COMING TO ILLINOIS IN 2018! THE NURSE PLATES WILL FINALLY BE AVAILABLE NEXT YEAR!
The Illinois Nurses Foundation wishes to thank everyone who supported securing the Nurse Plates in Illinois! Now that we have a budget in Illinois, the plates will be put into production and the monies donated to secure the plates will be allocated and distributed to the foundation.
We are excited to begin funding grants for nurseinitiated projects and award additional scholarships as we move forward. Next steps, the plate design is being developed based on the image we submitted to the Secretary of State (pictured here). Once the plate design is complete, the SOS office will produce a sample/draft of the plate and send it to the State Police for review. Once approved by the State Police, the plates will become available to the public. Those that RSVP’d will be notified of the plates availability and the steps necessary to secure your plates.
Again, Thank You for your support and patience during this process! Watch for further developments and announcements.
Each generation has its heroes. We grow up hearing stories of superheroes – the caped crusaders who leap tall buildings and use their powers in extraordinary feats.
Heroes make things look easy.
Nurses are some of the hardest working individuals in the healthcare industry. They are the so-called unsung heroes, the angels among us, and they deserve to be celebrated. But sometimes it is the normalcy of a person that makes them special – makes them a hero.
Nurses have the most interesting stories – they witness pain and heartache on a daily basis – Nurses make the world a better place.
The Honor a Nurse / Nurse of the Year award is a program that gives friends, family and colleagues a way to share the story of a nurse who has made a difference.
Donate and honor a nurse who has inspired you, mentored you, fought for the advancement of the profession, stood by you, or who deserves recognition for their commitment to their patients and the work nurses do every day.
With a $25 donation – the Honoree will be listed on the INF website and in the December issue of the Nursing Voice
With a $50 donation – the Honoree will be listed on the INF website, in the December issue of the Nursing Voice and will also be entered as a nominee for the “Nurse of the Year” award* which will be awarded during the Illinois Nurses Foundation December Holiday event.
*Donor must submit story about honoree to be eligible for the Illinois Nurse of the Year.
In Honor donations can be made on the Illinois Nurses Foundation website www. illinoisnurses.foundation and at https://ilnursesfoundation.wufoo.com/forms/honor-anurse/
Message froM the INf Pre s I deNt
I am greeting you on behalf of the Illinois Nurses Foundation Board of Directors. I have been a Director for over 5 years and been blessed with the work of the Foundation. As I reflect, I realize I was active since the inception of the Foundation. I have had the opportunity to participate in many of the projects and activities over the years. I say blessed, as it is a blessing to be able to share my passion for nursing and nursing education through the Foundation. As I look at 2017, I realize in the spring we celebrated with the “40 under 40” recognition; a program whereby nurses under the age of 40 who are making a difference are honored. To add to our celebrations, the summer and fall recognize the “Honor a Nurse” Program and “Nurse of the Year Award.” I know all of you know a special nurse, or have had a situation where you may have needed a nurse and he or she was “there.” The nurse left a special mark and memory at a time you needed them most. The Honor a Nurse and Nurse of the Year is a way to
acknowledge that nurse and at the same time support the Foundation with a $50 donation.
Speaking of donations, as a member of the INF Fundraising Committee, I am always looking for opportunities to have others join in the celebration of the Foundation work by making a small or large donation. There are no membership fees to be a part of the INF. We run 100% on donations, fundraising activities, and volunteers. We are always looking for additional volunteers to assist in many of our projects, including our upcoming Holiday Fundraising Gala on Saturday, December 9, 2017. We are already busy at work in the planning of the Gala. As we enter the “Giving” season of the year, remember the INF. Your donation promotes nursing and the work of nursing scholars in the state of Illinois. Thank you for your support. No gift is too small.
With gratitude, Cheryl Anema PhD, RN
American Nurses Association Elects Board Members
SILVER SPRING, MD –The American Nurses Association (ANA) announced that the voting representatives of ANA’s Membership Assembly elected four members to the ninemember board of directors. Ernest James Grant, PhD, RN, FAAN, of the North Carolina Nurses Association, has been re-elected as Vice President. The newly-elected board members are: Treasurer Jennifer Mensik, PhD, RN, NEABC, FAAN, Arizona Nurses Association; Director-at-Large MaryLee Pakieser, MSN, RN, FNP-BC, ANA-Michigan; and Director-At-Large, Recent Graduate Amanda Buechel, BSN, RN, ANA-Illinois. Terms of service begin January 1, 2018.
The following ANA board members continue their terms: President Pamela F. Cipriano, PhD, RN, NEA-BC,
FAAN, Virginia Nurses Association; Secretary Patricia Travis, PhD, RN, CCRP, Maryland Nurses Association; Faith Marie Jones, MSN, RN, NEA-BC, Wyoming Nurses Association; and Director-at-Large, Staff Nurse Gayle M. Peterson, RN-BC, ANA-Massachusetts; and Director-atLarge Tonisha J. Melvin, MS, CRRN, NP-C, Georgia Nurses Association.
Elected to serve on the Nominations and Elections Committee are: Thomas Stenvig, PhD, MPH, RN, NEA-BC, FAAN, South Dakota Nurses Association, who is chairelect; Anthony King, BSN, RN, CPN, ANA-New York; Terry Throckmorton PhD, RN, Texas Nurses Association; and Elizabeth Welch-Carre, MS, APRN, NNP-BC, Colorado Nurses Association.
www.ana-illinois.org
The Nursing Voice
Officers
Published by: Arthur L. Davis
INF Board of Directors
Maureen Shekleton, PhD, RN, DPNAP, FAAN President
Alma Labunski, PhD, MS, RN Vice President
Cathy Neuman, MSN, RN, CNAA Secretary/Treasurer
Directors
Cheryl Anema, PhD, RN
Maria Connolly, PhD, CNE, ANEF, FCCM
Karen Egenes, EdD, MSN, MA, RN
Jacqueline Garcia, MSN, APN, NP-BC
Rhys Gibson, RN, BSN
Guadalupe Hernandez, MSN, APN, FNP-BC
P. Joan Larsen, RN
Linda Olson, PhD, RN, NEA-BC
Bonnie Salvetti, BSN, RN
Kathryn Serbin, MS, DNP, RN
2015-2017 ANA-Illinois Board of Directors
Officers
Dan Fraczkowski, MSN, RN
Ann O’Sullivan, MSN, RN, CNE, NE-BC, ANEF
Pam Brown, PhD, RN, ANEF
Kathryn Serbin, MS, DNP, RN
Directors
Amanda Buechel, BSN, RN
Karen Egenes, EdD, MSN, MA, RN
Elaine Hardy, PhD, RN
Crystal Vasquez, DNP, MS, MBA, RN, NEA-BC
Bonnie Salvetti, BSN, RN
Editorial Committee
Editor Emeritus
Alma Labunski, PhD, MS, RN
Chief Editors
Lisa Anderson-Shaw, DrPH, MA, MSN
Karen Mayville, MSN, PhD, RN
Members
Cheryl Anema, PhD, RN
Nancy Brent, RN, MS, JD
Kathy Long-Martin, BSN, MSN, RN
Linda Olson, PhD, RN, NEA-BC
Lisa Hernandez, DNP, RN, CENP
Executive Director
Susan Y. Swart, MS, RN, CAE
ANA-Illinois/Illinois Nurses Foundation
Article Submission
• Subject to editing by the INF Executive Director & Editorial Committee
• Electronic submissions ONLY as an attachment (word document preferred)
• Email: syswart@ana-illinois.org
• Subject Line: Nursing Voice Submission: Name of the article
• Must include the name of the author and a title.
• INF reserves the right to pull or edit any article / news submission for space and availability and/or deadlines
• If requested, notification will be given to authors once the final draft of the Nursing Voice has been submitted.
• INF does not accept monetary payment for articles.
Article submissions, deadline information and all other inquiries regarding the Nursing Voice please email: syswart@ana-illinois.org
Article Submission Dates (submissions by end of the business day)
January 15th, April 15th, July 15th, October 15th
Advertising: for advertising rates and information please contact Arthur L. Davis Publishing Agency, Inc., 517 Washington Street, P.O. Box 216, Cedar Falls, Iowa 50613 (800-626-4081), sales@ aldpub.com. ANA-Illinois and the Arthur L. Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement.
Acceptance of advertising does not imply endorsement or approval by the ANA-Illinois and Illinois Nurses Foundation of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. ANA-Illinois and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of ANA-Illinois or those of the national or local associations.
PresIdeN t ' s Message sNaI UPdate
Greetings
Dan
Fraczkowski MSN, RN
Congratulations! We would like to thank each and every nurse, student and supporter for your tireless advocacy for passage of the new Nurse Practice Act. Whether you traveled to Springfield, called, emailed or met with your legislators, we came together and made the difference. Over 25 nursing organizations joined forces as the Illinois Coalition of Nursing Organizations (listed below) to develop recommendations and advance passage of the Nurse Practice Act. The act allows for full practice authority for Advanced Practice Nurses, and provides more authority for the Registered Nurse.
Despite our successes in the revised Nurse Practice Act, we did not secure passage of the Nurse Licensure Compact this year. Our efforts are not in vain, on average it takes several attempts to pass legislation. We will remain persistent, since we know that the Nurse Licensure Compact protects the nurse whether he or she is providing care coordination/telehealth to patients outside the state of Illinois, or educating students online who reside in a state other than Illinois. In both situations, the nurse should have a license for the state in which the patient or student is receiving care or education. In case you are not aware, the Nurse Licensure Compact would allow nurses to practice in states other than their “home” state by maintaining licensure requirements of that home state, and not being required to purchase a separate license from other states. The nurse simply notifies the state department of professional regulation that they are practicing in that other state. Since we live in an age of electronic licensure and discipline verification, we are now able to better track the status of a nurse’s license, and ability to practice.
I hope you have seen or heard about our Illinois activities to support the ANA Healthy Nurse Healthy Nation campaign. Our Illinois Chair, Toni Scott MSN, RN, CYT has been coordinating our efforts, which have included Saturday morning Yoga, Sunday morning bikerides, evenings out at Chicago Summerdance for free dance lessons, to name a few events. All nurses are welcome to participate, you can find our ANA-Illinois
Healthy Nurse Healthy Nation group on Facebook- please request to join it and we will add you. The Facebook page was created as a closed group in order to minimize the external ad content and consistency of message.
Elections for the ANA-Illinois Board of Directors will occur online from October 6th – October 20. Positions that are being elected include President, Secretary, two Directors at Large, and two Nominating and Elections committee members. Information about the process will occur via email, voting is electronic, and I encourage you to make your voice heard by participating. We have an excellent slate of candidates. Thank you to all those who consented to serve.
