Executive Director Report...Executive Director Report Legislative Year 2015 Vicky Byrd, BA, RN, OCN Executive Director The 2015 legislative year for the Montana Nurses Association

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T H E O F F I C I A L P U B L I C A T I O N O F T H E M O N T A N A N U R S E S A S S O C I A T I O N

VOL. 52 • NO. 2 SUMMER 2015

Montana to Malawi – 2nd Installment

Page 13-15

Montana Nurses Association 103rd Annual Convention

Page 8

VanDeer, Phillips, and Bonde Honoredby MT CAHN

Page 10

Quarterly publication direct mailed to approximately 17,000 RNs and LPNs in Montana.

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Executive Director ReportLegislative Year 2015

Vicky Byrd, BA, RN, OCNExecutive Director

The 2015 legislative year for the Montana N u r s e s A s s o c i a t i o n (MNA) was challenging, exciting, disappointing, and surprising all rolled into one. The process itself is something I had to learn and figure out, and determine the best way to commun icate with legislators and often competing associations with similar agendas, but with

different outcome agendas. This legislative year, our platform included:

raising awareness about Violence in the Workplace by addressing assault on a healthcare worker and emergency responder, and opposing any Nurse Licensure Compact. Additionally MNA continues their ongoing support of Medicaid expansion.

SB352: “Creating offense related to assault on healthcare and emergency providers” was tabled in committee shortly after the hearing on February 23rd. On March 27th the motion to bring the bill from the Table in Senate Judiciary Committee to 2nd Reading failed. Therefore killing the bill for this legislative year. The bill was to create an offense of assault on a health care provider or emergency responder; and provide a penalty. We carefully provided amendments to address those citizens that have developmental disabilities or suffer from a mental disorder (both as defined in Montana code). The penalty was if a person was convicted of assault on a healthcare provider or emergency responder (while on duty) they would be guilty of a misdemeanor punishable only by a fine in an amount not less than $1,000 or more than $25,000. We were hopeful as Republican Senator Buttrey (R) SD 11 carried the bill for us and the firefighters had assisted with their support as well. The hearing in the Senate Judiciary Committee chaired by Senator Scott Sales (R) SD 35 was February 23rd and there were many proponents that testified with the exception of one opponent, and upon learning of the amendments stated they would be amenable.

In addition to MNA testimony, I submitted all of the nurses’ testimonies who provided statements addressing assault and/or violence in their workplace. Unfortunately, hours following the hearing we were informed that the committee had tabled the bill. While very disappointed there was “another” way to maybe get the bill heard on the Senate floor for second reading and it would require a majority vote (26) in favor of “blasting” the motion out of committee and onto the

Senate floor. So with days to prepare we circulated two very specific flyers of nurse’s testimony that was extremely powerful to each and every Senator. We also spoke to key legislators asking for their assistance is passing the motion to at least hear (blast) the bill on the floor. Senator Robyn Driscoll (D) SD 25 made the blast motion for SB 352 on March 27th and unfortunately the motion for the bill to be heard was defeated 27 to 23 effectively killing this bill for this legislative year.

Nursing compact legislation, HB 147 Nurse Licensure Compact, did become law on February 27th. With this being said, MNA continues to provide input into the rules surrounding the compact via the Board of Nursing (BON) and the Department of Labor and Industry. MNA has also invited the Executive Director and the President of the Board of Nursing to our next MNA board meeting to inform and discuss the implementation process and the effects it will have on nursing and our patients. Of special note is our MNA bylaws that state you can only be an MNA member if you have been issued a license by the BON. As the compact is in conflict with this, we need to be prepared to address this issue in October at our annual convention. I attended the last BON meeting and was informed that the compact needs to be enacted by October 1, 2105.

MNA testified and supported Medicaid expansion. Senator Buttrey’s SB 405 “Creating the Healthy Montana Act to Expand Health Care Coverage” is the only bill to survive. This “compromise” Medicaid expansion bill has passed the House and Senate and was transmitted to the Governor on 4/22/15. He has 10 days to decide to sign it (becomes law), veto it, or not sign it thereby allowing it to become law without his signature. As this article is submitted on 4/24/15 the outcome is yet to be known.

Other legislation MNA spoke to and provided input for was advocating to include primary care provider and/or advanced practice registered nurses (APRN’s) where you would see physician or doctor being addressed as it related to patient care. MNA continues to advocate for and address legislators and legislation to include our APRN’s as primary care providers. Also MNA testified in favor of criminal background checks for nurse licensees and to change the composition of the BON while keeping the number of board members the same. The change was to decrease by one Licensed practical nurse (LPN) and increase by one Registered Nurse (RN), as Registered Nurses significantly outnumber LPN’s in the state and the BON composition would be more reflective of these numbers.

In the future with legislative agendas, if any relate to nursing or nursing practice or patient

Vicky Byrd,BA, RN, OCN

Executive Director continued on page 2

Page 2 Montana Nurses Association Pulse May, June, July 2015

Executive Director continued from page 1

care, MNA has encouraged all organizations and boards and associations to engage in immediate collaboration and information sharing to assist in the best possible outcomes.

We had the pleasure of our members support, whether in person or via technology, and additionally, the support and resources from the American Association of Nurse Practitioners (AANP), MEA-MFT (Montana Education Assoc.-Montana Federation of Teachers), MT AFL-CIO, American Nurses Association (ANA), American Federation of Teachers Nurses and Healthcare division (AFT), and the National Federation of Nurses (NFN) that includes (along with MNA) Oregon Nurses Association (ONA) Washington Nurses Association (WSNA) and Ohio Nurses Association (ONA). MNA thanks everyone for their prompt replies and support.

MNA will begin preparation now over the next two years and tap into Montana nurses and our members and resources to be in a better strategic position for Legislation 2017!

CONTACT MNAMontana Nurses Association

20 Old Montana State Highway, Montana City, MT 59634Phone (406) 442-6710 Fax (406) 442-1841

Email: [email protected]: www.mtnurses.org

Office Hours: 8:00 a.m.-5:00 p.m. Monday through Friday

VOICE OF NURSES IN MONTANAMNA is a non-profit, membership organization that advocates for nurse competency, scope of practice, patient safety, continuing education, and improved healthcare delivery and access. MNA members serve on the following Councils and other committees to achieve our mission:• CouncilonPractice&GovernmentAffairs(CPGA)• CouncilonEconomic&GeneralWelfare(E&GW)• CouncilonContinuingEducation(CCE)• CouncilonAdvancedPractice(CAP)

MISSION STATEMENTThe Montana Nurses Association promotes professional nursing practice,

standards and education; represents professional nurses; and provides nursing leadership in promoting high quality health care.

CONTINUING EDUCATIONMontana Nurses Association is accredited as an approver of

continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Montana Nurses Association (OH242, 12/01/2017) is an approved provider of continuing nursing education by the Ohio Nurses Association(OBN-001-91), an accredited approver by the American Nurses

Credentialing Center’s Commission on Accreditation.

MNABoard of Directors

Executive Committee: President Lucy Ednie, RN-BC Vice President Rayna Joshu, RN, MSN Secretary Brenda Donaldson, RN Treasurer Lorri Bennett, RN

Directors at Large:

Council Representatives: Advanced Practice Arlys Williams, APRN, FNP-BC CCE Deborah Lee, BSN, RN-BC CPGA JohnHonsky,APRN E&GW DaylynPorter,BAN,RNC

Editorial Board: Chair–Barbara Prescott Schaff, APRN, DNP, FNP-BC Mary Pappas, RN, EdD Kate Eby, APRN, MN, FNP-C

MNA Staff: VickyByrd,BA,RN,OCN,ExecutiveDirector PamDickerson,PhD,RN-BC,FAAN,DirectorofContinuingEducation Mary Thomas, BA, RN, OCN, RN Continuing Education Specialist Kathy Schaefer, Continuing Education Specialist Robin Haux, Labor Program Director Amy Hauschild, BSN, RN, Labor Representative Caroline Baughman, Labor Representative KimberlyKralicek,Administrative&MarketingSpecialist JillHindoien,Membership&FinanceSpecialist

Questions about your nursing license? Contact the MontanaBoard of Nursing at: www.nurse.mt.gov

PUBLISHER INFORMATION & AD RATESCirculation 17,000. Provided to every registered nurse, licensed practical

nurse, nursing student and nurse-related employer in Montana. The Pulse is published quarterly each February, May, August and November by the Arthur L. Davis Publishing Agency, Inc. for the Montana Nurses

Association, 20 Old Montana State Highway, Montana City, MT 59634, a constituent member of the American Nurses Association.

For advertising rates and information, please contact Arthur L. Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216, Cedar Falls, Iowa 50613, (800) 626-4081, [email protected]. MNA and the Arthur L.

Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next

issue or refund of price of advertisement.

Acceptance of advertising does not imply endorsement or approval by the Montana Nurses Association of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising iswithoutmerit,orthatthemanufacturerlacksintegrity,orthatthisassociationdisapproves of the product or its use. MNA and the Arthur L. Davis Publishing

Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or

membership of MNA or those of the national or local associations.

WRITER’S GUIDELINES:MNA welcomes the submission of articles and editorials related to nursing or about Montana nurses for publication in The PULSE. Please limit word size between 500-1000 words and provide resources and references. MNA has the right to accept,

edit or reject proposed material. Please send articles to: [email protected].

PULSE SUBMISSIONS

We are gathering articles that are relevant and appealing to YOU as a nurse. What is happening in your world today? Is there information we can provide that would be helpful to you? The Pulse is YOUR

publication, and we want to present you with content that pertains to your interests.

Please submit your ideas and suggestions to Kim.

[email protected]

Please visit MNA’s constantly updated website!

www.mtnurses.orgEnjoy a user friendly layout and access to more information, including membership material, labor resources, Independent Study Library, a

new Career Center for Job Seekers & Employers, and more downloadable information.

Published by:Arthur L. Davis

Publishing Agency, Inc.

www.mtnurses.org

RN or LPN – Half-time & On-Call Positions:

Half-time nursing position (RN or LPN) available at Journey Home Crisis Stabilization Facility in Helena, MT. Journey Home is a sub-facility of Western Montana Mental Health Center. Strong possibility of sharing this position with Community Mental Health to create a full-time position withabenefitandpaidtimeoffpackageconsidered“gold-level”inMontana.

AlsoseekingRNorLPNneededtobeon-callandavailableforcall-outonrotatingweekends,eveningsandovernights.$80.88per24-hourperiodtobeon-call.Paid$27.00perhourtocomeintoworkwhileoncallfordayshifts,$30.00perhourforweekendshiftsand$35.00perhour for overnight shifts. Wage is slightly less for LPN status.

