Fay W. Whitney School of Nursing Alumni Newsletter 2022

As we prepare for another year of educating the next generation of nurses, we are excited to share with you the latest accomplishments of our faculty, staff, and students. Despite the challenges presented by the pandemic, our School has been able to continue to provide educational services to benefit our students and our communities. It is no wonder that the National League for Nursing has declared 2022 the Year of the Nurse Educator. Our frontline nurses, like many of you, have deservedly been hailed as heroes who have fought in the more than two year battle against COVID-19. While less visible, our nurse educators here at the Fay W. Whitney School of Nursing have also gone above and beyond to ensure we are continuing to provide the next generation of nurses to meet our state’s workforce needs. We celebrate all their accomplishments and share some of them with you here.

And, as we move into the next academic year, we also share with you the new faculty and staff here at the University of Wyoming. On July 1st, Dr. Jacob Warren joined the university as our new Dean of the College of Health Sciences. Dean Warren comes to us from Georgia with a strong background in higher education, especially rural health. Within our own school, the last year has seen us welcome several new faculty and staff. In terms of staff, we have three UW alumni have joined us recently— Tabassum Mustary as our new Business Manager, Joanna Malmstrom as our inaugural Clinical Placement Coordinator, and Maureen King our pre-licensure academic advisor. In addition, we are excited to welcome faculty including a new tenure track faculty member, Dr. Jennifer Stephens, who comes to us from Athabasca University in Canada, although she has roots here in Wyoming. And, we also welcome Carrie Barr who will be our new BSN Director, who joins us after developing a program at Alaska Pacific University. Other new faculty include two new Lecturers—Dr. Jessica Bartlett who joins us to support our BRAND students and Dr. Shirley Boggs who will primarily be supporting our undergraduate students on campus. See more about their stories as you enjoy this year’s edition.

The disruptions of the last two years have required all of us to be both creative and resilient. We appreciate all of you and your strength in continuing to serve during these unprecedented times. And, thank you for also helping us to celebrate our nurse educators, because behind every great nurse is a great nursing instructor—and we have the best here at UW. Go Pokes!

Dean and Professor

Sherrill J. Smith, RN, PhD, CNL, CNE

Sherrill J. Smith RN, PhD, CNL, CNE Colonel, USAFR, NC (Ret)

Caleb Haack and Hannah Hansen of the BRAND program pictured with Lotta Veins (one of our simulation mannequins)

Kimberly Denningmann a Graduate Assistant with the School of Nursing. She was teaching a class of our BRAND students how to give injections.

EXCELLENCE IN NURSING EDUCATION UNDERSTANDING AND ADDRESSING DIABETES PREVENTION IN WYOMING

The overall goal of my research program is to promote health behavior change and address health disparities for individuals in culturally, ethnically, or racially distinct groups. My particular research interests include risk perception and communication related to type 2 diabetes prevention, health disparities associated with type 2 diabetes risk among individuals in rural areas, and increasing access to the National Diabetes Prevention Program (DPP).

Type 2 diabetes is a significant public health problem in the United States, with 10.5% of the population diagnosed and over 34.5% of adults at increased risk (Centers for Disease Control and Prevention [CDC], 2020). In addition, approximately 5-10% of at-risk individuals will develop type 2 diabetes without lifestyle modifications (Tabak et al., 2012). As such, type 2 diabetes prevention is an important public health concern and requires innovative approaches to prevention intervention delivery. Diabetes prevention is especially important in rural areas because of higher rates of obesity and limited access to risk reduction resources (Rural Health Information Hub, 2022). Although

the prevalence of type 2 diabetes in Wyoming (9%) is lower than the national average (10.5%), rates are rising (Wyoming Department of Health, 2021). In Wyoming, type 2 diabetes increased from 3.7% in 1994 to 7.8% in 2014 and to 8.3% in 2016 (CDC, 2018a; Wyoming Department of Health, 2018). Contributing to the increase in type 2 diabetes diagnoses is the estimation that 35.2% of adults in Wyoming have prediabetes; that is, increased risk due to higher than normal blood glucose levels (CDC, 2018b). Increasing access and support for the DPP in Wyoming is important for decreasing the rising rates of type 2 diabetes. Research examining the impact of the DPP indicates that people at-risk for type 2 diabetes who reduce their body weight (5-7%) by making modest changes, reduce their risk of developing the disease by about 58% (DPP Research Group, 2009).

Through my research on understanding perceptions of type 2 diabetes risk, I learned about the barriers to and facilitators of risk reduction activities. To address both as well as move my research forward, I focused on programming and intervention work and embarked upon two projects. The goal of the first project was to create

Rael Otuya, from Kenya, at the ACRES student-ran farm on campus. Rael is studying agroecokogy and sustainable agriculture in the College of Agriculture and Natural Resources. After college she hopes to travel back to her home in Kenya and help farmers there take up sustainable practices and provide more food with less resources to their people.

Christie Wildcat, a Northern Arapaho student from Riverton, WY, is a cross-country runner and works out with teammates in the High Altitude Performance Facility.

a student facilitator training program and learn about at-risk individual acceptance of students as facilitators. In collaboration with Bhibha Das PhD (East Carolina University) and members of my student research team (Strategies for Risk Reduction Lab), we created and implemented the training program and conducted focus groups with at-risk individuals. We presented this work at the Society of Behavioral Medicine Annual meeting (April 2022) and Fay W. Whitney School of Nursing Research and Scholarship Day (April 2022). We are currently working on a manuscript for publication and a conference abstract. The goal of the second project was to learn more about diabetes prevention in Wyoming and understand ways to address limited access to prevention programs. Through a collaboration with the Wyoming Department of Health, University of Wyoming College of Health Sciences, and Maggie Kougl of the UW Wyoming Center on Aging (regional coordinator), we developed a university-based DPP which began in February 2022. In addition, we met with state and university stakeholders to share ideas about current and future prevention programming collaborations. Our DPP sessions are currently in progress.

University of Wyoming students, staff, and faculty were invited to join the DPP. Maggie Kougl and I, both certified DPP lifestyle coaches, facilitate group sessions where participants learn the skills needed to reduce their risk, such as losing a modest amount of weight through changes to activity levels and nutrition. Participants in the program learn how to eat healthy, add physical activity to their routine, manage stress, stay motivated, and solve problems that can affect their lifestyle change efforts. The

Jenifer Thomas, PhD

group format provides a supportive environment for individuals who are facing similar challenges and trying to make the same changes. Participants receive encouragement from the lifestyle coaches and each other. The DPP meets for one year; weekly for the first six months, then once a month for the second six months.

