Texas Nursing Magazine - Summer 2018

texa s nu r s e s .o rg

TEXASNURSING M A G A Z I N E

Advocacy From Your Backyard to Around the Globe

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 8

SUMMER 2018 Volume 92, Number 3 EDITOR IN CHIEF: Cindy Zolnierek, PhD, RN, CAE MANAGING EDITOR: Kanaka Sathasivan, MPH 4807 Spicewood Springs Rd., Bldg 3, Suite 100, Austin, TX 78759-8444 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

Tamara “Tammy” Eades, DNP, MSN, RN, Vice President

Kleanthe Caruso, RN, MSN, NEA-BC, Secretary

Gayle Dasher, RN, PhD, ANP-BC, Treasurer DIRECTORS:

Tina Cuellar, PhD, RN, PMHCNS-BC

Melinda Hester, DNP, RN

Donna Wallis, MBA, MSN, RN

Patricia Freier, MSN, RN-BC, RCIS

Shakyryn Napier, DHSc, MSN, RN, CPN

TNA DISTRICT AND PRESIDENT Dist.1:

VISION Nurses transforming health TEXAS NURSING (ISSN 0095-36X) is published quarterly— Winter, Spring, Summer, Fall—by the Texas Nurses Association, 4807 Spicewood Springs Rd., Bldg 3, Suite 100, Austin, TX 78759-8444 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, 4807 Spicewood Springs Rd., Bldg 3, Suite 100, Austin, TX 78759-8444

Dist. 3: Linda Dunn, linda.dunn@usoncology.com, District Staff: Jamie Gilbert, jamiegilbert@texashealth.org Dist. 4: Jackie Michael, michaels@uta.edu, District office: Pat Pollock, P.O. Box 764468, Dallas, TX 75376; 972.435.2216; d4tna@flash.net; tnad4.org Dist. 5: David Burzynski, president.tnad5@gmail.com Dist. 7: Crissie Richardson, crissag98@gmail.com, District office: P.O. Box 1482, Belton, TX 76513, tnadistrict7@gmail.com Dist. 8: Linda Juenke, 830.739.7028, ljsoaringeagle3@gmail.com Dist. 9: Tina Cuellar, tinaatutmb@aol.com, District office: Melanie Truong, 7324 Southwest Freeway, Suite 2-1453, Houston, TX 77074; 713.523.3619; tna9@tnadistrict9.com; tnadistrict9.com Dist. 11: Linda Treitler, linda.treitler@mwsu.edu Dist. 15: Andrea Kerley, 325.670.4230, akerley@hendrickhealth.org Dist. 17: Cindy Keese, 361.332.1643, cakeese@aol.com Dist. 18: Darla Smith, darla.smith3@stjoe.org Dist. 19: Kleanthe Caruso, Secretary: Colleen Marzilli, cmarzilli@uttyler.edu Dist. 21: Jessica Tully, 432.254.1949, jessica.tully@midland-memorial.com Dist. 35: Chrystal Brown, 903.434.8302, cbrown@ntcc.edu Dist. 40: Contact TNA, 800.862.2022, ext. 129, brichey@texasnurses.org

ARE YOU MOVING? Need to change your address? If so, provide it quickly and easily in the Members Only section of the TNA website, texasnurses.org. Or mail 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 2018 © Texas Nurses Association

T E X A S N U R S I N G M AGA Z I N E | S U M M E R 2 018

Clarissa Silva, clarissa2277@att.net or Terry Acosta, shadowmon@sbcglobal.net

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The Road to Representation

E

TAK

12

Nurse Advocacy

84

If not YOU, who?

Implementing the ABLE Act in Texas

16

MAKE PLANS TO ADVOCATE IN 2019 NURSE DAY AT THE CAPITOL

February 18 – 19, 2019 Read more stories of advocacy online at TEXASNURSES.ORG.

Contents 5

6

PRESIDENT’S NOTES

TNA MEMBER NEWS

Hope for the Future

Kudos, Obituaries

10

14

20

23

LOCAL ADVOCACY

STATE ADVOCACY

NATIONAL ADVOCACY

GLOBAL ADVOCACY

Ron Rigsby Park

Students and Faculty at Nurses Day

Health Advocacy Student Coalition

Leading a Partnership in West Indies

Faithful Service

National Disaster Medical System

18 NURSE DAY AT THE CAPITOL

22 2019 HILL DAY

Caring for Texas

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President’s Notes Jeff Watson, DNP, RN-BC, NEA-BC, NE-BC, CRRN

HOPE FOR THE FUTURE Advocacy Through a Megacommunity

WE TALK ABOUT ADVOCACY in our work at the Texas Nurses Association (TNA) frequently. Have you considered what advocacy might look like in a community?

I learned recently from Texas Tech University Health Sciences Center (TTUHSC) Doctor of Nursing Practice student and TNA member Becky Geist of a collaborative health care advocacy effort that has taken place in Lubbock over the course of the past seven months. Becky explained the process to me, highlighting three key components: AWARENESS. In different venues over the past year, the issue of human sex trafficking has gained visibility. In January 2018, faculty members and nursing students attended a presentation by the Junior League of Lubbock on the growing issue of sex trafficking in the area. They learned that the victims included 16 minors, the youngest was eight years old.