On that note, I hope to see you at our inaugural ANAIllinois Professional Issues Conference on Saturday, November 4, 2017 in Normal, Illinois from 9am- 5pm. The event will feature 5 hours of CE, breakfast, lunch and a dessert reception. It promises to be illuminating and exciting, with a variety of presentations, from one about EHR handoff to updates on the opioid crisis. Registration is open online at www.ana-illinois.org
On a related note, one exciting event created for nursing students by nursing students, the Student Nurses Association of Illinois (SNAI) Convention is scheduled for Saturday, October 7, 2017 at Loyola University Chicago. This year’s theme “Bedside and Beyond” will feature a one day event at the scenic Lake Shore campus at Loyola, on the shoreline of Lake Michigan. SNAI will host a variety of speakers who have non-traditional nursing roles, as well as a session for faculty/advisors. More info and registration is available online at www.snaillinois.com or via the SNAI social media feeds.
Finally, as you know, proposed legislation in Washington, DC continues to evolve day by day that has the potential to impact the profession and patients we serve. Consider following @RNaction on Twitter or subscribing to ANA’s Capitol Beat blog at www. anacapitolbeat.com. Thank you again for all that you do on behalf of our patients and the profession. Do not hesitate to reach out or contact us with your questions, concerns, and suggestions.
Sincerely,
Dan Fraczkowski MSN, RN President- ANA-Illinois @NurseDanF
The Student Nurses Association of Illinois has been gearing up for our 65th Annual Convention. This year’s theme is “Bedside and Beyond.” Our goal is to introduce the nursing students around the state to not only traditional bedside nursing roles, but also to the multitude of other fields a nurse can pursue. The convention will be taking place at the beautiful Loyola University in Chicago, IL on Saturday, October 7th from 9am-6pm.
In addition to the many breakout sessions led by Illinois’s great nurses, we will also be hosting Bill Coon as our Keynote Speaker. Bill Coon will be giving a riveting motivational talk on the patient’s perspective, as a two- time organ donation recipient. It’s also that time of year where the current board members’ terms will be coming to a close. During our House of Delegates we will not only be voting on new bylaws, but also eligible students have the opportunity to run for all of the board positions. For details about running, please see the “Applications” tab on our website. Pre-slate applications are now open and must be submitted by Sept. 30th.
This year we are also introducing a faculty breakout session for nursing school educators and advisors. There are also five different awards that are available and will be presented at the convention. Not only are there awards for schools, but also individuals! Please see our websites “Awards” tab for more info. Whether you are thinking about the nursing field as a career, are in the throes of nursing school, or are a nursing school faculty member, the SNAI Annual Convention will be a great experience for you!
We would also like to congratulate our Board members who have recently graduated! Emily Ramirez- President, graduated from Aurora University; Erik Meyer- Legislation Director, graduated from Harper College; and Leontina Djuricic- Image of Nursing Director, graduated from Harper College. All three have also passed their NCLEX exams and are eager to start their amazing careers as nurses.
We look forward to having an amazing 65th Annual Convention. For more information, please visit our Website-snaillinois.com Facebook- facebook.com/SNAIllinois …and now Instagram!- snai_illinois
Emily Ramirez, RN, BSN President- Student Nurses Association of Illinois
contact:
Quincy, IL 62301
2017 aNa - I l l INoIs CaNdIdates a N N o UNCed
The election for the ANA-Illinois Officers and Directors will be held online October 6-October 20.
The election will be conducted electronically. Watch your email and the ANA-Illinois website www.ana-illinois. org for the additional details.
HERE ARE YOUR CANDIDATES:
President
Dan Fraczkowski MS, RN
Greetings, my name is Dan Fraczkowski, I have had the honor of serving as President of ANA-Illinois for the past two years, and I am seeking another term. I hope to have the privilege to serve you again on behalf of the association and nurses across the state. I am proud of the work we have done together to expand our outreach and impact on nursing practice as the voice for nursing in Illinois.
As the coordinator for the Illinois Coalition of Nursing Organizations we brought together over 25 nursing organizations to develop recommendations for the newest iteration of our Nurse Practice Act via that is breaking down regulatory barriers and modernizing practice. Together with our members, board of directors, and staff we have hosted over 50 nurse practice act events across Illinois.
At the same time, I know that we must continue to expand educational offerings to better serve our members. This year we are hosting events to connect our members and non-members alike through our Healthy Nurse Healthy Nation activities. We have reinstated our membership committee and will begin more educational outreach efforts. Based on member feedback we have changed the format of our annual membership meet to include five hours of CE. We continue to visit healthcare organizations and schools of nursing to share the role we play in policy development.
We will continue to harness our social media platforms and other technology to expand our reach. At the same time, we will continue to offer our in-person events that allow members to connect and develop relationships. I hope to see you at the upcoming ANA-Illinois Professional Issues Conference on 11/4/2017. I would be honored to have your vote.
Secretary
Kathryn Serbin, DNP, MS, BSN, CCM
Kathryn Serbin, DNP, MS, BSN, CCM has been a servant leader in nursing for over thirty-five years. Serbin is passionate about advocating for patients.
While serving as Chair of the Commission for Case Managers Certification a national certification
organization with over 35,000 certificants, she went to Capitol Hill to meet with legislative representatives on care coordination and transitions in care. She has published numerous articles on case management and cultural diversity and has been the Health Talk writer for the Association of the United States Navy Magazine since 2010.
In her civilian employment, Serbin is the Associate Chief Nurse for Surgical Services at the James A. Lovell Federal Health Care Center, North Chicago, IL. At Lovell, Kathryn is a member of the Institutional Review Board, as well as Chair of Preventive Ethics. She has her master's degree in psychiatric nursing and a certified case manager. She completed her DNP from the University of Illinois, Chicago campus in 2015.
Serbin has a solid knowledge of the role of Secretary and parliamentarian procedure, and has been honored to serve as Secretary of ANA-Illinois for the past two years. "I have been actively involved in initiatives and the implementation of the ANA-Illinois Strategic Plan. I am interested in continuing to serve as Secretary because, I strongly believe organizations such as ANA have a critical role in generating the flow of ideas and proactive work needed to maintain a healthy profession that advocates for the needs of nurses and the patients we serve. It is through our involvement with professional organizations and associations that we promote a healthy workforce for the future and ensure the trust of society. I have seen the positive impact of the strong lobbying efforts of ANAIllinois in Springfield and the strong relationships that have been developed through collaboration. It is a very exciting time for ANA-Illinois and I would like to continue serving on the Board as we move forward. I appreciate your support and your vote. Thank You.
Director at Large - 2 to be elected
Amanda Buechel BSN, RN
My name is Amanda Buechel and for the past year I have been serving as a Director at Large for ANA-Illinois. While in this position, I speak to many student nurses, and practicing nurses to encourage them to pursue leadership opportunities. I additionally organize and speak at various presentations throughout the state of Illinois. In several of these presentations, I have offered informed and educated opinions on political issues affecting nursing, leadership opportunities, and organizational involvement. My personality and willingness to accommodate others creates a comfortable atmosphere. I am available for anyone who is looking to get involved. In 2016, I was selected as a 40 under 40 Emerging Nurse Leader. In June of 2017, I was elected to the ANA Board of Directors as Director at Large-Recent Graduate. If elected to ANAIllinois Director at Large, I will continue to share my knowledge and advocate for the nursing profession. I hope to continue sharing my passion for nursing and empowering nurses to be involved in their profession. Please vote for Amanda Buechel as ANA-Illinois Director at Large. Thank you.
Colleen Morley MSN, RN, CMCN, ACM
I have been a registered nurse in the State of Illinois since 1999, having earned my ADN in 1999, BSN in 2008, MSN in 2010 and currently pursuing my DNP (target graduation date 12/2017). I have worked in several acute care facilities in the greater metropolitan Chicago area; primarily medical/surgical nursing, pediatrics and behavioral health and have transitioned in the case management nursing for past 12 years, in managed care (PPO and Managed Medicaid HMO) and acute care (inner city safety net & suburban) environments, which gives me a unique perspective on how different case management programs/settings can and should work together for the benefit of the patient/ client/member.
(CMCN) and promoted that certification as a step on the career ladder when certified case manager (CCM) requirements changed to exclude a population of the staff. I seek to promote education of all nurses about the impact of the revenue cycle on nursing and how to reconcile the caring and financial considerations of healthcare.
I have been an active member of Case Management Society of America (CMSA) Chicago Board of Directors for eight years; as a Director, Secretary, Membership Secretary and have been elected President-Elect for 2017-19. I consider myself an “idea person”, with the ability to critically analyze a situation and identify gaps and potential solutions. During my tenure as Secretary of CMSA Chicago, using a digital format for member communication, CMSA Chicago was able to decrease printing costs by over $7000 in the first year and to less than $500 per annum currently. In collaboration with another BOD member, we developed our weekend ½ day symposiums to reach a segment of our membership population that cannot attend our week night meetings. I would be honored to serve on the ANA Illinois Board of Directors and am submitting my nomination for consideration on the 2017 ballot. I look forward to serving the Board and all ANA Illinois membership.
Kathryn A Weigel MS, RN, GCNS
Hi! My name is Kate (Kathryn) Weigel, and I am seeking the opportunity to serve as a Director on the ANA-Illinois Board of Directors.
I am a Gerontological Clinical Nurse Specialist and an Assistant Professor in the University of St. Francis Leach College of Nursing in Joliet, where I teach courses in research, management, ethical/legal issues, and two courses in gerontology, including an international/interdisciplinary course. I have 30 years of prior employment in public health in Wisconsin and longterm care in Minnesota and Illinois in staff, management, administrative, and consultative positions, and completed my Masters at University of Illinois as a Hartford Foundation Scholar. As faculty advisor to our chapter of the Student Nurses Association since 2013, I support and foster student engagement in professional activities, including attendance at Student Nurses Association of Illinois (SNAI) and National Student Nurses Association (NSNA) conferences and conventions and Student Nurse Political Action Day, and involvement in school and community endeavors. I have been past chair of our departmental curriculum committee for three years, President of our chapter of Sigma Theta Tau International (STTI) since 2011, and a member since 2011 and served as President (2014) of the Board of Directors of a notfor-profit retirement facility in Joliet. I have worked collaboratively with others to enhance the operations of these entities. I have proven performance in community, professional, and academic areas. I serve with commitment, sound judgment, and integrity. I also am a strategic thinker, able to subordinate special interests, and have the time to commit to the responsibilities of a Director on the ANA-Illinois Board of Directors. I bring many experiences and talents to any table and believe that I can help ANA-Illinois increase its presence and relevancy for nurses and students in the state. I will be an extremely effective member of the Board of the Directors.