For the UW DPP, we plan to present or publish our experience conducting the program on a rural university campus as well as expand our programming to the community. In addition, a Doctor of Nursing Practice (DNP) student is conducting their quality improvement project with our DPP (fall 2022-spring 2023). The project goal is to implement and evaluate strategies, such as motivational tools, reminders, or social interactions, that improve participant engagement during the final six months of the program. This is especially important due to the reduced number of group meetings and contact with fellow group members. Finally, we expect our program to achieve

recognition, which will allow us

programming, and are exploring the ways in which UW can serve as a support network for DPPs throughout the state. We are enthusiastic about our current DPP and optimistic about the future of DPPs in Wyoming.

Rural Health Information Hub. (2022). Why diabetes is a concern for rural communities. Retrieved from https://www.ruralhealthinfo.org/toolkits/ diabetes/1/rural-concerns

Tabak, A., Herder, C., Rathmann, W., Brunner, E., & Kivimaki, M. (2012). Prediabetes: A high risk state for diabetes development. Lancet, 379, 2279-229 0.

Wyoming Department of Health. (2018). Wyoming behavior risk factor surveillance system, 2016 data. Retrieved from https://health.wyo.gov/publichealth/ chronic-disease-and-maternal-child-health-epidemiology-unit/ wyoming-behavior-risk-factor-surveillance-system-2/brfss-data2/2016-data/

Research Group. (2009). 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet, 374, 1677-1686.

Wyoming Department of Health. (2021). Chronic disease prevention program: Wyoming statistics. Retrieved from https://health.wyo.gov/publichealth/ prevention/chronicdisease/data/

EXCELLENCE IN NURSING EDUCATION BUILDING A PROGRAM OF RESEARCH

American Indians/Alaska Natives (AIANs) suffer from many health disparities including type 2 diabetes and decreased access to health care. Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects all women across all ethnicities with a prevalence of roughly 10-15%. Various hormone imbalances cause women with PCOS to have both fertility issues and an increased risk for type 2 diabetes. Researchers have demonstrated that PCOS symptoms and the symptoms that matter most to women with PCOS vary across ethnicities. Unfortunately, knowledge about PCOS in AIANs is very limited. My main research work in the FWWSON focuses on understanding PCOS in AIANs. I have conducted two recent studies examining the following: 1) symptoms and problems from PCOS in AIANs, and 2) prevalence of PCOS in AIAN women. My results indicated that women AIAN women suffer from many of the common problems of PCOS with weight management a main issue of concern. The study participants also indicated they would

information about PCOS, more

about PCOS, and, finally, they would like

diagnosed sooner. These results are helping me to continue to

R., Kooienga, S., Gilman-Kehrer,

& Alvero, R.

Rebecca Carron, PhD, RN, NP-C

Views along the Wind River Canyon in central Wyoming. The Wind River cuts through the expansive canyon as it meanders through the Wind River Indian Reservation and Hot Springs County.

James Trosper is Northern Arapaho and Eastern Shoshone. He is a descendant of Chief Washakie and Chief Friday. Trosper is director of UW’s High Plains American Indian Research Institute (HPAIRI), promoting positive and productive relationships between UW and regional Native American communities.

EXCELLENCE IN NURSING EDUCATION PARTNERING FOR SUCCESS

The future of nursing education is the Academic Practice Partnership. The University of Wyoming has a collaborative Academic Practice Partnership with Cheyenne Regional Medical Center. This role is an important mechanism to strengthen nursing practice. This role facilitates evidence-based practices, addresses current trends in nursing education and the future needs of the nursing workforce in real time, and streamlines clinical education and academic progression. Working with both the University and CRMC allows us to see nursing needs from academia to the transition to professional practice and beyond with continuing education for licensed nurses. Over the last two years a valuable and mutually beneficial relationship has been established.

As we emerge from COVID-19, the nursing workforce needs for are very complex. We continue to work on increasing the staff at CRMC to 80% Bachelor prepared nurses through encouragement of the nurse residents to continue or enroll in the ReNEW BSN

completion program at UW. This work continues despite ongoing nursing staffing difficulties encountered during the pandemic. Following the pandemic pause on the Accelerated BSN or BRAND program through UW, the program began a new cohort this fall with new clinical placement at Cheyenne Regional. We continue to recruit new and interested educators and faculty members to continue their education in the UW MSN program to educate the next generation of nurses needed to fill the gaps in nursing caused by an increasing number of patients, significant amounts of nurse retirement and employment shifts from the pandemic. There is a continued effort in partnership with both institutions to improve clinical education at CRMC and to prepare a workforce for the demands of the profession while off-loading the demands of the current nursing staff to decrease staff burnout.

At Cheyenne Regional Medical Center, having a research faculty promotes scholarship. At the time of this article, I have done consultations with five CRMC staff, both

Niki Eisenmann PhD, RN Clinical Assistant Professor Fay W. Whitney School of Nursing Academic Practice Partner Cheyenne Regional Medical Center

nursing and interprofessional staff to publish work in peer-reviewed journals. I am hopeful that as in-person conferences are coming back to have nurses and our residency projects represent CRMC and present their work to their colleagues on a national level.

Part of a successful academic practice partnership is working with the transition to practice of new graduate nurses through the nurse residency program. Understanding and using evidence to support practice is an important skill of all nurses, and all nurse residents are required to do a project asking a practice question and evaluating current literature related to the question. I work closely with the nurse residents to assist with their projects and some residency projects go further than presenting to stakeholders on their unit. One recent project started by nurse residents went to full implementation. Instead of assessment of pain using a severity scale (0-10), the use of a functional pain scale was explored. Further research was done regarding patient and

nurse satisfaction and with positive results, a pilot of the assessment scale was done on one nursing unit at CRMC. With positive outcomes of nursing staff in using the new pain assessment, the new pain scale was adopted to the whole hospital this summer.

Working to implement evidence-based practices is done with the help of the staff nurses who after successfully piloting the pain assessment scale, taught all the courses as the assessment was implemented hospital wide. Quality improvement and implementation of best practices are components of evidence-based practice facilitated by the academic practice partnership. There are other projects in various stages of research and implementation, including rounding best practices, fall prevention practices, and work with the electronic health record.

