current resident or

Non-Profit Org.U.S. Postage Paid

Princeton, MNPermit No. 14

Membership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2Wisconsin Nurses Association Updates: Summary of 2018 WNA Leadership Summit . . .4 WNA Legislative and Regulatory Update . . . . . 5 WNA Working for You – March 1, 2018 . . . . . . 8 Policy and Practice Implications the Focus for 2018 Nurses Day at the Capitol . . . . . . . . . 9 WNA Chronic Disease & Prevention Grant– Supporting Million Hearts® . . . . . . . . . . . . . . 10

Mentorship Corner . . . . . . . . . . . . . . . . . . . . . . . . .11Mutual Interest Groups (MIGs) Updates . . . . . .14ANA Updates: When Nurses Speak, Washington Listens . . . 16 2018 National Sample Survey of Registered Nurses – HELP! . . . . . . . . . . . . . . . 17 ANA’s Case for Evidence-Based Nursing Staffing . . . . . . . . . . . . . . . . . . . . . . . . 17Nurses Foundation of Wisconsin . . . . . . . . . . . .19

VOLUME 4 NUMBER 2APRIL 2018

The Official Publication of the Nurses Foundation of Wisconsin, in cooperation withthe Wisconsin Nurses Association. Delivered to you courtesy of the WNA membership.

NEWSLETTERALONG NURSECOLLEAGUE

TOA

PASS THIS

GAIN AMEMBER!

MEMBERSHIP APPLICATION ON PAGE 2

Linda Gobis, MN, RN, JDWNA President

As you know, the Institute of Medicine (IOM) Future of Nursing Report recommended that nurses should be full partners with physicians and other health professionals in redesigning health care in the United States . Although individual nurses can provide essential leadership professional organizations also have an obligation to do so . The Code of Ethics for Nurses, Provision 9 states that professional nursing organizations have a duty to “articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy .” Provision 9 .4 of the Code explains that nurses’ have special knowledge which gives them a greater understanding of health problems . In addition, this understanding poses a duty to interpret and speak out about legislation affecting the health of patients .

Accordingly, the Wisconsin Nurses Association (WNA) supports principles that the profession believes will result in the greatest benefits to patient care, such as speaking collectively to shape or reshape health care policy or legislation that affects accessibility, quality of care and health care costs/value . With the advent of the internet and social media, and the improved ability to communicate, nurses in the U .S . must also act collectively with the global community .

One professional organization leadership tool is strategic planning– a necessary tool for long term organizational planning . It gives the association

WNA – Leading the Way!direction, establishes priorities, and allocates time, money and human resources . It also sets forth organizational goals and objectives that will be accomplished . The WNA Board of Directors used the evidenced based research in the IOM report as the basis to revisit the WNA Strategic Plan . During the past year, the Board created a bold new vision for the organization which is reflected in its new 2017-2019 Strategic Plan .

The new WNA Strategic Plan is modeled after the American Nurses Association (ANA) Strategic Plan . It shifts the paradigm from an internally focused product or service based plan, to an external plan focused on member needs . The WNA Strategic Plan contains three primary goals: 1) nurse profession-wide engagement, 2) nurse focused innovation, and 3) nurse-to-consumer relationships .

Strategic Goal #1—Nurse State-wide EngagementStrategic goal one strives to increase the

number and engagement of nurses in Wisconsin by creating innovative approaches that increase direct relationships with all registered nurses . To shift the paradigm, WNA is changing its focus from initiatives to build membership

and create products, to enabling members to achieve outcomes that matter to them . In other words, WNA is interacting with members to: 1) understand their needs, 2) co-develop WNA’s value, and 3) define member’s individual involvement . What does such a shift look like? Members will say “I just could not do my job without access to the WNA peer network/mentors” or “I visit the WNA website every day to use the tools and resources .”

Attributes of an externally focused professional organization include emphasizing member outcomes . This requires identifying where Wisconsin nurses are trying to go and what obstacles are preventing them from getting there . A survey of the WNA membership and dialogue forums at the Fall Learning Symposium revealed multiple obstacles like more advertising further ahead of WNA events and holding events at hospitals, to allow additional time to ask off of work and decrease the time needed to participate . Other examples could be new and better tools for workplace violence, moral resilience or nurse innovation .

WNA – Leading the Way! continued on page 12

WNA President’s Message

Page 2 The Wisconsin Nurse April 2018

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THEWISCONSINNURSE

WISCONSIN NURSES ASSOCIATION2018 BOARD OF DIRECTORS

Linda Gobis, PresidentElizabeth Markham, Vice President

Pam Sanberg, Treasurer Julie Raaum, Secretary

Stacy McNall, Director-at-LargeTiffany Barta, Director-at-Large

Jaime L . Potopinskki, Director-at-LargeNicole Faulkner, Staff Nurse Representative

Lisa Pisney, APRN Representative

WISCONSIN NURSES ASSOCIATION STAFFGina Dennik-Champion, Executive Director

Megan Leadholm, Associate Director Cindy Virnig, Administrative & Projects

CoordinatorTeresa Prattke, Education Program Coordinator

Tracy Gast, Accountant

NURSES FOUNDATION OF WISCONSINBOARD OF DIRECTORS

SueAnne TeStrake, PresidentPamela Macari Sanberg, Treasurer

Jana Esden, Secretary Alex Hetzer, Director-at-LargeGina Fellenz, Director-at-Large

Isabelle Garibaldi, Director-at-LargeJill Berg, Director-at-Large

Laurie Radojevich, Director-at-LargeLindsey Lucero, Director-at-LargeRorey Pritchard, Director-at-Large

Cathy Berry, WNA Board Representative

THE WISCONSIN NURSE EDITORIAL STAFFSueAnne TeStrake, Executive Editor

Gina Dennik-Champion, Deputy Executive Editor

Cindy Virnig, Managing Editor

CONTACT INFORMATIONWisconsin Nurses Association/

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www .wisconsinnurses .org – @wisconsinnurses

American Nurses Association 8515 Georgia Avenue, Suite 400 Silver Spring, MD 20910-3492

memberinfo@ana .org – www .nursingworld .org

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NFW and the Arthur L . Davis Publishing Agency, Inc . reserve the right to reject any advertisement . Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement .

Acceptance of advertising does not imply endorsement or approval by the Nurses Foundation of Wisconsin of the products advertised, the advertisers or the claims made . Rejection of an advertisement does not imply that a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use . NFW and the Arthur L . Davis Publishing Agency, Inc . shall not be held liable for any consequences resulting from purchase or use of advertisers’ products . Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of WNA, or those of the American Nurses Association .

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For assistance with your membership activation form, contact ANA’s Membership Billing Department at (800) 923-7709 or e-mail us at memberinfo@ana.org

Please note: $49 of your membership dues is for a subscription to American NurseToday. American Nurses Association (ANA) membership dues are not deductible as charitable contributions for tax purposes, but may be deductible as a business expense. However, the percentage of dues used for lobbying by the ANA is not deductible as a business expense and changes each year. Please check with your State Nurses Association for the correct amount.

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Wisconsin Nurses Association Updates

Welcome New WNA Members! 11/14/17 – 02/14/18Katie AckermanAbigail AdamsMarie AldenDan AndersonLori AndersonAmy AntonichKatherine ArnettTracy AvilaElizabeth BarthelCathy BeckEmily BeckerDonna McCarthy BeckettLinda BentonAnnette BergumPatricia BicknerJordan BitterHeidi BlairJillian BoddenJessica BothunAshley BraithwaiteMathew BrasicKristine BraunKatie BredehornTrevor BrookAshley BrownMarie BruceHeidi BruckertMarilyn BurnsCheryl ButlerCarrie CarterKathryn CastanedaAmy ChaferSerena ChristianLisa ChristophersonJennifer ComyfordCarrie Cook-PicusLindsay CorderBrenda CouparAmanda CourtCrystal CowanStephanie CroftBridget CullenAshley De KeyserChelsea Derocha-CavaleaCheryl DevaultJennifer DewittRachel DiazCarrie DiehnKarol DillieVanessa Duhr

Alexandria EckmanKatie EllerLeah EricksonLisa EricksonGina FedericoCaroline FenderJane FowlerMarilyn FrennMegan FritzVictoria FuegerRyan GagnerSharon GajeskiMelissa GeachHaley GeeKimberly GehrigDeena GervaisCarole GescheidleMaria GodinesSusan GoldJudy GoodmanEdward GowanSusan GreeneSara GretenhartTanya GriffithNicole GrueblingLisa GundersonWendy HalmMelinda HansenRenee HansenStacy HartStephanie HassemerJaye HayJanel HebertJamie HeimanPam HigginsAbby HinzHaley HoushJaymie HowardMichelle IhlenfeldJenni JacobsAngela JosephKathleen KaczmarowskiJasvir KaileySarah KaldemCarrie KarczSara KatersPeggy KatsmaGrant KellerJackie KiltzRhonda Kittilstad

Jessica KlessigAngelene KodrichBrittany KornfehlSeptember KozickiShawna KratochwillAmara KrollGail Krummen-LeeMary KurtzweilMary KutkaKira LarsenJulia LaschMegan LavigneClarissa LawrenceMegan LeeTheresa LenaghanSusan LeonardBarbara LevineSuzanne LintonJennifer LiskaChyna LiuTabetha LockwoodKaren LongCrystal LotheRebekah LoweDana LuskBrent MacwilliamsPaulette MagurBrent MartinJulia MartinsonTracey MaszkaDoretha MayAllison McCannKatherine McEwenRosalyn McFarlandHeidi MedinaDana MerkelCaryn MilesJudith MillerLiz MixRaquel Montenegro-SalazarJamie MurkowskiBecki NellesTracy NelsonKeri NelsonLacey NettSchar NeuHeidi NeuhauserDan O’BrienSheryl ObernbergerEmily Olejniczak

Valerie OliverKeri OlsonLaurel OstergaardJulaina OwensKeisha PerrenoudGwen Perry-BryeCheryl PetersKellie PhillipsKatie PhillipsAmber PollockBritny PoplawskiKaren Goetsch PoupartLateisha PrescottAmy PulsKaren QuellaLynda RastallLori RichardsonCheryl RobertsTana RobertsSara Russell RodriguezAlma RodriguezDonna RogersMary RolloffJillian RouleauTami RybarikHeidi RymaszewskiAnessa SantiagoDeborah SchillBrendan SchottCaitlin SchuellerAlan SchulzEmily SchumacherAlisa SedarRhiannon SellmanAngela SendelbachStephany ShermanJulie ShowersStacy SimenzNicole SimonsonBrianne SimsCynthia SingletonSarah SlivonDelbert SlowikAshley Smeltzer

Katrina SmithAngela StarkeyAmber StempfMichelle StoffregenConnor StoneAngela StrainDr . Jodi StrongMolly StuettgenKathie SylteMarcia TalbottSandra ThillAlthea ThomasTammy ThomasCorinna TikkaAnn TomashekErica TorresKalie TownsendMichelle UnkeAmy ValloneKimberly Van KammenMichele VarickJennifer VernaMichelle VirtuesErin Voelz-WitzigmannAnn Maria WagnerJanet WagnerJune WedellJennifer WeissGina WelchBeckie WendorfKatelyn WendtCatherine WernbergChristine WhelleyHeather Wierima-AdamsTeresa WiersmaSharonda WilliamsDanny WillisChristine WilsonJessica WinklbauerKa Ying YangAbigail YogerstJennifer ZellmerKathryn Zellner-PerronneAnn Zenk

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Page 4 The Wisconsin Nurse April 2018

Wisconsin Nurses Association Updates

Representatives from WNA’s Board of Directors and Councils came together on Friday, January 26, 2018 at the WNA Office to gain a better understanding of WNA and their individual role and responsibility as a member of a leadership team . The morning started with WNA President Gobis sharing her perception and best-practices related to leadership and nurse’s role . Gina Dennik-Champion, WNA Executive Director, described WNAs organizational and governance structure . WNA’s Legal Counsel, Burt Wagner, joined the group to provide information on the fiduciary responsibilities of boards of directors and reviewed WNA’s Conflict of Interest Policy .