LOCAL LEADERSHIP. Two orthopedic surgeons, Dr. Melinda Schalow and Dr. Mimi Zumwalt, co-chairs of the SocioEconomic and Legislative Affairs Committee of the Lubbock County Medical Society, along with professional registered nurse Becky Geist, MSN, RN, PHNABC, steered a “Get HELP, Get Out” sticker initiative to stop human sex trafficking in this part of the state.

PARTNERSHIPS. Geist called on her relationships with the health care and education communities. She serves on Lubbock Independent School District’s (LISD) School Health Advisory Committee and chairs the Health Committee.

To further the effort, she met with Paulett Rozneck, MSN, RN-BC, CLNC, the LISD coordinator of Student Health Services; Charlotte Sessom, the LISD director of

counseling and college/ career readiness; Dr. Kathy Rollo, the LISD superintendent; and the LISD Board of Trustees. In that meeting, the “Get HELP, Get Out” sticker campaign was approved. LISD principals, teachers, nurses, counselors, and staff also gained additional support to receive education on this project before the beginning of the 2018-2019 school year.

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Geist and Rozneck partnered with Darla Smith, MSN, RN-BC, president of TNA District 18, and Elisa Perez, MSN, RN, CCRN-K, a TTUHSC faculty advisor to the Texas Student Nurses Association, to facilitate placing stickers in every secondary school bathroom and athletic venue stall on the LISD campus. Within two weeks, the team placed the “Get HELP, Get Out” stickers in all 2,257 bathroom stalls. Additionally, a sustainability plan was developed for implementation by the LISD team.

When advocacy finds harmony and crosses professional boundaries, a powerful megacommunity is created.

When advocacy finds harmony and crosses professional boundaries, a powerful megacommunity is created. In this case, the wisdom and expertise of nursing, medicine, education, and community leaders found synergy and accom-

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plished astonishing work that none of them could do alone.

Leadership author Susan Scott says, “A fierce leader commits to a way of life, not a business strategy. A way of life that over time becomes about we, not me.

About one another. About what’s best for the greater good.”* At every stage of this effort, we see fierce leaders in action. We see humanity in action. We see advocacy in action. We see a megacommunity in action.

Perhaps the real power of advocacy is best summed up in this quote from a nursing student who worked on the project: “As we were putting the stickers up, it gave us hope that one of these stickers will save a life.”

Peace, Jeff i

*Scott, S. (2009). Fierce leadership: A bold alternative to the worst best practices of business today. New York, NY: Random House, Inc.

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TEX AS NURS ES AS SOCIATION

TNA MEMBER NEWS SPOTLIGHT ON YOU KUDOS Cindy Zolnierek, PhD, RN, CAE, executive director of the Texas Nurses Association, has been recognized by the American Society of Association Executives as a Certified Association Executive (CAE). The CAE credential indicates a committed association professional who has demonstrated the wide range of knowledge essential to managing an association in today’s challenging environment. In recognition of her achievement and in keeping with current association practices, the TNA Board of Directors announced in July that Zolnierek will now have the title of chief executive officer.

Christina Murphey, PhD, RN, RNC-OB, department chair, undergraduate associate professor at Texas A&M University Corpus Christi College of Nursing and Health Sciences, has been selected to serve as a member of the state Maternal Mortality and Morbidity Task Force for a term to end September 1, 2024. Dr. Murphey is a member of TNA residing in Corpus Christi.

With TNA’s sponsorship, Olusola Ahmed Oyewuwo, BSN, RN, was selected for a fellowship with the American Nurses Advocacy Institute. This year-long mentored program helps students present at the annual convention, participate in ANA Hill Day, and serve as a contact for legislators. Fellows are supported through face-to-face sessions in Washington, DC, discussion calls, and educational activities. Oyewuwo, an active TNA member, became inter-

ested in advocacy through Nurse Day at the Capitol. He currently practices at MD Anderson Cancer Center.

Congratulations to Jan Zdanuk DNP, APRN, FNPBC, CNS, FAANP, who was selected as Nurse Practitioner of the Year by Texas Nurse Practitioners Association. Zdanuk is a doctor of nursing practice, family nurse practitioner at Visiting Physicians Association. She was recognized on September 8, 2018, for excellence as an NP and role model for nurse practitioners; improving health care for individuals, families, and communities; utilizing current research; and creativity in improving communication and quality of care for patients.

Congratulations to the 2018 American Academy of Nursing fellows!

Garry J. Brydges, DNP, MBA, CRNA, ACNP-BC – University of Texas MD Anderson Cancer Center Peggy J. Mancuso, PhD, CNM, RN – Texas Woman’s University David Marshall, JD, DNP, RN, CENP, NEA-BC, NHDP-BC – University of Texas Medical Branch Melanie McEwen, PhD, RN, CNE, ANEF – The University of Texas Health Science Center at Houston Lula Westrup Pelayo, PhD, RN – Uniformed Services University J. Dru Riddle, PhD, DNP, CRNA – Texas Christian University Jennifer Elizabeth Sanner Beauchamp, PhD, RN – The University of Texas Health Science Center at Houston

OBITUARIES Rebecca Ruth Sutter, MSN, RN, nurse and leader in nursing practice and education, passed away July 4, 2018. Ms. Sutter

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retired as assistant professor of clinical nursing at the University of Texas at Austin School of Nursing, where she received numerous faculty and teaching awards.

She was known for her expertise in critical care, rehabilitation, gerontology, ethics, and spiritual care. She received her nursing diploma from Mennonite Hospital School of Nursing, her BSN from Northern Illinois University, and an MSN from the University of California. Sutter was active in parish nursing, the International Council of Nursing, Sigma Theta Tau, and TNA, where she served as District 5 president, on the TNA Committee on Education, and as a delegate to the annual business meeting.