GRANTS AND FUNDING

Carron, R., Gilman-Kehrer, E., & Alvero, R. A Pilot Management Program for American Indian/Alaska Native Women with Polycystic Ovary Syndrome. Mountain West Clinical and Translational Research Grant (5U54GM104944-08), PI, $59,950, 2020-2022 (Completed).

Carron, R. (PI), Gilman-Kehrer, E., & Alvero, R, Sharon S. Humenick Enrichment Fund, Fay W. Whitney School of Nursing, University of Wyoming. An Institutional ethnographic analysis of online open support groups for women with polycystic ovary syndrome, PI, $5,000.00, 2019-2022 (Funded). Carron, R. (2020). Health disparities in American Indians/Alaska Natives: Implications for nurse practitioners. The Nurse Practitioner, 45(6), 26-32. DOI: 10.1097/01.NPR.0000666188.79797.a7

PUBLICATIONS

Carron, R. (2022). Using community-based participatory research to improve care for American Indians/Alaska Natives with type 2 diabetes mellitus. The Nurse Practitioner, 47(6), 10-19.

Carron, R. (2020). Health disparities in American Indians/Alaska Natives: Implications for nurse practitioners. The Nurse Practitioner, 45(6), 26-32. DOI: 10.1097/01.NPR.0000666188.79797.a7

Carron, R. Kooienga, S., Gilman-Kehrer, E., Alvero, R., & Boyle, D. K. (2019). Using the medicine wheel to study polycystic ovary syndrome in American Indian women. Research and Theory for Nursing Practice: An International Journal, 33(3), 246-256. http://dx.doi.org/10.1891/1541.6577.33.3.246.

PUBLICATIONS

Eisenmann, N. (2021). An innovative clinical concept map to promote clinical judgment in nursing students. Journal of Nursing Education, 60 (3).

Eisenmann N. (2020). Differences between licensed healthcare providers with substance use related licensure discipline. Substance Use & Misuse.

PRESENTATIONS

Differences between Licensed Healthcare Providers with substance use related licensure discipline. 2020. AACN innovations conference. Dec 2021 “An innovative clinical concept map to enhance clinical judgment”

PUBLICATIONS

Kyle, E.M., Miller, H. B., Schueler, J., Clinton, M., Alexander, B. M., Hart, A.M., & Larson-Meyer, D.E. (2022). Changes in Bone Mineral Density and Serum Lipids across the First Postpartum Year: Effect of Aerobic Fitness and Physical Activity. Nutrients, 14(3), 703. https://doi.org/10.3390/nu14030703

Hart, A.M. & Burman, M.E. (2023). Primary Care. In P.D. Larsen (Ed.). Lubkin’s Chronic illness care: Impact and intervention (11th ed., pp. 409-458). Jones & Bartlett.

PRESENTATIONS

Rugen, K.W., Hart, A.M., & Holzemer, W. (2021, July 27) How to use evaluation data to support your program’s value. National Nurse Practitioner Residency and Fellowship Training Consortium 4th Annual Conference. Virtual.

AWARDS

2020 Journal of Continuing Education in Nursing (JCEN) Innovation Award, 2021, Journal of Continuing Education in Nursing (JCEN)

Communication of Wisdom in Nursing Award, 2021, Fay W. Whitney School of Nursing

GRANTS AND FUNDING

Received, as Program Director/PI: HRSA grant Nurse Education, Practice, Quality, and Retention Interprofessional Collaborative Practice (NEPQR: Behavioral Health Integration Program). Award amount $1,500,000 over three years. Funding 7/1/2020 – 6/30/23

PUBLICATIONS

McGee NI, Proctor J, Hart AM, Burman M. Reconsidering Benzodiazepines and Z-drug Prescriptions: Responsible Prescribing and Deprescribing. The Journal for Nurse Practitioners. 2021;17(1):76-83.

Burman M, McGee NI, Proctor J, Hart AM, Moody EJ, Hardesty CL. ECHO: A Model for Professional Development in Nursing through Learning Networks. The Journal of Continuing Education in Nursing. 2021.

GRANTS AND FUNDING

Received, Co-Investigator (McGee N. Program Director/PI): HRSA grant Nurse Education, Practice, Quality, and Retention Interprofessional Collaborative Practice (NEPQR: Behavioral Health Integration Program). Award amount $1,500,000 over three years. Funding 7/1/2020 – 6/30/23

PRESENTATIONS (Invited)

McGee, N. & Proctor, J. (2021). Behavioral Health Integration. Increasing Access to Care for Individuals with Depression and Substance Abuse Risk in a Rural Community. Power of Rural Healthcare Conference. Online, May 18. Podium Presentation.

PUBLICATIONS

McGee, N., Proctor, J., Hart, A.M., & Burman, M. 2020. Reconsidering Benzodiazepines and Z-drug Prescriptions: Responsible

Rebecca Carron, PhD, RN, NP-C

J’Laine Proctor, DNP, FNP, PMHNP

Nancy McGee, DNP, PMHNP-BC

Nancy “Niki” Eisenmann, PhD, RN

Ann Marie Hart, PhD, FNP-BC, FAANP

Prescribing and Deprescribing. The Journal of Nurse Practitioners. doi: 10.1016/j.nurpra.2020.08.004

McGee, N., Proctor, J., Hart, A.M., Moody, E.J., & Hardesty, C. (2021). ECHO: A Model for professional development in nursing through learning networks. The Journal of Continuing Education in Nursing, 52(4), 198-204.

ARTICLES

Smith, S., & Farra, S. (2022). The impact of Covid-19 on the regulation of nursing practice and education. Teaching and Learning in Nursing, 17(3), 302-305. https://doi.org/10.1016/j.teln.2022.01.004.

TEXTBOOK CHAPTERS

Smith, S., & Farra, S. (in press). Public health nursing practice and the disaster management cycle. In M. Stanhope & J Lancaster, Public Health Nursing (11th ed.). St. Louis: Elsevier

GRANT FUNDING

Smith, S. (PI) & Warren, C. (Co-PI), Lair, A. (Team member). Pilot Test of the Use of Augmented Reality to Teach Assessment, Fay W. Whitney School of Nursing Humenick Award in the amount of $3936. January 2022-January 2023

GRANTS AND FUNDING

Investigator Subcontract: Research, National Institutes of Health (NIGMS), 2U54GM104944-06, Clinical and translational research infrastructure network IDeA-CTR. Community engagement and outreach core site director: J. Thomas (PI/Project Director: P. Kumar, University of Nevada Las Vegas, 9/15/13-6/30/23).

