Montana Nurses Association – Advocating for All RNs...November, December 2014, January 2015...

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

VOL. 51 • NO. 4 WINTER 2014

From Montana to Malawi

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102nd Convention, 2014

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Oral Health Care - Nurses MakeA Difference

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Quarterly circulation approximately 17,000 to all RNs, LPNs, and Student Nurses in Montana.

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Executive Director Report

Vicky Byrd, BA, RN, OCNMNA Executive Director

Many nurses over the years have misunderstood exactly what MNA is and I am hoping to clear some of that up! Comments from “I don’t want to join the union” to “do you monitor my license” are frequent and just a couple among many. I have been involved with MNA for the past 25 years in a variety of roles, and now am privileged to serve as your Executive Director. In my

new role, I want to be sure that everyone understands and appreciates who we are, what we do, and how we advocate for all Montana RNs.

MNA is your professional organization. It is comprised of Montana registered nurses and advanced practice registered nurses. MNA is your state voice to advocate for your profession. MNA is not exclusively a union, it is a professional organization that has a collective bargaining component.

MNA Mission statement: The Montana Nurses Association promotes professional nursing practice, standards and education; represents professional nurses; and provides nursing leadership in promoting high quality health care.

Did you know that MNA’s publication “The Pulse” is mailed to every RN in the state of Montana, whether or not they are a member? Many members assume because they receive the Pulse that they are members, and that is not so. It is just an awesome service we provide for all nurses, whether a MNA member or not, to stay connected.

Being a MNA member automatically makes you an American Nurses Association (ANA) member. You get two organizations that concentrate on registered nurses’ professional issues. ANA is the national voice to advocate for our profession. ANA is the only professional organization representing the

interests of all registered nurses, regardless of areas of specialization, clinical setting or work environment. Membership in ANA connects you with nurses from across the country. Your membership provides unique opportunities for you to advance your career, gain knowledge that will improve patient care, and influence decisions that impact nurses at national and state levels. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and

realistic view of nursing, and lobbying Congress and regulatory agencies on health care issues affecting nurses and the public.

ANA Mission Statement: Nurses advancing our profession to improve health for all.

MNA is comprised of two arms: bargaining unit and non-bargaining unit nurses. Approximately 91% of the membership is bargaining unit nurses, approximately 9% of the membership consists of non-bargaining nurses. The bargaining unit nurses are comprised of staff nurses, clinic nurses, public health nurses and most recently a group of stand-alone surgery center nurses who form local units. The non-bargaining nurses include nurse educators, advanced practice nurses, school nurses, and staff nurses not in a collective bargaining institution, nurse navigators and others in diverse nurse roles.

ANY registered nurse is welcome and can join MNA, no matter what work status or practice setting. Even retired nurses and new RN graduates can be members – and at a reduced price! The only qualification needed is possessing a Montana Registered Nurse license. MNA is our professional organization!!

Advocacy, education, representation, lobbying, networking, support, nursing practice, and high quality patient care are what we provide and promote to advance our profession and improve health for all (ANA mission).

In addition to our ANA affiliation, which is through our professional organization as a whole, we also have additional national affiliations through our collective bargaining arm. These include the National Federation of Nurses (NFN) and the American Federation of Teachers (AFT). At the state level through this arm is an affiliation with AFL-CIO and a ‘joint agreement’ with the Montana Education Association-Montana Federation of Teachers (MEA-MFT) that we have respected and enjoyed for years. Another affiliate MNA has joined is the American Association of Nurse Practitioners (AANP), giving us benefits and opportunities for collaboration for our advanced practice nurses and our organization.

Our main event annually is the MNA convention held in Helena the first week of October. Next year’s Convention is slated for Sept 30th, October 1st and 2nd 2015. Plan ahead now to take all 3 days off and attend convention for the continuing education (this year we offered 13.5 contact hours) and/or attend as a delegate from your respective district. Serving as a delegate offers you the opportunity to join the other delegates that form the business house (HOD-House of Delegates). Decisions by the HOD direct your MNA board and staff in business, legislation,

Montana Nurses Association – Advocating for All RNs

Vicky Rae Byrd, BA, RN, OCN

Executive Director continued on page 3

Montana Nurses Association Pulse November, December 2014, January 2015

CONTACT MNAMontana Nurses Association

20 Old Montana State Highway, Montana City, MT 59634Phone (406) 442-6710 Fax (406) 442-1841

Email: [email protected]: www.mtnurses.org

Office Hours: 8:00 a.m.-5:00 p.m. Monday through Friday

VOICE OF NURSES IN MONTANAMNA is a non-profit, membership organization that advocates for nurse competency, scope of practice, patient safety, continuing education, and improved healthcare delivery and access. MNA members serve on the following Councils and other committees to achieve our mission:• CouncilonPractice&GovernmentAffairs(CPGA)• CouncilonEconomic&GeneralWelfare(E&GW)• CouncilonContinuingEducation(CCE)• CouncilonAdvancedPractice(CAP)

MISSION STATEMENTThe Montana Nurses Association promotes professional nursing practice,

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

CONTINUING EDUCATIONMontana Nurses Association is accredited as an approver of

continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Montana Nurses Association (OH242, 12/01/2017) is an approved provider of continuing nursing education by the Ohio Nurses Association(OBN-001-91), an accredited approver by the American Nurses

Credentialing Center’s Commission on Accreditation.

MNABoard of Directors

Executive Committee: President Lucy Ednie, RN-BC Vice President Open Secretary Brenda Donaldson, RN Treasurer Linda Larsen, RN-BC

Directors at Large:

Council Representatives: Advanced Practice Arlys Williams, APRN, FNP-BC CCE Deborah Lee, BSN, RN-BC CPGA SharonSweeneyFee,RN,PhD E&GW DaylynPorter,RN-BC

Editorial Board: Chair–Barbara Prescott Schaff, APRN, DNP, FNP-BC Mary Pappas, RN, EdD Kate Eby, APRN, MN, FNP-C

MNA Staff: Vicky Rae Byrd, RN, OCN, Executive Director Pam Dickerson, PhD, RN-BC, FAAN, Director of Continuing Education Kathy Schaefer, Continuing Education Specialist Robin Haux, Labor Program Director Amy Hauschild, BSN, RN, Labor Representative Caroline Baughman, Labor Representative KimberlyKralicek,Administrative&MarketingSpecialist CathyRansier,Membership&FinanceSpecialist

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

PUBLISHER INFORMATION & AD RATESCirculation 17,000. Provided to every registered nurse, licensed practical

nurse, nursing student and nurse-related employer in Montana. The Pulse is published quarterly each February, May, August and November by the Arthur L. Davis Publishing Agency, Inc. for the Montana Nurses

Association, 20 Old Montana State Highway, Montana City, MT 59634, a constituent member of the American Nurses Association.

For advertising rates and information, please contact Arthur L. Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216, Cedar Falls, Iowa 50613, (800) 626-4081, [email protected]. MNA and the Arthur L.

Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next

issue or refund of price of advertisement.

Acceptance of advertising does not imply endorsement or approval by the Montana Nurses Association of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising

is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. MNA and the Arthur L. Davis Publishing

Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or

membership of MNA or those of the national or local associations.

WRITER’S GUIDELINES:MNA welcomes the submission of articles and editorials related to nursing or about Montana nurses for publication in The PULSE. Please limit word size between 500-1000 words and provide resources and references. MNA has the right to accept,

edit or reject proposed material. Please send articles to: [email protected].

Published by:Arthur L. Davis

Publishing Agency, Inc.

www.mtnurses.org

Please visit MNA’s constantly updated website!

www.mtnurses.org

Enjoy a user friendly layout and access to more information, including membership material, labor resources, Independent Study Library, a

new Career Center for Job Seekers & Employers, and more downloadable information.

PULSE SUBMISSIONS

We are gathering articles that are relevant and appealing to YOU as a nurse. What is happening in your world today? Is there information we can provide that

would be helpful to you? The Pulse is YOUR publication, and we want to present you

with content that pertains to your interests.Please submit your ideas and suggestions

to Kim.

[email protected]

Welcome, Caroline Baughman,

MNA’s New Labor Representative!

I moved to Montana over three years ago after falling in love with these mountains, and I’ve enjoyed plenty of miles of trail on them. My background is in Math and English education, but instead of teaching, I always knew I wanted to be involved in some level of advocacy.

M y u n d e r g r a d u a t e program showed me the

importance and power of professional organizations and affiliations, as I was heavily involved in the Association of Middle Level Education and sat on the Board of Directors for the Georgia Middle School Association. After volunteering and working for several Helena nonprofits (including some contract work with MNA), I’m so pleased to have found my niche as a Labor Representative for Montana nurses. It is such a great opportunity to be able to work for such a well-respected and high-impact organization, as well as support nurses as they serve as the faces for modern healthcare. Thank you for allowing me to be part of such a great team!

UPCOMING MNA EVENTS

uTransition to Practice – January 25th & 26th, 2015 (Helena, MT)

uAPRN Pharmacology Conference – March 13th & 14th, 2015 (Helena, MT)

uLabor Retreat – April 19th – 21st, 2015 (Chico Hot Springs…Pray, MT)

Caroline Baughman

AdvAnce your PrActice And cAreer

RN–BS | AGNP | DNPBoise State University is a leading center

for nursing education.

Contact us and experience our supportive approach and flexible online options!*

208-426-4632 [email protected]

hs.boisestate.edu/nursing/na* Program availability varies by state and program.

November, December 2014, January 2015 Montana Nurses Association Pulse

At our 2014 MNA Annual Convention, your labor department unveiled a new Nurse Advocate program for all of our local units! We are very excited to promote this program in each of our locals and look forward to encouraging participation with all of MNA’s local bargaining units!

The Nurse Advocate program was designed to create a new name for local unit reps, local

department reps, and local unit leaders, etc. We wanted to rename these positions to reflect what these nurses are already doing, advocating for their co-workers, their profession, and their patients! Our goal is to promote advocacy within your locals by encouraging more involvement.

