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TEXASNURSING M A G A Z I N E BACK TO SCHOOL WITH A 66,000-POSITION NURSE SHORTAGE PREDICTED IN 2030, NURSING FACULTY ARE AS NEEDED AS NURSING STUDENTS
T N A : E m p o w e r i n g Te x a s N u r s e s t o a d v a n c e t h e p r o f e s s i o n | S u m m e r 2 0 1 6
SUMMER 2016 Volume 90, Number 3 EDITOR-IN-CHIEF: Cindy Zolnierek, PhD, RN MANAGING EDITOR: Kat Hinson 8501 North MoPac Expressway, Suite 400, Austin, TX 78759-1292 P: 800.TNA.2022 or 512.452.0645; F: 512.452.0648 tna@texasnurses.org | texasnurses.org
MISSION Empowering Texas Nurses to advance the profession
BOARD of DIRECTORS OFFICERS: Jeff Watson, DNP, RN-BC, NEA-BC, NE-BC, CRRN, President Kim Belcik, PhD, RN-BC, CNE, Vice President Terry Throckmorton, PhD, RN, Secretary Sarah Moody, DNP, RN, NEA-BC, Treasurer REGIONAL DIRECTORS: Rhonda Winegar, DNP, RN, FNP-BC, CCRN, CPN, Central Tamara “Tammy” Eades, DNP, MSN, RN, North Pam Greene, PhD, RN, South Patricia “Pat” Morrell, DNP, RN, NEA-BC, East Patty Esposito, MSN, RN, NEA-BC, West EXECUTIVE DIRECTOR: Cindy Zolnierek, PhD, RN
TNA DISTRICT AND PRESIDENT
VISION Nurses Transforming Health TEXAS NURSING (ISSN 0095-36X) is published quarterly – Winter, Spring, Summer, Fall – by the Texas Nurses Association, 8501 N. MoPac Expy., Ste 400, Austin, TX 78759-8396 Periodical Postage is paid in Austin, Texas. One-year subscriptions: $25 (nursing schools, libraries, hospitals, non-nurses, out-of-state nurses) foreign, $30; single copy, $2.50. Subscription is not available to non-member Texas nurses. Some back issues may be viewed online at texasnurses.org. PUBLISHING PARTNER Monarch Media & Consulting, Inc. P: 512.680.3989 or 512.293.9277; F: 866.328.7199 monarchmediainc.com | chellie@monarchmediainc.com Advertising inquiries call Chellie Thompson at 512.293.9277. TEXAS NURSING is indexed in The Cumulative Index to Nursing and Allied Health Literature and in the International Nursing Index. 16mm, 35mm microfilm, 105mm microfiche, article copies available from University Microfilms International: 1.800.521.3044 Statements of fact and opinion are made on the responsibility of the authors alone and do not imply an opinion on the part of the officers or the membership of TNA. POSTMASTER Send address changes to TEXAS NURSING, 8501 North MoPac Expy., Suite 400, Austin, TX 78759-8396 ARE YOU MOVING? Need to change your address? If so, provide it quickly and easily in the Members Only section of the TNA web site, texasnurses.org. Or mail us your new address – at least six weeks prior to your move – to Texas Nurses Association headquarters. We’ll make sure your TEXAS NURSING makes the move with you. FEEDBACK EMAIL OR LETTER GUIDELINES TEXAS NURSING will select emails/letters on the basis of readership interest and relevance to current nursing/health-care events. TEXAS NURSING reserves the right to edit all letters. Guide: Limit to 200 words; focus on single issue; include writer’s name, mailing address, and daytime phone. Send to: editor@texasnurses.org. Copyright 2016 © Texas Nurses Association
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Dist.1:
Paula Meagher, 915-831-4530, pmeagher@epcc.edu
Dist. 2: Sharon Brewer, 806-414-9336, sharon.brewer@ttuhsc.edu Dist. 3: Elaine Nelson, 682-518-0819, elainenelson@texashealth.org District office: 817-249-5071, tna3@usapathway.com, tna3.org Dist. 4: Jeanie Zelanko, 972-270-4691, zelanko@sbcglobal.net District office: Pat Pollock, P.O. Box 764468, Dallas, TX 75376; 972-435-2216; d4tna@flash.net; tnad4.org Dist. 5: Matthew Davis, 413-841-1319, MatthewDavisRN@gmail.com, tna5.org Dist. 6: Rachel Ellis, 409-370-9600, rnellis@utmb.edu Dist. 7: Naomi Devers, nrdevers@yahoo.com, District office: P.O. Box 132, Belton, TX 76513, tnadistrict7@gmail.com Dist. 8: Linda Juenke, 830-739-7028, ljsoaringeagle3@gmail.com Dist. 9: Cheryl Lindy, 281-883-8229, cmlindy@earthlink.net District office: Melanie Truong, 2370 Rice Blvd., #109, Houston, TX 77005; 713-523-3619; tna9@tnadistrict9.com; tnadistrict9.com Dist. 10: Susan Wright, 254-498-3920, suwright@sw.org Dist. 11: Daria Close, 940-867-1134, daria.close@mwsu.edu Kathleen Williamson, 940-397-4610, Kathleen.williamson@mwsu.edu Dist. 12: Greg Friesz, 409-365-4952, gfriesz@mac.com Dist. 13: Linda Allison, lindaallison@texashealth.org Stacy Hicks, 903-821-0464, hicks21498@gmail.com Dist. 14: Eloisa Tamez, 956-882-5079, eloisa.tamez@utrgv.edu Dist. 15: Andrea Kerley, 325-670-4230, akerley@hendrickhealth.org Dist. 16: Holly White, 325-656-0231, holly.white@cookchildrens.org Dist. 17: Cindy Keese, 361-332-1643, cakeese@aol.com Dist. 18: Pat Francis Johnson, 806-743-2730, ext. 237, patricia.francis@ttuhsc.edu Dist. 19: Karen Koerber-Timmons, 903-452-3004, ktimmons@uttyler.edu Dist. 20: Deborah Pena, 361-570-0356, debbie.pena@victoriacollege.edu Dist. 21: Jessica Tully, 432-254-1949, jessica.tully@midland-memorial.com Dist. 22: Toni McDonald, 936-544-8823, t.mcdonald323@yahoo.com Dist. 26: Elizabeth Adamson, 956-362-3015, e.adamson@dhr-rgv.com Dist. 28: Jessica Smallwood, 903-280-2071, jessicasmallwood@me.com Dist. 35: Chrystal Brown, 903-434-8302, cbrown@ntcc.edu Dist. 40: Contact TNA, 800-862-2022, ext. 129, brichey@texasnurses.org
Printed on Recycled Paper
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COVER: photo courtesy iStock
TNA + ANCC = ACCREDITATION WITH DISTINCTION
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PRESIDENT’S NOTES
TNA/ANA NEWS
DISTRICT ACTIVITY
Kudos, Elections & Appointments
Faculty & Student Engagement Toolkit
TPAPN WELCOMES NEW LEADER
TNA DISTRICT SPOTLIGHT
Introducing Jonathan Wolfarth
District 18
INTRODUCING MONARCH MEDIA
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PASSION TO PRACTICE
ZIKA DANGERS NOT DIMINISHING
HEALTHY NURSE NOW
TN Interviews Incoming President Jeff Watson
Changes to TN
Vaccinations, Health Risk Appraisal, and Grand Challenge
What Does it mean to you?
