The Nursing Voice December 2020

The Nursing Voice

December 2020

Page 1

The Official Publication of the Illinois Nurses Foundation Quarterly publication direct mailed to approximately 4,500 RNs and electronically via email to 90,000+ RNs in Illinois.

VOLUME 8 | NUMBER 3 | DECEMBER 2020

Illinois Nurses Foundation Celebrates 6th Annual Emerging Nurse Leader Awards The 6th Annual 40 under 40 Emerging Nurse Leader event was held virtually and recognized 40 outstanding nurses in Illinois under 40. Those who receive the recognition are impacting health care delivery and the nursing profession and will undoubtedly shape the future of the profession.

The Emerging Nurse Leaders Planning committee began reviewing the nominations in May of this year, and awardees were notified in July. As seen since the awards first started, there was an abundance of worthy candidates nominated for the 2020 honors.

Nominations were received from friends, family, coworkers, employers, and students. Award recipients reflected leadership success, exemplary leadership qualities, participation in professional associations, and community service.

One of the primary purposes of the 40 Under 40 Award is to engage, support, and develop the next generation of Illinois Nurse Leaders. The committee was genuinely moved to have the honor of acknowledging fellow nurses who are known change agents that help shape health care statewide and beyond. Their efforts have served to expand and grow nursing practice as well as to empower our communities. Award recipients were proudly celebrated by members of their cohort and Illinois nursing leaders, and of course, their family members.

The 40 under 40 Planning Committee is comprised of nurses under 40, many who are previous awardees, who understand the importance of recognizing nurses early in their careers for the amazing work they are doing.

Committee members include Brandon Hauer MSN, RNChair, Jorge Cervantes BSN, RN, CCRN, Dan Fraczkowski MSN, RN-BC, Brittany Hohoff BSN, RN, Bethany LeBron MScN, MBA, BSN, RN, Stephanie Mendoza MSN, RN, Jenny Ocampo BSN, RN, CRRN, April Odom APRN, CRRN, FNP-BC, Kelly Ulrich BSN, RN, and Stephanie Yohannan DNP, MBA, RN, NE-BC. The advisory committee team members included Susana Gonzalez MHA, MSN, RN, CNML, Eli Heicher MSN, RN, CENP, and Linda B Roberts MSN, RN. The event began with the INF President, Dr. Cheryl Anema Ph.D., RN, thanking the event sponsors. ANAIllinois, whose steadfast support has helped make this and all our events possible, Loyola University Chicago

Marcella Niehoff School of Nursing, who is sponsoring this event for a second year SYS Consulting Solutions. The accomplishments of each award recognition recipient can be readily viewed at the Illinois Nurses Foundation website.

This year, our Guest Emcee for the evening was Fred, host of “Fred + Angi in the Morning: on 103.5 KISS FM in Chicago. “Nurses are the lifeblood of our healthcare system and are not only heroes on the frontlines of the pandemic, but in the daily lives of so many. Their

dedication, knowledge, passion, empathy, and sacrifice are to be commended and honored,” stated Fred.

A summary of each awardee’s professional achievements was shared with the attendees. It was an inspiring event held during a challenging time for the state and for the profession. Next year, we hope that we will be able to gather together in person and celebrate the next cohort of 40 under 40 Emerging Nurse Leaders. Please watch for further details at http://www. illinoisnurses.foundation/ Illinois Nurses Foundation Celebrates...continued on page 14

Index current resident or

Non-Profit Org. U.S. Postage Paid Princeton, MN Permit No. 14

INF President’s Message. . . . . . . . . . . . . . 2 ANA-Illinois President's Message. . . . . . . 3 Practice Corner. . . . . . . . . . . . . . . . . . . . . . 4 Ethics in Action. . . . . . . . . . . . . . . . . . . . . . 5 2020 Inaugural ANA-Illinois Awards. . . . 6 Continuing Education Offering . . . . . . . . 8 IASN. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 One stop - IDFPR home page for your online resources . . . . . . . . . . . . . . . . . . . 12

Nursing Policy in Times of Uncertainty Surviving, Thriving on the Edge . . . . . 13 ISAPN President's Message . . . . . . . . . . . 15 Illinois Advanced Practice Registered Nurses Elect New Board Members. . . . . . . . . . . . 15 PNAI News in the Midst of the Pandemic. 16 Public Health Nurses Advocating for Public Health Nursing: Creating Change. . . . . . 17 The Life of a Street Nurse. . . . . . . . . . . . 18

Page 2

December 2020

I N F P RE S I D E N T ' S M E S S A G E Cheryl Anema Ph.D., RN

It feels good to bring 2020 to an end! I believe most all of us have been touched by the events of this year. It is a year for history books, and unfortunately, the historical events have not concluded.

I do not believe we will ever be living the same "normal."

Change brings many emotions Cheryl Anema and adjustments. Change can PhD, RN also bring positive results.

Over the past few months, I have witnessed some families become closer, the return of family dinner time, improved family communications, and continued interest in individuals deciding to join the nursing profession. Nursing has always been at the forefront of patient care. When the family could not be there with the loved ones in the hospital, nurses were there to "be the family." I have heard so many stories of nurses who sat with and held the hand of isolated patients as they passed away. Nurses have filled the gaps caused by the required isolation guidelines. If nurses were not able to step up and give this emotional support to these patients, many would have died alone.

Often, nurses were able to set up face-time with family members so they could say good-bye or give words of encouragement to their loved ones, especially for those who spent weeks in hospital isolation.

We have seen the world rocked by the COVID‐19 pandemic, and most of the plans for the celebration of the 2020 International Year of the Nurse and Midwife have been put on hold. The Illinois Nurses Foundation (INF) celebrated with the annual 40 Under 40 celebration virtually. We were able to celebrate with 40 emerging nurse leaders. Their stories were shared, and those in attendance (virtually) were amazed by these young nurses' accomplishments. Amid a global life-changing historical and unprecedented pandemic, these nurses were able to flourish and make a difference.

ASSISTANT PROFESSORS (TENURE-TRACK) SCHOOL OF NURSING The Millikin University School of Nursing invites applicants to apply for faculty positions to teach in its CCNE-accredited baccalaureate, master’s, and DNP programs. These positions are ten-month, tenure-track positions at the rank of Assistant Professor, beginning August 1, 2021.

You may view a complete position description and minimum qualifications at

www.millikin.edu/employment Employment and first day of work is contingent upon successful completion of a background check. Millikin University is an equal opportunity employer. Candidates from traditionally underrepresented groups in this field are encouraged to apply. Beyond meeting fully its legal obligations for non-discrimination, Millikin University is committed to building a diverse and inclusive community where members from all backgrounds can live, learn, and thrive. Millikin offers a competitive salary and full benefit package. Review of applications will begin immediately and continue until the position is filled.

Economically we have all been affected by the pandemic. Many people, including nurses, have lost their employment and income source or significantly had it cut.

As a nurse educator, I witnessed nursing students' stress who were trying to balance their nursing education time demands and economic impact as their jobs were lost and now also had homebound children. I saw more mental health issues that impacted academic success. This only added to the students' stress. The INF has a robust scholarship program, but there still is never enough monies or opportunities for students desiring to join the nursing profession.

Annually, we depend on the INF fundraisers and donations from individuals, institutions, associations, and businesses to support the INF's actions and programs.

With the cancellation of our largest fundraiser, the Annual Holiday Gala and Fundraiser, we have a huge challenge this year. The INF has a strong foundation, and Illinois continues its work and support of our communities and nursing in Illinois. It is with YOUR HELP that we continue to support our nursing students with scholarships. It is with YOUR HELP that we continue our Nursing Grant program. It is with YOUR HELP that we continue to offer educational opportunities to the people of Illinois and promote health in Illinois. Can you HELP? There are multiple ways you can directly or indirectly help the INF: Direct donation, monthly donations, purchase a specialty license plate (nursing) through the Illinois Dept of Transportation, submit an Honor a Nurse nomination with a donation, use Amazon to do your regular purchasing but go to smile.amazon.com and select the INF as your charity, or even set up the INF as a beneficiary in your estate planning. As a 501C3 association, you may want to talk to your tax accountant to determine the best way for you to donate. Go to www.

Illinoisnurses.foundation to donate or read more about the INF and ways to support its programs. Your donation will go a long way! Thank you for your support!

Occupational Health Nurse (Full Time) Join us to become part of what we are building for our communities and patients! Erie Family Health Centers (EFHC) is looking for an Occupational Health Nurse to join our team.

Requirements

• Bachelor or Associate degree required • Current RN Illinois license and CPR certification required • Two years recent clinical experience as a professional registered nurse • Previous education in Infection Control and Prevention preferred • Demonstrated knowledge of assessment, planning, implementation, and evaluation of educational activities

Bachelor of Science in Health Care Management Minors available in: • Long Term Care Administration • Health Information and Informatics Management

Masters in Health Administration (MHA) • Certificate in Clinical Leadership (CCL) Masters in Health Informatics (MHI) • Certificate in Healthcare Informatics (CHI) Dual MHA/MHI

All undergraduate and graduate programs offered in both online and on-campus delivery formats!

For more information visit our website at:

sah.siu.edu or call 618-453-7211.

INF Board of Directors Officers Cheryl Anema PhD, RN. . . . . . . . . . . . . . . . . . . . . . . . . . President Brandon Hauer MSN, RN . . . . . . . . . . . . . . . . . . . . Vice President Cathy Neuman MSN, RN. . . . . . . . . . . . . . . . . . . . . . . . . Secretary Karen Egenes EdD, RN. . . . . . . . . . . . . . . . . . . . . . . . . . . Treasurer Directors Maureen Shekleton PhD, RN, DPNAP, FAAN Alma Labunski PhD, MS, RN Linda Olson PhD, RN, NEA-BC Amanda Buechel, BSN, RN, CCRN ANA-Illinois Board Rep Stephanie Yohannan, DNP, MBA, RN, NE-BC

ANA-Illinois Board of Directors Officers Elizabeth Aquino, PhD, RN. . . . . . . . . . . . . . . . . . . . . . . . President Monique Reed, PhD, MS, RN . . . . . . . . . . . . . . . . . . Vice President Jeannine Haberman . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Treasurer Colleen Morley, MSN, RN, CMCN, ACM . . . . . . . . . . . . . Secretary Directors Holly Farley, EdD, MS, RN Susana Gonzalez, MHA, MSN, RN, CNML Nicole Lewis, DNP, APRN, FNP-BC Stephanie Yohannan, DNP, MBA, RN, NE-BC Zeh Wellington, DNP (c), MSN, RN, NE-BC Editorial Committee Editor Emeritus Alma Labunski, PhD, MS, RN Chief Editor Lisa Anderson-Shaw, DrPH, MA, MSN Members Deborah S. Adelman, PhD, RN, NE-BC Linda Anders, MBA, MSN, RN Kathryn Booth, MSN, RN, CNL Nancy Brent, RN, MS, JD Irene McCarron, MSN, RN, NPD-BC Linda Olson, PhD, RN, NEA-BC Lanette Stuckey, PhD, MSN, RN, CNE, CMSRN, CNEcl, NEA-BC

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: kristy@sysconsultingsolutions.com Article Submission Dates (submissions by end of the business day) January 15th, April 15th, July 15th, October 15th

www.eriefamilyhealth.org/careers2/

Advertising: for advertising rates and information please contact Arthur L. Davis Publishing Agency, Inc., 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.

EARLY REPRESENTATION IS KEY TO A GOOD DEFENSE

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.

Please email careers@eriefamilyhealth.org with questions or contact Paulino Gonzalez, 312-432-2717

SCHOOL OF HEALTH SCIENCES GRADUATE

The Nursing Voice

Executive Director Susan Y. Swart, EdD, MS, RN, CAE ANA-Illinois/Illinois Nurses Foundation

HEALTH CARE MANAGEMENT UNDERGRADUATE

The Nursing Voice

Lillian Walanka and the attorneys at Crick Walanka Law Group have decades of combined experience defending LPNs, RNs, and APNs in investigations and disciplinary prosecutions before state and local administrative agencies related to various allegations, such as: Failure to Report a Conviction, Termination, or Out-of-State Disciplinary Action Drug and/or Alcohol Abuse l Mental or Physical Impairment Unprofessional Conduct l Drug Diversion l Patient Abuse Boundary Violations l Standard of Care Issues l Falsification of Information We also represent and consult with nurses regarding Petitions, Appeals, and Applications.

Crick Walanka Law Group, Ltd. 111 W. Washington St., #1820 Chicago, IL 60602 (312) 335-8860 • www.crickwalankalaw.com

The Nursing Voice

December 2020

Page 3

A N A - I L L I N O I S P R E S I D E N T ' S M E S S AG E Dear Illinois Nurse Colleagues, By now, we have elected a new President of the United States and re-elected or elected new national, statewide, and local elected officials.

Congratulations to the many nurses running for Illinois elected positions who won their elections. With change brings new hope, I look forward to strengthening existing relationships and building new Liz Aquino, PhD, RN ones to ensure this country moves in a direction that prioritizes healthcare, listens to science, and actively works to eliminate health disparities.

I believe what this election year reinforced more than ever is that every single vote matters, we must be informed voters, we must pay attention to the policies and decisions that govern us. We must hold elected officials accountable for their decisions.

Continuing with election results, congratulations to the newly elected members of the ANA-Illinois Board of Directors, Nominations Committee Members, and ANA Representatives installed at the November 7th ANAIllinois Virtual Membership Assembly. Thank you to our outgoing ANA-Illinois Board of Directors who have dedicated their time and commitment over the years to advance our work for the nursing profession in Illinois.