Must have nursing licensure in Montana and ability to pass backgroundcheck.Ifinterested,provideresumeand

3 professional references to [email protected]. Questions? Call 406-603-4010. Open until filled. EOE

Essential Functions: Montana Mental Health Nursing Care Center located in Lewistown, Montana provides long term care to adults with serious mental illness. This position is responsible for treating and prescribing care to residents as referred. Provides direct resident care and collaborates as a provider and care plan team member in medication management of facility residents.$78,500-$117,748DOE,plusStateofMontanaBenefitsPackage.Minimum Qualifications• Masters’DegreeasanAdvancedPracticeNurse• ANCCcertificationasPsychiatric-MentalHealthNursePractitioneror

Psychiatric -Mental Health Clinical Nurse Specialist• LicensedasAPNinthestateofMontana;prescriptiveauthoritywith

assignment of DEA number.• TwoyearsofexperienceprovidingpsychiatricpatientcareasanAPN

preferred.

Applications/Inquires can be addressed toDianne Scotten, SuperintendentMental Health Nursing Care Center800 Casino Creek DrLewistown, MT 59457406-538-7451 ext 218

Recovery Center Missoula (RCM) is designed to meet the needs of those suffering from

substance use and co-occurring psychiatric disorders.

Now hiring: RN - Evening shiftAddiction and/or Psychiatric experience preferred

To apply, please visit www.wmmhc.org

Big Sandy Medical Center, IncCritical Access Hospital, Longterm

Care Facility and Rural Health Clinic.166 Montana Ave. EastP.O. Box 530 Phone: (406) 378-2188Big Sandy, MT 59520 Fax: (406) 378-2180

May, June, July 2015 Montana Nurses Association Pulse Page 3

I have been a part of the Montana labor movement for 24 years. I began as a journeyman Operating Engineer with the International Union of Operating Engineers (IUOE). During my thirteen years with that union I was a nationally-certified H a z a r d o u s M a t e r i a l s Instructor, an OSHA Safety Instructor, and later the statewide Local #400 Union Organizer helping

workers win union contracts. As a Master Instructor for the IUOE National

Training Program, I taught classes at Department of Energy facilities and worked with NASA scientists and world class engineers testing new technologies to improve safety for those working around radiation, chemical hazards, and bloodborne pathogens.

For ten years I was the President of the Big Sky Central Labor Council, which is a group of delegates from many different unions in the region surrounding Helena. We worked on increasing wage standards, supporting workers that were unionizing, and hosting rallies and events that honor working professionals. We brought awareness about workplace injustices, and educated and mobilized people on congressional action. We screened political candidates and endorsed/supported those whose core values matched the values of Montana’s working families.

In 2001, the Governor of Kentucky signed an executive order granting 26,000 state employees the right to collectively bargain for the first time in history and I was given the opportunity to help the American Federation of Teachers (AFT) reach out to those state employees. Six unions competed for the privilege to represent those workers. It was among the largest single election organizing drives in the country.

In the early 2003 just after my daughter was born, I worked at the Montana Chemical Dependency

Labor Reports and News

Amy Hauschild BSN, RN

Frequently, nurses call with what they feel are violations of the collective bargaining agreement (CBA). In great detail, they relate to me the circumstances surrounding the violation. Often times they have evidence of their complaint and have gone to the trouble to commit to writing the egregious events. Once we get down to the nitty-gritty, fine details there are occasions when we find the nurse has allowed the timeline for filing a grievance expire. This is truly unfortunate as the Union’s ability to assist the nurse is much more limited.

I often hear from nurses that they were not sure if something was a grievance, or wanted to “check a couple more paychecks and see if it got better” or other things along these lines. We cannot stress enough, if a nurse feels like they “MAY” have been

aggrieved or are even “wondering” if a contract violation has occurred, it is absolutely imperative that the nurse take some action- call a nurse-rep (union steward, floor rep, union officer, etc.), call an MNA Labor Representative, or pick up a copy of the CBA and do some research on your own and then call one of the representatives for advice.

Each CBA has a specific and often times, unique, procedure for addressing contract violations. The grievance procedure is devised to outline in very specific terms the process for and timelines for addressing violations or, potential violations, of the contract. If the issue is not raised in the proper forum for example- with the immediate supervisor, vice president or the human resource department or in the proper form (written or verbal) and within the proper time limits, the matter is considered “null” or “disposed.” That means it’s like it never happened!

Monitor Your Timelines and Ask for Help ASAP!

Amy Hauschild, RN, BSN

Labor Representative

Sandi LuckeyLabor

Representative

Center alongside the RNs when they were first trying to gain union representation. During the same time I became a licensed Pharmacy Technician and worked in a pharmacy where the employees were unhappy due to poor treatment and a constant failure of the corporate office to comply with their own wage progression schedule. We held a union election and joined MEA-MFT, becoming the only union pharmacy in Montana. Steve Bullock, now our Governor, was at the time the attorney for the union that helped us achieve our goal of wage increases applied retroactively. The contract stabilized the workforce and ended the historically high turnover. I served as the president of the Montana Pharmacy Paraprofessionals and was on the bargaining team until I was offered the opportunity to work for the Montana AFL-CIO.

I spent nine years with the Montana AFL-CIO working as the Writer/Researcher and Communications Director. The AFL-CIO brings all unions together to work on issues common to all workers like better wages, access to healthcare, secure pensions, paid leave, unemployment insurance, worker’s compensation, etc. The work I did included writing position statements and resolutions, legislative testimony and speeches. I developed and managed a strategic social media program, blast email and text messaging program. I wrote guests columns, editorials and held press conferences. I worked with a lot of great local and national reporters and bloggers that allowed us to get important stories told from the perspective of the employees including; a rally in Kalispell to oppose the anti-worker/anti-union presence of Wisconsin Gov. Scott Walker, Easter Day layoffs of Steelworkers in Columbus, support for state pay plans, safety measures for railroad workers, the employment effects of trade agreements, and the battle for respect by the nurses picketing in Bozeman. I assisted Fire Fighters in passing mill levies, teachers pass full-day kindergarten, and wrote extensively on our economy and the role good wages and benefits play in lifting up entire communities. During my tenure, I had the ghost-writing privilege of writing the words that helped influence people, employers, legislators, Governors, Congress, and even the President.

I serve on the Champions Board for Montana Girls STEM, an organization encouraging young girls to consider science, technology, math and engineering jobs. The mission is to show girls there is a place for them in male-dominated fields and to increase the number of women in higher paying professions, which also helps close the gender wage gap that currently has women earning 76 cents less on average than men doing the same job.

I am a Vice President of the International Labor Communications Association (ILCA) headquartered at the AFL-CIO in Washington DC. Their mission is to help tell the stories and amplify the voice of working professionals so we can make more progress in improving the lives of hard-working Americans.

I’m also a youth mentor in the Youth Build program helping at-risk young adults learn useful coping skills and find a career path.

I’m a lot like Forest Gump or perhaps a tumble weed that keeps landing in interesting places during important times but over the years I have worked with dozens of unions and organizations that impact the lives of people. I have been really impressed with MNA. It’s a smart organization that has acquired an impressive stock of really inspiring and passionate people. I could not possibly express on paper how honored and excited I am to be taking on this new challenge working with the great people employed at MNA and representing the women and men that make their living caring for other human beings in their greatest time of need, and saving lives, as Montana’s Registered Nurses.

Welcome, Sandi Curriero Luckey!

www.montana.edu/nursing406-994-3783

BUILD A CAREER -MAKE A DIFFERENCE

Undergraduate Degree Options•BachelorofScienceinNursing(BSN)degree•AcceleratedBSNdegreeforpost-baccalaureate

students

Graduate Degree Options•MasterofNursing(MN)

Clinical Nurse Leader•DoctorofNursingPractice(DNP)

Family/Individual PopulationPsych/MentalHealthPopulation

See our current vacancy announcements at www.montana.edu/nursing

See ADRN—MN updates at www.montana.edu/nursing

Qualified Caring Staff

RNs • LPNs • CNAsWe are currently taking applications for traveling careers for licensed

/ certified nursing staff, for long term care, hospital, correctional, mental health, clinics and treatment facilities, throughout Montana.

Excellent wages, flexible work assignments, and other opportunities

For an application or more information contact us:406-360-5199 • 406-360-5149 • Fax 406-363-5726

Email [email protected]

Equal opportunity employer


Labor Reports and News

Amy Hauschild, BSN, RN

Local #4 nurses in Bozeman overwhelmingly ratified a new 3½ year collective bargaining agreement CBA. The parties spent approximately 6 days at the table and all involved worked long hours and were fully committed to the process.

The Federal Mediation and Conciliation Services FMCS came to Bozeman last fall and held an extensive training course with both the Labor and Management Teams in preparation for the upcoming bargaining. The course was held over approximately 4 days and both teams participated in the training together. The training was, to say the least, time well spent and both parties went into negotiations with the knowledge and tools to be able to successfully negotiate a successor agreement in just a fraction of the time they spent negotiating the 2012 agreement. Highlights of the FMCS training included enhancing communication between the parties as well as actual negotiation simulations.

Both teams worked diligently to solve the problem of inequitable wage rates as compared to years of experience as an RN among the nurses. Collaboratively, the teams worked creatively to design new wage scales and methodology for

Congratulations MNA Local #4 Nurses

Local #4 Bargaining TeamLeft to right: Jeanne Schlenbach RN, Matt Larson RN, Barb Johnson RN,

Maureen McGrath RN, Amy Hauschild RN and James Fredrickson RN

crediting nurses for years of experience as an RN. By 2018, a 20 step wage scale will be in place.

Productive discussions brought forth clarification in the CBA about topics which included RN certification, precepting, and orientation and overtime just to name a few.

On March 4th, 2015 a representation election was held by the National Labor Relations Board (NLRB) and dialysis nurses in Bozeman chose MNA as their certified bargaining agent.

We extend a warm welcome to the nurses of MNA’s newest local unit- MNA Local #6! Local #6 nurses are employed by Fresenius Medical Care as are the nurses from MNA Local # 33 in Missoula.

Officer/Negotiator elections have taken place and we are working on dates to commence collective bargaining sessions. Way to go Local #6!

Welcome MNA Local #6!

CHANGEChange. It seems to be a

constant in all of our lives. Over the past several years, the healthcare industry has been going through so many changes that most healthcare facilities have positions specifically created to keep track of all those changes! FYI: it takes a lot for new job positions to be created.

