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Volume 42, No. 4 August, September, October 2016

Brought to you by the Indiana Nurses Foundation (INF) and the Indiana State Nurses Association (ISNA) whosedues paying members make it possible to advocate for nurses and nursing at the state and federal level.

Quarterly publication direct mailed to approximately 106,000 RNs licensed in Indiana.

THE BULLETIN

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INFINDIANA NURSES FOUNDATION

Letter to the Department of Education Student Services

Policy Primer

2016 ISNA Convention Agenda

Message from the President

A culture of safety for both patients & providers is inherent within every nurses’ professional mind set. As we prepare for ISNA’s annual meeting, safety is our focus. Both the poster and the podium presentations will be directed toward safety. Our state organization is bringing ANA’s safety message to the state level.

As I write this message, I have just returned from Washington DC. June 23rd was ANA’s Lobby Day. Approximately 350 RNs went to “the hill” to meet with elected officials. Your three Indiana representatives (Cheryl Griffith, Jeni Embree and myself) held face to face meetings with four of the eleven Indiana federal congressional representatives. We distributed information packets to the remaining 7 offices. With the capital building in the center taking up a mega block, the representative offices are one block to the south and the senate offices are one block to the north. Sounds simple but in reality, approximately 5 miles of walking back and forth according to our Fitbits. Our feet took a toll, but what a rewarding day.

Our message on safety was very well received. Nursing’s voice was heard. The major issues we advocated for were:

1. Safe staffing—that nurses, the direct care givers, be involved in determining the safe staffing levels. Not a staffing ration, but a staff matrix. For example, what experience level mix is needed to provide optimal patient outcomes? (HR 2083/ S 1132)

2. Title VIII Nursing Workforce Funding—we must work to continually build a highly trained workforce to meet the challenges of today and tomorrow’s health care system. The HR 2713 bill would provide funding at 279 million dollars to educate women and men interested in becoming registered nurses. We specifically asked our senators to consider becoming sponsors to introduce the bill in the Senate. (HR2713)

3. Home Health Care I m p r o v e m e n t Act – the passage of this act would allow APNs to certify & make changes to home health treatment plans. Examples of this would be ordering ambulation assistive devices, ordering oxygen or changing an oxygen concentration order, or ordering a PT/OT consultation. (HR 1342/S 578)

The ANA Lobby Day was followed by the ANA Membership Assembly. In conjunction with the focus on safety focus, our profession would be remiss to not address the prevention of gun violence. Public safety, our safety and our patient’s safety hinges on effective gun legislation. While on “the hill,” we observed multiple citizen demonstrations against gun violence. We specifically lobbied for repeal of the congressionally-imposed, longstanding ban on the CDC & Prevention from conducting research on gun violence.

It was professionally rewarding to be directly involved in the legislative process. Each of us will follow-up our congressional visits with a thanks for taking the time to listen to our recommendations message. In a week or two, we will again contact the legislative offices to validate that our message was heard and enacted upon.

ANA/ISNA Culture of Safety Efforts

Save the Dates!Friday, September 16, 2016 2016 ISNA Convention “Culture of Safety” Indiana University - Kokomo CampusKokomo, IN 46216

Catch Me If You CanDiversion in the Workplace

Faith Church | 9125 N. College Ave Indianapolis, IN

Friday, August 26, 2016

More information on pages 6-8

• The Bulletin August, September, October 2016

Published by:Arthur L. Davis

Publishing Agency, Inc.

www.indiananurses.org

THE BULLETIN

An official publication of the Indiana Nurses Foundation and the Indiana State Nurses Association, 2915 North High School Road, Indianapolis, IN 46224-2969. Tel: 317/299-4575. Fax: 317/297-3525. E-mail: [email protected]. Web site: www.indiananurses.org

Materials may not be reproduced without written permission from the Editor. Views stated may not necessarily represent those of the Indiana Nurses Foundation or the Indiana State Nurses Association.

ISNA StaffGingy Harshey-Meade, MSN, RN, CAE, NEA-BC, CEOBlayne Miley, JD, Director of Policy and Advocacy

Marla Holbrook, BS, Office Manager

ISNA Board of DirectorsOfficers: Diana Sullivan, President; Angie Heckman, Vice-President; Barbara Kelly, Secretary; and Ella Harmeyer, Treasurer.

Directors: Emily Edwards, Lorie Brown, Denise Monahan, and Amy Pettit.

Recent Graduate Director: Audrey Hopper

ISNA Mission StatementISNA works through its members to promote and influence quality nursing and health care.

ISNA accomplishes its mission through unity, advocacy, professionalism, and leadership.

ISNA is a multi-purpose professional association serving registered nurses since 1903.

ISNA is a constituent member of the American Nurses Association.

Address ChangeThe INF Bulletin obtains its mailing list from the Indiana Board of Nursing. Send your address changes to the Indiana Board of Nursing.

Bulletin Copy Deadline DatesAll ISNA members are encouraged to submit material for publication that is of interest to nurses. The material will be reviewed and may be edited for publication. To submit an article mail to The Bulletin, 2915 North High School Road, Indianapolis, IN. 46224-2969 or E-mail to [email protected].

The Bulletin is published quarterly every February, May, August and November. Copy deadline is December 15 for publication in the February/March/April The Bulletin; March 15 for May/June/July publication; June 15 for August/September/October, and September 15 for November/December/January.

If you wish additional information or have questions, please contact ISNA headquarters.

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]. ISNA 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 Indiana Nurses Foundation 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. ISNA 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 ISNA or those of the national or local associations.

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August, September, October 2016 The Bulletin •

CEO Note

What is a “culture of safety”?ANA defines a Culture of Safety as “Core

values and behaviors resulting from a collective and sustained commitment by organizational leadership, managers and health care workers to emphasize safety over competing goals. The U.K. Health and Safety Commission developed one of the most commonly used definitions of safety culture as “The product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment to, and the style and proficiency of, an organization’s health and safety management.”[5] “Organizations with a positive safety culture are characterized by communications founded on mutual trust, by shared perceptions of the importance of safety and by confidence in the efficacy of preventive measures.” Which one do you like, it is clear that a “Culture of Safety” is imperative for a workplace who respects the staff and clients or in our case patients.

Why this topic? Why now?It has been 15 years since the Institute of Medicine (IOM) stunned the

nation and issued the clarion call for a safer health care system in its landmark reports To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century. Nurses have been instrumental in the gains made in improving the quality and safety of U.S. health care over the last decade and a half. In spite of the IOM report, research indicates more improvements are needed.

What is the Culture in your workplace? Who is involved in the decision making? If a Safe workplace is important to you, get involved, check out how safety is monitored and get on one of the committees. A Culture of Safety is what we promise our patients so let’s make it so.

Culture of SafetyMy Certification Journey

Certification Corner

Sue Johnson

Attaining clinical excellence in both critical care and psychiatric nursing is a real achievement. When the nurse obtains certification in both specialties, this is a tremendous accomplishment. I’d like you to meet such a nurse. Mickey Regenold’s professional journey with certification will hopefully give incentive for some of this column’s readers to take their own certification journey. Here is Mickey’s story in her own words:

“My journey with professional certification began in 1993. I had practiced nursing in an adult critical care for 13 years before I was challenged by a BSN professor to take the exam for certification with the AACN for the adult critical-care nursing certification. Now in those days, we had to drive to Indianapolis and take the exam on paper with a number 2 pencil. I still remember listening to Laura Gasparis’ lecture tapes in preparation for the exam. I was warned by others that it was a difficult test. My study efforts paid off when I received my first CCRN certification. In fact, I still have the original certificate! At the time, I remember being asked by my co-workers why I would get the certification

when we are not reimbursed for going the extra mile. The answer was simple but not easy. Our patients deserve the best professional nursing care and how could I be sure I was delivering that level of care? Answer….certification! Knowledge from certification not only resulted from studying for the exam but it also gave me the opportunity to keep up on what was new in the field after achieving certification. Most of us begin our nursing career with great intentions of attending seminars, lectures, and reading professional journals to achieve best practice for our patients but what holds us accountable to do that? Answer…..certification!

I held the CCRN certification for six years before I left the critical care unit to attend graduate school. It was there where I fell in love all over again with the nursing profession and landed in psychiatric nursing where I practice today. It was Oct 14, 2006 when I received the ANCC psychiatric and mental health nurse certification. This week I am preparing to submit my ANCC renewal for psychiatric and mental health and it looks much easier than past years. It is ALL online!”

Thanks, Mickey, for sharing your experience with us and for your role in ensuring that patients receive the best professional nursing care! Certification is the answer. How about trying it yourself?

