Washington Nurse - Winter 2014 by WSNA

The Washington Nurse

Prescription Monitoring Program

Fighting Accidental Deaths Volume 43, No 4

Winter 2014

PeaceHealth Southwest Members Are Getting Active

A Better Hand Sanitizer Making Our Tools Better

A Publication of the Washington State Nurses Association

Prescription Monitoring Program Hand Sanitizers Finding Their Path

Finding Their Path

Volume 43, No 4 Winter 2014

MEET 5 NURSES WHO PURSUED AN INTEREST AND ENDED UP CHANGING THEIR LIVES

For nurses, it’s a standing ovation. Congratulations to our nursing staff on achieving Magnet® status. The American Nurses Credentialing Center has designated Seattle Children’s a Magnet® hospital for nursing excellence. Only a small percentage of U.S. hospitals have qualified for the Magnet Recognition Program®. Seattle Children’s is the only pediatric hospital in the Northwest to receive this designation. We salute our skilled, compassionate and dedicated nurses—as do the many doctors, patients and families who benefit from their talents. It’s one more reason to support the mission of Seattle Children’s.

HANDS TO HEAL. HEARTS TO SERVE. NURSING: ONLINE Enrolling Now

WSNA Board of Directors and Staff

President Susan E. Jacobson, RN, CCRN – Yakima

Chair, Cabinet on Economic & General Welfare Kathy Ormsby, MSN, ARNP, RNC – Spokane

Vice President Jennifer Graves, MS, RN – Seattle

Chair, Professional Nursing & Health Care Council Jeaux Rinehart, RN – Seattle

Secretary / Treasurer Judith Turner, RN – Port Orchard

Chair, Legislative & Health Policy Council Ed Dolle, RN – Port Orchard

www.wsna.org

Directors-at-Large Susan K. Glass, MS, RN – Spokane Patricia Di Egido Tobis, MN, RN, CCM – Bellevue Evelyn Street, RN, CNOR – Olympia Ann Whitley, BSN, RN. CCRN – Yakima

Executive Director Judith A. Huntington, MN, RN Special Projects Manager & Assistant to the Executive Director Darlene Delgado, RN

The Washington Nurse (ISSN# 0734-5666) newsmagazine is published quarterly by the Washington State Nurses Association. It is distributed as a benefit of membership to all WSNA members. A member rate of $10 per year is included in WSNA membership dues. Institutional subscription rate is $30 per year (Canada/Mexico: US $36 per year; Foreign: US $49 per year).

Assistant Executive Director, Nursing Practice, Education & Research Sally Watkins, PhD, MS, RN Practice & Education Specialist Robin Fleming, PhD, RN

Bookkeeper Mary Reed

Education Specialist Hilke Faber, MN, RN, FAAN

Office Manager / Systems Administrator Martin Hsiung

Occupational & Environmental Health Specialist Karen R. Bowman, MN, RN, COHN-S

Assistant Executive Director, Government Affairs & Operations Anne Tan Piazza

Assistant Executive Director, Labor Relations Christine Himmelsbach, MN, RN

Senior Governmental Affairs Advisor Sofia Aragon, JD, BSN, RN

Assistant Director, Labor Relations Margaret Conley, RN, ARNP

Political Action Coordinator Richard Burton

General / Corporate Counsel Timothy Sears

Communications Specialist Lillie Cridland

General Counsel Laura Anderson Michael Sanderson

Web & Communications Specialist Ben Tilden Contract Lobbyist Kate White Tudor Melissa Johnson Membership Coordinator Mary Peterson Membership Processors Brissy Combs Kelly King Patrick McGraw Shastie Steinshouer Administrative Assistant, Programs & Operations Hue Tran Administrative Assistant, E&GW LInda Garrett Communications Processor Kathryn MacLeod

The Washington Nurse

W I N T E R 2014

Paralegal Maria Pettit

www.wsna.org

The information in this newsmagazine is for the benefit of WSNA members. WSNA is a multi-purpose, multi-faceted organization. The Washington Nurse provides a forum for members of all specialties and interests to express their opinions. Opinions expressed are the responsibilities of the authors and do not necessarily reflect the opinions of the officers or membership of WSNA, unless so stated. Copyright 2014, WSNA. No part of this publication may be reproduced without permission.

ADVERTISING Information on advertising rates may be obtained on the WSNA website or by contacting Martin Hsiung at 206.575.7979. Advertising deadlines are: March 1, June 1, September 1, and December 1. Advertising will be accepted on a first come, first served basis for preferred positions, pending space availability. WSNA reserves the right to reject advertising. Paid advertisements in The Washington Nurse do not necessarily reflect the endorsement of the WSNA Members, Staff or Organization.

CONTRI B UTOR G U I DE LI N ES

Nurse Representatives Deborah Bessmer, BSN, RN Jayson Dick, RN Travis Elmore, BSN, RN, RN-BC Sara Frey, JD, BSN, RN Carmen Garrison BSN, RN Mara Kieval, BSN, RN Kathi Landon, RN Pat McClure, RN Kathryn Nixon, RN Michele Rose, BSN, RN Hanna Welander, BSN, RN Terri Williams, MS, RN Ed Zercher, BSN, RN

WSNA welcomes the submission of manuscripts and artwork. Please contact Lillie Cridland by email at lcridland@wsna.org with submissions, article ideas or further questions. It is not the policy of WSNA to pay for articles or artwork.

Nurse Representative & Organizer Jaclyn Perkins, BSN, RN

DESIG N E D, E DITE D & PRI NTE D I N THE USA

Nurse Organizer Barbara Friesen, BSN, RN Tara Goode, BA, BSN, RN Judy Marken, BSN, RN

Receptionist / Mail Clerk Irene Mueller

Washington State Nurses Association 575 Andover Park West, Suite 101, Seattle, WA 98188 206.575.7979 • 206.575.1908 fax • wsna@wsna.org

ARTICLE SUBMISSION DEADLINES Spring ............................................................................... February 15 Summer....................................................................................... May 15 Fall .......................................................................................... August 15 Winter............................................................................ November 15

Executive Editor ..................................... Judith A. Huntington Editor ............................................................................ Lillie Cridland Designer ............................................................................ Ben Tilden

TA B L E O F C O N T E N T S

COVER STORY

FINDING THEIR PATH 5 NURSES WHO PURSUED AN INTEREST AND ENDED UP CHANGING THEIR LIVES Page 12 — Winter 2014 — UP FRONT

L A B O R R E L AT I O N S

C O N T I N U I N G E D U C AT I O N

Upcoming Events - - - - - - - - - - - - - - - - - - - - - - - 2

Photos Nurses at PeaceHealth Southwest Medical Center are Getting Active - - - - - - - - - - - - - - - - 20

Calendar Live Educational Events - - - - - - - - - - - - - - - - - 32

You Were Represented - - - - - - - - - - - - - - - - - - - 2 President's Letter In Focus - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5

Recently Settled Contracts - - - - - - - - - - - - - 22

Independent Study Options - - - - - - - - - - - - 32 Upcoming WSNA Webinars - - - - - - - - - - - - - 33

HMA Takeover - - - - - - - - - - - - - - - - - - - - - - - - - 24 AFT Convention - - - - - - - - - - - - - - - - - - - - - - - 24

MEMBER NEWS

L E G I S L AT I V E A F FA I R S

District News IENA & KCNA - - - - - - - - - - - - - - - - - - - - - - - - - - 34

Legislative Priorities - - - - - - - - - - - - - - - - - - - 25

In Memoriam - - - - - - - - - - - - - - - - - - - - - - - - - - 35

ANA News New Guides and Tools, Grants Available - - 10

Legislative & Health Policy Platform - - - - - 26

Membership Update - - - - - - - - - - - - - - - - - - - - 35

Photos from Advocacy Camp - - - - - - - - - - - - 28

The New Members List - - - - - - - - - - - - - - - - - 36

C OV E R STO RY

N U R S I N G P R AC T I C E

Finding Their Path - - - - - - - - - - - - - - - - - - - - - 12

Better Hand Sanitizers Not All Are Created Equal - - - - - - - - - - - - - - - 29

NURSING NEWS

News Briefs March of Dimes Awards, Continuing Competency Procedures, Washington Vaccine Association, and more... - - - - - - - - - - 6

Nursing Commission News - - - - - - - - - - - - - 30 Prescription Monitoring Program - - - - - - - 31

— SPOTLIGHT EVENTS —

Webinar on Health Care Reform April 16, 2014 / cne.wsna.org

Workshop: Nursing Wellness & Stress Managment May 8, 2014 / Spokane, WA

WSNA Leadership Conference September 28-30, 2014 / Chelan, WA

www.wsna.org The Washington Nurse W I N T E R 2 0 1 4

Upcoming Events

You Were Represented

MARCH 2014 20 - 21

WSNA Board of Directors Meeting

WSNA Hall of Fame Celebration Salty’s on Alki Beach, Seattle, WA

AFT-WSNA Nursing Faculty CE Workshop - Davenport Hotel, Spokane, WA

• AFT State Presidents Meeting

APRIL 2014 3

■ WSNA staff and elected and appointed leaders represent your interests in a wide variety of meetings, coalitions, conferences and work groups throughout the year, anticipating and responding to the issues the membership has identified as priorities. In addition to many meetings with legislators, regulators, policy makers, other health care and nursing organizations and unions, the following represents a partial listing of the many places and meetings where you were represented during the last three months...

• AFT Heathcare Division Program and Policy Council Meeting

WSNA PAC Board Meeting

• Alliance of Nurses for Health Environments (ANHE) Policy/Advocacy Committee

• NCQAC Rules Workshops on Continuing Competency & Nursing Education

CEARP Webinar – Demystifying CEARP

WSNA Webinar – Patty Hayes – “Health Care Reform”

17 - 18

Council of Nurse Educators of Washington State (CNEWS) - Spokane, WA

WSNA Professional Nursing & Health Care Council Meeting

• ANA Practice Network conference calls

• Prevention Alliance

• ARNPs United of Washington State

WSNA Cabinet on Economic & General Welfare Meeting

• Bellevue College Nursing Advisory Board

• Public Health Emergency Preparedness and Response Joint Advisory Committee

• American Academy of Nurse Practitioners Region X • American Cancer Society Cancer Action Network • American Nurses Association (ANA) Safe Staffing Conference

• CALNOC Conference Breakthrough to Zero: Eliminating Hospital Acquired Conditions

WSNA Collective Bargaining Local Unit Council Meeting

M AY 2014

• Council of Nurse Educators for Washington State (CNEWS)

7 - 12

NFN Labor Academy & AFT Professional Issues Conference - Baltimore, MD

• Department of Health (DOH) Healthcare Associated Infections Advisory Committee

Constituent Representative Council Meeting (Districts)

• DOH Midwifery Advisory Committee

Memorial Day Holiday – WSNA Office Closed

CEARP Webinar – Co-Providing / Commercial & Sponsor Support

• Comprehensive Health Education Foundation

• Department of Labor and Industries (L&I) rule-making on hazardous drug exposure • Equity in Education Coalition • Federal Basic Health Option legislative advisory committee • Future of Health Care Conference Planning Committee • Healthcare Personnel Shortage Task Force • Health Care Access Coalition (to maintain access to medications)

12 - 15

ANA Membership Assembly and related meetings - Washington, DC

CEARP Committee Meeting

• Health Coalition for Children and Youth

WSNA Cabinet on Economic & General Welfare Meeting

• Healthy Schools Summit

WSNA Professional Nursing & Health Care Council Meeting

• Health Care Without Harm

• Healthy Washington Coalition to Healthy Washington Steering Committee • Joint Task Force on Education Funding (Legislative Task Force)

J U LY 2 0 1 4 4

Independence Day Holiday – WSNA Office Closed

10 - 14

AFT Convention - Los Angeles, CA

21 - 24

WA State Labor Council Convention - Wenatchee, WA

• Public Health Roundtable • Racial Equity Team • Region X US Dept. of Health and Human Services (HHS)

• Collaborative on a Healthy Environment (CHE-WA)

CEARP Webinar – Demystifying Bias

• Pierce County Health Careers Council

• Rebuilding Our Economic Future Coalition

WSNA PAC Board Meeting

• Nursing Students of Washington State (NSWS) Board meetings

• Clark Community College Allied Advisory Board

WSNA CE: Nursing Wellness & Stress Management – Spokane, WA

• NCQAC: Nurse Practice Advisory Groups: School nurse, community health nursing

• Children’s Alliance

JUNE 2014

• Renton Center of Health and Occupational Health Education Labor Advisory Board • Renton Technical College Allied Health Advisory Board • School Nurse Organization of Washington State • Shoreline Community College Nursing Advisory Committee • South Seattle Community College Technical Advisory Board • State of Reform Health Policy Conference • Toxic Free Legacy Coalition • United Labor Lobby • University of Washington Continuing Nursing Education Advisory Committee • Washington Alliance for Gun Responsibility • Washington Alliance for School Health Care • Washington Center for Nursing (WCN) Board Meetings • Washington Chapter of Physicians for Social Responsibility • Washington Health Alliance • Washington Health Care Association • Washington Health Care Authority

• March of Dimes Nurse of the Year Celebration Event

• Washington Health Foundation Board Meeting

• National Academy for State Health Policy

• Washington Patient Safety Coalition Steering Committee

• National Association of County & City Health Officials • National Federation of Nurses (NFN) National Executive Board meetings & National Advisory Board meetings

• Washington Regional Action Coalition (WNAC) Steering Committee and Leadership Group • Washington State Board of Community and Technical Colleges

SEPTEMBER 2014

• North Seattle Community College Technical Advisory Board

• Washington State Labor Council (WSLC) Labor Caucus

28 - 30 WSNA Leadership Conference -

• NSO Advisory Board

• WSLC Political Committee

• Nursing Care Quality Assurance Commission Meetings (NCQAC)

• Washington State Public Health Association Board meeting

• NCQAC ARNP Subcommittee

• Washington Toxics Coalition

Campbell's Resort, Chelan, WA

• NCQAC Continuing Competency Subcommittee

• NCQAC Consistent Standards of Practice Subcommittee

The Washington Nurse

W I N T E R 2014

www.wsna.org

WANTED: COURAGEOUS CAREGIVERS. DRIVEN TO SUCCEED. INSPIRATION GUARANTEED. WGU Washington offers CCNE-accredited* BSN and MSN degree programs that are designed to fit your busy schedule. We’re online, affordable, and we’re seeking nurses who are driven to succeed.

washington.wgu.edu/wsna

*Through Western Governors University, WGU Washington’s nursing programs are accredited by the Commission on Collegiate Nursing Education (One Dupont Circle, NW, Suite 530, Washington, DC 20036, 202-887-6791).