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President’s Notes Jeff Watson, DNP, RN-BC, NEA-BC, NE-BC, CRRN
TEXAS NURSING INTERVIEWS INCOMING PRESIDENT JEFF WATSON WELCOME TO JEFF WATSON, the incoming president of the Texas Nurses Association! A professor and director of informatics for Texas Tech University Health Sciences Center, Watson has been a nurse for 30 years and involved with TNA for most of that time.
nursing anymore. I think more about the collective contributions of our discipline. I will say, though, that I am very fortunate to have the first male president of TNA, Dr. Michael Evans, as a mentor and friend.
Texas Nursing sat down with Watson to talk about his background and his vision for TNA.
A. The most significant event that influenced my nursing career was the HIV crisis of the 1980s and 1990s. I entered the nursing profession in the mid-1980s as a terribly naive young man. Watching the devastation unfold right in front of me was life altering.
Q. Men comprise less than 10% of the nursing profession. How did you come to be a nurse — a nurse who would become the 2nd male president in TNA’s 110 year history? A. My mother was the greatest influence on my life. She worked as a nursing assistant in acute and long term care. I was fascinated by her stories. It’s no surprise to me (and I don’t think it was to her either) that I chose nursing. In addition to that, I was an avid student of the sciences, particularly the human sciences. I recall a trip inside the Crosbyton Clinic Hospital in Crosbyton, Texas, when I was a very young man. This had to be around the late 1960s. My mother was in the hospital and we were allowed to visit her, but only briefly. I recall the sights and sounds — it was a world like nothing I had ever seen before. I knew that I wanted to be a part of that world. To be honest, I don’t really think much about gender in relation to
Q. What experiences/individuals have shaped the nurse you are?
stigmas needlessly contribute to human suffering. We are living in a time when stigmas are rampant, creating populations of individuals who become alienated from the social discourse. I am optimistic that we will take a vocal lead in challenging these societal stigmas, allowing us all to reclaim our humanity. Q. What do you see as the greatest challenge to the nursing profession? What role might TNA play in addressing this challenge?
A. I was fortunate to work with Donna Scott Tilley many years ago. At that time, Donna was President of District 18. She displayed a professionalism that I had rarely seen in the clinical environment. She understood how the voice of the nurse in practice was necessary to continuously improve healthcare. She taught me that TNA was the channel through which positive change could be achieved. I wanted healthcare to continue to be better. I believed that nurses knew how to make that happen — I was hooked.
A. I believe our greatest challenge is finding a way to join together as a united voice. What makes nursing such a wonderful profession is the diversity of work that can be found within. This diversity, however, can sometimes challenge us to find a space where we can all come together to create change. I am confident we can find that space where we honor the diversity of our work and engage together to lead healthcare change — we can do this! As a collective of professional Registered Nurses, we are uniquely positioned to influence healthcare unlike any other discipline. The opportunity is right before us — we need only join together, step forward, and lead policy change for a healthier Texas.
Q. What is your vision for your presidency — what will be your legacy?
Q. What’s the best piece of advice you’ve ever received?
A. My hope is that we become much more aware of how societal
A. I’ve received a lot of great ad-
Q. How did you come to be involved with TNA?
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MEMBER NEWS
TNA /ANA NEWS KUDOS Joyce Batcheller, DNP, RN, NEA-BC, FAAN, was selected by Worldwide Branding for inclusion on its Registry of Executives, Professionals and Entrepreneurs. A select group of the company’s members in each discipline are endorsed and promoted as leaders in their professional fields. Batcheller is Executive Nurse Advisor/Leadership Development for AMN Healthcare. She also serves on the TNA Policy Council, the Strategic Advisory Committee for the Texas Team Future of Nursing Initiative, and chairs the Healthcare System Excellence Expert Panel of the American Academy of Nursing.
Protect Your License!! If you have received: Letter of Investigation from the Texas Board of Nursing Notice of Peer Review
Terri Gibson, DNP, MSN, RN-BC, FCN, in July celebrated one year as an associate professor for the Department of Nursing at Southwestern Adventist University in Keene, Texas. She graduated from Loma Linda University in Loma Linda, Calif., in June 2016 with her DNP degree and received the Helen Emori King Professional Leadership Award, presented to a graduate student who demonstrates outstanding leadership ability in nursing.
ELECTIONS & APPOINTMENTS Catherine Robichaux, PhD, RN, CNS, has been appointed to the editorial advisory board of Online Journal of Issues in Nursing and will serve a two-year term from 2016 to 2018. She is the editor of “Ethical Competence in Nursing Practice: Competencies, Skills, DecisionMaking,” which will published in the fall by Springer. Robichaux also has served half of her term as a member of the ANA Ethics Advisory Board (2014-2018) and was on the steering committee to revise the Code of Ethics in 2015.
Call today, delay is not an option! Joyce Stamp Lilly RN JD Registered Nurse and Attorney
713.759.6430 jslilly@nurse-lawyer.com www.nurse-lawyer.com
If you are a Texas Nurses Association member and you’ve changed employers, been promoted, received an award, or been elected or appointed to a board or community organization, we’d like to hear from you. Notices printed in the TNA News section are limited to members of the Texas Nurses Association and are printed at no cost. Information must be submitted in writing, is subject to editing, and will be printed as space is available. Send submissions to editor@texasnurses.org.
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BACK TO SCHOOL FACULTY SHORTAGE LIMITS ABILITY TO SOLVE NURSING SHORTAGE By Cindy Zolnierek, PhD, RN, Executive Director and Ellen Martin, PhD, RN, Director of Practice, Texas Nurses Association
D
espite significant efforts and progress to address the ever increasing demand for nurses, the nursing shortage continues to be very real in Texas with no sign of relenting. A preliminary nursing demand/supply report from the Texas Center for Nursing Workforce Studies (TCNWS) suggests that Texas currently experiences a shortage of registered nurses to the tune of 17,227 FTEs. More significantly, this shortage is expected to more than triple by 2030 leaving Texas 66,474 FTE RNs short. This shortage affects all areas of nursing practice, including nurse faculty, at a time when schools of nursing (SONs) will be called upon to further ramp up efforts to increase the preparation of nurses entering the field. Increasing nurse graduates requires increasing nurse faculty, yet
faculty shortages are among the top two factors deans and directors of SONs identify as limiting capacity to expand nursing enrollments. Is there a nurse faculty shortage? And if so, why, and what will it take to address the issue?
IS THERE A FACULTY SHORTAGE?
faculty to fill real full time vacancies. Further, faculty “moonlighting” may distort the true faculty demand as many nurses admittedly work full time for one school while teaching additional courses for other schools. Further investigation is needed to more accurately depict the true picture of faculty vacancies.
