the 2014 recipient of the Cor-nelia Van kooy Award for Distin-guished Service in Public Health Nursing. This award recognizes a public-health nurse’s contributions to public-health nursing practice within his or her agency, commu-nity, region, state, nation or glob-ally, by providing leadership in professional organizations, demon-strating outstanding public-health-nursing performance or other accomplishments relating to pub-lic-health nursing. Stalheim was nominated by Tiffany Pietrowski, a peer at the health department. It is estimated that during her 17 years Stalheim has provided direct family services to more than 1,200 families. Stalheim has accom-

plished a great deal with advocacy at the heart of her actions, whether it was connecting a family with Shriner’s Hospital or arranging for an Amish family with an infant with Phenylketonuria to get the needed formula to properly grow and develop. Stalheim’s relation-ship with the plain community is one of her most notable achieve-ments, including promotion of immunizations, new-baby visits and emergency preparedness activ-ities. Stalheim is also a founding member of the Wisconsin Breast-feeding Coalition-Heart of Wis-consin Chapter. Marathon County Health Department was one of the first breastfeeding-friendly health departments in Wisconsin. Though Stalheim retired last fall, the groundwork she laid at the Mara-thon County Health Department will endure for years to come.

Two additional public-health nurses were recognized for contri-butions to public-health nursing. Starrlene Grossman and Teresa Boxrucker, both from Sheboygan County Division of Public Health, received the Carol Graham Schol-arship. They also received free 2014 Wisconsin Public Health Association membership and paid registration to 2014 Public Health Nursing. Graham was a public-health-nurse leader in Wis-consin for more than 36 years. She inspired and encouraged new public-health-nursing leadership; her family and friends established a memorial fund in her name to advance this effort. The Wisconsin Public Health Association, Public Health Nursing Section, awards up to five Carol Graham Scholar-ships annually. The purpose of the award is to recognize the contribu-tion public-health nursing is mak-ing in Wisconsin communities, foster Wisconsin Public Health Association participation among public-health nurses who entered the field within the past 10 years and assist in the development of new public-health-nursing leaders.

Several awards given last year

Carrie Wartman

Erica Sherman

Peggy Stalheim

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Reflections of our HeritageSigne Skott Cooper’s legacyJeanette M. Hays, 1888-1960

Reprint in a series written by Signe Cooper and introduced by Laurie Glass in Nursingmatters

Editor’s note: This column was written by Signe Cooper and originally published in 1994.

Jeanette Hays was born in Alderly, Dodge County, Wiscon-sin, to a well-known pioneer fam-ily. Her paternal grandfather came to Wisconsin in 1849; the family was prominent in early state politics.

Hays gradu-ated in 1910 from the Wisconsin Training School for Nurses in Mil-waukee. Estab-lished in 1888, this was the first school of nursing in the state, and was unique in the fact that students had their clinical experiences in sev-eral different hos-pitals. Hays began her career as a private-duty nurse. After a period of staff nursing in tuberculosis, she was an appointed field supervisor of the tuberculosis division of the Milwaukee Health Department.

During World War 1, Hays was sent to France with the Children’s Bureau of the American Red Cross. She directed three dispensaries designed for the care of children, particularly children suffering from malnutrition – a result of war-time food shortages.

Upon her return to the United

States, Hays served one year as a charge nurse in the out-patient department at Fordham Hospital in New York City. From 1922 to 1926 she lived in Columbia, South Carolina, where she was an advi-

sory nurse in the Bureau of Child Hygiene and Public Health Nursing, South Carolina Board of Health.

In 1927 Hays returned to Milwaukee as executive secre-tary and registrar of the Milwaukee District Nurses Association. She was executive secretary of the Milwaukee Dis-trict Nurses Asso-ciation for 25

years. As registrar, she arranged for

placement of private-duty nurses as requested by the various Mil-waukee hospitals. She was greatly respected for the assistance and guidance she gave to many nurses in her role as registrar.

Hays served as president of the Wisconsin State Nurses Association from 1930 to 1933. In her presiden-tial address at the 1933 Wisconsin State Nurses Association Conven-tion in Green Bay, she said, “There is a need for a new philosophy of work and perhaps it will be based on the needs of human beings –

present and anticipated… It seems likely that our present situation (the Great Depression) will result in increased respect for the rights of human beings.”

A modest, unassuming woman with a keen sense of humor, Hays was also a philosopher and a schol-ar. An article about her in the Bul-letin of the Wisconsin State Nurses Association described her as, “one

of those nurses who has never ceased to study and one whose interests are as broad as the profes-sion itself.”