Our appreciation and gratitude are expressed to the following outgoing Board of Directors: • Dr. Pamela Brown (served since 2012, Past President and recent two terms as Treasurer) • Dr. Karen Egenes (served since 2012, Past Director and recent term as Vice President) • Dr. Crystal Vasquez (Director) • Lauren Wojtkowski (Director) As 2020 comes to an end, I would be remiss if I did not acknowledge what a challenging year 2020 has been and

continues to be for all of us, and even more for nurses working the frontlines. At the beginning of 2020, ANAIllinois began with a lot of momentum and excitement to advocate for important legislation like the Nursing Staffing Improvement Act, the Nurse Licensure Compact, and hosting our largest Nurse Lobby Day in Springfield to celebrate the Year of the Nurse and Midwife. And then COVID-19 changed everything; nonetheless, ANA-Illinois was still able to keep working, just in different ways. Here are some accomplishments that we achieved over the past year….

• Increased ANA-Illinois membership to nearly 5,200 members! That means we can stay connected with more nurses in this state, providing resources and support for them while also having more membership support to advance the association’s mission.

• Launched Healthy Nurse Healthy Nation-ANA-IL led

by Molly Moran and regional representatives. Join the Facebook group to learn more.

• Hosted virtual happy hours and Nurses4Nurses networking calls to further support and connect with members.

• Shared COVID-19 resources and supported ANA letters to congress, demanding more PPE and resources to frontline healthcare providers.

• Issued an ANA-Illinois statement “Enough is Enough,” acknowledging our solidarity with the Black Lives Matter movement and nurses’ professional responsibility to stand up to racism and racial inequities. We hosted a listening session to understand experiences around diversity, equity, and inclusion of members of the nursing profession. We then created the Diversity, Equity, and Inclusion steering committee and advisory group to guide ANA-Illinois policy work and initiatives that address diversity, equity, and inclusion in all facets of nursing. They immediately got to work on the 5,200 Nurses to the Polls

Campaign and are on track for meeting their goals for 2021.

• Held a virtual Nurse Lobby Day, continued to support nurses running for office through our Nurses4Nurses advocacy page on our website, and attended virtual events to support local and national Illinois elected officials.

• There were several media campaigns launched, such as IAMANA-Illinois to spotlight members.

• Three inaugural awards were created and awarded at the ANA-Illinois Membership Assembly: Clinical Practice Award—Dr. Colleen Morley, Nurse Influencer Award—Susana Gonzalez, and Student Nurse of the Year Award—Rory Nicholson.

We will continue to move that work forward in the new year, along with increasing the number of nurses at decision-making tables and staying involved in advocacy and lobbying efforts to inform policymakers about healthcare and nursing issues. I encourage you to stay involved. There is still much work to be done this year, and years to come, so we look forward to your involvement!

Please know that ANA-Illinois is here for you; reach out if you have ideas, questions, concerns, or need additional support. We are here to serve you. Thank you for all that you do for your patients, your community, and the nursing profession. We appreciate you.

Wishing you and your family wellness and peace for 2021.

Sincerely,

Elizabeth Aquino, PhD, RN President, ANA-Illinois @LatinaPhDRN

Page 4

December 2020

ANA-Illinois Elects New Board Members Members of the ANA-Illinois elect new leadership MANTENO – The ANA-Illinois, the state’s largest professional nursing association for registered nurses in all practice settings, has elected new leadership.

ANA-Illinois leadership includes nurse leaders from across the state and with a variety of backgrounds. The elected leaders’ unique experiences are sure to enhance the work of ANA-Illinois and its vision of being the recognized leader of professional nursing and nurses in Illinois.

The newly elected board members are as follows: Vice President: Monique Reed PhD, MS, RN Treasurer: Jeannine Haberman DNP, MBA, RN, CNE Director: Holly Farley EdD, MS, RN Director: Nicole Lewis DNP, APRN, FNP-BC Director: Zeh Wellington DNP(c), MSN, RN, NE-BC Director: Stephanie Yohannan DNP, MBA, RN, NE-BC The new board members will join the following directors whose terms continue through October of 2021: President: Elizabeth Aquino PhD, RN Secretary: Colleen Morley DNP RN CCM CMAC CMCN ACM-RN Director: Susana Gonzalez MHA, MSN, RN, CNML Director: Nicole Lewis DNP, APRN, FNP-BC The 2020 ballot also included the election of members to the Nominations Committee to serve as representatives to the ANA Membership Assembly. We are happy to welcome these individuals as part of the ANA-Illinois leadership team. As we move forward these individuals will be instrumental in helping the association advance the profession.

Nominations Committee: Ann Altgilbers MSN, APRN Lisa Conley MSN, RN, CCM Joseph Hernandez BSN, RN ANA Membership Assembly Representatives: Ann Kowalczyk MS, RN-BC, CPN Ann M. O’Sullivan MSN, RN, CNE, NE-BC, ANEF Tracy Viers MSN, RN - alternate ANA-Illinois, a constituent member of the American Nurses Association, is a powerful network of registered nurses who are committed to advancing nursing through education, political action and workplace advocacy. ANA-Illinois is the leading voice of the approximately 187,000 professional registered nurses in Illinois.

The Nursing Voice

PRACTICE CORNER

Illinois Law & Nursing Practice Nancy J. Brent, MS, JD, RN QUESTION: An Illinois RN asks if a new law in Illinois requires a Sexual Assault Nurse Examiner (SANE) to do rape kits. She adds that she has been doing them for 10 of the 15 years she has worked in an ER and was trained to do the kits.

RESPONSE: Yes, but that particular requirement is not immediate.

In 2019, amendments to Illinois’ Sexual Assault Services Emergency Treatment Act (SASETA) were passed. The amendments apply to every hospital, approved pediatric health care facilities, hospital outpatient facilities, and hospital free standing ER Centers.

SANEs provide comprehensive, one-to-one care to survivors, including such services as a forensic examination, collection of DNA, and completion of the evidence collection kit (rape kit).

SANEs have been providing medical forensic services to survivors in ERs for some time, including here in Illinois. However, their expertise was not mandated by law until the 2019 amendments.

The amendments require many changes in the care and treatment of sexual assault survivors. ED and ER Center nurses and their nursing practice are affected by the changes.

Some highlights of the amendments for RNs. LPNs, and APRNs include: **By January 1, 2022, facilities “shall employ or contract with” a qualified medical provider to initiate medical forensic services **By January 1, 2022, a qualified Medical Provider shall provide medical forensic services to a survivor **An RN or an APRN who has completed a SANE training program that conforms to the Sexual Assault Nurse Examiner Education Guidelines established by the International Association of Forensic Nurses is defined as a “Qualified Medical Provider” **Beginning January 1, 2022, a qualified medical provider, including a SANE, must initiate medical forensic services to a sexual assault survivor within 90 minutes after the patient presents in the facility. **Forensic services include a general physical exam, evaluation and treatment for sexually transmitted diseases, and an offer to complete the Sexual Assault Evidence Collection Kit. **A SANE conducting a medical forensic examination using the Illinois State Police Sexual Assault Evidence Collection Kit may do so without the presence or participation of a physician consistent with the SANE’s training **Beginning January 1, 2019, all clinical staff, including APRNs, RNs, and LPNs, who are not qualified medical providers must receive a minimum of two hours of sexual assault training by July 1, 2020 **After July 1, 2020, those clinical staff must receive a minimum of two hours of continuing education on responding to survivors every two years You can learn more about how to become a SANE by going to the International Association of Forensic Nurses at: forensicnurses.org and clicking on Education.

Likewise, the Illinois Attorney General’s Office information on its free training programs can be found at: illinoisattorneygeneral.gov/index.html.

Although becoming a SANE will be required by 2022, certification is not required under the Illinois Amendments. It is encouraged, however. The Forensic Nurses Association’s certification programs can be found on its website by clicking on Certification.

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT TO BE TAKEN AS SPECIFIC LEGAL OR ANY OTHER ADVICE BY THE READER. IF LEGAL OR OTHER ADVICE IS NEEDED, THE READER IS ENCOURAGED TO SEEK SUCH ADVICE FROM A COMPETENT PROFESSIONAL. NOTE: This legal corner is new to The Nursing Voice. It is planned to continue with this corner each issue. If you have a nursing legal question, please forward your question to the INF Editorial Committee by emailing Susan Swart at susan@ sysconsultingsolutions.com

At Centerstone, our mission is delivering care that changes people’s lives. For over 60 years, Centerstone has been providing community-based behavioral health care, substance-abuse treatment and intellectual and developmental disabilities services in Florida, Illinois, Indiana, Kentucky and Tennessee. We’re committed to bringing passionate and customer experiencefocused individuals to help us continue to provide the best care to our communities. If you think you’re a good match to join our organization, please review the career opportunity below and submit your application. We look forward to hearing from you!

Open Positions Nurse Practitioner, Psychiatric **SIGN-ON BONUS**

This position offers a very competitive market salary and is eligible for a SIGN-ON and RETENTION BONUS of up to $7,500 and Student Loan Repayment Program (under the NHSC).

Behavioral Health Nurse (RN) Contact - Kim Fleck - Kim.Fleck@centerstone.org

The Nursing Voice

December 2020

Page 5

ETHICS IN ACTION The Code of Ethics for Nurses with Interpretive Statements, as the ethical standard for the profession, serves to guide nurses in analyzing ethical issues and concerns, as well as in ethical decision-making. It is non-negotiable, and is revised approximately every ten years by the American Nurses Association (ANA).

As a dynamic document, the Code changes in order to respond to changes in society, in healthcare, and in the role of nursing and the nursing profession. The values and obligations expressed in the Code apply to nurses in all roles, settings, and areas of practice. In the Preface to the Code, the following purposes are identified: “It is a succinct statement of the ethical values, obligations, duties, and professional ideals of nurses individually and collectively; It is the profession’s non-negotiable ethical standard, and It is an expression of nursing’s own understanding of its commitment to society,” (p. viii).

A major change to the Code in 2001 and continued in 2015 was a conceptualization of the patient to include individuals, families, communities, and populations, rather than the individual person. The Code consists of the provisions, which are broad statements of nurses’ ethical obligations, and interpretive statements, which apply these obligations to nursing practice. Additional and in-depth information on the application of these interpretive statements have been published (Fowler, 2015). The position and policy statements of the ANA, which are frequently reviewed and updated, provide additional guidance in addressing ethical issues in nursing practice, research, administration, public and healthcare policy, and global health issues.

Lisa Anderson-Shaw, DrPH, MA, MSN, APN-BC, HEC-C Linda L. Olson, PhD, RN, NEA-BC, FAAN Ethics in Action is a new series related to ethical issues in healthcare and our environment. Over the next several issues of The Nursing Voice, we will be reviewing the ANA Code of Ethics for Nurses with Interpretive Statements (ANA, 2015). There are nine provisions of this code as well as interpretive statements for each provision.

The ANA Code of Ethics for Nurses with Interpretive Statements (ANA, 2015) serves as the framework and compass that guides the ethical practice of nurses and the profession of nursing. As one of the profession’s foundational documents, the Code expresses nursing’s values and commitments, ethical responsibilities to patients, to the public, and to each other, and educates on ethical responsibilities. As the profession’s ethical

standard, it is non-negotiable; each nurse is obligated to uphold and adhere to the Code of Ethics. The Code, as a dynamic living document, reflects changes in the nursing profession, in society, and challenges to ethical practice, and as such, is revised and updated periodically. The Code expresses the core values of the nursing profession, recognizes the expansion of the scope of nursing practice and changes in the health care environment, and is clearly patient-focused.

The Code consists of nine provisions, with accompanying interpretive statements that provide additional guidance on application of the Code. The current Code was revised in 2015. Prior to that, the revisions in 2001 were the first revisions since the 1985 Code. One of the major revisions in 2001, which remained in 2015, addressed nurses’ duties to self (Provision 5). Provision 5 recognizes that nurses owe the same obligations to themselves as to others, and include the self-regarding duties of promoting our own health and safety, preserving wholeness of character and integrity, maintaining competence, and continuing personal and professional growth. In revising the Code in 2015, and due to the access to electronic communication, there were approximately 3000 respondents in a 2013 online survey that addressed the content included in and recommended for the Code of Ethics document. In addition, the content and suggestions were reviewed by the Code of Ethics Taskforce and the ANA Ethics Advisory Board, and was open for public comment in 2014. Some of the comments reviewed reflected need for a greater focus on leadership, and a focus on issues related to social media, social justice, and on global responsibilities and a changing health care system. The nine provisions in the Code are organized according to the fundamental values and commitments of the nurse (Provisions 1-3), the boundaries of duty and loyalty (Provisions 4-6), and the aspects of duties beyond individual patient encounters (Provisions 7-9). The Code is applicable to all nurses in all roles and the ethical and embodies the standards expected for professional nurses as well as assisting nurses in ethical analysis and decision-making. This series will explore the provision statements with examples and actions that are expected of professional nurses.

The provision we will discuss in this issue is Provision 5 which states “The nurse owes the same duties to self and others including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence and continue persona and professional growth.” This issue of The Nursing Voice will discuss Provision 5 and explore interpretive statements

Code of Ethics for Nurses PROVISION 1| PROVISION 2| PROVISION 3| PROVISION 4| PROVISION 5|

PROVISION 6|

PROVISION 7| PROVISION 8| PROVISION 9|

The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every patient.

The nurse’s primary commitment is to the patient, whether an individual, family, group or community, or population.

The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.

The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care.

The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.

The nurse through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care.

The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.

The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.

The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.

5.1 and 5.2: Professional nurses have a duty to self and others, should promote personal health, safety, and wellbeing as they relate to real life situations.

A current example from the Covid-19 pandemic related to the use of masking and social distancing in public spaces relates to Provision 5. In many parts of Illinois and across the county there is varied social dissent from individuals and groups regarding the wearing of a mask and social distancing in public areas mandates.