Work shortages are often reflected in position vacancy rates. In its 2015 survey, the TCNWS found that faculty vacancy rates averaged 8.3% across associate and baccalaureate programs. This is the highest rate since the survey began in 2007 (when reported vacancy rate was 5.8%). And, these numbers may be understated. Some schools may “officially” have no vacancies due to difficulty in obtaining administrative authorization for new positions. Such schools may hire numerous adjunct
Perhaps most concerning is the aging of the faculty workforce. While about 50% of the nursing workforce is over 45 years of age, almost 70% of nursing faculty are over age 45. Retirements alone will account for a grand exodus of faculty from the workforce in the next two decades — while the nursing shortage triples. The ability of SONs to recruit and retain faculty is and will continue to be critically important. Supply/demand projections for nursing faculty are needed to identify the full extent of the current
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and future shortage. Only then can adequate responses be developed.
WHY THE FACULTY SHORTAGE? The number of professional nursing graduates doubled between 2004 (5,677 graduates) and 2014 (11,797 graduates). This was accomplished through the efforts of all Texas SONs to increase enrollment and graduation rates as well as the introduction of new professional SONs in the state. These factors alone would create an increased demand for nursing faculty. Faculty can be difficult to recruit. The top barriers to attracting new faculty as reported by deans and directors of SONs to the TCNWS include: A limited qualified applicant pool (73.9%) Non-competitive salary (58%) Geographic location (38.7%) Traditionally, nurses interested in a career in academia would pursue a doctorate (usually PhD or EdD) with the intent of becoming a faculty member. Nurses now have the opportunity to pursue a practice doctorate (DNP) in addition to traditional terminal degrees. Additionally, practice settings increasingly value doctoral preparation. A career in academia is no longer the assumed natural trajectory of doctoral preparation. Doctorally prepared nurses have more options, and this may reduce the number interested in full-time academic positions, particularly when pay discrepancies are considered. Generally, nursing faculty earn less than their counterparts in other settings, particularly when their advanced education is considered. Low salaries in academia are a significant challenge in both recruitment and retention of nursing faculty. The TCNWS (2015) reports an aver-
A career in academia is no longer the assumed natural trajectory of doctoral preparation. Doctorally prepared nurses have more options, and this may reduce the number interested in fulltime academic positions ... age faculty turnover rate for all SON programs of 15.4%, a 4.8% increase from the previous year. Retention is linked to the quality of the work environment. Generally, people leave their jobs when they are dissatisfied and/or a better opportunity elsewhere is perceived. Faculty leave (turnover) when they become dissatisfied with their workload, work/life balance, salary, and teaching support (Derby-Davis, 2014, Ellis, 2013).
Are particular clinical specialties in demand to a greater extent than others?
CALL TO ACTION
Texas has been proactive in addressing the nursing shortage for almost two decades. TNA’s legislative efforts have resulted in a number of opportunities for SONs to pioneer original approaches in nursing education that may affect the faculty shortage, for example:
Kowalski and Kelley (2013) argue that clear visibility and definition of the faculty shortage is required to articulate the return on investment for health care organizations and to make the case for action: “first must come problem definition, visibility, and ROI; then and only then can the case be made for implementing solutions to the nurse faculty shortage.”(p.76). Texas is fortunate to have the TCNWS which surveys SONs and provides baseline data. There is an opportunity to refine the data collected to enable better definition of the problem, for example: What is the real demand for faculty, unmasked by administratively “approved” positions and nurse “moonlighting”? What academic preparation is most sought/difficult to find (MSN, DNP, PhD, EdD)?
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What is the effect of a lack of faculty on the ability to increase production of nurse graduates?
What is the salary differential between practice and academia and what factors affect this differential? (e.g. physical location, public/private, community college vs. university, etc.)
Pilot Programs for Innovative Applications enables the Board of Nursing to waive certain statutory or education rule requirements to allow an SON to implement a particular project. Past projects include enabling BSN-prepared nurses who are enrolled in a graduate nursing education program to provide clinical supervision of students. The Higher Education Coordinating Board Innovative Nursing Grant Program has made significant contributions to enhancing simulation capabilities of SONs as well as other clinical
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instruction innovations.
approach could reveal just what a “faculty friendly” — as well as “student friendly” — SON looks like. Once identified, these characteristics could be promoted as best practices for schools to emulate.
The Nursing Shortage Reduction Program has provided more than $171 million (2004-2016) in addition to formula funding to SONs to increase nurse graduates. This money is earmarked for the SON, is allocated according to actual increase in nurse graduates, and has few restrictions (could be dedicated to nurse faculty salaries).
CONCLUSION
A Faculty Loan Repayment Program exists, however its structure is suboptimal as the funding for nurses is derived from whatever is left over from the physician loan repayment program. To utilize loan repayment as an incentive for nurses to choose education as a career track, a funded loan repayment program is needed. TNA will be advocating for separate, dedicated funds for nursing student loan repayment for those who elect to become nursing faculty. Future opportunities abound! Magnet™ and Pathways to Excellence™ recognize clinical work environments that support best practices in nursing. Perhaps something similar is needed for nursing education. First, best practices need to be identified. An appreciative inquiry
Legal Issues?
Indeed, the nursing shortage in Texas extends to faculty. And, as with the nursing shortage, superficial, isolated, or band-aid approaches will not be effective in achieving lasting results. The issue must be fully understood, which requires data: defining the current and projected faculty shortage; relating to existing challenges SONs face in identifying and filling faculty vacancies; looking at recruitment and retention and the best practices for these efforts; and relating to innovative educational approaches that enable efficient use of faculty while achieving desired outcomes. The results Texas has achieved in addressing the nursing shortage demonstrate our ability to take on a challenge. The faculty shortage presents yet another opportunity. i SELECTED REFERENCES: American Association of Colleges of Nursing (2005). Faculty shortages in baccalaureate and graduate nursing programs: scope of the problem and strategies for expanding the supply, accessed from aacn.nche.edu/publications/white-papers/facultyshortages Derby-Davis, M. J. (2014). Predictors of nursing faculty’s job satisfaction and intent to stay in academe. Journal of Professional Nursing, 30, 19-25. Ellis, P. A. (2013). A comparison of policies on nurse faculty workload in the United States. Nursing Education Perspectives, 34, 303-309. Kowalski, K. & Kelley, B. M. (2013). What is the ROI for resolving the nursing faculty shortage? Nursing Economic$, 31, 70-76. Texas Center for Nursing Workforce Studies Nursing Workforce Reports and Nursing Education Reports accessed from dshs.texas.gov/chs/cnws/
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DISTRICT ACTIVITY:
Faculty & Student Engagement Toolkit By Ellen Martin, PhD, RN, Director of Practice, Texas Nurses Association
AS THE TEXAS NURSES ASSOCIATION implements its strategic plan, districts are being provided with a variety of toolkits. The purpose of the FacultyStudent Engagement Toolkit is to support district growth by engaging with faculty members and nursing students. Many nurses join TNA because an influential faculty member impressed upon them the professional responsibility and value of participating in professional associations. Using the toolkit is easy! Each district identifies one or more members to serve as School of Nursing Liaisons. The toolkit includes a spreadsheet with schools of nursing and contact information that can be sorted by district. The liaison contacts the nursing program to identify the student faculty advisor or faculty who teach professional issues, leadership, or management courses. The liaison makes at least one face-to-face contact with someone at each nursing school in the district. TNA members may be asked to give a presentation or do an activity with the students. The toolkit includes resources such as a brief customizable PowerPoint presentation, a PowerPoint show Jurisprudence and Ethics game, a historical letter from a pioneer of Texas nursing, and the BSN essentials on professional values.