Review of 2017-2020 WNA Strategic PlanParticipants received information from Linda

Gobis on the purpose and direction of the 2017-2020 WNA Strategic Plan . The identified activities contained within the plan were reviewed along with a discussion and decision on how to operationalize the approved 2017 WNA References . The day allowed for time for WNA Board of Directors and WNA’s three Councils, Tri-Council, Public Policy and Workforce Advocacy to meet and discuss their priorities related to the

Summary of 2018 WNA Leadership Summit strategic plan . The groups reconvened to share their priorities for the year .

WNA Organizational Assessment Process Identified

The participants were informed of one activity that the WNA Board will focus on in the strategic plan which is to implement an assessment of WNA’s capacity, accountability and sustainability .

WNA’s Legal Counsel, Burt Wagner, provides information on Fiduciary Responsibilities

of Boards of Directors.

Gina Dennik-Champion, WNA Executive Director, shares the approved 2017 WNA Reference

Report Recommendations, Mandatory Continuing Education for Renewal of RN License

This is the official notice to WNA members to become engaged in the following opportunities:

1 . WNA Professional Policy Committee – The process for submitting professional policy related topics that you would like the membership to approve at the 2018 WNA Annual Meeting need to be submitted to WNA’s Professional Policy Committee . Proposals are to be submitted to the WNA Board of Directors by August 1 . 2018 . To find the submission form and more information please go to WNA’s website . The information is under the About Us tab .

2018 WNA Call for Professional Policy Topics, Proposed Bylaw Changes, and Nominations for Leadership Positions

2 . WNA Bylaws – Anyone interested in recommending changes to the WNA Bylaws must notify and submit the changes to the WNA Bylaws Committee no later than June 30, 2018 . You can find WNA’s current Bylaws and the submission form please go to WNA’s website click on the “About Us” tab .

3 . Nominations for 2018 WNA Elections – If you have thought about contributing your time and talents to WNA, please consider running for a Board, Council, or Committee position . The open positions are for a two-year term of office:

WNA is adopting ANA’s recommended, Standards for Excellence: An Ethics and Accountability Code for the Nonprofit Sector resource tools . These tools were developed by Standards for Excellence Institute . The process that WNA Board has adopted for this year is to perform an assessment using the tools provided and develop and improvement plan in 2019 .

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April 2018 The Wisconsin Nurse Page 5

Wisconsin Nurses Association Updates

WNA Legislative and Regulatory UpdateFebruary 26, 2018

WNA continues to monitor and provide feedback to legislators on legislative proposals that are of interest to professional nurses and our patients . Below is a summary of WNA’s position on legislative and regulatory proposals .

2017 – 2019 Legislature Regular Sessions

AB41 – Grants to technical college district boards and technical college faculty, staff, and students and making appropriations .Position: SupportRationale: Increase the capacity of nursing education programs to minimize wait times for nursing students through targeted funding .Status: Referred to Committee on Workforce Development . 6/14/17 – Refused to suspend rules to withdraw from committee on Workforce Development and take up, Ayes 33, Notes 63, 2017 Assembly Bill 41

AB96/SB209 – Supply and use of epinephrine auto – injectors by certain authorized individualsPosition: SupportRationale: Apply evidence-based care to improve patient outcomesStatus: 4/20/17 AB 96 Passed the Assembly and referred to Senate Health and Human Services Committee . Passed Senate, 10/31/17 . 11/7/17 Correctly Enrolled . Waiting Governor’s decision to sign . 2017 Assembly Bill 96

AB146/SB114 – The practice of dental hygienists .Position: SupportRationale: Provide access to affordable dental and preventive health servicesStatus: 6/20/17 Signed by the Governor 2017 Wisconsin Act 20

AB225/SB307 – Placement of cigarettes, nicotine products, or tobacco products by retailers and providing a penalty .Position: SupportRationale: Apply evidence-based care to improve patient outcomes

Status: – SB 307 11/7/17, Passed full Senate . 6/15/17 – Referred to Senate Committee on Agriculture, Small Business and Tourism . 11/14/17 – Referred to Assembly Committee State Affairs 2017 Assembly Bill 225 2017 Senate Bill 307

AB227/SB161 – Training grants for advanced practice clinicians and making an appropriationPosition: SupportRationale: Support practice innovation to drive exceptional nursing careStatus: 5/3/17 Public hearing Assembly Committee on Rural Development 2017 Assembly Bill 2275/24/17 Public Hearing Mining and the Senate Committee Revenue, Financial Institutions, and Rural Issues 2017 Senate Bill 161

AB252/SB172 – Administration of vaccines by pharmacy studentsPosition: SupportRationale: Provide affordable prescription drugs, medical supplies, and healthcare services that are accessible and preventable .Status: AB 252 – 6/14/17 Passed the full Assembly, 6/16/17 – Passed the Senate – Correctly enrolled. 8/2/17 – Signed by the Governor http://docs.legis.wisconsin.gov/document/acts/2017/42

AB260/SB232 – Physical examinations conducted by chiropractors; performance of medical examinations by chiropractors for youth athletic activity and for the Federal Motor Carrier Safety AdministrationPosition: OpposeRationale: Protect the rights and safety of patients in and across all health care settings .Status: 6/22/17 – Passed the full Assembly, Public hearing Assembly Health Committee 2017 Assembly Bill 260 and Received by the Senate and referred to Committee on Health and Human Services

AB293/SB 242 – Communicable disease control and prevention fundingPosition: Support

Rationale: Promote a strong, viable, well-funded public health system and infrastructure that utilizes state and county health rankings to improve the health of the populationStatus: 6/13/17 – Passed out of the Committee on Health and referred to the Joint Committee on Finance. 5/17/17 Public hearing Assembly Committee on Health 2017 Assembly Bill 293 and 5/11/17 – Introduced and referred to Senate Committee on Health and Human Services

AB306/SB237 – Tracking the sale of pseudoephedrine productsPosition: SupportRationale: Apply evidence-based care to improve patient outcomesStatus: AB 306 – 7/21/17 Passed out of the full Assembly. 5/8/17 – Introduced and referred to Assembly Committee on Health . 2017 Assembly Bill 306 . 10/17/17 –Public hearing (AB306) in the Senate Health and Human Services Committee. 6/23/17 Senate – Received by the Assembly and referred to the Senate Committee on Health & Human Services . 5/11/17 Introduced and referred to Senate Committee on Health and Human Services .

AB 382/SB 382 – Screening school district employees for tuberculosis . Position: SupportRationale: Promote a strong, viable, well-funded public health system and infrastructure that utilizes state and county health rankings to improve the health of the populationStatus: 10/13/17 – AB 382 Waiting to be scheduled for a floor vote in the Assembly . AB 382 – Passed out of the Education Committee . 9/21/17 – Passed out of Education Committee . 8/24/17 – Public Hearing . 6/8/17 – Introduced and referred to Assembly Education Committee . Senate SB 382 – 9/28/17 – Waiting to be scheduled for a floor vote in the Senate . 9/28/17 – Passed out of the Senate Education Committee . 9/14/17 – Public

WNA Legislative and Regulatory Update continued on page 6

Page 6 The Wisconsin Nurse April 2018

Wisconsin Nurses Association Updates

Hearing . 8/3/17 – Introduced and referred to Senate Education Committee . 2017 Senate Bill 382 Signed by the Governor 2017 Wisconsin Act 107

AB432/SB 341 – Prohibits the hours of instructional program for nurse aids to be greater than the federal requirement of 75 hr . The hours required for Wisconsin 120 hours . Position: In discussionRationale: Protect the rights and safety of patients in and across all health care settings .Status: Assembly: 11/6/17 – Referred to Senate Committee on Health and Human Services; 11/2/17 – Passed full Assembly; 6/30/17 Introduced and referred to Assembly Committee on Aging and Long – Term Care . Senate: 7/13/17 Introduced and referred Senate Committee on Health and Human Services. 2017 Senate Bill 341

AB 500/SB 417 – Ratification of the Enhanced Nurse Licensure Compact, extending the time limit for emergency rule procedures, and providing an exemption from emergency rule procedures .Position: Strongly supportRationale: Appropriate utilization of APRNs and RNsStatus: Assembly: 10/18/17 – Scheduled to be passed out of the Committee . 10/11/17 – Fiscal Estimate received . 9/28/17 – Public Hearing in the Assembly Committee on Health . 9/20/17 – Introduced and referred to Assembly Committee on Health . 2017 Assembly Bill 500 Senate: 10/17/17 –Public hearing in Senate Health & Human Service Committee . 10/5/17 – Fiscal Estimate . 9/21/17 – Introduced and referred to Senate Health & Human Service Committee . 2017 Senate Bill 417 11/8/17. Passed full Assembly and Senate. 12/12/17 – Signed by the Governor 2017 Wisconsin Act 135

AB529/SB 452 – Requirements for certain services covered under the Medical Assistance programPosition: SupportRationale: Appropriate utilization of APRNs and RNs .Status 2017 Assembly Bill 529 – 10/18/17 – Scheduled for a public hearing 10/19/17 – Introduced and referred to Assembly Health Committee . 2017 Senate Bill 452 – 10/17/17 –Public hearing in Senate Health & Human Service Committee . 10/12/17 – Introduced and referred to Senate Committee on Health and Human Services .