Faculty Professional Development, Fay W. Whitney School of Nursing Wald Funding Opportunity, Society of Behavioral Medicine Leadership Institute, PI/Project Director: J. Thomas. $2,434, 1/1/2022-6/30/2022.

Research, Wyoming Department of Health Chronic Disease Prevention Program, University of Wyoming Community Diabetes Prevention Grant, PI/Project Director: J. Thomas. $14,500, 12/01/21-12/31/22.

PRESENTATIONS

Thomas, J., Das, B., Erickson, N., Graves, K., Smith, B., Gore, K., Mistica, A., Phister, K., Snow, E., Soske, G., Stout, C., & Wade, M. (2022). Diabetes interventionist training program for pre-professional students in the health sciences. Society of Behavioral Medicine Annual Meeting, Baltimore MD, April 6-9. Poster Presentation. Thomas, J. (2021). Human behavior and COVID-19. 5 Congreso Internacional de Investigacion en Ciencias de la Salud. Universidad de Guanajuato, Guanajuato, Mexico (Virtual meeting), October 14. Invited Podium Presentation.

KEY PUBLICATIONS

Thomas, J., Moring, J., Bowen, A., Rings, J., Emerson, T., & Lindt, A. (Online ahead of print 2021). The influence of stress and coping on diabetes self-care activities among college students. Journal of American College Health. (Data-based article) Purtzer, M.A., & Thomas, J. (2021). What Native Americans want nurses to know: Attitudes and behaviors desired in client/nurse relationships. Public Health Nursing, 38(2), 176-185. (Data-based article)

Thomas, J. (2020, November). Human behavior and COVID. Wyoming Nurse Reporter.

GRANTS AND FUNDING

Public Health, Immigration, and Social Justice. Education Abroad Site Visit Grant. May 2022. $3,500 Exploring the impact of aromatherapy and three-dimensional guided visualization on anxiety. McMurry Award, School of Nursing, PI Janet Willhaus, October 2020. $8,207.00

PRESENTATIONS AND POSTERS

Willhaus, J. K. (2022). The impact of vocal fidelity in student nurse learning in simulation. WNA Summit and conference. Casper, WY

Willhaus, J. & Snyder, A. (2022). Exploring auditory fidelity use in simulation programs. Scholarship Day University of Wyoming, Laramie.

Willhaus, J. K. & Snyder, A. (2021). Audio fidelity in simulation education. Wyoming Nurses Association Conference. Virtual.

PUBLICATIONS

Clark, C., Kardong-Edgren, S., &Willhaus, J. K. (Accepted for publication). Intervention Using Cognitive Rehearsal, Simulation, and Biomarker Data to Address Workplace Incivility. Journal of Continuing Education. Willhaus, J. & Snyder, A. (Accepted for publication). Exploring auditory fidelity use in simulation programs. Simulation Technology and Operations Resource Magazine (STORM).

Davis, S. P., Stover, C. F., & Willhaus, J. K. (2022). Simulation use in entry-to-practice respiratory care programs. Respiratory Care, https://doi.org/10.4187/respcare.08673

GRANTS AND FUNDING

St Clair, S. & Pepi Downey, McMurry funding to support “Wyoming Parents Speak Out About the Role of Mental Health in the Schools“ ($12,800 received for this research project for 2022-2023)

PRESENTATIONS AND POSTERS

St Clair, S. (2022, August 10). ECHO in Integrative Care. University of Wyoming ECHO in Health. Online presentation. St Clair, S. (2022, September 7). Safe Side Prevention. Given to DNP2 and DNP3 cohort in person.

Sherrill Smith, RN, PhD, CNL, CNE Janet Willhaus, PhD, RN, CHSE, CHSOS

Sherra St Clair, DNP, PMHNP

Jenifer Thomas, PhD

New Faculty

Shirley Boggs, DNP, CNE Assistant Lecturer

I hold a Master of Science in Nursing Leadership and a Graduate Certificate in Health Care Education, including a Doctor of Nursing Practice. I have taught full time as Nursing Faculty for over 8 years and over 10 years as online nursing faculty.

In Nursing I started as a CNA, then an LPN, to RN and on as Director of Nursing in LTC Nursing facilities. My nursing experiences have focused on geriatrics, skilled nursing and especially on psychiatric nursing practice. Teaching has always been my passion and joy! I started out to become a high school teacher before developing my interest in nursing.

I love to travel and just returned from Australia to see my son and grandson. I have also traveled to Egypt, Niger and Malawi and even rode on a camel and saw the pyramids in Egypt. I have three grown children and six grandchildren that range in age from three to age 30. (I relocated from Texas this summer to be closer to my family). I also have two very spoiled Golden Retrievers!

Jennifer M.L. Stephens, MA, PhD, RN, OCN, CCNE

Assistant Professor

I am a long-time nurse who has worked in many clinical areas including ICU, cardiology, home care, medical-surgical, geriatrics, tertiary, and on and on. My specialty and passion is oncology and I have extensive clinical experience in both the US and Canada working as a floor nurse, unit manager, clinical nurse specialist (CNS) and clinical nurse educator (CNE) in medsurg oncology, cancer critical care, cancer outpatient clinics, radiation suites, and in bone marrow transplant (BMT) and hematopoietic stem cell transplant units (HSCT). My PhD in nursing is from the University of British Columbia (Vancouver, Canada) where my dissertation research focused on oncology patient identity specific to hematological cancer patients. For the past few years, I have worked as a professor and nursing instructor for the British Columbia Institute of Technology (BCIT, Vancouver, Canada) and for Athabasca University (AU, Alberta, Canada). At AU, I served as BN Program Director and Associate Dean Undergraduate Programs. I am excited to be in Wyoming where I can continue to pursue research specific to oncology and the unique rural/frontier patient experience. Additionally, I have ongoing projects on nursing history, nursing education and curriculum revision, and the philosophy of nursing specific to transhumanism and nursing ontology.

