INSIDE...success in the Middle East, Asia, and Australia. ANA Membership Performance • The first half of 2018 has been a year of strong membership growth. In fact, Joint Membership

current resident or

Non-Profit Org.U.S. Postage Paid

Princeton, MNPermit No. 14

Colorado Nurses Association President...

From the Desk ofthe CNF President

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association

NURSEVolume 118 • No. 4 • November 2018

Quarterly publication direct mailed to approximately 82,000 RNs and LPNs in Colorado

Executive Director’s Column . . . . . . . . . . . . . . . . 3Government Affairs & Public Policy Committee . . . 4Peer Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . 5The Importance of Involvement and Power of Voice . . . . . . . . . . . . . . . . . . . . . . . . . . 6CNA Membership Assembly Highlights . . . . . .7-9CORHIO Updates . . . . . . . . . . . . . . . . . . . . . . . . 10

District & Special Interest Group Reports . . . . . 122017 RN Practice Analysis Now Available . . . . . 13DORA Updates . . . . . . . . . . . . . . . . . . . . . . . . . . 14Membership Application . . . . . . . . . . . . . . . . 14-15In Memorial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15American Nurses Association . . . . . . . . . . . . . . 16Environmental Wellness . . . . . . . . . . . . . . . . . . . 18

INSIDE

Donna Strickland, MS, RXN-P, PMHCNS-B

News from ANA’s Membership AssemblyOn June 21, 2018, 300 nurses from 45 states unified

their voices in into one and “took the hill” in Washington D.C. I was one of them. Five Colorado Nurses Association representatives formed the “Colorado Delegation.” We visited the offices of every Colorado Senator and Congressional Representatives in a span of just five hours. It was both exhausting and exhilarating. The event, called American Nurses Association (ANA) Hill Day, creates a unique opportunity for nurses and future nurses to speak up to influence key legislation on the table and to advocate for health-related policies of interest to nurses.

The agenda when we met with each lawmaker and/or their staff included:• Addiction Treatment Access Improvement Act of 2017 (S. 2317/H.R. 3692)• Safe Staffing for Nurse and Patient Safety Act (S. 2446/H.R. 5052/)• Title VIII Nursing Workforce Reauthorization Act (H.R. 959)• Funding of meaningful gun violence research.

We were part of the conversations that will help guide the path to our future, the path to expanded care access, top of license practice, and a workplace free from harm.

History in the Making: Our Newly Elected ANA PresidentAt this same ANA Membership Assembly meeting, our new president was

elected. Ernest Grant, PhD, RN, FAAN, was elected to serve as president of the American Nurses Association (ANA) effective in January 2019. This is one of many firsts for Grant and professional nursing. He was the first African-American man to serve as ANA vice president, which is his current role, and to earn a PhD in nursing from the University of North Carolina-Greensboro. He also was the first African-American male nurse to lead the North Carolina Nurses Association (NCNA) as its president. And, now, he is the first man to be the President of ANA, and the first African American.

Donna Strickland

CNA President continued on page 2CNF President continued on page 3

Looking to the Future of Nursing in Colorado:

Building Blocks for SuccessSara Jarrett, EdD, RN, CNS, President Colorado Nurses Foundation

These three words: Vision, Voice and Visibility must frame our thinking and actions as we work to assure that nursing is present and accounted for in the Sunset Process of the Nurse Practice Act in Colorado. The Foundation (CNF) is committed to support of the work based upon two of its goals: promotes education of nurses and is an advocate for nurses and the profession. The Foundation relies on contributions to support the organization’s activities. https://www.coloradonursesfoundation.com

ALL the members of our profession need to be prepared for and intimately involved in the upcoming sunset process. This is a two year endeavor. The first year 2018 -19 is a year of study and data collection. The second year 2019-2020 will be the legislative year with an actual piece of legislation (new nurse practice act) introduced in to 2020 legislative session. It is my hope that the Colorado Nurses Foundation will support and provide educational activities related to professional issues related to the Sunset Process. More important is the expectation that EVERY nurse be involved.

How do you participate and share your vision, express your opinions (voice) as well as help communicate issues to various groups. Do you belong to a nursing organization that is committed to assuring a viable and appropriate future for the profession? I would suggest that every nurse needs to fulfill a professional expectation by joining at least ONE organization that serves as a voice for the profession. Most of us will likely it need to be part of an association whose primary goals are support for current clinical practice. As a profession we need to also communicate to other groups including consumers of health care about the important roles that nurses have in the maintenance of a good health care system (visibility).

Sara Jarrett

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association2 • Colorado Nurse | November 2018

An internationally known expert on burn care and fire safety, he’s received numerous awards, including being presented with the Nurse of the Year Award in 2002 by former President George W. Bush for his work treating burn victims from the World Trade Center site.

On a recent call with President Cipriano, she reviewed several of ANA’s initiatives:

ViolenceViolence is “not part of the job”

• The American Nurses Association (ANA) has long viewed violence as a public health issue and has called to end it in all its forms. ANA stepped up its advocacy on gun violence prevention following the number of mass shootings. ANA continues its work on the #EndNurseAbuse campaign that was initiated following the August 2017 workplace violence incident against RN Alex Wubbles. Messaging has broadened to include anti-sexual harassment campaigns in response to rise of #MeToo movement.

• Over 15,000 individuals have signed the #EndNurseAbuse pledge since launch in October 2017, with a goal of at least 20,000 pledge signatures.

CNA President continued from page 1

COLORADO NURSE (ISSN-8750-846X) is published 4 times annually, February, May, August, and November, by the Arthur L. Davis Publishing Agency, Inc. for the Colorado Nurses Foundation, 2851 South Parker Rd, Ste 1210, Aurora, CO 80014; Mailing: P.O. Box 3406, Englewood, CO 80155-3406.

Subscription may be purchased for $20 per year, $35/2 years, $25 per year for foreign addresses.

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]. CNF 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 Colorado Nurses Foundation of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. CNF 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 CNF or those of the national or local associations.

Colorado Nurses Foundation wants to hear from you and welcomes letter to the editors. Correspondence may be sent to Colorado Nurses Foundation, 2851 South Parker Rd, Ste 1210, Aurora, CO 80014; Mailing: P.O. Box 3406, Englewood, CO 80155-3406; email, [email protected].

To submit an article for publication, please consider the following guidelines.

1. Topic is current and relevant to RN practice.2. 500 word limit3. Individuals may submit articles for consideration by emailing

https://civicamanagement.wufoo.com/forms/m10eei4p1ds8okp/

Material is copyrighted 2015 by the Colorado Nurses Foundation and may not be reprinted without written permission from CNF.

Co-Editors: Eve Hoygaard, MS, RN, WHNP (30) M. Colleen Casper, RN, MS, DNP (16)

CNA Executive Director: Colleen Casper, RN, MS, DNP

COLORADO NURSES FOUNDATION

EXECUTIVE COMMITTEEPresident: Sara Jarrett

Vice President: Margaret MulhallSecretary: Carol O’Meara

Treasurer: Carol Brookshire

BOARD MEMBERSLola Fehr, Eve Hoygaard, Judith Burke,

Linda Satkowiak, Norma Tubman

COLORADO NURSES ASSOCIATION

EXECUTIVE COMMITTEEPresident: Donna Strickland (31)

Vice President: Laura Rosenthal (30)President-Elect: Linda Stroup (20)

Secretary: Carol O’Meara (30)Treasurer: Sarah Baca (3)

BOARD OF DIRECTORS Region I Director: Region I Director: Rebecca Sposato (16) Kathy Shaw (30)

Region II Director: Region II Director: Hilary St. John (3) Amanda Clerkin (4)

Region III Director: Region III Director: Holly Covington (5) Mary Ciambelli (31)

Director-At-Large: Director-At-Large: Ingrid Johnson (16) Jody DeStigter (9)

New Graduate Director: Adam Diesi (16)

DNA PRESIDENTSSIG #2: Colleen Casper (Liaison) DNA #3: Anne Zobec, Colorado SpringsDNA #4: Kathryn Carpenter, Model, CODNA #5: Contact Holly Covington at [email protected] #6: Charlotte LeDonne, Alamosa, CODNA #7: DNA #9: Contact Colleen Casper at [email protected] for additional informationDNA #12: Contact Colleen Casper at [email protected] for additional informationDNA #16: Christine Schmidt, Denver, CODNA #20: Annette Cannon, Lakewood, CODNA #23: Contact Colleen Casper at [email protected] for additional informationSIG #30: Afton Williamson, Denver, COSIG #31: Karen Lyda, DNP, PMHNP, RN

To contact any person listed above, please use the CNA/CNF office numbers/address/email address.