Do you want to share your certification story with your colleagues? It may encourage them to join you! Please contact me at [email protected] to share your experiences!

Mickey Regenold MSN, RN-BC

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Policy Primer

Blayne Miley, JDISNA Director of Policy & Advocacy

This summer there have been major opportunities for you to be engaged in nurse policy, and these opportunities will continue into the fall. Policymakers want your input on how to regulate your profession, so speak up!

Improving Healthcare for VeteransThe biggest national nurse policy event of the

summer has been the Department of Veterans Affairs’ (VA) proposal to grant their advanced practice registered nurses full practice authority. All four APRN roles would be able to practice without a physician supervision requirement. However, the proposed rules do not supersede state restrictions on an APRN’s prescriptive authority. As with any proposed change to government administrative code, there was a public comment period to collect input on the policy recommendation. The VA proposal elicited 167,459 comments! The disparity of the comments garnered national and local media attention. Most news coverage followed a similar pattern of first explaining the proposal as a solution to long wait times, then discussing concerns raised about the standard of care, and next sometimes including a nursing representative to respond to the concerns. ISNA was interviewed for a local tv news segment in Indianapolis, and submitted the following comment to federal regulators:

On behalf of Indiana’s 103,705 registered nurses, I write to support proposed rule AP 44, which would permit full practice authority for advanced practice registered nurses working for the Department of Veterans Affairs. This change will increase the efficiency of all VA healthcare providers and increase access to healthcare for our veterans. APRN full practice authority is supported by the Institute of Medicine, and the numerous studies showing patient outcomes under the care of an APRN are equal to or better than those of a physician. It is already the policy of the Army, Navy, Air Force, Combat Support Hospitals, Forward Surgical Teams, and Indian and Public Health Services. AP 44 will allow APRNs to practice to the extent of their education and training and improve veteran healthcare. The Indiana State Nurses Association urges you to enact it.

Back to School Part 1The best state nursing policy news of the

summer comes courtesy of the Indiana High School Athletic Association (IHSAA) Executive Committee, which at its June meeting amended IHSAA bylaws to accept high school sports physicals completed by nurse practitioners and physician assistants. This change comes after a multi-organizational advocacy initiative to convince IHSAA to stop restricting parental choice when it comes to healthcare of student athletes. ISNA worked with the Coalition of Advanced Practice Nurses of Indiana, the Indiana Academy of Physician Assistants, and multiple hospital networks on the issue. This positive change is a result of individual engagement, and shows that policymaking and advocacy don’t just happen at the Statehouse. The new IHSAA pre-participation physical evaluation form, reflecting the bylaw change, is available at www.ihsaa.org.

Back to School Part 2The letter on page 2 of this Bulletin to the

Indiana State Department of Education Student Services from the ISNA Board of Directors is another effort to improve healthcare for Indiana’s schoolchildren. In May, the American Academy of Pediatrics (AAP) revised their guidance for school nurse staffing. Moving away from the previous 1 school nurse to 750 students in the school corporation, AAP now calls for a registered nurse in every school building. Current Indiana regulations require each school corporation to have an RN, and recommends a staffing ratio of 1 school nurse to 750 students. There is no penalty for failing to meet this ratio, so not all schools are compliant with this, now outdated, policy. As you can see from the letter, the ISNA Board of Directors has asked the Department of Education to change their regulations to maintain compliance with the recommendation of AAP. This would require promulgation of an amended administrative code section, and the administrative rulemaking process can take over a year. However, we have to start somewhere. The current regulation is a recommendation below the appropriate level of care, and our schoolchildren deserve better.

Study UpBetween sessions of the Indiana General

Assembly, legislative interim study committees are convened to study issues as a potential precursor to bills for the next session. There are regular topical committees that meet every year, including the Interim Study Committee on Public Health, Behavioral Health, and Human Services. The assigned topics for that committee in 2016 are:

• Hospitalimmunizations,including:(1) whether a hospital shall conduct immunizations in accordance with CDC guidelines, (2) who must be immunized and what exceptions should be granted, (3) any other issues concerning immunizations

• Multi-statenurselicensureagreements• Heroinuse,treatment,andrecoveryin

Indiana• Medicalrecordsconfidentialityand

disclosure in instances of child abuse and neglect

• Patientaccesstoandproviderreimbursement for medication assisted treatment in Medicaid

• EmploymentFirstProgram

The first topic is a follow-up to SB 162 from this past legislative session, which did not pass. This list represents the Indiana General Assembly saying we want to learn more about these topics. I encourage all of you to reach out to your legislators about these issues, especially the ones directly related to nursing, because you have valuable expertise to share. As we go to press, the Interim Health Committee has not yet announced its meeting dates, but they will be open to the public and webcast through the Indiana General Assembly website: www.iga.in.gov.

More For YouIn 2012, ISNA began implementing a staff

reorganization to expand our resources and capacity to provide services to you. This fall we are taking another step in that direction by launching our Graduate Student Nurse Internship. Each semester we plan to have a graduate nursing student completing projects for ISNA. This will provide policy experience for the intern and more organizational output designed to serve Indiana’s nurses. Our inaugural intern will be Leah Scalf, MSN, RN, NE-BC, who is in the Doctor of Nursing Practice program at IUPUI. As part of the practicum, she will be writing an article in the next issue of the Bulletin to increase our clinical content. I am excited to have Leah on board and hope the Graduate Student Nurse Internship will provide an ongoing mutually-beneficial opportunity for nurses who want to be more engaged in policy. Initiatives like this are only possible as a result of ISNA’s continued membership growth, so thank you to those reading who are members. Also, a reminder, this publication goes to every individual with an Indiana RN license. ISNA is supported by membership dues, not license renewal fees. Members receive weekly updates through our e-newsletter, the ISNAbler, as well as other benefits detailed at www.indiananurses.org/join-isna.

New Opioid Rules (Sort of)In June, the Indiana State Board of Nursing

adopted new rules regarding opioids. These regulations mirror those previously adopted by the Medical Licensing Board, and are already common practice around the state. The Board of Nursing rules are scheduled to become effective on October 1, 2016. The rules formally establish standards for advanced practice nurses (APN) prescribing opioids for pain management treatment. The requirements imposed by the regulations do not apply to (1) patients with a terminal condition, (2) residents of a licensed long-term care facility, (3) hospice patients, or (4) palliative care patients. If the regulations do apply, and a patient is prescribed over a threshold amount, then the APN is required to (1) conduct a risk stratification, (2) discuss alternative modalities with the patient, (3) have periodic face-to-face visits with the patient, (4) run an annual INSPECT report, and (5) order drug monitoring tests when medically necessary.

Conferences for You, Conferences for MePages 6-8 of this issue detail the upcoming

continuing nurse education conferences ISNA is hosting: (1) the biennial fundraiser for the Indiana State Nurses Assistance Program on August 26 in Indianapolis, and (2) the annual ISNA Convention on September 16 in Kokomo. In between, I’ll be headed to Washington, DC for the annual American Nurses Association (ANA) Government Affairs meeting, which brings together policy reps from all the state nursing associations. It’s a great opportunity to learn about what’s going on in nurse policy around the country and get a national level perspective on future initiatives from ANA staff. As always, if you have any questions or comments, you can send them to me at [email protected].

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Beatrice J. Kalisch, PhD, RN, FAAN, is the Titus Professor at the University of Michigan School of Nursing. Dr. Kalisch was the 2013- 14 Distinguished Nurse Scholar-in-Residence at the Institute of Medicine. She has conducted numerous research studies, and her current work centers on

missed nursing care (standard nursing care that is not being completed) and nursing teamwork. Dr. Kalisch has authored 11 books and more than 150 peer-reviewed articles in various professional medical journals. She also serves as a member in, and a leader of, numerous local, state, and national advisory committees addressing health policy and nursing issues.