Nominations Committee - 2 to be elected
Timbolin D. Holmes MSN, RN, APN, CNP, ACNP-BC, ACNPC
As a leader and mentor in case management, I am always encouraging case managers to get certified in whatever field or certification is appropriate for them. I was the first Registered Nurse at Blue Cross Blue Shield of Illinois to become a Certified Managed Care Nurse
I have been a nurse for the past 23 years in various capacities, but have worked as a nurse practitioner the last six years. During this time, I have amassed a wealth of different skills and experiences that will afford me the ability to provide a rich insight and perspective on topics and issues affecting nurses today. I have multiple nursing certifications and attend continuing education courses that help keep me current with the most up-to-date evidenced-based practice protocols. I also have contributed to the future nursing workforce as a
instructor/adjunct faculty member/professor
candidates and master’s-degree candidates as well as provide high-quality, compassionate care to patients in the clinic as a nurse practitioner. In my spare time, I volunteer whenever possible and have been a team member of the Illinois Medical Emergency Response Team/Illinois Nurse Volunteer Emergency Needs Team for many years. In conclusion, I would be a valuable team member and an asset to the ANA-Illinois Board.
Theresa Schwindenhammer PhD, RN
I have been in baccalaureate nursing education for the past 13 years. I have also taught at the graduate level and have been a nurse in Illinois for 30 years. I think it is very important for all nurses to be involved in political action and their state and national nursing organizations. It is so very important with all the changes occurring in health care and in nursing. Advocacy for our patients is necessary as well as for our profession. I am very passionate about nursing and want to instill in my students the importance of being involved in nursing organizations to promote the best practice that is evidence based. In order to accomplish this, I need to be a role model for them to show how important advocacy and political action are in one’s nursing career. My hope is to be a voice for nursing across the state and national levels. I have had many years of committee work within my organization, the National League of Nursing and American Nurses Association.
Benson Wright MSN, RN, CTN-B
Thank you for considering me for a board position with ANAIllinois. I have felt compelled to serve after seeing the tireless efforts of ANA-Illinois to protect nursing and improve patient care this past legislative session. I am proud of my membership in ANA-Illinois and want to give back to the organization. I have served on numerous nursing and other health related boards over the past 10 years and believe those experiences make me a strong candidate for the ANA-Illinois Nominations Committee. I helped create the NC3 (Nursing Care Committee Consortium) with the Illinois Organization of Nurse Leaders (IONL) to strengthen the mandated nursing care committees across Illinois hospitals. I chaired the Membership Connect and Engagement Task Force with Sigma Theta Tau International to provide the international organization with strategies to engage diverse members across the globe. Currently, I serve on the Board of Directors for the Sigma Theta Tau International Foundation for Nursing to assist the organization in active fundraising and fiscal stewardship. I live in the south loop of Chicago, but travel frequently for work across the state of Illinois.
2017 INF Scholarship Winners
SCHOLARSHIP
ARTHUR L. DAVIS
The Illinois Nurses Foundation gave a total of $12,000 in scholarship awards in June 2017. We are pleased to be able to support these nurses and/or student nurses.
Name SCHOOL/COLLEGE
Mary Bowman DePaul University
DR. WENDY BURGESS MEMORIAL Stephanie Gedzyk-Nieman Lewis University
CENTENNIAL Chanale Jackson Saint Xavier University
CENTENNIAL Kathleen Fabular Saint Xavier University
District 2 Raquel Harris University of Saint Francis
District 2
District 21
Grace Estrada Joliet Junior College
Timothy Hartmann Chamberlain College of Nursing
NORTH SUBURBAN NURSING Libby Ross Northern Illinois University
SONNE Angelica Michalak Dominican University
SOUTH SUBURBAN NURSING Chanel Smith Prairie State College
CoNtINUINg e d U C at IoN
Care of a Patient with an LVAD
Kimberly Buck, BSN, RN Blessing Hospital, Quincy, IL
Heart failure (HF) is a major health issue and there is an ever-increasing number of patients diagnosed with HF each year (Centers for Disease Control, 2016). In our community, we are seeing an increasing number of patients that have a left ventricular assist device (LVAD) placed as a bridge therapy to a heart transplant. These patients are presenting to our hospital and often require care unrelated to their device. It has been a standing practice to transfer these patients to the nearest implanting hospital for all care. However, this practice is changing and these patients are being admitted and staff are not well informed or not comfortable in the care of these patients. Therefore, the purpose of this article is to provide staff who may care for these patients with the essential basics of caring for a patient with a LVAD.
Brief Overview
It is estimated there are five million patients in the U.S. today who have heart failure, and approximately 50% will die within five years of diagnosis (Go, et al. 2013). Initially these patients can manage the HF with lifestyle modifications and medications. As their clinical status deteriorates, more aggressive therapies are required for their survival.
Heart transplant is the gold standard treatment for HF. However, this treatment is prohibitive due to the lack of available organ donations and the sheer increase in the prevalence of HF. There are only 2,000 heart transplants each year, and 4,000 worldwide, leaving a huge gap in viable treatment options for those patients diagnosed with advance heart failure. Approximately 50,000 to 100,000 patients could benefit from a ventricular assist device (VAD) (Centers for Disease Control, 2016).
Mechanical circulatory support devices (MCSDs) are the patient’s alternative to heart transplant. These devices are mechanical pumps surgically implanted in a HF patient’s chest to support heart function and blood flow such as a VAD.
Types of MCSDs/VADs
There are four types of ventricular and mechanical circulatory devices. They include:
• Right ventricular assist device (RVAD).
• Right ventricle to pulmonary artery pump, which is short term and only in the hospitalized patient.
• Biventricular assist device (BIVAD), which is used only when both ventricles require support.
• Left ventricular assist device (LVAD), which is a left ventricle to aorta pump.
Of these devices, the most common type used is the LVAD and will be the focus of the article. Over 20,000 patients have an implanted VAD, having been diagnosed with end-stage heart failure and are expected to live only weeks or months unless they receive a heart transplant or an LVAD. The survival rate of those who receive an LVAD implantation is 68% in the first year. Some patients are living more than eight years post implant (Centers for Disease Control, 2016).
Use of the LVAD
The use of the LVAD is determined through a multifaceted evaluation that can be used for a variety of aims in therapy such as (National Heart, Lung, and Blood Institute, 2012):
• Bridge to recovery: Used to promote myocardial function recovery to a level that allows for removal of the LVAD.
• Bridge to transplant: Heart is supported by the LVAD until a heart transplant becomes available.
• Bridge to decision: Heart function is supported by the LVAD until the decision related to transplant eligibility has been reached.
• Bridge to destination therapy: Used when patients are not eligible for transplant and the device is used as a permanent support until death.
Mechanisms of the Device
The basic design concepts of the LVAD are essentially the same regardless of the manufacturer. A titanium or stainless pump pulls blood from the apex of the left ventricle and pushes the blood into the aorta. An inflow cannula that is connected to the apex of the left ventricle draws blood from the left ventricle into the pump. An outflow cannula carries blood from the pump to the ascending aorta to circulate to the rest of the body. A drive line exits the patient’s body at the chest or abdomen, connecting the internal pump to the external controller and is one of the three lines that connect to the controller. The drive line allows the pump to receive power and instructions from the controller. It is essential to the patient’s heart function and life that this cable remains attached to the controller.
The controller is the brain of the pump system, adjusting the pump’s flow rate and monitors for issues and alarms. The controller also regulates power to the pump, monitors the pump’s performance, and collects data on the system’s operation. All systems have both visual and audible alarms. The power for the system is batteries and a plugged-in power module.
Types of Pumps
There are two types of pumps. One type of pump is the first generation pulsatileflow device that produces a pulse pressure, mimicking the systole and diastole of the heart. More commonly used is the second generation continuous-flow device. This pump is preferred because it is smaller, has a better rate of survival, increases quality of life, and has increased durability.
Common Complications
The common complications that staff need to anticipate include the following.
Hypotension
A MAP of 70-90 mmHg must be maintained and preload must also be maintained as the pump requires a continuous and consistent blood volume in order to function (Birati & Rame, 2014).
Infection
Infection is the most significant cause of morbidity and mortality for the patient with an LVAD (Hannan, et al., 2011). The most common site is the driveline. When sepsis occurs, treatment and causes are managed using the standard practices for sepsis (Hannan, et al., 2011).
CVA
Ischemic strokes due to thromboembolic events such as pump thrombosis, subtherapeutic anticoagulation, or immune system activation of prothrombotic state can occur (Tsukui, et al., 2007). Another risk is hemorrhagic strokes due to over anticoagulation or infection.
GI Bleeding
GI bleeding occurs in 24% of patients with an LVAD due to multimodal anticoagulation such as ASA, Coumadin, and Plavix (Slaughter, et al., 2010).
Dysrhythmias
LVAD patients have a high risk for atrial and ventricular dysrhythmias as noted below (Yancy, et al., 2013).
• Atrial dysrhythmias: Treatment is the same as those patients without an LVAD, with the use of Amiodarone being preferred.
• Ventricular dysrhythmias: Most LVAD patients have an automated implanted cardioverter defibrillator (AICD) for this dysrhythmia. The use of Amiodarone, fluids, and if patient is receiving internal shocks, treatment of anxiety is also indicated.
Device Specific Alarms
It is crucial that providers are aware of the critical alarms and how to correct the issues that they indicate. When responding to alarms, the patient and family are valuable resources because they are given extensive education prior to discharge from the original implanting facility. They also receive a “Go Bag” that carries information, batteries, and pieces of equipment to maintain the device’s specific needs; and they are highly encouraged to have this bag with them at all times.
The most common alarms include:
Pump Failure
The cause may be a driveline disconnection or fracture, electrical failure, or connector malfunction. The first line of correction is to ensure all connections are secure. If the issue is a fractured driveline, the correction will require surgical intervention. To assess if the pump is working, auscultation at the apex of the heart is done to listen for the whirling/humming sound that indicates the pump is functioning.
Low Battery Alarm
With this alarm, the actions are to ensure that the device is connected to the batteries and all connections are secure, or the patient is able to use an AC power source.
Controller Failure
The first action is to check the “Go Bag” for the spare preprogrammed controller and contact the VAD coordinator for assistance. The contact number is located on the module or in paperwork found in the “Go Bag.” It is essential to remember that the pump function is dependent on the energy source. Therefore before disconnecting the current controller in order to exchange it with the spare controller, it is critical to have all equipment prepared and connect the new preprogrammed controller to a power source prior to disconnection of the driveline from the current controller.