CNA Contact Information:Ph: 720-457-1194 • Fax: 303-200-7099

Email: [email protected]

CNF Contact Information: Ph: 720-457-1004Email: [email protected]

www.coloradonurses.org

We must continue our advocacy not only for our patients and communities, but also for ourselves. The relentless cycle of all types of violence is taking a toll on our emotional well-being and threatens our safety.

Nurses routinely face varying degrees of violence and are at greater risk when caring for patients with an altered mental status. In fact, healthcare workers have a 20% higher chance than other workers of being a victim of workplace violence. Regardless of the perpetrator, we deserve to remain safe, and firmly believe employers, individual nurses, and policymakers must work together to make healthcare settings safe for all. So, ANA has bolstered its work to reverse the increasing assaults against nurses in all work environments.

In April, The Joint Commission issued a Sentinel Event Alert on physical and verbal violence against healthcare workers. It reinforces the urgency to halt the cycle of harm and to prevent, handle, and heal from incidents of violence in the workplace.

We must continue our advocacy not only for our patients and communities, but also for ourselves. The relentless cycle of all types of violence is taking a toll on our emotional well-being and threatens our safety.

New APRN Graduates Did You KnowThe APRN graduate certification discount was

initiated July 1 and goes through January 31, 2019. For ANA members, this is a $225 off their application fee and nonmembers $125 off.

There is a great advantage of being an ANA member with such a significant cost savings on their APRN application fee.

With over 15,000 expected FNP graduates in 2018, there is a great cost savings to these students and students from other APRN program specialties to use the ANCC discount codes.

ANCC is spreading internationally, having the most success in the Middle East, Asia, and Australia.

ANA Membership Performance• The first half of 2018 has been a year of strong

membership growth. In fact, Joint Membership has increased by a net of almost 6,600 members in the first six months. That represents a growth of 5% over where we started the year. Breaking the first half down, in the first quarter net growth was extremely strong, with almost 4,200 new members. ANA is the #1 fastest growing large association over the past 5 years!

Join me, Join now!

Colorado Nurse Publication Article

Submission

• December 15 for February 2019 issue

• March 15 for May 2019 issue

• June 15 for August 2019 issue

• September 15 for November 2019 issue

Colorado Nurses Association in partnership with the Colorado Nurses Foundation seeks your regular reports

and any content you feel would be informative for Colorado Nurses.

Submit to: https://civicamanagement.wufoo.com/forms/m10eei4p1ds8okp/

http://extended.unco.edu/nursing

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association November 2018 | Colorado Nurse • 3

Executive Director's Column

What is a Nurse?Colleen Casper, DNP, RN, MS

The Colorado Nurse Practice Act (https://www.colorado.gov/pacific/dora/Nursing) explicitly states: “Registered nurse” or “registered professional nurse” means a professional nurse, and only a person who holds a license to practice professional nursing in this state pursuant to the provisions of this article or who holds a license in another state and is practicing in this state pursuant to section 24-60-3202, C.R.S., shall have the right to use the title “registered nurse” and its abbreviation, “R.N.” The Colorado Nurses Practice Act law further describes Requirements for professional nurse licensure in 12-38-111, including educational, examination, and endorsement methods to obtain licensure.

Protected titles by legislative statue, such as in the Nurse Practice Act, exist to protect the public and assure patient safety by the misuse of titles. Misuse of the title of ‘Nurse” may lead to physical or emotional harm with financial implications for all. The public recognizes health professional titles and licensure as a way to assure the public of provider competence and fitness to practice.

The American Nurses Association (ANA 2018) writes: “the title “nurse” has always been linked to the care of humans in the United States. Prior to 1903, anyone could call themselves a nurse and practice nursing, as there was no standardized training, registration or licensure. Nursing pioneers fought hard to

establish criteria for licensure identified in state nurse practice acts with the goals of protecting the public and increasing credibility of the practice of nursing. It is universally accepted within the US that the practice of nursing is providing care to individuals and groups requiring specialized knowledge, judgment, and skill derived from the principles of biological, physical, behavioral, social, and nursing sciences.”

Recently, the Colorado media have exposed imposters of multiple healthcare professions. Colorado Nurses Association (CNA) has worked to connect individuals who suspect imposters with the Department of Regulatory Affairs and State Board of Nursing staff. At the July 2018 Full Board of Nursing meeting, there was discussion about how the DORA staff are prioritizing complaints of imposters, and increased rigor in both administrative action to issue “cease and desist” orders, as well as strengthening collaboration with local police departments and Attorney General office for prosecution.

Colorado Nurses Association is committed to ongoing efforts to protect all consumers from fraudulent providers who use the term “nurse” to describe themselves. Nursing is the most trusted profession (Gallup) and as a community of professionals, we will do all that we can to assure that the public is protected from imposters. We look forward to collaborating with regulators and employers to assure that we prioritize preventing title misuse.

How do you decide what is your path to involvement? There are numerous resources and lists of nursing organizations. One rather comprehensive list is found at the following website: nurse.org. This resource names over 150 organizations that have a national and/or local presence in some way for our profession. There are fifty plus state organizations devoted particularly to state issues. In addition, a number of International Nursing Groups are also identified.

Now is the time for each and every nurse to be involved individually and collectively (through associations and coalitions.) The expectation to be involved in policy development and implementation is part of the “professional standards of practice.” This means that it is not just a good idea to be involved; it means that there is a professional expectation for participation.

What are the Building Blocks for Success? • BLOCK 1 – Join and Build Relationships

• BLOCK 2 – Educate and Communicate

• BLOCK 3 – Have Opinions Based upon Evidence

• BLOCK 4 – Advocate for Issues of Importance to Nursing – individually and collectively (coalitions and partnerships)

• BLOCK 5 – Lead in initiating Relevant and Appropriate Change

• BLOCK 6 – Monitor Activities to Determine Outcomes

Thus, the Building Blocks for Professional involvement.

CNF President continued from page 1 In summary, the profession of nursing in the US needs a clear and meaningful infrastructure with reasonable economic parameters for membership and participation in order to achieve ongoing success in the private and public and policy arenas. Lastly, individual contributions to the Colorado Nurses Foundation (CNF) are essential for the Foundation’s educational efforts.

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Government Affairs & Public Policy Committee

Interim Session UpdatesColleen Casper, DNP, RN, MS

Colorado Nurses Association Executive Director

All hopes for a quiet summer interim session have been dashed! CNA staff, lobbyist, Nurses for Political Action (NPAC) in Colorado and Government Affairs & Public Policy (GAPP) committee has been busy. Our primary focus has been on identifying and supporting candidates for the 2018 Elections. With a new Governor

and the reality of a legislature composed of 35% new members as a result of term limits, N-PAC and our lobbyist have been guiding an aggressive candidate vetting and endorsement process with many members volunteering to canvas and walk with candidates to assure a legislature that is informed and supportive of a strong nursing workforce in Colorado. Legislators that understand the importance of all nurses practicing at the top of their license is essential in assuring all Coloradans access to safe, affordable and quality healthcare.

ANA and CNA have partnered on the Federal elections and Gil Romero, Lobbyist, and Colleen Casper, Executive Director, have been active in the vetting and endorsement of national candidates.

The Colorado Legislature is involved in their 2nd year of Opioid and Substance Use Disorders Study Committee and our lobbyists have been in attendance at those meetings. The Interim Committee is designed to study and drafts bills for consideration by the 2019 Legislative Session. As examples, current conversations include methods of statewide tracking of behavioral health treatment services and the potential of expanding treatment of individuals within the criminal justice system. The Interim Committee will meet through Fall of 2018 so stay tuned to the 2019 Legislative Session to appreciate what has traction in the State in terms of political will and funding.

GAPP Committee is also working in parallel with the Colorado Professional Nursing Association Coalition (Coailtion) for the 2020 Sunset Review of the Colorado Nurse Practice Act. Currently invitations to the Coalition meetings include over 35 Professional Nursing Associations in Colorado with a primary and alternate representative receiving notification of emails. GAPP and the Coalition have begun work identifying priority issues for further research and exploration in anticipation of the Stakeholder input process to kick off October 2018. Please contact CNA at [email protected] if you or someone you know have an interest in contributing to this work.