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Keynote Speaker:Beatrice J. Kalisch, PhD, RN, FAAN

2016 Convention – “Culture of Safety”

Our Abstract Presenters:• Medication Safety: An Interprofessional

Approach to Improved Patient Outcomes for Undergraduate Nursing Student Learning - Linda Wallace, EdD, MSN, RN, NEA-BC, CNE & Pamela Karagory, MBA, MSN, MSB, RN, CNE

• Developing Safety Huddles to Meet Organizational Needs - Brett Shipley, MSN, RN, PCCN & Ann Steffe, MSN, RN, PCCN

• A Perfect Storm for Compromised Safety: Compassion Fatigue, Incivility, and Mandatory Overtime - Elizabeth Bonham, PhD, RN, PMHCNS-BC

• Improving Patient Safety through the Initiation of a Massive Transfusion Protocol in the Obstetric Hemorrhage Patient - Brittany Waggoner, MSN, RN, CNS

• The Role of Perioperative Services in the Prevention of Hospital Acquired Infections - Francesca Levitt, MSN, RN- BC, ACNS-BC

• Enhanced Recovery After Surgery: A New Era of Patient Care - Heather Hohenberger, MSN, RN

• Law & Order for Nurses to Promote Patient Safety - Lorie Brown, RN, MN, JD

Friday, September 16, 2016

Indiana University - Kokomo CampusKokomo, IN 46216

2016 Convention ScheduleIU Kokomo Campus

Friday, September 16, 2016(Note: All times EDT and are subject

to change without notice)

8:00 a.m. Registration

8:30 a.m. Welcome

8:45 a.m. Opening of the Meeting of the Members

9:15 a.m. “Errors of Omission: How Missed Nursing Care Imperils Patients”

Beatrice J. Kalisch, PhD, RN, FAAN

10:15 a.m. Break/Exhibitors/Posters

10:30 a.m. Abstract Presentations (3)

12:00 p.m. INF Fundraiser

12:15 p.m. Lunch with Indiana Director of Health Commissioner

Posters/Exhibitors

1:30 p.m. Abstract Presentations (3)

3:00 p.m. Break/Exhibitors/Posters

3:15 p.m. Abstract Presentation

3:45 p.m. Closing of the Meeting of the Members Gingy Harshey-Meade

Criteria for successful completion equals attendance for at least 80% of the continuing education activity and completion of an evaluation form

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2016 Convention – “Culture of Safety”Friday,

September 16, 2016Indiana University - Kokomo Campus

Kokomo, IN 46216

Summaries of Podium Presentations:

“Medication Safety – An Interprofessional Approach to Improved Patient Outcomes for Undergraduate Nursing Student Learning”

Presented by: Linda Wallace, EdD, MSN, RN, NEA-BC, CNE & Pamela Karagory, MBA, MSN, MSB, RN CNE

Summary: According to a 2006 report from the Institute of Medicine entitled ‘Preventing Medication Errors,’ there are 1.5 million preventable adverse drug events annually in the United States with an average inflation adjusted cost of $8,750 per incident. Making a difference as well as increasing/improving the safe use of medications in a variety of health care settings is imperative due to this high volume, high risk, and problem prone area in health care today. Developing interventions that reduce medication errors in these institutional heath care settings will aid in improving patient health outcomes by preventing adverse events.

Medication safety is a comprehensive and complex aspect of patient care. Recognizing the significant safety responsibility of nurses in the medication administration process, nursing faculty at a midwestern university sought to expand their students’ knowledge, skills and attitudes (KSA’s) beyond what traditional program content and pedagogical strategies historically addressed. With learning objectives focused on student development of broader, systematic knowledge and skills faculty implemented a Medication Safety Essentials program into their curriculum. With an evidenced based, inter-professional approach, the program reinforces the, advocacy, responsibility and leadership role professional nurses have in the medication administration process as a component of patient care. This evidence-based, comprehensive program, utilizing a systems approach, covers all “touch points” involved in medication administration. The modules were developed by pharmacists with input from physicians and nurses giving the modules an inter-professional focus. The topics are relevant for students studying for the NCLEX-RN and for newly licensed and experienced nurses. Offering these modules should better prepare our soon-to-be graduates to provide safe, effective care and should give them an advantage when they apply for their first job. The timing of these webinars is perfect!

When available, data from the NCLEX-RN will be used to help determine the effectiveness of the modules in preparing test-takers in the areas of medication administration safety and quality improvement. Student written comments, ATI NCLEX-RN predictor scores and analysis of NCLEX-RN results (if available) will be shared during the presentation.

“Developing Safety Huddles to Meet Organizational Needs”

Presented by: Brett Shipley MSN, RN & Ann Steffe MSN, RN, PCCN

Summary: As part of a strategic planning process an opportunity was identified to implement a systematic process for conducting daily safety huddles with an organizational focus. An inter-professional performance improvement team was formed to create a format for daily leadership safety huddles using the Plan Do Check Act Evaluate process. Key stake holders were identified and the voice of the customer was utilized as key inputs into the planning process. Evidence and best practices were reviewed along with the stake holder requirements and a unique safety huddle process was formalized. A formal agenda, department reporting template, scope and severity grid, and process for publishing

huddle notes were developed to guide the process. Practice huddles and one-to-one leadership preparation were utilized to develop buy-in and increase support. Using these techniques and formal documents allowed for successful implementation. The positive organizational changes that have occurred due to the huddles has created a culture that seeks to grow and refine our processes to improve the Culture of Safety.

“A Perfect Storm for Compromised Safety: Compassion Fatigue, Incivility, and Mandatory Overtime”

Presented by: Elizabeth Bonham, PhD, RN, PMHCNS-BC

Summary: This presentation will define compassion fatigue, incivility and mandatory overtime. Using case studies, the presenter will demonstrate how the combination of the three phenomena create a culture of danger for both patients and nurses. Becoming mindful and reflective of how these incidents play out is key to changing a dangerous environment into an environment that is safe, harmonious, and satisfying. Recommendations for personal and system transformation that include change strategies and plans of action nurses can develop will be discussed.

“Improving Patient Safety through the Initiation of a Massive Transfusion Protocol in the Obstetric Hemorrhage Patient”

Presented by: Brittany Waggoner MSN, RN, CNS

Summary: This presentation will give people the tools to use when developing a massive transfusion protocol. It will discuss how implementation was imbedded within a postpartum hemorrhage protocol. This work has successfully reduced blood product administration and has improved patient safety.

“The Role of Perioperative Services in the Prevention of Hospital Acquired Infections”

Presented by: Francesca Levitt, MSN, RN-BC, ACNS-BC

Summary: Specific hospital acquired infections (CLABSI and CAUTI) are identified and attributed to the inpatient units where patients are located when the infection is called. If a patient has had a surgical procedure requiring the insertion of a central venous catheter and/or a urinary catheter intraoperatively, what role does the perioperative team play in the prevention of CLABSIs and CAUTIs? By focusing on the specific components of clinical care related to the insertion, care and maintenance of these devices in the perioperative setting, essential components can be identified and solved for to assure safety for hospitalized patients.

“Enhanced Recovery After Surgery: A New Era of Patient Care”

Presented by: Heather Hohenberger, MSN, RNSummary: As the focus of health care

reimbursement shifts from quantity to quality, health care professionals are looking for ways to improve patient care in the value-driven environment. Implementing evidence-based guidelines as standards of care can positively affect numerous patient outcomes, including reductions in surgical site infections, length of stay, readmissions, and complications. The Enhanced Recovery After Surgery (ERAS) Society has developed an innovative set of guidelines for proactive surgical patient care management. The purpose of this presentation is to educate nurses on the elements of ERAS and the impact nurses have on patient compliance.

“Law & Order for Nurses to Promote Patient Safety”

Presented by: Lorie Brown, RN, MN, JD

Summary: The purpose of this presentation is to provide nurses with a tool to help them protect their most valuable asset: their license. When this tool is used, patient care and safety is also improved. I have represented over 300 nurses before the Licensing Board. Most nurses said they never thought they would have an issue with their license. They did not know the laws that they were required to follow. I looked at all the nurses I have represented and found commonalities. I developed a tool called “GIFTS.” The acronym “GIFTS” stands for giving, integrity, focus and follow through, trust and source. When nurses use their “GIFTS” they can protect their license and their patients. They can positively speak their mind and improve patient care and safety. During my highly interactive presentation, I will share case studies to exemplify the “GIFTS.”

Summaries of Poster Presentations:

“The Customer Survey Experience and HCAHPS”

Created by: Brian A. Arwood, RNSummary: This project was undertaken as a

response to the growing emphasis of customer satisfaction surveys and the survey experience in hospitals. Identifying common themes between communication, customer service, and nursing this project aims to establish a theoretical basis for navigating the customer service experience with hospitalization and medical care. Utilizing research from communication arts, the restaurant and service industry, grounding in therapeutic communication and psychiatric nursing, and psychology this project aims to develop a training program for nurses to help emphasize and enhance the aspects of customer service that are already in place while providing exemplary care to our patients. As the emphasis on the survey experience during hospitalization grows in light of compensatory mechanisms building these interpersonal skills into our nurse force could be a vital component to our success and importance as a profession moving forward.