Your workplace will always be changing; just ask the nurse who

has been there 30 years. What’s important to remember through the many evolutions of your job, is that there will always be reasons, too. The Affordable Care Act, budget cuts, acquisitions, new departments, etc. all generate facility adjustments. Just because your employer can cite a good reason, though, doesn’t mean it is always a good change.

Explore why different policies and procedures are being implemented in your workplace. They may not be as good-hearted as we all want to think—is that BSN differential about having a qualified staff, or is it about meeting Magnet requirements? They may not be as helpful as they look at first glance—yes, RNs are having to do registration and housekeeping on weekends, but how much does that interfere with patient care? They may be missing a detail that nurses are more exposed to—will that new entrance into the ER interfere with an efficient traffic pattern?

How is your facility’s administration carrying out change? Are you feeling confident in the intentions and diligence of your facility? If you ever have any questions about policies, parameters, or procedures that are changing in your workplace, call our labor staff. We’re happy to help you talk through what’s happening and help you determine what rights you have as an employee.

Caroline BaughmanLabor

Representative

www.tchealth.org • [email protected]

Glacier National Park, mountains, lakes, ski resorts, golf, fresh air, friendly people, and excellent schools all accompany this

rapidly progressing 303-bed hospital.

Currently recruiting for the following positions:

• Observation RNs-Fulltime

• IMC RN

• Critical Care RN

• Medical/Surgical/Oncology RN

• ICU RNs ($15,000 Sign on Bonus for night shift)

• Pathways Treatment Center (Psych & CD) RN

• Certified Nurse Aides/Brendan House

Laurie O’Leary, Human Resources310 Sunnyview Lane, Kalispell, MT 59901

[email protected]

www.kalispellregional.orgDrug Free • EOE

Spring is Here-It’s Time for a

New Day!

MNA Local #12 nurses in Havre gather to welcome spring and celebrate “A New Day”

Clinic Nurse ManagerLivingston HealthCare has an opening for a full-time Clinic Nurse Manager. The Clinic Nurse Manager is responsible for the management of clinic nursing staff, operations of the clinics, and the Diabetes Education department. A bachelor’s degree in Nursing and current Montana RN license required.

Ifyouenjoyflyfishing,skiingandhiking,orifyoujustlovetheoutdoorsandarelookingforabalanceoflifestyleandcareer,complete an application at www.livingstonhealthcare.org or

call 406-823-6471 for more information. Livingston HealthCare is an Equal Opportunity Employer.

Join our growing team!


Continuing Education

Whatis“ConflictofInterest”andWhyDoesitMatterinContinuingEducation?

Pam Dickerson, PhD, RN-BC, FAAN

One of the most important things planners of continuing education are accountable for is content integrity. Accreditation criteria that guide our work specify that all educational activities must be free of bias, free of commercial control, based on best-available evidence, and resolving conflicts of interest. Why? As a learner, you have a right to know that your time, and often your money,

are being invested in a way that will enhance your professional development and support your ability to do quality work, whether that work is in patient care, education, research, or administration. Knowing that providers have developed education that meets those content integrity standards assures you that you will get a quality educational experience.

Conflict of interest is defined by the American Nurses Credentialing Center’s Commission on Accreditation as a situation when “an individual has the ability to control or influence the content of an educational activity and has a financial relationship with a commercial interest, the products or services of which are pertinent to the content of the educational activity.” Further, a “commercial interest” is defined as “any entity producing, marketing,

reselling, or distributing healthcare goods or services consumed by or used on patients.”

Who has the ability to control content? Any member of a planning committee, any speaker, or any author of written materials that are used in an educational activity has the ability to control content. Therefore, planners must determine either that (1) the person does not have a conflict of interest, or (2) if he/she does, the conflict is resolved to ensure that content integrity for the activity is maintained.

Let’s look at some examples:Martha Whitstone owns stock in Eli Lilly, a

pharmaceutical company. We have established that she has a financial relationship with a commercial interest, because a pharmaceutical company makes drugs that are consumed by patients. Next question: what is Martha speaking about? If her topic is leadership development, there is no conflict of interest, because there’s no relationship between the topic of her presentation and the products of Eli Lilly. If her topic is managing blood sugar levels of patients with diabetes, there IS a conflict of interest, because the topic of the presentation is directly related to insulin products manufactured and sold by Eli Lilly. Now, the nurse planner for the activity needs to work with Martha to resolve the conflict. This can be done in a number of different ways, most commonly by talking with her about the need to present a fair and balanced session, by reviewing her slides or handouts, and perhaps by having her sign an agreement that she will present the session without bias. Additionally, a member of the planning committee often observes the session to assure that content integrity is maintained. A final step in

this process is that you, the learner, must receive information that this conflict has been addressed. You will see that written in your program materials something like “no planner or presenter has a conflict of interest in relation to this activity” or “no planner or presenter has a conflict of interest in relation to this activity except for Martha Whitstone, who owns stock in Eli Lilly.”

Teresa Thompkins is an advanced practice nurse with expertise in geriatric patients with numerous co-morbidities. She is a consultant to Merck, in their gerontology division. She is being considered as a speaker on the topic of avoiding hospital readmissions for patients with CHF and COPD. Does she have a conflict of interest? Yes – she has a financial relationship with a commercial interest, and the relationship is related to the topic on which she is invited to speak. Can she still be the speaker on this topic? Absolutely – the steps described above just need to be followed.

If you are asked to be a speaker for a continuing education event, or if you submit an article for publication, you will be asked to provide information about any financial relationships you have with a commercial interest entity. Please understand how very important it is that nurse planners have this information so they can take the appropriate steps to assure the quality of the educational activity.

When you participate in continuing education activities, look for that disclosure indicating that either no one has a conflict of interest, or if a person does have one, what that relationship is. Transparency of this information helps you decide how to invest your time and money in obtaining quality continuing education.

Pam Dickerson, PhD, RN-BC, FAANDirector, Continuing

Education

http://sclhealth.org/careers

http://sclhealth.org/careers



Gina BrandonReflective Paper, University of Montana

The conference in Montana City was very helpful and thoroughly enjoyable. I have been aware of the many resources that are available to me as a new nurse, but the conference clarified how to utilize these resources in a professional manner. The guest speakers were well spoken, and extremely generous as they shared with us their unique, and sometimes embarrassing experiences as nurses. I was impressed with each participant, and they all seemed to be very open and caring individuals.

Pam Dickerson was an effective speaker- stressing the importance of maintaining a sound mind and healthy body in the nursing profession. She spoke of getting a good night’s sleep, learning how to say no, and I couldn’t agree with her more when she suggested that nurses should refrain from wearing acts of self-sacrifice as badges of honor, such as skipping meals, or forgetting to take breaks. It is true that sacrifices such as these are detrimental to our ability to provide appropriate care, and may actually put our patients in danger.

Hope Ballew is a promising young nurse that inspired me to participate within the group dynamic of the work place in order to build relationships to become a better nurse. This includes attending faculty meeting that may not be mandatory, or joining a committee even if I don’t know the first thing about the committee’s topic, simply because it opens the doors of opportunity, and forces on to learn something new. She touched briefly on the importance of traveling to other parts of the world to provide nursing care for those less fortunate. I think that this is a noble cause that also provides many benefits for any nurse who has the opportunity to do so. I look up to her as a peer, and I have a feeling that we may meet again.

Transition from New Graduate to Professional Nurse

Sandy did a wonderful job getting us out of our seats and smiling, as we danced a few little jigs, and sang a few silly songs. She also shined light upon our successful mentoring program, and spoke of the importance of always offering our services as a mentor, as well as always seeking out opportunities to be a mentee. This enforced my belief that the best nurses are those who make it a point to be lifetime learners.

Megan Hamilton was very energetic and truly entertaining as she too spoke of self-care, a topic that is very dear to my heart after working as a massage therapist for 15 years. However, it was her excitement for continuing education that inspired me most. Here is a woman that accumulated over 100 hours of continuing education within her first year as an RN out of pure excitement to learn. I can honestly say that I am now looking forward to my continuing education classes.

Overall, I was truly inspired by every single person who took the floor to speak. I know I am not alone: every seasoned nurse was once a new graduate. We all must start somewhere, and after this conference I feel like I have gained some insight in utilizing the

resources that are provided to us, and I plan on doing just that.

Other comments from those who attended MNA’s “Transition from New Graduate to Professional Nurse” January 26,2015.

I plan to use the info to make a plan for my own professional growth & development

I am constantly aware of maintaining positive work environment, I can be a mentor(not to just other nurses) very important to empower mentors & stress personal care.

I have gained a new appreciation for MNA &involvement in professional organizations

I wasn’t aware of the special certifications offered for the different areas of nursing. Now I know I can seek specialty certifications depending on where I work. Also, how important it is to recognize stress on ourselves.

Very useful strategies learned to move forward with. I will be the positive light shining with hopes that I will unite with a great mentor & do great things for my patients.

Megan Hamilton, RN, BSN, CFRN, EMTP

Models the students designed creating and sustaining healthy work environments

Students in group working on models

RNs, APNs, CRNAsGIVE US TWO YEARS AND WE’LL

GIVE YOU AN EXPERIENCE OF A LIFETIME

For more information contact:Jody Kirkie-Orozco, 605-226-7585

[email protected] Oleyte, RN, 406-247-7109

[email protected]

Loan Repayment Opportunities • Competitive Salaries & Benefits

Our Mission is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.

BILLINGS AreA INdIAN HeALtH ServIce

Native American Nurses “Leading Future Generations to a Healthier Tomorrow”The Caring for Our Own Program (CO-OP), supports American Indian and AlaskaNativepopulationsindevelopingahighlyskilledandculturallycompetentnursingworkforcetopromotepositivechange and to improve the quality of healthcare within Native communities.

Degrees offered: • BachelorofScienceinNursing(BSN) (accelerated BSN option available)• MasterofNursing(MN)• DoctorofNursingPractice(DNP)

Note:Graduatecoursesareofferedprimarilyonlinewithteleconference and video conference used to supplement content.

Scholarships available for qualified full-time students.

*This program is supported by funding from the Health Resources and Services Administration (HRSA) and the Indian Health Service.

Why wait? Apply Today!