We are anticipating a full agenda in 2019 and look forward to engaging you in our work!

Nurses VoteJoin Today

Nightingale Luminary Nominations

DENVER - Nominations for the 2019 Colorado Nightingale Luminary Awards opened on Oct. 1, 2018 and will close on or about January 15, 2019 (some regions may vary) according to the event’s administrator, the Colorado Nurses Foundation.

Next year is the 34th installment of the awards, which culminates in the statewide Nightingale Luminary Awards & Gala on Saturday, May 11, 2019. The event will be held at the CU South Denver, 10035 S. Peoria Street, Lone Tree, CO 80134.

Please refer to the foundation’s website at www.coloradonursesfoundation.com for up-to-the-minute details.

Colorado RNs working in both clinical and non-traditional settings are recognized for their achievement in one of three categories: advocacy, innovation and leadership.

Local Area Health Education Centers and independent Nightingale Committees in 10 regions of the state designate up to 60 nurses as Luminaries. A state selection committee selects up to 12 of the Luminaries as recipients of the Colorado Nightingale Award, Colorado nursing’s highest honor.

In 2018, 235 nominations were received, with 52 nurses designated as Luminaries. The awards are named for Florence Nightingale, English social reformer and statistician, and the founder of modern nursing. The 2019 edition of the awards falls on the 199th anniversary of Nightingale’s birth. They also fall on the last day of National Nurses Week in the U.S.

http://bit.ly/ColoradoNurse112018

mailto:Emily.Smits%40sclhealth.org?subject=

http://www.coloradomtn.edu/bsn


Peer Assistance

Let’s be Blunt: Impacts of Marijuana on Nursing PracticeIn November 2000, voters in the State of Colorado passed Amendment 20,

which legalized the ability to possess and use limited amounts of medical marijuana for those patients holding a medical marijuana card or their primary care givers.1 Fast forward 12 years, and the State of Colorado became one of the first states in the United States to legalize the possession and consumption of recreational marijuana for individual’s age 21 and older with the passage of Amendment 64.2 Colorado’s unique marijuana laws have created significant confusion and brought about numerous questions such as: Does this mean I can use marijuana with no implications? Do I have different responsibilities as a nurse in regards to my marijuana use? Since marijuana is used for medical purposes, does that mean I’m not impaired if I use it?

Though Colorado law permits individuals to use marijuana both medically and recreationally without the fear of prosecution from county and state authorities; the use of marijuana remains illegal federally and marijuana remains a Schedule I Controlled Substance based on the United States Controlled Substances Act.3 While state officials may no longer prosecute the use and possession of marijuana by adults, the U.S. Constitution’s “Supremacy Clause” continues to grant ultimate control over policies related to marijuana to the Federal government.

When considering the employment aspect, a direct quote from Amendment 64 sums the situation up nicely: “Nothing in this Section is intended to require an employer to permit or to accommodate the use of marijuana in the workplace or to affect the ability of employers to have policies restricting the use of marijuana by employees.”2 Employers continue to have the ability to create and enforce drug free workplace policies to ensure their organization is providing quality and safe healthcare for the public. These include the same zero-tolerance policies, as they existed prior to marijuana legalization. Court cases, such as Coats vs. Dish Networks (heard by the Colorado Supreme Court), still maintain employers’ rights to enforce policies prohibiting the use of marijuana by employees; even if employees have medical marijuana cards.

While the medical marijuana system supports physicians’ ability to recommend marijuana as a treatment for certain health conditions, such as chronic pain or nausea, research continues to identify that marijuana use is related to certain cognitive impairments. Research conducted by the National Institute on Drug Abuse shows marijuana use impairs judgment and motor coordination, delays reaction time, and inhibits memory consolidation.4 Transfer these effects of marijuana use to the practice of nursing and consider how one’s ability to care for a patient in the operating room, conduct a sound clinical assessment of a patient, or ability to remember physician directions or patient history may be impacted.

Though the idea of marijuana use and impairment continues to be debated, the Colorado Physician Health Program (CPHP) has taken a stance and considers a physician who uses marijuana in any form, medically or recreationally, unsafe to practice medicine.5 Dr. Doris Gundersen, MD, Medical Director of CPHP, acknowledges that the State’s stance on physicians using marijuana is a conservative one, but clarifies that physicians are in safety-sensitive positions much like pilots and other healthcare professionals, making public protection a top priority. According to Dr. Gundersen, public safety supersedes individual rights and this policy not only protects the public from risks associated with impaired practice, it also averts even minor medical errors.5 Similarly, the Colorado Nursing Peer Health Assistance Program takes the same position on marijuana use and considers

a nurse who uses marijuana in any form unsafe to practice nursing, due to the safety sensitive nature of nursing and the priority of public protection.

While the use of marijuana as a legal substance remains controversial, it’s important to remember that other legal-yet-potentially-impairing substances have been addressed by such policies before, including alcohol and prescription medication. Those working in a healthcare setting should be aware that the use of marijuana could place an individual’s wellbeing, employment, and license in jeopardy.

Peer Assistance Services provides the statewide Nurses Peer Health Assistance program through a contract with the Colorado Board of Nursing. If you have any questions regarding the Program or for more information contact: Katherine Garcia, MA, LAC, MAC, Clinical Services Manager. [email protected].

Office locations:2170 South Parker Road, Suite 229, Denver, CO 80231303 369-0039

200 Grand Avenue, Suite 270, Grand Junction, CO 81501970 291-3209

24 hour information Line: 720 291-3209

1 Amendment 20 Medical Use of Marijuana: ARTICLE XVIII Section 14. (2000). Colorado.2 Amendment 64 Use and Regulation of Marijuana: Article XVIII Section 16. (2012).

Colorado.3 Title 21 United States Controlled Substances Act. (1978). Retrieved from US Department

of Justice: Drug Enforcement Administration: http://www.deadiversion.usdoj.gov/21cfr/21usc/812.htm

4 How does marijuana use affect your brain and body? (2012). Retrieved from National Institute on Drug Abuse: http://www.drugabuse.gov/publications/research-reports/marijuana/how-does-marijuana-use-affect-your-brain-body

5 Johnson, K. (2012, October 29). Physicians who use marijuana are ‘unsafe to practice’. Retrieved from Medscape: http://www.medscape.com/viewarticle/773544

http://www.phs.org/careers

mailto:dianet%40colocrm.com?subject=


The Importance of Involvement and Power of VoiceSarah Baca, MBA, BSN RN NEA-BC, PMP

On June 20th of this year, I landed in Washington, D.C. as a Colorado Nurses Association (CNA) delegate at the 2018 American Nurses Association (ANA) Membership Assembly. This was my first time attending this event; there was anxious and enthusiastic energy swirling around in my chest. Personally, and professionally, I take my responsibilities seriously and wanted to represent our state to the best of my abilities and so I was resolved to be a sponge. There were many high-points that at some point I can share. Right now, however, I want to share with you my parting reflection, the importance of involvement and the power of my [our] voice should never be taken for granted.

Dr. Pamela F. Cipriano, PhD, RN, NEA-BC, our 35th ANA president addressed the membership assembly. Her address was titled Advocacy and Activism. She gave an overview of the last four years, starting in 2014 when she assumed her current role with the ANA. I quickly identified the core of her terms agenda, was ensuring that nurses become top of mind and she believes strongly that we will achieve this aim by reigniting the flame of advocacy as a central competency to the role of all Registered Nurses (RN).

I was moved by her presence and conviction that as a collective voice, we can in fact make a difference. As she held up the rear-view mirror on our collective accomplishments, the assembly re-lived many things, here are a few that stood out to me. ANA members recognized the need to develop a contemporary ethical view in response to the evolving complexity and landscape of our patient populations and as a result updated the ANA Code of Ethics. Now armed with enhanced interpretative statements that guide nursing practice, as our

true north, we continue to reflect on how we care for our patients, how we practice advocacy in our communities and how we actively work to preserve the protection of our patients’ rights to include their right for self-determination and protection from harm. Nationally ANA worked to positively influence conversations related to workplace violence specifically incivility and bullying that is eroding the moral resilience of our nurses, by developing an evidence-based tool kit to help nurses and organizations address this epidemic locally. ANA has also partnered with leaders across the country advocating on behalf of nurses in every corner of our great nation to address safe staffing, nurse stress and fatigue, safe patient handling and mobility. They have also been at the forefront of quality care to reduce hospital acquired conditions and eliminating barriers to RN scope of practice.