Finally, ANA has useful resources for students through the ANA Student Subscriber program. The Welcome to the Profession Kit is a resource available to all new nurses. This valuable kit includes tips for resumes and interviewing, guidance about social media, and information about self-care, professional practice, and caring for patients. This toolkit will continue to evolve as new resources are discovered and improvements are identified. If you have used the toolkit and have feedback, please contact Director of Practice Ellen Martin at emartin@ texasnurses.org. i
TNA FACULTY-STUDENT ENGAGEMENT TOOLKIT Customizable PowerPoint presentation PowerPoint show Jurisprudence and Ethics game Historical letter from a pioneer of Texas nursing BSN essentials on professional values.
ANA STUDENT WELCOME KIT Tips for resumes and interviewing Guidance about social media Information about self-care, professional practice, and caring for patients.
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TNA + ANCC =
ACCREDITATION WITH DISTINCTION By Katherine Hinson, Director of Communications, Texas Nurses Association
FOR TEXAS NURSES who began practicing prior to 1991, the term “CNE” was as likely to conjure visions of wild concerts at the Canadian National Exhibition as it was to suggest improving nursing practice and competency. It wasn’t until 1989 that the Texas legislature passed a bill giving the Texas Board of Nurse Examiners (now the Board of Nursing) the authority to require continuing nursing education (CNE) for RN and LVN license renewal. Throughout the interim 25 years, the Texas Nurses Association, in conjunction with the American Nurses Credentialing Center (ANCC) and with guidance from the Texas Board of Nursing, has established the standards and best practices for continuing nursing education in the state of Texas. As defined by the ANCC’s Commission on Accreditation, continuing nursing education are “learning activities intended to build upon the educational and experiential bases of the professional RN for the enhancement of practice, education, administration, research, or theory development, to the end of improving the health of the public and the RN’s pursuit of their professional career goals.” (2015 ANCC Primary Accreditation Approver Application Manual, 2015, p. 55). The Texas Board of Nursing defines continuing nursing education as
“programs beyond the basic nursing preparation which are designed to promote and enrich knowledge, improve skills, and develop attitudes for the enhancement of nursing practice, thus improving health care to the public.” In Texas, ANCC establishes the evidence-based, best practice educational design principles that are used to develop CNE activities. The Board of Nursing establishes what is and what is not acceptable as CNE. The ANCC educational design principles and the Board of Nursing’s definition of and criteria for
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CNE come together in the development, implementation, and evaluation of a CNE activity. As with most aspects of nursing, CNE is about the patient/client. With continuous advances in health care, nurses must stay on top of the latest trends to ensure the best care for all the citizens of Texas. The intended outcome of continuing nursing education is to narrow or close identified gaps in knowledge, skill, or practice in an effort to impact nursing professionals and enhance patient outcomes. Therefore,
the focus of CNE is to enhance both nursing practice and competency. “As the most trusted profession in the United States,” said Laura Lerma, MSN, RN, CNE Program Manager for TNA, “nurses use CNE to stay on the cutting edge of health care in their area of practice.”
WORKING WITH ANCC Through the ANCC, one of the subsidiaries of the American Nurses Association (ANA) Enterprise, TNA is an accredited approver. An accredited approver is an entity that has demonstrated a capacity to assess and monitor other organizations’ ability to comply with ANCC criteria in the development, implementation, and evaluation of quality CNE activities either as an Approved Provider or as an individual activity applicant. The TNA accredited
approver unit just completed a rigorous, in-depth analysis of its processes and outcomes by ANCC. The accredited approver unit was awarded ANCC’s highest level of accreditation — Accreditation with Distinction. The mission of ANCC is to promote excellence in nursing and health care globally through its credentialing and certification programs. Internationally renowned, ANCC not only sets the gold standard for CNE, but also exemplifies the gold standard.
WHAT IS TNA’S ROLE IN CNE? Through the CNE Committee (see page 12) and staff, TNA provides CNE services in two ways: Approving approved providers: granting approved provider status to organizations seeking to provide CNE
offerings without contacting TNA for approval for each individual activity. Approving individual activities: granting approval for one CNE activity at a time. The CNE Committee consists of volunteers who act as mentors and coachers to Nurse Planners and Primary Nurse Planners. Nurse Planners are responsible for developing CNE activities and are required for all CNE activities, whether part of an approved provider unit or not. Primary Nurse Planners are ultimately responsible and accountable for the activities and outcomes of an approved provide group. The CNE Committee members — also known as Nurse Peer Reviewers — use a peer review process to review approved provider applications and individual activity applications in an effort to ensure
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TEXAS NURSES ASSOCIATION CNE COMMITTEE Charlene Adams Pat Alvoet Kathleen Baldwin Ruth Ann Bridges Jackie Brock Deborah Camak Kristy Causey Rachel Chapman Jenny Delk-Fikes Debra Edwards Tracia M. Forman Patricia Freier Jill Henry Sheree Henson Francine Kingston Joe Lacher Kathy-Jo Lee Cheryl M. Lindy Elizabeth Long DeVonna McNeill Jan Milligan Teresa Oehler Rebekah Powers Sally K. Roach Sahara Seyedkalal Janeen F. Smith Cindy Stinson Eloisa Garcia Tamez Sarah Towery Candice Lynn Ward-Herman
both ANCC and Board of Nursing criteria are met. The work of the CNE Committee is very much in line with TNA’s mission, “Empowering Texas Nurses to advance the profession.”
APPROVING PROVIDERS Twice each year — Jan. 15 and July 15 — TNA’s CNE department accepts applications to become an “approved provider.” Evaluating both core concepts related to the provision of CNE and three CNE activities from the preceding 12 months,
members of TNA’s CNE Committee determine whether each applicant has established the infrastructure, systems, and processes needed to develop, implement, and evaluate CNE activities internally, without going through TNA first. The three activities included in the application must meet the criteria established by the ANCC/TNA. “The process is set up to build on what the approved provider applicant has accomplished,” said Lerma. “For first-time applicants for approved provider status, we look at the three or more activities they provided in the past year. Since the activities have already met the ANCC/TNA standards, the TNA CNE Committee can focus on the systems and infrastructure of the potential approver unit.” Approved provider status is awarded for three years and is TNA’s way of publicly recognizing organizations that meet — and sometimes exceed — ANCC/TNA criteria for providing CNE.
INDIVIDUAL ACTIVITIES As nurses are quite familiar, a hot topic, new procedure, or innovative technology will suddenly emerge in the health care environment. As a result, a nurse, or nurses, might want to offer a class on the new information. If the nurse is not part of an approved provider unit but still wants to award contact hours, he or she can develop and submit to TNA an individual activity application for review and approval. Once approved, an individual activity is good for two years.