Retired Faculty

Carrie Barr, MSN, RN Director of Undergraduate Nursing/ Associate Lecturer

Carrie has served as a nurse for the past 16 years and worked as an ICU nurse in areas ranging from rural Georgia to metro Atlanta to an Alaska Native serving hospital in Anchorage, Alaska. She is a certified predictive health partner and has worked as a nurse coach and case manager for Cigna serving employees in factories across Northwest Georgia. Carrie has been an educator for the past 7 years, with experience teaching in both ADN and BSN programs. She served as program coordinator at Alaska Pacific University, where she was part of a team who created a new ACEN accredited ADN nursing program founded on the concept of cultural safety. Carrie’s scholarly and teaching interests include methods for teaching cultural safety to bedside nurses and nursing students, deliberate practice related to nursing skill acquisition, ICU delirium, Targeted temperature management after cardiac arrest, and basically anything cardiac related. She lives in Laramie where she enjoys the outdoors with her husband, Brian, and their dog, Rose.

Jessica Bartlett, DNP, CNM, RN, IBCLC

I have spent most my life in the healthcare setting starting as a CNA in my teens. I have been a nurse since 2011 and a Doctorate of Nursing Practice and Nurse Midwife since 2016. I primarily work in outpatient and community health settings in clinical practice. I have had the opportunity to work in education both as a patient educator and then as a nursing instructor for those who are in all levels of education from associate to graduate programs 2012 and this has continued to be an amazing experience of learning and growth. In addition to my professional life, I am a mother of 5 who loves to garden and spend my days soaking up the sun in the garden or in the mountains hiking and camping with my family.

Faculty/Staff Awards: Innovation in Teaching Award and Outstanding Staff Member (over 5 years)

Congratulations to Nursing Faculty member Paula Kihn and Nursing Staff member LeAnn Amen. Both were recognized at the College of Health Sciences Outstanding Faculty and Staff Awards Celebration on April 14, 2022.

Kihn received the College of Health Sciences “Innovation in Teaching” award. The Wyoming Innovations in Teaching Award recognizes not only excellence in teaching, but also innovative ways in which teaching is delivered to students.

Amen received the “Outstanding Staff Member (over 5 Years)” award, which recognizes an outstanding staff member within the College of Health Sciences who has made significant contributions.

Pamela Clarke, RN, MPH, PhD, FAAN

2022 PRECEPTOR AWARD: Becky Erpelding, RN Cheyenne Regional Medical Center ICU • Cheyenne, Wyoming

“Becky has become a true role model for me and is the most outstanding nurse and preceptor. She explains everything she is doing with respect and like we are coworkers, she has never been condescending or annoyed that I didn’t know an answer or how to perform a skill. During morning report Becky is making sure we get patients who are high acuity so there are multiple learning opportunities throughout the day. She always asks what assignments seem interesting to me and gets my input. If there is a procedure going on she will take initiative and ask someone if I can watch so I’m getting to see new things every day. Becky is very observant and attentive even when I’m taking a more independent role with our patients, she’s always asking what tasks I need help with or if I need to take a break. One example of this was when we had a patient who had switched to comfort care and his daughters and wife were in the room grieving over the patient. The patient was younger and his daughters were around my age and I was having a very hard time being in the room. Becky leaned over and said I could go take a break and then shortly after came to talk with me and check-in. Becky really goes the extra mile as a preceptor and helps me outside of just our 12-hour shifts together. After a very busy day when I took over one of our two patients together, Becky messaged me and complimented my patient care and how great I did working independently that day and how helpful it was to her. This inspired me to want to be even better the next day!! Another example of Becky going the extra mile was when I discussed a goal of mine to be more thorough when I give report and later that night after our shift she messaged me a list of tips to use when giving report. Her taking the time to send me those tips showed me that she really cares about my success as a future nurse. Becky also took the time to write me an amazing letter of recommendation for my application to the nurse residency program.

Becky Erpelding, RN

–Abigail Smith, Student & Nominator

2022 PRECEPTOR AWARD: Tina O’Connor, RN

Ivinson Memorial Hospital Cancer Center • Laramie, Wyoming

“Tina is an incredible preceptor who makes me feel safe and comfortable performing nursing skills. She actively seeks opportunities for me to learn, from watching various nurses perform skills to placing me with nurses in leadership positions. She does online NCLEX questions with me and encourages everyone to expand their knowledge base as opportunities arise. She pushes me out of my comfort zone but I also know I can go to her when I need help. I feel my skill level is already vastly improved and I still have about 6 weeks of clinical left. The last time Tina had a student nurse from the University, COVID impacted the length of that students stay and she has been so excited to see students back in the Cancer Center. To me, this is just one example of how much joy she gets from teaching and for all of these reasons, why I would like to nominate her for this award.”

– Brianna Vasquez, Basic BSN Student & Nominator

COMMUNITY PARTNER AWARD 2022: Hospice of Laramie

Laramie, Wyoming

The recipient of the Community Partner Award for 2021-2022 is Hospice of Laramie. The award was presented on August 24, 2022 in the Arts & Sciences Auditorium on the University of Wyoming Campus at the school’s annual Nightingale Ceremony introducing new junior students to professional nursing. The Mission of Hospice of Laramie is to promote acceptance of the process of dying as a natural, potentially fulfilling part of life, while providing emotional, spiritual, social, and material resources to support the dying, their families, and friends. Hospice of Laramie was founded in 1983 by a group of committed community members.

Tina O’Connor, RN

Dean Sherrill Smith, RN, PhD, CNL, CNE with Elizabeth (Liz) Theobald, RN

2022 AWARDEES CONVOCATION Congratulations

Brooklyn Stauffer, Kaylee Bentley, Kristin Mcrann & Monika Reynolds

Amelia Leino Memorial Award for demonstrating academic excellence

Alondra Hamilton

Gertrude Gould Memorial Award for demonstrating excellence in public health nursing practice

Julia Scadden

Rudolph “Rudy” & Louise Anselmi & Jeri Kirk Family Trust Nursing Scholarship for demonstrating leadership and responsibility

Megan Bryant and Sonia Klein

Dr. Patsy Hesen Haslam Leadership Award for demonstrating leadership & grace

Carlee Russow

School of Nursing Spirit Award for demonstrating exceptional spirit and enthusiasm

Natalie Simonson

Professional Nurse Award for demonstrating excellence in practice, community and professional service

Michelle Renner

Lina Kennedy White Memorial Award for demonstrating interest and aptitude for geriatric nursing

Connor Rezzonico

Susan McCabe Psychiatric Mental Health Graduate Award for demonstrating academic excellence, passion for knowledge, and superior clinical practice

Natalie Birdsley

Beverly McDermott Award for demonstrating leadership and political activism

Caley Galipeau

Dorothy Tupper Senior Award for demonstrating caring, compassion, and interpersonal communication

Brittany Cox

Rural Advanced Practice Nursing Award for demonstrating exemplary rural practice in nursing

Mattie Johnson

“Change Agent” Award for a graduating DNP student who has demonstrated a commitment to improving and changing health.