Get Your 2014 Season Tickets Today! Visit StormBasketball.com

Fri. 16th

7:00 PM

LOS ANGELES SPARKS Opening Night 15th Anniversary T-shirt Giveaway

Sun. 1st

6:00 PM

TULSA SHOCK

Fri. 6th

7:00 PM

MINNESOTA LYNX Go Green - Presented by Carter Subaru

Thurs. 19th

7:00 PM

SAN ANTONIO STARS Social Media Night

Sun. 22nd

6:00 PM

WASHINGTON MYSTICS Pride Kickoff

Fri. 27th

7:00 PM

MINNESOTA LYNX Pride Party Storm Beads Giveaway

Thurs. 3rd

7:00 PM

LOS ANGELES SPARKS Summer Fun

Sat. 5th

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CHICAGO SKY Hoops for Heroes

Tues. 15th

12 NOON

CONNECTICUT SUN Kids Day

Tues. 22nd

7:00 PM

PHOENIX MERCURY Emerald City Night Championship Celebration

Thurs. 24th |

7:00 PM

NEW YORK LIBERTY Inspiring Women Night

Sat. 26th

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Thurs. 31st |

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INDIANA FEVER 15th Anniversary Celebration

Sun. 3rd

6:00 PM

SAN ANTONIO STARS Tanisha’s 10th Season Celebration Breast Health Awareness

Thurs. 7th

7:00 PM

ATLANTA DREAM Thursday Night Fever Sunglasses Giveaway

Sun. 10th

6:00 PM

TULSA SHOCK Back to School Night Drawstring Bags for Kids

Sun. 17th

6:00 PM

PHOENIX MERCURY Fan Appreciation Storm T-shirt Giveaway

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In Focus By Susan E Jacobson, RN WSNA President

The 2014 Legislative Session has been marked by the urgency of time. This year, the session lasts only 60 days, making it necessary to not only have the specifics of the issues finely honed, but also the drive and passion to speak up and tell your stories to Legislators. This can seem a bit risky to people who’ve never been a part of the rapidpaced, energized, and sometimes frustrating process of the State Legislature. It takes a keen eye, quick thinking, and a strong passion for the issues (that might start sounding a bit more familiar for nurses). We also need the communication tools to express to lawmakers what the needs are for patient safety, quality health care, safe work environments, nursing practice/licensure boundaries, advanced practice nursing compensation, & school nurse delegation… to name a few of the many diverse issues that WSNA is addressing. Knowing about the issues isn’t enough though. In the words of a famous philosopher, Michael Jordan, you have to “Just Do It!” Take the leap, and move out of your comfort zone—stand up and speak out! Recently, WSNA held its Legislative Advocacy Camp in Olympia. It was a great learning opportunity for both new and experienced nurses to gather together, network, and learn how to share their stories with lawmakers. The tools of communication were explored, and the bonds of nursing were strengthened across the vast diversity of nursing practice. Nursing students, bedside nurses, advanced practice nurses, and school nurses came together and nurse legislators spoke about the issues concerning nurses and healthcare as well as the legislative process. The evening reception brought state legislators and their aides together with nurses and provided the opportunity for advocacy camp attendees to practice their communication skills firsthand. I was glad to see the interaction of nurses

and lawmakers and to feel the excitement and passion that flowed through the room. The next big event we’re gearing up for now is WSNA Nurse Legislative Day, Monday, February 24th, 2014. The education portion of the day is held at the Great Wolf Lodge where attendees hear about the legislative issues from WSNA’s Legislative and Health Care Policy Council and attend one of the several different break out sessions on topics like advanced practice or environmental health. Free shuttle buses then take people up and back to the Capital in Olympia for visits to hearings and appointments with Representatives and Senators that day. It’s an important way to be a part of Nursing in Action! Remember, this is your time—stand up and speak out! The legislative work continues beyond session and it is during the downtime when legislators are back in their districts that we often have the best opportunity to build relationships and educate them about nursing. Take the leap—Just Do It! On a personal note, I also have had to Just Do It! I remember attending my first WSNA Nurse Legislative Day in Olympia as a nursing student. I remember feeling the energy buzzing around the room as I sat and listened to the WSNA Legislative & Health Policy Council panel presentation on the issues. I attended the ‘Grassroots 101’ session to learn the ‘how to’ of sharing my story with my legislators. I remember listening to the President of WSNA speak about how I could make a difference by speaking up and getting involved. I dreamed of standing

on that stage and speaking—to other nursing students like myself and to nurses new and experienced—and empowering them to stand up, speak out, and get involved. I wanted more nurses to feel what I felt that first time I came to Nurse Legislative Day. The next action I took was to become involved. This meant I had to take risks, and leap into the unknown. Each step I’ve taken involved a little risk, and I have had many growth experiences along the way. As President of WSNA, I am learning so much now from the many people I meet and the places I’ve been. What an exciting opportunity I have had so far! And it all started from that one spark of an idea at Nurse Legislative Day. You can’t just show up and sit on the bench. Dare to dream. Take the leap — move out of your comfort zone. Just Do It! n

www.wsna.org The Washington Nurse W I N T E R 2 0 1 4

NEWS

In Brief

ALSO HONORED

NURSING NEWS BRIEFS

NURSES HONORED AT MARCH OF DIMES ‘WESTERN WASHINGTON NURSE OF THE YEAR AWARDS’ In recognition of nurses whose extraordinary efforts stand out, the March of Dimes Washington Chapter held its eleventh annual Western Washington Nurse of the Year Awards honoring local nurses. RNs working at all staff levels in Western Washington were honored in 12 categories surrounded by their peers; nursing professionals who every day set the standards of outstanding patient care. WSNA is proud of the two WSNA members honored with the award and the 19 WSNA members nominated. It was a special celebration this year with the March of Dimes celebrating its 75th anniversary and history of working to help all babies get a healthy start in life.

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Patient/Clinical Care – Laura Mills of Sammamish with Swedish Medical Center

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Leadership – Debbie Raniero of Tacoma with Franciscan Health System

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Innovation/Creativity – Marisa Gillaspie-Aziz of Renton with St. Joseph Medical Center

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Advocacy for Patients – Dianne Clancy of Seattle with Seattle Children's Hospital

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Community Volunteer – Heather Guthrie of Mountlake Terrace with Swedish Edmonds

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Mentoring – Anita Shoup of Edmonds with Swedish Edmonds

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Rising Star – Janet Bowen of Bothell with Overlake Hospital Medical Center

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New Generation – Stacy Woodard of Seattle with South Seattle Community College

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Perinatal/Pediatric – Samantha Thomas of Puyallup with Madigan Army Medical Center

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Distinguished Nurse of the Year – Linda Maschhoff of Seattle with Swedish Ballard

W S N A M E M B E R S N O M I N AT E D

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• Teresa Bauman, RN, Seattle Children’s Hospital •

Nastalie Byman, RN, BSN, University of Washington

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Stacy Breer, RN, Francistan Health System-St. Clare Hospital

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Michaela Buckner, RN, Seattle Children’s Hospital

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Michelle Caro, RN, Franciscan Health System – St. Joseph Medical Center-Tacoma

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Deborah Christiansen, RN, EvergreenHealth

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Lorrie Elliott, RNC-OB, BSN, University of Washington Medical Center

• Jessica Guenser, RN, Seattle Children’s Hospital •

Patricia Blissett, RN, Phd, CCRN, CNRN, CCNS, CCM, ACNS-BC Harborview Medical Center Education Champion – RNs who have made significant contributions in education, professional development and/or long-term learning of nursing professionals. Lindsay Boyd, RN University of Washington Medical Center Research/Advancing the Profession – RNs who have made contributions that have advanced research or advance the nursing profession.

The Washington Nurse

W I N T E R 2014

Cathy Hansen, RN, Seattle Children’s Hospital

• Trevor McLay, RN, Seattle Children’s Hospital

W S N A M E M B E R AWA R D W I N N E R S

Emily Barnes, RN, EvergreenHealth

www.wsna.org

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Sally Muskett, RN, University of Washington Medical Center

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Courtney Newhouse, RN, Seattle Children’s Hospital

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Angela Panda, RN, Seattle Children’s Hospital

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Betsy Pesek, MN, BSN, RN CCRN, Overlake Hospital Medical Center

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Kendra Powell, RN, Seattle Children’s Hospital

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Erin Rominger, RN, Seattle Children’s Hospital

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Lisa Taliaferro, RN, Seattle Children’s Hospital

• Jenni Zanatta, RN, Seattle Children’s Hospital

NURSING COMMISSION NEWS

NEW NURSING LICENSING PROCEDURE FOR CONTINUING COMPETENCY Continuing Competency requirements are due this year for the majority of nurses licensed in Washington State. Renewing a Registered Nurse or Licensed Practical Nurse license is no longer as simple as sending in money. All nurses are now required to attest to having met the Continuing Competency requirements of 531 hours of active nursing practice and 45 hours of continuing education within the previous three year cycle. When renewing online: Simply click “yes” in the box asking if the required continuing education hours and practice hours have been met. Once this is answered, the renewal process will continue. When renewing by mail: Note that located on the back of the renewal notice is the section for attesting to having met the continuing competency requirements. It must be signed and returned with the renewal fee. If the attestation is not signed the license will not be renewed. The Washington State Nursing Commission will contact nurses who are deficient in completing the attestation, but this will cause a delay in the renewal of the license. áá For additional information on the Continuing Competency Program, please go to http://1.usa.gov/1mfnmM6

Washington State Nurses Association

2014 HALL OF FAME HONORING

Janet Primomo, PhD, RN / Joan M. Caley, RN, MS, CNS, CNL, NEA, BC Thelma Cleveland, PhD, RN / Col. Margarethe (Grethe) Cammermeyer, (Ret.) PhD, RN Maxine Davis Haynes, MN, RN / Rheba De Tornyay, EdD, RN, FAAN

March 20, 2014 5:30 p.m. — 8:30 p.m. Salty's on Alki 1936 Harbor Avenue SW, Seattle, WA 98126 $40 per guest includes dinner choice of Grilled Wild Salmon, Herb & Garlic Roasted Chicken, or Vegetable Curry (vegan)

Washington State Nurses Association 575 Andover Park West, Suite 101, Seattle WA 98188

www.wsna.org/hall-of-fame

 Detach and return by mail to WSNA, 575 Andover Park West, Suite 101, Seattle WA 98188 or fax to 206.575.1908 R E G I ST R AT I O N FO R M

2014 WSNA Hall of Fame Awards Guest Name

Chicken

Salmon Vegetarian

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____________________ guests x $40 = $ _____________________ payable by:  MasterCard  VISA  Check (written to ‘WSNA’) _________________________________________________________________________ Cardholder Name

___________________________________________________

___________________

Card Number

Exp Date

_________________________________________________________________________ Billing Address

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NEWS

In Brief

WSU SECURES NEW GRANTS

NURSING NEWS BRIEFS

The WSU College of Nursing has secured two new grants to conduct research and pilot projects towards health improvement.

Public-Private Immunization Partnership By Edgar K. Marcuse, MD, MPH and Beth Harvey, MD

The Washington Vaccine Association (WVA) is helping our state ensure that all recommended vaccines are available to all qualified providers to administer to any child in Washington. But what does that mean for you? It means the WVA is working on your behalf so you can keep providing vaccinations to all children in your practice effectively and efficiently. The stabilization of vaccine funding is critical to improving Washington’s child immunization rates. Since opening its doors in May 2010, the WVA has administered the flow of funds collected from payers and remitted these funds to the state for the purchase of childhood vaccines. For the WVA’s fiscal year ending on June 30, 2013, funds passed through to the state totaled $55.9 million. The WVA’s unique dosage-based assessment (DBA) is the key element in the process. Recently, proposed policy changes at the Centers for Disease Control (CDC) mandated that providers segregate vaccines based on fund source, but Washington’s Department of Health (DOH) quickly convinced the CDC that the DBA system has proven reliable. Because payments are assessed at the payer source, providers shouldn’t have to segregate vaccines. It’s you and your fellow providers’ commitment to the process that makes the system work. The WVA thanks you and your office staff for doing your part. Less than five years ago, Washington state vaccine funds used to purchase vaccines for privately-insured children not covered by the Vaccines For Children (VFC) Program were

The Washington Nurse

W I N T E R 2014

www.wsna.org

cut from the DOH’s budget. A collaboration of key stakeholders then developed the WVA to preserve the state’s invaluable public-private immunization partnership and its costeffective universal purchase system. Now 99 percent of payers are making their assessment payments and providers like you, who administer over 95 percent of the vaccines, follow the one-of-a-kind DBA process. The WVA’s work continues. In December 2013, WVA updated the assessment grid—the table of charges for each vaccine—which increased the cost of vaccines, due to two key factors: • Unexpected changes in the federal CDC policies for vaccine purchasing • Unpredicted increases in the use of more expensive vaccines, like HPV and PCV13 The increase in vaccine assessment rates will bring WVA’s low DBAs in line with current expenses. The revised assessments remain well below vaccine catalogue prices, but still enable WVA to deliver vaccines to providers at no charge. The updated grid became effective December 1, 2013. Please ensure your systems are up-to-date. Explore the new grid and resources on the WVA website at wavaccine. org by clicking “For Providers.” We are serving as the physician members appointed by the Washington State Secretary of Health to the WVA Board. We welcome your questions.

The first project is a $1.3 million federal grant to teach people with multiple chronic health issues how to better manage their conditions. The four-year National Institute on Aging grant pairs the college with Aging and Long Term Care of Eastern Washington and the Community Health Association of Spokane (CHAS). The project will use a chronic care management model adopted by the Washington Department of Social and Health Services. The money will allow the Spokane group to hire a three-person care team, including a nurse and a social worker, that will recruit 300 CHAS patients with at least two chronic conditions, such as diabetes and high blood pressure. Half of the participants will receive regular visits from the care team, which will offer information and advice to patients and help them set health-related goals. The other participants will get minimal attention from the team. The patients will be mentored and monitored for a year. The purpose of the study is to determine whether the care team’s interventions will lead to better health for the people who receive the help. The partners are particularly interested in whether those patients become more actively involved in their own care and use hospital emergency rooms less frequently. With the second grant, the WSU College of Nursing and the Spokane Tribe of Indians are beginning a new project aimed at helping the tribe deal more effectively with substance abuse and mental health problems among its youth. They’ve won a three-year, $825,000 grant from the National Institute on Minority Health and Health Disparities (an arm of the National Institutes of Health) to conduct a community-based participatory research project. The seed for the grant was planted five years ago when the Spokane Tribe conducted a series of focus groups. The tribe

NEWS

In Brief

learned that its members are most worried about their young people’s emotional state and substance abuse. Tribal leaders then approached the university about collaborating on a research project that focuses on preventing suicides and substance abuse and helping young people deal with their unresolved grief. The process of preparing for the study will take about a year and include community assessments to identify the tribe’s needs, strengths and priorities. Then they’ll create, implement and test a pilot intervention program. The grant money will allow the tribe to hire at least three of its people to help with data collection and analysis. If the project is successful, the College of Nursing and the tribe could seek another multi-year NIH grant to continue it and perhaps even expand the study to other tribes.

UW SCHOOL OF NURSING'S HEALTHY AGING CENTER NAMES FUGATEWOODS NEW CO-DIRECTOR Nancy Fugate Woods, professor in the department of Biobehavioral Nursing and Health Systems and Dean Emertia, has been named co-director of the de Tornyay Center for Healthy Aging at the University of Washington School of Nursing. Woods joins existing Center director Barbara Cochrane, professor in the department of Family and Child Nursing, in leading one of the country’s top gerontological research units. The de Tornyay Center for Healthy Aging is named for founder and benefactor Rheba de Tornyay, dean emeritus of the UW School of Nursing. “Following Dr. de Tornyay’s recent death, we are pleased to honor her career and life with a new appointment and new resources for the de Tornyay Center,” said UW School of Nursing Dean Azita Emami. “The Center’s research is becoming increasingly important as our society ages. The work it does is helping to create healthier aging options for people nationwide.” Woods joined the School of Nursing faculty in 1978 and has focused her research

and teaching efforts on women’s health for more than 40 years. She has been a principle or co-investigator on many major research projects locally and nationally, including the Seattle Midlife Women’s Health Study. She and Dr. Cochrane have been researchers for the MS-FLASH study of symptom management approaches for hot flashes and menopause-related symptoms, and the Women’s Health Initiative Study. The latter, begun in 1991, consisted of a set of clinical and observational trials involving more than 160,000 women that has contributed crucial data on osteoporosis, vitamin supplementation, heart disease, fractures, cancer and hormone replacement therapy. Woods’ current work focuses on healthy aging in older women. In addition to her research, Dr. Woods teaches courses at the School of Nursing on research methodology, women’s health issues, gerontology,

and health policy. She was honored for her mentorship of graduate students and faculty with the Anna Shannon Mentorship Award from the Western Institute of Nursing in 2013, and has served as president of the American Academy of Nursing, the North American Menopause Society, and the Society for Menstrual Cycle Research. She currently chairs the Biology of Aging and Gerontology Interest Group for the Institute of Medicine. ■

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NEWS

ANA

ANA’S NEW GUIDE HIGHLIGHTS THE NURSE’S ROLE IN THE CARE COORDINATION REVOLUTION

ANA NEWS BRIEFS

American Association of Neuroscience Nurses Joins ANA The American Association of Neuroscience (AORN) and the American Psychiatric Nurses (AANN) has joined ANA as an Orga- Nurses Association (APNA) in providing nizational Affiliate Premier member. For this level of enhanced benefits to its indimany years, ANA has offered a category vidual members. of membership for nursing organizations AANN President Mary Kay Bader, MSN, called Organizational Affiliates (OAs). RN, CCNS, CCRN, CNRN, SCRN, said, Working together, ANA and these more “Offering ANA OA Premier benefits to than 30 organizational affiliates seek to AANN members drives our vision of being share information and collaborate in finding the leading authority in neuroscience nurssolutions to issues that face the nursing pro- ing. AANN is proud to offer its members fession, regardless of specialty. Addition- this new benefit that will help our nurses ally, ANA also offers OAs the opportunity improve patient care and support their neuto create stronger synergy by purchasing roscience nursing careers.” discounted e-memberships for their indiIndividual members of OA Premier orgavidual members. ANA established Orga- nizations receive the option of digital access nizational Affiliate Premier member status to ANA’s journals and e-newsletters, free for this enhanced relationship. and discounted access to a range of profesAANN is the third organization to join sional development programs, and through at the OA Premier level. It joins the Asso- their membership, strengthen ANA’s advociation of periOperative Registered Nurses cacy on behalf of nurses.