Some people consider mask mandates a violation of individual freedom. In addition, mixed messages from media and government officials regarding the scientific evidence surrounding these guidelines cause mistrust from the public regarding Centers for Disease Control and Prevention and The National Institutes of Health guidelines calling for masking and social distancing (Sandel, 2020). Our professional nursing Code of Ethics states that we, as nurses, have the “responsibility to promote health and safety” that is consistent with given standards of care. This professional responsibility extends outside the wall of a hospital, clinic, skilled nursing facility and the like. This Code statement holds us to the promotion of public health standards to promote health and safety of all persons, no matter the location.

Professional nurses have an ethical obligation to promote the use of masks and social distancing to all persons we are in contact with. It may be uncomfortable at times to ask someone who is not wearing a mask in close contact with you to step a few steps away (such as in a check out line) or to encourage those around you to wear a mask in public spaces. However, it is our professional obligation to be an example to others as well as to encourage our patients, community, and those we are in contact with in the promotion of health and safety guidelines.

American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements, Silver Spring, MD: Nursesbooks.org Fowler, M.D.M. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, MD: Nursesbooks. org Sandel, M. (2020). Why some Americans Refuse to Social Distance and Wear Masks. The Harvard Gazette. Retrieved October 10, 2020, from https://news.harvard.edu/gazette/ story/2020/08/sandel-explores-ethics-of-what-we-oweeach-other-in-a-pandemic/

Please submit your bioethics questions for consideration in future “Ethics in Action” articles to The Nursing Voice: Kristy@sysconsultingsolutions.com

Become someone's HERO today and join our team of

NURSING HEROES at HARRISBURG MEDICAL CENTER! Looking for RN positions for: • Ambulatory Care* • ER* • Behavioral Health* • Med Surg* • SCU/PCU* *offering Sign on Bonus

• Infection Preventionist

To see a complete list of all the nursing opportunities go to

recruitingsite.com/ csbsites/harrisburg/Careers.asp

*** resume not required and you can apply through our website today!

Page 6

December 2020

The Nursing Voice

2020 Inaugural ANA-Illinois Awards The board of directors wanted to make 2020 the year of the Nurse special so set their sights on an award program for the association. The board wishes to thank the awards development committee for their work on establishing our awards program.

Dr. Alma J. Labunski Renee Maeweather-Reed Dr. Sarah Silvest-Guerrero Dr. Martha Bergren Dewey Kimberly A Bertini Dr. Tiffany Greer Theresa Ellingsen Their work resulted in establishing three awards – the clinical practice award, the nurse influencer award, and the student nurse of the year award. We are proud to present the inaugural awards in this the year of the nurse.

The Clinical Practice Award recognizes an exemplary nurse who provides evidence of a high level of skill inpatient care through improving clinical practice and patient-centered outcomes.

Nominations must demonstrate evidence-based ability to design, implement, and evaluate evidence-based practice changes and/or quality improvement initiatives to promote improved patient outcomes.

2020 Clinical Practice Award winner – Dr. Colleen Morley DNP RN CCM CMAC CMCN ACM-RN The nomination statement received stated, Dr. Colleen Morley is nominated for the Clinical Practice Award in recognition of her conception, creation, and leadership of a program that exemplifies the role of Nurse Case Managers as the coordinators of the interdisciplinary team. Her thorough and visionary leadership of the project meets and exceeds every criterion listed for the award. As the Director of Case Management at West Suburban Medical Center (WSMC) in Oak Park, IL, Dr. Morley was the driving force behind an interdisciplinary team that included everyone from senior management to discharge planners and every member of the patient care team in between.

The project created an in-patient education intervention to better prepare patients with chronic medical conditions for more effective self-management after discharge using a Skills Simulation Experience and focused one-on-one structured education format in a circuit-based intervention. The Health Confidence Lab for patients admitted with COPD or CHF provides focused chronic condition management education. As an interdisciplinary intervention, the healthcare team presents standardized education in a circuit training presentation to allow for one-on-one interaction with healthcare professionals, using multiple teaching/ learning strategies, to assist the participant in acquiring or reinforcing skills needed to successfully self-manage their conditions post-discharge.

Dr. Morley has evolved and improved the discharge process. She brought it from physician orders, written discharge instructions accompanied by a stack of indecipherable patient education handouts, and recommendations for follow up to an interactive transitional process with active education and patient

engagement opportunities incorporated directly into the acute hospital stay. Her work is deserving of the Clinical Practice Award and deserves rapid adoption and support throughout our acute care system.

The Nurse Influencer Award recognizes an exemplary nurse who has influenced the science of nursing practice or care delivery system, a group/community/population (patient or other care providers) sick or well. Contributes to health or its recovery (or to peaceful death) in any care or community setting (at any level, local, regional or national level) or nursing profession through education, advocacy, policy, or practice.

Defined by Mariam Webster, an Influencer (noun): “one who exerts influence, a person who inspires or guides the actions of others.”

Nominations must demonstrate evidence of the nurse’s influence over the science of nursing practice or care delivery system, a group/community/population (patient or other care providers) sick or well, contributes to health or its recovery (or to peaceful death) in any care or community setting (at any level, local, regional or national level), or the profession of nursing through education, advocacy, policy or practice.

The Nursing Voice 2020 Nurse Influencer Award winner – Susan Gonzalez MHA, MSN, RN, CNML Ms Gonsalez’ nominator stated, “Susana González is an amazing nurse advocate and leader who fully commits to everything she embraces. Her purpose in life is to leave this world a little better than she found it. She is especially focused on mentoring and developing the next generation of bilingual, bicultural Spanish speaking nurses, and promoting all education levels in changing their lives.

Susana is currently a nurse educator and consultant providing education and training services for ASI Home Care agency in Chicago. In addition, she is an adjunct faculty at Morton College for the A.D.N. program and an adjunct faculty for DePaul University’s Master entry school of nursing. Susana is strong in developing and leading operations, academics, simulation skill learning, and excellent in coordinating partnership development.

Throughout her career, Susana has role modeled authentic servant leadership and served on numerous committees and boards of directors of key organizations on a local, state, and national level. She continues to be at the forefront of health care issues for women, infants, children, and the nursing profession. She is active on advisory committees for elected officials in the State of Illinois. She is an exemplar advocate for public policy change, especially for the nurse profession and diversity and inclusion in higher education. She is an exemplar role model and mentor to aspiring nurses who seek a career in healthcare. She mentors and guides students in any capacity that she can offer. She takes an opportunity to truly make a difference. A most recent service is her volunteerism on several yearlong medical missions on the island of Puerto Rico post-Hurricane Maria.

Susana has served on many boards of directors, such as the March of Dimes-Chicago, Mujeres Latinas en Accion, the Chicago Bilingual Nurse Consortium. At this time, she an active member of the National Association of

December 2020 Hispanic Nurses-Illinois as the Past President and serves as a National board member, where she Co-Chaired the National Policy and Advocacy and now the Membership committees. She is an active member of the Illinois HealthCare Action Coalition and the American Nurses Association-Illinois, where she serves on the board of directors. In addition, Susana is a member of the Illinois Organization of Nurse leaders on the Policy & Advocacy Committee. She has been profiled on WLS-TV Channel 7 during Hispanic Heritage Month. She has received the National Association of Hispanic Nurses-Community Service Award and the March of Dimes-Jonas Salk Nurse of the Year award for her commitment to service. She was recently named Nurse of the Year for the National Association of Hispanic Nurses and Ambassador of the year for 2018. She recently received the Nurse Leadership award for the Illinois chapter of NAHN in 2019.

She is a life role model for nursing education and community servant leadership. On a personal note: She lives by the philosophy that if there is something she can do for you now, then let it be so. For, we may not walk this path again.

The Student Nurse of the Year Award recognizes an outstanding student nurse who exemplifies compassion, exceptional promise in clinical expertise, and academic achievement- the underpinnings of nursing excellence.

Nominees for this award are recognized for outstanding achievement, exceptional academic or clinical ability, or exemplary compassion and caring toward their clients and peers during their years of study.

2020 Student Nurse of the Year Award winner - Rory Nicholson The nominator stated, “I have come to know Rory over the past few years in their time as a Master’s Entry to Nursing Practice student as well as a peertutor graduate assistant in the simulation lab. From the moment I first met Rory, I knew he would be a wonderful student and future nurse. He has an extremely pleasant disposition, excellent

Page 7

management skills, unmatched ability to improve educational processes, and a drive for thorough team collaboration. All these unique characteristics have made him an exemplary nursing student as well as an employee.

When I found out Rory had put in his application to be one of my graduate assistants, I was ecstatic, because I knew he would be a wonderful addition to our strong team. After a unanimous review decision, Rory was hired into our team, and made a lasting impression on the school of nursing immediately. Rory’s biggest contribution is a recreation of our on-boarding and support processes for graduate assistants, as well as making the graduate assistants more available to the students they serve. This has resulted in improvement of graduate assistant function and job satisfaction, which in turn has improved our student’s experience in nursing school.

Rory has achieved the highest levels of academic and clinical excellence, which is evidenced by his nomination and unanimous awarding of the DePaul University School of Nursing’s Fatima Patel Clinical Excellence award. Only one student per cohort can be awarded this distinction, and Rory was unanimously given this, despite being part of a highly achieving cohort. I would estimate at least ¼ of his cohort could have gotten this award if they were not in such a competitive pool.

I am sure at times he may have found me to be demanding. I have always held him to a very high standard didactically and clinically, as I have known he had some of the highest potential to be an extraordinary clinician, even from my first conversation with him years ago. Being in leadership and administration in both the academic and clinical realms of nursing, I can honestly say I have never come across a candidate with Rory’s qualities. He is among the best nursing students, if not the best, I have seen in my years in nursing education.

Rory is, without a doubt, a strong, unique candidate that is capable of anything within the field of nursing.

Therefore, I highly recommend Rory without any reservations for this award.

Page 8

December 2020

The Nursing Voice

CONTINUING EDUCATION OFFERING Barriers in Academia for Illinois Black Nurse Leaders Tamara Bland, EdD, MSN, RN

Abstract

Lack of Black women represented in higher education among nursing faculty is a challenge that affects the profession of nursing. The presence of barriers to Black nursing faculty has been documented in the literature. The purpose of this study was to explore the barriers to Black nurse leaders that results in their underrepresentation in academia in the State of Illinois.

Leadership opportunities was the dependent variable used to measure faculty achievement for attaining positions in higher education or nursing administrator roles. The independent variables where the various barriers: racism, financial disparity, self-efficacy, mentoring, and financial disparities. (Godfrey 2005).

Keywords: self-efficacy, leadership attributes, mentoring, racism, nurses, Black Nursing Faculty, women, institutional support, and financial support.

Introduction

The achievement of earning an advanced degree should be an obtainable goal that can be realized regardless of race. There is an invisible reality that higher-education is reserved for a select number of Black individuals. Research has shown there are many contributing factors in one’s success or failure within a profession and among races. Nursing education among Blacks shows an alarming disproportion when compared with their Caucasian counterparts. This disproportion is a phenomenon among higher-education in the United States (Godfrey 2005).

Background

Leadership Attributes Leadership is a crucial factor in organizations, especially within higher education. Successful leaders seek out and discover opportunities that provide an opportunity to learn. Attributes associated with leadership are open/honest communication and respect.

The perception of men in leadership is different from women. Men are viewed as “hard” while women are viewed as “soft;” however, there is no significant data to support differences in gender (Byham, 2016).

When assessing leadership attributes, it is important to recognize that 37% of all leaders are women whose financial performance falls in the top 20% (Byham, 2016).

Racism/Discrimination in Healthcare and in Academia There are many obstacles that impede Black women from pursing positions in Nursing Education identified in the literature. Both overt and covert acts of racism are significant barriers according to Hassouneh-Phillips and Beckett (2003). The disproportionately small percentage of persons of color with doctoral degrees in nursing is unlikely to improve because of the lack of retention and recruitment of diverse students at this level of education.

In addition, there is a lack of faculty role models for these students. (Hassouneh-Phillips & Beckett, 2003).

Self-efficacy Self- efficacy refers to an individual’s belief in his or her capacity to execute behaviors necessary to produce

specific performance attainments (Bandura, 1977, 1986, 1997). A person’s internal motivation is an important factor that serves as the driving force to accomplish task and goals. It is a person’s confidence in his or her ability to take action and to persist in that action despite encountering obstacles or challenges that; seems to be especially important for influencing change efforts (Bandura, 1997). Due to external variables, self-efficacy plans are vital roles for Black nurses to achieve their professional aspirations.

Lack of Mentoring A solution suggested to address the U.S. Healthcare disparities includes increasing the amount of healthcare providers who represent racial or ethnic minorities. The belief is that these providers will possess the healthcare knowledge and the cultural insight to effectively address health disparities within their own communities (Mkandawire-Valhmu, Kako &, Stevens, 2010). Lack of role models for Black women directly correlates with the number of Black women in healthcare (MkandawireValhmu, Kako &, Stevens, 2010). According to the National Sample Survey, only 10.7% of nurses in the U.S. are minorities (Mkandawire-Valhmu, Kako & Stevens, 2010).

There is a lack of minority educators and this is problematic because students of color need to be able to see themselves reflected in their nursing faculty. By seeing professional role models of one’s own race, it contributes to the belief that they can become competent and successful professionals who achieve in the educational arena (Mkandawire-Valhmu, Kako & Stevens, 2010).