Ashley Snyder

Carol Macnee Scholarship Award for demonstrating excellence in scholarship and/or research.

UW ALUMNI ASSOCIATION NURSING CHAPTER (UWAANC)

Update 2022

The UWAANC is busy as always!

SPEED MENTORING

The annual Speed Mentoring was held on March 23 by ZOOM. We had 8 mentor speakers from 5 states (Minnesota, Texas, Virginia, Colorado, and Wyoming) as well as an alumna now working in New Zealand. The specialties represented were Flight Nursing, Intensive Care, School Nursing, Informatics, Managed Care, Neonatal Intensive Care, Family Nurse Practitioner Practice, and International Nursing.

GENERAL MEMBERSHIP MEETING

UWAANC had the annual general membership meeting on April 13 via ZOOM. It is great to interact with colleagues and alumni from around the country.

CAPSTONE MENTORING

UWAANC finished off the spring semester with the capstone mentoring program. The goal of the program is to provide social support and assist in the transition from senior nursing student to professional nurse. The UWAANC board is always thankful for the wonderful and dedicated capstone mentors from around the country. If interested in being a capstone mentor, please email uwursingalumni@uwyo.edu.

We are gearing up for a very busy and exciting fall.

HOMECOMING MEET AND GREET RECEPTION

This will be held in the back room at Altitude Chophouse and Brewery on October 21, 2022, from 5:30 pm-7:30 pm. The UWAANC board looks forward to seeing our colleagues and friends. This is an excellent networking opportunity. Everyone is welcome, so please add this event to your calendar.

MEMORABLE MENTOR AWARD

The award will be presented during the above reception. If you have someone who influenced your nursing career, please consider submitting a nomination: http://

www.uwyo.edu/nursing/alumni/uwaa-nursing-chapter/ memorable-mentor-nomination-form.html Nominations are due every year on October 1.

UW NURSING & HEALTH PROFESSIONS CAREER FAIR

The UWAANC will have a table with information available for students on October 19th in the Wyoming Student Union Ballroom.

RESUME BLITZ

Reviewers will be present during the above career fair to review resumes of students. Resumes will also be reviewed online. The students remark that the feedback given with this review is helpful in acquiring their first professional nursing position.

SPEED MENTORING EVENT

This event is moving back to the fall semester. We are planning on October 26 but it is still in the planning phase at this writing. We are hoping to have a “hybrid” event with both mentor speakers and students on-campus as well as mentor speakers and students having the opportunity to join by ZOOM.

MOCK INTERVIEWS

The interviews will be held in November to assist the senior students in acquiring their first nursing position through honing their interviewing skills. Students have found this experience to be very valuable and the dedicated UWAANC board members have enjoyed participating in the interviews.

Please contact UWAANC at uwnursingalumni@uwyo.edu if interested in joining the chapter, being on the board, or participating in any of the events or programs.

2022 DISTINGUISHED ALUMNA

The Fay W. Whitney School of Nursing at the University of Wyoming announces their 2022 Distinguished Alumna, Holly Miller, MS, RN, CNE.

“The term distinguished per Webster states acknowledged for excellence or superiority. I would like to nominate a colleague and fellow nurse for the University of WY Fay W. Whitney School of Nursing Distinguished Alumni award. Holly E. King Miller exemplifies and demonstrates through her leadership the role of Distinguished Alumni. Initially Holly gave of herself through her position as coordinator of the Learning Resource Center, Clinical Simulation Center coordinator, Undergraduate Clinical Coordinator, and Director of BSN and BRAND programs. She continued to provide innovative guidance and leadership to nursing students in her various roles. Holly received various awards and accolades for her many accomplishments including Outstanding Career Achievement Award, Cowboy of the month Award, Top Prof award for four years and Outstanding teacher award in 2012.

Since her retirement from UW, Holly has been instrumental in the success of the UW Alumni Association Nursing Chapter. She has initiated several programs to assist students and new nurses to be successful in their future endeavors as a professional nurse.

She has most recently shown exceptional leadership with the Nursing Chapter of the Alumni Association through Young

Alumni Development. Most notable was organizing the nursing chapter to have both experienced leaders and coleaders who are more recent graduates and promising leaders for the offices of President, Vice President and Secretary. The purpose for this was to mentor the new and often less experienced leaders by having both an experienced leader, and a newer leader as Co-President, and Co-VP and a Co- Secretary to learn while leading and continue as a leader when the experienced leader retired from the position. That model was innovative and designed to build the future of the Nursing Chapter leadership.

Holly has also been instrumental in Membership Development by finding UWAA members who had belonged to the Alumni Association as a general member or lifetime member and encouraging them to be members of the Nursing Chapter! She worked with the staff at the Association to identify and include those nurses into the Nursing Chapter. That has really renewed the interest of members to continue as nursing members. This action will increase member involvement in the UWAA in the long term and support of the FWWSON.

Examples of Excellence:

1. Through leadership and Innovation activities Holly has advanced the profession of nursing through the UW Nursing Alumni Chapter. These activities have been initiated and continued through Holly’s volunteerism and her retirement.

Holly developed a New Innovative Program and Event Coordination, which was the mock interview program for seniors preparing to graduate and wanting help with interviews for their first nursing

position. Using volunteers Holly, assisted each student to participate in a formal interview process. In conjunction with this project of interviewing, Holly used seasoned professional nurses to assist the students to develop resumes that they could use in their future job seeking efforts.

Holly, assisted by fellow officers of the nursing alumni association, developed a social gathering for nurses to meet and greet fellow alumni and distinguished alumni during the UW homecoming activities. This type of gathering demonstrates to new nurses and students how nurses can be successful in their profession.

2. Holly also nearly single-handedly designed a Professional Development program where she found nurse mentors in communities where students completed their final practicum clinical rotation. The mentor was encouraged to become a friend and serve as a professional nurse support person for the students as they navigate through a foreign and new environment both in clinicals and the community. Holly found mentors in most of the communities and at times had more mentors than were needed! Another very successful and rewarding program to develop new nurses in their future profession.