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Care coordination has long been an integral part of nursing practice. RNs have been leading the way in designing and delivering successful team-based care coordination programs that improve patient care and reduce costs. ANA’s new guide Care Coordination: The Game Changer—How Nursing is Revolutionizing Quality Care recognizes the nurse’s role in advancing care coordination. It is the first book to show in clear, concise language how care coordination is positioned in the context of health care reform. Editor Gerri Lamb, PhD, RN, FAAN, and 23 of the brightest minds in care coordination examine care coordination from all sides, including: • A historical perspective on nursing and quality care • The role of care coordination in quality and safety • Models and tools for improving quality and safety • The role of nurse leaders in advancing care coordination • The care coordinator’s role in reducing avoidable hospital stays • Partnering with patients and families for better outcomes • Community-based care transitions Care Coordination: The Game Changer offers today’s most comprehensive insights, case studies and strategies to advance nursing's role in care coordination and health care transformation. This guide can be used in the classroom to introduce students to the care coordination model or by clinical nurses, nurse managers and nurse executives in professional practice settings.

NEWS

AMERICAN NURSES FOUNDATION TO AWARD UP TO $225,000 IN 2014 RESEARCH GRANTS

APPRAISAL AIMS AT BROAD VIEW OF RNS’ HEALTH, WELLNESS, SAFETY ON JOB

Priorities Include Nurse Leadership, Empowering Nurse Change Agents

HealthyNurse™ Program Seeks to Position RNs as Role Models

The American Nurses Foundation (ANF) is now accepting applications for its 2014 Nursing Research Grant (NRG) Program. The program will provide up to $225,000 in research awards to beginner and experienced nurse researchers. ANF is the charitable and philanthropic arm of ANA. The 2014 grant program will focus on nurse leadership and how to empower nurses to become change agents in the transformation of the health care system. “Nursing research improves health using a holistic approach, which is vital to promoting wellness, limiting chronic illness and optimizing health outcomes for patients, families, and caregivers,” said Robin Knobel, PhD, RN, chair of the ANF Nursing Research Grant Program, and an assistant professor at Duke University School of Nursing. Individual grants range from $5,000 to $25,000. The largest award, the Margretta Madden Styles Credentialing Research Award, is named for a past president of the American Nurses Credentialing Center, ANA and the International Council of Nurses. The award funds research on the impact of nurse credentialing programs for patients, nurses, and health care organizations. Information and access to the online application are available on ANF’s website at www.givetonursing.org. The application process is open through May 1, 2014. In 2013, 20 nurse researchers dedicated to transforming the nation’s health were the recipients of more than $185,000 in research grants from the ANF’s 2013 Nursing Research Grants (NRG) Program.

ANA

Registered nurses constantly evaluate the ing a balance and synergy of physical, intelhealth and wellness of their patients and lectual, emotional, social, spiritual, personal provide guidance and educational resources. and professional well-being,” and who But how many RNs really know the status “lives life to the fullest capacity, across the of their health, and how to improve their wellness/illness continuum, as they become wellness? stronger role models, advocates and eduNow RNs can compare their health, cators, personally, for their families, their safety and wellness to the overall U.S. popu- communities and work environments, and lation and other nurses within demographic ultimately for their patients.” categories, including nursing specialty, by ANA’s concept of a healthy nurse taking ANA’s new HealthyNurseTM Health includes five aspects that enable nurses to Risk Appraisal, which was developed in col- function at their highest potential: 1) Calling laboration with Pfizer, Inc. This HIPAA- to care; 2) Priority to self-care; 3) Opportucompliant online survey also allows nurses nity to serve as a role model; 4) Responsibilto assess workplace risks such as patient- ity to educate; and 5) Authority to advocate. lifting injuries and workplace violence. All RNs and RN nursing students are The appraisal is a component of ANA’s encouraged to take the appraisal for free HealthyNurseTM program, which encour- and access the Web Wellness Portal at ages nurses to focus on self-care so they can www.ANAhra.org. ■ be at their healthiest—physically, mentally, emotionally and spiritually—to provide the highest quality of care and serve as role models, advocates, and educators for their patients. The data-gathering tool is combined with an interactive “Web Wellness Portal,” a website for respondents to obtain information and educational resources based on their interests, workplace conditions and results in areas such as fitness, nutrition, stress management, health screenings, sleep and tobacco and alcohol use. The appraisal, which takes 20 to 30 minutes to complete, will become a continually accumulating database that will enhance the nursing profession’s ability to track trends and set policy and advocacy priorities and strategies. ANA has recognized a lack of current data on nurses’ health and work environment, or demographic comparisons to national health benchmarks. The most applicable data, the Nurses’ Health Study from the Harvard School of Public Health, is more limited in topics and focuses on women’s health issues. ANA defines a healthy nurse as one who “actively focuses on creating and maintain-

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COVER STORY

Finding Their Path MEET 5 NURSES WHO PURSUED AN INTEREST AND ENDED UP CHANGING THEIR LIVES

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Mary Margaret Thomas was inspired to find her career path when she saw the devastation of the BP Gulf Coast oil spill first-hand

Patty Hayes' nursing and public health experiences have helped her succesfully tackle several prominent health policy leadership roles

Ed Zercher volunteered to assist hurricane victims in the town of Washington, Illinois

In this issue of The Washington Nurse, we are highlighting some of the interesting work and projects that WSNA nurses are doing around the state—from short-term volunteering to longterm career choices. Each of these nurses took a step towards something new, which led to engaging and meaningful work. We asked them to give us a first-hand perspective on these new roles and the path that had taken them there, whether it was a career transition, new direction in their nursing practice, a volunteer project or a new leadership position. Though each perspective and story is unique, there were common threads that emerged from this collection: • Start with the first step. The whole path doesn’t need to be clear when you begin something new, but just getting interested in something and getting started will bring new opportunities and new connections. • Often times, the only essential ingredient is passion. Expertise, training, and proficiency can be learned and practiced, but it takes a desire and willingness to put the effort in. • The skills that make us great nurses in our workplaces—compassion, problem-solving, clear communication, and confident decision-making— translate into so many other areas of volunteerism and leadership… and also other nursing careers.

Barbara Bly has been lobbying legislators directly on behalf of public health nursing

Whether it’s political engagement, advocacy at the bedside, volunteering in the community, or wherever your passion guides you, WSNA wants to be your resource and ally. Getting involved in your Local Unit, hospital staffing committee, or our Patient Safety Reform campaign are great ways to gain experience and network with other involved nurses, but there are countless other ways to follow your interests. Do something you love and let us know how we can support you! As the most trusted profession, our voice and engagement on issues can be a powerful tool for improving patient care, nursing, health and our communities. Let’s get to it! Continued Î

Mary Pope advocates for patients while working to influence standards of care

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Finding Their Path

2, 13 0 M IL ES BY P L A NE , 3 H OUR S BY R E N TAL CA R , 7 MIN UTES IN A W O R K T R U CK A N D I WA S IN TH E MI D D L E OF WHAT L O O K E D L I K E A WA R ZONE. VOLUNTEERING FOR RELIEF WORK By Ed Zercher, BSN, RN

Ed Zercher, BSN, RN is a Nurse Representative for the Washington State Nurses Association. In December, 2013, he traveled to the town of Washington, Illinois to assist with the work of recovery and rebuilding after a devastating tornado. In the wake of the disaster, WSNA supported his efforts and the WSNA Board generously donated to relief efforts.

N E A R I N G F I V E Y E A R S as a Nurse Representative with WSNA, my position had brought me around Washington State and across the United States advocating for Registered Nurses and the patients they serve. When I was given the go-ahead by WSNA administration to take a week to travel to Illinois and assist the victims of a massive tornado and their efforts to dig out from the rubble, I jumped at the chance. 2,130 miles by plane, 3 hours by rental car, 7 minutes in a work truck and I was in the middle of what looked like a war zone: uprooted trees, 20 foot piles of unrecognizable construction debris, a fog so thick that visibility was less than a quarter mile. I felt like I was standing in the aftermath of an Armageddon… this is Ground Zero of a tornado that ripped through Washington, Illinois just days ago. A ripped up American flag winds itself around the 15 foot remains of what was once a 60 foot, flourishing Maple tree. The air is silent and stale….no cars, no trucks, no heavy equipment, no homeowners. I stood in the middle of a faceless community uprooted by a 10 minute warning of an E-4 Tornado that had swooped down and robbed this neighborhood of their belongings, their keepsakes, their clothing, household furniture and mate-

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rial goods. In return, it spit out two feet deep rubble and debris, mostly unrecognizable in its origin, and wiped away any sense of addresses and identity. Where to begin? Hand-loading mangled house debris into a dumpster on site while removing the copper pipes, copper wire, in addition to setting aside aluminum and random metal, would consume the next 8 hours. Being good stewards of the environment, it was the few dollars from selling the metal to a recycling company that bought fuel for the vehicles and machinery. There were trees needing to be cut by chainsaw, rounds of wood to be stacked, limbs to be hauled, piled and removed. Wouldn’t it figure that all of the wood in this area is dense maple and oak making cutting through it long and tedious? Of course, three days during my time in Illinois it dipped below 10 degrees, making multiple layers of clothes and a hat and coat a must. Some days saw volunteers showing up in numbers of two or three total while others had as many as 15 folks on a particular home site chipping away at the work to be done. Once the remainder of an almost unrecognizable structure had been demolished using a track hoe, it was time to move in the volunteers and start removing the remainder of debris from the basement. Twisted and splintered 2x4s littered the landscape along with chunks of drywall and bits and pieces of what were once important documents, photos and clothing. We worked until we found a stopping point, the machines gave out or the dumpsters were full. The need to deliver humanitarian assistance in the face of adversity was priority one. Long hours of prepping equipment in addition to servicing skid loaders and work trucks was nothing new for this crew. We were a bunch of ordinary people working together to accomplish extraordinary things. The joy of meeting the homeowners of these properties was the most rewarding part of this experience for me. Folks described where they were when the tornado touched down and what transpired during the minutes that felt like hours as the tornado swept through just weeks ago. Ordinary people shared hopes of rebuilding a stronger community. Louder than any personal story was a resounding notion that they were protected

by their faith through this horrific event and it was that belief that kept the light shining for a brighter tomorrow. Every greeting, every conversation and every meal served up an extra helping of hope and faith reminding me of the blessings that I have each and every day back in Seattle Washington. A full week in Washington, Illinois had me meeting groups of volunteers, faith-based organizations and homeowners that were eager to tell their stories of survival… and I was eager to listen. Kent was our volunteer coordinator and a volunteer himself. The organization is called Poured-Out. Founders Carlee, Steve, Chris and Levi were on site, all day, everyday coordinating efforts and working on machinery. This is a band of selfless missionaries that have dedicated the last five years of their lives serving victims of natural disasters such as Hurricane Katrina, the tornadoes in Joplin, Missouri, Hurricane Sandy, the Tornadoes in Moore, Oklahoma, and countless others. Another big part of Poured-Out’s energies are spent in Haiti bringing and building water filtration systems for families living in remote mountain villages and the city of Petit Goave, Haiti. For more information, go to poured-out.org Washington State Nurses Association assisted in making this trip possible by sending me off with wishes of safety and inspiration. Upon my return, I was notified that WSNA was able to offer financial assistance not only to me, but to the relief efforts in Washington, Illinois. I left to help others and returned having been helped. Thanks to everyone who supported me and the tornado survivors with your thoughts and prayers. Until the next opportunity I have to reconnect with the fine folks from Poured-Out, I will keep tabs on the disaster relief progress in Illinois and throughout the world. Thanks to everyone who made this possible through encouragement, prayers and financial support… and stay tuned for the next opportunity to make a difference. I have great respect and admiration to the amazing community of Washington, Illinois, the selfless folks at Poured-Out and the fantastic registered nurses of Washington State.

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I FEEL LIK E M Y C O L L E A G U ES A ND I A R E P ION E E R S . THE ROLE OF A PRIVATE PATIENT ADVOCATE – ONE NURSE’S EXPERIENCE By Mary Pope, BSN, RN

After many years in the business world, Mary Pope earned her BSN and RN in 2002. Her nursing experience includes work in Assisted Living, Oncology, and Pediatric Medicine. As a health advocate with Allied Health Advocates, she understands that people and families facing life-threatening or life-changing healthcare decisions often feel helpless, uninformed, overwhelmed and alone. Her goal is to reduce or eliminate those logistical and informational barriers for her clients, so together, they can focus on the best possible patient and family outcome.

E V E R W O N D E R W H A T it’s like to be a private patient advocate? Who do we serve? What do we do? How do we get paid? An ‘advocate’ is someone who supports and/or promotes the best interests of another. I’ve worked as a “private patient advocate” for almost 2 years. As such, my goal is to help shepherd, counsel, educate, defend and otherwise support the best interests of our clients and their loved-ones as they navigate the mine-filled path of the healthcare system. Our clients and their families usually find us because they have been confronted with a life-changing (usually life-threatening) diagnosis. They are scared, overwhelmed, sometimes alone, and often suffering physically. They come from all walks and stages of life, differing states of illness, and a variety of backgrounds. Some recover from their health crisis, others live for years with their diagnosis, and others die within weeks or months. Some have almost no experience with the healthcare system. Some come to us jaded, bullied, or just plain tired of the constant challenges presented by providers, treatment facilities, insurers and/or their declining health. Much of what I actually “do” in support of our clients includes: accompanying them to appointments, communicating information and outcomes to loved-ones and care

teams, finding and connecting people with appropriate resources, and helping manage paperwork and processes along the way. I am often asked to accompany my clients to medical appointments. There, I serve as an educated, caring, pen-wielding, additional set of eyes and ears to help absorb and decipher the immense amount of confusing and often frightening information frequently conveyed from provider to patient in 30 minutes or less. I help make sure my clients’ questions are answered to their satisfaction and I ask my own questions as appropriate. Afterward, I consolidate, type and distribute (as requested) notes from each appointment. Sometimes, I research, fact-find, and doublecheck things we’ve heard. Often when a family is facing a life-challenging illness, other service needs arise: alternate living arrangements, e.g., skilled nursing or live-in help; transportation assistance; hospice. These are some resources I have been asked to find and set-up for clients. In addition, I have called foreign consulates to discuss immigration papers, contacted auto mechanics to request donated services, reached out to domestic violence organizations, apartment rental agencies, real estate agents, estate sale services, medical equipment providers. The list of things we can (and will) do to help is long and varied. Private patient advocates are not yet covered by insurance. Obviously the expense can be a limiting factor for potential clients. We track our work hours, and bill clients monthly. The number of hours I work can vary greatly from month-to-month depending on client needs. That lack of consistent, predictable hours can be a challenge for those hoping to enter the field. One of the many rewarding aspects about being a private patient advocate is that we really “live” continuity of care. We are able to follow and assist our clients no matter the provider, insurer, or facility. I feel like my colleagues and I are pioneers. As advocates, our goal is always to support and/or promote the best interests of our clients and their families. In this new and evolving role of private patient advocate, we are also helping to create and fine-tune standards of care within a broad scope of practice. It is an exciting challenge. I love my work and look forward to helping define and grow the field of private patient advocacy.

Finding Their Path

I H AVE FOU ND T H AT NURSES CAN GET F RU S T RAT ED WHE N GRE AT I DE AS ARE NOT I M M EDI AT ELY EM BRAC E D. BEING A NURSE LEADER An Interview with Patty Hayes, MN, RN

Patty Hayes, MN, RN is the Director of the Community Health Services Division at Public Health Seattle King County. She also now serves on the Health Care Exchange Advisory Board and has been a key nursing leader in health reform implementation in Washington State. With over 367,000 enrollees since its launch in October, the Washington Health Benefit Exchange has been a success story in the national roll out of health reform. The Washington Nurse interviewed Patty to find out a little bit more about her role, being a nurse leader, and how nurses can get active.