11/3/17 Passed full Senate, 11/8/17 passed full Assembly. Signed by the Governor 11/30/17 2017 Wisconsin Act 119

AB 568/SB 497 – Relating to licensure of advanced practice registered nurses and granting rule-making authority.Position: Strongly supportRationale: Appropriate utilization of APRNs and RNsStatus: Assembly: 1/22/18 – Legislation withdrawn until further negotiations could be achieved . 10/24/17 – Introduced and referred to Health Committee . 2017 Assembly Bill 568Senate: 10/27/17 – Introduced and referred to Health and Human Services Committee 2017 Senate Bill 497

AB 582/SB 477 – Relating to: delegation of the practice of podiatry .Position: Information onlyRationale: Appropriate utilization of APRNs and RNsStatus: Assembly: 2/20/18 – Passed the Assembly and sent over to the Senate for a vote. 11/29/17 – Public Hearing . 10/24/17 – Introduced and referred to Committee on Health . 2017 Assembly Bill 582Senate: 2/12/18 – Received voted on bill from the Assembly and waiting to be scheduled. 2/8/18 – Passed out of Committee . 2/6/18 – Public Hearing, 10/18/17 – Introduced and referred to Health and Human Services Committee . 2017 Senate Bill 477

AB 633/SB 548 – Relating to: establishing a palliative care council .Position: SupportRationale: Protect the rights and safety of patients in and across all health care settings .Status: Assembly: 12/12/17 – Public Hearing. 11/10/17 – Introduced and referred to Committee on Mental Health . 2017 Assembly Bill 633Senate: 1/10/18 – Public Hearing. 11/20/17 Introduced and referred to Committee on Workforce Development, Military Affairs and Senior Issues . 2017 Senate Bill 548

AB 680/SB 576 – Authorizing pharmacists and pharmacy students to administer vaccines . If the vaccine is administered pursuant to the prescription order of a physician or other prescribing practitioner issued within the 29 days immediately preceding the day on which the vaccine is administered and the pharmacist has satisfied certain education requirements .Position: More information neededRationale: Protect the rights and safety of patients in and across all health care settings .

WNA Legislative and Regulatory Update continued from page 5

Status: Assembly: 1/25/18 – Public Hearing. 11/29/17 Introduced and referred to Committee on Health Senate: 2/26/18 – Public Hearing . 11/20/17 Introduced and referred to Committee on Health and Human Services

AB 681/SB 587 – Prohibiting the sale of dextromethorphan without a prescription to persons under 18 and providing a penalty . Position: SupportRationale: Protect the rights and safety of patients in and across all health care settings .Status: Assembly: 2/20/18 – Passed the full Assembly. 12/20/17 – Passed out of committee . 12/13/17 – Public Hearing . 11/29/17 – Introduced and Referred to Assembly Committee on HealthSenate: 2/21/18 – Waiting to be voted on by the full Senate. 2/9/18 – Passed out of Committee . 11/29/17 – Introduced and Referred to Senate Committee on Health and Human Services

AB 707/SB 595 – Relating to: administration of prescription drugs by correctional officers .Position: More info needed .Rationale: Protect the rights and safety of patients in and across all health care settings .Status: Assembly: 12/1/17 – Introduced and referred to Committee on Health. Senate: 11/30/17 – Introduced and Referred to Senate Committee on Judiciary and Public Safety

AB 819/ SB 689 – Relating to: employment of individuals with disabilities enrolled in long-term care programs and making an appropriation .Position: SupportRationale: Registered nurses and advanced practice registered nurses are uniquely positioned to improve the quality, safety and satisfaction of the patient and their family/caregivers .Status: Assembly: 2/20/18 – Passed out of the full Assembly. 2/2/18 – Passed out of committee . 1/30/18 – Public Hearing . 1/8/18 Introduced and referred to Committee on Workforce Development . Senate: 2/21/18 – Waiting to be voted on by the full Senate. 2/8/18 – Passed out of Committee . 1/17/18 Public Hearing . 1/4/18 Introduced and referred to Committee on Workforce Development, Military Affairs and Senior Issues

AB 848/SB 737 – Relating to: emergency outpatient mental health treatment for minors .Position: SupportRationale: Engagement of patients as partners in their health careStatus: Assembly: 2/20/18 – Passed the full Assembly. 2/13/18 – Passed out of committee, 1/30/18 – Public Hearing, 1/18/18 – Introduced and referred to Committee on Mental HealthSenate: 2/21/18 – Received from Assembly, waiting to be voted on by the full Senate. 2/9/18 – Passed out of Committee, 2/6/18 – Public Hearing, 1/29/18 – Introduced and referred to Committee on Health and Human Services .

AB 903/SB 751 – Relating to: various changes to statutes administered by the Department of Safety and Professional Services and attached credentialing boards .Position: 2/16/18 Actively Opposed the proposed amendment AA1 . 2/22/18 – Amendment removed – WNA now has a neutral position .Rationale: The mandatory nursing workforce survey needs to remain in place in order to proactively plan for an adequate supply of nurses for the future . Continue to fund data driven planning including forecasting supply and demand needs for the future nursing workforceStatus: Assembly: 2/21/18 – passed out of the full assembly without AA1. 2/21/18 – the author of AA1 was withdrawn . 2/13/18 – Amendment AA1 (changing nurse workforce survey to voluntary) this

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April 2018 The Wisconsin Nurse Page 7

Wisconsin Nurses Association Updates

was approved and passed out of the committee . 2/8/18 – Public Hearing, 1/31/18 – referred to Committee on Regulatory Licensing ReformStatus: Senate: 2/22/18 – Received from the Assembly and waiting to be voted on by the full Senate. 2/14/18 – Public hearing, 1/29/18 – Introduced and referred to Committee on Public Benefits, Licensing and State – Federal Relations

AB 907/SB 767 – Relating to: continuing education in prescribing controlled substances for certain health care practitioners; maintenance and detoxification treatment provided by physician assistants and advanced practice nurse prescribers; graduate training of psychiatric nurses and others .Position: SupportRationale: Increase the capacity of nursing education programs to minimize wait times for nursing students through targeted fundingStatus: Assembly: 2/20/18 – Passed the full Assembly; 2/12/18 – Passed out of Committee; 2/7/18 – Public Hearing; 1/31/18 – Introduced and referred to Joint Committee on Finance .Senate: 2/21/18 – Received the Assembly bill waiting to be voted on. 2/8/18 – Passed out of Committee; 2/7/18 – Public hearing, 2/2/18 – Introduced and referred to Joint Committee on Finance

SB27 – 2017 Senate Bill 27 Intravenous technician endorsement for emergency medical techniciansPosition: SupportRationale: Apply evidence-based care to improve patient outcomesStatus: 2/8/17 Introduced and referred to Assembly Health Committee

Administrative Rules/ Regulatory Updates

Scope Statement N3 – SS 034 – 16 Repeal Examining councils on registered nurses and licensed practical nursesPosition: Support—Apply evidence-based care to improve patient outcomesRationale: Wisconsin Board of Nursing no longer prepares the testing to become licensed as an LPN or RN . This is now a national standardized exam through National Council of States Board of Nursing . Status: Cleared Senate and Assembly Health Committees (no comments received).6/26/27 Submitted to Joint Commission on Administrative Rules

Scope Statement SS 012 – 17 N1 – School of Nursing Approval (Curriculum and Clinical)Position Support . Apply evidence-based care to improve patient outcomesRationale: Changes are being proposed that support the nursing student . Status: 2/9/18 – Passed out of the Board of Nursing; 1/11/18 – Public Hearing; Board of Nursing working on drafting of rule

Scope Statement SS 056 – 16 N1 Approval of Schools of Nursing . Position: Support . Provides greater clarity and expectations of schools of nursing . Rationale: Quality nursing care is dependent upon an educated, competent and sustainable nursing workforceStatus: 1/11/18 – Public Hearing; 12/18/17 – Proposed rule change submitted for review and approval by Governor .

Scope Statement CR 17 – 008 CSB 2/SS 004 17 Scheduling of AB – Fubinaca and ADB – Pinaca Position: SupportRationale: Categorizes as a schedule I controlled substanceStatus: 7/7/17 No action taken by Assembly or Senate Health Committees Legislative review process

Scope Statement CR 17 – 009 CSB 2/SS 002_17 Scheduling of Brivaracetam Position: SupportRationale: Categorizes Brivaracetam as a schedule V controlled substance .Status: 7/6/17 No action taken by Senate or Assembly Health Committees

Scope Statement CR 17 – 007 CSB 2/SS 003_17 Scheduling of Thiafentanil Position: SupportRationale: Categorizes Thiafentanil as a schedule II controlled substance .Status: Passed with Effective date of 8/1/17

Scope Statement CR 17 – 020 CSB 2/SS 015_17 Schedule U – 47700Position: SupportRationale: Categorizes U – 4770 as a schedule 1 controlled substanceStatus: 7/17/17/ – Submitted to the Assembly and Senate Health Committees – waiting for public comment. Passed 12/1/17.

January 2017 Special Session

AB1/SB1 – Emergency administration of opioid antagonist to pupils and other persons .Position: SupportRationale: Promote comprehensive and judicious approach to minimizing overuse/abuse of prescribed or non-prescribed opioids that include crisis intervention, inpatient, community-based treatment and support Status: 7/17/17 Signed by the Governor http://docs .legis .wisconsin .gov/2017/related/acts/29 .

AB4/SB4 – Prohibiting certain schedule V controlled substances from being dispensed without a prescription .Position: Support

Rationale: Apply evidence-based care to improve patient outcomesStatus: 7/17/17 Signed by the Governor http://docs .legis .wisconsin .gov/2017/related/acts/25

AB8/SB8 – Creating additional opioid treatment programs and making an appropriation .Position: SupportRationale: Apply evidence-based care to improve patient outcomesStatus: 7/17/17 Signed by the Governor http://docs .legis .wisconsin .gov/2017/related/acts/27

AB9/SB9 – Addiction medicine consultation program and making an appropriationPosition: SupportRationale: Allow registered nurses and advanced practice registered nurses to practice to the full extent of their education, training, experience and license .Status: 7/17/17 Signed by the Governor http://docs .legis .wisconsin .gov/2017/related/acts/28

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Page 8 The Wisconsin Nurse April 2018

WNA provides political advocacy, professional development and strategies that support nursing practice, competence, and personal health .

Nurse Workforce Health, Rights, & Safety

Activity

APRN Modernization Act 2017 Assembly Bill 568

Legislation did not get passed this biennium . WNA is working with key stakeholders on negotiated language . The goal of the legislation is for separate licensure for Advanced Practice RNs and to be able to work to the full practice authority .

APRNs

Board of Nursing Rules Revision CR 17-095 

Public hearing on proposed changes to Nursing Rule N1 –requirements for schools of nursing curriculum and clinical experiences, including simulation .

RNs

Nurse Licensure Compact (eNLC)

The Enhanced Nurse Licensure Compact was signed into law by the Governor Walker . 2017 Wisconsin Act 135 .

RNs

Addressing Workplace Violence survey

WNA’s Workforce Advocacy Council is surveying nurses regarding prevalence of violence in the workplace . A preliminary report will be provided on March 1 .

RNs

Healthy Nurses for Wisconsin MIG

WNA’s Healthy Nurses is a Mutual Interest Group (MIG) is interested in supporting nurse health . Join WNA’s Healthy Nurses for Wisconsin Mutual Interest Group

RNs

Increase autonomy for APRNs

Legislation was passed that allow APRNs treat patients and document encounters without a physician co-signature . 2017 Wisconsin Act 119

APRNs

Nurse Workforce Survey

WNA and other key stakeholders pushed back a proposed amendment that would have changed the RN & LPN workforce surveys to voluntary . https://wisconsinnurses .org/advocacy/nurses-voice/

All

Continued Competence & Conferences

WNA Spring 2018 Educational Offerings

3/1 – Nurses Day at the Capitol – Madison

4/7 – Healthy Nurses for Wisconsin – WI Dells

4/9 – Surviving for First Year Workshop – Pewaukee

4/13 – WI Nursing Leadership Academy – Grafton

4/18-4/20 – WI School Nurses Conference – Madison

4/26 – 4/28 APRN Conference – Madison

5/21 – Jail Health Conference – WI Dells

5/30 – Team Based Care & Hypertension Symposium – Pewaukee

Preceptor to UW-Madison Undergrad and Grad Nursing Students

Preceptor to UW-Milwaukee BSN Completion Student

Appropriate Nurse Staffing & Nurse Shortage

Topic Activity

Healthcare Workforce Planning

The Wisconsin Council on Medical Education and Workforce (WCMEW), of which WNA is a member, focuses on healthcare workforce data and health care delivery design models .