Fundamentals of Assessment and Care
When the patient is admitted, it is necessary to start with the patient and family. They are the best resources for care and assessment of the LVAD system and the patient’s baseline. When caring for and assessing the LVAD, the following interventions are implemented:
• Look for the patients “Go Bag:” This bag will have contact numbers, manufacture/operator guides, and extra items that may be required for the maintenance of the system such as extra controller, batteries, and other essential items.
• Check the color banding located on the controller: This intervention identifies the type of device, the institution that implanted it, and a contact number. The color-coding was developed by the VAD coordinators from the largest and most successful VAD implantation hospitals in the U.S. and is used as a means to assist in VAD identification and management of the patient.
• Look for the battery pack: The battery pack may be in a “gun’ vest, suspender system, or messenger-style bag with cables emerging from it. Generally there are two batteries and these connect to the controller. Assessing the battery pack is done by asking the following two questions. Are the batteries charged? Are the connections secured? Assessment is also done by looking for the indicator light on the batteries and exchange one battery at a time if indicated.
• Look for the fanny pack or bag: This bag usually holds the controller and may have two side packs that secure the rectangular batteries. There are generally three cables connecting to the controller. Two cables are from the batteries and one is the driveline that enters the patient’s abdomen or chest connecting the controller to the internal pump. Assessment is done by examining that the controller has power, all leads are securely connected, and an additional preprogrammed controller is in the patients “Go Bag” for exchange if it is absolutely required. Before exchanging the controller, it is imperative that the VAD coordinator is contacted to assist with this process.
• Access the pump: To access the pump, which is internal, a stethoscope is placed at or below the apex of the heart to listen for a low whirring sound or hum. This sound is heard when the pump is operating normally.
• Protect the driveline: This line is internal and exits the patient’s chest or abdomen. It is a percutaneous line that supplies the internal pump with power from the external controller. This line is the patient’s lifeline and must be protected at all times. Any repairs to this line will require surgery and as a result will require emergent transfer to an implanting facility.
• Note the generation of the device: This intervention is crucial because second and third generation devices may create a non-palpable pulse or blood pressure. Therefore, a Doppler is used to determine the mean arterial pressure (MAP) and may be the only method to yield a blood pressure measurement. The MAP will be the first sound heard with the Doppler when the cuff pressure is released. The goal in general is a MAP of 70-90 mmHg. When using a non-invasive blood pressure machine, the indicated mean reading is used.
• Use the American Heart Association (AHA) C-A-B for initial assessment: Using the AHA C-A-B sequence, with one small adjustment in the C category, is a sound method of initial patient evaluation. The sequence involves C for circulation and connections of the device, A for airway, and B for breathing. Other items to assess are the patient’s level of consciousness, skin color/turgor, and capillary refill. Assessing respiratory rate, quality, and waveform of capnography are the best measurement of respiratory function.
Common Questions Regarding the Care of the LVAD Patient
Staff caring for patients with a LVAD will have many questions such as the following:
• Can CPR be performed on a patient with an LVAD? The answer is only if absolutely necessary and only as a last resort IF THE PUMP IS NOT RUNNING. With most of the VAD devices, there is no hand pump or external device to use in the event of pump failure. If CPR is performed on the patient, staff must be aware that the patient is at a high risk for bleeding internally due to CPR causing pump dislodgment. If in an arrest, it is acceptable to use ACLS drugs per protocol with no CPR. However, when using ACLS protocol, the following drugs must be used with extreme caution: Amiodarone; Lidocaine; Beta-blockers such as Labetalol, Lopressor, and Esmolol; and Calcium channel blockers such as Nicardipine, Cardizem, and Amiodipine (Pratt, Shah, & Boyce, 2014). Magnesium sulfate should be avoided as it may cause hypotension from relaxation of smooth muscles. It is prudent to avoid any drug that decreases preload of the heart unless in an arrest condition.
• What is indicated if the device slows down/ low flow state, 2.5 lpm, as indicated by a red heart alarm light and steady audio alarm? The intervention is to give a bolus of 200-500 ml of normal saline and transfer the patient to an LVAD center (Aggarwal, et al., 2013). Normal flow rate is 4 lpm for cardiac output. It is essential to the function of the LVAD pump that preload be preserved and maintained. If the pump cannot fill, it can potentially collapse the heart in an attempt to fill. (Birati, & Rame, 2014). The speed of the device cannot be changed as this is a fixed rate.
• Does the patient need to be heparinized if the device slows down? The answer is not usually, but it is best practice to confer with the implanting center. Generally, the LVAD patient will be kept in the INR range of 2-3 plus and therefore may not require additional anticoagulation. The patient is also likely to bleed profusely with multiple attempts to insert any access device (saline lock) or with drawing of blood samples.
• Can the patient be defibrillated while remaining connected to the device? The answer is yes. They can be defibrillated, cardioverted, or paced with an LVAD in place. It is advisable to avoid placing the gel pads directly over an LVAD pump for any of the above-mentioned events. Staff must remember that not all pumps will have a palpable pulse. Therefore, reevaluation of pump function must be done through auscultation at the apex of the heart, listening for the whirling sound.
Dos
• What is an acceptable MAP reading for these patients? The answer is a MAP of 70 to 90 mmHg. This range is generally an acceptable finding (Birati & Rame, 2014). There are, however, indications not to exceed a MAP of over 80 mmHg for some devices. Therefore, it is recommended to contact the original implanting facility for additional information at first available opportunity.
• Can an EKG be performed and will it be accurate? The answer is yes. Most LVAD pumps will not affect EKG readings. LVADs as a general rule do not effect electrical conduction in the heart.
A Few Do’s and Don’ts
The following interventions are critical with an LVAD:
• Intubate the patient if the patient is respiratory compromised. If indicated, the provider can administer one Duoneb treatment to the patient.
• Get a 12 lead EKG to evaluate cardiac rhythm and conduction.
• Use O2 as indicated to maintain the patient’s oxygenation capacity.
• Give fluids to maintain the heart’s pre-load, a MAP of 70-90 mmHg, and LVAD pump function (Birati & Rame, 2014),
• Use medications such as Fentanyl, Ketamine, and Ativan when indicated.
Don’ts
These actions are not indicated with a LVAD:
• Do not administer ASA, Plavix, or any other anticoagulant prior to accessing the current INR due to the high probability of an already elevated level.
• Do not administer any NSAIDs due to their antiplatelet properties.
• Do not administer Nitroglycerin, Morphine, or other vasodilators due to preload reduction effects.
• Do not administer Valium or Versed if the MAP is under 65 mmHg due to preload reduction effects.
• Avoid the use of diuretics as this will reduce preload.
• Do not place the patient on CPAP as preload decreases with a higher peep.
Conclusion
The incidence of HF is increasing and the use of LVAD as advanced therapy is in high demand. Members of our community are undergoing LVAD implantations and we, as providers, will be responsible for the provision of well-informed care. All providers must have a working knowledge of VADs, the components, the critical alarms, common complications, how to assess and evaluate, and manage this patient population.
IONL Focuses on Leadership Pathway with Educational Programming
The Illinois Organization of Nurse Leaders (IONL) is dedicated to advancing leadership among nurses in the state, and one of its strengths has been educating nurses at many different levels of the leadership pathway. By offering programming that teaches specific skillsets crucial for success in the current world of Illinois healthcare, as well as providing timely discussions and policy statements regarding healthcare policy on the national level, IONL is consistently focused on the future of nursing.
IONL received great responses this year to its handson leadership approach to workshops that feature inperson education from leading nursing professionals. Earlier this summer, IONL offered the Midwest Institute for Healthcare Leadership at the Quinlan School of Business at Loyola University in Chicago, where attendees benefitted from presentations on how to integrate business techniques and healthcare delivery.
There are two more workshops scheduled for this year, including IONL’s first Finance Workshop, August 17, at Northern Illinois University in DeKalb. This workshop is designed for staff nurses, charge nurses, nurse coordinators, managers and directors who want to learn about specific financial topics related to nursing administration. The workshop will dive into creating
budgets and financial plans for nursing operations, the capital budgeting process, and value-based purchasing. The Aspiring Nurse Leader Workshop on November 17 at Rush University Medical Center will deliver vital information on certifications, resources and skills necessary for nurses interested in achieving more in their careers.
In addition to these workshops, IONL is celebrating its 40th anniversary at the Annual Conference, September 21-22, in Lisle, Illinois. While honoring the organization’s milestones and achievements over the years, IONL will also look towards the future with a newly-announced educational program. With the theme “Breaking the Status Quo: Innovations and Transformations,” experts will discuss current issues in healthcare and leadership that are relevant to all nurse leaders. The 40th Anniversary Celebration at the conference will include an awards ceremony to honor the work of outstanding nurse leaders, as well as speeches from IONL past presidents and leaders who will share their nursing expertise.
If you haven’t already, join IONL in commemorating its 40th anniversary and attend one of these exceptional events that offer the skills and perspectives necessary to achieve higher heights in your nursing career. Visit www. ionl.org or call (312) 265-3927 for more information.
CE Offering
1.0 Contact Hours
This offering expires in 2 years: August 23, 2019
Learner Outcome:
After reading the article, the nurse will be able state the essential basics of caring for a patient with a left ventricular assist device (LVAD).
HOW TO EARN
CONTINUING EDUCATION CREDIT
This course is 1.0 Contact Hours
1. Read the Continuing Education Article 2. Go to https://ilnursesfoundation.wufoo.com/ forms/sept-2017self-study/ to complete the test and evaluation. This link is also available on the INF website www.illinoisnurses.foundation under programs.
3. Submit payment online.
4. After the test is graded, the CE certificate will be emailed to you.
HARD COPY TEST MAY BE DOWNLOADED via the INF website www.illinoisnurses.foundation under programs
DEADLINE
TEST AND EVALUATION MUST BE COMPLETED BY August 23, 2019
Complete online payment of processing fee as follows:
ANA-Illinois members- $7.50 Non members- $15.00
ACHIEVEMENT
To earn 1.0 contact hours of continuing education, you must achieve a score of 80%
If you do not pass the test, you may take it again at no additional charge
Certificates indicating successful completion of this offering will be emailed to you.
The planners and faculty have declared no conflict of interest.
ACCREDITATION
This continuing nursing education activity was approved by the Ohio Nurses Association (OBN-00191), an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
CE quiz, evaluation, and payment are available online at https://ilnursesfoundation.wufoo.com/ forms/sept-2017self-study/ or via the INF website www.illinoisnurses.foundation under programs.