As the Director of Community Health Services Division at Public Health Seattle King County, what does your job entail? I oversee the public health programs that provide services to the low income, homeless, immigrant and refugee individual and families in King County. This includes our 10 public health centers providing primary care, WIC, Maternity Support Services, and Family Planning; the county Nurse Family Partnership Program; our Child Care Consultation program; Access and Outreach team; School based health centers; Health Care for the Homeless network and the Child Profile staff working with the state's Immunization Registry child profile system. There are about 700 staff in the division with a budget of approximately 100 million dollars.

How did you get involved with the Health Care Exchange Advisory Board? I was appointed to the Advisory board based on the work that King County is doing to coordinate access, outreach and enrollment efforts in King County. I also have experience in the development of large benefit portals through my former job at WithinReach and with the establishment of the WA Connection portal that has integrated benefits such as food stamps and TANF. www.wsna.org The Washington Nurse W I N T E R 2 0 1 4

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How has being a nurse helped you meet those challenges? My nursing and public health experience helps me to look at issues through an organized, problem-solving framework. The nursing process translates well into the public policy sector. I've developed system level planning and leadership skills through my nursing career and because of the communication skills I developed in working with families, I can help facilitate through complex issues.

What’s your advice for nurses who want to get more involved in policy planning & decisionmaking, such as health care reform? Find a mentor who can help guide you in learning public policy and the political landscape. I have found that nurses can get most frustrated when great ideas are not immediately embraced. The public policy realm involves looking at issues from multiple stakeholder lenses and also building a view from the economic context. Also, get experience by attending the WSNA legislative day and advocacy camp. These are great opportunities to learn from the experts and practice skill-building. Would you be interested in running for office? Then, get involved with your local Democratic or Republican party at the district level.

Right now is a critical time for the Health Benefit Exchange. How can nurses help make sure people in Washington are getting covered? Nurses can provide the information so that individuals and families know where to go to get assistance with enrollment. The HBE website is much improved so individuals can be directed to www.wahealthplanfinder.org. On that website, there is a link to organizations such as Public Health Seattle & King County who serve as enrollment specialists called In Person Assisters. That staff can help individuals who need assistance with the application or have questions about their coverage. There is a lot of misinformation about the ACA, subsides, who qualifies for Medicaid, and whether individuals can maintain their primary care provider. Nurses do not have to have all the answers, but should always be ready to direct folks to a source. Get informed, get involved, and use your voice!

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the burden of chronic disease is a priority to reduce overall health care costs. But how will this be collaboratively accomplished? The Affordable Care Act emphasizes population health management in conjunction with a systemic shift from fee-for-service reimbursement incentives to quality and efficiency bonus structures. The success of this paradigm shift requires that population disease prevention and effective workplace wellness programs replace reactive medical care. The role of the integral nurse coach in guiding this transition has never been more critical. It was the summer of 2011 when I first THE ROLE OF INTEGRATIVE decided that I needed to pursue wellness NURSE COACHING IN coaching to sustain my path in the field of REDUCING CHRONIC DISEASE environmental and occupational health nursBy Mary Margaret Thomas, RN, MSN ing—although I had no idea about the role of “holistic nurse coach.” That summer, I comMary Margaret Thomas, RN, MSN, is an Environpleted my Master’s in Community and Public mental and Occupational Health Nurse EducaHealth Nursing with a capstone project in tor and Consultant. With a Master of Science in Community and Public Health Nursing, Mary New Orleans, leading a public health coalition Margaret has spent the past two years Cofocused on addressing the health impacts Chairing the Health Care Without Harm Nurses of the British Petroleum Oil Spill in the Gulf Work Group and teaching nursing students. Her Coast. It was the largest manmade disaster passion and work focuses on translating enviin history: 4.2 million barrels of crude oil ronmental health nursing principles into practice both in hospitals and community settings, leaked over 87 days, and 1.8 million gallons of emphasizing the priority of health care to "First, chemical dispersants were applied to assist do no harm." Her recent work has focused on in cleanup. These products—Corexit 9500 and holistic nursing care, integrating the profesCorexit 9527—were banned in several counsional skill set and expertise of nurses into a tries including Britain, and not until one year personal patient/client relationship focused on a holistic understanding of the whole person after the spill and a legal settlement did the and their vision of health. EPA publicly disclose the chemicals in these dispersants: the 57 ingredients collectively pose health hazards to every organ system A P P R O X I M A T E L Y O N E H A L F of the adults in the human body, and 13 of the chemicals in the United States—over 133 million peoplepose harm to aquatic organisms and acute are currently living with at least one chronic toxicity to fish. Over 150,000 cleanup workers disease including diabetes, cardiovascular and millions more living along the Gulf Coast disease, obesity, and cancer. Together, these were exposed (Toxipedia, 2011). chronic diseases are responsible for 70% of Talk about a significant reality check! deaths and 75% of health care costs in our Even though I grew up in Louisiana, this country (Centers for Disease Control and Preexperience left me with a fresh perspective vention, 2011). In Washington State, personal on how cultural norms and behavioral habits health care spending per capita increased truly are the building blocks of population from $3,437 per person in 1998 to $6,782 health. I returned to Seattle contemplating per person in 2009 (Centers for Medicare & questions that never arose during nursing Medicaid Services, 2011). school or in clinical settings: “How do we The United States currently spends more empower patients to seek health care in the per capita on health care than any other face of new or unknown toxic exposures—and country in the world, yet our life expectanwithin a system not yet focused on prioritizcies are nearly four years shorter than they ing disease prevention?”; “How do collective should be based on expenditures (Robert cultural norms and attitudes toward health Wood Johnson Foundation, 2013). Both public care systems impact the health of a populaand private sectors understand that reducing tion?”; and the often elusive question we all

I T H A S BEEN OVER T W O Y E A R S S I NCE M Y EPI PH ANY I N NE W ORLE ANS T H AT I MU S T INT EGRAT E W ELLNES S C O A CH I NG AS A M E ANS OF D I S E A S E PREVENT I ON I NT O NU R S I N G PRACT I CE.

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face as nurses, “How do I continue to do this work while maintaining my own emotional and physical well being?” This urge toward emphasizing the link between behavior and environmental exposures with population health has only been further reinforced over the past two years while I’ve had the privilege of Co-Chairing the Health Care Without Harm Nurses Work Group (NWG). This group of environmental health nurse leaders (including my mentor and WSNA’s Occupational & Environmental Health Specialist Karen Bowman, MN, RN, COHN-S) was the first to confront the health hazards created by hospitals in the process of providing care—both from an occupational and environmental perspective. The NWG addressed nurses’ exposure to hazardous chemical agents in the hospital such as glutaraldehyde, chemotherapy and other hazardous drugs, and anesthetic gases. They have been monumental in shifting legislation and practices that impact population health: reducing the use of nontherapeutic antibiotics in animal agriculture, eliminating mercury containing devices from hospitals, and addressing the clinician’s role in addressing climate change and waste as they relate to population health. It has been over two years since my epiphany in New Orleans that I must integrate wellness coaching as a means of disease prevention into nursing practice. As fate would have it, that path was already being paved far before I began to consciously pursue it. In the past five months I have become acquainted with a unique Seattle-based occupational health and wellness company called Vera Whole Health as well as the International Nurse Coaches Association (INCA), a groundbreaking organization that trains nurses in the art and science of holistic nurse coaching with an emphasis on integrative assessment. Last fall while completing Vera’s holistic Wellness Coach training (founded on the principles of behavior change psychology), I was contacted by INCA’s co-founder Susan Luck, RN, BS, MA, HNC, CCN, HWNC-BC. Susan wanted to discuss how INCA could collaboratively partner with the environmental health work of Health Care Without Harm. This scope of nursing practice being formalized by INCA was the missing link I had been seeking in New Orleans: a vehicle for nurses to integrate their professional skill set and

expertise into a personal patient/client relationship focused on a holistic understanding of the whole person and their vision of health. The nurse coaching practice is grounded in the principles and values of professional nursing practice, following the same process of assessment, diagnosis, outcomes, plan, intervention, and evaluation (Dossey and Keegan, 2013). Yet the relationship of the nurse coach with the client/patient extends beyond the context of our historical silo approach to health care delivery. This model focuses on understanding and supporting the whole client: the values, beliefs, experiences and support systems that frame their wellbeing. Therefore, the traditional nursing process is expanded in an integrative framework which includes: 1) Connecting to the story; 2) Deep listening and skillful questioning; 3) Inviting opportunities, potentials, and change; 4) Integrating, practicing, and embodying change; and 5) Guiding and supporting the transforming self (Dossey, 2014). The Integrative Nurse Coach training is grounded in four nursing theories: 1) Theory of Integral Nursing 2) Vulnerability Model, and 3) Integrative Functional Health Model. The Theory of Integral Nursing offers a process to organize human experience from four perspectives: (1) the individual interior (personal/intentional); (2) the individual exterior (physiology/behavior); (3) collective interior (shared/cultural); and (4) collective exterior (systems/structures). The Schaub Vulnerability Model of Integrative Nurse Coaching explores health and healing through a mind/body lens, utilizing guided imagery, meditation, and principles of transpersonal development. Lastly, the Integrative Functional Health Model requires assessment of the bio, psycho, social, spiritual, cultural, and environmental factors affecting a patient’s health (Schaub, Luck, and Dossey, 2012). In order to be effective in the art and science of nurse coaching, the nurse learns to integrate these theories into practice while mindfully remaining free of his or her own agenda for the patient’s wellness. In my experience with current clients for Vera Whole Health’s Wellness Coach program, coaching occasionally feels like a diversion from classical clinical education and practice. Rather than the nurse’s “expert medical hat” serving as the primary compass to create a care plan, the patient becomes primary architect;

Finding Their Path

together you collaboratively design a wellness plan with relationship-centered trust as the foundation and the client’s own innate wisdom as the roadmap. Time and time again we have heard that nurses are considered the most trusted professional group in the United States. Nursing has always been grounded in the holistic principles of caring for the whole person. Given these facts, we must also be honest with ourselves and remind one another that the first step of health care is self-care. We have an ethical imperative as nurse leaders not only to support the health of our patients, but to model wellness by prioritizing our own health. This can be a true challenge for many nurses (myself included on occasion), but it is critical! Consider this reflection in the words of Florence Nightingale: “No amount of medical knowledge will lessen the accountability for nurses to do what nurses do, that is, manage the environment to promote life processes.” (Nightingale, 1859). We must manage our own environments and prioritize our own health to provide the best patient care. There are many factors that may feel beyond our control in this fast-paced and ever changing landscape that is our health care system. Over 3.1 million nurses in the U.S. represent the largest proportion of the health care workforce. Together we are ideally positioned to utilize our leadership skills and expertise to improve health care delivery models, but we must continue to encourage and model wellness amongst ourselves first. Erica Swedberg was a nurse at Seattle Cancer Treatment and Wellness Center for several years before becoming an INCA Certified Nurse Coach and yoga instructor. Erica’s enthusiasm for nurse coaching has served as a guiding light for my path as she shared, "This movement, this change in the way health care is delivered and viewed is going to become a tidal wave after being a slowly growing trickle for so long. We are on this edge, and we can make a big difference.” Many of us were originally drawn to nursing practice because we were inspired by the fact that our humanity could be utilized in the name of healing. The art and science of nurse coaching offers an opportunity for us to reconnect with what drew us to nursing in the first place—the ability to use all our faculties in the name relationship-centered health care. www.wsna.org The Washington Nurse W I N T E R 2 0 1 4

C OV E R STO RY

Finding Their Path

The International Nurse Coaches Association will be hosting an Integrative Nurse Coaching Training workshop this Spring from March 30th until April 4th at Harmony Hills Retreat Center in Union, Washington. I look forward to joining this training and the unique group of highly skilled professional nurse coaches as we collaboratively navigate how this new scope of practice can improve our current medical system. For more information on this training, please visit http://inursecoach.com/event-registrationharmony-hill/

W H AT I AM D OI NG NOW AS A R E T I R ED NU RS E—BEC OM I NG P O L I T I CALLY ACT I VE—I S A S VA LUABLE AS OF F ERI NG B E D S I DE CARE T O PAT I ENT S . PUBLIC HEALTH NURSING TO PUBLIC HEALTH ADVOCACY By Barbara Bly

Resources Centers for Disease Control and Prevention (2009). The Power of Prevention…the Public Health Challenge of the 21st Century. Retrieved online: www.cdc.gov/ chronicdisease/pdf/2009-Power-of-Prevention.pdf Centers for Medicare & Medicaid Services, Office of the Actuary (2011). Health Spending by State of Residence. Retrieved online from www.cms.gov/mmrr/ Downloads/MMRR2011_001_04_A03-.pdf Donner, G., & Wheeler, M. (2009). Coaching in nursing: An introduction. Indianapolis, IN: International Council of Nursing & Sigma Theta Tau. Retrieved online from: www.incn.ch/images/stories/documents/pillars/sew/ coaching_in_nursing.pdf Dossey, B., & Keegan, L. (2013). Holistic Nursing: a Handbook for Practice. Burlington, MA: Jones & Bartlett Learning. Duhigg, C. The Power of Habit (2012). The Power of Habit: Why We Do What We Do In Life and Business. New York: Random House. Nightingale, F. (1859). Notes on Nursing, What it is, and What it is not. Retrieved online from http://digital. library.upenn.edu/women/nightingale/nursing/nursing.html Robert Wood Johnson Foundation (n.d.). America Is Not Getting Good Value for Its Health Dollar. Retrieved online from: www.rwjf.org/en/topics/rwjf-topic-areas/ cost-and-value.html Toxipedia (2011). The Chaos of Clean-Up: Analysis of Potential Health and Environmental Impacts of Chemicals in Dispersant Products. Retrieved online: http://earthjustice.org/sites/default/files/Oil_Dispersants_Report.pdf

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Barbara Bly worked as a public health nurse for over 34 years and was a tireless Local Unit leader, becoming more active in advocacy and speaking out publicly about the importance of public health in recent years. Recently retired, Barbara now serves on the WSNA Legislative & Health Policy Council where she continues to advocate for nurses, patients and public health.

G R A D U A T I N G F R O M N U R S I N G school nearly 40 years ago, I reflect back on my education and what my ambitions were as a new grad. Those ambitions have matured, expanded and have been molded into who I am as an RN today. After over 34 years as a public health nurse, in September of last year I retired. I felt as a retired nurse that I could continue to find important ways to offer my knowledge and experience regarding the practice of nursing, and the specialty of public health nursing. Continuing as a member of WSNA, I have focused on the legislative movement by nurses for the profession of nursing. In nursing school the focus was bedside care. The nursing of my early years has exploded into a world of being a technician of both human beings and machines. Nursing now is much more than the “hands on” care that I valued and was taught. Yet what I am doing now as a retired nurse, becoming politically active, is as valuable as offering bedside care to patients. I attended the AD nursing program at Everett Community College and then moved into the RNB program at Seattle University. In the 1970s, never was it suggested that being politically active was an important role for a nurse. I remember my instructors telling us that it was only a matter of time before

an RN would require a Master’s degree. I thought, “Wow, nursing is changing." Working at Harborview Medical Center in the Burn Unit, I could see that politics played a huge role in the continued support of burn care and research. I wondered what my role was as a staff nurse with politics playing such a large role in my work place. When I moved into public health, the political influence was even more prevalent. I had felt drawn to the preventative arena of health care. Working to assess health risks of individuals and communities, offering health education, and referring people to resources that would promote optimum health all seemed to me like work that should be a primary focus in health care. I quickly learned that funding was the key to our programs and staffing. Our public health administrators were often lobbying to city, county and state officials for funding to support our mandated and preventative programs. However, the frontline staff who provided these services, such as public health nurses like myself, were not encouraged to lobby. The Health District in our county is governed by the Board of Health. The Board of Health members consist of city and county elected officials within our county. Most have limited knowledge of public health and are educated as they serve on the Board of Health. As political decisions have become even more significant for funding of programs and staff, education of policy makers is of utmost importance. With the downward spiraling of our national economy in 2008, public health nursing programs and positions continue to be gravely jeopardized. Our policy makers are very limited in their awareness of the education, knowledge and skills public health nurses possess and how the nurses impact their community members. Through the years, I have held various positions in our WSNA Local Unit. I found it gratifying to be involved and provide advocacy for our members. Supporting our members through the last five years of change within the field of public health has been very difficult, with funding eroding and positions for most non-mandated staff in jeopardy. Programs have been eliminated and many public health nurse position have been lost. As a WSNA member and Local Unit Chair, I began attending the Leadership Conferences in Chelan. I wanted to learn how