For more information call

406-994-7684

or visit our website at

www.montana.edu/nanurse

LaurelHealth&Rehab100% Employee Owned

Seeking RNs and LPNsFull-TimeNight–12HourShiftsMustbeIVandCPRCertified

Contact:Jackie Myers, DNS8203rdAve. Phone:406-628-8251Laurel,MT59044 Fax:406-628-8253



SILVER SPRING, Md. — February 4, 2015 — The American Nurses Credentialing Center (ANCC) announces the first nursing practice transition programs to achieve accreditation from the ANCC Practice Transition Accreditation ProgramTM (PTAP):

• Emory Critical Care Center NP Residency Program,Emory Critical Care Center

• VersantRNResidencyatBaptistHealthSouthFlorida• Versant RN Residency in Pediatrics at Children’s

Hospital Los Angeles

The ANCC Practice Transition Accreditation Program offers a new credential that validates a nursing residency or fellowship program that meets ANCC evidence-based standards and best practice criteria. Whether graduating from academia to clinical practice, returning to the field or transitioning between clinical settings, registered nurses (RNs) and advanced practice registered nurses (APRNs) who successfully complete ANCC-accredited transition programs gain the knowledge, skills and professional behaviors to deliver safe, quality care.

“Residency and fellowship programs for RNs and APRNs provide critical support for the transition between academia and clinical practice or between different practice settings,” explained Kathy Chappell, Ph.D., RN, vice president of the ANCC Accreditation Program and Institute of Credentialing Research. “Research evidence has demonstrated organizations implementing robust residency or fellowship programs significantly reduce costs associated with turnover and vacancy, resulting in a positive return on investment to the organization. In addition, nurses completing residency programs have demonstrated an improvement in work satisfaction, employee engagement, self-confidence, commitment to the organization, time management skills, relations with team members, clinical leadership skills, critical thinking skills, role socialization, absenteeism and clinical competence.”

The Emory Critical Care Center NP/PA Residency Program at Emory Healthcare attracts new graduates who seek a structured educational program in order to become experts and leaders in their field. For one year, nurse practitioners (NPs) are trained alongside physician assistants (PAs) to become highly skilled in taking care of patients in the intensive care unit. The comprehensive competency-based curriculum allows residents to experience hands-on learning in the clinical setting.

The Versant RN Residency at Baptist Health South Florida runs twice annually for a yearlong program. This program offers nurse residents training, competency and professional development, and support for the critical transition from graduation to clinical practice. Through supportive mentoring, coaching and learning, RN residents develop clinical and leadership skills and are cultivated into nurse professionals who deliver high-quality patient care. This program earned ANCC accreditation with distinction.

The Versant RN Residency in Pediatrics at Children’s Hospital in Los Angeles provides one-to-one training and expert clinical guidance to nurse residents. This yearlong, evidence-based program offers a 22-week immersion period with 220 hours of classroom experience that includes skills las, group work, and a pediatric core curriculum. Experienced bedside pediatric nurses and subject matter experts train RN residents to handle the most complex pediatric cases in their unit. Each resident is equipped with the knowledge and tools needed to care for patients and families. The program earned ANCC accreditation with distinction.

“We are so proud to be recognized by ANCC as a provider of one of the highest-quality transition programs for advanced practice nurses,” said Heather Meissen, ACNP, CCRN program director for the Emory Critical Care Center NP/PA Critical Care Residency. “Our APRN residency program is among the first to earn this distinction. This achievement reinforces the core values that guide our daily actions to produce great outcomes for patients and the nursing profession.”

ANCC Announces First Nursing Transition Programs toReceive ANCC Accreditation

Marjorie Lima, MSN, RN-BC, manager of the Versant RN Residency at Baptist Health South Florida, transition program spokesperson, said, “Achieving accreditation with distinction is a groundbreaking moment for our residency program. ANCC accreditation motivates us to keep improving in nursing excellence. Our program gives our graduates the confidence to enter into any clinical setting knowing they were trained with the most current, evidence-based best practices.”

“It is such an honor for our RN residency program to achieve this ANCC distinction,” said Mary Dee Hacker, MBA, RN, NEA-BC, FAAN, vice president, Patient Care Services and Chief Nursing Officer, Children’s Hospital Los Angeles. “At Children’s Hospital Los Angeles, we continue to ensure our nurses are well educated and versed so they can provide the best care to patients and families.”

About Emory HealthcareAs the largest healthcare system in Georgia and the

only health network in the state that brings together a full range of hospitals, clinics, and local practices, Emory Healthcare is committed to providing patients and families with better, more collaborative care for all their medical needs. The Emory Healthcare Network encompasses teams of providers at our locations across Georgia, including Emory University Hospital, Emory University Hospital Midtown, Emory University Orthopedics & Spine Hospital, Emory Rehabilitation Hospital and the Wesley Woods Center, Emory Saint Joseph’s Hospital and Emory Johns Creek Hospital, Emory Clinic, and the Emory Healthcare Network physicians, ranging from primary to specialty care providers. Through our integrated, collaborative care network, we are dedicated to providing the standard of care that our patients expect and deserve. emoryhealthcare.org

About Baptist Health South FloridaBaptist Health is the largest healthcare organization in

the region, with seven hospitals (Baptist Hospital, Baptist Children’s Hospital, Doctors Hospital, Homestead Hospital, Mariners Hospital, South Miami Hospital and West Kendall Baptist Hospital) and more than 30 outpatient and urgent care facilities spanning three counties. The not-for-profit, faith-based Baptist Health has more than 15,000 employees and 2,200 affiliated physicians, and also includes Baptist Health Medical Group, Baptist Outpatient Services, and internationally renowned centers of excellence. Baptist Health Foundation, the organization’s fundraising arm, supports services at all hospitals and facilities. Baptist Health is listed by Fortune magazine as one of the 100 Best Companies to Work for in America (No. 19 in the nation and No. 1 in Florida) and has remained on the list for 14 years. It was also recognized as one of the World’s Most Ethical Companies for the third year in a row by the Ethisphere Institute. baptisthealth.net

About Children’s Hospital Los AngelesChildren’s Hospital Los Angeles has been named the

Best Children’s Hospital in California and among the top five in the nation for clinical excellence, with its selection to the prestigious U.S. News & World Report Honor Roll. Children’s Hospital Los Angeles is home to The Saban Research Institute, one of the largest and most productive pediatric research facilities in the United States. Children’s Hospital Los Angeles is also one of America’s premier teaching hospitals through its affiliation since 1932 with

the Keck School of Medicine of the University of Southern California. chla.org

About the ANCC Accreditation ProgramThe ANCC Accreditation program recognizes the

importance of high-quality continuing nursing education (CNE), skills-based competency, and nurse practice transition programs. Around the world, ANCC-accredited organizations provide nurses with the knowledge and skills to help improve care and patient outcomes.

Accreditation by ANCC validates that a nursing residency or fellowship program has been operationalized to meet ANCC standards, regardless of whether the curriculum is developed in- house or purchased from a provider. Use of any course/material/service does not imply eligibility for or successful performance in the submission of credential applications, nor is it a requirement to qualify for accreditation. ANCC does not endorse any products or services.

About ANCCThe mission of the American Nurses Credentialing

Center (ANCC), a subsidiary of the American Nurses Association (ANA), is to promote excellence in nursing and health care globally through credentialing programs. ANCC’s internationally renowned credentialing programs certify and recognize individual nurses in specialty practice areas. ANCC recognizes healthcare organizations that promote nursing excellence and quality patient outcomes while providing safe, positive work environments. In addition, ANCC accredits healthcare organizations that provide and approve continuing nursing education. ANCC is the first and only healthcare certification organization in the United States to have successfully achieved ISO 9001:2008 certification. nursecredentialing.org

406-654-1100 • www.pchospital.us

RNs, LPNs, & CNAs

Currently seeking professional and progressive nurses to work in our small rural facility where we offer a family-oriented, supportive, TEAM–building work environment.

Wages – DOE

Benefits – Sign On Bonus, partial payment for single premium for health/vision insurance, accrued PTO/8 paid Holidays, eligible for 401(k) after 1 year of employment.

Our mission is To Make a Difference

in Healthcare!

Start a conversation

Find your local testing site

Visit us online

An average of 20 patients

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MONTANA

Are YOU talking with YOURS?

Call 406-248-3149 or Email: Vicki Thuesen•[email protected]

Montana Migrant & Seasonal Farmworker Council Inc.3318 3rd Ave. North, Suite 100 • Billings, MT 59101

MMC is seeking Full or Part Time Family Nurse Practitioners and

Registered Nurses for our farmworker health clinics in Billings, Dillon and

Fairview, Montana.New grads encouraged to apply.

Opportunity to provide primary health care services for agricultural families in clinics, mobile

clinics, homes, fields, schools and orchards.



Montana Nurses Association Approved Providers

St. Vincent Healthcare Alaska Native Medical CenterBillings, MT Anchorage, AK

Kalispell Regional Medical Center Fairbanks Memorial HospitalKalispell, MT Alaska

Benefis Healthcare Systems Central Peninsula General HospitalGreat Falls, MT Soldotna, AK

St. Peter’s Hospital Wrangell Medical CenterHelena, MT Wrangell, Alaska

Community Medical Center Montana Health NetworkMissoula, MT Miles City, MT

Bozeman Deaconess Hospital Livingston HealthcareBozeman, MT Livingston, MT

Providence St. Patrick Hospital Alaska Nurses AssociationMissoula, MT Anchorage, AK

Billings Clinic North Valley HospitalBillings, MT Whitefish, MT

MT Geriatric Education Center South Dakota Nurses AssociationMissoula, MT Pierre, SD

St. James Healthcare Partnership Health CenterButte, MT Missoula, MT

Providence Alaska Medical Center Mountain Pacific Quality HealthAnchorage, AK MT

South Peninsula Hospital Alzheimer’s Resource of AlaskaHomer, AK Anchorage, AK

Bartlett Regional Hospital Wisconsin Nurses AssociationJuneau, AK Madison, WI

Alaska Division of Public Health Shands HealthcareAnchorage, AK Gainesville, FL

Mat-Su Regional Medical Center Northside HospitalPalmer, AK Atlanta, GA

Montana Nurses Association103rd Annual Convention

September 30, Wednesday – October 2, Friday 2015Helena, MT

Best Western Premier Helena Great Northern Hotel

* 2 1/2 days of Continuing Education* House of Delegates

* Movie Night “The American Nurse”* Council Meetings

* Networking with Colleagues* Register with your District as a Delegate

Keynote Speakers

Register online at www.mtnurses.org

Nurses

The Heart of Healthcare

Pamela F. Cipriano, PhD, RN, NEA-BC, FAANPresident, American Nurses AssociationSeptember 30, 20159:00 am - 10:00 am

Jeannime Brant, PhD, APRN-CNS, AOCN, FAANOncology Clinical Nurse SpecialistOctober 1, 20159:00 am - 10:00 am

NSRH is a Joint Commission accredited facility with 18 acute care beds, 18 LTC beds serving the people of the Seward Peninsula and Bering Straits Region of Northwest Alaska.