“Confronting Conformity to Improve Client Safety”

Created by: Karen Hernes, MSN, RN, CNE & Vivian E. Ott, PhD, RN, NE-BC

Summary: The need for effective communication persists in healthcare, including nursing. Several authors demonstrated the relationship between a culture of ineffective communication and diminished client safety and other negative health outcomes (Polit, 2015; Maxfield, Grenny, McMillan, Patterson & Switzler, 2005; Leonard, Graham, & Bonacum,

Poster Presentations continued on page 9


Catch Me If You CanDiversion in the Workplace

Friday, August 26, 2016Faith Church | 9125 N. College Ave | Indianapolis, IN

Recommended For: Nurses, Physicians, Therapists, Social Workers, Employee Assistance Program, Worksite Monitors, Persons in Recovery. All Proceeds Benefit the ISNAP Needs Assistance Fund.

Program Description

“Catch Me If You Can” – Rodrigo Garcia, MSN, CRNA, MBA, Executive Program Director of Parkdale will discuss diversion from the work-place along with his personal experience working within the healthcare setting while dependent on prescription medications. As an anesthesia pro-vider, Rigo was exposed to some of the world’s most potent medications. He will conclude his presentation with proposed solutions, the future of addiction and heath care providers, and offer hope and affirmation.

“Recovering and Recovery” – Four former ISNAP participants will share their stories of how they did or did not get caught, their ISNAP experience, and what their lives are like now in recovery.

“Diversion: Prevention and Detection” - A panel of experts, include a pharmacist, security officer, CNO, and work supervisor, will share systems that their facilities have in place to prevent, and at the very least, to detect diversion in the workplace.

“Detecting Drugs of Abuse in the Workplace and Drug Screening” – Barry Lubin, M.D., FASAM, MRO, ASAM, Medical Director and RMO for Affinity eHealth, will discuss the metabolism and detection of commonly abused drugs, including alcohol, in the workplace. This will include how to conduct drug testing in the workplace, proper chain-of-custody, and the different types of urine, blood and hair testing.

“Current Trends in Drugs of Abuse” – Cindy Costello, Witham Toxicology Labs, will share the current trends in the drugs being used/abused in ISNAP, Indiana Schools, the Criminal Justice System, and other public sectors.

Friday, August 26, 2016(Note: Agenda May Change Without Notice.

All times EDT)8:00 a.m. Registration/Exhibit Hall

8:30 a.m. Welcome Gingy Harshey-Meade, CEO Indiana State Nurses Association

8:35 a.m. “Catch Me If You Can” Rodrigo Garcia, MSN,CRNA, MBA

10:10 a.m. Break and Exhibitors

10:30 a.m. “Recovering and Recovery” Panel of Recovering Nurses

11:45 a.m. Lunch and Exhibitors

12:45 p.m. “Diversion: Prevention and Detection” Panel of Workplace Experts

2:30 p.m. Break and Exhibitors

2:45 p.m. “Detecting Drugs of Abuse in the Workplace and Drug Screening” Barry Lubin, MD, FASAM, MRO Affinity e-Health, ASAM

3:45 p.m. “Current Trends in Drug of Abuse” Cindy Costello, Sales & Marketing Witham Toxicology Laboratory

4:15 pm. Closing Remarks and Evaluations

This activity has been submitted to the Ohio Nurses Association and ICADA for approval to award contact hours. The Ohio Nurses Associa-tion (OBN-OO1-91) is an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

Criteria for successful completion equals attendance for at least 80% of the continuing education activity and completion of an evaluation form.

Please call Blayne at 317-299-4575 for more information about contact hours.

Mail or FAX to:Indiana State Nurses Association

2915 North High School RoadIndianapolis, IN 46224

FAX 317-297-3525

ONLINE REGISTRATIONwww.IndianaNurses.org

For more information, contact Chuck Lindquist,ISNAP Program Director, 1-800-638-6623

or 317-295-9862 at ext. 1.

ISNAP Needs Assistance FundThis fund helps nurses who meet the criteria pay for their required screenings to stay in the Nurses Assistance Program. Screenings

can be very costly, especially for those nurses who are not currently working as nurses. The proceeds from this conference will go to

support nurses in their time of need.

For more information, contact Chuck Lindquist, ISNAP Program Director, 1-800-638-6623 or 317-295-9862 at ext. 1.


Reference Proposal

EXECUTIVE SUMMARY: Nurse Family Partnership, a home visiting nursing program with over 37 years of research data, utilizes registered nurses to improve the outcomes of first-time, low-income mothers. While Nurse Family Partnership is available in some counties within Indiana, there is a need to expand this program state-wide. It is proposed that registered nurses throughout the state actively advocate for the expansion of Nurse Family Partnerships for all mothers in Indiana through legislative, policy, and fiscal actions.

RECOMMENDATIONS:

WHEREAS… First-time, low-income expectant mothers encounter challenges and stressors related to conditions of poverty and un-met educational needs and

WHEREAS… Nurse Family Partnership is an evidence-based, home visiting nurse program utilizing registered nurses with over 37 years of research supporting its model with proven positive effects on child mortality, child vitality, and maternal self-sufficiency and

WHEREAS… Yearly, approximately 44% (39,000) of Indiana births are to mothers receiving Medicaid; and

WHEREAS…registered nurses are at the core of the Nurse Family Partnership model and play a vital role in impacting the lives of new mothers and babies through improved health and social outcomes

therefore it be RESOLVED, that the Indiana State Nurses Association

1. Advocate for the implementation of Nurse Family Partnerships across the state with availability to every first-time, low-income mother.

REPORT: Previous legislation passed in the form of the Patient Protection and Affordable Care Act (H.R. 3590) by President Obama in 2010 provided federal funding for home visiting nurse programs such as Nurse Family Partnership. Bi-partisan support of Nurse Family Partnership has been shown on various state levels due to the positive impact proven through the

SUBJECT: Nurse Family Partnership

INTRODUCED BY: Carrie Shahbahrami, RN, BSN

CONTACT PERSON:Carrie Shahbahrami, RN, BSN PHONE: 812.345.3435

Public Health Nurse EMAIL: [email protected]

implementation and data aggregated by existing programs. Currently there are five counties within Indiana being served by a Nurse Family Partnership agency. By focusing efforts to advocate for Nurse Family Partnerships across the State of Indiana, the ISNA is endorsing the use of registered nurses in creating a positive change in the lives of first-time, low-income mothers. This policy platform proposal is applicable to Provision 8 in the American Nurses Association Code of Ethics which reads “The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs.”

IMPLEMENTATION ACTIVITIES:

The ISNA may indicate to policy makers its advocacy of Nurse Family Partnership and the demonstrated need across the State of Indiana.

The ISNA can educate registered nurses in Indiana of the Nurse Family Partnership model and its existence to increase awareness and advocacy for the expansion of programming. [Suggested implementation activities are examples of how an action “might” be implemented. Care must be taken to focus the “resolved statements” on providing guidance and/or direction to ISNA without getting specific as to suggested implementation strategies.]

References:Kaiser Family Foundation. (2016). Births Financed

by Medicaid | The Henry J. Kaiser Family Foundation. Retrieved from http://kff.org/medicaid/state-indicator/births-financed-by-medicaid/?state=IN

Kids Count Data Center. (2016). Births to mothers on Medicaid | KIDS COUNT Data Center. Retrieved from http://datacenter.kidscount.org/data/tables/8972-births-to-mothers-on-medicaid?loc=16&loct=2#detailed/2/any/false/869,36,868/any/17919

Nurse Family Partnership. (2014, September). Nurse Family Partnership Overview. Retrieved from http://www.nursefamilypartnership.org/assets/PDF/Fact-sheets/NFP_Overview.aspx

Note: Implementation activities are determined by the ISNA Boardof Directors in keeping with its corporate and fiduciary authority.

Rule 1.To be admitted to the meeting room, the

individual must be wearing the registration badge.

Rule 2.To obtain the floor, a member shall rise,

approach the microphone, address the chairperson, give his/her name and region and, upon recognition by the chairperson, may speak.

Rule 3.A member may speak no more than two times

to the same question and may not speak the second time until all others have been given an opportunity to speak. Each speech may be no longer than three minutes. Non-members may speak when ISNA members has had the opportunity to speak.

Rule 4.All main motions and amendments, except

those of a routine nature, shall be in writing, signed by the maker, and shall be sent at once to the chair. Members may propose or vote on motions.

Proposed Standing Rules for the ISNA Meeting of the Members

Rule 5.Any substantive resolution, not of an

emergency nature, must receive an affirmative 3/4 vote for consideration and a 2/3 vote for adoption by the members attending the meeting.

Rule 6.Debate on each proposed resolution, motion,

or position statement shall be limited to 20 minutes.

Rule 7.Members shall act only on the resolve portion

of a resolution and the recommendation portion of reports. Clarification regarding intent and meaning of the resolution and recommendation shall be handled according to parliamentary procedure.