THE PROCESS For all CNE activities — be they in an approved provider unit or an individual activity applicant — a nurse planner is required. Responsible for adhering to ANCC/TNA criteria in the provision of continuing nursing
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education, the nurse planner must be a Registered Nurse with a valid, current, unencumbered RN license, a baccalaureate or higher degree in nursing, and demonstrate competence in the performance of his or her role. The same ANCC/TNA criteria holds for all CNE activities. The process for reviewing an approved provider application or an individual activity application are essentially the same. Approved provider applications are accepted every Jan. 15 or July 15. Individual activity applications must be received by TNA at least 45 days prior to the date of the activity’s first presentation. The applications are briefly reviewed for completeness and adherence to the Board of Nursing’s definition of and criteria for CNE. If they meet the preliminary criteria, they are processed and sent for review to the assigned Nurse Peer Review team. The Nurse Peer Review teams use standardized assessment tools to evaluate the applications. Final decisions related to the outcomes of approved provider applications are made at the CNE Committee’s semi-annual meetings. Final decisions related to the outcomes of individual activity applications are made by the Nurse Peer Review team in conjunction with the TNA CNE program manager.
WHY TNA? Contact hours awarded by an ANCC-affiliated/associated organization such as TNA are accepted everywhere. Employers, regulatory agencies, and certifying bodies recognize the quality of an activity that has awarded contact hours from an ANCC-affiliated organization. CNE is increasingly focusing on outcomes ultimately expressed through patients for whom nurses care.
TNA-approved activities support the lifelong learning needs of the RN by ensuring that they are designed using evidence-based criteria and that they are independent from commercial influence. “While there are many organizations throughout the country that approve CNE, not all meet national accreditation standards. CNE approved by organizations that are not national (e.g. individual state boards of nursing) may not meet the standards of CNE required by the Texas BON. Contact hours awarded by an ANCC- affiliated/associated organization are universally accepted. Employers, regulatory agencies, and certifying bodies recognize the quality of an activity that has been awarded contact hours from an ANCC-affiliated organization and for good reason. ANCC approval is a distinct mark of quality. The ANCC process is rigorous, and it ensures that continuing education activities are designed using the current evidence and support identified learning needs of nurses. Consistent with the greater focus on outcomes and value in health care generally, CNE increasingly focuses on outcomes. That is, how will the nurse’s learning eventually translate to improved patient care and outcomes? Patient outcomes are the ultimate value of a quality CNE activity. Lerma proudly states, “The process ensures that nurses get the most current, most evidence-based, and best practice information to provide the very best, highest quality care to the citizens of Texas. It makes what we do ... great.” For more information on how to apply for approval of an individual activity or to become an approved provider, visit texasnurses.org under the “Education” tab. i
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WHAT IS YOUR PASSION TO PRACTICE? By Rhonda Winegar, DNP, RN, FNP-BC, CCRN, CPN
At the 2016 Texas Nurses Association House of Delegates, “Mother of Primary Nursing” Marie Manthey, PhD (hon), MNA, FAAN, FRCN, gave an inspirational talk about her life, nursing, and nursing salons. Part of the presentation involved breaking into small groups and holding a mass nursing salon, made up of multiple simultaneous conversations about nursing. The feedback from attendees was overwhelmingly positive. TNA has developed a nursing salon toolkit that will be available on our website. In addition, stories from members about their experiences will be shared through Texas Nursing, TNA Check-up, and other outlets. The following article is a direct result of the conversations held at the House of Delegates nursing salon. AT THE 2016 TNA HOUSE OF DELEGATES, I was part of a mass nursing salon. My group (about 10 people) varied from seasoned nursing professionals in clinical practice, administration, and academics to a nursing student about to graduate and embark on her nursing career. One of the themes discussed in our group was “passion to practice.” We all described different issues related to nursing, in the area of “passion to practice.” One member of our group is a director of nursing at a facility and reported difficulty retaining qualified nurses. Another member of the group, a seasoned nurse, reported a recent change in employment and noted turmoil and cliquish behavior among the nursing staff at her new work site. This wonderful discussion with my nursing colleagues started me thinking, “What is my passion to practice?” I have been a registered nurse since 1991 and have enjoyed a diverse career. I have had the privilege of working in many different facets of nursing, including adult and pediatric intensive care, nursing faculty across many levels, and practicing as a family nurse practitioner in neurology. My passion for practice has always remained high, but I have had to develop strategies throughout my career to help offset times when my morale or motivation were not where they needed to be:
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1. 2. 3. 4.
Step out of your comfort zone. Never say “no” to opportunities. If you don’t know, ask questions! Never stop learning.
STEP OUT OF YOUR COMFORT ZONE Many times in my career, I have been asked to do things that are unfamiliar to me. As a brand new graduate nurse, I started working at a 22-bed, rural, community hospital in Oklahoma. I had the ability to learn many areas, but all at once. The nurses provided care to all patients, which included staffing the emergency room, the two-bed ICU, labor and delivery unit, and even caring for the woman who lived in the hospital. Yes, we had a woman who resided in the hospital. We provided her skilled nursing care. As a new graduate nurse, no license yet, I never knew what I was going to be doing. Some nights, I would just have my typical patient load of five patients. Another night, I might have to accompany my patient in the ambulance to Oklahoma City, or assist in the delivery of a baby. It was a stressful, but fun learning environment. In contrast, there were times I didn’t step out of my comfort zone and regretted it. After a year of practice at the small community hospital, I relocated to the “Big City” of Enid, Okla. The nursing recruiter wanted to hire me as the employee health nurse, but I felt too green to take on such an important job. She then asked me to apply for the ICU position. I had transferred patients (remember, I took them on the ambulance) many times to this facility and had seen all the machines (intra-aortic balloon pumps, ventilators, and Swan-Ganz lines). I didn’t feel comfortable working in the ICU, so I turned down that opportunity and took a stable job on the Med/Surg unit. Well, right off the bat, I was floated to the ICU and did just fine. In fact I did so well, they started requesting I be pulled down there on a routine basis. I transferred to the ICU within a month’s time. I look back fondly on that time
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What Does Passion to Practice Mean to You? As a nurse educator, this passion is two-fold. There is an inner core in me that is centered around caring and treating another person — the patient. But as a nurse educator, I am always asking myself “Who will be next in line to care for the patient?” For those of us who teach in nursing programs, I can say that the “passion to practice” is centered around forming the next generation of nurses who will do just that. — Danielle Quintana MSN, RN, CNOR Assistant Clinical Professor, University of Houston School of Nursing
Passion to Practice means that I greet my patients with a warm smile, show my interest in and engagement with them, offering my knowledge, expertise, and experience to partner with them in their health and wellness journey. I have embraced education and professional development so that I may offer my best, with evidence-based nursing practice at the forefront of my care delivery. — Terri Gibson, DNP, MSN, RN-BC, FCN
and realize how much I grew each time I stepped out my comfort zone.
NEVER SAY “NO” TO OPPORTUNITIES A few years later I found myself a newly divorced, single mother with an infant. I moved to Corpus Christi and was offered a job at Driscoll Children’s Hospital. I was again reluctant to change, “I am an adult ICU nurse. I don’t know anything about pediatrics.” They assured me I could do it. I took the job and loved it! The environment was so warm and inviting. This is a teaching hospital, and I learned so much. I was then approached to teach pediatric clinicals at Del Mar Junior College. Again, I hesitated. “I don’t know anything about teaching.” I took that opportunity and realized I love teaching. I have never been sorry when I take on a new opportunity, but I have regretted missed opportunities.