Your MNA Labor Representatives will be bringing the Nurse Advocate information to all of your local units as we travel to bring you support. To qualify for a Nurse Advocate Kit, each advocate will need to sign a Nurse Advocate job description. The job description requires a two year commitment to your local, two supporting signatures from other members, and a selection of any activity you agree to volunteer for. We understand your local leaders are consistently looking for assistance and wanted a program created that would offer that support, while allowing our nurse members to choose their level of involvement. Any involvement will aid your leaders and your MNA representatives. Remember your collective voice makes your union strong!!

Robin HauxLabor Program

Director

Become your Local Unit’s Nurse Advocate!!!

Here are some of the activities a Nurse Advocate can be involved in with your local:

◊ Print, post, and distribute informational flyers in other departments

◊ Attend local meetings◊ Help organize and promote union meetings◊ Participate in new employee orientation◊ Bring a new employee to a union meeting◊ Be available to assist Local leadership with

initial investigatory/disciplinary meetings◊ Help develop contract campaigns and pre-

bargaining surveys◊ Assist or participate in contract negotiations

and help encourage participation in pre-bargaining surveys.

◊ Track and inform members of proposed legislation that will impact nursing and collective bargaining

◊ Testify on behalf of nurse legislation during session

◊ Participate in efforts to recruit more MNA members and activists.

For more information on the MNA Nurse Advocate Program, please contact your labor representative. Your labor team is excited for this new program and we look forward to sharing all the details with each of you!

nurse practice and patient safety issues, to name a few. Delegates are also able to obtain all continuing education offered during the convention experience. All Registered nurses, members or not, are invited to attend convention under the MNA organization. This is a time when all nurses of all specialties of all work environments come together collectively to collaborate, learn, network, and tend to the business of Montana nurses. We do provide special group meetings for our advanced practice nurses and our collective bargaining nurses during convention week.

In addition to convention, MNA hosts an APRN Pharmacology conference held typically in March or April (for the advanced practice nurses) and a Labor retreat typically held in April (for those in a collective bargaining unit). Both of these offer continuing nursing education opportunities and are a great way to learn more about the organization and network with your fellow nurses.

In addition to these three major events, MNA maintains a library of independent study materials and offers a variety of “live” webinars and other learning opportunities to enhance your professional development.

Another benefit belonging to MNA is our recommendation for liability insurance through NSO. This organization is noted on our website and you know if MNA has recommended them, they are a trusted colleague providing a reputable service.

MNA as your professional organization has your best interests as a professional RN and the best interests of your patients at heart. We will do whatever it takes, for however long it takes, to advocate for our profession, with the ultimate outcome being high quality healthcare for all Montana citizens.

Please don’t hesitate to call or stop by YOUR office.

Executive Director continued from page 1

Labor Reports and News

Big Sky,Big Opportunities!

For more informationand to apply, visit

www.billingsclinic.com/careersor call (406) 238-2638

• Nurse Practitioners

• Nursing Leadership

• Experienced RNs

msun.edu/hr

THE MONTANA STATE UNIVERSITY SYSTEMMontana State University-Northern

Havre, MT 59501

Assistant Professor Nursing, Tenure-trackHavre Campus

RESPONSIBILITIES: Teach nursing courses in the associate degree and RN to BSN (online) nursing programs as well as provide clinical instruction in medical surgical or geriatric areas. Will teach approximately 24 semester credit hours of classes per year. For more information about the program and MSU-Northern, go to www.msun.edu. Effective teaching is the primary mission of this position and MSU Northern.

QUALIFICATIONS: Required:

• AMaster’sdegreeinNursingandcurrentlicensureasaregisterednurseinthestate of Montana.

• Demonstratedrecentexperienceinmedicalsurgicalorgeriatricnursing.

Preferred:• Doctorate,experienceindistanceeducationincludinginteractivetelevisionand

web-based course delivery.

APPLICATION: Applications accepted until position is filled. Please click on the Applicant Portal link to apply for this position at https://jobs.msun.edu

If you would like more information, please contact Kathy Jaynes, Human Resources Director,

P.O. Box 7751, Havre, MT 59501 (406)265-4147•[email protected]

Montana State University is an ADA/AA/EEO/Vets Preference Employer.

umt.edu/sell/cps/bigskypulmonaryFor more information call 406-243-4623

Sponsored by:

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Labor Reports and NewsMNA Local #2 Nurses in Billings Ratify New

3 year Agreement MNA Local #2 nurses

are pleased to report they ratified their new contract on October 8, 2014. This agreement came with a full recommendation from the bargaining team. Delayne Gall, RN, Barb Moser, RN, Deanna Evans, RN, Lynn Hilliard, RN, Brenda Doherty, RN, Just Humphrey, RN and Christina Van Dyke, RN represented their bargaining unit in

negotiating the successor agreement. Reaching an agreement during this round of

contract negotiations was extremely difficult. The parties spent approximately 115 hours at the bargaining table over the course of nearly six months, during which MNA filed an unfair labor practice complaint over actions the employer engaged in during bargaining. The National Labor Relations Board investigated the circumstances and found merit in the complaint.

The employer issued their last, best and final offer on August 4. The bargaining team did not recommend that proposal for ratification; on August 12 the membership failed to accept the offer. The parties resumed negotiations on September 28 and reached a tentative agreement on September 29 which was overwhelmingly ratified by the nurses on October 8.

Highlights of the ratified agreement includes assured wage increases over three years, rather than the former compensation system which included merit increases which were not assured (they were at the discretion of the hospital board of directors). The agreement also includes institution of on-call pay and increased stipends for Sexual Assault Nurse Examiner (SANE) nurses when they perform exams; increased “extra shift differential” when nurses work an extra shift; successor language protecting the contract should the hospital sell its assets to another entity and

language prohibiting bullying and workplace harassment and discrimination based on sexual orientation.

The parties are eager resume their monthly Conference Committee meetings and collaborating about delivering high-quality patient care.

MNA Local #12 Nurses Ratify Their New 3 Year Contract

MNA Local #12 nurses in Havre ratified their new contract by a very wide margin on September 17, 2014. Kristin Donoven RN, Riki Ross RN, Ellen Osborne RN and Jody Whittmer, RN were the nurse representatives at negotiations.

Several economic and non-economic agreements were reached during the bargaining process. Of note, nurses will no longer be scheduled above their FTE without mutual agreement. Nurses were being scheduled for mandatory overtime; RN morale and retention suffered greatly. Both parties are confident the new contract language will help both morale and recruitment/retention of nurses.

Many agreements were reached in an effort to clean up outdated language so the contract is clear and unambiguous. There was a complete overhaul and expansion of grievance and arbitration and shift differential/ shift time definitions. In addition to assured across the board increases, there was agreement to increase float differential and bonus shift pay (when a nurse agrees to work an extra shift).

Negotiations were completed in 3 days, approximately 20 hours were spent at the table working collaboratively for mutual gain.

Congratulations to all the nurses in Local #12!

MNA Local #38 Ratifies New 3 Year Agreement

MNA Local #38 RNs in Forsyth successfully bargained a new 3 year contract which was unanimously ratified in September. Debra Valdiviez R.N, new MNA member, represented her colleagues at the bargaining table. The contract was brought up-to-date in several areas. The nurses elected to begin a trial period of a two-pronged approach to annual compensation increases. One aspect is guaranteed across the board increases and the other is assured merit-based compensation based on objective criteria. The parties easily reached agreement and the bargaining process was accomplished in less than 4 hours.

Congratulations MNA Local #38 Nurses!!!

MNA Local #44 Ratifies New 3 Year Contract

Local #44 nurses in Miles City ratified their new collective bargaining agreement on October 6, 2014. The nurse bargaining team consisted of Penny Haughian, RN, Nettie Mitchell, RN, Denise Singleton, RN, Kim Flotkoetter R.N. and Jennifer Chamberlin R.N. and they tirelessly represented their colleagues throughout the bargaining process.

Local #44 RN’s came together and formed their Union in 2009. The first collective bargaining agreement in 2010 did not contain a wage scale for newly hired RN’s nor did it contain a “step scale” for wages which the nurses progress through over time. As a consequence, there was significant wage disparity and compression among rates of pay in correlation with experience as an RN.

Truly, in the spirit of cooperation and creativity, the parties crafted a wage scale based on years of experience. The system is objective and easily applied. All currently employed nurses were appropriately placed on the scale and all newly hired nurses will be placed on the same scale using the same methodology and equity will be assured.

Even though the contract was only 3 years old, there is always room for improvement and clarification. A complete overhaul of the layoff and recall and attendance articles was crafted. Strengthening and clarification of the articles containing language about scheduling, use of travel nurses, orientation and no strike/no lockout were also included.

Negotiations for the second agreement were smooth and relatively swift considering the complexity of constructing the equitable wage scale. The parties met on seven occasions over two months; approximately forty-two hours were spent at the table. The ratification timeline was somewhat protracted while the parties fine-tuned the wage scale and associated language. All wage increases were retroactive.

Congratulations Local #44 Nurses!

Amy Hauschild,BSN, RN, Labor Representative

Local #2 Bargaining Team having a light moment during caucus

MMA Local #2 nurses Joan Ferguson, (left) Sarah Leland (right) Delayne Gaill (center) review

documents before voting

MNA Local #2 “Union Hall on Wheels” - Nurses came out to the

RV for their ratification vote Tessa Whitney, MNA Local #44 member casting her ratification

ballot


Continuing Education

Thank You to MNA Member Volunteers

I would like to take this opportunity to celebrate the work of our MNA member volunteers who contribute substantially to the success of the continuing education program at MNA. The Council on Continuing Education is a team of volunteers elected by their peers to lead the work of the approver and provider units at MNA. The bylaws of the Association describe the purpose and functions of this Council. One Council member serves as

a representative on the MNA Board of Directors, so there is a direct link between the work of the Council and decisions affecting the organization as a whole.

Some members of the Council work with MNA’s approved provider unit. These volunteers serve on planning committees for MNA-provided learning activities, provide input regarding suggested topics and approaches to learning experiences, and help facilitate sessions at convention and other events. At times, members of the Council serve as speakers for our educational sessions.