C OV E R STO RY

WSNA might support our dwindling and devalued nursing staff. As I listened, Local Unit Chairs from hospitals and other agencies represented by WSNA shared the same familiar professional and work issues that were being played out in our agency. We learned the importance of speaking out and communicating our concerns, not only for our professional members, but for our patients. Sharing our concerns regarding safe patient care, uninterrupted rest and meal breaks, non-mandatory overtime, protecting the public from toxins in consumer products, and establishing nurse-patient ratios were of grave importance. We know nurses are the experts who should determine what we need to function as professional competent nurses. WSNA supported this. WSNA supported the funding of programs and services offered by public health nurses also. Public health nurses had our association behind us! I recognized that we were not alone. There is such great support through membership. At Leadership, we were also educated about developing partnerships with our legislators and how to teach them about nursing and what nurses do so that they would listen to us on nursing and health issues. WSNA encouraged and supported all nurses to take an active part in advocating for our profession and our patients. No other group can lobby for nurses. Nurses need to tell our own stories to promote laws that will protect nursing standards of practice, to provide laws for safe patient care and funding for public health. This is the way for us to have a voice, a way we would be heard. Again I thought “Wow, this makes total sense.” However, the thought of being politically active is scary to me. I don’t like talking to our legislators. It is hard for me to do! I’m sure I’m not alone in feeling out of place or out of my element in this kind of work. I did not go into nursing to be politically active and talking to lawmakers. Wow, how nursing has changed! As I mulled over this new role, I was struck with the importance. For years in public health, I heard our administrators say that our public has no idea what public health does and that we are poor educators about what we do. Unless we share our stories about what services we offer and how we can impact the health of our community members, we will continue to be portrayed in

Finding Their Path

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ways that may not fully capture the capabilities of our professional role and the benefits we bring to the community. In January, I attended the WSNA Advocacy Camp in Olympia so I could get more comfortable being an advocate in the legislative arena. Even though I tend to shy away from having to speak publically, I spoke to several legislators that day. I become nervous and flustered, but I just told myself that nurses and patients benefit from my advocacy. I have also found that WSNA makes it as easy as possible by providing the training, the research and speaking points for nurses. With information in hand, written by WSNA, it makes meeting with legislators something that feels much more approachable. Of course, as an organization by nurses for nurses, WSNA gives us clear communication, distributed both electronically and by paper. I have found WSNA staff to be available and happy to help in any way that I have requested and this makes me feel less nervous about taking action. I am totally

amazed by what an incredible association we belong to. Every legislative session, WSNA also hosts Nurse Legislative Day in Olympia with educational trainings about this year’s nursing and health issues. You learn how to talk to your legislator and how to be an advocate for these issues. I know I get nervous, but I have to push myself past this because I believe that educating those that make our laws is the only way that nurses will have an impact on the issues that make our profession so valuable. I hope to see you in Olympia or at a WSNA event soon. Your voice is so important. ■

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LABOR RELATIONS

PeaceHealth Southwest Washington Medical Center Building Unity and Momentum New energy and excitement are building in Vancouver, WA. With contract negotiations approaching, WSNA nurses at PeaceHealth Southwest Washington Medical (PHSW) are getting active and building unity in their hospital. On November 18th & 19th, WSNA held an open house celebration for our new field office in Vancouver. Situated across the street from PeaceHealth Southwest Washington Medical Center, the office will be the headquarters for our membership engagement campaign and upcoming contract negotiations. Nurses, their families, community members, and elected officials came out to welcome us to the neighborhood. During the open house, a food drive was held with all donations going to the Clark County Food Bank. Nurses at PHSW are committed to building the strength of their unit and have created a new Membership Engagement Team to reach out to nurses and build unity at PHSW. Over the past several months, they have developed and started executing plans to deepen the connection with WSNA members at PHSW and start helping nurses get to know WSNA if they’re unfamiliar with us. In mid-December, WSNA and the PHSW Local Unit held a Solidarity Celebration Dinner to recognize the work already underway and generate momentum heading into negotiations. With over a one hundred PHSW nurses in attendance, the event was a huge success. Several community leaders, NFN President Steve Rooney and WSNA President Susan Jacobson offered words of encouragement and solidarity. Local Unit leaders and Membership Engagement Team members also spoke about what WSNA meant to them personally, how to become involved in the Local Unit, and the importance of being strong together when negotiations start. It was a fun evening and great building block for the work ahead.

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L A B O R R E L AT I O N S

Recently Settled Contracts

Recently Settled Contracts The current economic environment continues to make negotiations challenging for collective bargaining units throughout the state. WSNA negotiation teams, nurse representatives and attorneys have worked hard to achieve fair contracts, with continued positive results. By participating in the collective bargaining process, WSNA members are standing together and continuing to demand strong contract language, that holds employers accountable. We are proud of our successes and will continue to hold the line, fighting for fair and equitable contracts that promote the interests and welfare of WSNA-represented nurses.

Wage Increase

American Medical Response

Changes / Gains ❱❱ Enhanced language regarding rotation of available hours/shifts

Retroactive

.1%

2014

1.5%

2015

1.5%

❱❱ Continuing Education Reimbursement: increased from $1000 to $1200/year ❱❱ Night shift differential of $2.00/hour for hours worked between 2200 and 0600. ❱❱ Numerous changes to language impacting benefit eligibility, medical, dental and vision insurance

Northwest Hospital & Medical Center

Upon ratification 5/15/2014 5/15/2015

Pullman Regional Hospital

Sacred Heart Medical Center

2% 2% 2%

1st Year

1.5%

2nd Year

1.75%

3rd Year

1st Year

2nd Year

2.5%

3rd Year

2.25%

Signing Bonus of $500.00 per RN

Seattle Children's Hospital

St Joseph Medical Center, Bellingham

St Joseph Medical Center, Tacoma

2nd Year

3rd Year

The Washington Nurse

❱❱ Employer will make Short Term Disability Insurance available for employees to purchase effective Jan 1, 2015

❱❱ Preceptor premium increased from $1.00 to $1.50/hour

❱❱ Certification Pay: Increased from $1.00 to $1.25/hour

❱❱ Enhanced WSNA Grievance procedure language

❱❱ BSN or MSN Premium Increased from $1.00 to $1.50, and increased for BSN with MSN to $2.50/hr

❱❱ Preceptor Pay increased from $1.25 to $1.50/hour

❱❱ Effective 1/1/2014 employer will provide $2000 to reimburse nurses for testing or renewal fee for certification. Amount to increase to $300 1/1/2015

❱❱ Callback: If required to stay more than one hour beyond shift shall be paid 1 1/2X for an minimum of 3 hours

❱❱ Missed Rest Breaks: New language stating that missed rest breaks will be paid overtime for 15 minutes if the missed break extends the nurse's work day

❱❱ Low census: Will be granted to volunteers. All nurses can be offered, but not required to take, partial low census ❱❱ Clinical Groups and Float Groups updated

❱❱ Timeline to file a grievance extended

❱❱ Night Shift Differential Increase effective 8/15 from $0.50 ❱❱ Nurses who volunteer (not on call) to work when not t0 $5.00 scheduled will be paid overtime. Nurses called back when on call will receive time and a half. ❱❱ Conference Committee will address ADO’s and attrition info at each meeting

2013

2.5%

❱❱ Enhanced weekend/holiday backup language

❱❱ Increase in On-Call premium from $6.00 to $7.00

2014

❱❱ Limit of shift rotation to one shift per rotation

❱❱ Conversion to PTO/EIB with increase in PTO accrual

2015

Upon ratification

❱❱ New Step 32 added, 2.5% higher than Step 30

❱❱ Full time benefit status retained for .7 and .8 FTE nurses until December 2015

11/1/2013

11/1/2014

1.5%

Ratification bonus of $800 per full time nurse, prorated for part time nurses

❱❱ Employer will provide and pay for Long Term Disability Insurance for employees

❱❱ Preceptor premium increased from $1.00 to $1.50/hour

❱❱ New Step 32 effective 8/15 1st Year

❱❱ Employer to provide Basic Life Insurance and Accidental Death and Dismemberment Insurance equal to 200% of base salary for employee at no cost to employee

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❱❱ Standby pay increased to $4.25/hour ❱❱ Certification pay increased to $1.10/hour ❱❱ Preceptor pay increased from $.25 to $1.25/hour

❱❱ Low Census; 48 hours per six months cap on mandatory low census was maintained ❱❱ Improved language re: repeated or lengthy call back ❱❱ Enhanced language for scheduled call in Labor and Delivery

L A B O R R E L AT I O N S

Tacoma General Hospital

Upon ratification

2014

2015

Ratification bonus of $1400 per FTE, prorated for part time nurses

University of Washington Medical Center

7/1/2013

7/1/2014

Recently Settled Contracts

❱❱ New steps between existing steps: steps 11, 13, 15, 17, 21, 23, 24, 26, 27, 29

❱❱ The Hospital will encourage attendance at WSNA orientation during Hospital orientation

❱❱ Low census: If a nurse is low censused out of turn the mistake will be remedied on the next rotation or as soon as possible.

❱❱ Memorandum of Understanding re: Clinical Services and Pilot Program

❱❱ Any nurse assigned to work as a Resource Nurse will receive a premium of $5.00 per hour. This reflects that there are no Stat Nurse or Admit Nurse positions. ❱❱ Effective Jan. 1, 2014 Added Steps 11 (L) 13 (N) 16(Q) and 17 to the RN 2 range ❱❱ Charge Nurse Pay: To be paid for one or more hours of assignment to this duty

❱❱ The Bargaining Unit is eligible to participate in the gain sharing program on the same basis as other eligible employees ❱❱ Multiple changes to the retirement plan ❱❱ Rest Breaks: The following language was added A missed rest break not documented in KRONOS by the nurse will be considered as taken for purposes of this section. ❱❱ Innovative work schedules maintained.

❱❱ Clinical Clusters revised

Virginia Mason Hospital & Medical Center

Yakima Regional Medical Center

1st Year

❱❱ Steps were added to the BSN and MSN wage scales

❱❱ Charge nurse premium increased from $2.25 to $2.75

2nd Year

❱❱ Evening shift differential increased from $2.50 to $2.75

3rd Year

❱❱ Night shift differential increased from $4.25 to $4.50

❱❱ Improved language regarding vacation approvals, and improved language regarding holiday rotation preferences.

Upon ratification

1.75%

11/1/2013

1.75%

❱❱ Low census for entire shift unless agreed to by nurse and employer

1.75%

❱❱ Seniority and recall… Enhanced language

11/1/2014

❱❱ Increased Charge Nurse Premium to $2.00/hour

❱❱ OR nurses on stand-by will be provided a communications device if requested ❱❱ Maintained PTO cash out value at 90%

Ratification bonus of $350

aft healthcare professional issues conference

national federation of nurses annual labor academy

MAY 8-10, 2014

hilton baltimore ■ baltimore, md.

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L A B O R R E L AT I O N S

AFT & NFN News

AFT AND NFN TAKE ACTION ON HEALTHCARE TAKEOVER BID Nurses represented by AFT and NFN traveled to the Health Management Associates (HMA) shareholders meeting in Naples, Florida, on January 8 to challenge the HMA board to answer questions about the effect a proposed merger with Community Health Systems (CHS) would have on patient care. The nurses, who work at CHS-run hospitals, were able to raise their concerns, but not until after the vote to approve the merger—and a generous package of "golden parachute" bonuses for HMA brass—was completed. Asked if he was denying a chance for questions and discussion prior to the vote, HMA Board Chairman Steven Shulman answered, "Yes I am." Nurses are concerned that the proposed sale is a questionable proposition with serious implications for patient care and shareholder value. After the vote was completed and the merger approved, nurses were allowed to finally raise their concerns. "As a registered nurse, quality care is paramount," said Lorraine Seidel, CEO of the National Federation of Nurses. "What is the thinking on how this merger can benefit patient care?" The nurses asked why the financially underperforming HMA, which is facing a U.S. Department of Justice investigation and lawsuits for alleged Medicare fraud, wants to merge with CHS, a corporation facing the

Asked if he was denying a chance for questions and discussion prior to the vote, HMA Board Chairman Steven Shulman answered, "Yes I am."

same scrutiny. They asked about the effect CHS' costcutting practices, as well as its practice of trying to deny nurses the right to speak out about workplace issues, will have on the quality of patient care.

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And they suggested that HMA's reputation and shareholder value could be better served if the resources involved in financing the purchase of CHS were spent instead on improving patient care, engaging the community and treating nurses as valued partners. AFT ran an ad in the Naples Daily News on January 8 detailing its concerns about the corporate merger. "As an organization that represents 2,000 employees of HMA and CHS, and that represents members and retirees who are shareholders with more than $1 trillion in pension fund assets— including investments with HMA and CHS—the American Federation of Teachers recommends a 'no' vote on this questionable transaction," the ad states. WSNA has been actively monitoring this issue and working with NFN and AFT to coordinate action around the growing trend of healthcare consolidation. In Washington, HMA owns the WSNA-represented Yakima Regional Hospital.

AFT CONVENTION ATTENTION WSNA BARGAINING UNIT MEMBERS! Watch your mail for a special consent form and information about a special election for WSNA Delegates to the 2014 AFT Convention. The American Federation of Teachers (AFT), AFL-CIO will hold its biennial Convention on July 11-14, 2014 in Los Angeles, CA. The purposes of the AFT Convention are to elect the national AFT officers, consider any proposed changes to the AFT Constitution and Bylaws, take action on proposed resolutions consistent with the AFT purposes and goals, and elect delegates to the AFL-CIO convention. WSNA was chartered as an AFT Statewide Local in February, 2013 and therefore is eligible to elect delegates to the 2014 AFT convention. A special mailed ballot election will be held for WSNA delegates and alternates to the 2014 AFT convention. WSNA will be electing up to 25 delegates. WSNA Delegates and alternates will be determined in order of the number of votes received. If a vacancy

occurs in the office of delegate, the position will be filled by the elected alternates in the order of votes received in the election. To run for and serve as WSNA delegate to the 2014 AFT convention, a person shall hold current membership in good standing in the AFT and WSNA and meet the delegate credentialing criteria as specified in the AFT Constitution and Bylaws. WSNA will provide a financial stipend to assist with travel expenses for the 25 elected delegates. WSNA bargaining unit members desiring to run for delegate may self-nominate and must complete a consent-to-serve form by the deadlines to have their name placed on the ballot. Write-in votes for eligible members on the mailed ballot will be accepted. A delegate consent-to-serve form for the special election was mailed to all eligible members on February 13th. Additional forms may be obtained by calling WSNA at 206.575.7979 and requesting an AFT delegate consent-to-serve form. Copies are also posted on the WSNA website. Consent-to-serve forms must be received at the WSNA headquarters by March 24, 2014. The ballot will be mailed out on April 7, 2014 by Integrity Voting Systems (IVS) and all ballots must be returned to IVS by May 5, 2014. The ballots will be counted by IVS and official election results declared on May 5, 2014. Watch the WSNA website for more information and important updates. In the future, WSNA delegates to the biennial AFT Convention will be elected by mailed ballot at the same time as other WSNA biennial elections. ■

LEGISLATIVE AFFAIRS

ALSO IN THIS SECTION Legislative & Health Policy Platform - - - - - - - - 26 Advocacy Camp Photos - - - - - - - - - - - - - - - - - - 28

At press time for this issue of The Washington Nurse, WSNA’s team of lobbyists and governmental affairs staff were hard at work on the following legislative priorities. For the latest updates and to find out how you can get involved, visit www.wsna.org/Political-Action.

Legislative Priorities for 2014 On January 13, the 2014 Washington State Legislative Session kicked off and WSNA has been hard at work pushing for nursing priorities in Olympia. Since this is the second year of the biennium, the session will last only 60 days. However, this session continues where the last session’s work ended, so we were able to pick up right where we left off with our Patient Safety Reform Package. Patient Safety Reform Package Nurses stop 85% of all preventable medical errors, injuries, and deaths at hospitals. These bills protect patients against errors caused by the fatigue which results from increasingly long hours and inadequate staffing, diminishing a nurse’s ability to provide safe, quality care. • Safe Staffing Bill HB 1095 (Green): builds on the work of current nurse staffing committees to establish statewide standards with input from nurses and patient safety experts. • Uninterrupted Rest Breaks Bill HB 1152 (Morrell): provides uninterrupted breaks for nurses and health

care staff who deliver direct patient care. In 2012, a unanimous Washington State Supreme Court found that rest periods help ensure nurses can maintain the necessary awareness and focus required to provide safe and quality patient care. Washington State Nurses Association v. Sacred Heart Medical Center, Slip Op. No. 86563-9 at *9 (Oct. 25, 2012) • Limit Mandatory Overtime Bill HB 1153 (Reykdal): applies overtime laws to prescheduled on-call. This current loophole allows for inappropriate extension of shifts and allows chronic staff shortages to continue.