IF YOU DON’T KNOW, ASK QUESTIONS This is one of my mantras. I was scared that if I asked a question, I would appear stupid. When I first started at Driscoll Children’s Hospital, I was so worried the nurses would “find out that I didn’t know anything.” I can remember one time in report, the nurse stated the patient had spooning of the fingernails. “What is spooning of the fingernails?” I had no idea, but she seemed so sure of it, and it seemed like I should know it. I was afraid to ask. This was before the internet. I now Google everything, but then I dove into the resources on the floor, nothing! No mention of spooning, anywhere. I walked around to the other nurses and asked them all, “so, do your patients have spooning of the fingernails, too?” They all looked at me oddly. Finally, I had to break down and ask. I know many of you are now Googling the term. It is just flat brittle fingernails! If you don’t know something, ASK! It will save you lots of time and frustration.
NEVER STOP LEARNING I graduated as an ADN in 1991. I thought I had no desire to go back to school, but I began to notice many of the nurses on the floor had BSNs. I was serving in the Air National Guard, and my commission was “grandfathered in” with the ADN. I was told I didn’t “need” to go back to school, but the military had many benefits for higher education, and I took advantage of them. I went on to earn my BSN and later my MSN/FNP. I found that I loved learning and wanted to keep going. I have since gotten my DNP and am now in school for a PhD. I am constantly learning. I have watched other colleagues become stagnant if they don’t embrace change. I remember continued on page 16
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TPAPN WELCOMES NEW LEADER THE TEXAS NURSES FOUNDATION welcomes Jonathan Wolfarth, MS, RNBC, as the new program director for the Texas Peer Assistance Program for Nurses (TPAPN). TPAPN helps nurses whose ability to provide professional nursing services is impaired by chemical dependency or mental illness return to safe practice as an alternative to license discipline. Formerly a staff psychiatric nurse and admissions coordinator for the Menninger Clinic in Houston, Wolfarth, is ANCC Board Certified in Psychiatric and Mental Health Nursing as well as Informatics Nursing. He also holds a master’s degree in health informatics. “I am honored to have the opportunity to lead the TPAPN program,” said Wolfarth. “When a substance use or mental health issue interferes with a nurse’s ability to care for patients, TPAPN is there to support that nurse. “For the past 29 years, TPAPN has been in very capable hands under program director Mike Van Doren, MSN, RN,
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CARN. Our current staff of 12 have a great diversity of skill sets and education including BS-CJ, BSN, MS, MSN, M.Div., RN, RN-BC, and LCDC. They are passionate about the work we do, and I look forward to working with them to build on everything that has been created so far to best serve the nurses of Texas.” Wolfarth received his nursing degree in 2008 from the University of Rochester, School of Nursing. By the next summer, he had accepted a position at the Menninger Clinic in Houston. While there, in addition to patient care, he helped develop an educational course, Putting Prevention into Practice, and served on several of the clinic’s committees. “I had been at the Menninger Clinic for seven years,” said Wolfarth. “Being involved in activities outside of patient care allowed me to see how expansive the opportunities are for nurses. And, as the director of TPAPN, I can still impact patient care by ensuring that the programs we administer are helping nurses return to work and provide safe patient care.” In addition, Wolfarth served as secretary of Texas Nurses Association’s District 9 (Houston). An active participant in the district, he helped develop and organize various events. He has also been active at the state level and served as a delegate to the American Nurses Association’s House of Delegates in 2012. i
PASSION TO PRACTICE continued from page 15
when we were “asked to wear gloves, while bathing patients.” One nurse was convinced the hospital would go broke if we all wasted gloves like that. The nurses who embraced changes were happy and eager to learn. Those nurses who knew their old method was right were usually bitter and not happy about the change. Never become complacent in your nursing career. If you work
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in diabetes, learn about hypertension. Go to nursing conferences, grand rounds, read your nursing journals, and go for those higher degrees. You won’t be disappointed, this strategy also keeps you invigorated and wanting to learn more! The strategies above have served me well. I hope each of you find your passion to practice. i
ZIKA DANGERS NOT DIMINISHING By Ellen Martin, PhD, RN, Director of Practice, Texas Nurses Association
REPORTS ON ZIKA are coming in almost daily. As Texas Nursing goes to press, Florida officials have announced that the first local mosquito-transmitted cases of Zika have been identified in the continental United States. Within a few days, 14 cases have been confirmed, with officials asserting that only a small area of Miami-Dade County has been affected. More than 1,300 Zika cases have been reported in the U.S., with all but 28 travel related. However, in U.S. territories, there have been 2,916 cases of Zika, with nearly all of those cases acquired locally. In Texas, the Department of State Health Services (DSHS) has identified 69 cases of Zika so far (as of July 20). The cases are concentrated where the most people live, with 20 cases in Harris county and 15 cases in Dallas County. On July 13, the first infant with Zika-related microcephaly was born in Harris County. So far in Texas, 37 individuals have been reported to the Centers for Disease Control (CDC) Zika Pregnancy registry. In the news recently, the Utah Department of Health requested assistance from the CDC to investigate a case of Zika in a family member of an elderly Utah resident who died in late June. The deceased patient had traveled to an area with Zika, and his lab work showed a Zika virus load more than 100,000 times higher than seen in other samples. The
CDC Emergency Response Team (CERT)Â is working to determine how the family contact became infected. The CERT includes experts in infection control, virology, mosquito control, disease investigation, and health communications. There is no vaccine to prevent Zika or treatment other than symptom management. The best protection is to prevent mosquito breeding and protect yourself from mosquito bites.
SIMPLE STEPS FO R TEX TO PREVENT ZIKA ANS You can take th ese simple ste ps to protect yo your loved ones urself and from the Zika vir us. Apply EPA-appr oved insect rep ell
Wear pants and long-sleeve shirt s. Use screens or close windows and doors. Remove standing water in and aro und your home. Cover trash cans or containers wh ere water can collect. Talk to your do cto
r if you have co
* Recommendati
KEEP UP WITH TH
The CDC Zika website contains important information for specific groups — from Zika prevention in pregnant women to guidelines for school administrators. Nurses may find several helpful tools to protect patients from Zika. These handy tools, available in English and Spanish, include testing algorithms, fact sheets, and counseling guides. There is also a guideline on preventing occupational exposure in healthcare workers. The DSHS Zika website contains materials in English and Spanish also. These easy to read materials include
ncerns.
ons are based on
E LATEST INFO AT
ZIKA RESOURCES
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ent.
emerging knowledge
about Zika.
TexasZika.org
6-28 05/26/16
graphics, push cards for people who work outside, and public service announcements for radio and television. Nurses can work with the media in their community to spread the word about Zika and encourage local prevention efforts. The DSHS website also has a News Media link on the left menu bar. This link contains all the latest news releases from DSHS including information on West Nile Virus and other public health threats. i
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TNA DISTRICT SPOTLIGHT District 18 Finds Fundraising Success with Restaurant Partnerships By Nadia Tamez-Robledo, Texas Nurses Association
“I think any district can do it,” she said. “There are partners in the community that you can work with, and being visible in the community has helped us.”