Holly serves as a member of the Friends of the FWWSON, a member and officer of SST, and a member of Southeast Region of WNA and ANA. Her volunteerism exemplifies leadership and professionalism in nursing. Holly’s innovation during the 2 past COVID years has maintained and grown the nursing alumni association through heightened support and guidance to students and new young nurses who began their nursing career during a very trying time.”

PLANS FOR CELEBRATION

Holly Miller will be honored in person during University of Wyoming Fall 2022

Homecoming week on Friday, October 21 at the Fay W. Whitney School of Nursing.

“I am proud to nominate a fellow nurse colleague as Distinguished Alumni for this year, with an emphasis on leadership and innovation in nursing.”

Holly Miller, MS, RN, CNE BSN ’82, MS ‘96

Nominated by Veronica Taylor, Colleague

2022-2023 SCHOLARSHIP AWARDS

The school awarded $239,110 in scholarships. The following donors make nursing education more manageable financially for some students, and make nursing education actually possible for others. A big Thank You for encouraging hard-working students with your gift of support.

Rudolph “Rudy” & Louise Anselmi & Jeri Kirk Family Trust Scholarship

Megan Weidler

Emma Ohman

Teresa D’Angelo

Nursing Alumni Scholarship Natalie Birdsley

Blue Cross Blue Shield Wyoming Basic Scholarships

Rachel Kuntz

Blue Cross Blue Shield Wyoming BSN Completion Scholarships

Risikat Triplett Hayley Francis Gabrielle Dickson Stacey Michel Kayla Stetz Steven Aragon Mason Agor

Blue Cross Blue Shield Wyoming DNP Scholars Program Scholarships

Bonnie Just Kimberly Lindeman Landon George Mckenzie Frederick Megan Ayla

Kathleen Buckingham Bohmont Nursing Scholarship

Alyssa Goncalves

BRAND Loan

Kenneth Goff

Chanel Smith Christina Rozier

Sonja Steinle

Polly Chase Memorial Scholarship Rachel Williams Ivan Olson

Kirsten Schlautmann

Marcia L. & William G. Dale Nursing Scholarship

Lilliana Nieves-Martin Jessi Schroeder

Finley O’Connor

Teddi Jones Emma Hall

Dowell Infectious Nursing Scholarship Kirsten Schlautmann

Rosalie Fields Nursing Scholarship Hannah Hansen

Frances E. Gasdek-Eaglehouse & Barry D. Gasdek Scholarship Gabrielle Dickson

Frank R. & Dorothy M. Gruden Scholarship in Nursing Chenoa Williams Cheryl Flores Haylee Madsen

Elizabeth Holland Scholarship in Nursing

Jennifer Pfisterer Hannah Hansen

Gertrude Gould Lindsay Scholarship Micelle Kitchen

John & Lois Malmquist Nursing Scholarship Rachel Williams Kendall Bellon Melissa Chehade Josh Keegan

Carolyn Bennett Miknis ’59 ReNEW and BRAND Nursing Scholarship Emma Snow Mason Agor

Carolyn Bennett Miknis, Nursing Scholar Chenoa Williams

Gordon S. and Charlott Myers (CHS) Christina Rozier Caleb Haack Jami Roberts

Bonnie M. and George E. Nugent Nursing Scholarship Jessi Schroeder

Pearl Crossley O’Kieffe Memorial Scholarship Hannah Humphreys

Jana Leigh Pruitt Memorial Scholarship

Katherine Breit

Joseph F. & Susan H. Steiner ReNEW Nursing Scholarship

Laura Shoopman

Paul Stock Foundation Health Science Scholarship Jennifer Pfisterer Rachel Kuntz

Dorothy Tupper Nursing Scholarship Kylee Holstad Abbie Samp

Clayton Unger Endowed Nursing Scholarship Laura Morrison Alyssa Turner Risikat Triplett

Wiest Nursing Scholarship Kara Lafollette

Jennie Enger Scholarship Abbey Muniz Ivan Olson

Jeanne Mogard Emerson Scholarship Shelby Gray

Diane Burns Memorial Nursing Scholarships Abbey Muniz

Susan K McMurry Strategic Partnership for the Advancement of Nursing in Wyoming BRAND Taylor Brown

Hannah Humphreys

Christina Rozier Hannah Hansen Kenneth Goff

Cassandra Newcomb Caleb Haack Chanel Smith

The Steamboat Society (formerly the President’s Society) is reserved exclusively for those loyal supporters whose generosity totals $1,000 or more each year.

Read more at www.uwyo.edu/foundation/ ways-to-give/annual-giving/index.html

LIST OF DONORS TO SCHOOL (JUNE 2021-MAY 2022)

A HUGE thank you to the following donors, who together contributed $1,146,180.41 in gifts as noted below.

Ann C. Enlow

Preceptors & Friends of the Nurse Practitioner Program

Dr. Charles P. DeWolf and Dr. Mary E. Burman Ann Marie Hart and Dr. E. Andrew Hart, II

APN Healthcare Solutions Fund Ann Marie Hart and Dr. E. Andrew Hart, II

Babson & Associates Primary Care Nursing Scholarship Babson & Associates Primary Care PC

Blue Cross Blue Shield Wyoming DNP Scholars Program Scholarships and BSN Completion Scholarships Blue Cross Blue Shield of Wyoming Caring Foundation

Diane Burns Memorial Nursing Scholarship Diane M. Howell and Richard C. Howell Gregory Howell James Burns Joni Bollinger Judy Schriener

Karen Carney and Michael D. Carney Mrs. Carol F. Kirkwood Mrs. Ellen A. Bernatis and Mr. John M. Bernatis

Ms. Sandra F. Steele Patricia Gorski Patrick A. Burns Rhonda Knapp and Butch Knapp Terrance Murtaugh and Rita Murtaugh Tom J. Steele and Mildred Steele William C. Miller

Fay W. Whitney School of Nursing Fund Greg Dyekman

Mr. Michael R. Dunn and Mrs. Jill Dunn Mr. Thomas L. Tonoli and Mrs. Jean E. Tonoli Ms. Billie Anderson and Greg Anderson

Joseph F. & Susan H. Steiner ReNEW Nursing Scholarship Susan H. Steiner, PhD and Dr. Joseph F. Steiner, Pharm D