ANA didn’t hesitate to jump into the trenches with our nurses in the armed services to change the military health systems view on force feeding detainees that were not prisoners and held at Guantánamo Bay, Cuba. If that wasn’t enough, we saw nurses unite with a strong and loud voice when one of our own Colorado nurses, was mocked during her Miss America monologue through the #NursesShareYourStethoscope movement! She sparked a national response and reminded us that “just a nurse” has no place in our daily internal conversations and that the people we care for are more than a room number and/or diagnosis. The work of a nurse is never done, we can and do make a difference daily.

I can go on about the amazing places ANA and its subsidiaries are making an impact, elevating the practice and profession of nurses. Here are just a few examples, the American Nurses Credentialing Center (ANCC) excellence designation structures,

process and outcomes are now fully ISO 1000 certified, which is the gold standard for certification organizations. American Nurses Foundation (ANF) continues to advocate and help prepare nurses to serve on boards; and the American Nurses Foundation (ANF) continues to work to transform health policy and practice through nursing knowledge; with focus on social justice, hosting a critical conversation on topic stress in children.

On my flight home, I did a lot of thinking and wish I would have gotten involved earlier. As I listened to the presenters and participated in the open dialogues on behalf of CNA members the full gravity of active participation landed in my lap. I had come to the realization that even though I had followed the story lines, my voice and perspective was limited because I was in fact a passive participant. So, I boldly support the ANA’s focus in 2018 as the Year of Advocacy! I will no longer be a passive participant responding or reacting when an event occurs. I will instead lean in, ask questions, run for office and help mentor future leaders by fostering a welcoming culture and lifting each other up. It’s imperative that we heighten the involvement of individual RN members in the next generation of policy and advocacy topics. Share how you plan to make an impact at #BedsideandBeyond and #ColoradoNursesAssociation.

I want to also extend a special thank you to Mary Ciambelli, Colleen Casper and Donna Strickland for being incredible CNA ambassadors and mentors, you made a difference for me. And to my fellow ANA membership assembly novice Adam Diesi, thank you for bringing the voice of our new graduate nurses forward with enthusiasm and passion. I am grateful to have made some new friends and look forward to putting my finger prints on the future of nursing here in Colorado and beyond.

www.ColoradoNursingCenter.org

Please register your service on boards, commissions, and councils @

www.NursesOnBoardsCoalition.org

Clinical Scholar Workshop: February 11-15, 2019

Powerful Presentations: January 7-9, 2019

ColoradoNursingCenter.org/powerfulColoradoNursingCenter.org/scholar


CNA MEMBERSHIP ASSEMBLY HIGHLIGHTS

CNA Membership Assembly Takes Action

on Gun ViolenceCarol O’Meara

The issue of gun violence has been addressed by many healthcare groups including nurses and physicians. Earlier this year, 95 professional nursing associations including the American Nurses Association co-signed a letter to the US House and Senate calling for a bipartisan National Commission on Mass Shootings. Multiple medical groups have proclaimed gun violence as a public health crisis.

At their meeting on September 15, 2018, the Colorado Nurses Association Membership Assembly adopted principles to guide association activities related to Gun Violence. The Assembly approved a motion to hold the following as paramount in addressing gun violence:

Uphold and strengthen the following laws already in statute in Colorado:

• Universal background checks.• Ban high capacity magazines.• Criminal background checks before purchasing a

firearm.• Prohibit anyone convicted of Domestic Violence

from owning a firearm (Federal Law).

Strive to support legislation that will:• Ban the sale and ownership of assault style

weapons.• Ban the sale of bump stocks.• Establish Red Letter legislation or Extreme Risk

Protection Orders.• Ban concealed carry without a permit.• Ban or severely restrict guns in schools.• Improve access to efficient and affordable mental

health care.• Promote suicide prevention to all populations

throughout Colorado.

This action by the CNA Membership Assembly will guide the CNA Governmental Affairs and Public Policy Committee as well as the CNA Board, Executive Director and Lobbyist as they consider activities related to gun violence.

Membership Assembly Approves Restructure Plan

Carol O’Meara

The Colorado Nurses Association Membership Assembly adopted a new structure at their meeting on September 15, 2018. CNA will now have six regions instead of the previous three. Regions are used to elect representatives to the CNA Board of Directors. It is hoped that by having each director represent a smaller area, they will be able to be more effective in fostering membership engagement. Each Region is comprised of District Nurses Associations (DNA’s) which are organized on a geographical basis by county. Members participate through these geographic DNA’s or through Special Interest Groups. The regional directors will be tasked with working to revitalize some of the DNA’s that are not active, as well as supporting the high functioning DNA’s. In addition to the Regional Representatives, there will be two Directors At Large which will represent the three current Special Interest Groups – Advanced Practice Nurses, Psychiatric Clinical Specialists and the Electronic DNA. New Special Interest Groups may be formed upon approval of the CNA Board. Finally, there is a Recent Graduate Director at Large who represents our newer graduate members. These Directors and the CNA Officers comprise the CNA Board of Directors.

The six new CNA regions are geographically the same as the six Colorado Area Health Education Centers. These Centers are well established in those regions and we anticipate forging collegial relationships between CNA and the AHECs.

The six CNA regions are:• Region I: Larimer, Weld, Logan, Sedgwick,

Phillips, Yuma, Washington, Kit Carson, Morgan, Lincoln, Elbert Counties (DNA 9).

• Region 2: Boulder, Broomfield, Denver, Adams, Arapahoe, Gilpin, Clear Creek, Jefferson, Douglas, El Paso Counties (DNA’s 3 (El Paso and Douglas), 12 (Boulder and Broomfield), 16 (Denver and Arapahoe), 20 (Jefferson, Clear Creek, Gilpin), and 23 (Adams).

• Region 3: Cheyenne, Kiowa, Bent, Prowers, Baca, Crowley, Otero, Pueblo, Huerfano, Teller, Las Animas, Custer Fremont, Park, Chaffee, Lake Counties (DNA 4).

• Region 4: Saguache, Mineral, Rio Grande, Alamosa, Conejos, Costilla Counties (DNA 6).

• Region 5: Ouray, San Miquel, Dolores, Montezuma, La Plata, Hinsdale, Archuleta, San Juan (DNA 7).

• Region 6: Jackson, Grand, Summit, Eagle, Pitkin, Routt, Gunnison, Moffatt, Rio Blanco, Garfield, Mesa, Montrose, Delta Counties (DNA 5).

A plan has been developed to allow representatives to be elected from the six new regions in 2019. Meanwhile, the current and newly elected Regional Representatives from the previous three regions will continue to serve and will begin work on revitalization efforts. Contact CNA Board Members Mary Ciambelli or Carol O’Meara with any questions about the new structure.

Big Thanks to Our 2018 Annual Membership Assembly Sponsors & Exhibitors

Presenting Sponsor

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Reception for Leaders Sponsor

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2018 Colorado Nurses Association Educational Event


Colleen Casper, RN, MS, DNPExecutive Director

The 2018 Colorado Nurses Association Annual Membership Assembly began with an educational event designed to inform and guide us in “Setting the State for a Successful Sunset Review.” CNA welcomed Senior Associate Director, State Government Affairs, American Nurses Association, Janet Haebler, MSN, RN. Ms. Haebler provided an energetic overview on assessing policy agenda drivers, and the steps we as a professional association can take to strategically connect with each other, consumers and legislators for effective policy change. She also emphasized the power of all of us connecting locally with Senators and Representatives through town halls and community events.

Ms. Haebler then reviewed numerous issues being addressed at State and National levels. Some of those issues include workplace violence, safe nurse staffing methodologies, delegation and unlicensed personnel, attempts to misuse the legally protected title of “nurse” by veterinary technicians and others. ANA and CNA is actively involved in assuring title protection of Nurse. Additional collaborative efforts occurring between States and at the Federal level include legislation to address opioid substance use disorder treatment access. Please check website RN Action American Nurses Association for more information.