Indian Nurses Association of Illinois (INAI)
Indian Nurses Association of Illinois (INAI) is a professional body to identify and meet the professional, educational, cultural and social needs unique to nurses of Indian origin and heritage. The INAI has shown its valuable presence in the community, among nurses of Indian origin and their professional peers.
The activities of this Association focus on free/discounted rate continuing education, career development opportunities, leadership enhancement training, mentoring programs, professional recognition, participation in legislative activities to make changes in health care, resume booster, social events, encouraging community relations and empowering nurses. The team focuses on health promotion of the community, professional development and personal growth of nurses, and educational and career guidance for nursing students.
The educational activities are in a threefold track, which comprises clinical, community outreach and advanced practice nurses. The Association has informational and CE seminars and the educational calendar is planned for the whole year in advance. Topics include legal issues in nursing, budget / finance, workplace safety, EKG and ABG interpretation. The APN forum is hosting the pharmacology conference during APN week this November and then in March.
The Association works in close conjunction with the community. Community outreach programs include CPR for friends and family in different venues and other events in collaboration with other health care disciplines. A Health Fair in September will include screening for vision, blood pressure, and diabetes, mini presentations on stroke, diabetes, cardiac arrest, sleep apnea, advance directives and gastrointestinal issues.
As a member association of the National Indian Nurses Association of America (NAINA), INAI participates in all educational and community outreach programs. The INAI has been working in close alignment with the American Nurses Association- Illinois in its initiatives. This chapter hosted the national conference in 2016. Many of the members of this association have been presenting topics in numerous other national health care platforms.
Supporting the education of its members is one of the primary goals of the Association. Mentoring program and writing assistance programs are planned. Many members have attained higher degrees, including terminal degrees and fellowships, including one from Harvard. Nurses are recognized for their clinical excellence, leadership and advance nursing practice roles.
This Association contributes to the charity initiatives and has stepped up to aid the needy in times of stress and natural calamities. Educational assistance to nursing students in the form of scholarships is also part of the initiative. Cultural programs to enrich the talents and to promote social interactions are also promoted.
The Association urges nurses to become proud partners in fulfilling its multifaceted goals and initiatives. The goals include collaboration among various health care disciplines and nursing organizations, enriching nurses’ knowledge regarding advancement in the profession and compliance regulations, providing educational opportunities to fulfill unique needs of nurses in different roles, and offering to mentor and fulfill the social commitment through community outreach programs.
Executive Board:
Beena Vallikalam (President)
Sunina Chacko (Secretary)
Mary Xavier (Executive Vice President)
Rani Kappen (Vice President)
Lucy Peters (Treasurer)
Too Tired to Function: Nurse Fatigue
Barbara Brunt, MA, MN, RNBC, NE-BC, FABC
Nurse fatigue is defined by the American Nurses Association (ANA) as impaired function resulting from physical labor or mental exertion. There are three types of fatigue: physiological (reduced physical capacity), objective (reduced productivity) and subjective (weary or unmotivated feeling).
Both registered nurses (RNs) and employers have an ethical responsibility to carefully consider the need for adequate rest and sleep when deciding whether to offer or accept work assignments, including on-call, voluntary, or mandatory overtime. Evidence-based strategies must be implemented to proactively address nurse fatigue and sleepiness; to promote the health, safety, and wellness of registered nurses; and to ensure optimal patient outcomes (ANA, 2014).
The following definitions are provided to ensure that everyone has the same understanding of terms.
Culture of safety: core values and behaviors resulting from a collective and sustained commitment by employers and health care workers to emphasize safety over competing goals.
Fatigue countermeasures: a range of evidence-based strategies aimed at either temporarily reducing and counteracting the effects of fatigue or sleepiness. Examples are the strategic (therapeutic) use of caffeine or naps and the combination of caffeine and naps to temporarily increase alertness.
Mandatory overtime: employer-mandated work hours beyond normally scheduled or contracted hours in a day or week, including required work over 40 hours in any seven-day period.
Sleepiness: the increased propensity to fall asleep. In contrast to fatigue, sleepiness is specifically due to imbalance in sleep and wake time, disrupted circadian rhythms, or inadequate quantity and quality of sleep.
Stakeholders: departments, organizations, union, individuals, families, communities, and populations that can affect or be affected by any policy, guideline, or change in a process that is implemented.
Voluntary overtime: work hours above and beyond the routinely recognized hours for the workweek without undue pressure from the management (ANA, 2014, pp. 8-9).
This article will provide background information, outline responsibilities of RNs and employers, and review research related to this issue.
Background
Inadequate sleep and resulting fatigue can affect a RN’s ability to deliver optimal patient care. Working fatigued can lead to an increased risk of error; a decline in short-term and working memory; a reduced ability to learn; a negative impact of divergent thinking, innovation, and insight; increased risk-taking behavior; and impaired mood and communication skills. In addition, fatigue and sleep-deprived nurses are more likely to report clinical decision regret, which occurs when their behaviors do not align with professional nursing practice standards or expectations (ANA, 2014).
Fatigue also has major implications for the health and safety of RNs. Substantial scientific evidence links shift work and long working hours to mood disorders, obesity, diabetes mellitus, metabolic syndrome, cardiovascular disease, cancer, and adverse reproductive outcomes (ANA, 2014).
In addition, driving when drowsy endangers the lives of both the driver and other people on the road.
With this being ANA’s Year of the Healthy Nurse, it behooves all of us to implement strategies to maintain our own health, to protect the health of those we serve.
In addition to the health and safety risks, the effects of fatigue and sleepiness have financial ramifications. Direct costs to employers include increases in health care costs, workers’ compensation claims, early disability costs, recruitment and training costs, and legal fees (ANA, 2014). Nurse fatigue is frequently linked to patient safety initiatives. Despite regulations on shift length and cumulative working hours for resident physicians and people in other industries, there are no national work hour policies for RNs. Staffing issues, coupled with
a weak economy, have motivated nurses to work past the end of their scheduled shift or to work additional shifts. One study using a sample of 22,275 RNs from four states showed that the longer the shift, the greater the likelihood of adverse nurse outcomes such as burnout and patient dissatisfaction (ONA, 2015). The Institute of Medicine recommends that RNs not exceed 12 hours of work in a 24-hour period and 60 hours of work within seven days (Institute of Medicine of the National Academies [IOM], 2004).
The Centers for Disease Control and Prevention provides training for nurses on shift work and long work hours through two free continuing education programs: CDC course numbers WB2408 and WB2409. The purpose of this online training program is to educate nurses and their managers about the health and safety risks associated with shift work, long work hours, and related workplace fatigue issues. Part 1 is designed to increase knowledge about the wide range of risks linked to these work schedules and related fatigue issues and promote understanding about why these risks occur. Part 2 is designed to increase knowledge about personal behaviors and workplace systems to reduce these risks. Content for this training program is derived from scientific literature on shift work, long work hours, sleep, and circadian rhythms (NIOSH, 2015).
Responsibilities of RNs
As advocates for health and safety, RNs are accountable for their practice and have an ethical responsibility to address fatigue and sleepiness in the workplace that may result in harm and prevent optimal patient care. Nurses need to arrive at work alert and well rested, and should take meal and rest breaks and implement fatigue countermeasures as necessary to maintain alertness. RNs are responsible for negotiating or even rejecting a work assignment that compromises the availability of sufficient time for sleep and recovery from work. The amount of recovery time necessary depends on the amount of work, including regularly scheduled shifts and mandatory or voluntary overtime (ANA, 2014). Examples of evidence-based fatigue countermeasures and personal strategies to reduce the risks of fatigue are outlined in the ANA position statement background information:
1. Sleep 7-9 hours within a 24-hour period and consider implementing strategies to improve the quality of sleep, such as adjusting the sleep environment so it is conducive to sleep (e.g. very dark, comfortable, quiet, and cool) and removing distractions such as bright lights and electronics from the sleep environment.
2. Rest before a shift to avoid coming to work fatigued.
3. Be aware of side effects of over-the-counter and prescription medications that may impair alertness and performance.
4. Improve overall personal health and wellness through stress management, nutrition, and frequent exercise.
5. Use benefits and services provided by employer, such as wellness programs, education and training sessions, worksite fitness centers, and designated rest areas.
6. Take scheduled meals and breaks during the work shift.
7. Use naps in accordance with workplace policies.
8. Follow established policies, and use existing reporting systems to provide information about accidents, errors, and near misses.
9. Follow steps to ensure safety while driving, such as recognizing the warning signs of drowsy driving, using naps or caffeine to be alert enough to drive, and avoiding driving after even small amounts of alcohol when sleep-deprived. Actions such as putting windows down, pinching themselves, or turning up the radio do not work.
10. Consider the length of a commute prior to applying for employment.
11. Prior to accepting a position, consider the employer’s demonstrated commitment to establishing a culture of safety and to reducing occupational hazards, including nurse fatigue (ANA, 2014).
If necessary, a RN should seek a schedule that is a better fit for his or her needs by negotiating with the employer or by seeking other employment if negotiation is not possible.
Responsibilities of Employers
Employers of RNs are responsible for establishing a culture of safety, a healthy work environment, and for implementing evidence-based policies, procedures, and strategies that promote healthy nursing work schedules and that improve alertness. Safe levels of staffing are
essential to providing optimal patient care and ensuring a safe environment for patients and RNs (ANA, 2014). Employers should limit shifts (including mandatory training and meetings) to a maximum of 12 hours in 24 hours. Those limitations should include on-call hours worked in addition to actual work hours. In addition, they should conduct regular audits to ensure scheduling policies are maintained. Employers have a duty to ensure that nurses can take meal and rest breaks during work shifts. Furthermore, employers should facilitate the use of naps during scheduled breaks, as the benefits of napping during long shifts are well supported by research (ANA, 2014).
ANA recommends implementation of the following evidence-based strategies:
1. Eliminate the use of mandatory overtime as a staffing solution.
2. Have employers adopt – as official policy- the position that RNs have the right to accept or reject a work assignment to prevent risks from fatigue, that such rejection does not constitute patient abandonment, and that RNs should not suffer adverse consequences in retaliation for rejecting in good faith a work assignment to prevent risks from fatigue. This should include a system to evaluate instances of RNs rejecting assignments to evaluate causes and effectiveness of staffing patterns.
3. Institute an anonymous reporting system for employees so they can give information about their accidents, errors, and near misses. Factors that increase the risk for fatigue-related errors should be included in incident investigations so employers can determine if fatigue was a contributing factor.