Dr. Colonel (Ret.) Clara Beatrice Wallace of San Antonio passed away August 9, 2018 surrounded by family and friends. At Prairie View A&M University College of Nursing, Wallace received a Bachelor of Science in Nursing. Soon after, she was commissioned into the United States Air Force as a second lieutenant. Her military titles included clinical nurse, nursing instructor, flight nurse, nursing administrator, and military consultant to the surgeon general. She received numerous awards and decorations in her 30 years of service. In 2007, at the age of 71, she completed her Doctorate in Nursing with a specialization in Nursing Leadership. i

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. Please send submissions to editor@texasnurses.org.

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Nurse Advocacy

If not YOU, who?

By James R. Hilliard, MSN, BSN, RN

THE ONLY CONSTANT IN NURSING IS CHANGE. As an assistant professor of nursing in the College of Nursing at Concordia University Texas, I drive this point home to students every semester. I’ve taught the Foundations course and spent time looking at the four roles of nursing as defined in the Differentiated Essential Competencies (DECs) of Graduates of Texas Nursing Programs under the Texas Board of Nursing. One of those roles is member of the profession.

RESPONSIBILITY TO THE PROFESSION Every nurse, as a member of the profession, has a responsibility to the profession. The DEC says “nurses must assume responsibility and accountability for the quality of nursing care provided to patients, families, populations, and communities.” It states that one of the ways nurses accomplish this is through the legislative advocacy process. Change will occur, and each nurse must be a part of that process and move the profession forward.

The IOM Report 2010: The Future of Nursing addresses three areas where nursing needs to change. A key area is advancing nursing leadership. Strong leadership is necessary in effecting change and that includes all nurses. Every nurse, from student to CNO, must be engaged

I encourage nurses to visit their elected representatives for several reasons: as experts regarding the nursing profession, as advocates for quality health care delivery, and to ensure their representatives know them and identify them as a goto source for information regarding legislation. in the profession to lead change and advance health care through legislative advocacy.

This is a call for all nurses in Texas to step up to the responsibility of being part of the profession of nursing and leading it into the future.

By joining a professional organization like Texas Nurses Association (TNA), you have taken the first step in being an advocate for the nursing profession. Professional

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nursing organizations seek to further the field by advocating for the profession.

TNA takes the lead in working to maintain control and oversight of the profession, represent the interest of the nurse, and protect the public interest.

Nurses are becoming more politically sophisticated and are able to increase the influence of nursing on legislation and practice, affecting policy decisions at every level.

State Representative Donna Howard (District 48 – Austin), a nurse who was elected to the state legislature in 2006, says “I encourage nurses to visit their elected representatives for several reasons: as experts regarding the nursing profession, as advocates for quality health care delivery, and to ensure their representatives know them and identify them as a go-to source for information regarding legislation.”

TNA has been a leader in advancing nursing through policy, keeping the best interest of nurses in the forefront and having a presence working with the legislature to pass bills that impact

nursing practice. TNA’s website provides a primer to becoming a legislative advocate in Student Policy 101 (www.texas nurses.org/students), and nurses can get involved in several ways.

TNA NURSE DAY AT THE CAPITOL During each session, TNA holds Nurse Day at the Capitol. This is a dynamic opportunity to have that presence as a member of the profession and advocate for bills being considered that impact nursing. Nurses go into the Capitol and meet with their legislators to talk about these bills and how they impact nursing and health care in Texas.

State Representative John Cyrier (District 17 – Bastrop) says, “As with all advocates, I feel that professionals from these different fields bring a unique perspective and are often a great resource on the subject.” He added, “Successful advocacy can bring about change in health care.”

ADVOCATE FOR NURSING Take the next step to increase your involvement through TNA: Become active in a district. TNA districts across the state meet and study the profession and where it is headed.

Contribute to TNA policy and government affairs committees. TNA’s Governmental Affairs Committee (GAC) is very active, especially during legislative sessions. They have a presence at the Capitol with legislators, in committee hearings, and advocating for nursing.

Find out who your legislators are and meet them personally, such as through Nurse Day. An established relationship means legislators know they can call you to answer questions and learn how nurses feel about the issues.

Jordan Wilson, RN, BSN, RN-BC, a December 2014 graduate of Covenant School of Nursing in Lubbock was very active in the political and legislative process while in nursing school. Three years ago he was invited to be a part of TNA GAC. He said he had three goals: 1. For more nurses to see that, together, we can become a very powerful voice in politics.

2.

To influence new nurses to get involved early.

3.

To personally change health care for the better.

The Nursing Legislative Agenda Coalition (NLAC) (www.texasnurses.org/ NLAC), a coalition of nursing organizations around Texas that join together to advocate for shared nursing priorities during the Texas Legislature, is another very influential group when it comes to nursing’s future and legislation needed to advance practice in Texas.

Rep. Howard emphasizes that “Nurses definitely have an impact on legislation.” She says that nurses raised the issue of workplace violence with her, and she then pursued legislation to address the problem. Testimony provided by nurses regarding violence in the workplace was instrumental to passing the legislation. She says maintaining a dialogue with active nurses in the profession helps her form her recommendations to fellow legislators. She counts on nurses to be her partner in shepherding these bills through the legislative process.