Following much discussion, an esteemed panel provided key points to consider while preparing for the 2020 Sunset Review of the Colorado Nurse Practice Act. Colorado is one of 36 States (Mercatus Center at GWU) that have laws requiring some form of Sunset Review as a method of auditing, reviewing, and updating laws and agency performance related to, in this case, the State Board of Nursing and the Nurse Practice Act. Through 2019 The Colorado Office of Policy Research & Regulatory Reform will be collecting data, evidence, and opinion regarding the language of the nurse practice act and the assurance of Colorado consumer protection and access to safe and quality nursing care.

Ms. Haebler facilitated the discussion among the esteemed panel of Sara Jarrett, EdD, RN, Linda Siderius, J.D., RN, Gil Romero, J.D., M.P.A., and Mary Ciambelli, PhD., PMHCNS-BC, RxN. The panel covered everything from thinking about the importance of future think about the practice of nursing, pitfalls and opportunities in prioritizing issues, importance of knowing key priorities, and the importance of strong collaboration within nursing and with stakeholders who share an interest in the practice of nursing. Dr. Mary Ciambelli offered her best hiking tips, including, “be prepared, work as a team, and keep your thinking cap on” through the journey!

Thank you to all who facilitated an engaging and invigorating education portion of our annual meeting.

2018 Membership AssemblyPresident Donna Strickland, MS, RXN-P, PMHCNS-

BC opened the 2018 annual member meeting with a refection on the multiple perspectives she has learned to seek and integrate in supporting the work of Colorado Nurses Association. President Strickland presented excerpts from Shakespeare and Einstein in challenging all of us as members to make opportunity to “think differently” and to allow ourselves to be a “little crazy” in imagining how we can build a statewide, engaged membership. Our capacity to influence each other and policy that guides work environments, State and Federal policy is the result of that collaborative effort.

Members then explored bylaw change proposals and affirmed a change in CNA Board of Directors statewide representation. Carol O’Meara, MS, RN, WHNP-BC, Chair of the CNA Bylaws Committee, has shared in greater detail the changes approved.

Additionally, one Reference Proposal was approved affirming CNA’s position in support of strengthening laws in Colorado address gun violence.

Teller results affirmed the following elected positions.

2018 Colorado Nurses Association ElectionsPresident – Elect Linda Stroup DNA 20Vice President – Laura Rosenthal SIG 30Treasurer – Sarah Baca DNA 3Region I Director – Rebecca Sposato DNA 16Region II Director – Amanda Clerkin DNA 4Region III – Mary Ciambelli SIG 31Director At Large – Jody DeStigter DNA 9


CNA Members Honored at Membership Assembly


Carol O’Meara

Several CNA members were honored at the Membership Assembly on September 15, 2018. CJ Cullinan, MS, RN was the recipient of the DNA 16 Nurse of the Year Award. She was recognized for her many years of service in designing and planning the annual Nurse Legislator Connection Dinners. Her peers noted that her attention to detail, highlighting of key legislative issues, dazzling creativity and genuine connecting with the legislative community has assured meaningful experiences for practicing nurses, nursing students and state legislators.

DNA 20 honored Jean Schroeder, PhD, MSN, RN as their Nurse of the Year. Dr. Schroeder was recognized for her outreach to new members which resulted in increased participation by new members in DNA meetings and activities. She was also recognized for bringing students to DNA meetings, thereby facilitating their introduction to the professional association.

The 2018 Carol O’Meara Award for Sustained Contributions to CNA was presented to Dr. Mary Ciambelli. Mary began her involvement in CNA at the

DNA Level when she moved to Colorado for graduate school in 1974. She was active in DNA 31 and served as their Chairperson. At the State level, Mary served as Co-Chair of the Governmental Affairs and Public Policy Committee and has served on several Sunset Review Committees. Mary served on the CNA board and was elected as CNA President in 2011. Following her term as President, Mary returned to the board as a Regional Director and assumed a major role in efforts to increase member engagement. At the ANA level, Mary has served several terms as CNA Representative to the ANA Membership Assembly. Mary once said “Being an engaged volunteer means you assist in doing the work of the association outside of meeting times and are willing to move the strategic goals of the association.” As an engaged volunteer for more than 40 years, Dr. Mary Ciambelli is a truly deserving recipient of the Sustained Contributions award.

The Sara Jarrett Award for Contributions to Nursing Practice and Health Policy through Political and Legislative Activity was awarded to CJ Cullinan. In addition to her work on the Nurse Legislator Connection Dinners for which she was honored as DNA 16 Nurse of the Year, CJ assisted in developing

nurse legislator receptions to raise funds for Nurses for Political Action in Colorado. These events raised thousands of dollars to support the political campaigns of nursing approved candidates. Her nomination stated: “She recognizes the importance of political action for nursing…and her passion and contributions in this arena promotes health policy which protects the health of the people in our state. CJ walks the talk and turns ideas into action.” CNA was proud to present the Sara Jarrett Award to CJ Cullinan.

Credit and Gratitude to CNA Member M. David Rodriguez, FNP for all photos


CORHIO Updates

What is Health Information Exchange and How Can Nurses Use it?Jennifer Mensch, CORHIO

August 2018

Health information exchange can be a noun or a verb. As a noun, health information exchange (HIE) is a system of shared medical records among qualified healthcare providers. CORHIO, which is Colorado’s HIE on the front range, works with hospitals, labs, imaging centers and physician practices to get their records into the HIE. CORHIO also works with those same entities to help them get records out of the HIE to improve patient care coordination.

As a verb, health information exchange refers to the action of

healthcare providers and organizations exchanging health data. CORHIO both stores the data and acts as a post office where providers can query a patient and all data available on that patient is viewable – from any system regardless of ownership, electronic health record system, and location. This helps fill information gaps when a patient has been seen out of your network or by a provider that is on a separate EHR system than your organization.

Continuity of CareWhether you’re a nurse at a hospital or physician’s office, in a big system or

small, you can benefit from being able to look patients up on PatientCare 360, CORHIO’s portal to the information stored in the database. You can view recent lab test results, radiology reports, care summaries, physician notes, medications, information from recent emergency department visits and more. This helps with new patient appointments and intake, clinical decision-making, and communication with other providers and the patients themselves. If you can see where they’ve been and what tests or procedures they had, you can have more informed discussions with patients.

Data From Most Major Health Systems in ColoradoCORHIO launched in 2011 and has since connected most of the major health

systems in Colorado to get patient data, including HealthONE, Centura, SCL Health, UCHealth, Banner Health, Boulder Community Health, Parkview Medical Center and Estes Park Medical Center. In addition, CORHIO receives lab data from PENRAD, Metropath, Schryver Labs, Quest Diagnostics. LabCorp, UniPath, Touchstone Imaging, and Health Images. Information from Kaiser Permanente and Department of Defense/Colorado Springs Military Health System is also viewable in PatientCare 360. For more information on participating providers and data available in the network, see http://www.corhio.org/participating-providers.

Recent Studies on HIE Benefits There have been studies proving the value of health information exchange. Most

recently, the Journal of Informatics in Health and Bioscience, released a study out of Indiana that reviewed the benefits of HIE and concluded that it reduces unnecessary or duplicate testing, lowers costs and improves patient outcomes. Another study concluded that use of HIE to gather patient information in the ED improves patient outcomes and reduced time spent on physician consults. And perhaps the most pivotal study came from Brookings Institute and concluded that had all physicians in the U.S. been using HIE, Medicare would have saved $63 million annually for each therapeutic procedure performed at physicians’ offices.

Supported by the State of ColoradoThe state of Colorado’s Department of Health Care Policy and Financing has

been a supportive partner to CORHIO for many years. Through a program called the Colorado Care Connections Program, the Department has made funds available for qualified healthcare organizations to join CORHIO for waived implementation fees. If you or your organization would like to learn more, visit us at www.CORHIO.org, email to [email protected] or call 720-285-3200.

PatientCare 360® is the secure web-based portal that qualified healthcare providers can use to query patient data in the CORHIO health

information exchange.