ContactRhondaSchneider,[email protected]

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2015 Nursing Summit Integrates Education and PracticeRita E. Cheek, RN, PhD

Co-Project Director, APIN GrantMontana Center to Advance Health through

Nursing (MT CAHN)

The Montana Center to Advance Health through Nursing (MT CAHN) is pleased to host the Second Nursing Practice and Education Collaborative Summit. The Summit (or Collaborative) is June 8 and 9, 2015 at the Great Northern Hotel in Helena. This collaborative is partially supported by the Academic Progression in Nursing (APIN) grant from the Robert Wood Johnson Foundation. Dr. Casey Blumenthal, Dr. Cynthia Gustafson, Dr. Sandra Kuntz, and Ms. Kailyn Dorhauer are the conference planners. The primary goal of the summit is to bring nurses from all practice settings together with nursing program educators to help co-create the future of nursing in Montana.

General objectives for this summit are to continue the dialogue we started last year about how to transform nursing education and practice so we can produce the nurse of the future. New nurses and practicing nurses, along with those who educate them, must be engaged in the development of nurses with the knowledge, skills, and abilities that will be necessary for our nursing workforce to meet the demands of patients in this fluid, changing healthcare environment. A transformation of this magnitude cannot be done in a vacuum; this is why we are providing a forum for your learning, your thoughts, and your recommendations so we can collectively move forward as a profession in Montana.

Dr. Nancy Spector, Director, Regulatory Innovations at the National Council of State Boards of Nursing will share information on the NCSBN’s

National Simulation Study and Transition to Practice Study in Hospital Settings. Dr. Spector was the Principal Investigator on NCSBN’s multisite Transition to Practice Study and a consultant on the National Simulation Study. She has worked on a number of other initiatives, including the regulatory implications of social media, innovations in nursing education, the future of nursing program approval and regulatory issues in distance learning programs. Dr. Spector presents and publishes nationally and internationally on regulatory issues in nursing education. Specific objectives for Dr. Spector’s sessions will include (a) identifying evidence for transitioning new nurses to practice, based on NCSBN’s recent study; and (b) policy recommendations for nursing programs using simulation, as a result of NCSBN’s multisite study of simulation.

A leader from the National Program Office will showcase the progress of APIN grantees in other states and Montana’s APIN leaders will update everyone on the work being done here at home, particularly on the Preceptor and Mentoring programs.

A panel presentation is planned on Native American Nursing with specific focus on the need for more Native American nurses and linkages between tribal colleges and nursing education programs. Information from the audience will be used by MT CAHN to establish a diversity plan for Montana.

We’ll also hear from Kaye Norris, Project Director, with an update on the HealthCARE grant from the Department of Labor and how these activities (particularly the revision of nursing education curriculum) are engaging nurses in practice and education across the entire state. There will be time

for idea generation and networking to help us forge new paths!

The gathering begins at 8:30 a.m. on Monday, June 8, and finishes at 12:00 p.m. on Tuesday, June 9. Participants may earn up to 10 contact hours of continuing education. Registration fees are $99 for an individual and $29 for nursing students and new graduates. A more detailed agenda will be posted on http://mtcahn.org as soon as it’s available with information on registration. A block of rooms is currently available at the Best Western Premier Helena Great Northern Hotel under the booking title “Nursing Education Summit.”

If you are not able to personally attend, please encourage someone from your organization to come and participate in the continued conversation about nursing in Montana. To obtain additional information, please contact Kailyn Dorhauer at [email protected] or call 406-994-7709.

Membership

MEMBERSHIP MATTERS!

Montana Nurses Association would like to invite you to join us today!

BENEFITS INCLUDE:•EMPOWERINGRNsTOUSETHEIR

VOICES IN THE WORKPLACE•IMPROVINGPATIENTCARE

•HAVINGINPUTREGARDINGWAGES&BENEFITS

•CONTINUINGEDUCATIONOPPORTUNITIES

•LEGISLATIVEREPRESENTATION

Call or email [email protected](406) 442-6710

Applications also available onour website.

mtnurses.org

Has your contact informationchanged?

New name? New address? New phone number? New email address?

To update your contact information, please email or call Montana Nurses Association:

[email protected] or 406-442-6710

MNA Welcomes New Membershipand

Finance SpecialistMontana Nurses

Association is pleased to announce Jill Hindoien has joined our team as our new Membership and Finance Specialist. Jill brings with her a background in membership database and finance and we are looking forward to improving our database.

Jill can be reached at 406-442-6710 or by email, [email protected].

Jill HindoienMembership &

Finance

Consider a Career at Saint Alphonsus Health System

Saint Alphonsus Health System is a four-hospital regional, faith-based Catholic ministry serving southwest Idaho and eastern Oregon.

Opportunities available in:• Intensive Care • Med-Surg• Coronary Care • Rehab• Emergency • OB/NICU Department • Main OR• Clinical Support Team • Nursing (Float Pool) Professionals

To learn more and to apply, please visit

www.saintalphonsus.org/careersOr call Roxanne Ohlund 208-367-3032

or Rick Diaz 208-367-3118

Northern Rockies Medical Center“The right care...right here!”

$2,000.00 SIGN-ONBONUS!

Northern Rockies Medical Center, a Critical Access Hospital in Cut Bank,

MT, is now hiring

Full-Time RNsPlease contact:Cherie Taylor at

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Statewide Nursing News

VanDaveer,Phillips,andBondeHonoredbyMTCAHNCasey Blumenthal, RN, DNP

From a field of multiple, highly qualified candidates, Karen Van Daveer, Kellie Phillips, and Dr. Trena Bonde were recognized for their excellent work by the Montana Center to Advance Health through Nursing (MT CAHN) at the MHA Health Summit in Bozeman on March 11. Ms. Karen Van Daveer was recognized as the Outstanding Nurse, Ms. Kellie Phillips earned the Outstanding Nursing Student award, and Dr. Trena Bonde was acknowledged as the Outstanding Nurse Champion. Many individuals across Montana were nominated for their outstanding work. Thanks to all who submitted nominations!

The nomination of Karen VanDaveer, RN, MN, Director of the Nursing Program at Montana Tech of the University of Montana in Butte, was submitted by Allison Marie Duffy on behalf of the entire nursing faculty and supported by Dr. Doug Coe, Dean of the College of Letters, Sciences, and Professional Studies, and Dr. Douglas M. Abbott, Provost and Vice Chancellor for Academic Affairs, at MT Tech. For many years Ms. Van Daveer has shown significant nursing leadership. She began her work in nursing education with the certificate program for the Licensed Practical Nurse (LPN). Karen led faculty in the development of an associate degree program for the LPN, and then an associate degree program for the Registered Nurse (RN), followed by a Bachelor of Science degree completion program for the RN with an associate degree. Karen was also instrumental in creating a statewide associate degree nursing curriculum. More recently she guided MT Tech nursing faculty in developing a 120-credit direct entry Bachelor of

Science degree nursing program which was approved by Montana’s Board of Nursing and Board of Regents this year. Her tireless work collaborating with other nurses in education and nursing practice as well as key individuals beyond nursing has contributed to her successful endeavors. Karen was patient, yet persistent as she brought nursing education to the “mining and engineering school” at MT Tech. Nursing education is now the third largest program on the MT Tech campus. All nursing faculty came to Bozeman to recognize Karen’s achievements! Congratulations, Karen!

Ms. Kellie Phillips, a senior nursing student at Montana State University (MSU) graduating in May, was nominated by Terry Lee Altemus, BSN, BA, MPH, Nurse Mentor for the Caring for Our Own Program (COOP) at MSU. Ms. Phillips was born in Eagle Butte, SD and is a proud Lakota from the Cheyenne River Sioux Tribe. Kellie graduated with A.S. degree in general studies from Sheridan College in 2010 before enrolling at MSU. As an MSU student, Kellie demonstrates excellent leadership characteristics. She participates in the National Student Nurse Association (member), Oncology Nursing Society (ONS) (member), Montana Student Nurse Association (State Board of Directors and Billings Campus Vice President), Breakthrough to Nursing, and MSU College of Nursing Student Forum (President and Treasurer) as well as the COOP program. During her nursing education, Kellie was awarded top honors including the Udall Scholarship honorable mention in 2013 and 2014, Spirit Outstanding Student award in 2013, Emerging Scholar award in 2014, and McNair Scholar in 2014. She was inducted into Zeta Upsilon Chapter of Sigma Theta Tau International, the Honor Society for Nursing, in 2014. As a research scholar, Kellie was mentored by

Dr. Jeannine Brant, PhD, APRN, AOCN, FAAN, Billings Clinic Oncology Clinical Nu r se Spec i a l i s t and Nurse Scientist. Specifically, Kellie worked with Dr. Brant to test a novel electronic platform, w h i c h g a t h e r e d p a t i e n t - r e p o r t e d outcomes in patients with gynecologic m a l i g n a n c i e s a n d t r a n s l a t e d their symptom reports into a supportive care plan. Kellie was instrumental in patient recruitment, data collection, and platform revision through team meetings. Kellie submitted an abstract to the ONS Annual Congress that was accepted for poster presentation in Orlando, FL spring 2015. Kellie’s goal is to obtain a DNP and possibly a PhD. Congratulations, Kellie!

Dr. Trena Bonde, MD, is Chief of Staff at the VA Hospital in Helena. She was nominated by Debra Charlton, MSN, RNC, Nurse Manager of Ambulatory Care, Central VA Montana Health Care Systems. Dr. Bonde is not a nurse, yet significantly supports nurses and nursing with her collaborative approach to health care. When Trena makes rounds in the departments, she asks for nursing input from both middle management and the frontline staff on ideas for patient care, patient flow, process improvement activities, and how to implement mandates. She is an active mentor for Leadership programs at both the local and VISN level. She fosters developing staff to their highest potential. According to Ms. Charlton, Trena “consistently promotes collaborative partnerships with nursing and embraces the value nursing contributes to improved outcomes, quality of care and coordinating ‘excellence’ in care.” Because she empowers nurses and promotes nursing autonomy, effective, innovative models of care have resulted. Trena is a great teacher and was one of the outstanding keynote speakers at MHA’s Health Summit in March. She teaches nurses the “unspoken rules” of collaboration between nurses and health care providers. Her advice is to “know your stuff, ask questions, build collaboration, and demonstrate that you can be trusted” These are the keys to building strong partnerships in patient care and achieve positive outcomes. Congratulations, Dr. Bonde!