The 86th Texas Legislature begins in January 2019. Be looking for opportunities to be engaged in moving nursing forward.

Attend Nurse Day at the Capitol and

Nurses definitely have an impact on legislation.

Testimony provided by nurses regarding violence in the workplace was instrumental to passing the legislation. make an effort to be part of that day of influence, where we advocate for legislation impacting nursing. I hope to see you there being that engaged member of the profession.

Rep. Howard says, “You never know what your own future holds—today’s nurse advocates may be tomorrow’s policymakers!” i

HELPING AT THE STATE AND LOCAL LEVELS There are two more ways you can help TNA at the state level while staying local:

Be a GARD Every active district has a Governmental Affairs Representatives – District (GARD) who is responsible for communicat-

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James R. Hilliard, MSN, BSN, RN, stands inside the Texas capitol during the 2017 Legislative Session.

ing local needs to the state Government Affairs Committee and TNA policy information back to nurses at the local level. GARDs attend GAC conference calls and are responsible for setting up an activity in their district, such as sharing advocacy information at the district meeting, arranging meetings with local legislators or hosting a Nurse PAC event.

Join the Capitol Corps If you are in the Austin area, consider joining the Capitol Corps. Decisions happen fast during the legislative session, and Capitol Corps members help TNA keep up with emerging and urgent needs. From testifying to disseminating handouts, members are called upon in short notice to get information to legislators.

If you are interested in being a GARD or joining the Capitol Corps, email governmentalaffairs@texasnurses.org.

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Local

Advocacy

RON RIGSBY PARK IN 1977, A 1-ACRE POCKET PARK in Austin was renamed Ron Rigsby Park after a neighbor who was killed in a military training accident. The residents at that time planted trees at each end of the park. But there were no improvements in the 30 years that followed. The park became a vacant lot plagued by illegal dumping, including ditching stolen cars in the creek bank.

As a neighbor, Ellen Martin, PhD, RN, CHPQ, CPPS, saw an opportunity to use community and local activism to create an accessible green space and improve mental wellbeing and quality of life.

The neighborhood association learned about Austin Parks Foundation grants and the garden club decided to take on the park as a community beautification project. As a neighbor, Ellen Martin, PhD, RN, CHPQ, CPPS, director of practice at Texas Nurses Association, saw an opportunity. Using community and local activism, they could create an accessible green space and improve mental well-being and quality of life for everyone in the neighborhood.

“I wanted to get involved because I could see the potential as a community gathering spot because of the central location of the park,” Martin says. “I was intrigued by the grant requirements for neighborhood involvement in collaboration with several city departments. The grant

Before

required matching funds and that could partially be met with volunteer labor.”

In May 2009, she attended a grant workshop and then met with a landscape architect from the city and a representative from the Austin Parks and Recreation department. The park had certain requirements. For example, playground equipment was not an option, but the city would supply trash cans that were emptied each week, a Mutt Mitt dispenser so people could pick up after their dogs, and a new park sign. They also installed a curb cut for wheelchair access.

The updates weren’t always straightforward.

“The park has a creek in the back, so any plans After we made had to involve sign-off by the Watershed Protection department,” Martin says. “We needed a water source to establish the new trees which required getting a permit. We had to hire an engineering firm and contractors to meet requirements. We wanted to also install a water fountain for people and dogs, but it was not approved by the city due to ongoing maintenance requirements.”

Martin and the group conducted a neighbor survey and found that neighbors wanted to preserve some of the openness of the park, continue to recognize Ron Rigsby, install places to sit, and create more shade and landscaping. They hand delivered fliers to 64 homes for a stakeholder meeting and held a design contest for landscaping.

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“In the end there was a tie and components of both designs were implemented,” Martin says. “Ultimately the real impact was the neighborhood engagement because 91 volunteers dedicated 267 work hours in the park, which doesn’t count the numerous meetings with city officials and trips to the permit office.”

The neighborhood celebrated the success of the project with a May Day picnic in the park to celebrate. Now, what used to be a vacant lot is used on a daily basis by neighbors. Seven years later, it remains an inviting place to walk dogs, have a picnic dinner with children, fly kites, and take family photos. i

FAITHFUL SERVICE ELIZABETH KIESLE, BSN, RN-BC, knew from the age of four that she wanted to be a nurse. “My father underwent coronary artery bypass grafting surgery and nearly died from complications afterwards. From the moment I saw his infected incision, I decided that when I grew up, I would become a nurse. At the age of 21, that dream was fulfilled!”

Kiesle dedicates much of her free time giving back to the community through Texas Nurses Association, Bell County Medical Reserve Corp (MRC), and a local soup kitchen, where her mom and brother also volunteered when she was young.

“In the last one to two years, I have become more involved with nursing advocacy and TNA as chair of the membership committee,” Kiesle says. She has already created a website for their local group, hoping to increase member involvement. “I attended the House of Delegates for TNA 2018, which energized me to promote the importance of nursing advocacy to my fellow nurses. I also attended and presented at the ANA national conference in Tampa, FL, in March 2017.”

Raised in the Central Texas countryside, Kiesle spent her childhood roaming the fields and hills, volunteering with 4-H and other organizations, and playing with various pets. She still loves to run and can frequently be found exercising with her dog around her neighborhood.

Kiesle’s motivation to volunteer in the community is also why she entered the nursing profession—a desire to help and make a difference in others’ lives. “After Hurricane Harvey, I saw the devastation both on the news and firsthand from stories of survivors who sought refuge in my community, which prompted me to join the MRC,” she says.