Institutions that lack diversity in their faculty and staff may inadvertently contribute to a system that marginalizes women faculty of color. Full time nursing faculty of color represent only 10.5% of the U.S. nursing faculty workforce, which is decidedly less than the 34% of the U.S. population, which claim a minority heritage (Mkandawire-Valhmu, Kako & Stevens, 2010). In universities, mentors would be readily available for newer nursing faculty of color. These mentors ideally would be of the same gender and race or ethnicity, to foster trust and can share experiences. Career-building skills, genuine support and role modeling are attributes that a good mentor would provide to their mentee (MkandawireValhmu, Kako & Stevens, 2010). Within the American Nurses Association (ANA) Ethnic/Racial Minority Doctoral Fellowship Program, mentoring is a critical responsibility to assist minority nurses in achieving doctoral degrees. Mentoring is an effective strategy for career advancement and the development of nurse leaders (Hill, Del Favero, & Ropers-Huilman, 2005). This study reinforced the importance of Black women mentees.

In a study by Hill, Del Favero, and Ropers-Huilman (2005), the authors found their sample of Black nurse leaders to be consistent with the overall composition of the nursing profession with 96% of the sample in baccalaureate and graduate nursing programs being female. Of this sample, 30% were deans, and 26% retired or left their leadership position. Of these nurse leaders, 85% of them had been mentored. The study suggested that graduate school is a good environment for fostering

mentoring relationships. In most graduate schools, mentors are not assigned to students at the time of admission into the program. Mentees are assigned once students enter their thesis course.

For many Black female administrators’ mentoring relationships do not end; rather they change in intensity and involvement. Black nurse leaders in higher-education characterize the mentoring experience and relationship as positive and they believe they are more confident and have more awareness of self (Hill, Del Favero, & Ropers-Huilman, 2005). Students of color need effective mentors and at the same time need acknowledgement of differences and levels of multicultural competence. For Black nurse leaders in the Hill, Del Favero, and RopersHuilman study (2005), mentoring was integral to both professional and personal growth of the leader. The evidence supports that mentoring is imperative whether it is same race or cross-race mentoring; however, there are additional benefits to having Black leaders providing mentorship.

Lack of Institutional Support Scholarly productivity and underrepresentation of minority faculty has been a longstanding problem. Some of the underpinnings to productivity and success as a Black nurse faculty member are related to discrimination, mentorship, pay inequity, geographical location of the university, tenure and promotion, and job satisfaction.

It has been well established that Black nurse faculty are underrepresented in higher-education, however it is important to note that the faculty member distribution throughout the nursing programs in the U.S. is not evenly distributed. In the 1990s, less than 30 nursing programs were located on campuses of historically Black colleges and universities. Nearly these 30 historically Black institutions employed half of the entire minoritynursing faculty, or approximately 450 minority educators.

This means for the remaining 1470 institutions with nursing programs, there were far less than one minority faculty member per institution (McNeal, 2003), (Bower & Wolverton, 2009), (Godfrey, 2005).

Financial Disparity In the study by Bond, Cason, and Baxley (2015), only 20% of nursing faculty members believe the number of available scholarships for minorities was in accord with the percentage of minority students and only 11% of minority students responded that scholarships were available to them. Financial disparity is a documented obstacle that continues to be a theme among the research.

Research Questions

The following research questions in this mixed method, explanatory correlational study guided the study.

The research questions in the study were: 1. What is the relationship between racism, leadership attributes, mentoring, institutional support, and financial disparity that influence the success of Black women in higher-education professional roles?

LPN/RN/RN-Trainer Full time/Part time/All Shifts NEW GRADS WELCOME! New higher wages of $24.10 for LPN and up to $30.10 for RN.

SIGN ON BONUS

$5,250.00

EXCELLENT BENEFITS!!

Resumes can be sent to hr@milestone-inc.org Apply online at MILESTONE-INC.ORG or in person at: Milestone, Inc., 4060 McFarland Rd., Rockford, IL 61111 815-654-6100

The Nursing Voice 2. How would Black women describe influences that contribute to their success as leaders in highereducation?

Methodology

A mixed method, explanatory correlational study (Creswell, 2014) collected survey data to investigate the impact of racism, leadership attributes, mentoring, institutional support, self-efficacy and financial disparity upon the success, attainment of leadership and administrative roles, and achievement of higher levels of education among Black nurses in the state of Illinois.

A statistical analysis of the survey data was conducted to determine any correlation between Black nurses and the influence of racism, leadership attributes, mentors, institutional support, self-efficacy and financial barriers and the participants’ achievement and success in their professional role. Narrative responses were evaluated for specific themes and categorized. The sample was evaluated until data saturation was reached and continued evaluation of additional responses consistently produced similar results.

In this study, face validity was verified through the process of racism, leadership attributes, mentoring, institutional support, and financial disparity that influence the success of Black women in highereducation professional roles based upon the respondents reply. In order to prevent an error in measurement due to reliability, two researchers reviewed the instrument for question and item content validity using inter-rater reliability as the measurement.

In addition, the researcher looked for consistency among the respondent’s replies knowing that personal characteristics and motivation could be a potential source of error.

Instrumentation The researcher developed the Factors that Impact Black Nurses Survey to assess success as identified by individual respondents. The Likert Survey consisted of questions to evaluate nurse’s beliefs about leadership roles within higher-education and the impact of racism, leadership attributes, mentoring, institutional support, self-efficacy and financial disparity. A pilot of the instrument was administered to nurse educators at a nursing school in an Illinois suburb. No changes were made to the pilot instrument after feedback from these professionals were received. Cronbach’s alpha of survey was performed with a result of .889 indicating a high level of internal consistency.

The survey consisted of 24 Likert scaled questions designed to discern the impact of racism, leadership attributes, mentoring, institutional support, financial disparities, and self-efficacy during the participant’s professional careers in nursing education. Respondents were asked to rate their level of satisfaction using a fivepoint scale. The rating scale for each item score ranged from 1 (very dissatisfied) to 5 (very satisfied). The Likert scale measured how respondents attribute personal success with satisfaction in higher-education. Finally, the survey instrument provided a narrative opportunity for participants to share their lived experience as a black educator in nursing or as an administrator within a school of nursing to evaluate the qualitative component of the study. Respondents who rank themselves as a 5 on the question (such as what has the impact of a mentor been on your achievement) had this information correlated with responses against rank, salary, administrative position, and level of education. Ultimately, the study identified the factors of influence that correlate with any of the identified measures of success.

December 2020 Participants This study occurred in Illinois, which houses colleges and universities, in urban, suburban and rural environments. Eighty-eight institutions in Illinois have nursing schools with varying sizes of graduating classes ranging from four to 561. These colleges grant degrees including the Associate Degree in Nursing (ADN), Baccalaureate Degree in Nursing (BSN), Master of Science in Nursing (MSN), and Doctoral Programs in Nursing including Doctorate in Nursing Practice (DNP), and Doctorate of Philosophy in Nursing (PhD).

Table 1.

Racial and Ethnic Identity of Participants Frequency

Percent

Asian American

1

2.1

Black/AfricanAmerican

28

58.2

Caucasian/White 14

29.2

Hispanic/Latino

1

2.1

Middle EasternAmerican

1

2.1

Pacific Islander/ Native Hawaiian

1

2.1

Other

2

4.2

Total

48

100.0

Page 9

Table 1 shows the participants included 49 nurses working in educational institutions throughout the state of Illinois. One participant was removed from the data set due to failure to complete the survey. Thus, the number of participants decreased from 49 to 48. Of the 48, participants, 24 were of Black or African descent, and 24 were from other ethnic groups.

For inclusion in the study, respondents identified themselves as Black, as female, and between the age of 35 – 65. In addition, they teach in one of the following programs: Associate Degree, Bachelor of Science in Nursing, or a Master’s of Science in Nursing Program.

Procedures The survey was delivered through Survey Monkey.

The survey first requested demographic information regarding the institution in which they work (size), location (urban or suburban), public, private, proprietary, or non-profit. Participant demographic information included age, gender, race, work status, professional title, salary range, highest level of education, and number of years in higher-education.

Participant Selection The data was collected from 88 colleges and universities, in urban, suburban and rural environments in the greater Chicagoland region and surrounding suburbs that have nursing schools with varying sizes of graduating nurse classes ranging from four to 561 students. A combination of a mixed method, explanatory correlational study collected data to design this study.

Barriers in Academia for Illinois...continued on page 10

Table 2 Correlations

Leadership

Pearson Correlation

Leadership Self-efficacy

Mentorship Institutional Racism Financial Disparity Support

1

.644**

.397

.415*

-.074

-.160

.001

.061

.049

.736

.465

1

-.087

.665**

-.253

.160

.694

.001

.243

.466

1

-.134

-.021

-.250

.543

.923

.250

1

-.188

.403

.390

.057

1

-.066

Sig. (2-tailed) Self-efficacy

Mentorship

Institutional Support Racism

Financial Disparity

Pearson Correlation

.644**

Sig. (2-tailed)

.001

Pearson Correlation

.397

-.087

Sig. (2-tailed)

.061

.694

Pearson Correlation

.415*

.665**

-.134

Sig. (2-tailed)

.049

.001

.543

Pearson Correlation

-.074

-.253

-.021

-.188

Sig. (2-tailed)

.736

.243

.923

.390

Pearson Correlation

-.160

.160

-.250

.403

-.066

Sig. (2-tailed)

.465

.466

.250

.057

.764

**. Correlation is significant at the 0.01 level (2-tailed). *. Correlation is significant at the 0.05 level (2-tailed).

NOW HIRING Health Service Nurse The Health Service Nurse (HSN) coordinates the school health program including the delivery of services to students and serves as the health resource to staff members in order to enhance health and wellness in the school community.

All qualified applicants should possess at least an Associates Degree in Nursing from an accredited college, or university; a Bachelors Degree is preferred. A valid Illinois nursing license and current certification in CPR is a must.

www.cps.edu

palladianmgt.com/careers

.764 1

Page 10

December 2020

Barriers in Academia for Illinois...continued from page 9 For purposes of analysis, the data were grouped by various demographic characteristics. These characteristics were; type of program, primary institution, type of institution, age, and years as a registered nurse, number of years as an educator, racial and ethnic identity, and highest degree earned. The grouping used is described in detail in each sub section.

Statistical analysis was conducted using and Pearson’s r correlation in SPSS. When applicable, a Pearson r was utilized to assess effect size. All data was assessed for missing data and outliers prior to statistical analysis, including for linearity.

Results Assumptions for an independent t-test was conducted to evaluate the impact Black nurses’ leadership opportunities in higher-education. Once all data was imported, the data file was split to evaluate the relation to five main factors: mentoring, leadership, institutional support, racism, and financial support. The Statistical Package analyzed the data for the Social Sciences (SPSS) VIX. When outliers were identified, data entry was examined and yielded no errors. Testing for homogeneity of variances, was conducted using Levine’s Test. Data was deemed reliable based on the robustness of statistical analysis. The chi-square statistic was used to test for statistically significant relationships among the various variables under consideration. The standard used to evaluate the data was statistical significance of p ≤ .05 level of confidence. Statistically significant results were analyzed using Cohens d. In several cases, more than 20% of the cell values in the calculation of the Chi-square statistic contained fewer than five items, causing the results of this calculation to be questionable. In those cases where 20% or more of the cells contained fewer than five responses a special notation was made.

The researcher computed all of the data (Table 2) to further examine the relationship between black nurses and self-efficacy, leadership, mentorship, racism, institutional support, and financial disparity. There was significant correlation with a strong effect among Black nurses self-efficacy when compared to leadership attributes Pearson’s r = .644, p ≤ .01 and self-efficacy and institutional support Pearson’s r = .665, p ≤ .01. There were no statistically significant findings among ethnicity, mentorship, and financial disparity Implications for Nursing Education Existing bodies of research supported the predicted gap in knowledge specific to leadership attainment by Black nurses in higher-education settings. Moreover, the literature reported similar conclusions, stating that further studies were needed to assess the variables influencing Black nurses and the association of those variables in relation to positions of leadership in highereducation. Hassaouneh-Phillips & Beckett (2003) found: The aim of this study was to describe the experiences, challenges, and understandings of women of color in doctoral programs. Analysis of interview data revealed that racism was pervasive and a harmful influence on participants and this influence was largely visible to Euro-American faculty and students. (p. 258) The afore mentioned research provides insight into the importance of this research study. This research further explains the need to better understand variables influencing Black nurses in leadership. While Black nurses comprise the largest percentage (4.9%) of all minorities (Hill, et al, 2005), they still fall behind in leadership positions. Schmeiding states:

The Nursing Voice Nurses in top-level leadership positions in government, health care organizations, advances practice, nursing schools, and professional organizations formulate national policies, establish governmental and private research priorities, develop nursing education agendas, and formulate strategic plans for health care delivery. Most of the nurses are in positions to address diversity issues in health care and in research, as well as the shortage of minority nurses…and the shortage of minority nurse leaders. (p.120)

as non-electronic surveys. Another recommendation would be to follow the respondent’s longitudinally to discover the impact of focusing on attacking barriers that would lead to leadership opportunities. In addition, future research should incorporate national participants for a larger, more diverse sample. The literature review found limited number of studies on the areas of racism, leadership attributes, mentoring, institutional support, self-efficacy, and financial disparity in relation to Black nurses. The results of this study will add to the existing body of knowledge in the nursing and academic fields.

Published literature reviews, meta-analysis, and dissertations concluded that additional research is needed to assess the variables that influence Black nurses in leadership. As noted in the article published by JonesBerry in the Nursing Standard, 2017, she states, “More needs to be done to ensure greater numbers of black and minority nurses take on executive positions due to underrepresentation at the leadership level.” Focusing on qualitative and quantitative data to measure leadership, financial disparity, racism, mentoring, institutional support and self-efficacy were well suggested by existing research. This information justified the need for the data collection of this study. In the dissertation performed by Huff (1998), she states “that faculty were more confident about teaching tasks than academic tasks of research, administration, and other miscellaneous academic duties.” She also mentions how leadership and selfefficacy influences a woman’s academic career.