RNs

RN Workforce Report

The Wisconsin Center for Nursing’s 2016 RN Workforce Report can be found including trends . 2016 Wisconsin RN Survey Report

Patient-Centered Team-Based Care

WNA developed a conceptual model that describes the benefits of using team based care for the care of populations with chronic disease can be found on WNA’s website .

RNs

New RN Grads WNA’s Mentorship Committee is sponsoring a mentorship program for WNA members .

RNs

Future Nursing Leader Award

WNA’s Mentorship Committee selected 5 student nurses for WNA’s 2017 Future Nursing Leader Award . Fall 2017 Future Nursing Leader Awards

RNs

Nurse Faculty Advocating for funding to increase the supply of nurse faculty

RNs

WNA Working for You – March 1, 2018Patient Safety/Advocacy

Topic

Legislation WNA is supporting a number of legislative bills that support patient access and care

RNs

Team-Based Care & Hypertension

WNA’s Clinical Expert Hypertension Panel has developed recommendations for health care organizations and teams that support decreasing the incidence of hypertension in Wisconsin .

RNs

PEOLC Nursing Coalition MIG

Members of WNA’s Palliative & End-of-Life Care Nursing Coalition MIG are developing a strategic plan for the newly formed Mutual Interest Group . Join the PEOLC Nursing Coalition on our website under the “Groups” tab .

RNs

Opioid Epidemic

WNA is part of a statewide coalition that is identifying strategies for addressing the opioid epidemic .

RNs

You Were Represented November, 2017 – February, 2018

Topic Audience Location Date

Advocacy Presentation of the APRN Modernization Act legislative proposal to the Board of Nursing .

Madison 11/21

Advocacy Board of Nursing response to APRN Modernization Act meeting

Madison 11/27

Leadership ANA Leadership Summit for State Presidents and Executive Directors

Washington, DC

11/28-30

Advocacy PEW Trust representatives on RN role in addressing opioid abuse

Madison 12/1

Advocacy Lead WI APRN Coalition Legislative Committee Meeting

Call 12/3

Advocacy Meeting with Legislators and key stakeholders on APRN Legislation .

State Capitol

12/4

Practice Legal Considerations for RN Delegation

UW-Oshkosh

12/8

Advocacy Nurse Licensure Compact Bill Signing by the Governor

Platteville 12/11

Advocacy Board of Nursing Meeting Madison 12/14

Leadership Presentation of WNA Future Nurse Leader Award

Janesville 12/14

Leadership Presentation of WNA Future Nurse Leader Award

Eau Claire 12/16

Leadership WNA Board of Directors Meeting Call 12/18

Advocacy Meeting with WI Hospital Association Lobbyists on APRN Legislation

Madison 1/10

Advocacy Board of Nursing Meeting Madison 1/11

Leadership WI APRN Forum Board Meeting WNA 1/13

Grant ASTHO Cardiovascular Health Meeting

Madison 1/16

Leadership Wisconsin Nursing Coalition Strategic Planning Meeting

WNA 1/25

Leadership WNA Leadership Summit WNA 1/26

Practice Palliative & End-of-Life Care Grant Planning Meeting

WNA 1/30

Advocacy APRN Coalition Member Update Call Call 2/7 & 8

Advocacy Testimony Worker’s Compensation Legislation

State Capitol

2/14

Leadership Wisconsin Nursing Coalition Update Meeting

Call 2/15

Leadership WNA Tri-Council Meeting Call 2/20

Leadership WNA Workforce Advocacy Council Meeting

Call 2/21

Advocacy Legislative Update Wisconsin Center for Nursing Board Meeting

WNA 2/22

For more information go to www .wisconsinnurses .org or info@wisconsinnurses .org

Wisconsin Nurses Association Updates

April 2018 The Wisconsin Nurse Page 9

There were 800 registrants attending the March 1, 2018 Nurses Day at the Capitol at Monona Terrace . Nurses and nursing students came from all over the state to listen to presenters, talk with exhibitors and meet with their legislators .

Nurses Day at the Capitol is designed to help nurses in Wisconsin appreciate the importance of their role in influencing health policy and affecting change in their practice . The intent is for nurses to take the information learned at Nurses Day and use it to advocate for better nursing practice and better patient care in their work environments and communities, and ultimately to advance the profession of nursing .

The educational sessions provided this year included a real-time informative update on Healthcare Reform and nurses need to know and be proactive on supporting insurance coverage for all . Donna Friedsam, MPH, who is the Health Policy Programs Director within the University of Wisconsin Population Health Institute, provided this important information .

WNA is once again refocusing its efforts on addressing incidents of workplace violence against nurses . WNA’s Workforce Advocacy Council and the UW-Eau Claire School of Nursing partnered to develop and implement an on-line survey to determine the prevalence of workplace violence against nurses by working with . Jodi Arriola, RN, DNP, UW- Eau Claire nursing faculty member and Amanda Shimko, BSN, UW-Eau Claire DNP student presented the preliminary results of the survey . Megan LeClaire-Netzel, BSN UW-Madison DNP student presented the policy solution that WNA is supporting .

Another one of WNA’s advocacy efforts is to support the recruitment and retention of nurse faculty . An update on the latest data and implications if the nurse faculty shortage is not addressed soon was presented by the Legislative Chairperson for the Association of Nurse Educator Administrators (ANEW) was provided by Linda Young, PhD, RN, CNE, CFLE and Dean, College of Nursing and Health Sciences, UW-Eau Claire .

WNA’s Public Policy Council thought that it was important to have presentations and discussions with state legislator as part of the day . Democratic State Senate Minority Leader, Jennifer Shilling and Republican State Assembly Representative Mike Rohrkaste presented their summaries of the health care legislative issues that impacted nurses . President Linda Gobis moderated a question and answer discussion that focused on the nurse faculty shortage, workplace violence and the APRN legislation . Questions were asked by a variety of participants related to these issues and others .

Policy and Practice Implications the Focus for 2018 Nurses Day at the Capitol

WisconsinEYE provided a live video stream of Dr . Young’s and the Legislator sessions . You can find these presentations at www .wiseye .org .

The participants attend the breakout session of their choice which included:

• Current Environmental Health Issues affecting Nursing, Nursing Practice, and your Patients presented by Kathryn Lammers, PhD, RN Professor, Winona State University School of Nursing .

• APRN Legislative Update, Forbes McIntosh – WNA Lobbyist and Gina Bryan, DNP, PMHCNS-BC, APNP, WNA APRN Forum Board Member; Clinical Associate Professor, UW-Madison School of Nursing .

• WNA Legislative Update, Chris Roelke, RN, CMSRN – WNA Public Policy Council; Staff Nurse, William S . Middleton Memorial Veterans Hospital and Shanon Brickner, MSN, RN – WNA Public Policy Council; NICU Nurse, UnityPoint/Meriter

• Briefing for Legislator Visits, Gina Dennik-Champion, MSN, MSHA, WNA Executive Director and Lobbyist . This was available to the 120 participants who had meetings scheduled with their legislators .

Participants took time to indicate on the map where they live.

Senator Jennifer Shilling and Representative Mike Rohrkaste participate in a “Town Hall”

style session.

WNA President, Linda Gobis (left) listens to the remarks presented by Wisconsin Student Nurses Association President, Megan Zusy as part of the

morning welcome.

800 participants attended WNA’s 2018 Nurses Day at the Capitol.

Dean Linda Young, UW-Eau Claire, provided information on Nurse Faculty crisis in WI and

recommendations for policy solutions.

Dennise Lavrenz meets with Senator Chris Kapenga.

Wisconsin Nurses Association Updates

Please save Wednesday February 27, 2019 for next year’s WNA Nurses Day at the Capitol .

Page 10 The Wisconsin Nurse April 2018

Wisconsin Nurses Association Updates

WNA Chronic Disease and Prevention Grant – Supporting the Efforts of Million Hearts®

The month of May not only celebrates National Nurses Week but it is also National Stroke Awareness Month and National High Blood Pressure Education Month . This month as part of our grant and Healthy Nurse efforts want to highlight the purpose of Million Hearts® and the many resources available to you .

Rationale for emphasisEvery 40 seconds, an adult dies from a heart attack, stroke, or other

adverse outcomes of cardiovascular disease (CVD) . These deaths account for about one third (30 .9%) of all deaths in the United States, or more than 800,000 deaths each year . About 1 in 5 of these deaths is a person younger than 65 . Heart disease and stroke can also lead to other serious illnesses, disabilities, and lower quality of life . The economic toll of CVD is high—more than $316 billion each year in the United States—with CVD treatment accounting for about $1 of every $7 spent on health care in this country . While cardiovascular deaths have been declining for the past 40 years, the reduction in these deaths has slowed since 2011, indicating the need for focused, sustained action by public and private partners to improve our nation’s cardiovascular health .

Million Hearts® 2022 Million Hearts® 2022 is a national initiative co-led by the Centers for

Disease Control and Prevention and the Centers for Medicare & Medicaid Services to prevent 1 million heart attacks and strokes in 5 years . The initiative focuses partner actions on a small set of priorities selected for their impact on heart disease, stroke, and related conditions .

Reaching the Million Hearts® 2022 Goals will result in 1 million fewer heart attacks and strokes in the next 5

years:

• 20% reduction in sodium intake

• 20% reduction in tobacco use

• 20% reduction in physical inactivity

• 80% performance on the ABCS Clinical Quality Measures

• 70% participation in cardiac rehab among eligible patients

Million Hearts® 2022 PrioritiesMillion Hearts® has set the following priorities to meet the aim of

preventing 1 million heart attacks and strokes by 2022:

Keeping people healthy with public health efforts that promote healthier levels of sodium consumption, increased physical activity, and decreased tobacco use .

Optimizing care by using teams, health information technology, and evidence-based processes to improve the ABCS (Aspirin when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation), increase use of cardiac rehab, and enhance heart-healthy behaviors .

Improving outcomes for priority populations selected based on data showing a significant cardiovascular health disparity, evidence of effective interventions, and partners ready to act . Populations include Blacks/African Americans, 35- to 64-year-olds, people who have had a heart attack or stroke, and people with mental illness or substance use disorders .

Opportunities for our patients, families and youThe only way we—as a nation—will meet the Million Hearts® goals

is through the collective and focused action of a diverse range of partners . As a Million Hearts® partner, determine where your individual or organizational mission aligns with the Million Hearts® priorities and explore the evidence-based strategies most suited to your talents, interests, and resources . Check out the Million Hearts® 2022 framework and commit with us to carry out the priority actions needed to prevent 1 million heart attacks and strokes .