Rule 8.Business interrupted by a recess of the

meeting shall be resumed at the next business meeting at the point where it was interrupted.

Action Items from Meeting of the MembersSeptember 27, 2012

2004). We suggest that the culture of conformity envelopes all necessary elements of psychological safety and can therefore augment or diminish the nurse’s ability to engage in effective communication. We propose that nurses use the culture of conformity to enhance client safety. While we know that nurses are obliged by our code of ethics to speak up or advocate on behalf of our clients (ANA, 2015), years of learning the art of effective communication have not made health care less risky to the clients served. A new intervention is necessary to maintain client safety.

“Giving Voice to Nurse and Patient Safety through Conscientious Objection”

Created by: Rachel Ramsey, MS, RN, CNESummary: There is no doubt that nurses today

are caring for multifarious and complicated patients in increasingly complex environments and with limited resources. Under these pressures, nurses with limited experience are assigned increasingly difficult tasks and responsibilities, while seasoned nurses are expected to manage the most complex assignments and duties; all while working more, working longer, and working harder.

These circumstances are threats to patient and nurse safety and put unfair, unethical pressures on nurses to “do more with less.” While there is no simple solution to these problems, there is one thing all nurses can do to promote safety: Speak up. Nurses have the ethical right and duty to voice their objections to working in situations or under conditions that put themselves and their patients at risk.

“Toolbox to Diminish Lateral Violence” Created by: Shannon Moore, RN, MSN & Sara

Germann, RN, MS, ANPSummary: A brief overview of lateral violence

in the healthcare setting will be provided. In addition to common characteristics of this concept, tools to combat the behavior will be presented. Attendees will be provided information applicable to their individual healthcare setting with the intent of limiting the prevalence of occurrence.

How will this presentation help attendees achieve a culture of safety? Attendees are currently aware of the presence lateral violence and its implications in the healthcare setting. This presentation will provide information regarding how to approach and decrease lateral violence among healthcare personnel. As a result of this presentation attendees will increase their awareness of lateral violence and have the tools necessary to move towards eliminating the behavior.

Poster Presentations continued from page 7


Indiana State Nurses Association Bylawsas amended September 28, 2012

ARTICLE I NAME, PURPOSES, AND FUNCTIONS

SECTION 1. NAMEThe name of this corporation shall be the

Indiana State Nurses Association, Inc., hereinafter also referred to as Corporation, Association, or ISNA.

SECTION 2. PURPOSESa) The purposes of the ISNA shall be to:

(1) Foster high standards of nursing, and(2) Promote the professional and educational

development of nurses and advance their welfare, and

(3) Work for the improvement of health standards and the availability of health care services for all people.

b) These purposes shall be unrestricted by consideration of age, color, creed, disability, gender, health status, lifestyle, nationality, race, religion, sexual orientation, or any other consideration in accordance with the Bylaws of the American Nurses Association, hereinafter also referred to as ANA.

SECTION 3. FUNCTIONSThe functions of the ISNA shall be:

a) To promote through appropriate means standards of nursing practice, nursing education, and nursing services as defined by the ANA.

b) To insure adherence to the Code of Ethics for Nurses established by the ANA.

c) To promote legislation and to speak for nurses in regard to legislative action.

d) To promote the welfare of nurses.e) To encourage and promote research designed to

enlarge the knowledge on which the practice of nursing is based.

f) To provide and promote continuing professional development of nurses.

g) To represent nurses and serve as their state spokesperson with allied professional, community and governmental groups, and with the public.

h) To provide for representation in the ANA Membership Assembly.

i) To promote relationships with nursing students.j) To promote the general health and welfare

of the public through association programs, relationships, and activities.

ARTICLE II CHAPTERS

SECTION 1. A chapter may be proposed by a minimum of ten (10) members to improve networking, professional practice, and development within a specific clinical, functional, or geographic area according to the policies and procedures of the Board of Directors. An ISNA member may join any chapter according to ISNA policies.

SECTION 2. Chapter leadership structure shall be determined by each chapter. The Chapter shall select a spokesperson to serve as a liaison to the ISNA Board of Directors.

SECTION 3. An ISNA Individual Affiliate or a representative from an Organizational Affiliate may participate in a chapter based on ISNA policies.

SECTION 4. The chapters shall have the opportunity to make recommendations to the Board of Directors and to the members at the annual meeting of the membership.

SECTION 5. Funding for chapter activities will be available according to ISNA policies

ARTICLE III MEMBERSHIP

SECTION 1. Members of the ISNA shall be those persons accepted in accordance with qualifications and other requirements described in the ISNA Bylaws, unrestricted by consideration of age, color, creed, disability, gender, health status, lifestyle, nationality, race, religion, sexual orientation, or any other consideration in accordance with the Bylaws of the ANA.

SECTION 2. QUALIFICATIONSa) An ISNA/ANA member is one:

(1) Who has been granted a license to practice as a registered nurse in at least one state,

territory, or the District of Columbia of the United States and who does not have a license under revocation in any of the foregoing areas, or

(2) Whose license is suspended or surrendered and can document, according to policies and procedures, a program of recovery from chemical dependency, or

(3) A nurse who has retired and/or no longer chooses to practice, but whose license was in good standing with the Board of Nursing at the time the nurse made the decision not to maintain an active license, and

(4) Whose dues are not delinquent, and(5) Whose membership is not under revocation

for violation of the Code of Ethics for Nurses or the Bylaws of the ANA or its constituent/state nurses associations (C/SNA).

b) An ISNA State-Only member is one:(1) Who has been granted a license to practice

as a registered nurse in at least one state, territory, or the District of Columbia of the United States and who does not have a license under revocation in any of the foregoing areas, or

(2) Whose license is suspended or surrendered and can document, according to policies and procedures, a program of recovery from chemical dependency, or

(3) A nurse who has retired and/or no longer chooses to practice, but whose license was in good standing with the Board of Nursing at the time the nurse made the decision not to maintain an active license,

(4) Whose dues are not delinquent, and(5) Whose membership is not under revocation

for violation of the Code of Ethics for Nurses or the Bylaws of the ANA or its constituent/state nurses associations.

SECTION 3. PRIVILEGESa) Privileges for ISNA/ANA Members are as

follows:(1) voting for ISNA officers, directors,

nominating committee, and representatives and alternates to the ANA Membership Assembly;

(2) serving in any ISNA and ANA office if elected or ISNA or ANA appointed position if so qualified and selected;

(3) attending and participating in meetings, and unrestricted activities of ISNA and ANA;

(4) receiving regular ISNA/ANA communications;

(5) receiving an ISNA/ANA membership card;(6) receiving all member discounts on ISNA

and ANA events;(7) receiving access to Members Only page on

ISNA’s and ANA’s web sites.b) Privileges for ISNA State-Only Members:

(1) voting for ISNA officers (except ISNA President, Vice-President or Treasurer, and representatives to the ANA Membership Assembly, directors, and nominating committee;

(2) serving in any ISNA elected (except ISNA President, Vice-President or Treasurer, and representatives to the ANA Membership Assembly or ISNA appointed position if so qualified and selected;

(3) attending and participating in meetings and unrestricted activities of ISNA;

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(4) receiving regular ISNA communications;(5) receiving an ISNA membership card;(6) receiving all member discounts on ISNA

events;(7) receiving access to Members Only page on

ISNA’s web site.

SECTION 4. DISCIPLINARY ACTIONa) A member shall be subject to censure or

expulsion by the ISNA or ANA for violations of The Code of Ethics for Nurses as established by the ANA; for violation of the ISNA or ANA Bylaws; or other actions which are detrimental to the purposes, goals, and functions of the ANA or the ISNA. No such action shall be taken against a member until such member shall have been served with written specific charges, given a reasonable time to prepare any defense, and afforded a full and fair hearing pursuant to common parliamentary and statutory laws.

b) Disciplinary action, appeal, and reinstatement shall be conducted in accordance with the policies and procedures of the ISNA or ANA.

c) Any disciplinary action taken by any other constituent/state nurses association against one of its members or against a member of ISNA shall be given full recognition and enforcement provided that such action was taken in accordance with that state nurses’ association’s bylaws and disciplinary procedures.

d) Members expelled under provisions of this section and who are subsequently reinstated shall be automatically reinstated by the ISNA.

e) Any disciplinary action taken by any other constituent/state nurses association against one of its members or against a member of ISNA shall be given full recognition and enforcement provided that such action was taken in accordance with that state nurses’ association’s bylaws and disciplinary procedures.