Some members of the Council work with MNA’s accredited approver unit. These volunteers serve as peer reviewers for individual activity applications and approved provider applications submitted to MNA for approval to award contact hours for nurses. Peer reviewers are educated on international accreditation program standards and evaluated on a regular basis to maintain their competence in the evaluation and approval processes. Qualified non-council peer reviewers also contribute to this important work. Between staff time and volunteer time, recent evidence shows that 12-20 hours are required for review of an individual activity application and up to 40 hours are required for review of an approved provider application. This is a substantial commitment of time, energy, and professional expertise for volunteers!

Being a volunteer in the work of the continuing education program at MNA supports us in our work and also contributes to the volunteer’s own learning and growth. Thanks to all of you who have contributed to the success of our efforts to enhance professional development of all nurses in Montana!

Pam DickersonPhD, RN-BC, FAAN

Director of Continuing Education

MNA Approved ProvidersSt. Vincent Healthcare

Billings, MT

Alaska Native Medical CenterAnchorage, AK

Kalispell Regional Medical Center

Kalispell, MT

Fairbanks Memorial HospitalAlaska or Montana

Benefis Healthcare SystemsGreat Falls, MT

Central Peninsula General Hospital

Soldotna, AK

St. Peter’s HospitalHelena, MT

Wrangell Medical CenterWrangell, Alaska

Community Medical CenterMissoula, MT

Montana Health NetworkMiles City

Bozeman Deaconess HospitalBozeman, MT

Livingston HealthcareLivingston, MT

Providence St. Patrick HospitalMissoula, MT

Alaska Nurses Association Anchorage, AK

Billings ClinicBillings, MT

North Valley HospitalWhitefish, MT

MT Geriatric Education CenterMissoula, MT

South Dakota Nurses Association Pierre, SD

St. James HealthcareButte, MT

Partnership Health Center Missoula, MT

Providence Alaska Medical Center

Anchorage, AK

Mountain Pacific Quality HealthMT, WY, HI, AK

South Peninsula HospitalHomer, AK

Alzheimer’s Resource of Alaska Anchorage, AK

Bartlett Regional HospitalJuneau, AK

Wisconsin Nurses AssociationMadison, WI

Alaska Division of Public HealthAnchorage, AK

Mat-Su Regional Medical CenterPalmer, AK

January 25 & 26, 2015 – Transition to Practice: To provide tips, tools and resources to enable the newly licensed registered nurse to effectively transition from student to engaged professional. Helena

March 13-14, 2015 – APRN Pharmacology Conference, HelenaApril 19-21, 2015 – Labor Retreat, Chico Hot SpringsMay 7-8, 2015 – Alaska Provider Update – AnchorageMay 14, 2015 – Montana Provider Update – HelenaSeptember 30-October 2, 2015 – Montana Nurses Association 103rd Convention – Helena

MNA Independent Study Library Available Online @ www.mtnurses.org

Upcoming Events

Register online at www.mtnurses.org

For more information call 406-442-6710

Montana Nurses Association

Chairperson – Department of NursingCarroll College invites applications for a full-time Chairperson with our CCNE accredited baccalaureate nursing program. Applicants must possess exceptional communication skills, commitment to academic excellence and support the mission of the college. A Masters Degree in Nursing is required, Doctoral degree preferred. For more information and to apply visit www.carroll.edu.

Home Care Nurses

Partners in Home Care is a nationally accredited,

not-for-profit, full-service home care agency

located in spectacular Missoula, Montana. We recruit registered

nurses for our Hospice and Home Health

programs to serve clients in their homes.

Additional information and applications can be found at:www.PartnersIn HomeCare.org

Livingston HealthCare in Livingston Montana, is accepting applications

for the position of Surgical Services Manager

This position is responsible for the management of nursing practice and operations on the Operating Suites, PACU, Day Surgery, and Central

Sterile units. A bachelor’s Degree in Nursing or equivalent and a minimum of two years of Peri-Operative nursing experience is required.

If you enjoy fly fishing, skiing and hiking, or if you just love the outdoors and are looking for a balance of lifestyle and career, complete an

application at www.livingstonhealthcare.org or call 406-823-6471 for more information. Pre-employment drug screen and background check

required. Livingston HealthCare is an Equal Opportunity Employer.

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Rita E. Cheek, RN, PhDCo-Project Director, APIN Grant

Montana Center to Advance Health through Nursing (MT CAHN)

The Robert Wood Johnson Foundation (RWJF) announced in August that Montana was chosen to receive another $300,000, two-year grant in Phase II of its Academic Progression in Nursing program (APIN). APIN is advancing state and regional strategies aimed at creating a more highly educated, diverse nursing workforce. This program is managed by the American Organization of Nurse Executives (AONE) on behalf of the Tri-Council for Nursing, consisting of the American Association of Colleges of Nursing, the National League for Nursing, American Nurses Association, and AONE, which is leading the four-year initiative. “Action Coalitions” in all nine states that were part of Phase I of the program have met or exceeded their benchmarks, and are receiving funding to continue their work for two additional years. Funding from RWJF to the states over the four years will total $5.4 million.

In addition to Montana, the states receiving Phase II APIN grants are California, Hawaii, Massachusetts, New Mexico, New York, North Carolina, Texas, and Washington. The grants will allow them to continue working with academic institutions and employers to help nurses in their states get higher degrees, so they can be essential partners in providing care and promoting health, as well as more easily continue their education and fill faculty and primary care nurse practitioner roles. The Action Coalitions in all these states have been encouraging strong partnerships between community colleges and universities to make it easier for nurses to transition to higher degrees.

The Montana grant was made to the Montana Office of Rural Health and Area Health Education Center in Montana State University (MSU) College of Nursing on behalf of the Montana Action Coalition. The Action Coalition in Montana will continue to focus on nursing education, specifically developing a model of nursing education that fosters seamless transition from one level of nursing education to the next. Dr. Cynthia Gustafson, Executive Director of the Montana Board of Nursing and co-lead of the Montana Action Coalition, said, “We are thrilled to be one of the nine states receiving the APIN grant because it gives our state significant resources to work together as leaders in education, practice and regulation in order to open up pathways for nurses to be prepared for the future health care needs of Montanans. We’ll be focusing on increasing the number of Native American nurses in Montana by working cooperatively with nursing education programs to provide inclusive environments for student success. It is an exciting time for nurses and for our citizens to understand the importance of how nurses, as the largest group of health care providers, really make a difference in advancing the health of Montanans!”

In its groundbreaking 2010 report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine (IOM) recommended that 80 percent of the nursing workforce be prepared at the baccalaureate level or higher by the year 2020. At present, about half of nurses in the United States have baccalaureate or higher degrees. While acknowledging the contributions of Licensed Practical and Licensed Vocational Nurses and associate-degree-prepared Registered Nurses, the IOM report said a better educated nursing workforce can help ensure that our nation’s population has access to high-quality, patient- and family-centered care and can meet the growing need to provide preventive care in schools, communities, and homes.

“The APIN teams have been making great progress developing initiatives and curricula that are encouraging and making it easier for more nurses to earn their BSN degrees,” said Pamela Austin Thompson, MS, RN, CENP, FAAN, national program

director for APIN, chief executive officer of AONE, and senior vice president for nursing at the American Hospital Association. “We know that the nation needs a well-educated nursing workforce to ensure an adequate supply of public health and primary care providers, improve care for patients living with chronic illness, and in other ways meet the needs of our aging and increasingly diverse population. The strategies these nine states are implementing, and the models they are developing for other states to replicate, will help us meet the IOM’s target for BSN and higher prepared nurses.”

As part of Phase II of this work, each state Action Coalition will develop a sustainability plan to ensure that the work to promote seamless academic progression for nurses in their states will continue beyond the grant period. During Phase II, each state also will develop a robust diversity plan and focus on academic-practice partnerships to expand and support the work to date.

The specific objectives for the Montana APIN grant during the next 2 years include:

1) Work with nursing leaders from education and practice to create a model of nursing education that will enable academic progression from LPN to ASN to BSN to masters and doctoral levels.

2) Expand current mentoring programs to reach more RN to BSN students and new BSN graduates entering the workforce.

3) Increase the number Native Americans that are in Montana nursing education programs and nursing leadership positions by July 2016.

4) Develop a comprehensive sustainability plan for academic progression in nursing strategies throughout the state of Montana.

5) Increase employer support of and engagement in academic progression in nursing initiatives in Montana through changes in practice and policy, participation in coalition leadership, and expanded involvement in preceptor and mentor opportunities.

6) Expand the depth and breadth of the MT CAHN Preceptor Continuing Education and Recognition Program to academic/practice partnerships in each of the five MHA Regions of the state.

RWJF is also helping advance recommendations in the IOM report by supporting the Future of Nursing: Campaign for Action – a collaborative effort to advance solutions to challenges facing the nursing profession in order to improve quality and transform the way Americans receive health care. It is coordinated through the Center to Champion Nursing in America, an initiative of AARP, the AARP Foundation, and RWJF. It supports state-based Action Coalitions in all 50 states and the District of Columbia; Action Coalitions are leading the APIN work in each of the nine funded states.

“Advancing a more highly educated, diverse workforce where nurses are able to practice to the top of their education and training is essential to achieving the Robert Wood Johnson Foundation’s

Montana Selected for Second Grant Towards Building a More Highly Educated Nursing Workforce

You have a CHOICE. Ask for us by name.

We’re looking for nurses of the CARING KIND

www.rockymountainhospice.com

Billings (406) 294-0785Bozeman (406) 556-0640

Butte (406) 494-6114Helena (406) 442-2214

Serving:

Missoula (406) 549-2766

We’re looking for nurses of the CARING KIND.

You have a CHOICE. Ask for us by name.