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District & Special Interest Group Reports

DNA 6 (San Luis Valley)

DNA 20 West Metro Area

DNA 16

SIG 30

Charlotte LeDonne, RN,BSN, MA, LPCPresident DNA 6

DNA 6, the San Luis Valley Area Health Education Center and the Women’s Citizenship Club of Alamosa sponsored The Many Faces of Addiction – It’s Not Just Drugs workshop from 6:00-8:00 p.m. Tuesday, October 2, 2018 at the First United Methodist Church at 2005 Mullins Ave. in Alamosa. Aimee Techau, PMHFNP, presented on the many forms of addiction, available treatments and ways the community can support people with addictions. The workshop was presented to nurses and community members in the San Luis Valley.

DNA 6, as one of their goals, is committed to providing public education on health related topics to our community. DNA 6 also sponsors scholarships to nursing students in both the Adams State University and Trinidad State Junior College Valley Campus nursing programs each year.

Christine Schmidt, RN, MS DNA 16 President

On August 20 ongoing and some new members enjoyed a “meet and greet” barbecue at clubhouse of Mary Kershner. President Donna Strickland joined us and graciously gave an overview of the new by-laws proposals to prepare all for convention. Elections were held and we planned much of the year ahead.

The following were our elections results:• President: Christine Schmidt 2018-2020• Vice President: Rebecca Sposato 2017-2019• Treasurer: Christine McDermott 2017-2019• Secretary: Joanie Engler 2018-2020

Norma Tubman, RN, MScN, Board Member at Large.

DNA 20’s first meeting of 2018-19 at St. Anthony Hospital, Lakewood welcomed Julie Wilken, RN, MPS, Director, Department of Health Services, Jeffco Public Schools, who spoke on the focus and challenges of school nursing today. She presented on how the art and skill of school nursing has expanded from its focus in the early 1900s when school nursing began with managing infectious diseases into today’s innovative nurse educators collaborating with school teams, community resources and families to empower students to reach their optimal learning potential. Our October speaker was Mary Blegen RN, MA, PhD, FAAN with Colorado Ceasefire, a Colorado Gun Violence

Prevention Group, who spoke on Gun Issues and Gun Safety. Mary presented on how the group advocates, lobbies and promotes responsible gun ownership. In November we will hold our meeting at Front Range Community College School of Nursing where Kathy Crisler will present on the benefits of belonging to ANA and CNA. We will close out 2018 with a holiday potluck in December.

Congratulations to DNA 20 Treasurer Linda Stroup who was elected as Colorado Nurses Association President-Elect at its September General Assembly. In May, Linda was honored at the MSU Denver nursing pinning ceremony for her 12 years of service to the Department of Nursing. Her accomplishments there included starting a traditional nursing program, starting a dual enrollment program with multiple community colleges and obtaining program re-accreditation. She retired from her full-time position as Department Chair of the nursing program at the end of July. Linda has served as CNA Treasurer and Board Member as well as serving on the boards of the Colorado Council on Nursing Education and the Alliance for Clinical Education. She is well qualified to become CNA’s next president.

Congratulations also to Jean Schroeder who was selected as DNA 20’s Nurse of the Year. Jean was recognized for her outreach to over 250 DNA 20 members resulting in increased attendance at our meetings and involvement of members in the district’s activities. Jean serves as the Vice President of DNA 20 and is responsible for the speakers at our meetings. She most recently assumed responsibility for sending our monthly Newsblast to all members interested in DNA 20 activities.

Kudos to DNA 20 President, Annette Cannon, on winning the primary election to be the Democratic nominee for Jefferson County Coroner. We wish her all the best in the November election.

Thank you to Ashley Stone, DNA 20 member, who organized a fundraiser at Skate City, Littleton to raise money for our 2019 scholarship. Thank you also to Allison Windes who stepped in to coordinate activities at the event when Ashley was called out of town. Our next fundraiser will be our attendance at a local musical in early spring.

For Information on DNA 20 meetings and speakers, contact Annette Cannon at [email protected] or see the CNA website.

Janece Moore, APN, MSN, Secretary

Our membership is growing! Colorado Society of Advanced Practice Nurses group, Special Interest Group 30 (SIG 30) continues to welcome new members. Monthly membership meeting information and contact form may be found at https://csapn.enpnetwork.com/. You may also connect with advanced practice nurses through Facebook. When on Facebook search for Colorado Society of Advance Practice Nurses (SIG 30).

Board of Directors• Rebecca Nemec 2018-2020• Sherry Janniksen 2018-2020• CJ Cullinan 2017-2019• Nan Morgan 2017-2019

Historian: Mary Kershner

Our upcoming events include the following: October 9, 6pm-8pm at Horan & McConaty Funeral

Services, 11150 E. Dartmouth Ave, Aurora, CO 80014, coordinated by CJ Cullinan:

Soul InjuryThe mental and emotional injuries that accompany

trauma are readily identified. Less recognized are the wounds that occur with trauma. This webinar discusses soul restoration, including learning how to re-own scattered pieces of self. Presentation will include a video by Deborah Grassman, Opus Peace in partnership with Hospice Foundation of America. Continuing Education Credit 1.5 hour by Horan & McConaty

November 13, Becky Nemec has confirmed a Community Educator from the Alzheimer’s Association on communications strategies with patients, 6-8pm at CNA HQ.

In December we will gather for our annual holiday dinner and gift donations to cheer those less fortunate.

In January we will plan a new idea, a New Year’s brunch meeting at a favorite restaurant.

February 25, 5-8pm, will be our 19th Annual Nurse Legislator Connection Dinner at the Scottish Rite across from the state Capitol Building, don’t miss this great event to discuss issues important to us and those for whom we care. DNA 16 is still accepting sponsorships from other DNAs, SIGs, and agencies to help with costs.

April will bring our annual volunteer evening at Project Cure, sorting medical supplies for shipment to developing countries in need.

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Reprinted from www.ncsbn.org

NCSBN is responsible to its members, the boards of nursing in the U.S. and its member board territories, for the preparation of psychometrically sound and legally defensible licensure examinations. The periodic performance of practice analysis (i.e., job analysis) studies assists NCSBN in evaluating the validity of the test plan that guides content distribution of the licensure examinations. Because the health care industry is rapidly changing, practice analysis studies are traditionally conducted by NCSBN on a three-year cycle.

A number of steps are necessary to perform an analysis of newly licensed registered nurse (RN) practice:

• A panel of subject matter experts was assembled;

• A list of RN activities was created and incorporated into a survey that was sent to a randomly drawn sample of newly licensed registered nurses, and

• Data was collected and analyzed

The 2017 RN Practice Analysis used several methods to describe the practice of newly licensed RNs in the US and Canada:

• Document reviews;

• Daily logs of newly licensed RNs;

• Subject matter experts’ knowledge, and

• A large scale survey

The 2017 RN Practice Analysis is now available on the NCSBN website. The report contains an analysis of entry-level practice in both the U.S. and Canada. Respondents to the practice analysis found the activities listed in the survey to be representative of the work they performed in their practice settings.

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Just Because You Received This Publication,

Updates from the Department of

Regulatory AffairsThe Colorado Board of Nursing wants to help

ensure that candidates for Advanced Practice Prescriptive Authority (RXN) understand mentorship requirements to avert potential headaches when these applications are considered for final approval.

The Board has recently reviewed RXN applications where mentorship hours do not correspond with the population focus for which the candidate is applying or entering.

As a result, applications for prescriptive authority have been delayed until the nurse can demonstrate he or she has obtained the proper mentorship hours.

It also may be difficult for nurses lacking mentorship hours in a particular specialty area after completing his or her first 1,000 hours to locate another healthcare professional willing to provide a short-term mentorship.

Two examples of the proper application of mentorship hours are listed below.

• An APRN seeking prescriptive authority as a Family Nurse Practitioner demonstrating practice and prescribing through the entire lifespan - pediatrics through geriatric.

• An APRN seeking prescriptive authority as an Adult Nurse Practitioner demonstrating practice and prescribing with the adult population as part of his or her mentorship.

Strategic planning at the start by RXN candidates

is critical. Nurse educators have been advised to ensure mentorship hours are synched with a chosen population focus, as well.

For more information on Advanced Practice Prescriptive Authority, please see Chapter 15, Section 5 of the Board’s rules or contact the Board at [email protected] with any questions or concerns.

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Doesn’t Mean You Are A CNA Member In Memorial

Vicki Erickson,PNP-BC, PhD, FAANP

Inimitable is a word that describes CU Nursing Emerita Faculty member, Dr. Vicki Erickson, who after a valiant fight battling ovarian cancer, died on 9/11/18. From her trademark, spiked hair to her colorful and crazy socks, Vicki was one-of-a-kind.