SECTION 5. DUESa) The annual dues for a member of ISNA may

be recommended by the Board of Directors. A change in the amount of dues shall be determined by a majority vote of all members in good standing and in attendance at the annual Meeting of the Members or special meeting of the membership provided reasonable notice of the intent to take such a vote shall have been given. The vote will be by secret ballot.

b) ISNA/ANA dues shall include the assessment paid by the association to the ANA, in accordance with the policies adopted by the ANA. Any change in the ANA Assessment will automatically be passed through to the members.

c) ISNA State-Only member dues shall include the ISNA state amount plus the amount identified in the agreement with ANA for the state only, individual membership option.

d) The forfeiture of all membership rights shall

occur if dues are not paid as required by current policy.

e) No additional dues, fees, or assessments will be required to participate in a chapter.

f) Members who qualify for one of the following categories may elect to pay fifty percent (50%) of the full annual dues:(1) nurses who are not employed;(2) registered nurse students in full-time

study;g) Members who are permanently disabled or

sixty-two (62) years of age or older who are not employed may elect to pay twenty-five percent (25%) of the annual dues.

h) The Board of Directors may approve a variance in dues for special membership projects. Each project shall not exceed two years in length.

SECTION 6. CHANGE OF DUES CATEGORYNo monies shall be refunded nor additional monies collected when a change in dues category is made within a membership year.

SECTION 7. DISAFFILIATION FROM ANAISNA shall continue to pay the assessment to the ANA pursuant to policy and/or the ANA bylaws until such time as 2/3 (two thirds) of the ISNA/ANA members vote to disaffiliate from the ANA.

SECTION 8. TRANSFERSa) Members of the ISNA who have completed full

payment of dues shall be transferred to another state association that is a constituent of the ANA, upon written request giving cause. ISNA will not refund individual dues already paid

to the member nor to the receiving constituent/state nurses association.

b) Members of another constituent of the ANA who have requested a transfer of membership to the ISNA may be accepted for the remaining portion of the membership year for which the ANA assessment has been paid, without further payment of dues to the ISNA. Any charge of additional fees for services to transferred members shall not interfere with the rights of members as defined in these bylaws.

ARTICLE IV AFFILIATES

SECTION 1. ORGANIZATIONAL AFFILIATESa) An organizational affiliate is an organization

which is not a member but(1) Has Articles of Incorporation that govern

its members and regulate its affairs.(2) Has stated purposes and functions

harmonious with those of the ISNA.(3) Has a governing body composed of a

majority of registered nurses.(4) Has paid a fee as established by the Board

of Directors.b) Organizational affiliates shall have privileges

as granted by the ISNA Board of Directors.

SECTION 2. INDIVIDUAL AFFILIATEa) An individual affiliate is a person who is not a

member but who:(1) Elects to join ISNA in accordance with the

provisions of this section, and

Bylaws continued on page 12

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(2) Pays the fee established by the ISNA Board of Directors, and

(3) Whose views are congruent with ISNA.b) Individual affiliates shall have privileges as

granted by the ISNA Board of Directors.

ARTICLE V OFFICERS AND THEIR DUTIES

SECTION 1.a) The officers of the ISNA shall be a President, a

Vice-President, a Secretary, and a Treasurer.b) The President, Vice-President, and Treasurer

must be ISNA/ANA members. The Secretary may be an ISNA State-Only member.

SECTION 2. Vacancies in office shall be filled as provided in Article VI, Section 6.j.

SECTION 3. The President shall:a) Preside at meetings of the:

(1) Board of Directors,(2) Board Executive Committee,(3) Annual Meeting of the Members.

b) Appoint, with the approval of the Board of Directors, a Parliamentarian who shall be a non-member of this Association.

c) Serve as an elected representative to the ANA Membership Assembly.

d) Perform all other duties pertaining to the office.

SECTION 4. In the event a vacancy occurs in the office of President, the Vice-President shall assume such office for the unexpired term and/or until a successor is elected.

SECTION 6. The Secretary shall:a) Be responsible for and cause the proper

recording of minutes of the:(1) Board of Directors,(2) Board Executive Committee,(3) Annual Meeting of the Members.

b) Be the official custodian of all fiscal records and the corporate seal of the ISNA.

c) Send to the secretary of the ANA the name and address of the President immediately after election.

d) Send to the headquarters office of the ANA a complete copy of all amendments or a revision of the Bylaws of the ISNA within one month after adopting and after printing send copies of Articles of Incorporation and Bylaws.

e) Authenticate corporation minutes and documents.

SECTION 7. The Treasurer shall be responsible for:a) The proper receipt, deposit, disbursement, and

withdrawal of funds of the ISNA.b) The proper care of its fiscal records.

c) Reporting the financial standing of the ISNA to the Board of Directors and to the annual Meeting of the Members.

SECTION 8. The Executive Director shall assume such duties in connection with the work of the Secretary and Treasurer as shall be designated by the Board of Directors.

SECTION 9. All officers shall, within two (2) weeks upon resignation or expiration of their terms of office, surrender all property of the ISNA in their possession to their successors or to the Headquarters office.

ARTICLE VI BOARD OF DIRECTORS

SECTION 1. Members of the Board of Directors shall be four (4) officers and five (5) directors. No member shall serve more than eight (8) consecutive years on the Board of Directors.

SECTION 2.a) The five (5) directors shall be elected for a term

of two (2) years and no director shall serve more than four (4) consecutive terms.

b) One seat shall be designated for a recent graduate of an RN licensure program.

c) One who has served more than one-half of a term shall be credited with having served that term.

PROVISO: This shall become effective for the 2013 elections of directors. Directors elected in 2011 shall complete the four-year term (2011-2015) they were elected to.

SECTION 3. The Board of Directors of the ISNA shall exercise all powers of the Association not reserved in the Bylaws to the officers.

SECTION 4. The Board of Directors shall meet at least annually and at such other times as shall be determined by the President or by the Board. Absence from three (3) meetings within one calendar year without good cause as determined by the Board of Directors shall constitute a resignation, and the vacancy shall be filled as provided for in these Bylaws.

SECTION 5. Special meetings of the Board of Directors may be called by the President or by a majority of the members of the Board.

SECTION 6. The Board of Directors shall:a) Transact the business of the Association in

the interim between annual Meetings of the Members.

b) Establish major administrative policies governing the affairs of the Association and

devise and coordinate measures for the growth and development of the Association.

c) Provide for:(1) The maintenance of the Headquarters

office.(2) An office, making it the center of activities

of the Association.(3) The care of materials, equipment, and

funds of the Association.(4) The payment of legitimate expenses.

d) Assume responsibility for disciplinary action and rights of members as specified in these Bylaws.

e) Appoint, define the duties, and set compensation for the chief staff officer.

f) Determine what officers and other persons shall be bonded, fix the amount of bond for each, and approve the same.

g) Provide for the auditing of all books of account at least annually by a certified public accountant.

h) Create special committees and task forces as the need arises to perform specific functions.

i) Appoint the Chairperson and members for all appointments not otherwise provided for in these bylaws.

j) Fill vacancies on the Committee on Nominations and on the Board of Directors, except for a vacancy occurring in the office of President.

k) Assign such other activities to the committees as is deemed necessary.

l) Decide upon:(1) Registration fees, date, and place of the

annual Meeting of the Members.(2) Time and place of meetings of the Board of

Directors.m) Adopt criteria for selection of representatives

of the profession to be submitted to the appropriate State authorities for consideration in making appointments to the Indiana State Board of Nursing and other State agencies, and name the representatives to be submitted.

n) Approve the minutes of the annual Meeting of the Members.

o) Adopt an annual budget.p) Report to annual Meetings of the Members.q) Approve establishment or dissolution of

chapters.

SECTION 7. There shall be an Executive Committee of the Board of Directors composed of the four (4) elected officers. This committee shall have all the powers of the Board to transact business of an emergency nature between Board meetings. All transactions of this committee shall be reported to the Board at its next meeting.

SECTION 8. Any action required or permitted to be taken at any meeting of the Board of Directors or of any committee thereof may be taken without

Bylaws continued from page 11

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a meeting, if prior to such action a written consent to such action is signed by eighty percent (80%) of the board or committee members, as the case may be, and such written consent is filed with the minutes or proceedings of the board or committee.

SECTION 9. Any meeting of the Board of Directors or of a committee or task force designated by the Board may be conducted by means of a conference telephone or similar communication equipment by which all persons participating in the meeting can communicate with each other, and participation in this manner constitutes presence in person at the meeting.

ARTICLE VII ELECTIONS

SECTION 1. Members who seek nomination and election to office must maintain current ISNA membership without a lapse throughout the nomination, election, and term of office.

SECTION 2. Elections will be held in the odd-numbered calendar years, and the term of office shall commence at the adjournment of the annual Meeting of the Members at which their election is announced.