Serving:Billings (406) 294-0785 Butte (406) 494-6114

Bozeman (406) 556-0640 Helena (406) 442-2214Missoula (406) 549-2766

Salish Kootenai College Nursing Department

Offering Accredited RN-BSN Program

New curriculum beginning Fall 2014

RN-BSN program online with decreased clinical hours

Admission application deadline for RN-BSN:Winter Quarter: November 24, 2014Spring Quarter: February 23, 2015

For more information Call: 406-275-4909 or Email: [email protected]

Also check us out on Facebook

Chester, MT

Chief Nursing Officer

Liberty Medical Center has an immediate opening for a Chief Nursing Officer, this position includes quality of patient care, program/care management, environmental safety, budget constraints, and responding to identified need to ensure regulatory compliance, performing necessary delegation and coordination of clinical, operational, and managerial activities to accomplish the objectives of the departments

Applicant must be a graduate from Accredited College; Prefer Bachelors Degree in Nursing with experience but not required; Must be an RN licensed within the State of Montana

Check out our excellent benefits! www.libertymedicalcenter.org

Applications are available from Bev Halter, Director of Human Resources406-759-5181 ext. 5972

Applications will be taken until position is filled.

EXTENDED CARE FACILITYEmployment Opportunities

DIRECTOR OF NURSING-RNRequirements: 2 years of supervisory & leadership skill

R.N. & L.P.NNew Graduates are welcome to apply!

If you would like more information about our facility go to: www.ponderamedical.com

Contact Human Resources at 406-271-2235 or Fax 406-271-3917 [email protected]

OPPORTUNITIES AVAILABLERNs, LPNs – StatewidePCAs, CNAs – Greater Missoula area, Helena, Billings, Ravalli Co.

For more information contact us today!

Missoula Helena Billings 406-549-8059 406-442-6755 406-969-2846

RWJF continued on page 8



102nd Convention, 2014

Kathy Chappell, PhD, RNVP, Accreditation Program and Institute for

Credentialing ResearchDirector, ANCC Accreditation ProgramAmerican Nurses Credentialing Center

It was a sincere pleasure participating in Montana Nurses Association’s 102nd Annual Convention. Learners, from “soon-to-graduate” to “mature-and-experienced”, were actively engaged in presentations on Interprofessional Education to Improve Interprofessional Collaborative Practice and Patient Outcomes, and Transition Programs for Registered Nurses and Advanced Practice Registered Nurses. Different learner perspectives facilitated depth in discussions. One experience in particular was highly interactive. Learners planned an Interprofessional educational activity as members of a 6-person planning team that included a Nurse, Student Nurse, Physician, Social Worker, Mother and Patient. One group even added the role of Father to the discussion! All groups were quick to recognize how important it is to include the patient’s perspective when planning educational activities. Throughout discussions, there was a frequent request from Patients – “Listen to me!” An important “ah-ha” moment for us all!

Gwyn Palchak, BSN, RN-BCMNA CE Council Member

Perhaps the most exciting aspect of Convention this year was the presence of Dr. Kathy Chappell, Director of Accreditation Programs at ANCC. In addition to her three presentations during Convention she was also able to meet with senior students from Carroll College, attend the CE Council meeting early in the week, work the CE staff and was easily available for conversation with attendees.

Kathy’s 3 sessions during Convention focused on the role of Interprofessional education in both the

academic and continuing education arenas. In her first session she provided definitions of what this concept is and what it is not, why it needs to be initiated or fully and the benefits to the patient and the health care system. Using this foundation, her next session was a hands-on practice of planning an educational session involving all players: RN, SW, MD, parent, adolescent patient and respective support professionals. The overwhelming “aha” moment occurred with the inclusion of the patient and their respective ideas of what and how education should occur. This proved to be very different from how the RN planner would have put together the educational session. The last session Kathy presented was on integrating the new RN successfully into professional practice. She identified the hopes and fears of the new grads and examined ways to leverage that information to ensure a smooth and enduring transition.

So how it is that MNA was able to have Dr. Chappell at our convention? Kathy’s presence, and the length of time she was in Montana, is a testament to the respect MNA is accorded at the national level. Not only for the work of our CE staff and Council members but our leadership in advocating for nurses and patients alike. The rigor and exactness to upholding accreditation standards make for comprehensive and time intensive work and occasionally tough decisions for an applicant, but it is this very commitment to excellence that sets MNA apart.

Thank you to Council on Continuing Education and the Board of Directors for a great Convention.

Susan Porrovecchio, BSN, RN, CARNCE Council Member

It was such an honor to have guest Kathy Chappell, PhD, RN, Director, ANCC Accreditation Program with us both before and throughout the Convention. She has a wealth of knowledge and that spark of enthusiasm that really engages an audience. Thank

Kathy Chappell, PhD, RN and Sandy Sacry, MSN, RN

Amy Clary Assistant Director AFT Healthcare

Katherine R. Petersen, Detective Missoula Police Department

House of Delegates 102nd MNA Convention

102nd Montana Nurses Association Convention 2014

you! As a 2003 Carroll College graduate of the Parish Nurse Program, I was very interested in the development of the Faith Community Nursing Program and pleased to hear how this area of nursing remains relevant and vital to our Montana communities. It is an area of nursing I still hold dear and hope one day to revisit. The whole discussion of interdisciplinary collaboration was fascinating and very engaging – the time is NOW! Our new MNA Executive Director, Vicky Byrd, BA, RN, OCN did a wonderful job during the Convention and received a very warm welcome from her colleagues. For me, one of the biggest surprises, and most memorable, was hearing from the Montana Student Nurses Association President, Zack Stricklin, and viewing his video of a local fundraising activity he was responsible for – we are in good hands!


Kathy Umphres, MS, RN-BC

I was fortunate enough to attend the Association for Nursing Professional Development (ANPD) annual convention “Aspire to Innovation” July 16-19, 2014 in Orlando, Florida. There were so many excellent concurrent sessions that it was difficult to choose which sessions to attend. After reviewing the titles and objectives I chose sessions based on the challenges we were facing at Benefis Health System, including retention and cost-effective training through simulation.

One of the most helpful sessions was “Improving Nursing Retention: The Magic of Mentoring,” reminding us how important mentors are as they care for patients while teaching and advising new staff. Reward and recognition, from a written thank you

Benefis Nurse Reflects On National Conference Attendance

note to extra paid time off, may help the mentors stay energized as they continually work with new staff.

Another excellent session, “Aspire to THRIVE not SURVIVE: Innovative Tools for a Successful Transition to Practice”, included team activities emphasizing how much is expected of new nurses and how difficult it can be to prioritize the multitude of tasks required to care for more and sicker patients than they encountered in school with the support of instructors. It is important to have good mentors to help the new nurse transition to practice in the hospital setting and to use simulation in a safe environment to bridge the practice gaps encountered as a new nurse, hopefully resulting in our goal of retaining nurses.

Attending the ANPD conference was a rewarding experience. The speakers were phenomenal and I came away with “pearls” from each of the 17 sessions I attended. Networking with other NPD specialists is extremely valuable, as we face many of the same issues and are finding some creative ways to address those issues. It is reassuring to know that whether you work in a small hospital or a large teaching hospital, there are similar challenges and our colleagues are more than happy to share ideas and information that can be adapted to different settings. I came away from the conference feeling energized, with information that will benefit my organization.

Blackfeet Community Hospital/Indian Health Service

Browning, Montana

Recruiting for experienced: Labor & Delivery, Newborn Care, and

Medical –Surgical Clinical Nurses

Contact Inpatient Unit at 406 338-6277Or 406 338-6269

To view current openings and apply online,

visit: www.usajobs.gov

Rocky Boy Health BoardisanoutpatientclinicandoffersGeneralClinic,Dental,Pharmacy,Lab and Optometry Clinics and is committed to provide, maintain, and improve the highest quality of health care delivery systems in the spirit ofSelf-GovernanceandSelf-Determination.TheRockyBoyHealthBoardrecognizes and respects the holistic and unique structure of the Chippewa Cree and will remain dedicated to their health needs.

Clinical Nurse Position AvailableMontana RN licensed required, BSN desired

ContactGeriRacine,PersonnelOfficerorTaunia Racine, Personnel Asst.

Rocky Boy Health BoardRR 1, Box 664, Box Elder, MT 59521

406-395-4486, ext. 2080

Qualified Caring Staff

RNs • LPNs • CNAsWe are currently taking applications for traveling careers for licensed

/ certified nursing staff, for long term care, hospital, correctional, mental health, clinics and treatment facilities, throughout Montana.

Excellent wages, flexible work assignments, and other opportunities

For an application or more information contact us:406-360-5199 • 406-360-5149 • Fax 406-363-5726

Email [email protected]

Equal opportunity employer

Full Time Adult Health Instructor

Miles Community College is seeking a dynamic, learning-centered, student-oriented individual to instruct second year nursing students

in Adult Health Nursing for our Associate Degree Registered Nurse Program.

This is a full-time, nine-month teaching appointment which is renewable annually based upon satisfactory job performance. Overload and summer teaching opportunities are sometimes available. The college provides a competitive benefits package.

Master’s Degree in Nursing required by the current Statutes and Rules Relating to Nursing, issued by the Montana State Board of Nursing. Minimum of two (2) years experience in clinical nursing. Teaching experience preferred. RN license in the State of Montana Required.

To apply for this position, please send a cover letter, résumé, list of three references, unofficial college transcripts, and a completed Miles Community College application to Kylene Phipps, Human Resources Director, Miles Community College, 2715 Dickinson Street, Miles City MT 59301 or you may e-mail your application materials to [email protected].

For further information about this employment opportunity and a MCC application please view our website at www.milescc.edu.

Miles Community College is an equal opportunity employer.

Blackfeet Community CollegePO Box 819, Browning, MT 59417-0819

Nursing Instructor: Will instruct courses in general nursing and in the instructor’s specialty area following a rural community based curriculum; will have classroom, lab and clinical responsibilities; will provide guidance and direction to allow students to achieve course objectives. Working within a detailed course syllabus, the instructor is expected to be an effective classroom/clinical manager and an advocate of the philosophy and policies of BCC. Required Qualifications: Master degree in Nursing from a nationally accredited program; completed course work in curriculum development, principles and methods of teaching, and measurement and evaluation of learner outcomes in nursing program or community health nursing; two years of teaching experience in nursing education; current unencumbered RN licensure in the State of Montana. Open until filled.