In the article by Hill, Del Favero, & Ropers-Huilman (2005), black nurses identified that stated mentors also serves as protectors that assisted them with obtaining and maintaining their leadership roles. Anita, one of the nurse leaders interviewed, stated the following lived experience: I’m sure she was instrumental in my becoming a faculty member in a majority institution that did not have a minority faculty…I’m sure she lobbied very hard for me to become the first chairperson and director of the program in South Africa because the organization at the University had someone else in mind…a faculty (member) in another department (science)…I remember her calling and saying ‘this will never do, we can’t allow that to happen,’ plus the person wasn’t even a nurse (laughing) so they had the nerve to put somebody to start a program in another country who was not a nurse and she (mentor) thought I was custom made for it. (p. 344)

Conclusion Overall, the majority of the findings were of concern when comparing Black nurse’s ability to advance within higher education because of the impact of the variables racism, leadership attributes, mentoring, institutional support, self-efficacy, and financial disparity. Such significant findings should remind administrators to value the role that Black nurses bring to academia, to Black students, and the profession of nursing. This includes valuing their roles, backgrounds, and desire to advance to enhance their personal experiences and those of students. The current study also shows that empowerment of Black nurses into the field of nurse educators within academia will help extinguish stereotypes and break the “minority” stigma to diversify nursing university and colleges. According to Giddens and Thompson, “common challenges facing academic nursing leaders include changes in funding and budgetary constraints. This in addition to a limited pool of qualified nursing faculty and an arduous funding climate to support and advance nursing science” (Giddens, and Thompson, 2018).

The above experience speaks to many of the lived experiences that have been expressed in previous research. It was the expectation that his study would illicit similar themes.

Limitations While this study promises to adhere mostly to the quantitative analysis of key features of Black women in higher-education, there are several potential limitations.

This study was limited in the area of size and instrumentation. A larger sample size might reveal greater distinction, Black nurses and their perceptions of selfefficacy, racism, leadership, mentoring, institutional support, and financial disparity. Because the study was limited to the State of Illinois, the results cannot be generalized to Black faculty in other parts of the country.

The internal threat of respondents interacting was identified as a limitation.

Recommendations for Future Research Future studies might examine other methods of data collection, using different quantitative methods, such

Holiday Greetings from the Board & Staff of the Illinois Nurses Foundation

CE Offering 1.0 Contact Hours This offering expires in 2 years: December 1, 2022 Learner Outcome: 80% of those reading the article and completing the post-test will self-report increased knowledge of the barriers present for black nurse leaders in academia in Illinois.

HOW TO EARN CONTINUING EDUCATION CREDIT This course is 1.0 Contact Hours 1. Read the Continuing Education Article 2. Go to https://www.surveymonkey.com/r/ SelfStudy12-2020 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 November 30, 2022 Complete online payment of processing fee as follows: ANA-Illinois members- $8.00 Nonmembers- $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, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

(OBN-001-91) CE quiz, evaluation, and payment are available online at https://www.surveymonkey.com/r/ SelfStudy12-2020 or via the INF website www. illinoisnurses.foundation under programs.

The Nursing Voice

December 2020

Page 11

IASN “How was your summer?”: The Role of the School Nurse During a Pandemic Nurses want to provide quality care for their patients.

The Nurses Political Action Committee (Nurses- PAC) makes sure Springfield gives them the resources to do that.

Help the Nurses-PAC, help YOU! So. . . . . . . if you think nurses need more visibility . . . . . . . . . if you think nurses united can speak more effectively in the political arena . . . . . . . . . if you think involvement in the political process is every citizen’s responsibility.

Become a Nurses-PAC contributor TODAY! ❑

I wish to make my contribution via personal check (Make check payable to Nurses-PAC).

❑

I wish to make a monthly contribution to NursesPAC via my checking account. By signing this form, I authorize the charge of the specified amount payable to Nurses-PAC be withdrawn from my account on or after the 15th of each month.

(PLEASE INCLUDE A VOIDED CHECK WITH FORM)

❑

I wish to make my monthly Nurses-PAC contribution via credit card. By signing this form, I authorize the charge of the specified contribution to Nurses-PAC on or after the 15th of each month.

❑

I wish to make my annual lump sum Nurses-PAC contribution via a credit or debit card. By signing this form, I authorize ANA-Illinois to charge the specified contribution to Nurses-PAC via a ONE TIME credit/debit card charge.

❑

Mastercard ❑

VISA

________________________ ____________ _________ Credit card number Expires CVV  Signature:______________________________________ Date:__________________________________________ Printed Name:___________________________________ E-Mail:________________________________________

Cameron Traut RN, MS, BSN, PEL-IL, NCSN member of ANA-IL and affiliate organization, The Illinois Association of School Nurses When I mention I’m a school nurse, I’m usually met with questions like, “How was your summer off? Must be nice to have summers off,” and more recently, ”since the school is closed, do you still have to work?” For the record, in all of my 25+ years of school nursing, I have never had a complete “summer off,” and I do not know too many school nurses who have. But the paperwork, conferences, projects, volunteering, and summer school programs are for another story…...

When I was asked what I did over “summer break” this past August, I had much to share, and it all started with COVID-19. It actually began last February, fielding questions during the school day such as “what do you think about or know about this COVID-19 thing?” My nurse colleague and I started monitoring the John Hopkins COVID-19 dashboard and quickly realized this was becoming much bigger than we initially knew. As school nurses across the state began to hear of a few cases in our areas and schools closed, we spent the next three months educating ourselves and our school communities on emerging research and information. We reminded our administrators of our public health roles, providing resources and assistance as they grappled with cases in our communities, as well as school closures and health department recommendations. Early on, many school nurses across the state and country organized and led the collection of unused PPEs in schools and donated them to local hospital systems, fire departments, longterm care facilities, health departments, and private healthcare providers.

In May/June, as nurses do, we began to anticipate and create skeleton plans for reopening our schools as we waited for ISBE and IDPH to provide more specific guidelines. We knew various supplies, PPEs, and physical barriers would be difficult to acquire, so we worked with our administrations in creative ways to find supplies and get those orders placed early in the summer. Moreover, throughout those last few months of the school year, we were still caring for our students. We were ensuring they were safe and cared for in their homes, and still receiving accommodations and needed medical management to support their ability to be present for online learning.

As the pandemic spread, and we moved into the summer months, school nurses began to participate in

Address:_______________________________________ City, State, Zip Code:_____________________________ Preferred Phone Number:__________________________ Please mail completed form & check to: ANA-Illinois Atten: Nurses-PAC PO Box 636 Manteno, Illinois 60950

If you are looking for a rewarding career opportunity and want to make a difference in the lives of others COME JOIN OUR TEAM!

Nursing Opportunities Available RN - LPNs PREFERENTIAL DEPARTMENTS: Behavorial Health, Emergency Room, and Home Health Will assist with licensing from one state to another up to $500 We offer competitive compensation, a wide range of benefits to include health/dental/life insurance, paid time off (PTO), tuition reimbursement, employer match 401K plan & a GREAT work environment.

APPLY ONLINE AT :

www.touchette.org Or contact us at 618-332-5303 Touchette Regional Hospital 5900 Bond Ave Centreville, IL 62207

EOE

school district workgroups to create reopening plans, protocols, and procedures for responding to COVID-19.

Unfortunately, some school nurses were and still are, being left out of the planning conversations, despite professionally self-advocating their importance and expertise in pandemic planning and decision-making processes. Despite this, school nurses continued to educate school staff and our communities on the proper use of PPEs for various workers and the community at large. We have been involved in increasing technology uses, from reviewing mass temperature scanners to developing phone apps for tracking and reporting symptoms in students and staff. Because of our public health surveillance and disease transmission knowledge, school nurses knew to monitor and contact trace cases, working with local health departments, long before official COVID-19 guidelines were developed on the local level. We know our communities. Many were “on-call” for late-night phone conversations with administrators regarding constantly changing and updated guidelines from IDPH and the Illinois State Board of Education, as well as discussing case notifications and scenarios of students and staff testing positive or being exposed to COVID-19. All the while, members of the Illinois Association of School Nurses continued to “drink from the fire hose” of emerging research, literature, podcasts, webinars, and other sources of evidence-based research and reliable information to monitor and care for our communities.

Aside from school responsibilities, our summers were filled with volunteering in communities, such as at testing sites, providing contact tracing assistance, donating blood, sewing masks, and working in local healthcare systems. School nurses continued to volunteer well into the school year by offering their expertise in community workgroups, such as places of worship and nonprofit organizations, as a public health resource, developing protocols and procedures for responding to COVID-19.

Furthermore, as a former director from Illinois to the National Association of School Nurses board, I learned of similar stories of challenging work conditions and volunteerism from my colleagues around the U.S. Regardless of what the season may be, school nurses will continue to work on the frontlines of the COVID-19 response, working with our children, school staff, and communities to educate, ensure their safety, and promote healthy learning.

Page 12

December 2020

The Nursing Voice

One stop - IDFPR home page for your online resources

The IDFPR home page (https://idfpr.com/) has a direct link to the following: • The State of Illinois Coronavirus Response Site: Up-to-date information on what Illinois is doing protecting the health, safety, and well-being of Illinoisans. It can be found at https://coronavirus. illinois.gov/s/ • IDFPR’s webpage with resources for Illinois residents and licensees impacted by COVID-19). It may be found at https://www.idfpr.com/COVID-19. asp o This webpage lists the guidance and variances issued by IDFPR during the COVID-19 pandemic.

That includes prescriber guidelines that are in effect during the COVID-19 emergency declaration. Also listed are the Out of State Temporary Practice Permits Granted so far.

Those will expire on December 31, 2020.

IDPH and local health department COVID-19 Resources (https://coronavirus.illinois.gov/s/) This website has information about the number of people in Illinois who have been tested for COVID-19,

the number of positive tests, and the number of deaths.

These numbers are updated daily by 5pm. This page also has the latest Executive Orders from Governor Pritzker regarding COVID-19.

Restore Illinois is about saving lives and livelihoods.

The five-phased plan will reopen our state, guided by health metrics and with distinct business, education, and recreation activities characterizing each phase. This is an initial framework that will likely be updated as research and science develop and as the potential for treatments or vaccines is realized. The plan is based upon regional healthcare availability, and it recognizes the distinct impact COVID-19 has had on different regions of our state as well as regional variations in hospital capacity.

As always, the IDFPR home page (https://idfpr.com/) offers several features for licensees, including: • To print your license or download an electronic copy to your phone: use the icon under the blue middle section of the IDFPR homepage. www.idfpr. com • Address update: Please note that all IDFPR correspondence are now delivered electronically, including renewal reminders (in lieu of the paper postcard sent by U. S. Mail). Licensees are strongly encouraged to visit IDFPR’s online address change webpage (https://www.idfpr.com/applications/

LicenseReprint/) to provide a current email address and ensure contact information is up-to-date and accurate.

• Name change: Change of name CANNOT be completed via this online process. If your name has changed, you must submit a written notice to the Department and include documentation of the name change (marriage license, court order, or divorce decree) For a copy of the written notice, please use this link https://www.idfpr.com/Forms/ DPR/DPRCOAnamechange.pdf If you have questions, assistance is available Monday through Friday by contacting the IDFPR call center at 1-800-560-6420, or by email at FPR.PRFGROUP09@ illinois.gov The Illinois Nursing Workforce Center (http://nursing. illinois.gov/) has a list of all Illinois nursing education programs, beginning with the pre-licensure nursing education programs approved by the Board of Nursing.

Post-licensure Illinois nursing education programs are separated between baccalaureate completion and graduate education. There is also a grid of which practice specialty each graduate program includes. Reports highlighting data collected during online license renewal are available, and date back to 2007 may be found at http://nursing.illinois.gov/ResearchData.asp.

Chicago Undergraduate Chapter Sorority of Student Nurses Volunteers Services

Marilynn Parker, APRN, MSN, FNP, MSEd- The Beta Mu Chapter of Lambda Pi Alpha Sorority Undergraduate Chapter Committee Chairman Chicago State University student nurses who are pledging the Beta Alpha Undergraduate Chapter of

Lambda Pi Alpha Sorority volunteered as greeters, ushers and assisted with serving refreshments to guests attending the 32nd Annual National Black Nurses Day Celebration. The event was held on February 28, 2020, at Apostolic Faith Church where Bishop Horace Smith, MD is Pastor. The pledges also participated in the exhilarating ‘Parade of Nursing Students’ portion of the program.

Many attending student nurses from various Chicagoland nursing schools were recognized and celebrated as each school name was announced by the National Black Nurses Day planning committee chairman, Sandra Webb-Booker, Ph.D. The pledges marched with several of their peers and professors to represent the Chicago State University School of Nursing.

The undergraduate student nurse chapter is a branch of the Beta Mu Chapter of Lambda Pi Alpha Sorority. Valaria Hubbard, RN, is president of the Beta Mu Chapter. Hulda Margaret Lyttle established Lambda

Pi Alpha Sorority in Nashville, Tennessee, at Meharry Medical College School of Nursing in 1930. In 1934, the Beta Mu Chapter was incorporated at Provident Hospital in Chicago, Illinois. Lambda Pi Alpha Sorority is a professional nursing organization committed to providing community services, scholarships to student nurses, mentoring services to nursing students, and supporting various charitable organizations.

The Beta Alpha undergraduate chapter was incorporated in 2008 by the Beta Mu graduate chapter to offer student nurses the opportunity to join a nursing sorority with the benefits of promoting a sisterhood, community services, and access to a professional network of nurses to obtain mentoring, academic and career support. For more information about the undergraduate chapter and the graduate chapter, visit the website: www. lambdapialpha.org

(From left to right:) During the 32nd Annual National Black Nurses Day Celebration: Beta Alpha Chapter of Lambda Pi Alpha Sorority Nursing Sorority Pledges and Chicago State University student nurses: Kimberly Bailey, Patsy Toussaint, Antoinette Chambers, Koyuma Reese, Shontele Clements, Angelica Rosales, Shana’ Hubbard, Luecretia Jacobs, and Kayla Freeny.