SECTION 3. Five (5) Directors shall be elected to serve for two (2) years.

SECTION 4. Five (5) members of the Committee on Nominations shall be elected in the odd-numbered calendar years to serve for two (2) years.

SECTION 5. A member shall be considered eligible for only one office in ISNA elected by the entire membership at any one time. This does not apply to representatives to the ANA Membership Assembly.

SECTION 6. The ISNA shall have elected representatives and alternates to the ANA Membership Assembly who shall be elected by the official ballot of the ISNA.a) One representative to ANA shall be the

President, andb) The alternate for the President shall be the

Vice-President.c) The second representative shall be elected

according to ISNA policy.d) Additional alternates shall be elected

according to the number of votes received.e) Election of the representatives and alternates

shall be in agreement with ANA Bylaws and policies.

f) Each representatives and alternate shall be elected for a two-year term or until a successor is elected.

g) ISNA State-Only members are not eligible to elect or be elected as representatives or alternates to the ANA Membership Assembly.

h) Representatives and alternates to the ANA Membership Assembly may serve no more than eight (8) consecutive years.

SECTION 7. Elections shall be carried out by secret ballot (mail or electronic) of the members. State-Only members will receive a separate ballot than that of ISNA/ANA members.

SECTION 8. The ballots shall be tabulated in accord with policies and procedures as determined by the Board of Directors.

SECTION 9.a) A plurality majority vote of members voting

shall constitute an election for officers. If there is not a majority vote for an officer, a run-off election shall be held according to ISNA Policy and Procedures.

b) A plurality vote of members voting shall constitute an election for Directors and Committee on Nominations. The nominees for Directors and for the Committee on Nominations receiving the highest number of votes shall be declared elected.

c) The nominees for the second representative to the ANA Membership Assembly who receives the highest number of votes shall be declared elected and the nominees who receive the next highest number of votes shall serve as alternates.

SECTION 10. In case of a tie, the choice shall be decided by lot.

SECTION 11. All ballots, credentials of the voting body, and other records of the election shall be preserved for a minimum of one year.

ARTICLE VIII STANDING COMMITTEES

SECTION 1. Standing committees shall consist of no fewer than three (3) members appointed by the Board of Directors, unless otherwise specified by these Bylaws, to serve for two (2) years or until their successors are appointed/elected. Standing committees appointed by the Board of Directors shall be accountable to the Board of Directors and shall submit biennial reports to the membership.

SECTION 2. The absence without good cause from two (2) meetings of a committee shall constitute a resignation, and the vacancy shall be filled by the Board.

SECTION 3. There shall be Standing Committees on:a) Bylaws.b) Nominations.

SECTION 4. RESPONSIBILITIES OF COMMITTEESa) The Committee on Bylaws shall:

(1) Have in its membership one member of the Board.

(2) Review the Bylaws of the ISNA and recommend corrections or amendments in order to keep them consistent with accepted organization practices and in harmony with the Association’s program and activities.

(3) Draft or approve the proposed text of all amendments to the bylaws prior to their submission to the annual Meeting of the Members.

(4) Consider other matters referred to it and report its findings and recommendations as appropriate.

b) The Committee on Nominations shall:(1) Consist of five (5) members elected by

members of the ISNA. The chairperson shall be the member receiving the highest number of votes. No member shall serve more than four consecutive years.

(2) Prepare a list of candidates for each position to be filled by election--officers, directors, members of the Committee on Nominations, and ANA representative and alternates, using procedures established by the Board of Directors.

(3) Place on the ballot only those who have submitted their qualifications and written consent to serve if elected.

(4) Submit its final report to the Executive Director at least three months prior to the opening day of the annual Meeting of the Members.

ARTICLE IX ASSOCIATION MEETINGS

SECTION 1. The ISNA shall hold an annual Meeting of the Members in good standing, at such time and place as shall be designated by the Board of Directors and announced in the official publication of the ISNA.

SECTION 2. ANNUAL MEETINGa) The annual meeting shall be composed of

members present.b) Members shall:

(1) Establish the order of business at the beginning of the annual meeting.

(2) Adopt and maintain the Bylaws of the ISNA.

Bylaws continued on page 14


(3) Take positions, determine policy, and set direction on substantive issues of a broad nature necessitating the authority and backing of the official voting body of the ISNA except as otherwise provided for in these Bylaws.

(4) Take action on Association business as required by law or these Bylaws.

(5) Transact all other lawful business as may be in order.

SECTION 3. Special meetings of the ISNA may be called by the Board of Directors, and they shall be called by the President upon the written request of a majority of the chapters at least one month prior to the special meeting.

ARTICLE X HONORARY RECOGNITION

SECTION 1. Honorary recognition may be conferred by a unanimous vote of the ISNA Board of Directors on a nurse or a person who is not a nurse who has rendered distinguished service or valuable assistance to the nursing profession.

SECTION 2. Any ISNA member or structural unit may recommend to the ISNA Board of Directors the name(s) of any individual(s) deserving recognition. The recognition shall be conferred at an annual Meeting of the Members at a time and place selected by the Board of Directors.

SECTION 3. Honorary Recognition confers social privileges only. One may be a member and also hold Honorary Recognition.

ARTICLE XI QUORUMS

SECTION 1. A majority of the Board of Directors, one of whom shall be the President or the Vice-President, shall constitute a quorum at any meeting of the Board.

SECTION 2. A majority of the members shall constitute a quorum for all committees.

SECTION 3. Five (5) members of the Board of Directors, one of whom shall be the President or the Vice-President, and three (3) percent of the current membership shall constitute a quorum for the transaction of business at any annual or special meeting.

ARTICLE XII FISCAL YEAR

The fiscal year of the ISNA shall be January 1 through December 31.

ARTICLE XII OFFICIAL PUBLICATIONS

The American Nurse, The Indiana Nurse, and the ISNA Bulletin shall be the official publications of the Association.

ARTICLE XIV PARLIAMENTARY AUTHORITY

The rules contained in the most current edition of Robert’s Rules of Order Newly Revised shall govern the ISNA in all cases to which they are applicable and in which they are not inconsistent with these Bylaws.

ARTICLE XV AMENDMENTS

SECTION 1. These Bylaws may be amended at any annual or special meeting of the ISNA by a two-thirds vote, provided notice shall have been sent to all members at least thirty (30) days prior to the annual or special meeting.

SECTION 2. These Bylaws except for Purposes, Functions, and Dues may be amended by the ISNA Board of Directors by a two-thirds vote, provided notice shall has been sent to all members at least sixty (60) days prior to the board meeting.

SECTION 3. These Bylaws may be amended without previous notice at an annual or special meeting by a ninety-nine percent (99%) vote of those present.

Bylaws continued from page 13

American Nurses Association

Faith M. Jones, MSN, RN, NEA-BC, Director-at-Large; Jesse M. L. Kennedy, BSN, RN, Director-At-Large, Recent Graduate; Patricia Travis, PhD, RN, CCRP, Secretary; Ernest J. Grant, PhD, RN, FAAN, Vice President; Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, President; Gingy Harshey-Meade, MSN, RN, CAE, NEA-BC, Treasurer; Gayle Peterson, RN-BC, Director-At-Large, Staff Nurse; Tonisha J. Melvin, MS, CPRN, NP-C, Director-At-Large; Elizabeth Fildes, EdD, RN, CNE, CARN-AP,

APHN-BC, Director-At-Large

ANA Board of Directors

WASHINGTON, DC – In the wake of the Orlando, FL, massacre, the American Nurses Association (ANA) issued a declaration today calling for sensible gun control measures, including one that lifts a ban on the Centers for Disease Control and Prevention from studying gun violence. ANA held its annual Membership Assembly this week in Washington, DC. ANA is the premiere professional association representing the interests of the nation’s 3.6 million registered nurses (RNs).

“Now is the time to enact meaningful gun control legislation at the state and federal level to protect society,” said ANA President Pamela F.

Cipriano, PhD, RN, NEA-BC, FAAN. “We all must join with other members of our community and at every level of civil society in dialogue and action to address the underlying issues that result in hate and motivate unspeakable acts of violence.”

The declaration follows ANA’s Lobby Day on June 23, when almost 300 nurses from across the country went to Capitol Hill to share their perspectives and concerns about key nursing and health care issues, including safe nurse staffing, access to home health care, and gun violence.

The declaration reads (in part):• WHEREAS,inrecentyears,ourcountryhas

endured unspeakable acts of violence with the common thread in each of these mass-casualty tragedies being easy access to guns.

• WHEREAS, the easy access to guns andinadequate access to mental health services contributes to an unsafe environment.