Heart disease is the leading cause of death in Wisconsin, accounting for more than 2 out of every 10 deaths statewidei

Approximately 1 .3 million adults in Wisconsin have hypertension, and 2 out of 5 of them are unaware of their condition .ii

Consider joining your other nurse colleagues at the Saturday April 7, 2018 Healthy Nurses Conference . More information is available on the Events Tab on WNA’s website .

Engage in WNA’s Healthy Nurses for Wisconsin Mutual Interest Group .

iMcKenna M, Collins J . Current Issues and Challenges in Chronic Disease Control . Chronic Disease Epidemiology and Control, 2010 .

iiVital Signs: Awareness of Treatment of Uncontrolled Hypertension Among Adults, MMWR September 12, 2012; 61(35);703-709 .

PHARMACOLOGY AND CLINICAL UPDATE

April 2018 The Wisconsin Nurse Page 11

Mentorship Corner

This December, the Mentorship Committee selected 5 recipients of the WNA Future Nursing Leader Award . The award recognizes outstanding students who embody the ethics and values of nursing and exemplary leadership qualities . It is given out twice a year to graduating prelicensure students from the Spring and Fall semesters at the pinning ceremonies . Winners receive a complimentary year of membership in the Wisconsin Nurses Association, along with an appointment to a WNA council or committee of his or her choosing . He or she will also receive a certificate and lapel pin presented at their pinning ceremony .

The winners this Fall are:• Connor Stone – University of Wisconsin – Milwaukee• Grant Sklenar – University of Wisconsin - Eau Claire• Allyson McCann – Milwaukee Area Technical College• Jenni Jacobs – Alverno College• Heather Kempf – Blackhawk Technical College The Wisconsin Nurses Association

congratulates them on their achievements, and is excited to welcome such promising leaders to our organization!

Nominations for Spring 2018 are now open! Enter your

student for the award today at WisconsinNurses.org/nominate-fnla

Fall 2017 Future Nursing Leader Award

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Gina Dennik-Champion and Heather Kempf

Jenni Jacobs and Elizabeth Markham

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Page 12 The Wisconsin Nurse April 2018

A second attribute of externally focused organizations is co-creating with members . Specifically, utilizing member talents in a meaningful way and having members shape initiatives and influence the direction of WNA . The 2017 membership survey and 2018 Leadership Summit also revealed a desire for WNA to be more inclusive, such as partnering with academic institutions; expanding opportunities to participate in rural areas; and being more politically bipartisan and balanced (i .e . including more conservative ideas, information and approaches) .

A third attribute is focusing on communities of practice like the WNA Mutual Interest Groups (MIGs) . Currently, WNA MIGs include palliative and end of life care, environmental health nurses, faith community nurses, healthy nurses, APRN forum, Waukesha County and St . Croix Valley . Members surveyed wanted more opportunities to interact and network . New and different MIGs can always be created . WNA MIGs, task forces and other groups are also being encouraged to engage in joint activities, build relationships and develop shared learnings, resources and information . The Coordinating Cabinet has successfully used this approach for the three Councils (Public Policy, Tri-Council, Workplace Advocacy) since its inception and will continue to coordinate collaboration within WNA along with the Board .

A fourth attribute of externally focused organizations is moving beyond passive continuing education to continuous learning and professional growth and development . Members suggested increasing the use of technology to develop webinars available 24/7, online opportunities to participate in WNA and additional online nursing practice related brochures, tools and resources .

As I have traveled across Wisconsin as WNA President, members have told me an obstacle to joining WNA is the price . So I have good news . In February 2017, a value based membership option was introduced which reduces the annual membership fee to $15/month or $174/year . Over 600 new members have taken advantage of the savings . You can too!

Additional benefits come with a value based joint ANA/WNA membership . Members get discounted CE modules and free monthly Navigate Nursing webinars from ANA, including a financial series (e .g . planning for retirement, paying off student loans), a staffing series (e .g . wellness for nurses) and an ANCC series (e .g . how to succeed in a graduate program) . You can stay up-to-date on news and issues affecting nurses through member only journals like American Nurse Today or Online Journal of Nursing (OJIN), publications and resources . Job opportunities are posted on the ANA and WNA websites, in newsletters and in emails . You can develop and/or improve leadership skills by attending the WNA or ANA Leadership Summit which gives you access to innumerable member only, electronic leadership resources . Finally, you can make your voice heard

WNA – Leading the way! continued from page 1 by joining WNA or ANA grass roots advocacy groups, such as WNA’s Nurse’s Voice or ANA’s Take Action . These programs help you contact state and federal legislators, write letters and access talking points on hot topic issues important to nurses .

Strategic Goal #2 Nurse Focused InnovationThe objective of strategic goal two is to

advocate for, and disseminate, nursing best practices and/or nurse focused innovations that significantly impact patient and nurse outcomes for healthcare improvement . You have choices when it comes to advocacy . You can sit back and let others make decisions for you and other nurses, continue to make do, and/or feel victimized by changes with no control . Alternatively, you can actively participate and search for opportunities to improve nursing practice, education, health policy and healthcare standards . Apolitical no longer “flies;” all nurses need to take action .

Advocating for patients and nurses is just using your nursing skills in a different way . Patton, Zalon and Ludwick (2015) compared the nursing process with the policy process as shown in the following table .

You can see that the nursing process and policy process mirror each other . They both require assessment, planning, implementation and evaluation .

It all begins with being actively involved . Join WNA, learn about healthcare and policy issues, become familiar with the policymaking process and build relationships with legislators . For example, sign up for a nursing-related listserv such as the WNA Monitor or one of the ANA Smart Briefs . They are filled with policy issues and can help you identify one that interests you . Read the newspaper or watch a news program . Pick a policy or political issue that was discussed, such as the opioid epidemic or human trafficking in Wisconsin . Consider why your particular issue is important to nursing . New graduates can identify a policy issue that they’ve learned about in school, and determine two goals related to the policy that can be accomplished within two years of graduation . Experienced nurses can identify two workplace policy issues currently under

discussion, think about its impact on nursing practice and develop two plans to bring about change .

Make a difference through activism . Follow WNA’s or ANA’s lead in policymaking and health care reform initiatives . Be knowledgeable about, and develop skills inherent in nursing activism . For example, many nurses join WNA to financially support Wisconsin nurses having a seat at the table, taking positions on pending legislation (WNA Legislative Activities available on website) and developing proposed legislation (e .g . Enhanced Nursing Licensure Compact, APRN Modernization Act) . Other WNA policy making examples include WNA Position Statements and White Papers (e .g . prescription drug abuse), the WNA Public Policy Council (reviews proposed legislation and recommends organizational positions to the WNA Board), WNA Legislative and Regulatory Agenda for the 2017-2019 Biennium (i .e . WNA Policy Agenda), WNA Working for You (summary of advocacy activities) and the WNA Grassroots Advocacy booklet, Take Action Alerts and Rapid Response Conference Calls .17 Participating in a one hour conference call, volunteering for a task force, or running for election to a Council are easy ways to increase your activism .

WNA and ANA sponsor Lobby Days where you can meet with your legislators . For me 2017 was a year of meeting new people and shaking a lot of hands . Over 100 nurses and graduate students participated in the Wisconsin APRN Coalition Lobby Day held on October 13, 2017 . Over 800 nurses and student nurses participated in Nurses Day at the Capitol on March 1st . Three WNA representatives participated in the ANA Hill Day in Washington D .C . in June, 2017 . Altogether, ANA members made over 500 visits to federal legislators that day . The WNA representatives and I met with all the Republican and Democratic Wisconsin Senators, Legislators, and staff, plus the Speaker of the House’s (Paul Ryan) staff .

All registered nurses received a letter from Department of Safety and Professional Services (DSPS) about the Enhanced Nurse Licensure Compact (eNLC) and its impact on Wisconsin nurses . WNA developed the Wisconsin Nurse Compact bill to revise the compact statutes, rules and regulations . Senate Bill 417 and Assembly Bill 500 were passed by both houses and then signed into law by the Governor in December 2017 . The new legislation went into effect on January 20, 2018 giving Wisconsin nurses a seamless transition from the original to the new eNLC, and maintaining Wisconsin’s status as a compact state . Participation in the compact is essential for Wisconsin nurses who respond to disasters throughout the U .S ., work in telehealth, advise and teach out of state patients and are traveling nurses .

Another bill, developed jointly between WNA and the Wisconsin APRN Nursing Coalition is the APRN Modernization Act . It was introduced into the legislature on October 11, 2017 and an APRN

Nursing Process Policy Process

Assess and diagnoseRecognize and identify a nursing issue or problem

Plan interventionsFormulate healthcare policy

Implement careImplement the policy change

EvaluateMonitor and evaluate the result

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Lobby Day was held two days later . APRNs traveled to Madison to ask their legislators to sign on to the bill along with the two co-sponsors . The bill adds an advance practice provision, with consistent requirements, to Chapter 441 of the Wisconsin Statutes for all four advance practice roles . It also changes the title from APNP to APRN to be consistent with advanced nurse titles and terminology nationwide . The bill had to be withdrawn in 2018, but will be reintroduced in 2019

Strategic Goal #3—Nurse-to-Consumer RelationshipsStrategic goal three has two objectives . First, to sustain a statewide

campaign to improve the health of nurses in Wisconsin . This objective is consistent with the Code of Ethics for Nurses, Provision 5 .1 that states nurses have a duty to take care of themselves as they would their patients . A statewide campaign, Healthy Nurses of Wisconsin, was initiated along with a new Mutual Interest Group (MIG) to move forward . A Healthy Nurses for Wisconsin Conference will be held on April 7th in Wisconsin Dells .

The second objective involves partnering with providers and consumers to increase awareness of the value of nursing to improve healthcare in society . WNA developed a White Paper on a new Wisconsin Patient-Centered Team-Based Care model in 2016 . Then an expert panel was convened which made recommendations and developed action steps for hypertension management in Wisconsin . The December 2017 Expert Panel Report outlines how to improve the detection, treatment and control of hypertension, particularly in undiagnosed and uncontrolled patients .

WNA also received a DHS/CDC chronic disease grant . Hypertension and accurate blood pressure measurement were selected because CDC estimates that less than 50% of patients with hypertension are under good control . In addition, 30% of nurses in Wisconsin have been diagnosed with hypertension . WNA’s efforts focus on proper patient positioning and use of automatic and manual blood pressure equipment, plus advancing the Wisconsin-centric model of Patient-Centered Team-Based Care . A free, on-demand web-based training module is available on the WNA website . Nurses can earn 1 CE contact hour for taking the course .

A new Wisconsin specialty nursing license plate was introduced at a joint press conference by WONE and WNA during National Nurses Week in 2017 . The plate recognizes the work and dedication of Wisconsin’s 100,000 nurses and provides a visual reminder to consider nursing as a career option . Plates are available through the Wisconsin Department of Transportation .

In sum, as Florence Nightingale once said “I think one’s feelings waste themselves in words, they ought all to be distilled into actions, which bring results .”26 Will you pick up the banner and help WNA and the Board lead the way? If you already belong to WNA, will you help engage members and/or disseminate best practices? If you are just starting out, will you join WNA and actively participate? Wherever you are on the continuum, join me in increasing awareness of registered nurses and the value of nursing . As nurses, we must all do our part to transform and redesign health care in Wisconsin!