Full Implementation of Health Reform • Medicaid expansion: would offer coverage to 328,000 new low income Washington State residents and would save around $225 million in the first biennium and provide WA with nearly $1 billion in federal funds. • Funding for the Health Benefit Exchange: Provides consumers with access to a new marketplace for health insurance. Because the Exchange must be self-sustaining by 2015 we support a fair and equitable funding source for the exchange.

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L E G I S L AT I V E A F FA I R S

Legislative & Health Policy Platform

Limited Dispensing of Drugs by Governmental Public Health Nurses HB 1538 (Morrell) As a current public health practice, public health nurses in local health jurisdictions are providing medications under the direction of physicians and other providers with prescriptive authority for family planning, treatment for sexually transmitted infections, and communicable disease control. Not providing medications at the same time a patient is seen by an RN endangers the health of the public, and this bill ensures nurses can do so. Preserve Key Health Safety Net Programs and Generate New Revenues By denying these services, Washington State tax payers stand to experience higher costs due to increased emergency room visits and more expensive treatment of chronic illness. We urge the Governor and the Legislature to consider all options to preserve the safety net, including Maternity Support Services: One in three women giving birth in Washington receives MSS. Cuts or elimination of this program will impact thousands of women with pregnancies at high risk for poor birth outcomes, resulting in expensive hospitalization such as low birth weight or prematurity.

2014 Legislative & Health Policy Platform The Washington State Nurses Association provides leadership for the nursing profession and promotes quality health care for consumers through education, advocacy, and influencing health care policy in the State of Washington. Nursing Practice & Education • Support implementation of the Washington State Strategic Plan for Nursing to address the nursing shortage. • Support implementation of the recommendations of the Institute of Medicine’s report on the Future of Nursing and the Master Plan for Nursing Education in Washington State. • Support nursing's leadership and unique role in the development and delivery of comprehensive and cost-effective quality care. • Support the principle of individual licensure as mandatory for the practice of registered nursing through completion of a RN education program approved by the Nursing Care Quality Assurance Commission. • Encourage specialty certification and advanced practice of nursing. • Support nursing education funding for: 1. Increased access to nursing programs within institutions of higher education. 2. Nursing faculty salaries and faculty scholarships/loans. 3. Specialty certification and advance practice preparation. • Support funding for: 1. Grants and loans to encourage nursing recruitment and retention.

Nursing Education WSNA is working to enhance nurse faculty recruitment and retention. An estimated 23% of nurse educators retired in 2012 and increased demand for nurses is estimated to persist through 2030. Other Policy Issues • increased access to school nurses • hospital consolidation and preserving access to care • maintain access to nurse practitioners • telehealth and nursing services For more information, please contact Sofia Aragon, JD, RN, WSNA Senior Governmental Affairs Advisor at 206.799.5913 or saragon@wsna.org

Transform the Future of Health Care Executive Master of Health Administration and Certificate in Medical Management Choose from two flexible programs that sharpen your essential leadership and management skills. Offered in formats designed for mid-career professionals. WWW.EXECUTIVEMHA.UW.EDU

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L E G I S L AT I V E A F FA I R S

2. Increasing the diversity of the nursing workforce. 3. Nursing research to maximize nursing’s contribution to health. 4. Data collection and analysis on the nursing workforce. • Protect the public by promoting the role and practice of registered nurses across all settings.

Access to Quality Care • Support implementation of the Affordable Care Act and continue work towards full access to safe, effective, patient-centered, timely, efficient, affordable, and equitable health care for all. • Support nurses’ active involvement as leaders in enhancing system integration and shaping the state health innovation planning efforts. • Support health promotion education, health literacy, and disease prevention as a major focus of the health care system. • Address social determinants of health and support efforts to reduce health disparities. • Support comprehensive health care and wellness services in familiar, accessible and convenient community sites such as schools, workplaces and homes, as well as traditional health care settings. • Ensure access to nursing services that emphasize the role of registered nurses as qualified providers of health care in all practice settings. • Enhance patient safety through a systems approach such as the prevention of medical errors and injuries. • Support and promote advanced practice registered nurses as primary care providers.

Financing Health & Social Services • Support an equitable tax base and other methods which will provide adequate funding for needed social and health services and state agency oversight. • Ensure adequate and stable funding for state health plans, public health, and public health nursing services. • Support evidenced based cost containment incentives in the health care delivery system that do not compromise quality of care or increase health disparities and that: • apply to all providers, payors and vendors. • are based on continued review of the appropriateness of health care services. • serve to eliminate significant waste and inefficiency. • Protect dedicated health funding and ensure it is used solely for health services.

Human Rights • Support the basic right of all people for equity under the law regardless of race, creed, color, gender, age, disability, lifestyle, religion, health status, nationality, or sexual orientation. • Promote a culturally competent health care system that recognizes and values differences among people. • Promote education of nurses, other healthcare providers and the general public about the problems of violence, bullying, sexual assault and harassment.

Economic & General Welfare • Promote RN staffing standards to ensure quality care and safety for patients and health care providers.

Legislative & Health Policy Platform

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REV 10/13

• Endorse and actively support the rights of all employees to participate in the collective bargaining process. • Support measures, including comparable worth and parity, which promote the economic welfare of all nurses. • Promote reimbursement policies that support the principle of equal payment for equal services provided. • Promote and seek enactment of legislation and regulation that protects the economic and employment rights of all nurses, including their right to advocate for patients. • Support measures that create a work environment where nurses are respected, valued, and included in leadership and decision making processes.

Occupational & Environmental Health • Support research and education for the prevention and treatment of occupational and environmental health problems. • Support efforts to assure adequate prevention, preparedness, and response to natural, biological and chemical disasters, and acts of terrorism. • Support legislation and regulation that assures workplace safety, public safety, and promotes environmental health. • Support a precautionary approach towards occupational and environmental health. Recommended by the Legislative and Health Policy Council Deceber 2, 2013

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WSNA Members Use Their Voices at Advocacy Camp Dozens of WSNA members attended Advocacy Camp on Jan. 23rd to learn about the important legislative issues for nurses this year and how to be effective advocates in Olympia. Morning sessions covered WSNAâ&#x20AC;&#x2122;s Campaign for Patient Safety and legislative priorities. Attendees also heard from nurse Legislators Dawn Morrell, RN and Tami Green, RN who both offered insight into the legislative process and emphasized how important it is for nurses to engage with their lawmakers. Afternoon sessions emphasized learning and practicing the skills needed to be an effective advocate through role-playing and small group conversations. After the day of education, attendees were able to put their new skills into practice during an evening reception with Legislators.

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W I N T E R 2014

NURSING PRACTICE

ALSO IN THIS SECTION Nursing Commission News - - - - - - - - - - - - - - - - 30 Prescription Monitoring Program - - - - - - - - - - 31

For more information on hand sanitizers and hand washing, visit the website of the Environmental Working Group (www.ewg.org), and check out the Physicians for Social Responsibility's 2010 Study “Hazardous Chemicals in Health Care: A Snapshot of Chemicals in Doctors and Nurses,” available online at at www.psr.org/resources/hazardouschemicals-in-health.html

Not All Hand Sanitizers Are Created Equal WSNA Switches to New Non-Alcohol Based Fragrance-Free Hand Sanitizer By Karen Bowman, MN, RN, COHN-S WSNA Environmental Health Specialist

any nurses have raised concerns about the chemicals found in their homes and the health care settings where they work. Hand sanitizers are one of those products. Eliminating nosocomial infections is paramount in the hospital setting, and nurses use hand sanitizers multiple times throughout the day so it’s important to have a hand sanitizer that’s the safest possible. Eliminating fragrance and Triclosan is a great start. Over the last year, WSNA has conducted extensive research on hand sanitizers and as a result has changed our giveaway hand sanitizer to a safer product that has no fragrance or Triclosan and does not pose a fire risk. Smell is one of our incredible senses that alerts us to hazards like fires or gas

leaks, and gets our mouths watering with smells of barbeque and sweet peach pie on a warm summer’s night. It evokes memories of our first school lunch, our first date and yes … our first job as nurses in a hospital. But not all smells are equal. Fragrance in hand sanitizers creates an unneeded risk for toxic chemical exposure. Fragrance is considered to be among the top five known allergens, according to the Campaign for Safe Cosmetics (http://www.safecosmetics. org/article.php?id=222). Because fragrance is considered a trade secret, companies are not required to disclose their fragrance formulas. Often containing dozens or hundreds of chemicals, these chemicals—whether organic essential oils or manmade—can cause allergic reactions, are sensitizers,

and can cause or exacerbate asthma. Consequently, a number of health care facilities across the nation have deemed their facilities “fragrance free” to reduce the potential of negative health outcomes. Additionally, products with fragrance, including hand sanitizers, generally contain phthalates (either Di(2-ethylhexyl) phthalate (DEHP) or Diethyl phthalate (DEP)) which are endocrine disruptors, linked to asthma and may cause reproductive harm such as hypospadias—a birth defect involving an abnormally placed urethra in infant males. Finally, there is some concern about alcohol based hand sanitizers causing fire. There have been cases where individuals have become burned by applying alcohol

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N U R S I N G P R AC T I C E

Hand Sanitizers • Nursing Commission News

Nursing Commission News

based hand sanitizers (ABHS), briskly rubbing their hands together and either touching electronic equipment or creating static electricity, resulting in combustion.

NEW RETIRED ACTIVE CREDENTIAL STATUS WENT INTO EFFECT FEBRUARY 1ST

“Portland hospital fire investigated; hand sanitizer link suspected in girl's injuries. However, other similar incidents have happened. In 2002, doctors in Kentucky reported that a nurse's hand antiseptic ignited from a spark of static electricity; and in a 1998 Arizona case, a patient suffered serious injuries in an operating room fire involving an alcohol-based antiseptic.” Nick Budnick. The Oregonian Feb 18, 2013 http://www. oregonlive.com/health/index.ssf/2013/02/portland_ hospital_fire_investi.html

“A fire occurred when a nurse in a neonatal intensive care unit placed an alcoholbased sanitizer in her hands and then, while rubbing in the sanitizer, walked toward an oxygen/air proportioner to change a setting on the device. Her hand was still wet with the sanitizer when she reached for the device's control knob. She then felt a shock, heard a "whoosh" sound, and saw the knob immediately catch fire. Other clinicians disconnected the device, extinguished the flames, and cared for the infant nearby. The nurse's hand was burned, but no other injuries were reported.”

Washing hands with warm water and soap, with 60 seconds of friction, is a great alternative to using hand sanitizers and does not expose you to the aerosolization of the hand sanitizer at face level where it increases the potential for exposure through inhalation. Become an active member of your health and safety team and review your institutions current purchasing protocols around hand sanitizers. Nurses have great power in their voice and the health care industry desperately needs our guidance. ■

(ECRI, 2006). Health Devices Alerts Action Item Accession Number: A7964 Fire Risk from Alcohol-Based Hand Sanitizers Worsens in Oxygen-Enriched Environments.

Though these fires and injuries are rare, they do occur. As a precautionary approach, WSNA’s giveaway hand sanitizer is now alcohol free. It is important to follow your institution’s policies and procedures on hand washing and the use of hand sanitizers.

áá For information about ordering WSNA hand sanitizer in quantities of five or more, contact Martin Hsiung at mhsiung@wsna.org or 206.575.7979, ext 3003.

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W I N T E R 2014

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The Nursing Care Quality Assurance Commission held a final hearing on November 8, 2013 regarding a new category for nurse licensure: “retired active” status. On February 1, 2014, this new rule was adopted as WAC 246-840-125. The law establishes a new section for a retired active license status for registered nurses and licensed practical nurses. The rule allows these nurses to practice on an intermittent or emergent basis, yet retain competency through continuing education and practice hours. It gives direction to nurses on the limits of a retired active status, renewal process, and reinstatement process. Fees for this new credential have been adopted separately. NCQAC is requiring that the nurse wanting to change their status to “retired active” submit a request in writing directly to NCQAC. You can use your renewal notice to request the status change and to send in the payment of $66.00 at that time. The full text of the rule is available at http://apps.leg.wa.gov/documents/laws/ wsr/2014/02/14-02-026.htm. Or contact the Nursing Commission at 360.236.4700 or nursing@doh.wa.gov for more information.

FOR LICENSURE RENEWALS REMEMBER TO SIGN ATTESTATION! The Nursing Commission is finding that many nurses applying for license renewal are not getting approval to renew their nursing licenses because they are not signing the renewal form attestation that they have met the continuing competency requirements. (This information is located on the back of the renewal form.) If submitting your renewal by mail, please be sure to read the entire document before sending it in. Online renewals avoid this issue, as a check box is required for completion of online renewals. For any questions, please contact NCQAC at 360.236.4700. ■

N U R S I N G P R AC T I C E

Prescription Monitoring Program

Prescription Monitoring Program Promoting Patient Safety

By Chris Baumgartner Washington State Department of Health

“T

his program has changed my practice. No single thing in the last 10 years has had such a positive impact on my practice and my patients as this program, so thank you!” These words from a Washington State emergency room physician are typical of the feedback we’ve received about a relatively new program called the Prescription Monitoring Program (PMP). Another physician told us: “I believe this program has literally saved the lives of several of my patients. I have been floored by the number of narcotics that dozens of teenage girls have been obtaining (1,500 to 2,000 pills in six months). I have now been able to have meaningful interventions with In 2012, more than 2.3 million Washthem and their families.” ingtonians filled at least one prescription The department has established sevfor a controlled substance. Hydrocodone/ eral prevention initiatives including the Acetaminophen (the generic form of VicoPrescription Monitoring Program. A main din, a pain reliever) is the most dispensed reason was to help combat drug overdose controlled substance and makes up roughly deaths due mostly to the misuse or abuse 25 percent of all the prescriptions we colof prescription drugs, the leading cause of lect. There were more than 156 million pills accidental deaths here in Washington State. dispensed for this drug in 2012, enough for The program collects information on the each person in the state to receive 23 pills. purchases of pain medications and other potentially dangerous medicines. The Who Can Access Data information comes from pharmacies and The law allows health care providers, health care providers. It is then used to help patients, and others to view the prescription improve patient safety and reduce prescriprecords for certain reasons. Prescribers and tion drug misuse. pharmacists can use the data to intervene Actual data collection began in Octowith patients earlier. They can also identify ber 2011, and health care providers started dangerous drug interactions, address issues requesting information in January 2012. By of misuse, and recognize under-managed the end of December 2013, more than 10,000 pain or the need for substance abuse treatprescribers and 3,500 pharmacists were ment. Health professional licensing boards using the program, which averages more and law enforcement can view the records than 900,000 records per month. It now based on authorized investigations. holds more than 27.1 million prescription Health care providers can register for records. So far, pharmacists, prescribers, access by going to www.wapmp.org/pracand prescriber delegates have made more titioner/pharmacist/ and following the regthan 1.1 million patient history requests. istration steps outlined in the training guide.

Misuse or abuse of prescription drugs is the leading cause of accidental deaths in Washington State. Generic Vicodin makes up roughly 25% of all prescriptions — enough for every person in the state to receive 23 pills.

What the Future Holds The department is pleased with the success the program so far. With additional grant funding recently received, there are plans for several improvements. We plan to share data on patients filling prescriptions across borders, to connect with our health information exchange to provide more seamless access for providers, and make other improvements. A third physician shared with us: “I really am grateful to have the PMP active. It is absolutely essential for any pain management practice and essential for any physician prescribing controlled substances.” ■

áá You can find more information on the program, also known as Prescription Review, online at www.doh.wa.gov/PMP. Contact program director Chris Baumgartner, 360-236-4806, for more information about this article.