• WHEREAS, at an alarming rate, registerednurses and other health professionals, in emergency departments, hospitals and clinics across the country, are called upon to care for victims of mass shootings, homicides, suicides, and accidental shootings.

• WHEREAS, ANA commends the nursesand entire health care team at Orlando Regional Medical Center and the other receiving facilities for their dedication and professionalism during this tragic event.

• WHEREAS, of grave concern to ANA areall human rights violations, including hate crimes. The Code of Ethics for Nurses with Interpretive Statements calls on nurses to respect all cultures, value systems, sexual orientation or gender expression and act to change those aspects of social structures that detract from health and well-being.

• WHEREAS,since1994,ANAhasconsideredgun violence to be a public health issue with subsequent policy action calling on the need for limits on the availability of handguns, a ban on assault weapons, and a waiting period and background check of purchasers.

American Nurses Association Urges Nurses to Help Stop Gun Violence

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ISNA Welcomes Our New and Reinstated Members

Lillian Abdur-Rahman IndianapolisKristi Abriani IndianapolisNatalie Abshire IndianapolisMichelle Adwell FowlerJolynne Anderson IndianapolisCynthia Ansbro NewburghJune Arthur SeymourJoy Barnes South BendMarie Baye FerdinandAndrea Bell ShelbyvilleTeresa Benefit ValparaisoBarbara Ann Borkowski Rolling PrairieCaitlyn Byrd New SalisburyMelody Campbell MishawakaDebra Chandler BloomingtonNell Clay EvansvilleBarb Clem GoshenKori Cooper Gas CityAlison Cottrell ClintonAnna Daily LawrenceburgJan Davis West LafayetteApril Deloney Carmel

Monica Dewitt BrownsburgMartha Dinning RockportGloria Dixon BrookvilleMolly Dodt West LafayetteMarianne Duke RichmondNatalie Eddy ValparaisoLydia Ellis IndianapolisRachel Everage SellersburgAlicia Floor Fort WayneChristina Gagnon FranklinTimothy Grino BrownsburgJudith Halstead NewburghDiane Hancock NewburghAlexandra Harsha FishersKathleen Haughan AvonTiffany Hayes CorydonKatherine Hayes New CastleGeneva Heath IndianapolisDana Hento LafayetteAshley Hobbs FishersKaren Hoffman MarionKandi Horney Colfax

Cynthia Houser IndianapolisBrooke Huber ZionsvilleLois Hughes IndianapolisSomer Kantz WhitelandLisa Kennedy BrownsburgTracy Kinner EvansvilleKaren Klink IndianapolisSamuel Kobba AvonSherri Latka Saint JohnTrisha Lozier JeffersonvilleRonald Marks II IndianapolisCarolyn Masengale CarmelJo May New PalestineDeborah McCarter GreensburgTara McVay LogansportAlyson Mehringer GreenwoodJennifer Mendonca BloomingtonLaura Moffat West LafayetteMargaret Mudd Crown PointKathryn Name SheridanSusan Nelson BrownsburgJessica Nicholson BedfordDiane Paschall NewburghVanessa Phares IndianapolisLisa Pharis ManillaTracey Pruden DecaturBrooke Randol WolcottvilleLori Resler SullivanRochelle Richard PlainfieldSusette Roark SellersburgVicki Robinson Columbia CityAmy Rogers FishersPeggy Rose WestvilleJessica Rougee IndianapolisErin Rowe-Griffin ElkhartDamon Russell Floyds KnobsLeah Scalf IndianapolisJessica Schirch South BendMargaret Schwimer CarmelVeronica Sebree IndianapolisVicki Simpson LafayetteValencia Sims CarmelTina Slusher DecaturLarry Smith IndianapolisAmy Sprague IndianapolisJody Srof GoshenRenelle Stauffer BlufftonDaniel Stec MartinsvilleCarol Stoner ValparaisoMindy Stuard ElwoodJennifer Surma Clay CityEmily Tebrow CambyAmy Todd LoogooteeJohnnie Tolbert HobartAmanda Turner PrincetonLeticia Vance ColumbusKatrina Wagner GriffinConnie Walker DalevilleDerek Watson PlainfieldKristina Welchans WestpointMargaret Wickert San PierreSamantha Wilson MishawakaMegan Winegarden Fort WayneTama Withrow Noblesville

The ISNA is a Constituent Member of the American Nurses Association

APPLICATION FOR RN MEMBERSHIP in ANA / ISNAOr complete online at www.NursingWorld.org

PLEASE PRINT OR TYPE

_____________________________________________________________________________ ____________________________________Last Name, First Name, Middle Initial Name of Basic School of Nursing

______________________________________ ____________________________________ ____________________________________Street or P.O. Box Home phone number & area code Graduation Month & Year

______________________________________ ____________________________________ ____________________________________County of Residence Work phone number & area code RN License Number State

______________________________________ ____________________________________ ____________________________________City, State, Zip+4 Preferred email address Name of membership sponsor

1. SELECT PAY CATEGORY

_________ Full Dues – 100%Employed full or part time.Annual – $281Monthly (EDPP) – $23.92

_________ Reduced Dues – 50%Not employed; full-time student, or 62 years or older. Annual – $140.50Monthly (EDPP) – $12.39

_________ Special Dues – 25%62 years or older and not employed or permanently disabled. Annual – $70.25Monthly (EDPP) $6.85

2. SELECT PAYMENT TYPE

_________ FULL PAY – CHECK

_________ FULL PAY – BANKCARD

_________________________________________________________ Card Number

_________________________________________________________VISA/Master card Exp. Date

_________________________________________________________Signature for Bankcard Payment

_________ ELECTRONIC DUES PAYMENT PLAN, MONTHLY

The Electronic Dues Payment Plan (EDPP) provides for convenient monthly payment of dues through automatic monthly electronic transfer from your checking account.

To authorize this method of monthly payment of dues, please read, sign the authorization below, and enclose a check for the first month (full reduced $12.38).

This authorizes ANA to withdraw 1/12 of my annual dues and the specified service fee of $0.50 each month from my checking account. It is to be withdrawn on/after the 15th day of each month. The checking account designated and maintained is as shown on the enclosed check.

The amount to be withdrawn is $ _______________ each month. ANA is authorized to change the amount by giving me (the under-signed) thirty (30) days written notice.

To cancel the authorization, I will provide ANA written notification thirty (30) days prior to the deduction date.

_________________________________________________________________Signature for Electronic Dues Payment Plan

3. SEND COMPLETED FORM AND PAYMENT TO: Customer and Member Billing American Nurses Association P.O. Box 504345 St. Louis, MO 63150-4345

✁

GET YOUR PROFESSIONAL TOOLKIT LICENSE – BOARD OF NURSING

MEMBERSHIP – INDIANA STATE NURSES ASSOCIATION (ISNA)

ISNA IS CARING FOR YOU WHILE YOU PRACTICEWWW.INDIANANURSES.ORG

✁

With a degree from USI, you will be able to compete for select nursing jobs. Our programs focus on extensive clinical nursing experience while providing superior preparation for professional licensing / certification exams. Our award-winning faculty provide personalized attention that fosters supportive relationships with nursing students. We are currently offering the following degrees:

•BachelorofScienceinNursing •PostMSNCertificate•RNCompletion(RN-BSN) •DoctorofNursingPractice•MasterofScienceinNursing

USI promotes:•highlysoughtworkplaceskills •flexiblecoursedelivery•onlineeducation •variedclinicalexperiences

For more information about these programs, please visit our website at http://USI.edu/health

Knowledge for Life


Join ISNA Today!Application on page 15 or join online at www.indiananurses.org

With a nursing career at Parkview, you can change lives. Our mission is to improve the health and well-being of the communities we serve in northeast Indiana and northwest Ohio. We have a reputation for quality healthcare, exciting innovation and community engagement.

At Parkview, you can experience:• Collaborativecaremodelthatenhancespatients’safety,satisfactionandoutcomes• ParkviewCenterforAdvancedMedicalSimulationandtheParkviewResearchCenter• Epicelectronicmedicalrecordsystemthatprovidesasinglestoryofcareforpatients• Continuedexpansion,includinga$55millioninvestmentinParkview’scommunityhospitalinnear-centralFortWayneandtheParkviewCancerInstituteonthecampusofParkviewRegionalMedicalCenter

• MyWell-being,aninternalprogramforco-workersfocusedonthemind,body,spiritand community aspects of personal health

• Availabilityofsign-onbonusandrelocationpackages

Nursing Excellence.Innovation.Growth. www.parkview.com/employment

Learn about living and working in northeast Indiana atwww.yourstorymadehere.com.

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