Karen VanDaveer, RN, MNDirector of Nursing at Montana Tech of the

University of Montana, ButteDr. Trena Bonde, MD

Bridging Your Practice for the Future100% Online

No Campus Visits Required

DNP - Doctor of Nursing PracticeMSN - Two tracks available

• Nursing Education• PrimaryCareNursePractitionerAdult/GeroorFamily

http://www.uccs.edu/bethel/programs.html

For more information about these programs, contact Diane Busch, Program Assistant, at 719.255.4424,

800.990.8227 (x4424) or [email protected].

The Doctor of Nursing Practice and Master’s Degree in Nursing at Helen and Arthur E. Johnson Beth-El College of Nursing and Health Sciences at the University of Colorado are accredited

by the Commission on Collegiate Nursing Education(http://www.aacn.nche.edu/ccne-accreditation)

Livingston HealthCare has an opening for a Full-Time Emergency Department Manager

who will also oversee Outpatient Infusion and Cardiopulmonary Services

This position is responsible for management and 24 hour responsibility for the day-to-day nursing operations of nursing practice and operations

in the Emergency Department, Outpatient Infusion Services and Cardiopulmonary Units. This position works closely with the Director

of Nursing Services, Physician Leadership and staff in insuring that the Units maintain the highest standards of patient care and are responsive

to the needs of the patient & family as well as the organization.

A bachelor’s degree or advance degree in Nursing required. Current Montana RN or NP license required.

If you enjoy fly fishing, skiing and hiking, or if you just love the outdoors and are looking for a balance of lifestyle and career, complete an application at www.livingstonhealthcare.org or call 406-823-6471 for more information.

Pre-employment drug screen and background check required. Livingston HealthCare is an Equal Opportunity Employer.

Join our growing team!

Psychiatric Nurse Practitioner Advance Practice RN to provide psychiatric evaluation and medication monitoring to patients in addiction treatment setting. Flexible daytime hours, full or part-time.

RN/LPN Full-time day shift position for RN or LPN caring for patients in 12 bed Medical Unit.

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National News

Evidence-Based Practice Protects Against LitigationJennifer Flynn, BA

Manager, Healthcare Risk ManagementNurses Service Organization (NSO)

You’re taking care of Mr. Smith, a 78-year-old man who just arrived in the emergency department with signs and symptoms of a stroke. The steps you take next will contribute to Mr. Smith’s short- and long-term outcomes. If you base those steps on the latest evidence, you’ll also protect yourself from litigation if an untoward event occurs.

Evidence-based practice (EBP) is a problem-solving approach that encompasses research, clinical expertise, and patient values and circumstances. Nurses should use information from these three components to make informed decisions that are in the best interest of their patients. Integrating EBP with your practice will improve patient care and reduce your risk for legal action.

The gold standard Evidence-based practice is accepted as the gold

standard for professional nursing practice because it improves patient outcomes. For example, the 2003 Institute of Medicine (IOM) report Health Professionals Education: A Bridge to Quality states EBP is a core competency for healthcare professionals, and IOM’s 2010 landmark report The Future of Nursing: Leading Change, Advancing Health confirms EBP as a basic competency.

Additional support comes from general and specialty nursing associations. The American Nurses Association’s Standards of Practice include the competency, “The registered nurse utilizes evidence-based interventions and treatments specific to the diagnosis and problem.” Other competencies also mention the importance of evidence. Standards from specialty nursing organizations include EBP as well. For example, the American Association of Critical-Care Nurses’ standard of professional practice related to research has this as its measurement criteria: “The nurse continually questions and evaluates practice and uses best available evidence or research findings to develop appropriate plans of care.”

All this adds up to a consensus that EBP is a vital part of the profession. In a court case, an attorney will stress this fact while attempting to prove that you failed to engage in EBP. That’s why your practice must be based on evidence, even though doing so can be challenging.

Barriers to EBP A 2012 study published in the Journal of Nursing

Administration found that only 34.5 percent of

nurses agreed or strongly agreed that their colleagues consistently use EBP in managing patients. If EBP is so effective in improving outcomes, why don’t more nurses practice it? The study found that although nurses believe in EBP, they encounter multiple barriers, with the top two being lack of time and lack of support from the organization where they work, including resistance from colleagues and managers.

The same study found that most nurses want to learn more about EBP but find education resources lacking. They also lack mentors to guide them.

Overcoming the time barrier Fortunately, many resources are available to break

the time barrier, particularly when it comes to collecting and evaluating the evidence. These resources include:

• CochraneDatabaseof SystematicReviews (www.cochrane.org), which provides analysis of available literature related to a topic (some information is available for free)

• Journals such as Worldviews on Evidence-BasedNursing and Nursing Research, as well as journals in your specialty practice area (requires a subscription)

• NationalGuidelineClearinghouse(www.guideline.gov), which provides summaries of clinical practice guidelines and has a tool that allows you to compare multiple guidelines (free access)

• Resources from specialty associations. Forexample, AACN Practice Alerts provides nursing actions related to a specific issue, such as assessing pain in the critically ill adult. The actions are backed by evidence found in the literature (free access).

• Joanna Briggs Institute (joannabriggs.org), which provides evidence reviews (some information available for free)

• U.S. Preventive Services Task Force(uspreventiveservicestaskforce.org), which provides evidence-based recommendations for preventive care (free access)

• Tools for appraising the evidence. Several scalesare available to help you evaluate the evidence you find. You can link to these scales at http://nursingworld.org/Research-Toolkit/Appraising-the-Evidence.

An often overlooked but highly valuable resource is the medical librarian. A medical librarian at your facility, local university, or health center can guide you through the process of conducting a literature search so it’s more efficient.

Overcoming resistance Overcoming resistance can be challenging. You

can start by serving as a role model for others. Take the lead in suggesting practices that could benefit from a re-examination. For instance, is the acuity tool you currently use really the best one to ensure that assignments benefit patients?

Suggest your nurse practice council embrace EBP as a tool to improve patient care. Managers might choose to tap into clinical nurse specialists to serve as resources to staff who want to engage in EBP projects and build such projects into job descriptions and evaluations. Another option is to partner with a faculty member at a local university.

Overcoming a lack of knowledge You don’t need a large budget to gain knowledge

about EBP. You can access free self-study programs online. For example, staff at Duke University Medical Center Library and the Health Sciences Library at the University of North Carolina at Chapel Hill developed an “Introduction to Evidence-Based Practice” tutorial, available online at http://guides.mclibrary.duke.edu/content.php?pid=431451&sid=3529491.

For tips on interpreting the information you find, access the “How to read a paper” section of the BMJ website, which contains an article on how to read and interpret different types of research studies and includes two articles related to statistics (www.bmj. com/about-bmj/resources-readers/publications/how-read-paper).

If your organization provides educational reimbursement, consider attending a workshop on EBP. Retain documentation of the courses you complete so you can show evidence of your efforts should you be involved in a lawsuit. The evidence will also be helpful for career advancement.

Evidence-Based Practice continued on page 12

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Medical Review Nurse Full-time position for RN Medical Review Nurse who would enjoy working in an office environment with a culture of professional friendliness. This full-time Registered Nurse position provides career stability and has room for professional growth.

As a Medical Review Nurse your experience working with Milliman care and the National Comprehensive Cancer Network guidelines will be keys to success in landing this unique opportunity. Other responsibilities will include performing retrospective review of high dollar claims, review claims that require medical knowledge evaluation of medical necessity, benefit coverage. Cross training to perform Utilization Review, Case Management and Concurrent Review function.

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National NewsEvidence-Based Practice continued from page 11

Keeping up Staying on top of developments in your field helps ensure you are aware of the

latest research. You can use technology to make the process easier. For example, services such as Feedly (www.feedly.com) let you customize feeds of news stories related to your interest areas. You can easily scan the headlines and short descriptions to determine if you want to learn more. Other options you might want to try:

• Signuptoreceiveelectronictablesofcontentfromjournalsyouareinterestedin. You can scan the table of contents to determine what’s of interest to you.

• Subscribe to electronic newsletters such as those provided by Medscape orSmartBrief.

• Listentopodcastsasyouexerciseordrivetowork.• DownloadanappsuchasMendeley(www. mendeley.com) that lets you capture

articles as PDFs and organize them according to keywords and other parameters.

Taking just these few steps can ensure that you are current in your evidence-based knowledge.

Steps of evidence-based practice Here are the basic steps of EBP: • Cultivate a spirit of inquiry. • Ask the clinical question in PICOT (Patient population, Intervention or Issue of

interest, Comparison intervention or group, Outcome, and Time frame) format. • Search for and collect the most relevant best evidence. This includes searching

for system-atic reviews and meta-analyses. • Criticallyappraise the evidence for its validity, reliability, and applicability. • Integrate the best evidence with your clinical expertise and patient preferences

and values in making a practice decision or change. • Evaluate outcomes of the practice decision or change based on evidence. • Disseminate the outcomes of the EBP decision or change. Source: Melnyk BM,

Fienout-Overholdt E. Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice, 2nd ed. Philadelphia: Lippincott, Williams & Wilkins; 2010.

Practicing effectively Basing your practice on evidence will benefit your patients by ensuring optimal

outcomes. It will also benefit you by providing support for your decisions should you find yourself in the uncomfortable position of being named in a legal action.

RESOURCES American Association of Critical-Care Nurses. Standards for acute and critical care nursing

practice. http://www.aacn.org/wd/practice/content/standards.for.acute.and.ccnursing.practice.pcms?menu.

American Nurses Association. Nursing: Scope and Standards of Practice, 2nd ed. American Nurses Association: Silver Spring, Md. 2010.

Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. October 5, 2010. http://www.iom.edu/Reports/2010/The-future-of-nursing-leading-change-advancing-health.aspx.

Institute of Medicine. Health Professions Education: A Bridge to Quality. April 18, 2003. http://www.iom.edu/reports/2003/health-professions-education-a-bridge-to-quality.aspx.

Melynik BM, Fienout-Overholdt E, Gallagher-Ford L, Kaplan L. The state of evidence-based practice in US nurses: critical implications for nurse leaders and educators. J Nurs Admin. 2012;42(9):410-417.

Melnyk BM, Fienout-Overholdt E. Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice, 2nd ed. Philadelphia: Lippincott, Williams & Wilkins; 2010.