.5 FTE Clinical Resource Registered Nurse Instructor: Responsible for instruction within clinical settings for clinical education of nursing students. This position may include afternoons or weekends. Individual may work a semester at a time or year-round. Required Qualifications: Minimum of bachelor degree in nursing from a nationally accredited program; previous experience in supervision of nursing students in clinical sites; three years or more of clinical experience; current unencumbered RN license in the state of Montana. Open until filled.

Application procedures/materials are available at www.bfcc.edu or contact Human Resources Director Dana Pemberton at (406) 338-5441, Ext. 2205; [email protected] Blackfeet/Indian preference applies. EOE/ADA

MissoulaHealth and Rehab Center

Missoula Health and Rehabilitation seeking candidates to fill open FT/PT nursing positions. We offer competitive wages, full health benefits, dental, 401k, life insurance, and flex plans. Candidates need to have active, in good standing MT license. Evening and Night shifts available.Offering a sign on bonus of up to $2,000 Contact us today for career opportunities!

Clark Keith, RN, Director of Nursing ServicesFax: 406-549-3064 • [email protected]

http://missoulahealthandrehab.com

Advanced Practice Nurse - PsychiatricEssential Functions: Montana Mental Health Nursing Care Center located in Lewistown, Montana provides long term care to adults with serious mental illness. This position is responsible for treating and prescribing care to residents as referred. Provides direct resident care and collaborates as a provider and care plan team member in medication management of facility residents. $78,500-$117,748 DOE, plus State of Montana Benefits Package.Minimum Qualifications• Masters’DegreeasanAdvancedPracticeNurse• ANCCcertificationasPsychiatric-MentalHealthNursePractitioneror

Psychiatric -Mental Health Clinical Nurse Specialist• LicensedasAPNinthestateofMontana;prescriptiveauthoritywith

assignment of DEA number.• TwoyearsofexperienceprovidingpsychiatricpatientcareasanAPN

preferred.

Applications/Inquires can be addressed toRon Balas, SuperintendentMental Health Nursing Care Center800 Casino Creek DrLewistown, MT 59457406-538-7451 ext 218

mission to advance a culture of health in our nation,” said RWJF Senior Adviser for Nursing Susan B. Hassmiller, PhD, RN, FAAN. “In the last two years, APIN grantees have laid important groundwork to build that workforce. We are pleased to provide the financial support they need to continue their essential work.”

About the Robert Wood Johnson FoundationFor more than 40 years the Robert Wood Johnson

Foundation has worked to improve the health and health care of all Americans. We are striving to build a national Culture of Health that will enable all Americans to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.

About the Tri-Council for NursingThe Tri-Council for Nursing is an alliance of four

autonomous nursing organizations each focused on leadership for education, practice and research. The four organizations are the: American Association of Colleges of Nursing; American Nurses Association; American Organization of Nurse Executives; and the National League for Nursing. While each organization has its own constituent membership and unique mission, they are united by common values and convene regularly for the purpose of dialogue and consensus building, to provide stewardship within the profession of nursing. These organizations represent nurses in practice, nurse executives and nursing educators. The Tri-Council’s diverse interests encompass the nursing work environment, health care legislation and policy, quality of health care, nursing education, practice, research and leadership across all segments of the health delivery system.

The Montana Center to Advance Health through Nursing (MT CAHN) is committed to leading nursing practice through collaboration in order to advance the health of Montanans. Please visit mtcahn.org to learn more about the Montana Action Coalition.

Continuing EducationRWJF continued from page 6


Membership

Cathy RansierMembership & Finance Specialist

October started with our 102nd Annual Convention. Attendance was good with some new faces as well as our many faithful. This is a fun three days and the CE contact hours benefit nurses all over the state. Networking is always a success at convention. We had some super guest speakers and the possibility of some of those speakers returning in the future was mentioned more than once.

Joining us this year was a group of nursing students attending classes, watching the process of the House of Delegates and generally infusing us with their youth and enthusiasm. The Student Nurses Association scheduled their annual convention to follow our convention, and having their participation is warmly welcomed. We not only had the power of youth in attendance, we also had the power of wisdom with long-standing MNA member Mary Munger also attending for a day. Mary is a past Executive Director and has been a very active member with Montana Nurses Association for 69 years. Isn’t that incredible?

I would like to extend a big cheer to our Labor Representative, Amy Hauschild, for her excellent work at Billings Clinic in negotiating that contract. It was a long summer of dedicated effort from Amy and Local Unit 2, but it paid off in a great contract for over 500 nurses. If you see Amy around, be sure to give her a pat on the back.

A few changes at MNA have also taken place recently. We welcomed a new Western Labor Representative, Caroline Baughman. She is small but mighty, and I know you will enjoy getting to know her. It was with great sadness that we then saw Lori Chovanak take her skills to Ohio. Lucky for Ohio, sad for us here, but I can’t find enough great words to describe our new Executive Director, Vicky Byrd. One thing is for sure, she is here to take care of nurses all over Montana and we are extremely lucky to have her with us.

It is going to be a fun ending to 2014 around here, and I hope to share that with as many new members as I can. Keep spreading the word, share your enthusiasm of nursing and lets work together to create one strong voice to advocate your enduring profession.

Recently, I experienced a sudden, rather extended stay at our Helena hospital, St Peter’s. I can’t tell you enough how important you are when one is ill. My care from nurses was outstanding and of exceptional comfort.

Never underestimate the power of yourself as a nurse!

Cathy RansierMembership &

Finance Specialist

The Power of Involvement

We would like to welcome the following nurses to Montana Nurses Association!

Below are the names of New Members and Members who have renewed their membership between June 15, 2014 & September 30, 2014.

If your name is not listed, and you believe it should be, please contact Cathy Ransier at

406-442-6710 or email [email protected]

Teri Sparrow Karmen WilliamsAmelia Clark Diane HurdAlexis Czorny Olivia ThompsonDonna Britzius Rory ClarkDebra Holm Tara GallagherDeborah Davis Judy WonnacottKristen Downey Teresa KnepperGloria Clark Sadie WisemanTheresa (Polly) Jasmine Zamora Troutman Debra GeselKelly Hunt Debra RapaportMark Duda Jennifer TollefsonKelly Damberger Jamie DaviesAngela Brady Jodi WipfSarah Beams Lara PollingtonBrandi Glibbery Janet CampanaValerie Gordon Kelly CassidyBruce Squires Jeni MurphyKacia Bundle Valerie DetonancourLisa Jewett Heidi HittnerSeely Bergstad Bonnie CampbellMichael Denny Melissa FinleySandra Dubose April CrowleyKelly Kurvink Jan FredrickCandace Barrenchea Linda McDonaldTony Ballensky Emmarie SchledewitzMichelle Boyer Kristin ShermanAustin Wagner Linda Ann BuxtonKristin Hawkinson Katherine KaiserWilliam Brewer Scott HollingsworthKathy Toney Mary GoldammerKlista Roberts Melissa ScharfMaria Brosnan Cindy SheridanKathryn Jordan Lezlie McKenzieJennifer Elison Pamela KeierleberMerridee Moshien Celeste BonnecarrereMelinda Christman Adrian ShivelyAngela Schell Lisa HastingsChelsey Jansman Virginia TymrakRebecca Gibson Krystal FaulknerJulia Bechtold Callie Hastings

Welcome New Members!

MEMBERSHIP MATTERS!

Montana Nurses Association would like to invite you to join us today!

BENEFITS INCLUDE:

• EMPOWERING RNs TO USE THEIR VOICES IN THE WORKPLACE

• IMPROVING PATIENT CARE

• HAVING INPUT REGARDING WAGES & BENEFITS

• CONTINUING EDUCATION OPPORTUNITIES

• LEGISLATIVE REPRESENTATION

Call or email today

[email protected]

(406) 442-6710

Applications also available on our website.mtnurses.org

Has your contact information changed?

New name? New address?New phone number?New email address?

To update your contact information, please email or call Montana Nurses Association: [email protected] or

406-442-6710

RN to BSN Online Program MSN Online Program

BSN-LINC: 1-877-656-1483 or bsn-linc.wisconsin.eduMSN-LINC: 1-888-674-8942 or uwgb.edu/nursing/msn

• No Campus Visits• Liberal Transfer Credits

• Classes That Fit Your Schedule• Competitive Tuition

Sidney Health Center is accepting applicationsfor the following positions:

• Charge Nurse • Clinic RN or LPN • Med/Surg RN • OB RN • Surgery RN

For additional information or to apply online, please visit our website at:www.sidneyhealth.org

0r contact: Marilyn Olson216 14th Ave SW • Sidney, MT 59270 • Phone: (406) 488-2571

[email protected]

EOE

DID YOU KNOW…Teton Medical Center in Choteau, MT qualifies for the NURSE Corps Funding Program?

In exchange for a 2 year service commitment at TMC, nurses can get 60% of their school loan paid with a 3rd year eligibility to receive an additional 25% of loan balance.

Applicant eligibility includes:• Baccalaureateorassociatedegreeinnursing• UnrestrictedlicenseasanRNinthestateofMontana• Beemployedatleast32hours

Current openings: RNs and CNAsFull-time and Part-time

competitive wages and benefits

To take advantage of this federally funded NURSE Corps Program and for more information contact Human Resources at

(406) 466-5763 • www.tetonmedicalcenter.net


Around the State

Elizabeth Kinion, Ed.D, MSN, RN

“I am a professor in the College of Nursing at Montana State University and an MNA member. I teach in the undergraduate and graduate programs. I became aware of the importance of the nurses role in oral health several years ago when I was the Director of a Nurse Managed Center in Akron, Ohio. We provided health care to persons who did not have health insurance and who were not eligible for other health care resources. Many of our clients had chronic illnesses and poor oral health. I was fortunate to collaborate with public health dentists, and together, we were funded by HRSA so that through collaboration we could provide oral health care and our clients would have access to dental care.” ~ Elizabeth

As nurses, we are key players as client advocates, inter-professional team members, and direct care providers. Yet oral health is often excluded during medical care and overlooked by nurses. More than ten years ago the Surgeon General called oral health disease a “silent epidemic.” Unfortunately this situation remains largely unchanged. Diseases of the oropharynx, which includes the oral cavity, teeth, and supporting structures, have a significant impact of the overall health of the U.S. population (Institute of Medicine {IOM}, 2011).