Hays died May 26, 1960, at the St. Joan Antida Home in Mil-waukee. She is buried in Mapleton.

Signe Cooper is a retired nurse and emeritus professor for the School of Nursing at the University of Wisconsin-Madison.

Remember those who paved the way

Jeanette M. Hays

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SILVER SPRING, MARYLAND – The American Nurses Associa-tion is embarking on a yearlong campaign to highlight the impor-tance of nursing ethics and their impact on patients and healthcare quality. Meanwhile the annual Gallup survey on trust in profes-sions shows the public continues to rate nursing as the most honest and ethical.

For the past 13 years, the public

has voted nurses as the most honest and ethical profession in America in the Gallup poll. This past year, 80 percent of Americans rated nurse honesty and ethical stan-dards as “very high” or “high,” 15 percentage points above any other profession.

“All nurses share the critical

responsibility to adhere to the highest ethical standards in their practice to ensure they provide superior healthcare to patients and society,” said Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, and association president. “(The as-sociation) is calling 2015 the Year of Ethics to highlight ethics as an essential component of everyday nursing practice and reinforce the trust patients have that nurses will

protect their health and safety, and advocate on their behalf.”

The Year of Ethics will include educational activities supporting the code and a three-day experts’ symposium.

As more Americans gain access to healthcare under the Affordable Care Act, consumers increasingly are finding they can rely upon nurses to provide their preventive, wellness and primary-care ser-vices.

Additionally, the association has completed a revision of its Code of Ethics for Nurses, a cornerstone document of the nursing profession that upholds the best interests of patients, families and communities. The new code reflects many chang-es and evolutions in healthcare and considers the most current ethical challenges nurses face in practice. The revision involved a four-year process in which a committee received and evaluated comments on ethical issues from thousands of nurses.

Nurses most honest and ethical Association launches Year of Ethics

A new board certification through portfolio for rheumatology nursing will be launching this year.

The American Nurses Creden-tialing Center’s new certification through portfolio is an alternative assessment method for creden-tialing registered nurses in their specialty areas. Nurses document skills, knowledge, abilities and career accomplishments as part of the application-assessment process. Certification through portfolio requires equivalent rigor as examinations to meet accredit-ing bodies’ criteria to determine proficiency through a peer-review process informed by nurse experts.

“Certification through portfolio is an excellent method for cre-dentialing and will greatly serve the nursing profession as nurses’ knowledge grows ever more specialized,” said Linda C. Lewis, executive vice-president and chief officer, MSA, RN, NEA-BC, FACHE. “We look forward to a

productive collaboration with the Rheumatology Nurses Society and its members, as (the center) aims to develop the first-ever certifica-tion in rheumatology nursing.”

Nurses certified through the portfolio assessment method are regarded as experts in their spe-cialties and are considered to be among the highest-qualified nurses in the world. These credentials foster both professional growth and job satisfaction while demon-strating a nurse’s commitment to providing excellent care.

“We are delighted and excited to endorse (the center’s) development of a board certification to recog-

nize the passion, commitment and quality that rheumatology nurses bring to their practices and the care of their patients every day,” said Sheree C. Carter, PhD, RN, and president of the Rheumatol-ogy Nurses Society. “As leaders in healthcare, rheumatology nurses continue to reach for excellence in professional development and nursing practice. (The center’s) board certification will provide a credible means for Rheumatology Nurses Society members and all rheumatology nurses to validate their knowledge, engage in life-long learning and be recognized for their experience.”

The center incorporates the latest nursing practice standards, ensur-ing that nurses are credentialed us-ing the most current criteria, Lewis said. The center’s experience with in-house test development using psychometric practices provides a foundation for the development of the rheumatology certification through portfolio. The ability to operationalize and administer in-dividual credentialing programs is one of the center’s core competen-cies, she said, with the center the only nurse-credentialing organi-zation to achieve ISO 9001:2008 certification in the design, devel-opment and delivery of global-credentialing services and support products for nurses and healthcare organizations.

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SILVER SPRING, MARYLAND – The American Nurses Association is calling for stronger collabora-tion between registered nurses and their employers to reduce the risks of nurse fatigue for patients and nurses. Nurse fatigue is associated with shift work and long hours. The new position statement emphasizes strengthening a culture of safety in the work environment.