Dr. Erickson joined the University of Colorado College of Nursing in January 1987 with her newly minted PhD from the University of Texas. She was a pediatric nurse practitioner, serving as option coordinator for the Pediatric Nurse Practitioner Program (PNP) from 1990-2007 and Director of the Masters and DNP programs from 2006-2014. She dedicated her life to the care of children and to creating the PNP workforce of the next generation. The U.S. News & World Report rankings of the University of Colorado PNP program rose to #1 with her tenure and remained there for a several years under her guidance.

Dr. Erickson practiced what she preached. She was a leader in faculty practice, creating clinics (literally) from small and unusual places with her construction and woodworking skills. She provided care to children in primary care clinics, youth corrections, and women’s shelters. She was part of the team at Sheridan Health Services School Based Health Center from its inception until her retirement in June 2016.

In 2010, Dr. Erickson was recognized as a Fellow of the American Association of Nurse Practitioners (FAANP). The FAANP program was established in 2000 to recognize nurse practitioner leaders who have made outstanding contributions to health care through nurse practitioner clinical practice, research, education, or policy.

Dr. Erickson served as President of the Colorado State Board of Nursing and long time member of the Board. Dr. Erickson’s was recognized by the Board of Nursing as providing a strong and respected voice, with a dedication assuring public protection through education and betterment of the nursing profession.

Honoring Erickson’s impact, a scholarship was established in her name to support students at the University of Colorado College of Nursing. Please go to https://giving.cu.edu/campuses/cu-anschutz to contribute in Dr. Vicki Erickson’s name.

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Social Media Missteps Could Put Your Nursing License at RiskReprinted with permission from the

American Nurses AssociationAmerican Nurse Today March 2018 Vol. 13 No.3

Learn the rules and what to do if you make a mistake.

Takeaways:• For nurses, social media use has daily applications

in their personal and professional lives, facilitating conversations with colleagues about best practices and advancing healthcare.

• Inappropriate use of social media can create legal problems for nurses, including job termination, malpractice claims, and disciplinary action from boards of nursing (BON), which could negatively impact their nursing license and career.

By Melanie L. Balestra, NP, EsqWithout a doubt, social media has become an

integral part of modern life. Today, seven in 10 Americans use social media to get news, connect with others, and share information. Facebook leads the way with more than 2 billion users worldwide, followed by other popular platforms such as Twitter, Instagram, LinkedIn, and YouTube. For nurses, social media use has daily applications in their personal and professional lives, facilitating conversations with colleagues about best practices and advancing healthcare.

American Nurses Association

Although social media offers many benefits, inappropriate use can create legal problems for nurses, including job termination, malpractice claims, and disciplinary action from boards of nursing (BON), which could negatively impact their nursing license and career.

What to avoid when postingRemember that professional standards are the same

online as in any other circumstance. And although you should approach all social media posts with caution, several high-risk areas deserve closer examination.

Breaches of patient privacy and confidentialityWhether intentional or inadvertent, social media

posts that breach patient privacy and confidentially are the most egregious. They include patient photos, negative comments about patients, or details that might identify them, the healthcare setting, or specific departments. Even when posted with the best intentions, such as trying to get professional advice from colleagues about patient care, these posts are discoverable and can lead to legal problems, with potential fines and jail time for Health Insurance Portability and Accountability Act (HIPAA) violations, termination or other discipline from your employer, action taken against your license by a BON, civil litigation, or professional liability claims.

According to the 2015 nurse professional liability exposures claim report update from the Nurses Service Organization, examples of civil litigation and closed claims in connection with inappropriate electronic and social media use include:

• An RN who took a picture of a man getting an electrocardiogram and posted it on Facebook.

• An RN who sent text messages to another nurse and physician describing a sick child and his mother in an unfavorable light.

• Staff members at a long-term-care facility who videotaped and photographed a certified nursing assistant colleague who was in labor. They allegedly mocked the woman, posting photos, including of her vaginal area, on various social media sites.

Unprofessional behaviorA second high-risk area are posts that could

be considered unprofessional or reflect unethical conduct—anything defined as unbecoming of the nursing profession. For example, negative comments about your workplace, complaints about coworkers and employers, or threatening or harassing comments fall into this category.

The highly publicized firing in 2013 of an emergency department nurse at New York–Presbyterian Hospital demonstrates the risks connected with posting workplace photos. The nurse shared a photo on Instagram depicting an empty trauma room where a patient had been treated after getting hit by a subway train. Although the post didn’t violate HIPAA rules or the hospital’s social media policy, she was terminated for being insensitive.

Posts about your personal life also can negatively affect your professional life. Posting photos or comments about alcohol or drug use, domestic violence (even comments about arguing with a spouse) and use of profanity, or sexually explicit or racially derogatory comments could lead to charges of unprofessional behavior by a BON. And keep in mind that complaints can come from anywhere, including employers and coworkers, family and friends, and intimate partners, so the privacy setting on the social media platform won’t protect you.

Court rulings have supported disciplinary actions by BONs against nurses for unprofessional behavior in their personal lives. A key example is the 2012 decision by the California Supreme Court, which left intact an appellate ruling (Sulla v Board of Registered Nursing) that allowed a state board to discipline a nurse who was caught driving drunk, even though his arrest had nothing to do with his job. The BON placed the nurse on 3 years’ probation after his arrest. The appeals court ruled that state laws authorize disciplinary action against a nurse who uses alcohol, on or off the job, in

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American Nurses Associationa way that endangers others. The result is that nurses in California who are convicted of driving under the influence will have their nursing license suspended by the BON. This has clear implications for social media posting about alcohol use (or any high-risk topic) in your personal life. (See How to avoid social media pitfalls.)

If you hear from the BONIf you receive a letter from the BON about an

investigation, don’t represent yourself. Hire an attorney who specializes in administrative law and procedure— ideally one who’s familiar with your state BON. Decisions about a complaint can take from several months to more than a year, and outcomes can range from case dismissal for lack of merit or insufficient evidence to referral to the state’s attorney general office for prosecution. If no settlement is reached, you and your attorney will argue the case at a hearing with potential outcomes that include public admonition/ reprimand, restriction, probation, suspension, or revocation of your nursing license.

Other serious repercussions are possible. Decisions made by BONs are communicated via Nursys.com, a national database for verification of nurse licensure, discipline, and practice privilege administered by the National Council of State Boards of Nursing. If disciplined, you also could receive a letter from the U.S. Social media missteps could put your nursing license at risk Department of Justice restricting your ability to work in any facility that receives reimbursement from Medicare and Medicaid. In addition, disciplinary action in one state may affect your license in another. After you’ve been disciplined, each state in which you hold a license can review or open the case.

To protect yourself, carry your own malpractice/disciplinary insurance (don’t rely on the insurance carrier for your hospital or private practice). This is especially important with the anticipated increase in medical professional liability claims associated with social media use.

Think twiceSocial media is a great way to connect personally

and professionally. But remember that online posts live forever and that social media misfires could negatively affect your license and ability to practice. To protect yourself, think twice before you post content that could be judged as unprofessional.

Melanie L. Balestra is nurse practitioner and has her own law office in Irvine and Newport Beach, California. She focuses on legal and business issues that affect physicians, nurses, nurse practitioners, and other healthcare providers and represents them before their respective boards.

Selected referencesBrous E. How to avoid the pitfalls of social media. Am Nurse

Today. 2013;8(5).Brown CG. Must-read social media advice for nurses. Nurse.

org. June 9, 2016.Nurses Service Organization. Nurse professional liability

exposures: 2015 claim report update.Egelko B. High court lets nurse’s probation stand. SF Gate.

August 8, 2012.EveryNurse.org. How nurses should be using social media.Jackson J, Fraser R, Ash P. Social media and nurses: Insights

for promoting health for individual and professional use. Online J Issues Nurs. 2014;19(3):2.

National Council of State Boards of Nursing. A Nurse’s Guide to the Use of Social Media. November 2011.

National Council of State Boards of Nursing. Welcome to Nursys.

Pew Research Center: Internet & Technology. Social media fact sheet. January 12, 2017.