4. Institute policies that address the design of work schedules, such as limits on overtime; actions to take when a worker is too fatigued to work; and policies and procedures during emergencies caused by weather and major disasters, when a large influx of patients may unexpectedly arrive at the health care organization.
5. Design schedules according to evidence-based recommendations. This includes involving nurses in the design of work schedules, using a regular and predictable schedule so the nurse can plan for work and personal responsibilities, and examining work demands with respect to shift length. Other strategies include limiting shifts to 12 hours, limiting work weeks to 40 or fewer hours per week, promoting frequent, uninterrupted rest breaks during work shifts, and planning two rest days after three consecutive 12-hour shifts, and limiting the number of consecutive 12-hour shifts to three shifts.
6. Reduce risks of drowsy driving by providing transportation home when a nurse is too tired to drive safely or by providing sleeping rooms close to the health care facility.
7. Promote fatigue management training and education for employees and managers, including education about sleep disorders (ANA, 2014).
Research Studies
Wolf and colleagues (2017) studied the effects of sleep and fatigue on cognitive performance. Their sample consisted of 1,506 nurses who worked at least one shift a week in an Emergency Department in the United States. They evaluated their performance on timed cognitive skill tests on medication dosage calculations. Although there were not statistically significant relationships between the speed and accuracy of their responses with sleep patterns, sleep quality and fatigue, a significant percentage of the sample reported high levels of sleepiness and chronic and acute fatigue that impeded full function both at work and at home. Although the authors could not determine from this study whether levels of self-reported fatigue affect cognitive function, participants did report difficulty with providing both selfcare and patient care. Further research is needed.
A qualitative interview study was conducted by Steege and Rainbow (2017) to explore barriers and facilitators within the hospital nurse work system to nurse coping and fatigue. Twenty-two nurses working in intensive care and medical-surgical units within a large academic medical center participated in the interviews. All nurses in the study experienced fatigue, yet they had varying perspectives on the importance of addressing fatigue in relation to other health system challenges. A new construct related to nursing professional culture was
Barbara Brunt
Thank You for Having Tea with Florence
“Observation is not for the sake of piling up miscellaneous information or curious facts, but for the sake of saving life and increasing health and comfort. Take in the whole of a thing; person or place for only the whole can reveal to you the patterns of meaning.” On May 13, an audience of 225, nurses and their colleagues, heard actress Megan Wells interpret the life of Florence Nightingale. The actress received a standing ovation for her perceptive interpretation of the nursing icon from the grateful crowd attending “Tea with Florence” at the Irish American Heritage Center.
“Tea with Florence” was a collaborative project between the Hektoen Nurses and the Humanities organization and the IAHC.
Nurses & The Humanities originated in June 2006 to present programs that demonstrate and encourage the healing power of the arts and the humanities for healthcare workers and their patients. We partner with many of the significant cultural institutions in Chicago to develop programs addressing diverse themes of nursing and the humanities (art, literature, history, music, theater, and dance) through various formats, including lectures,
workshops, classes, and Art and Healing Tours to France. Programs are geared towards nurses, caregivers, medical professionals, and nursing students, but are always open to the general public. Nurses and the Humanities have conducted programs with: Art Institute, Goodman Theater, Mexican American Museum, Garfield Park Conservatory, the Food Buddha, Hubbard Street Dance and the Awareness Foundation among others.
The Hektoen Nurses and Humanities Committee believes nurses need to balance the science of nursing with an appreciation of the arts that can offer new strategies for self-care and expands their range of resources for holistic caregiving. The Committee promotes the skills of artistic expression, heightened sensory perception, and exposure to the vast realm of aesthetic possibilities the humanities have to offer as essential to the art of nursing.
To follow our 2017-2018 program schedule, or to join our email list for program information, please contact us through our Facebook https://www.facebook.com/ nursesandhumanities or Sandra Gaynor PhD, RN at dsgaynor@sbcglobal.net
Illinois Association of School Nurses Changes, Challenges and Opportunities
Linda A. Vollinger MS, RN, PEL/school nurse President, Illinois Association of School Nurses
It is not a secret that times are changing in how we interact with people, organizations, our members, stakeholders, and policy makers to name a few. Reflecting on past activities at Illinois Association of School Nurses (IASN) Board meetings, specifically our discussion of the book The Change Cycle: How people can survive and thrive in organizational change, by Ann Salerno and Lillie Brock, it was a perfect time to look at where we are in the change cycle on a personal and organizational level. Change, while uncomfortable and challenging (in a good way), is ever present. If it is ignored or avoided, we will not have a chance to move in directions of our choosing or grow as an individual, or as an Association. As a result, an ad hoc committee was formed in January 2017 to look at the organizational structure and function of IASN.
After years of discussion among IASN members and Board members at both the local Division and State level, it was clear that the challenges all were facing to sustain and serve our membership and develop leadership within our Association are similar. The ad hoc committee was charged to evaluate ways to improve the functioning of IASN. At the April 2017 board meeting, the ad hoc committee presented their findings and recommendations to the IASN Board of Directors. The topic was discussed at length and all present shared their thoughts, ideas and concerns over the bulk of the meeting time.
Ultimately, at the April 2017 meeting of the IASN Board of Directors, the Board voted unanimously to make some changes in both the structure and governance model of the Association. These changes are planned to roll out in two steps. First, the current Division structure will be changed to a unified statewide organization in November 2017. Second, the IASN Board of Directors will be reorganized for efficiency and effectiveness with the full implementation taking effect in October 2018.
Information has been shared with members at local Division meetings, on the IASN Facebook page, Twitter feed (@ilschoolnurses), at four “listening tour” dates (2 online and 2 in a face-to-face format), on the IASN website (iasn.
org) and via our members-only Discussion List on NASN SchoolNurseNet (formerly known as the IASN Listserv).
You will find a link to a YouTube video that explains this change and the process in greater detail. It discusses our next steps and how members were given opportunities to share their questions, comments, and suggestions as we move through this change process.
You can access the YouTube video presentation at https://youtu.be/E9A4xauTX4o
An infographic was developed and provides a onepage summary, adding detail of these changes. The infographic and the link to the YouTube video can be accessed on the IASN website at www.iasn.org
The ad hoc committee continues to assist the Association and the Board of Directors with guiding us through this process. We realize that while change is difficult, it is necessary for growth. This change will allow the Illinois Association of School Nurses to grow and serve all our members in Illinois as we move into the future.
This summer, many Illinois school nurses attended the NASN 2017 Conference in San Diego, California. There were also quite a few Illinois School Nurses that presented on a range of topics in a variety of formats. Illinois once again had a very strong presence at the NASN Conference with our delegation having the 4th highest number of attendees. We followed California, Colorado and Texas. There were topics for all interests and areas of NASN’s Framework for 21st Century School Nursing Practice. San Diego was a fantastic venue as well to explore and learn.
At the close of the Annual Business meeting, outgoing NASN President Beth Mattey installed Nina Fekaris as the next NASN President. NASN is poised to continue to grow with Nina’s vision, voice and leadership. Illinois attendees enjoyed the opportunity to network and visit with one another after the NASN Annual Meeting concluded. Should you have the opportunity to attend a NASN Conference, you will not be disappointed! NASN 2018 will be held in Baltimore, Maryland from June 30 -July 3, 2018 (preconference June 29, 2018). Start making plans to attend! Finally, please mark your calendars and plan to attend IASN’s Annual Conference on October 20-21, 2017. The conference will be held at the Q Center in St. Charles, Illinois. Information can be found on the IASN Website.
IDFPR Online Licensure Transformation Nears Completion
Paper Applications
Accepted Until September 1st for Certain Professions
SPRINGFIELD – With threequarters of all professions within the Division of Professional Regulation now able to apply and renew their license via the Illinois Department of Financial and Professional Regulation’s (IDFPR) Online Services Portal, https://ilesonline.idfpr.illinois.gov/DFPR/Default.
aspx Secretary Bryan A. Schneider is announcing the Department will no longer accept paper applications for specific professions that have already been migrated online beginning September 1, 2017.
Professions impacted by this deadline include: Advance Practice Nurse, Licensed Practical Nurse, Registered Nurse, Barber, Cosmetologist, Esthetician, Nail Technician, Certified Public Accountant, Massage Therapist, Limited Liability Company, Medical Corporation, Permanent Employee Registration Card, Pharmacy Technician, Professional Service Corporation and Public Accounting Firm.
All paper applications or payments postmarked before September 1st will be accepted and processed. Those postmarked on or after September 1st will be returned to the sender.
More than 800,000 regulated professionals are now able to take advantage of IDFPR’s online licensure services to quickly and easily apply and renew their license. For a complete list of professions now online, please visit IDFPR’s Online Services Portal. IDFPR began the transition to paperless, digital technology in 2016 as a part of Governor Rauner’s efforts to transform state services and reduce processing delays. The initiative is saving the state nearly $3 million in postage, paper and printing costs over the next five years.
“Promoting efficiency, while providing an overall better experience for licensed professionals has been the focus of our endeavor to create a modernized licensure process,” said Bryan A. Schneider, IDFPR Secretary. “As we look to further improve service to our professions already migrated online, we are ending the practice of accepting the paper application. By doing this, we complete their electronic transformation, granting our licensees the ability to apply for licensure or renewal anytime, anyplace through the convenience of their electronic device of choice.”
IDFPR’s Division of Professional Regulation currently licenses over 1.1 million professionals in more than 200 license categories throughout the State of Illinois.
Follow IDFPR on Facebook, Twitter and YouTube to stay current on the latest from the state’s regulatory agency.
The Illinois Department of Financial and Professional Regulation website http://idfpr.com is updated regularly to provide Illinois licensed professionals with useful resources. From our homepage, a variety of licensing user guides and tools can be found by clicking “Online Resources.”
Online Resources http://www.idfpr.com/ onlineresources.asp has four sections:
• Initial Application Checklists, including Advanced Practice Nurse Controlled Substance License Application, Licensed Practical Nurse New Application Checklist and Registered New Nurse Application Checklist
• Portal Administration, which includes document upload instructions, account creation and online services portal dashboard
• Licensing Forms which includes a limited number of forms separate from applications
• Prerequisite instructions, which includes licensed fingerprint vendors and fingerprint background check guide
Print a copy of your license or store a copy on your smartphone or tablet:
The section “eLicense Search” http://www.idfpr.com/ DPR.asp allows “Licensed Professionals” (the middle option) the opportunity to print a free copy of their license. Licensees only need to provide their individual license number and either date of birth or last four digits of social security number.