Dental decay continues to be one of the most prevalent diseases of childhood (IOM, 2011 p. xi). The factors contributing to dental decay are complex, spanning individual, family, and community-level influences (Fisher-Owens et al., 2007). Decayed, broken, and abscessed teeth are the end stage of a pathological process caused by a chronic bacterial infection, associated with the Mutans streptococci organism (Milgrom, Weinstein, Huebner, Graves, & Tut, (2011) and Berkowitz, (2006). Children become infected with the decay-causing bacteria shortly after birth through transmission from caregivers, most often mothers. Infection offers an increased risk for chronic dental disease; however, early preventive care may alter the progression of disease. Nurses have a primary role in facilitating prevention by identifying children at high-risk for dental decay, providing guidance to parents, and offering primary preventive services (Kagihara, Niederhauser & Stark, 2009).

Preventive care can begin as early as pregnancy. Nurses may identify mothers with high rates of dental decay, refer them to a dental provider, and reduce the risk of transmission of decay-causing bacteria to the infant following birth. Increasing the utilization of dental care among women during pregnancy offers an opportunity to improve the oral health of U.S. children and mothers. “Dental decay is not the only oral disease affecting the U.S. population. Periodontal (gum) disease among adults has an impact on overall health. The inflammation associated with periodontal disease may create negative health consequences for individuals with heart disease, diabetes and other health conditions.” Jeffcoat, Jeffcoat, Gladowski, Bramson, and Blum, (2014), p. 166.

For many Montanans oral health is a health disparity. Individuals have limited access to dental care for multiple reasons; Montana is a large rural state, inclement weather may prevent travel and seeking dental care may require an overnight stay, and loss of time at work. Many rural communities do not have dentists. Addressing the web of causes of health disparities is beyond the scope of this article; however nurses can become full partners with clients by learning about oral health care and assisting clients with oral health. The Smiles for Life: A National Oral Health Curriculum is an excellent resource for nurse practitioners. www.smilesforlifeoralhealth.org. This curriculum is designed to enhance the role of primary care clinicians in the promotion of oral health for all age groups. This program consists of online courses, patient education materials and resources. Two additional important resources that provides a wealth of information about oral health are the Montana Department of Health and Human Services Oral Health Program http://www.dphhs.mt.gov/publichealth/oralhealth/. Tonette Hollingsworth, Oral Health Program Coordinator, can be reached at [email protected] to offer resources and primary prevention guidance. The mission of the Oral Health Program is to improve the oral health of Montanans through prevention and education. The Oral Health Program collaborates with and identifies oral health resources available for local health departments, schools, daycares, tribes, Head Start programs, and others concerned with oral health promotion activities. The website will soon

Oral Health Care – Nurses Make A Differencebe updated with additional resources on Dental Services in Montana, Access to Baby and Child Dentistry (ABCD), Fluoride, Oral Health Education and Training, School Based Oral Health Screenings, National and State-Reports, Brochures, and a Newsletter.

The Association of State and Territorial Dental Directors(ASTDD) http://www.astdd.org, a national nonprofit organization representing the directors and staff of state public health agency programs for oral health. The mission of the ASTDD is to provide leadership to promote a governmental oral health presence in each state and territory, to formulate and promote sound oral health policy, to increase an awareness of oral health issues, and to assist in the development of initiatives for prevention and control of oral disease. The organization web site also provides a plethora of information on a variety of oral health topics from A-Z, some examples are Basic Screening Surveys, Best Practices Approach Reports, Community Water Fluoridation, Perinatal Oral Health, and Periodontal Disease.

References: Berkowitz, R. (2006) Mutans Streptococci: Acquisition

and Transmission (2006) Pediatric Dentistry (28), 2 106-109.

Fisher-Owens, S., Gansky, S., Platt, L., Weintraub, J., Soobader, M., Bramlett, M., & Newacheck, P. (2007). Influences on children’s oral health: A conceptual model. Pediatrics, 120(3) 120e510. Doi:10.1542/peds.2006-3084

Kagihara, L. E., Niederhauser, V. P., & Star, M. (2009). Assessment, management, and prevention of early childhood caries. Journal of the American Academy of Nurse Practitioners, 21, 1-10. doi:10.1111/j1745-7599.2008.00367.x:

Institute of Medicine (IOM) Committee on an Oral Health Initiative (2011) Advancing Oral Health in America. National Academies Press Washington D.C. www.nap.edu

Jeffcoat, M., Jeffcoat, R., Gladowski, P., Bramson, J., Blum, J., (2014). Impact of periodontal therapy on general health: Evidence from insurance data for five systemic conditions. American Journal of Preventive Medicine 47(2) 166-174.

Milgrom, P., Weinstein, P., Huebner, C., Graves, J., & Tut, O., (2011.) Empowering Head Start to improve access to good oral health for children from low income families. Maternal Child Health Journal; 15(7) 876-882. doi 10.1007/s10995-008-03316-6


Around the State

Montana’s Smokefree Housing Program – A Resource for your PatientsAlison Reidmohr,

Smokefree Multi-Unit Housing Project Lead

Montana’s Clean Indoor Air Act protects people from secondhand smoke in restaurants, workplaces and other public areas. But it doesn’t apply to apartment buildings.

Even if they don’t smoke themselves, many renters end up breathing smoke from neighboring units.

Secondhand tobacco smoke contains more than 4,000 chemicals, 11 of which are known cancer-causing poisons. Exposure to secondhand smoke increases the risk for heart disease, lung cancer, ear infections, Sudden Infant Death Syndrome and many other health problems. For these reasons, the U.S. Surgeon General has concluded there is no safe level of secondhand exposure.

However, only 25 percent of Montana renters are protected by policies that ban smoking inside multi-unit buildings. Without an indoor smoking ban, smoke travels through walls, ventilation ducts, windows, doorways and even electrical outlets.

Making sure more renters have access to smokefree housing is a major goal of the Montana Tobacco Use Prevention Program (MTUPP), which is part of the state’s Department of Health and Human Services.

MTUPP has achieved a lot in just a few years. It has persuaded many of Montana’s housing authorities to go smokefree, and it convinced the state Board of Housing to pass a tax incentive that

encourages developers of publicly-funded housing to institute smokefree policies.

MTUPP’s Tobacco Use Prevention Specialists, based out of county health departments across the state, advise landlords and tenants who want to implement smokefree policies and provide landlords with free smokefree signage, QuitLine contact information and smokefree lease language.

Montana health professionals can help in our efforts.

If you have patients who want to protect their health and the health of their children from secondhand smoke, encourage them to visit our website so they can learn more about advocating for a smokefree policy in their buildings.

The site includes a link renters can use to search for smokefree housing and a letter to landlords that physicians can sign on behalf of patients/tenants who have health issues exacerbated by tobacco smoke.

There are other ways to get involved, too. Please see our website at http://www.dphhs.mt.gov/mtupp/tobaccofreehousing, or contact:

Alison Reidmohr, Smokefree Multi-Unit Housing Project Lead

[email protected](406) 444-7896

MT CAHN, the Montana Center to Advance Health Through Nursing, hosted a webinar on September 19 in follow-up to the first Nursing Education Summit held in Helena this past June. There were 64 participants connected by computer across the state. Dr. Cynthia Gustafson, Executive Director of the Montana Board of Nursing and Co-Lead of MT CAHN, welcomed everyone and reviewed progress and plans toward developing a statewide model of nursing education in Montana.

Dr. Gustafson reviewed objectives for the Academic Progression in Nursing (APIN) grant with continued funding from the Robert Wood Johnson Foundation for two more years.

Those objectives are to

1) Work with nursing leaders from education and practice to create a model of nursing education that will enable academic progression from LPN to ASN to BSN to masters and doctoral levels.

2) Expand current mentoring programs to reach more RN to BSN students and new BSN graduates entering the workforce.

3) Increase the number Native Americans that are in Montana nursing education programs and nursing leadership positions by July 2016.

4) Develop a comprehensive sustainability plan for academic progression in nursing strategies throughout the state of Montana.

5) Increase employer support of and engagement in academic progression in nursing initiatives in Montana through changes in practice and policy, participation in coalition leadership, and expanded involvement in preceptor and mentor opportunities.

6) Expand the depth and breadth of the MT CAHN Preceptor Continuing Education and Recognition Program to academic/practice partnerships in each of the five MHA Regions of the state.

Kelly Peterson and Kaye Norris reviewed objectives for the Montana HealthCARE grant submitted to the Department of Labor and how the APIN grant and Montana HealthCARE grant will complement each other toward the overall goal of a statewide model of nursing education that fosters academic progression in nursing. On September 29, 2014 the Montana Governor’s Office announced that the Montana HealthCARE grant was awarded; this grant provides funds to redesign the associate degree nursing curriculum to coordinate with a bachelor’s degree program or higher in a more efficient manner.

Finally, a call for action came from Kailyn Dorhauer, Coordinator for the APIN grant at the Montana Area Health Education Center (AHEC) and Office of Rural Health. She reviewed the main ideas from the Nursing Education Summit and asked for volunteers to work on each one of the APIN objectives. Anyone interested in working on nursing education strategies in MT can volunteer by signing up at the MT CAHN website at http://mtcahn.org or contacting Kailyn Dorhauer at [email protected]. A recording of the Summit Follow-up Webinar is available for viewing on the http://mtcahn.org website as well.

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From Montana to MalawiJan Ivers

In a faraway country many years ago, my husband and I were Peace Corps volunteers. As newlyweds we were anxious to have an adventure before we started a family, which came sooner than anticipated. My husband taught English, and I taught Science in Zaire, which has since become the Democratic Republic of the Congo. With the pregnancy, we were medically terminated before our two-year commitment was complete. We returned to Montana to raise our family.