LaDonna Fountain, RN - Dean is not shown.

The Nursing Voice

December 2020

Page 13

Nursing Policy in Times of Uncertainty Surviving, Thriving on the Edge Leadership in policy and care quality and safety Rebecca M. Patton, DNP, RN, CNOR, FAAN Margarete L. Zalon, PhD, RN, ACNS-BC, FAAN Ruth Ludwick, PhD, RN-BC, APRN-CNS, FAAN Marian K. Shaughnessy Nurse Leadership Academy Case Western Reserve University https://case.edu/nursing/nurse-leadershipacademy As we confront new and existing realities and move into this decade launched by the Year of the Nurse and Midwife, we critically examine the history and the future of nursing by inaugurating a new column called, Leadership in Policy, Care Quality and Safety. The purpose of the column is to engage nurses in dialogue and galvanize them to take leadership in the individual but overlapping aspects of policy, care quality and safety. Each quarter you will find a short column on a topic related to one or more of these intersecting factors. Leadership is the framework that underpins each column. We believe that no matter where nurses work or the position held, leadership is a critical skill for all nurses not only those who hold titles that imply leadership, e.g. manager, director, dean, but every nurse regardless of practice setting or role. Our goal is to raise awareness about the leadership opportunities in policy, care quality, and safety across settings, specialties, communities and the globe by focusing on inspiring exemplars and action steps that that be taken by nurses.

Rebecca M. Patton, DNP, RN, CNOR, FAAN Margarete L. Zalon, PhD, RN, ACNS-BC, FAAN Ruth Ludwick, PhD, RN-BC, APRN-CNS, FAAN Marian K. Shaughnessy Nurse Leadership Academy Case Western Reserve University https://case.edu/nursing/nurse-leadershipacademy Call to Action As we write this column during the COVID-19 pandemic, we are in the midst of unprecedented change and risk for our personal lives, our families, our professional lives, our communities, our country, and our world. Little did we think when we planned this column about policy, leadership, quality and safety that we would be facing one of the greatest challenges in our lifetimes. This crisis has thrust nurses into the forefront of the public’s mind. How ironic that this coincides with the World Health Organization’s declaration that this is the Year of the Nurse and the Midwife. While nurses are essential on the frontlines at the sharp edge of care, it is the lens of nurses that provide critical insights in evaluating and formulating policy to achieve quality and safety patient care outcomes.

Everyday nurses walk the tightrope of uncertainty.

The uncertainty of practice is a constant that requires the attention of all nurses, vigilance, and most importantly activism. COVID-19 has magnified these unknowns to astronomical proportions. The accelerated pace of uncertainty with COVID-19 has led to care dilemmas and crises, with variations in practice standards that negatively impact health outcomes.

We are bombarded with challenges like mass shootings, climate change, water supply, and emerging diseases. Now we are in the midst of a pandemic, which not only impacts the health of our communities and workforce, but has dire financial consequences for so many. How many of these challenges have you faced?

What challenges have you faced that are not even listed here? What will come next? We don’t always know what will come next. We do know that nurses will be there on

the frontlines. When nurses are asked to volunteer in a crisis, they show up for wars, disasters, and pandemics.

Nurses are in the frontlines of policy implementation.

Often in times of crisis, policies are disregarded, ignored, or unofficially discarded. Nurses often know whether a policy is workable, flawed or whether it is doomed to fail.

We have seen policy failures like changing instructions on the use of personal protective equipment (PPE) as supplies dwindle. On the other hand, times of crisis can lead to policy gains as illustrated by a willingness to allow advance practice registered nurses full practice authority.

To counteract policy failures, correct flaws and take advantage of opportunities for policy advancements, we need to be knowledgeable, and prepared. This means participating in policy so that we understand concerns expressed by broad constituencies and take action using our nursing expertise. This expertise is needed so that the policies are realistic, workable and meet the needs they were designed to address. Policy is more than enacting a law; it includes formulating rules, regulations and guidelines. Policies occur at many levels, often simply referred to as Big “P” and little “p”, the former often focus on state, federal or international laws and the latter to local government or local associations or organizations.

Move to Action Moving to action requires identifying the preferred outcome with clarity. This is achieved by examining the data, sharing information, and capitalize on your skills to move an issue forward.

Know the data, appraise credibility of sources, and interpret its meaning “In God we trust, but everyone else needs to bring data” This quote attributed to Edward Fisher when testifying before Congress (Source) is a fitting start for policy involvement. Nurses have the knowledge and are in a unique position to use and leverage data for patient advocacy. Knowing the data, appraising sources and interpreting its meaning are critical steps in the processes for research, quality improvement and evidence-based practice. Nurses all have intellectual capital related to these processes regardless of their practice setting or role. Your intellectual capital can be enhanced with the following strategies: • Use the resources available from professional associations: the American Nurses Association, state nurses associations, specialty nurses associations and interdisciplinary professional groups.

• Subscribe to a wide variety of data sources including journals, news alerts, list servs • Track and identify progress on issues you are passionate about • Determine the credibility of sources • Verify the facts • Identify content experts for policy issues • Interpret the meaning • Identify policy implications of research and quality improvement projects • Identify the strengths and weaknesses in the data in support of your • Sift fact verifying the facts and determining the credibility of sources • Interpret the meaning of information Have the stories, share them widely.

Stories can be more powerful than only presenting data. Stories provide an emotional tug, create drama, and provide context. Stories get attention, but data strengthens the power of stories. Most stories have multiple audiences. Framing your story in a way that varying audiences understand transmits important knowledge and fosters identification with stark realities.

Storying telling is subject to several caveats. With the advent of social media, sharing stories has become easier, it also has created a medium for false stories to grow exponentially (as they are often salaciously framed).

Second, be aware of people and organizations that try to block stories, especially when bad news happens. (p 320 book) As the most trusted profession, nurses have a strategic position opportunity to frame and share their narratives widely with a variety of audiences at the little p to the Big P to level as outlined below varying audiences and frame stories using the following avenues. These strategies are not static and can be adapted to the virtual world. Garnering the support of colleagues, stakeholders and the public can be accomplished with these strategies:

• • • • • • • • • • • •

Post digital content (social media) Disseminate facts and reports in print media (fact sheets, policy briefs, articles, letters, press releases) Disseminate research findings Engage key stakeholders Contact legislators about key issues on an ongoing basis and when votes come up Speaking up at public meetings Presenting in public forums Model inspirational behaviors Participate in town hall meetings Meet with legislators and regulators Create elevator speeches Be social media savvy

Know your skills, capitalize on them.

Nurses have the skills to move beyond only being implementers of policy and only on the sharp edge of policies; we need to be the developers of policies. To capitalize on the potential of four million nurses, all nurses in any setting or role need to assess how their skills can be applied to policy. This positions nurses to enhance practice and the work environment as well as advance issues of importance to nurses and the public we serve. Policy work needs to become ingrained as part of the culture of nursing. P. 470 Common and overlooked strategies to improve an individual policy role would include the following which you can act upon immediately : • Register and vote • Be a poll worker • Join interest-based organizations and become an active member • Finding a mentor • Volunteer to work on a campaign.

• Serve on a workplace committee, task force or practice council • Attend networking events • Participate in legislative days • Contribute to candidates and political action committees • Complete your profile for Nurses on Boards (nursesonboard.org) • Seek local community board positions • Communicate with elected officials • Capitalize on workplace communication channels for policy discussions • Volunteering for an organizational or communitybased initiative The following are generally are longer term actions, but can be done in the short-term as well depending your policy trajectory: • Assume a leadership role for a workplace committee, task force or practice council • Be a mentor • Representing your organization to the external community • Seek an internship or fellowship with a legislator or other policymaker • Further your formal policy and content education • Serve on a political action committee board • Seek a board position • Volunteer for appointed office • Run for office in your organization or community In times of uncertainty, there are certainties. One certainty is the mandate for all nurses becoming involved in policy. The American Nurses Association’s Code of Ethics for Nurses’ (2015) supports nurses’ roles in policy with the expectation that nurses advocate for the health and safety of patients, collaborate in the promotion of health, work to improve the ethical environment of practice settings, and advance the profession through nursing and health policy.

We have highlighted strategies that nurses should use to increase their involvement in making policy decisions to strengthen our practice and improve the health of the public we serve. The collective action of over four million nurses in our country and 21 million nurses across the globe has the potential to be a powerful force for policy change.

American Nurses Association. (2015). Code of Ethics for Nurses with interpretive statements. Silver Spring, MD: Author. https://www. nursingworld.org/practice-policy/nursing-excellence/ethics/codeof-ethics-for-nurses/

Page 14

December 2020

The Nursing Voice

Illinois Nurses Foundation Celebrates...continued from page 1

Loneliness and Social Isolation Cause Emotional Pain in the Elderly Karra Harrington and Martin J. Sliwinski ** This article was published in The Conversation, a free on-line newsletter. “We believe in the free flow of information. Republish our articles for free, online or in print, under a Creative Commons license.” Read the newsletter at www.theconversation.com Maintaining high quality relationships may be a key for protecting brain health from the negative impacts of loneliness. The loneliness of social isolation can affect your brain.

Physical pain is unpleasant, yet it’s vital for survival because it’s a warning that your body is in danger. Pain tells you to take your hand off a hot burner or to see a doctor about discomfort in your chest. Pain reminds us all that we need to take care of ourselves.

Feeling lonely is the social equivalent to feeling physical pain. It even triggers the same pathways in the brain that are involved in processing emotional responses to physical pain.

Just like feeling physical pain, feeling lonely and disconnected from others is also a signal that we need to take care of ourselves by seeking the safety and comfort of companionship. But what happens when we are unable to find companionship and the loneliness persists?

As scholars at the Center for Healthy Aging at Penn State, we study the impact of stress on the aging body and brain, including how it can worsen cognitive decline and risk for dementia. The social isolation older adults

are experiencing now amid the coronavirus pandemic is raising new mental health risks, but there are things people can do to protect themselves.

The health consequences of loneliness The COVID-19 pandemic has put many older adults’ social lives on hold, leaving them at greater risk for loneliness. They know they face a higher risk of developing severe symptoms from COVID-19, so many are staying home. Restaurant closures and limits on visitors to assisted living centers have made it harder to see family and friends.

But even prior to the pandemic, public health experts were concerned about the prevalence and health impacts of loneliness in the U.S. Loneliness affects between 19% and 43% of adults ages 60 and older, and many adults ages 50 and over are at risk of poor health from prolonged loneliness.

Research has shown that prolonged loneliness is associated with increased risk for premature death, similar to smoking, alcohol consumption and obesity.

Other health consequences are also associated with loneliness, including elevated risk for heart disease and stroke, and it is associated with increased physician visits and emergency room visits.

Loneliness can affect brain health and mental sharpness Older adults who are socially isolated or feel lonely also tend to perform worse on tests of thinking abilities, especially when required to process information rapidly.

Moreover, those who feel lonely show more rapid decline in performance on these same tests over several years of follow-up testing.

It is thought that loneliness may contribute to cognitive decline through multiple pathways, including physical inactivity, symptoms of depression, poor sleep and increased blood pressure and inflammation.

Loneliness has also been found to increase the risk of developing dementia by as much as 20%. In fact, loneliness has an influence similar to other more wellestablished dementia risk factors such as diabetes, hypertension, physical inactivity and hearing loss.

Although the underlying neural mechanisms are not fully understood, loneliness has been linked with the two key brain changes that occur in Alzheimer’s disease: the buildup of beta-amyloid and tau proteins in the brain. Other indicators of psychological distress, such as repetitive negative thinking, have also be linked with the buildup of beta-amyloid and tau in the brain. Theories suggest that loneliness and other psychological stressors act to chronically trigger the biological stress response, which in turn appears to increase beta-amyloid and tau accumulation in the brain.

How loneliness can contribute to disease The evidence suggests that prolonged feelings of loneliness are detrimental to health. So, how do those feelings get converted into disease?

Loneliness and Social Isolation...continued on page 19

The Nursing Voice

I SA P N P R E S I D E N T ' S M E S S A G E

This is my last column as President of ISAPN. I have had the honor and privilege of serving as the President of this organization for two terms and, before that, for 1 ½ terms as Treasurer. During this time, I have seen ISAPN grow as an organization to better meet our membership's needs.

Meeting member needs during the time of the COVID-19 pandemic brought unique challenges to ISAPN. Instead of gathering together for professional education and networking during our annual conference, the Midwest Conference was "Reimagined" this year. Our 2020 Midwest Conference consisted of both synchronous and asynchronous clinically focused, evidence-based information presentations.

During my time on the ISAPN Board of Directors, we have Ricki Loar PhD, developed initiatives to represent our members better. APRN, CNP, FNPWe have eliminated the need for Written Collaborative BC, GNP-BC Agreements, developed and implemented an investment strategy, and created a scholarship program. We have reorganized the state regions and ISAPN committees to better focus on member engagement. We have also created a program for online education so that APRNs in Illinois have access to quality continuing education offerings. Our website has been revised and renewed so that information is quickly at-hand for our members. Finally, to leverage our deep professional experience, we have created a Past President's Council.

While I will not represent you on the Board of Directors any longer, I will continue my involvement with ISAPN as a member of several of the outstanding committees.

Please join me in supporting the critical work that benefits all APRNs in Illinois by joining a committee. If your time does not permit this type of involvement, please consider reaching out to any Board of Directors member or Susan Swart for shorter, time-limited opportunities.

I would like to thank our current ISAPN members for their continued support. If you are not an ISAPN member, please consider joining. There is strength in numbers, and if all the APRNs in Illinois join ISAPN, the sky is the limit! There are several levels of membership: Full Members, Senior Members, Student Members, Associate Members, and Corporate Members.