Marcia Dale Aspire Scholars Program Fund Ann Strenger and Steve Strenger

Marcia L. and William G. Dale Nursing Scholarship Bev Ambrose

Ms. Linda M. Sears Terri S. Erdman and Steve H. Erdman

Mary E. Burman Fund for Student Experiential Opportunities in Nursing Guthmann Revocable Trust

Mary Behrens and Dr. Jerome A. Behrens Mrs. Faith M. Jones and Mr. Gregory A. Jones

Mrs. Kathleen M. Bieber and Prof. Stephen L. Bieber Mrs. Susan P. Mills, PhD, RN and Mr. Brady W. Mills Mrs. Tamara L. Mason and Mr. Robert S. Mason Ms. Billie Anderson and Greg Anderson Ms. Carol A. Holland Ms. Marilyn B. Klocksiem Pamala D. Larsen

Nursing Alumni Scholarship

Dr. Allen H. Brady and Mrs. Yvonne C. Brady Mrs. Barbara J. McCormick Mrs. Nancy A. Butcher and Mr. Robert S. Butcher

Nursing Educational Technology Susie McMurry

Nursing School

Ann Marie Hart and Dr. E. Andrew Hart, II Carole L. Hoveland Cathy J. Quenelle-Peterson Cynthia S. Woods and Willard M. Woods Dana L. Brickell and Tyler J. Brickell Daniel L. Shinn Debra V. Stauffer and Mr. David W. Stauffer Dr. Charles E. Moon and Mrs. Joan L. Moon Dr. David L. Jones and Dr. Mary A. Hardin-Jones Dr. Gaurdia E. Banister and Mr. Paul W. Smith Dr. Michael F. Enright Esther H. Gilman-Kehrer and Mr. Paul T. Kehrer Janet De Gise Sarmiere Joan L. Moon and Dr. Charles E. Moon John P. Thalken and Mrs. Twyla M. Thalken Karen F. Sacrison and Bob Leach Kathy J. Moore Lt. Col. Teryl A. Loendorf Maria C. Kidner and Martin E. Kidner Martha Steadman Matloff, MD and Dr. David B. Matloff

Megan J. Weidler Mr. Al Carollo, Jr. and Mrs. Carolyn M. Carollo Mr. Britt W. Wilson

Mr. Carl E. Lindberg and Mrs. Donna G. Lindberg Mr. Cary D. Enlow and Mrs. Ann Enlow

Mr. Darrell L. Asbell and Mrs. Susan J. Asbell

Mr. Edward A. Henry Mr. Jack R. King and Mrs. Mary Jane King

Mr. James D. Zeller and B Arleen Zeller

Mr. Jeffrey J. Smith and Ms. Sherrill Smith

Mr. Kenneth G. Mercado and Mrs. Jenny M. Mercado

Mr. Lawrence H. Boram, Jr. Mr. Michael C. White and Mrs. L. Susan White

Mr. Michael R. Dunn and Mrs. Jill Dunn

Mr. Richard E. Browne and Mrs. Sandra C. Browne

Mr. Stanley A. Denoo and Mrs. Janice K. Denoo

Mr. Steven D. Broman

Mr. Thomas L. Tonoli and Mrs. Jean E. Tonoli

Mr. Troy A. Herman and Carol M. Herman Mrs. Cheryl L. Koski

Mrs. Dawn K. Evans and Mr. James H. Evans

Mrs. Holly E. Miller and Mr. David L. Miller

Mrs. Jean C. Forseth and Mr. Thorm R. Forseth Mrs. Joelle N. Appel and Mr. Bruce H. Appel

Mrs. Lana Shepard

Mrs. Lori L. Bowdler and Scott S. Bowdler

Mrs. Marcia Kuhlman and Mr. David H. Kuhlman

Mrs. Marian Gruenfelder

Mrs. Mary Jo Garvin and Mr. Gerald Garvin

Mrs. Maurita R. Meehan and Dr. Patrick M. Meehan Mrs. Nancy Hanson and Mr. Monte J. Hanson

Mrs. Shaheda Ula and Dr. A. H. Ula

Mrs. Terry L. Hathaway and Mr. Gary Hathaway

Mrs. Vera L. Nelson

Mrs. Veronica K. Taylor and Mr. Frank J. Taylor

Ms. Audry B. Van Houweling and Jacob P. Wagner

Ms. Catherine E. Soberekon

Ms. Denise B. Ramp

Ms. Emmajean Amrhein

Ms. Jeanine T. Niemoller and Mr. Robert Niemoller

Ms. Kay Calloway and Richard Williams

Ms. Patricia R. Shoults

Ms. Sherrill Smith and Mr. Jeffrey J. Smith

Patricia K. Fritz and Mr. Bruce D. Fritz Prof. Rebecca C. Carron and Prof. Keith T. Carron Stacey Young-McCaughan and Mr. Patrick B. McCaughan Suzey J. Delger and Stephen M. Delger Thomas B. Lee and Leslie A. Lee Tina L. O’Connor and Mr. Frederic O’Connor, Jr. Susie McMurry

Professional Nurse Award Fund Mr. Roy Whitney, Jr. and Dr. Fay W. Whitney

Ralph and Fay Whitney Family Endowment in Nursing Mrs. Jenna Z. Tennant and Mr. Jack T. Tennant

Rita Bragg Nursing Scholarship Mrs. Laura D. Gaddis and Mr. Thomas A. Gaddis

Susan K. McMurry Strategic Partnership for the Advancement of Nursing in Wyoming Susie McMurry

The Dowell Infectious Nursing Scholarship Active Scholarship Mark E. Dowell, MD and Caryn Dowell

The McMurry Foundation Fund in Mental Health and Integrated Care in Honor of Mary Burman The McMurry Foundation

Transition Practicum Scholarship in Nursing

Mrs. Carolyn M. Carollo and Mr. Al Carollo, Jr Nancy C. Brazelton

UW-Cheyenne Regional Medical Center (CRMC) Faculty Partnership Cheyenne Regional Medical Center

766-6300

831-7795

Marian H. Rochelle Gateway Center,

South 22nd

WY 82070-5204

FAY W. WHITNEY

SCHOOL OF NURSING

College of Health Sciences Dept. 3065 1000 E. University Avenue Laramie, WY 82071

Printer to insert their indicia

Morgan Lu, nursing student from Mead, CO. photographed outside the Downtown Clinic in which she worked.