Ramisetti K. ‘NY Med’ star Katie Duke speaks out on getting fired from NYC hospital for posting Instagram photo of trauma room. New York Daily News. July 8, 2014.

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Reprinted from American Nurse Today

Pay attention to your environment–it can affect your body, mind, and spirit.

This is the ninth installment in a series of articles on wellness. You can read the earlier articles at americannursetoday.com/category/wellness101/.

You DON’T HAVE TO GO FAR to experience nature–it can be in your own backyard, a community park, or walking trail. You also can venture miles from home for hiking, waterskiing, camping, or canoeing. When you’re outdoors, the rest of life seems to disappear. You become “one with nature”–spiritually, mentally, and physically–as you appreciate all the beauty this planet has to offer. Your senses heighten as you become more aware of your surroundings. And you may not realize it, but you’re improving your health and well being. Yes, outdoor activities, from a simple walk around the block to snow tubing down a wintry hill, enhance your overall health.

We may not give a lot of thought to how the environment fits into our wellness efforts, but the

Mind/Body/Spirit

Environmental Wellnessenvironment and how we take care of it can have a huge impact on our overall well-being.

The evidence is in Research has demonstrated that green space, such

as parks, forests, and river corridors, are good for our physical and mental health. In a study by Blumenthal and colleagues, 71% of people found a reduction in depression after going for a walk outdoors, versus a 45% reduction in those who took an indoor walk. In a 2013 study from Roe and colleagues, gardening demonstrated a significant reduction in subjects’ levels of the stress hormone cortisol. And in 2016,

the World Health Organization conducted a systematic review of 60 studies from

the United States, Canada, Australia, New Zealand, and Europe and

concluded that green space is associated with reduced obesity.

More than nature “Environment” doesn’t

mean only the great outdoors. Your environment is everything that surrounds

you– your home, your car, your workplace, the food you

eat, and the people you interact with. Nurses’ work environments

contain many hazards, so we need to pay extra attention to this component

of our wellness. The U.S. Department of Labor rates hospitals as one of the most dangerous

places to work. In 2017, the Bureau of Labor Statistics reported that private industry hospital workers face a higher incidence of injury and illness–six cas es per 100 full-time workers–than employees working in other industries traditionally considered dangerous, such as manufacturing and construction. In 2015, the most common event leading to injuries in hospitals was overexertion and bodily reaction, including injuries from moving or lifting patients. In other words, those of us working with patients outside of a hospital setting are vulnerable, too.

Improve your workplace environmentThe good news is that many injuries can be

prevented with proper equipment and training. For in stance, almost 50% of reported injuries and

illnesses among nurses and other hospital workers were musculoskeletal, many (25% of all workers’ compensation claims for the healthcare industry in 2011) caused by overexertion from lifting, transferring, and repositioning patients. Learning safe ways to handle patients can safeguard your well-being as well as your patients’. It may be time to review your workplace safety stan dards or form a committee to

6 ways you can improve your environment

When we take care of our environment, we take care of ourselves. Get started with these ideas:

• Reuse it. Drink from reusable water bottles and shop with reusable bags. Glass or stainless steel water bottles are the best options, but a plastic water bottle works well, too–as long as you reuse it. Reusable shopping bags cut down on plastic bag waste. According to The Wall Street Journal, the United States goes through 100 billion plastic shopping bags annually. Evidence shows that they slowly release toxic chemicals once they get in the soil. If you use plastic bags, recycle them at your local grocery store.

• Eat local. Take advantage of farmers’ markets, community-supported agriculture, and restaurants that serve local foods. Most local foods are packed with more nutrients because they don’t have to travel long distances to reach your plate. Locally grown food also means less energy (fuel) is used to transport it to your kitchen or grocery store.

• Turn it off. Whether it’s a faucet you leave running while you brush your teeth or the TV that’s on when you’re not in the room, if you’re not using something, turn it off. You’ll save energy and, as a bonus, you may save money in cheaper utility bills.

• Travel light. If you can, find environmentally friendly ways to travel–walk, ride your bike, or take public transportation.

• Clean green. Using natural or homemade cleaning products is better for you, your home, your pets, and the environment. Some items to keep on hand include white vinegar, natural salt, baking soda, and lemons.

• Recycle. Most communities recycle, whether by a city-sponsored pickup route or at a drop-off location. Learn more about what you can recycle from your local solid waste authority.

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WELLNESS 101

review patient-handling procedures and other safety measures.

Of course, the people we deal with every day aren’t just risk factors for disease and injury. Everyone brings his or her personalities, attitudes, and behaviors, and we can’t always avoid the stress they add to our environment. We can, however, cushion ourselves against stress by modifying our own behavior.

Nurse.org offers these suggestions when dealing with a difficult patient:

• Avoid defensive thoughts. Remember, it’s not about you, it’s about the patient. Don’t blow up at him or her because you’re frustrated.

• Set boundaries. If someone behaves inappropriately toward you by swearing or yelling, set limits by saying, “There are certain things we allow here, and this behavior is not one of them. I’ll step out of the room to give you time to calm down.”

• Let them tell their story. Letting a patient tell you how he or she got to this point can help reduce distress and might give you insight into the behavior. Even if you don’t agree with what the patient says, he or she will feel listened to, which may be calming.

• Realign your body language. Taking a few measured breaths to refocus your thoughts can help you calm down. Tension can create defensive body language that patients may react to negatively.

Choosing to thrive Studies show that we thrive better when surrounded

by people who support our goals and want to help us succeed. We can’t usually choose the people we work with, but we can consciously choose to spend more time with those friends and family members who sup-port and uplift us.

And we can all contribute to making our physical surroundings healthier, from recycling to creating a culture of respect and gratitude. (See 6 ways you can im prove your environment.) Start with a small step to-day–at work, at home, at school, with your family, or by volunteering in the community–to improve your environmental wellness.

The authors work at The Ohio State University in Columbus, Ohio. Megan Amaya is director of health promotion and wellness and assistant professor of clinical nurs ing practice at the College of Nursing and president of the National Consortium for Building Healthy Academic Communities. Bernadette Mazurek Melnyk is the vice president for health promotion, university chief wellness officer, dean and profes sor

in the College of Nursing, professor of pediatrics and psychiatry in the College of Medicine, and executive director of the Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare. Susan Neale is senior writer/editor of marketing and communications in the College of Nursing.

Selected references Blumenthal JA, Babyak MA, Moore KA, et al. Effects

of exercise train ing on older patients with major depression. Arch Intern Med. 1999; 15909):2349-56.

Bureau of Labor Statistics. Hospital workers: An assessment of occu pational injuries and illnesses. June 2017. www.bls.gov/opub/mlr/ 2017 /article/hospital-workers-an-assessment-of-occupational-injuries and-illnesses.htrn

Cohen DA, McKenzie n, Sehgal A, Williamson S, Golinelli D, Lurie N. Contribution of public parks to physical activity. Am J Public Health. 2007;97(3):509-14.

Groenewegen PP, van den Berg AE, de Vries S, Verheij RA.

Vitamin G: Effects of green space on health, well-being, and social safety. BMC Public Health. 2006;6:149.

HealthyPeople.gov. Environmental health. healthypeople.gov/2020/ topics-objectives/topic/environmental-health

Nelson L. 10 tips for dealing with difficult patients. Nurse.org. Febru ary 20, 2018. nurse.org/articles/dealing-with-difficult-patients

Occupational Safety and Health Administration. Safe Patient Han dling Programs: Effectiveness and Cost Savings. osha.gov/dsg/hospi tals/documents/3.5_SPH_effectiveness_508.pdf

Roe JJ, Thompson CW, Aspinall PA, et al. Green space and stress: Ev idence from cortisol measure in deprived urban communities. Int J Environ Res Public Health. 2013;10(9):4086-103.

World Health Organization. Ambient (outdoor) air quality and health. May 2, 2018. who.int/mediacentre/factsheets/fs313/en/

World Health Organization. Urban green spaces and health: A review of evidence. 2016. euro.who.int/_data/assets/pdf_file/0005/321971/Urban-green-spaces-and-health-review-evidence.pdJ?ua=l

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HappyHolidays

from the Boards and Staff of theColorado Nurses Foundation and

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INSIDE...success in the Middle East, Asia, and Australia. ANA Membership Performance • The first half of 2018 has been a year of strong membership growth. In fact, Joint Membership