Saver C. Keeping practice knowledge current. Part 1. Nurse Pract. 2012;37(12):1-5.

This risk management information was provided by Nurses Service Organization (NSO), the nation’s largest provider of nurses’ professional liability insurance coverage for over 650,000 nurses since 1976. The individual professional liability insurance policy is administered through NSO and underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company. Reproduction without permission of the publisher is prohibited. For questions, send an e-mail to [email protected] or call 1-800-247-1500. www.nso.com.

Keven Comer, APRN, MN, FNP-BC

Seventy-five advanced practice registered nurses networked at the APRN Pharmacology Conference in Helena on March 13th and 14th, 2015! When asked how they planned to use this learning activity to strengthen their practice the replies varied and were as follows:

“I will use the guidelines presented for updating Hepatitis C and B, the concussion assessment and the opioid use in my present practice.”

“The prescription drug registry information will be further implemented.”

”I found the Detox information had a better description of addiction issues and plan to utilize the Prescription Drug Registry in my practice immediately.”

“I will use the End of Life strategies to work with my patients in need.”

”This conference reinforced treatment plans and implementation of new ideas.”

”I want to learn more on wound practices at our clinic and will check PDR for my scripts to patients monthly.”

”I have a better understanding of HIV and Hepatitis C and family planning patients and their treatments.”

“I plan to make changes based on new updates and pass on this information to other providers in the clinic.”

”I have an improved plan of care for concussion screening and improve my diabetic care.”

When the participants were asked which gaps in knowledge were closed, these were their replies:

“Good information on how to describe the brain to a child and his parents.””I have a better understanding of the new Diabetes Mellitus medications.””I will become more vigilant in narcotic prescribing and use the drug registry more.””Really increased my knowledge concerning concussions.””My assessment skills were really enhanced.””Helped update my diabetic knowledge and wound evaluation!”And last but not least, MNA’s favorite comment was: “Excellent conference! Always enjoy this conference! Very knowledgeable speakers!

The quality gets better each year!” Mark your calendars for next year, March 4 & 5, 2016.

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MontanatoMalawi–2ndInstallmentJan Ivers

My life is full of circling circles, parading circles, bars and messages to refresh. “No internet available” is common. The frustration of unreliable internet. And I don’t know what to do about it. When internet is available it is so incredibly slow; that is why I have a Kindle and Sudoku book by my computer. And I really am trying to learn patience (again and still!)

We started teaching the first week of November. My responsibility is to help team teach adult acute health. I teach with two other lecturers, W and M (we call her M-with-a-cape as she wears a Florence Nightingale type cape). My first assignment was to teach documentation. I reviewed with a PowerPoint and then broke the class into groups to discuss how they would document specific events that I had given them on little slips of paper. It went fairly well. Then we got into the Malawian style of teaching. We have 253 students in this class. It is a regular classroom, not auditorium style seating. It is hot. One day I had a thermometer with me (before I left Washington D.C. I bought a compass. It had a thermometer on the back, which has come in handier than the compass. Complete with wind chill factor, which I have not needed), and it was 92 degrees in the classroom. Sometimes we even have electricity, but no microphone system. I have to admit the students are very quiet. So, back to Malawian style...topics are assigned to groups of about twenty students. The group presents the topic, and I grade them on how well they did, give corrections and additions. So, I am busy studying up on the specific topics. My students, whose first language is Chichewa and second language is English, speak with a British accent. In addition, it is common in Malawi to switch “Ls” and “Rs” (for example, “lumen” would become “rumen”) when speaking. These language differences have sometimes been challenging for me, but as I have spent more time in Malawi, comprehension has become easier.

Demonstrating insertion of an NG tube or suctioning.

We spent five weeks in theory. Then the students have clinicals for twelve weeks. At the end of theory, we had an exam. Keep in mind 253 students. Can you believe we wrote an essay test? Never again. All multiple choice from now on. The theory part has been over for about a month and a half and we just finished entering the grades. Sounded like a good idea. Didn’t work.

On to clinicals. During a meeting, the nurses and preceptors were each assigned a ward/area of supervision of students. I waited for my assignment. I was sitting next to the head of the Medical-surgical department. She had a list of areas for the assignments of the nurses. I saw ICU at the bottom. I pointed to it, and she said, “And Janet will help me in the ICU.” Yippee. I really enjoyed working with the students in small groups in the ICU. So, I get to go back. ICU clinicals are year four students. Right now we don’t have students as year four is in another campus, but later in the month the next group comes in. I did work with some students right before Christmas vacation, and it is so very interesting.

This ICU experience started in October. The head of the Medical-surgical Department was at a conference for two weeks, but she was in charge of eight students in the ICU and surgery (surgery is called “theater” here). Since I had some ICU experience, she asked me to supervise them. Great! But no orientation to this position. The first day I introduced myself after the students were done with “hand-over,” (which we call report-the passing of information about the patients from the departing shift to the shift coming on). I said, “I want you to answer two questions: Why is your patient in the ICU and what are you going to do for your patient today?” They said, “The charge nurse told us we have to dust first.” “Dusting” means cleaning everything except the floors, which are done by housekeeping. OK, so, first you dust, then take care of your patients.

There are four beds in ICU. This is a 1000-bed hospital. Every ward has an HDU (High Dependency Unit), which has oxygen. I have heard that most patients do not want oxygen as they had a relative or friend that came to the hospital, had oxygen, then died. So, back to our patients. First patient: 34 year old woman who had had a miscarriage and presented with a hemoglobin of 1.8 mg/dl. They gave her blood to raise her hemoglobin, but by that time she was in multiple organ failure. She has a “reactive” HIV status, which was kept secret from her husband. HIV affects many of the systems, especially the ability to fight off infection. She died of septic shock. So, we wonder, why would a woman keep HIV status from your husband, and have come up with possibilities:

• ShecontractedHIVfromanotherman.• HerhusbandcontractedHIVandgaveittoher.• HerhusbandmayuseherHIVstatustodivorce

her, leaving her to raise children all by herself.It is a very social/public health problem. And very

complex. I am sure I will learn much more about HIV/AIDS this year. All I know at this point is that a pregnant woman died at the age of 34 years old leaving her children to be raised by someone else.

Second case: This 26 year old male hurt his right ring finger. He bandaged it, then ten days later had muscle cramping and could not chew. He came into the ward, and they took him into theater (surgery) to clean his wound. At that time the diagnosis was made and he was admitted to the ICU with tetanus. I had to review tetanus and the medications involved, as most people in the US have immunizations. The patient was apparently given anti-toxin, and sedated. Ideally, he was to be kept in a quiet room, which was not the ICU. Minimal touching of patient is recommended as touch brings on spasms. He was given magnesium sulfate and Lorazepam. The students documented the spasms as far as frequency and the Lorazepam was adjusted accordingly. Every day I saw him he was in extreme pain moaning through clenched teeth. I was so very worried for him.

Third case: a five-day old came in with difficulty breathing. They took him to theater to intubate him, and found a para-tracheal abscess. They withdrew 10 cc of pus and sent him to the ICU. I asked if they send the specimen to the lab. They laughed. No, Madame. Ok, so what are we giving him? Broad spectrum antibiotics. By the week’s end, he had been to theater once more to re-drain the abscess.

By the end of the second week, he was discharged to pediatrics and eventually went home. This little tyke had been through two surgeries, antibiotics, a ventilator and multiple other procedures in his short life. But he made it. I had one of my students and two students from other nursing colleges. I was speaking to my student, and the other two were listening, then talking quietly. Finally, one of the others said, “My fellow student thinks you are being selective. He thinks you should teach all of us.” My responsibility is only for my student, but I took this as a compliment, and I said, “Are you studying to be a nurse?” They both said, “Yes.” I said, “Then I will teach you, too.” I gave them assignments, such as, “Why is this patient on two antibiotics? Which antibiotic is effective for anaerobes? I will be back tomorrow for the answer.” The student who did not have a patient yet was googling Atropine. I asked her about it. She held up a vial and said she was just curious. I told her that tomorrow I wanted to know about that drug. When is it used? Why would you use it? What does it do? I want her to tell me about it.

One day I was tearful. It started in the morning with feelings of missing home. I don’t know why-no specific reason. I was just sad. Missing family, friends, and familiarity. I had to swallow tears. I hate to start the day crying. I walked to work, and at 10 am I had a medical-surgical meeting. Everyone is very nice about speaking English during the meeting, but during the breaks, my colleagues revert to Chichewa, which makes me feel isolated. So, I revert to checking my emails and text messages. I was still sad when I left the meeting. As I was exploring options as to how to handle this situation if it occurs again, I saw a little boy about 2 years old. He saw me and his eyes got big. I was sure he was going to burst into tears like many of the other children do. I smiled. He smiled the biggest grin, tottled over to me and wrapped his arms around my legs. I got a knee-down hug. He kept grinning at me. He was absolutely adorable. We were able to communicate without spoken language which made me feel the human connection I had been missing.

I went to ICU and ran into one of the doctors there. I asked him about the man with tetanus, and he said he had been transferred out to the ward. He said, “You should go see him.” After I finished my work in ICU I went to the ward. I asked about the patient, and went to see him. He was sitting up

Montana to Malawi continued on page 14

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and three of his family members were in the room. I introduced myself and told him I was working in ICU when he was there. He said he remembered very little about ICU. As much pain as he was in that was a blessing. He was going home the next day. He reached for my hand, and I held his hand. I told him I was very worried about him. He said, “God bless you” with tears in his eyes. He still could not walk, but he was alive. My tearful day finally ended, but on a good note. I felt so good and needed about what I had done. I hope it works as well once I start teaching classes.