I want to take the opportunity to introduce Dr. Raechel Ferry-Rooney, APRN, your next ISAPN President! Please join me in welcoming Raechel to her new role!

With Kindest Regards,

Ricki Loar, Ph.D., APRN, FNP-BC, GNP-BC

December 2020

Page 15

Illinois Advanced Practice Registered Nurses Elect New Board Members MANTENO – The Illinois Society for Advanced Practice Nursing announced the election results during the association’s 2020 annual meeting during the Virtual Midwest Conference held on October 23rd.

The new leadership includes advanced practice registered nurse leaders from across the state and from a variety of backgrounds.

The newly elected board members are as follows: President - Raechel Ferry-Rooney DNP, APRN Secretary - Melissa Murphey DNP, APRN, NP-C GR/PAC Chair - Julie Darley APRN, FNP-BC Membership Committee Chair - Iesha Coleman-Nwagwu MSN, APRN, FNP-BC CNS Rep - Christine Somberg MSN, APRN, CNS, ACNS-BC, NE-BC CRNA Rep - Susan Krawczyk DNP, CRNA, APRN Northeast/North (NE/N) Region Chair - Andrea Fuller APRN, FNP-BC East Central (EC) Region Chair - Wamaitha Sullivan DNP, APRN, FNP The new board members will join the following directors whose terms end in October 2021: Vice President - April Odom APRN, FNP-BC Treasurer - Maria Jefferson- Walker DNP, APRN, FNP-BC GR/PAC Chair - Julie Darley APRN, FNP-BC Program Chair - Patty Hess, MSN, APRN, FNP-BC CNM Rep - Debra Lowrance DNP, APRN, CNM, WHNP, IBCLC CNP Rep - Elizabeth Wengel DNP, APRN, FNP-BC Northwest (NW) Region Chair - Max Button, DNP, APRN, FNP-BC West Central (WC) Region Chair - Debra Myers, APRN, FNP-BC South (S) Region Chair - Melissa Bogle, DNP, APRN, FNP-BC, ACNP-BC Northeast/South (NE/S) Region Chair - Lauren Hedenschoug MSN, APRN, FNP-BC About ISAPN: Formed in 2002, the Illinois Society for Advanced Practice Nursing is a powerful network of advanced practice registered nurses who are committed to advancing the profession through education and political action. ISAPN is the leading voice of the approximately 14,000 advanced practice registered nurses in Illinois. To become a member of the Illinois Society for Advanced Practice Nursing, visit www. isapn.org.

Tamara Bland Talks About Diversity in Nursing Education and Practice “You will never make it through this program.”

Tamara Bland, RN, MSN, Ed.D. is a Southside Chicago girl and proud of it. Her passion for diversity started as a student while attending Concordia University’s Bachelor of Science in Nursing (BSN) program.

One of four students of color in her cohort, Bland expressly remembers walking into an advisor’s office and being told, point blank, “You will never make it through this program.”

That sentence lit a flame.

Bland knew in that moment that she was going to do whatever it took to prove her advisor wrong. Beyond that, the experience also drove home for her the fact that Bland ultimately wanted to go into education. She wanted to be that person—the person who showed other nurses of color that it was possible.

And Bland has done exactly that. She went on to earn her Master’s of Science in Nursing (MSN) in nursing education at Resurrection University, and then her Doctorate at St. Francis University.

Today, Bland is an experienced critical care nurse who teaches medical-surgical and critical care at Dominican University in Chicago’s west suburbs. She is also the Director of the Tamara and her daughter RN – BSN program at Dominican.

Madysen, a senior at Mother McAuley High school.

Only 6.6% of nurses in the United States are nurses of color. 99% of nursing faculty are women, but only 1% are women of color. Institutions of higher education know diversity in nursing education is a problem, but in many instances, it feels like they are just waiting and watching it.

And that is, in part, because increasing the diversity of nursing educators and the nursing workforce is a really complex issue. Bland explains, “When people talk about ‘institutionalized barriers’ they are talking about systems that perpetuate inequalities. Part of what we have to do is examine the practices that create these barriers in higher education and the nursing workforce, beginning with HR and hiring practices. Nursing administrators and allies need to stop and take a look at the curriculum, at the profession. We need to ask ourselves: how many people of color are sitting at the decision-making table?

We need to incorporate underrepresented voices into the decision-making process.”

She adds that it isn’t just an issue of getting more students or more faculty of color. It’s also an issue of ongoing support. And, frankly, being willing to talk about challenges.

“Honest, reflective, open conversations about diversity and racial inequality are crucial conversations we need to have, and we can’t afford to be afraid to talk about it.

We need to look at mentorship for both nursing students and faculty of color. We need to look at supporting new researchers of color with scholarship and the publication process. In the classroom, we need to utilize new sources, books from different ethnicities – these are things allies can help push.”

On the topic of being an ally, Bland expands, “People need to know and understand. Then, take action. But it takes both knowing and understanding. Oftentimes, in nursing education we associate cultural differences with risks. X ethnicity is higher risk for X disease. We can’t continue to only examine it from that negative perspective; we need to make people people, and then talk about the disease. Weaving experiential learning into nursing programs is important because it will guide all

Tamara and her husband Tim. students to look at their work through a civic lens. Civic responsibility and social responsibility should be taught in every course to better prepare students to enter the workforce able to be an ally from that place of knowing and understanding.”

As a woman of color in a professional environment that lacks diversity, Bland navigates experiences that render her both invisible and simultaneously hyper visible. It has not been an easy road for her. “Lack of confidence comes from personal experiences. When you are the only person at the table who looks like you or comes from the same background as you, you cannot help but ask yourself, ‘If I speak up, is anyone going to support me?’”

Bland points to mentoring as the thing that pulled her through. “Those small gestures are what made me believe I could be a leader, have a seat at the table, a voice in the room.”

Bland’s advice for young nurses or students just starting out?

“Start speaking up now. Be a better advocate for yourself now. You don’t have to follow the linear path you set for yourself, or maybe your parents set for you. Enjoy the adventure.”

Page 16

December 2020

The Nursing Voice

PNAI News In the Midst of the Pandemic New beginnings: The Philippine Nurses Association of Illinois (PNAI) held an election by mail last May, 2020.

On July 27th, the organization did a virtual swearing in of the newly elected executive board. This October, the executive board is conducting weekly trainings virtually due to the COVID-19 pandemic.

New Talent: While most of us whiled away our lockdown in ennui, some explored activities that heretofore were neglected. PNAI Treasurer Bessie Baldovino, who worked at Loyola University for 33 years, started painting in May 2020. A retired dialysis nurse, she teaches a Dialysis Technician course at Triton Community College and Jethro Healthcare School. She started doodling on paper, then proceeded to paint on canvas after watching YouTube tutorials and attending a

park district online program. Bessie believes she inherited the artistic flame within from her uncle who was a professional mural painter, but the pandemic stoked it into a blazing fire. Besides the acrylic on canvas, she also uses trash bin as another medium. Trash bin art was an effort to improve plain black bins that she wanted to use as pots for planting but the results caught on in her social media page and she got the idea to use her art to help the PNAI fundraising. Being able to pursue a new hobby and knowing that it contributes towards the causes that the PNAI espouses gives her a feeling of fulfillment.

Recognition: Bryan Ranchero, PNAI Community Outreach Chair, will be a speaker at the Filipino-American History Month on October 28th. This year’s theme is about the history of Filipino heroism and activism in the United States. Bryan, a retired Cook County Public Health

Nurse with extensive experience in fetal-maternal health nursing and correctional nursing, has done research on high-risk infants and presented a study on extreme prematurity focusing on 20-28 weeks gestation. He will also be receiving an award for Filipino American Pioneer by the Philippine American Cultural Foundation on October 25, 2020.

Reaching out: PNAI delivered face shields to Allbest Home Health Care last September 30. PNAI worked with US Army Staff Sergeant James Ahn and his team who fabricated the face shields. Since the pandemic began, we have donated face shields and foods to the Frontline workers at Loyola University. We also brought Filipino staple foods and joined our fellow nurses in the picket lines fighting for safer patient care during this pandemic.

Bryan Ranchero at his presentation on high-risk infants.

Chicago Skyline by Bessie Baldovino

Bessie Baldovino painting the Chicago Skyline

The PNAI newly elected Executive Board at their virtual swearing in, June 27, 2020

The Nursing Voice

December 2020

Page 17

Public Health Nurses Advocating for Public Health Nursing: Creating Change

How do we engage with the community and legislative members to provide information, to grab their attention to recruit and retain public health nurses while replenishing state and local coffers depleted by the pandemic? How do we explain public health nursing in terms that demonstrate the importance of this moment? How do we provide specific information that people will remember about public health nursing?

Generations of nurses have been educated to be patient advocates. Nursing has changed from an acute care focus, expanding advocacy to communities, populations, regions, nations. Nurses must be a collective voice, speaking out loud and often, backed up with data and testimonials. Use the visibility of the COVID-19, SARS-2 virus pandemic to illustrate the value of public health and public health nursing.

On October 29, the Illinois Public Health Nurse Workgroup presented a one-hour webinar to showcasing strategies to put the “V” in advocacy. Strategies on how to be a collective voice targeting your local elected leaders to increase the number of public health nurses and improve our neighborhoods. This one-hour webinar provided a map for you to use to address issues in public health nursing: before, during, and after a pandemic. It is time to be visible voicing the value of public health nurses.

The webinar is still available for you to access and to use with students on the Illinois Nurses Foundation website www.illinoisnurses.foundation.

This webinar was supported in part by the Robert Wood Johnson Foundation (RWJF).

Robin Hannon, MSN, RN

Karen Kelly EdD, RN, NEA-BC

Glenda Morris Burnett, PhD, MUPP, RN

Presenters: • Robin Hannon, MSN, RN, RWJF Public Health Nurse Leader – Illinois; Administrative Adviser, SCCHD, Retired Nursing Director St. Clair County Health Department.

• Karen Kelly EdD, RN, NEA-BC, Retired Nurse Educator, Former Nurse Executive, Always a Nurse Advocate.

• Glenda Morris Burnett, PhD, MUPP, RN, Rush University, College of Nursing, Assistant Professor, Department of Community, Systems and Mental Health Nursing

The Risks to Travel Nurses During the Pandemic Reprinted with permission from South Carolina Nurse June 2020 Travel nurses are in great demand right now, as they are helping to relieve frontline workers during COVID-19.

While health care facilities are doing everything they can to make environments safe, there are still specific risks that travel nurses are dealing with during this pandemic.

Georgia Reiner, Senior Risk Specialist, Nurses Service Organization (NSO), gave us the latest information about what’s happening with travel nurses, what the risks are, and what they can do to protect themselves.

Are hospitals throughout the country calling on travel nurses to relieve frontline workers? Is the main purpose to alleviate burnout of the frontline workers?

Travel nurses are in high-demand across the United States as hospitals work to treat surges of coronavirus (COVID-19) patients. This crisis arrived at a time when nurse staffing was already a concern due to a multitude of factors, including the growing health care demands of an aging population and nurses aging out of the workforce. Therefore, the demand for travel nurses seems to be primarily driven by a need to build up hospital capacity to handle the influx of COVID-19 patients.

Data from different staffing platforms show that throughout the pandemic, travel nurses are in highest demand in areas most impacted by the coronavirus, like New York and Washington State, and certain nursing specialties like ICU/Critical Care, ER/Trauma, and Med/ Surg.

Certainly, as the pandemic continues, the sense of burnout among health care workers will intensify, and travel nurses will likely play an important role in helping to alleviate burnout.

This is a different situation for travel nurses. One risk is checking licensing in different states. What can travel nurses do to be sure that their license transfers?

If it doesn’t, but frontline workers are still needed, are exceptions being made?

Before deciding to accept a job, nurses need to ensure that their licenses will allow them to practice in that state/jurisdiction. Multi-state licenses are available for nurses who meet the requirements, which include elements like background checks and education criteria.

Temporary licenses are also an option—these are generally reserved for travel nurses who have accepted a job in another state and are awaiting their permanent license.

During the nationwide public health emergency due to COVID-19, some statutes and regulations regarding licensure portability may be relaxed or waived, so it is important for nurses to be aware of what the requirements are both during and following the emergency period. The National Council of State Boards of Nursing (NCSBN) has compiled information about the nurse licensure compact and emergency action taken by states, which is a great starting place for information.

When travel nurses are thrust into an unknown situation in a hospital/medical center that isn’t familiar to them, and they are working with systems they’re not familiar with, what’s the best way for them to cope? How can they avoid burnout themselves? Please explain.

Working in a new environment is inherently stressful.

Getting used to new processes, technologies, hospitals layouts, and new people can be overwhelming under normal circumstances, and can be amplified during a crisis like COVID-19. Travel nurses should make sure to take time for self-care to preserve their mental health.

This is a stressful time for everyone, so don’t be afraid to reach out to colleagues with questions and for support. Failing to make an effort to cope with these rapid changes can have a negative impact on personal wellness and patient care.

What about a nurse’s scope of practice? What can nurses do to make sure that they are acting in the scope of practice? What if the facility allows them to do more than their own state? Does their scope of practice relate to the state they’re in or the one they’re licensed in, or both?

As the COVID-19 crisis rapidly evolves, travel nurses may be given patient assignments outside of their typical practice areas and locations. When faced with situations that exceed the scope of practice for the state in which they are practicing, or the skills or knowledge required to care for patients, travel nurses, like all other nurses, should develop and implement proactive strategies to alleviate unsafe patient assignments.

Nurses need to advocate for patient safety and for their nursing license by speaking up if an assignment does not fall under their scope of practice.