1 . National Academies of Sciences, Engineering and Medicine . (2010) . The future of nursing: Leading change advancing health. Washington, D .C .: Institute of Medicine of the National Academies Press .

2 . National Academies of Sciences, Engineering and Medicine . (2010) . The future of nursing: Leading change advancing health (pp . 32 & 221) . Washington, D .C .: Institute of Medicine of the National Academies Press .

3 . Anselmo, J . (2016) . Mindful and intentional: Embodying interbeing awareness in grassroots leadership . In W . Rosa (Ed .) Nurses as leaders: Evolutionary visions of leadership (p . 18) . New York, NY: Springer Publishing Company .

4 . Fowler, M . (2015) . Provision 9 . In M . Fowler, Guide to the code of ethics for nurses with interpretative statements. (p . 151) . Silver Spring, MD: Nursebooks .org .

5 . Fowler, M . (2015) . Provision 9 .4 . In M . Fowler, Guide to the code of ethics for nurses with interpretative statements. (p . 163) . Silver Spring, MD: Nursebooks .org .

6 . Fowler, M . (2015) . Provision 9 .4 . In M . Fowler, Guide to the code of ethics for nurses with interpretative statements. (pp . 160-166) . Silver Spring, MD: Nursebooks .org .

7 . American Nurses Association . (2017) . 2017-2020 Strategic Plan . Retrieved from http://www .nursingworld .org/FunctionalMenuCategories/AboutANA/ANAStrategicPlan/2017-2020-StrategicPlan .pdf

8 . Caraveli, A ., & Engle, E . (2015, May) . Leading engagement from the outside in: Become an indispensable partner in your members’ success . Retrieved from http://getmespark .com/wp-content/uploads/LeadingEngagement .pdf

9 . Caraveli, A ., & Engle, E . (2015, May) . Leading engagement from the outside in: Become an indispensable partner in your members’ success . (p . 2) . Retrieved from http://getmespark .com/wp-content/uploads/LeadingEngagement .pdf

10 . Caraveli, A ., & Engle, E . (2015, May) . Leading engagement from the outside in: Become an indispensable partner in your members’ success . (pp . 9-10) . Retrieved from http://getmespark .com/wp-content/uploads/LeadingEngagement .pdf

11 . Caraveli, A ., & Engle, E . (2015, May) . Leading engagement from the outside in: Become an indispensable partner in your members’ success . (pp . 10-11) . Retrieved from http://getmespark .com/wp-content/uploads/LeadingEngagement .pdf

12 . Caraveli, A ., & Engle, E . (2015, May) . Leading engagement from the outside in: Become an indispensable partner in your members’ success . (pp . 11-13) . Retrieved from http://getmespark .com/wp-content/uploads/LeadingEngagement .pdf

13 . Caraveli, A ., & Engle, E . (2015, May) . Leading engagement from the outside in: Become an indispensable partner in your members’ success . (p . 13) . Retrieved from http://getmespark .com/wp-content/uploads/LeadingEngagement .pdf

14 . Patton, R ., Zalon, M . & Ludwick, R . (2015) . Leading the way in policy . In Patton, R ., Zalon, M ., Ludwick, R . Nurses making policy from bedside to boardroom (p . 10) . New York, NY: Springer Publishing Company .

15 . Wisconsin Nurses Association . (2017) . Legislative and regulatory agenda for the 2017-2019 biennium . Retrieved from https://wisconsinnurses .org/wp-content/uploads/2016/09/2017-19-PPA-for-the-Biennium-09_28_16-Draft .pdf

16 . Wisconsin Nurses Association . (n .d .) . Nurse’s voice . Retrieved from https://wisconsinnurses .org/advocacy/nurses-voice/

17 . Wisconsin Nurses Association . (2017, May 19) . Rapid response call on enhanced nurse licensure compact . Retrieved from https://wisconsinnurses .org/rapid-response-call-enhanced-nurse-licensure-compact/

18 . Wisconsin Nurses Association . (2017, October 13) . eNurse licensure compact update . Retrieved from https://wisconsinnurses .org/update-enurse-licensure-compact-enlc/

19 . Wisconsin Nurses Association . (n .d .) . APRN modernization act . Retrieved from https://wisconsinnurses .org/wp-content/uploads/2017/10/17-1538_P4 .pdf

20 . Wisconsin Nurses Association . (n .d .) . Graphics depicting the new legislation . Retrieved from https://wisconsinnurses .org/wp-content/uploads/2017/10/APRN-Graphics .pdf

21 . Fowler, M . (2015) . Provision 5 .1 . In M . Fowler, Guide to the code of ethics for nurses with interpretative statements. (pp . 78-79) . Silver Spring, MD: Nursebooks .org .

22 . Dennick-Champion, G ., Schmelzer, M . (2016, November 1) . Patient-centered team-based care in Wisconsin: A working conceptual model . Madison, WI: Wisconsin Nurses Association . Retrieved from https://wisconsinnurses.org/wp-content/uploads/2016/12/PCTBC-Narrative-Final.pdf

23 . Wisconsin Nurses Association . (2017, December 5) . Hypertension expert clinical panel recommendations for hypertension management in Wisconsin . Madison, WI: Author . Retrieved from https://wisconsinnurses .org/wp-content/uploads/2018 /01/Combined-Document-Background-Recommendations-Contributors-1 .11 .18 .pdf

24 . Wisconsin Nurses Association . (2016, May 24) . Beyond the 50%: It starts with accurate blood pressure measurement . Madison, WI: Author . Retrieved from https://wisconsinnurses .org/beyond-the-50/

25 . Wisconsin Nurses Association . (n .d .) . Hypertension prevention, detection and management in Wisconsin 2017 . Retrieved from https://wisconsinnurses .org/htn-detection-management-prevention/

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WNA’s Award Committee would like to increase recognition of the 2018 WNA Awards recipients by hosting their acknowledgement ceremony in the city where they live or work . WNA would like to see the award winners be recognized in their community by an audience of family, friends and nurse colleagues . The award winners will be recognized during the months of September and October leading up to the 2018 WNA Annual Meeting . Nominations are now being accepted on-line . You will find the application and the criteria posted on WNA’s home page . The deadline for submission is July 31, 2018 .

• Signe Cooper Image of Nursing Award. The recipient of this award is involved in activities that enhance the image of professional nursing and the image of WNA .

• Vivien DeBack Leadership Award. The recipient of this award is involved in activities that demonstrate innovation in the advancement of the profession .

• Service to WNA Award. The recipient of this award exhibits outstanding participation in the WNA, including (but not limited to) service through elected office and committee involvement .

• Community Impact Award. The recipient exercises extraordinary contributions to

public education, community outreach, health promotion and population health .

• Rita Kisting Sparks Excellence in Nursing Education Award. The recipient of this award demonstrates extraordinary contribution to excellence in nursing education for students and to the development and implementation of continuing education .

• Nursing Practice Award . The recipient of this award is involved in activities that demonstrate innovations in patient care; role model for nursing practice; commitment to the practice of professional nurse; and utilization/dissemination of research in practice .

• Norma Lang Excellence in Nursing Research Award. The recipient of this award conducts original research of relevance to nursing practice and theory development in nursing; serves as principal investigator on externally funded, peer reviewed nursing research projects; generates a substantial record of data-based, referenced publications; delivers invited research presentations at professional/scientific meetings; and communicates nursing research to the general public and the nursing community .

• Staff Nurse Advocacy Award. This award is given to recognize excellence in individual

2018 WNA Awards Will Bring Recognition to Where the Winner Lives

staff nurses who provide direct patient care in all practice settings and who advocate for their patients . The recipient has demonstrated outstanding advocacy in a clinical setting at the staff nurse level .

• Advanced Practice Nurse of the Year Award. This award is selected by the WNA APRN Forum . The recipient is employed as an Advanced Practice Nurse, demonstrates expert knowledge and practice in an APN clinical area of nursing, demonstrates involvement and contributions in the areas of patient care, consultation, education, or research and demonstrates leadership within the nursing profession .

• Barbara Nichols Political Nurse Award. This award is selected by the WNA Public Policy Council . The recipient demonstrates involvement in political activities that promote quality of care; acts as a positive role model in his/her use of the political process to advance health care and/or nursing; encourages nurses to become involved in the political process; promotes the education of nurses and consumers in the use of the political process and the value of involvement in governmental affairs; and promotes increased political awareness and involvement within professional organizations .

Mutual Interest Groups (MIGs) Updates

April 2018 The Wisconsin Nurse Page 15

Kris Wisnefske, RN MSN, Chair, FCNC MIG

Welcome to 2018 . As I write this article, I anticipate spring although it is snowing, windy and very cold . On our recent faith community mutual interest group monthly conference call, we discussed what we could contribute to this publication .

One suggestion was to include a position paper written by Dr . Deborah Ziebarth, PhD, titled “How is Faith Community Nursing the same or different than other nursing specialties? This paper is informative, and I hope that you enjoy reading it . Discussion of the scope and standards of Faith Community Nursing referenced were from the 2nd edition . The scope and standards were just updated in November 2017 and are now in the 3rd edition .

On another note, the International Parish Nurse Resource Center has been renamed the Westberg Institute . More information on this can be found at https://westberginstitute .org/

Another thought from our conference call was to discuss how the FCN (Faith Community Nurse) can collaborate within her/his community . Some personal examples include:

1) Working with Green County Public Health, and the ASTHO Million Hearts Learning Collaborative,

2) Grapevine educational programming through the Wisconsin Women’s Health Foundation on self-care for women at the Monroe Public Library and

3) BP screening with Green County YMCA for Heart Health Month4) Beginning and sustaining a breast cancer support group in Monroe

through the assistance of the Episcopal Diocese of Milwaukee for funding . This group is open to all women in the communities affected by breast cancer .

These four examples are just a few of many opportunities I have had to collaborate and partner with community organizations . It’s been a great way to get the word out about faith community nursing .

As a mutual interest group, we can provide the Basic Foundation Education course for Faith Community Nursing . Our next class will be planned for this coming summer . For further information, please check with Megan at WNA office .

Wishing all of you a healthy and blessed 2018 .

Mutual Interest Groups (MIGs) Updates

Faith and HealthDr. Mary Ellen Wurzbach

Although I was initially not certain of whether to write anything about faith and health, I felt compelled to do so since they seem to be so intertwined . I cannot say that faith improves physical health necessarily, but I can say that it allows one to deal with physical maladies, confront physical challenges and promotes comfort and contentment even when one is in dire physical straits .

Faith is not a panacea for all ailments but it certainly allows one to look with equanimity on the challenges of life – physical and mental . It allows one hope when life seems hopeless . It allows one belief in the positive possible outcome that may or may not come .

Faith is that which allows one to overcome insurmountable odds . It allows one peace and contentment even in the midst of terror and strife . Faith in the “other” – the thou – allows one to believe that someone somewhere is attending to one’s needs, wants and interests .

My own faith is in persons whom I believe would act in my best interests if necessary but always, if I wished, with a substitution of my own judgment – substituted judgment . This may sound legalistic but in some essential sense is the epitome of caring . Health care practitioners talk a lot about caring, and its essence is preserving the health of others through choices that support the beliefs and ideation of the patients we serve .