Fast forward thirty–plus years. Our lives have changed. Armed with a couple more degrees and after years of child-rearing, we found ourselves with an empty nest. My husband came home one day and stated that Peace Corps had a new program especially for health care professionals, and it was a one-year commitment. Now, that piqued my interest. I applied, and we had a Skype interview. I was accepted pending medical and legal clearance. That was November of 2013.

My husband and I discussed it and decided I would go by myself. It was a very hard decision, but the house and the dogs played a major role in the decision-making process. And

only for a year. So, I started the process. I had had an unpleasant experience with another NGO (Non-governmental organization), where I had applied and told friends and family that I had applied and then got rejected. That was not going to happen again. I told two friends, and that was it.

I spent the next six months with the dental, eye and medical clearance, immunizations, exams, more exams till there was no orifice left unprobed. I actually had a FAX card I sent so many faxes. Finally in April I was cleared. For the legal clearance, I had my fingerprints taken in November and got cleared in March-not exactly like television.

Since I was not granted a sabbatical, I resigned from my position of a bedside nurse. Another tough decision. I had earned my Masters of Science in Nursing in 2011, and was ready to use my education. As a staff nurse in a Frontier hospital in Montana, using my MSN was highly unlikely.

In July of 2014, my family and friends gathered around, we had parties and hugs and tears. There were many comments like, “You are so very brave” to

“WHAT? ARE YOU NUTS?” The answer to both is, “No I am not really brave; I just want to make a small difference in the global health community. And yes, I am nuts. Why would I leave a good paying job to volunteer for less than $400 per month to live in a developing country? I guess it is because I just want to make a small difference in the global health community.”

The first two weeks were in Washington D.C. for training. The program is technically called GHSP (Global Health Services Partnership) and is a union between Seed Global Health and Peace Corps. Peace Corps is the main program, and Seed provides the funding. This is only the second year of this program, so we are still considered pilot. There were volunteers for Tanzania, Uganda and Malawi. I had heard in May that I would be teaching Medical-surgical nursing at the Kamuzu College of Nursing (KCN) in Malawi.

There were 12 of us going to Malawi, seven nurses, four doctors and one spouse. Two doctors from last year’s program decided to extend for another year. I met my roommate, and we got, and still get, along great. She has a master’s in public health, is from Tennessee and will be teaching community health.

The Malawi-12 spent two weeks in Lilongwe, the capital of Malawi. More training. On August 5 we boarded a pickup with all of our in-country worldly possessions and headed to Blantyre, the second to the largest city in Malawi and our home for the next year. We have a lovely home complete with electricity, indoor plumbing and a cat that eats spiders and lizards.

Orientation started August 11. I was assigned to the men’s medical ward. It was a tough day, but I managed to survive. On August 12, my second day of orientation, we had a death on the ward. It was a 22-year old man (boy) who died from sepsis due to typhoid fever. He had HIV/Aids. I helped prepare him for the mortuary, complete with removing IVs, catheters and wrapping him in a blanket for transport to the morgue. The whole extended family followed the stretcher crying and singing. He was placed in the morgue, and his funeral will be within a day or two due to no embalming and the high heat. The family stays outside the mortuary singing all day. It was so very sad for me. Twenty-two years old and dead. Preventable death. I left the hospital and went to the office of my counterpart, the KCN instructor who had been assigned to help me adjust. I told her about my day, then cried. It was also my thirty-fifth wedding anniversary. Really, seriously, what had I done?

Queen Elizabeth Central Hospital (QECH) is 1000 beds and considered a referral hospital, meaning that the health clinics use QECH as the ultimate health care center. Before I started my orientation, the hospital was without water for three days. I will be teaching at Kamuzu College of Nursing (KCN), but clinical rounds will be at QECH.

My orientation ended September 5. I needed four weeks orientation in order to get my Malawian nurse’s license. I oriented in Men’s medical, women’s surgical, outpatient department, adult emergency, pediatric emergency, and the pediatric ward-including high dependency unit (similar to intensive care), medical, surgical, nutritional center, orthopedic and nursery. I was glad to have orientation ending, but that opened another question. With classes starting November 5, what would I do to keep busy until then?

I had met some folks, and one woman in particular was very interesting. She teaches school at a private primary school, and said that I could help out there. I try to go two days a week to read with the students. Generally, they can read the words, but the comprehension is lacking. It is a 45-minute walk (one way), but very enjoyable.

I am busy helping the other nursing school teachers grade and input the grades from the year-end testing from last year. And just life in Blantyre is more time-consuming; shopping takes longer, transportation (by foot) takes longer, banking takes longer. And since we are a pilot program, we need to fill out reports for Seed Global Health, which takes longer. And I have started local language classes. Chichewa for one hour a day, five days a week.

Once the department head heard that I had worked in Intensive Care, she asked me to supervise some students in the Cardiac Care unit, so I will start that tomorrow. Tionana (so long for now) until I start teaching classes.

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that I could use my nursing education without the selfish concern of ‘what’s in it for me?’

Helping those of us who don’t speak Spanish that well (yet), were a terrific group of translators. Triaging patients through translators, most of whom have little medical knowledge, was a challenge. Add to that the ever-present concern that some commonly-used words and phrases don’t translate well from one language to another, and you’ve got yourself one terrific language barrier. Worth a few good laughs and blushing apologies as you try to explain what you meant to say.

I’ve been an LPN since 1982, and in those 30+ years, I have worked in a variety of healthcare settings. Last fall, I decided to go back to college, again, to work toward a Registered Nursing license. My nursing skills came in handy during the Peru trip, of course. I went on the medical mission trip expecting to learn a few things, too. What I learned was how to overcome a language barrier, as well as an educational variant. By that I mean that I had to quickly learn the difference in how the Peruvians described their health concerns to me, and what our American nursing education generally teaches us. Not everything we learn is in a textbook nor follows what our textbooks tell us we should expect. Even though I had just finished a nursing assessment course, I managed to get by with liberal use of Medscape and some rapidly-developing new critical thinking skills.

Oh, how grateful I became for the translators patience to explain things to me. In one instance, a lady’s complaint of ‘kidney pain’ as she was pointing to her back, was more likely a UTI. In another instance, the lady’s description could have been either a UTI, a yeast infection or an STD. Imagine running a medical clinic where you have no patient medical records, where you are not able to do a physical exam or lab testing to confirm a diagnosis. Virtually unheard of in modern-day American healthcare. The doctors’ diagnostic skills and the nurse’s triage skills were put to the ultimate test, to be sure. Healthcare workers never really understand the value of hand washing, until you’re in places where you can’t wash your hands. Using hand sanitizer doesn’t seem sufficient when there is no running water, the toilet is outside and ‘flushes’ with a bucket of water.

Would I go to Peru again? Oh, Absolutely. I’m already planning for next year’s trip. This time, I’ll have almost a full year to raise the funds, instead of only four months. I’ll also have taken a few more nursing classes and had time to work on improving my Spanish-speaking ability.

If you have a heart to serve, this is an amazing experience. A short-term medical mission trip in a foreign country may be the best test of American nursing education. Go to improve your nursing education. Go to learn a new culture. Spend your money on a working vacation like a mission trip, actually meeting the people who live there. Know that when you buy that tourist T-shirt, you’ve really earned it because you’ve actually been where you said you’ve gone.

Peruvian meal. Lomo Saltado is a delicious dish which looks to be a beef stir fry over rice, also served with French fries. When you’re in a foreign country where you can’t drink the local water, you quickly learn new things like keeping the shower water off your face (out of your eyes and mouth), and also how to brush your teeth with bottled water or mouthwash.

We traveled by bus to a different village each day to see patients. Our quickly set up clinics were usually held in the local Church, using whatever space, tables, chairs or benches were available. Rarely did the clinic resemble a typical American medical clinic. Some of the Churches were just four walls, no roof, otherwise open to the air. Not intended for a medical clinic, the structure didn’t give much of the privacy American healthcare patients expect. Adapting and improvising was vital. In one location, our clinic was held in a person’s home. The family’s two small bedrooms became an ‘exam’ room and a counseling room. The home’s one light bulb dangling from the ceiling did its best to help the doctor see his patients.

On average, we saw between 50 and 75 people in each location. The youngest patients were babies only a few months old. The oldest patient was a man who I was told was 100 years old. We carried with us a ‘pharmacy’ of antibiotics, vitamins and various OTC medications. Vitamins which seemed to be a universal need in Peru, are readily available in their numerous pharmacies, but were prohibitively expensive for the average Peruvian’s income. Despite being able to give out only a month’s worth of vitamins to a patient, our supply ran out in just a few days. The other necessary thing we ran out of far too quickly was candy. One adorable little boy who was treated at the clinic was steadfastly determined he was not leaving the clinic until he got some candy. By that day, though, all of the candy we had brought with us, was already gone. We were finally able to distract him from the missing candy, by playing with him for a few minutes.

Understandably, we could not do surgery, invasive exams or X-rays, but there were only a few patients we had to refer to local healthcare. Rudimentary medical care is better than none at all. Quite a few of the Peruvians we met had ‘access,’ if one could call it that, to healthcare, but that does not mean they could afford it. Others

faced transportation barriers that kept them from obtaining care. Most of the villages where we held medical clinics were far from the local hospitals, or on the side of a mountain in areas where even our bus had difficulty getting into and out of each day.