Elizabeth Kiesle, BSN, RN-BC, helps to pack to-go lunches at the Feed My Sheep soup kitchen, which serves around 100-150 homeless and disadvantaged people daily.

she explains.

There, Kiesle assists with supervising other volunteers. They typically serve 100-150 homeless and disadvantaged people daily.

“I believe that my greatest impact is the friendship and trust built over years of faithful service.” i

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Performing focused assessments, monitoring vital signs, documenting findings, and reporting to providers, Kiesle was able to use her nursing skills to help the community when they needed it most.

Join a team that is making a difference!

Performing focused assessments, monitoring vital signs, documenting findings, and reporting to providers, Kiesle was able to use her nursing skills to help the community when they needed it most.

Giving back to the community has presented a few challenges for Kiesle. Working 12-hour shifts at Baylor Scott and White Health in Temple, she adjusted her schedule and planned months ahead to request off certain days to attend volunteer activities. “For example, Feed My Sheep, the soup kitchen, is open daily for meals, so that afforded some flexibility with my variable work schedule,”

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The Bell County MRC is a group of trained volunteers, medical personnel, and non-medical staff available to respond to public health needs. Kiesle has served for around one year, attending monthly meetings and preparing to respond during a regional or state emergency. “I triaged patients at shelters in my county and worked with other medical teams following Hurricane Harvey, providing care to dozens of evacuees,” she says.

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The Road to Representation INTRODUCING THE NURSES IN OFFICE INITIATIVE

By Lolly Lockhart, PhD, RN

I HAVE BEEN IN NURSING for 60 years in a wide variety of roles and continue to work with Texas Nurses Association (TNA), the Board of Nursing, and other health-related organizations.

Even at a young age I was engaged in local politics, such as getting people out to vote for hospital bonds during high school and later testifying for and against legislative bills as requested by TNA. In 2010 I was the expert witness for Anne Mitchell, the RN in Winkler County who had criminal charges brought against her for reporting an incompetent physician to the Texas Medical Board. She was found “not guilty” and was vindicated for doing the right thing for patient safety, consistent with the law and the Code of Ethics for Nurses.

As TNA staff for several years in the 1960s, I helped amend the Nursing Practice Act. I was actively engaged in campaigns for several candidates, including Rep. Lloyd Doggett’s first state run and win. In addition, while on the ANA Task Force, I helped develop the current statement on workplace violence.

NURSING REPRESENTATIVES NEEDED Looking at our current political landscape, I am concerned that we do not have nurses represented in leadership roles such as elected and appointed positions of authority. When I

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YOU CAN MAKE THE DIFFERENCE The profession needs nurses to run for school boards or other local elected offices. It might be the start of something big—the Legislature? Congress? saw Dr. Billye Brown for her 91st birthday, she insisted I read a book by her student Brenda Cleary: Women In Politics.

I could not put it down.

Thinking of how Representative Donna Howard started on the local school board, I realized that was the way to go: Get early and mid-career nurses to run for school boards or other local elected offices. In a few years, they would be ready for the Legislature, and in a few more years, for Governor or Congress. I already know of three TNA members planning to run in 2020 or sooner.

Getting more nurses ready to run would require a concerted campaign. So, I started strategizing with Kevin Stewart, Texas School Nurses Organization general counsel, and Ellen Martin, TNA director of practice.

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We invite all of you to think about how you can improve your community by serving on a school board or other local avenues.

Help make nurse voices heard and use your expertise to create a healthier Texas.

We know nurses tend to underestimate what we can do, in spite of how much we are respected. So, our goal became to offer specific encouragement and support to help nurses get into office.

Running for elected office is not something with which many nurses are familiar. They also may not have the time and resources to run a campaign.

RESOURCES TO RUN To help nurses get started, TNA is helping to produce various resources for nurses

who are interested in running or finding a nurse to run for their local school board, city council, or other elected office. In the coming months, there will be many opportunities to share experiences and to learn about the various aspects of running for office as well as school board functions and processes.

MAKE A LOCAL IMPACT With this issue of Texas Nursing, we launch the Nurses in Office initiative. We invite all of you to think about how you

"As a registered nurse and a member of the Texas House of Representatives, I use the nursing process daily to analyze complex public policy issues. The nursing process is a great framework for solving complex problems. Nurses are experts in solving problems. We need more problem solvers running for office."

— Representative Stephanie Klick

can improve your community by serving on a school board or other local avenues. Help make nurse voices heard and use your expertise to create a healthier Texas. Visit texasnurses.org/nursesinoffice to learn more. i

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State

Advocacy "I am impressed with how quickly our students develop their clarity of purpose and learn how our presence can influence the legislative process." awareness of their responsibilities to advocate for their patients. However, she also knows students require mentorship and exposure to the legislative process.

“I am impressed with how quickly our students develop their clarity of purpose and learn how nurses' presence can influence the legislative process,” Lowe says. “I am grateful for their contribution. I proudly recognize them as outstanding colleagues who advocate for our profession and the safe, effective care of Texans.”

STUDENTS AND FACULTY AT NURSES DAY “Tell me and I forget. Teach me and I remember.

Involve me and I learn.” —BENJAMIN FRANKLIN ANITA LOWE, MSN, RN, clinical instructor for the University of Texas at Tyler, employs the philosophy of Benjamin Franklin in teaching and encouraging students to attend Nurse Day at the Capitol: “Tell me and I forget. Teach me and I remember. Involve me and I learn.”