Faith is a nebulous concept . For me it means believing in another person, idea or truth beyond the point of logic . Faith in an idea may be seen as ideology . Faith in another person is equally beyond reason, but more justifiable .

Not all would agree with me . Some would say that faith in an idea would be much more justified than faith in a person . Others would say faith only involves a good and many people are not good . Some would say that believing in another person beyond reason is folly .

In our profession many nurses believe in humanity rather than an individual or a deity . It is this faith in humanity that allows nurses to remain resilient and healthy despite very stressful circumstances . Without faith in the people we serve health care would be adversely affected, but faith must be mutual . Our patients need to have faith in us as well .

What engenders faith? For our patients, believing and trusting that we are able to help them when they need advice, counsel and care . They have faith that our treatment of them will, above all, do no harm and, hopefully, benefit

them . For ourselves, we have a belief and trust that our patients will attend to our advice and counsel, appreciate our care and try to follow the plan we have agreed upon .

Too often patients and clinicians are stereotyped by each other, which interferes with the practitioner-patient relationship . Patients may see us as unapproachable or judgmental or simply “not there” for them . We may see patients as “drug seekers” or “malingerers” or “manipulators .” “Non-compliance” is seen as a major problem . Even the term suggests that patients are in a dependent position and negating our faith in them .

Faith entails allowing for the benefit of the doubt, taking patients’ word for what is happening to them . As with pain, “pain is what the person says it is .” Faith also means having a strong belief that both patients and practitioners can and will do what they say they can and will do . Or, at the very least, have “good intentions” and make “good faith promises .”

If faith is not reciprocal, both patients and practitioners may feel disrespect . Faith is a necessary extension of respect until one knows for certain it is misplaced . If one believes one’s faith is misplaced, perhaps trying to assess why a patient is unable or unwilling to follow the agreed upon plan of care or why a practitioner is not meeting the patient’s expectations will resolve the issue . Confronting the issue sometimes is all that is necessary .

This is a year in which the ANA is supporting the idea that nurses need to be healthy in order to take care of the health of others . Faith may be one important aspect of our and our patients’ mental and physical health and may, as the ANA suggests, strengthen health care .

Page 16 The Wisconsin Nurse April 2018

ANA Updates

The American Nurses Association strives to represent nurses on Capitol Hill, provide support for state nurses associations as they advance their own advocacy agendas, and help federal agencies and elected officials propose and enforce new laws that will advance the nursing profession . ANA serves to amplify nurses’ voices as policies are conceived, debated, and implemented . We create long-lasting relationships with nurses and their representatives, working to establish a health system where care is accessible, of high quality, and recognizes the nursing profession as an integral component .

Registered nurses represent the largest segment of health professionals, with more than 3 .6 million nationwide . Nurses not only represent an incredible force by sheer numbers, but policymakers rely upon their expertise as they work to improve our nation’s health system . For 16 years, nurses have outranked all other professions in Gallup’s annual honesty and ethics survey and are viewed as the most trusted profession .

Throughout the year, we will feature examples of ANA members advocating for patients and the

profession in various roles and settings, hosted at www .RNAction .org as well as shared through social media . The advocates’ stories will be paired with associated tools and ANA products & services . Each quarter will have a dedicated theme, building from local to more global examples, but overlap with other quarterly themes will occur .

Nurses are advocates every day, so examples are endless and no illustration is too small . Please consider sharing your story and being recognized by ANA and your colleagues .

Send either a brief written description (under 150 words) OR a video (less than a minute) capturing your experience: actions, any challenges / barriers as well as strategies and any words of wisdom or tips for colleagues . If providing in writing, please include a high-resolution picture .

Questions or submissions should be directed to Janet Haebler, janet .haebler@ana .org, at ANA .

GET ENGAGED: #BedsideandBeyond

Each quarter will have a dedicated theme, building from local to more global examples, but overlap will occur .

Q1: Nurses advocating locally (January – March) Highlighting efforts at the bedside or in the

community both for individual and/or groups of patients and/or nurses . Some examples: patient-focused practice changes/process improvements; workplace safety policies addressing issues such as staffing, workplace violence, safe patient handling and mobility; and representing the interests of patients, consumers and/or the profession while serving on a committee, council or board .

When Nurses Speak, Washington ListensQ2: Nurses influencing elected officials and other key decision makers (April – June)

Highlighting efforts to impact change with key decision makers that are local, state or federal . Could be employer specific, immediate community/county, state legislative/regulatory, or federal . Individual influence as well as participation in a coalition .

Q3: Nurses get out the vote! (July- September)With the approach of election day, emphasis

will shift to political examples . Highlighting nurses leveraging their position as most trusted profession to impact policy change and 2018 campaigns . Will feature nurses who participated in a campaign, currently in or running for an elected or appointed position, and/or have a productive relationship with their elected official .

Q4: Global Impact and Making every year a year of advocacy (October – December)

Continue highlighting nurses who have had an impact within their community, state, or at the federal level, while also expanding to experiences beyond the US borders . Considering 2019 and future policy issues relevant to the nursing profession, will include an analysis of the November election results as well as insight on potential impact of political advocacy, and tips and words of wisdom on how to make every year a year of advocacy at any level in any role and setting .

To learn more about ANA advocacy efforts and what you can do to help, visit: http://www .nursingworld .org/MainMenuCategories/Policy-Advocacy .

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April 2018 The Wisconsin Nurse Page 17

ANA Updates

ANA’s Case for Evidence-Based Nursing Staffing

Essential for cost-effective, high-quality hospital-based care and patient safety

Registered nurse (RN) staffing makes a critical difference for patients and the quality of their care . ANA champions the role of direct-care nurses and nurse managers in working with their hospital leadership to define the best skill mix for each hospital unit, recognizing the role of nurses in managing each patient’s treatment plan and continuously assessing each patient’s health status . Our work demonstrates that patients, nurses, and health care systems thrive with appropriate and flexible nurse staffing . For hospitals to succeed, tools and processes must support evidence-based staffing decisions driven by nurses who understand the dynamic nature of patient care .

ANA bases its advocacy on research . ANA commissioned a comprehensive evaluation of nurse staffing practices as they influence patient outcomes and health care costs . A white paper, authored by consulting firm Avalere, evaluated a review of published literature, government reports, and other publicly available sources, along with information gathered from a series of panels of nurse researchers, health care thought leaders, and hospital managers .

To read ANA’s first staffing white paper Optimal Nurse Staffing to Improve Quality of Care and Patient Outcomes, visit info .nursingworld .org/staffingwp .

Key FindingsBest practices consider many variables when

determining the appropriate care team on each hospital unit:

• Patients: Ongoing assessment of patients’ conditions, their ability to communicate, their emotional or mental states, family dynamics, and the amount of patient turnover (admission and discharges) on the unit

• Care teams: Each nurse’s experience, education, and training; technological support and requirements; and the skill mix of other care team members, including nurse aides, social workers, and transport and environmental specialists

Nurse staffing models affect patient care, which also drives health care costs . Safe staffing affects a range of hospital-based care issues, including:

• Medical and medication errors• Length of stay• Patient mortality• Readmissions• Preventable adverse events, including falls,

pressure ulcers, health care-associated infections, and other complications

• Nurse injury, fatigue, and low retention

Findings point to the importance and cost-effectiveness of nurse staffing decisions that are based on evidence rather than traditional formulas and grids . To foster innovation and transparency in staffing models, it is essential to capture and disseminate outcomes-based best practices .

Staffing and Cost ContainmentNurse salaries and benefits are among the

largest components of a hospital’s expenses

and thus are an easy target when balancing budgets . However, decisions to cut labor costs are sometimes shortsighted when the long-term impacts on cost and patient care quality are not considered .

Other variables to consider in addressing hospital-based care costs include:

• High-tech devices and procedures• Prescribed drugs and other medicine • Clinician and system practice insurance• Facility construction, renovation, and

maintenance• Information technology investments and

upgrades

Well-managed hospitals/health systems continuously balance competing needs to keep organizations fiscally sound .

Legislated nurse-patient ratios versus flexible, nurse-driven staffing

Some organizations advocate for legislated nurse-patient ratios, believing that strict ratios will ensure patient safety . Based on our experience with unintended consequences, ANA does not support numeric, fixed ratios . In many cases, to meet these ratios, hospital administrators have eliminated other care team positions and then shifted noncore patient care work to nurses . This leaves nurses overextended and distracted from their core responsibilities of continuously monitoring patient status and implementing clinical treatment plans .

Conclusion

ANA supports direct-care nurses and nurse managers in working with hospital clinical and management teams to address pressures to control costs while providing high-quality care in a safe environment . Outcomes-based staffing models require partnerships between nurses and hospital/health system leadership, including those in finance, operations, and clinical areas . Together, we can find pragmatic solutions to complex and pressing issues .

info.nursingworld.org/staffingwp

Nurses play a critical role in the lives of patients across the country. That is why the U.S. Department of Health and Human Services is dedicated to provid-ing you, policy makers, and researchers with the most comprehensive data on U.S. registered nurses and nurse practitioners. To accomplish this, we need your help.

Please support and encourage participation in the 2018 National Sample Survey of Registered Nurses (NS-SRN). This vital national survey is the primary source of data on the nursing workforce, the largest group of healthcare providers.

The Purpose of the StudyThe NSSRN will gather up-to-date information about

the status of registered nurses in the U.S. These data will be used to describe the registered nurse population at both the national and state level, so policymakers can ensure an adequate supply of registered nurses locally and nationally.

Data CollectionThe NSSRN will be sent to over 100,000 registered

nurses in March of 2018. Nurses will be able to fill out the survey electronically or through a paper question-naire. It is imperative that nurses participate and send back as soon as possible.

The Survey ContractorHRSA has contracted with the U.S. Census Bureau,

the leading statistical federal agency in the United States. Census has assembled a team of expert survey meth-odologists responsible for gathering the lists of licensed RNs, constructing the national sample, and administer-ing the survey by mail, and on the internet.

Did you Know?Did you know…employment settings change as nurs-

es age? The vast majority of registered nurses under 30 years old work in hospitals, but over 50 percent of regis-tered nurses 55 years or older work in non-hospital em-ployment settings. Information like this from the NSSRN survey helps policymakers and healthcare leaders plan for future staffing needs.

The Survey ResultsWe plan to release the public use file from the 2018

study by January 2019. A report from the 2008 study is available at http://bhw.hrsa.gov/healthworkforce.

EndorsementsThe following nursing organizations have endorsed

this survey. The National Council of State Board of Nurs-ing and individual state boards of nursing have gener-ously provided mailing lists for the survey.

American Academy of Ambulatory Care Nursing

American Association of Colleges of Nursing

American Association of Nurse Anesthetists

American Nurses Association

American Organization of Nurse Executives

National Association of Hispanic Nurses

National Black Nurses Association, Inc.

National Council of State Boards of Nursing

National League for Nursing

National Organization of Nurse Practitioner Faculties

2018 National Sample Survey of

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Page 18 The Wisconsin Nurse April 2018

UWM and Aurora Medical Center Kenosha Collaborate to Improve Outcomes

Southeastern Wisconsin, a place families flock to live because of its proximity to the beautiful shores of Lake Michigan and accessibility to both Milwaukee and Chicago . This beautiful community is also home to many new moms and babies who face challenging health care issues .