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C O N T I N U I N G E D U C AT I O N

Calendar & Independant Study Courses

CONTINUING EDUCATION CALENDAR M A R C H 2 0 14 Multi-Drug Resistant Organisms: An Infectious Disease Update; Pacific Lutheran University; Friday, March 14, 2014, 8:30am – 4:30pm; Fee: $149.00; Contact Hours: 6.25; Contact www.plu.edu/~ccnl/ or 253.535.7683. Pediatric Drug Therapy; University of Washington School of Nursing Continuing Nursing Education; March 18, 2014 • Shoreline Conference Center; Contact Hours: 7.1; Fee: $265 Individual; $245 Group Rate; $199 Student Rate; Contact: www.uwcne.org PTSD: An Overview of Symptoms and Risk Factors; Pacific Lutheran University; Friday, March 28, 2014, 8:00am – 12:00pm; Fee: $79.00; Contact Hours: 3.8; Contact www.plu.edu/~ccnl/ or 253.535.7683. Understanding Reiki in Nursing Practice; Soar With the Eagles (Victoria C. Leo); March 29; Federal Way Office of Soar with the Eagles: 28203 – 22nd Ave. S; Contact Hours: 2.0; Fee: $40; Contact: www.reikitrainingfornurses.com, Victoria.leo.reiki@gmail.com, 253.203.6676 Reiki I in Nursing Practice; Soar With the Eagles (Victoria C. Leo); March 29; Federal Way Office of Soar with the Eagles: 28203 – 22nd Ave. S; Contact Hours: 4.0; Fee: $90; Contact: www.reikitrainingfornurses.com, Victoria.leo.reiki@gmail.com, 253.203.6676 Reiki II in Nursing Practice; Soar With the Eagles (Victoria C. Leo); March 28; Federal Way Office of Soar with the Eagles: 28203 – 22nd Ave. S; Contact Hours: 5.5; Fee: $120; Contact: www.reikitrainingfornurses.com; Victoria.leo.reiki@gmail.com, 253.203.6676 April 2014 Foundations of Faith Community Nursing; Pacific Lutheran University; April 2, 3, 4, 2014 and May 8 & 9, 2014 from 8:00am – 5:00pm; Fee: $519.00; Contact Hours: 34; Contact www.plu.edu/~ccnl/ or 253.535.7683. Motivational Interviewing; University of Washington School of Nursing Continuing Nursing Education; April 2, 2014 • Shoreline Conference Center; Contact Hours: 7.1; Fee: $265 Individual; $245 Group Rate; $199 Student Rate; Contact: www.uwcne.org Foot Care for Older Adults: Update 2014; University of Washington School of Nursing Continuing Nursing Education; April 9, 2014 • Shoreline Conference Center; Contact Hours: 7.0; Fee: $265 Individual; $245 Group Rate; $199 Student Rate; Contact: www.uwcne.org

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W I N T E R 2014

National Certification Review Course for School Nurses (NCSN) Exam; Pacific Lutheran University; Thursdays, April 10, April 24 2014 and May 8, 22, 2014, 6pm – 7 pm online via PLU Sakai; Fee: $239.00; Contact Hours: 12.5; Contact www.plu.edu/~ccnl/ or 253.535.7683. Spanish for Health Care Providers; Pacific Lutheran University; Saturdays, April 12 & April 26, 2014 from 8:00am – 3:30pm; Fee: $259.00 (Includes Textbook); Contact Hours: 12.5; Contact www.plu.edu/~ccnl/ or 253.535.7683. Understanding Reiki in Nursing Practice; Soar With the Eagles (Victoria C. Leo); April 15; Federal Way Office of Soar with the Eagles: 28203 – 22nd Ave. S; Contact Hours: 2.0; Fee: $40; Contact: www.reikitrainingfornurses.com, Victoria.leo.reiki@gmail.com, 253.203.6676 Reiki I in Nursing Practice; Soar With the Eagles (Victoria C. Leo); April 15; Federal Way Office of Soar with the Eagles: 28203 – 22nd Ave. S; Contact Hours: 4.0; Fee: $90; Contact: www.reikitrainingfornurses. com, Victoria.leo.reiki@gmail.com, 253.203.6676 Reiki II in Nursing Practice; Soar With the Eagles (Victoria C. Leo); April 16; Federal Way Office of Soar with the Eagles: 28203 – 22nd Ave. S; Contact Hours: 5.5; Fee: $120; Contact: www.reikitrainingfornurses.com; Victoria.leo.reiki@gmail.com, 253.203.6676 25th Annual Pacific Northwest: Ambulatory Care Nursing Conference; University of Washington School of Nursing Continuing Nursing Education; April 23-24, 2014 • Lynnwood Conference Center; Contact Hours: 13.3; Fee: Entire Conference: $395/375, Single Day $295/$265; Contact: www.uwcne.org May 2014 RN Re-Entry into Practice Skills Review Clinical Experience; Pacific Lutheran University; Monday-Friday, May 2014 – July 2014; Contact www.plu.edu/~ccnl/ or 253.535.7683. Geriatric Assessment; Pacific Lutheran University; Friday, May 2, 2014 from 8:30am – 4:00pm; Fee: $149.00; Contact Hours: 6.25; Contact www.plu.edu/~ccnl/ or 253.535.7683. Women’s Health Drug Therapy 2014; University of Washington School of Nursing Continuing Nursing Education; May 8, 2014 • Shoreline Conference Center; Contact Hours: 7.1; Fee: $265 Individual; $245 Group Rate; $199 Student Rate; Contact: www.uwcne.org

INDEPENDENT STUDY COURSES Understanding Reiki in Nursing Practice; Soar With the Eagles (Victoria C. Leo); May 15; Federal Way Office of Soar with the Eagles: 28203 – 22nd Ave. S; Contact Hours: 2.0; Fee: $40; Contact: www.reikitrainingfornurses.com, Victoria.leo.reiki@gmail.com, 253.203.6676 Reiki I in Nursing Practice; Soar With the Eagles (Victoria C. Leo); May 15; Federal Way Office of Soar with the Eagles: 28203 – 22nd Ave. S; Contact Hours: 4.0; Fee: $90; Contact: www.reikitrainingfornurses.com, Victoria.leo.reiki@gmail.com, 253.203.6676 Dementia Care: The Tools You Need to Make a Difference; Pacific Lutheran University; Friday, May 16, 2014 from 8:00am – 12:00pm; Fee: $ 79.00; Contact Hours: 3.8; Contact www. plu.edu/~ccnl/ or 253.535.7683. Reiki II in Nursing Practice; Soar With the Eagles (Victoria C. Leo); May 17; Federal Way Office of Soar with the Eagles: 28203 – 22nd Ave. S; Contact Hours: 5.5; Fee: $120; Contact: www.reikitrainingfornurses.com; Victoria.leo.reiki@gmail.com, 253.203.6676 Adult/Geriatric Drug Therapy; University of Washington School of Nursing Continuing Nursing Education; May 22, 2014 • Shoreline Conference Center; Contact Hours: 7.1; Fee: $265 Individual; $245 Group Rate; $199 Student Rate; Contact: www.uwcne.org Wound Care: Management of Peripheral Vascular Disease and Pressure Ulcers; Pacific Lutheran University; Friday, May 23, 2014 from 8:30am – 4:00pm; Fee: $149.00; Contact Hours: 6.25; Contact www.plu.edu/~ccnl/ or 253.535.7683.

Dementia - Dementia in Older Adults; Contact Hours: 7.5; Fee: $195 C Depression - IMPACT: Online Training for Depression Care Management; Contact Hours: 17.5; Fee: $50 C Diabetes Update 2013; Contact Hours: 7.0; Fee: $95 C Domestic Violence - Domestic Violence Recognizing and Responding to Victims; Contact Hours: 2.0; Fee: $20 C Ethics - Ethics as a Compass: A Model for Dealing with Complex Issues in Patient Care; Contact Hours: 7.7; Fees: $195 C Ethics Related to Nursing Practice; Fees: $200 D Foot Care for the Older Adult; Rainier Medical Education Programs; Contact Hours: 6.5; Contact: www.RainierMedEd.com Geriatric Health - Geriatric Health Promotion Lecture Series; Contact Hours: 85.5 Fee: $460; 1.5 Fee: $30 C Health Assessment and Documentation; Fees: $150 D Hepatitis - Hepatitis Case Studies; Contact Hours: 0.5; Free to view C High Cholesterol Pt. 1: Western Medicine; Contact Hours: 7; Fee: $50; Contact: www.healthcmi.com High Cholesterol Pt. 2: Chinese Medicine Theory; Contact Hours: 4; Fee: $50; Contact: www.healthcmi.com High Cholesterol Pt. 3: Chinese Medicine Dietetics; Fee: $50; Contact Hours: 12; Contact: www.healthcmi.com HIV - HIV/AIDS Education Implications for Nurses; Contact Hours: 9.0; Fee: $95 C HIV – Routine HIV Screening; Contact Hours: 1.5; Fee: Free C Managing Change – Working within the Kotter Model; Contact Hours: .5; Fee: Free to Staff; The Evangelical Lutheran Good Samaritan Society / Kris Pronto at Kponto@good-sam.com or 605.362.3279; expires: October 2015 Managing Change – Working with Individuals; Contact Hours: .5; Fee: Free to Staff; The Evangelical Lutheran Good Samaritan Society / Kris Pronto at Kponto@good-sam.com or 605.362.3279; expires: October 2015 Managing Type 2 Diabetes Contact Hours: 1.5; Contact: www.nphealthcarefoundation.org Management of Persistent Pain; Contact Hours: 1.8; Fee: No Fee; Contact: www.nphealthcarefoundation.org A

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C O N T I N U I N G E D U C AT I O N

Webinars

WSNA WEBINAR SERIES Medical Spanish for Hospital Nurses; Contact Hours: 25 B Medical Spanish for Office Nurses; Contact Hours: 25 B Medical Spanish for NPs, Physicians and PAs – Course A; Contact Hours: 25 B Medical Spanish for NPs, Physicians and Pas – Course B; Contact Hours: 25 B OTC Advisor: Advancing Patient SelfCare Contact Hours: 17.0; Contact: www.nphealthcarefoundation.org A Pharmacology – Clinical Pharmacology Series Contact Hours: 7 – 8.0; Fee: $195 / 175* C Pharmacology – Adult/Geriatric Drug Therapy: Contact Hours: 7 – 8.0; Fee: $195 / 175* C Pharmacology – Neuropsychotropic Drug Therapy: Contact Hours: 7 – 8.0; Fee: $195 / 175* C Pharmacology – Women’s Health Drug Therapy: Contact Hours: 7 – 8.0; Fee: $195 / 175* C

Pharmacology – Prescribing Scheduled Drugs: Contact Hours: 10; Fee: $195 / 175* C RN Refresher Course Fees Theory: $700; Health Assessment and Skills Review: $700; Clinical Placement for Precept Clinical Experience: $700 D

C O NTA C T S A

Nurse Practitioner Health Care Foundation www.nphealthcarefoundation.org

MedicalSpanish.com Kari L. Ivanyl, BSN, RN, MSN, FNP PO Box 110567 Anchorage, AK 99511 klivany@gmail.com www.medicalspanish.com

The Pain Management Dilemma; Contact Hours: 1.5; Contact: www. nphealthcarefoundation.org Wound Academy – Course 1 (Wound Assessment & Preparation for Healing); Fee: $40; Contact Hours: 4.3 C

Wound Academy – Course 2 (Lower Extremities and Pressure for Ulcers); Fee: $60; Contact Hours: 6.8 C Wound Academy – Course 3 (Dressing Selection & Infection); Fee: $30; Contact Hours: 2.5 C Wound Academy – Course 4 (The Role of Collagen in Wound Healing); Fee: $30; Contact Hours: 2.5 C Wound Assessment and Documentation; Fee: $60; Contact Hours: 2.0 C Wound & Ostomy; Fee: $60; Contact Hours: 2.0 C

University of Washington School of Nursing Continuing Nursing Education Box 359440 Seattle, WA 98195 206.543.1047 CNE@UW.Edu www.uwcne.org Washington State University College of Nursing Professional Development Room 153 PO Box 1495 Spokane, WA 99210-1495 509.324.7354 http://nursing.wsu.edu/ContinuingEducation/index.html

Visit WSNA’s online CNE page at cne.wsna.org for more information and registration (open several weeks in advance of each webinar). U P C O M I N G TO P I C S April 16, 2014 - Noon-1pm Health Reform: The King County Experience Patty Hayes, MN, RN, Director of the Community Health Services Division at Public Health Seattle King County May 22, 2014 - Noon-1pm Mergers, Affiliations, Partnerships: Implications for Nurses June 2014 E-Resources for Point-ofCare Decision Making July 2014 Vulnerable Populations and Health Reform September 2014 Access for all: ARNPs and Health Reform

MARK YOUR CALENDAR U P C O M I N G W E E K S TO C E L E B R AT E & E D U C AT E

National Public Health Week, April 7 - 13 “Public Health: Start Here”

National Nurses Week, May 6 – 12 "Nurses Leading the Way"

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District News

King County Nurses Association

Inland Empire Nurses Association

DISTRICT 2

DISTRICT 4

King County Nurses Association (KCNA) has two upcoming events:

The Inland Empire Nurses Association (IENA), as part of the 4th district of the Washington State Nurses Association, was proud to Positive Influence for Heart Healthy Behavior host our annual Legislative dinner in October 2013 at the Red Lion Saturday, March 22, 8:00 a.m. – 1:30 p.m. Hotel Inn at the Park, in Spokane, WA. This event is always a huge Seattle University, Campion Hall success for area nurses, as many of our local and state representa4.25 contact hours tives attend. It gives them a chance to share their legislative views, priorities, and overall agenda with our nurses, as well as giving This event is a follow-up to last year’s popular Heart Truth event. our nurses and the nursing community a chance to dialogue with Speakers will focus on motivational interviewing as it relates to our legislators, asking questions and offering feedback to our repheart health and other health and lifestyle issues. Participants will resentatives in a neutral setting. This event ensures our presence focus on behaviors related to cardiovascular disease, how to work is felt at the local, state, and federal levels, helping achieve a voice motivational interviewing into their practices, and techniques for for our nursing specific priorities in the political arena. changing attitudes and behaviors. We also look forward to offering nurses in our area a Continuing Speaker Aaron Turner, PhD, ABPP(RP), Director of RehaEducation dinner this Spring, centering around horizontal violence bilitation Psychology at the VA, will present the keynote address. and incivility in the workplace. This talk will take place at the Red Alicia Sloan, MPH, MSW, LICSW, Research and Project CoorLion Hotel Inn at the Park, March 17th, from 5:30-8pm. Looking dinator at the VA, will lead a small-groups session allowing parahead into May, we offer our Spring gala, an annual celebration of ticipants to practice motivational interviewing techniques using nurses, and all the work they do. Please keep an eye on our website case studies related to cardiovascular disease. Register online at for more details regarding this fun and free event. www.kcnurses.org. It is a pleasure serving the greater Spokane community this year. As President, I am always looking for fresh faces to serve on our board of directors, and bringing forth new ideas for nurse visibilKCNA Annual Meeting & Spring Banquet ity. If you have a passion for nursing, and feel the call to help your Thursday, May 8, 5:30 p.m. – 9:00 p.m. fellow nurses through this volunteer opportunity, please feel free Venue TBD to contact me at iena@aimcomm.net. Thank you and best wishes Join us for a fun, festive event that gives nurses an opportunity to for a beautiful Spring celebrate themselves and the profession. The evening includes the —Bobbi Woodward, BSN, RN annual KCNA auction (100% benefits the scholarship fund), Shining Star nurse awards and presentation of scholarships to deserving nursing students. Register at www.kcnurses.org by March 15 and save $10. Come join us!

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W I N T E R 2014

www.wsna.org

In Memoriam

Membership Update

In Memoriam

By Patrick McGraw

Shirley Irons 1949 - 2013

Patty Maguire 1935 - 2013

Wednesday, September 18th, 2013 Shirley Irons, 63 of Clear Lake, Washington was reunited with her lord. She passed peacefully, at home, surrounded by family members and friends. Shirley was born on November 22nd, 1949 to Edwin T. and Vivian Marie Johnson in Detroit Lakes, Minnesota. She moved to Anacortes, Washington in 1962 and was married to Richard Irons of Quincy, California on June 18th, 1966, recently celebrating their 47th anniversary. Shirley earned her Registered Nursing degree in 1986 and spent her career caring for others; she retired from Island Hospital in Anacortes, WA in 2000 to dedicate more time to her family and community. Shirley moved to Clear Lake, Washington in 1997 and quickly became involved with the local community. She enjoyed donating her time to the Community Covenant Church of Clear Lake and helping the children at Clear Lake Elementary. She touched all those around her with her many talents, love & generosity. Shirley is survived by her husband, Richard Irons; daughter, Sherri Savage; son, Damon and his wife, Betty Irons; beloved grandchildren, Hayden & Jordan Savage, Jasmine & Jeremy Irons; mother, Vivian M. Talbot & stepfather, Allen R. Talbot; 6 brothers, 7 sisters and numerous members of extended family. She was preceeded in death by her father, Edwin T. Johnson and a brother and sister. In lieu of flowers, please remit any donations in her memory to Clear Lake Community Food Bank or Skagit Valley Hospital Regional Cancer Care Center. Share your memories of Shirley and sign the online guest register at www.lemleychapel.com.