STUDENTS AT NURSE DAY Lowe is the district president-elect for the Texas Nurses Association (TNA) District 19 and serves on the Governmental Affairs

Committee for TNA. In 2015 and 2017, she accompanied around 35 students to Nurse Day events.

“I recognize the opportunity that Nurse Day presents, impacting our future advocates,” Lowe says. “As an educator, I believe it is our responsibility to encourage nursing students to find their professional voice and recognize their role to serve our profession.”

Lowe has seen many students enter school with an altruistic spirit and an

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STUDENT REACTIONS The student attendees shared their thoughts about the experience.

Taylor Dotson, BSN, RN, TNSA State President, 2016-2017: It was an experience I couldn’t have had in any other part of my education. The advocacy felt very grassroots: straightforward conversations with representatives on what support nurses need to improve the community.

The energy was buzzing and targeted towards cultivating a presence that nursing requires.

Blake Williams, BSN, RN, NSNA Chapter President, 2014-2015: Attending was an important and influential experience for me. It showed me the overwhelming impact nurses have in helping shape health policy decisions that influence the way that health care is delivered.

Kelsey Spelce, BSN, RN, NSNA Chapter President, 2016-2017: Nurse Day was a career-changing experience for me.

The interactions and observations that day proved nurses have input and can affect how we care for our patients. Patient advocacy is an ongoing process, and Nurse Day encouraged me to play an active role.

Advance to the Next Level

Nurse Day was a careerchanging experience for me. The interactions and observations that day proved nurses have input and can affect how we care for our patients. Patient advocacy is an ongoing process, and Nurse Day encouraged me to play an active role.

Jazzlyn Lawson, BSN, RN: My experience at the capitol was one to remember!

Being in the presence of APRN’s—hearing and seeing them advocate for their practice—was so empowering. The highlight was sitting down with Representative Stephanie Klick to discuss full practice authority for APRNs. Allison Werline, BSN, RN: As nurses, we spend a lot of time advocating for our patients, so it shouldn’t be surprising that we would advocate for ourselves and the profession. The legislators wanted to know what we thought, so we could educate them and offer perspectives on the issues they were voting on.

Alyssa Phillips, BSN, RN: As a student nurse, I frequently felt my opinions on nursing issues weren’t as influential as a seasoned nurse’s. Until I attended Nurse Day. My voice was heard loud and clear as we shared our thoughts with our representatives. The experience showed me my own ability to make a difference.

EMPOWER A STUDENT Nurse educators and mentors: The future of the profession depends on us to encourage our student nurses to get involved. Collectively, we have a tremendous impact on the issues and legislation that affect our profession. Our legislators depend on our expertise. Nurse Day at the Capitol is the spark that can ignite the passion of advocacy early in the career of our next generation of nurses. Visit the website to learn more about the influence you and your students can have. i

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S U M M E R 2 018 | T E X A S N U R S I N G M AGA Z I N E

ABLE to help

IMPLEMENTING THE ABLE ACT IN TEXAS “WHEN I THINK BACK on my personal as well as professional journey, I would have to say I have been advocating my whole life.”

Sharon Hornfischer, MSN, RN, has 30 years experience as a nurse, working primarily in large urban emergency departments. She credits her family for her drive and passion for advocacy.

“I was raised in a family of educators and school administrators, where their leadership encouraged and supported equal educational opportunities for all. If being raised in this environment was not enough to make me an advocate, I was born alongside a twin sister with Down’s Syndrome. Looking out for her and others with special challenges is just very ingrained in my core.”

During her graduate studies, Hornfischer learned about The Achieving A Better Life Experience (ABLE) Act, signed into law

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WHAT IS TEXAS ABLE? ABLE programs permit individuals and families to save and pay for disability-related expenses to maintain an eligible individual’s health, independence and quality of life.

by President Obama in December of 2014. ABLE programs permit individuals and families to save and pay for disabilityrelated expenses to maintain an eligible individual’s health, independence and quality of life. Individual states were directed to explore implementation on state levels.

The act piqued her interest, so she pursued an interview with Linda Fernandez, director of educational opportunities and investment opportunities at the Texas Comptroller’s Office, the state

PAGE 16

I felt this was an opportunity to proactively contribute my decades of personal and professional experience to historic legislation impacting the lives of thousands of Texans. to learn the legislative process regarding the state implementation of federal law. She researched the history of disability laws in the United States and the personal struggles for rights of the people with disabilities throughout the years. She also had to learn both sides of the issues, as people, activists, and lobbyists fight for their own causes and professions that might be in conflict with ABLE’s passage.

“This research took me back decades to learn about grassroot efforts held around kitchen tables across the country, within individual families, local leadership and advocacy groups that formed to give a voice regarding the lack of opportunities for this population of our citizens,” Hornfischer says. office directed to further explore implementation of ABLE in Texas.

“The Comptroller’s Office was very informative on the legislative process for ABLE within Texas. She made me aware of the Legislature’s directive for an appointed advisory board to aid in implementation of ABLE. I felt this was an opportunity to proactively contribute my decades of personal and professional experience to historic legislation impacting the lives of thousands of Texans.”

Her work paid off and TexasABLE opened enrollment in the spring of 2018 statewide. She says, “I am very proud to be a part of this historic legislation for thousands of Texans.” i

The Texas Nursing Practice Act provides nurses with the authority to practice, but the legalese can be challenging to understand.