I have been settling into a routine. My buddy, A, loves to shop for fabric almost as much as I do. Our Saturdays are generally set aside for fabric shopping. So, there is a huge market about 30 minutes by mini-bus from us. There is lots and lots of fabric. It was quite fun. A and my housemate, C, and I spent about an hour just looking. We cruised every stall that had fabric, asking prices, then returned to the ones offering the best deal. I walked up to a particular lovely chunk of fabric and picked it up to look at it. A bee was sitting on the other side-guess he was looking, too. Anyway, I got stung on my left palm. Luckily I was in the presence of a doctor, a nurse and a Swiss Army knife. Got the stinger out and was back looking at, but not touching, more fabric in no time. A is a champion negotiator for the best price. I have learned lots from her. Ask what the price is, cut it down drastically, and then state that we can get the same thing down the street a much better price. And go from there. It is a game. The rules are as follows: Do not ask a price until you are ready to buy. Negotiation is fun. Get very personal: I am a volunteer. I came to Malawi to help educate nurses. Why are you charging me the mzungu (foreigner) price? And the seller will tell you that this is for his grandfather who is ill. Please help us here in Malawi. But I am. I quit my job in America to work here, for no pay, in Malawi. And we go back and forth until we are both happy and laughing about the process. Sometimes, I just get too tired to negotiate. But usually, especially if I am with A, I have fun with it. The vegetable market is similar, but not quite as intense. They sell heaps of vegetables. For example, a heap of tomatoes (about 3-4 medium tomatoes) for 200 Kwacha (about 40 cents). We shop around in the vegetable market, determine the going rate for vegetables, and then buy. Tomatoes are cheap. Mangoes are cheap right now. Papayas seem to always be in season. Pineapples are delicious and in season. Mushrooms just started showing up in the market. Peanuts, dried beans, spices, eggplant, lettuce, sweet potatoes, Irish potatoes,

r i c e a vo c a d o e s , eggs, dried fish, cauliflower, zucchini, kale, apples, grapes, and live chickens are all available. We were just there today, and stocked up. The eggs are kept at room temperature and sold in big flats of 30 eggs for about $3.60. The Peace Corps (PC) cookbook has instructions for how to test eggs for freshness.

I have a friend, N. She said, “One day I will have you to my house for lunch.” I replied, “OK. How about this Saturday? What time? What can I bring?” N graduated from nursing school a couple of years ago. She was hired to help the students with their clinicals. I have worked with her on a couple of practical demonstrations. Very good instructor. Just got married in August. So, we met on Saturday. We, my housemate and I, brought fish. We had to stop at the market to buy additional food. And we made lunch. She showed us how to make nsima, which is the corn flour carbohydrate staple, and very difficult to make for this mzungu. We cooked pumpkin leaves with peanut butter flour. And we fried fish. We ate, then we came back home. It was a very fun day, and we learned a lot. Next, I will teach her how to make bread. Without a bread machine. There are instructions in the Peace Corps’ cookbook to bake bread. I have been baking banana bread with chocolate chips.

My husband came to visit at Christmas time. He arrived on Friday and on Saturday we headed to a town on Lake Malawi. It was absolutely beautiful.

A couple of months ago there was a Trivial Pursuit competition at a nearby sports club. There were 19 teams, and we came out #17. BUT there was a raffle, and I won two-nights accommodations at a local reserve. So, during my husband’s visit, we went to a nature park, which has lots of big animals. But they were hiding that day. We were anxious to see elephants, and saw a couple elephant behinds as they were running away. We saw hippos. It was a nice tour, and we had a nice Malawian lunch. Then we went to a different park, which is a little farther south. We took a game ride that afternoon. This

park’s claim to fame is cape buffalo. We saw them, and our guide was very knowledgeable about the cape buffalo-cranky, and very unpredictable. He called them “grumpy old men” as the female cape buffalo were away giving birth. We saw them from a safe distance. We saw movement in the trees, and pretty soon a woman started running across the field. The driver explained to us that the poachers set snares, then the women (porters) come in and carry the meat off. We discussed this farther, and when this park was established, the locals were no longer allowed to hunt on the reserve. Many of the locals still wanted to hunt to feed their families. The driver told us that if he was alone, he would have followed the poacher/porter. I encouraged him to pretend we weren’t there as I was ready for some action, but he declined. I suppose it could be dangerous. Big guns and all. It opened up a whole new way of poacher perception. I have considered poachers the sleaze bags who slaughter elephants to cut off the tusks to sell for money, but poachers are also those locals who want to feed their families. Food for thought, so to speak. Back to the lodge for a nice dinner and sleep in an AIR CONDITIONED ROOM. Oh, my!

We returned home, then left two days later to go to another National Park. The cabin was accessible by boat, and the first thing we saw was crocodiles sunning themselves on the banks of the river. And lots of hippos swimming or whatever they do in the water all day. Our cabin was on the banks of the Shire (pronounced SHE-ray) river, and we had a great view of the hippos. And we could hear them grunt and snort. Cool. Later that afternoon we went on a game drive. Bunches of wart hogs. Lots of Nyala antelope. The roads were challenging, but we had a good 4-wheel drive vehicle. Just as we were negotiating a road, off to our left we could see big grey legs in the trees. The driver pulled over to the side of the road, and a small herd of elephants came right up to the fence, munching on vegetation along the way. The matriarch led the group, including some young ones. They just kept munching and ripping and tearing and munching as they kept on their trail. We were separated from them by a one-strand electric fence about two feet off the ground. I have never seen an elephant so close, and to say they are big is like, DUH! I felt like an ant with Goliath eye-balling me while ripping a tree out of the ground with brute force. They are majestic and beautiful animals. We watched until they strolled off to find more to eat. They really are quite destructive, but it reminds me of the joke: What does a three ton elephant eat? Anything he wants. It was a life changing experience-seeing those beautiful, majestic animals in the wild. Well, in the wild surrounded by an electric fence. Incredible. I had just finished the book Elephant

Making nsima under the direction of my friend N. The shirt I am wearing

was made by the tailor H using Malawian fabric.

Montana to Malawi continued from page 13

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Whisperer, and developed an appreciation for them and their incredible challenges, sensitivity and family/social structure.

The next day we took the boat back across the river. We sat and read, ate coconut cookies, and waited for our driver. My husband found a snake on the walkway to the parking lot. It was a pretty lime green, and we watched it for a long time, taking photos. The guard said it was poisonous-they always say that. So, after I got back to work, I showed my colleagues the photo, and one lecturer said, “I think that is a green mamba.” A lot of snake identification is from the shape and structure of the head. So I enlarged the head to show him, as I wanted to see how he identified it. The snake had a rather small, boxy head, with sharp angles. I said, “How can you tell?” waiting for the educational explanation. He said, “Well...it is green.” (Silly Americans) So, that night I googled it. Sure enough-green mamba. Very poisonous, but very timid. The black mambas are poisonous, but aggressive. Both live in wooded areas. According to references, the venom for the bites travels through the lymph system, so tourniquets don’t work to stop the venom from traveling from an appendage to the major organs. Anti-venom works, but the time frame is very limited. Death, by respiratory system paralysis, can occur in as little as twenty minutes. Enough information, time to go to sleep. Wonder what I will dream about tonight...

So, back to work. Had 253 papers to mark (we call it grade) and grades to put into the computer. My friend B woke one morning and moved a file box. Underneath it was what she thought was a piece of black plastic. For some reason she hesitated and got a flashlight. You guessed it...a black snake all coiled up. Her husband killed it with a broom, and ended up disabling the broom, too. They took photos, and called the guard. It was black, but had a pink mouth. Black mambas are silver with a black mouth. She was glad it was not a black mamba, but still has no idea when or how it got into her house and took up residency under a file box. More nighttime fodder. My plan this week is to make draft stoppers to block the gaps under our doors. Snake stoppers?

Our friend J is here teaching medical students. She needed a mannequin to teach Neonatal Resuscitation to medical students. In the country of limited resources, we got out the sewing machine. She outlined the shape, and I sewed the doll. We dressed the doll in traditional Malawian fabric complete with a matching head cover. She is just the right size for practicing CPR for the medical students. I guess she was quite a hit. Now we have to come up with a name.

Last week I woke up with one eye glued shut. Yep. Pink eye. Went to the pharmacy and got Chloramphenicol eye ointment, for the price of about 40 cents. Since then I have been on gentamycin eye drops, an anti-viral eye ointment and Cipro eye drops. It is finally looking good. I have the opthamologist

Crocodile on the shore.

A “school” of hippos.

The green mamba.

A momma hippo with a baby. The guide said the baby was less than two weeks old as the mom

hippo keep them in the shallow water for the first two weeks of life.

on speed dial, and he is very good. Other than that I am healthy, happy, and enjoying what I am doing. Plus, I am learning a lot-about educational systems, time management and nursing in another culture. This is the month that GHSP volunteers are to make decisions about extending for another year. It is a big decision that I will have to give careful consideration. In addition, the GHSP program is projected to expand in the coming years as announced on World AIDS Day 2014 by the US Government.

It is raining cats and dogs here, which has lead to disastrous effects. There has been flooding and deaths due to drowning and collapsed buildings. We, however, are thankfully safe and healthy. Until next time. Jan Ivers

Correction to previous article regarding programmatic funding:

Global Health Service Partnership (GHSP) is a unique public – private partnership between Seed Global Health, Peace Corps and PEPFAR. Seed Global Health offers technical expertise to recruit, select, place, and provide on-going support to its GHSP

volunteers while the Peace Corps delivers critical on-the-ground support. PEPFAR provides core funding for the program.

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having you join our team today.

We offer excellent compensation and full benefits package. Interested applicants please visit our website and apply online.

• RNs • LPNs • New Grads Welcome!

Registered Nurses

At Benefis, you can fulfill your passion for nursing and your passion for life. As a Benefis RN you’ll be part of the state’s premier healthcare system where we provide the highest quality of nursing care using the most sophisticated technology available. When you join the Benefis family you’ll be helping to heal the whole person - body, mind and spirit. So if you have a passion for healing, a desire to succeed, where opportunities forgrowthareendless, thenBenefis is looking foryou.Weoffercompetitivesalaries,excellent benefits, relocation assistance and flexible scheduling. Call 406.455.5876 or 1.800.648.6620 to learn more. Or apply online at benefis.org.

Live the Alaskan Dream at Mat-Su Regional Medical Center, named as one of 150 Great Places to Work in Healthcare!

Join us at the newest medical center in Alaska’s fastest growing economy. Mat-Su Regional Medical Center has earned recognition as a National and State quality leader and also as a Top Performing

Hospital by The Joint Commission.

We value top nursing talent and offer exceptional benefits that

include Medical/Dental/Vision/Life,

401k with Employer match, Paid Time Off, relocation and sign on

bonus.

Apply online at www.matsuregional.com or email

[email protected]

2500 South Woodworth LoopPalmer AK 99645 • (907) 861-6000

Current Nursing Openings:Director of Labor and Delivery

Director, Critical CareFT ICU RN’s

FT Labor and Delivery RN’sFT Surgical Services RN’s

http://benefis.org

http://facebook.com/benefishealthsystem

http://www.matsuregional.com

Documents

Executive Director Report...Executive Director Report Legislative Year 2015 Vicky Byrd, BA, RN, OCN Executive Director The 2015 legislative year for the Montana Nurses Association