The association contends that evidence-based strategies must be implemented to proactively address nurse fatigue and sleepiness. Such strategies are needed to promote the health, safety and wellness of nurses and ensure optimal patient outcomes.

“Research shows that prolonged work hours can hinder a nurse’s performance and have negative impacts on patients’ safety and outcomes,” said association Presi-dent Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN. “We’re concerned not only with the greater likelihood for errors, diminished problem-solving, slower reaction time and other performance deficits related to fatigue, but also with dangers posed to nurses’ own health.”

Research links shift work and long

working hours to sleep disturbances, injuries, musculoskeletal disorders, gastrointestinal problems, mood disorders, obesity, diabetes mellitus, metabolic syndrome, cardiovascular disease, cancer and adverse repro-ductive outcomes.

The association offers numerous evidence-based recommendations for nurses and employers to enhance performance, safety and patient outcomes. • Involve nurses in the design of

work schedules and use a regular and predictable schedule so nurses can plan for work and personal responsibilities.

• Limit work weeks to 40 hours within seven days and work shifts to 12 hours.

• Eliminate the use of mandatory overtime as a “staffing solution.”

• Promote frequent, uninterrupted rest breaks during work shifts.

• Enact official policy that con-fers nurses the right to accept or reject a work assignment based on preventing risks from fatigue. The policy should include conditions that a rejected assignment does not constitute patient abandonment, and that nurses should not suffer

Lessen fatigue to promote safety

see FATIGUE on page 12

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SILVER SPRING, MARYLAND – American Nurses Association officials have expressed their sincere appreciation for the work of Marilyn Tavenner, MHA, BSN, RN, admin-istrator of the Centers for Medicare and Medicaid Services.

“As the first permanent administra-tor of the Centers for Medicare and Medicaid Services since 2006, Mari-lyn Tavenner took the helm of (the Centers) during a time of enormous change in our country’s healthcare system,” said association President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN. “Tavenner is a superb, collaborative leader, attributes that allowed her to foster an innovative, patient-centered approach to improv-ing the quality of care.

“Her nursing expertise, along with her public- and private-sector experience, enabled her to guide the opening of the Health Insurance Marketplace. Under Tavenner’s lead-

ership, and despite initial challeng-es, the marketplace is now thriving and millions of Americans who were previously uninsured now have ac-cess to high-quality healthcare. For that, she deserves the highest levels of respect and gratitude.”

Tavenner, a former Intensive Care Unit nurse, served as chief executive officer of the Hospital Corporation of America and was Virginia’s sec-retary of Health and Human Re-sources under former Governor Tim Kaine before being confirmed as the Centers administrator in 2013.

The American Nurses Association is the only full-service professional organization representing the inter-ests of the nation’s 3.1 million regis-tered nurses through its constituent and state nurses associations and its organizational affiliates. The asso-ciation advances the nursing pro-fession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on healthcare issues affecting nurses and the public. Visit www.nursing-world.org for more information.

ANA appreciates Tavenner

Marilyn Tavenner

Nurses on boards given funding push

SILVER SPRING, MARY-LAND – The Rita and Alex Hillman Foundation has con-tributed $150,000 to fund the American Nurses Foundation’s work to increase the number of nurses serving on national boards of directors.

The foundation is the phil-anthropic arm of the American Nurses Association; its work is part of a coalition of national nursing organizations working together to increase nursing presence on corporate and non-profit health-related boards of directors throughout the coun-try. Marla J. Weston, PhD, RN, FAAN, chief executive officer of the association and the foun-dation, co-chairs the national coalition. Kate Judge, executive director of the foundation, will co-chair one of the coalition’s work groups focused on board appointments.

“This grant aligns with the Hillman Foundation’s commit-ment to improving lives through nursing,” said Ahrin Mishan, Hillman Foundation’s execu-tive director. “We believe that patients and families will be the ultimate beneficiaries of this

impor-tant initia-tive led by the Ameri-can Nurses Founda-tion. The Hillman Foundation seeks to positively impact lives by spearheading programs to support the next generation of nursing leaders and funding nurse-driven ap-proaches to transforming the cost and delivery of care.”

Placing nurses on boards is in alignment with the Institute of Medicine report, “The Future of Nursing: Leading Change, Advancing Health (2011),” which recommends nurses play more pivotal roles on boards and commissions in improv-ing the health of all Americans. The foundation, the association and the American Academy of Nursing are all founding mem-bers of the Nurses on Boards Coalition.