DISTRICT 18 MAJOR CITIES: Lubbock TNA MEMBERS: 364 SIZE: 2,805 square miles PRESIDENT: Patricia Francis Johnson, DNP, RN
The district’s longest-running restaurant partnership is with Applebee’s, said District Fundraising Chair Susan Dossey, MSN, RN. Members sell tickets to the quarterly flapjack breakfast for $7 each, while the restaurant provides the food, and district board members serve patrons during the event. Francis Johnson reported that each Applebee’s fundraiser yields $200-$600.
Some TNA districts have come up with creative approaches to supplement the funds they receive directly from member dues. District 18 (Lubbock) is one such district. Their innovative ideas are highlighted here.
The owner of local Wingstop and Pie Five Pizza restaurants contributes to the district 10% of Wingstop sales from nurses, nursing students, and nursing school employees who patronize the Lubbock locations on Wednesdays and Thursdays. Although, the district has only been in the partnership for a few months, they raised more than $800 in the first month. A similar promotion will be implemented at Pie Five Pizza restaurants August through October.
According to District President Patricia Francis Johnson, DNP, RN, 2016 marks the third year District 18 has partnered with local restaurants to receive a portion of food sales during fundraising events or on designated days.
The district uses advertising material provided by each restaurant to promote its fundraisers online on the District 18 home page on the TNA website, through email, and with flyers. Local nursing schools help promote the events
WELCOME to the first TNA District Spotlight! TNA’s 25 districts share many similarities and proudly express their unique differences.
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as well, Dossey said, and members are happy with the return on their time invested. “It’s a win-win for them because it brings more customers to them,” Francis Johnson said of the symbiotic relationship with businesses. “Not only [nurses] but the nurses’ family and the nurses’ friends. We have 3,000 RNs in District 18, and there’s that potential meta effect. This past year our fundraising, especially with adding Wingstop, we’ve been very successful.” Francis Johnson said that the additional funds help support member events and projects. In February, the District hosted Andrew Cates, TNA
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director of government affairs, for a presentation on legislative advocacy. In May, the district awarded four $500 scholarships to members pursuing their master’s and doctorate degrees. Funds have been used to support member travel to events such as Nurse Day at the Capitol and the
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Spring classes start Jan. 9, 2017
TNA Nurse Leadership Conference. The district has sponsored Lubbock Christian University’s distinguished speaker series and other local events such as the local Texas Nurse Practitioners conference. Members also utilize a portion of their funds to augment meals or provide general support to a local soup kitchen,
where they volunteer each quarter. Any district is capable of emulating the Lubbock region’s fundraising success, Francis Johnson said. “It’s just making connections and talking to the right people.” i
Money District 18 Raises Is Used for a Variety of Member and Community Events: Geriatrics ethics CNE Community Poverty Simulation in partnership with Covenant School of Nursing Support for two members to attend the TNA leadership conference Support for five delegates and one student to attend House of Delegates Support for member travel to TNA Nurse Day at the Capitol
Sponsored visit and legislative affairs talk with Andrew Cates, TNA general counsel/director of government affairs Lunch and Learn series, with meals and CNE periodically provided Local nurse practitioner conference sponsorship Local school nurse conference sponsorship
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Research Brown Bag at Lubbock Christian University sponsorship Distinguished Speaker Series at Lubbock Christian University sponsorship West Texas Symposium on Synthetic Compounds in collaboration with Lubbock Christian University sponsorship Volunteer hours and supplies for Carpenter’s Kitchen (soup kitchen)
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HEALTHY NURSE NOW START THE SCHOOL YEAR WITH A VACCINE ACCORDING TO THE CENTERS FOR DISEASE CONTROL, routine childhood immunization saves over 40,000 lives, avoids over 20 million vaccine-preventable illnesses, and saves over $13 billion in direct costs FOR EACH BIRTH YEAR COHORT of infants. The Centers for Disease Control and Prevention has Educational Resources for Providers that include the current vaccine recommendation schedules and materials to facilitate conversations with parents about vaccines for infants. Another helpful resource for nurses is the Immunization Action Coalition (immunize.org). The website has information organized by parental concern. For example, some parents worry about the number of vaccines an infant receives at one time. This website has reassuring information that nurses can use in their discussions with parents. For example, that infants are exposed to numerous antigens on a daily basis from the day they are born, including natural bacteria on foods, viruses normally present in the environment, and every time they put their hands in their mouth — which infants do hundreds of times each day. Research into the topic of motivated reasoning indicates that sometimes pro-vaccine messaging and targeting misinformation about
vaccines may not be effective in changing deeply held beliefs about vaccine safety and side effects. During parent education encounters, it is important for nurses to recognize whether providing factual information is making the person more resistant or making misperceptions worse. Rather than highlighting vaccine safety, a more effective approach may be for the nurse to describe the potential dangers of the disease. The Immunization Action Coalition maintains a repository of stories called the Unprotected People reports to highlight what can happen without immunization and counterbalance some of the anti-vaccination news stories. Because of vaccines, illnesses such as measles have become very rare, and parents may not realize how devastating some vaccine-preventable illnesses can be. i
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ADDITIONAL RESOURCES TEXAS DEPARTMENT OF STATE HEALTH SERVICES This resource lists the immunization requirements for schools and daycare facilities in Texas.
EVERY CHILD BY TWO This nonprofit organization committed to reducing the burden of vaccine-preventable diseases among families and contains resources and videos for parents and professionals.
HealthyNurse
Health Risk Appraisal The American Nurses Association (ANA) developed a Health Risk Appraisal (HRA) in collaboration with Pfizer Inc., specifically for registered nurses and for nursing students (en-
rolled in a nursing program leading to RN licensure). Now is your chance to assess your personal and professional health, safety, and wellness risks and compare your results to ideal standards and national averages. A web wellness portal attached to your responses allows you to gain access to further resources. Aggregate data collection allows for top nursing health, safety, and wellness issues to be identified and addressed. The HRA is free, HIPAA-compliant, secure, and easy to use. Visit www.anahra.org today.
The Healthy Nurse, Healthy Nation Grand Challenge GET READY!
BETA-PHASE
In January 2017, the ANA Enterprise is launching the Healthy Nurse, Healthy Nation™ Grand Challenge (HNHN GC), a national movement designed to transform the health of the nation by improving the health of the nation’s 3.6 million registered nurses. This Grand Challenge will broadly connect and engage individual nurses, employers of nurses, state nurses associations, specialty nurses associations, schools of nursing, and others to take action in five key areas: sleep, rest, nutrition, quality of life, and safety.
The Texas Nurses Association is one of 12 organizations invited to participate in the beta-phase launch of the HNHN GC, which will begin in September of 2016. The primary goal of the beta-phase will be to test the HNHN GC web platform and provide feedback to the ANA Enterprise. The platform will be designed to gather data, inspire action, cultivate friendly competition, provide content and resources, and to connect registered nurses with each other, with employers, and organizations.
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INTRODUCING
MONARCH MEDIA AND CONSULTING IN THE TEXAS NURSING PUBLICATION that you are now reading, you may notice something different. Maybe not obvious initially … but something just isn’t the same. Welcome to the first issue of Texas Nursing in almost a decade that includes advertising! The Texas Nurses Association is excited to announce our partnership with Monarch Media and Consulting, Inc. An Austin-based publishing company that specializes in association publications, Monarch Media has been doing business for more than five years. Prior to that, the founders — Andrea Exter and Chellie Thompson — served as staff at another statewide association. In 2015 TNA ceased the partnership with Arthur L. Davis, publisher of Texas Nursing Voice. This opened the door for TNA to accept advertising in Texas Nursing.