Hornfischer submitted her interest in board membership and was appointed by Texas Comptroller Glen Hegar. “I guess I would have to say I found myself in the right place at the right time,” she says. “The professional and personal catalyst that placed me in the position to advocate for a cause I feel so strongly about just seemed meant to be.”

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PAGE 17

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TOP: Texas nurses gather on the steps of the Texas State House Chamber during 2017 Nurse Day at the Capitol.

BOTTOM: State Representative Donna Howard poses with Texas nurses attending 2017 Nurse Day at the Capitol. From left: Anita Lowe, Anthe Caruso, Karen Koerber-Timmons.

February 18 – 19, 2019 LOOK INTO THE FUTURE, and see yourself among hundreds of Texas nurses improving the health of Texans.

JOIN US! Join the Texas Nurses Association and organizations in the Nursing Legislative Agenda Coalition to talk with legislators about needed policy that shapes the Texas Nursing Practice Act, impacts nurses’ workplaces, and creates an environment where nurses provide the best care to Texans. Nurses affect the health of their family, friends, and fellow Texans every day.

Who better to educate policy makers on what is needed than nurses? It’s been 20 years since the first Nurse Day at the Capitol, March 3, 1999, so let’s make it the biggest and best yet!

2019 ACTIVITIES Day 1 will provide education, motivation, and tools to ensure all attendees have successful visits with their home-

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town Senators and Representatives and their staff when they visit the Texas State Capitol on Day 2.

MAKE YOUR PLANS Consider joining with colleagues from your local area to bring a bus or van to Austin for this event. You can use the travel time to strategize, network, and make plans for how to support the policies locally. If you’re interested in coordinating a group from your area to attend, TNA will help you find the appropriate transportation and promote the opportunity to nurses in your area.

REGISTER TODAY Registration and hotel details can be found at texasnurses.org. i

Advocacy Scholarships Available Texas Nurses Foundation has been granted two $1,000 scholarships through the American Nurses Foundation Advocacy Scholarship Program, made possible by the generosity of Fresenius Kabi. This scholarship recognizes nurses’ exemplary advocacy efforts, whether at the bedside speaking up for a patient, in the community working to create a healthier environment, or at the state level speaking to policy makers about the legislation.

Scholarships of $1,000 each will be awarded to two Texas registered nurses who are pursuing a nursing degree: BSN, MSN, DNP, or PhD. Scholarships will be awarded October 2018.

Email tna@texasnurses.org for more information.

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National

Advocacy HEALTH ADVOCACY STUDENT COALITION KELSEY MUMFORD, a senior in the Bachelor of Science in Nursing honors program at The University of Texas at Austin (UT), was unhappy with her ability to get involved in health policy and advocacy.

After trying Student Government, the Student Health Advisory Committee, and even creating a Health Policy Committee in the UT Nursing Students Association, Mumford realized she needed to build and promote advocacy opportunities herself.

In March of 2017, Mumford became the first undergraduate nursing student to win the National Student Grassroots Ambassador Prize at the American Association of Colleges of Nursing Student Policy Summit. The prize funded her proposal to create a grassroots advocacy campaign in support of Texas House Bill 1938, which aimed to create a statewide opt-out organ donation policy system.

“What began as a crazy idea has now expanded to a seven-student research team and four-student editing team who send health policy newsletters to over 500 students around the nation,” Mumford says. “We also have a sevenstudent advocacy team that organizes legislator calling sessions, marches to the Capitol, and more for the over 2,500 student members of our partner organizations.”

Originally from Lago Vista in Central Texas, Mumford is an active tennis player and was part of UT cheerleading for two years. She currently studies the relationship between design, policy, and health, such as investigating user experiences in a health library for patients with varying needs.

“It was difficult to start the first advocacy

Mumford started the Health Advocacy Student Coalition (HASC) at UT to expand into other policy areas. The idea quickly grew. campaign without having any campus partners,” Mumford says. A simple Facebook event for an information session on the opt-out organ donation policy brought out more students than the tiny meeting room could fit. “It was difficult to manage this group of students by myself. I quickly appointed others to leadership positions within the group and relied on their unique strengths and varying backgrounds to effectively run the campaign.”

Now that she had a dedicated group of students from the organ donation campaign, Mumford started the Health Advocacy Student Coalition (HASC) at UT to expand into other policy areas. The idea quickly grew. “I presented a poster about the coalition at the 2017 National Student Nurses Association MidYear Planning Conference in San Diego, CA, and received interest from students at universities across the United States.”

The coalition now has university branches in New York, Virginia, and California and is working to partner with national health organizations in the near future.

“Creating HASC has enabled me to empower students I have never met and taught me how to excite others about rethinking the current system,” Mumford says. “I have learned so much through this experience—communication, team-

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Kelsey Mumford (center) at the Texas Capitol with Representative Jason Villalba (center right) and other UT students during the 2017 Day at the Capitol to support the opt-out organ donation bill.

work, adaptability—and I became even more passionate about bringing together groups from different backgrounds to discuss the policies that will affect their future. I believe that interprofessional collaboration will be key to rethinking the way that care is delivered, and this experience has uniquely prepared me to facilitate that.”

In the Fall, Mumford will serve on the Board of Directors for the National Student Nurses Association as chair of the Ethics and Governance Committee and on the Health Policy and Advocacy and Population and Global Health Committees. i

E

TAK

NATIONAL DISASTER MEDICAL SYSTEM

By Jane Le Vieux

“Advocating for patients during a disaster is an honor and a privilege.”