For licensees interested in storing an electronic license pocket card on their smartphone or tablet, please visit: www.idfpr.com/GetMyLicense. Electronic pocket cards may be saved as a PDF file or by taking a screenshot and storing as a photo.
To Change your Address:
A change of address, including the updating of email address or phone number can be accomplished by entering the new information online. https://www.idfpr.com/ applications/LicenseReprint/ A change of name cannot be completed via online process, as supporting documents must be submitted to Licensing in Springfield, IL.
If you have questions, is there someone to talk to? Yes, assistance is available Monday through Friday by contacting the IDFPR call center at: 1-800-560-6420; or by email at:FPR.LMU@illinois.gov
CBNC Celebrates 15 Years
The Chicago Bilingual Nurse Consortium (CBNC), which is primarily funded by the Chicago Community Trust, has been making a difference in the lives of Internationally Educated Nurses (IENs) for 15 years. On International Nurses’ Day, Friday May 12th, CBNC’s work and the efforts of IENs in meeting the requirements for licensure in Illinois were celebrated at their annual event. Jinglei He (China), Giulia Innocenti (Italy), Maria Jaramillo (Mexico) and Andy Ponce (Ecuador) were honored for passing the NCLEX-RN this past year.
Even though not all of the honorees were present at the celebration Andy Ponce described the arduous path to licensure IENs face.
Understanding the process for becoming licensed is key because time constraints are present at each step in the process. When IENs begin by having credentials evaluated, they often learn that they have yet to pass the TOEFL exam to demonstrate English proficiency. This step may take several years and the credentials report may not be available when the IEN is ready and they must pay the fee again to get another report.
Another obstacle IENs must overcome relates to gathering documentation for the credentials report. Transcripts, diplomas and licenses for verification may take months from some countries. This is especially true for those countries with economic and political issues or if the school has closed. Once credential evaluation
West Suburban Hospital College of Nursing Reunion
“On behalf of the Alumni Association of West Suburban Hospital (AAWSH), this is to inform colleagues regarding an upcoming reunion for all classes from the School of Nursing. Commemorating its 103 rd anniversary, the Association is honored to hold the gathering on Saturday, September 30, 2017 at 10:00 a.m.at the Billy Graham Center, Wheaton College, Wheaton, IL The reunion correlates with Homecoming weekend at the College. The guest speaker for the Reunion is Dr. Lisa Anderson Shaw, colleague and Co-Chair member of our Editorial Committee for Nursing Voice. Dr. Shaw serves as Director, Univ of IL. Clinical Ethics Council Service. Her presentation topic is “Ethics in Current Health Care”.
Mark your calendar and plan to join us for this special occasion.
demonstrates that the IEN’s education is comparable to U.S. they are allowed to sit for the exam. There is currently a three year time frame for passing. The next challenge is passing the NCLEX-RN.
In many countries, nursing exams are a combination of oral, written narrative, and even skill demonstration. Multiple choice exams with questions that ask for the best choice or the acceptable choice is often confusing. CBNC has learned by working with IENs preparing for the exam, even very knowledgeable nurses, who can discuss the content of a test item with a high degree of
accuracy, may not give a correct answer simply due to not understanding what the question is asking. Preparing takes intense focus and time. Depending on their financial obligations, IENs may not have the time or familial support to be successful in such a short timeframe.
Andy commended CBNC for coaching him through the process toward licensure, which he accomplished within 2 ½ years. In his profile he explained that he studied for 40 hours a week and acknowledged his wife’s tremendous support.
IsaPN UP date
This is a very exciting time for Advanced Practice Nursing in Illinois. The Senate and House recently voted to approve the Nurse Practice Act – which included exciting provisions for Advanced Practice Nursing that truly move our practice forward and eliminates the need for a written collaborative agreement. All that is left is for Governor Rauner to sign the legislation and for the Rules to be written. Writing the rules is no small task, but we expect that this process will go smoothly.
In order to really understand the significance of this event, it is important to know how our practice has evolved:
1994: FNPs and PNPs granted reimbursement for Medicaid at 70% of the physician amount.
1998: Governor Edgar signed into law licensure for CNPs, CNMs and CNSs.
During the timeframe from 1998 to 2007, we practiced under a written collaborative agreement that mandated physician medical direction with services provided that the physician would normally perform, approval of guidelines, and the prescribing of legend and Schedule III – V drugs.
1999: CRNAs were added as licensed APNs
2002: ISAPN was formed as the only organization in Illinois to represent ALL Advanced Practice Nurses.
2002: APNs are granted the authority to sign school physicals
2003: APNs are granted the authority to determine disability for driver’s licenses
2004: APNs are granted the authority to refer to physical therapists
2005: APNS are granted the authority to sign school employee physicals
2006: NPs and CNMS are granted the authority for reimbursement for Medicaid patients and to bill under their own names.
Among other changes under the newest legislation, our title will be APRN – bringing us in alignment with the national title for advanced practice nurses. NPs, CNMs and CNSs will be able to practice without a written collaborative agreement after 4000 practice hours and 250 continuing education hours – which will include professional development activities which is expected to include not only CEs but also serving as a preceptor, publications and presentations. We will be able to prescribe benzodiazepines and Schedule II opioids with the use of the PMP and a consulting physician – not a written collaborative practice agreement as we have now.
If you think about it, Advanced Practice Nursing has come a long way! This progress would not have been possible without ISAPN and the lobbying activities of Sue Clark and Debbie Broadfield. Please consider contributing to the PAC so that we can keep the momentum going. If you are not an ISAPN member, please join this year to help us celebrate our 15th year as an organization. If you are an ISAPN member, please consider running for a board of directors position, becoming a regional vice chair, or joining a committee. We are stronger together!
identified and defined as “supernurse.” Identified subthemes of supernurse included: extraordinary powers used for good; cloak of invulnerability; no sidekick; Krpytonite, and an alterego. These values, beliefs, and behaviors define the aspect of culture that can act as barriers to fatigue risk management programs and patient safety initiatives.
Sagherian and colleagues (2016) conducted a descriptive cross-sectional study looking at the association between fatigue, work schedules, and perceived work performance among nurses. Seventy-seven bedside nurses participated in this study. Nurses’ acute and chronic fatigue levels were significantly associated with performance of physical and mental nursing care activities. Low intershift recovery was associated with inadequate hours of sleep, waking not fully refreshed, and working overtime. These findings indicated nurses had insufficient time to restore depleted energy levels outside work hours, which has patient safety implications. The findings of this study are consistent with the findings of a larger study (n=340) conducted by Steege, Pasupathy, and Drake (2017).
A risk management model for nurse executives to address occupational fatigue in nurses was described by Steege and Pinekenstiein (2016). They synthesized existing evidence on fatigue risk management and decision making in nursing leadership and developed a conceptual model of multilevel fatigue risk management in nursing work systems to address current fatigue management challenges. Their model included data sources, nurse fatigue monitoring, decision-support tools and risk management responsibilities/controls to improve patient outcomes. Evaluation of the effectiveness of specific hazard controls in minimizing fatigue and mitigating its associated risks is needed to guide nurse leaders in practice.
Fatigue is an issue that must be addressed to promote quality patient care. All nurses need to be aware of fatigue countermeasures and implement strategies to ensure they can safely function, whether taking care of themselves or others.
References American Nurses Association. (2014). Position statement: Addressing nurse fatigue to promote safety and health: Joint responsibilities of registered nurses and employers to reduce risks. Silver Spring, MA: Author.
Institute of Medicine of the National Academies, Committee on the work Environment for Nurses and Patient Safety Board on Health Care Services. (2004). Keeping patients safe: Transforming the work environment of nurses. Washington, DC: National Academies
NIOSH, Caruso, C.C., Geiger-Brown, J., Takahashi, M., Tinkoff, A., & Natkata, A. (2015). NIOSH training for nurses on shift work and long work hours. DHHS (NIOSH) Publication No. 2015115. Cincinnati OH: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Retrieved from: http://www.cdc.gov/niosh/docs/2015-115/ Ohio Nurses Association. (2015). Reference proposal: Preventing nurse fatigue. Columbus, OH: Author. Sagherian, K., Clinton, M. E., Huijer, H. A., & Geiger-Brown, J. (2016). Fatigue, work schedules, and perceived performance in bedside care nurses. Workplace Health and Safety. Doi: 10.1177/2165079916665398
Steege, L. M., Pasupathy, K. S., & Drake, D. A. (2017). A work systems analysis approach to understanding fatigue in hospital nurses. Ergonomics. Doi: http://dx.doi.org/10.1080.0014013 9.2017.1280186
Steege, L. M. & Pinekenstein, B. (2016). Addressing occupational fatigue in nurses: A Risk management model for nurse executives. Journal of Nursing Administration, 46(4), 193-200. Doi: 10.1097/NNA.0000000000000325
Steege, L. M. & Rainbow, J. G. (2017). Fatigue in hospital nurses – “Supernurse” culture is a barrier to addressing problems: A qualitative interview study. International Journal of Nursing Studies, 67, 20-28. Doi: http://dx.doi.org/10.1016/j.ijnurstu.2016.11.014
Wolf, L. A., Perhats, C., Deloa, A., & Martinovich, Z. (2017). The effect of reported sleep, perceived fatigue, and sleepiness on cognitive performance in a sample of emergency nurses. Journal of Nursing Administration, 47(1), 41-49. Doi: 10.1097/NNA.0000000000000435
Barbara Brunt, MA, MN, RN-BC, NE-BC is currently an Education Consultant for Brunt Consulting Services. She has 28 years of experience in various nursing professional development (NPD) positions, from instructor, coordinator, to director. She retired from Summa Health System in February 2016 where she served as Magnet Program Director. She is an ANCC appraiser for continuing education through the American Nurses Credentialing Center and is the content editor for TrendLines, a monthly newsletter for NPD practitioners.
She Continued to Fight…
Seated: Mother Bickerdyke (Pam Johnson), Howard Bickerdyke (cousin), Representative Dan Swanson, 74th District (red shirt), next to him former Representative Don Moffitt, who in 2013 sponsored HJR#20 which established Mary Ann “Mother” Bickerdyke Day on the Wednesday in May during Nurses Week.
P. Joanie Larsen, RN
By the end of the war, she reportedly organized 300 field hospitals and volunteered at 19 battles while offering welcome comfort to over 100,000 wounded, sick, and dying men. No, this is not Clara Barton, nor Florence Nightingale, but Illinois’ own, Mary Ann “Mother” Bickerdyke from Galesburg, Illinois.