Texas Nurses Association selected Monarch Media for a variety of reasons, but one genuinely stood out. In their proposal, Monarch included a personal statement from one of their founders expressing the gratitude she has for our industry and the impact nurses have on her personally. TNA is sharing this personal statement so you, our members, can see what a difference you truly make in the lives of your patients.
A PERSONAL STATEMENT The opportunity to partner with the Texas Nurses Association is more than a business endeavor for me, it’s a chance to work on an ongoing project that would benefit and serve nurses—a profession that truly impacts me personally. Nurses have long served an important role in my life and continue to be critical in helping me be a productive mom, wife, and business owner. They have helped me manage some of the hardest times and celebrate some of the best. Through ongoing treatment and management of rheumatoid arthritis, my nurses have been with me for over a decade, introducing the newest advances in my treatments, overcoming obstacles, and helping me every step of the way. I want to personally acknowledge my commitment to the nursing profession for which I have so much respect and admiration.
Andrea Exter
Cofounder & CEO Monarch Media & Consulting, Inc.
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WHAT DOES THIS MEAN FOR TNA MEMBERS? As with many TNA programs, the Texas Nursing magazine is changing and evolving to better meet the needs of TNA members. The content will feature a combination of news about TNA and TNA members, nursing practice, legislation, and advocacy. Within the next year, a readership survey will be conducted, and Texas Nursing will undergo a redesign. It is an exciting time to be part of the Texas Nursing magazine. WHO MAKES UP MONARCH MEDIA? Exter and Thompson worked together prior to opening Monarch Media. As the firm’s principal designer, Exter ensures that Monarch’s publications are the perfect combination of clean design, attractiveness, and readability. She is flexible and creative, keeping the needs of readers as the central focus.
Monarch Media founders: Exter (left) and Thompson (right)
A natural-born saleswoman, Thompson encases her sales talents in the best customer service. She is easy to work with and extremely responsive. If you wish to advertise in Texas Nursing, contact Monarch Media at: Chellie Thompson Monarch Media & Consulting, Inc. chellie@monarchmediainc.com 512-293-9277 Advertising information is also available by visiting the TNA website at texasnurses.org. Hover over the Resources menu, and click on Advertising Opportunities at the bottom of the drop-down menu. i
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PRESIDENT’S NOTES continued from page 4
vice in my life. The most valuable is this: with something gained, there is always something lost. This reminds me to treasure every day and every experience.
Q. TNA is known for its advocacy. Why do you think it’s important to the nursing profession to stay on top of policy and legislation?
Q. What advice would you offer to either a nurse entering the profession or a new member of TNA? A. Too many times, the opinions of new-to-the-profession Registered Nurses are undervalued. I would say to new professional Registered Nurses and new TNA members to remain engaged and keep speaking up. We are at our best as a profession when we value the contribution of each and every member. And, when we are at our best, the populations we serve benefit.
A. This is quite simple. If we don’t stay on top of policy and legislation related to healthcare and nursing, some other group will. Each and every legislative session, TNA champions the cause of the professional Registered Nurse and those we serve in Texas. We know our profession. We know what our challenges are and the challenges of those we serve. We know where we can have the greatest impact for the health of Texans. TNA serves as the unifying voice for nurses in Texas.
Q. What do you do for fun?
Q. What book have you most recently read?
A. I enjoy a good game of trivia, most board games, and the chaotic card game of Nertz. I also value time with my family and friends.
A. Quiet: The Power of Introverts in a World That Can’t Stop Talking by Susan Cain
Q. You served as a nurse manager for more than 10 years, a Chief Nursing Officer for two, and then three years ago, you moved to academia. What prompted the move? A. I knew at some point I wanted to work in an academic setting. While I do miss the world of acute care, I now have the chance to influence and learn from a new generation of nurse leaders. It’s a great next step in my career.
Q. What are your top two favorite books (1 nursing; 1 non-nursing)? A. Non-Nursing: The Places that Scare You: A Guide to Fearlessness in Difficult Times by Pema Chödrön Nursing: The Heart of Nursing: Expressions of Creative Art in Nursing by M. Cecilia Wendler and Jean Watson Q. If you weren’t a nurse, what would you be? A. I would be a chef! Food makes people happy — well, most people I know, anyway. The fondest moments of my life can be traced back to the kitchen and the creation of (usually) tasty food. Q. What is your peak experience as a nurse, that is, a time in your career when you felt most like “THIS is what it means to be a nurse.”
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A. In the early 1990s, I worked with countless individuals suffering from opportunistic infections as a result of the Human Immunodeficiency Virus. I can easily summon the memories of entering room after room and providing nursing care for those young men in final stages of life — young men who would frequently be left alone to die. There was nothing available that would save their lives. There was nothing that could restore the lost sense of relationship. There was nothing I could do but to be present as tears were shed for what was lost, and what had been taken away. This was one of those flashes in time where I knew what it was to be a nurse. Sometimes, the best we can do as nurses is to allow ourselves to be present with those who are suffering — and in those moments, trust that it is enough. i
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S U M M E R 2 016 | T E X A S N U R S I N G M AGA Z I N E
8501 North MoPac Expressway Suite 400 Austin, TX 78759-8396
BEYOND THE CAPITOL WHERE IS TNA REPRESENTING YOU? The Texas Nurses Association’s advocacy for nurses and the profession extends far beyond the Texas Capitol. Look at where you were represented in the last quarter!
TEXAS TEAM: ADVANCING HEALTH THROUGH NURSING Texas Team Advancing Education Committee Conference Call BOARD OF NURSING Quarterly BON meeting TERCAP Pilot Workgroup Conference Call
TEXAS MOST COALITION INTERAGENCY PRESCRIPTION MONITORING PROGRAM WORK GROUP TEXAS HOUSE SELECT COMMITTEE ON MENTAL HEALTH, INVITED TESTIMONY
Sunset Committee, TPAPN
NURSING SHORTAGE REDUCTION PROGRAM STAKEHOLDER MEETING
TEXAS HEALTH AND HUMAN SERVICES COMMISSION
TEXAS PUBLIC HEALTH COALITION UNIVERSITY OF HEALTH
Public Health Action Plan Steering Committee
SHOW ME YOUR STETHOSCOPE DAY AT THE CAPITOL
Sunset Committee
HHSC Behavioral Health Advisory Committee House Appropriations – House Public Health Hearing TEXAS WOMEN’S HEALTH COALITION AMERICAN NURSES ASSOCIATION President/ED Conference Call South Eastern Executive Directors Conference Call Healthy Nurse, Healthy Nation Conference Call Value Pricing Webinar ANA Membership Assembly
COALITION FOR HEALTHY MINDS MEETING TEXAS PUBLIC HEALTH COALITION TEXAS HIGHER EDUCATION COORDINATING BOARD Prelicensure Nursing Curriculum Committee meeting APRN ALLIANCE – STAFF MEETING AUSTIN APRNS MEETING TEXAS MEDICAID WELLNESS ADVISORY BOARD MEETING