AS A MEMBER of the National Disaster Medical System, Jane Le Vieux, PhD, RN-BC, LPC-S, NHDP-BC, is part of a first line of care during disasters and major national events. “We deploy to assist during emergencies, providing expert care and services in conditions that are often severe and challenging.”

NDMS includes specially trained physicians, registered nurses, paramedics, and other medical and support professionals.

Nurses like Le Vieux provide patients with both medical and psychosocial care to help them cope with the aftermath of traumatic incidents. NDMS members work closely with the community and first responders to coordinate care.

“Volunteering and working in the community was role modeled for me by my family and education,” Le Vieux says. “When the opportunity to join NDMS presented itself, I took it. The chance to work in conjunction with local fire, police, and emergency medical services to provide comprehensive disaster relief through appropriation of effective resources was very appealing.” Her interest in trauma, moral distress, and mental health continued on page 22

In Puerto Rico, Jane Le Vieux prepares to go to her assignment at the trauma center working with people living in shelter tents.

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continued from page 21 made NDMS a natural fit.

In 2017, Hurricanes Harvey, Irma, and Maria made landfall within one month, affecting the southwest United States and Puerto Rico. Le Vieux was deployed to Houston for two weeks and then San Juan, Puerto Rico, for 30 days.

“Before going to San Juan, we flew to Atlanta for debriefings and training. The Incident Response Coordination Team was working on the logistics of getting to San Juan since the airport was severely damaged and there were significant power outages. In Puerto Rico, many of the hospitals were without power, and roads and highways were blocked, limiting the ability to transport patients.”

Even with the numerous challenges, Le Vieux and other NDMS members were

able to help decompress the emergency room at the trauma center and see patients from many communities.

When she’s not working on national disasters, Le Vieux is a clinical nurse manager at Children’s Health, part of Children’s Medical Center Dallas. She has been a pediatric nurse for more than 30 years. She says, “I’m really grateful to Children’s Health for the opportunity to deploy when disaster strikes. I can leave, and I know that my team will be okay.”

Her national advocacy has given her the chance to be part of something bigger than herself and give back on a different level. Le Vieux says, “You see people who need you, and they’re so happy and grateful that you are there.” i

JOIN US FOR ANA HILL DAY IN 2019 EACH YEAR, ANA Hill Day provides a chance for nurses to discuss key issues — such as safe staffing, workforce development, and opioid addiction treatment — with federal lawmakers. In 2018, around 300 nurses from 45 states came together to meet members of Congress and staff on Capitol Hill. Search #ANAHillDay on Twitter to see lots of photos.

Join us in June 2019 for the next ANA Hill Day. Advocate for your profession on Capitol Hill! i

Nurses from Texas traveled to Washington, D.C., to meet with federal legislators in June 2018.

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PAGE 22

Global

Advocacy LEADING A PARTNERSHIP IN THE WEST INDIES “THE BEST WAY TO FIND YOURSELF is to lose yourself in the service of others.”

Jamie Langston, BSN, RN, CCRP, believes nursing exemplifies these words of Mahatma Gandhi. “I am proud to be able to serve the world as a nurse,” she says.

As chief research officer of Life Seasons, Inc., an International Nutraceutical Company based in Lewisville, TX, Langston traveled with CEO Darrin Peterson to St. George’s University (SGU) in Grenada.

Peterson’s company assists in the financing of South Sudanese medical student education. The first students received their white coats in a special ceremony held on the campus at SGU. Langston reviewed the medical needs of the island and was surprised to see a high incidence of chronic illness in Grenada.

“We formed a partnership to study the effectiveness of a nutraceutical product for the treatment of metabolic syndrome to prevent progression to diabetes,” Langston says. On her second visit to Grenada to review data and provide oversight for the study, she met Jennifer Solomon, RN, BSN, PhD, Dean of Nursing.

Langston learned there were multiple opportunities to help future nurses in the West Indies. “I have found that wherever I go in the world, nurses speak a certain love language unique to them,” Langston says. “They are a smart, determined group that blesses the world around them with compassionate action.”

Langston recruited a nursing partner and friend, Kelly Parker, RN, BSN, OCN, an oncology nurse manager for Texas Oncology. Together, they prepared and taught six units at SGU School of Nursing.

Jamie Langston RN, BSN, CCRP, Chief Research Officer for LifeSeasons, Inc., (left) and Kelly Parker, RN, BSN, Nurse Manager for Texas Oncology, in Grenada where they taught courses for BSN students.

I have found that wherever I go in the world, nurses speak a certain love language unique to them.

They also visited the hospital and taught an onsite in-service. Parker was able to share policy and procedural expertise with the new and only oncology nurse at the hospital.

Langston also reviewed resources and research for a palliative care program with oversight by Grenadian nurses. Due to an MD shortage on the island, and restrictions on medical student residencies, home visits are all done by nurses.

The research nurses currently participating in the LifeSeasons Research Project are highly skilled. They have agreed

PAGE 23

to mentor student nurses during the research project to model in-home assessment skills.

Dean Solomon organized the first palliative care meeting, recruiting pain management and palliative care specialists as well as local visiting nursing directors.

The first meeting established goals and cooperation between team members.

Langston says, “Our hope is that this multi-year project will create overreaching change in how the terminally ill are supported in the West Indies.” i

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