The optometrist in our group was the busiest of us all. He and his team saw an average of 120 people daily. In his busiest day, 206 Peruvians received a basic eye exam. Each person who needed them was given free eyeglasses, thanks in large part to those generous people who donate glasses to the Lions Clubs. We provided medical care without cost or obligation. Can you imagine any American medical facility accepting the grateful hugs and kisses offered, as payment in full for the care offered? I’m not criticizing the American healthcare system. It was, however, a blessing to me to know

Talma Brown

The common thing, the seemingly expected thing to do when visiting a new place is to purchase the tourist T-shirt proclaiming that you’ve been somewhere. But have you really been to that place? Have you met the people who live there, experienced their culture? Or did you just stay in the ‘tourist area’? Yes, I did buy the obligatory tourist T-shirt on my recent trip to Trujillo, Peru. I admit I wanted a tangible reminder of the trip in addition to my collection of photos and unspent Peruvian money. After a hectic four-month fundraising effort and the incredible generosity of my local Church members, I went to Trujillo, Peru recently on a medical mission trip being led by Tom Cox World Ministries.

I’d been on an international mission trip before this one. I knew that I’d see people living in poverty, extreme poverty according to U.S. standards. Given the contrast in living standards between the U.S and the Peruvians we met, I expected to feel sorry for them, that they don’t have what we do. Then I chided myself for my American attitude. Not everyone wants what we have. I went to Peru to learn about their culture, not to impose American culture upon them. While their homes were usually constructed of concrete walls with dirt floors, some homes we saw were only bamboo walls or black plastic sheeting. The Peruvian people I met were extremely friendly, grateful for the small bit of medical care we were able to give them. Hugs and kisses are universal ... and we got lots of them.

A group of ten of us from Montana were part of the larger nationwide group of about 50 people who traveled with Tom Cox World Ministries to provide basic medical care and evangelism to poor residents in several villages in and around Trujillo, Peru. In our team were doctors, nurses and people skilled in other jobs. The ministry group owns a large seminary complex which is their headquarters for Peru. As our ‘home’ during the trip, the bunk-bed filled dorm rooms encouraged plenty of laughter, quickly turning strangers into friends. The seminary’s cooks kept us all very well fed. The day we arrived in Trujillo was the national Independence Day, so we got to try a favorite

National News

Been There, Done That, Got the T-Shirt

Courtyard of Seminary owned by Tom Cox World Ministries.

Typical medical clinic day in Peru.

Typical “pharmacy”… improvising was vital.

Peru Independence Day Celebration.


National News

Jennifer Flynn, BAManager, Healthcare Risk Management

Nurses Service Organization (NSO)

As a nurse, you likely understand the need for professional liability insurance to protect yourself against malpractice claims related to patient care. But did you know you also need insurance to protect your license against action taken by a board of nursing (BON)? In this situation, the event might not even be related to patient care. For example, a state’s nurse practice act (NPA) may include a “moral character” component, which means a BON can take action in cases such as driving under the influence, use of illicit drugs (both on and off the job), or failure to pay child support.

The BON’s view is that licensure is a privilege, not a right. What many nurses fail to understand is that the BON is tasked to protect the public, not the nurse. While many articles have been written on how nurses can protect themselves from malpractice, far fewer have focused on how they can protect their license. Yet without a license, nurses can’t provide patient care, significantly affecting the nurse’s livelihood.

Allegations against a licenseLicense-related actions typically begin with

a complaint to the BON in the state where the nurse practices. Sources of complaints include patients, patient families, colleagues, or employers. Many BONs require an nurse to self-report certain violations, including misdemeanors. Finally, one state’s BON may be notified by another state’s BON, another agency, or law enforcement of action taken against an nurse.

Types of allegations include unprofessional conduct (e.g., privacy violations, lapses in moral character) to breach of confidentiality and

substance abuse. A BON may also take action related to disciplinary action taken in another state.

Incidents and paymentsAccording to Understanding Nurse Liability,

2006-1010: A Three-part Approach, a claims analysis from CNA and NSO, 1,127 incidents related to license protection were reported by registered nurses, LPNs, and LVNs insured by CNA/NSO with an average amount of $3,353. Payments reflect the costs of reimbursing an insured for legal representation in defending these actions to the BON. Most registered nurses involved in paid claims worked in a hospital (57.3 percent), followed by an aging services facility (19.6 percent). Similarly, LPN/LVNs involved in paid claims worked in a nursing home (56.0 percent), followed by a hospital (27.8 percent).

The three allegation classes with the highest percentage of paid claims affecting registered nurses were unprofessional conduct (23.5 percent) followed by improper care and treatment (21.1 percent), and errors related to medication administration (19.7 percent).

The three allegation classes with the highest percentage of paid claims affecting LPN/LVNs were errors related to medication administration (25.4 percent), abuse/patients’ rights (22.4 percent) followed by improper care and treatment (19.4 percent). So how can you protect your license against similar allegations?

Improve communicationDeveloping effective communication skills is the

most important step you can take to protect your license. Patients and families who feel they have a personal connection with a nurse are less likely to file a complaint. Listen, act with empathy, and don’t lose your temper.

Part of good communication is being able to resolve conflicts. If a serious conflict occurs, consider involving a mediator to help you and your patient work through the situation.

Be professionalMaintain a professional profile—complaints

are less likely to occur if you are perceived as a professional healthcare provider. Professional nurses stay current in their knowledge and function within their scope of practice. If a job description

or common practice at your place of employment differs from your state’s NPA, follow the NPA. If you are unclear whether something falls in your scope of practice, ask for a written opinion from your state’s BON.

You can also demonstrate your professionalism by belonging to professional associations. Ideally, one should be a general organization and the other should relate to your area of clinical practice. Subscribing to professional journals serves a dual function: providing evidence of professional practice and ensuring that you are current in your clinical knowledge.

Maintain professional boundaries. Do not have a relationship with a patient outside of a professional context—even if your professional relationship has ended.

Social media can be filled with perils such as boundary crossing and unintentionally revealing confidential information. Don’t engage in social media with patients and take care in what you post or text. Follow the guidelines outlined in the 2011 white paper from the National Council of State Boards of Nursing, available online at www.ncsbn.org/Social_Media.pdf. Should a complaint be filed, your reputation as a professional will stand you in good stead when mounting a defense.

Keep a recordBack up your reputation with documentation.

Maintain a file with documents that show your efforts to ensure your competency, such as continuing education classes completed and specialty certifications. Include general materials that provide evidence of your professionalism such as letters of recommendation, thank-you letters from patients and families, performance appraisals, awards, and certificates of accomplishment. Documents that show how you have served the public, such as participation in health fairs, should be part of your professional record, too.

Understand your state’s NPAAs a nurse in practice, you are responsible for

understanding what is contained in your state’s NPA. In some cases, the legal writing style may make NPAs difficult to understand, but with

How to Protect Your License

Protect Your License continued on page 15

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National News

perseverance, it’s possible to grasp the information. Many state BONs have created education programs to help nurses understand their NPA. The NPA will outline your responsibilities, from patient care to basics such as requirements for notifying the board of address or name changes.

It’s also wise to periodically visit your state BON’s website, where you can read board news and access information about disciplinary action. Reading past cases can help you identify areas of vulnerability in your own practice. You might also consider occasionally attending BON meetings, which are open to the public, to gain greater insight into how the BON functions.

License protection insuranceNurses should not rely on employers for their

license protection coverage. Usually, employer coverage only applies to malpractice charges that occur in the workplace. In addition, employers will focus on defending the organization, not defending an individual employee. Check to ensure that you have coverage—both malpractice and license protection.

When a board takes actionIf you are notified by your state’s BON that an

investigation will be started, immediately contact NSO, your professional liability insurance provider, and retain an attorney immediately. Your attorney will assist you in responding promptly to any requests from the BON during the investigation. At the end of the investigation, the BON will decide whether to take further action. If disciplinary action is chosen, possible outcomes include a consent agreement, settlement, or stipulation; an informal settlement conference; or a formal hearing. Often, notice of the final disciplinary action, including the name of the nurse involved, will be posted on the BON’s website and printed in its newsletter. The information may also be reported to databases such as the National Practitioner Data Bank, which means additional action can be taken by BONs in other states where the nurse is licensed.

Nurses can take some comfort in the fact that according to the CNA/NSO report, half of claims (50.0 percent) were closed without any BON action. Examples of BON actions taken include monitoring, education, or some type of caution issued.

Protect yourselfYou can take many steps inside and outside the

workplace to protect your professional license. Taking these steps and maintaining professional liability insurance that includes license protection will help ensure you can practice as an nurse for a long time to come.

Avoiding board complaintsHere are some steps you can take to protect

yourself against board complaints:• Follow established procedures and protocols.• Provide clear, timely communication to

patients and families.• Recognize stressors that can lead to substance

abuse and allegations of unprofessional conduct; be proactive in seeking support.

• Document consistently and in detail. Include discussions with patients regarding their treatment.

• Keep current. Complete education requirements, maintain physician agreement documents, and ensure access to up-to date medication and other reference material.

• Be sure your patient understands and is comfortable with the assessment process before you begin. If appropriate or requested by the patient, include another staff member during the assessment.

• Submit updates to credentials on time.

RESOURCESBrous E. Common misconceptions about professional

licensure. Am J Nurs. 2012; 112(10):55-59.Brous E. Professional licensure: Investigation and

disciplinary action. Am J Nurs. 2012; 112(11):53-60.

Brous E. Professional licensure protection strategies. Am J Nurs. 2012; 112(12):43-47.

CNA, NSO. Understanding Nurse Liability, 2006-2010: A Three-part Approach. http://www.n so.com /nu r s i ng - r e sou rce s/c l a im - s t ud ie s .jsp?refID=nurseclaimreport2011.

National Council of State Boards of Nursing White paper: A nurse’s guide to the use of social media. August 2011. https://www.ncsbn.org/Social_media_guidelines.pdf.

Editor’s note: This article is based on a three-part series on professional licensure by Edie Brous, JD, MS, MPH, RN, originally published in the American Journal of Nursing, 2012.

Author: Cynthia Saver, MS, RN, President, CLS Development, Columbia, Maryland.

This risk management information was provided by Nurses Service Organization (NSO), the nation’s largest provider of nurses’ professional liability insurance coverage for over 650,000 nurses since 1976. The individual professional liability insurance policy is administered through NSO and underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company. Reproduction without permission of the publisher is prohibited. For questions, send an e-mail to [email protected] or call 1-800-247-1500. www.nso.com.

Protect Your License continued from page 14

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