Visit www.givetonursing.org for more information.

adverse consequences in retalia-tion for such a decision.

• Encourage nurses to manage their health and rest, including sleep-ing seven to nine hours per day; developing effective stress-man-agement, nutrition and exercise habits; and using naps in accor-dance with policy. The position statement was devel-

oped by a Professional Issues Panel, established by the association’s Board of Directors. The panel was comprised of 15 member nurses with expertise on the issue, with

additional input from an advisory committee of about 350 members who expressed interest in participat-ing. The statement was distributed broadly for public comment to nurs-ing organizations, federal agencies, employers, individual registered nurses, safety- and risk-assessment experts and others. The suggestions were evaluated by the panel for incorporation in the statement. The new position statement replaces two 2006 position statements – one for employers and one for nurses. The statement clearly articulates that healthcare employers and nurses are jointly responsible for addressing the risks of nurse fatigue.

Fatiguecontinued from page 11

Ahrin Mishan

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2014-2015 Experienced Nurse Faculty Leadership Academy ParticipantsExperienced Nurse Faculty Leadership Academy Scholars Terry Delpier, DNP, RN, CPNP, Northern Michigan University Karen Gorton, PhD, MS, RN, ATC, University of ColoradoDeborah Greenawald, PhD, RN, CNE, Alvernia UniversityShelley Hawkins, PhD, FNA-BC, GNP, FAANP, University of San DiegoRebecca Lee, PhD, RN, PHCNS-BC, CTN-A, University of CincinnatiGreta Marek, DNP, RN, CNE, East Tennessee State UniversityJoAnn Oliver, PhD, ANP-BC, CNE, University of AlabamaPennie Sessler Branden, PhD, MSN, RN, CNM, Sacred Heart UniversityKathryn Trotter, DNP, CNM, FNP-BC, Duke University

Experienced Nurse Faculty Leadership Academy MentorsKaren Morin, DSN, RN, ANEF, FAAN, University of Wisconsin-MilwaukeeAngela McNelis, PhD, RN, ANEF, CNE, Indiana UniversityZane Wolf, PhD, RN, FAAN, La Salle UniversityDebra Lyon, PhD, RN, FAAN, University of FloridaGwen Sherwood, PhD, RN, FAAN, University of North Carolina at Chapel HillMary Hays, DSN, RN, COI, University of Alabama at HuntsvilleSandra Millon-Underwood, PhD, RN, FAAN, University of Wisconsin-MilwaukeeJane Kirschling, PhD, RN, FAAN, University of Maryland, BaltimoreAnne Moore, DNP, APN, FAANP, Vanderbilt University

Experienced Nurse Faculty Leadership Academy Faculty Karen Carlson, PhD, RN, University of New Mexico Cindy Clark, PhD, RN, ANEF, FAAN, Boise State University Carol Huston, MSN, MPA, DPA, FAAN, California State University, Chico Pam Jeffries, PhD, RN, FAAN, ANEF, Johns Hopkins University Donna M. Nickitas PhD, RN, NEA-BC, CNE, FNAP, FAAN, Hunter College Suzanne Prevost, PhD, RN, University of Alabama Alyce Schultz, PhD, RN, FAAN, EBP Concepts Clarann Weinert, SC, PhD, RN, FAAN, Montana State University

INDIANAPOLIS — The Honor Society of Nursing, Sigma Theta Tau Inter-national, has announced the participants and faculty in the inaugural cohort of the Experienced Nurse Faculty Leadership Academy. Sigma Theta Tau International/Chamberlain College of Nursing Center for Excellence in Nurs-ing Education administers the academy-mentoring program thanks to a grant from the Chamberlain College of Nursing.

The Experienced Nurse Faculty Leadership Academy is a highly selective 12-month mentored leadership academy designed to:• Further academic career development and success,• Promote personal and professional leadership development,• Develop and begin to implement a personal leadership-progression plan,• Expand the influence of the Leadership Scholar within his or her sponsor-

ing academic institution, the community and the profession in the context of teaching, scholarship or service,

• Advance nursing education through leadership-development projects imple-mented by Leadership Scholars during the program, and

• Promote experienced nurse-faculty retention in academe. The Experienced Nurse Faculty Leadership Academy pairs experienced

full-time faculty leaders, called scholars, with mentors, who are then support-ed by Experienced Nurse Faculty Leadership Academy faculty members. The academy curriculum includes a variety of educational strategies for develop-ing leadership knowledge, competence and outcomes.