Southeast Wisconsin, and the nation, is facing real problems with diabetes, hypertension (high blood pressure), and obesity of new moms that impact the delivery and the health of the new baby . Over half of the new moms at the Aurora Medical Center Kenosha (AMCK) find themselves managing, aside from their pregnancy, hypertension (high blood pressure) or diabetes related issues . Hypertensive disorders affect approximately 22% of all pregnancies in Wisconsin and contribute to approximately 15-20% of NICU admissions . Both moms and babies may experience detrimental effects by needing medication, dietary adjustments, and face the increased risk of a premature birth .

A number of national and statewide initiatives focus on preventing premature birth and improving the outcomes for the mom and baby . For example, the March of Dimes releases the Premature Birth Report Card* which highlights priority areas for action with the goal of giving every mother and baby a fair chance for a healthy pregnancy and

birth . The 2017 Report Card presents a nationwide Preterm Birth Rate of 9 .6% (2016 data), or Grade C . Despite many efforts, the rate has continued to trend upwards, from 8 .3% in 2007 to now 9 .6% in 2016, the national goal is to reach 8 .1% by 2020 .

Nurses at the Aurora Medical Center Kenosha reached out to AkkeNeel Talsma, PhD, RN, FAAN, Walter Schroeder Chair of Nursing Research, at UW-Milwaukee College of Nursing to monitor clinical care and evaluate solutions for better outcomes for new moms and babies . The Aurora Medical Center in Kenosha (AMCK) delivers approximately 800 babies per year and more than half of all deliveries involve issues with hypertension and diabetes putting babies at higher risk for delayed growth, premature birth, and need for specialty care . Moms that develop high blood pressure or diabetes during pregnancy may have a difficult time reversing these diagnoses and may result in challenges for babies as they grow up .

During the Fall Dr . Talsma and her doctoral nursing students, Lindsey Roddy, BSN, RN and Becky Parizek, MS, RN started meeting with nurse leaders at Aurora Medical Center in Kenosha (AMCK), including Donna Jamieson, PhD, RN, Vice President and Chief Nursing Officer and maternal child nurse leaders [Megan Pignatari, CNS, Krista Berger, Manager] to evaluate and monitor maternal care for patients with hypertension and diabetes and their babies . The goal is to use day-to-day clinical data to generate nursing care measures that help monitor practices that lead to better outcomes . This project is modeled after Dr . Talsma’s previous multi-hospital perioperative improvement initiative that demonstrated important improvements in patient outcomes .

Dr . Jamieson stated that “The collaboration with UWM and Aurora has been long standing and I’m very excited that we are setting up a monitoring

system here in Kenosha that can become a network across Southeastern Wisconsin as we are targeting better outcomes for our families .” Dr . Talsma and her doctoral nursing students have initiated a literature review in collaboration with Dr . Cindy Phelan, senior research scientist at the Aurora Center for Nursing Research and Practice (CNRP) . The results of the review are used to prepare quality measures that help prevent and manage care for moms and babies before and after delivery .

While this project is in the beginning stages, the project team draws from both organizations and best clinical practices for healthier moms and babies in Wisconsin . The team, with all care givers in the community, wishes to meet the March of Dimes goal of 2020 .

*March of Dimes, Report Card: https://www .marchofdimes .org/mission/prematurity-reportcard .aspx

The APRN Modernization Act, Legislation Bills Assembly Bill 568 and the Companion Bill 497 were introduced on October 24, 2017 . Since that time WNA APRN Forum Board of Directors, WNA members and WNA Lobbyists worked with representatives and lobbyists from the Nurse

Midwife, Nurse Anesthetist and Clinical Nurse Specialists associations to get the bills advanced through the legislature .

This group, the Wisconsin APRN Coalition Legislative Committee, met with legislators, legislator sponsored meetings, attending Wisconsin Board of Nursing meetings and the Wisconsin Hospital Association (WHA) during October 2017 through January 2018 . The Committee members reviewed and responded to the proposals that were provided by the Board of Nursing and the Wisconsin Hospital Association . There were 26 desired changes to the bill that were submitted by the Board of Nursing and WHA .

The APRN Coalition Legislative Committee members supported the changes recommended by the Board of Nursing . WNA’s Legal Counsel provided suggested legislative drafting instructions that were used by the bill sponsor to develop the

amendment language related to the Board of Nursing request . Meetings with the Wisconsin Hospital Association representatives were productive . However, there was one item where we could achieve agreement given the legislative timeline .

The APRN Coalition members agreed to stop lobbying for the legislation . The APRN Coalition Legislative Committee and lobbyist will be meeting in March to review success and challenges to develop a grass-roots advocacy strategy for the summer and through the November 2018 general elections .

The bill sponsors, Senator Devin LaMahieu, District 9, Oostburg, and Assembly Representative Mike Rohrkaste, District 55, Neenah have indicated that they want to be the lead the bill sponsors for the next biennium . If you are interested in supporting the APRN Modernization Act, please consider joining the Wisconsin APRN Coalition . For more information go to WNA’s website and click on the advocacy tab .

APRN Modernization Act Update

Current RN jobs available (due to continued growth):• Medical Intensive Care Unit (MICU)• Critical Care Resource Team (CCRT) – scheduled shifts on both the ED and the MICU

As a market leader in providing outstanding patient care in the Twin Cities Metro area, located in Stillwater, MN, we share the beautiful St. Croix River as a border to western Wisconsin.

We offer market competitive pay and benefits at 0.5 FTE and above.To view and apply for these positions go to www.lakeviewhealth.org/lakeviewjobs

Lakeview Hospital – what our employees are saying about working at Lakeview:I love the work I do, the people I work with, and the support that Leadership provides”

We seek RNs to join our award winning team!

EEO-Disability/Vet

• Operating Room (OR)• Hospice• Homecare

How Can You Help WhenDisaster Strikes?

Put your skills to work for Wisconsin!

Learn more and sign up at the Wisconsin Emergency Assistance Volunteer Registry (WEAVR)

https://weavrwi.org/

NURSES ROCK OUR WORLD – THANK YOU!National Nurses Week May 6-12, 2018

Save the Date April 25, 2018Annual Spring Meeting | 6:00-8:00 pm

Inspire Center – Gateway Technical CollegeTopic: Simulation

Check out our website for more details

Join Today at www.wisconsinwln.org• Scholarship opportunities• Fall & Spring Conferences

Find us on Facebook & Instagram:Wisconsin League for NursingServing Nursing Education and Supporting Nursing Service in the State of Wisconsin

April 2018 The Wisconsin Nurse Page 19

Have you seen the television commercial- “what’s in your wallet” or what about “where’s the beef?” Today the question posed, while we are deep into Wisconsin winter snow and cold – is ‘what’s in your garden?’

Winter weather prompts us to start thinking about spring flowers and summer vegetable and herb gardens . An alternate garden might also include water or rock gardening . Water gardens are typically designed for their soothing views, cleansing feeling, peaceful waterfall reflections and overall emotional relaxation . Rock gardens are also contemplative but involve anchoring our energies so we can slow down and embrace calmness .

Managing an ornamental, root, vegetable or herb garden involves action on our part, tilling the soil, cultivating, weeding and planting seeds or cuttings . These seeds and cuttings, when properly nourished grow into foods and beauty that nourish and support our overall health . Our taste buds come alive with nourishments that are fresh and without preservatives . Aromatherapy and beauty from herbs and flowers nourish our souls . There is self-satisfaction in working with the earth . It takes commitment, patience, research and hands on energy . Time commitment and patience both involve our personal investment of time and require establishing priorities . In order for the seedlings to grow, the weeds need to be removed at regular intervals . Research involves discovering the right variety seeds or cuttings, planted at the right time of year, based on the right environmental needs of the seedlings for soil, sun, water and fertilizer . We tend to choose tried and true varieties and species based on positive or negative results of previous garden success . Hands-on-energy involves the sweat and sore hand and back muscles needed to maintain a garden space . Nurturing this investment of our time gleans satisfaction in beauty of foliage and flowers and consumption and possible medicinal use of the root and leaf vegetables, fruits and herbs .

How well can we correlate the ornamental, root and leafy vegetable, fruit and herb gardens to a collegial growth garden? How do we grow our collegial friendships? In order to maintain this people centered garden, what tools and skills are necessary?

Mingling and inter-mingling involves active nursing conference participation, involvement in focus group and staff meetings, seeking out colleagues with like interests and hobbies, similar to tilling the soil and cultivating . Joining as members in Wisconsin Nurses Association (WNA), Mutual Interest Groups (MIG) — and Nurses Foundation of Wisconsin (NFW) promotes planting seeds of professional collegial growth . Planting seeds of friendship involves an active participation in face-to-face, online and research activities . Seeking out opportunities for personal and professional growth requires commitment, patience and hands on energy . In order to nurture this garden, as with earth gardens, hands on energy involve the time commitment, sensitivity to others, professional respect, and the nurses’ dedication to the population supported in clinical, education, research or retired practice . Aligning yourself with a professional support system assists in keeping up to date with nursing practice and legislative changes, and the voice of nurse colleagues statewide .

How then do you support self-worth, and personal growth in the tilling, cultivating, weeding and nurturing your own support garden? We expend energy to stay in touch via social media, telephone network or face-to-

face get-togethers . Most of the time this takes a commitment and setting priorities . Providing emotional, social and physical support, as needed to our friends, family and neighborhood contacts, also takes a time commitment . Nurturing this support system assists in our self-esteem growth and lends credence to support we receive in turn –paying it forward .

We schedule time for ourselves on a regular basis, for exercise, massage therapies, and occasional social hour or two . We spend family/friend time to lighten our stress burden, tilling, cultivating and planting friendship memories to sustain this garden . An essential component is making time for me . This is a difficult commitment to follow thru, especially for the busy multi-tasking professional, with multiple personal,

What’s in Your Garden?

Nurses Foundation of Wisconsin

professional and family commitments . Rule of thumb: establish priorities, schedule me time, weed and till your garden to remove the toxic and negatives to maintain your individual positive supports . Schedule wellness appointments, build in daily exercise, add solid nutritional efforts and drink plenty of water . These efforts can make the difference in quality of life and a strong personal garden .

Gardens, whether they are earthen, professional or personal, need tending to include a time commitment, nutrients, sunshine and weeding in order to glean all the rewards a garden can bring .

SueAnne TeStrake MSN, RN-CPresident Nurses Foundation of Wisconsin

If you are looking for a unique opportunity to improve and enrich the lives of others, please visit our website atriumlivingcenters.com or contact one of our

Wisconsin locations:

Prescott Nursing & Rehabilitation Community 1505 Orrin Rd., Prescott, WI 54021 • 715-262-5661

Tomah Nursing & Rehabilitation 1505 Butts Ave., Tomah, WI 54660 • 608-372-3241

Frederic Nursing & Rehabilitation Community 205 United Way, Frederic, WI 54837 • 715-327-4297

Atrium Centersis looking for

RN’s, LPN’s & CNA’s

EOE/M/W/Vets/Disabled