July 19, 2017 was the 200th anniversary of Mother Bickerdyke’s birth, and Galesburg, Illinois held a day-long celebration. Her 92-year-old cousin Howard Bickerdyke and his daughter Diane Nielsen travelled from Arizona to participate in the celebrations. P. Joan Larsen, RN, Illinois Nurses Foundation Board member coordinated efforts with the Galesburg Cottage Hospital Nurses Alumni Association and the Galesburg Historical Society (www.galesburghistoricalsociety.com) to make the day memorable. There were speeches, a re-enactment and an ice cream social. The day was a success.
Mother Bickerdyke moved to Illinois from Ohio in 1856 with her husband and sons. She had received her nurses training at a hospital in Cincinnati, Ohio after attending Oberlin College. After the Civil War broke out in 1861 Mother Bickerdyke took supplies to Cairo, Illinois at the request of a neighbor, Dr. Woodward, a surgeon attached to the 22nd Illinois Volunteer Infantry. At the time, no woman under 30 years of age was allowed to care for soldiers; Mother Bickerdyke was 44 years and a recent widow. She found deplorable conditions where hundreds of men were dying, not from battle, but from typhoid, dysentery and other diseases, lack of nutrition and infection. She helped to establish the hospital in Cairo, Illinois and continued to perform valuable service for the Union Army.
For the next four years, Mother Bickerdyke continued her efforts, following the armies of the western theater
led by Generals John Logan, Sherman and Grant. She set up dietary kitchens, bartering with local farmers and established laundry services. She was famous for her ability to bypass bureaucracy, scrounge together supplies and help run the army field hospitals. She followed Grant’s army down the Mississippi River and later accompanied the forces of General William Tecumseh Sherman on their march through Georgia to the sea. Once, a colonel came to General Sherman to complain about “the meddlesome old woman from the North;” he received little help from the admiring general, who simply said “I can’t do anything for you; she outranks me.”
In addition to her field work during the Civil War, she was sent on major fundraising tours to secure support for medical needs, sometimes to procure cattle and supplies. Her dedication to suffering soldiers, her “boys in blue” never wavered. She remained active in veterans’ causes for the rest of her life, including post-war trips to Washington DC to press for pension claims.
At the end of the July 19 celebrations, the Bickerdyke family placed a wreath at the 1906 statue of Mary Ann Bickerdyke kneeling beside a wounded soldier holding a cup to his lips.
The celebration included Pam Johnson, dressed and speaking as if she were Mother Bickerdyke, wearing her calico dress and bonnet, telling her story; General Sherman stood by supporting her presentation. The ice cream social was held outside in Standish Park and served free ice cream and cake to approximately 300 people. After the social there were speeches from sponsors, local politicians, including 74th District State Representative Dan Swanson. Mother Bickerdyke’s story is truly one of care wedded to heroism, a bright spot, amidst the dark horror of war. The Galesburg Historical Society is a 501.c.3 organization, donations are tax deductible.
The IDFPR/Illinois Center for Nursing hosted a roundtable discussion focused on the transition of internationally educated nurses to Illinois licensure. The discussion’s purpose was to obtain input regarding the process, explore available information, and share resources among participating organizations. The discussion also provided an opportunity to review the barriers and facilitators to obtaining an Illinois nursing license.
Carmen Hovanec, MS, RN, Illinois Center for Nursing/ICN Chairperson led the group, which included representatives of Illinois minority nurses’ associations. The groups shared personal accounts of similarities and differences in professional nursing education in Eastern European countries and in countries such as the Philippines and India where nursing instruction is in English and the nurse graduates with a bachelor’s degree. Other topics of discussion included English as a second language, British vs American English language, and variances amongst state licensure requirements. Association resources and programs were also mentioned.
Michele Bromberg, IDFPR Nursing Coordinator, reviewed changes to the 2015 Illinois Nurse Practice
Act Rules that are directed at the Foreign Educated Nurse/FEN who is unable to provide proof of successful completion of primary and secondary education requirements. Details of this change may be found in the Nurse Practice Act Rules 1300.320, subsection (a)(5)(A)(i): the applicant may be allowed to provide proof of successful passage of the General Education Development Test/GED. Fran LaMonica, Executive Director Chicago Bilingual Nurses Association stated this is an issue for nurses educated in Eastern European countries. For some this was new information.
In summary, we had a lively discussion of resources, barriers and regulatory differences amongst states for the licensure and education of nurses, as well as the variances amongst different countries. M. Bromberg spoke at length about the enhanced Nursing Compact proposed legislation and the potential impact for Illinois, in addition to answering other licensure questions. The group also delved into how we, as nurses, work to support and transition foreign educated nurses in our community as they seek Illinois licensure. The group plans to meet again later this year.
(L) P. Joanie Larsen speaks at the anniversary event in the blue birthday commemorative T-shirt; (R) Roger Reynolds, President Galesburg Historical Society.
(L-R) Howard Bickerdyke (cousin), Mother Bickerdyke (Pam Johnson), Diane Nielsen (cousin)
Left-Right: Linda B. Roberts, MSN, RN/Illinois Center for Nursing Manager; Franciszka Staszewski, RN, BSN, CNOR, International Polish Nurses Association; Jolanta Mirecka, RN/IPNA; Carmen Hovanec, MSN, RN/Chairperson, Illinois Center for Nursing; Fran LaMonica, MS, RN/Chicago Bilingual Nurses Consortium; Susan Mathew DNP, RN/Indian Nurses Association of Illinois; Gloria Simon, MSN, RN/President Philippine Nurses Association of Illinois; Michele Bromberg, MS, RN/IDFPR Nursing Coordinator; Susan Edamala, MSN, RN/Indian Nurses Association of Illinois.
The 29th Annual National Black Nurses’s Day Ceremony
Nontraditional Nursing Education Programs and Behavioral Health Nurse Providers
“Lift Every Voice and Sing: …Sing a song, full of the hope that the dark past has taught us; Sing a song, full of the hope that the present has brought us; Facing the rising sun, of our new day begun; Let us march on, till Victory is Won.” (J. W. Johnson & R. Johnson)
Linda B. Roberts, MSN, RN –Manager, Illinois Center for Nursing, Dr. Mildred Taylor, Member of Health Policy, CCNBNA and Dr. Lisa Young, Interim Chairperson, Department of Nursing Chicago State University.
Dr. Sandra Webb-Booker (Chair of NBNDC), Delores Baker, Corresponding Secretary of CCNBNA, Toni Oats, RN, President of Alpha Eta Chapter of Chi Eta Phi, Ellen Durant, President of Chicago Chapter National Black Nurses’ Association, Dr. Mildred Taylor and Dr. Linda Howard, Program Chair of CCNNA.
This year’s ceremony was held on February 24, 2017 recognized the contributions of African-American Nurses working in Behavioral Health supporting some of our most vulnerable healthcare consumers and families. The sponsoring nurse’s associations were: Alpha Eta Chapter of Chi Eta Phi Sorority, Inc. Beta Mu Chapter of Lambda Pi Alpha Sorority, Chicago Chapter National Black Nurses Association and the Provident Hospital Nurses’ Alumni Association.
For the twelfth year, the event was held at Apostolic Faith Church, where Dr. Horace Smith is the Bishop. Opening remarks from: Patricia Price, RN, Vice- President, Beta Mu Chapter of Lambda Pi Alpha Sorority; Ellen Durant, RN, President Chicago Chapter National Black Nurses’ Association; Toni Oats, RN, President, Alpha Eta Chapter of Chi Eta Phi Sorority, Inc.; Louise Hoskins Broadnax, RN, President Provident Hospital Nurses Alumni. Attendees included: Illinois Nurses Foundation (INF) Board of Directors and Deputy Director, National Association Hispanic Nurses- Illinois, President ANA-Illinois, The Illinois Center for Nursing Managing Director, Member - Board of Directors National Black Nurses Association, National Women Veterans United, Fellow Nursing Colleagues, Student Nurses, Friends and Family.
The Roosevelt Gallion Memorial Scholarship Committee launched a fundraiser to memorialize Mr. Gallion, (1942-2016), a well-known and respected nursing educator, outstanding professional leader, advocate for nursing advancement and beloved colleague and friend. In his 30 years of practice he served on INA-Illinois’ Board of Governors, numerous professional organizations and advisory boards. His last 10 years were spent at Advocate Bethany Hospital and RML Specialty Hospital as Director of Hospital-wide Education. The scholarship recipients exemplified his professional life and values.
The focus for this year’s event was the provision of Nursing Education by nontraditional providers. Presentation were given by representative from Drexel University Online and University of St. Francis, each highlighting their key pragmatic efforts to enhance the educational preparation of African American nurses pursuing BSN’s and graduate degrees in nursing. The National Black Nurses’ Day Committee felt that due to the survey done by the National Council of State Boards of Nursing in 2013, that this would be a topic of interest to not only Black healthcare providers but to all healthcare providers.
The National Black Nurses Day was proclaimed February 3, 1989 to applaud black health care practitioners.” February is the month that we have set aside to honor the contributions made by black Americans to this country, therefore it is fitting that black nurses be recognized and honored for their outstanding contribution to our community and country.” (Congressman Charles Rangel).
Save February 23, 2018 Mark your calendars now for the 30th National Black Nurses Day Celebration to be held on February 23, 2018 at Apostolic Faith Church 3823 S. Indiana, at 6pm. Honoring Nurses working as care-providers in: Public Health, Community Health and Corrections; Organ Transplantation, and nurses actively involved in Health Advocacy will be recognized. Plans are in the making to acknowledge past nurse awardees. All prospective awardees and past honorees are asked to contact: nbndc@gmail.com for additional information.
Psychiatric Nurse Honorees
This year’s award recipients were: Carolyn Rimmer-Owens, RN (Mercy Hospital and Medical Center), Whitney Motton, RN (Christ Advocate) and Ellen Durant, RN, Metropolitan Consultant Services. Award recipients were referred to as compassionate, dedicated psychiatric nurses, extending a multitude of years to patients afflicted by mental illness, receiving accolades as psychiatric nurse extraordinaire!
The Roosevelt Gallion Scholarship Recipients
This was the first year of the Roosevelt Gallion, MA, BSN, RN scholarship. June Crayton BSN, MSN, RN (Coordinator), extended scholastic awards to: Nikkita Neealy, senior nursing student at Chicago State University; Rakisha Wilks, graduate student at the University of St. Francis – pursuing a Psychiatric Mental Health Nurse Practitioner degree (Mercy Hospital and Medical Center); Rosemary Snipes, nursing student at Chicago City Colleges - Malcolm X College; and Brandee Stanton, senior nursing student at Chicago State University. Congratulations awardees!
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