Patty Maguire, age 78 of Bellingham, passed away from ovarian cancer on September 1, 2013. She was born May 18, 1935 in Seattle to Harold and Marguerite Duffy. She lived between Seattle and Mount Vernon. She met and married Don Nielson (deceased) in 1953 and they had two children, Larry and Cheryll. After Don passed away in 1968 she went back to school to become an RN. She worked at both Skagit Valley Hospital and United General Hospital. She married Dr. Richard X. Maguire in 1974 and they lived life to the fullest. After Richard died in 2003 she moved to Bellingham to be near her daughter and her family. She was so happy to watch her grandchildren and great-grandchildren grow up. Patty is survived by her daughter Cheryll (Gary) Peterson, son Larry Nielsen, sister Megan Terry (JoAnn), 6 grandchildren, Sky (Robin), Hannah and Carl, Travis (Rina), Tyson (Angie) and Trent and 5 greatgrandchildren whom she cherished. She is also survived by her childhood friend Marguerite Matusak and a very special friend Linda Kennedy who meant the world to her and her family. Mom was small and strong but she knew when it was time to say goodbye. She was only going to do it her way and she did. Mom, your family and friends will always miss you and love you. We will see you again someday. The family and friends want to thank Hospice and their staff for all the wonderful care and support and a special thank you to Karen Weitzel who went above and beyond for her and the family. In lieu of flowers, memorials may be made to Hospice. Share memories with the family at www.westfordfuneralhome.com. n

A new WSNA membership card is on its way to you WSNA has begun sending updated membership cards via mail. The card features a new format for your membership information. The membership card will now list WSNA, AFT and ANA membership numbers. If you have not yet received your card, please note that the timing of delivery is dependent upon the dues payment method of each member. The first cards were mailed in early 2014 to renewing members who pay dues monthly via payroll deduction or electronic funds transfer. Members who pay dues monthly by payroll deduction or electronic funds transfer will find that the expiration date on the card is 12/31/2014. The card is good for the remainder of the year provided the membership is maintained in good standing. A membership card is mailed to renewing members who pay dues via installment (three times per year) after the close of the month when an installment payment has been received by WSNA. Members who pay dues via installment would receive three cards per year with the most current expiration date provided the membership is maintained in good standing. A member who pays once per year will receive a membership card after the close of the month in which an annual payment has been received by WSNA. The expiration date on the card would be equal to the end date of that annual dues period. If you do not have a current membership card and would like to receive one by mail, please feel free to contact the WSNA membership department. If you would like to provide updated information for your membership, please download a change of information card from the WSNA Web site (www.wsna.org/Membership/COI) or contact the membership department. The membership department may be reached by phone at 206.575.7979, by fax at 206.838.3099 or by email at membership@wsna.org. Thank you for your continued support of and participation in WSNA. n

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PIERCE COUNTY Abelson, Jennifer Alba, Jennifer Ellen Allard, Crystal Anderson, Rebekah Bailey, Meghan Barker, Megan Barker, Steven Barnett, Kaleigh Barrow, Alison Beadling, Beth Bennett, Debra Bentley, Joy Bishop, Caitlin Blank, Keith Bosse, June Brinton, Stacey Brumidge, Nandi Buenavista, Joshua Burke, Isabelle Burke, Susan Bury, David Cannon, Julie Carlisle, Cary Chacon, Patricia Chen, Jonathan Chen, Xiaojun Collett, Vanessa Comfort, Jet Cook, Bernard Cook, Beth Crandell, Amanda Crumpacker, Deanna Defibaugh, Carla

Dodd, Diane Dow, Jenifer Dzyub, Alla Egner, Monica Eichelberger, Amanda Engelland, Charlene Erickson, Tori Foreman, Chloe Fox, Amy Francis, Christine French, Alycia French, Victoria Galloway, Flora Garcia, Fallon Garcia, Trisha Gardner, Shana Glasby, Molly Goodall, Tara Gordon, Kenna Grams, Ashley Green, Charmaine Guier, Tisha Guthrie-Stoneburner, Aubrey Haire, Natalia Halligan, Erinn Hanley, Sarah Herzog, Shanti Hesch, Michael Hilger, Nicole Hirano, Monica Hoffman, Christine Holbrook, Sharon Hubbard, Lauren Hurst, Tina Hutmacher, Kerry Jasseh, Alieu Jones, Kayla Jorgenson, Denise Julien, Catherine Kannarr, Sylvia Kaufman, Heather Kelleher, Dana Kilpatrick, Callie Kim, Kimber Kinkead, Faye Kozub, Oksana Ladia, Grace Lamb, Palmer Langham, Carol Leatherberry, Christine Leitzinger, Linda Liu, Chih-Ju Long, Shannon Lorenzo, Kristine Lu, Yunyun Lucas, Carmila May Luther, Shannon Martinez, Patricia Martinez, Valerie Matthews, Shannon

Mccutchen, Stacey Melnik, Louella Mendez, Maria Mills, Elaina Miner, Brenda Minjire, Nancy Mix, Bridgette Mix, Bridgette Moore, Shanna Murphy, Melissa Myers, Jennifer Newton, Marilyn Nguyen, My-Dung Nino, Sharine Nistrian, Emanuel O'Loughlin, Larissa O'Neil, Holly Oates, Laurene Odoh, Chika Orlova, Irina Parker, Sarah Pfann, Penny Pham, Manh Powers, Julie Pritchow, Melissa Rabara, Mark Ramirez Rovira, Raquel Raplee, Shay Rasch, Elisabeth Reichard, Shannon Rivas, Britani Rochon, Lauren Roth, Brigitte Rubin, Megan Sales, Mary Jane Sarysz, Natalia Shnieder, Ryann Siekkinen, Kelsey Sigafoos, Colleen Slote, Anne Smith, Brian Stockho, Pamalla Stokes, Robert Strobel, Rebecca Swan, Christina Tellier, Raymond Thrall, Emily Torres, Karla Trapp, Cheryl Travi, Patricia Tumulak, Mercedes Underhill, Tasha Urrutia, Valerie Walker, Shandria Walters, Summer White, Lindsay Wick, Janice Wintjen, Collin Wood, Sarah Woodfield, Mary

SPOKANE / ADAMS / LINCOLN / PEND OREILLE COUNTIES Alban, Tracie Allen, Sherri Baird, Nicole Barasha, Jenine Beacham, Kathleen Belsvig, Erika Benefiel, Heather Berge, Allison Berry, Leah Blakeley, Cassandra Bolser, Belina Bremer, Beth Britz, Katlyn Brown, Jamie Burton, Claudia Buu, Bridget Byers, Arlana Cade, Amy Cameron, Deborah Carroll, Alia Chen, Xiaohuan Claflin-Hubbard, Melissa Collin, Gregory Cortner, Karen Crawford, Amanda Demars, Todd Dixon, Kathleen Dominguez, Terren Dunn, Nicole Ells, Michelle Emch, Rachelle Enns, Amber Ernst, Bjorn Fuller, Amanda Garman, Tonya Gartrell, Melody Griswold, Angie Hammer, Lynette Helton, Jennifer Irvine, Hannah Kemmish, Jackilyn King, Lynda Knigge, Jennifer Lambert, Carol Lassan, Tali Liu, Tia Luzynski, Michael Markell, Aurore Mcginnity, Shannon Mecum, Janet Mezengie, Faye Mitchell, Cathy Moree, Shannon Muncey, Lora Nagahiro, Ann Navarro, Candice Newberg, Holden Newman, Lynda

NOTICE: MEMBERSHIP INFORMATION & EMPLOYMENT STATUS CHANGES It is the responsibility of each nurse to notify the Washington State Nurses Association of any change in work status which may include, but is not limited to: name, address, phone number, FTE increase or decrease, leave of absence, medical leave, maternity leave, leaving or joining a bargaining unit. This change must be done in writing either by using a Change of Information Card or sending an email to wsna@wsna.org The Cabinet on Economic and General Welfare (CE&GW) policy states: When a nurse is on an unpaid leave of absence, the dues are adjusted to the Reduced Membership Category during the unpaid Leave of Absence period. The accumulated dues payment is to begin within 90 days of return to work. The nurse will have up to twelve months to complete payment of these dues. It is the responsibility of the nurse to notify WSNA of this change in work status.

New Members Noland, Lynn Nye, Alecia Ocker, Kathy Omari, Ednah Ortman, Phoebe Pace, Cynthia Rae, Lindsey Remek, Karen Rife, Macarthur Rockstrom, Mackensie Saunders, Stephenie Smith, Darci Smith, Kay Lynn Snelgrove-Simpson, Elizabeth Spencer, Rachel Staton, Alicia Summy, Halasi Swem, Marlee Temerlin, Rebekah Thomas, Annette Toro, Elizabeth Tzeng, Huey-ming Werhane, Brianna Wilson, Bethany Winther, Kristen

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Allen, Susan Avery, Carey Baugher, Brianna Bishop, Diana Campbell, C. Mary Cejka, Catie Chamberlain, Anna Chase, Susan Cross, Megan Dahl, Erica Dieringer, Charlene Donaldson, Barbara Edden, Mariah Forman, Stephanie Guhl, Andrew Hall, Kimberly Hart, Jamie Harville, Sarah Hawkins, Amy Heasley, Summer Hipps, Sarah James, Sarah Jameson, Kristen Karns, Erica Kinnunen, Amanda Llorente, Isabel Locke, Diana Mackay, Carly Manary, Erica Miclat, Jocelyn Newbould, Megan Palmore, Kavita Payne, April Peterson, Sherri Peterson, Tod Proudfoot, Michael

GRAYS HARBOR COUNTY Avery, Jamie Boley, Nicole Bray, Meta Stead, Shauna Wedding Lambert, Alisha

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YAKIMA CITY / NORTH YAKIMA Burrell, Michelle Eagan, Priscilla Jones, Janet Light, Melissa Morford, Darci Neal, Brianna Plachta, Krista Santiago, Maria Walsh, Viktoriya

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WAHKIAKUM / COWLITZ COUNTIES Buddrius, Jacki Mccoy, Artemisa Ward, Michael Weeks, Adam

Rain, Bryon Rule, Brittany Spicker, Tanya Tangen, Martina Taulier, Natalya Tawwater, Robin Thomure, Ryan Walters, Lynne Weston, Margaret White, Kelly Williams, Gayle Wilson, Natasha Wixon, Tina

CLALLAM / JEFFERSON COUNTY Whittaker, Dora

BENTON / FRANKLIN COUNTIES Bishop, Ronica Brogoitti, Carly Cabasug, Edna Cartmell, Hope Carver, Kelly Caufield, Courtnay Chavez, Briseida Cheney, Anne Crotto, Joshua Daviscourt, Timothy Fancher, Cassandra Fenno, Judith Garcia, Maria Huck, Nicole Kaiser, Linda King, Susanna Klein, Kellen

Krebs, Katelyn Mack, Kirsten Messenger, Alisa Potter, Kaylee Robles Romero, Marisol Schmidtgall, Jaclyn Wagner, Susan

SKAGIT / ISLAND / SAN JUAN COUNTIES Boren, Julie Bullock, Erin Cinkovich-wilson, Sandra Dahl, Lisa Dever, Alyse Engbrecht, Jean Flanigan, Erin Frazier, Bryn Gold, Julie Granados, Regine Hartman, George Heaps, Traci Heckman, Erin Hikade, Kathryn Hipolito, Hannah Jo Horn, Rachel Johnson, Mia Jones, June Little, Taylor Maddox, Heather Mcdowell, Nicole Pattison, Joanna Richardson, Angela Schofield, Tanya Sellgren, Dawn Smith, Erika Smith, Tara Stoller, Richard

Studnicka, Kimberly Sutherland, Kathryn Wallin, Gayle Weide, Jaymee Woehle, Courtney York, Donald

KITSAP COUNTY Fischbach, Carol Jetter, Amy Shanks, Naomi

KITTITAS COUNTY Berkas, Erik

ALL OTHER COUNTIES Guel, Gabriela Rangel, Liliana Rodriguez, Melissa Thome, Ashley

WHY I CHOSE THE DOCTOR OF NURSING PRACTICE (DNP) IN COMMUNITY HEALTH NURSING “This interdisciplinary program provided a place where I could explore possibilities; and it allowed me to focus my energy and passion in an area that is of most interest to me. I’ve been able to develop new skills and apply them where I work in public health, and to engage with colleagues around the country and internationally about improving the health of communities and populations. The education that I received from the UW School of Nursing was a sound education. They are really invested in students learning and they are really invested in our success.” David Reyes, MN, MPH, RN Future DNP Graduate Health Services Administrator Public Health—Seattle & King County

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Be prepared for the unexpected. Get a WSNA Emergency Preparedness Kit .

Standard Kit $34 .99 8 Datrex Emergency Drinking Water Pouches

1 flashlight with 2 D cell batteries

1 Datrex packet of 9 food bars

1 Whistle

1 Thermal Blanket - 84” x 52”

1 deck playing cards

2 Air-activated 12-hour body / hand warmers

1 pair leather palm gloves 1 sling bag

1 Hooded Poncho 3 Trash Bags 2 12-hour light sticks 2 zip baggies

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First Responder Kit $49 .99 1 hygiene pack (1 tissue packet, 3 moist towlettes, 1 biohazard wate bag, 1 n-95 dust mask, 2 sanitary napkins, 1 zip baggie) 1 first aid pack (3 2”x”2 gauze pads, 1 5”x9” abdominal pad, 10 plastic strip bandages, 1 roll Kendall tape, 3 antiseptic towlettes, 2 antibiotic ointments, 1 pair vinyl gloves, 3 alcohol wipes)

16 Datrex Emergency Drinking Water Pouches 1 Datrex packet of 18 food bars

_______________________________________________________________________________ Address _______________________________________________________________________________

1 AM/FM radio 1 Whistle

2 Air-activated 12-hour body / hand warmers

1 deck playing cards

1 Hooded Poncho 3 Trash Bags

______________________ State

___________________________________________________ Zip

_______________________________________________________________________________ Phone

1 first aid pack (3 2”x”2 gauze pads, 1 5”x9” abdominal pad, 10 plastic strip bandages, 1 roll Kendall tape, 3 antiseptic towlettes, 2 antibiotic ointments, 1 pair vinyl gloves, 3 alcohol wipes)

1 pair leather palm gloves 1 sling bag

2 12-hour light sticks

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First Responder Kits . . _______ x $49 .99 = __________

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$12 .50 shipping charge per item + __________ Subtotal = __________

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1 hygiene pack (1 tissue packet, 3 moist towlettes, 1 biohazard wate bag, 1 n-95 dust mask, 2 sanitary napkins, 1 zip baggie)

1 flashlight with 2 D cell batteries

1 Thermal Blanket - 84” x 52”

o Same as billing address _______________________________________________________________________________ Name

2 zip baggies

9 .50% sales tax + __________

_______________________________________________________________________________ City ______________________ State

Total = ________

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CREDIT CARD _______________________________________________________________________________ Cardholder Name

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Washington State Nurses Association Continuing Education MEMBER BENEFIT

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Upon passing a course, print your CNE contact hour certificate immediately

Keep a record of the courses you’ve completed through WSNA online CNE for up to seven years

WSNA brings Washington State nurses the most recent, relevant, and evidence-based learning opportunities by providing continuing education from respected authors noted for expertise in their fields. • Avoiding Toxic Trespass: Incorporating an Environmental Assessment into Your Practice • Continuing Competency • Grassroots Political and Legislative Action • Guidelines for the Registered Nurse in Giving, Accepting, or Rejecting an Assignment

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• Safe Staffing • Transformational Leadership for Direct Care Nurses • Washington State Nurse Practice Act for RNs • Violence in the Workplace • Washington State Nurse Practice Act for RNs • More on the way!

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