Visit www.nursingsociety.org for more information.

Leadership Academy participants chosen

United Cooperative, based in Beaver Dam with locations throughout Wisconsin, will offer 30, $1,000 scholarships to gradu-ating high-school seniors pursu-ing nursing or pre-med careers, along with other majors.

At least seven of the scholar-ships will be awarded to students majoring in an agricultural field, and at least three will be awarded to students attending a short course or technical school. The remainder are available to all majors – in nursing, accounting, pre-medicine, etc. The applica-tion deadline is March 3.

To be eligible, the student or the parent must be an active pa-tron member of United Coopera-tive; the student must attend an accredited college, university, or technical school; and the student must maintain a grade-point average of 2.0 or above on a 4.0 scale.

The scholarships will be paid upon receipt of transcript show-ing completion of the first se-mester and proof of registration for the second semester. Vis-it www.unitedcooperative.com to download the scholarship appli-cation or call 800-924-2991.

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Twelve higher-education institu-tions have received grants to share and build upon the lessons learned through an innovative and highly successful scholarship program for second-career nurses, called New Careers in Nursing. The program was created eight years ago by the Robert Wood Johnson Foundation and the American Association of Colleges of Nursing to increase the diversity of the nursing workforce by providing scholarships to people from groups under-represented in nursing. The program will help those students to earn accelerated baccalaureate or master’s degrees in nursing. Schools of nursing that received program grants to provide these scholarships report great success in recruiting and retaining minority and male nursing students and making their institutions more diverse and inclusive.

“We are so proud of all that (the program) has accomplished over the past seven years,” said Eileen T. Breslin, PhD, RN, FAAN and association president. “Our grant-ees have dramatically increased their recruitment, retention and graduation of students from groups

under-represented in nursing. They have truly changed the culture of their institutions, which are now more diverse and inclusive. There is much to learn from them.”

The two new grant programs, Innovations in Accelerated Nursing Education and the Legacy Pro-gram, will fund teams of nursing schools that have received program grants.

“It’s our great hope that by gathering the ideas and stories of our grantees, we can sustain and encourage replication of (the program’s) successful efforts and expand them to more institu-tions,” said David Krol, MD, MPH, FAAP, and senior program offi -cer. “These grants are intended to provide information that will help schools of nursing continue to do the important work of increasing the diversity of the nursing work-force, including nurse faculty, and increasing the number of nurses holding bachelor’s of nursing de-grees or higher.”

Four teams of schools received Innovations in Accelerated Nursing Education grants of $10,000 each to develop and enhance educational projects. They will work to imple-ment innovative approaches to accelerated nursing education that can be taken to scale and replicated in a variety of educational settings.

New Careers in Nursing program helps studentsTHE PROJECTS AND GRANTEES ARE: New Careers in Nursing Alumni ToolkitNew York UniversitySUNY Downstate Medical Center College of NursingStony Brook University

Replicating an Innovative Educational Pedagogy for Physical Examination and Problem-Setting SkillsMount St. Mary’s CollegeYale University

Gaming the SystemQuinnipiac UniversitySouthern Connecticut State University

Strengthening Cultural Competence in Prenatal Carewith a Virtual Community: Building Capacity through Collaboration

Ashland University College of Nursing and Health SciencesDuquesne University School of NursingAnother team of schools received a $2,500 Legacy grant to report on how those institutions were affected by participating in the program, and what has changed as a result of that participation. That project will focus on new alliances and partnerships.

THOSE GRANTEES ARE: Creighton UniversityNebraska Methodist CollegeUniversity of Nebraska Medical Center

The 2010 Institute of Medicine report, “The Future of Nursing: Leading Change, Advancing Health,” recommends increasing the proportion of nurses with a baccalaureate degree or higher, and increasing the diversity of students to create a nursing workforce prepared to meet the healthcare demands of diverse populations across the lifespan. New Careers in Nurs-ing is helping to advance those recommendations by enabling schools to expand student capacity and by encouraging more diversity. Since 2008, the New Careers in Nursing program has distributed 3,517 scholarships to students at 130 unique schools of nursing.Visit www.NewCareersInNursing.org for more information.

SPECIAL SCREENING OF

“THE AMERICAN NURSE”

COMPLIMENTARY LUNCHEON

Still time to register! See Page 16 for details.

FREE FOR NURSES!

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on Facebook! Enjoy Updates, find links and infor-mation about upcoming events and job listings, make comments and see photos from events like the Nursingmatters Expo!