When the assignment is within a nurse’s scope of practice, but not within their realm of experience or training, saying “no” to the assignment could lead to dismissal. At the same time, if the nurse does not feel they are equipped to handle the assignment, they could potentially put patient safety at risk. In these scenarios, nurses should tell their supervisor that they

have very limited experience in that area and should not be left in charge. The nurse should describe the task or assignment they don’t feel equipped to handle, the reason for their feelings, and the training they would need to be more confident and better prepared.

What changes have occurred during COVID-19 regarding travel nurses and the risks they face that you think should be permanent either for the near future or forever?

Currently, there are certain state and federal regulations, declarations, and orders that extend liability immunity in the fight against COVID-19. What’s not clear at this time is the breadth and scope of these regulations and orders.

For example, it is not clear if these orders and declarations extend to all providers in all areas of service or if such immunity will be limited and specific to certain types of health care providers. Since there is lack of clarity in terms of immunity, it is prudent for nurses to not presume they have any immunity.

Further, plaintiff’s counsel can file a lawsuit, immunity or no immunity, if the plaintiff’s counsel believes the client was injured and that injury was the direct result of the nurse or other health care professional providing or failing to provide professional services. In the best-case scenario, the suit brought against the nurse will be deemed baseless and their malpractice insurer will work to get the suit dropped/ dismissed.

Is there any other information that is important for our readers to know?

The COVID-19 pandemic is still evolving, and there is much we still do not know about the virus. All nurses should continue to follow the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) for updates and guidance to help prevent the spread of the virus and protect themselves and their patients.

This risk management information was provided by Nurses Service Organization (NSO), the nation's largest provider of nurses’ professional liability insurance coverage for over 550,000 nurses since 1976. SCNA endorses the individual professional liability insurance policy administered through NSO and underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company. Reproduction without permission of the publisher is prohibited. For questions, send an e-mail to service@nso.com or call 1-800-247-1500. www.nso.com.

Page 18

December 2020

The Nursing Voice

The Life of a Street Nurse John A. Pucker, MS, JD, APN, CEN, CNS ED/Critical Care/Flight nurse (May 30, 2020, Chicago) I knew as I watched all of the bridges being raised that things had gone sideways. I was finishing up bandaging a young woman’s arm from glass shattered behind her as the looting continued. She was just a bystander and got hit with stray glass from the broken window. My bandages should hold till she gets to more sustainable medical care, but with us being trapped, who knows when that might be. We discussed the need for an x-ray to ensure the glass was not still present, possible steri-strips, and a tetanus shot. I stressed to her the importance of going to the hospital.

Protesters continued to loot. Gunshots from them in the distance were unsettling and made me slightly apprehensive. There was no way to know if they were coming from the looters or the police. I suspected the looters, which put me on edge. Tonight anything can happen, and it looked like it was going to. I quickly rekindled my resolve as I was taken back to my days in the military. As I looked around and down the streets, riot police were blocking all avenues north and east and pushing the protesters south and west to the La Salle Street Bridge. I packed my medical bag and made the risky decision to try and get around the police line to the closest Red Line stop. I zigzagged into an alley, through an abandoned parking lot, another alley, and I made it behind the police line, adding one more safe episode to my Street Nursing experience.

Nursing occurs in a variety of traditional and untraditional venues. Having been a Street Nurse at

protests since the 1990’s AIDS epidemic, there has been a lot that has changed since my introduction. Street Nursing is one of the most unconventional nursing platforms that I have had the privilege of participating in. If a police officer gets hurt during a protest, they are rushed to an ambulance and out. If a protester gets hurt, medical care comes sporadically, if at all. It might be hours before sustainable medical treatment can be obtained.

Street Nurses also run the risk of arrest, assault by both the police and protesters, and in some cases, other life harrowing situations.

Street nurses usually work with what supplies and equipment they can carry on their backs. They focus on specific injuries and illnesses and carry portable equipment for some chronic conditions. In my pack, I carry a portable pulse oximeter, a glucometer, sugar packets, cold packs, earplugs, Naloxone, and a variety of bandages, Band-Aids, antibiotic ointment, alcohol wipes, water, and PPE. Just to name the basics. A street nurse’s bag can weigh as much as 50 pounds that must be carried. Often getting to an injured/sick person requires running through dense crowds of hundreds or thousands that are chanting, carrying signs and banners, and protesting.

Common injuries that Street Nurses see are everything from twisted ankles, cuts/scrapes/bruises, and heatrelated injuries to more severe injuries like flashbangs (a grenade that produces a bright flash and a loud noise so as to stun or disorient people), tear gas, rubber bullets, pepper spray, Tazer burns and LRAD’s (Long Range Acoustic Devices). More serious injuries can include closed head injuries, heat exhaustion, broken bones (including spinal injuries), and acute exacerbations of chronic conditions like DKA, HTN, seizures, etc. The Street Nurse’s abilities during a protest for limited response to these more serious conditions coupled with prolonged EMS arrival times (if at all) require keen assessment skills and the use of the nursing process to facilitate triage of the situation and what is the most important medical issue to focus on. All the while, the primary importance is maintaining self-safety and, when possible moving the patient to a safer location.

(May 31, 2020) As I set up camp at the final stop of the next protest in South Chicago, I get a call on my radio telling me that a man had been Billy clubbed and was bleeding from the head and face. The team I was with had one medic that was close that we dispatched into the throes of chaos to provide medical care. The crowd had managed to pull him into a side parking lot, so she could reach him and provide help until the more organized medical team could get to him.

For many of the larger and more organized protests, many levels of providers work together, everything from paramedics, physicians, nurses, and EMT’s. There is no one central organization. The volunteers gather together with red tape on themselves to identify each other and, after introductions, attempt to set up some sort of organized healthcare. There are a few organized groups, but they are loosely organized at best. There might be tents set up at the starting point and ending point of the protest (usually by the protest organizers), so care can be more organized. The Street Nurse brings a unique perspective to these teams as their holistic abilities, and quick assessment skills can help the other providers diagnose and treat street injuries. Also, Street Nurses are

uniquely qualified to rove into and through the crowds to put skilled eyes on individuals and assess people before health issues become severe. The “across the room” assessment taught in nursing school and reinforced in Emergency/Critical Care and Flight nursing is crucial to catching an issue before it can become life-threatening.

Heat-related injuries are a perfect example of this.

Knowing how to assess the difference between sunburn, heat exhaustion, heat cramps, and heat stroke from a distance is essential when working with large crowds in the sun for long periods, especially after walking multiple miles.

(June 6, 2020, at a Northside Chicago Protest) There have been reports of the police targeting healthcare providers and supply volunteers in other cities and destroying their water bottles that are crucial for hydration and protection from the heat. The police rational is so they cannot be used as weapons. There are rumors that the same might happen with further protests in Chicago. We carry our own water on our backs for subsequent protests now. (https://crimethinc. com/2020/0 6/0 8/protocols-for- common- injuriesfrom-police-weapons-for-street-medics-and-medicalprofessionals-treating-demonstrators) In the last two months of providing health care at protests, six to eight in all, most of them were event-free and peaceful. The Street Nurses I worked with provided a few band-aids, some dressings, an occasional ace wrap, and ice packs. However, those protests that became more violent required a more disciplined approach to caring for more serious injuries—protecting oneself while bandaging up injuries, moving protesters to safety, and frequently attempting to get them out of the protest for more sustainable medical care.

The Nursing Voice Two professional issues that are always on our mind is consent to treat and liability. Consent to treat always comes into play when caring for patients on the street. Using professional judgment mixed with medical knowledge comes with a political reflection of why we are there, to begin with. How we approach people and put our care into practice to avoid reproducing the relationships of domination, management, and dispossession that characterizes many medical institutions is an understanding that must be had when one decides to engage in Street Nursing. As Street Nurses, we want to make the consent of injured people a priority and give the information they need to make clear and informed decisions for themselves. Should the injured, no matter how injured, refuse care, care will not be provided.

(June 15, 2020) Three thousand strong today at a combination protest and March. There were dedicated medical tents set up at both the starting point and the finish. At least 25 healthcare providers came out to assist.

It makes it easier when we have the numbers.

There is also the concern of liability and legality.

Every state is different, and Street Nurses need to know the law in their state. Here in Illinois, Street Nurses are covered under the Good Samaritan laws. “Nurses and Advanced Practice Nurses are exempt from civil liability for emergency care. A person licensed as a nurse under the Nurse Practice Act in Illinois or any other state who in good faith provides emergency care without fee to a person shall not as a result of her or his acts or omissions, except for willful or wanton misconduct on the part of the person, in providing the care be liable for civil damages.” (745 ILCS 49/341 &351). So in Illinois, so long as the person injured consents or would consent if had the opportunity, the Street Nurse is protected from

December 2020

Page 19

civil liability. The Street Nurse is still responsible for any criminal act committed, however.

(June 27, 2020) It was a hot day with several thousand protesters out in the sun for 4-5 hours. There was a threemile march followed by hours of speakers. Though there were few injuries, worrying about heat-related injuries was a priority. We still carried the water for rescue in our medical packs as if they stayed in the tents or with the volunteers, and there was still the fear of losing them to the police.

Street Nursing can be rewarding, exciting, and allows a nurse to give back in a way that many in the community simply cannot. It requires plenty of forethought and preparation, a calm demeanor, excellent assessment skills, and knowledge of their limits. Certainly not what one thinks about in nursing school or when we enter into practice.

References 1. The Good Samaritan Act, (745 ILSC 49/) Retrieved June 24, 2020 from: http://www.ilga.gov/legislation/ilcs/ilcs3. asp?ActID=2076&ChapterID=58 2. Young, Jeffrey (2020) The Police Are Targeting Protest Medics, Huffpost, Retrieved June 12, 2020 from: (https:// crimethinc.com/2020/06/08/protocols-for- commoninjuries-from-police-weapons-for-street-medics-andmedical-professionals-treating-demonstrators 3. Nakad, Julia (2016) A brief History of modern street medics, Hesperian Health guides, Retrieved June 20, 2020 from : https://hesperian.org/2016/01/06/care-for-where-there-isno-justice-the-modern-history-of-street-medics-and-howthey-support-social-movements/ 4. Young, Patrick (2019) Street Medics-Keeping our Movements Healthy and Safe, Medium, Retrieved June 20, 2020 from: https://medium.com/@patrickyoung_29256/street-medicskeeping-our-movements-healthy-and-safe-f7eab44d31cc All photographs were taken by the author

Loneliness and Social Isolation...continued from page 14 Feeling lonely and socially isolated can contribute to unhealthy behaviors such as getting too little exercise, drinking too much alcohol and smoking.

Loneliness is also an important social stressor that can activate the body’s stress responses. When prolonged, that response can lead to increased inflammation and reduced immunity, particularly in older adults.

Inflammation is the body’s response to fight off infection or heal an injury, but when it continues unchecked it can have a harmful impact on health. Stress hormones play an important role in making sure that inflammation doesn’t get out of control. But, under chronic stress, the body becomes less sensitive to the effects of the stress hormones, leading to increased inflammation and eventually disease.

In healthy older people, loneliness is related to a stress hormone pattern similar to that of people who are under chronic stress. This altered pattern in the stress response explained why people who were lonelier had poorer attention, reasoning and memory ability.

Social activity can buffer against the decline Maintaining high quality relationships may be a key for protecting brain health from the negative impacts of loneliness.

Older adults who feel more satisfied in their relationships have a 23% lower risk of dementia, while those who feel their relationships are supportive have a 55% lower risk of dementia, compared to those who feel dissatisfied or unsupported in their relationships.

Maintaining social activity also buffers against decline in thinking abilities, even for those who live alone or who have signs of beta-amyloid accumulation in their brain.

One reason for these benefits to brain health is that maintaining strong social ties and cultivating satisfying relationships may help people to cope better with stress; people who feel better able to cope with difficulties or bounce back after a stressful event show less buildup of tau protein in their brains.

This is good news because, with the importance of social distancing for controlling the COVID-19 pandemic, how people manage their feelings and relationships is likely more important for brain health than the fact that they are spending time physically apart.

779-529-2012

Strategies for coping with loneliness Loneliness is a common and normal human experience.

An important first step is to recognize this and accept that what you are feeling is part of being human.

Rather than focusing on what’s not possible at the moment, try to refocus your attention on what you can do to stay connected and make a plan to take action. This could include planning to reach out to friends or family, or trying new activities at home that you normally wouldn’t have time for, such as online classes or book clubs.

During times of high stress, self-care is essential.

Following recommendations to maintain regular exercise and sleep routines, healthy eating and continuing to engage in enjoyable activities will help to manage stress and maintain mental and physical health.

Karra Harrington is a Postdoctoral Research Fellow, Clinical Psychologist, at Pennsylvania State University.

Martin J. Sliwinski is the Professor of Human Development and Family Studies, Director of the Center for Healthy Aging, at Pennsylvania State University.

JOIN THE RUSH MAGNET NURSING TEAM Rush University Medical Center is a five-time Magnet® facility, and was recently ranked among the top 20 hospitals in the nation by U.S. News & World Report.

Rush offers a competitive salary, and valuable healthy living benefits including: health, dental and vision to help you maintain and improve your health. Rush also offers several ways to invest in your future.

All programs at our Rush University College of Nursing are ranked at 6 or above. For RNs seeking to continue their education, tuition reimbursement is available after one year of employment.

Based in Chicago and the Chicagoland areas, Rush is an academic health system comprising Rush University Medical Center, Rush Copley Medical Center and Rush Oak Park Hospital.

WE HAVE A NUMBER OF RN OPENINGS IN THE FOLLOWING AREAS/DEPARTMENTS: • Medical-Surgical Nursing • Operating Room Nursing • Critical Care Nursing • Cardiovascular ICU • Neuro ICU

• Oncology Nursing • Anesthesiology/CRNA • Internal Medicine • Gastroenterology Nursing

SEARCH OPEN POSITIONS AND APPLY AT: https://www.rush.edu/careers