For more information or to register forthis event call (608)796-3670 or [email protected]

Sponsored by: Viterbo UniversityParish Nurse Ministry

Parish Nurse Day ofEnrichment

“Therapeutic Approaches toHolistic Well-being”

When: Friday, March 20, 2015Where: Viterbo University

Fine Arts CenterLa Crosse, WI

Cost: $55.00 per participantRegister by March 10, 2015

• Healing properties of essential oils• Reverie harp: Healing at the bedside• Breath & movement for well-being• Healing Service• Networking & Exhibits

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Call Christina 608-333-5871 with questions

EEOC employer

February • 2015

Contact Kaye Lillesand,editor of

Nursingmatterswith news or events youwould like to submit at

608-222-4774

or

email [email protected]

Connect with

on

FacebookEnjoy updates, find links and

information about upcoming events and job listings, make comments

and see photos from events like the

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While at Expo, be sure to visit the Exhibit Hall!Employers – Shopping – Holistic Health – Education – Uniforms – Books – Chair Massage

THURSDAY, FEB. 19 • 8:30 a.m.-3:30 p.m.

Judith Hansen, MS, BSN, RNExecutive Director Wisconsin Centerfor NursingThe Wisconsin Workforce: Pathway,Progress, and PotentialThis presentation will provide participants

with results from the 2014 Wisconsin RN Survey, updateson implementing the IOM Future of Nursing Report in ourstate, and plans for the future.

Karen Klemp, MA, BSN, RNNICU nurseHope 2 OthersLearn what drove Karen to theother side of the world, bringing Hope 2Others, mothers desperatefor their babies’ lives.

Margaret Schmelzer, MS, RNChair, Prescription DrugAbuse Task ForceWisconsin Nurses Association

Louis Oppor, Section ChiefSubstance Abuse Services SectionBureau of Prevention Treatment

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Addressing the Problem of Prescription Drug Abuse

EXHIBITION HALL AT THE ALLIANT ENERGY CENTER MADISON, WI

We are fortunate to be able to screen thisimportant documentary which gives voiceto nurses on the front lines of some of thebiggest issues facing America. The film hasreceived nationwide accolades, from theWhite House to the American Journal ofNursing, and raves in the national media.When you watch the film you are eligiblefor continuing education credits.

BREAKOUT SESSIONS - 2:15 p.m.SPECIAL SCREENING“The American Nurse”10 a.m.

Complimentary luncheonsponsored byAlthough the luncheon is free, you must register at

www.nursingmattersonline.com.Luncheon sponsored by UW Health.

PHOTO: LEO SOREL

FREE FOR NURSES & NURSING STUDENTS!

12:15 p.m.Complimentary LuncheonGuest speaker, Carolyn Jones, author and filmmaker ofThe American Nurse. Known internationally for her sociallyproactive photography, Carolyn is also an award winningfilmmaker. She personally interviewed and photographeddozens of nurses for The American Nurse Project.

EXHIBITORSArbonneAttic Angel CommunityBellin CollegeBlue River ChiropracticBrightstart CareCardinal Stritch UniversityCoalition of Wisconsin Aging Groups

/ Wis. SMP (Senior Medicare Patrol)College of St. ScholasticaDale Medical ProductsEaster Seals of WisconsinEast-West Healing Arts Institute

Edgewood CollegeFroedert HealthGorge Williams College - AuroraGideon’s InternationalGilda’s Club of MadisonGrand Canyon UniversityGroup Health Cooperative

of South Central WIHealth & Wellness OptionsHeartland Home Health Care & HospiceHerzing UniversityHome Health UnitedHope 2 Others

Kaplan HealthL’BRI Pure ‘n NaturalLong Term Care Insurance Solutions LLCMarian UniversityMilwaukee School of EngineeringNational Registered Nurse Case

Manager Training CenterRainbow Hospice CareSelect Specialty Hospital MadisonStoughton HospitalUniforms Direct LLCUW HealthUW-Madison School of Nursing

UW-Milwaukee College of NursingViterbo University Center Adult LearningWalden UniversityWaukesha County Technical CollegeWildtreeWilliam S. Middleton Memorial

Veterans HospitalWisconsin Center for NursingWisconsin Department of CorrectionsWisconsin Nurses AssociationWPSYoung Living Essential OilsAnd MORE . . .

For information about exhibit space, contact Teague Racine, 608-252-6038, [email protected]

nursing matters february 2015

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